Nutritional care as a concept first emerged in hospital settings, in clinics or rehabilitation centres. The term came to mean planning and administering diets for patients in an individualized manner. This implies that we cannot plan a diet for a patient without keeping the person and his or her special needs in mind. A nutritional care plan is prepared in most large hospitals after the following information has been carefully collected:
- the nature and possible duration of the disease
- underlying causes of the disease
- food habits of the person
- nature of dietary changes required
- problems such as food allergies
On the basis of this a dietary prescription is worked out by the doctor as also the need for any special feeding methods. The prescription should ideally specify the amount of calories, protein and any other nutrients that must be supplied. In addition foods to be restricted should also be clearly outlined. This is the point where the dietitian in a hospital/clinic takes over and an individualized ,nutritional care plan is made. The plan includes
- an estimate of adequacy of the patient's usual dietary intake
- any nutritional.problems
- plans for overcoming nutritional and other related problems
- objectives for patient education
- notes on progress of the patient and
- an evaluation of how successful diet therapy has been.
Several social, economic, psychological and emotional factors play a role in diet planning as you know.
In this context we also need to take a quick look at how nutritional care is administered in a large hospital or clinic setting. A patient is the responsibility of a "health team". The chief members of this team are the physician or doctor, the nurse and the dietitian.
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