Nutrition Care Process Flashcards
Overview of NCP
Recommended by: International Confederation of Dietetic Associations (ICDA).
Framework: ADIME (Assessment, Diagnosis, Intervention, Monitoring & Evaluation).
ADIME Framework
Assessment: Collect and interpret nutrition-related data.
Diagnosis: Create PES statements to identify nutrition problems.
Intervention: Develop and implement a nutrition care plan.
Monitoring & Evaluation: Track progress, reassess, and refine the plan.
Nutrition Assessment
Definition: Systematic method to identify nutrition-related problems.
Domains:
Food/nutrition history.
Anthropometric measurements.
Biochemical data/tests.
Physical findings.
Client history.
Monitoring & evaluation tools.
Nutrition Diagnosis (PES Statement)
PES Statement: Problem, Etiology, Signs & Symptoms.
Example: Inadequate energy intake related to mental illness as evidenced by dietary record showing intake of 3200kJ/day and 8kg weight loss in 6 weeks.
Categories:
Intake (e.g., energy deficiency).
Clinical (e.g., malnutrition).
Behavioral-environmental (e.g., limited access to food).
Nutrition Intervention
Definition: Purposeful actions to address identified issues.
Planning:
Identify goals (e.g., weight gain of 1kg/week).
Create a nutrition prescription (e.g., 2000kcal/day, high protein).
Prioritise based on needs.
Implementation:
Delivery of meals or supplements.
Nutrition education and counseling.
Coordination of care with health professionals.
SMART Goals: Specific, Measurable, Achievable, Realistic, Time-based.
Monitoring & Evaluation
Progress Tracking: Assess compliance with interventions.
Evaluation Tools: PG-SGA, MUST, MNA.
Adjustments: Modify interventions based on effectiveness.
Key Screening Tools
MST: Simple; evaluates weight loss and appetite changes (score 0-3).
MUST: Includes BMI, weight loss, acute illness; guides care plans.
Scores: 0 (low risk), 1 (medium), 2+ (high, refer to RD).
MNA: For individuals >65; assesses lifestyle, diet, and health.
Scores: 12-14 (adequate), 8-11 (at risk), 0-7 (malnourished).
SGA/PG-SGA: Clinical evaluation; best for acute malnutrition diagnosis.
SNAQ: Identifies weight loss risk in aged care residents.
Malnutrition Screening & Categories
Settings:
Acute care: MST, MUST, NRS (MST simplest).
Community: MNA for older adults.
Aged care: MNA, MST, or MUST.
BMI Categories (MUST):
20 = Low risk (0).
18.5-20 = Moderate (1).
<18.5 = High risk (2).
Nutrition Counselling Approaches
Theories:
CBT: Focus on problematic thoughts affecting behavior.
Health Belief Model: Attitudes and beliefs guide actions.
Transtheoretical Model: Stages of change (e.g., precontemplation → maintenance).
Strategies:
Motivational interviewing (MI), goal setting, stress management, relapse prevention.
Key Tools for Evaluation
MST: Simple, quick.
MUST: Comprehensive with BMI, weight loss, and illness.
MNA: Older adults in community and aged care.
PG-SGA: Self-reported data for malnutrition assessment.
Screening Locations
ACF: Hospitals and clinics.
Community Settings: For individuals >65 living independently.
Aged Care Facilities: Assess malnutrition risk and predict future weight loss.
Key Screening Tools
MST (Malnutrition Screening Tool)
Purpose: Quick and simple (3 questions, no calculations).
Measures: Recent weight loss and appetite changes.
MUST (Malnutrition Universal Screening Tool)
Purpose: Screening and diagnosis of malnutrition.
Measures: BMI, weight loss, acute illness impact.
Scoring: 0 (low risk), 1 (moderate risk), 2+ (high risk).
NRS (Nutrition Risk Screening)
Purpose: Screening and diagnosis.
Measures: Weight loss, food intake, and disease severity.
SGA (Subjective Global Assessment)
Purpose: Comprehensive evaluation in acute settings.
Best for: Diagnosing malnutrition using clinical judgment.
PG-SGA (Patient-Generated SGA)
Purpose: Self-reported malnutrition screening.
Best for: Diagnosing malnutrition in patients able to self-report.
Older Adult Screening Tools
MNA (Mini Nutritional Assessment)
Purpose: Assess nutritional status of older adults.
Factors: Dietary habits, physical function, lifestyle.
Scoring:
12-14: Adequate nutrition.
8-11: At risk of malnutrition.
0-7: Malnourished.
SNAQ (Short Nutritional Assessment Questionnaire)
Purpose: Predict weight loss risk in aged care residents.
Scoring: Low risk (<14) predicts minimal weight loss in 6 months.
Best Screening Practices
Acute Settings: Use MST, MUST, or NRS. MST is the simplest.
Community Settings: Use MNA for older adults living independently.
Aged Care Facilities: Use MNA, MST, or MUST.
