Evaluation of adherence to a nutrition-screening programme over a 5-year period

BACKGROUND: Nutrition screening using the Malnutrition Universal Screening Tool (MUST) was implemented for adult patients in 2006. The aim of this study was to assess adherence to the screening programme over a 5-year period after a targeted approach to training ward staff. SUBJECTS/METHODS: Following the implementation of MUST on 32 wards, regular audits were carried out. Data on completion rates at ward level were collected by nutrition link nurses and submitted electronically for collation. RESULTS: Data on MUST were collected on a total of 17 876 patients during this period. Mean percentage of patients screened with a moderate or high risk of malnutrition was 19% in those screened within 24 h after admission and 28% in those screened at 7 days. Twenty percent of patients had an uncompleted MUST score at 24 h after admission and 15% were uncompleted after 7 inpatient days. After implementation, half the hospital population were being screened on admission. However, a number of wards were neither reporting the data nor completing the screening process. Following targeted training on wards, screening rates improved in 2009 and the number of patients screened improved as ward engagement increased. CONCLUSION: Audit has been fundamental in the implementation of MUST and has allowed training, additional time and educational resources to be allocated to specific wards to facilitate improvements in screening. Lead nurse support and monitoring has improved adherence rates and facilitated an increase in the identification of patients at moderate and high risk of malnutrition.