Updated: Jan 28, 2020
Welcome to the Beginners Guide To The Nutrition Care Process!
Knowing about the Nutrition Care Process and its 4 crucial steps is one of the first things every Registered Dietitian needs to know!
In your dietetic internship or when working as an RD/RDN, you will use the Nutrition Care process (NCP) every single day! When you first learn about it in school, the NCP can seem overwhelming, but its actually super simple once you get the hang of it, and it makes caring for a patient and filling out all the medical documentation really easy and organized.
Let’s start with the definition of the Nutrition Care Process (NCP)!
According the the Academy of Nutrition and Dietetics (2020):
“The Nutrition Care Process (NCP) is a systematic approach to providing high quality nutrition care. The NCP consists of four distinct, interrelated steps: Nutrition Assessment, Nutrition Diagnosis, Nutrition Intervention, and Nutrition Monitoring/Evaluation.”
Essentially, the Nutrition Care Process is the basic framework that the dietitian uses to assess, diagnose, treat, and monitor a patient’s nutritional progress.
The“ADIME” Acronym to Easily Remember the 4 NCP Steps
I’ll be honest…the NCP can seem a bit overwhelming at first, so we are going to break it down to make it as simple as possible to understand! The Nutrition Care Process is often referred to as ADIME, which is simply a way to remember the 4 steps. Here is what ADIME stands for:
Okay, I know that looks like 5 steps, but I promise it really is 4! The last 2 steps (Monitoring and Evaluation) are lumped together, and in a moment we will go over why this is!
Here is an Overview of the 4 Steps of the Nutrition Care Process:
(Academy of Nutrition & Dietetics, 2020)
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.”
In the NCP Nutrition Assessment, you will examine your patient, calculate BMI and weight changes, record and assess food intake, go over the medical records for diagnoses, and check out their most recent lab values.
It’s also the step where you will conduct a Nutrition-Focused Physical Exam (NFPE), which is the hands-on part of the RD’s nutrition assessment. Learn more about Nutrition Assessment and the NFPE here.
DIAGNOSIS: “Data collected during the nutrition assessment guides the RDN in selection of the appropriate nutrition diagnosis (i.e., naming the specific problem).”
In the NCP Nutrition Diagnosis, you will use your assessment data to determine what the #1 priority nutrition diagnosis is for the patient.
This is also the step where you will write your PES Statement, which stands for Problem (Nutrition Diagnosis), Etiology, and Signs/Symptoms. Learn more about Nutrition Diagnosis and PES Statements here.
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.”
NCP Nutrition Interventions may include changes to food/nutrient/fluid delivery, nutrition education, nutrition counseling, coordination of care with other providers, and more. Learn more about Nutrition Intervention here.
MONITORING/EVALUATION: “The final step of the process is monitoring and evaluation, which the RDN uses to determine if the client has achieved, or is making progress toward, the planned goals.”
The 2 NCP steps of Monitoring and Evaluation steps are lumped together because monitoring the client involves identifying specific parameters you will measure, such as BMI or caloric intake, and based on the progress of these specific outcomes, you will then write an evaluation of whether the client met the goal, needs continued care, or can be discharged. Learn more about Nutrition Monitoring/Evaluation here.
What is Nutrition Care Process Terminology (NCPT)?
There are specific terms used for each step of the NCP, which makes it easier to document and fill out patient records. This terminology is called the NCPT, which stands for…you guessed it…Nutrition Care Process Terminology.
I highly recommend subscribing to the eNCPT, which you can find at this link: https://www.ncpro.org. You can download the terminology sheets, which I like to carry around with me at work to refer to at any time.
You do NOT have to have it all memorized! If you are learning the Nutrition Care Process for the first time, take a deep breath! I promise you will get this down with a little practice!
And Finally….What is the Nutrition Care Process Model?
I don’t want to get too technical in this Beginner’s Guide to the Nutrition Care Process, but you may hear the term “Nutrition Care Model,” and I want to briefly cover what that is referring to. When you are assessing a patient for the first time, you will probably go through the NCP steps in a linear fashion, but when you are looking at re-assessment and monitoring the individual’s nutrition status, it’s really more of a circle. This is why you might hear it called the “Nutrition Care Model,” which looks like this:
(don't worry too much about the model for now!)
Your Next Steps in Learning About the Nutrition Care Process!
We have an entire guide dedicated to each step in the NCP, complete with FREE Pdfs for you to download!
If you are a Registered Dietitian or Dietetic Student looking to master the Nutrition Care Process, check out the informative blogs below, which break down each part of the Nutrition Care Process in easy-to-understand steps, including specific terminology, infographics and downloadable PDFs!
NCP: Nutrition Diagnosis and PES Statements
NCP: Nutrition Intervention
NCP: Nutrition Monitoring/Evaluation
And definitely do not forget this FREE bonus…..
Awesome Nutrition PES Statement Examples Cheat Sheet!
3 Steps to Become a Brilliant Registered Dietitian TODAY!
Sign up for FREE to receive MNT Cheat Sheets for Dietitians, and be in-the-know about new podcast episodes, blogs, and other top-notch resources for dietitians and dietetic students! (bottom of this page!)
Read the Brilliant Dietitian Blog!
Head over to the Medical Nutrition Therapy Podcast and subscribe!
Hey you, awesome RD or RD-to-be! Do you still have questions about the Nutrition Care Process? You can email me directly at firstname.lastname@example.org with your questions and requests and I will get back to you ASAP!
“Have a fantastic day and get out there and BE A BRILLIANT DIETITIAN!”
😀 Bethany, MS, RDN
Your Dietitian Success Coach!
Academy of Nutrition & Dietetics: https://www.ncpro.org/nutrition-care-process
Nutrition Care Process Model: https://www.researchgate.net/figure/The-Nutrition-Care-Process-Model_fig1_336121981