Introduction The British Association of Parenteral and Enteral Nutrition’s (BAPEN) nutritional screening week in 2011 found that 25–34% of patients admitted to hospital were at risk of malnutrition. It results in longer admissions and greater morbidity and mortality, costing in excess of £13 billion per annum. Malnutrition poses a substantial burden both medically and financially, which has resulted in the National Institute of Clinical Excellence (NICE), formulating quality statements and guidelines, which state that all patients must be screened for the risk of malnutrition using a validated screening tool. The Malnutrition Universal Screen Tool (MUST) is a well recognised and utilised screening tool, which is also recommended by NICE and BAPEN. The aim of this audit is to investigate whether inpatients at a specialist hospital are being screened for malnutrition using the validated MUST and whether this is being utilised correctly.
Methods Inpatients at a spcialist hospital were identified. All patients’ notes were obtained and searched for the presence of the MUST and a MUST score. Patients’ age and time taken from admission for a MUST score to be calculated were recorded. The MUST score was also independently calculated and checked against documented scores.
Results 61 inpatients were identified (31 males and 30 females). The MUST was present for 59 (96.7%) patients and a MUST score was documented for 51 (83.6%) of these patients. The MUST score was calculated after a mean of 2 days. 23 (37.7%) patients had an incorrect MUST score. A total of 33 (54.1%) patients either had no MUST present, no MUST score documented or an incorrect MUST score. 24 (39.3%) of these patients were subsequently allocated the incorrect risk category.
Conclusion Malnutrition poses a major medical and financial burden. Whilst the MUST is a well-validated tool and is being completed in the majority of patients, it is not being utilised correctly and a significant number of inpatients at risk of malnutrition are not receiving the correct management. It is evident that unintentional weight loss of patients is not being elicited and in some cases alternative routes to calculating a patients BMI, if weight and height are unobtainable, have not been explored. Healthcare professionals need to be educated on the importance of unintentional weight loss and a patients’ BMI and these must be elicited. Trust guidance on calculating the MUST score must be reviewed by all nurses and doctors. The availability of the MUST application for mobile devices, designed to aid calculating the MUST score, should be promoted.
Disclosure of Interest None Declared
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