Validity and reliability of the new Canadian Nutrition Screening Tool in the ‘real-world’ hospital setting

Abstract

The simple and reliable CNST shows good sensitivity and specificity and significantly predicts adverse outcomes. Completion by several untrained nursing personnel confirms its utility in the nursing admission assessment.

Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition

“…A recent review suggests that no single tool is best (van Bokhost-de van der Schueren et al 2014). Screening tools commonly include patient recall of weight change, food intake, and if there are objective measures, height and weight to determine BMI (Elia 2003;Ferguson et al 1999;Laporte et al 2015;Stratton et al 2004). Height and weight can be difficult to obtain in a busy clinical environment .…”

More-2-Eat: evaluation protocol of a multi-site implementation of the Integrated Nutrition Pathway for Acute Care

“…Demographics, admission diagnosis and length of stay were recorded. The patient was screened with the CNST [38]. SGA was completed if they were at risk, and the clinical dietitian providing care to the unit was notified of the status of the patient.…”

“…Key decision points promote quality nutrition care for every patient, at the appropriate time, by the right health provider. Care activities include: 1) screening at admission with the valid and reliable Canadian Nutrition Screening Tool (CNST) [38]; 2) using subjective global assessment (SGA) to definitively diagnose malnutrition after screening and assist with triaging patients for individualized assessment and care [39,40]; 3) monitoring of food intake for all patients, with frequency depending on nutritional status; 4) implementation of preventative practices to support food intake and address common mealtime barriers; and 6) inclusion of nutrition concerns and hospital treatment on discharge communications to support patient transitions to community care. Tools to assess food intake and identify mealtime barriers, and a questionnaire to identify the knowledge, attitudes and practices (KAP) of hospital staff have also been developed [41][42][43].…”

Need for the Integrated Nutrition Pathway for Acute Care (INPAC): gaps in current nutrition care in five Canadian hospitals

“…Three of the five sites already had screening for nutrition risk in place, using the CNST [29], the Malnutrition Screening Tool (MST) [34] or a site-specific screening form. The remaining two sites had a small proportion of screening completed by the M2E RA for the purpose of data collection during the baseline period; these participants were not included in the counts provided below and in tables.…”

“…nursing can screen; physicians can institute non-volitional feeding; patients can self report barriers to food intake). INPAC focuses on the following activities: i) nutrition screening on admission using a valid, easy to complete nutrition screening tool, such as the Canadian Nutrition Screening Tool, [CNST] [29]; ii) timely and efficient nutrition assessment using the subjective global assessment (SGA) for patients identified to be at risk [30], iii) standard nutrition care strategies (for all patients) that overcome common barriers, thus promoting food intake, iv) advanced nutrition care strategies (e.g. supplements, snacks) for those with SGA score of mild to moderately malnourished, v) timely comprehensive dietitian assessment and individualized treatments for those severely malnourished, vi) food monitoring to identify need for further nutrition interventions, and vii) connecting/referring malnourished patients to community services as they transition out of hospital.…”