Malnutrition Universal Screening Tool (MUST)

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‘MUST’ is a five-step tool to identify adults who are at risk of malnutrition and includes guidelines to develop a care plan.

1. Measure height and weight to get a BMI score. Use the ‘MUST’ BMI charts or calculate as follows: BMI= weight (kg)/height (m)2 >20 (>30 obese) = score 0, 18.5 - 20 = score 1 <18.5 = score 2.

2. Calculate the score for percentage unplanned weight loss in last 3-6 months: <5% = score 0, 5-10% = score 1, >10% = score 2.

3. Calculate the score for effect of acute disease: If the patient is acutely ill AND there is likely to be or has been no nutritional intake for >5 days = score 2.

4. Calculate overall risk of malnutrition by adding together scores from steps 1, 2 and 3: low risk = score 0, medium risk = score 1 high risk = score 2 or more.

5. Develop a care plan using ‘MUST’ guidelines or local policy

Management guidelines

2 or more = High risk

(i) Refer to dietitian/nutrition support team according to local policy.

(ii) Set goals to improve overall nutritional intake.

(iii) Monitor/review care plan: if in hospital – minimum weekly; care home – monthly; community – monthly.

1= Medium risk

(i) Document dietary intake for 3 days.

(ii) See (ii) and (iii) above.

0 = Low risk

(i) Repeat screening according to local policy. If in hospital – minimum weekly; care home – monthly; community – annually if > 75 years.

For further information and e-learning module on nutritional screening using ‘MUST’ see