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Nutrition
Therapy

Nutrition Care Process
...


Nutrition Care Process:
A systematic problem solving method that food and nutrition professionals use to think
critically and make decisions that address practice related problems
...
It helps in evaluation a patient’s condition and thus providing
results accordingly
...
It improves the
consistency and quality of individualized patient/client care and the predictability of the
patient/client outcomes
...
It provide a standardized language source
...
Nutrition Assessment
...
Nutrition Diagnosis
...
Nutrition Intervention
...
Nutrition Monitoring and Evaluating
...
”
The data for nutrition assessment is obtained through:
I
...


II
...
g
...


III
...


IV
...


Client history: Include medication and supplement history, social history, medical/health
history, and personal history
...

o Determining the need for additional information
...

o Applying assessment tools in valid and reliable ways
...

o Distinguishing important from unimportant data
...

2) NUTRITION DIAGNOSIS:
Nutritional problem that the dietitian is responsible for treating
...
The problem or disease may
already exist, or may be at risk of occurring
...

i
...
Excessive carbohydrate intake resulting in elevated blood glucose levels
= nutrition diagnosis
...

Nutrition diagnosis is documented by writing a PES statement
...


(E) Etiology: Cause/Contributing risk factors linked to the nutrition diagnosis label by the
words

“related

to”

(S) Signs/Symptoms: Data used to determine that the patient has the nutrition diagnosis
specified
...
”
The

format

for

the

PES

statement

is:

“Nutrition problem label related to ___________ as evidenced by _____________
...


3

PES statements should be:
a) Clear and Concise
...

c) Focused on one problem at a time
...

e) Accessed through the signs and symptoms
...
His
HbA1C is, FBS is 300, and 24 hr recall shows patient’s diet is high in refined carbohydrates,
patient has never received nutrition education on T2 DM management / Carbohydrate counting
...
5% and
FBS of 300
...
, he is unable to prepare meals for himself,
has unintended weight loss of 15 lbs
...
He has no interest in eating
...

Inadequate oral intake related to lack of interest in eating as evidenced by reported intake less
than 75% of estimated requirements
...

Inadequate oral intake related to inability to consume sufficient calories as evidenced by report
of nausea, vomiting, and pain
...


4

The three general domains of Nutrition diagnosis are as follow:
i
...

o Composed of five categories:
o Energy balance
...

o Fluid intake
...

o Nutrient

ii
...

o Biochemical
o Weight

iii
...

o Composed of three categories:
o Knowledge and beliefs
...

o Food safety and access
...

Final goal is to modify an individual, a specific group, or a community’s nutrition behavior
...


Selecting

II
...


Implementing

5

Purpose: To resolve or improve the nutrition diagnosis or nutrition problem by provision
of:
Advice
Education
Delivery of the food component of a specific diet or meal plan tailored to the
patient/client’s needs
...

The
nutrition
intervention
chosen
is
based
by
the
nutrition diagnosis and uses:
Team involvement
Science based principles
Additional research, if available
...

Long-term interventions:
Determine readiness for change
Emphasize what to eat, rather than what not to eat
Suggest only 1-2 changes at a time
Nutrition education: Should be tailored to
o Person’s age
o Level of literacy
o Cultural background
NUTRITION INTERVENTION STRATEGIES:
o Food and/or Nutrient Delivery
o Nutrition Education
o Nutrition Counseling
6

PLANNING THE NUTRITION INTERVENTION:
o Prioritize nutrition diagnoses
o Consult AND’s EBNPG
o Determine patient-focused expected outcomes
o Confer with family members/caregivers
o Define nutrition plan and strategies
STEPS OF NUTRITION INTERVENTION:
The plan of action will be based on the patient's diagnosis:
o Select the appropriate strategy based on the problem
o Discuss the intervention to the patient (include family)
o Explain the plan (i
...
nutrition education)
o Schedule of care (program duration follow-ups)
o Additional materials, documentations, financial/food resources
IMPLEMENTATION:
Is the action phase and involves:
o Communication of the nutrition care plan
o Carrying out the plan
...
These are accurate, timely, and applicable records
Scrutiny of patient’s file should include:
o Date and time
o Goals and outcomes
o Plan’s adjustments
o Patient’s receptiveness
o Resources and referrals
o Follow-ups (observe progress) and frequency
o Discharge (if applicable)
TYPES OF INTERVENTIONS:
o Behavioral interventions: Focus on the adjustment of personal practices and habits
...

o Regulatory interventions: Are those aimed at regulating certain nutrition-related activities
or actions which have an impact on nutrition and health outcomes
...

4) NUTRITION MONITORING AND EVALUATION:
The critical steps that defines the outcomes specific of nutrition care:
o Overlapping between nutrition assessment, monitoring and evaluation terminology
(except client history)
...

The purpose is to:
o To determine whether progress made is related to the patient’s nutrition intervention goals
and/or desired outcomes
...

o To evaluate nutrition care outcomes
...


Relationship between MONITORING, INTERVENTION & NCP
...

o Measuring outcomes by using from the nutrition care indicators
...

TO EVALUATE:
Determine proper indicator/measures
Determine suitable data for comparison
Determine

the

process

why

the

of

the

clients

relating

to

expected

outcomes
Determine

patient

outcomes

are

different

from

the

expected outcomes
Determine issues that assist or hamper improvement
Determine

how

long

a

patient

care
HEALTH CARE OUTCOME:
Patient outcomes
o Improved nutrition intake
o Changes in physical signs and symptoms
o Increases patients quality of life
Health & disease outcomes
o Prevention or maintenance of health
o Changes in knowledge
o Changes in severity, duration of disease
Cost outcomes
o Decreased cost to health care system
o Length of hospital stay
o Outpatient visits
o Procedures
o Medication and equipment used

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