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Nutrition Care Process

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Nutrition Care Process (NCP) is a systematic method of providing high-quality nutrition to patients. It was published as part of the Nutrition Care Model to improve the quality and consistency of individualized care for patients and the predictability of their outcomes. Use of the NCP doesn’t guarantee the same care to all clients but it provides a framework for the Registered Dietitian Nutritionist (RDN) to customize care, considering the client’s values and needs and making decisions by using the best evidence available. Using the NCP can bring about more effective and efficient care, nutrition research, and greater realization of nutrition and dietetic professionals’ role in all care settings. The Nutrition Care Process consists of four distinct, corresponding steps that form a framework for the Registered Dietician (RD) to create an individualized nutrition plan. Here’s a breakdown of the steps;

Step 1: Nutrition Assessment and Reassessment:

This is the first step in the NCP and it begins when a referral to the dietician professional is made. The Registered Dietician collects and documents key evidence such as anthropometric measurements, food or nutrition-related history, medical tests and procedures, biochemical data, client history, and nutrition-focused physical findings and client history. The dietitian begins by talking with the client and/or their family to assess usual dietary patterns, weight history, any food allergies or intolerances, any nutritional concerns, and any difficulties chewing or swallowing.

Step 2: Nutrition Diagnosis.

The second step in the Nutrition Care Process connects nutrition assessment to intervention. Data from the nutrition assessment guides the Registered Dietician Nutritionist in selecting the suitable nutrition diagnosis. The Registered Dietician picks out and labels a specific nutrition diagnosis that he/she is responsible for treating, with the help of a standardized NCP language. The nutrition diagnosis statement must be clear, concise, relating to one problem, and should be based on accurate and reliable assessment data. It is important to keep in mind that the nutrition diagnosis is not a medical diagnosis.

Step 3: Nutrition Intervention.

The third step of NCP involves planning and implementation of a plan that is focused on the nutrition problem identified during the nutrition diagnosis. After nutrition diagnosis, the RDN chooses the nutrition intervention to be directed to the etiology of the nutrition problem and one that will alleviate the signs and symptoms of the diagnosis. In this step, the RD discusses with the client/patient and other interdisciplinary team members about the realistic goals and creating a plan to meet that goal.

Step 4: Nutrition Monitoring and Evaluation.

The fourth and final step of NCP involves monitoring the progress made by the patient to determine if they have achieved or are making progress toward the planned goals. This step links back to the first step as the Registered Dietician assesses the progress made in meal intake, weight status, labs, and nutrition-focused physical findings.  In long-term care, the Registered Dietician monitors the client’s progress annually if the client is nutritionally stable. More frequent monitoring is done if the client is at higher nutritional risk such as weight changes, decreased meal intakes, skin alterations, or Total Parenteral Nutrition (TPN).

The Nutrition Care Process may at first seem like a linear approach, but amidst interaction with a client, the RDN will complete steps 1 and 2 pertaining to assessment and diagnosis. When the client reveals new assessment information, the RDN may then begin a Nutrition Intervention, re-assess and re-diagnose, and probably even modify the plan he/she had with the client. The Nutrition Care Process has been adopted in healthcare, occupational and physical therapy and is very significant in the provision of high-quality nutrition. To learn more about the NCP, visit the Humanitarian Global Institute website and enroll for a course in Nutrition and Dietetics today.



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