Nutritional status classification in the Department of Veterans Affairs

The Department of Veterans Affairs (VA) Nutrition Status Classification sch eme uses clinical data that are routinely collected on admission or shortly thereafter for quick inpatient nutrition screening. In this scheme, patien ts are assigned to 1 of 4 classification levels according to 7 individual i ndicators. The indicators include nutrition history, unintentional weight l oss as a percent of usual body weight, percent of ideal body weight, diet, diagnosis, albumin, and total lymphocyte count. After ratings (1 to 4) are assigned to each of the 7 indicators, overall nutritional status for each p atient is determined by an algorithm. The VA classification system includes many of the same criteria used in oth er nutritional status classifications. Where it differs is in the greater e mphasis on the use of objective criteria and in the rigorous evaluation of reliability and validity that went into its development. Because of these e xtra measures, the VA classification can be used for prioritizing workload, as well as for determining staff requirements and for comparing workload a nd productivity across health care facilities. So that others might benefit from using this system, this article provides information on how the class ification scheme was developed and explains how it is used.