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Calculate malnutrition risk using the Malnutrition Universal Screening Tool (MUST). Screen for undernutrition based on BMI, weight loss, and acute disease status.
>20 = 0 points, 18.5-20 = 1 point, <18.5 = 2 points
<5% = 0 points, 5-10% = 1 point, >10% = 2 points
Adds 2 points if checked
The Malnutrition Universal Screening Tool (MUST) is a five-step screening tool designed to identify adults who are malnourished, at risk of malnutrition, or obese. It includes guidelines for developing individualized care plans.
Routine clinical care. Repeat screening: Hospital weekly, care homes monthly, community annually for special groups.
Observe and document dietary intake for 3 days. If adequate, repeat screening. If inadequate, follow local policy.
Treat: Refer to dietitian or implement local policy. Set goals, improve nutrition, monitor regularly.
MUST (Malnutrition Universal Screening Tool) is used to identify adults who are malnourished, at risk of malnutrition, or obese. It helps healthcare professionals determine appropriate nutritional interventions and monitoring frequency.
Screening frequency depends on the setting and risk level. In hospitals, weekly screening is recommended for low-risk patients. In care homes, monthly screening for low-risk residents. Community patients should be screened annually or when clinical condition changes.
A BMI less than 18.5 kg/m² indicates high risk (2 points). BMI between 18.5-20 kg/m² indicates medium risk (1 point). BMI greater than 20 kg/m² is considered low risk (0 points) in the MUST scoring system.
Weight loss percentage = [(Usual weight - Current weight) / Usual weight] × 100. The timeframe should be 3-6 months of unplanned weight loss. Less than 5% is low risk, 5-10% is medium risk, and greater than 10% is high risk.
This refers to patients who are severely ill and have had no nutritional intake (or are likely to have no intake) for more than 5 days. This could be due to surgery, illness, inability to eat, or other acute medical conditions. This adds 2 points to the MUST score.
High-risk patients (score ≥2) should receive treatment including: referral to a dietitian or nutritional support team, implementation of local nutritional support policies, setting nutritional goals, improving and increasing nutritional intake, and regular monitoring and review of the care plan.
MUST is designed for adult patients (18+ years). It may require modification for certain populations such as pregnant women, amputees, or patients with fluid retention. Different screening tools exist for pediatric populations. Always consider clinical judgment alongside MUST scores.
MUST is validated for use across all healthcare settings (hospital, community, care homes) and focuses on undernutrition risk. Other tools like MNA (Mini Nutritional Assessment) are specific to elderly populations, while SGA (Subjective Global Assessment) is more subjective. MUST is quick, objective, and widely validated.