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Malnutrition Universal Screening Tool
‘MUST’ is a five-step screening tool to identify adults, who are malnourished, at risk of malnutrition
(undernutrition), or obese. It also includes management guidelines which can be used to develop
a care plan.
It is for use in hospitals, community and other care settings and can be used
by all care workers.
This guide contains:
A flow chart showing the 5 steps to use for screening and management
BMI chart
Weight loss tables
Alternative measurements when BMI cannot be obtained by measuring weight and height.
Please refer to The ‘MUST’ Explanatory Booklet for more information when weight and height cannot be measured, and
when screening patient groups in which extra care in interpretation is needed (e.g. those with fluid disturbances,
plaster casts, amputations, critical illness and pregnant or lactating women). The booklet can also be used for training.
See The ‘MUST’ Report for supporting evidence. Please note that ‘MUST’ has not been designed to detect
deficiencies or excessive intakes of vitamins and minerals and is of use only in adults.
The 5 MUST Steps
Step 1
Measure height and weight to get a BMI score using chart provided. If unable to obtain
height and weight, use the alternative procedures shown in this guide.
Step 2
Note percentage unplanned weight loss and score using tables provided.
Step 3
Establish acute disease effect and score.
Step 4
Add scores from steps 1, 2 and 3 together to obtain overall risk of malnutrition.
Step 5
Use management guidelines and/or local policy to develop care plan.
Malnutrition Advisory Group
A Standing Committee of BAPEN
AGMalnutrition Universal Screening Tool
B A P E N
Advancing Clinical Nutrition
MUST
BAPEN is registered charity number 1023927 .uk
? BAPEN
Step 1 – BMI score ( BMI)
Height (feet and inches)
W
eight
(stones
and
pounds)
W
ei
gh
t
(k
g)
Height (m)
Note : The black lines denote the exact cut off points ( 30,20 and 18.5 kg/m2), figures on the chart have been rounded to the nearest whole number.
? BAPEN
Step 1
BM
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