NUTRITION CARE PROCESS LECTURE - Google Docs.pdf
Document Details
University of Santo Tomas
2026
Tags
Full Transcript
UNIVERSITY OF SANTO TOMAS BS IN NUTRITION AND DIETETICS BATCH 2026 UTRITION CARE PROCESS (LECTURE) N PROF. AILYN MAE K. DEL RIO ADAPTED FROM:POWERPOI...
UNIVERSITY OF SANTO TOMAS BS IN NUTRITION AND DIETETICS BATCH 2026 UTRITION CARE PROCESS (LECTURE) N PROF. AILYN MAE K. DEL RIO ADAPTED FROM:POWERPOINT/LECTURE COURSE OUTLINE: PRELIMS rofessional competence of nutritionist-dietitians p through continuing professional development NIT 1&2:Introduction to Nutrition Care Process U UNIT 3:Nutrition Assessment UNIT 4:Nutrition Diagnosis DOH AO 2019-0033 uidelines on the implementation of NCP in G Hospitals Rationale: Republic Act No.10862 or the Nutrition andDieteticsLawof2016wasenactedtoregulate and standardize the practice of nutrition and dietetics in the Philippines, with a provision on NUTRITION CARE PROCESS Medical Nutrition Therapy (MNT) through the application of Nutrition Care Process (NCP) for (LECTURE) purposes of disease prevention, treatment, and management. UNIT 1&2: INTRODUCTION TO NUTRITION CARE This Order provides guidelines in the implementation of Nutrition Care Process (NCP)in PROCESS public and private hospitals. BRIEF BACKGROUND OF DIETETICS THE ROLE OF A CLINICAL DIETITIAN t. Bartholomew Hospital S Florence Nightingale he practice of clinical nutrition is called nutrition T Alexis Soyer therapy. Clinical dietitians are the educated and trained 1952 - The Philippine General Hospital revamped its organization, separating the Dietetic Service professionalswhocanbestdelivernutritiontherapy by using the nutrition care process (NCP). from the Nursing Department. Mrs. Preciosa Irma Optimize the health and well-being of PinedaFlorentin became the head of the new Dietary Department, and she established the patients/clients through the delivery of quality following: products, programs and services. Promotes nutritional health and well-being of o A. First dietetic internship program. o B. First hospital based-Nutrition Clinic. individuals, groups, communities and populations. o C. First metabolic unit Sets standards, guidelines andpoliciesthatcreate 1957 -Senator Pacita M. Gonzales and and encourage an environment that supports nutritional health. Congresswoman Tecla San Adres-Ziga sponsored a bill in Congress on regulation of the practice of Dietetics CLINICAL NUTRITION TEAM 1960 President Carlos P. Garcia signed into law ometimes called “Nutrition Support Team” S Republic Act (RA) 2674 “An Act to Regulate the In the healthcaresetting,individualsfromdifferent Practice of Dietetics in the Philippines.” disciplinescommunicatewitheachotherregularlyin DAP, now known as Nutritionist-Dietitians order to best care for their patients. Association of the Philippines (NDAP) became a Dietitians are integral members of the patient’s member of the International Committee of Dietetic health care team and collaborate with physicians, Association. pharmacists, nurses, speech pathologists, 1977– PD 1286 – creation of BOND occupational therapists, social workers, and many 2016– RA 10862 – ND Law others when providing nutritional treatment. 2019- NCP practice mandated in the Philippines Nutritional care requires collaboration among members of the entire health care team. RA 10862 Interprofessional teams work together to provide n Act Regulating the Practice of Nutrition and A optimal patient care. Dietetics in the Philippines, Repealing for the purpose Presidential Decree No. 1286, known as NUTRITION CARE PROCESS the "Nutrition and Dietetics Decree of 1977", he Nutrition Care Process is a systematic T appropriating Funds therefor and for other related problem-solving method that food and nutrition purposes. professionals use to think critically and make ThisAct,consistingof46sectionsdividedintonine decisions that address practice-related problems. articles,aimsatregulatingthenutritionanddietetics Applicationofindividualizedcareandtheuseofthe matters.Itshallgovern:(a)thestandardizationand best available evidence to inform practice decisions. regulation of nutrition and dietetics education; (b) Improved health outcomes should enhance the examination, registration and licensing of recognition of Nutrition and Dietetics professionals. nutritionist-dietitians; (c) the standardization, The Nutrition Care Process provides the structure supervision, control, and regulation of the practice forcustomizedcaretobethemostefficientplanin of nutrition and dietetics; (d) the development of a dietitian's “toolbox” . The set framework of the 1 I BSND-3N3 UNIVERSITY OF SANTO TOMAS BS IN NUTRITION AND DIETETICS BATCH 2026 UTRITION CARE PROCESS (LECTURE) N PROF. AILYN MAE K. DEL RIO ADAPTED FROM:POWERPOINT/LECTURE odelallowstheRNDto“fillintheblanks”foreach m rovided a consistent framework that enabled P patient. comprehensiveandindividualizedsolutionstocase 1970-1986 - One of the earlyvisionsofanNCPM studies and practice issues diagramemergedwhenMarianHammond,MS,RD, Madeteachingandlearningmoreefficientbecause created a series of visual diagrams called the components were easy to picture, internalize, and Hammond models. recall 2003-AcademyofNutritionandDietetics,adopted Promoted quickcross-checksandtargetsforstudy a Nutrition Care Process and Model (NCPM) that and practice updates through a visual image identifies the unique contribution of dietetics Allowed patient-specific data to vary across practitioners to health care outcomes and patients/clients, health issues, and settings establishes a global standard for provision of Encouraged flexibility and creativity byadaptingto nutrition care by dietetics practitioners different student/practitioner skill levels, learning/practice styles, and practice environments OMPARISON OF HAMMOND MODELS AND C Demonstrated commonalities among clinical ACADEMY OF NUTRITION AND DIETETICS dietitians and other health care professionals Showed potential forprovidingacommonbasefor MODELS introductory applied nutrition courses with minor changes in languages Showed potential for standardizing dietetics instructionacrossacademiaandpracticeacrossthe dietetics profession Portrayeddieteticscareasastimulatingintegration of biological and behavioral science NCP MODEL escribes the NCP by presenting the workflow of D professionals in diverse individual and population care delivery settings. Implementation of the NCPMhasbeenassociated with several advantages, including use of a commonframeworkfornutritioncareandresearch, promotionofcriticalthinking,more-focusednutrition care documentation, increased acknowledgement of the value of nutrition care by other health care professionals,andimprovedapplicationofevidence based guidelines. NCPMincorporatesscientificevidenceandaimsto move professionals from experience-based to evidence-based practice. The NCPM strives to provide quality, consistent practice and to achieve expected outcomes at all levels of career development. If the NCPM is applied consistently, quality of care and improved health outcomes should enhance recognition for professionals on multidisciplinary teams. BENEFITS ATTRIBUTED TO HAMMOND MODEL efined key concepts and systematized Nutrition D Counseling/Nutrition Care Planning Integrated practice components (counseling, procedural, and environmentalinfluences)intoone focus 2 I BSND-3N3 UNIVERSITY OF SANTO TOMAS BS IN NUTRITION AND DIETETICS BATCH 2026 UTRITION CARE PROCESS (LECTURE) N PROF. AILYN MAE K. DEL RIO ADAPTED FROM:POWERPOINT/LECTURE o . Rootcause(oretiology)ofthenutrition a problemandaimedatalleviatingthesigns and symptoms of the diagnosis. Nutrition Diagnosis o a. Data collected during the nutrition assessment guides theRDinselectionof theappropriatenutritiondiagnosis(es)(i.e., naming the specific problem).. Nutrition Intervention Monitoring & Evaluation o a. Determine if the patient/client has achievedorismakingprogresstowardthe planned goals. If patient/client reveals another piece of new assessmentdata/information,thatwillcausetheRD to reassess, re-diagnose and perhaps modify the plan that he/she had started discussing with the client NUTRITION CARE PROCESS TERMINOLOGY tandardized language for nutrition and dietetics S To provide a dictionary of terms, codes and definitions specific to dietary practicenecessaryto document the delivery and study of nutrition care. Nutrition problems and interventions were often charted using broad, nonspecific language. e.g., “poor nutritional status,” “at risk for malnutrition,” or“nutritionalimbalance”mightmean change in weight, poor intake, or difficulty with chewing or swallowing. In 2014, International Dietetics and Nutrition Terminology was converted to an electronic database, called the eNCPT STEPS IN NUTRITION CARE PROCESS UNIT 3: NUTRITION ASSESSMENT NUTRITION ASSESSMENT It is initiated by the referral and/or screening of individuals or groups for nutritional risk factors. “A systematic process of obtaining, verifying, and interpreting data in order to make decisionsabout the nature and cause of nutrition-related problems.” STEPS IN NCP MODEL Initiates the data collection process that is Nutrition assessment continued throughout the NCP and forms the 3 I BSND-3N3 UNIVERSITY OF SANTO TOMAS BS IN NUTRITION AND DIETETICS BATCH 2026 UTRITION CARE PROCESS (LECTURE) N PROF. AILYN MAE K. DEL RIO ADAPTED FROM:POWERPOINT/LECTURE foundation for reassessment and reanalysis ofthe o utrition-Related Patient/Client Centered N data in Nutrition Monitoring and Evaluation (Step 4). Measures Itisanongoing,dynamicprocessthatinvolvesnot e.g.,Totalenergyintake,fatandcholesterolintake, only initial data collection, but also continual meal/snack pattern, area and level of knowledge, reassessment and analysisofaclient’sneedsand eligibility for community programs,typeofphysical condition. activity Eachpieceofnutritionassessmentdataiscollected foraspecificpurpose.Ithelpsanswerthefollowing ANTHROPOMETRIC MEASUREMENTS (AD) types of questions: eight, weight, H o 1. What can be determined about this body mass index (BMI), person’s nutritional status and all of the growth pattern indices/percentile ranks, and possible factors that contribute to weight history nutritional balance? e.g., Weight, weight change, body mass index o 2.Whatpossiblenutritiondiagnosis/esare supported by the available evidence? IOCHEMICAL B DATA, MEDICAL TESTS, o 3. What additional data might be PROCEDURES (BD) necessary to validate the suspected nutrition diagnoses? ab data (e.g., electrolytes, glucose) and L As dietetics practitioners collect data, they should Tests(e.g.,gastricemptyingtime,restingmetabolic simultaneouslybethinkingaboutthe“why”(factors rate) that contribute to or cause imbalanceinnutritional e.g., BUN : creatinine ratio; fasting glucose; status) and the “what” (possible nutrition cholesterol, HDL diagnoses). NUTRITION FOCUSED PHYSICAL FINDINGS OBTAIN AND VERIFY APPROPRIATE DATA indings from evaluation of body systems, F ata can varydependingonthepracticesettingor d muscle and subcutaneous fat wasting, present health status oral health, suck/swallow/breathing ability, o e.g., RND working in a pediatric clinic – appetite, and affect head circumference, height, and weight e.g., Body language, skin plotted on a growth charts to assess development. CLIENT HISTORY (CH) o Outpatient clinic - obtain height, weight, urrent and past information related to personal, C percentage body fat, and skinfold medical, family, and social history thickness e.g., education, medical treatment/therapy, o Lipid profiles – for patients with type 2 socioeconomic factors diabetes and cardiovascular diseases o BUNandserumphosphorus–forpatients VALUATE THE E DATA USING RELIABLE with renal diseases STANDARDS Know the most appropriate data to collect and Comparative standards determine validity and accuracy. o Compare the obtained data to reliable o Stated weight = usual weight or actual weight? standards or ideal goals. o Identify the appropriate reference Establishatrustingandnonthreateningrelationship with the client standards to determine nutrient needs – energy, macronutrient, fluid, micronutrients, body weight computation, CLUSTER AND ORGANIZE ASSESSMENT DATA and growth. o Usedtoformulatenutritionprescriptionsor lusterandorganizethedataaccordingtothefive C for reevaluation after an intervention. domains to reveal possible nutrition problem Important in making nutrition diagnosis domains and specify accurately the nutrition o Data gathered are evaluated and diagnosis statement. compared to the reference standards or recommendation (individual needs). FOOD/NUTRITION RELATED HISTORY (FH) Food and Nutrient Intake CRITICAL THINKING o Food and Nutrient Administration bserving verbal and non-verbal cues to guide O o Medication and interviewing methods Complementary/Alternative Medicine Use Determining appropriate data to collect o Knowledge/Beliefs/Attitudes Selecting assessment tools and procedures and o Behavior applying in valid and reliable ways o Factors Affecting Access to Food and Distinguishing relevant from irrelevant data Food/ Nutrition-Related Supplies Organizing data to relate to nutrition problems o Physical Activity and Function 4 I BSND-3N3 UNIVERSITY OF SANTO TOMAS BS IN NUTRITION AND DIETETICS BATCH 2026 UTRITION CARE PROCESS (LECTURE) N PROF. AILYN MAE K. DEL RIO ADAPTED FROM:POWERPOINT/LECTURE Determining when problems require referral RESULTS OF THE NUTRITION ASSESSMENT eads to appropriate initial determination that a L nutrition diagnosis/problem exists If a nutrition problem is not identified, further informationortestingmaybenecessarytomakea determination If the assessment indicates that no nutrition problem currently exists that warrants a nutrition intervention,theterm“Nonutritiondiagnosisatthis time” may be documented Ifanutritiondiagnosiscanbemade,theRNDlabels theproblemandcreatesaPES*statementinStep 2 of the Nutrition Care Process SUMMARY utrition Assessment is the first step of the NCP N Nutrition assessment should ensure that appropriateandreliabledataarecollectedforusein determining the existence of specific nutrition problems. Organizing and categorizing data utilizing the five domains of the assessment standardized terms improves the efficiency and effectiveness of nutrition assessment and nutrition diagnosis Dynamic process that develops throughout the NCP Data is used for all other steps of the NCP New information may provide reason for reassessment or change in approach and intervention 5 I BSND-3N3 UNIVERSITY OF SANTO TOMAS BS IN NUTRITION AND DIETETICS BATCH 2026 UTRITION CARE PROCESS (LECTURE) N PROF. AILYN MAE K. DEL RIO ADAPTED FROM:POWERPOINT/LECTURE UNIT 4: NUTRITION DIAGNOSIS TERM definition TERM definition TERM definition 6 I BSND-3N3
