Evaluation of Nutritional Assessment Quality and Rate of Referral to A Dietitian in Shariati Hospital, Tehran, Iran: A Clinical Audit

  • Mohammadreza Emami
  • Meysam Zarezadeh
  • Mohammad Sharifzadeh
  • Zahra Fazelifarsani
  • Masoud Khorshidid
Keywords: Clinical audit; Nutrition assessment; Quality of health care; Hospital practice


Background: Malnutrition is an acute or a chronic condition resulting from an imbalance in the intake, both in the form of undernutrition and over nutrition, leading to changes in the composition or reduced function of the body. Bio-social conditions and acute or chronic diseases are the most important factors affecting nutrition. It has been suggested that awareness of the prevalence and severity of malnutrition in hospitalized patients can be used by managers to understand the causes, health care system requirements, and health plans.

Methods: Medical records of 483 patients from 11 different wards of Shariati general hospital were assessed to evaluate the quality of nutritional assessment and the rate of referral to nutrition experts by physicians. This study consisted of two phases: evaluation of initial nutritional assessment and assessing the accuracy of malnutrition screening forms completion.

Results: Our study showed no initial nutritional assessment for 34% of the patients. Assessment of the accuracy of malnutrition screening showed that there was a considerable error in the reporting of BMI (66%), weight loss (51%), appetite loss (50%), and severity of the patient’s situation (39%). Also, the rate of referral to a nutritionist was 0% and 1% in the first and second phases of the study, respectively.

Conclusion: The present study showed that the quality of nutritional screening and subsequent referral to nutrition experts for professional nutritional assessment is negligible in Shariati hospital, Tehran, Iran.