Screening for Malnutrition
Malnutrition is a significant problem in the UK where around 3 million people are malnourished or at risk of malnutrition1. Many different factors can contribute to malnutrition, such as diseases that cause loss of appetite or feeling sick, mental health conditions (e.g. depression can affect desire to eat), if your body needs more energy or protein for recovery (e.g. healing after surgery), and physical and social factors (e.g. being socially isolated).2
Nutritional screening is the first-line process of identifying patients who are already malnourished or at risk of becoming so. It is a multidisciplinary responsibility. According to the NICE Clinical Guideline [CG32]3, healthcare professionals should screen:
- All hospital inpatients on admission
- All outpatients at their first appointments
- All people in care homes on admission
- All people on registration at GP surgeries and considered at other opportunities (for example health checks, flu injections)
- Upon clinical concern (e.g. if the person has unintentional weight loss, fragile skin, poor wound healing, apathy, wasted muscles, poor appetite, altered taste sensation, impaired swallow, altered bowel habit, loose fitting clothes or prolonged intercurrent illness)4
The ‘Malnutrition Universal Screening Tool (MUST)5 is a validated screening tool for use across settings to identify individuals who are malnourished or at risk of malnutrition.
Screening for Malnutrition using ‘MUST’ e-learning
Need help in screening your patients for malnutrition?
Nutricia are developing a free e-learning to support your knowledge of screening and managing malnutrition. To register your interest, please ensure you tick 'Frailty & Related Malnutrition' as one of your areas of interest within your profile.
After completing this module, you will understand:
- What is malnutrition
- The impact of malnutrition
- How to identify malnutrition - nutrition screening using 'MUST'
- How to manage malnutrition
- The range of ONS options available and how to tailor these to the patient’s needs and preferences
Malnutrition in different conditions
Malnutrition is highly prevalent in conditions such as dysphagia and COPD. Find out more in these e-learnings.
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- Elia M, Russell CA. Combatting malnutrition: Recommendations for action. Report from the advisory group on Malnutrition. Led by BAPEN. 2009.
- NHS, 2020. Malnutrition https://www.nhs.uk/conditions/malnutrition/causes/ [Accessed: April 2020]
- NICE, 2006. Nutrition Support in Adults CG32. Last review 2017. https://www.nice.org.uk/guidance/cg32 [Accessed: December 2020]
- NICE , 2012. Nutrition Support in Adults QS24. https://www.nice.org.uk/guidance/qs24/resources/nutrition-support-in-adults-pdf-2098545777349
- The ‘MUST’ toolkit. BAPEN. https://www.bapen.org.uk/screening-and-must/must/must-toolkit [Accessed: December 2020
- Carrión S, Roca M, Costa A, Arreola V, Ortega O, Palomera E, et al. Nutritional status of older patients with oropharyngeal dysphagia in a chronic versus an acute clinical situation. Clinical Nutrition. 2017;36(4):1110-6.
- Steer J, et al. Thorax 2010;65(Suppl 4):A127.
- Collins PF, et al. Clin Nutr. 2015;5(Suppl 2):17
- Ravosco, et al. J. Clin. Med. 2019; 8: 1211.
All products shown are Foods for Special Medical Purposes for the dietary management of disease related malnutrition and/or dysphagia and must be used under medical supervision.