PES statements

Presentation for NUT 390iBy Chris Shelton

NUT 4700

PES = Problem, Etiology, Signs/Symptoms

• PES statements are written by Registered Dietitians. They are used when an RD diagnoses a patient’s problem or needs.

• It’s a simple written statement that identifies the Problem; states the Etiology of the problem; and gives the Signs or Symptoms that support the diagnosis of a patient.

When do RDs write a PES?

Writing PES statements

• There is a standardized language for writing a PES statement:

• It always includes: whatever the Problem is, how it is related to the Etiology of the problem, as evidenced by the Signs or Symptoms that you see as an RD

• The key words in this statement are “related to” and “as evidenced by.”

PES examples

• 70-yr old white male admitted for cardiac bypass surgery. Doctor sees that patient is underweight so refers patient to RD

• RD conducts an assessment and finds patient has lost weight (15 pounds in 3 months) without trying and has been eating poorly for several weeks. He lives alone at home and his wife died 3 months ago

PES examples

• A sample PES would be: • “Involuntary weight loss related to missing

meals as evidenced by loss of 15 pounds over 3 months.”

• The Problem is the weight loss. The Etiology is related to missing meals. The Signs or Symptoms are the 15 pounds lost over 3 months.

More PES examples

• “Inadequate energy intake related to calorie intake not meeting calculated needs as evidenced by 15lb weight loss in 3 months.”

More PES examples

• Based on lab results:• “Inadequate mineral intake (iron) related to

iron intake not meeting needs as evidenced by low Hgb/Hct and ferritin.”

More PES examples

• Socioeconomic:• “Limited access to food related to inability to

acquire food as evidenced by lack of income.”

Don’t forget

• PES statements are a written diagnosis of a patient’s nutritional problem.

• A PES is a simple statement that identifies the Problem, gives the Etiology of the diagnosis and states the Signs/Symptoms that support the diagnosis.

• Always use the words “related to” and “as evidenced by.”

Thank you!

References:• Mahan KL, Escott-Stump S. Krause’s Food and Nutrition

Therapy. 12th ed. St. Louis, MO: Saunders Elsevier; 2008.• Lecture notes from NUT 4700 with Anne Keller, MS, RD;

Metropolitan State University of Denver; Aug. 2013.