malnutrition screening tool (mst)

Tool and Resource Evaluation Template Adapted by NARI from an evaluation template created by Melbourne Health.

Some questions may not be applicable to every tool and resource. Name and purpose Name of the resource: Malnutrition Screening Tool (MST)

Author(s) of the resource: M. Ferguson, S. Capra, J. Bauer, M. Banks.

Please state why the resource was developed and what gap it proposes to fill: This tool is designed to identify malnourished individuals and individuals at risk of malnutrition. It does not require any anthropometric measurement such as weight or calculation (body mass index, percent weight loss). Any health worker can use this screening tool. It has been demonstrated to be simple, quick, valid and reliable.

Target audience (the tool is to be used by)

Please check all that apply:

Health service users Carers

Medical staff Nursing staff Any member of an interdisciplinary team

Medical specialist, please specify:

Specific allied health staff, please specify:

Other, please specify:

Target population/setting (to be used on/in)

Is the resource targeted for a specific setting? Please check all that apply:

Emergency Department Inpatient acute Inpatient subacute Ambulatory


The MST was developed for use in acute adult hospital patients. It has also been validated for use in patients undergoing cancer treatments (radiotherapy, chemotherapy).

For which particular health service users would you use this resource (e.g. a person with suspected cognitive impairment)?

It is suitable for all adult inpatients, excluding maternity and psychiatry.

Structure of tool Website Education package Video

Pamphlet Assessment tool Screening tool

Methodology Resource guide Awareness raising resource (posters etc.)


Please state the size of the resource (e.g. number of pages, minutes to read):

The MST is one page in length, with three questions. It takes approximately 30 seconds to read.

Availability and cost of tool

Is the resource readily available? Yes No Unknown Not applicable

Is there a cost for the resource? Yes No Unknown Not applicable

Please state how to get the resource:

Provided below:

Malnutrition Screening Tool

It is also available on the internet at: http://www.health.qld.gov.au/patientsafety/pupp/documents/malsc.pdf

Applicability to rural settings and culturally and linguistically diverse populations

Is the resource suitable for use in rural health services (e.g. the necessary staff are usually available in rural settings)? Yes No Unknown Not applicable

Is the resource available in different languages?

Yes No Unknown Not applicable

Is the content appropriate for different cultural groups?

Yes No Unknown Not applicable Must be able to speak English

Person-centred principles

Does the resource adhere to/promote person-centred health care?


Training requirements

Is additional training necessary to use the resource?


If applicable, please state how extensive any training is, and what resources are required:

Administration details

How long does the resource take to use? 0-5 mins 5-15 mins 15-25mins 25mins + Can the resource be used as a standalone, or must it be used in conjunction with other tools, resources, and procedures?

Standalone

Must be used with other resources, please specify: A positive result (score > 2) indicates further expert assessment by a dietitian.

Can be used with other tools, please specify:

Data collection and analysis

Are additional resources required to collect and analyse data from the resource?


If applicable, please state any special resources required (e.g. computer software):

Sensitivity and specificity

Has the sensitivity and specificity of the resource been reported? Yes No Unknown Not applicable

If applicable, please state what has been reported: The sensitivity has been reported as 93% (95% CI 84 98%) and the specificity 93% (95% CI 90-95%).

Face Validity Does the resource appear to meet the intended purpose? Yes No Unknown Not applicable

Reliability Has the reliability of the resource been reported?

Yes No Unknown Not applicable If applicable, please state what has been reported: Inter-rater reliability reported to be between 90-97%.

Strengths What are the strengths of the resource? Is the resource easy to understand and use? Are instructions provided on how to use the resource? Is the resource visually well presented (images, colour, font type/ size)? Does the resource use older friendly terminology (where relevant), avoiding jargon? Please state any other known strengths, using dot points:

Quick & simple Free Sensitive & high level of inter-rater reliability Can be used by any health professional Does not require any anthropometrical or biochemical measurements

Limitations What are the limitations of the tool/resource? Is the tool/resource difficult to understand and use? Are instructions provided on how to use the tool/resource? Is the tool/resource poorly presented (images, colour, font type/ size)? Does the tool/resource use difficult to understand jargon? Please state any other known limitations, using dot points:

Difficult to use in patients with communication difficulties such as delirium, dementia, hearing impairments or of non English-speaking backgrounds

Not specifically designed for the older, sub-acute population

References and further reading

Supporting references and associated reading.

1. Ferguson M et al. Development of a valid and reliable malnutrition screening tool for adult acute hospital patients. Nutrition 1999; Vol 15, No 6: 458-464.

2. Van Veenrooij et al. Quick-and-easy nutritional screening tools to detect disease-related

undernutrition in hospital in- and outpatient settings: A systematic review of sensitivity and specificity. Clinical Nutrition 2007; Vol 2: 21-37.

3. Isenring I et al. Validity of the Malnutrition Screening tool as an effective predictor of

nutritional risk in oncology outpatients receiving chemotherapy. Supportive Care in Cancer 2006. Vol 14, No 11: 1152-1156.

MalnutritionIs your patient at risk?

1. Have you / the patient lost weight recently without trying?

No 0

Unsure 2

Yes, how much (kg)?

1 5 1

6 10 2

11 15 3

> 15 4

Unsure 2

2.Have you / the patient been eating poorly because ofa decreased appetite?

No 0

Yes 1

Total Score

References: 1. Ferguson M, et al. Nutrition 1999;15:458-464. 2. Banks M, et al. Malnutrition and Pressure Ulcers in Queensland Hospitals. Proceedings of 22nd National DAA Conference,Melbourne 2004. Abbott Australasia Pty Ltd. ABN 95 000 180 389. Captain Cook Drive, Kurnell NSW 2231. Ph 1800 225 311. TM Trademark. The Health Agency NUT001:04/04.

If your patients have lost weight and / or are eating poorly they may be at risk

of malnutrition i.e. score 2 or more

1. Refer to Malnutrition Action Flowchart and / or refer toDietitian for full assessment and intervention

2. Document

3. Weigh patients on admission and: (a) weekly (acute)(b) monthly (long-term care)

4. Rescreen patients: (a) weekly (acute)(b) monthly (long-term care)

Small weight losses weekly add up to significant weight lossand malnutrition

Note: Overweight / obese patients who have unexplained weight loss andillness can become protein depleted / malnourished too

Action

Malnutrition Screening Tool 1

Applies tothe last

6 months

Of weight lossand appetite

questions

If unsure, ask if they suspect

they have lost weight e.g. clothes are looser

For example,less than 3/4

of usual intake

May also beeating poorly

due to chewingand swallowing

problems

Malnutrition occurs

in approximately

30-35% of acute

and 40-45%

of residential

patients in

Queensland

Health

Institutions2

N U T R I T I O N

Developed by Merrilyn Banks, APD with assistance from Abbott

The Makers of Ensure

NUT001 14/5/04 10:23 AM Page 1

Tool and Resource Evaluation Template Name and purposeTarget audience(the tool is to beused by)Targetpopulation/setting(to be used on/in)Structure of toolAvailability andcost of toolApplicability torural settings andculturally andlinguisticallydiversepopulationsPerson-centredprinciplesTrainingrequirementsAdministrationdetailsData collection andanalysisSensitivity andspecificityFace ValidityReliabilityStrengthsLimitationsReferences andfurther reading

Malnutrition Screening Tool

malnutrition screening tool (mst)

Documents