What Exactly is the Malnutrition Screening Tool (MST)?
The Malnutrition Screening Tool (MST) is a simple, two-question screening tool used to identify the risk of malnutrition in adults. It is widely used in various healthcare settings, including hospitals and aged care facilities, due to its efficiency and reliability. The MST assesses risk based on two primary factors: unintentional weight loss and decreased appetite. By addressing these two key indicators, the tool provides a rapid, initial assessment of a patient's nutritional status, guiding healthcare professionals on the need for further, more comprehensive nutritional assessment. The MST is designed to be a quick and easy-to-use measure that helps catch potential nutritional problems early, before they lead to more severe health complications. The ultimate goal is to prompt timely intervention, which is essential for better patient outcomes and a quicker recovery.
Deciphering What is a Score of 3 on the Malnutrition Screening Tool
An MST score is the sum of points from two simple questions: one about recent unintentional weight loss and another about decreased appetite. The scoring system is as follows:
- Weight Loss:
- No unintentional weight loss: 0 points
- Unsure: 2 points
- Yes, how much? 1-5 kg (2-13 lbs): 1 point
- Yes, how much? 6-10 kg (14-23 lbs): 2 points
- Yes, how much? 11-15 kg (24-33 lbs): 3 points
- Yes, how much? 15+ kg (34+ lbs): 4 points
- Appetite:
- No decreased appetite: 0 points
- Yes, decreased appetite: 1 point
A score of 3 is a clear and direct indicator of a high risk of malnutrition. This score can be reached in several ways, such as a loss of 11-15 kg (24-33 lbs) in the last six months (scoring 3 points), or a combination of moderate weight loss (e.g., 6-10 kg) and a decreased appetite (scoring 2+1=3). Regardless of how the score is achieved, a 3 places the individual in the highest risk category, requiring immediate and significant nutritional intervention. This score is a serious alert for healthcare professionals that the individual's current nutritional intake and status are dangerously insufficient.
Health Implications of a High-Risk MST Score
Malnutrition, when left unaddressed, can lead to a host of serious health consequences. A high-risk MST score, such as a 3, is associated with various adverse outcomes.
- Reduced Immunity: Malnutrition weakens the immune system, making individuals more susceptible to infections and slower to recover.
- Increased Morbidity: High-risk patients are more likely to experience increased illness, longer hospital stays, and more complications from medical treatments or surgery.
- Impaired Wound Healing: Lack of essential nutrients, particularly protein, can significantly delay wound healing.
- Decreased Muscle Strength and Mobility: Involuntary weight loss often involves a significant reduction in muscle mass, leading to weakness, fatigue, and reduced mobility.
- Depression and Poor Concentration: Poor nutrition can affect mental health, contributing to low mood, sadness, depression, and poor concentration.
- Higher Mortality Risk: Studies have shown that patients with a higher MST score have a significantly increased risk of mortality.
Actionable Nutrition Diet Strategies for Intervention
For an individual with a high-risk MST score of 3, immediate action is crucial. A referral to a dietitian is a standard recommendation to develop a comprehensive nutrition care plan.
- Increase Energy and Protein Intake: The primary goal is to increase caloric and protein density in the diet. This can be achieved through fortified foods and snacks. The dietitian will tailor recommendations based on individual needs and preferences.
- Food Fortification: This involves adding high-energy and high-protein ingredients to everyday foods without significantly increasing portion size. Examples include:
- Adding milk powder or cheese to soups, mashed potatoes, and sauces.
- Stirring butter, margarine, or oil into cooked vegetables.
- Mixing high-energy ingredients like cream, honey, or peanut butter into puddings and milkshakes.
- Oral Nutrition Supplements (ONS): For those unable to meet their nutritional needs through diet alone, supplements like shakes, puddings, or powders can provide a concentrated source of calories and protein.
- Small, Frequent Meals and Snacks: For individuals with a decreased appetite, several smaller meals throughout the day can be less daunting than three large ones.
Malnutrition Screening Tool (MST) Score Comparison
| MST Score | Malnutrition Risk | Recommended Action |
|---|---|---|
| 0-1 | Low Risk | Routinely monitor weight and re-screen weekly if there is any change in health status. No immediate intervention is necessary. |
| 2 | Moderate Risk | Discuss weight and eating habits with a doctor or nurse. A dietitian referral is recommended, and nutrition interventions should be considered. |
| 3-5 | High Risk | Urgent referral to a dietitian. Rapidly implement nutritional intervention and perform a nutritional consult within 24-72 hours, depending on the severity of the risk. |
The Crucial Role of a Dietitian
When a high-risk score of 3 is identified, a dietitian is the key professional to guide the path to recovery. The dietitian will perform a comprehensive nutritional assessment that goes beyond the MST, incorporating clinical history, physical examination, and laboratory tests to understand the full picture of the individual’s nutritional status. A personalized nutrition care plan will then be developed, often including strategies for oral nutrition support, supplements, and dietary modifications. Dietitians are uniquely qualified to monitor progress and adjust interventions as needed to ensure the best possible outcome.
Conclusion
What is a score of 3 on the malnutrition screening tool? It is a critical warning sign of a high risk of malnutrition. This score requires swift and decisive action, including a mandatory referral to a dietitian for a comprehensive nutritional assessment and the implementation of a tailored dietary intervention plan. By understanding the implications of this score and following the necessary steps, it is possible to reverse the effects of malnutrition, promote better health, and improve overall quality of life. Regular monitoring and ongoing nutritional support are vital for a successful recovery journey.
Additional Guidance for High-Risk Malnutrition
Addressing the underlying causes of malnutrition is essential for sustained recovery. For individuals scoring 3 or higher, healthcare providers should work to address any physical or psychological issues contributing to the poor nutritional intake, such as pain, depression, or difficulty chewing and swallowing. Family involvement and support can also play a vital role in ensuring adherence to the nutrition plan. By focusing on both the nutritional and contributing factors, a more holistic and effective treatment plan can be established.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Please consult a qualified healthcare professional for personalized medical guidance.
