Nutrition care involves a team of professionals working together to address patients' complex needs. From dietitians creating meal plans to speech therapists helping with swallowing issues, each role is crucial for comprehensive care.

Nurses play a key part in nutrition care, using clinical judgment to assess patients and develop personalized plans. They consider factors like culture, finances, and support systems to create realistic recommendations that fit patients' lives and preferences.

Interdisciplinary Teams in Nutrition Care

Roles in interdisciplinary nutrition care

• Registered Dietitian (RD) or Registered Dietitian Nutritionist (RDN) conducts comprehensive nutrition assessments, develops personalized nutrition care plans, provides nutrition education and counseling (portion control, balanced meals), and collaborates with other team members to monitor and evaluate patient progress
• Physician diagnoses and treats medical conditions related to nutrition (diabetes, obesity), prescribes medications and medical nutrition therapy, and oversees the overall patient care plan
• Nurse assesses patient's nutritional status and identifies risk factors (malnutrition, dehydration), implements and monitors nutrition interventions, provides patient education and support, and communicates with other team members to ensure continuity of care
• Speech-Language Pathologist (SLP) evaluates and treats swallowing disorders (dysphagia), recommends diet modifications and adaptive feeding techniques (thickened liquids, pureed foods), and collaborates with the RD to ensure appropriate nutrition for patients with dysphagia
• Occupational Therapist (OT) assesses and addresses functional limitations affecting meal preparation and feeding (arthritis, stroke), recommends adaptive equipment and strategies to improve independence in eating (weighted utensils, plate guards)
• Social Worker identifies and addresses psychosocial and socioeconomic factors impacting nutrition (food insecurity, social isolation), connects patients with community resources and support services (food banks, meal delivery programs), and facilitates communication between the patient, family, and healthcare team

Interdisciplinary Collaboration and Patient-Centered Care

• Implement interdisciplinary collaboration to ensure comprehensive patient care and improve outcomes
• Conduct nutritional screening as part of routine patient assessment to identify those at risk for malnutrition
• Practice cultural competence to provide appropriate and respectful care to diverse patient populations
• Utilize evidence-based practice to inform nutrition interventions and care plans
• Consider health literacy when providing patient education and developing nutrition recommendations

Nutrition in Nursing Practice

Application of clinical judgment model

• Recognize cues by gathering relevant data from patient assessment, medical history, and laboratory results (weight changes, skin integrity) and identifying signs and symptoms of nutritional deficiencies or excesses (anemia, edema)
• Analyze cues by interpreting the collected data to determine the patient's nutritional status and identifying potential nutrition-related risks and complications (pressure ulcers, delayed wound healing)
• Prioritize hypotheses by formulating possible nutrition diagnoses based on the analysis of cues and prioritizing the most likely and significant nutrition problems (protein-energy malnutrition, micronutrient deficiencies)
• Generate solutions by developing an individualized nutrition care plan addressing the prioritized problems, setting specific, measurable, achievable, relevant, and time-bound (SMART) goals (increase protein intake by 25% within 2 weeks), and selecting appropriate nutrition interventions based on evidence-based guidelines (high-protein oral nutrition supplements)
• Take action by implementing the nutrition care plan in collaboration with the patient and healthcare team, providing nutrition education and counseling to support behavior change (portion control strategies), and monitoring and documenting the patient's response to interventions
• Evaluate outcomes by reassessing the patient's nutritional status and progress towards goals, modifying the nutrition care plan as needed based on the evaluation of outcomes, and communicating findings and recommendations to the healthcare team

Holistic factors in nutrition recommendations

• Consider the patient's cultural background and food preferences by incorporating culturally familiar foods and preparation methods (traditional herbs and spices) and respecting religious or cultural dietary restrictions and practices (halal, kosher)
• Address the patient's socioeconomic status and access to resources by recommending affordable and accessible food options (frozen vegetables, canned beans) and connecting patients with community nutrition programs and resources (SNAP benefits, food pantries)
• Assess the patient's readiness for change and motivation level by using motivational interviewing techniques to elicit behavior change (open-ended questions, reflective listening) and setting realistic goals and expectations based on the patient's stage of change (contemplation, preparation)
• Evaluate the patient's social support system and living environment by involving family members or caregivers in nutrition education and planning (grocery shopping, meal preparation) and considering the impact of living arrangements on meal preparation and access to food (communal dining, limited kitchen facilities)
• Incorporate the patient's personal values, beliefs, and priorities by aligning nutrition recommendations with the patient's health goals and quality of life (maintaining independence, enjoying social meals) and respecting the patient's autonomy and right to make informed decisions about their nutrition
• Address the patient's emotional and psychological relationship with food by identifying and addressing disordered eating patterns or emotional eating triggers (stress, boredom) and collaborating with mental health professionals when necessary to support behavior change (cognitive-behavioral therapy, mindfulness practices)