Nutritin Care Prcess Mdel Tutrials Nutritin Care Prcess and Terminlgy Cmmittee Academy f Nutritin and Dietetics Nutritin Care Prcess Terminlgy 2015 Editin Nutritin Mnitring & Evaluatin: Overview & Definitin Mdule Objectives By the end f this mdule, the participant will: Understand a wrking definitin and purpse f nutritin mnitring & evaluatin Understand the cmpnents f nutritin mnitring & evaluatin, including Activities f the nutritin and dietetics prfessinal during the nutritin mnitring & evaluatin step Critical thinking skills that are useful during the nutritin mnitring & evaluatin step Surces f data needed fr decisin making during nutritin mnitring & evaluatin Nutritin Mnitring & Evaluatin: Nutritin Mnitring & Evaluatin is the furth f 4 steps in the Nutritin Care Prcess Purpse: t determine and measure the amunt f prgress made fr the nutritin interventin and whether the nutritin related gals/expected utcmes are being met. This step prmtes unifrmity within the dietetics prfessin in assessing the effectiveness f the nutritin interventin. Prcess: determine what t measure and cllect fr the patient and using aggregated mnitring & evaluatin utcme data. 1
M & E: Activities f the RDN Mnitr Prgress Measure Outcmes Evaluate Outcmes M & E: Activities f the RDN Mnitr Prgress Check patient s understanding and cmpliance with nutritin interventin Determine whether the interventin is being implemented as prescribed Identify ther psitive and negative utcmes Gather infrmatin indicating reasns fr lack f prgress Supprt cnclusins with evidence M & E: Activities f the RDN Measure Outcmes Select the nutritin care indicatr(s) t measure the desired utcmes Use standardized nutritin care indicatr(s) t increase the validity and reliability f the measurements f change 2
M & E: Activities f the RDN Evaluate Outcmes Cmpare mnitring data with the nutritin prescriptin/gals r reference standard t assess prgress and determine future actin Evaluate impact f the sum f all interventins n verall patient health utcmes Critical Thinking Critical thinking skills that are useful: Selecting apprpriate indicatrs/measures. Using apprpriate reference standards fr cmparisn. Defining where patient/client is in terms f expected utcmes. Explaining a variance frm expected utcmes Determining factrs that help r hinder prgress Deciding between discharge r cntinuatin f nutritin care Nutritin Mnitring & Evaluatin Surces f Data: determining what t measure Data fr determining what t mnitr and evaluate will riginate frm: the health recrd system the nutritin assessment and re-assessment phase the nutritin diagnsis the nutritin interventin 3
Nutritin Mnitring & Evaluatin Surces f Data: determining what t measure Nutritin care indicatrs are markers that can be bserved and measured and therefre will reflect a change as a result f nutritin care Additinal factrs t cnsider are: Medical diagnsis Health care utcme gals Nutritin quality management gals Practice setting Patient/client ppulatin Disease state and/r severity Nutritin Mnitring & Evaluatin Cllectin and use f mnitring and evaluatin data Cnsists f three cmpnents: mnitring, measuring, and evaluating changes in nutritin care indicatrs Mnitring: prviding evidence that the nutritin interventin is r is nt changing the patients behavir r status Measuring: cllecting data n the apprpriate nutritin utcme indicatr(s) Evaluating: cmpare current findings with» previus status» nutritin interventin gals» reference standards evaluate the impact f the nutritin interventin n the patient health utcmes Nutritin Mnitring & Evaluatin Nutritin Care Indicatrs Current patient data can be cmpared against The nutritin prescriptin The reference standard r cmparative standard Natinal standards fr ppulatins such as DRIs, US Dietary Guidelines Guidelines fr specific disease cnditins, e.g., A.S.P.E.N., E.S.P.E.N., U.S. Kidney Fundatin Institutinal standards Regulatry standards 4
Nutritin Mnitring & Evaluatin Reassessment ccurs during the mnitring and evaluatin phase when the RDN Determines whether the previusly identified M&E parameters have changed Identifies the status f the nutritin diagnsis using the fllwing language: N imprvement Imprvement Diagnsis n lnger apprpriate Reslved Determines if there is a new nutritin diagnsis Determines whether additinal data f any kind is needed If gals were met and n further care is needed, the patient can be discharged frm care Summary Nutritin Mnitring & Evaluatin describes the patients prgress thrugh cnsistent terms that are evaluated based n carefully selected indicatrs and criteria. Please prceed t the next mdule fr a discussin f the Nutritin M & E Terminlgy and their use. 5