Current through all regulations passed and filed through September 16, 2024
The standards of practice in nutrition care provide a common
understanding about the profession's minimum expectations for practice, and
form a basis for self-evaluation and improvement and an expectation about
nutritional care and service delivery. The standards of practice in nutrition
care are comprised of four standards representing the four steps of the
nutrition care process.
The "nutrition care process" is a systematic problem-solving
method that dietitians may use to critically think and make decisions when
providing medical nutrition therapy or to address nutrition related problems
and provide safe, effective, high quality nutrition care.
The nutrition care process shall consist of four distinct, but
interrelated steps including nutrition assessment, nutrition diagnosis,
nutrition intervention and nutrition monitoring and evaluation.
(A) The licensee uses accurate and relevant
data and information to perform nutrition assessment and identify
nutrition-related problems, as the foundation for nutrition diagnosis, the
second step of the nutrition care process.
(1)
"Nutrition assessment" means the same as "nutritional assessment" defined in
paragraph (A) of rule
4759-2-01 of the
Administrative Code.
(2) A
nutrition assessment is initiated by referral and / or screening of individuals
or groups for nutrition risk factors.
(3) The licensee systematically obtains,
verifies and interprets data in order to make decisions about the nature and
cause of nutrition-related problems.
(4) Nutrition assessment is an ongoing,
dynamic process that involves not only initial data collection, but also
reassessment and analysis of client or community needs.
(5) Problems that require consultation with
or referral to another provider are recognized.
(6) Documentation and communication of
nutritional assessment shall be complete, relevant, accurate and
timely.
(B) The licensee
determines a nutrition diagnosis to identify and label specific nutrition
problem(s) that the dietitian is responsible for treating.
(1) "Nutrition diagnosis" is the
identification and labeling that describes an actual occurrence, risk of, or
potential for developing, a nutritional problem that dietetics practitioners
are responsible for treating independently.
(2) The nutrition diagnosis is not a medical
diagnosis. It results following nutrition assessment and the clustering,
analysis, and synthesis of data and demonstrates a link to determining goals
for outcomes, selecting appropriate interventions and tracking progress in
attaining expected outcomes.
(3)
Documentation of nutrition diagnosis(es) shall be relevant, accurate and timely
and shall be revised and updated as additional assessment data become
available.
(C) The
licensee utilizes nutrition intervention as the third step in the nutrition
care process to identify and implement appropriate, purposefully planned
actions designed with the intent of changing a nutrition-related behavior, risk
factor, environmental condition or aspect of health status for an individual,
target group, or the community at large.
(1)
"Nutrition Intervention" is a specific set of activities and associated
materials used to address the problem; 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, target group, or the
community at large. It involves selection, planning, and implementing
appropriate actions to meet patient / client / group's nutrition
needs.
(2) "Intervention planning"
involves prioritizing the nutrition diagnoses, conferring with the patient /
client / and / or others, reviewing practice guides and policies, and setting
goals and defining the specific nutrition intervention strategy.
(3) "Implementation of the nutrition
intervention" is the action phase that includes carrying out and communicating
the plan of care, continuing data collection, and revising the nutrition
intervention strategy, as warranted, based on the patient / client
response.
(4) The licensee performs
the interventions or assigns the nutrition care that other competent
practitioners may provide in accordance with federal, state and local laws and
regulations.
(D) The
licensee monitors and evaluates indicators and outcomes data directly related
to the nutrition diagnosis, goals and intervention strategies to determine the
progress made in achieving desired outcomes of nutrition care and whether
planned interventions should be continued or revised.
(1) "Nutrition monitoring and evaluation" is
the fourth step of the nutrition care process. Monitoring specifically refers
to the review and measurement of the patient / client / group's status at a
scheduled (preplanned) follow-up point with regard to the nutrition diagnosis,
intervention plans / goals and outcomes, whereas evaluation is the systematic
comparison of current findings with previous status, intervention goals, or a
reference standard. Monitoring and evaluation use selected outcome indicators
(markers) that are relevant to the patient / client / group's defined needs,
nutrition diagnosis, nutrition goals, and disease state.
(2) The licensee uses standard nutrition care
outcome indicator(s) to measure outcomes.
(3) Monitoring data should be compared with
the nutrition prescription / goals / or reference standards to evaluate impact
of the sum of all interventions on overall patient / client health
outcomes.
(4) Documentation of
nutrition monitoring and evaluation shall be comprehensive, specific, accurate,
relevant and timely and reflect the indicators measured, results and method for
obtaining measurement. The criteria to which the indicator is compared and
factors facilitating or hampering progress should be referenced in support of
positive or negative outcomes. Future plans for nutrition care, monitoring and
follow-up or discharge should be included.
