Pp132-Sun Choice of Nutrition Screening Tool and Continuity of Care

Russell, Christine; Oldale, C.; Elia, M.

doi:10.1016/s1744-1161(11)70186-7

Cited by 8 publications

(11 citation statements)

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“…This study indicates the feasibility of self-screening by using MUST-the most widely used validated nutrition screening tool in hospitals, mental health units, and care homes across several countries with different health care systems (Scotland, Northern Ireland, Wales, England, and Republic of Ireland) (22,23,27,28). The study suggests that outpatients were able to self-screen by using a patient-friendly version of MUST, with minimal instruction from the HCP.…”

Section: Discussionmentioning

confidence: 82%

“…There is a lack of information about self-administration of validated screening instruments that incorporate objective measurements, such as weight or BMI. An example of a validated screening tool that incorporates such measurements is the Malnutrition Universal Screening Tool (MUST) (5), which is the most commonly used screening tool in several countries with different health care systems (8,22,23). MUST is based on 3 criteria: BMI, unintentional weight loss, and the effect that acute disease can have in abolishing oral nutritional intake over .5 d. Because selfscreening with MUST has not been explored previously, this study aimed to investigate the practicalities of implementing patient self-screening in busy hospital outpatient clinics.…”

Section: Introductionmentioning

confidence: 99%

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Malnutrition self-screening by using MUST in hospital outpatients: validity, reliability, and ease of use

Cawood¹,

Elia²,

Sharp³

et al. 2012

The American Journal of Clinical Nutrition

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Background: Although nutritional screening with a tool such as the Malnutrition Universal Screening Tool (MUST) is recommended for outpatients, staff are under pressure to undertake a variety of other tasks. Little attention has been paid to the validity of patient self-screening with MUST.Objective: This study in 205 outpatients with a mean (6SD) age of 55 6 17 y (56% male) assessed the practicalities of self-screening, its agreement with screening undertaken by a trained health care professional (HCP), and its test-retest reliability. Design: After the participants provided consent, screening was undertaken by the patients themselves and then by a trained HCP who was unaware of the self-screening results. All patients completed an ease-of-use questionnaire. Test-retest reliability of self-screening was established in a subset of 60 patients. Results: A total of 19.6% of patients categorized themselves as "at risk" of malnutrition (9.8% medium, 9.8% high). For the 3-category classification of MUST (low, medium, high), agreement between self-screening and HCP screening was 90% (k = 0.70; SE = 0.058, P , 0.001). For the 2-category classification (low risk, medium + high risk), agreement was 93% (k = 0.78, SE = 0.057, P , 0.001). Disagreements were not systematically under-or overcategorized. Test-retest reliability was almost perfect (k = 0.94, P , 0.001). Most patients (71%) completed self-screening in ,5 min. Patients found the tool easy or very easy to understand (96%) and complete (98%), with 94% reporting that they were happy to screen themselves. Conclusion: Self-screening involving MUST in outpatients is acceptable to patients, user-friendly, reliable, and associated with good agreement with HCP screening. This trial was registered at clinicaltrials.gov as NCT00714324.Am J Clin Nutr 2012;96:

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Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Malnutrition self-screening by using MUST in hospital outpatients: validity, reliability, and ease of use

Cawood¹,

Elia²,

Sharp³

et al. 2012

The American Journal of Clinical Nutrition

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“…Multinational studies report that 34%–39% of hospital inpatients aged over 65 years are at risk of malnutrition. 1 2 Further deterioration in dietary intake during a hospital admission may increase malnutrition risk, affecting up to 60% of older people. 3 Malnutrition is expensive 4 as it is associated with poor healthcare outcomes including increased hospital admissions, longer length of stay and increased mortality.…”

Section: Introductionmentioning

confidence: 99%

Can trained volunteers improve the mealtime care of older hospital patients? An implementation study in one English hospital

et al. 2018

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ObjectiveMultinational studies report undernutrition among 39% older inpatients; importantly, malnutrition risk may further increase while in hospital. Contributory factors include insufficient mealtime assistance from time-pressured hospital staff. A pilot study showed trained volunteers could safely improve mealtime care. This study evaluates the wider implementation of a mealtime assistance programme.DesignMixed methods prospective quasi-experimental study.SettingNine wards across Medicine for Older People (MOP), Acute Medical Unit, Orthopaedics and Adult Medicine departments in one English hospital.ParticipantsPatients, volunteers, ward staff.InterventionVolunteers trained to help patients aged ≥70 years at weekday lunchtime and evening meals.Main outcome measuresThe number of volunteers recruited, trained and their activity was recorded. Barriers and enablers to the intervention were explored through interviews and focus groups with patients, ward staff and volunteers. The total cost of the programme was evaluated.Results65 volunteers (52 female) helped at 846 meals (median eight/volunteer, range 2–109). The mix of ages (17–77 years) and employment status enabled lunch and evening mealtimes to be covered. Feeding patients was the most common activity volunteers performed, comprising 56% of volunteer interactions on MOP and 34%–35% in other departments. Patients and nurses universally valued the volunteers, who were skilled at encouraging reluctant eaters. Training was seen as essential by volunteers, patients and staff. The volunteers released potential costs of clinical time equivalent to a saving of £27.04/patient/day of healthcare assistant time or £45.04 of newly qualified nurse time above their training costs during the study.ConclusionsPatients in all departments had a high level of need for mealtime assistance. Trained volunteers were highly valued by patients and staff. The programme was cost-saving releasing valuable nursing time.Trial registration numberNCT02229019; Pre-results.

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“…Nutritional screening, which may involve different criteria within and between care settings, can be regarded as the first step in the management of malnutrition. The Malnutrition Universal Screening Tool ('MUST'), the most commonly used malnutrition screening tool in both hospital and community settings in the UK (8)(9)(10) , is based on three criteria: BMI, unintentional weight loss and an effect of acute disease preventing oral nutritional intake (>5 d). In the first paper to examine the feasibility of self-screening with 'MUST' our group reported that the procedure is acceptable to patients, is user-friendly, reliable and has good agreement with healthcare professional (HCP) screening (11) .…”

mentioning

confidence: 99%

‘Self-screening’ for malnutrition with an electronic version of the Malnutrition Universal Screening Tool (‘MUST’) in hospital outpatients: concurrent validity, preference and ease of use

et al. 2018

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Self-screening using an electronic version of the Malnutrition Universal Screening Tool ('MUST') has been developed but its implementation requires investigation. A total of 100 outpatients (mean age 50 (sd 16) years; 57 % male) self-screened with an electronic version of 'MUST' and were then screened by a healthcare professional (HCP) to assess concurrent validity. Ease of use, time to self-screen and prevalence of malnutrition were also assessed. A further twenty outpatients (mean age 54 (sd 15) years; 55 % male) examined preference between self- screening with paper and electronic versions of 'MUST'. For the three-category classification of 'MUST' (low, medium and high risk), agreement between electronic self-screening and HCP screening was 94 % (κ=0·74, se 0·092; P<0·001). For the two-category classification (low risk; medium+high risk) agreement was 96 % (κ=0·82, se 0·085; P<0·001), comparable with the previously reported paper-based self-screening. In all, 15 % of patients categorised themselves 'at risk' of malnutrition (5 % medium, 10 % high). Electronic self-screening took 3 min (sd 1·2 min), 40 % faster than previously reported for the paper-based version. Patients found the tool easy or very easy to understand (99 %) and complete (98 %). Patients that assessed both tools found the electronic tool easier to complete (65 %) and preferred it (55 %) to the paper version. Electronic self-screening using 'MUST' in a heterogeneous group of hospital outpatients is acceptable, user-friendly and has 'substantial to almost-perfect' agreement with HCP screening. The electronic format appears to be as agreeable and often the preferred format when compared with the validated paper-based 'MUST' self-screening tool.

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Pp132-Sun Choice of Nutrition Screening Tool and Continuity of Care

Cited by 8 publications

References 0 publications

Malnutrition self-screening by using MUST in hospital outpatients: validity, reliability, and ease of use

Malnutrition self-screening by using MUST in hospital outpatients: validity, reliability, and ease of use

Can trained volunteers improve the mealtime care of older hospital patients? An implementation study in one English hospital

‘Self-screening’ for malnutrition with an electronic version of the Malnutrition Universal Screening Tool (‘MUST’) in hospital outpatients: concurrent validity, preference and ease of use

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