Lecture 22: Nutrition Care Process Flashcards
What do individual consultations require?
- Effective communication
- Accurate information gathering
- Problem solving
- Using knowledge and evidence
Why do we need a framework to guide us through this process?
So that we not only assess the individuals nutrition status but also provide a solution to their needs
What does the nutrition care process provide?
a systematic, problem-solving framework for nutrition-related problems
What does the nutrition care process enable?
Safe, effective, high quality nutrition care
What does the nutrition care process facilitate?
Critical thinking and decision making
What are the rings of the nutrition care process? (3)
- Social and environmental factors
- Strengths and weaknesses of the practitioner
- Inputs/outputs
What are the four steps of the nutrition care process? (ANDIME)
- Assessment
- Nutrition Diagnosis
- Intervention
- Monitoring and Evaluation
What is the central core of nutrition care process?
Relationship between the client and nutrition professional
- Individualised and patient-centred care
What is the patient-centred care approach?
- Exploring clients history, needs, values and environment
- While promoting active client participation
- Via shared decision making and lifestyle education
How should communication with a client be?
- Articulate
- Accessible/understandable
- Emotionally-balanced
- Professional
What is emotionally-balanced?
have empathy and understanding of the what is going on, yet still keeping it professional
What are inputs to the nutrition care process?
Screening and referral system
What is the outermost ring of the nutrition care process?
Social and environmental factors
- Impact the clients ability to receive and benefit from nutrition care
What are examples of social and environmental factors?
- Practice settings
- Health care systems
- Economics (money)
- Social systems
What are the middle rings of the nutrition care process?
Strengths and weaknesses of practitioner
What are examples of strengths and weaknesses of practitioners?
- Knowledge
- Communication
- Evidence-based practice
- Critical thinking
- Code of ethics
What are outputs of the nutrition care process?
Outcomes management system
What is the outcomes management system?
- Undertaken by researchers
- Provides quality improvement of the NCP model in healthcare
What are the steps of the NCP?
- Assessment
- Diagnosis
- Intervention
- Monitoring and Evaluation
What is nutrition assessment (step 1)?
Systematically obtains, verifies and interprets relevant information against recognised standards to identify nutrition related problems
What type of data do we need to collect during nutrition assessment? (5)
A = Anthropometric measurements
B = Biochemical data, medical tests, procedures
C = Clinical - nutrition-focused physical findings
D = Diet - food/nutrition related history
E = Extra information - client history (exercise, lifestyle, medical and social history)
What evidence based standards would you compare nutrition assessment findings to?
- Eating and activity guidelines
- NRV’s and food composition tables
- BMI or growth standard charts
What is nutrition diagnosis? (step 2)
Identifies the specific nutrition problem - need to think about the “what?”
Nutrition diagnosis is NOT a….
Medical diagnosis
e.g. would say excessive sodium intake not hypertension (this is what is driving the hypertension)
What are the range of possible reasons for the nutrition diagnosis?
- Intake
- Clinical
- Behavioural/environmental
Decide on the best nutritional diagnosis based on the….
Aetiology that fits your clients situation
Need to communicate the nutrition diagnosis in a….
Standardised, clear and effective manner - PASS Statements!!
What is Aetiology?
the root cause or the origin of the disease/problem
What are PASS statements?
- Problem (What?)
- Aetiology (Why?)
- Signs and Symptoms (How do I know?)
How do you communicate the problem? (PASS)
State the problem - if you can’t solve it however there is no point in stating it
How do you communicate the aetiology? (PASS)
State the nutrition related factors that are contributing to or causing the problem
How do you communicate signs and symptoms? (PASS)
State the quantifiable data as a basis for monitoring and evaluation outcomes
Signs vs Symptoms
Signs = Objective data (e.g. lab data)
Symptoms = Subjective data (e.g. how someone feels)
What is nutrition intervention?
Selection of nutritional stratagies to resolve or improve the nutrition diagnosis
- You’ve done all of the assessments and are now going to make some goals for the client
How should nutrition intervention be communicated?
Using SMART goals
What does SMART goal stand for?
Specific
Measurable
Achievable
Relevant
Timely
What are smart goals?
a framework for designing goals so that they are attainable within a certain time-frame and meaningful to the client
What are the 4 categories of Nutrition intervention stratagies?
- Nutrition intervention (food, supplements, PA)
- Nutrition Education
- Nutrition Counselling
- Co-ordination of nutrition care (referall)
What is choice point?
their decisions mark whether they are moving away or towards the goals/values
What is nutrition monitoring and evaluation? (step 4)
Determines progress being made by the client and whether goals and outcomes are being achieved
Progress should be ??, ?? and ?? on a planned schedule for nutrition monitoring and evaluation
Monitored, measured and evaluated
What does monitoring involve? (step 4)
Identifying any changes in the clients condition
- May require gathering additional information
- May require diagnosis and intervention changes
What needs to be measured during monitoring and evaluation?(step 4)
- Direct nutrition outcomes
- Clinical/health outcomes
- Client-centred outcomes
- Health-care cost outcomes
