Presentation for NUT 390i By Chris Shelton PES statements Presentation for NUT 390i By Chris Shelton

NUT 4700

PES = Problem, Etiology, Signs/Symptoms PES statements are written by Registered Dietitians. They are used when an RD diagnoses a patient’s problem or needs. It’s a simple written statement that identifies the Problem; states the Etiology of the problem; and gives the Signs or Symptoms that support the diagnosis of a patient.

When do RDs write a PES?

Writing PES statements There is a standardized language for writing a PES statement: It always includes: whatever the Problem is, how it is related to the Etiology of the problem, as evidenced by the Signs or Symptoms that you see as an RD The key words in this statement are “related to” and “as evidenced by.”

PES examples 70-yr old white male admitted for cardiac bypass surgery. Doctor sees that patient is underweight so refers patient to RD RD conducts an assessment and finds patient has lost weight (15 pounds in 3 months) without trying and has been eating poorly for several weeks. He lives alone at home and his wife died 3 months ago

PES examples A sample PES would be: “Involuntary weight loss related to missing meals as evidenced by loss of 15 pounds over 3 months.” The Problem is the weight loss. The Etiology is related to missing meals. The Signs or Symptoms are the 15 pounds lost over 3 months.

More PES examples “Inadequate energy intake related to calorie intake not meeting calculated needs as evidenced by 15lb weight loss in 3 months.”

More PES examples Based on lab results: “Inadequate mineral intake (iron) related to iron intake not meeting needs as evidenced by low Hgb/Hct and ferritin.”

More PES examples Socioeconomic: “Limited access to food related to inability to acquire food as evidenced by lack of income.”

Don’t forget PES statements are a written diagnosis of a patient’s nutritional problem. A PES is a simple statement that identifies the Problem, gives the Etiology of the diagnosis and states the Signs/Symptoms that support the diagnosis. Always use the words “related to” and “as evidenced by.”

Thank you! References: Mahan KL, Escott-Stump S. Krause’s Food and Nutrition Therapy. 12th ed. St. Louis, MO: Saunders Elsevier; 2008. Lecture notes from NUT 4700 with Anne Keller, MS, RD; Metropolitan State University of Denver; Aug. 2013.