Tools to identify adults at risk of malnutrition

Adults at risk of malnutrition are defined as those who: National Institute for Clinical Excellence (NICE), 2006

• have eaten little or nothing for more than 5 days, or are likely to eat little or nothing for the next 5 days or more
• have poor absorptive capacity, high nutrient losses or increased nutritional needs (eg due to catabolism).

The risk of malnutrition is increased in patients with:

• chronic disease (eg dementia, chronic obstructive pulmonary disease, cancer, inflammatory bowel disease, and other gastrointestinal, kidney or liver disease)
• eating disorders
• debility (eg immobility, frailty, depression)
• social issues (eg poverty, social isolation, inability to cook or shop)
• excessively strict and inflexible diets.

Adults at risk of malnutrition can be identified using a validated screening tool such as the Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), or short-form Mini Nutritional Assessment (MNA-SF) tool. These screening tools are available from the Victorian health department website.

All patients admitted to hospital or a residential care facility should be screened for risk of malnutrition and, if found to be at risk, referred to an accredited practising dietitian for assessment and managementNational Institute for Clinical Excellence (NICE), 2006.