MALNUTRITION UNIVERSAL

SCREENING TOOL MUST

Nutrition screening tool should be completed on
admission and then weekly.
Patients Name:

Date of birth:

Date of admission:
Height (m):

NHS Number:

Normal Weight (kg) (Reported):

estimate / actual (please circle)

BMI :

For each section below circle one score

Date
Signature
Actual
Actual
Actual
Actual
Weight (kg) Actual

kg
kg
kg
kg
kg
Weekly BMI
Body mass index (BMI) kg/m2 - calculate from chart over page
20 or more
18.5 - 20
less than 18.5
If unable to obtain height and weight see `MUST` Explanatory booklet
for alternative measurement and use subjective criteria
Unplanned weight loss in the last 3-6 months - calculate from
tables over page
<5%
5-10%
>10%
Medical condition
If patient is acutely ill and there has been or is likely to be no
nutritional intake for >5 days score 2

0
1
2

0
1
2

0
1
2

0
1
2

0
1
2

0
1
2

0
1
2

0
1
2

0
1
2

0
1
2

Any patients commenced on NG/PEG/RIG/TPN Refer to Dietitian

Totals
0 = Low risk
Routine Clinical Care

Ensure adequate fluid intake
Offer advice on food and drink
choices
Offer help and advice with feeding
if needed
Use appropriate feeding aids if
required
Help with positioning, sit out / up for
meals
Weigh weekly, recalculate %
weight loss over the last 3 6
months and rescreen weekly
Document action taken in nursing
notes

Action
1 = Medium risk
Observe
Complete food and fluid chart for 3
days. If improved or adequate intake:
Little clinical concern, discontinue
food intake chart
Weigh weekly and repeat screen.
If inadequate intake or no improvement:
Encourage and assist to eat and
drink
Continue accurate food and fluid
intake chart daily
If patients managing less than
meals, offer non-prescribable
supplement drinks (Complan /
Build up) at least twice daily
Weigh weekly, recalculate %
weight loss over the last 3 6
months and rescreen weekly
Document action plan
Liaise with catering if patient
dislikes hospital food

2 or more = High risk

Treat
Follow action plan for medium risk
Refer to dietitian*
Weigh twice weekly, recalculate
% weight loss over the last 3 6
months and monitor
Document action taken in nursing
notes
*Unless detrimental or no benefit is
expected from nutritional support for
example end of life care pathway.
Referral to Dietitian (tick)
Date
Signature

This is a tool to assist your assessment. If in doubt use your professional judgement.
BAPEN does not necessarily support the use of any products in particular.

100
99
98
97
96
95
94
93
92
91
90
89
88
87
86
85
84
83
82
81
80
79
78
77
76
75
74
73
72
71
70
69
68
67
66
65
64
63
62
61
60
59
58
57
56
55
54
53
52
51
50
49
48
47
46
45
44
43
42
41
40
39
38
37
36
35
34

63

Height (m)

1.48 1.50 1.52 1.54 1.56 1.58 1.60 1.62 1.64 1.66 1.68 1.70 1.72 1.74 1.76 1.78 1.80 1.82 1.84 1.86 1.88 1.90

57 571/2 581/2 591/2 510 511 5111/2 601/2 61 62

Height (feet and inches)

4101/2 411 50 501/2 511/2 52 53 54 541/2 551/2 56

55

56

57

15 10
15 8
15 6
15 4
15 2
15 0
14 11
14 9
14 7
14 5
14 2
14 0
13 12
13 10
13 8
13 6
13 3
13 1
12 13
12 11
12 8
12 6
12 4
12 1
11 11
11 9
11 7
11 4
11 3
11 0
10 11
10 10
10 7
10 6
10 3
10 1
9 13
9 10
98
96
94
91
90
8 11
88
87
84
83
80
7 13
7 10
77
76
73
71
6 13
6 11
68
66
64
61
60
5 11
59

Step 2 Weight loss score

Weight before weight loss (st lb)

Note : The black lines denote the exact cut off points (30, 20 and 18.5 kg/m2), figures on the chart have been rounded to the nearest whole number.
The Malnutrition Universal Screening Tool MUST is reproduced here with the kind permission of BAPEN (British Association for Parenteral and Enteral Nutrition).
Further information on the MUST materials is available on the BAPEN website www.bapen.org.uk

Weight (kg)

Step 2 Weight loss score

Weight before weight loss (kg)

Step 1 BMI score (& BMI)

Weight (stones and pounds)