Nutrition Lab Nutri Care Process
Nutrition Lab Nutri Care Process
Nutrition Lab Nutri Care Process
PROCESS
Nutrition Laboratory
Relationship
Between
Patient/Client/Group Nutrition Intervention
& Dietetics Plan nutrition intervention
Professional Formulate goals and
determine a plan of action
Implement the nutrition intervention
Nutrition Monitoring and Care is delivered and actions
-
Evaluation are carried out
Monitor progress Document
Measure outcome indicators
Evaluate outcomes
Document
Outcomes
Management System
Monitor the success of the Nutrition Care
Process implementation
Evaluate the impact with aggregate data
Identify and analyze causes of less than
optimal performance and outcomes
Refine the use of the Nutrition Care
Process
HOW DO FOOD AND NUTRITION
PROFESSIONALS DETERMINE WHERE TO
OBTAIN NUTRITION ASSESSMENT DATA?
• For individuals:
– Patient/client through interview
– Observation and measurements
– Medical records
– Referring health care provider
• For population groups:
– Data from surveys
– Administrative data sets
– Epidemiological or research studies
Nutrition Care Process Snapshot NCP step 1: Assessment www.eatright.or
Nutrition Care Process Steps
• Nutrition Assessment
• Nutrition Diagnosis
• Nutrition Intervention
• Nutrition Monitoring and Evaluation
Nutrition Assessment (Definition)
• Nutrition Assessment
• Nutrition Diagnosis
• Nutrition Intervention
• Nutrition Monitoring and Evaluation
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.
Nutrition Dx Domains: Intake
Defined as “actual problems related to
intake of energy, nutrients, fluids, bioactive
substances through oral diet or nutrition
support (enteral or parenteral nutrition)
• Class: Calorie energy balance
• Class: Oral or nutrition support intake
• Class: Fluid intake balance
• Class: Bioactive substances balance
• Class: Nutrient balance
Nutrition Dx Domains: Clinical
Defined as “nutritional findings/problems identified
that relate to medical or physical conditions
• Class: functional balance (change in physical or
mechanical functioning with nutritional
consequences)
• Class: Biochemical balance: change in capacity
to metabolize nutrients as a result of
medications, surgery, or as indicated by altered
lab values
• Class: weight balance: chronic weight or
changed weight status when compared with
usual or desired body weight
Nutrition Dx Domains:
Behavioral-Environmental
Defined as “nutritional findings/problems
identified that relate to knowledge,
attitudes/beliefs, physical encironment, or
access to food and food safety
• Class: knowledge and beliefs
• Class: physical activity, balance and
function
• Class: food safety and access
Nutrition Diagnosis Components
• Signs/Symptoms (Defining
characteristics)
– Evidence that problem exists
– Linked to etiology by words “as
evidenced by”
Nutrition Diagnosis Components
• Etiology (Cause/Contributing Factors)
– Excessive calorie intake (problem) “related
to” regular consumption of large portions
of high-fat meals (etiology) as evidenced
by diet history and weight status
– Swallowing difficulty (problem) related to
stroke (etiology) as evidenced by coughing
following drinking of thin liquids (signs and
symptoms)
Nutrition Diagnosis
• Nutrition Assessment
• Nutrition Diagnosis
• Nutrition Intervention
• Nutrition Monitoring and Evaluation
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
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
Intervention Objectives
• Nutrition Assessment
• Nutrition Diagnosis
• Nutrition Intervention
• Nutrition Monitoring and Evaluation
Nutrition Monitoring &
Evaluation Components
Evaluate outcomes
Compare current findings
with previous status,
intervention goals, and/or
reference standards
What gets Measured?
Nutrition
Monitoring
and Evaluation
Types of Outcomes