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Hospital USM  |  Kampus Kesihatan


Ordering of a therapeutic diet initials a dietetic assessment of the patient’s nutritional needs. The following sequence of events should occur to initiate a therapeutic diet and dietetic review.

  1. Documentation in case notes by doctor involved with the patient requesting a normal diet / a therapeutic diet / enteral feeding formula / dietetic review.
  1. Patients’ Diet order using a standard form prepared by nurse in every  ward on a daily basic sent to food service area, every morning (before 7.30 am).
  1. For Dietetic Assessment, a notification of the Dietitian for the ward by the nurse or doctor involved in the patients admission process, or Dietitian noticed himself / herself during morning round to check and verify diet order, so that if there is a need to, an assessment ca be undertaken as soon as possible.
  1. After assessing a patient (if there is a need to), the dietitian will;
  1. Check and verify diet order, and aware or update diet order list (both in ward & infant service area).
  2. Document the details of the nutrition care plan which includes Nutrition Assessment, Nutrition Diagnosis, Nutrition Intervention and Monitoring / Evaluation in the case-notes and Dietitian’s notes (MNT Record)
  3. Review which include nutrition monitoring and evaluation of the patient for education about modified diet, tolerance of modified diet, alterations etc.

      Documentation will continue in the patient’s case-notes and dietitian’s notes (MNT record)

Notes: Prior to discharge, if the patient is assessed to require dietary education or revision, an appointment at the Dietetic Outpatient Clinic should be offered to the patient; the reason for the referral should be clear.