Malnutrition Universal Screening Tool (MUST)
Back to Nursing Essentials Crib Cards
‘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 bapen.org.uk