Nutritional care, just like other aspects of treatment, involves understanding a patient's individual needs to form a basis for intervention (or counseling), monitoring the results of such intervention, and making necessary adjustments. Although each patient is an individual, it is possible to identify phases in the provision of nutritional care that will be common to all. Effective dietetic management involves a sequence of activities; these have been summarized below:

Assessment

The systematic collection of information about patients, their conditions, and environments, which provides a baseline for the determination of therapeutic needs.

Analysis

The analysis of baseline data, providing profiles of patients' nutrition-related health statuses and identifying needs for intervention.

Planning

The setting of goals and objectives and the identification of strategies for achieving these. putting the plans into action through the provision of appropriate food and counseling.

Evaluation

The examination of the results of implementation. and the assessment of any needs to change patient care.

The details will differ from one patient to another, from one circumstance to another, but the activities the dietitian carries out and their sequence will be the same. In the assessment phase, a dietitian must gather all the relevant data about a patient's present problem, including the behaviors that may have contributed to that problem. Analysis of this data enables the dietitian to identify the patient's needs for changes in diet, education, and counseling.

Planning can then take place to provide a diet with a specific nutritional profile in the hospital, and counseling strategies to help the patient understand what is required and, if necessary, continue to modify his or her diet at home. Once the dietary planning is complete, tailored to individual needs, the process of implementation can be started by consulting the patient about the appropriateness of the plan and securing acceptance and cooperation. Following its implementation, it is essential to evaluate the outcome of the activities undertaken.

• Is the dietary modification producing the desired changes in the patient's physical condition?
• Does the patient understand how and why the diet is being modified and feel confident about implementing such changes at home, if necessary?

Careful monitoring enables a dietitian to decide if and what changes in the approach to the management of a particular patient are necessary. Perhaps a change to the dietary prescription is needed, or maybe a factor that interferes with the patient's ability to follow dietary advice was not sufficiently considered.

Of course, alternatively, a dietitian may find that a patient's condition. is responding well to the prescribed modifications and that the patient is coping well with the modified diet and understands it fully.