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      Nutrition Evaluation Screening Tool: An Easy to Use Screening Tool for Hospitalised Children

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          Abstract

          Purpose

          Nutrition screening is vital to ensure patients are appropriately managed in hospital. In paediatrics there is currently no universally accepted nutrition screening tool. The Nutrition Evaluation Screening Tool (NEST) was developed as an easy to use and practical screening tool for hospitalised children. We aim to evaluate compliance of the NEST and assess agreement of the NEST with the already validated nutrition screening tools, Screening Tool for Risk on Nutritional Status and Growth (STRONGkids), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the Subjective Global Nutritional Assessment (SGNA) tool.

          Methods

          Retrospective review of 102 patient episodes at the Evelina London Children's Hospital. Electronic records were used to assess NEST compliance and to complete the nutrition tools for each patient episode. Cohen's kappa was used to determine the level of agreement between each nutrition tool.

          Results

          There was moderate agreement between the NEST and the two screening tools, STRONGkids (κ=0.472) and STAMP (κ=0.416) for patients on initial screening at admission. 87.2% of patient episodes were NEST compliant within 24 hours of admission to hospital.

          Conclusion

          The moderate agreement between these two already validated screening tools enhances the NEST's validity as a paediatric screening tool. The NEST had the strongest correlation with the SGNA tool compared to other screening tools. The NEST is user friendly screening tool for hospitalised children.

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          Most cited references29

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          STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT

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            ESPEN guidelines on definitions and terminology of clinical nutrition.

            A lack of agreement on definitions and terminology used for nutrition-related concepts and procedures limits the development of clinical nutrition practice and research.
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              Defining pediatric malnutrition: a paradigm shift toward etiology-related definitions.

              Lack of a uniform definition is responsible for underrecognition of the prevalence of malnutrition and its impact on outcomes in children. A pediatric malnutrition definitions workgroup reviewed existing pediatric age group English-language literature from 1955 to 2011, for relevant references related to 5 domains of the definition of malnutrition that were a priori identified: anthropometric parameters, growth, chronicity of malnutrition, etiology and pathogenesis, and developmental/ functional outcomes. Based on available evidence and an iterative process to arrive at multidisciplinary consensus in the group, these domains were included in the overall construct of a new definition. Pediatric malnutrition (undernutrition) is defined as an imbalance between nutrient requirements and intake that results in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes. A summary of the literature is presented and a new classification scheme is proposed that incorporates chronicity, etiology, mechanisms of nutrient imbalance, severity of malnutrition, and its impact on outcomes. Based on its etiology, malnutrition is either illness related (secondary to 1 or more diseases/injury) or non-illness related, (caused by environmental/behavioral factors), or both. Future research must focus on the relationship between inflammation and illness-related malnutrition. We anticipate that the definition of malnutrition will continue to evolve with improved understanding of the processes that lead to and complicate the treatment of this condition. A uniform definition should permit future research to focus on the impact of pediatric malnutrition on functional outcomes and help solidify the scientific basis for evidence-based nutrition practices.
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                Author and article information

                Journal
                Pediatr Gastroenterol Hepatol Nutr
                Pediatr Gastroenterol Hepatol Nutr
                PGHN
                Pediatric Gastroenterology, Hepatology & Nutrition
                The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
                2234-8646
                2234-8840
                January 2021
                08 January 2021
                : 24
                : 1
                : 90-99
                Affiliations
                [1 ]Faculty of Life Science and Medicine, King's College London, London, UK.
                [2 ]Department of Paediatric Gastroenterology, Evelina London Children's Hospital, London, UK.
                Author notes
                Correspondence to Mohamed Mutalib. Department of Paediatric Gastroenterology, Evelina London Children's Hospital, Westminster Bridge Road, London SE1 7EH, UK. Mohamed.mutalib@ 123456gstt.nhs.uk
                Author information
                https://orcid.org/0000-0002-2516-0823
                https://orcid.org/0000-0003-0526-0787
                https://orcid.org/0000-0001-8869-9466
                Article
                10.5223/pghn.2021.24.1.90
                7813567
                33505898
                38aedfb0-ea6d-40f1-846c-ac271982fb38
                Copyright © 2021 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 June 2020
                : 25 July 2020
                : 17 August 2020
                Categories
                Original Article

                nutrition assessment,malnutrition,nutritional status,child,pediatrics

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