Nursing staff must:

• listen to patients, their relatives and carers
• understand how ageing affects nutritional needs
• understand how illness and medication affect appetite and nutritional needs
• become food aware, meals are just as important as medication
• assess patients for signs or risk of malnourishment in health and social care settings and in the community
• assess skin integrity on admission and at regular intervals
• work with the patient, families and members of the MDT to address malnutrition
• ensure that the appropriate diet is being provided in health and social care settings
• provide advice and support to families and carers about diet
• make sure mealtimes are protected.

Seeking advice from specialist colleagues is important as appropriate.

NICE has produced guidance to help health professionals identify those who are malnourished, or at risk of malnutrition.

BAPEN e-Learning Portal: A range of free e-Learning modules with case studies covering malnutrition, nutrition support and nutritional screening using ‘MUST’.

There are certain groups of people who are at higher risk of malnutrition, such as those living with chronic conditions, those with mental health needs and those who are approaching the end of life.

Those undergoing major surgery or having experienced trauma may also be at risk.

Signs and effects of malnutrition may include:

• unplanned or unexplained weight loss
• feeling tired, lacking energy
• an increased risk of illnesses or infections
• poor concentration
• difficulty keeping warm
• low mood/depression
• having a BMI under 18.5
• reduced/weaker muscle and tissue mass
• risk of pressure ulcer development 
• delayed wound healing
• decreased mobility and stamina
• increased respiratory difficulties
• poor libido (sex drive) and fertility problems
• increased chance in developing post-operative complications.