Is nutrition diagnosis really needed?
Been a clinical RD for about 20 years now, passed my third CNSC exam last year. I am still not seeing the utility of nutrition diagnosis. It’s a nice logical exercise, but doctors or other medical staff never read it. It seems to be used mainly by dietitians to nitpick or penalize each other.
Interns I’ve precepted over the years have an outsized anxiety about creating the ideal nutrition diagnosis— often being prioritized over the quality of the actual nutrition assessment.
Every time I ask a dietitian to explain why a nutrition diagnosis is necessary for a nutritional assessment, I get a lot of humming and hawing 🤠, and a lot of unclear and/or different answers… usually related to “billing” or something. Really? Would you bill a patient more because they have trouble chewing? That doesn’t seem fair or sensible.
I can see billing for services provided, but not for poor PO intake, for example. I think the malnutrition screening tools have the actual value in a nutrition assessment. Wound protocols are also valuable. Nutrition diagnosis? Not really— I don’t need it for follow up assessments from other RDs because the patient data needs to be re-reviewed anyway.
Thoughts? Could you sell me on the necessity of a nutrition diagnosis? After tens of thousands of nutrition assessments (the majority in the ICU), I’m just not seeing it.