Experiences of Registered Nutritionist-Dietitians in Selected Tertiary Government Hospitals in Metro Manila on the Implementation of the Nutrition Care Process (NCP): Basis for a Clinical Nutrition Framework

Abstract

The Nutrition Care Process (NCP) was developed as a standardized and evidence-based approach to improve the quality and consistency of clinical nutrition care. Despite policy mandates in the Philippines, its implementation in tertiary government hospitals remained inconsistent. This study explored the lived experiences of Registered Nutritionist-Dietitians (RNDs) in implementing the NCP in selected tertiary government hospitals in Metro Manila and served as a basis for developing a Clinical Nutrition Framework. A phenomenological qualitative design was employed, involving purposively selected RNDs. Data were collected through in-depth interviews and analyzed using thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR). The findings revealed that NCP enhanced clinical reasoning and professional accountability but was constrained by limited resources, manpower shortages, and inconsistent organizational support. Leadership engagement, professional commitment, and adaptive strategies were identified as key facilitators. The study concluded that successful NCP implementation depended on the interaction of organizational, individual, and external factors. A Clinical Nutrition Framework was proposed to strengthen implementation through policy support, organizational readiness, capacity building, patient-centered adaptation, and monitoring mechanisms.