INTERVENSI GIZI

Ir. AAG Anom Aswin, MPS

 ADA’s Nutrition Care
Process Steps

 Nutrition Assessment
 Nutrition Diagnosis
 Nutrition Intervention
 Nutrition Monitoring and
Evaluation
 STEP 3. NUTRITION INTERVENTION

Definisi & Tujuan:

 Intervensi adalah serangkaian aktivitas beserta
materi yang ditujukan untuk pemecahan
masalah.
 Intervensi Gizi adalah perencanaan aktivitas yang
direncanakan untuk secara intensif merubah
prilaku berkaitan dengan gizi, faktor resiko,
kondisi lingkungan, atau aspek status kesehatan
untuk individu, target group atau komunitas.
 Nutrition Intervention

 Ahli Gizi Profesional bekerja secara

kolaborasi dengan
pasien/klien/kelompok, keluarga atau
caregiver untuk merealisasikan
rencana untuk memberi pengaruh
positif thd masalah/diagnosa.
 Orientasi pada klien merupakan kunci
dari keberhasilan langkah ini.
 Rencana Intervensi Gizi

Berbicara ttg“what, where, when, how”

 Dikembangkan dengan pasien/keluarganya selaras

dengan kondisi-kondisi lingkungannya.
 Mempertimbangkan sumber daya pasien, skil dan
motivasi pasien
 Tetapkan hasil dalam tujuan, tuliskan perubahan
prilaku yang diharapkan yang dapat dikuantifikasikan
dan biasanya dinyatakan apa yang pasien bisa
lakukan atau dapat dicapai
INTERVENSI GIZI Langkah setelah Diagnosa

Nutrition Nutrition Nutrition Nutrition

Assessment Diagnosis Intervention Mon/Eval

Problem Etiology Signs & Symptoms

 Komponen
Nutrition Intervention

 Langkah ini terdiri dari dua proses

yang saling berkaitan :
 1. Rencana Intervensi (formulasi &
penetapan POA)
 2. Implementasi Intervensi
 Rencana Intervensi Gizi

 Harus targetnya mengarah pada

etiology
 Jika tidak ada maka diarahkan pada
signs dan symptoms
 Relationships of NCP Steps
Assessment 

Nutrition Dx
Intervention

Monitoring & Evaluation

Identify, label
& set
priorities

Problem Etiology Signs and Symptoms

 PES Statement
Excessive energy intake P

Related to eating frequently in fast E

food restaurants

As evidenced by BMI of 30 and diet S

history
Signs and Symptoms Direct Intervention
and Evaluation

Intervention/ Eval

P Excessive
energy intake

E RT eating Intervention: Counsel

frequently in patient about best
fast food choices in fast food
restaurants restaurants
S As evidenced Eval: Recheck weight
by BMI and and diet history at
diet history next visit
 Intervensi Gizi- Terminology
Standar
Interventions

Food or Nutrient Nutrition Care

Nutrition Education Nutrition Counseling
Delivery Management

Counseling
Meals or Snacks Initial/Brief Team Meeting
Theory or Approach

Enteral or
Comprehensive Strategies Referral to Another RD
Parenteral Nutrition

Medical Food Identify Phase Collaboration with

Supplements of the Client Other Providers

Vitamin and Mineral Referral to Community

Involving
Supplements Agency or Program

Bioactive Substance Discharge/Referral to

Exploring
Supplements Another Program

Nutrition-Related
Medication Management
Resolving

Delivery Closing

Feeding Environment Feeding Assistance

 INTERVENSI GIZI
Intervensi Gizi dibagi dalam empat katagori

1. Food and/or Nutrient Delivery (ND)(Pemberian

makanan dan/atau zat gizi)
2. Nutrition Education (E)(Pendidikan Gizi)
3. Nutrition Counseling(C)(Konseling Gizi)
4. Coordination of Care (RC)(Asuhan Terkolaborasi)
 TERMINOLOGY INTERVENSI

 Food and/or Nutrient Delivery

a. Meal and Snacks (ND-1)
b. Enteral and Parenteral Nutrition (ND-2)
c. Supplement (ND-3)
1. Medical Food Supplement (ND-3.1)
2. Vitamin and Mineral Supplement
(ND-3.2)
3. Bioactive Substance Suplement
(ND-3.3)
d. Feeding Assistence (ND-4)
e. Feeding Environment (ND-5)
f. Nutrition Related Medication Management
(ND-6)
Food and/or Nutrient Delivery

 Meals and snacks (ND-1)

 Enteral/parenteral nutrition (ND-2)
 Medical food supplements (ND-3.1)
 Vitamin and mineral supplement (ND-3.2)
 Bioactive substance supplement (ND-3.3)
 Feeding assistance (ND-4)
 Feeding environment (ND-5)
 Nutrition-related medication management
(ND-6)
 Nutrition Education (E)

 Initial/brief nutrition education (E-1)

 E.g. survival skills on discharge
 Comprehensive nutrition education
(E-2)
 Purpose
 Recommended modifications
 Result interpretation
 Other

Note: Education is appropriate for food and nutrition-related knowledge

deficit. If the client knows the content, more education probably won’t help
 Nutrition Counseling (C)

 Theory or approach
 Strategies
 Phase
 Nutrition Counseling: Theory or Approach

The theories or models used to

design and implement an
intervention; provide a
research-based rationale for
designing and tailoring nutrition
interventions
 Cognitive-behavioral therapy
(C-1.2)
 Health belief model (C-1.3)
 Social learning theory (C-1.4)
 Transtheoretical Model/Stages
of Change (C-1.5)
 Other (C-1.6)
 Nutrition Counseling: Strategies*

 Motivational  Cognitive restructuring

interviewing (C-2.1) (C-2.8)
 Goal setting (C-2.2)  Relapse prevention (C-
 Self-monitoring (C-2.3) 2.9)
 Problem solving (C-  Rewards/contingency
2.4) mgt (C-2.10)
 Social support (C-2.5)  Other
 Stress management
(C-2.6)
 Stimulus control (C-
2.7)

*Selectively applied evidence-based method or plan of action designed to

achieve a particular goal
 Nutrition Counseling: Phase

 Involving:
RD and patient/client introducing the ideas, discussing
potential problem areas, and identifying how to discuss
concepts and approaches

 Exploring:
RD and client actively discussing feasibility of concepts and
approaches

 Resolving:
RD and client selecting approaches and moving toward
identifying approach to resolve nutrition problem

 Closing:
RD and client are satisfied with approach taken and fully
ready to implement

These describe the type of interaction between the RD and the client
 Coordination of Care (RC)
 Coordination of other care during nutrition
care (RC-1)
 Team meeting
 Referral to RD
 Collaboration with other providers
 Referral to community agencies/programs

 Discharge and transfer of nutrition care to new

setting/provider (RC-2)
 Collaboration
 Referral to community agencies/programs
Nutrition Diagnosis & Intervention
(example)
 Nutrition Diagnosis
 Excessive fat intake (NI 51.1) related to frequent
consumption of high fat meals as evidenced by a
dietary fat intake of 55% of total calories.

 Nutrition Intervention
 Nutrition Education on TLC diet (E-1)
 Limit sat fats and trans fats
 Increase MUFAs, etc.
 Nutrition Counseling – behavior modification (C-1)
 Referral to Weight Management Program (RC-1)
 Nutrition Diagnosis & Intervention

Possible expected outcomes

 Limits foods high in total fat, chol & sat fats
 Uses food sources of MUFA as preferred fat

Possible evidence-based ideal goals

 Total fat 25-35%
 < 7% SFA
 Up to 10% PUFA / Up to 25% MUFA
 PLANNING SUMARY

1. Prioritas diagnosis (keparahan,

keamanan, kebutuhan pasien).
2. Kolaborasi
3. Konfirmasi pasien
4. Data prescripsi diet
5. Outcome
6. Waktu dan frekuensi pemberian
 Dokumentasi Intervensi Gizi

 Dokumentasi proses yang berjalan

yang mendukung langkah NCP
 Tanggal dan waktu
 Treatmen khusus untuk mencapai
tujuan dan outcomes
 Recomendasi intervensi, bersifat
individu untuk pasien
 NUTRITION INTERVENTION
REFERENCE SHEETS

1. Definisi
2. Rincian Intervensi
a. Direkomendasikan,Implementasi atau adaptasi
b. Direkomendasikan, design atau implemnantasi
c. dsb

3. Indikasi Pemberian
4. Pertimbangan lain
TERIMA KASIH