Interview Questions for Nutrition Care Plan Development

The Nutrition Care Process (NCP) is a standardized, four-step process used by registered dietitians (RDs) and other qualified nutrition professionals to provide high-quality, patient-centered nutrition care. Think of it as a roadmap guiding us from initial assessment to successful outcome monitoring. The four steps are:

• Assessment: This involves collecting comprehensive information about the patient’s nutritional status, medical history, lifestyle, and dietary habits. We use various tools like 24-hour dietary recalls, food frequency questionnaires, and anthropometric measurements (height, weight, BMI) to gather this data. For example, assessing a patient with diabetes involves reviewing their blood glucose levels, medication history, and understanding their current carbohydrate intake.
• Diagnosis: Here, we analyze the assessment data and identify the specific nutrition problem. We use the PES statement (Problem, Etiology, Signs/Symptoms) to formulate a clear and concise diagnosis. This is where we pinpoint the root cause of the nutritional issue. For instance, a patient with low albumin levels (Problem) due to inadequate protein intake (Etiology) resulting in edema (Signs/Symptoms) might receive the diagnosis of “Inadequate Protein Intake”.
• Intervention: This is the action plan. Based on the nutrition diagnosis, we develop a tailored plan to address the identified problem. This might involve recommending specific dietary changes, providing nutritional education, or referring the patient to other healthcare professionals. A plan for the low albumin patient could involve increasing their protein intake through specific food choices and supplements, along with education on appropriate meal planning.
• Monitoring and Evaluation: This crucial step involves regularly tracking the patient’s progress and making necessary adjustments to the intervention plan. We monitor outcomes using various methods, such as reassessing dietary intake, checking weight changes, and reviewing lab results. For the low albumin patient, monitoring could involve tracking weight, albumin levels, and dietary adherence to the plan.

A comprehensive nutrition assessment is a multifaceted process that gathers data from multiple sources to gain a holistic understanding of a patient’s nutritional status. It’s not just about what someone eats, but also about their overall health and well-being. The components typically include:

• Anthropometric data: This includes measurements like height, weight, BMI, body composition (e.g., using bioelectrical impedance analysis), and waist circumference. These provide a physical picture of the individual’s nutritional status.
• Biochemical data: This involves reviewing laboratory results such as blood glucose, cholesterol, albumin, and hemoglobin levels. These provide clues about the body’s use of nutrients.
• Clinical data: This includes a physical examination to identify signs and symptoms related to nutritional deficiencies or excesses. For example, looking for skin lesions, muscle wasting, or edema.
• Dietary data: This is obtained through various methods such as 24-hour dietary recalls, food frequency questionnaires, food records, and even direct observation of eating habits. This helps quantify nutrient intake.
• Client history: This encompasses information about medical history (including chronic diseases and medications), social history (e.g., socioeconomic status, education level), psychosocial history (e.g., stress levels, support systems), and lifestyle factors (e.g., physical activity level, smoking).

Combining these data sources paints a complete picture, allowing for a more accurate and effective nutrition diagnosis and intervention.

The PES statement is a crucial tool for formulating accurate nutrition diagnoses. It provides a structured format to clearly define the nutrition problem, its underlying cause, and the observable evidence. The format is:

For example:

To determine an appropriate nutrition diagnosis, follow these steps:

1. Identify the Problem (P): This describes the nutrition problem based on the assessment data. Common problems include inadequate energy intake, excessive fat intake, or imbalanced intake of specific nutrients.
2. Determine the Etiology (E): This pinpoints the underlying cause of the problem. The etiology might be a medical condition, a behavioral factor, or an environmental influence. It explains *why* the problem exists.
3. Identify the Signs/Symptoms (S): These are the measurable or observable indicators that support the problem and etiology. These can be physical findings (edema, weight loss), lab results (low hemoglobin), or client statements.

Using this structured approach ensures clear communication and facilitates consistent documentation across healthcare settings.

An effective nutrition intervention plan must be individualized, achievable, and measurable. Key elements include:

• Prioritized Nutrition Diagnoses: The plan should address the most pressing nutrition problems first.
• Specific, Measurable, Achievable, Relevant, and Time-bound (SMART) Goals: Goals should be clearly defined, quantifiable, achievable within a reasonable timeframe, and relevant to the patient’s needs. For example: “Increase daily protein intake by 30 grams within one month.”
• Specific Recommendations: These should outline dietary changes, meal planning strategies, and supplement recommendations. The plan should be tailored to the patient’s preferences, culture, and lifestyle.
• Education and Counseling: Providing education on proper nutrition, healthy food choices, and behavior modification techniques is crucial for long-term success.
• Collaboration with other healthcare providers: Working with physicians, nurses, and other professionals is essential, particularly for patients with complex medical conditions.
• Regular Monitoring and Evaluation: Tracking progress and making adjustments to the plan is critical.

The plan should be documented clearly and communicated effectively to the patient and other healthcare professionals.

Monitoring and evaluation are essential for ensuring the effectiveness of a nutrition care plan and determining whether adjustments are needed. This involves regularly tracking the patient’s progress toward the established goals. Methods include:

• Follow-up appointments: These provide opportunities to assess dietary adherence, review any changes in symptoms, and gather further data through interviews and physical examinations.
• Dietary assessments: Repeating dietary assessments (24-hour recalls, food records) to measure changes in food intake.
• Weight monitoring: Tracking weight changes to assess progress towards weight goals.
• Biochemical tests: Re-testing relevant laboratory values (e.g., blood glucose, albumin) to monitor changes in nutritional status.
• Client self-monitoring: Encouraging patients to self-monitor through food diaries, tracking apps, and regular self-weighing.

If progress is not being made, the plan needs reevaluation. This might involve adjusting dietary recommendations, modifying goals, addressing barriers to adherence, or consulting other healthcare professionals. Effective monitoring and evaluation are cyclical—data gathered influences adjustments, and these adjustments are then monitored again to ensure the plan is effective.

While both medical nutrition therapy (MNT) and nutritional counseling aim to improve nutritional health, they differ in scope and approach:

• Medical Nutrition Therapy (MNT): This is a medically supervised intervention provided by registered dietitians (RDs) or other qualified nutrition professionals. MNT is focused on treating disease through nutrition and is often part of a larger medical care plan. It’s very individualized and evidence-based. Examples include managing diabetes through carbohydrate counting, providing nutrition support for cancer patients, or addressing nutritional deficiencies in kidney disease.
• Nutritional Counseling: This is a broader term that encompasses educational and behavioral interventions to promote healthy eating habits and improve overall well-being. It may or may not be medically supervised. Nutritional counseling could involve teaching healthy cooking techniques, assisting with weight management, or providing guidance on making dietary changes to prevent disease. Often, RDs conduct nutritional counseling as part of their MNT services, but the scope of services and level of medical integration differ.

In essence, MNT is a specialized form of nutritional counseling often used to manage specific medical conditions, whereas nutritional counseling is a more general approach focused on overall health and well-being.

Throughout my career, I’ve used several nutrition software and electronic health record (EHR) systems. My experience spans from simple nutrition analysis software to fully integrated EHRs. Some examples include:

• Nutrition analysis software: I’ve used programs like Nutritics and ESHA Research to analyze dietary intake data, calculate nutrient values, and generate reports. These programs streamline the process of assessing dietary intake and identifying potential nutrient deficiencies or excesses.
• Electronic Health Records (EHRs): I’ve worked with EHR systems such as Epic and Cerner which often include integrated nutrition modules. These allow for seamless documentation of nutrition assessments, interventions, and progress notes, improving communication among healthcare team members. The ability to track lab results and vital signs directly within the EHR is very time-saving and efficient.
• Specialized diabetes management software: In managing patients with diabetes, I utilized programs that assist with carbohydrate counting, blood glucose tracking, and meal planning, enabling better patient self-management.

My proficiency in these systems allows for efficient data collection, analysis, and documentation. I’m always eager to learn and adapt to new technologies to improve the quality and effectiveness of nutrition care.

Cultural competence is paramount in nutrition care. Adapting a plan requires understanding a patient’s beliefs, traditions, and food preferences. This involves more than just avoiding disliked foods; it’s about respecting their cultural food practices and integrating them into the plan, not replacing them.

• Active Listening and Inquiry: I begin by having an open conversation, asking about their usual diet, favorite foods, cooking methods, and any religious or cultural restrictions (e.g., halal, kosher, vegetarianism).
• Food Preferences and Availability: I explore the foods readily available to them, considering socioeconomic factors and access to grocery stores. A plan requiring exotic ingredients might be unrealistic.
• Recipe Modification and Substitution: I collaboratively work on modifying traditional recipes to meet their nutritional needs. For example, a high-sodium traditional dish could be adapted by reducing salt and incorporating herbs and spices for flavor.
• Respectful Language and Education: I ensure my language is culturally sensitive and avoid imposing my own views. Education should be tailored to their understanding and learning style, using culturally appropriate materials or visual aids.

Example: A patient following a traditional South Asian diet might consume substantial amounts of rice and lentils. Instead of completely removing these staples, I would focus on selecting nutrient-rich varieties and incorporating more vegetables and fruits.

Non-compliance is common and rarely intentional. It often stems from misunderstandings, unrealistic expectations, or lack of support. Addressing this requires a collaborative approach, focusing on understanding the reasons behind the non-compliance rather than placing blame.

• Open Communication and Empathy: I start by having a non-judgmental conversation, actively listening to their concerns and perspectives. Why are they struggling? Are there barriers to following the plan?
• Identify and Address Barriers: Common barriers include lack of access to food, financial constraints, time constraints, lack of cooking skills, or competing priorities. Identifying these allows for tailored solutions.
• Goal Setting and Adjustment: Sometimes, the initial plan is too ambitious. We may need to adjust goals, making them smaller and more achievable. Celebrate small wins to build confidence.
• Family and Social Support: Engaging family members or support systems can significantly improve adherence. They can assist with meal preparation, grocery shopping, or encouragement.
• Behavioral Strategies: We can use techniques like motivational interviewing, cognitive behavioral therapy (CBT) principles, or self-monitoring to enhance compliance.

Example: A patient struggling with portion control might benefit from using measuring cups and food scales, along with a food diary to track their intake.

Prioritization in patients with multiple conditions requires a holistic approach, considering the interplay between different health issues and their nutritional impact. I use a framework that integrates urgency, severity, and potential impact of nutritional interventions.

• Assess and Prioritize: A thorough assessment is crucial, considering the patient’s overall nutritional status, disease severity, and potential for nutritional interventions to improve outcomes. Conditions with immediate nutritional needs (e.g., uncontrolled diabetes or severe malnutrition) take precedence.
• Collaboration with Healthcare Team: Collaboration with physicians, nurses, and other healthcare providers is essential to coordinate care and ensure that the nutrition plan aligns with the overall treatment plan.
• Evidence-Based Guidelines: I rely on evidence-based guidelines for the management of each condition, recognizing that some dietary recommendations might overlap or conflict. We need to find ways to integrate them effectively.
• Patient-Centered Approach: The patient’s preferences and values are also considered when prioritizing interventions. The final plan should be realistic and achievable, tailored to their lifestyle and circumstances.

Example: A patient with type 2 diabetes and hypertension might require prioritization of blood glucose control through carbohydrate management, while simultaneously focusing on lowering sodium intake to manage hypertension. Both are essential, but the approach to achieving these goals must be carefully coordinated.

Evidence-based practice (EBP) is the cornerstone of effective nutrition care. It involves integrating the best available research evidence with clinical expertise and patient values to make informed decisions. This ensures that interventions are safe, effective, and tailored to individual needs.

• Systematic Reviews and Meta-analyses: I rely heavily on high-quality research, such as systematic reviews and meta-analyses, to inform my recommendations regarding nutrition interventions for specific conditions.
• Clinical Guidelines and Practice Standards: I follow established clinical guidelines and practice standards from reputable organizations, such as the Academy of Nutrition and Dietetics, to ensure that my interventions align with current best practices.
• Critical Appraisal of Research: It’s vital to critically appraise research studies for validity, reliability, and applicability to the individual patient. Not all research is created equal.
• Continual Learning and Updating: Nutrition science is constantly evolving. I regularly update my knowledge and skills through continuing education, journal articles, and professional conferences.

Example: When developing a nutrition plan for a patient with heart failure, I would consult evidence-based guidelines on sodium restriction and fluid management, considering the patient’s specific condition and preferences.

I have extensive experience with both enteral and parenteral nutrition support, having managed numerous patients requiring these interventions. My experience encompasses assessment, plan development, monitoring, and troubleshooting potential complications.

• Enteral Nutrition (EN): I’ve worked with various EN formulas, delivery methods (e.g., nasogastric, gastrostomy, jejunostomy tubes), and assessed patients’ tolerance, bowel sounds, and residual volumes regularly to ensure safe and effective delivery.
• Parenteral Nutrition (PN): My experience includes calculating PN prescriptions, collaborating with pharmacists to ensure appropriate nutrient delivery, and closely monitoring patients for complications such as infection, electrolyte imbalances, and liver dysfunction. I am proficient in assessing patients’ metabolic needs.
• Transition Planning: A key aspect is planning the transition from artificial nutrition support to oral intake as soon as clinically appropriate. This gradual process ensures optimal patient recovery.

Example: I successfully transitioned a patient from PN to EN and then to oral intake after a severe illness. This required careful monitoring of their tolerance and gradual increases in the volume and nutrient density of their nutrition.

Accurate documentation and communication are crucial for continuity of care and patient safety. I employ a systematic approach that ensures clear, concise, and comprehensive recording of all nutrition-related information.

• Electronic Health Records (EHRs): I utilize EHR systems to document all aspects of nutrition care, including assessments, diagnoses, interventions, progress notes, and education provided. This facilitates easy access for the entire healthcare team.
• Standardized Terminology: I utilize standardized nutrition terminology and documentation formats (e.g., standardized language for nutrition diagnoses and interventions) to ensure clarity and consistency across the healthcare team.
• Team Communication: I participate actively in multidisciplinary rounds and communicate effectively with physicians, nurses, and other healthcare providers. This collaborative approach ensures coordinated care.
• Patient Education Materials: I often provide patients with written materials summarizing the nutrition plan, emphasizing key points, and including contact information.

Example: After assessing a patient’s nutritional status, I would document the findings in the EHR, including anthropometric measurements, laboratory results, and dietary intake. I then document my nutrition diagnosis, interventions, and patient goals.

Throughout my career, I’ve encountered various nutrition-related complications. Addressing these required a systematic approach focusing on identification, intervention, and monitoring.

• Refeeding Syndrome: I’ve managed patients with refeeding syndrome, a potentially life-threatening condition that can occur when severely malnourished individuals are rapidly refed. This requires careful monitoring of electrolytes and gradual increases in caloric intake.
• Nutrient Deficiencies: I’ve addressed various nutrient deficiencies (e.g., anemia, vitamin D deficiency) through dietary modifications, supplementation, and lifestyle changes. The approach depends on the specific deficiency and its severity.
• Food Allergies and Intolerances: I have managed patients with food allergies and intolerances by carefully assessing their dietary needs and developing individualized plans that exclude triggering foods while ensuring adequate nutrient intake.
• Gastrointestinal Issues: I’ve worked with patients experiencing diarrhea, constipation, nausea, or vomiting, often requiring adjustments to the diet, such as changes in fiber content, fat intake, or meal timing.

Example: A patient with refeeding syndrome required close electrolyte monitoring and a gradual increase in caloric intake to prevent complications. This involved collaboration with the medical team and careful adjustment of the feeding regimen based on regular lab results.

Staying current in the rapidly evolving field of nutrition science requires a multi-faceted approach. I actively engage in continuous professional development through several key strategies. First, I subscribe to and regularly read peer-reviewed journals like the American Journal of Clinical Nutrition and the Journal of the Academy of Nutrition and Dietetics. These publications provide the latest research findings and evidence-based practice guidelines.

Secondly, I participate in professional organizations like the Academy of Nutrition and Dietetics (AND), attending their conferences and webinars. This allows me to network with other professionals and learn about the newest technologies and approaches in the field. These conferences often feature presentations by leading experts and offer continuing education credits. Finally, I regularly review reputable online resources, such as the websites of the National Institutes of Health (NIH) and the USDA, to stay abreast of changes in dietary recommendations and public health initiatives.

I also actively seek out continuing education opportunities, such as online courses and workshops, to expand my knowledge and skills in specialized areas. For example, I recently completed a course on the nutritional management of inflammatory bowel disease.

One particularly challenging case involved a 65-year-old male patient with advanced pancreatic cancer, cachexia (severe muscle wasting), and severe nausea. His nutritional needs were complex, as he experienced significant anorexia and had difficulty tolerating oral intake. The goal was to prevent further weight loss, maintain muscle mass, and improve his quality of life.

My approach was multi-pronged. First, I conducted a thorough nutrition assessment, using tools like the Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) to evaluate his nutritional status. Next, I collaborated closely with the oncology team, oncologist, and his family to understand his preferences and limitations. We considered various feeding options, including oral nutritional supplements, enteral nutrition (tube feeding), and parenteral nutrition (IV nutrition).

Given his nausea, we initially focused on small, frequent meals of easily digestible foods, while also using antiemetic medications as prescribed by his physician. We started him on an oral nutritional supplement specifically designed to be easy on the stomach. We monitored his weight, visceral protein levels (albumin, prealbumin), and his tolerance to food. As his condition progressed, we transitioned to enteral nutrition via a nasogastric tube, providing a consistent supply of complete nutrition tailored to his specific needs and calorie goals, to maintain his weight and minimize further muscle wasting. We regularly adjusted the plan based on his response and the oncologist’s input.

Technology plays a crucial role in enhancing my nutrition care plan development and implementation. I use Electronic Health Records (EHRs) extensively for accessing patient information, documenting assessments, creating care plans, and monitoring progress. Many EHR systems now include nutritional assessment tools and modules that streamline the process and ensure data consistency.

I also utilize nutrition analysis software, such as those that can analyze dietary intake from food records or recall interviews. This software helps me accurately calculate nutrient intake and identify deficiencies or excesses, allowing for precise adjustments to the care plan. Furthermore, telehealth platforms enable remote patient monitoring, allowing me to monitor progress, provide support, and adjust care plans as needed, particularly beneficial for patients who have mobility issues or live in remote areas. I utilize patient education apps and websites to provide patients with resources and support for adherence to their plans. Finally, data analysis tools within EHRs or specialized nutrition software allow me to assess outcomes and improve the effectiveness of my interventions over time.

Calculating nutrient requirements for patients with varying needs is a nuanced process that requires considering several factors. I use established guidelines and equations, such as the Estimated Energy Requirement (EER) equations from the Institute of Medicine, which take into account age, sex, weight, height, and physical activity level. However, these equations provide estimates, and adjustments are often necessary based on individual patient characteristics and conditions.

For example, patients with severe illnesses or injuries, such as burns or sepsis, may have significantly increased energy requirements due to the body’s heightened metabolic rate. In these cases, I may use the indirect calorimetry, a procedure that directly measures resting energy expenditure, to obtain a more precise estimate. Similarly, patients with chronic diseases such as kidney disease or diabetes may require adjustments to their protein, carbohydrate, and fluid intakes.

I also take into account the patient’s individual needs considering their disease state and goals. For example, a patient with diabetes will require careful management of carbohydrate intake. I always consider the patient’s individual preferences, cultural background, and access to food resources when developing a nutrition plan. A collaborative approach with other members of the healthcare team ensures the plan is safe, effective, and sustainable.

Collaboration is essential for providing optimal nutrition care. I regularly communicate with physicians, nurses, pharmacists, occupational therapists, and other healthcare professionals to coordinate care and ensure a holistic approach. For instance, if a patient is on multiple medications, I collaborate with the pharmacist to check for potential drug-nutrient interactions.

Effective communication is vital. This involves attending patient care rounds, participating in interdisciplinary team meetings, and using electronic communication tools to quickly share updates. I also work closely with the patient’s family or caregiver to educate them on the nutrition plan and to encourage support and adherence. This collaborative effort is vital for achieving positive outcomes, especially in complex cases. A shared understanding across disciplines creates a cohesive and effective approach to patient care.

Educating patients effectively is critical for empowering them to make healthy choices. My approach is centered around clear, concise, and patient-centered communication. I begin by assessing their understanding of their condition and their nutritional needs, adapting my language and approach accordingly. I use a combination of verbal explanations, visual aids (such as brochures or handouts), and interactive demonstrations to enhance comprehension.

For example, I might use food models to visually illustrate portion sizes or demonstrate meal preparation techniques. Setting realistic and achievable goals with the patient increases their confidence and adherence. I incorporate culturally sensitive approaches, understanding that dietary habits and preferences vary significantly. Finally, regular follow-up and feedback sessions provide an opportunity to address any challenges, make adjustments to the plan, and reinforce positive behaviors. Providing resources and support beyond the initial consultation, like phone calls, email, or online support groups can help ensure long-term success.

I have extensive experience using standardized nutrition assessment tools, including the Subjective Global Assessment (SGA), Mini Nutritional Assessment (MNA), and Nutrition Focused Physical Examination (NFPE). These tools provide a structured and consistent approach to evaluating a patient’s nutritional status, aiding in the identification of risk factors and the development of targeted interventions. The SGA, for instance, combines clinical observations with patient history to determine nutritional status, while the MNA is a validated screening tool particularly useful for identifying malnutrition in older adults. The NFPE uses physical examination findings to assess various aspects of nutritional status, providing another layer of data beyond dietary intake.

The use of standardized tools ensures objectivity and consistency, allowing for accurate comparisons between patients and across time. The data collected through these assessments are integrated into the overall nutrition care plan, allowing for a more comprehensive and effective approach to nutritional management. These tools also facilitate communication amongst healthcare providers, improving the accuracy and clarity of shared information.

My strengths in nutrition care plan development lie in my ability to conduct thorough nutrition assessments, tailoring plans to individual needs and cultural backgrounds. I’m proficient in utilizing evidence-based practices, integrating patient preferences, and setting realistic, measurable goals. I excel at building strong therapeutic relationships, fostering patient adherence through clear communication and education. For example, I recently developed a plan for a diabetic patient who was struggling with adherence. By incorporating culturally appropriate recipes and involving family members in the process, we achieved excellent glycemic control.

However, I recognize a weakness in my time management when juggling multiple patients with complex needs. I’m actively working on improving this through implementing efficient scheduling strategies and utilizing technology to streamline documentation. I also regularly seek feedback from colleagues to refine my workflow processes.

Conflicting information is a common challenge. My approach involves a systematic evaluation of the sources’ credibility and bias. I assess the methodology, sample size, and publication date of research articles. For example, I prefer peer-reviewed studies over anecdotal evidence. I also cross-reference information across several reliable sources before drawing conclusions. If conflicting data persists, I consult with other registered dietitians or specialists to reach a consensus based on the most current and relevant evidence. Ultimately, the patient’s unique condition and preferences guide my final decision.

Understanding reimbursement and billing is crucial. My knowledge encompasses various billing codes, such as CPT codes for medical nutrition therapy (MNT), and the process of submitting claims to insurance providers. I’m familiar with the different types of insurance coverage and the nuances of pre-authorization processes. I also understand the documentation requirements for successful claim processing; accurate and detailed notes are essential for demonstrating the medical necessity of the services provided. For instance, I meticulously document the patient’s diagnosis, assessment findings, nutrition interventions, and outcomes to ensure proper reimbursement. Staying current with changes in billing regulations and payer policies is an ongoing priority.

Confidentiality and patient privacy are paramount. I adhere strictly to HIPAA regulations and maintain the strictest confidence regarding patient information. This includes securing electronic health records, limiting access to patient data only to authorized individuals, and following proper disposal procedures for confidential documents. During consultations, I always ensure privacy by conducting sessions in private rooms. I obtain informed consent before disclosing any patient information to third parties, even family members unless the patient explicitly grants permission. For example, I never discuss a patient’s case in public areas or with unauthorized individuals.

Measuring the success of interventions involves both quantitative and qualitative assessments. Quantitatively, I track changes in biomarkers like weight, blood pressure, cholesterol levels, and HbA1c. For a patient with hypertension, I would monitor their blood pressure readings regularly and document the changes in response to dietary modifications. Qualitatively, I assess patient satisfaction through regular feedback and evaluate changes in their overall health status, energy levels, and quality of life using validated questionnaires. For instance, I might use a food frequency questionnaire to assess changes in diet quality or a quality-of-life scale to assess improvements in patient well-being. A combination of both provides a comprehensive picture of the effectiveness of the intervention.

I’ve been involved in several nutrition-related projects. One significant project involved a quality improvement initiative to improve the glycemic control of hospitalized patients with diabetes. We implemented a standardized nutrition care protocol, resulting in a statistically significant reduction in average blood glucose levels. We also presented our findings at a national conference. Another experience involved collaborating on research studying the impact of a specific dietary pattern on cardiovascular risk factors. My role involved designing the dietary intervention, collecting data, and contributing to the analysis and interpretation of the results, ultimately contributing to a published manuscript. This ongoing involvement in research and quality improvement demonstrates my commitment to evidence-based practice and continuous improvement in patient care.