This assignment will discuss a trust adapted version of the Malnutrition Universal Screening Tool (MUST). It will demonstrate an understanding of theoretical knowledge used to develop the assessment tool. The assignment will focus on three components within the tool; discussing the reliability and validity when used in a clinical environment. A reflection of my own experience using the tool will be included and linked to aspects of reliability. Any issues with reliability will be identified and suggestions given on how they can be corrected to aid future use.
MUST is a five-step screening tool designed for healthcare professionals to identify adult patients who at risk of, or are malnourished. It includes guidelines on how to develop an effective treatment plan. The Malnutrition Advisory Group (MAG) in 2000 adapted and extended their community screening tool to include care homes and hospitals, in response to national concerns. (Department of Health, 2001). In 2003 MUST was designed by MAG and the British Association for Parenteral and Enteral Nutrition (BAPEN). It was piloted across many care settings, to target patients who may be at risk of malnutrition.
I have chosen this tool as it is widely used in healthcare; however malnutrition is often unrecognised and mismanaged. According BAPEN some three million people in the UK are at risk or are malnourished. Malnutrition can affect a patient physically, mentally and can also increase recovery time (Zellipour, & Stratton, 2005). This assignment will help me understand the theory and rationale behind the development of the MUST.
The first component of the MUST involves measuring the patient’s height and weight to establish their Body Mass Index (BMI). BMI is the’ relationship between weight and height that is associated with body fat and health risks’ (Bumgardner 2008). BMI gives an idea into the health risks associated with being a certain height for your weight; however it does not take into account the persons, age, frame size or muscularity. (Jeukendrup & Gleeson 2005).
BMI provides some indication as to the patient’s nutritional status. A low BMI is associated with inadequate nutritional intake; this occurs when there is a deficiency or imbalance in the nutrients consumed, which can lead to malnutrition. (Lennard-Jones,1992). However some patients may have a normal or high BMI and be classed as malnourished. This can be because they have a low intake of nutrients such as vitamins and protein, or because they may be consuming the wrong type of foods (Ward and Rollins, 1999).
There are three main ways that malnutrition can occur, either through impaired absorption, impaired nutritional intake or an increased metabolic demand. (Cartwright & Williams, 2002).
BMI cannot differentiate between body fat and muscle mass. This often results in misleading information with regard to the amount of fat in the individual, as muscle is denser than fat. (British Heart Foundation 2009). Meaning...