What is a PES statement?
A PES statement is a nutrition diagnosis that is part of the nutrition care process (not to be confused with a medical diagnosis). It is a structured sentence that is typically a part of your chart note to help communicate your nutrition diagnosis.
This blog post has been developed based on information retrieved from the Nutrition Care Process Reference Terminology (NCPT) Manual (2017) (1).
Writing PES statements can feel a bit complicated, so we created our Nutrition PES Statement Cheat Sheet, a free resource with 17 pages of sample PES statements for dietetic practice! Get your free nutrition pes statement cheat sheet.
Why do we need PES Statements?
PES statements are useful for communicating the nutrition-related problem that can be improved or resolved by nutrition intervention. They help to summarize your nutrition assessment and give justification for the next steps of the nutrition intervention.
Parts of a PES Statement
A PES statement has 3 parts (1):
P: Problem
- A nutrition-related problem or diagnosis that can be improved or resolved through nutrition intervention.
E: Etiology
- The cause that an RD can address to resolve or lessen the signs and symptoms. The nutrition intervention targets this.
S: Signs & Symptoms
- The signs and symptoms determining the diagnosis and whether it can be resolved or improved. These should be monitored to determine the effectiveness of the nutrition intervention.
The sections above are then combined in a structured sentence by the phrases “related to” and “as evidenced by”, as shown below:
The PROBLEM related to ETIOLOGY as evidenced by SIGNS and SYMPTOMS
How To Write a PES Statement
Start with the Problem
There are 3 domains that the “problem” in your statement might fall under:
- Intake – too much or too little energy, nutrients, fluid, etc. (The intake is the more preferable domain because it is more likely the dietitian can address problems within this domain.)
- Clinical – medical/physical conditions.
- Behavioral-Environmental – knowledge/attitudes/beliefs, physical environment (access to food, food safety), etc.
Then, check your “problem” statement by asking yourself the following questions:
- Can the dietitian improve this nutrition diagnosis?
- Is the most important problem addressed?
The Etiology
The etiology is the root cause of the problem that the dietitian can address or at least lessen the signs and symptoms of.
Check your PES etiology by asking yourself the following questions:
- Is this the root cause?
- Will the dietitian be addressing this in the intervention?
The Signs and Symptoms
The signs and symptoms are the supporting evidence that the nutrition problem exists. They help to provide quantitative and qualitative data to support the problem.
Check your signs and symptoms by asking yourself the following questions:
- Will measuring the signs and symptoms help to evaluate progress?
- Are they specific enough that the dietitian can monitor the improvement of the nutrition diagnosis?
Check your entire PES statement by asking yourself the following questions:
- Is the statement based on the nutrition assessment data?
- Is the statement clear and concise?
- Is this statement factually correct and specific to this client?
Sample PES Statements
Use the PES statement examples created with our Nutrition PES Statement Cheat Sheet to get started! Remember to design your own PES statement based on your unique client’s assessment and nutritional needs.
Sample PES Statements for Hypertension
Excessive sodium intake related to nutrition knowledge deficit as evidenced by blood pressure value of 185/115, diagnosed hypertension, 24-hour recall showing estimated sodium intake > needs.
Sample PES Statements for Malnutrition
Moderate malnutrition related to limited access to food due to food insecurity as evidenced by unintended weight loss, self-reported loss of muscle and fat stores, and diet history showing total energy, macronutrient, and micronutrient intake less than needs.
Sample PES Statements for Diabetes
Inadequate fiber intake related to nutrition knowledge deficit as evidenced by lack of formal diabetes education, diet history showing fiber intake lower than needs with high carbohydrate and simple sugar intake, history of uncontrolled blood glucose.
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