Nutritional Screening and Malnutrition
About this PSP
The Nutritional Screening and Malnutrition PSP was established in early 2018. The PSP considered malnutrition across all disease states, in all environments and in the adult population (18 years and over).
The PSP was funded by the General and Educational Trust, which is part of the British Dietetic Association, and was managed by a research team at the University of Manchester.
The initial question-gathering survey for this PSP opened in June 2018. It received 268 responses from people with malnutrition experience, who between them submitted 1,128 questions.
The Nutritional Screening and Malnutrition Top 10 was published in July 2019.
Top 10 Priorities
- How can early intervention be initiated in vulnerable groups to help prevent malnutrition?
- What is the best way to carry out screening in the community for effective identification of malnutrition?
- Are people/patients aware of malnutrition, do they know how to prevent it and do they think screening for malnutrition is important?
- Should multi agency working be implemented across all care settings to ensure standardised identification and treatment of malnutrition?
- How useful are nutritional supplements, are there alternatives and should independent research into supplements be carried out, rather than research lead by pharmaceutical companies?
- Is it appropriate and accurate to use standard BMI ranges to diagnose malnutrition in elderly people, dementia patients, bed-bound patients and patients with fluid imbalances?
- What other types of community support could be used to prevent malnutrition? E.g. - surplus from supermarkets and restaurants
- Is there evidence that treating malnutrition in the community would lower hospital admissions and length of stay?
- Can technology and electronic records be used to record and improve nutritional treatments and to convey nutritional advice?
- Should treatment be geared to specific disease states and patient groups (e.g. high fat diets can be inappropriate in cardiovascular disease)?
The following questions were also discussed and put in order of priority at the workshop:
- Does social interaction, the use of volunteers and more sociable mealtimes in hospitals improve patient’s food intake?
- Would viewing malnutrition as more of a medical condition help with prevention?
- How beneficial is the food first approach (meeting dietary needs through ordinary foods & fluids), is it used often enough, does it need promoting more & what advice should the food first message convey?
- Is malnutrition getting worse over time and is this related to poverty and affordability?
- How can we help, treat and support those with mental health issues, or dementia, or those who refuse to eat, and how does their mental wellbeing impact on nutritional status?
- Is dietitian led treatment more effective in terms of outcomes and should their input increase?
- Are nutrition telephone consultations with patients as effective as home visits?
- What is the extent of malnutrition in deprived/low income/hard to reach groups and what is the best way to provide them with nutritional support, education and good quality food?
- What is the standard practice after malnutrition has been identified and is this carried out routinely and effectively?
- How to decide if more invasive treatment is required and if certain patients should be prioritised over others?
- Can good nutrition, nutritional support and nutritional intervention lead to health improvements and decreased length of stay in hospital?
- Has the ongoing public health campaign against obesity caused confusion and encouraged disordered eating and can we help people who are struggling with changes in eating behaviour?
- What is the best healthy eating advice and how should this be communicated to patients at home and people at home who may be at risk of malnutrition?
- Is decreased appetite in the elderly down to the aging process?
- What are the views of health care provider, local authority and commissioners on malnutrition? - Are they aware of cutbacks and can commissioners be more engaged to provide quality assurance (cquin)?
- How accurate and valid are current nutritional screening tools?
Document downloads
For full details of all of the questions identified by this PSP, please see the document below.