Methods for Providing Nutritional Care - NUT 33 PDF

# Methods for providing nutritional care - NUT 33 ## Nutrition Care Process (NCP) - **Assessment** - **Monitoring & Evaluation** - **Diagnosis** - **Intervention** **Prof. Dr. Hala Khattab** ## What is the Nutrition Care Process? The Nutrition Care Process, also known as the NCP, as defined by...

# Methods for providing nutritional care - NUT 33 ## Nutrition Care Process (NCP) - **Assessment** - **Monitoring & Evaluation** - **Diagnosis** - **Intervention** **Prof. Dr. Hala Khattab** ## What is the Nutrition Care Process? The Nutrition Care Process, also known as the NCP, as defined by the Academy of Nutrition and Dietetics, it is: "Systematic approach to providing high-quality nutrition care". The NCP provides the structure for customized care to be the most efficient plan for each patient. **Prof. Dr. Hala Khattab** ## The NCP is designed to: 1. Improve the regularity and quality of individualized care for patients/clients or groups. 2. 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. **Prof. Dr. Hala Khattab** ## Steps of NCP Four separate interrelated steps. - Step 1: Nutrition Assessment - Step 2: Nutrition Diagnosis - Step 3: Nutrition Intervention - Step 4: Nutrition Monitoring and Evaluation **Prof. Dr. Hala Khattab** ## A.D.I.M.E ### Nutrition Care Process - **A:** assessment - BMI, 40, 7 SDS for wt., sat. recall - **D:** Nutrition diagnosis - "Overweight" - **I:** intervention - **M:** monitor - Wt., sat. intake - **E:** evaluate - Follow pt. records 3-4 wks **Prof. Dr. Hala Khattab** ## Step 1: Nutrition Assessment **A.D.I.M.E** It is a systematic approach to collect, classify, and synthesize important and relevant data needed to identify nutrition-related problems and their causes. This step also includes reassessment for comparing and re-evaluating data from the previous interaction to the next, as well as collection of new data that may lead to new or revised nutrition diagnoses based on the client's status or situation. ## The assessment is an ongoing, dynamic process that involves initial data collection and continual reassessment and analysis of the client's status compared to accepted standards, recommendations, and/or goals. The collected data includes dietary, medical, health, social, medication, supplemental or herbal history, physical, anthropometrics, and laboratory. **Prof. Dr. Hala Khattab** ## The purpose is to make professional judgment about nutrition status, and this is the basis of NCP. Data collected during the nutrition assessment guides in selection of the appropriate nutrition diagnosis(es) (i.e., naming the specific problem). **Prof. Dr. Hala Khattab** ## Assessment ABCD's ### Anthropometrics Physical measurements that can be compared to standards in order to reveal the nutritional status, growth, and health of an individual. The Ht., Wt., age, and gender are commonly used. Others? This data provides the means to establish energy, protein, and fluid intake. **Prof. Dr. Hala Khattab** ### Biochemical Tests and procedures that may include Na, K, BUN, Creat, Gluc, total Chol, LDL-chol, Alb,... or others. ### Clinical Physical exam conducted on the patient. This exam is used to assess everything from eyesight and reflexes to movement on the body and medical history. **Prof. Dr. Hala Khattab** ### Dietary Dietary reports begin with a 24 hrs. recalls on what the patient has consumed. This assessment may include: - Questionnaires - Surveys - Worksheets... and more in order to obtain an accurate amount of food-related history from the patient. **Prof. Dr. Hala Khattab** ## A.D.I.M.E ## Step 2: Nutrition Diagnosis It is a nutrition specialist or dietitian's identification and labeling of an existing nutrition problem(s) that the practitioner is responsible for treating. 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 nutrition professional. **Prof. Dr. Hala Khattab** ## Categories - **Intake**: Too much or too little of a food or nutrient compared to actual or estimated needs. Ex. excess energy intake (NI). - **Clinical**: Nutrition problems that relate to medical or physical conditions. ex. difficulty swallowing (NC) - **Behavioral**: Knowledge, attitudes, beliefs, physical environment, access to food, or safety ex. disordered eating pattern (NB). **Prof. Dr. Hala Khattab** ## PES Statement - Names the nutrition problem (P). - Identifies its cause (or etiology) (E) - Lists the assessment data (signs and symptoms) (S) that justify the problem. **Prof. Dr. Hala Khattab** ## Problem (P). Etiology (E). Signs and symptoms (S) Written as: Nutrition diagnosis term "related to" etiology "as evidenced by" signs and symptoms of the nutrition diagnosis. ex: In obese client: Excess energy intake related to food and nutrition-related knowledge deficit as evidenced by patient's/ client's food selections as recorded on food diary. **Prof. Dr. Hala Khattab** ## A.D.I.M.E ## Step 3: Nutrition Intervention It is an intentionally planned action(s) designed with the intent of changing the nutrition-related behavior, risk factor, environmental condition, or aspect of health status to resolve or improve the identified nutrition diagnosis(es) or nutrition problem(s). Nutrition interventions are selected and personalized to the client needs by planning and implementing appropriate interventions. Its aim to alleviate the signs and symptoms of the diagnosis. ## The intervention is the purposeful action aim to improve the condition of the patient's nutrition diagnosis. Interventions include "nutrition education," and "nutrition counseling." ## Goals must be: - Measurable. - Realistically. - Attainable. - Personalized. - Related to PES statements. - Has a time frame. In order to create association throughout the NCP. **Prof. Dr. Hala Khattab** ## A.D.I.M.E ## Step 4:. Monitoring & Evaluation Nutrition monitoring and evaluation identifies outcomes/ indicators relevant to the diagnosis and nutrition intervention plans and goals. Determine if the patient/client has achieved or is making progress toward the planned goals. **Prof. Dr. Hala Khattab** ## 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. **Prof. Dr. Hala Khattab** ## Monitoring & Evaluation: 3 Components - **Monitoring**: Provide evidence that the nutrition intervention is changing/not changing patients behavior or status? - **Measuring**: Measure outcomes by collecting data on nutrition outcomes indicators. - **Evaluating**: Compare current findings to intervention goals/reference standards and EVALUATE overall impact. Decide to discontinue or continue counseling. ## 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. - Continue to measure in order to assess progress. **Prof. Dr. Hala Khattab** ## Evaluation - Compare new data to old. - Compare the obtained results to the desired goals. - Assess whether goals are being obtained. - Assess whether goals are truly helping to improve the health of the patient. If not, discuss alternatives. **Prof. Dr. Hala Khattab** ## If patient/client reveals another new assessment data/information, That will cause the re-assess, re-diagnose and perhaps modify the plan that had started discussing with the client. **Prof. Dr. Hala Khattab** ## Don't forget... - Monitor Progress. - Measure Outcome. - Evaluate Outcomes. - Document **Prof. Dr. Hala Khattab**