Jaafar, A.; Hawkyard, C.; Lapworth, K.; Davidson, B.; Ledger, J.; Wilkins, J.; Mansfield, J.; Thompson, N.P.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA11
Academic Journal
Introduction: Malnutrition is commonly found in hospital in-patients, with a frequency of up to 40%. Intervention studies suggest this is an independent and reversible prognostic factor. The MUST is a validated, simple tool enabling systematic identification of malnutrition. Aims: To establish whether patients were being screened for malnutrition before the introduction of a specific screening tool; then to assess the practicality and effect of introducing the MUST. Methods: All patients on eight wards (general medical, general surgery, care of the elderly, and orthopaedic) at two teaching hospitals were surveyed at one time-point. Patients' medical and nursing notes and bedside charts were examined. Demographic, nutritional status and dietetic referral details were recorded. The audit was repeated 2 months after the MUST was introduced to these eight wards. Results: In the first audit 172 patients were surveyed; mean age 68 years, 90 men, 111 medical/61 surgical, mean length of stay (LOS) 17 days. Sixty four (37%) had weights recorded, 6 (3%) had a BMI recorded, and 120 (70%) had comment about appetite made; 55 (31%) patients were referred to the dietetic service, 40% within 2 days of admission. In the second audit 173 patients were surveyed; mean age 66 years, 96 men, 99 medical/74 surgical, mean LOS 13 days; 103 (60%) had weights recorded, 125 (72%) had comment about appetite made; 62 (36%) had a BMI recorded (p < 0.001 compared to previously).Forty six (26%) patients were referred to the dietetic service, 44% within 2 days of admission. The MUST tool was used in 70 (40%) patients, in these patients the BMI was recorded in 89% patients and the dietetic referral rate was 56% compared with 11% where the MUST was not used (p < 0.001). Conclusions: Prior to the introduction of a specific screening tool patients' weight and BMI were rarely recorded. A pilot introduction of the MUST tool was partially successful and when used increased appropriate dietetic...


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