MUST, MNA, & Nutrition Risk Score Free PDF of Validated Nutrition Screens
- Samantha
- Feb 1
- 3 min read
Updated: Feb 3
Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional risk screening and assessment. Journal of Clinical Medicine. 2019;8(7):1065. doi:10.3390/jcm8071065
This journal article published in The Journal of Clinical Medicine describes the initial nutrition assessment process : screening adult patients for risk of malnutrition.
The MUST, MNA, & the Nutrition Risk Score are all acceptable initial nutrition assessment tools that TJC (The Joint Commission) accepts for the mandatory at risk of malnutrition screen that needs to be completed within 24 hrs of inpatient admission in American healthcare facilities. If the patient screens at risk of malnutrition or being already malnourished, TJC states that an initial nutrition assessment and nutrition care plan must be completed by a RDN/RD within 48 hrs of the patient screening for being at risk of malnutrition.
This published article from 2019 is a great resource for any RDN/RD working at an inpatient facility accepting admissions. If an inpatient scores less than 3 points of the MUST screen then the nutrition screen can be repeated weekly and recorded in the patient's electronic chart records as a follow-up note and can be used for audits. Having evidence that a clinical team has been compliant to following inpatient standards of charting for malnutrition screening/documentation can help an inpatient facility make a better impression during a Joint Commission inspection.
An example of a follow-up note for an inpatient that initially scored < 3 points on the MUST ( not at risk of malnutrition ) is :
2 follow-up note examples
Patient still not at risk of malnutrition - One week after admission after initially screening not at risk of malnutrition, patient's newest MUST screen evaluated _______ (date) is 2 points which means the patient is currently not at risk of malnutrition. Follow-up MUST screen to be completed the week of ________ (date - first Monday of the week).
Patient at risk of malnutrition - One week after admission after initially screening not at risk of malnutrition, patient's newest MUST screen evaluated ______ (date) is 6 points which means the patient is currently at risk of developing malnutrition in the inpatient facility. An Initial Nutrition Assessment and a Nutrition Care Plan will be generated by a RDN/RD within the next 2 days. Upon follow-up RDN will evaluate current patient weights and conduct a NFPE to assess both recent wt loss & subcutaneous fat/muscle reserves.
These RDN charting notes utilizing malnutrition screening tools will make a good impression on TJC inspectors.
To save paper, these 3 screens can be printed in this publication and then placed in a sheet protector. Whenever the screen is being used on an inpatient, the RDN/RD can use an expo marker to evaluate the patient's score then erase the expo marker after the score has been recorded in the facilities electronic medical records system. This is also a more HIPAA friendly way of conducting a nutrition screen because each inpatient does not generate a medical document that needs to be shredded.
The Commission on Dietetic Registration (CDR) & the Academy of Nutrition and Dietetics Evidence Analysis Library (EAL) recognize several validated tools to evaluate the risk of malnutrition in pediatric nutrition assessment :
PNST (Pediatric Nutrition Screening Tool): A simple 4-question screen for hospitalized children that assesses recent weight loss and poor weight gain.
STRONGkids (Screening Tool for Risk on Nutritional Status and Growth): Often favored for its speed and high sensitivity; it evaluates high-risk diseases, nutritional intake, and weight loss.
STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics): A three-step tool (diagnosis, intake, and growth percentiles) primarily for hospitalized children aged 2–17.
PYMS (Paediatric Yorkhill Malnutrition Score): Known for its high specificity, it assesses BMI, recent weight loss, and the effect of current condition on future intake.
SGNA (Subjective Global Nutritional Assessment): While highly accurate and comprehensive (including a physical exam), it is often considered an assessment tool rather than a quick screen.
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