Nutrition Care Process: How Foodzilla Improves your NCP Experience
🖊️ Authored by Hannah (July 2022)
As nutrition professionals, it is a constant goal to improve the efficiency and effectiveness of our nutrition care practice. However, juggling nutrition counseling, business management, and process improvement can add up quickly and become overwhelming. The founders of Foodzilla have designed this platform to advance your experience as a nutrition care provider and reduce the barriers to running a successful practice. In this article, we’ll explain what the Nutrition Care Process is, why it’s useful in the field of dietetics, and how Foodzilla can improve this process.
Figure 1. The Nutrition Care Process Four Core Steps
Note: This model is adapted from the Academy of Nutrition and Dietetic’s Nutrition Care Model (2002).
What is the Nutrition Care Process, and Why Does it Matter?
The Nutrition Care Process (NCP) was developed by the Academy of Nutrition and Dietetics (AND) to provide nutrition professionals with the framework for critical thinking and decision-making in their practice setting2. Since its development, the NCP has helped many Registered Dietitian Nutritionists (RDNs) and Nutrition and Diet Technicians, Registered (NDTRs) standardize their care process and create more positive client outcomes4. However, checking all the boxes during each process step can be time-consuming and sometimes overwhelming. Let’s review the four stages of the NCP:
- 1. Nutrition analysis
- 2. Nutrition diagnosis
- 3. Nutrition intervention
- 4. Nutrition monitoring and evaluation
Each nutrition counseling session should begin with the nutrition analysis2. The goal of the nutrition analysis is to gather information about the client which will guide the direction of the nutrition encounter. The nutrition analysis collects information from six domains(3):
- - Food and nutrition-related history
- - Anthropometric measurements
- - Biochemical data, medical tests, and procedures
- - Nutrition-focused physical findings
- - Client history
The primary function of the RDN and NDTR in the nutrition analysis is to document, obtain, verify, and interpret data collected through a variety of methods. Forms, interviews, diet recalls, and physical assessments are all useful data collection tools. This data will highlight pertinent nutrition-related problems to address throughout the current NCP and for benchmarking progress during the monitoring and evaluation phase.
Due to the nature of data collection and documentation, the nutrition analysis tends to be time-consuming and complex. Many nutrition professionals can attest to the lengthy nature of dietary recalls. Clients become uncomfortable while straining to remember everything they’ve consumed in the last 72 hours, down to the last teaspoon. Practitioners lose valuable time during this step which can be spent educating the client or building rapport. Regardless, this client information is vital to the NCP and must be collected. This leaves many wondering… are documents and dietary recalls the most efficient and effective way of collecting client data?
Foozilla seeks to advance your data collection experience by replacing time-consuming and tedious tasks with a more efficient process. Doctor’s notes, referrals, and other files can be uploaded to your client’s chart to avoid repetitive and unnecessary questioning. The Foodzilla Mobile App’s food tracking feature can completely eliminate dietary recalls. This can be done by instructing your client to begin logging all foods consumed before your initial encounter. Foodzilla will provide you with an automatically calculated nutrient analysis of your client’s diet to discuss during your meeting.
These two suggestions alone can improve your client’s experience by avoiding long periods of questioning and opening more time for discussion. Alternatively, these suggestions can improve your experience by creating more time in your workday for additional appointments. Regardless, time-saving features in the nutrition analysis can significantly improve your client management experience.
The nutrition diagnosis portion of the NCP is driven by the client data collected in the nutrition analysis3. The role of the nutrition professional in this stage is to identify the most relevant nutrition-related problems to address in the nutrition encounter. This involves identifying the problem's signs, symptoms, and etiology. Note my use of the term nutrition-related problem. This diagnosis is different from a medical diagnosis as the Scope of Practice (SOP) for RDNs and NDTRs in this step is limited to(2):
- - Intake: problems associated with intake of energy, nutrients, fluids, and other substances
- - Clinical: nutritional problems associated with a medical or physical condition
- - Behavioral-environmental: problems associated with nutrition-related knowledge, attitudes, beliefs, environment, access to food, and food safety
Please note that nutrition professionals can diagnose nutrition problems related to clinical diagnoses (i.e., unintended weight loss, altered GI function, malnutrition) but not their clinical counterparts (i.e., diabetes, Chron’s Disease, COPD). The Nutrition Care Process Terminology (NCPT) database has created standardized diagnostic codes and terms to guide nutrition professionals in this task.
The nutrition diagnosis aims to identify the chief complaint and its related cause2. RDNs and NDTRs may need to assume the role of a detective by evaluating signs and symptoms to draw upon the dominant cause. Identifying the root cause of a problem is crucial to developing an effective intervention. Using the NCPT, a dietitian can create a PES statement to clearly state the problem as it relates to the etiology as evidenced by signs and symptoms. This type of simple documentation has become standardized in American nutrition practice among many healthcare fields(1).
Figure 3. The PES Statement Correct Format
Note: PES statement adapted from Dr. Marjory Gordon, founder and former president of NANDA-I.
The PES Statement can be easily added to your client’s notes and files for documentation and quick reference. This statement can be easily translated to a modifiable health goal in your client’s dashboard. Your client can view their health goals in the mobile app throughout their treatment process.
The nutrition intervention is built upon the nutrition diagnosis, using the etiology of the recognized problems to develop health goals and treatment plans3. The nutrition practitioner’s role in this stage is to guide the client in setting goals and identifying ways in which the client can meet those goals. This stage may involve nutrition education, planning, nutrition prescriptions, and counseling.
The nutrition intervention should be client-driven to achieve the best outcomes. The client should be deeply involved in the conversation and development of treatment plans and goals. Clients with more of a say in the creation of a treatment plan are more likely to be highly motivated and dedicated to their plan.
Goals, or desired outcomes, should be documented clearly and in observable and measurable terms for the nutrition practitioner and client to refer back to. Foodzilla involves goals throughout the client management process. The nutrition professional can set goals while setting up a new client profile, then continue to add or modify existing goals in the client profile. The nutrition care provider can tailor any existing goal prompt or create a new custom goal. Each client’s individual goals will reflect in their mobile app for referencing during their care process. This is integral to the development and adaptation of treatment plans.
RDNs and NDTRs can use these goals to develop a suitable nutrition intervention. Nutrition interventions can vary widely depending on the client’s needs. Some interventions may be as intensive as parenteral nutrition formulas or as simple as reducing single-item food intake. Regardless, each nutrition intervention requires care and focus from the nutrition professional and client to ensure its implementation.
Foodzilla offers features which aids in the implementation of a nutrition plan:
- - Nutrition and Health Goal-setting
- - Customizable meal planning and mobile app to keep them motivated
- - Templates ready to be used for various diets
- - Extensive food database collections to analyze nutrition
- - App experience customizations and branding
Foodzilla’s meal planning feature allows nutrition professionals to easily create a meal plan tailored to their client’s goals and needs. Meal plans can be customized to meet macronutrient and energy targets, micronutrient restrictions, and health requirements such as FODMAP-free, gluten-free, allergen-free, vegan, vegetarian, kidney-friendly, and keto. These meal plans can be autogenerated at the click of a button or custom-made to meet your goals and expectations.
Additionally, the client app can be highly customized to reinforce the treatment plan. There are many ways to support your client’s treatment plan using Foodzilla’s app experience customization feature. For example, calorie, nutrition, and food insight information can be hidden from your clients. This is useful for disordered eating treatment plans. Alternatively, this information can be made available for your client to track and view throughout their day. This way, your client can compare their intake with daily food targets. This is useful for clients who are counting carbohydrates for insulin therapy or watching protein for muscle growth.
Nutrition education websites and PDFs can be added as quick links to your client’s app for referencing and learning. This can be done by visiting the branding tab in your Foodzilla browser. This feature can improve your client’s connectivity to the resources your brand has to offer.
Nutrition Monitoring and Evaluating
There is no ‘final step’ to the nutrition care process as it is continuous. The nutrition monitoring and evaluation stage can be viewed as a stepping stone between the previous and future steps in a client’s treatment process. This stage is similar to the nutrition analysis stage concerning data collection and assessment2. In this step, the nutrition professional should monitor, measure, and evaluate their client’s progress during treatment(3).
This step requires the RDN or NDTR to reflect on their client’s goal achievement by asking several questions including:
- - Did the client meet their goals?
- - If not, is the nutrition intervention being implemented as agreed upon?
- - Has the client’s condition changed at all?
This assessment will drive the subsequent nutrition diagnosis and intervention.
As mentioned above, the monitoring and evaluation phase involves gathering data to evaluate progress, lack of progress, and any information to describe why the goals have not been met. This involves more forms, interviews, dietary recalls, and clinical data collection. This process occurs over time, with intention and documentation.
Many nutrition care professionals can attest to the complexity of monitoring and evaluation. Comparing data, adding numbers, and evaluating intake can become a time-consuming part of the NCP. Foodzilla makes this process much easier for RDNs and NDTRs with the nutrition insights feature. Each client profile features displays their nutrition overview for the day, week, and month. This feature shows meals consumed, macronutrients, micronutrients, fluid, and physical activity. This allows the nutrition professional to easily identify which targets are met or not met and how to develop a new intervention to assist their client’s nutrition treatment.
- 1. How to Write a Perfect PES Statement | Dietitians On Demand. (2022, May 27). Dietitians On Demand | Professional Recruiting Services for Contract and Permanent-Hire Positions. https://dietitiansondemand.com/how-to-write-a-perfect-pes-statement/
- 2. Nelms, M., & Sucher, K. (2020). Nutrition Therapy & Pathophysiology. (4th ed.). Cengage
- 3. Nutrition Care Process. (n.d.).Eat Right Pro Academy of Nutrition and Dietetics. https://www.eatrightpro.org/practice/quality-management/nutrition-care-process
- 4. The Nutrition Care Process (NCP). (n.d.). Electronic Nutrition Care Process Terminology. https://www.ncpro.org/nutrition-care-process
- 5. Swan, W. I., Vivanti, A., Hakel-Smith, N. A., Hotson, B., Orrevall, Y., Trostler, N., Beck Howarter, K., & Papoutsakis, C. (2017). Nutrition Care Process and Model Update: Toward Realizing People-Centered Care and Outcomes Management. Journal of the Academy of Nutrition and Dietetics, 117(12), 2003–2014. https://doi.org/10.1016/j.jand.2017.07.015
Ready to level-up?
The purpose of the NCP is to simplify and standardize the complex process of nutrition care. Foodzilla aims to make the NCP experience more efficient and effective to benefit the nutrition care provider and the client. Try Foodzilla free for 10 days to see how it can help you build and improve your nutrition coaching business.