Examining The Reliability Of Malnutrition Universal Screening Tool Nursing Essay


This essay will be looking at the malnutrition universal screening tool in relation to validity and reliability. This assessment tool is designed to identify whether adult patients are malnourished, at potential risk of malnutrition (undernutrition) or those that are obese. It also includes management guidelines which can be used to develop a care plan. (BAPEN, 2003)

The authors’ rationale for choosing to discuss this particular tool is to find out more information on the tool itself to enhance their personal development. Also to identify whether there are any weaknesses found in any of the components of the tool which could affect the reliability of the tool as it is used in various clinical settings. She has come across this tool during clinical placements; some of the components of the tool may lack sensitivity and specificity which could result in inaccurate results.

The essay will consist of a brief history of the assessment tool, its development, the client group it is used for and where it is used. This will be followed by brief definitions of validity and reliability. The main focus will be on validity and reliability of the tool itself, whether it accurately measures what it is designed to find and if the information found is a valid set of findings.

Then the author will give their own reflection on when she has used the tool while in a clinical setting, followed by a brief summary of the overall essay. Finally to conclude she will summarise by stating whether she feels that it is an effective assessment tool in relation to the evidence based findings.

History of the Tool

The MUST tool was developed by the Malnutrition Advisory Group (MAG) who are the standing committee of Bapen (British Association of Parenteral and Enteral Nutrition). Bapen was formed after the King’s Fund Centre produced the report ‘A Positive Approach to Nutrition as a Treatment’ (King’s Fund, 1992) which was designed for the multidisciplinary team which outlined the importance of nutrition in hospitals. ‘MUST (Appendix 1.1) is a screening tool that has been devised for application to all adult patients across all health care settings. (Elia, 2003)

Malnutrition adversely affects physical and psychological function (Elisa, 2000; Stratton et al. 2003b) and impairs patients’ recovery from disease and injury, thereby increasing morbidity and mortality. According to (Bapen, 2003) it affects 18%-10% of patients attending out patient clinics and GP surgeries and between 20-60% of hospital admissions be medical, surgical, elderly and orthopaedic wards.

In busy clinical settings malnutrition can go unnoticed ‘thousands of patients are starved’ (Florence Nightingale, 1859) therefore this assessment tool has been designed to identify if adult patients are at risk or are malnourished, so appropriate medical interventions can be implemented if required and care plans can be formulated. It is designed to increase recovery and decreases diseases; GP visits and the period patients are in hospital. It is used for adults in healthcare settings such as hospitals, care homes and in the community, also those with eating disorders, mental health problems and critically ill patients.

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