CHS92 Review and monitor a patient's nutritional wellbeing

Overview

This standard is about identifying the dietary needs of the patient and negotiating with them a nutritional plan that the patient is likely to sustain. Tension can occur when staff are not cognisant of religious, cultural, social and age customs and requirements and the implications these can have on the patient’s lifestyle and habits. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. The impact on health of obesity, dietary imbalance, tobacco, drugs and alcohol
2. Medical conditions impacting on diet (e.g. diabetes, constipation, ulcerative colitis, diverticulitis, bowel surgery)
3. How to obtain data about a patient by, for example, observations, patient questionnaires, assessment records, blood chemistry
4. The effects of aspects of lifestyle on health
5. Enabling a patient to change habits
6. Methods of overcoming resistance to accepting information
7. Methods of teaching scientific concepts in ways to enable patients to understand
8. How to highlight the patient’s abilities and experiences in a positive way
9. How to obtain and record accurate information about patients, and how to do so
10. The effects of disease and  replacement therapies on metabolism
11. Interrelation of diet, medication and blood chemistry
12. Significance of tests used in  patient care (e.g. blood chemistry, urinalysis)
13. Reduction in nutrient intake and identification of under-nutrition
14. The positive and negative impact of diet on a patient’s health and wellbeing
15. The significance for diet of cultural background and religious belief
16. How to identify a range of menus that take into account the patient’s  requirements and their food preferences
17. The psychology of habitual or addictive behaviour
18. The psychology of change
19. Methods of assessing where patients are in the readiness to change cycle
20. Assessment of a patient’s health from observation, measurement and records
21. The roles of other members of the multidisciplinary team, the support and information they can provide
22. How to identify how the patient wishes to be addressed and communicated with, and how to do so
23. How to highlight the patient’s abilities in a positive way
24. The communication skills required in sensitive situations

Performance Criteria

You must be able to do the following:

1. provide regular intervals, for the patient to discuss their nutritional wellbeing
2. retrieve and give feedback on physical and physiological measurements  where appropriate and consider other medical conditions impacting on diet
3. encourage the patient to employ a written record of their own thoughts, diet and questions and to identify areas which require change
4. discuss any physiological and sensitive problems the patient may have
5. review any previous assessment and dietary plan to determine changes and referral, if appropriate, to multi-disciplinary team
6. make a global assessment to determine the patient’s state of wellbeing
7. renegotiate the nutritional targets where possible to bring them nearer the dietary ideal
8. record the review and make it available to members of the multidisciplinary team
9. offer reviews to a non-consenting or negotiated non-compliant patient
10. be open to negotiation and encourage the exploration of possibilities
11. be sure that effective assessment and diet therapy is underpinned by the latest  guidelines and evidence available

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB2 Assessment and care planning to meet people's health and wellbeing needs This standard has replaced RenRL1