title: The two-step Mini Nutritional Assessment procedure in community resident homes.
abstract: AIMS AND OBJECTIVITIES: The aims were to test internal consistency and interrater reliability of Mini Nutritional Assessment during implementation of Mini Nutritional Assessment in community residential homes and to test sensitivity, specificity and diagnostic predictivity of Mini Nutritional Assessment-short form vs. Mini Nutritional Assessment.
  
  
  BACKGROUND
  There is a need in clinical practice to assess nutritional status in older people and to identify those who could benefit from early intervention.
  
  
  METHODS
  The two-step Mini Nutritional Assessment procedure (Mini Nutritional Assessment-short form and Mini Nutritional Assessment) was used in 127 older people admitted to eight residential homes. In three of those homes (A, B and C), registered nurses simultaneously performed the assessment procedure, after receiving education and training. The intention was to offer the registered nurses a tool for independent practice use.
  
  
  RESULTS
  Internal consistency was 0.68 (Cronbach's alpha) (n = 127). In residential home A, B and C, the registered nurses carried out Mini Nutritional Assessment in 45 residents out of 68. The agreement level between the author's and the registered nurses' assessments was 62% (kappa 0.41). In residential home A, B and C, the agreement level was 89%, 89% and 44%, respectively. Sensitivity, specificity and diagnostic predictivity of Mini Nutritional Assessment-short form vs. Mini Nutritional Assessment were 89%, 82% and 92%, respectively.
  
  
  CONCLUSIONS
  The two-step Mini Nutritional Assessment procedure seems to be a useful tool to identify residents in need of nutritional interventions, despite the registered nurses not carrying out Mini Nutritional Assessment in all residents and the low agreement in residential home C. It indicates that to implement and use Mini Nutritional Assessment in nursing care demands the creating necessary staff resources, such as adequate staffing, sufficient education and continual supervision.
  
  
  CONCLUSIONS
  Because of the high sensitivity of Mini Nutritional Assessment-short form and Mini Nutritional Assessment, Mini Nutritional Assessment-short form alone might be sufficient for practice use, as its simplicity might increase its usefulness.
authors.affiliation: Department of Nursing Science, University College of Health Sciences, Jönköping University, Jönköping, Sweden. kerstin.wikby@telia.com
authors.forename: Kerstin
authors.initials: K
authors.lastname: Wikby
authors.forename: Anna-Christina
authors.initials: AC
authors.lastname: Ek
authors.forename: Lennart
authors.initials: L
authors.lastname: Christensson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D009752:Nutritional Status; D012112:Residential Facilities; D013548:Sweden