Plan De Cuidado Nutricio

Nutrition Care Process and Model Part I:

The 2008 Update

The Nutrition Care Process and

Model (NCPM) is a systematic

problem-solving method that

food and nutrition professionals use

to think critically and make decisions

that address practice-related problems

(1). The NCPM provides a consistent

structure and framework for

food and nutrition professionals to

use when delivering nutrition care

and is designed for use with patients,

clients, groups, and communities of

all ages and conditions of health or

disease (herein referred to as “patients/

clients”). The original model

was developed following a review of

the literature and was intended to replace

other nutrition care processes

used in practice and education (1).

This update is the result of a

planned, regularly scheduled review of

the NCPM to ensure that it reflects current

practice. It incorporates the results

of a survey of American Dietetic

Association groups experienced with

the NCPM and incorporates decisions

made by the Nutrition Care Process/

Standardized Language Committee.

Part II of this article, which will appear

in an upcoming issue of the Journal,

describes the official international dietetics

and nutrition terminology as outlined

in the International Dietetics and

Nutrition Terminology (INDT) Reference

Manual (2), which elaborates on

and supports the NCPM. The information

in Parts I and II of this article

replaces previous information describing

the NCPM.

BACKGROUND

The NCPM contains four distinct but

interrelated and connected steps:

nutrition assessment, nutrition diagnosis,

nutrition intervention, and

nutrition monitoring and evaluation

(described in Figure 1). In theory,

each step informs the subsequent

step. However, as new information

is obtained, a registered dietitian

(RD) may revisit previous steps of

the process to reassess, add, or revise

nutrition diagnoses, modify interventions,

or adjust goals and

monitoring parameters. The NCPM

is designed to incorporate a scientific

base that moves food and nutrition

professionals beyond experience-

based practice to evidencebased

practice. If the NCPM is used

consistently by all food and nutrition

professionals, improved health

outcomes should enhance recognition

of RDs and dietetic technicians,

registered (DTRs), as the preferred

providers of nutrition services.

THE NCPM

Figure 2 is a graphic representation

of the NCPM. The outer ring of the

Model influences how patients/clients

receive nutrition information. The

practice setting reflects rules and regulations

governing practice, the age

and health conditions of particular

patients/clients, and how a food and

nutrition professional’s time is allocated.

The health care system mandates

the amount of time available to

food and nutrition professionals, the

type of services provided, and who

provides the services. The social system

reflects patients’/clients’ healthrelated

knowledge, values, and the

time devoted to improving nutritional

health. The economic aspect incorporates

resources allocated to nutrition

care, including the value of a food and

nutrition professional’s time in the

form of salary and reimbursement.

The middle ring of the Model distinguishes

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