3.5 Explain the purpose of nutritional screening and associated risk assessment

This guide will help you answer 3.5 Explain the purpose of nutritional screening and associated risk assessment.

Nutritional screening and related risk assessments play an essential role in health and social care. They help identify individuals at risk of malnutrition or undernutrition, as well as those who may experience poor health outcomes due to their diet. Nutrition is a key factor in maintaining health, promoting recovery from illness, and ensuring overall wellbeing. This process allows health and care workers to address issues before they escalate into serious conditions.

What Is Nutritional Screening?

Nutritional screening is a quick and simple process used to identify people who are at risk of, or who are already experiencing, malnutrition. Malnutrition refers to deficiencies, imbalances, or excesses in a person’s intake of energy and nutrients. While some think malnutrition exclusively refers to not getting enough food, it can also mean receiving too much of certain types of nutrition, leading to poor health outcomes such as obesity.

Screening tools provide a practical way for care workers to assess someone’s nutritional status and identify problems early. Commonly used tools in the UK include:

• The Malnutrition Universal Screening Tool (MUST)
• The Mini Nutritional Assessment (MNA) for older people

Screening helps flag up potential risks which may require a more detailed nutritional assessment.

Why Is Nutritional Screening Important?

Nutritional status can have a massive impact on physical and mental health. Without proper nutrition, the body might not function effectively, making individuals more vulnerable to diseases and slower to recover from illnesses. Poor nutrition also increases the risk of complications in those already managing chronic conditions such as diabetes or high blood pressure.

In health and social care, effective nutritional screening ensures individuals at risk receive appropriate interventions. It may involve dietary adjustments, medical treatment, or support with mealtime routines, such as providing assistance with eating.

The screening also helps health workers better manage resources by prioritising care for those most in need. Early detection and treatment are always more cost-effective and better for individuals’ overall outcomes than addressing issues once they cause severe problems.

Steps Involved in Nutritional Screening

The process of nutritional screening typically involves a series of straightforward steps:

1. Identifying Risk Factors – Workers use a structured screening tool to check for key indicators of malnutrition risk. These indicators might include drastic weight changes, reduced appetite, or the inability to eat certain foods due to health conditions.
2. Measuring Weight and Height – A person’s Body Mass Index (BMI) is calculated through their weight and height. A BMI that is too low or too high might indicate poor nutritional health.
3. Investigating Food Intake – Care workers assess how much food and drink the individual is consuming daily. They may ask about portion sizes, food preferences, and meal frequency.
4. Assessing Physical and Medical Health – A screening will take into account any medical conditions that directly impact food intake or energy requirements. For instance, someone living with conditions like dementia, cancer, or swallowing difficulties may face additional barriers to proper nutrition.
5. Recording the Results – The findings of the screening are carefully documented so that care teams can create and implement a clear plan of action. This may include referrals to dietitians or medical professionals.

What Is a Nutritional Risk Assessment?

Once someone has been flagged during screening, a nutritional risk assessment goes deeper. This in-depth process evaluates the specific causes of their poor nutritional status and analyses how to address them. It aims to identify all the factors contributing to the problem.

Risk assessments consider things such as:

• Current and past medical conditions
• Medication use that might interfere with appetite or digestion
• Physical limitations (e.g., difficulty chewing or swallowing)
• Mental health conditions, including anxiety or depression, which often reduce appetite
• Social factors, such as a lack of access to nutritious food or social isolation
• Cultural or religious dietary restrictions

The resulting information helps professionals develop personalised care plans to address these individual challenges.

Who Benefits from Nutritional Screening?

Nutritional screening and assessments are particularly beneficial for:

1. Older Adults
   Ageing often reduces appetite, energy requirements, and the ability to prepare meals. Older populations are more likely to suffer from unintentional weight loss or reduced muscle mass, which increases their risk of falls and illnesses.
2. Hospitalised Patients
   People recovering from surgery or illness often experience appetite changes but may require heightened nutrition to aid their recovery.
3. People with Chronic Conditions
   Individuals with long-term illnesses like cancer, diabetes, or digestive disorders frequently experience difficulties maintaining a balanced diet.
4. People with Disabilities or Poor Mobility
   These individuals might struggle with physical barriers, such as reaching for food, cooking independently, or eating without assistance.
5. Those Experiencing Socioeconomic Challenges
   Poor access to food, whether due to financial constraints or social isolation, can lead to malnutrition. Screening helps identify these individuals so financial or community resources can be brought to their aid.

Consequences of Poor Nutrition

Failing to address nutritional issues can lead to serious consequences. Malnutrition can weaken an individual’s immune system, making them more vulnerable to infections and slowing healing rates. Muscle and tissue loss are common, increasing the risk of falls and injuries. Overnutrition, like obesity, can lead to diabetes, heart disease, and other chronic health issues.

In care settings, poor nutritional management might contribute to declines in the quality of life. Individuals may experience reduced energy, becoming less able to engage in activities or maintain independence.

Benefits of Nutritional Screening and Assessment

When carried out effectively, screening and risk assessments improve lives by:

• Reducing hospital admissions through early intervention
• Increasing recovery rates for illnesses and surgeries
• Boosting mental health and physical energy
• Preventing long-term complications associated with malnutrition

Professional Responsibilities for Care Workers

In health and social care, care workers play a key role in identifying and addressing nutritional issues. They must monitor individuals regularly for any changes in weight, eating habits, or physical appearance. If they suspect malnutrition, they should always act by initiating the nutritional screening process.

Workers should remain non-judgemental when discussing nutrition-related concerns. Food can be a sensitive topic tied to personal and cultural values, and individuals may feel embarrassed to discuss their eating habits. Maintaining clear, respectful communication is essential.

Common Barriers to Nutritional Screening

Some challenges can make screening more complicated. These include:

• Lack of training or confidence among care staff to use screening tools
• A high ratio of service users to staff, limiting available time for screening
• Resistance from individuals who don’t understand the value of screening or think their diet is fine
• Difficulties accessing resources, such as weighing scales or accurate BMI charts

To overcome these barriers, team leaders must ensure all care workers understand the importance of screening and know how to use the tools effectively. Regular training and adequate time should always be provided for this essential part of care.

Legal and Ethical Considerations

In the UK, nutritional screening and risk assessments are part of the duty of care health professionals owe to those they support. Helping individuals maintain or improve their health is a core ethical obligation. Failing to detect or address malnutrition may put an organisation at risk of breaching its legal responsibilities under regulations like the Care Act 2014.

Confidentiality is another important factor. Nutritional records must be handled securely and only shared with relevant professionals, adhering to the Data Protection Act 2018.

How to Implement Change After Screening

Following up on screening should involve creating a plan that works for the individual. This plan may include:

• Referrals to a dietitian or nutritionist for specialist advice
• Introducing a balanced meal plan tailored to personal preferences
• Providing education on healthy eating habits
• Offering physical or social support, such as arranging meal delivery services or helping with feeding during mealtimes

For those living in care settings, teamwork is essential. Everyone involved in the individual’s care should be aware of their nutritional needs and work together to improve outcomes.

Why Ongoing Monitoring Matters

Once someone has been identified as being at risk of malnutrition, further monitoring is needed to measure progress. Nutrition isn’t static—an individual’s needs might change over time, especially if they develop new medical conditions or as their physical abilities evolve.

Regular monitoring during care reviews ensures that interventions remain effective and are adjusted as needed.

Final Thoughts

Nutritional screening and associated risk assessments are lifesaving tools. They help protect individuals from avoidable harm caused by poor nutrition. Their simplicity masks their significance—through this process, problems can be identified and tackled early, improving health outcomes, boosting recovery, and enhancing overall quality of life. Health and care workers play a key role in this by aligning their actions with the needs and wellbeing of the individuals they support.