Nutrition Care Process (NCP).pptx

Nutrition Care Process is a systematic approach to providing high quality nutrition care.

1. N UTRITION C ARE P ROCESS SAS 2: N UTRITION C ARE P ROCESS

2. Nutrition Care Process is a systematic a pproach to providing high quality nutrition care.

3. Nutrition Care Process Four steps ( ADIME ): Nutrition A ssessment Nutrition D iagnosis Nutrition I ntervention Nutrition M onitoring/ E valuation

4. Nutrition Assessment The assessment is a dynamic and ongoing evaluation of data that includes medical, health, social, dietary, nutritional, medication, supplemental or herbal history, physical, anthropometrics, and laboratory. The purpose is to make professional judgement about nutrition status, and this is the foundation of nutrition care .

5. Nutrition Assessment Five domains (categories): Food/Nutrition Related History Anthropometric Measurements Biochemical Data, Medical Tests, and Procedures Medical Tests and Procedures Client History

6. Nutrition Assessment Food/Nutrition-related History  Intake, a dministration (oral/enteral nutrition/parenteral nutrition), i ntravenous fluid, m edication and herbal supplements, knowledge/beliefs/attitudes, s een by dietitian previously, behavior , meal-time behaviors , feeding difficulties, nutrition-related activities of daily living, nutrition-related quality of life, readiness to change, access to food, physical activity and function.

7. Nutrition Assessment Anthropometric Measurements Height, weight, weight history, BMI, growth pattern indices/percentile, hand-grip strength, mid-upper arm circumference, Subjective Global Assessment

8. Nutrition Assessment Biochemical Data, Medical Tests and Procedures Examples include laboratory data, fluid balance tests, gastric residual volume, resting metabolic rate

9. Nutrition Assessment Nutrition-Focused Physical Findings Muscle and subcutaneous fat wasting, oral health, cognition, bowels, pressure injury, vital signs, nutrition impact symptoms

10. Nutrition Assessment Client History Personal (age, language, literacy), medical, family and social history (housing, economic considerations), recent crisis, supports

11. Nutrition Diagnosis The purpose of the nutrition diagnosis it to identify and describe a specific nutrition problem that can be resolved or improved through treatment/nutrition intervention by a food and nutrition professional.

12. Nutrition Diagnosis Three ( 3 ) domains (categories): Intake Clinical Behavioral -Environmental

13. Nutrition Diagnosis INTAKE : Too much or too little of a food or nutrient compared to actual or estimated needs. Ex. Excessive Energy Intake [NI - 1.5]

14. Nutrition Diagnosis CLINICAL : Nutrition problems that relate to medical or physical conditions. Ex. Difficulty Swallowing [NC - 1.1]

15. Nutrition Diagnosis BEHAVIORAL-ENVIRONMENTAL : Knowledge, attitudes, beliefs, physical environment, access to food, or safety. Ex . Disordered Eating Pattern [NB - 1.5]

16. Nutrition Diagnosis P.E.S. Statement Names the nutrition problem (P) Identifies its cause (or etiology ) (E) Lists the assessment data ( signs and symptoms ) (S) that justify the problem.

17. Nutrition Diagnosis Written as: Nutrition diagnosis term “ related to ” etiology “ as evidenced by ” signs and symptoms of the nutrition diagnosis.

18. Nutrition Diagnosis Example: Inadequate energy intake related to food and nutrition-related knowledge deficit as evidenced by patient’s/ client’s food selections as recorded on food diary.

19. Nutrition Intervention The intervention is the purposeful action of the RD aimed at improving the condition of the patient’s nutrition diagnosis . They include interventions, such as, “nutrition related medication management,” “nutrition education,” “coordination of nutrition care,” and “nutrition counselling.”

20. Nutrition Intervention Goals must be: SMART Measurable/Realistically Attainable/Personalized Related to P.E.S. Statements in order to create unification throughout the NCP.

21. Nutrition Monitoring/Evaluation The purpose of nutrition and monitoring and evaluation is to determine and measure the amount of progress made for the nutrition intervention and whether the nutrition related goals/expected outcomes are being met.

22. Nutrition Monitoring : preplanned review and measurement of selected nutrition care indicators of patient/client’s status Nutrition Evaluation : the systematic comparison of current findings with the previous status

23. Nutrition Monitoring/Evaluation Three (3) components: Monitoring Measuring Evaluating

24. Monitoring : Provide evidence that the nutrition intervention is changing/not changing patients behavior or status. Measuring : Measure outcomes by collecting data on nutrition outcome indicators. Evaluating : Compare current findings to intervention goals/reference standards & EVALUATE overall impact.

25. MONITORING Ensure patient understands goals and their importance. Not doing it “just because”. Discuss problems, questions, and concerns with patients regarding goals. Adhering, Continue on path or Needs to change Continue to document, update data to patient’s file and continue to measure in order to assess progress.

26. EVALUATING Compare new data to old & Compare the obtained results to the desired goals. Assess whether goals are being obtained, and if they are truly helping to improve the health of the patient. If not, discuss alternatives .

27. Nutrition Monitoring/Evaluation Don’t forget… Monitor Progress Measure Outcome Evaluate Outcomes DOCUMENT

28. CHECK FOR UNDERSTANDING B C D A C

29. THAT’S ALL, THANK YOU.