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Introduction Malnutrition Assessing malnutrition - MUST Treatment of malnutrition ◦Food first approach ◦Practical examples Appropriate use of oral nutritional supplements Malnutrition A common clinical and public health problem, affecting all ages and all care settings Definition: ‘ A state in which a deficiency of nutrients such as energy, protein, vitamins and minerals causes measurable adverse effects on body composition, function or clinical outcome’ NICE [CG32]– Nutritional Support for Adults, February 2006 Those at risk of malnutrition: Sick, frail and elderly Cancer, Stroke Acute/chronic pain Chronic respiratory disorders, i.e. COPD Poor dentitian Clinical consequences include: Reduced muscle strength Impaired wound healing Longer recovery from illness/surgery Poorer clinical outcomes More frequent GP visits and hospital admissions Facts In 2010, 34% of hospital in-patients on admission were medium/high risk of malnutrition 93% of those at risk from malnutrition, live in the community Malnutrition costs £13b per year and affects at least 2 million people in the UK Effective and regular screening to identify malnutrition or risk of malnutrition is essential Tackling malnutrition can improve nutritional status, clinical outcomes and reduce health care use BAPEN, 2010 Malnutrition Universal Screening Tool (‘MUST’) What is ‘MUST’? ◦A five-step malnutrition screening tool for adults in hospital and the community, including care homes, outpatient clinics and general practice What does ‘MUST’ do? ◦Identify those who may be malnourished or at risk of malnutrition MUST Score of: 0 – low risk 1 – medium risk 2 or above – high risk
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