From mrogard at charter.net  Thu Jan  1 02:11:24 2009
From: mrogard at charter.net (mrogard at charter.net)
Date: Thu, 1 Jan 2009 2:11:24 -0800
Subject: [Cnm] Initial Nutrition Assessments for pts readmitted shortly
 after discharge
In-Reply-To: <120AAA8883F193448149DA50511E16DB01665637@EXBEVS3.nbhdhqdomain.nbhd.org>
Message-ID: <20090101051124.D3N0T.725722.root@mp13>

At our facility we model our assessment policy for recent admission/discharge patients on the medical staff policy.  
MJ
--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org
Professional email: mrogard at charter.net

---- "McLaughlin wrote: 
> Are there any guidelines that say the Initial Nutrition Assessment can
> be copied from a previous admission if the patient was readmitted within
> _______ days of last discharge?
>  
> The dietitians say they used to copy the Assessment from the previous
> admit if the pt had been discharged less than 2 weeks prior.
>  
> Does anyone else do something like this and what are everyone's thoughts
> on this?  
>  
> Thanks!
> Julie McLaughlin
> Clinical Nutrition Manager
> BGMC
> Ft. Lauderdale, FL
> 
> - ----------------------------------------------
> Broward Health CONFIDENTIALITY NOTICE: 
> This message and any included attachments are intended for the sole use of 
> The individual or entity to which it is addressed. This message may contain information 
> that is confidential and protected by federal and state law. If you are not the intended 
> recipient, you are hereby notified that any disclosure, copying, or distribution of this 
> message is strictly prohibited. If you received this message in error, please immediately 
> notify the sender by reply e-mail and then delete the original message and its 
> attachments without reading or saving the attachments in any manner. (This email has been scanned by the Broward Health email security system) Thank you.



From tggilbert at att.net  Thu Jan  1 03:54:17 2009
From: tggilbert at att.net (Theresa Gilbert)
Date: Thu, 1 Jan 2009 03:54:17 -0800 (PST)
Subject: [Cnm] Initial Nutrition Assessments for pts readmitted shortly
	after discharge
Message-ID: <129872.88663.qm@web81204.mail.mud.yahoo.com>

How about with nutrition screening - our nurses do this and sometimes we? have to call to remind them to do it when over 24 hrs - I have had questions about - well, pt was admitted 30 days ago, can't you use the same screen from that admit?
Thanks!
Theresa Gilbert
88 MDG
WPAFB, OH




________________________________
From: "mrogard at charter.net" <mrogard at charter.net>
To: "McLaughlin, Julie" <JMcLaughlin at browardhealth.org>; cnm at lists.my180.net
Sent: Thursday, January 1, 2009 5:11:24 AM
Subject: Re: [Cnm] Initial Nutrition Assessments for pts readmitted shortly after discharge

At our facility we model our assessment policy for recent admission/discharge patients on the medical staff policy.? 
MJ
--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org
Professional email: mrogard at charter.net

---- "McLaughlin wrote: 
> Are there any guidelines that say the Initial Nutrition Assessment can
> be copied from a previous admission if the patient was readmitted within
> _______ days of last discharge?
>? 
> The dietitians say they used to copy the Assessment from the previous
> admit if the pt had been discharged less than 2 weeks prior.
>? 
> Does anyone else do something like this and what are everyone's thoughts
> on this?? 
>? 
> Thanks!
> Julie McLaughlin
> Clinical Nutrition Manager
> BGMC
> Ft. Lauderdale, FL
> 
> - ----------------------------------------------
> Broward Health CONFIDENTIALITY NOTICE: 
> This message and any included attachments are intended for the sole use of 
> The individual or entity to which it is addressed. This message may contain information 
> that is confidential and protected by federal and state law. If you are not the intended 
> recipient, you are hereby notified that any disclosure, copying, or distribution of this 
> message is strictly prohibited. If you received this message in error, please immediately 
> notify the sender by reply e-mail and then delete the original message and its 
> attachments without reading or saving the attachments in any manner. (This email has been scanned by the Broward Health email security system) Thank you.


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090101/0d3aec2b/attachment.html 

From kpersyn at nixhealth.com  Fri Jan  2 06:09:45 2009
From: kpersyn at nixhealth.com (Karen Persyn)
Date: Fri, 2 Jan 2009 08:09:45 -0600
Subject: [Cnm] audit
Message-ID: <69E4E15A86CCC14D9F37245E9D2C49C12628A2@NIXMAIL.nixhealth.org>

It is time consuming, but we track if we received the Nutrition Screen from Nursing by the 2nd day.   I have the Nutrition staff track down missing screens.  We still use a paper chart. Once we switch to EMR, we will be able to complete this from the Nutrition office.  
During our JCAHO visit 6-7 years ago, the surveyors questioned how we knew we had completed our assessments within our policy of 48 hours.  As we had no records to document this, I was not able adequately satisfy their query.  We were not penalized, but I realized this was an area we needed to address.  I felt it was easier to gather the data as we did the assessments than to audit charts later.  Each RD keeps a log of assessments, instructions, f/u, etc and we indicate if the assessment was completed within 48 hours.  If it was not, we indicate why not.  For example, risk not identified on admission, change in status, RD not available, pt./chart not available (i.e. in surgery), etc.  I report both the Nutrition Screens within 24 hours and Nutrition Assessments within 48 hours PI.

Hope this helps.

Karen Persyn


Message: 3
Date: Tue, 30 Dec 2008 16:25:03 -0500
From: CKeinath at chs-mi.com
Subject: [Cnm] audit
To: "cnm at lists.my180.net" <cnm at lists.my180.net>
Message-ID:
        <OFBEC655B8.E222A60E-ON8525752F.00755A1E-8525752F.0075A868 at CHSProdl2.chs-mi.com>
       
Content-Type: text/plain;       charset="US-ASCII"


Does anyone know of a way to "audit" to see if your techs has screened
patients within 24 hours, (or the Nurses)?
Also, for auditing the dietitians on if they had assessed the patient
within the appropriate time?
Does anyone have a form that they had used?

Carol Keinath
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090102/05bfcdc3/attachment.html 

From LAltenburger5 at matherhospital.org  Fri Jan  2 06:45:14 2009
From: LAltenburger5 at matherhospital.org (Altenburger, Linda)
Date: Fri, 2 Jan 2009 09:45:14 -0500
Subject: [Cnm] Coumadin
In-Reply-To: <A21BD3652C008E47BFD8BC00152BF7E60222EB1E@Exchange.jtmmh.org>
Message-ID: <A21BD3652C008E47BFD8BC00152BF7E60222EBDB@Exchange.jtmmh.org>

Is anyone able to ID "new" coumadin patients?

From: Altenburger, Linda 
Sent: Monday, December 15, 2008 8:11 AM
To: 'Sheila Walsh'
Subject: RE: [Cnm] Coumadin

Dear Sheila:  how does Nutrition identify only the "new to coumadin"
users?  We get a daily coumadin use report; however, can not tell who
has been on it already.  I had asked IS to look into this for us, but
got no where.  Thanks. Linda

Linda Altenburger, RD, CDN

Clinical Nutrition Manager

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sheila Walsh
Sent: Friday, December 12, 2008 3:06 PM
To: cnm at lists.my180.net; Laura Leciejewski
Subject: Re: [Cnm] Coumadin

 

We got this directive, as well.

 

We (dietary) only educate new to Coumadin users.  Pharmacy educates all
Coumadin users.

 

We didn't need to adjust anything on our menues because we use portion
control and we serve meals at the same time everyday.

 

We didn't do anything about Cranberry juice.

 

We share the load with pharmacy and we got together on the patient
education packet so that we are both saying the same thing about food
and Coumadin use.

>>> "Laura Leciejewski" <Laura.Leciejewski at stalexius.net> 12/12/2008
12:12 PM >>>

I know that the Food Drug Interaction topic has circled around this
listserv a few times already, but the dietary department has just been
assigned the task to educate all patients on coumadin...

 

I'm wondering how many hospitals are going to have dietary responsible
for this task? And what adjustments you are making on your menus?  Are
you creating a "cranberry allergy"? Not changing anything?

 

Thank you for your input.

 

Laura

 

Laura C. Leciejewski, MS, RD, LDN, CNSD
Clinical Nutrition Manager
St. Alexius Medical Center
1555 Barrington Rd
Hoffman Estates, IL 60194
847-843-2000 ext 6591
pager # 711



CONFIDENTIALITY NOTICE: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090102/d33c207d/attachment.html 

From jwelch02 at unityhealth.org  Fri Jan  2 07:00:51 2009
From: jwelch02 at unityhealth.org (Janel Welch)
Date: Fri, 02 Jan 2009 10:00:51 -0500
Subject: [Cnm] Coumadin
In-Reply-To: <A21BD3652C008E47BFD8BC00152BF7E60222EBDB@Exchange.jtmmh.org>
References: <A21BD3652C008E47BFD8BC00152BF7E60222EB1E@Exchange.jtmmh.org>
	<A21BD3652C008E47BFD8BC00152BF7E60222EBDB@Exchange.jtmmh.org>
Message-ID: <495DE5D3.931E.00AD.0@unityhealth.org>

Yes, Our ITS department set it up in Cerner that anyone NEW on coumadin prints out in a report every day, once a day.

Good luck
Janel


Janel Welch MS, RD, CDN
Clinical Nutrition Manager
Unity Health System
89 Genesee Street
Rochester NY 14611
(585) 368-3108 Phone
(585) 368-3743 Fax
(585) 463-0019 Pager
 


>>> "Altenburger, Linda" <LAltenburger5 at matherhospital.org> 1/2/2009 9:45 AM >>>
Is anyone able to ID "new" coumadin patients?

From: Altenburger, Linda 
Sent: Monday, December 15, 2008 8:11 AM
To: 'Sheila Walsh'
Subject: RE: [Cnm] Coumadin

Dear Sheila:  how does Nutrition identify only the "new to coumadin"
users?  We get a daily coumadin use report; however, can not tell who
has been on it already.  I had asked IS to look into this for us, but
got no where.  Thanks. Linda

Linda Altenburger, RD, CDN

Clinical Nutrition Manager

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] 
On Behalf Of Sheila Walsh
Sent: Friday, December 12, 2008 3:06 PM
To: cnm at lists.my180.net; Laura Leciejewski
Subject: Re: [Cnm] Coumadin

 

We got this directive, as well.

 

We (dietary) only educate new to Coumadin users.  Pharmacy educates all
Coumadin users.

 

We didn't need to adjust anything on our menues because we use portion
control and we serve meals at the same time everyday.

 

We didn't do anything about Cranberry juice.

 

We share the load with pharmacy and we got together on the patient
education packet so that we are both saying the same thing about food
and Coumadin use.

>>> "Laura Leciejewski" <Laura.Leciejewski at stalexius.net> 12/12/2008
12:12 PM >>>

I know that the Food Drug Interaction topic has circled around this
listserv a few times already, but the dietary department has just been
assigned the task to educate all patients on coumadin...

 

I'm wondering how many hospitals are going to have dietary responsible
for this task? And what adjustments you are making on your menus?  Are
you creating a "cranberry allergy"? Not changing anything?

 

Thank you for your input.

 

Laura

 

Laura C. Leciejewski, MS, RD, LDN, CNSD
Clinical Nutrition Manager
St. Alexius Medical Center
1555 Barrington Rd
Hoffman Estates, IL 60194
847-843-2000 ext 6591
pager # 711



CONFIDENTIALITY NOTICE: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message. 



PLEASE NOTE: Property of Unity Health System -- www.unityhealth.org  
The information contained in this message may be privileged and confidential, protected from disclosure, and/or intended only for the user of the individual or entity named above. If the recipient of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication in error, please notify the sender immediately by replying to this message and deleting it from your computer. This email message is considered Virus Free by our virus scanning software. All email is considered property of Unity Health System. 
Address policy questions to address below. 
gwadministrator at unityhealth.org





From cketterman at wellspan.org  Fri Jan  2 07:11:33 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Fri, 2 Jan 2009 10:11:33 -0500
Subject: [Cnm] Coumadin
In-Reply-To: <A21BD3652C008E47BFD8BC00152BF7E60222EBDB@Exchange.jtmmh.org>
References: <A21BD3652C008E47BFD8BC00152BF7E60222EB1E@Exchange.jtmmh.org>
	<A21BD3652C008E47BFD8BC00152BF7E60222EBDB@Exchange.jtmmh.org>
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AC0C@EXCH4.wellspan.org>

We have the same problem.  
 
Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934
 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Altenburger, Linda
Sent: Friday, January 02, 2009 9:45 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] Coumadin



Is anyone able to ID "new" coumadin patients?

From: Altenburger, Linda 
Sent: Monday, December 15, 2008 8:11 AM
To: 'Sheila Walsh'
Subject: RE: [Cnm] Coumadin

Dear Sheila:  how does Nutrition identify only the "new to coumadin"
users?  We get a daily coumadin use report; however, can not tell who
has been on it already.  I had asked IS to look into this for us, but
got no where.  Thanks. Linda

Linda Altenburger, RD, CDN

Clinical Nutrition Manager

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sheila Walsh
Sent: Friday, December 12, 2008 3:06 PM
To: cnm at lists.my180.net; Laura Leciejewski
Subject: Re: [Cnm] Coumadin

 

We got this directive, as well.

 

We (dietary) only educate new to Coumadin users.  Pharmacy educates all
Coumadin users.

 

We didn't need to adjust anything on our menues because we use portion
control and we serve meals at the same time everyday.

 

We didn't do anything about Cranberry juice.

 

We share the load with pharmacy and we got together on the patient
education packet so that we are both saying the same thing about food
and Coumadin use.

>>> "Laura Leciejewski" <Laura.Leciejewski at stalexius.net> 12/12/2008
12:12 PM >>>

I know that the Food Drug Interaction topic has circled around this
listserv a few times already, but the dietary department has just been
assigned the task to educate all patients on coumadin...

 

I'm wondering how many hospitals are going to have dietary responsible
for this task? And what adjustments you are making on your menus?  Are
you creating a "cranberry allergy"? Not changing anything?

 

Thank you for your input.

 

Laura

 

Laura C. Leciejewski, MS, RD, LDN, CNSD
Clinical Nutrition Manager
St. Alexius Medical Center
1555 Barrington Rd
Hoffman Estates, IL 60194
847-843-2000 ext 6591
pager # 711



CONFIDENTIALITY NOTICE: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________


CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090102/63f53507/attachment-0001.html 

From kharriso at stagnes.org  Fri Jan  2 07:22:01 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Fri, 2 Jan 2009 09:22:01 -0600
Subject: [Cnm] Coumadin
In-Reply-To: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AC0C@EXCH4.wellspan.org>
References: <A21BD3652C008E47BFD8BC00152BF7E60222EB1E@Exchange.jtmmh.org><A21BD3652C008E47BFD8BC00152BF7E60222EBDB@Exchange.jtmmh.org>
	<5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AC0C@EXCH4.wellspan.org>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B3922469B@ahcmascdc034.DS.SJHS.COM>

Just because you receive a report of patients new to coumadin at the
hospital, how do you know they were not already taking coumadin at home?
We have nursing do all teaching for NEW patients and pharmacy and RD are
available for consult if further information is needed.  We helped
approve the hospital wide handout.

Kerry

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Ketterman-Hopkins, Cindra
Sent: Friday, January 02, 2009 10:12 AM
To: Altenburger, Linda; cnm at lists.my180.net
Subject: Re: [Cnm] Coumadin

 

We have the same problem.  

 

Cindra L. Ketterman, M.S., L.D.N., R.D.

Chief Clinical Dietitian

Nutrition Support Service

York Hospital

1001 South George Street

York, PA  17405-7198

717-851-3991 or 717-851-2345 ask for pager 0093

Fax 717-8512934

 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Altenburger, Linda
Sent: Friday, January 02, 2009 9:45 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] Coumadin

Is anyone able to ID "new" coumadin patients?

From: Altenburger, Linda 
Sent: Monday, December 15, 2008 8:11 AM
To: 'Sheila Walsh'
Subject: RE: [Cnm] Coumadin

Dear Sheila:  how does Nutrition identify only the "new to coumadin"
users?  We get a daily coumadin use report; however, can not tell who
has been on it already.  I had asked IS to look into this for us, but
got no where.  Thanks. Linda

Linda Altenburger, RD, CDN

Clinical Nutrition Manager

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sheila Walsh
Sent: Friday, December 12, 2008 3:06 PM
To: cnm at lists.my180.net; Laura Leciejewski
Subject: Re: [Cnm] Coumadin

 

We got this directive, as well.

 

We (dietary) only educate new to Coumadin users.  Pharmacy educates all
Coumadin users.

 

We didn't need to adjust anything on our menues because we use portion
control and we serve meals at the same time everyday.

 

We didn't do anything about Cranberry juice.

 

We share the load with pharmacy and we got together on the patient
education packet so that we are both saying the same thing about food
and Coumadin use.

>>> "Laura Leciejewski" <Laura.Leciejewski at stalexius.net> 12/12/2008
12:12 PM >>>

I know that the Food Drug Interaction topic has circled around this
listserv a few times already, but the dietary department has just been
assigned the task to educate all patients on coumadin...

 

I'm wondering how many hospitals are going to have dietary responsible
for this task? And what adjustments you are making on your menus?  Are
you creating a "cranberry allergy"? Not changing anything?

 

Thank you for your input.

 

Laura

 

Laura C. Leciejewski, MS, RD, LDN, CNSD
Clinical Nutrition Manager
St. Alexius Medical Center
1555 Barrington Rd
Hoffman Estates, IL 60194
847-843-2000 ext 6591
pager # 711



CONFIDENTIALITY NOTICE: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally
privileged.  This information is intended for the use of the named
recipient(s). The authorized recipient of this information is prohibited
from disclosing this information to any party unless required to do so
by law or regulation and is required to destroy the information after
its stated need has been fulfilled.  If you are not the intended
recipient, you are hereby notified that any disclosure, copying,
distribution, or action taken in reliance on the contents of this email
is strictly prohibited.  If you receive this e-mail message in error,
please notify the sender immediately to arrange disposition of the
information. 


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090102/98380996/attachment.html 

From jonessl at upmc.edu  Fri Jan  2 07:58:27 2009
From: jonessl at upmc.edu (Jones, Sherri)
Date: Fri, 2 Jan 2009 10:58:27 -0500
Subject: [Cnm] Coumadin
In-Reply-To: <9AB3ADBD43ABFD46B0DC4E80280F3B3922469B@ahcmascdc034.DS.SJHS.COM>
References: <A21BD3652C008E47BFD8BC00152BF7E60222EB1E@Exchange.jtmmh.org><A21BD3652C008E47BFD8BC00152BF7E60222EBDB@Exchange.jtmmh.org>
	<5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AC0C@EXCH4.wellspan.org>
	<9AB3ADBD43ABFD46B0DC4E80280F3B3922469B@ahcmascdc034.DS.SJHS.COM>
Message-ID: <5AF9B08B39F8AD4380E2797E4125AEA1E8668340@msxmbxnsprd17.acct.upmchs.net>

Kerry - Your point below is well taken. However keep in mind that the JCAHO NPSG (3E) does specify that nutrition department must be informed of pts on Coumadin if food services are provided by nutrition department at your facility. It's hard even from an EHR (electronic health record) perspective to filter out pts that may already have been on Coumadin at home. However, it is then up to your facility to determine how the educational component of the JCAHO NPSG (National Pt Safety Goal) is handled for the food/drug interaction component. If your facility specifies that it is nursing's responsibility to educate and consult dietitians only as needed then from a JCAHO perspective your facility is still within compliance of the NPSG.
For Cerner users - note that we were able to build a "rule" that fires a task automatically to the dietary task list that indicates pts who have been ordered Coumadin. The task only fires once per admission/occurrence and the first time the Coumadin order is written. This has helped us and much more efficient than having to flip through a printed report. Plus there is then a trail in the EHR and less room for pts to "slip through the cracks". ...just wanted to share that option available from EHRs too.
Sherri
Sherri L. Jones, MS, RD, LDN
Clinical Nutrition Manager
UPMC Shadyside
Phone: (412) 623-1629
Pager: (412) 263-8518
Fax: (412) 6232429
jonessl at upmc.edu<mailto:jonessl at upmc.edu>
________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Harrison, Kerry
Sent: Friday, January 02, 2009 10:22 AM
To: Ketterman-Hopkins, Cindra; Altenburger, Linda; cnm at lists.my180.net
Subject: Re: [Cnm] Coumadin

Just because you receive a report of patients new to coumadin at the hospital, how do you know they were not already taking coumadin at home?  We have nursing do all teaching for NEW patients and pharmacy and RD are available for consult if further information is needed.  We helped approve the hospital wide handout.
Kerry

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152

To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong enough to take everything you have.
-Thomas Jefferson
________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ketterman-Hopkins, Cindra
Sent: Friday, January 02, 2009 10:12 AM
To: Altenburger, Linda; cnm at lists.my180.net
Subject: Re: [Cnm] Coumadin

We have the same problem.

Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934


________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Altenburger, Linda
Sent: Friday, January 02, 2009 9:45 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] Coumadin
Is anyone able to ID "new" coumadin patients?
From: Altenburger, Linda
Sent: Monday, December 15, 2008 8:11 AM
To: 'Sheila Walsh'
Subject: RE: [Cnm] Coumadin
Dear Sheila:  how does Nutrition identify only the "new to coumadin" users?  We get a daily coumadin use report; however, can not tell who has been on it already.  I had asked IS to look into this for us, but got no where.  Thanks. Linda

Linda Altenburger, RD, CDN

Clinical Nutrition Manager

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Sheila Walsh
Sent: Friday, December 12, 2008 3:06 PM
To: cnm at lists.my180.net; Laura Leciejewski
Subject: Re: [Cnm] Coumadin

We got this directive, as well.

We (dietary) only educate new to Coumadin users.  Pharmacy educates all Coumadin users.

We didn't need to adjust anything on our menues because we use portion control and we serve meals at the same time everyday.

We didn't do anything about Cranberry juice.

We share the load with pharmacy and we got together on the patient education packet so that we are both saying the same thing about food and Coumadin use.

>>> "Laura Leciejewski" <Laura.Leciejewski at stalexius.net> 12/12/2008 12:12 PM >>>
I know that the Food Drug Interaction topic has circled around this listserv a few times already, but the dietary department has just been assigned the task to educate all patients on coumadin...

I'm wondering how many hospitals are going to have dietary responsible for this task? And what adjustments you are making on your menus?  Are you creating a "cranberry allergy"? Not changing anything?

Thank you for your input.

Laura

Laura C. Leciejewski, MS, RD, LDN, CNSD
Clinical Nutrition Manager
St. Alexius Medical Center
1555 Barrington Rd
Hoffman Estates, IL 60194
847-843-2000 ext 6591
pager # 711


CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________



CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.

CONFIDENTIALITY NOTICE:

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090102/5c4ac535/attachment-0001.html 

From Heberle-Heather at aramark.com  Fri Jan  2 08:03:17 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Fri, 2 Jan 2009 10:03:17 -0600
Subject: [Cnm] Initial Nutrition Assessments for pts readmitted shortly
 after discharge
In-Reply-To: <mailman.1.1230840002.19997.cnm_lists.my180.net@lists.my180.net>
References: <mailman.1.1230840002.19997.cnm_lists.my180.net@lists.my180.net>
Message-ID: <0BA6E9AB-68FA-439C-A17C-C4EC00DFBF3D@mimectl>

We do not use previous admission assessment forms for current admissions no matter how recently they have been discharged.  Our dietitians must do a complete reassessment due to how drastically things can change in just a few days for certain patients.  We use electronic charting and none of the previous admission info will flow into the current notes. 

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879



From: cnm-request at lists.my180.net
Sent: Thu 1/1/09 2:00 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 1


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: RDA for iron for breastfeeding women
      (Ketterman-Hopkins, Cindra)
   2. JCAHO standards (Susan Watson)
   3. Initial Nutrition Assessments for pts readmitted shortly
      after discharge (McLaughlin, Julie)
   4. Re: Initial Nutrition Assessments for pts readmitted shortly
      after discharge (mrogard at charter.net)
   5. Re: Initial Nutrition Assessments for pts readmitted shortly
      after discharge (Theresa Gilbert)


----------------------------------------------------------------------

Message: 1
Date: Wed, 31 Dec 2008 14:45:21 -0500
From: "Ketterman-Hopkins, Cindra" <cketterman at wellspan.org>
Subject: Re: [Cnm] RDA for iron for breastfeeding women
To: "Gendron, Amy L." <Amy.Gendron at cvmc.org>,<cnm at lists.my180.net>
Message-ID:
	<5B32BC7FE9D04B43A8B78CA7A19CBD4E0250ABFE at EXCH4.wellspan.org>
Content-Type: text/plain;	charset="us-ascii"

The recommendation for lactating women minuses menstrual loses but
factors in average amount of iron secreted in human milk.  The reference
is the DRI test from the Institute of Medicine of the National
Academies. 


Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Gendron, Amy L.
Sent: Wednesday, December 31, 2008 1:02 PM
To: cnm at lists.my180.net
Subject: [Cnm] RDA for iron for breastfeeding women


Does anyone know why the RDA for iron for a lactating woman (9 mg/d) is
less than for a non lactating woman of the same age (18 mg/d)?
Thanks - we're trying to educate a new breastfeeding mom for high iron
diet that the doctor requested.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________



------------------------------

Message: 2
Date: Mon, 29 Dec 2008 13:38:27 -0500
From: "Susan Watson" <hrtspw at ghs.org>
Subject: [Cnm] JCAHO standards
To: <cnm at lists.my180.net>
Message-ID:
	<D134A05B4A5B564B8D5BE1D0B4E6A3AC05E32A03 at ghsexcmbxisc02.ghs.org>
Content-Type: text/plain; charset="us-ascii"

I am new at my position as CNM at a large acute care facility and for
the past several years been in outpatient - cardiac rehab and diabetes
care.  We have an upcoming visit from Joint Commission early next year
and I want to make sure I am familiar with all the standards that may
impact our clinical nutrition services.  Could anyone be willing provide
me tips on how to quickly and effectively navigate the maze of standards
that confront me?  

 

Thanks in advance. 

 

Susan Watson, MS, RD, LD

Clinical Nutrition Manager

Food and Nutrition Department

Greenville Hospital System

swatson at ghs.org <mailto:swatson at ghs.org> 

(864) 455-7824  office

(864) 996-2681   pager

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20081229/4d787cd1/attachment-0001.html 

------------------------------

Message: 3
Date: Wed, 31 Dec 2008 14:17:43 -0500
From: "McLaughlin, Julie" <JMcLaughlin at browardhealth.org>
Subject: [Cnm] Initial Nutrition Assessments for pts readmitted
	shortly	after discharge
To: <cnm at lists.my180.net>
Message-ID:
	<120AAA8883F193448149DA50511E16DB01665637 at EXBEVS3.nbhdhqdomain.nbhd.org>
	
Content-Type: text/plain; charset="us-ascii"

Are there any guidelines that say the Initial Nutrition Assessment can
be copied from a previous admission if the patient was readmitted within
_______ days of last discharge?
 
The dietitians say they used to copy the Assessment from the previous
admit if the pt had been discharged less than 2 weeks prior.
 
Does anyone else do something like this and what are everyone's thoughts
on this?  
 
Thanks!
Julie McLaughlin
Clinical Nutrition Manager
BGMC
Ft. Lauderdale, FL

- ----------------------------------------------
Broward Health CONFIDENTIALITY NOTICE: 
This message and any included attachments are intended for the sole use of 
The individual or entity to which it is addressed. This message may contain information 
that is confidential and protected by federal and state law. If you are not the intended 
recipient, you are hereby notified that any disclosure, copying, or distribution of this 
message is strictly prohibited. If you received this message in error, please immediately 
notify the sender by reply e-mail and then delete the original message and its 
attachments without reading or saving the attachments in any manner. (This email has been scanned by the Broward Health email security system) Thank you.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20081231/99661bcc/attachment-0001.html 

------------------------------

Message: 4
Date: Thu, 1 Jan 2009 2:11:24 -0800
From: <mrogard at charter.net>
Subject: Re: [Cnm] Initial Nutrition Assessments for pts readmitted
	shortly after discharge
To: "McLaughlin, Julie" <JMcLaughlin at browardhealth.org>,
	cnm at lists.my180.net
Message-ID: <20090101051124.D3N0T.725722.root at mp13>
Content-Type: text/plain; charset=utf-8

At our facility we model our assessment policy for recent admission/discharge patients on the medical staff policy.  
MJ
--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org
Professional email: mrogard at charter.net

---- "McLaughlin wrote: 
> Are there any guidelines that say the Initial Nutrition Assessment can
> be copied from a previous admission if the patient was readmitted within
> _______ days of last discharge?
>  
> The dietitians say they used to copy the Assessment from the previous
> admit if the pt had been discharged less than 2 weeks prior.
>  
> Does anyone else do something like this and what are everyone's thoughts
> on this?  
>  
> Thanks!
> Julie McLaughlin
> Clinical Nutrition Manager
> BGMC
> Ft. Lauderdale, FL
> 
> - ----------------------------------------------
> Broward Health CONFIDENTIALITY NOTICE: 
> This message and any included attachments are intended for the sole use of 
> The individual or entity to which it is addressed. This message may contain information 
> that is confidential and protected by federal and state law. If you are not the intended 
> recipient, you are hereby notified that any disclosure, copying, or distribution of this 
> message is strictly prohibited. If you received this message in error, please immediately 
> notify the sender by reply e-mail and then delete the original message and its 
> attachments without reading or saving the attachments in any manner. (This email has been scanned by the Broward Health email security system) Thank you.




------------------------------

Message: 5
Date: Thu, 1 Jan 2009 03:54:17 -0800 (PST)
From: Theresa Gilbert <tggilbert at att.net>
Subject: Re: [Cnm] Initial Nutrition Assessments for pts readmitted
	shortly	after discharge
To: cnm at lists.my180.net
Message-ID: <129872.88663.qm at web81204.mail.mud.yahoo.com>
Content-Type: text/plain; charset="iso-8859-1"

How about with nutrition screening - our nurses do this and sometimes we? have to call to remind them to do it when over 24 hrs - I have had questions about - well, pt was admitted 30 days ago, can't you use the same screen from that admit?
Thanks!
Theresa Gilbert
88 MDG
WPAFB, OH




________________________________
From: "mrogard at charter.net" <mrogard at charter.net>
To: "McLaughlin, Julie" <JMcLaughlin at browardhealth.org>; cnm at lists.my180.net
Sent: Thursday, January 1, 2009 5:11:24 AM
Subject: Re: [Cnm] Initial Nutrition Assessments for pts readmitted shortly after discharge

At our facility we model our assessment policy for recent admission/discharge patients on the medical staff policy.? 
MJ
--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org
Professional email: mrogard at charter.net

---- "McLaughlin wrote: 
> Are there any guidelines that say the Initial Nutrition Assessment can
> be copied from a previous admission if the patient was readmitted within
> _______ days of last discharge?
>? 
> The dietitians say they used to copy the Assessment from the previous
> admit if the pt had been discharged less than 2 weeks prior.
>? 
> Does anyone else do something like this and what are everyone's thoughts
> on this?? 
>? 
> Thanks!
> Julie McLaughlin
> Clinical Nutrition Manager
> BGMC
> Ft. Lauderdale, FL
> 
> - ----------------------------------------------
> Broward Health CONFIDENTIALITY NOTICE: 
> This message and any included attachments are intended for the sole use of 
> The individual or entity to which it is addressed. This message may contain information 
> that is confidential and protected by federal and state law. If you are not the intended 
> recipient, you are hereby notified that any disclosure, copying, or distribution of this 
> message is strictly prohibited. If you received this message in error, please immediately 
> notify the sender by reply e-mail and then delete the original message and its 
> attachments without reading or saving the attachments in any manner. (This email has been scanned by the Broward Health email security system) Thank you.


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090101/0d3aec2b/attachment-0001.html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 1
**********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090102/67ce5446/attachment.html 

From kharriso at stagnes.org  Fri Jan  2 08:05:46 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Fri, 2 Jan 2009 10:05:46 -0600
Subject: [Cnm] Coumadin
In-Reply-To: <5AF9B08B39F8AD4380E2797E4125AEA1E8668340@msxmbxnsprd17.acct.upmchs.net>
References: <A21BD3652C008E47BFD8BC00152BF7E60222EB1E@Exchange.jtmmh.org><A21BD3652C008E47BFD8BC00152BF7E60222EBDB@Exchange.jtmmh.org><5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AC0C@EXCH4.wellspan.org>
	<9AB3ADBD43ABFD46B0DC4E80280F3B3922469B@ahcmascdc034.DS.SJHS.COM>
	<5AF9B08B39F8AD4380E2797E4125AEA1E8668340@msxmbxnsprd17.acct.upmchs.net>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B392246A6@ahcmascdc034.DS.SJHS.COM>

Thanks Sherri and your point is well taken as well.  We do get a list in
our kitchen every morning of patients on coumadin.  We keep this list
but only use it if necessary.  We offer a consistent amount of Vit K
foods and offer no high vit k foods, only medium and low.  If we need to
make adjustments we then go to the list.  This keeps us in compliance.

Kerry

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: Jones, Sherri [mailto:jonessl at upmc.edu] 
Sent: Friday, January 02, 2009 10:58 AM
To: Harrison, Kerry; Ketterman-Hopkins, Cindra; Altenburger, Linda;
cnm at lists.my180.net
Subject: RE: [Cnm] Coumadin

 

Kerry - Your point below is well taken. However keep in mind that the
JCAHO NPSG (3E) does specify that nutrition department must be informed
of pts on Coumadin if food services are provided by nutrition department
at your facility. It's hard even from an EHR (electronic health record)
perspective to filter out pts that may already have been on Coumadin at
home. However, it is then up to your facility to determine how the
educational component of the JCAHO NPSG (National Pt Safety Goal) is
handled for the food/drug interaction component. If your facility
specifies that it is nursing's responsibility to educate and consult
dietitians only as needed then from a JCAHO perspective your facility is
still within compliance of the NPSG.

For Cerner users - note that we were able to build a "rule" that fires a
task automatically to the dietary task list that indicates pts who have
been ordered Coumadin. The task only fires once per admission/occurrence
and the first time the Coumadin order is written. This has helped us and
much more efficient than having to flip through a printed report. Plus
there is then a trail in the EHR and less room for pts to "slip through
the cracks". ...just wanted to share that option available from EHRs
too.

Sherri 

Sherri L. Jones, MS, RD, LDN

Clinical Nutrition Manager

UPMC Shadyside

Phone: (412) 623-1629

Pager: (412) 263-8518

Fax: (412) 6232429

jonessl at upmc.edu

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Harrison, Kerry
Sent: Friday, January 02, 2009 10:22 AM
To: Ketterman-Hopkins, Cindra; Altenburger, Linda; cnm at lists.my180.net
Subject: Re: [Cnm] Coumadin

 

Just because you receive a report of patients new to coumadin at the
hospital, how do you know they were not already taking coumadin at home?
We have nursing do all teaching for NEW patients and pharmacy and RD are
available for consult if further information is needed.  We helped
approve the hospital wide handout.

Kerry

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Ketterman-Hopkins, Cindra
Sent: Friday, January 02, 2009 10:12 AM
To: Altenburger, Linda; cnm at lists.my180.net
Subject: Re: [Cnm] Coumadin

 

We have the same problem.  

 

Cindra L. Ketterman, M.S., L.D.N., R.D.

Chief Clinical Dietitian

Nutrition Support Service

York Hospital

1001 South George Street

York, PA  17405-7198

717-851-3991 or 717-851-2345 ask for pager 0093

Fax 717-8512934

 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Altenburger, Linda
Sent: Friday, January 02, 2009 9:45 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] Coumadin

Is anyone able to ID "new" coumadin patients?

From: Altenburger, Linda 
Sent: Monday, December 15, 2008 8:11 AM
To: 'Sheila Walsh'
Subject: RE: [Cnm] Coumadin

Dear Sheila:  how does Nutrition identify only the "new to coumadin"
users?  We get a daily coumadin use report; however, can not tell who
has been on it already.  I had asked IS to look into this for us, but
got no where.  Thanks. Linda

Linda Altenburger, RD, CDN

Clinical Nutrition Manager

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sheila Walsh
Sent: Friday, December 12, 2008 3:06 PM
To: cnm at lists.my180.net; Laura Leciejewski
Subject: Re: [Cnm] Coumadin

 

We got this directive, as well.

 

We (dietary) only educate new to Coumadin users.  Pharmacy educates all
Coumadin users.

 

We didn't need to adjust anything on our menues because we use portion
control and we serve meals at the same time everyday.

 

We didn't do anything about Cranberry juice.

 

We share the load with pharmacy and we got together on the patient
education packet so that we are both saying the same thing about food
and Coumadin use.

>>> "Laura Leciejewski" <Laura.Leciejewski at stalexius.net> 12/12/2008
12:12 PM >>>

I know that the Food Drug Interaction topic has circled around this
listserv a few times already, but the dietary department has just been
assigned the task to educate all patients on coumadin...

 

I'm wondering how many hospitals are going to have dietary responsible
for this task? And what adjustments you are making on your menus?  Are
you creating a "cranberry allergy"? Not changing anything?

 

Thank you for your input.

 

Laura

 

Laura C. Leciejewski, MS, RD, LDN, CNSD
Clinical Nutrition Manager
St. Alexius Medical Center
1555 Barrington Rd
Hoffman Estates, IL 60194
847-843-2000 ext 6591
pager # 711



CONFIDENTIALITY NOTICE: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

 
CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.

CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally
privileged.  This information is intended for the use of the named
recipient(s). The authorized recipient of this information is prohibited
from disclosing this information to any party unless required to do so
by law or regulation and is required to destroy the information after
its stated need has been fulfilled.  If you are not the intended
recipient, you are hereby notified that any disclosure, copying,
distribution, or action taken in reliance on the contents of this email
is strictly prohibited.  If you receive this e-mail message in error,
please notify the sender immediately to arrange disposition of the
information. 


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090102/e37fd2e6/attachment-0001.html 

From Heberle-Heather at aramark.com  Fri Jan  2 08:07:51 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Fri, 2 Jan 2009 10:07:51 -0600
Subject: [Cnm] audit
In-Reply-To: <mailman.249.1230909133.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.249.1230909133.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <8E21EA10-B5EA-4113-9B48-8BC49F6FEE10@mimectl>

We use PI forms to monitor whether nursing has done their screen in 24hr and whether or not we received a consult from that screen.  We also monitor the nurses doing screens and who is sending consults when needed.  We use EMR and have a "back door" to know when a consult is warranted.  For example, we receive consults based on nutrition screen on admit and by a Modified Norton Score or skin risk score.  If a nurse charts one of these any time during admission that would trigger us a consult but they did not send it, we receive what is called an electronic notification.  It is only on the computer but it compiles in 1 area for the dietitians to review daily and they treat them as if it were a consult.  This way we are not missing any patients we "should" be seeing but did not receive a consult for.  I attached our PI form for your use if needed.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879



From: cnm-request at lists.my180.net
Sent: Fri 1/2/09 9:12 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 2


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. audit (Karen Persyn)
   2. Re: Coumadin (Altenburger, Linda)
   3. Re: Coumadin (Janel Welch)
   4. Re: Coumadin (Ketterman-Hopkins, Cindra)


----------------------------------------------------------------------

Message: 1
Date: Fri, 2 Jan 2009 08:09:45 -0600
From: "Karen Persyn" <kpersyn at nixhealth.com>
Subject: [Cnm] audit
To: <cnm at lists.my180.net>
Message-ID:
	<69E4E15A86CCC14D9F37245E9D2C49C12628A2 at NIXMAIL.nixhealth.org>
Content-Type: text/plain; charset="iso-8859-1"

It is time consuming, but we track if we received the Nutrition Screen from Nursing by the 2nd day.   I have the Nutrition staff track down missing screens.  We still use a paper chart. Once we switch to EMR, we will be able to complete this from the Nutrition office.  
During our JCAHO visit 6-7 years ago, the surveyors questioned how we knew we had completed our assessments within our policy of 48 hours.  As we had no records to document this, I was not able adequately satisfy their query.  We were not penalized, but I realized this was an area we needed to address.  I felt it was easier to gather the data as we did the assessments than to audit charts later.  Each RD keeps a log of assessments, instructions, f/u, etc and we indicate if the assessment was completed within 48 hours.  If it was not, we indicate why not.  For example, risk not identified on admission, change in status, RD not available, pt./chart not available (i.e. in surgery), etc.  I report both the Nutrition Screens within 24 hours and Nutrition Assessments within 48 hours PI.

Hope this helps.

Karen Persyn


Message: 3
Date: Tue, 30 Dec 2008 16:25:03 -0500
From: CKeinath at chs-mi.com
Subject: [Cnm] audit
To: "cnm at lists.my180.net" <cnm at lists.my180.net>
Message-ID:
        <OFBEC655B8.E222A60E-ON8525752F.00755A1E-8525752F.0075A868 at CHSProdl2.chs-mi.com>
       
Content-Type: text/plain;       charset="US-ASCII"


Does anyone know of a way to "audit" to see if your techs has screened
patients within 24 hours, (or the Nurses)?
Also, for auditing the dietitians on if they had assessed the patient
within the appropriate time?
Does anyone have a form that they had used?

Carol Keinath
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090102/05bfcdc3/attachment-0001.html 

------------------------------

Message: 2
Date: Fri, 2 Jan 2009 09:45:14 -0500
From: "Altenburger, Linda" <LAltenburger5 at matherhospital.org>
Subject: Re: [Cnm] Coumadin
To: <cnm at lists.my180.net>
Message-ID:
	<A21BD3652C008E47BFD8BC00152BF7E60222EBDB at Exchange.jtmmh.org>
Content-Type: text/plain; charset="us-ascii"

Is anyone able to ID "new" coumadin patients?

From: Altenburger, Linda 
Sent: Monday, December 15, 2008 8:11 AM
To: 'Sheila Walsh'
Subject: RE: [Cnm] Coumadin

Dear Sheila:  how does Nutrition identify only the "new to coumadin"
users?  We get a daily coumadin use report; however, can not tell who
has been on it already.  I had asked IS to look into this for us, but
got no where.  Thanks. Linda

Linda Altenburger, RD, CDN

Clinical Nutrition Manager

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sheila Walsh
Sent: Friday, December 12, 2008 3:06 PM
To: cnm at lists.my180.net; Laura Leciejewski
Subject: Re: [Cnm] Coumadin

 

We got this directive, as well.

 

We (dietary) only educate new to Coumadin users.  Pharmacy educates all
Coumadin users.

 

We didn't need to adjust anything on our menues because we use portion
control and we serve meals at the same time everyday.

 

We didn't do anything about Cranberry juice.

 

We share the load with pharmacy and we got together on the patient
education packet so that we are both saying the same thing about food
and Coumadin use.

>>> "Laura Leciejewski" <Laura.Leciejewski at stalexius.net> 12/12/2008
12:12 PM >>>

I know that the Food Drug Interaction topic has circled around this
listserv a few times already, but the dietary department has just been
assigned the task to educate all patients on coumadin...

 

I'm wondering how many hospitals are going to have dietary responsible
for this task? And what adjustments you are making on your menus?  Are
you creating a "cranberry allergy"? Not changing anything?

 

Thank you for your input.

 

Laura

 

Laura C. Leciejewski, MS, RD, LDN, CNSD
Clinical Nutrition Manager
St. Alexius Medical Center
1555 Barrington Rd
Hoffman Estates, IL 60194
847-843-2000 ext 6591
pager # 711



CONFIDENTIALITY NOTICE: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090102/d33c207d/attachment-0001.html 

------------------------------

Message: 3
Date: Fri, 02 Jan 2009 10:00:51 -0500
From: "Janel Welch" <jwelch02 at unityhealth.org>
Subject: Re: [Cnm] Coumadin
To: <cnm at lists.my180.net>,	"Linda Altenburger"
	<LAltenburger5 at matherhospital.org>
Message-ID: <495DE5D3.931E.00AD.0 at unityhealth.org>
Content-Type: text/plain;	charset=US-ASCII

Yes, Our ITS department set it up in Cerner that anyone NEW on coumadin prints out in a report every day, once a day.

Good luck
Janel


Janel Welch MS, RD, CDN
Clinical Nutrition Manager
Unity Health System
89 Genesee Street
Rochester NY 14611
(585) 368-3108 Phone
(585) 368-3743 Fax
(585) 463-0019 Pager
 


>>> "Altenburger, Linda" <LAltenburger5 at matherhospital.org> 1/2/2009 9:45 AM >>>
Is anyone able to ID "new" coumadin patients?

From: Altenburger, Linda 
Sent: Monday, December 15, 2008 8:11 AM
To: 'Sheila Walsh'
Subject: RE: [Cnm] Coumadin

Dear Sheila:  how does Nutrition identify only the "new to coumadin"
users?  We get a daily coumadin use report; however, can not tell who
has been on it already.  I had asked IS to look into this for us, but
got no where.  Thanks. Linda

Linda Altenburger, RD, CDN

Clinical Nutrition Manager

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] 
On Behalf Of Sheila Walsh
Sent: Friday, December 12, 2008 3:06 PM
To: cnm at lists.my180.net; Laura Leciejewski
Subject: Re: [Cnm] Coumadin

 

We got this directive, as well.

 

We (dietary) only educate new to Coumadin users.  Pharmacy educates all
Coumadin users.

 

We didn't need to adjust anything on our menues because we use portion
control and we serve meals at the same time everyday.

 

We didn't do anything about Cranberry juice.

 

We share the load with pharmacy and we got together on the patient
education packet so that we are both saying the same thing about food
and Coumadin use.

>>> "Laura Leciejewski" <Laura.Leciejewski at stalexius.net> 12/12/2008
12:12 PM >>>

I know that the Food Drug Interaction topic has circled around this
listserv a few times already, but the dietary department has just been
assigned the task to educate all patients on coumadin...

 

I'm wondering how many hospitals are going to have dietary responsible
for this task? And what adjustments you are making on your menus?  Are
you creating a "cranberry allergy"? Not changing anything?

 

Thank you for your input.

 

Laura

 

Laura C. Leciejewski, MS, RD, LDN, CNSD
Clinical Nutrition Manager
St. Alexius Medical Center
1555 Barrington Rd
Hoffman Estates, IL 60194
847-843-2000 ext 6591
pager # 711



CONFIDENTIALITY NOTICE: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message. 



PLEASE NOTE: Property of Unity Health System -- www.unityhealth.org  
The information contained in this message may be privileged and confidential, protected from disclosure, and/or intended only for the user of the individual or entity named above. If the recipient of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication in error, please notify the sender immediately by replying to this message and deleting it from your computer. This email message is considered Virus Free by our virus scanning software. All email is considered property of Unity Health System. 
Address policy questions to address below. 
gwadministrator at unityhealth.org






------------------------------

Message: 4
Date: Fri, 2 Jan 2009 10:11:33 -0500
From: "Ketterman-Hopkins, Cindra" <cketterman at wellspan.org>
Subject: Re: [Cnm] Coumadin
To: "Altenburger, Linda" <LAltenburger5 at matherhospital.org>,
	<cnm at lists.my180.net>
Message-ID:
	<5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AC0C at EXCH4.wellspan.org>
Content-Type: text/plain; charset="us-ascii"

We have the same problem.  
 
Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934
 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Altenburger, Linda
Sent: Friday, January 02, 2009 9:45 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] Coumadin



Is anyone able to ID "new" coumadin patients?

From: Altenburger, Linda 
Sent: Monday, December 15, 2008 8:11 AM
To: 'Sheila Walsh'
Subject: RE: [Cnm] Coumadin

Dear Sheila:  how does Nutrition identify only the "new to coumadin"
users?  We get a daily coumadin use report; however, can not tell who
has been on it already.  I had asked IS to look into this for us, but
got no where.  Thanks. Linda

Linda Altenburger, RD, CDN

Clinical Nutrition Manager

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sheila Walsh
Sent: Friday, December 12, 2008 3:06 PM
To: cnm at lists.my180.net; Laura Leciejewski
Subject: Re: [Cnm] Coumadin

 

We got this directive, as well.

 

We (dietary) only educate new to Coumadin users.  Pharmacy educates all
Coumadin users.

 

We didn't need to adjust anything on our menues because we use portion
control and we serve meals at the same time everyday.

 

We didn't do anything about Cranberry juice.

 

We share the load with pharmacy and we got together on the patient
education packet so that we are both saying the same thing about food
and Coumadin use.

>>> "Laura Leciejewski" <Laura.Leciejewski at stalexius.net> 12/12/2008
12:12 PM >>>

I know that the Food Drug Interaction topic has circled around this
listserv a few times already, but the dietary department has just been
assigned the task to educate all patients on coumadin...

 

I'm wondering how many hospitals are going to have dietary responsible
for this task? And what adjustments you are making on your menus?  Are
you creating a "cranberry allergy"? Not changing anything?

 

Thank you for your input.

 

Laura

 

Laura C. Leciejewski, MS, RD, LDN, CNSD
Clinical Nutrition Manager
St. Alexius Medical Center
1555 Barrington Rd
Hoffman Estates, IL 60194
847-843-2000 ext 6591
pager # 711



CONFIDENTIALITY NOTICE: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________


CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090102/63f53507/attachment.html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 2
**********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090102/fa4d0f85/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Nutrition Screen PI Form.xls
Type: application/vnd.ms-excel
Size: 19968 bytes
Desc: Nutrition Screen PI Form.xls
Url : /pipermail/cnm_lists.my180.net/attachments/20090102/fa4d0f85/attachment-0001.xls 

From lmerrima at nyp.org  Fri Jan  2 12:51:12 2009
From: lmerrima at nyp.org (Louise R. Merriman)
Date: Fri, 02 Jan 2009 15:51:12 -0500
Subject: [Cnm] vegan organic tube feeding
Message-ID: <495E7E40.3000701@nyp.org>

Is any one aware of such a product or any ideas as to what one could use 
for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates') information management and security policies (http://infonet.nyp.org/QA/HospManual/).



From LCarver at Reshealthcare.org  Fri Jan  2 13:25:49 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Fri, 2 Jan 2009 15:25:49 -0600
Subject: [Cnm] vegan organic tube feeding
In-Reply-To: <495E7E40.3000701@nyp.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03A32DAC@rhcexch3.reshealthcare.org>

The short answer is no but something like Vivonex RTF might pass the
vegan test.  Leslee Carver 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Louise R. Merriman
Sent: Friday, January 02, 2009 2:51 PM
To: Clinical Nutrition Managment
Cc: Heather Anderson
Subject: [Cnm] vegan organic tube feeding

Is any one aware of such a product or any ideas as to what one could use

for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates')
information management and security policies
(http://infonet.nyp.org/QA/HospManual/).


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From LCarver at Reshealthcare.org  Fri Jan  2 13:38:56 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Fri, 2 Jan 2009 15:38:56 -0600
Subject: [Cnm] vegan organic tube feeding
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E03A32DAC@rhcexch3.reshealthcare.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03A32DB8@rhcexch3.reshealthcare.org>

Further checking:  Fibersource and Isosource are soy based but I don't
think you will find anything commercial that is "organic" as all these
formulas will have some sort of microbial inhibitors and/or
preservatives.  Leslee 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Carver, Leslee
Sent: Friday, January 02, 2009 3:26 PM
To: Louise R. Merriman; Clinical Nutrition Managment
Cc: Heather Anderson
Subject: Re: [Cnm] vegan organic tube feeding

The short answer is no but something like Vivonex RTF might pass the
vegan test.  Leslee Carver 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Louise R. Merriman
Sent: Friday, January 02, 2009 2:51 PM
To: Clinical Nutrition Managment
Cc: Heather Anderson
Subject: [Cnm] vegan organic tube feeding

Is any one aware of such a product or any ideas as to what one could use

for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates')
information management and security policies
(http://infonet.nyp.org/QA/HospManual/).


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From peggymsrdld at cox.net  Fri Jan  2 16:11:06 2009
From: peggymsrdld at cox.net (Peggy Turner)
Date: Fri, 2 Jan 2009 18:11:06 -0600
Subject: [Cnm] Ross/Abbott
Message-ID: <8829A7B2-EC69-475A-B7FB-A1919BE1F584@cox.net>

Hello,

We are in the process of switching from Nestles to Abbott as our  
vendor for formulas.

I did use Ross many years ago so some things are still the same  
(Perative, Promote, Nepro, Suplena).

The major change I see is all the new Glucerna products (Glucerna  
Select, Glucerna 1.0, 1.2, 1.5 etc).

If you use Abbott and if you have the time, would you mind sharing  
with me which Abbott products are on your formulary.

Thanks, I appreciate your help.

Peggy Turner MS, RD/LD



From CShipman at baymedical.org  Sat Jan  3 05:20:39 2009
From: CShipman at baymedical.org (Shipman, Cindy)
Date: Sat, 3 Jan 2009 07:20:39 -0600
Subject: [Cnm] Ross/Abbott
References: <8829A7B2-EC69-475A-B7FB-A1919BE1F584@cox.net>
Message-ID: <28C9A616766126479E11A1BC4DDA43B2070CB658@BMCEXCHVS2.corp.baymedical.org>

Glucerna Select is going away. We have been using it due to 20% protein. Will change too Glucerna 1.5 after a trial. Nepro did change last year- slightly lower cal and higher pro. Cindy Shipman

________________________________

From: cnm-bounces at lists.my180.net on behalf of Peggy Turner
Sent: Fri 1/2/2009 6:11 PM
To: CNM at lists.my180.net serve
Subject: [Cnm] Ross/Abbott



Hello,

We are in the process of switching from Nestles to Abbott as our 
vendor for formulas.

I did use Ross many years ago so some things are still the same 
(Perative, Promote, Nepro, Suplena).

The major change I see is all the new Glucerna products (Glucerna 
Select, Glucerna 1.0, 1.2, 1.5 etc).

If you use Abbott and if you have the time, would you mind sharing 
with me which Abbott products are on your formulary.

Thanks, I appreciate your help.

Peggy Turner MS, RD/LD


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
 
--------------------------------------------------------
Confidentiality Notice:
The information contained in this e-mail is intended solely for the person(s) to whom it is addressed. This information is the property of Bay Medical Center and may be confidential. If you are not the intended addressee, you should not distribute, copy or disclose this e-mail. Please notify the sender immediately if you received this e-mail by mistake and delete this email from your system and destroy all printed copies.


From lmerrima at nyp.org  Sat Jan  3 06:02:26 2009
From: lmerrima at nyp.org (Louise R. Merriman)
Date: Sat, 03 Jan 2009 09:02:26 -0500
Subject: [Cnm] vegan organic tube feeding
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E03A32DB8@rhcexch3.reshealthcare.org>
References: <5330B54133B6194BA13930BDEFE9A30E03A32DB8@rhcexch3.reshealthcare.org>
Message-ID: <495F6FF2.8000609@nyp.org>

this is a response we got from Abbott - might be of interest re: source 
of Vitamin E
AN has NO organic formulas (except Similac) and nothing vegan...our 
vitamin E comes from sheep lanolin
Carver, Leslee wrote:
> Further checking:  Fibersource and Isosource are soy based but I don't
> think you will find anything commercial that is "organic" as all these
> formulas will have some sort of microbial inhibitors and/or
> preservatives.  Leslee 
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Carver, Leslee
> Sent: Friday, January 02, 2009 3:26 PM
> To: Louise R. Merriman; Clinical Nutrition Managment
> Cc: Heather Anderson
> Subject: Re: [Cnm] vegan organic tube feeding
>
> The short answer is no but something like Vivonex RTF might pass the
> vegan test.  Leslee Carver 
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Louise R. Merriman
> Sent: Friday, January 02, 2009 2:51 PM
> To: Clinical Nutrition Managment
> Cc: Heather Anderson
> Subject: [Cnm] vegan organic tube feeding
>
> Is any one aware of such a product or any ideas as to what one could use
>
> for an adult patient? thanks and happy new year!
>
>
> --------------------
> Confidential Information subject to NYP's (and its affiliates')
> information management and security policies
> (http://infonet.nyp.org/QA/HospManual/).
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>   




--------------------

This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited.  If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message.  Thank you.




From cjnhlank at dmv.com  Sat Jan  3 18:05:14 2009
From: cjnhlank at dmv.com (Chris and Nancy Lank)
Date: Sat, 3 Jan 2009 21:05:14 -0500
Subject: [Cnm] CNM Symposium 2010
Message-ID: <A92309ADCC394F57A5D80207AAC3ADAE@LANK1>

Does anyone know where the CNM Symposium will be held next year --2010?
Nancy Lank, MS,RD
Milton DE
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090103/8a843d34/attachment.html 

From DerrickK at health.missouri.edu  Sun Jan  4 06:41:51 2009
From: DerrickK at health.missouri.edu (Derrick, Karen)
Date: Sun, 4 Jan 2009 08:41:51 -0600
Subject: [Cnm] roommate needed for CNM symposium
In-Reply-To: <41CA05D55BF105489D33F8E57D71A905171435D9B5@MAIL-C.healthall.com>
References: <41CA05D55BF105489D33F8E57D71A905171435D9B5@MAIL-C.healthall.com>
Message-ID: <6D7787A6B00FCF41993911F1118272370499B942@UM-XMAIL02.um.umsystem.edu>

Hi,

Would anyone like to share a room for the symposium in March? 

 

Karen Derrick, MA,RD,LD,CDE

University of Missouri Health Care

Nutrition and Food Service

Assistant Manager, Clinical Nutrition

One Hospital Drive; GE26

Columbia, MO 65211

573-882-2251 (office)

573-884-4990 (fax)

573-499-7070 (pager)

573-999-4484 (cell)

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090104/799f1272/attachment.html 

From Heberle-Heather at aramark.com  Sun Jan  4 11:30:35 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Sun, 4 Jan 2009 14:30:35 -0500
Subject: [Cnm] Ross/Abbott
References: <mailman.1.1231012802.12939.cnm_lists.my180.net@lists.my180.net>
Message-ID: <CF3735565E46CC4DBA31E7A3C08BC84E02AA0CE0@STARWEXC32.fss.aramark.com>

We use Ross products and currently our formulary consists of:
Osmolite 1 cal
Promote
Promote with Fiber
Jevity 1.2 cal
Glucerna 1.0 cal
Glucerna 1.2 cal
Glucerna Select (to be DC'd March 1st)
Oxepa
Nepro
TwoCal HN
we still use Vivonex from nestle for our elemental formula.
 
Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879

________________________________

From: cnm-bounces at lists.my180.net on behalf of cnm-request at lists.my180.net
Sent: Sat 1/3/09 2:00 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 6



Send Cnm mailing list submissions to
        cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
        http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
        cnm-request at lists.my180.net

You can reach the person managing the list at
        cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. vegan organic tube feeding (Louise R. Merriman)
   2. Re: vegan organic tube feeding (Carver, Leslee)
   3. Re: vegan organic tube feeding (Carver, Leslee)
   4. Ross/Abbott (Peggy Turner)
   5. Re: Ross/Abbott (Shipman, Cindy)
   6. Re: vegan organic tube feeding (Louise R. Merriman)


----------------------------------------------------------------------

Message: 1
Date: Fri, 02 Jan 2009 15:51:12 -0500
From: "Louise R. Merriman" <lmerrima at nyp.org>
Subject: [Cnm] vegan organic tube feeding
To: Clinical Nutrition Managment <cnm at lists.my180.net>
Cc: Heather Anderson <hea9016 at nyp.org>
Message-ID: <495E7E40.3000701 at nyp.org>
Content-Type: text/plain; charset=ISO-8859-1; format=flowed

Is any one aware of such a product or any ideas as to what one could use
for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates') information management and security policies (http://infonet.nyp.org/QA/HospManual/).




------------------------------

Message: 2
Date: Fri, 2 Jan 2009 15:25:49 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] vegan organic tube feeding
To: "Louise R. Merriman" <lmerrima at nyp.org>,    "Clinical Nutrition
        Managment" <cnm at lists.my180.net>
Cc: Heather Anderson <hea9016 at nyp.org>
Message-ID:
        <5330B54133B6194BA13930BDEFE9A30E03A32DAC at rhcexch3.reshealthcare.org>
Content-Type: text/plain;       charset="us-ascii"

The short answer is no but something like Vivonex RTF might pass the
vegan test.  Leslee Carver

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Louise R. Merriman
Sent: Friday, January 02, 2009 2:51 PM
To: Clinical Nutrition Managment
Cc: Heather Anderson
Subject: [Cnm] vegan organic tube feeding

Is any one aware of such a product or any ideas as to what one could use

for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates')
information management and security policies
(http://infonet.nyp.org/QA/HospManual/).


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 3
Date: Fri, 2 Jan 2009 15:38:56 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] vegan organic tube feeding
To: "Carver, Leslee" <LCarver at Reshealthcare.org>,       "Louise R. Merriman"
        <lmerrima at nyp.org>,     "Clinical Nutrition Managment"
        <cnm at lists.my180.net>
Cc: Heather Anderson <hea9016 at nyp.org>
Message-ID:
        <5330B54133B6194BA13930BDEFE9A30E03A32DB8 at rhcexch3.reshealthcare.org>
Content-Type: text/plain;       charset="us-ascii"

Further checking:  Fibersource and Isosource are soy based but I don't
think you will find anything commercial that is "organic" as all these
formulas will have some sort of microbial inhibitors and/or
preservatives.  Leslee

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Carver, Leslee
Sent: Friday, January 02, 2009 3:26 PM
To: Louise R. Merriman; Clinical Nutrition Managment
Cc: Heather Anderson
Subject: Re: [Cnm] vegan organic tube feeding

The short answer is no but something like Vivonex RTF might pass the
vegan test.  Leslee Carver

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Louise R. Merriman
Sent: Friday, January 02, 2009 2:51 PM
To: Clinical Nutrition Managment
Cc: Heather Anderson
Subject: [Cnm] vegan organic tube feeding

Is any one aware of such a product or any ideas as to what one could use

for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates')
information management and security policies
(http://infonet.nyp.org/QA/HospManual/).


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 4
Date: Fri, 2 Jan 2009 18:11:06 -0600
From: Peggy Turner <peggymsrdld at cox.net>
Subject: [Cnm] Ross/Abbott
To: "CNM at lists.my180.net serve" <cnm at lists.my180.net>
Message-ID: <8829A7B2-EC69-475A-B7FB-A1919BE1F584 at cox.net>
Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes

Hello,

We are in the process of switching from Nestles to Abbott as our 
vendor for formulas.

I did use Ross many years ago so some things are still the same 
(Perative, Promote, Nepro, Suplena).

The major change I see is all the new Glucerna products (Glucerna 
Select, Glucerna 1.0, 1.2, 1.5 etc).

If you use Abbott and if you have the time, would you mind sharing 
with me which Abbott products are on your formulary.

Thanks, I appreciate your help.

Peggy Turner MS, RD/LD




------------------------------

Message: 5
Date: Sat, 3 Jan 2009 07:20:39 -0600
From: "Shipman, Cindy" <CShipman at baymedical.org>
Subject: Re: [Cnm] Ross/Abbott
To: "Peggy Turner" <peggymsrdld at cox.net>,       "CNM at lists.my180.net serve"
        <cnm at lists.my180.net>
Message-ID:
        <28C9A616766126479E11A1BC4DDA43B2070CB658 at BMCEXCHVS2.corp.baymedical.org>
       
Content-Type: text/plain;       charset="iso-8859-1"

Glucerna Select is going away. We have been using it due to 20% protein. Will change too Glucerna 1.5 after a trial. Nepro did change last year- slightly lower cal and higher pro. Cindy Shipman

________________________________

From: cnm-bounces at lists.my180.net on behalf of Peggy Turner
Sent: Fri 1/2/2009 6:11 PM
To: CNM at lists.my180.net serve
Subject: [Cnm] Ross/Abbott



Hello,

We are in the process of switching from Nestles to Abbott as our
vendor for formulas.

I did use Ross many years ago so some things are still the same
(Perative, Promote, Nepro, Suplena).

The major change I see is all the new Glucerna products (Glucerna
Select, Glucerna 1.0, 1.2, 1.5 etc).

If you use Abbott and if you have the time, would you mind sharing
with me which Abbott products are on your formulary.

Thanks, I appreciate your help.

Peggy Turner MS, RD/LD


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

--------------------------------------------------------
Confidentiality Notice:
The information contained in this e-mail is intended solely for the person(s) to whom it is addressed. This information is the property of Bay Medical Center and may be confidential. If you are not the intended addressee, you should not distribute, copy or disclose this e-mail. Please notify the sender immediately if you received this e-mail by mistake and delete this email from your system and destroy all printed copies.



------------------------------

Message: 6
Date: Sat, 03 Jan 2009 09:02:26 -0500
From: "Louise R. Merriman" <lmerrima at nyp.org>
Subject: Re: [Cnm] vegan organic tube feeding
To: "Carver, Leslee" <LCarver at Reshealthcare.org>
Cc: Clinical Nutrition Managment <cnm at lists.my180.net>
Message-ID: <495F6FF2.8000609 at nyp.org>
Content-Type: text/plain; charset=ISO-8859-1; format=flowed

this is a response we got from Abbott - might be of interest re: source
of Vitamin E
AN has NO organic formulas (except Similac) and nothing vegan...our
vitamin E comes from sheep lanolin
Carver, Leslee wrote:
> Further checking:  Fibersource and Isosource are soy based but I don't
> think you will find anything commercial that is "organic" as all these
> formulas will have some sort of microbial inhibitors and/or
> preservatives.  Leslee
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Carver, Leslee
> Sent: Friday, January 02, 2009 3:26 PM
> To: Louise R. Merriman; Clinical Nutrition Managment
> Cc: Heather Anderson
> Subject: Re: [Cnm] vegan organic tube feeding
>
> The short answer is no but something like Vivonex RTF might pass the
> vegan test.  Leslee Carver
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Louise R. Merriman
> Sent: Friday, January 02, 2009 2:51 PM
> To: Clinical Nutrition Managment
> Cc: Heather Anderson
> Subject: [Cnm] vegan organic tube feeding
>
> Is any one aware of such a product or any ideas as to what one could use
>
> for an adult patient? thanks and happy new year!
>
>
> --------------------
> Confidential Information subject to NYP's (and its affiliates')
> information management and security policies
> (http://infonet.nyp.org/QA/HospManual/).
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>  




--------------------

This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited.  If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message.  Thank you.





------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 6
**********************************


-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: application/ms-tnef
Size: 14108 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090104/324b9c88/attachment.bin 

From jlworden at att.net  Sun Jan  4 19:59:54 2009
From: jlworden at att.net (Jo Lynn Worden)
Date: Sun, 4 Jan 2009 21:59:54 -0600
Subject: [Cnm] Liability Insurance
Message-ID: <004a01c96eea$11b00240$351006c0$@net>

Does anyone know anything about getting liability insurance.?

 

I am covered through my company as a dietitian, but I also teach nutrition
at a local university. They want proof of liability insurance (a new thing,
worked for them 10 years and this is the first time they want it).  Anyway,
I sent off for a policy through Healthcare Providers Service Organization,.
Hatboro, PA  (provided by American Casualty Company, Chicago, IL) Is this
the one that ADA sends out information on from time to time.   Before I pay
the premium, I thought I would check to see if anyone else has had to get
coverage for anything - and who/what you did. 

 

Thanks in advance, 

Jo Worden

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090104/71ed77b5/attachment.html 

From peggyrdld at cox.net  Mon Jan  5 03:17:59 2009
From: peggyrdld at cox.net (Peggy Turner)
Date: Mon, 5 Jan 2009 05:17:59 -0600
Subject: [Cnm] Ross/Abbott
Message-ID: <8FD4AA79-B486-49B8-A662-FBCE06C0BBD4@cox.net>

Thanks so much for everyone that responded to my inquiry about Ross  
Products.

I have attached a copy of the grid for the products I plan to request.

For those of you that use Ross, Do you have any opinion/experience  
using Juven or Promod. Still haven't made up on my mind on both of  
those.

Thanks everybody.

Peggy Turner, MS, RD/LD
-------------- next part --------------
A non-text attachment was scrubbed...
Name: RossOralFormulary.doc
Type: application/octet-stream
Size: 72704 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090105/40d06a38/attachment-0002.obj 
-------------- next part --------------


-------------- next part --------------
A non-text attachment was scrubbed...
Name: RossEnteralFormulary.doc
Type: application/octet-stream
Size: 75264 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090105/40d06a38/attachment-0003.obj 
-------------- next part --------------


From fynan-carla at CooperHealth.edu  Mon Jan  5 04:01:04 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Mon, 5 Jan 2009 07:01:04 -0500
Subject: [Cnm] interviewing
Message-ID: <77F33794DD223B40BF24AB3D37930250172B0A0280@mxmbx01.chsmail.root.cooperhealth.edu>

Good Morning!

I am a new CNM and am interviewing new candidates for a RD slot.  In the past the CNM had the RD/DTR team involved with the process.  Does anyone have ideas about that?  Pros and Cons?

Thanks!

Carla Fynan, RD
Clinical Nutrition Manager
Food & Nutrition Department
Cooper University Hospital
One Cooper Paza
Camden, NJ 08103
(856) 342-2320



****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/aad1514e/attachment.html 

From peggymsrdld at cox.net  Mon Jan  5 04:12:56 2009
From: peggymsrdld at cox.net (Peggy Turner)
Date: Mon, 5 Jan 2009 06:12:56 -0600
Subject: [Cnm] interviewing
In-Reply-To: <77F33794DD223B40BF24AB3D37930250172B0A0280@mxmbx01.chsmail.root.cooperhealth.edu>
References: <77F33794DD223B40BF24AB3D37930250172B0A0280@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: <B841596F-B412-43A5-A4C2-C65B79376020@cox.net>

I don't have a problem with others being involved in the interview.  
But you also need to determine what kind of interview you want to  
conduct.

I think all of us need to considering adopting PBI (Performance Based  
Interviewing).
http://www.va.gov/pbi/

You can have several people and each person ask one or two PB type  
questions.

More and more places are adopting this practice. See what you think.

Peggy Turner, MS, RD/LD

On Jan 5, 2009, at 6:01 AM, Fynan, Carla wrote:

> Good Morning!
>
> I am a new CNM and am interviewing new candidates for a RD slot.  In  
> the past the CNM had the RD/DTR team involved with the process.   
> Does anyone have ideas about that?  Pros and Cons?
>
> Thanks!
>
> Carla Fynan, RD
> Clinical Nutrition Manager
> Food & Nutrition Department
> Cooper University Hospital
> One Cooper Paza
> Camden, NJ 08103
> (856) 342-2320
>
>
> ****************************************************************  
> This email, including attachments, may include confidential and/or  
> proprietary information, and may be used only by the person or  
> entity to which it is addressed. If the reader of this email is not  
> the intended recipient or his or her authorized agent, the reader is  
> hereby notified that any dissemination, distribution, or copying of  
> this email is prohibited. If you received this email in error,  
> please notify the sender by replying to this message and delete this  
> email immediately. _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/ead7e8a1/attachment.html 

From MKarustis at dh.org  Mon Jan  5 04:24:14 2009
From: MKarustis at dh.org (Karustis, Marcelle)
Date: Mon, 5 Jan 2009 07:24:14 -0500
Subject: [Cnm] interviewing
In-Reply-To: <77F33794DD223B40BF24AB3D37930250172B0A0280@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: <526B6282E69E0F4B9C80A8B646A6FADB0150BA4F@dhmail.dhorg.org>

I always include the rest of the team.  
For an entry level job, I usually do the formal interview process with the candidate and then let someone from my staff give them "the tour".
Then, me and my staff compare notes later.
That way, my team gets to know them but the person isn't being interviewed in front of a "line up" of people.  
That would make me nervous just starting out.  
However, if it was an interview for a higher level job, I would probably use the "line up" method.
When my team has input in the decision, they seem have more of a vested interst in the success of that individual.
The only possible "con" I can think of is - you need to coach your team on what constitutes legal interview questions, how they can be phrased, etc.
Marcelle Karustis MS RD RN LDN
www.dh.org

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Fynan, Carla
Sent: Monday, January 05, 2009 7:01 AM
To: Cnm at lists.my180.net
Subject: [Cnm] interviewing



Good Morning!

 

I am a new CNM and am interviewing new candidates for a RD slot.  In the past the CNM had the RD/DTR team involved with the process.  Does anyone have ideas about that?  Pros and Cons?

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


**************************************************************** This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed. If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited. If you received this email in error, please notify the sender by replying to this message and delete this email immediately. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/d51ead62/attachment.html 

From kharriso at stagnes.org  Mon Jan  5 06:14:53 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Mon, 5 Jan 2009 08:14:53 -0600
Subject: [Cnm] Ross/Abbott
In-Reply-To: <CF3735565E46CC4DBA31E7A3C08BC84E02AA0CE0@STARWEXC32.fss.aramark.com>
References: <mailman.1.1231012802.12939.cnm_lists.my180.net@lists.my180.net>
	<CF3735565E46CC4DBA31E7A3C08BC84E02AA0CE0@STARWEXC32.fss.aramark.com>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B3922472A@ahcmascdc034.DS.SJHS.COM>

We use Abbott:

 

Osmolite 1.2- use very little

Promote with Fiber

Jevity 1.5

Optimental -  use very little

Nepro

Ensure Plus for oral intake

 

We kept Resource Breeze, Enlive was not very good.

 

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Heberle, Heather N.
Sent: Sunday, January 04, 2009 2:31 PM
To: cnm at lists.my180.net
Subject: RE:Re: Ross/Abbott 

 

We use Ross products and currently our formulary consists of:

Osmolite 1 cal

Promote

Promote with Fiber

Jevity 1.2 cal

Glucerna 1.0 cal

Glucerna 1.2 cal

Glucerna Select (to be DC'd March 1st)

Oxepa

Nepro

TwoCal HN

we still use Vivonex from nestle for our elemental formula.

 

Heather Heberle, RD, LD

Clinical Nutrition Manager

Capital Region Medical Center

1125 Madison St

Jefferson City, MO 65101

phone: 573.632.5192

fax: 573.632.5879

 

________________________________

From: cnm-bounces at lists.my180.net on behalf of
cnm-request at lists.my180.net
Sent: Sat 1/3/09 2:00 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 6

Send Cnm mailing list submissions to
        cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
        http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
        cnm-request at lists.my180.net

You can reach the person managing the list at
        cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. vegan organic tube feeding (Louise R. Merriman)
   2. Re: vegan organic tube feeding (Carver, Leslee)
   3. Re: vegan organic tube feeding (Carver, Leslee)
   4. Ross/Abbott (Peggy Turner)
   5. Re: Ross/Abbott (Shipman, Cindy)
   6. Re: vegan organic tube feeding (Louise R. Merriman)


----------------------------------------------------------------------

Message: 1
Date: Fri, 02 Jan 2009 15:51:12 -0500
From: "Louise R. Merriman" <lmerrima at nyp.org>
Subject: [Cnm] vegan organic tube feeding
To: Clinical Nutrition Managment <cnm at lists.my180.net>
Cc: Heather Anderson <hea9016 at nyp.org>
Message-ID: <495E7E40.3000701 at nyp.org>
Content-Type: text/plain; charset=ISO-8859-1; format=flowed

Is any one aware of such a product or any ideas as to what one could use
for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates')
information management and security policies
(http://infonet.nyp.org/QA/HospManual/).




------------------------------

Message: 2
Date: Fri, 2 Jan 2009 15:25:49 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] vegan organic tube feeding
To: "Louise R. Merriman" <lmerrima at nyp.org>,    "Clinical Nutrition
        Managment" <cnm at lists.my180.net>
Cc: Heather Anderson <hea9016 at nyp.org>
Message-ID:
 
<5330B54133B6194BA13930BDEFE9A30E03A32DAC at rhcexch3.reshealthcare.org>
Content-Type: text/plain;       charset="us-ascii"

The short answer is no but something like Vivonex RTF might pass the
vegan test.  Leslee Carver

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Louise R. Merriman
Sent: Friday, January 02, 2009 2:51 PM
To: Clinical Nutrition Managment
Cc: Heather Anderson
Subject: [Cnm] vegan organic tube feeding

Is any one aware of such a product or any ideas as to what one could use

for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates')
information management and security policies
(http://infonet.nyp.org/QA/HospManual/).


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 3
Date: Fri, 2 Jan 2009 15:38:56 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] vegan organic tube feeding
To: "Carver, Leslee" <LCarver at Reshealthcare.org>,       "Louise R.
Merriman"
        <lmerrima at nyp.org>,     "Clinical Nutrition Managment"
        <cnm at lists.my180.net>
Cc: Heather Anderson <hea9016 at nyp.org>
Message-ID:
 
<5330B54133B6194BA13930BDEFE9A30E03A32DB8 at rhcexch3.reshealthcare.org>
Content-Type: text/plain;       charset="us-ascii"

Further checking:  Fibersource and Isosource are soy based but I don't
think you will find anything commercial that is "organic" as all these
formulas will have some sort of microbial inhibitors and/or
preservatives.  Leslee

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Carver, Leslee
Sent: Friday, January 02, 2009 3:26 PM
To: Louise R. Merriman; Clinical Nutrition Managment
Cc: Heather Anderson
Subject: Re: [Cnm] vegan organic tube feeding

The short answer is no but something like Vivonex RTF might pass the
vegan test.  Leslee Carver

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Louise R. Merriman
Sent: Friday, January 02, 2009 2:51 PM
To: Clinical Nutrition Managment
Cc: Heather Anderson
Subject: [Cnm] vegan organic tube feeding

Is any one aware of such a product or any ideas as to what one could use

for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates')
information management and security policies
(http://infonet.nyp.org/QA/HospManual/).


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 4
Date: Fri, 2 Jan 2009 18:11:06 -0600
From: Peggy Turner <peggymsrdld at cox.net>
Subject: [Cnm] Ross/Abbott
To: "CNM at lists.my180.net serve" <cnm at lists.my180.net>
Message-ID: <8829A7B2-EC69-475A-B7FB-A1919BE1F584 at cox.net>
Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes

Hello,

We are in the process of switching from Nestles to Abbott as our 
vendor for formulas.

I did use Ross many years ago so some things are still the same 
(Perative, Promote, Nepro, Suplena).

The major change I see is all the new Glucerna products (Glucerna 
Select, Glucerna 1.0, 1.2, 1.5 etc).

If you use Abbott and if you have the time, would you mind sharing 
with me which Abbott products are on your formulary.

Thanks, I appreciate your help.

Peggy Turner MS, RD/LD




------------------------------

Message: 5
Date: Sat, 3 Jan 2009 07:20:39 -0600
From: "Shipman, Cindy" <CShipman at baymedical.org>
Subject: Re: [Cnm] Ross/Abbott
To: "Peggy Turner" <peggymsrdld at cox.net>,       "CNM at lists.my180.net
serve"
        <cnm at lists.my180.net>
Message-ID:
 
<28C9A616766126479E11A1BC4DDA43B2070CB658 at BMCEXCHVS2.corp.baymedical.org
>
       
Content-Type: text/plain;       charset="iso-8859-1"

Glucerna Select is going away. We have been using it due to 20% protein.
Will change too Glucerna 1.5 after a trial. Nepro did change last year-
slightly lower cal and higher pro. Cindy Shipman

________________________________

From: cnm-bounces at lists.my180.net on behalf of Peggy Turner
Sent: Fri 1/2/2009 6:11 PM
To: CNM at lists.my180.net serve
Subject: [Cnm] Ross/Abbott



Hello,

We are in the process of switching from Nestles to Abbott as our
vendor for formulas.

I did use Ross many years ago so some things are still the same
(Perative, Promote, Nepro, Suplena).

The major change I see is all the new Glucerna products (Glucerna
Select, Glucerna 1.0, 1.2, 1.5 etc).

If you use Abbott and if you have the time, would you mind sharing
with me which Abbott products are on your formulary.

Thanks, I appreciate your help.

Peggy Turner MS, RD/LD


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

--------------------------------------------------------
Confidentiality Notice:
The information contained in this e-mail is intended solely for the
person(s) to whom it is addressed. This information is the property of
Bay Medical Center and may be confidential. If you are not the intended
addressee, you should not distribute, copy or disclose this e-mail.
Please notify the sender immediately if you received this e-mail by
mistake and delete this email from your system and destroy all printed
copies.



------------------------------

Message: 6
Date: Sat, 03 Jan 2009 09:02:26 -0500
From: "Louise R. Merriman" <lmerrima at nyp.org>
Subject: Re: [Cnm] vegan organic tube feeding
To: "Carver, Leslee" <LCarver at Reshealthcare.org>
Cc: Clinical Nutrition Managment <cnm at lists.my180.net>
Message-ID: <495F6FF2.8000609 at nyp.org>
Content-Type: text/plain; charset=ISO-8859-1; format=flowed

this is a response we got from Abbott - might be of interest re: source
of Vitamin E
AN has NO organic formulas (except Similac) and nothing vegan...our
vitamin E comes from sheep lanolin
Carver, Leslee wrote:
> Further checking:  Fibersource and Isosource are soy based but I don't
> think you will find anything commercial that is "organic" as all these
> formulas will have some sort of microbial inhibitors and/or
> preservatives.  Leslee
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Carver, Leslee
> Sent: Friday, January 02, 2009 3:26 PM
> To: Louise R. Merriman; Clinical Nutrition Managment
> Cc: Heather Anderson
> Subject: Re: [Cnm] vegan organic tube feeding
>
> The short answer is no but something like Vivonex RTF might pass the
> vegan test.  Leslee Carver
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Louise R. Merriman
> Sent: Friday, January 02, 2009 2:51 PM
> To: Clinical Nutrition Managment
> Cc: Heather Anderson
> Subject: [Cnm] vegan organic tube feeding
>
> Is any one aware of such a product or any ideas as to what one could
use
>
> for an adult patient? thanks and happy new year!
>
>
> --------------------
> Confidential Information subject to NYP's (and its affiliates')
> information management and security policies
> (http://infonet.nyp.org/QA/HospManual/).
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>  




--------------------

This electronic message is intended to be for the use only of the named
recipient, and may contain information that is confidential or
privileged.  If you are not the intended recipient, you are hereby
notified that any disclosure, copying, distribution or use of the
contents of this message is strictly prohibited.  If you have received
this message in error or are not the named recipient, please notify us
immediately by contacting the sender at the electronic mail address
noted above, and delete and destroy all copies of this message.  Thank
you.





------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 6
**********************************


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/860955be/attachment-0001.html 

From kharriso at stagnes.org  Mon Jan  5 06:49:47 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Mon, 5 Jan 2009 08:49:47 -0600
Subject: [Cnm] QA
In-Reply-To: <00a801c8e1d1$e01de850$6400a8c0@Front>
References: <mailman.19813.1215612889.3834.cnm_lists.my180.net@lists.my180.net><69DD80845D7F524BB1C8C59479ED062501016A97@exchsvfulton01.mx.state.mo.us>
	<00a801c8e1d1$e01de850$6400a8c0@Front>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B3922476C@ahcmascdc034.DS.SJHS.COM>

We are devising our yearly QA projects.  Would anyone be willing to share what they are monitoring?  We have a few problem childs that we will continue to monitor, but wanted something new for the year.

Thank you,
Kerry Harrison

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong enough to take everything you have. 
-Thomas Jefferson 



CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/cf283e82/attachment.html 

From lhodgson at SARATOGACARE.ORG  Mon Jan  5 07:24:35 2009
From: lhodgson at SARATOGACARE.ORG (Hodgson, Lisa)
Date: Mon, 5 Jan 2009 10:24:35 -0500
Subject: [Cnm] interviewing
In-Reply-To: <mailman.574.1231164895.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.574.1231164895.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <F15F698E03068A4CA11D19D3E0ED28150590708D@shexch1.saratogacare.org>

I feel strongly that the Clinical Staff needs to be part of the
interview process as they will work with the new person directly. Lisa
Hodgson

Lisa Hodgson, RD, CDN, CDE
Clinical Nutrition Manager
Saratoga Hospital
Saratoga Springs, NY 12866

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of cnm-request at lists.my180.net
Sent: Monday, January 05, 2009 9:15 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 9

Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. interviewing (Fynan, Carla)
   2. Re: interviewing (Peggy Turner)
   3. Re: interviewing (Karustis, Marcelle)
   4. Re: Ross/Abbott (Harrison, Kerry)


----------------------------------------------------------------------

Message: 1
Date: Mon, 5 Jan 2009 07:01:04 -0500
From: "Fynan, Carla" <fynan-carla at CooperHealth.edu>
Subject: [Cnm] interviewing
To: "CNM Mailing List (Cnm at lists.my180.net)" <Cnm at lists.my180.net>
Message-ID:
	
<77F33794DD223B40BF24AB3D37930250172B0A0280 at mxmbx01.chsmail.root.cooperh
ealth.edu>
	
Content-Type: text/plain; charset="us-ascii"

Good Morning!

I am a new CNM and am interviewing new candidates for a RD slot.  In the
past the CNM had the RD/DTR team involved with the process.  Does anyone
have ideas about that?  Pros and Cons?

Thanks!

Carla Fynan, RD
Clinical Nutrition Manager
Food & Nutrition Department
Cooper University Hospital
One Cooper Paza
Camden, NJ 08103
(856) 342-2320



****************************************************************
This email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed.  If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited.  If you received this email in error, please notify the
sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20090105/aad1514e/attachment-
0001.html 

------------------------------

Message: 2
Date: Mon, 5 Jan 2009 06:12:56 -0600
From: Peggy Turner <peggymsrdld at cox.net>
Subject: Re: [Cnm] interviewing
To: "Fynan, Carla" <fynan-carla at CooperHealth.edu>
Cc: "CNM at lists.my180.net serve" <cnm at lists.my180.net>
Message-ID: <B841596F-B412-43A5-A4C2-C65B79376020 at cox.net>
Content-Type: text/plain; charset="us-ascii"

I don't have a problem with others being involved in the interview.  
But you also need to determine what kind of interview you want to  
conduct.

I think all of us need to considering adopting PBI (Performance Based  
Interviewing).
http://www.va.gov/pbi/

You can have several people and each person ask one or two PB type  
questions.

More and more places are adopting this practice. See what you think.

Peggy Turner, MS, RD/LD

On Jan 5, 2009, at 6:01 AM, Fynan, Carla wrote:

> Good Morning!
>
> I am a new CNM and am interviewing new candidates for a RD slot.  In  
> the past the CNM had the RD/DTR team involved with the process.   
> Does anyone have ideas about that?  Pros and Cons?
>
> Thanks!
>
> Carla Fynan, RD
> Clinical Nutrition Manager
> Food & Nutrition Department
> Cooper University Hospital
> One Cooper Paza
> Camden, NJ 08103
> (856) 342-2320
>
>
> ****************************************************************  
> This email, including attachments, may include confidential and/or  
> proprietary information, and may be used only by the person or  
> entity to which it is addressed. If the reader of this email is not  
> the intended recipient or his or her authorized agent, the reader is  
> hereby notified that any dissemination, distribution, or copying of  
> this email is prohibited. If you received this email in error,  
> please notify the sender by replying to this message and delete this  
> email immediately. _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20090105/ead7e8a1/attachment-
0001.html 

------------------------------

Message: 3
Date: Mon, 5 Jan 2009 07:24:14 -0500
From: "Karustis, Marcelle" <MKarustis at dh.org>
Subject: Re: [Cnm] interviewing
To: <Cnm at lists.my180.net>
Message-ID:
	<526B6282E69E0F4B9C80A8B646A6FADB0150BA4F at dhmail.dhorg.org>
Content-Type: text/plain; charset="iso-8859-1"

I always include the rest of the team.  
For an entry level job, I usually do the formal interview process with
the candidate and then let someone from my staff give them "the tour".
Then, me and my staff compare notes later.
That way, my team gets to know them but the person isn't being
interviewed in front of a "line up" of people.  
That would make me nervous just starting out.  
However, if it was an interview for a higher level job, I would probably
use the "line up" method.
When my team has input in the decision, they seem have more of a vested
interst in the success of that individual.
The only possible "con" I can think of is - you need to coach your team
on what constitutes legal interview questions, how they can be phrased,
etc.
Marcelle Karustis MS RD RN LDN
www.dh.org

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On
Behalf Of Fynan, Carla
Sent: Monday, January 05, 2009 7:01 AM
To: Cnm at lists.my180.net
Subject: [Cnm] interviewing



Good Morning!

 

I am a new CNM and am interviewing new candidates for a RD slot.  In the
past the CNM had the RD/DTR team involved with the process.  Does anyone
have ideas about that?  Pros and Cons?

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20090105/d51ead62/attachment-
0001.html 

------------------------------

Message: 4
Date: Mon, 5 Jan 2009 08:14:53 -0600
From: "Harrison, Kerry" <kharriso at stagnes.org>
Subject: Re: [Cnm] Ross/Abbott
To: "Heberle, Heather N." <Heberle-Heather at aramark.com>,
	<cnm at lists.my180.net>
Message-ID:
	
<9AB3ADBD43ABFD46B0DC4E80280F3B3922472A at ahcmascdc034.DS.SJHS.COM>
Content-Type: text/plain; charset="us-ascii"

We use Abbott:

 

Osmolite 1.2- use very little

Promote with Fiber

Jevity 1.5

Optimental -  use very little

Nepro

Ensure Plus for oral intake

 

We kept Resource Breeze, Enlive was not very good.

 

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Heberle, Heather N.
Sent: Sunday, January 04, 2009 2:31 PM
To: cnm at lists.my180.net
Subject: RE:Re: Ross/Abbott 

 

We use Ross products and currently our formulary consists of:

Osmolite 1 cal

Promote

Promote with Fiber

Jevity 1.2 cal

Glucerna 1.0 cal

Glucerna 1.2 cal

Glucerna Select (to be DC'd March 1st)

Oxepa

Nepro

TwoCal HN

we still use Vivonex from nestle for our elemental formula.

 

Heather Heberle, RD, LD

Clinical Nutrition Manager

Capital Region Medical Center

1125 Madison St

Jefferson City, MO 65101

phone: 573.632.5192

fax: 573.632.5879

 

________________________________

From: cnm-bounces at lists.my180.net on behalf of
cnm-request at lists.my180.net
Sent: Sat 1/3/09 2:00 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 6

Send Cnm mailing list submissions to
        cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
        http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
        cnm-request at lists.my180.net

You can reach the person managing the list at
        cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. vegan organic tube feeding (Louise R. Merriman)
   2. Re: vegan organic tube feeding (Carver, Leslee)
   3. Re: vegan organic tube feeding (Carver, Leslee)
   4. Ross/Abbott (Peggy Turner)
   5. Re: Ross/Abbott (Shipman, Cindy)
   6. Re: vegan organic tube feeding (Louise R. Merriman)


----------------------------------------------------------------------

Message: 1
Date: Fri, 02 Jan 2009 15:51:12 -0500
From: "Louise R. Merriman" <lmerrima at nyp.org>
Subject: [Cnm] vegan organic tube feeding
To: Clinical Nutrition Managment <cnm at lists.my180.net>
Cc: Heather Anderson <hea9016 at nyp.org>
Message-ID: <495E7E40.3000701 at nyp.org>
Content-Type: text/plain; charset=ISO-8859-1; format=flowed

Is any one aware of such a product or any ideas as to what one could use
for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates')
information management and security policies
(http://infonet.nyp.org/QA/HospManual/).




------------------------------

Message: 2
Date: Fri, 2 Jan 2009 15:25:49 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] vegan organic tube feeding
To: "Louise R. Merriman" <lmerrima at nyp.org>,    "Clinical Nutrition
        Managment" <cnm at lists.my180.net>
Cc: Heather Anderson <hea9016 at nyp.org>
Message-ID:
 
<5330B54133B6194BA13930BDEFE9A30E03A32DAC at rhcexch3.reshealthcare.org>
Content-Type: text/plain;       charset="us-ascii"

The short answer is no but something like Vivonex RTF might pass the
vegan test.  Leslee Carver

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Louise R. Merriman
Sent: Friday, January 02, 2009 2:51 PM
To: Clinical Nutrition Managment
Cc: Heather Anderson
Subject: [Cnm] vegan organic tube feeding

Is any one aware of such a product or any ideas as to what one could use

for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates')
information management and security policies
(http://infonet.nyp.org/QA/HospManual/).


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 3
Date: Fri, 2 Jan 2009 15:38:56 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] vegan organic tube feeding
To: "Carver, Leslee" <LCarver at Reshealthcare.org>,       "Louise R.
Merriman"
        <lmerrima at nyp.org>,     "Clinical Nutrition Managment"
        <cnm at lists.my180.net>
Cc: Heather Anderson <hea9016 at nyp.org>
Message-ID:
 
<5330B54133B6194BA13930BDEFE9A30E03A32DB8 at rhcexch3.reshealthcare.org>
Content-Type: text/plain;       charset="us-ascii"

Further checking:  Fibersource and Isosource are soy based but I don't
think you will find anything commercial that is "organic" as all these
formulas will have some sort of microbial inhibitors and/or
preservatives.  Leslee

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Carver, Leslee
Sent: Friday, January 02, 2009 3:26 PM
To: Louise R. Merriman; Clinical Nutrition Managment
Cc: Heather Anderson
Subject: Re: [Cnm] vegan organic tube feeding

The short answer is no but something like Vivonex RTF might pass the
vegan test.  Leslee Carver

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Louise R. Merriman
Sent: Friday, January 02, 2009 2:51 PM
To: Clinical Nutrition Managment
Cc: Heather Anderson
Subject: [Cnm] vegan organic tube feeding

Is any one aware of such a product or any ideas as to what one could use

for an adult patient? thanks and happy new year!


--------------------
Confidential Information subject to NYP's (and its affiliates')
information management and security policies
(http://infonet.nyp.org/QA/HospManual/).


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 4
Date: Fri, 2 Jan 2009 18:11:06 -0600
From: Peggy Turner <peggymsrdld at cox.net>
Subject: [Cnm] Ross/Abbott
To: "CNM at lists.my180.net serve" <cnm at lists.my180.net>
Message-ID: <8829A7B2-EC69-475A-B7FB-A1919BE1F584 at cox.net>
Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes

Hello,

We are in the process of switching from Nestles to Abbott as our 
vendor for formulas.

I did use Ross many years ago so some things are still the same 
(Perative, Promote, Nepro, Suplena).

The major change I see is all the new Glucerna products (Glucerna 
Select, Glucerna 1.0, 1.2, 1.5 etc).

If you use Abbott and if you have the time, would you mind sharing 
with me which Abbott products are on your formulary.

Thanks, I appreciate your help.

Peggy Turner MS, RD/LD




------------------------------

Message: 5
Date: Sat, 3 Jan 2009 07:20:39 -0600
From: "Shipman, Cindy" <CShipman at baymedical.org>
Subject: Re: [Cnm] Ross/Abbott
To: "Peggy Turner" <peggymsrdld at cox.net>,       "CNM at lists.my180.net
serve"
        <cnm at lists.my180.net>
Message-ID:
 
<28C9A616766126479E11A1BC4DDA43B2070CB658 at BMCEXCHVS2.corp.baymedical.org
>
       
Content-Type: text/plain;       charset="iso-8859-1"

Glucerna Select is going away. We have been using it due to 20% protein.
Will change too Glucerna 1.5 after a trial. Nepro did change last year-
slightly lower cal and higher pro. Cindy Shipman

________________________________

From: cnm-bounces at lists.my180.net on behalf of Peggy Turner
Sent: Fri 1/2/2009 6:11 PM
To: CNM at lists.my180.net serve
Subject: [Cnm] Ross/Abbott



Hello,

We are in the process of switching from Nestles to Abbott as our
vendor for formulas.

I did use Ross many years ago so some things are still the same
(Perative, Promote, Nepro, Suplena).

The major change I see is all the new Glucerna products (Glucerna
Select, Glucerna 1.0, 1.2, 1.5 etc).

If you use Abbott and if you have the time, would you mind sharing
with me which Abbott products are on your formulary.

Thanks, I appreciate your help.

Peggy Turner MS, RD/LD


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

--------------------------------------------------------
Confidentiality Notice:
The information contained in this e-mail is intended solely for the
person(s) to whom it is addressed. This information is the property of
Bay Medical Center and may be confidential. If you are not the intended
addressee, you should not distribute, copy or disclose this e-mail.
Please notify the sender immediately if you received this e-mail by
mistake and delete this email from your system and destroy all printed
copies.



------------------------------

Message: 6
Date: Sat, 03 Jan 2009 09:02:26 -0500
From: "Louise R. Merriman" <lmerrima at nyp.org>
Subject: Re: [Cnm] vegan organic tube feeding
To: "Carver, Leslee" <LCarver at Reshealthcare.org>
Cc: Clinical Nutrition Managment <cnm at lists.my180.net>
Message-ID: <495F6FF2.8000609 at nyp.org>
Content-Type: text/plain; charset=ISO-8859-1; format=flowed

this is a response we got from Abbott - might be of interest re: source
of Vitamin E
AN has NO organic formulas (except Similac) and nothing vegan...our
vitamin E comes from sheep lanolin
Carver, Leslee wrote:
> Further checking:  Fibersource and Isosource are soy based but I don't
> think you will find anything commercial that is "organic" as all these
> formulas will have some sort of microbial inhibitors and/or
> preservatives.  Leslee
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Carver, Leslee
> Sent: Friday, January 02, 2009 3:26 PM
> To: Louise R. Merriman; Clinical Nutrition Managment
> Cc: Heather Anderson
> Subject: Re: [Cnm] vegan organic tube feeding
>
> The short answer is no but something like Vivonex RTF might pass the
> vegan test.  Leslee Carver
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Louise R. Merriman
> Sent: Friday, January 02, 2009 2:51 PM
> To: Clinical Nutrition Managment
> Cc: Heather Anderson
> Subject: [Cnm] vegan organic tube feeding
>
> Is any one aware of such a product or any ideas as to what one could
use
>
> for an adult patient? thanks and happy new year!
>
>
> --------------------
> Confidential Information subject to NYP's (and its affiliates')
> information management and security policies
> (http://infonet.nyp.org/QA/HospManual/).
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>  




--------------------

This electronic message is intended to be for the use only of the named
recipient, and may contain information that is confidential or
privileged.  If you are not the intended recipient, you are hereby
notified that any disclosure, copying, distribution or use of the
contents of this message is strictly prohibited.  If you have received
this message in error or are not the named recipient, please notify us
immediately by contacting the sender at the electronic mail address
noted above, and delete and destroy all copies of this message.  Thank
you.





------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 6
**********************************


CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20090105/860955be/attachment.
html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 9
**********************************


This e-mail communication and any attachments may contain
confidential and privileged information for the use of the
designated recipients named above.
If you are not the intended recipient, you are hereby notified
that you have received this communication in error and that
any review, disclosure, dissemination, distribution or copying
of it or its contents is prohibited. If you have received this
communication in error, please notify Saratoga Hospital
immediately by e-mail at privacy at saratogacare.org and
destroy all copies of this communication and any attachments.



From Dierks.Lisa at mayo.edu  Mon Jan  5 08:21:08 2009
From: Dierks.Lisa at mayo.edu (Dierks, Lisa M., R.D., L.D.)
Date: Mon, 5 Jan 2009 10:21:08 -0600
Subject: [Cnm] Protected Project time for staff
Message-ID: <CE5737EC36E6EC4A83CDF57D8599E45103C188BF@msgebe23.mfad.mfroot.org>

Are your staff involved in work related projects outside of their day to
day patient care time?  Examples may be
*	Development of proposals and pilots for practice innovation
*	Quality improvement projects
*	Prevention of sentinel event
*	Performance and development of patient satisfaction and patient
education projects
*	Interdivisional or Interdepartmental project development
*	Practice guideline development and implementation
 
How do you ensure that they have time for these commitments?  Do you
offer "protected" or "scholarly activity" time?  

If you do have this option, who decides how much time is granted?  Do
you have a formal system set up?

Thanks in advance

Lisa Dierks RD, LD
Clinical Manager - Hospital Clinical Nutrition 
Department of Endocrinology
Pager: 507-538-2180
Phone: 507-255-8757
Secretary: 507-255-5221
E-mail: Dierks.lisa at mayo.edu 
Mayo Clinic
200 First Street SW
Rochester, MN 55905 
www.mayoclinic.org <http://www.mayoclinic.org/> 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/3bcaa62c/attachment.html 

From Susan.Teske at chsys.org  Mon Jan  5 08:45:31 2009
From: Susan.Teske at chsys.org (Sue Teske)
Date: Mon, 5 Jan 2009 10:45:31 -0600
Subject: [Cnm] Protected Project time for staff
In-Reply-To: <CE5737EC36E6EC4A83CDF57D8599E45103C188BF@msgebe23.mfad.mfroot.org>
References: <CE5737EC36E6EC4A83CDF57D8599E45103C188BF@msgebe23.mfad.mfroot.org>
Message-ID: <3D0B6F497247834CAC5FF0C30ED7A5C402494A42@chexmain.chsys.org>

All of my full-time RDs are salaried so these things are just part of
their job expectations.

 

Susan  C. Teske, MS, RD, LD, CNSD

Director, Dept. of Clinical Nutrition and Lactation Services

Children's Health System

1600 7th Ave. South

3rd Floor hospital, Room 334 

Birmingham, AL  35233

(205) 939-9203 Office

(205) 939-6047 Fax

susan.teske at chsys.org     

 

 

Confidentiality Notice: The information transmitted is intended only for
the person or company to which it is addressed and may contain
confidential or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in reliance upon,
this information by person or company other than the intended recipient
is prohibited. If you receive this in error, please contact the sender
and delete the material from any computer. 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Dierks, Lisa M., R.D., L.D.
Sent: Monday, January 05, 2009 10:21 AM
To: Clinical List
Subject: [Cnm] Protected Project time for staff

 

Are your staff involved in work related projects outside of their day to
day patient care time?  Examples may be 

				*	Development of proposals and
pilots for practice innovation
				*	Quality improvement projects
				*	Prevention of sentinel event
				*	Performance and development of
patient satisfaction and patient education projects
				*	Interdivisional or
Interdepartmental project development
				*	Practice guideline development
and implementation

  
How do you ensure that they have time for these commitments?  Do you
offer "protected" or "scholarly activity" time?  

If you do have this option, who decides how much time is granted?  Do
you have a formal system set up? 

Thanks in advance 

Lisa Dierks RD, LD 
Clinical Manager - Hospital Clinical Nutrition
Department of Endocrinology 
Pager: 507-538-2180 
Phone: 507-255-8757 
Secretary: 507-255-5221 
E-mail: Dierks.lisa at mayo.edu <mailto:Dierks.lisa at mayo.edu>  
Mayo Clinic
200 First Street SW
Rochester, MN 55905 
www.mayoclinic.org <http://www.mayoclinic.org/>  



The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material.  Any review, retransmission dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited.  If you receive this in error, please contact the sender and delete the material from any computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/2a105512/attachment-0001.html 

From Annalynn_Skipper at Comcast.net  Mon Jan  5 09:58:58 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Mon, 5 Jan 2009 11:58:58 -0600
Subject: [Cnm] Attend and share with staff: Nutrition Care Process and
	Physical Assessment workshops in New Orleans
Message-ID: <F2636E87F6D846AC8313B0D1BBD32F22@ANNALYNN>


You won't want to miss these two outstanding CNW Preconference Workshops!!
Register now to assure yourself a spot!

Advanced Nutrition Skills Lab: Physical Assessment

Enhance your practice as a nutrition support clinician! Move beyond reading
charts and doing calculations, and begin doing physical assessments.
Abdominal assessments, lung sounds, blood pressure, and nutrition-focused
physical assessment can be part of your daily routine. This hands-on,
interactive workshop will provide you with all of these important skills,
making you an even more vital member of your healthcare team. Learn from the
experts and enhance your knowledge at this advanced-level workshop.

This lab is limited to the first 50 registrants.


 

Advance 
(by 1/14/09)

On-site
(After 1/14/09)


 

$115/$165

$145/$195

January 30, 2009 -7:30-11:30 AM

Ernest Morial Convention Center, New Orleans, LA
Register online at http://www.nutritioncare.org/

The Nutrition Care Process - Making It Work in the ICU


Heard of the Nutrition Care Process (NCP) but unsure how to apply it in the
critical care setting? Contemplating the potential of the critical thinking
process as a framework for dietetic practice? Are you using the process but
questioning how to best make it work for the environment in which you work?
Don't miss this invaluable, expert overview of the key components of the
NCP, with step-by-step application of the NCP to nutrition care of
critically ill patients. Review the difference between a medical diagnosis
and a nutrition diagnosis. Discuss and understand the roles of models,
guidelines and terminology to inform and assist critical care nutrition
practice. Review the importance of intervention, monitoring and evaluation
in describing and documenting the care you provide. Bring a complex patient
case and take the opportunity to discuss it with leaders in the development
and application of the NCP. 

This session is limited to the first 50 registrants.

 Registration Rates: (member/nonmember)


 

Advance 
(by 1/14/09)

On-site
(After 1/14/09)


 

$115/$165

$145/$195

 


 

January 30, 2009 - 12:30PM - 6 PM

Ernest Morial Convention Center New Orleans, LA

Supported by a medical education grant from Abbott Nutrition
Register online at http://www.nutritioncare.org/

 

 

Happy New Year! 

 

Annalynn

 

Annalynn Skipper Ph.D., R.D., FADA

 


a consultancy devoted to advancing nutrition practice

P.O. Box 45

Oak Park, IL 60303

 <mailto:Annalynn_Skipper at Comcast.net> Annalynn_Skipper at Comcast.net

Advanced Medical Nutrition Therapy Practice, 

a 2008 text, is available from Jones and Bartlett. 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/e19c4729/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 170 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090105/e19c4729/attachment.gif 

From CKeinath at chs-mi.com  Mon Jan  5 10:35:22 2009
From: CKeinath at chs-mi.com (CKeinath at chs-mi.com)
Date: Mon, 5 Jan 2009 13:35:22 -0500
Subject: [Cnm] RD salary or hourly
Message-ID: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   


From CKeinath at chs-mi.com  Mon Jan  5 10:36:24 2009
From: CKeinath at chs-mi.com (CKeinath at chs-mi.com)
Date: Mon, 5 Jan 2009 13:36:24 -0500
Subject: [Cnm] NICU RD
Message-ID: <OF2B11449D.E070B79E-ON85257535.0065F956-85257535.006637A1@CHSProdl2.chs-mi.com>


Anybody have NICU RDs, how many FTE for how many in NICU and how many is
the average seen per day?

Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   


From CKeinath at chs-mi.com  Mon Jan  5 10:37:42 2009
From: CKeinath at chs-mi.com (CKeinath at chs-mi.com)
Date: Mon, 5 Jan 2009 13:37:42 -0500
Subject: [Cnm] Fw: standards of care
Message-ID: <OF02CF0BD7.593BB901-ON85257535.006618F9-85257535.00665602@CHSProdl2.chs-mi.com>



Can you share with me the standards of care for how often minimal  follow
up care?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning to
Dance in The Rain".


-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   


From fynan-carla at CooperHealth.edu  Mon Jan  5 10:39:17 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Mon, 5 Jan 2009 13:39:17 -0500
Subject: [Cnm] RD salary or hourly
In-Reply-To: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
References: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
Message-ID: <77F33794DD223B40BF24AB3D37930250172B12A772@mxmbx01.chsmail.root.cooperhealth.edu>

Salary

Carla Fynan
Cooper University Hospital

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 1:35 PM
To: Clinical List
Subject: [Cnm] RD salary or hourly


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.


From Michael.Smith at LPNT.net  Mon Jan  5 10:45:03 2009
From: Michael.Smith at LPNT.net (Smith Michael - Palestine)
Date: Mon, 5 Jan 2009 12:45:03 -0600
Subject: [Cnm] RD salary or hourly
In-Reply-To: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
References: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
Message-ID: <B0B3BB7F0AC03B4780174D2286A0918D25AA893899@NADCWPMSGCMS01.hca.corpad.net>

Salary.

Michael Smith RD LD
Palestine Regional Medical Center
Palestine, Texas 
Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From Linda.Woods at healthall.com  Mon Jan  5 10:46:36 2009
From: Linda.Woods at healthall.com (Woods, Linda)
Date: Mon, 5 Jan 2009 13:46:36 -0500
Subject: [Cnm] RD salary or hourly
In-Reply-To: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
References: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
Message-ID: <2B1106A6A593B147A65BD5A8939D3E11171574188A@MAIL-C.healthall.com>

All of our RDs used to be salaried, but a few years ago a decision was made by our corporate HR that any exempt positions less than 0.8 FTE (not just RDs) would need to clock in/out. This affected about 25% of my staff.

Linda Woods, RD, LD
Clinical Nutrition Coordinator
The University Hospital
234 Goodman Street
Cincinnati, OH  45219
linda.woods at healthall.com
Office:  513-584-4534
Fax:  513-584-1027



-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 1:35 PM
To: Clinical List
Subject: [Cnm] RD salary or hourly


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information.  Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.


From JEdwards at hfmhealth.org  Mon Jan  5 10:49:08 2009
From: JEdwards at hfmhealth.org (Jeanne Edwards)
Date: Mon, 5 Jan 2009 12:49:08 -0600
Subject: [Cnm] RD salary or hourly
In-Reply-To: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
Message-ID: <1E611D0D82010049A4E087DFA59CA44203E2B31B@holy1.hfmhealth.com>

We were salary up until 2 years ago,
when we were made hourly. This purpose, I believe
was so we could  take low census  if needed. (unpaid time )
However, this has never happened.

Jeanne Edwards MS RD
Clinical Dietitian
Holy Family Memorial
Manitowoc, WI 


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 12:35 PM
To: Clinical List
Subject: [Cnm] RD salary or hourly



Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From bhomola at comhs.org  Mon Jan  5 10:56:35 2009
From: bhomola at comhs.org (Bobbi Homola)
Date: Mon, 5 Jan 2009 12:56:35 -0600
Subject: [Cnm] RD salary or hourly
In-Reply-To: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
Message-ID: <A54EFD4D2B0E924B970F363E6CCA949302E53C3D@sm-xchg.comhs.org>

Salaried

Thank you,
Bobbi
 
Bobbi Homola, MPA, RD, CD
Clinical Manager, Food and Nutrition Services
St. Mary Medical Center / St. Catherine Hospital
1500 South Lake Park Avenue
Hobart, IN 46342
219-947-6048 / 219-392-7081
219-947-6049 fax
bhomola at comhs.org
 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 12:35 PM
To: Clinical List
Subject: [Cnm] RD salary or hourly


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net




From bahrj at southwesthealth.org  Mon Jan  5 11:02:12 2009
From: bahrj at southwesthealth.org (Joan Bahr)
Date: Mon, 5 Jan 2009 13:02:12 -0600
Subject: [Cnm] RD salary or hourly
In-Reply-To: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
References: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
Message-ID: <001201c96f68$2042a410$60c7ec30$@org>

Manager is salaried; part-time RD is hourly.
Joan Bahr RD CDE


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 12:35 PM
To: Clinical List
Subject: [Cnm] RD salary or hourly


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



From kharriso at stagnes.org  Mon Jan  5 11:04:25 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Mon, 5 Jan 2009 13:04:25 -0600
Subject: [Cnm] RD salary or hourly
In-Reply-To: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
References: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B392248BB@ahcmascdc034.DS.SJHS.COM>

Salary, but get on call pay on saturdays. 


Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 1:35 PM
To: Clinical List
Subject: [Cnm] RD salary or hourly


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.


From Susan.Teske at chsys.org  Mon Jan  5 11:50:14 2009
From: Susan.Teske at chsys.org (Sue Teske)
Date: Mon, 5 Jan 2009 13:50:14 -0600
Subject: [Cnm] RD salary or hourly
In-Reply-To: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
References: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
Message-ID: <3D0B6F497247834CAC5FF0C30ED7A5C402494A49@chexmain.chsys.org>

All full-time RDs are salaried, part-time are hourly.

Susan  C. Teske, MS, RD, LD, CNSD
Director, Dept. of Clinical Nutrition and Lactation Services
Children's Health System
1600 7th Ave. South
3rd Floor hospital, Room 334 
Birmingham, AL  35233
(205) 939-9203 Office
(205) 939-6047 Fax
susan.teske at chsys.org     


Confidentiality Notice: The information transmitted is intended only for
the person or company to which it is addressed and may contain
confidential or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in reliance upon,
this information by person or company other than the intended recipient
is prohibited. If you receive this in error, please contact the sender
and delete the material from any computer. 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 12:35 PM
To: Clinical List
Subject: [Cnm] RD salary or hourly


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material.  Any review, retransmission dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited.  If you receive this in error, please contact the sender and delete the material from any computer.


From sdehoog at u.washington.edu  Mon Jan  5 11:54:52 2009
From: sdehoog at u.washington.edu (susan)
Date: Mon, 5 Jan 2009 11:54:52 -0800 (PST)
Subject: [Cnm] RD salary or hourly
In-Reply-To: <3D0B6F497247834CAC5FF0C30ED7A5C402494A49@chexmain.chsys.org>
Message-ID: <Pine.LNX.4.43.0901051154520.29451@hymn14.u.washington.edu>

Classified - .5FTE or > are salaried

Hourly -less than .5FTE



Susan DeHoog
Associate Director
Food and Nutrition
University of Washington Medical Center
BOX 356057
Seattle Washington 98195
(206) 598-4533
email  sdehoog at u.washington.edu
FAX (206) 598-8105
pager (206)540-8874





From Tess_Canlas at memorial.org  Mon Jan  5 12:07:43 2009
From: Tess_Canlas at memorial.org (Canlas, Tess)
Date: Mon, 5 Jan 2009 13:07:43 -0700
Subject: [Cnm] RD salary or hourly
In-Reply-To: <Pine.LNX.4.43.0901051154520.29451@hymn14.u.washington.edu>
References: <3D0B6F497247834CAC5FF0C30ED7A5C402494A49@chexmain.chsys.org>
	<Pine.LNX.4.43.0901051154520.29451@hymn14.u.washington.edu>
Message-ID: <A8FDAAC31D6E6A4993B37716EC7866FE66222A@chimsx04.CHI.catholichealth.net>

Full time- salaried
Registry- hourly


Tess Canlas, RD.LDN
Clinical Nutrition Manager
Memorial Health Care System
Memorial Nutrition Services
Phone- 423-495-8375
Email-tess_canlas at memorial.org
Fax: 423-495-4404 

Patients & Residents are the heart of    everything we do! 

 

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of susan
Sent: Monday, January 05, 2009 2:55 PM
To: Sue Teske
Cc: CKeinath at chs-mi.com; Clinical List
Subject: Re: [Cnm] RD salary or hourly

Classified - .5FTE or > are salaried

Hourly -less than .5FTE



Susan DeHoog
Associate Director
Food and Nutrition
University of Washington Medical Center
BOX 356057
Seattle Washington 98195
(206) 598-4533
email  sdehoog at u.washington.edu
FAX (206) 598-8105
pager (206)540-8874




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net




This message and accompanying documents are covered by
the Electronic Communications Privacy Act 18
U.S.C. "Sections 2510-2521," and contain information
intended for the specified individual(s) only. This
information is confidential.  If you are not the intended
recipient or an agent responsible for delivering it to
the intended recipient, you are hereby notified that you
have received this document in error and that any review,
dissemination, copying, or the taking of any action based
on the contents of this information is strictly
prohibited.  If you have received this communication in
error, please notify us immediately by e-mail, and delete
the original message.
 





From Kim_Bandelier at elcaminohospital.org  Mon Jan  5 12:15:21 2009
From: Kim_Bandelier at elcaminohospital.org (Kim Bandelier)
Date: Mon, 5 Jan 2009 12:15:21 -0800
Subject: [Cnm] RD salary or hourly
In-Reply-To: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
References: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
Message-ID: <3F6110A9189815479AE870FD47D83744010A3C61@ECH-EXCHANGE.elcaminohospital.org>

Hourly - regardless of full-time or part time.  

Kim Bandelier, MPH, RD
Clinical Nutrition Manager
El Camino Hospital
2500 Grant Road, ECHG40
Mountain View, CA 94040
Phone: 650-940-7117
Fax: 650-966-9204

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 10:35 AM
To: Clinical List
Subject: [Cnm] RD salary or hourly


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From cahns at carthageareahospital.com  Mon Jan  5 12:34:41 2009
From: cahns at carthageareahospital.com (Dawn Berry, RD)
Date: Mon, 5 Jan 2009 15:34:41 -0500
Subject: [Cnm] Bariatric surgery
Message-ID: <696776B2474A4DC2AE5EE0A72F326264@CAHNS1>

We are about to start a bariatric surgery program (lap band, bypass and
sleeve gastrectomy) and I am interested in finding out the level of
involvement other RD's have in the Bariatric programs.

 

I have been to the 1st information session and the surgeon spoke at length
about the surgery but very little about lifestyle change afterwards - I am
uncomfortable with the thought of patients getting into this without knowing
exactly what they are getting into.  So here are my questions if you are
involved in a bariatric surgery program:

 

1.	Is an RD involved in the information session for interested patients
and if so what does the presentation focus on and how long does the
presentation last?
2.	Does the RD do any PR  for the program or any public info sessions?
3.	is there something you do in your program that you feel has helped
improve outcomes for the patients?
4.	What do you track for QA and statistics?

 

Thank you!

 

 

Dawn Berry, RD CDN

Director of Clinical Nutrition

Carthage Area Hospital

1001 West Street

Carthage, NY 13619

 

315-493-1005  ext 3222

cahns at carthageareahospital.com

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/b7ec0c9d/attachment.html 

From andrea.johnson at bassett.org  Mon Jan  5 12:52:44 2009
From: andrea.johnson at bassett.org (Johnson, Andrea)
Date: Mon, 5 Jan 2009 15:52:44 -0500
Subject: [Cnm] RD salary or hourly
In-Reply-To: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
Message-ID: <415700FC732DE14491A3E39367834F7701E6DADE@ex3.bassett.org>

Salaried

Andrea Johnson, MS, RD, CDE
Clinical Nutrition Manager
Bassett Healthcare
One Atwell Road
Cooperstown, NY 13326
andrea.johnson at bassett.org
607-547-6665


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On
Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 1:35 PM
To: Clinical List
Subject: [Cnm] RD salary or hourly



Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


-------------- next part --------------
A non-text attachment was scrubbed...
Name: Johnson, Andrea.vcf
Type: text/x-vcard
Size: 145 bytes
Desc: Johnson, Andrea.vcf
Url : /pipermail/cnm_lists.my180.net/attachments/20090105/0b6d8d11/attachment.vcf 

From andrea.johnson at bassett.org  Mon Jan  5 13:01:49 2009
From: andrea.johnson at bassett.org (Johnson, Andrea)
Date: Mon, 5 Jan 2009 16:01:49 -0500
Subject: [Cnm] Bariatric surgery
In-Reply-To: <696776B2474A4DC2AE5EE0A72F326264@CAHNS1>
Message-ID: <415700FC732DE14491A3E39367834F7701E6DAE1@ex3.bassett.org>

 
 

Andrea Johnson, MS, RD, CDE 
Clinical Nutrition Manager 
Bassett Healthcare 
One Atwell Road 
Cooperstown, NY 13326 
andrea.johnson at bassett.org 
607-547-6665 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Dawn Berry, RD
Sent: Monday, January 05, 2009 3:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Bariatric surgery



We are about to start a bariatric surgery program (lap band, bypass and sleeve gastrectomy) and I am interested in finding out the level of involvement other RD's have in the Bariatric programs.

 

I have been to the 1st information session and the surgeon spoke at length about the surgery but very little about lifestyle change afterwards - I am uncomfortable with the thought of patients getting into this without knowing exactly what they are getting into.  So here are my questions if you are involved in a bariatric surgery program:

 

1.	Is an RD involved in the information session for interested patients and if so what does the presentation focus on and how long does the presentation last? [Johnson, Andrea] NO  

2.	Does the RD do any PR  for the program or any public info sessions? [Johnson, Andrea] The Rd will on ocassion lead a public info session and  periodically does support groups  

3.	is there something you do in your program that you feel has helped improve outcomes for the patients? [Johnson, Andrea] All patients see the dietitian twice prior to surgery. They are given a homework assignment to plan meals following the surgey this is helpful for the patient and for RD to understand the patient's  level of understanding prior to surgery. 

4.	What do you track for QA and statistics? [Johnson, Andrea] I am not involved in any tracking besides keeping appointments before and after surgery. 

 

Thank you!

 

 

Dawn Berry, RD CDN

Director of Clinical Nutrition

Carthage Area Hospital

1001 West Street

Carthage, NY 13619

 

315-493-1005  ext 3222

cahns at carthageareahospital.com

 



-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/fc2e90f0/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Johnson, Andrea.vcf
Type: text/x-vcard
Size: 145 bytes
Desc: Johnson, Andrea.vcf
Url : /pipermail/cnm_lists.my180.net/attachments/20090105/fc2e90f0/attachment.vcf 

From Heberle-Heather at aramark.com  Mon Jan  5 13:07:21 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Mon, 5 Jan 2009 16:07:21 -0500
Subject: [Cnm] RD salary or hourly
References: <mailman.3.1231185603.13125.cnm_lists.my180.net@lists.my180.net>
Message-ID: <CF3735565E46CC4DBA31E7A3C08BC84E02AA0CE1@STARWEXC32.fss.aramark.com>

all RD's are salary.
 
Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879

________________________________

From: cnm-bounces at lists.my180.net on behalf of cnm-request at lists.my180.net
Sent: Mon 1/5/09 2:00 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 12



Send Cnm mailing list submissions to
        cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
        http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
        cnm-request at lists.my180.net

You can reach the person managing the list at
        cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: RD salary or hourly (Joan Bahr)
   2. Re: RD salary or hourly (Harrison, Kerry)
   3. Re: RD salary or hourly (Sue Teske)
   4. Re: RD salary or hourly (susan)


----------------------------------------------------------------------

Message: 1
Date: Mon, 5 Jan 2009 13:02:12 -0600
From: "Joan Bahr" <bahrj at southwesthealth.org>
Subject: Re: [Cnm] RD salary or hourly
To: <CKeinath at chs-mi.com>, "'Clinical List'" <cnm at lists.my180.net>
Message-ID: <001201c96f68$2042a410$60c7ec30$@org>
Content-Type: text/plain;       charset="us-ascii"

Manager is salaried; part-time RD is hourly.
Joan Bahr RD CDE


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 12:35 PM
To: Clinical List
Subject: [Cnm] RD salary or hourly


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.  

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net




------------------------------

Message: 2
Date: Mon, 5 Jan 2009 13:04:25 -0600
From: "Harrison, Kerry" <kharriso at stagnes.org>
Subject: Re: [Cnm] RD salary or hourly
To: <CKeinath at chs-mi.com>,      "Clinical List" <cnm at lists.my180.net>
Message-ID:
        <9AB3ADBD43ABFD46B0DC4E80280F3B392248BB at ahcmascdc034.DS.SJHS.COM>
Content-Type: text/plain; charset="us-ascii"

Salary, but get on call pay on saturdays.


Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152

To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong
enough to take everything you have.
-Thomas Jefferson


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 1:35 PM
To: Clinical List
Subject: [Cnm] RD salary or hourly


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.  

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.



------------------------------

Message: 3
Date: Mon, 5 Jan 2009 13:50:14 -0600
From: "Sue Teske" <Susan.Teske at chsys.org>
Subject: Re: [Cnm] RD salary or hourly
To: <CKeinath at chs-mi.com>,      "Clinical List" <cnm at lists.my180.net>
Message-ID:
        <3D0B6F497247834CAC5FF0C30ED7A5C402494A49 at chexmain.chsys.org>
Content-Type: text/plain;       charset="us-ascii"

All full-time RDs are salaried, part-time are hourly.

Susan  C. Teske, MS, RD, LD, CNSD
Director, Dept. of Clinical Nutrition and Lactation Services
Children's Health System
1600 7th Ave. South
3rd Floor hospital, Room 334
Birmingham, AL  35233
(205) 939-9203 Office
(205) 939-6047 Fax
susan.teske at chsys.org    


Confidentiality Notice: The information transmitted is intended only for
the person or company to which it is addressed and may contain
confidential or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in reliance upon,
this information by person or company other than the intended recipient
is prohibited. If you receive this in error, please contact the sender
and delete the material from any computer.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Monday, January 05, 2009 12:35 PM
To: Clinical List
Subject: [Cnm] RD salary or hourly


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.  

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material.  Any review, retransmission dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited.  If you receive this in error, please contact the sender and delete the material from any computer.



------------------------------

Message: 4
Date: Mon, 5 Jan 2009 11:54:52 -0800 (PST)
From: susan <sdehoog at u.washington.edu>
Subject: Re: [Cnm] RD salary or hourly
To: Sue Teske <Susan.Teske at chsys.org>
Cc: CKeinath at chs-mi.com, Clinical List <cnm at lists.my180.net>
Message-ID:
        <Pine.LNX.4.43.0901051154520.29451 at hymn14.u.washington.edu>
Content-Type: TEXT/PLAIN; charset=US-ASCII; format=flowed

Classified - .5FTE or > are salaried

Hourly -less than .5FTE



Susan DeHoog
Associate Director
Food and Nutrition
University of Washington Medical Center
BOX 356057
Seattle Washington 98195
(206) 598-4533
email  sdehoog at u.washington.edu
FAX (206) 598-8105
pager (206)540-8874






------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 12
***********************************


-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: application/ms-tnef
Size: 10577 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090105/fe39968a/attachment-0001.bin 

From cketterman at wellspan.org  Mon Jan  5 13:09:10 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Mon, 5 Jan 2009 16:09:10 -0500
Subject: [Cnm] Bariatric surgery
In-Reply-To: <696776B2474A4DC2AE5EE0A72F326264@CAHNS1>
References: <696776B2474A4DC2AE5EE0A72F326264@CAHNS1>
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AC42@EXCH4.wellspan.org>

We have a Clinical Weight Loss Center that provides bariatric surgical
options as well more traditional weight loss options that focus on
behavioral, nutritional and lifestyle changes.  PR is primarily the
responsibility of the director of the center but probably 4 times per
year they offer a community program that promotes all their services and
the whole team (RD included) is part of the presentation panel.   Their
goal is to provide an variety of options for weight loss and find the
best fit for the patient
the PI and data tracking is done at the center -- I'm on the steering
committee and they present the data 4 times per year but it's in-line
with national data.  They have made some changes that brought better
patient outcomes but they were on the physician side of the program.  We
have a FT RD that is a member of our staff.  We recently changed to
group classes for the 6 month medically supervised requirement prior to
surgery but that has only been in effect for 3 months so we don't know
what impact that change will have.  The RD sees each pt individually to
assess readiness and ability to comply with the changes after surgery
(along with a psychologist) and then see them individually again 6 weeks
post opt and then at 4 - 6 months (or sooner) depending upon individual
need.  The RD also participates in the support groups.
Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934
 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Dawn Berry, RD
Sent: Monday, January 05, 2009 3:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Bariatric surgery



We are about to start a bariatric surgery program (lap band, bypass and
sleeve gastrectomy) and I am interested in finding out the level of
involvement other RD's have in the Bariatric programs.

 

I have been to the 1st information session and the surgeon spoke at
length about the surgery but very little about lifestyle change
afterwards - I am uncomfortable with the thought of patients getting
into this without knowing exactly what they are getting into.  So here
are my questions if you are involved in a bariatric surgery program:

 

1.	Is an RD involved in the information session for interested
patients and if so what does the presentation focus on and how long does
the presentation last? 
2.	Does the RD do any PR  for the program or any public info
sessions? 
3.	is there something you do in your program that you feel has
helped improve outcomes for the patients? 
4.	What do you track for QA and statistics? 

 

Thank you!

 

 

Dawn Berry, RD CDN

Director of Clinical Nutrition

Carthage Area Hospital

1001 West Street

Carthage, NY 13619

 

315-493-1005  ext 3222

cahns at carthageareahospital.com

 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________


CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/76469f18/attachment.html 

From jross at jaycountyhospital.com  Mon Jan  5 13:30:32 2009
From: jross at jaycountyhospital.com (Julayne Ross)
Date: Mon, 5 Jan 2009 16:30:32 -0500
Subject: [Cnm] Coumadin/Vit K
Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D01DB54DE@EX1.jaycountyhospital.com>

Anyone ever have a patient whose INR jumps around so much that they
figure out a meal plan to go by?  I have a co-worker and it doesn't
sound like she eats many foods high in vitamin K (she has an occasional
serving of broccoli but doesn't overdo it at all), but she can't get it
under control and the Dr. keeps increasing her Coumadin.  

Any suggestions for me to give her?

Thanks,

Julayne

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/b5ced87b/attachment.html 

From Terese.Scollard at providence.org  Mon Jan  5 13:50:14 2009
From: Terese.Scollard at providence.org (Scollard, Terese)
Date: Mon, 5 Jan 2009 13:50:14 -0800
Subject: [Cnm] Protected Project time for staff
In-Reply-To: <3D0B6F497247834CAC5FF0C30ED7A5C402494A42@chexmain.chsys.org>
Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A03239ECC@wn1221.or.providence.org>

Same here. We do try to designate time for various audits, projects etc.
as the budget allows though. Depends on the project, circumstances and
the timing. 
Terese Scollard, MBA, RD, LD
Regional Clinical Nutition Manager
Providence Health & Services
Portland Service Area
Portland Oregon

________________________________

From: Sue Teske [mailto:Susan.Teske at chsys.org] 
Sent: Monday, January 05, 2009 8:46 AM
To: Dierks, Lisa M., R.D., L.D.; Clinical List
Subject: Re: [Cnm] Protected Project time for staff



All of my full-time RDs are salaried so these things are just part of
their job expectations.

 

Susan  C. Teske, MS, RD, LD, CNSD

Director, Dept. of Clinical Nutrition and Lactation Services

Children's Health System

1600 7th Ave. South

3rd Floor hospital, Room 334 

Birmingham, AL  35233

(205) 939-9203 Office

(205) 939-6047 Fax

susan.teske at chsys.org     

 

 

Confidentiality Notice: The information transmitted is intended only for
the person or company to which it is addressed and may contain
confidential or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in reliance upon,
this information by person or company other than the intended recipient
is prohibited. If you receive this in error, please contact the sender
and delete the material from any computer. 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Dierks, Lisa M., R.D., L.D.
Sent: Monday, January 05, 2009 10:21 AM
To: Clinical List
Subject: [Cnm] Protected Project time for staff

 

Are your staff involved in work related projects outside of their day to
day patient care time?  Examples may be 

				*	Development of proposals and
pilots for practice innovation 
				*	Quality improvement projects 
				*	Prevention of sentinel event 
				*	Performance and development of
patient satisfaction and patient education projects 
				*	Interdivisional or
Interdepartmental project development 
				*	Practice guideline development
and implementation 


How do you ensure that they have time for these commitments?  Do you
offer "protected" or "scholarly activity" time?  

If you do have this option, who decides how much time is granted?  Do
you have a formal system set up? 

Thanks in advance 

Lisa Dierks RD, LD 
Clinical Manager - Hospital Clinical Nutrition
Department of Endocrinology 
Pager: 507-538-2180 
Phone: 507-255-8757 
Secretary: 507-255-5221 
E-mail: Dierks.lisa at mayo.edu <mailto:Dierks.lisa at mayo.edu>  
Mayo Clinic
200 First Street SW
Rochester, MN 55905 
www.mayoclinic.org <http://www.mayoclinic.org/>  

________________________________

The information transmitted is intended only for the person or company
to which it is addressed and may contain confidential or privileged
material. Any review, retransmission dissemination or other use of, or
taking of any action in reliance upon, this information by person or
company other than the intended recipient is prohibited. If you receive
this in error, please contact the sender and delete the material from
any computer. 



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/7e7f184e/attachment.html 

From CBergin at echn.org  Mon Jan  5 13:57:46 2009
From: CBergin at echn.org (Bergin, Carol)
Date: Mon, 5 Jan 2009 16:57:46 -0500
Subject: [Cnm] Order Writing Privileges for the RD
Message-ID: <F3F33241F4E7B64AAADA5DCDE2D7FCFA097FB6F0@echnexchange.echn.org>

Hi,

I am looking for documentation that states it is within the scope of
practice for an RD to order relevant labs necessary to complete the
nutrition assessment, if it is not available.

 

I already have copies of the ADA's "Revised 2008 Standards of Practice
for Registered Dietitians" and "White Paper" (regarding therapeutic diet
orders).  

 

We use Meditech here and are trying to increase the compliance of RD
recommendations in nutrition notes being ordered.  We thought that
completing the ordering ourselves would facilitate the ordering process.
Thank you in advance for any assistance that you can provide.  I will
appreciate it.

 

Carol Bergin, MEd, RD, CD-N

ECHN Clinical Nutrition Manager

Manchester Memorial Hospital

71 Haynes Street

Manchester, CT 06040

Phone     860-533-3411 ext. 2149     

Pager      860-820-5507

E-Mail     cbergin at echn.org <mailto:cbergin at echn.org> 
 
"This message originates from Eastern Connecticut Health Network. The information contained in this message may be privileged and confidential. If you are the intended recipient, you must maintain this message in a secure and confidential manner. If you are not the intended recipient, please notify the sender immediately and destroy this message, Thank you."
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/f4a6b83b/attachment-0001.html 

From robinnrodriguez at gmail.com  Mon Jan  5 14:11:07 2009
From: robinnrodriguez at gmail.com (Robin Rodriguez)
Date: Mon, 5 Jan 2009 14:11:07 -0800
Subject: [Cnm] Cnm Digest, Vol 26, Issue 14
In-Reply-To: <mailman.621.1231192669.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.621.1231192669.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <e21fef8e0901051411s36815e21l9f2ad518a4f3d8d7@mail.gmail.com>

Regarding bariatric surgery:

I am a full time RD in a bariatric surgery program.

The initial information session our patients attend ("orientation") is done
in a class format where a surgeon describes the surgeries, a nurse case
manager describes how our program works, and I describe in detail behavior
changes for surgery, as well as pre and postop meal plans. I do not do
one-to-one assessments, but I am open to consult for patients who request it
or who have special dietary needs. (The assessment for ability to change is
done by our psychologists).
I teach an additional class for preop patients as well as postop classes at
3, 6 and 12 months.

The one thing I have found that seems to make an impact with preop patients
is a preop weight loss requirement. I've seen it documented in literature
that patients who lose weight preoperatively have better outcomes and safer
surgeries. In our program we provide a meal plan for patients to follow and
discourage the use of liquid fasts. I've found this to be effective because
they must learn mindful eating habits such as chewing, measuring and food
journaling preop so they are more prepared postop.

If you're looking for information on bariatric surgery programs, you might
want to consider joining the Weight Management DPG, it has a bariatric
surgery sub group with it's own mailing list.

Robin Rodriguez, MS RD
Bariatric Surgery Department
Kaiser Permanente - Richmond Medical Center
Richmond, CA

On Mon, Jan 5, 2009 at 1:57 PM, <cnm-request at lists.my180.net> wrote:

> Send Cnm mailing list submissions to
>        cnm at lists.my180.net
>
> To subscribe or unsubscribe via the World Wide Web, visit
>        http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
> or, via email, send a message with subject or body 'help' to
>        cnm-request at lists.my180.net
>
> You can reach the person managing the list at
>        cnm-owner at lists.my180.net
>
> When replying, please edit your Subject line so it is more specific
> than "Re: Contents of Cnm digest..."
>
> Today's Topics:
>
>   1. Re: Bariatric surgery (Ketterman-Hopkins, Cindra)
>   2. Coumadin/Vit K (Julayne Ross)
>   3. Re: Protected Project time for staff (Scollard, Terese)
>   4. Order Writing Privileges for the RD (Bergin, Carol)
>
>
> ---------- Forwarded message ----------
> From: "Ketterman-Hopkins, Cindra" <cketterman at wellspan.org>
> To: "Dawn Berry, RD" <cahns at carthageareahospital.com>,<cnm at lists.my180.net
> >
> Date: Mon, 5 Jan 2009 16:09:10 -0500
> Subject: Re: [Cnm] Bariatric surgery
>  We have a Clinical Weight Loss Center that provides bariatric surgical
> options as well more traditional weight loss options that focus on
> behavioral, nutritional and lifestyle changes.  PR is primarily the
> responsibility of the director of the center but probably 4 times per year
> they offer a community program that promotes all their services and the
> whole team (RD included) is part of the presentation panel.   Their goal is
> to provide an variety of options for weight loss and find the best fit for
> the patient
> the PI and data tracking is done at the center -- I'm on the steering
> committee and they present the data 4 times per year but it's in-line with
> national data.  They have made some changes that brought better patient
> outcomes but they were on the physician side of the program.  We have a FT
> RD that is a member of our staff.  We recently changed to group classes for
> the 6 month medically supervised requirement prior to surgery but that has
> only been in effect for 3 months so we don't know what impact that change
> will have.  The RD sees each pt individually to assess readiness and ability
> to comply with the changes after surgery (along with a psychologist) and
> then see them individually again 6 weeks post opt and then at 4 - 6 months
> (or sooner) depending upon individual need.  The RD also participates in the
> support groups.
> Cindra L. Ketterman, M.S., L.D.N., R.D.
> Chief Clinical Dietitian
> Nutrition Support Service
> York Hospital
> 1001 South George Street
> York, PA  17405-7198
> 717-851-3991 or 717-851-2345 ask for pager 0093
> Fax 717-8512934
>
>
>  ------------------------------
> *From:* cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] *On
> Behalf Of *Dawn Berry, RD
> *Sent:* Monday, January 05, 2009 3:35 PM
> *To:* cnm at lists.my180.net
> *Subject:* [Cnm] Bariatric surgery
>
>  We are about to start a bariatric surgery program (lap band, bypass and
> sleeve gastrectomy) and I am interested in finding out the level of
> involvement other RD's have in the Bariatric programs.
>
>
>
> I have been to the 1st information session and the surgeon spoke at length
> about the surgery but very little about lifestyle change afterwards ? I am
> uncomfortable with the thought of patients getting into this without knowing
> exactly what they are getting into.  So here are my questions if you are
> involved in a bariatric surgery program:
>
>
>
>    1. Is an RD involved in the information session for interested patients
>    and if so what does the presentation focus on and how long does the
>    presentation last?
>    2. Does the RD do any PR  for the program or any public info sessions?
>    3. is there something you do in your program that you feel has helped
>    improve outcomes for the patients?
>    4. What do you track for QA and statistics?
>
>
>
> Thank you!
>
>
>
>
>
> Dawn Berry, RD CDN
>
> Director of Clinical Nutrition
>
> Carthage Area Hospital
>
> 1001 West Street
>
> Carthage, NY 13619
>
>
>
> 315-493-1005  ext 3222
>
> cahns at carthageareahospital.com
>
>
>
> ______________________________________________________________________
> This e-mail has been scanned by MCI Managed Email Content Service, using
> Skeptic(tm) technology powered by MessageLabs. For more information on MCI's
> Managed Email Content Service, visit http://www.mci.com.
> ______________________________________________________________________
>
> ______________________________________________________________________
> This e-mail has been scanned by MCI Managed Email Content Service, using
> Skeptic(tm) technology powered by MessageLabs. For more information on MCI's
> Managed Email Content Service, visit http://www.mci.com.
> ______________________________________________________________________
>
> CONFIDENTIALITY NOTICE:
>
> This email may contain confidential health information that is legally
> privileged.  This information is intended for the use of the named
> recipient(s). The authorized recipient of this information is prohibited
> from disclosing this information to any party unless required to do so by
> law or regulation and is required to destroy the information after its
> stated need has been fulfilled.  If you are not the intended recipient, you
> are hereby notified that any disclosure, copying, distribution, or action
> taken in reliance on the contents of this email is strictly prohibited.  If
> you receive this e-mail message in error, please notify the sender
> immediately to arrange disposition of the information.
>
>
> ---------- Forwarded message ----------
> From: "Julayne Ross" <jross at jaycountyhospital.com>
> To: <cnm at lists.my180.net>
> Date: Mon, 5 Jan 2009 16:30:32 -0500
> Subject: [Cnm] Coumadin/Vit K
>
> Anyone ever have a patient whose INR jumps around so much that they figure
> out a meal plan to go by?  I have a co-worker and it doesn't sound like she
> eats many foods high in vitamin K (she has an occasional serving of broccoli
> but doesn't overdo it at all), but she can't get it under control and the
> Dr. keeps increasing her Coumadin.
>
> Any suggestions for me to give her?
>
> Thanks,
>
> Julayne
>
>
> ---------- Forwarded message ----------
> From: "Scollard, Terese" <Terese.Scollard at providence.org>
> To: "Sue Teske" <Susan.Teske at chsys.org>, "Dierks, Lisa M., R.D., L.D." <
> Dierks.Lisa at mayo.edu>, "Clinical List" <cnm at lists.my180.net>
> Date: Mon, 5 Jan 2009 13:50:14 -0800
> Subject: Re: [Cnm] Protected Project time for staff
>  Same here. We do try to designate time for various audits, projects etc.
> as the budget allows though. Depends on the project, circumstances and the
> timing.
> Terese Scollard, MBA, RD, LD
> Regional Clinical Nutition Manager
> Providence Health & Services
> Portland Service Area
> Portland Oregon
>
>  ------------------------------
> *From:* Sue Teske [mailto:Susan.Teske at chsys.org]
> *Sent:* Monday, January 05, 2009 8:46 AM
> *To:* Dierks, Lisa M., R.D., L.D.; Clinical List
> *Subject:* Re: [Cnm] Protected Project time for staff
>
>  All of my full-time RDs are salaried so these things are just part of
> their job expectations.
>
>
>
> *Susan  C. Teske, MS, RD, LD, CNSD*
>
> Director, Dept. of Clinical Nutrition and Lactation Services
>
> Children's Health System
>
> 1600 7th Ave. South
>
> 3rd Floor hospital, Room 334
>
> Birmingham, AL  35233
>
> (205) 939-9203 Office
>
> (205) 939-6047 Fax
>
> susan.teske at chsys.org
>
>
>
>
>
> Confidentiality Notice: The information transmitted is intended only for
> the person or company to which it is addressed and may contain confidential
> or privileged material. Any review, retransmission, dissemination or other
> use of, or taking of any action in reliance upon, this information by person
> or company other than the intended recipient is prohibited. If you receive
> this in error, please contact the sender and delete the material from any
> computer.
>
>
>  ------------------------------
>
> *From:* cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] *On
> Behalf Of *Dierks, Lisa M., R.D., L.D.
> *Sent:* Monday, January 05, 2009 10:21 AM
> *To:* Clinical List
> *Subject:* [Cnm] Protected Project time for staff
>
>
>
> Are your staff involved in work related projects outside of their day to
> day patient care time?  Examples may be
>
>      - Development of proposals and pilots for practice innovation
>                - Quality improvement projects
>                - Prevention of sentinel event
>                - Performance and development of patient satisfaction and
>                patient education projects
>                - Interdivisional or Interdepartmental project development
>                - Practice guideline development and implementation
>
>
> How do you ensure that they have time for these commitments?  Do you offer
> "protected" or "scholarly activity" time?
>
> If you do have this option, who decides how much time is granted?  Do you
> have a formal system set up?
>
> Thanks in advance
>
> *Lisa Dierks RD**, LD*
> Clinical Manager - Hospital Clinical Nutrition
> Department of Endocrinology
> Pager: 507-538-2180
> Phone: 507-255-8757
> Secretary: 507-255-5221
> E-mail: Dierks.lisa at mayo.edu
> *Mayo Clinic*
> 200 First Street SW
> Rochester, MN 55905* *
> www.mayoclinic.org
>
> ------------------------------
> The information transmitted is intended only for the person or company to
> which it is addressed and may contain confidential or privileged material.
> Any review, retransmission dissemination or other use of, or taking of any
> action in reliance upon, this information by person or company other than
> the intended recipient is prohibited. If you receive this in error, please
> contact the sender and delete the material from any computer.
>
>  DISCLAIMER:
> This message is intended for the sole use of the addressee, and may contain
> information that is privileged, confidential and exempt from disclosure
> under applicable law. If you are not the addressee you are hereby notified
> that you may not use, copy, disclose, or distribute to anyone the message or
> any information contained in the message. If you have received this message
> in error, please immediately advise the sender by reply email and delete
> this message.
>
>
> ---------- Forwarded message ----------
> From: "Bergin, Carol" <CBergin at echn.org>
> To: <cnm at lists.my180.net>
> Date: Mon, 5 Jan 2009 16:57:46 -0500
> Subject: [Cnm] Order Writing Privileges for the RD
>
> Hi,
>
> I am looking for documentation that states it is within the scope of
> practice for an RD to order relevant labs necessary to complete the
> nutrition assessment, if it is not available.
>
>
>
> I already have copies of the ADA's "Revised 2008 Standards of Practice for
> Registered Dietitians" and "White Paper" (regarding therapeutic diet
> orders).
>
>
>
> We use Meditech here and are trying to increase the compliance of RD
> recommendations in nutrition notes being ordered.  We thought that
> completing the ordering ourselves would facilitate the ordering process.
>  Thank you in advance for any assistance that you can provide.  I will
> appreciate it.
>
>
>
> *Carol Bergin**, MEd, RD, CD-N*
>
> *ECHN Clinical Nutrition Manager*
>
> *Manchester Memorial Hospital*
>
> *71 Haynes Street*
>
> *Manchester, CT 06040*
>
> *Phone     860-533-3411 ext. 2149     *
>
> *Pager      860-820-5507*
>
> *E-Mail     cbergin at echn.org*
>
>
>
>
>
>  *"This message originates from Eastern Connecticut Health Network. The
> information contained in this message may be privileged and confidential. If
> you are the intended recipient, you must maintain this message in a secure
> and confidential manner. If you are not the intended recipient, please
> notify the sender immediately and destroy this message, Thank you." *
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
>
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/00f16309/attachment.html 

From pcharney at mac.com  Mon Jan  5 14:23:15 2009
From: pcharney at mac.com (Pam Charney)
Date: Mon, 05 Jan 2009 14:23:15 -0800
Subject: [Cnm] Order Writing Privileges for the RD
In-Reply-To: <F3F33241F4E7B64AAADA5DCDE2D7FCFA097FB6F0@echnexchange.echn.org>
References: <F3F33241F4E7B64AAADA5DCDE2D7FCFA097FB6F0@echnexchange.echn.org>
Message-ID: <CEB58216-83DD-493D-AFE1-783878BA73D8@mac.com>

Greetings,

Do you know why the RDs recommendations aren't being taken? Is it  
because the physicians don't agree, or maybe don't read them? Annalynn  
Skipper is the preeminent expert on scope of practice issues, but my  
understanding is that your facility would determine who should be able  
to write orders. Is your facility using CPOE? In that case, in  
addition to having the capability, you have to then be allowed to  
order in CPOE.

Regards,
pam



Pam Charney PhD, RD
Clinical Coordinator
Graduate Coordinated Program in Dietetics
Lecturer, Department of Epidemiology
Nutrition Sciences Program
School of Public Health and Community Medicine
Box 353410, 306-C Raitt Hall

Affiliate Associate Professor
School of Pharmacy

MS Student
Clinical Informatics and Patient Centered Technology
School of Nursing

University of Washington
Seattle, WA
charnepa at u.washington.edu
"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jan 5, 2009, at 1:57 PM, Bergin, Carol wrote:

> Hi,
> I am looking for documentation that states it is within the scope of  
> practice for an RD to order relevant labs necessary to complete the  
> nutrition assessment, if it is not available.
>
> I already have copies of the ADA?s ?Revised 2008 Standards of  
> Practice for Registered Dietitians? and ?White Paper? (regarding  
> therapeutic diet orders).
>
> We use Meditech here and are trying to increase the compliance of RD  
> recommendations in nutrition notes being ordered.  We thought that  
> completing the ordering ourselves would facilitate the ordering  
> process.  Thank you in advance for any assistance that you can  
> provide.  I will appreciate it.
>
> Carol Bergin, MEd, RD, CD-N
> ECHN Clinical Nutrition Manager
> Manchester Memorial Hospital
> 71 Haynes Street
> Manchester, CT 06040
> Phone     860-533-3411 ext. 2149
> Pager      860-820-5507
> E-Mail     cbergin at echn.org
>
>
>
> "This message originates from Eastern Connecticut Health Network.  
> The information contained in this message may be privileged and  
> confidential. If you are the intended recipient, you must maintain  
> this message in a secure and confidential manner. If you are not the  
> intended recipient, please notify the sender immediately and destroy  
> this message, Thank you."
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/f2ed95a8/attachment-0001.html 

From Lauri.Ek at providence.org  Mon Jan  5 14:27:57 2009
From: Lauri.Ek at providence.org (Ek, Lauri M.)
Date: Mon, 5 Jan 2009 13:27:57 -0900
Subject: [Cnm] Protected Project time for staff
In-Reply-To: <37ABAEB17B0B5B40AA0B6118E57CF59A03239ECC@wn1221.or.providence.org>
Message-ID: <E66025C48FBA6C43888E7C65EACEF3A6744C9A@wn1286.ak.providence.org>

Hi Terese,

 

So all your dietitians are salaried?!! My experience in most cases
except at PAMC.  They are clocking employees here!

 

Lauri M. Ek, RD, CDE, LD
Chief Clinical Dietitian
Providence Alaska Medical Center
3200 Providence Drive
Anchorage, Alaska  99508
Lauri.Ek at providence.org
(907) 212-3046
Fax:  (907) 212-4886
Pager:  (907) 212-5800, #3046 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Scollard, Terese
Sent: Monday, January 05, 2009 12:50 PM
To: Sue Teske; Dierks, Lisa M., R.D., L.D.; Clinical List
Subject: Re: [Cnm] Protected Project time for staff

 

Same here. We do try to designate time for various audits, projects etc.
as the budget allows though. Depends on the project, circumstances and
the timing. 

Terese Scollard, MBA, RD, LD
Regional Clinical Nutition Manager

Providence Health & Services

Portland Service Area

Portland Oregon

 

________________________________

From: Sue Teske [mailto:Susan.Teske at chsys.org] 
Sent: Monday, January 05, 2009 8:46 AM
To: Dierks, Lisa M., R.D., L.D.; Clinical List
Subject: Re: [Cnm] Protected Project time for staff

All of my full-time RDs are salaried so these things are just part of
their job expectations.

 

Susan  C. Teske, MS, RD, LD, CNSD

Director, Dept. of Clinical Nutrition and Lactation Services

Children's Health System

1600 7th Ave. South

3rd Floor hospital, Room 334 

Birmingham, AL  35233

(205) 939-9203 Office

(205) 939-6047 Fax

susan.teske at chsys.org     

 

 

Confidentiality Notice: The information transmitted is intended only for
the person or company to which it is addressed and may contain
confidential or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in reliance upon,
this information by person or company other than the intended recipient
is prohibited. If you receive this in error, please contact the sender
and delete the material from any computer. 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Dierks, Lisa M., R.D., L.D.
Sent: Monday, January 05, 2009 10:21 AM
To: Clinical List
Subject: [Cnm] Protected Project time for staff

 

Are your staff involved in work related projects outside of their day to
day patient care time?  Examples may be 

				*	Development of proposals and
pilots for practice innovation 
				*	Quality improvement projects 
				*	Prevention of sentinel event 
				*	Performance and development of
patient satisfaction and patient education projects 
				*	Interdivisional or
Interdepartmental project development 
				*	Practice guideline development
and implementation 


How do you ensure that they have time for these commitments?  Do you
offer "protected" or "scholarly activity" time?  

If you do have this option, who decides how much time is granted?  Do
you have a formal system set up? 

Thanks in advance 

Lisa Dierks RD, LD 
Clinical Manager - Hospital Clinical Nutrition
Department of Endocrinology 
Pager: 507-538-2180 
Phone: 507-255-8757 
Secretary: 507-255-5221 
E-mail: Dierks.lisa at mayo.edu <mailto:Dierks.lisa at mayo.edu>  
Mayo Clinic
200 First Street SW
Rochester, MN 55905 
www.mayoclinic.org <http://www.mayoclinic.org/>  

________________________________

The information transmitted is intended only for the person or company
to which it is addressed and may contain confidential or privileged
material. Any review, retransmission dissemination or other use of, or
taking of any action in reliance upon, this information by person or
company other than the intended recipient is prohibited. If you receive
this in error, please contact the sender and delete the material from
any computer. 

DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message.



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/a5f331ad/attachment.html 

From Terese.Scollard at providence.org  Mon Jan  5 14:29:42 2009
From: Terese.Scollard at providence.org (Scollard, Terese)
Date: Mon, 5 Jan 2009 14:29:42 -0800
Subject: [Cnm] Order Writing Privileges for the RD
In-Reply-To: <F3F33241F4E7B64AAADA5DCDE2D7FCFA097FB6F0@echnexchange.echn.org>
Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A03239EDA@wn1221.or.providence.org>

>From what we understand, we had to go to our medical staff with policy
documents that state exactly what is ok within the scope of the RD. Your
state RD licensure if you have it may have some structure too.  We built
in an electronic selection option in our charting that asks if the RD
reccs were followed for TF and TPN. this is not part of the permanent
record and is only viewable by the dietitians--everyone else is locked
out. But then we query the chart and extract that data if the RD had
clicked in that area. it is pretty slick way to audit. 
Terese Scollard, MBA, RD, LD 
Regional Clinical Nutrition Manager 
Providence Health System-PSA 
Nutrition Services 
503-216-2496 phone 
503-216-2717 fax 


________________________________

From: Bergin, Carol [mailto:CBergin at echn.org] 
Sent: Monday, January 05, 2009 1:58 PM
To: cnm at lists.my180.net
Subject: [Cnm] Order Writing Privileges for the RD



Hi,

I am looking for documentation that states it is within the scope of
practice for an RD to order relevant labs necessary to complete the
nutrition assessment, if it is not available.

I already have copies of the ADA's "Revised 2008 Standards of Practice
for Registered Dietitians" and "White Paper" (regarding therapeutic diet
orders).  

We use Meditech here and are trying to increase the compliance of RD
recommendations in nutrition notes being ordered.  We thought that
completing the ordering ourselves would facilitate the ordering process.
Thank you in advance for any assistance that you can provide.  I will
appreciate it.

Carol Bergin, MEd, RD, CD-N

ECHN Clinical Nutrition Manager

Manchester Memorial Hospital

71 Haynes Street

Manchester, CT 06040

Phone     860-533-3411 ext. 2149     

Pager      860-820-5507

E-Mail     cbergin at echn.org <mailto:cbergin at echn.org> 

 
"This message originates from Eastern Connecticut Health Network. The
information contained in this message may be privileged and
confidential. If you are the intended recipient, you must maintain this
message in a secure and confidential manner. If you are not the intended
recipient, please notify the sender immediately and destroy this
message, Thank you." 


DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/07c464bc/attachment.html 

From LCarver at Reshealthcare.org  Mon Jan  5 14:33:14 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Mon, 5 Jan 2009 16:33:14 -0600
Subject: [Cnm] Protected Project time for staff
In-Reply-To: <E66025C48FBA6C43888E7C65EACEF3A6744C9A@wn1286.ak.providence.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03A33202@rhcexch3.reshealthcare.org>

yes, except for registry (PRN) staff, and including part-time w/
benefits folks.  Leslee

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Ek, Lauri M.
Sent: Monday, January 05, 2009 4:28 PM
To: Scollard, Terese; Sue Teske; Dierks, Lisa M., R.D., L.D.; Clinical
List
Subject: Re: [Cnm] Protected Project time for staff



Hi Terese,

 

So all your dietitians are salaried?!! My experience in most cases
except at PAMC.  They are clocking employees here!

 

Lauri M. Ek, RD, CDE, LD
Chief Clinical Dietitian
Providence Alaska Medical Center
3200 Providence Drive
Anchorage, Alaska  99508
Lauri.Ek at providence.org
(907) 212-3046
Fax:  (907) 212-4886
Pager:  (907) 212-5800, #3046 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Scollard, Terese
Sent: Monday, January 05, 2009 12:50 PM
To: Sue Teske; Dierks, Lisa M., R.D., L.D.; Clinical List
Subject: Re: [Cnm] Protected Project time for staff

 

Same here. We do try to designate time for various audits, projects etc.
as the budget allows though. Depends on the project, circumstances and
the timing. 

Terese Scollard, MBA, RD, LD
Regional Clinical Nutition Manager

Providence Health & Services

Portland Service Area

Portland Oregon

 

________________________________

From: Sue Teske [mailto:Susan.Teske at chsys.org] 
Sent: Monday, January 05, 2009 8:46 AM
To: Dierks, Lisa M., R.D., L.D.; Clinical List
Subject: Re: [Cnm] Protected Project time for staff

All of my full-time RDs are salaried so these things are just part of
their job expectations.

 

Susan  C. Teske, MS, RD, LD, CNSD

Director, Dept. of Clinical Nutrition and Lactation Services

Children's Health System

1600 7th Ave. South

3rd Floor hospital, Room 334 

Birmingham, AL  35233

(205) 939-9203 Office

(205) 939-6047 Fax

susan.teske at chsys.org     

 

 

Confidentiality Notice: The information transmitted is intended only for
the person or company to which it is addressed and may contain
confidential or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in reliance upon,
this information by person or company other than the intended recipient
is prohibited. If you receive this in error, please contact the sender
and delete the material from any computer. 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Dierks, Lisa M., R.D., L.D.
Sent: Monday, January 05, 2009 10:21 AM
To: Clinical List
Subject: [Cnm] Protected Project time for staff

 

Are your staff involved in work related projects outside of their day to
day patient care time?  Examples may be 

				*	Development of proposals and
pilots for practice innovation 
				*	Quality improvement projects 
				*	Prevention of sentinel event 
				*	Performance and development of
patient satisfaction and patient education projects 
				*	Interdivisional or
Interdepartmental project development 
				*	Practice guideline development
and implementation 


How do you ensure that they have time for these commitments?  Do you
offer "protected" or "scholarly activity" time?  

If you do have this option, who decides how much time is granted?  Do
you have a formal system set up? 

Thanks in advance 

Lisa Dierks RD, LD 
Clinical Manager - Hospital Clinical Nutrition
Department of Endocrinology 
Pager: 507-538-2180 
Phone: 507-255-8757 
Secretary: 507-255-5221 
E-mail: Dierks.lisa at mayo.edu <mailto:Dierks.lisa at mayo.edu>  
Mayo Clinic
200 First Street SW
Rochester, MN 55905 
www.mayoclinic.org <http://www.mayoclinic.org/>  

________________________________

The information transmitted is intended only for the person or company
to which it is addressed and may contain confidential or privileged
material. Any review, retransmission dissemination or other use of, or
taking of any action in reliance upon, this information by person or
company other than the intended recipient is prohibited. If you receive
this in error, please contact the sender and delete the material from
any computer. 

DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message.

DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/4c599457/attachment-0001.html 

From mrogard at charter.net  Mon Jan  5 15:36:25 2009
From: mrogard at charter.net (mrogard at charter.net)
Date: Mon, 5 Jan 2009 15:36:25 -0800
Subject: [Cnm] CNM Symposium 2010
In-Reply-To: <A92309ADCC394F57A5D80207AAC3ADAE@LANK1>
Message-ID: <20090105183625.JAICD.864712.root@mp19>

We are in the process of identifying the location of the 2010 symposium.  Hoping to announce at the 2009 symposium.
MJ
--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org
Professional email: mrogard at charter.net

---- Chris and Nancy Lank <cjnhlank at dmv.com> wrote: 
> Does anyone know where the CNM Symposium will be held next year --2010?
> Nancy Lank, MS,RD
> Milton DE



From Terese.Scollard at providence.org  Mon Jan  5 15:47:38 2009
From: Terese.Scollard at providence.org (Scollard, Terese)
Date: Mon, 5 Jan 2009 15:47:38 -0800
Subject: [Cnm] Protected Project time for staff
In-Reply-To: <E66025C48FBA6C43888E7C65EACEF3A6744C9A@wn1286.ak.providence.org>
Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A03239EE1@wn1221.or.providence.org>

yes, however, all are exempt status, but there is a special exempt that
puts some part time and oncall into a clock in and out situation.
Terese Scollard, MBA, RD, LD 
Regional Clinical Nutrition Manager 
Providence Health System-PSA 
Nutrition Services 
503-216-2496 phone 
503-216-2717 fax 


________________________________

From: Ek, Lauri M. 
Sent: Monday, January 05, 2009 2:28 PM
To: Scollard, Terese; Sue Teske; Dierks, Lisa M., R.D., L.D.; Clinical
List
Subject: Re: [Cnm] Protected Project time for staff



Hi Terese,

 

So all your dietitians are salaried?!! My experience in most cases
except at PAMC.  They are clocking employees here!

 

Lauri M. Ek, RD, CDE, LD
Chief Clinical Dietitian
Providence Alaska Medical Center
3200 Providence Drive
Anchorage, Alaska  99508
Lauri.Ek at providence.org
(907) 212-3046
Fax:  (907) 212-4886
Pager:  (907) 212-5800, #3046 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Scollard, Terese
Sent: Monday, January 05, 2009 12:50 PM
To: Sue Teske; Dierks, Lisa M., R.D., L.D.; Clinical List
Subject: Re: [Cnm] Protected Project time for staff

 

Same here. We do try to designate time for various audits, projects etc.
as the budget allows though. Depends on the project, circumstances and
the timing. 

Terese Scollard, MBA, RD, LD
Regional Clinical Nutition Manager

Providence Health & Services

Portland Service Area

Portland Oregon

 

________________________________

From: Sue Teske [mailto:Susan.Teske at chsys.org] 
Sent: Monday, January 05, 2009 8:46 AM
To: Dierks, Lisa M., R.D., L.D.; Clinical List
Subject: Re: [Cnm] Protected Project time for staff

All of my full-time RDs are salaried so these things are just part of
their job expectations.

 

Susan  C. Teske, MS, RD, LD, CNSD

Director, Dept. of Clinical Nutrition and Lactation Services

Children's Health System

1600 7th Ave. South

3rd Floor hospital, Room 334 

Birmingham, AL  35233

(205) 939-9203 Office

(205) 939-6047 Fax

susan.teske at chsys.org     

 

 

Confidentiality Notice: The information transmitted is intended only for
the person or company to which it is addressed and may contain
confidential or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in reliance upon,
this information by person or company other than the intended recipient
is prohibited. If you receive this in error, please contact the sender
and delete the material from any computer. 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Dierks, Lisa M., R.D., L.D.
Sent: Monday, January 05, 2009 10:21 AM
To: Clinical List
Subject: [Cnm] Protected Project time for staff

 

Are your staff involved in work related projects outside of their day to
day patient care time?  Examples may be 

				*	Development of proposals and
pilots for practice innovation 
				*	Quality improvement projects 
				*	Prevention of sentinel event 
				*	Performance and development of
patient satisfaction and patient education projects 
				*	Interdivisional or
Interdepartmental project development 
				*	Practice guideline development
and implementation 


How do you ensure that they have time for these commitments?  Do you
offer "protected" or "scholarly activity" time?  

If you do have this option, who decides how much time is granted?  Do
you have a formal system set up? 

Thanks in advance 

Lisa Dierks RD, LD 
Clinical Manager - Hospital Clinical Nutrition
Department of Endocrinology 
Pager: 507-538-2180 
Phone: 507-255-8757 
Secretary: 507-255-5221 
E-mail: Dierks.lisa at mayo.edu <mailto:Dierks.lisa at mayo.edu>  
Mayo Clinic
200 First Street SW
Rochester, MN 55905 
www.mayoclinic.org <http://www.mayoclinic.org/>  

________________________________

The information transmitted is intended only for the person or company
to which it is addressed and may contain confidential or privileged
material. Any review, retransmission dissemination or other use of, or
taking of any action in reliance upon, this information by person or
company other than the intended recipient is prohibited. If you receive
this in error, please contact the sender and delete the material from
any computer. 

DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message.

DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message. 



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/407b9acf/attachment.html 

From dietitiandarcy at yahoo.com  Mon Jan  5 16:47:31 2009
From: dietitiandarcy at yahoo.com (Darcy Butler)
Date: Mon, 5 Jan 2009 16:47:31 -0800 (PST)
Subject: [Cnm] RD salary or hourly
In-Reply-To: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
Message-ID: <810670.66908.qm@web57408.mail.re1.yahoo.com>

For those of you who are salary do you get extra pay for on-call, weekends and holidays or is that included into your salary?

I'm pretty much the 1 and only even though my hospital does have 2 PRNs.  I'm hourly and I have to watch my time if I'm over and then if census is low and I could leave early I have to use my PTO time if I want to be paid for 8 hour day to be able to get a full 40 hr/wk pay.  The 2 PRNs are also hourly.

Is salary better then hourly or vise versa?
Thanks,
Darcy

CKeinath at chs-mi.com wrote: 
Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



Darcy Butler, RD, LD

 Ponca City, Oklahoma 74601


       
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/51b7d33f/attachment.html 

From LCarver at Reshealthcare.org  Mon Jan  5 06:20:25 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Mon, 5 Jan 2009 08:20:25 -0600
Subject: [Cnm] interviewing
In-Reply-To: <77F33794DD223B40BF24AB3D37930250172B0A0280@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03A32E7D@rhcexch3.reshealthcare.org>

we never hire a dietitian w/out doing "peer interviews".  the staff just
needs some basic training about questions not to ask (i.e. do you have
children?, what is your ethnic background?, etc) and some ideas for
questions perhaps.  we try to have 2 RD's involved in the peer interview
and the process lasts ~ 1/2 hr.
 
I have only pro's from my viewpoint:  more than one set of eyes to help
in the eval, a buy in once the decision is made, and an increased
commitment to training the new person.  also, the potential employee
gets to meet some of the staff.  
 
Of course, you do not want "problem" employees involved in the
process...it should be an honor to be asked to do a peer interview.
Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Fynan, Carla
Sent: Monday, January 05, 2009 6:01 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] interviewing



Good Morning!

 

I am a new CNM and am interviewing new candidates for a RD slot.  In the
past the CNM had the RD/DTR team involved with the process.  Does anyone
have ideas about that?  Pros and Cons?

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately. 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/2043f151/attachment-0001.html 

From marissa.hofman at ucdmc.ucdavis.edu  Mon Jan  5 18:34:53 2009
From: marissa.hofman at ucdmc.ucdavis.edu (Marissa Hofman)
Date: Mon, 5 Jan 2009 18:34:53 -0800
Subject: [Cnm] interviewing
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E03A32E7D@rhcexch3.reshealthcare.org>
Message-ID: <OF4562A856.1131FD8F-ON88257536.000DD98B-88257536.000E2DD5@ucdmc.ucdavis.edu>


I agree with Leslee.  We interview in a panel with 3-4 interviewees, myself
always included.  It is an honor for the staff to sit on an interview panel
and I review guidelines and procedures before hand. I also create a set of
planned interview questions that we each take turns on.  I do inform
candidates beforehand and it is appreciated as interviewing with multiple
people can be intimidating.

If second interviews are needed, I then have additional staff meet the top
2 candidates.  It fosters buy-in for the current staff and they appreciate
having some input.

I will also say that you do have to choose wisely on who interviews the
candidate with you.


Marissa Hofman, RD
Clinical Nutrition Manager
UC Davis Medical Center
Food & Nutrition Dept.
2315 Stockton Blvd
Sacramento, CA 95817
Phone: (916) 734-5100
Fax: (916)734-3154


                                                                           
             "Carver, Leslee"                                              
             <LCarver at Reshealt                                             
             hcare.org>                                                 To 
             Sent by:                  "Fynan, Carla"                      
             cnm-bounces at lists         <fynan-carla at CooperHealth.edu>,     
             .my180.net                <Cnm at lists.my180.net>               
                                                                        cc 
                                                                           
             01/05/2009 06:20                                      Subject 
             PM                        Re: [Cnm] interviewing              
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           




we never hire a dietitian w/out doing "peer interviews".  the staff just
needs some basic training about questions not to ask (i.e. do you have
children?, what is your ethnic background?, etc) and some ideas for
questions perhaps.  we try to have 2 RD's involved in the peer interview
and the process lasts ~ 1/2 hr.

I have only pro's from my viewpoint:  more than one set of eyes to help in
the eval, a buy in once the decision is made, and an increased commitment
to training the new person.  also, the potential employee gets to meet some
of the staff.

Of course, you do not want "problem" employees involved in the process...it
should be an honor to be asked to do a peer interview.  Leslee Carver

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Fynan, Carla
Sent: Monday, January 05, 2009 6:01 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] interviewing

Good Morning!

I am a new CNM and am interviewing new candidates for a RD slot.  In the
past the CNM had the RD/DTR team involved with the process.  Does anyone
have ideas about that?  Pros and Cons?

Thanks!

Carla Fynan, RD
Clinical Nutrition Manager
Food & Nutrition Department
Cooper University Hospital
One Cooper Paza
Camden, NJ 08103
(856) 342-2320




**************************************************************** This
email, including attachments, may include confidential and/or proprietary
information, and may be used only by the person or entity to which it is
addressed. If the reader of this email is not the intended recipient or his
or her authorized agent, the reader is hereby notified that any
dissemination, distribution, or copying of this email is prohibited. If you
received this email in error, please notify the sender by replying to this
message and delete this email immediately.
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/3eb27fa4/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: graycol.gif
Type: image/gif
Size: 105 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090105/3eb27fa4/attachment.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: pic26134.gif
Type: image/gif
Size: 1255 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090105/3eb27fa4/attachment-0001.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: ecblank.gif
Type: image/gif
Size: 45 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090105/3eb27fa4/attachment-0002.gif 

From kmershon at bak.rr.com  Mon Jan  5 21:48:32 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Mon, 5 Jan 2009 21:48:32 -0800
Subject: [Cnm] Liability Insurance
In-Reply-To: <004a01c96eea$11b00240$351006c0$@net>
References: <004a01c96eea$11b00240$351006c0$@net>
Message-ID: <C650BC9868F74BD99F24489FF2F06B6F@KathyPC>

I carry $2 mil through ADA's liability insurance provider Marsh Seabury. Premium is under $200 per year. I purchased when doing consulting but continue to keep coverage to keep my options open. 
Kathleen Mershon, RD
  ----- Original Message ----- 
  From: Jo Lynn Worden 
  To: 'CNM Mailing List' 
  Sent: Sunday, January 04, 2009 7:59 PM
  Subject: [Cnm] Liability Insurance


  Does anyone know anything about getting liability insurance.?

   

  I am covered through my company as a dietitian, but I also teach nutrition at a local university. They want proof of liability insurance (a new thing, worked for them 10 years and this is the first time they want it).  Anyway, I sent off for a policy through Healthcare Providers Service Organization,. Hatboro, PA  (provided by American Casualty Company, Chicago, IL) Is this the one that ADA sends out information on from time to time.   Before I pay the premium, I thought I would check to see if anyone else has had to get coverage for anything - and who/what you did. 

   

  Thanks in advance, 

  Jo Worden



------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/01da6abf/attachment.html 

From kmershon at bak.rr.com  Mon Jan  5 21:38:55 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Mon, 5 Jan 2009 21:38:55 -0800
Subject: [Cnm] RD salary or hourly
In-Reply-To: <810670.66908.qm@web57408.mail.re1.yahoo.com>
References: <810670.66908.qm@web57408.mail.re1.yahoo.com>
Message-ID: <1704C1DAEAC640E8BA1879E2E791C918@KathyPC>

When salaried, there is no additional compensation. Thus the term salary rather than wage per hour. That said, I also don't have to watch the clock i.e. if I need to leave a few minutes early or come in a few minutes later, my checks are not docked. I am on call 24/7 (except when on vacation) as a manager but my staff are the ones who take patient calls and chart and go in to complete assessments on the weekends. In CA, to be salaried, 51% of your time must be in management. So my staff RDs are hourly but I would present the argument that other clinical professions are salaried and are "doing" not managing. Our hospital is the only one in town that has the staff RDs hourly. 

I believe there are plusses and minuses to both. It is hard for my staff RDs to tell a doctor, "Oops, sorry, have to get off the clock" or the nurse or the patient. We have zero overtime target goals but it does happen from time to time for this reason. 

Kathleen Mershon, RD

My staff RDs are hourly and are paid on call pay, holiday pay, and overtime. 
  ----- Original Message ----- 
  From: Darcy Butler 
  To: cnm at lists.my180.net 
  Sent: Monday, January 05, 2009 4:47 PM
  Subject: Re: [Cnm] RD salary or hourly


  For those of you who are salary do you get extra pay for on-call, weekends and holidays or is that included into your salary?

  I'm pretty much the 1 and only even though my hospital does have 2 PRNs.  I'm hourly and I have to watch my time if I'm over and then if census is low and I could leave early I have to use my PTO time if I want to be paid for 8 hour day to be able to get a full 40 hr/wk pay.  The 2 PRNs are also hourly.

  Is salary better then hourly or vise versa?
  Thanks,
  Darcy

  CKeinath at chs-mi.com wrote:

    Can you tell me if your RDs are salary or hourly?

    Thanks,
    Carol Keinath

    -------------------------------------------------------------------------

    This email may contain legally privileged and/or confidential
    information. If you are not the intended recipient, or the employee
    or agent responsible for delivery of this message to the intended
    recipient, you are hereby notified that any dissemination,
    distribution or copying of this email is strictly prohibited. If
    you have received this message in error, please immediately notify
    the sender and delete this email from your computer. Your
    cooperation is appreciated. 

    _______________________________________________
    Cnm mailing list
    Cnm at lists.my180.net
    http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net





  Darcy Butler, RD, LD

  Ponca City, Oklahoma 74601




------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090105/4d7c1619/attachment.html 

From Janet.Ross at healthall.com  Tue Jan  6 03:17:08 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Tue, 6 Jan 2009 06:17:08 -0500
Subject: [Cnm] RD salary or hourly
In-Reply-To: <1704C1DAEAC640E8BA1879E2E791C918@KathyPC>
References: <810670.66908.qm@web57408.mail.re1.yahoo.com>
	<1704C1DAEAC640E8BA1879E2E791C918@KathyPC>
Message-ID: <41CA05D55BF105489D33F8E57D71A90517169865EF@MAIL-C.healthall.com>

When census is low, management prefers hourly; when census is high, management prefers salaried.  The key is to pick one and stick by it.  Wage and hour looks unkindly at employers who switch job titles back and forth.

Jan Ross
Clinical Nutrition Coordinator
418-2603, Drake Center
  "Attitude is a little thing that makes a big difference."  Winston Churchill
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Kathleen Mershon
Sent: Tuesday, January 06, 2009 12:39 AM
To: Darcy Butler; cnm at lists.my180.net
Subject: Re: [Cnm] RD salary or hourly

When salaried, there is no additional compensation. Thus the term salary rather than wage per hour. That said, I also don't have to watch the clock i.e. if I need to leave a few minutes early or come in a few minutes later, my checks are not docked. I am on call 24/7 (except when on vacation) as a manager but my staff are the ones who take patient calls and chart and go in to complete assessments on the weekends. In CA, to be salaried, 51% of your time must be in management. So my staff RDs are hourly but I would present the argument that other clinical professions are salaried and are "doing" not managing. Our hospital is the only one in town that has the staff RDs hourly.

I believe there are plusses and minuses to both. It is hard for my staff RDs to tell a doctor, "Oops, sorry, have to get off the clock" or the nurse or the patient. We have zero overtime target goals but it does happen from time to time for this reason.

Kathleen Mershon, RD

My staff RDs are hourly and are paid on call pay, holiday pay, and overtime.
----- Original Message -----
From: Darcy Butler<mailto:dietitiandarcy at yahoo.com>
To: cnm at lists.my180.net<mailto:cnm at lists.my180.net>
Sent: Monday, January 05, 2009 4:47 PM
Subject: Re: [Cnm] RD salary or hourly

For those of you who are salary do you get extra pay for on-call, weekends and holidays or is that included into your salary?

I'm pretty much the 1 and only even though my hospital does have 2 PRNs.  I'm hourly and I have to watch my time if I'm over and then if census is low and I could leave early I have to use my PTO time if I want to be paid for 8 hour day to be able to get a full 40 hr/wk pay.  The 2 PRNs are also hourly.

Is salary better then hourly or vise versa?
Thanks,
Darcy

CKeinath at chs-mi.com wrote:

Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


Darcy Butler, RD, LD
Ponca City, Oklahoma 74601
________________________________
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/bb2891e9/attachment.html 

From Julie.Finney at csauh.com  Tue Jan  6 05:03:31 2009
From: Julie.Finney at csauh.com (Finney, Julie)
Date: Tue, 6 Jan 2009 08:03:31 -0500
Subject: [Cnm] RD salary or hourly
In-Reply-To: <810670.66908.qm@web57408.mail.re1.yahoo.com>
References: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
	<810670.66908.qm@web57408.mail.re1.yahoo.com>
Message-ID: <B9A8C7549DCFE748BFF67E8AB640572603012A59@csauhex02.csauh.com>

Dietitians working weekends or holidays are paid the weekend
differential and receive holiday pay.  (I enter their hours into KRONOS
in a different manner so that they receive these differentials.)  I like
salaried, because it is one group of people that I don't have to watch
hours on a daily basis, but if the census is low, people do need to be
prepared to take the entire day off because salaried staff are paid for
8 hours whether they work 6 hours and get the work done, or need to stay
for 10.  Not everyone likes that concept.

 

Julie

 

Julie Finney, MS, RD, LD

Clinical Nutrition Manager

Mercy Medical Center

1320 Mercy Drive, NW

Canton, Ohio 44708

330-489-1000 ext. 1600

 

Julie.Finney at csauh.com

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Darcy Butler
Sent: Monday, January 05, 2009 7:48 PM
To: cnm at lists.my180.net
Subject: Re: [Cnm] RD salary or hourly

 

For those of you who are salary do you get extra pay for on-call,
weekends and holidays or is that included into your salary?

I'm pretty much the 1 and only even though my hospital does have 2 PRNs.
I'm hourly and I have to watch my time if I'm over and then if census is
low and I could leave early I have to use my PTO time if I want to be
paid for 8 hour day to be able to get a full 40 hr/wk pay.  The 2 PRNs
are also hourly.

Is salary better then hourly or vise versa?
Thanks,
Darcy

CKeinath at chs-mi.com wrote:


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated. 

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net





Darcy Butler, RD, LD

Ponca City, Oklahoma 74601

  




-----------------------------------------
The enclosed information is STRICTLY CONFIDENTIAL and is intended
for the use of the addressee only.   CSAHS/UHHS-Canton, Inc and its
affiliates disclaim any responsibility for unauthorized disclosure
of this information other than the addressee.

Federal and Ohio law protect patient medical information disclosed
in this email, including psychiatric disorders, (HIV) test results,
AIDs-related conditions, alcohol, and/or drug dependence or abuse.
Federal regulation (42 CFR Part 2) and Ohio Revised Code section
5122.31 and 3701.243 prohibit disclosure of this information
without the specific written consent of the person to whom it
pertains, or as otherwise permitted by law.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/2f26fd58/attachment-0001.html 

From kharriso at stagnes.org  Tue Jan  6 06:30:41 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Tue, 6 Jan 2009 08:30:41 -0600
Subject: [Cnm] Nutrition and Wounds
In-Reply-To: <00a801c8e1d1$e01de850$6400a8c0@Front>
References: <mailman.19813.1215612889.3834.cnm_lists.my180.net@lists.my180.net><69DD80845D7F524BB1C8C59479ED062501016A97@exchsvfulton01.mx.state.mo.us>
	<00a801c8e1d1$e01de850$6400a8c0@Front>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B39224A26@ahcmascdc034.DS.SJHS.COM>

Hi everyone,

We have an outpatient wound clinic that does not employ an RD.  I am on
the inpatient wound care team and want to develop handouts for the
clinic that can help with nutrition and healing.  Anyone already have
anything made that relates to nutrition and wounds that they would be
willing to share?  Thank you in advance.

Kerry

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 


_____________________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Janet Skates
Sent: Wednesday, July 09, 2008 10:42 AM
To: 'Hornick, Leslie G.'
Cc: cnm at lists.my180.net
Subject: Re: [Cnm] outcomes measures

Leslie,

Schneider (Schneider PJ.  Nutrition support teams: an evidence-based
practice. Nutr Clin Pract  2006;21:62-67) has identified examples of
performance aims for a nutrition support team.  Each aim is consistent
with the IOM's six aims for improvement and each is framed as measurable
team performance goals.  They can be useful as QA outcomes measures for
critical care nutrition and can get you thinking about how to approach
QA for other nutrition areas. 

*	Aim #1: Nutrition support should be indicated. No patient should
receive expensive, potentially risky treatment unless it is clearly
needed. 
Goal: The team will improve the ordering system so that 100% of patient
records meet predefined clinical indications before treatment begins. 

*	Aim #2: The route of administration should be appropriate. The
improper method for providing specialized nutrition support can result
in unnecessary costs and risk. 
Goal: The team will improve the selection of access route so that 100%
of patients who can be fed enterally are fed via this route. 

*	Aim #3. The patient should benefit from therapy. No patient
should receive expensive, potentially risky treatment unless there is
meaningful clinical improvement. 
Goal. The team will improve the monitoring of nutrition therapy so that
100% of patients who receive nutrition support are shown to improve
clinically according to pretreatment goals. 

*	Aim #4. The incidence of complications should be low.
Complications are inevitable, but using proper techniques can minimize
their rate. 
Goal. The team will standardize ordering, preparing, and administering
nutrition support so that the infection rate, glucose imbalance, fluid
and electrolyte alterations, and acid-base disturbances are reduced
compared with baseline frequencies. 

*	Aim #5. The patient should understand the risks and benefits of
therapy. The choice to use expensive or risky treatment should involve
the patient. 
Goal. The team will improve patient education so that 100% of patients
understand the risks and benefits of nutrition support before treatment
is initiated, as documented by signed informed consent. 

*	Aim #6. The proper quantity of nutrition substrate should be
ordered. Too much or too little substrate can predispose patients to
harm. 
Goal. The team will improve the ordering process so that no patients are
over- or underfed according to clinical practice guidelines. 

*	Aim #7. The proper quantity of nutrition support should be
administered. If nutrition support is administered incorrectly, the
wrong quantities of nutrition support substrates will be given even if
the order is correct. 
Goal. The team will improve the method of administering nutrition so
that 100% of patients receive the appropriate quantity of nutrition
support substrate. 

*	Aim #8. The patient should not experience a detrimental
drug-nutrient interaction. Nutrition can interact negatively with other
prescribed drug treatment if not properly monitored. 
Goal. The team will improve the process of screening orders in the
pharmacy and monitoring patients who receive nutrition support so that
no patients have predictable and preventable drug-nutrient interactions.


*	Aim #9. The patient should receive nutrition support in a timely
manner. Nutrition therapy should be provided promptly after treatment
decisions are made. 
Goal. The team will reduce the time from order to start of treatment to
2 hours


Janet
Janet Skates MS, RD, LDN, CNSD, FADA
Nutrition Consulting Services
Kingsport, TN  37663
janetskates at yahoo.com
(423) 239-7176

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Hornick, Leslie G.
Sent: Wednesday, July 09, 2008 9:42 AM
To: cnm at lists.my180.net
Subject: [Cnm] outcomes measures

I would love to know more about this...if anyone has any examples of QA
outcomes measures or good references, please share.  Thanks.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of cnm-request at lists.my180.net
Sent: Wednesday, July 09, 2008 9:15 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 20, Issue 54

Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Was Retaining New RDS, now outcome measures (Leibhart, Rosanne)


----------------------------------------------------------------------

Message: 1
Date: Wed, 9 Jul 2008 09:28:10 -0400
From: "Leibhart, Rosanne" <Rosanne.Leibhart at crozer.org>
Subject: [Cnm] Was Retaining New RDS, now outcome measures
To: <jwmsrd at earthlink.net>, "SORACCO, KELLY"
	<KSoracco at lutheran-hosp.com>,	"Wells, Khongmany
ARMC-Nutrition
	Services" <WellsK at armc.sbcounty.gov>, 	<cnm at lists.my180.net>
Message-ID:
	
<1904FBE1EFD42940AA44982E67B5B44E027FE379 at exchange02.CKHSAD.CROZER.ORG>
	
Content-Type: text/plain; charset="us-ascii"

Just to add to this conversation-

Last week we had surveyors from Health Facilities Accreditation Program
(HFAP, formerly AOA)

The nutrition interview went well except when he asked me the question
"Why do you do a nutrition consult?"

I began my response with  "physician orders......" 

he cut me off and said " wrong answer."

I began to clarify that there are many ways a patient can come to our
attention, nursing screens etc.

He basically said he was not interested in any of that. He wanted to
know what is it that we do for the patient, what is the efficacy of your
service....are you just pushing a pen to complete a consult? He said he
was looking for QA on outcome measures. He did not care about QA that
states we answered X number of consults in whatever timeframe we had
established.

While there was no citation on this, our hospital president heard the
interview and wants us to change our QA to outcome measures.

I am not sure how I will proceed but we recently switched over to the
Nutrition Care Process and I think it will be easier to get the data.

Rosanne Leibhart, RD  

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Jo Lynn Worden
Sent: Tuesday, July 08, 2008 8:11 PM
To: 'SORACCO, KELLY'; 'Wells, Khongmany ARMC-Nutrition Services';
cnm at lists.my180.net
Subject: Re: [Cnm] Retaining New RDS

 

Please post to list. 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of SORACCO, KELLY
Sent: Tuesday, July 08, 2008 12:15 PM
To: Wells, Khongmany ARMC-Nutrition Services; cnm at lists.my180.net
Subject: [Cnm] Retaining New RDS

 

Excellent Discussion!  Thanks to everyone that has responded so far.  I
like Khongmany 's last question and would like to encourage further
responses on this subject: What are others out there doing to improve
patient outcomes and how is this being show cased?   

 

Kelly Soracco, MS, RD

Patient Services Manager

Lutheran, St Joe & Rehab Hospitals

ksoracco at lutheran-hosp.com <mailto:ksoracco at lutheran-hosp.com> 

260-435-7983 phone

260-435-6999 fax

 

________________________________

From: Wells, Khongmany ARMC-Nutrition Services
[mailto:WellsK at armc.sbcounty.gov] 
Sent: Tuesday, July 08, 2008 12:34 PM
To: SORACCO, KELLY; cnm at lists.my180.net
Subject: RE: [Cnm] Retaining New RDS

 

I don't think it is happening with just new grads. I know of several
dietitians who have gone back to school to pursue another career that
would, of course, get them more pay, more recognition, and more
authority.  One dietitian is going back to school to do Pre-Med and she
has been an RD for 10 years.  Another went to PA school after 5 years of
working as an RD and an intern that we had last year went on to Pharmacy
School after she finished her internship.   One dietitian dropped her RD
all together and is working as a Hospital Administrator with her MBA.  

 

It's hard to find dietitians in general, at least in our area. I only
have one applicant on my list of candidates for interview and I am still
in search of a qualified candidate (position has been opened since
February).   

 

  I've been lucky that I have not had much turn over.  The newest one in
the field has been with us for almost two years-not sure how much longer
she will stay given that other hospitals around the area are offering
more pay.  I have another dietitian who is constantly looking for
another job but continue to stay on board b/c we are a trauma center and
offer a lot of challenging patients for him to work with.   We are a
county facility and many stay on b/c of the good retirement plan, but
many people don't look to that first-they look at the $ amount that they
are being paid.  I am looking at creating a career ladder or trying to
get some extra compensation for CNSDs and CDEs at least; but I know that
is going to be a challenge being a County system and there are not a lot
of hospitals out there that compensate for extra certifications.  

 

In regards to dietitians not being valued and they want to make more of
a difference, I often feel that way myself sometimes-but b/c I do enjoy
what I am doing for the most part I am sticking with it-at least for
now.  It is very discouraging to see other positions within the County
with less educational background and less responsibilities receive  as
much or more money as our profession (clinical RD and myself included).
My DTR will make more money as a secretary (that is another story).   I
try not to look at that since it will just get me more discouraged.   My
goal for our staff is to be recognized like other disciplines (PT for
their LIFT Team, Social Services for helping to decrease LOS, and of
coarse nursing for their quality nursing care).   I am often talking to
the dietitians about wanting to show admin that we do make an impact on
the patients' outcome b/c I don't think admin really understands what we
do in clinical nutrition.  I know our CEO has really good intentions and
he urges us to provide quality care to our patients, but he does not
fully understand the role that we play in patient care.   When Nutrition
is recognized, we are often recognized for the GREAT Food and great
service provided at the Employee Picnic etc.  Although I don't mind
being associated with Foodservice, I would like to see what we can do to
make our Clinical Nutrition Section better recognized.  What are others
out there doing to improve patient outcomes and how is this being show
cased?   

Khongmany Wells, RD, MPH, CNSD

Colton CA

(909) 580-2466

________________________________

From: cnm-bounces at lists.my180.net on behalf of SORACCO, KELLY
Sent: Sun 7/6/2008 7:18 PM
To: cnm at lists.my180.net
Subject: [Cnm] Retaining New RDS

I have a staff of 10 Clinical RDS.  5 are fairly new to the field (less
than 4 years) and 4 of them are seriously looking into PA school. They
feel dietitians are not valued and they want to make more of a
difference.    3 of them received, for the first time in our facility
for RDs, a hefty sign on or loan forgiveness bonus to the tune of $8000
with a 2 year contract.  I get the feeling they will bail at the end of
this time frame.  I felt I really hired some exceptional candidates who
would stay, and now it seems that I can't trust my instincts!  

 

Is anyone else experiencing this with new grads?  Is this a generational
thing (no offense to you young managers)?  I am at a loss.  How have you
retained your RDS?  

Kelly Soracco, MS, RD

Patient Services Manager

Lutheran & St. Joseph Hospitals

435-7983

 

________________________________

________________________________

Disclaimer: This electronic message may contain information that is
Proprietary, Confidential, or legally privileged or protected. It is
intended only for the use of the individual(s) and entity named in the
message. If you are not an intended recipient of this message, please
notify the sender immediately and delete the material from your
computer. Do not deliver, distribute or copy this message and do not
disclose its contents or take any action in reliance on the information
it contains.

-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20080709/605145d2/attachment.
html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 20, Issue 54
***********************************

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net << File:
ATT1629416.txt >> 

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/6c8f74ed/attachment-0001.html 

From Letitia.Hess at cchmc.org  Tue Jan  6 06:46:58 2009
From: Letitia.Hess at cchmc.org (Letitia Hess)
Date: Tue, 06 Jan 2009 09:46:58 -0500
Subject: [Cnm] copy of Future Dimensions article
Message-ID: <49632892020000B700039417@n6mcgw16.cchmc.org>

Does anyone have the Spring 2001 copy of Future Dimensions? (The on-line archive does not go back that far.)
I am looking for the article on the 1999 CNM staffing survey in that issue.

Thank you.

Letitia Hess, MS, RD, LD
Senior Clinical Director
Nutrition Therapy Division - ML  5043
Cincinnati Children's Hospital Medical Center
3333 Burnet Ave.
Cincinnati, OH  45229
tel:  513/636-7285
fax:  513/636-5887
email:  letitia.hess at cchmc.org




From Cathy.Poquette at stjoe.org  Tue Jan  6 06:52:55 2009
From: Cathy.Poquette at stjoe.org (Cathy Poquette)
Date: Tue, 6 Jan 2009 06:52:55 -0800
Subject: [Cnm] Nutrition and Wounds
In-Reply-To: <9AB3ADBD43ABFD46B0DC4E80280F3B39224A26@ahcmascdc034.DS.SJHS.COM>
References: <mailman.19813.1215612889.3834.cnm_lists.my180.net@lists.my180.net><69DD80845D7F524BB1C8C59479ED062501016A97@exchsvfulton01.mx.state.mo.us>
	<00a801c8e1d1$e01de850$6400a8c0@Front>,
	<9AB3ADBD43ABFD46B0DC4E80280F3B39224A26@ahcmascdc034.DS.SJHS.COM>
Message-ID: <E3453D1D67CA5E4DA378CB009C9AD6A66EAD98EC45@SJSNT-SCMAIL01.stjoe.org>

I am very interested in this kind of handout too.  Please share any handout(s) with me.

Thanks in advance.

Cathy Poquette, MS, RD
Clinical Nutrition Operations Manager
St Jude Medical Center
Fullerton, CA  92835
(714) 992-3000, ext. 3897
________________________________
From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Harrison, Kerry [kharriso at stagnes.org]
Sent: Tuesday, January 06, 2009 6:30 AM
Cc: cnm at lists.my180.net
Subject: [Cnm] Nutrition and Wounds


Hi everyone,

We have an outpatient wound clinic that does not employ an RD.  I am on the inpatient wound care team and want to develop handouts for the clinic that can help with nutrition and healing.  Anyone already have anything made that relates to nutrition and wounds that they would be willing to share?  Thank you in advance.

Kerry

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152



To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong enough to take everything you have.
-Thomas Jefferson

_____________________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Janet Skates
Sent: Wednesday, July 09, 2008 10:42 AM
To: 'Hornick, Leslie G.'
Cc: cnm at lists.my180.net
Subject: Re: [Cnm] outcomes measures

Leslie,

Schneider (Schneider PJ.  Nutrition support teams: an evidence-based practice. Nutr Clin Pract  2006;21:62-67) has identified examples of performance aims for a nutrition support team.  Each aim is consistent with the IOM?s six aims for improvement and each is framed as measurable team performance goals.  They can be useful as QA outcomes measures for critical care nutrition and can get you thinking about how to approach QA for other nutrition areas.

?       Aim #1: Nutrition support should be indicated. No patient should receive expensive, potentially risky treatment unless it is clearly needed.

Goal: The team will improve the ordering system so that 100% of patient records meet predefined clinical indications before treatment begins.

?       Aim #2: The route of administration should be appropriate. The improper method for providing specialized nutrition support can result in unnecessary costs and risk.

Goal: The team will improve the selection of access route so that 100% of patients who can be fed enterally are fed via this route.

?       Aim #3. The patient should benefit from therapy. No patient should receive expensive, potentially risky treatment unless there is meaningful clinical improvement.

Goal. The team will improve the monitoring of nutrition therapy so that 100% of patients who receive nutrition support are shown to improve clinically according to pretreatment goals.

?       Aim #4. The incidence of complications should be low. Complications are inevitable, but using proper techniques can minimize their rate.

Goal. The team will standardize ordering, preparing, and administering nutrition support so that the infection rate, glucose imbalance, fluid and electrolyte alterations, and acid-base disturbances are reduced compared with baseline frequencies.

?       Aim #5. The patient should understand the risks and benefits of therapy. The choice to use expensive or risky treatment should involve the patient.

Goal. The team will improve patient education so that 100% of patients understand the risks and benefits of nutrition support before treatment is initiated, as documented by signed informed consent.

?       Aim #6. The proper quantity of nutrition substrate should be ordered. Too much or too little substrate can predispose patients to harm.

Goal. The team will improve the ordering process so that no patients are over- or underfed according to clinical practice guidelines.

?       Aim #7. The proper quantity of nutrition support should be administered. If nutrition support is administered incorrectly, the wrong quantities of nutrition support substrates will be given even if the order is correct.

Goal. The team will improve the method of administering nutrition so that 100% of patients receive the appropriate quantity of nutrition support substrate.

?       Aim #8. The patient should not experience a detrimental drug-nutrient interaction. Nutrition can interact negatively with other prescribed drug treatment if not properly monitored.

Goal. The team will improve the process of screening orders in the pharmacy and monitoring patients who receive nutrition support so that no patients have predictable and preventable drug-nutrient interactions.

?       Aim #9. The patient should receive nutrition support in a timely manner. Nutrition therapy should be provided promptly after treatment decisions are made.

Goal. The team will reduce the time from order to start of treatment to 2 hours

Janet

Janet Skates MS, RD, LDN, CNSD, FADA

Nutrition Consulting Services

Kingsport, TN  37663

janetskates at yahoo.com<mailto:janetskates at yahoo.com>

(423) 239-7176

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Hornick, Leslie G.
Sent: Wednesday, July 09, 2008 9:42 AM
To: cnm at lists.my180.net
Subject: [Cnm] outcomes measures

I would love to know more about this...if anyone has any examples of QA

outcomes measures or good references, please share.  Thanks.

-----Original Message-----

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]

On Behalf Of cnm-request at lists.my180.net

Sent: Wednesday, July 09, 2008 9:15 AM

To: cnm at lists.my180.net

Subject: Cnm Digest, Vol 20, Issue 54

Send Cnm mailing list submissions to

        cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit

        http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

or, via email, send a message with subject or body 'help' to

        cnm-request at lists.my180.net

You can reach the person managing the list at

        cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific

than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Was Retaining New RDS, now outcome measures (Leibhart, Rosanne)


----------------------------------------------------------------------

Message: 1

Date: Wed, 9 Jul 2008 09:28:10 -0400

From: "Leibhart, Rosanne" <Rosanne.Leibhart at crozer.org>

Subject: [Cnm] Was Retaining New RDS, now outcome measures

To: <jwmsrd at earthlink.net>, "SORACCO, KELLY"

        <KSoracco at lutheran-hosp.com>,   "Wells, Khongmany

ARMC-Nutrition

        Services" <WellsK at armc.sbcounty.gov>,   <cnm at lists.my180.net>

Message-ID:



<1904FBE1EFD42940AA44982E67B5B44E027FE379 at exchange02.CKHSAD.CROZER.ORG>



Content-Type: text/plain; charset="us-ascii"

Just to add to this conversation-

Last week we had surveyors from Health Facilities Accreditation Program

(HFAP, formerly AOA)

The nutrition interview went well except when he asked me the question

"Why do you do a nutrition consult?"

I began my response with  "physician orders......"

he cut me off and said " wrong answer."

I began to clarify that there are many ways a patient can come to our

attention, nursing screens etc.

He basically said he was not interested in any of that. He wanted to

know what is it that we do for the patient, what is the efficacy of your

service....are you just pushing a pen to complete a consult? He said he

was looking for QA on outcome measures. He did not care about QA that

states we answered X number of consults in whatever timeframe we had

established.

While there was no citation on this, our hospital president heard the

interview and wants us to change our QA to outcome measures.

I am not sure how I will proceed but we recently switched over to the

Nutrition Care Process and I think it will be easier to get the data.

Rosanne Leibhart, RD



________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]

On Behalf Of Jo Lynn Worden

Sent: Tuesday, July 08, 2008 8:11 PM

To: 'SORACCO, KELLY'; 'Wells, Khongmany ARMC-Nutrition Services';

cnm at lists.my180.net

Subject: Re: [Cnm] Retaining New RDS



Please post to list.



From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]

On Behalf Of SORACCO, KELLY

Sent: Tuesday, July 08, 2008 12:15 PM

To: Wells, Khongmany ARMC-Nutrition Services; cnm at lists.my180.net

Subject: [Cnm] Retaining New RDS



Excellent Discussion!  Thanks to everyone that has responded so far.  I

like Khongmany 's last question and would like to encourage further

responses on this subject: What are others out there doing to improve

patient outcomes and how is this being show cased?



Kelly Soracco, MS, RD

Patient Services Manager

Lutheran, St Joe & Rehab Hospitals

ksoracco at lutheran-hosp.com <mailto:ksoracco at lutheran-hosp.com>

260-435-7983 phone

260-435-6999 fax



________________________________

From: Wells, Khongmany ARMC-Nutrition Services

[mailto:WellsK at armc.sbcounty.gov]

Sent: Tuesday, July 08, 2008 12:34 PM

To: SORACCO, KELLY; cnm at lists.my180.net

Subject: RE: [Cnm] Retaining New RDS



I don't think it is happening with just new grads. I know of several

dietitians who have gone back to school to pursue another career that

would, of course, get them more pay, more recognition, and more

authority.  One dietitian is going back to school to do Pre-Med and she

has been an RD for 10 years.  Another went to PA school after 5 years of

working as an RD and an intern that we had last year went on to Pharmacy

School after she finished her internship.   One dietitian dropped her RD

all together and is working as a Hospital Administrator with her MBA.



It's hard to find dietitians in general, at least in our area. I only

have one applicant on my list of candidates for interview and I am still

in search of a qualified candidate (position has been opened since

February).



  I've been lucky that I have not had much turn over.  The newest one in

the field has been with us for almost two years-not sure how much longer

she will stay given that other hospitals around the area are offering

more pay.  I have another dietitian who is constantly looking for

another job but continue to stay on board b/c we are a trauma center and

offer a lot of challenging patients for him to work with.   We are a

county facility and many stay on b/c of the good retirement plan, but

many people don't look to that first-they look at the $ amount that they

are being paid.  I am looking at creating a career ladder or trying to

get some extra compensation for CNSDs and CDEs at least; but I know that

is going to be a challenge being a County system and there are not a lot

of hospitals out there that compensate for extra certifications.



In regards to dietitians not being valued and they want to make more of

a difference, I often feel that way myself sometimes-but b/c I do enjoy

what I am doing for the most part I am sticking with it-at least for

now.  It is very discouraging to see other positions within the County

with less educational background and less responsibilities receive  as

much or more money as our profession (clinical RD and myself included).

My DTR will make more money as a secretary (that is another story).   I

try not to look at that since it will just get me more discouraged.   My

goal for our staff is to be recognized like other disciplines (PT for

their LIFT Team, Social Services for helping to decrease LOS, and of

coarse nursing for their quality nursing care).   I am often talking to

the dietitians about wanting to show admin that we do make an impact on

the patients' outcome b/c I don't think admin really understands what we

do in clinical nutrition.  I know our CEO has really good intentions and

he urges us to provide quality care to our patients, but he does not

fully understand the role that we play in patient care.   When Nutrition

is recognized, we are often recognized for the GREAT Food and great

service provided at the Employee Picnic etc.  Although I don't mind

being associated with Foodservice, I would like to see what we can do to

make our Clinical Nutrition Section better recognized.  What are others

out there doing to improve patient outcomes and how is this being show

cased?

Khongmany Wells, RD, MPH, CNSD

Colton CA

(909) 580-2466

________________________________

From: cnm-bounces at lists.my180.net on behalf of SORACCO, KELLY

Sent: Sun 7/6/2008 7:18 PM

To: cnm at lists.my180.net

Subject: [Cnm] Retaining New RDS

I have a staff of 10 Clinical RDS.  5 are fairly new to the field (less

than 4 years) and 4 of them are seriously looking into PA school. They

feel dietitians are not valued and they want to make more of a

difference.    3 of them received, for the first time in our facility

for RDs, a hefty sign on or loan forgiveness bonus to the tune of $8000

with a 2 year contract.  I get the feeling they will bail at the end of

this time frame.  I felt I really hired some exceptional candidates who

would stay, and now it seems that I can't trust my instincts!



Is anyone else experiencing this with new grads?  Is this a generational

thing (no offense to you young managers)?  I am at a loss.  How have you

retained your RDS?

Kelly Soracco, MS, RD

Patient Services Manager

Lutheran & St. Joseph Hospitals

435-7983



________________________________

________________________________

Disclaimer: This electronic message may contain information that is

Proprietary, Confidential, or legally privileged or protected. It is

intended only for the use of the individual(s) and entity named in the

message. If you are not an intended recipient of this message, please

notify the sender immediately and delete the material from your

computer. Do not deliver, distribute or copy this message and do not

disclose its contents or take any action in reliance on the information

it contains.

-------------- next part --------------

An HTML attachment was scrubbed...

URL:

/pipermail/cnm_lists.my180.net/attachments/20080709/605145d2/attachment.

html

------------------------------

_______________________________________________

Cnm mailing list

Cnm at lists.my180.net

http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 20, Issue 54

***********************************

_______________________________________________

Cnm mailing list

Cnm at lists.my180.net

http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net << File: ATT1629416.txt >>

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.


________________________________
Notice from St.Joseph Health System:
Please note that the information contained in this message may be privileged and confidential and protected from disclosure.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/da2a0e39/attachment-0001.html 

From lhodgson at SARATOGACARE.ORG  Tue Jan  6 06:56:37 2009
From: lhodgson at SARATOGACARE.ORG (Hodgson, Lisa)
Date: Tue, 6 Jan 2009 09:56:37 -0500
Subject: [Cnm] Cnm Digest, Vol 26, Issue 19
In-Reply-To: <mailman.732.1231252296.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.732.1231252296.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <F15F698E03068A4CA11D19D3E0ED2815059070B4@shexch1.saratogacare.org>

The ADA Nutrition Care Manual has evidence-based wound healing and
prevention recommendations--and some are surprising in terms of what the
evidence is. Lisa Hodgson

Lisa Hodgson, RD, CDN, CDE
Clinical Nutrition Manager
Saratoga Hospital
211 Church Street
Saratoga Springs, NY 12866
(518) 580-2481

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of cnm-request at lists.my180.net
Sent: Tuesday, January 06, 2009 9:32 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 19

Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Nutrition and Wounds (Harrison, Kerry)


----------------------------------------------------------------------

Message: 1
Date: Tue, 6 Jan 2009 08:30:41 -0600
From: "Harrison, Kerry" <kharriso at stagnes.org>
Subject: [Cnm] Nutrition and Wounds
Cc: <cnm at lists.my180.net>
Message-ID:
	
<9AB3ADBD43ABFD46B0DC4E80280F3B39224A26 at ahcmascdc034.DS.SJHS.COM>
Content-Type: text/plain; charset="us-ascii"

Hi everyone,

We have an outpatient wound clinic that does not employ an RD.  I am on
the inpatient wound care team and want to develop handouts for the
clinic that can help with nutrition and healing.  Anyone already have
anything made that relates to nutrition and wounds that they would be
willing to share?  Thank you in advance.

Kerry

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 


_____________________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Janet Skates
Sent: Wednesday, July 09, 2008 10:42 AM
To: 'Hornick, Leslie G.'
Cc: cnm at lists.my180.net
Subject: Re: [Cnm] outcomes measures

Leslie,

Schneider (Schneider PJ.  Nutrition support teams: an evidence-based
practice. Nutr Clin Pract  2006;21:62-67) has identified examples of
performance aims for a nutrition support team.  Each aim is consistent
with the IOM's six aims for improvement and each is framed as measurable
team performance goals.  They can be useful as QA outcomes measures for
critical care nutrition and can get you thinking about how to approach
QA for other nutrition areas. 

*	Aim #1: Nutrition support should be indicated. No patient should
receive expensive, potentially risky treatment unless it is clearly
needed. 
Goal: The team will improve the ordering system so that 100% of patient
records meet predefined clinical indications before treatment begins. 

*	Aim #2: The route of administration should be appropriate. The
improper method for providing specialized nutrition support can result
in unnecessary costs and risk. 
Goal: The team will improve the selection of access route so that 100%
of patients who can be fed enterally are fed via this route. 

*	Aim #3. The patient should benefit from therapy. No patient
should receive expensive, potentially risky treatment unless there is
meaningful clinical improvement. 
Goal. The team will improve the monitoring of nutrition therapy so that
100% of patients who receive nutrition support are shown to improve
clinically according to pretreatment goals. 

*	Aim #4. The incidence of complications should be low.
Complications are inevitable, but using proper techniques can minimize
their rate. 
Goal. The team will standardize ordering, preparing, and administering
nutrition support so that the infection rate, glucose imbalance, fluid
and electrolyte alterations, and acid-base disturbances are reduced
compared with baseline frequencies. 

*	Aim #5. The patient should understand the risks and benefits of
therapy. The choice to use expensive or risky treatment should involve
the patient. 
Goal. The team will improve patient education so that 100% of patients
understand the risks and benefits of nutrition support before treatment
is initiated, as documented by signed informed consent. 

*	Aim #6. The proper quantity of nutrition substrate should be
ordered. Too much or too little substrate can predispose patients to
harm. 
Goal. The team will improve the ordering process so that no patients are
over- or underfed according to clinical practice guidelines. 

*	Aim #7. The proper quantity of nutrition support should be
administered. If nutrition support is administered incorrectly, the
wrong quantities of nutrition support substrates will be given even if
the order is correct. 
Goal. The team will improve the method of administering nutrition so
that 100% of patients receive the appropriate quantity of nutrition
support substrate. 

*	Aim #8. The patient should not experience a detrimental
drug-nutrient interaction. Nutrition can interact negatively with other
prescribed drug treatment if not properly monitored. 
Goal. The team will improve the process of screening orders in the
pharmacy and monitoring patients who receive nutrition support so that
no patients have predictable and preventable drug-nutrient interactions.


*	Aim #9. The patient should receive nutrition support in a timely
manner. Nutrition therapy should be provided promptly after treatment
decisions are made. 
Goal. The team will reduce the time from order to start of treatment to
2 hours


Janet
Janet Skates MS, RD, LDN, CNSD, FADA
Nutrition Consulting Services
Kingsport, TN  37663
janetskates at yahoo.com
(423) 239-7176

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Hornick, Leslie G.
Sent: Wednesday, July 09, 2008 9:42 AM
To: cnm at lists.my180.net
Subject: [Cnm] outcomes measures

I would love to know more about this...if anyone has any examples of QA
outcomes measures or good references, please share.  Thanks.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of cnm-request at lists.my180.net
Sent: Wednesday, July 09, 2008 9:15 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 20, Issue 54

Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Was Retaining New RDS, now outcome measures (Leibhart, Rosanne)


----------------------------------------------------------------------

Message: 1
Date: Wed, 9 Jul 2008 09:28:10 -0400
From: "Leibhart, Rosanne" <Rosanne.Leibhart at crozer.org>
Subject: [Cnm] Was Retaining New RDS, now outcome measures
To: <jwmsrd at earthlink.net>, "SORACCO, KELLY"
	<KSoracco at lutheran-hosp.com>,	"Wells, Khongmany
ARMC-Nutrition
	Services" <WellsK at armc.sbcounty.gov>, 	<cnm at lists.my180.net>
Message-ID:
	
<1904FBE1EFD42940AA44982E67B5B44E027FE379 at exchange02.CKHSAD.CROZER.ORG>
	
Content-Type: text/plain; charset="us-ascii"

Just to add to this conversation-

Last week we had surveyors from Health Facilities Accreditation Program
(HFAP, formerly AOA)

The nutrition interview went well except when he asked me the question
"Why do you do a nutrition consult?"

I began my response with  "physician orders......" 

he cut me off and said " wrong answer."

I began to clarify that there are many ways a patient can come to our
attention, nursing screens etc.

He basically said he was not interested in any of that. He wanted to
know what is it that we do for the patient, what is the efficacy of your
service....are you just pushing a pen to complete a consult? He said he
was looking for QA on outcome measures. He did not care about QA that
states we answered X number of consults in whatever timeframe we had
established.

While there was no citation on this, our hospital president heard the
interview and wants us to change our QA to outcome measures.

I am not sure how I will proceed but we recently switched over to the
Nutrition Care Process and I think it will be easier to get the data.

Rosanne Leibhart, RD  

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Jo Lynn Worden
Sent: Tuesday, July 08, 2008 8:11 PM
To: 'SORACCO, KELLY'; 'Wells, Khongmany ARMC-Nutrition Services';
cnm at lists.my180.net
Subject: Re: [Cnm] Retaining New RDS

 

Please post to list. 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of SORACCO, KELLY
Sent: Tuesday, July 08, 2008 12:15 PM
To: Wells, Khongmany ARMC-Nutrition Services; cnm at lists.my180.net
Subject: [Cnm] Retaining New RDS

 

Excellent Discussion!  Thanks to everyone that has responded so far.  I
like Khongmany 's last question and would like to encourage further
responses on this subject: What are others out there doing to improve
patient outcomes and how is this being show cased?   

 

Kelly Soracco, MS, RD

Patient Services Manager

Lutheran, St Joe & Rehab Hospitals

ksoracco at lutheran-hosp.com <mailto:ksoracco at lutheran-hosp.com> 

260-435-7983 phone

260-435-6999 fax

 

________________________________

From: Wells, Khongmany ARMC-Nutrition Services
[mailto:WellsK at armc.sbcounty.gov] 
Sent: Tuesday, July 08, 2008 12:34 PM
To: SORACCO, KELLY; cnm at lists.my180.net
Subject: RE: [Cnm] Retaining New RDS

 

I don't think it is happening with just new grads. I know of several
dietitians who have gone back to school to pursue another career that
would, of course, get them more pay, more recognition, and more
authority.  One dietitian is going back to school to do Pre-Med and she
has been an RD for 10 years.  Another went to PA school after 5 years of
working as an RD and an intern that we had last year went on to Pharmacy
School after she finished her internship.   One dietitian dropped her RD
all together and is working as a Hospital Administrator with her MBA.  

 

It's hard to find dietitians in general, at least in our area. I only
have one applicant on my list of candidates for interview and I am still
in search of a qualified candidate (position has been opened since
February).   

 

  I've been lucky that I have not had much turn over.  The newest one in
the field has been with us for almost two years-not sure how much longer
she will stay given that other hospitals around the area are offering
more pay.  I have another dietitian who is constantly looking for
another job but continue to stay on board b/c we are a trauma center and
offer a lot of challenging patients for him to work with.   We are a
county facility and many stay on b/c of the good retirement plan, but
many people don't look to that first-they look at the $ amount that they
are being paid.  I am looking at creating a career ladder or trying to
get some extra compensation for CNSDs and CDEs at least; but I know that
is going to be a challenge being a County system and there are not a lot
of hospitals out there that compensate for extra certifications.  

 

In regards to dietitians not being valued and they want to make more of
a difference, I often feel that way myself sometimes-but b/c I do enjoy
what I am doing for the most part I am sticking with it-at least for
now.  It is very discouraging to see other positions within the County
with less educational background and less responsibilities receive  as
much or more money as our profession (clinical RD and myself included).
My DTR will make more money as a secretary (that is another story).   I
try not to look at that since it will just get me more discouraged.   My
goal for our staff is to be recognized like other disciplines (PT for
their LIFT Team, Social Services for helping to decrease LOS, and of
coarse nursing for their quality nursing care).   I am often talking to
the dietitians about wanting to show admin that we do make an impact on
the patients' outcome b/c I don't think admin really understands what we
do in clinical nutrition.  I know our CEO has really good intentions and
he urges us to provide quality care to our patients, but he does not
fully understand the role that we play in patient care.   When Nutrition
is recognized, we are often recognized for the GREAT Food and great
service provided at the Employee Picnic etc.  Although I don't mind
being associated with Foodservice, I would like to see what we can do to
make our Clinical Nutrition Section better recognized.  What are others
out there doing to improve patient outcomes and how is this being show
cased?   

Khongmany Wells, RD, MPH, CNSD

Colton CA

(909) 580-2466

________________________________

From: cnm-bounces at lists.my180.net on behalf of SORACCO, KELLY
Sent: Sun 7/6/2008 7:18 PM
To: cnm at lists.my180.net
Subject: [Cnm] Retaining New RDS

I have a staff of 10 Clinical RDS.  5 are fairly new to the field (less
than 4 years) and 4 of them are seriously looking into PA school. They
feel dietitians are not valued and they want to make more of a
difference.    3 of them received, for the first time in our facility
for RDs, a hefty sign on or loan forgiveness bonus to the tune of $8000
with a 2 year contract.  I get the feeling they will bail at the end of
this time frame.  I felt I really hired some exceptional candidates who
would stay, and now it seems that I can't trust my instincts!  

 

Is anyone else experiencing this with new grads?  Is this a generational
thing (no offense to you young managers)?  I am at a loss.  How have you
retained your RDS?  

Kelly Soracco, MS, RD

Patient Services Manager

Lutheran & St. Joseph Hospitals

435-7983

 

________________________________

________________________________

Disclaimer: This electronic message may contain information that is
Proprietary, Confidential, or legally privileged or protected. It is
intended only for the use of the individual(s) and entity named in the
message. If you are not an intended recipient of this message, please
notify the sender immediately and delete the material from your
computer. Do not deliver, distribute or copy this message and do not
disclose its contents or take any action in reliance on the information
it contains.

-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20080709/605145d2/attachment.
html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 20, Issue 54
***********************************

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net << File:
ATT1629416.txt >> 

CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20090106/6c8f74ed/attachment.
html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 19
***********************************


This e-mail communication and any attachments may contain
confidential and privileged information for the use of the
designated recipients named above.
If you are not the intended recipient, you are hereby notified
that you have received this communication in error and that
any review, disclosure, dissemination, distribution or copying
of it or its contents is prohibited. If you have received this
communication in error, please notify Saratoga Hospital
immediately by e-mail at privacy at saratogacare.org and
destroy all copies of this communication and any attachments.



From TUCKERJ at lourdesnet.org  Tue Jan  6 07:03:40 2009
From: TUCKERJ at lourdesnet.org (Tucker, Jennifer)
Date: Tue, 6 Jan 2009 10:03:40 -0500
Subject: [Cnm] Wounds and Triggers
In-Reply-To: <A54EFD4D2B0E924B970F363E6CCA949302E53C3D@sm-xchg.comhs.org>
References: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com>
	<A54EFD4D2B0E924B970F363E6CCA949302E53C3D@sm-xchg.comhs.org>
Message-ID: <CD224776317D2C438D1D201880C6705428687B@ITSSSXM01V1.one.ads.che.org>

Good Morning,
    I would greatly appreciate any input on what "types" of wounds would
trigger your RD's.

Pressure ulcers stage II and greater?
Venous?
Just the word wound upon admission?

Thank you so much for any input,

Jennifer Tucker RD
Clinical Nutrition Manager
Lourdes Health System
856-757-3596
Confidentiality Notice:
This email, including any attachments is the 
property of Catholic Health East and is intended 
for the sole use of the intended recipient(s).  
It may contain information that is privileged and 
confidential.  Any unauthorized review, use,
disclosure, or distribution is prohibited. If you are 
not the intended recipient, please reply to the 
sender that you have received the message in 
error, then delete this message.



From TUCKERJ at lourdesnet.org  Tue Jan  6 07:05:05 2009
From: TUCKERJ at lourdesnet.org (Tucker, Jennifer)
Date: Tue, 6 Jan 2009 10:05:05 -0500
Subject: [Cnm] FW: Wounds and Triggers
Message-ID: <CD224776317D2C438D1D201880C6705428687C@ITSSSXM01V1.one.ads.che.org>


Good Morning,
    I would greatly appreciate any input on what "types" of wounds would
trigger your RD's.

Pressure ulcers stage II and greater?
Venous?
Just the word wound upon admission?

Thank you so much for any input,

Jennifer Tucker RD
Clinical Nutrition Manager
Lourdes Health System
856-757-3596
Confidentiality Notice:
This email, including any attachments is the 
property of Catholic Health East and is intended 
for the sole use of the intended recipient(s).  
It may contain information that is privileged and 
confidential.  Any unauthorized review, use,
disclosure, or distribution is prohibited. If you are 
not the intended recipient, please reply to the 
sender that you have received the message in 
error, then delete this message.



From johnstonj at wvuh.com  Tue Jan  6 07:14:11 2009
From: johnstonj at wvuh.com (Johnston, Jill L)
Date: Tue, 6 Jan 2009 10:14:11 -0500
Subject: [Cnm] Wounds and Triggers
In-Reply-To: <CD224776317D2C438D1D201880C6705428687B@ITSSSXM01V1.one.ads.che.org>
References: <OF1CBA6988.0A7DBFC7-ON85257535.0065D0B8-85257535.00661F82@CHSProdl2.chs-mi.com><A54EFD4D2B0E924B970F363E6CCA949302E53C3D@sm-xchg.comhs.org>
	<CD224776317D2C438D1D201880C6705428687B@ITSSSXM01V1.one.ads.che.org>
Message-ID: <BAE3D81A18522C45AD890CC59B5485B6040A797E@NT-EXCHANGE.wvuh.wvuhs.com>

We use Stage II or greater or non-healing wound as a nursing trigger. 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Tucker, Jennifer
Sent: Tuesday, January 06, 2009 10:04 AM
To: Bobbi Homola; CKeinath at chs-mi.com; Clinical List
Subject: [Cnm] Wounds and Triggers

Good Morning,
    I would greatly appreciate any input on what "types" of wounds would
trigger your RD's.

Pressure ulcers stage II and greater?
Venous?
Just the word wound upon admission?

Thank you so much for any input,

Jennifer Tucker RD
Clinical Nutrition Manager
Lourdes Health System
856-757-3596
Confidentiality Notice:
This email, including any attachments is the property of Catholic Health
East and is intended for the sole use of the intended recipient(s).  
It may contain information that is privileged and confidential.  Any
unauthorized review, use, disclosure, or distribution is prohibited. If
you are not the intended recipient, please reply to the sender that you
have received the message in error, then delete this message.


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-----------------------------------------
Confidentiality Notice: This e-mail message, including any
attachments, is for the sole use of the intended recipient(s) and
may contain confidential and privileged information.  Any
unauthorized review, use, disclosure or distribution is prohibited.
 If you are not the intended recipient, please contact the sender
by reply e-mail and destroy all copies of the original message.


From kathleenb at fmchealth.org  Tue Jan  6 07:18:05 2009
From: kathleenb at fmchealth.org (Kathleen Meyer)
Date: Tue, 6 Jan 2009 10:18:05 -0500
Subject: [Cnm] copy of Future Dimensions article
In-Reply-To: <49632892020000B700039417@n6mcgw16.cchmc.org>
Message-ID: <EF903244A6329F47AFF009CF471ADD63015B29C6@ex03.fmchealth.org>

I have the issue, but it is from Fall of 2002.   I will fax it to you.

Kathleen Meyer, RD, LD
Assistant Manager, Dietary
Fairfield Medical Center
Lancaster, Ohio

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On
Behalf Of Letitia Hess
Sent: Tuesday, January 06, 2009 9:47 AM
To: cnm at lists.my180.net
Subject: [Cnm] copy of Future Dimensions article


Does anyone have the Spring 2001 copy of Future Dimensions? (The on-line archive does not go back that far.)
I am looking for the article on the 1999 CNM staffing survey in that issue.

Thank you.

Letitia Hess, MS, RD, LD
Senior Clinical Director
Nutrition Therapy Division - ML  5043
Cincinnati Children's Hospital Medical Center
3333 Burnet Ave.
Cincinnati, OH  45229
tel:  513/636-7285
fax:  513/636-5887
email:  letitia.hess at cchmc.org



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

"Confidentiality Notice: This e-mail message, including any
attachments is for the sole use of the intended recipient(s)
and may contain confidential and privileged information.
Any unauthorized review; use; disclosure or distribution
is prohibited.  If you are not the intended recipient,
please contact the sender by reply e-mail and destroy all copies of
the original message."


From YDionne at westerlyhospital.org  Tue Jan  6 07:59:55 2009
From: YDionne at westerlyhospital.org (Yvette Dionne)
Date: Tue, 6 Jan 2009 10:59:55 -0500
Subject: [Cnm] Initial Nutrition Assessments for pts readmitted
	shortlyafter discharge
In-Reply-To: <120AAA8883F193448149DA50511E16DB01665637@EXBEVS3.nbhdhqdomain.nbhd.org>
References: <120AAA8883F193448149DA50511E16DB01665637@EXBEVS3.nbhdhqdomain.nbhd.org>
Message-ID: <E8876826D209234E9756A1C959D0A28F022458E4@whmail.westerlyhospital.local>

We do a full assessment according to our standards/policies.  A lot can
change in 2 weeks. 

________________________________

From: McLaughlin, Julie [mailto:JMcLaughlin at browardhealth.org] 
Sent: Wednesday, December 31, 2008 2:18 PM
To: cnm at lists.my180.net
Subject: [Cnm] Initial Nutrition Assessments for pts readmitted
shortlyafter discharge


Are there any guidelines that say the Initial Nutrition Assessment can
be copied from a previous admission if the patient was readmitted within
_______ days of last discharge?
 
The dietitians say they used to copy the Assessment from the previous
admit if the pt had been discharged less than 2 weeks prior.
 
Does anyone else do something like this and what are everyone's thoughts
on this?  
 
Thanks!
Julie McLaughlin
Clinical Nutrition Manager
BGMC
Ft. Lauderdale, FL

- ----------------------------------------------
Broward Health CONFIDENTIALITY NOTICE: 
This message and any included attachments are intended for the sole use
of 
The individual or entity to which it is addressed. This message may
contain information 
that is confidential and protected by federal and state law. If you are
not the intended 
recipient, you are hereby notified that any disclosure, copying, or
distribution of this 
message is strictly prohibited. If you received this message in error,
please immediately 
notify the sender by reply e-mail and then delete the original message
and its 
attachments without reading or saving the attachments in any manner.
(This email has been scanned by the Broward Health email security
system) Thank you.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/e36e0e10/attachment.html 

From kharriso at stagnes.org  Tue Jan  6 08:04:14 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Tue, 6 Jan 2009 10:04:14 -0600
Subject: [Cnm] copy of Future Dimensions article
In-Reply-To: <49632892020000B700039417@n6mcgw16.cchmc.org>
References: <49632892020000B700039417@n6mcgw16.cchmc.org>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B39224AAB@ahcmascdc034.DS.SJHS.COM>

Anyone can access Future Dimensions from the CNM website if you are a
member.
http://www.cnmdpg.org/MemIndex_300.cfm?CFID=1623283&CFTOKEN=93624102
Hope this helps.

Kerry

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Letitia Hess
Sent: Tuesday, January 06, 2009 9:47 AM
To: cnm at lists.my180.net
Subject: [Cnm] copy of Future Dimensions article

Does anyone have the Spring 2001 copy of Future Dimensions? (The on-line
archive does not go back that far.)
I am looking for the article on the 1999 CNM staffing survey in that
issue.

Thank you.

Letitia Hess, MS, RD, LD
Senior Clinical Director
Nutrition Therapy Division - ML  5043
Cincinnati Children's Hospital Medical Center
3333 Burnet Ave.
Cincinnati, OH  45229
tel:  513/636-7285
fax:  513/636-5887
email:  letitia.hess at cchmc.org



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.


From Annalynn_Skipper at Comcast.net  Tue Jan  6 09:03:23 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Tue, 6 Jan 2009 11:03:23 -0600
Subject: [Cnm] Nutrition and Wounds
In-Reply-To: <E3453D1D67CA5E4DA378CB009C9AD6A66EAD98EC45@SJSNT-SCMAIL01.stjoe.org>
References: <mailman.19813.1215612889.3834.cnm_lists.my180.net@lists.my180.net><69DD80845D7F524BB1C8C59479ED062501016A97@exchsvfulton01.mx.state.mo.us><00a801c8e1d1$e01de850$6400a8c0@Front>,
	<9AB3ADBD43ABFD46B0DC4E80280F3B39224A26@ahcmascdc034.DS.SJHS.COM>
	<E3453D1D67CA5E4DA378CB009C9AD6A66EAD98EC45@SJSNT-SCMAIL01.stjoe.org>
Message-ID: <063BF0BDA081426B802FC06DB9CB50C8@ANNALYNN>

I vaguely recall seeing some nutrition handouts in ADA's Nutrition Care
Manual.  Have you seen them?  We're re-doing that chapter this year, and if
the patient education materials don't meet your needs, please let me know.
I'd appreciate constructive critique on this (or any other) NCM topic. 

 

Happy New Year!    

 

Annalynn

 

Annalynn Skipper Ph.D., R.D., FADA

 


a consultancy devoted to advancing nutrition practice

P.O. Box 45

Oak Park, IL 60303

 <mailto:Annalynn_Skipper at Comcast.net> Annalynn_Skipper at Comcast.net

Advanced Medical Nutrition Therapy Practice, 

a 2008 text, is available from Jones and Bartlett. 

 

  _____  

From: Cathy Poquette [mailto:Cathy.Poquette at stjoe.org] 
Sent: Tuesday, January 06, 2009 8:53 AM
To: Harrison, Kerry
Cc: cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition and Wounds

 

I am very interested in this kind of handout too.  Please share any
handout(s) with me.  

 

Thanks in advance.

 

Cathy Poquette, MS, RD

Clinical Nutrition Operations Manager

St Jude Medical Center

Fullerton, CA  92835

(714) 992-3000, ext. 3897

  _____  

From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of
Harrison, Kerry [kharriso at stagnes.org]
Sent: Tuesday, January 06, 2009 6:30 AM
Cc: cnm at lists.my180.net
Subject: [Cnm] Nutrition and Wounds

Hi everyone,

We have an outpatient wound clinic that does not employ an RD.  I am on the
inpatient wound care team and want to develop handouts for the clinic that
can help with nutrition and healing.  Anyone already have anything made that
relates to nutrition and wounds that they would be willing to share?  Thank
you in advance.

Kerry

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong enough to
take everything you have.
-Thomas Jefferson

_____________________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Janet Skates
Sent: Wednesday, July 09, 2008 10:42 AM
To: 'Hornick, Leslie G.'
Cc: cnm at lists.my180.net
Subject: Re: [Cnm] outcomes measures

Leslie,

Schneider (Schneider PJ.  Nutrition support teams: an evidence-based
practice. Nutr Clin Pract  2006;21:62-67) has identified examples of
performance aims for a nutrition support team.  Each aim is consistent with
the IOM's six aims for improvement and each is framed as measurable team
performance goals.  They can be useful as QA outcomes measures for critical
care nutrition and can get you thinking about how to approach QA for other
nutrition areas. 

.       Aim #1: Nutrition support should be indicated. No patient should
receive expensive, potentially risky treatment unless it is clearly needed. 

Goal: The team will improve the ordering system so that 100% of patient
records meet predefined clinical indications before treatment begins. 

.       Aim #2: The route of administration should be appropriate. The
improper method for providing specialized nutrition support can result in
unnecessary costs and risk. 

Goal: The team will improve the selection of access route so that 100% of
patients who can be fed enterally are fed via this route. 

.       Aim #3. The patient should benefit from therapy. No patient should
receive expensive, potentially risky treatment unless there is meaningful
clinical improvement. 

Goal. The team will improve the monitoring of nutrition therapy so that 100%
of patients who receive nutrition support are shown to improve clinically
according to pretreatment goals. 

.       Aim #4. The incidence of complications should be low. Complications
are inevitable, but using proper techniques can minimize their rate. 

Goal. The team will standardize ordering, preparing, and administering
nutrition support so that the infection rate, glucose imbalance, fluid and
electrolyte alterations, and acid-base disturbances are reduced compared
with baseline frequencies. 

.       Aim #5. The patient should understand the risks and benefits of
therapy. The choice to use expensive or risky treatment should involve the
patient. 

Goal. The team will improve patient education so that 100% of patients
understand the risks and benefits of nutrition support before treatment is
initiated, as documented by signed informed consent. 

.       Aim #6. The proper quantity of nutrition substrate should be
ordered. Too much or too little substrate can predispose patients to harm. 

Goal. The team will improve the ordering process so that no patients are
over- or underfed according to clinical practice guidelines. 

.       Aim #7. The proper quantity of nutrition support should be
administered. If nutrition support is administered incorrectly, the wrong
quantities of nutrition support substrates will be given even if the order
is correct. 

Goal. The team will improve the method of administering nutrition so that
100% of patients receive the appropriate quantity of nutrition support
substrate. 

.       Aim #8. The patient should not experience a detrimental
drug-nutrient interaction. Nutrition can interact negatively with other
prescribed drug treatment if not properly monitored. 

Goal. The team will improve the process of screening orders in the pharmacy
and monitoring patients who receive nutrition support so that no patients
have predictable and preventable drug-nutrient interactions. 

.       Aim #9. The patient should receive nutrition support in a timely
manner. Nutrition therapy should be provided promptly after treatment
decisions are made. 

Goal. The team will reduce the time from order to start of treatment to 2
hours

Janet

Janet Skates MS, RD, LDN, CNSD, FADA

Nutrition Consulting Services

Kingsport, TN  37663

 <mailto:janetskates at yahoo.com> janetskates at yahoo.com

(423) 239-7176

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Hornick, Leslie G.
Sent: Wednesday, July 09, 2008 9:42 AM
To: cnm at lists.my180.net
Subject: [Cnm] outcomes measures

I would love to know more about this...if anyone has any examples of QA

outcomes measures or good references, please share.  Thanks.

-----Original Message-----

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]

On Behalf Of cnm-request at lists.my180.net

Sent: Wednesday, July 09, 2008 9:15 AM

To: cnm at lists.my180.net

Subject: Cnm Digest, Vol 20, Issue 54

Send Cnm mailing list submissions to

        cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit

        http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

or, via email, send a message with subject or body 'help' to

        cnm-request at lists.my180.net

You can reach the person managing the list at

        cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific

than "Re: Contents of Cnm digest..."

 

Today's Topics:

   1. Was Retaining New RDS, now outcome measures (Leibhart, Rosanne)

 

----------------------------------------------------------------------

Message: 1

Date: Wed, 9 Jul 2008 09:28:10 -0400

From: "Leibhart, Rosanne" <Rosanne.Leibhart at crozer.org>

Subject: [Cnm] Was Retaining New RDS, now outcome measures

To: <jwmsrd at earthlink.net>, "SORACCO, KELLY"

        <KSoracco at lutheran-hosp.com>,   "Wells, Khongmany

ARMC-Nutrition

        Services" <WellsK at armc.sbcounty.gov>,   <cnm at lists.my180.net>

Message-ID:

        

<1904FBE1EFD42940AA44982E67B5B44E027FE379 at exchange02.CKHSAD.CROZER.ORG>

        

Content-Type: text/plain; charset="us-ascii"

Just to add to this conversation-

Last week we had surveyors from Health Facilities Accreditation Program

(HFAP, formerly AOA)

The nutrition interview went well except when he asked me the question

"Why do you do a nutrition consult?"

I began my response with  "physician orders......" 

he cut me off and said " wrong answer."

I began to clarify that there are many ways a patient can come to our

attention, nursing screens etc.

He basically said he was not interested in any of that. He wanted to

know what is it that we do for the patient, what is the efficacy of your

service....are you just pushing a pen to complete a consult? He said he

was looking for QA on outcome measures. He did not care about QA that

states we answered X number of consults in whatever timeframe we had

established.

While there was no citation on this, our hospital president heard the

interview and wants us to change our QA to outcome measures.

I am not sure how I will proceed but we recently switched over to the

Nutrition Care Process and I think it will be easier to get the data.

Rosanne Leibhart, RD  

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]

On Behalf Of Jo Lynn Worden

Sent: Tuesday, July 08, 2008 8:11 PM

To: 'SORACCO, KELLY'; 'Wells, Khongmany ARMC-Nutrition Services';

cnm at lists.my180.net

Subject: Re: [Cnm] Retaining New RDS

 

Please post to list. 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]

On Behalf Of SORACCO, KELLY

Sent: Tuesday, July 08, 2008 12:15 PM

To: Wells, Khongmany ARMC-Nutrition Services; cnm at lists.my180.net

Subject: [Cnm] Retaining New RDS

 

Excellent Discussion!  Thanks to everyone that has responded so far.  I

like Khongmany 's last question and would like to encourage further

responses on this subject: What are others out there doing to improve

patient outcomes and how is this being show cased?   

 

Kelly Soracco, MS, RD

Patient Services Manager

Lutheran, St Joe & Rehab Hospitals

ksoracco at lutheran-hosp.com <mailto:ksoracco at lutheran-hosp.com> 

260-435-7983 phone

260-435-6999 fax

 

________________________________

From: Wells, Khongmany ARMC-Nutrition Services

[mailto:WellsK at armc.sbcounty.gov] 

Sent: Tuesday, July 08, 2008 12:34 PM

To: SORACCO, KELLY; cnm at lists.my180.net

Subject: RE: [Cnm] Retaining New RDS

 

I don't think it is happening with just new grads. I know of several

dietitians who have gone back to school to pursue another career that

would, of course, get them more pay, more recognition, and more

authority.  One dietitian is going back to school to do Pre-Med and she

has been an RD for 10 years.  Another went to PA school after 5 years of

working as an RD and an intern that we had last year went on to Pharmacy

School after she finished her internship.   One dietitian dropped her RD

all together and is working as a Hospital Administrator with her MBA.  

 

It's hard to find dietitians in general, at least in our area. I only

have one applicant on my list of candidates for interview and I am still

in search of a qualified candidate (position has been opened since

February).   

 

  I've been lucky that I have not had much turn over.  The newest one in

the field has been with us for almost two years-not sure how much longer

she will stay given that other hospitals around the area are offering

more pay.  I have another dietitian who is constantly looking for

another job but continue to stay on board b/c we are a trauma center and

offer a lot of challenging patients for him to work with.   We are a

county facility and many stay on b/c of the good retirement plan, but

many people don't look to that first-they look at the $ amount that they

are being paid.  I am looking at creating a career ladder or trying to

get some extra compensation for CNSDs and CDEs at least; but I know that

is going to be a challenge being a County system and there are not a lot

of hospitals out there that compensate for extra certifications.  

 

In regards to dietitians not being valued and they want to make more of

a difference, I often feel that way myself sometimes-but b/c I do enjoy

what I am doing for the most part I am sticking with it-at least for

now.  It is very discouraging to see other positions within the County

with less educational background and less responsibilities receive  as

much or more money as our profession (clinical RD and myself included).

My DTR will make more money as a secretary (that is another story).   I

try not to look at that since it will just get me more discouraged.   My

goal for our staff is to be recognized like other disciplines (PT for

their LIFT Team, Social Services for helping to decrease LOS, and of

coarse nursing for their quality nursing care).   I am often talking to

the dietitians about wanting to show admin that we do make an impact on

the patients' outcome b/c I don't think admin really understands what we

do in clinical nutrition.  I know our CEO has really good intentions and

he urges us to provide quality care to our patients, but he does not

fully understand the role that we play in patient care.   When Nutrition

is recognized, we are often recognized for the GREAT Food and great

service provided at the Employee Picnic etc.  Although I don't mind

being associated with Foodservice, I would like to see what we can do to

make our Clinical Nutrition Section better recognized.  What are others

out there doing to improve patient outcomes and how is this being show

cased?   

Khongmany Wells, RD, MPH, CNSD

Colton CA

(909) 580-2466

________________________________

From: cnm-bounces at lists.my180.net on behalf of SORACCO, KELLY

Sent: Sun 7/6/2008 7:18 PM

To: cnm at lists.my180.net

Subject: [Cnm] Retaining New RDS

I have a staff of 10 Clinical RDS.  5 are fairly new to the field (less

than 4 years) and 4 of them are seriously looking into PA school. They

feel dietitians are not valued and they want to make more of a

difference.    3 of them received, for the first time in our facility

for RDs, a hefty sign on or loan forgiveness bonus to the tune of $8000

with a 2 year contract.  I get the feeling they will bail at the end of

this time frame.  I felt I really hired some exceptional candidates who

would stay, and now it seems that I can't trust my instincts!  

 

Is anyone else experiencing this with new grads?  Is this a generational

thing (no offense to you young managers)?  I am at a loss.  How have you

retained your RDS?  

Kelly Soracco, MS, RD

Patient Services Manager

Lutheran & St. Joseph Hospitals

435-7983

 

________________________________

________________________________

Disclaimer: This electronic message may contain information that is

Proprietary, Confidential, or legally privileged or protected. It is

intended only for the use of the individual(s) and entity named in the

message. If you are not an intended recipient of this message, please

notify the sender immediately and delete the material from your

computer. Do not deliver, distribute or copy this message and do not

disclose its contents or take any action in reliance on the information

it contains.

-------------- next part --------------

An HTML attachment was scrubbed...

URL:

/pipermail/cnm_lists.my180.net/attachments/20080709/605145d2/attachment.

html 

------------------------------

_______________________________________________

Cnm mailing list

Cnm at lists.my180.net

http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

 

End of Cnm Digest, Vol 20, Issue 54

***********************************

_______________________________________________

Cnm mailing list

Cnm at lists.my180.net

http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net << File:
ATT1629416.txt >> 

CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended only
for the named recipient(s). If you are not the intended recipient(s), you
are hereby notified that the dissemination, distribution, and or copying of
this message is strictly prohibited. If you receive this message in error,
or are not the named recipient(s), please notify the sender at the email
address above, delete this email from your computer, and destroy any copies
in any form immediately.  Receipt by anyone other than the named
recipient(s) is not a waiver of any attorney-client, work product, or other
applicable privilege.

 

  _____  

Notice from St.Joseph Health System:
Please note that the information contained in this message may be privileged
and confidential and protected from disclosure.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/eb1cf2f0/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 170 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/eb1cf2f0/attachment-0001.gif 

From Janet.Ross at healthall.com  Tue Jan  6 08:59:36 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Tue, 6 Jan 2009 11:59:36 -0500
Subject: [Cnm] Nutrition and Wounds
In-Reply-To: <E3453D1D67CA5E4DA378CB009C9AD6A66EAD98EC45@SJSNT-SCMAIL01.stjoe.org>
References: <mailman.19813.1215612889.3834.cnm_lists.my180.net@lists.my180.net><69DD80845D7F524BB1C8C59479ED062501016A97@exchsvfulton01.mx.state.mo.us>
	<00a801c8e1d1$e01de850$6400a8c0@Front>,
	<9AB3ADBD43ABFD46B0DC4E80280F3B39224A26@ahcmascdc034.DS.SJHS.COM>
	<E3453D1D67CA5E4DA378CB009C9AD6A66EAD98EC45@SJSNT-SCMAIL01.stjoe.org>
Message-ID: <41CA05D55BF105489D33F8E57D71A90517169865FC@MAIL-C.healthall.com>

This is what we use--nothing to write home about.
Novartis and Walgreens used to have a booklet that marketed beneprotein and arginaid with some generic words also.  Phone number on pamphlet is 1-800-333-3785 or talk to your former novartis rep?

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Cathy Poquette
Sent: Tuesday, January 06, 2009 9:53 AM
To: Harrison, Kerry
Cc: cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition and Wounds

I am very interested in this kind of handout too.  Please share any handout(s) with me.

Thanks in advance.

Cathy Poquette, MS, RD
Clinical Nutrition Operations Manager
St Jude Medical Center
Fullerton, CA  92835
(714) 992-3000, ext. 3897
________________________________
From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Harrison, Kerry [kharriso at stagnes.org]
Sent: Tuesday, January 06, 2009 6:30 AM
Cc: cnm at lists.my180.net
Subject: [Cnm] Nutrition and Wounds

Hi everyone,

We have an outpatient wound clinic that does not employ an RD.  I am on the inpatient wound care team and want to develop handouts for the clinic that can help with nutrition and healing.  Anyone already have anything made that relates to nutrition and wounds that they would be willing to share?  Thank you in advance.

Kerry

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152



To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong enough to take everything you have.
-Thomas Jefferson

_____________________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Janet Skates
Sent: Wednesday, July 09, 2008 10:42 AM
To: 'Hornick, Leslie G.'
Cc: cnm at lists.my180.net
Subject: Re: [Cnm] outcomes measures

Leslie,

Schneider (Schneider PJ.  Nutrition support teams: an evidence-based practice. Nutr Clin Pract  2006;21:62-67) has identified examples of performance aims for a nutrition support team.  Each aim is consistent with the IOM's six aims for improvement and each is framed as measurable team performance goals.  They can be useful as QA outcomes measures for critical care nutrition and can get you thinking about how to approach QA for other nutrition areas.

*       Aim #1: Nutrition support should be indicated. No patient should receive expensive, potentially risky treatment unless it is clearly needed.

Goal: The team will improve the ordering system so that 100% of patient records meet predefined clinical indications before treatment begins.

*       Aim #2: The route of administration should be appropriate. The improper method for providing specialized nutrition support can result in unnecessary costs and risk.

Goal: The team will improve the selection of access route so that 100% of patients who can be fed enterally are fed via this route.

*       Aim #3. The patient should benefit from therapy. No patient should receive expensive, potentially risky treatment unless there is meaningful clinical improvement.

Goal. The team will improve the monitoring of nutrition therapy so that 100% of patients who receive nutrition support are shown to improve clinically according to pretreatment goals.

*       Aim #4. The incidence of complications should be low. Complications are inevitable, but using proper techniques can minimize their rate.

Goal. The team will standardize ordering, preparing, and administering nutrition support so that the infection rate, glucose imbalance, fluid and electrolyte alterations, and acid-base disturbances are reduced compared with baseline frequencies.

*       Aim #5. The patient should understand the risks and benefits of therapy. The choice to use expensive or risky treatment should involve the patient.

Goal. The team will improve patient education so that 100% of patients understand the risks and benefits of nutrition support before treatment is initiated, as documented by signed informed consent.

*       Aim #6. The proper quantity of nutrition substrate should be ordered. Too much or too little substrate can predispose patients to harm.

Goal. The team will improve the ordering process so that no patients are over- or underfed according to clinical practice guidelines.

*       Aim #7. The proper quantity of nutrition support should be administered. If nutrition support is administered incorrectly, the wrong quantities of nutrition support substrates will be given even if the order is correct.

Goal. The team will improve the method of administering nutrition so that 100% of patients receive the appropriate quantity of nutrition support substrate.

*       Aim #8. The patient should not experience a detrimental drug-nutrient interaction. Nutrition can interact negatively with other prescribed drug treatment if not properly monitored.

Goal. The team will improve the process of screening orders in the pharmacy and monitoring patients who receive nutrition support so that no patients have predictable and preventable drug-nutrient interactions.

*       Aim #9. The patient should receive nutrition support in a timely manner. Nutrition therapy should be provided promptly after treatment decisions are made.

Goal. The team will reduce the time from order to start of treatment to 2 hours

Janet

Janet Skates MS, RD, LDN, CNSD, FADA

Nutrition Consulting Services

Kingsport, TN  37663

janetskates at yahoo.com<mailto:janetskates at yahoo.com>

(423) 239-7176

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Hornick, Leslie G.
Sent: Wednesday, July 09, 2008 9:42 AM
To: cnm at lists.my180.net
Subject: [Cnm] outcomes measures

I would love to know more about this...if anyone has any examples of QA

outcomes measures or good references, please share.  Thanks.

-----Original Message-----

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]

On Behalf Of cnm-request at lists.my180.net

Sent: Wednesday, July 09, 2008 9:15 AM

To: cnm at lists.my180.net

Subject: Cnm Digest, Vol 20, Issue 54

Send Cnm mailing list submissions to

        cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit

        http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

or, via email, send a message with subject or body 'help' to

        cnm-request at lists.my180.net

You can reach the person managing the list at

        cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific

than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Was Retaining New RDS, now outcome measures (Leibhart, Rosanne)


----------------------------------------------------------------------

Message: 1

Date: Wed, 9 Jul 2008 09:28:10 -0400

From: "Leibhart, Rosanne" <Rosanne.Leibhart at crozer.org>

Subject: [Cnm] Was Retaining New RDS, now outcome measures

To: <jwmsrd at earthlink.net>, "SORACCO, KELLY"

        <KSoracco at lutheran-hosp.com>,   "Wells, Khongmany

ARMC-Nutrition

        Services" <WellsK at armc.sbcounty.gov>,   <cnm at lists.my180.net>

Message-ID:



<1904FBE1EFD42940AA44982E67B5B44E027FE379 at exchange02.CKHSAD.CROZER.ORG>



Content-Type: text/plain; charset="us-ascii"

Just to add to this conversation-

Last week we had surveyors from Health Facilities Accreditation Program

(HFAP, formerly AOA)

The nutrition interview went well except when he asked me the question

"Why do you do a nutrition consult?"

I began my response with  "physician orders......"

he cut me off and said " wrong answer."

I began to clarify that there are many ways a patient can come to our

attention, nursing screens etc.

He basically said he was not interested in any of that. He wanted to

know what is it that we do for the patient, what is the efficacy of your

service....are you just pushing a pen to complete a consult? He said he

was looking for QA on outcome measures. He did not care about QA that

states we answered X number of consults in whatever timeframe we had

established.

While there was no citation on this, our hospital president heard the

interview and wants us to change our QA to outcome measures.

I am not sure how I will proceed but we recently switched over to the

Nutrition Care Process and I think it will be easier to get the data.

Rosanne Leibhart, RD



________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]

On Behalf Of Jo Lynn Worden

Sent: Tuesday, July 08, 2008 8:11 PM

To: 'SORACCO, KELLY'; 'Wells, Khongmany ARMC-Nutrition Services';

cnm at lists.my180.net

Subject: Re: [Cnm] Retaining New RDS



Please post to list.



From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]

On Behalf Of SORACCO, KELLY

Sent: Tuesday, July 08, 2008 12:15 PM

To: Wells, Khongmany ARMC-Nutrition Services; cnm at lists.my180.net

Subject: [Cnm] Retaining New RDS



Excellent Discussion!  Thanks to everyone that has responded so far.  I

like Khongmany 's last question and would like to encourage further

responses on this subject: What are others out there doing to improve

patient outcomes and how is this being show cased?



Kelly Soracco, MS, RD

Patient Services Manager

Lutheran, St Joe & Rehab Hospitals

ksoracco at lutheran-hosp.com <mailto:ksoracco at lutheran-hosp.com>

260-435-7983 phone

260-435-6999 fax



________________________________

From: Wells, Khongmany ARMC-Nutrition Services

[mailto:WellsK at armc.sbcounty.gov]

Sent: Tuesday, July 08, 2008 12:34 PM

To: SORACCO, KELLY; cnm at lists.my180.net

Subject: RE: [Cnm] Retaining New RDS



I don't think it is happening with just new grads. I know of several

dietitians who have gone back to school to pursue another career that

would, of course, get them more pay, more recognition, and more

authority.  One dietitian is going back to school to do Pre-Med and she

has been an RD for 10 years.  Another went to PA school after 5 years of

working as an RD and an intern that we had last year went on to Pharmacy

School after she finished her internship.   One dietitian dropped her RD

all together and is working as a Hospital Administrator with her MBA.



It's hard to find dietitians in general, at least in our area. I only

have one applicant on my list of candidates for interview and I am still

in search of a qualified candidate (position has been opened since

February).



  I've been lucky that I have not had much turn over.  The newest one in

the field has been with us for almost two years-not sure how much longer

she will stay given that other hospitals around the area are offering

more pay.  I have another dietitian who is constantly looking for

another job but continue to stay on board b/c we are a trauma center and

offer a lot of challenging patients for him to work with.   We are a

county facility and many stay on b/c of the good retirement plan, but

many people don't look to that first-they look at the $ amount that they

are being paid.  I am looking at creating a career ladder or trying to

get some extra compensation for CNSDs and CDEs at least; but I know that

is going to be a challenge being a County system and there are not a lot

of hospitals out there that compensate for extra certifications.



In regards to dietitians not being valued and they want to make more of

a difference, I often feel that way myself sometimes-but b/c I do enjoy

what I am doing for the most part I am sticking with it-at least for

now.  It is very discouraging to see other positions within the County

with less educational background and less responsibilities receive  as

much or more money as our profession (clinical RD and myself included).

My DTR will make more money as a secretary (that is another story).   I

try not to look at that since it will just get me more discouraged.   My

goal for our staff is to be recognized like other disciplines (PT for

their LIFT Team, Social Services for helping to decrease LOS, and of

coarse nursing for their quality nursing care).   I am often talking to

the dietitians about wanting to show admin that we do make an impact on

the patients' outcome b/c I don't think admin really understands what we

do in clinical nutrition.  I know our CEO has really good intentions and

he urges us to provide quality care to our patients, but he does not

fully understand the role that we play in patient care.   When Nutrition

is recognized, we are often recognized for the GREAT Food and great

service provided at the Employee Picnic etc.  Although I don't mind

being associated with Foodservice, I would like to see what we can do to

make our Clinical Nutrition Section better recognized.  What are others

out there doing to improve patient outcomes and how is this being show

cased?

Khongmany Wells, RD, MPH, CNSD

Colton CA

(909) 580-2466

________________________________

From: cnm-bounces at lists.my180.net on behalf of SORACCO, KELLY

Sent: Sun 7/6/2008 7:18 PM

To: cnm at lists.my180.net

Subject: [Cnm] Retaining New RDS

I have a staff of 10 Clinical RDS.  5 are fairly new to the field (less

than 4 years) and 4 of them are seriously looking into PA school. They

feel dietitians are not valued and they want to make more of a

difference.    3 of them received, for the first time in our facility

for RDs, a hefty sign on or loan forgiveness bonus to the tune of $8000

with a 2 year contract.  I get the feeling they will bail at the end of

this time frame.  I felt I really hired some exceptional candidates who

would stay, and now it seems that I can't trust my instincts!



Is anyone else experiencing this with new grads?  Is this a generational

thing (no offense to you young managers)?  I am at a loss.  How have you

retained your RDS?

Kelly Soracco, MS, RD

Patient Services Manager

Lutheran & St. Joseph Hospitals

435-7983



________________________________

________________________________

Disclaimer: This electronic message may contain information that is

Proprietary, Confidential, or legally privileged or protected. It is

intended only for the use of the individual(s) and entity named in the

message. If you are not an intended recipient of this message, please

notify the sender immediately and delete the material from your

computer. Do not deliver, distribute or copy this message and do not

disclose its contents or take any action in reliance on the information

it contains.

-------------- next part --------------

An HTML attachment was scrubbed...

URL:

/pipermail/cnm_lists.my180.net/attachments/20080709/605145d2/attachment.

html

------------------------------

_______________________________________________

Cnm mailing list

Cnm at lists.my180.net

http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 20, Issue 54

***********************************

_______________________________________________

Cnm mailing list

Cnm at lists.my180.net

http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net << File: ATT1629416.txt >>

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.

________________________________
Notice from St.Joseph Health System:
Please note that the information contained in this message may be privileged and confidential and protected from disclosure.

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/100d82e4/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Protein-Calories.doc
Type: application/msword
Size: 57856 bytes
Desc: Protein-Calories.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/100d82e4/attachment-0001.doc 

From pcharney at mac.com  Tue Jan  6 09:15:58 2009
From: pcharney at mac.com (Pam Charney)
Date: Tue, 06 Jan 2009 09:15:58 -0800
Subject: [Cnm] Nutrition and Wounds
In-Reply-To: <41CA05D55BF105489D33F8E57D71A90517169865FC@MAIL-C.healthall.com>
References: <mailman.19813.1215612889.3834.cnm_lists.my180.net@lists.my180.net>
	<69DD80845D7F524BB1C8C59479ED062501016A97@exchsvfulton01.mx.state.mo.us>
	<00a801c8e1d1$e01de850$6400a8c0@Front>
	<9AB3ADBD43ABFD46B0DC4E80280F3B39224A26@ahcmascdc034.DS.SJHS.COM>
	<E3453D1D67CA5E4DA378CB009C9AD6A66EAD98EC45@SJSNT-SCMAIL01.stjoe.org>
	<41CA05D55BF105489D33F8E57D71A90517169865FC@MAIL-C.healthall.com>
Message-ID: <AAE72A0D-EC0D-40F8-97C2-E790FB51110D@mac.com>

What is the cost of beneprotein and arginaid? Should we really be  
advocating for patients, particularly outpatients, to pay for  
nutrients that might be found in a scrambled egg or a hamburger, which  
would taste better and cost less?

The evidence to this point really doesn't support supplements that  
claim to "support wound healing". I'm not even sure I understand what  
the definition of the concept "supporting wound healing" is.

Probably the best advice to patients would be to consume a diet with  
adequate energy, protein, and micronutrients. We should challenge  
ourselves to be creative in helping patients do that with food. After  
all, it doesn't take a college degree to hand a patient a can of "heal  
it all".

Patients who are overweight and/or have type 2 diabetes should focus  
also on weight control (since weight in and of itself is a risk  
factor) and blood glucose control. They also need to have advice on  
physical activity; wound healing is impeded in moist, dark places. The  
more you move it, the better. I'm not talking about running a  
marathon; chair exercises, range of motion, anything to relieve  
pressure and shear forces.

Regards,
pam


Pam Charney PhD, RD
Clinical Coordinator
Graduate Coordinated Program in Dietetics
Lecturer, Department of Epidemiology
Nutrition Sciences Program
School of Public Health and Community Medicine
Box 353410, 306-C Raitt Hall

Affiliate Associate Professor
School of Pharmacy

MS Student
Clinical Informatics and Patient Centered Technology
School of Nursing

University of Washington
Seattle, WA
charnepa at u.washington.edu
"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jan 6, 2009, at 8:59 AM, Ross, Janet wrote:

> This is what we use--nothing to write home about.
> Novartis and Walgreens used to have a booklet that marketed  
> beneprotein and arginaid with some generic words also.  Phone number  
> on pamphlet is 1-800-333-3785 or talk to your former novartis rep?
>
> Janet V. Ross, MBA,RD,LD
> Clinical Nutrition Coordinator
> Drake Center
> janet.ross at healthall.com
> http://www.health-alliance.com/
> ph 513-418-2603
> fx 513-418-5939
> pg 513-577-6879
> P Please consider the environment before printing.
>
>
> From: cnm-bounces at lists.my180.net [mailto:cnm- 
> bounces at lists.my180.net] On Behalf Of Cathy Poquette
> Sent: Tuesday, January 06, 2009 9:53 AM
> To: Harrison, Kerry
> Cc: cnm at lists.my180.net
> Subject: Re: [Cnm] Nutrition and Wounds
>
> I am very interested in this kind of handout too.  Please share any  
> handout(s) with me.
>
> Thanks in advance.
>
> Cathy Poquette, MS, RD
> Clinical Nutrition Operations Manager
> St Jude Medical Center
> Fullerton, CA  92835
> (714) 992-3000, ext. 3897
> From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On  
> Behalf Of Harrison, Kerry [kharriso at stagnes.org]
> Sent: Tuesday, January 06, 2009 6:30 AM
> Cc: cnm at lists.my180.net
> Subject: [Cnm] Nutrition and Wounds
> Hi everyone,
> We have an outpatient wound clinic that does not employ an RD.  I am  
> on the inpatient wound care team and want to develop handouts for  
> the clinic that can help with nutrition and healing.  Anyone already  
> have anything made that relates to nutrition and wounds that they  
> would be willing to share?  Thank you in advance.
> Kerry
> Kerry Harrison, MS,RD,LDN
> Clinical Nutrition Manager
> St. Agnes Hospital
> Baltimore, MD 21229
> 410.368.2152
>
> To eat is a necessity, but to eat intelligently is an art.
> -LaRoche Foucauld
> A government big enough to give you everything you want, is strong  
> enough to take everything you have.
> -Thomas Jefferson
> _____________________________________________
> From: cnm-bounces at lists.my180.net [mailto:cnm- 
> bounces at lists.my180.net] On Behalf Of Janet Skates
> Sent: Wednesday, July 09, 2008 10:42 AM
> To: 'Hornick, Leslie G.'
> Cc: cnm at lists.my180.net
> Subject: Re: [Cnm] outcomes measures
> Leslie,
> Schneider (Schneider PJ.  Nutrition support teams: an evidence-based  
> practice. Nutr Clin Pract  2006;21:62-67) has identified examples of  
> performance aims for a nutrition support team.  Each aim is  
> consistent with the IOM?s six aims for improvement and each is  
> framed as measurable team performance goals.  They can be useful as  
> QA outcomes measures for critical care nutrition and can get you  
> thinking about how to approach QA for other nutrition areas.
> ?       Aim #1: Nutrition support should be indicated. No patient  
> should receive expensive, potentially risky treatment unless it is  
> clearly needed.
> Goal: The team will improve the ordering system so that 100% of  
> patient records meet predefined clinical indications before  
> treatment begins.
> ?       Aim #2: The route of administration should be appropriate.  
> The improper method for providing specialized nutrition support can  
> result in unnecessary costs and risk.
> Goal: The team will improve the selection of access route so that  
> 100% of patients who can be fed enterally are fed via this route.
> ?       Aim #3. The patient should benefit from therapy. No patient  
> should receive expensive, potentially risky treatment unless there  
> is meaningful clinical improvement.
> Goal. The team will improve the monitoring of nutrition therapy so  
> that 100% of patients who receive nutrition support are shown to  
> improve clinically according to pretreatment goals.
> ?       Aim #4. The incidence of complications should be low.  
> Complications are inevitable, but using proper techniques can  
> minimize their rate.
> Goal. The team will standardize ordering, preparing, and  
> administering nutrition support so that the infection rate, glucose  
> imbalance, fluid and electrolyte alterations, and acid-base  
> disturbances are reduced compared with baseline frequencies.
> ?       Aim #5. The patient should understand the risks and benefits  
> of therapy. The choice to use expensive or risky treatment should  
> involve the patient.
> Goal. The team will improve patient education so that 100% of  
> patients understand the risks and benefits of nutrition support  
> before treatment is initiated, as documented by signed informed  
> consent.
> ?       Aim #6. The proper quantity of nutrition substrate should be  
> ordered. Too much or too little substrate can predispose patients to  
> harm.
> Goal. The team will improve the ordering process so that no patients  
> are over- or underfed according to clinical practice guidelines.
> ?       Aim #7. The proper quantity of nutrition support should be  
> administered. If nutrition support is administered incorrectly, the  
> wrong quantities of nutrition support substrates will be given even  
> if the order is correct.
> Goal. The team will improve the method of administering nutrition so  
> that 100% of patients receive the appropriate quantity of nutrition  
> support substrate.
> ?       Aim #8. The patient should not experience a detrimental drug- 
> nutrient interaction. Nutrition can interact negatively with other  
> prescribed drug treatment if not properly monitored.
> Goal. The team will improve the process of screening orders in the  
> pharmacy and monitoring patients who receive nutrition support so  
> that no patients have predictable and preventable drug-nutrient  
> interactions.
> ?       Aim #9. The patient should receive nutrition support in a  
> timely manner. Nutrition therapy should be provided promptly after  
> treatment decisions are made.
> Goal. The team will reduce the time from order to start of treatment  
> to 2 hours
> Janet
> Janet Skates MS, RD, LDN, CNSD, FADA
> Nutrition Consulting Services
> Kingsport, TN  37663
> janetskates at yahoo.com
> (423) 239-7176
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm- 
> bounces at lists.my180.net] On Behalf Of Hornick, Leslie G.
> Sent: Wednesday, July 09, 2008 9:42 AM
> To: cnm at lists.my180.net
> Subject: [Cnm] outcomes measures
> I would love to know more about this...if anyone has any examples of  
> QA
> outcomes measures or good references, please share.  Thanks.
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of cnm-request at lists.my180.net
> Sent: Wednesday, July 09, 2008 9:15 AM
> To: cnm at lists.my180.net
> Subject: Cnm Digest, Vol 20, Issue 54
> Send Cnm mailing list submissions to
>         cnm at lists.my180.net
> To subscribe or unsubscribe via the World Wide Web, visit
>         http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
> or, via email, send a message with subject or body 'help' to
>         cnm-request at lists.my180.net
> You can reach the person managing the list at
>         cnm-owner at lists.my180.net
> When replying, please edit your Subject line so it is more specific
> than "Re: Contents of Cnm digest..."
>
> Today's Topics:
>    1. Was Retaining New RDS, now outcome measures (Leibhart, Rosanne)
>
> ----------------------------------------------------------------------
> Message: 1
> Date: Wed, 9 Jul 2008 09:28:10 -0400
> From: "Leibhart, Rosanne" <Rosanne.Leibhart at crozer.org>
> Subject: [Cnm] Was Retaining New RDS, now outcome measures
> To: <jwmsrd at earthlink.net>, "SORACCO, KELLY"
>         <KSoracco at lutheran-hosp.com>,   "Wells, Khongmany
> ARMC-Nutrition
>         Services" <WellsK at armc.sbcounty.gov>,   <cnm at lists.my180.net>
> Message-ID:
>
> < 
> 1904FBE1EFD42940AA44982E67B5B44E027FE379 at exchange02.CKHSAD.CROZER.ORG>
>
> Content-Type: text/plain; charset="us-ascii"
> Just to add to this conversation-
> Last week we had surveyors from Health Facilities Accreditation  
> Program
> (HFAP, formerly AOA)
> The nutrition interview went well except when he asked me the question
> "Why do you do a nutrition consult?"
> I began my response with  "physician orders......"
> he cut me off and said " wrong answer."
> I began to clarify that there are many ways a patient can come to our
> attention, nursing screens etc.
> He basically said he was not interested in any of that. He wanted to
> know what is it that we do for the patient, what is the efficacy of  
> your
> service....are you just pushing a pen to complete a consult? He said  
> he
> was looking for QA on outcome measures. He did not care about QA that
> states we answered X number of consults in whatever timeframe we had
> established.
> While there was no citation on this, our hospital president heard the
> interview and wants us to change our QA to outcome measures.
> I am not sure how I will proceed but we recently switched over to the
> Nutrition Care Process and I think it will be easier to get the data.
> Rosanne Leibhart, RD
>
> ________________________________
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Jo Lynn Worden
> Sent: Tuesday, July 08, 2008 8:11 PM
> To: 'SORACCO, KELLY'; 'Wells, Khongmany ARMC-Nutrition Services';
> cnm at lists.my180.net
> Subject: Re: [Cnm] Retaining New RDS
>
> Please post to list.
>
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of SORACCO, KELLY
> Sent: Tuesday, July 08, 2008 12:15 PM
> To: Wells, Khongmany ARMC-Nutrition Services; cnm at lists.my180.net
> Subject: [Cnm] Retaining New RDS
>
> Excellent Discussion!  Thanks to everyone that has responded so  
> far.  I
> like Khongmany 's last question and would like to encourage further
> responses on this subject: What are others out there doing to improve
> patient outcomes and how is this being show cased?
>
> Kelly Soracco, MS, RD
> Patient Services Manager
> Lutheran, St Joe & Rehab Hospitals
> ksoracco at lutheran-hosp.com <mailto:ksoracco at lutheran-hosp.com>
> 260-435-7983 phone
> 260-435-6999 fax
>
> ________________________________
> From: Wells, Khongmany ARMC-Nutrition Services
> [mailto:WellsK at armc.sbcounty.gov]
> Sent: Tuesday, July 08, 2008 12:34 PM
> To: SORACCO, KELLY; cnm at lists.my180.net
> Subject: RE: [Cnm] Retaining New RDS
>
> I don't think it is happening with just new grads. I know of several
> dietitians who have gone back to school to pursue another career that
> would, of course, get them more pay, more recognition, and more
> authority.  One dietitian is going back to school to do Pre-Med and  
> she
> has been an RD for 10 years.  Another went to PA school after 5  
> years of
> working as an RD and an intern that we had last year went on to  
> Pharmacy
> School after she finished her internship.   One dietitian dropped  
> her RD
> all together and is working as a Hospital Administrator with her MBA.
>
> It's hard to find dietitians in general, at least in our area. I only
> have one applicant on my list of candidates for interview and I am  
> still
> in search of a qualified candidate (position has been opened since
> February).
>
>   I've been lucky that I have not had much turn over.  The newest  
> one in
> the field has been with us for almost two years-not sure how much  
> longer
> she will stay given that other hospitals around the area are offering
> more pay.  I have another dietitian who is constantly looking for
> another job but continue to stay on board b/c we are a trauma center  
> and
> offer a lot of challenging patients for him to work with.   We are a
> county facility and many stay on b/c of the good retirement plan, but
> many people don't look to that first-they look at the $ amount that  
> they
> are being paid.  I am looking at creating a career ladder or trying to
> get some extra compensation for CNSDs and CDEs at least; but I know  
> that
> is going to be a challenge being a County system and there are not a  
> lot
> of hospitals out there that compensate for extra certifications.
>
> In regards to dietitians not being valued and they want to make more  
> of
> a difference, I often feel that way myself sometimes-but b/c I do  
> enjoy
> what I am doing for the most part I am sticking with it-at least for
> now.  It is very discouraging to see other positions within the County
> with less educational background and less responsibilities receive  as
> much or more money as our profession (clinical RD and myself  
> included).
> My DTR will make more money as a secretary (that is another  
> story).   I
> try not to look at that since it will just get me more  
> discouraged.   My
> goal for our staff is to be recognized like other disciplines (PT for
> their LIFT Team, Social Services for helping to decrease LOS, and of
> coarse nursing for their quality nursing care).   I am often talking  
> to
> the dietitians about wanting to show admin that we do make an impact  
> on
> the patients' outcome b/c I don't think admin really understands  
> what we
> do in clinical nutrition.  I know our CEO has really good intentions  
> and
> he urges us to provide quality care to our patients, but he does not
> fully understand the role that we play in patient care.   When  
> Nutrition
> is recognized, we are often recognized for the GREAT Food and great
> service provided at the Employee Picnic etc.  Although I don't mind
> being associated with Foodservice, I would like to see what we can  
> do to
> make our Clinical Nutrition Section better recognized.  What are  
> others
> out there doing to improve patient outcomes and how is this being show
> cased?
> Khongmany Wells, RD, MPH, CNSD
> Colton CA
> (909) 580-2466
> ________________________________
> From: cnm-bounces at lists.my180.net on behalf of SORACCO, KELLY
> Sent: Sun 7/6/2008 7:18 PM
> To: cnm at lists.my180.net
> Subject: [Cnm] Retaining New RDS
> I have a staff of 10 Clinical RDS.  5 are fairly new to the field  
> (less
> than 4 years) and 4 of them are seriously looking into PA school. They
> feel dietitians are not valued and they want to make more of a
> difference.    3 of them received, for the first time in our facility
> for RDs, a hefty sign on or loan forgiveness bonus to the tune of  
> $8000
> with a 2 year contract.  I get the feeling they will bail at the end  
> of
> this time frame.  I felt I really hired some exceptional candidates  
> who
> would stay, and now it seems that I can't trust my instincts!
>
> Is anyone else experiencing this with new grads?  Is this a  
> generational
> thing (no offense to you young managers)?  I am at a loss.  How have  
> you
> retained your RDS?
> Kelly Soracco, MS, RD
> Patient Services Manager
> Lutheran & St. Joseph Hospitals
> 435-7983
>
> ________________________________
> ________________________________
> Disclaimer: This electronic message may contain information that is
> Proprietary, Confidential, or legally privileged or protected. It is
> intended only for the use of the individual(s) and entity named in the
> message. If you are not an intended recipient of this message, please
> notify the sender immediately and delete the material from your
> computer. Do not deliver, distribute or copy this message and do not
> disclose its contents or take any action in reliance on the  
> information
> it contains.
> -------------- next part --------------
> An HTML attachment was scrubbed...
> URL:
> /pipermail/cnm_lists.my180.net/attachments/20080709/605145d2/ 
> attachment.
> html
> ------------------------------
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
> End of Cnm Digest, Vol 20, Issue 54
> ***********************************
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net << File:  
> ATT1629416.txt >>
> CONFIDENTIALITY NOTICE: This email message and any accompanying data  
> or files is confidential and may contain privileged information  
> intended only for the named recipient(s). If you are not the  
> intended recipient(s), you are hereby notified that the  
> dissemination, distribution, and or copying of this message is  
> strictly prohibited. If you receive this message in error, or are  
> not the named recipient(s), please notify the sender at the email  
> address above, delete this email from your computer, and destroy any  
> copies in any form immediately.  Receipt by anyone other than the  
> named recipient(s) is not a waiver of any attorney-client, work  
> product, or other applicable privilege.
>
> Notice from St.Joseph Health System:
> Please note that the information contained in this message may be  
> privileged and confidential and protected from disclosure.
>
> Confidentiality Notice: This e-mail message, including any  
> attachments, is for the sole use of the intended recipient(s) and  
> may contain confidential and privileged information. Any  
> unauthorized review, use, disclosure or distribution is prohibited.  
> If you are not the intended recipient, please contact the sender by  
> reply e-mail and destroy all copies of the original message.
> <Protein-Calories.doc>_______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/1a05b224/attachment-0001.html 

From Amy.Gendron at cvmc.org  Tue Jan  6 09:46:56 2009
From: Amy.Gendron at cvmc.org (Gendron, Amy L.)
Date: Tue, 6 Jan 2009 12:46:56 -0500
Subject: [Cnm] Need to co-sign flor RD eligible?
In-Reply-To: <mailman.4016.1210959464.3834.cnm_lists.my180.net@lists.my180.net>
Message-ID: <ED658CF94165704EBE82F8D0D00A3F3605CA0C65@cvmcnt1.cvmc.org>

Is it necessary to co-sign RD eligible notes/assessments?  What do you
do at your facility? We are a small hospital so if we were to hire a new
grad often she would be the only 'dietitian' in the building.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org





From johnstonj at wvuh.com  Tue Jan  6 09:59:10 2009
From: johnstonj at wvuh.com (Johnston, Jill L)
Date: Tue, 6 Jan 2009 12:59:10 -0500
Subject: [Cnm] Need to co-sign flor RD eligible?
In-Reply-To: <ED658CF94165704EBE82F8D0D00A3F3605CA0C65@cvmcnt1.cvmc.org>
References: <mailman.4016.1210959464.3834.cnm_lists.my180.net@lists.my180.net>
	<ED658CF94165704EBE82F8D0D00A3F3605CA0C65@cvmcnt1.cvmc.org>
Message-ID: <BAE3D81A18522C45AD890CC59B5485B6040A7986@NT-EXCHANGE.wvuh.wvuhs.com>

We have licensure in the state and they recommended we follow our
hospital guidelines.   We are required to co-sign all RD eligible staff
notes until they pass their RD exam.   

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Gendron, Amy L.
Sent: Tuesday, January 06, 2009 12:47 PM
To: cnm at lists.my180.net
Subject: [Cnm] Need to co-sign flor RD eligible?

Is it necessary to co-sign RD eligible notes/assessments?  What do you
do at your facility? We are a small hospital so if we were to hire a new
grad often she would be the only 'dietitian' in the building.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-----------------------------------------
Confidentiality Notice: This e-mail message, including any
attachments, is for the sole use of the intended recipient(s) and
may contain confidential and privileged information.  Any
unauthorized review, use, disclosure or distribution is prohibited.
 If you are not the intended recipient, please contact the sender
by reply e-mail and destroy all copies of the original message.


From LCarver at Reshealthcare.org  Tue Jan  6 10:00:28 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 6 Jan 2009 12:00:28 -0600
Subject: [Cnm] Need to co-sign flor RD eligible?
In-Reply-To: <ED658CF94165704EBE82F8D0D00A3F3605CA0C65@cvmcnt1.cvmc.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03A33455@rhcexch3.reshealthcare.org>

In Illinois, until someone is RD and licensed, they are not considered
eligible to practice.  Therefore, all notes would have to be co-signed.
Leslee 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Gendron, Amy L.
Sent: Tuesday, January 06, 2009 11:47 AM
To: cnm at lists.my180.net
Subject: [Cnm] Need to co-sign flor RD eligible?

Is it necessary to co-sign RD eligible notes/assessments?  What do you
do at your facility? We are a small hospital so if we were to hire a new
grad often she would be the only 'dietitian' in the building.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From kharriso at stagnes.org  Tue Jan  6 10:01:02 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Tue, 6 Jan 2009 12:01:02 -0600
Subject: [Cnm] Need to co-sign flor RD eligible?
In-Reply-To: <ED658CF94165704EBE82F8D0D00A3F3605CA0C65@cvmcnt1.cvmc.org>
References: <mailman.4016.1210959464.3834.cnm_lists.my180.net@lists.my180.net>
	<ED658CF94165704EBE82F8D0D00A3F3605CA0C65@cvmcnt1.cvmc.org>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B39224B0C@ahcmascdc034.DS.SJHS.COM>

Yes, we co-sign.  We have licensure and they can not get a license until
they pass the RD exam.

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Gendron, Amy L.
Sent: Tuesday, January 06, 2009 12:47 PM
To: cnm at lists.my180.net
Subject: [Cnm] Need to co-sign flor RD eligible?

Is it necessary to co-sign RD eligible notes/assessments?  What do you
do at your facility? We are a small hospital so if we were to hire a new
grad often she would be the only 'dietitian' in the building.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.


From bhaine at Elliot-HS.org  Tue Jan  6 10:05:19 2009
From: bhaine at Elliot-HS.org (Haine, Barbara)
Date: Tue, 6 Jan 2009 13:05:19 -0500
Subject: [Cnm] Need to co-sign flor RD eligible?
In-Reply-To: <ED658CF94165704EBE82F8D0D00A3F3605CA0C65@cvmcnt1.cvmc.org>
Message-ID: <FFAF784627F78444BAAC71732949E2CC0816AA1B@exchange03.elliot-hs.org>

We do not co-sign.  In NH, no one other than a registered dietitian can use the title dietitian, so we have a separate job description that is called clinical nutritionist.  It is the same description as for clinical dietitians, but they can only be in that position for up to one year and must pass the exam within the year.  
Barbara Haine
Elliot Hospital
Manchester, NH

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On
Behalf Of Gendron, Amy L.
Sent: Tuesday, January 06, 2009 12:47 PM
To: cnm at lists.my180.net
Subject: [Cnm] Need to co-sign flor RD eligible?


Is it necessary to co-sign RD eligible notes/assessments?  What do you
do at your facility? We are a small hospital so if we were to hire a new
grad often she would be the only 'dietitian' in the building.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-----------------------------------------
**** CONFIDENTIAL COMMUNICATION - PLEASE READ PRIVACY NOTICE ****  
       
This communication is confidential and may be read only by its
intended recipient(s). It may contain legally privileged and
protected information. If you believe you have received this
communication in error, please "Reply" to the Sender and so
indicate or call (603) 663-2800. Then, please promptly "Delete"
this communication from your computer. This communication, and any
information contained herein, may only be forwarded, printed,
disclosed, copied or disseminated by those specifically authorized
to do so. UNAUTHORIZED DISCLOSURE MAY RESULT IN LEGAL LIABILITY FOR
THOSE PERSONS RESPONSIBLE.



From cohmart at mainehospital.org  Tue Jan  6 10:15:59 2009
From: cohmart at mainehospital.org (Cece Ohmart)
Date: Tue,  6 Jan 2009 13:15:59 -0500 (EST)
Subject: [Cnm] Need to co-sign flor RD eligible?
In-Reply-To: <ED658CF94165704EBE82F8D0D00A3F3605CA0C65@cvmcnt1.cvmc.org>
References: <mailman.4016.1210959464.3834.cnm_lists.my180.net@lists.my180.net>
	<ED658CF94165704EBE82F8D0D00A3F3605CA0C65@cvmcnt1.cvmc.org>
Message-ID: <20090106131559.AEO56595@mail.mainehospital.org>

In Maine, cosigning a note for anyone other than a student in an ADA approved program/internship is not allowed.  Graduates of a program that meet guidelines for taking the ADA exam are eligible for a temporary license, good for one year after issuance.  Temporary dietitians do not need their notes cosigned.  I would consult my local licensing board (if you have one) to see what their rules require.

Cece Ohmart, Chair, Maine Board of Licensure of Dietetic Practice
This message is intended for the use of the addressee only and may contain information that is privileged and confidential.  If you are not the intended recipient of this message, be notified that any dissemination or use of this message is strictly prohibited.  Un-intended transmission does not constitute waiver of attorney-client privilege or any other privilege.  If you have received this message in error, please delete all copies of the message and its attachments and notify the sender immediately.  Thank you.


From rdallosta at mcvh-vcu.edu  Tue Jan  6 10:36:49 2009
From: rdallosta at mcvh-vcu.edu (Regine Dallosta)
Date: Tue, 6 Jan 2009 13:36:49 -0500
Subject: [Cnm] Need to co-sign flor RD eligible?
Message-ID: <OF48C1F362.7E1AC3DB-ON85257536.00663F81@MCVH-VCU.EDU>

An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/af64cd31/attachment.html 

From Terese.Scollard at providence.org  Tue Jan  6 10:46:51 2009
From: Terese.Scollard at providence.org (Scollard, Terese)
Date: Tue, 6 Jan 2009 10:46:51 -0800
Subject: [Cnm] copy of Future Dimensions article
In-Reply-To: <49632892020000B700039417@n6mcgw16.cchmc.org>
Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A03239F12@wn1221.or.providence.org>

That was my article, and I have found the old Nutrition
Dimensions..there was a summary and then the full article. We will scan
it and put it on the website. Here are  parts of original text docs, but
may have been edited for publication in the newsletter.  

Terese M. Scollard RD, LD, MBA 
Regional Clinical Nutrition Manager 
Regional Nutrition Service PHS-PSA Acute Care 
Phone: 503-216-2496 or 503-215-6974 
terese.scollard at providence.org 


 

-----Original Message-----
From: Letitia Hess [mailto:Letitia.Hess at cchmc.org] 
Sent: Tuesday, January 06, 2009 6:47 AM
To: cnm at lists.my180.net
Subject: [Cnm] copy of Future Dimensions article

Does anyone have the Spring 2001 copy of Future Dimensions? (The on-line
archive does not go back that far.) I am looking for the article on the
1999 CNM staffing survey in that issue.

Thank you.

Letitia Hess, MS, RD, LD
Senior Clinical Director
Nutrition Therapy Division - ML  5043
Cincinnati Children's Hospital Medical Center
3333 Burnet Ave.
Cincinnati, OH  45229
tel:  513/636-7285
fax:  513/636-5887
email:  letitia.hess at cchmc.org






DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.
-------------- next part --------------
A non-text attachment was scrubbed...
Name: staffing survey complete summer 02.doc
Type: application/msword
Size: 51712 bytes
Desc: staffing survey complete summer 02.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/7b105f2c/attachment-0002.doc 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: staffing survey edited spring 2001-final.doc
Type: application/msword
Size: 44032 bytes
Desc: staffing survey edited spring 2001-final.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/7b105f2c/attachment-0003.doc 

From kwyne at barlow2000.org  Tue Jan  6 11:07:17 2009
From: kwyne at barlow2000.org (Wyne, Kateri)
Date: Tue, 6 Jan 2009 11:07:17 -0800
Subject: [Cnm] Performance Improvement/Patient Satisfaction
In-Reply-To: <OF48C1F362.7E1AC3DB-ON85257536.00663F81@MCVH-VCU.EDU>
References: <OF48C1F362.7E1AC3DB-ON85257536.00663F81@MCVH-VCU.EDU>
Message-ID: <BFF381777A7F91478A399ABB3C6747FE01B37B84@MAIL1.barlow.com>

Hello! I know performance improvement has been discussed previously on
the list serv. However, I feel like I have run out of ideas. I am in an
LTACH with ~2/3rds of patients on tube feeding. Those who are eating are
primarily on texture modified diets. We've all been asked to review our
PI projects with a renewed focus on patient satisfaction. The only idea
I had was auditing the trays for those patients that are eating,
ensuring accuracy and that the preferences we can provide within their
diet orders are adhered to. Not a very novel idea. I was curious what
others are doing. Thank you, Kateri

 

Kateri Wyne RD,MPH,CNSD

Barlow Respiratory Hospital

Los Angeles, CA 90036

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/ee41e902/attachment.html 

From CBergin at echn.org  Tue Jan  6 11:24:26 2009
From: CBergin at echn.org (Bergin, Carol)
Date: Tue, 6 Jan 2009 14:24:26 -0500
Subject: [Cnm] Wound Healing
Message-ID: <F3F33241F4E7B64AAADA5DCDE2D7FCFA0C7301EA@echnexchange.echn.org>

There are patient handouts and other information regarding wound healing
on the internet at RD411 in the Wound Resource Center section.  These
handouts are what I have provided to our outpatient Wound Center as we
are in the same situation with no RD staffed there.  Good luck!

 

Carol Bergin, MEd, RD, CD-N

ECHN Clinical Nutrition Manager

Manchester Memorial Hospital

71 Haynes Street

Manchester, CT 06040

Phone     860-533-3411 ext. 2149     

Pager      860-820-5507

E-Mail     cbergin at echn.org <mailto:cbergin at echn.org> 
 
"This message originates from Eastern Connecticut Health Network. The information contained in this message may be privileged and confidential. If you are the intended recipient, you must maintain this message in a secure and confidential manner. If you are not the intended recipient, please notify the sender immediately and destroy this message, Thank you."
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/9093f827/attachment.html 

From YDionne at westerlyhospital.org  Tue Jan  6 12:12:15 2009
From: YDionne at westerlyhospital.org (Yvette Dionne)
Date: Tue, 6 Jan 2009 15:12:15 -0500
Subject: [Cnm] V8 vitamin K
Message-ID: <E8876826D209234E9756A1C959D0A28F022458EB@whmail.westerlyhospital.local>

 

Hello, 
 
I am looking for information on the vitamin K content of V8.  At the
moment it is on the High >100mcg list on our teaching tool for Warfarin
patients.
 
Campbell's / V8 answered an email stating that they do not currently
have nutrient date for vitamin k in V8.  The USDA National Nutrient
Database lists -- Vegetable juice cocktail, canned 1cup = 12.8ug.  
 
Does anybody have a better source or know of why V8 juice 5.5oz would be
on the high list? 
 
Thank you for your input, 
Yvette Dionne, RD, LDN
Ext. 3464
may you be well and happy
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/a4666170/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: aleabanr.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/a4666170/attachment.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 4389 bytes
Desc: Leaves Bkgrd.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/a4666170/attachment.jpe 

From msohal at frhg.org  Tue Jan  6 12:35:02 2009
From: msohal at frhg.org (Sohal, Manjit)
Date: Tue, 6 Jan 2009 12:35:02 -0800
Subject: [Cnm] Test Trays
Message-ID: <CFD5C8F06DA56D4FA4363E7161B3C4B303A455D9@rmh-mse-02.frhg.org>

If your facility does test trays, how are they scheduled?  

Is there a rotation between the different diets?

Are test trays done on weekends and at dinner meals?

 

TIA,
Manjit

 

Manjit Sohal, M.S., R.D.

Manager, Clinical Nutrition

Fremont-Rideout Health Group 

726 Fourth Street, Suite E

Marysville, CA  95901

Ph: 530.749.4336

Pgr: 530.740.9992

Fax: 530.749.4337

www.frhg.org <http://www.frhg.org>  

Exceptional Care, Close to Home 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/4f271c15/attachment.html 

From NEgelhofer at saintjosephri.com  Tue Jan  6 13:13:46 2009
From: NEgelhofer at saintjosephri.com (Egelhofer, Nancy)
Date: Tue, 6 Jan 2009 16:13:46 -0500
Subject: [Cnm] Test Trays
In-Reply-To: <CFD5C8F06DA56D4FA4363E7161B3C4B303A455D9@rmh-mse-02.frhg.org>
Message-ID: <EDA5D3F1218538449BB79A345387487EE90348@exchange-2.sjhs.local>

They are not scheduled.  Various employees are expected to do test trays
monthly (RD's, managers, lead cooks, etc.) but everyone is encouraged.
IAny employee of FS can do a test tray (ie if I don't have lunch
money??).
We encourage non-standard diets, and all meals are done (different
people work different shifts, so meal times vary).

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sohal, Manjit
Sent: Tuesday, January 06, 2009 3:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Test Trays



If your facility does test trays, how are they scheduled?  

Is there a rotation between the different diets?

Are test trays done on weekends and at dinner meals?

 

TIA,
Manjit

 

Manjit Sohal, M.S., R.D.

Manager, Clinical Nutrition

Fremont-Rideout Health Group 

726 Fourth Street, Suite E

Marysville, CA  95901

Ph: 530.749.4336

Pgr: 530.740.9992

Fax: 530.749.4337

www.frhg.org <http://www.frhg.org>  

Exceptional Care, Close to Home 

 



(THIS DOCUMENT IS INTENDED ONLY FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED.  IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL, AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW.)  If you are not the intended recipient any dissemination, distribution, copying or use of this document is strictly prohibited.  If you have received this communication in error, please notify me immediately at the email address above and delete all copies of this communication.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/623929ac/attachment.html 

From NEgelhofer at saintjosephri.com  Tue Jan  6 13:15:17 2009
From: NEgelhofer at saintjosephri.com (Egelhofer, Nancy)
Date: Tue, 6 Jan 2009 16:15:17 -0500
Subject: [Cnm] V8 vitamin K
In-Reply-To: <E8876826D209234E9756A1C959D0A28F022458EB@whmail.westerlyhospital.local>
Message-ID: <EDA5D3F1218538449BB79A345387487EE90349@exchange-2.sjhs.local>

What is the reference for your teaching tool?  Sounds incorrect.

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Yvette Dionne
Sent: Tuesday, January 06, 2009 3:12 PM
To: cnm at lists.my180.net
Subject: [Cnm] V8 vitamin K


 

Hello, 
 
I am looking for information on the vitamin K content of V8.  At the
moment it is on the High >100mcg list on our teaching tool for Warfarin
patients.
 
Campbell's / V8 answered an email stating that they do not currently
have nutrient date for vitamin k in V8.  The USDA National Nutrient
Database lists -- Vegetable juice cocktail, canned 1cup = 12.8ug.  
 
Does anybody have a better source or know of why V8 juice 5.5oz would be
on the high list? 
 
Thank you for your input, 
Yvette Dionne, RD, LDN
Ext. 3464
may you be well and happy
 


(THIS DOCUMENT IS INTENDED ONLY FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED.  IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL, AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW.)  If you are not the intended recipient any dissemination, distribution, copying or use of this document is strictly prohibited.  If you have received this communication in error, please notify me immediately at the email address above and delete all copies of this communication.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/7c70b84b/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: aleabanr.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/7c70b84b/attachment-0001.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 4389 bytes
Desc: Leaves Bkgrd.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/7c70b84b/attachment-0001.jpe 

From bhomola at comhs.org  Tue Jan  6 13:30:52 2009
From: bhomola at comhs.org (Bobbi Homola)
Date: Tue, 6 Jan 2009 15:30:52 -0600
Subject: [Cnm] Test Trays
In-Reply-To: <CFD5C8F06DA56D4FA4363E7161B3C4B303A455D9@rmh-mse-02.frhg.org>
Message-ID: <A54EFD4D2B0E924B970F363E6CCA949302E53C44@sm-xchg.comhs.org>

We do a Breakfast, Lunch and dinner each week.  They are rotated among
managers and dietitians, units are rotated, and different diets are
encouraged.

They are usually not done on the week-end, unless it is that
individual's week-end and they choose to do it then.

 

Bobbi Homola, MPA, RD, CD

Clinical Manager, Food and Nutrition Services

St. Mary Medical Center / St. Catherine Hospital

1500 South Lake Park Avenue

Hobart, IN 46342

219-947-6048/219-392-7081

bhomola at comhs.org

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sohal, Manjit
Sent: Tuesday, January 06, 2009 2:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Test Trays

 

If your facility does test trays, how are they scheduled?  

Is there a rotation between the different diets?

Are test trays done on weekends and at dinner meals?

 

TIA,
Manjit

 

Manjit Sohal, M.S., R.D.

Manager, Clinical Nutrition

Fremont-Rideout Health Group 

726 Fourth Street, Suite E

Marysville, CA  95901

Ph: 530.749.4336

Pgr: 530.740.9992

Fax: 530.749.4337

www.frhg.org <http://www.frhg.org>  

Exceptional Care, Close to Home 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/0f1385cb/attachment.html 

From bhomola at comhs.org  Tue Jan  6 13:39:52 2009
From: bhomola at comhs.org (Bobbi Homola)
Date: Tue, 6 Jan 2009 15:39:52 -0600
Subject: [Cnm] RD salary or hourly
In-Reply-To: <810670.66908.qm@web57408.mail.re1.yahoo.com>
Message-ID: <A54EFD4D2B0E924B970F363E6CCA949302E53C45@sm-xchg.comhs.org>

Our salaried employees do not get any extra compensation for
anything...including on-call, week-ends, holidays, etc.

 

Bobbi Homola, MPA, RD, CD

Clinical Manager, Food and Nutrition Services

St. Mary Medical Center / St. Catherine Hospital

1500 South Lake Park Avenue

Hobart, IN 46342

219-947-6048/219-392-7081

bhomola at comhs.org

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Darcy Butler
Sent: Monday, January 05, 2009 6:48 PM
To: cnm at lists.my180.net
Subject: Re: [Cnm] RD salary or hourly

 

For those of you who are salary do you get extra pay for on-call,
weekends and holidays or is that included into your salary?

I'm pretty much the 1 and only even though my hospital does have 2 PRNs.
I'm hourly and I have to watch my time if I'm over and then if census is
low and I could leave early I have to use my PTO time if I want to be
paid for 8 hour day to be able to get a full 40 hr/wk pay.  The 2 PRNs
are also hourly.

Is salary better then hourly or vise versa?
Thanks,
Darcy

CKeinath at chs-mi.com wrote:


Can you tell me if your RDs are salary or hourly?

Thanks,
Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated. 

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net





Darcy Butler, RD, LD

Ponca City, Oklahoma 74601

  

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/7128018a/attachment.html 

From Heberle-Heather at aramark.com  Tue Jan  6 13:40:13 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Tue, 6 Jan 2009 15:40:13 -0600
Subject: [Cnm] Cnm Need to co-sign flor RD eligible?
In-Reply-To: <mailman.782.1231267644.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.782.1231267644.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <F38AF757-E992-448D-973C-800A14413A88@mimectl>

In MO we have licensure and you must pass your RD exam before you can receive licensure, so a new grad would have to be co-signed.  We also are not allowed to use the term "dietitian" in phrase that does not pertain to a registered dietitian so our new grads sign as nutrition graduates.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879



From: cnm-request at lists.my180.net
Sent: Tue 1/6/09 12:47 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 24


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Need to co-sign flor RD eligible? (Gendron, Amy L.)
   2. Re: Need to co-sign flor RD eligible? (Johnston, Jill L)
   3. Re: Need to co-sign flor RD eligible? (Carver, Leslee)
   4. Re: Need to co-sign flor RD eligible? (Harrison, Kerry)
   5. Re: Need to co-sign flor RD eligible? (Haine, Barbara)
   6. Re: Need to co-sign flor RD eligible? (Cece Ohmart)
   7. Re: Need to co-sign flor RD eligible? (Regine Dallosta)
   8. Re: copy of Future Dimensions article (Scollard, Terese)


----------------------------------------------------------------------

Message: 1
Date: Tue, 6 Jan 2009 12:46:56 -0500
From: "Gendron, Amy L." <Amy.Gendron at cvmc.org>
Subject: [Cnm] Need to co-sign flor RD eligible?
To: <cnm at lists.my180.net>
Message-ID:
	<ED658CF94165704EBE82F8D0D00A3F3605CA0C65 at cvmcnt1.cvmc.org>

Is it necessary to co-sign RD eligible notes/assessments?  What do you
do at your facility? We are a small hospital so if we were to hire a new
grad often she would be the only 'dietitian' in the building.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org






------------------------------

Message: 2
Date: Tue, 6 Jan 2009 12:59:10 -0500
From: "Johnston, Jill L" <johnstonj at wvuh.com>
Subject: Re: [Cnm] Need to co-sign flor RD eligible?
To: "Gendron, Amy L." <Amy.Gendron at cvmc.org>,	<cnm at lists.my180.net>
Message-ID:
	<BAE3D81A18522C45AD890CC59B5485B6040A7986 at NT-EXCHANGE.wvuh.wvuhs.com>
Content-Type: text/plain;	charset="US-ASCII"

We have licensure in the state and they recommended we follow our
hospital guidelines.   We are required to co-sign all RD eligible staff
notes until they pass their RD exam.   

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Gendron, Amy L.
Sent: Tuesday, January 06, 2009 12:47 PM
To: cnm at lists.my180.net
Subject: [Cnm] Need to co-sign flor RD eligible?

Is it necessary to co-sign RD eligible notes/assessments?  What do you
do at your facility? We are a small hospital so if we were to hire a new
grad often she would be the only 'dietitian' in the building.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-----------------------------------------
Confidentiality Notice: This e-mail message, including any
attachments, is for the sole use of the intended recipient(s) and
may contain confidential and privileged information.  Any
unauthorized review, use, disclosure or distribution is prohibited.
 If you are not the intended recipient, please contact the sender
by reply e-mail and destroy all copies of the original message.



------------------------------

Message: 3
Date: Tue, 6 Jan 2009 12:00:28 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] Need to co-sign flor RD eligible?
To: "Gendron, Amy L." <Amy.Gendron at cvmc.org>,	<cnm at lists.my180.net>
Message-ID:
	<5330B54133B6194BA13930BDEFE9A30E03A33455 at rhcexch3.reshealthcare.org>
Content-Type: text/plain;	charset="us-ascii"

In Illinois, until someone is RD and licensed, they are not considered
eligible to practice.  Therefore, all notes would have to be co-signed.
Leslee 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Gendron, Amy L.
Sent: Tuesday, January 06, 2009 11:47 AM
To: cnm at lists.my180.net
Subject: [Cnm] Need to co-sign flor RD eligible?

Is it necessary to co-sign RD eligible notes/assessments?  What do you
do at your facility? We are a small hospital so if we were to hire a new
grad often she would be the only 'dietitian' in the building.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 4
Date: Tue, 6 Jan 2009 12:01:02 -0600
From: "Harrison, Kerry" <kharriso at stagnes.org>
Subject: Re: [Cnm] Need to co-sign flor RD eligible?
To: "Gendron, Amy L." <Amy.Gendron at cvmc.org>,	<cnm at lists.my180.net>
Message-ID:
	<9AB3ADBD43ABFD46B0DC4E80280F3B39224B0C at ahcmascdc034.DS.SJHS.COM>
Content-Type: text/plain; charset="us-ascii"

Yes, we co-sign.  We have licensure and they can not get a license until
they pass the RD exam.

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Gendron, Amy L.
Sent: Tuesday, January 06, 2009 12:47 PM
To: cnm at lists.my180.net
Subject: [Cnm] Need to co-sign flor RD eligible?

Is it necessary to co-sign RD eligible notes/assessments?  What do you
do at your facility? We are a small hospital so if we were to hire a new
grad often she would be the only 'dietitian' in the building.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.



------------------------------

Message: 5
Date: Tue, 6 Jan 2009 13:05:19 -0500
From: "Haine, Barbara" <bhaine at Elliot-HS.org>
Subject: Re: [Cnm] Need to co-sign flor RD eligible?
To: "Gendron, Amy L." <Amy.Gendron at cvmc.org>,	<cnm at lists.my180.net>
Message-ID:
	<FFAF784627F78444BAAC71732949E2CC0816AA1B at exchange03.elliot-hs.org>
Content-Type: text/plain;	charset="iso-8859-1"

We do not co-sign.  In NH, no one other than a registered dietitian can use the title dietitian, so we have a separate job description that is called clinical nutritionist.  It is the same description as for clinical dietitians, but they can only be in that position for up to one year and must pass the exam within the year.  
Barbara Haine
Elliot Hospital
Manchester, NH

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On
Behalf Of Gendron, Amy L.
Sent: Tuesday, January 06, 2009 12:47 PM
To: cnm at lists.my180.net
Subject: [Cnm] Need to co-sign flor RD eligible?


Is it necessary to co-sign RD eligible notes/assessments?  What do you
do at your facility? We are a small hospital so if we were to hire a new
grad often she would be the only 'dietitian' in the building.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-----------------------------------------
**** CONFIDENTIAL COMMUNICATION - PLEASE READ PRIVACY NOTICE ****  
       
This communication is confidential and may be read only by its
intended recipient(s). It may contain legally privileged and
protected information. If you believe you have received this
communication in error, please "Reply" to the Sender and so
indicate or call (603) 663-2800. Then, please promptly "Delete"
this communication from your computer. This communication, and any
information contained herein, may only be forwarded, printed,
disclosed, copied or disseminated by those specifically authorized
to do so. UNAUTHORIZED DISCLOSURE MAY RESULT IN LEGAL LIABILITY FOR
THOSE PERSONS RESPONSIBLE.




------------------------------

Message: 6
Date: Tue,  6 Jan 2009 13:15:59 -0500 (EST)
From: Cece Ohmart <cohmart at mainehospital.org>
Subject: Re: [Cnm] Need to co-sign flor RD eligible?
To: "Gendron, Amy L." <Amy.Gendron at cvmc.org>, cnm at lists.my180.net
Message-ID: <20090106131559.AEO56595 at mail.mainehospital.org>
Content-Type: text/plain; charset=ISO-8859-1

In Maine, cosigning a note for anyone other than a student in an ADA approved program/internship is not allowed.  Graduates of a program that meet guidelines for taking the ADA exam are eligible for a temporary license, good for one year after issuance.  Temporary dietitians do not need their notes cosigned.  I would consult my local licensing board (if you have one) to see what their rules require.

Cece Ohmart, Chair, Maine Board of Licensure of Dietetic Practice
This message is intended for the use of the addressee only and may contain information that is privileged and confidential.  If you are not the intended recipient of this message, be notified that any dissemination or use of this message is strictly prohibited.  Un-intended transmission does not constitute waiver of attorney-client privilege or any other privilege.  If you have received this message in error, please delete all copies of the message and its attachments and notify the sender immediately.  Thank you.



------------------------------

Message: 7
Date: Tue, 6 Jan 2009 13:36:49 -0500
From: "Regine Dallosta" <rdallosta at mcvh-vcu.edu>
Subject: Re: [Cnm] Need to co-sign flor RD eligible?
To: <cnm at lists.my180.net>
Message-ID: <OF48C1F362.7E1AC3DB-ON85257536.00663F81 at MCVH-VCU.EDU>
Content-Type: text/plain; charset="us-ascii"

An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/af64cd31/attachment-0001.html 

------------------------------

Message: 8
Date: Tue, 6 Jan 2009 10:46:51 -0800
From: "Scollard, Terese" <Terese.Scollard at providence.org>
Subject: Re: [Cnm] copy of Future Dimensions article
To: "Letitia Hess" <Letitia.Hess at cchmc.org>, <cnm at lists.my180.net>
Message-ID:
	<37ABAEB17B0B5B40AA0B6118E57CF59A03239F12 at wn1221.or.providence.org>
Content-Type: text/plain; charset="us-ascii"

That was my article, and I have found the old Nutrition
Dimensions..there was a summary and then the full article. We will scan
it and put it on the website. Here are  parts of original text docs, but
may have been edited for publication in the newsletter.  

Terese M. Scollard RD, LD, MBA 
Regional Clinical Nutrition Manager 
Regional Nutrition Service PHS-PSA Acute Care 
Phone: 503-216-2496 or 503-215-6974 
terese.scollard at providence.org 


 

-----Original Message-----
From: Letitia Hess [mailto:Letitia.Hess at cchmc.org] 
Sent: Tuesday, January 06, 2009 6:47 AM
To: cnm at lists.my180.net
Subject: [Cnm] copy of Future Dimensions article

Does anyone have the Spring 2001 copy of Future Dimensions? (The on-line
archive does not go back that far.) I am looking for the article on the
1999 CNM staffing survey in that issue.

Thank you.

Letitia Hess, MS, RD, LD
Senior Clinical Director
Nutrition Therapy Division - ML  5043
Cincinnati Children's Hospital Medical Center
3333 Burnet Ave.
Cincinnati, OH  45229
tel:  513/636-7285
fax:  513/636-5887
email:  letitia.hess at cchmc.org






DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.
-------------- next part --------------
A non-text attachment was scrubbed...
Name: staffing survey complete summer 02.doc
Type: application/msword
Size: 51712 bytes
Desc: staffing survey complete summer 02.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/7b105f2c/attachment.doc 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: staffing survey edited spring 2001-final.doc
Type: application/msword
Size: 44032 bytes
Desc: staffing survey edited spring 2001-final.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/7b105f2c/attachment-0001.doc 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 24
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/89cc0f6d/attachment-0001.html 

From Leslie.Hornick at dmh.mo.gov  Tue Jan  6 13:41:08 2009
From: Leslie.Hornick at dmh.mo.gov (Hornick, Leslie G.)
Date: Tue, 6 Jan 2009 15:41:08 -0600
Subject: [Cnm] Test Trays
In-Reply-To: <CFD5C8F06DA56D4FA4363E7161B3C4B303A455D9@rmh-mse-02.frhg.org>
References: <CFD5C8F06DA56D4FA4363E7161B3C4B303A455D9@rmh-mse-02.frhg.org>
Message-ID: <69DD80845D7F524BB1C8C59479ED0625013A82FA@exchsvfulton01.mx.state.mo.us>

Our dining room supervisors and food service helpers have scheduled test
tray times.   The RD's do test trays as time allows.  Different diets
are encouraged.  We do include weekends, holidays and dinner since the
supervisors and food service helpers are here those days.  A report is
done quarterly on results. 

 

 

Leslie Hornick, RD, LD

Chief Clinical Dietitian

FSH/MMMHC

 

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments
may contain confidential and privileged information for the use of the
designated recipients named above. The designated recipients are
prohibited from redisclosing this information to any other party without
authorization and are required to destroy the information after its
stated need has been fulfilled. If you are not the intended recipient,
you are hereby notified that you have received this communication in
error and that any review, disclosure, dissemination, distribution or
copying of it or its contents is prohibited by federal or state law. If
you have received this communication in error, please notify me
immediately by telephone at 573-592-2059, and destroy all copies of this
communication and any attachments.

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sohal, Manjit
Sent: Tuesday, January 06, 2009 2:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Test Trays

 

If your facility does test trays, how are they scheduled?  

Is there a rotation between the different diets?

Are test trays done on weekends and at dinner meals?

 

TIA,
Manjit

 

Manjit Sohal, M.S., R.D.

Manager, Clinical Nutrition

Fremont-Rideout Health Group 

726 Fourth Street, Suite E

Marysville, CA  95901

Ph: 530.749.4336

Pgr: 530.740.9992

Fax: 530.749.4337

www.frhg.org <http://www.frhg.org>  

Exceptional Care, Close to Home 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/00789bb3/attachment.html 

From Heberle-Heather at aramark.com  Tue Jan  6 13:51:17 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Tue, 6 Jan 2009 15:51:17 -0600
Subject: [Cnm] Test Trays
In-Reply-To: <mailman.803.1231276529.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.803.1231276529.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <FF2DABEF-7662-437A-A3E5-F0367E121E2B@mimectl>

we do schedule test trays.  Currently the CNM and the 3 clinical dietitians are in charge of test trays.  One person is schedule for a test tray each week. They are also responsible for setting up a test tray that day for a diet clerk and a cook.  So on the day of a test tray there will be one at Breakfast, Lunch, & Dinner.  Diets to be done are on the schedule.  This way we cover all meals, all days of the week, and all diets.  I have attached a copy of our test tray schedule for those who are interested.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879



From: cnm-request at lists.my180.net
Sent: Tue 1/6/09 3:15 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 26


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. V8 vitamin K (Yvette Dionne)
   2. Test Trays (Sohal, Manjit)
   3. Re: Test Trays (Egelhofer, Nancy)
   4. Re: V8 vitamin K (Egelhofer, Nancy)


----------------------------------------------------------------------

Message: 1
Date: Tue, 6 Jan 2009 15:12:15 -0500
From: "Yvette Dionne" <YDionne at westerlyhospital.org>
Subject: [Cnm] V8 vitamin K
To: <cnm at lists.my180.net>
Message-ID:
	<E8876826D209234E9756A1C959D0A28F022458EB at whmail.westerlyhospital.local>
	
Content-Type: text/plain; charset="us-ascii"

 

Hello, 
 
I am looking for information on the vitamin K content of V8.  At the
moment it is on the High >100mcg list on our teaching tool for Warfarin
patients.
 
Campbell's / V8 answered an email stating that they do not currently
have nutrient date for vitamin k in V8.  The USDA National Nutrient
Database lists -- Vegetable juice cocktail, canned 1cup = 12.8ug.  
 
Does anybody have a better source or know of why V8 juice 5.5oz would be
on the high list? 
 
Thank you for your input, 
Yvette Dionne, RD, LDN
Ext. 3464
may you be well and happy
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/a4666170/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: aleabanr.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/a4666170/attachment-0001.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 4389 bytes
Desc: Leaves Bkgrd.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/a4666170/attachment-0001.jpe 

------------------------------

Message: 2
Date: Tue, 6 Jan 2009 12:35:02 -0800
From: "Sohal, Manjit" <msohal at frhg.org>
Subject: [Cnm] Test Trays
To: <cnm at lists.my180.net>
Message-ID:
	<CFD5C8F06DA56D4FA4363E7161B3C4B303A455D9 at rmh-mse-02.frhg.org>
Content-Type: text/plain; charset="us-ascii"

If your facility does test trays, how are they scheduled?  

Is there a rotation between the different diets?

Are test trays done on weekends and at dinner meals?

 

TIA,
Manjit

 

Manjit Sohal, M.S., R.D.

Manager, Clinical Nutrition

Fremont-Rideout Health Group 

726 Fourth Street, Suite E

Marysville, CA  95901

Ph: 530.749.4336

Pgr: 530.740.9992

Fax: 530.749.4337

www.frhg.org <http://www.frhg.org>  

Exceptional Care, Close to Home 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/4f271c15/attachment-0001.html 

------------------------------

Message: 3
Date: Tue, 6 Jan 2009 16:13:46 -0500
From: "Egelhofer, Nancy" <NEgelhofer at saintjosephri.com>
Subject: Re: [Cnm] Test Trays
To: "Sohal, Manjit" <msohal at frhg.org>,	<cnm at lists.my180.net>
Message-ID:
	<EDA5D3F1218538449BB79A345387487EE90348 at exchange-2.sjhs.local>
Content-Type: text/plain; charset="us-ascii"

They are not scheduled.  Various employees are expected to do test trays
monthly (RD's, managers, lead cooks, etc.) but everyone is encouraged.
IAny employee of FS can do a test tray (ie if I don't have lunch
money??).
We encourage non-standard diets, and all meals are done (different
people work different shifts, so meal times vary).

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sohal, Manjit
Sent: Tuesday, January 06, 2009 3:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Test Trays



If your facility does test trays, how are they scheduled?  

Is there a rotation between the different diets?

Are test trays done on weekends and at dinner meals?

 

TIA,
Manjit

 

Manjit Sohal, M.S., R.D.

Manager, Clinical Nutrition

Fremont-Rideout Health Group 

726 Fourth Street, Suite E

Marysville, CA  95901

Ph: 530.749.4336

Pgr: 530.740.9992

Fax: 530.749.4337

www.frhg.org <http://www.frhg.org>  

Exceptional Care, Close to Home 

 



(THIS DOCUMENT IS INTENDED ONLY FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED.  IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL, AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW.)  If you are not the intended recipient any dissemination, distribution, copying or use of this document is strictly prohibited.  If you have received this communication in error, please notify me immediately at the email address above and delete all copies of this communication.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/623929ac/attachment-0001.html 

------------------------------

Message: 4
Date: Tue, 6 Jan 2009 16:15:17 -0500
From: "Egelhofer, Nancy" <NEgelhofer at saintjosephri.com>
Subject: Re: [Cnm] V8 vitamin K
To: "Yvette Dionne" <YDionne at westerlyhospital.org>,
	<cnm at lists.my180.net>
Message-ID:
	<EDA5D3F1218538449BB79A345387487EE90349 at exchange-2.sjhs.local>
Content-Type: text/plain; charset="us-ascii"

What is the reference for your teaching tool?  Sounds incorrect.

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Yvette Dionne
Sent: Tuesday, January 06, 2009 3:12 PM
To: cnm at lists.my180.net
Subject: [Cnm] V8 vitamin K


 

Hello, 
 
I am looking for information on the vitamin K content of V8.  At the
moment it is on the High >100mcg list on our teaching tool for Warfarin
patients.
 
Campbell's / V8 answered an email stating that they do not currently
have nutrient date for vitamin k in V8.  The USDA National Nutrient
Database lists -- Vegetable juice cocktail, canned 1cup = 12.8ug.  
 
Does anybody have a better source or know of why V8 juice 5.5oz would be
on the high list? 
 
Thank you for your input, 
Yvette Dionne, RD, LDN
Ext. 3464
may you be well and happy
 


(THIS DOCUMENT IS INTENDED ONLY FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED.  IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL, AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW.)  If you are not the intended recipient any dissemination, distribution, copying or use of this document is strictly prohibited.  If you have received this communication in error, please notify me immediately at the email address above and delete all copies of this communication.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/7c70b84b/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: aleabanr.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/7c70b84b/attachment.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 4389 bytes
Desc: Leaves Bkgrd.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/7c70b84b/attachment.jpe 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 26
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/328bfa3f/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: TEST TRAY SCHEDULE - 2008.doc
Type: application/msword
Size: 48128 bytes
Desc: TEST TRAY SCHEDULE - 2008.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090106/328bfa3f/attachment-0001.doc 

From msohal at frhg.org  Tue Jan  6 14:40:34 2009
From: msohal at frhg.org (Sohal, Manjit)
Date: Tue, 6 Jan 2009 14:40:34 -0800
Subject: [Cnm] Braden Score and Dietitian Consult
Message-ID: <CFD5C8F06DA56D4FA4363E7161B3C4B3203B58@rmh-mse-02.frhg.org>

Anyone using a particular Braden Score to warrant a Dietitian consult?  If so, what score do you use?
 
TIA
 
Manjit Sohal, MS, RD
Manager, Clinical Nutrition
Fremont-Rideout Health Group
726 4th Street
Marysville, CA 95901
530.749.4336 phone
530.740.9992 pager
530.749.4337 fax
www.frhg.org <http://www.frhg.org/> 
Exceptional Care, Close to Home 
<http://www.frhg.org/>  
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/aacdfc5c/attachment.html 

From Janet.Ross at healthall.com  Wed Jan  7 02:45:47 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Wed, 7 Jan 2009 05:45:47 -0500
Subject: [Cnm] Nutrition and Wounds
In-Reply-To: <AAE72A0D-EC0D-40F8-97C2-E790FB51110D@mac.com>
References: <mailman.19813.1215612889.3834.cnm_lists.my180.net@lists.my180.net>
	<69DD80845D7F524BB1C8C59479ED062501016A97@exchsvfulton01.mx.state.mo.us>
	<00a801c8e1d1$e01de850$6400a8c0@Front>
	<9AB3ADBD43ABFD46B0DC4E80280F3B39224A26@ahcmascdc034.DS.SJHS.COM>
	<E3453D1D67CA5E4DA378CB009C9AD6A66EAD98EC45@SJSNT-SCMAIL01.stjoe.org>
	<41CA05D55BF105489D33F8E57D71A90517169865FC@MAIL-C.healthall.com>
	<AAE72A0D-EC0D-40F8-97C2-E790FB51110D@mac.com>
Message-ID: <41CA05D55BF105489D33F8E57D71A9051716986601@MAIL-C.healthall.com>

Agree with Pam strongly--our facility handout that was attached does not mention these products.

Jan Ross
Clinical Nutrition Coordinator
418-2603, Drake Center
  "Attitude is a little thing that makes a big difference."  Winston Churchill
P Please consider the environment before printing.


From: Pam Charney [mailto:pcharney at mac.com]
Sent: Tuesday, January 06, 2009 12:16 PM
To: Ross, Janet; CNM list serve
Cc: Cathy Poquette; Kerry Harrison
Subject: Re: [Cnm] Nutrition and Wounds

What is the cost of beneprotein and arginaid? Should we really be advocating for patients, particularly outpatients, to pay for nutrients that might be found in a scrambled egg or a hamburger, which would taste better and cost less?

The evidence to this point really doesn't support supplements that claim to "support wound healing". I'm not even sure I understand what the definition of the concept "supporting wound healing" is.

Probably the best advice to patients would be to consume a diet with adequate energy, protein, and micronutrients. We should challenge ourselves to be creative in helping patients do that with food. After all, it doesn't take a college degree to hand a patient a can of "heal it all".

Patients who are overweight and/or have type 2 diabetes should focus also on weight control (since weight in and of itself is a risk factor) and blood glucose control. They also need to have advice on physical activity; wound healing is impeded in moist, dark places. The more you move it, the better. I'm not talking about running a marathon; chair exercises, range of motion, anything to relieve pressure and shear forces.

Regards,
pam


Pam Charney PhD, RD
Clinical Coordinator
Graduate Coordinated Program in Dietetics
Lecturer, Department of Epidemiology
Nutrition Sciences Program
School of Public Health and Community Medicine
Box 353410, 306-C Raitt Hall

Affiliate Associate Professor
School of Pharmacy

MS Student
Clinical Informatics and Patient Centered Technology
School of Nursing

University of Washington
Seattle, WA
charnepa at u.washington.edu<mailto:charnepa at u.washington.edu>
"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jan 6, 2009, at 8:59 AM, Ross, Janet wrote:


This is what we use--nothing to write home about.
Novartis and Walgreens used to have a booklet that marketed beneprotein and arginaid with some generic words also.  Phone number on pamphlet is 1-800-333-3785 or talk to your former novartis rep?

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com<mailto:janet.ross at healthall.com>
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net<mailto:cnm-bounces at lists.my180.net> [mailto:cnm-bounces at lists.my180.net] On Behalf Of Cathy Poquette
Sent: Tuesday, January 06, 2009 9:53 AM
To: Harrison, Kerry
Cc: cnm at lists.my180.net<mailto:cnm at lists.my180.net>
Subject: Re: [Cnm] Nutrition and Wounds

I am very interested in this kind of handout too.  Please share any handout(s) with me.

Thanks in advance.

Cathy Poquette, MS, RD
Clinical Nutrition Operations Manager
St Jude Medical Center
Fullerton, CA  92835
(714) 992-3000, ext. 3897
________________________________
From: cnm-bounces at lists.my180.net<mailto:cnm-bounces at lists.my180.net> [cnm-bounces at lists.my180.net<mailto:cnm-bounces at lists.my180.net>] On Behalf Of Harrison, Kerry [kharriso at stagnes.org<mailto:kharriso at stagnes.org>]
Sent: Tuesday, January 06, 2009 6:30 AM
Cc: cnm at lists.my180.net<mailto:cnm at lists.my180.net>
Subject: [Cnm] Nutrition and Wounds
Hi everyone,
We have an outpatient wound clinic that does not employ an RD.  I am on the inpatient wound care team and want to develop handouts for the clinic that can help with nutrition and healing.  Anyone already have anything made that relates to nutrition and wounds that they would be willing to share?  Thank you in advance.
Kerry
Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152

To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong enough to take everything you have.
-Thomas Jefferson
_____________________________________________
From: cnm-bounces at lists.my180.net<mailto:cnm-bounces at lists.my180.net> [mailto:cnm-bounces at lists.my180.net] On Behalf Of Janet Skates
Sent: Wednesday, July 09, 2008 10:42 AM
To: 'Hornick, Leslie G.'
Cc: cnm at lists.my180.net<mailto:cnm at lists.my180.net>
Subject: Re: [Cnm] outcomes measures
Leslie,
Schneider (Schneider PJ.  Nutrition support teams: an evidence-based practice. Nutr Clin Pract  2006;21:62-67) has identified examples of performance aims for a nutrition support team.  Each aim is consistent with the IOM's six aims for improvement and each is framed as measurable team performance goals.  They can be useful as QA outcomes measures for critical care nutrition and can get you thinking about how to approach QA for other nutrition areas.
*       Aim #1: Nutrition support should be indicated. No patient should receive expensive, potentially risky treatment unless it is clearly needed.
Goal: The team will improve the ordering system so that 100% of patient records meet predefined clinical indications before treatment begins.
*       Aim #2: The route of administration should be appropriate. The improper method for providing specialized nutrition support can result in unnecessary costs and risk.
Goal: The team will improve the selection of access route so that 100% of patients who can be fed enterally are fed via this route.
*       Aim #3. The patient should benefit from therapy. No patient should receive expensive, potentially risky treatment unless there is meaningful clinical improvement.
Goal. The team will improve the monitoring of nutrition therapy so that 100% of patients who receive nutrition support are shown to improve clinically according to pretreatment goals.
*       Aim #4. The incidence of complications should be low. Complications are inevitable, but using proper techniques can minimize their rate.
Goal. The team will standardize ordering, preparing, and administering nutrition support so that the infection rate, glucose imbalance, fluid and electrolyte alterations, and acid-base disturbances are reduced compared with baseline frequencies.
*       Aim #5. The patient should understand the risks and benefits of therapy. The choice to use expensive or risky treatment should involve the patient.
Goal. The team will improve patient education so that 100% of patients understand the risks and benefits of nutrition support before treatment is initiated, as documented by signed informed consent.
*       Aim #6. The proper quantity of nutrition substrate should be ordered. Too much or too little substrate can predispose patients to harm.
Goal. The team will improve the ordering process so that no patients are over- or underfed according to clinical practice guidelines.
*       Aim #7. The proper quantity of nutrition support should be administered. If nutrition support is administered incorrectly, the wrong quantities of nutrition support substrates will be given even if the order is correct.
Goal. The team will improve the method of administering nutrition so that 100% of patients receive the appropriate quantity of nutrition support substrate.
*       Aim #8. The patient should not experience a detrimental drug-nutrient interaction. Nutrition can interact negatively with other prescribed drug treatment if not properly monitored.
Goal. The team will improve the process of screening orders in the pharmacy and monitoring patients who receive nutrition support so that no patients have predictable and preventable drug-nutrient interactions.
*       Aim #9. The patient should receive nutrition support in a timely manner. Nutrition therapy should be provided promptly after treatment decisions are made.
Goal. The team will reduce the time from order to start of treatment to 2 hours
Janet
Janet Skates MS, RD, LDN, CNSD, FADA
Nutrition Consulting Services
Kingsport, TN  37663
janetskates at yahoo.com<mailto:janetskates at yahoo.com>
(423) 239-7176
-----Original Message-----
From: cnm-bounces at lists.my180.net<mailto:cnm-bounces at lists.my180.net> [mailto:cnm-bounces at lists.my180.net] On Behalf Of Hornick, Leslie G.
Sent: Wednesday, July 09, 2008 9:42 AM
To: cnm at lists.my180.net<mailto:cnm at lists.my180.net>
Subject: [Cnm] outcomes measures
I would love to know more about this...if anyone has any examples of QA
outcomes measures or good references, please share.  Thanks.
-----Original Message-----
From: cnm-bounces at lists.my180.net<mailto:cnm-bounces at lists.my180.net> [mailto:cnm-bounces at lists.my180.net]
On Behalf Of cnm-request at lists.my180.net<mailto:cnm-request at lists.my180.net>
Sent: Wednesday, July 09, 2008 9:15 AM
To: cnm at lists.my180.net<mailto:cnm at lists.my180.net>
Subject: Cnm Digest, Vol 20, Issue 54
Send Cnm mailing list submissions to
        cnm at lists.my180.net<mailto:cnm at lists.my180.net>
To subscribe or unsubscribe via the World Wide Web, visit
        http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
        cnm-request at lists.my180.net<mailto:cnm-request at lists.my180.net>
You can reach the person managing the list at
        cnm-owner at lists.my180.net<mailto:cnm-owner at lists.my180.net>
When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."

Today's Topics:
   1. Was Retaining New RDS, now outcome measures (Leibhart, Rosanne)

----------------------------------------------------------------------
Message: 1
Date: Wed, 9 Jul 2008 09:28:10 -0400
From: "Leibhart, Rosanne" <Rosanne.Leibhart at crozer.org<mailto:Rosanne.Leibhart at crozer.org>>
Subject: [Cnm] Was Retaining New RDS, now outcome measures
To: <jwmsrd at earthlink.net<mailto:jwmsrd at earthlink.net>>, "SORACCO, KELLY"
        <KSoracco at lutheran-hosp.com<mailto:KSoracco at lutheran-hosp.com>>,   "Wells, Khongmany
ARMC-Nutrition
        Services" <WellsK at armc.sbcounty.gov<mailto:WellsK at armc.sbcounty.gov>>,   <cnm at lists.my180.net<mailto:cnm at lists.my180.net>>
Message-ID:

<1904FBE1EFD42940AA44982E67B5B44E027FE379 at exchange02.CKHSAD.CROZER.ORG<mailto:1904FBE1EFD42940AA44982E67B5B44E027FE379 at exchange02.CKHSAD.CROZER.ORG>>

Content-Type: text/plain; charset="us-ascii"
Just to add to this conversation-
Last week we had surveyors from Health Facilities Accreditation Program
(HFAP, formerly AOA)
The nutrition interview went well except when he asked me the question
"Why do you do a nutrition consult?"
I began my response with  "physician orders......"
he cut me off and said " wrong answer."
I began to clarify that there are many ways a patient can come to our
attention, nursing screens etc.
He basically said he was not interested in any of that. He wanted to
know what is it that we do for the patient, what is the efficacy of your
service....are you just pushing a pen to complete a consult? He said he
was looking for QA on outcome measures. He did not care about QA that
states we answered X number of consults in whatever timeframe we had
established.
While there was no citation on this, our hospital president heard the
interview and wants us to change our QA to outcome measures.
I am not sure how I will proceed but we recently switched over to the
Nutrition Care Process and I think it will be easier to get the data.
Rosanne Leibhart, RD

________________________________
From: cnm-bounces at lists.my180.net<mailto:cnm-bounces at lists.my180.net> [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Jo Lynn Worden
Sent: Tuesday, July 08, 2008 8:11 PM
To: 'SORACCO, KELLY'; 'Wells, Khongmany ARMC-Nutrition Services';
cnm at lists.my180.net<mailto:cnm at lists.my180.net>
Subject: Re: [Cnm] Retaining New RDS

Please post to list.

From: cnm-bounces at lists.my180.net<mailto:cnm-bounces at lists.my180.net> [mailto:cnm-bounces at lists.my180.net]
On Behalf Of SORACCO, KELLY
Sent: Tuesday, July 08, 2008 12:15 PM
To: Wells, Khongmany ARMC-Nutrition Services; cnm at lists.my180.net<mailto:cnm at lists.my180.net>
Subject: [Cnm] Retaining New RDS

Excellent Discussion!  Thanks to everyone that has responded so far.  I
like Khongmany 's last question and would like to encourage further
responses on this subject: What are others out there doing to improve
patient outcomes and how is this being show cased?

Kelly Soracco, MS, RD
Patient Services Manager
Lutheran, St Joe & Rehab Hospitals
ksoracco at lutheran-hosp.com<mailto:ksoracco at lutheran-hosp.com> <mailto:ksoracco at lutheran-hosp.com>
260-435-7983 phone
260-435-6999 fax

________________________________
From: Wells, Khongmany ARMC-Nutrition Services
[mailto:WellsK at armc.sbcounty.gov]
Sent: Tuesday, July 08, 2008 12:34 PM
To: SORACCO, KELLY; cnm at lists.my180.net<mailto:cnm at lists.my180.net>
Subject: RE: [Cnm] Retaining New RDS

I don't think it is happening with just new grads. I know of several
dietitians who have gone back to school to pursue another career that
would, of course, get them more pay, more recognition, and more
authority.  One dietitian is going back to school to do Pre-Med and she
has been an RD for 10 years.  Another went to PA school after 5 years of
working as an RD and an intern that we had last year went on to Pharmacy
School after she finished her internship.   One dietitian dropped her RD
all together and is working as a Hospital Administrator with her MBA.

It's hard to find dietitians in general, at least in our area. I only
have one applicant on my list of candidates for interview and I am still
in search of a qualified candidate (position has been opened since
February).

  I've been lucky that I have not had much turn over.  The newest one in
the field has been with us for almost two years-not sure how much longer
she will stay given that other hospitals around the area are offering
more pay.  I have another dietitian who is constantly looking for
another job but continue to stay on board b/c we are a trauma center and
offer a lot of challenging patients for him to work with.   We are a
county facility and many stay on b/c of the good retirement plan, but
many people don't look to that first-they look at the $ amount that they
are being paid.  I am looking at creating a career ladder or trying to
get some extra compensation for CNSDs and CDEs at least; but I know that
is going to be a challenge being a County system and there are not a lot
of hospitals out there that compensate for extra certifications.

In regards to dietitians not being valued and they want to make more of
a difference, I often feel that way myself sometimes-but b/c I do enjoy
what I am doing for the most part I am sticking with it-at least for
now.  It is very discouraging to see other positions within the County
with less educational background and less responsibilities receive  as
much or more money as our profession (clinical RD and myself included).
My DTR will make more money as a secretary (that is another story).   I
try not to look at that since it will just get me more discouraged.   My
goal for our staff is to be recognized like other disciplines (PT for
their LIFT Team, Social Services for helping to decrease LOS, and of
coarse nursing for their quality nursing care).   I am often talking to
the dietitians about wanting to show admin that we do make an impact on
the patients' outcome b/c I don't think admin really understands what we
do in clinical nutrition.  I know our CEO has really good intentions and
he urges us to provide quality care to our patients, but he does not
fully understand the role that we play in patient care.   When Nutrition
is recognized, we are often recognized for the GREAT Food and great
service provided at the Employee Picnic etc.  Although I don't mind
being associated with Foodservice, I would like to see what we can do to
make our Clinical Nutrition Section better recognized.  What are others
out there doing to improve patient outcomes and how is this being show
cased?
Khongmany Wells, RD, MPH, CNSD
Colton CA
(909) 580-2466
________________________________
From: cnm-bounces at lists.my180.net<mailto:cnm-bounces at lists.my180.net> on behalf of SORACCO, KELLY
Sent: Sun 7/6/2008 7:18 PM
To: cnm at lists.my180.net<mailto:cnm at lists.my180.net>
Subject: [Cnm] Retaining New RDS
I have a staff of 10 Clinical RDS.  5 are fairly new to the field (less
than 4 years) and 4 of them are seriously looking into PA school. They
feel dietitians are not valued and they want to make more of a
difference.    3 of them received, for the first time in our facility
for RDs, a hefty sign on or loan forgiveness bonus to the tune of $8000
with a 2 year contract.  I get the feeling they will bail at the end of
this time frame.  I felt I really hired some exceptional candidates who
would stay, and now it seems that I can't trust my instincts!

Is anyone else experiencing this with new grads?  Is this a generational
thing (no offense to you young managers)?  I am at a loss.  How have you
retained your RDS?
Kelly Soracco, MS, RD
Patient Services Manager
Lutheran & St. Joseph Hospitals
435-7983

________________________________
________________________________
Disclaimer: This electronic message may contain information that is
Proprietary, Confidential, or legally privileged or protected. It is
intended only for the use of the individual(s) and entity named in the
message. If you are not an intended recipient of this message, please
notify the sender immediately and delete the material from your
computer. Do not deliver, distribute or copy this message and do not
disclose its contents or take any action in reliance on the information
it contains.
-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20080709/605145d2/attachment.
html
------------------------------
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net<mailto:Cnm at lists.my180.net>
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

End of Cnm Digest, Vol 20, Issue 54
***********************************
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net<mailto:Cnm at lists.my180.net>
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net << File: ATT1629416.txt >>

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.

________________________________
Notice from St.Joseph Health System:
Please note that the information contained in this message may be privileged and confidential and protected from disclosure.

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
<Protein-Calories.doc>_______________________________________________
Cnm mailing list
Cnm at lists.my180.net<mailto:Cnm at lists.my180.net>
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/317c5e81/attachment-0001.html 

From Annalynn_Skipper at Comcast.net  Wed Jan  7 03:23:07 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Wed, 7 Jan 2009 05:23:07 -0600
Subject: [Cnm] Braden Score and Dietitian Consult
In-Reply-To: <CFD5C8F06DA56D4FA4363E7161B3C4B3203B58@rmh-mse-02.frhg.org>
References: <CFD5C8F06DA56D4FA4363E7161B3C4B3203B58@rmh-mse-02.frhg.org>
Message-ID: <011001c970ba$52aa99f0$f7ffcdd0$@net>

The problem with using the Braden scale is that much of the score is not
related to nutrition, but to pressure, friction, shear, and activity.  These
are things that dietitians working within a traditional scope cannot
control.  So, the total Braden scale score is not a specific indicator of a
nutrition problem.   A small part of the Braden scale is the nutrition
score.  If the nutrition score is 2 or less, there is a reason for an RD to
do a nutrition assessment, and based on the results, intervene.  I tried to
explain this in more detail in a paper that is posted on the Nestle website.
You may want to read it as part of your investigation into this topic.

 

Regards,

 

Annalynn Skipper Ph.D., R.D., FADA

Annalynn Skipper and Associates is a consultancy dedicated to advancing
nutrition practice  

 

From: Sohal, Manjit [mailto:msohal at frhg.org] 
Sent: Tuesday, January 06, 2009 4:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Braden Score and Dietitian Consult

 

Anyone using a particular Braden Score to warrant a Dietitian consult?  If
so, what score do you use?

 

TIA

 

Manjit Sohal, MS, RD
Manager, Clinical Nutrition
Fremont-Rideout Health Group
726 4th Street
Marysville, CA 95901
530.749.4336 phone
530.740.9992 pager
530.749.4337 fax
www.frhg.org <http://www.frhg.org/> 
Exceptional Care, Close to Home 

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/770acb41/attachment.html 

From tbaton at lmhosp.org  Wed Jan  7 04:52:35 2009
From: tbaton at lmhosp.org (Baton, Terri)
Date: Wed, 7 Jan 2009 07:52:35 -0500
Subject: [Cnm] V8 vitamin K
In-Reply-To: <EDA5D3F1218538449BB79A345387487EE90349@exchange-2.sjhs.local>
References: <E8876826D209234E9756A1C959D0A28F022458EB@whmail.westerlyhospital.local>
	<EDA5D3F1218538449BB79A345387487EE90349@exchange-2.sjhs.local>
Message-ID: <612268DBF47B5E44AB898DB224E39246053D2D92@LMMAIL.lmhosp.local>

  

Think the person creating the tool looked at the potassium (K) column by
mistake? TBJ

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Egelhofer, Nancy
Sent: Tuesday, January 06, 2009 4:15 PM
To: Yvette Dionne; cnm at lists.my180.net
Subject: Re: [Cnm] V8 vitamin K

 

What is the reference for your teaching tool?  Sounds incorrect.

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Yvette Dionne
Sent: Tuesday, January 06, 2009 3:12 PM
To: cnm at lists.my180.net
Subject: [Cnm] V8 vitamin K

 

Hello, 

 

I am looking for information on the vitamin K content of V8.  At the
moment it is on the High >100mcg list on our teaching tool for Warfarin
patients.

 

Campbell's / V8 answered an email stating that they do not currently
have nutrient date for vitamin k in V8.  The USDA National Nutrient
Database lists -- Vegetable juice cocktail, canned 1cup = 12.8ug.  

 

Does anybody have a better source or know of why V8 juice 5.5oz would be
on the high list? 

 

Thank you for your input, 

Yvette Dionne, RD, LDN

Ext. 3464

may you be well and happy

 

 

(THIS DOCUMENT IS INTENDED ONLY FOR THE USE OF THE PERSON TO WHOM IT IS
ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL,
AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW). If you are not the
intended recipient any dissemination, distribution, copying or use of
this document is strictly prohibited. If you have received this
communication in error, please notify me immediately at the email
address above and delete all copies of this communication. 


This message (and any included attachments) is from Lawrence & Memorial Corporation, Inc. or one of its affiliates and is intended only for the addressee(s). The information contained herein may include privileged or otherwise confidential information. Unauthorized review, forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you received this message in error, or have reason to believe you are not authorized to receive it, please promptly delete this message and notify the sender by e-mail.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/b56bff33/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 4389 bytes
Desc: image001.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/b56bff33/attachment.jpe 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: image002.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/b56bff33/attachment.gif 

From JPorcari at NSHS.edu  Wed Jan  7 05:18:09 2009
From: JPorcari at NSHS.edu (Porcari, Judy)
Date: Wed, 7 Jan 2009 08:18:09 -0500
Subject: [Cnm] FW:  Braden Score and Dietitian Consult
Message-ID: <1A886083D8A7FA46B6DC32734D60EB0B029C72E9@EXCHVS01.nslijhs.net>

Another part of the problem using a composite Braden Scale is that as a
practical matter RNs may not always use the detailed criteria for each
of the nutrition scores within the Braden Scale.  That is, the nutrition
score of the Braden Scale becomes a subjective score - which has
implications for the rest of the components and therefore the composite
score.

 

Judy 

Judith Porcari, MBA, MS, RD
Assistant Director, Nutrition and Food Service Department
North Shore University Hospital
300 Community Drive
Manhasset, New York  11030 

jporcari at nshs.edu 

voice (516) 562-4113; fax (516) 562-1298 

The information contained in this electronic e-mail transmission and any
attachments are intended only for the use of the individual or entity to
whom or to which it is addressed, and may contain information that is
privileged, confidential and exempt from disclosure under applicable
law. If the reader of this communication is not the intended recipient,
or the employee or agent responsible for delivering this communication
to the intended recipient, you are hereby notified that any
dissemination, distribution, copying or disclosure of this communication
and any attachment is strictly prohibited. If you have received this
transmission in error, please notify the sender immediately by telephone
and electronic mail, and delete the original communication and any
attachment from any computer, server or other electronic recording or
storage device or medium. Receipt by anyone other than the intended
recipient is not a waiver of any attorney-client, physician-patient or
other privilege.

Thank you. 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Annalynn Skipper
Sent: Wednesday, January 07, 2009 6:23 AM
To: 'Sohal, Manjit'; cnm at lists.my180.net
Subject: Re: [Cnm] Braden Score and Dietitian Consult



The problem with using the Braden scale is that much of the score is not
related to nutrition, but to pressure, friction, shear, and activity.
These are things that dietitians working within a traditional scope
cannot control.  So, the total Braden scale score is not a specific
indicator of a nutrition problem.   A small part of the Braden scale is
the nutrition score.  If the nutrition score is 2 or less, there is a
reason for an RD to do a nutrition assessment, and based on the results,
intervene.  I tried to explain this in more detail in a paper that is
posted on the Nestle website.  You may want to read it as part of your
investigation into this topic.

 

Regards,

 

Annalynn Skipper Ph.D., R.D., FADA

Annalynn Skipper and Associates is a consultancy dedicated to advancing
nutrition practice  

 

From: Sohal, Manjit [mailto:msohal at frhg.org] 
Sent: Tuesday, January 06, 2009 4:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Braden Score and Dietitian Consult

 

Anyone using a particular Braden Score to warrant a Dietitian consult?
If so, what score do you use?

 

TIA

 

Manjit Sohal, MS, RD
Manager, Clinical Nutrition
Fremont-Rideout Health Group
726 4th Street
Marysville, CA 95901
530.749.4336 phone
530.740.9992 pager
530.749.4337 fax
www.frhg.org <http://www.frhg.org/> 
Exceptional Care, Close to Home 

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/3f285855/attachment-0001.html 
-------------- next part --------------
An embedded and charset-unspecified text was scrubbed...
Name: ATT2512249.txt
Url: /pipermail/cnm_lists.my180.net/attachments/20090107/3f285855/attachment-0001.txt 

From cketterman at wellspan.org  Wed Jan  7 05:20:39 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Wed, 7 Jan 2009 08:20:39 -0500
Subject: [Cnm] Test Trays
In-Reply-To: <CFD5C8F06DA56D4FA4363E7161B3C4B303A455D9@rmh-mse-02.frhg.org>
References: <CFD5C8F06DA56D4FA4363E7161B3C4B303A455D9@rmh-mse-02.frhg.org>
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AC53@EXCH4.wellspan.org>

We do test trays once per month.  It's a rotating schedule of all the
patient floor areas and a variety of diets as well as a variety of meal
times.  Unfortunately it does not include weekends because of staffing.
Our test trays are conducted as a team of 1 clinical nutrition staff
member, 1 kitchen operation staff  member (tray service supervisors, the
PI person and the director) and one production staff member (chef's and
cook's).
 
Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934
 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sohal, Manjit
Sent: Tuesday, January 06, 2009 3:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Test Trays



If your facility does test trays, how are they scheduled?  

Is there a rotation between the different diets?

Are test trays done on weekends and at dinner meals?

 

TIA,
Manjit

 

Manjit Sohal, M.S., R.D.

Manager, Clinical Nutrition

Fremont-Rideout Health Group 

726 Fourth Street, Suite E

Marysville, CA  95901

Ph: 530.749.4336

Pgr: 530.740.9992

Fax: 530.749.4337

www.frhg.org <http://www.frhg.org>  

Exceptional Care, Close to Home 

 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________


CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/e9582a40/attachment.html 

From TUCKERJ at lourdesnet.org  Wed Jan  7 06:02:02 2009
From: TUCKERJ at lourdesnet.org (Tucker, Jennifer)
Date: Wed, 7 Jan 2009 09:02:02 -0500
Subject: [Cnm] Bariatric Inservices
In-Reply-To: <CBE0048956D4B14C893378F8D13A36E201A9A5AD@IRMEXCH02.irm.inhs.org>
References: <CD224776317D2C438D1D201880C6705428687C@ITSSSXM01V1.one.ads.che.org>
	<CBE0048956D4B14C893378F8D13A36E201A9A5AD@IRMEXCH02.irm.inhs.org>
Message-ID: <CD224776317D2C438D1D201880C670542DC7F2@ITSSSXM01V1.one.ads.che.org>

Good morning,
     Administration would like to start a bariatric support group as a
webinar type program.  Naturally, they would like nutrition to present
topics twice monthly.  I was hoping you might have some ideas for
topics.

Any input would be much appreciated!

Jennifer Tucker RD
Clinical Nutrition Manager
Lourdes Health System
856-757-3596
Confidentiality Notice:
This email, including any attachments is the 
property of Catholic Health East and is intended 
for the sole use of the intended recipient(s).  
It may contain information that is privileged and 
confidential.  Any unauthorized review, use,
disclosure, or distribution is prohibited. If you are 
not the intended recipient, please reply to the 
sender that you have received the message in 
error, then delete this message.



From harrison at gunnison.com  Wed Jan  7 06:15:36 2009
From: harrison at gunnison.com (Brad Harrison)
Date: Wed, 7 Jan 2009 07:15:36 -0700
Subject: [Cnm] cost/meal
Message-ID: <01b401c970d2$8f263a20$ad72ae60$@com>

I was asked by the administrator of the LTC facility where I work to find a
"industry standard" for cost/meal. Does anyone work LTC and know what your
$/meal is?

 

Thanks, Susan Harrison, MS, RD

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/3a1d3757/attachment.html 

From cmccoy at hsd.cccounty.us  Wed Jan  7 07:24:56 2009
From: cmccoy at hsd.cccounty.us (cmccoy at hsd.cccounty.us)
Date: Wed, 7 Jan 2009 07:24:56 -0800
Subject: [Cnm] FW:  Braden Score and Dietitian Consult
In-Reply-To: <1A886083D8A7FA46B6DC32734D60EB0B029C72E9@EXCHVS01.nslijhs.net>
Message-ID: <OF27DD76A5.9217361F-ON88257537.005188D1-88257537.0054D7D8@hsd.co.contra-costa.ca.us>

I also find the Nutrition Score to be quite subjective or in error when 
made by the RN. 

I encourage my team to  use it as a tool, not an absolute. 

For this reason we do not chase it and have left it out of our "Nutrition 
Triggers". 
However, we do include it in our chart review and NCP "Nutrition 
Assessment". 


Caitlyn E. McCoy, RD,CNSD
Assistant Director of Nutrition Services 
2500 Alhambra Avenue 
Martinez, CA 94553

925-370-5384
Pager 184




"Porcari, Judy" <JPorcari at NSHS.edu> 
Sent by: cnm-bounces at lists.my180.net
01/07/2009 05:18 AM

To
<cnm at lists.my180.net>
cc

Subject
[Cnm] FW:  Braden Score and Dietitian Consult






Another part of the problem using a composite Braden Scale is that as a 
practical matter RNs may not always use the detailed criteria for each of 
the nutrition scores within the Braden Scale.  That is, the nutrition 
score of the Braden Scale becomes a subjective score - which has 
implications for the rest of the components and therefore the composite 
score.
 
Judy 
Judith Porcari, MBA, MS, RD
Assistant Director, Nutrition and Food Service Department
North Shore University Hospital
300 Community Drive
Manhasset, New York  11030 
jporcari at nshs.edu 
voice (516) 562-4113; fax (516) 562-1298 
The information contained in this electronic e-mail transmission and any 
attachments are intended only for the use of the individual or entity to 
whom or to which it is addressed, and may contain information that is 
privileged, confidential and exempt from disclosure under applicable law. 
If the reader of this communication is not the intended recipient, or the 
employee or agent responsible for delivering this communication to the 
intended recipient, you are hereby notified that any dissemination, 
distribution, copying or disclosure of this communication and any 
attachment is strictly prohibited. If you have received this transmission 
in error, please notify the sender immediately by telephone and electronic 
mail, and delete the original communication and any attachment from any 
computer, server or other electronic recording or storage device or 
medium. Receipt by anyone other than the intended recipient is not a 
waiver of any attorney-client, physician-patient or other privilege.
Thank you. 
 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On 
Behalf Of Annalynn Skipper
Sent: Wednesday, January 07, 2009 6:23 AM
To: 'Sohal, Manjit'; cnm at lists.my180.net
Subject: Re: [Cnm] Braden Score and Dietitian Consult

The problem with using the Braden scale is that much of the score is not 
related to nutrition, but to pressure, friction, shear, and activity. 
These are things that dietitians working within a traditional scope cannot 
control.  So, the total Braden scale score is not a specific indicator of 
a nutrition problem.   A small part of the Braden scale is the nutrition 
score.  If the nutrition score is 2 or less, there is a reason for an RD 
to do a nutrition assessment, and based on the results, intervene.  I 
tried to explain this in more detail in a paper that is posted on the 
Nestle website.  You may want to read it as part of your investigation 
into this topic.
 
Regards,
 
Annalynn Skipper Ph.D., R.D., FADA
Annalynn Skipper and Associates is a consultancy dedicated to advancing 
nutrition practice 
 
From: Sohal, Manjit [mailto:msohal at frhg.org] 
Sent: Tuesday, January 06, 2009 4:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Braden Score and Dietitian Consult
 
Anyone using a particular Braden Score to warrant a Dietitian consult?  If 
so, what score do you use?
 
TIA
 
Manjit Sohal, MS, RD
Manager, Clinical Nutrition
Fremont-Rideout Health Group
726 4th Street
Marysville, CA 95901
530.749.4336 phone
530.740.9992 pager
530.749.4337 fax
www.frhg.org
Exceptional Care, Close to Home 
 
 _______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/22411e04/attachment.html 

From Shannon.Jackson at wilmed.org  Wed Jan  7 07:49:39 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Wed, 7 Jan 2009 10:49:39 -0500
Subject: [Cnm] Height Chart
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA779774@wmhcs03.wmh.org>

Hi,
 
Our Peds floor is looking for the height chart (not the CDC growth chart)
that you can put on the wall to measure a child's height. Does anyone know
where I can find one?
 
Thanks!

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/5b2b5cad/attachment.html 

From Pamela.Beanum at HCAhealthcare.com  Wed Jan  7 10:03:54 2009
From: Pamela.Beanum at HCAhealthcare.com (Beanum Pamela)
Date: Wed, 7 Jan 2009 12:03:54 -0600
Subject: [Cnm] Performance Evaluations
Message-ID: <19833324B774F042B1FE1C34A79695BA12B7E583B4@NADCWPMSGCMS07.hca.corpad.net>

Does anyone have electronic copies of performance evaluations for the following positions?
*        Clinical Dietitians
*        Food Service Worker/Aide
*        Utility Aide
*        Food Service Supervisor

Thanks so much for sharing!


Pamela Beanum, RD
Clinical Nutrition/Catering Manager
804-254-9823 (phone)
804-254-5538 (fax)
Retreat Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave
Richmond VA 23220
pamela.beanum at hcahealthcare.com<mailto:pamela.beanum at hcahealthcare.com>

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/d0229654/attachment-0001.html 

From fynan-carla at CooperHealth.edu  Wed Jan  7 10:10:19 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Wed, 7 Jan 2009 13:10:19 -0500
Subject: [Cnm] criteria for RD's ordering PAL
Message-ID: <77F33794DD223B40BF24AB3D37930250172B1C0319@mxmbx01.chsmail.root.cooperhealth.edu>

Good Afternoon,

Our RD's have petitioned for direct order of PAL and I am not opposed to it with strict criteria.  Does anyone have RD's ordering PAL and what the criteria is?

Thank You!

Carla Fynan, RD
Clinical Nutrition Manager
Food & Nutrition Department
Cooper University Hospital
One Cooper Paza
Camden, NJ 08103
(856) 342-2320



****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/931fdf34/attachment.html 

From Terese.Scollard at providence.org  Wed Jan  7 10:21:52 2009
From: Terese.Scollard at providence.org (Scollard, Terese)
Date: Wed, 7 Jan 2009 10:21:52 -0800
Subject: [Cnm] FW:  Braden Score and Dietitian Consult
In-Reply-To: <1A886083D8A7FA46B6DC32734D60EB0B029C72E9@EXCHVS01.nslijhs.net>
Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A03239F70@wn1221.or.providence.org>

We too have nursing policies that state nurses to order nutrition
consult for 2 or 1 Nutrition Score; then also if the total score is over
16 or 18--
Terese M. Scollard RD, LD, MBA 
Regional Clinical Nutrition Manager
Regional Nutrition Service PHS-PSA Acute Care
Phone: 503-216-2496 or 503-215-6974
terese.scollard at providence.org 


________________________________

From: Porcari, Judy [mailto:JPorcari at NSHS.edu] 
Sent: Wednesday, January 07, 2009 5:18 AM
To: cnm at lists.my180.net
Subject: [Cnm] FW: Braden Score and Dietitian Consult


Another part of the problem using a composite Braden Scale is that as a
practical matter RNs may not always use the detailed criteria for each
of the nutrition scores within the Braden Scale.  That is, the nutrition
score of the Braden Scale becomes a subjective score - which has
implications for the rest of the components and therefore the composite
score.

 

Judy 

Judith Porcari, MBA, MS, RD
Assistant Director, Nutrition and Food Service Department
North Shore University Hospital
300 Community Drive
Manhasset, New York  11030 

jporcari at nshs.edu 

voice (516) 562-4113; fax (516) 562-1298 

The information contained in this electronic e-mail transmission and any
attachments are intended only for the use of the individual or entity to
whom or to which it is addressed, and may contain information that is
privileged, confidential and exempt from disclosure under applicable
law. If the reader of this communication is not the intended recipient,
or the employee or agent responsible for delivering this communication
to the intended recipient, you are hereby notified that any
dissemination, distribution, copying or disclosure of this communication
and any attachment is strictly prohibited. If you have received this
transmission in error, please notify the sender immediately by telephone
and electronic mail, and delete the original communication and any
attachment from any computer, server or other electronic recording or
storage device or medium. Receipt by anyone other than the intended
recipient is not a waiver of any attorney-client, physician-patient or
other privilege.

Thank you. 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Annalynn Skipper
Sent: Wednesday, January 07, 2009 6:23 AM
To: 'Sohal, Manjit'; cnm at lists.my180.net
Subject: Re: [Cnm] Braden Score and Dietitian Consult



The problem with using the Braden scale is that much of the score is not
related to nutrition, but to pressure, friction, shear, and activity.
These are things that dietitians working within a traditional scope
cannot control.  So, the total Braden scale score is not a specific
indicator of a nutrition problem.   A small part of the Braden scale is
the nutrition score.  If the nutrition score is 2 or less, there is a
reason for an RD to do a nutrition assessment, and based on the results,
intervene.  I tried to explain this in more detail in a paper that is
posted on the Nestle website.  You may want to read it as part of your
investigation into this topic.

 

Regards,

 

Annalynn Skipper Ph.D., R.D., FADA

Annalynn Skipper and Associates is a consultancy dedicated to advancing
nutrition practice  

 

From: Sohal, Manjit [mailto:msohal at frhg.org] 
Sent: Tuesday, January 06, 2009 4:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Braden Score and Dietitian Consult

 

Anyone using a particular Braden Score to warrant a Dietitian consult?
If so, what score do you use?

 

TIA

 

Manjit Sohal, MS, RD
Manager, Clinical Nutrition
Fremont-Rideout Health Group
726 4th Street
Marysville, CA 95901
530.749.4336 phone
530.740.9992 pager
530.749.4337 fax
www.frhg.org <http://www.frhg.org/> 
Exceptional Care, Close to Home 

 

 



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/69bb18b3/attachment.html 

From Terese.Scollard at providence.org  Wed Jan  7 10:28:15 2009
From: Terese.Scollard at providence.org (Scollard, Terese)
Date: Wed, 7 Jan 2009 10:28:15 -0800
Subject: [Cnm] FW:  Braden Score and Dietitian Consult
In-Reply-To: <1A886083D8A7FA46B6DC32734D60EB0B029C72E9@EXCHVS01.nslijhs.net>
Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A03239F72@wn1221.or.providence.org>

Patient Fails Standard

As shown by...

Potential Independent Nursing Actions

What to Order in Computer


Braden Scale Nutrition Score


 


Braden Scale Total Score


 

?         Nutrition score 1 to 2 for > 2 days

?         Overall ranking score of 18 or less for >2 days  (including prior to admission if suspected)

?          Weigh twice weekly and record -monitor ability to maintain appropriate weight

?          Support and encourage patient to eat meals & snacks

?          Monitor and record mealtime and snack intakes 

?          Plan care to avoid conflict with mealtimes

?          Initiate Nursing Standards of Care related to nutrition & diet

?          Assure diet order correct for texture, treatment and diagnosis

?          Educate on eating to heal and have energy to gain strength

?          Include nutrition care in discharge plan

-  example: weigh weekly, eat snacks, follow-up with physician

Correct diet order is imperative.

(diet manual reference is on-line)

Nutrition Consult-Malnutrition Risk 

Explain problem details in text in computer order

Consider including between meal snacks (especially from floor stock) if patient needs & agrees to consume.

 

This is what our Nursing policy standard states.

6. Ensure adequate nutrient and fluid intake to maximize the potential for wound healing. Refer

all patients with stage III and IV pressure ulcer to Nutritional Services if indicated by Braden

subscore of ? 2 ("very poor" or "probably inadequate").

 

Terese M. Scollard RD, LD, MBA 
Regional Clinical Nutrition Manager
Regional Nutrition Service PHS-PSA Acute Care
Phone: 503-216-2496 or 503-215-6974
terese.scollard at providence.org 


________________________________

From: Porcari, Judy [mailto:JPorcari at NSHS.edu] 
Sent: Wednesday, January 07, 2009 5:18 AM
To: cnm at lists.my180.net
Subject: [Cnm] FW: Braden Score and Dietitian Consult


Another part of the problem using a composite Braden Scale is that as a practical matter RNs may not always use the detailed criteria for each of the nutrition scores within the Braden Scale.  That is, the nutrition score of the Braden Scale becomes a subjective score - which has implications for the rest of the components and therefore the composite score.

 

Judy 

Judith Porcari, MBA, MS, RD
Assistant Director, Nutrition and Food Service Department
North Shore University Hospital
300 Community Drive
Manhasset, New York  11030 

jporcari at nshs.edu 

voice (516) 562-4113; fax (516) 562-1298 

The information contained in this electronic e-mail transmission and any attachments are intended only for the use of the individual or entity to whom or to which it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering this communication to the intended recipient, you are hereby notified that any dissemination, distribution, copying or disclosure of this communication and any attachment is strictly prohibited. If you have received this transmission in error, please notify the sender immediately by telephone and electronic mail, and delete the original communication and any attachment from any computer, server or other electronic recording or storage device or medium. Receipt by anyone other than the intended recipient is not a waiver of any attorney-client, physician-patient or other privilege.

Thank you. 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Annalynn Skipper
Sent: Wednesday, January 07, 2009 6:23 AM
To: 'Sohal, Manjit'; cnm at lists.my180.net
Subject: Re: [Cnm] Braden Score and Dietitian Consult



The problem with using the Braden scale is that much of the score is not related to nutrition, but to pressure, friction, shear, and activity.  These are things that dietitians working within a traditional scope cannot control.  So, the total Braden scale score is not a specific indicator of a nutrition problem.   A small part of the Braden scale is the nutrition score.  If the nutrition score is 2 or less, there is a reason for an RD to do a nutrition assessment, and based on the results, intervene.  I tried to explain this in more detail in a paper that is posted on the Nestle website.  You may want to read it as part of your investigation into this topic.

 

Regards,

 

Annalynn Skipper Ph.D., R.D., FADA

Annalynn Skipper and Associates is a consultancy dedicated to advancing nutrition practice  

 

From: Sohal, Manjit [mailto:msohal at frhg.org] 
Sent: Tuesday, January 06, 2009 4:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Braden Score and Dietitian Consult

 

Anyone using a particular Braden Score to warrant a Dietitian consult?  If so, what score do you use?

 

TIA

 

Manjit Sohal, MS, RD
Manager, Clinical Nutrition
Fremont-Rideout Health Group
726 4th Street
Marysville, CA 95901
530.749.4336 phone
530.740.9992 pager
530.749.4337 fax
www.frhg.org <http://www.frhg.org/> 
Exceptional Care, Close to Home 

 

 



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/8f45864e/attachment-0001.html 

From loydg at andersonhospital.org  Wed Jan  7 10:28:59 2009
From: loydg at andersonhospital.org (Gayle S. Loyd)
Date: Wed, 7 Jan 2009 12:28:59 -0600
Subject: [Cnm] (no subject)
Message-ID: <A4BFB19561F2EF4C9B6C07739EEDCE3901BAFF18@ANH-EXCHANGE.ANH.NET>

Hello all.   I am asking for some strange help.
 
There is an outpatient coming tomorrow afternoon.   39y/o male- vegan;
Mother wanting information concerning Copper and its toxicity esp since
he is consuming alot of beans;   Also Yeast overgrowth in the body and
diet, seritonin levels, Calcium and Vit D in Vegans.   AND what is
making him sensitive to cell phone signals.
 
We generally are just concerned with DSMT, Renal and Cardiac conditions
and diet control.
 
  HELP.
 
Gayle Loyd RD LDN
Sodexo  Healthcare
Anderson Hospital
Maryville, IL 62025
618-391-5241
loydg at andersonhospital.org
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/59635c08/attachment.html 

From Janet.Ross at healthall.com  Wed Jan  7 10:37:12 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Wed, 7 Jan 2009 13:37:12 -0500
Subject: [Cnm] CNM Symposium - Boston - March 28 - 31,
 2009 - Registration Now Open
In-Reply-To: <LYRIS-8670019-410022-2009.01.06-18.42.21--rossjv#healthall.com@mercury.lyris.net>
References: <LYRIS-8670019-410022-2009.01.06-18.42.21--rossjv#healthall.com@mercury.lyris.net>
Message-ID: <41CA05D55BF105489D33F8E57D71A905171698661A@MAIL-C.healthall.com>

Expressing my frustration.  I just tried to register on-line for the symposium and couldn't figure out how to do it--I think there is something missing from the instruction sheet (am I supposed to go to the store to do this?).  Since I only have 3 college degrees, I will just download the form and snail mail it.  The "instruction sheet" also refers to Carl Scott if you have questions, but the extension belongs to someone else.  Hmmmm.  ADA's website and electronic cababilities have improved significantly in the past 5 years, but there's still a lot of room for improvement.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
? Please consider the environment before printing.



-----Original Message-----
From: CNMeblast at gmail.com [mailto:CNMeblast at gmail.com]
Sent: Tuesday, January 06, 2009 9:42 PM
To: Ross, Janet
Subject: CNM Symposium - Boston - March 28 - 31, 2009 - Registration Now Open

 Clinical Nutrition Management (CNM) Dietetic Practice Group (DPG) Symposium
March 28, 2009 ? March 31, 2009
Renaissance Boston Waterfront Hotel
606 Congress Street
Boston, Massachusetts 02210


Leading System Change: Opportunity to Achieve System Improvements

Registration is now open at www.eatright.org/cnm2009symposium !

The changing healthcare environment continues to impact how we deliver quality nutrition care.  National healthcare initiatives, regulatory and professional standards, healthcare reform and the highly technological health care environment continue to drive our strategic plans and budget priorities. As clinical nutrition leaders, we must be innovative in designing our systems and lead change to achieve system level improvements and overall quality in our organization.

Please join your colleagues in historic Boston to learn innovated strategies to lead system change. Topics will include:
?       Developing nutrition programs that support national healthcare initiatives and new regulatory requirements
?       Utilizing instruments and tools, such as informatics, dash boards and the nutrition care process, to demonstrate positive nutrition outcomes
?       Implementing an Advanced Practice Program

Prioritize the 2009 CNM DPG Symposium into your budget and add it to your calendar.  Brochures, registration forms, online registration and a hotel reservation link are now available at www.eatright.org/cnm2009symposium  Take advantage of the early discounted fee by registering on or before February 26, 2009.  Questions?  Please contact Rita Pollack at pollackmtg at aol.com.

If you would like to consider sponsorship or exhibiting at the symposium, please contact Kelly Danis at 1-412-647-3621 or daniska@;upmc.edu no later than February 1, 2009.

Hope to see you in Boston,

Mary Jane Rogalski, MBA, RD, LDN
Chair-elect CNM DPG




---
You are currently subscribed to cnm_2008 as: rossjv at healthall.com.
To unsubscribe click here: http://mercury.lyris.net/u?id=8670019.aed4fe12502b7aa4b3eac999bf14f4c0&n=T&l=cnm_2008&o=410022
or send a blank email to leave-410022-8670019.aed4fe12502b7aa4b3eac999bf14f4c0 at mercury.lyris.net


Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information.  Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

From sheila.walsh at nahealth.com  Wed Jan  7 11:15:08 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Wed, 07 Jan 2009 12:15:08 -0700
Subject: [Cnm] 39 year old vegan and his mother?
In-Reply-To: <A4BFB19561F2EF4C9B6C07739EEDCE3901BAFF18@ANH-EXCHANGE.ANH.NET>
References: <A4BFB19561F2EF4C9B6C07739EEDCE3901BAFF18@ANH-EXCHANGE.ANH.NET>
Message-ID: <49649CCC.485B.0001.0@nahealth.com>

First of all, get cash up front for this visit.
Second tell the mother to mind her own business; the guy is 39!!!
thirdly, vegan diets are basic ash so the guy's pH is probably high; he needs to be taking 1000 IU Vit D, daily; and he probably needs to learn some variety;
he probably doesn't want to talk to his mother on the cell phone.....
 
waddayathink?
 
Oh, that was a great laugh!!!!  thanks for the list question, Gayle!!!

>>> "Gayle S. Loyd" <loydg at andersonhospital.org> 1/7/2009 11:28 AM >>>
Hello all.   I am asking for some strange help.
 
There is an outpatient coming tomorrow afternoon.   39y/o male- vegan;   Mother wanting information concerning Copper and its toxicity esp since he is consuming alot of beans;   Also Yeast overgrowth in the body and diet, seritonin levels, Calcium and Vit D in Vegans.   AND what is making him sensitive to cell phone signals.
 
We generally are just concerned with DSMT, Renal and Cardiac conditions and diet control.
 
  HELP.
 
Gayle Loyd RD LDN
Sodexo  Healthcare
Anderson Hospital
Maryville, IL 62025
618-391-5241
loydg at andersonhospital.org
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/6c996206/attachment.html 

From LCarver at Reshealthcare.org  Wed Jan  7 10:45:09 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Wed, 7 Jan 2009 12:45:09 -0600
Subject: [Cnm] (no subject)
In-Reply-To: <A4BFB19561F2EF4C9B6C07739EEDCE3901BAFF18@ANH-EXCHANGE.ANH.NET>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03A3384D@rhcexch3.reshealthcare.org>

w/ the info below I would bet there is a conflict betw mom and client
re: his being on a vegan diet.  I would also suggest staying out of the
cell phone issue w/ a referral back to the PCP, as it is completely
appropriate to state that this is not anything nutritional as much as
you are aware.   
 
If you can get a hold of the clients primary care physician, I would do
so and ask if you can get some pertinent history - I would not normally
expect the mother of a 39 yr old to be present for a health care visit
unless the client is mentally/physically limited.  Meanwhile, there are
web sites which, along w/ the info available via the ADA nutrition care
manual, that can give you the basics on healthy vegan diets.  
 
Good luck - I spent many years as an outpatient dietitian and every day
brings variety.  (I'd also be sure to ask the client if he wants his mom
present - he has the right to say "no".)  
 
Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Gayle S. Loyd
Sent: Wednesday, January 07, 2009 12:29 PM
To: cnm at lists.my180.net
Subject: [Cnm] (no subject)


Hello all.   I am asking for some strange help.
 
There is an outpatient coming tomorrow afternoon.   39y/o male- vegan;
Mother wanting information concerning Copper and its toxicity esp since
he is consuming alot of beans;   Also Yeast overgrowth in the body and
diet, seritonin levels, Calcium and Vit D in Vegans.   AND what is
making him sensitive to cell phone signals.
 
We generally are just concerned with DSMT, Renal and Cardiac conditions
and diet control.
 
  HELP.
 
Gayle Loyd RD LDN
Sodexo  Healthcare
Anderson Hospital
Maryville, IL 62025
618-391-5241
loydg at andersonhospital.org
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/b590f008/attachment.html 

From bzabinsky at rcn.com  Wed Jan  7 11:20:57 2009
From: bzabinsky at rcn.com (bzabinsky at rcn.com)
Date: Wed,  7 Jan 2009 14:20:57 -0500 (EST)
Subject: [Cnm] Psych Floor Menus
Message-ID: <20090107142057.BWE26777@ms10.lnh.mail.rcn.net>

I was wondering if you could help me.  We currently have a fixed menus for our psych floor and out patient satisfaction scores are not too great...we are looking to improve.  How are other hospital handling food preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would be much appreciated.

Beth Zabinsky


From skonruff at rehabhospitalwi.com  Wed Jan  7 11:21:14 2009
From: skonruff at rehabhospitalwi.com (Sallie Konruff)
Date: Wed, 7 Jan 2009 13:21:14 -0600
Subject: [Cnm] Juicer for MS patient
In-Reply-To: <37ABAEB17B0B5B40AA0B6118E57CF59A03239F72@wn1221.or.providence.org>
References: <1A886083D8A7FA46B6DC32734D60EB0B029C72E9@EXCHVS01.nslijhs.net>
	<37ABAEB17B0B5B40AA0B6118E57CF59A03239F72@wn1221.or.providence.org>
Message-ID: <25C9E6831265CF4EB6A5E031A3E38F1B03285025@ch17.centerrehc.com>

Hello;

Does anyone have any experience with juicers - for extracting juice from fruits and vegetables etc?? A patient is interested in getting a juicer for home use and unfortunately I have never had to buy one to know pros and cons of features.? Thanks in advance.

? 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Scollard, Terese
Sent: Wednesday, January 07, 2009 12:28 PM
To: Porcari, Judy; cnm at lists.my180.net
Subject: Re: [Cnm] FW: Braden Score and Dietitian Consult

 

Patient Fails Standard

As shown by...

Potential Independent Nursing Actions

What to Order in Computer


Braden Scale Nutrition Score


 


Braden Scale Total Score


 

*         Nutrition score 1 to 2 for > 2 days

*         Overall ranking score of 18 or less for >2 days? (including prior to admission if suspected)

*          Weigh twice weekly and record -monitor ability to maintain appropriate weight

*          Support and encourage patient to eat meals & snacks

*          Monitor and record mealtime and snack intakes 

*          Plan care to avoid conflict with mealtimes

*          Initiate Nursing Standards of Care related to nutrition & diet

*          Assure diet order correct for texture, treatment and diagnosis

*          Educate on eating to heal and have energy to gain strength

*          Include nutrition care in discharge plan

-? example: weigh weekly, eat snacks, follow-up with physician

Correct diet order is imperative.

(diet manual reference is on-line)

Nutrition Consult-Malnutrition Risk 

Explain problem details in text in computer order

Consider including between meal snacks (especially from floor stock) if patient needs & agrees to consume.

 

This is what our Nursing policy standard states.

6. Ensure adequate nutrient and fluid intake to maximize the potential for wound healing. Refer

all patients with stage III and IV pressure ulcer to Nutritional Services if indicated by Braden

subscore of ? 2 ("very poor" or "probably inadequate").

 

Terese M. Scollard RD, LD, MBA 
Regional Clinical Nutrition Manager
Regional Nutrition Service PHS-PSA Acute Care
Phone: 503-216-2496 or 503-215-6974
terese.scollard at providence.org 

 

________________________________

From: Porcari, Judy [mailto:JPorcari at NSHS.edu] 
Sent: Wednesday, January 07, 2009 5:18 AM
To: cnm at lists.my180.net
Subject: [Cnm] FW: Braden Score and Dietitian Consult

Another part of the problem using a composite Braden Scale is that as a practical matter RNs may not always use the detailed criteria for each of the nutrition scores within the Braden Scale.  That is, the nutrition score of the Braden Scale becomes a subjective score - which has implications for the rest of the components and therefore the composite score.

 

Judy 

Judith Porcari, MBA, MS, RD
Assistant Director, Nutrition and Food Service Department
North Shore University Hospital
300 Community Drive
Manhasset, New York  11030 

jporcari at nshs.edu 

voice (516) 562-4113; fax (516) 562-1298 

The information contained in this electronic e-mail transmission and any attachments are intended only for the use of the individual or entity to whom or to which it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering this communication to the intended recipient, you are hereby notified that any dissemination, distribution, copying or disclosure of this communication and any attachment is strictly prohibited. If you have received this transmission in error, please notify the sender immediately by telephone and electronic mail, and delete the original communication and any attachment from any computer, server or other electronic recording or storage device or medium. Receipt by anyone other than the intended recipient is not a waiver of any attorney-client, physician-patient or other privilege.

Thank you. 

 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Annalynn Skipper
Sent: Wednesday, January 07, 2009 6:23 AM
To: 'Sohal, Manjit'; cnm at lists.my180.net
Subject: Re: [Cnm] Braden Score and Dietitian Consult

The problem with using the Braden scale is that much of the score is not related to nutrition, but to pressure, friction, shear, and activity.  These are things that dietitians working within a traditional scope cannot control.  So, the total Braden scale score is not a specific indicator of a nutrition problem.   A small part of the Braden scale is the nutrition score.  If the nutrition score is 2 or less, there is a reason for an RD to do a nutrition assessment, and based on the results, intervene.  I tried to explain this in more detail in a paper that is posted on the Nestle website.  You may want to read it as part of your investigation into this topic.

 

Regards,

 

Annalynn Skipper Ph.D., R.D., FADA

Annalynn Skipper and Associates is a consultancy dedicated to advancing nutrition practice  

 

From: Sohal, Manjit [mailto:msohal at frhg.org] 
Sent: Tuesday, January 06, 2009 4:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Braden Score and Dietitian Consult

 

Anyone using a particular Braden Score to warrant a Dietitian consult?  If so, what score do you use?

 

TIA

 

Manjit Sohal, MS, RD
Manager, Clinical Nutrition
Fremont-Rideout Health Group
726 4th Street
Marysville, CA 95901
530.749.4336 phone
530.740.9992 pager
530.749.4337 fax
www.frhg.org <http://www.frhg.org/> 
Exceptional Care, Close to Home 

 

 

DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/1728205e/attachment-0001.html 

From Amy.Gendron at cvmc.org  Wed Jan  7 11:29:46 2009
From: Amy.Gendron at cvmc.org (Gendron, Amy L.)
Date: Wed, 7 Jan 2009 14:29:46 -0500
Subject: [Cnm] Psych Floor Menus
In-Reply-To: <20090107142057.BWE26777@ms10.lnh.mail.rcn.net>
Message-ID: <ED658CF94165704EBE82F8D0D00A3F3605CA0C70@cvmcnt1.cvmc.org>

Our psych patients do fill out their own menus, then we change them as
needed in the diet office for any special diets.  We have diet techs who
are available to assist a patient who may have a hard time filling out a
menu or getting started.  We also allow them access to our cafeteria
menu as diet allows.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org

-----Original Message-----
From: bzabinsky at rcn.com [mailto:bzabinsky at rcn.com] 
Sent: Wednesday, January 07, 2009 2:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky





From LCarver at Reshealthcare.org  Wed Jan  7 11:29:58 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Wed, 7 Jan 2009 13:29:58 -0600
Subject: [Cnm] Psych Floor Menus
In-Reply-To: <20090107142057.BWE26777@ms10.lnh.mail.rcn.net>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03A3388C@rhcexch3.reshealthcare.org>

They fill out their own menus w/ assistance from the staff there. 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of bzabinsky at rcn.com
Sent: Wednesday, January 07, 2009 1:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From janet.fletcher at eamc.org  Wed Jan  7 11:33:44 2009
From: janet.fletcher at eamc.org (Jan Fletcher)
Date: Wed, 7 Jan 2009 13:33:44 -0600
Subject: [Cnm] Psych Floor Menus
In-Reply-To: <20090107142057.BWE26777@ms10.lnh.mail.rcn.net>
References: <20090107142057.BWE26777@ms10.lnh.mail.rcn.net>
Message-ID: <8AF41BE5480EB240A37098F30EA04FD604DBCA8E@max.AD.EAMC.ORG>

We have our psych patients fill out menus.  We leave them on the unit
and they do them in group.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of bzabinsky at rcn.com
Sent: Wednesday, January 07, 2009 1:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
This email and any files transmitted with it are confidential and
intended solely for the use of the individual or entity to whom they are
addressed. If you have received this email in error please notify the
system manager. This message contains confidential information and is
intended only for the individual named. If you are not the named
addressee you should not disseminate, distribute or copy this e-mail.


From pdaws at charter.net  Wed Jan  7 11:34:22 2009
From: pdaws at charter.net (pdaws at charter.net)
Date: Wed, 7 Jan 2009 11:34:22 -0800
Subject: [Cnm] 39 year old vegan and his mother?
In-Reply-To: <49649CCC.485B.0001.0@nahealth.com>
Message-ID: <20090107143422.S0YO4.2611842.root@mp20>

We might be rushing to assumptions about the mother's involvement.  I do have clients where the parent is the primary caregiver for a disabled older child.  While I understand that it is not the normal routine and can raise some alarms for a parent to be so involved for an adult child, let's not be hasty in the assessment of why she is involved.

Pam D.
Washington
---- Sheila Walsh <sheila.walsh at nahealth.com> wrote: 

=============
First of all, get cash up front for this visit.
Second tell the mother to mind her own business; the guy is 39!!!
thirdly, vegan diets are basic ash so the guy's pH is probably high; he needs to be taking 1000 IU Vit D, daily; and he probably needs to learn some variety;
he probably doesn't want to talk to his mother on the cell phone.....
 
waddayathink?
 
Oh, that was a great laugh!!!!  thanks for the list question, Gayle!!!

>>> "Gayle S. Loyd" <loydg at andersonhospital.org> 1/7/2009 11:28 AM >>>
Hello all.   I am asking for some strange help.
 
There is an outpatient coming tomorrow afternoon.   39y/o male- vegan;   Mother wanting information concerning Copper and its toxicity esp since he is consuming alot of beans;   Also Yeast overgrowth in the body and diet, seritonin levels, Calcium and Vit D in Vegans.   AND what is making him sensitive to cell phone signals.
 
We generally are just concerned with DSMT, Renal and Cardiac conditions and diet control.
 
  HELP.
 
Gayle Loyd RD LDN
Sodexo  Healthcare
Anderson Hospital
Maryville, IL 62025
618-391-5241
loydg at andersonhospital.org



From cketterman at wellspan.org  Wed Jan  7 11:44:12 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Wed, 7 Jan 2009 14:44:12 -0500
Subject: [Cnm] Psych Floor Menus
In-Reply-To: <20090107142057.BWE26777@ms10.lnh.mail.rcn.net>
References: <20090107142057.BWE26777@ms10.lnh.mail.rcn.net>
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AC62@EXCH4.wellspan.org>

Our psych pt. depending on the diet rx, have the same menus as any other
patient.  They do choose their meals but it's trying at times!  We have
rules for them (like one entree!) but we frequently get almost every
item circled.  But that is probably 10% of the pt population.  The rest
do pretty good.  The menus are completed by the patients as a group
activity in the evening.   


Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of bzabinsky at rcn.com
Sent: Wednesday, January 07, 2009 2:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________


From bhomola at comhs.org  Wed Jan  7 12:00:31 2009
From: bhomola at comhs.org (Bobbi Homola)
Date: Wed, 7 Jan 2009 14:00:31 -0600
Subject: [Cnm] Psych Floor Menus
In-Reply-To: <20090107142057.BWE26777@ms10.lnh.mail.rcn.net>
Message-ID: <A54EFD4D2B0E924B970F363E6CCA949302E53C4A@sm-xchg.comhs.org>

We've tried a variety of things over the years. Currently we are serving
them in bulk from a hot cart...so the menu has more choices and is more
varied - sometimes it's leftovers, sometimes cafeteria items, sometimes
whatever the cook feels like making. 

 

Bobbi Homola, MPA, RD, CD

Clinical Manager, Food and Nutrition Services

St. Mary Medical Center / St. Catherine Hospital

1500 South Lake Park Avenue

Hobart, IN 46342

219-947-6048 / 219-392-7081

219-947-6049 fax

bhomola at comhs.org

 

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of bzabinsky at rcn.com
Sent: Wednesday, January 07, 2009 1:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

 

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?

Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

 

Beth Zabinsky

 

_______________________________________________

Cnm mailing list

Cnm at lists.my180.net

http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

 


____________________________________

This message and attachment(s), if any, is intended for the sole use of the individual and/or entity 
of which it is addressed, and may contain information that is privileged,confidential and prohibited 
from disclosure under applicable law. If you are not the addressee, or authorized to receive this on 
behalf of the addressee, you are hereby notified that you may not use, copy, disclose or distribute 
to anyone this message or any part thereof. If you have received this in error, please immediately advise 
the sender by e-mail and delete this information and all attachments from your computer and network. 
Thank you.
____________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/a2c75c3c/attachment.html 

From Michael.Smith at LPNT.net  Wed Jan  7 12:23:05 2009
From: Michael.Smith at LPNT.net (Smith Michael - Palestine)
Date: Wed, 7 Jan 2009 14:23:05 -0600
Subject: [Cnm] criteria for RD's ordering PAL
In-Reply-To: <77F33794DD223B40BF24AB3D37930250172B1C0319@mxmbx01.chsmail.root.cooperhealth.edu>
References: <77F33794DD223B40BF24AB3D37930250172B1C0319@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: <B0B3BB7F0AC03B4780174D2286A0918D25AA8943B6@NADCWPMSGCMS01.hca.corpad.net>

What is "PAL"?

Michael Smith RD LD
Palestine Regional Medical Center
Palestine, Texas
________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Fynan, Carla
Sent: Wednesday, January 07, 2009 12:10 PM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] criteria for RD's ordering PAL

Good Afternoon,

Our RD's have petitioned for direct order of PAL and I am not opposed to it with strict criteria.  Does anyone have RD's ordering PAL and what the criteria is?

Thank You!

Carla Fynan, RD
Clinical Nutrition Manager
Food & Nutrition Department
Cooper University Hospital
One Cooper Paza
Camden, NJ 08103
(856) 342-2320


**************************************************************** This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed. If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited. If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/183a6c02/attachment.html 

From janetskates at charter.net  Tue Jan  6 09:54:10 2009
From: janetskates at charter.net (Janet Skates)
Date: Tue, 6 Jan 2009 12:54:10 -0500
Subject: [Cnm] Order Writing Privileges for the RD
In-Reply-To: <F3F33241F4E7B64AAADA5DCDE2D7FCFA097FB6F0@echnexchange.echn.org>
References: <F3F33241F4E7B64AAADA5DCDE2D7FCFA097FB6F0@echnexchange.echn.org>
Message-ID: <020901c97027$c725f9c0$6400a8c0@Front>

Carol,

 

There is no one document that states it is within the scope of practice for
all RDs to order labs.  Scope of practice for dietitians is flexible and
varies according to the RD, facility, state, etc.  That said, I recommend
you check the ADA member only website for information on using the Scope of
Dietetics Practice Framework to work through the process of obtaining lab
order writing privileges for your staff.  Among many other resources, there
is a case study on obtaining order writing privileges for RDs that may prove
helpful to you.   On the member-only website, click on the "Practice" tab on
the left; then select "Scope of Dietetics Practice Framework" under
Practice.  The case study is found under the Case Studies tab, but there are
many resources that will probably help you.  Good luck.   

 

Janet

Janet Skates MS, RD, LDN, CNSD, FADA

Nutrition Consulting Services

Kingsport, TN  37663

janetskates at yahoo.com

(423) 239-7176

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Bergin, Carol
Sent: Monday, January 05, 2009 4:58 PM
To: cnm at lists.my180.net
Subject: [Cnm] Order Writing Privileges for the RD

 

Hi,

I am looking for documentation that states it is within the scope of
practice for an RD to order relevant labs necessary to complete the
nutrition assessment, if it is not available.

 

I already have copies of the ADA's "Revised 2008 Standards of Practice for
Registered Dietitians" and "White Paper" (regarding therapeutic diet
orders).  

 

We use Meditech here and are trying to increase the compliance of RD
recommendations in nutrition notes being ordered.  We thought that
completing the ordering ourselves would facilitate the ordering process.
Thank you in advance for any assistance that you can provide.  I will
appreciate it.

 

Carol Bergin, MEd, RD, CD-N

ECHN Clinical Nutrition Manager

Manchester Memorial Hospital

71 Haynes Street

Manchester, CT 06040

Phone     860-533-3411 ext. 2149     

Pager      860-820-5507

E-Mail      <mailto:cbergin at echn.org> cbergin at echn.org

 

 

 

"This message originates from Eastern Connecticut Health Network. The
information contained in this message may be privileged and confidential. If
you are the intended recipient, you must maintain this message in a secure
and confidential manner. If you are not the intended recipient, please
notify the sender immediately and destroy this message, Thank you." 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090106/fb268439/attachment.html 

From Heberle-Heather at aramark.com  Wed Jan  7 13:06:35 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Wed, 7 Jan 2009 15:06:35 -0600
Subject: [Cnm] Modified Nutrition Score (version of Braden) and Pediatrics
In-Reply-To: <mailman.1.1231358402.16557.cnm_lists.my180.net@lists.my180.net>
References: <mailman.1.1231358402.16557.cnm_lists.my180.net@lists.my180.net>
Message-ID: <06819B00-CC8E-4CAF-88AE-DED26B381331@mimectl>

Does anyone know if there is different scoring available for pediatric patients vs. adults?  We are getting constant screens on our pediatric patients due to they are unable to walk.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879



From: cnm-request at lists.my180.net
Sent: Wed 1/7/09 2:00 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 34


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: Psych Floor Menus (Gendron, Amy L.)
   2. Re: Psych Floor Menus (Carver, Leslee)
   3. Re: Psych Floor Menus (Jan Fletcher)
   4. Re: 39 year old vegan and his mother? (pdaws at charter.net)
   5. Re: Psych Floor Menus (Ketterman-Hopkins, Cindra)


----------------------------------------------------------------------

Message: 1
Date: Wed, 7 Jan 2009 14:29:46 -0500
From: "Gendron, Amy L." <Amy.Gendron at cvmc.org>
Subject: Re: [Cnm] Psych Floor Menus
To: <bzabinsky at rcn.com>,	<CNMeblast at gmail.com>,	"CNM"
	<cnm at lists.my180.net>
Cc: rladuke at challiance.org
Message-ID:
	<ED658CF94165704EBE82F8D0D00A3F3605CA0C70 at cvmcnt1.cvmc.org>

Our psych patients do fill out their own menus, then we change them as
needed in the diet office for any special diets.  We have diet techs who
are available to assist a patient who may have a hard time filling out a
menu or getting started.  We also allow them access to our cafeteria
menu as diet allows.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org

-----Original Message-----
From: bzabinsky at rcn.com [mailto:bzabinsky at rcn.com] 
Sent: Wednesday, January 07, 2009 2:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky






------------------------------

Message: 2
Date: Wed, 7 Jan 2009 13:29:58 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] Psych Floor Menus
To: <bzabinsky at rcn.com>,	<CNMeblast at gmail.com>,	"CNM"
	<cnm at lists.my180.net>
Cc: rladuke at challiance.org
Message-ID:
	<5330B54133B6194BA13930BDEFE9A30E03A3388C at rhcexch3.reshealthcare.org>
Content-Type: text/plain;	charset="us-ascii"

They fill out their own menus w/ assistance from the staff there. 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of bzabinsky at rcn.com
Sent: Wednesday, January 07, 2009 1:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 3
Date: Wed, 7 Jan 2009 13:33:44 -0600
From: "Jan Fletcher" <janet.fletcher at eamc.org>
Subject: Re: [Cnm] Psych Floor Menus
To: <bzabinsky at rcn.com>,	<CNMeblast at gmail.com>,	"CNM"
	<cnm at lists.my180.net>
Cc: rladuke at challiance.org
Message-ID: <8AF41BE5480EB240A37098F30EA04FD604DBCA8E at max.AD.EAMC.ORG>
Content-Type: text/plain;	charset="us-ascii"

We have our psych patients fill out menus.  We leave them on the unit
and they do them in group.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of bzabinsky at rcn.com
Sent: Wednesday, January 07, 2009 1:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
This email and any files transmitted with it are confidential and
intended solely for the use of the individual or entity to whom they are
addressed. If you have received this email in error please notify the
system manager. This message contains confidential information and is
intended only for the individual named. If you are not the named
addressee you should not disseminate, distribute or copy this e-mail.



------------------------------

Message: 4
Date: Wed, 7 Jan 2009 11:34:22 -0800
From: <pdaws at charter.net>
Subject: Re: [Cnm] 39 year old vegan and his mother?
To: "Gayle S. Loyd" <loydg at andersonhospital.org>, 	Sheila Walsh
	<sheila.walsh at nahealth.com>, cnm at lists.my180.net
Message-ID: <20090107143422.S0YO4.2611842.root at mp20>
Content-Type: text/plain; charset=utf-8

We might be rushing to assumptions about the mother's involvement.  I do have clients where the parent is the primary caregiver for a disabled older child.  While I understand that it is not the normal routine and can raise some alarms for a parent to be so involved for an adult child, let's not be hasty in the assessment of why she is involved.

Pam D.
Washington
---- Sheila Walsh <sheila.walsh at nahealth.com> wrote: 

=============
First of all, get cash up front for this visit.
Second tell the mother to mind her own business; the guy is 39!!!
thirdly, vegan diets are basic ash so the guy's pH is probably high; he needs to be taking 1000 IU Vit D, daily; and he probably needs to learn some variety;
he probably doesn't want to talk to his mother on the cell phone.....
 
waddayathink?
 
Oh, that was a great laugh!!!!  thanks for the list question, Gayle!!!

>>> "Gayle S. Loyd" <loydg at andersonhospital.org> 1/7/2009 11:28 AM >>>
Hello all.   I am asking for some strange help.
 
There is an outpatient coming tomorrow afternoon.   39y/o male- vegan;   Mother wanting information concerning Copper and its toxicity esp since he is consuming alot of beans;   Also Yeast overgrowth in the body and diet, seritonin levels, Calcium and Vit D in Vegans.   AND what is making him sensitive to cell phone signals.
 
We generally are just concerned with DSMT, Renal and Cardiac conditions and diet control.
 
  HELP.
 
Gayle Loyd RD LDN
Sodexo  Healthcare
Anderson Hospital
Maryville, IL 62025
618-391-5241
loydg at andersonhospital.org




------------------------------

Message: 5
Date: Wed, 7 Jan 2009 14:44:12 -0500
From: "Ketterman-Hopkins, Cindra" <cketterman at wellspan.org>
Subject: Re: [Cnm] Psych Floor Menus
To: <bzabinsky at rcn.com>,<CNMeblast at gmail.com>,"CNM"
	<cnm at lists.my180.net>
Cc: rladuke at challiance.org
Message-ID:
	<5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AC62 at EXCH4.wellspan.org>
Content-Type: text/plain;	charset="us-ascii"

Our psych pt. depending on the diet rx, have the same menus as any other
patient.  They do choose their meals but it's trying at times!  We have
rules for them (like one entree!) but we frequently get almost every
item circled.  But that is probably 10% of the pt population.  The rest
do pretty good.  The menus are completed by the patients as a group
activity in the evening.   


Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of bzabinsky at rcn.com
Sent: Wednesday, January 07, 2009 2:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________



------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 34
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/e851b5f5/attachment-0001.html 

From Kerry.Scott at providence.org  Tue Jan  6 09:24:11 2009
From: Kerry.Scott at providence.org (Scott, Kerry  R.)
Date: Tue, 6 Jan 2009 09:24:11 -0800
Subject: [Cnm] FW: Wounds and Triggers
In-Reply-To: <CD224776317D2C438D1D201880C6705428687C@ITSSSXM01V1.one.ads.che.org>
References: <CD224776317D2C438D1D201880C6705428687C@ITSSSXM01V1.one.ads.che.org>
Message-ID: <CBE0048956D4B14C893378F8D13A36E201A9A5AD@IRMEXCH02.irm.inhs.org>

We use Braden score <=12 as an automatic trigger on admission, in
addition to nutrition referrals from our enterostomal therapists.  We
are still working out the "bugs" as we do get some false positives if
Braden evaluation is not completed thouroughly.
Kerry Scott, RD, CD
Clinical Nutrition Manager
Food & Nutrition Services
Sacred Heart Medical Center
(509)474-4774
scottk1 at shmc.org

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Tucker, Jennifer
Sent: Tuesday, January 06, 2009 7:05 AM
To: cnm at lists.my180.net
Subject: [Cnm] FW: Wounds and Triggers


Good Morning,
    I would greatly appreciate any input on what "types" of wounds would
trigger your RD's.

Pressure ulcers stage II and greater?
Venous?
Just the word wound upon admission?

Thank you so much for any input,

Jennifer Tucker RD
Clinical Nutrition Manager
Lourdes Health System
856-757-3596
Confidentiality Notice:
This email, including any attachments is the property of Catholic Health
East and is intended for the sole use of the intended recipient(s).  
It may contain information that is privileged and confidential.  Any
unauthorized review, use, disclosure, or distribution is prohibited. If
you are not the intended recipient, please reply to the sender that you
have received the message in error, then delete this message.


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From Shannon.Jackson at wilmed.org  Wed Jan  7 13:59:15 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Wed, 7 Jan 2009 16:59:15 -0500
Subject: [Cnm] Parenteral Solutions
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA779789@wmhcs03.wmh.org>

Hi,
 
How many options do physicians at your facility have for Central Parenteral
Nutrition? Do they have one they can customize as well?
Our docs wanted one of each and I don't feel that is sufficient to meet all
of the patients' needs.
Thanks,
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/b89ef843/attachment.html 

From LCarver at Reshealthcare.org  Wed Jan  7 14:10:02 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Wed, 7 Jan 2009 16:10:02 -0600
Subject: [Cnm] Parenteral Solutions
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA779789@wmhcs03.wmh.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03A33980@rhcexch3.reshealthcare.org>

we have 1 standard and then a customizable option (used most often by
Nephrology). I've attached the forms we use - the order section is
correct in content but I don't have the final PDF on my hard drive.
Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Wednesday, January 07, 2009 3:59 PM
To: CNM (E-mail)
Subject: [Cnm] Parenteral Solutions


Hi,
 
How many options do physicians at your facility have for Central
Parenteral Nutrition? Do they have one they can customize as well?
Our docs wanted one of each and I don't feel that is sufficient to meet
all of the patients' needs.
Thanks,
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
www.wilmed.org <http://www.wilmed.org/> 

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: TPNBACK 06 revision.DOC
Type: application/msword
Size: 12800 bytes
Desc: TPNBACK 06 revision.DOC
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment-0001.dot 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Daily Adult Parenteral Nutrition Order Form 2006.doc
Type: application/msword
Size: 31744 bytes
Desc: Daily Adult Parenteral Nutrition Order Form 2006.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment-0001.doc 

From janetskates at charter.net  Wed Jan  7 14:15:34 2009
From: janetskates at charter.net (Janet Skates)
Date: Wed, 7 Jan 2009 17:15:34 -0500
Subject: [Cnm] Order Writing Privileges for the RD
In-Reply-To: <F3F33241F4E7B64AAADA5DCDE2D7FCFA097FB6F0@echnexchange.echn.org>
References: <F3F33241F4E7B64AAADA5DCDE2D7FCFA097FB6F0@echnexchange.echn.org>
Message-ID: <044b01c97115$761f1450$6400a8c0@Front>

There is no one document that states it is within the scope of practice for
all RDs to order labs.  Scope of practice for dietitians is flexible and
varies according to the RD, facility, state, etc.  That said, I recommend
you check the ADA member only website for information on using the Scope of
Dietetics Practice Framework to work through the process of obtaining lab
order writing privileges for your staff.  Among many other resources, there
is a case study on obtaining order writing privileges for RDs that may prove
helpful to you.   On the member-only website, click on the "Practice" tab on
the left; then select "Scope of Dietetics Practice Framework" under
Practice.  The case study is found under the Case Studies tab, but there are
many resources that will probably help you.  Good luck.   

 

Janet

Janet Skates MS, RD, LDN, CNSD, FADA

Nutrition Consulting Services

Kingsport, TN  37663

 <mailto:janetskates at yahoo.com> janetskates at yahoo.com

(423) 239-7176

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Bergin, Carol
Sent: Monday, January 05, 2009 4:58 PM
To: cnm at lists.my180.net
Subject: [Cnm] Order Writing Privileges for the RD

 

Hi,

I am looking for documentation that states it is within the scope of
practice for an RD to order relevant labs necessary to complete the
nutrition assessment, if it is not available.

 

I already have copies of the ADA's "Revised 2008 Standards of Practice for
Registered Dietitians" and "White Paper" (regarding therapeutic diet
orders).  

 

We use Meditech here and are trying to increase the compliance of RD
recommendations in nutrition notes being ordered.  We thought that
completing the ordering ourselves would facilitate the ordering process.
Thank you in advance for any assistance that you can provide.  I will
appreciate it.

 

Carol Bergin, MEd, RD, CD-N

ECHN Clinical Nutrition Manager

Manchester Memorial Hospital

71 Haynes Street

Manchester, CT 06040

Phone     860-533-3411 ext. 2149     

Pager      860-820-5507

E-Mail      <mailto:cbergin at echn.org> cbergin at echn.org

 

 

 

"This message originates from Eastern Connecticut Health Network. The
information contained in this message may be privileged and confidential. If
you are the intended recipient, you must maintain this message in a secure
and confidential manner. If you are not the intended recipient, please
notify the sender immediately and destroy this message, Thank you." 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/3e1f9513/attachment.html 

From bahrj at southwesthealth.org  Wed Jan  7 14:49:43 2009
From: bahrj at southwesthealth.org (Joan Bahr)
Date: Wed, 7 Jan 2009 16:49:43 -0600
Subject: [Cnm] Parenteral Solutions
In-Reply-To: <3869251104618A4CA35EB2D4021C24D1019D666B@exchange.southwesthealth.org>
References: <3869251104618A4CA35EB2D4021C24D1019D666B@exchange.southwesthealth.org>
Message-ID: <003601c9711a$3d694f90$b83beeb0$@org>

We use a standard solution and customize based on rate, lipids, etc.
Attached are the choices available for TPN and PPN .. in addition to the
solutions, there is the option of with and without electrolytes.  

This order set has worked well for us for the past several years.

Joan Bahr RD CDE

Southwest Health Center

1400 East Side Road

Platteville, WI

608-342-4766

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Shannon Byrd Jackson
Sent: Wednesday, January 07, 2009 03:59 PM
To: CNM (E-mail)
Subject: [Cnm] Parenteral Solutions

 

Hi,

 

How many options do physicians at your facility have for Central Parenteral
Nutrition? Do they have one they can customize as well?

Our docs wanted one of each and I don't feel that is sufficient to meet all
of the patients' needs.

Thanks,

 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/73bf49e5/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Parenteral nutrition order form revised 5 06 TPN form 12	07.doc
Type: application/msword
Size: 58368 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/73bf49e5/attachment-0001.doc 

From Kerry.Scott at providence.org  Wed Jan  7 15:58:42 2009
From: Kerry.Scott at providence.org (Scott, Kerry  R.)
Date: Wed, 7 Jan 2009 15:58:42 -0800
Subject: [Cnm] Modified Nutrition Score (version of Braden) and
	Pediatrics
In-Reply-To: <06819B00-CC8E-4CAF-88AE-DED26B381331@mimectl>
References: <mailman.1.1231358402.16557.cnm_lists.my180.net@lists.my180.net>
	<06819B00-CC8E-4CAF-88AE-DED26B381331@mimectl>
Message-ID: <CBE0048956D4B14C893378F8D13A36E201A9A5E1@IRMEXCH02.irm.inhs.org>

Our hospital will be using the Braden Q Scale for children less than 5
years old.    I don't know a lot about it.  Heather I can fax you a
sample of the proposed screen if you want to send your me your fax #.
 

Kerry Scott, RD, CD 
Clinical Nutrition Manager 
Food & Nutrition Services 
Sacred Heart Medical Center 
(509)474-4774 

Kerry.Scott at providence.org 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Heberle, Heather N.
Sent: Wednesday, January 07, 2009 1:07 PM
To: cnm at lists.my180.net
Subject: [Cnm] Modified Nutrition Score (version of Braden) and
Pediatrics


Does anyone know if there is different scoring available for pediatric
patients vs. adults?  We are getting constant screens on our pediatric
patients due to they are unable to walk.
 
Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879

________________________________

From: cnm-request at lists.my180.net
Sent: Wed 1/7/09 2:00 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 34


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: Psych Floor Menus (Gendron, Amy L.)
   2. Re: Psych Floor Menus (Carver, Leslee)
   3. Re: Psych Floor Menus (Jan Fletcher)
   4. Re: 39 year old vegan and his mother? (pdaws at charter.net)
   5. Re: Psych Floor Menus (Ketterman-Hopkins, Cindra)


----------------------------------------------------------------------

Message: 1
Date: Wed, 7 Jan 2009 14:29:46 -0500
From: "Gendron, Amy L." <Amy.Gendron at cvmc.org>
Subject: Re: [Cnm] Psych Floor Menus
To: <bzabinsky at rcn.com>,	<CNMeblast at gmail.com>,	"CNM"
	<cnm at lists.my180.net>
Cc: rladuke at challiance.org
Message-ID:
	<ED658CF94165704EBE82F8D0D00A3F3605CA0C70 at cvmcnt1.cvmc.org>

Our psych patients do fill out their own menus, then we change them as
needed in the diet office for any special diets.  We have diet techs who
are available to assist a patient who may have a hard time filling out a
menu or getting started.  We also allow them access to our cafeteria
menu as diet allows.

Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org

-----Original Message-----
From: bzabinsky at rcn.com [mailto:bzabinsky at rcn.com] 
Sent: Wednesday, January 07, 2009 2:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky






------------------------------

Message: 2
Date: Wed, 7 Jan 2009 13:29:58 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] Psych Floor Menus
To: <bzabinsky at rcn.com>,	<CNMeblast at gmail.com>,	"CNM"
	<cnm at lists.my180.net>
Cc: rladuke at challiance.org
Message-ID:
	
<5330B54133B6194BA13930BDEFE9A30E03A3388C at rhcexch3.reshealthcare.org>
Content-Type: text/plain;	charset="us-ascii"

They fill out their own menus w/ assistance from the staff there. 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of bzabinsky at rcn.com
Sent: Wednesday, January 07, 2009 1:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 3
Date: Wed, 7 Jan 2009 13:33:44 -0600
From: "Jan Fletcher" <janet.fletcher at eamc.org>
Subject: Re: [Cnm] Psych Floor Menus
To: <bzabinsky at rcn.com>,	<CNMeblast at gmail.com>,	"CNM"
	<cnm at lists.my180.net>
Cc: rladuke at challiance.org
Message-ID: <8AF41BE5480EB240A37098F30EA04FD604DBCA8E at max.AD.EAMC.ORG>
Content-Type: text/plain;	charset="us-ascii"

We have our psych patients fill out menus.  We leave them on the unit
and they do them in group.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of bzabinsky at rcn.com
Sent: Wednesday, January 07, 2009 1:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
This email and any files transmitted with it are confidential and
intended solely for the use of the individual or entity to whom they are
addressed. If you have received this email in error please notify the
system manager. This message contains confidential information and is
intended only for the individual named. If you are not the named
addressee you should not disseminate, distribute or copy this e-mail.



------------------------------

Message: 4
Date: Wed, 7 Jan 2009 11:34:22 -0800
From: <pdaws at charter.net>
Subject: Re: [Cnm] 39 year old vegan and his mother?
To: "Gayle S. Loyd" <loydg at andersonhospital.org>, 	Sheila Walsh
	<sheila.walsh at nahealth.com>, cnm at lists.my180.net
Message-ID: <20090107143422.S0YO4.2611842.root at mp20>
Content-Type: text/plain; charset=utf-8

We might be rushing to assumptions about the mother's involvement.  I do
have clients where the parent is the primary caregiver for a disabled
older child.  While I understand that it is not the normal routine and
can raise some alarms for a parent to be so involved for an adult child,
let's not be hasty in the assessment of why she is involved.

Pam D.
Washington
---- Sheila Walsh <sheila.walsh at nahealth.com> wrote: 

=============
First of all, get cash up front for this visit.
Second tell the mother to mind her own business; the guy is 39!!!
thirdly, vegan diets are basic ash so the guy's pH is probably high; he
needs to be taking 1000 IU Vit D, daily; and he probably needs to learn
some variety;
he probably doesn't want to talk to his mother on the cell phone.....
 
waddayathink?
 
Oh, that was a great laugh!!!!  thanks for the list question, Gayle!!!

>>> "Gayle S. Loyd" <loydg at andersonhospital.org> 1/7/2009 11:28 AM >>>
Hello all.   I am asking for some strange help.
 
There is an outpatient coming tomorrow afternoon.   39y/o male- vegan;
Mother wanting information concerning Copper and its toxicity esp since
he is consuming alot of beans;   Also Yeast overgrowth in the body and
diet, seritonin levels, Calcium and Vit D in Vegans.   AND what is
making him sensitive to cell phone signals.
 
We generally are just concerned with DSMT, Renal and Cardiac conditions
and diet control.
 
  HELP.
 
Gayle Loyd RD LDN
Sodexo  Healthcare
Anderson Hospital
Maryville, IL 62025
618-391-5241
loydg at andersonhospital.org




------------------------------

Message: 5
Date: Wed, 7 Jan 2009 14:44:12 -0500
From: "Ketterman-Hopkins, Cindra" <cketterman at wellspan.org>
Subject: Re: [Cnm] Psych Floor Menus
To: <bzabinsky at rcn.com>,<CNMeblast at gmail.com>,"CNM"
	<cnm at lists.my180.net>
Cc: rladuke at challiance.org
Message-ID:
	<5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AC62 at EXCH4.wellspan.org>
Content-Type: text/plain;	charset="us-ascii"

Our psych pt. depending on the diet rx, have the same menus as any other
patient.  They do choose their meals but it's trying at times!  We have
rules for them (like one entree!) but we frequently get almost every
item circled.  But that is probably 10% of the pt population.  The rest
do pretty good.  The menus are completed by the patients as a group
activity in the evening.   


Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of bzabinsky at rcn.com
Sent: Wednesday, January 07, 2009 2:21 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus

I was wondering if you could help me.  We currently have a fixed menus
for our psych floor and out patient satisfaction scores are not too
great...we are looking to improve.  How are other hospital handling food
preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would
be much appreciated.

Beth Zabinsky

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally
privileged.  This information is intended for the use of the named
recipient(s). The authorized recipient of this information is prohibited
from disclosing this information to any party unless required to do so
by law or regulation and is required to destroy the information after
its stated need has been fulfilled.  If you are not the intended
recipient, you are hereby notified that any disclosure, copying,
distribution, or action taken in reliance on the contents of this email
is strictly prohibited.  If you receive this e-mail message in error,
please notify the sender immediately to arrange disposition of the
information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________



------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 34
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/c9269bea/attachment.html 

From Lisa.N.Faucon at kp.org  Wed Jan  7 16:35:01 2009
From: Lisa.N.Faucon at kp.org (Lisa.N.Faucon at kp.org)
Date: Wed, 7 Jan 2009 16:35:01 -0800
Subject: [Cnm] Nutrition Care Process Terminology
Message-ID: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.org>

We are putting the Nutrition Care process into our electronic charting 
system.  Does anyone know if there are approved abbreviations?  Are the 
diagnosis copyrighted?  Or can we abbreviate?

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this 
e-mail, you are prohibited from sharing, copying, or otherwise using or 
disclosing its contents.  If you have received this e-mail in error, 
please notify the sender immediately by reply e-mail and permanently 
delete this e-mail and any attachments without reading, forwarding or 
saving them.  Thank you.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/76d69a40/attachment.html 

From Remi.Hayashi at CHW.EDU  Wed Jan  7 16:50:37 2009
From: Remi.Hayashi at CHW.EDU (Hayashi, Remi  - GMHHC)
Date: Wed, 7 Jan 2009 17:50:37 -0700
Subject: [Cnm] IBW for under 5 ft
Message-ID: <3F15BB776BDDF847B55DACB387D41ABC057CCC1E@CHW-MSG-303.chw.edu>

Happy New Year

This was probably discussed before.....how do you calculate the IBW for
patient under 5 feet?  I was always taught to multiply the number of
inches that are under 5 feet by 2.5 then subtract from 100lb for female.
Is there any reference to this method?  TIA.

Remi Hayashi, MS, RD
Clinical Nutrition Manager
Glendale Memorial Hospital and Health Center
1420 South Central Avenue
Glendale, CA 91204
(818)409-7643 Direct
(818)507-4665 Fax

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/c31d2221/attachment.html 

From marissa.hofman at ucdmc.ucdavis.edu  Wed Jan  7 16:55:26 2009
From: marissa.hofman at ucdmc.ucdavis.edu (Marissa Hofman)
Date: Wed, 7 Jan 2009 16:55:26 -0800
Subject: [Cnm] IBW for under 5 ft
In-Reply-To: <3F15BB776BDDF847B55DACB387D41ABC057CCC1E@CHW-MSG-303.chw.edu>
Message-ID: <OF100BAFDF.C0AE2BDC-ON88257538.0004D325-88257538.00051339@ucdmc.ucdavis.edu>

Here's an interesting article using IBW instead of Hamwi for short stature
females.  We are going to discuss this at our next staff meeting.

The article focuses on using a BMI of 22 which is associated with the
lowest mortality risk.


Marissa Hofman, RD
Clinical Nutrition Manager
UC Davis Medical Center
Food & Nutrition Dept.
2315 Stockton Blvd
Sacramento, CA 95817
Phone: (916) 734-5100
Fax: (916)734-3154


                                                                           
             "Hayashi, Remi  -                                             
             GMHHC"                                                        
             <Remi.Hayashi at CHW                                          To 
             .EDU>                     <cnm at lists.my180.net>               
             Sent by:                                                   cc 
             cnm-bounces at lists                                             
             .my180.net                                            Subject 
                                       [Cnm] IBW for under 5 ft            
                                                                           
             01/07/2009 04:52                                              
             PM                                                            
                                                                           
                                                                           
                                                                           




Happy New Year


This was probably discussed before?..how do you calculate the IBW for
patient under 5 feet?  I was always taught to multiply the number of inches
that are under 5 feet by 2.5 then subtract from 100lb for female.  Is there
any reference to this method?  TIA.


Remi Hayashi, MS, RD
Clinical Nutrition Manager
Glendale Memorial Hospital and Health Center
1420 South Central Avenue
Glendale, CA 91204
(818)409-7643 Direct
(818)507-4665 Fax _______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/74de5c6b/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: graycol.gif
Type: image/gif
Size: 105 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/74de5c6b/attachment.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: pic22005.gif
Type: image/gif
Size: 1255 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/74de5c6b/attachment-0001.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: ecblank.gif
Type: image/gif
Size: 45 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/74de5c6b/attachment-0002.gif 

From jlworden at att.net  Wed Jan  7 21:23:59 2009
From: jlworden at att.net (Jo Lynn Worden)
Date: Wed, 7 Jan 2009 23:23:59 -0600
Subject: [Cnm] 39 year old vegan and his mother?
In-Reply-To: <20090107143422.S0YO4.2611842.root@mp20>
References: <49649CCC.485B.0001.0@nahealth.com>
	<20090107143422.S0YO4.2611842.root@mp20>
Message-ID: <00ce01c97151$50324050$f096c0f0$@net>

I think we all got a quick smile out of the story with 'mothers involvemnt'
but the rest of the information does make one think. Copper toxicity, cell
phone, yeast overgrowth....hallmarks of a consumer reading lots of
information online or other sources. Not that these aren't valid concerns
perhaps -- they just aren't something we commonly see or are asked about.
An RD who specializes in CAM, herbs, supplements might be someone for Gayle
to find in her area?  Got me to thinking that maybe I should find one as a
resource to refer people out to. 

Mother (and son)  may have pre-conceived ideas and challenge the RD on
everything.  I've had women tell me they read a 'book' on using coconut oil
in the diet for lowering cholesterol (I checked the AHA just in case someone
found something new that I had never heard about) and when I tried to
tactfully tell her that wasn't the usual recommendation, she just said
"well, it's in the book."   (Which by the way, if there IS something out
there, let me know). Since she was so adamant, I decided not to push,
advised her to check with AHA (her husband was in for cardiac stents). 

My other favorite happened this week -- a person looking for a 'retired,
older dietitian' to talk to because the last one she talked to was 'about 12
years old and knew absolutely nothing."  
And that is the last I will comment on this area so we can get back to more
serious stuff. 
j

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of pdaws at charter.net
Sent: Wednesday, January 07, 2009 1:34 PM
To: Gayle S. Loyd; Sheila Walsh; cnm at lists.my180.net
Subject: Re: [Cnm] 39 year old vegan and his mother?

We might be rushing to assumptions about the mother's involvement.  I do
have clients where the parent is the primary caregiver for a disabled older
child.  While I understand that it is not the normal routine and can raise
some alarms for a parent to be so involved for an adult child, let's not be
hasty in the assessment of why she is involved.

Pam D.
Washington
---- Sheila Walsh <sheila.walsh at nahealth.com> wrote: 

=============
First of all, get cash up front for this visit.
Second tell the mother to mind her own business; the guy is 39!!!
thirdly, vegan diets are basic ash so the guy's pH is probably high; he
needs to be taking 1000 IU Vit D, daily; and he probably needs to learn some
variety;
he probably doesn't want to talk to his mother on the cell phone.....
 
waddayathink?
 
Oh, that was a great laugh!!!!  thanks for the list question, Gayle!!!

>>> "Gayle S. Loyd" <loydg at andersonhospital.org> 1/7/2009 11:28 AM >>>
Hello all.   I am asking for some strange help.
 
There is an outpatient coming tomorrow afternoon.   39y/o male- vegan;
Mother wanting information concerning Copper and its toxicity esp since he
is consuming alot of beans;   Also Yeast overgrowth in the body and diet,
seritonin levels, Calcium and Vit D in Vegans.   AND what is making him
sensitive to cell phone signals.
 
We generally are just concerned with DSMT, Renal and Cardiac conditions and
diet control.
 
  HELP.
 
Gayle Loyd RD LDN
Sodexo  Healthcare
Anderson Hospital
Maryville, IL 62025
618-391-5241
loydg at andersonhospital.org


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



From jlworden at att.net  Wed Jan  7 21:27:05 2009
From: jlworden at att.net (Jo Lynn Worden)
Date: Wed, 7 Jan 2009 23:27:05 -0600
Subject: [Cnm] IBW for under 5 ft
In-Reply-To: <3F15BB776BDDF847B55DACB387D41ABC057CCC1E@CHW-MSG-303.chw.edu>
References: <3F15BB776BDDF847B55DACB387D41ABC057CCC1E@CHW-MSG-303.chw.edu>
Message-ID: <00cf01c97151$beea3700$3cbea500$@net>

Please post to list. This is what I was taught but I've had people 4'6' so
their IBW would be <85 lbs?   What do other people do?

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Hayashi, Remi - GMHHC
Sent: Wednesday, January 07, 2009 6:51 PM
To: cnm at lists.my180.net
Subject: [Cnm] IBW for under 5 ft

 

Happy New Year 

This was probably discussed before...how do you calculate the IBW for
patient under 5 feet?  I was always taught to multiply the number of inches
that are under 5 feet by 2.5 then subtract from 100lb for female.  Is there
any reference to this method?  TIA.

Remi Hayashi, MS, RD 
Clinical Nutrition Manager 
Glendale Memorial Hospital and Health Center 
1420 South Central Avenue 
Glendale, CA 91204 
(818)409-7643 Direct 
(818)507-4665 Fax 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/f1131517/attachment.html 

From kharriso at stagnes.org  Thu Jan  8 05:58:16 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Thu, 8 Jan 2009 07:58:16 -0600
Subject: [Cnm] Nutrition Care Process Terminology
In-Reply-To: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.org>
References: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.org>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B39224EA1@ahcmascdc034.DS.SJHS.COM>

Each facility usually has an abbreviation reference that they follow.
Here we use Stedman's and AEB and R/T are in the book, so we use them.

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa.N.Faucon at kp.org
Sent: Wednesday, January 07, 2009 7:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

 


We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate? 

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/cc143a1b/attachment.html 

From rtripp at PINNACLEHEALTH.org  Thu Jan  8 06:28:32 2009
From: rtripp at PINNACLEHEALTH.org (Roberta Tripp)
Date: Thu, 8 Jan 2009 09:28:32 -0500
Subject: [Cnm] Nutrition Care Process Terminology
In-Reply-To: <9AB3ADBD43ABFD46B0DC4E80280F3B39224EA1@ahcmascdc034.DS.SJHS.COM>
Message-ID: <7375E17267B3DB4583032BDEFDA2D76E05DF7775@mailphs.pinnaclehealth.org>

If you want to use the standardized language (terminology) in drop downs
in your EMR you need to contact ADA for permission.  The contact info is
below.
 
Kay B. Howarter, MS, RD

Senior Research Manager

Evidence Analysis Library

American Dietetic Association

120 S. Riverside Plaza

Chicago, IL  60606-6995

TEL:  312-899-4797

FAX:  312-899-4812

 

khowarter at eatright.org <mailto:khowarter at eatright.org> 

www.adaevidencelibrary.com <http://www.adaevidencelibrary.com/> 

 

 

 

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org <mailto:rtripp at pinnaclehealth.org> 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Harrison, Kerry
Sent: Thursday, January 08, 2009 8:58 AM
To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology



Each facility usually has an abbreviation reference that they follow.
Here we use Stedman's and AEB and R/T are in the book, so we use them.

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa.N.Faucon at kp.org
Sent: Wednesday, January 07, 2009 7:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

 


We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate? 

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.

CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.


The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/03d071c6/attachment.html 

From Heberle-Heather at aramark.com  Thu Jan  8 06:45:41 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Thu, 8 Jan 2009 08:45:41 -0600
Subject: [Cnm] Parenteral Solutions
In-Reply-To: <mailman.1001.1231366199.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.1001.1231366199.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <567FB54A-103E-4BCC-BEDB-092FD7303A0A@mimectl>

We currently have 4 standard formulas and 1 section where you are able to modify and make your own solution.  We also have 2 lipid choices to choose from.  However, we have a policy in place that physicians are not allowed to do TPN.  we have a "TPN Team" which consists of a dietitian and a pharmacist.  Unless the physician specifically writes DC TPN Team, the TPN Team will be in full control of the TPN.  If a physician does write to DC TPN Team, it is reported to our pharmacy and therapeutics committee and the physician is notified.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879



From: cnm-request at lists.my180.net
Sent: Wed 1/7/09 4:09 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 36


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: FW: Wounds and Triggers (Scott, Kerry  R.)
   2. Parenteral Solutions (Shannon Byrd Jackson)
   3. Re: Parenteral Solutions (Carver, Leslee)


----------------------------------------------------------------------

Message: 1
Date: Tue, 6 Jan 2009 09:24:11 -0800
From: "Scott, Kerry  R." <Kerry.Scott at providence.org>
Subject: Re: [Cnm] FW: Wounds and Triggers
To: "Tucker, Jennifer" <TUCKERJ at lourdesnet.org>,	<cnm at lists.my180.net>
Message-ID:
	<CBE0048956D4B14C893378F8D13A36E201A9A5AD at IRMEXCH02.irm.inhs.org>
Content-Type: text/plain;	charset="us-ascii"

We use Braden score <=12 as an automatic trigger on admission, in
addition to nutrition referrals from our enterostomal therapists.  We
are still working out the "bugs" as we do get some false positives if
Braden evaluation is not completed thouroughly.
Kerry Scott, RD, CD
Clinical Nutrition Manager
Food & Nutrition Services
Sacred Heart Medical Center
(509)474-4774
scottk1 at shmc.org

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Tucker, Jennifer
Sent: Tuesday, January 06, 2009 7:05 AM
To: cnm at lists.my180.net
Subject: [Cnm] FW: Wounds and Triggers


Good Morning,
    I would greatly appreciate any input on what "types" of wounds would
trigger your RD's.

Pressure ulcers stage II and greater?
Venous?
Just the word wound upon admission?

Thank you so much for any input,

Jennifer Tucker RD
Clinical Nutrition Manager
Lourdes Health System
856-757-3596
Confidentiality Notice:
This email, including any attachments is the property of Catholic Health
East and is intended for the sole use of the intended recipient(s).  
It may contain information that is privileged and confidential.  Any
unauthorized review, use, disclosure, or distribution is prohibited. If
you are not the intended recipient, please reply to the sender that you
have received the message in error, then delete this message.


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 2
Date: Wed, 7 Jan 2009 16:59:15 -0500
From: "Shannon Byrd Jackson" <Shannon.Jackson at wilmed.org>
Subject: [Cnm] Parenteral Solutions
To: "CNM (E-mail)" <cnm at lists.my180.net>
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA779789 at wmhcs03.wmh.org>
Content-Type: text/plain; charset="iso-8859-1"

Hi,
 
How many options do physicians at your facility have for Central Parenteral
Nutrition? Do they have one they can customize as well?
Our docs wanted one of each and I don't feel that is sufficient to meet all
of the patients' needs.
Thanks,
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/b89ef843/attachment-0001.html 

------------------------------

Message: 3
Date: Wed, 7 Jan 2009 16:10:02 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] Parenteral Solutions
To: "Shannon Byrd Jackson" <Shannon.Jackson at wilmed.org>,	"CNM
	(E-mail)" <cnm at lists.my180.net>
Message-ID:
	<5330B54133B6194BA13930BDEFE9A30E03A33980 at rhcexch3.reshealthcare.org>
Content-Type: text/plain; charset="us-ascii"

we have 1 standard and then a customizable option (used most often by
Nephrology). I've attached the forms we use - the order section is
correct in content but I don't have the final PDF on my hard drive.
Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Wednesday, January 07, 2009 3:59 PM
To: CNM (E-mail)
Subject: [Cnm] Parenteral Solutions


Hi,
 
How many options do physicians at your facility have for Central
Parenteral Nutrition? Do they have one they can customize as well?
Our docs wanted one of each and I don't feel that is sufficient to meet
all of the patients' needs.
Thanks,
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
www.wilmed.org <http://www.wilmed.org/> 

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: TPNBACK 06 revision.DOC
Type: application/msword
Size: 12800 bytes
Desc: TPNBACK 06 revision.DOC
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.dot 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Daily Adult Parenteral Nutrition Order Form 2006.doc
Type: application/msword
Size: 31744 bytes
Desc: Daily Adult Parenteral Nutrition Order Form 2006.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.doc 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 36
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/62412482/attachment-0001.html 

From Heberle-Heather at aramark.com  Thu Jan  8 06:53:06 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Thu, 8 Jan 2009 08:53:06 -0600
Subject: [Cnm] IBW for under 5 ft
In-Reply-To: <mailman.1133.1231425951.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.1133.1231425951.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <860209A7-B50E-4338-82EB-53C60277C2DB@mimectl>

We use the general rule of subtracting 3# for every inch below 5ft.  I am not sure there is any reference behind it however.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879



From: cnm-request at lists.my180.net
Sent: Thu 1/8/09 8:45 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 39


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: IBW for under 5 ft (Jo Lynn Worden)
   2. Re: Nutrition Care Process Terminology (Harrison, Kerry)
   3. Re: Nutrition Care Process Terminology (Roberta Tripp)
   4. Re: Parenteral Solutions (Heberle, Heather N.)


----------------------------------------------------------------------

Message: 1
Date: Wed, 7 Jan 2009 23:27:05 -0600
From: "Jo Lynn Worden" <jlworden at att.net>
Subject: Re: [Cnm] IBW for under 5 ft
To: "'Hayashi, Remi  - GMHHC'" <Remi.Hayashi at CHW.EDU>,
	<cnm at lists.my180.net>
Message-ID: <00cf01c97151$beea3700$3cbea500$@net>
Content-Type: text/plain; charset="us-ascii"

Please post to list. This is what I was taught but I've had people 4'6' so
their IBW would be <85 lbs?   What do other people do?

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Hayashi, Remi - GMHHC
Sent: Wednesday, January 07, 2009 6:51 PM
To: cnm at lists.my180.net
Subject: [Cnm] IBW for under 5 ft

 

Happy New Year 

This was probably discussed before...how do you calculate the IBW for
patient under 5 feet?  I was always taught to multiply the number of inches
that are under 5 feet by 2.5 then subtract from 100lb for female.  Is there
any reference to this method?  TIA.

Remi Hayashi, MS, RD 
Clinical Nutrition Manager 
Glendale Memorial Hospital and Health Center 
1420 South Central Avenue 
Glendale, CA 91204 
(818)409-7643 Direct 
(818)507-4665 Fax 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/f1131517/attachment-0001.html 

------------------------------

Message: 2
Date: Thu, 8 Jan 2009 07:58:16 -0600
From: "Harrison, Kerry" <kharriso at stagnes.org>
Subject: Re: [Cnm] Nutrition Care Process Terminology
To: <Lisa.N.Faucon at kp.org>,	<cnm at lists.my180.net>
Message-ID:
	<9AB3ADBD43ABFD46B0DC4E80280F3B39224EA1 at ahcmascdc034.DS.SJHS.COM>
Content-Type: text/plain; charset="us-ascii"

Each facility usually has an abbreviation reference that they follow.
Here we use Stedman's and AEB and R/T are in the book, so we use them.

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa.N.Faucon at kp.org
Sent: Wednesday, January 07, 2009 7:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

 


We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate? 

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/cc143a1b/attachment-0001.html 

------------------------------

Message: 3
Date: Thu, 8 Jan 2009 09:28:32 -0500
From: "Roberta Tripp" <rtripp at PINNACLEHEALTH.org>
Subject: Re: [Cnm] Nutrition Care Process Terminology
To: "Harrison, Kerry" <kharriso at stagnes.org>, <Lisa.N.Faucon at kp.org>,
	<cnm at lists.my180.net>
Message-ID:
	<7375E17267B3DB4583032BDEFDA2D76E05DF7775 at mailphs.pinnaclehealth.org>
Content-Type: text/plain; charset="us-ascii"

If you want to use the standardized language (terminology) in drop downs
in your EMR you need to contact ADA for permission.  The contact info is
below.
 
Kay B. Howarter, MS, RD

Senior Research Manager

Evidence Analysis Library

American Dietetic Association

120 S. Riverside Plaza

Chicago, IL  60606-6995

TEL:  312-899-4797

FAX:  312-899-4812

 

khowarter at eatright.org <mailto:khowarter at eatright.org> 

www.adaevidencelibrary.com <http://www.adaevidencelibrary.com/> 

 

 

 

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org <mailto:rtripp at pinnaclehealth.org> 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Harrison, Kerry
Sent: Thursday, January 08, 2009 8:58 AM
To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology



Each facility usually has an abbreviation reference that they follow.
Here we use Stedman's and AEB and R/T are in the book, so we use them.

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa.N.Faucon at kp.org
Sent: Wednesday, January 07, 2009 7:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

 


We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate? 

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.

CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.


The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/03d071c6/attachment-0001.html 

------------------------------

Message: 4
Date: Thu, 8 Jan 2009 08:45:41 -0600
From: "Heberle, Heather N." <Heberle-Heather at aramark.com>
Subject: Re: [Cnm] Parenteral Solutions
To: <cnm at lists.my180.net>
Message-ID: <567FB54A-103E-4BCC-BEDB-092FD7303A0A at mimectl>
Content-Type: text/plain; charset="iso-8859-1"

We currently have 4 standard formulas and 1 section where you are able to modify and make your own solution.  We also have 2 lipid choices to choose from.  However, we have a policy in place that physicians are not allowed to do TPN.  we have a "TPN Team" which consists of a dietitian and a pharmacist.  Unless the physician specifically writes DC TPN Team, the TPN Team will be in full control of the TPN.  If a physician does write to DC TPN Team, it is reported to our pharmacy and therapeutics committee and the physician is notified.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879



From: cnm-request at lists.my180.net
Sent: Wed 1/7/09 4:09 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 36


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: FW: Wounds and Triggers (Scott, Kerry  R.)
   2. Parenteral Solutions (Shannon Byrd Jackson)
   3. Re: Parenteral Solutions (Carver, Leslee)


----------------------------------------------------------------------

Message: 1
Date: Tue, 6 Jan 2009 09:24:11 -0800
From: "Scott, Kerry  R." <Kerry.Scott at providence.org>
Subject: Re: [Cnm] FW: Wounds and Triggers
To: "Tucker, Jennifer" <TUCKERJ at lourdesnet.org>,	<cnm at lists.my180.net>
Message-ID:
	<CBE0048956D4B14C893378F8D13A36E201A9A5AD at IRMEXCH02.irm.inhs.org>
Content-Type: text/plain;	charset="us-ascii"

We use Braden score <=12 as an automatic trigger on admission, in
addition to nutrition referrals from our enterostomal therapists.  We
are still working out the "bugs" as we do get some false positives if
Braden evaluation is not completed thouroughly.
Kerry Scott, RD, CD
Clinical Nutrition Manager
Food & Nutrition Services
Sacred Heart Medical Center
(509)474-4774
scottk1 at shmc.org

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Tucker, Jennifer
Sent: Tuesday, January 06, 2009 7:05 AM
To: cnm at lists.my180.net
Subject: [Cnm] FW: Wounds and Triggers


Good Morning,
    I would greatly appreciate any input on what "types" of wounds would
trigger your RD's.

Pressure ulcers stage II and greater?
Venous?
Just the word wound upon admission?

Thank you so much for any input,

Jennifer Tucker RD
Clinical Nutrition Manager
Lourdes Health System
856-757-3596
Confidentiality Notice:
This email, including any attachments is the property of Catholic Health
East and is intended for the sole use of the intended recipient(s).  
It may contain information that is privileged and confidential.  Any
unauthorized review, use, disclosure, or distribution is prohibited. If
you are not the intended recipient, please reply to the sender that you
have received the message in error, then delete this message.


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 2
Date: Wed, 7 Jan 2009 16:59:15 -0500
From: "Shannon Byrd Jackson" <Shannon.Jackson at wilmed.org>
Subject: [Cnm] Parenteral Solutions
To: "CNM (E-mail)" <cnm at lists.my180.net>
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA779789 at wmhcs03.wmh.org>
Content-Type: text/plain; charset="iso-8859-1"

Hi,
 
How many options do physicians at your facility have for Central Parenteral
Nutrition? Do they have one they can customize as well?
Our docs wanted one of each and I don't feel that is sufficient to meet all
of the patients' needs.
Thanks,
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/b89ef843/attachment-0001.html 

------------------------------

Message: 3
Date: Wed, 7 Jan 2009 16:10:02 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] Parenteral Solutions
To: "Shannon Byrd Jackson" <Shannon.Jackson at wilmed.org>,	"CNM
	(E-mail)" <cnm at lists.my180.net>
Message-ID:
	<5330B54133B6194BA13930BDEFE9A30E03A33980 at rhcexch3.reshealthcare.org>
Content-Type: text/plain; charset="us-ascii"

we have 1 standard and then a customizable option (used most often by
Nephrology). I've attached the forms we use - the order section is
correct in content but I don't have the final PDF on my hard drive.
Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Wednesday, January 07, 2009 3:59 PM
To: CNM (E-mail)
Subject: [Cnm] Parenteral Solutions


Hi,
 
How many options do physicians at your facility have for Central
Parenteral Nutrition? Do they have one they can customize as well?
Our docs wanted one of each and I don't feel that is sufficient to meet
all of the patients' needs.
Thanks,
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
www.wilmed.org <http://www.wilmed.org/> 

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: TPNBACK 06 revision.DOC
Type: application/msword
Size: 12800 bytes
Desc: TPNBACK 06 revision.DOC
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.dot 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Daily Adult Parenteral Nutrition Order Form 2006.doc
Type: application/msword
Size: 31744 bytes
Desc: Daily Adult Parenteral Nutrition Order Form 2006.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.doc 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 36
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/62412482/attachment.html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 39
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/592d327d/attachment.html 

From Terese.Scollard at providence.org  Thu Jan  8 07:13:12 2009
From: Terese.Scollard at providence.org (Scollard, Terese)
Date: Thu, 8 Jan 2009 07:13:12 -0800
Subject: [Cnm] Nutrition Care Process Terminology
References: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.org>
Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A02F883BF@wn1221.or.providence.org>

If my memory serves me right, there is a form on the ADA website under the NCP to fill out and send to ADA to get permission. You can call, too.
Terese Scollard
Providence Health & Services
Portland Oregon


-----Original Message-----
From: Lisa.N.Faucon at kp.org [mailto:Lisa.N.Faucon at kp.org]
Sent: Wed 1/7/2009 4:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology
 
We are putting the Nutrition Care process into our electronic charting 
system.  Does anyone know if there are approved abbreviations?  Are the 
diagnosis copyrighted?  Or can we abbreviate?

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this 
e-mail, you are prohibited from sharing, copying, or otherwise using or 
disclosing its contents.  If you have received this e-mail in error, 
please notify the sender immediately by reply e-mail and permanently 
delete this e-mail and any attachments without reading, forwarding or 
saving them.  Thank you.



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.


From Shannon.Jackson at wilmed.org  Thu Jan  8 07:18:13 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Thu, 8 Jan 2009 10:18:13 -0500
Subject: [Cnm] Food and Medication Interaction Form
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA7797A2@wmhcs03.wmh.org>

Hi,
 
This is the form nursing gives to all patients at discharge. What are other
facilities using? We are in the process of revising since we haven't since
2005.
Thank you,
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/09e66228/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Food and Drug Interactions revised Oct 2005.doc
Type: application/msword
Size: 50688 bytes
Desc: Food and Drug Interactions revised Oct 2005.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090108/09e66228/attachment-0001.doc 

From Pauline.Chapman at emoryhealthcare.org  Thu Jan  8 07:46:17 2009
From: Pauline.Chapman at emoryhealthcare.org (Chapman, Susan)
Date: Thu, 8 Jan 2009 10:46:17 -0500
Subject: [Cnm] Nutrition Screen to meet The Joint Commission - screen within
	24 hours
Message-ID: <488A28F4B40F8A4F8E21ACC33FCE046701FA8651C14B@EXCHANGE21.Enterprise.emory.net>

We are evaluating our entire Nutrition Screen process.  We currently rely on  the RN to ask the screening triggers ( and submit via data entry in the computer).  Does anyone utilize a different discipline to complete the 24 hour initial screen? If so, who does the screen and by what method?

Our current screening triggers are :
Unplanned Weight loss greater than or equal to 10 pounds in 3 months
Poor appetite for more than 5 days
Inability to chew or swallow
Difficulty chewing or swallowing
Decubitus ulcer
Non-healing wound
Enteral feedings
TPN feedings

Does anyone utilize different triggers?  We are also seeking evidence to support the use of the triggers, any good references you would recommend is appreciated.

Thank you in advance,
Susan Chapman

P. Susan Chapman MS, RD, LD
Clinical Dietitian Specialist
Emory Orthopaedic and Spine Hospital
1455 Montreal Road
Atlanta, Georgia  30084
404-803-0297



________________________________
This e-mail message (including any attachments) is for the sole use of
the intended recipient(s) and may contain confidential and privileged
information. If the reader of this message is not the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this message (including any attachments) is strictly
prohibited.

If you have received this message in error, please contact
the sender by reply e-mail message and destroy all copies of the
original message (including attachments).
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/ac3e40c3/attachment.html 

From nmarinel at chsbuffalo.org  Thu Jan  8 08:12:45 2009
From: nmarinel at chsbuffalo.org (Marinelli, Nancy)
Date: Thu, 8 Jan 2009 11:12:45 -0500
Subject: [Cnm] Nutrition Care Process Terminology
In-Reply-To: <37ABAEB17B0B5B40AA0B6118E57CF59A02F883BF@wn1221.or.providence.
	org>
References: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.or
	g>, <37ABAEB17B0B5B40AA0B6118E57CF59A02F883BF@wn1221.or.providence.org>
Message-ID: <3E6DC8D8B3285C449C883257CA6012D7582D29689A@CHEXCHANGE01.ad.wnychs.org>



There is a fee of $150/year

________________________________________
From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Scollard, Terese [Terese.Scollard at providence.org]
Sent: Thursday, January 08, 2009 10:13 AM
To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology

If my memory serves me right, there is a form on the ADA website under the NCP to fill out and send to ADA to get permission. You can call, too.
Terese Scollard
Providence Health & Services
Portland Oregon


-----Original Message-----
From: Lisa.N.Faucon at kp.org [mailto:Lisa.N.Faucon at kp.org]
Sent: Wed 1/7/2009 4:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate?

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------------------

CONFIDENTIALITY NOTICE: This message is confidential, intended only for the named recipient(s) and may contain information that is privileged, or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender by reply e-mail, delete this e-mail from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.  This message and all contents may be reviewed by authorized parties of the Catholic Health System other than those named in the message header.

The contents of this message do not bind the Catholic Health System to any contract, position, or course of action unless the sender is specifically authorized to enter into contracts on behalf of the Catholic Health System. The contents of this message do not necessarily constitute an official representation of the Catholic Health System.


From kharriso at stagnes.org  Thu Jan  8 08:21:48 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Thu, 8 Jan 2009 10:21:48 -0600
Subject: [Cnm] Nutrition Care Process Terminology
In-Reply-To: <3E6DC8D8B3285C449C883257CA6012D7582D29689A@CHEXCHANGE01.ad.wnychs.org>
References: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.org>,
	<37ABAEB17B0B5B40AA0B6118E57CF59A02F883BF@wn1221.or.providence.org>
	<3E6DC8D8B3285C449C883257CA6012D7582D29689A@CHEXCHANGE01.ad.wnychs.org>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B39224F2A@ahcmascdc034.DS.SJHS.COM>

WHAT????  They want us to use the terminology and then they charge us
for it?

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Marinelli, Nancy
Sent: Thursday, January 08, 2009 11:13 AM
To: Scollard, Terese; Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology



There is a fee of $150/year

________________________________________
From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On
Behalf Of Scollard, Terese [Terese.Scollard at providence.org]
Sent: Thursday, January 08, 2009 10:13 AM
To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology

If my memory serves me right, there is a form on the ADA website under
the NCP to fill out and send to ADA to get permission. You can call,
too.
Terese Scollard
Providence Health & Services
Portland Oregon


-----Original Message-----
From: Lisa.N.Faucon at kp.org [mailto:Lisa.N.Faucon at kp.org]
Sent: Wed 1/7/2009 4:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate?

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.



DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------------------

CONFIDENTIALITY NOTICE: This message is confidential, intended only for
the named recipient(s) and may contain information that is privileged,
or exempt from disclosure under applicable law. If you are not the
intended recipient(s), you are notified that the dissemination,
distribution or copying of this message is strictly prohibited. If you
receive this message in error, or are not the named recipient(s), please
notify the sender by reply e-mail, delete this e-mail from your
computer, and destroy any copies in any form immediately. Receipt by
anyone other than the named recipient(s) is not a waiver of any
attorney-client, work product, or other applicable privilege.  This
message and all contents may be reviewed by authorized parties of the
Catholic Health System other than those named in the message header.

The contents of this message do not bind the Catholic Health System to
any contract, position, or course of action unless the sender is
specifically authorized to enter into contracts on behalf of the
Catholic Health System. The contents of this message do not necessarily
constitute an official representation of the Catholic Health System.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.


From nmarinel at chsbuffalo.org  Thu Jan  8 08:22:35 2009
From: nmarinel at chsbuffalo.org (Marinelli, Nancy)
Date: Thu, 8 Jan 2009 11:22:35 -0500
Subject: [Cnm] Nutrition Care Process Terminology
In-Reply-To: <9AB3ADBD43ABFD46B0DC4E80280F3B39224F2A@ahcmascdc034.DS.SJHS.CO M>
References: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.or
	g>, 
	<37ABAEB17B0B5B40AA0B6118E57CF59A02F883BF@wn1221.or.providence.org>	<3E6DC8
	D8B3285C449C883257CA6012D7582D29689A@CHEXCHANGE01.ad.wnychs.org><9AB3ADBD43
	ABFD46B0DC4E80280F3B39224F2A@ahcmascdc034.DS.SJHS.COM>
Message-ID: <3E6DC8D8B3285C449C883257CA6012D7582DA915EC@CHEXCHANGE01.ad.wnychs.org>



yep!

? Please consider the environment before printing this email.

Nancy Marinelli, RD, CDN, CNSD
Clinical Nutrition Manager
Sisters of Charity Hospital
2157 Main Street
Buffalo, New York 14214
(716) 862-1621
(716) 862-1846 - FAX



-----Original Message-----
From: Harrison, Kerry [mailto:kharriso at stagnes.org] 
Sent: Thursday, January 08, 2009 11:22 AM
To: Marinelli, Nancy; Scollard, Terese; Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: RE: [Cnm] Nutrition Care Process Terminology

WHAT????  They want us to use the terminology and then they charge us
for it?

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Marinelli, Nancy
Sent: Thursday, January 08, 2009 11:13 AM
To: Scollard, Terese; Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology



There is a fee of $150/year

________________________________________
From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On
Behalf Of Scollard, Terese [Terese.Scollard at providence.org]
Sent: Thursday, January 08, 2009 10:13 AM
To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology

If my memory serves me right, there is a form on the ADA website under
the NCP to fill out and send to ADA to get permission. You can call,
too.
Terese Scollard
Providence Health & Services
Portland Oregon


-----Original Message-----
From: Lisa.N.Faucon at kp.org [mailto:Lisa.N.Faucon at kp.org]
Sent: Wed 1/7/2009 4:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate?

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.



DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------------------

CONFIDENTIALITY NOTICE: This message is confidential, intended only for
the named recipient(s) and may contain information that is privileged,
or exempt from disclosure under applicable law. If you are not the
intended recipient(s), you are notified that the dissemination,
distribution or copying of this message is strictly prohibited. If you
receive this message in error, or are not the named recipient(s), please
notify the sender by reply e-mail, delete this e-mail from your
computer, and destroy any copies in any form immediately. Receipt by
anyone other than the named recipient(s) is not a waiver of any
attorney-client, work product, or other applicable privilege.  This
message and all contents may be reviewed by authorized parties of the
Catholic Health System other than those named in the message header.

The contents of this message do not bind the Catholic Health System to
any contract, position, or course of action unless the sender is
specifically authorized to enter into contracts on behalf of the
Catholic Health System. The contents of this message do not necessarily
constitute an official representation of the Catholic Health System.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.

-------------------------

CONFIDENTIALITY NOTICE: This message is confidential, intended only for the named recipient(s) and may contain information that is privileged, or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender by reply e-mail, delete this e-mail from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.  This message and all contents may be reviewed by authorized parties of the Catholic Health System other than those named in the message header.

The contents of this message do not bind the Catholic Health System to any contract, position, or course of action unless the sender is specifically authorized to enter into contracts on behalf of the Catholic Health System. The contents of this message do not necessarily constitute an official representation of the Catholic Health System.

From pcharney at mac.com  Thu Jan  8 08:27:21 2009
From: pcharney at mac.com (Pam Charney)
Date: Thu, 08 Jan 2009 08:27:21 -0800
Subject: [Cnm] Nutrition Screen to meet The Joint Commission - screen
 within	24 hours
In-Reply-To: <488A28F4B40F8A4F8E21ACC33FCE046701FA8651C14B@EXCHANGE21.Enterprise.emory.net>
References: <488A28F4B40F8A4F8E21ACC33FCE046701FA8651C14B@EXCHANGE21.Enterprise.emory.net>
Message-ID: <CEDC84A4-5826-4354-B361-7F0E69E4E742@mac.com>

Greetings,
It seems to me you have overkill here. Inability to chew or swallow is  
simply a degree of difficulty chewing or swallowing. Decubitus ulcers  
and wound healing issues are also far too similar. Take a look at some  
of the already validated screens out there (and nursing will love you  
for simplifying things); the Malnutrition Screening Tool by Ferguson  
utilizes only weight change and change in appetite. It's been  
validated in several settings now; the original work was done in an  
acute care setting. The Malnutrition Universal Screening Tool is very  
similar to the MST and is used widely in Europe; it was also  
originally validated in acute care, although that validation study  
utilized a population that included a high proportion of stroke  
patients.

It makes sense to have who ever is doing the admission assessment  
collect screening data. That way there's economy in motion; the  
information in both of the screens above are important for folks  
besides nutrition and that information can be shared. You don't have  
to pay more than one person to gather data twice!

Regards,
pam


Pam Charney PhD, RD
Clinical Coordinator
Graduate Coordinated Program in Dietetics
Lecturer, Department of Epidemiology
Nutrition Sciences Program
School of Public Health and Community Medicine
Box 353410, 306-C Raitt Hall

Affiliate Associate Professor
School of Pharmacy

MS Student
Clinical Informatics and Patient Centered Technology
School of Nursing

University of Washington
Seattle, WA
charnepa at u.washington.edu
"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jan 8, 2009, at 7:46 AM, Chapman, Susan wrote:

> We are evaluating our entire Nutrition Screen process.  We currently  
> rely on  the RN to ask the screening triggers ( and submit via data  
> entry in the computer).  Does anyone utilize a different discipline  
> to complete the 24 hour initial screen? If so, who does the screen  
> and by what method?
>
> Our current screening triggers are :
> Unplanned Weight loss greater than or equal to 10 pounds in 3 months
> Poor appetite for more than 5 days
> Inability to chew or swallow
> Difficulty chewing or swallowing
> Decubitus ulcer
> Non-healing wound
> Enteral feedings
> TPN feedings
>
> Does anyone utilize different triggers?  We are also seeking  
> evidence to support the use of the triggers, any good references you  
> would recommend is appreciated.
>
> Thank you in advance,
> Susan Chapman
>
> P. Susan Chapman MS, RD, LD
> Clinical Dietitian Specialist
> Emory Orthopaedic and Spine Hospital
> 1455 Montreal Road
> Atlanta, Georgia  30084
> 404-803-0297
>
>
>
> This e-mail message (including any attachments) is for the sole use of
> the intended recipient(s) and may contain confidential and privileged
> information. If the reader of this message is not the intended
> recipient, you are hereby notified that any dissemination,  
> distribution
> or copying of this message (including any attachments) is strictly
> prohibited.
>
> If you have received this message in error, please contact
> the sender by reply e-mail message and destroy all copies of the
> original message (including attachments).
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/624efd52/attachment-0001.html 

From kharriso at stagnes.org  Thu Jan  8 08:30:21 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Thu, 8 Jan 2009 10:30:21 -0600
Subject: [Cnm] Nutrition Care Process Terminology
In-Reply-To: <3E6DC8D8B3285C449C883257CA6012D7582DA915EC@CHEXCHANGE01.ad.wnychs.org>
References: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.org>,
	<37ABAEB17B0B5B40AA0B6118E57CF59A02F883BF@wn1221.or.providence.org>	<3E6DC8D8B3285C449C883257CA6012D7582D29689A@CHEXCHANGE01.ad.wnychs.org><9AB3ADBD43ABFD46B0DC4E80280F3B39224F2A@ahcmascdc034.DS.SJHS.COM>
	<3E6DC8D8B3285C449C883257CA6012D7582DA915EC@CHEXCHANGE01.ad.wnychs.org>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B39224F2F@ahcmascdc034.DS.SJHS.COM>

I am sorry if my question offended anyone, but that is a valid question.  There has been a lot of resistance to this process and this may only complicate things further.  I am using the terminology here and have been trying to advocate its benefit to my RD's but to ignore that there is resistance is a problem.  Also, how will this be enforced?

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong enough to take everything you have. 
-Thomas Jefferson 


-----Original Message-----
From: Marinelli, Nancy [mailto:nmarinel at chsbuffalo.org] 
Sent: Thursday, January 08, 2009 11:23 AM
To: Harrison, Kerry; Scollard, Terese; Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: RE: [Cnm] Nutrition Care Process Terminology



yep!

? Please consider the environment before printing this email.

Nancy Marinelli, RD, CDN, CNSD
Clinical Nutrition Manager
Sisters of Charity Hospital
2157 Main Street
Buffalo, New York 14214
(716) 862-1621
(716) 862-1846 - FAX



-----Original Message-----
From: Harrison, Kerry [mailto:kharriso at stagnes.org] 
Sent: Thursday, January 08, 2009 11:22 AM
To: Marinelli, Nancy; Scollard, Terese; Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: RE: [Cnm] Nutrition Care Process Terminology

WHAT????  They want us to use the terminology and then they charge us
for it?

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Marinelli, Nancy
Sent: Thursday, January 08, 2009 11:13 AM
To: Scollard, Terese; Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology



There is a fee of $150/year

________________________________________
From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On
Behalf Of Scollard, Terese [Terese.Scollard at providence.org]
Sent: Thursday, January 08, 2009 10:13 AM
To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology

If my memory serves me right, there is a form on the ADA website under
the NCP to fill out and send to ADA to get permission. You can call,
too.
Terese Scollard
Providence Health & Services
Portland Oregon


-----Original Message-----
From: Lisa.N.Faucon at kp.org [mailto:Lisa.N.Faucon at kp.org]
Sent: Wed 1/7/2009 4:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate?

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.



DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------------------

CONFIDENTIALITY NOTICE: This message is confidential, intended only for
the named recipient(s) and may contain information that is privileged,
or exempt from disclosure under applicable law. If you are not the
intended recipient(s), you are notified that the dissemination,
distribution or copying of this message is strictly prohibited. If you
receive this message in error, or are not the named recipient(s), please
notify the sender by reply e-mail, delete this e-mail from your
computer, and destroy any copies in any form immediately. Receipt by
anyone other than the named recipient(s) is not a waiver of any
attorney-client, work product, or other applicable privilege.  This
message and all contents may be reviewed by authorized parties of the
Catholic Health System other than those named in the message header.

The contents of this message do not bind the Catholic Health System to
any contract, position, or course of action unless the sender is
specifically authorized to enter into contracts on behalf of the
Catholic Health System. The contents of this message do not necessarily
constitute an official representation of the Catholic Health System.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.

-------------------------

CONFIDENTIALITY NOTICE: This message is confidential, intended only for the named recipient(s) and may contain information that is privileged, or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender by reply e-mail, delete this e-mail from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.  This message and all contents may be reviewed by authorized parties of the Catholic Health System other than those named in the message header.

The contents of this message do not bind the Catholic Health System to any contract, position, or course of action unless the sender is specifically authorized to enter into contracts on behalf of the Catholic Health System. The contents of this message do not necessarily constitute an official representation of the Catholic Health System.

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.

From Heberle-Heather at aramark.com  Thu Jan  8 08:33:11 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Thu, 8 Jan 2009 10:33:11 -0600
Subject: [Cnm] Nutrition Screen to meet The Joint Commission - screen
 within 24 hours
In-Reply-To: <mailman.1156.1231432047.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.1156.1231432047.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <7D0CA3DA-95BB-426E-B31B-D8896145965C@mimectl>

currently we only have 4 nutrition screen questions: 
Loss of appetite > 2 weeks
Wt loss > 10# in 2 weeks
Any unhealing wounds
on TPN/TF past month

We use ARAMARK company standards.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/9139591e/attachment.html 

From m-rodrig at msmc.com  Thu Jan  8 08:33:00 2009
From: m-rodrig at msmc.com (Maritza Rodriguez)
Date: Thu, 8 Jan 2009 11:33:00 -0500
Subject: [Cnm] Lecture
Message-ID: <32EDCA3D1F5C4C41B7E1A4573DFACCC60327DA58@SVIPEXC1.msmc.com>

Hi all,

 

I have been asked to provide a series of presentations about healthy
eating, weight management, Diabetes and Hypertension to the staff of a
police station close to my facility.  They want me to start providing
these presentations by next week.  With the short notice, I feel I won't
be able to prepare an appropriate one.  Do any of you have one already
done that is willing to share, at least to start next week?

 

Thank you in advance,

 

Maritza Rodriguez

 

Maritza Rodriguez, RD LDN

Clinical Nutrition Manager

Mount Sinai Medical Center

4300 Alton Road

Miami Beach, Florida 33140

 

Tel: 305-674-2121 Ext. 56181

Fax: 305-674-2234

m-rodrig at msmc.com

 

 

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
CONFIDENTIAL or PRIVILEGED information.  Any unauthorized review, use,
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and immediately
destroy all copies of the original message and all attachments.  Any
opinions expressed here are not necessarily those of Mount Sinai Medical
Center.

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/bca24502/attachment.html 

From pcharney at mac.com  Thu Jan  8 08:36:39 2009
From: pcharney at mac.com (Pam Charney)
Date: Thu, 08 Jan 2009 08:36:39 -0800
Subject: [Cnm] Nutrition Care Process Terminology
In-Reply-To: <9AB3ADBD43ABFD46B0DC4E80280F3B39224F2A@ahcmascdc034.DS.SJHS.COM>
References: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.org>
	<37ABAEB17B0B5B40AA0B6118E57CF59A02F883BF@wn1221.or.providence.org>
	<3E6DC8D8B3285C449C883257CA6012D7582D29689A@CHEXCHANGE01.ad.wnychs.org>
	<9AB3ADBD43ABFD46B0DC4E80280F3B39224F2A@ahcmascdc034.DS.SJHS.COM>
Message-ID: <41DCF5CB-120E-433E-8CD8-53E330F00AA4@mac.com>

It's not unheard of for terminologies to charge a licensing fee. The  
situation is incredibly complex when you start looking at using  
individual terminologies vs those that have terms included in UMLS.  
For example, SNOMED is the terminology EMR vendors are now encouraged  
to include in their products. You can apply for a free license to work  
with SNOMED but you cannot change anything. NANDA, one of the nursing  
terminologies is included in SNOMED and thus, you can work with NANDA  
as an individual researcher in terminology but you cannot change it.  
However, if you want to include NANDA in a commercial product, you pay  
a fee. I"m not sure if there's a fee for SNOMED use in a commercial  
product. UMLS includes hundreds of terminologies; the last time I  
looked at the licensing fees, there were several tiers. Licensing gets  
even more complex when you are working in another country

Look at it this way, when purchasing software, we indirectly pay for a  
licensing fee by agreeing to all those terms of use. By charging a  
fee, the developer has some control in preventing changes to the  
terminology as well as hopefully ensuring that there's a known list of  
users who can receive updates.

Regards
pam


Pam Charney PhD, RD
Clinical Coordinator
Graduate Coordinated Program in Dietetics
Lecturer, Department of Epidemiology
Nutrition Sciences Program
School of Public Health and Community Medicine
Box 353410, 306-C Raitt Hall

Affiliate Associate Professor
School of Pharmacy

MS Student
Clinical Informatics and Patient Centered Technology
School of Nursing

University of Washington
Seattle, WA
charnepa at u.washington.edu
"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jan 8, 2009, at 8:21 AM, Harrison, Kerry wrote:

> WHAT????  They want us to use the terminology and then they charge us
> for it?
>
> Kerry Harrison, MS,RD,LDN
> Clinical Nutrition Manager
> St. Agnes Hospital
> Baltimore, MD 21229
> 410.368.2152
>
> To eat is a necessity, but to eat intelligently is an art.
> -LaRoche Foucauld
> A government big enough to give you everything you want, is strong
> enough to take everything you have.
> -Thomas Jefferson
>
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Marinelli, Nancy
> Sent: Thursday, January 08, 2009 11:13 AM
> To: Scollard, Terese; Lisa.N.Faucon at kp.org; cnm at lists.my180.net
> Subject: Re: [Cnm] Nutrition Care Process Terminology
>
>
>
> There is a fee of $150/year
>
> ________________________________________
> From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On
> Behalf Of Scollard, Terese [Terese.Scollard at providence.org]
> Sent: Thursday, January 08, 2009 10:13 AM
> To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
> Subject: Re: [Cnm] Nutrition Care Process Terminology
>
> If my memory serves me right, there is a form on the ADA website under
> the NCP to fill out and send to ADA to get permission. You can call,
> too.
> Terese Scollard
> Providence Health & Services
> Portland Oregon
>
>
> -----Original Message-----
> From: Lisa.N.Faucon at kp.org [mailto:Lisa.N.Faucon at kp.org]
> Sent: Wed 1/7/2009 4:35 PM
> To: cnm at lists.my180.net
> Subject: [Cnm] Nutrition Care Process Terminology
>
> We are putting the Nutrition Care process into our electronic charting
> system.  Does anyone know if there are approved abbreviations?  Are  
> the
> diagnosis copyrighted?  Or can we abbreviate?
>
> Lisa N Faucon MS, RD
> Assistant Department Administrator, Nutrition Services
> Kaiser Permanente
> 4647 Zion Ave
> San Diego, CA, 92120
> (619) 528-5515 office
> (619) 528-3024 fax
> (619) 682-0672 pager
>
> NOTICE TO RECIPIENT:  If you are not the intended recipient of this
> e-mail, you are prohibited from sharing, copying, or otherwise using  
> or
> disclosing its contents.  If you have received this e-mail in error,
> please notify the sender immediately by reply e-mail and permanently
> delete this e-mail and any attachments without reading, forwarding or
> saving them.  Thank you.
>
>
>
> DISCLAIMER:
> This message is intended for the sole use of the addressee, and may
> contain information that is privileged, confidential and exempt from
> disclosure under applicable law. If you are not the addressee you are
> hereby notified that you may not use, copy, disclose, or distribute to
> anyone the message or any information contained in the message. If you
> have received this message in error, please immediately advise the
> sender by reply email and delete this message.
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
> -------------------------
>
> CONFIDENTIALITY NOTICE: This message is confidential, intended only  
> for
> the named recipient(s) and may contain information that is privileged,
> or exempt from disclosure under applicable law. If you are not the
> intended recipient(s), you are notified that the dissemination,
> distribution or copying of this message is strictly prohibited. If you
> receive this message in error, or are not the named recipient(s),  
> please
> notify the sender by reply e-mail, delete this e-mail from your
> computer, and destroy any copies in any form immediately. Receipt by
> anyone other than the named recipient(s) is not a waiver of any
> attorney-client, work product, or other applicable privilege.  This
> message and all contents may be reviewed by authorized parties of the
> Catholic Health System other than those named in the message header.
>
> The contents of this message do not bind the Catholic Health System to
> any contract, position, or course of action unless the sender is
> specifically authorized to enter into contracts on behalf of the
> Catholic Health System. The contents of this message do not  
> necessarily
> constitute an official representation of the Catholic Health System.
>
> _______________________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/429e68c1/attachment-0001.html 

From Annalynn_Skipper at Comcast.net  Thu Jan  8 08:54:15 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Thu, 8 Jan 2009 10:54:15 -0600
Subject: [Cnm] Nutrition Care Process Terminology
In-Reply-To: <3E6DC8D8B3285C449C883257CA6012D7582DA915EC@CHEXCHANGE01.ad.wnychs.org>
References: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.org>,
	<37ABAEB17B0B5B40AA0B6118E57CF59A02F883BF@wn1221.or.providence.org>	<3E6DC8D8B3285C449C883257CA6012D7582D29689A@CHEXCHANGE01.ad.wnychs.org><9AB3ADBD43ABFD46B0DC4E80280F3B39224F2A@ahcmascdc034.DS.SJHS.COM>
	<3E6DC8D8B3285C449C883257CA6012D7582DA915EC@CHEXCHANGE01.ad.wnychs.org>
Message-ID: <271F668494C048269D62B63E99244364@ANNALYNN>

You may want to check to see what is covered by the fee.  My recollection is that it covers the updates that your IS department will need to keep your electronic medical record current as the terminology changes.  Given the typical IS budget, $150 is a miniscule amount and much cheaper than locating and putting in changes "by hand".  

It would be interesting to compare to the annual licensing fee that our institutions pay for the CPT codes.  Anyone have that information?

Annalynn

Annalynn Skipper Ph.D., R.D., FADA

a consultancy devoted to advancing nutrition practice
P.O. Box 45
Oak Park, IL 60303
Annalynn_Skipper at Comcast.net
Advanced Medical Nutrition Therapy Practice, 
a 2008 text, is available from Jones and Bartlett. 

-----Original Message-----
From: Marinelli, Nancy [mailto:nmarinel at chsbuffalo.org] 
Sent: Thursday, January 08, 2009 10:23 AM
To: Harrison, Kerry; Scollard, Terese; Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology



yep!

? Please consider the environment before printing this email.

Nancy Marinelli, RD, CDN, CNSD
Clinical Nutrition Manager
Sisters of Charity Hospital
2157 Main Street
Buffalo, New York 14214
(716) 862-1621
(716) 862-1846 - FAX



-----Original Message-----
From: Harrison, Kerry [mailto:kharriso at stagnes.org] 
Sent: Thursday, January 08, 2009 11:22 AM
To: Marinelli, Nancy; Scollard, Terese; Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: RE: [Cnm] Nutrition Care Process Terminology

WHAT????  They want us to use the terminology and then they charge us
for it?

Kerry Harrison, MS,RD,LDN
Clinical Nutrition Manager
St. Agnes Hospital
Baltimore, MD 21229
410.368.2152
 
To eat is a necessity, but to eat intelligently is an art.
-LaRoche Foucauld
A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Marinelli, Nancy
Sent: Thursday, January 08, 2009 11:13 AM
To: Scollard, Terese; Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology



There is a fee of $150/year

________________________________________
From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On
Behalf Of Scollard, Terese [Terese.Scollard at providence.org]
Sent: Thursday, January 08, 2009 10:13 AM
To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology

If my memory serves me right, there is a form on the ADA website under
the NCP to fill out and send to ADA to get permission. You can call,
too.
Terese Scollard
Providence Health & Services
Portland Oregon


-----Original Message-----
From: Lisa.N.Faucon at kp.org [mailto:Lisa.N.Faucon at kp.org]
Sent: Wed 1/7/2009 4:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate?

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.



DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------------------

CONFIDENTIALITY NOTICE: This message is confidential, intended only for
the named recipient(s) and may contain information that is privileged,
or exempt from disclosure under applicable law. If you are not the
intended recipient(s), you are notified that the dissemination,
distribution or copying of this message is strictly prohibited. If you
receive this message in error, or are not the named recipient(s), please
notify the sender by reply e-mail, delete this e-mail from your
computer, and destroy any copies in any form immediately. Receipt by
anyone other than the named recipient(s) is not a waiver of any
attorney-client, work product, or other applicable privilege.  This
message and all contents may be reviewed by authorized parties of the
Catholic Health System other than those named in the message header.

The contents of this message do not bind the Catholic Health System to
any contract, position, or course of action unless the sender is
specifically authorized to enter into contracts on behalf of the
Catholic Health System. The contents of this message do not necessarily
constitute an official representation of the Catholic Health System.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.

-------------------------

CONFIDENTIALITY NOTICE: This message is confidential, intended only for the named recipient(s) and may contain information that is privileged, or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender by reply e-mail, delete this e-mail from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.  This message and all contents may be reviewed by authorized parties of the Catholic Health System other than those named in the message header.

The contents of this message do not bind the Catholic Health System to any contract, position, or course of action unless the sender is specifically authorized to enter into contracts on behalf of the Catholic Health System. The contents of this message do not necessarily constitute an official representation of the Catholic Health System.



From Terese.Scollard at providence.org  Thu Jan  8 09:11:25 2009
From: Terese.Scollard at providence.org (Scollard, Terese)
Date: Thu, 8 Jan 2009 09:11:25 -0800
Subject: [Cnm] Nutrition Care Process Terminology
In-Reply-To: <3E6DC8D8B3285C449C883257CA6012D7582D29689A@CHEXCHANGE01.ad.wnychs.org>
Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A03239FA0@wn1221.or.providence.org>

I suspect it goes to fund the work on the project and just recognize the
copyrights.
Terese M. Scollard RD, LD, MBA 
Regional Clinical Nutrition Manager 
Regional Nutrition Service PHS-PSA Acute Care 
Phone: 503-216-2496 or 503-215-6974 
terese.scollard at providence.org 

 

-----Original Message-----
From: Marinelli, Nancy [mailto:nmarinel at chsbuffalo.org] 
Sent: Thursday, January 08, 2009 8:13 AM
To: Scollard, Terese; Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology



There is a fee of $150/year

________________________________________
From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On
Behalf Of Scollard, Terese [Terese.Scollard at providence.org]
Sent: Thursday, January 08, 2009 10:13 AM
To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology

If my memory serves me right, there is a form on the ADA website under
the NCP to fill out and send to ADA to get permission. You can call,
too.
Terese Scollard
Providence Health & Services
Portland Oregon


-----Original Message-----
From: Lisa.N.Faucon at kp.org [mailto:Lisa.N.Faucon at kp.org]
Sent: Wed 1/7/2009 4:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate?

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.



DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------------------

CONFIDENTIALITY NOTICE: This message is confidential, intended only for
the named recipient(s) and may contain information that is privileged,
or exempt from disclosure under applicable law. If you are not the
intended recipient(s), you are notified that the dissemination,
distribution or copying of this message is strictly prohibited. If you
receive this message in error, or are not the named recipient(s), please
notify the sender by reply e-mail, delete this e-mail from your
computer, and destroy any copies in any form immediately. Receipt by
anyone other than the named recipient(s) is not a waiver of any
attorney-client, work product, or other applicable privilege.  This
message and all contents may be reviewed by authorized parties of the
Catholic Health System other than those named in the message header.

The contents of this message do not bind the Catholic Health System to
any contract, position, or course of action unless the sender is
specifically authorized to enter into contracts on behalf of the
Catholic Health System. The contents of this message do not necessarily
constitute an official representation of the Catholic Health System.




DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.


From Terese.Scollard at providence.org  Thu Jan  8 09:13:37 2009
From: Terese.Scollard at providence.org (Scollard, Terese)
Date: Thu, 8 Jan 2009 09:13:37 -0800
Subject: [Cnm] Lecture
In-Reply-To: <32EDCA3D1F5C4C41B7E1A4573DFACCC60327DA58@SVIPEXC1.msmc.com>
Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A03239FA1@wn1221.or.providence.org>

try RD411 and the Nebraska extension service...great stuff
Terese M. Scollard RD, LD, MBA 
Regional Clinical Nutrition Manager
Regional Nutrition Service PHS-PSA Acute Care
Phone: 503-216-2496 or 503-215-6974
terese.scollard at providence.org 


________________________________

From: Maritza Rodriguez [mailto:m-rodrig at msmc.com] 
Sent: Thursday, January 08, 2009 8:33 AM
To: cnm at lists.my180.net
Subject: [Cnm] Lecture



Hi all,

 

I have been asked to provide a series of presentations about healthy
eating, weight management, Diabetes and Hypertension to the staff of a
police station close to my facility.  They want me to start providing
these presentations by next week.  With the short notice, I feel I won't
be able to prepare an appropriate one.  Do any of you have one already
done that is willing to share, at least to start next week?

 

Thank you in advance,

 

Maritza Rodriguez

 

Maritza Rodriguez, RD LDN

Clinical Nutrition Manager

Mount Sinai Medical Center

4300 Alton Road

Miami Beach, Florida 33140

 

Tel: 305-674-2121 Ext. 56181

Fax: 305-674-2234

m-rodrig at msmc.com

 

 

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
CONFIDENTIAL or PRIVILEGED information.  Any unauthorized review, use,
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and immediately
destroy all copies of the original message and all attachments.  Any
opinions expressed here are not necessarily those of Mount Sinai Medical
Center.

 

 



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/00d08baf/attachment.html 

From Robin.Herr at scrmc.org  Thu Jan  8 09:14:17 2009
From: Robin.Herr at scrmc.org (Herr, Robin)
Date: Thu, 8 Jan 2009 11:14:17 -0600
Subject: [Cnm] software or internet services
Message-ID: <304EAB7120CEBC418CA9D1C7D8CE06BF0285FB7D@mailserver.scrmc.loc>

I'm looking for a software program or an internet service that you'd
recommend for nutritional analysis of recipes and menus!!!
 
Thank you for your assistance,
 
Robin Herr
robin.herr at scrmc.org
715.483.0248
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/df490390/attachment.html 

From Sandra.Miller at CHW.edu  Thu Jan  8 10:32:22 2009
From: Sandra.Miller at CHW.edu (Miller, Sandra - MMC)
Date: Thu, 8 Jan 2009 11:32:22 -0700
Subject: [Cnm] Parenteral Solutions Amino acid concentration
In-Reply-To: <003601c9711a$3d694f90$b83beeb0$@org>
References: <3869251104618A4CA35EB2D4021C24D1019D666B@exchange.southwesthealth.org>
	<003601c9711a$3d694f90$b83beeb0$@org>
Message-ID: <CE50A73BE0204542A71BD4AE515469AC05480CC7@CHW-MSG-203.chw.edu>

Is anyone using 5% amino acid solutions for PPN?
Sandra Miller MS, RD, CDE 
Clinical Nutrition Manager 
French Hospital Medical Center 
email: sandra.miller at chw.edu 
Phone: (805) 542-6229 


________________________________

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/eefaa26c/attachment.html 

From LFlanagan at eatright.org  Thu Jan  8 10:41:24 2009
From: LFlanagan at eatright.org (Linda  Flanagan Vahl)
Date: Thu, 8 Jan 2009 12:41:24 -0600
Subject: [Cnm] ADA Books needs your help!!
In-Reply-To: <EA727D981AD45E4099BD143F4853FE86059DA6FD@adaexchsrvm.ada-net.local>
References: <EA727D981AD45E4099BD143F4853FE86059DA6FD@adaexchsrvm.ada-net.local>
Message-ID: <EA727D981AD45E4099BD143F4853FE8606BA9FAA@adaexchsrvm.ada-net.local>

ADA Books needs your help!!

 

We are in the process of trying to determine members' information needs
in business-related topics, specifically improving customer service. We
would greatly value your input. Would you take a moment to answer this
brief survey? 

 

http://www.surveymonkey.com/s.aspx?sm=cZCB1LHKFcqbHtqT9tcWQw_3d_3d

 

Thank you!

 

ADA Books Team

 

Laura Pelehach

Acquisitions and Development Manager, Book Publishing

American Dietetic Association

120 S. Riverside Plaza, Ste. 2000

Chicago, IL 60606-6995

 lpelehach at eatright.org

312-899-4828

1-800-877-1600, ext 4828

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/1193a00e/attachment-0001.html 

From cathysmith at mhsjvl.org  Thu Jan  8 11:12:06 2009
From: cathysmith at mhsjvl.org (Smith, Cathy)
Date: Thu, 8 Jan 2009 13:12:06 -0600
Subject: [Cnm] Psych Floor Menus
References: <20090107142057.BWE26777@ms10.lnh.mail.rcn.net>
Message-ID: <4973FD77BA585043AC3C49ED6D7B9F836B8E57@MXV1.mercy.org>

They fill out their own menu from a one week cycle with NO allowed write-ins.

________________________________

From: cnm-bounces at lists.my180.net on behalf of bzabinsky at rcn.com
Sent: Wed 1/7/2009 1:20 PM
To: 'CNMeblast at gmail.com'; CNM
Cc: rladuke at challiance.org
Subject: [Cnm] Psych Floor Menus



I was wondering if you could help me.  We currently have a fixed menus for our psych floor and out patient satisfaction scores are not too great...we are looking to improve.  How are other hospital handling food preferences on psych floors?
Do you have psych patients fill out their own menus?  Any feedback would be much appreciated.

Beth Zabinsky

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/4a4a261c/attachment.html 

From abf9007 at nyp.org  Thu Jan  8 11:34:07 2009
From: abf9007 at nyp.org (Amy B. Friedman)
Date: Thu, 08 Jan 2009 14:34:07 -0500
Subject: [Cnm] Out-patient Medicare Billing
Message-ID: <4966552F.8020801@nyp.org>

I understand the a Nurse Practitioner's scope of practice varies from 
state to state.  In New York NPs work in collaboration with physicians.  
I was told collaboration means that an NP can open an independent 
private practice as long as there is a collaborating physician.  That 
physician collaborates as a resource.  Not for over site or supervision 
of each individual patient.  So it is not the physician's patient it is 
the NP's patient.  A PA needs supervision and it would be both the 
physician and PA's patient.

So here is my question Medicare requires a physician referral for MNT 
counseling/billing.  The physician at our clinic will not write the 
referral because it is not his patient it is the NPs patient.  He feels 
writing the referral would be illegal since he has never seen the 
patient and he might not agree with the NP.

Has anyone had to deal with a similar situation?  If so how did you get 
the referral to provide the MNT?

Thank You,
Amy Friedman MS, RD, CDN




--------------------

This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited.  If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message.  Thank you.




From FREED_KATHARINE at GUTHRIE.ORG  Thu Jan  8 11:42:59 2009
From: FREED_KATHARINE at GUTHRIE.ORG (FREED_KATHARINE at GUTHRIE.ORG)
Date: Thu, 8 Jan 2009 14:42:59 -0500
Subject: [Cnm] Psych Floor Menus
In-Reply-To: <20090107142057.BWE26777@ms10.lnh.mail.rcn.net>
Message-ID: <OFE597D41B.C9E9C3D0-ON85257538.006A8C0B-85257538.006C4E28@guthrie.org>

Beth,
Our Psych Floor patients get the same selective menu as the rest of the 
hospital.  It is a 1 week cycle and their LOS is usually longer so we do 
provide a "write on" list which I will attach to this memo.  We do limit 
them to 2 entrees and 2 desserts.  For the most part it works out OK.  We 
do get the occasional patient who circles everything and/or adds " X2 or 
X3 to everything; but that happens on the other units too.  We also offer 
a  Nutrition Group every Tuesday AM where we provide information on and 
encourage healthy eating.  It is fairly well attended.
Kait Freed


Katharine Ward Freed, MS, RD, LDN, CDE
Clinical Supervisor
Food & Nutrition Dept.
Robert Packer Hospital
One Guthrie Square
Sayre, PA 18840
Tel  570-882-4297   Fax  570-882-5122
Email: "freed_katharine at guthrie.org"


CONFIDENTIALITY NOTICE: This e-mail, including attachments, may
include confidential, restricted, protected health and/or
proprietary information, and may be used only for the person or
entity to which it is addressed. If the reader of this e-mail is
not the intended recipient or his or her authorized agent, the
reader is hereby notified that any dissemination, distribution or
copying of this e-mail is prohibited. If you have received this
e-mail in error, please notify the sender by replying to this
message and delete this e-mail immediately. Notice: The disclosure
of medical information is strictly prohibited by federal
regulation. Unauthorized release of medical information may result
in administrative, civil and criminal sanctions.  
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/8ea095c9/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: BSU Alternate Menu Selections.doc
Type: application/octet-stream
Size: 29696 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090108/8ea095c9/attachment-0001.obj 

From horlowsk at ppmh.org  Thu Jan  8 12:27:46 2009
From: horlowsk at ppmh.org (Orlowski, Hannah)
Date: Thu, 8 Jan 2009 15:27:46 -0500
Subject: [Cnm] IBW for under 5 ft
References: <mailman.1133.1231425951.3783.cnm_lists.my180.net@lists.my180.net>
	<860209A7-B50E-4338-82EB-53C60277C2DB@mimectl>
Message-ID: <0DAF44B706E29940A409E32DC69005C0044F40A9@exchange1.phoebe.com>

I have also ways heard 2.5# under 5'.  Do not know if there is a reference.  I was taught that in school that 19+ yrs ago.

________________________________

From: cnm-bounces at lists.my180.net on behalf of Heberle, Heather N.
Sent: Thu 1/8/2009 9:53 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] IBW for under 5 ft


We use the general rule of subtracting 3# for every inch below 5ft.  I am not sure there is any reference behind it however.
 
Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879

________________________________

From: cnm-request at lists.my180.net
Sent: Thu 1/8/09 8:45 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 39


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: IBW for under 5 ft (Jo Lynn Worden)
   2. Re: Nutrition Care Process Terminology (Harrison, Kerry)
   3. Re: Nutrition Care Process Terminology (Roberta Tripp)
   4. Re: Parenteral Solutions (Heberle, Heather N.)


----------------------------------------------------------------------

Message: 1
Date: Wed, 7 Jan 2009 23:27:05 -0600
From: "Jo Lynn Worden" <jlworden at att.net>
Subject: Re: [Cnm] IBW for under 5 ft
To: "'Hayashi, Remi  - GMHHC'" <Remi.Hayashi at CHW.EDU>,
	<cnm at lists.my180.net>
Message-ID: <00cf01c97151$beea3700$3cbea500$@net>
Content-Type: text/plain; charset="us-ascii"

Please post to list. This is what I was taught but I've had people 4'6' so
their IBW would be <85 lbs?   What do other people do?

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Hayashi, Remi - GMHHC
Sent: Wednesday, January 07, 2009 6:51 PM
To: cnm at lists.my180.net
Subject: [Cnm] IBW for under 5 ft

 

Happy New Year 

This was probably discussed before...how do you calculate the IBW for
patient under 5 feet?  I was always taught to multiply the number of inches
that are under 5 feet by 2.5 then subtract from 100lb for female.  Is there
any reference to this method?  TIA.

Remi Hayashi, MS, RD 
Clinical Nutrition Manager 
Glendale Memorial Hospital and Health Center 
1420 South Central Avenue 
Glendale, CA 91204 
(818)409-7643 Direct 
(818)507-4665 Fax 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/f1131517/attachment-0001.html 

------------------------------

Message: 2
Date: Thu, 8 Jan 2009 07:58:16 -0600
From: "Harrison, Kerry" <kharriso at stagnes.org>
Subject: Re: [Cnm] Nutrition Care Process Terminology
To: <Lisa.N.Faucon at kp.org>,	<cnm at lists.my180.net>
Message-ID:
	<9AB3ADBD43ABFD46B0DC4E80280F3B39224EA1 at ahcmascdc034.DS.SJHS.COM>
Content-Type: text/plain; charset="us-ascii"

Each facility usually has an abbreviation reference that they follow.
Here we use Stedman's and AEB and R/T are in the book, so we use them.

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa.N.Faucon at kp.org
Sent: Wednesday, January 07, 2009 7:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

 


We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate? 

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/cc143a1b/attachment-0001.html 

------------------------------

Message: 3
Date: Thu, 8 Jan 2009 09:28:32 -0500
From: "Roberta Tripp" <rtripp at PINNACLEHEALTH.org>
Subject: Re: [Cnm] Nutrition Care Process Terminology
To: "Harrison, Kerry" <kharriso at stagnes.org>, <Lisa.N.Faucon at kp.org>,
	<cnm at lists.my180.net>
Message-ID:
	<7375E17267B3DB4583032BDEFDA2D76E05DF7775 at mailphs.pinnaclehealth.org>
Content-Type: text/plain; charset="us-ascii"

If you want to use the standardized language (terminology) in drop downs
in your EMR you need to contact ADA for permission.  The contact info is
below.
 
Kay B. Howarter, MS, RD

Senior Research Manager

Evidence Analysis Library

American Dietetic Association

120 S. Riverside Plaza

Chicago, IL  60606-6995

TEL:  312-899-4797

FAX:  312-899-4812

 

khowarter at eatright.org <mailto:khowarter at eatright.org> 

www.adaevidencelibrary.com <http://www.adaevidencelibrary.com/> 

 

 

 

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org <mailto:rtripp at pinnaclehealth.org> 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Harrison, Kerry
Sent: Thursday, January 08, 2009 8:58 AM
To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology



Each facility usually has an abbreviation reference that they follow.
Here we use Stedman's and AEB and R/T are in the book, so we use them.

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa.N.Faucon at kp.org
Sent: Wednesday, January 07, 2009 7:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology

 


We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate? 

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.

CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.


The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/03d071c6/attachment-0001.html 

------------------------------

Message: 4
Date: Thu, 8 Jan 2009 08:45:41 -0600
From: "Heberle, Heather N." <Heberle-Heather at aramark.com>
Subject: Re: [Cnm] Parenteral Solutions
To: <cnm at lists.my180.net>
Message-ID: <567FB54A-103E-4BCC-BEDB-092FD7303A0A at mimectl>
Content-Type: text/plain; charset="iso-8859-1"

We currently have 4 standard formulas and 1 section where you are able to modify and make your own solution.  We also have 2 lipid choices to choose from.  However, we have a policy in place that physicians are not allowed to do TPN.  we have a "TPN Team" which consists of a dietitian and a pharmacist.  Unless the physician specifically writes DC TPN Team, the TPN Team will be in full control of the TPN.  If a physician does write to DC TPN Team, it is reported to our pharmacy and therapeutics committee and the physician is notified.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879



From: cnm-request at lists.my180.net
Sent: Wed 1/7/09 4:09 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 36


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: FW: Wounds and Triggers (Scott, Kerry  R.)
   2. Parenteral Solutions (Shannon Byrd Jackson)
   3. Re: Parenteral Solutions (Carver, Leslee)


----------------------------------------------------------------------

Message: 1
Date: Tue, 6 Jan 2009 09:24:11 -0800
From: "Scott, Kerry  R." <Kerry.Scott at providence.org>
Subject: Re: [Cnm] FW: Wounds and Triggers
To: "Tucker, Jennifer" <TUCKERJ at lourdesnet.org>,	<cnm at lists.my180.net>
Message-ID:
	<CBE0048956D4B14C893378F8D13A36E201A9A5AD at IRMEXCH02.irm.inhs.org>
Content-Type: text/plain;	charset="us-ascii"

We use Braden score <=12 as an automatic trigger on admission, in
addition to nutrition referrals from our enterostomal therapists.  We
are still working out the "bugs" as we do get some false positives if
Braden evaluation is not completed thouroughly.
Kerry Scott, RD, CD
Clinical Nutrition Manager
Food & Nutrition Services
Sacred Heart Medical Center
(509)474-4774
scottk1 at shmc.org

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Tucker, Jennifer
Sent: Tuesday, January 06, 2009 7:05 AM
To: cnm at lists.my180.net
Subject: [Cnm] FW: Wounds and Triggers


Good Morning,
    I would greatly appreciate any input on what "types" of wounds would
trigger your RD's.

Pressure ulcers stage II and greater?
Venous?
Just the word wound upon admission?

Thank you so much for any input,

Jennifer Tucker RD
Clinical Nutrition Manager
Lourdes Health System
856-757-3596
Confidentiality Notice:
This email, including any attachments is the property of Catholic Health
East and is intended for the sole use of the intended recipient(s).  
It may contain information that is privileged and confidential.  Any
unauthorized review, use, disclosure, or distribution is prohibited. If
you are not the intended recipient, please reply to the sender that you
have received the message in error, then delete this message.


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 2
Date: Wed, 7 Jan 2009 16:59:15 -0500
From: "Shannon Byrd Jackson" <Shannon.Jackson at wilmed.org>
Subject: [Cnm] Parenteral Solutions
To: "CNM (E-mail)" <cnm at lists.my180.net>
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA779789 at wmhcs03.wmh.org>
Content-Type: text/plain; charset="iso-8859-1"

Hi,
 
How many options do physicians at your facility have for Central Parenteral
Nutrition? Do they have one they can customize as well?
Our docs wanted one of each and I don't feel that is sufficient to meet all
of the patients' needs.
Thanks,
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/b89ef843/attachment-0001.html 

------------------------------

Message: 3
Date: Wed, 7 Jan 2009 16:10:02 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] Parenteral Solutions
To: "Shannon Byrd Jackson" <Shannon.Jackson at wilmed.org>,	"CNM
	(E-mail)" <cnm at lists.my180.net>
Message-ID:
	<5330B54133B6194BA13930BDEFE9A30E03A33980 at rhcexch3.reshealthcare.org>
Content-Type: text/plain; charset="us-ascii"

we have 1 standard and then a customizable option (used most often by
Nephrology). I've attached the forms we use - the order section is
correct in content but I don't have the final PDF on my hard drive.
Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Wednesday, January 07, 2009 3:59 PM
To: CNM (E-mail)
Subject: [Cnm] Parenteral Solutions


Hi,
 
How many options do physicians at your facility have for Central
Parenteral Nutrition? Do they have one they can customize as well?
Our docs wanted one of each and I don't feel that is sufficient to meet
all of the patients' needs.
Thanks,
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
www.wilmed.org <http://www.wilmed.org/> 

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: TPNBACK 06 revision.DOC
Type: application/msword
Size: 12800 bytes
Desc: TPNBACK 06 revision.DOC
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.dot 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Daily Adult Parenteral Nutrition Order Form 2006.doc
Type: application/msword
Size: 31744 bytes
Desc: Daily Adult Parenteral Nutrition Order Form 2006.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.doc 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 36
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/62412482/attachment.html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 39
***********************************

-----------------------------------------
Disclaimer:
The HIPAA Final Privacy Rule requires covered entities to safeguard
certain Protected Health Information (PHI) related to a person's
healthcare.  Information being faxed to you may include PHI after
appropriate authorization from the patient or under circumstances
that do not require patient authorization.  You, the recipient, are
obligated to maintain PHI in a safe and secure manner.  You may not
re-disclose without additional patient consent or as required by
law.  Unauthorized re-disclosure or failure to safeguard PHI could
subject you to penalties described in federal (HIPAA) and state
law.  If you the reader of this message are not the intended
recipient, or the employee or agent responsible to deliver it to
the intended recipient, please notify us immediately and destroy
the related message.



From marissa.hofman at ucdmc.ucdavis.edu  Thu Jan  8 12:32:04 2009
From: marissa.hofman at ucdmc.ucdavis.edu (Marissa Hofman)
Date: Thu, 8 Jan 2009 12:32:04 -0800
Subject: [Cnm] IBW for under 5 ft
In-Reply-To: <0DAF44B706E29940A409E32DC69005C0044F40A9@exchange1.phoebe.com>
Message-ID: <OFA2D1AED8.4089FB1D-ON88257538.0070B531-88257538.0070CC84@ucdmc.ucdavis.edu>


I searched & searched for research on subtracting 2.5lbs for every inch
under 5ft and came up with nothing.  That is how I discovered the IBW
article using BMI of 22 as a standard.


Marissa Hofman, RD
Clinical Nutrition Manager
UC Davis Medical Center
Food & Nutrition Dept.
2315 Stockton Blvd
Sacramento, CA 95817
Phone: (916) 734-5100
Fax: (916)734-3154


                                                                           
             "Orlowski,                                                    
             Hannah"                                                       
             <horlowsk at ppmh.or                                          To 
             g>                        "Heberle, Heather N."               
             Sent by:                  <Heberle-Heather at aramark.com>,      
             cnm-bounces at lists         <cnm at lists.my180.net>               
             .my180.net                                                 cc 
                                                                           
                                                                   Subject 
             01/08/2009 12:30          Re: [Cnm] IBW for under 5 ft        
             PM                                                            
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           




I have also ways heard 2.5# under 5'.  Do not know if there is a reference.
I was taught that in school that 19+ yrs ago.

________________________________

From: cnm-bounces at lists.my180.net on behalf of Heberle, Heather N.
Sent: Thu 1/8/2009 9:53 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] IBW for under 5 ft


We use the general rule of subtracting 3# for every inch below 5ft.  I am
not sure there is any reference behind it however.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879

________________________________

From: cnm-request at lists.my180.net
Sent: Thu 1/8/09 8:45 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 39


Send Cnm mailing list submissions to
             cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
             http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
             cnm-request at lists.my180.net

You can reach the person managing the list at
             cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: IBW for under 5 ft (Jo Lynn Worden)
   2. Re: Nutrition Care Process Terminology (Harrison, Kerry)
   3. Re: Nutrition Care Process Terminology (Roberta Tripp)
   4. Re: Parenteral Solutions (Heberle, Heather N.)


----------------------------------------------------------------------

Message: 1
Date: Wed, 7 Jan 2009 23:27:05 -0600
From: "Jo Lynn Worden" <jlworden at att.net>
Subject: Re: [Cnm] IBW for under 5 ft
To: "'Hayashi, Remi  - GMHHC'" <Remi.Hayashi at CHW.EDU>,
             <cnm at lists.my180.net>
Message-ID: <00cf01c97151$beea3700$3cbea500$@net>
Content-Type: text/plain; charset="us-ascii"

Please post to list. This is what I was taught but I've had people 4'6' so
their IBW would be <85 lbs?   What do other people do?



From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Hayashi, Remi - GMHHC
Sent: Wednesday, January 07, 2009 6:51 PM
To: cnm at lists.my180.net
Subject: [Cnm] IBW for under 5 ft



Happy New Year

This was probably discussed before...how do you calculate the IBW for
patient under 5 feet?  I was always taught to multiply the number of inches
that are under 5 feet by 2.5 then subtract from 100lb for female.  Is there
any reference to this method?  TIA.

Remi Hayashi, MS, RD
Clinical Nutrition Manager
Glendale Memorial Hospital and Health Center
1420 South Central Avenue
Glendale, CA 91204
(818)409-7643 Direct
(818)507-4665 Fax

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/f1131517/attachment-0001.html


------------------------------

Message: 2
Date: Thu, 8 Jan 2009 07:58:16 -0600
From: "Harrison, Kerry" <kharriso at stagnes.org>
Subject: Re: [Cnm] Nutrition Care Process Terminology
To: <Lisa.N.Faucon at kp.org>,          <cnm at lists.my180.net>
Message-ID:

<9AB3ADBD43ABFD46B0DC4E80280F3B39224EA1 at ahcmascdc034.DS.SJHS.COM>
Content-Type: text/plain; charset="us-ascii"

Each facility usually has an abbreviation reference that they follow.
Here we use Stedman's and AEB and R/T are in the book, so we use them.



Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152



To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have.
-Thomas Jefferson

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa.N.Faucon at kp.org
Sent: Wednesday, January 07, 2009 7:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology




We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate?

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.


CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended only
for the named recipient(s). If you are not the intended recipient(s), you
are hereby notified that the dissemination, distribution, and or copying of
this message is strictly prohibited. If you receive this message in error,
or are not the named recipient(s), please notify the sender at the email
address above, delete this email from your computer, and destroy any copies
in any form immediately.  Receipt by anyone other than the named recipient
(s) is not a waiver of any attorney-client, work product, or other
applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/cc143a1b/attachment-0001.html


------------------------------

Message: 3
Date: Thu, 8 Jan 2009 09:28:32 -0500
From: "Roberta Tripp" <rtripp at PINNACLEHEALTH.org>
Subject: Re: [Cnm] Nutrition Care Process Terminology
To: "Harrison, Kerry" <kharriso at stagnes.org>, <Lisa.N.Faucon at kp.org>,
             <cnm at lists.my180.net>
Message-ID:

<7375E17267B3DB4583032BDEFDA2D76E05DF7775 at mailphs.pinnaclehealth.org>
Content-Type: text/plain; charset="us-ascii"

If you want to use the standardized language (terminology) in drop downs
in your EMR you need to contact ADA for permission.  The contact info is
below.

Kay B. Howarter, MS, RD

Senior Research Manager

Evidence Analysis Library

American Dietetic Association

120 S. Riverside Plaza

Chicago, IL  60606-6995

TEL:  312-899-4797

FAX:  312-899-4812



khowarter at eatright.org <mailto:khowarter at eatright.org>

www.adaevidencelibrary.com <http://www.adaevidencelibrary.com/>







Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org <mailto:rtripp at pinnaclehealth.org>

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Harrison, Kerry
Sent: Thursday, January 08, 2009 8:58 AM
To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology



Each facility usually has an abbreviation reference that they follow.
Here we use Stedman's and AEB and R/T are in the book, so we use them.



Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152



To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have.
-Thomas Jefferson

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa.N.Faucon at kp.org
Sent: Wednesday, January 07, 2009 7:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology




We are putting the Nutrition Care process into our electronic charting
system.  Does anyone know if there are approved abbreviations?  Are the
diagnosis copyrighted?  Or can we abbreviate?

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this
e-mail, you are prohibited from sharing, copying, or otherwise using or
disclosing its contents.  If you have received this e-mail in error,
please notify the sender immediately by reply e-mail and permanently
delete this e-mail and any attachments without reading, forwarding or
saving them.  Thank you.

CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.


The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/03d071c6/attachment-0001.html


------------------------------

Message: 4
Date: Thu, 8 Jan 2009 08:45:41 -0600
From: "Heberle, Heather N." <Heberle-Heather at aramark.com>
Subject: Re: [Cnm] Parenteral Solutions
To: <cnm at lists.my180.net>
Message-ID: <567FB54A-103E-4BCC-BEDB-092FD7303A0A at mimectl>
Content-Type: text/plain; charset="iso-8859-1"

We currently have 4 standard formulas and 1 section where you are able to
modify and make your own solution.  We also have 2 lipid choices to choose
from.  However, we have a policy in place that physicians are not allowed
to do TPN.  we have a "TPN Team" which consists of a dietitian and a
pharmacist.  Unless the physician specifically writes DC TPN Team, the TPN
Team will be in full control of the TPN.  If a physician does write to DC
TPN Team, it is reported to our pharmacy and therapeutics committee and the
physician is notified.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879



From: cnm-request at lists.my180.net
Sent: Wed 1/7/09 4:09 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 36


Send Cnm mailing list submissions to
             cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
             http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
             cnm-request at lists.my180.net

You can reach the person managing the list at
             cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: FW: Wounds and Triggers (Scott, Kerry  R.)
   2. Parenteral Solutions (Shannon Byrd Jackson)
   3. Re: Parenteral Solutions (Carver, Leslee)


----------------------------------------------------------------------

Message: 1
Date: Tue, 6 Jan 2009 09:24:11 -0800
From: "Scott, Kerry  R." <Kerry.Scott at providence.org>
Subject: Re: [Cnm] FW: Wounds and Triggers
To: "Tucker, Jennifer" <TUCKERJ at lourdesnet.org>,
<cnm at lists.my180.net>
Message-ID:

<CBE0048956D4B14C893378F8D13A36E201A9A5AD at IRMEXCH02.irm.inhs.org>
Content-Type: text/plain;            charset="us-ascii"

We use Braden score <=12 as an automatic trigger on admission, in
addition to nutrition referrals from our enterostomal therapists.  We
are still working out the "bugs" as we do get some false positives if
Braden evaluation is not completed thouroughly.
Kerry Scott, RD, CD
Clinical Nutrition Manager
Food & Nutrition Services
Sacred Heart Medical Center
(509)474-4774
scottk1 at shmc.org



-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Tucker, Jennifer
Sent: Tuesday, January 06, 2009 7:05 AM
To: cnm at lists.my180.net
Subject: [Cnm] FW: Wounds and Triggers


Good Morning,
    I would greatly appreciate any input on what "types" of wounds would
trigger your RD's.

Pressure ulcers stage II and greater?
Venous?
Just the word wound upon admission?

Thank you so much for any input,

Jennifer Tucker RD
Clinical Nutrition Manager
Lourdes Health System
856-757-3596
Confidentiality Notice:
This email, including any attachments is the property of Catholic Health
East and is intended for the sole use of the intended recipient(s).
It may contain information that is privileged and confidential.  Any
unauthorized review, use, disclosure, or distribution is prohibited. If
you are not the intended recipient, please reply to the sender that you
have received the message in error, then delete this message.


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 2
Date: Wed, 7 Jan 2009 16:59:15 -0500
From: "Shannon Byrd Jackson" <Shannon.Jackson at wilmed.org>
Subject: [Cnm] Parenteral Solutions
To: "CNM (E-mail)" <cnm at lists.my180.net>
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA779789 at wmhcs03.wmh.org>
Content-Type: text/plain; charset="iso-8859-1"

Hi,

How many options do physicians at your facility have for Central Parenteral
Nutrition? Do they have one they can customize as well?
Our docs wanted one of each and I don't feel that is sufficient to meet all
of the patients' needs.
Thanks,


Shannon B. Jackson, RD, LDN
Clinical Dietitian Supervisor
Wilson Medical Center
1705 Tarboro Street SW
Wilson, NC 27893-3428
(252) 399-8768
 <http://www.wilmed.org/> www.wilmed.org


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/b89ef843/attachment-0001.html


------------------------------

Message: 3
Date: Wed, 7 Jan 2009 16:10:02 -0600
From: "Carver, Leslee" <LCarver at Reshealthcare.org>
Subject: Re: [Cnm] Parenteral Solutions
To: "Shannon Byrd Jackson" <Shannon.Jackson at wilmed.org>,           "CNM
             (E-mail)" <cnm at lists.my180.net>
Message-ID:

<5330B54133B6194BA13930BDEFE9A30E03A33980 at rhcexch3.reshealthcare.org>
Content-Type: text/plain; charset="us-ascii"

we have 1 standard and then a customizable option (used most often by
Nephrology). I've attached the forms we use - the order section is
correct in content but I don't have the final PDF on my hard drive.
Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Wednesday, January 07, 2009 3:59 PM
To: CNM (E-mail)
Subject: [Cnm] Parenteral Solutions


Hi,

How many options do physicians at your facility have for Central
Parenteral Nutrition? Do they have one they can customize as well?
Our docs wanted one of each and I don't feel that is sufficient to meet
all of the patients' needs.
Thanks,


Shannon B. Jackson, RD, LDN
Clinical Dietitian Supervisor
Wilson Medical Center
1705 Tarboro Street SW
Wilson, NC 27893-3428
(252) 399-8768
www.wilmed.org <http://www.wilmed.org/>


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.html

-------------- next part --------------
A non-text attachment was scrubbed...
Name: TPNBACK 06 revision.DOC
Type: application/msword
Size: 12800 bytes
Desc: TPNBACK 06 revision.DOC
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.dot

-------------- next part --------------
A non-text attachment was scrubbed...
Name: Daily Adult Parenteral Nutrition Order Form 2006.doc
Type: application/msword
Size: 31744 bytes
Desc: Daily Adult Parenteral Nutrition Order Form 2006.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090107/1aeebb70/attachment.doc


------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 36
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/62412482/attachment.html


------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 39
***********************************

-----------------------------------------
Disclaimer:
The HIPAA Final Privacy Rule requires covered entities to safeguard
certain Protected Health Information (PHI) related to a person's
healthcare.  Information being faxed to you may include PHI after
appropriate authorization from the patient or under circumstances
that do not require patient authorization.  You, the recipient, are
obligated to maintain PHI in a safe and secure manner.  You may not
re-disclose without additional patient consent or as required by
law.  Unauthorized re-disclosure or failure to safeguard PHI could
subject you to penalties described in federal (HIPAA) and state
law.  If you the reader of this message are not the intended
recipient, or the employee or agent responsible to deliver it to
the intended recipient, please notify us immediately and destroy
the related message.


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090108/799b6ab4/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: graycol.gif
Type: image/gif
Size: 105 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090108/799b6ab4/attachment-0003.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: pic23292.gif
Type: image/gif
Size: 1255 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090108/799b6ab4/attachment-0004.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: ecblank.gif
Type: image/gif
Size: 45 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090108/799b6ab4/attachment-0005.gif 

From jonessl at upmc.edu  Thu Jan  8 13:15:47 2009
From: jonessl at upmc.edu (Jones, Sherri)
Date: Thu, 8 Jan 2009 16:15:47 -0500
Subject: [Cnm] Nutrition Care Process Terminology
In-Reply-To: <37ABAEB17B0B5B40AA0B6118E57CF59A02F883BF@wn1221.or.providence.org>
References: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.org>
	<37ABAEB17B0B5B40AA0B6118E57CF59A02F883BF@wn1221.or.providence.org>
Message-ID: <5AF9B08B39F8AD4380E2797E4125AEA1E86683C2@msxmbxnsprd17.acct.upmchs.net>




In response to the question of NCP Language and ADA license...

I'm a current member of the NCP-SL Committee and as I understand it - Yes, technically you are to apply for a license from ADA for the use of NCP language in your EHR. The license will ensure that you receive the most up to date information and will automatically be sent any updates as they occur in a downloadable format, I believe. However, the application now does not specify a fee. Instead, I believe, you submit the application to ADA and then they will determine the fee based upon the request and intended use of the terms. Note that ADA however has been working with some of the EHR Companies to maintain a license with them directly. So, I would recommend you call Lisa Ornstein at ADA for clarification of what is appropriate in your individual case. Her email address is listed at the very bottom of the response. Additionally, just as an FYI - on the ADA website there is a Q&A document that explains about the term licensing issue. I've cut and pasted it below. But the format did not come across as nice. ...I hope this helps to clarify.

Excerpt From ADA Website: 

Electronic Health Records
?
I?m developing a product and would like to include the NCP/SL terminology. Do I need permission from the ADA?
o
Yes. The ADA holds copyright for the NCP/SL terminology and use of the terminology in any product requires a license. To use NCP/SL in a product that will be sold or distributed to others, please obtain a distribution license.
?
How can I get a distribution license for the NCP/SL terminology?
o
To initiate the license process, complete the Distribution License Application and return it to us. Completed license applications can be faxed to 312?899?5344.
?
How long does it take to get a distribution license?
o
Typically we will be able to return a draft agreement to you within 2 weeks of permissions request. This time may be affected by our ability to ask additional questions if the application is not clear, and the legal review of the draft agreement on your end will determine how long it take for you to return the agreement. Once the agreement is received, an invoice is submitted for payment. This usually takes 1 week. Once the payment is received, the permission process is considered complete and the electronic version of the terms will be provided.
?
I want to incorporate the NCP/SL terminology into my hospital/health care system?s electronic health records. What kind of license do I need?
o
You need an ?internal use? license. An internal use license grants permission when the terminology will only be used within a company and will not be sold or redistributed. To apply for an internal use license, complete the Internal Use License Application. Completed license applications can be faxed to ________________.
?
My product will only include a few NCP/SL terms. Do I need a license?
o
You should evaluate whether your proposed use of the terms falls within ?fair use.? The U.S. Copyright Law, under Chapter One, Section 107,
exempts limited use of copyrighted works, referred to as ?fair use? and such uses are allowable without a license. For more information on fair use and the copyright law, please visit www.copyright.gov. Consulting with your legal advisor is also a good idea.
?
What is the correct format for the copyright notice?
o
Copyright 2008 American Dietetic Association. All rights reserved.
?
If I need further information, who can I contact? Lisa Ornstein can set up a teleconference with either Dr Esther Myers or Kay Howarter. Lisa can be reached at lornstein at eatright.org.

Sherri 
Sherri L. Jones, MS, RD, LDN
Clinical Nutrition Manager
UPMC Shadyside
Phone: (412) 623-1629
Pager: (412) 263-8518
Fax: (412) 6232429
jonessl at upmc.edu

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Scollard, Terese
Sent: Thursday, January 08, 2009 10:13 AM
To: Lisa.N.Faucon at kp.org; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Care Process Terminology

If my memory serves me right, there is a form on the ADA website under the NCP to fill out and send to ADA to get permission. You can call, too.
Terese Scollard
Providence Health & Services
Portland Oregon


-----Original Message-----
From: Lisa.N.Faucon at kp.org [mailto:Lisa.N.Faucon at kp.org]
Sent: Wed 1/7/2009 4:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Care Process Terminology
 
We are putting the Nutrition Care process into our electronic charting 
system.  Does anyone know if there are approved abbreviations?  Are the 
diagnosis copyrighted?  Or can we abbreviate?

Lisa N Faucon MS, RD
Assistant Department Administrator, Nutrition Services
Kaiser Permanente
4647 Zion Ave
San Diego, CA, 92120
(619) 528-5515 office
(619) 528-3024 fax
(619) 682-0672 pager

NOTICE TO RECIPIENT:  If you are not the intended recipient of this 
e-mail, you are prohibited from sharing, copying, or otherwise using or 
disclosing its contents.  If you have received this e-mail in error, 
please notify the sender immediately by reply e-mail and permanently 
delete this e-mail and any attachments without reading, forwarding or 
saving them.  Thank you.



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

From jcannon01 at harthosp.org  Fri Jan  9 05:17:47 2009
From: jcannon01 at harthosp.org (Janice Cannon)
Date: Fri, 09 Jan 2009 08:17:47 -0500
Subject: [Cnm] Calorie counts
Message-ID: <49670825.786D.00B4.1@harthosp.org>

Wondering if any of you have chosen to stop orders for calorie counts due to the variable information obtained and who is obtaining, and if so, how are you ensuring adequacy of intake if needed?
Thank you
 
Janice Cannon, M.S.,RD,CD-N
Clinical Nutrition Manager
Hartford Hospital
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/1b04b6ed/attachment.html 

From cindy at harperjobs.com  Fri Jan  9 06:05:57 2009
From: cindy at harperjobs.com (Cindy Krainen)
Date: Fri, 9 Jan 2009 09:05:57 -0500
Subject: [Cnm] NICU RD Opportunity
Message-ID: <00d701c97263$6512f600$7e01a8c0@hprdomain.local>

 

*                  NICU DIETITIAN - GEORGIA

Progressive Medical Center in Southern Georgia is seeking a Registered
Dietitian for a great NICU opportunity.  This is an interdisciplinary
position which requires a strong team player. The RD will write TPN orders
in this facility where RDs are extremely well-respected.  An excellent
computer program is utilized.  NICU experience is strongly preferred,
however, the employer will sponsor a NICU internship for a Registered
Dietitian with at least three years of pediatric clinical experience and a
very serious interest in specializing in NICU.  Competitive salary, based on
experience.  Outstanding benefits including on-site childcare facility and
other great perks.  Find out why many healthcare professionals consider this
facility to be a hidden jewel of an employer! 

 

All inquiries will remain confidential; your resume will not be forwarded
anywhere without your permission.

Email resume in a Word attachment to:

Cindy Krainen RD,  Harper Associates      

31000 Northwestern Hwy., Suite 240, Farmington Hills, MI 48334


Phone: 248-932-3662/800-933-1170 ext. 106      

Fax:248-932-1214

 <mailto:cindy at harperjobs.com> cindy at harperjobs.com    

 <http://www.harperjobs.com> www.harperjobs.com

 


Harper Associates is proudly celebrating its 40th year! (1968-2008)

 

Join Dietitians Job Network at
<blocked::http://www.linkedin.com/pub/a/689/76b>
http://www.linkedin.com/pub/a/689/76b

 

Dietitians-visit the Career Advancement Section of
<http://www.eatright.org/> www.eatright.org  for many of our job search
tips!

 

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/d7a67721/attachment.html 

From CKeinath at chs-mi.com  Fri Jan  9 07:01:37 2009
From: CKeinath at chs-mi.com (CKeinath at chs-mi.com)
Date: Fri, 9 Jan 2009 10:01:37 -0500
Subject: [Cnm] OB screening
Message-ID: <OF51E6EF31.2BEF5453-ON85257539.00522E52-85257539.00528DBD@CHSProdl2.chs-mi.com>


Can you tell me in your hospital OB units, what kind of questions for
nutrition screening does your nurse or tech do?

Our OB doesn't use the same nutrition questions as the other units.  Most
are in and out in 24-36 hours, but others are high risk and we would follow
up in 3-4 day.

Thanks for your input,

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning to
Dance in The Rain".

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   


From afrdrun at aol.com  Fri Jan  9 07:02:51 2009
From: afrdrun at aol.com (afrdrun at aol.com)
Date: Fri, 09 Jan 2009 10:02:51 -0500
Subject: [Cnm] 2009 Clinical Nutrition Management Symposium, Boston, MA
Message-ID: <8CB40827A6C9FAB-15AC-1086@WEBMAIL-MZ09.sysops.aol.com>


Clinical Nutrition Management (CNM) Dietetic Practice Group (DPG) Symposium
March 28, 2009 ? March 31, 2009

Renaissance Boston Waterfront Hotel
606 Congress Street
Boston, Massachusetts 02210


Leading System Change: Opportunity to Achieve System Improvements

Registration is now open at www.eatright.org/cnm2009symposium !
The changing healthcare environment continues to impact how we deliver quality nutrition care.? National healthcare initiatives, regulatory and professional standards, healthcare reform and the highly technological health care environment continue to drive our strategic plans and budget priorities. As clinical nutrition leaders, we must be innovative in designing our systems and lead change to achieve system level improvements and overall quality in our organization.
Please join your colleagues in historic Boston to learn innovated strategies to lead system change. Topics will include:
??????? Developing nutrition programs that support national healthcare initiatives and new regulatory requirements
??????? Utilizing instruments and tools, such as informatics, dash boards and the nutrition care process, to demonstrate positive nutrition outcomes
??????? Implementing an Advanced Practice Program

Prioritize the 2009 CNM DPG Symposium into your budget and add it to your calendar.? Brochures, registration forms, online registration and a hotel reservation link are now available at www.eatright.org/cnm2009symposium? Take advantage of the early discounted fee by regis
tering on or before February 26, 2009.? Questions?? Please contact Rita Pollack at pollackmtg at aol.com.

If you would like to consider sponsorship or exhibiting at the symposium, please contact Kelly Danis at 1-412-647-3621?or daniska@;upmc.edu no later than February 1, 2009.

Hope to see you in Boston,
Mary Jane Rogalski, MBA, RD, LDN
Chair-elect CNM DPG
Krista M. Clark, MBA, RD, LD, CNSD
Professional Development & Member Services Chair, CNM DPG
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/21186ea5/attachment.html 

From STiller at Lifespan.org  Fri Jan  9 07:09:41 2009
From: STiller at Lifespan.org (Tiller, Susan B)
Date: Fri, 9 Jan 2009 10:09:41 -0500
Subject: [Cnm] Renal dietitian job description
In-Reply-To: <OF51E6EF31.2BEF5453-ON85257539.00522E52-85257539.00528DBD@CHSProdl2.chs-mi.com>
References: <OF51E6EF31.2BEF5453-ON85257539.00522E52-85257539.00528DBD@CHSProdl2.chs-mi.com>
Message-ID: <EF41F4CF8441694FBD80E75359FD1A1F010E4BE6@LSCOEXCH1.lsmaster.lifespan.org>

Hi,

Does anyone have a copy of a renal dietitian job description they would
be willing to share?

Thanks, 
Sue

Susan Tiller, MBA, RD, LDN, CNSD
Manager, Clinical Nutrition
Rhode Island Hospital/Hasbro Children's Hospital
Phone 401-444-5603
Cell 401-639-3012
Fax 401-444-6360
 


From bahrj at southwesthealth.org  Fri Jan  9 07:19:42 2009
From: bahrj at southwesthealth.org (Joan Bahr)
Date: Fri, 9 Jan 2009 09:19:42 -0600
Subject: [Cnm] OB screening
In-Reply-To: <OF51E6EF31.2BEF5453-ON85257539.00522E52-85257539.00528DBD@CHSProdl2.chs-mi.com>
References: <OF51E6EF31.2BEF5453-ON85257539.00522E52-85257539.00528DBD@CHSProdl2.chs-mi.com>
Message-ID: <000001c9726d$b314db20$193e9160$@org>

These are the triggers for our OB patients -- actually most of these should
be a trigger from the physician's office at the time of prenatal care ....
Having said that, We do provide education on an adequate breastfeeding diet
for all moms who are breastfeeding ... Occassionally the OB nurses will send
a referral to us for a new mom who is severely underweight.

(these originally came from the manual of clinical dietetics years ago:  (I
do need to update ... the policy..)
      Under 17 or over 35 years of age
.	Conceived within 12 months of previous pregnancy
.	History of poor obstetric or fetal performance (pre-term labor, low
birth weight infant, 
more than two spontaneous abortions)
.	Economically deprived
.	Usual diet is nutritionally restrictive or includes unsound
nutritional practices
.	Heavy smoker, drug addict, or alcoholic
.	Modified diet for chronic systemic disease
.	Diabetic (Gestational - In our facility, Type I Pregnant Women are
typically referred to Madison)
.	Overall weight loss
.	Multiple gestation
.	Breast-feeding a previous child
.	Pre-eclampsia
.	On a special diet
.	On medications for or diagnosed with a digestive disorder
AND
.	Offer a referral and RD provide a MNT for breast-feeding diet if the
patient plans to breast-feed. (usually mandatory for first time moms,
discretionary for repeat moms..  
Joan Bahr RD CDE
Southwest Health Center
Platteville, WI

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of CKeinath at chs-mi.com
Sent: Friday, January 09, 2009 09:02 AM
To: cnm at lists.my180.net
Subject: [Cnm] OB screening


Can you tell me in your hospital OB units, what kind of questions for
nutrition screening does your nurse or tech do?

Our OB doesn't use the same nutrition questions as the other units.  Most
are in and out in 24-36 hours, but others are high risk and we would follow
up in 3-4 day.

Thanks for your input,

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning to
Dance in The Rain".

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



From Readnut436 at aol.com  Fri Jan  9 07:20:47 2009
From: Readnut436 at aol.com (Readnut436 at aol.com)
Date: Fri, 9 Jan 2009 10:20:47 EST
Subject: [Cnm] LTC Policy on anti-coagulation
Message-ID: <d37.3a69c0d0.3698c54f@aol.com>

Good Morning.  Does anyone have a LTC policy on anti  coagulation?
 
TIA.
 
Claudine
 
Claudine Mauriello MPH,RD
Sodexho Regional Dietitian
Cell  (201) 240-0023
**************New year...new news.  Be the first to know what is making 
headlines. (http://www.aol.com/?ncid=emlcntaolcom00000026)
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/ded8d8f2/attachment.html 

From Shannon.Jackson at wilmed.org  Fri Jan  9 08:34:35 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Fri, 9 Jan 2009 11:34:35 -0500
Subject: [Cnm] Question re. nutrition info for frying foods
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF18E@wmhcs03.wmh.org>

Say you have a product (breaded stuffed jalapenos with cheddar cheese). The
nutrition label states that 3 pieces have 6 grams fat and 180 kcal. When you
deep fry these, how do you determine how much fat and how many calories are
added?
Is there a way to determine this...like an equation or something.
 
Thanks,

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/1ff2620c/attachment-0001.html 

From Phyllis.Kaskel at mountsinai.org  Fri Jan  9 09:19:32 2009
From: Phyllis.Kaskel at mountsinai.org (Kaskel, Phyllis)
Date: Fri, 9 Jan 2009 12:19:32 -0500
Subject: [Cnm] Job Opportunity
Message-ID: <850F6C2F598EF84F8FA5BEF9CC0CC96D03F0ACD7@EXCEBW2K325.msnyuhealth.org>

   The Mount Sinai Medical Center in New York City is seeking a renal
dietitian for their out patient dialysis center.  A minimum of one year
as a Registered Dietitian is required.

Please pass on to staff who may be interested.

Thank you.

 

Phyllis Kaskel,  MA, RD, CDN

Director, Clinical Nutrition

Mount Sinai Hospital and

Faculty, Department of Community and Preventive Medicine

Mount Sinai School of Medicine

212 241 6198

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/fb6482b7/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 3040 bytes
Desc: image001.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090109/fb6482b7/attachment.jpe 

From duff.frances at gmail.com  Fri Jan  9 09:35:49 2009
From: duff.frances at gmail.com (Frances Duff)
Date: Fri, 9 Jan 2009 12:35:49 -0500
Subject: [Cnm] Nutrition Care Process Terminology
In-Reply-To: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.org>
References: <OFB1AA6121.F15A8D09-ON88257538.00030A2E-88257538.00033417@kp.org>
Message-ID: <6e81fc0c0901090935m4d0bdda9wc0c7ee8cf12f9b1b@mail.gmail.com>

Please share with list

On 1/7/09, Lisa.N.Faucon at kp.org <Lisa.N.Faucon at kp.org> wrote:
>
>
> We are putting the Nutrition Care process into our electronic charting
> system.  Does anyone know if there are approved abbreviations?  Are the
> diagnosis copyrighted?  Or can we abbreviate?
>
> Lisa N Faucon MS, RD
> Assistant Department Administrator, Nutrition Services
> Kaiser Permanente
> 4647 Zion Ave
> San Diego, CA, 92120
> (619) 528-5515 office
> (619) 528-3024 fax
> (619) 682-0672 pager
>
> *NOTICE TO RECIPIENT:*  If you are not the intended recipient of this
> e-mail, you are prohibited from sharing, copying, or otherwise using or
> disclosing its contents.  If you have received this e-mail in error, please
> notify the sender immediately by reply e-mail and permanently delete this
> e-mail and any attachments without reading, forwarding or saving them.
>  Thank you.
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
>


-- 
Frances Duff RD LDN
Assistant Director of Patient Services
Nash Health Care Systems
Rocky Mount, NC
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/f3b98ed8/attachment.html 

From cphkll at msj.org  Fri Jan  9 10:23:30 2009
From: cphkll at msj.org (Karen Lutomski)
Date: Fri, 9 Jan 2009 13:23:30 -0500
Subject: [Cnm] Pediatric RD Opportunity in Asheville, NC
In-Reply-To: <00d701c97263$6512f600$7e01a8c0@hprdomain.local>
References: <00d701c97263$6512f600$7e01a8c0@hprdomain.local>
Message-ID: <E66D9ADF12A9F34283898046834EFDA10143FC7A@EMAIL3C.MSJ.ORG>

Job opportunity available.  If you have questions please feel free to
contact me . Please read below. 

Karen Lutomski, RD, LDN, CSP, CNSD

Pediatric / Neonatal Dietitian

Metabolic Support,Dept.of Pharamcy

Mission Hpospitals 

509 Biltmore Ave., Asheville, NC 28801

O:  (828) 213-8307

P:   (828) 207-7379

F:   (828) 213-8963

 

Metabolic Support Services, Department of Pharmacy at Mission Hospitals
in Asheville, NC has the following openings:  

 Metabolic Support Dietitian - Pediatrics & NICU, Full-time

We are looking for dynamic, enthusiastic individuals to join the
Pediatric arm of our Metabolic Support Team. Our team, which includes a
Metabolic Support Pharmacist, works closely with our Pediatric
Intensivists, Pediatric Hospitalists, & Neonatologists, as well as our
Pediatric / Neonatal Pharmacists, Nurses, & Feeding Team (OT & SLP). We
provide Medical Nutrition Therapy to all patients in our NICU & three
Pediatric units, which includes Enteral & Parenteral Nutrition, as well
as p.o. diets & infant formula.

We are committed to providing quality care in a compassionate setting.

Asheville, in the mountains of Western NC, is consistently ranked among
the top 15 places to live in the U.S. We work hard to promote an
environment that brings out the best in our staff.   Join us!

Jobs postings and online application can be found at
www.missionhospitals.org <http://www.missionhospitals.org> , 

Select: 1. Find A Job, 2. Search Jobs: Keywords "Metabolic Support
Dietitian". Online application required. 

 

 



----------------------------------------------------------------------------------------------------
This message and its attachments may contain confidential and/or
legally-sensitive information that is intended for the sole use of
the addressee(s). Any unauthorized review, use, disclosure, or
distribution of the information contained in this message and its
attachments is prohibited. If you have received this message or any
of its attachments in error, please destroy all originals and
copies of the same and notify the sender immediately.  
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/ef234b1a/attachment.html 

From rtripp at PINNACLEHEALTH.org  Fri Jan  9 11:14:18 2009
From: rtripp at PINNACLEHEALTH.org (Roberta Tripp)
Date: Fri, 9 Jan 2009 14:14:18 -0500
Subject: [Cnm] Calorie counts
In-Reply-To: <49670825.786D.00B4.1@harthosp.org>
Message-ID: <7375E17267B3DB4583032BDEFDA2D76E05DF778F@mailphs.pinnaclehealth.org>

Yes, several years ago.  We informed nursing and physicians that we were
relying on nursing documentation of intake as well as other methods
(speaking with the patient, observation, etc) to determine if
nutritional support through any means is appropriate.  When they
realized that any calorie count data they relied on was sketchy at best
and after the fact, they were agreeable.  We all know that nursing
documentation of intake is not 100% reliable either, but let's face it,
hospitals are not staffed like a metabolic unit where the leftover food
can be weighed and nutrient intake calculated accurately.   This is not
to say docs never order calorie counts anymore, but 99% of the time they
are ok when we say that the Med Exec Committee approved dc'ing the
process.
 
Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org <mailto:rtripp at pinnaclehealth.org> 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Janice Cannon
Sent: Friday, January 09, 2009 8:18 AM
To: cnm at lists.my180.net
Subject: [Cnm] Calorie counts


Wondering if any of you have chosen to stop orders for calorie counts
due to the variable information obtained and who is obtaining, and if
so, how are you ensuring adequacy of intake if needed?
Thank you
 
Janice Cannon, M.S.,RD,CD-N
Clinical Nutrition Manager
Hartford Hospital


The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/74d57c89/attachment.html 

From steppinoutwithmrh at yahoo.com  Fri Jan  9 12:04:15 2009
From: steppinoutwithmrh at yahoo.com (Amy Jones)
Date: Fri, 9 Jan 2009 12:04:15 -0800 (PST)
Subject: [Cnm] Any good weight loss resources for new mothers?
Message-ID: <316450.21032.qm@web52510.mail.re2.yahoo.com>

Hello all,
?
Our main OBGYN office wants us to begin providing weight loss education to ALL new mothers before discharge from our Birth Center.? We are already teaching a class at OBGYN on pregnancy nutrition, but his main concern is that new mothers lose their pregnancy weight before becoming pregnant again.
?
We have a fairly small birth center (no more than 5-7 patients at any one time), so I think doing individual education is more practical than a group setting.? Also, there is no really convenient place on that unit to even have a class.? 
?
What I would like to do is provide a packet of general nutrition info for mom and baby, with a special emphasis on how important it is to lose baby weight to ensure healthier subsequent pregnancies.? Does anyone have any good resources that they have used on this subject?? 
?
I am not looking to provide each mother an individualized meal plan--if they need specialized MNT they will need to have that as an outpatient.? I want to provide general weight loss tips, breastfeeding/calorie guidelines (for those nursing), and other basic guidelines.? As a new mom myself, I woudn't want to be handed strict diet guidelines; rather, I would want someone to treat me with "kid gloves" and gently encourage healthy habits for losing the extra pounds.
?
Any ideas for this group?? 
TIA!
Amy Jones, M.S., R.D., L.D.
?


      
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/183ffa97/attachment.html 

From ESCOTTSTUMPS at ecu.edu  Fri Jan  9 15:36:43 2009
From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia)
Date: Fri, 9 Jan 2009 18:36:43 -0500
Subject: [Cnm] On the Pulse - January 9, 2009 highlights
References: <LYRIS-14232391-3395306-2009.01.09-13.34.58--escottstumps#ecu.edu@list.eatright.org>
Message-ID: <BD44FF0CF4C18245854BBE03590A4C130150CCF0@ECUFS7.intra.ecu.edu>

 

Welcome to 2009!  Hope you are all planning to participate in PPW activities on February 8-9th.  There are also student activities on the 10th.

S. Escott-Stump, CNM Legislative Chair

 

 

ADA weighs in on stimulus package

ADA, along with 19 other health care related organizations, has written Congress urging the inclusion of "funding that invests in our nation's health professional education system as it begins seeking a consensus on ideas for stimulating the US economy."  The letter sent to Senate Majority Leader Harry Reid (D-NV), Senate Minority Leader Mitch McConnell (R-KY), the Speaker of the House, Nancy Pelosi (D-CA) and House Minority Leader John Boehner (R-OH) says:

 

"Local hospitals, nursing homes, home health agencies, community health centers, clinics, and other facilities across the country that provide health care services are experiencing dramatic shortages of critical health professionals to meet the needs of the communities they serve.  Yet, health professionals in schools are struggling to increase student capacity to meet the current demand because of budget constraints, limited classroom and other instruction space,  a lack of faculty, and technological limitations.  An immediate injection of funding to increase the capacity of existing health professional programs and create new programs to rain health professionals in colleges and universities across the nation meets both the goal of improving access to health care services or Americans and providing necessary job training opportunities in these tough economic times."

 

 

Food assistance request made in economic recovery package

Anti-hunger groups are requesting lawmakers and President-elect Barak Obama's team to allocate $24 billion over two years in the economic stimulus bill to increase food assistance benefits.    Making the request were the Food Research and Action Center, the Congressional Hunger Center and the American Public Human Services Association.   In addition, these groups are requesting an additional $250 million per year to upgrade automated systems and to hire more case workers, which would assist in expanding participation. Advocates say that boosting food assistance would stimulate the economy by generating $10 of economic activity for every $5 extended.  A Moody's Economy.com study showed "that every extra dollar of spent on food stamps would generate $1.73 in GDP within a year.   A dollar of extended unemployment benefits generates $1.64;  a dollar of infrastructure spending, $1.59; and a dollar of state aid, $1.36." 

James D. Weill, president of FRAC, has said there is fairly uniform bi-partisan support for stimulus nutrition funding, however neither lawmakers nor the incoming administration have suggested a where the nutrition portion of the stimulus should be set. 

 

 

Ads link health care and economic situation

"Quality, affordable health care -- it's not just something we should do for America's families.  It's something we must do for America's economy." That is the message of a television ad scheduled to run nationally on the major cable channels and networks between now and Feb. 5.  The campaign is funded by the American Cancer Society Cancer Action Network, the American Medical Association, Families USA, the Pharmaceutical Research and Manufacturers of America, Regence BlueCross BlueShield and the Service Employees International Union. It emphasizes the importance of universal coverage, preventive health and healthy living to overall efforts to improve the economy, and thus links two of the major issues together.  Noteworthy in the discussion of health care issues at this time, is the support of business groups for health care reform, who describe their costs for providing health care as crushing for their competitiveness and hurting their bottom lines.  

 

 

Majority Leader Reid introduces health care reform bill

On the opening day of the 111th Congress, Majority Leader Harry Reid (D-NV) introduced S. 4, the Comprehensive Health Reform Act.   Reid was joined by 18 other Senators who co-sponsored the bill. The placeholder bill contains no real provisions, only a statement that reads:

 

It is the sense of Congress that Congress should enact, and the President should sign, legislation to guarantee health coverage, improve health care quality and disease prevention, and reduce health care costs for all Americans and the health care system.

 

The purpose of a hollow measure is to underscore how serious the Senate leadership is that health care reform be passed this year.  S. 4 has not been referred to any Committee, but is on the Senate calendar.  This means that the Reid can bring it to the Senate at any time for debate.  

 

 

Registration open for 2009 Public Policy Workshop;  program  taking shape

Former acting U.S. Surgeon General Kenneth P. Moritsugu, MD, MPH, FACPM; RADM, USPHS (Ret) and the first dietitian elected to the U.S. House of Representatives Kathy Dahlkemper will headline the opening session of ADA's 2009 Public Policy Workshop.

 

The workshop will be held online Feb. 8-10 in an electronic format.  Members may now register online at the ADA website at   www.eatright.org/ppw <http://www.eatright.org/ppw> .  There is no fee for participating in the workshop, which will be held in a series of webinars.  A copy of the full agenda, background materials and additional resources also are located at that site.  Members will need to register for each webinar session they plan to attend.  

 

Even though ADA has changed the format of the2009 workshop, its purpose has not changed.  Similar to years past the agenda combines topics dealing with big picture food,  nutrition and health  issues, ADA priorities, and grassroots training.  Participants can learn how to be effective in lobbying on behalf of the public and their profession at both the state and federal levels.  

 

The opening plenary session scheduled for Sunday will be celebrated in gatherings of members throughout the country, said Tracy Wilczek, chair of the Legislative and Public Policy committee, which hosts PPW.  To learn about plenary parties planned for your state, please contact your state's public policy coordinator.  A listing of these leaders can be found at the PPW portion of the website -- http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/10988_10927_ENU_HTML.htm <http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/10988_10927_ENU_HTML.htm> 

Plenary parties will be followed by strategic planning and training so that participants are prepared and scheduled to meet with congressmen and senators in coming weeks and months in support of ADA's policy agenda.

 

 

Dahlkemper is a former RD and member of ADA elected to Congress from the third district of Pennsylvania.  She will talk about her perspective on what to expect from Congress this year.  Dahlkemper has been appointed to serve on the House Agriculture Committee, a panel that helps shape many of the nation's nutrition policies.

 

 

SCHIP projected to be one of the first bills signed by new President

Congressional Democrats may pass a couple of big-impact bills in the first few weeks the 111th Congress.  Besides the economic stimulus package, the State Children's Health Insurance Program is cued up for action.  As early as next week, the House could vote on a five-year reauthorization of SCHIP.  The new bill is expected to be similar to the legislation vetoed by President Bush in 2007.  That bill intended to increase enrollment from 6.6 million children to more than 10 million and would have provided $60 billion to the states over the next five years, $35 billion more than current spending.   Congressional Democrats say that one difference in the bill moving forward next week is that it will expand SCHIP eligibility to 11million children.  President Bush vetoed the bill with objections that it allowed more children from middle-class families to enroll.  

The current SCHIP program is funded through March.    

 

Child nutrition briefings draw crowd

Work on the economic stimulus package may be center stage, but Congressional staff are very interested in the child nutrition and WIC programs, gauging by attendance at two hill briefings during the first week of the 111th Congress.  Members of the National Alliance for Nutrition and Activity presented the coalition's recommendations for Child Nutrition and WIC Reauthorization to 50 House and 35 Senate staff this week. Jennifer Weber, ADA manager of national nutrition policy. Spoke about the need for qualified nutrition professionals, such as the RD and DTR, at the school district level.  "The right team of people is integral to schools providing appealing and nutritious food to children that they will eat and appreciate," Weber said.  The increased complexity of nutrition standards, and increase in number of school-age children with chronic health conditions, will only increase the need for trained professionals in schools.  

 

 

Eating Disorders Awareness, Prevention, and Education Act introduced

Rep. Judy Biggert (R-IL) has re-introduced H.R. 26, the Eating Disorders Awareness, Prevention and Education Act.    It would authorize the use of innovative assistance funds for programs to: (1) improves identification of students with eating disorders; (2) increase awareness of such disorders among parents and students; and (3) train educators with respect to effective eating disorder prevention and assistance methods. The bill also directs the Secretary of Education to carry out a program to broadcast public service announcements to improve public awareness, and to promote the identification and prevention, of eating disorders. 

 

 

National eHealth Collaborative established
The National eHealth Collaborative has officially launched as a successor organization to the American Health Information Community.  A public and private sector collaboration, it is intended to provide a credible forum for developing health IT systems.  Obstacles such as infrastructure, standards, and protections necessary to create a safe, interoperable, nationwide network are on the agenda.   The Collaborative builds on the efforts of AHIC, which was a federally-chartered advisory committee established in 2005 under the U.S. Department of Health and Human Services.  The website is www.nationalehealth.org <http://www.nationalehealth.org/> . 

 

 

FDA guidance for scientific substantiation for dietary supplements health claim 

The Food and Drug Administration has published guidance, which takes the form of recommendations rather than rulemaking that refer to all nutritional deficiency, structure/function or general well-being claims on dietary supplement products.   Published in the Federal Register and open to public comment, the guidance describes the amount, type and quality of evidence that FDA considers necessary to substantiate claims.  Neither the Federal Food, Drug, and Cosmetic Act nor the Dietary Supplement Health and Education Act define 'substantiation', prompting the current guidance from FDA. 

FDA appears to have drawn of its own enforcement experience as well as that of the Federal Trade Commission  and the Commission on Dietary Supplement Labels, in guiding that competent and reliable scientific evidence needed to back a substantiation standard constitutes "tests, analyses, research, studies, or other evidence based on the expertise of professionals in the relevant area, that has been conducted and evaluated in an objective manner by persons qualified to do so, using procedures generally accepted in the profession to yield accurate and reliable results."  FDA highlighted four major issues that manufacturers need to consider when assessing whether their substantiation has been met with the necessary type of evidence:  The meaning of the claim(s) being made, relationship of the evidence to the claim, quality of the evidence and totality of the evidence. To access the guidance, go to <http://ww.cfsan.fda.gov/~dms/dsclmgu2.html> http:// <http://www.cfsan.fda.gov/~dms/dsclmgu2.html> www.cfsan.fda.gov/~dms/dsclmgu2.html. 

 

USDA FSIS issues E. coli O157:H7 safety notice

The Agriculture Department has issued measures to address E. coli O157:H7 for establishments that receive, grind, or process raw beef products.  Officials said action was necessary because current measures to address E. coli 0157 are inadequate.  An establishment that receives, grinds, or otherwise processes raw beef products cannot conclude that E. coli O157:H7 is not reasonably likely to occur in its production process because the product it receives bears the mark of inspection. The mark of inspection is a reflection of a finding made by the Food Safety and Inspection Service that the establishment has followed the validated procedures in its HACCP plan, not that the pathogen has been eliminated or reduced to undetectable levels. Additional details are available at http://www.fsis.usda.gov/OPPDE/rdad/FSISNotices/05-09.pdf <http://www.fsis.usda.gov/OPPDE/rdad/FSISNotices/05-09.pdf> 

 

 

Quest acknowledges errors in Vitamin D tests

Quest Diagnostics, the nation's largest medical laboratory company, possibly provided erroneous laboratory test results to thousands of people who had their vitamin D levels tested in the last two years, the New York Times reported this week.  Skip to next paragraphQuest has already sent letters to thousands of doctors listing the patients who might have received "questionable" test results and is offering free retests. The company said it had fixed the problems.  Quest's action represents "the largest patient test recall I'm aware of in my 20 years in the business," said Robert L. Michel, editor of The Dark Report, a newsletter for pathologists that first reported on Quest's action. 

 

 

Massachusetts in motion may decrease numbers

With a 16 percent rise in obesity rates and a 50 percent rise in diabetes rates, since 1990, Massachusetts has unveiled 'Mass in Motion", an anti-obesity campaign.   It will require restaurant chains to post calorie counts and will work to educate parents about childhood obesity.  Students in grades 1, 4, 7 and 10 will have their Body Mass Index (BMI) measured, with results sent to parents in a package explaining what they mean and how parents can best combat obesity.  

Other features of the statewide campaign:

 

?        Requiring state agencies responsible for large-scale food purchasing to follow healthy nutrition guidelines;

?        Making wellness grants to cities and towns;

?        Expanding state-sponsored Workplace Wellness programs

 

Congress organizing committee assignments

House Ways and Means Committee Chairman Charlie Rangel (D-NY) announced the members serving on the Health Subcommittee for this Congress.  Like in the last Congress, the Health subcommittee will be chaired by Rep. Pete Stark (D-CA).   Other Democrats serving on the committee include:   Lloyd Doggett (TX), Mike Thompson (CA), Xavier Becerra (CA), Earl Pomeroy (ND), Ron Kind (WI), Earl Blumenauer (OR), Bill Pascrell (NJ) and Shelley Berkley (NV).  Republicans have not announced their subcommittee assignments.  Rep. Dave Camp (R-MI) will serve as the new ranking member on Ways and Means, replacing Rep. Jim McCrery (R-LA) who retired last year.   He was elected by the Republican caucus to serve in this top minority post, leaping frogging  California Rep. Wally Herger who has more seniority.

 

 

Editor's Note: In his own words

Nomination hearings for Secretary of Health and Human Services-Designate Tom Daschle were held this week.   In his opening statement, Daschle pledged to tackle health reform, revitalize CDC, restore trust in FDA, and strengthen NIH.  During the hearing, Daschle also talked about the importance of nutrition.  

 

We include a portion of his comments: So much of it has to do with nutrition ... it's got to be nutrition. We aren't going to address obesity and prevention and wellness unless we make better school lunches and unless we take the junk food out of schools and unless we put physical exercise back into the school curriculum. Those kinds of things could go a long way to helping us create this wellness paradigm we need so badly.

 

 

Upcoming:

 

*	Second meeting of the Dietary Guidelines Advisory Committee is Jan. 29 - 30 here.  Registration is required.  Details available at www.dietaryguidelines.gov <http://www.dietaryguidelines.gov/> . 

      

*	All-Member, On-Line PPW 2009 is February 8 - 10.   Go to http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/10882_ENU_HTML.htm <http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/10882_ENU_HTML.htm>  for up-to-date information on attending the online conference. 

 

----------------------------------------------------------------------------------------------------------------------------

Government Relations Contacts:

 

 

 

Nutrition Policy

Jennifer Weber

jweber at eatright.org <mailto:jweber at eatright.org> 

Regulatory Issues

Mary Hager

mhager at eatright.org <mailto:mhager at eatright.org> 

Congressional & Political Affairs

Ron Smith

rsmith at eatright.org <mailto:rsmith at eatright.org> 

 

Jennifer Teters

jteters at eatright.org <mailto:jteters at eatright.org> 

 

Charmaine Jones

cjones at eatright.org <mailto:cjones at eatright.org> 

State Government Relations

Juliana Smith

jsmith at eatright.org <mailto:jsmith at eatright.org> 

State & Regulatory Coordinator

Dana Whitley

dwhitley at eatright.org <mailto:dwhitley at eatright.org> 

Reimbursement Issues

Pam Michael

pmichael at eatright.org <mailto:pmichael at eatright.org> 

 

Tori Bender

tbender at eatright.org <mailto:tbender at eatright.org> 

General Issues

Stephanie Patrick

spatrick at eatright.org <mailto:spatrick at eatright.org> 

-----------------------------------------------------------------------------------------------------------------------------

 

 

 

 


---
You are currently subscribed to receive On The Pulse at: escottstumps at ecu.edu
To unsubscribe send a blank email to leave-3395306-14232391.c25a8f8417898df068b326123ea47b18 at list.eatright.org or contact pulse at eatright.org with a request to remove your e-mail address.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/11b0daab/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 11163 bytes
Desc: image002.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090109/11b0daab/attachment-0001.jpe 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: PPW Agenda.mht
Type: application/octet-stream
Size: 96758 bytes
Desc: PPW Agenda.mht
Url : /pipermail/cnm_lists.my180.net/attachments/20090109/11b0daab/attachment-0001.obj 

From dietitiandarcy at yahoo.com  Fri Jan  9 16:10:47 2009
From: dietitiandarcy at yahoo.com (Darcy Butler)
Date: Fri, 9 Jan 2009 16:10:47 -0800 (PST)
Subject: [Cnm] clinical dietitian job description
Message-ID: <495658.74011.qm@web57403.mail.re1.yahoo.com>

Does anyone have a clinical dietitian job description that they would be willing to share?  Currently my job description does not mention anything about the clinical position/duties/responsibilities, etc.  I believe that I have my director convinced that this needs to be changed, so any examples that I can provide will be a great help.

Thanks,
Darcy


Darcy Butler, RD, LD

 Ponca City, Oklahoma 74601


       
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/62ce8878/attachment.html 

From fynan-carla at CooperHealth.edu  Sat Jan 10 09:27:39 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Sat, 10 Jan 2009 12:27:39 -0500
Subject: [Cnm] TJC
Message-ID: <77F33794DD223B40BF24AB3D37930250172B258C14@mxmbx01.chsmail.root.cooperhealth.edu>

Hello All!

We are expecting JC any day and are hoping that any of you that have experienced your survey in the last few months could send some "hot topics".

Thank you in advance!

Carla Fynan, RD
Clinical Nutrition Manager
Food & Nutrition Department
Cooper University Hospital
One Cooper Paza
Camden, NJ 08103
(856) 342-2320



****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090110/285fac1f/attachment.html 

From fynan-carla at CooperHealth.edu  Sat Jan 10 09:30:19 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Sat, 10 Jan 2009 12:30:19 -0500
Subject: [Cnm] Bulk Juice Regs
Message-ID: <77F33794DD223B40BF24AB3D37930250172B258C15@mxmbx01.chsmail.root.cooperhealth.edu>

Hi All!

We had a question on our bulk juices that we send to nursing units.  Do these need to be dated once opened by nursing?

Thanks!

Carla Fynan, RD
Clinical Nutrition Manager
Food & Nutrition Department
Cooper University Hospital
One Cooper Paza
Camden, NJ 08103
(856) 342-2320



****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090110/f03bad0a/attachment.html 

From mansishah79 at gmail.com  Sat Jan 10 12:27:02 2009
From: mansishah79 at gmail.com (Mansi Shah)
Date: Sat, 10 Jan 2009 12:27:02 -0800
Subject: [Cnm] Late Trays, Transfers, Discharges and meal supplies - Help!
Message-ID: <bb1846bf0901101227j600fc999k6a9560015f72f161@mail.gmail.com>

I have a few questions regarding handling of late trays and after hour
meals, as well as sending food-supplies to the floors.

We are a 200-bed acute care facility. After dinner tray-line we have a few
late trays stocked in the kitchen for late orders. Food-services deliver
these late trays (Nursing is not allowed into the kitchen). In addition, we
stock a designated refrigerator on the nursing unit with sandwiches and
additional hot meals for the late admissions. However, nursing staff are
complaining about not having enough food and want food-services to send 5-7
extra "regular" diet trays to each nursing unit with the dinner cart, so
that during the change of shift at 7pm, they don't have to run to the Stock
Refrigerator.
In addition, we are also being asked to "monitor" the need for meals in the
ER and supply hot meals to them, especially for dinner.
Also, patients that are NPO during meal time for tests, after returning are
asking for food, and this creates a huge burden on the food-service staff
who is not able to move on with other tasks, becuase they are fielding these
individual food requests, preparing cold items and delivering them almost
all day long.

The problem is that with the amount of food-service staffing we have, and
the amount of demands we get from nursing, we are not able to meet their
demands.
Please reply to these questions & if you have any tips/solutions you have
implemented, that would help a great deal too.

1) How does your facility handle late trays (for after meal hours and also
for late admissions after kitchen is closed)?

2) Do you supply hot meals to the E.R? and if yes, how many times/day, or
upto what time?

3) For patients that are NPO during a meal-period for a test/procedure, what
is the procedure to give them food after meal-hours are over. Eg: 2 or 3pm
in the afternoon ? (Do you refer nursing to use the floor-stock supplies, or
do you offer cold sandwiches, etc. from the kitchen?)

4) How do you supply apple-sauce for medications to the nursing units?
(Previously, we gave the 4oz pre-packaged apple sauce, but then RNs left
open apple sauce on counters and so we started supplying 1 oz
single-use plated apple sauce to each floor as requested, but this is very
time consuming for our staff).

5) For patients that are discharged, but still are waiting to be picked up,
how do you handle meals? We are experiencing a substantial food and labor
waste related to preparing of trays for these patients. Is there a policy
that you have instated? Does your facility have a specific "discharge time"?
Are D/C orders entered into the computer system as soon as the orders are
written, or do you wait to enter the D/C order until after the patient has
physicially left (our nursing staff is doing the later - so that they don't
have to re-enter all the data, incase something happens and the patient
needs to be re-admitted. As a result, we don't get the accurate count of
D/Cs for meal time and trays are supplied, those patients are gone by that
time, and we run out of food at the end of tray-line for late patients).

6) For patients that are transferred between floors during meal hours, how
are you notified of the transfer, so the tray can be send to the right unit?

Thank you in advance for your feedback.

Mansi Shah, RD, CNSD
Chief Clinical Dietitian
Olympia Medical Center
Los Angeles, CA
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090110/2da4d87a/attachment.html 

From mansishah79 at gmail.com  Sat Jan 10 12:29:11 2009
From: mansishah79 at gmail.com (Mansi Shah)
Date: Sat, 10 Jan 2009 12:29:11 -0800
Subject: [Cnm] Calorie counts
In-Reply-To: <49670825.786D.00B4.1@harthosp.org>
References: <49670825.786D.00B4.1@harthosp.org>
Message-ID: <bb1846bf0901101229g4ec5e83s1b2922dacb9260cc@mail.gmail.com>

What do you say to doctors who ask for Calorie Counts for "documentation"
purposes for justification to persue alternate feeding options?

Mansi Shah, RD, CNSD
Chief Clinical Dietitian
Olympia Medical Center
Los Angeles, CA

On Fri, Jan 9, 2009 at 5:17 AM, Janice Cannon <jcannon01 at harthosp.org>wrote:

>  Wondering if any of you have chosen to stop orders for calorie counts due
> to the variable information obtained and who is obtaining, and if so, how
> are you ensuring adequacy of intake if needed?
> Thank you
>
> Janice Cannon, M.S.,RD,CD-N
> Clinical Nutrition Manager
> Hartford Hospital
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
>
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090110/e693eb4c/attachment.html 

From MAHTRedF at aol.com  Sat Jan 10 18:07:39 2009
From: MAHTRedF at aol.com (MAHTRedF at aol.com)
Date: Sat, 10 Jan 2009 21:07:39 EST
Subject: [Cnm] TJC
Message-ID: <c23.53f9ff8e.369aae6b@aol.com>

Carla,
we went through TJC survey the week before Christmas - Monday to Friday -  
and did very well.  We had 4 -5 surveyors per day.  They really  focused on the 
patient and did multiple tracers daily where they interviewed  staff from all 
disciplines.  The only area they focused on in-depth in  relation to nutrition 
was bariatric surgery.  They were looking for  coordination between inpatient 
and outpatient and lucky for us, they interviewed  one RD who covers part 
time in the outpatient bariatric area and part time  on the surgical unit where 
these patients are admitted.  We do not have a  seamless system as yet for 
documentation between in patient and outpatient so  this was a focus - can the 
staff pull up the outpatient record from the  inpatient area?  Are they able to 
speak to the different systems and find  the information they need?  
 
They did interview a food service employee about procedures for handwashing  
when preparing and delivering trays.  They also asked her about  patient 
identification (two patient identifiers). 
 
This is the first survey I have been in where and RD personnel file has not  
been pulled for scrutiny in relation to competencies.  In fact we were  
dismissed from the 3 hour competency session.  
 
There was a 1.5 hour medication management session.  They focused  on plans 
by all disciplines for national patient safety goal #3 -  anticoagulation 
therapy - for implementation Jan 1, 09.  They asked us  to describe what we had 
done and our approach.  Overall they were very  pleased with what we had done.  
As part of this meeting, they took a  physical tour of the pharmacy.  
 
One of the MD surveyors was a pediatric GI MD.  His area of  interest was IBD 
and he did state that he was going to look at TPN in  detail.  We were 
prepared for that but he ended up being called away on day  3 so didn't get to it.  
Our adult MDs are privileged to write TPN  orders but our pediatric MDs are 
not.  THis was a problem.  If  there is privileging, then the same privileging 
is needed across the board -  which is happening now! 
They scrutinized the OR and ER areas.  TIme out procedures were high  on the 
list and they went back to the ORs again and again.  They were  looking mainly 
for demonstration of the same procedure throughout all surgical  suites.  
They were very specific with regard to marking of the patient by  the surgeon and 
not a technician which they did find on one procedure.  
Infection control was also a big focus.  
I hope this helps a little.
 
Margaret Hagerty, MS,RD
Cedars-Sinai Medical Center
Los Angeles, CA 90048
**************A Good Credit Score is 700 or Above. See yours in just 2 easy 
steps! 
(http://pr.atwola.com/promoclk/100000075x1215855013x1201028747/aol?redir=http://www.freecreditreport.com/pm/default.aspx?sc=668072%26hmpgID=62%26bcd=De
cemailfooterNO62)
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090110/4931e37a/attachment.html 

From DChampeon at stmarysmaine.com  Sun Jan 11 07:19:02 2009
From: DChampeon at stmarysmaine.com (DChampeon at stmarysmaine.com)
Date: Sun, 11 Jan 2009 10:19:02 -0500
Subject: [Cnm] TJC - Please post to list
In-Reply-To: <77F33794DD223B40BF24AB3D37930250172B258C14@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: <OFFD41912E.13CA5893-ON8525753B.00541EA6-8525753B.00541CD0@stmarysmaine.com>

                                                                           
             "Fynan, Carla"                                                
             <fynan-carla at Coop                                             
             erHealth.edu>                                              To 
             Sent by:                  "CNM Mailing List                   
             cnm-bounces at lists         (Cnm at lists.my180.net)"              
             .my180.net                <Cnm at lists.my180.net>               
                                                                        cc 
                                       "Cassidy, Fran"                     
             01/10/2009 12:29          <Cassidy-Fran at CooperHealth.edu>     
             PM                                                    Subject 
                                       [Cnm] TJC                           
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           








Hello All!



We are expecting JC any day and are hoping that any of you that have
experienced your survey in the last few months could send some ?hot
topics?.



Thank you in advance!



Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper UniversityHospital

One Cooper Paza

Camden, NJ08103

(856) 342-2320


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

From LCarver at Reshealthcare.org  Sun Jan 11 07:51:12 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Sun, 11 Jan 2009 09:51:12 -0600
Subject: [Cnm] Bulk Juice Regs
In-Reply-To: <77F33794DD223B40BF24AB3D37930250172B258C15@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03AE568D@rhcexch3.reshealthcare.org>

we no longer send bulk juices for this reason - all are in PC's w/ dates
on them. 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Fynan, Carla
Sent: Saturday, January 10, 2009 11:30 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Cc: Cassidy, Fran
Subject: [Cnm] Bulk Juice Regs



Hi All!

 

We had a question on our bulk juices that we send to nursing units.  Do
these need to be dated once opened by nursing?  

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately. 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090111/404e223f/attachment.html 

From LCarver at Reshealthcare.org  Sun Jan 11 07:50:36 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Sun, 11 Jan 2009 09:50:36 -0600
Subject: [Cnm] Late Trays, Transfers,
	Discharges and meal supplies - Help!
In-Reply-To: <bb1846bf0901101227j600fc999k6a9560015f72f161@mail.gmail.com>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03AE568C@rhcexch3.reshealthcare.org>

see below

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Mansi Shah
Sent: Saturday, January 10, 2009 2:27 PM
To: cnm at lists.my180.net
Subject: [Cnm] Late Trays, Transfers, Discharges and meal supplies -
Help!


I have a few questions regarding handling of late trays and after hour
meals, as well as sending food-supplies to the floors. 
 
We are a 200-bed acute care facility. After dinner tray-line we have a
few late trays stocked in the kitchen for late orders. Food-services
deliver these late trays (Nursing is not allowed into the kitchen). In
addition, we stock a designated refrigerator on the nursing unit with
sandwiches and additional hot meals for the late admissions. However,
nursing staff are complaining about not having enough food and want
food-services to send 5-7 extra "regular" diet trays to each nursing
unit with the dinner cart, so that during the change of shift at 7pm,
they don't have to run to the Stock Refrigerator. 
In addition, we are also being asked to "monitor" the need for meals in
the ER and supply hot meals to them, especially for dinner. 
Also, patients that are NPO during meal time for tests, after returning
are asking for food, and this creates a huge burden on the food-service
staff who is not able to move on with other tasks, becuase they are
fielding these individual food requests, preparing cold items and
delivering them almost all day long. 
 
The problem is that with the amount of food-service staffing we have,
and the amount of demands we get from nursing, we are not able to meet
their demands. 

Please reply to these questions & if you have any tips/solutions you
have implemented, that would help a great deal too. 
 
1) How does your facility handle late trays (for after meal hours and
also for late admissions after kitchen is closed)?  we sent late trays
as the orders are received by the diet office (per CMS standards that
there needs to be written confirmation of the order)  for ~1 hr after
meal time the meal is per the menu choices, after that until 40 minute
prior to the next meal (7pm for dinner), we send cold plates w/ hot soup
and beverages - exc. for purees of course.  after the kitchen is closed
(7pm) there is food in 4 frigs on the units. 
 
2) Do you supply hot meals to the E.R? and if yes, how many times/day,
or upto what time?   yes, as ordered per the same time frame as above.  
 
3) For patients that are NPO during a meal-period for a test/procedure,
what is the procedure to give them food after meal-hours are over. Eg: 2
or 3pm in the afternoon ? (Do you refer nursing to use the floor-stock
supplies, or do you offer cold sandwiches, etc. from the kitchen?)   see
answer to #1 above.   
 
4) How do you supply apple-sauce for medications to the nursing units?
(Previously, we gave the 4oz pre-packaged apple sauce, but then RNs left
open apple sauce on counters and so we started supplying 1 oz single-use
plated apple sauce to each floor as requested, but this is very time
consuming for our staff).  yes - 2 oz servings that are ordered by
nursing as part of floor stock. 
 
5) For patients that are discharged, but still are waiting to be picked
up, how do you handle meals? We are experiencing a substantial food and
labor waste related to preparing of trays for these patients. Is there a
policy that you have instated? Does your facility have a specific
"discharge time"? Are D/C orders entered into the computer system as
soon as the orders are written, or do you wait to enter the D/C order
until after the patient has physicially left (our nursing staff is doing
the later - so that they don't have to re-enter all the data, incase
something happens and the patient needs to be re-admitted. As a result,
we don't get the accurate count of D/Cs for meal time and trays are
supplied, those patients are gone by that time, and we run out of food
at the end of tray-line for late patients).   no specific discharge time
- when we get the notice from nursing of the discharge we assume they
are gone - which is correct 99.5 % of the time.  if we get a call that
the patient is still there, we send the tray. 
 
6) For patients that are transferred between floors during meal hours,
how are you notified of the transfer, so the tray can be send to the
right unit?   this is a problem - the VP of Patient Services has come
down on nursing to state they should transfer the tray if the order does
not come through prior to meal service on that particular floor.  the
big issue for us is that the notice when a patient leaves acute care and
goes to Rehab, Skilled, Behavioral  Health or Chem Dep (btw any of these
units) it is a discharge and then new admission, which makes keeping
track of menus a real challenge.   
 
Thank you in advance for your feedback. 
 
Mansi Shah, RD, CNSD
Chief Clinical Dietitian
Olympia Medical Center
Los Angeles, CA 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090111/45874783/attachment-0001.html 

From jlworden at att.net  Sun Jan 11 11:32:22 2009
From: jlworden at att.net (Jo Lynn Worden)
Date: Sun, 11 Jan 2009 13:32:22 -0600
Subject: [Cnm] Bulk Juice Regs
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E03AE568D@rhcexch3.reshealthcare.org>
References: <77F33794DD223B40BF24AB3D37930250172B258C15@mxmbx01.chsmail.root.cooperhealth.edu>
	<5330B54133B6194BA13930BDEFE9A30E03AE568D@rhcexch3.reshealthcare.org>
Message-ID: <008e01c97423$53b8ff00$fb2afd00$@net>

Same here.  They would NEVER get dated in our hospital and I wouldn't  want
an open container of ANYTHING in a unit refrigerator where anyone could get
their hands on it. 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Carver, Leslee
Sent: Sunday, January 11, 2009 9:51 AM
To: Fynan, Carla; Cnm at lists.my180.net
Cc: Cassidy, Fran
Subject: Re: [Cnm] Bulk Juice Regs

 

we no longer send bulk juices for this reason - all are in PC's w/ dates on
them. 

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Fynan, Carla
Sent: Saturday, January 10, 2009 11:30 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Cc: Cassidy, Fran
Subject: [Cnm] Bulk Juice Regs

Hi All!

 

We had a question on our bulk juices that we send to nursing units.  Do
these need to be dated once opened by nursing?  

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


**************************************************************** This email,
including attachments, may include confidential and/or proprietary
information, and may be used only by the person or entity to which it is
addressed. If the reader of this email is not the intended recipient or his
or her authorized agent, the reader is hereby notified that any
dissemination, distribution, or copying of this email is prohibited. If you
received this email in error, please notify the sender by replying to this
message and delete this email immediately. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090111/9ff2deea/attachment.html 

From Psutor at emhc.org  Fri Jan  9 15:15:14 2009
From: Psutor at emhc.org (Pat Sutor)
Date: Fri, 09 Jan 2009 17:15:14 -0600
Subject: [Cnm] Meditech documentation sample
Message-ID: <496786220200003400022C62@email3.emhc.org>

I received the attached Meditech documetation sample via the list serve sometime around July 08 and am trying to locate the person who sent it. If this is your form please respond to the list or to me at psutor at emhc.org
I think it is great and I would like to see what else you have buildt in the other sections.Thanks, Pat

The information contained in this electronic mail transmittal is protected by law and is intended only for the use of the designated recipient(s) named above. If the reader of this transmission is not the intended recipient(s), you are notified that any disclosure, dissemination, distribution or duplication of its contents is strictly prohibited. If you have received this transmittal in error, please notify the sender by return e-mail and delete the transmittal immediately. Thank you. 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090109/56af01c1/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: meditech documentation.pdf
Type: application/pdf
Size: 1719759 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090109/56af01c1/attachment-0001.pdf 

From nfdziak at metrohealth.org  Mon Jan 12 06:28:25 2009
From: nfdziak at metrohealth.org (Nancy Farmer-Dziak)
Date: Mon, 12 Jan 2009 09:28:25 -0500
Subject: [Cnm] Fwd: RE:  IBW for under 5 ft
Message-ID: <496B0D39.6228.0033.0@metrohealth.org>

>>> Marissa Hofman <marissa.hofman at ucdmc.ucdavis.edu> 1/8/2009 1:08 PM >>>

(See attached file: IBW.pdf)

Sorry about that. Here you go.

Marissa Hofman, RD
Clinical Nutrition Manager
UC Davis Medical Center
Food & Nutrition Dept.
2315 Stockton Blvd
Sacramento, CA 95817
Phone: (916) 734-5100
Fax: (916)734-3154
"Jo Lynn Worden" <jlworden at att.net>


"Jo Lynn Worden" <jlworden at att.net> 
01/07/2009 09:28 PM

To
"'Marissa Hofman'" <marissa.hofman at ucdmc.ucdavis.edu>


cc



Subject
RE: [Cnm] IBW for under 5 ft



I didn?t see an attachment. Can you send reference for the article. Thanks
Jo Lynn Worden
Rush Copley Medical Center
Aurora, IL 60504

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Marissa Hofman
Sent: Wednesday, January 07, 2009 6:55 PM
To: Hayashi, Remi - GMHHC
Cc: CNM at lists.my180.net
Subject: Re: [Cnm] IBW for under 5 ft

Here's an interesting article using IBW instead of Hamwi for short stature females. We are going to discuss this at our next staff meeting.

The article focuses on using a BMI of 22 which is associated with the lowest mortality risk.


Marissa Hofman, RD
Clinical Nutrition Manager
UC Davis Medical Center
Food & Nutrition Dept.
2315 Stockton Blvd
Sacramento, CA 95817
Phone: (916) 734-5100
Fax: (916)734-3154
"Hayashi, Remi - GMHHC" <Remi.Hayashi at CHW.EDU>

"Hayashi, Remi - GMHHC" <Remi.Hayashi at CHW.EDU> 
Sent by: cnm-bounces at lists.my180.net 
01/07/2009 04:52 PMTo
<cnm at lists.my180.net>
cc
Subject
[Cnm] IBW for under 5 ft





Happy New Year 
This was probably discussed before?..how do you calculate the IBW for patient under 5 feet? I was always taught to multiply the number of inches that are under 5 feet by 2.5 then subtract from 100lb for female. Is there any reference to this method? TIA. 
Remi Hayashi, MS, RD 
Clinical Nutrition Manager 
Glendale Memorial Hospital and Health Center 
1420 South Central Avenue 
Glendale, CA 91204 
(818)409-7643 Direct 
(818)507-4665 Fax _______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/52f80c6a/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 45 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090112/52f80c6a/attachment-0001.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: IBW.pdf
Type: application/pdf
Size: 201602 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090112/52f80c6a/attachment-0001.pdf 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Header
Type: application/octet-stream
Size: 911 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090112/52f80c6a/attachment-0001.obj 
-------------- next part --------------
MetroHealth is an Academic Health Care System committed to Our 
Communities by Saving Lives, Restoring Health, Promoting 
Wellness, and providing Outstanding, Life-long Care Accessible 
to All.  Visit us at www.metrohealth.org 

This email and all attachments that may have been included are 
intended only for the use of the party to whom/which the email 
is addressed and may contain information that is privileged, 
confidential, or exempt from disclosure under applicable law. 
If you are not the addressee or the employee or agent of the 
intended recipient, you are hereby notified that you are 
strictly prohibited from printing, storing, disseminating, 
distributing, or copying this communication. If you have 
received this notification in error, please contact the 
Director of Risk/Privacy Management at (216)778-5728. For a 
copy of our Notice of Privacy Practices, please visit: 
http://www.metrohealth.org/general/privacy.asp 


From Felicia.Vatakis at UHhospitals.org  Mon Jan 12 07:07:25 2009
From: Felicia.Vatakis at UHhospitals.org (Vatakis, Felicia)
Date: Mon, 12 Jan 2009 10:07:25 -0500
Subject: [Cnm] Competencies for  Dietitians
Message-ID: <3911A73BA69B5546B66F648E22F0D334028DF4F5@UHEVS3.uhhs.com>

Good Morning,
What competencies are being  used in hospitals for inpatient and
outpatient dietitians?

Felicia Vatakis, MS, RD, LD
Clinical Nutrition Manager/ Dietetic Internship Director
University Hospitals Case Medical Center
Department of Nutrition Services
11100 Euclid Avenue
Mailstop : LKSD 5021
Cleveland, Ohio 44106
felicia.vatakis at UHhospitals.org
Telephone: 216-844-3677
Fax: 216-844-8188



Visit us at www.UHhospitals.org.

The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. University Hospitals and its affiliates disclaim any responsibility for unauthorized disclosure of this information to anyone other than the addressee.

Federal and Ohio law protect patient medical information, including psychiatric_disorders, (H.I.V) test results, A.I.Ds-related conditions, alcohol, and/or drug_dependence or abuse disclosed in this email. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/d5658b02/attachment.html 

From steppinoutwithmrh at yahoo.com  Mon Jan 12 08:14:13 2009
From: steppinoutwithmrh at yahoo.com (Amy Jones)
Date: Mon, 12 Jan 2009 08:14:13 -0800 (PST)
Subject: [Cnm] Mona vie, Acai Berry
Message-ID: <911295.47429.qm@web52505.mail.re2.yahoo.com>

Hi all,
?? I am researching the acai berry-craze as I am getting frequent questions from clients.? From all the reading I've done, there is only one small study that showed that acai did anything above and beyond other fruits.
?
Additionally, I have a colleague (who works in clinical nutrition) who has unfortunately gotten herself and her husband mixed up in a multi-level marketing business selling MonaVie.? I have cautioned her that I don't feel it's appropriate for her to use her credential when marketing the juice, and I have cautioned her against marketing this to our patients.? Obviously what she does on her time is her own business; however, I feel there is a conflict of interest in marketing this type of unproven product.
?
I'd be interested in thoughts and any information anyone may have on acai or MonaVie.
?
Thanks!
Amy 


      
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/31faaffa/attachment.html 

From steppinoutwithmrh at yahoo.com  Mon Jan 12 08:14:56 2009
From: steppinoutwithmrh at yahoo.com (Amy Jones)
Date: Mon, 12 Jan 2009 08:14:56 -0800 (PST)
Subject: [Cnm] Weight loss info for new moms
Message-ID: <57959.51124.qm@web52502.mail.re2.yahoo.com>



if (typeof YAHOO == "undefined") {
 var YAHOO = {};
}
YAHOO.Shortcuts = YAHOO.Shortcuts || {};
YAHOO.Shortcuts.hasSensitiveText = true;
YAHOO.Shortcuts.sensitivityType = ["adult"];
YAHOO.Shortcuts.doUlt = false;
YAHOO.Shortcuts.location = "us";
YAHOO.Shortcuts.document_id = 0;
YAHOO.Shortcuts.document_type = "";
YAHOO.Shortcuts.document_title = "Any good weight loss resources for new mothers?";
YAHOO.Shortcuts.document_publish_date = "";
YAHOO.Shortcuts.document_author = "steppinoutwithmrh at yahoo.com";
YAHOO.Shortcuts.document_url = "";
YAHOO.Shortcuts.document_tags = "";
YAHOO.Shortcuts.document_language = "english";
YAHOO.Shortcuts.annotationSet = {
"lw_1231776862_0": {
"text": "weight loss education",
"extended": 0,
"startchar": 209,
"endchar": 229,
"start": 209,
"end": 229,
"extendedFrom": "",
"predictedCategory": "",
"predictionProbability": "0",
"weight": 0.404238,
"relScore": 10.1568,
"type": ["shortcuts:/concept"],
"category": ["CONCEPT"],
"wikiId": "",
"relatedWikiIds": [],
"relatedEntities": [],
"showOnClick": [],
"context": "all,       Our main OBGYN office wants us to begin providing weight loss education to ALL new mothers before discharge from our Birth Center",
"metaData": {
"visible": "false"
}
 },
"lw_1231776862_1": {
"text": "new mothers",
"extended": 0,
"startchar": 238,
"endchar": 248,
"start": 238,
"end": 248,
"extendedFrom": "",
"predictedCategory": "",
"predictionProbability": "0",
"weight": 0.399219,
"relScore": 4.75805,
"type": ["shortcuts:/concept"],
"category": ["CONCEPT"],
"wikiId": "",
"relatedWikiIds": [],
"relatedEntities": [],
"showOnClick": [],
"context": "wants us to begin providing weight loss education to ALL new mothers before discharge from our Birth Center.  We are already teaching",
"metaData": {
"visible": "false"
}
 },
"lw_1231776862_2": {
"text": "Birth Center",
"extended": 0,
"startchar": 276,
"endchar": 287,
"start": 276,
"end": 287,
"extendedFrom": "",
"predictedCategory": "",
"predictionProbability": "0",
"weight": 0.35485,
"relScore": 6.96063,
"type": ["shortcuts:/concept"],
"category": ["CONCEPT"],
"wikiId": "Birthing_center",
"relatedWikiIds": [],
"relatedEntities": [],
"showOnClick": [],
"context": "loss education to ALL new mothers before discharge from our Birth Center.  We are already teaching a class at OBGYN on pregnancy",
"metaData": {
"visible": "true"
}
 },
"lw_1231776862_3": {
"text": "nutrition info",
"extended": 0,
"startchar": 824,
"endchar": 837,
"start": 824,
"end": 837,
"extendedFrom": "",
"predictedCategory": "",
"predictionProbability": "0",
"weight": 0.505871,
"relScore": 3.32785,
"type": ["shortcuts:/concept"],
"category": ["CONCEPT"],
"wikiId": "Nutrition",
"relatedWikiIds": ["Badakhshan", "Food_Stamp_Program", "Food_guide_pyramid", "Health", "Land_Rover", "MTV_Video_Music_Awards", "Nutrition_facts_label", "Nutritionist", "Pollen", "Vitamin"],
"relatedEntities": [],
"showOnClick": [],
"context": "would like to do is provide a packet of general nutrition info for mom and baby, with a special emphasis on how",
"metaData": {
"visible": "false"
}
 },
"lw_1231776862_4": {
"text": "weight loss tips",
"extended": 0,
"startchar": 1276,
"endchar": 1291,
"start": 1276,
"end": 1291,
"extendedFrom": "",
"predictedCategory": "",
"predictionProbability": "0",
"weight": 0.404238,
"relScore": 10.1568,
"type": ["shortcuts:/concept"],
"category": ["CONCEPT"],
"wikiId": "",
"relatedWikiIds": [],
"relatedEntities": [],
"showOnClick": [],
"context": "have that as an outpatient.  I want to provide general weight loss tips, breastfeeding/calorie guidelines (for those nursing), and other basic guidelines.  As",
"metaData": {
"visible": "false"
}
 }
};
YAHOO.Shortcuts.headerID = "4177b876a3f44e82d51959c5d8a6f6bf";







Hello all,
?
Our main OBGYN office wants us to begin providing weight loss education to ALL new mothers before discharge from our Birth Center.? We are already teaching a class at OBGYN on pregnancy nutrition, but his main concern is that new mothers lose their pregnancy weight before becoming pregnant again.
?
We have a fairly small birth center (no more than 5-7 patients at any one time), so I think doing individual education is more practical than a group setting.? Also, there is no really convenient place on that unit to even have a class.? 
?
What I would like to do is provide a packet of general nutrition info for mom and baby, with a special emphasis on how important it is to lose baby weight to ensure healthier subsequent pregnancies.? Does anyone have any good resources that they have used on this subject?? 
?
I am not looking to provide each mother an individualized meal plan--if they need specialized MNT they will need to have that as an outpatient.? I want to provide general weight loss tips, breastfeeding/calorie guidelines (for those nursing), and other basic guidelines.? As a new mom myself, I woudn't want to be handed strict diet guidelines; rather, I would want someone to treat me with "kid gloves" and gently encourage healthy habits for losing the extra pounds.
?
Any ideas for this group?? 
TIA!
Amy Jones, M.S., R.D., L.D.


      
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/1b23fb33/attachment.html 

From sheila.walsh at nahealth.com  Mon Jan 12 09:05:07 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Mon, 12 Jan 2009 10:05:07 -0700
Subject: [Cnm] Late Trays, Transfers,
	Discharges and meal supplies	- Help!
In-Reply-To: <bb1846bf0901101227j600fc999k6a9560015f72f161@mail.gmail.com>
References: <bb1846bf0901101227j600fc999k6a9560015f72f161@mail.gmail.com>
Message-ID: <496B15D3.485B.0001.0@nahealth.com>

see below

>>> "Mansi Shah" <mansishah79 at gmail.com> 1/10/2009 1:27 PM >>>
I have a few questions regarding handling of late trays and after hour meals, as well as sending food-supplies to the floors. 
 
We are a 200-bed acute care facility. After dinner tray-line we have a few late trays stocked in the kitchen for late orders. Food-services deliver these late trays (Nursing is not allowed into the kitchen). In addition, we stock a designated refrigerator on the nursing unit with sandwiches and additional hot meals for the late admissions. However, nursing staff are complaining about not having enough food and want food-services to send 5-7 extra "regular" diet trays to each nursing unit with the dinner cart, so that during the change of shift at 7pm, they don't have to run to the Stock Refrigerator. 
In addition, we are also being asked to "monitor" the need for meals in the ER and supply hot meals to them, especially for dinner. 
Also, patients that are NPO during meal time for tests, after returning are asking for food, and this creates a huge burden on the food-service staff who is not able to move on with other tasks, becuase they are fielding these individual food requests, preparing cold items and delivering them almost all day long. 
 
The problem is that with the amount of food-service staffing we have, and the amount of demands we get from nursing, we are not able to meet their demands. 
Please reply to these questions & if you have any tips/solutions you have implemented, that would help a great deal too. 
 
1) How does your facility handle late trays (for after meal hours and also for late admissions after kitchen is closed)?  
 
we send up a par level of sandwiches to floors, everyday, for their use with late admits, etc.
 
2) Do you supply hot meals to the E.R? and if yes, how many times/day, or upto what time? 
either hot meals during the meal time; or cold sandwiches in between meals.  We also stock ER with a par level of sandwiches
 
3) For patients that are NPO during a meal-period for a test/procedure, what is the procedure to give them food after meal-hours are over. Eg: 2 or 3pm in the afternoon ? (Do you refer nursing to use the floor-stock supplies, or do you offer cold sandwiches, etc. from the kitchen?)
we send up cold plates 
 
4) How do you supply apple-sauce for medications to the nursing units? (Previously, we gave the 4oz pre-packaged apple sauce, but then RNs left open apple sauce on counters and so we started supplying 1 oz single-use plated apple sauce to each floor as requested, but this is very time consuming for our staff). 
 
we have a par level of floor stock items that includes applesauce for meds in the 4 oz pcs
 
5) For patients that are discharged, but still are waiting to be picked up, how do you handle meals? We are experiencing a substantial food and labor waste related to preparing of trays for these patients. Is there a policy that you have instated? Does your facility have a specific "discharge time"? Are D/C orders entered into the computer system as soon as the orders are written, or do you wait to enter the D/C order until after the patient has physicially left (our nursing staff is doing the later - so that they don't have to re-enter all the data, incase something happens and the patient needs to be re-admitted. As a result, we don't get the accurate count of D/Cs for meal time and trays are supplied, those patients are gone by that time, and we run out of food at the end of tray-line for late patients).
 
we have a D/C lounge and sometimes we are asked to send a tray there.  
 
6) For patients that are transferred between floors during meal hours, how are you notified of the transfer, so the tray can be send to the right unit?
 
The transport staff have been asked to give us a call, when they transport patients from one room to another.  It has been super helpful to have them notify us, as we can run to trayline and move the tray ticket, etc.  IT has saved many trays of food from being wasted.
 
Thank you in advance for your feedback. 
 
Mansi Shah, RD, CNSD
Chief Clinical Dietitian
Olympia Medical Center
Los Angeles, CA 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/f16c1c45/attachment.html 

From Margaret.Chaffin at hcahealthcare.com  Mon Jan 12 10:22:49 2009
From: Margaret.Chaffin at hcahealthcare.com (Chaffin Meg)
Date: Mon, 12 Jan 2009 12:22:49 -0600
Subject: [Cnm] enteral formula delivery
Message-ID: <FE4E4942DC04FF4DA336172CB2CC522D12A60FE682@NADCWPMSGCMS06.hca.corpad.net>

This question is for anyone who has their enteral formulas stocked and delivered by foodservice and not pharmacy. Our tube formulas are currently delivered on the breakfast carts with all the other patient meals and carried directly to the patients room. The problem I am finding is that when the patient is discharged any unopen bottles make their way to the nursing stock room and over time can accumulate, making it hard for us to do accurate inventory counts. I have often rounded on patients and when I enter the room I find, for example, Glucerna 1.2 infusing when Glucerna Select was ordered and this is usually because the nurse has grabbed a bottle from their floor stock and didn't pay attention to the details.

Is it aseptic and safe to even remove and reuse these unopen bottles from the discharged patient's room or should any unopen product be discarded?

Since we are generally sending up 2 1-L bottles daily/patient, would it be smarter (& more cost effective) to purchase 1.5-L bottles and reduce the risk of having any unused formula left over?

What delivery format has worked well for others in similar situations?

TIA!

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Center
(229)434-2394

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/a764042f/attachment.html 

From Maureen.McAndrews at emoryhealthcare.org  Mon Jan 12 10:29:32 2009
From: Maureen.McAndrews at emoryhealthcare.org (McAndrews, Maureen)
Date: Mon, 12 Jan 2009 13:29:32 -0500
Subject: [Cnm] Competencies for  Dietitians
In-Reply-To: <3911A73BA69B5546B66F648E22F0D334028DF4F5@UHEVS3.uhhs.com>
References: <3911A73BA69B5546B66F648E22F0D334028DF4F5@UHEVS3.uhhs.com>
Message-ID: <A89529EC413D384A8BB8F8C936C49E7B02316998DF95@EXCHANGE23.Enterprise.emory.net>

Please post responses to the list.
Thanks.

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Vatakis, Felicia
Sent: Monday, January 12, 2009 10:07 AM
To: cnm at lists.my180.net
Subject: [Cnm] Competencies for Dietitians


Good Morning,
What competencies are being  used in hospitals for inpatient and outpatient dietitians?

Felicia Vatakis, MS, RD, LD
Clinical Nutrition Manager/ Dietetic Internship Director
University Hospitals Case Medical Center
Department of Nutrition Services
11100 Euclid Avenue
Mailstop : LKSD 5021
Cleveland, Ohio 44106
felicia.vatakis at UHhospitals.org
Telephone: 216-844-3677
Fax: 216-844-8188

Visit us at www.UHhospitals.org.

The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. University Hospitals and its affiliates disclaim any responsibility for unauthorized disclosure of this information to anyone other than the addressee.

Federal and Ohio law protect patient medical information, including psychiatric_disorders, (H.I.V) test results, A.I.Ds-related conditions, alcohol, and/or drug_dependence or abuse disclosed in this email. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law.

________________________________
This e-mail message (including any attachments) is for the sole use of
the intended recipient(s) and may contain confidential and privileged
information. If the reader of this message is not the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this message (including any attachments) is strictly
prohibited.

If you have received this message in error, please contact
the sender by reply e-mail message and destroy all copies of the
original message (including attachments).
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/8ee0229a/attachment-0001.html 

From loydg at andersonhospital.org  Mon Jan 12 10:50:35 2009
From: loydg at andersonhospital.org (Gayle S. Loyd)
Date: Mon, 12 Jan 2009 12:50:35 -0600
Subject: [Cnm] enteral formula delivery
Message-ID: <A4BFB19561F2EF4C9B6C07739EEDCE3901BAFF2F@ANH-EXCHANGE.ANH.NET>

My problem is your statement is that you may find the wrong formula
hanging.  I found that when this is given a problem documentation as a
med error for the wrong product being administered, they start being
more careful.    
 
Our feedings are delivered to a storage cabinet on the nursing unit.
The F&N person is suppose to bring down any  product over the amount
ordered and those still there for discharged or advanced patients.   Yes
there is often a build up when this is not done, but not a big problem.
 
Gayle Loyd RD LDN
Anderson Hospital
Maryville, IL
 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Chaffin Meg
Sent: Monday, January 12, 2009 12:23 PM
To: cnm at lists.my180.net
Subject: [Cnm] enteral formula delivery



This question is for anyone who has their enteral formulas stocked and
delivered by foodservice and not pharmacy. Our tube formulas are
currently delivered on the breakfast carts with all the other patient
meals and carried directly to the patients room. The problem I am
finding is that when the patient is discharged any unopen bottles make
their way to the nursing stock room and over time can accumulate, making
it hard for us to do accurate inventory counts. I have often rounded on
patients and when I enter the room I find, for example, Glucerna 1.2
infusing when Glucerna Select was ordered and this is usually because
the nurse has grabbed a bottle from their floor stock and didn't pay
attention to the details.

 

Is it aseptic and safe to even remove and reuse these unopen bottles
from the discharged patient's room or should any unopen product be
discarded?

 

Since we are generally sending up 2 1-L bottles daily/patient, would it
be smarter (& more cost effective) to purchase 1.5-L bottles and reduce
the risk of having any unused formula left over?

 

What delivery format has worked well for others in similar situations?

 

TIA!

 

Meg Chaffin MA,RD,LD

Clinical Nutrition Manager

Palmyra Medical Center

(229)434-2394

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/c0eddaf6/attachment.html 

From Shannon.Jackson at wilmed.org  Mon Jan 12 11:38:41 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Mon, 12 Jan 2009 14:38:41 -0500
Subject: [Cnm] Low Sodium Crackers
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF1B9@wmhcs03.wmh.org>

Hello,
 
What type of low sodium crackers are other facilities using to stock floors?
 
Thanks,
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/b22fff6e/attachment.html 

From RachelFlores at sach.org  Mon Jan 12 12:00:31 2009
From: RachelFlores at sach.org (Flores, Rachel)
Date: Mon, 12 Jan 2009 12:00:31 -0800
Subject: [Cnm] enteral formula delivery
Message-ID: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D5C9@S1EXH002>

We don't routinely deliver enteral products.  The diet office staff doesn't
know when formula is being held.  Nursing notifies us when they need a new
bottle and it gets sent up either with tray line, nourishments, or
separately by a runner.  All enteral products are delivered to nursing unit
kitchens, not to the pt rooms.  We still sometimes get build up of product.
The RDs are responsible for checking the nursing unit kitchen periodically
and sending extra products back to the main kitchen.  

 

I agree that there should be some type of documentation if nursing is
hanging the wrong product.  It may not "matter" much if it's just a 1 cal v.
a 1.2 cal product, but what if your pt that should be on semi-elemental gets
a renal formula?

 

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

  _____  

From: Gayle S. Loyd [mailto:loydg at andersonhospital.org] 
Sent: Monday, January 12, 2009 10:51 AM
To: Chaffin Meg; cnm at lists.my180.net
Subject: Re: [Cnm] enteral formula delivery

 

My problem is your statement is that you may find the wrong formula hanging.
I found that when this is given a problem documentation as a med error for
the wrong product being administered, they start being more careful.    

 

Our feedings are delivered to a storage cabinet on the nursing unit.  The
F&N person is suppose to bring down any  product over the amount ordered and
those still there for discharged or advanced patients.   Yes there is often
a build up when this is not done, but not a big problem.

 

Gayle Loyd RD LDN

Anderson Hospital

Maryville, IL

 

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Chaffin Meg
Sent: Monday, January 12, 2009 12:23 PM
To: cnm at lists.my180.net
Subject: [Cnm] enteral formula delivery

This question is for anyone who has their enteral formulas stocked and
delivered by foodservice and not pharmacy. Our tube formulas are currently
delivered on the breakfast carts with all the other patient meals and
carried directly to the patients room. The problem I am finding is that when
the patient is discharged any unopen bottles make their way to the nursing
stock room and over time can accumulate, making it hard for us to do
accurate inventory counts. I have often rounded on patients and when I enter
the room I find, for example, Glucerna 1.2 infusing when Glucerna Select was
ordered and this is usually because the nurse has grabbed a bottle from
their floor stock and didn't pay attention to the details.

 

Is it aseptic and safe to even remove and reuse these unopen bottles from
the discharged patient's room or should any unopen product be discarded?

 

Since we are generally sending up 2 1-L bottles daily/patient, would it be
smarter (& more cost effective) to purchase 1.5-L bottles and reduce the
risk of having any unused formula left over?

 

What delivery format has worked well for others in similar situations?

 

TIA!

 

Meg Chaffin MA,RD,LD

Clinical Nutrition Manager

Palmyra Medical Center

(229)434-2394

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/24fced6c/attachment.html 

From Heberle-Heather at aramark.com  Mon Jan 12 13:07:40 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Mon, 12 Jan 2009 15:07:40 -0600
Subject: [Cnm] enteral formula delivery
In-Reply-To: <mailman.1.1231790403.18413.cnm_lists.my180.net@lists.my180.net>
References: <mailman.1.1231790403.18413.cnm_lists.my180.net@lists.my180.net>
Message-ID: <CE78371B-1713-44DF-B355-68787F1A4507@mimectl>

We currently stock our products in our kitchen.  We have the dietitian place the TF product and rate in the diet order section (i.e. Glucerna 1.2 @ 50ml/hr) and our diet staff sends the amount needed for 1 day on the dinner carts (2 1-liter bottles for 1200ml).  Nursing does put these in their med room until they are needed.  However, we have the dietitians working the floors checking the med rooms on at least a weekly basis and returning any TF product, etc down on the meal carts.  This helps to prevent the products from expiring or collecting on the floors.  

In response to your issue with the wrong TF being hung, we have pharmacy enter the TF products, water flushes, etc into our MAR for nursing to see on a daily basis.  This has extremely helped with more accurate TF being hung as well as accuracy with advancing our TF to the goal rates.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879
Heberle-Heather at aramark.com



From: cnm-request at lists.my180.net
Sent: Mon 1/12/09 2:00 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 55


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: enteral formula delivery (Gayle S. Loyd)
   2. Low Sodium Crackers (Shannon Byrd Jackson)


----------------------------------------------------------------------

Message: 1
Date: Mon, 12 Jan 2009 12:50:35 -0600
From: "Gayle S. Loyd" <loydg at andersonhospital.org>
Subject: Re: [Cnm] enteral formula delivery
To: "Chaffin Meg" <Margaret.Chaffin at hcahealthcare.com>,
	<cnm at lists.my180.net>
Message-ID:
	<A4BFB19561F2EF4C9B6C07739EEDCE3901BAFF2F at ANH-EXCHANGE.ANH.NET>
Content-Type: text/plain; charset="us-ascii"

My problem is your statement is that you may find the wrong formula
hanging.  I found that when this is given a problem documentation as a
med error for the wrong product being administered, they start being
more careful.    
 
Our feedings are delivered to a storage cabinet on the nursing unit.
The F&N person is suppose to bring down any  product over the amount
ordered and those still there for discharged or advanced patients.   Yes
there is often a build up when this is not done, but not a big problem.
 
Gayle Loyd RD LDN
Anderson Hospital
Maryville, IL
 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Chaffin Meg
Sent: Monday, January 12, 2009 12:23 PM
To: cnm at lists.my180.net
Subject: [Cnm] enteral formula delivery



This question is for anyone who has their enteral formulas stocked and
delivered by foodservice and not pharmacy. Our tube formulas are
currently delivered on the breakfast carts with all the other patient
meals and carried directly to the patients room. The problem I am
finding is that when the patient is discharged any unopen bottles make
their way to the nursing stock room and over time can accumulate, making
it hard for us to do accurate inventory counts. I have often rounded on
patients and when I enter the room I find, for example, Glucerna 1.2
infusing when Glucerna Select was ordered and this is usually because
the nurse has grabbed a bottle from their floor stock and didn't pay
attention to the details.

 

Is it aseptic and safe to even remove and reuse these unopen bottles
from the discharged patient's room or should any unopen product be
discarded?

 

Since we are generally sending up 2 1-L bottles daily/patient, would it
be smarter (& more cost effective) to purchase 1.5-L bottles and reduce
the risk of having any unused formula left over?

 

What delivery format has worked well for others in similar situations?

 

TIA!

 

Meg Chaffin MA,RD,LD

Clinical Nutrition Manager

Palmyra Medical Center

(229)434-2394

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/c0eddaf6/attachment-0001.html 

------------------------------

Message: 2
Date: Mon, 12 Jan 2009 14:38:41 -0500
From: "Shannon Byrd Jackson" <Shannon.Jackson at wilmed.org>
Subject: [Cnm] Low Sodium Crackers
To: "CNM (E-mail)" <cnm at lists.my180.net>
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF1B9 at wmhcs03.wmh.org>
Content-Type: text/plain; charset="iso-8859-1"

Hello,
 
What type of low sodium crackers are other facilities using to stock floors?
 
Thanks,
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/b22fff6e/attachment-0001.html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 55
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/a6b86e79/attachment.html 

From Leslie.Hornick at dmh.mo.gov  Mon Jan 12 13:51:34 2009
From: Leslie.Hornick at dmh.mo.gov (Hornick, Leslie G.)
Date: Mon, 12 Jan 2009 15:51:34 -0600
Subject: [Cnm] Low Sodium Crackers
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF1B9@wmhcs03.wmh.org>
References: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF1B9@wmhcs03.wmh.org>
Message-ID: <69DD80845D7F524BB1C8C59479ED0625013A83D2@exchsvfulton01.mx.state.mo.us>

We use Keebler waldorf sodium free crackers.

 

 

Leslie Hornick, RD, LD

Chief Clinical Dietitian

FSH/MMMHC

 

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments
may contain confidential and privileged information for the use of the
designated recipients named above. The designated recipients are
prohibited from redisclosing this information to any other party without
authorization and are required to destroy the information after its
stated need has been fulfilled. If you are not the intended recipient,
you are hereby notified that you have received this communication in
error and that any review, disclosure, dissemination, distribution or
copying of it or its contents is prohibited by federal or state law. If
you have received this communication in error, please notify me
immediately by telephone at 573-592-2059, and destroy all copies of this
communication and any attachments.

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Monday, January 12, 2009 1:39 PM
To: CNM (E-mail)
Subject: [Cnm] Low Sodium Crackers

 

Hello,

 

What type of low sodium crackers are other facilities using to stock
floors?

 

Thanks,

 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
www.wilmed.org <http://www.wilmed.org/> 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/109a1895/attachment.html 

From hargenlisa at hotmail.com  Mon Jan 12 14:04:29 2009
From: hargenlisa at hotmail.com (Lisa Trombley)
Date: Mon, 12 Jan 2009 14:04:29 -0800
Subject: [Cnm] Cafeteria Hours in Large Facilities
Message-ID: <COL107-W144D8C87FD9056EBB5A657CFD80@phx.gbl>


For anyone in a large hospital (greater than 500 beds), can you please let me know the hours of operation for your employee or visitor cafeteria(s)?  Thanks so much.
Lisa Trombley, MA, RD, CNSD 

LAC+USC Healthcare Network
Los Angeles, CA
hargenlisa at hotmail.com
 
_________________________________________________________________
Windows Live?: Keep your life in sync. 
http://windowslive.com/explore?ocid=TXT_TAGLM_WL_t1_allup_explore_012009
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/1cee22d5/attachment.html 

From LCarver at Reshealthcare.org  Mon Jan 12 13:53:42 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Mon, 12 Jan 2009 15:53:42 -0600
Subject: [Cnm] enteral formula delivery
In-Reply-To: <FE4E4942DC04FF4DA336172CB2CC522D12A60FE682@NADCWPMSGCMS06.hca.corpad.net>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03AE5A57@rhcexch3.reshealthcare.org>

we label the liters w/ the patient name, room #, DOB and tube feeding
order.  the bottles are brought to the nursing station rather than the
room because, once in the room they can not be taken out and used for
someone else if the product is not needed.  We send the product up based
on the rate that is ordered - 50 ml/ hr = 1 liter.  75 ml/hr = 1 liter
MWF and 2 liters the other day.  Whether or not 1.5 liters would work
better depends upon the most common tube feeding orders and their rates.
We also try not to have on the formulary 2 very similarly named tube
feeding products to avoid name confusion.  None of this works perfectly
but perhaps some things would help your process.  Leslee

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Chaffin Meg
Sent: Monday, January 12, 2009 12:23 PM
To: cnm at lists.my180.net
Subject: [Cnm] enteral formula delivery



This question is for anyone who has their enteral formulas stocked and
delivered by foodservice and not pharmacy. Our tube formulas are
currently delivered on the breakfast carts with all the other patient
meals and carried directly to the patients room. The problem I am
finding is that when the patient is discharged any unopen bottles make
their way to the nursing stock room and over time can accumulate, making
it hard for us to do accurate inventory counts. I have often rounded on
patients and when I enter the room I find, for example, Glucerna 1.2
infusing when Glucerna Select was ordered and this is usually because
the nurse has grabbed a bottle from their floor stock and didn't pay
attention to the details.

 

Is it aseptic and safe to even remove and reuse these unopen bottles
from the discharged patient's room or should any unopen product be
discarded?

 

Since we are generally sending up 2 1-L bottles daily/patient, would it
be smarter (& more cost effective) to purchase 1.5-L bottles and reduce
the risk of having any unused formula left over?

 

What delivery format has worked well for others in similar situations?

 

TIA!

 

Meg Chaffin MA,RD,LD

Clinical Nutrition Manager

Palmyra Medical Center

(229)434-2394

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/78f3cd5b/attachment-0001.html 

From cahns at carthageareahospital.com  Mon Jan 12 14:29:59 2009
From: cahns at carthageareahospital.com (Dawn Berry, RD)
Date: Mon, 12 Jan 2009 17:29:59 -0500
Subject: [Cnm] Gastric bypass pt with dwarfism
Message-ID: <34D1229980EF49BA88B42C8F0978BCCE@CAHNS1>

Help!  I have a patient with dwarfism, s/p gastric bypass in March 08.  He
has lost 150# and weights 145#, his height is 48 inches.  How do I figure
IBW, adjusted body weight and calorie/ protein needs?  Is BMI calculated any
differently?

 

Thank you!

 

Dawn Berry, RD CDN

Director of Clinical Nutrition

Carthage Area Hospital

1001 West Street

Carthage, NY 13619

 

315-493-1005  ext 3222

cahns at carthageareahospital.com

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/ef18fa38/attachment.html 

From FREED_KATHARINE at GUTHRIE.ORG  Mon Jan 12 15:06:35 2009
From: FREED_KATHARINE at GUTHRIE.ORG (FREED_KATHARINE at GUTHRIE.ORG)
Date: Mon, 12 Jan 2009 18:06:35 -0500
Subject: [Cnm] Low Sodium Crackers
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF1B9@wmhcs03.wmh.org>
Message-ID: <OF10B83D26.4738B570-ON8525753C.007E5C26-8525753C.007EF260@guthrie.org>

Shannon,
We use Keebler Waldorf Crackers Sodium Free - they come is small pkts of 2 
crackers.  Patients LOVE them, very sweet tasting but only 4 gm CHO per 
pkt..
Kait Freed


Katharine Ward Freed, MS, RD, LDN, CDE
Clinical Supervisor
Food & Nutrition Dept.
Robert Packer Hospital
One Guthrie Square
Sayre, PA 18840
Tel  570-882-4297   Fax  570-882-5122
Email: "freed_katharine at guthrie.org"


CONFIDENTIALITY NOTICE: This e-mail, including attachments, may
include confidential, restricted, protected health and/or
proprietary information, and may be used only for the person or
entity to which it is addressed. If the reader of this e-mail is
not the intended recipient or his or her authorized agent, the
reader is hereby notified that any dissemination, distribution or
copying of this e-mail is prohibited. If you have received this
e-mail in error, please notify the sender by replying to this
message and delete this e-mail immediately. Notice: The disclosure
of medical information is strictly prohibited by federal
regulation. Unauthorized release of medical information may result
in administrative, civil and criminal sanctions.  
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/5399750a/attachment.html 

From Karen.Auwaerter at chw.edu  Mon Jan 12 16:08:04 2009
From: Karen.Auwaerter at chw.edu (Auwaerter, Karen - MSJ)
Date: Mon, 12 Jan 2009 17:08:04 -0700
Subject: [Cnm] Clinical privileges for RDs/credentialing
In-Reply-To: <3911A73BA69B5546B66F648E22F0D334028DF4F5@UHEVS3.uhhs.com>
References: <3911A73BA69B5546B66F648E22F0D334028DF4F5@UHEVS3.uhhs.com>
Message-ID: <891DC7E14FC0F449874219D643CB1CA802834208@CHW-MSG-403.chw.edu>

 

I have just rejoined the listserve after a couple months' absence, so
forgive me if this has been discussed recently...

 

Have any of you gotten your RDs "credentialed by the medical staff as an
allied health professional or granted clinical privileges"?  One of our
affiliated hospitals was cited by CMS surveyor for using a medical
staff-approved MNT Protocol to change diet orders "without being
credentialed to write orders".

 

If any of you RDs credentialed to write orders, I'd like to know:

 

1.	What exactly can the RD do?  (ie order labs, vit/min
supplements, change diets, etc.  Did you limit any diet changes the RD
can make, if so, what?).
2.	Do you have a copy of your protocol to share?  (we are rewriting
our general protocol and creating instead separate and specific
protocols by problem/nutr dx (ie TF, Inadequate Food/Bev Intake, DM,
Wounds, etc that lists exactly what the RD can do and under which
circumstances)
3.	If credentialed to write orders, does the RD write orders on any
pt he/she is seeing, or only if the MD has requested the RD to follow
the pt (by ordering a nutrition consult).

 

Thanks so much!

Karen Auwaerter, RD

Manager, Nutrition and Food Services

Mercy San Juan Medical Center

Greater Sacramento Area

916 537 5104 phone

916 859 1238 fax

 

 


Visit us at www.UHhospitals.org. 

The enclosed information is STRICTLY CONFIDENTIAL and is intended for
the use of the addressee only. University Hospitals and its affiliates
disclaim any responsibility for unauthorized disclosure of this
information to anyone other than the addressee.

Federal and Ohio law protect patient medical information, including
psychiatric_disorders, (H.I.V) test results, A.I.Ds-related conditions,
alcohol, and/or drug_dependence or abuse disclosed in this email.
Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31
and 3701.243 prohibit disclosure of this information without the
specific written consent of the person to whom it pertains, or as
otherwise permitted by law.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/f9001fb8/attachment.html 

From Sandra.Miller at CHW.edu  Mon Jan 12 16:46:10 2009
From: Sandra.Miller at CHW.edu (Miller, Sandra - MMC)
Date: Mon, 12 Jan 2009 17:46:10 -0700
Subject: [Cnm] enteral formula delivery
In-Reply-To: <FE4E4942DC04FF4DA336172CB2CC522D12A60FE682@NADCWPMSGCMS06.hca.corpad.net>
References: <FE4E4942DC04FF4DA336172CB2CC522D12A60FE682@NADCWPMSGCMS06.hca.corpad.net>
Message-ID: <CE50A73BE0204542A71BD4AE515469AC05480CD0@CHW-MSG-203.chw.edu>

we had a patient drink the formula that was supposed to be fed via the
tube. So we now no longer send formula to the room instead we send it to
the nursing station with a patient identifying label on them.
Periodically I check the stations and remove extra formula.
 
Sandra Miller RD CDE

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Chaffin Meg
Sent: Monday, January 12, 2009 10:23 AM
To: cnm at lists.my180.net
Subject: [Cnm] enteral formula delivery



This question is for anyone who has their enteral formulas stocked and
delivered by foodservice and not pharmacy. Our tube formulas are
currently delivered on the breakfast carts with all the other patient
meals and carried directly to the patients room. The problem I am
finding is that when the patient is discharged any unopen bottles make
their way to the nursing stock room and over time can accumulate, making
it hard for us to do accurate inventory counts. I have often rounded on
patients and when I enter the room I find, for example, Glucerna 1.2
infusing when Glucerna Select was ordered and this is usually because
the nurse has grabbed a bottle from their floor stock and didn't pay
attention to the details.

 

Is it aseptic and safe to even remove and reuse these unopen bottles
from the discharged patient's room or should any unopen product be
discarded?

 

Since we are generally sending up 2 1-L bottles daily/patient, would it
be smarter (& more cost effective) to purchase 1.5-L bottles and reduce
the risk of having any unused formula left over?

 

What delivery format has worked well for others in similar situations?

 

TIA!

 

Meg Chaffin MA,RD,LD

Clinical Nutrition Manager

Palmyra Medical Center

(229)434-2394

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/d2129de2/attachment.html 

From jlworden at att.net  Mon Jan 12 18:45:51 2009
From: jlworden at att.net (Jo Lynn Worden)
Date: Mon, 12 Jan 2009 20:45:51 -0600
Subject: [Cnm] Gastric bypass pt with dwarfism
In-Reply-To: <34D1229980EF49BA88B42C8F0978BCCE@CAHNS1>
References: <34D1229980EF49BA88B42C8F0978BCCE@CAHNS1>
Message-ID: <009701c97529$0c95c2a0$25c147e0$@net>

Post to list? This sounds like a puzzle most of us would be interested in. 

Thanks

 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Dawn Berry, RD
Sent: Monday, January 12, 2009 4:30 PM
To: cnm at lists.my180.net
Subject: [Cnm] Gastric bypass pt with dwarfism

 

Help!  I have a patient with dwarfism, s/p gastric bypass in March 08.  He
has lost 150# and weights 145#, his height is 48 inches.  How do I figure
IBW, adjusted body weight and calorie/ protein needs?  Is BMI calculated any
differently?

 

Thank you!

 

Dawn Berry, RD CDN

Director of Clinical Nutrition

Carthage Area Hospital

1001 West Street

Carthage, NY 13619

 

315-493-1005  ext 3222

cahns at carthageareahospital.com

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090112/edab694d/attachment.html 

From rdconnect at yahoo.com  Tue Jan 13 02:00:31 2009
From: rdconnect at yahoo.com (Jean Harnisch)
Date: Tue, 13 Jan 2009 02:00:31 -0800 (PST)
Subject: [Cnm] Bariatric staffing plan for RD
Message-ID: <255846.66189.qm@web62004.mail.re1.yahoo.com>

Any resources/ info on #RD's needed to staff a bariatric program?


      


From mrogard at charter.net  Tue Jan 13 03:18:50 2009
From: mrogard at charter.net (mrogard at charter.net)
Date: Tue, 13 Jan 2009 6:18:50 -0500
Subject: [Cnm] Cafeteria Hours in Large Facilities
In-Reply-To: <COL107-W144D8C87FD9056EBB5A657CFD80@phx.gbl>
Message-ID: <20090113061850.NG1KN.2936957.root@mp15>

We are a 700 bed hospital and maintain 3 cafe sites on the main campus.  One cafe is open 24/7.  However, are patient service is room service and we are considering expanding our room service operation to 24 hours and shutting down the night cafe service.
MJ
--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org
Professional email: mrogard at charter.net

---- Lisa Trombley <hargenlisa at hotmail.com> wrote: 
> 
> For anyone in a large hospital (greater than 500 beds), can you please let me know the hours of operation for your employee or visitor cafeteria(s)?  Thanks so much.
> Lisa Trombley, MA, RD, CNSD 
> 
> LAC+USC Healthcare Network
> Los Angeles, CA
> hargenlisa at hotmail.com
>  
> _________________________________________________________________
> Windows Live?: Keep your life in sync. 
> http://windowslive.com/explore?ocid=TXT_TAGLM_WL_t1_allup_explore_012009



From Bhsemmens at aol.com  Tue Jan 13 03:31:35 2009
From: Bhsemmens at aol.com (Bhsemmens at aol.com)
Date: Tue, 13 Jan 2009 06:31:35 EST
Subject: [Cnm] software or internet services
Message-ID: <be1.4e14bb9f.369dd597@aol.com>

Please share with the group.
 
Thank you,
Beth Semmens
 
 
In a message dated 1/8/2009 12:16:31 P.M. Eastern Standard Time,  
Robin.Herr at scrmc.org writes:

I'm looking for a  software program or an internet service that you'd 
recommend for  nutritional analysis of recipes and menus!!!
 
Thank you for your  assistance,
 
Robin  Herr
_robin.herr at scrmc.org_ (mailto:robin.herr at scrmc.org) 
715.483.0248


_______________________________________________
Cnm  mailing  list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


**************A Good Credit Score is 700 or Above. See yours in just 2 easy 
steps! 
(http://pr.atwola.com/promoclk/100000075x1215855013x1201028747/aol?redir=http://www.freecreditreport.com/pm/default.aspx?sc=668072%26hmpgID=62%26bcd=De
cemailfooterNO62)
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/863571e4/attachment.html 

From peggymsrdld at cox.net  Tue Jan 13 04:24:17 2009
From: peggymsrdld at cox.net (Peggy Turner)
Date: Tue, 13 Jan 2009 06:24:17 -0600
Subject: [Cnm] Clinical privileges for RDs/credentialing
In-Reply-To: <891DC7E14FC0F449874219D643CB1CA802834208@CHW-MSG-403.chw.edu>
References: <3911A73BA69B5546B66F648E22F0D334028DF4F5@UHEVS3.uhhs.com>
	<891DC7E14FC0F449874219D643CB1CA802834208@CHW-MSG-403.chw.edu>
Message-ID: <018F96D8-63A3-4930-96E7-F07792726842@cox.net>

Hi Karen,

I'm working on getting myself credentialed. I'll find out Thursday if  
I am successful!

The answer to your questions will take me a while to respond. I was  
surprised when I started investigating all this to find out there  
isn't a simple yes/no solution.

You can start by doing a search on the ADA website for order writing  
privileges. Or if you would rather wait until I get home from work  
tonight, I'll send you some of the links I found.

I'm off to work right now. (that is where all my research on this  
topic is). If you want, you can call me there later today.  
405-310-5443 or 405-570-5207

The best search words are: Scope of Practice Framework.

Good luck, talk to you later.

Peggy
On Jan 12, 2009, at 6:08 PM, Auwaerter, Karen - MSJ wrote:

>
> I have just rejoined the listserve after a couple months? absence,  
> so forgive me if this has been discussed recently?
>
> Have any of you gotten your RDs ?credentialed by the medical staff  
> as an allied health professional or granted clinical privileges??   
> One of our affiliated hospitals was cited by CMS surveyor for using  
> a medical staff-approved MNT Protocol to change diet orders ?without  
> being credentialed to write orders?.
>
> If any of you RDs credentialed to write orders, I?d like to know:
>
> What exactly can the RD do?  (ie order labs, vit/min supplements,  
> change diets, etc.  Did you limit any diet changes the RD can make,  
> if so, what?).
> Do you have a copy of your protocol to share?  (we are rewriting our  
> general protocol and creating instead separate and specific  
> protocols by problem/nutr dx (ie TF, Inadequate Food/Bev Intake, DM,  
> Wounds, etc that lists exactly what the RD can do and under which  
> circumstances)
> If credentialed to write orders, does the RD write orders on any pt  
> he/she is seeing, or only if the MD has requested the RD to follow  
> the pt (by ordering a nutrition consult).
>
> Thanks so much!
> Karen Auwaerter, RD
> Manager, Nutrition and Food Services
> Mercy San Juan Medical Center
> Greater Sacramento Area
> 916 537 5104 phone
> 916 859 1238 fax
>
>
>
> Visit us at www.UHhospitals.org.
>
> The enclosed information is STRICTLY CONFIDENTIAL and is intended  
> for the use of the addressee only. University Hospitals and its  
> affiliates disclaim any responsibility for unauthorized disclosure  
> of this information to anyone other than the addressee.
>
> Federal and Ohio law protect patient medical information, including  
> psychiatric_disorders, (H.I.V) test results, A.I.Ds-related  
> conditions, alcohol, and/or drug_dependence or abuse disclosed in  
> this email. Federal regulation (42 CFR Part 2) and Ohio Revised Code  
> section 5122.31 and 3701.243 prohibit disclosure of this information  
> without the specific written consent of the person to whom it  
> pertains, or as otherwise permitted by  
> law._______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/794ad906/attachment-0001.html 

From MKarustis at dh.org  Tue Jan 13 04:55:15 2009
From: MKarustis at dh.org (Karustis, Marcelle)
Date: Tue, 13 Jan 2009 07:55:15 -0500
Subject: [Cnm] Meditech documentation sample
In-Reply-To: <496786220200003400022C62@email3.emhc.org>
Message-ID: <526B6282E69E0F4B9C80A8B646A6FADB0150BA9E@dhmail.dhorg.org>

Pat,
Not sure if you got my first message.  That appears to be my EMR assessment form.
You can reach me at mkarustis at dh.org or 215 345-2504 if you have questions.
Thanks
Marcelle Karustis MS RD RN LDN
www.dh.org

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Pat Sutor
Sent: Friday, January 09, 2009 6:15 PM
To: cnm at lists.my180.net
Subject: [Cnm] Meditech documentation sample


I received the attached Meditech documetation sample via the list serve sometime around July 08 and am trying to locate the person who sent it. If this is your form please respond to the list or to me at psutor at emhc.org
I think it is great and I would like to see what else you have buildt in the other sections.Thanks, Pat


The information contained in this electronic mail transmittal is protected by law and is intended only for the use of the designated recipient(s) named above. If the reader of this transmission is not the intended recipient(s), you are notified that any disclosure, dissemination, distribution or duplication of its contents is strictly prohibited. If you have received this transmittal in error, please notify the sender by return e-mail and delete the transmittal immediately. Thank you. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/d8e1d3d4/attachment.html 

From fynan-carla at CooperHealth.edu  Tue Jan 13 05:03:46 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Tue, 13 Jan 2009 08:03:46 -0500
Subject: [Cnm] Clinical privileges for RDs/credentialing
In-Reply-To: <018F96D8-63A3-4930-96E7-F07792726842@cox.net>
References: <3911A73BA69B5546B66F648E22F0D334028DF4F5@UHEVS3.uhhs.com>
	<891DC7E14FC0F449874219D643CB1CA802834208@CHW-MSG-403.chw.edu>
	<018F96D8-63A3-4930-96E7-F07792726842@cox.net>
Message-ID: <77F33794DD223B40BF24AB3D37930250172B2BF4AE@mxmbx01.chsmail.root.cooperhealth.edu>

Hi,

Please post all of your responses with regards to writing privileges to the list.

Thanks,

Carla

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Peggy Turner
Sent: Tuesday, January 13, 2009 7:24 AM
To: Auwaerter, Karen - MSJ
Cc: cnm at lists.my180.net
Subject: Re: [Cnm] Clinical privileges for RDs/credentialing

Hi Karen,

I'm working on getting myself credentialed. I'll find out Thursday if I am successful!

The answer to your questions will take me a while to respond. I was surprised when I started investigating all this to find out there isn't a simple yes/no solution.

You can start by doing a search on the ADA website for order writing privileges. Or if you would rather wait until I get home from work tonight, I'll send you some of the links I found.

I'm off to work right now. (that is where all my research on this topic is). If you want, you can call me there later today. 405-310-5443 or 405-570-5207

The best search words are: Scope of Practice Framework.

Good luck, talk to you later.

Peggy
On Jan 12, 2009, at 6:08 PM, Auwaerter, Karen - MSJ wrote:



I have just rejoined the listserve after a couple months' absence, so forgive me if this has been discussed recently...

Have any of you gotten your RDs "credentialed by the medical staff as an allied health professional or granted clinical privileges"?  One of our affiliated hospitals was cited by CMS surveyor for using a medical staff-approved MNT Protocol to change diet orders "without being credentialed to write orders".

If any of you RDs credentialed to write orders, I'd like to know:


 1.  What exactly can the RD do?  (ie order labs, vit/min supplements, change diets, etc.  Did you limit any diet changes the RD can make, if so, what?).
 2.  Do you have a copy of your protocol to share?  (we are rewriting our general protocol and creating instead separate and specific protocols by problem/nutr dx (ie TF, Inadequate Food/Bev Intake, DM, Wounds, etc that lists exactly what the RD can do and under which circumstances)
 3.  If credentialed to write orders, does the RD write orders on any pt he/she is seeing, or only if the MD has requested the RD to follow the pt (by ordering a nutrition consult).

Thanks so much!
Karen Auwaerter, RD
Manager, Nutrition and Food Services
Mercy San Juan Medical Center
Greater Sacramento Area
916 537 5104 phone
916 859 1238 fax



Visit us at www.UHhospitals.org<http://www.UHhospitals.org>.

The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. University Hospitals and its affiliates disclaim any responsibility for unauthorized disclosure of this information to anyone other than the addressee.

Federal and Ohio law protect patient medical information, including psychiatric_disorders, (H.I.V) test results, A.I.Ds-related conditions, alcohol, and/or drug_dependence or abuse disclosed in this email. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law._______________________________________________
Cnm mailing list
Cnm at lists.my180.net<mailto:Cnm at lists.my180.net>
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net




****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/593abb21/attachment.html 

From Catherine.McIsaac at vtmednet.org  Tue Jan 13 06:26:17 2009
From: Catherine.McIsaac at vtmednet.org (McIsaac, Catherine L.)
Date: Tue, 13 Jan 2009 09:26:17 -0500
Subject: [Cnm] Cafeteria Hours in Large Facilities
In-Reply-To: <20090113061850.NG1KN.2936957.root@mp15>
Message-ID: <DFD774BB7BA21545914AD7765EC3BC7483E513FA6B@EMAIL1.fahc.fletcherallen.org>

 We are right at 500 beds, we have 3 on site operations, one of which is open 22 hours a day (closed from 3a-5a).

Cathy McIsaac, MS, RD
Manager, Clinical Nutrition
Nutrition Services
Fletcher Allen Health Care
111 Colchester Ave
Burlington, VT 05401
P: 802-847-2703
F: 802-847-2790
Please consider the environment before printing this email.



-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of mrogard at charter.net
Sent: Tuesday, January 13, 2009 6:19 AM
To: Lisa Trombley; cnm at lists.my180.net
Subject: Re: [Cnm] Cafeteria Hours in Large Facilities

We are a 700 bed hospital and maintain 3 cafe sites on the main campus.  One cafe is open 24/7.  However, are patient service is room service and we are considering expanding our room service operation to 24 hours and shutting down the night cafe service.
MJ
--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org
Professional email: mrogard at charter.net

---- Lisa Trombley <hargenlisa at hotmail.com> wrote:
>
> For anyone in a large hospital (greater than 500 beds), can you please let me know the hours of operation for your employee or visitor cafeteria(s)?  Thanks so much.
> Lisa Trombley, MA, RD, CNSD
>
> LAC+USC Healthcare Network
> Los Angeles, CA
> hargenlisa at hotmail.com
>
> _________________________________________________________________
> Windows Live(tm): Keep your life in sync.
> http://windowslive.com/explore?ocid=TXT_TAGLM_WL_t1_allup_explore_0120
> 09


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From Laura.Neubauer-Cheng at mckennan.org  Tue Jan 13 07:20:37 2009
From: Laura.Neubauer-Cheng at mckennan.org (Laura Neubauer-Cheng)
Date: Tue, 13 Jan 2009 09:20:37 -0600
Subject: [Cnm] Emplacement Opportunity
Message-ID: <3056CD3132613245B82DD67F56A36E5901E5BEB9@mck235.averamail.net>

Employment Opportunity for a Registered Dietitian in South Dakota 

Avera McKennan, in partnership with Hy-Vee Foods, seeks a highly
motivated, customer service orientated professional to join our team.
This opportunity is part-time, with hours ranging from 10:00am to
7:00pm, Monday through Friday, with every other Saturday requirements.
Responsibilities include providing nutritional expertise to clients in a
retail setting while working in collaboration with retail Pharmacists.
Because this position is in a retail climate, all applicants need to
possess a strong customer service background. SD licensure as a
Registered Dietitian is required.  Avera McKennan Hospital and
University Health Center offers competitive compensation, benefits and
professional growth opportunities in a caring working environment.  Only
written or online applications will be considered. Please reference Req.
#4373 when applying. Applications accepted until position is filled.
Avera McKennan Hospital & University Health Center contact: 

Avera McKennan HR 
phone (605) 322-7850 
fax: (605) 322-7868 
email: hr at mckennan.org <mailto:hr at mckennan.org>  
www.AveraMcKennan.org <http://www.AveraMcKennan.org>  
 
 


-----------------------------------------
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/cf41a6dc/attachment.html 

From dlquirk at lexhealth.org  Tue Jan 13 07:23:37 2009
From: dlquirk at lexhealth.org (Donna Quirk)
Date: Tue, 13 Jan 2009 10:23:37 -0500
Subject: [Cnm] Low Platelet Count and Tube Feedings
Message-ID: <E7F14288C5230F489C59B669526780E00622B1A4@lmcmail01.lmc.lexhealth.org>

Would appreciate some assistance with the following - Can a patient be
fed via tube when their platelets are low?  I am thinking placing a tube
is contraindicated, but I am trying to clarify if an existing tube can
be used.  Any expertise you can share is appreciated.

 

Thanks,

 

Donna

 

Donna Quirk RD

Clinical Nutrition Manager

Lexington Medical Center

2720 Sunset Blvd

West Columbia, SC 29169

803-791-2248

 

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/f5d60b97/attachment.html 

From mtewes at wchsys.org  Tue Jan 13 07:45:05 2009
From: mtewes at wchsys.org (Melissa Tewes)
Date: Tue, 13 Jan 2009 10:45:05 -0500
Subject: [Cnm] Nutritional Analysis of Menus
Message-ID: <20090113154504.D9E57B52B4@custmx01.expedient.net>

What are facilities doing as far as nutritional analysis of patient menus?
Regular Diet Standards only?  Or all therapeutics?

 

Thanks in advance

 

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washingon County Health System

251 East Antietam Street

Hagerstown, MD 21740

Phone:  301-790-8084

Fax:  301-790-8535

 

mtewes at wchsys.org

 



***** CONFIDENTIALITY NOTICE *****
This message contains confidential information and is intended only for
the individual named. If you are not the named addressee you should not
disseminate, distribute or copy this e-mail. Please notify the sender
immediately by e-mail if you have received this e-mail by mistake and
delete this e-mail from your system.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/38274280/attachment-0001.html 

From andrea.johnson at bassett.org  Tue Jan 13 07:56:09 2009
From: andrea.johnson at bassett.org (Johnson, Andrea)
Date: Tue, 13 Jan 2009 10:56:09 -0500
Subject: [Cnm] Dining out
In-Reply-To: <20090113154504.D9E57B52B4@custmx01.expedient.net>
Message-ID: <415700FC732DE14491A3E39367834F7701E6DB23@ex3.bassett.org>

I am doing a phone interview on eating out talking about Italian, Chinese, Greek, and Vietnamese. Any assistance would be greatly appreciated i.e. hand-outs, web sites, etc.
Thanks,
Andrea
 

Andrea Johnson, MS, RD, CDE 
Clinical Nutrition Manager 
Bassett Healthcare 
One Atwell Road 
Cooperstown, NY 13326 
andrea.johnson at bassett.org 
607-547-6665 

 



-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/6dc1ca89/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Johnson, Andrea.vcf
Type: text/x-vcard
Size: 145 bytes
Desc: Johnson, Andrea.vcf
Url : /pipermail/cnm_lists.my180.net/attachments/20090113/6dc1ca89/attachment.vcf 

From Remi.Hayashi at CHW.EDU  Tue Jan 13 08:02:28 2009
From: Remi.Hayashi at CHW.EDU (Hayashi, Remi  - GMHHC)
Date: Tue, 13 Jan 2009 09:02:28 -0700
Subject: [Cnm] Trayline Temperature Log
Message-ID: <3F15BB776BDDF847B55DACB387D41ABC057CCC31@CHW-MSG-303.chw.edu>

We are in the process of revising our trayline food temperature log
form.  Would anyone willing to share?

Thank you very much.

Remi Hayashi, MS, RD
Clinical Nutrition Manager
Glendale Memorial Hospital and Health Center
1420 South Central Avenue
Glendale, CA 91204
(818)409-7643 Direct
(818)507-4665 Fax

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/1341e705/attachment.html 

From jeannine.hutchcraft at sih.net  Tue Jan 13 08:09:08 2009
From: jeannine.hutchcraft at sih.net (Jeannine Hutchcraft/SIH)
Date: Tue, 13 Jan 2009 10:09:08 -0600
Subject: [Cnm] Bariatric staffing plan for RD
In-Reply-To: <255846.66189.qm@web62004.mail.re1.yahoo.com>
Message-ID: <OFED03DD3C.EF9CDF3D-ON8625753D.0058AC5E-8625753D.0058BA54@sih.net>

I would like this information, also.

Jeannine Hutchcraft, MS RD LDN CDE
Clinical Nutrition Coordinator
Herrin Hospital
618 942-2171 x35213
Fax: 618 351-4907

To eat is a necessity, but to eat intelligently is an art.
- La Rochefoucauld



From steppinoutwithmrh at yahoo.com  Tue Jan 13 09:05:22 2009
From: steppinoutwithmrh at yahoo.com (Amy Jones)
Date: Tue, 13 Jan 2009 09:05:22 -0800 (PST)
Subject: [Cnm] Dining out
In-Reply-To: <415700FC732DE14491A3E39367834F7701E6DB23@ex3.bassett.org>
Message-ID: <425912.55577.qm@web52510.mail.re2.yahoo.com>

A nice talking points article from Today's Dietitian.
?
http://www.todaysdietitian.com/archives/td_0505p48.shtml
?
Amy Jones, M.S., R.D., L.d.


--- On Tue, 1/13/09, Johnson, Andrea <andrea.johnson at bassett.org> wrote:

From: Johnson, Andrea <andrea.johnson at bassett.org>
Subject: [Cnm] Dining out
To: cnm at lists.my180.net
Date: Tuesday, January 13, 2009, 10:56 AM



 _filtered #yiv2035344350 {
font-family:Script MT Bold;}
 _filtered #yiv2035344350 {margin:1.0in 1.25in 1.0in 1.25in;}
#yiv2035344350 P.MsoNormal {
FONT-SIZE:12pt;MARGIN:0in 0in 0pt;FONT-FAMILY:"Times New Roman";}
#yiv2035344350 LI.MsoNormal {
FONT-SIZE:12pt;MARGIN:0in 0in 0pt;FONT-FAMILY:"Times New Roman";}
#yiv2035344350 DIV.MsoNormal {
FONT-SIZE:12pt;MARGIN:0in 0in 0pt;FONT-FAMILY:"Times New Roman";}
#yiv2035344350 A:link {
COLOR:blue;TEXT-DECORATION:underline;}
#yiv2035344350 SPAN.MsoHyperlink {
COLOR:blue;TEXT-DECORATION:underline;}
#yiv2035344350 A:visited {
COLOR:purple;TEXT-DECORATION:underline;}
#yiv2035344350 SPAN.MsoHyperlinkFollowed {
COLOR:purple;TEXT-DECORATION:underline;}
#yiv2035344350 SPAN.EmailStyle17 {
FONT-WEIGHT:normal;COLOR:black;FONT-STYLE:normal;FONT-FAMILY:"Times New Roman";TEXT-DECORATION:none;}
#yiv2035344350 DIV.Section1 {
}


I am doing a phone interview on eating out talking about Italian, Chinese, Greek, and Vietnamese. Any assistance would be greatly appreciated i.e. hand-outs, web sites, etc.
Thanks,
Andrea
?
Andrea Johnson, MS, RD, CDE 
Clinical Nutrition Manager 
Bassett Healthcare 
One Atwell Road 
Cooperstown, NY 13326 
andrea.johnson at bassett.org 
607-547-6665 
?NOTICE OF CONFIDENTIALITY This electronic message, including attachments, is for the sole use of the named recipient and may contain confidential or privileged information protected by New York State, and Federal regulations. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. If you are not the intended recipient or have received this communication in error please contact the sender or email.security at bassett.org and destroy all copies of the original message. Thank you. _______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



      
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/c5864035/attachment.html 

From Linda.Woods at healthall.com  Tue Jan 13 09:20:26 2009
From: Linda.Woods at healthall.com (Woods, Linda)
Date: Tue, 13 Jan 2009 12:20:26 -0500
Subject: [Cnm] Nutritional Analysis of Menus
In-Reply-To: <20090113154504.D9E57B52B4@custmx01.expedient.net>
References: <20090113154504.D9E57B52B4@custmx01.expedient.net>
Message-ID: <2B1106A6A593B147A65BD5A8939D3E1117157418FA@MAIL-C.healthall.com>

We completed nutrient analyses of our regular, consistent carbohydrate, cardiac, renal and dysphagia 1/pureed diets.  We use Cbord and chose to do these diets as a representative group since most other therapeutic diets are patterned off of these diets in the way we've set up diet grades and course code requirements.

Linda Woods, RD, LD
Clinical Nutrition Coordinator
The University Hospital
234 Goodman Street
Cincinnati, OH  45219
linda.woods at healthall.com
Office:  513-584-4534
Fax:  513-584-1027



From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Melissa Tewes
Sent: Tuesday, January 13, 2009 10:45 AM
To: cnm at lists.my180.net
Subject: [Cnm] Nutritional Analysis of Menus

What are facilities doing as far as nutritional analysis of patient menus?  Regular Diet Standards only?  Or all therapeutics?

Thanks in advance

Melissa Tewes RD, LDN
Clinical Nutrition Manager
Washingon County Health System
251 East Antietam Street
Hagerstown, MD 21740
Phone:  301-790-8084
Fax:  301-790-8535

mtewes at wchsys.org


***** CONFIDENTIALITY NOTICE ***** This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system.

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/c0c8b85e/attachment.html 

From nancy.hakel-smith at bryanlgh.org  Tue Jan 13 10:49:19 2009
From: nancy.hakel-smith at bryanlgh.org (Nancy A. Hakel-Smith)
Date: Tue, 13 Jan 2009 12:49:19 -0600
Subject: [Cnm] [Fwd: Potential Author(s) and Reviewers for Updating the
 Article "Guidelines Regarding the Recommendation and Sale of Dietary
 Supplements]
Message-ID: <496CE22F.7070005@bryanlgh.org>

An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/239e80d4/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 7234 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090113/239e80d4/attachment-0001.jpe 

From fynan-carla at CooperHealth.edu  Tue Jan 13 11:12:10 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Tue, 13 Jan 2009 14:12:10 -0500
Subject: [Cnm] OB Patient with Metallic Taste
Message-ID: <77F33794DD223B40BF24AB3D37930250172B30831D@mxmbx01.chsmail.root.cooperhealth.edu>

Hello,

I did a high risk OB clinic and one of the patients is 6.5 weeks pregnant and can not eat ANYTHING without tasting metal (describes it as licking an ashtray).

She has lost 12# and does not have it to spare.

Has anyone ever had this before and do any of you have ideas?

Carla Fynan, RD
Clinical Nutrition Manager
Food & Nutrition Department
Cooper University Hospital
One Cooper Paza
Camden, NJ 08103
(856) 342-2320



****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/47396fe0/attachment.html 

From LCarver at Reshealthcare.org  Tue Jan 13 11:26:35 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 13 Jan 2009 13:26:35 -0600
Subject: [Cnm] OB Patient with Metallic Taste
In-Reply-To: <77F33794DD223B40BF24AB3D37930250172B30831D@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03AE5CF5@rhcexch3.reshealthcare.org>

I've never seen the taste aversions be this bad - generally the worst
aversions are strong smelling stuff (sometimes anything hot), and esp.
coffee.  W/ her I would assume any meats, esp. red meats are the worst.
 
Perhaps she could try something w/ a strong, non-metal containing flavor
like tart lemonade or pickled ginger.  One common "trick" is something
real salty tasting (i.e. chips) and then thirst-driven lemonade.  
 
there are couple of older books (early 90's) I found helpful - No More
Morning Sickness by Miriam Erick, RD (Plume Book is the Publisher)
1993.  The other one I can't find at the moment - I think it was simply
called Pickles and Ice-Cream.  Both were really helpful to me when I
worked in that arena more regularly.  
 
Leslee

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Fynan, Carla
Sent: Tuesday, January 13, 2009 1:12 PM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] OB Patient with Metallic Taste



Hello,

 

I did a high risk OB clinic and one of the patients is 6.5 weeks
pregnant and can not eat ANYTHING without tasting metal (describes it as
licking an ashtray).

 

She has lost 12# and does not have it to spare.

 

Has anyone ever had this before and do any of you have ideas?

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately. 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/f7a6f57b/attachment.html 

From debiasse at bu.edu  Tue Jan 13 12:00:32 2009
From: debiasse at bu.edu (Michele A. DeBiasse)
Date: Tue, 13 Jan 2009 15:00:32 -0500
Subject: [Cnm] OB Patient with Metallic Taste
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E03AE5CF5@rhcexch3.reshealthcare.org>
References: <77F33794DD223B40BF24AB3D37930250172B30831D@mxmbx01.chsmail.root.cooperhealth.edu>
	<5330B54133B6194BA13930BDEFE9A30E03AE5CF5@rhcexch3.reshealthcare.org>
Message-ID: <203C0CCDF3F847359A3ADED7F5D059AD@ad.bu.edu>

Ladies -

I am forwarding this thread to my friend/colleague Miriam Erick (mentioned
in Leslee's note).  If anyone has a strategy that might help this woman,
Miriam will!

Miriam - 

Any thoughts on this case?

Michele

 

Michele A. DeBiasse, MS, RD, CNSD

Clinical Assistant Professor

Boston University

College of Health & Rehabilitation Sciences: Sargent

Department of Health Sciences

635 Commonwealth Ave, Rm 433

Boston, MA  02215

Ph: 617.358.5479

Fax: 617.353.7567

 

Lecturer

Tufts University School of Medicine

136 Harrison Ave

Boston, MA  02111

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Carver, Leslee
Sent: Tuesday, January 13, 2009 2:27 PM
To: Fynan, Carla; Cnm at lists.my180.net
Subject: Re: [Cnm] OB Patient with Metallic Taste

 

I've never seen the taste aversions be this bad - generally the worst
aversions are strong smelling stuff (sometimes anything hot), and esp.
coffee.  W/ her I would assume any meats, esp. red meats are the worst.

 

Perhaps she could try something w/ a strong, non-metal containing flavor
like tart lemonade or pickled ginger.  One common "trick" is something real
salty tasting (i.e. chips) and then thirst-driven lemonade.  

 

there are couple of older books (early 90's) I found helpful - No More
Morning Sickness by Miriam Erick, RD (Plume Book is the Publisher)  1993.
The other one I can't find at the moment - I think it was simply called
Pickles and Ice-Cream.  Both were really helpful to me when I worked in that
arena more regularly.  

 

Leslee

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Fynan, Carla
Sent: Tuesday, January 13, 2009 1:12 PM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] OB Patient with Metallic Taste

Hello,

 

I did a high risk OB clinic and one of the patients is 6.5 weeks pregnant
and can not eat ANYTHING without tasting metal (describes it as licking an
ashtray).

 

She has lost 12# and does not have it to spare.

 

Has anyone ever had this before and do any of you have ideas?

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


**************************************************************** This email,
including attachments, may include confidential and/or proprietary
information, and may be used only by the person or entity to which it is
addressed. If the reader of this email is not the intended recipient or his
or her authorized agent, the reader is hereby notified that any
dissemination, distribution, or copying of this email is prohibited. If you
received this email in error, please notify the sender by replying to this
message and delete this email immediately. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/87bc34f3/attachment.html 

From Shannon.Jackson at wilmed.org  Tue Jan 13 12:53:33 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Tue, 13 Jan 2009 15:53:33 -0500
Subject: [Cnm] Diarrhea with tube feeding
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF1F3@wmhcs03.wmh.org>

For a 97 year old patient on Osmolite who is having loose, watery stools, are
there any other suggestions for tube feeding formula?
 
We are currently trying Banatrol.  Would you suggest changing to a
fiber-containing formula or maybe Optimental?
 
GI Tract Cultures found nothing. 
 
Thanks,

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/c04a40b7/attachment.html 

From LCarver at Reshealthcare.org  Tue Jan 13 13:12:01 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 13 Jan 2009 15:12:01 -0600
Subject: [Cnm] Diarrhea with tube feeding
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF1F3@wmhcs03.wmh.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03AE5DA2@rhcexch3.reshealthcare.org>

I would suggest a formula w/ soluble fiber (like jevity 1.2) plus adding
a probiotic (ask your pharmacy what they carry).  Leslee

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Tuesday, January 13, 2009 2:54 PM
To: CNM (E-mail)
Subject: [Cnm] Diarrhea with tube feeding


For a 97 year old patient on Osmolite who is having loose, watery
stools, are there any other suggestions for tube feeding formula?
 
We are currently trying Banatrol.  Would you suggest changing to a
fiber-containing formula or maybe Optimental?
 
GI Tract Cultures found nothing. 
 
Thanks,

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
www.wilmed.org <http://www.wilmed.org/> 

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/985c945d/attachment.html 

From cathy.peterjohn at medicorp.org  Tue Jan 13 13:12:46 2009
From: cathy.peterjohn at medicorp.org (cathy.peterjohn at medicorp.org)
Date: Tue, 13 Jan 2009 16:12:46 -0500
Subject: [Cnm] renal MNT CEU's
Message-ID: <OF2D77EDE4.3047BF07-ON8525753D.007453DA-8525753D.007486A2@medicorp.org>


Any ideas for a thorough update of renal nutrition (self study format) that
provides significant CEU's to use toward ADA and CDE? The one from Wolf
Rinke Assoc. we were looking at is under revision and not ready for several
months.







Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA  22401
540-741-1680
Fax: 540-741-4022
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/e9ddd530/attachment.html 

From Phyllis.Kaskel at mountsinai.org  Tue Jan 13 13:18:23 2009
From: Phyllis.Kaskel at mountsinai.org (Kaskel, Phyllis)
Date: Tue, 13 Jan 2009 16:18:23 -0500
Subject: [Cnm] renal MNT CEU's
In-Reply-To: <OF2D77EDE4.3047BF07-ON8525753D.007453DA-8525753D.007486A2@medicorp.org>
Message-ID: <850F6C2F598EF84F8FA5BEF9CC0CC96D03F0AD16@EXCEBW2K325.msnyuhealth.org>

The National Kidney Foundation has several on line programs that are
free.  Each has 2 CEUs.

 

Phyllis Kaskel,  MA, RD, CDN

Director, Clinical Nutrition

Mount Sinai Hospital and

Faculty, Department of Community and Preventive Medicine

Mount Sinai School of Medicine

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of cathy.peterjohn at medicorp.org
Sent: Tuesday, January 13, 2009 4:13 PM
To: cnm at lists.my180.net
Subject: [Cnm] renal MNT CEU's

 

Any ideas for a thorough update of renal nutrition (self study format)
that provides significant CEU's to use toward ADA and CDE? The one from
Wolf Rinke Assoc. we were looking at is under revision and not ready for
several months.







Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA 22401
540-741-1680
Fax: 540-741-4022

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/b04da153/attachment.html 

From Hollie_Colle at ssmhc.com  Tue Jan 13 13:18:41 2009
From: Hollie_Colle at ssmhc.com (Hollie_Colle at ssmhc.com)
Date: Tue, 13 Jan 2009 15:18:41 -0600
Subject: [Cnm] nutrition and respiratory concerns
Message-ID: <OF103CD542.79EB4B2F-ON8625753D.007486FB-8625753D.00751140@SSMHC>

We have been asked to speak at a respiratory therapy conference.  We have 
some topics (critical care/nutrition support, COPD, etc) in mind, but 
looking for any ideas.  Does anyone have a presentation?  Any help would 
greatly appreciated.

Thanks,

Hollie Colle, MS, RD, LDN
Clinical Nutrition Manager
St. Mary's Good Samaritan, Inc. 
Mount Vernon IL 62864 
(618) 241-2356 
Centralia IL 62801
(618) 436-8897
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/49957c9b/attachment.html 

From Jennifer.DeHart at stvhs.com  Tue Jan 13 13:23:20 2009
From: Jennifer.DeHart at stvhs.com (DeHart, Jennifer)
Date: Tue, 13 Jan 2009 15:23:20 -0600
Subject: [Cnm] Nourishments/snacks for breast-feeding patients
Message-ID: <790BE6DACA733D45A2EFE7875E03CC7CDC0DDC@ahcmascdc024.DS.SJHS.COM>

I've tried to search the archives and haven't come up with anything -
we're looking at setting up standard/scheduled snacks for our
breastfeeding patients and wanted some feedback from other facilities.
What have you found successful?  What have you tried that didn't work?
I hate to re-create the wheel -  I appreciate any tips!

Thanks,

Jennifer

 

Jennifer DeHart, MS, RD, LD, CNSD

Clinical Nutrition Manager

St. Vincent's Birmingham

810 St. Vincent's Drive

Birmingham, AL 35202

(205) 939-7012

Pgr: (205) 888-0092

FAX: (205) 930-2433

jennifer.dehart at stvhs.com

 

Confidentiality Notice: This e-mail message, including any attachments
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review; use;
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message.

 

P Please consider the environment before printing this e-mail

 

 


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/0990f000/attachment-0001.html 

From janet.fletcher at eamc.org  Tue Jan 13 13:38:59 2009
From: janet.fletcher at eamc.org (Jan Fletcher)
Date: Tue, 13 Jan 2009 15:38:59 -0600
Subject: [Cnm] Nourishments/snacks for breast-feeding patients
In-Reply-To: <790BE6DACA733D45A2EFE7875E03CC7CDC0DDC@ahcmascdc024.DS.SJHS.COM>
References: <790BE6DACA733D45A2EFE7875E03CC7CDC0DDC@ahcmascdc024.DS.SJHS.COM>
Message-ID: <8AF41BE5480EB240A37098F30EA04FD604E54A28@max.AD.EAMC.ORG>

We send fresh fruit, cookies and PNB crackers as HS snack.

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of DeHart, Jennifer
Sent: Tuesday, January 13, 2009 3:23 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nourishments/snacks for breast-feeding patients

 

I've tried to search the archives and haven't come up with anything -
we're looking at setting up standard/scheduled snacks for our
breastfeeding patients and wanted some feedback from other facilities.
What have you found successful?  What have you tried that didn't work?
I hate to re-create the wheel -  I appreciate any tips!

Thanks,

Jennifer

 

Jennifer DeHart, MS, RD, LD, CNSD

Clinical Nutrition Manager

St. Vincent's Birmingham

810 St. Vincent's Drive

Birmingham, AL 35202

(205) 939-7012

Pgr: (205) 888-0092

FAX: (205) 930-2433

jennifer.dehart at stvhs.com

 

Confidentiality Notice: This e-mail message, including any attachments
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review; use;
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message.

 

P Please consider the environment before printing this e-mail

 

 

 
CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.

 

This email and any files transmitted with it are confidential and
intended solely for the use of the individual or entity to whom they are
addressed. If you have received this email in error please notify the
system manager. This message contains confidential information and is
intended only for the individual named. If you are not the named
addressee you should not disseminate, distribute or copy this e-mail.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/ca148046/attachment.html 

From jlworden at att.net  Tue Jan 13 19:41:02 2009
From: jlworden at att.net (Jo Lynn Worden)
Date: Tue, 13 Jan 2009 21:41:02 -0600
Subject: [Cnm] CEU question
Message-ID: <000c01c975f9$ed01bb70$c7053250$@net>

What has anyone done for CEU's that pertain to management in dietetics?  I
selected Professional Skills (1000) and Leadership, Critical & Strategic
Thinking (1070)on my portfolio. After two years, I am still wondering how to
find things that pertain that are approved through CDR..can anyone point me
in the right direction?  I keep thinking it must be easier than I am making
it? I haven't been able to figure out where to start.

 

Jo Lynn

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/289b80ed/attachment.html 

From kmershon at bak.rr.com  Tue Jan 13 21:45:23 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Tue, 13 Jan 2009 21:45:23 -0800
Subject: [Cnm] Nutritional Analysis of Menus
In-Reply-To: <20090113154504.D9E57B52B4@custmx01.expedient.net>
References: <20090113154504.D9E57B52B4@custmx01.expedient.net>
Message-ID: <0634850C485547BFA9A7A44FC16B1770@KathyPC>

We have CBORD DOMS but the database and nutrient analysis is maintained at our corporate office. The challenge is when we need to change a menu item or revise a recipe. We recently purchased a comprhensive menu program from U.S. Foods that comes with all the nutrient analysis, HACCP, production sheets, and order guides. The menu program is Cygnet. For clarification this is a menu system that will be uploaded into our diet office management system. 

Kathleen Mershon, RD
  ----- Original Message ----- 
  From: Melissa Tewes 
  To: cnm at lists.my180.net 
  Sent: Tuesday, January 13, 2009 7:45 AM
  Subject: [Cnm] Nutritional Analysis of Menus


  What are facilities doing as far as nutritional analysis of patient menus?  Regular Diet Standards only?  Or all therapeutics?

   

  Thanks in advance

   

  Melissa Tewes RD, LDN

  Clinical Nutrition Manager

  Washingon County Health System

  251 East Antietam Street

  Hagerstown, MD 21740

  Phone:  301-790-8084

  Fax:  301-790-8535

   

  mtewes at wchsys.org

   


  ***** CONFIDENTIALITY NOTICE ***** This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. 



------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090113/d5ad135a/attachment.html 

From Dierks.Lisa at mayo.edu  Wed Jan 14 03:59:27 2009
From: Dierks.Lisa at mayo.edu (Dierks, Lisa M., R.D., L.D.)
Date: Wed, 14 Jan 2009 05:59:27 -0600
Subject: [Cnm] CEU question
References: <000c01c975f9$ed01bb70$c7053250$@net>
Message-ID: <CE5737EC36E6EC4A83CDF57D8599E4510378D3C6@msgebe23.mfad.mfroot.org>

I thought with the portfolio system that CDR did not need to approve the program?  Our state and district associations occasionally have topics related to management at their CEU programs.   Because I am at a large institution, our employee education department offers a variety of Mgmt courses, which meet my portfolio for mgmt skills.  

________________________________

From: cnm-bounces at lists.my180.net on behalf of Jo Lynn Worden
Sent: Tue 1/13/2009 9:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] CEU question



What has anyone done for CEU's that pertain to management in dietetics?  I selected Professional Skills (1000) and Leadership, Critical & Strategic Thinking (1070)on my portfolio. After two years, I am still wondering how to find things that pertain that are approved through CDR....can anyone point me in the right direction?  I keep thinking it must be easier than I am making it? I haven't been able to figure out where to start.

 

Jo Lynn

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/eb04dd10/attachment.html 

From Dierks.Lisa at mayo.edu  Wed Jan 14 04:13:43 2009
From: Dierks.Lisa at mayo.edu (Dierks, Lisa M., R.D., L.D.)
Date: Wed, 14 Jan 2009 06:13:43 -0600
Subject: [Cnm] CEU question
References: <000c01c975f9$ed01bb70$c7053250$@net>
	<CE5737EC36E6EC4A83CDF57D8599E4510378D3C6@msgebe23.mfad.mfroot.org>
Message-ID: <CE5737EC36E6EC4A83CDF57D8599E4510378D3C9@msgebe23.mfad.mfroot.org>

I apologize for 2nd posting - has anyone ever attended a course/seminar offered by this company?  http://www.skillpath.com/  I receive fliers from them frequently, but have not attended.

________________________________

From: Dierks, Lisa M., R.D., L.D.
Sent: Wed 1/14/2009 5:59 AM
To: Jo Lynn Worden; cnm at lists.my180.net
Subject: RE: [Cnm] CEU question


I thought with the portfolio system that CDR did not need to approve the program?  Our state and district associations occasionally have topics related to management at their CEU programs.   Because I am at a large institution, our employee education department offers a variety of Mgmt courses, which meet my portfolio for mgmt skills.  

________________________________

From: cnm-bounces at lists.my180.net on behalf of Jo Lynn Worden
Sent: Tue 1/13/2009 9:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] CEU question



What has anyone done for CEU's that pertain to management in dietetics?  I selected Professional Skills (1000) and Leadership, Critical & Strategic Thinking (1070)on my portfolio. After two years, I am still wondering how to find things that pertain that are approved through CDR....can anyone point me in the right direction?  I keep thinking it must be easier than I am making it? I haven't been able to figure out where to start.

 

Jo Lynn

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/e62df518/attachment.html 

From Amy.Gendron at cvmc.org  Wed Jan 14 05:12:43 2009
From: Amy.Gendron at cvmc.org (Gendron, Amy L.)
Date: Wed, 14 Jan 2009 08:12:43 -0500
Subject: [Cnm] Nourishments/snacks for breast-feeding patients
In-Reply-To: <790BE6DACA733D45A2EFE7875E03CC7CDC0DDC@ahcmascdc024.DS.SJHS.COM>
Message-ID: <ED658CF94165704EBE82F8D0D00A3F3605CA0C77@cvmcnt1.cvmc.org>

We (diet techs) used to take the time and effort to go around and ask
new moms what they wanted for snacks. Since we've changed to room
service and since we realized they didn't always eat their snacks, we've
stopped that and instead put a laminated sheet in each room that lists
snacks available on the unit and that they can call room service if they
want something additional.  Snacks on the unit include: bread/toast,
graham crax, saltines, cheddar cheese packets, PB, jelly, honey, cream
cheese, butter/marg, ice cream, sherbet, popsicles, juices, milk, hot
cocoa, coffee, tea, gingerale.  I'd send you the sheet but it's in
Microsoft publisher format.

 

 

Amy Gendron, RD

Senior Inpatient Dietitian

Central Vermont Medical Center

ph: 802-371-4143    fax: 802-371-5376

amy.gendron at cvmc.org

-----Original Message-----
From: DeHart, Jennifer [mailto:Jennifer.DeHart at stvhs.com] 
Sent: Tuesday, January 13, 2009 4:23 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nourishments/snacks for breast-feeding patients

 

I've tried to search the archives and haven't come up with anything -
we're looking at setting up standard/scheduled snacks for our
breastfeeding patients and wanted some feedback from other facilities.
What have you found successful?  What have you tried that didn't work?
I hate to re-create the wheel -  I appreciate any tips!

Thanks,

Jennifer

 

Jennifer DeHart, MS, RD, LD, CNSD

Clinical Nutrition Manager

St. Vincent's Birmingham

810 St. Vincent's Drive

Birmingham, AL 35202

(205) 939-7012

Pgr: (205) 888-0092

FAX: (205) 930-2433

jennifer.dehart at stvhs.com

 

Confidentiality Notice: This e-mail message, including any attachments
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review; use;
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message.

 

P Please consider the environment before printing this e-mail

 

 

 
CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/8939203b/attachment-0001.html 

From tbaton at lmhosp.org  Wed Jan 14 05:14:20 2009
From: tbaton at lmhosp.org (Baton, Terri)
Date: Wed, 14 Jan 2009 08:14:20 -0500
Subject: [Cnm] CEU question
In-Reply-To: <CE5737EC36E6EC4A83CDF57D8599E4510378D3C6@msgebe23.mfad.mfroot.org>
References: <000c01c975f9$ed01bb70$c7053250$@net>
	<CE5737EC36E6EC4A83CDF57D8599E4510378D3C6@msgebe23.mfad.mfroot.org>
Message-ID: <612268DBF47B5E44AB898DB224E392460548A6AE@LMMAIL.lmhosp.local>

I guess CDR does subsequent approval - My employer also provides many
management development seminars, and I have used them with those codes.
They have been approved. TB

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Dierks, Lisa M., R.D., L.D.
Sent: Wednesday, January 14, 2009 6:59 AM
To: Jo Lynn Worden; cnm at lists.my180.net
Subject: Re: [Cnm] CEU question

 

I thought with the portfolio system that CDR did not need to approve the
program?  Our state and district associations occasionally have topics
related to management at their CEU programs.   Because I am at a large
institution, our employee education department offers a variety of Mgmt
courses, which meet my portfolio for mgmt skills.  

 

________________________________

From: cnm-bounces at lists.my180.net on behalf of Jo Lynn Worden
Sent: Tue 1/13/2009 9:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] CEU question

What has anyone done for CEU's that pertain to management in dietetics?
I selected Professional Skills (1000) and Leadership, Critical &
Strategic Thinking (1070)on my portfolio. After two years, I am still
wondering how to find things that pertain that are approved through
CDR....can anyone point me in the right direction?  I keep thinking it
must be easier than I am making it? I haven't been able to figure out
where to start.

 

Jo Lynn


This message (and any included attachments) is from Lawrence & Memorial Corporation, Inc. or one of its affiliates and is intended only for the addressee(s). The information contained herein may include privileged or otherwise confidential information. Unauthorized review, forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you received this message in error, or have reason to believe you are not authorized to receive it, please promptly delete this message and notify the sender by e-mail.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/eed4380a/attachment.html 

From Amy.Gendron at cvmc.org  Wed Jan 14 05:15:03 2009
From: Amy.Gendron at cvmc.org (Gendron, Amy L.)
Date: Wed, 14 Jan 2009 08:15:03 -0500
Subject: [Cnm] CEU question
In-Reply-To: <000c01c975f9$ed01bb70$c7053250$@net>
Message-ID: <ED658CF94165704EBE82F8D0D00A3F3605CA0C78@cvmcnt1.cvmc.org>

Do you precept students at all? Check out cdrnet.educationdirector.com
for 8 free CEUs for online preceptor course made by CDR.

 

 

Amy Gendron, RD

Senior Inpatient Dietitian

Central Vermont Medical Center

ph: 802-371-4143    fax: 802-371-5376

amy.gendron at cvmc.org

-----Original Message-----
From: Jo Lynn Worden [mailto:jlworden at att.net] 
Sent: Tuesday, January 13, 2009 10:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] CEU question

 

What has anyone done for CEU's that pertain to management in dietetics?
I selected Professional Skills (1000) and Leadership, Critical &
Strategic Thinking (1070)on my portfolio. After two years, I am still
wondering how to find things that pertain that are approved through
CDR....can anyone point me in the right direction?  I keep thinking it
must be easier than I am making it? I haven't been able to figure out
where to start.

 

Jo Lynn

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/75aece53/attachment.html 

From mtewes at wchsys.org  Wed Jan 14 05:52:14 2009
From: mtewes at wchsys.org (Melissa Tewes)
Date: Wed, 14 Jan 2009 08:52:14 -0500
Subject: [Cnm] Latex Allergies
Message-ID: <20090114135214.85229B414C@custmx01.expedient.net>

How are these being handled in your facilities?  Do you have a specific
question when a pt has a latex allergy regarding foods?  Or do you assume
they would report a food allergy if they have any associated sensitivities?

 

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washingon County Health System

251 East Antietam Street

Hagerstown, MD 21740

Phone:  301-790-8084

Fax:  301-790-8535

 

mtewes at wchsys.org

 



***** CONFIDENTIALITY NOTICE *****
This message contains confidential information and is intended only for
the individual named. If you are not the named addressee you should not
disseminate, distribute or copy this e-mail. Please notify the sender
immediately by e-mail if you have received this e-mail by mistake and
delete this e-mail from your system.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/412035f8/attachment.html 

From Lori.Zimmerman at ministryhealth.org  Wed Jan 14 07:12:27 2009
From: Lori.Zimmerman at ministryhealth.org (Zimmerman, Lori A)
Date: Wed, 14 Jan 2009 09:12:27 -0600
Subject: [Cnm] CEU question
In-Reply-To: <CE5737EC36E6EC4A83CDF57D8599E4510378D3C9@msgebe23.mfad.mfroot.org>
References: <000c01c975f9$ed01bb70$c7053250$@net>
	<CE5737EC36E6EC4A83CDF57D8599E4510378D3C6@msgebe23.mfad.mfroot.org>
	<CE5737EC36E6EC4A83CDF57D8599E4510378D3C9@msgebe23.mfad.mfroot.org>
Message-ID: <CB047BDA1CB67343A4C829AFB7E45AA10484B45FD4@EXMHCMBX03VS.ministryhealth.net>

Many years ago, they were quite good.


Lori A. Zimmerman MS, RD, CD



________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Dierks, Lisa M., R.D., L.D.
Sent: Wednesday, January 14, 2009 6:14 AM
To: Dierks, Lisa M., R.D., L.D.; Jo Lynn Worden; cnm at lists.my180.net
Subject: Re: [Cnm] CEU question

I apologize for 2nd posting - has anyone ever attended a course/seminar offered by this company?  http://www.skillpath.com/  I receive fliers from them frequently, but have not attended.

________________________________
From: Dierks, Lisa M., R.D., L.D.
Sent: Wed 1/14/2009 5:59 AM
To: Jo Lynn Worden; cnm at lists.my180.net
Subject: RE: [Cnm] CEU question

I thought with the portfolio system that CDR did not need to approve the program?  Our state and district associations occasionally have topics related to management at their CEU programs.   Because I am at a large institution, our employee education department offers a variety of Mgmt courses, which meet my portfolio for mgmt skills.

________________________________
From: cnm-bounces at lists.my180.net on behalf of Jo Lynn Worden
Sent: Tue 1/13/2009 9:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] CEU question

What has anyone done for CEU's that pertain to management in dietetics?  I selected Professional Skills (1000) and Leadership, Critical & Strategic Thinking (1070)on my portfolio. After two years, I am still wondering how to find things that pertain that are approved through CDR....can anyone point me in the right direction?  I keep thinking it must be easier than I am making it? I haven't been able to figure out where to start.

Jo Lynn

________________________________
CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/c651fc42/attachment.html 

From rtripp at PINNACLEHEALTH.org  Wed Jan 14 07:24:06 2009
From: rtripp at PINNACLEHEALTH.org (Roberta Tripp)
Date: Wed, 14 Jan 2009 10:24:06 -0500
Subject: [Cnm] CEU question
In-Reply-To: <000c01c975f9$ed01bb70$c7053250$@net>
Message-ID: <7375E17267B3DB4583032BDEFDA2D76E05DF77DE@mailphs.pinnaclehealth.org>

Does CDR still accept grad credit for CEUs?  I used the classes I took
toward my MS in Health Services Administration for those areas.
 
Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org <mailto:rtripp at pinnaclehealth.org> 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Jo Lynn Worden
Sent: Tuesday, January 13, 2009 10:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] CEU question



What has anyone done for CEU's that pertain to management in dietetics?
I selected Professional Skills (1000) and Leadership, Critical &
Strategic Thinking (1070)on my portfolio. After two years, I am still
wondering how to find things that pertain that are approved through
CDR....can anyone point me in the right direction?  I keep thinking it
must be easier than I am making it? I haven't been able to figure out
where to start.

 

Jo Lynn



The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/fb020099/attachment.html 

From kathleenb at fmchealth.org  Wed Jan 14 07:24:29 2009
From: kathleenb at fmchealth.org (Kathleen Meyer)
Date: Wed, 14 Jan 2009 10:24:29 -0500
Subject: [Cnm] CEU question
In-Reply-To: <CB047BDA1CB67343A4C829AFB7E45AA10484B45FD4@EXMHCMBX03VS.ministryhealth.net>
Message-ID: <EF903244A6329F47AFF009CF471ADD63015B2A8E@ex03.fmchealth.org>

I have attended some management-related programs from skillpath in the past and found them to be very useful.  I have included these in my portfolio.
 
Kathleen Meyer, RD, LD
Assistant Manager, Dietary
Fairifield Medical Center
Lancaster, Ohio 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Zimmerman, Lori A
Sent: Wednesday, January 14, 2009 10:12 AM
To: 'Dierks, Lisa M., R.D., L.D.'; 'Jo Lynn Worden'; 'cnm at lists.my180.net'
Subject: Re: [Cnm] CEU question


Many years ago, they were quite good.
 

Lori A. Zimmerman MS, RD, CD 

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Dierks, Lisa M., R.D., L.D.
Sent: Wednesday, January 14, 2009 6:14 AM
To: Dierks, Lisa M., R.D., L.D.; Jo Lynn Worden; cnm at lists.my180.net
Subject: Re: [Cnm] CEU question


I apologize for 2nd posting - has anyone ever attended a course/seminar offered by this company?  http://www.skillpath.com/  I receive fliers from them frequently, but have not attended.

  _____  

From: Dierks, Lisa M., R.D., L.D.
Sent: Wed 1/14/2009 5:59 AM
To: Jo Lynn Worden; cnm at lists.my180.net
Subject: RE: [Cnm] CEU question


I thought with the portfolio system that CDR did not need to approve the program?  Our state and district associations occasionally have topics related to management at their CEU programs.   Because I am at a large institution, our employee education department offers a variety of Mgmt courses, which meet my portfolio for mgmt skills.  

  _____  

From: cnm-bounces at lists.my180.net on behalf of Jo Lynn Worden
Sent: Tue 1/13/2009 9:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] CEU question



What has anyone done for CEU's that pertain to management in dietetics?  I selected Professional Skills (1000) and Leadership, Critical & Strategic Thinking (1070)on my portfolio. After two years, I am still wondering how to find things that pertain that are approved through CDR....can anyone point me in the right direction?  I keep thinking it must be easier than I am making it? I haven't been able to figure out where to start.

 

Jo Lynn


  _____  

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation.



"Confidentiality Notice: This e-mail message, including any
attachments is for the sole use of the intended recipient(s)
and may contain confidential and privileged information.
Any unauthorized review; use; disclosure or distribution
is prohibited.  If you are not the intended recipient,
please contact the sender by reply e-mail and destroy all copies of
the original message."
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/c2df3c88/attachment-0001.html 

From fynan-carla at CooperHealth.edu  Wed Jan 14 08:43:52 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Wed, 14 Jan 2009 11:43:52 -0500
Subject: [Cnm] obesity
Message-ID: <77F33794DD223B40BF24AB3D37930250172B308EBE@mxmbx01.chsmail.root.cooperhealth.edu>

Good Day!

We get consults for obesity from nursing and physicians and typically the patient has been admitted for another crisis that may or may not be r/t obesity.  We no longer have obesity in our high risk criteria for assessment, however, feel that we need to address obesity as an out patient-LT management plan.

Do any of you have a policy that relates to referrals to out patient dietitians?  We just currently hand out our out patient RD card and jot a note in the chart.

Thank you!

Carla Fynan, RD
Clinical Nutrition Manager
Food & Nutrition Department
Cooper University Hospital
One Cooper Paza
Camden, NJ 08103
(856) 342-2320



****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/b49a30ca/attachment.html 

From LCarver at Reshealthcare.org  Wed Jan 14 08:58:34 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Wed, 14 Jan 2009 10:58:34 -0600
Subject: [Cnm] Latex Allergies
In-Reply-To: <20090114135214.85229B414C@custmx01.expedient.net>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03AE600A@rhcexch3.reshealthcare.org>

we do not put a stop on any foods because of a latex allergy unless we
are told specifically.  Leslee

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Melissa Tewes
Sent: Wednesday, January 14, 2009 7:52 AM
To: cnm at lists.my180.net
Subject: [Cnm] Latex Allergies



How are these being handled in your facilities?  Do you have a specific
question when a pt has a latex allergy regarding foods?  Or do you
assume they would report a food allergy if they have any associated
sensitivities?

 

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washingon County Health System

251 East Antietam Street

Hagerstown, MD 21740

Phone:  301-790-8084

Fax:  301-790-8535

 

mtewes at wchsys.org

 


***** CONFIDENTIALITY NOTICE ***** This message contains confidential
information and is intended only for the individual named. If you are
not the named addressee you should not disseminate, distribute or copy
this e-mail. Please notify the sender immediately by e-mail if you have
received this e-mail by mistake and delete this e-mail from your system.


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/791ef4dd/attachment.html 

From sragland at tanner.org  Wed Jan 14 11:07:25 2009
From: sragland at tanner.org (Shauntel Ragland)
Date: Wed, 14 Jan 2009 14:07:25 -0500
Subject: [Cnm] State of GA: 4 day Emergency Water/Food Supply
Message-ID: <138AE4B62F86AC4D9BC23F0168F106550A072C15@EXCHCLUSTER.ths.local>

CNM List Subscribers in the state of GA - 

 

I would like to know how your facilities are complying with 4 day
emergency water/food supply on-site; specifically storage space for
water and rotation.  In the past I know facilities had agreements with
milk companies to supply water in an emergency but this is no longer
acceptable.

 

Last year the state inspector indicated requirement to have on hand, but
did not ding us for it.   Does any one have suggestions on meeting
compliance in this area? 

 

Thanks in advance!

 

 

 

Shauntel Ragland, MS, RD, LD

System Clinical Nutrition Manager

Tanner Health System

770-836-9147 (o)

770-782-1373 (p)

P Please consider the environment before printing this email

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/6a1824f3/attachment.html 

From sragland at tanner.org  Wed Jan 14 11:12:01 2009
From: sragland at tanner.org (Shauntel Ragland)
Date: Wed, 14 Jan 2009 14:12:01 -0500
Subject: [Cnm] State of GA: 4 day water/food supply
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E03AE600A@rhcexch3.reshealthcare.org>
Message-ID: <138AE4B62F86AC4D9BC23F0168F106550A072C16@EXCHCLUSTER.ths.local>

CNM List Subscribers in the state of GA - 

 

I would like to know how your facilities are complying with 4 day
emergency water/food supply on-site; specifically storage space for
water and rotation.  In the past I know facilities had agreements with
milk companies to supply water in an emergency but this is no longer
acceptable.

 

Last year the state inspector indicated requirement to have on hand, but
did not ding us for it.   Does any one have suggestions on meeting
compliance in this area? 

 

Thanks in advance!

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Carver, Leslee
Sent: Wednesday, January 14, 2009 11:59 AM
To: Melissa Tewes; cnm at lists.my180.net
Subject: Re: [Cnm] Latex Allergies

 

we do not put a stop on any foods because of a latex allergy unless we
are told specifically.  Leslee

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Melissa Tewes
Sent: Wednesday, January 14, 2009 7:52 AM
To: cnm at lists.my180.net
Subject: [Cnm] Latex Allergies

How are these being handled in your facilities?  Do you have a specific
question when a pt has a latex allergy regarding foods?  Or do you
assume they would report a food allergy if they have any associated
sensitivities?

 

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washingon County Health System

251 East Antietam Street

Hagerstown, MD 21740

Phone:  301-790-8084

Fax:  301-790-8535

 

mtewes at wchsys.org

 


***** CONFIDENTIALITY NOTICE ***** This message contains confidential
information and is intended only for the individual named. If you are
not the named addressee you should not disseminate, distribute or copy
this e-mail. Please notify the sender immediately by e-mail if you have
received this e-mail by mistake and delete this e-mail from your system.


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/c4fad075/attachment.html 

From rtripp at PINNACLEHEALTH.org  Wed Jan 14 12:26:34 2009
From: rtripp at PINNACLEHEALTH.org (Roberta Tripp)
Date: Wed, 14 Jan 2009 15:26:34 -0500
Subject: [Cnm] Disaster Menu
Message-ID: <7375E17267B3DB4583032BDEFDA2D76E05DF77EC@mailphs.pinnaclehealth.org>

Has anyone written something into their Disaster Plan menu (for those
situations where your facility has NO power--not even generators) that
patients (except pureed) will be served a regular diet during the
disaster unless the doctor writes another order?  I have been asked to
revise our 5 day menu for the contingency that there are no generators
and no transportation (no refrigerated trucks avaiilable either).  If
all you've got is canned chicken, canned tuna, and peanut butter, it's
somewhat limiting!  I'm not sure how much I need to work at spreading
the diets. I'm guessing canned puree food or baby food would have to
suffice for purees.  Thanks in advance.
 
Roberta
 
Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org <mailto:rtripp at pinnaclehealth.org> 
 


The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/0a02489e/attachment.html 

From janetskates at charter.net  Wed Jan 14 15:46:32 2009
From: janetskates at charter.net (Janet Skates)
Date: Wed, 14 Jan 2009 18:46:32 -0500
Subject: [Cnm] CEU question
In-Reply-To: <7375E17267B3DB4583032BDEFDA2D76E05DF77DE@mailphs.pinnaclehealth.org>
References: <000c01c975f9$ed01bb70$c7053250$@net>
	<7375E17267B3DB4583032BDEFDA2D76E05DF77DE@mailphs.pinnaclehealth.org>
Message-ID: <013101c976a2$544000f0$6400a8c0@Front>

Yes, CDR does still give CPEU credit for academic coursework.  As further
explanation, here is the descriptor from the PDP Guide 

 

100. Academic Coursework

Dietetics-related academic coursework, including distance learning, at a
U.S. regionally accredited college or university can be awarded CPEUs
according to the listing below. Under the activity description on the log
form, indicate whether coursework taken was during a semester, trimester, or
quarter. Academic coursework must be started after practitioner becomes an
RD/DTR, and must be completed in your current recertification cycle in order
to receive CPE credit. After June 1, 2007, the date of completion of
academic coursework can be either the date of notification of successful
course completion, or the date of the final examination required for course
completion.

 

CPEUs Approved            CourseTaken for Credit                   Course
Audited

1 semester credit hour                    15 CPEUs
8 CPEUs

1 trimester credit hour                     14 CPEUs
7 CPEUs

1 quarter credit hour                         10 CPEUs
5 CPEUs

 

 

Janet

Janet Skates MS, RD, LDN, CNSD, FADA

Nutrition Consulting Services

Kingsport, TN  37663

janetskates at yahoo.com

(423) 239-7176

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Roberta Tripp
Sent: Wednesday, January 14, 2009 10:24 AM
To: Jo Lynn Worden; cnm at lists.my180.net
Subject: Re: [Cnm] CEU question

 

Does CDR still accept grad credit for CEUs?  I used the classes I took
toward my MS in Health Services Administration for those areas.

 

Roberta Tripp MS RD LDN

Clinical Nutrition Manager

PinnacleHealth

Department of Food and Nutrition Services

111 S. Front Street

Harrisburg PA  17101

717 782 5283

 <mailto:rtripp at pinnaclehealth.org> rtripp at pinnaclehealth.org

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Jo Lynn Worden
Sent: Tuesday, January 13, 2009 10:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] CEU question

What has anyone done for CEU's that pertain to management in dietetics?  I
selected Professional Skills (1000) and Leadership, Critical & Strategic
Thinking (1070)on my portfolio. After two years, I am still wondering how to
find things that pertain that are approved through CDR..can anyone point me
in the right direction?  I keep thinking it must be easier than I am making
it? I haven't been able to figure out where to start.

 

Jo Lynn

The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/b793e21e/attachment.html 

From kmershon at bak.rr.com  Wed Jan 14 20:23:40 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Wed, 14 Jan 2009 20:23:40 -0800
Subject: [Cnm] CEU question
In-Reply-To: <ED658CF94165704EBE82F8D0D00A3F3605CA0C78@cvmcnt1.cvmc.org>
References: <ED658CF94165704EBE82F8D0D00A3F3605CA0C78@cvmcnt1.cvmc.org>
Message-ID: <53CF3F952D704F3EA563FD80B311937F@KathyPC>

Yes, I have completed this course and required it for all my staff RDs. We are seeing the difference in how we precept our current interns. You will earn every bit of the 8 CEs as it is definitely 8 hours of online learning, but interesting and worth the read. I allowed my staff to work on it as project time and my band newbie has heard so much about it, she is looking forward to taking the course too. 

Kathleen Mershon, RD
  ----- Original Message ----- 
  From: Gendron, Amy L. 
  To: Jo Lynn Worden ; cnm at lists.my180.net 
  Sent: Wednesday, January 14, 2009 5:15 AM
  Subject: Re: [Cnm] CEU question


  Do you precept students at all? Check out cdrnet.educationdirector.com for 8 free CEUs for online preceptor course made by CDR.





  Amy Gendron, RD

  Senior Inpatient Dietitian

  Central Vermont Medical Center

  ph: 802-371-4143    fax: 802-371-5376

  amy.gendron at cvmc.org

  -----Original Message-----
  From: Jo Lynn Worden [mailto:jlworden at att.net] 
  Sent: Tuesday, January 13, 2009 10:41 PM
  To: cnm at lists.my180.net
  Subject: [Cnm] CEU question



  What has anyone done for CEU's that pertain to management in dietetics?  I selected Professional Skills (1000) and Leadership, Critical & Strategic Thinking (1070)on my portfolio. After two years, I am still wondering how to find things that pertain that are approved through CDR..can anyone point me in the right direction?  I keep thinking it must be easier than I am making it? I haven't been able to figure out where to start.



  Jo Lynn



------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090114/538033fc/attachment.html 

From Shannon.Jackson at wilmed.org  Thu Jan 15 05:28:47 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Thu, 15 Jan 2009 08:28:47 -0500
Subject: [Cnm] Calcium supplements and exercise
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF230@wmhcs03.wmh.org>

A physician told a co-worker of mine that if she did not exercise the day
after taking her calcium supplements, there was no point in taking it b/c she
would excrete it through urination. She asked me if that was true.
Has anyone ever heard of this?
Thanks, 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/dad0f2ba/attachment.html 

From Shannon.Jackson at wilmed.org  Thu Jan 15 05:58:22 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Thu, 15 Jan 2009 08:58:22 -0500
Subject: [Cnm] Joint Commission
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF231@wmhcs03.wmh.org>

In preparing for Joint Commission, what type of questions do you ask FNS
staff during Tracers for practice?
 
For example, what 2 patient identifiers do you use when delivering trays?
 
Thanks
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/51ba591b/attachment.html 

From bahrj at southwesthealth.org  Thu Jan 15 06:22:57 2009
From: bahrj at southwesthealth.org (Joan Bahr)
Date: Thu, 15 Jan 2009 08:22:57 -0600
Subject: [Cnm] Joint Commission
In-Reply-To: <3869251104618A4CA35EB2D4021C24D1019D684A@exchange.southwesthealth.org>
References: <3869251104618A4CA35EB2D4021C24D1019D684A@exchange.southwesthealth.org>
Message-ID: <002a01c9771c$c36f9830$4a4ec890$@org>

We use the patient name and birthdate.  We had to alter the "permissions"
for the food service staff in order to gain access to the birthdate. In our
program, the diet census sheet via the computer only lists the age --- not
the birthdate.  The change for the computer vendor is not urgent. 

 

Joan Bahr 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Shannon Byrd Jackson
Sent: Thursday, January 15, 2009 07:58 AM
To: CNM (E-mail)
Subject: [Cnm] Joint Commission

 

In preparing for Joint Commission, what type of questions do you ask FNS
staff during Tracers for practice?

 

For example, what 2 patient identifiers do you use when delivering trays?

 

Thanks

 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/b25ded40/attachment-0001.html 

From YDionne at westerlyhospital.org  Thu Jan 15 06:47:01 2009
From: YDionne at westerlyhospital.org (Yvette Dionne)
Date: Thu, 15 Jan 2009 09:47:01 -0500
Subject: [Cnm] Chewing/swallowing - altered texture diet patients
Message-ID: <E8876826D209234E9756A1C959D0A28F0224592D@whmail.westerlyhospital.local>

 

 
Hello,
I would appreciate some input from the group regarding patients on
altered texture diets and using chewing/swallowing as a trigger for
consults.  
 
As I have worked in a few hospitals in my short career as an RD I know
there are different schools of thought on these issues.  Seeing every
patient on an altered texture diet seems like it adds  to the RD
workload without necessarily improving patient care.  
Many people do fine on altered textures.  Once the appropriate texture
is in place the chewing/swallowing issue has been alleviated.
 
Please, let me know what you are doing and what is working well. 
 
Thank you,
Yvette Dionne, RD, LDN
Westerly Hospital
25 Wells St
Westerly, RI 02891
401-348-3464
may you be well and happy
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/b01718f5/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: aleabanr.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090115/b01718f5/attachment.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 4389 bytes
Desc: Leaves Bkgrd.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090115/b01718f5/attachment.jpe 

From LCarver at Reshealthcare.org  Thu Jan 15 07:03:51 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Thu, 15 Jan 2009 09:03:51 -0600
Subject: [Cnm] CBORD/McKesson
In-Reply-To: <20090114135214.85229B414C@custmx01.expedient.net>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03BB365B@rhcexch3.reshealthcare.org>

Hello all.  We are starting the process of converting from a paper menu
system to CBORD bedside menu entry.  Our hospital computer system is
McKesson Star and we do not have computer order entry by physicians at
this time.  I am having concerns about how to develop the interface
effectively and would appreciate input from anyone else who may have
gone through a similar conversion.
 
Please contact me off the listserve at lcarver at reshealthcare.org or
773-665-3326.  Thank you!
 
Also, if anyone has a job description for the individual who work w/ the
hand-held devises at the bedside and/or the diet office folks who handle
the office end of things, I would greatly appreciate seeing a copy of
those job descriptions.  Thanks again.  
 
Leslee Carver, RD, MSPH, LDN
Clinical Nutrition Manager
Saint Joseph Hospital
Chicago, Il 60657
773-665-3326

________________________________

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/c840ae42/attachment.html 

From Jean_Wingard at URMC.Rochester.edu  Thu Jan 15 07:04:53 2009
From: Jean_Wingard at URMC.Rochester.edu (Wingard, Jean)
Date: Thu, 15 Jan 2009 10:04:53 -0500
Subject: [Cnm] Nutrition Counseling Charges
Message-ID: <F34A580F93101E4A8023D0BE97A167A40128314C@e2k3ms2.urmc-sh.rochester.edu>

For those of you who have outpatient counseling programs or know anyone who does private practice, what are you charging for 1 hour, ? hour and group sessions?  Our hospital is looking at charging a flat rate and not submitting to insurance due to the lack of reimbursement.  I was not present for this discussion and from what I gather; the dollar amount that was thrown out was $20.00 for a visit.  As you can guess, I am appalled that a dietitian's time is only regarded being worth that little.  I guess it is a reminder how much work needs to be done in our field. 

 

I hope this is okay to ask on the list serve- I know that sharing salaries is off limits.  If it is not okay, I apologize and if those willing to share could just email me privately.

 

 

Thanks.

J. Wingard, RD

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/81b30ade/attachment.html 

From LCarver at Reshealthcare.org  Thu Jan 15 07:14:21 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Thu, 15 Jan 2009 09:14:21 -0600
Subject: [Cnm] Nutrition Counseling Charges
In-Reply-To: <F34A580F93101E4A8023D0BE97A167A40128314C@e2k3ms2.urmc-sh.rochester.edu>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03BB3678@rhcexch3.reshealthcare.org>

w/out going into exact dollar figures, I would suggest you check what CMS reimbursement rates are for covered MNT.  It varies somewhat from region to region but is definitely far higher than $20, and is reimbursed in 15 minute increments.  If you have not gone through the process of becoming an MNT provider you really should do that - for legal as well as financial reasons.  Pam Michaels at the ADA is a reimbursement expert and many of us on this list serve have gone through the process.  Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Wingard, Jean
Sent: Thursday, January 15, 2009 9:05 AM
To: CNM Listserv (E-mail 2)
Subject: [Cnm] Nutrition Counseling Charges



For those of you who have outpatient counseling programs or know anyone who does private practice, what are you charging for 1 hour, ? hour and group sessions?  Our hospital is looking at charging a flat rate and not submitting to insurance due to the lack of reimbursement.  I was not present for this discussion and from what I gather; the dollar amount that was thrown out was $20.00 for a visit.  As you can guess, I am appalled that a dietitian's time is only regarded being worth that little.  I guess it is a reminder how much work needs to be done in our field. 

 

I hope this is okay to ask on the list serve- I know that sharing salaries is off limits.  If it is not okay, I apologize and if those willing to share could just email me privately.

 

 

Thanks.

J. Wingard, RD

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/a78ba5be/attachment.html 

From Janet.Barcroft at HCAhealthcare.com  Thu Jan 15 08:30:14 2009
From: Janet.Barcroft at HCAhealthcare.com (Barcroft Janet)
Date: Thu, 15 Jan 2009 10:30:14 -0600
Subject: [Cnm] Meal times
Message-ID: <65833C2337856946BD02F46A4DC8E8A1420EC9C9@NADCWPMSGCMS07.hca.corpad.net>

We are currently working on a Lean Healthcare project.  For our Rehab pt's no more than 14 hours can pass between dinner and bfst.  I am supposing this is a Medicare requirement and would be the same for all hospital patients.  Is this correct?



Janet Barcroft, RD,LDN
Clinical Nutrition Manager
Skyline Medical Center
Nashville, TN  37207
(615) 769-2243  Pager (615) 923-8014
Janet.Barcroft at HCAHealthcare.com

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/733929c9/attachment-0001.html 

From janetskates at charter.net  Thu Jan 15 09:01:32 2009
From: janetskates at charter.net (Janet Skates)
Date: Thu, 15 Jan 2009 12:01:32 -0500
Subject: [Cnm] CEU question
In-Reply-To: <CE5737EC36E6EC4A83CDF57D8599E4510378D3C6@msgebe23.mfad.mfroot.org>
References: <000c01c975f9$ed01bb70$c7053250$@net>
	<CE5737EC36E6EC4A83CDF57D8599E4510378D3C6@msgebe23.mfad.mfroot.org>
Message-ID: <01e001c97732$eadfb790$6400a8c0@Front>

You are right, CDR does not have to prior approve lectures and seminars in
the PDP system.  This is from CDR . . .

 

"Lecture/seminars (that are not self-study materials) do not have to be
prior-approved by CDR in order for the RD or DTR to receive CPEUs.   That
having been said, sometimes practitioners prefer prior-approved courses, and
some state licensing boards require prior-approval for their required CE.
If the practitioner wishes to find such CPE activities, they are listed in
CDR's CPE Online Database at www.cdrnet.org   Searching for CPE activities
related to learning need code 1070 Leadership, critical and strategic
thinking yields 90 different CPE activities .  One hint when searching the
database, is to start with fewer search criteria to yield maximum results."

 

Janet

Janet Skates MS, RD, LDN, CNSD, FADA

Nutrition Consulting Services

Kingsport, TN  37663

janetskates at yahoo.com

(423) 239-7176

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Dierks, Lisa M., R.D., L.D.
Sent: Wednesday, January 14, 2009 6:59 AM
To: Jo Lynn Worden; cnm at lists.my180.net
Subject: Re: [Cnm] CEU question

 

I thought with the portfolio system that CDR did not need to approve the
program?  Our state and district associations occasionally have topics
related to management at their CEU programs.   Because I am at a large
institution, our employee education department offers a variety of Mgmt
courses, which meet my portfolio for mgmt skills.  

 

  _____  

From: cnm-bounces at lists.my180.net on behalf of Jo Lynn Worden
Sent: Tue 1/13/2009 9:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] CEU question

What has anyone done for CEU's that pertain to management in dietetics?  I
selected Professional Skills (1000) and Leadership, Critical & Strategic
Thinking (1070)on my portfolio. After two years, I am still wondering how to
find things that pertain that are approved through CDR..can anyone point me
in the right direction?  I keep thinking it must be easier than I am making
it? I haven't been able to figure out where to start.

 

Jo Lynn

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/c7d65741/attachment.html 

From Heberle-Heather at aramark.com  Thu Jan 15 09:30:40 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Thu, 15 Jan 2009 11:30:40 -0600
Subject: [Cnm] Chewing/swallowing - altered texture diet patients
In-Reply-To: <mailman.2329.1232037019.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.2329.1232037019.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <64622046-F32A-4222-B98C-6AF799FDB401@mimectl>

We do not see patients due to altered texture diet or chew/swallow trouble.  We currently screen for the following dietary reasons: 
?          Full Liquid Diet > 7 days
?          Diet providing < 1000 kcal for > 4 days
?          Sodium Restriction of < 1 gm
?          Gluten Free
?          Protein Restricted
?          Fluid Restriction < 1000 ml
?          Mineral restriction other than sodium
We used to use chew/swallow trouble as a screen trigger on our admission screen but removed it due to nursing put in a consult due to the patient having dentures,etc.


Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879
Heberle-Heather at aramark.com
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/14f68007/attachment.html 

From Heberle-Heather at aramark.com  Thu Jan 15 09:32:32 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Thu, 15 Jan 2009 11:32:32 -0600
Subject: [Cnm] Nutrition Counseling Charges
In-Reply-To: <mailman.2329.1232037019.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.2329.1232037019.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <B171D99A-EE7A-480C-8D77-8F13EB18CCDA@mimectl>

We currently charge ~$80/hour or $20 per 15 minutes.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879
Heberle-Heather at aramark.com
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/fe8acdb9/attachment.html 

From sheila.walsh at nahealth.com  Thu Jan 15 09:40:14 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Thu, 15 Jan 2009 10:40:14 -0700
Subject: [Cnm] Meal times
In-Reply-To: <65833C2337856946BD02F46A4DC8E8A1420EC9C9@NADCWPMSGCMS07.hca.corpad.net>
References: <65833C2337856946BD02F46A4DC8E8A1420EC9C9@NADCWPMSGCMS07.hca.corpad.net>
Message-ID: <496F128E.485B.0001.0@nahealth.com>

Most States have a time requirement between dinner and breakfast for
long term care patient homes.  You can check with your Dept of Health
Services for the requirement.

>>> "Barcroft Janet" <Janet.Barcroft at HCAhealthcare.com> 1/15/2009 9:30
AM >>>

We are currently working on a Lean Healthcare project.  For our Rehab
pt?s no more than 14 hours can pass between dinner and bfst.  I am
supposing this is a Medicare requirement and would be the same for all
hospital patients.  Is this correct?  
 
 
 
Janet Barcroft, RD,LDN
Clinical Nutrition Manager
SkylineMedical Center
Nashville, TN  37207
(615) 769-2243  Pager (615) 923-8014
Janet.Barcroft at HCAHealthcare.com
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/183fd7cc/attachment.html 

From aimeenut at yahoo.com  Thu Jan 15 09:52:59 2009
From: aimeenut at yahoo.com (aimee crant)
Date: Thu, 15 Jan 2009 09:52:59 -0800 (PST)
Subject: [Cnm] exercise & calories
Message-ID: <419633.20271.qm@web52605.mail.re2.yahoo.com>

Does anyone have any good handouts for nutrition month on these topics?? Thanks
?Aimee Crant-Oksa MS, RD
Clinical Nutrition Manager
Centrastate Medical Center
tel: 732-294-2767
email: acrantok at centrastate.com 


      


From sherrythrash at comcast.net  Thu Jan 15 10:34:46 2009
From: sherrythrash at comcast.net (sherrythrash at comcast.net)
Date: Thu, 15 Jan 2009 18:34:46 +0000
Subject: [Cnm] Liberalization of diets in acute care
Message-ID: <011520091834.19665.496F81C6000ABF7C00004CD12200750784089C0E9D089B979D9D0A089C@comcast.net>

Hello all,
We've had an issue come up here with our head of nursing requesting that we "liberalize" most all of our diets which would necessitate the discontinuation of many of our diets. I believe that they are looking for us to get rid of diets such as our consistent CHO, reduced na+, renal, cardiac, etc... 
What are everyone's opinion on this matter? I know that liberalization of diets is common in long term care for obvious reasons- but there are different schools of thought regarding the acute care setting.
Does anyone out there have any experience and/or research in this subject?
TIA for your responses!

--
Regards, 
Sherry Zalewski Thrash, RD, LDN

The Chester County Hospital
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/5e769ce2/attachment.html 

From jonessl at upmc.edu  Thu Jan 15 10:43:57 2009
From: jonessl at upmc.edu (Jones, Sherri)
Date: Thu, 15 Jan 2009 13:43:57 -0500
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <011520091834.19665.496F81C6000ABF7C00004CD12200750784089C0E9D089B979D9D0A089C@comcast.net>
References: <011520091834.19665.496F81C6000ABF7C00004CD12200750784089C0E9D089B979D9D0A089C@comcast.net>
Message-ID: <5AF9B08B39F8AD4380E2797E4125AEA1E8668485@msxmbxnsprd17.acct.upmchs.net>

Sherry - I have extensive experience with this. Back in 2004 we implemented a Liberalized Diet Program at University of Pittsburgh Medical Center - an acute care system of hospitals. I wrote an article about it in a past issue of CNM Newsletter. You can access it via the CNM website newsletter archives. It is edition Winter 2006. If you have questions after you read the article just pop me an email.

Sherri
Sherri L. Jones, MS, RD, LDN
Clinical Nutrition Manager
UPMC Shadyside
Phone: (412) 623-1629
Pager: (412) 263-8518
Fax: (412) 6232429
jonessl at upmc.edu<mailto:jonessl at upmc.edu>
________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of sherrythrash at comcast.net
Sent: Thursday, January 15, 2009 1:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Liberalization of diets in acute care

Hello all,
We've had an issue come up here with our head of nursing requesting that we "liberalize" most all of our diets which would necessitate the discontinuation of many of our diets. I believe that they are looking for us to get rid of diets such as our consistent CHO, reduced na+, renal, cardiac, etc...
What are everyone's opinion on this matter? I know that liberalization of diets is common in long term care for obvious reasons- but there are different schools of thought regarding the acute care setting.
Does anyone out there have any experience and/or research in this subject?
TIA for your responses!

--
Regards,
Sherry Zalewski Thrash, RD, LDN

The Chester County Hospital
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/caab74e0/attachment-0001.html 

From sheila.walsh at nahealth.com  Thu Jan 15 11:33:23 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Thu, 15 Jan 2009 12:33:23 -0700
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <011520091834.19665.496F81C6000ABF7C00004CD12200750784089C0E9D089B979D9D0A089C@comcast.net>
References: <011520091834.19665.496F81C6000ABF7C00004CD12200750784089C0E9D089B979D9D0A089C@comcast.net>
Message-ID: <496F2D12.485B.0001.0@nahealth.com>

My experience with the push to liberalize diets ended in a stalemate.  I requested support from the physicians treating the patients because my food svc supervisor was an Army Lt-Co and she wanted to switch to all MREs.  I took a survey of all patients on therapeutic diets and learned that 98% of them follow a therapeutic diet at home.  To give them salt and sugar would have been terribly confusing and would have complicated their hospital stays.
 
So, my suggestion is to survey at least 100 patients and talk to all of the doctors that you can to help with this situation.  The next step is to eliminate the need for dietitians.  Horrors!!!
 
 
Sheila A. Walsh, MPH, RD
Nutrition Services Coordinator

"My gold neither sparkles nor jingles.  
It glistens in the sunlight & whinnies in the darkness."
 


>>> <sherrythrash at comcast.net> 1/15/2009 11:34 AM >>>
Hello all,
We've had an issue come up here with our head of nursing requesting that we "liberalize" most all of our diets which would necessitate the discontinuation of many of our diets. I believe that they are looking for us to get rid of diets such as our consistent CHO, reduced na+, renal, cardiac, etc... 
What are everyone's opinion on this matter? I know that liberalization of diets is common in long term care for obvious reasons- but there are different schools of thought regarding the acute care setting.
Does anyone out there have any experience and/or research in this subject?
TIA for your responses!
 
--
Regards, 
Sherry Zalewski Thrash, RD, LDN
 
The Chester County Hospital
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/ba726800/attachment.html 

From lbarker at randolphhospital.org  Thu Jan 15 11:39:30 2009
From: lbarker at randolphhospital.org (Barker, Linda)
Date: Thu, 15 Jan 2009 14:39:30 -0500
Subject: [Cnm] Nutrition needs
Message-ID: <95A089DB69910A4D96FE2627A27D78E5255654F3FB@RH-EXCH02.rhnc.org>

Hi,  I'm looking for help determining nutritional needs for the following patient:

57 yo male admitted with infected sacral decub, s/p debridement, currently NPO
Ht:  6' 2"   Weight:  440 pounds
Hx:  Diet controlled DM, DJD, non-ambulatory for last 3 years, morbid obesity
COPD-on home oxygen, OSA, decubs
MD has already mentioned diet and weight loss

Thanks!
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/2a58fc69/attachment.html 

From Janet.Ross at healthall.com  Thu Jan 15 12:03:02 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Thu, 15 Jan 2009 15:03:02 -0500
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <496F2D12.485B.0001.0@nahealth.com>
References: <011520091834.19665.496F81C6000ABF7C00004CD12200750784089C0E9D089B979D9D0A089C@comcast.net>
	<496F2D12.485B.0001.0@nahealth.com>
Message-ID: <41CA05D55BF105489D33F8E57D71A90517169866C1@MAIL-C.healthall.com>

I would suggest to all that a regular diet in the institution is healthier than most people eat at home; therefore, we have already restricted them and "low sodium" or "low fat" is probably not necessary.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Sheila Walsh
Sent: Thursday, January 15, 2009 2:33 PM
To: sherrythrash at comcast.net; cnm at lists.my180.net
Subject: Re: [Cnm] Liberalization of diets in acute care

My experience with the push to liberalize diets ended in a stalemate.  I requested support from the physicians treating the patients because my food svc supervisor was an Army Lt-Co and she wanted to switch to all MREs.  I took a survey of all patients on therapeutic diets and learned that 98% of them follow a therapeutic diet at home.  To give them salt and sugar would have been terribly confusing and would have complicated their hospital stays.

So, my suggestion is to survey at least 100 patients and talk to all of the doctors that you can to help with this situation.  The next step is to eliminate the need for dietitians.  Horrors!!!


Sheila A. Walsh, MPH, RD
Nutrition Services Coordinator
"My gold neither sparkles nor jingles.
It glistens in the sunlight & whinnies in the darkness."




>>> <sherrythrash at comcast.net> 1/15/2009 11:34 AM >>>
Hello all,
We've had an issue come up here with our head of nursing requesting that we "liberalize" most all of our diets which would necessitate the discontinuation of many of our diets. I believe that they are looking for us to get rid of diets such as our consistent CHO, reduced na+, renal, cardiac, etc...
What are everyone's opinion on this matter? I know that liberalization of diets is common in long term care for obvious reasons- but there are different schools of thought regarding the acute care setting.
Does anyone out there have any experience and/or research in this subject?
TIA for your responses!

--
Regards,
Sherry Zalewski Thrash, RD, LDN

The Chester County Hospital

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/b4f2d7cb/attachment.html 

From NEgelhofer at saintjosephri.com  Thu Jan 15 12:47:57 2009
From: NEgelhofer at saintjosephri.com (Egelhofer, Nancy)
Date: Thu, 15 Jan 2009 15:47:57 -0500
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <41CA05D55BF105489D33F8E57D71A90517169866C1@MAIL-C.healthall.com>
Message-ID: <EDA5D3F1218538449BB79A345387487EE90364@exchange-2.sjhs.local>

Liberalization, as I understand it, means limiting the number and
severity of restricted diets.  For example, in a nursing home, they may
have a Limited Concentrated Sweets (no regular soda, no regular pancake
syrup), a No Added Salt (no salt packet and limits to very high sodium
foods > 400mg per serving) and a Regular.  There have been studies that
show patients following these "liberal" diets do as well as those on
"cardiac (lowfat, low chol, 2 gm Na)" or Consistent CHO or Renal diets
in the long term.

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Ross, Janet
Sent: Thursday, January 15, 2009 3:03 PM
To: 'Sheila Walsh'; sherrythrash at comcast.net; cnm at lists.my180.net
Subject: Re: [Cnm] Liberalization of diets in acute care



I would suggest to all that a regular diet in the institution is
healthier than most people eat at home; therefore, we have already
restricted them and "low sodium" or "low fat" is probably not necessary.

 

Janet V. Ross, MBA,RD,LD

Clinical Nutrition Coordinator

Drake Center

janet.ross at healthall.com

http://www.health-alliance.com/

ph 513-418-2603

fx 513-418-5939

pg 513-577-6879

P Please consider the environment before printing.

 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sheila Walsh
Sent: Thursday, January 15, 2009 2:33 PM
To: sherrythrash at comcast.net; cnm at lists.my180.net
Subject: Re: [Cnm] Liberalization of diets in acute care

 

My experience with the push to liberalize diets ended in a stalemate.  I
requested support from the physicians treating the patients because my
food svc supervisor was an Army Lt-Co and she wanted to switch to all
MREs.  I took a survey of all patients on therapeutic diets and learned
that 98% of them follow a therapeutic diet at home.  To give them salt
and sugar would have been terribly confusing and would have complicated
their hospital stays.

 

So, my suggestion is to survey at least 100 patients and talk to all of
the doctors that you can to help with this situation.  The next step is
to eliminate the need for dietitians.  Horrors!!!

 

 

Sheila A. Walsh, MPH, RD
Nutrition Services Coordinator

"My gold neither sparkles nor jingles.  
It glistens in the sunlight & whinnies in the darkness."


 



>>> <sherrythrash at comcast.net> 1/15/2009 11:34 AM >>>

Hello all,

We've had an issue come up here with our head of nursing requesting that
we "liberalize" most all of our diets which would necessitate the
discontinuation of many of our diets. I believe that they are looking
for us to get rid of diets such as our consistent CHO, reduced na+,
renal, cardiac, etc... 

What are everyone's opinion on this matter? I know that liberalization
of diets is common in long term care for obvious reasons- but there are
different schools of thought regarding the acute care setting.

Does anyone out there have any experience and/or research in this
subject?

TIA for your responses!

 

--
Regards, 
Sherry Zalewski Thrash, RD, LDN

 

The Chester County Hospital


________________________________

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message.



(THIS DOCUMENT IS INTENDED ONLY FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED.  IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL, AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW.)  If you are not the intended recipient any dissemination, distribution, copying or use of this document is strictly prohibited.  If you have received this communication in error, please notify me immediately at the email address above and delete all copies of this communication.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/737aad58/attachment.html 

From kharriso at stagnes.org  Thu Jan 15 12:51:18 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Thu, 15 Jan 2009 14:51:18 -0600
Subject: [Cnm] Hospitals in MD, DC, Va and PA
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B3925708E@ahcmascdc034.DS.SJHS.COM>

Hi,

 

I am looking for Hospitals in these areas that use a clinical ladder
approved by their HR.  I made a proposal to my HR and they would like
references of hospitals in the area that she can speak with.  Thank you
so much.

 

Kerry Harrison

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

 


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/780fe358/attachment.html 

From sdehoog at u.washington.edu  Thu Jan 15 13:12:28 2009
From: sdehoog at u.washington.edu (susan)
Date: Thu, 15 Jan 2009 13:12:28 -0800 (PST)
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <41CA05D55BF105489D33F8E57D71A90517169866C1@MAIL-C.healthall.com>
Message-ID: <Pine.LNX.4.43.0901151312280.10191@hymn32.u.washington.edu>

I agree with Janet - the patients want food that is more like home and in resturants.  When we put in all the "restricted" diets they complain about our food not tasting good.  Down goes the Press Ganey scores.

We try to get all our patients on general diets - especially if they are not eating well. We also have room service menus and I got pretty liberal in the creation of the menus and approval of the recipes - the diabetic patient chooses from the general menu (has CHO count on it)



> I would suggest to all that a regular diet in the institution is healthier than most people eat at home; therefore, we have already restricted them and "low sodium" or "low fat" is probably not necessary.
>
> Janet V. Ross, MBA,RD,LD
> Clinical Nutrition Coordinator
> Drake Center
> janet.ross at healthall.com
> http://www.health-alliance.com/
> ph 513-418-2603
> fx 513-418-5939
> pg 513-577-6879
> P Please consider the environment before printing.
>
>
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Sheila Walsh
> Sent: Thursday, January 15, 2009 2:33 PM
> To: sherrythrash at comcast.net; cnm at lists.my180.net
> Subject: Re: [Cnm] Liberalization of diets in acute care
>
> My experience with the push to liberalize diets ended in a stalemate.  I requested support from the physicians treating the patients because my food svc supervisor was an Army Lt-Co and she wanted to switch to all MREs.  I took a survey of all patients on therapeutic diets and learned that 98% of them follow a therapeutic diet at home.  To give them salt and sugar would have been terribly confusing and would have complicated their hospital stays.
>
> So, my suggestion is to survey at least 100 patients and talk to all of the doctors that you can to help with this situation.  The next step is to eliminate the need for dietitians.  Horrors!!!
>
>
> Sheila A. Walsh, MPH, RD
> Nutrition Services Coordinator
> "My gold neither sparkles nor jingles.
> It glistens in the sunlight & whinnies in the darkness."
>
>
>
>
>>>> <sherrythrash at comcast.net> 1/15/2009 11:34 AM >>>
> Hello all,
> We've had an issue come up here with our head of nursing requesting that we "liberalize" most all of our diets which would necessitate the discontinuation of many of our diets. I believe that they are looking for us to get rid of diets such as our consistent CHO, reduced na+, renal, cardiac, etc...
> What are everyone's opinion on this matter? I know that liberalization of diets is common in long term care for obvious reasons- but there are different schools of thought regarding the acute care setting.
> Does anyone out there have any experience and/or research in this subject?
> TIA for your responses!
>
> --
> Regards,
> Sherry Zalewski Thrash, RD, LDN
>
> The Chester County Hospital
>
> ________________________________
> Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
>

Susan DeHoog
Associate Director
Food and Nutrition
University of Washington Medical Center
BOX 356057
Seattle Washington 98195
(206) 598-4533
email  sdehoog at u.washington.edu
FAX (206) 598-8105
pager (206)540-8874




From Lori.Zimmerman at ministryhealth.org  Thu Jan 15 13:50:01 2009
From: Lori.Zimmerman at ministryhealth.org (Zimmerman, Lori A)
Date: Thu, 15 Jan 2009 15:50:01 -0600
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <Pine.LNX.4.43.0901151312280.10191@hymn32.u.washington.edu>
References: <41CA05D55BF105489D33F8E57D71A90517169866C1@MAIL-C.healthall.com>
	<Pine.LNX.4.43.0901151312280.10191@hymn32.u.washington.edu>
Message-ID: <CB047BDA1CB67343A4C829AFB7E45AA10484B46385@EXMHCMBX03VS.ministryhealth.net>

How liberal do you get with Sodium?  We use a very low sodium mashed potato which I personally think is awful. However was the only product low enough in sodium that we could use across the board.  What are others doing?


Lori A. Zimmerman MS, RD, CD

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of susan
Sent: Thursday, January 15, 2009 3:12 PM
To: Ross, Janet
Cc: cnm at lists.my180.net; 'Sheila Walsh'
Subject: Re: [Cnm] Liberalization of diets in acute care

I agree with Janet - the patients want food that is more like home and in resturants.  When we put in all the "restricted" diets they complain about our food not tasting good.  Down goes the Press Ganey scores.

We try to get all our patients on general diets - especially if they are not eating well. We also have room service menus and I got pretty liberal in the creation of the menus and approval of the recipes - the diabetic patient chooses from the general menu (has CHO count on it)



> I would suggest to all that a regular diet in the institution is healthier than most people eat at home; therefore, we have already restricted them and "low sodium" or "low fat" is probably not necessary.
>
> Janet V. Ross, MBA,RD,LD
> Clinical Nutrition Coordinator
> Drake Center
> janet.ross at healthall.com
> http://www.health-alliance.com/
> ph 513-418-2603
> fx 513-418-5939
> pg 513-577-6879
> P Please consider the environment before printing.
>
>
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Sheila Walsh
> Sent: Thursday, January 15, 2009 2:33 PM
> To: sherrythrash at comcast.net; cnm at lists.my180.net
> Subject: Re: [Cnm] Liberalization of diets in acute care
>
> My experience with the push to liberalize diets ended in a stalemate.  I requested support from the physicians treating the patients because my food svc supervisor was an Army Lt-Co and she wanted to switch to all MREs.  I took a survey of all patients on therapeutic diets and learned that 98% of them follow a therapeutic diet at home.  To give them salt and sugar would have been terribly confusing and would have complicated their hospital stays.
>
> So, my suggestion is to survey at least 100 patients and talk to all of the doctors that you can to help with this situation.  The next step is to eliminate the need for dietitians.  Horrors!!!
>
>
> Sheila A. Walsh, MPH, RD
> Nutrition Services Coordinator
> "My gold neither sparkles nor jingles.
> It glistens in the sunlight & whinnies in the darkness."
>
>
>
>
>>>> <sherrythrash at comcast.net> 1/15/2009 11:34 AM >>>
> Hello all,
> We've had an issue come up here with our head of nursing requesting that we "liberalize" most all of our diets which would necessitate the discontinuation of many of our diets. I believe that they are looking for us to get rid of diets such as our consistent CHO, reduced na+, renal, cardiac, etc...
> What are everyone's opinion on this matter? I know that liberalization of diets is common in long term care for obvious reasons- but there are different schools of thought regarding the acute care setting.
> Does anyone out there have any experience and/or research in this subject?
> TIA for your responses!
>
> --
> Regards,
> Sherry Zalewski Thrash, RD, LDN
>
> The Chester County Hospital
>
> ________________________________
> Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
>

Susan DeHoog
Associate Director
Food and Nutrition
University of Washington Medical Center
BOX 356057
Seattle Washington 98195
(206) 598-4533
email  sdehoog at u.washington.edu
FAX (206) 598-8105
pager (206)540-8874



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation.


From Annalynn_Skipper at Comcast.net  Thu Jan 15 14:12:32 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Thu, 15 Jan 2009 16:12:32 -0600
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <Pine.LNX.4.43.0901151312280.10191@hymn32.u.washington.edu>
References: <41CA05D55BF105489D33F8E57D71A90517169866C1@MAIL-C.healthall.com>
	<Pine.LNX.4.43.0901151312280.10191@hymn32.u.washington.edu>
Message-ID: <8F77ED6086A84E90A2C4312C61675611@ANNALYNN>

There are several different approaches to "liberalizing" diets.  We added a
brief review of these issues to the most recent edition of ADA's Nutrition
Care Manual.  You'll find it under the "ordering the diet prescription"
section.  I hope it's helpful.      

Annalynn

Annalynn Skipper Ph.D., R.D., FADA

a consultancy devoted to advancing nutrition practice
P.O. Box 45
Oak Park, IL 60303
Annalynn_Skipper at Comcast.net
Advanced Medical Nutrition Therapy Practice, 
a 2008 text, is available from Jones and Bartlett. 


-----Original Message-----
From: susan [mailto:sdehoog at u.washington.edu] 
Sent: Thursday, January 15, 2009 3:12 PM
To: Ross, Janet
Cc: cnm at lists.my180.net; 'Sheila Walsh'
Subject: Re: [Cnm] Liberalization of diets in acute care

I agree with Janet - the patients want food that is more like home and in
resturants.  When we put in all the "restricted" diets they complain about
our food not tasting good.  Down goes the Press Ganey scores.

We try to get all our patients on general diets - especially if they are not
eating well. We also have room service menus and I got pretty liberal in the
creation of the menus and approval of the recipes - the diabetic patient
chooses from the general menu (has CHO count on it)



> I would suggest to all that a regular diet in the institution is healthier
than most people eat at home; therefore, we have already restricted them and
"low sodium" or "low fat" is probably not necessary.
>
> Janet V. Ross, MBA,RD,LD
> Clinical Nutrition Coordinator
> Drake Center
> janet.ross at healthall.com
> http://www.health-alliance.com/
> ph 513-418-2603
> fx 513-418-5939
> pg 513-577-6879
> P Please consider the environment before printing.
>
>
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Sheila Walsh
> Sent: Thursday, January 15, 2009 2:33 PM
> To: sherrythrash at comcast.net; cnm at lists.my180.net
> Subject: Re: [Cnm] Liberalization of diets in acute care
>
> My experience with the push to liberalize diets ended in a stalemate.  I
requested support from the physicians treating the patients because my food
svc supervisor was an Army Lt-Co and she wanted to switch to all MREs.  I
took a survey of all patients on therapeutic diets and learned that 98% of
them follow a therapeutic diet at home.  To give them salt and sugar would
have been terribly confusing and would have complicated their hospital
stays.
>
> So, my suggestion is to survey at least 100 patients and talk to all of
the doctors that you can to help with this situation.  The next step is to
eliminate the need for dietitians.  Horrors!!!
>
>
> Sheila A. Walsh, MPH, RD
> Nutrition Services Coordinator
> "My gold neither sparkles nor jingles.
> It glistens in the sunlight & whinnies in the darkness."
>
>
>
>
>>>> <sherrythrash at comcast.net> 1/15/2009 11:34 AM >>>
> Hello all,
> We've had an issue come up here with our head of nursing requesting that
we "liberalize" most all of our diets which would necessitate the
discontinuation of many of our diets. I believe that they are looking for us
to get rid of diets such as our consistent CHO, reduced na+, renal, cardiac,
etc...
> What are everyone's opinion on this matter? I know that liberalization of
diets is common in long term care for obvious reasons- but there are
different schools of thought regarding the acute care setting.
> Does anyone out there have any experience and/or research in this subject?
> TIA for your responses!
>
> --
> Regards,
> Sherry Zalewski Thrash, RD, LDN
>
> The Chester County Hospital
>
> ________________________________
> Confidentiality Notice: This e-mail message, including any attachments, is
for the sole use of the intended recipient(s) and may contain confidential
and privileged information. Any unauthorized review, use, disclosure or
distribution is prohibited. If you are not the intended recipient, please
contact the sender by reply e-mail and destroy all copies of the original
message.
>

Susan DeHoog
Associate Director
Food and Nutrition
University of Washington Medical Center
BOX 356057
Seattle Washington 98195
(206) 598-4533
email  sdehoog at u.washington.edu
FAX (206) 598-8105
pager (206)540-8874







From janet.fletcher at eamc.org  Thu Jan 15 14:05:50 2009
From: janet.fletcher at eamc.org (Jan Fletcher)
Date: Thu, 15 Jan 2009 16:05:50 -0600
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <CB047BDA1CB67343A4C829AFB7E45AA10484B46385@EXMHCMBX03VS.ministryhealth.net>
References: <41CA05D55BF105489D33F8E57D71A90517169866C1@MAIL-C.healthall.com><Pine.LNX.4.43.0901151312280.10191@hymn32.u.washington.edu>
	<CB047BDA1CB67343A4C829AFB7E45AA10484B46385@EXMHCMBX03VS.ministryhealth.net>
Message-ID: <8AF41BE5480EB240A37098F30EA04FD604E55889@max.AD.EAMC.ORG>

We mix ours half and half.  Half very low sodium flakes and half
regular.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Zimmerman, Lori A
Sent: Thursday, January 15, 2009 3:50 PM
To: 'susan'; 'Ross, Janet'
Cc: 'cnm at lists.my180.net'; 'Sheila Walsh'
Subject: Re: [Cnm] Liberalization of diets in acute care

How liberal do you get with Sodium?  We use a very low sodium mashed
potato which I personally think is awful. However was the only product
low enough in sodium that we could use across the board.  What are
others doing?


Lori A. Zimmerman MS, RD, CD

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of susan
Sent: Thursday, January 15, 2009 3:12 PM
To: Ross, Janet
Cc: cnm at lists.my180.net; 'Sheila Walsh'
Subject: Re: [Cnm] Liberalization of diets in acute care

I agree with Janet - the patients want food that is more like home and
in resturants.  When we put in all the "restricted" diets they complain
about our food not tasting good.  Down goes the Press Ganey scores.

We try to get all our patients on general diets - especially if they are
not eating well. We also have room service menus and I got pretty
liberal in the creation of the menus and approval of the recipes - the
diabetic patient chooses from the general menu (has CHO count on it)



> I would suggest to all that a regular diet in the institution is
healthier than most people eat at home; therefore, we have already
restricted them and "low sodium" or "low fat" is probably not necessary.
>
> Janet V. Ross, MBA,RD,LD
> Clinical Nutrition Coordinator
> Drake Center
> janet.ross at healthall.com
> http://www.health-alliance.com/
> ph 513-418-2603
> fx 513-418-5939
> pg 513-577-6879
> P Please consider the environment before printing.
>
>
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Sheila Walsh
> Sent: Thursday, January 15, 2009 2:33 PM
> To: sherrythrash at comcast.net; cnm at lists.my180.net
> Subject: Re: [Cnm] Liberalization of diets in acute care
>
> My experience with the push to liberalize diets ended in a stalemate.
I requested support from the physicians treating the patients because my
food svc supervisor was an Army Lt-Co and she wanted to switch to all
MREs.  I took a survey of all patients on therapeutic diets and learned
that 98% of them follow a therapeutic diet at home.  To give them salt
and sugar would have been terribly confusing and would have complicated
their hospital stays.
>
> So, my suggestion is to survey at least 100 patients and talk to all
of the doctors that you can to help with this situation.  The next step
is to eliminate the need for dietitians.  Horrors!!!
>
>
> Sheila A. Walsh, MPH, RD
> Nutrition Services Coordinator
> "My gold neither sparkles nor jingles.
> It glistens in the sunlight & whinnies in the darkness."
>
>
>
>
>>>> <sherrythrash at comcast.net> 1/15/2009 11:34 AM >>>
> Hello all,
> We've had an issue come up here with our head of nursing requesting
that we "liberalize" most all of our diets which would necessitate the
discontinuation of many of our diets. I believe that they are looking
for us to get rid of diets such as our consistent CHO, reduced na+,
renal, cardiac, etc...
> What are everyone's opinion on this matter? I know that liberalization
of diets is common in long term care for obvious reasons- but there are
different schools of thought regarding the acute care setting.
> Does anyone out there have any experience and/or research in this
subject?
> TIA for your responses!
>
> --
> Regards,
> Sherry Zalewski Thrash, RD, LDN
>
> The Chester County Hospital
>
> ________________________________
> Confidentiality Notice: This e-mail message, including any
attachments, is for the sole use of the intended recipient(s) and may
contain confidential and privileged information. Any unauthorized
review, use, disclosure or distribution is prohibited. If you are not
the intended recipient, please contact the sender by reply e-mail and
destroy all copies of the original message.
>

Susan DeHoog
Associate Director
Food and Nutrition
University of Washington Medical Center
BOX 356057
Seattle Washington 98195
(206) 598-4533
email  sdehoog at u.washington.edu
FAX (206) 598-8105
pager (206)540-8874



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments
may contain confidential and privileged information for the use of the
designated recipient(s) named above. If you are not the intended
recipient, you are hereby notified that you have received this
communication in error and that any review, disclosure, dissemination,
distribution or copying of it or its contents is prohibited. If you have
received this communication in error, please notify the sender at the
electronic mail address noted above and destroy all copies of this
communication and any attachments. Thank you for your cooperation.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
This email and any files transmitted with it are confidential and
intended solely for the use of the individual or entity to whom they are
addressed. If you have received this email in error please notify the
system manager. This message contains confidential information and is
intended only for the individual named. If you are not the named
addressee you should not disseminate, distribute or copy this e-mail.


From Annalynn_Skipper at Comcast.net  Thu Jan 15 15:54:11 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Thu, 15 Jan 2009 17:54:11 -0600
Subject: [Cnm] Link for Pressure Ulcer Article on Nestle Website
Message-ID: <067F0A5B628D4244BF9A540DB6322F97@ANNALYNN>

Several people have asked for this information, so I thought I'd post it to
the list.  

 

The article I wrote for the Nestle website can be located by Googling Nestle
Clinical Nutrition.  On their website is a spot for healthcare professionals
to sign in.  Then there is a list of expert articles under the resources tab
to the left of the screen.  I've been told the link below works, but you'll
probably have to cut and past it into your browser.  I think a couple of
paragraphs were posted out of order, so it may not flow as well as I
intended.  All the information is there however.   

 

http://www.nestle-nutrition.com/Clinical_Resources/Expert_Article_Detail.asp
x?ArticleId=359f9651-2639-4b46-b154-605b7081b6a7

 

At any rate, I hope this information is helpful to those who are interested.


 

Annalynn

 

Annalynn Skipper Ph.D., R.D., FADA

 


a consultancy devoted to advancing nutrition practice

P.O. Box 45

Oak Park, IL 60303

 <mailto:Annalynn_Skipper at Comcast.net> Annalynn_Skipper at Comcast.net

Advanced Medical Nutrition Therapy Practice, 

a 2008 text, is available from Jones and Bartlett. 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/66c6e46f/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 170 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090115/66c6e46f/attachment.gif 

From kmershon at bak.rr.com  Thu Jan 15 22:03:51 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Thu, 15 Jan 2009 22:03:51 -0800
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <Pine.LNX.4.43.0901151312280.10191@hymn32.u.washington.edu>
References: <Pine.LNX.4.43.0901151312280.10191@hymn32.u.washington.edu>
Message-ID: <067097961F29495A87DFD2FBBE315D53@KathyPC>

Amen! So now how do we convince our docs....one at a time.
Kathleen Mershon, RD

----- Original Message ----- 
From: "susan" <sdehoog at u.washington.edu>
To: "Ross, Janet" <Janet.Ross at healthall.com>
Cc: <cnm at lists.my180.net>; "'Sheila Walsh'" <sheila.walsh at nahealth.com>
Sent: Thursday, January 15, 2009 1:12 PM
Subject: Re: [Cnm] Liberalization of diets in acute care


>I agree with Janet - the patients want food that is more like home and in 
>resturants.  When we put in all the "restricted" diets they complain about 
>our food not tasting good.  Down goes the Press Ganey scores.
>
> We try to get all our patients on general diets - especially if they are 
> not eating well. We also have room service menus and I got pretty liberal 
> in the creation of the menus and approval of the recipes - the diabetic 
> patient chooses from the general menu (has CHO count on it)
>
>
>
>> I would suggest to all that a regular diet in the institution is 
>> healthier than most people eat at home; therefore, we have already 
>> restricted them and "low sodium" or "low fat" is probably not necessary.
>>
>> Janet V. Ross, MBA,RD,LD
>> Clinical Nutrition Coordinator
>> Drake Center
>> janet.ross at healthall.com
>> http://www.health-alliance.com/
>> ph 513-418-2603
>> fx 513-418-5939
>> pg 513-577-6879
>> P Please consider the environment before printing.
>>
>>
>> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On 
>> Behalf Of Sheila Walsh
>> Sent: Thursday, January 15, 2009 2:33 PM
>> To: sherrythrash at comcast.net; cnm at lists.my180.net
>> Subject: Re: [Cnm] Liberalization of diets in acute care
>>
>> My experience with the push to liberalize diets ended in a stalemate.  I 
>> requested support from the physicians treating the patients because my 
>> food svc supervisor was an Army Lt-Co and she wanted to switch to all 
>> MREs.  I took a survey of all patients on therapeutic diets and learned 
>> that 98% of them follow a therapeutic diet at home.  To give them salt 
>> and sugar would have been terribly confusing and would have complicated 
>> their hospital stays.
>>
>> So, my suggestion is to survey at least 100 patients and talk to all of 
>> the doctors that you can to help with this situation.  The next step is 
>> to eliminate the need for dietitians.  Horrors!!!
>>
>>
>> Sheila A. Walsh, MPH, RD
>> Nutrition Services Coordinator
>> "My gold neither sparkles nor jingles.
>> It glistens in the sunlight & whinnies in the darkness."
>>
>>
>>
>>
>>>>> <sherrythrash at comcast.net> 1/15/2009 11:34 AM >>>
>> Hello all,
>> We've had an issue come up here with our head of nursing requesting that 
>> we "liberalize" most all of our diets which would necessitate the 
>> discontinuation of many of our diets. I believe that they are looking for 
>> us to get rid of diets such as our consistent CHO, reduced na+, renal, 
>> cardiac, etc...
>> What are everyone's opinion on this matter? I know that liberalization of 
>> diets is common in long term care for obvious reasons- but there are 
>> different schools of thought regarding the acute care setting.
>> Does anyone out there have any experience and/or research in this 
>> subject?
>> TIA for your responses!
>>
>> --
>> Regards,
>> Sherry Zalewski Thrash, RD, LDN
>>
>> The Chester County Hospital
>>
>> ________________________________
>> Confidentiality Notice: This e-mail message, including any attachments, 
>> is for the sole use of the intended recipient(s) and may contain 
>> confidential and privileged information. Any unauthorized review, use, 
>> disclosure or distribution is prohibited. If you are not the intended 
>> recipient, please contact the sender by reply e-mail and destroy all 
>> copies of the original message.
>>
>
> Susan DeHoog
> Associate Director
> Food and Nutrition
> University of Washington Medical Center
> BOX 356057
> Seattle Washington 98195
> (206) 598-4533
> email  sdehoog at u.washington.edu
> FAX (206) 598-8105
> pager (206)540-8874
>
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net 



From kmershon at bak.rr.com  Thu Jan 15 22:04:41 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Thu, 15 Jan 2009 22:04:41 -0800
Subject: [Cnm] Hospitals in MD, DC, Va and PA
In-Reply-To: <9AB3ADBD43ABFD46B0DC4E80280F3B3925708E@ahcmascdc034.DS.SJHS.COM>
References: <9AB3ADBD43ABFD46B0DC4E80280F3B3925708E@ahcmascdc034.DS.SJHS.COM>
Message-ID: <4B076006BB4D4C33816D3BDE07A6D075@KathyPC>

Margaret Hagherty of Cedars Sinai has one. She has posted before so you might check the archives.
Kathleen Mershon, RD
  ----- Original Message ----- 
  From: Harrison, Kerry 
  To: cnm at lists.my180.net 
  Sent: Thursday, January 15, 2009 12:51 PM
  Subject: [Cnm] Hospitals in MD, DC, Va and PA


  Hi,

   

  I am looking for Hospitals in these areas that use a clinical ladder approved by their HR.  I made a proposal to my HR and they would like references of hospitals in the area that she can speak with.  Thank you so much.

   

  Kerry Harrison

   

  Kerry Harrison, MS,RD,LDN

  Clinical Nutrition Manager

  St. Agnes Hospital

  Baltimore, MD 21229

  410.368.2152

   

  To eat is a necessity, but to eat intelligently is an art.

  -LaRoche Foucauld

  A government big enough to give you everything you want, is strong enough to take everything you have. 
  -Thomas Jefferson 

   

CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.


------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/36fc14ce/attachment-0001.html 

From KSoracco at lutheran-hosp.com  Fri Jan 16 04:15:47 2009
From: KSoracco at lutheran-hosp.com (SORACCO, KELLY)
Date: Fri, 16 Jan 2009 06:15:47 -0600
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <5AF9B08B39F8AD4380E2797E4125AEA1E8668485@msxmbxnsprd17.acct.upmchs.net>
Message-ID: <A838DC8FA2520F4B9D53D8FB96781E23D29C92@TNTRIEXEVS03.triadhospitals.net>

We moved to a liberal menu in September of this year. I used Sherri's
and UPMC's guidelines and they were extremely helpful.  

 

What we did was to create one Room Service menu with carb information
and symbols to indicate hi sodium, hi fat and hi potassium and/ or
phosphorus.  Our nutrition assistants explain the menu and diet
restrictions to their patients then guide them to select the best
choices within their diet restrictions. However, if they want something
that is marked as inappropriate for their diet - they allow it.  They
mark it as an "opportunity for improvement" (or OFI) in our computer
system. When a patient reaches 3 OFIs in a week the dietitian/tech will
visit and educate.  

 

Physicians may still write "do not liberalize" for those patients that
need strict control.  Our thought was that patients eating poorly should
not be restricted in their choices in hopes of maximizing intake.   The
dietitians' role is actually heightened and more focused by knowing
exactly who would benefit most from education. 

 

The new model of staffing of our nutrition assistants also helps
identify those patients eating poorly more quickly - these associates
also deliver and pick up the patients' trays and can immediately alert
the dietitian.  For patients that are eating poorly and choosing what
would be considered inappropriate choices we do not count these as OFIs.
They track in our computer system how much of each nutrient the patient
has selected and/or consumed.  Eg: renal patient wants a banana.  If the
banana only puts the patient at 600 mg potassium for that consumed meal,
it is within the range of a 2-3 gram potassium (standard renal) for the
day, if we watch other selections.

 

We are still training some associates, as it was a big learning curve
for them, but we are making progress. And it is, by far, not a perfect
system, but a change and a good one, I believe, for our patients.  If
anyone has any questions, please feel free to contact me.

 

Kelly Soracco, MS, RD

Patient Services Manager

Lutheran, St Joe & Rehab Hospitals

ksoracco at lutheran-hosp.com <mailto:ksoracco at lutheran-hosp.com> 

260-435-7983 phone

260-435-6999 fax

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Jones, Sherri
Sent: Thursday, January 15, 2009 1:44 PM
To: 'sherrythrash at comcast.net'; cnm at lists.my180.net
Subject: Re: [Cnm] Liberalization of diets in acute care

 

Sherry - I have extensive experience with this. Back in 2004 we
implemented a Liberalized Diet Program at University of Pittsburgh
Medical Center - an acute care system of hospitals. I wrote an article
about it in a past issue of CNM Newsletter. You can access it via the
CNM website newsletter archives. It is edition Winter 2006. If you have
questions after you read the article just pop me an email. 

 

Sherri 

Sherri L. Jones, MS, RD, LDN

Clinical Nutrition Manager

UPMC Shadyside

Phone: (412) 623-1629

Pager: (412) 263-8518

Fax: (412) 6232429

jonessl at upmc.edu

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of sherrythrash at comcast.net
Sent: Thursday, January 15, 2009 1:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Liberalization of diets in acute care

 

Hello all,

We've had an issue come up here with our head of nursing requesting that
we "liberalize" most all of our diets which would necessitate the
discontinuation of many of our diets. I believe that they are looking
for us to get rid of diets such as our consistent CHO, reduced na+,
renal, cardiac, etc... 

What are everyone's opinion on this matter? I know that liberalization
of diets is common in long term care for obvious reasons- but there are
different schools of thought regarding the acute care setting.

Does anyone out there have any experience and/or research in this
subject?

TIA for your responses!

 

--
Regards, 
Sherry Zalewski Thrash, RD, LDN

 

The Chester County Hospital



--------------------------------------------------------------------------
Disclaimer: This electronic message may contain information that is
Proprietary, Confidential, or legally privileged or protected. It
is intended only for the use of the individual(s) and entity named
in the message. If you are not an intended recipient of this
message, please notify the sender immediately and delete the
material from your computer. Do not deliver, distribute or copy
this message and do not disclose its contents or take any action in
reliance on the information it contains.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/69d6b8e8/attachment.html 

From Janet.Ross at healthall.com  Fri Jan 16 05:45:49 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Fri, 16 Jan 2009 08:45:49 -0500
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <A838DC8FA2520F4B9D53D8FB96781E23D29C92@TNTRIEXEVS03.triadhospitals.net>
References: <5AF9B08B39F8AD4380E2797E4125AEA1E8668485@msxmbxnsprd17.acct.upmchs.net>
	<A838DC8FA2520F4B9D53D8FB96781E23D29C92@TNTRIEXEVS03.triadhospitals.net>
Message-ID: <41CA05D55BF105489D33F8E57D71A90517169866CD@MAIL-C.healthall.com>

I'd be interested in seeing training materials used for your staff if you can share.  I've struggled with getting my hosts to truly understand the ins and outs of so many dietary restrictions, no matter how simple I make it.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of SORACCO, KELLY
Sent: Friday, January 16, 2009 7:16 AM
To: Jones, Sherri; cnm at lists.my180.net
Subject: Re: [Cnm] Liberalization of diets in acute care

We moved to a liberal menu in September of this year. I used Sherri's and UPMC's guidelines and they were extremely helpful.

What we did was to create one Room Service menu with carb information and symbols to indicate hi sodium, hi fat and hi potassium and/ or phosphorus.  Our nutrition assistants explain the menu and diet restrictions to their patients then guide them to select the best choices within their diet restrictions. However, if they want something that is marked as inappropriate for their diet - they allow it.  They mark it as an "opportunity for improvement" (or OFI) in our computer system. When a patient reaches 3 OFIs in a week the dietitian/tech will visit and educate.

Physicians may still write "do not liberalize" for those patients that need strict control.  Our thought was that patients eating poorly should not be restricted in their choices in hopes of maximizing intake.   The dietitians' role is actually heightened and more focused by knowing exactly who would benefit most from education.

The new model of staffing of our nutrition assistants also helps identify those patients eating poorly more quickly - these associates also deliver and pick up the patients' trays and can immediately alert the dietitian.  For patients that are eating poorly and choosing what would be considered inappropriate choices we do not count these as OFIs. They track in our computer system how much of each nutrient the patient has selected and/or consumed.  Eg: renal patient wants a banana.  If the banana only puts the patient at 600 mg potassium for that consumed meal, it is within the range of a 2-3 gram potassium (standard renal) for the day, if we watch other selections.

We are still training some associates, as it was a big learning curve for them, but we are making progress. And it is, by far, not a perfect system, but a change and a good one, I believe, for our patients.  If anyone has any questions, please feel free to contact me.

Kelly Soracco, MS, RD
Patient Services Manager
Lutheran, St Joe & Rehab Hospitals
ksoracco at lutheran-hosp.com<mailto:ksoracco at lutheran-hosp.com>
260-435-7983 phone
260-435-6999 fax

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jones, Sherri
Sent: Thursday, January 15, 2009 1:44 PM
To: 'sherrythrash at comcast.net'; cnm at lists.my180.net
Subject: Re: [Cnm] Liberalization of diets in acute care

Sherry - I have extensive experience with this. Back in 2004 we implemented a Liberalized Diet Program at University of Pittsburgh Medical Center - an acute care system of hospitals. I wrote an article about it in a past issue of CNM Newsletter. You can access it via the CNM website newsletter archives. It is edition Winter 2006. If you have questions after you read the article just pop me an email.

Sherri
Sherri L. Jones, MS, RD, LDN
Clinical Nutrition Manager
UPMC Shadyside
Phone: (412) 623-1629
Pager: (412) 263-8518
Fax: (412) 6232429
jonessl at upmc.edu<mailto:jonessl at upmc.edu>
________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of sherrythrash at comcast.net
Sent: Thursday, January 15, 2009 1:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Liberalization of diets in acute care

Hello all,
We've had an issue come up here with our head of nursing requesting that we "liberalize" most all of our diets which would necessitate the discontinuation of many of our diets. I believe that they are looking for us to get rid of diets such as our consistent CHO, reduced na+, renal, cardiac, etc...
What are everyone's opinion on this matter? I know that liberalization of diets is common in long term care for obvious reasons- but there are different schools of thought regarding the acute care setting.
Does anyone out there have any experience and/or research in this subject?
TIA for your responses!

--
Regards,
Sherry Zalewski Thrash, RD, LDN

The Chester County Hospital
________________________________

Disclaimer: This electronic message may contain information that is Proprietary, Confidential, or legally privileged or protected. It is intended only for the use of the individual(s) and entity named in the message. If you are not an intended recipient of this message, please notify the sender immediately and delete the material from your computer. Do not deliver, distribute or copy this message and do not disclose its contents or take any action in reliance on the information it contains.

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/259e87c3/attachment-0001.html 

From FREED_KATHARINE at GUTHRIE.ORG  Fri Jan 16 08:38:47 2009
From: FREED_KATHARINE at GUTHRIE.ORG (FREED_KATHARINE at GUTHRIE.ORG)
Date: Fri, 16 Jan 2009 11:38:47 -0500
Subject: [Cnm] Requesting help - Pediatric TPN ASAP
Message-ID: <OF48706820.E492C816-ON85257540.00596AAD-85257540.005B714F@guthrie.org>

We are not a Pediatric Hospital - just a few rooms on 1 unit designated 
for Peds.  We had an 8 yr old female in last week for an open Appendectomy 
on 1/8, she was discharged the next day.  Readmitted on 1/14 with elevated 
temp., abd. pain and N/V.  She has been unable to eat - is currently NPO. 
Surgeon wants to start TPN.  Ht. 50"  Wt. 72.2# (32.8kg).  They have 
consulted us.  Since my staff and I don't have much experience with 
pediatric TPN, any help or guidance would be much appreciated.  The 
surgical resident had written an order for 33 gm Amino Acid, 340 gm 
Dextrose and 33 gm Fat for ~ 1618 Kcal/Day and NO electrolytes!!  We had 
estimated her calorie needs sig. higher ~ 2200/Day.  Nothing will start 
till 7 PM tonight, orders must be in by 3 PM today.
Thanks for any help,
Kait Freed


Katharine Ward Freed, MS, RD, LDN, CDE
Clinical Supervisor
Food & Nutrition Dept.
Robert Packer Hospital
One Guthrie Square
Sayre, PA 18840
Tel  570-882-4297   Fax  570-882-5122
Email: "freed_katharine at guthrie.org"


CONFIDENTIALITY NOTICE: This e-mail, including attachments, may
include confidential, restricted, protected health and/or
proprietary information, and may be used only for the person or
entity to which it is addressed. If the reader of this e-mail is
not the intended recipient or his or her authorized agent, the
reader is hereby notified that any dissemination, distribution or
copying of this e-mail is prohibited. If you have received this
e-mail in error, please notify the sender by replying to this
message and delete this e-mail immediately. Notice: The disclosure
of medical information is strictly prohibited by federal
regulation. Unauthorized release of medical information may result
in administrative, civil and criminal sanctions.  
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/e5bb6b31/attachment.html 

From nmarinel at chsbuffalo.org  Fri Jan 16 08:59:50 2009
From: nmarinel at chsbuffalo.org (Marinelli, Nancy)
Date: Fri, 16 Jan 2009 11:59:50 -0500
Subject: [Cnm] Liberalization of diets in acute care
In-Reply-To: <41CA05D55BF105489D33F8E57D71A90517169866CD@MAIL-C.healthall.co m>
References: <5AF9B08B39F8AD4380E2797E4125AEA1E8668485@msxmbxnsprd17.acct.upm
	chs.net><A838DC8FA2520F4B9D53D8FB96781E23D29C92@TNTRIEXEVS03.triadhospitals
	.net> <41CA05D55BF105489D33F8E57D71A90517169866CD@MAIL-C.healthall.com>
Message-ID: <3E6DC8D8B3285C449C883257CA6012D7582DCDE225@CHEXCHANGE01.ad.wnychs.org>



I would be interested in this as well.

Thank  you.

P Please consider the environment before printing this email.

Nancy Marinelli, RD, CDN, CNSD
Clinical Nutrition Manager
Sisters of Charity Hospital
2157 Main Street
Buffalo, New York 14214
(716) 862-1621
(716) 862-1846 - FAX



From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ross, Janet
Sent: Friday, January 16, 2009 8:46 AM
To: 'SORACCO, KELLY'; cnm at lists.my180.net
Subject: Re: [Cnm] Liberalization of diets in acute care

I'd be interested in seeing training materials used for your staff if you can share.  I've struggled with getting my hosts to truly understand the ins and outs of so many dietary restrictions, no matter how simple I make it.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of SORACCO, KELLY
Sent: Friday, January 16, 2009 7:16 AM
To: Jones, Sherri; cnm at lists.my180.net
Subject: Re: [Cnm] Liberalization of diets in acute care

We moved to a liberal menu in September of this year. I used Sherri's and UPMC's guidelines and they were extremely helpful.

What we did was to create one Room Service menu with carb information and symbols to indicate hi sodium, hi fat and hi potassium and/ or phosphorus.  Our nutrition assistants explain the menu and diet restrictions to their patients then guide them to select the best choices within their diet restrictions. However, if they want something that is marked as inappropriate for their diet - they allow it.  They mark it as an "opportunity for improvement" (or OFI) in our computer system. When a patient reaches 3 OFIs in a week the dietitian/tech will visit and educate.

Physicians may still write "do not liberalize" for those patients that need strict control.  Our thought was that patients eating poorly should not be restricted in their choices in hopes of maximizing intake.   The dietitians' role is actually heightened and more focused by knowing exactly who would benefit most from education.

The new model of staffing of our nutrition assistants also helps identify those patients eating poorly more quickly - these associates also deliver and pick up the patients' trays and can immediately alert the dietitian.  For patients that are eating poorly and choosing what would be considered inappropriate choices we do not count these as OFIs. They track in our computer system how much of each nutrient the patient has selected and/or consumed.  Eg: renal patient wants a banana.  If the banana only puts the patient at 600 mg potassium for that consumed meal, it is within the range of a 2-3 gram potassium (standard renal) for the day, if we watch other selections.

We are still training some associates, as it was a big learning curve for them, but we are making progress. And it is, by far, not a perfect system, but a change and a good one, I believe, for our patients.  If anyone has any questions, please feel free to contact me.

Kelly Soracco, MS, RD
Patient Services Manager
Lutheran, St Joe & Rehab Hospitals
ksoracco at lutheran-hosp.com<mailto:ksoracco at lutheran-hosp.com>
260-435-7983 phone
260-435-6999 fax

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jones, Sherri
Sent: Thursday, January 15, 2009 1:44 PM
To: 'sherrythrash at comcast.net'; cnm at lists.my180.net
Subject: Re: [Cnm] Liberalization of diets in acute care

Sherry - I have extensive experience with this. Back in 2004 we implemented a Liberalized Diet Program at University of Pittsburgh Medical Center - an acute care system of hospitals. I wrote an article about it in a past issue of CNM Newsletter. You can access it via the CNM website newsletter archives. It is edition Winter 2006. If you have questions after you read the article just pop me an email.

Sherri
Sherri L. Jones, MS, RD, LDN
Clinical Nutrition Manager
UPMC Shadyside
Phone: (412) 623-1629
Pager: (412) 263-8518
Fax: (412) 6232429
jonessl at upmc.edu<mailto:jonessl at upmc.edu>
________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of sherrythrash at comcast.net
Sent: Thursday, January 15, 2009 1:35 PM
To: cnm at lists.my180.net
Subject: [Cnm] Liberalization of diets in acute care

Hello all,
We've had an issue come up here with our head of nursing requesting that we "liberalize" most all of our diets which would necessitate the discontinuation of many of our diets. I believe that they are looking for us to get rid of diets such as our consistent CHO, reduced na+, renal, cardiac, etc...
What are everyone's opinion on this matter? I know that liberalization of diets is common in long term care for obvious reasons- but there are different schools of thought regarding the acute care setting.
Does anyone out there have any experience and/or research in this subject?
TIA for your responses!

--
Regards,
Sherry Zalewski Thrash, RD, LDN

The Chester County Hospital
________________________________

Disclaimer: This electronic message may contain information that is Proprietary, Confidential, or legally privileged or protected. It is intended only for the use of the individual(s) and entity named in the message. If you are not an intended recipient of this message, please notify the sender immediately and delete the material from your computer. Do not deliver, distribute or copy this message and do not disclose its contents or take any action in reliance on the information it contains.

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.


-------------------------

CONFIDENTIALITY NOTICE: This message is confidential, intended only for the named recipient(s) and may contain information that is privileged, or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender by reply e-mail, delete this e-mail from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.  This message and all contents may be reviewed by authorized parties of the Catholic Health System other than those named in the message header.

The contents of this message do not bind the Catholic Health System to any contract, position, or course of action unless the sender is specifically authorized to enter into contracts on behalf of the Catholic Health System. The contents of this message do not necessarily constitute an official representation of the Catholic Health System.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/89b846c0/attachment.html 

From m-rodrig at msmc.com  Fri Jan 16 11:25:21 2009
From: m-rodrig at msmc.com (Maritza Rodriguez)
Date: Fri, 16 Jan 2009 14:25:21 -0500
Subject: [Cnm] Wound care
Message-ID: <32EDCA3D1F5C4C41B7E1A4573DFACCC60327DEB6@SVIPEXC1.msmc.com>

Do any of you have a presentation about the importance of nutrition in
wound care management directed to physicians that is willing to share?

 

Thank you,

 

 

Maritza Rodriguez

 

Maritza Rodriguez, RD LDN

Clinical Nutrition Manager

Mount Sinai Medical Center

4300 Alton Road

Miami Beach, Florida 33140

 

Tel: 305-674-2121 Ext. 56181

Fax: 305-674-2234

m-rodrig at msmc.com

 

 

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
CONFIDENTIAL or PRIVILEGED information.  Any unauthorized review, use,
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and immediately
destroy all copies of the original message and all attachments.  Any
opinions expressed here are not necessarily those of Mount Sinai Medical
Center.

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/5f708ded/attachment-0001.html 

From Shannon.Jackson at wilmed.org  Fri Jan 16 11:32:17 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Fri, 16 Jan 2009 14:32:17 -0500
Subject: [Cnm] Packet of salt
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF26A@wmhcs03.wmh.org>

Does anyone know how much sodium is in a little packet of salt (1/2 gram
packet)?
 
 
Thanks

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/ac9b6c5f/attachment.html 

From kharriso at stagnes.org  Fri Jan 16 11:57:27 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Fri, 16 Jan 2009 13:57:27 -0600
Subject: [Cnm] CMS
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B392572C8@ahcmascdc034.DS.SJHS.COM>

Does anyone know about the new CMS guidelines that were past for more
MNT come 1/2009?

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

 


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/ebe322d7/attachment.html 

From Linda.Woods at healthall.com  Fri Jan 16 12:18:15 2009
From: Linda.Woods at healthall.com (Woods, Linda)
Date: Fri, 16 Jan 2009 15:18:15 -0500
Subject: [Cnm] Packet of salt
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF26A@wmhcs03.wmh.org>
References: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF26A@wmhcs03.wmh.org>
Message-ID: <2B1106A6A593B147A65BD5A8939D3E111715741931@MAIL-C.healthall.com>

0.5 gm salt = 194 mg sodium according to the USDA database.

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Shannon Byrd Jackson
Sent: Friday, January 16, 2009 2:32 PM
To: CNM (E-mail)
Subject: [Cnm] Packet of salt

Does anyone know how much sodium is in a little packet of salt (1/2 gram packet)?


Thanks

Shannon B. Jackson, RD, LDN
Clinical Dietitian Supervisor
Wilson Medical Center
1705 Tarboro Street SW
Wilson, NC 27893-3428
(252) 399-8768
www.wilmed.org<http://www.wilmed.org/>


________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/6f9ae614/attachment.html 

From pavlinac at ohsu.edu  Fri Jan 16 12:32:16 2009
From: pavlinac at ohsu.edu (Jessie Pavlinac)
Date: Fri, 16 Jan 2009 12:32:16 -0800
Subject: [Cnm] Packet of salt
In-Reply-To: <2B1106A6A593B147A65BD5A8939D3E111715741931@MAIL-C.healthall.com>
References: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF26A@wmhcs03.wmh.org>
	<2B1106A6A593B147A65BD5A8939D3E111715741931@MAIL-C.healthall.com>
Message-ID: <DEBAA538779D914FAF11D158611547A76D17B2@EX-BE04.ohsu.edu>

A good rule of thumb is that crystallized NaCl (salt) is 40% sodium.  

Jessie

Jessie Pavlinac, MS, RD, CRS, LD

Manager, Clinical Nutrition

Food & Nutrition Services

Oregon Health & Science University

3181 SW Sam Jackson Park Road

Portland, OR  97239

503-494-3762

503-494-3769 (fax)

pavlinac at ohsu.edu

 

 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Woods, Linda
Sent: Friday, January 16, 2009 12:18 PM
To: 'Shannon Byrd Jackson'; CNM (E-mail)
Subject: Re: [Cnm] Packet of salt

 

0.5 gm salt = 194 mg sodium according to the USDA database.

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Shannon Byrd Jackson
Sent: Friday, January 16, 2009 2:32 PM
To: CNM (E-mail)
Subject: [Cnm] Packet of salt

 

Does anyone know how much sodium is in a little packet of salt (1/2 gram packet)?

 

 

Thanks

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
www.wilmed.org <http://www.wilmed.org/> 

 

 

________________________________

Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/d47d2c26/attachment.html 

From aimeenut at yahoo.com  Fri Jan 16 12:42:57 2009
From: aimeenut at yahoo.com (aimee crant)
Date: Fri, 16 Jan 2009 12:42:57 -0800 (PST)
Subject: [Cnm] biochemistry lecture
Message-ID: <661313.63038.qm@web52609.mail.re2.yahoo.com>

Does anyone have a nutrition biochemistry lecture?
?Aimee Crant-Oksa MS, RD
Clinical Nutrition Manager
Centrastate Medical Center
tel: 732-294-2767
email: acrantok at centrastate.com 


      


From DChampeon at stmarysmaine.com  Fri Jan 16 13:59:47 2009
From: DChampeon at stmarysmaine.com (DChampeon at stmarysmaine.com)
Date: Fri, 16 Jan 2009 16:59:47 -0500
Subject: [Cnm] Question for ADA Nutrition Care Manual Users
Message-ID: <OF6FAD0FEF.6FC50BE1-ON85257540.007720C3-85257540.0078D51D@stmarysmaine.com>


I'm having difficulty figuring out how to use the ADA Nutrition Care Manual
as a reference for my hospital's diet orders.  Nutrition therapy is listed
by disease rather than diet type.

Do your physicians still order by diet type, e.g.,  2 gram sodium?  Or do
they order by disease, e.g., heart failure?

Has anyone created recommended and not recommended lists by diet type using
the nutrition therapy client education sheets?

I feel like I must be missing something.

Diana.

Diana Champeon
Director, Nutrition Services
St. Mary's Regional Medical Center
100 Campus Avenue
Lewiston, ME 04240
dchampeon at stmarysmaine.com
phone (207)777-8603
fax (207)777-8609






From jross at jaycountyhospital.com  Fri Jan 16 14:56:49 2009
From: jross at jaycountyhospital.com (Julayne Ross)
Date: Fri, 16 Jan 2009 17:56:49 -0500
Subject: [Cnm] Isagenix
Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D01E07F60@EX1.jaycountyhospital.com>

What can you tell me about Isagenix. I am trying to find some
information but all the sites are funded by Isagenix.  Thanks

Julayne

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/1e68774b/attachment.html 

From sherrythrash at comcast.net  Sat Jan 17 09:29:14 2009
From: sherrythrash at comcast.net (sherrythrash at comcast.net)
Date: Sat, 17 Jan 2009 17:29:14 +0000
Subject: [Cnm] Isagenix
Message-ID: <011720091729.28651.4972156A000BA83600006FEB2200761064089C0E9D089B979D9D0A089C@comcast.net>

I managed to find this site:
http://junkfoodscience.blogspot.com/2006/11/can-you-really-cleanse-your-way-to.html

I remember looking into it years ago for a client- and not being impressed (of course). Though now the specifics have failed me! I remember a young female doctor blogging about it on some site- but I can't remember which one. If it comes to me- I'll let you know.

--
Regards, 
Sherry Zalewski Thrash, RD, LDN

-------------- Original message -------------- 
From: "Julayne Ross" <jross at jaycountyhospital.com> 

What can you tell me about Isagenix. I am trying to find some information but all the sites are funded by Isagenix.  Thanks
Julayne
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090117/4b53b646/attachment.html 
-------------- next part --------------
An embedded message was scrubbed...
From: "Julayne Ross" <jross at jaycountyhospital.com>
Subject: [Cnm] Isagenix
Date: Fri, 16 Jan 2009 22:59:59 +0000
Size: 634
Url: /pipermail/cnm_lists.my180.net/attachments/20090117/4b53b646/attachment.mht 

From sherrythrash at comcast.net  Sat Jan 17 13:01:29 2009
From: sherrythrash at comcast.net (sherrythrash at comcast.net)
Date: Sat, 17 Jan 2009 21:01:29 +0000
Subject: [Cnm] Chewing/swallowing - altered texture diet patients
Message-ID: <011720092101.22323.497247290002D6D0000057332200761064089C0E9D089B979D9D0A089C@comcast.net>

We currently do see all patients w/chewing/swallowing difficulties as per the nursing screen- as well as anyone placed on a dysphagia diet (generally those w/thickened liquids). 

If that is the only reason that we get triggered to see the patient, we may or may not complete a full assessment based on other perameters (ie is the pt eating, experiencing n/v/d, wounds, etc...). We are also checking that SLP was consulted appropriately. If the patient has been on this diet before and is eating fine and has no other issues- we'll just make a note in the chart and then would r/s at our LOS mark. 

However, in my experience- many of these patients don't eat or drink well, particularly if it is a new diet (say s/p CVA). Then we would be following the patient much more closely. We have an algorithm in our P&Ps that helps the RDs to assign accuity to the patients and determine the time frame for f/u care. 

It works well for us. I can't say that chewing/swallowing problems greatly increases our work load, but that could certainly vary by facility. 

--
Regards, 
Sherry Zalewski Thrash, RD, LDN

-------------- Original message -------------- 
From: "Yvette Dionne" <YDionne at westerlyhospital.org> 



Hello,
I would appreciate some input from the group regarding patients on altered texture diets and using chewing/swallowing as a trigger for consults.  

As I have worked in a few hospitals in my short career as an RD I know there are different schools of thought on these issues.  Seeing every patient on an altered texture diet seems like it adds  to the RD workload without necessarily improving patient care.  
Many people do fine on altered textures.  Once the appropriate texture is in place the chewing/swallowing issue has been alleviated.

Please, let me know what you are doing and what is working well. 

Thank you,
Yvette Dionne, RD, LDN
Westerly Hospital
25 Wells St
Westerly, RI 02891
401-348-3464
may you be well and happy
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090117/ace938e8/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090117/ace938e8/attachment.gif 
-------------- next part --------------
An embedded message was scrubbed...
From: "Yvette Dionne" <YDionne at westerlyhospital.org>
Subject: [Cnm] Chewing/swallowing - altered texture diet patients
Date: Thu, 15 Jan 2009 14:50:46 +0000
Size: 678
Url: /pipermail/cnm_lists.my180.net/attachments/20090117/ace938e8/attachment.mht 

From mrogard at charter.net  Sun Jan 18 06:02:26 2009
From: mrogard at charter.net (mrogard at charter.net)
Date: Sun, 18 Jan 2009 6:02:26 -0800
Subject: [Cnm] Chewing/swallowing - altered texture diet patients
In-Reply-To: <011720092101.22323.497247290002D6D0000057332200761064089C0E9D089B979D9D0A089C@comcast.net>
Message-ID: <20090118090226.Y733U.1495592.root@mp06>

Sherry,
I would be interested in seeing your algorithm for f/u care.  Would you be willing to post to the listserv?
MJ
--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org
Professional email: mrogard at charter.net

---- sherrythrash at comcast.net wrote: 
> We currently do see all patients w/chewing/swallowing difficulties as per the nursing screen- as well as anyone placed on a dysphagia diet (generally those w/thickened liquids). 
> 
> If that is the only reason that we get triggered to see the patient, we may or may not complete a full assessment based on other perameters (ie is the pt eating, experiencing n/v/d, wounds, etc...). We are also checking that SLP was consulted appropriately. If the patient has been on this diet before and is eating fine and has no other issues- we'll just make a note in the chart and then would r/s at our LOS mark. 
> 
> However, in my experience- many of these patients don't eat or drink well, particularly if it is a new diet (say s/p CVA). Then we would be following the patient much more closely. We have an algorithm in our P&Ps that helps the RDs to assign accuity to the patients and determine the time frame for f/u care. 
> 
> It works well for us. I can't say that chewing/swallowing problems greatly increases our work load, but that could certainly vary by facility. 
> 
> --
> Regards, 
> Sherry Zalewski Thrash, RD, LDN
> 
> -------------- Original message -------------- 
> From: "Yvette Dionne" <YDionne at westerlyhospital.org> 
> 
> 
> 
> Hello,
> I would appreciate some input from the group regarding patients on altered texture diets and using chewing/swallowing as a trigger for consults.  
> 
> As I have worked in a few hospitals in my short career as an RD I know there are different schools of thought on these issues.  Seeing every patient on an altered texture diet seems like it adds  to the RD workload without necessarily improving patient care.  
> Many people do fine on altered textures.  Once the appropriate texture is in place the chewing/swallowing issue has been alleviated.
> 
> Please, let me know what you are doing and what is working well. 
> 
> Thank you,
> Yvette Dionne, RD, LDN
> Westerly Hospital
> 25 Wells St
> Westerly, RI 02891
> 401-348-3464
> may you be well and happy



From ESCOTTSTUMPS at ecu.edu  Sun Jan 18 07:54:57 2009
From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia)
Date: Sun, 18 Jan 2009 10:54:57 -0500
Subject: [Cnm] FW: On the Pulse - January 16, 2009
References: <LYRIS-14232391-3425576-2009.01.16-14.26.33--escottstumps#ecu.edu@list.eatright.org>
Message-ID: <BD44FF0CF4C18245854BBE03590A4C130150CD52@ECUFS7.intra.ecu.edu>

Dear Colleagues:
A historic week is upon us!  We might consider dining on inaugural foods.  Enjoy!
Sylvia Escott-Stump
CNM Legislative Chair

 
 

-----------------------------------------------------------------------------------------------------------------------------

Friday, January 16, 2009

----------------------------------------------------------------------------------------------------------------------------- 

 

Another advancement in nutrition coverage possible in children's health bill

In coming days, the American Dietetic Association may achieve another venue for the public to receive medical nutrition therapy.  MNT authorities are included in the State Children's Health Insurance Program reauthorization, which flew through the House this week.  A similar measure has been passed by the Senate Finance Committee but without references to MNT.  That bill will be on the Senate floor possibly next week.  

 

ADA has been highly active on SCHIP for the past year.  According to Ron Smith and Jennifer Teters who carry the SCHIPS portfolio for ADA on Capitol Hill, they expected a simple five year reauthorization with few-to-no changes to the original bill that was vetoed by President Bush in 2007.  However, the House's new language includes clinical preventive services like Medical Nutrition Therapy for existing obesity reduction pilot programs, as well as funding towards the development of a formal model for electronic health records for children enrolled in SCHIP.  The House bill also includes a new provision that would allow states to remove the five year waiting period for legal immigrant children and pregnant women.  

 

The House version is estimated to cost $32.3 billion and expands enrollment eligibility to 4 million children, allowing the program to cover 11 million uninsured children.  The Senate version differs on how to pay for the program.  Those differences will need to be sorted out by a conference committee after Senate approval.  The conference report then must be approved by House and Senate before it can be sent to the President.

 

 

Prevention partnership leader to speak at 2009 Public Policy Workshop

Kenneth Thorpe, Ph.D., executive director of the Partnership to Fight Chronic Disease, will kick off the Monday, Feb. 9 session on health care at the 2009 Public Policy Workshop.   "Systems for Health in the 21st Century" will begin at noon (Eastern) and reach members across the country through webinar technology. He joins Lorri Holzberg, MA, RD, CDE and Jane V. White, PhD, LDN, RD, FADA as speakers at this session which contemplates health care reform and lays out ADA's stances on legislation.  Holzberg chaired and White served with four others on an ADA task force charged to study the issues and make recommendations for the association's work on anticipated legislation. ADA is a senior member of the Partnership to Fight Chronic Disease, and has been active in Washington and some states to carry its messages, which underscore the importance of policies that do a better job of preventing, managing and treating chronic diseases.    Information on PFCD and its materials are at http://www.fightchronicdisease.org/. <http://www.fightchronicdisease.org/> 

 

Registration for PPW surges

Registration for the 2009 Public Policy Workshop surged this week as all members were sent invitations to participate, without cost, in this year's program.  To register, go to  <http://www.surveymonkey.com/s.aspx?sm=ZVbX5FhUOUdkPi6DznTXnA_3d_3d> http://www.surveymonkey.com/s.aspx?sm=ZVbX5FhUOUdkPi6DznTXnA_3d_3d <http://www.surveymonkey.com/s.aspx?sm=ZVbX5FhUOUdkPi6DznTXnA_3d_3d.> . PPW section of eatright.org includes information about the workshop and its objectives, sessions, and requirements.  Pre-reading materials are provided and new tutorials on advocacy have been posted for personal viewing.   As details are finalized, additional materials will be made available.  Members must register for every PPW session they want to attend.  Those who plan to participate in a plenary party hosted by a state affiliate or other group should mark on the registration form that they plan to go to a group site.   If a session fills up, ADA will post a recording of the session so that interested members may still take advantage of this grassroots training and information.  Upon registration, please contact your state's public policy coordinator to learn where group sites will be held.  To find a list of PPCs, go to http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/10988_10927_ENU_HTML.htm <http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/10988_10927_ENU_HTML.htm> 

 

Oregon RD to receive ADA Award for Grassroots Excellence
Nancy Becker, MS, RD, LD of Portland, OR has been named winner of the 2009 Award for Grassroots Excellence.   This is ADA's top award for nutrition advocacy.  In addition to developing, mentoring and training leaders and students within ODA, she testified to her state legislature on breast feeding and school nutrition, and worked with state legislators on the importance of high nutrition standards for foods sold outside of the school lunch program.  Becker received attention throughout Oregon for bringing food, nutrition and health issues to then candidate and now new U.S. Senator Jeff Merkley.  

 

Something for everyone in the House stimulus package 

Speaker of the House Nancy Pelosi (D-CA) and Chairman of the House Appropriations Committee David Obey (D-WI) released their draft stimulus package this week.  Unprecedented in its scale and reach, the estimated cost is $875 billion.  The proposal consists of numerous individual spending and tax provisions.   Two-thirds of the total costs are in spending proposals and one-third in tax cuts.  Among its many provisions, the bill provides help for the poor and unemployed and hands out grants for local schools and state governments.

Virtually everyone living in the United States would be affected by the plan. A $500 tax cut would reach 95 percent of workers and $1,000 for working couples. 

 

 "A key component of attaining universal health care reform will be ensuring the supply of primary health care providers - family medicine, internal medicine, pediatricians, dentists, and nurses," the committee report says.   Another $600 million is provided to double annual funding for training primary care doctors and dentists, as well as double support for nursing programs such as nurse scholarships, nurse faculty loans, and advanced nursing.  The increased funding also will increase the number of health care providers that can be supported through the National Health Service Corps program.

 

Future agriculture secretary connects agriculture and public health

President-elect Obama's choice as the next Agriculture Secretary-nominee this week spoke repeatedly at this confirmation hearing about the importance of food and nutrition.  Former Iowa Governor and now secretary designate Tom Vilsack stressed the connection between agriculture and public health.  "The health care crisis aligns squarely with the need to promote more nutrition in our diets," he said.  Vilsack said he already has begun coordinating efforts to combat child hunger and that he hopes to align the USDA and HHS agendas on nutrition.  

 

At that hearing, Senate Agriculture Committee Chairman Tom Harkin announced he will propose that USDA use Institute of Medicine guidelines to set standards for food sold in schools.  Current standards exempt many snack foods because they are sold outside the school lunch program.  Vilsack previously has backed limits on the kinds of snacks and beverages students can buy outside the lunch line.   And at the hearing he said he would work for "more nutritious food produced in a sustainable way." Vilsack faced no opposition at his hearing and may receive full Senate approval as early as Jan. 20.

 

Senators call for increased funding for child nutrition programs

Forty senators united in calling for targeted investments in the child nutrition programs to be a top priority of the next administration.  In a letter initiated by Sen. Tom Harkin (D-IA) in his role as chair of the Agriculture, Nutrition and Forestry Committee, the group requested that President-Elect Barack Obama include new funding in the federal child nutrition programs, slated for reauthorization in 2009.  The group called for increased funding for program access and participation, nutritional improvement, and program integrity and modernization.

 

Obesity overtakes overweight

The percent of Americans obese has exceeded those that are just overweight, according to the most recent data from the National Health and Nutrition Examination Survey.  The findings, based on measured heights and weights, indicate that 34.3 percent of U.S. adults 20 years and older are obese and 32.7 percent are overweight.  Almost 6 percent of U.S. adults are extremely obese.  The NHANES data suggest an increase in obesity in the United States between the late 1980s and today, with the estimated prevalence moving upward from a previous level of 23 percent in the late 1980s to approximately 34 percent in 2005/06. One of the national health objectives for 2010 is to reduce the prevalence of obesity among adults to less than 15 percent. 

 

Peanut butter linked to salmonella outbreak

Food safety is back in the news this week as a salmonella outbreak extends across 43 states, sickening over 400 people and possibly contributing to five deaths.  The source of the outbreak appears to be peanut butter.  

According to the Minnesota Department of Health and Minnesota Department of Agriculture, laboratory analysis of an open container of peanut butter from a long-term care facility found a strain of salmonella.  The finding led to a voluntary recall of peanut butter by its producer, Peanut Corporation of America.  The peanut butter recalled is sold in bulk packaging for institutional and food service use.  While none of the peanut butter being recalled is sold directly to consumers in retail stores, it may reach stores through other products.  Kellogg asked stores to stop selling Austin and Keebler brand peanut butter sandwich crackers and urged consumers not to eat those products for now.  Peanut Corporation of America was one of Kellogg's suppliers.

 

CMS won't cover surgical errors

This week the Centers for Medicare & Medicaid Services posted three National Coverage Decision memos that posit that surgical errors are not reasonable or necessary, nor do they benefit the patient.  CMS internally initiated the National Coverage Determination process as a formality in establishing a no-payment policy for surgical errors which are considered avoidable.  The NCDs for each are available on the web:  Surgery on the Wrong Body Part, https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=222 <https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=222> ; Surgery on the Wrong Patient, https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=221 <https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=221> ; and Wrong Surgery Performed on a Patient, https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=223 <https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=223%20> .

 

USP issues standard for stevia-based sweetener

In response to the growing popularity of a plant-based sweetener, Rebaudioside A, US Pharmacopeia is developing a new standard to be included in the Food Chemicals Codex that will help food and beverage manufacturers assure the product's quality for consumers.  Rebaudioside A is a stevia (Stevia rebaudiana Bertoni)-based sweetener used in foods and beverages around the world as an alternative to sugar and other non-caloric sugar substitutes, such as sucralose and aspartame.  USP is seeking comments from the food and beverage industry as well as all other interested parties.  The proposed monograph standard became available in the FCC Forum on the USP web site (http://www.usp.org/fcc/forum <http://www.usp.org/fcc/forum> ) on Dec. 31 for 90 days.    

 

 

Editor's note:  Obama inauguration next week 

The inauguration of the nation's 44th President brings most Americans to contemplate what our way of government is about.  Then, too, is our curiosity about presidents themselves.  For foodies, culinary historians and interested public alike, you can find out what new President Barak Obama and family will be eating on Inauguration Day.  Check out the Inaugural Luncheon website at http://inaugural.senate.gov/luncheon/ <http://inaugural.senate.gov/luncheon/> .  Insiders report that the meal replicates many of President Lincoln's (a fellow Illinois politician) favorite dishes-such as seafood stew, duck, sweet potatoes and apple cinnamon sponge cake.

 

Plus, wonder what other presidential families enjoyed during their tenure at the White House? Look no further than the Library of Congress, which has compiled an eight page reference guide of books, magazine articles and internet resources chronicling presidential cuisine.  A majority of the books have been written by White House chefs, housekeepers and others associated with the presidents and first ladies.  Besides the menu, the books detail on topics such as fine china, entertainment, weddings and holidays.  The guide titled "Presidential Food: Selected Resource Guide" can be viewed online at

http://www.loc.gov/rr/scitech/SciRefGuides/presidentialfood.html <http://www.loc.gov/rr/scitech/SciRefGuides/presidentialfood.html> .  

 

And on a more serious note, when Barack Obama lays his hand on the Bible next Tuesday, he will repeat an oath of fewer than 40 words:  

 

"I do solemnly swear (or affirm) that I will faithfully execute the office of President of the United States, and will to the best of my ability, preserve, protect, and defend the Constitution of the United States."

 

Upcoming:

 

*	ADA testifies as the second meeting of the Dietary Guidelines Advisory Committee, Jan.  29 - 30 here.  Registration is required.  Details available at www.dietaryguidelines.gov <http://www.dietaryguidelines.gov/> . 

      

*	All-Member, On-Line PPW 2009 is February 8 - 10.   Go to http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/10882_ENU_HTML.htm <http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/10882_ENU_HTML.htm>  to register and see up-to-date information on attending the online conference. 

 

----------------------------------------------------------------------------------------------------------------------------

Government Relations Contacts:

 

 

 

Nutrition Policy

Jennifer Weber

jweber at eatright.org <mailto:jweber at eatright.org> 

Regulatory Issues

Mary Hager

mhager at eatright.org <mailto:mhager at eatright.org> 

Congressional & Political Affairs

Ron Smith

rsmith at eatright.org <mailto:rsmith at eatright.org> 

 

Jennifer Teters

jteters at eatright.org <mailto:jteters at eatright.org> 

 

Charmaine Jones

cjones at eatright.org <mailto:cjones at eatright.org> 

State Government Relations

Juliana Smith

jsmith at eatright.org <mailto:jsmith at eatright.org> 

State & Regulatory Coordinator

Dana Whitley

dwhitley at eatright.org <mailto:dwhitley at eatright.org> 

Reimbursement Issues

Pam Michael

pmichael at eatright.org <mailto:pmichael at eatright.org> 

 

Tori Bender

tbender at eatright.org <mailto:tbender at eatright.org> 

General Issues

Stephanie Patrick

spatrick at eatright.org <mailto:spatrick at eatright.org> 

-----------------------------------------------------------------------------------------------------------------------------

 

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090118/118247ac/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 11163 bytes
Desc: image003.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090118/118247ac/attachment-0001.jpe 

From sadiecat14 at verizon.net  Sun Jan 18 09:32:44 2009
From: sadiecat14 at verizon.net (Deborah Gore)
Date: Sun, 18 Jan 2009 12:32:44 -0500
Subject: [Cnm] test please ignore
Message-ID: <3A45F3C16A36437781B2200269A3D78D@owner84d523d58>

test
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090118/4930a066/attachment.html 

From LCarver at Reshealthcare.org  Fri Jan 16 12:20:17 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Fri, 16 Jan 2009 14:20:17 -0600
Subject: [Cnm] CMS
In-Reply-To: <9AB3ADBD43ABFD46B0DC4E80280F3B392572C8@ahcmascdc034.DS.SJHS.COM>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03BB3C70@rhcexch3.reshealthcare.org>

I believe it opens up the possibility for more diagnoses to be covered
but that is not automatic.  Each diagnosis must go through a process and
nothing has been added at this time.  please - any of you working in the
legislative arena, add to or correct.  Leslee

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Harrison, Kerry
Sent: Friday, January 16, 2009 1:57 PM
To: cnm at lists.my180.net
Subject: [Cnm] CMS



Does anyone know about the new CMS guidelines that were past for more
MNT come 1/2009?

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

 

CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/06b6c0c7/attachment.html 

From LCarver at Reshealthcare.org  Fri Jan 16 14:36:44 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Fri, 16 Jan 2009 16:36:44 -0600
Subject: [Cnm] Question for ADA Nutrition Care Manual Users
In-Reply-To: <OF6FAD0FEF.6FC50BE1-ON85257540.007720C3-85257540.0078D51D@stmarysmaine.com>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03BB3D1D@rhcexch3.reshealthcare.org>

To me, the optimal goal is for the doc to know the diagnosis, and, if
not sure what the best diet for that diagnosis is, look it up in the
on-line manual and match the diet order to the diagnosis (or, God
forbid, ask a dietitian).  I do not want the diets coming to our diet
office as "diet for CHF and ESRD". That would mean the diet office would
be making interpretations of medical diagnoses and assuming knowledge of
the patient that they could not possibly have - you would have to set up
some sort of conversion table and get it approved by you Nutrition
Committee or P+T Committee.  

Docs are pretty comfortable w/ looking at diagnoses - I doubt that most
ever look at a diet manual (paper or on-line) but those I've taught love
looking up a diagnosis then just hitting "client education".  That
pretty much gives them the down-and-dirty of what the diet should be.
If they question that, (i.e. why a high protein diet for liver disease),
they can click on references.  

>From my view point, the most difficult element is the combination diet.
There is not way to print out a diet for a patient w/ type 2 diabetes
plus renal disease so you end up having to modify by hand.  

Note:  the ADA nutrition care manual, even when in hard copy, has always
grouped by diagnosis.  Leslee 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of DChampeon at stmarysmaine.com
Sent: Friday, January 16, 2009 4:00 PM
To: cnm at lists.my180.net
Subject: [Cnm] Question for ADA Nutrition Care Manual Users


I'm having difficulty figuring out how to use the ADA Nutrition Care
Manual
as a reference for my hospital's diet orders.  Nutrition therapy is
listed
by disease rather than diet type.

Do your physicians still order by diet type, e.g.,  2 gram sodium?  Or
do
they order by disease, e.g., heart failure?

Has anyone created recommended and not recommended lists by diet type
using
the nutrition therapy client education sheets?

I feel like I must be missing something.

Diana.

Diana Champeon
Director, Nutrition Services
St. Mary's Regional Medical Center
100 Campus Avenue
Lewiston, ME 04240
dchampeon at stmarysmaine.com
phone (207)777-8603
fax (207)777-8609





_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From jwelch02 at unityhealth.org  Sun Jan 18 17:22:52 2009
From: jwelch02 at unityhealth.org (Janel Welch)
Date: Sun, 18 Jan 2009 20:22:52 -0500
Subject: [Cnm] Question for ADA Nutrition Care Manual Users
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E03BB3D1D@rhcexch3.reshealthcare.org>
References: <OF6FAD0FEF.6FC50BE1-ON85257540.007720C3-85257540.0078D51D@stmarysmaine.com>
	<5330B54133B6194BA13930BDEFE9A30E03BB3D1D@rhcexch3.reshealthcare.org>
Message-ID: <49738F9C020000AD000206C8@smtp.unityhealth.org>

Our health care system does give access to on line care manual and I agree, they often use it to get the basics.  It is also great for when the RD staff is not available (evenings/weekends) for information.

Janel




>>> "Carver, Leslee" <LCarver at Reshealthcare.org> 1/16/2009 5:36 PM >>>
To me, the optimal goal is for the doc to know the diagnosis, and, if
not sure what the best diet for that diagnosis is, look it up in the
on-line manual and match the diet order to the diagnosis (or, God
forbid, ask a dietitian).  I do not want the diets coming to our diet
office as "diet for CHF and ESRD". That would mean the diet office would
be making interpretations of medical diagnoses and assuming knowledge of
the patient that they could not possibly have - you would have to set up
some sort of conversion table and get it approved by you Nutrition
Committee or P+T Committee.  

Docs are pretty comfortable w/ looking at diagnoses - I doubt that most
ever look at a diet manual (paper or on-line) but those I've taught love
looking up a diagnosis then just hitting "client education".  That
pretty much gives them the down-and-dirty of what the diet should be.
If they question that, (i.e. why a high protein diet for liver disease),
they can click on references.  

>From my view point, the most difficult element is the combination diet.
There is not way to print out a diet for a patient w/ type 2 diabetes
plus renal disease so you end up having to modify by hand.  

Note:  the ADA nutrition care manual, even when in hard copy, has always
grouped by diagnosis.  Leslee 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] 
On Behalf Of DChampeon at stmarysmaine.com 
Sent: Friday, January 16, 2009 4:00 PM
To: cnm at lists.my180.net 
Subject: [Cnm] Question for ADA Nutrition Care Manual Users


I'm having difficulty figuring out how to use the ADA Nutrition Care
Manual
as a reference for my hospital's diet orders.  Nutrition therapy is
listed
by disease rather than diet type.

Do your physicians still order by diet type, e.g.,  2 gram sodium?  Or
do
they order by disease, e.g., heart failure?

Has anyone created recommended and not recommended lists by diet type
using
the nutrition therapy client education sheets?

I feel like I must be missing something.

Diana.

Diana Champeon
Director, Nutrition Services
St. Mary's Regional Medical Center
100 Campus Avenue
Lewiston, ME 04240
dchampeon at stmarysmaine.com 
phone (207)777-8603
fax (207)777-8609





_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net 

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



PLEASE NOTE: Property of Unity Health System -- www.unityhealth.org  
The information contained in this message may be privileged and confidential, protected from disclosure, and/or intended only for the user of the individual or entity named above. If the recipient of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication in error, please notify the sender immediately by replying to this message and deleting it from your computer. This email message is considered Virus Free by our virus scanning software. All email is considered property of Unity Health System. 
Address policy questions to address below. 
gwadministrator at unityhealth.org





From SWatson at ghs.org  Sun Jan 18 17:24:22 2009
From: SWatson at ghs.org (Susan Watson)
Date: Sun, 18 Jan 2009 20:24:22 -0500
Subject: [Cnm] Chewing/swallowing - altered texture diet patients
In-Reply-To: <20090118090226.Y733U.1495592.root@mp06>
Message-ID: <D134A05B4A5B564B8D5BE1D0B4E6A3AC04FC652A@ghsexcmbxisc02.ghs.org>

I would be interested in the algorithm as well.  Thank you very much. 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of mrogard at charter.net
Sent: Sunday, January 18, 2009 9:02 AM
To: sherrythrash at comcast.net; cnm at lists.my180.net
Subject: Re: [Cnm] Chewing/swallowing - altered texture diet patients

Sherry,
I would be interested in seeing your algorithm for f/u care.  Would you
be willing to post to the listserv?
MJ
--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org
Professional email: mrogard at charter.net

---- sherrythrash at comcast.net wrote: 
> We currently do see all patients w/chewing/swallowing difficulties as
per the nursing screen- as well as anyone placed on a dysphagia diet
(generally those w/thickened liquids). 
> 
> If that is the only reason that we get triggered to see the patient,
we may or may not complete a full assessment based on other perameters
(ie is the pt eating, experiencing n/v/d, wounds, etc...). We are also
checking that SLP was consulted appropriately. If the patient has been
on this diet before and is eating fine and has no other issues- we'll
just make a note in the chart and then would r/s at our LOS mark. 
> 
> However, in my experience- many of these patients don't eat or drink
well, particularly if it is a new diet (say s/p CVA). Then we would be
following the patient much more closely. We have an algorithm in our
P&Ps that helps the RDs to assign accuity to the patients and determine
the time frame for f/u care. 
> 
> It works well for us. I can't say that chewing/swallowing problems
greatly increases our work load, but that could certainly vary by
facility. 
> 
> --
> Regards,
> Sherry Zalewski Thrash, RD, LDN
> 
> -------------- Original message --------------
> From: "Yvette Dionne" <YDionne at westerlyhospital.org>
> 
> 
> 
> Hello,
> I would appreciate some input from the group regarding patients on
altered texture diets and using chewing/swallowing as a trigger for
consults.  
> 
> As I have worked in a few hospitals in my short career as an RD I know
there are different schools of thought on these issues.  Seeing every
patient on an altered texture diet seems like it adds  to the RD
workload without necessarily improving patient care.  
> Many people do fine on altered textures.  Once the appropriate texture
is in place the chewing/swallowing issue has been alleviated.
> 
> Please, let me know what you are doing and what is working well. 
> 
> Thank you,
> Yvette Dionne, RD, LDN
> Westerly Hospital
> 25 Wells St
> Westerly, RI 02891
> 401-348-3464
> may you be well and happy


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From jwelch02 at unityhealth.org  Sun Jan 18 17:24:22 2009
From: jwelch02 at unityhealth.org (Janel Welch)
Date: Sun, 18 Jan 2009 20:24:22 -0500
Subject: [Cnm] CMS
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E03BB3C70@rhcexch3.reshealthcare.org>
References: <9AB3ADBD43ABFD46B0DC4E80280F3B392572C8@ahcmascdc034.DS.SJHS.COM>
	<5330B54133B6194BA13930BDEFE9A30E03BB3C70@rhcexch3.reshealthcare.org>
Message-ID: <49738FF6020000AD000206CE@smtp.unityhealth.org>

The CMS website is difficult to navigate through but you can find infor on the Ftags and 3.0 MDS




>>> "Carver, Leslee" <LCarver at Reshealthcare.org> 1/16/2009 3:20 PM >>>
I believe it opens up the possibility for more diagnoses to be covered
but that is not automatic.  Each diagnosis must go through a process and
nothing has been added at this time.  please - any of you working in the
legislative arena, add to or correct.  Leslee

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] 
On Behalf Of Harrison, Kerry
Sent: Friday, January 16, 2009 1:57 PM
To: cnm at lists.my180.net 
Subject: [Cnm] CMS



Does anyone know about the new CMS guidelines that were past for more
MNT come 1/2009?

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

 

CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.


PLEASE NOTE: Property of Unity Health System -- www.unityhealth.org  
The information contained in this message may be privileged and confidential, protected from disclosure, and/or intended only for the user of the individual or entity named above. If the recipient of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication in error, please notify the sender immediately by replying to this message and deleting it from your computer. This email message is considered Virus Free by our virus scanning software. All email is considered property of Unity Health System. 
Address policy questions to address below. 
gwadministrator at unityhealth.org





From mrogard at charter.net  Mon Jan 19 03:28:41 2009
From: mrogard at charter.net (mrogard at charter.net)
Date: Mon, 19 Jan 2009 3:28:41 -0800
Subject: [Cnm] Question for ADA Nutrition Care Manual Users
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E03BB3D1D@rhcexch3.reshealthcare.org>
Message-ID: <20090119062841.BNS7Z.3310441.root@mp17>

Finding by diagnosis is fine for the dietitian and medical/nursing staff, but having a way to search by diet would be helpful for the diet office/production staff to look up  answers for food related issues.  Both search methods should be incorporated into the manual.
MJ


--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org
Professional email: mrogard at charter.net

---- "Carver wrote: 
> To me, the optimal goal is for the doc to know the diagnosis, and, if
> not sure what the best diet for that diagnosis is, look it up in the
> on-line manual and match the diet order to the diagnosis (or, God
> forbid, ask a dietitian).  I do not want the diets coming to our diet
> office as "diet for CHF and ESRD". That would mean the diet office would
> be making interpretations of medical diagnoses and assuming knowledge of
> the patient that they could not possibly have - you would have to set up
> some sort of conversion table and get it approved by you Nutrition
> Committee or P+T Committee.  
> 
> Docs are pretty comfortable w/ looking at diagnoses - I doubt that most
> ever look at a diet manual (paper or on-line) but those I've taught love
> looking up a diagnosis then just hitting "client education".  That
> pretty much gives them the down-and-dirty of what the diet should be.
> If they question that, (i.e. why a high protein diet for liver disease),
> they can click on references.  
> 
> >From my view point, the most difficult element is the combination diet.
> There is not way to print out a diet for a patient w/ type 2 diabetes
> plus renal disease so you end up having to modify by hand.  
> 
> Note:  the ADA nutrition care manual, even when in hard copy, has always
> grouped by diagnosis.  Leslee 
> 
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of DChampeon at stmarysmaine.com
> Sent: Friday, January 16, 2009 4:00 PM
> To: cnm at lists.my180.net
> Subject: [Cnm] Question for ADA Nutrition Care Manual Users
> 
> 
> I'm having difficulty figuring out how to use the ADA Nutrition Care
> Manual
> as a reference for my hospital's diet orders.  Nutrition therapy is
> listed
> by disease rather than diet type.
> 
> Do your physicians still order by diet type, e.g.,  2 gram sodium?  Or
> do
> they order by disease, e.g., heart failure?
> 
> Has anyone created recommended and not recommended lists by diet type
> using
> the nutrition therapy client education sheets?
> 
> I feel like I must be missing something.
> 
> Diana.
> 
> Diana Champeon
> Director, Nutrition Services
> St. Mary's Regional Medical Center
> 100 Campus Avenue
> Lewiston, ME 04240
> dchampeon at stmarysmaine.com
> phone (207)777-8603
> fax (207)777-8609
> 
> 
> 
> 
> 
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
> 
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



From Margaret.Chaffin at hcahealthcare.com  Mon Jan 19 06:46:22 2009
From: Margaret.Chaffin at hcahealthcare.com (Chaffin Meg)
Date: Mon, 19 Jan 2009 08:46:22 -0600
Subject: [Cnm] screening criteria
Message-ID: <FE4E4942DC04FF4DA336172CB2CC522D12B16AC88E@NADCWPMSGCMS06.hca.corpad.net>

First, thanks to all for the great advice and feedback on my enteral delivery problems. Now I'm looking at changing my NPO/clear liquids > 3 days to NPO/clear liquids > 5 days and for those already doing this, could you site me any references (or feedback in general) that may help me in my decision making.

TIA!

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Center
(229)434-2394

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/a3a37e0d/attachment.html 

From kharriso at stagnes.org  Mon Jan 19 07:13:41 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Mon, 19 Jan 2009 09:13:41 -0600
Subject: [Cnm] Hospitals in MD, DC, Va and PA
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B3925739D@ahcmascdc034.DS.SJHS.COM>

Submitting again:

 

Hi,

 

I am looking for Hospitals in these areas that use a clinical ladder
approved by their HR.  I made a proposal to my HR and they would like
references of hospitals in the area that she can speak with.  Thank you
so much.

 

Kerry Harrison

 

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

 


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/a8835331/attachment.html 

From cathy.peterjohn at medicorp.org  Mon Jan 19 07:25:18 2009
From: cathy.peterjohn at medicorp.org (cathy.peterjohn at medicorp.org)
Date: Mon, 19 Jan 2009 10:25:18 -0500
Subject: [Cnm] servers and hair nets
Message-ID: <OF145A794E.AE1B88F4-ON85257543.00549E1D-85257543.0054B6ED@medicorp.org>


Do your servers wear hair nets when they deliver/pick up trays to patients?



Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA  22401
540-741-1680
Fax: 540-741-4022
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/df83d936/attachment.html 

From cathy.peterjohn at medicorp.org  Mon Jan 19 07:26:50 2009
From: cathy.peterjohn at medicorp.org (cathy.peterjohn at medicorp.org)
Date: Mon, 19 Jan 2009 10:26:50 -0500
Subject: [Cnm] NCP
Message-ID: <OFE7226E81.8D79E8C1-ON85257543.0054B906-85257543.0054DAD8@medicorp.org>


For those of you doing the NCP, how are you formating your notes?  ADIME or
the modified version ADI?  Examples would be helpful.




Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA  22401
540-741-1680
Fax: 540-741-4022
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/03195a60/attachment.html 

From m-rodrig at msmc.com  Mon Jan 19 07:44:41 2009
From: m-rodrig at msmc.com (Maritza Rodriguez)
Date: Mon, 19 Jan 2009 10:44:41 -0500
Subject: [Cnm] Recommendations for patient with pressure ulcers
In-Reply-To: <OFE7226E81.8D79E8C1-ON85257543.0054B906-85257543.0054DAD8@medicorp.org>
References: <OFE7226E81.8D79E8C1-ON85257543.0054B906-85257543.0054DAD8@medicorp.org>
Message-ID: <32EDCA3D1F5C4C41B7E1A4573DFACCC60327DF0D@SVIPEXC1.msmc.com>

1. How do you make sure your recommendations for patients with pressure
ulcers are done?  

 

2. Do you have privileges to writes order in the chart?  If so, what
procedure did you follow to obtain that privilege?  

 

 3. Do any of you use some standing orders to be signed by the physician
or maybe a stamp or a sticker to remind doctors of your recommendations?

 

   Your feedback is very important.    

 

Maritza Rodriguez

 

Maritza Rodriguez, RD LDN

Clinical Nutrition Manager

Mount Sinai Medical Center

4300 Alton Road

Miami Beach, Florida 33140

 

Tel: 305-674-2121 Ext. 56181

Fax: 305-674-2234

m-rodrig at msmc.com

 

 

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
CONFIDENTIAL or PRIVILEGED information.  Any unauthorized review, use,
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and immediately
destroy all copies of the original message and all attachments.  Any
opinions expressed here are not necessarily those of Mount Sinai Medical
Center.

 

________________________________

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/429cdb56/attachment-0001.html 

From kharriso at stagnes.org  Mon Jan 19 07:53:53 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Mon, 19 Jan 2009 09:53:53 -0600
Subject: [Cnm] Recommendations for patient with pressure ulcers
In-Reply-To: <32EDCA3D1F5C4C41B7E1A4573DFACCC60327DF0D@SVIPEXC1.msmc.com>
References: <OFE7226E81.8D79E8C1-ON85257543.0054B906-85257543.0054DAD8@medicorp.org>
	<32EDCA3D1F5C4C41B7E1A4573DFACCC60327DF0D@SVIPEXC1.msmc.com>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B392573B9@ahcmascdc034.DS.SJHS.COM>

 

1. How do you make sure your recommendations for patients with pressure
ulcers are done?  We follow up and call the physician if need be!!

 

2. Do you have privileges to writes order in the chart?  If so, what
procedure did you follow to obtain that privilege?  Yes, we have order
writing privileges for TPN, TF, Vit/Min and Supplements.

 

 3. Do any of you use some standing orders to be signed by the physician
or maybe a stamp or a sticker to remind doctors of your recommendations?
No standing orders.

 

   Your feedback is very important.    

 

Maritza Rodriguez

 

Maritza Rodriguez, RD LDN

Clinical Nutrition Manager

Mount Sinai Medical Center

4300 Alton Road

Miami Beach, Florida 33140

 

Tel: 305-674-2121 Ext. 56181

Fax: 305-674-2234

m-rodrig at msmc.com

 

 

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
CONFIDENTIAL or PRIVILEGED information.  Any unauthorized review, use,
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and immediately
destroy all copies of the original message and all attachments.  Any
opinions expressed here are not necessarily those of Mount Sinai Medical
Center.

 

________________________________


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/4b348e5b/attachment.html 

From marsha.schofield at att.net  Mon Jan 19 08:01:35 2009
From: marsha.schofield at att.net (Marsha Schofield)
Date: Mon, 19 Jan 2009 11:01:35 -0500
Subject: [Cnm] CMS
Message-ID: <C6A71393-D23C-4120-99B0-74DFE6150B75@att.net>

Kerry,

Effective 1/2009 the reimbursement rates for Medicare MNT services  
provided by RDs increased.  Another change also opened the door for  
the possibility of MNT services for other diseases to be covered  
under what is called the National Coverage Determination process.   
ADA is in the process of gathering data to submit a request for  
consideration of coverage of some diagnoses related to heart  
disease.  Once a request is submitted, it can take 6-12 months for a  
decision and potential implementation.  So, stay tuned...

Marsha Schofield
Speaker, ADA House of Delegates
Director, ADA Board of Directors

On Jan 18, 2009, at 8:24 PM, Janel Welch wrote:


> The CMS website is difficult to navigate through but you can find  
> infor on the Ftags and 3.0 MDS
>
>
>
>
>
>>>> "Carver, Leslee" <LCarver at Reshealthcare.org> 1/16/2009 3:20 PM >>>
>>>>
> I believe it opens up the possibility for more diagnoses to be covered
> but that is not automatic.  Each diagnosis must go through a  
> process and
> nothing has been added at this time.  please - any of you working  
> in the
> legislative arena, add to or correct.  Leslee
>
> ________________________________
>
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Harrison, Kerry
> Sent: Friday, January 16, 2009 1:57 PM
> To: cnm at lists.my180.net
> Subject: [Cnm] CMS
>
>
>
> Does anyone know about the new CMS guidelines that were past for more
> MNT come 1/2009?
>
>
>
> Kerry Harrison, MS,RD,LDN
>
> Clinical Nutrition Manager
>
> St. Agnes Hospital
>
> Baltimore, MD 21229
>
> 410.368.2152
>
>
>
> To eat is a necessity, but to eat intelligently is an art.
>
> -LaRoche Foucauld
>
> A government big enough to give you everything you want, is strong
> enough to take everything you have.
> -Thomas Jefferson
>
>
>
> CONFIDENTIALITY NOTICE: This email message and any accompanying  
> data or
> files is confidential and may contain privileged information intended
> only for the named recipient(s). If you are not the intended
> recipient(s), you are hereby notified that the dissemination,
> distribution, and or copying of this message is strictly  
> prohibited. If
> you receive this message in error, or are not the named recipient(s),
> please notify the sender at the email address above, delete this email
> from your computer, and destroy any copies in any form immediately.
> Receipt by anyone other than the named recipient(s) is not a waiver of
> any attorney-client, work product, or other applicable privilege.
>
>
> PLEASE NOTE: Property of Unity Health System -- www.unityhealth.org
> The information contained in this message may be privileged and  
> confidential, protected from disclosure, and/or intended only for  
> the user of the individual or entity named above. If the recipient  
> of this message is not the intended recipient, you are hereby  
> notified that any dissemination, distribution or copying of this  
> communication is strictly prohibited. If you received this  
> communication in error, please notify the sender immediately by  
> replying to this message and deleting it from your computer. This  
> email message is considered Virus Free by our virus scanning  
> software. All email is considered property of Unity Health System.
> Address policy questions to address below.
> gwadministrator at unityhealth.org
>
>
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>



From kharriso at stagnes.org  Mon Jan 19 08:49:42 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Mon, 19 Jan 2009 10:49:42 -0600
Subject: [Cnm] FW:  Recommendations for patient with pressure ulcers
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B392573E2@ahcmascdc034.DS.SJHS.COM>

This came to me Maritza, hope it helps.

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: Cathy Poquette [mailto:Cathy.Poquette at stjoe.org] 
Sent: Monday, January 19, 2009 11:43 AM
To: Harrison, Kerry
Subject: RE: [Cnm] Recommendations for patient with pressure ulcers

 

Hi Kerry,

 

My answers are the same as below.  Per our JC Consultant's
recommendation, we sent our MNT Protocol (which outlined our Scope of
Practice per California Law and also ADA SOP) and attached our Job
Descriptions, explained in our Protocol that competency of the RD's was
assessed upon hire and then annually thereafter - then sent it through 3
committees - Pharmacy and Therapeutics, Executive Medical Staff and the
Governing Board.  We also sent our EN and PN Protocol to the same
committees for approval.   We also make it a requirement when orders are
entered in CPOE/Meditech, a query (Dietitian may implement MNT Protocol)
pops up requiring the staff to select from the following:  "yes", "no",
or "not otherwise specified".  So, before we can initiate our MNT
Protocol, the physicians has to order "may implement MNT Protocol" which
allows us to carry out the order functions specified in the protocol.
Physicians agreed to let this query default to "yes" when orders are
entered in the standard order sets (all but 2 Physicians) in CPOE.  For
those 2 physicians, the RD has to contact the physician if the need
arises to order/change order for their patient.  Basically, our MNT
Protocol allows us to modify diet orders, add supplements, order labs,
weights, vitamins/minerals to meet pts assessed.  The PN Protocol allows
us to order labs if the physician has ordered "may implement MNT
Protocol or when the physician orders "RD Consult" for PN.  The EN
Protocol allows us to order everything that is spelled out in the MNT
Protocol when the physician orders "RD Consult" for tube feeding. We DO
NOT write PN orders, per California Law.

 

We have privileges to write orders noted above.  The only standing
orders we have is regarding TF initiation and PN initiation - once the
doctor orders to start TF and if he doesn't specify the rate, the nurses
start TF per protocol and orders an RD Consult.  Orders for PN received
before 12 noon, the pharmacy will begin patient on a starter solution
until 8 p.m. that evening when their custom PN is delivered from our out
source.  Orders for PN received after 12 noon daily, the pharmacy will
begin patient on a starter PN solution and the patient will start their
custom PN by 8 p.m. the following day.

 

We have a very supportive medical staff with regards to letting us
manage the nutrition of the patients.  The process of getting the
protocols approved began in 2007.  I have been continued to work on
refinement of the protocols.  The best person that helped us get the
protocols through the Exec Medical Staff was our Director of Medical
Staff office. 

 

We are expecting JC and DPH (formerly DHS) anytime.  We do not know if
they will accept what we have done, but were told by our JC Consultant
that this was the process per his interpretation across the nation.
Hope this helps.

 

Cathy Poquette, MS, RD

Clinical Nutrition Operations Manager

St Jude Medical Center

Fullerton, CA.

 

 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Harrison, Kerry
Sent: Monday, January 19, 2009 7:54 AM
To: Maritza Rodriguez; cnm at lists.my180.net
Subject: Re: [Cnm] Recommendations for patient with pressure ulcers

 

 

1. How do you make sure your recommendations for patients with pressure
ulcers are done?  We follow up and call the physician if need be!!

 

2. Do you have privileges to writes order in the chart?  If so, what
procedure did you follow to obtain that privilege?  Yes, we have order
writing privileges for TPN, TF, Vit/Min and Supplements.

 

 3. Do any of you use some standing orders to be signed by the physician
or maybe a stamp or a sticker to remind doctors of your recommendations?
No standing orders.

 

   Your feedback is very important.    

 

Maritza Rodriguez

 

Maritza Rodriguez, RD LDN

Clinical Nutrition Manager

Mount Sinai Medical Center

4300 Alton Road

Miami Beach, Florida 33140

 

Tel: 305-674-2121 Ext. 56181

Fax: 305-674-2234

m-rodrig at msmc.com

 

 

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
CONFIDENTIAL or PRIVILEGED information.  Any unauthorized review, use,
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and immediately
destroy all copies of the original message and all attachments.  Any
opinions expressed here are not necessarily those of Mount Sinai Medical
Center.

 

________________________________

 
CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.

 

________________________________

Notice from St.Joseph Health System:
Please note that the information contained in this message may be
privileged and confidential and protected from disclosure.


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/c15d07b0/attachment-0001.html 

From Linda.Woods at healthall.com  Mon Jan 19 08:51:39 2009
From: Linda.Woods at healthall.com (Woods, Linda)
Date: Mon, 19 Jan 2009 11:51:39 -0500
Subject: [Cnm] servers and hair nets
In-Reply-To: <OF145A794E.AE1B88F4-ON85257543.00549E1D-85257543.0054B6ED@medicorp.org>
References: <OF145A794E.AE1B88F4-ON85257543.00549E1D-85257543.0054B6ED@medicorp.org>
Message-ID: <2B1106A6A593B147A65BD5A8939D3E111715741940@MAIL-C.healthall.com>

No.

Linda Woods, RD, LD
Clinical Nutrition Coordinator
The University Hospital
234 Goodman Street
Cincinnati, OH  45219
linda.woods at healthall.com
Office:  513-584-4534
Fax:  513-584-1027



From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of cathy.peterjohn at medicorp.org
Sent: Monday, January 19, 2009 10:25 AM
To: cnm at lists.my180.net
Subject: [Cnm] servers and hair nets


Do your servers wear hair nets when they deliver/pick up trays to patients?



Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA 22401
540-741-1680
Fax: 540-741-4022

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/42dd0a3d/attachment.html 

From Amy.Gendron at cvmc.org  Mon Jan 19 09:15:12 2009
From: Amy.Gendron at cvmc.org (Gendron, Amy L.)
Date: Mon, 19 Jan 2009 12:15:12 -0500
Subject: [Cnm] Isoniazid food/drug handout?
In-Reply-To: <mailman.2915.1232383765.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <ED658CF94165704EBE82F8D0D00A3F3605CA0C7F@cvmcnt1.cvmc.org>

Does anyone have an Isoniazid (INH) food/drug interaction teaching
sheet/handout that they would be willing to share?
Thanks
 
Amy Gendron, RD
Senior Inpatient Dietitian
Central Vermont Medical Center
ph: 802-371-4143    fax: 802-371-5376
amy.gendron at cvmc.org

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of cnm-request at lists.my180.net
Sent: Monday, January 19, 2009 11:49 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 78

Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."



From Lori.Zimmerman at ministryhealth.org  Mon Jan 19 08:05:20 2009
From: Lori.Zimmerman at ministryhealth.org (Zimmerman, Lori A)
Date: Mon, 19 Jan 2009 10:05:20 -0600
Subject: [Cnm] servers and hair nets
In-Reply-To: <OF145A794E.AE1B88F4-ON85257543.00549E1D-85257543.0054B6ED@medicorp.org>
References: <OF145A794E.AE1B88F4-ON85257543.00549E1D-85257543.0054B6ED@medicorp.org>
Message-ID: <CB047BDA1CB67343A4C829AFB7E45AA10484D2CC75@EXMHCMBX03VS.ministryhealth.net>

NO
________________________________
From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of cathy.peterjohn at medicorp.org [cathy.peterjohn at medicorp.org]
Sent: Monday, January 19, 2009 9:25 AM
To: cnm at lists.my180.net
Subject: [Cnm] servers and hair nets


Do your servers wear hair nets when they deliver/pick up trays to patients?



Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA 22401
540-741-1680
Fax: 540-741-4022

________________________________
CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/33b8b491/attachment.html 

From Linda.Bartholomay at meritcare.com  Mon Jan 19 11:19:19 2009
From: Linda.Bartholomay at meritcare.com (Linda Bartholomay)
Date: Mon, 19 Jan 2009 13:19:19 -0600
Subject: [Cnm] Question for ADA Nutrition Care Manual Users
In-Reply-To: <20090119062841.BNS7Z.3310441.root@mp17>
References: <5330B54133B6194BA13930BDEFE9A30E03BB3D1D@rhcexch3.reshealthcare.org>
	<20090119062841.BNS7Z.3310441.root@mp17>
Message-ID: <49747DD6.309B.00D0.0@meritcare.com>

I totally agree.  The physicians have to order diets that also coincide with our CBord system.  These are specific parameters and the diets translated by the unit clerk.  If the diet office staff has to "translate" it based on diagnosis, this won't work.  We did not previously use the ADA diet manual as our official diet manual, but had one that was listed by diet type.  
 
We need it to be referenced both ways.
Linda
 
Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer


>>> <mrogard at charter.net> 1/19/2009 5:28 AM >>>
Finding by diagnosis is fine for the dietitian and medical/nursing staff, but having a way to search by diet would be helpful for the diet office/production staff to look up  answers for food related issues.  Both search methods should be incorporated into the manual.
MJ


--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org 
Professional email: mrogard at charter.net 

---- "Carver wrote: 
> To me, the optimal goal is for the doc to know the diagnosis, and, if
> not sure what the best diet for that diagnosis is, look it up in the
> on-line manual and match the diet order to the diagnosis (or, God
> forbid, ask a dietitian).  I do not want the diets coming to our diet
> office as "diet for CHF and ESRD". That would mean the diet office would
> be making interpretations of medical diagnoses and assuming knowledge of
> the patient that they could not possibly have - you would have to set up
> some sort of conversion table and get it approved by you Nutrition
> Committee or P+T Committee.  
> 
> Docs are pretty comfortable w/ looking at diagnoses - I doubt that most
> ever look at a diet manual (paper or on-line) but those I've taught love
> looking up a diagnosis then just hitting "client education".  That
> pretty much gives them the down-and-dirty of what the diet should be.
> If they question that, (i.e. why a high protein diet for liver disease),
> they can click on references.  
> 
> >From my view point, the most difficult element is the combination diet.
> There is not way to print out a diet for a patient w/ type 2 diabetes
> plus renal disease so you end up having to modify by hand.  
> 
> Note:  the ADA nutrition care manual, even when in hard copy, has always
> grouped by diagnosis.  Leslee 
> 
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] 
> On Behalf Of DChampeon at stmarysmaine.com 
> Sent: Friday, January 16, 2009 4:00 PM
> To: cnm at lists.my180.net 
> Subject: [Cnm] Question for ADA Nutrition Care Manual Users
> 
> 
> I'm having difficulty figuring out how to use the ADA Nutrition Care
> Manual
> as a reference for my hospital's diet orders.  Nutrition therapy is
> listed
> by disease rather than diet type.
> 
> Do your physicians still order by diet type, e.g.,  2 gram sodium?  Or
> do
> they order by disease, e.g., heart failure?
> 
> Has anyone created recommended and not recommended lists by diet type
> using
> the nutrition therapy client education sheets?
> 
> I feel like I must be missing something.
> 
> Diana.
> 
> Diana Champeon
> Director, Nutrition Services
> St. Mary's Regional Medical Center
> 100 Campus Avenue
> Lewiston, ME 04240
> dchampeon at stmarysmaine.com 
> phone (207)777-8603
> fax (207)777-8609
> 
> 
> 
> 
> 
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net 
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net 
> 
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net 
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net 


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


This e-mail message is intended only for the named recipient(s) above and is covered by the Electronic Communications Privacy Act 18 U.S.C.  Section 2510-2521.   This e-mail is confidential and may contain information that is privileged or exempt from disclosure under applicable law.  If you have received this message in error please immediately notify the sender by return e-mail and delete this e-mail message from your computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/66ac9406/attachment.html 

From pcharney at mac.com  Mon Jan 19 11:26:34 2009
From: pcharney at mac.com (Pam Charney)
Date: Mon, 19 Jan 2009 11:26:34 -0800
Subject: [Cnm] Question for ADA Nutrition Care Manual Users
In-Reply-To: <49747DD6.309B.00D0.0@meritcare.com>
References: <5330B54133B6194BA13930BDEFE9A30E03BB3D1D@rhcexch3.reshealthcare.org>
	<20090119062841.BNS7Z.3310441.root@mp17>
	<49747DD6.309B.00D0.0@meritcare.com>
Message-ID: <A6CC9EDC-7C9C-4296-8677-F1CC6FC734AF@mac.com>

Has anyone formally requested this of ADA? It can be quite the chore  
to do such an index but I can see the need.

Regards,
pam

Pam Charney PhD, RD
Clinical Coordinator
Graduate Coordinated Program in Dietetics
Lecturer, Department of Epidemiology
Nutrition Sciences Program
School of Public Health and Community Medicine
Box 353410, 306-C Raitt Hall

Affiliate Associate Professor
School of Pharmacy

MS Student
Clinical Informatics and Patient Centered Technology
School of Nursing

University of Washington
Seattle, WA
charnepa at u.washington.edu
"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jan 19, 2009, at 11:19 AM, Linda Bartholomay wrote:

> I totally agree.  The physicians have to order diets that also  
> coincide with our CBord system.  These are specific parameters and  
> the diets translated by the unit clerk.  If the diet office staff  
> has to "translate" it based on diagnosis, this won't work.  We did  
> not previously use the ADA diet manual as our official diet manual,  
> but had one that was listed by diet type.
>
> We need it to be referenced both ways.
> Linda
>
> Linda Bartholomay, LRD
> Manager, Nutrition Therapy
> MeritCare Health Systems
> Linda.Bartholomay at meritcare.com
> (701) 234-6166
> Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer
>
>
> >>> <mrogard at charter.net> 1/19/2009 5:28 AM >>>
> Finding by diagnosis is fine for the dietitian and medical/nursing  
> staff, but having a way to search by diet would be helpful for the  
> diet office/production staff to look up  answers for food related  
> issues.  Both search methods should be incorporated into the manual.
> MJ
>
>
> --
> Mary Jane Rogalski, MBA, RD, LDN
> Manager, Clinical Nutrition
> Food and Nutrition Services - C1340
> Baystate Medical Center
> 759 Chestnut Street
> Springfield, MA 01199
> Work #: 413-794-4954
> Fax #: 413-794-4949
> Work email: mary.jane.rogalski at bhs.org
> Professional email: mrogard at charter.net
>
> ---- "Carver wrote:
> > To me, the optimal goal is for the doc to know the diagnosis, and,  
> if
> > not sure what the best diet for that diagnosis is, look it up in the
> > on-line manual and match the diet order to the diagnosis (or, God
> > forbid, ask a dietitian).  I do not want the diets coming to our  
> diet
> > office as "diet for CHF and ESRD". That would mean the diet office  
> would
> > be making interpretations of medical diagnoses and assuming  
> knowledge of
> > the patient that they could not possibly have - you would have to  
> set up
> > some sort of conversion table and get it approved by you Nutrition
> > Committee or P+T Committee.
> >
> > Docs are pretty comfortable w/ looking at diagnoses - I doubt that  
> most
> > ever look at a diet manual (paper or on-line) but those I've  
> taught love
> > looking up a diagnosis then just hitting "client education".  That
> > pretty much gives them the down-and-dirty of what the diet should  
> be.
> > If they question that, (i.e. why a high protein diet for liver  
> disease),
> > they can click on references.
> >
> > >From my view point, the most difficult element is the combination  
> diet.
> > There is not way to print out a diet for a patient w/ type 2  
> diabetes
> > plus renal disease so you end up having to modify by hand.
> >
> > Note:  the ADA nutrition care manual, even when in hard copy, has  
> always
> > grouped by diagnosis.  Leslee
> >
> > -----Original Message-----
> > From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net 
> ]
> > On Behalf Of DChampeon at stmarysmaine.com
> > Sent: Friday, January 16, 2009 4:00 PM
> > To: cnm at lists.my180.net
> > Subject: [Cnm] Question for ADA Nutrition Care Manual Users
> >
> >
> > I'm having difficulty figuring out how to use the ADA Nutrition Care
> > Manual
> > as a reference for my hospital's diet orders.  Nutrition therapy is
> > listed
> > by disease rather than diet type.
> >
> > Do your physicians still order by diet type, e.g.,  2 gram  
> sodium?  Or
> > do
> > they order by disease, e.g., heart failure?
> >
> > Has anyone created recommended and not recommended lists by diet  
> type
> > using
> > the nutrition therapy client education sheets?
> >
> > I feel like I must be missing something.
> >
> > Diana.
> >
> > Diana Champeon
> > Director, Nutrition Services
> > St. Mary's Regional Medical Center
> > 100 Campus Avenue
> > Lewiston, ME 04240
> > dchampeon at stmarysmaine.com
> > phone (207)777-8603
> > fax (207)777-8609
> >
> >
> >
> >
> >
> > _______________________________________________
> > Cnm mailing list
> > Cnm at lists.my180.net
> > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
> >
> > _______________________________________________
> > Cnm mailing list
> > Cnm at lists.my180.net
> > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
> This e-mail message is intended only for the named recipient(s)  
> above and is covered by the Electronic Communications Privacy Act 18  
> U.S.C. Section 2510-2521. This e-mail is confidential and may  
> contain information that is privileged or exempt from disclosure  
> under applicable law. If you have received this message in error  
> please immediately notify the sender by return e-mail and delete  
> this e-mail message from your computer.
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/e3af6b75/attachment-0001.html 

From Annalynn_Skipper at Comcast.net  Mon Jan 19 11:51:14 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Mon, 19 Jan 2009 13:51:14 -0600
Subject: [Cnm] Question for ADA Nutrition Care Manual Users
In-Reply-To: <49747DD6.309B.00D0.0@meritcare.com>
References: <5330B54133B6194BA13930BDEFE9A30E03BB3D1D@rhcexch3.reshealthcare.org><20090119062841.BNS7Z.3310441.root@mp17>
	<49747DD6.309B.00D0.0@meritcare.com>
Message-ID: <60424662D2EF45938BB5483DA278B261@ANNALYNN>

Please look in the Meal Plans Section of ADA's Nutrition Care Manual.  The
first chart is entitled "Meal Plan Crosswalk".  I believe this document is
intended to meet the needs expressed in the messages below.  Of course, the
NCM staff is happy to review your feedback on this document.  Feel free to
submit specific and actionable comments directly to me, or if you prefer via
the NCM website.   

Thanks!  

Annalynn

 

Annalynn Skipper Ph.D., R.D., FADA

Editor, ADA's Nutrition Care Manual

 

  _____  

From: Linda Bartholomay [mailto:Linda.Bartholomay at meritcare.com] 
Sent: Monday, January 19, 2009 1:19 PM
To: mrogard at charter.net; cnm at lists.my180.net; Leslee Carver;
DChampeon at stmarysmaine.com
Subject: Re: [Cnm] Question for ADA Nutrition Care Manual Users

 

I totally agree.  The physicians have to order diets that also coincide with
our CBord system.  These are specific parameters and the diets translated by
the unit clerk.  If the diet office staff has to "translate" it based on
diagnosis, this won't work.  We did not previously use the ADA diet manual
as our official diet manual, but had one that was listed by diet type.  

 

We need it to be referenced both ways.

Linda

 

Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer



>>> <mrogard at charter.net> 1/19/2009 5:28 AM >>>
Finding by diagnosis is fine for the dietitian and medical/nursing staff,
but having a way to search by diet would be helpful for the diet
office/production staff to look up  answers for food related issues.  Both
search methods should be incorporated into the manual.
MJ


--
Mary Jane Rogalski, MBA, RD, LDN
Manager, Clinical Nutrition
Food and Nutrition Services - C1340
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Work #: 413-794-4954
Fax #: 413-794-4949
Work email: mary.jane.rogalski at bhs.org
Professional email: mrogard at charter.net

---- "Carver wrote: 
> To me, the optimal goal is for the doc to know the diagnosis, and, if
> not sure what the best diet for that diagnosis is, look it up in the
> on-line manual and match the diet order to the diagnosis (or, God
> forbid, ask a dietitian).  I do not want the diets coming to our diet
> office as "diet for CHF and ESRD". That would mean the diet office would
> be making interpretations of medical diagnoses and assuming knowledge of
> the patient that they could not possibly have - you would have to set up
> some sort of conversion table and get it approved by you Nutrition
> Committee or P+T Committee.  
> 
> Docs are pretty comfortable w/ looking at diagnoses - I doubt that most
> ever look at a diet manual (paper or on-line) but those I've taught love
> looking up a diagnosis then just hitting "client education".  That
> pretty much gives them the down-and-dirty of what the diet should be.
> If they question that, (i.e. why a high protein diet for liver disease),
> they can click on references.  
> 
> >From my view point, the most difficult element is the combination diet.
> There is not way to print out a diet for a patient w/ type 2 diabetes
> plus renal disease so you end up having to modify by hand.  
> 
> Note:  the ADA nutrition care manual, even when in hard copy, has always
> grouped by diagnosis.  Leslee 
> 
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of DChampeon at stmarysmaine.com
> Sent: Friday, January 16, 2009 4:00 PM
> To: cnm at lists.my180.net
> Subject: [Cnm] Question for ADA Nutrition Care Manual Users
> 
> 
> I'm having difficulty figuring out how to use the ADA Nutrition Care
> Manual
> as a reference for my hospital's diet orders.  Nutrition therapy is
> listed
> by disease rather than diet type.
> 
> Do your physicians still order by diet type, e.g.,  2 gram sodium?  Or
> do
> they order by disease, e.g., heart failure?
> 
> Has anyone created recommended and not recommended lists by diet type
> using
> the nutrition therapy client education sheets?
> 
> I feel like I must be missing something.
> 
> Diana.
> 
> Diana Champeon
> Director, Nutrition Services
> St. Mary's Regional Medical Center
> 100 Campus Avenue
> Lewiston, ME 04240
> dchampeon at stmarysmaine.com
> phone (207)777-8603
> fax (207)777-8609
> 
> 
> 
> 
> 
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
> 
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

  _____  

This e-mail message is intended only for the named recipient(s) above and is
covered by the Electronic Communications Privacy Act 18 U.S.C. Section
2510-2521. This e-mail is confidential and may contain information that is
privileged or exempt from disclosure under applicable law. If you have
received this message in error please immediately notify the sender by
return e-mail and delete this e-mail message from your computer. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/9fdaaef5/attachment.html 

From Annalynn_Skipper at Comcast.net  Mon Jan 19 12:45:33 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Mon, 19 Jan 2009 14:45:33 -0600
Subject: [Cnm] NCP
In-Reply-To: <OFE7226E81.8D79E8C1-ON85257543.0054B906-85257543.0054DAD8@medicorp.org>
References: <OFE7226E81.8D79E8C1-ON85257543.0054B906-85257543.0054DAD8@medicorp.org>
Message-ID: <ED63EFE9DCD2421998745C1F176D6CEA@ANNALYNN>

Hi Cathy, 

 

I believe the ADI format evolved because terminology wasn't available for
the Monitoring and Evaluation step.  If you include monitoring and
evaluation, you can more easily measure dietitian effectiveness by measuring
patient progress toward goals.  

 

Annalynn

 

Annalynn Skipper Ph.D., R.D., FADA

 


a consultancy devoted to advancing nutrition practice

P.O. Box 45

Oak Park, IL 60303

 <mailto:Annalynn_Skipper at Comcast.net> Annalynn_Skipper at Comcast.net

Advanced Medical Nutrition Therapy Practice, 

a 2008 text, is available from Jones and Bartlett. 

 

  _____  

From: cathy.peterjohn at medicorp.org [mailto:cathy.peterjohn at medicorp.org] 
Sent: Monday, January 19, 2009 9:27 AM
To: cnm at lists.my180.net
Subject: [Cnm] NCP

 

For those of you doing the NCP, how are you formating your notes? ADIME or
the modified version ADI? Examples would be helpful.




Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA 22401
540-741-1680
Fax: 540-741-4022

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/8f99f2ed/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 170 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090119/8f99f2ed/attachment.gif 

From pcharney at mac.com  Mon Jan 19 13:43:19 2009
From: pcharney at mac.com (Pam Charney)
Date: Mon, 19 Jan 2009 13:43:19 -0800
Subject: [Cnm] NCP
In-Reply-To: <ED63EFE9DCD2421998745C1F176D6CEA@ANNALYNN>
References: <OFE7226E81.8D79E8C1-ON85257543.0054B906-85257543.0054DAD8@medicorp.org>
	<ED63EFE9DCD2421998745C1F176D6CEA@ANNALYNN>
Message-ID: <AE497891-3F53-4076-9CC2-FEDF5BEA5D96@mac.com>

Also, remember that you aren't "obligated" to use a particular  
documentation method in order to use a care process such as the  
Nutrition Care Process.

Some folks don't have the ability to change documentation formats;  
that's fine!

pam

Pam Charney PhD, RD
Clinical Coordinator
Graduate Coordinated Program in Dietetics
Lecturer, Department of Epidemiology
Nutrition Sciences Program
School of Public Health and Community Medicine
Box 353410, 306-C Raitt Hall

Affiliate Associate Professor
School of Pharmacy

MS Student
Clinical Informatics and Patient Centered Technology
School of Nursing

University of Washington
Seattle, WA
charnepa at u.washington.edu
"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jan 19, 2009, at 12:45 PM, Annalynn Skipper wrote:

> Hi Cathy,
>
> I believe the ADI format evolved because terminology wasn?t  
> available for the Monitoring and Evaluation step.  If you include  
> monitoring and evaluation, you can more easily measure dietitian  
> effectiveness by measuring patient progress toward goals.
>
> Annalynn
>
> Annalynn Skipper Ph.D., R.D., FADA
> <image001.gif>
>
> a consultancy devoted to advancing nutrition practice
> P.O. Box 45
> Oak Park, IL 60303
> Annalynn_Skipper at Comcast.net
> Advanced Medical Nutrition Therapy Practice,
> a 2008 text, is available from Jones and Bartlett.
>
> From: cathy.peterjohn at medicorp.org [mailto:cathy.peterjohn at medicorp.org 
> ]
> Sent: Monday, January 19, 2009 9:27 AM
> To: cnm at lists.my180.net
> Subject: [Cnm] NCP
>
> For those of you doing the NCP, how are you formating your notes?  
> ADIME or the modified version ADI? Examples would be helpful.
>
>
>
>
> Cathy Peterjohn, MS, RD, CDE
> Clinical Nutrition/Diabetes Manager
> c/o Nutrition Services
> Mary Washington Hospital
> 1001 Sam Perry Blvd.
> Fredericksburg, VA 22401
> 540-741-1680
> Fax: 540-741-4022
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/94fd561d/attachment.html 

From sadiecat14 at verizon.net  Mon Jan 19 17:08:59 2009
From: sadiecat14 at verizon.net (Deborah Gore)
Date: Mon, 19 Jan 2009 20:08:59 -0500
Subject: [Cnm] Searching the ADA NCM
References: <20090119062841.BNS7Z.3310441.root@mp17>
Message-ID: <F51619ACD75A43BFA8484939BF71D6BF@owner84d523d58>

RE: Finding by diagnosis is fine for the dietitian and medical/nursing staff, but having a way to search by diet would be helpful for the diet office/production staff to look up  answers for food related issues.  Both search methods should be incorporated into the manual.

I agree, sometimes I want a diet explanation but not with a diagnosis attached to it. I don't always have a patient with a MI that I
want to give heart healthy tips for. Looking for a high fiber diet, etc. is tricky. My pet peeve has been using the search function that comes up with hundreds
of results even when I use multiple words trying to get a short list. It is not like using Google!

Deborah Gore, RD, CNSD
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/b6c9c9b2/attachment.html 

From kmershon at bak.rr.com  Mon Jan 19 19:59:45 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Mon, 19 Jan 2009 19:59:45 -0800
Subject: [Cnm] Searching the ADA NCM
In-Reply-To: <F51619ACD75A43BFA8484939BF71D6BF@owner84d523d58>
References: <20090119062841.BNS7Z.3310441.root@mp17>
	<F51619ACD75A43BFA8484939BF71D6BF@owner84d523d58>
Message-ID: <098E15DC0BED46DC915163034B8AF9B9@KathyPC>

I do agree the search feature leaves much to be desired. Diana Fahaber is who we should contact.
Kathleen Mershon, RD 
  ----- Original Message ----- 
  From: Deborah Gore 
  To: cnm at lists.my180.net 
  Sent: Monday, January 19, 2009 5:08 PM
  Subject: [Cnm] Searching the ADA NCM


  RE: Finding by diagnosis is fine for the dietitian and medical/nursing staff, but having a way to search by diet would be helpful for the diet office/production staff to look up  answers for food related issues.  Both search methods should be incorporated into the manual.

  I agree, sometimes I want a diet explanation but not with a diagnosis attached to it. I don't always have a patient with a MI that I
  want to give heart healthy tips for. Looking for a high fiber diet, etc. is tricky. My pet peeve has been using the search function that comes up with hundreds
  of results even when I use multiple words trying to get a short list. It is not like using Google!

  Deborah Gore, RD, CNSD


------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/a6d35c55/attachment-0001.html 

From kmershon at bak.rr.com  Mon Jan 19 20:07:10 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Mon, 19 Jan 2009 20:07:10 -0800
Subject: [Cnm] servers and hair nets
In-Reply-To: <OF145A794E.AE1B88F4-ON85257543.00549E1D-85257543.0054B6ED@medicorp.org>
References: <OF145A794E.AE1B88F4-ON85257543.00549E1D-85257543.0054B6ED@medicorp.org>
Message-ID: <EE7B295C16D94717928DB563495BB618@KathyPC>


  ----- Original Message ----- 
  From: cathy.peterjohn at medicorp.org 
  To: cnm at lists.my180.net 
  Sent: Monday, January 19, 2009 7:25 AM
  Subject: [Cnm] servers and hair nets


  Do your servers wear hair nets when they deliver/pick up trays to patients? No

  Kathleen Mershon, RD



  Cathy Peterjohn, MS, RD, CDE
  Clinical Nutrition/Diabetes Manager
  c/o Nutrition Services
  Mary Washington Hospital
  1001 Sam Perry Blvd.
  Fredericksburg, VA 22401
  540-741-1680
  Fax: 540-741-4022



------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/54a4898c/attachment.html 

From kmershon at bak.rr.com  Mon Jan 19 20:13:01 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Mon, 19 Jan 2009 20:13:01 -0800
Subject: [Cnm] screening criteria
In-Reply-To: <FE4E4942DC04FF4DA336172CB2CC522D12B16AC88E@NADCWPMSGCMS06.hca.corpad.net>
References: <FE4E4942DC04FF4DA336172CB2CC522D12B16AC88E@NADCWPMSGCMS06.hca.corpad.net>
Message-ID: <3E0CCB682B934C458AA33D540FBF2CA5@KathyPC>

Meg
We made the switch based on the chatter on the listserv and the average LOS in our hospital (5 days). We found we would race up to do an assessment on day 4 only to have the well nourished patient advance to a regular day right after we completed our assessment. Patients till on NPO beyond 5 days have more going on. It has served us well. It seems there was an article in the CNM newletter or maybe it was the MNT newsletter. I am sure there is something out there if you do the search.

Good Luck
Kathleen Mershon, RD
  ----- Original Message ----- 
  From: Chaffin Meg 
  To: cnm at lists.my180.net 
  Sent: Monday, January 19, 2009 6:46 AM
  Subject: [Cnm] screening criteria


  First, thanks to all for the great advice and feedback on my enteral delivery problems. Now I'm looking at changing my NPO/clear liquids > 3 days to NPO/clear liquids > 5 days and for those already doing this, could you site me any references (or feedback in general) that may help me in my decision making. 

   

  TIA!

   

  Meg Chaffin MA,RD,LD

  Clinical Nutrition Manager

  Palmyra Medical Center

  (229)434-2394

   



------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/6a05d595/attachment.html 

From mtewes at wchsys.org  Tue Jan 20 06:24:31 2009
From: mtewes at wchsys.org (Melissa Tewes)
Date: Tue, 20 Jan 2009 09:24:31 -0500
Subject: [Cnm] Obese Pts
Message-ID: <20090120142431.605EBB4DFB@custmx01.expedient.net>

We currently screen all pts w/a 250% IBW or higher.  Are other facilities
intervening on obese patients?  I was considering formulating a packet of
nutrition information to be provided to all pts. Any thoughts or suggestions
would be greatly appreciated.


Thanks

 

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washingon County Health System

251 East Antietam Street

Hagerstown, MD 21740

Phone:  301-790-8084

Fax:  301-790-8535

 

mtewes at wchsys.org

 



***** CONFIDENTIALITY NOTICE *****
This message contains confidential information and is intended only for
the individual named. If you are not the named addressee you should not
disseminate, distribute or copy this e-mail. Please notify the sender
immediately by e-mail if you have received this e-mail by mistake and
delete this e-mail from your system.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/21894c76/attachment.html 

From Shannon.Jackson at wilmed.org  Tue Jan 20 07:23:41 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Tue, 20 Jan 2009 10:23:41 -0500
Subject: [Cnm] servers and hair nets
In-Reply-To: <EE7B295C16D94717928DB563495BB618@KathyPC>
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF287@wmhcs03.wmh.org>

Yes our servers wear hair nets when they deliver and pick up trays.
Thanks
shannon

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On
Behalf Of Kathleen Mershon
Sent: Monday, January 19, 2009 11:07 PM
To: cnm at lists.my180.net; cathy.peterjohn at medicorp.org
Subject: Re: [Cnm] servers and hair nets


 

----- Original Message ----- 
From: cathy.peterjohn at medicorp.org 
To: cnm at lists.my180.net 
Sent: Monday, January 19, 2009 7:25 AM
Subject: [Cnm] servers and hair nets


Do your servers wear hair nets when they deliver/pick up trays to patients?
No

Kathleen Mershon, RD



Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA 22401
540-741-1680
Fax: 540-741-4022



  _____  




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/4232c2c9/attachment.html 

From vcounselman at HHC.org  Tue Jan 20 07:23:06 2009
From: vcounselman at HHC.org (Valerie Counselman)
Date: Tue, 20 Jan 2009 10:23:06 -0500
Subject: [Cnm] NCM sodium restriction for cardiac diets
Message-ID: <7B75865298C8B44B9931B1F9E1B197F10656B663@HHCEXCHANGE.hhc.org>

Would anyone who has the online nutrition care manual be willing to
share with me the recommended sodium level for the cardiac diet?

 

Our system is planning on liberalizing to 4 gram sodium diet and we want
to be sure we are following the manual.

 

We are currently using ADA manual, but plan to use the online program in
the next few months. However, the diet changes are to be reviewed on P&T
tomorrow.

 

Thanks in advance.

 

Valerie Counselman, MPH, RD, LD

Clinical Nutrition Manager

Houston Medical Center

1601 Watson Blvd

Warner Robins, GA 31088

(478) 542-7953

vcounselman at hhc.org

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/f57bb85d/attachment.html 

From ESCOTTSTUMPS at ecu.edu  Fri Jan 16 08:55:57 2009
From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia)
Date: Fri, 16 Jan 2009 11:55:57 -0500
Subject: [Cnm] Necessary cruise!
References: <BLU113-DS52A37CA84BE78A7F6DC5EB4D40@phx.gbl>
Message-ID: <BD44FF0CF4C18245854BBE03590A4C130150CD44@ECUFS7.intra.ecu.edu>

Hello everyone,
We hope you can join us for a Continuing Ed cruise related to the Nutrition care process (and good fun!)  Many of you need this break because your weather has been so miserable!  Our cruise to Bermuda is sponsored by our university and a collaborator, Rich Rados (whose daughter is an RD.)  Join us for good food, relaxation, and a short trip away from the worksite~!
 
Sylvia
Sylvia Escott-Stump, MA, RD, LDN
East Carolina University
Greenville, NC 27858
Phone 252-328-1352
Fax 252-328-4276
escottstumps at ecu.edu
 
 
 
 

________________________________

From: RICH RADOS [mailto:RICHRADOS at HOTMAIL.COM]
Sent: Fri 1/16/2009 8:56 AM
To: Escott-Stump, Sylvia
Subject: Fw: ADA list


Hey Sylvia...
 
I've included the attachment that has the cruise and course information.  This is the time of year that people would be looking for opportunities such as this. With luck we'll get a good group. My agents hope to get some calls. Take Care!!

Rich Rados
Managing Partner
Quixote Travels / American Express
252-757-0234
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/9a5059c3/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Quixote-EC-CE Bro.pdf
Type: application/pdf
Size: 1225104 bytes
Desc: Quixote-EC-CE Bro.pdf
Url : /pipermail/cnm_lists.my180.net/attachments/20090116/9a5059c3/attachment-0001.pdf 

From Janet.Ross at healthall.com  Thu Jan 15 09:33:29 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Thu, 15 Jan 2009 12:33:29 -0500
Subject: [Cnm] CBORD/McKesson
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E03BB365B@rhcexch3.reshealthcare.org>
References: <20090114135214.85229B414C@custmx01.expedient.net>
	<5330B54133B6194BA13930BDEFE9A30E03BB365B@rhcexch3.reshealthcare.org>
Message-ID: <41CA05D55BF105489D33F8E57D71A90517169866BA@MAIL-C.healthall.com>

We have LastWord to Cbord, but are actively using BME.
Here are some of our "tools".  Call anytime.  The key is quality people who care.  I rotated my hosts for 4 weeks to different assignments and it became painfully obvious who was communicating with patients and who was going through the motions.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee
Sent: Thursday, January 15, 2009 10:04 AM
To: cnm at lists.my180.net
Cc: Miklusak, Joseph
Subject: Re: [Cnm] CBORD/McKesson

Hello all.  We are starting the process of converting from a paper menu system to CBORD bedside menu entry.  Our hospital computer system is McKesson Star and we do not have computer order entry by physicians at this time.  I am having concerns about how to develop the interface effectively and would appreciate input from anyone else who may have gone through a similar conversion.

Please contact me off the listserve at lcarver at reshealthcare.org<mailto:lcarver at reshealthcare.org> or 773-665-3326.  Thank you!

Also, if anyone has a job description for the individual who work w/ the hand-held devises at the bedside and/or the diet office folks who handle the office end of things, I would greatly appreciate seeing a copy of those job descriptions.  Thanks again.

Leslee Carver, RD, MSPH, LDN
Clinical Nutrition Manager
Saint Joseph Hospital
Chicago, Il 60657
773-665-3326

________________________________

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090115/1752a69e/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: 2009 Expectations.doc
Type: application/msword
Size: 63488 bytes
Desc: 2009 Expectations.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090115/1752a69e/attachment-0007.doc 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: 2008 Script Admission.doc
Type: application/msword
Size: 29696 bytes
Desc: 2008 Script Admission.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090115/1752a69e/attachment-0008.doc 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: 2008 Script BME.doc
Type: application/msword
Size: 26112 bytes
Desc: 2008 Script BME.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090115/1752a69e/attachment-0009.doc 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: 2008 Script Tray Pass.doc
Type: application/msword
Size: 22016 bytes
Desc: 2008 Script Tray Pass.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090115/1752a69e/attachment-0010.doc 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: 2008 TWS HOSTESS.doc
Type: application/msword
Size: 62464 bytes
Desc: 2008 TWS HOSTESS.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090115/1752a69e/attachment-0011.doc 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: B6-pfg 01 - Food and Beverage Services v5-08.doc
Type: application/msword
Size: 49152 bytes
Desc: B6-pfg 01 - Food and Beverage Services v5-08.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090115/1752a69e/attachment-0012.doc 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Sorry I Missed U.doc
Type: application/msword
Size: 27136 bytes
Desc: Sorry I Missed U.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090115/1752a69e/attachment-0013.doc 

From Heberle-Heather at aramark.com  Tue Jan 20 07:30:53 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Tue, 20 Jan 2009 09:30:53 -0600
Subject: [Cnm] Cnm] Obese Pts
In-Reply-To: <mailman.3117.1232465145.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.3117.1232465145.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <291385CC-B236-4996-945D-A317DF5EE7F1@mimectl>

We currently screen for BMI >40 and <19 not just IBW 250%.  If you follow the morbidly obese standards, 200% IBW is considered morbidly obese.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879
Heberle-Heather at aramark.com



From: cnm-request at lists.my180.net
Sent: Tue 1/20/09 9:25 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 82


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: servers and hair nets (Kathleen Mershon)
   2. Re: screening criteria (Kathleen Mershon)
   3. Obese Pts (Melissa Tewes)
   4. Re: servers and hair nets (Shannon Byrd Jackson)
   5. NCM sodium restriction for cardiac diets (Valerie Counselman)
   6. Necessary cruise! (Escott-Stump, Sylvia)


----------------------------------------------------------------------

Message: 1
Date: Mon, 19 Jan 2009 20:07:10 -0800
From: "Kathleen Mershon" <kmershon at bak.rr.com>
Subject: Re: [Cnm] servers and hair nets
To: <cnm at lists.my180.net>,	<cathy.peterjohn at medicorp.org>
Message-ID: <EE7B295C16D94717928DB563495BB618 at KathyPC>
Content-Type: text/plain; charset="iso-8859-1"


  ----- Original Message ----- 
  From: cathy.peterjohn at medicorp.org 
  To: cnm at lists.my180.net 
  Sent: Monday, January 19, 2009 7:25 AM
  Subject: [Cnm] servers and hair nets


  Do your servers wear hair nets when they deliver/pick up trays to patients? No

  Kathleen Mershon, RD



  Cathy Peterjohn, MS, RD, CDE
  Clinical Nutrition/Diabetes Manager
  c/o Nutrition Services
  Mary Washington Hospital
  1001 Sam Perry Blvd.
  Fredericksburg, VA 22401
  540-741-1680
  Fax: 540-741-4022



------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/54a4898c/attachment-0001.html 

------------------------------

Message: 2
Date: Mon, 19 Jan 2009 20:13:01 -0800
From: "Kathleen Mershon" <kmershon at bak.rr.com>
Subject: Re: [Cnm] screening criteria
To: "Chaffin Meg" <Margaret.Chaffin at hcahealthcare.com>,
	<cnm at lists.my180.net>
Message-ID: <3E0CCB682B934C458AA33D540FBF2CA5 at KathyPC>
Content-Type: text/plain; charset="iso-8859-1"

Meg
We made the switch based on the chatter on the listserv and the average LOS in our hospital (5 days). We found we would race up to do an assessment on day 4 only to have the well nourished patient advance to a regular day right after we completed our assessment. Patients till on NPO beyond 5 days have more going on. It has served us well. It seems there was an article in the CNM newletter or maybe it was the MNT newsletter. I am sure there is something out there if you do the search.

Good Luck
Kathleen Mershon, RD
  ----- Original Message ----- 
  From: Chaffin Meg 
  To: cnm at lists.my180.net 
  Sent: Monday, January 19, 2009 6:46 AM
  Subject: [Cnm] screening criteria


  First, thanks to all for the great advice and feedback on my enteral delivery problems. Now I'm looking at changing my NPO/clear liquids > 3 days to NPO/clear liquids > 5 days and for those already doing this, could you site me any references (or feedback in general) that may help me in my decision making. 

   

  TIA!

   

  Meg Chaffin MA,RD,LD

  Clinical Nutrition Manager

  Palmyra Medical Center

  (229)434-2394

   



------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090119/6a05d595/attachment-0001.html 

------------------------------

Message: 3
Date: Tue, 20 Jan 2009 09:24:31 -0500
From: "Melissa Tewes" <mtewes at wchsys.org>
Subject: [Cnm] Obese Pts
To: <cnm at lists.my180.net>
Message-ID: <20090120142431.605EBB4DFB at custmx01.expedient.net>
Content-Type: text/plain; charset="us-ascii"

We currently screen all pts w/a 250% IBW or higher.  Are other facilities
intervening on obese patients?  I was considering formulating a packet of
nutrition information to be provided to all pts. Any thoughts or suggestions
would be greatly appreciated.


Thanks

 

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washingon County Health System

251 East Antietam Street

Hagerstown, MD 21740

Phone:  301-790-8084

Fax:  301-790-8535

 

mtewes at wchsys.org

 



***** CONFIDENTIALITY NOTICE *****
This message contains confidential information and is intended only for
the individual named. If you are not the named addressee you should not
disseminate, distribute or copy this e-mail. Please notify the sender
immediately by e-mail if you have received this e-mail by mistake and
delete this e-mail from your system.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/21894c76/attachment-0001.html 

------------------------------

Message: 4
Date: Tue, 20 Jan 2009 10:23:41 -0500
From: "Shannon Byrd Jackson" <Shannon.Jackson at wilmed.org>
Subject: Re: [Cnm] servers and hair nets
To: "Kathleen Mershon" <kmershon at bak.rr.com>, <cnm at lists.my180.net>,
	<cathy.peterjohn at medicorp.org>
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF287 at wmhcs03.wmh.org>
Content-Type: text/plain; charset="iso-8859-1"

Yes our servers wear hair nets when they deliver and pick up trays.
Thanks
shannon

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On
Behalf Of Kathleen Mershon
Sent: Monday, January 19, 2009 11:07 PM
To: cnm at lists.my180.net; cathy.peterjohn at medicorp.org
Subject: Re: [Cnm] servers and hair nets


 

----- Original Message ----- 
From: cathy.peterjohn at medicorp.org 
To: cnm at lists.my180.net 
Sent: Monday, January 19, 2009 7:25 AM
Subject: [Cnm] servers and hair nets


Do your servers wear hair nets when they deliver/pick up trays to patients?
No

Kathleen Mershon, RD



Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA 22401
540-741-1680
Fax: 540-741-4022



  _____  




_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/4232c2c9/attachment-0001.html 

------------------------------

Message: 5
Date: Tue, 20 Jan 2009 10:23:06 -0500
From: "Valerie Counselman" <vcounselman at HHC.org>
Subject: [Cnm] NCM sodium restriction for cardiac diets
To: <cnm at lists.my180.net>
Message-ID:
	<7B75865298C8B44B9931B1F9E1B197F10656B663 at HHCEXCHANGE.hhc.org>
Content-Type: text/plain; charset="us-ascii"

Would anyone who has the online nutrition care manual be willing to
share with me the recommended sodium level for the cardiac diet?

 

Our system is planning on liberalizing to 4 gram sodium diet and we want
to be sure we are following the manual.

 

We are currently using ADA manual, but plan to use the online program in
the next few months. However, the diet changes are to be reviewed on P&T
tomorrow.

 

Thanks in advance.

 

Valerie Counselman, MPH, RD, LD

Clinical Nutrition Manager

Houston Medical Center

1601 Watson Blvd

Warner Robins, GA 31088

(478) 542-7953

vcounselman at hhc.org

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/f57bb85d/attachment-0001.html 

------------------------------

Message: 6
Date: Fri, 16 Jan 2009 11:55:57 -0500
From: "Escott-Stump, Sylvia" <ESCOTTSTUMPS at ecu.edu>
Subject: [Cnm] Necessary cruise!
To: "CNM" <CNM at lists.my180.net>
Message-ID:
	<BD44FF0CF4C18245854BBE03590A4C130150CD44 at ECUFS7.intra.ecu.edu>
Content-Type: text/plain; charset="iso-8859-1"

Hello everyone,
We hope you can join us for a Continuing Ed cruise related to the Nutrition care process (and good fun!)  Many of you need this break because your weather has been so miserable!  Our cruise to Bermuda is sponsored by our university and a collaborator, Rich Rados (whose daughter is an RD.)  Join us for good food, relaxation, and a short trip away from the worksite~!
 
Sylvia
Sylvia Escott-Stump, MA, RD, LDN
East Carolina University
Greenville, NC 27858
Phone 252-328-1352
Fax 252-328-4276
escottstumps at ecu.edu
 
 
 
 

________________________________

From: RICH RADOS [mailto:RICHRADOS at HOTMAIL.COM]
Sent: Fri 1/16/2009 8:56 AM
To: Escott-Stump, Sylvia
Subject: Fw: ADA list


Hey Sylvia...
 
I've included the attachment that has the cruise and course information.  This is the time of year that people would be looking for opportunities such as this. With luck we'll get a good group. My agents hope to get some calls. Take Care!!

Rich Rados
Managing Partner
Quixote Travels / American Express
252-757-0234
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090116/9a5059c3/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Quixote-EC-CE Bro.pdf
Type: application/pdf
Size: 1225104 bytes
Desc: Quixote-EC-CE Bro.pdf
Url : /pipermail/cnm_lists.my180.net/attachments/20090116/9a5059c3/attachment.pdf 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 82
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/ff5e6d2f/attachment.html 

From hargenlisa at hotmail.com  Tue Jan 20 07:33:04 2009
From: hargenlisa at hotmail.com (Lisa Trombley)
Date: Tue, 20 Jan 2009 07:33:04 -0800
Subject: [Cnm] Order Writing & Licensure
Message-ID: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>


For those in states without licensure (particularly interested in CA), are the RDs permitted to write orders as long as they go through proper procedure as outlined in state regulations?  I heard of a facility recently receiving a citation for order-writing despite the fact that the RDs had established the practice based on state regulations.  The CMS/state surveyor cited the fact that the RDs were not licensed so could not write orders.  Is this new for 2009?  Thanks in advance. 
Lisa Trombley, MA, RD, CNSD 

Los Angeles, CA
hargenlisa at hotmail.com
 
_________________________________________________________________
Windows Live?: Keep your life in sync. 
http://windowslive.com/howitworks?ocid=TXT_TAGLM_WL_t1_allup_howitworks_012009
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/c96b634b/attachment.html 

From Sheri.Loflin at va.gov  Tue Jan 20 07:38:31 2009
From: Sheri.Loflin at va.gov (Loflin, Sheri C.)
Date: Tue, 20 Jan 2009 10:38:31 -0500
Subject: [Cnm] servers and hair nets
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF287@wmhcs03.wmh.org>
References: <EE7B295C16D94717928DB563495BB618@KathyPC>
	<8169B6DBE9D5194DA89219B5C5A6AFBA011DF287@wmhcs03.wmh.org>
Message-ID: <F01BD3CF8EABBF4F9C72ABAF206E6DAB2423360F@VHAV07MSG2.v07.med.va.gov>

Yes

 

Sheri Loflin

CNVAMC Clinical Nutrition Manager

706-733-0188  (ext. 3929)

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Shannon Byrd Jackson
Sent: Tuesday, January 20, 2009 10:24 AM
To: Kathleen Mershon; cnm at lists.my180.net; cathy.peterjohn at medicorp.org
Subject: Re: [Cnm] servers and hair nets

 

Yes our servers wear hair nets when they deliver and pick up trays.

Thanks

shannon

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On
Behalf Of Kathleen Mershon
Sent: Monday, January 19, 2009 11:07 PM
To: cnm at lists.my180.net; cathy.peterjohn at medicorp.org
Subject: Re: [Cnm] servers and hair nets

 

----- Original Message ----- 

From: cathy.peterjohn at medicorp.org 

To: cnm at lists.my180.net 

Sent: Monday, January 19, 2009 7:25 AM

Subject: [Cnm] servers and hair nets

 

Do your servers wear hair nets when they deliver/pick up trays to patients?
No

Kathleen Mershon, RD



Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA 22401
540-741-1680
Fax: 540-741-4022


  _____  


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/82d5256f/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: smime.p7s
Type: application/x-pkcs7-signature
Size: 5940 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/82d5256f/attachment.bin 

From m-rodrig at msmc.com  Tue Jan 20 07:53:31 2009
From: m-rodrig at msmc.com (Maritza Rodriguez)
Date: Tue, 20 Jan 2009 10:53:31 -0500
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>
References: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>
Message-ID: <32EDCA3D1F5C4C41B7E1A4573DFACCC60327DF83@SVIPEXC1.msmc.com>

Please post to the list

 

Maritza Rodriguez

 

Maritza Rodriguez, RD LDN

Clinical Nutrition Manager

Mount Sinai Medical Center

4300 Alton Road

Miami Beach, Florida 33140

 

Tel: 305-674-2121 Ext. 56181

Fax: 305-674-2234

m-rodrig at msmc.com

 

 

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
CONFIDENTIAL or PRIVILEGED information.  Any unauthorized review, use,
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and immediately
destroy all copies of the original message and all attachments.  Any
opinions expressed here are not necessarily those of Mount Sinai Medical
Center.

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa Trombley
Sent: Tuesday, January 20, 2009 10:33 AM
To: cnm at lists.my180.net
Subject: [Cnm] Order Writing & Licensure

 

For those in states without licensure (particularly interested in CA),
are the RDs permitted to write orders as long as they go through proper
procedure as outlined in state regulations?  I heard of a facility
recently receiving a citation for order-writing despite the fact that
the RDs had established the practice based on state regulations.  The
CMS/state surveyor cited the fact that the RDs were not licensed so
could not write orders.  Is this new for 2009?  Thanks in advance. 

Lisa Trombley, MA, RD, CNSD 

Los Angeles, CA

hargenlisa at hotmail.com

 





________________________________

Windows Live(tm): Keep your life in sync. See how it works.
<http://windowslive.com/howitworks?ocid=TXT_TAGLM_WL_t1_allup_howitworks
_012009> 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/2448821b/attachment-0001.html 

From Annalynn_Skipper at Comcast.net  Tue Jan 20 08:22:46 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Tue, 20 Jan 2009 10:22:46 -0600
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>
References: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>
Message-ID: <7011FE812E0541E699EC09763AED12C2@ANNALYNN>

Hi Lisa,

 

Are you sure that the person relaying the story to you didn't confuse the
term "licensed" with the term "credentialed"?  Perhaps a copy of the
citation is available so that you can be sure.  I can see a surveyor writing
in a citation "unlicensed personnel ordering nutrition therapy", but in that
case "unlicensed" would likely refer to people other than physicians, nurse
practitioners and PA's.  Even in California, order writing is under the
control of the medical staff in the institution in conjunction with state
law.  

 

Regards,        

 

Annalynn

 

Annalynn Skipper Ph.D., R.D., FADA

 


a consultancy devoted to advancing nutrition practice

P.O. Box 45

Oak Park, IL 60303

 <mailto:Annalynn_Skipper at Comcast.net> Annalynn_Skipper at Comcast.net

Advanced Medical Nutrition Therapy Practice, 

a 2008 text, is available from Jones and Bartlett. 

 

  _____  

From: Lisa Trombley [mailto:hargenlisa at hotmail.com] 
Sent: Tuesday, January 20, 2009 9:33 AM
To: cnm at lists.my180.net
Subject: [Cnm] Order Writing & Licensure

 

For those in states without licensure (particularly interested in CA), are
the RDs permitted to write orders as long as they go through proper
procedure as outlined in state regulations?  I heard of a facility recently
receiving a citation for order-writing despite the fact that the RDs had
established the practice based on state regulations.  The CMS/state surveyor
cited the fact that the RDs were not licensed so could not write orders.  Is
this new for 2009?  Thanks in advance. 

Lisa Trombley, MA, RD, CNSD 

Los Angeles, CA

hargenlisa at hotmail.com

 





  _____  

Windows LiveT: Keep your life in sync. See how it works.
<http://windowslive.com/howitworks?ocid=TXT_TAGLM_WL_t1_allup_howitworks_012
009> 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/be82b57f/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 170 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/be82b57f/attachment.gif 

From cahns at carthageareahospital.com  Tue Jan 20 08:25:23 2009
From: cahns at carthageareahospital.com (Dawn Berry, RD)
Date: Tue, 20 Jan 2009 11:25:23 -0500
Subject: [Cnm] GDM Video
Message-ID: <3EC1C5C543BC4BE2BD5C22B95F6E1AB5@CAHNS1>

I am looking for a video to show newly diagnosed gestational diabetics,
before nutritional counseling.

We currently have the old one put out by Milner Fenwick and ADA, we want to
update - and I have found the new version of this same video but before we
purchase it I wanted to make sure there wasn't something better out there.
Any suggestions would be appreciated.

 

Dawn

 

Dawn Berry, RD CDN

Director of Clinical Nutrition

Carthage Area Hospital

1001 West Street

Carthage, NY 13619

 

315-493-1005  ext 3222

cahns at carthageareahospital.com

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/b2379383/attachment.html 

From horlowsk at ppmh.org  Tue Jan 20 08:29:27 2009
From: horlowsk at ppmh.org (Orlowski, Hannah)
Date: Tue, 20 Jan 2009 11:29:27 -0500
Subject: [Cnm] GDM Video
In-Reply-To: <3EC1C5C543BC4BE2BD5C22B95F6E1AB5@CAHNS1>
Message-ID: <0DAF44B706E29940A409E32DC69005C00505E9EE@exchange1.phoebe.com>

Please reply to all.  We are also looking for new Gest DM vidio and one on Exercise.  Any assistant at all is greatly appreciated.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Dawn Berry, RD
Sent: Tuesday, January 20, 2009 11:25 AM
To: cnm at lists.my180.net
Subject: [Cnm] GDM Video



I am looking for a video to show newly diagnosed gestational diabetics, before nutritional counseling.

We currently have the old one put out by Milner Fenwick and ADA, we want to update - and I have found the new version of this same video but before we purchase it I wanted to make sure there wasn't something better out there.  Any suggestions would be appreciated.

 

Dawn

 

Dawn Berry, RD CDN

Director of Clinical Nutrition

Carthage Area Hospital

1001 West Street

Carthage, NY 13619

 

315-493-1005  ext 3222

cahns at carthageareahospital.com

 




-----------------------------------------
Disclaimer:
The HIPAA Final Privacy Rule requires covered entities to safeguard
certain Protected Health Information (PHI) related to a person's
healthcare.  Information being faxed to you may include PHI after
appropriate authorization from the patient or under circumstances
that do not require patient authorization.  You, the recipient, are
obligated to maintain PHI in a safe and secure manner.  You may not
re-disclose without additional patient consent or as required by
law.  Unauthorized re-disclosure or failure to safeguard PHI could
subject you to penalties described in federal (HIPAA) and state
law.  If you the reader of this message are not the intended
recipient, or the employee or agent responsible to deliver it to
the intended recipient, please notify us immediately and destroy
the related message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/42e89e40/attachment.html 

From Leslie.Hornick at dmh.mo.gov  Tue Jan 20 08:32:13 2009
From: Leslie.Hornick at dmh.mo.gov (Hornick, Leslie G.)
Date: Tue, 20 Jan 2009 10:32:13 -0600
Subject: [Cnm] Cnm] Obese Pts
In-Reply-To: <291385CC-B236-4996-945D-A317DF5EE7F1@mimectl>
References: <mailman.3117.1232465145.3783.cnm_lists.my180.net@lists.my180.net>
	<291385CC-B236-4996-945D-A317DF5EE7F1@mimectl>
Message-ID: <69DD80845D7F524BB1C8C59479ED0625013A84D8@exchsvfulton01.mx.state.mo.us>

We screen for >40 and <19 for our short term care patients and >30 and
<19 for our long term care facility ( we only get about 25
admissions/month in the long term care facility so >30 is doable).

 

 

Leslie Hornick, RD, LD

Chief Clinical Dietitian

FSH/MMMHC

 

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments
may contain confidential and privileged information for the use of the
designated recipients named above. The designated recipients are
prohibited from redisclosing this information to any other party without
authorization and are required to destroy the information after its
stated need has been fulfilled. If you are not the intended recipient,
you are hereby notified that you have received this communication in
error and that any review, disclosure, dissemination, distribution or
copying of it or its contents is prohibited by federal or state law. If
you have received this communication in error, please notify me
immediately by telephone at 573-592-2059, and destroy all copies of this
communication and any attachments.

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Heberle, Heather N.
Sent: Tuesday, January 20, 2009 9:31 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] Cnm] Obese Pts

 

We currently screen for BMI >40 and <19 not just IBW 250%.  If you
follow the morbidly obese standards, 200% IBW is considered morbidly
obese.

 

Heather Heberle, RD, LD

Clinical Nutrition Manager

Capital Region Medical Center

1125 Madison St

Jefferson City, MO 65101

phone: 573.632.5192

fax: 573.632.5879

Heberle-Heather at aramark.com <mailto:Heberle-Heather at aramark.com> 

 

________________________________

From: cnm-request at lists.my180.net
Sent: Tue 1/20/09 9:25 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 82

Send Cnm mailing list submissions to
        cnm at lists.my180.net
 
To subscribe or unsubscribe via the World Wide Web, visit
        http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
        cnm-request at lists.my180.net
 
You can reach the person managing the list at
        cnm-owner at lists.my180.net
 
When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."
 
 
Today's Topics:
 
   1. Re: servers and hair nets (Kathleen Mershon)
   2. Re: screening criteria (Kathleen Mershon)
   3. Obese Pts (Melissa Tewes)
   4. Re: servers and hair nets (Shannon Byrd Jackson)
   5. NCM sodium restriction for cardiac diets (Valerie Counselman)
   6. Necessary cruise! (Escott-Stump, Sylvia)
 
 
----------------------------------------------------------------------
 
Message: 1
Date: Mon, 19 Jan 2009 20:07:10 -0800
From: "Kathleen Mershon" <kmershon at bak.rr.com>
Subject: Re: [Cnm] servers and hair nets
To: <cnm at lists.my180.net>,     <cathy.peterjohn at medicorp.org>
Message-ID: <EE7B295C16D94717928DB563495BB618 at KathyPC>
Content-Type: text/plain; charset="iso-8859-1"
 
 
  ----- Original Message ----- 
  From: cathy.peterjohn at medicorp.org 
  To: cnm at lists.my180.net 
  Sent: Monday, January 19, 2009 7:25 AM
  Subject: [Cnm] servers and hair nets
 
 
  Do your servers wear hair nets when they deliver/pick up trays to
patients? No
 
  Kathleen Mershon, RD
 
 
 
  Cathy Peterjohn, MS, RD, CDE
  Clinical Nutrition/Diabetes Manager
  c/o Nutrition Services
  Mary Washington Hospital
  1001 Sam Perry Blvd.
  Fredericksburg, VA 22401
  540-741-1680
  Fax: 540-741-4022
 
 
 
------------------------------------------------------------------------
------
 
 
  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20090119/54a4898c/attachment-
0001.html 
 
------------------------------
 
Message: 2
Date: Mon, 19 Jan 2009 20:13:01 -0800
From: "Kathleen Mershon" <kmershon at bak.rr.com>
Subject: Re: [Cnm] screening criteria
To: "Chaffin Meg" <Margaret.Chaffin at hcahealthcare.com>,
        <cnm at lists.my180.net>
Message-ID: <3E0CCB682B934C458AA33D540FBF2CA5 at KathyPC>
Content-Type: text/plain; charset="iso-8859-1"
 
Meg
We made the switch based on the chatter on the listserv and the average
LOS in our hospital (5 days). We found we would race up to do an
assessment on day 4 only to have the well nourished patient advance to a
regular day right after we completed our assessment. Patients till on
NPO beyond 5 days have more going on. It has served us well. It seems
there was an article in the CNM newletter or maybe it was the MNT
newsletter. I am sure there is something out there if you do the search.
 
Good Luck
Kathleen Mershon, RD
  ----- Original Message ----- 
  From: Chaffin Meg 
  To: cnm at lists.my180.net 
  Sent: Monday, January 19, 2009 6:46 AM
  Subject: [Cnm] screening criteria
 
 
  First, thanks to all for the great advice and feedback on my enteral
delivery problems. Now I'm looking at changing my NPO/clear liquids > 3
days to NPO/clear liquids > 5 days and for those already doing this,
could you site me any references (or feedback in general) that may help
me in my decision making. 
 
   
 
  TIA!
 
   
 
  Meg Chaffin MA,RD,LD
 
  Clinical Nutrition Manager
 
  Palmyra Medical Center
 
  (229)434-2394
 
   
 
 
 
------------------------------------------------------------------------
------
 
 
  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20090119/6a05d595/attachment-
0001.html 
 
------------------------------
 
Message: 3
Date: Tue, 20 Jan 2009 09:24:31 -0500
From: "Melissa Tewes" <mtewes at wchsys.org>
Subject: [Cnm] Obese Pts
To: <cnm at lists.my180.net>
Message-ID: <20090120142431.605EBB4DFB at custmx01.expedient.net>
Content-Type: text/plain; charset="us-ascii"
 
We currently screen all pts w/a 250% IBW or higher.  Are other
facilities
intervening on obese patients?  I was considering formulating a packet
of
nutrition information to be provided to all pts. Any thoughts or
suggestions
would be greatly appreciated.
 
 
Thanks
 
 
 
Melissa Tewes RD, LDN
 
Clinical Nutrition Manager
 
Washingon County Health System
 
251 East Antietam Street
 
Hagerstown, MD 21740
 
Phone:  301-790-8084
 
Fax:  301-790-8535
 
 
 
mtewes at wchsys.org
 
 
 
 
 
***** CONFIDENTIALITY NOTICE *****
This message contains confidential information and is intended only for
the individual named. If you are not the named addressee you should not
disseminate, distribute or copy this e-mail. Please notify the sender
immediately by e-mail if you have received this e-mail by mistake and
delete this e-mail from your system.
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20090120/21894c76/attachment-
0001.html 
 
------------------------------
 
Message: 4
Date: Tue, 20 Jan 2009 10:23:41 -0500
From: "Shannon Byrd Jackson" <Shannon.Jackson at wilmed.org>
Subject: Re: [Cnm] servers and hair nets
To: "Kathleen Mershon" <kmershon at bak.rr.com>, <cnm at lists.my180.net>,
        <cathy.peterjohn at medicorp.org>
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF287 at wmhcs03.wmh.org>
Content-Type: text/plain; charset="iso-8859-1"
 
Yes our servers wear hair nets when they deliver and pick up trays.
Thanks
shannon
 
-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On
Behalf Of Kathleen Mershon
Sent: Monday, January 19, 2009 11:07 PM
To: cnm at lists.my180.net; cathy.peterjohn at medicorp.org
Subject: Re: [Cnm] servers and hair nets
 
 
 
 
----- Original Message ----- 
From: cathy.peterjohn at medicorp.org 
To: cnm at lists.my180.net 
Sent: Monday, January 19, 2009 7:25 AM
Subject: [Cnm] servers and hair nets
 
 
Do your servers wear hair nets when they deliver/pick up trays to
patients?
No
 
Kathleen Mershon, RD
 
 
 
Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA 22401
540-741-1680
Fax: 540-741-4022
 
 
 
  _____  
 
 
 
 
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
 
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20090120/4232c2c9/attachment-
0001.html 
 
------------------------------
 
Message: 5
Date: Tue, 20 Jan 2009 10:23:06 -0500
From: "Valerie Counselman" <vcounselman at HHC.org>
Subject: [Cnm] NCM sodium restriction for cardiac diets
To: <cnm at lists.my180.net>
Message-ID:
        <7B75865298C8B44B9931B1F9E1B197F10656B663 at HHCEXCHANGE.hhc.org>
Content-Type: text/plain; charset="us-ascii"
 
Would anyone who has the online nutrition care manual be willing to
share with me the recommended sodium level for the cardiac diet?
 
 
 
Our system is planning on liberalizing to 4 gram sodium diet and we want
to be sure we are following the manual.
 
 
 
We are currently using ADA manual, but plan to use the online program in
the next few months. However, the diet changes are to be reviewed on P&T
tomorrow.
 
 
 
Thanks in advance.
 
 
 
Valerie Counselman, MPH, RD, LD
 
Clinical Nutrition Manager
 
Houston Medical Center
 
1601 Watson Blvd
 
Warner Robins, GA 31088
 
(478) 542-7953
 
vcounselman at hhc.org
 
 
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20090120/f57bb85d/attachment-
0001.html 
 
------------------------------
 
Message: 6
Date: Fri, 16 Jan 2009 11:55:57 -0500
From: "Escott-Stump, Sylvia" <ESCOTTSTUMPS at ecu.edu>
Subject: [Cnm] Necessary cruise!
To: "CNM" <CNM at lists.my180.net>
Message-ID:
        <BD44FF0CF4C18245854BBE03590A4C130150CD44 at ECUFS7.intra.ecu.edu>
Content-Type: text/plain; charset="iso-8859-1"
 
Hello everyone,
We hope you can join us for a Continuing Ed cruise related to the
Nutrition care process (and good fun!)  Many of you need this break
because your weather has been so miserable!  Our cruise to Bermuda is
sponsored by our university and a collaborator, Rich Rados (whose
daughter is an RD.)  Join us for good food, relaxation, and a short trip
away from the worksite~!
 
Sylvia
Sylvia Escott-Stump, MA, RD, LDN
East Carolina University
Greenville, NC 27858
Phone 252-328-1352
Fax 252-328-4276
escottstumps at ecu.edu
 
 
 
 
 
________________________________
 
From: RICH RADOS [mailto:RICHRADOS at HOTMAIL.COM]
Sent: Fri 1/16/2009 8:56 AM
To: Escott-Stump, Sylvia
Subject: Fw: ADA list
 
 
Hey Sylvia...
 
I've included the attachment that has the cruise and course information.
This is the time of year that people would be looking for opportunities
such as this. With luck we'll get a good group. My agents hope to get
some calls. Take Care!!
 
Rich Rados
Managing Partner
Quixote Travels / American Express
252-757-0234
-------------- next part --------------
An HTML attachment was scrubbed...
URL:
/pipermail/cnm_lists.my180.net/attachments/20090116/9a5059c3/attachment.
html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Quixote-EC-CE Bro.pdf
Type: application/pdf
Size: 1225104 bytes
Desc: Quixote-EC-CE Bro.pdf
Url :
/pipermail/cnm_lists.my180.net/attachments/20090116/9a5059c3/attachment.
pdf 
 
------------------------------
 
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
 
 
End of Cnm Digest, Vol 26, Issue 82
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/8bd94118/attachment-0001.html 

From Heberle-Heather at aramark.com  Tue Jan 20 08:49:06 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Tue, 20 Jan 2009 10:49:06 -0600
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <mailman.3129.1232469134.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.3129.1232469134.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <A6137B84-8670-4D95-9645-928A2058AC98@mimectl>

To my knowledge if your state requires licensure, you are not allowed to write orders until the licensure is obtained.  That is how our licensure is in MO.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879
Heberle-Heather at aramark.com

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/087b9795/attachment.html 

From CKeinath at chs-mi.com  Tue Jan 20 09:55:16 2009
From: CKeinath at chs-mi.com (CKeinath at chs-mi.com)
Date: 20-Jan-2009 12:55:16 EST
Subject: [Cnm] RD daily load


Can you tell me how your facility handles the RD daily load of patient
care?
Do you have each of your RD has a regular floor unit and distribute
additional when a staff member is off on vacation?
Do you have all the RDs look at the load for the day and pick and choose
what each one will do?
Either way, is it working?  Pros/cons?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning to
Dance in The Rain".

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   


From marissa.hofman at ucdmc.ucdavis.edu  Tue Jan 20 09:57:51 2009
From: marissa.hofman at ucdmc.ucdavis.edu (Marissa Hofman)
Date: Tue, 20 Jan 2009 09:57:51 -0800
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>
Message-ID: <OFF8A0DC66.A0048294-ON88257544.0061FCAC-88257544.0062AE19@ucdmc.ucdavis.edu>

For an RD to write an order, a couple of critical steps must be taken
before that can happen.

1.  All RDs who write orders must be credentialed by the Credentialing body
of the institution.  A separate credentialing process is required.
2.  RDs must first be granted PRIVILEGES to write orders which are approved
by the Medical Executive Board and specific privileges written into the
hospitals By-Laws

After that is accomplished, that does not give the RD the ability to pick
up a pen and write any nutrition orders. On a case by case basis, they must
be                     "delegated" the authority to do so by the physician.

Very recently, it appears that CMS has tightened up on RDs writing orders
and it's something they seem to be focusing on during surveys.  They know
it's a hot topic and they are on the lookout.

Contrary to what we previously believed as acceptable practice, RDs cannot
even down-grade textures unless granted privileges.  You cannot order any
oral supplements, add fiber, add protein, provide a high cal/high pro diet
unless ordered by the MD or granted privileges by the governing body of the
institution.

I just found this out this morning myself.

Marissa Hofman, RD
Clinical Nutrition Manager
UC Davis Medical Center
Food & Nutrition Dept.
2315 Stockton Blvd
Sacramento, CA 95817
Phone: (916) 734-5100
Fax: (916)734-3154


                                                                           
             Lisa Trombley                                                 
             <hargenlisa at hotma                                             
             il.com>                                                    To 
             Sent by:                  <cnm at lists.my180.net>               
             cnm-bounces at lists                                          cc 
             .my180.net                                                    
                                                                   Subject 
                                       [Cnm] Order Writing & Licensure     
             01/20/2009 07:33                                              
             AM                                                            
                                                                           
                                                                           
                                                                           
                                                                           




For those in states without licensure (particularly interested in CA), are
the RDs permitted to write orders as long as they go through proper
procedure as outlined in state regulations?  I heard of a facility recently
receiving a citation for order-writing despite the fact that the RDs had
established the practice based on state regulations.  The CMS/state
surveyor cited the fact that the RDs were not licensed so could not write
orders.  Is this new for 2009?  Thanks in advance.

Lisa Trombley, MA, RD, CNSD
Los Angeles, CA
hargenlisa at hotmail.com




Windows Live?: Keep your life in sync. See how it works.
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/29a9371b/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: graycol.gif
Type: image/gif
Size: 105 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/29a9371b/attachment.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: pic13931.gif
Type: image/gif
Size: 1255 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/29a9371b/attachment-0001.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: ecblank.gif
Type: image/gif
Size: 45 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/29a9371b/attachment-0002.gif 

From marissa.hofman at ucdmc.ucdavis.edu  Tue Jan 20 09:59:29 2009
From: marissa.hofman at ucdmc.ucdavis.edu (Marissa Hofman)
Date: Tue, 20 Jan 2009 09:59:29 -0800
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <OFF8A0DC66.A0048294-ON88257544.0061FCAC-88257544.0062AE19@ucdmc.ucdavis.edu>
Message-ID: <OF3E9DD536.47E66710-ON88257544.0062BC1B-88257544.0062D477@ucdmc.ucdavis.edu>

As an addendum: this is for California and other states that do not have
licensure and can be granted the authority by their State Laws to write
diet orders.


Marissa Hofman, RD
Clinical Nutrition Manager
UC Davis Medical Center
Food & Nutrition Dept.
2315 Stockton Blvd
Sacramento, CA 95817
Phone: (916) 734-5100
Fax: (916)734-3154


                                                                           
             Marissa Hofman                                                
             <marissa.hofman at u                                             
             cdmc.ucdavis.edu>                                          To 
             Sent by:                  Lisa Trombley                       
             cnm-bounces at lists         <hargenlisa at hotmail.com>            
             .my180.net                                                 cc 
                                       cnm at lists.my180.net,                
                                       cnm-bounces at lists.my180.net         
             01/20/2009 09:58                                      Subject 
             AM                        Re: [Cnm] Order Writing & Licensure 
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           




For an RD to write an order, a couple of critical steps must be taken
before that can happen.

1. All RDs who write orders must be credentialed by the Credentialing body
of the institution. A separate credentialing process is required.
2. RDs must first be granted PRIVILEGES to write orders which are approved
by the Medical Executive Board and specific privileges written into the
hospitals By-Laws

After that is accomplished, that does not give the RD the ability to pick
up a pen and write any nutrition orders. On a case by case basis, they must
be "delegated" the authority to do so by the physician.

Very recently, it appears that CMS has tightened up on RDs writing orders
and it's something they seem to be focusing on during surveys. They know
it's a hot topic and they are on the lookout.

Contrary to what we previously believed as acceptable practice, RDs cannot
even down-grade textures unless granted privileges. You cannot order any
oral supplements, add fiber, add protein, provide a high cal/high pro diet
unless ordered by the MD or granted privileges by the governing body of the
institution.

I just found this out this morning myself.

Marissa Hofman, RD
Clinical Nutrition Manager
UC Davis Medical Center
Food & Nutrition Dept.
2315 Stockton Blvd
Sacramento, CA 95817
Phone: (916) 734-5100
Fax: (916)734-3154
Inactive hide details for Lisa Trombley <hargenlisa at hotmail.com>Lisa
Trombley <hargenlisa at hotmail.com>

                                                                           
                         Lisa Trombley                                     
                         <hargenlisa at ho                                    
                         tmail.com>                                        
                         Sent by:                                          
                         cnm-bounces at li                                 To 
                         sts.my180.net                                     
                                                      <cnm at lists.my180.net 
                                                      >                    
                         01/20/2009                                        
                         07:33 AM                                       cc 
                                                                           
                                                                           
                                                                   Subject 
                                                                           
                                                      [Cnm] Order Writing  
                                                      & Licensure          
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           



For those in states without licensure (particularly interested in CA), are
the RDs permitted to write orders as long as they go through proper
procedure as outlined in state regulations? I heard of a facility recently
receiving a citation for order-writing despite the fact that the RDs had
established the practice based on state regulations. The CMS/state surveyor
cited the fact that the RDs were not licensed so could not write orders. Is
this new for 2009? Thanks in advance.

Lisa Trombley, MA, RD, CNSD
Los Angeles, CA
hargenlisa at hotmail.com




Windows Live?: Keep your life in sync. See how it works.
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/f3642c78/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: graycol.gif
Type: image/gif
Size: 105 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/f3642c78/attachment.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: pic13290.gif
Type: image/gif
Size: 1255 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/f3642c78/attachment-0001.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: ecblank.gif
Type: image/gif
Size: 45 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/f3642c78/attachment-0002.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: 14608595.gif
Type: image/gif
Size: 1255 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/f3642c78/attachment-0003.gif 

From MariaLewis at dochs.org  Tue Jan 20 10:38:49 2009
From: MariaLewis at dochs.org (Lewis, Maria (SMC))
Date: Tue, 20 Jan 2009 10:38:49 -0800
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <OFF8A0DC66.A0048294-ON88257544.0061FCAC-88257544.0062AE19@ucdmc.ucdavis.edu>
References: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>
	<OFF8A0DC66.A0048294-ON88257544.0061FCAC-88257544.0062AE19@ucdmc.ucdavis.edu>
Message-ID: <304A991E3C8B4948A52DB718FF048D7F03E8ED00@DOCHS-MSG-SMC.BAY.DOCHS.LOCAL>

This is true, as we were written up for this by MaryAnn Hanthorn in June
2008.  We are now in the process of obtaining practice privileges for
each individual dietitian on staff.

 

Maria C. Lewis, RD, CNSD

Clinical Nutrition Manager

Seton Medical Center & Seton Coastside

1900 Sullivan Avenue

Daly City, CA 94015

(650) 991-5915

 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Marissa Hofman
Sent: Tuesday, January 20, 2009 9:58 AM
To: Lisa Trombley
Cc: cnm at lists.my180.net; cnm-bounces at lists.my180.net
Subject: Re: [Cnm] Order Writing & Licensure

 

For an RD to write an order, a couple of critical steps must be taken
before that can happen.

1. All RDs who write orders must be credentialed by the Credentialing
body of the institution. A separate credentialing process is required.
2. RDs must first be granted PRIVILEGES to write orders which are
approved by the Medical Executive Board and specific privileges written
into the hospitals By-Laws

After that is accomplished, that does not give the RD the ability to
pick up a pen and write any nutrition orders. On a case by case basis,
they must be "delegated" the authority to do so by the physician.

Very recently, it appears that CMS has tightened up on RDs writing
orders and it's something they seem to be focusing on during surveys.
They know it's a hot topic and they are on the lookout. 

Contrary to what we previously believed as acceptable practice, RDs
cannot even down-grade textures unless granted privileges. You cannot
order any oral supplements, add fiber, add protein, provide a high
cal/high pro diet unless ordered by the MD or granted privileges by the
governing body of the institution.

I just found this out this morning myself.

Marissa Hofman, RD
Clinical Nutrition Manager
UC Davis Medical Center
Food & Nutrition Dept.
2315 Stockton Blvd
Sacramento, CA 95817
Phone: (916) 734-5100
Fax: (916)734-3154
 Lisa Trombley <hargenlisa at hotmail.com>



Lisa Trombley <hargenlisa at hotmail.com> 
Sent by: cnm-bounces at lists.my180.net 

01/20/2009 07:33 AM

 

To

 
<cnm at lists.my180.net>



cc





Subject


[Cnm] Order Writing & Licensure

 






For those in states without licensure (particularly interested in CA),
are the RDs permitted to write orders as long as they go through proper
procedure as outlined in state regulations? I heard of a facility
recently receiving a citation for order-writing despite the fact that
the RDs had established the practice based on state regulations. The
CMS/state surveyor cited the fact that the RDs were not licensed so
could not write orders. Is this new for 2009? Thanks in advance. 

Lisa Trombley, MA, RD, CNSD 
Los Angeles, CA
hargenlisa at hotmail.com <mailto:hargenlisa at hotmail.com> 





________________________________

Windows Live(tm): Keep your life in sync. See how it works.
<http://windowslive.com/howitworks?ocid=TXT_TAGLM_WL_t1_allup_howitworks
_012009> _______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/c4297252/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 105 bytes
Desc: image001.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/c4297252/attachment-0003.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 73 bytes
Desc: image004.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/c4297252/attachment-0004.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 73 bytes
Desc: image005.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/c4297252/attachment-0005.gif 

From Janet.Ross at healthall.com  Tue Jan 20 11:09:54 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Tue, 20 Jan 2009 14:09:54 -0500
Subject: [Cnm] NCM sodium restriction for cardiac diets
In-Reply-To: <7B75865298C8B44B9931B1F9E1B197F10656B663@HHCEXCHANGE.hhc.org>
References: <7B75865298C8B44B9931B1F9E1B197F10656B663@HHCEXCHANGE.hhc.org>
Message-ID: <41CA05D55BF105489D33F8E57D71A9051716986709@MAIL-C.healthall.com>

It's a lot more complicated than that.  But....under CABG the statement is made "where indicated 1500-2300 mg Na".  I think AHA recommends less than 2500 mg.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Valerie Counselman
Sent: Tuesday, January 20, 2009 10:23 AM
To: cnm at lists.my180.net
Subject: [Cnm] NCM sodium restriction for cardiac diets

Would anyone who has the online nutrition care manual be willing to share with me the recommended sodium level for the cardiac diet?

Our system is planning on liberalizing to 4 gram sodium diet and we want to be sure we are following the manual.

We are currently using ADA manual, but plan to use the online program in the next few months. However, the diet changes are to be reviewed on P&T tomorrow.

Thanks in advance.

Valerie Counselman, MPH, RD, LD
Clinical Nutrition Manager
Houston Medical Center
1601 Watson Blvd
Warner Robins, GA 31088
(478) 542-7953
vcounselman at hhc.org


________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/26692365/attachment.html 

From rtripp at PINNACLEHEALTH.org  Tue Jan 20 11:18:37 2009
From: rtripp at PINNACLEHEALTH.org (Roberta Tripp)
Date: Tue, 20 Jan 2009 14:18:37 -0500
Subject: [Cnm] RD daily load
In-Reply-To: <7375E17267B3DB4583032BDEFDA2D76E0745EF2D@mailphs.pinnaclehealth.org>
Message-ID: <7375E17267B3DB4583032BDEFDA2D76E0902F373@mailphs.pinnaclehealth.org>

We have floors assigned but when a staff member is off everyone divides
up her work
It seems to be working 

Roberta Tripp MS RD LDN

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org
 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Tuesday, January 20, 2009 12:55 PM
To: cnm at lists.my180.net
Subject: [Cnm] RD daily load



Can you tell me how your facility handles the RD daily load of patient
care?
Do you have each of your RD has a regular floor unit and distribute
additional when a staff member is off on vacation?
Do you have all the RDs look at the load for the day and pick and choose
what each one will do?
Either way, is it working?  Pros/cons?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to Dance in The Rain".

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.


From bhomola at comhs.org  Tue Jan 20 11:29:29 2009
From: bhomola at comhs.org (Bobbi Homola)
Date: Tue, 20 Jan 2009 13:29:29 -0600
Subject: [Cnm] RD daily load
In-Reply-To: <6568CECB0XO1132791-01@Compliance_Server_comhs.org>
Message-ID: <A54EFD4D2B0E924B970F363E6CCA949302E53CA1@sm-xchg.comhs.org>

I have two facilities....One has assigned floors and if someone is off,
they cover for that area. The other puts everything in a pile and
distributes it evenly, based on the staff available.  I must say, it
works well at each facility....and they like it that way. I see no
reason to convert one to the other....they each have pros and cons....I
just want to make sure the work gets done...and as long as it does, I
leave well enough alone. There are always a few bunps along the road,
especially when someone is new to the mix...but, for the most
part....everybody's happy.  I also have prn's to cover vacations, so the
work does not become overwhelming.

Bobbi Homola, MPA, RD, CD
Clinical Manager, Food and Nutrition Services
St. Mary Medical Center / St. Catherine Hospital
1500 South Lake Park Avenue
Hobart, IN 46342
219-947-6048 / 219-392-7081
219-947-6049 fax
bhomola at comhs.org
 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Tuesday, January 20, 2009 11:55 AM
To: cnm at lists.my180.net
Subject: [Cnm] RD daily load


Can you tell me how your facility handles the RD daily load of patient
care?
Do you have each of your RD has a regular floor unit and distribute
additional when a staff member is off on vacation?
Do you have all the RDs look at the load for the day and pick and choose
what each one will do?
Either way, is it working?  Pros/cons?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to
Dance in The Rain".

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net




From Janet.Ross at healthall.com  Tue Jan 20 11:33:06 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Tue, 20 Jan 2009 14:33:06 -0500
Subject: [Cnm] RD daily load
In-Reply-To: <7375E17267B3DB4583032BDEFDA2D76E0902F373@mailphs.pinnaclehealth.org>
References: <7375E17267B3DB4583032BDEFDA2D76E0745EF2D@mailphs.pinnaclehealth.org>
	<7375E17267B3DB4583032BDEFDA2D76E0902F373@mailphs.pinnaclehealth.org>
Message-ID: <41CA05D55BF105489D33F8E57D71A905171698670B@MAIL-C.healthall.com>

Ditto.  It works beautifully if everyone is part of the team.  Took awhile to get two problem staff members to believe that the other guy wasn't getting away with something.  Now the one on late shift sends an email at the end of her day to the am folks--"if needed, I can pick up...."

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
? Please consider the environment before printing.


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Roberta Tripp
Sent: Tuesday, January 20, 2009 2:19 PM
To: CKeinath at chs-mi.com; cnm at lists.my180.net
Subject: Re: [Cnm] RD daily load

We have floors assigned but when a staff member is off everyone divides
up her work
It seems to be working

Roberta Tripp MS RD LDN

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Tuesday, January 20, 2009 12:55 PM
To: cnm at lists.my180.net
Subject: [Cnm] RD daily load



Can you tell me how your facility handles the RD daily load of patient
care?
Do you have each of your RD has a regular floor unit and distribute
additional when a staff member is off on vacation?
Do you have all the RDs look at the load for the day and pick and choose
what each one will do?
Either way, is it working?  Pros/cons?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to Dance in The Rain".

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information.  Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

From hgreenw2 at fairview.org  Tue Jan 20 11:33:24 2009
From: hgreenw2 at fairview.org (Greenwaldt, Heidi J)
Date: Tue, 20 Jan 2009 13:33:24 -0600
Subject: [Cnm] RD daily load
In-Reply-To: <200901201759.n0KHxZSP011753@digsmailscan3.fairview.org>
Message-ID: <59F3EAD5C3376A42B3CD083F034A61270455CE47@digsmxmbx06.Fairview.org>

  
 Please post responses to list service or send summary!

We have a few methods at our facility. 
The majority of the RDs have designated units. 
The Bariatric and Cystic Fibrosis RDs follow their patients no matter
what unit they are on (ICU or med/surg or outpt clinics). 
We do have 1.5 "relief" FTEs to help out for weekend coverage,
vacations, etc. If more people are off than that, the caseload is
distributed across the RDs. 

Heidi Jo Greenwaldt MS, RD, LD, CNSD
Clinical Nutrition Manager
University of Minnesota Medical Center, Fairview
 
Phone 612-273-3216
Pager 612-539-7451


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Tuesday, January 20, 2009 11:55 AM
To: cnm at lists.my180.net
Subject: [Cnm] RD daily load


Can you tell me how your facility handles the RD daily load of patient
care?
Do you have each of your RD has a regular floor unit and distribute
additional when a staff member is off on vacation?
Do you have all the RDs look at the load for the day and pick and choose
what each one will do?
Either way, is it working?  Pros/cons?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to Dance in The Rain".

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From cketterman at wellspan.org  Tue Jan 20 11:47:48 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Tue, 20 Jan 2009 14:47:48 -0500
Subject: [Cnm] RD daily load
In-Reply-To: <5B32BC7FE9D04B43A8B78CA7A19CBD4E036454B4@EXCH4.wellspan.org>
References: <5B32BC7FE9D04B43A8B78CA7A19CBD4E036454B4@EXCH4.wellspan.org>
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250ACF3@EXCH4.wellspan.org>

Our dietitians are all assigned to floor areas in teams of 2.  When
someone is off I complete daily reassignment schedules assigning other
dietitians to assist the remaining team member cover the floors.  Our
social service/case mangers used to handle their tasks on a consult
assigned basis instead of a floor assigned basis and switched to floor
assignments a few years a go because they found it inefficient to have
their staff all over the hospital on a daily basis.   


Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Tuesday, January 20, 2009 12:55 PM
To: cnm at lists.my180.net
Subject: [Cnm] RD daily load


Can you tell me how your facility handles the RD daily load of patient
care?
Do you have each of your RD has a regular floor unit and distribute
additional when a staff member is off on vacation?
Do you have all the RDs look at the load for the day and pick and choose
what each one will do?
Either way, is it working?  Pros/cons?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to Dance in The Rain".

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________


From cathy.peterjohn at medicorp.org  Tue Jan 20 12:00:11 2009
From: cathy.peterjohn at medicorp.org (cathy.peterjohn at medicorp.org)
Date: Tue, 20 Jan 2009 15:00:11 -0500
Subject: [Cnm] pysch nutrition triggers
Message-ID: <OF9FBB2C58.8F2CEFD7-ON85257544.006DBFAD-85257544.006DE163@medicorp.org>


I know someone posted this recently but I'm hoping for more responses.
For those of you with inpatient and/or outpatient Psych. facilitites, what
nutrition criteria trigger an RD consult?





Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA  22401
540-741-1680
Fax: 540-741-4022
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/22f88891/attachment.html 

From Heberle-Heather at aramark.com  Tue Jan 20 12:11:50 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Tue, 20 Jan 2009 14:11:50 -0600
Subject: [Cnm] RD daily load
In-Reply-To: <mailman.1.1232481602.17647.cnm_lists.my180.net@lists.my180.net>
References: <mailman.1.1232481602.17647.cnm_lists.my180.net@lists.my180.net>
Message-ID: <145D05FD-2F2B-4229-A7DF-7804E15834D4@mimectl>

We assign floors to each dietitian and that way the nurses and physicians know who covers where.  It also makes it easier on the dietitians with consistency.  If one of them is sick or off, I cover their floors.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879
Heberle-Heather at aramark.com



From: cnm-request at lists.my180.net
Sent: Tue 1/20/09 2:00 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 87


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Re: NCM sodium restriction for cardiac diets (Ross, Janet)
   2. Re: RD daily load (Roberta Tripp)
   3. Re: RD daily load (Bobbi Homola)
   4. Re: RD daily load (Ross, Janet)
   5. Re:  (Greenwaldt, Heidi J)
   6. Re: RD daily load (Ketterman-Hopkins, Cindra)
   7. pysch nutrition triggers (cathy.peterjohn at medicorp.org)


----------------------------------------------------------------------

Message: 1
Date: Tue, 20 Jan 2009 14:09:54 -0500
From: "Ross, Janet" <Janet.Ross at healthall.com>
Subject: Re: [Cnm] NCM sodium restriction for cardiac diets
To: "'Valerie Counselman'" <vcounselman at HHC.org>,
	"cnm at lists.my180.net"	<cnm at lists.my180.net>
Message-ID:
	<41CA05D55BF105489D33F8E57D71A9051716986709 at MAIL-C.healthall.com>
Content-Type: text/plain; charset="us-ascii"

It's a lot more complicated than that.  But....under CABG the statement is made "where indicated 1500-2300 mg Na".  I think AHA recommends less than 2500 mg.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Valerie Counselman
Sent: Tuesday, January 20, 2009 10:23 AM
To: cnm at lists.my180.net
Subject: [Cnm] NCM sodium restriction for cardiac diets

Would anyone who has the online nutrition care manual be willing to share with me the recommended sodium level for the cardiac diet?

Our system is planning on liberalizing to 4 gram sodium diet and we want to be sure we are following the manual.

We are currently using ADA manual, but plan to use the online program in the next few months. However, the diet changes are to be reviewed on P&T tomorrow.

Thanks in advance.

Valerie Counselman, MPH, RD, LD
Clinical Nutrition Manager
Houston Medical Center
1601 Watson Blvd
Warner Robins, GA 31088
(478) 542-7953
vcounselman at hhc.org


________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/26692365/attachment-0001.html 

------------------------------

Message: 2
Date: Tue, 20 Jan 2009 14:18:37 -0500
From: "Roberta Tripp" <rtripp at PINNACLEHEALTH.org>
Subject: Re: [Cnm] RD daily load
To: <CKeinath at chs-mi.com>,	<cnm at lists.my180.net>
Message-ID:
	<7375E17267B3DB4583032BDEFDA2D76E0902F373 at mailphs.pinnaclehealth.org>
Content-Type: text/plain;	charset="us-ascii"

We have floors assigned but when a staff member is off everyone divides
up her work
It seems to be working 

Roberta Tripp MS RD LDN

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org
 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Tuesday, January 20, 2009 12:55 PM
To: cnm at lists.my180.net
Subject: [Cnm] RD daily load



Can you tell me how your facility handles the RD daily load of patient
care?
Do you have each of your RD has a regular floor unit and distribute
additional when a staff member is off on vacation?
Do you have all the RDs look at the load for the day and pick and choose
what each one will do?
Either way, is it working?  Pros/cons?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to Dance in The Rain".

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.



------------------------------

Message: 3
Date: Tue, 20 Jan 2009 13:29:29 -0600
From: "Bobbi Homola" <bhomola at comhs.org>
Subject: Re: [Cnm] RD daily load
To: CKeinath at chs-mi.com,	cnm at lists.my180.net
Message-ID:
	<A54EFD4D2B0E924B970F363E6CCA949302E53CA1 at sm-xchg.comhs.org>
Content-Type: text/plain; charset=us-ascii

I have two facilities....One has assigned floors and if someone is off,
they cover for that area. The other puts everything in a pile and
distributes it evenly, based on the staff available.  I must say, it
works well at each facility....and they like it that way. I see no
reason to convert one to the other....they each have pros and cons....I
just want to make sure the work gets done...and as long as it does, I
leave well enough alone. There are always a few bunps along the road,
especially when someone is new to the mix...but, for the most
part....everybody's happy.  I also have prn's to cover vacations, so the
work does not become overwhelming.

Bobbi Homola, MPA, RD, CD
Clinical Manager, Food and Nutrition Services
St. Mary Medical Center / St. Catherine Hospital
1500 South Lake Park Avenue
Hobart, IN 46342
219-947-6048 / 219-392-7081
219-947-6049 fax
bhomola at comhs.org
 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Tuesday, January 20, 2009 11:55 AM
To: cnm at lists.my180.net
Subject: [Cnm] RD daily load


Can you tell me how your facility handles the RD daily load of patient
care?
Do you have each of your RD has a regular floor unit and distribute
additional when a staff member is off on vacation?
Do you have all the RDs look at the load for the day and pick and choose
what each one will do?
Either way, is it working?  Pros/cons?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to
Dance in The Rain".

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net





------------------------------

Message: 4
Date: Tue, 20 Jan 2009 14:33:06 -0500
From: "Ross, Janet" <Janet.Ross at healthall.com>
Subject: Re: [Cnm] RD daily load
To: "'Roberta Tripp'" <rtripp at PINNACLEHEALTH.org>,
	"CKeinath at chs-mi.com"	<CKeinath at chs-mi.com>, "cnm at lists.my180.net"
	<cnm at lists.my180.net>
Message-ID:
	<41CA05D55BF105489D33F8E57D71A905171698670B at MAIL-C.healthall.com>
Content-Type: text/plain; charset="utf-8"

Ditto.  It works beautifully if everyone is part of the team.  Took awhile to get two problem staff members to believe that the other guy wasn't getting away with something.  Now the one on late shift sends an email at the end of her day to the am folks--"if needed, I can pick up...."

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
? Please consider the environment before printing.


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Roberta Tripp
Sent: Tuesday, January 20, 2009 2:19 PM
To: CKeinath at chs-mi.com; cnm at lists.my180.net
Subject: Re: [Cnm] RD daily load

We have floors assigned but when a staff member is off everyone divides
up her work
It seems to be working

Roberta Tripp MS RD LDN

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Tuesday, January 20, 2009 12:55 PM
To: cnm at lists.my180.net
Subject: [Cnm] RD daily load



Can you tell me how your facility handles the RD daily load of patient
care?
Do you have each of your RD has a regular floor unit and distribute
additional when a staff member is off on vacation?
Do you have all the RDs look at the load for the day and pick and choose
what each one will do?
Either way, is it working?  Pros/cons?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to Dance in The Rain".

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information.  Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

------------------------------

Message: 5
Date: Tue, 20 Jan 2009 13:33:24 -0600
From: "Greenwaldt, Heidi J" <hgreenw2 at fairview.org>
Subject: Re: [Cnm] RD daily load
To: <CKeinath at chs-mi.com>, <cnm at lists.my180.net>
Message-ID:
	<59F3EAD5C3376A42B3CD083F034A61270455CE47 at digsmxmbx06.Fairview.org>
Content-Type: text/plain;	charset="US-ASCII"

  
 Please post responses to list service or send summary!

We have a few methods at our facility. 
The majority of the RDs have designated units. 
The Bariatric and Cystic Fibrosis RDs follow their patients no matter
what unit they are on (ICU or med/surg or outpt clinics). 
We do have 1.5 "relief" FTEs to help out for weekend coverage,
vacations, etc. If more people are off than that, the caseload is
distributed across the RDs. 

Heidi Jo Greenwaldt MS, RD, LD, CNSD
Clinical Nutrition Manager
University of Minnesota Medical Center, Fairview
 
Phone 612-273-3216
Pager 612-539-7451


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Tuesday, January 20, 2009 11:55 AM
To: cnm at lists.my180.net
Subject: [Cnm] RD daily load


Can you tell me how your facility handles the RD daily load of patient
care?
Do you have each of your RD has a regular floor unit and distribute
additional when a staff member is off on vacation?
Do you have all the RDs look at the load for the day and pick and choose
what each one will do?
Either way, is it working?  Pros/cons?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to Dance in The Rain".

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 6
Date: Tue, 20 Jan 2009 14:47:48 -0500
From: "Ketterman-Hopkins, Cindra" <cketterman at wellspan.org>
Subject: Re: [Cnm] RD daily load
To: <CKeinath at chs-mi.com>,<cnm at lists.my180.net>
Message-ID:
	<5B32BC7FE9D04B43A8B78CA7A19CBD4E0250ACF3 at EXCH4.wellspan.org>
Content-Type: text/plain;	charset="us-ascii"

Our dietitians are all assigned to floor areas in teams of 2.  When
someone is off I complete daily reassignment schedules assigning other
dietitians to assist the remaining team member cover the floors.  Our
social service/case mangers used to handle their tasks on a consult
assigned basis instead of a floor assigned basis and switched to floor
assignments a few years a go because they found it inefficient to have
their staff all over the hospital on a daily basis.   


Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Tuesday, January 20, 2009 12:55 PM
To: cnm at lists.my180.net
Subject: [Cnm] RD daily load


Can you tell me how your facility handles the RD daily load of patient
care?
Do you have each of your RD has a regular floor unit and distribute
additional when a staff member is off on vacation?
Do you have all the RDs look at the load for the day and pick and choose
what each one will do?
Either way, is it working?  Pros/cons?

Thanks

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to Dance in The Rain".

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________



------------------------------

Message: 7
Date: Tue, 20 Jan 2009 15:00:11 -0500
From: cathy.peterjohn at medicorp.org
Subject: [Cnm] pysch nutrition triggers
To: cnm at lists.my180.net
Message-ID:
	<OF9FBB2C58.8F2CEFD7-ON85257544.006DBFAD-85257544.006DE163 at medicorp.org>
	
Content-Type: text/plain; charset="us-ascii"


I know someone posted this recently but I'm hoping for more responses.
For those of you with inpatient and/or outpatient Psych. facilitites, what
nutrition criteria trigger an RD consult?





Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA  22401
540-741-1680
Fax: 540-741-4022
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/22f88891/attachment-0001.html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 87
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/1927f304/attachment.html 

From rtripp at PINNACLEHEALTH.org  Tue Jan 20 12:24:55 2009
From: rtripp at PINNACLEHEALTH.org (Roberta Tripp)
Date: Tue, 20 Jan 2009 15:24:55 -0500
Subject: [Cnm] pysch nutrition triggers
In-Reply-To: <OF9FBB2C58.8F2CEFD7-ON85257544.006DBFAD-85257544.006DE163@medicorp.org>
Message-ID: <7375E17267B3DB4583032BDEFDA2D76E0902F378@mailphs.pinnaclehealth.org>

See below.  Level 4 means "no risk", Level 3 is "low", Level 2 is
"moderate" and Level 1 is "high".
  

All patients on the PPI Inpatient Psych units will be considered at
Priority Level 4 when admitted and assessed within 9 days of admission
unless they have a nutrition consult ordered or have an admission
diagnosis of an eating disorder.  

Follow-ups for patients will be completed  and documented as follows: 

             Priority Level 1:  every 3 days  

Priority Level 2:  every 5 days 

Priority Level 3:  every 10 days 

*Priority Level 4:  every 14 days

*(only documented on in Medical Record if priority level changes from 4)

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org <mailto:rtripp at pinnaclehealth.org> 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of cathy.peterjohn at medicorp.org
Sent: Tuesday, January 20, 2009 3:00 PM
To: cnm at lists.my180.net
Subject: [Cnm] pysch nutrition triggers



I know someone posted this recently but I'm hoping for more responses.
For those of you with inpatient and/or outpatient Psych. facilitites,
what nutrition criteria trigger an RD consult?





Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA 22401
540-741-1680
Fax: 540-741-4022



The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/8f1b37ef/attachment-0001.html 

From nmarinel at chsbuffalo.org  Tue Jan 20 12:57:12 2009
From: nmarinel at chsbuffalo.org (Marinelli, Nancy)
Date: Tue, 20 Jan 2009 15:57:12 -0500
Subject: [Cnm] Productivity
Message-ID: <3E6DC8D8B3285C449C883257CA6012D7582DD5CB5A@CHEXCHANGE01.ad.wnychs.org>



What is everyone using to track productivity for acute care dietitians and diet technicians? Does anyone know if there is any industry standards for this? I am in a position where we are needing to establish productivity targets and because we are part of food service they want use meals served as our indicator.

Any help will be enormously appreciated!!

Thank you!

P Please consider the environment before printing this email.

Nancy Marinelli, RD, CDN, CNSD
Clinical Nutrition Manager
Sisters of Charity Hospital
2157 Main Street
Buffalo, New York 14214
(716) 862-1621
(716) 862-1846 - FAX





-------------------------

CONFIDENTIALITY NOTICE: This message is confidential, intended only for the named recipient(s) and may contain information that is privileged, or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender by reply e-mail, delete this e-mail from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.  This message and all contents may be reviewed by authorized parties of the Catholic Health System other than those named in the message header.

The contents of this message do not bind the Catholic Health System to any contract, position, or course of action unless the sender is specifically authorized to enter into contracts on behalf of the Catholic Health System. The contents of this message do not necessarily constitute an official representation of the Catholic Health System.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/95033347/attachment.html 

From sheila.walsh at nahealth.com  Tue Jan 20 14:40:40 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Tue, 20 Jan 2009 15:40:40 -0700
Subject: [Cnm] pysch nutrition triggers
In-Reply-To: <OF9FBB2C58.8F2CEFD7-ON85257544.006DBFAD-85257544.006DE163@medicorp.org>
References: <OF9FBB2C58.8F2CEFD7-ON85257544.006DBFAD-85257544.006DE163@medicorp.org>
Message-ID: <4975F079.485B.0001.0@nahealth.com>

Our "psych" ward does not have triggers for nutrition, per se.  All patients we see there are by physician/nurse/case manager consult.  We are also invited to participate on specific patient rounds, weekly; and to participate in disordered eating team meetings with and without the patient.
 
We just started this, so I don't have good data on how it will all work, yet.
 
Previously, we were seeing them like they were sick patients with med-surg type problems.
 
 
Sheila A. Walsh, MPH, RD
Nutrition Services Coordinator

"My gold neither sparkles nor jingles.  
It glistens in the sunlight & whinnies in the darkness."
 


>>> <cathy.peterjohn at medicorp.org> 1/20/2009 1:00 PM >>>

I know someone posted this recently but I'm hoping for more responses.
For those of you with inpatient and/or outpatient Psych. facilitites, what nutrition criteria trigger an RD consult?





Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA 22401
540-741-1680
Fax: 540-741-4022
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/37aed785/attachment.html 

From LCarver at Reshealthcare.org  Tue Jan 20 12:53:17 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 20 Jan 2009 14:53:17 -0600
Subject: [Cnm] pysch nutrition triggers
In-Reply-To: <OF9FBB2C58.8F2CEFD7-ON85257544.006DBFAD-85257544.006DE163@medicorp.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03BB44AC@rhcexch3.reshealthcare.org>

same as the rest of the hospital for adm screening.  after that,
doc/nurse consult, abn. labs trigger a rescreen for nutritional
implications.  we automatically rescreen the geriatric side at 7 days
and the adult side at 14 days.  Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of cathy.peterjohn at medicorp.org
Sent: Tuesday, January 20, 2009 2:00 PM
To: cnm at lists.my180.net
Subject: [Cnm] pysch nutrition triggers



I know someone posted this recently but I'm hoping for more responses.
For those of you with inpatient and/or outpatient Psych. facilitites,
what nutrition criteria trigger an RD consult?





Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA 22401
540-741-1680
Fax: 540-741-4022

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/d491af7c/attachment.html 

From lpettet at sfmc.net  Tue Jan 20 16:24:51 2009
From: lpettet at sfmc.net (Lori Pettet)
Date: Tue, 20 Jan 2009 18:24:51 -0600
Subject: [Cnm] CArdiac rehab programs
Message-ID: <497616F3020000C7000132FA@email_gateway.sfmc.net>

We are looking to revamp our Cardiac Rehab program and are looking for a tool (ie: food frequency? ) to use w/ outpts to assist in determining pt nutritional needs. We currently are on a consultant only basis w/ a nurse determining need. 
Any ideas?
thanks, Lori

Lori Pettet, MA, RD, LD, CDE
Assistant Manager, Nutrition Services
Saint Francis Medical Center
211 St. Francis Dr. 
Cape Girardeau, MO  63703
Phone: 331-5145
LPettet at sfmc.net

This email transmittal is intended only for the use of the individual or entity to which it is addressed.  It may contain Protected Health Information, which is privileged and confidential.  Protected Health Information may only be used or disclosed in accordance with law and you may be subject to penalties under law for improper use or further disclosure of the Protected Health Information in this email.    If you are not the intended recipient of this email,  you may not read, copy, distribute or otherwise use or disclose the information contained in this email.    If you received this email  in error, please notify the sender immediately and request instructions on return or destruction of the information in this email. 




From Lauri.Ek at providence.org  Tue Jan 20 16:38:29 2009
From: Lauri.Ek at providence.org (Ek, Lauri M.)
Date: Tue, 20 Jan 2009 15:38:29 -0900
Subject: [Cnm] Assessing protein needs with obese patients
In-Reply-To: <37ABAEB17B0B5B40AA0B6118E57CF59A03239F12@wn1221.or.providence.org>
Message-ID: <E66025C48FBA6C43888E7C65EACEF3A6744D54@wn1286.ak.providence.org>

My clinical team is curious what every one else is using to assess the
protein needs for obese patients since adjusted weights aren't evidence
based for assessing caloric needs.

Especially with renal patients we aren't comfortable using actual
weights for protein needs.

What is everyone else doing!???

Thanks,

Lauri M. Ek, RD, CDE, LD
Chief Clinical Dietitian 
Providence Alaska Medical Center 
3200 Providence Drive 
Anchorage, Alaska  99508 
Lauri.Ek at providence.org 
(907) 212-3046 
Fax:  (907) 212-4886 
Pager:  (907) 212-5800, #3046 



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.


From kmershon at bak.rr.com  Tue Jan 20 20:28:06 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Tue, 20 Jan 2009 20:28:06 -0800
Subject: [Cnm] Productivity
In-Reply-To: <3E6DC8D8B3285C449C883257CA6012D7582DD5CB5A@CHEXCHANGE01.ad.wnychs.org>
References: <3E6DC8D8B3285C449C883257CA6012D7582DD5CB5A@CHEXCHANGE01.ad.wnychs.org>
Message-ID: <5F778BB9ED2A4C36B2CF56A8360A3FB8@KathyPC>

CNM has a task force on this vitally cruicial topic and one day I dream we will really have a staffing standard. We too are part of Nutritional Service but have a separate dept. code and are staffed under average daily census. Doesn't take into account acuity, but when I presented a nutrition acuity it was rejected by Admin because there is no national benchmarking available. 

Best wishes,
Kathleen Mershon, RD
  ----- Original Message ----- 
  From: Marinelli, Nancy 
  To: cnm at lists.my180.net 
  Sent: Tuesday, January 20, 2009 12:57 PM
  Subject: [Cnm] Productivity


  What is everyone using to track productivity for acute care dietitians and diet technicians? Does anyone know if there is any industry standards for this? I am in a position where we are needing to establish productivity targets and because we are part of food service they want use meals served as our indicator.

   

  Any help will be enormously appreciated!!

   

  Thank you!

   

  P Please consider the environment before printing this email.

   

  Nancy Marinelli, RD, CDN, CNSD

  Clinical Nutrition Manager

  Sisters of Charity Hospital

  2157 Main Street

  Buffalo, New York 14214

  (716) 862-1621

  (716) 862-1846 - FAX

   

   

   

        -------------------------

        CONFIDENTIALITY NOTICE: This message is confidential, intended only for the named recipient(s) and may contain information that is privileged, or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender by reply e-mail, delete this e-mail from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege. This message and all contents may be reviewed by authorized parties of the Catholic Health System other than those named in the message header.
       
        The contents of this message do not bind the Catholic Health System to any contract, position, or course of action unless the sender is specifically authorized to enter into contracts on behalf of the Catholic Health System. The contents of this message do not necessarily constitute an official representation of the Catholic Health System.
       



------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/c3fe0219/attachment.html 

From kmershon at bak.rr.com  Tue Jan 20 20:43:21 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Tue, 20 Jan 2009 20:43:21 -0800
Subject: [Cnm] RD daily load
Message-ID: <643EDE458F204D919D56CB631C0F5D6D@KathyPC>

Bolded responses below. 

----- Original Message ----- 
From: <CKeinath at chs-mi.com>
To: <cnm at lists.my180.net>
Sent: Tuesday, January 20, 2009 9:55 AM
Subject: [Cnm] RD daily load


> 
> Can you tell me how your facility handles the RD daily load of patient
> care? 
1 RD had both ICUs (21 beds, and will have the NICU when it opens and the third ICU when it opens), plus TPN and Vent rounds; 
1 RD has the Med Surg, (burn unit, and step down opening soon) = 75 beds will expand to105 beds,
 1 PT RD has Telemetry and Surgical floors (100 beds).
> Do you have each of your RD has a regular floor unit and distribute
> additional when a staff member is off on vacation? Yes
> Do you have all the RDs look at the load for the day and pick and choose
> what each one will do? No. They look at their unit patient census sheets and identify their patients from clinical reports (TF, NPO/CL >5 days, TPN, BMI<19, and consult referrals), and any due for follow ups.
> Either way, is it working?  Yes Pros/cons? 
Pros: Nursing staff and case managers know "their" unit /attending dietitian. Teamwork, communication, consistency, specialized skill set development in specialty care units. 
Cons: Potential for some staff to grow specialized in critical care or burn unit at a different rate of expertise than those assigned to higher volume, lower acuity units. 

All staff get some exposure to critical care and specialty units as they rotate weekend coverage and relief coverage when someone is off for vacation, illness, midweek day off to cover weekend, etc. My staff are happy and they don't know anything else. When I came onboard 7 years ago we had the scramble thing going and it was inefficient. I made the unit assignment change and it has worked well. Not changing what works. When someone has a heavy load and another fewer patients, they triage together and help each other out....teamwork! :>)
Kathleen Mershon, RD

> 
> Thanks
> 
> Carol E. Keinath, MS RD
> Clinical Nutrition Manager            Covenant HealthCare
> Phone: 989-583-4663                   1447 N. Harrison St.
> FAX: 989-583-4851                        Saginaw, MI 48602
> http://www.covenanthealthcare.com/
> 
> "Life isn't about waiting for The Storm to Pass -- it's about Learning to
> Dance in The Rain".
> 
> -------------------------------------------------------------------------
> 
> This email may contain legally privileged and/or confidential
> information. If you are not the intended recipient, or the employee
> or agent responsible for delivery of this message to the intended
> recipient, you are hereby notified that any dissemination,
> distribution or copying of this email is strictly prohibited. If
> you have received this message in error, please immediately notify
> the sender and delete this email from your computer. Your
> cooperation is appreciated.   
> 
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/99fe878b/attachment-0001.html 

From kmershon at bak.rr.com  Tue Jan 20 20:49:16 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Tue, 20 Jan 2009 20:49:16 -0800
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <7011FE812E0541E699EC09763AED12C2@ANNALYNN>
References: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>
	<7011FE812E0541E699EC09763AED12C2@ANNALYNN>
Message-ID: <E289D5B5B1ED40BBA3F40BE66CE024F0@KathyPC>

Hi Annalynn
I believe Lisa is referring to Enloe Medical Center in northern CA, and the surveyor is Dagmar Bender. I immediately wrote to Mary Hagar and Kara Caldwell-Freeman on this issue. CA does not have licensure and for Dagmar to penalize CA RDs for not having licensure even though they have worked through the privileging process with their medical staff is just mind boggling. I have a few other thoughts on this but will reserve them for sharing in a less widely distributed forum. :>)
Kathleen Mershon, RD
  ----- Original Message ----- 
  From: Annalynn Skipper 
  To: 'Lisa Trombley' ; cnm at lists.my180.net 
  Sent: Tuesday, January 20, 2009 8:22 AM
  Subject: Re: [Cnm] Order Writing & Licensure


  Hi Lisa,

   

  Are you sure that the person relaying the story to you didn't confuse the term "licensed" with the term "credentialed"?  Perhaps a copy of the citation is available so that you can be sure.  I can see a surveyor writing in a citation "unlicensed personnel ordering nutrition therapy", but in that case "unlicensed" would likely refer to people other than physicians, nurse practitioners and PA's.  Even in California, order writing is under the control of the medical staff in the institution in conjunction with state law.  

   

  Regards,        

   

  Annalynn

   

  Annalynn Skipper Ph.D., R.D., FADA

   



  a consultancy devoted to advancing nutrition practice

  P.O. Box 45

  Oak Park, IL 60303

  Annalynn_Skipper at Comcast.net

  Advanced Medical Nutrition Therapy Practice, 

  a 2008 text, is available from Jones and Bartlett. 

   


------------------------------------------------------------------------------

  From: Lisa Trombley [mailto:hargenlisa at hotmail.com] 
  Sent: Tuesday, January 20, 2009 9:33 AM
  To: cnm at lists.my180.net
  Subject: [Cnm] Order Writing & Licensure

   

  For those in states without licensure (particularly interested in CA), are the RDs permitted to write orders as long as they go through proper procedure as outlined in state regulations?  I heard of a facility recently receiving a citation for order-writing despite the fact that the RDs had established the practice based on state regulations.  The CMS/state surveyor cited the fact that the RDs were not licensed so could not write orders.  Is this new for 2009?  Thanks in advance. 

  Lisa Trombley, MA, RD, CNSD 

  Los Angeles, CA

  hargenlisa at hotmail.com

   






------------------------------------------------------------------------------

  Windows LiveT: Keep your life in sync. See how it works.



------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/4a7645cd/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 170 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090120/4a7645cd/attachment.gif 

From pcharney at mac.com  Tue Jan 20 21:51:50 2009
From: pcharney at mac.com (Pam Charney)
Date: Tue, 20 Jan 2009 21:51:50 -0800
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <E289D5B5B1ED40BBA3F40BE66CE024F0@KathyPC>
References: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>
	<7011FE812E0541E699EC09763AED12C2@ANNALYNN>
	<E289D5B5B1ED40BBA3F40BE66CE024F0@KathyPC>
Message-ID: <3C94447A-DA60-4AA3-A6A6-9AC5C4D75B6C@mac.com>

I feel your pain. There is often a misunderstanding about how  
dietetics is licensed or not licensed in various states. Because we  
have CDR and the registration process, along with a mishmash of  
certification, licensure and no licensure, it's pretty understandable  
that surveyors would be confused.

In my own state, (WA), we have certification. Last year I was told by  
a local school nurse that I could not train volunteers to provide  
diabetes care in schools because I am not "licensed" in WA. This is  
because the WA state laws regarding care of diabetes in school specify  
a "licensed" health care provider do the training. Nurses, physicians,  
and others are licensed. Folks understand licensure. After explaining  
the situation and being somewhat persistent, the objection was lifted.

Now mind you, I'm not saying that this particular surveyor was simply  
a bit confused, but I can certainly see that happening, considering  
the vast number of rules and regulations these folks must ponder while  
they evaluate a given facility!

Regards,
pam

Pam Charney PhD, RD
Clinical Coordinator
Graduate Coordinated Program in Dietetics
Lecturer, Department of Epidemiology
Nutrition Sciences Program
School of Public Health and Community Medicine
Box 353410, 306-C Raitt Hall

Affiliate Associate Professor
School of Pharmacy

MS Student
Clinical Informatics and Patient Centered Technology
School of Nursing

University of Washington
Seattle, WA
charnepa at u.washington.edu
"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jan 20, 2009, at 8:49 PM, Kathleen Mershon wrote:

> Hi Annalynn
> I believe Lisa is referring to Enloe Medical Center in northern CA,  
> and the surveyor is Dagmar Bender. I immediately wrote to Mary Hagar  
> and Kara Caldwell-Freeman on this issue. CA does not have licensure  
> and for Dagmar to penalize CA RDs for not having licensure even  
> though they have worked through the privileging process with their  
> medical staff is just mind boggling. I have a few other thoughts on  
> this but will reserve them for sharing in a less widely distributed  
> forum. :>)
> Kathleen Mershon, RD
> ----- Original Message -----
> From: Annalynn Skipper
> To: 'Lisa Trombley' ; cnm at lists.my180.net
> Sent: Tuesday, January 20, 2009 8:22 AM
> Subject: Re: [Cnm] Order Writing & Licensure
>
> Hi Lisa,
>
> Are you sure that the person relaying the story to you didn?t  
> confuse the term ?licensed? with the term ?credentialed??  Perhaps a  
> copy of the citation is available so that you can be sure.  I can  
> see a surveyor writing in a citation ?unlicensed personnel ordering  
> nutrition therapy?, but in that case ?unlicensed? would likely refer  
> to people other than physicians, nurse practitioners and PA?s.  Even  
> in California, order writing is under the control of the medical  
> staff in the institution in conjunction with state law.
>
> Regards,
>
> Annalynn
>
> Annalynn Skipper Ph.D., R.D., FADA
> <image001.gif>
>
> a consultancy devoted to advancing nutrition practice
> P.O. Box 45
> Oak Park, IL 60303
> Annalynn_Skipper at Comcast.net
> Advanced Medical Nutrition Therapy Practice,
> a 2008 text, is available from Jones and Bartlett.
>
> From: Lisa Trombley [mailto:hargenlisa at hotmail.com]
> Sent: Tuesday, January 20, 2009 9:33 AM
> To: cnm at lists.my180.net
> Subject: [Cnm] Order Writing & Licensure
>
> For those in states without licensure (particularly interested in  
> CA), are the RDs permitted to write orders as long as they go  
> through proper procedure as outlined in state regulations?  I heard  
> of a facility recently receiving a citation for order-writing  
> despite the fact that the RDs had established the practice based on  
> state regulations.  The CMS/state surveyor cited the fact that the  
> RDs were not licensed so could not write orders.  Is this new for  
> 2009?  Thanks in advance.
> Lisa Trombley, MA, RD, CNSD
> Los Angeles, CA
> hargenlisa at hotmail.com
>
>
>
> Windows Live?: Keep your life in sync. See how it works.
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090120/da97fd0f/attachment-0001.html 

From Janet.Ross at healthall.com  Wed Jan 21 05:06:34 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Wed, 21 Jan 2009 08:06:34 -0500
Subject: [Cnm] Food temperature safety
Message-ID: <41CA05D55BF105489D33F8E57D71A9051716986716@MAIL-C.healthall.com>

How hot is "safe" for hot cereal or hot coffee?  I have a resident who does not sense temperatures well, but insists that 130 degree grits are not hot enough.  If staff microwaves the cereal for her, how hot is maximum to prevent a burn?  I'd like to say to staff that they can "heat for 30 seconds, stir, and check temperature.  Should be no hotter than XXX degrees."

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.



________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/638a44c1/attachment.html 

From Margaret.Chaffin at hcahealthcare.com  Wed Jan 21 05:47:18 2009
From: Margaret.Chaffin at hcahealthcare.com (Chaffin Meg)
Date: Wed, 21 Jan 2009 07:47:18 -0600
Subject: [Cnm] Assessing protein needs with obese patients
In-Reply-To: <E66025C48FBA6C43888E7C65EACEF3A6744D54@wn1286.ak.providence.org>
References: <37ABAEB17B0B5B40AA0B6118E57CF59A03239F12@wn1221.or.providence.org>
	<E66025C48FBA6C43888E7C65EACEF3A6744D54@wn1286.ak.providence.org>
Message-ID: <FE4E4942DC04FF4DA336172CB2CC522D12B1D3204D@NADCWPMSGCMS06.hca.corpad.net>

Please post to list. I'm interested in this as well.

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Center
(229)434-2394
-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ek, Lauri M.
Sent: Tuesday, January 20, 2009 7:38 PM
To: cnm at lists.my180.net
Subject: [Cnm] Assessing protein needs with obese patients

My clinical team is curious what every one else is using to assess the
protein needs for obese patients since adjusted weights aren't evidence
based for assessing caloric needs.

Especially with renal patients we aren't comfortable using actual
weights for protein needs.

What is everyone else doing!???

Thanks,

Lauri M. Ek, RD, CDE, LD
Chief Clinical Dietitian 
Providence Alaska Medical Center 
3200 Providence Drive 
Anchorage, Alaska  99508 
Lauri.Ek at providence.org 
(907) 212-3046 
Fax:  (907) 212-4886 
Pager:  (907) 212-5800, #3046 



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From Lyn.Haft at rexhealth.com  Wed Jan 21 05:51:29 2009
From: Lyn.Haft at rexhealth.com (Haft, Lyn)
Date: Wed, 21 Jan 2009 08:51:29 -0500
Subject: [Cnm] Assessing protein needs with obese patients
In-Reply-To: <FE4E4942DC04FF4DA336172CB2CC522D12B1D3204D@NADCWPMSGCMS06.hca.corpad.net>
Message-ID: <6C5C5FBEE636A043BC7466A8CAE0732F09685509@exchmail1.rexhealth.com>

Especially for Bariatric patients 

Lyn Haft
Clinical Nutrition Manager
Rex Healthcare
4420 Lake Boone Trail
Raleigh, NC 27607 
919-784-3162



-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Chaffin Meg
Sent: Wednesday, January 21, 2009 8:47 AM
To: Ek, Lauri M.; cnm at lists.my180.net
Subject: Re: [Cnm] Assessing protein needs with obese patients


Please post to list. I'm interested in this as well.

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Center
(229)434-2394
-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Ek, Lauri M.
Sent: Tuesday, January 20, 2009 7:38 PM
To: cnm at lists.my180.net
Subject: [Cnm] Assessing protein needs with obese patients

My clinical team is curious what every one else is using to assess the
protein needs for obese patients since adjusted weights aren't evidence
based for assessing caloric needs.

Especially with renal patients we aren't comfortable using actual
weights for protein needs.

What is everyone else doing!???

Thanks,

Lauri M. Ek, RD, CDE, LD
Chief Clinical Dietitian 
Providence Alaska Medical Center 
3200 Providence Drive 
Anchorage, Alaska  99508 
Lauri.Ek at providence.org 
(907) 212-3046 
Fax:  (907) 212-4886 
Pager:  (907) 212-5800, #3046 



DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


----- Confidentiality Notice -----
This e-mail and any attached documents contain confidential information belonging
to the sending entity, Rex Healthcare, and is intended only for the use of the 
individual(s) or entity(s) associated with the recipient addresses listed in the message 
header.  The authorized recipient of this information is prohibited from disclosing this 
information to any other party.  If you are not the intended recipient, you are hereby 
notified that any disclosure, copying, distribution or action taken in reliance on the 
contents of the email and/or attachments is strictly prohibited.  If you received this 
e-mail transmission in error, please notify the sender immediately to arrange for return 
or destruction of this information.

To report abuse or inappropriate use, please email abuse at rexhealth.com.(b)



From Phyllis.Kaskel at mountsinai.org  Wed Jan 21 06:11:16 2009
From: Phyllis.Kaskel at mountsinai.org (Kaskel, Phyllis)
Date: Wed, 21 Jan 2009 09:11:16 -0500
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <3C94447A-DA60-4AA3-A6A6-9AC5C4D75B6C@mac.com>
Message-ID: <850F6C2F598EF84F8FA5BEF9CC0CC96D03F0AD8F@EXCEBW2K325.msnyuhealth.org>

We have the same problem here in New York.  When you pull up the New
York State Education Office of the Profession web page it clearly states
"Licensee Names".  We are "Certified Dietitian/Nutritionist" and many
non-RDs have been grandfathered in.  

 

I have even had issues with our HR Department on the hiring of
Registered Dietitians because they are not "Licensed". 

 

I just wonder if they trust a "Certified Public Accountant" to do their
taxes!  And is it fine that a "Licensed" nail saloon technician is
better?

 

Phyllis Kaskel,  MA, RD, CDN

Director, Clinical Nutrition

Mount Sinai Hospital and

Faculty, Department of Community and Preventive Medicine

Mount Sinai School of Medicine

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Pam Charney
Sent: Wednesday, January 21, 2009 12:52 AM
To: Kathleen Mershon
Cc: Annalynn_Skipper at Comcast.net; cnm at lists.my180.net
Subject: Re: [Cnm] Order Writing & Licensure

 

I feel your pain. There is often a misunderstanding about how dietetics
is licensed or not licensed in various states. Because we have CDR and
the registration process, along with a mishmash of certification,
licensure and no licensure, it's pretty understandable that surveyors
would be confused. 

 

In my own state, (WA), we have certification. Last year I was told by a
local school nurse that I could not train volunteers to provide diabetes
care in schools because I am not "licensed" in WA. This is because the
WA state laws regarding care of diabetes in school specify a "licensed"
health care provider do the training. Nurses, physicians, and others are
licensed. Folks understand licensure. After explaining the situation and
being somewhat persistent, the objection was lifted. 

 

Now mind you, I'm not saying that this particular surveyor was simply a
bit confused, but I can certainly see that happening, considering the
vast number of rules and regulations these folks must ponder while they
evaluate a given facility!

 

Regards,

pam

 

Pam Charney PhD, RD

Clinical Coordinator

Graduate Coordinated Program in Dietetics

Lecturer, Department of Epidemiology

Nutrition Sciences Program

School of Public Health and Community Medicine

Box 353410, 306-C Raitt Hall

 

Affiliate Associate Professor

School of Pharmacy

 

MS Student

Clinical Informatics and Patient Centered Technology

School of Nursing

 

University of Washington

Seattle, WA

charnepa at u.washington.edu

"The person who says it can't be done should not 

interrupt the person doing it" - Ethel Kennedy

 

On Jan 20, 2009, at 8:49 PM, Kathleen Mershon wrote:





Hi Annalynn

I believe Lisa is referring to Enloe Medical Center in northern CA, and
the surveyor is Dagmar Bender. I immediately wrote to Mary Hagar and
Kara Caldwell-Freeman on this issue. CA does not have licensure and for
Dagmar to penalize CA RDs for not having licensure even though they have
worked through the privileging process with their medical staff is just
mind boggling. I have a few other thoughts on this but will reserve them
for sharing in a less widely distributed forum. :>)

Kathleen Mershon, RD

	----- Original Message -----

	From: Annalynn Skipper <mailto:Annalynn_Skipper at Comcast.net> 

	To: 'Lisa Trombley' <mailto:hargenlisa at hotmail.com>  ;
cnm at lists.my180.net

	Sent: Tuesday, January 20, 2009 8:22 AM

	Subject: Re: [Cnm] Order Writing & Licensure

	 

	Hi Lisa,

	 

	Are you sure that the person relaying the story to you didn't
confuse the term "licensed" with the term "credentialed"?  Perhaps a
copy of the citation is available so that you can be sure.  I can see a
surveyor writing in a citation "unlicensed personnel ordering nutrition
therapy", but in that case "unlicensed" would likely refer to people
other than physicians, nurse practitioners and PA's.  Even in
California, order writing is under the control of the medical staff in
the institution in conjunction with state law. 

	 

	Regards,        

	 

	Annalynn

	 

	Annalynn Skipper Ph.D., R.D., FADA

	<image001.gif> 

	
	

	a consultancy devoted to advancing nutrition practice

	P.O. Box 45

	Oak Park, IL 60303

	Annalynn_Skipper at Comcast.net
<mailto:Annalynn_Skipper at Comcast.net> 

	Advanced Medical Nutrition Therapy Practice,

	a 2008 text, is available from Jones and Bartlett.

	 

	
________________________________


	From: Lisa Trombley [mailto:hargenlisa at hotmail.com] 
	Sent: Tuesday, January 20, 2009 9:33 AM
	To: cnm at lists.my180.net
	Subject: [Cnm] Order Writing & Licensure

	 

	For those in states without licensure (particularly interested
in CA), are the RDs permitted to write orders as long as they go through
proper procedure as outlined in state regulations?  I heard of a
facility recently receiving a citation for order-writing despite the
fact that the RDs had established the practice based on state
regulations.  The CMS/state surveyor cited the fact that the RDs were
not licensed so could not write orders.  Is this new for 2009?  Thanks
in advance. 

	Lisa Trombley, MA, RD, CNSD

	Los Angeles, CA

	hargenlisa at hotmail.com

	 

	
	
	
	

	
________________________________


	Windows Live(tm): Keep your life in sync. See how it works.
<http://windowslive.com/howitworks?ocid=TXT_TAGLM_WL_t1_allup_howitworks
_012009> 

	 

	
________________________________


	 

	_______________________________________________
	Cnm mailing list
	Cnm at lists.my180.net
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/5abbb829/attachment-0001.html 

From MELLINGTON at wakemed.org  Wed Jan 21 06:51:47 2009
From: MELLINGTON at wakemed.org (MARTHA ELLINGTON)
Date: Wed, 21 Jan 2009 09:51:47 -0500
Subject: [Cnm] Searching the ADA NCM
In-Reply-To: <F51619ACD75A43BFA8484939BF71D6BF@owner84d523d58>
References: <20090119062841.BNS7Z.3310441.root@mp17>
	<F51619ACD75A43BFA8484939BF71D6BF@owner84d523d58>
Message-ID: <C9B465BC4B43194C8497ED552436EBD57038F968D4@EXCCR01MBX.wakemed.org>

This is why we have chosen to use our own format for our Intra net "Diet Manual" we have one user access to the NCM so we can use it as an up-to-date reference for our on-line manual.  This is much more user friendly if a nurse rarely needed to know what WE serve on OUR Mechanical  diet.
Martha J Ellington, RD, LDN
Clinical Nutrition Manager, Food and Nutrition Services
WakeMed Health and Hospitals
Raleigh, NC
919-350-8182
mellington at wakemed.org



From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Deborah Gore
Sent: Monday, January 19, 2009 8:09 PM
To: cnm at lists.my180.net
Subject: [Cnm] Searching the ADA NCM

RE: Finding by diagnosis is fine for the dietitian and medical/nursing staff, but having a way to search by diet would be helpful for the diet office/production staff to look up  answers for food related issues.  Both search methods should be incorporated into the manual.

I agree, sometimes I want a diet explanation but not with a diagnosis attached to it. I don't always have a patient with a MI that I
want to give heart healthy tips for. Looking for a high fiber diet, etc. is tricky. My pet peeve has been using the search function that comes up with hundreds
of results even when I use multiple words trying to get a short list. It is not like using Google!

Deborah Gore, RD, CNSD
-------------------------------------------------------------------------------

WakeMed Confidentiality Notice: 

This message, including any attachments, is for the sole use of the individual 
or entity to whom it is addressed and may contain confidential and/or legally 
privileged information.  If you are not the intended recipient, please contact 
the sender by reply e-mail and destroy all copies of the original message.  
Any unauthorized review, use, copying, disclosure, or distribution of this 
message and attachments is strictly prohibited.

-------------------------------------------------------------------------------
 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/2a1c0363/attachment.html 

From heidi at sysexperts.com  Wed Jan 21 07:20:24 2009
From: heidi at sysexperts.com (Heidi Kiehl)
Date: Wed, 21 Jan 2009 07:20:24 -0800
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <E289D5B5B1ED40BBA3F40BE66CE024F0@KathyPC>
References: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>	<7011FE812E0541E699EC09763AED12C2@ANNALYNN>
	<E289D5B5B1ED40BBA3F40BE66CE024F0@KathyPC>
Message-ID: <49773D38.40203@sysexperts.com>

For California RD's on this list, want to let you know that there is a 
CDA Professional Practice Task Force, of which I am a member, that has 
been meeting regularly to address these survey citations and scope of 
practice issues since late summer. We are closely working with CDPH 
through monthly meetings in Sacramento at their main office. We are 
making this a collaborative effort so that all sides will have the same 
understanding and the same vision and use the same terminology. There 
have been learning curves on professional practice issues and regulatory 
aspects for both groups. Sitting together at the table rather than 
butting heads/not discussing the problems and issues with the CDPH 
leaders has been valuable. The action plan/next steps are going to be 
communicated by our CDA VP of Public Policy (Lorri Holzberg) very soon 
-- she will be reporting to the CDA Executive Board this week what has 
transpired at our meetings and then share this with all CDA members.

Thank You.
Heidi Kiehl, MS, RD, CNSC
Professional Practice Task Force
California Dietetic Association
Clinical Nutrition Manager
ValleyCare Health System, Pleasanton CA


Kathleen Mershon wrote:
> Hi Annalynn
> I believe Lisa is referring to Enloe Medical Center in northern CA, 
> and the surveyor is Dagmar Bender. I immediately wrote to Mary Hagar 
> and Kara Caldwell-Freeman on this issue. CA does not have licensure 
> and for Dagmar to penalize CA RDs for not having licensure even though 
> they have worked through the privileging process with their medical 
> staff is just mind boggling. I have a few other thoughts on this but 
> will reserve them for sharing in a less widely distributed forum. :>)
> Kathleen Mershon, RD
>
>     ----- Original Message -----
>     *From:* Annalynn Skipper <mailto:Annalynn_Skipper at Comcast.net>
>     *To:* 'Lisa Trombley' <mailto:hargenlisa at hotmail.com> ;
>     cnm at lists.my180.net <mailto:cnm at lists.my180.net>
>     *Sent:* Tuesday, January 20, 2009 8:22 AM
>     *Subject:* Re: [Cnm] Order Writing & Licensure
>
>     Hi Lisa,
>
>     Are you sure that the person relaying the story to you didn?t
>     confuse the term ?licensed? with the term ?credentialed?? Perhaps
>     a copy of the citation is available so that you can be sure. I can
>     see a surveyor writing in a citation ?unlicensed personnel
>     ordering nutrition therapy?, but in that case ?unlicensed? would
>     likely refer to people other than physicians, nurse practitioners
>     and PA?s. Even in California, order writing is under the control
>     of the medical staff in the institution in conjunction with state
>     law.
>
>     Regards,
>
>     Annalynn
>
>     Annalynn Skipper Ph.D., R.D., FADA
>
>     * *
>
>
>     a consultancy devoted to advancing nutrition practice
>
>     P.O. Box 45
>
>     Oak Park, IL 60303
>
>     Annalynn_Skipper at Comcast.net <mailto:Annalynn_Skipper at Comcast.net>
>
>     Advanced Medical Nutrition Therapy Practice,
>
>     a 2008 text, is available from Jones and Bartlett.
>
>     ------------------------------------------------------------------------
>
>     *From:* Lisa Trombley [mailto:hargenlisa at hotmail.com]
>     *Sent:* Tuesday, January 20, 2009 9:33 AM
>     *To:* cnm at lists.my180.net
>     *Subject:* [Cnm] Order Writing & Licensure
>
>     For those in states without licensure (particularly interested in
>     CA), are the RDs permitted to write orders as long as they go
>     through proper procedure as outlined in state regulations? I heard
>     of a facility recently receiving a citation for order-writing
>     despite the fact that the RDs had established the practice based
>     on state regulations. The CMS/state surveyor cited the fact that
>     the RDs were not licensed so could not write orders. Is this new
>     for 2009? Thanks in advance.
>
>     //Lisa Trombley, MA, RD, CNSD //
>
>     Los Angeles, CA
>
>     hargenlisa at hotmail.com <mailto:hargenlisa at hotmail.com>
>
>
>
>     ------------------------------------------------------------------------
>
>     Windows Live?: Keep your life in sync. See how it works.
>     <http://windowslive.com/howitworks?ocid=TXT_TAGLM_WL_t1_allup_howitworks_012009>
>
>     ------------------------------------------------------------------------
>     _______________________________________________
>     Cnm mailing list
>     Cnm at lists.my180.net
>     http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
> ------------------------------------------------------------------------
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>   



From KRzad at med.miami.edu  Wed Jan 21 07:41:39 2009
From: KRzad at med.miami.edu (Rzad, Karon)
Date: Wed, 21 Jan 2009 10:41:39 -0500
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <E289D5B5B1ED40BBA3F40BE66CE024F0@KathyPC>
Message-ID: <DFE35E9E46C195459D20853641E2E1EA02ECB12AA7@MEDEXMB01.ad.med.miami.edu>

Dear Colleagues,

I am wondering how much of this is related to "terf" issues.  And, that not all licensed Nutritionists are qualified to do all levels of nutrition interventions.  But, they do not know what they do not know.  No one has died on their watch so therefore it is ok?

Case in point, I was at a conference where an ARNP announced that she does the Medical Nutrition Therapy at her hospital facility in NYC.  I listened to her description of what that entails.  She is supervising kitchen help regarding their prescribed diets.  Ironically, I later gave a talk on Medical Nutrition Therapy.  She attended the talk and was "blown away" by the food science and kinesiology of nutrients described in my talk.  We gained a better respect for each other that day.  She has asked for my email.

Additionally, we had a home economics major doing the dietary management functions at a facility I was consulting.  She stated how "over rated" the RD credential was to her.  Later that day, she was asked to do a TPN.  She asked for the check list, form and handout.  When told there was no check list or form she blanched and said, "How am I supposed to do this"?   Right!  She called me and a consult was requested.  I walked her through the assessment steps.  She left before I finished the in-service and now refers to me more often.

My point:  We need to be more visible and confident.  We need to be easy to talk to and informative.  In that way, we will become part of the team more often.
It is frustrating have so many valuable skills and be so under appreciated.  It is scary to feel that as a profession, RD functions are being swallowed up by those with fewer skills.

Our voices need to be heard in this wave of change and hope for the future. Because: Health is Wealth and Investing in Nutrition is Essential.

Thanks for reading this. Let your state legislatures here your voices.  And, keep on doing such important work.

Karon Rzad RD LDN CDE CPT LSMC
UM/S

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Kathleen Mershon
Sent: Tuesday, January 20, 2009 11:49 PM
To: Annalynn_Skipper at Comcast.net; 'Lisa Trombley'; cnm at lists.my180.net
Subject: Re: [Cnm] Order Writing & Licensure

Hi Annalynn
I believe Lisa is referring to Enloe Medical Center in northern CA, and the surveyor is Dagmar Bender. I immediately wrote to Mary Hagar and Kara Caldwell-Freeman on this issue. CA does not have licensure and for Dagmar to penalize CA RDs for not having licensure even though they have worked through the privileging process with their medical staff is just mind boggling. I have a few other thoughts on this but will reserve them for sharing in a less widely distributed forum. :>)
Kathleen Mershon, RD
----- Original Message -----
From: Annalynn Skipper<mailto:Annalynn_Skipper at Comcast.net>
To: 'Lisa Trombley'<mailto:hargenlisa at hotmail.com> ; cnm at lists.my180.net<mailto:cnm at lists.my180.net>
Sent: Tuesday, January 20, 2009 8:22 AM
Subject: Re: [Cnm] Order Writing & Licensure

Hi Lisa,

Are you sure that the person relaying the story to you didn't confuse the term "licensed" with the term "credentialed"?  Perhaps a copy of the citation is available so that you can be sure.  I can see a surveyor writing in a citation "unlicensed personnel ordering nutrition therapy", but in that case "unlicensed" would likely refer to people other than physicians, nurse practitioners and PA's.  Even in California, order writing is under the control of the medical staff in the institution in conjunction with state law.

Regards,

Annalynn

Annalynn Skipper Ph.D., R.D., FADA
[cid:image002.gif at 01C97BB4.D76FFC20]

a consultancy devoted to advancing nutrition practice
P.O. Box 45
Oak Park, IL 60303
Annalynn_Skipper at Comcast.net<mailto:Annalynn_Skipper at Comcast.net>
Advanced Medical Nutrition Therapy Practice,
a 2008 text, is available from Jones and Bartlett.

________________________________
From: Lisa Trombley [mailto:hargenlisa at hotmail.com]
Sent: Tuesday, January 20, 2009 9:33 AM
To: cnm at lists.my180.net
Subject: [Cnm] Order Writing & Licensure

For those in states without licensure (particularly interested in CA), are the RDs permitted to write orders as long as they go through proper procedure as outlined in state regulations?  I heard of a facility recently receiving a citation for order-writing despite the fact that the RDs had established the practice based on state regulations.  The CMS/state surveyor cited the fact that the RDs were not licensed so could not write orders.  Is this new for 2009?  Thanks in advance.
Lisa Trombley, MA, RD, CNSD
Los Angeles, CA
hargenlisa at hotmail.com<mailto:hargenlisa at hotmail.com>


________________________________
Windows Live(tm): Keep your life in sync. See how it works.<http://windowslive.com/howitworks?ocid=TXT_TAGLM_WL_t1_allup_howitworks_012009>
________________________________
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/689c5933/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image002.gif
Type: image/gif
Size: 170 bytes
Desc: image002.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090121/689c5933/attachment-0001.gif 

From peggymsrdld at cox.net  Wed Jan 21 08:17:27 2009
From: peggymsrdld at cox.net (Peggy Turner)
Date: Wed, 21 Jan 2009 10:17:27 -0600
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <DFE35E9E46C195459D20853641E2E1EA02ECB12AA7@MEDEXMB01.ad.med.miami.edu>
References: <DFE35E9E46C195459D20853641E2E1EA02ECB12AA7@MEDEXMB01.ad.med.miami.edu>
Message-ID: <7D4CB232-C700-4A7E-868C-324FB211CD69@cox.net>

Personally, I don't think it is a turf thing. I think it is a lack of  
information/education.

Just let me say that I am in the process of obtaining order writing  
privileges and I am blown away about how little people, including my  
boss (non RD) and the docs understands all this. Her comment was that  
ADA credentials you so that should be all you need. Docs think the  
same thing.

We have a lot of work in to be done regarding this important issue.

Just my two cents but I'm sticking to it!

Have a great day.

Peggy Turner, MS, RD/LD
On Jan 21, 2009, at 9:41 AM, Rzad, Karon wrote:

> Dear Colleagues,
>
> I am wondering how much of this is related to ?terf? issues.  And,  
> that not all licensed Nutritionists are qualified to do all levels  
> of nutrition interventions.  But, they do not know what they do not  
> know.  No one has died on their watch so therefore it is ok?
>
> Case in point, I was at a conference where an ARNP announced that  
> she does the Medical Nutrition Therapy at her hospital facility in  
> NYC.  I listened to her description of what that entails.  She is  
> supervising kitchen help regarding their prescribed diets.   
> Ironically, I later gave a talk on Medical Nutrition Therapy.  She  
> attended the talk and was ?blown away? by the food science and  
> kinesiology of nutrients described in my talk.  We gained a better  
> respect for each other that day.  She has asked for my email.
>
> Additionally, we had a home economics major doing the dietary  
> management functions at a facility I was consulting.  She stated how  
> ?over rated? the RD credential was to her.  Later that day, she was  
> asked to do a TPN.  She asked for the check list, form and handout.   
> When told there was no check list or form she blanched and said,  
> ?How am I supposed to do this??   Right!  She called me and a  
> consult was requested.  I walked her through the assessment steps.   
> She left before I finished the in-service and now refers to me more  
> often.
>
> My point:  We need to be more visible and confident.  We need to be  
> easy to talk to and informative.  In that way, we will become part  
> of the team more often.
> It is frustrating have so many valuable skills and be so under  
> appreciated.  It is scary to feel that as a profession, RD functions  
> are being swallowed up by those with fewer skills.
>
> Our voices need to be heard in this wave of change and hope for the  
> future. Because: Health is Wealth and Investing in Nutrition is  
> Essential.
>
> Thanks for reading this. Let your state legislatures here your  
> voices.  And, keep on doing such important work.
>
> Karon Rzad RD LDN CDE CPT LSMC
> UM/S
>
> From: cnm-bounces at lists.my180.net [mailto:cnm- 
> bounces at lists.my180.net] On Behalf Of Kathleen Mershon
> Sent: Tuesday, January 20, 2009 11:49 PM
> To: Annalynn_Skipper at Comcast.net; 'Lisa Trombley'; cnm at lists.my180.net
> Subject: Re: [Cnm] Order Writing & Licensure
>
> Hi Annalynn
> I believe Lisa is referring to Enloe Medical Center in northern CA,  
> and the surveyor is Dagmar Bender. I immediately wrote to Mary Hagar  
> and Kara Caldwell-Freeman on this issue. CA does not have licensure  
> and for Dagmar to penalize CA RDs for not having licensure even  
> though they have worked through the privileging process with their  
> medical staff is just mind boggling. I have a few other thoughts on  
> this but will reserve them for sharing in a less widely distributed  
> forum. :>)
> Kathleen Mershon, RD
> ----- Original Message -----
> From: Annalynn Skipper
> To: 'Lisa Trombley' ; cnm at lists.my180.net
> Sent: Tuesday, January 20, 2009 8:22 AM
> Subject: Re: [Cnm] Order Writing & Licensure
>
> Hi Lisa,
>
> Are you sure that the person relaying the story to you didn?t  
> confuse the term ?licensed? with the term ?credentialed??  Perhaps a  
> copy of the citation is available so that you can be sure.  I can  
> see a surveyor writing in a citation ?unlicensed personnel ordering  
> nutrition therapy?, but in that case ?unlicensed? would likely refer  
> to people other than physicians, nurse practitioners and PA?s.  Even  
> in California, order writing is under the control of the medical  
> staff in the institution in conjunction with state law.
>
> Regards,
>
> Annalynn
>
> Annalynn Skipper Ph.D., R.D., FADA
> <image002.gif>
>
> a consultancy devoted to advancing nutrition practice
> P.O. Box 45
> Oak Park, IL 60303
> Annalynn_Skipper at Comcast.net
> Advanced Medical Nutrition Therapy Practice,
> a 2008 text, is available from Jones and Bartlett.
>
> From: Lisa Trombley [mailto:hargenlisa at hotmail.com]
> Sent: Tuesday, January 20, 2009 9:33 AM
> To: cnm at lists.my180.net
> Subject: [Cnm] Order Writing & Licensure
>
> For those in states without licensure (particularly interested in  
> CA), are the RDs permitted to write orders as long as they go  
> through proper procedure as outlined in state regulations?  I heard  
> of a facility recently receiving a citation for order-writing  
> despite the fact that the RDs had established the practice based on  
> state regulations.  The CMS/state surveyor cited the fact that the  
> RDs were not licensed so could not write orders.  Is this new for  
> 2009?  Thanks in advance.
> Lisa Trombley, MA, RD, CNSD
> Los Angeles, CA
> hargenlisa at hotmail.com
>
>
> Windows Live?: Keep your life in sync. See how it works.
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/33989ac2/attachment.html 

From YDionne at westerlyhospital.org  Wed Jan 21 09:00:49 2009
From: YDionne at westerlyhospital.org (Yvette Dionne)
Date: Wed, 21 Jan 2009 12:00:49 -0500
Subject: [Cnm] Assessing protein needs with obese patients
In-Reply-To: <E66025C48FBA6C43888E7C65EACEF3A6744D54@wn1286.ak.providence.org>
References: <37ABAEB17B0B5B40AA0B6118E57CF59A03239F12@wn1221.or.providence.org>
	<E66025C48FBA6C43888E7C65EACEF3A6744D54@wn1286.ak.providence.org>
Message-ID: <E8876826D209234E9756A1C959D0A28F02245941@whmail.westerlyhospital.local>

Please, reply to group.  

-----Original Message-----
From: Ek, Lauri M. [mailto:Lauri.Ek at providence.org] 
Sent: Tuesday, January 20, 2009 7:38 PM
To: cnm at lists.my180.net
Subject: [Cnm] Assessing protein needs with obese patients

My clinical team is curious what every one else is using to assess the
protein needs for obese patients since adjusted weights aren't evidence
based for assessing caloric needs.

Especially with renal patients we aren't comfortable using actual
weights for protein needs.

What is everyone else doing!???

Thanks,

Lauri M. Ek, RD, CDE, LD
Chief Clinical Dietitian
Providence Alaska Medical Center
3200 Providence Drive
Anchorage, Alaska  99508
Lauri.Ek at providence.org
(907) 212-3046
Fax:  (907) 212-4886
Pager:  (907) 212-5800, #3046 



DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message.




From dfieldrd at aol.com  Wed Jan 21 09:12:53 2009
From: dfieldrd at aol.com (dfieldrd at aol.com)
Date: Wed, 21 Jan 2009 12:12:53 -0500
Subject: [Cnm] Pediatric Reference
Message-ID: <8CB4A02A12A75BF-1108-1973@FWM-D42.sysops.aol.com>

I know this was discussed previously, but I cannot find the ordering information in my saved mail.? We are looking for a pediatric reference book, my dietitians are using multiple different tables and all coming up with different recommendations.? Any information is much appreciated.
?
Thank You.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/92342cfc/attachment.html 

From Annalynn_Skipper at Comcast.net  Wed Jan 21 09:35:33 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Wed, 21 Jan 2009 11:35:33 -0600
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <49773D38.40203@sysexperts.com>
References: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>	<7011FE812E0541E699EC09763AED12C2@ANNALYNN><E289D5B5B1ED40BBA3F40BE66CE024F0@KathyPC>
	<49773D38.40203@sysexperts.com>
Message-ID: <35BD2C1FF3CD417CBE211AE165458F34@ANNALYNN>

Heidi,

Kudos on this good work!  I hope that your information can be shared on this
list as well.  

Annalynn

Annalynn Skipper Ph.D., R.D., FADA

a consultancy devoted to advancing nutrition practice
P.O. Box 45
Oak Park, IL 60303
Annalynn_Skipper at Comcast.net
Advanced Medical Nutrition Therapy Practice, 
a 2008 text, is available from Jones and Bartlett. 


-----Original Message-----
From: Heidi Kiehl [mailto:heidi at sysexperts.com] 
Sent: Wednesday, January 21, 2009 9:20 AM
To: Kathleen Mershon
Cc: cnm at lists.my180.net
Subject: Re: [Cnm] Order Writing & Licensure

For California RD's on this list, want to let you know that there is a 
CDA Professional Practice Task Force, of which I am a member, that has 
been meeting regularly to address these survey citations and scope of 
practice issues since late summer. We are closely working with CDPH 
through monthly meetings in Sacramento at their main office. We are 
making this a collaborative effort so that all sides will have the same 
understanding and the same vision and use the same terminology. There 
have been learning curves on professional practice issues and regulatory 
aspects for both groups. Sitting together at the table rather than 
butting heads/not discussing the problems and issues with the CDPH 
leaders has been valuable. The action plan/next steps are going to be 
communicated by our CDA VP of Public Policy (Lorri Holzberg) very soon 
-- she will be reporting to the CDA Executive Board this week what has 
transpired at our meetings and then share this with all CDA members.

Thank You.
Heidi Kiehl, MS, RD, CNSC
Professional Practice Task Force
California Dietetic Association
Clinical Nutrition Manager
ValleyCare Health System, Pleasanton CA


Kathleen Mershon wrote:
> Hi Annalynn
> I believe Lisa is referring to Enloe Medical Center in northern CA, 
> and the surveyor is Dagmar Bender. I immediately wrote to Mary Hagar 
> and Kara Caldwell-Freeman on this issue. CA does not have licensure 
> and for Dagmar to penalize CA RDs for not having licensure even though 
> they have worked through the privileging process with their medical 
> staff is just mind boggling. I have a few other thoughts on this but 
> will reserve them for sharing in a less widely distributed forum. :>)
> Kathleen Mershon, RD
>
>     ----- Original Message -----
>     *From:* Annalynn Skipper <mailto:Annalynn_Skipper at Comcast.net>
>     *To:* 'Lisa Trombley' <mailto:hargenlisa at hotmail.com> ;
>     cnm at lists.my180.net <mailto:cnm at lists.my180.net>
>     *Sent:* Tuesday, January 20, 2009 8:22 AM
>     *Subject:* Re: [Cnm] Order Writing & Licensure
>
>     Hi Lisa,
>
>     Are you sure that the person relaying the story to you didn't
>     confuse the term "licensed" with the term "credentialed"? Perhaps
>     a copy of the citation is available so that you can be sure. I can
>     see a surveyor writing in a citation "unlicensed personnel
>     ordering nutrition therapy", but in that case "unlicensed" would
>     likely refer to people other than physicians, nurse practitioners
>     and PA's. Even in California, order writing is under the control
>     of the medical staff in the institution in conjunction with state
>     law.
>
>     Regards,
>
>     Annalynn
>
>     Annalynn Skipper Ph.D., R.D., FADA
>
>     * *
>
>
>     a consultancy devoted to advancing nutrition practice
>
>     P.O. Box 45
>
>     Oak Park, IL 60303
>
>     Annalynn_Skipper at Comcast.net <mailto:Annalynn_Skipper at Comcast.net>
>
>     Advanced Medical Nutrition Therapy Practice,
>
>     a 2008 text, is available from Jones and Bartlett.
>
>
------------------------------------------------------------------------
>
>     *From:* Lisa Trombley [mailto:hargenlisa at hotmail.com]
>     *Sent:* Tuesday, January 20, 2009 9:33 AM
>     *To:* cnm at lists.my180.net
>     *Subject:* [Cnm] Order Writing & Licensure
>
>     For those in states without licensure (particularly interested in
>     CA), are the RDs permitted to write orders as long as they go
>     through proper procedure as outlined in state regulations? I heard
>     of a facility recently receiving a citation for order-writing
>     despite the fact that the RDs had established the practice based
>     on state regulations. The CMS/state surveyor cited the fact that
>     the RDs were not licensed so could not write orders. Is this new
>     for 2009? Thanks in advance.
>
>     //Lisa Trombley, MA, RD, CNSD //
>
>     Los Angeles, CA
>
>     hargenlisa at hotmail.com <mailto:hargenlisa at hotmail.com>
>
>
>
>
------------------------------------------------------------------------
>
>     Windows LiveT: Keep your life in sync. See how it works.
>
<http://windowslive.com/howitworks?ocid=TXT_TAGLM_WL_t1_allup_howitworks_012
009>
>
>
------------------------------------------------------------------------
>     _______________________________________________
>     Cnm mailing list
>     Cnm at lists.my180.net
>     http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
> ------------------------------------------------------------------------
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>   






From pavlinac at ohsu.edu  Wed Jan 21 09:31:54 2009
From: pavlinac at ohsu.edu (Jessie Pavlinac)
Date: Wed, 21 Jan 2009 09:31:54 -0800
Subject: [Cnm] FW:  GDM Video
Message-ID: <DEBAA538779D914FAF11D158611547A7738832@EX-BE04.ohsu.edu>

FYI,  from our RD who works with the GDM population.

Jessie

Jessie Pavlinac, MS, RD, CRS, LD

Manager, Clinical Nutrition

Food & Nutrition Services

Oregon Health & Science University

3181 SW Sam Jackson Park Road

Portland, OR  97239

503-494-3762

503-494-3769 (fax)

pavlinac at ohsu.edu

 

 

 

 

From: Christie Naze 
Sent: Wednesday, January 21, 2009 9:02 AM
To: Jessie Pavlinac
Subject: RE: [Cnm] GDM Video

 

I know of the Milner Fenwick one also as it is endorsed by the American Association of Diabetes Educators.  I looked through my catalogues and found one available through NCES but it?s from 2003 and costs $119.  It?s a 13-minute DVD available in English and Spanish.  When I did an internet search it seems like there were some options but they were also older videos.  

 

I looked up the Sweet Success program and there was a link to these free video streams done in collaboration with Kaiser and topics covering gestational diabetes- English and Spanish.  May be worth looking at as well.  

 

http://www.permanente.net/homepage/kaiser/pages/f51226.html

 

Christie Naze RD, CDE

Clinical Dietitian

Center For Women's Health, OHSU

503-494-6539

digmanc at ohsu.edu

 

 

 

 

From: Jessie Pavlinac 
Sent: Tuesday, January 20, 2009 8:33 AM
To: Christie Naze
Subject: FW: [Cnm] GDM Video

 

Christie, if you know of such a video could you let me know and I will post to the list serve.

 

Thanks.

Jessie

 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Dawn Berry, RD
Sent: Tuesday, January 20, 2009 8:25 AM
To: cnm at lists.my180.net
Subject: [Cnm] GDM Video

 

I am looking for a video to show newly diagnosed gestational diabetics, before nutritional counseling.

We currently have the old one put out by Milner Fenwick and ADA, we want to update ? and I have found the new version of this same video but before we purchase it I wanted to make sure there wasn?t something better out there.  Any suggestions would be appreciated.

 

Dawn

 

Dawn Berry, RD CDN

Director of Clinical Nutrition

Carthage Area Hospital

1001 West Street

Carthage, NY 13619

 

315-493-1005  ext 3222

cahns at carthageareahospital.com

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/0ab9f819/attachment.html 

From Sandra.Harrison at lrmc.com  Wed Jan 21 09:58:49 2009
From: Sandra.Harrison at lrmc.com (Sandra Harrison)
Date: Wed, 21 Jan 2009 12:58:49 -0500
Subject: [Cnm] Performance Improvement Measures
Message-ID: <49771C09.B0D7.000E.0@lrmc.com>

What are some of the performance improvement measures others are doing?
 
 
Sandra Harrison, MSA, RD
Clinical Nutrition Manager
Lakeland Regional Medical Center
Ext. 2631
Sandra.Harrison at lrmc.com 






Confidentiality Notice: This is a transmission from Lakeland Regional Medical Center.  This message and any attached documents may be confidential and contain information protected by state and federal medical privacy statutes.  They are intended only for the use of the addressee.  If you are not the intended recipient, any disclosure, copying, or distribution of this information is strictly prohibited.  If you received this transmission in error, please accept our apologies and notify the sender. This Message has been scanned for Viruses and objectionable content by McAfee Webshield."
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/4a966fc7/attachment.html 

From JUnderwood at jflusvi.org  Wed Jan 21 10:47:43 2009
From: JUnderwood at jflusvi.org (Underwood, Jennifer)
Date: Wed, 21 Jan 2009 14:47:43 -0400
Subject: [Cnm] liquacel presentation
Message-ID: <C0CCCCB3BAFC7541BB5D1B8AD1EF308B3396D4@JFL-MAIL.jflusvi.org>

My hospital is looking at switching to Liquacel.

I have been asked to put something together for the product evaluation
meeting this Friday.

I have basic information on the product, but last minute- am interested if
anyone has additional information I could utilized for a presentation.

 

Thank you in advance,

 

JUnderwood

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/210a9926/attachment.html 

From Pamela.Beanum at HCAhealthcare.com  Wed Jan 21 11:46:04 2009
From: Pamela.Beanum at HCAhealthcare.com (Beanum Pamela)
Date: Wed, 21 Jan 2009 13:46:04 -0600
Subject: [Cnm] Nutrition Risk Levels
Message-ID: <19833324B774F042B1FE1C34A79695BA12C82D8EE6@NADCWPMSGCMS07.hca.corpad.net>

What risk levels are RDs capturing in your facilities?  We are currently using "at risk" or "not at risk" as per a JC survey readiness a few years ago, are others doing the same or still sticking with "high", "moderate" & "low"?

Thanks so much!


Pamela Beanum, RD
Clinical Nutrition/Catering Manager
804-254-9823 (phone)
804-254-5538 (fax)
Retreat Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave
Richmond VA 23220
pamela.beanum at hcahealthcare.com<mailto:pamela.beanum at hcahealthcare.com>

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/27ad942c/attachment.html 

From mltphd at mindspring.com  Wed Jan 21 12:13:06 2009
From: mltphd at mindspring.com (Mary Litchford)
Date: Wed, 21 Jan 2009 15:13:06 -0500
Subject: [Cnm] liquacel presentation
Message-ID: <380-22009132120136328@mindspring.com>

Liquacel is a collagen based protein supplement. The IAA/DAA information is on the website and pasted below.  You will notice that the level for tryptophan is 0. Since tryptophan is an indispensable amino acid, the PDCAAS = 0. For more information about protein nutrition and evaluating protein supplement refer to: Protein Powders, Potions & Elixirs (2007); www.casesoftware.com. 
Amino Acids, g/100 
Alanine 8.27 
Arginine 15.51 
Aspartate 4.43 
Cysteine 0.01 
Glutamate 9.85 
Glycine 22.94 
Histidine 0.89 
Isoleucine 1.18 
Leucine 2.56 
Lysine 3.25 
Methionine 0.89 
Phenylalanine 1.58 
Proline 13.49 
Serine 3.35 
Threonine 1.87 
Tryptophan 0.00 
Tyrosine 0.59 
Valine 2.17


Mary Litchford PhD, RD, LDN
mltphd at mindspring.com
www.casesoftware.com
CASE Software & Books is your source for advanced-level reference books and CPE courses.


----- Original Message ----- 
From: Underwood, Jennifer 
To: cnm at lists.my180.net
Sent: 1/21/2009 1:47:48 PM 
Subject: [Cnm] liquacel presentation


My hospital is looking at switching to Liquacel.
I have been asked to put something together for the product evaluation meeting this Friday.
I have basic information on the product, but last minute- am interested if anyone has additional information I could utilized for a presentation.
 
Thank you in advance,
 
JUnderwood
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/7101823a/attachment.html 

From Christine.Schwartz at sfdph.org  Wed Jan 21 12:14:44 2009
From: Christine.Schwartz at sfdph.org (Christine Schwartz)
Date: Wed, 21 Jan 2009 12:14:44 -0800
Subject: [Cnm] RMR Predictive equations
Message-ID: <OFDDFD123A.09DB752F-ON88257545.006EEC98-88257545.006F1309@sfgov.org>


We just changed over from the HBE to Mifflin St. Jeor based on recent
evidence comparing various predictive equations,  and Penn State for ICU
patients on a vent.  One thing we haven't seen much evidence for is whether
or not to use an activity factor or injury/stress factor.

Any feedback, references?  What are you doing at your facility?
Thanks!

Christine Schwartz, RD ~ Chief Dietitian
San Francisco General Hospital & Trauma Center
Voice Mail: (415) 206-6286
Fax: (415) 206-6291
Pager: (415) 327-4139
Christine.Schwartz at sfdph.org



From aimeenut at yahoo.com  Wed Jan 21 12:18:40 2009
From: aimeenut at yahoo.com (aimee crant)
Date: Wed, 21 Jan 2009 12:18:40 -0800 (PST)
Subject: [Cnm] Nutrition Risk Levels
References: <19833324B774F042B1FE1C34A79695BA12C82D8EE6@NADCWPMSGCMS07.hca.corpad.net>
Message-ID: <280294.89738.qm@web52609.mail.re2.yahoo.com>

We still use high, mod and low.
?Aimee Crant-Oksa MS, RD
Clinical Nutrition Manager
Centrastate Medical Center
tel: 732-294-2767
email: acrantok at centrastate.com 




________________________________
From: Beanum Pamela <Pamela.Beanum at HCAhealthcare.com>
To: "cnm at lists.my180.net" <cnm at lists.my180.net>
Sent: Wednesday, January 21, 2009 2:46:04 PM
Subject: [Cnm] Nutrition Risk Levels


What risk levels are RDs capturing in your facilities?? We are currently using ?at risk? or ?not at risk? as per a JC survey readiness a few years ago, are others doing the same or still sticking with ?high?, ?moderate? & ?low??
?
Thanks so much!
?
Pamela Beanum, RD
Clinical Nutrition/Catering Manager 
804-254-9823 (phone)
804-254-5538 (fax)
Retreat Hospital : A Campus of Henrico Doctors' Hospital
2621 Grove Ave 
Richmond VA 23220 
pamela.beanum at hcahealthcare.com


      
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/d8646250/attachment.html 

From Leslie.Hornick at dmh.mo.gov  Wed Jan 21 12:56:59 2009
From: Leslie.Hornick at dmh.mo.gov (Hornick, Leslie G.)
Date: Wed, 21 Jan 2009 14:56:59 -0600
Subject: [Cnm] Nutrition Risk Levels
In-Reply-To: <280294.89738.qm@web52609.mail.re2.yahoo.com>
References: <19833324B774F042B1FE1C34A79695BA12C82D8EE6@NADCWPMSGCMS07.hca.corpad.net>
	<280294.89738.qm@web52609.mail.re2.yahoo.com>
Message-ID: <69DD80845D7F524BB1C8C59479ED0625013A8510@exchsvfulton01.mx.state.mo.us>

We have a priority 1 high risk and a priority 2 low risk.

 

 

Leslie Hornick, RD, LD

Chief Clinical Dietitian

FSH/MMMHC

 

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments
may contain confidential and privileged information for the use of the
designated recipients named above. The designated recipients are
prohibited from redisclosing this information to any other party without
authorization and are required to destroy the information after its
stated need has been fulfilled. If you are not the intended recipient,
you are hereby notified that you have received this communication in
error and that any review, disclosure, dissemination, distribution or
copying of it or its contents is prohibited by federal or state law. If
you have received this communication in error, please notify me
immediately by telephone at 573-592-2059, and destroy all copies of this
communication and any attachments.

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of aimee crant
Sent: Wednesday, January 21, 2009 2:19 PM
To: Beanum Pamela; cnm at lists.my180.net
Subject: Re: [Cnm] Nutrition Risk Levels

 

We still use high, mod and low.
 

Aimee Crant-Oksa MS, RD
Clinical Nutrition Manager
Centrastate Medical Center
tel: 732-294-2767
email: acrantok at centrastate.com 

 

 

________________________________

From: Beanum Pamela <Pamela.Beanum at HCAhealthcare.com>
To: "cnm at lists.my180.net" <cnm at lists.my180.net>
Sent: Wednesday, January 21, 2009 2:46:04 PM
Subject: [Cnm] Nutrition Risk Levels

What risk levels are RDs capturing in your facilities?  We are currently
using "at risk" or "not at risk" as per a JC survey readiness a few
years ago, are others doing the same or still sticking with "high",
"moderate" & "low"?

 

Thanks so much!

 

Pamela Beanum, RD 
Clinical Nutrition/Catering Manager 
804-254-9823 (phone)

804-254-5538 (fax)
Retreat Hospital : A Campus of Henrico Doctors' Hospital
2621 Grove Ave 
Richmond VA 23220 
pamela.beanum at hcahealthcare.com

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/78429d90/attachment.html 

From cahns at carthageareahospital.com  Wed Jan 21 12:57:01 2009
From: cahns at carthageareahospital.com (Dawn Berry, RD)
Date: Wed, 21 Jan 2009 15:57:01 -0500
Subject: [Cnm] RMR Predictive equations
In-Reply-To: <OFDDFD123A.09DB752F-ON88257545.006EEC98-88257545.006F1309@sfgov.org>
References: <OFDDFD123A.09DB752F-ON88257545.006EEC98-88257545.006F1309@sfgov.org>
Message-ID: <D0E68ABD20194DF288F65662B50092C5@CAHNS1>

Please post to list

Dawn Berry, RD CDN
Director of Clinical Nutrition
Carthage Area Hospital
1001 West Street
Carthage, NY 13619
 
315-493-1005  ext 3222
cahns at carthageareahospital.com
 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Christine Schwartz
Sent: Wednesday, January 21, 2009 3:15 PM
To: cnm at lists.my180.net
Subject: [Cnm] RMR Predictive equations


We just changed over from the HBE to Mifflin St. Jeor based on recent
evidence comparing various predictive equations,  and Penn State for ICU
patients on a vent.  One thing we haven't seen much evidence for is whether
or not to use an activity factor or injury/stress factor.

Any feedback, references?  What are you doing at your facility?
Thanks!

Christine Schwartz, RD ~ Chief Dietitian
San Francisco General Hospital & Trauma Center
Voice Mail: (415) 206-6286
Fax: (415) 206-6291
Pager: (415) 327-4139
Christine.Schwartz at sfdph.org


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net




From CKeinath at chs-mi.com  Wed Jan 21 13:10:00 2009
From: CKeinath at chs-mi.com (CKeinath at chs-mi.com)
Date: 21-Jan-2009 16:10:00 EST
Subject: [Cnm] clinical staff in separate cost center


I would like to hear from you on under what cost center you have the
clnical staff under?
Are they under a Nutrition services as a whole?
Are they clinical staff is along with production in their own buildings if
separate building?
Are in their separate clinical cost center?
Are they under patient services?

Carol

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning to
Dance in The Rain".

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   


From Linda.Woods at healthall.com  Wed Jan 21 13:22:44 2009
From: Linda.Woods at healthall.com (Woods, Linda)
Date: Wed, 21 Jan 2009 16:22:44 -0500
Subject: [Cnm] clinical staff in separate cost center
In-Reply-To: <200901212115.n0LLF2PC051852@FW2.healthall.com>
References: <200901212115.n0LLF2PC051852@FW2.healthall.com>
Message-ID: <2B1106A6A593B147A65BD5A8939D3E11171574196E@MAIL-C.healthall.com>

The dietitians and diet techs are under Food & Nutrition Services.  Their offices are in the patient care areas.  We have 3 separate cost centers in our department and the dietitians, techs and managers are in a cost center separate from the food service workers, cooks, etc.

Linda Woods, RD, LD
Clinical Nutrition Coordinator
The University Hospital
234 Goodman Street
Cincinnati, OH  45219
linda.woods at healthall.com
Office:  513-584-4534
Fax:  513-584-1027



-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of CKeinath at chs-mi.com
Sent: Wednesday, January 21, 2009 4:10 PM
To: cnm at lists.my180.net
Subject: [Cnm] clinical staff in separate cost center


I would like to hear from you on under what cost center you have the
clnical staff under?
Are they under a Nutrition services as a whole?
Are they clinical staff is along with production in their own buildings if
separate building?
Are in their separate clinical cost center?
Are they under patient services?

Carol

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning to
Dance in The Rain".

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information.  Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.


From Hollie_Colle at ssmhc.com  Wed Jan 21 13:38:18 2009
From: Hollie_Colle at ssmhc.com (Hollie_Colle at ssmhc.com)
Date: Wed, 21 Jan 2009 15:38:18 -0600
Subject: [Cnm] clinical staff in separate cost center
In-Reply-To: <OF3A096C11.CBB42C26-ON86257545.00747280@LocalDomain>
Message-ID: <OFB3F9F19E.0C116CD7-ON86257545.0076B90E-86257545.0076DD27@SSMHC>

In our facilities, Clinical Nutrition is a separate cost center within the 
Nutrition Services Department.  Diabetes Self Management is also it's own 
cost center under nutrition services.  We are in the same building, near 
the kitchen but in our own office.

Hollie Colle, MS, RD, LDN
Clinical Nutrition Manager
St. Mary's Good Samaritan, Inc. 
Mount Vernon IL 62864 
(618) 241-2356 
Centralia IL 62801
(618) 436-8897



CKeinath at chs-mi.com 
Sent by: cnm-bounces at lists.my180.net
01/21/2009 03:10 PM

To
<cnm at lists.my180.net>
cc

Subject
[Cnm] clinical staff in separate cost center







I would like to hear from you on under what cost center you have the
clnical staff under?
Are they under a Nutrition services as a whole?
Are they clinical staff is along with production in their own buildings if
separate building?
Are in their separate clinical cost center?
Are they under patient services?

Carol

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning to
Dance in The Rain".

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated. 

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/ee9adf57/attachment.html 

From RachelFlores at sach.org  Wed Jan 21 13:46:40 2009
From: RachelFlores at sach.org (Flores, Rachel)
Date: Wed, 21 Jan 2009 13:46:40 -0800
Subject: [Cnm] clinical staff in separate cost center
Message-ID: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D607@S1EXH002>

We have 5 separate costs centers:  Catering, Caf?, Production (includes
cooks and chefs for all areas), Patient Care (includes tray line and tray
servers), and Nutritional Care (RD, DTR, diet office staff).  I think this
is actually a huge headache for my director, but anytime we try to combine
something we run into a lot of resistance. 

Rachel Flores, RD, CNSC
Clinical Nutrition Manager
San Antonio Community Hospital
(909) 985-2811 x24430
-----Original Message-----
From: CKeinath at chs-mi.com [mailto:CKeinath at chs-mi.com] 
Sent: Wednesday, January 21, 2009 1:10 PM
To: cnm at lists.my180.net
Subject: [Cnm] clinical staff in separate cost center


I would like to hear from you on under what cost center you have the
clnical staff under?
Are they under a Nutrition services as a whole?
Are they clinical staff is along with production in their own buildings if
separate building?
Are in their separate clinical cost center?
Are they under patient services?

Carol

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning to
Dance in The Rain".

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From keiden at lumc.edu  Wed Jan 21 14:03:36 2009
From: keiden at lumc.edu (Kelly Eiden)
Date: Wed, 21 Jan 2009 16:03:36 -0600
Subject: [Cnm] clinical staff in separate cost center
In-Reply-To: <OFB3F9F19E.0C116CD7-ON86257545.0076B90E-86257545.0076DD27@SSMHC>
References: <OF3A096C11.CBB42C26-ON86257545.00747280@LocalDomain>
	<OFB3F9F19E.0C116CD7-ON86257545.0076B90E-86257545.0076DD27@SSMHC>
Message-ID: <49774795.2CB5.0017.0@lumc.edu>

We are our own cost center/department.  Food and Nutrition is separate.  All dietitians (inpatient, outpatient and dialysis) are under my cost center.  We do however budget transfer hours for dietitians services outside the hospital (includes cancer center, dialysis, outpatient, diabetes center, clinics etc.)



Kelly Eiden, MS, RD, LDN
Director, Clinical Nutrition Services
Loyola University Medical Center
Phone: 708-216-0434
Email: keiden at lumc.edu

>>> <Hollie_Colle at ssmhc.com> 1/21/2009 3:38 PM >>>
In our facilities, Clinical Nutrition is a separate cost center within the 
Nutrition Services Department.  Diabetes Self Management is also it's own 
cost center under nutrition services.  We are in the same building, near 
the kitchen but in our own office.

Hollie Colle, MS, RD, LDN
Clinical Nutrition Manager
St. Mary's Good Samaritan, Inc. 
Mount Vernon IL 62864 
(618) 241-2356 
Centralia IL 62801
(618) 436-8897



CKeinath at chs-mi.com 
Sent by: cnm-bounces at lists.my180.net 
01/21/2009 03:10 PM

To
<cnm at lists.my180.net>
cc

Subject
[Cnm] clinical staff in separate cost center







I would like to hear from you on under what cost center you have the
clnical staff under?
Are they under a Nutrition services as a whole?
Are they clinical staff is along with production in their own buildings if
separate building?
Are in their separate clinical cost center?
Are they under patient services?

Carol

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/ 

"Life isn't about waiting for The Storm to Pass -- it's about Learning to
Dance in The Rain".

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated. 

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net 




From smorris at goshenhealth.com  Wed Jan 21 15:02:34 2009
From: smorris at goshenhealth.com (Sandra  Morris)
Date: Wed, 21 Jan 2009 18:02:34 -0500
Subject: [Cnm] clinical staff in separate cost center
Message-ID: <s9776350.046@ggh-email1.ggh.ghs>

We are under our own cost center/our own dept.  Our office is in the
main building of the hospital.

Sandi Morris, RD/CD
Clinical Nutrition Manager
Goshen General Hospital
200 High Park Ave.
Goshen, IN  46526
Phone:  574/535-2679

CONFIDENTIALITY NOTICE:  This transmission and the documents
accompanying this transmission may contain confidential information. 
The information is intended only for the use of the individual(s) or
entity named above.  If you are not the intended recipient, you are
notified that any disclosure, copying, distribution or the taking of any
action in reliance on the contents of this information is not
permissible.  If you have received this message in error, please
immediately reply and then destroy it.  Thank you.

>>> <CKeinath at chs-mi.com> 1/21/2009 4:10 PM >>>

I would like to hear from you on under what cost center you have the
clnical staff under?
Are they under a Nutrition services as a whole?
Are they clinical staff is along with production in their own buildings
if
separate building?
Are in their separate clinical cost center?
Are they under patient services?

Carol

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/ 

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to
Dance in The Rain".

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   




From WellsK at armc.sbcounty.gov  Wed Jan 21 15:18:42 2009
From: WellsK at armc.sbcounty.gov (Wells, Khongmany  ARMC-Nutrition Services)
Date: Wed, 21 Jan 2009 15:18:42 -0800
Subject: [Cnm] Hi Risk Patient and Weight Evaluation
Message-ID: <4411CB5C30A2674CB4708C0CA3CBB9668655E7@sbc-exmsg5.sbcounty.gov>

I am doing some chart audits and am looking to see whether patients are
being weighed etc (b/c staff report not getting admit and f/u weights).
Now that  I am reviewing the charts, I  am finding that many of our
dietitians are not even addressing weights in their follow-up visits. Is
this a common practice at other facilities?  Not sure if it is b/c they
have given up on using weights b/c it is not available etc.  
Wanted to see what you require in your assessment and f/u notes.  How do
you objectively evaluate a patient's nutritional status. What parameters
are being looked at?  For a patient who has a major wound, how would
evaluate whether your intervention is having an impact?  
 
 Thanks for your feedback. 
Khongmany Wells, RD, MPH, CNSD
Clinical Nutrition Manager
Arrowhead Regional Medical Center
(909) 580-2466
 
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/9bbb5efa/attachment.html 

From Annalynn_Skipper at Comcast.net  Wed Jan 21 16:37:06 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Wed, 21 Jan 2009 18:37:06 -0600
Subject: [Cnm] RMR Predictive equations
In-Reply-To: <OFDDFD123A.09DB752F-ON88257545.006EEC98-88257545.006F1309@sfgov.org>
References: <OFDDFD123A.09DB752F-ON88257545.006EEC98-88257545.006F1309@sfgov.org>
Message-ID: <B11BE74527E3481F8C432A214A1F755A@ANNALYNN>

I keep having to explain this for NCM users, so let's see if I can do it
again.  The Harris-Benedict Equation was derived from a population of young,
healthy men and later validated in women and older adults.  It was
"adjusted" to meet the "hypermetabolism" of illness based on some research
by Calvin Long and John Kinney and a whole lot of hype by others.  Since it
was obtained at rest, activity factors were also needed.  In today's
hospital, activity isn't much of an issue, because once the patient can move
about they're on the way home.

The Mifflin-St. Jeor and Penn State Equations are both based on the
populations for which they are recommended in the Evidence Analysis Library.
(e.g. Mifflin St. Jeor for normal and overweight adults; Penn State for
critically ill/ICU patients) So, there's no need to apply injury factors to
"adjust" these equations for illness.  Again, in the hospital, activity
isn't much of an issue, but for the outpatient population, the RDs might
want to increase the Mifflin-St. Jeor results based on the patient's
activity history and the data in the DRI tables.

There is an article in JADA that explains all this.  Search under David
Frankenfield's name within the last five years or check out the EAL which is
a wonderful resource.    

I'm apologizing in advance that I don't have time to search the literature
for the reference if people can't locate it themselves.  Perhaps another
list-serve member can volunteer to help with that.

Regards,   

Annalynn

Annalynn Skipper Ph.D., R.D., FADA

a consultancy devoted to advancing nutrition practice
P.O. Box 45
Oak Park, IL 60303
Annalynn_Skipper at Comcast.net
Advanced Medical Nutrition Therapy Practice, 
a 2008 text, is available from Jones and Bartlett. 

-----Original Message-----
From: Christine Schwartz [mailto:Christine.Schwartz at sfdph.org] 
Sent: Wednesday, January 21, 2009 2:15 PM
To: cnm at lists.my180.net
Subject: [Cnm] RMR Predictive equations


We just changed over from the HBE to Mifflin St. Jeor based on recent
evidence comparing various predictive equations,  and Penn State for ICU
patients on a vent.  One thing we haven't seen much evidence for is whether
or not to use an activity factor or injury/stress factor.

Any feedback, references?  What are you doing at your facility?
Thanks!

Christine Schwartz, RD ~ Chief Dietitian
San Francisco General Hospital & Trauma Center
Voice Mail: (415) 206-6286
Fax: (415) 206-6291
Pager: (415) 327-4139
Christine.Schwartz at sfdph.org






From jlworden at att.net  Wed Jan 21 16:42:05 2009
From: jlworden at att.net (Jo Lynn Worden)
Date: Wed, 21 Jan 2009 18:42:05 -0600
Subject: [Cnm] RMR Predictive equations
In-Reply-To: <B11BE74527E3481F8C432A214A1F755A@ANNALYNN>
References: <OFDDFD123A.09DB752F-ON88257545.006EEC98-88257545.006F1309@sfgov.org>
	<B11BE74527E3481F8C432A214A1F755A@ANNALYNN>
Message-ID: <006a01c97c2a$4101fdd0$c305f970$@net>

I understand the activity factor -- what about stress factors?  There used
to be a listing of things that referred to major surgery, sepsis, whether
patient was febrile, wounds, etc. I think I have it in a small reference
book that I purchased through the DPG Dietitians in Long Term Care when I
was doing nursing home work. 
Does anyone know what I'm talking about or use that information.......? I
don't, but I still look at it from time to time to see if the estimated
needs actually 'sound like they make sense."

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Annalynn Skipper
Sent: Wednesday, January 21, 2009 6:37 PM
To: 'Christine Schwartz'; cnm at lists.my180.net
Subject: Re: [Cnm] RMR Predictive equations

I keep having to explain this for NCM users, so let's see if I can do it
again.  The Harris-Benedict Equation was derived from a population of young,
healthy men and later validated in women and older adults.  It was
"adjusted" to meet the "hypermetabolism" of illness based on some research
by Calvin Long and John Kinney and a whole lot of hype by others.  Since it
was obtained at rest, activity factors were also needed.  In today's
hospital, activity isn't much of an issue, because once the patient can move
about they're on the way home.

The Mifflin-St. Jeor and Penn State Equations are both based on the
populations for which they are recommended in the Evidence Analysis Library.
(e.g. Mifflin St. Jeor for normal and overweight adults; Penn State for
critically ill/ICU patients) So, there's no need to apply injury factors to
"adjust" these equations for illness.  Again, in the hospital, activity
isn't much of an issue, but for the outpatient population, the RDs might
want to increase the Mifflin-St. Jeor results based on the patient's
activity history and the data in the DRI tables.

There is an article in JADA that explains all this.  Search under David
Frankenfield's name within the last five years or check out the EAL which is
a wonderful resource.    

I'm apologizing in advance that I don't have time to search the literature
for the reference if people can't locate it themselves.  Perhaps another
list-serve member can volunteer to help with that.

Regards,   

Annalynn

Annalynn Skipper Ph.D., R.D., FADA

a consultancy devoted to advancing nutrition practice
P.O. Box 45
Oak Park, IL 60303
Annalynn_Skipper at Comcast.net
Advanced Medical Nutrition Therapy Practice, 
a 2008 text, is available from Jones and Bartlett. 

-----Original Message-----
From: Christine Schwartz [mailto:Christine.Schwartz at sfdph.org] 
Sent: Wednesday, January 21, 2009 2:15 PM
To: cnm at lists.my180.net
Subject: [Cnm] RMR Predictive equations


We just changed over from the HBE to Mifflin St. Jeor based on recent
evidence comparing various predictive equations,  and Penn State for ICU
patients on a vent.  One thing we haven't seen much evidence for is whether
or not to use an activity factor or injury/stress factor.

Any feedback, references?  What are you doing at your facility?
Thanks!

Christine Schwartz, RD ~ Chief Dietitian
San Francisco General Hospital & Trauma Center
Voice Mail: (415) 206-6286
Fax: (415) 206-6291
Pager: (415) 327-4139
Christine.Schwartz at sfdph.org





_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



From Annalynn_Skipper at Comcast.net  Wed Jan 21 17:26:50 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Wed, 21 Jan 2009 19:26:50 -0600
Subject: [Cnm] RMR Predictive equations
In-Reply-To: <006a01c97c2a$4101fdd0$c305f970$@net>
References: <OFDDFD123A.09DB752F-ON88257545.006EEC98-88257545.006F1309@sfgov.org>
	<B11BE74527E3481F8C432A214A1F755A@ANNALYNN>
	<006a01c97c2a$4101fdd0$c305f970$@net>
Message-ID: <61A623799FDA45ECAB073B0CC6E48AA4@ANNALYNN>

Yes, those were the factors that Dr. Long and Dr. Kinney did.  (Well except
for wounds anyway.  There is new wound data that I would love to summarize
and publish so that RDs will have a resource.)  Back to the "stress" or
injury factors.  Except for the ones referenced above, and published in the
70's, most of them are just made up numbers.  If you use the Penn State
Equation, you don't need them  If you're still using Harris-Benedict, I
think that a 20% increase is about right for hospitalized patients according
to what Carol Ireton-Jones and David Frankenfield have published.  Don't go
on my say so however.  As they say in Philadelphia, read their "stuff".    

Cheers yall! 

Annalynn

Annalynn Skipper Ph.D., R.D., FADA

a consultancy devoted to advancing nutrition practice
P.O. Box 45
Oak Park, IL 60303
Annalynn_Skipper at Comcast.net
Advanced Medical Nutrition Therapy Practice, 
a 2008 text, is available from Jones and Bartlett. 


-----Original Message-----
From: Jo Lynn Worden [mailto:jlworden at att.net] 
Sent: Wednesday, January 21, 2009 6:42 PM
To: Annalynn_Skipper at Comcast.net; 'Christine Schwartz'; cnm at lists.my180.net
Subject: RE: [Cnm] RMR Predictive equations

I understand the activity factor -- what about stress factors?  There used
to be a listing of things that referred to major surgery, sepsis, whether
patient was febrile, wounds, etc. I think I have it in a small reference
book that I purchased through the DPG Dietitians in Long Term Care when I
was doing nursing home work. 
Does anyone know what I'm talking about or use that information.......? I
don't, but I still look at it from time to time to see if the estimated
needs actually 'sound like they make sense."

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Annalynn Skipper
Sent: Wednesday, January 21, 2009 6:37 PM
To: 'Christine Schwartz'; cnm at lists.my180.net
Subject: Re: [Cnm] RMR Predictive equations

I keep having to explain this for NCM users, so let's see if I can do it
again.  The Harris-Benedict Equation was derived from a population of young,
healthy men and later validated in women and older adults.  It was
"adjusted" to meet the "hypermetabolism" of illness based on some research
by Calvin Long and John Kinney and a whole lot of hype by others.  Since it
was obtained at rest, activity factors were also needed.  In today's
hospital, activity isn't much of an issue, because once the patient can move
about they're on the way home.

The Mifflin-St. Jeor and Penn State Equations are both based on the
populations for which they are recommended in the Evidence Analysis Library.
(e.g. Mifflin St. Jeor for normal and overweight adults; Penn State for
critically ill/ICU patients) So, there's no need to apply injury factors to
"adjust" these equations for illness.  Again, in the hospital, activity
isn't much of an issue, but for the outpatient population, the RDs might
want to increase the Mifflin-St. Jeor results based on the patient's
activity history and the data in the DRI tables.

There is an article in JADA that explains all this.  Search under David
Frankenfield's name within the last five years or check out the EAL which is
a wonderful resource.    

I'm apologizing in advance that I don't have time to search the literature
for the reference if people can't locate it themselves.  Perhaps another
list-serve member can volunteer to help with that.

Regards,   

Annalynn

Annalynn Skipper Ph.D., R.D., FADA

a consultancy devoted to advancing nutrition practice
P.O. Box 45
Oak Park, IL 60303
Annalynn_Skipper at Comcast.net
Advanced Medical Nutrition Therapy Practice, 
a 2008 text, is available from Jones and Bartlett. 

-----Original Message-----
From: Christine Schwartz [mailto:Christine.Schwartz at sfdph.org] 
Sent: Wednesday, January 21, 2009 2:15 PM
To: cnm at lists.my180.net
Subject: [Cnm] RMR Predictive equations


We just changed over from the HBE to Mifflin St. Jeor based on recent
evidence comparing various predictive equations,  and Penn State for ICU
patients on a vent.  One thing we haven't seen much evidence for is whether
or not to use an activity factor or injury/stress factor.

Any feedback, references?  What are you doing at your facility?
Thanks!

Christine Schwartz, RD ~ Chief Dietitian
San Francisco General Hospital & Trauma Center
Voice Mail: (415) 206-6286
Fax: (415) 206-6291
Pager: (415) 327-4139
Christine.Schwartz at sfdph.org





_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net




From jwelch02 at unityhealth.org  Wed Jan 21 17:57:15 2009
From: jwelch02 at unityhealth.org (Janel Welch)
Date: Wed, 21 Jan 2009 20:57:15 -0500
Subject: [Cnm] Nutrition Risk Levels
In-Reply-To: <19833324B774F042B1FE1C34A79695BA12C82D8EE6@NADCWPMSGCMS07.hca.corpad.net>
References: <19833324B774F042B1FE1C34A79695BA12C82D8EE6@NADCWPMSGCMS07.hca.corpad.net>
Message-ID: <49778C2B020000AD00020B3E@smtp.unityhealth.org>

We are using the low, mod, high.  I am interested in changing to the risk and not at risk. What is the criteria for the not at risk?  at risk?  Where would I find the guidelines?

Thanks for your  help
Janel 



>>> Beanum Pamela <Pamela.Beanum at HCAhealthcare.com> 1/21/2009 2:46 PM >>>
What risk levels are RDs capturing in your facilities?  We are currently using "at risk" or "not at risk" as per a JC survey readiness a few years ago, are others doing the same or still sticking with "high", "moderate" & "low"?

Thanks so much!


Pamela Beanum, RD
Clinical Nutrition/Catering Manager
804-254-9823 (phone)
804-254-5538 (fax)
Retreat Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave
Richmond VA 23220
pamela.beanum at hcahealthcare.com<mailto:pamela.beanum at hcahealthcare.com>



PLEASE NOTE: Property of Unity Health System -- www.unityhealth.org  
The information contained in this message may be privileged and confidential, protected from disclosure, and/or intended only for the user of the individual or entity named above. If the recipient of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication in error, please notify the sender immediately by replying to this message and deleting it from your computer. This email message is considered Virus Free by our virus scanning software. All email is considered property of Unity Health System. 
Address policy questions to address below. 
gwadministrator at unityhealth.org





From kmershon at bak.rr.com  Wed Jan 21 20:28:33 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Wed, 21 Jan 2009 20:28:33 -0800
Subject: [Cnm] Order Writing & Licensure
In-Reply-To: <35BD2C1FF3CD417CBE211AE165458F34@ANNALYNN>
References: <COL107-W695E3F06B9A065EB35A901CFD00@phx.gbl>	<7011FE812E0541E699EC09763AED12C2@ANNALYNN><E289D5B5B1ED40BBA3F40BE66CE024F0@KathyPC>
	<49773D38.40203@sysexperts.com>
	<35BD2C1FF3CD417CBE211AE165458F34@ANNALYNN>
Message-ID: <8040AF8784C74D1E8130F384789E3E68@KathyPC>

Thank you Heidi for your representation and diligence in trying to find 
common ground for providing expedient quality patient care, and advocating 
for the expertise the registered dietitian is able to provide in the area of 
nutrition. We very much look forward to receiving information that will 
finally put this issue to rest. Funny how even legal opinions on this topic 
do not indicate "licensure" in CA is required given we have a scope of 
practice on our law books.

Kathleen Mershon, RD
----- Original Message ----- 
From: "Annalynn Skipper" <Annalynn_Skipper at Comcast.net>
To: "'Heidi Kiehl'" <heidi at sysexperts.com>; "'Kathleen Mershon'" 
<kmershon at bak.rr.com>
Cc: <cnm at lists.my180.net>
Sent: Wednesday, January 21, 2009 9:35 AM
Subject: RE: [Cnm] Order Writing & Licensure


> Heidi,
>
> Kudos on this good work!  I hope that your information can be shared on 
> this
> list as well.
>
> Annalynn
>
> Annalynn Skipper Ph.D., R.D., FADA
>
> a consultancy devoted to advancing nutrition practice
> P.O. Box 45
> Oak Park, IL 60303
> Annalynn_Skipper at Comcast.net
> Advanced Medical Nutrition Therapy Practice,
> a 2008 text, is available from Jones and Bartlett.
>
>
> -----Original Message-----
> From: Heidi Kiehl [mailto:heidi at sysexperts.com]
> Sent: Wednesday, January 21, 2009 9:20 AM
> To: Kathleen Mershon
> Cc: cnm at lists.my180.net
> Subject: Re: [Cnm] Order Writing & Licensure
>
> For California RD's on this list, want to let you know that there is a
> CDA Professional Practice Task Force, of which I am a member, that has
> been meeting regularly to address these survey citations and scope of
> practice issues since late summer. We are closely working with CDPH
> through monthly meetings in Sacramento at their main office. We are
> making this a collaborative effort so that all sides will have the same
> understanding and the same vision and use the same terminology. There
> have been learning curves on professional practice issues and regulatory
> aspects for both groups. Sitting together at the table rather than
> butting heads/not discussing the problems and issues with the CDPH
> leaders has been valuable. The action plan/next steps are going to be
> communicated by our CDA VP of Public Policy (Lorri Holzberg) very soon
> -- she will be reporting to the CDA Executive Board this week what has
> transpired at our meetings and then share this with all CDA members.
>
> Thank You.
> Heidi Kiehl, MS, RD, CNSC
> Professional Practice Task Force
> California Dietetic Association
> Clinical Nutrition Manager
> ValleyCare Health System, Pleasanton CA
>
>
> Kathleen Mershon wrote:
>> Hi Annalynn
>> I believe Lisa is referring to Enloe Medical Center in northern CA,
>> and the surveyor is Dagmar Bender. I immediately wrote to Mary Hagar
>> and Kara Caldwell-Freeman on this issue. CA does not have licensure
>> and for Dagmar to penalize CA RDs for not having licensure even though
>> they have worked through the privileging process with their medical
>> staff is just mind boggling. I have a few other thoughts on this but
>> will reserve them for sharing in a less widely distributed forum. :>)
>> Kathleen Mershon, RD
>>
>>     ----- Original Message -----
>>     *From:* Annalynn Skipper <mailto:Annalynn_Skipper at Comcast.net>
>>     *To:* 'Lisa Trombley' <mailto:hargenlisa at hotmail.com> ;
>>     cnm at lists.my180.net <mailto:cnm at lists.my180.net>
>>     *Sent:* Tuesday, January 20, 2009 8:22 AM
>>     *Subject:* Re: [Cnm] Order Writing & Licensure
>>
>>     Hi Lisa,
>>
>>     Are you sure that the person relaying the story to you didn't
>>     confuse the term "licensed" with the term "credentialed"? Perhaps
>>     a copy of the citation is available so that you can be sure. I can
>>     see a surveyor writing in a citation "unlicensed personnel
>>     ordering nutrition therapy", but in that case "unlicensed" would
>>     likely refer to people other than physicians, nurse practitioners
>>     and PA's. Even in California, order writing is under the control
>>     of the medical staff in the institution in conjunction with state
>>     law.
>>
>>     Regards,
>>
>>     Annalynn
>>
>>     Annalynn Skipper Ph.D., R.D., FADA
>>
>>     * *
>>
>>
>>     a consultancy devoted to advancing nutrition practice
>>
>>     P.O. Box 45
>>
>>     Oak Park, IL 60303
>>
>>     Annalynn_Skipper at Comcast.net <mailto:Annalynn_Skipper at Comcast.net>
>>
>>     Advanced Medical Nutrition Therapy Practice,
>>
>>     a 2008 text, is available from Jones and Bartlett.
>>
>>
> ------------------------------------------------------------------------
>>
>>     *From:* Lisa Trombley [mailto:hargenlisa at hotmail.com]
>>     *Sent:* Tuesday, January 20, 2009 9:33 AM
>>     *To:* cnm at lists.my180.net
>>     *Subject:* [Cnm] Order Writing & Licensure
>>
>>     For those in states without licensure (particularly interested in
>>     CA), are the RDs permitted to write orders as long as they go
>>     through proper procedure as outlined in state regulations? I heard
>>     of a facility recently receiving a citation for order-writing
>>     despite the fact that the RDs had established the practice based
>>     on state regulations. The CMS/state surveyor cited the fact that
>>     the RDs were not licensed so could not write orders. Is this new
>>     for 2009? Thanks in advance.
>>
>>     //Lisa Trombley, MA, RD, CNSD //
>>
>>     Los Angeles, CA
>>
>>     hargenlisa at hotmail.com <mailto:hargenlisa at hotmail.com>
>>
>>
>>
>>
> ------------------------------------------------------------------------
>>
>>     Windows LiveT: Keep your life in sync. See how it works.
>>
> <http://windowslive.com/howitworks?ocid=TXT_TAGLM_WL_t1_allup_howitworks_012
> 009>
>>
>>
> ------------------------------------------------------------------------
>>     _______________________________________________
>>     Cnm mailing list
>>     Cnm at lists.my180.net
>>     http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>>
>> ------------------------------------------------------------------------
>>
>> _______________________________________________
>> Cnm mailing list
>> Cnm at lists.my180.net
>> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>>
>
>
>
> 



From cketterman at wellspan.org  Thu Jan 22 04:29:57 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Thu, 22 Jan 2009 07:29:57 -0500
Subject: [Cnm] clinical staff in separate cost center
In-Reply-To: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0364552F@EXCH4.wellspan.org>
References: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0364552F@EXCH4.wellspan.org>
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AD16@EXCH4.wellspan.org>

We are under Food and Nutrition but we are a separate cost center.  Our
offices are separate from Food and Nutrition and located in clinical or
outpatient areas. 


Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Wednesday, January 21, 2009 4:10 PM
To: cnm at lists.my180.net
Subject: [Cnm] clinical staff in separate cost center


I would like to hear from you on under what cost center you have the
clnical staff under?
Are they under a Nutrition services as a whole?
Are they clinical staff is along with production in their own buildings
if separate building?
Are in their separate clinical cost center?
Are they under patient services?

Carol

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to Dance in The Rain".

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee or
agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this email is strictly prohibited. If you have received
this message in error, please immediately notify the sender and delete
this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________


From YDionne at westerlyhospital.org  Thu Jan 22 06:00:26 2009
From: YDionne at westerlyhospital.org (Yvette Dionne)
Date: Thu, 22 Jan 2009 09:00:26 -0500
Subject: [Cnm] Nutrition Risk Levels
In-Reply-To: <19833324B774F042B1FE1C34A79695BA12C82D8EE6@NADCWPMSGCMS07.hca.corpad.net>
References: <19833324B774F042B1FE1C34A79695BA12C82D8EE6@NADCWPMSGCMS07.hca.corpad.net>
Message-ID: <E8876826D209234E9756A1C959D0A28F02245949@whmail.westerlyhospital.local>

When screened on admission it is at or not at - With assessments it is
high, moderate, low. 

________________________________

From: Beanum Pamela [mailto:Pamela.Beanum at HCAhealthcare.com] 
Sent: Wednesday, January 21, 2009 2:46 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Risk Levels



What risk levels are RDs capturing in your facilities?  We are currently
using "at risk" or "not at risk" as per a JC survey readiness a few
years ago, are others doing the same or still sticking with "high",
"moderate" & "low"?

 

Thanks so much!

 

Pamela Beanum, RD 
Clinical Nutrition/Catering Manager 
804-254-9823 (phone)

804-254-5538 (fax)
Retreat Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave 
Richmond VA 23220 
pamela.beanum at hcahealthcare.com

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/c9f10ee7/attachment-0001.html 

From Heberle-Heather at aramark.com  Thu Jan 22 06:45:15 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Thu, 22 Jan 2009 08:45:15 -0600
Subject: [Cnm] Assessing protein needs with obese patients
In-Reply-To: <mailman.3274.1232547059.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.3274.1232547059.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <66D77567-EA85-4009-9868-E4C4C417DE3E@mimectl>

We currently use IBW for assessing overweight/obese patient protein needs whether they are renal patients or not.  If someone is above within normal limits on their weight we use their IBW.  If they are below or within normal limits, we use their current weight.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879
Heberle-Heather at aramark.com



From: cnm-request at lists.my180.net
Sent: Wed 1/21/09 8:10 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 91


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1. Food temperature safety (Ross, Janet)
   2. Re: Assessing protein needs with obese patients (Chaffin Meg)
   3. Re: Assessing protein needs with obese patients (Haft, Lyn)
   4. Re: Order Writing & Licensure (Kaskel, Phyllis)


----------------------------------------------------------------------

Message: 1
Date: Wed, 21 Jan 2009 08:06:34 -0500
From: "Ross, Janet" <Janet.Ross at healthall.com>
Subject: [Cnm] Food temperature safety
To: "cnm at lists.my180.net" <cnm at lists.my180.net>, EML Forum
	<cdhcf-forums at v2.listbox.com>
Message-ID:
	<41CA05D55BF105489D33F8E57D71A9051716986716 at MAIL-C.healthall.com>
Content-Type: text/plain; charset="us-ascii"

How hot is "safe" for hot cereal or hot coffee?  I have a resident who does not sense temperatures well, but insists that 130 degree grits are not hot enough.  If staff microwaves the cereal for her, how hot is maximum to prevent a burn?  I'd like to say to staff that they can "heat for 30 seconds, stir, and check temperature.  Should be no hotter than XXX degrees."

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.



________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/638a44c1/attachment-0001.html 

------------------------------

Message: 2
Date: Wed, 21 Jan 2009 07:47:18 -0600
From: Chaffin Meg <Margaret.Chaffin at hcahealthcare.com>
Subject: Re: [Cnm] Assessing protein needs with obese patients
To: "Ek, Lauri M." <Lauri.Ek at providence.org>, "cnm at lists.my180.net"
	<cnm at lists.my180.net>
Message-ID:
	<FE4E4942DC04FF4DA336172CB2CC522D12B1D3204D at NADCWPMSGCMS06.hca.corpad.net>
	
Content-Type: text/plain; charset="us-ascii"

Please post to list. I'm interested in this as well.

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Center
(229)434-2394
-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ek, Lauri M.
Sent: Tuesday, January 20, 2009 7:38 PM
To: cnm at lists.my180.net
Subject: [Cnm] Assessing protein needs with obese patients

My clinical team is curious what every one else is using to assess the
protein needs for obese patients since adjusted weights aren't evidence
based for assessing caloric needs.

Especially with renal patients we aren't comfortable using actual
weights for protein needs.

What is everyone else doing!???

Thanks,

Lauri M. Ek, RD, CDE, LD
Chief Clinical Dietitian 
Providence Alaska Medical Center 
3200 Providence Drive 
Anchorage, Alaska  99508 
Lauri.Ek at providence.org 
(907) 212-3046 
Fax:  (907) 212-4886 
Pager:  (907) 212-5800, #3046 



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



------------------------------

Message: 3
Date: Wed, 21 Jan 2009 08:51:29 -0500
From: "Haft, Lyn" <Lyn.Haft at rexhealth.com>
Subject: Re: [Cnm] Assessing protein needs with obese patients
To: <cnm at lists.my180.net>
Message-ID:
	<6C5C5FBEE636A043BC7466A8CAE0732F09685509 at exchmail1.rexhealth.com>
Content-Type: text/plain;	charset="us-ascii"

Especially for Bariatric patients 

Lyn Haft
Clinical Nutrition Manager
Rex Healthcare
4420 Lake Boone Trail
Raleigh, NC 27607 
919-784-3162



-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Chaffin Meg
Sent: Wednesday, January 21, 2009 8:47 AM
To: Ek, Lauri M.; cnm at lists.my180.net
Subject: Re: [Cnm] Assessing protein needs with obese patients


Please post to list. I'm interested in this as well.

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Center
(229)434-2394
-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Ek, Lauri M.
Sent: Tuesday, January 20, 2009 7:38 PM
To: cnm at lists.my180.net
Subject: [Cnm] Assessing protein needs with obese patients

My clinical team is curious what every one else is using to assess the
protein needs for obese patients since adjusted weights aren't evidence
based for assessing caloric needs.

Especially with renal patients we aren't comfortable using actual
weights for protein needs.

What is everyone else doing!???

Thanks,

Lauri M. Ek, RD, CDE, LD
Chief Clinical Dietitian 
Providence Alaska Medical Center 
3200 Providence Drive 
Anchorage, Alaska  99508 
Lauri.Ek at providence.org 
(907) 212-3046 
Fax:  (907) 212-4886 
Pager:  (907) 212-5800, #3046 



DISCLAIMER:
This message is intended for the sole use of the addressee, and may
contain information that is privileged, confidential and exempt from
disclosure under applicable law. If you are not the addressee you are
hereby notified that you may not use, copy, disclose, or distribute to
anyone the message or any information contained in the message. If you
have received this message in error, please immediately advise the
sender by reply email and delete this message.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


----- Confidentiality Notice -----
This e-mail and any attached documents contain confidential information belonging
to the sending entity, Rex Healthcare, and is intended only for the use of the 
individual(s) or entity(s) associated with the recipient addresses listed in the message 
header.  The authorized recipient of this information is prohibited from disclosing this 
information to any other party.  If you are not the intended recipient, you are hereby 
notified that any disclosure, copying, distribution or action taken in reliance on the 
contents of the email and/or attachments is strictly prohibited.  If you received this 
e-mail transmission in error, please notify the sender immediately to arrange for return 
or destruction of this information.

To report abuse or inappropriate use, please email abuse at rexhealth.com.(b)




------------------------------

Message: 4
Date: Wed, 21 Jan 2009 09:11:16 -0500
From: "Kaskel, Phyllis" <Phyllis.Kaskel at mountsinai.org>
Subject: Re: [Cnm] Order Writing & Licensure
To: "Pam Charney" <pcharney at mac.com>, "Kathleen Mershon"
	<kmershon at bak.rr.com>
Cc: Annalynn_Skipper at Comcast.net, cnm at lists.my180.net
Message-ID:
	<850F6C2F598EF84F8FA5BEF9CC0CC96D03F0AD8F at EXCEBW2K325.msnyuhealth.org>
Content-Type: text/plain; charset="us-ascii"

We have the same problem here in New York.  When you pull up the New
York State Education Office of the Profession web page it clearly states
"Licensee Names".  We are "Certified Dietitian/Nutritionist" and many
non-RDs have been grandfathered in.  

 

I have even had issues with our HR Department on the hiring of
Registered Dietitians because they are not "Licensed". 

 

I just wonder if they trust a "Certified Public Accountant" to do their
taxes!  And is it fine that a "Licensed" nail saloon technician is
better?

 

Phyllis Kaskel,  MA, RD, CDN

Director, Clinical Nutrition

Mount Sinai Hospital and

Faculty, Department of Community and Preventive Medicine

Mount Sinai School of Medicine

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Pam Charney
Sent: Wednesday, January 21, 2009 12:52 AM
To: Kathleen Mershon
Cc: Annalynn_Skipper at Comcast.net; cnm at lists.my180.net
Subject: Re: [Cnm] Order Writing & Licensure

 

I feel your pain. There is often a misunderstanding about how dietetics
is licensed or not licensed in various states. Because we have CDR and
the registration process, along with a mishmash of certification,
licensure and no licensure, it's pretty understandable that surveyors
would be confused. 

 

In my own state, (WA), we have certification. Last year I was told by a
local school nurse that I could not train volunteers to provide diabetes
care in schools because I am not "licensed" in WA. This is because the
WA state laws regarding care of diabetes in school specify a "licensed"
health care provider do the training. Nurses, physicians, and others are
licensed. Folks understand licensure. After explaining the situation and
being somewhat persistent, the objection was lifted. 

 

Now mind you, I'm not saying that this particular surveyor was simply a
bit confused, but I can certainly see that happening, considering the
vast number of rules and regulations these folks must ponder while they
evaluate a given facility!

 

Regards,

pam

 

Pam Charney PhD, RD

Clinical Coordinator

Graduate Coordinated Program in Dietetics

Lecturer, Department of Epidemiology

Nutrition Sciences Program

School of Public Health and Community Medicine

Box 353410, 306-C Raitt Hall

 

Affiliate Associate Professor

School of Pharmacy

 

MS Student

Clinical Informatics and Patient Centered Technology

School of Nursing

 

University of Washington

Seattle, WA

charnepa at u.washington.edu

"The person who says it can't be done should not 

interrupt the person doing it" - Ethel Kennedy

 

On Jan 20, 2009, at 8:49 PM, Kathleen Mershon wrote:





Hi Annalynn

I believe Lisa is referring to Enloe Medical Center in northern CA, and
the surveyor is Dagmar Bender. I immediately wrote to Mary Hagar and
Kara Caldwell-Freeman on this issue. CA does not have licensure and for
Dagmar to penalize CA RDs for not having licensure even though they have
worked through the privileging process with their medical staff is just
mind boggling. I have a few other thoughts on this but will reserve them
for sharing in a less widely distributed forum. :>)

Kathleen Mershon, RD

	----- Original Message -----

	From: Annalynn Skipper <mailto:Annalynn_Skipper at Comcast.net> 

	To: 'Lisa Trombley' <mailto:hargenlisa at hotmail.com>  ;
cnm at lists.my180.net

	Sent: Tuesday, January 20, 2009 8:22 AM

	Subject: Re: [Cnm] Order Writing & Licensure

	 

	Hi Lisa,

	 

	Are you sure that the person relaying the story to you didn't
confuse the term "licensed" with the term "credentialed"?  Perhaps a
copy of the citation is available so that you can be sure.  I can see a
surveyor writing in a citation "unlicensed personnel ordering nutrition
therapy", but in that case "unlicensed" would likely refer to people
other than physicians, nurse practitioners and PA's.  Even in
California, order writing is under the control of the medical staff in
the institution in conjunction with state law. 

	 

	Regards,        

	 

	Annalynn

	 

	Annalynn Skipper Ph.D., R.D., FADA

	<image001.gif> 

	
	

	a consultancy devoted to advancing nutrition practice

	P.O. Box 45

	Oak Park, IL 60303

	Annalynn_Skipper at Comcast.net
<mailto:Annalynn_Skipper at Comcast.net> 

	Advanced Medical Nutrition Therapy Practice,

	a 2008 text, is available from Jones and Bartlett.

	 

	
________________________________


	From: Lisa Trombley [mailto:hargenlisa at hotmail.com] 
	Sent: Tuesday, January 20, 2009 9:33 AM
	To: cnm at lists.my180.net
	Subject: [Cnm] Order Writing & Licensure

	 

	For those in states without licensure (particularly interested
in CA), are the RDs permitted to write orders as long as they go through
proper procedure as outlined in state regulations?  I heard of a
facility recently receiving a citation for order-writing despite the
fact that the RDs had established the practice based on state
regulations.  The CMS/state surveyor cited the fact that the RDs were
not licensed so could not write orders.  Is this new for 2009?  Thanks
in advance. 

	Lisa Trombley, MA, RD, CNSD

	Los Angeles, CA

	hargenlisa at hotmail.com

	 

	
	
	
	

	
________________________________


	Windows Live(tm): Keep your life in sync. See how it works.
<http://windowslive.com/howitworks?ocid=TXT_TAGLM_WL_t1_allup_howitworks
_012009> 

	 

	
________________________________


	 

	_______________________________________________
	Cnm mailing list
	Cnm at lists.my180.net
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090121/5abbb829/attachment.html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 91
***********************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/d1fbf14f/attachment.html 

From YDionne at westerlyhospital.org  Thu Jan 22 07:10:11 2009
From: YDionne at westerlyhospital.org (Yvette Dionne)
Date: Thu, 22 Jan 2009 10:10:11 -0500
Subject: [Cnm] ordering privileges for RDs
Message-ID: <E8876826D209234E9756A1C959D0A28F0224594D@whmail.westerlyhospital.local>

 

Hi,
Can anybody direct me to the actual CCMS policy?  I have tried searching
their website but am getting nowhere. 
Thank you, 
Yvette Dionne, RD, LDN
Ext. 3464
may you be well and happy
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/09892057/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: aleabanr.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090122/09892057/attachment-0001.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 4389 bytes
Desc: Leaves Bkgrd.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090122/09892057/attachment-0001.jpe 

From NEgelhofer at saintjosephri.com  Thu Jan 22 07:26:14 2009
From: NEgelhofer at saintjosephri.com (Egelhofer, Nancy)
Date: Thu, 22 Jan 2009 10:26:14 -0500
Subject: [Cnm] Hi Risk Patient and Weight Evaluation
In-Reply-To: <4411CB5C30A2674CB4708C0CA3CBB9668655E7@sbc-exmsg5.sbcounty.gov>
Message-ID: <EDA5D3F1218538449BB79A345387487EE90375@exchange-2.sjhs.local>

We cannot use weight if it not there.

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Wells, Khongmany ARMC-Nutrition Services
Sent: Wednesday, January 21, 2009 6:19 PM
To: CNM (E-mail)
Subject: [Cnm] Hi Risk Patient and Weight Evaluation


I am doing some chart audits and am looking to see whether patients are
being weighed etc (b/c staff report not getting admit and f/u weights).
Now that  I am reviewing the charts, I  am finding that many of our
dietitians are not even addressing weights in their follow-up visits. Is
this a common practice at other facilities?  Not sure if it is b/c they
have given up on using weights b/c it is not available etc.  
Wanted to see what you require in your assessment and f/u notes.  How do
you objectively evaluate a patient's nutritional status. What parameters
are being looked at?  For a patient who has a major wound, how would
evaluate whether your intervention is having an impact?  
 
 Thanks for your feedback. 
Khongmany Wells, RD, MPH, CNSD
Clinical Nutrition Manager
Arrowhead Regional Medical Center
(909) 580-2466
 
 


(THIS DOCUMENT IS INTENDED ONLY FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED.  IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL, AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW.)  If you are not the intended recipient any dissemination, distribution, copying or use of this document is strictly prohibited.  If you have received this communication in error, please notify me immediately at the email address above and delete all copies of this communication.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/74412dfc/attachment.html 

From Margaret.Chaffin at hcahealthcare.com  Thu Jan 22 07:45:30 2009
From: Margaret.Chaffin at hcahealthcare.com (Chaffin Meg)
Date: Thu, 22 Jan 2009 09:45:30 -0600
Subject: [Cnm] PI
Message-ID: <FE4E4942DC04FF4DA336172CB2CC522D12B1DBAFC3@NADCWPMSGCMS06.hca.corpad.net>

I'm looking to evaluate my screening program to make sure that I am capturing all the patients who may need nutrition assessments & interventions, so I'm wondering if others have any suggestions or processes already in place that have worked in doing the same. I have meditech so all my nursing screens are auto generated daily and I rescreen at day 7 for those who do not trigger a consult on admission. What else should I be doing?

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Center
(229)434-2394

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/f8a0dcd5/attachment.html 

From kharriso at stagnes.org  Thu Jan 22 07:46:52 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Thu, 22 Jan 2009 09:46:52 -0600
Subject: [Cnm] Out Patients in Maryland
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B392887BD@ahcmascdc034.DS.SJHS.COM>

Hi,

 

I am looking for a contact in the state of Maryland who has an
outpatient clinic or sees outpatients in Cardiac Rehab and has billing
in Place.  If this person has a willing participant in their
finance/compliance office that would be willing to share how this was
accomplished it would be greatly appreciated.  I ask for MD contacts
only since we are different from every other state with HSCRC.  Thank
you in advance.

 

Kerry Harrison

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

 


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/f2f028f9/attachment.html 

From Linda.Bartholomay at meritcare.com  Thu Jan 22 07:48:20 2009
From: Linda.Bartholomay at meritcare.com (Linda Bartholomay)
Date: Thu, 22 Jan 2009 09:48:20 -0600
Subject: [Cnm] clinical staff in separate cost center
In-Reply-To: <s9776350.046@ggh-email1.ggh.ghs>
References: <s9776350.046@ggh-email1.ggh.ghs>
Message-ID: <497840E3.309B.00D0.0@meritcare.com>

In our facility, we are Nutrition Therapy (dietitians and clinical nutrition technicians) in our own cost center.  We are in the Internal Medicine aggregate (chain of command) and Food Services is completely separate and reports to a different aggregate.  
Our offices for inpatient people are primarily in the main hospital.  Our clinic dietitians have offices in several local and regional clinics.  We have one cost center for Inpatient dietitians and one cost center for outpatient dietitians.
We will be starting to use ACTION data from the inpatient standpoint.  My understanding is that they don't really have benchmarking for clinical dietitians.  Does anyone else use this ACTION data for comparison to other facilities and benchmarking?
 
thanks,
 
 
Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer


>>> "Sandra  Morris" <smorris at goshenhealth.com> 1/21/2009 5:02 PM >>>
We are under our own cost center/our own dept.  Our office is in the
main building of the hospital.

Sandi Morris, RD/CD
Clinical Nutrition Manager
Goshen General Hospital
200 High Park Ave.
Goshen, IN  46526
Phone:  574/535-2679

CONFIDENTIALITY NOTICE:  This transmission and the documents
accompanying this transmission may contain confidential information. 
The information is intended only for the use of the individual(s) or
entity named above.  If you are not the intended recipient, you are
notified that any disclosure, copying, distribution or the taking of any
action in reliance on the contents of this information is not
permissible.  If you have received this message in error, please
immediately reply and then destroy it.  Thank you.

>>> <CKeinath at chs-mi.com> 1/21/2009 4:10 PM >>>

I would like to hear from you on under what cost center you have the
clnical staff under?
Are they under a Nutrition services as a whole?
Are they clinical staff is along with production in their own buildings
if
separate building?
Are in their separate clinical cost center?
Are they under patient services?

Carol

Carol E. Keinath, MS RD
Clinical Nutrition Manager            Covenant HealthCare
Phone: 989-583-4663                   1447 N. Harrison St.
FAX: 989-583-4851                        Saginaw, MI 48602
http://www.covenanthealthcare.com/ 

"Life isn't about waiting for The Storm to Pass -- it's about Learning
to
Dance in The Rain".

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


This e-mail message is intended only for the named recipient(s) above and is covered by the Electronic Communications Privacy Act 18 U.S.C.  Section 2510-2521.   This e-mail is confidential and may contain information that is privileged or exempt from disclosure under applicable law.  If you have received this message in error please immediately notify the sender by return e-mail and delete this e-mail message from your computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/87ef1c71/attachment.html 

From esmerl21 at aol.com  Thu Jan 22 08:42:20 2009
From: esmerl21 at aol.com (esmerl21 at aol.com)
Date: Thu, 22 Jan 2009 11:42:20 -0500
Subject: [Cnm] thickened liquids
Message-ID: <8CB4AC7873FB2AA-110-A61@WEBMAIL-MB09.sysops.aol.com>


I am looking for suggestions of ways to identify residents on thickened liquids in a LTC facility (ie. colored dots on arm bands etc.)? If anyone has a system that works well for them, please share.

Thank you,

Erika Schmerl, MS, RD
Chief Clinical Dietitian
Sea Crest Health Care Center
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/0bd0cb50/attachment.html 

From LCarver at Reshealthcare.org  Thu Jan 22 08:42:38 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Thu, 22 Jan 2009 10:42:38 -0600
Subject: [Cnm] ordering privileges for RDs
In-Reply-To: <E8876826D209234E9756A1C959D0A28F0224594D@whmail.westerlyhospital.local>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03C6E889@rhcexch3.reshealthcare.org>

24.00.05 Diet  Orders.

Therapeutic diets must be prescribed by the Professional Medical Staff
responsible for the care of patients. 482.28(b)(1)

Nutritional needs must be met in accordance with recognized dietary
practices and in accordance with orders of the practitioner or
practitioners responsible for the care of the patients.

Policies provide that there are orders in the chart, from a member of
the Professional Medical Staff, before serving the meal.  Such policies
address the transmittal of these orders, including the use of telephone
or verbal orders.  The hospital ensures that each patient's nutritional
needs are met.

 


INTERVIEW


&

CHART REVIEW

 

Verify that a member of the Staff writes diet orders.  Determine the
receipt of orders for outpatient counseling (by prescription or oral
transmittal to a qualified receiver).  Determine that "Diet as
Tolerated" orders are clarified prior to serving.  Interview with staff
in the Dietary Department, Nursing and patient.  How do you meet the
nutritional needs of the patient?  Determine if answers are the same.

the bolded numbers above should link you to the CMS statement, which may
have changed slightly from the  statement in the first column. the
second column was the interpretation of our accreditation agency, HFAP
(that was 2005).  Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Yvette Dionne
Sent: Thursday, January 22, 2009 9:10 AM
To: cnm at lists.my180.net
Cc: mailto
Subject: [Cnm] ordering privileges for RDs


 

Hi,
Can anybody direct me to the actual CCMS policy?  I have tried searching
their website but am getting nowhere. 
Thank you, 
Yvette Dionne, RD, LDN
Ext. 3464
may you be well and happy
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/6f002360/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: aleabanr.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090122/6f002360/attachment-0001.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 4389 bytes
Desc: Leaves Bkgrd.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090122/6f002360/attachment-0001.jpe 

From Nicole.Pefley at Reshealthcare.org  Thu Jan 22 08:55:09 2009
From: Nicole.Pefley at Reshealthcare.org (Pefley, Nicole)
Date: Thu, 22 Jan 2009 10:55:09 -0600
Subject: [Cnm] Standards of Care
Message-ID: <F47E9B5A465FC94182C3574D9326DF920396EABE@rhcexch2.reshealthcare.org>

Good Morning,
I was wondering if anyone had standards of care/guidelines for
nutritional care at their facilities?  I just want to make sure my
dietitians and I are on the same page/up to date when calculating
kcal/pro/fld needs, making recommendations etc.  

If anyone would be willing to share their SOC, I would appreciate it!

Thank you in advance,

Nicole Pefley, RD, LDN
Clinical Nutrition Manager
RHC-West Suburban Medical Center
Phone: (708) 763-6951
Pager:  (773) 990-7243;  #18236

Confidentiality Notice: This email message, including any attachments,
is for the sole use of the intended recipient (s) and may contain
confidential and privileged information. All personal messages express
views solely of the sender, which are not to be attributed to
Resurrection Health Care. Unauthorized review, use, disclosure or
distribution is prohibited.  If you are not the intended recipient,
please contact the sender by reply e-mail and destroy all copies of the
original message.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/dea943a5/attachment.html 

From LAltenburger5 at matherhospital.org  Thu Jan 22 09:23:04 2009
From: LAltenburger5 at matherhospital.org (Altenburger, Linda)
Date: Thu, 22 Jan 2009 12:23:04 -0500
Subject: [Cnm] dentures
Message-ID: <A21BD3652C008E47BFD8BC00152BF7E60222ECBC@Exchange.jtmmh.org>

  

Curious what others have done in their institutions to prevent patients
dentures from getting put on meals trays and tossed in garbage?  I
thought I recently heard about some type of "clip on" cup of sorts that
goes onto patients tray tables for dentures, glasses/hearing aides.
Anyone using such and has it helped? Thanks in advance. Linda 

 

Linda Altenburger, RD, CDN

Clinical Nutrition Manager

John. T. Mather Memorial Hospital

75 North Country Road

Port Jefferson, NY  11777

(631) 473-1320 ext 4176

laltenburger5 at matherhospital.org

fax:631-473-8752

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/e5a37f28/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 2743 bytes
Desc: image001.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090122/e5a37f28/attachment.jpe 

From Cathy.Poquette at stjoe.org  Thu Jan 22 09:25:25 2009
From: Cathy.Poquette at stjoe.org (Cathy Poquette)
Date: Thu, 22 Jan 2009 09:25:25 -0800
Subject: [Cnm] Long Term Care Regulations Regarding Assessment and Follow-up
 Timeframes
Message-ID: <E3453D1D67CA5E4DA378CB009C9AD6A66F0B3DDE97@SJSNT-SCMAIL01.stjoe.org>

Hi Everyone,

I am a Clinical Nutrition Manager at a regional medical center in California.  We have a Transitional Care Unit which I understand is like a Long Term Care.  I am trying to find out if I have to follow the same guidelines / regulations regarding timeframes for assessments and follow-ups to patients in that unit as I do for patients in the acute hospital setting?   Specifically, our policy for seeing/providing care to patients in the hospital is this:  We prioritize the risk level of our patients based on set criteria; those at high risk are seen and assessed by the RD by the third day of admission and follow-ups occur twice weekly thereafter; those at moderate risk are seen and assessed by the RD by the fourth day of admission and follow-ups occur once a week thereafter.

Do I have to follow the same timeframes for patients in our TCC unit?  If not, could someone tell me what the timeframes are in the TCC setting and direct me to the source (website) and location of the regulation?

Thank you.

Cathy Poquette, MS, RD
Clinical Nutrition Operations Manager
St Jude Medical Center
Fullerton, CA

________________________________
Notice from St.Joseph Health System:
Please note that the information contained in this message may be privileged and confidential and protected from disclosure.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/21b43621/attachment.html 

From Janet.Ross at healthall.com  Thu Jan 22 10:12:34 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Thu, 22 Jan 2009 13:12:34 -0500
Subject: [Cnm] Long Term Care Regulations Regarding Assessment and
 Follow-up Timeframes
In-Reply-To: <E3453D1D67CA5E4DA378CB009C9AD6A66F0B3DDE97@SJSNT-SCMAIL01.stjoe.org>
References: <E3453D1D67CA5E4DA378CB009C9AD6A66F0B3DDE97@SJSNT-SCMAIL01.stjoe.org>
Message-ID: <41CA05D55BF105489D33F8E57D71A905171698673E@MAIL-C.healthall.com>

Set your policy to meet the needs of the patient.

We have different guidelines for our TCU (licensed as SNF) than for our LTACH (licensed as hospital) even though the patients can be similar and the stay is about 3-4 weeks on both.

Our extended care SNF follows the MDS charting criteria--giving us 5 to 14 days to assess, while we do it in 3 days for our LTACH.
My staff wanted to apply this 5-14 days to TCU.  This works if your TCU is all hip replacements for healthy 65 year olds, but NOT if you have assorted other higher risk diagnoses.  Even with mostly hip replacements, someone needs to see them for satisfaction with the food service in the first 24-48 hours.  Even with mostly hip replacements, they could slip in someone with more acute issues or greater age or complications or......

We left our policy at 5 days for TCU, but we try to see them within 2-3 if staffing allows.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Cathy Poquette
Sent: Thursday, January 22, 2009 12:25 PM
To: cnm at lists.my180.net
Subject: [Cnm] Long Term Care Regulations Regarding Assessment and Follow-up Timeframes

Hi Everyone,

I am a Clinical Nutrition Manager at a regional medical center in California.  We have a Transitional Care Unit which I understand is like a Long Term Care.  I am trying to find out if I have to follow the same guidelines / regulations regarding timeframes for assessments and follow-ups to patients in that unit as I do for patients in the acute hospital setting?   Specifically, our policy for seeing/providing care to patients in the hospital is this:  We prioritize the risk level of our patients based on set criteria; those at high risk are seen and assessed by the RD by the third day of admission and follow-ups occur twice weekly thereafter; those at moderate risk are seen and assessed by the RD by the fourth day of admission and follow-ups occur once a week thereafter.

Do I have to follow the same timeframes for patients in our TCC unit?  If not, could someone tell me what the timeframes are in the TCC setting and direct me to the source (website) and location of the regulation?

Thank you.

Cathy Poquette, MS, RD
Clinical Nutrition Operations Manager
St Jude Medical Center
Fullerton, CA

________________________________
Notice from St.Joseph Health System:
Please note that the information contained in this message may be privileged and confidential and protected from disclosure.

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/dba17501/attachment.html 

From sconnell at atriumhealthcare.net  Thu Jan 22 10:32:47 2009
From: sconnell at atriumhealthcare.net (Susie Connell)
Date: Thu, 22 Jan 2009 12:32:47 -0600
Subject: [Cnm] Long Term Care Regulations Regarding Assessment and
 Follow-up Timeframes
In-Reply-To: <41CA05D55BF105489D33F8E57D71A905171698673E@MAIL-C.healthall.com>
References: <E3453D1D67CA5E4DA378CB009C9AD6A66F0B3DDE97@SJSNT-SCMAIL01.stjoe.org>
	<41CA05D55BF105489D33F8E57D71A905171698673E@MAIL-C.healthall.com>
Message-ID: <BAY111-W406E6AB88A5F34F7A45E6AECE0@phx.gbl>


With LTACH, what time frames are being used for follow up?
I find it frustrating to document on patient care conference forms weekly
and still have to document the same thing in the progress notes.
 
Any sugestions?       Susie Connell, MS, RD, LD Clinical Nutrition ManagerAtrium  Medical Center3305 Corinth ParkwayCorinth , Texas 76208940-270-4196sconnell at atriumhealthcare.net



 EMAILING FOR THE GREATER GOODJoin me

From: Janet.Ross at healthall.comTo: Cathy.Poquette at stjoe.org; cnm at lists.my180.netDate: Thu, 22 Jan 2009 13:12:34 -0500Subject: Re: [Cnm] Long Term Care Regulations Regarding Assessment and Follow-up Timeframes





Set your policy to meet the needs of the patient.
 
We have different guidelines for our TCU (licensed as SNF) than for our LTACH (licensed as hospital) even though the patients can be similar and the stay is about 3-4 weeks on both.
 
Our extended care SNF follows the MDS charting criteria--giving us 5 to 14 days to assess, while we do it in 3 days for our LTACH.
My staff wanted to apply this 5-14 days to TCU.  This works if your TCU is all hip replacements for healthy 65 year olds, but NOT if you have assorted other higher risk diagnoses.  Even with mostly hip replacements, someone needs to see them for satisfaction with the food service in the first 24-48 hours.  Even with mostly hip replacements, they could slip in someone with more acute issues or greater age or complications or??
 
We left our policy at 5 days for TCU, but we try to see them within 2-3 if staffing allows.
 

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.
 
 


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Cathy PoquetteSent: Thursday, January 22, 2009 12:25 PMTo: cnm at lists.my180.netSubject: [Cnm] Long Term Care Regulations Regarding Assessment and Follow-up Timeframes
 
Hi Everyone,
 
I am a Clinical Nutrition Manager at a regional medical center in California.  We have a Transitional Care Unit which I understand is like a Long Term Care.  I am trying to find out if I have to follow the same guidelines / regulations regarding timeframes for assessments and follow-ups to patients in that unit as I do for patients in the acute hospital setting?   Specifically, our policy for seeing/providing care to patients in the hospital is this:  We prioritize the risk level of our patients based on set criteria; those at high risk are seen and assessed by the RD by the third day of admission and follow-ups occur twice weekly thereafter; those at moderate risk are seen and assessed by the RD by the fourth day of admission and follow-ups occur once a week thereafter.
 
Do I have to follow the same timeframes for patients in our TCC unit?  If not, could someone tell me what the timeframes are in the TCC setting and direct me to the source (website) and location of the regulation?
 
Thank you.
 
Cathy Poquette, MS, RD
Clinical Nutrition Operations Manager
St Jude Medical Center
Fullerton, CA
 



Notice from St.Joseph Health System:Please note that the information contained in this message may be privileged and confidential and protected from disclosure.

Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/71104628/attachment-0001.html 

From kwyne at barlow2000.org  Thu Jan 22 11:00:16 2009
From: kwyne at barlow2000.org (Wyne, Kateri)
Date: Thu, 22 Jan 2009 11:00:16 -0800
Subject: [Cnm] Long Term Care Regulations Regarding Assessment and
	Follow-up Timeframes
In-Reply-To: <BAY111-W406E6AB88A5F34F7A45E6AECE0@phx.gbl>
References: <E3453D1D67CA5E4DA378CB009C9AD6A66F0B3DDE97@SJSNT-SCMAIL01.stjoe.org><41CA05D55BF105489D33F8E57D71A905171698673E@MAIL-C.healthall.com>
	<BAY111-W406E6AB88A5F34F7A45E6AECE0@phx.gbl>
Message-ID: <BFF381777A7F91478A399ABB3C6747FE01B842CF@MAIL1.barlow.com>

Attached are our nutrition assessment/reassessment policies (LTACH). I
haven't figured out how to avoid the double documentation. Although I
try to keep the information on the patient care conference forms
minimal. We are now utilizing an EMR which makes all the documentation
much more efficient. 

 

Kateri Wyne RD, MPH, CNSD

Chief Clinical Dietitian

Barlow Respiratory Hospital

Los Angeles, CA 90026

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Susie Connell
Sent: Thursday, January 22, 2009 10:33 AM
To: janet.ross at healthall.com; cathy.poquette at stjoe.org;
cnm at lists.my180.net
Subject: Re: [Cnm] Long Term Care Regulations Regarding Assessment and
Follow-up Timeframes

 

With LTACH, what time frames are being used for follow up?
I find it frustrating to document on patient care conference forms
weekly
and still have to document the same thing in the progress notes.
 
Any sugestions?

 
 
 
 
 
 
 
Susie Connell, MS, RD, LD 
Clinical Nutrition Manager
Atrium  Medical Center
3305 Corinth Parkway
Corinth , Texas 76208
940-270-4196
sconnell at atriumhealthcare.net <mailto:sconnell at atriumhealthcare.net> 








i'mEMAILING FOR THE GREATER GOOD
Join me
<http://im.live.com/Messenger/IM/Home/?source=EML_WLHM_GreaterGood> 

 

________________________________

From: Janet.Ross at healthall.com
To: Cathy.Poquette at stjoe.org; cnm at lists.my180.net
Date: Thu, 22 Jan 2009 13:12:34 -0500
Subject: Re: [Cnm] Long Term Care Regulations Regarding Assessment and
Follow-up Timeframes

Set your policy to meet the needs of the patient.

 

We have different guidelines for our TCU (licensed as SNF) than for our
LTACH (licensed as hospital) even though the patients can be similar and
the stay is about 3-4 weeks on both.

 

Our extended care SNF follows the MDS charting criteria--giving us 5 to
14 days to assess, while we do it in 3 days for our LTACH.

My staff wanted to apply this 5-14 days to TCU.  This works if your TCU
is all hip replacements for healthy 65 year olds, but NOT if you have
assorted other higher risk diagnoses.  Even with mostly hip
replacements, someone needs to see them for satisfaction with the food
service in the first 24-48 hours.  Even with mostly hip replacements,
they could slip in someone with more acute issues or greater age or
complications or......

 

We left our policy at 5 days for TCU, but we try to see them within 2-3
if staffing allows.

 

Janet V. Ross, MBA,RD,LD

Clinical Nutrition Coordinator

Drake Center

janet.ross at healthall.com

http://www.health-alliance.com/

ph 513-418-2603

fx 513-418-5939

pg 513-577-6879

P Please consider the environment before printing.

 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Cathy Poquette
Sent: Thursday, January 22, 2009 12:25 PM
To: cnm at lists.my180.net
Subject: [Cnm] Long Term Care Regulations Regarding Assessment and
Follow-up Timeframes

 

Hi Everyone,

 

I am a Clinical Nutrition Manager at a regional medical center in
California.  We have a Transitional Care Unit which I understand is like
a Long Term Care.  I am trying to find out if I have to follow the same
guidelines / regulations regarding timeframes for assessments and
follow-ups to patients in that unit as I do for patients in the acute
hospital setting?   Specifically, our policy for seeing/providing care
to patients in the hospital is this:  We prioritize the risk level of
our patients based on set criteria; those at high risk are seen and
assessed by the RD by the third day of admission and follow-ups occur
twice weekly thereafter; those at moderate risk are seen and assessed by
the RD by the fourth day of admission and follow-ups occur once a week
thereafter.

 

Do I have to follow the same timeframes for patients in our TCC unit?
If not, could someone tell me what the timeframes are in the TCC setting
and direct me to the source (website) and location of the regulation?

 

Thank you.

 

Cathy Poquette, MS, RD

Clinical Nutrition Operations Manager

St Jude Medical Center

Fullerton, CA

 

________________________________

Notice from St.Joseph Health System:
Please note that the information contained in this message may be
privileged and confidential and protected from disclosure.

 

________________________________

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/aa9a10eb/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Policy 22 - Nutritional Assessment.doc
Type: application/msword
Size: 59904 bytes
Desc: Policy 22 - Nutritional Assessment.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090122/aa9a10eb/attachment-0002.doc 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Policy 23 - Nutritional Reassessment.doc
Type: application/msword
Size: 48640 bytes
Desc: Policy 23 - Nutritional Reassessment.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090122/aa9a10eb/attachment-0003.doc 

From jwelch02 at unityhealth.org  Thu Jan 22 11:19:21 2009
From: jwelch02 at unityhealth.org (Janel Welch)
Date: Thu, 22 Jan 2009 14:19:21 -0500
Subject: [Cnm] thickened liquids
In-Reply-To: <8CB4AC7873FB2AA-110-A61@WEBMAIL-MB09.sysops.aol.com>
References: <8CB4AC7873FB2AA-110-A61@WEBMAIL-MB09.sysops.aol.com>
Message-ID: <49788069.931E.00AD.0@unityhealth.org>

We color code their name plates at the dining tables with dots.
Janel


Janel Welch MS, RD, CDN
Clinical Nutrition Manager
Unity Health System
89 Genesee Street
Rochester NY 14611
(585) 368-3108 Phone
(585) 368-3743 Fax
(585) 463-0019 Pager
 


>>> <esmerl21 at aol.com> 1/22/2009 11:42 AM >>>

I am looking for suggestions of ways to identify residents on thickened liquids in a LTC facility (ie. colored dots on arm bands etc.)? If anyone has a system that works well for them, please share.

Thank you,

Erika Schmerl, MS, RD
Chief Clinical Dietitian
Sea Crest Health Care Center


PLEASE NOTE: Property of Unity Health System -- www.unityhealth.org  
The information contained in this message may be privileged and confidential, protected from disclosure, and/or intended only for the user of the individual or entity named above. If the recipient of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication in error, please notify the sender immediately by replying to this message and deleting it from your computer. This email message is considered Virus Free by our virus scanning software. All email is considered property of Unity Health System. 
Address policy questions to address below. 
gwadministrator at unityhealth.org





From Liz.Anthony at milfordhospital.org  Thu Jan 22 11:21:23 2009
From: Liz.Anthony at milfordhospital.org (Anthony Liz)
Date: Thu, 22 Jan 2009 14:21:23 -0500
Subject: [Cnm] ICD-9-CM Code definitions
In-Reply-To: <497840E3.309B.00D0.0@meritcare.com>
Message-ID: <B70176422F4C8944BD6F374DDF83DD2E0ACCE9C113@MH-MAIL.mhdomain.local>

            Hello,

I was just wondering if you have standard definitions of Kwashiokor, Marasmus, Mild, moderate and severe PCM that you use to identify these conditions.  If so, can you share these with me.  I currently have a policy/procedure to identify these diagnosis, but they are with IBW and I am hoping to change to BMI.

Thank you,
Liz Anthony
Milford Hospital

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/28d3d8c3/attachment.html 

From JKrzeminski at Reshealthcare.org  Thu Jan 22 08:58:39 2009
From: JKrzeminski at Reshealthcare.org (Krzeminski, Janet)
Date: Thu, 22 Jan 2009 10:58:39 -0600
Subject: [Cnm] FW:  Cincinnati Children's Pediatric Nutrition Handbook
Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F2724939@rhcexch3.reshealthcare.org>

Forwarding to answer the PEDs reference book question...

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Letitia Hess
Sent: Friday, December 05, 2008 1:39 PM
To: cnm at lists.my180.net
Subject: [Cnm] Cincinnati Children's Pediatric Nutrition Handbook

Hello Everyone!

The Registered Dietitians at Cincinnati Children's are pleased to
announce that the third edition of the CCHMC Pediatric Nutrition
Handbook is now available.  The handbook includes chapters on: 

Nutrition assessment parameters
Feeding guidelines including breast-feeding Infant formulas Pediatric
formulas Adult formulas used in the pediatric setting References for
vitamin and mineral supplements Enteral and parenteral nutrition support
Food allergies and much more

New to this edition are standards of care for specific disease states.

The cost is $15.00.  
 

To order your copy complete the information below.

Please send me _____copies of the Cincinnati Children's Pediatric
Nutrition Handbook.
($15.00 per copy which includes shipping)
 
Payment Enclosed:   
 Check (Payable to Division of Nutrition Therapy, CCHMC)

Credit Card: Type:  Visa        MasterCard            American Express 
             Discover    
Number: _______________________       Expiration date:  ____________   
                             
 
Name on card:  _________________________________________________
 
Shipping address:
 
Name:         __________________________________
 
Title:           __________________________________
 
Address:      __________________________________
 
                    __________________________________
 
                    __________________________________
 
                    __________________________________
 
Telephone Number: _______________________
 
Email Address: _______________________
 
Fax:_______________________
                    
The form may be emailed to tanya.ivery at cchmc.org or faxed.
Tanya Ivery, Administrative Assistant
Cincinnati Children's Hospital Medical Center Division of Nutrition
Therapy - ML 5043
3333 Burnet Ave.
Cincinnati, OH  45229
Telephone:  513-636-4211
Fax:    513-636-5887 

Letitia Hess, MS, RD, LD
Senior Clinical Director
Nutrition Therapy Division - ML  5043
Cincinnati Children's Hospital Medical Center
3333 Burnet Ave.
Cincinnati, OH  45229
tel:  513/636-7285
fax:  513/636-5887
email:  letitia.hess at cchmc.org


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From YDionne at westerlyhospital.org  Fri Jan 23 05:10:42 2009
From: YDionne at westerlyhospital.org (Yvette Dionne)
Date: Fri, 23 Jan 2009 08:10:42 -0500
Subject: [Cnm] Rhode Island RDs - ordering privileges
Message-ID: <E8876826D209234E9756A1C959D0A28F0224594F@whmail.westerlyhospital.local>

 

Hi,
 
I would appreciate information from other RDs in RI regarding what their
current practice is regarding RDs ordering supplements, etc.  
 
How do you manage this?
Do you have policies in place?
Have you worked with your risk management people on this? 
 
Thank you, 
Yvette Dionne, RD, LDN
Ext. 3464
may you be well and happy
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/8b55b538/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: aleabanr.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/8b55b538/attachment.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 4389 bytes
Desc: Leaves Bkgrd.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/8b55b538/attachment.jpe 

From KRzad at med.miami.edu  Fri Jan 23 06:10:40 2009
From: KRzad at med.miami.edu (Rzad, Karon)
Date: Fri, 23 Jan 2009 09:10:40 -0500
Subject: [Cnm] Please change my email to Talkfood@bellsouth.net
Message-ID: <DFE35E9E46C195459D20853641E2E1EA02ECB12ABB@MEDEXMB01.ad.med.miami.edu>

Please confirm change.  Thank you.

Karon M. Rzad RD LDN CDE CPT
Lic. Stress Management Coach
CAM Practitioner

Medical Nutrition Services Manager
UM/Sylvester
1475 NW 12th Avenue C002-H
Miami, FL 33136
305 243 8885
krzad at med.miami.edu<mailto:krzad at med.miami.edu>


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/e3ce9b45/attachment.html 

From Linda.Bartholomay at meritcare.com  Fri Jan 23 07:20:51 2009
From: Linda.Bartholomay at meritcare.com (Linda Bartholomay)
Date: Fri, 23 Jan 2009 09:20:51 -0600
Subject: [Cnm] Sorian and Cbord
Message-ID: <49798BF2.309B.00D0.0@meritcare.com>

Hi, all.
 
We are going to be very quickly trying to change from our paper chart to Sorian for inpatient orders in particular.  The orders involve diet orders.  We use Cbord for clinical workload reports, Room Service and the Food Service area uses other modules as well.
 
We are in the process of reviewing our diets.  Down the road, the plan is for automated Physician Order Entry.  I think we will not be able to make additional changes to our diets likely for years.  Thus, I'm interested in how others have labeled their diet order lists.  For example, does your facility use the term Renal Diet or is it specified by parameters (such as 80 gm protein, 80 mEq Potassium, NAS, low phosphorus, 1200 ml fluid), or Congestive Heart Failure diet vs 2 gram Sodium???
 
We are a teaching facility, so have new residents and med students often.  We also use primarily hospitalists for the inpatient units.  It seems many physicians struggle with what to order for diets.  
 
We are also about 18 versions behind in Cbord, so have quite a few processes that are still manual entry for us on the Cbord workload reports.  We will also be upgrading to the newest version of Cbord at the same time some other things are being implemented (like changing to D.A.M type of Allergies).  
 
I would really appreciate it if any of you who are currently working on Sorian and Cbord or have already done so could send me your name and contact information.
 
Thank you so much!!
 
Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer


This e-mail message is intended only for the named recipient(s) above and is covered by the Electronic Communications Privacy Act 18 U.S.C.  Section 2510-2521.   This e-mail is confidential and may contain information that is privileged or exempt from disclosure under applicable law.  If you have received this message in error please immediately notify the sender by return e-mail and delete this e-mail message from your computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/887f1ed9/attachment.html 

From andrea.johnson at bassett.org  Fri Jan 23 08:00:33 2009
From: andrea.johnson at bassett.org (Johnson, Andrea)
Date: Fri, 23 Jan 2009 11:00:33 -0500
Subject: [Cnm] diverticulitis
In-Reply-To: <DFE35E9E46C195459D20853641E2E1EA02ECB12ABB@MEDEXMB01.ad.med.miami.edu>
Message-ID: <415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org>

Does anyone have an article or a reference that details the new diverticulitis recommendations that allow fiber, seeds etc on the diet.
Thanks,
Andrea
 

Andrea Johnson, MS, RD, CDE 
Clinical Nutrition Manager 
Bassett Healthcare 
One Atwell Road 
Cooperstown, NY 13326 
andrea.johnson at bassett.org 
607-547-6665 

 

 



-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/68e72893/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Johnson, Andrea.vcf
Type: text/x-vcard
Size: 145 bytes
Desc: Johnson, Andrea.vcf
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/68e72893/attachment.vcf 

From tak9006 at nyp.org  Fri Jan 23 08:06:43 2009
From: tak9006 at nyp.org (Takami Kim)
Date: Fri, 23 Jan 2009 11:06:43 -0500
Subject: [Cnm] diverticulitis
In-Reply-To: <415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org>
References: <415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org>
Message-ID: <4979EB13.2080201@nyp.org>

There was an an article in JAMA in 2008; 300 (8):907-914 titled Nut, 
Corn and Popcorn Consumption and the Incidence of Diverticular Disease 
that showed inverse associations between nuts and popcorn consumption 
and the risk of diverticulitis.  There are multiple articles in websites 
that speak to this.

Takami Kim, MS RD CND
Supervisor, Clinical Nutriiton Services
NewYork-Presbyterian Hospital
Johnson, Andrea wrote:
> Does anyone have an article or a reference that details the new 
> diverticulitis recommendations that allow fiber, seeds etc on the diet.
> Thanks,
> Andrea
>  
>
> Andrea Johnson, MS, RD, CDE
> Clinical Nutrition Manager
> Bassett Healthcare
> One Atwell Road
> Cooperstown, NY 13326
> andrea.johnson at bassett.org
> 607-547-6665
>
>      
>
>      
>
> NOTICE OF CONFIDENTIALITY This electronic message, including 
> attachments, is for the sole use of the named recipient and may 
> contain confidential or privileged information protected by New York 
> State, and Federal regulations. Any unauthorized review, use, 
> disclosure, copying or distribution is strictly prohibited. If you are 
> not the intended recipient or have received this communication in 
> error please contact the sender or email.security at bassett.org and 
> destroy all copies of the original message. Thank you.
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>   




--------------------

This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited.  If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message.  Thank you.




From RDavis-Cote at bmhsc.org  Fri Jan 23 08:13:07 2009
From: RDavis-Cote at bmhsc.org (Roxanne J. Davis-Cote)
Date: Fri, 23 Jan 2009 11:13:07 -0500
Subject: [Cnm] braden score as nutrition risk indicator
Message-ID: <95FEAD2B8B155B4D9290B464182C5A8E024C467D@BRAYS.bmhsc.org>

What are other facilities using for braden score triggers if this is
used at all as a nutrition risk indicator?

 

 

Roxanne Davis-Cote, RD,LD

Clinical Nutrition Manager

Beaufort Memorial Hospital

rdavis-cote at bmhsc.org

phone: 843-522-5084

fax: 843-522-5700

 


**********************************************************************
This email and any files transmitted with it are confidential and
intended solely for the use of the individual or entity to whom they
are addressed. If you have received this email in error please notify
the system manager.

This footnote also confirms that this email message has been swept by
MIMEsweeper for the presence of computer viruses.

www.clearswift.com
**********************************************************************



This message was scanned with MIMESweeper.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/a304f072/attachment.html 

From giseleleblanc at comcast.net  Fri Jan 23 09:10:04 2009
From: giseleleblanc at comcast.net (giseleleblanc at comcast.net)
Date: Fri, 23 Jan 2009 17:10:04 +0000 (UTC)
Subject: [Cnm] Sorian and Cbord
In-Reply-To: <49798BF2.309B.00D0.0@meritcare.com>
Message-ID: <545404526.498091232730604937.JavaMail.root@sz0139a.westchester.pa.mail.comcast.net>



Hi Linda, 



We also are using Soarian.? We had been using the actual name for the diet i.e. 2gm Na instead of CHF.? We had implemented Soarian in 2006.? Currently, we're getting ready for CPOE where the physician will be ordering diets.? We are putting together "bundles" based on the diagnosis, so that if a pt comes in with a dx of CHF, the suggested diets will default in the order sets.? The docs will be able to modify and add as needed.? We're still in the building process.? I'm hopeful that this will work for us. 

Hope this helps! 




Gisele LeBlanc, MS RD LDN CNSD 
Clinical Nutrition Manager 

UMASS Memorial HealthAlliance 

GiseleLeBlanc at IamMorrison.com 





----- Original Message ----- 
From: "Linda Bartholomay" <Linda.Bartholomay at meritcare.com> 
To: cnm at lists.my180.net 
Sent: Friday, January 23, 2009 10:20:51 AM GMT -05:00 US/Canada Eastern 
Subject: [Cnm] Sorian and Cbord 


Hi, all. 

We are going to be very quickly trying to change from our paper chart to Sorian for inpatient orders in particular.? The orders involve diet orders.? We use Cbord for clinical workload reports, Room Service and the Food Service area uses other modules as well. 

We are in the process of reviewing our diets.? Down the road, the plan is for automated Physician Order Entry.? I think we will not be able to make additional changes to our diets likely for years.? Thus, I'm interested in how others have labeled their diet order lists.??For example, does your facility use the term Renal Diet or is it specified?by parameters (such as 80 gm protein, 80?mEq Potassium, NAS, low?phosphorus,?1200 ml fluid), or Congestive Heart Failure diet vs 2 gram Sodium??? 

We are a teaching facility, so have new residents and med students often.? We also use primarily hospitalists for the inpatient units.? It seems many physicians struggle with what to order for diets.? 

We are also about 18 versions behind in Cbord, so have quite a few processes that are still manual entry for us on the Cbord workload reports.? We will also be upgrading to the newest version of Cbord at the same time some other things are being implemented (like changing to D.A.M type of Allergies).? 

I would really appreciate it if any of you who are currently working on Sorian and Cbord or have already done so could send me your name and contact information. 

Thank you so much!! 


Linda Bartholomay, LRD 
Manager, Nutrition Therapy 
MeritCare Health Systems 
Linda.Bartholomay at meritcare.com 
(701) 234-6166 
Strengths:? Arranger, Ideation, Adaptability, Empathy, Maximizer 



This e-mail message is intended only for the named recipient(s) above and is covered by the Electronic Communications Privacy Act 18 U.S.C. Section 2510-2521. This e-mail is confidential and may contain information that is privileged or exempt from disclosure under applicable law. If you have received this message in error please immediately notify the sender by return e-mail and delete this e-mail message from your computer. 


_______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/4bb59476/attachment.html 

From RachelFlores at sach.org  Fri Jan 23 09:21:39 2009
From: RachelFlores at sach.org (Flores, Rachel)
Date: Fri, 23 Jan 2009 09:21:39 -0800
Subject: [Cnm] braden score as nutrition risk indicator
Message-ID: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D61E@S1EXH002>

< 12 is high risk, seen within 24 hours, 13-16 is moderate risk, seen within
3 days.

 

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

  _____  

From: Roxanne J. Davis-Cote [mailto:RDavis-Cote at bmhsc.org] 
Sent: Friday, January 23, 2009 8:13 AM
To: cnm at lists.my180.net
Subject: [Cnm] braden score as nutrition risk indicator

 

What are other facilities using for braden score triggers if this is used at
all as a nutrition risk indicator?

 

 

Roxanne Davis-Cote, RD,LD

Clinical Nutrition Manager

Beaufort Memorial Hospital

rdavis-cote at bmhsc.org <mailto:rdavis-cote at bmhsc.org> 

phone: 843-522-5084

fax: 843-522-5700

 

**********************************************************************

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the system manager.

 

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

 

www.clearswift.com

**********************************************************************

 

 

This message was scanned with MIMESweeper.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/633379f5/attachment.html 

From Beth.Dorsey at tmcaz.com  Fri Jan 23 09:47:54 2009
From: Beth.Dorsey at tmcaz.com (Beth Dorsey)
Date: Fri, 23 Jan 2009 10:47:54 -0700
Subject: [Cnm] Sorian and Cbord
Message-ID: <410CA779BF3C39428E37B41D6F06AFC802F30515@TMCMAIL02.tmc.tmcaz.com>

We are implementing CBORD currently. I have attached our diet
restriction list which includes all diet orders & modifiers (so it looks
a little busy) As of this morning, we have decided to eliminate clear
liquid diabetic & full liquid diabetic diets. Our Renal diet is designed
to be 60gm pro, 2gm Na, 2 gm K. 

Beth

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Linda Bartholomay
Sent: Friday, January 23, 2009 8:21 AM
To: cnm at lists.my180.net
Subject: [Cnm] Sorian and Cbord

 

Hi, all.

 

We are going to be very quickly trying to change from our paper chart to
Sorian for inpatient orders in particular.  The orders involve diet
orders.  We use Cbord for clinical workload reports, Room Service and
the Food Service area uses other modules as well.

 

We are in the process of reviewing our diets.  Down the road, the plan
is for automated Physician Order Entry.  I think we will not be able to
make additional changes to our diets likely for years.  Thus, I'm
interested in how others have labeled their diet order lists.  For
example, does your facility use the term Renal Diet or is it specified
by parameters (such as 80 gm protein, 80 mEq Potassium, NAS, low
phosphorus, 1200 ml fluid), or Congestive Heart Failure diet vs 2 gram
Sodium???

 

We are a teaching facility, so have new residents and med students
often.  We also use primarily hospitalists for the inpatient units.  It
seems many physicians struggle with what to order for diets.  

 

We are also about 18 versions behind in Cbord, so have quite a few
processes that are still manual entry for us on the Cbord workload
reports.  We will also be upgrading to the newest version of Cbord at
the same time some other things are being implemented (like changing to
D.A.M type of Allergies).  

 

I would really appreciate it if any of you who are currently working on
Sorian and Cbord or have already done so could send me your name and
contact information.

 

Thank you so much!!

 

Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer

  _____  

This e-mail message is intended only for the named recipient(s) above
and is covered by the Electronic Communications Privacy Act 18 U.S.C.
Section 2510-2521. This e-mail is confidential and may contain
information that is privileged or exempt from disclosure under
applicable law. If you have received this message in error please
immediately notify the sender by return e-mail and delete this e-mail
message from your computer. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/9a529d57/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Diet Restriction Codes 2009-01-21.xls
Type: application/vnd.ms-excel
Size: 39936 bytes
Desc: Diet Restriction Codes 2009-01-21.xls
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/9a529d57/attachment-0001.xls 

From aimeenut at yahoo.com  Fri Jan 23 09:50:11 2009
From: aimeenut at yahoo.com (aimee crant)
Date: Fri, 23 Jan 2009 09:50:11 -0800 (PST)
Subject: [Cnm] Sorian and Cbord
References: <545404526.498091232730604937.JavaMail.root@sz0139a.westchester.pa.mail.comcast.net>
Message-ID: <544312.37261.qm@web52601.mail.re2.yahoo.com>

we also have Soarian.? We use main diet types and then add modifiers.? For example, 

diet type:? carb controlled, sodium restricted
modifier: 2 gm Na, 1800 cal
?Aimee Crant-Oksa MS, RD
Clinical Nutrition Manager
Centrastate Medical Center
tel: 732-294-2767
email: acrantok at centrastate.com 




________________________________
From: "giseleleblanc at comcast.net" <giseleleblanc at comcast.net>
To: Linda Bartholomay <Linda.Bartholomay at meritcare.com>
Cc: cnm at lists.my180.net
Sent: Friday, January 23, 2009 12:10:04 PM
Subject: Re: [Cnm] Sorian and Cbord


Hi Linda,
?
We also are using Soarian.? We had been using the actual name for the diet i.e. 2gm Na instead of CHF.? We had implemented Soarian in 2006.? Currently, we're getting ready for CPOE where the physician will be ordering diets.? We are putting together "bundles" based on the diagnosis, so that if a pt comes in with a dx of CHF, the suggested diets will default in the order sets.? The docs will be able to modify and add as needed.? We're still in the building process.? I'm hopeful that this will work for us.
Hope this helps!
?

Gisele LeBlanc, MS RD LDN CNSD
Clinical Nutrition Manager
UMASS Memorial HealthAlliance
GiseleLeBlanc at IamMorrison.com




----- Original Message -----
From: "Linda Bartholomay" <Linda.Bartholomay at meritcare.com>
To: cnm at lists.my180.net
Sent: Friday, January 23, 2009 10:20:51 AM GMT -05:00 US/Canada Eastern
Subject: [Cnm] Sorian and Cbord


Hi, all.

We are going to be very quickly trying to change from our paper chart to Sorian for inpatient orders in particular.? The orders involve diet orders.? We use Cbord for clinical workload reports, Room Service and the Food Service area uses other modules as well.

We are in the process of reviewing our diets.? Down the road, the plan is for automated Physician Order Entry.? I think we will not be able to make additional changes to our diets likely for years.? Thus, I'm interested in how others have labeled their diet order lists.??For example, does your facility use the term Renal Diet or is it specified?by parameters (such as 80 gm protein, 80?mEq Potassium, NAS, low?phosphorus,?1200 ml fluid), or Congestive Heart Failure diet vs 2 gram Sodium???

We are a teaching facility, so have new residents and med students often.? We also use primarily hospitalists for the inpatient units.? It seems many physicians struggle with what to order for diets.? 

We are also about 18 versions behind in Cbord, so have quite a few processes that are still manual entry for us on the Cbord workload reports.? We will also be upgrading to the newest version of Cbord at the same time some other things are being implemented (like changing to D.A.M type of Allergies).? 

I would really appreciate it if any of you who are currently working on Sorian and Cbord or have already done so could send me your name and contact information.

Thank you so much!!

Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:? Arranger, Ideation, Adaptability, Empathy, Maximizer

________________________________
This e-mail message is intended only for the named recipient(s) above and is covered by the Electronic Communications Privacy Act 18 U.S.C. Section 2510-2521. This e-mail is confidential and may contain information that is privileged or exempt from disclosure under applicable law. If you have received this message in error please immediately notify the sender by return e-mail and delete this e-mail message from your computer. 
_______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net 


      
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/1dfb2751/attachment.html 

From Janet.Ross at healthall.com  Thu Jan 22 10:41:51 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Thu, 22 Jan 2009 13:41:51 -0500
Subject: [Cnm] Long Term Care Regulations Regarding Assessment and
 Follow-up Timeframes
In-Reply-To: <BAY111-W406E6AB88A5F34F7A45E6AECE0@phx.gbl>
References: <E3453D1D67CA5E4DA378CB009C9AD6A66F0B3DDE97@SJSNT-SCMAIL01.stjoe.org>
	<41CA05D55BF105489D33F8E57D71A905171698673E@MAIL-C.healthall.com>
	<BAY111-W406E6AB88A5F34F7A45E6AECE0@phx.gbl>
Message-ID: <41CA05D55BF105489D33F8E57D71A9051716986741@MAIL-C.healthall.com>

We average seven days but have written into our policy per RD discretion.  This allows us flexibility if we have someone longer term and stable or if we have a holiday or.....  Our new assessment forms say "will follow in 3 days, 7 days, 7-10 days with check boxes.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: Susie Connell [mailto:sconnell at atriumhealthcare.net]
Sent: Thursday, January 22, 2009 1:33 PM
To: Ross, Janet; cathy.poquette at stjoe.org; cnm at lists.my180.net
Subject: RE: [Cnm] Long Term Care Regulations Regarding Assessment and Follow-up Timeframes

With LTACH, what time frames are being used for follow up?
I find it frustrating to document on patient care conference forms weekly
and still have to document the same thing in the progress notes.

Any sugestions?








Susie Connell, MS, RD, LD
Clinical Nutrition Manager
Atrium  Medical Center
3305 Corinth Parkway
Corinth , Texas 76208
940-270-4196
sconnell at atriumhealthcare.net<mailto:sconnell at atriumhealthcare.net>






[http://gfx1.hotmail.com/mail/w3/ltr/i_charity.gif]EMAILING FOR THE GREATER GOOD
Join me<http://im.live.com/Messenger/IM/Home/?source=EML_WLHM_GreaterGood>


________________________________
From: Janet.Ross at healthall.com
To: Cathy.Poquette at stjoe.org; cnm at lists.my180.net
Date: Thu, 22 Jan 2009 13:12:34 -0500
Subject: Re: [Cnm] Long Term Care Regulations Regarding Assessment and Follow-up Timeframes
Set your policy to meet the needs of the patient.

We have different guidelines for our TCU (licensed as SNF) than for our LTACH (licensed as hospital) even though the patients can be similar and the stay is about 3-4 weeks on both.

Our extended care SNF follows the MDS charting criteria--giving us 5 to 14 days to assess, while we do it in 3 days for our LTACH.
My staff wanted to apply this 5-14 days to TCU.  This works if your TCU is all hip replacements for healthy 65 year olds, but NOT if you have assorted other higher risk diagnoses.  Even with mostly hip replacements, someone needs to see them for satisfaction with the food service in the first 24-48 hours.  Even with mostly hip replacements, they could slip in someone with more acute issues or greater age or complications or......

We left our policy at 5 days for TCU, but we try to see them within 2-3 if staffing allows.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Cathy Poquette
Sent: Thursday, January 22, 2009 12:25 PM
To: cnm at lists.my180.net
Subject: [Cnm] Long Term Care Regulations Regarding Assessment and Follow-up Timeframes

Hi Everyone,

I am a Clinical Nutrition Manager at a regional medical center in California.  We have a Transitional Care Unit which I understand is like a Long Term Care.  I am trying to find out if I have to follow the same guidelines / regulations regarding timeframes for assessments and follow-ups to patients in that unit as I do for patients in the acute hospital setting?   Specifically, our policy for seeing/providing care to patients in the hospital is this:  We prioritize the risk level of our patients based on set criteria; those at high risk are seen and assessed by the RD by the third day of admission and follow-ups occur twice weekly thereafter; those at moderate risk are seen and assessed by the RD by the fourth day of admission and follow-ups occur once a week thereafter.

Do I have to follow the same timeframes for patients in our TCC unit?  If not, could someone tell me what the timeframes are in the TCC setting and direct me to the source (website) and location of the regulation?

Thank you.

Cathy Poquette, MS, RD
Clinical Nutrition Operations Manager
St Jude Medical Center
Fullerton, CA

________________________________
Notice from St.Joseph Health System:
Please note that the information contained in this message may be privileged and confidential and protected from disclosure.

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090122/653607cd/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Nutrition Care and Documentation for Inpatients.doc
Type: application/msword
Size: 245248 bytes
Desc: Nutrition Care and Documentation for Inpatients.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090122/653607cd/attachment-0001.doc 

From CKeinath at chs-mi.com  Fri Jan 23 10:10:40 2009
From: CKeinath at chs-mi.com (CKeinath at chs-mi.com)
Date: 23-Jan-2009 13:10:40 EST
Subject: [Cnm] diverticulitis
In-Reply-To: <415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org>

I was wondering if anyone has then changed their diet sheets according to
the newest research, or are you educating the doctors on this to bring them
up to speed??

Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   


From jarnet at bjc.org  Fri Jan 23 10:27:12 2009
From: jarnet at bjc.org (Judith Arnet)
Date: Fri, 23 Jan 2009 12:27:12 -0600
Subject: [Cnm] diverticulitis
In-Reply-To: <6564D6A31JW2832867-01@MMS_bjc.org>
References: <415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org>
	<6564D6A31JW2832867-01@MMS_bjc.org>
Message-ID: <4979B548.3533.00BC.0@bjc.org>

Educating the doctors with slow progress.  We're doing it face-to-face as cases present.
 
Judy Arnet, RD LD
Clinical Nutrition Manager
Boone Hospital Center
Columbia, MO  65203
(573)815-3353

>>> <CKeinath at chs-mi.com> 1/23/2009 12:10 PM >>>
I was wondering if anyone has then changed their diet sheets according to
the newest research, or are you educating the doctors on this to bring them
up to speed??

Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/deabc614/attachment.html 

From Kerry.Scott at providence.org  Fri Jan 23 10:25:16 2009
From: Kerry.Scott at providence.org (Scott, Kerry  R.)
Date: Fri, 23 Jan 2009 10:25:16 -0800
Subject: [Cnm] diverticulitis
In-Reply-To: <4979B548.3533.00BC.0@bjc.org>
References: <415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org><6564D6A31JW2832867-01@MMS_bjc.org>
	<4979B548.3533.00BC.0@bjc.org>
Message-ID: <CBE0048956D4B14C893378F8D13A36E2028B30DC@IRMEXCH02.irm.inhs.org>

I may be incorrect, but if I recall the study was on a very small group
and suggested that perhaps further research was warrented?  
 

Kerry Scott, RD, CD 
Clinical Nutrition Manager 
Food & Nutrition Services 
Providence Sacred Heart Medical Center & Children's Hospital 
(509)474-4774 

Kerry.Scott at providence.org 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Judith Arnet
Sent: Friday, January 23, 2009 10:27 AM
To: CKeinath at chs-mi.com; cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis


Educating the doctors with slow progress.  We're doing it face-to-face
as cases present.
 
Judy Arnet, RD LD
Clinical Nutrition Manager
Boone Hospital Center
Columbia, MO  65203
(573)815-3353

>>> <CKeinath at chs-mi.com> 1/23/2009 12:10 PM >>>
I was wondering if anyone has then changed their diet sheets according
to
the newest research, or are you educating the doctors on this to bring
them
up to speed??

Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/55260397/attachment.html 

From julie.mclaughlin at hotmail.com  Fri Jan 23 10:33:04 2009
From: julie.mclaughlin at hotmail.com (Julie McLaughlin)
Date: Fri, 23 Jan 2009 13:33:04 -0500
Subject: [Cnm] Nutrition Risk Levels
In-Reply-To: <69DD80845D7F524BB1C8C59479ED0625013A8510@exchsvfulton01.mx.state.mo.us>
References: <19833324B774F042B1FE1C34A79695BA12C82D8EE6@NADCWPMSGCMS07.hca.corpad.net>
	<280294.89738.qm@web52609.mail.re2.yahoo.com> 
	<69DD80845D7F524BB1C8C59479ED0625013A8510@exchsvfulton01.mx.state.mo.us>
Message-ID: <BLU144-W43E13C63E98C6B4BF2F61E8CCF0@phx.gbl>


For Assessments, we use the Aramark policy which defines Severe, Moderate, Mild and Normal, ie. No Risk.
 
Nursing screens upon admission and identifies At Risk (based on pre-established screening criteria) or No Risk Indicators Present.
Julie McLaughlin 

Date: Wed, 21 Jan 2009 14:56:59 -0600From: Leslie.Hornick at dmh.mo.govTo: cnm at lists.my180.netSubject: Re: [Cnm] Nutrition Risk Levels





We have a priority 1 high risk and a priority 2 low risk.
 

 
Leslie Hornick, RD, LD
Chief Clinical Dietitian
FSH/MMMHC
 
CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. The designated recipients are prohibited from redisclosing this information to any other party without authorization and are required to destroy the information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited by federal or state law. If you have received this communication in error, please notify me immediately by telephone at 573-592-2059, and destroy all copies of this communication and any attachments.
 


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of aimee crantSent: Wednesday, January 21, 2009 2:19 PMTo: Beanum Pamela; cnm at lists.my180.netSubject: Re: [Cnm] Nutrition Risk Levels
 


We still use high, mod and low. 
Aimee Crant-Oksa MS, RDClinical Nutrition ManagerCentrastate Medical Centertel: 732-294-2767email: acrantok at centrastate.com 

 

 




From: Beanum Pamela <Pamela.Beanum at HCAhealthcare.com>To: "cnm at lists.my180.net" <cnm at lists.my180.net>Sent: Wednesday, January 21, 2009 2:46:04 PMSubject: [Cnm] Nutrition Risk Levels

What risk levels are RDs capturing in your facilities?  We are currently using ?at risk? or ?not at risk? as per a JC survey readiness a few years ago, are others doing the same or still sticking with ?high?, ?moderate? & ?low??
 
Thanks so much!
 
Pamela Beanum, RD Clinical Nutrition/Catering Manager 804-254-9823 (phone)
804-254-5538 (fax)Retreat Hospital : A Campus of Henrico Doctors' Hospital2621 Grove Ave Richmond VA 23220 pamela.beanum at hcahealthcare.com
 
 
_________________________________________________________________
Windows Live? Hotmail?:?more than just e-mail. 
http://windowslive.com/explore?ocid=TXT_TAGLM_WL_t2_hm_justgotbetter_explore_012009
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/8472431e/attachment.html 

From Janet.Ross at healthall.com  Fri Jan 23 10:42:51 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Fri, 23 Jan 2009 13:42:51 -0500
Subject: [Cnm] diverticulitis
In-Reply-To: <CBE0048956D4B14C893378F8D13A36E2028B30DC@IRMEXCH02.irm.inhs.org>
References: <415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org><6564D6A31JW2832867-01@MMS_bjc.org>
	<4979B548.3533.00BC.0@bjc.org>
	<CBE0048956D4B14C893378F8D13A36E2028B30DC@IRMEXCH02.irm.inhs.org>
Message-ID: <41CA05D55BF105489D33F8E57D71A9051716986760@MAIL-C.healthall.com>

Maybe, but my mother's surgeon (fistula caused by a diverticulum) says he has NEVER seen a seed or piece of corn inside a diverticulum after years and years of surgery.  Hmmm.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Scott, Kerry R.
Sent: Friday, January 23, 2009 1:25 PM
To: Judith Arnet; CKeinath at chs-mi.com; cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis

I may be incorrect, but if I recall the study was on a very small group and suggested that perhaps further research was warrented?


Kerry Scott, RD, CD
Clinical Nutrition Manager
Food & Nutrition Services
Providence Sacred Heart Medical Center & Children's Hospital
(509)474-4774

Kerry.Scott at providence.org


________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Judith Arnet
Sent: Friday, January 23, 2009 10:27 AM
To: CKeinath at chs-mi.com; cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis
Educating the doctors with slow progress.  We're doing it face-to-face as cases present.

Judy Arnet, RD LD
Clinical Nutrition Manager
Boone Hospital Center
Columbia, MO  65203
(573)815-3353

>>> <CKeinath at chs-mi.com> 1/23/2009 12:10 PM >>>
I was wondering if anyone has then changed their diet sheets according to
the newest research, or are you educating the doctors on this to bring them
up to speed??

Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/50649ac7/attachment.html 

From RiddifordR at childrensdayton.org  Fri Jan 23 10:48:50 2009
From: RiddifordR at childrensdayton.org (Rachel Riddiford)
Date: Fri, 23 Jan 2009 13:48:50 -0500
Subject: [Cnm] diverticulitis
In-Reply-To: <41CA05D55BF105489D33F8E57D71A9051716986760@MAIL-C.healthall.com>
References: <415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org><6564D6A31JW2832867-01@MMS_bjc.org>	<4979B548.3533.00BC.0@bjc.org>	<CBE0048956D4B14C893378F8D13A36E2028B30DC@IRMEXCH02.irm.inhs.org>
	<41CA05D55BF105489D33F8E57D71A9051716986760@MAIL-C.healthall.com>
Message-ID: <09E2B22E8D76B04280E994018E133C510DAFDD9C88@PEXCHNG2.cmc-dayton.org>

Happen to have the Nov '08 JADA open and it cites a large (over 47,000 men) study published in JAMA Aug 27 '08.

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ross, Janet
Sent: Friday, January 23, 2009 1:43 PM
To: 'Scott, Kerry R.'; Judith Arnet ; CKeinath at chs-mi.com; cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis

Maybe, but my mother's surgeon (fistula caused by a diverticulum) says he has NEVER seen a seed or piece of corn inside a diverticulum after years and years of surgery.  Hmmm.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Scott, Kerry R.
Sent: Friday, January 23, 2009 1:25 PM
To: Judith Arnet; CKeinath at chs-mi.com; cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis

I may be incorrect, but if I recall the study was on a very small group and suggested that perhaps further research was warrented?


Kerry Scott, RD, CD
Clinical Nutrition Manager
Food & Nutrition Services
Providence Sacred Heart Medical Center & Children's Hospital
(509)474-4774

Kerry.Scott at providence.org


________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Judith Arnet
Sent: Friday, January 23, 2009 10:27 AM
To: CKeinath at chs-mi.com; cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis
Educating the doctors with slow progress.  We're doing it face-to-face as cases present.

Judy Arnet, RD LD
Clinical Nutrition Manager
Boone Hospital Center
Columbia, MO  65203
(573)815-3353

>>> <CKeinath at chs-mi.com> 1/23/2009 12:10 PM >>>
I was wondering if anyone has then changed their diet sheets according to
the newest research, or are you educating the doctors on this to bring them
up to speed??

Carol Keinath

-------------------------------------------------------------------------

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

________________________________
NOTICE: The information contained in this e-mail and any accompanying documents or files is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited and possibly a violation of federal/state law or regulations.

If you received this information in error, please notify The Children's Medical Center of Dayton immediately via telephone at (937) 641-5293, or via electronic mail cmcconfidentiality at childrensdayton.org and promptly destroy the original message. Thank you.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/a769531f/attachment-0001.html 

From LAltenburger5 at matherhospital.org  Fri Jan 23 11:06:19 2009
From: LAltenburger5 at matherhospital.org (Altenburger, Linda)
Date: Fri, 23 Jan 2009 14:06:19 -0500
Subject: [Cnm] spoken menu
Message-ID: <A21BD3652C008E47BFD8BC00152BF7E60222ECD2@Exchange.jtmmh.org>

  

For those of you who have implemented a form of spoken menu, would you
be willing to share any pro's /con's you encountered with such?  Thank
you in advance. Feel free to email or call me personally.  Linda

 

Linda Altenburger, RD, CDN

Clinical Nutrition Manager

John. T. Mather Memorial Hospital

75 North Country Road

Port Jefferson, NY  11777

(631) 473-1320 ext 4176

laltenburger5 at matherhospital.org

fax:631-473-8752

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/35927d9e/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 2743 bytes
Desc: image001.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/35927d9e/attachment.jpe 

From Beth.Dorsey at tmcaz.com  Fri Jan 23 11:07:29 2009
From: Beth.Dorsey at tmcaz.com (Beth Dorsey)
Date: Fri, 23 Jan 2009 12:07:29 -0700
Subject: [Cnm] diverticulitis
Message-ID: <410CA779BF3C39428E37B41D6F06AFC802F3051A@TMCMAIL02.tmc.tmcaz.com>

What are the new recommendations and are they based on this research
from '08 JAMA?

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Friday, January 23, 2009 11:11 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis

I was wondering if anyone has then changed their diet sheets according
to
the newest research, or are you educating the doctors on this to bring
them
up to speed??

Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net




From horlowsk at ppmh.org  Fri Jan 23 11:33:33 2009
From: horlowsk at ppmh.org (Orlowski, Hannah)
Date: Fri, 23 Jan 2009 14:33:33 -0500
Subject: [Cnm] diverticulitis
In-Reply-To: <410CA779BF3C39428E37B41D6F06AFC802F3051A@TMCMAIL02.tmc.tmcaz.com>
Message-ID: <0DAF44B706E29940A409E32DC69005C00505EA40@exchange1.phoebe.com>

Please reply to all.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On
Behalf Of Beth Dorsey
Sent: Friday, January 23, 2009 2:07 PM
To: cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis


What are the new recommendations and are they based on this research
from '08 JAMA?

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Friday, January 23, 2009 11:11 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis

I was wondering if anyone has then changed their diet sheets according
to
the newest research, or are you educating the doctors on this to bring
them
up to speed??

Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-----------------------------------------
Disclaimer:
The HIPAA Final Privacy Rule requires covered entities to safeguard
certain Protected Health Information (PHI) related to a person's
healthcare.  Information being faxed to you may include PHI after
appropriate authorization from the patient or under circumstances
that do not require patient authorization.  You, the recipient, are
obligated to maintain PHI in a safe and secure manner.  You may not
re-disclose without additional patient consent or as required by
law.  Unauthorized re-disclosure or failure to safeguard PHI could
subject you to penalties described in federal (HIPAA) and state
law.  If you the reader of this message are not the intended
recipient, or the employee or agent responsible to deliver it to
the intended recipient, please notify us immediately and destroy
the related message.



From Becky.Wagner at health-partners.org  Fri Jan 23 13:02:28 2009
From: Becky.Wagner at health-partners.org (Becky.Wagner at health-partners.org)
Date: Fri, 23 Jan 2009 16:02:28 -0500
Subject: [Cnm] Becky A Wagner is out of the office.
Message-ID: <OFB8DAB26B.3FD7D42F-ON85257547.00739542-85257547.00739542@health-partners.org>


I will be out of the office starting  01/23/2009 and will not return until
01/26/2009.

I will respond to your message when I return.




CONFIDENTIALITY NOTICE:  This message, including any attachments, is for 
the sole use of the intended recipient(s) and may contain confidential and 
privileged information.  Any unauthorized review, use, disclosure or distribution 
is prohibited.  If you are not the intended recipient, please contact the 
sender by reply e-mail and destroy all copies of the original message.



From lpettet at sfmc.net  Fri Jan 23 13:49:55 2009
From: lpettet at sfmc.net (Lori Pettet)
Date: Fri, 23 Jan 2009 15:49:55 -0600
Subject: [Cnm] braden score as nutrition risk indicator
In-Reply-To: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D61E@S1EXH002>
References: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D61E@S1EXH002>
Message-ID: <4979E723020000C700013503@email_gateway.sfmc.net>

are these risk levels standard w/ the Braden scale or it this specific for your facility?

Lori Pettet, MA, RD, LD, CDE
Assistant Manager, Nutrition Services
Saint Francis Medical Center
211 St. Francis Dr. 
Cape Girardeau, MO  63703
Phone: 331-5145
LPettet at sfmc.net

This email transmittal is intended only for the use of the individual or entity to which it is addressed.  It may contain Protected Health Information, which is privileged and confidential.  Protected Health Information may only be used or disclosed in accordance with law and you may be subject to penalties under law for improper use or further disclosure of the Protected Health Information in this email.    If you are not the intended recipient of this email,  you may not read, copy, distribute or otherwise use or disclose the information contained in this email.    If you received this email  in error, please notify the sender immediately and request instructions on return or destruction of the information in this email. 


>>> "Flores, Rachel" <RachelFlores at sach.org> 01/23/09 11:21 AM >>>
< 12 is high risk, seen within 24 hours, 13-16 is moderate risk, seen within
3 days.

 

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

  _____  

From: Roxanne J. Davis-Cote [mailto:RDavis-Cote at bmhsc.org] 
Sent: Friday, January 23, 2009 8:13 AM
To: cnm at lists.my180.net 
Subject: [Cnm] braden score as nutrition risk indicator

 

What are other facilities using for braden score triggers if this is used at
all as a nutrition risk indicator?

 

 

Roxanne Davis-Cote, RD,LD

Clinical Nutrition Manager

Beaufort Memorial Hospital

rdavis-cote at bmhsc.org <mailto:rdavis-cote at bmhsc.org> 

phone: 843-522-5084

fax: 843-522-5700

 

**********************************************************************

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the system manager.

 

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

 

www.clearswift.com 

**********************************************************************

 

 

This message was scanned with MIMESweeper.




From RachelFlores at sach.org  Fri Jan 23 13:58:01 2009
From: RachelFlores at sach.org (Flores, Rachel)
Date: Fri, 23 Jan 2009 13:58:01 -0800
Subject: [Cnm] braden score as nutrition risk indicator
Message-ID: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D621@S1EXH002>

This is our facility.  I don't know if there is a standard nutrition risk
level for Braden scores.  This was proposed in our skin care committee, and
accepted as policy.  Personally, I would like to see the moderate risk
lowered from 16, but I don't think I have the clout to do it right now.

Rachel Flores, RD, CNSC
Clinical Nutrition Manager
San Antonio Community Hospital
(909) 985-2811 x24430
-----Original Message-----
From: Lori Pettet [mailto:lpettet at sfmc.net] 
Sent: Friday, January 23, 2009 1:50 PM
To: 'Roxanne J. Davis-Cote'; cnm at lists.my180.net; Rachel Flores
Subject: Re: [Cnm] braden score as nutrition risk indicator

are these risk levels standard w/ the Braden scale or it this specific for
your facility?

Lori Pettet, MA, RD, LD, CDE
Assistant Manager, Nutrition Services
Saint Francis Medical Center
211 St. Francis Dr. 
Cape Girardeau, MO  63703
Phone: 331-5145
LPettet at sfmc.net

This email transmittal is intended only for the use of the individual or
entity to which it is addressed.  It may contain Protected Health
Information, which is privileged and confidential.  Protected Health
Information may only be used or disclosed in accordance with law and you may
be subject to penalties under law for improper use or further disclosure of
the Protected Health Information in this email.    If you are not the
intended recipient of this email,  you may not read, copy, distribute or
otherwise use or disclose the information contained in this email.    If you
received this email  in error, please notify the sender immediately and
request instructions on return or destruction of the information in this
email. 


>>> "Flores, Rachel" <RachelFlores at sach.org> 01/23/09 11:21 AM >>>
< 12 is high risk, seen within 24 hours, 13-16 is moderate risk, seen within
3 days.

 

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

  _____  

From: Roxanne J. Davis-Cote [mailto:RDavis-Cote at bmhsc.org] 
Sent: Friday, January 23, 2009 8:13 AM
To: cnm at lists.my180.net 
Subject: [Cnm] braden score as nutrition risk indicator

 

What are other facilities using for braden score triggers if this is used at
all as a nutrition risk indicator?

 

 

Roxanne Davis-Cote, RD,LD

Clinical Nutrition Manager

Beaufort Memorial Hospital

rdavis-cote at bmhsc.org <mailto:rdavis-cote at bmhsc.org> 

phone: 843-522-5084

fax: 843-522-5700

 

**********************************************************************

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the system manager.

 

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

 

www.clearswift.com 

**********************************************************************

 

 

This message was scanned with MIMESweeper.



From skonruff at rehabhospitalwi.com  Fri Jan 23 14:08:58 2009
From: skonruff at rehabhospitalwi.com (Sallie Konruff)
Date: Fri, 23 Jan 2009 16:08:58 -0600
Subject: [Cnm] Nectar thick supplements
In-Reply-To: <4979E723020000C700013503@email_gateway.sfmc.net>
References: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D61E@S1EXH002>
	<4979E723020000C700013503@email_gateway.sfmc.net>
Message-ID: <B3EC332627F1E842A36F5E232F0CCCD1497D47@ch17.centerrehc.com>

Hi There;
Does anyone consider Ensure Plus (not regular Ensure) a nectar thick
liquid?  Another RD at another facility was using it this way but I
don't see that much difference and it isn't listed as nectar thick
liquid in the Ross Pocket Guide.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lori Pettet
Sent: Friday, January 23, 2009 3:50 PM
To: 'Roxanne J. Davis-Cote'; cnm at lists.my180.net; Rachel Flores
Subject: Re: [Cnm] braden score as nutrition risk indicator

are these risk levels standard w/ the Braden scale or it this specific
for your facility?

Lori Pettet, MA, RD, LD, CDE
Assistant Manager, Nutrition Services
Saint Francis Medical Center
211 St. Francis Dr. 
Cape Girardeau, MO  63703
Phone: 331-5145
LPettet at sfmc.net

This email transmittal is intended only for the use of the individual or
entity to which it is addressed.  It may contain Protected Health
Information, which is privileged and confidential.  Protected Health
Information may only be used or disclosed in accordance with law and you
may be subject to penalties under law for improper use or further
disclosure of the Protected Health Information in this email.    If you
are not the intended recipient of this email,  you may not read, copy,
distribute or otherwise use or disclose the information contained in
this email.    If you received this email  in error, please notify the
sender immediately and request instructions on return or destruction of
the information in this email. 


>>> "Flores, Rachel" <RachelFlores at sach.org> 01/23/09 11:21 AM >>>
< 12 is high risk, seen within 24 hours, 13-16 is moderate risk, seen
within
3 days.

 

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

  _____  

From: Roxanne J. Davis-Cote [mailto:RDavis-Cote at bmhsc.org] 
Sent: Friday, January 23, 2009 8:13 AM
To: cnm at lists.my180.net 
Subject: [Cnm] braden score as nutrition risk indicator

 

What are other facilities using for braden score triggers if this is
used at
all as a nutrition risk indicator?

 

 

Roxanne Davis-Cote, RD,LD

Clinical Nutrition Manager

Beaufort Memorial Hospital

rdavis-cote at bmhsc.org <mailto:rdavis-cote at bmhsc.org> 

phone: 843-522-5084

fax: 843-522-5700

 

**********************************************************************

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the system manager.

 

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

 

www.clearswift.com 

**********************************************************************

 

 

This message was scanned with MIMESweeper.



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From rtripp at PINNACLEHEALTH.org  Fri Jan 23 14:19:15 2009
From: rtripp at PINNACLEHEALTH.org (Roberta Tripp)
Date: Fri, 23 Jan 2009 17:19:15 -0500
Subject: [Cnm] Nectar thick supplements
In-Reply-To: <B3EC332627F1E842A36F5E232F0CCCD1497D47@ch17.centerrehc.com>
Message-ID: <7375E17267B3DB4583032BDEFDA2D76E0902F3B2@mailphs.pinnaclehealth.org>

I was told that any liquid supplement would have to be thickened to meet
the definition of a nectar thickened liquid.

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org
 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sallie Konruff
Sent: Friday, January 23, 2009 5:09 PM
To: Lori Pettet; Roxanne J. Davis-Cote; cnm at lists.my180.net; Rachel
Flores
Subject: [Cnm] Nectar thick supplements


Hi There;
Does anyone consider Ensure Plus (not regular Ensure) a nectar thick
liquid?  Another RD at another facility was using it this way but I
don't see that much difference and it isn't listed as nectar thick
liquid in the Ross Pocket Guide.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lori Pettet
Sent: Friday, January 23, 2009 3:50 PM
To: 'Roxanne J. Davis-Cote'; cnm at lists.my180.net; Rachel Flores
Subject: Re: [Cnm] braden score as nutrition risk indicator

are these risk levels standard w/ the Braden scale or it this specific
for your facility?

Lori Pettet, MA, RD, LD, CDE
Assistant Manager, Nutrition Services
Saint Francis Medical Center
211 St. Francis Dr. 
Cape Girardeau, MO  63703
Phone: 331-5145
LPettet at sfmc.net

This email transmittal is intended only for the use of the individual or
entity to which it is addressed.  It may contain Protected Health
Information, which is privileged and confidential.  Protected Health
Information may only be used or disclosed in accordance with law and you
may be subject to penalties under law for improper use or further
disclosure of the Protected Health Information in this email.    If you
are not the intended recipient of this email,  you may not read, copy,
distribute or otherwise use or disclose the information contained in
this email.    If you received this email  in error, please notify the
sender immediately and request instructions on return or destruction of
the information in this email. 


>>> "Flores, Rachel" <RachelFlores at sach.org> 01/23/09 11:21 AM >>>
< 12 is high risk, seen within 24 hours, 13-16 is moderate risk, seen
within
3 days.

 

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

  _____  

From: Roxanne J. Davis-Cote [mailto:RDavis-Cote at bmhsc.org]
Sent: Friday, January 23, 2009 8:13 AM
To: cnm at lists.my180.net
Subject: [Cnm] braden score as nutrition risk indicator

 

What are other facilities using for braden score triggers if this is
used at
all as a nutrition risk indicator?

 

 

Roxanne Davis-Cote, RD,LD

Clinical Nutrition Manager

Beaufort Memorial Hospital

rdavis-cote at bmhsc.org <mailto:rdavis-cote at bmhsc.org> 

phone: 843-522-5084

fax: 843-522-5700

 

**********************************************************************

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the system manager.

 

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

 

www.clearswift.com 

**********************************************************************

 

 

This message was scanned with MIMESweeper.



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.


From Julie.Finney at csauh.com  Fri Jan 23 14:19:54 2009
From: Julie.Finney at csauh.com (Finney, Julie)
Date: Fri, 23 Jan 2009 17:19:54 -0500
Subject: [Cnm] braden score as nutrition risk indicator
In-Reply-To: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D621@S1EXH002>
References: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D621@S1EXH002>
Message-ID: <B9A8C7549DCFE748BFF67E8AB640572603012AED@csauhex02.csauh.com>

At one point someone on this list indicated that they used the nutrition
component of the Braden Score as a trigger.  Not every patient with a
Braden that totals 16 has nutrition problems, but if the Braden Score is
applied properly, a nutrition score of 2 or less can be a tool to
identify patients eating <50% of their meals and probably someone (RD or
tech or Diet office) should see what can be done to improve the
situation.

We have adopted the practice of seeing patients with a Braden Nutrition
Score of 2 or less.  Our hospital did considerable training during 2008
on the Braden score and we generally get appropriate referrals through
this trigger.  Our skin work group was sensitive to the dietitian
staffing implications that using the total score (they wanted to raise
the total score from 14 to 18 for an automatic RD referral - pulling out
the nutrition score was an acceptable compromise.)

Skin committees like the Braden scale because it does indicate risk of
developing pressure ulcers.  Thing is, pressure ulcers can develop in a
well-nourished patient and our time is best spent with the patients at
greatest nutrition risk, intact skin, or not.  You are catching me on a
day that I just feel some people just start everyone on a supplement -
which is another favorite intervention of skin committees.

Have a great weekend!

Julie

Julie Finney, MS, RD, LD
Clinical Nutrition Manager
Mercy Medical Center
1320 Mercy Drive, NW
Canton, Ohio 44708
330-489-1000 ext. 1600
 
Julie.Finney at csauh.com

-----------------------------------------
The enclosed information is STRICTLY CONFIDENTIAL and is intended
for the use of the addressee only.   CSAHS/UHHS-Canton, Inc and its
affiliates disclaim any responsibility for unauthorized disclosure
of this information other than the addressee.

Federal and Ohio law protect patient medical information disclosed
in this email, including psychiatric disorders, (HIV) test results,
AIDs-related conditions, alcohol, and/or drug dependence or abuse.
Federal regulation (42 CFR Part 2) and Ohio Revised Code section
5122.31 and 3701.243 prohibit disclosure of this information
without the specific written consent of the person to whom it
pertains, or as otherwise permitted by law.


From lheller at chla.usc.edu  Fri Jan 23 14:21:19 2009
From: lheller at chla.usc.edu (Heller, Linda)
Date: Fri, 23 Jan 2009 14:21:19 -0800
Subject: [Cnm] Nectar thick supplements
In-Reply-To: <7375E17267B3DB4583032BDEFDA2D76E0902F3B2@mailphs.pinnaclehealth.org>
References: <B3EC332627F1E842A36F5E232F0CCCD1497D47@ch17.centerrehc.com>
	<7375E17267B3DB4583032BDEFDA2D76E0902F3B2@mailphs.pinnaclehealth.org>
Message-ID: <3205F1A677E3B641B2DCC676554B4C1703220140@CHLAEXVS01.LA.AD.CHLA.ORG>

Agreed. My understanding also was that there is no unaltered nectar
thick liquid. I'd be interested in looking at the Ross guide.

Linda Heller, MS RD CSP CLE 
Clinical Nutrition Manager 
Childrens Hospital Los Angeles 

(323)361-2179

(323) 361-3619 FAX

lheller at chla.usc.edu

 


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Roberta Tripp
Sent: Friday, January 23, 2009 2:19 PM
To: Sallie Konruff; Lori Pettet; Roxanne J. Davis-Cote;
cnm at lists.my180.net; Rachel Flores
Subject: Re: [Cnm] Nectar thick supplements

I was told that any liquid supplement would have to be thickened to meet
the definition of a nectar thickened liquid.

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org
 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sallie Konruff
Sent: Friday, January 23, 2009 5:09 PM
To: Lori Pettet; Roxanne J. Davis-Cote; cnm at lists.my180.net; Rachel
Flores
Subject: [Cnm] Nectar thick supplements


Hi There;
Does anyone consider Ensure Plus (not regular Ensure) a nectar thick
liquid?  Another RD at another facility was using it this way but I
don't see that much difference and it isn't listed as nectar thick
liquid in the Ross Pocket Guide.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lori Pettet
Sent: Friday, January 23, 2009 3:50 PM
To: 'Roxanne J. Davis-Cote'; cnm at lists.my180.net; Rachel Flores
Subject: Re: [Cnm] braden score as nutrition risk indicator

are these risk levels standard w/ the Braden scale or it this specific
for your facility?

Lori Pettet, MA, RD, LD, CDE
Assistant Manager, Nutrition Services
Saint Francis Medical Center
211 St. Francis Dr. 
Cape Girardeau, MO  63703
Phone: 331-5145
LPettet at sfmc.net

This email transmittal is intended only for the use of the individual or
entity to which it is addressed.  It may contain Protected Health
Information, which is privileged and confidential.  Protected Health
Information may only be used or disclosed in accordance with law and you
may be subject to penalties under law for improper use or further
disclosure of the Protected Health Information in this email.    If you
are not the intended recipient of this email,  you may not read, copy,
distribute or otherwise use or disclose the information contained in
this email.    If you received this email  in error, please notify the
sender immediately and request instructions on return or destruction of
the information in this email. 


>>> "Flores, Rachel" <RachelFlores at sach.org> 01/23/09 11:21 AM >>>
< 12 is high risk, seen within 24 hours, 13-16 is moderate risk, seen
within
3 days.

 

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

  _____  

From: Roxanne J. Davis-Cote [mailto:RDavis-Cote at bmhsc.org]
Sent: Friday, January 23, 2009 8:13 AM
To: cnm at lists.my180.net
Subject: [Cnm] braden score as nutrition risk indicator

 

What are other facilities using for braden score triggers if this is
used at
all as a nutrition risk indicator?

 

 

Roxanne Davis-Cote, RD,LD

Clinical Nutrition Manager

Beaufort Memorial Hospital

rdavis-cote at bmhsc.org <mailto:rdavis-cote at bmhsc.org> 

phone: 843-522-5084

fax: 843-522-5700

 

**********************************************************************

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the system manager.

 

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

 

www.clearswift.com 

**********************************************************************

 

 

This message was scanned with MIMESweeper.



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net




From tak9006 at nyp.org  Fri Jan 23 14:31:50 2009
From: tak9006 at nyp.org (Takami Kim)
Date: Fri, 23 Jan 2009 17:31:50 -0500
Subject: [Cnm] Nectar thick supplements
In-Reply-To: <B3EC332627F1E842A36F5E232F0CCCD1497D47@ch17.centerrehc.com>
References: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D61E@S1EXH002>
	<4979E723020000C700013503@email_gateway.sfmc.net>
	<B3EC332627F1E842A36F5E232F0CCCD1497D47@ch17.centerrehc.com>
Message-ID: <497A4556.8090009@nyp.org>

This depends on what your practice is at your institution and how 
closely the dietitian works with the SLPs to ensure what the patient is 
tolerating.
In my first job as a dietitian, I worked on a TBI rehab floor filled 
with dysphagia patients.  SLPs often checked patients' tolerance during 
lunch time and I used to do meal rounds daily to monitor tolerance, 
intake and communicate with SLPs.  We communicated daily about patients- 
new patients, upgrades, downgrades of food texture and liquid 
consistencies.  When a patient was on nectar (ie. can not tolerate thin 
liquid, as thin as water, juice, tea) the patient received prethickened 
products.  Thickener was also used according to the instructions to 
thicken other beverages/liquids.  But especially when a patient's intake 
was suboptimal, I would speak to the SLPs to see if the can tolerate 
Ensure + without thickening.  Then she would tell me yes or no.  It 
would be communicated to the care team and documented.  Individualizing 
dysphagia care really helped boost intake in cases like this.  I was 
able to do this because of the low patient to SLP ratio on this unit and 
the high frequency of follow-up and communication among the care team.

So Ensure + can be nectar depending on what the patient can tolerate.  
It is significantly thicker than thin but not as thick as prethickened 
beverages or beverages thickened using the instruction on a thickener.  
But you need communication, team work and appropriate documentation to 
do this.

Hope this helps.
Takami Kim, MS RD CDN
Supervisor, Clinical Nutrition Services
NewYork-Presbyterian Hospital

Sallie Konruff wrote:
> Hi There;
> Does anyone consider Ensure Plus (not regular Ensure) a nectar thick
> liquid?  Another RD at another facility was using it this way but I
> don't see that much difference and it isn't listed as nectar thick
> liquid in the Ross Pocket Guide.
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Lori Pettet
> Sent: Friday, January 23, 2009 3:50 PM
> To: 'Roxanne J. Davis-Cote'; cnm at lists.my180.net; Rachel Flores
> Subject: Re: [Cnm] braden score as nutrition risk indicator
>
> are these risk levels standard w/ the Braden scale or it this specific
> for your facility?
>
> Lori Pettet, MA, RD, LD, CDE
> Assistant Manager, Nutrition Services
> Saint Francis Medical Center
> 211 St. Francis Dr. 
> Cape Girardeau, MO  63703
> Phone: 331-5145
> LPettet at sfmc.net
>
> This email transmittal is intended only for the use of the individual or
> entity to which it is addressed.  It may contain Protected Health
> Information, which is privileged and confidential.  Protected Health
> Information may only be used or disclosed in accordance with law and you
> may be subject to penalties under law for improper use or further
> disclosure of the Protected Health Information in this email.    If you
> are not the intended recipient of this email,  you may not read, copy,
> distribute or otherwise use or disclose the information contained in
> this email.    If you received this email  in error, please notify the
> sender immediately and request instructions on return or destruction of
> the information in this email. 
>
>
>   
>>>> "Flores, Rachel" <RachelFlores at sach.org> 01/23/09 11:21 AM >>>
>>>>         
> < 12 is high risk, seen within 24 hours, 13-16 is moderate risk, seen
> within
> 3 days.
>
>  
>
> Rachel Flores, RD, CNSC
>
> Clinical Nutrition Manager
>
> San Antonio Community Hospital
>
> (909) 985-2811 x24430
>
>   _____  
>
> From: Roxanne J. Davis-Cote [mailto:RDavis-Cote at bmhsc.org] 
> Sent: Friday, January 23, 2009 8:13 AM
> To: cnm at lists.my180.net 
> Subject: [Cnm] braden score as nutrition risk indicator
>
>  
>
> What are other facilities using for braden score triggers if this is
> used at
> all as a nutrition risk indicator?
>
>  
>
>  
>
> Roxanne Davis-Cote, RD,LD
>
> Clinical Nutrition Manager
>
> Beaufort Memorial Hospital
>
> rdavis-cote at bmhsc.org <mailto:rdavis-cote at bmhsc.org> 
>
> phone: 843-522-5084
>
> fax: 843-522-5700
>
>  
>
> **********************************************************************
>
> This email and any files transmitted with it are confidential and
>
> intended solely for the use of the individual or entity to whom they
>
> are addressed. If you have received this email in error please notify
>
> the system manager.
>
>  
>
> This footnote also confirms that this email message has been swept by
>
> MIMEsweeper for the presence of computer viruses.
>
>  
>
> www.clearswift.com 
>
> **********************************************************************
>
>  
>
>  
>
> This message was scanned with MIMESweeper.
>
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>   




--------------------

This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited.  If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message.  Thank you.




From marissa.hofman at ucdmc.ucdavis.edu  Fri Jan 23 14:35:11 2009
From: marissa.hofman at ucdmc.ucdavis.edu (Marissa Hofman)
Date: Fri, 23 Jan 2009 14:35:11 -0800
Subject: [Cnm] Nectar thick supplements
In-Reply-To: <3205F1A677E3B641B2DCC676554B4C1703220140@CHLAEXVS01.LA.AD.CHLA.ORG>
Message-ID: <OF2717A2B7.BCE03507-ON88257547.007BB8C7-88257547.007C1246@ucdmc.ucdavis.edu>


The only product I know of that is Nectar consistency is Resource NSA
Health Shakes. The regular version may be as well, but I am not certain.

We work very closely with our speech pathologists on the appropriate
consistency of supplements for patients.  They should be able to tell you
if a specific formula is the appropriate consistency for a patient.


Marissa Hofman, RD
Clinical Nutrition Manager
UC Davis Medical Center
Food & Nutrition Dept.
2315 Stockton Blvd
Sacramento, CA 95817
Phone: (916) 734-5100
Fax: (916)734-3154


                                                                           
             "Heller, Linda"                                               
             <lheller at chla.usc                                             
             .edu>                                                      To 
             Sent by:                  "Roberta Tripp"                     
             cnm-bounces at lists         <rtripp at PINNACLEHEALTH.org>,        
             .my180.net                "Sallie Konruff"                    
                                       <skonruff at rehabhospitalwi.com>,     
                                       "Lori Pettet" <lpettet at sfmc.net>,   
             01/23/2009 02:25          "Roxanne J. Davis-Cote"             
             PM                        <RDavis-Cote at bmhsc.org>,            
                                       cnm at lists.my180.net, "Rachel        
                                       Flores" <RachelFlores at sach.org>     
                                                                        cc 
                                                                           
                                                                   Subject 
                                       Re: [Cnm] Nectar thick supplements  
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           




Agreed. My understanding also was that there is no unaltered nectar
thick liquid. I'd be interested in looking at the Ross guide.

Linda Heller, MS RD CSP CLE
Clinical Nutrition Manager
Childrens Hospital Los Angeles

(323)361-2179

(323) 361-3619 FAX

lheller at chla.usc.edu




-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Roberta Tripp
Sent: Friday, January 23, 2009 2:19 PM
To: Sallie Konruff; Lori Pettet; Roxanne J. Davis-Cote;
cnm at lists.my180.net; Rachel Flores
Subject: Re: [Cnm] Nectar thick supplements

I was told that any liquid supplement would have to be thickened to meet
the definition of a nectar thickened liquid.

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sallie Konruff
Sent: Friday, January 23, 2009 5:09 PM
To: Lori Pettet; Roxanne J. Davis-Cote; cnm at lists.my180.net; Rachel
Flores
Subject: [Cnm] Nectar thick supplements


Hi There;
Does anyone consider Ensure Plus (not regular Ensure) a nectar thick
liquid?  Another RD at another facility was using it this way but I
don't see that much difference and it isn't listed as nectar thick
liquid in the Ross Pocket Guide.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lori Pettet
Sent: Friday, January 23, 2009 3:50 PM
To: 'Roxanne J. Davis-Cote'; cnm at lists.my180.net; Rachel Flores
Subject: Re: [Cnm] braden score as nutrition risk indicator

are these risk levels standard w/ the Braden scale or it this specific
for your facility?

Lori Pettet, MA, RD, LD, CDE
Assistant Manager, Nutrition Services
Saint Francis Medical Center
211 St. Francis Dr.
Cape Girardeau, MO  63703
Phone: 331-5145
LPettet at sfmc.net

This email transmittal is intended only for the use of the individual or
entity to which it is addressed.  It may contain Protected Health
Information, which is privileged and confidential.  Protected Health
Information may only be used or disclosed in accordance with law and you
may be subject to penalties under law for improper use or further
disclosure of the Protected Health Information in this email.    If you
are not the intended recipient of this email,  you may not read, copy,
distribute or otherwise use or disclose the information contained in
this email.    If you received this email  in error, please notify the
sender immediately and request instructions on return or destruction of
the information in this email.


>>> "Flores, Rachel" <RachelFlores at sach.org> 01/23/09 11:21 AM >>>
< 12 is high risk, seen within 24 hours, 13-16 is moderate risk, seen
within
3 days.



Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

  _____

From: Roxanne J. Davis-Cote [mailto:RDavis-Cote at bmhsc.org]
Sent: Friday, January 23, 2009 8:13 AM
To: cnm at lists.my180.net
Subject: [Cnm] braden score as nutrition risk indicator



What are other facilities using for braden score triggers if this is
used at
all as a nutrition risk indicator?





Roxanne Davis-Cote, RD,LD

Clinical Nutrition Manager

Beaufort Memorial Hospital

rdavis-cote at bmhsc.org <mailto:rdavis-cote at bmhsc.org>

phone: 843-522-5084

fax: 843-522-5700



**********************************************************************

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the system manager.



This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.



www.clearswift.com

**********************************************************************





This message was scanned with MIMESweeper.



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/27fff5f5/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: graycol.gif
Type: image/gif
Size: 105 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/27fff5f5/attachment-0003.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: pic08932.gif
Type: image/gif
Size: 1255 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/27fff5f5/attachment-0004.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: ecblank.gif
Type: image/gif
Size: 45 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/27fff5f5/attachment-0005.gif 

From Cathy.Poquette at stjoe.org  Fri Jan 23 14:49:32 2009
From: Cathy.Poquette at stjoe.org (Cathy Poquette)
Date: Fri, 23 Jan 2009 14:49:32 -0800
Subject: [Cnm] Nectar thick supplements
In-Reply-To: <497A4556.8090009@nyp.org>
Message-ID: <E3453D1D67CA5E4DA378CB009C9AD6A66F0B3DE604@SJSNT-SCMAIL01.stjoe.org>

That is exactly the process here at my hospital.  Our SLP's work closely with the patients to determine tolerance and make adjustments in their diet consistency and liquid consistency to meet the patients needs to avoid chance of aspiration.  We have an interdisciplinary committee that includes the Manager of the SLP's, a practicing SLP, myself (RD/CNM) and one of our FS Operations Managers.  We have put together a 4 level texture diet and 4 level of liquid consistencies starting with the National Dysphagia Diet as our guide.  The SLP's on this committee test all liquids we serve and have developed a list of liquids that are appropriate for each liquid consistency level.

Regarding nectar thick liquids, they have approved the following to be served as nectar thick - do not have to be thickened to nectar thick as they are nectar thick:
Carbonated beverages (carbonation is the real key to approval of this)
Buttermilk
Apricot , Mango and papaya nectar fruit juices
Tomato of V-8 juice

Carnation Instant Breakfast - Very High Calorie (VHC)
Machine Milkshakes (soft serve)
Frozen sugar free health shake and mighty shake
Enlive or Boost Breeze
Resource Juice Drink

Hope this helps.  I have attached a copy of our educational handout that we have developed to train staff and educate patients to the different texture levels and liquid consistencies of the Dysphagia Diet.

Cathy Poquette, MS, RD
Clinical Nutrition Operations Manager
St Jude Medical Center
Fullerton, CA

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Takami Kim
Sent: Friday, January 23, 2009 2:32 PM
To: Sallie Konruff
Cc: Roxanne J. Davis-Cote; cnm at lists.my180.net; Rachel Flores
Subject: Re: [Cnm] Nectar thick supplements

This depends on what your practice is at your institution and how
closely the dietitian works with the SLPs to ensure what the patient is
tolerating.
In my first job as a dietitian, I worked on a TBI rehab floor filled
with dysphagia patients.  SLPs often checked patients' tolerance during
lunch time and I used to do meal rounds daily to monitor tolerance,
intake and communicate with SLPs.  We communicated daily about patients-
new patients, upgrades, downgrades of food texture and liquid
consistencies.  When a patient was on nectar (ie. can not tolerate thin
liquid, as thin as water, juice, tea) the patient received prethickened
products.  Thickener was also used according to the instructions to
thicken other beverages/liquids.  But especially when a patient's intake
was suboptimal, I would speak to the SLPs to see if the can tolerate
Ensure + without thickening.  Then she would tell me yes or no.  It
would be communicated to the care team and documented.  Individualizing
dysphagia care really helped boost intake in cases like this.  I was
able to do this because of the low patient to SLP ratio on this unit and
the high frequency of follow-up and communication among the care team.

So Ensure + can be nectar depending on what the patient can tolerate.
It is significantly thicker than thin but not as thick as prethickened
beverages or beverages thickened using the instruction on a thickener.
But you need communication, team work and appropriate documentation to
do this.

Hope this helps.
Takami Kim, MS RD CDN
Supervisor, Clinical Nutrition Services
NewYork-Presbyterian Hospital

Sallie Konruff wrote:
> Hi There;
> Does anyone consider Ensure Plus (not regular Ensure) a nectar thick
> liquid?  Another RD at another facility was using it this way but I
> don't see that much difference and it isn't listed as nectar thick
> liquid in the Ross Pocket Guide.
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Lori Pettet
> Sent: Friday, January 23, 2009 3:50 PM
> To: 'Roxanne J. Davis-Cote'; cnm at lists.my180.net; Rachel Flores
> Subject: Re: [Cnm] braden score as nutrition risk indicator
>
> are these risk levels standard w/ the Braden scale or it this specific
> for your facility?
>
> Lori Pettet, MA, RD, LD, CDE
> Assistant Manager, Nutrition Services
> Saint Francis Medical Center
> 211 St. Francis Dr.
> Cape Girardeau, MO  63703
> Phone: 331-5145
> LPettet at sfmc.net
>
> This email transmittal is intended only for the use of the individual or
> entity to which it is addressed.  It may contain Protected Health
> Information, which is privileged and confidential.  Protected Health
> Information may only be used or disclosed in accordance with law and you
> may be subject to penalties under law for improper use or further
> disclosure of the Protected Health Information in this email.    If you
> are not the intended recipient of this email,  you may not read, copy,
> distribute or otherwise use or disclose the information contained in
> this email.    If you received this email  in error, please notify the
> sender immediately and request instructions on return or destruction of
> the information in this email.
>
>
>
>>>> "Flores, Rachel" <RachelFlores at sach.org> 01/23/09 11:21 AM >>>
>>>>
> < 12 is high risk, seen within 24 hours, 13-16 is moderate risk, seen
> within
> 3 days.
>
>
>
> Rachel Flores, RD, CNSC
>
> Clinical Nutrition Manager
>
> San Antonio Community Hospital
>
> (909) 985-2811 x24430
>
>   _____
>
> From: Roxanne J. Davis-Cote [mailto:RDavis-Cote at bmhsc.org]
> Sent: Friday, January 23, 2009 8:13 AM
> To: cnm at lists.my180.net
> Subject: [Cnm] braden score as nutrition risk indicator
>
>
>
> What are other facilities using for braden score triggers if this is
> used at
> all as a nutrition risk indicator?
>
>
>
>
>
> Roxanne Davis-Cote, RD,LD
>
> Clinical Nutrition Manager
>
> Beaufort Memorial Hospital
>
> rdavis-cote at bmhsc.org <mailto:rdavis-cote at bmhsc.org>
>
> phone: 843-522-5084
>
> fax: 843-522-5700
>
>
>
> **********************************************************************
>
> This email and any files transmitted with it are confidential and
>
> intended solely for the use of the individual or entity to whom they
>
> are addressed. If you have received this email in error please notify
>
> the system manager.
>
>
>
> This footnote also confirms that this email message has been swept by
>
> MIMEsweeper for the presence of computer viruses.
>
>
>
> www.clearswift.com
>
> **********************************************************************
>
>
>
>
>
> This message was scanned with MIMESweeper.
>
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>




--------------------

This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited.  If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message.  Thank you.



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


Notice from St.Joseph Health System:
Please note that the information contained in this message may be privileged and confidential and protected from disclosure.
-------------- next part --------------
A non-text attachment was scrubbed...
Name: DYSPHAGIA DIET SUMMARY - Revised 4.08.doc
Type: application/msword
Size: 55808 bytes
Desc: DYSPHAGIA DIET SUMMARY - Revised 4.08.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/67de800a/attachment-0002.doc 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Dysphagia SJMC Approved Liquid Consistencies 4.08.doc
Type: application/msword
Size: 47616 bytes
Desc: Dysphagia SJMC Approved Liquid Consistencies 4.08.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/67de800a/attachment-0003.doc 

From tak9006 at nyp.org  Fri Jan 23 15:14:19 2009
From: tak9006 at nyp.org (Takami Kim)
Date: Fri, 23 Jan 2009 18:14:19 -0500
Subject: [Cnm] Nectar thick supplements
In-Reply-To: <E3453D1D67CA5E4DA378CB009C9AD6A66F0B3DE604@SJSNT-SCMAIL01.stjoe.org>
References: <E3453D1D67CA5E4DA378CB009C9AD6A66F0B3DE604@SJSNT-SCMAIL01.stjoe.org>
Message-ID: <497A4F4B.3000900@nyp.org>

That is wonderful that you are working so closely with the SLPs.
What does the SLPs at your site use to test patients' tolerance to liquid?

Takami Kim, MS RD CDN
Supervisor, Clinical Nutrition Services
NewYork-Prebyterian Hospital

Cathy Poquette wrote:
> That is exactly the process here at my hospital.  Our SLP's work closely with the patients to determine tolerance and make adjustments in their diet consistency and liquid consistency to meet the patients needs to avoid chance of aspiration.  We have an interdisciplinary committee that includes the Manager of the SLP's, a practicing SLP, myself (RD/CNM) and one of our FS Operations Managers.  We have put together a 4 level texture diet and 4 level of liquid consistencies starting with the National Dysphagia Diet as our guide.  The SLP's on this committee test all liquids we serve and have developed a list of liquids that are appropriate for each liquid consistency level.
>
> Regarding nectar thick liquids, they have approved the following to be served as nectar thick - do not have to be thickened to nectar thick as they are nectar thick:
> Carbonated beverages (carbonation is the real key to approval of this)
> Buttermilk
> Apricot , Mango and papaya nectar fruit juices
> Tomato of V-8 juice
>
> Carnation Instant Breakfast - Very High Calorie (VHC)
> Machine Milkshakes (soft serve)
> Frozen sugar free health shake and mighty shake
> Enlive or Boost Breeze
> Resource Juice Drink
>
> Hope this helps.  I have attached a copy of our educational handout that we have developed to train staff and educate patients to the different texture levels and liquid consistencies of the Dysphagia Diet.
>
> Cathy Poquette, MS, RD
> Clinical Nutrition Operations Manager
> St Jude Medical Center
> Fullerton, CA
>
> -----Original Message-----
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Takami Kim
> Sent: Friday, January 23, 2009 2:32 PM
> To: Sallie Konruff
> Cc: Roxanne J. Davis-Cote; cnm at lists.my180.net; Rachel Flores
> Subject: Re: [Cnm] Nectar thick supplements
>
> This depends on what your practice is at your institution and how
> closely the dietitian works with the SLPs to ensure what the patient is
> tolerating.
> In my first job as a dietitian, I worked on a TBI rehab floor filled
> with dysphagia patients.  SLPs often checked patients' tolerance during
> lunch time and I used to do meal rounds daily to monitor tolerance,
> intake and communicate with SLPs.  We communicated daily about patients-
> new patients, upgrades, downgrades of food texture and liquid
> consistencies.  When a patient was on nectar (ie. can not tolerate thin
> liquid, as thin as water, juice, tea) the patient received prethickened
> products.  Thickener was also used according to the instructions to
> thicken other beverages/liquids.  But especially when a patient's intake
> was suboptimal, I would speak to the SLPs to see if the can tolerate
> Ensure + without thickening.  Then she would tell me yes or no.  It
> would be communicated to the care team and documented.  Individualizing
> dysphagia care really helped boost intake in cases like this.  I was
> able to do this because of the low patient to SLP ratio on this unit and
> the high frequency of follow-up and communication among the care team.
>
> So Ensure + can be nectar depending on what the patient can tolerate.
> It is significantly thicker than thin but not as thick as prethickened
> beverages or beverages thickened using the instruction on a thickener.
> But you need communication, team work and appropriate documentation to
> do this.
>
> Hope this helps.
> Takami Kim, MS RD CDN
> Supervisor, Clinical Nutrition Services
> NewYork-Presbyterian Hospital
>
> Sallie Konruff wrote:
>   
>> Hi There;
>> Does anyone consider Ensure Plus (not regular Ensure) a nectar thick
>> liquid?  Another RD at another facility was using it this way but I
>> don't see that much difference and it isn't listed as nectar thick
>> liquid in the Ross Pocket Guide.
>>
>> -----Original Message-----
>> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
>> On Behalf Of Lori Pettet
>> Sent: Friday, January 23, 2009 3:50 PM
>> To: 'Roxanne J. Davis-Cote'; cnm at lists.my180.net; Rachel Flores
>> Subject: Re: [Cnm] braden score as nutrition risk indicator
>>
>> are these risk levels standard w/ the Braden scale or it this specific
>> for your facility?
>>
>> Lori Pettet, MA, RD, LD, CDE
>> Assistant Manager, Nutrition Services
>> Saint Francis Medical Center
>> 211 St. Francis Dr.
>> Cape Girardeau, MO  63703
>> Phone: 331-5145
>> LPettet at sfmc.net
>>
>> This email transmittal is intended only for the use of the individual or
>> entity to which it is addressed.  It may contain Protected Health
>> Information, which is privileged and confidential.  Protected Health
>> Information may only be used or disclosed in accordance with law and you
>> may be subject to penalties under law for improper use or further
>> disclosure of the Protected Health Information in this email.    If you
>> are not the intended recipient of this email,  you may not read, copy,
>> distribute or otherwise use or disclose the information contained in
>> this email.    If you received this email  in error, please notify the
>> sender immediately and request instructions on return or destruction of
>> the information in this email.
>>
>>
>>
>>     
>>>>> "Flores, Rachel" <RachelFlores at sach.org> 01/23/09 11:21 AM >>>
>>>>>
>>>>>           
>> < 12 is high risk, seen within 24 hours, 13-16 is moderate risk, seen
>> within
>> 3 days.
>>
>>
>>
>> Rachel Flores, RD, CNSC
>>
>> Clinical Nutrition Manager
>>
>> San Antonio Community Hospital
>>
>> (909) 985-2811 x24430
>>
>>   _____
>>
>> From: Roxanne J. Davis-Cote [mailto:RDavis-Cote at bmhsc.org]
>> Sent: Friday, January 23, 2009 8:13 AM
>> To: cnm at lists.my180.net
>> Subject: [Cnm] braden score as nutrition risk indicator
>>
>>
>>
>> What are other facilities using for braden score triggers if this is
>> used at
>> all as a nutrition risk indicator?
>>
>>
>>
>>
>>
>> Roxanne Davis-Cote, RD,LD
>>
>> Clinical Nutrition Manager
>>
>> Beaufort Memorial Hospital
>>
>> rdavis-cote at bmhsc.org <mailto:rdavis-cote at bmhsc.org>
>>
>> phone: 843-522-5084
>>
>> fax: 843-522-5700
>>
>>
>>
>> **********************************************************************
>>
>> This email and any files transmitted with it are confidential and
>>
>> intended solely for the use of the individual or entity to whom they
>>
>> are addressed. If you have received this email in error please notify
>>
>> the system manager.
>>
>>
>>
>> This footnote also confirms that this email message has been swept by
>>
>> MIMEsweeper for the presence of computer viruses.
>>
>>
>>
>> www.clearswift.com
>>
>> **********************************************************************
>>
>>
>>
>>
>>
>> This message was scanned with MIMESweeper.
>>
>>
>>
>> _______________________________________________
>> Cnm mailing list
>> Cnm at lists.my180.net
>> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>>
>> _______________________________________________
>> Cnm mailing list
>> Cnm at lists.my180.net
>> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>>
>>     
>
>
>
>
> --------------------
>
> This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited.  If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message.  Thank you.
>
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
>
> Notice from St.Joseph Health System:
> Please note that the information contained in this message may be privileged and confidential and protected from disclosure.
>   




--------------------

This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited.  If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message.  Thank you.




From Karen.Auwaerter at chw.edu  Fri Jan 23 15:16:40 2009
From: Karen.Auwaerter at chw.edu (Auwaerter, Karen - MSJ)
Date: Fri, 23 Jan 2009 16:16:40 -0700
Subject: [Cnm] nutrition labeling for cafeteria
Message-ID: <891DC7E14FC0F449874219D643CB1CA8063D02D5@CHW-MSG-403.chw.edu>

Sacramento County has a new food regulation:  we must label all self
serve foods with the ingredients, serving size, place of business.  In
addition, we would like to add a UPC code for our cash register scanner
and a nutrition label.  We just had a sales rep visit us and he had a
very expensive printer and label program, but we weren't satisfied with
it.  Do any of you know of a software program that will create nutrition
labels and a UPC code?  Thanks so much.

Karen Auwaerter, RD
Manager, Nutrition and Food Services
Mercy San Juan Medical Center
Greater Sacramento Area
916 537 5104 phone
916 859 1238 fax

"Those who think they have no time for healthy eating will sooner or
later have to find
time for illness."


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/f1613795/attachment.html 

From steppinoutwithmrh at yahoo.com  Fri Jan 23 17:30:11 2009
From: steppinoutwithmrh at yahoo.com (Amy Jones)
Date: Fri, 23 Jan 2009 17:30:11 -0800 (PST)
Subject: [Cnm] diverticulitis
In-Reply-To: <0DAF44B706E29940A409E32DC69005C00505EA40@exchange1.phoebe.com>
Message-ID: <689328.66514.qm@web52507.mail.re2.yahoo.com>


NIDDK changed all their education materials on diverticular disease to reflect the new research.? I use the NIDDK materials as part of our education.? I'm educating on a case-by-case basis with the caveat "your doctor may or may not be aware of the new research, but here it is."

Most of our doctors have little interest in nutrition anyway, so I felt a blanket education wasn't worth the time.? I do cite the research in my reports back to doctors so they know where I am coming from.

Amy Jones, M.S., R.D., L.D.
--- On Fri, 1/23/09, Orlowski, Hannah <horlowsk at ppmh.org> wrote:
From: Orlowski, Hannah <horlowsk at ppmh.org>
Subject: Re: [Cnm] diverticulitis
To: "Beth Dorsey" <Beth.Dorsey at tmcaz.com>, cnm at lists.my180.net
Date: Friday, January 23, 2009, 2:33 PM

Please reply to all.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On
Behalf Of Beth Dorsey
Sent: Friday, January 23, 2009 2:07 PM
To: cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis


What are the new recommendations and are they based on this research
from '08 JAMA?

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of CKeinath at chs-mi.com
Sent: Friday, January 23, 2009 11:11 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis

I was wondering if anyone has then changed their diet sheets according
to
the newest research, or are you educating the doctors on this to bring
them
up to speed??

Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-----------------------------------------
Disclaimer:
The HIPAA Final Privacy Rule requires covered entities to safeguard
certain Protected Health Information (PHI) related to a person's
healthcare.  Information being faxed to you may include PHI after
appropriate authorization from the patient or under circumstances
that do not require patient authorization.  You, the recipient, are
obligated to maintain PHI in a safe and secure manner.  You may not
re-disclose without additional patient consent or as required by
law.  Unauthorized re-disclosure or failure to safeguard PHI could
subject you to penalties described in federal (HIPAA) and state
law.  If you the reader of this message are not the intended
recipient, or the employee or agent responsible to deliver it to
the intended recipient, please notify us immediately and destroy
the related message.


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net



      
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/590f1fff/attachment.html 

From pcharney at mac.com  Fri Jan 23 20:17:22 2009
From: pcharney at mac.com (Pam Charney)
Date: Fri, 23 Jan 2009 20:17:22 -0800
Subject: [Cnm] braden score as nutrition risk indicator
In-Reply-To: <95FEAD2B8B155B4D9290B464182C5A8E024C467D@BRAYS.bmhsc.org>
References: <95FEAD2B8B155B4D9290B464182C5A8E024C467D@BRAYS.bmhsc.org>
Message-ID: <B0B853AA-85A2-4F6D-A34D-6B25C2E37F56@mac.com>

Kottner J, Dassen TWN. An interrater reliability study of the Braden  
scale in two nursing homes. Int J Nurs Stud. 2008; 45(10):1501-1511.

This particular study found that the nutrition sections of the Braden  
score had less than acceptable interrater reliability and so did not  
contribute much to the usefulness of the score.

pam


Pam Charney PhD, RD
Clinical Coordinator
Graduate Coordinated Program in Dietetics
Lecturer, Department of Epidemiology
Nutrition Sciences Program
School of Public Health and Community Medicine
Box 353410, 306-C Raitt Hall

Affiliate Associate Professor
School of Pharmacy

MS Student
Clinical Informatics and Patient Centered Technology
School of Nursing

University of Washington
Seattle, WA
charnepa at u.washington.edu
"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jan 23, 2009, at 8:13 AM, Roxanne J. Davis-Cote wrote:

> What are other facilities using for braden score triggers if this is  
> used at all as a nutrition risk indicator?
>
>
> Roxanne Davis-Cote, RD,LD
> Clinical Nutrition Manager
> Beaufort Memorial Hospital
> rdavis-cote at bmhsc.org
> phone: 843-522-5084
> fax: 843-522-5700
>
> **********************************************************************
>
> This email and any files transmitted with it are confidential and
>
> intended solely for the use of the individual or entity to whom they
>
> are addressed. If you have received this email in error please notify
>
> the system manager.
>
>
>
> This footnote also confirms that this email message has been swept by
>
> MIMEsweeper for the presence of computer viruses.
>
>
>
> www.clearswift.com
>
> **********************************************************************
>
>
>
>
> This message was scanned with MIMESweeper.
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/776ba7ee/attachment.html 

From ESCOTTSTUMPS at ecu.edu  Fri Jan 23 20:48:31 2009
From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia)
Date: Fri, 23 Jan 2009 23:48:31 -0500
Subject: [Cnm] FW:
References: <EA727D981AD45E4099BD143F4853FE8606F875CC@adaexchsrvm.ada-net.local>
Message-ID: <BD44FF0CF4C18245854BBE03590A4C130150CD83@ECUFS7.intra.ecu.edu>

Regards from ADA.
S. Escott-Stump, CNM Legislative Chair

 

Consistent with our proposal, here is a summary copy of On The Pulse for posting to your DPG listserv.  Thank you.

 

Sincerely,

 

Stephanie Patrick
Vice President, Policy Initiatives and Advocacy

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/e4a15c69/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: On the Pulse summary  012309.doc
Type: application/msword
Size: 146432 bytes
Desc: On the Pulse summary  012309.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/e4a15c69/attachment-0001.doc 

From Lynn.Greenberg at va.gov  Mon Jan 26 05:23:13 2009
From: Lynn.Greenberg at va.gov (Greenberg, Lynn)
Date: Mon, 26 Jan 2009 08:23:13 -0500
Subject: [Cnm] Nectar thick supplements
In-Reply-To: <B3EC332627F1E842A36F5E232F0CCCD1497D47@ch17.centerrehc.com>
References: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D61E@S1EXH002><4979E723020000C700013503@email_gateway.sfmc.net>
	<B3EC332627F1E842A36F5E232F0CCCD1497D47@ch17.centerrehc.com>
Message-ID: <9AD6AFAD537B7C4DA9AB91D9AE68E44404126D43@VHAV05MSGA2.v05.med.va.gov>

I recently asked our Speech Pathologist Chief and she did allow Ensure
Plus to be considered as a Nectar Thick.

Lynn Greenberg RD, LD, MS
Site Manager
Nutrition and Food Service, Baltimore/BRECC
VA Maryland Healthcare System
410-605-7053
410-446-6566 (cell)
410-605-7835 (fax)
PPlease consider the environment before printing this email.
 
-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sallie Konruff
Sent: Friday, January 23, 2009 5:09 PM
To: Lori Pettet; Roxanne J. Davis-Cote; cnm at lists.my180.net; Rachel
Flores
Subject: [Cnm] Nectar thick supplements

Hi There;
Does anyone consider Ensure Plus (not regular Ensure) a nectar thick
liquid?  Another RD at another facility was using it this way but I
don't see that much difference and it isn't listed as nectar thick
liquid in the Ross Pocket Guide.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lori Pettet
Sent: Friday, January 23, 2009 3:50 PM
To: 'Roxanne J. Davis-Cote'; cnm at lists.my180.net; Rachel Flores
Subject: Re: [Cnm] braden score as nutrition risk indicator

are these risk levels standard w/ the Braden scale or it this specific
for your facility?

Lori Pettet, MA, RD, LD, CDE
Assistant Manager, Nutrition Services
Saint Francis Medical Center
211 St. Francis Dr. 
Cape Girardeau, MO  63703
Phone: 331-5145
LPettet at sfmc.net

This email transmittal is intended only for the use of the individual or
entity to which it is addressed.  It may contain Protected Health
Information, which is privileged and confidential.  Protected Health
Information may only be used or disclosed in accordance with law and you
may be subject to penalties under law for improper use or further
disclosure of the Protected Health Information in this email.    If you
are not the intended recipient of this email,  you may not read, copy,
distribute or otherwise use or disclose the information contained in
this email.    If you received this email  in error, please notify the
sender immediately and request instructions on return or destruction of
the information in this email. 


>>> "Flores, Rachel" <RachelFlores at sach.org> 01/23/09 11:21 AM >>>
< 12 is high risk, seen within 24 hours, 13-16 is moderate risk, seen
within
3 days.

 

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

  _____  

From: Roxanne J. Davis-Cote [mailto:RDavis-Cote at bmhsc.org] 
Sent: Friday, January 23, 2009 8:13 AM
To: cnm at lists.my180.net 
Subject: [Cnm] braden score as nutrition risk indicator

 

What are other facilities using for braden score triggers if this is
used at
all as a nutrition risk indicator?

 

 

Roxanne Davis-Cote, RD,LD

Clinical Nutrition Manager

Beaufort Memorial Hospital

rdavis-cote at bmhsc.org <mailto:rdavis-cote at bmhsc.org> 

phone: 843-522-5084

fax: 843-522-5700

 

**********************************************************************

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the system manager.

 

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

 

www.clearswift.com 

**********************************************************************

 

 

This message was scanned with MIMESweeper.



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


From JUnderwood at jflusvi.org  Mon Jan 26 05:36:17 2009
From: JUnderwood at jflusvi.org (Underwood, Jennifer)
Date: Mon, 26 Jan 2009 09:36:17 -0400
Subject: [Cnm] Liquacel
Message-ID: <C0CCCCB3BAFC7541BB5D1B8AD1EF308B3397E2@jfl-mail.jflusvi.org>

Good Day,

I would like to get some feedback from those who are using Liquacel.

 

How long have you used it for?

Do you use it for both oral and enteral feedings?

Any feedback from nursing? 

Patient compliance?

Do you carry it in the dietary department?     Packets or  Bottles

 

 

Thank you in advance,

 

JUnderwood,RD

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090126/a0539138/attachment.html 

From FREED_KATHARINE at GUTHRIE.ORG  Mon Jan 26 08:29:18 2009
From: FREED_KATHARINE at GUTHRIE.ORG (FREED_KATHARINE at GUTHRIE.ORG)
Date: Mon, 26 Jan 2009 11:29:18 -0500
Subject: [Cnm] Nectar thick supplements
In-Reply-To: <B3EC332627F1E842A36F5E232F0CCCD1497D47@ch17.centerrehc.com>
Message-ID: <OFE87F868A.3AF8E163-ON8525754A.0058A186-8525754A.005A9320@guthrie.org>

Sallie,
If the ENSURE PLUS is chilled, we consider it "Nectar" thick; if room 
temperature - it's not "Nectar" thick.    Our Abbott rep gave us this info 
years ago & our SLPs have gone along with it.   It is listed this way in 
the Abbott Nutrition 2008 POCKET GUIDE (last item under Technical Data). 
One concern is if patients save the ENSURE at the bedside for later.  We 
do carry some pre thickened products but all of our patients on thickened 
liquids have a can of thickener @ the bedside in case it's needed.
Kait Freed


Katharine Ward Freed, MS, RD, LDN, CDE
Clinical Supervisor
Food & Nutrition Dept.
Robert Packer Hospital
One Guthrie Square
Sayre, PA 18840
Tel  570-882-4297   Fax  570-882-5122
Email: "freed_katharine at guthrie.org"


CONFIDENTIALITY NOTICE: This e-mail, including attachments, may
include confidential, restricted, protected health and/or
proprietary information, and may be used only for the person or
entity to which it is addressed. If the reader of this e-mail is
not the intended recipient or his or her authorized agent, the
reader is hereby notified that any dissemination, distribution or
copying of this e-mail is prohibited. If you have received this
e-mail in error, please notify the sender by replying to this
message and delete this e-mail immediately. Notice: The disclosure
of medical information is strictly prohibited by federal
regulation. Unauthorized release of medical information may result
in administrative, civil and criminal sanctions.  
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090126/ffdc0e31/attachment.html 

From YDionne at westerlyhospital.org  Mon Jan 26 08:35:22 2009
From: YDionne at westerlyhospital.org (Yvette Dionne)
Date: Mon, 26 Jan 2009 11:35:22 -0500
Subject: [Cnm] diverticulitis
In-Reply-To: <09E2B22E8D76B04280E994018E133C510DAFDD9C88@PEXCHNG2.cmc-dayton.org>
References: <415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org><6564D6A31JW2832867-01@MMS_bjc.org>	<4979B548.3533.00BC.0@bjc.org>	<CBE0048956D4B14C893378F8D13A36E2028B30DC@IRMEXCH02.irm.inhs.org><41CA05D55BF105489D33F8E57D71A9051716986760@MAIL-C.healthall.com>
	<09E2B22E8D76B04280E994018E133C510DAFDD9C88@PEXCHNG2.cmc-dayton.org>
Message-ID: <E8876826D209234E9756A1C959D0A28F0224595F@whmail.westerlyhospital.local>

Foods Not Recommended 

Your doctor or registered dietitian may have asked you not to eat nuts
and seeds in the past. Recent research suggests that this may not be
necessary. Talk with your doctor or dietitian about what is best for
you, with your condition and food tolerance in mind. 

This is what is in the ADA handout from the diet web (diet manual). 

________________________________

From: Rachel Riddiford [mailto:RiddifordR at childrensdayton.org] 
Sent: Friday, January 23, 2009 1:49 PM
To: 'Ross, Janet'; 'Scott, Kerry R.' ; Judith Arnet ;
CKeinath at chs-mi.com; cnm at lists.my180.net 
Subject: Re: [Cnm] diverticulitis



Happen to have the Nov '08 JADA open and it cites a large (over 47,000
men) study published in JAMA Aug 27 '08.  

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Ross, Janet
Sent: Friday, January 23, 2009 1:43 PM
To: 'Scott, Kerry R.'; Judith Arnet ; CKeinath at chs-mi.com;
cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis

 

Maybe, but my mother's surgeon (fistula caused by a diverticulum) says
he has NEVER seen a seed or piece of corn inside a diverticulum after
years and years of surgery.  Hmmm.

 

Janet V. Ross, MBA,RD,LD

Clinical Nutrition Coordinator

Drake Center

janet.ross at healthall.com

http://www.health-alliance.com/

ph 513-418-2603

fx 513-418-5939

pg 513-577-6879

P Please consider the environment before printing.

 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Scott, Kerry R.
Sent: Friday, January 23, 2009 1:25 PM
To: Judith Arnet; CKeinath at chs-mi.com; cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis

 

I may be incorrect, but if I recall the study was on a very small group
and suggested that perhaps further research was warrented?  

 

Kerry Scott, RD, CD 
Clinical Nutrition Manager 
Food & Nutrition Services 
Providence Sacred Heart Medical Center & Children's Hospital 
(509)474-4774 

Kerry.Scott at providence.org 

 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Judith Arnet
Sent: Friday, January 23, 2009 10:27 AM
To: CKeinath at chs-mi.com; cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis

Educating the doctors with slow progress.  We're doing it face-to-face
as cases present.

 

Judy Arnet, RD LD
Clinical Nutrition Manager
Boone Hospital Center
Columbia, MO  65203
(573)815-3353

>>> <CKeinath at chs-mi.com> 1/23/2009 12:10 PM >>>
I was wondering if anyone has then changed their diet sheets according
to
the newest research, or are you educating the doctors on this to bring
them
up to speed??

Carol Keinath

------------------------------------------------------------------------
-

This email may contain legally privileged and/or confidential
information. If you are not the intended recipient, or the employee
or agent responsible for delivery of this message to the intended
recipient, you are hereby notified that any dissemination,
distribution or copying of this email is strictly prohibited. If
you have received this message in error, please immediately notify
the sender and delete this email from your computer. Your
cooperation is appreciated.   

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

 

________________________________

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
confidential and privileged information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy all
copies of the original message.


________________________________

NOTICE: The information contained in this e-mail and any accompanying
documents or files is intended for the sole use of the recipient to whom
it is addressed, and may contain information that is privileged,
confidential, and prohibited from disclosure under applicable law. If
you are not the intended recipient, or authorized to receive this on
behalf of the recipient, you are hereby notified that any review, use,
disclosure, copying, or distribution is prohibited and possibly a
violation of federal/state law or regulations.

If you received this information in error, please notify The Children's
Medical Center of Dayton immediately via telephone at (937) 641-5293, or
via electronic mail cmcconfidentiality at childrensdayton.org and promptly
destroy the original message. Thank you.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090126/594471a3/attachment.html 

From YDionne at westerlyhospital.org  Mon Jan 26 08:58:19 2009
From: YDionne at westerlyhospital.org (Yvette Dionne)
Date: Mon, 26 Jan 2009 11:58:19 -0500
Subject: [Cnm] Coumadin - 1 question
Message-ID: <E8876826D209234E9756A1C959D0A28F02245961@whmail.westerlyhospital.local>

 

Hello,
 
1)    What are people doing for a measure of success on NPSG.03.05.01
(5)?  Our pharmacy prints a list and delivers to the RD office daily
(except Sunday there is no RD on).  Is keeping record of the list
sufficient for a measure of success?
 
  
 
Thank you for your input,
Yvette Dionne, RD, LDN
Ext. 3464
may you be well and happy
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090126/e3e3d52e/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: aleabanr.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090126/e3e3d52e/attachment-0001.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 4389 bytes
Desc: Leaves Bkgrd.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090126/e3e3d52e/attachment-0001.jpe 

From smorris at goshenhealth.com  Mon Jan 26 09:08:43 2009
From: smorris at goshenhealth.com (Sandra  Morris)
Date: Mon, 26 Jan 2009 12:08:43 -0500
Subject: [Cnm] Standards of Care
Message-ID: <s97da7d4.077@ggh-email1.ggh.ghs>

See attached.  We are in the process of revising ours so any
evidence-based practice guidelines anyone has to share would be greatly
appreciated, especially in the area of protein needs.

Sandi Morris, RD/CD
Clinical Nutrition Manager
Goshen General Hospital
200 High Park Ave.
Goshen, IN  46526
Phone:  574/535-2679

CONFIDENTIALITY NOTICE:  This transmission and the documents
accompanying this transmission may contain confidential information. 
The information is intended only for the use of the individual(s) or
entity named above.  If you are not the intended recipient, you are
notified that any disclosure, copying, distribution or the taking of any
action in reliance on the contents of this information is not
permissible.  If you have received this message in error, please
immediately reply and then destroy it.  Thank you.

>>> "Pefley, Nicole" <Nicole.Pefley at Reshealthcare.org> 1/22/2009 11:55
AM >>>
Good Morning,
I was wondering if anyone had standards of care/guidelines for
nutritional care at their facilities?  I just want to make sure my
dietitians and I are on the same page/up to date when calculating
kcal/pro/fld needs, making recommendations etc.  

If anyone would be willing to share their SOC, I would appreciate it!

Thank you in advance,

Nicole Pefley, RD, LDN
Clinical Nutrition Manager
RHC-West Suburban Medical Center
Phone: (708) 763-6951
Pager:  (773) 990-7243;  #18236

Confidentiality Notice: This email message, including any attachments,
is for the sole use of the intended recipient (s) and may contain
confidential and privileged information. All personal messages express
views solely of the sender, which are not to be attributed to
Resurrection Health Care. Unauthorized review, use, disclosure or
distribution is prohibited.  If you are not the intended recipient,
please contact the sender by reply e-mail and destroy all copies of
the
original message.

-------------- next part --------------
A non-text attachment was scrubbed...
Name: Standards of Practice.doc
Type: application/msword
Size: 48640 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090126/5c1129a3/attachment-0001.doc 

From Janet.Ross at healthall.com  Mon Jan 26 09:35:54 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Mon, 26 Jan 2009 12:35:54 -0500
Subject: [Cnm] Standards of Care
In-Reply-To: <s97da7d4.077@ggh-email1.ggh.ghs>
References: <s97da7d4.077@ggh-email1.ggh.ghs>
Message-ID: <41CA05D55BF105489D33F8E57D71A905171698677C@MAIL-C.healthall.com>

Our standards of care refer to the ADA Pocket Guide for Nutritional Assessment.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
? Please consider the environment before printing.


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Sandra Morris
Sent: Monday, January 26, 2009 12:09 PM
To: cnm at lists.my180.net; Nicole Pefley
Subject: Re: [Cnm] Standards of Care

See attached.  We are in the process of revising ours so any evidence-based practice guidelines anyone has to share would be greatly appreciated, especially in the area of protein needs.

Sandi Morris, RD/CD
Clinical Nutrition Manager
Goshen General Hospital
200 High Park Ave.
Goshen, IN  46526
Phone:  574/535-2679

CONFIDENTIALITY NOTICE:  This transmission and the documents accompanying this transmission may contain confidential information.
The information is intended only for the use of the individual(s) or entity named above.  If you are not the intended recipient, you are notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is not permissible.  If you have received this message in error, please immediately reply and then destroy it.  Thank you.

>>> "Pefley, Nicole" <Nicole.Pefley at Reshealthcare.org> 1/22/2009 11:55
AM >>>
Good Morning,
I was wondering if anyone had standards of care/guidelines for nutritional care at their facilities?  I just want to make sure my dietitians and I are on the same page/up to date when calculating kcal/pro/fld needs, making recommendations etc.

If anyone would be willing to share their SOC, I would appreciate it!

Thank you in advance,

Nicole Pefley, RD, LDN
Clinical Nutrition Manager
RHC-West Suburban Medical Center
Phone: (708) 763-6951
Pager:  (773) 990-7243;  #18236

Confidentiality Notice: This email message, including any attachments, is for the sole use of the intended recipient (s) and may contain confidential and privileged information. All personal messages express views solely of the sender, which are not to be attributed to Resurrection Health Care. Unauthorized review, use, disclosure or distribution is prohibited.  If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.


Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information.  Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

From ESCOTTSTUMPS at ecu.edu  Sat Jan 24 06:50:26 2009
From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia)
Date: Sat, 24 Jan 2009 09:50:26 -0500
Subject: [Cnm] Please vote to benefit YOUR affiliates
References: <EA727D981AD45E4099BD143F4853FE86065C05B5@adaexchsrvm.ada-net.local>
	<BD44FF0CF4C18245854BBE03590A4C130150CD9E@ECUFS7.intra.ecu.edu>
Message-ID: <BD44FF0CF4C18245854BBE03590A4C130150CD9F@ECUFS7.intra.ecu.edu>

 
Please vote in the ADA election this year!  High regards,
Sylvia Escott-Stump, Chair, Nominating Committee
 


Project Vote is almost here!  Details on the competition as well as links to resources are below. 

 

About

The ADA Nominating Committee has organized the Affiliate Project Vote challenge to increase awareness of the ADA National Election.  Affiliates compete for two prizes based on the overall affiliate voting percentages in the ADA National Election. 

 

The ADA National Election takes place February 1 through March 3, 2009 on the ADA Web site at www.eatright.org/elections. At the end of the elections, the affiliate with the highest percentage of its members voting in the national election as well as the affiliate with the most improved percentage of its members voting in the ADA National Election will receive awards.

 

Awards

Each winner will receive one free ADA membership to distribute how the leaders see fit. 

 

Resources On-Line (www.eatright.org/elections)

?        2009 Candidate Biographies and Campaign Statements 

?        Affiliate Voting Statistics that show the percentage of affiliate members voted in previous elections

?        Link to voting (will be live on February 1)

?        Link to real-time affiliate voting statistics during the election (will be live on February 1)

 

Resources Attached

?        Web banners and print ads to encourage your members to vote (3 attachments)

?        ADA Times article Think National, Act Affiliate: Tips for Increasing Voter Turnout (1 attachment)

 

Please contact Heidi Schwartz, MS, RD, CSP, Nominating Committee Staff Resource (hschwartz at eatright.org | 800/877-1600 ext 4893) with any questions about Project Vote.

 

Remember - every vote counts!

 

ADA Nominating Committee

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090124/76da89b5/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Think National Act Affiliate.pdf
Type: application/octet-stream
Size: 140577 bytes
Desc: Think National Act Affiliate.pdf
Url : /pipermail/cnm_lists.my180.net/attachments/20090124/76da89b5/attachment-0003.obj 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: ADA_Vote_tall-120x240.jpg
Type: image/jpeg
Size: 29828 bytes
Desc: ADA_Vote_tall-120x240.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090124/76da89b5/attachment-0002.jpg 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: ADA_Vote_wide-468x60.jpg
Type: image/jpeg
Size: 25227 bytes
Desc: ADA_Vote_wide-468x60.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090124/76da89b5/attachment-0003.jpg 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: 0109 Governance Vote Now.pdf
Type: application/octet-stream
Size: 257724 bytes
Desc: 0109 Governance Vote Now.pdf
Url : /pipermail/cnm_lists.my180.net/attachments/20090124/76da89b5/attachment-0004.obj 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: 2.F Organization Unit Assignments EL2009.docx
Type: application/octet-stream
Size: 58012 bytes
Desc: 2.F Organization Unit Assignments EL2009.docx
Url : /pipermail/cnm_lists.my180.net/attachments/20090124/76da89b5/attachment-0005.obj 

From m-rodrig at msmc.com  Fri Jan 23 10:32:51 2009
From: m-rodrig at msmc.com (Maritza Rodriguez)
Date: Fri, 23 Jan 2009 13:32:51 -0500
Subject: [Cnm] diverticulitis
In-Reply-To: <415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org>
References: <DFE35E9E46C195459D20853641E2E1EA02ECB12ABB@MEDEXMB01.ad.med.miami.edu>
	<415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org>
Message-ID: <32EDCA3D1F5C4C41B7E1A4573DFACCC602117CFA@SVIPEXC1.msmc.com>

Here is the article form JAMA.

 

Maritza Rodriguez

 

Maritza Rodriguez, RD LDN

Clinical Nutrition Manager

Mount Sinai Medical Center

4300 Alton Road

Miami Beach, Florida 33140

 

Tel: 305-674-2121 Ext. 56181

Fax: 305-674-2234

m-rodrig at msmc.com

 

 

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
CONFIDENTIAL or PRIVILEGED information.  Any unauthorized review, use,
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and immediately
destroy all copies of the original message and all attachments.  Any
opinions expressed here are not necessarily those of Mount Sinai Medical
Center.

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Johnson, Andrea
Sent: Friday, January 23, 2009 11:01 AM
To: cnm at lists.my180.net
Subject: [Cnm] diverticulitis

 

Does anyone have an article or a reference that details the new
diverticulitis recommendations that allow fiber, seeds etc on the diet.

Thanks,

Andrea

 

Andrea Johnson, MS, RD, CDE 
Clinical Nutrition Manager 
Bassett Healthcare 
One Atwell Road 
Cooperstown, NY 13326 
andrea.johnson at bassett.org 
607-547-6665 

	 

	 

NOTICE OF CONFIDENTIALITY This electronic message, including
attachments, is for the sole use of the named recipient and may contain
confidential or privileged information protected by New York State, and
Federal regulations. Any unauthorized review, use, disclosure, copying
or distribution is strictly prohibited. If you are not the intended
recipient or have received this communication in error please contact
the sender or email.security at bassett.org and destroy all copies of the
original message. Thank you. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090123/319bbbfe/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Nuts.pdf
Type: application/octet-stream
Size: 170404 bytes
Desc: Nuts.pdf
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/319bbbfe/attachment-0001.obj 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Diverticulas D New Recommendations.doc
Type: application/msword
Size: 24576 bytes
Desc: Diverticulas D New Recommendations.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090123/319bbbfe/attachment-0001.doc 

From Christine.Schwartz at sfdph.org  Mon Jan 26 12:36:58 2009
From: Christine.Schwartz at sfdph.org (Christine Schwartz)
Date: Mon, 26 Jan 2009 12:36:58 -0800
Subject: [Cnm] burn orders & pedi TF questions
Message-ID: <OFE1FACF5D.B13B7184-ON8825754A.0071195A-8825754A.00711C28@sfgov.org>


Also posted to DNS list:

1. We are in the process of updating standing burn orders.  Can anyone
share theirs?  Is selenium automatically part of the orders now?  Any
others?  Ours currently has vit A, C, Zn, MVI (additional thiamine & folate
if ETOH hx).  Unfortunately, I can only get attachments if they are sent
directly to my email address (not just posted to the list).

2. We do not have a large pediatric service and have not had a pediatric TF
in a while.  Are residuals checked at the same frequency in kids as in
adults?  At what volume do you hold the TF or is there a set GRV and you
just watch for GI symptoms?

I appreciate any feedback you can provide.  Thank you.

Christine Schwartz, RD ~ Chief Dietitian
San Francisco General Hospital & Trauma Center
Voice Mail: (415) 206-6286
Fax: (415) 206-6291
Pager: (415) 327-4139
Christine.Schwartz at sfdph.org



From duff.frances at gmail.com  Mon Jan 26 14:29:26 2009
From: duff.frances at gmail.com (Frances Duff)
Date: Mon, 26 Jan 2009 17:29:26 -0500
Subject: [Cnm] Acute care menus
Message-ID: <6e81fc0c0901261429r656444b6h6596ed3142329e64@mail.gmail.com>

I am currently in the proccess of review my facilities menus and I was
wondering how many meals a day other facilities are giving milk to their non
select adult patients.
Thank you,
-- 
Frances Duff RD LDN
Rocky Mount, NC
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090126/7f9943bf/attachment.html 

From SharonFischer at IamMorrison.com  Mon Jan 26 14:42:11 2009
From: SharonFischer at IamMorrison.com (Fischer, Sharon)
Date: Mon, 26 Jan 2009 17:42:11 -0500
Subject: [Cnm] Coumadin - 1 question
References: <E8876826D209234E9756A1C959D0A28F02245961@whmail.westerlyhospital.local>
Message-ID: <F822927E59B277418E2A2A6CAB95E93A0153D1B2@cguschp602.NA.compassgroup.corp>

Yvonne - 
 
We started a PI to track the coumadin education this year at the request of the P & T committee.  Like you we get a daily list from the Pharmacy, and have been tracking the number of patients who are inappropriate for education (tube feeders, nursing home patients, etc), the number who decline education (usually people who were educated in the past and have no questions), and the number of the remaining patients who we educate.   It is a pretty easy PI for us,  our usual census is in the low 200's, and we usually have fewer than 5 new coumadin patients on the list each day.  
 
 
Sharon Fischer, M.Ed, R.D.
Clinical Nutrition Manager
Jackson North Medical Center

________________________________

From: cnm-bounces at lists.my180.net on behalf of Yvette Dionne
Sent: Mon 1/26/2009 10:58 AM
To: cnm at lists.my180.net
Subject: [Cnm] Coumadin - 1 question


 <https://mail.iammorrison.com/exchange/SharonFischer/Drafts/RE:%20%5BCnm%5D%20Coumadin%20-%201%20question.EML/1_multipart/aleabanr.gif> 

Hello,
 
1)    What are people doing for a measure of success on NPSG.03.05.01 (5)?  Our pharmacy prints a list and delivers to the RD office daily (except Sunday there is no RD on).  Is keeping record of the list sufficient for a measure of success?
 
  
 
Thank you for your input,
Yvette Dionne, RD, LDN
Ext. 3464
may you be well and happy
 


DISCLAIMER Important! This message is intended for the above named person(s) only and is CONFIDENTIAL AND PROPRIETARY. If you are not the intended recipient of this e-mail and have received it in error, please immediately notify the sender by return email and then delete it from your mailbox. This message may be protected by the attorney-client privilege and/or work product doctrine.  Accessing, copying, disseminating or re-using any of the information contained in this e-mail by anyone other than the intended recipient is strictly prohibited. Finally, you should check this email and any attachments for the presence of viruses, as the sender accepts no liability for any damage caused by any virus transmitted by this email.  Thank you.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090126/c90afc32/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 7830 bytes
Desc: aleabanr.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090126/c90afc32/attachment.gif 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 4389 bytes
Desc: Leaves Bkgrd.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090126/c90afc32/attachment.jpe 

From peggymsrdld at cox.net  Tue Jan 27 04:20:37 2009
From: peggymsrdld at cox.net (Peggy Turner)
Date: Tue, 27 Jan 2009 06:20:37 -0600
Subject: [Cnm] j-tubes
Message-ID: <3F92AE7C-4AF3-4035-A835-DCD6A4200B5E@cox.net>

Hello,

We seem to be having a sale on J-tubes this week. We've gone from 0 to  
3 j-tube feeders in just a matter of days.

Would anyone happen to have a ready made powepoint or handouts that I  
could use to help educate our nurses?

Thanks

Peggy Turner, MS, RD/LD


From DPeterson at greenehealth.org  Tue Jan 27 05:28:57 2009
From: DPeterson at greenehealth.org (Peterson, Dina)
Date: Tue, 27 Jan 2009 08:28:57 -0500
Subject: [Cnm] warfarin diet orders
Message-ID: <B00C3105874BC94EB9D63BA80329C9CA08D7BA54@GMHMAIL.ghp.local>

We have been asked to produce a warfarin diet for inpatients.  Does anyone currently have one in place?  I am not in favor of doing this, so the other question is; has anyone been asked to put a warfarin diet in place for inpatients and how did you handle the request? Thank you for any response.

Dina

 

Dina J Peterson MS, RD, LD
Nutrition Services Director
Greene Memorial Hospital




 

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/75eed781/attachment.html 

From bhomola at comhs.org  Tue Jan 27 05:50:48 2009
From: bhomola at comhs.org (Bobbi Homola)
Date: Tue, 27 Jan 2009 07:50:48 -0600
Subject: [Cnm] Acute care menus
In-Reply-To: <6e81fc0c0901261429r656444b6h6596ed3142329e64@mail.gmail.com>
Message-ID: <A54EFD4D2B0E924B970F363E6CCA949302E53CC6@sm-xchg.comhs.org>

2 - Breakfast and lunch

 

Bobbi Homola, MPA, RD, CD

Clinical Manager, Food and Nutrition Services

St. Mary Medical Center / St. Catherine Hospital

1500 South Lake Park Avenue

Hobart, IN 46342

219-947-6048 / 219-392-7081

219-947-6049 fax

bhomola at comhs.org

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Frances Duff
Sent: Monday, January 26, 2009 4:29 PM
To: Cnm at lists.my180.net
Cc: faduff at nhcs.org
Subject: [Cnm] Acute care menus

 

I am currently in the proccess of review my facilities menus and I was
wondering how many meals a day other facilities are giving milk to their
non select adult patients.

Thank you,
-- 
Frances Duff RD LDN
Rocky Mount, NC 


____________________________________

This message and attachment(s), if any, is intended for the sole use of the individual and/or entity 
of which it is addressed, and may contain information that is privileged,confidential and prohibited 
from disclosure under applicable law. If you are not the addressee, or authorized to receive this on 
behalf of the addressee, you are hereby notified that you may not use, copy, disclose or distribute 
to anyone this message or any part thereof. If you have received this in error, please immediately advise 
the sender by e-mail and delete this information and all attachments from your computer and network. 
Thank you.
____________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/9c4ce63b/attachment.html 

From cahns at carthageareahospital.com  Tue Jan 27 05:56:01 2009
From: cahns at carthageareahospital.com (Dawn Berry, RD)
Date: Tue, 27 Jan 2009 08:56:01 -0500
Subject: [Cnm] Reference for # of calories in a pound
Message-ID: <B4A0FCE7BE2F4291A5C39F605936E431@CAHNS1>

My bariatric surgeon has been giving a presentation stating that there are
3800 calories in a pound - I have always learned that the correct number is
3500 calories.  He has agreed to change his presentation if I can produce a
reference but I can't find one anywhere.  

 

Does anyone have a reference for this?

 

Thank you!

 

Dawn Berry, RD CDN

Director of Clinical Nutrition

Carthage Area Hospital

1001 West Street

Carthage, NY 13619

 

315-493-1005  ext 3222

cahns at carthageareahospital.com

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/95658980/attachment-0001.html 

From SMunson at orhc.com  Tue Jan 27 06:01:40 2009
From: SMunson at orhc.com (Stacey Munson)
Date: Tue, 27 Jan 2009 08:01:40 -0600
Subject: [Cnm] warfarin diet orders
In-Reply-To: <B00C3105874BC94EB9D63BA80329C9CA08D7BA54@GMHMAIL.ghp.local>
Message-ID: <EFD452EEB5F9A04D8919C4228C5C392DCBEAC1@p1ws0001.orhcnet.local>

We are currently working on a safety initiative for patients on coumadin
therapy.  For those patients on coumadin, we are only avoiding cooked
spinach, brussel sprouts, and cranberry juice. All of the other foods on
our menu are low or only moderately high in vitamin K, so we have
choosen to continue to offer those. 

 

Stacey Munson, MS, RD, LD

Chief Clinical Dietitian

Ottumwa Regional Health Center

Ph: 641-684-2595

Fax: 641-684-2736

smunson at orhc.com

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Peterson, Dina
Sent: Tuesday, January 27, 2009 7:29 AM
To: cnm at lists.my180.net
Subject: [Cnm] warfarin diet orders

 

We have been asked to produce a warfarin diet for inpatients.  Does
anyone currently have one in place?  I am not in favor of doing this, so
the other question is; has anyone been asked to put a warfarin diet in
place for inpatients and how did you handle the request? Thank you for
any response.

Dina

 

Dina J Peterson MS, RD, LD
Nutrition Services Director
Greene Memorial Hospital



 

 

 

The information contained in this communication may be confidential, is
intended
only for the use of the recipient(s) named above, and may be legally
privileged.
If the reader of this message is not the intended recipient, you are
hereby 
notified that any dissemination, distribution, or copying of this
communication,
or any of its contents, is strictly prohibited.  If you have received
this
communication in error, please return it to the sender immediately and
delete the
original message and any copy of it from your computer system.  If you
have any
questions concerning this message, please contact the sender. 

The information contained in this communication may be confidential, is intended
only for the use of the recipient(s) named above, and may be legally privileged.
If the reader of this message is not the intended recipient, you are hereby 
notified that any dissemination, distribution, or copying of this communication,
or any of its contents, is strictly prohibited.  If you have received this
communication in error, please return it to the sender immediately and delete the
original message and any copy of it from your computer system.  If you have any
questions concerning this message, please contact the sender. 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/7f5c0e9b/attachment.html 

From lmerrima at nyp.org  Tue Jan 27 06:12:29 2009
From: lmerrima at nyp.org (Louise R. Merriman)
Date: Tue, 27 Jan 2009 09:12:29 -0500
Subject: [Cnm] warfarin diet orders
In-Reply-To: <B00C3105874BC94EB9D63BA80329C9CA08D7BA54@GMHMAIL.ghp.local>
References: <B00C3105874BC94EB9D63BA80329C9CA08D7BA54@GMHMAIL.ghp.local>
Message-ID: <497F164D.2040908@nyp.org>

We use a points system for our dietary guidelines for patient on 
Warfarin - as we know - the idea is not to limit vit K intake but to be 
consistent (actually if the patient is vitamin K deficient it is harder 
to achieve a therapeutic INR)  - with our system the patient has more 
choice with how to achieve a consistent intake of vitamin K
Peterson, Dina wrote:
> We have been asked to produce a warfarin diet for inpatients.  Does anyone currently have one in place?  I am not in favor of doing this, so the other question is; has anyone been asked to put a warfarin diet in place for inpatients and how did you handle the request? Thank you for any response.
>
> Dina
>
>  
>
> Dina J Peterson MS, RD, LD
> Nutrition Services Director
> Greene Memorial Hospital
>
>
>
>
>  
>
>  
>
>  
>
>
>   
> ------------------------------------------------------------------------
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>   



--------------------

This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited.  If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message.  Thank you.




From cohmart at mainehospital.org  Tue Jan 27 07:07:36 2009
From: cohmart at mainehospital.org (Cece Ohmart)
Date: Tue, 27 Jan 2009 10:07:36 -0500 (EST)
Subject: [Cnm] warfarin diet orders
In-Reply-To: <497F164D.2040908@nyp.org>
References: <B00C3105874BC94EB9D63BA80329C9CA08D7BA54@GMHMAIL.ghp.local>
	<497F164D.2040908@nyp.org>
Message-ID: <20090127100736.AEQ91227@mail.mainehospital.org>

Can you share this point system with the list?
Thanks,
Cece
This message is intended for the use of the addressee only and may contain information that is privileged and confidential.  If you are not the intended recipient of this message, be notified that any dissemination or use of this message is strictly prohibited.  Un-intended transmission does not constitute waiver of attorney-client privilege or any other privilege.  If you have received this message in error, please delete all copies of the message and its attachments and notify the sender immediately.  Thank you.


From Shannon.Jackson at wilmed.org  Tue Jan 27 07:36:15 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Tue, 27 Jan 2009 10:36:15 -0500
Subject: [Cnm] Renal tube feeding formulas
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF346@wmhcs03.wmh.org>

Are any other facilities using Novasource Renal? We are using it but some
concern has been raised about it containing arginine and using it in ICU for
patients with sepsis. The Novasource Renal contains 3.7 grams/liter of
supplemental L-arginine.
 
Does anyone know the reasoning behind adding the arginine?
 
Thanks
 

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/eb60c972/attachment.html 

From Hollie_Colle at ssmhc.com  Tue Jan 27 07:48:05 2009
From: Hollie_Colle at ssmhc.com (Hollie_Colle at ssmhc.com)
Date: Tue, 27 Jan 2009 09:48:05 -0600
Subject: [Cnm] BMI Charting
Message-ID: <OF203E1958.41BBC82D-ON8625754B.00559C44-8625754B.0056CD1B@SSMHC>

I know we've talked about this alot on here, but we have a new issue.  In 
the 4th Quarter of 2008, there was a change made to coding. Our coding 
department shared this update from the Coding Clinic with us and are 
asking us to educate ALL obese patients on weight reduction!!!

It states:  Effective immediately, in order to code V85.X for BMI, as 
documented by dietary, you must also meet the following requirement:
1. The provider (the physician or any qualified healthcare practitioner 
who is legally accountable for establishing the patient's diagnosis) must 
also document the corresponding clinical condition (e.g. malnutrition, 
overweight, obesity or morbid obesity) in the record and
2. The clinical condition must affect patient care by requiring 
evaluation, treatment, diagnostic workup, increase LOS or nursing 
care/monitoring.

I interpret this as we can document a BMI, but are not necessarily 
required to instruct on weight loss.  The case manager (utilization 
review) states in order to use dietary's documented BMI, we must show 
education as a treatment.  From the above, treatment is only 1 on the 
list. For obesity reimbursement, I would think any of the above would 
count (like extra nursing care for transfers, bariatric beds, increased 
LOS, or other equipment needed to treat morbid obese patients).  I doubt 
we are only receiving more reimbursement dollars if I instruct a patient 
on a weight loss diet in their 3 day stay.  The case manager is paging us 
to instruct all obese patients even after we've documented BMI.

Any thoughts would be appreciated!


Hollie Colle, MS, RD, LDN
Clinical Nutrition Manager
St. Mary's Good Samaritan, Inc. 
Mount Vernon IL 62864 
(618) 241-2356 
Centralia IL 62801
(618) 436-8897
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/33cc23a6/attachment.html 

From kharriso at stagnes.org  Tue Jan 27 07:53:40 2009
From: kharriso at stagnes.org (Harrison, Kerry)
Date: Tue, 27 Jan 2009 09:53:40 -0600
Subject: [Cnm] BMI Charting
In-Reply-To: <OF203E1958.41BBC82D-ON8625754B.00559C44-8625754B.0056CD1B@SSMHC>
References: <OF203E1958.41BBC82D-ON8625754B.00559C44-8625754B.0056CD1B@SSMHC>
Message-ID: <9AB3ADBD43ABFD46B0DC4E80280F3B39288E75@ahcmascdc034.DS.SJHS.COM>

We document, but do not instruct.  It is not the only way to receive
reimbursement as you stated.  Your coding department should talk to the
case managers, besides they should not be deciding what care your
patients need from you.

 

Kerry

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Hollie_Colle at ssmhc.com
Sent: Tuesday, January 27, 2009 10:48 AM
To: Cnm at lists.my180.net
Subject: [Cnm] BMI Charting

 


I know we've talked about this alot on here, but we have a new issue.
In the 4th Quarter of 2008, there was a change made to coding. Our
coding department shared this update from the Coding Clinic with us and
are asking us to educate ALL obese patients on weight reduction!!! 

It states:  Effective immediately, in order to code V85.X for BMI, as
documented by dietary, you must also meet the following requirement: 
1. The provider (the physician or any qualified healthcare practitioner
who is legally accountable for establishing the patient's diagnosis)
must also document the corresponding clinical condition (e.g.
malnutrition, overweight, obesity or morbid obesity) in the record and 
2. The clinical condition must affect patient care by requiring
evaluation, treatment, diagnostic workup, increase LOS or nursing
care/monitoring. 

I interpret this as we can document a BMI, but are not necessarily
required to instruct on weight loss.  The case manager (utilization
review) states in order to use dietary's documented BMI, we must show
education as a treatment.  From the above, treatment is only 1 on the
list. For obesity reimbursement, I would think any of the above would
count (like extra nursing care for transfers, bariatric beds, increased
LOS, or other equipment needed to treat morbid obese patients).  I doubt
we are only receiving more reimbursement dollars if I instruct a patient
on a weight loss diet in their 3 day stay.  The case manager is paging
us to instruct all obese patients even after we've documented BMI. 

Any thoughts would be appreciated! 


Hollie Colle, MS, RD, LDN
Clinical Nutrition Manager
St. Mary's Good Samaritan, Inc. 
Mount Vernon IL 62864           
(618) 241-2356    
Centralia IL 62801
(618) 436-8897


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/1285c682/attachment.html 

From Leslie.Hornick at dmh.mo.gov  Tue Jan 27 08:53:06 2009
From: Leslie.Hornick at dmh.mo.gov (Hornick, Leslie G.)
Date: Tue, 27 Jan 2009 10:53:06 -0600
Subject: [Cnm] Acute care menus
In-Reply-To: <A54EFD4D2B0E924B970F363E6CCA949302E53CC6@sm-xchg.comhs.org>
References: <6e81fc0c0901261429r656444b6h6596ed3142329e64@mail.gmail.com>
	<A54EFD4D2B0E924B970F363E6CCA949302E53CC6@sm-xchg.comhs.org>
Message-ID: <69DD80845D7F524BB1C8C59479ED0625013A8629@exchsvfulton01.mx.state.mo.us>

2 breakfast and 1 lunch

 

 

Leslie Hornick, RD, LD

Chief Clinical Dietitian

FSH/MMMHC

 

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments
may contain confidential and privileged information for the use of the
designated recipients named above. The designated recipients are
prohibited from redisclosing this information to any other party without
authorization and are required to destroy the information after its
stated need has been fulfilled. If you are not the intended recipient,
you are hereby notified that you have received this communication in
error and that any review, disclosure, dissemination, distribution or
copying of it or its contents is prohibited by federal or state law. If
you have received this communication in error, please notify me
immediately by telephone at 573-592-2059, and destroy all copies of this
communication and any attachments.

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Bobbi Homola
Sent: Tuesday, January 27, 2009 7:51 AM
To: Frances Duff; Cnm at lists.my180.net
Cc: faduff at nhcs.org
Subject: Re: [Cnm] Acute care menus

 

2 - Breakfast and lunch

 

Bobbi Homola, MPA, RD, CD

Clinical Manager, Food and Nutrition Services

St. Mary Medical Center / St. Catherine Hospital

1500 South Lake Park Avenue

Hobart, IN 46342

219-947-6048 / 219-392-7081

219-947-6049 fax

bhomola at comhs.org

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Frances Duff
Sent: Monday, January 26, 2009 4:29 PM
To: Cnm at lists.my180.net
Cc: faduff at nhcs.org
Subject: [Cnm] Acute care menus

 

I am currently in the proccess of review my facilities menus and I was
wondering how many meals a day other facilities are giving milk to their
non select adult patients.

Thank you,
-- 
Frances Duff RD LDN
Rocky Mount, NC 

____________________________________

This message and attachment(s), if any, is intended for the sole use of
the individual and/or entity 

of which it is addressed, and may contain information that is
privileged,confidential and prohibited 

from disclosure under applicable law. If you are not the addressee, or
authorized to receive this on 

behalf of the addressee, you are hereby notified that you may not use,
copy, disclose or distribute 

to anyone this message or any part thereof. If you have received this in
error, please immediately advise 

the sender by e-mail and delete this information and all attachments
from your computer and network. 

Thank you.

 
____________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/97f8f9f5/attachment-0001.html 

From Leslie.Hornick at dmh.mo.gov  Tue Jan 27 08:58:20 2009
From: Leslie.Hornick at dmh.mo.gov (Hornick, Leslie G.)
Date: Tue, 27 Jan 2009 10:58:20 -0600
Subject: [Cnm] warfarin diet orders
In-Reply-To: <B00C3105874BC94EB9D63BA80329C9CA08D7BA54@GMHMAIL.ghp.local>
References: <B00C3105874BC94EB9D63BA80329C9CA08D7BA54@GMHMAIL.ghp.local>
Message-ID: <69DD80845D7F524BB1C8C59479ED0625013A862A@exchsvfulton01.mx.state.mo.us>

We put them on "Vitamin K precautions" in the dining room and they are
allowed only 1 serving of the higher vit. K foods and we do not serve
cranberry products.  We just started this in 2008.  We went back and
forth with it too.

 

 

Leslie Hornick, RD, LD

Chief Clinical Dietitian

FSH/MMMHC

 

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments
may contain confidential and privileged information for the use of the
designated recipients named above. The designated recipients are
prohibited from redisclosing this information to any other party without
authorization and are required to destroy the information after its
stated need has been fulfilled. If you are not the intended recipient,
you are hereby notified that you have received this communication in
error and that any review, disclosure, dissemination, distribution or
copying of it or its contents is prohibited by federal or state law. If
you have received this communication in error, please notify me
immediately by telephone at 573-592-2059, and destroy all copies of this
communication and any attachments.

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Peterson, Dina
Sent: Tuesday, January 27, 2009 7:29 AM
To: cnm at lists.my180.net
Subject: [Cnm] warfarin diet orders

 

We have been asked to produce a warfarin diet for inpatients.  Does
anyone currently have one in place?  I am not in favor of doing this, so
the other question is; has anyone been asked to put a warfarin diet in
place for inpatients and how did you handle the request? Thank you for
any response.

Dina

 

Dina J Peterson MS, RD, LD
Nutrition Services Director
Greene Memorial Hospital



 

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/46626f95/attachment.html 

From LCarver at Reshealthcare.org  Tue Jan 27 08:08:33 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 27 Jan 2009 10:08:33 -0600
Subject: [Cnm] BMI Charting
In-Reply-To: <9AB3ADBD43ABFD46B0DC4E80280F3B39288E75@ahcmascdc034.DS.SJHS.COM>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03CD164A@rhcexch3.reshealthcare.org>

I totally agree w/ Kerry on all accounts.  You may want to talk to
whomever the case managers report to as well.  Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Harrison, Kerry
Sent: Tuesday, January 27, 2009 9:54 AM
To: Hollie_Colle at ssmhc.com; Cnm at lists.my180.net
Subject: Re: [Cnm] BMI Charting



We document, but do not instruct.  It is not the only way to receive
reimbursement as you stated.  Your coding department should talk to the
case managers, besides they should not be deciding what care your
patients need from you.

 

Kerry

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Hollie_Colle at ssmhc.com
Sent: Tuesday, January 27, 2009 10:48 AM
To: Cnm at lists.my180.net
Subject: [Cnm] BMI Charting

 


I know we've talked about this alot on here, but we have a new issue.
In the 4th Quarter of 2008, there was a change made to coding. Our
coding department shared this update from the Coding Clinic with us and
are asking us to educate ALL obese patients on weight reduction!!! 

It states:  Effective immediately, in order to code V85.X for BMI, as
documented by dietary, you must also meet the following requirement: 
1. The provider (the physician or any qualified healthcare practitioner
who is legally accountable for establishing the patient's diagnosis)
must also document the corresponding clinical condition (e.g.
malnutrition, overweight, obesity or morbid obesity) in the record and 
2. The clinical condition must affect patient care by requiring
evaluation, treatment, diagnostic workup, increase LOS or nursing
care/monitoring. 

I interpret this as we can document a BMI, but are not necessarily
required to instruct on weight loss.  The case manager (utilization
review) states in order to use dietary's documented BMI, we must show
education as a treatment.  From the above, treatment is only 1 on the
list. For obesity reimbursement, I would think any of the above would
count (like extra nursing care for transfers, bariatric beds, increased
LOS, or other equipment needed to treat morbid obese patients).  I doubt
we are only receiving more reimbursement dollars if I instruct a patient
on a weight loss diet in their 3 day stay.  The case manager is paging
us to instruct all obese patients even after we've documented BMI. 

Any thoughts would be appreciated! 


Hollie Colle, MS, RD, LDN
Clinical Nutrition Manager
St. Mary's Good Samaritan, Inc. 
Mount Vernon IL 62864           
(618) 241-2356    
Centralia IL 62801
(618) 436-8897

CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/8f5281b8/attachment.html 

From sheila.walsh at nahealth.com  Tue Jan 27 09:35:05 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Tue, 27 Jan 2009 10:35:05 -0700
Subject: [Cnm] warfarin diet for patients
In-Reply-To: <B00C3105874BC94EB9D63BA80329C9CA08D7BA54@GMHMAIL.ghp.local>
References: <B00C3105874BC94EB9D63BA80329C9CA08D7BA54@GMHMAIL.ghp.local>
Message-ID: <497EE358.485B.0001.0@nahealth.com>

Hi Dina,
My response to a "warfarin diet for patients" is that we serve a consistent portion of vegetables at the same time each day.
 
 
Sheila A. Walsh, MPH, RD
Clinical Nutrition Manager
Flagstaff Medical Center
Where patients are our purpose.
 


>>> "Peterson, Dina" <DPeterson at greenehealth.org> 1/27/2009 6:28 AM >>>

We have been asked to produce a warfarin diet for inpatients.  Does anyone currently have one in place?  I am not in favor of doing this, so the other question is; has anyone been asked to put a warfarin diet in place for inpatients and how did you handle the request? Thank you for any response.
Dina
 

Dina J Peterson MS, RD, LD
Nutrition Services Director
Greene Memorial Hospital




 

 

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/60dabf41/attachment.html 

From Terese.Scollard at providence.org  Tue Jan 27 10:04:13 2009
From: Terese.Scollard at providence.org (Scollard, Terese)
Date: Tue, 27 Jan 2009 10:04:13 -0800
Subject: [Cnm] BMI Charting
In-Reply-To: <9AB3ADBD43ABFD46B0DC4E80280F3B39288E75@ahcmascdc034.DS.SJHS.COM>
Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A0323A1D4@wn1221.or.providence.org>

What they are saying is that you just cannot submit a code for BMI for
reimbursement potential without having some kind of care plan related to
the obesity. 
Terese M. Scollard RD, LD, MBA 
Regional Clinical Nutrition Manager
Regional Nutrition Service PHS-PSA Acute Care
Phone: 503-216-2496 or 503-215-6974
terese.scollard at providence.org 


________________________________

From: Harrison, Kerry [mailto:kharriso at stagnes.org] 
Sent: Tuesday, January 27, 2009 7:54 AM
To: Hollie_Colle at ssmhc.com; Cnm at lists.my180.net
Subject: Re: [Cnm] BMI Charting



We document, but do not instruct.  It is not the only way to receive
reimbursement as you stated.  Your coding department should talk to the
case managers, besides they should not be deciding what care your
patients need from you.

 

Kerry

 

Kerry Harrison, MS,RD,LDN

Clinical Nutrition Manager

St. Agnes Hospital

Baltimore, MD 21229

410.368.2152

 

To eat is a necessity, but to eat intelligently is an art.

-LaRoche Foucauld

A government big enough to give you everything you want, is strong
enough to take everything you have. 
-Thomas Jefferson 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Hollie_Colle at ssmhc.com
Sent: Tuesday, January 27, 2009 10:48 AM
To: Cnm at lists.my180.net
Subject: [Cnm] BMI Charting

 


I know we've talked about this alot on here, but we have a new issue.
In the 4th Quarter of 2008, there was a change made to coding. Our
coding department shared this update from the Coding Clinic with us and
are asking us to educate ALL obese patients on weight reduction!!! 

It states:  Effective immediately, in order to code V85.X for BMI, as
documented by dietary, you must also meet the following requirement: 
1. The provider (the physician or any qualified healthcare practitioner
who is legally accountable for establishing the patient's diagnosis)
must also document the corresponding clinical condition (e.g.
malnutrition, overweight, obesity or morbid obesity) in the record and 
2. The clinical condition must affect patient care by requiring
evaluation, treatment, diagnostic workup, increase LOS or nursing
care/monitoring. 

I interpret this as we can document a BMI, but are not necessarily
required to instruct on weight loss.  The case manager (utilization
review) states in order to use dietary's documented BMI, we must show
education as a treatment.  From the above, treatment is only 1 on the
list. For obesity reimbursement, I would think any of the above would
count (like extra nursing care for transfers, bariatric beds, increased
LOS, or other equipment needed to treat morbid obese patients).  I doubt
we are only receiving more reimbursement dollars if I instruct a patient
on a weight loss diet in their 3 day stay.  The case manager is paging
us to instruct all obese patients even after we've documented BMI. 

Any thoughts would be appreciated! 


Hollie Colle, MS, RD, LDN
Clinical Nutrition Manager
St. Mary's Good Samaritan, Inc. 
Mount Vernon IL 62864           
(618) 241-2356    
Centralia IL 62801
(618) 436-8897

CONFIDENTIALITY NOTICE: This email message and any accompanying data or
files is confidential and may contain privileged information intended
only for the named recipient(s). If you are not the intended
recipient(s), you are hereby notified that the dissemination,
distribution, and or copying of this message is strictly prohibited. If
you receive this message in error, or are not the named recipient(s),
please notify the sender at the email address above, delete this email
from your computer, and destroy any copies in any form immediately.
Receipt by anyone other than the named recipient(s) is not a waiver of
any attorney-client, work product, or other applicable privilege.


DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/f63f3669/attachment-0001.html 

From Leslie.Hornick at dmh.mo.gov  Tue Jan 27 10:40:28 2009
From: Leslie.Hornick at dmh.mo.gov (Hornick, Leslie G.)
Date: Tue, 27 Jan 2009 12:40:28 -0600
Subject: [Cnm] diverticulitis
In-Reply-To: <32EDCA3D1F5C4C41B7E1A4573DFACCC602117CFA@SVIPEXC1.msmc.com>
References: <DFE35E9E46C195459D20853641E2E1EA02ECB12ABB@MEDEXMB01.ad.med.miami.edu><415700FC732DE14491A3E39367834F7701E6DB82@ex3.bassett.org>
	<32EDCA3D1F5C4C41B7E1A4573DFACCC602117CFA@SVIPEXC1.msmc.com>
Message-ID: <69DD80845D7F524BB1C8C59479ED0625013A8647@exchsvfulton01.mx.state.mo.us>

Having some trouble with e-mailing, if this goes through more than once,
I apologize..

 

 

I have an old "cheat sheet" for the BEE  that has the calculations

    already done and in charts for wts, ht. and age and you just add the

    three together, has anyone seen anything like that for the Mifflin

    equation?  I don't know where I got the one for the BMI, I've had it

    for years...

 

 

 

Leslie Hornick, RD, LD

Chief Clinical Dietitian

FSH/MMMHC

 

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments
may contain confidential and privileged information for the use of the
designated recipients named above. The designated recipients are
prohibited from redisclosing this information to any other party without
authorization and are required to destroy the information after its
stated need has been fulfilled. If you are not the intended recipient,
you are hereby notified that you have received this communication in
error and that any review, disclosure, dissemination, distribution or
copying of it or its contents is prohibited by federal or state law. If
you have received this communication in error, please notify me
immediately by telephone at 573-592-2059, and destroy all copies of this
communication and any attachments.

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/fb70dc90/attachment.html 

From LCarver at Reshealthcare.org  Tue Jan 27 11:05:22 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 27 Jan 2009 13:05:22 -0600
Subject: [Cnm] warfarin diet for patients
In-Reply-To: <497EE358.485B.0001.0@nahealth.com>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03CD1738@rhcexch3.reshealthcare.org>

We do and say the exact same thing and use the NIH handout on Warfarin
as a reference.  Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sheila Walsh
Sent: Tuesday, January 27, 2009 11:35 AM
To: Dina Peterson; cnm at lists.my180.net
Subject: Re: [Cnm] warfarin diet for patients


Hi Dina,
My response to a "warfarin diet for patients" is that we serve a
consistent portion of vegetables at the same time each day.
 
 
Sheila A. Walsh, MPH, RD
Clinical Nutrition Manager
Flagstaff Medical Center
Where patients are our purpose.
 


>>> "Peterson, Dina" <DPeterson at greenehealth.org> 1/27/2009 6:28 AM >>>


We have been asked to produce a warfarin diet for inpatients.  Does
anyone currently have one in place?  I am not in favor of doing this, so
the other question is; has anyone been asked to put a warfarin diet in
place for inpatients and how did you handle the request? Thank you for
any response.

Dina

 

Dina J Peterson MS, RD, LD
Nutrition Services Director
Greene Memorial Hospital




 

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/97ff4445/attachment.html 

From mtewes at wchsys.org  Tue Jan 27 11:21:11 2009
From: mtewes at wchsys.org (Melissa Tewes)
Date: Tue, 27 Jan 2009 14:21:11 -0500
Subject: [Cnm] Nutrition Screening with an EMR
Message-ID: <20090127192110.D7DE7B4832@custmx01.expedient.net>

How are your facilities handling JCAHO requirement for nutritional screening
within 24 hours of admission with nursing policies that allow for a 8 hour
period of time to enter admission data into the computer system?  Who
completes your nutrition screening.nsg or the dietitians?   We currently
have automated reports that pull data from the computer and are running into
issues for patients admitted from midnight to 6 am.not technically being
screened within 24 hours.potential for nutrition screening to be completed
up to 25-30 hours after admission.

 

Thanks in advance,

 

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washingon County Health System

251 East Antietam Street

Hagerstown, MD 21740

Phone:  301-790-8084

Fax:  301-790-8535

 

mtewes at wchsys.org

 



***** CONFIDENTIALITY NOTICE *****
This message contains confidential information and is intended only for
the individual named. If you are not the named addressee you should not
disseminate, distribute or copy this e-mail. Please notify the sender
immediately by e-mail if you have received this e-mail by mistake and
delete this e-mail from your system.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/55458597/attachment.html 

From CShipman at baymedical.org  Tue Jan 27 11:28:24 2009
From: CShipman at baymedical.org (Shipman, Cindy)
Date: Tue, 27 Jan 2009 13:28:24 -0600
Subject: [Cnm] MIfflin
In-Reply-To: <69DD80845D7F524BB1C8C59479ED0625013A8647@exchsvfulton01.mx.state.mo.us>
Message-ID: <28C9A616766126479E11A1BC4DDA43B20576D5CF@BMCEXCHVS2.corp.baymedical.org>

Here is the "Cheat Sheet" you asked for

 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Hornick, Leslie G.
Sent: Tuesday, January 27, 2009 12:40 PM
To: cnm at lists.my180.net
Subject: Re: [Cnm] diverticulitis

 

Having some trouble with e-mailing, if this goes through more than once,
I apologize..

 

 

I have an old "cheat sheet" for the BEE  that has the calculations

    already done and in charts for wts, ht. and age and you just add the

    three together, has anyone seen anything like that for the Mifflin

    equation?  I don't know where I got the one for the BMI, I've had it

    for years...

 

 

 

Leslie Hornick, RD, LD

Chief Clinical Dietitian

FSH/MMMHC

 

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments
may contain confidential and privileged information for the use of the
designated recipients named above. The designated recipients are
prohibited from redisclosing this information to any other party without
authorization and are required to destroy the information after its
stated need has been fulfilled. If you are not the intended recipient,
you are hereby notified that you have received this communication in
error and that any review, disclosure, dissemination, distribution or
copying of it or its contents is prohibited by federal or state law. If
you have received this communication in error, please notify me
immediately by telephone at 573-592-2059, and destroy all copies of this
communication and any attachments.
 
--------------------------------------------------------
Confidentiality Notice:
The information contained in this e-mail is intended solely for the person(s) to whom it is addressed. This information is the property of Bay Medical Center and may be confidential. If you are not the intended addressee, you should not distribute, copy or disclose this e-mail. Please notify the sender immediately if you received this e-mail by mistake and delete this email from your system and destroy all printed copies.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/f0289ec5/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: MJS_cheat_sheet1.xls
Type: application/vnd.ms-excel
Size: 92672 bytes
Desc: MJS_cheat_sheet1.xls
Url : /pipermail/cnm_lists.my180.net/attachments/20090127/f0289ec5/attachment-0001.xls 

From LCarver at Reshealthcare.org  Tue Jan 27 11:31:40 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 27 Jan 2009 13:31:40 -0600
Subject: [Cnm] Nutrition Screening with an EMR
In-Reply-To: <20090127192110.D7DE7B4832@custmx01.expedient.net>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03CD176A@rhcexch3.reshealthcare.org>

We do not have computerized charting yet.  RN's have, per their own
policy, 8 hrs to complete the patient admission form.  This form should
then be turned over to the unit secretary for computer entry.  
 
Note:  the requirement is that the screen is completed w/in 24 hrs; not
that it is entered into the computer w/in 24 hrs.  Leslee

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Melissa Tewes
Sent: Tuesday, January 27, 2009 1:21 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Screening with an EMR



How are your facilities handling JCAHO requirement for nutritional
screening within 24 hours of admission with nursing policies that allow
for a 8 hour period of time to enter admission data into the computer
system?  Who completes your nutrition screening...nsg or the dietitians?
We currently have automated reports that pull data from the computer and
are running into issues for patients admitted from midnight to 6
am...not technically being screened within 24 hours...potential for
nutrition screening to be completed up to 25-30 hours after admission.

 

Thanks in advance,

 

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washingon County Health System

251 East Antietam Street

Hagerstown, MD 21740

Phone:  301-790-8084

Fax:  301-790-8535

 

mtewes at wchsys.org

 


***** CONFIDENTIALITY NOTICE ***** This message contains confidential
information and is intended only for the individual named. If you are
not the named addressee you should not disseminate, distribute or copy
this e-mail. Please notify the sender immediately by e-mail if you have
received this e-mail by mistake and delete this e-mail from your system.


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/31ed1e64/attachment.html 

From mtewes at wchsys.org  Tue Jan 27 11:43:38 2009
From: mtewes at wchsys.org (Melissa Tewes)
Date: Tue, 27 Jan 2009 14:43:38 -0500
Subject: [Cnm] Standards of Care
Message-ID: <20090127194337.87444B4ADF@custmx01.expedient.net>

Do your facilities have standards of care or do you refer to the ADA manual?
If you do refer to the ADA manual, do you use all specific screening
criteria?

 

Thanks

 

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washingon County Health System

251 East Antietam Street

Hagerstown, MD 21740

Phone:  301-790-8084

Fax:  301-790-8535

 

mtewes at wchsys.org

 



***** CONFIDENTIALITY NOTICE *****
This message contains confidential information and is intended only for
the individual named. If you are not the named addressee you should not
disseminate, distribute or copy this e-mail. Please notify the sender
immediately by e-mail if you have received this e-mail by mistake and
delete this e-mail from your system.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/e8af4c45/attachment.html 

From mtewes at wchsys.org  Tue Jan 27 12:09:34 2009
From: mtewes at wchsys.org (Melissa Tewes)
Date: Tue, 27 Jan 2009 15:09:34 -0500
Subject: [Cnm] Nutrition Screening Criteria
Message-ID: <20090127200933.860F6B439A@custmx01.expedient.net>

Anyone willing to share your facilities nutrition screening criteria?

Thanks in advance

 

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washingon County Health System

251 East Antietam Street

Hagerstown, MD 21740

Phone:  301-790-8084

Fax:  301-790-8535

 

mtewes at wchsys.org

 



***** CONFIDENTIALITY NOTICE *****
This message contains confidential information and is intended only for
the individual named. If you are not the named addressee you should not
disseminate, distribute or copy this e-mail. Please notify the sender
immediately by e-mail if you have received this e-mail by mistake and
delete this e-mail from your system.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/4a41e886/attachment.html 

From Shannon.Jackson at wilmed.org  Tue Jan 27 12:49:02 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Tue, 27 Jan 2009 15:49:02 -0500
Subject: [Cnm] Low Residue vs. Low Fiber
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF361@wmhcs03.wmh.org>

Hi,
 
A physician asked why we had collards on our low-residue diet. Our answer was
that 1/2 cup only has 2.3 gm fiber. Our collards are canned and well-cooked.
Looking through our low-residue menu, I noticed some other questionable foods
such as sweet potatoes and green beans. How low is low-residue and low-fiber?

 
This can get very confusing when asked on the spot by a physician. Can anyone
share their low-residue diet? We also combine our soft/low-residue diet. Is
that what others are doing?
 
What vegetables are others sending on a low-residue diet?  Does anyone have
any good lists of recommended /not recommended foods for low-residue? We have
checked out the on-line NCM. 
 
Can someone give me a simple explanation of the difference b/w residue,
roughage and fiber?
 
Thanks

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
 <http://www.wilmed.org/> www.wilmed.org

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/d80e6249/attachment.html 

From RBijold1 at smdc.org  Tue Jan 27 12:56:37 2009
From: RBijold1 at smdc.org (Bijold, Roxanne M.)
Date: Tue, 27 Jan 2009 14:56:37 -0600
Subject: [Cnm] Looking for a Roommate for CNM Conference
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF361@wmhcs03.wmh.org>
References: <8169B6DBE9D5194DA89219B5C5A6AFBA011DF361@wmhcs03.wmh.org>
Message-ID: <42A90F8376E770489AF180BC11195B05010DF62F@BOREAL.ntcampus.smdc.org>

I have booked a room at the Renaissance Boston Waterfront Hotel for the
CNM DPG Symposium.  Would anyone like to share a room and split the
cost?  Please email me privately if interested.  Thanks.
 
Roxanne Bijold, MSE, RD, LD 
Clinical Nutrition Manager 
SMDC Health System 
400 E 3rd Street 
Duluth, MN   55807 
218-786-4669 
rbijold1 at smdc.org 

"Nutrition Services:  Nourishing Your Body and Soul" 



This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. As required by federal and state laws, you need to hold this information as privileged and confidential. If you have received this communication in error, please notify the sender and destroy all copies of this communication and any attachments. 

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/0b26a888/attachment.html 

From bahrj at southwesthealth.org  Tue Jan 27 13:21:43 2009
From: bahrj at southwesthealth.org (Joan Bahr)
Date: Tue, 27 Jan 2009 15:21:43 -0600
Subject: [Cnm] Nutrition Screening with an EMR
In-Reply-To: <20090127192110.D7DE7B4832@custmx01.expedient.net>
References: <20090127192110.D7DE7B4832@custmx01.expedient.net>
Message-ID: <001701c980c5$4285fe00$c791fa00$@org>

My facility is in the process of evaluating the nutrition risk screening and
referral process.  We have had the EMR for 2 years maybe (time flies) and
now we need to perfect some of the processes.  Our nutrition screen is
completed by the nurses with the initial assessment - but it is problematic
to inform the nutrition office. We are small - (but also being small, we
only have 1.5 dietitians - we have one hospital (25 bed), one nursing home
(84 bed), one SBS unit (10 bed) (geropsych) and outpatient diabetes program
and outpatients in general) so we rely on the referrals to prioritize our
day.  We have completed a two week data collection process and will meet on
2/10/09 to discuss the findings.  

Our computer program also will not allow a person to "order entry" a
nutrition consult - without kicking out the current diet order - (crazy I
know, but not fixable supposedly)-so, we need to implement a process of
adding the nutrition consult as an "order detail" to the current diet order.
This will allow it to also print on the meal census .. which will allow the
food service staff to alert the dietitian to a consult.  Once the consult is
completed, the dietitian can enter an additional comment in the "order
detail" such as - 2/27/09 completed.  This will allow the circle to be
completed - and the staff will know the consult was completed and won't need
to contact the dietitian (and if it is a weekend, they do call us at home..)
Well, the plan sounds good, but we will see how well it can be implemented .
and/or any other obstacles that are unknown. 

Following the education on the process and implementation, there will be
another one-week of data collection to determine if an improvement has been
made.  

Unfortunately, our computer system will also not automatically trigger a
nutrition consult and send a request for a consult - it has to be manually
completed.. currently sometimes a phone call is made, or a request while on
the floor - these are ok ..but with the EMR, it will be so much more
efficient if it is documented and the circle completed.

Joan Bahr RD CDE

Southwest Health Center

Platteville, WI 53818

www.southwesthealth.org

 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Melissa Tewes
Sent: Tuesday, January 27, 2009 01:21 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition Screening with an EMR

 

How are your facilities handling JCAHO requirement for nutritional screening
within 24 hours of admission with nursing policies that allow for a 8 hour
period of time to enter admission data into the computer system?  Who
completes your nutrition screening.nsg or the dietitians?   We currently
have automated reports that pull data from the computer and are running into
issues for patients admitted from midnight to 6 am.not technically being
screened within 24 hours.potential for nutrition screening to be completed
up to 25-30 hours after admission.

 

Thanks in advance,

 

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washingon County Health System

251 East Antietam Street

Hagerstown, MD 21740

Phone:  301-790-8084

Fax:  301-790-8535

 

mtewes at wchsys.org

 


***** CONFIDENTIALITY NOTICE ***** This message contains confidential
information and is intended only for the individual named. If you are not
the named addressee you should not disseminate, distribute or copy this
e-mail. Please notify the sender immediately by e-mail if you have received
this e-mail by mistake and delete this e-mail from your system. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/70fdad8f/attachment.html 

From Bhsemmens at aol.com  Tue Jan 27 14:47:57 2009
From: Bhsemmens at aol.com (Bhsemmens at aol.com)
Date: Tue, 27 Jan 2009 17:47:57 EST
Subject: [Cnm] Low Residue vs. Low Fiber
Message-ID: <c7c.42da65ce.36b0e91d@aol.com>

Please answer to the group.  We had this discussion among the clinical  staff 
last week.  For instance, hot chocolate has 2.5 gm of fiber.  At  one time, I 
thought milk was restricted to 2 servings a day.  According to  the NCM there 
is no such thing as a low residue diet.  Basically any diet,  but a clear 
liquid diet will produce residue.  Unfortunately, some doctors  and/or tests 
still request a low residue diet.  
 
How are other facilities handling this?
Thanks,
Beth
 
 
In a message dated 1/27/2009 3:47:15 P.M. Eastern Standard Time,  
Shannon.Jackson at wilmed.org writes:

Hi,
 
A physician  asked why we had collards on our low-residue diet. Our answer 
was that 1/2 cup  only has 2.3 gm fiber. Our collards are canned and 
well-cooked. Looking  through our low-residue menu, I noticed some other questionable 
foods such as  sweet potatoes and green beans. How low is low-residue and  
low-fiber? 
 
This can get  very confusing when asked on the spot by a physician. Can  
anyone share their low-residue diet? We also combine our  soft/low-residue diet. 
Is that what others are doing?
 
What vegetables are others sending on a low-residue diet?   Does anyone have 
any good lists of recommended /not recommended foods for  low-residue? We have 
checked out the on-line NCM. 
 
Can someone give me a simple explanation of the difference b/w  residue, 
roughage and fiber?
 
Thanks
Shannon B. Jackson, RD,  LDN 
Clinical Dietitian Supervisor  
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428  
(252) 399-8768 
_www.wilmed.org_ (http://www.wilmed.org/)  



_______________________________________________
Cnm  mailing  list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


**************A Good Credit Score is 700 or Above. See yours in just 2 easy 
steps! 
(http://pr.atwola.com/promoclk/100000075x1215855013x1201028747/aol?redir=http://www.freecreditreport.com/pm/default.aspx?sc=668072%26hmpgID=62%26bcd=De
cemailfooterNO62)
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/8c6c873e/attachment.html 

From Karen.Auwaerter at chw.edu  Tue Jan 27 14:51:19 2009
From: Karen.Auwaerter at chw.edu (Auwaerter, Karen - MSJ)
Date: Tue, 27 Jan 2009 15:51:19 -0700
Subject: [Cnm] Tube feeding quantity
In-Reply-To: <s97da7d4.077@ggh-email1.ggh.ghs>
References: <s97da7d4.077@ggh-email1.ggh.ghs>
Message-ID: <891DC7E14FC0F449874219D643CB1CA8063D0300@CHW-MSG-403.chw.edu>

Does anyone have a cheat sheet that specifies how many liter bottles of
TF to send each day based on specific infusion rates?  

Thanks in advance!

Karen Auwaerter, RD
Manager, Nutrition and Food Services
Mercy San Juan Medical Center
Greater Sacramento Area
916 537 5104 phone
916 859 1238 fax

"Those who think they have no time for healthy eating will sooner or
later have to find
time for illness."


From sdehoog at u.washington.edu  Tue Jan 27 14:55:57 2009
From: sdehoog at u.washington.edu (susan)
Date: Tue, 27 Jan 2009 14:55:57 -0800 (PST)
Subject: [Cnm] Low Residue vs. Low Fiber
In-Reply-To: <c7c.42da65ce.36b0e91d@aol.com>
Message-ID: <Pine.LNX.4.43.0901271455570.16352@hymn11.u.washington.edu>

We are treating it like a low fiber diet.

> Please answer to the group.  We had this discussion among the clinical  staff
> last week.  For instance, hot chocolate has 2.5 gm of fiber.  At  one time, I
> thought milk was restricted to 2 servings a day.  According to  the NCM there
> is no such thing as a low residue diet.  Basically any diet,  but a clear
> liquid diet will produce residue.  Unfortunately, some doctors  and/or tests
> still request a low residue diet.
>
> How are other facilities handling this?
> Thanks,
> Beth
>
>
> In a message dated 1/27/2009 3:47:15 P.M. Eastern Standard Time,
> Shannon.Jackson at wilmed.org writes:
>
> Hi,
>
> A physician  asked why we had collards on our low-residue diet. Our answer
> was that 1/2 cup  only has 2.3 gm fiber. Our collards are canned and
> well-cooked. Looking  through our low-residue menu, I noticed some other questionable
> foods such as  sweet potatoes and green beans. How low is low-residue and
> low-fiber?
>
> This can get  very confusing when asked on the spot by a physician. Can
> anyone share their low-residue diet? We also combine our  soft/low-residue diet.
> Is that what others are doing?
>
> What vegetables are others sending on a low-residue diet?   Does anyone have
> any good lists of recommended /not recommended foods for  low-residue? We have
> checked out the on-line NCM.
>
> Can someone give me a simple explanation of the difference b/w  residue,
> roughage and fiber?
>
> Thanks
> Shannon B. Jackson, RD,  LDN
> Clinical Dietitian Supervisor
> Wilson Medical Center
> 1705 Tarboro Street SW
> Wilson, NC 27893-3428
> (252) 399-8768
> _www.wilmed.org_ (http://www.wilmed.org/)
>
>
>
> _______________________________________________
> Cnm  mailing  list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
>
> **************A Good Credit Score is 700 or Above. See yours in just 2 easy
> steps!
> (http://pr.atwola.com/promoclk/100000075x1215855013x1201028747/aol?redir=http://www.freecreditreport.com/pm/default.aspx?sc=668072%26hmpgID=62%26bcd=De
> cemailfooterNO62)
>

Susan DeHoog
Associate Director
Food and Nutrition
University of Washington Medical Center
BOX 356057
Seattle Washington 98195
(206) 598-4533
email  sdehoog at u.washington.edu
FAX (206) 598-8105
pager (206)540-8874




From Bhsemmens at aol.com  Tue Jan 27 15:02:52 2009
From: Bhsemmens at aol.com (Bhsemmens at aol.com)
Date: Tue, 27 Jan 2009 18:02:52 EST
Subject: [Cnm] Length of time trays are allowed to stay in a patient's room
	(acute care)
Message-ID: <d5e.41c2a157.36b0ec9c@aol.com>

Question:  Does anyone in acute care have a policy determining the  length of 
time a tray can be kept in a room (i.e. 45 minutes or 60  minutes?).  
 
Recently we have had several patients request to hold their trays from meal  
to meal.  It has created a problem with having adequate trays/lids when  
census is high as well as a food safety issue.
 
Thank you,
Beth Semmens
**************A Good Credit Score is 700 or Above. See yours in just 2 easy 
steps! 
(http://pr.atwola.com/promoclk/100000075x1215855013x1201028747/aol?redir=http://www.freecreditreport.com/pm/default.aspx?sc=668072%26hmpgID=62%26bcd=De
cemailfooterNO62)
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/cad2bec9/attachment-0001.html 

From LCarver at Reshealthcare.org  Tue Jan 27 15:14:58 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 27 Jan 2009 17:14:58 -0600
Subject: [Cnm] Tube feeding quantity
In-Reply-To: <891DC7E14FC0F449874219D643CB1CA8063D0300@CHW-MSG-403.chw.edu>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03CD18F2@rhcexch3.reshealthcare.org>

Hope this helps.  leslee 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Auwaerter, Karen - MSJ
Sent: Tuesday, January 27, 2009 4:51 PM
To: cnm at lists.my180.net
Subject: [Cnm] Tube feeding quantity

Does anyone have a cheat sheet that specifies how many liter bottles of
TF to send each day based on specific infusion rates?  

Thanks in advance!

Karen Auwaerter, RD
Manager, Nutrition and Food Services
Mercy San Juan Medical Center
Greater Sacramento Area
916 537 5104 phone
916 859 1238 fax

"Those who think they have no time for healthy eating will sooner or
later have to find
time for illness."

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Tube Feeding Conversion Chart.doc
Type: application/msword
Size: 27648 bytes
Desc: Tube Feeding Conversion Chart.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090127/8f93bf9b/attachment.doc 

From kmershon at bak.rr.com  Tue Jan 27 21:26:49 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Tue, 27 Jan 2009 21:26:49 -0800
Subject: [Cnm] Length of time trays are allowed to stay in a patient's
	room(acute care)
In-Reply-To: <d5e.41c2a157.36b0ec9c@aol.com>
References: <d5e.41c2a157.36b0ec9c@aol.com>
Message-ID: <5748264C2B87406695192AB5127BF8DF@KathyPC>

Yes. We teach our nurses and aides "Never Wait, Refrigerate." No trays are held is the policy. The practice is quite a different story and is always an ongoing nursing education. Besides holding the tray at room temp and giving a nice case of diarrhea and vomiting so we can pass out antinausea, antiemetic, and anti-diarrheal meds..... it also drives the satisfaction scores down when patients have to eat cold, dried out foods! We have hostesses to take late trays up and our carts are on the units 45 minutes plugged in with hot side hot and cold side cold. A La Carte delivery system. 

Kathleen Mershon, RD
  ----- Original Message ----- 
  From: Bhsemmens at aol.com 
  To: cnm at lists.my180.net 
  Sent: Tuesday, January 27, 2009 3:02 PM
  Subject: [Cnm] Length of time trays are allowed to stay in a patient's room(acute care)


  Question:  Does anyone in acute care have a policy determining the length of time a tray can be kept in a room (i.e. 45 minutes or 60 minutes?).  

  Recently we have had several patients request to hold their trays from meal to meal.  It has created a problem with having adequate trays/lids when census is high as well as a food safety issue.

  Thank you,
  Beth Semmens


------------------------------------------------------------------------------
  A Good Credit Score is 700 or Above. See yours in just 2 easy steps!


------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090127/85d4cc19/attachment.html 

From cketterman at wellspan.org  Wed Jan 28 04:08:45 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Wed, 28 Jan 2009 07:08:45 -0500
Subject: [Cnm] Length of time trays are allowed to stay in a patient's
	room(acute care)
In-Reply-To: <d5e.41c2a157.36b0ec9c@aol.com>
References: <d5e.41c2a157.36b0ec9c@aol.com>
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AD62@EXCH4.wellspan.org>

We are trying to deal with this issue right now.  Unfortunately, one of
our city health inspectors had a relative in the hospital and, due to
delay in tests, the tray sat in the patient's room 4 hours!  We changed
the policy to all trays need to be held in the floor kitchens and
appropriate foods refrigerated but nursing just couldn't make that
happen.  So, now the policy is that all trays must be held in the floor
kitchens and will be removed by the food service employee and placed in
the truck when he/she takes the truck of dirty trays down to the dish
room.  That would mean the held tray would sit at room temperature, at
the most, about 90 minutes.  Our health inspector is visiting this week
and so we are waiting for his input to officially implement the policy.

 
Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934
 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Bhsemmens at aol.com
Sent: Tuesday, January 27, 2009 6:03 PM
To: cnm at lists.my180.net
Subject: [Cnm] Length of time trays are allowed to stay in a patient's
room(acute care)


Question:  Does anyone in acute care have a policy determining the
length of time a tray can be kept in a room (i.e. 45 minutes or 60
minutes?).  
 
Recently we have had several patients request to hold their trays from
meal to meal.  It has created a problem with having adequate trays/lids
when census is high as well as a food safety issue.
 
Thank you,
Beth Semmens

________________________________

A Good Credit Score is 700 or Above. See yours in just 2 easy steps!
<http://pr.atwola.com/promoclk/100000075x1215855013x1201028747/aol?redir
=http://www.freecreditreport.com/pm/default.aspx?sc=668072%26hmpgID=62%2
6bcd=DecemailfooterNO62>  

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________


CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/abc95ea7/attachment-0001.html 

From annalynn_skipper at comcast.net  Wed Jan 28 05:21:13 2009
From: annalynn_skipper at comcast.net (annalynn_skipper at comcast.net)
Date: Wed, 28 Jan 2009 13:21:13 +0000 (UTC)
Subject: [Cnm] Low residue vs. low fiber (please respond)
In-Reply-To: <199856199.17951233148848897.JavaMail.root@sz0060a.emeryville.ca.mail.comcast.net>
Message-ID: <465920447.18001233148873817.JavaMail.root@sz0060a.emeryville.ca.mail.comcast.net>



In my mind, the low residue diet is obsolete although the expert authors of the NCM made that distinction before I became editor.??As far as I recall, the low residue diet was replaced with a low fiber diet years ago.? Why?? Think of the difficulty of measuring colonic residue of a mixed diet in an individual patient ?vs.?measuring fiber in?single foods.? How do we accurately know how much?"residue" is produced?? And, as dietitians, we love accuracy, right?? ? 



It would be helpful however if members of the group could answer a couple of questions.? Feel free to respond privately to avoid "list clutter" 



1.? How often do you receive orders for a low residue diet? 

2.? What are the indications for a low residue diet in your facility? 

3.? What is the specialty of the physicians who order a low residue diet? 

4.? What is the level of training of the?physicians who order the low residue diet? 

???? a.? attending physicians 

???? b.? resident physicians 


Thank you and regards to all. 



Annalynn 



Annalynn Skipper, Ph.D., R.D., FADA 

Editor, ADA's Nutrition Care Manual
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/7f0dc595/attachment.html 

From KBOEHME at meriter.com  Wed Jan 28 06:25:02 2009
From: KBOEHME at meriter.com (Boehme, Karen)
Date: Wed, 28 Jan 2009 08:25:02 -0600
Subject: [Cnm] Low Residue vs. Low Fiber
Message-ID: <3FC71015D5712E4ABBBF3F3901CC7DE3053A10DB@pcwex01>

Your question is great timing.  I was just returning from a dietitian
meeting where we have been updating our Low Residue diet.  We have
recently updated our High Fiber, Low Fiber, Selective Fiber but saved
Low Residue for the last.  We suggest 25-35 grams of fiber on our high
fiber and selective fiber diets.  Our Low Fiber diet we set at 10-15
grams per day and our Very Low Fiber/Low Residue diet we set at 8 grams
or less per day.  We would not allow something with 2.0 grams of fiber
on our low residue.  We restrict to 1-3 grams fiber per meal.  I can't
send you our current version because it is in a state of a mess!
 
Our question is in regard to residue in Milk and milk products.  We
cannot find any data to support that milk has residue which adds to the
bulk of stool.  Is residue in milk products only a problem for lactose
intolerant people or is it a problem for everyone?  Does anyone has data
to support either way?
Thanks!
Karen
 
 

Karen Boehme RD, CD  Madison, Wi

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Tuesday, January 27, 2009 2:49 PM
To: CNM (E-mail)
Subject: [Cnm] Low Residue vs. Low Fiber


Hi,
 
A physician asked why we had collards on our low-residue diet. Our
answer was that 1/2 cup only has 2.3 gm fiber. Our collards are canned
and well-cooked. Looking through our low-residue menu, I noticed some
other questionable foods such as sweet potatoes and green beans. How low
is low-residue and low-fiber? 
 
This can get very confusing when asked on the spot by a physician. Can
anyone share their low-residue diet? We also combine our
soft/low-residue diet. Is that what others are doing?
 
What vegetables are others sending on a low-residue diet?  Does anyone
have any good lists of recommended /not recommended foods for
low-residue? We have checked out the on-line NCM. 
 
Can someone give me a simple explanation of the difference b/w residue,
roughage and fiber?
 
Thanks

Shannon B. Jackson, RD, LDN 
Clinical Dietitian Supervisor 
Wilson Medical Center 
1705 Tarboro Street SW 
Wilson, NC 27893-3428 
(252) 399-8768 
www.wilmed.org <http://www.wilmed.org/> 

 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/d501503f/attachment.html 

From Becky.Wagner at health-partners.org  Wed Jan 28 07:01:32 2009
From: Becky.Wagner at health-partners.org (Becky.Wagner at health-partners.org)
Date: Wed, 28 Jan 2009 10:01:32 -0500
Subject: [Cnm] Becky A Wagner is out of the office.
Message-ID: <OFE02015F7.E065913C-ON8525754C.005289C2-8525754C.005289C4@health-partners.org>


I will be out of the office starting  01/28/2009 and will not return until
01/30/2009.

I will respond to your message when I return.




CONFIDENTIALITY NOTICE:  This message, including any attachments, is for 
the sole use of the intended recipient(s) and may contain confidential and 
privileged information.  Any unauthorized review, use, disclosure or distribution 
is prohibited.  If you are not the intended recipient, please contact the 
sender by reply e-mail and destroy all copies of the original message.



From rtripp at PINNACLEHEALTH.org  Wed Jan 28 07:10:03 2009
From: rtripp at PINNACLEHEALTH.org (Roberta Tripp)
Date: Wed, 28 Jan 2009 10:10:03 -0500
Subject: [Cnm] Low Residue vs. Low Fiber
In-Reply-To: <Pine.LNX.4.43.0901271455570.16352@hymn11.u.washington.edu>
Message-ID: <7375E17267B3DB4583032BDEFDA2D76E0902F3F7@mailphs.pinnaclehealth.org>

Excuse my ignorance, but where does the fiber come from in hot
chocolate?  Do all brands contain guar gum or carrageenan or something
similar?

Roberta

Roberta Tripp MS RD LDN
Clinical Nutrition Manager
PinnacleHealth
Department of Food and Nutrition Services
111 S. Front Street
Harrisburg PA  17101
717 782 5283
rtripp at pinnaclehealth.org
 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of susan
Sent: Tuesday, January 27, 2009 5:56 PM
To: Bhsemmens at aol.com
Cc: clinical nutrition managers; Shannon.Jackson at wilmed.org
Subject: Re: [Cnm] Low Residue vs. Low Fiber


We are treating it like a low fiber diet.

> Please answer to the group.  We had this discussion among the clinical

> staff last week.  For instance, hot chocolate has 2.5 gm of fiber.  At

> one time, I thought milk was restricted to 2 servings a day.  
> According to  the NCM there is no such thing as a low residue diet.  
> Basically any diet,  but a clear liquid diet will produce residue.  
> Unfortunately, some doctors  and/or tests still request a low residue
diet.
>
> How are other facilities handling this?
> Thanks,
> Beth
>
>
> In a message dated 1/27/2009 3:47:15 P.M. Eastern Standard Time, 
> Shannon.Jackson at wilmed.org writes:
>
> Hi,
>
> A physician  asked why we had collards on our low-residue diet. Our 
> answer was that 1/2 cup  only has 2.3 gm fiber. Our collards are 
> canned and well-cooked. Looking  through our low-residue menu, I 
> noticed some other questionable foods such as  sweet potatoes and 
> green beans. How low is low-residue and low-fiber?
>
> This can get  very confusing when asked on the spot by a physician. 
> Can anyone share their low-residue diet? We also combine our
soft/low-residue diet.
> Is that what others are doing?
>
> What vegetables are others sending on a low-residue diet?   Does
anyone have
> any good lists of recommended /not recommended foods for  low-residue?

> We have checked out the on-line NCM.
>
> Can someone give me a simple explanation of the difference b/w  
> residue, roughage and fiber?
>
> Thanks
> Shannon B. Jackson, RD,  LDN
> Clinical Dietitian Supervisor
> Wilson Medical Center
> 1705 Tarboro Street SW
> Wilson, NC 27893-3428
> (252) 399-8768
> _www.wilmed.org_ (http://www.wilmed.org/)
>
>
>
> _______________________________________________
> Cnm  mailing  list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
>
> **************A Good Credit Score is 700 or Above. See yours in just 2

> easy steps!
> (http://pr.atwola.com/promoclk/100000075x1215855013x1201028747/aol?red
> ir=http://www.freecreditreport.com/pm/default.aspx?sc=668072%26hmpgID=
> 62%26bcd=De
> cemailfooterNO62)
>

Susan DeHoog
Associate Director
Food and Nutrition
University of Washington Medical Center
BOX 356057
Seattle Washington 98195
(206) 598-4533
email  sdehoog at u.washington.edu
FAX (206) 598-8105
pager (206)540-8874



_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.


From fynan-carla at CooperHealth.edu  Wed Jan 28 08:16:42 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Wed, 28 Jan 2009 11:16:42 -0500
Subject: [Cnm] Late Trays
Message-ID: <77F33794DD223B40BF24AB3D379302501735118ABF@mxmbx01.chsmail.root.cooperhealth.edu>

Good Morning!

Do any of you have stats on average number of late trays?

Thanks!

Carla Fynan, RD
Clinical Nutrition Manager
Food & Nutrition Department
Cooper University Hospital
One Cooper Paza
Camden, NJ 08103
(856) 342-2320



****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/58f5a675/attachment.html 

From Beth.Dorsey at tmcaz.com  Wed Jan 28 08:19:20 2009
From: Beth.Dorsey at tmcaz.com (Beth Dorsey)
Date: Wed, 28 Jan 2009 09:19:20 -0700
Subject: [Cnm] Late Trays
Message-ID: <410CA779BF3C39428E37B41D6F06AFC802F3052F@TMCMAIL02.tmc.tmcaz.com>

We are doing about 2500-3000/month.

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Fynan, Carla
Sent: Wednesday, January 28, 2009 9:17 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] Late Trays

 

Good Morning!

 

Do any of you have stats on average number of late trays?

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/56f1f9c1/attachment.html 

From cketterman at wellspan.org  Wed Jan 28 08:37:18 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Wed, 28 Jan 2009 11:37:18 -0500
Subject: [Cnm] Late Trays
In-Reply-To: <410CA779BF3C39428E37B41D6F06AFC802F3052F@TMCMAIL02.tmc.tmcaz.com>
References: <410CA779BF3C39428E37B41D6F06AFC802F3052F@TMCMAIL02.tmc.tmcaz.com>
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AD6A@EXCH4.wellspan.org>

175 - 200 /day
 
Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934
 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Beth Dorsey
Sent: Wednesday, January 28, 2009 11:19 AM
To: Fynan, Carla; Cnm at lists.my180.net
Subject: Re: [Cnm] Late Trays



We are doing about 2500-3000/month.

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Fynan, Carla
Sent: Wednesday, January 28, 2009 9:17 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] Late Trays

 

Good Morning!

 

Do any of you have stats on average number of late trays?

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately.

CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/ba78a994/attachment-0001.html 

From Sandra.Miller at CHW.edu  Wed Jan 28 09:22:03 2009
From: Sandra.Miller at CHW.edu (Miller, Sandra - MMC)
Date: Wed, 28 Jan 2009 10:22:03 -0700
Subject: [Cnm] Late Trays
In-Reply-To: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AD6A@EXCH4.wellspan.org>
References: <410CA779BF3C39428E37B41D6F06AFC802F3052F@TMCMAIL02.tmc.tmcaz.com>
	<5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AD6A@EXCH4.wellspan.org>
Message-ID: <CE50A73BE0204542A71BD4AE515469AC05480D0C@CHW-MSG-203.chw.edu>

These stats don't make allot of sense unless one knows what the average
meal count is or % of meals served that are late trays. Also what are
you considering a late tray?
Thanks
Sandra Miller MS, RD, CDE 
Clinical Nutrition Manager 
French Hospital Medical Center 
email: sandra.miller at chw.edu 
Phone: (805) 542-6229 


________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Ketterman-Hopkins, Cindra
Sent: Wednesday, January 28, 2009 8:37 AM
To: Beth Dorsey; Fynan,Carla; Cnm at lists.my180.net
Subject: Re: [Cnm] Late Trays


175 - 200 /day
 
Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934
 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Beth Dorsey
Sent: Wednesday, January 28, 2009 11:19 AM
To: Fynan, Carla; Cnm at lists.my180.net
Subject: Re: [Cnm] Late Trays



We are doing about 2500-3000/month.

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Fynan, Carla
Sent: Wednesday, January 28, 2009 9:17 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] Late Trays

 

Good Morning!

 

Do any of you have stats on average number of late trays?

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately. 
______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________


CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally
privileged.  This information is intended for the use of the named
recipient(s). The authorized recipient of this information is prohibited
from disclosing this information to any party unless required to do so
by law or regulation and is required to destroy the information after
its stated need has been fulfilled.  If you are not the intended
recipient, you are hereby notified that any disclosure, copying,
distribution, or action taken in reliance on the contents of this email
is strictly prohibited.  If you receive this e-mail message in error,
please notify the sender immediately to arrange disposition of the
information. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/dd2a296e/attachment.html 

From Beth.Dorsey at tmcaz.com  Wed Jan 28 09:52:16 2009
From: Beth.Dorsey at tmcaz.com (Beth Dorsey)
Date: Wed, 28 Jan 2009 10:52:16 -0700
Subject: [Cnm] Late Trays
Message-ID: <410CA779BF3C39428E37B41D6F06AFC802F30535@TMCMAIL02.tmc.tmcaz.com>

We are counting any item that does not go out on our carts with the meal
service. We have a system called "one call", where patients can order
anything they would like. If a patient does not like their food or if
they would like to add something such as a soda or juice, they will use
this service. This increases the late tray count drastically. 

 

  _____  

From: Miller, Sandra - MMC [mailto:Sandra.Miller at CHW.edu] 
Sent: Wednesday, January 28, 2009 10:22 AM
To: Ketterman-Hopkins, Cindra; Beth Dorsey; Fynan,Carla;
Cnm at lists.my180.net
Subject: RE: [Cnm] Late Trays

 

These stats don't make allot of sense unless one knows what the average
meal count is or % of meals served that are late trays. Also what are
you considering a late tray?

Thanks

Sandra Miller MS, RD, CDE 
Clinical Nutrition Manager 
French Hospital Medical Center 
email: sandra.miller at chw.edu 
Phone: (805) 542-6229 

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Ketterman-Hopkins, Cindra
Sent: Wednesday, January 28, 2009 8:37 AM
To: Beth Dorsey; Fynan,Carla; Cnm at lists.my180.net
Subject: Re: [Cnm] Late Trays

175 - 200 /day

 

Cindra L. Ketterman, M.S., L.D.N., R.D.

Chief Clinical Dietitian

Nutrition Support Service

York Hospital

1001 South George Street

York, PA  17405-7198

717-851-3991 or 717-851-2345 ask for pager 0093

Fax 717-8512934

 

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Beth Dorsey
Sent: Wednesday, January 28, 2009 11:19 AM
To: Fynan, Carla; Cnm at lists.my180.net
Subject: Re: [Cnm] Late Trays

We are doing about 2500-3000/month.

 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Fynan, Carla
Sent: Wednesday, January 28, 2009 9:17 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] Late Trays

 

Good Morning!

 

Do any of you have stats on average number of late trays?

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately. 
______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________



CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally
privileged.  This information is intended for the use of the named
recipient(s). The authorized recipient of this information is prohibited
from disclosing this information to any party unless required to do so
by law or regulation and is required to destroy the information after
its stated need has been fulfilled.  If you are not the intended
recipient, you are hereby notified that any disclosure, copying,
distribution, or action taken in reliance on the contents of this email
is strictly prohibited.  If you receive this e-mail message in error,
please notify the sender immediately to arrange disposition of the
information. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/0cb1cef2/attachment.html 

From Susan_Zoll at bshsi.org  Wed Jan 28 09:59:45 2009
From: Susan_Zoll at bshsi.org (Zoll, Susan)
Date: Wed, 28 Jan 2009 12:59:45 -0500
Subject: [Cnm] Late Trays
In-Reply-To: <410CA779BF3C39428E37B41D6F06AFC802F3052F@TMCMAIL02.tmc.tmcaz.com>
References: <410CA779BF3C39428E37B41D6F06AFC802F3052F@TMCMAIL02.tmc.tmcaz.com>
Message-ID: <2C7750460C3E7545AC11099BE6A7ABD60204171A@EDC-MAIL-02.ads.bshsi.com>

15 per day

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Beth Dorsey
Sent: Wednesday, January 28, 2009 11:19 AM
To: Fynan, Carla; Cnm at lists.my180.net
Subject: Re: [Cnm] Late Trays



We are doing about 2500-3000/month.

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Fynan, Carla
Sent: Wednesday, January 28, 2009 9:17 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] Late Trays

 

Good Morning!

 

Do any of you have stats on average number of late trays?

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately.

________________________________________________________________________________________________________
The information in this communication is intended to be confidential to the Individual(s) and/or Entity to whom it is addressed.
It may contain information of a Privileged and/or Confidential nature, which is subject to Federal and/or State privacy regulations.
In the event that you are not the intended recipient or the agent of the intended recipient, do not copy or use the information
contained within this communication, or allow it to be read, copied or utilized in any manner, by any other person(s). Should
this communication be received in error, please notify the sender immediately either by response e-mail or by phone,
and permanently delete the original e-mail, attachment(s), and any copies.
________________________________________________________________________________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/10f6fd7b/attachment-0001.html 

From cketterman at wellspan.org  Wed Jan 28 10:00:40 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Wed, 28 Jan 2009 13:00:40 -0500
Subject: [Cnm] Late Trays
In-Reply-To: <CE50A73BE0204542A71BD4AE515469AC05480D0C@CHW-MSG-203.chw.edu>
References: <410CA779BF3C39428E37B41D6F06AFC802F3052F@TMCMAIL02.tmc.tmcaz.com>
	<5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AD6A@EXCH4.wellspan.org>
	<CE50A73BE0204542A71BD4AE515469AC05480D0C@CHW-MSG-203.chw.edu>
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AD75@EXCH4.wellspan.org>

The original question that was asked was simply for the late tray count
which is what I supplied.  Our eating census averages 400 per meal or
1200/day so the late trays are about 17% of total patient meals served.
I don't really care about the percentage, I care more about the reason
for the late tray and oar's are about equally split between holds for
tests/new admits/last minute diet changes and nursing not entering the
diet order in the EMR.  
 
Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934
 

________________________________

From: Miller, Sandra - MMC [mailto:Sandra.Miller at CHW.edu] 
Sent: Wednesday, January 28, 2009 12:22 PM
To: Ketterman-Hopkins, Cindra; Beth Dorsey; Fynan,Carla;
Cnm at lists.my180.net
Subject: RE: [Cnm] Late Trays


These stats don't make allot of sense unless one knows what the average
meal count is or % of meals served that are late trays. Also what are
you considering a late tray?
Thanks
Sandra Miller MS, RD, CDE 
Clinical Nutrition Manager 
French Hospital Medical Center 
email: sandra.miller at chw.edu 
Phone: (805) 542-6229 


________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Ketterman-Hopkins, Cindra
Sent: Wednesday, January 28, 2009 8:37 AM
To: Beth Dorsey; Fynan,Carla; Cnm at lists.my180.net
Subject: Re: [Cnm] Late Trays


175 - 200 /day
 
Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934
 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Beth Dorsey
Sent: Wednesday, January 28, 2009 11:19 AM
To: Fynan, Carla; Cnm at lists.my180.net
Subject: Re: [Cnm] Late Trays



We are doing about 2500-3000/month.

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Fynan, Carla
Sent: Wednesday, January 28, 2009 9:17 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] Late Trays

 

Good Morning!

 

Do any of you have stats on average number of late trays?

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately. 
______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________


CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally
privileged.  This information is intended for the use of the named
recipient(s). The authorized recipient of this information is prohibited
from disclosing this information to any party unless required to do so
by law or regulation and is required to destroy the information after
its stated need has been fulfilled.  If you are not the intended
recipient, you are hereby notified that any disclosure, copying,
distribution, or action taken in reliance on the contents of this email
is strictly prohibited.  If you receive this e-mail message in error,
please notify the sender immediately to arrange disposition of the
information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using
Skeptic(tm) technology powered by MessageLabs. For more information on
MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/c4ac9eca/attachment.html 

From cathy.peterjohn at medicorp.org  Wed Jan 28 10:32:26 2009
From: cathy.peterjohn at medicorp.org (cathy.peterjohn at medicorp.org)
Date: Wed, 28 Jan 2009 13:32:26 -0500
Subject: [Cnm] NCP and diet techs
Message-ID: <OF8AEDC3B6.3D15C1A9-ON8525754C.0065B4F4-8525754C.0065DA1A@medicorp.org>


I know it's been discussed before but can't rememer the responses, can the
diet tech write chart notes using a PES statement?  What limitations are
there related to the NCP in general?







Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA  22401
540-741-1680
Fax: 540-741-4022
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/97ca3abd/attachment.html 

From Fischenich.Joanne at mayo.edu  Wed Jan 28 10:55:58 2009
From: Fischenich.Joanne at mayo.edu (Fischenich, Joanne M., R.D.)
Date: Wed, 28 Jan 2009 12:55:58 -0600
Subject: [Cnm] Late Trays
In-Reply-To: <77F33794DD223B40BF24AB3D379302501735118ABF@mxmbx01.chsmail.root.cooperhealth.edu>
References: <77F33794DD223B40BF24AB3D379302501735118ABF@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: <C7732C4F83B85F499225F8156CF537FE030F50CD@msgebe21.mfad.mfroot.org>

Average number of trays per month - 17,000
Percent of trays that are late trays - average 6-7%
Late trays are all that are not assembled on trayline


________________________________

	From: cnm-bounces at lists.my180.net
[mailto:cnm-bounces at lists.my180.net] On Behalf Of Fynan, Carla
	Sent: Wednesday, January 28, 2009 9:17 AM
	To: CNM Mailing List (Cnm at lists.my180.net)
	Subject: [Cnm] Late Trays
	
	

	Good Morning!

	 

	Do any of you have stats on average number of late trays?

	 

	Thanks!

	 

	Carla Fynan, RD

	Clinical Nutrition Manager

	Food & Nutrition Department

	Cooper University Hospital

	One Cooper Paza

	Camden, NJ 08103

	(856) 342-2320

	 


	****************************************************************
This email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately. 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/b220ddde/attachment.html 

From JKrzeminski at Reshealthcare.org  Wed Jan 28 10:46:19 2009
From: JKrzeminski at Reshealthcare.org (Krzeminski, Janet)
Date: Wed, 28 Jan 2009 12:46:19 -0600
Subject: [Cnm] Late Trays
In-Reply-To: <77F33794DD223B40BF24AB3D379302501735118ABF@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F272502D@rhcexch3.reshealthcare.org>

We are a 350 bed hospital
Late trays now run approximately 60-80 per day
 
Janet K
Chicago, IL

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Fynan, Carla
Sent: Wednesday, January 28, 2009 10:17 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] Late Trays



Good Morning!

 

Do any of you have stats on average number of late trays?

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately. 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/9c3a8e1a/attachment-0001.html 

From dhutsler at chmca.org  Wed Jan 28 11:27:48 2009
From: dhutsler at chmca.org (dhutsler at chmca.org)
Date: Wed, 28 Jan 2009 14:27:48 -0500
Subject: [Cnm] Peds Nutrition Symposium
Message-ID: <OFDE9DC4A9.DC3F20E0-ON8525754C.006A90B8-8525754C.006AF047@chmca.org>


Please Join Us for the 4th Annual Pediatric Nutrition Symposium:
 Putting Pediatric Nutrition into Practice
April 1-3, 2009
Raleigh Marriott City Center, Raleigh, North Carolina

The Pediatric Nutrition Practice Group (PNPG) invites you to enhance your
skills in providing medical nutrition therapy, and to increase your
knowledge of a number of emerging pediatric nutrition issues. Some of the
key objectives include:
   Applying Assessment in the Pediatric Nutrition Care Process, and Use of
      the Infant and Neonatal Tool Kit
   Managing Pediatric Feeding Disorders and Conflict with Families
   The Use of Fish Oil (Omega 3s) in the Management of TPN Liver Disease
   Nutrition Management of Children with Autism, Inflammatory Bowel
      Disease, Food Allergies, and Neurological Impairment
   The Use of Human Milk for Infants with Special Needs, and Indirect
      Calorimetry to Target Nutrition Interventions

The target audience for this symposium is dietetic practitioners working
with pediatric patients and their families in hospital and community
settings.

12 hours of continuing education are available for this symposium.
Registration is discounted for early registration and PNPG members.

Go to www.pnpg.org for the Pediatric Nutrition brochure and registration
form.  Registration is also available on the ADA website at
www.eatright.org


Deb Hutsler MS, RD/LD
Children's Hospital Medical Center
Akron, Ohio




Akron Children's Hospital - Proud winner of the NorthCoast 99 "Best
Workplace" award! 

*************************************************************************
This electronic mail transmission, including any attached files, may contain confidential and/or privileged information for the sole use of the intended recipient(s). It is not intended for transmission to, or receipt by, any unauthorized parties. Any review, use, distribution, dissemination, downloading, copying or disclosure by others is strictly
prohibited. If you are not the intended recipient (or authorized to receive information for the intended recipient), you are hereby notified that you have received this transmission in error. If you have received this transmission in error, please delete it, as well as any copies, from your system without copying it, and notify the sender by reply e-mail.


From MariaLewis at dochs.org  Wed Jan 28 11:43:27 2009
From: MariaLewis at dochs.org (Lewis, Maria (SMC))
Date: Wed, 28 Jan 2009 11:43:27 -0800
Subject: [Cnm] modulars policy
Message-ID: <304A991E3C8B4948A52DB718FF048D7F08E3810E@DOCHS-MSG-SMC.BAY.DOCHS.LOCAL>

  

Does anyone have any policies on how modulars (beneprotein, banana
flakes, etc. ) are distributed, administered and documented in your
facility?  Our facility desperately needs to develop some policies re:
this issue. 

Thank You,

Maria C. Lewis, RD, CNSD

Clinical Nutrition Manager

Seton Medical Center & Seton Coastside

1900 Sullivan Avenue

Daly City, CA 94015

(650) 991-5915

 

  

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/8db16c10/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 11748 bytes
Desc: image001.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090128/8db16c10/attachment.jpe 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 2184 bytes
Desc: image002.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090128/8db16c10/attachment.gif 

From MaryAnn.Browne at inova.org  Wed Jan 28 11:46:27 2009
From: MaryAnn.Browne at inova.org (Browne, MaryAnn)
Date: Wed, 28 Jan 2009 14:46:27 -0500
Subject: [Cnm] modulars policy
In-Reply-To: <304A991E3C8B4948A52DB718FF048D7F08E3810E@DOCHS-MSG-SMC.BAY.DOCHS.LOCAL>
References: <304A991E3C8B4948A52DB718FF048D7F08E3810E@DOCHS-MSG-SMC.BAY.DOCHS.LOCAL>
Message-ID: <BD908A8E30B9BE4A9FF9C6A6924CD1B701627463@NBWINEXH006M.net.inova.org>

  

Please post to the list.

 

Mary Ann Browne R.D. CDE

Nutrition Care Manager

703-664-7425

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lewis, Maria (SMC)
Sent: Wednesday, January 28, 2009 2:43 PM
To: cnm at lists.my180.net
Subject: [Cnm] modulars policy

 

Does anyone have any policies on how modulars (beneprotein, banana
flakes, etc. ) are distributed, administered and documented in your
facility?  Our facility desperately needs to develop some policies re:
this issue. 

Thank You,

Maria C. Lewis, RD, CNSD

Clinical Nutrition Manager

Seton Medical Center & Seton Coastside

1900 Sullivan Avenue

Daly City, CA 94015

(650) 991-5915

 

  

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/1294daaa/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 11748 bytes
Desc: image001.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090128/1294daaa/attachment-0001.jpe 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 2184 bytes
Desc: image002.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090128/1294daaa/attachment-0001.gif 

From Kerry.Scott at providence.org  Wed Jan 28 13:41:32 2009
From: Kerry.Scott at providence.org (Scott, Kerry  R.)
Date: Wed, 28 Jan 2009 13:41:32 -0800
Subject: [Cnm] modulars policy
In-Reply-To: <304A991E3C8B4948A52DB718FF048D7F08E3810E@DOCHS-MSG-SMC.BAY.DOCHS.LOCAL>
References: <304A991E3C8B4948A52DB718FF048D7F08E3810E@DOCHS-MSG-SMC.BAY.DOCHS.LOCAL>
Message-ID: <CBE0048956D4B14C893378F8D13A36E2028B3125@IRMEXCH02.irm.inhs.org>

Benefiber, beneprotein and glutamine are distributed through pharmacy w/
meds so appear on the MAR with administratin insturctions.
 

Kerry Scott, RD, CD 
Clinical Nutrition Manager 
Food & Nutrition Services 
Providence Sacred Heart Medical Center & Children's Hospital 
(509)474-4774 

Kerry.Scott at providence.org 

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lewis, Maria (SMC)
Sent: Wednesday, January 28, 2009 11:43 AM
To: cnm at lists.my180.net
Subject: [Cnm] modulars policy


  

Does anyone have any policies on how modulars (beneprotein, banana
flakes, etc. ) are distributed, administered and documented in your
facility?  Our facility desperately needs to develop some policies re:
this issue. 

Thank You,

Maria C. Lewis, RD, CNSD

Clinical Nutrition Manager

Seton Medical Center & Seton Coastside

1900 Sullivan Avenue

Daly City, CA 94015

(650) 991-5915

 

  

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/5cc7a57b/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 11748 bytes
Desc: image001.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090128/5cc7a57b/attachment.jpe 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 2184 bytes
Desc: image002.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090128/5cc7a57b/attachment.gif 

From talk2tml at yahoo.com  Wed Jan 28 13:59:55 2009
From: talk2tml at yahoo.com (Tina Marie)
Date: Wed, 28 Jan 2009 13:59:55 -0800 (PST)
Subject: [Cnm] Brooms
Message-ID: <725333.88641.qm@web53811.mail.re2.yahoo.com>

Hello List!
?
Our infection control nurse inspected our kitchen and said we couldn't use a broom -- had to be a dust mop ???? Is this a new rule -- am I missing something??? 
?
Are you guys using brooms (no straw) or dusting mops ???
?
Tina Marie MS, RD
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/b663c906/attachment.html 

From sw1979 at nahealth.com  Wed Jan 28 15:13:45 2009
From: sw1979 at nahealth.com (Sheila Walsh)
Date: Wed, 28 Jan 2009 16:13:45 -0700
Subject: [Cnm] modulars policy
In-Reply-To: <304A991E3C8B4948A52DB718FF048D7F08E3810E@DOCHS-MSG-SMC.BAY.DOCHS.LOCAL>
References: <304A991E3C8B4948A52DB718FF048D7F08E3810E@DOCHS-MSG-SMC.BAY.DOCHS.LOCAL>
Message-ID: <49808439.485B.0001.0@nahealth.com>

I am interested in this issue of modular distribution, as well.

Thanks,


Sheila A. Walsh, MPH, RD
Clinical Nutrition Manager
Flagstaff Medical Center
Where patients are our purpose.
 


>>> "Lewis, Maria (SMC)" <MariaLewis at dochs.org> 1/28/2009 12:43 PM >>>
 
Does anyone have any policies on how modulars (beneprotein, banana flakes, etc. ) are distributed, administered and documented in your facility?  Our facility desperately needs to develop some policies re: this issue. 
Thank You,
Maria C. Lewis, RD, CNSD
Clinical Nutrition Manager
Seton Medical Center & Seton Coastside
1900 Sullivan Avenue
Daly City, CA 94015
(650) 991-5915
 
 
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/94f1f447/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 11748 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090128/94f1f447/attachment-0001.jpe 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/gif
Size: 2184 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090128/94f1f447/attachment-0001.gif 

From mantlecm at henrymayo.com  Wed Jan 28 15:41:23 2009
From: mantlecm at henrymayo.com (Clarissa M. Mantle)
Date: Wed, 28 Jan 2009 15:41:23 -0800
Subject: [Cnm] TF hold times for meds?
Message-ID: <CE4008CB7E637647B55D26B172BD4FEF71D0DD@MAIL01.henrymayo.net>

Does anyone (or their Pharmacy) have a policy (or guidelines) that
nursing is supposed to follow re medications and tube feeding hold
times?   Appreciate anyone willing to share. 

 

Thanks, 

Clarissa Mantle, MS,RD,CDE

Clinical Nutrition Manager

Henry Mayo Newhall Memorial Hospital

Valencia, CA 

 

This electronic transmission contains information that may be
confidential or priviliged.  The information in this electronic message
is only for the use of the intended recipient.  If you are not the
intended recipient, be aware that any disclosure, copying, distribution
or other use of the contents of this electronic message is strictly
prohibited.  If you have received this electronic transmission in error,
please notify me immediately either by phone or by electronic mail.

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/8df4affa/attachment.html 

From cathy.peterjohn at medicorp.org  Thu Jan 29 04:52:05 2009
From: cathy.peterjohn at medicorp.org (cathy.peterjohn at medicorp.org)
Date: Thu, 29 Jan 2009 07:52:05 -0500
Subject: [Cnm] small hospital coverage
Message-ID: <OF5B821854.832DD84F-ON8525754D.00466C0E-8525754D.0046B250@medicorp.org>



We are opening a new hospital. What are small hospitals (100 bed with
expected census of 40 pts.) doing about Sat. and Sun. coverage and what is
your standard for hrs. from cns. completion.  We are looking at 1 CNM/Pt.
Services Manager and 1 PT clinical RD.




-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/51ed20ca/attachment.html 

From fynan-carla at CooperHealth.edu  Thu Jan 29 05:00:47 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Thu, 29 Jan 2009 08:00:47 -0500
Subject: [Cnm] FW:  Brooms
Message-ID: <77F33794DD223B40BF24AB3D37930250173511942C@mxmbx01.chsmail.root.cooperhealth.edu>

Our infection control GURU replied that the broom must be one that does not kick up dust.  A gnarled plastic is best.

________________________________
From: White, Joan
Sent: Thursday, January 29, 2009 7:40 AM
To: Fynan, Carla
Subject: RE: [Cnm] Brooms

We should use a method that does not raise dust.  Let's discuss.  Call me this morning, soon.

________________________________
From: Fynan, Carla
Sent: Thursday, January 29, 2009 7:31 AM
To: White, Joan
Subject: FW: [Cnm] Brooms

Hi,

I wanted to forward this to you because I figured that you would know the answer!  I also wanted to chat with you if you have a few minutes about tomorrows JC Infection Control tracer.  I will be attending the meeting to represent Food & Nutrition.

Thank you,

Carla Fynan, RD
X 2320

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Tina Marie
Sent: Wednesday, January 28, 2009 5:00 PM
To: cnm at lists.my180.net
Subject: [Cnm] Brooms

Hello List!

Our infection control nurse inspected our kitchen and said we couldn't use a broom -- had to be a dust mop ???  Is this a new rule -- am I missing something???

Are you guys using brooms (no straw) or dusting mops ???

Tina Marie MS, RD




****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/84bfa24e/attachment.html 

From talk2tml at yahoo.com  Thu Jan 29 05:44:06 2009
From: talk2tml at yahoo.com (Tina Marie)
Date: Thu, 29 Jan 2009 05:44:06 -0800 (PST)
Subject: [Cnm] JCAHO - Brooms / Boxes
In-Reply-To: <5622A1B2C15F5949B8CD15C53F9744FA13000F1E5A@NADCWPMSGCMS04.hca.corpad.net>
Message-ID: <481299.84329.qm@web53806.mail.re2.yahoo.com>

No, she said brooms are not allowed to be used in the kitchen beacuse they kick up dust -- 
?
I asked her if she was talking about "patient care areas", which I think she is.
?
I just want to know if anyone else is holding the standard for the kitchen -- or if any surveys required no brooms in the kitchen.
?
What about outside boxes?? Do you have to breakdown all shipping boxes?? Even for the freezer and emergency supply items??? We will be spending a ton of money to buy clear storage boxes!!!? How do you lable freeze items once outside their box...? I think this will be very difficult to itentify FIFO.....? Freezer bags....???? EXPENSIVE !!!
?
Thanks Kim!!
?
Tina Marie

--- On Thu, 1/29/09, Wyllie Kim? wrote:




Tina,
We use brooms (synthetic bristles) in the kitchen.??Was it a?storage/location issue with the nurse?? Our county health inspector is adamant that brooms and mops be stored in a closet and not out on the floor.
?
Kim H. Wyllie, MS,RD,LD 


++++++++++++++++++++++++++++++++++++++++++++++++






Hello List!
?
Our infection control nurse inspected our kitchen and said we couldn't use a broom -- had to be a dust mop ???? Is this a new rule -- am I missing something??? 
?
Are you guys using brooms (no straw) or dusting mops ???
?
Tina Marie MS, RD
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/b30cf280/attachment.html 

From Janet.Ross at healthall.com  Thu Jan 29 06:06:11 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Thu, 29 Jan 2009 09:06:11 -0500
Subject: [Cnm] Length of time trays are allowed to stay in a
	patient's	room(acute care)
In-Reply-To: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AD62@EXCH4.wellspan.org>
References: <d5e.41c2a157.36b0ec9c@aol.com>
	<5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AD62@EXCH4.wellspan.org>
Message-ID: <41CA05D55BF105489D33F8E57D71A905171698679E@MAIL-C.healthall.com>

We teach no longer than 30 minutes and hostesses have become pretty good at refrigerating before the retherm cart heats AND discarding if they know there will be a delay.  How about a table tent to put in the room:  Please call for a meal tray when you return?  Also, we have transporters who are trained to call for a meal tray.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ketterman-Hopkins, Cindra
Sent: Wednesday, January 28, 2009 7:09 AM
To: Bhsemmens at aol.com; cnm at lists.my180.net
Subject: Re: [Cnm] Length of time trays are allowed to stay in a patient's room(acute care)

We are trying to deal with this issue right now.  Unfortunately, one of our city health inspectors had a relative in the hospital and, due to delay in tests, the tray sat in the patient's room 4 hours!  We changed the policy to all trays need to be held in the floor kitchens and appropriate foods refrigerated but nursing just couldn't make that happen.  So, now the policy is that all trays must be held in the floor kitchens and will be removed by the food service employee and placed in the truck when he/she takes the truck of dirty trays down to the dish room.  That would mean the held tray would sit at room temperature, at the most, about 90 minutes.  Our health inspector is visiting this week and so we are waiting for his input to officially implement the policy.

Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934


________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Bhsemmens at aol.com
Sent: Tuesday, January 27, 2009 6:03 PM
To: cnm at lists.my180.net
Subject: [Cnm] Length of time trays are allowed to stay in a patient's room(acute care)
Question:  Does anyone in acute care have a policy determining the length of time a tray can be kept in a room (i.e. 45 minutes or 60 minutes?).

Recently we have had several patients request to hold their trays from meal to meal.  It has created a problem with having adequate trays/lids when census is high as well as a food safety issue.

Thank you,
Beth Semmens

________________________________
A Good Credit Score is 700 or Above. See yours in just 2 easy steps!<http://pr.atwola.com/promoclk/100000075x1215855013x1201028747/aol?redir=http://www.freecreditreport.com/pm/default.aspx?sc=668072%26hmpgID=62%26bcd=DecemailfooterNO62>

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

CONFIDENTIALITY NOTICE:

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information.

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/1b8eaa79/attachment-0001.html 

From Janet.Ross at healthall.com  Thu Jan 29 06:12:23 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Thu, 29 Jan 2009 09:12:23 -0500
Subject: [Cnm] Low residue vs. low fiber (please respond)
In-Reply-To: <465920447.18001233148873817.JavaMail.root@sz0060a.emeryville.ca.mail.comcast.net>
References: <199856199.17951233148848897.JavaMail.root@sz0060a.emeryville.ca.mail.comcast.net>
	<465920447.18001233148873817.JavaMail.root@sz0060a.emeryville.ca.mail.comcast.net>
Message-ID: <41CA05D55BF105489D33F8E57D71A90517169867A1@MAIL-C.healthall.com>

Usually ostomy diets and each patient is at a different place.  we then liberalize using the attached handout--approved by our WOCN. (Wound, Ostomy continence Nurse).

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of annalynn_skipper at comcast.net
Sent: Wednesday, January 28, 2009 8:21 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] Low residue vs. low fiber (please respond)


In my mind, the low residue diet is obsolete although the expert authors of the NCM made that distinction before I became editor.  As far as I recall, the low residue diet was replaced with a low fiber diet years ago.  Why?  Think of the difficulty of measuring colonic residue of a mixed diet in an individual patient  vs. measuring fiber in single foods.  How do we accurately know how much "residue" is produced?  And, as dietitians, we love accuracy, right?



It would be helpful however if members of the group could answer a couple of questions.  Feel free to respond privately to avoid "list clutter"



1.  How often do you receive orders for a low residue diet?

2.  What are the indications for a low residue diet in your facility?

3.  What is the specialty of the physicians who order a low residue diet?

4.  What is the level of training of the physicians who order the low residue diet?

     a.  attending physicians

     b.  resident physicians

Thank you and regards to all.



Annalynn



Annalynn Skipper, Ph.D., R.D., FADA

Editor, ADA's Nutrition Care Manual

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/91424d61/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Ostomy.doc
Type: application/msword
Size: 70656 bytes
Desc: Ostomy.doc
Url : /pipermail/cnm_lists.my180.net/attachments/20090129/91424d61/attachment-0001.doc 

From Heberle-Heather at aramark.com  Thu Jan 29 06:27:54 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Thu, 29 Jan 2009 08:27:54 -0600
Subject: [Cnm] hold times for meds?
In-Reply-To: <mailman.4752.1233237938.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.4752.1233237938.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <E492630F-4134-4C33-AE80-D4C2E2599625@mimectl>

We do not have a policy per say about the holding of TF for med.  The nurses just hold the Tf to give meds then restart, unless there is a specific order for certain medications to hold the TF before and after meds such as dilantin or carafate.

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879
Heberle-Heather at aramark.com



From: cnm-request at lists.my180.net
Sent: Thu 1/29/09 8:05 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 26, Issue 126


Send Cnm mailing list submissions to
	cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
or, via email, send a message with subject or body 'help' to
	cnm-request at lists.my180.net

You can reach the person managing the list at
	cnm-owner at lists.my180.net

When replying, please edit your Subject line so it is more specific
than "Re: Contents of Cnm digest..."


Today's Topics:

   1.  (Clarissa M. Mantle)
   2. small hospital coverage (cathy.peterjohn at medicorp.org)
   3. FW:  Brooms (Fynan, Carla)
   4. Re: JCAHO - Brooms / Boxes (Tina Marie)
   5. Re: Length of time trays are allowed to stay in a	patient's
      room(acute care) (Ross, Janet)


----------------------------------------------------------------------

Message: 1
Date: Wed, 28 Jan 2009 15:41:23 -0800
From: "Clarissa M. Mantle" <mantlecm at henrymayo.com>
Subject: [Cnm] TF hold times for meds?
To: <cnm at lists.my180.net>
Message-ID:
	<CE4008CB7E637647B55D26B172BD4FEF71D0DD at MAIL01.henrymayo.net>
Content-Type: text/plain; charset="us-ascii"

Does anyone (or their Pharmacy) have a policy (or guidelines) that
nursing is supposed to follow re medications and tube feeding hold
times?   Appreciate anyone willing to share. 

 

Thanks, 

Clarissa Mantle, MS,RD,CDE

Clinical Nutrition Manager

Henry Mayo Newhall Memorial Hospital

Valencia, CA 

 

This electronic transmission contains information that may be
confidential or priviliged.  The information in this electronic message
is only for the use of the intended recipient.  If you are not the
intended recipient, be aware that any disclosure, copying, distribution
or other use of the contents of this electronic message is strictly
prohibited.  If you have received this electronic transmission in error,
please notify me immediately either by phone or by electronic mail.

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090128/8df4affa/attachment-0001.html 

------------------------------

Message: 2
Date: Thu, 29 Jan 2009 07:52:05 -0500
From: cathy.peterjohn at medicorp.org
Subject: [Cnm] small hospital coverage
To: cnm at lists.my180.net
Message-ID:
	<OF5B821854.832DD84F-ON8525754D.00466C0E-8525754D.0046B250 at medicorp.org>
	
Content-Type: text/plain; charset="us-ascii"



We are opening a new hospital. What are small hospitals (100 bed with
expected census of 40 pts.) doing about Sat. and Sun. coverage and what is
your standard for hrs. from cns. completion.  We are looking at 1 CNM/Pt.
Services Manager and 1 PT clinical RD.




-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/51ed20ca/attachment-0001.html 

------------------------------

Message: 3
Date: Thu, 29 Jan 2009 08:00:47 -0500
From: "Fynan, Carla" <fynan-carla at CooperHealth.edu>
Subject: [Cnm] FW:  Brooms
To: "CNM Mailing List (Cnm at lists.my180.net)" <Cnm at lists.my180.net>
Message-ID:
	<77F33794DD223B40BF24AB3D37930250173511942C at mxmbx01.chsmail.root.cooperhealth.edu>
	
Content-Type: text/plain; charset="us-ascii"

Our infection control GURU replied that the broom must be one that does not kick up dust.  A gnarled plastic is best.

________________________________
From: White, Joan
Sent: Thursday, January 29, 2009 7:40 AM
To: Fynan, Carla
Subject: RE: [Cnm] Brooms

We should use a method that does not raise dust.  Let's discuss.  Call me this morning, soon.

________________________________
From: Fynan, Carla
Sent: Thursday, January 29, 2009 7:31 AM
To: White, Joan
Subject: FW: [Cnm] Brooms

Hi,

I wanted to forward this to you because I figured that you would know the answer!  I also wanted to chat with you if you have a few minutes about tomorrows JC Infection Control tracer.  I will be attending the meeting to represent Food & Nutrition.

Thank you,

Carla Fynan, RD
X 2320

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Tina Marie
Sent: Wednesday, January 28, 2009 5:00 PM
To: cnm at lists.my180.net
Subject: [Cnm] Brooms

Hello List!

Our infection control nurse inspected our kitchen and said we couldn't use a broom -- had to be a dust mop ???  Is this a new rule -- am I missing something???

Are you guys using brooms (no straw) or dusting mops ???

Tina Marie MS, RD




****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/84bfa24e/attachment-0001.html 

------------------------------

Message: 4
Date: Thu, 29 Jan 2009 05:44:06 -0800 (PST)
From: Tina Marie <talk2tml at yahoo.com>
Subject: Re: [Cnm] JCAHO - Brooms / Boxes
To: Wyllie Kim <Kim.Wyllie at HCAHealthcare.com>
Cc: cnm at lists.my180.net
Message-ID: <481299.84329.qm at web53806.mail.re2.yahoo.com>
Content-Type: text/plain; charset="iso-8859-1"

No, she said brooms are not allowed to be used in the kitchen beacuse they kick up dust -- 
?
I asked her if she was talking about "patient care areas", which I think she is.
?
I just want to know if anyone else is holding the standard for the kitchen -- or if any surveys required no brooms in the kitchen.
?
What about outside boxes?? Do you have to breakdown all shipping boxes?? Even for the freezer and emergency supply items??? We will be spending a ton of money to buy clear storage boxes!!!? How do you lable freeze items once outside their box...? I think this will be very difficult to itentify FIFO.....? Freezer bags....???? EXPENSIVE !!!
?
Thanks Kim!!
?
Tina Marie

--- On Thu, 1/29/09, Wyllie Kim? wrote:




Tina,
We use brooms (synthetic bristles) in the kitchen.??Was it a?storage/location issue with the nurse?? Our county health inspector is adamant that brooms and mops be stored in a closet and not out on the floor.
?
Kim H. Wyllie, MS,RD,LD 


++++++++++++++++++++++++++++++++++++++++++++++++






Hello List!
?
Our infection control nurse inspected our kitchen and said we couldn't use a broom -- had to be a dust mop ???? Is this a new rule -- am I missing something??? 
?
Are you guys using brooms (no straw) or dusting mops ???
?
Tina Marie MS, RD
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/b30cf280/attachment-0001.html 

------------------------------

Message: 5
Date: Thu, 29 Jan 2009 09:06:11 -0500
From: "Ross, Janet" <Janet.Ross at healthall.com>
Subject: Re: [Cnm] Length of time trays are allowed to stay in a
	patient's	room(acute care)
To: "'Ketterman-Hopkins, Cindra'" <cketterman at wellspan.org>,
	"Bhsemmens at aol.com" <Bhsemmens at aol.com>, "cnm at lists.my180.net"
	<cnm at lists.my180.net>
Message-ID:
	<41CA05D55BF105489D33F8E57D71A905171698679E at MAIL-C.healthall.com>
Content-Type: text/plain; charset="us-ascii"

We teach no longer than 30 minutes and hostesses have become pretty good at refrigerating before the retherm cart heats AND discarding if they know there will be a delay.  How about a table tent to put in the room:  Please call for a meal tray when you return?  Also, we have transporters who are trained to call for a meal tray.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ketterman-Hopkins, Cindra
Sent: Wednesday, January 28, 2009 7:09 AM
To: Bhsemmens at aol.com; cnm at lists.my180.net
Subject: Re: [Cnm] Length of time trays are allowed to stay in a patient's room(acute care)

We are trying to deal with this issue right now.  Unfortunately, one of our city health inspectors had a relative in the hospital and, due to delay in tests, the tray sat in the patient's room 4 hours!  We changed the policy to all trays need to be held in the floor kitchens and appropriate foods refrigerated but nursing just couldn't make that happen.  So, now the policy is that all trays must be held in the floor kitchens and will be removed by the food service employee and placed in the truck when he/she takes the truck of dirty trays down to the dish room.  That would mean the held tray would sit at room temperature, at the most, about 90 minutes.  Our health inspector is visiting this week and so we are waiting for his input to officially implement the policy.

Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934


________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Bhsemmens at aol.com
Sent: Tuesday, January 27, 2009 6:03 PM
To: cnm at lists.my180.net
Subject: [Cnm] Length of time trays are allowed to stay in a patient's room(acute care)
Question:  Does anyone in acute care have a policy determining the length of time a tray can be kept in a room (i.e. 45 minutes or 60 minutes?).

Recently we have had several patients request to hold their trays from meal to meal.  It has created a problem with having adequate trays/lids when census is high as well as a food safety issue.

Thank you,
Beth Semmens

________________________________
A Good Credit Score is 700 or Above. See yours in just 2 easy steps!<http://pr.atwola.com/promoclk/100000075x1215855013x1201028747/aol?redir=http://www.freecreditreport.com/pm/default.aspx?sc=668072%26hmpgID=62%26bcd=DecemailfooterNO62>

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

CONFIDENTIALITY NOTICE:

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information.

________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/1b8eaa79/attachment.html 

------------------------------

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


End of Cnm Digest, Vol 26, Issue 126
************************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/5c316bb3/attachment.html 

From Heberle-Heather at aramark.com  Thu Jan 29 07:41:19 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Thu, 29 Jan 2009 09:41:19 -0600
Subject: [Cnm] Outpatient Re-imbursement
In-Reply-To: <mailman.4756.1233238314.3783.cnm_lists.my180.net@lists.my180.net>
References: <mailman.4756.1233238314.3783.cnm_lists.my180.net@lists.my180.net>
Message-ID: <310D7504-E5F1-4A2E-9497-0F86BCB2705B@mimectl>

Our new Cancer Center is wanting our RD's to do outpatient one-on-one counseling.  Does anyone have any information or incite into this option regarding re-imbursement and where this literature can be found?

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879
Heberle-Heather at aramark.com
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/cc08cd1c/attachment.html 

From POTTERM at fauquierhealth.org  Thu Jan 29 08:31:31 2009
From: POTTERM at fauquierhealth.org (Potter, Mary E.)
Date: Thu, 29 Jan 2009 11:31:31 -0500
Subject: [Cnm] inpatient billing
Message-ID: <8ECF425A281B4A4D88E99F028700A3AA038E3456@fh-excbe01.fauquierhospital.org>

For those of you who are billing for in-patient consults, what code is
being used?

 

Beth Potter, RD
Clinical Nutrition Manager
Fauquier Health|500 Hospital Dr. Warrenton,VA 20186
540-316-4406
potterm at fauquierhealth.org <mailto:e-mail at fauquierhealth.org> 

** Note my new email address is potterm at fauquierhealth.org
<mailto:potterm at fauquierhealth.org>  and new phone number is
540-316-4406**

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/1276c599/attachment.html 

From Terese.Scollard at providence.org  Thu Jan 29 08:55:26 2009
From: Terese.Scollard at providence.org (Scollard, Terese)
Date: Thu, 29 Jan 2009 08:55:26 -0800
Subject: [Cnm] Late Trays
In-Reply-To: <2C7750460C3E7545AC11099BE6A7ABD60204171A@EDC-MAIL-02.ads.bshsi.com>
Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A0323A225@wn1221.or.providence.org>

If you move to room service, late trays and associated expenses and work
go away!  
Terese M. Scollard RD, LD, MBA 
Regional Clinical Nutrition Manager
Regional Nutrition Service PHS-PSA Acute Care
Phone: 503-216-2496 or 503-215-6974
terese.scollard at providence.org 


________________________________

From: Zoll, Susan [mailto:Susan_Zoll at bshsi.org] 
Sent: Wednesday, January 28, 2009 10:00 AM
To: Beth Dorsey; Fynan, Carla; Cnm at lists.my180.net
Subject: Re: [Cnm] Late Trays


15 per day

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Beth Dorsey
Sent: Wednesday, January 28, 2009 11:19 AM
To: Fynan, Carla; Cnm at lists.my180.net
Subject: Re: [Cnm] Late Trays



We are doing about 2500-3000/month.

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Fynan, Carla
Sent: Wednesday, January 28, 2009 9:17 AM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] Late Trays

 

Good Morning!

 

Do any of you have stats on average number of late trays?

 

Thanks!

 

Carla Fynan, RD

Clinical Nutrition Manager

Food & Nutrition Department

Cooper University Hospital

One Cooper Paza

Camden, NJ 08103

(856) 342-2320

 


**************************************************************** This
email, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed. If the reader of this email is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution, or copying of this email is
prohibited. If you received this email in error, please notify the
sender by replying to this message and delete this email immediately. 
________________________________________________________________________
________________________________
The information in this communication is intended to be confidential to
the Individual(s) and/or Entity to whom it is addressed.
It may contain information of a Privileged and/or Confidential nature,
which is subject to Federal and/or State privacy regulations.
In the event that you are not the intended recipient or the agent of the
intended recipient, do not copy or use the information
contained within this communication, or allow it to be read, copied or
utilized in any manner, by any other person(s). Should
this communication be received in error, please notify the sender
immediately either by response e-mail or by phone,
and permanently delete the original e-mail, attachment(s), and any
copies.
________________________________________________________________________
________________________________



DISCLAIMER:
This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/92f6c705/attachment-0001.html 

From cathy.peterjohn at medicorp.org  Thu Jan 29 09:12:28 2009
From: cathy.peterjohn at medicorp.org (cathy.peterjohn at medicorp.org)
Date: Thu, 29 Jan 2009 12:12:28 -0500
Subject: [Cnm] Mediterranean pt. menu
Message-ID: <OF07907592.5E9A164F-ON8525754D.005E6B7C-8525754D.005E8941@medicorp.org>


Would someone repost that great menu from Vermont that was shared in the
past?  We are working on the same and some how it got thrown away and
deleted.  Thanks.




Cathy Peterjohn, MS, RD, CDE
Clinical Nutrition/Diabetes Manager
c/o Nutrition Services
Mary Washington Hospital
1001 Sam Perry Blvd.
Fredericksburg, VA  22401
540-741-1680
Fax: 540-741-4022
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/d2bcf29c/attachment.html 

From Cheryl.Burns at st-johns.org  Thu Jan 29 09:43:20 2009
From: Cheryl.Burns at st-johns.org (Burns, Cheryl)
Date: Thu, 29 Jan 2009 11:43:20 -0600
Subject: [Cnm] Outpatient Re-imbursement  Cancer services
In-Reply-To: <310D7504-E5F1-4A2E-9497-0F86BCB2705B@mimectl>
References: <mailman.4756.1233238314.3783.cnm_lists.my180.net@lists.my180.net>
	<310D7504-E5F1-4A2E-9497-0F86BCB2705B@mimectl>
Message-ID: <35F522FDAEBF6C439FDFCC33B123C8EB013118ED@SJSEXCHCLAG.st-johns.local>

I had this request last week and have the same question.  Heather, I'd
like to be included in what you find out.  I would like to know what we
can list as referral options for the doctor.  For example, is it better
to have the referral say "RD to see for Weight Loss" (or other specific
reason) or should the doctor order "Nutrition Assessment" with a medical
diagnosis.  I'd appreciate any insight too.  

 

Cheryl Burns RD, CSR, LDN

Clinical Nutrition Manager

St. John's Hospital

800 E Carpenter

Springfield IL 62769

 

Phone: 217-544-6464, ext 44818

Fax: 217-757-6871

 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Heberle, Heather N.
Sent: Thursday, January 29, 2009 9:41 AM
To: cnm at lists.my180.net
Subject: [Cnm] Outpatient Re-imbursement

 

Our new Cancer Center is wanting our RD's to do outpatient one-on-one
counseling.  Does anyone have any information or incite into this option
regarding re-imbursement and where this literature can be found?

 

Heather Heberle, RD, LD

Clinical Nutrition Manager

Capital Region Medical Center

1125 Madison St

Jefferson City, MO 65101

phone: 573.632.5192

fax: 573.632.5879

Heberle-Heather at aramark.com <mailto:Heberle-Heather at aramark.com> 

 


This E-mail and any of its attachments contain St. John's Hospital proprietary information,
which is privileged, confidential, or subject to copyright belonging to St. John's Hospital.
This E-mail is intended solely for the use of the individual or entity to which it is addressed.
If you are not the intended recipient of this E-mail, you are hereby notified that any dissemination,
distribution, copying, or action taken in relation to the contents of and attachments to this E-mail
is strictly prohibited and may be unlawful.  If you have received this E-mail in error, please
notify the sender immediately and permanently delete the original and destroy any copy of this
E-mail and any printout.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/b8f36eb2/attachment.html 

From Margaret.Chaffin at hcahealthcare.com  Thu Jan 29 09:44:23 2009
From: Margaret.Chaffin at hcahealthcare.com (Chaffin Meg)
Date: Thu, 29 Jan 2009 11:44:23 -0600
Subject: [Cnm] banana flakes
Message-ID: <FE4E4942DC04FF4DA336172CB2CC522D12B2034208@NADCWPMSGCMS06.hca.corpad.net>

For those of you who are using banana flakes in your facilities, how are you preparing it for patients who take it orally and is it well accepted?

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Center
(229)434-2394

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/fd29a976/attachment.html 

From fynan-carla at CooperHealth.edu  Thu Jan 29 09:50:57 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Thu, 29 Jan 2009 12:50:57 -0500
Subject: [Cnm] FW: Outpatient Re-imbursement
Message-ID: <77F33794DD223B40BF24AB3D3793025017351BC85B@mxmbx01.chsmail.root.cooperhealth.edu>

Here is a response from one of our part time out patient RD's.

Make it a great day!

Carla Fynan, RD
Cooper University Hospital

________________________________
From: Goldsmith, Linda
Sent: Thursday, January 29, 2009 11:20 AM
To: Fynan, Carla; Michaux, Alicia
Subject: RE: Outpatient Re-imbursement

There is a chapter on Reimbursement for MNT in "The Clinical Guide to Oncology Nutrition" available from the American Dietetic Association.  We do not bill for services.

Linda A. Goldsmith, MA, RD
Cooper Cancer Institute
One Cooper Plaza
Camden, NJ  08043
(856) 342-2586

________________________________
From: Fynan, Carla
Sent: Thursday, January 29, 2009 11:16 AM
To: Michaux, Alicia; Goldsmith, Linda
Subject: FW: Outpatient Re-imbursement
I can only get by with a little help from my friends!

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Heberle, Heather N.
Sent: Thursday, January 29, 2009 10:41 AM
To: cnm at lists.my180.net
Subject: [Cnm] Outpatient Re-imbursement

Our new Cancer Center is wanting our RD's to do outpatient one-on-one counseling.  Does anyone have any information or incite into this option regarding re-imbursement and where this literature can be found?

Heather Heberle, RD, LD
Clinical Nutrition Manager
Capital Region Medical Center
1125 Madison St
Jefferson City, MO 65101
phone: 573.632.5192
fax: 573.632.5879
Heberle-Heather at aramark.com<mailto:Heberle-Heather at aramark.com>



****************************************************************
This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed.  If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited.  If you received this email in error, please notify the sender by replying to this message and delete this email immediately.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/ea825f9b/attachment.html 

From DChampeon at stmarysmaine.com  Thu Jan 29 10:27:14 2009
From: DChampeon at stmarysmaine.com (DChampeon at stmarysmaine.com)
Date: Thu, 29 Jan 2009 13:27:14 -0500
Subject: [Cnm] FW: Outpatient Re-imbursement
In-Reply-To: <77F33794DD223B40BF24AB3D3793025017351BC85B@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: <OF7B47D422.383CE39D-ON8525754D.0065015F-8525754D.006561C6@stmarysmaine.com>

One of our clinical dietitians does outpatient assessments in our
hospital's Cancer Center.  The Cancer Center does not charge for the
service.  Cancer Center pays our department for her time with funds from a
Lance Armstrong grant.

Diana.

Diana Champeon
Director, Nutrition Services
St. Mary's Regional Medical Center
100 Campus Avenue
Lewiston, ME 04240
dchampeon at stmarysmaine.com
phone (207)777-8603
fax (207)777-8609





                                                                           
             "Fynan, Carla"                                                
             <fynan-carla at Coop                                             
             erHealth.edu>                                              To 
             Sent by:                  "CNM Mailing List                   
             cnm-bounces at lists         (Cnm at lists.my180.net)"              
             .my180.net                <Cnm at lists.my180.net>               
                                                                        cc 
                                                                           
             01/29/2009 12:54                                      Subject 
             PM                        [Cnm] FW: Outpatient Re-imbursement 
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           





Here is a response from one of our part time out patient RD?s.



Make it a great day!



Carla Fynan, RD

Cooper University Hospital





From: Goldsmith, Linda
Sent: Thursday, January 29, 2009 11:20 AM
To: Fynan, Carla; Michaux, Alicia
Subject: RE: Outpatient Re-imbursement



There is a chapter on Reimbursement for MNT in "The Clinical Guide to
Oncology Nutrition" available from the American Dietetic Association.? We
do not bill for services.



Linda A. Goldsmith, MA, RD

Cooper Cancer Institute

One CooperPlaza

Camden, NJ? 08043

(856) 342-2586





From: Fynan, Carla
Sent: Thursday, January 29, 2009 11:16 AM
To: Michaux, Alicia; Goldsmith, Linda
Subject: FW: Outpatient Re-imbursement

I can only get by with a little help from my friends!





From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Heberle, Heather N.
Sent: Thursday, January 29, 2009 10:41 AM
To: cnm at lists.my180.net
Subject: [Cnm] Outpatient Re-imbursement



Our new CancerCenteris wanting our RD's to do outpatient one-on-one
counseling.? Does anyone have any information or incite into this option
regarding re-imbursement and where this literature can be found?



Heather Heberle, RD, LD

Clinical Nutrition Manager

Capital RegionMedicalCenter

1125 Madison St

Jefferson City, MO65101

phone: 573.632.5192

fax: 573.632.5879

Heberle-Heather at aramark.com


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

From cketterman at wellspan.org  Thu Jan 29 10:49:42 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Thu, 29 Jan 2009 13:49:42 -0500
Subject: [Cnm] FW: Outpatient Re-imbursement
In-Reply-To: <OF7B47D422.383CE39D-ON8525754D.0065015F-8525754D.006561C6@stmarysmaine.com>
References: <77F33794DD223B40BF24AB3D3793025017351BC85B@mxmbx01.chsmail.root.cooperhealth.edu>
	<OF7B47D422.383CE39D-ON8525754D.0065015F-8525754D.006561C6@stmarysmaine.com>
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E0250AD9D@EXCH4.wellspan.org>

We have 2 dietitians in our cancer center and we do not charge for their services either.  This was done at administration's request as the health system wanted to offer comprehensive health services to the cancer center patients that could be accessed by all.  The cancer center offers an array of supportive services and they are all free.   


Cindra L. Ketterman, M.S., L.D.N., R.D.
Chief Clinical Dietitian
Nutrition Support Service
York Hospital
1001 South George Street
York, PA  17405-7198
717-851-3991 or 717-851-2345 ask for pager 0093
Fax 717-8512934

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of DChampeon at stmarysmaine.com
Sent: Thursday, January 29, 2009 1:27 PM
To: Fynan, Carla; cnm at lists.my180.net
Subject: Re: [Cnm] FW: Outpatient Re-imbursement

One of our clinical dietitians does outpatient assessments in our hospital's Cancer Center.  The Cancer Center does not charge for the service.  Cancer Center pays our department for her time with funds from a Lance Armstrong grant.

Diana.

Diana Champeon
Director, Nutrition Services
St. Mary's Regional Medical Center
100 Campus Avenue
Lewiston, ME 04240
dchampeon at stmarysmaine.com
phone (207)777-8603
fax (207)777-8609





                                                                           
             "Fynan, Carla"                                                
             <fynan-carla at Coop                                             
             erHealth.edu>                                              To 
             Sent by:                  "CNM Mailing List                   
             cnm-bounces at lists         (Cnm at lists.my180.net)"              
             .my180.net                <Cnm at lists.my180.net>               
                                                                        cc 
                                                                           
             01/29/2009 12:54                                      Subject 
             PM                        [Cnm] FW: Outpatient Re-imbursement 
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           
                                                                           





Here is a response from one of our part time out patient RD's.



Make it a great day!



Carla Fynan, RD

Cooper University Hospital





From: Goldsmith, Linda
Sent: Thursday, January 29, 2009 11:20 AM
To: Fynan, Carla; Michaux, Alicia
Subject: RE: Outpatient Re-imbursement



There is a chapter on Reimbursement for MNT in "The Clinical Guide to Oncology Nutrition" available from the American Dietetic Association.  We do not bill for services.



Linda A. Goldsmith, MA, RD

Cooper Cancer Institute

One CooperPlaza

Camden, NJ  08043

(856) 342-2586





From: Fynan, Carla
Sent: Thursday, January 29, 2009 11:16 AM
To: Michaux, Alicia; Goldsmith, Linda
Subject: FW: Outpatient Re-imbursement

I can only get by with a little help from my friends!





From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Heberle, Heather N.
Sent: Thursday, January 29, 2009 10:41 AM
To: cnm at lists.my180.net
Subject: [Cnm] Outpatient Re-imbursement



Our new CancerCenteris wanting our RD's to do outpatient one-on-one counseling.  Does anyone have any information or incite into this option regarding re-imbursement and where this literature can be found?



Heather Heberle, RD, LD

Clinical Nutrition Manager

Capital RegionMedicalCenter

1125 Madison St

Jefferson City, MO65101

phone: 573.632.5192

fax: 573.632.5879

Heberle-Heather at aramark.com


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email Content Service, visit http://www.mci.com.
______________________________________________________________________

CONFIDENTIALITY NOTICE:  

This email may contain confidential health information that is legally privileged.  This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited.  If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information. 


______________________________________________________________________
This e-mail has been scanned by MCI Managed Email Content Service, using Skeptic(tm) technology powered by MessageLabs. For more information on MCI's Managed Email  Content Service, visit http://www.mci.com.
______________________________________________________________________


From Margaret.Chaffin at hcahealthcare.com  Thu Jan 29 11:39:26 2009
From: Margaret.Chaffin at hcahealthcare.com (Chaffin Meg)
Date: Thu, 29 Jan 2009 13:39:26 -0600
Subject: [Cnm] banana flakes
Message-ID: <FE4E4942DC04FF4DA336172CB2CC522D12B203450B@NADCWPMSGCMS06.hca.corpad.net>

Let me clarify my previous question (how are other facilities preparing banana flakes for oral intake?) since I've gotten some responses about just giving the patient a banana, instead of the flakes if they are able to eat. It is for a renal patient with c.diff and since the flakes have < 100mg K+/serving, we were thinking of it as an alternative to a banana with > 400mg K+.

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Center
(229)434-2394

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/b8d85f0d/attachment.html 

From MKarustis at dh.org  Thu Jan 29 11:55:36 2009
From: MKarustis at dh.org (Karustis, Marcelle)
Date: Thu, 29 Jan 2009 14:55:36 -0500
Subject: [Cnm] Malnutrition Coding
Message-ID: <526B6282E69E0F4B9C80A8B646A6FADB0150BB58@dhmail.dhorg.org>

Anyone have any forms to share that they are using for malnutrition coding?
Sure would appreciate it if anyone can share.
Thanks

Marcelle Karustis MS RD RN LDN 
Clinical Nutrition Manager 
Doylestown Hospital 
595 West State Street 
Doylestown, PA 18901 
215 345-2504 
Fax 215 345-2510



 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/f7da94a8/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 2570 bytes
Desc: image002.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090129/f7da94a8/attachment.jpe 

From sw1979 at nahealth.com  Thu Jan 29 12:43:08 2009
From: sw1979 at nahealth.com (Sheila Walsh)
Date: Thu, 29 Jan 2009 13:43:08 -0700
Subject: [Cnm] Malnutrition Coding
In-Reply-To: <526B6282E69E0F4B9C80A8B646A6FADB0150BB58@dhmail.dhorg.org>
References: <526B6282E69E0F4B9C80A8B646A6FADB0150BB58@dhmail.dhorg.org>
Message-ID: <4981B26C.485B.0001.0@nahealth.com>

Identifying malnutrition helps the coders attach co-morbidities to our patients' diagnoses, which will improve reimbursement.


Sheila A. Walsh, MPH, RD
Clinical Nutrition Manager
Flagstaff Medical Center
Where patients are our purpose.
 


>>> "Karustis, Marcelle" <MKarustis at dh.org> 1/29/2009 12:55 PM >>>

Anyone have any forms to share that they are using for malnutrition coding?
Sure would appreciate it if anyone can share.
Thanks
Marcelle Karustis MS RD RN LDN 
Clinical Nutrition Manager 
Doylestown Hospital 
595 West State Street 
Doylestown, PA 18901 
215 345-2504 
Fax 215 345-2510
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/c38c4c73/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 2570 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090129/c38c4c73/attachment-0001.jpe 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: 2007 ICD.doc
Type: application/msword
Size: 65024 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090129/c38c4c73/attachment-0002.doc 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: malnutrition ICD 9 code sheet-	this one.doc
Type: application/msword
Size: 32768 bytes
Desc: not available
Url : /pipermail/cnm_lists.my180.net/attachments/20090129/c38c4c73/attachment-0003.doc 

From mansishah79 at gmail.com  Thu Jan 29 13:40:42 2009
From: mansishah79 at gmail.com (Mansi Shah)
Date: Thu, 29 Jan 2009 13:40:42 -0800
Subject: [Cnm] FS worker job descriptions
Message-ID: <bb1846bf0901291340r5fd43a07p27c4dc95c567a7ba@mail.gmail.com>

Is anyone willing to share job descriptions for food-service workers. We are
looking into revising our job descriptions for FS staff.

Thanks in advance
Mansi Shah, RD, CNSD
Olympia Medical Center
Los Angeles, CA 90036
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/8adcb72f/attachment.html 

From mansishah79 at gmail.com  Thu Jan 29 14:51:22 2009
From: mansishah79 at gmail.com (Mansi Shah)
Date: Thu, 29 Jan 2009 14:51:22 -0800
Subject: [Cnm] Group Outpt class charge
Message-ID: <bb1846bf0901291451n3511a17fw42348db8a7998f88@mail.gmail.com>

If your facility offers group outpatient nutrition classes (eg: Diabetes),
what $ amount do you charge from individuals to attend that group? We have
charges for one-on-one counselling but want to find out what an appropriate
charge amount would be for a group class, I'm thinking between
$10-$20/person???

Thanks
Mansi Shah, RD, CNSD
Olympia Medical Center
Los Angeles, CA 90036
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/0dd1759c/attachment.html 

From RachelFlores at sach.org  Thu Jan 29 16:29:50 2009
From: RachelFlores at sach.org (Flores, Rachel)
Date: Thu, 29 Jan 2009 16:29:50 -0800
Subject: [Cnm] Group Outpt class charge
Message-ID: <FDB253808C3BD611AE6F0002A5D9E8EB0C48D63F@S1EXH002>

We charge $25 per person.  It's a 2 hour class with RD and nurse educator.

 

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

  _____  

From: Mansi Shah [mailto:mansishah79 at gmail.com] 
Sent: Thursday, January 29, 2009 2:51 PM
To: CNM-ListServe
Subject: [Cnm] Group Outpt class charge

 

If your facility offers group outpatient nutrition classes (eg: Diabetes),
what $ amount do you charge from individuals to attend that group? We have
charges for one-on-one counselling but want to find out what an appropriate
charge amount would be for a group class, I'm thinking between
$10-$20/person???

 

Thanks

Mansi Shah, RD, CNSD

Olympia Medical Center

Los Angeles, CA 90036

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/777f3645/attachment.html 

From MKarustis at dh.org  Fri Jan 30 05:30:18 2009
From: MKarustis at dh.org (Karustis, Marcelle)
Date: Fri, 30 Jan 2009 08:30:18 -0500
Subject: [Cnm] Malnutrition Coding
In-Reply-To: <49820D87.7080605@bryanlgh.org>
Message-ID: <526B6282E69E0F4B9C80A8B646A6FADB0150BB5C@dhmail.dhorg.org>

Thanks, all!
One question:  is anyone using anything based on BMI instead of IBW?
We are already seeing low BMI's and I was hoping to "spring board" off of what we are already doing.
Or, must we stick EXACTLY to the phrasing in the coding manual?
Thanks again
Marcelle

-----Original Message-----
From: Nancy A. Hakel-Smith [mailto:nancy.hakel-smith at bryanlgh.org]
Sent: Thursday, January 29, 2009 3:12 PM
To: Karustis, Marcelle
Subject: Re: [Cnm] Malnutrition Coding


Marcelle,
This is what we are currently using.
NH-S

Karustis, Marcelle wrote: 

Anyone have any forms to share that they are using for malnutrition coding?
Sure would appreciate it if anyone can share.
Thanks

Marcelle Karustis MS RD RN LDN 
Clinical Nutrition Manager 
Doylestown Hospital 
595 West State Street 
Doylestown, PA 18901 
215 345-2504 
Fax 215 345-2510



 


  _____  


_______________________________________________

Cnm mailing list

Cnm at lists.my180.net

http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

  


-- 

CONFIDENTIALITY NOTICE: This e-mail message,including any

attachments,is for the sole use of the intended recipient(s)

and may contain confidential and privileged information. Any

unauthorized review, use, disclosure or distribution is 

prohibited. If you are not the intended recipient,please

contact the sender by reply e-mail and destroy all copies

of the original message.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090130/731901c7/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 2570 bytes
Desc: ATT100285838.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090130/731901c7/attachment.jpe 

From Maureen.McAndrews at emoryhealthcare.org  Fri Jan 30 06:02:39 2009
From: Maureen.McAndrews at emoryhealthcare.org (McAndrews, Maureen)
Date: Fri, 30 Jan 2009 09:02:39 -0500
Subject: [Cnm] Malnutrition Coding
In-Reply-To: <526B6282E69E0F4B9C80A8B646A6FADB0150BB5C@dhmail.dhorg.org>
References: <49820D87.7080605@bryanlgh.org>
	<526B6282E69E0F4B9C80A8B646A6FADB0150BB5C@dhmail.dhorg.org>
Message-ID: <A89529EC413D384A8BB8F8C936C49E7B02316998E0E5@EXCHANGE23.Enterprise.emory.net>

We did an extensive review of the literature last year and had the attached criteria for diagnosing malnutrition and obesity approved by our Nutrition Support Committee. We had criteria previous to this that included visceral proteins, but found no support for it in most categories.
Maureen

Maureen McAndrews, MPH, RD, LD
Director, Dietetic Internship
Asst. Director, Food & Nutrition Services
Emory Hospitals
Atlanta, GA
404-712-4176


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karustis, Marcelle
Sent: Friday, January 30, 2009 8:30 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] Malnutrition Coding

Thanks, all!
One question:  is anyone using anything based on BMI instead of IBW?
We are already seeing low BMI's and I was hoping to "spring board" off of what we are already doing.
Or, must we stick EXACTLY to the phrasing in the coding manual?
Thanks again
Marcelle
-----Original Message-----
From: Nancy A. Hakel-Smith [mailto:nancy.hakel-smith at bryanlgh.org]
Sent: Thursday, January 29, 2009 3:12 PM
To: Karustis, Marcelle
Subject: Re: [Cnm] Malnutrition Coding
Marcelle,
This is what we are currently using.
NH-S

Karustis, Marcelle wrote:
Anyone have any forms to share that they are using for malnutrition coding?
Sure would appreciate it if anyone can share.
Thanks

Marcelle Karustis MS RD RN LDN
Clinical Nutrition Manager
Doylestown Hospital
595 West State Street
Doylestown, PA 18901
215 345-2504
Fax 215 345-2510

[cid:image001.jpg at 01C982B9.7A62B660]





________________________________






_______________________________________________

Cnm mailing list

Cnm at lists.my180.net<mailto:Cnm at lists.my180.net>

http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net





--

CONFIDENTIALITY NOTICE: This e-mail message,including any

attachments,is for the sole use of the intended recipient(s)

and may contain confidential and privileged information. Any

unauthorized review, use, disclosure or distribution is

prohibited. If you are not the intended recipient,please

contact the sender by reply e-mail and destroy all copies

of the original message.

________________________________
This e-mail message (including any attachments) is for the sole use of
the intended recipient(s) and may contain confidential and privileged
information. If the reader of this message is not the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this message (including any attachments) is strictly
prohibited.

If you have received this message in error, please contact
the sender by reply e-mail message and destroy all copies of the
original message (including attachments).
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090130/0218c297/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image001.jpg
Type: image/x-citrix-jpeg
Size: 2570 bytes
Desc: image001.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090130/0218c297/attachment-0002.bin 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: malnutrition and obesity chart.docx
Type: application/vnd.openxmlformats-officedocument.wordprocessingml.document
Size: 15711 bytes
Desc: malnutrition and obesity chart.docx
Url : /pipermail/cnm_lists.my180.net/attachments/20090130/0218c297/attachment-0003.bin 

From LCarver at Reshealthcare.org  Fri Jan 30 06:41:55 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Fri, 30 Jan 2009 08:41:55 -0600
Subject: [Cnm] Malnutrition Coding
In-Reply-To: <A89529EC413D384A8BB8F8C936C49E7B02316998E0E5@EXCHANGE23.Enterprise.emory.net>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03CD2173@rhcexch3.reshealthcare.org>

Maureen:  could you share some of the most pertinent literature
citations you used to support the malnutrition coding chart?  Thanks.
Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of McAndrews, Maureen
Sent: Friday, January 30, 2009 8:03 AM
To: 'Karustis, Marcelle'; cnm at lists.my180.net
Subject: Re: [Cnm] Malnutrition Coding



We did an extensive review of the literature last year and had the
attached criteria for diagnosing malnutrition and obesity approved by
our Nutrition Support Committee. We had criteria previous to this that
included visceral proteins, but found no support for it in most
categories.

Maureen

 

Maureen McAndrews, MPH, RD, LD

Director, Dietetic Internship

Asst. Director, Food & Nutrition Services

Emory Hospitals

Atlanta, GA

404-712-4176

 

 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Karustis, Marcelle
Sent: Friday, January 30, 2009 8:30 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] Malnutrition Coding

 

Thanks, all!

One question:  is anyone using anything based on BMI instead of IBW?

We are already seeing low BMI's and I was hoping to "spring board" off
of what we are already doing.

Or, must we stick EXACTLY to the phrasing in the coding manual?

Thanks again

Marcelle

	-----Original Message-----
	From: Nancy A. Hakel-Smith
[mailto:nancy.hakel-smith at bryanlgh.org]
	Sent: Thursday, January 29, 2009 3:12 PM
	To: Karustis, Marcelle
	Subject: Re: [Cnm] Malnutrition Coding

	Marcelle,
	This is what we are currently using.
	NH-S
	
	Karustis, Marcelle wrote: 

	Anyone have any forms to share that they are using for
malnutrition coding?

	Sure would appreciate it if anyone can share.

	Thanks

	Marcelle Karustis MS RD RN LDN 
	Clinical Nutrition Manager 
	Doylestown Hospital 
	595 West State Street 
	Doylestown, PA 18901 
	215 345-2504 
	Fax 215 345-2510

	 

	 

	
________________________________



	 
	_______________________________________________
	Cnm mailing list
	Cnm at lists.my180.net
	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
	  

	
	
	

	-- 
	CONFIDENTIALITY NOTICE: This e-mail message,including any
	attachments,is for the sole use of the intended recipient(s)
	and may contain confidential and privileged information. Any
	unauthorized review, use, disclosure or distribution is 
	prohibited. If you are not the intended recipient,please
	contact the sender by reply e-mail and destroy all copies
	of the original message.


________________________________

This e-mail message (including any attachments) is for the sole use of
the intended recipient(s) and may contain confidential and privileged
information. If the reader of this message is not the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this message (including any attachments) is strictly
prohibited.

If you have received this message in error, please contact
the sender by reply e-mail message and destroy all copies of the
original message (including attachments).

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090130/af39f0ad/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/x-citrix-jpeg
Size: 2570 bytes
Desc: image001.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090130/af39f0ad/attachment.bin 

From LCarver at Reshealthcare.org  Fri Jan 30 06:35:23 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Fri, 30 Jan 2009 08:35:23 -0600
Subject: [Cnm] Malnutrition Coding
In-Reply-To: <526B6282E69E0F4B9C80A8B646A6FADB0150BB5C@dhmail.dhorg.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03CD216C@rhcexch3.reshealthcare.org>

Since Medicare coding looks at BMI I am personally comfortable using low
BMI as a starting point - that often, esp. in the elderly and
chronically ill, ends up leading to dystrophy (muscle wasting) as the
coding detail in CMS.  Leslee Carver

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Karustis, Marcelle
Sent: Friday, January 30, 2009 7:30 AM
To: cnm at lists.my180.net
Subject: Re: [Cnm] Malnutrition Coding


Thanks, all!
One question:  is anyone using anything based on BMI instead of IBW?
We are already seeing low BMI's and I was hoping to "spring board" off
of what we are already doing.
Or, must we stick EXACTLY to the phrasing in the coding manual?
Thanks again
Marcelle

	-----Original Message-----
	From: Nancy A. Hakel-Smith
[mailto:nancy.hakel-smith at bryanlgh.org]
	Sent: Thursday, January 29, 2009 3:12 PM
	To: Karustis, Marcelle
	Subject: Re: [Cnm] Malnutrition Coding
	
	
	Marcelle,
	This is what we are currently using.
	NH-S
	
	Karustis, Marcelle wrote: 

		Anyone have any forms to share that they are using for
malnutrition coding?
		Sure would appreciate it if anyone can share.
		Thanks

		Marcelle Karustis MS RD RN LDN 
		Clinical Nutrition Manager 
		Doylestown Hospital 
		595 West State Street 
		Doylestown, PA 18901 
		215 345-2504 
		Fax 215 345-2510

		 

		 
		
________________________________


		_______________________________________________
		Cnm mailing list
		Cnm at lists.my180.net
		
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
		  


	-- 
	CONFIDENTIALITY NOTICE: This e-mail message,including any
	attachments,is for the sole use of the intended recipient(s)
	and may contain confidential and privileged information. Any
	unauthorized review, use, disclosure or distribution is 
	prohibited. If you are not the intended recipient,please
	contact the sender by reply e-mail and destroy all copies
	of the original message.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090130/ab51c778/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 2570 bytes
Desc: ATT100285838.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090130/ab51c778/attachment.jpe 

From cloose at agmc.org  Tue Jan 27 08:55:33 2009
From: cloose at agmc.org (Claire Loose)
Date: Tue, 27 Jan 2009 11:55:33 -0500
Subject: [Cnm] MS and diet, mercury levels?
Message-ID: <497EF6350200005A00010ADE@webmail.agmc.org>

OK.  One of those lovely questions routed to me through the hospital
operator from "outside" our facility.  Pt's brother has MS- reading a
book called "Healing".  It recommends salmon over tuna due to the high
mercury content of tuna.  We go on from there. Anyone heard of this book
or work with folks that have MS to give me some pointers?  We really do
not encounter this at our facility so I am not up on it, nothing in the
Evidence library on it.  What I recall is that there isn't much of a
connection between diet and MS.  Help?


*
*
*
Akron General - Never Underestimate the Power of Trust

www.akrongeneral.org 
-------------- next part --------------
An embedded and charset-unspecified text was scrubbed...
Name: Claire Loose.vcf
Url: /pipermail/cnm_lists.my180.net/attachments/20090127/98dbb6e9/attachment.pl 

From Janet.Ross at healthall.com  Thu Jan 29 06:26:22 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Thu, 29 Jan 2009 09:26:22 -0500
Subject: [Cnm] modulars policy
In-Reply-To: <CBE0048956D4B14C893378F8D13A36E2028B3125@IRMEXCH02.irm.inhs.org>
References: <304A991E3C8B4948A52DB718FF048D7F08E3810E@DOCHS-MSG-SMC.BAY.DOCHS.LOCAL>
	<CBE0048956D4B14C893378F8D13A36E2028B3125@IRMEXCH02.irm.inhs.org>
Message-ID: <41CA05D55BF105489D33F8E57D71A90517169867A3@MAIL-C.healthall.com>


Benefiber and glutamine are distributed through pharmacy.
I would love to get beneprotein moved to pharmacy because that is the only way it would be documented.  We now send out beneprotein packets (about 75 per day) and I suspect that about 20 percent eventually come back to us--labels removed, so it's impossible to track consistently which nurse, which shift is not doing her job.  Most of the beneprotein should be going down a G tube; we deliver before 9am from the kitchen.
Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
P Please consider the environment before printing.


From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Scott, Kerry R.
Sent: Wednesday, January 28, 2009 4:42 PM
To: Lewis, Maria (SMC); cnm at lists.my180.net
Subject: Re: [Cnm] modulars policy

Benefiber, beneprotein and glutamine are distributed through pharmacy w/ meds so appear on the MAR with administratin insturctions.


Kerry Scott, RD, CD
Clinical Nutrition Manager
Food & Nutrition Services
Providence Sacred Heart Medical Center & Children's Hospital
(509)474-4774

Kerry.Scott at providence.org


________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Lewis, Maria (SMC)
Sent: Wednesday, January 28, 2009 11:43 AM
To: cnm at lists.my180.net
Subject: [Cnm] modulars policy
Does anyone have any policies on how modulars (beneprotein, banana flakes, etc. ) are distributed, administered and documented in your facility?  Our facility desperately needs to develop some policies re: this issue.
Thank You,
Maria C. Lewis, RD, CNSD
Clinical Nutrition Manager
Seton Medical Center & Seton Coastside
1900 Sullivan Avenue
Daly City, CA 94015
(650) 991-5915

 [cid:image002.gif at 01C981F3.A55050B0]


________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090129/74b78725/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image001.jpg
Type: image/jpeg
Size: 11748 bytes
Desc: image001.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090129/74b78725/attachment-0001.jpg 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image002.gif
Type: image/gif
Size: 2184 bytes
Desc: image002.gif
Url : /pipermail/cnm_lists.my180.net/attachments/20090129/74b78725/attachment-0001.gif 

From lmerrima at nyp.org  Tue Jan 27 14:44:41 2009
From: lmerrima at nyp.org (Louise R. Merriman)
Date: Tue, 27 Jan 2009 17:44:41 -0500
Subject: [Cnm] warfarin diet orders
In-Reply-To: <20090127100736.AEQ91227@mail.mainehospital.org>
References: <B00C3105874BC94EB9D63BA80329C9CA08D7BA54@GMHMAIL.ghp.local>
	<497F164D.2040908@nyp.org>
	<20090127100736.AEQ91227@mail.mainehospital.org>
Message-ID: <497F8E59.1010601@nyp.org>

patient ed piece attached
Cece Ohmart wrote:
> Can you share this point system with the list?
> Thanks,
> Cece
> This message is intended for the use of the addressee only and may contain information that is privileged and confidential.  If you are not the intended recipient of this message, be notified that any dissemination or use of this message is strictly prohibited.  Un-intended transmission does not constitute waiver of attorney-client privilege or any other privilege.  If you have received this message in error, please delete all copies of the message and its attachments and notify the sender immediately.  Thank you.
>   



--------------------

This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited.  If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message.  Thank you.


-------------- next part --------------
An embedded and charset-unspecified text was scrubbed...
Name: Warfarin (Coumadin?) (9-08) FINAL.doc
Url: /pipermail/cnm_lists.my180.net/attachments/20090127/1575d861/attachment-0001.pl 

From LCarver at Reshealthcare.org  Fri Jan 30 08:38:48 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Fri, 30 Jan 2009 10:38:48 -0600
Subject: [Cnm] MS and diet, mercury levels?
In-Reply-To: <497EF6350200005A00010ADE@webmail.agmc.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E03CD2224@rhcexch3.reshealthcare.org>

Weinstock-Guttman B, Baier M, Park Y, Feichter J, Lee-Kwen P, Gallagher
E, Venkatraman J, Meksawan K, Deineher, S, Pendergast D, Awad AB,
Ramanathan M, Munschauer F, Rudick R. "Low fat dietary intervention with
omega-3 fatty acid supplementation in multiple sclerosis patients."
Prostaglandins, Leukotrienes and Essential Fatty Acids Volume 73, Issue
5 , November 2005, Pages 397-404.

Miller A, Korem M, Almog R, Galboiz Y. "Vitamin B12, demyelination,
remyelination and repair in multiple sclerosis." Journal of the
Neurological Sciences Volume 233, Issues 1-2 , 15 June 2005, Pages
93-97. 

Lauer K. "Sausage Preservation Methods and the Prevalence of Multiple
Sclerosis: An Ecological Study." Ecology of Food and Nutrition, Volume
46, Number 1, January-February 2007, pp. 1-11(11) 

Cantorna MT, Mahon BD. "Mounting evidence for vitamin D as an
environmental factor affecting autoimmune disease prevalence."
Experimental Biology and Medicine 229:1136-1142 (2004).


Here are some references.  We had a dietitian here (I don't have a
current e-mail address for her) who has MS and, of course followed the
research carefully.  Basically, her conclusions were to have a diet rich
in omega-3's, fruits and vegetables and low in saturated fats.  The
research on B12 and Vit D been more recent.  Basically, the data is not
strong at this point but the recommendations certainly fall in the "do
no harm" category.  Leslee Carver 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Claire Loose
Sent: Tuesday, January 27, 2009 10:56 AM
To: CNM at lists.my180.net
Subject: [Cnm] MS and diet, mercury levels?

OK.  One of those lovely questions routed to me through the hospital
operator from "outside" our facility.  Pt's brother has MS- reading a
book called "Healing".  It recommends salmon over tuna due to the high
mercury content of tuna.  We go on from there. Anyone heard of this book
or work with folks that have MS to give me some pointers?  We really do
not encounter this at our facility so I am not up on it, nothing in the
Evidence library on it.  What I recall is that there isn't much of a
connection between diet and MS.  Help?


*
*
*
Akron General - Never Underestimate the Power of Trust

www.akrongeneral.org 


From cwatters at ualberta.ca  Fri Jan 30 09:00:52 2009
From: cwatters at ualberta.ca (cwatters at ualberta.ca)
Date: Fri, 30 Jan 2009 10:00:52 -0700
Subject: [Cnm] State of GA: 4 day water/food supply
In-Reply-To: <138AE4B62F86AC4D9BC23F0168F106550A072C16@EXCHCLUSTER.ths.local>
References: <138AE4B62F86AC4D9BC23F0168F106550A072C16@EXCHCLUSTER.ths.local>
Message-ID: <20090130100052.57796d23r8wke1cs@webmail.ualberta.ca>

Can anyone please tell me Where it is this written regarding the 4  
days of emergency water/ food supply, are there specific regulations  
through JCAHO?
Need to have an official regulation to represent to our health region  
for the need to have water and food supplies on hand.


Corilee Watters, MSc, RD, PhD
Coordinator, Nutrition Services
Victoria General, Royal Jubilee, Saanich Peninsula and Lady Minto Hospitals




Quoting "Shauntel Ragland" <sragland at tanner.org>:

> CNM List Subscribers in the state of GA -
>
>
>
> I would like to know how your facilities are complying with 4 day
> emergency water/food supply on-site; specifically storage space for
> water and rotation.  In the past I know facilities had agreements with
> milk companies to supply water in an emergency but this is no longer
> acceptable.
>
>
>
> Last year the state inspector indicated requirement to have on hand, but
> did not ding us for it.   Does any one have suggestions on meeting
> compliance in this area?
>
>
>
> Thanks in advance!
>
>
>
> ________________________________
>
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Carver, Leslee
> Sent: Wednesday, January 14, 2009 11:59 AM
> To: Melissa Tewes; cnm at lists.my180.net
> Subject: Re: [Cnm] Latex Allergies
>
>
>
> we do not put a stop on any foods because of a latex allergy unless we
> are told specifically.  Leslee
>
>
>
> ________________________________
>
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Melissa Tewes
> Sent: Wednesday, January 14, 2009 7:52 AM
> To: cnm at lists.my180.net
> Subject: [Cnm] Latex Allergies
>
> How are these being handled in your facilities?  Do you have a specific
> question when a pt has a latex allergy regarding foods?  Or do you
> assume they would report a food allergy if they have any associated
> sensitivities?
>
>
>
> Melissa Tewes RD, LDN
>
> Clinical Nutrition Manager
>
> Washingon County Health System
>
> 251 East Antietam Street
>
> Hagerstown, MD 21740
>
> Phone:  301-790-8084
>
> Fax:  301-790-8535
>
>
>
> mtewes at wchsys.org
>
>
>
>
> ***** CONFIDENTIALITY NOTICE ***** This message contains confidential
> information and is intended only for the individual named. If you are
> not the named addressee you should not disseminate, distribute or copy
> this e-mail. Please notify the sender immediately by e-mail if you have
> received this e-mail by mistake and delete this e-mail from your system.
>
>
>



From Janet.Ross at healthall.com  Fri Jan 30 09:38:29 2009
From: Janet.Ross at healthall.com (Ross, Janet)
Date: Fri, 30 Jan 2009 12:38:29 -0500
Subject: [Cnm] MS and diet,
 mercury levels?  Steer him to this VIT D research.
In-Reply-To: <497EF6350200005A00010ADE@webmail.agmc.org>
References: <497EF6350200005A00010ADE@webmail.agmc.org>
Message-ID: <41CA05D55BF105489D33F8E57D71A90517169867BD@MAIL-C.healthall.com>

Vitamin D Linked to Genetic, Environmental Risk for MS
Allison Gandey
http://www.medscape.com/viewarticle/581125?src=mpnews&spon=26&uac=66422BV  Dr. George Ebers discusses the new study.
September 26, 2008 (Salt Lake City, Utah) ? Results from a new study unite the genetic and environmental risks of multiple sclerosis in a disease-specific and gene-environment interaction. Presenting at the American Neurological Association 133rd Annual Meeting, researchers described a link between vitamin D and the pathogenesis of MS.
"There's a connection between the 2 ? no question about it," lead investigator George Ebers, MD, from the University of Oxford, in the United Kingdom, told Medscape Neurology & Neurosurgery. "But exactly how it works is not clear yet."
Asked to comment on the work, Emmanuelle Waubant, MD, from the University of California, San Francisco said, "MS is a very heterogeneous disease, and this is an interesting way to look at the factors that predispose people."
She noted, "This study looks at the bigger picture and is the way things should be done. The data provide decent traction and it is an interesting result."
Dr. Ebers and his team examined the major histocompatibility complex
(MHC) for deoxyribonucleic acid (DNA) sequences predicted to respond to vitamin-D complexes.
They identified a single sequence, which appeared to be functionally active because it transfected the segment into cell lines and measured functional expression in response to added vitamin D.
Unexpectedly, they found this sequence is haplotype-specific and perhaps evolving in response to selective pressures characterizing the northern migration of European populations.
This solitary MHC vitamin-D?responsive element is strategically located in the promoter region of the class II complex specific to a haplotype associated with MS risk, Dr. Ebers told the meeting.
"These findings further implicate vitamin D in environmentally mediated MS risk," he said.
Sequence Haplotype-Specific
During an interview after the session, Dr. Ebers said his group was surprised by what it found. "Most times you don't find exactly what you are looking for, but in this case, that is exactly what we found. It was as plain as day."
The data suggesting vitamin D is deficient in MS are strong, Dr. Waubant added. "What is unclear is whether or not it also affects the severity of disease."
"Everyone who has examined this from the National Academy of Sciences to the dietary committee of the European Union to a variety of professional organizations all agree pretty much that the amount of vitamin D that people are getting is too low," Dr. Ebers pointed out.
"I know all the experts in the field, and they've sort of voted with their feet," he said. "They're all on vitamin D and their family is on it too. As far as anyone can tell, the amounts in question are harmless, and it's dirt cheap."
Some experts are advocating that given the potential benefit, vitamin D should be widely administered. But others have reservations and are recommending a more cautious approach.
"I'm reluctant to say there's absolutely no risk, because people have been wrong on these things," Dr. Ebers told Medscape Neurology & Neurosurgery. "But I think in this particular case, the evidence has been so strong that it's safe, and all the experts who examine this are comfortable. Plus, many are giving 2000 units a day to pregnant women, so that should be as reassuring as anything."
This study was funded by the Scientific Foundation of the Canadian MS Society and the UK MS Society. The researchers have disclosed no relevant financial relationships.
American Neurological Association 133rd Annual Meeting: Derek Denny-Brown New Member Symposium. Presented September 23, 2008.

Janet V. Ross, MBA,RD,LD
Clinical Nutrition Coordinator
Drake Center
janet.ross at healthall.com
http://www.health-alliance.com/
ph 513-418-2603
fx 513-418-5939
pg 513-577-6879
? Please consider the environment before printing.


-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Claire Loose
Sent: Tuesday, January 27, 2009 11:56 AM
To: CNM at lists.my180.net
Subject: [Cnm] MS and diet, mercury levels?

OK.  One of those lovely questions routed to me through the hospital operator from "outside" our facility.  Pt's brother has MS- reading a book called "Healing".  It recommends salmon over tuna due to the high mercury content of tuna.  We go on from there. Anyone heard of this book or work with folks that have MS to give me some pointers?  We really do not encounter this at our facility so I am not up on it, nothing in the Evidence library on it.  What I recall is that there isn't much of a connection between diet and MS.  Help?


*
*
*
Akron General - Never Underestimate the Power of Trust

www.akrongeneral.org

Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information.  Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

From cathysmith at mhsjvl.org  Fri Jan 30 11:25:02 2009
From: cathysmith at mhsjvl.org (Smith, Cathy)
Date: Fri, 30 Jan 2009 13:25:02 -0600
Subject: [Cnm] FW: Outpatient Re-imbursement
References: <OF7B47D422.383CE39D-ON8525754D.0065015F-8525754D.006561C6@stmarysmaine.com>
Message-ID: <4973FD77BA585043AC3C49ED6D7B9F8302E22D1C@MXV1.mercy.org>

We also provide consulting services on a referral basis at no charge to the patient.  The Cancer Center/Oncology Clinics pay for the RD's salary for that time.  It is always schedualed for a time they will be in for a treatment.  Those who have completed radiation or chemo and are just following up in those clinics are charges as any other outpatient & seen by that RD at a different site.
Cathy

________________________________

From: cnm-bounces at lists.my180.net on behalf of DChampeon at stmarysmaine.com
Sent: Thu 1/29/2009 12:27 PM
To: Fynan, Carla; cnm at lists.my180.net
Subject: Re: [Cnm] FW: Outpatient Re-imbursement



One of our clinical dietitians does outpatient assessments in our
hospital's Cancer Center.  The Cancer Center does not charge for the
service.  Cancer Center pays our department for her time with funds from a
Lance Armstrong grant.

Diana.

Diana Champeon
Director, Nutrition Services
St. Mary's Regional Medical Center
100 Campus Avenue
Lewiston, ME 04240
dchampeon at stmarysmaine.com
phone (207)777-8603
fax (207)777-8609





                                                                          
             "Fynan, Carla"                                               
             <fynan-carla at Coop                                            
             erHealth.edu>                                              To
             Sent by:                  "CNM Mailing List                  
             cnm-bounces at lists         (Cnm at lists.my180.net)"             
             .my180.net                <Cnm at lists.my180.net>              
                                                                        cc
                                                                          
             01/29/2009 12:54                                      Subject
             PM                        [Cnm] FW: Outpatient Re-imbursement
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          





Here is a response from one of our part time out patient RD's.



Make it a great day!



Carla Fynan, RD

Cooper University Hospital





From: Goldsmith, Linda
Sent: Thursday, January 29, 2009 11:20 AM
To: Fynan, Carla; Michaux, Alicia
Subject: RE: Outpatient Re-imbursement



There is a chapter on Reimbursement for MNT in "The Clinical Guide to
Oncology Nutrition" available from the American Dietetic Association.  We
do not bill for services.



Linda A. Goldsmith, MA, RD

Cooper Cancer Institute

One CooperPlaza

Camden, NJ  08043

(856) 342-2586





From: Fynan, Carla
Sent: Thursday, January 29, 2009 11:16 AM
To: Michaux, Alicia; Goldsmith, Linda
Subject: FW: Outpatient Re-imbursement

I can only get by with a little help from my friends!





From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Heberle, Heather N.
Sent: Thursday, January 29, 2009 10:41 AM
To: cnm at lists.my180.net
Subject: [Cnm] Outpatient Re-imbursement



Our new CancerCenteris wanting our RD's to do outpatient one-on-one
counseling.  Does anyone have any information or incite into this option
regarding re-imbursement and where this literature can be found?



Heather Heberle, RD, LD

Clinical Nutrition Manager

Capital RegionMedicalCenter

1125 Madison St

Jefferson City, MO65101

phone: 573.632.5192

fax: 573.632.5879

Heberle-Heather at aramark.com


_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net


-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090130/a998cdb5/attachment.html 

From m-rodrig at msmc.com  Fri Jan 30 12:18:22 2009
From: m-rodrig at msmc.com (Maritza Rodriguez)
Date: Fri, 30 Jan 2009 15:18:22 -0500
Subject: [Cnm] (no subject)
Message-ID: <32EDCA3D1F5C4C41B7E1A4573DFACCC602117D2A@SVIPEXC1.msmc.com>

 

Do any of you can recommend me a good catalog/ vendor where I can
purchase some BMI calculators?

 

Thank you,

 

Maritza Rodriguez

 

Maritza Rodriguez, RD LDN

Clinical Nutrition Manager

Mount Sinai Medical Center

4300 Alton Road

Miami Beach, Florida 33140

 

Tel: 305-674-2121 Ext. 56181

Fax: 305-674-2234

m-rodrig at msmc.com

 

 

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
CONFIDENTIAL or PRIVILEGED information.  Any unauthorized review, use,
disclosure or distribution is prohibited.  If you are not the intended
recipient, please contact the sender by reply e-mail and immediately
destroy all copies of the original message and all attachments.  Any
opinions expressed here are not necessarily those of Mount Sinai Medical
Center.

 

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090130/dc075c82/attachment.html 

From ESCOTTSTUMPS at ecu.edu  Fri Jan 30 14:17:45 2009
From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia)
Date: Fri, 30 Jan 2009 17:17:45 -0500
Subject: [Cnm] FW: On the Pulse - January 30, 2009
References: <LYRIS-14232391-3493679-2009.01.30-13.31.35--escottstumps#ecu.edu@list.eatright.org>
Message-ID: <BD44FF0CF4C18245854BBE03590A4C130150CE0A@ECUFS7.intra.ecu.edu>

For your review.  Best wishes!
 
Sylvia Escott-Stump, MA, RD, LDN               114 Rivers Building
Dietetic Internship Director                          Greenville, NC 27858
East Carolina University                              Phone 252-328-1352                                                              
escottstumps at ecu.edu                                     Fax 252-328-4276
 
 
 
 

 
 

ADA calls for accountability in Dietary Guidelines 

ADA this week called for procedural revisions in the Dietary Guidelines for Americans to make the government's most authoritative source of advice on good dietary habits more effective in helping Americans achieve better health. "Issuing the Dietary Guidelines every five years does not provide adequate time to conduct and review emerging nutrition research, nor does it provide enough time to effectively roll out and communicate key information about the Guidelines to consumers," said registered dietitian Constance Geiger, PhD, RD, CD, a member of ADA's Board of Directors. ADA recommends ten-year intervals instead the current five-year time frame, which is consistent with the issuance of other public health guidance.  According to Geiger, ten-year intervals would "strengthen the research basis, implementation and communication, and the impact and evaluation of the Dietary Guidelines."

 

Public Policy Workshop sets registration record;  members should still register for ed credits

Nearly 1,500 ADA members and dietetics students are now registered for the 2009 Public Policy Workshop - a level that shatters previous records for workshop participation.   Session M-I on Feb. 9 is closed out, and space is becoming tight for most sessions on that day, said Tracy Wilczek, MS, RD, LD, chair of the Legislative and Public Policy Committee.  However, members will be able to access all sessions after the conclusion of the event for some weeks in February.   

 

FDA says to toss out peanut products from Georgia plant

In one of the largest food recalls in history, the U.S. Food and Drug Administration asked retailers, manufacturers and consumers yesterday to throw out every peanut product made in 2007 and 2008 at Peanut Corporation of America.  The action came after federal officials discovered the company knowingly shipped products contaminated with salmonella 12 times in the past two years.  In a written statement, the company's president said the company's goal "over the past 33 years has always been to follow the U.S. Food and Drug Administration's good manufacturing practices in order to provide a safe product for consumers." The current salmonella outbreak has impacted about 500 people in 43 states and about half of those affected are children.  The outbreak has been linked to eight deaths. A list of recalled products is posted on FDA's Web site at http://www.accessdata.fda.gov/scripts/peanutbutterrecall/index.cfm <http://www.accessdata.fda.gov/scripts/peanutbutterrecall/index.cfm> .

 

Christian Science Monitor assesses health impacts of House stimulus

The massive and costly economic stimulus package passed by the House of Representatives earlier this week includes a sizeable portion focused to help what the Christian Science Monitor calls 

"the nation's unraveling health care system." Of the $819 billion in the package, CSM reports, there is $87 billion in additional federal Medicaid funds for states; $29 billion to subsidize health insurance premiums for recently unemployed workers under COBRA; $20 billion for health care information technology; and $11 billion to allow low-income workers who lose jobs that did not provide health insurance to apply for Medicaid.   It redefines that recently unemployed workers ages 55 and older or those with at least 10 years of tenure at their jobs may continue to receive health insurance through COBRA until they find a new job that offers coverage or reach age 65, when they can enroll in Medicare.

 

ADA weighs in USP dietary supplement safety review process

ADA responded this week to US Pharmacopeia's invitation to stakeholders for comments on its dietary supplement safety review process.  The process includes evaluation of the safety profile of the ingredient by the USP Dietary Supplements Information Expert Committee.  As a food ingredient, unlike a pharmaceutical agent, there is no allowance balancing risk against benefit.  

 

 

When a referral comes from the physician, patients will listen

According to a national study by the Center for Studying Health System Change (HSC), most consumers still rely on physician referrals and word-of-mouth recommendations from family and friends when choosing health care providers.  Of the 5,805 adult participants, HSC's 2007 Health Tracking Household Survey found few consumers used price and quality informa?tion or online information sources to choose providers.  People with chronic conditions and those in fair or poor health were more likely to rely solely on their primary care physicians' referrals, while younger and more-educated consumers were more likely to turn to other sources, including the Internet and health plan information.  The survey was conducted between April 2007 and January 2008. Many registered dietitians (RDs) are well aware of the power of physician referral and dedicate much time and energy to cultivating relationships with physicians.  The chart below from the study sheds light on what consumers might consider before they visit an RD.   

 

Food assistance paradox:  state employees sometimes laid off when demand is greatest

With increasing unemployment rates, many states are reporting increased caseloads for SNAP/Food Stamps and cash assistance programs.  For instance, the state of Oregon, has called the situation "an emergency" as caseworkers deal with lines that stretch out the door and around the block.  To deal with the escalating caseload, additional staff are being hired with funds provided by the USDA as a bonus for good SNAP/Food Stamp program administration.  Unfortunately, not all states are in the same position.  In Orange County, California, budget cuts have led to a downsizing of SNAP/Food Stamp processors, which can lead to lengthened response times for residents in need of the services. 

 

It found that "the average monthly loss of food purchasing power for households receiving the maximum benefit" was $22 in fiscal 2008, significantly steeper than in recent years.  The study reported that "the average monthly loss of food purchasing power for households receiving the maximum benefits ranged from $2.60 in fiscal 2003 to $12 in fiscal 2007, and to $22 in fiscal 2008."   Access to the report is at: http://www.ers.usda.gov/Publications/EIB41/ <http://org2.democracyinaction.org/dia/track.jsp?v=2&c=tpvZstxj%2B5DENqn0MGpYIREuNLVl0Cf0>   

 

Texas obesity rate could reach 15 million in 2040 

The number of obese Texans will increase from 5 million today to a high of 15 million in 2040, if the state's obesity rate continues into the future, a new study reported this week.   State Sen. Jane Nelson said obesity is the "single most serious threat that we face".  It strains the entire health care system.  It hinders our economic productivity.  It drains our state budget," she said. Nelson, author of laws requiring elementary schools and middle schools to restore physical education classes, said she will try to pass more such legislation this year.  Nelson also vowed to push bills stressing nutrition education and ordering studies of whether youngsters easily can obtain healthy food.  

 

Baucus receives ADA 2009 Public Policy Leadership Award

Sen.  Max Baucus (D-MT) has been recognized by the ADA Board of Directors with the 2009 Public Policy Leadership Award for his support of providing nutrition services in national health care policy.  "Sen.  Baucus has worked to support important health and nutrition policy initiatives contained in the Medicare Improvements for Patients and Providers Act of 2008," said ADA President Martin M. Yadrick, MS, MBA, RD, FADA.  "These provisions direct Medicare to expand preventive nutrition services to those proven to be reasonable and necessary for the prevention or early detection of an illness or disability."  

 

Upcoming:

*	All-Member, On-Line PPW 2009 is February 8 - 10.   Go to http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/10882_ENU_HTML.htm to register and see up-to-date information on the online conference. 

 

----------------------------------------------------------------------------------------------------------------------------

Government Relations Contacts:

 

 

 

Nutrition Policy

Jennifer Weber

jweber at eatright.org <mailto:jweber at eatright.org> 

Regulatory Issues

Mary Hager

mhager at eatright.org <mailto:mhager at eatright.org> 

Congressional & Political Affairs

Ron Smith

rsmith at eatright.org <mailto:rsmith at eatright.org> 

 

Jennifer Teters

jteters at eatright.org <mailto:jteters at eatright.org> 

 

Charmaine Jones

cjones at eatright.org <mailto:cjones at eatright.org> 

State Government Relations

Juliana Smith

jsmith at eatright.org <mailto:jsmith at eatright.org> 

State & Regulatory Coordinator

Dana Whitley

dwhitley at eatright.org <mailto:dwhitley at eatright.org> 

Reimbursement Issues

Pam Michael

pmichael at eatright.org <mailto:pmichael at eatright.org> 

 

Tori Bender

tbender at eatright.org <mailto:tbender at eatright.org> 

General Issues

Stephanie Patrick

spatrick at eatright.org <mailto:spatrick at eatright.org> 

-----------------------------------------------------------------------------------------------------------------------------

 

 

 

 


---
You are currently subscribed to receive On The Pulse at: escottstumps at ecu.edu
To unsubscribe send a blank email to leave-3493679-14232391.c25a8f8417898df068b326123ea47b18 at list.eatright.org or contact pulse at eatright.org with a request to remove your e-mail address.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090130/ac5c5fa7/attachment-0001.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 11163 bytes
Desc: image002.jpg
Url : /pipermail/cnm_lists.my180.net/attachments/20090130/ac5c5fa7/attachment-0001.jpe 

From mansishah79 at gmail.com  Fri Jan 30 16:16:30 2009
From: mansishah79 at gmail.com (Mansi Shah)
Date: Fri, 30 Jan 2009 16:16:30 -0800
Subject: [Cnm] Inpatient Nutrition Charging
Message-ID: <bb1846bf0901301616v448c3bbft448f631e4f106415@mail.gmail.com>

I know this question has been posed before to this group. I'm trying to
figure out how we can charge for inpatient nutrition services.
At this time, we are charging for all MD ordered consults using the CPT
codes below, however, we are not seing the reimbursement. Is there something
wrong we are doing?
We are also not capturing charges for  all the work we are doing when we see
patients (wounds, enteral/parenteral, etc.) without a physician's consult.

>From what I'm reading and understanding, Medicare doesn't reimburse
separately for inpatient nutrition care. It is part of the DRG based
reimbursement that is received by the hospital. So Nutrition Dept wouldn't
receive a reimbursement for their services.

Medicare MNT CPT Codes are: 97802 - MNT Initial Assessment, 97803 -
Re-assessment, 97804-Group
CMS covers Medicare MNT for two diseases - DM and Kidney.

For those that do charge for nutrition services inpatient - what charge
codes are you using?
How are you charging - for all high risk patients or for consults only?

Thanks in advance for the feedback.
Mansi Shah, RD, CNSD
Olympia Medical Center
Los Angeles, CA 90036
Phone: 323-932-5267
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090130/0c7d1689/attachment.html 

From kmershon at bak.rr.com  Fri Jan 30 19:15:45 2009
From: kmershon at bak.rr.com (Kathleen Mershon)
Date: Fri, 30 Jan 2009 19:15:45 -0800
Subject: [Cnm] Inpatient Nutrition Charging
In-Reply-To: <bb1846bf0901301616v448c3bbft448f631e4f106415@mail.gmail.com>
References: <bb1846bf0901301616v448c3bbft448f631e4f106415@mail.gmail.com>
Message-ID: <32916F0A966F4282A0DDD98417F4BE66@KathyPC>

We don't charge for inpatients. The MNT codes are only for outpatient services. 
Kathleen Mershon, RD
  ----- Original Message ----- 
  From: Mansi Shah 
  To: CNM-ListServe 
  Sent: Friday, January 30, 2009 4:16 PM
  Subject: [Cnm] Inpatient Nutrition Charging


  I know this question has been posed before to this group. I'm trying to figure out how we can charge for inpatient nutrition services. 
  At this time, we are charging for all MD ordered consults using the CPT codes below, however, we are not seing the reimbursement. Is there something wrong we are doing? 
  We are also not capturing charges for  all the work we are doing when we see patients (wounds, enteral/parenteral, etc.) without a physician's consult. 

  From what I'm reading and understanding, Medicare doesn't reimburse separately for inpatient nutrition care. It is part of the DRG based reimbursement that is received by the hospital. So Nutrition Dept wouldn't receive a reimbursement for their services.

  Medicare MNT CPT Codes are: 97802 - MNT Initial Assessment, 97803 - Re-assessment, 97804-Group 
  CMS covers Medicare MNT for two diseases - DM and Kidney. 

  For those that do charge for nutrition services inpatient - what charge codes are you using? 
  How are you charging - for all high risk patients or for consults only?

  Thanks in advance for the feedback. 
  Mansi Shah, RD, CNSD
  Olympia Medical Center
  Los Angeles, CA 90036
  Phone: 323-932-5267



------------------------------------------------------------------------------


  _______________________________________________
  Cnm mailing list
  Cnm at lists.my180.net
  http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090130/06e4e98c/attachment.html 

From Laura.Leciejewski at stalexius.net  Sat Jan 31 05:43:06 2009
From: Laura.Leciejewski at stalexius.net (Laura Leciejewski)
Date: Sat, 31 Jan 2009 07:43:06 -0600
Subject: [Cnm] Inpatient Nutrition Charging
References: <bb1846bf0901301616v448c3bbft448f631e4f106415@mail.gmail.com>
Message-ID: <20090131T074306Z_168A00100000@stalexius.net>

I would be interested in this as well.  From my understanding, we are not allowed to charge for inpatient nutrition services.  The Medicare codes you have listed are for outpatient nutrition services.

Laura

Laura C. Leciejewski, MS, RD, LDN, CNSD
Clinical Nutrition Manager
St. Alexius Medical Center
1555 Barrington Rd
Hoffman Estates, IL 60194
847-843-2000 ext 6591
pager # 711

>>> Mansi Shah <mansishah79 at gmail.com> 1/30/2009 6:16 PM >>>

I know this question has been posed before to this group. I'm trying to figure out how we can charge for inpatient nutrition services. 
At this time, we are charging for all MD ordered consults using the CPT codes below, however, we are not seing the reimbursement. Is there something wrong we are doing? 
We are also not capturing charges for  all the work we are doing when we see patients (wounds, enteral/parenteral, etc.) without a physician's consult. 

From what I'm reading and understanding, Medicare doesn't reimburse separately for inpatient nutrition care. It is part of the DRG based reimbursement that is received by the hospital. So Nutrition Dept wouldn't receive a reimbursement for their services.

Medicare MNT CPT Codes are: 97802 - MNT Initial Assessment, 97803 - Re-assessment, 97804-Group 
CMS covers Medicare MNT for two diseases - DM and Kidney. 

For those that do charge for nutrition services inpatient - what charge codes are you using? 
How are you charging - for all high risk patients or for consults only?

Thanks in advance for the feedback. 
Mansi Shah, RD, CNSD
Olympia Medical Center
Los Angeles, CA 90036
Phone: 323-932-5267

 
CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/cnm_lists.my180.net/attachments/20090131/5b005753/attachment.html 

From lmerrima at nyp.org  Sat Jan 31 06:17:51 2009
From: lmerrima at nyp.org (Louise R. Merriman)
Date: Sat, 31 Jan 2009 09:17:51 -0500
Subject: [Cnm] Inpatient Nutrition Charging
In-Reply-To: <20090131T074306Z_168A00100000@stalexius.net>
References: <bb1846bf0901301616v448c3bbft448f631e4f106415@mail.gmail.com>
	<20090131T074306Z_168A00100000@stalexius.net>
Message-ID: <49845D8F.6010405@nyp.org>

A great way in-patient RD's can help the bottom line is hospitals is by 
collaborating with MD's, documentation improvement specialists and the 
coding department to insure that those patients with protein-energy 
malnutrition  get appropriately identified, diagnosed, documented and 
that a care plan is enacted. The revenue impact can vary depending on 
the patient populations of the institution - but such programs do not 
require any additional funds to implement - you just need to connect the 
dots.
Laura Leciejewski wrote:
> I would be interested in this as well.  From my understanding, we are 
> not allowed to charge for inpatient nutrition services.  The Medicare 
> codes you have listed are for outpatient nutrition services.
>  
> Laura
>  
> Laura C. Leciejewski, MS, RD, LDN, CNSD
> Clinical Nutrition Manager
> St. Alexius Medical Center
> 1555 Barrington Rd
> Hoffman Estates, IL 60194
> 847-843-2000 ext 6591
> pager # 711
>
> >>> Mansi Shah <mansishah79 at gmail.com> 1/30/2009 6:16 PM >>>
> I know this question has been posed before to this group. I'm trying 
> to figure out how we can charge for inpatient nutrition services.
> At this time, we are charging for all MD ordered consults using the 
> CPT codes below, however, we are not seing the reimbursement. Is there 
> something wrong we are doing?
> We are also not capturing charges for  all the work we are doing when 
> we see patients (wounds, enteral/parenteral, etc.) without a 
> physician's consult.
>  
> From what I'm reading and understanding, Medicare doesn't reimburse 
> separately for inpatient nutrition care. It is part of the DRG based 
> reimbursement that is received by the hospital. So Nutrition Dept 
> wouldn't receive a reimbursement for their services.
>  
> Medicare MNT CPT Codes are: 97802 - MNT Initial Assessment, 97803 - 
> Re-assessment, 97804-Group
> CMS covers Medicare MNT for two diseases - DM and Kidney.
>  
> For those that do charge for nutrition services inpatient - what 
> charge codes are you using?
> How are you charging - for all high risk patients or for consults only?
>  
> Thanks in advance for the feedback.
> Mansi Shah, RD, CNSD
> Olympia Medical Center
> Los Angeles, CA 90036
> Phone: 323-932-5267
>  
>
>
> *CONFIDENTIALITY NOTICE: *This e-mail message, including any 
> attachments, is for the sole use of the intended recipient(s) and may 
> contain confidential and privileged information. Any unauthorized 
> review, use, disclosure or distribution is prohibited. If you are not 
> the intended recipient, please contact the sender by reply e-mail and 
> destroy all copies of the original message.
> ------------------------------------------------------------------------
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>   



--------------------

This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited.  If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message.  Thank you.