The Malnutrition Universal Screening Tool (MUST) is frequently cited as a simple screening tool for malnutrition. However, anecdotally, it seems that not all staff find it simple to use. If staff do not find MUST simple to complete, then screening is less likely to be completed accurately. Accurate completion of MUST is essential for malnutrition to be identified and treated, otherwise the nutritional needs of patients with unrecognised malnutrition may be neglected. The use of simplified versions of body mass index score, weight loss score and ulna-length charts together with ongoing training and support may help to improve accurate MUST completion. Audit of MUST completion must consider the accuracy of completion rather than completion alone. Therefore, those auditing MUST completion require a good understanding of the tool. This article draws on the author's own significant experience with applying the MUST tool and synthesises this with evidence from the literature to demonstrate the potential barriers to effective MUST implementation.

Alison Smith - Prescribing Support Dietitian, Medicines Management Team, Aylesbury Vale CCG and Chiltern CCG; Nutrition Advisory Group for Older People (NAGE), British Dietetic Association