The Nutrition Order resource describes a request for oral diets (including general diets such as General Healthy diet, or therapeutic diets such as Consistent Carbohydrate, two gram Sodium, or Fluid Restricted), oral nutrition supplements (such as nutritionally complete pre-packed drinks), enteral nutrition (tube feedings) and infant formula which govern the distribution of food and nutritional products used to feed patients within an in-patient setting. It does not cover orders for parenteral (IV) nutrition which are typically filled by pharmacy. Enteral orders are distinguished from supplements because they have some unique attributes and typically include administration information whereas oral nutritional supplements may simply be supplied (e.g. home health or outpatient settings). In a simple case, the requestor may designate type of product, product name and the route of administration along with free text instructions without a having to complete the additional structured details.
This resource is intended to be used by providers from a variety of specialties such as physicians, dietitian/nutritionists, or speech therapists. One provider may simply order a base element oral diet such as General Healthful diet. Another provider, based on scope of practice, may use other elements to communicate additional therapeutic needs or patient preferences. The optionality included gives an ordering provider the capability to write a simple order for an oral diet, nutritional supplement or formula with minimal requirements beyond that of specifying the diet, supplement or formula product, but also supports the ability to provide more detailed information that may be further augmented by a dietitian or nutrition specialist. For example, a physician may order a two g sodium diet. A speech therapist, based on the results of a swallowing evaluation, then orders a mechanically altered texture with nectar thick liquids.
The Nutrition Order resource is used for requesting oral diets, oral nutrition supplements and enteral feedings in an in-patient setting. The Medication Request resource should be used for requesting parenteral (IV) nutrition and prescribing dietary supplements such as vitamin or mineral supplements. The Nutrition Order is a record of the request for the supply of a diet, oral supplement or enteral formulas for a patient. However, to initiate the request requires the use of the Task resource and its associated workflow with the Nutrition Order referenced from Task based On, or by using the Nutrition Task resource in the context of a messaging or service workflow where the request is explicit or implicit.