Invited Review: The Nutrition Screening Initiative: A 5‐Year Perspective

Abstract

A history of the goals, activities, and accomplishments of the Nutrition Screening Initiative (NSI) is provided. A commentary on the development and intended use of the NSI's self-assessment and screening tools is given to facilitate selection of feeding devices for older Americans who need nutrition care. Additional questionnaires and interventions designed to address the needs identified through the NSI's standardized, interdisciplinary approach to the assessment of nutritional risk are described and their use encouraged. Legislative and public policy advocacy is summarized. A systemic approach to the assessment and maintenance of optimal nutritional health in the older population will have a profound effect on health care delivery systems.

Nutrition as a Vital Sign: Progress Since the 1990 Multidisciplinary Nutrition Screening Initiative and Opportunities for Nursing

“…Those older Americans most vulnerable to malnutrition are the oldest old (aged 85 and older), minority group members, women, those with limited income or resources, those isolated from family or friends, those who lack access to adequate diet, and those whose selfcare abilities are limited [12]. With the population of older people steeply on the rise, the number of those in nursing homes decreasing and the known higher risk for malnutrition in the oldest of the older population, home-based nursing and community-based efforts to identify, prevent, and treat malnutrition and its antecedents are a vital part of preventive healthcare and thus are important for the long-term health of the population.…”

“…Two other instruments (the Level I and Level II screens- Table 4) focused more on assessment by healthcare professionals, were less widely used, and (to our knowledge) have not been validated. The NSI produced a variety of other checklists including the Oral Health Checklist, Medications Use Checklist, Feeding Difficulties Checklist, and Nutrition Counseling Checklist [12]. …”

“…The NSI along with other organizations distributed one million Checklists within the first five years. The Checklist was translated into several languages, and 40 states instituted projects based on NSI's model [12]. The Administration on Aging promoted the material, and federal funds were awarded for research on screening and interventions [12].…”

“…The Checklist was translated into several languages, and 40 states instituted projects based on NSI's model [12]. The Administration on Aging promoted the material, and federal funds were awarded for research on screening and interventions [12]. Some researchers found that the NSI instruments were particularly helpful for identifying those at risk and guiding educational interventions in a variety of settings [20][21][22].…”

Assessing the Validity of the DETERMINE Checklist in a Short-Term Longitudinal Study

“…It was validated using both retrospective simulation and prospective validation methods. Both methodologies showed that older persons with higher Checklist scores were likely to have the lowest levels of nutrient intakes compared to recommended allowances and be at increased risk for adverse health events (Barrocas et al, 1996;White, 1996). The intended uses of the Checklist were to increase public awareness of the importance of nutrition and health, and to initiate dialogue between health professionals and older adults concerning adequate nutrition.…”