ArticleEuropean journal of clinical nutrition2023
Application of NRS2002 to detect malnutrition in a tertiary care centre: agreement between nurse and dietician's screening steps and relation with clinical outcomes.
Article in European journal of clinical nutrition, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 1 citations in OpenAlex.
- From Nurse-Led to Clinical Dietitian-Led Nutritional Care in Hospital Practice: Changes in Nutritional Risk Screening Rates, Patient Nutritional Intake and Professional Perspectives.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026Article
- Towards accurate malnutrition identification in individuals with Spinal Cord Injury: a qualitative investigation.Spinal cord series and cases · 2026Article
- Nutritional risk status and related influencing factors in patients with tuberculosis complicated with type 2 diabetes mellitus.Frontiers in nutrition · 2026Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the agreement between nurse and dietician nutritional risk assessments when using the Nutritional Risk Screening 2002 (NRS2002) protocol, and to explore the relations of falsely labeling patients 'not at risk' for malnutrition and the screening time difference (STD) between nurse and dietician with the length of stay (LoS).
methodsIncluded are all patients hospitalized in a tertiary care center between January 2017 and December 2019 and screened for malnutrition by both a nurse and a dietician. The inter-rater reliability is evaluated using Cohen's Kappa. The relation between STD and the patient classification (PCET) is assessed by a linear mixed effect model. The relation between the LoS and PCET is evaluated with the Kaplan-Meier method and multivariable Cox regression including STD with pathology group and severity of illness as random effect.
results9085 patients are assessed by nurse and dietician. 72% of all assessments agree (Kappa = 0.44 [0.43-0.46]). The dietician is involved later for patients falsely labeled 'not at risk' (1.06 [0.92-1.20] days; p < 0.001). Compared to patients where the dietician is involved within 3 days, the LoS is 7.37 days (Hazard Ratio (HR): 0.51 [0.43-0.61]) longer for patients falsely labeled 'not at risk', while only 3.51 days (HR: 0.72 [0.64-0.80]) longer for patients correctly labeled 'at risk'.
conclusionsAgreement of screening for malnutrition between nurses and dieticians is weak. Avoiding falsely labeling patients 'not at risk' should be a main concern upon patient admission as later involvement of dieticians is correlated with a longer LoS.
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