Registered Nursing Home Association

NICE recommendations on screening


In February 2006, the National Institute for Health and Clinical Excellence (NICE) formally acknowledged the relevance and usefulness of the MUST screening tool developed three years earlier with support from the RNHA (click here to see a copy of the tool).


NICE recommended that older people being admitted to hospitals and care homes should be screened for possible signs of malnutrition. This is sound advice, says the RNHA, which encourages all nursing homes to make regular and systematic use of the MUST tool.

Figures quoted by NICE in 2006 confirmed that many individuals may already be suffering from various forms of malnutrition, including foliate and vitamin deficiency, before they go into hospital or a care home. As many as one in ten people among the over-65s in the community is considered to be at a medium to high risk of malnutrition. 

Assessing and documenting risk

For the RNHA, this underlines the critical importance of identifying and acting upon such risks at the earliest possible opportunity after a new patient has taken up residence in a nursing home. The association also recommends nursing homes to ensure that they fully document the outcomes of their risk assessments, including any unsuccessful attempts they may make to persuade an ‘at risk’ patient to accept essential nutritional support and intervention.


Support for community nutrition teams

The RNHA supports a proposal from NICE that community nutrition teams comprising dietitians, district nurses, care home staff and other relevant professionals should be established to provide a locally co-ordinated approach. The idea fits in well with the RNHA’s campaign for greater partnership working between the NHS and the independent sector in the care of older people.

Click here for a link to the NICE web site.








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