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Process for Nutrition and Dietetic Practice
Transcript of Process for Nutrition and Dietetic Practice
Adapted from the British Dietetic Association (2012) Model and process for dietetic practice. Birmingham: BDA (Recommended Reading)
of nutrition and dietetic diagnosis
nutrition and dietetic intervention
nutrition and dietetic intervention
Identifying Nutritional Need - Dietetic Nutritional Assessment
"Nutritional assessment is a comprehensive process of identifying and evaluating nutritional status of an individual using appropriate and measurable methods."
It consists of gathering data using four main techniques:
Nutritional assessment is able to quantify impairment of nutritional status"
(British Dietetic Association, 1999)
Therefore the first step is the assessment - tools include:
Referral letter/ patient notes, the patient and information systems.
Aim: To enable the dietitian to develop a clinically reasoned nutritional treatment plan
details past and present - including drugs and diagnoses
Estimation of requirements
- often consider nutrient deficit or excess
, social and psychological history - Remember communication and to assess level of understanding
Service User's Values and
Service User/ Dietitian
Remember Communication Counts!
What is a nutritional diagnosis?
It is NOT the same as the medical diagnosis
Can be thought as having Three Components
- Described alterations in patients nutritional status (think excess or deficit)
- Relation to the disease, psychosocial or situational problem. May be useful to remember biochemistry and pathology / physiology
- Identified as part of the assessment process
- Evidence of the existence of a nutritional problem
Planning a nutrition and dietetic intervention
Have a dietetic aim
- Link to expected outcomes
What are you
trying to achieve
Change a food or lifestyle
Food or nutrient intake
or consumption pattern?
Clinical or health outcome
Patient centred outcome
The plan should be linked to an aim which will acheive one or more of these
Plans should be patient centred and negotiated
Outcomes increasingly being used to commision services
Is there a difference between the intervention and plan?
The intervention is putting the plan into action
The dietitian may carry out the plan themselves, but it more likely that the plan will be carried out by others - other healthcare professionals, carers or the patients themselves
with the patient/ carers/ other healthcare professionals
Think carefully and critically
about how it will happen
of plan to person who has to deliver the plan
need for follow
review and monitoring
(and who needs to do it)
Why monitor and review?
To see if the
acheived / acheivable
? This should include how the plan had been implemented
Depending on the intervention,
may be set to add further to the initial nutritional intervention
- justifies need for dietetic service
reported and perceived
This is often the area of the care process missed or overlooked by students
Evaluation - continuing to build the evidence base?
Evaluation is the systematic comparison of current findings against previous status, intervention goals and outcomes or a reference standard and takes place at the end of the process. (BDA 2012)
This can include:
Feedback from patients
/ carers, both informally and through surveys
Case study reviews
- one of the reasons they are part of placements
and service evaluations
In its simplest form, did the intervention work, is it worth using the same approach again or does it need changing?
Dr Duane Mellor PhD RD RNutr.