ONC: Scope of Guideline (2013)

Guideline Scope Characteristics

Below you will find a list of characteristics that describe the Scope of this Guideline.

Disease/Condition(s)

The purpose of this guideline is to provide an evidence-based summary of effective practice in the nutrition management of the adult oncology patient. Recommendations have been formulated for oncology within the context of the A.N.D. Nutrition Care Process.

The major focus of this guideline is screening for malnutrition risk, nutrition assessment and intervention.

This guideline is intended for use by dietetics practitioners involved in care for patients undergoing cancer treatment. The information in this guideline should be used to provide individualized nutrition care with practical nutrition recommendations that are based on the current state of the science for nutrition in cancer patients.

Below you will find a list of characteristics that describe the Scope of this Guideline.

Nomenclature

Please note that the terms "patient" and "client" are used interchangeably throughout this guideline to describe an individual receiving care.

Considerations

Clinical judgment is critical. Careful consideration should be given to the application of these guidelines for patients receiving hospice, palliative care, or those with significant medical co-morbidities. Advance directives may also indicate if treatment is desired or not.

Guideline Category

Assessment of Therapeutic Effectiveness, Treatment

Clinical Specialty

Oncology

Intended Users

Registered Dietitians, Advanced Practice Nurses, Health Care Providers, Health Plans, Hospitals, Managed Care Organizations, Nurses, Physician Assistants, Students

Guideline Objective(s)

Overall Objective

To provide MNT guidelines aimed at managing symptoms, preventing weight loss and maintaining optimal nutritional status during cancer treatment.

Specific Objectives

To define evidence-based recommendations for registered dietitian nutritionists (RDNs) that are carried out in collaboration with other healthcare providers

To guide practice decisions that integrate medical, nutritional and behavioral elements

To reduce variations in practice among RDNs

To promote self-management strategies that empower the patient to take responsibility for day-to-day management

To enhance the quality of life for the patient, utilizing customized strategies based on the individual’s preferences, lifestyle and goals

To develop guidelines for interventions that have measureable clinical outcomes

To define the highest quality of care within cost constraints of the current healthcare environment.

Target Population

Adult (19 to 44 years), Middle Age (45 to 64 years), Aged (65 to 79 years), Male, Female

Target Population Description

Adults who are receiving oncology treatment or care.

Interventions and Practices Considered

The Oncology guideline is based on the Academy of Nutrition and Dietetics’ Nutrition Care Process and Model, which involves the following steps. Terms relevant to the treatment of critically ill patients come from the International Dietetics & Nutrition Terminology (IDNT) Reference Manual: Standardized Language for the Nutrition Care Process. Fourth Edition.

Nutrition Assessment

Nutrition Diagnosis

Nutrition Intervention

Nutrition Monitoring and Evaluation.

This guideline addresses topics that correspond to the following areas of the Nutrition Care Process. Please refer to the Algorithms in this guideline for a more detailed view of the recommendations and their application within the Nutrition Care Process.

I. Referral to a Registered Dietitian Nutritionist
II. Medical Nutrition Therapy

A. Nutritional Assessment and Treatment

B. Nutrition Diagnosis

C. Nutrition Intervention (Planning and Implementation)

Individualized prescription based on:

Dietary interventions

Physical activity interventions

Behavioral interventions

Pharmacotherapy or surgery, when indicated.

D. Monitoring and Evaluation

The monitoring of progress, measuring of outcomes, and evaluating of outcomes against criteria to determine changes in specific indicators of nutrition care outcomes.

For more information on the NCP Terminology, visit http://ncpt.webauthor.com.

Future Research Needs

For the Oncology Work Group's suggestions for future research, see ONC: Future Research Suggestions.