Overview of PES Statements
PES statements are structured sentences that use standardized terminology. They are used by dietitians to communicate the nutrition diagnosis of a patient.
PES statements are part of the Nutrition Care Process (NCP) which provides dietitians a framework for providing nutritional services.
How To Write a PES Statement
PES statements are written as follows:
[Problem/nutrition diagnosis] related to [Etiology], as evidenced by [Signs/symptoms].
The P is the nutrition problem the patient presents with, while the etiology is the “root cause” of the nutrition problem, and the signs and symptoms are the defining characteristics of the problem.
For more information on PES statements and the NCP, click over to these other blog posts:
Nutrition Diagnosis: Definition & Examples
Domains of Nutrition Diagnostic Terminology
The nutrition diagnostic terminology, found in the Electronic Nutrition Care Process Terminology (eNCPT), is broken down into three main domains being the intake, clinical and behavioral-environmental.
PES Statement Examples
Intake Domain
Inadequate energy intake related to difficulty swallowing as evidenced by <25% of meals consumed and reported weight loss of 10 lbs in the last three months.
Excessive energy intake related to binge eating behaviors as evidenced by feeling loss of control around food, consuming a whole bag of chips in one sitting.
Inadequate enteral nutrition infusion related to poor tolerance of ordered infusion rate as evidenced by diarrhea and multiple discontinuations of tube feed, loss of 3 lbs in last 5 days.
Inadequate fluid intake related to fear of urinary incontinence as evidenced by poor skin turgor, estimated fluid intake of 16 oz daily.
Inadequate protein intake related to food aversions as evidenced by estimated protein intake of 20 g per day, temporal wasting.
Inadequate fiber intake related to limited high-fiber foods in the home as evidenced by daily consumption of refined grains, <2 servings of vegetables per week.
Excessive sodium intake related to reliance on convenience and fast foods as evidenced by an daily average intake of 4343 mg sodium, ankle edema and elevated blood pressure readings.
Clinical Domain
Unintended weight loss related to early satiety as evidenced by estimated intake being 50% of calculated needs, patient’s clothes from last year are now too big.
Obesity Class III related to physical inactivity as evidenced by an average of 2000 steps per day, BMI 42.4.
Unintended weight gain related to physical inactivity as evidenced by patient no longer going to YMCA, weight gain of 6% in last month.
Severe starvation-related malnutrition related to depression as evidenced by 30% weight loss in one year, frequent meal skipping.
Moderate chronic disease or condition related malnutrition related to ovarian cancer as evidenced by 5% weight loss in last month, estimated energy intake <75% of calculated needs.
Moderate acute disease or injury related malnutrition related to increased energy needs as evidenced by burn covering 25% of body, edema, intake <25% at meals and enteral feeds have yet to be started.
Behavioral-Environmental Domain
Food and nutrition related knowledge deficit related to limited previous nutrition education as evidenced by patient statement “I didn’t know eating certain foods would help my constipation.”
Not ready for nutrition related behavior change related to perception that time constraints prevent change as evidenced by patient stating he does not have enough time to eat healthy.
Self monitoring deficit related to no previous glucometer training as evidenced by unopened glucometer box, blank blood sugar logs.
Limited adherence to nutrition-related recommendations related to cognitive deficit as evidenced by patient not being able to teach-back the plate method.
Limited food acceptance related to nausea and food aversions as evidenced by patient frustration, food refusal.
Physical inactivity related to knowledge deficit of health benefits of physical activity as evidenced by patient reported no structured physical activity, significant sedentary time.
Limited ability to prepare food for eating related to fatigue as evidenced by decreased overall estimated intake, meal skipping.
More Examples
Looking for PES statements for specific disease states? Check out these links for more:
Tips for Writing the Perfect PES Statement
- Use information gathered in the assessment to determine the nutrition problem
- Use critical thinking to make inferences
- The nutrition diagnosis can ideally be resolved, or at least improved, through a nutrition intervention provided by the dietitian
- Choose nutrition diagnoses from the intake domain, over other domains, as these are the most likely to be resolved by the dietitian through a nutrition intervention
- PES statements should be clear and concise
- Keep PES statements to three or less for a patient
- Feel free to not write complete sentences by leaving words such as “and” and “the” out
Note that the 2023 edition of the Nutrition Care Process Terminology (eNCP) is used, which is the most current version at the time of this article being published.
References:
Electronic Nutrition Care Process Terminology (eNCPT)