Nutrition Care Process


The Nutrition Care Process & eNCPT

The Nutrition Care Process is a systematic approach to providing high quality nutrition care. The NCP consists of four distinct, interrelated steps:
  • Nutrition Assessment: The RDN collects and documents information such as food or nutrition-related history; biochemical data, medical tests and procedures; anthropometric measurements, nutrition-focused physical findings and client history.
  • Diagnosis: Data collected during the nutrition assessment guides the RDN in selection of the appropriate nutrition diagnosis (i.e., naming the specific problem).
  • Intervention: The RDN then selects the nutrition intervention that will be directed to the root cause (or etiology) of the nutrition problem and aimed at alleviating the signs and symptoms of the diagnosis.
  • Monitoring/Evaluation: The final step of the process is monitoring and evaluation, which the RDN uses to determine if the patient/client has achieved, or is making progress toward, the planned goals.
Using the NCP does not mean that all patients get the same care. Use of a care process provides a framework for the RDN to individualize care, taking into account the patient’s needs and values and using the best evidence available to make decisions. Other disciplines in healthcare, including nursing, physical therapy and occupational therapy have adopted care processes specific to their discipline. In 2003, the Academy's House of Delegates adopted the NCP to provide RDNs with a framework for critical thinking and decision-making — leading to more efficient and effective care and greater recognition of the role of RDNs in all care settings.

At first the Nutrition Care Process may seem like a linear approach; however, during the course of an interaction/appointment with a patient or client, the RDN will often complete the assessment and diagnosis steps, and may begin a Nutrition Intervention when a patient reveals another piece of new assessment data/information that will cause the RDN to re-assess, and re-diagnose and perhaps modify the plan that he/she had started discussing with the client. Therefore, the Nutrition Care Process is represented as a circle in the Nutrition Care Model.

The Nutrition Care Model is a graphic visualization that illustrates the steps of the Nutrition Care Process as well as internal and external factors that impact application of the NCP. The central component of the Model is the relationship of the target patient, client, or group and the RDN. One of two outer rings represents the skills and abilities of the RDN along with application of evidence-based practice, application of the Code of Ethics, and knowledge of the RDN. The second of two outer rings represents environmental factors such as healthcare systems, socioeconomics and practice settings that impact the ability of the target group or client to benefit from RDN services. Screening and referral and outcomes management are also components of the model.

What is the Nutrition Care Process and Model?

Nutrition Care Process is a standardized model intended to guide RDNs, registered in providing high quality nutrition care.
What does the eNCPT provide?
  1. The eNCPT contains a narrative describing the Nutrition Care Process and is broken down by Nutrition Care Process step. Critical thinking skills are highlighted for Nutrition Assessment, Nutrition Diagnosis, Nutrition Intervention, and Nutrition Monitoring and Evaluation. There are pages in the Nutrition Diagnosis section that highlight how to formulate PES Statements. This section also includes interactive matrices in assisting dietitians in formulating PES Statements. The Nutrition Assessment and Nutrition Diagnosis Etiology Matrices are also available to subscribers as PDF downloadable documents.

  2. The eNCPT contains interactive terminology lists. The terminology lists are organized by NCP step (Assessment, Diagnosis, Intervention, Monitoring & Evaluation) and then broken down further by domain. The interactive terminology lists link to the respective term's reference sheet. Also available within this section are Terminology Lists downloadable as PDF documents.

  3. Also included within an eNCPT subscription are all the reference sheets for all the terminology, again organized by NCP step (Assessment, Diagnosis, Intervention, Monitoring & Evaluation) and then broken down further by domain. Dietitians refer to the reference sheets to read in depth about a specific term and it’s definitions, and, if appropriate, its etiologies, signs and symptoms, etc.

  4. Organizational Subscribers and Developer Subscribers to the eNCPT have access to a downloadable spreadsheet that contains all the terminology, outlines the hierarchy of the terminology, includes alphanumeric codes that many IT departments use in building their facility’s EHR, and also includes codes that reference how the terminology is being mapped to the SNOMED/LOINC body of medical terminology.
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