Practice Consideration
Re-assessment Versus Initial Assessment
The first step in a follow-up consultation is a re-assessment and evaluation of progress.(1) The dietitian does not repeat the work done in the previous consultation, but determines which of the Nutrition Assessment components identified in that visit remain relevant and whether new Nutrition Assessment data are required.
The dietitian uses data from the Monitoring and Evaluation outcomes identified in the previous visit to measure whether the patient has reached the indicator criteria. Next the dietitian assesses any changes in the patient’s condition, living situation or lifestyle so as to determine whether any of the existing assessment has changed or additional Nutrition Assessment data and analysis are required. For example, if in a previous consultation the dietitian had undertaken an estimation of the patient's energy and protein needs, she/he will determine whether the estimates need to be adjusted to take account of changes in their condition.
The dietitian does not have to recalculate energy needs at every consultation, and applies clinical judgment to decide if that is warranted. Factors in the decision include whether the Monitoring and Evaluation outcomes can be measured without undertaking a dietary analysis, time since the last visit and the likelihood that the diet has changed.
References
1. Writing Group of the Nutrition Care Process/Standardized Language Committee. Nutrition care process and model part I: The 2008 update. JADA. 2008; 108: 1113-1117.
The dietitian uses data from the Monitoring and Evaluation outcomes identified in the previous visit to measure whether the patient has reached the indicator criteria. Next the dietitian assesses any changes in the patient’s condition, living situation or lifestyle so as to determine whether any of the existing assessment has changed or additional Nutrition Assessment data and analysis are required. For example, if in a previous consultation the dietitian had undertaken an estimation of the patient's energy and protein needs, she/he will determine whether the estimates need to be adjusted to take account of changes in their condition.
The dietitian does not have to recalculate energy needs at every consultation, and applies clinical judgment to decide if that is warranted. Factors in the decision include whether the Monitoring and Evaluation outcomes can be measured without undertaking a dietary analysis, time since the last visit and the likelihood that the diet has changed.
References
1. Writing Group of the Nutrition Care Process/Standardized Language Committee. Nutrition care process and model part I: The 2008 update. JADA. 2008; 108: 1113-1117.
Updated February 01, 2018