NHD CPD eArticle
Volume 7.18 - 2nd November 2017
Stoke Mandeville Hospital (SMH) currently uses MUST which should be completed within 24 hours of admission . . . and which identifies patients at risk of undernutrition and who might benefit from nutrition support either with or without input from a dietitian. poor physical status. We know that in both the under- and overweight, malnutrition and loss of weight are associated with falls, increased infection risk, worse surgical outcomes and loss of independence. Primarily through the work of BAPEN, it is no surprise to fellow dietitians that malnutrition is often unrecognised and untreated in hospitals (both in- and out-patients), nursing homes and in the community. This is a great cause for concern for healthcare professionals, national organisations and colleges, UK government departments, and the Council of Europe. Nutritional screening, which is the focus of this article, refers to a rapid, general, often initial evaluation undertaken by nurses, medical or other staff, to detect significant risk of malnutrition and to implement a clear plan of action, such as simple dietary measures, or referral for expert advice.1 NICE advises that there are conflicting views on the value of nutritional screening in any setting, and there is no clear evidence as to whether screening in primary care or the wider community is really beneficial, or how it should be carried out - a Guideline Development Group (GDG) is taking this forward.3 In the meantime, and mindful of my remit to reduce undernutrition
risk to BHT patients, accurate nutritional screening was always going to be a big part of my plan. However, I am too encouraged and grateful for the key role that other ‘nutrition savvy’ health professionals play in helping to identify suitable patients. My REACT colleagues in all disciplines have proved helpful and supportive by encouraging MUST screening, but also simply by promoting excellent communication about a patient’s background, weight, and oral intake and sharing this appropriately in MDT and ward meetings. MUST IN BUCKINGHAMSHIRE HEALTHCARE
Stoke Mandeville Hospital (SMH) currently uses MUST which should be completed within 24 hours of admission, following Buckinghamshire Healthcare NHS Trust (BHT) policy and which identifies patients at risk of undernutrition who might benefit from nutrition support either with or without input from a dietitian. BHT process is that dietitians are only asked to see patients with scores of 2 or more who have ongoing weight loss, and/ or who are more complex patients, e.g. with dysphagia, diabetes or other diagnoses, though in practice many more are referred.
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