title: Development of a Nutrition Screening Tool for an Outpatient Wound Center.
abstract: OBJECTIVE
  To construct a quickly and easily administered nutrition screening tool using variables believed to be predictive of malnutrition risk in the wound patient population.
  
  
  METHODS
  A prospective pilot study assessed patients on a list of suspected variables, as well as the Scored Patient-Generated Subjective Global Assessment (PG-SGA), chosen as the criterion standard. Variables were analyzed to select the most appropriate items for inclusion on a new nutrition screening tool using preliminary bivariate correlations and χ tests of association. Items significantly associated with malnutrition were dichotomized, and binary logistic regression analyses were performed to arrive at a final model. A sum score was computed, and receiver operating characteristic analysis was used to determine designation of risk.
  
  
  METHODS
  An outpatient wound center in Northeast Ohio.
  
  
  METHODS
  The pilot study included a convenience sample of 105 outpatients with at least 1 active wound.
  
  
  METHODS
  Malnutrition as assessed by the Scored PG-SGA.
  
  
  RESULTS
  The final nutrition screening tool, the MEAL Scale, is composed of 4 dichotomous elements: multiple wounds (number of wounds), eats less than 3 meals per day, appetite decrease (eats less than usual), and level of activity. These variables predicted 83.7% of the malnutrition cases assessed by the Scored PG-SGA. The receiver operating characteristic analysis showed an acceptable area under the curve (0.8581), and a cutoff score of 2 or greater was selected to indicate risk (median sensitivity = 91.4%, median specificity = 60.9%).
  
  
  CONCLUSIONS
  Although further studies of validity and reliability are necessary to establish the tool before widespread use, the MEAL Scale is a needed step toward nutrition screening in a wound patient population.
authors: Judith Fulton, PhD • Scientist • The Serena Group Innovation Lab • Rootstown, Ohio Brad Evans, BS • Medical Student • University of Toledo College of Medicine and Life Sciences • Ohio Stephannie Miller, MPH • Research Assistant • Akron General Medical Center • Ohio Kimberly N. Blasiole, MSN, RN, CWOCN • Clinical Research Nurse • Akron General Medical Center • Ohio Nancy Beinlich, MSN, RN, CWON • Director • Wound Center • Akron General Medical Center • Ohio Anita Meehan, MSN, RN-BC, ONC, FNGNA • Clinical Nurse Specialist • Akron General Medical Center • Ohio Claire Loose, MA, RD, LD • Clinical Manager, Nutrition Services • Akron General Medical Center • Ohio Raymond Leone, DO • Physician • Akron General Medical Center • Ohio.
authors: Judith
authors: J
authors: Fulton
authors: Brad
authors: B
authors: Evans
authors: Stephannie
authors: S
authors: Miller
authors: Kimberly N
authors: KN
authors: Blasiole
authors: Raymond
authors: R
authors: Leone
authors: Nancy
authors: N
authors: Beinlich
authors: Anita
authors: A
authors: Meehan
authors: Claire
authors: C
authors: Loose
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D006801:Humans; D044342:Malnutrition / Q000175:diagnosis* / Q000209:etiology; D008403:Mass Screening / Q000379:methods*; D015596:Nutrition Assessment; D009752:Nutritional Status; D009820:Ohio; D017063:Outcome Assessment, Health Care; D010045:Outpatients / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011446:Prospective Studies; D014947:Wounds and Injuries / Q000150:complications