Must (Malnutrition Universal Screening Tool) Chart

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MALNUTRITION UNIVERSAL
SCREENING TOOL ‘MUST’
Nutrition screening tool should be completed on
admission and then weekly.
Patient’s Name:
Date of birth:
NHS Number:
Date of admission:
Normal Weight (kg) (Reported):
Height (m):
estimate / actual (please circle)
BMI :
For each section below circle one score
Date
Signature
Weight (kg) Actual
Actual
Actual
Actual
Actual
kg
kg
kg
kg
kg
Weekly BMI
Body mass index (BMI) kg/m2 - calculate from chart over page
• 20 or more
0
0
0
0
0
1
1
1
1
1
• 18.5 - 20
• less than 18.5
2
2
2
2
2
If unable to obtain height and weight see `MUST` Explanatory booklet
for alternative measurement and use subjective criteria
Unplanned weight loss in the last 3-6 months - calculate from
tables over page
0
0
0
0
0
• <5%
1
1
1
1
1
• 5-10%
2
2
2
2
2
• >10%
Medical condition
2
• If patient is acutely ill and there has been or is likely to be no
2
2
2
2
nutritional intake for >5 days score 2
Any patients commenced on NG/PEG/RIG/TPN – Refer to Dietitian
T
otals
Action
0 = Low risk
1 = Medium risk
2 or more = High risk
Treat
Routine Clinical Care
Observe
• Follow action plan for medium risk
Complete food and fluid chart for 3
• Refer to dietitian*
• Ensure adequate fluid intake
days. If improved or adequate intake:
• Weigh twice weekly, recalculate
• Offer advice on food and drink
• Little clinical concern, discontinue
% weight loss over the last 3 – 6
choices
food intake chart
months and monitor
• Offer help and advice with feeding
• Weigh weekly and repeat screen.
• Document action taken in nursing
if needed
If inadequate intake or no improvement:
notes
• Use appropriate feeding aids if
• Encourage and assist to eat and
required
drink
*Unless detrimental or no benefit is
• Help with positioning, sit out / up for
• Continue accurate food and fluid
expected from nutritional support for
meals
intake chart daily
example end of life care pathway.
• Weigh weekly, recalculate %
• If patient’s managing less than
weight loss over the last 3 – 6
½ meals, offer non-prescribable
months and rescreen weekly
supplement drinks † (Complan /
Referral to Dietitian (tick)
• Document action taken in nursing
Build up) at least twice daily
notes
• Weigh weekly, recalculate %
Date
weight loss over the last 3 – 6
months and rescreen weekly
Signature
• Document action plan
• Liaise with catering if patient
dislikes hospital food
This is a tool to assist your assessment. If in doubt use your professional judgement.
† BAPEN does not necessarily support the use of any products in particular.

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