Victorian ADIME/IDNT Working Party Version 3: May 2014 Facilitator Notes Prior to presenting to your group, print out the final slide in A4 size and use this for your participants worksheet. It is recommended not to print out the presentation for use during the presentation The presentation will provide 1 refresher example for your participants and then proceed with case example. The presentation is designed so that your participants complete the diagnosis section first followed with a discussion about the most appropriate diagnosis to use. The completion of the PES statement should only be completed after this discussion. Victorian ADIME/IDNT Working Party Version 3: May 2014

Low Fibre and Diverticulitis Case Example Presented by Victorian ADIME/IDNT Working Party Version 3: May 2014

Refresher Example of PES statement Excessive energy intake (NI-1.5) related to frequent consumption of large portions of high-fat meals as evidenced by average daily energy intake exceeding recommended amount by 2000kj & 6kg gain during the past 18 months Victorian ADIME/IDNT Working Party Version 3: May 2014

Victorian ADIME/IDNT Working Party Version 3: May 2014 Name of Case Study 45 y.o. Male referred for diet advice to assist with a new diagnosis for management of Diverticulitis Anthropometry: 70kg, 155cm, BMI: 29kg.m2. Pt is weight stable Clincial Pain, abdominal distension, nausea, diarrhoea, chills and a fever Victorian ADIME/IDNT Working Party Version 3: May 2014

Victorian ADIME/IDNT Working Party Version 3: May 2014 Name of Case study Social Hx: Married with 1 child. Work full time as a teacher Exercise ½ hour daily of walking Intake in hospital: Consuming 90% of hospital meals and drinking quite well. The hospital dietary intake is providing ~30-35g fibre No prior counselling received Victorian ADIME/IDNT Working Party Version 3: May 2014

Victorian ADIME/IDNT Working Party Version 3: May 2014 Using the nutrition diagnosis reference sheet Identify possible nutrition diagnoses that could fit this case study 1. ____________________________________________________________ 2. ____________________________________________________________ 3. ____________________________________________________________ 4. ____________________________________________________________ 5. ____________________________________________________________ 6. ____________________________________________________________ 7. ____________________________________________________________ 8. ____________________________________________________________ 9. ____________________________________________________________ 10. ___________________________________________________________ Learners should find at least 9. Victorian ADIME/IDNT Working Party Version 3: May 2014

All Possible Diagnoses Excessive fibre intake (NI-5.8.6) Excessive Bioactive substance intake (NI-4.3) 3. Food and nutrition-related knowledge deficit (NB-1.1) Victorian ADIME/IDNT Working Party Version 3: May 2014

Victorian ADIME/IDNT Working Party Version 3: May 2014 Key Diagnoses Most appropriate diagnoses for this case study: Excessive fibre intake (NI-5.8.6) Food and nutrition-related knowledge deficit (NB-1.1) Victorian ADIME/IDNT Working Party Version 3: May 2014

Other diagnoses and reason/s why you might not use them Excessive Bioactive substance intake (NI-4.3) You could use this diagnosis in place of the low fibre diagnosis, however considering there is a diagnosis specific to fibre, it is better to use the specific diagnosis. Victorian ADIME/IDNT Working Party Version 3: May 2014

Based on the above case study write 2 to 3 possible PES Statements ___________________ as related to E:______________________________ _________________as evidenced by S/S:_____________________________ ______________________________ Victorian ADIME/IDNT Working Party Version 3: May 2014

Evaluating your PES Statement When developing your PES statements, think about the following: { } can the dietitian resolve the nutrition diagnosis? { } if tossing up between 2 diagnoses, attempt to select the INTAKE domain first { } is the aetiology the “root cause” (ask “but why”) { } will measuring the ‘signs and symptoms’ tell you if the problem is resolved? { } are the signs and symptoms specific enough that you can measure them?   Victorian ADIME/IDNT Working Party Version 3: May 2014

Victorian ADIME/IDNT Working Party Version 3: May 2014 PES statement 1 Excessive fibre intake (NI-5.8.6) as related to knowledge deficit regarding recommended dietary changes for diverticulitis as evidenced by symptoms including pain, abdominal distension, nausea, diarrhoea, hospital dietary intake of ~30-35g of fibre Victorian ADIME/IDNT Working Party Version 3: May 2014

Victorian ADIME/IDNT Working Party Version 3: May 2014 PES statement 2 Food and nutrition-related knowledge deficit (NB-1.1) related to no prior counselling received related to diverticulitis as evidenced by hospital dietary intake of ~30-35g of fibre Victorian ADIME/IDNT Working Party Version 3: May 2014

Victorian ADIME/IDNT Working Party Version 3: May 2014 References PowerPoint Presentations Ferguson M, et al. Webinar 3: Implementation, DAA IDNT Working Party, www.daa.asn.au Vivanti A, Micallef N. Webinar 2: Diagnoses, PES statements and Case Study, DAA IDNT Working Party, www.daa.asn.au Capra S, Ferguson M, et al. Standardised Language: A powerful tool for dietetic professionals, 2009 www.daa.asn.au Manuals ADA, (2013) International Dietetics and Nutrition Terminology (IDNT) Reference Manual: Standardized Language for the Nutrition Care Process, Fourth Edition, American Dietetic Association, 2013 ADA, (2010) International Dietetics and Nutrition Terminology (IDNT) Reference Manual: Standardized Language for the Nutrition Care Process, American Dietetic Association, 2010 PES FAQ and Terminology IDNT Edition 3, v4, Nutrition and Dietetics Department, Princess Alexandra Hospital, Queensland Victorian ADIME/IDNT Working Party Version 3: May 2014

Contacts Alison Qvist alison.qvist@wh.org.au Ai Vee Lim AiVee.Lim@petermac.org Anna Cardamis Anna.Cardamis@easternhealth.org.au Anna Whitley Anna.Whitley@svhm.org.au Annika Dorey adorey@cabrini.com.au Caitlyn Green caitlyn.green@austin.org.au Lina Breik lina.breik@nh.org.au Loretta Bufalino LorettaBufalino@hotmail.com Kate Furness kate.furness@southernhealth.org.au Rubina Raja Rubina.Raja@southernhealth.org.au Sonia Brockington sonia.brockington@deakin.edu.au

Low Fibre and Diverticulitis 45 y.o. Male referred for diet advice to assist with a new diagnosis for management of Diverticulitis Social Hx: Married with 1 child. Work full time as a teacher Anthropometry: 70kg, 155cm, BMI: 29kg.m2. Pt is weight stable Clincial: Pain, abdominal distension, nausea, diarrhoea, chills and a fever. Exercise: ½ hour daily of walking Intake in hospital: Consuming 90% of hospital meals and drinking quite well. The hospital dietary intake is providing ~30-35g fibre No prior counselling received Using the nutrition diagnosis reference sheet, identify possible nutrition diagnoses that could fit this case study 1. _______________________________________________ 5. ____________________________________________________ 2. _______________________________________________ 6. ____________________________________________________ 3. _______________________________________________ 7. ____________________________________________________ 4. _______________________________________________ 8. ____________________________________________________ Based on the above case study write three possible PES statements PES Statement 1: P:__________________________________________________________________________________________as related to E:________________________________________________________________________________________as evidenced by S/S:___________________________________________________________________________________________________ PES Statement 2: PES Statement 3: A4 working sheet, write in font 12, when printing print to A4 size