Overall Risk of Malnutrition and Management Guidelines

Low risk Medium risk High risk

Routine clinical care

• Repeat screening Hospital - weekly Care homes - monthly Community - annually for special groups (e.g., those >75 y)

Observe

Document dietary intake for 3 days if subject in hospital or care home If improved or adequate intake, little clinical concern; if no improvement, clinical concern - follow local policy • Repeat screening Hospital - weekly Care home - at least monthly Community - at least every 2-3 months

* Unless detrimental or no benefit is expected from nutritional support e.g Record malnutrition risk category, presence of obesity and the need for

Treat*

Refer to dietitian, nutrition support team or implement local policy Improve and increase overall nutritional intake Monitor and review care plan Hospital - weekly Care home - monthly Community - monthly imminent death. special diets and follow total policy.

Figure 1 'Malnutrition Universal Screening Tool' (MUST). A copy of MUST and further details on taking alternative measurements, special circumstances, and subjective criteria can be downloaded at www.bapen.org.uk.

nutrition (PN)). The simplest and most commonly used treatment involves oral nutritional support, which is considered before home enteral tube feeding (HETF) and home parenteral nutrition (HPN).

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