The Academy of Nutrition and Dietetics/the American Society for Parenteral and Enteral Nutrition consensus malnutrition characteristics: application in practice.

Malnutrition in adult hospitalized patients has been a significant issue for almost 40 years. Changes in 2007 to the diagnosis related groups reimbursement methodology, as outlined by the Center for Medicare and Medicaid Services, provided an impetus to improve the diagnosis and documentation of malnutrition in adult patients. Being able to accurately assess, diagnose, and document malnutrition has been challenged by the lack of a standard malnutrition definition. In 2012 a workgroup of the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition published a consensus paper outlining characteristics for the diagnosis of adult hospital malnutrition. Using the etiology approach for defining malnutrition as outlined by Jensen and colleagues, 6 general characteristics are outlined with specific thresholds to delineate severe and nonsevere malnutrition. The purpose of this article is to provide practical strategies for criteria implementation and to describe one institution's experience in implementing a broad-based "malnutrition program" within its healthcare system.