Victorian ADIME/IDNT Working Party Version 3: May 2014 Introduction to International Dietetics & Nutrition Terminology (IDNT) and ADIME Documentation Method Presented by Victorian ADIME/IDNT Working Party Version 3: May 2014

Outline Introduction to IDNT What is IDNT How does it fit into e-Health Benefits of IDNT Using IDNT today Introduction to ADIME What is the ADIME Comparing ADIME documentation to current documentation formats Victorian ADIME/IDNT Working Party Version 3: May 2014

What is IDNT? (International Dietetic & Nutrition Terminology) Developed by ADA and is supported by the International Confederation of Dietetic Association. IDNT is a standardised language for dietitians: standard , specific terms used to document patient assessment information in medical records Adds structure to the dietetic process same work process, different language Victorian ADIME/IDNT Working Party Version 3: May 2014

Examples of IDNT Excessive Carbohydrate Intake (NI_5.8.2) Inadequate Oral intake (NI_2.1) Excessive Energy Intake (NI_1.3) Malnutrition (NI_5.2) Swallowing Difficulties (NC_1.1) Physical Inactivity (NB_2.1) Overweight/Obesity (NC_3.3) Excessive Alcohol Intake (NI_4.3) Imbalance of Nutrients (NI_5.5) Victorian ADIME/IDNT Working Party Version 3: May 2014

Benefits of IDNT Clearer linking between diagnosis, interventions and outcomes Solving patients nutritional problems Optimising reimbursement possibilities Easier to assess outcomes and performance to prove efficacy Improve communication between health care team members Part of evidence based approach to health care Better statistical reporting Prepares Department/dietitians for students who have been trained in IDNT Victorian ADIME/IDNT Working Party Version 3: May 2014

Benefits of IDNT Better assessment of cost analysis across or within practices or dietetic departments. Will benefit population health-based nutrition programs and research World wide use of accepted definitions and wordings : provides common ground for facilitation of information exchange Prepares for transition to E-health Improve professional recognition Victorian ADIME/IDNT Working Party Version 3: May 2014

Implementing IDNT across Victoria DAA supportive and encouraging: voluntary uptake Several states have or will be implementing Some Victorian health organisations have commenced Universities are starting to teach 3rd years in 2012 Victorian ADIME/IDNT Working Party Version 3: May 2014

Nutrition Care Process Model : ADIME Victorian ADIME/IDNT Working Party Version 3: May 2014

What is ADIME? ADIME refers to the steps of the ADA standardised Nutrition Care Process The Nutrition Care Process describes documentation of Assessment, Diagnosis, Intervention, Monitoring, and Evaluation (ADIME) steps In Victoria the focus will be on the “D” or Diagnosis step of the ADIME Nutritional Diagnosis will be written in PES format (explained in next presentation) Victorian ADIME/IDNT Working Party Version 3: May 2014

Nutrition Care Process & Model Lacey, K and Pritchett, E. (2003). Nutrition Care Process Part II: Using the International Dietetics and Nutrition Terminology to Document the Nutrition Care Process.2008. JADA, 108(8): 1287-1293 Victorian ADIME/IDNT Working Party Version 3: May 2014

Nutrition Assessment Categories Nutrition Assessment is divided into 5 categories: food/nutrient–related history anthropometric measurements biochemical data, medical tests and procedures nutrition-focused physical findings client history

Nutrition Care Process & Model Lacey, K and Pritchett, E. (2003). Nutrition Care Process Part II: Using the International Dietetics and Nutrition Terminology to Document the Nutrition Care Process.2008. JADA, 108(8): 1287-1293 Victorian ADIME/IDNT Working Party Version 3: May 2014 12

Nutrition Intervention Categories Nutrition Intervention is divided into 4 categories: Food and Nutrient Delivery Nutrition Education Nutrition Counselling Coordination of Nutrition Care

Nutrition Care Process & Model Lacey, K and Pritchett, E. (2003). Nutrition Care Process Part II: Using the International Dietetics and Nutrition Terminology to Document the Nutrition Care Process.2008. JADA, 108(8): 1287-1293 Victorian ADIME/IDNT Working Party Version 3: May 2014 14

Nutrition Monitoring & Evaluation Categories Nutrition Monitoring & Evaluation is divided into 4 categories: Food/Nutrition History Outcomes Anthropometric Measurement Outcomes Biochemical data, medical tests and Procedure Outcomes Nutrition-Focused Physical Finding Outcomes

Nutrition Care Process & Model Lacey, K and Pritchett, E. (2003). Nutrition Care Process Part II: Using the International Dietetics and Nutrition Terminology to Document the Nutrition Care Process.2008. JADA, 108(8): 1287-1293 Victorian ADIME/IDNT Working Party Version 3: May 2014 16

Comparison of Documentation Formats Nutrition Care Process Steps SOAP ABCD ADIME Assess Collect data Subjective and Objective (Anthro, Bio, Clinical , Diet etc) Anthropometry Biochemistry Clinical Diet Assessment (Anthro, Bio, Clinical , Diet etc) 2. Diagnose Identify issues Assessment Diagnosis 3. Intervene Management Plan Intervention 4. Monitor and Evaluate Follow-up plan Refine Information Refine information Monitoring and Evaluation f Victorian ADIME/IDNT Working Party Version 3: May 2014

The Nutrition Care Process Steps: ADIME Nutrition Assessment A Nutrition Diagnosis D Nutrition Intervention I Nutrition Monitoring M Nutrition Evaluation E By following this nutrition care process and achieving outcomes Dietitians can show that quality care is provided Todays focus is on the nutritional diagnosis Victorian ADIME/IDNT Working Party Version 3: May 2014

What Next? This presentation is the first of a series of user friendly presentations for your department. The following presentations are: Creating a PES statement: the nutrition diagnosis Introduction to E-Health Case Study 1: Poor oral intake Case Study 2: Weight Management Case Study 3: Diabetes Management Case Study 4: Hypertension Case Study 5: Hypercholesterolemia Case Study 6: High Fibre and Diverticulosis Case Study 7: Low Fibre and Diverticulitis Case Study 8: Not meeting core foods group Case Study 9: Re-feeding Case Study 10: Enteral Nutrition Case Study 11: TPN Case Study 12: Mental Health Physical Inactivity Case Study 13: Coeliac Case Study 14: Food Allergy Case Study 15: Palliative Care Case Study 16: Predicted loss of weight Case Study 17: Renal Failure Case Study 18: Haemodialysis/Peritoneal Dialysis Victorian ADIME/IDNT Working Party Version 3: May 2014

Online reference manual www.adancp.com -Requires DAA membership for access Link on DAA: http://daa.asn.au/members/publications-and-resources/idnt-manual-and-resources/ 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 Voevodin M. IDNT – International Dietetics and Nutrition Terminology, Monash University, 2010 Bufalino L, et al. Introduction to IDNT, Victorian Wide IDNT Working Party, 2011 Journals Bueche J, et al. Nutrition Care Process and Model Part 1: The 2008 update, Journal of the American Dietetic Association, 2008 O’Sullivan T, et al. Just what the Doctor Ordered; Moving Forward with Electronic Health Records, Journal of Nutrition and Dietetics 2011; 68: 179-184 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