Writing PES Statements is a skill that takes time to develop it, but with practice, it can be a breeze for you! I’ll help you figure out the right nutrition diagnosis for scenarios and give you confidence in your ability to write a PES Statement.

Introduction to PES Statements

PES statements are a way that we as Dietitians standardize the way we diagnose and recognize nutrition problems in our patients.

PES statements use standardized nutrition terminology for the nutrition diagnosis. The nutrition diagnosis will be the first part of your statement.

To break it down into the simplest terms:

P = Problem

E = Etiology

S = Signs and Symptoms

Your PES statements will follow the same format every single time.

Problem related to Etiology as evidenced by Signs and Symptoms.

Let’s take a closer look at each.

Nutrition Problem

You can see below in the chart the common nutrition diagnosis that we use in long term care.

We derive our PES statements from standardized terminology, there’s no need to memorize this stuff, we’re fortunate that we can print off our booklets and keep them with us. If you don’t have one, they’re pretty accessible if you google it, I’ll attach a link at the bottom of this article.

P = The Nutrition Problem
This is going to be the issue that you are trying to resolve, only put a problem here that your nutrition interventions are going to address. For example if you’re putting ‘unintentional weight loss’, your interventions may be to increase calories.

Nutrition Etiology

E = Etiology
This is what you think is causing the problem that you just chose. Your nutrition assessment will help you find out the etiology and will help guide your nutrition interventions. Only give an etiology after you have done a full nutrition assessment, you can’t write this statement blind. You need your subjective and objective data to support your statement.

Nutrition Signs and Symptoms

S/S = Signs & Symptoms
This is fairly self explanatory, but this is the evidence of your problem and root cause. The signs can be objective data that you discovered in your nutrition assessment. If we stick with our weight loss example, this could be the resident lost a significant amount of weight in 1/12 equaling 10% and is now below IBW at 40 kg.

Your symptoms could be something you have spoken to the resident amount, resident feeling increased fatigue, decreased appetite. Ensure that your S/S are evidence to back up the rest of your statement.

Also ensure that your nutrition intervention will try to reduce the signs and symptoms that you have measured/observed.

Format for PES Statements

Your statement will always follow this format:

Problem related to Etiology as evidenced by Signs & Symptoms

It’s standardized language and this includes the format that the statement is written in.

Common PES Statement Examples

Okay, now that you know the basis of what a PES statement is composed of, let’s look at some commonly used PES statements in LTC/NH and why we use them.

Note that these are only just a few statements, but they are quite frequently used in LTC. Get some practice and do some research to get your statements flowing!

What if There is NO Nutrition Diagnosis?

Also just a last note that sometimes there is ‘No nutrition diagnosis at this time.’ Some RD’s might not feel comfortable using this, but we need to be honest, that sometimes our patients are nutritionally stable.

Yes, they are at risk of malnutrition, but if you feel that your resident is stable, don’t feel compelled to just invent a diagnosis just to write one. Frequently if I have an annual assessment for a resident, their intake is stable over the past year, weight has been stable +/- 1-2 kg, no swallowing difficulty, medical status is stable, then I will write, ‘No nutrition diagnosis at this time.’

Still Looking for More PES Statements?

You can read this article for the Top 7 Malnutrition PES Statement examples!