Stacy Cité ; High body fas, Patent ADIME Audit Form NUTRITION ASSESSMENT: Does the Assessment follow the IDNT guidelines for writing an assessment including: (Note: all sections may not be required in all assessments) a) Food/Nutrition-Related History b) Biochemical Data, Medical Tests, & Procedures c) Anthropometric Measurements d) Nutrition Focused Physical Findings e) Client History e Yes, No "Assessment includes info that is succinct, relevant ang-appropriate to support the nutrition diagnosis (PES Statement) ‘Yes No Appropriate comparative standards used? (Yes No Cnomtion reconnencatiung) NUTRITION DIAGNOSIS: Was a nutrition problem/diagnosis identified based on sclected data available? CS No Ts there initial documented evidence in the Assessment portigarof the note to support a nutrition diagnosis? _ No AIL3 components of PES statement present using nutrtign a ogy(R/T) and signs/symptoms (AEB). ( Yes No Diagnosis uses exact NCP terminology? No Etiology is root cause that RD can resolve or reduce signs/symptoms. (No INTERVENTION: |A nuttition prescription is written that supports the nutzition sis and identifies goals that are measurable, achievable and time-defined. (ie) No ‘The intervention is directed at changing the etiology but i£not possible to change etiology, itis directed at reducing the impact of signs/symptoms s No GOAL Is patient’s goal related to the documented plan for an intervention or actual intervention? Goal- edit a4 leo, (Ev0 kcals CO No MONITORING AND EVALUATION: M/E component addresses the nuttition (Yes No