Why screen for malnutrition?
Malnutrition is a prevalent yet often hidden problem in hospitals, agedcare homes and community health services. In Queensland, studies indicate that up to 30% of admitted patients are at risk of malnutrition, with higher rates in older adults, people with chronic disease and those undergoing surgery.
Early identification allows clinicians to intervene before weight loss, muscle wasting, delayed wound healing, increased infection risk and prolonged length of stay occur. The Queensland HealthStrategy20222027 explicitly recognises nutrition as a core component of patient safety and quality care.
Policy & Guidelines
All public health facilities in Queensland follow a unified set of directives:
- Queensland Health Nutrition Policy (2021) mandates systematic nutrition screening for every adult admitted to acute, subacute and agedcare services.
- Clinical Guideline: Nutrition Screening and Assessment (2022) outlines the timing, responsibility and documentation requirements.
- National Health and Medical Research Council (NHMRC) Standards provide the evidence base for the recommended tools and referral pathways.
Compliance is monitored through the Clinical Governance and Safety Programme, with regular audits reported to the Queensland Health Executive Board.
Screening Process
The standard workflow is as follows:
- Admission: Within the first 24hours, a registered nurse or allied health assistant completes a nutrition screening tool.
- Risk Identification: Scores are automatically flagged in the electronic medical record (eMR). A score 2 on the Malnutrition Screening Tool (MST) or <20% of the MUST total indicates risk.
- Dietitian Referral: Patients identified as at risk receive a full nutrition assessment within 48hours.
- Intervention: Tailored nutrition care plans are developed, including oral supplements, texturemodified diets, fortified meals or, when required, enteral/parenteral nutrition.
- Followup & Monitoring: Rescreening occurs weekly or at each change of clinical status; outcomes are recorded in the eMR.
- Discharge Planning: Nutrition recommendations are communicated to community health services, general practitioners and caregivers.
Screening Tools Used in Queensland
Queensland Health endorses two validated tools, both integrated into the eMR:
| Tool | Population | Scoring QuickGuide | Threshold for Referral |
|---|---|---|---|
| Malnutrition Screening Tool (MST) | Adults 18y, all settings | 1 point for recent weight loss; 1 point for reduced appetite | Score2 |
| MUST (Malnutrition Universal Screening Tool) | Adults & older people | Score 02 based on BMI, weight loss, acute disease effect | Total score2 (medium risk) or <1% BMI (high risk) |
Both tools have been culturally adapted for Aboriginal and Torres Strait Islander peoples and for nonEnglish speakers, with translation packs available through the Queensland Health Cultural Services Unit.
Outcomes & Benefits
Key performance indicators (KPIs) from 20232024 data:
- Screening compliance reached 96% across acute hospitals.
- Dietitian referrals for atrisk patients increased by 22%.
- Average length of stay for malnourished patients fell by 1.3days after implementation of rapid intervention pathways.
- Readmission rates for nutritionrelated complications dropped by 15%.
Beyond the measurable metrics, staff report higher confidence in recognising nutrition problems, and patients appreciate the holistic approach to their care.
Resources for Staff and Patients
- Queensland Health Nutrition Portal training modules, policy documents and elearning courses.
- eLearning: Nutrition Screening in Clinical Practice 30minute interactive module approved for CPD points.
- Patient handouts: Why Nutrition Matters (available in 10 languages).
- Community linkup: Queensland Dietitians Association supports postdischarge followup.
