Introduction : 40% of elderly inpatients are malnourished on admission and continue loosing weight while in hospital due to inappropriate or delayed nutritional assessment and intervention.  In an audit that was conducted in  33 departments in the hospital underwent review.  755, out of 1200, hospitalized patients were included in the survey.  11% had pressure ulcers. 69% had Albumin level. Below 3.5 grams, 11% undocumented
Aim :Early detection and intervention of high risk individuals independently of their cognitive status by developing and pre testing a Nutritional Status Assessment Tool
Pretest :In a pilot study 30 geriatric patients were tested for there nutritional status by  albumin levels and by  the Mini Nutritional Assessment 53% of all patients with a plasma albumin above 3gr (non-intervened) were graded as at risk of malnutrition by the Mini Nutritional Assessment tool - MNA,The MNA  is limited to communicative patients only, the researcher developt a new assessment for all patient. 

Validity and reliability of Nutritional Status Assessment (NSA)
 The NSA was found valid (p<0.00) and reliable (in all anthropometric and biochemical data p<0.00) for use in geriatric communicative and impaired communication patients. Finally, the newly validated NSA and the nutritional protocol that follows were introduced and implemented in the population of the two wards of the geriatric hospital 

 Results of the intervention; Cycle 2 sought to evaluate the early assessment and intervention on the nutritional, functional, cognitive states, and track the reduction in the rate of complications, represented by pressure ulcers and falls. The results proved that early detection and nutritional intervention improved the nutritional (p<0.00), functional (p<0.00), cognitive status (p<0.00)

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