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

1. NUTRITION
CARE PROCESS
SAS 2:
NUTRITION
CARE PROCESS

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

3. Nutrition Care Process
Four steps (ADIME):
• Nutrition Assessment
• Nutrition Diagnosis
• Nutrition Intervention
• Nutrition Monitoring/Evaluation

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, administration (oral/enteral
nutrition/parenteral nutrition), intravenous fluid,
medication and herbal supplements,
knowledge/beliefs/attitudes, seen 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
1. B
2. C
3. D
4. A
5. C

29. THAT’S ALL, THANK YOU.