Food First - Protocols

Protocols For The Management Of Malnutrition

Inpatients

All Adult In-Patients - Acute or Planned Admissions

(excluding maternity, paediatrics, renal, ITU, day cases and overnight stays)

Complete a MUST assessment

MUST score of 2 or more = High Risk

• Document result on Nursing Care Plan.
• Check if dietetic referral has been completed by pre-assessment clinic
• If not refer to dietitian and inform medical staff
• Record daily oral intake on food record chart
• Encourage small frequent meals and snacks
• Repeat MUST screen weekly as a monitoring tool

MUST score of 1 = Medium Risk

• Document result on Nursing Care Plan.
• Inform medical staff
• Record daily oral intake on food record chart
• Encourage small frequent meals and snacks
• Repeat MUST screen weekly
• Refer to dietitian if: MUST score deteriorates or oral intake poor

MUST score of 0 = Low risk

Routine clinical care

• Document result on Nursing Care Plan
• Repeat MUST screen weekly

Pre-assessment Clinic - Planned Admissions (Excluding day cases and overnight stays)

Complete a MUST assessment

MUST score of 2 or more = High Risk

• refer to dietitian. Send completed form to SLH dietetic department
• Offer the diet sheet 'Eating  With a Small Appetite' available from Dietetic department ext. 5033
• Record referral in medical notes

MUST score of 1 = Medium Risk

• Offer the diet sheet 'Eating  With a Small Appetite' available from Dietetic department ext. 5033
• If for referral then reccommend referral to dietitian once admitted.
• Record concern in medical notes

MUST score of 0 = Low risk

Routine clinical care

If BMI > 30 or BMI>27 with comorbidity and MUST = O then

• inform Primary care
• Give first line advice sheet 'Lose weight feel great'
  
• encourage access to local services e.g. commercial slimming groups or GP referral to local dietitian