Evaluation table.

Analysis

British Journal of Nursing,

1999 – Jan. 2000;8,22

hospital & community

NRS: Nutrition Risk Score

NNST: Nutrition Screening Tool

SIP: Screening in Practice

MNA: Mini Nutritional Assessment

NNAT : Nursing Nutritional Assessment Tool

R:Reliability

Specificity: Ability to detect not malnourish or those at risk

NRS: Inter-rater

Reliability 0.91

NNST: No specific measures

SIP:

P<0.01

MNA: Predictive validity well nourished (>21 )or undernour.(<21)

*Two tools not tested for validity and reliability prior to publication

* No positive benefit demonstrated on clinical outcomes

Strengths:

*Nurses in ideal position to use tools

*Ease of tools was demonstrated

Conclusion:

Tools developed

*Replication studies needed to test validity and reliability

Analysis

CNRA: Community

Nutrition risk assessment administered

All newly referred patients to 8 district nurses from Feb. 1 to July 31 2001

62% female

38% male

118 patients>70

136 patients in their own home

30 patients in residential care

MR: Medium Risk for malnutrition

LR :Low risk for malnutrition

Cost Pre: Cost pre-community nutrition risk assessment

Cost Post: Cost post-community nutrition risk assessment

age and gender

Distribution of nutrition scores

Location of patients domicile was recorded & summarized

Percent requiring further intervention

Risk assessment scores   (n=166)

N=117; 71% little or no risk

N=49 (30%) required further

evaluation

*No reassessment

*Sample size

*Small number of nurses using the tool (n=8) in this study

*Experience of nurses may not be similar to other groups of nurses

Strengths:

*Quick structured simple tool

*Easy use in community settings

12% received dietetic

Intervention

Conclusion:

A systematic process can reduce financial cost

Multiprofessional team working is an important behavior motivator for changing clinical practice

A nutrition risk assessment tool is not intended to be 100% accurate and does not replace clinical judgment, but does serve to increase the nutritional vigilance in healthcare professionals

Analysis

Journal of Clinical Nursing, 22, 723-732

Participants (n=81) were hemodialysis patients from 4 satellite centers in metropolitan Australian health services

DV: Dietetic services

of referrals

to dietetic services for nutritional support for intervention vs. control group at 6 months

Group (26.3 vs. 9.3%)

No significant changes in :quality of life, BP. Mortality rates or other biochemical indices at either 6 or 9 months

*No measurement of actual nutrition intervention

* 16% drop out rate

* No measure of compliance of patients

Strength:

*Use of validated assessment tool

*Use leads to appropriate dietetic referrals

Conclusion:

Monthly systematic nurse-completed nutritional screening can increase dietetic referrals that may lead to increased nutritional care for people in satellite dialysis centers

This study has demonstrated that a nurse-led intervention can assist in identifying these nutritionally at-risk dialysis patients

Analysis

Journal Nutr. Educ. Behav. 2006; 38: 286 -292

Study

44 Brown University Medical students

31 consumers in Rhode Island

Reliability and calibration study of the revised tool with 94 consumers

Saturated fat

Cholesterol

Sodium

Grains

Vegetables

Fruit

Dairy

Meat

Variety

Study revised tool with 94 consumers in R.I * Mass.

Calibration demonstrated that REAP has excellent test-retest reliability

(r=08.86, P<.0001) is correlated with Healthy Indexscore (r= 0.39, P=.0007) and is significantly associated with most nutrients studied

Convenience samples were primarily used for evaluating the tool

Strengths:

Implementation feasibility testing of REAP with physicians and medical students revealed that the tool can easily be used in a clinical setting to assess and discuss patients’ diet

REAP has excellent reliability scores, correlates with the HEI

Conclusion:

REAP has adequate reliability and validity to be used in primary care practices for nutrition assessment and counselling, and is also user friendly for providers

Analysis

Journal of Advanced Nursing 54 (4), 477 -490

review

Inter-rater reliability reported in four papers

Intra-rater reliability in one paper

Possible exclusion of assessment tools due to a wide variety of publications

Description, development and testing of the tools varies greatly in terms of quantity and quality

Strengths:

Conclusion:

Reliability validity, specificity, sensitivity and acceptability of nutritional screening and assessment tools should be examined prior to use in clinical practice

Analysis

Nutrition: 65: 162 – 167 & Dietetics 2008

1,145 HACC eligible clients (mean age 76.5 +/- 7.2 years were screened for nutritional risk during 2003 – 2005

MST: Malnutrition Screening Tool

PG-SGA: Patient Generated-Subjective Global Assessment

Chi-square using Yates Correction for Continuity were used to establish association between dichotomous variables (I.E gender, malnutrition status)

Statistical significance reported at the conventional P<0.05 level (two-tailed)

Of these 170 (44%) which is 75 clients agreed to a dietetic referral and PSG-SGA assessment.   57 of these clients were assessed as malnourished.

Malnutrition prevalence suggested at 5 and 11%.

Nutrition screening tools were those used in practice and were selected because of clinician preference

Inter-rater reliability not assessed between the five dieticians

Only a [portion of the HACC eligible agencie3s took part is the screening

Different strategies employed by HACC agents in choosing screening for all clients or only new clients presenting to their service

Strengths:

Malnutrition screening identified HACC eligible clients at risk

Provided referral and subsequent dietetic interventions

Nutritional status improved in the majority (82%) of those receiving dietetic services

Conclusion:

Analysis

Journal of American Dietetic Association, 2008;108:817 – 822

GBFFQ:Gladys Block Food Frequency Questionnaire

FIT: Family Intervention Trial for Heart Health

TLC:Therapeutic Lifestyle Changes Diet

*Small sample size within each age and race start which could have limited power to detect differences between age and racial groups

*Minority study participants were largely English speaking and most had completed high school which may affect generalizibility of these findings to non-English speaking or less educated groups

* The use of an FFQ as a comparison method has been asscvoiated with limitations due to measurement error

Strengths:

*MEDFICTS is a fast, free diet assessment tool that is easily accessible and recommended in national prevention guidelines

*In this diverse population without known CVD, the study showed a significant correlation between MEDFICTS score and Block FFQ for dietary intake of saturated fats, total fat, andcholesterol.

Conclusion:

Analysis

Estimates of regression parameters

Sensitivity and specificity

Women: recalls 31.3%, screener, 28.4%, FFQ, 30.0%.

Estimated correlations between true intake and screener were 0.64 and 0.58 for men and women, respectively, and between true intake and FFQ were 0.67 for men and 0.72 for women.

Estimated attenuation coefficients for the screener were 1.29 (men) and 0.98 (women) and for the FFQ were 0.56 (men) and 0.57 (women)

Percentage energy from fat screener’s ability to accurately assess the individual’s diet is limited. In addition its use in intervention studies with self-selected and potentially biased participants has not been evaluated.

Strengths:

In the absence of more accurate dietary intake methods the screener may be useful to characterize population intakes ofpercentage of energy from fat, allowing comparisons across subpopulations and across time for the same population.

Conclusion: percentage of energy from fat screener, when used in conjunction with external reference data, may be useful to compare mean intakes of fat for different population subgroups, and to examine relationships between fat intake and other factors.