Implementing a Clinical Practice Change: Adopting the Nutrition Care Process

Publication: Canadian Journal of Dietetic Practice and Research
25 March 2019

Abstract

The Nutrition Care Process (NCP), created by the Academy of Nutrition and Dietetics, provides a framework that encourages critical thinking and promotes uniform documentation by Registered Dietitians (RD). Additionally, it creates a link between the nutrition assessment, nutrition intervention, and the predicted or actual nutrition outcome. NCP has been integrated into a number of institutions in Canada and internationally. A committee of nonmanagement RDs at the Hospital for Sick Children led the Department of Clinical Dietetics in adopting the NCP. The committee developed and consecutively delivered a tailored education plan to 5 groups of RDs within the department. Additional resources were developed to complement the learning plan. The committee administered informal pre- and post-education surveys to measure outcomes. RDs reported receiving adequate training and felt confident implementing NCP into their practice. Adopting the NCP was well-received and RDs within the department continue to integrate it into their current practice.

Résumé

Le processus de soins en nutrition (PSN), créé par l’Academy of Nutrition and Dietetics, fournit un cadre qui favorise la pensée critique et qui promeut la documentation uniforme chez les diététistes. De plus, il crée un lien entre l’évaluation nutritionnelle, l’intervention nutritionnelle et le résultat nutritionnel escompté ou réel. Le PSN a été intégré dans certains établissements au Canada et ailleurs dans le monde. Un comité de diététistes non gestionnaires au Hospital for Sick Children a dirigé l’adoption du PSN par le service de diététique clinique. Le comité a élaboré puis mis en œuvre un plan de formation sur mesure pour cinq groupes de diététistes au sein du service. Des ressources additionnelles ont été conçues pour compléter le plan d’apprentissage. Le comité a mené des sondages non officiels avant et après la formation pour mesurer les résultats. Les diététistes ont indiqué avoir reçu une formation adéquate et se sentaient à l’aise de mettre en œuvre le PSN dans leur pratique. L’adoption du PSN a été bien reçue, et les diététistes du service continuent de l’intégrer dans leur pratique actuelle.

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Financial support: None.
Conflicts of interest: The authors declare that they have no competing interests.

References

1
Desroches S, Lapointe A, Deschenes SM, and Gagnon MP. Psychosocial factors and intention to use the nutrition care process among dietitians and dietetic interns. Can J Diet Pract Res. 2014;75(1):e335–41.
2
Dietitians of Canada. Canadian perspectives on the nutrition care process and international dietetics and nutrition terminology; 2010 [cited 2018 Mar 29]. Available from: https://www.dietitians.ca/Downloads/Public/NCP-and-IDNT-Statement-Eng.aspx.
3
Van Heukelom H, Fraser V, Koh J, McQueen K, Vogt K, and Johnson F. Implementing nutrition diagnosis: at a multisite health care organization. Can J Diet Pract Res. 2011;72:178–80.
4
Vivanti A, Ferguson M, Porter J, O’sullivan T, and Hulcombe J. Increased familiarity, knowledge and confidence with Nutrition Care Process Terminology following implementation across a statewide health-care system. Nutr Diet. 2015;72(3):222–31.
5
Lacey K and Pritchett E. Nutrition care process and model: ADA adopts a road map to quality care and outcomes management. J Am Diet Assoc. 2003;103(8):1061–72.
6
Mathieu J, Foust M, and Ouellette P. Implementing nutrition diagnosis, step two in the nutrition care process and model: challenges and lessons learned in two health care facilities. J Am Diet Assoc. 2005;105(10):1636–40.
7
Swan WI, Vivanti A, Hakel-Smith NA, Hotson B, Orrevall Y, Trostler N, et al. Nutrition care process and model update: toward realizing people-centred care and outcomes management. J Acad Nutr Diet. 2017;117(12):2003–14.
8
Vivanti A, Ferguson M, Porter J, and O’sullivan T. Staff knowledge, confidence and perceptions prior to implementation of the Nutrition Care Process (NCP) and International Dietetics and Nutrition Terminology (IDNT). J Acad Nutr Diet. 2011;111(9):A73.
9
Lovestam E, Bostrom AM, and Orrevall Y. Nutrition care process: experiences in various dietetics environments in Sweden. J Acad Nutr Diet. 2017;117(11):1738–48.
10
Gibbons K. Toward international best outcomes: the shared path of the nutrition care process, informatics, and research translation. J Acad Nutr Diet. 2017;117(11):1727–30.
11
Hammond MI, Myers EF, and Trostler N. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet. 2014;114(12):1879–94.
12
European Federation of the Associations of Dietitians. Dietitians in Europe: definition, profession and education; 2016 [cited 2019 Feb. 22]. Available from: http://www.efad.org/media/1128/revised-definition-of-a-dietitian.pdf.
13
College of Dietitians of Ontario. Professional practice standards for record keeping; 2017 [cited 2018 Mar 10]. Available from: https://www.collegeofdietitians.org/Resources/Standards/Record-Keeping.aspx.
14
Hakel-Smith N, Lewis NM, and Eskridge KM. Orientation to nutrition care process standards improves nutrition care documentation by nutrition practitioners. J Am Diet Assoc. 2005;105:1582–89.
15
Taylor LM, Moriartey S, Stadnyk J, and Basualdo-Hammond C. Assessment of Registered Dietitians’ beliefs and practices for a nutrition counselling approach. Can J Diet Pract Res. 2016;77:140–47.
16
Memmer D. Implementation and practical application of the nutrition care process in the dialysis unit. J Renal Nutr. 2013;23(1):65–73.
17
Porter JM, Devine A, Vivanti A, Ferguson M, and O’sullivan TA. Development of a nutrition care process implementation package for hospital dietetic departments. Nutr Diet. 2015;72:205–212.
18
Alberta Health Services. The nutrition care process. Edmonton, AB: Nutrition Services; 2015.
19
Writing Group of the Nutrition Care Process/Standardized Language Committee. Nutrition care process and model part 1: the 2008 update. J Am Diet Assoc. 2008;108(7):1113–17.
20
Lacey K and Cross N. A problem-based nutrition care model that is diagnostic driven and allows for monitoring and managing outcomes. J Am Diet Assoc. 2002;102(4):578–89.
21
Porter JM, Devine A, and O’sullivan TA. Evaluation of a nutrition care process implementation package in hospital dietetic departments. Nutr Diet. 2015;72:213–21.
22
Rossi M, Campbell KL, and Ferguson M. Implementation of the nutrition care process and international dietetics and nutrition terminology in a single-centre hemodialysis unit: comparing paper vs electronic records. J Acad Nutr Diet. 2014;114(1):124–30.

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Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 80Number 3September 2019
Pages: 127 - 130

History

Version of record online: 25 March 2019

Authors

Affiliations

Andrea Carpenter RD
Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON
Jordan Mann RD
Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON
Dianna Yanchis RD
Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON
Alison Campbell RD, CDE
Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON
Louise Bannister MSc, RD
Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON
Laura Vresk MSc, RD
Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON

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