Nutritional assessment in elderly care: a MUST!

Area of Science:

• Clinical Nutrition
• Healthcare Auditing
• Patient Outcomes

Background:

• Malnutrition impacts over 3 million people in the UK, costing over £13 billion annually.
• Hospitalized malnourished patients face increased complications, morbidity, mortality, readmissions, and longer stays.
• The malnutrition universal screening tool (MUST) is vital for identifying at-risk patients.

Purpose of the Study:

• To audit the documentation and accuracy of malnutrition universal screening tool (MUST) scores in an elderly care ward.
• To assess the implementation of nutritional interventions following MUST screening.
• To identify areas for improvement in the malnutrition screening and intervention process.

Main Methods:

• Three audits were conducted between May and November 2013 on an elderly care ward at Watford General Hospital.
• Malnutrition universal screening tool (MUST) scores documented in nursing notes were recorded and independently recalculated.
• Nutritional interventions documented in patient records were reviewed.

Main Results:

• Inconsistent documentation and incorrect calculation of MUST scores were identified, often due to BMI errors or unknown historical weights.
• High-risk MUST scores were not consistently acted upon with appropriate interventions.
• Interventions included nurse training and collaboration with the dietitian department, leading to improved MUST score documentation (73% to 97%) and dietitian referrals (62% to 86%).

Conclusions:

• Accurate and consistent malnutrition screening using the MUST tool is essential for improving patient care and reducing healthcare costs.
• Regular audits, staff training, and interdisciplinary collaboration are key to effective malnutrition management.
• Implementing targeted interventions based on MUST scores significantly enhances patient outcomes and resource utilization.