Abstract
In this article, we evaluate relationships between Nutrition Care Process (NCP) chain
links and improvement or resolution of the nutrition diagnosis. We conducted a retrospective
record review for 12 months in a single Veterans Health Administration health care
system using the Veterans Health Administration–specific monitoring and evaluation
terms, NCP terminology, and its etiology categories to evaluate outcomes. Logistic
regression analysis revealed that the strongest predictor for diagnosis improvement
was the etiology–intervention link. The odds of improving the nutrition diagnosis
were 51.43 times higher when the etiology–intervention link was present. The odds
of improving the nutrition diagnosis were 19.74 times higher when the evidence–diagnosis
link was present and 9.46 times higher when the intervention–goal link was present.
For every added nutrition visit by the registered dietitian nutritionist, the odds
of improving the nutrition diagnosis increased by 32.5%. For every increased point
on the NCP audit score, the odds of resolving or improving the nutrition diagnosis
increased by 37.7%. When applying the NCP, the presence of the etiology–intervention
link significantly improves the odds of resolving the nutrition diagnosis in a Veterans
Health Administration population. For the first time, we show evidence that the NCP
works as designed. Also, we demonstrate that the quality of NCP documentation impacts
resolution of the diagnosis, and we describe the methodology for how to evaluate NCP
outcomes. Registered dietitian nutritionists are encouraged to critically evaluate
links of the NCP chain, assess NCP documentation for quality, and pursue follow-up
visits to improve resolution of nutrition problems.
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Biography
S. L. Lewis is internship director for the Anne Brezina Dietetic Internship Program at the James A. Haley Veterans Hospitals and Clinics in Tampa, FL; at the time of the study, she was a graduate student, University of North Florida, Jacksonville.
Biography
L. Wright is chair, Department of Nutrition and Dietetics, University of North Florida, Jacksonville.
Biography
A. Y. Arikawa is associate professor, Department of Nutrition and Dietetics, University of North Florida, Jacksonville.
Biography
C. Papoutsakis is senior director, Data Science Center, International and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, IL.
Article info
Publication history
Published online: July 28, 2020
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST C. Papoutsakis is an employee of the Academy of Nutrition and Dietetics, which has a financial interest in the Nutrition Care Process terminology described here. No potential conflict of interest was reported by the other authors.
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© 2021 by the Academy of Nutrition and Dietetics.
