Diagnosing Malnutrition

British Association for Parenteral and Enteral Nutrition (BAPEN) has developed a quick to use screening tool called MUST (Malnutrition Universal Screening Tool) to identify those at risk of malnutrition:

MUST (Malnutrition Universal Screening Tool) :

MUST has been designed to identify adults, especially elderly people, who are:

  • Malnourished
  • At risk of malnutrition (undernutrition)
  • Obese

MUST also includes management guidelines which can be used to develop a care plan. It is a five-step tool for use in hospitals, community and other health care centers and can be used by all health care workers to identify those at risk from malnutrition.

MUST 5-step plan:

  • Step 1 - Measure height and weight to get a BMI (body mass index) score.
  • Step 2 - Note percentage unplanned weight loss and score.
  • Step 3 - Establish acute disease (any underlying illness, such as a psychological condition) effect and score.
  • Step 4 - Add scores from steps 1, 2 and 3 together to obtain overall risk of malnutrition.
  • Step 5 - Use management guidelines and/or local policy to develop care plan.

MUST is only used for identifying malnutrition or risk of malnutrition in adults. It is not designed to identify deficiencies/excesses in vitamin and/or mineral intake.

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