Nutrition Care Process

(NCP)

Dadang Arief Primana

Program Studi Gizi
Sekolah Tinggi Ilmu Kesehatan Immanuel
Nutrition Care Process (NCP)

ADA’s Nutrition Care Process is

defined as
“a systematic problem-solving method
that dietetics professionals use to
critically think and make decisions to
address nutrition related problems and
provide safe and effective quality
nutrition care.”
Nutrition Care Process (NCP)
Process is a series of connected steps or
actions to achieve an outcome and/or any
activity or set of activities that transforms
inputs to outputs.

Critical Thinking integrates facts, informed

opinions, active listening and observations.
Characteristics of critical thinking include the
ability to do: conceptualize; think rationally;
think creatively; be inquiring; think autonomously
Nutrition Care Process ADA NUTRITION CARE PROCESS AND MODEL
Screening & Referral
System
 Identify risk factors
 Use appropriate tools
and methods
 Involve
interdisciplinary
collaboration Nutrition Diagnosis
 Identify and label problem
Nutrition Assessment  Determine cause/contributing risk
 Obtain/collect timely and
factors
appropriate data  Cluster signs and symptoms/
 Analyze/interpret with defining characteristics
evidence- based standards
Document
 Document

Relationship
Between
Patient/Client/Group Nutrition Intervention
& Dietetics  Plan nutrition intervention
Professional  Formulate goals and
determine a plan of action
Implement the nutrition intervention
Nutrition Monitoring and  Care is delivered and actions
-
Evaluation are carried out
 Monitor progress  Document
 Measure outcome indicators
 Evaluate outcomes
 Document

Outcomes
Management System
 Monitor the success of the Nutrition Care
Process implementation
 Evaluate the impact with aggregate data
 Identify and analyze causes of less than
optimal performance and outcomes
 Refine the use of the Nutrition Care
Process
Figure : NCP
Nutrition Care Process (NCP)
PURPOSE OF NCP
ADA’s Nutrition Care Process also assists
dietetics professionals to scientifically and
holistically manage nutrition care, thus
helping patients better meet their health and
nutrition goals.
Nutrition Care Process (NCP)
PURPOSE OF NCP
As dietetics professionals consistently use
the Nutrition Care Process, one should
expect a higher probability of producing
good outcomes.
Nutrition Care Process (NCP)
PURPOSE OF NCP
The Nutrition Care Process then begins to
establish a link between quality and
professional autonomy
NCP
Nutrition Care Process ADA NUTRITION CARE PROCESS AND MODEL
Screening & Referral
System
 Identify risk factors
 Use appropriate tools
and methods
 Involve
interdisciplinary
collaboration Nutrition Diagnosis
 Identify and label problem
Nutrition Assessment  Determine cause/contributing risk
 Obtain/collect timely and
factors
appropriate data  Cluster signs and symptoms/
 Analyze/interpret with defining characteristics
evidence- based standards
Document
 Document

Relationship
Between
Patient/Client/Group Nutrition Intervention
& Dietetics  Plan nutrition intervention
Professional  Formulate goals and
determine a plan of action
Implement the nutrition intervention
Nutrition Monitoring and  Care is delivered and actions
-
Evaluation are carried out
 Monitor progress  Document
 Measure outcome indicators
 Evaluate outcomes
 Document

Outcomes
Management System
 Monitor the success of the Nutrition Care
Process implementation
 Evaluate the impact with aggregate data
 Identify and analyze causes of less than
optimal performance and outcomes
 Refine the use of the Nutrition Care
Process
Figure : NCP
ADA’s Nutrition Care Process
Steps
• Nutrition
Assessment
• Nutrition Diagnosis
• Nutrition Intervention
• Nutrition Monitoring and
Evaluation
Nutrition Assessment (Definition)
• “Nutrition Assessment” is the first step of
the Nutrition Care Process.
• “A systematic process of obtaining,
verifying, and interpreting data in order to
make decisions about the nature and
cause of nutrition-related problems.

• The Nutrition Assessment includes signs

and symptoms.
Nutrition Assessment
Assessment gizi
Assessment gizi merupakan evaluasi
sistematis pemeriksaan status gizi pasien
dengan nutritional risk untuk mendapatkan,
memverifikasi dan menginterpretasi data
status gizi agar dibuat diagnosis gizi.
Assessment gizi membandingkan informasi
atau data yang didapat dengan standar-
standar pemeriksaan gizi yang dilakukan.
Nutrition Assessment
• The purpose of nutrition assessment is to
collect and interpret relevant patient
information to identify nutrition-related
problems and their causes
• The first step in the Nutrition Care Process
• Different from monitoring and evaluation
where similar or same data may be used
to determine changes in patient behavior
or nutrition status and the efficacy of
nutrition intervention
Nutrition Assessment
• Determine appropriate data to collect
and selecting valid and reliable tools
• Distinguish relevant from irrelevant
data
• Select appropriate norms and
standards for comparing the data
• Organizing and categorizing the data
in a meaningful way that relates to
nutrition problems
Nutrition Assessment
• Data collected depends on the practice
setting
• For individuals, data can come from
patient through interview, observations,
and measurement; from health care
providers or referring agencies, medical
record or laboratory tests
• For populations, data from surveys,
administrative data sets, and
epidemiological and research studies
NUTRITION ASSESSMENT : DATA
In the development of the standardized
nutrition diagnosis, 5 categories of
nutrition assessment data :
— food/nutrition history
— anthropometric measurements
— biochemical data, medical tests,
and procedures
— physical examination findings
— client history
NUTRITION ASSESSMENT : DATA
Food/Nutrition History consists of four
areas:
- food intake
- nutrition and health awareness
and management
- physical activity and exercise
- food availability.
NUTRITION ASSESSMENT : DATA
Anthropometric Measurements
Anthropometric Measurements include
height, weight, body mass index (BMI),
growth rate, and rate of weight change.
NUTRITION ASSESSMENT : DATA

Biochemical Data, Medical Tests, and

Procedures
Biochemical Data, Medical Tests, and
Procedures include laboratory data (e.g.,
electrolytes, glucose, lipid panel, and gastric
emptying time).
NUTRITION ASSESSMENT : DATA
Physical Examination Findings
Physical Examination Findings include
oral health, general physical
appearance, muscle and subcutaneous
fat wasting, and affect.
Pemeriksaan fisik berkaitan penyakitnya utk
mdeteksi gejala dan tanda yg berhubungan
dengan malnutrisi.
Pemeriksaan fisik meliputi inspeksi, palpasi,
auskultasi dan perkusi.
NUTRITION ASSESSMENT : DATA

Client History
Client History consists of four areas:
- medication and supplement history
- social history
- medical/health history
- personal history.
Nutrition Assessment : History
• Integrating assessment data
- Subjective Global Assessment (SGA)
- Combines historical information with
results of physical examination

• Functional Assessment
– Exercise tolerance
– Respiratory muscle strength
– Immunity
Nutrition Care Process ADA NUTRITION CARE PROCESS AND MODEL
Screening & Referral
System
 Identify risk factors
 Use appropriate tools
and methods
 Involve
interdisciplinary
collaboration Nutrition Diagnosis
 Identify and label problem
Nutrition Assessment  Determine cause/contributing risk
 Obtain/collect timely and
factors
appropriate data  Cluster signs and symptoms/
 Analyze/interpret with defining characteristics
evidence- based standards
Document
 Document

Relationship
Between
Patient/Client/Group Nutrition Intervention
& Dietetics  Plan nutrition intervention
Professional  Formulate goals and
determine a plan of action
Implement the nutrition intervention
Nutrition Monitoring and  Care is delivered and actions
-
Evaluation are carried out
 Monitor progress  Document
 Measure outcome indicators
 Evaluate outcomes
 Document

Outcomes
Management System
 Monitor the success of the Nutrition Care
Process implementation
 Evaluate the impact with aggregate data
 Identify and analyze causes of less than
optimal performance and outcomes
 Refine the use of the Nutrition Care
Process
Figure : NCP
ADA’s Nutrition Care Process
Steps
• Nutrition Assessment
• Nutrition Diagnosis
• Nutrition Intervention
• Nutrition Monitoring and Evaluation
Nutrition Diagnosis
Nutrition Diagnosis is the
identification and labeling that
describes an actual occurrence,
risk of, or potential for developing
a nutritional problem that
dietetics professionals are
responsible for treating
independently.
Nutrition Diagnosis
Diagnosis gizi
Diagnosis gizi adalah identifikasi
dan memberi nama yang menerangkan
kejadian aktual, risiko atau potensi
terjadinya gangguan atau masalah gizi.
Nutrition Diagnosis
Diagnosis gizi
Diagnosis gizi merupakan kegiatan
indentifikasi dan penetapan masalah
yang menggambarkan kondisi pasien
serta risiko dan /atau potensi terjadinya
masalah gizi yang perlu ditindak lanjuti
Nutrition Diagnosis
Diagnosis gizi
Diagnosis gizi yang tepat
dihasilkan berdasarkan data status
gizi yg diperoleh dari Assessment
gizi kemudian bisa dijadikan acuan
untuk intervensi gizi.
Using Assessment Data to Identify
the Nutrition Diagnosis
Nutrition Assessment

Biochemical Client History Anthropometric Physical Exam Food/nutrition/

Data Measures Findings client History

Labs wnl GERD 10lb Weight loss Lost subq adipose Decreased intake
Mild HTN Temp elevated Nausea
Presumed pneumonia

<50% of meals

Involuntary Weight Loss

(NC-3.2)
 Nutrition Diagnosis
• The nutrition diagnosis is derived from
the synthesis of nutrition assessment
data, and the wording is obtained from
the nutrition diagnoses reference sheets
Example
• Swallowing Difficulty NC-1.1
Nutrition Diagnosis
Penulisan diagnosis gizi dilakukan dg
format P E S yaitu Problem, Etiologi,
dan Sign/Simptons.

Written as the P-E-S statement:

• Problem: What is it that the dietetics
professional has identified?
• Etiology: What is the cause or contributing
factor for this problem?
• Signs and symptoms: What is the patient
showing or telling that leads to identification
of the problem?
Nutrition Diagnosis

33
Nutrition Diagnosis

34
Nutrition Diagnosis
• Problem (Diagnostic Label)
–Data collected in the assessment
lead to the problem
–Statement describes alterations in
patients nutritional status
Nutrition Diagnosis
Problem (Diagnostic Label)
Komponen Problem menggambarkan
kondisi yang dapat berpengaruh
terhadap perubahan status gizi

Problem dikelompokkan atas 3 (tiga)

domain yaitu Intake, Clinic (klinis)
dan Behaviour environment
(perilaku lingkungan).
Nutrition Diagnosis
The 62 nutrition diagnoses/problems
have been given labels that are
clustered into 3 domains:
1. Intake
2. Clinical
3. Behavioral-environmental.

Each domain represents unique

characteristics that contribute to
nutritional health.
Nutrition Diagnosis
Nutrition diagnosis domain Intake,
defined as “actual problems related
to intake of energy, nutrients,
fluids, bioactive substances
through oral diet or nutrition
support (enteral or parenteral
nutrition)
Nutrition Diagnosis
Nutrition diagnosis domain Intake.
Intake merupakan masalah aktual
yang berhubungan dengan asupan
energi, zat gizi, cairan, substansi
bioaktif dari makanan, baik makanan
yang melalui oral, maupun parenteral
dan enteral.
Contoh:
- Peningkatan kebutuhan energi
Nutrition Diagnosis Domains: Intake
Nutrition Diagnosis Domains: Intake
Composed of 5 (five) classes:
–Class: Calorie energy balance
–Class: Oral or nutrition support intake
–Class: Fluid intake balance
–Class: Bioactive substances balance
–Class: Nutrient balance
Nutrition Diagnosis Domains: Intake
Intake (NI)
- Calorie/ Energy Balance (NI-1)
- Oral or Nutrition Support Intake (NI-2)
- Fluid Intake Balance (NI-3)
- Bioactive Substances Balances (NI-4)
- Nutrient Balance (NI-5)
Fat and Cholesterol, Protein,
Carbohydrate and Fiber,
Vitamin, Mineral
Nutrition Diagnosis
Nutrition Diagnosis Domains: Intake
Domain Intake (NI)
Class :
• NI-1.5 Excessive energy intake
• NI-2.2 Excessive oral food/beverage intake
• NI-4.3 Excessive alcohol intake
Nutrition Diagnosis Domains: Intake
Domain Intake (NI)
Subclass :
• NI-5.6.2 Excessive fat intake
• NI-5.6.3 Inappropriate intake of food fats
• NI-5.8.2 Excessive carbohydrate intake
• NI-5.8.3 Inappropriate intake of types of
carbohydrate
• NI-5.8.4 Inconsistent carbohydrate intake
• NI-5.8.5 Inadequate fiber intake
Nutrition Diagnosis
Nutrition diagnosis domains
Clinical, defined as “nutritional
findings/problems identified that
relate to medical or physical
conditions
Nutrition Diagnosis Domains: Clinical
Defined as “nutritional
findings/problems identified that relate
to medical or physical conditions

Composed of 3 (three) classes :

– Class: Functional balance
– Class: Biochemical balance
– Class: Weight balance:
Nutrition Diagnosis Domains: Clinical
Domain Clinical (NC)
- Functional (NC-1)
- Biochemical (NC-2)
- Weight (NC-3)
Nutrition Diagnosis
Nutrition Diagnosis
Nutrition diagnosis domains
Behavioral – environmental, defined
as “nutritional findings/problems
identified that relate to knowledge,
attitudes/beliefs, physical
environment, or access to food and
food safety
Nutrition Diagnosis Behavioral -
envirenmental
Nutrition diagnosis domain
Behavioral – environmental.
Perilaku lingkungan merupakan Masalah
gizi yg berkaitan dengan pengetahuan,
perilaku/kepercayaan, lingkungan fisik
dan akses serta keamanan makanan
Contoh:
- Tidak mampu makan secara mandiri
- Gangguan pola makan
Nutrition Diagnosis Domains:
Behavioral - environmental
Defined as “nutritional findings/problems
identified that relate to knowledge,
attitudes/beliefs, physical environment, or
access to food and food safety
Composed of 3 (three) Classes:
–Class: Knowledge and beliefs
–Class: Physical activity, balance
and function
–Class: Food safety and access
Nutrition Diagnosis Domains:
Behavioral - environmental
Domain Behavioral -Environmental
(NB)
- Knowledge and Belief (NB-1)
- Physical Activity (NB-2)
- Food Safety and Access (NB-3)
Nutrition Diagnosis
Nutrition Diagnosis
• Etiology (Cause/Contributing Factors)
– Related factors that contribute to problem, or
maintenance of pathophysiological
– Identifies cause of the problem
– Link to the problem diagnostic labels by word
“related to” (RT)
– Helps determine whether nutrition intervention
will improve problem
– Note: etiology may not always be clear
Nutrition Diagnosis
Etiology (Cause/Contributing Factors)
• Komponen etiologi merupakan pernyataan
dari faktor penyebab atau faktor-faktor yang
mempunyai kontribusi terjadinya problem.
• Faktor etiologi/penyebab dapat berkaitan
dengan patofisiologi, psikososial,
lingkungan
• Etiologi merupakan dasar dari penentuan
intervensi
Nutrition Diagnosis
• Etiology (Cause/Contributing Factors)
– Excessive calorie intake (problem) related
to regular consumption of large portions of
high-fat meals (etiology)
– Swallowing difficulty (problem) related to
stroke (etiology)
Nutrition Diagnosis
Signs/Symptoms
(Defining characteristics)
– Evidence that problem exists
– Linked to etiology by words
“as evidenced by” (AEB)
Nutrition Diagnosis
Signs/Symptoms
• Sign/simpton merupakan pernyataan
yang menggambarkan besarnya atau
kritisnya kondisi pasien.
• Sign atau Tanda merupakan data
objektif
• Simptom atau Gejala merupakan data
subjektif
Nutrition Diagnosis
• The practitioner obtains the etiology and
the signs and symptoms during the
nutrition assessment phase of the
nutrition care process.
Nutrition Diagnosis Components
• Example :
– Swallowing difficulty (Problem) related to
stroke (Etiology) as evidenced by
coughing following drinking of thin liquids
(Signs and Symptoms)
Nutrition Diagnosis Components
Interventions are often guided by the
etiology of each problem.

Signs and symptoms may provide

measures to evaluate outcomes and
the effectiveness of care.
Nutrition Care Process ADA NUTRITION CARE PROCESS AND MODEL
Screening & Referral
System
 Identify risk factors
 Use appropriate tools
and methods
 Involve
interdisciplinary
collaboration Nutrition Diagnosis
 Identify and label problem
Nutrition Assessment  Determine cause/contributing risk
 Obtain/collect timely and
factors
appropriate data  Cluster signs and symptoms/
 Analyze/interpret with defining characteristics
evidence- based standards
Document
 Document

Relationship
Between
Patient/Client/Group Nutrition Intervention
& Dietetics  Plan nutrition intervention
Professional  Formulate goals and
determine a plan of action
Implement the nutrition intervention
Nutrition Monitoring and  Care is delivered and actions
-
Evaluation are carried out
 Monitor progress  Document
 Measure outcome indicators
 Evaluate outcomes
 Document

Outcomes
Management System
 Monitor the success of the Nutrition Care
Process implementation
 Evaluate the impact with aggregate data
 Identify and analyze causes of less than
optimal performance and outcomes
 Refine the use of the Nutrition Care
Process
Figure : NCP
ADA’s Nutrition Care Process
Steps

– Nutrition Assessment
– Nutrition Diagnosis
– Nutrition Intervention
– Nutrition Monitoring and
Evaluation
Nutrition Intervention
Definition :
• “Purposely-planned actions designed
with the intent of changing a nutrition-
related behavior, risk factor,
environmental condition, or aspect of
health status for an individual, a
target group, or population at large.”
Nutrition Intervention
Intervensi gizi merupakan kegiatan/
tindakan terencana yg didesain untuk
mengubah kebiasaan, faktor risiko dan
kondisi lingkungan yang berhubungan
dengan masalah gizi, atau status
kesehatan perorangan, kelompok atau
masyarakat.
Nutrition Intervention
Intervensi gizi berhubungan dg seleksi,
perencanaan (planning) & pelaksanaan
(implementation) pelayanan gizi yang
tepat sesuai kebutuhan gizi pasien

Intervensi gizi bisa dimaksudkan untuk

mengantisipasi perubahan metabolik
dan patogenesis penyakit.
Nutrition Intervention
Nutrition Intervention
• The intervention documentation
includes :
– a goal(s) or a desired outcome(s)
– a nutrition prescription
– implementation of the plan.
Nutrition Intervention
• Nutrition intervention consists of two
interrelated components :
– Planning
– Implementation
of appropriate action to meet patient
nutrition nedds
Nutrition Intervention
• The Nutrition Intervention cannot be
completed unless both components
(planning and implementation) are in
place to support the nutrition
intervention.
Nutrition Intervention
Planning
• An essential part of planning the
nutrition intervention is detailing the
Nutrition Prescription.
• The nutrition prescription either
drives the nutrition intervention
selection or is the context within which
the nutrition intervention should be
implemented.
Nutrition Intervention
Planning
The nutrition prescription, the patient
individualized recommended dietary
intake of : - energy and nutrients
- foods
based on current reference standards,
dietary guidelines, the patient’s health
condition and nutrition diagnosis
Nutrition Intervention
Planning, The nutrition prescription
The recommended dietary intake of :
- energy
- nutrients - carbohydrate
- protein
- fat
- vitamin
- mineral
Nutrition Intervention
Planning, The nutrition prescription
The recommended dietary intake of :
- food - portion
- composition
- type
- delivery of food
- oral
- enteral
- parenteral …………. etc
Nutrition Intervention
Implementation
-Implementation is the action phase
of the nutrition care process.

- Care is delivered and actions are

carried out
Nutrition Intervention
Implementation
The Standardized Language Task Force
identified four main classes of nutrition
interventions :
• Food and/or Nutrient Delivery/
Provision(ND)
• Nutrition Education (NE)
• Nutrition Counseling (NC)
• Coordination of Nutrition Care (RC)
Each class is defined with subclasses
Nutrition Intervention
Implementation
Food and/or Nutrient Provision (ND) :
• refers to an individualized
approach for food/nutrient provision
• will commonly be used by
practitioners in institutional settings
and home care.
Nutrition Intervention
Implementation
Food and/or Nutrient Delivery (ND)
– Meal and Snacks .. (ND-1)
– Enteral and Parenteral Nutrition ..(ND-2)
– Supplements .. (ND-3)
– Feeding Assistance .. (ND-4)
– Feeding Environment .. (ND-5)
– Nutrition-Related Medication
Management .. (ND-6)
Nutrition Intervention
Implementation
Meal and Snacks (ND-1)
• Meals are regular eating events that
include a variety of foods consisting of
grains and/or starches, meat and/or meat
alternatives, fruits and vegetables, and milk
or milk products.
• A snack is defined as food served
between regular meals.
 Nutrition Intervention
Implementation
Enteral and Parenteral Nutrition (ND-2)
• Nutrition provided through the gastro-
intestinal tract via tube, catheter, or stoma
that delivers nutrients distal to the oral cavity
(enteral) or the administration of nutrients
intravenously, centrally or peripherally,
(parenteral).
Nutrition Intervention
Implementation
Supplements (ND-3)
• Foods or nutrients that are not intended as
a sole item or a meal or diet, but that are
intended to provide additional nutrients.
Nutrition Intervention
Implementation
Supplements (ND-3)
• Supplements consists of :
• Medical Food Supplement .. (ND-3.1)
• Vitamin and Mineral Supplement .. (ND-3.2)
• Bioactive Substance Supplement .. (ND-3.3)
Nutrition Intervention
Implementation
Feeding Assistance (ND-4)
• Accommodation or assistance in eating
designed to restore the patient’s ability to
eat independently, support adequate
nutrient intake, and reduce the incidence of
unplanned weight loss and dehydration.
Nutrition Intervention
Implementation
Feeding Environment (ND-5)
• adjustment of the physical environment,
temperature, convenience, and
attractiveness of the location where food is
served that impacts food consumption.
Nutrition Intervention
Implementation
Nutrition-Related Medication
Management (ND-6)
• Modification of a drug or herbal to optimize
patient nutritional or health status.
Nutrition Intervention
Implementation
Nutrition Education (NE)
• Nutrition education is a formal
process to instruct or train a patient
in a skill or to impart knowledge to
help patients voluntarily manage or
modify food choices
Nutrition Intervention
Implementation
Nutrition Education (NE)
Nutrition education is appropriate for
food and nutrition-related knowledge
deficit.
If the patient knows the content of food
and nutrition-related, more education
probably won’t help
Nutrition Intervention
Implementation
Nutrition Education (NE)
• Initial/Brief Nutrition Education
(NE-1) -

• Comprehensive Nutrition
Education (NE-2) –
Nutrition Intervention
Implementation
Nutrition Counseling (NC)
• Nutrition Counseling (C) is a supportive
process, characterized by a collaborative
counselor-patient relationship, to set
priorities, establish goals, create individual-
ized action plans that acknowledge and
foster responsibility for self-care to treat an
existing condition and promote health.
Nutrition Intervention
Implementation
Nutrition Counseling (NC)
• Nutrition Counseling will likely be used
more by professionals in outpatient/ non-
institutionalized settings due to the nature
of the nutrition intervention and the practice
setting.
Nutrition Intervention
Implementation
Coordination of Nutrition Care (RC)
• Coordination of Nutrition Care (RC)
is consultation with, referral to, or
coordination of nutrition care with
other health care providers,
institutions, or agencies that can
assist in treating or managing
nutrition-related problems.
Nutrition Intervention
Implementation
Coordination of Nutrition Care (RC)
• Coordination of Nutrition Care (RC)
interventions will be used by
practitioners from a variety of
practice settings.
Nutrition Care Process ADA NUTRITION CARE PROCESS AND MODEL
Screening & Referral
System
 Identify risk factors
 Use appropriate tools
and methods
 Involve
interdisciplinary
collaboration Nutrition Diagnosis
 Identify and label problem
Nutrition Assessment  Determine cause/contributing risk
 Obtain/collect timely and
factors
appropriate data  Cluster signs and symptoms/
 Analyze/interpret with defining characteristics
evidence- based standards
Document
 Document

Relationship
Between
Patient/Client/Group Nutrition Intervention
& Dietetics  Plan nutrition intervention
Professional  Formulate goals and
determine a plan of action
Implement the nutrition intervention
Nutrition Monitoring and  Care is delivered and actions
-
Evaluation are carried out
 Monitor progress  Document
 Measure outcome indicators
 Evaluate outcomes
 Document

Outcomes
Management System
 Monitor the success of the Nutrition Care
Process implementation
 Evaluate the impact with aggregate data
 Identify and analyze causes of less than
optimal performance and outcomes
 Refine the use of the Nutrition Care
Process
Figure : NCP
ADA’s Nutrition Care Process
Steps
• Nutrition Assessment
• Nutrition Diagnosis
• Nutrition Intervention
• Nutrition Monitoring
and Evaluation
Nutrition Monitoring & Evaluation

Nutrition Monitoring is “the review

and measurement of the patient status
at a scheduled (preplanned) follow-up
point with regard to the nutrition
diagnosis, intervention plans/goals,
and outcomes.”
Nutrition Monitoring & Evaluation
Monitoring merupakan review dan
pengukuran yang terencana dan
sistematis untuk mem-follow up
diagnosis gizi, perencanaan/ tujuan
intervensi gizi dan juga melihat hasil
(outcomes) intervensi gizi.
Nutrition Monitoring & Evaluation
Monitoring patient outcome data:
a. Nutrient intake monitoring
b. Goals achieved or failures
c. Quality of life
d. Morbidity and mortality
e. Cost effectiveness
Nutrition Monitoring & Evaluation
Evaluation is “the systematic
comparison of current findings
with previous status, intervention
goals, or a reference standard.”

• Evaluation may measure

changes in signs and symptoms.
Nutrition Monitoring & Evaluation
Evaluasi gizi, kegiatan sistematis
membandingkan status gizi pasien
hasil intervensi gizi dg status gizi
sebelum dilakukan intervensi gizi.

Evaluasi melihat perubahan dari gejala

dan keluhan
Nutrition Monitoring & Evaluation
Evaluasi gizi biasanya menggunakan
indikator yang berhubungan diagnosis
klinik (status klinis), diagnosis gizi
(status gizi) atau standar referensi.
Nutrition Monitoring & Evaluation
Monitoring and evaluation use selected
outcome indicators that are relevant to
the patient defined needs, nutrition
diagnosis, nutrition goals, disease state.

The purpose of monitoring and

evaluation is to determine the degree to
which progress is being made and
goals or desired outcomes of nutrition
care are being met.
Nutrition Monitoring & Evaluation
Nutrition Monitoring & Evaluation
Nutrition Monitoring & Evaluation
Nutrition Care Process