Implementing Diet Orders

It is very important the facility provide meals that are properly implemented and accurately reflect the physician’s orders to ensure the residents nutritional needs and safety. Follow the policy and procedures written to be sure the diets are followed correctly.

Policy Interpretation And Implementation

1: The physician should prescribe each individual with a diet order upon admission. If the physician has not prescribed a diet order upon admission. Nursing will contact the physician for an order before feeding the individual.

2: The written diet order will be prescribed by the physician.

3: The dietitian may make recommendations to modify diet orders.

4: The nursing staff will notify the physician of the dietitian’s recommendation to modify diet orders.

5: The physician may accept or reject the dietitian’s recommendations to modify diet orders.

6: The nursing staff will notify the dietitian of any changes made in the consumer’s orders.

7: The diets prescribed by the physician may be modified to meet a person’s individual diet needs. Diets can be mechanically or therapeutically altered.

8: The Mechanically altered diets are modified in texture and consistency to facilitate consumption.

9: The standard terminology for textured modified diets in this facility are: Regular Cut up, Bite size, Chopped, Minced and Moist (or Ground), and Puree.

10: Therapeutic diets offered are altered for the treatment or prevention of various diseases.

11: The standard terminology for therapeutic modified diets in this facility are: Lowfat, Consistent Carbohydrate, No Added Salt, Renal, and Bland.

12: The physician is not limited to the standard texture and therapeutic modified diet orders.

13: The facility should notify the dietitian, if a diet order is not a standard diet order for instructions and or guidelines.

14: Mechanically and therapeutically altered diets will both be served to provide a nutritious balanced diet.

15: The diet orders prescribed by the physician will be written in the physician’s orders and medication administration record. (MAR)

16: The diet orders written in the physician’s orders and medication administration record will be consistently written. The nurse will monitor the physician’s orders and medication administration record for consistency.

17: The staff will verify the written diet order before serving consumer food.

18: The staff will document in the MAR the proper diet was provided to the consumer by initials in the MAR.

19: The QIDP will maintain a current meal service guide for all consumers. If a consumer is NPO and not eating oral foods the QIDP will note NPO on the daily diet plans. The meal service guide will include : Consumer’s name or ID, prescribed current diet order, and food allergies or intolerances. The meal service guide may also include adaptive equipment needed, food preferences, and treatments.

20: The staff will follow the guidelines written on the meal service guide.

21: The staff will notify the QIDP if the guidelines are unclear and need adjustment.