Introduction The National Institute for Health and Clinical Excellence (NICE) recommends that screening tools such as the five step MUST (Malnutrition universal screening tool) be used on patients admitted to hospital and weekly thereafter.1 Early identification of nutritionally deficient patients is vital so that nutritional intervention can be targeted.
Methods All patients (n=80) on four general medical wards were reviewed and followed up for 4 weeks or until discharged. Medical and nursing notes were assessed to see if MUST scoring was used and if the appropriate intervention was carried out based on the MUST score. The trust policy is that 100% compliance should be achieved in the use of MUST for inpatients.
Results The Abstract PMO-034 table 1 shows that compliance with the nutritional screening tool is below the expected standard of 100% and slowly reduces over the first 4 weeks from admission. There were 14 instances of MUST score 1 but this resulted in only 36% of patients being given a high energy diet and 57% of patients being placed on a food diary. There were 28 instances of MUST score 2–3, but this led to only 46% of patients being placed on a high energy diet and 68% of patients being placed on a food chart. There were six instances of MUST score 4–6, however this led to only 50% of patients on a high energy diet, 67% of patients being placed on a food chart although 100% of these patients were referred to a dietician.
Conclusion The adherence to nutritional scoring in medical patients is high but below the expected 100%. As time goes by the adherence to weekly screening drops slowly. Although there is a relatively high adherence to working out the MUST score, the final step in the screening tool which concentrates on nutritional intervention is disappointingly low. Continued education for both medical and nursing staff is needed so that targeted nutritional intervention can be delivered more effectively.
Competing interests None declared.
Reference 1. NICE. Clinical Guidance 32. Nutrition Support in Adults. 2006