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What is Screening?
Penapisan/identifikasi untuk mengetahui orang yg berisiko terjadi masalah gizi atau malnutrisi Tes Skrining sebaiknya bersifat non-invasive, murah dan hasilnya cepat diketahui Cakupan utama skrining :
1. 2. 3. 4. Berat IMT Penurunan BB Selera makan Kondisi medis dimana tjd peningkatan kebutuhan
Skrining vs Assessment
Nutrition Screening Purpose : to quickly identify individuals nutritionally at-risk or who are malnourished Rapid, simple general procedure done at first contact with subject to detect risk of malnutrition, done by nurses, doctors or others Nutrition Assessment Purpose: to identify early signs of malnutrition and prevent it from morbidity and mortality Detailed, more specific in depth evaluation, done by those with nutritional expertise
Developed in 1990 Validated for ages 65+ Simple, reliable, non-invasive, & quick Inexpensive Validated in hospital & community setting For screening & assessment
Guigoz et al., Nutr. Rev. 1996;54:S59-65 Vellas B et al., J Am Geriatr Soc 2000;48:1300-1309c Rubenstein LZ et al., J Gerontol 2001;56:M366-M372
Validation of
MNA
Nursing home, hospitalized & free living elderly Sensitivity 96% Specificity 98%
4 sections: Anthropometrics Diet questionnaire Global assessment lifestyle medications mobility Subjective assessment self perception of health & nutrition
MUST
Malnutrition Universal Screening Tool
A practical, reliable, validated tool for nutrition screening Allows comparable nutritional screening across different care settings by different health professionals primary care, home, acute care, long term care Identifies individuals who are undernourished or obese Not specific for the elderly, but adults
Step 1
BMI
Subjective criteria
Step 4
Overall Risk Of Malnutrition 0 Low risk 1 Medium Risk 2 or more High Risk
Step 5
Consider using suggested management guidelines
Reassess risk category as subject moves through care settings
MUST Validity
Malnutrition Universal Screening Tool
Hospitals
predicts Length of stay predicts discharge destination mortality
Community
predicts rates of hospitali admissions predicts rates of GP visits shows that appropriate intervention improves outcome