Nutrition Care Process: An Overview
Nutrition Care Process: An Overview
The Nutrition Care Process (NCP) is a systematic approach to medical nutrition therapy where the registered dietitian identifies the problem, treats the problem, and monitors the problem. There are 4 steps to the NCP model:
- Nutrition Assessment
- Nutrition Diagnosis
- Nutrition Intervention
- Nutrition Monitoring and Evaluation
The model can be viewed as a cyclical figure (image below). The patient is first assessed. A nutrition diagnosis is determined. An intervention is initiated. And the status of the problem is monitored. If the problem is not corrected, the cycle then repeats. The patient is reassessed. Either a new diagnosis is assigned or the original one is continued. A new intervention or a modification to the original one might be implemented. The status is monitored again, and so on.
But not every patient admitted to the hospital is placed in the NCP model. A patient being treated for a broken leg may not be at nutritional risk, and therefore does not have a need for a nutrition intervention. So how do we determine which patients are candidates for nutrition care? The answer is with a proper nutrition screening.
Nutrition Screening
The nutrition screening is the step which precedes the NCP model. The purpose of the screening is to identify patients who are already malnourished or are at risk of becoming malnourished. If the patient is identified as such, they then enter the NCP model.
Nutrition Assessment
In nutrition assessment, registered dietitians collect and analyze health-related information to identify nutrition problems and their underlying causes. This information is collected from the medical record, nutrition focused physical exam (NFPE), lab work and medical procedures, and through interviews with the patient or caregiver.
Nutrition Diagnosis
The nutrition diagnosis is the step for identifying any existing and potential nutrition problems. Each problem has its own diagnosis, which includes a problem, the etiology, and signs and symptoms, known as a PES statement.
Nutrition Intervention
In the nutrition intervention, the registered dietitian will develop and implement the appropriate nutrition care to help resolve or improve the nutrition diagnosis. The intervention should modify certain dietary and lifestyle practices or environmental conditions that impede on the patient’s nutrition status. The interventions must be evidence-based, meaning they are based on scientific rationale and are supported by results of research. The goals are stated in measurable outcomes, such as future lab results or anthropometric measurements.
Nutrition Monitoring and Evaluation
In the final step of the NCP model, monitoring and evaluation, the patient will either exit the model, meaning they are no longer at nutritional risk and their problem has resolved, or they will re-enter the model and be reassessed, and new or revised diagnoses and interventions may be set.
