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An audit to evaluate the effect of staff training on the use of Malnutrition Universal Screening Tool

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Malnutrition is common in hospitalized adults and it is associated with adverse hospital outcomes. Patients admitted to hospital should be routinely screened and monitored regularly (NICE, 2006). The Malnutrition Universal Screening Tool (MUST) (Elia, 2003) has been used for nutrition screening since 2004. A survey conducted 2005 showed that 54% of patient's records contained a completed MUST form. As a result regular training on nutritional screening for ward staff by dietitians was introduced. The aims of the present audit were to assess the current use of MUST in district general hospitals and to evaluate the effect of regular training for clinical staff on the use of the MUST tool. Methods: 

This audit was conducted during May and June 2007, at three hospital sites. The medical and dietetic notes of 432 patients, who had been admitted not <72 h previously, on 30 adult wards from all specialties, apart from a spinal injuries unit, were examined by dietitians and the presence of a correctly completed MUST form recorded. A Chi-squared test was used to compare the number of completed tools in 2005 with the number completed in 2007. Results: 

A completed MUST form was present in 67% (288) of patient's records. This was a significant (P < 0.001) increase compared with the audit conducted in 2005. The audit in 2005 found that 54% (212/392) of patient's records had a correctly completed MUST form. Discussion: 

There has been a significant improvementin the use of the MUST tool for malnutrition screening on adult wards in this trust. The introduction of training on the use of MUST for all clinical staff appears to have been effective in increasing the use of the MUST tool. Training is now included as a part of the trust mandatory training. Conclusions: 

Training of clinical staff in the use of the MUST tool is an effective method of increasing the tool's use. References 

Elia, M. (2003) Screening for Malnutrition: A multidisciplinary Responsibility. Development and Use of the Malnutrition Universal Screening Tool (MUST) for adults. BAPEN.

NICE. (2006) Nutrition Support in Adults: Oral nutrition support, enteral tube feeding and parenteral nutrition. Available at (accessed on 17 January 2008).
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Document Type: Research Article

Affiliations: 1: Department of Nutrition and Dietetics, Stoke Mandeville Hospital, Buckinghamshire Hospitals NHS Trust, Buckinghamshire, UK 2: Health and Emergency Professions, University of Hertfordshire, Hatfield, Herts, UK, Email: [email protected]

Publication date: 2008-08-01

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