CHAPTER 11 | Apply Standards of Nutrition Care & Review Effectiveness of the Nutrition Care Plan
nutritional status, feeding tube, dehydration/fluid maintenance, dental care, and pressure ulcer/injury. The care plan is then developed through the client interview and goals expressed by the client. The care plan is used as a framework of care for the team and the client going forward. The nutrition team’s communication in the care plan conferences should include all aspects of daily nutritional care, including the client’s wishes based upon those needs, during the care conference.
The IDT participates in care conferences at least quarterly and sometimes more often if a significant change in condition with the client occurs. The client and designated family or caregivers are invited to attend this conference. These care conferences are a time for the IDT and the client and/or family to address all current goals and adjust as needed/desired. Goals may change and the care plan must be updated as needed to reflect the client’s goals. Care plans should be in constant flux as the needs and the desires of the client change. The CDM, CFPP and the entire IDT need to routinely review, assess, modify, document, and communicate any new information and findings regarding the client.
Figure 11.4 is another illustration that summarizes the CDM, CFPP’s responsibility in the RAI process.
Nutrition Fundamentals and Medical Nutrition Therapy