Must do M.U.S.T in Bradford
The Malnutrition Screening tool (MUST) is now being used on most adults admitted to Bradford hospitals. This tool has been recommended by the National Institute for Clinical Excellence (NICE) and tested on a wide range of different patient groups and is felt to be accurate. It is designed to help recognise patients who are either at risk of malnutrition or who are already malnourished.
Research shows that people who are malnourished are at greater risk of infection, heal poorly, have longer hospital stays and a poorer prognosis. Some studies estimate that up to 60% of patients admitted to hospital are already malnourished and this number increases during their hospital stay.
10 years ago Bradford dietitians recognised this problem and developed a screening tool called the Malnutrition Quotient (MQ) which also assessed a patient’s risk of malnutrition. As the screening tool of choice in many hospitals is now MUST it has been agreed that Bradford should change to this more universally recognised tool.
Nursing staff at ward level have been trained on how to complete the tool and an internet training package has also been designed for ASPEN. Work continues to review using the tool for patients attending outpatients
MUST use Food First
The screening tool is linked to the trust “Food First “action plan to help patients meet their nutritional needs whilst in hospital and on discharge home. Catering, nursing and dietetic services work together to aim to provide food that patients like and are able to eat whilst meeting their individual nutritional and cultural needs. Menus include hot meal choices at lunch and supper and many options are fortified to help patients with poor appetites meet their needs more easily.
The MUST tool looks at scores for body mass index, weight loss over the previous 3 months and amount of time the person has eaten poorly. These scorce are added together to give an overall risk score which is linked to an individualised nutritional care plan. Patients can be offered smaller portions with snacks in-between, supplementary snacks and milky drinks to help them to consume enough when appetites are poor. If a patient is unable to meet their needs through the use of food then special prescribable drinks can be used to help. In some cases patients need to be supported by tube feeding. In all cases patients should be nutritionally assessed ,the right foods and drinks provided and their actual intakes monitored. MUST makes sure that any patient who is at risk of malnutrition is highlighted and action can be taken to treat.