Use of Malnutrition Screening Tools by Paediatric Nurses in Acute Hospital Settings: A Systematic Literature Review

Abstract

Background: Malnourishment is detrimental in a hospital setting, and all children are at risk of malnourishment once admitted. Malnutrition screening tools (MSTs) are meant to identify inpatients most at risk, and yet some are more reliable, sensitive, and selective than others. While many MSTs have become available over the past two decades, no gold standard exists. Although many widely used MSTs have strengths, it is not always efficacious to utilize them in clinical practice. Keywords: malnutrition screen tools, paediatrics, anthropometry, nursing Aim: The objective of this research is to analyse the strengths and limitations of some of the most common MSTs so that nurses will better understand how and why MSTs are used and what issues may arise in the process. Methods: A systematic review of the literature was conducted to evaluate MSTs frequently used by nurses in acute hospital settings to assess paediatric patients. Using the Cochrane method to guide this review, eight studies were selected that assessed malnutrition screening by nurses in children ages 0-18 years in a hospital or acute care setting. In addition, the studies selected were observation cohorts or randomised control trials. Results: The review found five paediatric malnutrition screening tools that were validated for use in clinical settings: Paediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), Screening Tool for Risk on Nutritional Status and Growth (STRONGkids), Paediatric Nutrition Screening Tool (PNST), and Subjective Global Nutrition Assessment (SGNA). Conclusion: Nurses play a vital role in detecting malnourished paediatric patients in acute settings. Based on the findings, it becomes evident that each of the MSTs has its unique strengths and weaknesses depending on if the tool is suited for the specific patient. Understanding how and why to use particular tools by nurses can help create more effective screening practices. Additional research needs to be done to address the screening complications of chronic illness and obesity as well as study how to budget shortcomings impact effective malnutrition screening.