NUTRITION INTERVENTION TO NUTRITION COUNSELING

nutrition intervention

• Purposely planned action/designed with the intent of

• changing a
  nutrition-related behavior, risk factor, environmental condition or aspect of nutritional health status

planning, implementation

two irrelated components of nutrition intervention

planning

• prioritize the nutrition diagnoses

• review practice guidelines

• confer with the patient

• define time and frequency of care

implementation

• communicate the plan of care

• carry out the plan of care

• continue data collection

monitor and evaluate

• Follow-up and implementation verify the implementation.

• Revise nutrition intervention strategy if needed

Four Domain of Nutrition Intervention

• Food and Nutrient Delivery (ND)

• Nutrition Education (E)

• Nutrition Counseling (C)

• Coordination of Nutrition Care (RC)

Food and Nutrient Delivery (ND)

• Individual approach for food/ nutrient provision

• Prescribing nutritionally fortified meals

• Adding high-protein or high energy snacks

nutrition education

• instruct or train a patient in a skill

• impart knowledge

• examples: reading food labels, making recipe modification

• improve behavior

Nutrition Counseling (C)

• Collaborative counselor-patient relationship

• Help patients identify and solve their nutrition-related problem

coordination of nutrition care (rc)

• Consulting with and referring to other health professionals

• Coordination of nutrition care with other health-care providers/ nutrition/ dietitian with special skills

• Institutional
  Settings
  (hospital, long-term care)

• Home care

use of food and nutrient delivery on a practice setting

institutional settings

Use of nutrition-education content Based on

Practice Setting

• Outpatient/Non-institutional

• settings

• Private practice

use of Nutrition Education - Application based on practice setting

Planning

(Formulate and Determine Plan of Act)

prioritize nutrition diagnosis based on severity of problems safety, patients need, likelihood that intervention will impact

communicate

carry out

continue monitorinh

steps of implementation

nutrition prescription

• The opening action in the Nutrition Intervention

• Should state the individual recommended energy and nutrition intake

How to Choose an Appropriate Nutrition

Intervention

1. Decide which of the Nutrition
   Diagnosis takes priority

2. Use/Consult appropriate evidence-base guidelines and policies

3. Discuss possible interventions with he individual and his/her family

4. Identify the expectations of the individual and his/her family in relation to nutrition care

5. Create
   specific

Nutrition

Prescription hat meets patrios nutritional needs

6. Develop a plan for follow-up/review consultations

*Nutrition Intervention Form

monitoring

refers to the review and measurement of the patient's

status at a scheduled follow-up point with regard to nut dx, intervention plans, and outcomes

evaluation

systematic comparison of current findings with previous

status, intervention goals, or a reference standard

• OUTCOMES MANAGEMENT SYSTEMS

evaluation is used to create an

monitor progress, measure outcomes, evaluate outcomes

3 outcome management systems

monitor progress

• Check patient/ client group understanding and compliance with plan

• determined if the intervention is being implemented as prescribed

measure outcomes

• Select outcome indicators that are relevant to the nutrition diagnosis or signs or symptoms, nutrition goals, medical diagnosis, and outcomes and quality management goals

• Use standardized indicators to increase the validity and reliability of measurements of change; and facilitate electronic charting, coding and outcomes management

evaluate measures

Compare current findings with previous status, intervention goals, and/or reference standards

Direct nutrition outcomes

• Behavior change, food or nutrient intake changes,

  improved NS, knowledge gained

clinical and health status outcomes

Lab values, weight, BP, risk factor, profile changes,

signs and symptoms, clinical status, infections

client centered outcomes

Quality of life measures, satisfaction, self-efficacy, self-management, and client’s functional ability

healthcare utilization and cost outcomes

Medication changes, special procedures, planned/ unplanned

1. Food and Nutrition Related History
   (FH) Outcomes

2. Anthropometric Measurements (AD)
   Outcomes

3. Biochemical Data, Medical Tests and Procedures (BD) Outcomes

4. Nutrition-Focused Physical Findings
   (PD) Outcomes

CATEGORIES IN NUTRITION MONITORING AND EVALUATION

medical record

Permanent legal document that records the client’s history, assessment and diagnosis.

1. Identification Information

2. Medical History

• Allergies

• Surgery

• Any treatment (prev./present)

1. Medication Information

2. Family History

• what diagnosis is related to family history

1. Treatment History

2. Medical Directives

• Patient's request is followed

7. Laboratory Results

• CBC, urinalysis

8. Consent forms

• Giving information to the patient

• Safety

9. Financial Information

• Ability of the patient to pay

COMPONENTS OF MEDICAL RECORD

Problem Oriented MedicalRecord

(POMR)

MR approach that provides a quick & structured acquisition of patients history

• Unlike

classical health record, focuses on a patient's problem, their evolution and the relation b/w clinical events.

1. Data base - history, physical exam, & laboratory data

2. Complete problem list

3. Initial Plans

4. Daily Progress Note

5. Final Progress Note or Discharge
   Summary

basic components of pomr

• Legal documents, ink

• Accurate, complete, clear, concise info

• Each page is identified by client’s
  Each page is identified by client's name and record number, date, time

• Only standard abbreviations

• Sign all entries, complete

• Co-signed by C.I, if interns

• Should not be used for argument

General Guidelines

nutrition counselor

• Providing expert advice to help a person with current or potential nutrition problems

• A process which a health professional, usually an RND works with an individual to assess his or her usual dietary intake and identify areas where change is needed

• Assessing Dietary Habits

• Assessing Body Weight

• Identifying Changes Needed

• Identifying Barriers to Change
  Setting Goals

• Finding Support from Family and Friends

• Maintaining Changes

general procedures of nutri counseling

• Personal tastes

• Ethic or cultural background

• Educational level

• Attitudes towards food

• Economic obstacles

• Social lifestyle

• Should be done in a

• Trying to make dietary changes is difficult because of the following:

ethical principles for counseling

1. Keep client information confidential

2. Respect client's autonomy

3. Keep client's interests in mind

4. provide accurate information

5. do not harm

6. be fair

1. Try to include portion size for specific nutrient-rich foods

2. Use pictures of food groups, with healthy foods divided into sections to show recommended daily
   consumption, to counsel on dietary diversity

3. Demonstrate how to prepare or use foods whenever possible

Counseling on Diet

Effective Counseling

• Do more listening than talking

• Ask open-ended questions...

• Repeat what client say to make sure you understood them correctly

• Show interest in and empathy for client's problems and situations

• Avoid judging clients

• Listen to what clients think and respect their feelings,..

• Recognize and praise what clients are doing correctly

• Suggest actions that are possible for clients given their situations

• Give only a little bit of information at a time

• Use simple language

tips for nutri counseling

nutrition care plan

It's a detailed plan of interventions/ actions to support a person to achieve their nutrition goals