19. Nutrition Intervention Planning.pptx

This ppt help in nutrition interventions

1. Nutrition Intervention Planning

2. Basis for nutritional interventions Diet is one of the most important and modifiable life-style determinants of human health. Under-nutrition and over-nutrition play a role in morbidity and mortality and therefore nutritional interventions are needed to reduce morbidity and mortality through dietary change. They can be implemented at an individual, local, or national level for example through policy.

3. Levels of Intervention Nutrition education needs to develop programs at several levels of intervention

4. 1. Individual level or intrapersonal level: Focusing on the psychobiological core of experience with food, food preferences and enjoyment of food, beliefs, attitudes, values, knowledge, social and cultural norms or life experience.

5. 2. Interpersonal level: Focusing on family, friends, peers, interactions with health professionals, social roles and social networks.

6. Focusing on the rules, policies and informal structures in workplaces, schools or religious and social organizations to which individuals belong . 3. Institutional/organizational level:

7. Focusing on social networks, norms and community expectations, grocery stores or restaurants. 4. Community level:

8. Focusing on policies and structure that regulate health actions. 5. Social structure, policy and system level:

9. Stages of nutrition intervention Primary prevention: Nutrition intervention that precedes the onset or diagnosis of a disease is called primary prevention

10. Secondary prevention: Nutrition programs that are implemented after a diagnosis as a result of services given to a target group are called secondary prevention or secondary intervention.

11. Tertiary care: Nutrition programs provided to an individual or group after disease symptoms appear and the disease expresses itself with increasing morbidity and pending mortality are known as tertiary care. Tertiary care or intervention is an attempt to offset early mortality.

12. Examples of nutritional interventions include: Education campaigns to improve knowledge and attitudes e.g. 5 a day campaign and Traffic Light food labelling. Supplementation and food fortification to increase consumption e.g. fortification of salt with iodine and bread/flour with folate or other micronutrients, and fluoridation of water. 

13. Contd. Collaboration with food manufacturers to reduce the salt, sugar or fat content of foods . National Healthy Schools Programme (NHSP) - more than 95% of schools nationally are now involved in the programme and over 60% of schools have achieved National Healthy Schools Status

14. Steps to develop community based nutrition programs Community assessment Priorities, goals and objectives The nutrition plan Implementation Monitoring and evaluation

15. NUTRITION CARE PROCESS (NCP)

16. The Nutrition Care Process (NCP) The nutrition care process (NCP) is designed to improve the consistency and quality of individualized care for patients/clients or groups and the predictability of the patient/client outcomes. It is not intended to standardize nutrition care for each patient/client, but to establish a standardized process for providing care. 

17. CONTD. There are four steps in the process : Nutrition Assessment Nutrition Diagnosis Nutrition Intervention Nutrition Monitoring and Evaluation

18. Relationship Between Patient/Client/Group & Dietetics Professional - Nutrition Diagnosis Ø Identify and label problem Ø Determine cause/contributing risk factors Ø Cluster signs and symptoms/ defining characteristics Nutrition Assessment Ø Obtain/collect timely and appropriate data Ø Analyze/interpret with evidence - based standards Ø Ø Identify risk factors Ø Use appropriate tools and methods Ø Involve interdisciplinary collaboration Screening & Referral System Outcomes Management Sys tem Ø Monitor the success of the Nutrition Care Process implementation Ø Evaluate the impact with aggregate data Ø Identify and analyze causes of less than optimal performance and outcomes Ø Refine the use of the Nutrition Care Process ADA NUTRITION CARE PROCESS AND MODEL Ø Document Nutrition Monitoring and Evaluation Ø Monitor progress Ø Measure outcome indicators Ø Evaluate outcomes Ø Document Nutrition Intervention Ø Plan nutrition intervention · Formulate goals and determine a plan of action Ø Implement the nutrition intervention · Care is delivered and actions are carried out Ø Documen t Document

19. Nutrition Assessment (Definition) “A systematic process of obtaining, verifying, and interpreting data in order to make decisions about the nature and cause of nutrition-related problems .” Lacey and Pritchett, JADA 2003;103:1061-1072.

20. Nutrition Assessment Components Gather data, considering Dietary intake Nutrition related consequences of health and disease condition Psycho-social, functional, and behavioral factors Knowledge, readiness, and potential for change Compare to relevant standards Identify possible problem areas

21. Nutrition Assessment: Critical Thinking Observing verbal and non-verbal cues to guide interviewing methods Determining appropriate data to collect Selecting assessment tools and procedures and applying in valid and reliable ways Distinguishing relevant from irrelevant data Organizing data to relate to nutrition problems Determining when problems require referral

22. Nutrition Care Process Steps Nutrition Assessment Nutrition Diagnosis Nutrition Intervention Nutrition Monitoring and Evaluation

23. Nutrition Diagnosis Nutritional problem that the dietitian is responsible for treating Names and describes the problem Problem may already exist, or may be at risk of occurring Not a medical diagnosis Type 2 diabetes = medical diagnosis Excessive carbohydrate intake resulting in elevated blood glucose levels = nutrition diagnosis.

24. Nutrition Diagnosis Components Problem (Diagnostic Label) Etiology (Cause/contributing risk factors) Signs/Symptoms (Defining characteristics) Signs = objective data = observable, measurable changes Symptoms = subjective data = changes pt feels and expresses

25. CONTD. Problem (Diagnostic Label) Describes alterations in pt’s nutritional status Diagnostic labels Impaired (nutrient utilization…) Altered (GI function…) Inadequate/excessive (calorie intake…) Inappropriate (intake of types of carbohydrate) Swallowing difficulty

26. Etiology (Cause/Contributing Factors) Related factors that contribute to problem Identifies cause of the problem Helps determine whether nutrition intervention will improve problem Linked to problem by words “related to” (RT ) Note: etiology may not always be clear CONTD.

27. Signs/Symptoms (Defining characteristics) Evidence that problem exists Linked to etiology by words “as evidenced by” CONTD.

28. Nutrition Diagnosis Components Food, nutrition and nutrition-related knowledge deficit (P) R/T lack of education on infant feeding practices (E) as evidenced by infant receiving bedtime juice in a bottle (S ) Altered GI function R/T ileal resection (E) as evidenced by medical history and dumping syndrome symptoms after meals (S)

29. Nutrition Diagnosis Components Nutrition Diagnosis Statement should be: clear, concise specific related to one problem accurate – related to one etiology based on reliable, accurate assessment data

30. Nutrition Care Process Steps Nutrition Assessment Nutrition Diagnosis Nutrition Intervention Nutrition Monitoring and Evaluation

31. Nutrition Intervention Definition “Purposely-planned actions designed with the intent of changing a nutrition-related behavior, risk factor, environmental condition, or aspect of health status for an individual, a target group, or population at large.” – Lacey and Pritchett, JADA 2003;103:1061-1072 Directed at the etiology or effects of a diagnosis

32. Intervention Objectives Should be patient-centered Must be achievable Stated in behavioral terms, quantifiable terms Pt and counselor must establish goals together may involve other members of health care team What will the patient do or achieve if objectives met

33. Intervention Objectives Problem 1: Involuntary weight loss Objectives: 1. Pt will stop losing wt and begin to gain wt slowly, to a target wt of 145# 2. Pt will modify his diet to increase intake to meet calorie and protein needs

34. Problem 2: Inadequate protein-energy intake AND poor appetite Objectives: 1. Pt will attend senior center for lunch daily to improve socialization and calorie intake 2. Pt will include nutrient-dense foods in his diet Intervention Objectives

35. Nutrition Intervention Intervention translates assessment data into strategies, activities, or interventions that will enable the patient or client to meet the established objectives . Interventions should be specific: — What? —When? —Where? —How?

36. Nutrition Intervention Problem 1: Involuntary Weight loss Intervention: Pt will try to eat three meals a day plus bedtime snack Pt will include at least one nutrient-dense supplement per day in his diet Pt will increase energy intake to 1800 kcal per day, complete 3-day food record for analysis of adequacy

37. Problem 2: Inadequate protein-calorie intake AND poor appetite Intervention: Pt will include nutrient-dense foods with meals, especially when appetite is minimal Patient will begin meal with nutrient-dense foods, follow with others Pt will attend senior center for lunch daily to improve socialization/appetite Nutrition Intervention

38. Nutrition Care Process Steps Nutrition Assessment Nutrition Diagnosis Nutrition Intervention Nutrition Monitoring and Evaluation

39. Nutrition Monitoring & Evaluation Components Evaluate outcomes Compare current findings with previous status, intervention goals, and/or reference standards

40. What gets Measured? Nutrition Monitoring and Evaluation Types of Outcomes End-result outcome Direct nutrition outcomes Clinical and health status outcomes Patient/client-centered outcomes Healthcare utilization Intermediate-result outcome

41. Nutrition Goals and Objectives Are necessary in order to evaluate the effectiveness of nutrition care Should be achievable and based on scientific evidence Should be directly or indirectly related to nutrition care

42. REFERENCES https:// www.powershow.com/view/3e4462-YWNkM/The_Nutrition_Care_Process_powerpoint_ppt_presentation?varnishcache=1 Gibney M.J., Margetts B.M., Kearney J.M. and Arab L. Public Health Nutrition. The Nutrition Society. Lewis, G. Sheringham , J. Kalim , K. Crayford , T. (2008) Mastering Public Health: A postgraduate guide to examinations and revalidation. The Royal Society of Medicine Press Limited.