Nutrition Care Process Overview
The Nutrition Care Process is a systematic method that dietetics and nutrition professionals use to provide nutrition care. It is comprised of four steps: nutrition assessment and reassessment, nutrition diagnosis, nutrition intervention and nutrition monitoring and evaluation.
Use of the Nutrition Care Process does not mean that all patients get the same care. Rather, the Nutrition Care Process provides a framework for practitioners to customize care — taking into account the client's needs and values and using the best evidence available to make decisions. Use of the Nutrition Care Process can lead to more efficient and effective care, nutrition research and greater recognition of the role of credentialed nutrition and dietetics practitioners.
Based on the scientific problem-solving method, the Nutrition Care Process and Model's primary use is for the clinical practitioner. However, as a framework used for critical thinking and decision making, the Nutrition Care Process can be utilized by RDNs in all work settings — including clinical, management, food service, research, community health and education. Every member of the profession should be able to articulate the Nutrition Care Process and Model, which describes what nutrition and dietetics practitioners do every day.
The Standards of Practice in Nutrition Care and Standards of Professional Performance for RDNs and NDTRs include the use of the Nutrition Care Process. Per the Centers for Medicare & Medicaid Services' Condition of Participation: Food and Dietetic Services that a qualified dietitian supervising aspects of nutrition care must maintain professional standards of practice. The CMS interpretive guidelines outline dietitian responsibilities incorporating the Nutrition Care Process.
The Academy works with a number of accreditation organizations — such as DNV GL Healthcare Accreditation, the Accreditation Commission for Health Care and The Joint Commission — to use the Nutrition Care Process in guiding survey evaluation of dietetic services' standards and elements of performance. In addition, the Nutrition Care Process and Model are an integral part of dietetics education and credentialing criteria for the RDN and NDTR exams.
The Nutrition Care Process can be used in any charting or documentation system. For example, many RDNs are using the ADI or ADIME format, which directly parallels the Nutrition Care Process. RDNs may not always have the authority to change the format for documentation; however, using the Nutrition Care Process allows RDNs to focus their chart notes and make documentation more concise.
Nutrition Care Process Quality Evaluation & Standardization Tool (NCP QUEST)
The NCP QUEST is an audit tool used to evaluate dietitian documentation notes using the Nutrition Care Process. Developed through a joint study by the Academy and Advancing Practice Nutrition Consultants (APNC) of US Veterans Affairs, the NCP QUEST evaluates all components and links, especially outcomes as a result of continuous care (via evaluation of the full monitoring and evaluation step), new elements of the NCP Terminology such as status labels, and explicit documentation of the etiology category. The tool has high content validity, which suggests its usefulness in improving accuracy in charting and helping to ensure quality data collection. In conjunction with a comprehensive manual, the NCP QUEST can be used as a practical rubric to apply or teach the Nutrition Care Process effectively.
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