Development of a Practical Tool for Selecting a Nutrition Diagnostic Code in the Nutrition Care Process

Abstract

Objective: This study aimed to develop a flowchart for selecting nutrition diagnostic codes (NDCs) with high validity and consistency in the nutrition care process.

Methods: The NDC selection flowchart consisted of two parts: first, NDC (P1) related to nutritional intake was derived, and then the second, NDC (P2) indicating the root cause of the nutritional problem was derived. Registered dietitians/dietitians were asked to determine the nutritional diagnosis of simulated patients using the NDC selection flowchart. Based on this, the flowchart was evaluated.

Results: Responses were received from 43.2% of the participants. For patient A simulation, the agreement on correct answers for both P1 and P2 was ≥ 80%, and the validity rate exceeded 90%. In contrast, for patient B simulation, the agreements on correct answers and the validity rate for P1 were approximately 40% and 90%, respectively. For P2, the agreement on correct answers was 10%, and the validity rate was 50%. The degree of difficulty of the NDC selection flowchart was rated lower than its efficacy.

Conclusion: Although the efficacy of the NDC selection flowchart was confirmed as expected, the results of this study show that the flowchart needs further improvement to serve as a tool for selecting NDCs with high validity and consistency.