This Nutrition Assessment Audit has been developed to assist with the implementation and ongoing monitoring of MUST assessments in Healthcare.
A MUST assessment is a Malnutrition Universal Screening Tool and has been developed to help identify and manage patients at risk of malnutrition in all areas of healthcare.
The Nutrition audit software has been developed with reference to the following best practice guidance and research:
- Universal Screening Tool' ('MUST') for Adults.
- Department of Health and Children (2009) Food and Nutritional Care in Hospitals; Guidelines for Preventing Under-Nutrition in Acute Hospitals. IHI (2015) How to Improve.
- Langley et al (2009) The Improvement Guide, A Practical Approach to Enhancing Organisational Performance. 2nd ed: Jossey-Bass, San Francisco.
- NICE (2012) Nutrition Support in Adults Quality.
- Quality standard 24
- NICE (2006) Nutrition Support for Adults Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition. Guideline 32.
- Russell C. A. & Elia M. (2012) Nutrition Screening Survey in the UK and Republic of Ireland in 2011.
- Malnutrition screening using "MUST": A brief guide for improving HSE (2016)
Patients care plan is individualised to their risks including risk of Malnutrition based on a recent MUST score.
Nutrition Assessment in Hospitals
MUST malnutrition assessments are an essential component of safe patient care.
Without an audit of compliance with Malnutrion assessments, gaps in practice can be missed and patient's can be at risk of weight loss and reduced nutritional intake.
This is especially true following stroke and major surgery.
Nutrition in Care Homes
Residents of care homes and nursing homes also require Malnutrition Assessments to ensure their care is individualised to their risks including risk of Malnutrition based on a recent MUST score.
According to the MUST assessment (Malnutrition Universal Screening Tool) the following actions are recommended based on the result of the assessment.
LOW MUST score - Routine care
- Provide Routine clinical care
- Repeat MUST screening:
- Hospital – weekly
- Care Homes – monthly
- Community – annually for special groups e.g. those >75 years
MEDIUM MUST Score - Observe
- Document dietary intake for 3 days
- If adequate –repeat screening:
- Hospital – weekly
- Care Home – at least monthly
- Community – at least every 2-3 months
- If inadequate – treat as per HIGH MUST Score
HIGH MUST SCORE – Treat
- Refer to dietitian, Nutritional Support Team and/or implement local policy
- Set goals, improve and increase overall nutritional intake
- Monitor and review care plan
- Hospital – weekly
- Care Home – monthly
- Community – monthly
This Paper based audit software, specifically designed to enable easy and efficient monitoring of Nutrition status is also audit software to purchase as a combined Nutrition and Hydration Audit system.
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