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Nutrition Diagnosis
Prof Dian Handayani SKM, MKes, PhD
TA 2023/2024
Education
2008 – 2012 : PhD program University of Wollongong – NSW - Australia
1999 – 2002 : Postgraduate Program Brawijaya University (Biomedical Study Program)
1996 – 1998 : Bachelor in Public Health, Indonesia University
1992 – 1995 : Academy Of Nutrition, Health Ministry, Malang, east Java

PROFESIONAL SOCIETIES
1. Official of AIPGI (Indonesian Association of Nutrition Education Institution)
2. Official of PERSAGI (Indonesian Dietitian Association) in Malang, Indonesia
3. Member of Nutrition and Dietetic Association (USA) (2012 – Now)
4. Member of Indonesia Nutrigenomics and Nutrigenetics Society
5. Member of World obesity

TOPIC OF INTEREST in Research :

1. Lipid and obesities
2. Diabetes mellitus
3. Nutrition Diagnosis and Nutritional Care Process
4. Functional food and nutrition therapy
 NUTRITION DIAGNOSIS
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Rencana Pembelajaran Semester

Nama PS S1- Gizi

Nama MK Diagnosis Gizi

SKS 2

Semester 3

Dosen Pengampu 1. Prof. Dian Handayani, SKM.MKes PhD

2. Inggita Kusumastuty, SGz. MBiomed

3. Ida Restiyani, SST. MKes
4. A/Prof Barakatun Nisak PhD (UPM)

Metode Pembelajaran : Kuliah TM - Diskusi / Presentasi / Penugasan

Penilaian :
1. Ujian 50% : UTS – UAS @ 25%
2. Penugasan 50% : Nilai Presentasi dan Pengumpulan Tugas Jadwal
Perkuliahan
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 RPS
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 A 4-STEP PROCESS NCP -PAGT

• Nutrition Assessment
• Nutrition Diagnosis
• Nutrition Intervention
• Nutrition Monitoring and Evaluation
A

ME D

I
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REFERENSI
 Academy of Nutrition And Dietetics (2013). International Dietetics and Nutrition
Terminology (IDNT) Reference Manual : Standardized Language for The Nutrition Care
Process 120 South Riverside Plaza, Suite 2000, Chicago IL, 60606-6995, 800/877 - 1600,
Academy of Nutrition and Dietetics.
 Charney, P. and S. Escot-Stump (2012). Overview of Nutrition Diagnosis and Interview.
Krause's Food and the Nutrition Care Process. . L. Mahan, S. Escot-Stump and J. Raymond.
St Louise, Missouri 63043, Elsevier Saunders. .
 Handayani, D. and I. Kusumastuty (2023). Diagnosis Gizi. Malang, UB Press.
 Handayani, D., O. Anggraeni, F. Nila, K. Permaningtyas, I. Kusumastuty, U. Erliana, C.
Yanuardi, M. Mutiyani, I. Inggita Kusumastuty and O. Anggareni, Eds. (2015). Nutritional
Care Process. Jogjakarta, Graha Ilmu
 Mahan, L., S. Escott-Stump, et al., Eds. (2012). Krause's Food and The Nutrition Care
Process. St Louis, Missoure, Elsevier Sauders.
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BACHELOR IN NUTRITION

• Clinical Nutrition
• Community Nutrition
• Food service and Food management
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CASE STUDY

 Tn JW usia 70 tahun baru saja menjalani operasi by pass jantung. T

JW tinggal seorang diri di rumah, istrinya meninggal dunia 3 bulan
yang lalu. Tn JW tidak pernah memasak di ruman, hasil screening
gizi menunjukkan tn JW kehilangan berat badan yang tidak
diinginkan dan pola makan sangat tidak sehat karena lebih sering
mengkonsumsi makan-makanan siap saji dan instan. Tn JW dirujuk
ke ahli gizi untuk dilakukan asesmen gizi.
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WHAT DIETITIAN CAN DO ?
 What is Nutrition Care Process
WHAT IS NUTRITION CARE PROCESS (NCP) ?
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(NCP) ?
• Definition :
“…..a systematic problem-solving method
that dietetics professionals use to critically
thing and make decisions to address nutrition
related problems and provide safe and
effective quality nutrition care.”
• Lacey, K. and E. Pritchett (2003). "Nutrition Care Process and Model: ADA adopts
road map to quality care and outcomes management." Journal of THE AMERICAN
DIETETIC ASSOCIATION 103(8): 1061-1072.
 THE NCP
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Critical Thinking
 The ability the examine a problem, formulate solutions and
evaluate those solutions

Decision making
 The ability to choose the best actions to solve a problem solving

Problem Solving
 Not just solving but evaluating these result

Collaboration
 Finding those folks who can help solve the problem

Charney, P. and J. O. Mailet "Nutrition diagnosis - standardizing the language of dietetics."

 WHAT DOES THE (NCP) PROVIDE FOR US ?
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✓A framework for critical thinking, decision making,

problem solving and collaboration

✓A terminology that describes what is the RDs “do”

✓A mechanism to communicate across professions

and setting

✓A system of problem identification, intervention

and an evaluation of the results of that intervention

Charney, P. and J. O. Mailet "Nutrition diagnosis - standardizing the language of dietetics."

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THE STEPS OF NCP

Nutrition assessment (A)

Nutrition Diagnosis (D)

Nutrition Intervention (I)

Monitoring and evaluation (ME)

Mahan, L., S. Escott-Stump, et al., Eds. (2012). Krause's Food and The Nutrition Care Process. St Louis, Missoure, Elsevier Sauders.
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NCP MODEL
Outer ring

Middle
ring

Area
outside
the ring

Inner ring
 22 NCP MODEL

• Mempengaruhi bagaimana
Outer Ring klien/pasien menerima informasi gizi

• Membedakan profesi gizi yang unik

Middle Ring dengan profesi yang lain

• Menggambarkan 4 tahapan NCP,

Inner Ring pentingnya kolaborasi dengan klien

Area Outside • Screening & referral system

the Ring • Outcomes management system
 NCP MODEL, CONT
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Outer Ring • Mempengaruhi bagaimana

klien/pasien menerima informasi gizi

ctice Setting
Pra Influence positive or
s

Negative output

Health Care Systems

Economics

• Practice Setting, menggambarkan peraturan

pemerintah, kondisi kesehatan

• Health Care System, mengatur alokasi waktu petugas

gizi, jenis layanan yang diberikan & siapa yang
memberikan layanan

Social Systems
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HEALTH CARE SYSTEM → Influence positive

or
Negative output

Imfeld, K., et al., "Diet Order Entry by Registered Dietitians Results in a Reduction in Error Rates
and Time Delays Compared with Other Health Professionals," Journal of the Academy of Nutrition
and Dietetics, Vol. Article in press, No. 2012.

•this project was to document any changes in the numbers and types of diet order errors and time
delays that were associated with this policy change
•Error rates for all nutrition-related orders decreased by 15% after RD order entry access (P<0.01).
•Error rates for diet orders entered by RDs were significantly lower in comparison with those entered
by clerical assistants or registered nurses (P<0.001)
 NCP MODEL
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Outer Ring • Mempengaruhi bagaimana

klien/pasien menerima informasi gizi

ctice Setting Influence positive or

Pra Negative output
s

Health Care Systems

Economics

• Sosial System, menggambarkan pengetahuan klien

tentang gizi-kesehatan, nilai, kemauan/kesempatan
klien untuk meningkatkan gizi-kesehatan

• Economic Aspect, berhubungan dengan alokasi biaya

perawatan, biaya makanan yang disajikan, gaji petugas
gizi

Social Systems
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THE MIDDLE RING:

RD SKILLS AND KNOWLEDGE
Pengetahuan, ketrampilan dan kompetensi Ahli Gizi,
membedakannya dengan profesi lain
Dietetics Knowledge

Code of Ethics

Communication

Collaboration

Critical Thinking

Skills & Competencies

Evidence-based Practice
 INNER RING:
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A FOUR-STEP PROCESS
Menggambarkan 4 tahapan N
1. Nutrition Assessment
2. Nutrition Diagnosis
3. Nutrition Intervention
1 2 4. Nutrition Monitoring
and Evaluation
4 3

Central core of the model

pentingnya kolaborasi
dengan klien
 NCP AS STANDARDIZE
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PROCESS
• Standardize Process
• A consistent structure and framework used to provide nutrition care
• This process supports and promotes individualized care, not
standardized care

Standard care

That all patient/clients receive the same care

 DISTINCTION BETWEEN MEDICAL
NUTRITION THERAPY (MNT) AND THE
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NUTRITIONAL CARE PROCESS (NCP)

MNT NCP

• MNT not synonym with • The NCP is used to

NCP, but is one specific
type of nutritional care.
provide MNT, and other
forms of nutrition care
such as obtaining
feeding assistance, or
referring to another
practitioner
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THE STEPS OF NCP

Nutrition assesment

Nutrition Diagnosis

Nutrition Intervention

Monitoring and evaluation

Mahan, L., S. Escott-Stump, et al., Eds. (2012). Krause's Food and The Nutrition Care Process. St Louis, Missoure, Elsevier Sauders.
 A NUTRITION DIAGNOSTIC
STATEMENT
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P-E-S statement
Nutrition Monitoring
Nutrition Interventio /evaluation
Nutrition Diagnosis n
(Signs/Sym
Assessment
(Problem)
( Etiology) ptom)

Charney, P. and J. O. Mailet "Nutrition diagnosis - standardizing the language of dietetics."

 A NUTRITION DIAGNOSTIC
STATEMENT
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P-E-S statement
Nutrition Monitoring/evalu
Nutrition Intervention ation

Nutrition Diagnosis ( Etiology) (Signs/Symptom)

Signs: what the
Assessment (Problem) “the cause clinician see
Symptom : What the
of the patient/client tells
you
problem”
“So, we have the problem, which is related to the etiology, and is evidence by, the signs and
symptoms”

Charney, P. and J. O. Mailet "Nutrition diagnosis - standardizing the language of dietetics."

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