Development of a quick and easy malnutrition screening tool for hospitalized children: the short nutritional assessment questionnaire (SNAQkids)

Undernutrition is characterized by inadequate intake of protein, energy and micronutrients and associated with frequent infections or disease. Earlier studies estimated that undernutrition occurs in 26% of children admitted to a hospital.
Factors that may increase the risk of developing undernutrition are prolonged periods of fasting prior to tests and surgery, failure to recognize the increased energy requirements because of infection, unknown food intake, increased losses of energy and nutrients due to malabsorption, unknown weight and height and inadequate nutritional therapy/ no or a late start of nutritional therapy.

In children, undernutrition has serious consequences, such as reduction in growth, increased mortality and morbidity, higher risk to various infections and wound-healing problems. Undernutrition is also associated with a longer time of recovery, increased risk of adverse clinical events and a longer hospital stay with increased health care costs.

Screening children on undernutrition at hospital admission and monitoring the nutritional status during medical treatment makes it possible to effectively intervene, for example with extra meals, enteral tube feeding or, when the intestines do not function properly, parenteral nutrition.
Therefore an important task for nurses and doctors is to recognize undernutrition of children, when admitted to a hospital. In the ideal situation nurses will obtain information on weight, height and growth of every child at hospital admission. If the results are abnormal the doctor and dietician can do further diagnostics and proper interventions can be taken. In daily practice these measurements are not routinely performed because they are too time-consuming and are not the nurses priority.

Screening of nutritional status at admission has been hindered by the lack of a simple, short nutritional assessment tool for children, that can be integrated at nurses’ intake and will take less than five minutes of time. The hospital screening tool for undernutrition used in adults cannot be used because other criteria for undernutrition apply to children.
This study was designed to determine which questions best predict the nutritional status of a child at hospital-admission.

The recognition of malnourished children will improve by using the short nutritional assessment questionnaire.

All children will be studied within twenty-four hours after admission to the hospital.

All parents are asked to answer a list of 23 questions. It contains medical conditions like ability to eat, swallow and retain food, food intake, weight loss, feeding interventions and pain.

Nutritional status is measured using height, weight, mid-upperarmcircumference and bioelectrical impedance.