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From Annalynn_Skipper at Comcast.net  Fri Jul 10 05:21:00 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Fri, 10 Jul 2009 07:21:00 -0500
Subject: [Cnm] FW: definition of refeeding syndrome
Message-ID: <402812FB7659469DA3738587DD39A672@ANNALYNN>

Does anyone use a clinically measurable definition of refeeding syndrome in
their practice?  If so, I would be grateful if you could share that
definition.  A related question is whether you measure the incidence and/or
prevalence of refeeding syndrome in your practice/facility?  

Thanks and have a great weekend.    

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. 

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From amy.lafalce at gwu-hospital.com  Fri Jul 10 05:44:47 2009
From: amy.lafalce at gwu-hospital.com (Amy LaFalce)
Date: Fri, 10 Jul 2009 08:44:47 -0400
Subject: [Cnm] Online Diet Manual
In-Reply-To: <56BD66F92D85B1438E3661D306508C281837DB7B@MSGWSDCPMB07.nyumc.org>
References: <10DE3A7624A2BD48B81AFE4E90A5094D01EFD2F0@EX1.jaycountyhospital.com>	
	<5330B54133B6194BA13930BDEFE9A30E04851E8B@rhcexch3.reshealthcare.org>, 
	<56BD66F92D85B1438E3661D306508C281837DB7B@MSGWSDCPMB07.nyumc.org>
Message-ID: 

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From LCarver at Reshealthcare.org  Fri Jul 10 06:14:35 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Fri, 10 Jul 2009 08:14:35 -0500
Subject: [Cnm] Online Diet Manual
In-Reply-To: <56BD66F92D85B1438E3661D306508C281837DB7B@MSGWSDCPMB07.nyumc.org>
References: <10DE3A7624A2BD48B81AFE4E90A5094D01EFD2F0@EX1.jaycountyhospital.com>
	<5330B54133B6194BA13930BDEFE9A30E04851E8B@rhcexch3.reshealthcare.org>
	<56BD66F92D85B1438E3661D306508C281837DB7B@MSGWSDCPMB07.nyumc.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E04852705@rhcexch3.reshealthcare.org>

the fee is for # of users who can log in at 1 time - 1000 people can
share 1 license but only 1 person would be able to use the manual at any
given time.  Leslee

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
Sent: Friday, July 10, 2009 7:01 AM
To: Carver, Leslee; Flowers Mary-Anne; cnm at lists.my180.net
Subject: RE: [Cnm] Online Diet Manual

Hi all I'm confused I was under the impression we had to pay an
additional licensing fee to have it installed on multiple computers. Can
someone from ADA clarify. Thanks

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Carver, Leslee
Sent: Tuesday, July 07, 2009 5:58 PM
To: Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

since the ADA is more than fine w/ it (we do this w/ their knowledge and
approval) perhaps you can get an e-mail from the ADA nutr care manual
support folks so stating.  Leslee

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Flowers Mary-Anne
Sent: Tuesday, July 07, 2009 2:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] Online Diet Manual

I know that this has been discussed in the past but I appear to be
hitting a road block with my IT department and making the online version
of the ADA manual available on the nursing floors. I am being told that
it is a copyright infringement if we place the manual on our intranet
for the staff to use.

1.     How do you get around this problem? 

2.     If you bought multiple copies how many copies of the manual have
you purchased for your facilities and how did you arrive at that number?

3.      With the paper version we had one copy on every unit, 1 in the
dietitian's office and 1 in administration.

4.     Have you had any issues or questions come up from Joint
Commission about the manual? 

Mary-Anne Flowers 
Chief Clinical Dietitian 

Oak Hill Hospital 
11375 Cortez Blvd., Brooksville, FL, 34613 
office (352) 597-6313  fax (352) 597-6087 

This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of
its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
prohibited. If you have received this email in error, please immediately
purge it and all attachments and notify the sender by reply email or
contact the sender at the number listed.

I

------------------------------------------------------------
This email message, including any attachments, is for the sole use of
the intended recipient(s) and may contain information that is
proprietary, confidential, and exempt from disclosure under applicable
law. Any unauthorized review, use, disclosure, or distribution is
prohibited. If you have received this email in error please notify the
sender by return email and delete the original message. Please note, the
recipient should check this email and any attachments for the presence
of viruses. The organization accepts no liability for any damage caused
by any virus transmitted by this email.
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From Heberle-Heather at aramark.com  Fri Jul 10 06:20:54 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Fri, 10 Jul 2009 08:20:54 -0500
Subject: [Cnm] Online Diet Manual
In-Reply-To: 
References: 
Message-ID: 

We put it on our hospital Intranet site.  This way staff can access it from any computer.  We paid for 2 user accesses and so 2 people can be on it at a time, but now computer installation restriction to my knowledge

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
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From jeannine.hutchcraft at sih.net  Fri Jul 10 06:21:30 2009
From: jeannine.hutchcraft at sih.net (Jeannine Hutchcraft/SIH)
Date: Fri, 10 Jul 2009 08:21:30 -0500
Subject: [Cnm] FW: definition of refeeding syndrome
In-Reply-To: <402812FB7659469DA3738587DD39A672@ANNALYNN>
Message-ID: 

Please post to list

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

             "Annalynn                                                     
             Skipper"                                                      

             Sent by:                                                   cc 
             cnm-bounces at lists                                             
             .my180.net                                            Subject 
                                       [Cnm] FW: definition of refeeding   
                                       syndrome                            
             07/10/2009 07:21                                              
             AM                                                            

             Please respond to                                             
             Annalynn_Skipper@                                             
                Comcast.net                                                

Does anyone use a clinically measurable definition of refeeding syndrome in
their practice?  If so, I would be grateful if you could share that
definition.  A related question is whether you measure the incidence and/or
prevalence of refeeding syndrome in your practice/facility?

Thanks and have a great weekend.

Annalynn

Annalynn Skipper Ph.D., R.D., FADA
(Embedded image moved to file: pic26777.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.
 _______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
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From BLusk at unch.unc.edu  Fri Jul 10 06:30:56 2009
From: BLusk at unch.unc.edu (Lusk, Barbara)
Date: Fri, 10 Jul 2009 09:30:56 -0400
Subject: [Cnm] Online Diet Manual
In-Reply-To: <56BD66F92D85B1438E3661D306508C281837DB7B@MSGWSDCPMB07.nyumc.org>
References: <10DE3A7624A2BD48B81AFE4E90A5094D01EFD2F0@EX1.jaycountyhospital.com>

	<5330B54133B6194BA13930BDEFE9A30E04851E8B@rhcexch3.reshealthcare.org>
	<56BD66F92D85B1438E3661D306508C281837DB7B@MSGWSDCPMB07.nyumc.org>
Message-ID: 

We utilize the NCM (online manual) and in our initial research with ADA
about this, we chose to purchase a set number of concurrent
subscriptions and utilize the option to allow all hospital computer
addresses to access the site (so the user did not have to input a
password).  Only hospital computers can access this link.  The number of
concurrent subscriptions purchased is the number of people that can have
it open in the hospital at one time.  Every computer has the link and
this was installed on our department's webpage and in the reference page
of the physician's electronic order entry / charting system.

I hope that helps.

Barbara Lusk, R.D., L.D.N.

Associate Director

Clinical Nutrition / Patient Services Director

Nutrition and Food Services

University of North Carolina Hospitals

101 Manning Drive

Chapel Hill, NC  27514

phone: (919) 843-0062

email: BLusk at unch.unc.edu

________________________________

From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
Sent: Friday, July 10, 2009 8:01 AM
To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

Hi all I'm confused I was under the impression we had to pay an
additional licensing fee to have it installed on multiple computers. Can
someone from ADA clarify. Thanks

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Carver, Leslee
Sent: Tuesday, July 07, 2009 5:58 PM
To: Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

since the ADA is more than fine w/ it (we do this w/ their knowledge and
approval) perhaps you can get an e-mail from the ADA nutr care manual
support folks so stating.  Leslee

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Flowers Mary-Anne
Sent: Tuesday, July 07, 2009 2:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] Online Diet Manual

I know that this has been discussed in the past but I appear to be
hitting a road block with my IT department and making the online version
of the ADA manual available on the nursing floors. I am being told that
it is a copyright infringement if we place the manual on our intranet
for the staff to use.

1.     How do you get around this problem? 

2.     If you bought multiple copies how many copies of the manual have
you purchased for your facilities and how did you arrive at that number?

3.      With the paper version we had one copy on every unit, 1 in the
dietitian's office and 1 in administration.

4.     Have you had any issues or questions come up from Joint
Commission about the manual? 

Mary-Anne Flowers 
Chief Clinical Dietitian 

Oak Hill Hospital 
11375 Cortez Blvd., Brooksville, FL, 34613 
office (352) 597-6313  fax (352) 597-6087 

This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of
its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
prohibited. If you have received this email in error, please immediately
purge it and all attachments and notify the sender by reply email or
contact the sender at the number listed.

I

------------------------------------------------------------
This email message, including any attachments, is for the sole use of
the intended recipient(s) and may contain information that is
proprietary, confidential, and exempt from disclosure under applicable
law. Any unauthorized review, use, disclosure, or distribution is
prohibited. If you have received this email in error please notify the
sender by return email and delete the original message. Please note, the
recipient should check this email and any attachments for the presence
of viruses. The organization accepts no liability for any damage caused
by any virus transmitted by this email.
================================= 

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From Valerie.Peters1 at hcahealthcare.com  Fri Jul 10 07:29:52 2009
From: Valerie.Peters1 at hcahealthcare.com (Peters Valerie - Charleston)
Date: Fri, 10 Jul 2009 09:29:52 -0500
Subject: [Cnm] tray question
Message-ID: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88DB9F75@NADCWPMSGCMS10.hca.corpad.net>

Hi all-
   Has anyone found a speedy way to have trays delivered to rooms once they are on floors?  Nursing has their PCT's doing this.  Any suggestions appreciated.   Appreciate any attachments, suggestions, etc...

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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From Remi.Hayashi at CHW.EDU  Fri Jul 10 07:37:01 2009
From: Remi.Hayashi at CHW.EDU (Hayashi, Remi  - GMHHC)
Date: Fri, 10 Jul 2009 07:37:01 -0700
Subject: [Cnm] NICU Nutritional Triggers
Message-ID: <3F15BB776BDDF847B55DACB387D41ABC08709C00@CHW-MSG-303.chw.edu>

Hi All,

Does anyone have nutritional triggers for NICU babies for RNs? 

Please share your nutritional triggers.   Thank you.

Remi Hayashi, MS, RD

Clinical Nutrition Manager

Glendale Memorial Hospital and Health Center

(818)409-7643 Office

(818)507-4665 Fax

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From LDALGLEISH at lakelandregional.org  Fri Jul 10 07:46:24 2009
From: LDALGLEISH at lakelandregional.org (Lisa Dalgleish)
Date: Fri, 10 Jul 2009 10:46:24 -0400
Subject: [Cnm] tray question
In-Reply-To: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88DB9F75@NADCWPMSGCMS10.hca.corpad.net>
References: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88DB9F75@NADCWPMSGCMS10.hca.corpad.net>
Message-ID: <4A571BE3.DF60.000C.0@lakelandregional.org>

Our dept has host/hostesses assigned to each nursing unit (~40 pts per
host/hostess).  They assist pts with meal orders prn, deliver trays, set
up trays prn, and pick up trays.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> Peters Valerie - Charleston 
7/10/2009 10:29 AM >>>

Hi all-
   Has anyone found a speedy way to have trays delivered to rooms once
they are on floors?  Nursing has their PCT?s doing this.  Any
suggestions appreciated.   Appreciate any attachments, suggestions,
etc?

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live itwell.
This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of
its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
prohibited. If you have received this email in error, please immediately
purge it and all attachments and notify the sender by reply email or
contact the sender at the number listed.

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From Farzeen.Sukheswalla at HCAhealthcare.com  Fri Jul 10 07:46:10 2009
From: Farzeen.Sukheswalla at HCAhealthcare.com (Sukheswalla Farzeen)
Date: Fri, 10 Jul 2009 09:46:10 -0500
Subject: [Cnm] Nutrition Diagnostic Terminology Handout
Message-ID: 

Does anyone have an electronic version the Nutrition Diagnostic Terminology reference guide that is just one page, it lists all the Nutrition Diagnostic Terminologies.  I have one you can fold in half and carry in your pocket, but it is the 2006 version.  I know we have an updated one.
Can someone please share!

Farzeen Sukheswalla MS, RD, LD
Clinical Nutrition Manager
Medical Center of McKinney
972-540-4487

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From cketterman at wellspan.org  Fri Jul 10 07:48:08 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Fri, 10 Jul 2009 10:48:08 -0400
Subject: [Cnm] Homemade tube feedings
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1A4A@EXCH4.wellspan.org>

A physician is requesting that we make a homemade tube feeding based on
a recipe the family has been using for a new admit.  Patient has Crohn's
disease and has tried every commercial product known to man.  I'm
thinking No.  Have anyone has a request like this recently and how did
you handle it.  Any input is welcomed.  Thanks  Cindy

Cindra L. Ketterman, MS, RD, LDN

Chief Clinical Dietitian

York Hospital.WellSpan Health

1001 South George Street

York, PA  17405-7198

(717) 851 - 3991

(717) 851 - 2345 ask for pager 0093

(717) 851 - 2934 (fax)

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.
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From Valerie.Peters1 at hcahealthcare.com  Fri Jul 10 07:56:43 2009
From: Valerie.Peters1 at hcahealthcare.com (Peters Valerie - Charleston)
Date: Fri, 10 Jul 2009 09:56:43 -0500
Subject: [Cnm] tray question
In-Reply-To: <4A571BE3.DF60.000C.0@lakelandregional.org>
References: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88DB9F75@NADCWPMSGCMS10.hca.corpad.net>
	<4A571BE3.DF60.000C.0@lakelandregional.org>
Message-ID: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88DBA0AE@NADCWPMSGCMS10.hca.corpad.net>

Lisa,
  Thanks, they would be a nice fix if we had the staff to cover.....unfortunately, remains a nursing fxn here.  Any suggestions on motivating another dept?  I don't especially want to do a time study.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

________________________________
From: Lisa Dalgleish [mailto:LDALGLEISH at lakelandregional.org]
Sent: Friday, July 10, 2009 10:46 AM
To: Peters Valerie - Charleston; cnm at lists.my180.net
Subject: Re: [Cnm] tray question

Our dept has host/hostesses assigned to each nursing unit (~40 pts per host/hostess).  They assist pts with meal orders prn, deliver trays, set up trays prn, and pick up trays.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>> Peters Valerie - Charleston  7/10/2009 10:29 AM >>>
Hi all-
   Has anyone found a speedy way to have trays delivered to rooms once they are on floors?  Nursing has their PCT's doing this.  Any suggestions appreciated.   Appreciate any attachments, suggestions, etc...

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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From LDALGLEISH at lakelandregional.org  Fri Jul 10 08:03:54 2009
From: LDALGLEISH at lakelandregional.org (Lisa Dalgleish)
Date: Fri, 10 Jul 2009 11:03:54 -0400
Subject: [Cnm] tray question
In-Reply-To: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88DBA0AE@NADCWPMSGCMS10.hca.corpad.net>
References: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88DB9F75@NADCWPMSGCMS10.hca.corpad.net>
	<4A571BE3.DF60.000C.0@lakelandregional.org>
	<0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88DBA0AE@NADCWPMSGCMS10.hca.corpad.net>
Message-ID: <4A571FFD.DF60.000C.0@lakelandregional.org>

Do you use Press Ganey?  You could share the Food Temp and Quality
scores with the nursing units.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> Peters Valerie - Charleston 
7/10/2009 10:56 AM >>>

Lisa,
  Thanks, they would be a nice fix if we had the staff to
cover?..unfortunately, remains a nursing fxn here.  Any suggestions
on motivating another dept?  I don?t especially want to do a time
study.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live itwell.
This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of
its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
prohibited. If you have received this email in error, please immediately
purge it and all attachments and notify the sender by reply email or
contact the sender at the number listed.

From:Lisa Dalgleish [mailto:LDALGLEISH at lakelandregional.org] 
Sent: Friday, July 10, 2009 10:46 AM
To: Peters Valerie - Charleston; cnm at lists.my180.net 
Subject: Re: [Cnm] tray question

Our dept has host/hostesses assigned to each nursing unit (~40 pts per
host/hostess).  They assist pts with meal orders prn, deliver trays, set
up trays prn, and pick up trays.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> Peters Valerie - Charleston 
7/10/2009 10:29 AM >>>

Hi all-
   Has anyone found a speedy way to have trays delivered to rooms once
they are on floors?  Nursing has their PCT?s doing this.  Any
suggestions appreciated.   Appreciate any attachments, suggestions,
etc?

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live itwell.
This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of
its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
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From Annalynn_Skipper at Comcast.net  Fri Jul 10 08:06:48 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Fri, 10 Jul 2009 10:06:48 -0500
Subject: [Cnm] Online Diet Manual
In-Reply-To: 
References: <10DE3A7624A2BD48B81AFE4E90A5094D01EFD2F0@EX1.jaycountyhospital.com><5330B54133B6194BA13930BDEFE9A30E04851E8B@rhcexch3.reshealthcare.org><56BD66F92D85B1438E3661D306508C281837DB7B@MSGWSDCPMB07.nyumc.org>

Message-ID: 

Hi Johnathan,

As Editor of the NCM, I work on content rather than sales and IT issues.
However, I agree with the general trend of this thread.  The subscription
fee for the NCM is based on the number of users who will need the manual at
a single time.  I'm not aware that there is an additional charge for
installing the NCM on your hospital's intranet.  However, I recommend that
you check with ADA's IT department on this issue.  As others have mentioned,
they are quite helpful in making the NCM easily accessible throughout your
facility.  

As always, we welcome constructive feedback on the NCM and how it might
better serve the needs of subscribers.

Regards and good wishes for the weekend ahead.  

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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 
Sent: Friday, July 10, 2009 8:31 AM
To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

We utilize the NCM (online manual) and in our initial research with ADA
about this, we chose to purchase a set number of concurrent subscriptions
and utilize the option to allow all hospital computer addresses to access
the site (so the user did not have to input a password).  Only hospital
computers can access this link.  The number of concurrent subscriptions
purchased is the number of people that can have it open in the hospital at
one time.  Every computer has the link and this was installed on our
department's webpage and in the reference page of the physician's electronic
order entry / charting system.

I hope that helps.

Barbara Lusk, R.D., L.D.N.

Associate Director

Clinical Nutrition / Patient Services Director

Nutrition and Food Services

University of North Carolina Hospitals

101 Manning Drive

Chapel Hill, NC  27514

phone: (919) 843-0062

email: BLusk at unch.unc.edu

  _____  

From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
Sent: Friday, July 10, 2009 8:01 AM
To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

Hi all I'm confused I was under the impression we had to pay an additional
licensing fee to have it installed on multiple computers. Can someone from
ADA clarify. Thanks

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Carver, Leslee
Sent: Tuesday, July 07, 2009 5:58 PM
To: Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

since the ADA is more than fine w/ it (we do this w/ their knowledge and
approval) perhaps you can get an e-mail from the ADA nutr care manual
support folks so stating.  Leslee

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express view 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

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Flowers Mary-Anne
Sent: Tuesday, July 07, 2009 2:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] Online Diet Manual

I know that this has been discussed in the past but I appear to be hitting a
road block with my IT department and making the online version of the ADA
manual available on the nursing floors. I am being told that it is a
copyright infringement if we place the manual on our intranet for the staff
to use.

1.     How do you get around this problem? 

2.     If you bought multiple copies how many copies of the manual have you
purchased for your facilities and how did you arrive at that number?

3.      With the paper version we had one copy on every unit, 1 in the
dietitian's office and 1 in administration.

4.     Have you had any issues or questions come up from Joint Commission
about the manual? 

Mary-Anne Flowers 
Chief Clinical Dietitian 

Oak Hill Hospital 
11375 Cortez Blvd., Brooksville, FL, 34613 
office (352) 597-6313  fax (352) 597-6087 

This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of its
attachments, please be advised that you have received this email in error
and that any use, dissemination, distribution, forwarding, printing, or
copying of this email or any attached files is strictly prohibited. If you
have received this email in error, please immediately purge it and all
attachments and notify the sender by reply email or contact the sender at
the number listed.

I

------------------------------------------------------------
This email message, including any attachments, is for the sole use of the
intended recipient(s) and may contain information that is proprietary,
confidential, and exempt from disclosure under applicable law. Any
unauthorized review, use, disclosure, or distribution is prohibited. If you
have received this email in error please notify the sender by return email
and delete the original message. Please note, the recipient should check
this email and any attachments for the presence of viruses. The organization
accepts no liability for any damage caused by any virus transmitted by this
email.
================================= 

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From RachelFlores at sach.org  Fri Jul 10 08:39:13 2009
From: RachelFlores at sach.org (Flores, Rachel)
Date: Fri, 10 Jul 2009 08:39:13 -0700
Subject: [Cnm] Homemade tube feedings
Message-ID: 

I once had a patient with multiple intolerances, including corn syrup, and
the daughter insisted that all commercial formulas would be a problem.  I
helped her design a nutritionally adequate blendarized formula for home, and
from then on the physician would write the order that the patient could have
tube feeds from home.  It worked really well.  The daughter was very
conscientious about food safety and maintaining temps, and the patient
tolerated it without problems.  Would that be an option?

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

  _____  

From: Ketterman-Hopkins, Cindra [mailto:cketterman at wellspan.org] 
Sent: Friday, July 10, 2009 7:48 AM
To: cnm at lists.my180.net
Subject: [Cnm] Homemade tube feedings

A physician is requesting that we make a homemade tube feeding based on a
recipe the family has been using for a new admit.  Patient has Crohn's
disease and has tried every commercial product known to man.  I'm thinking
No.  Have anyone has a request like this recently and how did you handle it.
Any input is welcomed.  Thanks  Cindy

Cindra L. Ketterman, MS, RD, LDN

Chief Clinical Dietitian

York Hospital.WellSpan Health

1001 South George Street

York, PA  17405-7198

(717) 851 - 3991

(717) 851 - 2345 ask for pager 0093

(717) 851 - 2934 (fax)

______________________________________________________________________
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. 

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From cketterman at wellspan.org  Fri Jul 10 08:51:29 2009
From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra)
Date: Fri, 10 Jul 2009 11:51:29 -0400
Subject: [Cnm] Homemade tube feedings
In-Reply-To: 
References: 
Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1A4C@EXCH4.wellspan.org>

I arranged for an in-room little refrigerator to be delivered to the
patient room.  The family is going to bring in the homemade tube feeding
and administer it to the patient themselves.  Our Infection Control
Department staff supported us not making the tube feeding and also that
nursing service not administer the feeding.  Thanks for everyone's
input.  I hate to say no to this stuff but it's a whole new ball game
out there these days!  

Cindra L. Ketterman, MS, RD, LDN

Chief Clinical Dietitian

York Hospital.WellSpan Health

1001 South George Street

York, PA  17405-7198

(717) 851 - 3991

(717) 851 - 2345 ask for pager 0093

(717) 851 - 2934 (fax)

________________________________

From: Flores, Rachel [mailto:RachelFlores at sach.org] 
Sent: Friday, July 10, 2009 11:39
To: Ketterman-Hopkins, Cindra; cnm at lists.my180.net
Subject: RE: [Cnm] Homemade tube feedings

I once had a patient with multiple intolerances, including corn syrup,
and the daughter insisted that all commercial formulas would be a
problem.  I helped her design a nutritionally adequate blendarized
formula for home, and from then on the physician would write the order
that the patient could have tube feeds from home.  It worked really
well.  The daughter was very conscientious about food safety and
maintaining temps, and the patient tolerated it without problems.  Would
that be an option?

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

________________________________

From: Ketterman-Hopkins, Cindra [mailto:cketterman at wellspan.org] 
Sent: Friday, July 10, 2009 7:48 AM
To: cnm at lists.my180.net
Subject: [Cnm] Homemade tube feedings

A physician is requesting that we make a homemade tube feeding based on
a recipe the family has been using for a new admit.  Patient has Crohn's
disease and has tried every commercial product known to man.  I'm
thinking No.  Have anyone has a request like this recently and how did
you handle it.  Any input is welcomed.  Thanks  Cindy

Cindra L. Ketterman, MS, RD, LDN

Chief Clinical Dietitian

York Hospital.WellSpan Health

1001 South George Street

York, PA  17405-7198

(717) 851 - 3991

(717) 851 - 2345 ask for pager 0093

(717) 851 - 2934 (fax)

______________________________________________________________________
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.
______________________________________________________________________
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From sandradeewells at yahoo.com  Fri Jul 10 09:11:13 2009
From: sandradeewells at yahoo.com (Sandra Wells)
Date: Fri, 10 Jul 2009 09:11:13 -0700 (PDT)
Subject: [Cnm] Online Diet Manual- ADA response
Message-ID: <748943.55857.qm@web57704.mail.re3.yahoo.com>

Hello Everyone,
?
I am the sales manager for the NCM and would be happy to clear up any questions or concerns you may have. Please feel free to contact me directly as well. My contact information is below.
?
There is no additional fee to have the NCM available across your entire facility. The preferred method of using NCM is to set it up so that all computers you want to have access would have access 24/7. 
?
Just to clear up some terminology: since NCM is Web based, there is nothing to install on the intranet. Your?intranet is simply set up to access the NCM through a custom url set up for your organization. ?Your IT person simply sets up parameters in the NCM admin screen by which your computers can access NCM by clicking on an icon or link without logging in with a user name and password.?Most of our subscribers do this now, and?is very easy to?set up.?Here is the link to the FAQ in NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf
?
There is no licensing fee, since there is no software to install. NCM is purchased on a subscription basis and the price is based on concurrent users. For example, 5 people would want to access?NCM?at any given same?time, 5 subscriptions would be purchased. If a 6th person comes along, they would simply wait until someone logs off. You can add subscriptions at any time should you need more.
?
Again, please feel free to email or call me directly. I can speak to your IT person directly as well if the instructions are not clear.

Best regards,
Sandra
?
Sandra D. Beil
Nutrition Care Manual? Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois 60606-6995
sbeil at eatright.org 
Direct:? 312-899-4795
Toll Free: 800-877-1600 x4795
Fax: 312-899-5339 
--- On Fri, 7/10/09, Annalynn Skipper  wrote:

From: Annalynn Skipper 
Subject: Re: [Cnm] Online Diet Manual
To: "'Lusk, Barbara'" , "'Murray, Jonathan'" , "'Carver, Leslee'" , "'Flowers Mary-Anne'" , cnm at lists.my180.net
Date: Friday, July 10, 2009, 10:06 AM

Hi Johnathan,
?
As Editor of the NCM, I work on content rather than sales and IT issues.? However, I agree with the general trend of this thread.? The subscription fee for the NCM is based on the number of users who will need the manual at a single time.? I?m not aware that there is an additional charge for installing the NCM on your hospital?s intranet.? However, I recommend that you check with ADA ?s IT department on this issue.? As others have mentioned, they are quite helpful in making the NCM easily accessible throughout your facility.? 
?
As always, we welcome constructive feedback on the NCM and how it might better serve the needs of subscribers.
?
Regards and good wishes for the weekend ahead.? 
?

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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 
Sent: Friday, July 10, 2009 8:31 AM
To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
?
We utilize the NCM (online manual) and in our initial research with ADA about this, we chose to purchase a set number of concurrent subscriptions and utilize the option to allow all hospital computer addresses to access the site (so the user did not have to input a password).? Only hospital computers can access this link.? The number of concurrent subscriptions purchased is the number of people that can have it open in the hospital at one time.? Every computer has the link and this was installed on our department?s webpage and in the reference page of the physician?s electronic order entry / charting system.
?
I hope that helps.
?

Barbara Lusk, R.D., L.D.N.
Associate Director
Clinical Nutrition / Patient Services Director
Nutrition and Food Services
University of North Carolina Hospitals
101 Manning Drive
Chapel Hill, NC ? 27514
phone: (919) 843-0062
email: BLusk at unch.unc.edu

From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
Sent: Friday, July 10, 2009 8:01 AM
To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
?
Hi all I?m confused I was under the impression we had to pay an additional licensing fee to have it installed on multiple computers. Can someone from ADA clarify. Thanks
?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee
Sent: Tuesday, July 07, 2009 5:58 PM
To: Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
?
since the ADA is more than fine w/ it (we do this w/ their knowledge and approval) perhaps you can get an e-mail from the ADA nutr care manual support folks so stating.? Leslee

?
Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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. ?All personal messages express view 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

?
?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Flowers Mary-Anne
Sent: Tuesday, July 07, 2009 2:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] Online Diet Manual
I know that this has been discussed in the past but I appear to be hitting a road block with my IT department and making the online version of the ADA manual available on the nursing floors. I am being told that it is a copyright infringement if we place the manual on our intranet for the staff to use.
1.???? How do you get around this problem? 
2.???? If you bought multiple copies how many copies of the manual have you purchased for your facilities and how did you arrive at that number?
3.???? ?With the paper version we had one copy on every unit, 1 in the dietitian?s office and 1 in administration.
4.???? Have you had any issues or questions come up from Joint Commission about the manual? 
Mary-Anne Flowers 
Chief Clinical Dietitian 
Oak Hill Hospital 
11375 Cortez Blvd., Brooksville , FL , 34613 
office (352) 597-6313? fax (352) 597-6087 
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.
?
?
I
------------------------------------------------------------
This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain information that is proprietary, confidential, and exempt from disclosure under applicable law. Any unauthorized review, use, disclosure, or distribution is prohibited. If you have received this email in error please notify the sender by return email and delete the original message. Please note, the recipient should check this email and any attachments for the presence of viruses. The organization accepts no liability for any damage caused by any virus transmitted by this email.
=================================  ?
-----Inline Attachment Follows-----

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
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From Linda.Bartholomay at meritcare.com  Fri Jul 10 09:24:19 2009
From: Linda.Bartholomay at meritcare.com (Linda Bartholomay)
Date: Fri, 10 Jul 2009 11:24:19 -0500
Subject: [Cnm] Online Diet Manual- ADA response
In-Reply-To: <748943.55857.qm@web57704.mail.re3.yahoo.com>
References: <748943.55857.qm@web57704.mail.re3.yahoo.com>
Message-ID: <4A5724E3.309B.00D0.0@meritcare.com>

Just some input from having the ADA on-line manual now for several years.
It would be desirable to be notified when anything new is added or revised in the manual.  
We want the ability to print off education materials without the diagnosis listed as the "diet".  We currently are still using some of our own materials as this has been a turn off to our staff to give to patients.  
If we had the ability to modify the education materials or add to them (i.e. addendums) , that would be very helpful.

Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer

>>> Sandra Wells  7/10/2009 11:11 AM >>>

Hello Everyone,

I am the sales manager for the NCM and would be happy to clear up any questions or concerns you may have. Please feel free to contact me directly as well. My contact information is below.

There is no additional fee to have the NCM available across your entire facility. The preferred method of using NCM is to set it up so that all computers you want to have access would have access 24/7. 

Just to clear up some terminology: since NCM is Web based, there is nothing to install on the intranet. Your intranet is simply set up to access the NCM through a custom url set up for your organization.  Your IT person simply sets up parameters in the NCM admin screen by which your computers can access NCM by clicking on an icon or link without logging in with a user name and password. Most of our subscribers do this now, and is very easy to set up. Here is the link to the FAQ in NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf

There is no licensing fee, since there is no software to install. NCM is purchased on a subscription basis and the price is based on concurrent users. For example, 5 people would want to access NCM at any given same time, 5 subscriptions would be purchased. If a 6th person comes along, they would simply wait until someone logs off. You can add subscriptions at any time should you need more.

Again, please feel free to email or call me directly. I can speak to your IT person directly as well if the instructions are not clear.

Best regards,
Sandra

Sandra D. Beil
Nutrition Care Manual? Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois 60606-6995
sbeil at eatright.org 
Direct:  312-899-4795
Toll Free: 800-877-1600 x4795
Fax: 312-899-5339 
--- On Fri, 7/10/09, Annalynn Skipper  wrote:

From: Annalynn Skipper 
Subject: Re: [Cnm] Online Diet Manual
To: "'Lusk, Barbara'" , "'Murray, Jonathan'" , "'Carver, Leslee'" , "'Flowers Mary-Anne'" , cnm at lists.my180.net
Date: Friday, July 10, 2009, 10:06 AM

Hi Johnathan,

As Editor of the NCM, I work on content rather than sales and IT issues.  However, I agree with the general trend of this thread.  The subscription fee for the NCM is based on the number of users who will need the manual at a single time.  I?m not aware that there is an additional charge for installing the NCM on your hospital?s intranet.  However, I recommend that you check with ADA ?s IT department on this issue.  As others have mentioned, they are quite helpful in making the NCM easily accessible throughout your facility.  

As always, we welcome constructive feedback on the NCM and how it might better serve the needs of subscribers.

Regards and good wishes for the weekend ahead.  

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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 
Sent: Friday, July 10, 2009 8:31 AM
To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

We utilize the NCM (online manual) and in our initial research with ADA about this, we chose to purchase a set number of concurrent subscriptions and utilize the option to allow all hospital computer addresses to access the site (so the user did not have to input a password).  Only hospital computers can access this link.  The number of concurrent subscriptions purchased is the number of people that can have it open in the hospital at one time.  Every computer has the link and this was installed on our department?s webpage and in the reference page of the physician?s electronic order entry / charting system.

I hope that helps.

Barbara Lusk, R.D., L.D.N.
Associate Director
Clinical Nutrition / Patient Services Director
Nutrition and Food Services
University of North Carolina Hospitals
101 Manning Drive
Chapel Hill, NC   27514
phone: (919) 843-0062
email: BLusk at unch.unc.edu

From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
Sent: Friday, July 10, 2009 8:01 AM
To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

Hi all I?m confused I was under the impression we had to pay an additional licensing fee to have it installed on multiple computers. Can someone from ADA clarify. Thanks

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee
Sent: Tuesday, July 07, 2009 5:58 PM
To: Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

since the ADA is more than fine w/ it (we do this w/ their knowledge and approval) perhaps you can get an e-mail from the ADA nutr care manual support folks so stating.  Leslee

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express view 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

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Flowers Mary-Anne
Sent: Tuesday, July 07, 2009 2:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] Online Diet Manual
I know that this has been discussed in the past but I appear to be hitting a road block with my IT department and making the online version of the ADA manual available on the nursing floors. I am being told that it is a copyright infringement if we place the manual on our intranet for the staff to use.
1.     How do you get around this problem? 
2.     If you bought multiple copies how many copies of the manual have you purchased for your facilities and how did you arrive at that number?
3.      With the paper version we had one copy on every unit, 1 in the dietitian?s office and 1 in administration.
4.     Have you had any issues or questions come up from Joint Commission about the manual? 
Mary-Anne Flowers 
Chief Clinical Dietitian 
Oak Hill Hospital 
11375 Cortez Blvd., Brooksville , FL , 34613 
office (352) 597-6313  fax (352) 597-6087 
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

I
------------------------------------------------------------
This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain information that is proprietary, confidential, and exempt from disclosure under applicable law. Any unauthorized review, use, disclosure, or distribution is prohibited. If you have received this email in error please notify the sender by return email and delete the original message. Please note, the recipient should check this email and any attachments for the presence of viruses. The organization accepts no liability for any damage caused by any virus transmitted by this email.
================================= 

-----Inline Attachment Follows-----

_______________________________________________
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.
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From janice.scott at scott-pc.com  Fri Jul 10 09:49:50 2009
From: janice.scott at scott-pc.com (Janice )
Date: Fri, 10 Jul 2009 11:49:50 -0500
Subject: [Cnm] Homemade tube feedings
In-Reply-To: <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1A4A@EXCH4.wellspan.org>
Message-ID: 

We make "blended"  formulas fairly often at our hospital.  Our caveats are
1) must be made by a technician or an RD, 2) we supply all the ingredients,
3) We have a designated blender, but share space with the trayline prep
area, 4) We use sterile water bottles to store and transport it and 5) we
make only 24 hours worth.  Since we are a pediatric facility, we will
analyze it for adequate nutrition and make recommendations based on our
results. 

My first job at this hospital was as the formula tech (many years ago) and I
would on occasion make 4 or 5 blended formulas in a single day.  Of course
this was before the advent of most commercial enteral formulas. 

Janice Scott MS,RD,CSP,LD

Texas Scottish Rite Hospital for Children

2222 Welborn Street

Dallas, Texas 76219

214-559-7681

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Ketterman-Hopkins, Cindra
Sent: Friday, July 10, 2009 9:48 AM
To: cnm at lists.my180.net
Subject: [Cnm] Homemade tube feedings

A physician is requesting that we make a homemade tube feeding based on a
recipe the family has been using for a new admit.  Patient has Crohn's
disease and has tried every commercial product known to man.  I'm thinking
No.  Have anyone has a request like this recently and how did you handle it.
Any input is welcomed.  Thanks  Cindy

Cindra L. Ketterman, MS, RD, LDN

Chief Clinical Dietitian

York Hospital.WellSpan Health

1001 South George Street

York, PA  17405-7198

(717) 851 - 3991

(717) 851 - 2345 ask for pager 0093

(717) 851 - 2934 (fax)

______________________________________________________________________
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
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are hereby notified that any disclosure, copying, distribution, or action
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From NEgelhofer at saintjosephri.com  Fri Jul 10 10:02:21 2009
From: NEgelhofer at saintjosephri.com (Egelhofer, Nancy)
Date: Fri, 10 Jul 2009 13:02:21 -0400
Subject: [Cnm] Online Diet Manual- ADA response
In-Reply-To: <4A5724E3.309B.00D0.0@meritcare.com>
Message-ID: 

We, too, often avoid the manual "Diets" for patient use because the
dianosis is written on top of the sheet.  The diets are occasionally
used with a slightly different diagnosis than is listed on the ADA Diet,
and it is confusing for the patient and families.
Nancy

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Linda Bartholomay
Sent: Friday, July 10, 2009 12:24 PM
To: Annalynn_Skipper at Comcast.net; Barbara''Lusk; cnm at lists.my180.net;
'Flowers Mary-Anne'; Jonathan''Murray; Leslee''Carver; Sandra Wells
Cc: Sandra Beil
Subject: Re: [Cnm] Online Diet Manual- ADA response

Just some input from having the ADA on-line manual now for several
years.

1.	It would be desirable to be notified when anything new is added
or revised in the manual.  
2.	We want the ability to print off education materials without the
diagnosis listed as the "diet".  We currently are still using some of
our own materials as this has been a turn off to our staff to give to
patients.  
3.	If we had the ability to modify the education materials or add
to them (i.e. addendums) , that would be very helpful.

4.	
	Linda Bartholomay, LRD
	Manager, Nutrition Therapy
	MeritCare Health Systems
	Linda.Bartholomay at meritcare.com
	(701) 234-6166
	Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer

>>> Sandra Wells  7/10/2009 11:11 AM >>>

Hello Everyone,

I am the sales manager for the NCM and would be happy to clear up any
questions or concerns you may have. Please feel free to contact me
directly as well. My contact information is below.

There is no additional fee to have the NCM available across your entire
facility. The preferred method of using NCM is to set it up so that all
computers you want to have access would have access 24/7. 

Just to clear up some terminology: since NCM is Web based, there is
nothing to install on the intranet. Your intranet is simply set up to
access the NCM through a custom url set up for your organization.  Your
IT person simply sets up parameters in the NCM admin screen by which
your computers can access NCM by clicking on an icon or link without
logging in with a user name and password. Most of our subscribers do
this now, and is very easy to set up. Here is the link to the FAQ in
NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf

There is no licensing fee, since there is no software to install. NCM is
purchased on a subscription basis and the price is based on concurrent
users. For example, 5 people would want to access NCM at any given same
time, 5 subscriptions would be purchased. If a 6th person comes along,
they would simply wait until someone logs off. You can add subscriptions
at any time should you need more.

Again, please feel free to email or call me directly. I can speak to
your IT person directly as well if the instructions are not clear.

Best regards,
Sandra

Sandra D. Beil
Nutrition Care Manual(r) Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois 60606-6995
sbeil at eatright.org 
Direct:  312-899-4795
Toll Free: 800-877-1600 x4795
Fax: 312-899-5339 
--- On Fri, 7/10/09, Annalynn Skipper 
wrote:

	From: Annalynn Skipper 
	Subject: Re: [Cnm] Online Diet Manual
	To: "'Lusk, Barbara'" , "'Murray, Jonathan'"
, "'Carver, Leslee'"
, "'Flowers Mary-Anne'"
, cnm at lists.my180.net
	Date: Friday, July 10, 2009, 10:06 AM

	Hi Johnathan,

	As Editor of the NCM, I work on content rather than sales and IT
issues.  However, I agree with the general trend of this thread.  The
subscription fee for the NCM is based on the number of users who will
need the manual at a single time.  I'm not aware that there is an
additional charge for installing the NCM on your hospital's intranet.
However, I recommend that you check with ADA 's IT department on this
issue.  As others have mentioned, they are quite helpful in making the
NCM easily accessible throughout your facility.  

	As always, we welcome constructive feedback on the NCM and how
it might better serve the needs of subscribers. 

	Regards and good wishes for the weekend ahead.  

	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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 
	Sent: Friday, July 10, 2009 8:31 AM
	To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne;
cnm at lists.my180.net
	Subject: Re: [Cnm] Online Diet Manual

	We utilize the NCM (online manual) and in our initial research
with ADA about this, we chose to purchase a set number of concurrent
subscriptions and utilize the option to allow all hospital computer
addresses to access the site (so the user did not have to input a
password).  Only hospital computers can access this link.  The number of
concurrent subscriptions purchased is the number of people that can have
it open in the hospital at one time.  Every computer has the link and
this was installed on our department's webpage and in the reference page
of the physician's electronic order entry / charting system. 

	I hope that helps. 

	Barbara Lusk, R.D., L.D.N.

	Associate Director 

	Clinical Nutrition / Patient Services Director 

	Nutrition and Food Services 

	University of North Carolina Hospitals 

	101 Manning Drive 

	Chapel Hill, NC   27514 

	phone: (919) 843-0062 

	email: BLusk at unch.unc.edu

________________________________

	From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
	Sent: Friday, July 10, 2009 8:01 AM
	To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
	Subject: Re: [Cnm] Online Diet Manual

	Hi all I'm confused I was under the impression we had to pay an
additional licensing fee to have it installed on multiple computers. Can
someone from ADA clarify. Thanks 

	From: cnm-bounces at lists.my180.net
[mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee
	Sent: Tuesday, July 07, 2009 5:58 PM
	To: Flowers Mary-Anne; cnm at lists.my180.net
	Subject: Re: [Cnm] Online Diet Manual

	since the ADA is more than fine w/ it (we do this w/ their
knowledge and approval) perhaps you can get an e-mail from the ADA nutr
care manual support folks so stating.  Leslee 

	Leslee R. Carver, MSPH, RD, LDN 
	Clinical Nutrition Manager 
	Saint Joseph Hospital 
	2900 N. Lake Shore Dr. 
	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.  All personal messages
express view 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

________________________________

	From: cnm-bounces at lists.my180.net
[mailto:cnm-bounces at lists.my180.net] On Behalf Of Flowers Mary-Anne
	Sent: Tuesday, July 07, 2009 2:28 PM
	To: cnm at lists.my180.net
	Subject: [Cnm] Online Diet Manual 

	I know that this has been discussed in the past but I appear to
be hitting a road block with my IT department and making the online
version of the ADA manual available on the nursing floors. I am being
told that it is a copyright infringement if we place the manual on our
intranet for the staff to use. 

	1.     How do you get around this problem? 

	2.     If you bought multiple copies how many copies of the
manual have you purchased for your facilities and how did you arrive at
that number? 

	3.      With the paper version we had one copy on every unit, 1
in the dietitian's office and 1 in administration. 

	4.     Have you had any issues or questions come up from Joint
Commission about the manual? 

	Mary-Anne Flowers 
	Chief Clinical Dietitian 

	Oak Hill Hospital 
	11375 Cortez Blvd., Brooksville , FL , 34613 
	office (352) 597-6313  fax (352) 597-6087 

	This email and any files transmitted with it may contain
PRIVILEGED or CONFIDENTIAL information and may be read or used only by
the intended recipient. If you are not the intended recipient of the
email or any of its attachments, please be advised that you have
received this email in error and that any use, dissemination,
distribution, forwarding, printing, or copying of this email or any
attached files is strictly prohibited. If you have received this email
in error, please immediately purge it and all attachments and notify the
sender by reply email or contact the sender at the number listed. 

	I 

	------------------------------------------------------------
	This email message, including any attachments, is for the sole
use of the intended recipient(s) and may contain information that is
proprietary, confidential, and exempt from disclosure under applicable
law. Any unauthorized review, use, disclosure, or distribution is
prohibited. If you have received this email in error please notify the
sender by return email and delete the original message. Please note, the
recipient should check this email and any attachments for the presence
of viruses. The organization accepts no liability for any damage caused
by any virus transmitted by this email.
	================================= 

	-----Inline Attachment Follows-----

	_______________________________________________
	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. 

(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.
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From sandradeewells at yahoo.com  Fri Jul 10 10:05:35 2009
From: sandradeewells at yahoo.com (Sandra Wells)
Date: Fri, 10 Jul 2009 10:05:35 -0700 (PDT)
Subject: [Cnm] Online Diet Manual- ADA response
Message-ID: <428586.33841.qm@web57701.mail.re3.yahoo.com>

Thank you for your input and support Linda!
1. The NCM automatically sends out update notifications to anyone listed as an administrator via email 30 days in advance of an update. Sometimes these get caught up in SPAM filter since they are sent via mass mail. This year, we will be posting the notice on the ADA Facebook page as well. Updates are scheduled for the Fall.
2.?I know that our publishing manager has been working on client education titles for the Fall update. We understand that sometimes the diagnosis does not fit the intent. ?I?ll let her know that another request has come to my attention.
3. Annalyn refers to Sticky Notes in her reply. As an admin you can add sticky notes on NCM pages for internal?viewing so that you and others see comments,?but not for clients to see. 
As far as modifying the educational materials, you can add your client?s information and your logo on most now. Allowing users to modify the content itself may potentially create a liability issue for the ADA since each page has our logo and copyright information. Remember that, in some cases, people other than RDs use our client education materials. I have suggested to the editor a ?Notes from your RD? page though. She will do some market testing on this idea.
If you have any content suggestions, please feel free to email me or the publishing manager at: editor at nutritioncaremanual.org
Best regards,
Sandra
Sandra D. Beil
Nutrition Care Manual? Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois?60606-6995
sbeil at eatright.org
Direct:? 312-899-4795
Fax: 312-899-5339
Toll Free: 800-877-1600 x4795
www.eatright.org
www.nutritioncaremanual.org

--- On Fri, 7/10/09, Linda Bartholomay  wrote:

From: Linda Bartholomay 
Subject: Re: [Cnm] Online Diet Manual- ADA response
To: Annalynn_Skipper at Comcast.net, "Barbara''Lusk" , cnm at lists.my180.net, "'Flowers Mary-Anne'" , "Jonathan''Murray" , "Leslee''Carver" , "Sandra Wells" 
Cc: "Sandra Beil" 
Date: Friday, July 10, 2009, 11:24 AM

Just some input from having the ADA on-line manual now for several years.

It would be desirable to be notified when anything new is added or revised in the manual.? 
We want the ability to print off education materials without the diagnosis listed as the "diet".? We currently are still using some of our own materials as this has been a turn off to our staff to give to patients.? 
If we had the ability to modify the education materials or add to them (i.e. addendums) , that would be very helpful.

Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:? Arranger, Ideation, Adaptability, Empathy, Maximizer

>>> Sandra Wells  7/10/2009 11:11 AM >>>

Hello Everyone,
?
I am the sales manager for the NCM and would be happy to clear up any questions or concerns you may have. Please feel free to contact me directly as well. My contact information is below.
?
There is no additional fee to have the NCM available across your entire facility. The preferred method of using NCM is to set it up so that all computers you want to have access would have access 24/7. 
?
Just to clear up some terminology: since NCM is Web based, there is nothing to install on the intranet. Your?intranet is simply set up to access the NCM through a custom url set up for your organization. ?Your IT person simply sets up parameters in the NCM admin screen by which your computers can access NCM by clicking on an icon or link without logging in with a user name and password.?Most of our subscribers do this now, and?is very easy to?set up.?Here is the link to the FAQ in NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf
?
There is no licensing fee, since there is no software to install. NCM is purchased on a subscription basis and the price is based on concurrent users. For example, 5 people would want to access?NCM?at any given same?time, 5 subscriptions would be purchased. If a 6th person comes along, they would simply wait until someone logs off. You can add subscriptions at any time should you need more.
?
Again, please feel free to email or call me directly. I can speak to your IT person directly as well if the instructions are not clear.

Best regards,
Sandra
?
Sandra D. Beil
Nutrition Care Manual? Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois 60606-6995
sbeil at eatright.org 
Direct:? 312-899-4795
Toll Free: 800-877-1600 x4795
Fax: 312-899-5339 
--- On Fri, 7/10/09, Annalynn Skipper  wrote:

From: Annalynn Skipper 
Subject: Re: [Cnm] Online Diet Manual
To: "'Lusk, Barbara'" , "'Murray, Jonathan'" , "'Carver, Leslee'" , "'Flowers Mary-Anne'" , cnm at lists.my180.net
Date: Friday, July 10, 2009, 10:06 AM

Hi Johnathan,
?
As Editor of the NCM, I work on content rather than sales and IT issues.? However, I agree with the general trend of this thread.? The subscription fee for the NCM is based on the number of users who will need the manual at a single time.? I?m not aware that there is an additional charge for installing the NCM on your hospital?s intranet.? However, I recommend that you check with ADA ?s IT department on this issue.? As others have mentioned, they are quite helpful in making the NCM easily accessible throughout your facility.? 

? 

As always, we welcome constructive feedback on the NCM and how it might better serve the needs of subscribers. 

? 

Regards and good wishes for the weekend ahead.? 

? 

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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 
Sent: Friday, July 10, 2009 8:31 AM
To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

? 

We utilize the NCM (online manual) and in our initial research with ADA about this, we chose to purchase a set number of concurrent subscriptions and utilize the option to allow all hospital computer addresses to access the site (so the user did not have to input a password).? Only hospital computers can access this link.? The number of concurrent subscriptions purchased is the number of people that can have it open in the hospital at one time.? Every computer has the link and this was installed on our department?s webpage and in the reference page of the physician?s electronic order entry / charting system. 

? 

I hope that helps. 

? 

Barbara Lusk, R.D., L.D.N.
Associate Director 

Clinical Nutrition / Patient Services Director 

Nutrition and Food Services 

University of North Carolina Hospitals 

101 Manning Drive 

Chapel Hill, NC ? 27514 

phone: (919) 843-0062 

email: BLusk at unch.unc.edu 

From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
Sent: Friday, July 10, 2009 8:01 AM
To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

? 

Hi all I?m confused I was under the impression we had to pay an additional licensing fee to have it installed on multiple computers. Can someone from ADA clarify. Thanks 

? 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee
Sent: Tuesday, July 07, 2009 5:58 PM
To: Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

? 

since the ADA is more than fine w/ it (we do this w/ their knowledge and approval) perhaps you can get an e-mail from the ADA nutr care manual support folks so stating.? Leslee 

?

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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. ?All personal messages express view 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

?

? 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Flowers Mary-Anne
Sent: Tuesday, July 07, 2009 2:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] Online Diet Manual 

I know that this has been discussed in the past but I appear to be hitting a road block with my IT department and making the online version of the ADA manual available on the nursing floors. I am being told that it is a copyright infringement if we place the manual on our intranet for the staff to use. 

1.???? How do you get around this problem? 

2.???? If you bought multiple copies how many copies of the manual have you purchased for your facilities and how did you arrive at that number? 

3.???? ?With the paper version we had one copy on every unit, 1 in the dietitian?s office and 1 in administration. 

4.???? Have you had any issues or questions come up from Joint Commission about the manual? 

Mary-Anne Flowers 
Chief Clinical Dietitian 

Oak Hill Hospital 
11375 Cortez Blvd., Brooksville , FL , 34613 
office (352) 597-6313? fax (352) 597-6087 

This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed. 

? 

? 

I 

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This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain information that is proprietary, confidential, and exempt from disclosure under applicable law. Any unauthorized review, use, disclosure, or distribution is prohibited. If you have received this email in error please notify the sender by return email and delete the original message. Please note, the recipient should check this email and any attachments for the presence of viruses. The organization accepts no liability for any damage caused by any virus transmitted by this email.
================================= 
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Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

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From Kathy.Kesling at ssfhs.org  Fri Jul 10 10:16:16 2009
From: Kathy.Kesling at ssfhs.org (Kesling Kathy)
Date: Fri, 10 Jul 2009 13:16:16 -0400
Subject: [Cnm] Online Diet Manual- ADA response
Message-ID: <30812031.145255.1247246177264.JavaMail.root@oailxiron1.ssfhs.org>

I would second Linda's comments below.  Sometimes there are revisions between updates or changes which are not listed in the update  notification and when hospital menus and policies are based on the content and it suddenly changes, then the policies, etc have to be revised quickly.  I also agree with the diagnosis comment.  Physicians order diets for reasons other than the listed diagnosis and it is more difficult to find the diet and to use the educational materials with the diagnosis as the diet name.  I have found the editors to be responsive to comments and have had no issues with number of subscribers, using the hospital intranet link to access the manual or regulatory agencies.

Thanks,
Kathy

Kathy Kesling,MS RD CD
Manager, Food and Nutrition Services
Saint Anthony Memorial
301 West Homer St
Michigan City, IN 46360
Phone: 219-877-1543
Fax: 219-877-2011
Email: kathy.kesling at ssfhs.org

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Linda Bartholomay
Sent: Friday, July 10, 2009 11:24 AM
To: Annalynn_Skipper at Comcast.net; Barbara''Lusk; cnm at lists.my180.net; 'Flowers Mary-Anne'; Jonathan''Murray; Leslee''Carver; Sandra Wells
Cc: Sandra Beil
Subject: Re: [Cnm] Online Diet Manual- ADA response

Just some input from having the ADA on-line manual now for several years.

 1.  It would be desirable to be notified when anything new is added or revised in the manual.
 2.  We want the ability to print off education materials without the diagnosis listed as the "diet".  We currently are still using some of our own materials as this has been a turn off to our staff to give to patients.
 3.  If we had the ability to modify the education materials or add to them (i.e. addendums) , that would be very helpful.
 4.
Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer

>>> Sandra Wells  7/10/2009 11:11 AM >>>
Hello Everyone,

I am the sales manager for the NCM and would be happy to clear up any questions or concerns you may have. Please feel free to contact me directly as well. My contact information is below.

There is no additional fee to have the NCM available across your entire facility. The preferred method of using NCM is to set it up so that all computers you want to have access would have access 24/7.

Just to clear up some terminology: since NCM is Web based, there is nothing to install on the intranet. Your intranet is simply set up to access the NCM through a custom url set up for your organization.  Your IT person simply sets up parameters in the NCM admin screen by which your computers can access NCM by clicking on an icon or link without logging in with a user name and password. Most of our subscribers do this now, and is very easy to set up. Here is the link to the FAQ in NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf

There is no licensing fee, since there is no software to install. NCM is purchased on a subscription basis and the price is based on concurrent users. For example, 5 people would want to access NCM at any given same time, 5 subscriptions would be purchased. If a 6th person comes along, they would simply wait until someone logs off. You can add subscriptions at any time should you need more.

Again, please feel free to email or call me directly. I can speak to your IT person directly as well if the instructions are not clear.
Best regards,
Sandra

Sandra D. Beil
Nutrition Care Manual(r) Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois 60606-6995
sbeil at eatright.org
Direct:  312-899-4795
Toll Free: 800-877-1600 x4795
Fax: 312-899-5339
--- On Fri, 7/10/09, Annalynn Skipper  wrote:

From: Annalynn Skipper 
Subject: Re: [Cnm] Online Diet Manual
To: "'Lusk, Barbara'" , "'Murray, Jonathan'" , "'Carver, Leslee'" , "'Flowers Mary-Anne'" , cnm at lists.my180.net
Date: Friday, July 10, 2009, 10:06 AM

Hi Johnathan,

As Editor of the NCM, I work on content rather than sales and IT issues.  However, I agree with the general trend of this thread.  The subscription fee for the NCM is based on the number of users who will need the manual at a single time.  I'm not aware that there is an additional charge for installing the NCM on your hospital's intranet.  However, I recommend that you check with ADA 's IT department on this issue.  As others have mentioned, they are quite helpful in making the NCM easily accessible throughout your facility.
As always, we welcome constructive feedback on the NCM and how it might better serve the needs of subscribers.
Regards and good wishes for the weekend ahead.
Annalynn
Annalynn Skipper Ph.D., R.D., FADA
[cid:991425916 at 10072009-2E7A]

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: Lusk, Barbara [mailto:BLusk at unch.unc.edu]
Sent: Friday, July 10, 2009 8:31 AM
To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
We utilize the NCM (online manual) and in our initial research with ADA about this, we chose to purchase a set number of concurrent subscriptions and utilize the option to allow all hospital computer addresses to access the site (so the user did not have to input a password).  Only hospital computers can access this link.  The number of concurrent subscriptions purchased is the number of people that can have it open in the hospital at one time.  Every computer has the link and this was installed on our department's webpage and in the reference page of the physician's electronic order entry / charting system.
I hope that helps.
Barbara Lusk, R.D., L.D.N.
Associate Director
Clinical Nutrition / Patient Services Director
Nutrition and Food Services
University of North Carolina Hospitals
101 Manning Drive
Chapel Hill, NC   27514
phone: (919) 843-0062
email: BLusk at unch.unc.edu
________________________________
From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org]
Sent: Friday, July 10, 2009 8:01 AM
To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
Hi all I'm confused I was under the impression we had to pay an additional licensing fee to have it installed on multiple computers. Can someone from ADA clarify. Thanks
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee
Sent: Tuesday, July 07, 2009 5:58 PM
To: Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
since the ADA is more than fine w/ it (we do this w/ their knowledge and approval) perhaps you can get an e-mail from the ADA nutr care manual support folks so stating.  Leslee

Leslee R. Carver, MSPH, RD, LDN
Clinical Nutrition Manager
Saint Joseph Hospital
2900 N. Lake Shore Dr.
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.  All personal messages express view 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

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Flowers Mary-Anne
Sent: Tuesday, July 07, 2009 2:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] Online Diet Manual
I know that this has been discussed in the past but I appear to be hitting a road block with my IT department and making the online version of the ADA manual available on the nursing floors. I am being told that it is a copyright infringement if we place the manual on our intranet for the staff to use.

1.     How do you get around this problem?

2.     If you bought multiple copies how many copies of the manual have you purchased for your facilities and how did you arrive at that number?

3.      With the paper version we had one copy on every unit, 1 in the dietitian's office and 1 in administration.

4.     Have you had any issues or questions come up from Joint Commission about the manual?
Mary-Anne Flowers
Chief Clinical Dietitian
Oak Hill Hospital
11375 Cortez Blvd., Brooksville , FL , 34613
office (352) 597-6313  fax (352) 597-6087
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.
I
------------------------------------------------------------
This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain information that is proprietary, confidential, and exempt from disclosure under applicable law. Any unauthorized review, use, disclosure, or distribution is prohibited. If you have received this email in error please notify the sender by return email and delete the original message. Please note, the recipient should check this email and any attachments for the presence of viruses. The organization accepts no liability for any damage caused by any virus transmitted by this email.
=================================

-----Inline Attachment Follows-----

_______________________________________________
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.

The information contained in this e-mail and any accompanying documents 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. If you are not the intended recipient(s), please contact the sender by e-mail and destroy all copies of the original message. Thank you.
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From kfeldberkowitz at jhha.org  Fri Jul 10 11:21:32 2009
From: kfeldberkowitz at jhha.org (Feld-Berkowitz, Kathy)
Date: Fri, 10 Jul 2009 14:21:32 -0400
Subject: [Cnm] Cnm Digest, Vol 32, Issue 36-cost for subscription to NCM
In-Reply-To: 
References: 
Message-ID: 

Would you be so kind as to share the cost of subscription to the NCM?
Is this info available on the ADA website? 

Kathy Feld Berkowitz MS, RD, CDE, CDN
Assistant Director Food and Nutrition Services
Jewish Home Lifecare
Bronx Division
100 W Kingsbridge Road
Bronx, NY 10468
(718) 410-1522
kfeldberkowitz at jhha.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: Friday, July 10, 2009 12:11 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 32, 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: Homemade tube feedings (Ketterman-Hopkins, Cindra)
   2. Re: Online Diet Manual- ADA response (Sandra Wells)

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

Message: 1
Date: Fri, 10 Jul 2009 11:51:29 -0400
From: "Ketterman-Hopkins, Cindra" 
Subject: Re: [Cnm] Homemade tube feedings
To: "Flores, Rachel" ,	
Message-ID:
	<5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1A4C at EXCH4.wellspan.org>
Content-Type: text/plain; charset="us-ascii"

I arranged for an in-room little refrigerator to be delivered to the
patient room.  The family is going to bring in the homemade tube feeding
and administer it to the patient themselves.  Our Infection Control
Department staff supported us not making the tube feeding and also that
nursing service not administer the feeding.  Thanks for everyone's
input.  I hate to say no to this stuff but it's a whole new ball game
out there these days!  

Cindra L. Ketterman, MS, RD, LDN

Chief Clinical Dietitian

York Hospital.WellSpan Health

1001 South George Street

York, PA  17405-7198

(717) 851 - 3991

(717) 851 - 2345 ask for pager 0093

(717) 851 - 2934 (fax)

________________________________

From: Flores, Rachel [mailto:RachelFlores at sach.org] 
Sent: Friday, July 10, 2009 11:39
To: Ketterman-Hopkins, Cindra; cnm at lists.my180.net
Subject: RE: [Cnm] Homemade tube feedings

I once had a patient with multiple intolerances, including corn syrup,
and the daughter insisted that all commercial formulas would be a
problem.  I helped her design a nutritionally adequate blendarized
formula for home, and from then on the physician would write the order
that the patient could have tube feeds from home.  It worked really
well.  The daughter was very conscientious about food safety and
maintaining temps, and the patient tolerated it without problems.  Would
that be an option?

Rachel Flores, RD, CNSC

Clinical Nutrition Manager

San Antonio Community Hospital

(909) 985-2811 x24430

________________________________

From: Ketterman-Hopkins, Cindra [mailto:cketterman at wellspan.org] 
Sent: Friday, July 10, 2009 7:48 AM
To: cnm at lists.my180.net
Subject: [Cnm] Homemade tube feedings

A physician is requesting that we make a homemade tube feeding based on
a recipe the family has been using for a new admit.  Patient has Crohn's
disease and has tried every commercial product known to man.  I'm
thinking No.  Have anyone has a request like this recently and how did
you handle it.  Any input is welcomed.  Thanks  Cindy

Cindra L. Ketterman, MS, RD, LDN

Chief Clinical Dietitian

York Hospital.WellSpan Health

1001 South George Street

York, PA  17405-7198

(717) 851 - 3991

(717) 851 - 2345 ask for pager 0093

(717) 851 - 2934 (fax)

______________________________________________________________________
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Skeptic(tm) technology powered by MessageLabs. For more information on
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------------------------------

Message: 2
Date: Fri, 10 Jul 2009 09:11:13 -0700 (PDT)
From: Sandra Wells 
Subject: Re: [Cnm] Online Diet Manual- ADA response
To: Barbara''Lusk ,	Jonathan''Murray
	,	Leslee''Carver
	,	'Flowers Mary-Anne'
	,	cnm at lists.my180.net,
	Annalynn_Skipper at Comcast.net
Cc: Sandra Beil 
Message-ID: <748943.55857.qm at web57704.mail.re3.yahoo.com>
Content-Type: text/plain; charset="utf-8"

Hello Everyone,
?
I am the sales manager for the NCM and would be happy to clear up any
questions or concerns you may have. Please feel free to contact me
directly as well. My contact information is below.
?
There is no additional fee to have the NCM available across your entire
facility. The preferred method of using NCM is to set it up so that all
computers you want to have access would have access 24/7. 
?
Just to clear up some terminology: since NCM is Web based, there is
nothing to install on the intranet. Your?intranet is simply set up to
access the NCM through a custom url set up for your organization. ?Your
IT person simply sets up parameters in the NCM admin screen by which
your computers can access NCM by clicking on an icon or link without
logging in with a user name and password.?Most of our subscribers do
this now, and?is very easy to?set up.?Here is the link to the FAQ in
NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf
?
There is no licensing fee, since there is no software to install. NCM is
purchased on a subscription basis and the price is based on concurrent
users. For example, 5 people would want to access?NCM?at any given
same?time, 5 subscriptions would be purchased. If a 6th person comes
along, they would simply wait until someone logs off. You can add
subscriptions at any time should you need more.
?
Again, please feel free to email or call me directly. I can speak to
your IT person directly as well if the instructions are not clear.

Best regards,
Sandra
?
Sandra D. Beil
Nutrition Care Manual? Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois 60606-6995
sbeil at eatright.org 
Direct:? 312-899-4795
Toll Free: 800-877-1600 x4795
Fax: 312-899-5339 
--- On Fri, 7/10/09, Annalynn Skipper 
wrote:

From: Annalynn Skipper 
Subject: Re: [Cnm] Online Diet Manual
To: "'Lusk, Barbara'" , "'Murray, Jonathan'"
, "'Carver, Leslee'"
, "'Flowers Mary-Anne'"
, cnm at lists.my180.net
Date: Friday, July 10, 2009, 10:06 AM

Hi Johnathan,
?
As Editor of the NCM, I work on content rather than sales and IT
issues.? However, I agree with the general trend of this thread.? The
subscription fee for the NCM is based on the number of users who will
need the manual at a single time.? I?m not aware that there is an
additional charge for installing the NCM on your hospital?s intranet.?
However, I recommend that you check with ADA ?s IT department on this
issue.? As others have mentioned, they are quite helpful in making the
NCM easily accessible throughout your facility.? 
?
As always, we welcome constructive feedback on the NCM and how it might
better serve the needs of subscribers.
?
Regards and good wishes for the weekend ahead.? 
?

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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 
Sent: Friday, July 10, 2009 8:31 AM
To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne;
cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
?
We utilize the NCM (online manual) and in our initial research with ADA
about this, we chose to purchase a set number of concurrent
subscriptions and utilize the option to allow all hospital computer
addresses to access the site (so the user did not have to input a
password).? Only hospital computers can access this link.? The number of
concurrent subscriptions purchased is the number of people that can have
it open in the hospital at one time.? Every computer has the link and
this was installed on our department?s webpage and in the reference page
of the physician?s electronic order entry / charting system.
?
I hope that helps.
?

Barbara Lusk, R.D., L.D.N.
Associate Director
Clinical Nutrition / Patient Services Director
Nutrition and Food Services
University of North Carolina Hospitals
101 Manning Drive
Chapel Hill, NC ? 27514
phone: (919) 843-0062
email: BLusk at unch.unc.edu

From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
Sent: Friday, July 10, 2009 8:01 AM
To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
?
Hi all I?m confused I was under the impression we had to pay an
additional licensing fee to have it installed on multiple computers. Can
someone from ADA clarify. Thanks
?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Carver, Leslee
Sent: Tuesday, July 07, 2009 5:58 PM
To: Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
?
since the ADA is more than fine w/ it (we do this w/ their knowledge and
approval) perhaps you can get an e-mail from the ADA nutr care manual
support folks so stating.? Leslee

?
Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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. ?All personal messages express
view 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

?
?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Flowers Mary-Anne
Sent: Tuesday, July 07, 2009 2:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] Online Diet Manual
I know that this has been discussed in the past but I appear to be
hitting a road block with my IT department and making the online version
of the ADA manual available on the nursing floors. I am being told that
it is a copyright infringement if we place the manual on our intranet
for the staff to use.
1.???? How do you get around this problem? 
2.???? If you bought multiple copies how many copies of the manual have
you purchased for your facilities and how did you arrive at that number?
3.???? ?With the paper version we had one copy on every unit, 1 in the
dietitian?s office and 1 in administration.
4.???? Have you had any issues or questions come up from Joint
Commission about the manual? 
Mary-Anne Flowers 
Chief Clinical Dietitian 
Oak Hill Hospital 
11375 Cortez Blvd., Brooksville , FL , 34613 
office (352) 597-6313? fax (352) 597-6087 
This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
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its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
prohibited. If you have received this email in error, please immediately
purge it and all attachments and notify the sender by reply email or
contact the sender at the number listed.
?
?
I
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the intended recipient(s) and may contain information that is
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prohibited. If you have received this email in error please notify the
sender by return email and delete the original message. Please note, the
recipient should check this email and any attachments for the presence
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End of Cnm Digest, Vol 32, Issue 36
***********************************

From LCarver at Reshealthcare.org  Fri Jul 10 11:26:19 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Fri, 10 Jul 2009 13:26:19 -0500
Subject: [Cnm] Online Diet Manual- ADA response
In-Reply-To: <428586.33841.qm@web57701.mail.re3.yahoo.com>
References: <428586.33841.qm@web57701.mail.re3.yahoo.com>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E048528A9@rhcexch3.reshealthcare.org>

I believe I am one of the Administrators but have never received a
notice of update - we do have a pretty aggressive firewall here.
perhaps the easiest method for many of us would be to have a notice
posted on the first page of the manual - most of us are in there often
enough to see it.  if there was a link to more details that would be
even better.  

I really like the on-line manual but do agree that the use of diagnoses
rather than diet types in the headings of diet instr material narrows it
usability.  a cross reference by diet type (diet orders) would be
extremely helpful for the diet office folks.  

thanks!  Leslee

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: Sandra Wells [mailto:sandradeewells at yahoo.com] 
Sent: Friday, July 10, 2009 12:06 PM
To: Annalynn_Skipper at Comcast.net; Barbara''Lusk; cnm at lists.my180.net;
'Flowers Mary-Anne'; Jonathan''Murray; Carver, Leslee; Linda Bartholomay
Cc: Sandra Beil
Subject: Re: [Cnm] Online Diet Manual- ADA response

Thank you for your input and support Linda! 

1. The NCM automatically sends out update notifications to anyone listed
as an administrator via email 30 days in advance of an update. Sometimes
these get caught up in SPAM filter since they are sent via mass mail.
This year, we will be posting the notice on the ADA Facebook page as
well. Updates are scheduled for the Fall. 

2. I know that our publishing manager has been working on client
education titles for the Fall update. We understand that sometimes the
diagnosis does not fit the intent.  I'll let her know that another
request has come to my attention. 

3. Annalyn refers to Sticky Notes in her reply. As an admin you can add
sticky notes on NCM pages for internal viewing so that you and others
see comments, but not for clients to see. 

As far as modifying the educational materials, you can add your client's
information and your logo on most now. Allowing users to modify the
content itself may potentially create a liability issue for the ADA
since each page has our logo and copyright information. Remember that,
in some cases, people other than RDs use our client education materials.
I have suggested to the editor a "Notes from your RD" page though. She
will do some market testing on this idea. 

If you have any content suggestions, please feel free to email me or the
publishing manager at: editor at nutritioncaremanual.org 

Best regards, 

Sandra 

Sandra D. Beil 

Nutrition Care Manual(r) Sales Manager 

American Dietetic Association 

120 South Riverside Plaza, Suite 2000 

Chicago, Illinois 60606-6995 

sbeil at eatright.org 

Direct:  312-899-4795 

Fax: 312-899-5339 

Toll Free: 800-877-1600 x4795 

www.eatright.org 

www.nutritioncaremanual.org 

--- On Fri, 7/10/09, Linda Bartholomay 
wrote:

	From: Linda Bartholomay 
	Subject: Re: [Cnm] Online Diet Manual- ADA response
	To: Annalynn_Skipper at Comcast.net, "Barbara''Lusk"
, cnm at lists.my180.net, "'Flowers Mary-Anne'"
, "Jonathan''Murray"
, "Leslee''Carver"
, "Sandra Wells" 
	Cc: "Sandra Beil" 
	Date: Friday, July 10, 2009, 11:24 AM

	Just some input from having the ADA on-line manual now for
several years.

	1.	It would be desirable to be notified when anything new
is added or revised in the manual.  
	2.	We want the ability to print off education materials
without the diagnosis listed as the "diet".  We currently are still
using some of our own materials as this has been a turn off to our staff
to give to patients.  
	3.	If we had the ability to modify the education materials
or add to them (i.e. addendums) , that would be very helpful.

	4.	
		Linda Bartholomay, LRD
		Manager, Nutrition Therapy
		MeritCare Health Systems
		Linda.Bartholomay at meritcare.com
		(701) 234-6166
		Strengths:  Arranger, Ideation, Adaptability, Empathy,
Maximizer

	>>> Sandra Wells  7/10/2009 11:11 AM
>>>

Hello Everyone,

I am the sales manager for the NCM and would be happy to clear up any
questions or concerns you may have. Please feel free to contact me
directly as well. My contact information is below.

There is no additional fee to have the NCM available across your entire
facility. The preferred method of using NCM is to set it up so that all
computers you want to have access would have access 24/7. 

Just to clear up some terminology: since NCM is Web based, there is
nothing to install on the intranet. Your intranet is simply set up to
access the NCM through a custom url set up for your organization.  Your
IT person simply sets up parameters in the NCM admin screen by which
your computers can access NCM by clicking on an icon or link without
logging in with a user name and password. Most of our subscribers do
this now, and is very easy to set up. Here is the link to the FAQ in
NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf

There is no licensing fee, since there is no software to install. NCM is
purchased on a subscription basis and the price is based on concurrent
users. For example, 5 people would want to access NCM at any given same
time, 5 subscriptions would be purchased. If a 6th person comes along,
they would simply wait until someone logs off. You can add subscriptions
at any time should you need more.

Again, please feel free to email or call me directly. I can speak to
your IT person directly as well if the instructions are not clear.

Best regards,
Sandra

Sandra D. Beil
Nutrition Care Manual(r) Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois 60606-6995
sbeil at eatright.org

Direct:  312-899-4795
Toll Free: 800-877-1600 x4795
Fax: 312-899-5339 
--- On Fri, 7/10/09, Annalynn Skipper 
wrote:

	From: Annalynn Skipper 
	Subject: Re: [Cnm] Online Diet Manual
	To: "'Lusk, Barbara'" , "'Murray, Jonathan'"
, "'Carver, Leslee'"
, "'Flowers Mary-Anne'"
, cnm at lists.my180.net
	Date: Friday, July 10, 2009, 10:06 AM

	Hi Johnathan,

	As Editor of the NCM, I work on content rather than sales and IT
issues.  However, I agree with the general trend of this thread.  The
subscription fee for the NCM is based on the number of users who will
need the manual at a single time.  I'm not aware that there is an
additional charge for installing the NCM on your hospital's intranet.
However, I recommend that you check with ADA 's IT department on this
issue.  As others have mentioned, they are quite helpful in making the
NCM easily accessible throughout your facility.  

	As always, we welcome constructive feedback on the NCM and how
it might better serve the needs of subscribers. 

	Regards and good wishes for the weekend ahead.  

	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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 
	Sent: Friday, July 10, 2009 8:31 AM
	To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne;
cnm at lists.my180.net
	Subject: Re: [Cnm] Online Diet Manual

	We utilize the NCM (online manual) and in our initial research
with ADA about this, we chose to purchase a set number of concurrent
subscriptions and utilize the option to allow all hospital computer
addresses to access the site (so the user did not have to input a
password).  Only hospital computers can access this link.  The number of
concurrent subscriptions purchased is the number of people that can have
it open in the hospital at one time.  Every computer has the link and
this was installed on our department's webpage and in the reference page
of the physician's electronic order entry / charting system. 

	I hope that helps. 

	Barbara Lusk, R.D., L.D.N.

	Associate Director 

	Clinical Nutrition / Patient Services Director 

	Nutrition and Food Services 

	University of North Carolina Hospitals 

	101 Manning Drive 

	Chapel Hill, NC   27514 

	phone: (919) 843-0062 

	email: BLusk at unch.unc.edu

________________________________

	From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
	Sent: Friday, July 10, 2009 8:01 AM
	To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
	Subject: Re: [Cnm] Online Diet Manual

	Hi all I'm confused I was under the impression we had to pay an
additional licensing fee to have it installed on multiple computers. Can
someone from ADA clarify. Thanks 

	From: cnm-bounces at lists.my180.net
[mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee
	Sent: Tuesday, July 07, 2009 5:58 PM
	To: Flowers Mary-Anne; cnm at lists.my180.net
	Subject: Re: [Cnm] Online Diet Manual

	since the ADA is more than fine w/ it (we do this w/ their
knowledge and approval) perhaps you can get an e-mail from the ADA nutr
care manual support folks so stating.  Leslee 

	Leslee R. Carver, MSPH, RD, LDN 
	Clinical Nutrition Manager 
	Saint Joseph Hospital 
	2900 N. Lake Shore Dr. 
	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.  All personal messages
express view 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

________________________________

	From: cnm-bounces at lists.my180.net
[mailto:cnm-bounces at lists.my180.net] On Behalf Of Flowers Mary-Anne
	Sent: Tuesday, July 07, 2009 2:28 PM
	To: cnm at lists.my180.net
	Subject: [Cnm] Online Diet Manual 

	I know that this has been discussed in the past but I appear to
be hitting a road block with my IT department and making the online
version of the ADA manual available on the nursing floors. I am being
told that it is a copyright infringement if we place the manual on our
intranet for the staff to use. 

	1.     How do you get around this problem? 

	2.     If you bought multiple copies how many copies of the
manual have you purchased for your facilities and how did you arrive at
that number? 

	3.      With the paper version we had one copy on every unit, 1
in the dietitian's office and 1 in administration. 

	4.     Have you had any issues or questions come up from Joint
Commission about the manual? 

	Mary-Anne Flowers 
	Chief Clinical Dietitian 

	Oak Hill Hospital 
	11375 Cortez Blvd., Brooksville , FL , 34613 
	office (352) 597-6313  fax (352) 597-6087 

	This email and any files transmitted with it may contain
PRIVILEGED or CONFIDENTIAL information and may be read or used only by
the intended recipient. If you are not the intended recipient of the
email or any of its attachments, please be advised that you have
received this email in error and that any use, dissemination,
distribution, forwarding, printing, or copying of this email or any
attached files is strictly prohibited. If you have received this email
in error, please immediately purge it and all attachments and notify the
sender by reply email or contact the sender at the number listed. 

	I 

	------------------------------------------------------------
	This email message, including any attachments, is for the sole
use of the intended recipient(s) and may contain information that is
proprietary, confidential, and exempt from disclosure under applicable
law. Any unauthorized review, use, disclosure, or distribution is
prohibited. If you have received this email in error please notify the
sender by return email and delete the original message. Please note, the
recipient should check this email and any attachments for the presence
of viruses. The organization accepts no liability for any damage caused
by any virus transmitted by this email.
	================================= 

	-----Inline Attachment Follows-----

	_______________________________________________
	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
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From sandradeewells at yahoo.com  Fri Jul 10 11:41:01 2009
From: sandradeewells at yahoo.com (Sandra Wells)
Date: Fri, 10 Jul 2009 11:41:01 -0700 (PDT)
Subject: [Cnm] Online Diet Manual- ADA response
Message-ID: <962688.47428.qm@web57707.mail.re3.yahoo.com>

Hello Barbara,
?
There is a list. If you navigate to the Meal Plans section of the NCM, (it's the teal colored tab in the horizontal banner) you will find a list with links for the client education and a crosswalk to what were formerly called diets. Each also has a link to foods recommended and not recommended, and sample menus.
?
Best regards,
Sandra

--- On Fri, 7/10/09, Haine, Barbara  wrote:

From: Haine, Barbara 
Subject: RE: [Cnm] Online Diet Manual- ADA response
To: "Egelhofer, Nancy" , "Linda Bartholomay" , Annalynn_Skipper at Comcast.net, "Barbara''Lusk" , cnm at lists.my180.net, "Flowers Mary-Anne" , "Jonathan''Murray" , "Leslee''Carver" , "Sandra Wells" 
Cc: "Sandra Beil" 
Date: Friday, July 10, 2009, 12:13 PM

#yiv1615451476 p.MsoNormal
	{margin-left:3.0pt;}

It would be helpful to have a list of all of the diets that one could pull up instead of going through all of the diagnoses to find the diet you are looking for.? The current manual is much less useful to the diet office staff who need a reference as to what is allowed on different diets.? We have had to keep the old, un-updated hardcopy version as a backup for them.
Barbara Haine
?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Egelhofer, Nancy
Sent: Friday, July 10, 2009 1:02 PM
To: Linda Bartholomay; Annalynn_Skipper at Comcast.net; Barbara''Lusk; cnm at lists.my180.net; Flowers Mary-Anne; Jonathan''Murray; Leslee''Carver; Sandra Wells
Cc: Sandra Beil
Subject: Re: [Cnm] Online Diet Manual- ADA response
?
We, too, often avoid the manual "Diets" for patient use because the dianosis is written on top of the sheet.? The diets are occasionally used with a slightly different diagnosis than is listed on the ADA Diet, and it is confusing for the patient and families.
Nancy
?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Linda Bartholomay
Sent: Friday, July 10, 2009 12:24 PM
To: Annalynn_Skipper at Comcast.net; Barbara''Lusk; cnm at lists.my180.net; 'Flowers Mary-Anne'; Jonathan''Murray; Leslee''Carver; Sandra Wells
Cc: Sandra Beil
Subject: Re: [Cnm] Online Diet Manual- ADA response

Just some input from having the ADA on-line manual now for several years.

It would be desirable to be notified when anything new is added or revised in the manual.? 
We want the ability to print off education materials without the diagnosis listed as the "diet".? We currently are still using some of our own materials as this has been a turn off to our staff to give to patients.? 
If we had the ability to modify the education materials or add to them (i.e. addendums) , that would be very helpful.
Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:? Arranger, Ideation, Adaptability, Empathy, Maximizer

>>> Sandra Wells  7/10/2009 11:11 AM >>>

Hello Everyone,

?

I am the sales manager for the NCM and would be happy to clear up any questions or concerns you may have. Please feel free to contact me directly as well. My contact information is below.

?

There is no additional fee to have the NCM available across your entire facility. The preferred method of using NCM is to set it up so that all computers you want to have access would have access 24/7. 

?

Just to clear up some terminology: since NCM is Web based, there is nothing to install on the intranet. Your?intranet is simply set up to access the NCM through a custom url set up for your organization. ?Your IT person simply sets up parameters in the NCM admin screen by which your computers can access NCM by clicking on an icon or link without logging in with a user name and password.?Most of our subscribers do this now, and?is very easy to?set up.?Here is the link to the FAQ in NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf

?

There is no licensing fee, since there is no software to install. NCM is purchased on a subscription basis and the price is based on concurrent users. For example, 5 people would want to access?NCM?at any given same?time, 5 subscriptions would be purchased. If a 6th person comes along, they would simply wait until someone logs off. You can add subscriptions at any time should you need more.

?

Again, please feel free to email or call me directly. I can speak to your IT person directly as well if the instructions are not clear.

Best regards,
Sandra

?

Sandra D. Beil
Nutrition Care Manual? Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois 60606-6995

sbeil at eatright.org 
Direct:? 312-899-4795
Toll Free: 800-877-1600 x4795
Fax: 312-899-5339 
--- On Fri, 7/10/09, Annalynn Skipper  wrote:

From: Annalynn Skipper 
Subject: Re: [Cnm] Online Diet Manual
To: "'Lusk, Barbara'" , "'Murray, Jonathan'" , "'Carver, Leslee'" , "'Flowers Mary-Anne'" , cnm at lists.my180.net
Date: Friday, July 10, 2009, 10:06 AM

Hi Johnathan,
?
As Editor of the NCM, I work on content rather than sales and IT issues.? However, I agree with the general trend of this thread.? The subscription fee for the NCM is based on the number of users who will need the manual at a single time.? I?m not aware that there is an additional charge for installing the NCM on your hospital?s intranet.? However, I recommend that you check with ADA ?s IT department on this issue.? As others have mentioned, they are quite helpful in making the NCM easily accessible throughout your facility.? 
As always, we welcome constructive feedback on the NCM and how it might better serve the needs of subscribers. 
Regards and good wishes for the weekend ahead.? 

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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 
Sent: Friday, July 10, 2009 8:31 AM
To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
We utilize the NCM (online manual) and in our initial research with ADA about this, we chose to purchase a set number of concurrent subscriptions and utilize the option to allow all hospital computer addresses to access the site (so the user did not have to input a password).? Only hospital computers can access this link.? The number of concurrent subscriptions purchased is the number of people that can have it open in the hospital at one time.? Every computer has the link and this was installed on our department?s webpage and in the reference page of the physician?s electronic order entry / charting system. 
I hope that helps. 

Barbara Lusk, R.D., L.D.N.
Associate Director 
Clinical Nutrition / Patient Services Director 
Nutrition and Food Services 
University of North Carolina Hospitals 
101 Manning Drive 
Chapel Hill, NC ? 27514 
phone: (919) 843-0062 
email: BLusk at unch.unc.edu 

From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
Sent: Friday, July 10, 2009 8:01 AM
To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
Hi all I?m confused I was under the impression we had to pay an additional licensing fee to have it installed on multiple computers. Can someone from ADA clarify. Thanks 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee
Sent: Tuesday, July 07, 2009 5:58 PM
To: Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual
since the ADA is more than fine w/ it (we do this w/ their knowledge and approval) perhaps you can get an e-mail from the ADA nutr care manual support folks so stating.? Leslee 

?

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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. ?All personal messages express view 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

?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Flowers Mary-Anne
Sent: Tuesday, July 07, 2009 2:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] Online Diet Manual 
I know that this has been discussed in the past but I appear to be hitting a road block with my IT department and making the online version of the ADA manual available on the nursing floors. I am being told that it is a copyright infringement if we place the manual on our intranet for the staff to use. 
1.???? How do you get around this problem? 
2.???? If you bought multiple copies how many copies of the manual have you purchased for your facilities and how did you arrive at that number? 
3.???? ?With the paper version we had one copy on every unit, 1 in the dietitian?s office and 1 in administration. 
4.???? Have you had any issues or questions come up from Joint Commission about the manual? 
Mary-Anne Flowers 
Chief Clinical Dietitian 
Oak Hill Hospital 
11375 Cortez Blvd., Brooksville , FL , 34613 
office (352) 597-6313? fax (352) 597-6087 
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed. 
I 
------------------------------------------------------------
This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain information that is proprietary, confidential, and exempt from disclosure under applicable law. Any unauthorized review, use, disclosure, or distribution is prohibited. If you have received this email in error please notify the sender by return email and delete the original message. Please note, the recipient should check this email and any attachments for the presence of viruses. The organization accepts no liability for any damage caused by any virus transmitted by this email.
================================= ??

-----Inline Attachment Follows-----

_______________________________________________
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. 
?
(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. ----------------------------------------- **** 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
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From sandradeewells at yahoo.com  Fri Jul 10 11:54:31 2009
From: sandradeewells at yahoo.com (Sandra Wells)
Date: Fri, 10 Jul 2009 11:54:31 -0700 (PDT)
Subject: [Cnm] Online Diet Manual- ADA response
Message-ID: <279214.93084.qm@web57701.mail.re3.yahoo.com>

Hi Leslee,
?
Yes, I completely forgot about that part! If you navigate the Home page of the NCM, you'll see the complete update summary for 2008. We'll post it the new one 30 days in advance there as well.
?
Please see my previous response about the Meal Plans sections of NCM.
?
Hope that helps! Sandra

--- On Fri, 7/10/09, Carver, Leslee  wrote:

From: Carver, Leslee 
Subject: RE: [Cnm] Online Diet Manual- ADA response
To: "Sandra Wells" , Annalynn_Skipper at Comcast.net, "Barbara''Lusk" , cnm at lists.my180.net, "Flowers Mary-Anne" , "Jonathan''Murray" , "Linda Bartholomay" 
Cc: "Sandra Beil" 
Date: Friday, July 10, 2009, 1:26 PM

I believe I am one of the Administrators but have never received a notice of update - we do have a pretty aggressive firewall here.? perhaps the easiest method for many of us would be to have a notice posted on the first page of the manual - most of us are in there often enough to see it.? if there was a link to more details that would be even better.? 
?
I really like the on-line manual but do agree that the use of diagnoses rather than diet types in the headings of diet instr material narrows it usability.? a cross reference by diet type (diet orders) would be extremely helpful for the diet office folks.? 
?
thanks!? Leslee
?
Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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. ?All personal messages express view 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

?

From: Sandra Wells [mailto:sandradeewells at yahoo.com] 
Sent: Friday, July 10, 2009 12:06 PM
To: Annalynn_Skipper at Comcast.net; Barbara''Lusk; cnm at lists.my180.net; 'Flowers Mary-Anne'; Jonathan''Murray; Carver, Leslee; Linda Bartholomay
Cc: Sandra Beil
Subject: Re: [Cnm] Online Diet Manual- ADA response

Thank you for your input and support Linda! 

1. The NCM automatically sends out update notifications to anyone listed as an administrator via email 30 days in advance of an update. Sometimes these get caught up in SPAM filter since they are sent via mass mail. This year, we will be posting the notice on the ADA Facebook page as well. Updates are scheduled for the Fall. 

2.?I know that our publishing manager has been working on client education titles for the Fall update. We understand that sometimes the diagnosis does not fit the intent. ?I?ll let her know that another request has come to my attention. 

3. Annalyn refers to Sticky Notes in her reply. As an admin you can add sticky notes on NCM pages for internal?viewing so that you and others see comments,?but not for clients to see. 

As far as modifying the educational materials, you can add your client?s information and your logo on most now. Allowing users to modify the content itself may potentially create a liability issue for the ADA since each page has our logo and copyright information. Remember that, in some cases, people other than RDs use our client education materials. I have suggested to the editor a ?Notes from your RD? page though. She will do some market testing on this idea. 

If you have any content suggestions, please feel free to email me or the publishing manager at: editor at nutritioncaremanual.org 

Best regards, 

Sandra 

Sandra D. Beil 

Nutrition Care Manual? Sales Manager 

American Dietetic Association 

120 South Riverside Plaza, Suite 2000 

Chicago, Illinois?60606-6995 

sbeil at eatright.org 

Direct:? 312-899-4795 

Fax: 312-899-5339 

Toll Free: 800-877-1600 x4795 

www.eatright.org 

www.nutritioncaremanual.org 

--- On Fri, 7/10/09, Linda Bartholomay  wrote:

From: Linda Bartholomay 
Subject: Re: [Cnm] Online Diet Manual- ADA response
To: Annalynn_Skipper at Comcast.net, "Barbara''Lusk" , cnm at lists.my180.net, "'Flowers Mary-Anne'" , "Jonathan''Murray" , "Leslee''Carver" , "Sandra Wells" 
Cc: "Sandra Beil" 
Date: Friday, July 10, 2009, 11:24 AM

Just some input from having the ADA on-line manual now for several years.

It would be desirable to be notified when anything new is added or revised in the manual.? 
We want the ability to print off education materials without the diagnosis listed as the "diet".? We currently are still using some of our own materials as this has been a turn off to our staff to give to patients.? 
If we had the ability to modify the education materials or add to them (i.e. addendums) , that would be very helpful.

Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:? Arranger, Ideation, Adaptability, Empathy, Maximizer

>>> Sandra Wells  7/10/2009 11:11 AM >>>

Hello Everyone,
?
I am the sales manager for the NCM and would be happy to clear up any questions or concerns you may have. Please feel free to contact me directly as well. My contact information is below.
?
There is no additional fee to have the NCM available across your entire facility. The preferred method of using NCM is to set it up so that all computers you want to have access would have access 24/7. 
?
Just to clear up some terminology: since NCM is Web based, there is nothing to install on the intranet. Your?intranet is simply set up to access the NCM through a custom url set up for your organization. ?Your IT person simply sets up parameters in the NCM admin screen by which your computers can access NCM by clicking on an icon or link without logging in with a user name and password.?Most of our subscribers do this now, and?is very easy to?set up.?Here is the link to the FAQ in NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf
?
There is no licensing fee, since there is no software to install. NCM is purchased on a subscription basis and the price is based on concurrent users. For example, 5 people would want to access?NCM?at any given same?time, 5 subscriptions would be purchased. If a 6th person comes along, they would simply wait until someone logs off. You can add subscriptions at any time should you need more.
?
Again, please feel free to email or call me directly. I can speak to your IT person directly as well if the instructions are not clear.

Best regards,
Sandra
?
Sandra D. Beil
Nutrition Care Manual? Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois 60606-6995
sbeil at eatright.org 
Direct:? 312-899-4795
Toll Free: 800-877-1600 x4795
Fax: 312-899-5339 
--- On Fri, 7/10/09, Annalynn Skipper  wrote:

From: Annalynn Skipper 
Subject: Re: [Cnm] Online Diet Manual
To: "'Lusk, Barbara'" , "'Murray, Jonathan'" , "'Carver, Leslee'" , "'Flowers Mary-Anne'" , cnm at lists.my180.net
Date: Friday, July 10, 2009, 10:06 AM

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Hi Johnathan,
? 

As Editor of the NCM, I work on content rather than sales and IT issues.? However, I agree with the general trend of this thread.? The subscription fee for the NCM is based on the number of users who will need the manual at a single time.? I?m not aware that there is an additional charge for installing the NCM on your hospital?s intranet.? However, I recommend that you check with ADA ?s IT department on this issue.? As others have mentioned, they are quite helpful in making the NCM easily accessible throughout your facility.? 

As always, we welcome constructive feedback on the NCM and how it might better serve the needs of subscribers. 

Regards and good wishes for the weekend ahead.? 

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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 
Sent: Friday, July 10, 2009 8:31 AM
To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

We utilize the NCM (online manual) and in our initial research with ADA about this, we chose to purchase a set number of concurrent subscriptions and utilize the option to allow all hospital computer addresses to access the site (so the user did not have to input a password).? Only hospital computers can access this link.? The number of concurrent subscriptions purchased is the number of people that can have it open in the hospital at one time.? Every computer has the link and this was installed on our department?s webpage and in the reference page of the physician?s electronic order entry / charting system. 

I hope that helps. 

Barbara Lusk, R.D., L.D.N.

Associate Director 

Clinical Nutrition / Patient Services Director 

Nutrition and Food Services 

University of North Carolina Hospitals 

101 Manning Drive 

Chapel Hill, NC ? 27514 

phone: (919) 843-0062 

email: BLusk at unch.unc.edu 

From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
Sent: Friday, July 10, 2009 8:01 AM
To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

Hi all I?m confused I was under the impression we had to pay an additional licensing fee to have it installed on multiple computers. Can someone from ADA clarify. Thanks 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee
Sent: Tuesday, July 07, 2009 5:58 PM
To: Flowers Mary-Anne; cnm at lists.my180.net
Subject: Re: [Cnm] Online Diet Manual

since the ADA is more than fine w/ it (we do this w/ their knowledge and approval) perhaps you can get an e-mail from the ADA nutr care manual support folks so stating.? Leslee 

?

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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. ?All personal messages express view 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

?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Flowers Mary-Anne
Sent: Tuesday, July 07, 2009 2:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] Online Diet Manual 

I know that this has been discussed in the past but I appear to be hitting a road block with my IT department and making the online version of the ADA manual available on the nursing floors. I am being told that it is a copyright infringement if we place the manual on our intranet for the staff to use. 

1.???? How do you get around this problem? 

2.???? If you bought multiple copies how many copies of the manual have you purchased for your facilities and how did you arrive at that number? 

3.???? ?With the paper version we had one copy on every unit, 1 in the dietitian?s office and 1 in administration. 

4.???? Have you had any issues or questions come up from Joint Commission about the manual? 

Mary-Anne Flowers 
Chief Clinical Dietitian 

Oak Hill Hospital 
11375 Cortez Blvd., Brooksville , FL , 34613 
office (352) 597-6313? fax (352) 597-6087 

This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed. 

I 

------------------------------------------------------------
This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain information that is proprietary, confidential, and exempt from disclosure under applicable law. Any unauthorized review, use, disclosure, or distribution is prohibited. If you have received this email in error please notify the sender by return email and delete the original message. Please note, the recipient should check this email and any attachments for the presence of viruses. The organization accepts no liability for any damage caused by any virus transmitted by this email.
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From cwatters at ualberta.ca  Fri Jul 10 12:45:42 2009
From: cwatters at ualberta.ca (cwatters at ualberta.ca)
Date: Fri, 10 Jul 2009 13:45:42 -0600
Subject: [Cnm] Chloride lab value
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F47F9@wmhcs03.wmh.org>
References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F47F9@wmhcs03.wmh.org>
Message-ID: <20090710134542.65952mrrn7obip44@webmail.ualberta.ca>

Hi Shannon,
Increased chloride levels are more common with excessive 'normal  
saline' causing a hyperchloremic acidosis.

For a low chloride,
- usually occurs with metabolic alkalosis.  Hypovolemia d/t  
overdiuresis or unreplaced NG suctioning, severe vomiting or diarrhea  
can lead to contraction alkalosis	- usual dose of chloride in TPN is  
100-150 mmol/d, 40 mmol change in chloride is required to produce a  
therapeutic change.

Corilee Watters, MSc, RD, PhD
Coordinator, Nutrition Services
Victoria General Hospital
Vancouver Island Health Authority
Victoria, BC
ph: 250-370-8111 L 5258

Quoting "Shannon Byrd Jackson" :

> Does anyone do any nutrition support intervention for low chloride levels?
>
>
> 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 
>
>
>

From MKepich at jupitermed.com  Fri Jul 10 13:15:30 2009
From: MKepich at jupitermed.com (Mimi Kepich)
Date: Fri, 10 Jul 2009 16:15:30 -0400
Subject: [Cnm] Cnm Digest, Vol 32, Issue 42 Joint Commission visit
In-Reply-To: 
References: 
Message-ID: 

TJC surveyors just left us after a 4 day survey. Their focus was
competencies, medication reconciliation, legibility, abbreviations,
critical values, contracts and documentation. Of course, safety &
infection control was paramount. They tried to interview almost every
patient & to do tracers on a wide variety of cases. The least amount of
people they interacted with the better. All interviews were done
privately. The life safety engineer was here for 1 day & did not tour
the kitchen. The MD & RN never spoke with a dietitian or dietary
employee; they just read the ancillary notes in the computer- we were
not present during tracers- we just made ourselves available! They were
extremely detail-oriented. They did not mention NPSG#3
(anticoagulation), even though they referred to Pharmacy almost
continually.

They did interview 2 RN's that ended up as an "indirect" RFI: they asked
about what they felt they needed to do a good job, do they work in a
"safe" environment, what keeps them awake & anxious about their jobs.

They were looking for their participation in training & education; where
we train our staff that they know they can report anything to CMS &
JCAHO without fear of retaliation or repercussions. Our RNs did not
mention having that training & that did it!

So, watch those unapproved abbreviations in handwriting & free text in
the computer notes! Other than that, the MD said he'd like to move here
to have us as his hospital!

Mimi Kepich

Clinical Nutrition Manager

Jupiter Medical Center

741-6813

voice mail 747-2234, ext. 3517

Mission: To deliver excellent and compassionate healthcare advancing the
well-being of the people we serve.

NOTICE: This message is confidential, intended for the named recipients
and may contain information that is proprietary to the sender, and/or
privileged, confidential and/or otherwise exempt from disclosure under
applicable Florida and federal law, including, but not limited to,
privacy standards imposed pursuant to HIPAA. Receipt by anyone other
than the named recipients is not a waiver of any applicable privilege.
Thank you

-----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: Friday, July 10, 2009 2:54 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 32, Issue 42

Send Cnm mailing list submissions to

     cnm at lists.my180.net

To subscribe or unsubscribe via the World Wide Web, visit

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When replying, please edit your Subject line so it is more specific

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Today's Topics:

   1. Re: Online Diet Manual- ADA response (Sandra Wells)

   2. Re: Online Diet Manual- ADA response (Sandra Wells)

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

Message: 1

Date: Fri, 10 Jul 2009 11:41:01 -0700 (PDT)

From: Sandra Wells 

Subject: Re: [Cnm] Online Diet Manual- ADA response

To: cnm at lists.my180.net, BarbaraHaine 

Cc: Sandra Beil 

Message-ID: <962688.47428.qm at web57707.mail.re3.yahoo.com>

Content-Type: text/plain; charset="utf-8"

Hello Barbara,

?

There is a list. If you navigate to the Meal Plans section of the NCM,
(it's the teal colored tab in the horizontal banner) you will find a
list with links for the client education and a crosswalk to what were
formerly called diets. Each also has a link to foods recommended and not
recommended, and sample menus.

?

Best regards,

Sandra

--- On Fri, 7/10/09, Haine, Barbara  wrote:

From: Haine, Barbara 

Subject: RE: [Cnm] Online Diet Manual- ADA response

To: "Egelhofer, Nancy" , "Linda
Bartholomay" ,
Annalynn_Skipper at Comcast.net, "Barbara''Lusk" ,
cnm at lists.my180.net, "Flowers Mary-Anne"
, "Jonathan''Murray"
, "Leslee''Carver"
, "Sandra Wells" 

Cc: "Sandra Beil" 

Date: Friday, July 10, 2009, 12:13 PM

#yiv1615451476 p.MsoNormal

     {margin-left:3.0pt;}

It would be helpful to have a list of all of the diets that one could
pull up instead of going through all of the diagnoses to find the diet
you are looking for.? The current manual is much less useful to the diet
office staff who need a reference as to what is allowed on different
diets.? We have had to keep the old, un-updated hardcopy version as a
backup for them.

Barbara Haine

?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Egelhofer, Nancy

Sent: Friday, July 10, 2009 1:02 PM

To: Linda Bartholomay; Annalynn_Skipper at Comcast.net; Barbara''Lusk;
cnm at lists.my180.net; Flowers Mary-Anne; Jonathan''Murray;
Leslee''Carver; Sandra Wells

Cc: Sandra Beil

Subject: Re: [Cnm] Online Diet Manual- ADA response

?

We, too, often avoid the manual "Diets" for patient use because the
dianosis is written on top of the sheet.? The diets are occasionally
used with a slightly different diagnosis than is listed on the ADA Diet,
and it is confusing for the patient and families.

Nancy

?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Linda Bartholomay

Sent: Friday, July 10, 2009 12:24 PM

To: Annalynn_Skipper at Comcast.net; Barbara''Lusk; cnm at lists.my180.net;
'Flowers Mary-Anne'; Jonathan''Murray; Leslee''Carver; Sandra Wells

Cc: Sandra Beil

Subject: Re: [Cnm] Online Diet Manual- ADA response

Just some input from having the ADA on-line manual now for several
years.

It would be desirable to be notified when anything new is added or
revised in the manual.? 

We want the ability to print off education materials without the
diagnosis listed as the "diet".? We currently are still using some of
our own materials as this has been a turn off to our staff to give to
patients.? 

If we had the ability to modify the education materials or add to them
(i.e. addendums) , that would be very helpful.

Linda Bartholomay, LRD

Manager, Nutrition Therapy

MeritCare Health Systems

Linda.Bartholomay at meritcare.com

(701) 234-6166

Strengths:? Arranger, Ideation, Adaptability, Empathy, Maximizer

>>> Sandra Wells  7/10/2009 11:11 AM >>>

Hello Everyone,

?

I am the sales manager for the NCM and would be happy to clear up any
questions or concerns you may have. Please feel free to contact me
directly as well. My contact information is below.

?

There is no additional fee to have the NCM available across your entire
facility. The preferred method of using NCM is to set it up so that all
computers you want to have access would have access 24/7. 

?

Just to clear up some terminology: since NCM is Web based, there is
nothing to install on the intranet. Your?intranet is simply set up to
access the NCM through a custom url set up for your organization. ?Your
IT person simply sets up parameters in the NCM admin screen by which
your computers can access NCM by clicking on an icon or link without
logging in with a user name and password.?Most of our subscribers do
this now, and?is very easy to?set up.?Here is the link to the FAQ in
NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf

?

There is no licensing fee, since there is no software to install. NCM is
purchased on a subscription basis and the price is based on concurrent
users. For example, 5 people would want to access?NCM?at any given
same?time, 5 subscriptions would be purchased. If a 6th person comes
along, they would simply wait until someone logs off. You can add
subscriptions at any time should you need more.

?

Again, please feel free to email or call me directly. I can speak to
your IT person directly as well if the instructions are not clear.

Best regards,

Sandra

?

Sandra D. Beil

Nutrition Care Manual? Sales Manager

American Dietetic Association

120 South Riverside Plaza, Suite 2000

Chicago, Illinois 60606-6995

sbeil at eatright.org 

Direct:? 312-899-4795

Toll Free: 800-877-1600 x4795

Fax: 312-899-5339 

--- On Fri, 7/10/09, Annalynn Skipper 
wrote:

From: Annalynn Skipper 

Subject: Re: [Cnm] Online Diet Manual

To: "'Lusk, Barbara'" , "'Murray, Jonathan'"
, "'Carver, Leslee'"
, "'Flowers Mary-Anne'"
, cnm at lists.my180.net

Date: Friday, July 10, 2009, 10:06 AM

Hi Johnathan,

?

As Editor of the NCM, I work on content rather than sales and IT
issues.? However, I agree with the general trend of this thread.? The
subscription fee for the NCM is based on the number of users who will
need the manual at a single time.? I?m not aware that there is an
additional charge for installing the NCM on your hospital?s intranet.?
However, I recommend that you check with ADA ?s IT department on this
issue.? As others have mentioned, they are quite helpful in making the
NCM easily accessible throughout your facility.? 

As always, we welcome constructive feedback on the NCM and how it might
better serve the needs of subscribers. 

Regards and good wishes for the weekend ahead.? 

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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 

Sent: Friday, July 10, 2009 8:31 AM

To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne;
cnm at lists.my180.net

Subject: Re: [Cnm] Online Diet Manual

We utilize the NCM (online manual) and in our initial research with ADA
about this, we chose to purchase a set number of concurrent
subscriptions and utilize the option to allow all hospital computer
addresses to access the site (so the user did not have to input a
password).? Only hospital computers can access this link.? The number of
concurrent subscriptions purchased is the number of people that can have
it open in the hospital at one time.? Every computer has the link and
this was installed on our department?s webpage and in the reference page
of the physician?s electronic order entry / charting system. 

I hope that helps. 

Barbara Lusk, R.D., L.D.N.

Associate Director 

Clinical Nutrition / Patient Services Director 

Nutrition and Food Services 

University of North Carolina Hospitals 

101 Manning Drive 

Chapel Hill, NC ? 27514 

phone: (919) 843-0062 

email: BLusk at unch.unc.edu 

From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 

Sent: Friday, July 10, 2009 8:01 AM

To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net

Subject: Re: [Cnm] Online Diet Manual

Hi all I?m confused I was under the impression we had to pay an
additional licensing fee to have it installed on multiple computers. Can
someone from ADA clarify. Thanks 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Carver, Leslee

Sent: Tuesday, July 07, 2009 5:58 PM

To: Flowers Mary-Anne; cnm at lists.my180.net

Subject: Re: [Cnm] Online Diet Manual

since the ADA is more than fine w/ it (we do this w/ their knowledge and
approval) perhaps you can get an e-mail from the ADA nutr care manual
support folks so stating.? Leslee 

?

Leslee R. Carver, MSPH, RD, LDN 

Clinical Nutrition Manager 

Saint Joseph Hospital 

2900 N. Lake Shore Dr. 

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. ?All personal messages express
view 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

?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Flowers Mary-Anne

Sent: Tuesday, July 07, 2009 2:28 PM

To: cnm at lists.my180.net

Subject: [Cnm] Online Diet Manual 

I know that this has been discussed in the past but I appear to be
hitting a road block with my IT department and making the online version
of the ADA manual available on the nursing floors. I am being told that
it is a copyright infringement if we place the manual on our intranet
for the staff to use. 

1.???? How do you get around this problem? 

2.???? If you bought multiple copies how many copies of the manual have
you purchased for your facilities and how did you arrive at that number?

3.???? ?With the paper version we had one copy on every unit, 1 in the
dietitian?s office and 1 in administration. 

4.???? Have you had any issues or questions come up from Joint
Commission about the manual? 

Mary-Anne Flowers 

Chief Clinical Dietitian 

Oak Hill Hospital 

11375 Cortez Blvd., Brooksville , FL , 34613 

office (352) 597-6313? fax (352) 597-6087 

This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of
its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
prohibited. If you have received this email in error, please immediately
purge it and all attachments and notify the sender by reply email or
contact the sender at the number listed. 

I 

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

This email message, including any attachments, is for the sole use of
the intended recipient(s) and may contain information that is
proprietary, confidential, and exempt from disclosure under applicable
law. Any unauthorized review, use, disclosure, or distribution is
prohibited. If you have received this email in error please notify the
sender by return email and delete the original message. Please note, the
recipient should check this email and any attachments for the presence
of viruses. The organization accepts no liability for any damage caused
by any virus transmitted by this email.

================================= ??

-----Inline Attachment Follows-----

_______________________________________________

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. 

?

(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.
----------------------------------------- **** 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
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and so indicate or call (603) 663-2800. Then, please promptly "Delete"
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------------------------------

Message: 2

Date: Fri, 10 Jul 2009 11:54:31 -0700 (PDT)

From: Sandra Wells 

Subject: Re: [Cnm] Online Diet Manual- ADA response

To: cnm at lists.my180.net, LesleeCarver 

Cc: Sandra Beil 

Message-ID: <279214.93084.qm at web57701.mail.re3.yahoo.com>

Content-Type: text/plain; charset="utf-8"

Hi Leslee,

?

Yes, I completely forgot about that part! If you navigate the Home page
of the NCM, you'll see the complete update summary for 2008. We'll post
it the new one 30 days in advance there as well.

?

Please see my previous response about the Meal Plans sections of NCM.

?

Hope that helps! Sandra

--- On Fri, 7/10/09, Carver, Leslee  wrote:

From: Carver, Leslee 

Subject: RE: [Cnm] Online Diet Manual- ADA response

To: "Sandra Wells" ,
Annalynn_Skipper at Comcast.net, "Barbara''Lusk" ,
cnm at lists.my180.net, "Flowers Mary-Anne"
, "Jonathan''Murray"
, "Linda Bartholomay"

Cc: "Sandra Beil" 

Date: Friday, July 10, 2009, 1:26 PM

I believe I am one of the Administrators but have never received a
notice of update - we do have a pretty aggressive firewall here.?
perhaps the easiest method for many of us would be to have a notice
posted on the first page of the manual - most of us are in there often
enough to see it.? if there was a link to more details that would be
even better.? 

?

I really like the on-line manual but do agree that the use of diagnoses
rather than diet types in the headings of diet instr material narrows it
usability.? a cross reference by diet type (diet orders) would be
extremely helpful for the diet office folks.? 

?

thanks!? Leslee

?

Leslee R. Carver, MSPH, RD, LDN 

Clinical Nutrition Manager 

Saint Joseph Hospital 

2900 N. Lake Shore Dr. 

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. ?All personal messages express
view 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

?

From: Sandra Wells [mailto:sandradeewells at yahoo.com] 

Sent: Friday, July 10, 2009 12:06 PM

To: Annalynn_Skipper at Comcast.net; Barbara''Lusk; cnm at lists.my180.net;
'Flowers Mary-Anne'; Jonathan''Murray; Carver, Leslee; Linda Bartholomay

Cc: Sandra Beil

Subject: Re: [Cnm] Online Diet Manual- ADA response

Thank you for your input and support Linda! 

1. The NCM automatically sends out update notifications to anyone listed
as an administrator via email 30 days in advance of an update. Sometimes
these get caught up in SPAM filter since they are sent via mass mail.
This year, we will be posting the notice on the ADA Facebook page as
well. Updates are scheduled for the Fall. 

2.?I know that our publishing manager has been working on client
education titles for the Fall update. We understand that sometimes the
diagnosis does not fit the intent. ?I?ll let her know that another
request has come to my attention. 

3. Annalyn refers to Sticky Notes in her reply. As an admin you can add
sticky notes on NCM pages for internal?viewing so that you and others
see comments,?but not for clients to see. 

As far as modifying the educational materials, you can add your client?s
information and your logo on most now. Allowing users to modify the
content itself may potentially create a liability issue for the ADA
since each page has our logo and copyright information. Remember that,
in some cases, people other than RDs use our client education materials.
I have suggested to the editor a ?Notes from your RD? page though. She
will do some market testing on this idea. 

If you have any content suggestions, please feel free to email me or the
publishing manager at: editor at nutritioncaremanual.org 

Best regards, 

Sandra 

Sandra D. Beil 

Nutrition Care Manual? Sales Manager 

American Dietetic Association 

120 South Riverside Plaza, Suite 2000 

Chicago, Illinois?60606-6995 

sbeil at eatright.org 

Direct:? 312-899-4795 

Fax: 312-899-5339 

Toll Free: 800-877-1600 x4795 

www.eatright.org 

www.nutritioncaremanual.org 

--- On Fri, 7/10/09, Linda Bartholomay 
wrote:

From: Linda Bartholomay 

Subject: Re: [Cnm] Online Diet Manual- ADA response

To: Annalynn_Skipper at Comcast.net, "Barbara''Lusk" ,
cnm at lists.my180.net, "'Flowers Mary-Anne'"
, "Jonathan''Murray"
, "Leslee''Carver"
, "Sandra Wells" 

Cc: "Sandra Beil" 

Date: Friday, July 10, 2009, 11:24 AM

Just some input from having the ADA on-line manual now for several
years.

It would be desirable to be notified when anything new is added or
revised in the manual.? 

We want the ability to print off education materials without the
diagnosis listed as the "diet".? We currently are still using some of
our own materials as this has been a turn off to our staff to give to
patients.? 

If we had the ability to modify the education materials or add to them
(i.e. addendums) , that would be very helpful.

Linda Bartholomay, LRD

Manager, Nutrition Therapy

MeritCare Health Systems

Linda.Bartholomay at meritcare.com

(701) 234-6166

Strengths:? Arranger, Ideation, Adaptability, Empathy, Maximizer

>>> Sandra Wells  7/10/2009 11:11 AM >>>

Hello Everyone,

?

I am the sales manager for the NCM and would be happy to clear up any
questions or concerns you may have. Please feel free to contact me
directly as well. My contact information is below.

?

There is no additional fee to have the NCM available across your entire
facility. The preferred method of using NCM is to set it up so that all
computers you want to have access would have access 24/7. 

?

Just to clear up some terminology: since NCM is Web based, there is
nothing to install on the intranet. Your?intranet is simply set up to
access the NCM through a custom url set up for your organization. ?Your
IT person simply sets up parameters in the NCM admin screen by which
your computers can access NCM by clicking on an icon or link without
logging in with a user name and password.?Most of our subscribers do
this now, and?is very easy to?set up.?Here is the link to the FAQ in
NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf

?

There is no licensing fee, since there is no software to install. NCM is
purchased on a subscription basis and the price is based on concurrent
users. For example, 5 people would want to access?NCM?at any given
same?time, 5 subscriptions would be purchased. If a 6th person comes
along, they would simply wait until someone logs off. You can add
subscriptions at any time should you need more.

?

Again, please feel free to email or call me directly. I can speak to
your IT person directly as well if the instructions are not clear.

Best regards,

Sandra

?

Sandra D. Beil

Nutrition Care Manual? Sales Manager

American Dietetic Association

120 South Riverside Plaza, Suite 2000

Chicago, Illinois 60606-6995

sbeil at eatright.org 

Direct:? 312-899-4795

Toll Free: 800-877-1600 x4795

Fax: 312-899-5339 

--- On Fri, 7/10/09, Annalynn Skipper 
wrote:

From: Annalynn Skipper 

Subject: Re: [Cnm] Online Diet Manual

To: "'Lusk, Barbara'" , "'Murray, Jonathan'"
, "'Carver, Leslee'"
, "'Flowers Mary-Anne'"
, cnm at lists.my180.net

Date: Friday, July 10, 2009, 10:06 AM

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Hi Johnathan,

? 

As Editor of the NCM, I work on content rather than sales and IT
issues.? However, I agree with the general trend of this thread.? The
subscription fee for the NCM is based on the number of users who will
need the manual at a single time.? I?m not aware that there is an
additional charge for installing the NCM on your hospital?s intranet.?
However, I recommend that you check with ADA ?s IT department on this
issue.? As others have mentioned, they are quite helpful in making the
NCM easily accessible throughout your facility.? 

As always, we welcome constructive feedback on the NCM and how it might
better serve the needs of subscribers. 

Regards and good wishes for the weekend ahead.? 

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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 

Sent: Friday, July 10, 2009 8:31 AM

To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne;
cnm at lists.my180.net

Subject: Re: [Cnm] Online Diet Manual

We utilize the NCM (online manual) and in our initial research with ADA
about this, we chose to purchase a set number of concurrent
subscriptions and utilize the option to allow all hospital computer
addresses to access the site (so the user did not have to input a
password).? Only hospital computers can access this link.? The number of
concurrent subscriptions purchased is the number of people that can have
it open in the hospital at one time.? Every computer has the link and
this was installed on our department?s webpage and in the reference page
of the physician?s electronic order entry / charting system. 

I hope that helps. 

Barbara Lusk, R.D., L.D.N.

Associate Director 

Clinical Nutrition / Patient Services Director 

Nutrition and Food Services 

University of North Carolina Hospitals 

101 Manning Drive 

Chapel Hill, NC ? 27514 

phone: (919) 843-0062 

email: BLusk at unch.unc.edu 

From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 

Sent: Friday, July 10, 2009 8:01 AM

To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net

Subject: Re: [Cnm] Online Diet Manual

Hi all I?m confused I was under the impression we had to pay an
additional licensing fee to have it installed on multiple computers. Can
someone from ADA clarify. Thanks 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Carver, Leslee

Sent: Tuesday, July 07, 2009 5:58 PM

To: Flowers Mary-Anne; cnm at lists.my180.net

Subject: Re: [Cnm] Online Diet Manual

since the ADA is more than fine w/ it (we do this w/ their knowledge and
approval) perhaps you can get an e-mail from the ADA nutr care manual
support folks so stating.? Leslee 

?

Leslee R. Carver, MSPH, RD, LDN 

Clinical Nutrition Manager 

Saint Joseph Hospital 

2900 N. Lake Shore Dr. 

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. ?All personal messages express
view 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

?

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Flowers Mary-Anne

Sent: Tuesday, July 07, 2009 2:28 PM

To: cnm at lists.my180.net

Subject: [Cnm] Online Diet Manual 

I know that this has been discussed in the past but I appear to be
hitting a road block with my IT department and making the online version
of the ADA manual available on the nursing floors. I am being told that
it is a copyright infringement if we place the manual on our intranet
for the staff to use. 

1.???? How do you get around this problem? 

2.???? If you bought multiple copies how many copies of the manual have
you purchased for your facilities and how did you arrive at that number?

3.???? ?With the paper version we had one copy on every unit, 1 in the
dietitian?s office and 1 in administration. 

4.???? Have you had any issues or questions come up from Joint
Commission about the manual? 

Mary-Anne Flowers 

Chief Clinical Dietitian 

Oak Hill Hospital 

11375 Cortez Blvd., Brooksville , FL , 34613 

office (352) 597-6313? fax (352) 597-6087 

This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of
its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
prohibited. If you have received this email in error, please immediately
purge it and all attachments and notify the sender by reply email or
contact the sender at the number listed. 

I 

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

This email message, including any attachments, is for the sole use of
the intended recipient(s) and may contain information that is
proprietary, confidential, and exempt from disclosure under applicable
law. Any unauthorized review, use, disclosure, or distribution is
prohibited. If you have received this email in error please notify the
sender by return email and delete the original message. Please note, the
recipient should check this email and any attachments for the presence
of viruses. The organization accepts no liability for any damage caused
by any virus transmitted by this email.

================================= 

 ?

-----Inline Attachment Follows-----

_______________________________________________

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. 

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End of Cnm Digest, Vol 32, Issue 42

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From STiller at Lifespan.org  Fri Jul 10 15:31:53 2009
From: STiller at Lifespan.org (Tiller, Susan B)
Date: Fri, 10 Jul 2009 18:31:53 -0400
Subject: [Cnm] Hospital outpatient nutrition services and Medicare
In-Reply-To: 
References: 
Message-ID: 

Back in the day when Medicare added MNT as a benefit we rushed to
complete applications for outpatient RDs to become Medicare providers
and reassign benefits to the hospital.  I have not had to do this for
awhile and am now at a different facility with a new RD on staff
providing outpatient services.  I am receiving conflicting information
as to whether or not RDs need to become Medicare providers now that we
have NPI numbers, and that the Medicare provider numbers assigned to the
RDs are not sent to Medicare in the billing process. We bill on a UB.
Has anyone had recent experience with this they can share with me?

Thanks,
Sue

Susan Tiller, MBA, RD, LDN, CNSD
Manager, Patient Services
Food & Nutrition Services
Rhode Island Hospital/Hasbro Children's Hospital
Phone 401-444-5602
Cell 401-639-3012
Fax 401-444-6360

From sheila.walsh at nahealth.com  Fri Jul 10 16:17:32 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Fri, 10 Jul 2009 16:17:32 -0700
Subject: [Cnm] Pediatric nutrition care process statements
In-Reply-To: <8399E503ADA6AB438FDF86223B23A83E02881491@mason.nvrh.local>
References: <0D52666873E5914EBC179207FAC7A0541009D4@stl-pmailrsgp02.smrcy.com>
	<8399E503ADA6AB438FDF86223B23A83E02881491@mason.nvrh.local>
Message-ID: <4A576987.485B.0001.0@nahealth.com>

Does anyone have a baby bottle tooth decay nutrition care process statement
developed?

Sheila A. Walsh, MPH, RD
Clinical Nutrition Manager
Flagstaff Medical Center
Where patients are our purpose.
<\__~
/ \

>>> "Anderson, Sharon"  7/7/2009 1:25 PM >>>

We are starting the Shapedown program in the fall which we purchased.  For this
first time around, we are going to charge $40.00 per person which will cover our
costs for materials.  We are not going to even bother billing insurance this
first time around as one of our administrators feels that the return on trying
to get coverage is not worth the hassle nor the time.   I?m looking forward to
getting our first group started.

Sharon Anderson, RD,CD

From:cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf
Of Hill, Laura L
Sent: Tuesday, July 07, 2009 3:32 PM
To: cnm at lists.my180.net 
Subject: [Cnm] Pediatric Weight loss programs

Has anyone started a pediatric weight loss program? 

Did you develop your own curriculum or purchase one? 

What did you charge for the program? 

How many sessions?

Thanks for the input!

Laura

Laura Hill PhD, RD, LD, CDE
Clinical Manager
Nutrition Services Department
Mercy Medical Center of NWA
2170 Rife Medical Lane
Rogers, AR 72758
(479) 338-3279

This e-mail contains information which (a) may be PROPRIETARY IN NATURE
OROTHERWISE PROTECTED BY LAW FROM DISCLOSURE, and (b) is intended only for
theuse of the addressee(s) named above. If you are not the addressee, or
theperson responsible for delivering this to the addressee(s), you are
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From ESCOTTSTUMPS at ecu.edu  Fri Jul 10 17:39:01 2009
From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia)
Date: Fri, 10 Jul 2009 20:39:01 -0400
Subject: [Cnm] On the Pulse - Friday, July 10, 2009
In-Reply-To: 
References: 
Message-ID: 

Interesting updates from the D.C. office.  Have a good weekend.

College of Human Ecology

Enriching Lives.  Enhancing Communities.

Sylvia Escott-Stump, MA, RD, LDN
Legislative Chair, CNM
252-328-1352
Fax 252-328-4276

________________________________
From: On the Pulse [pulse at eatright.org]
Sent: Friday, July 10, 2009 5:31 PM
To: Escott-Stump, Sylvia
Subject: On the Pulse - Friday, July 10, 2009

[cid:image003.jpg at 01CA0184.3E76E2D0]
Editor?s Note: The Policy Initiatives and Advocacy group publishes On the Pulse to inform members of the American Dietetic Association of developments affecting food, nutrition and health. Topics reflect ADA?s legislative and regulatory priorities in Washington and the states, reimbursement issues, related matters and larger developments that affect the environment in which these topics are considered.

Information contained in On the Pulse includes sensitive material and should not be shared outside the American Dietetic Association. For additional information or to seek permission for reprinting, please contact ADA Policy Initiatives and Advocacy at 800/877-0877.   Please send comments to: pulse at eatright.org.
-----------------------------------------------------------------------------------------------------------------------------
Friday, July 10, 2009
-----------------------------------------------------------------------------------------------------------------------------

SPECIAL EDITION:  HEALTH REFORM

 *   Paying for health reform threatens quick passage of a bill
 *   ADA Action Alert coming
 *   Blue Dogs stall Tri-committee bill action

?        Revenue issues bog down Senate action

?        CBO finds saving in tri-committee bill preventive services

 *   Read for yourself:  Health reform proposals

 *   Upcoming
-----------------------------------------------------------------------------------------------------------------------------
Today we focus on one topic:  health reform.

The debate heats up significantly next week and will be at a level rarely experienced.   Congress? most recent comprehensive health reform debate in the early 1990s, ended without resolution.  You have to look back another 27 years before that to see a debate of this magnitude.  With extreme challenges and opportunities, the upcoming debate about health and health care is momentous for the nation and us as Americans.

Developments on the Hill and ADA advocacy are both included here.

Paying for health reform threatens quick passage of a bill
House and Senate committees working on health reform are making tangible progress on coverage and delivery issues, but one issue continues to evade policy makers:  how to pay for it all.  As a result, much anticipated markup sessions now appear to be a week or more away.

Three committees in the House are working jointly.   The so-called Tri-committee bill?s original draft did not contain any of the ?pay for? provisions and was mute on many other issues that since have been worked out by legislators and staff.   Until today, we anticipated the final draft House bill would be released on July 10 with each committee beginning their markup sessions on July 13.   Congressional leaders predicted fast-paced floor action to be completed in the House by Aug .1 and Aug 10 for the Senate.

The timetable appears to be slipping, in part due to the action of a coalition of moderate Democrats, the Blue Dogs.  Ironically, Democratic centrist now are the biggest obstacle to Speaker Nancy Pelosi's (D-CA) ability to pass health reform.

ADA Action Alert coming
ADA has been working with several members of Congress who serve on either the House Energy and Commerce Committee or the Ways and Means Committee to expand the role Medical Nutrition Therapy plays in preventive services.  Until the new and final Tri-committee bill is made public, it remains unclear to what degree these efforts have been successful.

Once ADA knows for certain what is in the bill, everyone receiving On the Pulse will be sent one or more Action Alert messages, asking for your support for expanded coverage.   In all likelihood, the turnaround time for getting a message into a member?s office will be very short, perhaps less than a day, said Ron Smith, ADA?s government relations director.   ?We are asking members to watch email next week and be prepared to take action. ?

ADA has recommended that Congress amend the section of the law that limits MNT to diabetes and renal diseases so that it also includes Medicare beneficiaries diagnosed as being pre-diabetic.   This recommendation was included in a bill introduced by Rep. Diana DeGette (D-CO), H.R. 2590, Preventing Diabetes in Medicare Act of 2009.   As Vice Chair of the Energy and Commerce Committee, DeGette is in a position to ask that the provisions of the bill be included in the final drift of the Tri-committee bill.  If it is not, ADA is encouraging her to offer it as an amendment during committee markup.

Next week?s Action Alert will ask ADA members to support the DeGette language contained in the bill or her amendment.

The American Diabetes Association has endorsed H.R. 2590, and wrote the Congressional Diabetes Caucus in support earlier this month.  The CDC has 250 members which gives it tremendous influence on issues relating to diabetes.

Having both ADA?s (the American Diabetes Association and the American Dietetic Association) may be a powerful step in getting the support of the Diabetes Caucus.

Blue Dogs stall Tri-committee bill action

The day before the Tri-committee final draft was to be released a group of moderate Democrat Congressmen, known as Blue Dogs, indicated they would oppose the bill unless the bill?s cost was reduced.  With almost certain opposition from every Republican member of the House, opposition from the 40 member Blue Dog coalition would mean that the bill would not pass.

There are several issues which cause Blue Dogs concern, including a public insurance plan (similar to Medicare but open to anyone who wants to sign up for coverage) designed to compete with private insurance plans.  The idea behind the public option is to keep private insurance company premiums down through competition by providing less expensive coverage in the public opinion.

Opponents argue that such a program would so undermine the ability of private companies to attract customers that they would eventually go out of business.  Many conservative Democrats and virtually all Republican member of Congress oppose a public option as unfair to private insurers.

What complicates the issue is that the members of the Progressive Caucus made of 75 members of the House is on record as opposing any health reform bill that does not include a public option.  Efforts to find a compromise public option, one for example would only take effect if private insurance rates continue to outpace inflation, have been unsuccessful.

Therefore, Tri-committee chairs may be forced to revisit these provisions.  All interested parties are meeting in hopes of finding a balanced approach that can get the support of both moderate and progressive Democrats, a task that is far from certain.

The Blue Dog coalition also raised other issues with the Tri-committee bill that deal with paying providers based on quality.  Yet another issue that seems to be of concern to the coalition is rural hospital rates.  Ways and Means Health Subcommittee Chairman Pete Stark (D-CA) said he is working to find middle ground on negotiated hospital rates.

In addition to the Blue Dogs, a group of politically vulnerable freshman lawmakers, including members of the Democratic Congressional Campaign Committee's Frontline Program, raised concerns about a potential tax on sodas and other sugar-sweetened beverages.  According to Reps. Michael Arcuri (D-NY) and Leonard Boswell (D-IA) "These taxes would most heavily impact low- and middle-income Americans and create new burdens for small retailers and grocers.?

Members of the Ways and Means Committee has been working behind closed doors trying to draft new legislation to pay for the bill.  One option they appear to have settled on is a surtax of 3 percent on taxpayers earning more than $200,000 in adjusted gross income, or $250,000 in the case of joint returns.  According to the Chairman of the Ways and Means Committee Charles Rangel (D-NY), a 3- percent surtax would raise much of the needed new $600 billion in revenues and that a new excise tax on beverages of 10-cents-per-can on non-diet sodas could raise $112 billion.

The Speaker announced this week that the Tri-committee bill will not tax health benefits, a proposal that has been considered for several weeks.

Revenue issues bog down Senate action

The Senate Finance Committee appears to be bogged down over revenue issues.  In a move that shocked many, Senate Majority Leader Harry Reid (D-NV) ordered Finance Chairman Max Baucus (D-MT) to stop chasing votes from Republicans and report a bill as soon as possible.   A Democrat senator told ADA that Reid felt that is was not worth losing time and perhaps even a few Democratic votes to get a bill that the Ranking Republican on Finance, Charles Grassley (R-IA) would support.

Even if Grassley were to support the bill, vote counters expect few Republicans would join him once the bill reaches the Senate floor.  Reportedly Reid told Baucus that taxing health benefits and failing to include a strong government-run insurance option of some sort in his bill would cost 10 to 15 Democratic votes;   securing the support of Grassley and at best a few additional Republicans is not a good tradeoff.

The Finance committee is trying to find as much as $1 trillion to cover the anticipated Congressional Budget Office?s score of their bill.  Members of the Finance Committee are saying that they are making great progress on policy issues, but are having a difficult time in making the overall bill deficit neutral as promised by President Obama.  Members are coming to the realization that a deficit neutral bill will almost certainly require a hefty tax increase, an issue which most certainly would make the bill more difficult to pass once it gets to the Senate floor.

CBO finds saving in tri-committee bill preventive services
The House Committees on Ways and Means and Energy and Commerce released a preliminary estimate from the CBO on a portion of the Tri-committee health reform draft.  The draft proposals included in the estimate would slow spending, yielding more than $500 billion in gross savings to Medicare over ten years while also extending the solvency of the Medicare Trust Fund and providing key payment and delivery system reforms.

Included in the CBO estimates are important investments in the Medicare program that would fix the deeply flawed physician payment system, close the Medicare prescription drug donut hole, encourage prevention and wellness by eliminating cost-sharing for preventive services, and improve access for low-income Medicare beneficiaries.

According to the Centers for Medicare and Medicaid Services the reimbursement rates paid to physicians will decrease at the end of 2009 by 21.5 percent.  Reimbursement rates adjustments rely on what is call the Sustainable Growth Rate, a highly complex formula that compares Medicare expenditures to the growth in the GDP.

For a number of years, the SGR calculations have resulted in a reduction in reimbursement rates and Congress has had to pass temporary adjustments to prevent those from occurring.  In order to ?fix? the SGR formula used by CMS, congressional action is required.  Provisions in healthcare reform bills under consideration by the House would address the SGR problem.  The draft House bill would provide for a complete reform of the flawed physician payment mechanism in Medicare (the ?SGR? formula), with an update that wipes away accumulated deficits, provides for a fresh start, and rewards primary care services, care coordination and efficiency.

Another important provision contain in the bill would eliminate co-payments for preventive services.  The bill lists 15 specific preventive services for which the beneficiary?s co-payment is eliminated.  This list includes Medical Nutrition Therapy.

The bill also contains language establishing a basic benefits package which private insurance companies would be required to provide.  That package would include any preventive services recommended by the US Preventive Services Task Force with an ?A? or ?B? rating.  The USPSTF ?recommends intensive behavioral dietary counseling for adult patients with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease. Intensive counseling can be delivered by primary care clinicians or by referral to other specialists, such as nutritionists or dietitians? and gives this recommendation a ?B? rating meaning that insurance companies would have to cover it should the House language be signed into law.

The Senate Health, Education, Labor and Pensions Committee continued marking up their draft legislation even as Sen. Chris Dodd (D-CT) had to give up the gavel to attend his sister?s funeral.  Dodd had assumed the role of Chairman for Sen. Edward Kennedy (D-MA) who is unable to attend the committee meetings due to his poor health.  Nevertheless, the HELP Committee continued working through it draft bill but was unable to finish it work.

Included in the HELP Committee?s bill is a provision that would require chain restaurants to list calories on their menus and menu boards. This provision is supported by ADA.  It is designed to ensure that consumers receive nutrition information in a consistent and accurate manner; the proposal establishes a uniform standard regarding which nutrition items are disclosed on menus and menu boards, and the manner of the disclosure.

Another important provision contained in the HELP bill is the establishment of grants to establish community health teams to support medical homes.  These grants are designed to ensure the health team includes a multidisciplinary, inter-professional team of providers that include nurses, nutritionists, dietitians, social workers, behavioral and mental health providers, licensed complementary and alternative medicine practitioners.

The Senate Finance Committee has not released its draft bill.  All of the Medicare and Medicaid issues are under the jurisdiction of the Finance Committee and therefore are not included in the HELP Committee?s draft.

Read for yourself:  Health reform proposals
To see for yourself what is on the table in the discussions of health reform, you can turn to the Kaiser Family Foundation?s interactive, regularly updated, side-by-side comparison of comprehensive health care reform proposals.  This resource includes formally introduced legislation as well as concept papers and principles for reform.    Click on the hyperlink above or go to http://www.kff.org/healthreform/sidebyside.cfm

Upcoming

?        Registration and housing reservations for FNCE is now open.  More information is available at www.eatright.org/events.

 *   Look in the Federal Register on Monday for publication of CMS proposed rules on  Physician Fee Schedule, Telehealth, Chronic Kidney Disease Stage 4 Education Program in Rural Settings, Cardiac Rehabilitation, COPD Rehabilitation and other topics.

?        The National Advisory Council (NAC) will review the progress and/or potential recommendations of NAC subcommittees and working groups on the Stafford Act, National Response Framework, National Incident Management System, Post-Disaster Housing, Special Needs, Public/Private Partnerships, and Target Capabilities List.   For information go to http://edocket.access.gpo.gov/2009/E9-14932.htm.

 *   A special Open Door Forum: Children's Health Insurance Program Reauthorization Act (CHIPRA) Outreach and Enrollment Grants- Cycle I takes place July 22 to go over Outreach and Enrollment Grants.   For more information, go to http://www.cms.hhs.gov/OpenDoorForums/23_ODF_PNAHP.asp

----------------------------------------------------------------------------------------------------------------------------
Government Relations Contacts:

Nutrition Policy

Jennifer Weber

jweber at eatright.org

Regulatory Issues

Mary Hager

mhager at eatright.org

Congressional & Political Affairs

Ron Smith

rsmith at eatright.org

Jennifer Teters

jteters at eatright.org

Charmaine Jones

cjones at eatright.org

State Government Relations

Juliana Smith

jsmith at eatright.org

State & Regulatory Coordinator

Dana Whitley

dwhitley at eatright.org

Reimbursement Issues

Pam Michael

pmichael at eatright.org

Tori Bender

tbender at eatright.org

General Issues

Stephanie Patrick

spatrick at eatright.org

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

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From Susan_R_Paredez at uhs.org  Sat Jul 11 11:07:08 2009
From: Susan_R_Paredez at uhs.org (Susan_R_Paredez at uhs.org)
Date: Sat, 11 Jul 2009 14:07:08 -0400
Subject: [Cnm] Fw: NICU TPN form and FTT
Message-ID: 

Good Day All,

I am looking for samples of NICU TPN forms and standing orders and/or
policies and procedures related to Failure to Thrive pts.  Please contact
me directly if you are willing to share these.

Thanks.

Susan Paredez
Clinical Nutrition Coordinator
UHS Hospitals
Susan_R_Paredez at UHS.org
607-763-6600
Fax: 607-763-5302
----- Forwarded by Susan R Paredez/WMH/UHS on 07/11/2009 02:04 PM -----

---
Think before you print.

This message and any attachments may contain information that is protected by law as privileged and confidential, and is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient, you are hereby notified that any use, dissemination, copying or retention of this e-mail or the information contained herein is strictly prohibited. If you have received this e-mail in error, please immediately notify the sender by e-mail, and permanently delete this e-mail.
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From JUnderwood at jflusvi.org  Sun Jul 12 06:04:14 2009
From: JUnderwood at jflusvi.org (Underwood, Jennifer)
Date: Sun, 12 Jul 2009 09:04:14 -0400
Subject: [Cnm] NCM usage
Message-ID: 

Good Day,

I have to put together a memo to my VP regarding the rationale for having
the NCM.

Is there a JC standard or CMS standard I can refer to?

Thanks in advance,

JU

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From LCarver at Reshealthcare.org  Sun Jul 12 08:05:50 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Sun, 12 Jul 2009 10:05:50 -0500
Subject: [Cnm] Hospital outpatient nutrition services and Medicare
In-Reply-To: 
References: 

Message-ID: <5330B54133B6194BA13930BDEFE9A30E048529C5@rhcexch3.reshealthcare.org>

yes, they do need to become Medicare providers.  NPI is necessary but
not sufficient to supply services to Medicare pts.  the Medicare
Provider # should be on the bill.  Pam Michaels is the ADA guru on this
subject.   

Leslee R. Carver, MSPH, RD, LDN
Clinical Nutrition Manager
Saint Joseph Hospital
2900 N. Lake Shore Dr.
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.  All personal messages express
view 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

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Tiller, Susan B
Sent: Friday, July 10, 2009 5:32 PM
To: cnm at lists.my180.net
Subject: [Cnm] Hospital outpatient nutrition services and Medicare

Back in the day when Medicare added MNT as a benefit we rushed to
complete applications for outpatient RDs to become Medicare providers
and reassign benefits to the hospital.  I have not had to do this for
awhile and am now at a different facility with a new RD on staff
providing outpatient services.  I am receiving conflicting information
as to whether or not RDs need to become Medicare providers now that we
have NPI numbers, and that the Medicare provider numbers assigned to the
RDs are not sent to Medicare in the billing process. We bill on a UB.
Has anyone had recent experience with this they can share with me?

Thanks,
Sue

Susan Tiller, MBA, RD, LDN, CNSD
Manager, Patient Services
Food & Nutrition Services
Rhode Island Hospital/Hasbro Children's Hospital
Phone 401-444-5602
Cell 401-639-3012
Fax 401-444-6360

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

From pam at humanbionics.com  Sun Jul 12 09:00:28 2009
From: pam at humanbionics.com (Pam DuRousseau)
Date: Sun, 12 Jul 2009 12:00:28 -0400
Subject: [Cnm] census-based RD coverage
Message-ID: <2FD3763A65FD45C2B890C567C0456192@Neuron>

All,

Does anyone have a tool to perform census-based dietitian coverage?  Our
census is down on many units (with the exception of neuro, NICU, and the
heart center) and with a large facility and 15 dietitians, some do not have
enough to occupy their full day's time.  I am working on having them do
special projects, but this may not be enough.  My director has tasked me
with coming up with a number of RDs needed to cover the various units.  I
can use the standard tool and plug in the varying census number there, but
does anyone have anything better or less cumbersome?  Any suggestions or
help would be appreciated.

Thx

Pamela DuRousseau MPH, RD

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From bhaine at Elliot-HS.org  Fri Jul 10 10:13:18 2009
From: bhaine at Elliot-HS.org (Haine, Barbara)
Date: Fri, 10 Jul 2009 13:13:18 -0400
Subject: [Cnm] Online Diet Manual- ADA response
In-Reply-To: 
References: <4A5724E3.309B.00D0.0@meritcare.com>

Message-ID: 

It would be helpful to have a list of all of the diets that one could
pull up instead of going through all of the diagnoses to find the diet
you are looking for.  The current manual is much less useful to the diet
office staff who need a reference as to what is allowed on different
diets.  We have had to keep the old, un-updated hardcopy version as a
backup for them.

Barbara Haine

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Egelhofer, Nancy
Sent: Friday, July 10, 2009 1:02 PM
To: Linda Bartholomay; Annalynn_Skipper at Comcast.net; Barbara''Lusk;
cnm at lists.my180.net; Flowers Mary-Anne; Jonathan''Murray;
Leslee''Carver; Sandra Wells
Cc: Sandra Beil
Subject: Re: [Cnm] Online Diet Manual- ADA response

We, too, often avoid the manual "Diets" for patient use because the
dianosis is written on top of the sheet.  The diets are occasionally
used with a slightly different diagnosis than is listed on the ADA Diet,
and it is confusing for the patient and families.

Nancy

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Linda Bartholomay
Sent: Friday, July 10, 2009 12:24 PM
To: Annalynn_Skipper at Comcast.net; Barbara''Lusk; cnm at lists.my180.net;
'Flowers Mary-Anne'; Jonathan''Murray; Leslee''Carver; Sandra Wells
Cc: Sandra Beil
Subject: Re: [Cnm] Online Diet Manual- ADA response

Just some input from having the ADA on-line manual now for several
years.

1.	It would be desirable to be notified when anything new is added
or revised in the manual.  
2.	We want the ability to print off education materials without the
diagnosis listed as the "diet".  We currently are still using some of
our own materials as this has been a turn off to our staff to give to
patients.  
3.	If we had the ability to modify the education materials or add
to them (i.e. addendums) , that would be very helpful.
4.	Linda Bartholomay, LRD
	Manager, Nutrition Therapy
	MeritCare Health Systems
	Linda.Bartholomay at meritcare.com
	(701) 234-6166
	Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer

>>> Sandra Wells  7/10/2009 11:11 AM >>>

Hello Everyone,

I am the sales manager for the NCM and would be happy to clear up any
questions or concerns you may have. Please feel free to contact me
directly as well. My contact information is below.

There is no additional fee to have the NCM available across your entire
facility. The preferred method of using NCM is to set it up so that all
computers you want to have access would have access 24/7. 

Just to clear up some terminology: since NCM is Web based, there is
nothing to install on the intranet. Your intranet is simply set up to
access the NCM through a custom url set up for your organization.  Your
IT person simply sets up parameters in the NCM admin screen by which
your computers can access NCM by clicking on an icon or link without
logging in with a user name and password. Most of our subscribers do
this now, and is very easy to set up. Here is the link to the FAQ in
NCM: http://www.nutritioncaremanual.org/files/Custom_URL.pdf

There is no licensing fee, since there is no software to install. NCM is
purchased on a subscription basis and the price is based on concurrent
users. For example, 5 people would want to access NCM at any given same
time, 5 subscriptions would be purchased. If a 6th person comes along,
they would simply wait until someone logs off. You can add subscriptions
at any time should you need more.

Again, please feel free to email or call me directly. I can speak to
your IT person directly as well if the instructions are not clear.

Best regards,
Sandra

Sandra D. Beil
Nutrition Care Manual(r) Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois 60606-6995

sbeil at eatright.org 
Direct:  312-899-4795
Toll Free: 800-877-1600 x4795
Fax: 312-899-5339 
--- On Fri, 7/10/09, Annalynn Skipper 
wrote:

	From: Annalynn Skipper 
	Subject: Re: [Cnm] Online Diet Manual
	To: "'Lusk, Barbara'" , "'Murray, Jonathan'"
, "'Carver, Leslee'"
, "'Flowers Mary-Anne'"
, cnm at lists.my180.net
	Date: Friday, July 10, 2009, 10:06 AM

	Hi Johnathan,

	As Editor of the NCM, I work on content rather than sales and IT
issues.  However, I agree with the general trend of this thread.  The
subscription fee for the NCM is based on the number of users who will
need the manual at a single time.  I'm not aware that there is an
additional charge for installing the NCM on your hospital's intranet.
However, I recommend that you check with ADA 's IT department on this
issue.  As others have mentioned, they are quite helpful in making the
NCM easily accessible throughout your facility.  

	As always, we welcome constructive feedback on the NCM and how
it might better serve the needs of subscribers. 

	Regards and good wishes for the weekend ahead.  

	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: Lusk, Barbara [mailto:BLusk at unch.unc.edu] 
	Sent: Friday, July 10, 2009 8:31 AM
	To: Murray, Jonathan; Carver, Leslee; Flowers Mary-Anne;
cnm at lists.my180.net
	Subject: Re: [Cnm] Online Diet Manual

	We utilize the NCM (online manual) and in our initial research
with ADA about this, we chose to purchase a set number of concurrent
subscriptions and utilize the option to allow all hospital computer
addresses to access the site (so the user did not have to input a
password).  Only hospital computers can access this link.  The number of
concurrent subscriptions purchased is the number of people that can have
it open in the hospital at one time.  Every computer has the link and
this was installed on our department's webpage and in the reference page
of the physician's electronic order entry / charting system. 

	I hope that helps. 

	Barbara Lusk, R.D., L.D.N.

	Associate Director 

	Clinical Nutrition / Patient Services Director 

	Nutrition and Food Services 

	University of North Carolina Hospitals 

	101 Manning Drive 

	Chapel Hill, NC   27514 

	phone: (919) 843-0062 

	email: BLusk at unch.unc.edu

________________________________

	From: Murray, Jonathan [mailto:Jonathan.Murray at nyumc.org] 
	Sent: Friday, July 10, 2009 8:01 AM
	To: 'Carver, Leslee'; Flowers Mary-Anne; cnm at lists.my180.net
	Subject: Re: [Cnm] Online Diet Manual

	Hi all I'm confused I was under the impression we had to pay an
additional licensing fee to have it installed on multiple computers. Can
someone from ADA clarify. Thanks 

	From: cnm-bounces at lists.my180.net
[mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee
	Sent: Tuesday, July 07, 2009 5:58 PM
	To: Flowers Mary-Anne; cnm at lists.my180.net
	Subject: Re: [Cnm] Online Diet Manual

	since the ADA is more than fine w/ it (we do this w/ their
knowledge and approval) perhaps you can get an e-mail from the ADA nutr
care manual support folks so stating.  Leslee 

	Leslee R. Carver, MSPH, RD, LDN 
	Clinical Nutrition Manager 
	Saint Joseph Hospital 
	2900 N. Lake Shore Dr. 
	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.  All personal messages
express view 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

________________________________

	From: cnm-bounces at lists.my180.net
[mailto:cnm-bounces at lists.my180.net] On Behalf Of Flowers Mary-Anne
	Sent: Tuesday, July 07, 2009 2:28 PM
	To: cnm at lists.my180.net
	Subject: [Cnm] Online Diet Manual 

	I know that this has been discussed in the past but I appear to
be hitting a road block with my IT department and making the online
version of the ADA manual available on the nursing floors. I am being
told that it is a copyright infringement if we place the manual on our
intranet for the staff to use. 

	1.     How do you get around this problem? 

	2.     If you bought multiple copies how many copies of the
manual have you purchased for your facilities and how did you arrive at
that number? 

	3.      With the paper version we had one copy on every unit, 1
in the dietitian's office and 1 in administration. 

	4.     Have you had any issues or questions come up from Joint
Commission about the manual? 

	Mary-Anne Flowers 
	Chief Clinical Dietitian 

	Oak Hill Hospital 
	11375 Cortez Blvd., Brooksville , FL , 34613 
	office (352) 597-6313  fax (352) 597-6087 

	This email and any files transmitted with it may contain
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in error, please immediately purge it and all attachments and notify the
sender by reply email or contact the sender at the number listed. 

	I 

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	_______________________________________________
	Cnm mailing list
	Cnm at lists.my180.net

	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

________________________________

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From LDALGLEISH at lakelandregional.org  Mon Jul 13 06:59:18 2009
From: LDALGLEISH at lakelandregional.org (Lisa Dalgleish)
Date: Mon, 13 Jul 2009 09:59:18 -0400
Subject: [Cnm] Hospital outpatient nutrition services and Medicare
In-Reply-To: 
References: 

Message-ID: <4A5B0558.DF60.000C.0@lakelandregional.org>

Medicare allows hospitals to bill outpt MNT as a facility fee on the UB.  When the UB is used, the RD does not need an NPI and does not need to be a Medicare provider.  One of the drawbacks of billing this way is the RD cannot participate in the PQRI.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> "Tiller, Susan B"  7/10/2009 6:31 PM >>>
Back in the day when Medicare added MNT as a benefit we rushed to
complete applications for outpatient RDs to become Medicare providers
and reassign benefits to the hospital.  I have not had to do this for
awhile and am now at a different facility with a new RD on staff
providing outpatient services.  I am receiving conflicting information
as to whether or not RDs need to become Medicare providers now that we
have NPI numbers, and that the Medicare provider numbers assigned to the
RDs are not sent to Medicare in the billing process. We bill on a UB.
Has anyone had recent experience with this they can share with me?

Thanks,
Sue

Susan Tiller, MBA, RD, LDN, CNSD
Manager, Patient Services
Food & Nutrition Services
Rhode Island Hospital/Hasbro Children's Hospital
Phone 401-444-5602
Cell 401-639-3012
Fax 401-444-6360

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
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From sandradeewells at yahoo.com  Mon Jul 13 07:31:04 2009
From: sandradeewells at yahoo.com (Sandra Wells)
Date: Mon, 13 Jul 2009 07:31:04 -0700 (PDT)
Subject: [Cnm] NCM usage
Message-ID: <999012.17636.qm@web57702.mail.re3.yahoo.com>

Good Morning Jennifer,
?
This?is?Sandra Beil, the NCM Sales Manager.
?
When I have spoken to people about Joint Commission, the?Standard 2009 IM.03.01.01 has been mentioned. 
?
"Knowledge-based information resources are available, current, and authoritative.
?
"The hospital provides access to knowledge-based information resources 24 hours a day, 7 days a week."
?
ADA is the authority,?having NCM online allows access 24/7 and we update & review the information every year.
?
If you need anything else, please let me know. 
?
Sandra D. Beil
Nutrition Care Manual? Sales Manager
sbeil at eatright.org 
Direct:? 312-899-4795
Toll Free: 800-877-1600 x4795

--- On Sun, 7/12/09, Underwood, Jennifer  wrote:

From: Underwood, Jennifer 
Subject: [Cnm] NCM usage
To: cnm at lists.my180.net
Date: Sunday, July 12, 2009, 8:04 AM

Good Day,
I have to put together a memo to my VP regarding the rationale for having the NCM.
Is there a JC standard or CMS standard I can refer to?
Thanks in advance,
?
JU
?
-----Inline Attachment Follows-----

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
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From Lori.Zimmerman at ministryhealth.org  Mon Jul 13 07:37:06 2009
From: Lori.Zimmerman at ministryhealth.org (Zimmerman, Lori A)
Date: Mon, 13 Jul 2009 09:37:06 -0500
Subject: [Cnm] FW: Floor Stock
Message-ID: 

I think this may have been asked but of course at the time it wasn't a concern so sorry if this is a repeat request.  I wondering if you all will share with me what you stock on your nursing units?  Please also indicate what type of food service program you have at your facility.  We have Room Service and have a Green Belt Project looking at standardizing unit stocks and reducing what is stocked.
Thank you for your help,
Lori

Lori Zimmerman
Assist. Director - Clinical Nutrition
Saint Joseph's Hospital
Ministry Health Care

  ________________________________
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 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.
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From Linda.Bartholomay at meritcare.com  Mon Jul 13 07:50:29 2009
From: Linda.Bartholomay at meritcare.com (Linda Bartholomay)
Date: Mon, 13 Jul 2009 09:50:29 -0500
Subject: [Cnm] Evidence for NPO - nutrition support
Message-ID: <4A5B0365.309B.00D0.0@meritcare.com>

Hi, all.

I have a physician who has concerns about dietitians seeing his patients.  He really doesn't see any need for nutrition support (enterally and especially not parenterally).  We have had some patients who have been admitted with a poor nutrition status and intake from the get-go.  On these people, our dietitians recommended consideration of alternative nutrition if unable to resume orals in a short amount of time.  Both had significant GI issues chronically.

Anyway, he would like some evidence of outcomes for patients (not critical care patients) where enteral feeding makes any improved outcome.  He also wants to see evidence that we should be starting enteral feedings sooner than 10 or more days of being NPO.  I have a couple of staff who are looking for references/research, but wondered if anyone has had to defend what dietitians do to any physicians.

He is also not happy when social services make recommendations, or PT or ....   (so we are not an exclusive ancillary group).

Thanks for any input you may have.  I did check in our ADA manual in the evidence library and also the NCM we have on-line.  I didn't find any specific studies to support early intervention of nutrition support in the non-critically ill patient population. 

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.
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From hgreenw2 at fairview.org  Mon Jul 13 08:04:58 2009
From: hgreenw2 at fairview.org (Greenwaldt, Heidi J)
Date: Mon, 13 Jul 2009 10:04:58 -0500
Subject: [Cnm] Evidence for NPO - nutrition support
In-Reply-To: <4A5B0365.309B.00D0.0@meritcare.com>
Message-ID: <59F3EAD5C3376A42B3CD083F034A612705676FFB@digsmxmbx06.Fairview.org>

Check out the May-June 2009 issue of JPEN (Journal of Parenteral and
Enteral Nutrition) or they are co-published in CCM (Critical Care
Medicine) 2009, volume 37, number 5. ASPEN and SCCM just came out with
Clinical Guidelines for the Use of Parenteral and Enteral Nutrition in
Adult and Pediatric Patients, 2009.  
Dr. McClave and Martindale were contributors and they have done lots of
presentations on the topic!

Heidi Jo Greenwaldt MS, RD, LD, CNSD
Clinical Nutrition Manager
University of Minnesota Medical Center, Fairview

Phone 612-273-3216
Pager 612-539-7451

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Linda Bartholomay
Sent: Monday, July 13, 2009 9:50 AM
To: cnm at lists.my180.net
Subject: [Cnm] Evidence for NPO - nutrition support

Hi, all.

I have a physician who has concerns about dietitians seeing his
patients.  He really doesn't see any need for nutrition support
(enterally and especially not parenterally).  We have had some patients
who have been admitted with a poor nutrition status and intake from the
get-go.  On these people, our dietitians recommended consideration of
alternative nutrition if unable to resume orals in a short amount of
time.  Both had significant GI issues chronically.

Anyway, he would like some evidence of outcomes for patients (not
critical care patients) where enteral feeding makes any improved
outcome.  He also wants to see evidence that we should be starting
enteral feedings sooner than 10 or more days of being NPO.  I have a
couple of staff who are looking for references/research, but wondered if
anyone has had to defend what dietitians do to any physicians.

He is also not happy when social services make recommendations, or PT or
....   (so we are not an exclusive ancillary group).

Thanks for any input you may have.  I did check in our ADA manual in the
evidence library and also the NCM we have on-line.  I didn't find any
specific studies to support early intervention of nutrition support in
the non-critically ill patient population. 

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. 

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From aimeenut at yahoo.com  Mon Jul 13 09:19:15 2009
From: aimeenut at yahoo.com (aimee crant)
Date: Mon, 13 Jul 2009 09:19:15 -0700 (PDT)
Subject: [Cnm] FW: Floor Stock
In-Reply-To: 
References: 
Message-ID: <688773.87403.qm@web52602.mail.re2.yahoo.com>

What is the Green Belt Project?
?Aimee Crant-Oksa MS, RD
Clinical Nutrition Manager
Centrastate Medical Center
tel: 732-294-2767
email: acrantok at centrastate.com 

________________________________
From: "Zimmerman, Lori A" 
To: "cnm at lists.my180.net" 
Sent: Monday, July 13, 2009 10:37:06 AM
Subject: [Cnm] FW: Floor Stock

I think this may have been asked but of course at the time it wasn't a concern so sorry if this is a repeat request.? I wondering if you all will share with me what you stock on your nursing units?? Please also indicate what type of food service program you have at your facility.? We have Room Service and have a Green Belt Project looking at standardizing unit stocks and reducing what is stocked.? 
________________________________
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.

Thank you for your help,
Lori? 

Lori Zimmerman
Assist. Director - Clinical Nutrition
Saint Joseph's Hospital
Ministry Health Care
?

? ________________________________ ?
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.

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From Valerie.Peters1 at hcahealthcare.com  Mon Jul 13 10:00:09 2009
From: Valerie.Peters1 at hcahealthcare.com (Peters Valerie - Charleston)
Date: Mon, 13 Jul 2009 12:00:09 -0500
Subject: [Cnm] Question
In-Reply-To: <4A5B0558.DF60.000C.0@lakelandregional.org>
References: 

	<4A5B0558.DF60.000C.0@lakelandregional.org>
Message-ID: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88E7EAEF@NADCWPMSGCMS10.hca.corpad.net>

Please excuse the duh, am uninformed here, but why would facility want to bill MNT that way?

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Lisa Dalgleish
Sent: Monday, July 13, 2009 9:59 AM
To: Susan B Tiller; cnm at lists.my180.net
Subject: Re: [Cnm] Hospital outpatient nutrition services and Medicare

Medicare allows hospitals to bill outpt MNT as a facility fee on the UB.  When the UB is used, the RD does not need an NPI and does not need to be a Medicare provider.  One of the drawbacks of billing this way is the RD cannot participate in the PQRI.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>> "Tiller, Susan B"  7/10/2009 6:31 PM >>>
Back in the day when Medicare added MNT as a benefit we rushed to
complete applications for outpatient RDs to become Medicare providers
and reassign benefits to the hospital.  I have not had to do this for
awhile and am now at a different facility with a new RD on staff
providing outpatient services.  I am receiving conflicting information
as to whether or not RDs need to become Medicare providers now that we
have NPI numbers, and that the Medicare provider numbers assigned to the
RDs are not sent to Medicare in the billing process. We bill on a UB.
Has anyone had recent experience with this they can share with me?

Thanks,
Sue

Susan Tiller, MBA, RD, LDN, CNSD
Manager, Patient Services
Food & Nutrition Services
Rhode Island Hospital/Hasbro Children's Hospital
Phone 401-444-5602
Cell 401-639-3012
Fax 401-444-6360

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
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From LDALGLEISH at lakelandregional.org  Mon Jul 13 10:11:56 2009
From: LDALGLEISH at lakelandregional.org (Lisa Dalgleish)
Date: Mon, 13 Jul 2009 13:11:56 -0400
Subject: [Cnm] Question
In-Reply-To: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88E7EAEF@NADCWPMSGCMS10.hca.corpad.net>
References: 

	<4A5B0558.DF60.000C.0@lakelandregional.org>
	<0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88E7EAEF@NADCWPMSGCMS10.hca.corpad.net>
Message-ID: <4A5B327F.DF60.000C.0@lakelandregional.org>

Not all hospitals are set up to bill MNT as a professional service (using the 1500 form).  CMS allows the UB to accommodate these facilities.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> Peters Valerie - Charleston  7/13/2009 1:00 PM >>>

Please excuse the duh, am uninformed here, but why would facility want to bill MNT that way?

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live itwell.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

From:cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Lisa Dalgleish
Sent: Monday, July 13, 2009 9:59 AM
To: Susan B Tiller; cnm at lists.my180.net 
Subject: Re: [Cnm] Hospital outpatient nutrition services and Medicare

Medicare allows hospitals to bill outpt MNT as a facility fee on the UB.  When the UB is used, the RD does not need an NPI and does not need to be a Medicare provider.  One of the drawbacks of billing this way is the RD cannot participate in the PQRI.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> "Tiller, Susan B"  7/10/2009 6:31 PM >>>
Back in the day when Medicare added MNT as a benefit we rushed to
complete applications for outpatient RDs to become Medicare providers
and reassign benefits to the hospital.  I have not had to do this for
awhile and am now at a different facility with a new RD on staff
providing outpatient services.  I am receiving conflicting information
as to whether or not RDs need to become Medicare providers now that we
have NPI numbers, and that the Medicare provider numbers assigned to the
RDs are not sent to Medicare in the billing process. We bill on a UB.
Has anyone had recent experience with this they can share with me?

Thanks,
Sue

Susan Tiller, MBA, RD, LDN, CNSD
Manager, Patient Services
Food & Nutrition Services
Rhode Island Hospital/Hasbro Children's Hospital
Phone 401-444-5602
Cell 401-639-3012
Fax 401-444-6360

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
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From sragland at tanner.org  Mon Jul 13 10:11:36 2009
From: sragland at tanner.org (Shauntel Ragland)
Date: Mon, 13 Jul 2009 13:11:36 -0400
Subject: [Cnm] fresh flower delivery
In-Reply-To: <688773.87403.qm@web52602.mail.re2.yahoo.com>
Message-ID: <138AE4B62F86AC4D9BC23F0168F106550A0730B6@EXCHCLUSTER.ths.local>

One of our facility administrators would like to enhance service by
delivering a fresh flower each day.

After working with infection prevention and establishing a process we
are awaiting final approval from the oncology docs.

Just wondering if any other facilities deliver or have delivered fresh
flowers in the past and share process; any road blocks along the way
etc.

Thanks in advance.

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of aimee crant
Sent: Monday, July 13, 2009 12:19 PM
To: Zimmerman, Lori A; cnm at lists.my180.net
Cc: acrantok at centrastate.com
Subject: Re: [Cnm] FW: Floor Stock

What is the Green Belt Project?

Aimee Crant-Oksa MS, RD
Clinical Nutrition Manager
Centrastate Medical Center
tel: 732-294-2767
email: acrantok at centrastate.com 

________________________________

From: "Zimmerman, Lori A" 
To: "cnm at lists.my180.net" 
Sent: Monday, July 13, 2009 10:37:06 AM
Subject: [Cnm] FW: Floor Stock

I think this may have been asked but of course at the time it wasn't a
concern so sorry if this is a repeat request.  I wondering if you all
will share with me what you stock on your nursing units?  Please also
indicate what type of food service program you have at your facility.
We have Room Service and have a Green Belt Project looking at
standardizing unit stocks and reducing what is stocked.  

Thank you for your help,

Lori  

Lori Zimmerman

Assist. Director - Clinical Nutrition

Saint Joseph's Hospital

Ministry Health Care

  ________________________________  

CONFIDENTIALITY NOTICE: This e-mail communication and any attachments
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From KBOEHME at meriter.com  Mon Jul 13 10:33:10 2009
From: KBOEHME at meriter.com (Boehme, Karen)
Date: Mon, 13 Jul 2009 12:33:10 -0500
Subject: [Cnm] Question
In-Reply-To: <4A5B327F.DF60.000C.0@lakelandregional.org>
References: 

	<4A5B0558.DF60.000C.0@lakelandregional.org>
	<0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88E7EAEF@NADCWPMSGCMS10.hca.corpad.net>
	<4A5B327F.DF60.000C.0@lakelandregional.org>
Message-ID: <8CFCAB1537E1964AB1BAB60E81B019B683DE3618@EXVS1.meriter.com>

I have to say also.......please excuse the duh but what is UB, NPI, and PQRI???
Thanks!
Karen

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Lisa Dalgleish
Sent: Monday, July 13, 2009 12:12 PM
To: Peters Valerie - Charleston; cnm at lists.my180.net
Subject: Re: [Cnm] Question

Not all hospitals are set up to bill MNT as a professional service (using the 1500 form).  CMS allows the UB to accommodate these facilities.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>> Peters Valerie - Charleston  7/13/2009 1:00 PM >>>
Please excuse the duh, am uninformed here, but why would facility want to bill MNT that way?

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Lisa Dalgleish
Sent: Monday, July 13, 2009 9:59 AM
To: Susan B Tiller; cnm at lists.my180.net
Subject: Re: [Cnm] Hospital outpatient nutrition services and Medicare

Medicare allows hospitals to bill outpt MNT as a facility fee on the UB.  When the UB is used, the RD does not need an NPI and does not need to be a Medicare provider.  One of the drawbacks of billing this way is the RD cannot participate in the PQRI.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>> "Tiller, Susan B"  7/10/2009 6:31 PM >>>
Back in the day when Medicare added MNT as a benefit we rushed to
complete applications for outpatient RDs to become Medicare providers
and reassign benefits to the hospital.  I have not had to do this for
awhile and am now at a different facility with a new RD on staff
providing outpatient services.  I am receiving conflicting information
as to whether or not RDs need to become Medicare providers now that we
have NPI numbers, and that the Medicare provider numbers assigned to the
RDs are not sent to Medicare in the billing process. We bill on a UB.
Has anyone had recent experience with this they can share with me?

Thanks,
Sue

Susan Tiller, MBA, RD, LDN, CNSD
Manager, Patient Services
Food & Nutrition Services
Rhode Island Hospital/Hasbro Children's Hospital
Phone 401-444-5602
Cell 401-639-3012
Fax 401-444-6360

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
-------------- next part --------------
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From LDALGLEISH at lakelandregional.org  Mon Jul 13 10:59:38 2009
From: LDALGLEISH at lakelandregional.org (Lisa Dalgleish)
Date: Mon, 13 Jul 2009 13:59:38 -0400
Subject: [Cnm] Question
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E048ACCCC@rhcexch3.reshealthcare.org>
References: <4A5B0558.DF60.000C.0@lakelandregional.org><0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88E7EAEF@NADCWPMSGCMS10.hca.corpad.net><4A5B327F.DF60.000C.0@lakelandregional.org>
	<8CFCAB1537E1964AB1BAB60E81B019B683DE3618@EXVS1.meriter.com>
	<5330B54133B6194BA13930BDEFE9A30E048ACCCC@rhcexch3.reshealthcare.org>
Message-ID: <4A5B3DAB.DF60.000C.0@lakelandregional.org>

Physician Quality Reporting Initiative--it's a PI program whereby healthcare professionals can earn bonus reimbursement from Medicare.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> "Carver, Leslee"  7/13/2009 1:47 PM >>>
UB is the Medicare billing form for Medicare Part A, NPI = National Provider ID.  any and all medical professionals billing insurance must have it.  It can be obtained for all health care professionals (all my dietitians have it) and can be applied for on-line - just Google NPI application.
PQRI (don't remember what the exact letters refer to) is a quality program run by Medicare and just started ~ 1 yr ago where submitting certain quality data can result in slightly higher reimbursement.  The nature of the program does not have a method for submitting the data when billing via the UB form.

Leslee

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express view 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

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Boehme, Karen
Sent: Monday, July 13, 2009 12:33 PM
To: 'Lisa Dalgleish'; Peters Valerie -Charleston; cnm at lists.my180.net 
Subject: Re: [Cnm] Question

I have to say also.......please excuse the duh but what is UB, NPI, and PQRI???
Thanks!
Karen

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Lisa Dalgleish
Sent: Monday, July 13, 2009 12:12 PM
To: Peters Valerie - Charleston; cnm at lists.my180.net 
Subject: Re: [Cnm] Question

Not all hospitals are set up to bill MNT as a professional service (using the 1500 form).  CMS allows the UB to accommodate these facilities.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> Peters Valerie - Charleston  7/13/2009 1:00 PM >>>

Please excuse the duh, am uninformed here, but why would facility want to bill MNT that way?

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live itwell.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

From:cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Lisa Dalgleish
Sent: Monday, July 13, 2009 9:59 AM
To: Susan B Tiller; cnm at lists.my180.net 
Subject: Re: [Cnm] Hospital outpatient nutrition services and Medicare

Medicare allows hospitals to bill outpt MNT as a facility fee on the UB.  When the UB is used, the RD does not need an NPI and does not need to be a Medicare provider.  One of the drawbacks of billing this way is the RD cannot participate in the PQRI.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> "Tiller, Susan B"  7/10/2009 6:31 PM >>>
Back in the day when Medicare added MNT as a benefit we rushed to
complete applications for outpatient RDs to become Medicare providers
and reassign benefits to the hospital.  I have not had to do this for
awhile and am now at a different facility with a new RD on staff
providing outpatient services.  I am receiving conflicting information
as to whether or not RDs need to become Medicare providers now that we
have NPI numbers, and that the Medicare provider numbers assigned to the
RDs are not sent to Medicare in the billing process. We bill on a UB.
Has anyone had recent experience with this they can share with me?

Thanks,
Sue

Susan Tiller, MBA, RD, LDN, CNSD
Manager, Patient Services
Food & Nutrition Services
Rhode Island Hospital/Hasbro Children's Hospital
Phone 401-444-5602
Cell 401-639-3012
Fax 401-444-6360

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
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From MELLINGTON at wakemed.org  Mon Jul 13 11:01:06 2009
From: MELLINGTON at wakemed.org (MARTHA ELLINGTON)
Date: Mon, 13 Jul 2009 14:01:06 -0400
Subject: [Cnm] Allergy Power point for tray line/hostess staff
In-Reply-To: <007601c9f9f4$8bae1d30$a30a5790$@net>
References: <007601c9f9f4$8bae1d30$a30a5790$@net>
Message-ID: 

Does any one have a presentation they have used that is for kitchen/ tray line staff on the importance of honoring food allergies.
Thanks for your help.
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

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

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.  
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-------------------------------------------------------------------------------

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From JCrowley at shorememorial.org  Mon Jul 13 11:00:42 2009
From: JCrowley at shorememorial.org (JCrowley at shorememorial.org)
Date: Mon, 13 Jul 2009 14:00:42 -0400
Subject: [Cnm] Inpatient Malnutrition Coding
Message-ID: 

Good Afternoon,
I am working with our hospital coders to improve documentation of 
malnutrition.
Would anyone be willing to share definitions or parameters of malnutrition 
that are consistent with ICD-9 codes and professional practice?  I would 
like to provide the parameters for our clinicians but fail to find 
specifics.  Apparently the ADA is currently working on guidelines which 
are due out in the fall.
Thanks in advance!

Jennifer E. Crowley RD CNSC
Clinical Nutrition Manager
Shore Memorial Hospital
1 East New York Avenue 
Somers Point NJ
08244-2387

jcrowley at shorememorial.org
Office / Zone Phone (609) 653-3290
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From LCarver at Reshealthcare.org  Mon Jul 13 10:47:47 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Mon, 13 Jul 2009 12:47:47 -0500
Subject: [Cnm] Question
In-Reply-To: <8CFCAB1537E1964AB1BAB60E81B019B683DE3618@EXVS1.meriter.com>
References: <4A5B0558.DF60.000C.0@lakelandregional.org><0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88E7EAEF@NADCWPMSGCMS10.hca.corpad.net><4A5B327F.DF60.000C.0@lakelandregional.org>
	<8CFCAB1537E1964AB1BAB60E81B019B683DE3618@EXVS1.meriter.com>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E048ACCCC@rhcexch3.reshealthcare.org>

UB is the Medicare billing form for Medicare Part A, NPI = National
Provider ID.  any and all medical professionals billing insurance must
have it.  It can be obtained for all health care professionals (all my
dietitians have it) and can be applied for on-line - just Google NPI
application.
PQRI (don't remember what the exact letters refer to) is a quality
program run by Medicare and just started ~ 1 yr ago where submitting
certain quality data can result in slightly higher reimbursement.  The
nature of the program does not have a method for submitting the data
when billing via the UB form.

Leslee

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Boehme, Karen
Sent: Monday, July 13, 2009 12:33 PM
To: 'Lisa Dalgleish'; Peters Valerie -Charleston; cnm at lists.my180.net
Subject: Re: [Cnm] Question

I have to say also.......please excuse the duh but what is UB, NPI, and
PQRI???
Thanks!
Karen

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa Dalgleish
Sent: Monday, July 13, 2009 12:12 PM
To: Peters Valerie - Charleston; cnm at lists.my180.net
Subject: Re: [Cnm] Question

Not all hospitals are set up to bill MNT as a professional service
(using the 1500 form).  CMS allows the UB to accommodate these
facilities.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>> Peters Valerie - Charleston 
7/13/2009 1:00 PM >>>

Please excuse the duh, am uninformed here, but why would facility want
to bill MNT that way?

Best,

Valerie

_________________________

Valerie L. Peters, MS, RD, LD

Supervisor

Nutrition Therapy Department

Trident Health System

9330 Medical Plaza Drive

Charleston, SC     29406-9195

(843) 847-4570

Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well. 
This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of
its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
prohibited. If you have received this email in error, please immediately
purge it and all attachments and notify the sender by reply email or
contact the sender at the number listed.

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa Dalgleish
Sent: Monday, July 13, 2009 9:59 AM
To: Susan B Tiller; cnm at lists.my180.net
Subject: Re: [Cnm] Hospital outpatient nutrition services and Medicare

Medicare allows hospitals to bill outpt MNT as a facility fee on the UB.
When the UB is used, the RD does not need an NPI and does not need to be
a Medicare provider.  One of the drawbacks of billing this way is the RD
cannot participate in the PQRI.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>> "Tiller, Susan B"  7/10/2009 6:31 PM >>>
Back in the day when Medicare added MNT as a benefit we rushed to
complete applications for outpatient RDs to become Medicare providers
and reassign benefits to the hospital.  I have not had to do this for
awhile and am now at a different facility with a new RD on staff
providing outpatient services.  I am receiving conflicting information
as to whether or not RDs need to become Medicare providers now that we
have NPI numbers, and that the Medicare provider numbers assigned to the
RDs are not sent to Medicare in the billing process. We bill on a UB.
Has anyone had recent experience with this they can share with me?

Thanks,
Sue

Susan Tiller, MBA, RD, LDN, CNSD
Manager, Patient Services
Food & Nutrition Services
Rhode Island Hospital/Hasbro Children's Hospital
Phone 401-444-5602
Cell 401-639-3012
Fax 401-444-6360

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

-------------- next part --------------
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From LCarver at Reshealthcare.org  Mon Jul 13 10:14:29 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Mon, 13 Jul 2009 12:14:29 -0500
Subject: [Cnm] Question
In-Reply-To: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88E7EAEF@NADCWPMSGCMS10.hca.corpad.net>
References: <4A5B0558.DF60.000C.0@lakelandregional.org>
	<0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88E7EAEF@NADCWPMSGCMS10.hca.corpad.net>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E048ACC9D@rhcexch3.reshealthcare.org>

the advantage of the UB form is that hospital billing depts are all
already set up to use that format, as it is the same as that used for
Medicare Part A.  many hospitals do not do Medicare Part B billing.
However, I have to say that our Medicare office definitely wants the PIN
AND the Medicare provider # for the dietitian.  we have had
conversations betw us, them and billing that made that very clear.
Leslee

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Peters Valerie - Charleston
Sent: Monday, July 13, 2009 12:00 PM
To: Lisa Dalgleish; cnm at lists.my180.net
Subject: [Cnm] Question

Please excuse the duh, am uninformed here, but why would facility want
to bill MNT that way?

Best,

Valerie

_________________________

Valerie L. Peters, MS, RD, LD

Supervisor

Nutrition Therapy Department

Trident Health System

9330 Medical Plaza Drive

Charleston, SC     29406-9195

(843) 847-4570

Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well. 
This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of
its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
prohibited. If you have received this email in error, please immediately
purge it and all attachments and notify the sender by reply email or
contact the sender at the number listed.

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa Dalgleish
Sent: Monday, July 13, 2009 9:59 AM
To: Susan B Tiller; cnm at lists.my180.net
Subject: Re: [Cnm] Hospital outpatient nutrition services and Medicare

Medicare allows hospitals to bill outpt MNT as a facility fee on the UB.
When the UB is used, the RD does not need an NPI and does not need to be
a Medicare provider.  One of the drawbacks of billing this way is the RD
cannot participate in the PQRI.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>> "Tiller, Susan B"  7/10/2009 6:31 PM >>>
Back in the day when Medicare added MNT as a benefit we rushed to
complete applications for outpatient RDs to become Medicare providers
and reassign benefits to the hospital.  I have not had to do this for
awhile and am now at a different facility with a new RD on staff
providing outpatient services.  I am receiving conflicting information
as to whether or not RDs need to become Medicare providers now that we
have NPI numbers, and that the Medicare provider numbers assigned to the
RDs are not sent to Medicare in the billing process. We bill on a UB.
Has anyone had recent experience with this they can share with me?

Thanks,
Sue

Susan Tiller, MBA, RD, LDN, CNSD
Manager, Patient Services
Food & Nutrition Services
Rhode Island Hospital/Hasbro Children's Hospital
Phone 401-444-5602
Cell 401-639-3012
Fax 401-444-6360

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

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From Kerry.Scott at providence.org  Mon Jul 13 11:58:06 2009
From: Kerry.Scott at providence.org (Scott, Kerry  R.)
Date: Mon, 13 Jul 2009 11:58:06 -0700
Subject: [Cnm] Question
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E048ACCCC@rhcexch3.reshealthcare.org>
References: <4A5B0558.DF60.000C.0@lakelandregional.org><0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88E7EAEF@NADCWPMSGCMS10.hca.corpad.net><4A5B327F.DF60.000C.0@lakelandregional.org><8CFCAB1537E1964AB1BAB60E81B019B683DE3618@EXVS1.meriter.com>
	<5330B54133B6194BA13930BDEFE9A30E048ACCCC@rhcexch3.reshealthcare.org>
Message-ID: 

At our facility, all OP RD's have an NPI ( I thought it was  a
requirement for Medicare MNT) and our billing office puts the RD NPI on
the UB form.

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 Carver, Leslee
Sent: Monday, July 13, 2009 10:48 AM
To: Boehme, Karen; Lisa Dalgleish; Peters Valerie -Charleston;
cnm at lists.my180.net
Subject: Re: [Cnm] Question

UB is the Medicare billing form for Medicare Part A, NPI = National
Provider ID.  any and all medical professionals billing insurance must
have it.  It can be obtained for all health care professionals (all my
dietitians have it) and can be applied for on-line - just Google NPI
application.
PQRI (don't remember what the exact letters refer to) is a quality
program run by Medicare and just started ~ 1 yr ago where submitting
certain quality data can result in slightly higher reimbursement.  The
nature of the program does not have a method for submitting the data
when billing via the UB form.

Leslee

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Boehme, Karen
Sent: Monday, July 13, 2009 12:33 PM
To: 'Lisa Dalgleish'; Peters Valerie -Charleston; cnm at lists.my180.net
Subject: Re: [Cnm] Question

I have to say also.......please excuse the duh but what is UB, NPI, and
PQRI???
Thanks!
Karen

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa Dalgleish
Sent: Monday, July 13, 2009 12:12 PM
To: Peters Valerie - Charleston; cnm at lists.my180.net
Subject: Re: [Cnm] Question

Not all hospitals are set up to bill MNT as a professional service
(using the 1500 form).  CMS allows the UB to accommodate these
facilities.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>> Peters Valerie - Charleston 
7/13/2009 1:00 PM >>>

Please excuse the duh, am uninformed here, but why would facility want
to bill MNT that way?

Best,

Valerie

_________________________

Valerie L. Peters, MS, RD, LD

Supervisor

Nutrition Therapy Department

Trident Health System

9330 Medical Plaza Drive

Charleston, SC     29406-9195

(843) 847-4570

Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well. 
This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of
its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
prohibited. If you have received this email in error, please immediately
purge it and all attachments and notify the sender by reply email or
contact the sender at the number listed.

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Lisa Dalgleish
Sent: Monday, July 13, 2009 9:59 AM
To: Susan B Tiller; cnm at lists.my180.net
Subject: Re: [Cnm] Hospital outpatient nutrition services and Medicare

Medicare allows hospitals to bill outpt MNT as a facility fee on the UB.
When the UB is used, the RD does not need an NPI and does not need to be
a Medicare provider.  One of the drawbacks of billing this way is the RD
cannot participate in the PQRI.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>> "Tiller, Susan B"  7/10/2009 6:31 PM >>>
Back in the day when Medicare added MNT as a benefit we rushed to
complete applications for outpatient RDs to become Medicare providers
and reassign benefits to the hospital.  I have not had to do this for
awhile and am now at a different facility with a new RD on staff
providing outpatient services.  I am receiving conflicting information
as to whether or not RDs need to become Medicare providers now that we
have NPI numbers, and that the Medicare provider numbers assigned to the
RDs are not sent to Medicare in the billing process. We bill on a UB.
Has anyone had recent experience with this they can share with me?

Thanks,
Sue

Susan Tiller, MBA, RD, LDN, CNSD
Manager, Patient Services
Food & Nutrition Services
Rhode Island Hospital/Hasbro Children's Hospital
Phone 401-444-5602
Cell 401-639-3012
Fax 401-444-6360

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

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From SRassekh at stfranciscare.org  Mon Jul 13 12:04:54 2009
From: SRassekh at stfranciscare.org (Rassekh, Shoreh)
Date: Mon, 13 Jul 2009 15:04:54 -0400
Subject: [Cnm] Allergy Power point for tray line/hostess staff
In-Reply-To: 
Message-ID: <0AB0670D124B96418F1D6AAFB11D5C310126C77A@SFH15110MV23.sfhad.stfranciscare.org>

I am interested as well.

Shoreh

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of MARTHA ELLINGTON
Sent: Monday, July 13, 2009 2:01 PM
To: cnm at lists.my180.net
Subject: [Cnm] Allergy Power point for tray line/hostess staff

Does any one have a presentation they have used that is for kitchen/
tray line staff on the importance of honoring food allergies.  

Thanks for your help.

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

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From Christine.Schwartz at sfdph.org  Mon Jul 13 13:18:37 2009
From: Christine.Schwartz at sfdph.org (Christine Schwartz)
Date: Mon, 13 Jul 2009 13:18:37 -0700
Subject: [Cnm] Hand hygiene for the patients
Message-ID: 

Do you provide any kind of hand wipe on patient meal trays so they can
clean their hands before meals or is there another process to get patients
involved in hand hygiene?  They are encouraged, if appropriate, to get to
the bathroom and wash their hands, but we all know it is insufficient.
Nursing is asking us to get the individual packages of hand wipes to put on
the trays, which actually sounds like a pretty good idea IF the patients
actually use them and can open the packaging.  The push is related to TJC's
Nat'l Patient Safety Goals and getting patients more involved.

I look forward to your feedback.  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 Valerie.Peters1 at hcahealthcare.com  Mon Jul 13 13:26:51 2009
From: Valerie.Peters1 at hcahealthcare.com (Peters Valerie - Charleston)
Date: Mon, 13 Jul 2009 15:26:51 -0500
Subject: [Cnm] oncology
Message-ID: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88E7F21D@NADCWPMSGCMS10.hca.corpad.net>

Hi all-
  Does anyone have specific food plan recommendations for brain tumor patients?  Patient has glial cell and is on chemo regimen.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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From LCarver at Reshealthcare.org  Mon Jul 13 13:31:53 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Mon, 13 Jul 2009 15:31:53 -0500
Subject: [Cnm] Hand hygiene for the patients
In-Reply-To: 
References: 
Message-ID: <5330B54133B6194BA13930BDEFE9A30E048ACE02@rhcexch3.reshealthcare.org>

we put hand wipes on trays, although I don't think they are widely used.

Leslee R. Carver, MSPH, RD, LDN
Clinical Nutrition Manager
Saint Joseph Hospital
2900 N. Lake Shore Dr.
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.  All personal messages express
view 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

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Christine Schwartz
Sent: Monday, July 13, 2009 3:19 PM
To: cnm at lists.my180.net
Subject: [Cnm] Hand hygiene for the patients

Do you provide any kind of hand wipe on patient meal trays so they can
clean their hands before meals or is there another process to get
patients
involved in hand hygiene?  They are encouraged, if appropriate, to get
to
the bathroom and wash their hands, but we all know it is insufficient.
Nursing is asking us to get the individual packages of hand wipes to put
on
the trays, which actually sounds like a pretty good idea IF the patients
actually use them and can open the packaging.  The push is related to
TJC's
Nat'l Patient Safety Goals and getting patients more involved.

I look forward to your feedback.  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 lneuhaus at chsbuffalo.org  Mon Jul 13 13:39:29 2009
From: lneuhaus at chsbuffalo.org (Neuhaus, Lisa)
Date: Mon, 13 Jul 2009 16:39:29 -0400
Subject: [Cnm] Hand hygiene for the patients
In-Reply-To: 
References: 
Message-ID: <3E6DC8D8B3285C449C883257CA6012D75A5FD5D8E2@CHEXCHANGE01.ad.wnychs.org>

This does seem like a good idea to get patients more involved but, I think that these could be available on the nursing units.  To arbitrarily put on every tray when they will go right into the garbage would be a huge waste of money. I think if you are going to do this, the nursing units should be responsible for ordering them and keeping a supply on hand for their patients. Its not a food related cost that the nutrition department should have to incur. Interesting to see what the cost would be for three per day for every pt. for a year.

I wonder if a mini hand sanitizer given with each new admit like toothpaste and such would be cheaper?? Just a thought.

Lisa Neuhaus MS RD CNSD
Director, Food & Nutrition Services
Buffalo Mercy Hospital
565 Abbott Road
Buffalo, NY 14220
716-828-2106

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Christine Schwartz
Sent: Monday, July 13, 2009 4:19 PM
To: cnm at lists.my180.net
Subject: [Cnm] Hand hygiene for the patients

Do you provide any kind of hand wipe on patient meal trays so they can
clean their hands before meals or is there another process to get patients
involved in hand hygiene?  They are encouraged, if appropriate, to get to
the bathroom and wash their hands, but we all know it is insufficient.
Nursing is asking us to get the individual packages of hand wipes to put on
the trays, which actually sounds like a pretty good idea IF the patients
actually use them and can open the packaging.  The push is related to TJC's
Nat'l Patient Safety Goals and getting patients more involved.

I look forward to your feedback.  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

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

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.

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From mrogard at charter.net  Tue Jul 14 03:12:58 2009
From: mrogard at charter.net (mrogard at charter.net)
Date: Tue, 14 Jul 2009 6:12:58 -0400
Subject: [Cnm] Hand hygiene for the patients
In-Reply-To: 
Message-ID: <20090714061258.K181L.1767124.root@mp06>

We sent wipes on the trays for about 2 years.  When we needed to look at expense cuts we evaluated this practice and found most trays came down with the wipes not used.  We discontinued the practice.
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

---- Christine Schwartz  wrote: 
> 
> Do you provide any kind of hand wipe on patient meal trays so they can
> clean their hands before meals or is there another process to get patients
> involved in hand hygiene?  They are encouraged, if appropriate, to get to
> the bathroom and wash their hands, but we all know it is insufficient.
> Nursing is asking us to get the individual packages of hand wipes to put on
> the trays, which actually sounds like a pretty good idea IF the patients
> actually use them and can open the packaging.  The push is related to TJC's
> Nat'l Patient Safety Goals and getting patients more involved.
> 
> I look forward to your feedback.  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 Jryan at holyredeemer.com  Tue Jul 14 05:22:26 2009
From: Jryan at holyredeemer.com (Jeanie Ryan)
Date: Tue, 14 Jul 2009 08:22:26 -0400
Subject: [Cnm] Hand hygiene for the patients
In-Reply-To: 
Message-ID: 

We have a room service program, so that we have hostesses who serve the
trays.  They offer hand sanitizers to the patients when they deliver the
trays.  If someone would like them they usually give several and remind
the patient to ask for more when they need them.  We are using a fair
amount but they are being given to those that desire them.

 Jeanie Ryan RD LDN
Clinical Nutrition Manager
Nutrition Services
Holy Redeemer Hospital  and Medical Center
215-938-4332
FAX 215-938-4336
jryan at holyredeemer.com

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Christine Schwartz
Sent: Monday, July 13, 2009 4:19 PM
To: cnm at lists.my180.net
Subject: [Cnm] Hand hygiene for the patients

Do you provide any kind of hand wipe on patient meal trays so they can
clean their hands before meals or is there another process to get
patients
involved in hand hygiene?  They are encouraged, if appropriate, to get
to
the bathroom and wash their hands, but we all know it is insufficient.
Nursing is asking us to get the individual packages of hand wipes to put
on
the trays, which actually sounds like a pretty good idea IF the patients
actually use them and can open the packaging.  The push is related to
TJC's
Nat'l Patient Safety Goals and getting patients more involved.

I look forward to your feedback.  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

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

CONFIDENTIALITY NOTICE:

This E-Mail is intended only for the use of the individual or entity to which
it was sent. It may contain information that is privileged and/or confidential,
and the use or disclosure of such information may also be restricted under applicable
federal and state law. If you received this communication in error, please do not
distribute any part of it or retain any copies, and delete the original E-Mail.
Please notify the sender of any error by E-Mail.

Thank you for your cooperation.

From LDALGLEISH at lakelandregional.org  Tue Jul 14 05:35:42 2009
From: LDALGLEISH at lakelandregional.org (Lisa Dalgleish)
Date: Tue, 14 Jul 2009 08:35:42 -0400
Subject: [Cnm] Hand hygiene for the patients
In-Reply-To: 
References: 

Message-ID: <4A5C4340.DF60.000C.0@lakelandregional.org>

Yes, we provide a sealed wipe with every tray.  

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> "Jeanie Ryan"  7/14/2009 8:22 AM >>>
We have a room service program, so that we have hostesses who serve the
trays.  They offer hand sanitizers to the patients when they deliver the
trays.  If someone would like them they usually give several and remind
the patient to ask for more when they need them.  We are using a fair
amount but they are being given to those that desire them.

Jeanie Ryan RD LDN
Clinical Nutrition Manager
Nutrition Services
Holy Redeemer Hospital  and Medical Center
215-938-4332
FAX 215-938-4336
jryan at holyredeemer.com 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] 
On Behalf Of Christine Schwartz
Sent: Monday, July 13, 2009 4:19 PM
To: cnm at lists.my180.net 
Subject: [Cnm] Hand hygiene for the patients

Do you provide any kind of hand wipe on patient meal trays so they can
clean their hands before meals or is there another process to get
patients
involved in hand hygiene?  They are encouraged, if appropriate, to get
to
the bathroom and wash their hands, but we all know it is insufficient.
Nursing is asking us to get the individual packages of hand wipes to put
on
the trays, which actually sounds like a pretty good idea IF the patients
actually use them and can open the packaging.  The push is related to
TJC's
Nat'l Patient Safety Goals and getting patients more involved.

I look forward to your feedback.  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 

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

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it was sent. It may contain information that is privileged and/or confidential,
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federal and state law. If you received this communication in error, please do not
distribute any part of it or retain any copies, and delete the original E-Mail.
Please notify the sender of any error by E-Mail.

Thank you for your cooperation.

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From mtewes at wchsys.org  Tue Jul 14 07:05:03 2009
From: mtewes at wchsys.org (Melissa Tewes)
Date: Tue, 14 Jul 2009 10:05:03 -0400
Subject: [Cnm] CBORD & Food Allergies
Message-ID: <006e01ca048c$15b29c80$4117d580$@org>

Is anyone using Meditech and CBORD?  If so.how are food allergies being
handled?

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washington 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
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From Heberle-Heather at aramark.com  Tue Jul 14 07:09:08 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Tue, 14 Jul 2009 09:09:08 -0500
Subject: [Cnm] Hand hygiene for the patients
In-Reply-To: 
References: 
Message-ID: 

We send hand wipes on all patient trays.  They seemed to be used frequently by the patients just upon observation.

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
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From CLJarcik at pwhs.org  Tue Jul 14 07:44:59 2009
From: CLJarcik at pwhs.org (Jarcik, Cheryl)
Date: Tue, 14 Jul 2009 10:44:59 -0400
Subject: [Cnm] CBORD & Food Allergies
In-Reply-To: <006e01ca048c$15b29c80$4117d580$@org>
References: <006e01ca048c$15b29c80$4117d580$@org>
Message-ID: 

We do and the two systems are interfaced to pick up on the allergies.
Of course, CBord cannot handle the zillions of allergies from meditech,
so we highlight the biggies and have staff in the am compare the two
each am.

Cheryl Jarcik

Prince William, Manassas, VA

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Melissa Tewes
Sent: Tuesday, July 14, 2009 10:05 AM
To: cnm at lists.my180.net
Subject: [Cnm] CBORD & Food Allergies

Is anyone using Meditech and CBORD?  If so...how are food allergies
being handled?

Melissa Tewes RD, LDN

Clinical Nutrition Manager

Washington 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
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From nfdziak at metrohealth.org  Tue Jul 14 08:45:34 2009
From: nfdziak at metrohealth.org (Nancy Farmer-Dziak)
Date: Tue, 14 Jul 2009 11:45:34 -0400
Subject: [Cnm] Fwd: FW: Anticoagulation Therapy
References: <91848DCE3158624AABDCC0E30EEC558A0367F870@ugh-ms1.UGHHOU.local>
Message-ID: <4A5C6FDE.6228.0033.0@metrohealth.org>

>>> "Derri Denton"  7/14/2009 11:43 AM >>>

Hello,

I am new to this user group and not familiar with the kinds of
questions etc posted.  Any input would be appreciated.
Who does the education on FDI for your patients on anticoagulants and
other drugs with possible FDI?s?  What drugs do you include in your FDI
programs?
Can you share any free resources for educational materials?

Thank you for your help,  

Derri Denton
Director Food and Nutrition Services
              Office 713.375.7580
                Cell 713.471.0627
ddenton at ughospital.com

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
http://www.metrohealth.org or for stories of MetroHealth miracles and
hope, visit: http://www.mhwallofhope.com 

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From LCarver at Reshealthcare.org  Tue Jul 14 09:19:10 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 14 Jul 2009 11:19:10 -0500
Subject: [Cnm] Fwd: FW: Anticoagulation Therapy
In-Reply-To: <4A5C6FDE.6228.0033.0@metrohealth.org>
References: <91848DCE3158624AABDCC0E30EEC558A0367F870@ugh-ms1.UGHHOU.local>
	<4A5C6FDE.6228.0033.0@metrohealth.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E048AD092@rhcexch3.reshealthcare.org>

w/ the help of our VP of Patient Services, we moved Warfarin instruction
to Pharmacy.  I gave in-services and diet handouts to the Pharmacists.
This way the drug-drug and diet-drug interactions are all covered.  we
are available on consult, of course.

we have a lot of MAOI here as it is widely used in our Headache Tx
Program and we handle that.

the Infectious Disease docs, by their preference, handle the HIV drugs. 

Pretty much everyone is responsible for the DM drugs - we weave that
into our instr (timing of meds and meals for instance) and just make a
point of stating so in documentation.  

I believe some of the food-drug interaction info is in the ADA on-line
nutrition care manual. 

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Nancy Farmer-Dziak
Sent: Tuesday, July 14, 2009 10:46 AM
To: cnm at lists.my180.net
Subject: [Cnm] Fwd: FW: Anticoagulation Therapy

>>> "Derri Denton"  7/14/2009 11:43 AM >>>

Hello,

I am new to this user group and not familiar with the kinds of questions
etc posted.  Any input would be appreciated.

Who does the education on FDI for your patients on anticoagulants and
other drugs with possible FDI's?  What drugs do you include in your FDI
programs?

Can you share any free resources for educational materials?

Thank you for your help,  

Derri Denton

Director Food and Nutrition Services

              Office 713.375.7580

                Cell 713.471.0627

ddenton at ughospital.com

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
http://www.metrohealth.org   or for stories
of MetroHealth miracles and hope, visit: http://www.mhwallofhope.com

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
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From bdromazos at summithealth.org  Tue Jul 14 09:54:07 2009
From: bdromazos at summithealth.org (Barbara Dromazos)
Date: Tue, 14 Jul 2009 12:54:07 -0400
Subject: [Cnm] NCP in Meditech
Message-ID: <4A5C7FEF.3F09.0083.0@summithealth.org>

I am looking for Meditech users who have the Nutrition Care Process in place.  Does Meditech have a NCP module developed? and, if so, how can I direct our IS department to connect with it?
Thank you.

Barbara K. Dromazos, RD, LDN
Clinical Nutrition Manager
Chambersburg Hospital
112 North Seventh Street
Chambersburg, PA   17201
Telephone:  717-267-7903
Fax:  717-267-4831

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 entitites 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 DDuardo at humed.com  Tue Jul 14 13:04:00 2009
From: DDuardo at humed.com (Duardo, Donna)
Date: Tue, 14 Jul 2009 16:04:00 -0400
Subject: [Cnm] formula for determining RD staffing
Message-ID: 

Does anyone have a current formula that they are using to determine RD
staffing needs? Thanks.

Donna Duardo, MA, RD
Systems Coordinator
Nutrition & Food Management
Hackensack University Medical Center
201-996-2239
dduardo at humed.com

**************************************************************************************************
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From sheila.walsh at nahealth.com  Tue Jul 14 13:31:28 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Tue, 14 Jul 2009 13:31:28 -0700
Subject: [Cnm] formula for determining RD staffing
In-Reply-To: 
References: 
Message-ID: <4A5C8915.485B.0001.0@nahealth.com>

Please post.

>>> "Duardo, Donna"  7/14/2009 1:04 PM >>>

Does anyone have a current formula that they are using to determine RD staffing needs? Thanks.

Donna Duardo, MA, RD
Systems Coordinator
Nutrition & Food Management
HackensackUniversity Medical Center
201-996-2239
dduardo at humed.com

************************************************************************************************** Important news about our email communications. Hackensack University Medical Center has implemented secure messaging services. If you need assistance with retrieving a secure email, please send an e-mail to postmaster at humed.com *************************************************************************************************** Confidentiality Notice: This e-mail message and any attachments from Hackensack University Medical Center are confidential and for the sole use of the intended recipient. This communication may contain Protected Health Information ("PHI"). PHI is confidential information that may only be used or disclosed in accordance with applicable law. There are penalties under the law for the improper use or further disclosure of PHI. If you are not the intended recipient of this e-mail or the employee or agent responsible for delivering the communication to the intended recipient, then you may not read, copy, distribute or otherwise use or disclose the information contained in this message. If you received this message in error, please notify us by telephone at 201.996.2000 or by e-mail to postmaster at humed.com. Please indicate that you were not the intended recipient, and confirm that you have deleted the original message. Please do not retransmit the contents of the message. Thank you. Hackensack University Medical Center is the proud recipient of Quality New Jersey's Governor's Gold Award for Performance Excellence ************************************************************************************************** 
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From Valerie.Peters1 at hcahealthcare.com  Wed Jul 15 07:36:44 2009
From: Valerie.Peters1 at hcahealthcare.com (Peters Valerie - Charleston)
Date: Wed, 15 Jul 2009 09:36:44 -0500
Subject: [Cnm] contact phone or email
Message-ID: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88F00A7C@NADCWPMSGCMS10.hca.corpad.net>

Hi all-
  Does anyone have a contact for Brenda Byer?  (sp?)

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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From HopkinsA at sjchs.org  Wed Jul 15 07:55:25 2009
From: HopkinsA at sjchs.org (Hopkins, Anne)
Date: Wed, 15 Jul 2009 10:55:25 -0400
Subject: [Cnm] NCP in Meditech
Message-ID: 

Please post to list. We are currently revising our Meditech
documentation and I'm interested in how facilities may be using M'tech
(examples of forms, functionalities) to document NCP. 

Anne Hopkins, RD, LD
Clinical Operations Manager, Nutrition Services
St. Joseph's Candler Health System
Savannah, GA

(912) 819-2556 (office)
(912) 819-4070 (fax)

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Barbara Dromazos
Sent: Tuesday, July 14, 2009 12:54 PM
To: cnm at lists.my180.net
Subject: [Cnm] NCP in Meditech

I am looking for Meditech users who have the Nutrition Care Process in
place.  Does Meditech have a NCP module developed? and, if so, how can I
direct our IS department to connect with it?
Thank you.

Barbara K. Dromazos, RD, LDN
Clinical Nutrition Manager
Chambersburg Hospital
112 North Seventh Street
Chambersburg, PA   17201
Telephone:  717-267-7903
Fax:  717-267-4831

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
entitites 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
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From MPAPPO at montefiore.org  Wed Jul 15 10:07:31 2009
From: MPAPPO at montefiore.org (Miriam Pappo)
Date: Wed, 15 Jul 2009 13:07:31 -0400
Subject: [Cnm] Hand hygiene for the patients
Message-ID: 

I really like the idea of a small sanitizer as part of the admitting
package.  Likely cheaper than packets on each tray & will likely be used
more.

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>>  07/14/09 6:12 AM >>>
We sent wipes on the trays for about 2 years.  When we needed to look
at expense cuts we evaluated this practice and found most trays came
down with the wipes not used.  We discontinued the practice.
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 

---- Christine Schwartz  wrote: 
> 
> Do you provide any kind of hand wipe on patient meal trays so they
can
> clean their hands before meals or is there another process to get
patients
> involved in hand hygiene?  They are encouraged, if appropriate, to
get to
> the bathroom and wash their hands, but we all know it is
insufficient.
> Nursing is asking us to get the individual packages of hand wipes to
put on
> the trays, which actually sounds like a pretty good idea IF the
patients
> actually use them and can open the packaging.  The push is related to
TJC's
> Nat'l Patient Safety Goals and getting patients more involved.
> 
> I look forward to your feedback.  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 

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
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From Andrea.McHugh at crozer.org  Wed Jul 15 10:16:29 2009
From: Andrea.McHugh at crozer.org (McHugh, Andrea)
Date: Wed, 15 Jul 2009 13:16:29 -0400
Subject: [Cnm] Survey readiness
Message-ID: <1904FBE1EFD42940AA44982E67B5B44E06774791@exchange02.CKHSAD.CROZER.ORG>

Hello,

I need to train one of my RD's in survey readiness in case we have a
visit from J-Co, etc while I am on maternity leave.  Does anyone have a
list of survey questions I could use as a reference?

Thanks,

Andrea

Andrea McHugh, MA, RD, LDN

Assistant Director, Nutrition Services

Crozer-Chester Medical Center

Upland, PA 19013

phone number: 610-447-6016

fax number: 610-447-2325

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From jeannine.hutchcraft at sih.net  Wed Jul 15 11:06:45 2009
From: jeannine.hutchcraft at sih.net (Jeannine Hutchcraft/SIH)
Date: Wed, 15 Jul 2009 13:06:45 -0500
Subject: [Cnm] Survey readiness
In-Reply-To: <1904FBE1EFD42940AA44982E67B5B44E06774791@exchange02.CKHSAD.CROZER.ORG>
Message-ID: 

Please post

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

             "McHugh, Andrea"                                              
                                                               To 
             Sent by:                                 
             cnm-bounces at lists                                          cc 
             .my180.net                                                    
                                                                   Subject 
                                       [Cnm] Survey readiness              
             07/15/2009 12:16                                              
             PM                                                            

Hello,

I need to train one of my RD?s in survey readiness in case we have a visit
from J-Co, etc while I am on maternity leave.  Does anyone have a list of
survey questions I could use as a reference?

Thanks,
Andrea

Andrea McHugh, MA, RD, LDN
Assistant Director, Nutrition Services
Crozer-Chester Medical Center
Upland, PA 19013
phone number: 610-447-6016
fax number: 610-447-2325
 _______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

From fynan-carla at CooperHealth.edu  Wed Jul 15 11:15:00 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Wed, 15 Jul 2009 14:15:00 -0400
Subject: [Cnm] FW:  JCAHO Visit
Message-ID: <77F33794DD223B40BF24AB3D3793025019931A2D5A@mxmbx01.chsmail.root.cooperhealth.edu>

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of lrichter at notes.cc.sunysb.edu
Sent: Friday, June 19, 2009 4:43 PM
To: cnm at lists.my180.net
Subject: [Cnm] JCAHO Visit

JCAHO was in our facility this week.

Their focus was on competencies.

They asked for one dietitian's HR file and wanted to see the credential verification from the ADA Website for Registration. They checked the date it was printed from the Web page.
They also wanted to know my credentials.
Since they interviewed a dietitian on the Pediatric unit, they wanted to see how she was competent to work in Pediatrics.
The dietitian is a Board Certified Specialist in Pediatric Nutrition.

They also did many tracers but only interviewed 2 dietitians.
They observed a dietitian doing an assessment on MICU and one on PICU.
The surveyor asked the dietitian what their plan of care was for the patient and verified that the information was also written in the Medical Record.

They did visit the Food & Nutrition Department with one of their tracers. The surveyor wanted to observe our Room Service Staff taking an meal order in our Call Center. They liked the scripting.

Feel free to contact me if you have any questions.

Lisa L. Richter, MS, RD
Clinical Nutrition Manager
Stony Brook University Hospital
Stony Brook, New York 11794-7012
631-444-8233

******************************************************************************
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contain confidential and privileged information.
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From fynan-carla at CooperHealth.edu  Wed Jul 15 11:16:17 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Wed, 15 Jul 2009 14:16:17 -0400
Subject: [Cnm] (no subject)
Message-ID: <77F33794DD223B40BF24AB3D3793025019931A2D61@mxmbx01.chsmail.root.cooperhealth.edu>

Good ones that I have received over the past few months.

Carla Fynan
Cooper University Hospital

****************************************************************
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From jross at jaycountyhospital.com  Wed Jul 15 12:12:15 2009
From: jross at jaycountyhospital.com (Julayne Ross)
Date: Wed, 15 Jul 2009 15:12:15 -0400
Subject: [Cnm] CHF recommendations
Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D0220B049@EX1.jaycountyhospital.com>

When someone has CHF but serum sodium is low... do you wait till sodium
normalizes before recommending a sodium restriction?

TIA
JRoss

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From jross at jaycountyhospital.com  Wed Jul 15 12:19:14 2009
From: jross at jaycountyhospital.com (Julayne Ross)
Date: Wed, 15 Jul 2009 15:19:14 -0400
Subject: [Cnm] colon resection
Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D0220B04C@EX1.jaycountyhospital.com>

I feel like I might be missing something I should be doing... partially
due to a lack of time.  But when we have a colon resection... the Dr.
starts them on liquids when ready and they progress the diet working
with the nurse on patient's tolerance.  I usually don't make any
recommendations...unless it involves diverticulitis...etc.

Anyone doing anything different?

Thanks ~

Julayne

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From Valerie.Peters1 at hcahealthcare.com  Wed Jul 15 12:48:35 2009
From: Valerie.Peters1 at hcahealthcare.com (Peters Valerie - Charleston)
Date: Wed, 15 Jul 2009 14:48:35 -0500
Subject: [Cnm] TJC
Message-ID: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88F5DFF5@NADCWPMSGCMS10.hca.corpad.net>

Hi all-
  If anyone has any hospital wide conversations/questions from recent JCAHO inspections please forward.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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From Keri.Davis at hcahealthcare.com  Wed Jul 15 13:00:09 2009
From: Keri.Davis at hcahealthcare.com (Stoner-Davis Keri)
Date: Wed, 15 Jul 2009 15:00:09 -0500
Subject: [Cnm] Rhabdomyelitis
In-Reply-To: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88F5DFF5@NADCWPMSGCMS10.hca.corpad.net>
References: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88F5DFF5@NADCWPMSGCMS10.hca.corpad.net>
Message-ID: <5E0556AC846DFB4ABB636C8497BF5015746C505F7E@FWDCWPMSGCMS05.hca.corpad.net>

Does anyone have any good resources on nutritional care and intervention in Rhabdo?

Incr calorie needs? Need for restricted protein? Need for K or Phos restriction? Are there nutritional standards of care or references on nutritional care for Rhabdo? Thanks.

Keri Stoner-Davis MS, RD/LD
Lead Clinical Dietitian
Medical Center of Lewisville
500 West Main Street
Lewisville, TX 75057-3699
Office: (972) 219-5113
Fax: (972) 219-6777
Keri.Davis at hcahealthcare.com

This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.
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From julie.mclaughlin at hotmail.com  Wed Jul 15 13:18:40 2009
From: julie.mclaughlin at hotmail.com (Julie McLaughlin)
Date: Wed, 15 Jul 2009 16:18:40 -0400
Subject: [Cnm] TJC
In-Reply-To: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88F5DFF5@NADCWPMSGCMS10.hca.corpad.net>
References: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88F5DFF5@NADCWPMSGCMS10.hca.corpad.net>
Message-ID: 

They are at our facility right now!  I will give more detail next week, but for right now, they have involved nutrition quite a bit.

They have requested the RD at every unit visit.

The first day, they asked the RD about why she had not seen a particular pt. (They had not met any of our screening criteria and we had not received any consults).  The RD explained the nursing initial nutrition screen and our screening criteria.  She then asked about time frames for seeing pts.  2 RDs have been asked this same info.

We have one surveyor who sits the whole team down and then reviews the chart page by page.  We are mostly paper charting except for nursing, MAR, lab.  When looking at a pt in PICU, he asked the RD, "has this pt always been underweight?"  The pt was a chronically ill pt, so she explained yes, and what she was doing for him.  This same surveyor is also very particular with refrigerators and asked the RD if we followed the National Food Code 1999.  She said, "yes, we do!"  ????!!  I looked after the fact at the 2005 recs and it's just regular food about refrigerator temps, holding, cooling/reheating, etc. 

They have asked our traypasser to locate the fire ext on her unit and then what would she do in case of a fire.

They asked to see the RD worksheets and while looking at them, saw the notes that the RDs type to each other in CBORD about making a recommendation.  She then asked about how often the physician's take our recs and what do we do if they don't.

She also asked us to find a pt on a renal or fluid restricted diet.  She spoke with the pt, reviewed the record and then came to the diet office to see how we receive orders, modify menus (everything is automated), prepare trays.  She asked how we ensure accuracy of trays.  She asked, with the automated system, does it ever get confused with complicated diets and not know what to give.  She also if the traypassers were involved in documenting or communicating meal consumption.

More to come!

Julie McLaughlin, RD, LD/N
Assistant Director, Patient Services
Broward General Medical Center
Ft. Lauderdale, FL 33316

From: Valerie.Peters1 at hcahealthcare.com
To: cnm at lists.my180.net
Date: Wed, 15 Jul 2009 14:48:35 -0500
Subject: [Cnm] TJC

Hi all-
  If anyone has any hospital wide conversations/questions from recent JCAHO inspections please forward.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well. 
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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From jross at jaycountyhospital.com  Wed Jul 15 13:58:29 2009
From: jross at jaycountyhospital.com (Julayne Ross)
Date: Wed, 15 Jul 2009 16:58:29 -0400
Subject: [Cnm] Nutrition program for Freshmen
Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D0220B083@EX1.jaycountyhospital.com>

Our hospital foundation is going to raise money for a group (Childhood
obesity task force) to use in the schools.  We are going to target
Freshmen...our local high school has a freshman academy.

Does anyone have any kind of curriculum for nutrition/health ...anything
at all that would be an idea for me?

Or any ideas of programs, books...etc that would be helpful?

Anyone heard of Jean Bladyes-Madigan who started Smart Moves?

Thanks,

Julayne

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From LDALGLEISH at lakelandregional.org  Tue Jul 14 05:34:54 2009
From: LDALGLEISH at lakelandregional.org (Lisa Dalgleish)
Date: Tue, 14 Jul 2009 08:34:54 -0400
Subject: [Cnm] Allergy Power point for tray line/hostess staff
In-Reply-To: <0AB0670D124B96418F1D6AAFB11D5C310126C77A@SFH15110MV23.sfhad.stfranciscare.org>
References: 
	<0AB0670D124B96418F1D6AAFB11D5C310126C77A@SFH15110MV23.sfhad.stfranciscare.org>
Message-ID: <4A5C430F.DF60.000C.0@lakelandregional.org>

Here is a food allergy presentation we prepared for schools.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> "Rassekh, Shoreh"  7/13/2009 3:04 PM >>>
I am interested as well.

Shoreh

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of MARTHA ELLINGTON
Sent: Monday, July 13, 2009 2:01 PM
To: cnm at lists.my180.net 
Subject: [Cnm] Allergy Power point for tray line/hostess staff

Does any one have a presentation they have used that is for kitchen/ tray line staff on the importance of honoring food allergies.  
Thanks for your help.
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

------------------------------------------------------------------------------- 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. ------------------------------------------------------------------------------- 
NOTICE: This email and/or attachments may contain confidential or proprietary information which may be legally privileged. It is intended only for the named recipient(s). If an addressing or transmission error has misdirected this email, please notify the author by replying to this message. If you are not the named recipient, you are not authorized to use, disclose, distribute, make copies or print this email, and should immediately delete it from your computer system. Saint Francis Care has scanned this email and its attachments for malicious content. However, the recipient should check this email and any attachments for the presence of viruses. Saint Francis Care accepts no liability for any damage caused by any virus transmitted by this email.
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From rossjanv at fuse.net  Mon Jul 13 13:30:15 2009
From: rossjanv at fuse.net (Janet V. Ross)
Date: Mon, 13 Jul 2009 16:30:15 -0400
Subject: [Cnm] Allergy Power point for tray line/hostess staff
In-Reply-To: <0AB0670D124B96418F1D6AAFB11D5C310126C77A@SFH15110MV23.sfhad.stfranciscare.org>
Message-ID: 

Shared on the list a while back. Might be of use.

Janet V. Ross, MBA, RD, LD

rossjanv at fuse.net

4615 Joana Pl

Cincinnati, OH 45238

513-478-0135

http://www.linkedin.com/in/rossjanv

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Rassekh, Shoreh
Sent: Monday, July 13, 2009 3:05 PM
To: MARTHA ELLINGTON; cnm at lists.my180.net
Subject: Re: [Cnm] Allergy Power point for tray line/hostess staff

I am interested as well.

Shoreh

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of MARTHA ELLINGTON
Sent: Monday, July 13, 2009 2:01 PM
To: cnm at lists.my180.net
Subject: [Cnm] Allergy Power point for tray line/hostess staff

Does any one have a presentation they have used that is for kitchen/ tray
line staff on the importance of honoring food allergies.  

Thanks for your help.

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

----------------------------------------------------------------------------
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individual 
or entity to whom it is addressed and may contain confidential and/or
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Any unauthorized review, use, copying, disclosure, or distribution of this 
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From mdoyle1 at tuftsmedicalcenter.org  Tue Jul 14 03:58:29 2009
From: mdoyle1 at tuftsmedicalcenter.org (Marcia Doyle)
Date: Tue, 14 Jul 2009 10:58:29 +0000
Subject: [Cnm] Hand hygiene for the patients
In-Reply-To: <20090714061258.K181L.1767124.root@mp06>
References: <20090714061258.K181L.1767124.root@mp06>
Message-ID: <158219980-1247569027-cardhu_decombobulator_blackberry.rim.net-1553051484-@bxe1073.bisx.prod.on.blackberry>

I remember using pkgs of wipes on patient trays in the 1970s.(Yes,we did have them years ago) One of my patients opened the pkg and put it in her hot water,thinking it was a tea bag!! Just food for thought!
Sent from my Verizon Wireless BlackBerry

-----Original Message-----
From: 

Date: Tue, 14 Jul 2009 6:12:58 
To: Christine Schwartz; 
Subject: Re: [Cnm] Hand hygiene for the patients

We sent wipes on the trays for about 2 years.  When we needed to look at expense cuts we evaluated this practice and found most trays came down with the wipes not used.  We discontinued the practice.
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

---- Christine Schwartz  wrote: 
> 
> Do you provide any kind of hand wipe on patient meal trays so they can
> clean their hands before meals or is there another process to get patients
> involved in hand hygiene?  They are encouraged, if appropriate, to get to
> the bathroom and wash their hands, but we all know it is insufficient.
> Nursing is asking us to get the individual packages of hand wipes to put on
> the trays, which actually sounds like a pretty good idea IF the patients
> actually use them and can open the packaging.  The push is related to TJC's
> Nat'l Patient Safety Goals and getting patients more involved.
> 
> I look forward to your feedback.  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

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

From Suzanne_Mach at CHS.net  Thu Jul 16 05:44:05 2009
From: Suzanne_Mach at CHS.net (Suzanne_Mach at CHS.net)
Date: Thu, 16 Jul 2009 08:44:05 -0400
Subject: [Cnm] NSF approved food storage containers
Message-ID: 

Do all food storage containers used for patient service, including storage 
containers used in nourishment rooms on the hospital floors for holding 
snacks,  have to be NSF approved?  If yes, where does one find this 
regulation?
We are in the process of updating our snack lists and are wishing to 
purchase new containers for holding these items.  The current containers 
are not NSF approved.
Thank you.

Suzanne Mach, MS, RD
Assistant Director of Patient Services 
Clinical Nutrition Manager
Southside Regional Medical Center
200 Medical Park BLVD.
Petersburg, VA 23805
Office:  804-765-5178 
Email:  suzanne_mach at chs.net

--------------------------------------------------------------------------
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From Heberle-Heather at aramark.com  Thu Jul 16 06:55:40 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Thu, 16 Jul 2009 08:55:40 -0500
Subject: [Cnm] CHF recommendations
In-Reply-To: 
References: 
Message-ID: 

No.  The sodium level is low due to the excess fluid on the patient, so the sodium in the blood is diluted.  By putting the patient on a sodium restriction, you are decreasing the fluid the body holds on too and the sodium level will in turn start to increase.

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 7/15/09 6:21 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 32, Issue 56

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. CHF recommendations (Julayne Ross)
   2. colon resection (Julayne Ross)
   3. TJC (Peters Valerie - Charleston)
   4. Rhabdomyelitis (Stoner-Davis Keri)
   5. Re: TJC (Julie McLaughlin)
   6. Nutrition program for Freshmen (Julayne Ross)
   7. Re: Allergy Power point for tray line/hostess staff
      (Lisa Dalgleish)

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

Message: 1
Date: Wed, 15 Jul 2009 15:12:15 -0400
From: "Julayne Ross" 
Subject: [Cnm] CHF recommendations
To: 
Message-ID:
	<10DE3A7624A2BD48B81AFE4E90A5094D0220B049 at EX1.jaycountyhospital.com>
Content-Type: text/plain; charset="us-ascii"

When someone has CHF but serum sodium is low... do you wait till sodium
normalizes before recommending a sodium restriction?

TIA
JRoss

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

Message: 2
Date: Wed, 15 Jul 2009 15:19:14 -0400
From: "Julayne Ross" 
Subject: [Cnm] colon resection
To: 
Message-ID:
	<10DE3A7624A2BD48B81AFE4E90A5094D0220B04C at EX1.jaycountyhospital.com>
Content-Type: text/plain; charset="us-ascii"

I feel like I might be missing something I should be doing... partially
due to a lack of time.  But when we have a colon resection... the Dr.
starts them on liquids when ready and they progress the diet working
with the nurse on patient's tolerance.  I usually don't make any
recommendations...unless it involves diverticulitis...etc.

Anyone doing anything different?

Thanks ~

Julayne

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

Message: 3
Date: Wed, 15 Jul 2009 14:48:35 -0500
From: Peters Valerie - Charleston 
Subject: [Cnm] TJC
To: "cnm at lists.my180.net" 
Message-ID:
	<0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88F5DFF5 at NADCWPMSGCMS10.hca.corpad.net>

Content-Type: text/plain; charset="us-ascii"

Hi all-
  If anyone has any hospital wide conversations/questions from recent JCAHO inspections please forward.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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

Message: 4
Date: Wed, 15 Jul 2009 15:00:09 -0500
From: Stoner-Davis Keri 
Subject: [Cnm] Rhabdomyelitis
To: "cnm at lists.my180.net" 
Message-ID:
	<5E0556AC846DFB4ABB636C8497BF5015746C505F7E at FWDCWPMSGCMS05.hca.corpad.net>

Content-Type: text/plain; charset="us-ascii"

Does anyone have any good resources on nutritional care and intervention in Rhabdo?

Incr calorie needs? Need for restricted protein? Need for K or Phos restriction? Are there nutritional standards of care or references on nutritional care for Rhabdo? Thanks.

Keri Stoner-Davis MS, RD/LD
Lead Clinical Dietitian
Medical Center of Lewisville
500 West Main Street
Lewisville, TX 75057-3699
Office: (972) 219-5113
Fax: (972) 219-6777
Keri.Davis at hcahealthcare.com

This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.
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------------------------------

Message: 5
Date: Wed, 15 Jul 2009 16:18:40 -0400
From: Julie McLaughlin 
Subject: Re: [Cnm] TJC
To: , CNM List Serve

Message-ID: 
Content-Type: text/plain; charset="iso-8859-1"

They are at our facility right now!  I will give more detail next week, but for right now, they have involved nutrition quite a bit.

They have requested the RD at every unit visit.

The first day, they asked the RD about why she had not seen a particular pt. (They had not met any of our screening criteria and we had not received any consults).  The RD explained the nursing initial nutrition screen and our screening criteria.  She then asked about time frames for seeing pts.  2 RDs have been asked this same info.

We have one surveyor who sits the whole team down and then reviews the chart page by page.  We are mostly paper charting except for nursing, MAR, lab.  When looking at a pt in PICU, he asked the RD, "has this pt always been underweight?"  The pt was a chronically ill pt, so she explained yes, and what she was doing for him.  This same surveyor is also very particular with refrigerators and asked the RD if we followed the National Food Code 1999.  She said, "yes, we do!"  ????!!  I looked after the fact at the 2005 recs and it's just regular food about refrigerator temps, holding, cooling/reheating, etc. 

They have asked our traypasser to locate the fire ext on her unit and then what would she do in case of a fire.

They asked to see the RD worksheets and while looking at them, saw the notes that the RDs type to each other in CBORD about making a recommendation.  She then asked about how often the physician's take our recs and what do we do if they don't.

She also asked us to find a pt on a renal or fluid restricted diet.  She spoke with the pt, reviewed the record and then came to the diet office to see how we receive orders, modify menus (everything is automated), prepare trays.  She asked how we ensure accuracy of trays.  She asked, with the automated system, does it ever get confused with complicated diets and not know what to give.  She also if the traypassers were involved in documenting or communicating meal consumption.

More to come!

Julie McLaughlin, RD, LD/N
Assistant Director, Patient Services
Broward General Medical Center
Ft. Lauderdale, FL 33316

From: Valerie.Peters1 at hcahealthcare.com
To: cnm at lists.my180.net
Date: Wed, 15 Jul 2009 14:48:35 -0500
Subject: [Cnm] TJC

Hi all-
  If anyone has any hospital wide conversations/questions from recent JCAHO inspections please forward.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well. 
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

_________________________________________________________________
Insert movie times and more without leaving Hotmail?. 
http://windowslive.com/Tutorial/Hotmail/QuickAdd?ocid=TXT_TAGLM_WL_HM_Tutorial_QuickAdd_062009
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------------------------------

Message: 6
Date: Wed, 15 Jul 2009 16:58:29 -0400
From: "Julayne Ross" 
Subject: [Cnm] Nutrition program for Freshmen
To: 
Message-ID:
	<10DE3A7624A2BD48B81AFE4E90A5094D0220B083 at EX1.jaycountyhospital.com>
Content-Type: text/plain; charset="us-ascii"

Our hospital foundation is going to raise money for a group (Childhood
obesity task force) to use in the schools.  We are going to target
Freshmen...our local high school has a freshman academy.

Does anyone have any kind of curriculum for nutrition/health ...anything
at all that would be an idea for me?

Or any ideas of programs, books...etc that would be helpful?

Anyone heard of Jean Bladyes-Madigan who started Smart Moves?

Thanks,

Julayne

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Message: 7
Date: Tue, 14 Jul 2009 08:34:54 -0400
From: "Lisa Dalgleish" 
Subject: Re: [Cnm] Allergy Power point for tray line/hostess staff
To: , "Shoreh Rassekh"
	,	"MARTHA ELLINGTON"

Message-ID: <4A5C430F.DF60.000C.0 at lakelandregional.org>
Content-Type: text/plain; charset="us-ascii"

Here is a food allergy presentation we prepared for schools.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> "Rassekh, Shoreh"  7/13/2009 3:04 PM >>>
I am interested as well.

Shoreh

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of MARTHA ELLINGTON
Sent: Monday, July 13, 2009 2:01 PM
To: cnm at lists.my180.net 
Subject: [Cnm] Allergy Power point for tray line/hostess staff

Does any one have a presentation they have used that is for kitchen/ tray line staff on the importance of honoring food allergies.  
Thanks for your help.
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

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End of Cnm Digest, Vol 32, Issue 56
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From fynan-carla at CooperHealth.edu  Thu Jul 16 10:20:35 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Thu, 16 Jul 2009 13:20:35 -0400
Subject: [Cnm] billing for consults in ER
Message-ID: <77F33794DD223B40BF24AB3D3793025019931F2049@mxmbx01.chsmail.root.cooperhealth.edu>

Good Afternoon!

I got an email from our finance department that inpatient RD's are charging for consults completed in the Emergency Department and this is not allowed because the patient is not "inpatient" status.  We get a couple a week.

Has anyone ever had to deal with this?

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.
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From Maureen.McAndrews at emoryhealthcare.org  Thu Jul 16 10:50:40 2009
From: Maureen.McAndrews at emoryhealthcare.org (McAndrews, Maureen)
Date: Thu, 16 Jul 2009 13:50:40 -0400
Subject: [Cnm] billing for consults in ER
In-Reply-To: <77F33794DD223B40BF24AB3D3793025019931F2049@mxmbx01.chsmail.root.cooperhealth.edu>
References: <77F33794DD223B40BF24AB3D3793025019931F2049@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: 

We stopped charging at all over ten years ago at the direction of our CFO.
Maureen

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Fynan, Carla
Sent: Thursday, July 16, 2009 1:21 PM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] billing for consults in ER

Good Afternoon!

I got an email from our finance department that inpatient RD's are charging for consults completed in the Emergency Department and this is not allowed because the patient is not "inpatient" status.  We get a couple a week.

Has anyone ever had to deal with this?

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.

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From cathysmith at mhsjvl.org  Thu Jul 16 11:23:50 2009
From: cathysmith at mhsjvl.org (Smith, Cathy)
Date: Thu, 16 Jul 2009 13:23:50 -0500
Subject: [Cnm] billing for consults in ER
References: <77F33794DD223B40BF24AB3D3793025019931F2049@mxmbx01.chsmail.root.cooperhealth.edu>
Message-ID: <4973FD77BA585043AC3C49ED6D7B9F8302E22F26@MXV1.mercy.org>

We charge ours using outpatient codes.  We do the same for endoscopy & other depts like that that are housed in the hospital complex.
Cathy

________________________________

From: cnm-bounces at lists.my180.net on behalf of Fynan, Carla
Sent: Thu 7/16/2009 12:20 PM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] billing for consults in ER

Good Afternoon!

I got an email from our finance department that inpatient RD's are charging for consults completed in the Emergency Department and this is not allowed because the patient is not "inpatient" status.  We get a couple a week.

Has anyone ever had to deal with this?

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. 
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From Sandra.Moretz at tiftregional.com  Thu Jul 16 10:58:52 2009
From: Sandra.Moretz at tiftregional.com (Sandra Moretz)
Date: Thu, 16 Jul 2009 13:58:52 -0400
Subject: [Cnm] billing for consults in ER
In-Reply-To: 
References: <77F33794DD223B40BF24AB3D3793025019931F2049@mxmbx01.chsmail.root.cooperhealth.edu>

Message-ID: <4F21268C197FF8408219D0D6B7614AEE0331F4C145@EXCHANGE2.trmc.us>

Same here; no inpatient charges at all - something about Medicare not allowing it maybe because it's considered part of their room and board??
Sandra

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of McAndrews, Maureen
Sent: Thursday, July 16, 2009 1:51 PM
To: 'Fynan, Carla'; CNM Mailing List (Cnm at lists.my180.net)
Subject: Re: [Cnm] billing for consults in ER

We stopped charging at all over ten years ago at the direction of our CFO.
Maureen

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Fynan, Carla
Sent: Thursday, July 16, 2009 1:21 PM
To: CNM Mailing List (Cnm at lists.my180.net)
Subject: [Cnm] billing for consults in ER

Good Afternoon!

I got an email from our finance department that inpatient RD's are charging for consults completed in the Emergency Department and this is not allowed because the patient is not "inpatient" status.  We get a couple a week.

Has anyone ever had to deal with this?

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.

________________________________
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From fynan-carla at CooperHealth.edu  Thu Jul 16 12:02:38 2009
From: fynan-carla at CooperHealth.edu (Fynan, Carla)
Date: Thu, 16 Jul 2009 15:02:38 -0400
Subject: [Cnm] Epic and CBORD
Message-ID: <77F33794DD223B40BF24AB3D3793025019931F2311@mxmbx01.chsmail.root.cooperhealth.edu>

Happy Thursday!

Is there anyone out there that has Epic and went from CBORD DOS to Windows?

Please respond to me and I will call you at your convenience.

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.
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From Valerie.Peters1 at hcahealthcare.com  Thu Jul 16 12:32:08 2009
From: Valerie.Peters1 at hcahealthcare.com (Peters Valerie - Charleston)
Date: Thu, 16 Jul 2009 14:32:08 -0500
Subject: [Cnm] Food Drug
Message-ID: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88FB6C78@NADCWPMSGCMS10.hca.corpad.net>

Hi all,

   I am  looking for a policy where food/drug interaction originates from the Pharmacy and then can be dispensed to the floor in a timely fashion.  If anyone has something they can share :)

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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From dianac226 at aol.com  Thu Jul 16 13:31:02 2009
From: dianac226 at aol.com (dianac226 at aol.com)
Date: Thu, 16 Jul 2009 16:31:02 -0400
Subject: [Cnm] Dietary aides and Dishroom
Message-ID: <8CBD46B78BA77DB-1764-44@webmail-dx16.sysops.aol.com>

Hi All,

We are working on changing our meal service system. The new system will 
winvolve the dietary aides who assemble trays and deliver them to work 
in the dishroom scraping and loading dirty dishes or removing clean 
ones from the machine.  Does any other facilitie do this?  Are there 
any infeciton control issues.  I was under the impression that as long 
as you don't load the dirty and take off the clean dishes during the 
same meal period.

Any advice or if you could share how your facility handles washing the 
serviceware would be very helpful!

Thanks in Advance
Diana

From Virginia.Carney at STJUDE.ORG  Thu Jul 16 15:10:28 2009
From: Virginia.Carney at STJUDE.ORG (Carney, Virginia H)
Date: Thu, 16 Jul 2009 17:10:28 -0500
Subject: [Cnm] FW: [aspenet] Advantage to implementing NCP
Message-ID: <6EAE916704479E4BB6AB5A133BA224F7151F0B92DA@SJMEMXMBS11.stjude.sjcrh.local>

-----Original Message-----
From: Jennings, Carol [mailto:Carol.Jennings at AHSS.ORG]
Sent: Thursday, July 16, 2009 2:34 PM
To: ASPENet
Subject: RE: [aspenet] Advantage to implementing NCP

You are preaching to the choir!!!

Thanks for putting it so well.

Carol Jennings, MPH, RD, LD

-----Original Message-----
From: JRCF [mailto:jeray31 at comcast.net]
Sent: Tuesday, July 14, 2009 7:02 PM
To: ASPENet
Subject: Re: [aspenet] Advantage to implementing NCP

Totally Agree with you Charlie.

CF, RD, CNSD
----- Original Message -----
From: "Charles M. Mueller, PhD" 
To: "ASPENet" 
Sent: Tuesday, July 14, 2009 2:06 PM
Subject: Re: [aspenet] Advantage to implementing NCP

>I hear you Barb. The ADA NCP is an artificial construct intended with
the
>best intentions for and by dietitians. But since the diagnoses and
other
>constructs have minimal evidence based basis, the whole exercise  is
>anathma to other professionals.
>
> Very self serving professional construct which as per my previous note

> has no academic or scientific validity.
>
> I believe it is a major setback for RDs.
>
> Charlie Mueller
> From my IPhone
>
> On Jul 14, 2009, at 1:54 PM, Barbara Corey
 > wrote:
>
>> I come at this from a different perspective. I have been in nutrition
>> support for over 25 years. I am currently in home care. I often have
to
>> rely on hospital RD notes (among other clinical documentation) to
"paint
>> a picture" of the patient in order to develop a plan. I also
frequently
>> need this documentation for insurance coverage.
>>
>> With that said, I have to say I get very little useful information
from
>> RD notes anymore. I get referrals from many hospitals so the problem
is
>> not just how one group is documenting. What is in the notes is
>> non-specific. I don't want to know  "alteration in body weight, less
>> than ideal". I want and need to know that 'pt Jane Smith has
>> unintentionally lost 25# over a period of 6 weeks due to early
satiety,
>> not improved with eating several small meals or by a trial with
Reglan'
>> Documentation is meant to communicate with other professionals in
order
>> to deliver efficient care. It is great if you can somehow collect
>> outcome data but not at the expense of effective communication.
>>
>> RDs have much to add to the care delivery team. During years of
working
>> in teaching hospitals, I was always proud when another health
>> professional would say "I always read the dietitian's notes because I
>> learn so much from it" or "because you guys really know what's going
on
>> with the patient."  It is true. We do know a lot about our patients.
I'm
>> not sure the diagnosis driven documentation reflects this.  In these
>> days of cost cutting and budget constraints everyone is looking at
the
>> "value added" factor. This is what worries me when I see some of the
>> current documentation. I don't see the value added.
>>
>> Just my two cents. I'll get off my soapbox now.
>>
>> Barb Corey RD CNSC LPN
>>
>> -----Original Message-----
>> From: Best, Kathleen A. [mailto:Kathleen.Best at UHhospitals.org]
>> Sent: Tuesday, July 14, 2009 12:53 PM
>> To: ASPENet
>> Subject: RE: [aspenet] Advantage to implementing NCP
>>
>> We've implemented "our version" of it (dropped the PES statement, use
>> the diagnoses, include relevant data to support dx but in our own
>> format). None of our staff cares for using the diagnoses even with
the
>> modifications regarding the statement, but we have adopted them
>> primarily because we have an internship & understand NCP is part of
the
>> curriculum & is included (although I do not know to what degree) on
the
>> registration exam.
>>
>> Part of the problem with the diagnoses is they have a generic feel to
>> them. I prefer to be specific. "Hyperglycemia" instead of "altered
>> nutrition related labs".......the PES statement is designed to
include
>> the specifics, but I find that I would then have to use superfluous
>> words to describe what's going on - I like to get to the point as I
am a
>> busy dietitian, as most of us are! We have tried to make sure our
>> assessment is a discussion of the specifics that are relevant to our
>> conclusions & interventions beyond just documenting the nutrition
>> diagnosis.
>>
>>
>> My opinion regarding the interns using it: Some do fine, but some
get so
>> caught up in choosing the "correct" diagnosis & formulating a PES
>> statement (which comes off like poor grammar) that they miss the big
>> picture. They use it as a crutch for charting instead of using their
>> heads to construct a note which reflects their thoughts. Granted the
>> problem may very well be the intern & not the process. It may be pure
>> coincidence, but we have had multiple interns that have had serious
>> issues with critical thinking since the initiation of this, & there
have
>> been times where I wish I could yank NCP out of their heads because I
>> felt it was actually a barrier. Too much focus on "selecting the
right
>> thought" from the list:)
>>
>> My two cents....
>>
>> Kathleen Best RD,LD,CNSD
>> Clinical Dietitian
>> University Hospitals Case Medical Center
>> (216) 844-2324
>> pager 32003
>> -----Original Message-----
>> From: amusa at slrh.net [mailto:amusa at slrh.net]
>> Sent: Tuesday, July 14, 2009 10:22 AM
>> To: ASPENet
>> Subject: [aspenet] Advantage to implementing NCP
>>
>> Has hospitals that have implemented NCP seen any benefits?
advantages? I
>> greatly appreciate your help!!!! I am not convinced that NCP is the
way
>> (I have read all the pertaining articles) to go and if you have any
data
>> for pros and cons I will be grateful!
>>
>> Thanks
>> ---
>> To manage your listserv settings, click here:
>> http://lists.nutritioncare.org:81/read/?forum=aspenet
>>
>> You are currently subscribed to aspenet as:
>> kathleen.best at uhhospitals.org.
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>> or send a blank email to leave-135438-11290P at lists.nutritioncare.org
>>
>>
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>>
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From pcharney at mac.com  Thu Jul 16 15:23:39 2009
From: pcharney at mac.com (Pam Charney)
Date: Thu, 16 Jul 2009 15:23:39 -0700
Subject: [Cnm] FW: [aspenet] Advantage to implementing NCP
In-Reply-To: <6EAE916704479E4BB6AB5A133BA224F7151F0B92DA@SJMEMXMBS11.stjude.sjcrh.local>
References: <6EAE916704479E4BB6AB5A133BA224F7151F0B92DA@SJMEMXMBS11.stjude.sjcrh.local>
Message-ID: <98BA8040-4FA9-4681-9158-F6389E19211D@mac.com>

All care processes can be thought of as artificial constructs if you  
want. However, we all use some sort of process when approaching  
patient care. We all have a framework for thinking through each case,  
and the experienced clinician, knowingly or not, will use the same  
thought process each time. That's all that a care process is. Every  
health profession has one or more.

The dietetics terminology is not a part of the NCP. It is simply a  
clinical terminology that can be used by those in clinical settings to  
describe the work they do using terms that have been defined in a  
standardized manner. All healthcare terminologies are "artificial", as  
is any word that we use to describe a concept in nature. We can get  
very, very philosophical regarding language and terminology  
development, but what we're really trying to do is name what we see  
and do in a consistent and agreed upon manner.

Documentation methods are also not part of the NCP. One might decide  
to document care using a particular method with the thought that the  
method "supports" the NCP, but we have no data to prove or disprove  
that hypothesis.

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
http://www.linkedin.com/in/pamcharney

"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jul 16, 2009, at 3:10 PM, Carney, Virginia H wrote:

> -----Original Message-----
> From: Jennings, Carol [mailto:Carol.Jennings at AHSS.ORG]
> Sent: Thursday, July 16, 2009 2:34 PM
> To: ASPENet
> Subject: RE: [aspenet] Advantage to implementing NCP
>
> You are preaching to the choir!!!
>
> Thanks for putting it so well.
>
>
> Carol Jennings, MPH, RD, LD
>
> -----Original Message-----
> From: JRCF [mailto:jeray31 at comcast.net]
> Sent: Tuesday, July 14, 2009 7:02 PM
> To: ASPENet
> Subject: Re: [aspenet] Advantage to implementing NCP
>
> Totally Agree with you Charlie.
>
> CF, RD, CNSD
> ----- Original Message -----
> From: "Charles M. Mueller, PhD" 
> To: "ASPENet" 
> Sent: Tuesday, July 14, 2009 2:06 PM
> Subject: Re: [aspenet] Advantage to implementing NCP
>
>
>> I hear you Barb. The ADA NCP is an artificial construct intended with
> the
>> best intentions for and by dietitians. But since the diagnoses and
> other
>> constructs have minimal evidence based basis, the whole exercise  is
>> anathma to other professionals.
>>
>> Very self serving professional construct which as per my previous  
>> note
>
>> has no academic or scientific validity.
>>
>> I believe it is a major setback for RDs.
>>
>> Charlie Mueller
>> From my IPhone
>>
>> On Jul 14, 2009, at 1:54 PM, Barbara Corey
> >> wrote:
>>
>>> I come at this from a different perspective. I have been in  
>>> nutrition
>>> support for over 25 years. I am currently in home care. I often have
> to
>>> rely on hospital RD notes (among other clinical documentation) to
> "paint
>>> a picture" of the patient in order to develop a plan. I also
> frequently
>>> need this documentation for insurance coverage.
>>>
>>> With that said, I have to say I get very little useful information
> from
>>> RD notes anymore. I get referrals from many hospitals so the problem
> is
>>> not just how one group is documenting. What is in the notes is
>>> non-specific. I don't want to know  "alteration in body weight, less
>>> than ideal". I want and need to know that 'pt Jane Smith has
>>> unintentionally lost 25# over a period of 6 weeks due to early
> satiety,
>>> not improved with eating several small meals or by a trial with
> Reglan'
>>> Documentation is meant to communicate with other professionals in
> order
>>> to deliver efficient care. It is great if you can somehow collect
>>> outcome data but not at the expense of effective communication.
>>>
>>> RDs have much to add to the care delivery team. During years of
> working
>>> in teaching hospitals, I was always proud when another health
>>> professional would say "I always read the dietitian's notes  
>>> because I
>>> learn so much from it" or "because you guys really know what's going
> on
>>> with the patient."  It is true. We do know a lot about our patients.
> I'm
>>> not sure the diagnosis driven documentation reflects this.  In these
>>> days of cost cutting and budget constraints everyone is looking at
> the
>>> "value added" factor. This is what worries me when I see some of the
>>> current documentation. I don't see the value added.
>>>
>>> Just my two cents. I'll get off my soapbox now.
>>>
>>> Barb Corey RD CNSC LPN
>>>
>>> -----Original Message-----
>>> From: Best, Kathleen A. [mailto:Kathleen.Best at UHhospitals.org]
>>> Sent: Tuesday, July 14, 2009 12:53 PM
>>> To: ASPENet
>>> Subject: RE: [aspenet] Advantage to implementing NCP
>>>
>>> We've implemented "our version" of it (dropped the PES statement,  
>>> use
>>> the diagnoses, include relevant data to support dx but in our own
>>> format). None of our staff cares for using the diagnoses even with
> the
>>> modifications regarding the statement, but we have adopted them
>>> primarily because we have an internship & understand NCP is part of
> the
>>> curriculum & is included (although I do not know to what degree) on
> the
>>> registration exam.
>>>
>>> Part of the problem with the diagnoses is they have a generic feel  
>>> to
>>> them. I prefer to be specific. "Hyperglycemia" instead of "altered
>>> nutrition related labs".......the PES statement is designed to
> include
>>> the specifics, but I find that I would then have to use superfluous
>>> words to describe what's going on - I like to get to the point as I
> am a
>>> busy dietitian, as most of us are! We have tried to make sure our
>>> assessment is a discussion of the specifics that are relevant to our
>>> conclusions & interventions beyond just documenting the nutrition
>>> diagnosis.
>>>
>>>
>>> My opinion regarding the interns using it: Some do fine, but some
> get so
>>> caught up in choosing the "correct" diagnosis & formulating a PES
>>> statement (which comes off like poor grammar) that they miss the big
>>> picture. They use it as a crutch for charting instead of using their
>>> heads to construct a note which reflects their thoughts. Granted the
>>> problem may very well be the intern & not the process. It may be  
>>> pure
>>> coincidence, but we have had multiple interns that have had serious
>>> issues with critical thinking since the initiation of this, & there
> have
>>> been times where I wish I could yank NCP out of their heads  
>>> because I
>>> felt it was actually a barrier. Too much focus on "selecting the
> right
>>> thought" from the list:)
>>>
>>> My two cents....
>>>
>>> Kathleen Best RD,LD,CNSD
>>> Clinical Dietitian
>>> University Hospitals Case Medical Center
>>> (216) 844-2324
>>> pager 32003
>>> -----Original Message-----
>>> From: amusa at slrh.net [mailto:amusa at slrh.net]
>>> Sent: Tuesday, July 14, 2009 10:22 AM
>>> To: ASPENet
>>> Subject: [aspenet] Advantage to implementing NCP
>>>
>>> Has hospitals that have implemented NCP seen any benefits?
> advantages? I
>>> greatly appreciate your help!!!! I am not convinced that NCP is the
> way
>>> (I have read all the pertaining articles) to go and if you have any
> data
>>> for pros and cons I will be grateful!
>>>
>>> Thanks
>>> ---
>>> To manage your listserv settings, click here:
>>> http://lists.nutritioncare.org:81/read/?forum=aspenet
>>>
>>> You are currently subscribed to aspenet as:
>>> kathleen.best at uhhospitals.org.
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>>> http://lists.nutritioncare.org:81/u?id=11290P&n=T&l=aspenet&o=135438
>>> or send a blank email to leave-135438-11290P at lists.nutritioncare.org
>>>
>>>
>>> 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
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>>> Federal regulation (42 CFR Part 2) and Ohio Revised Code section
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>>> and 3701.243 prohibit disclosure of this information without the
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>>> To manage your listserv settings, click here:
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>>>
>>> You are currently subscribed to aspenet as:  
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>>
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>
>
> ---
> To manage your listserv settings, click here:
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> You are currently subscribed to aspenet as: carol.jennings at ahss.org.
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From LDALGLEISH at lakelandregional.org  Fri Jul 17 06:25:44 2009
From: LDALGLEISH at lakelandregional.org (Lisa Dalgleish)
Date: Fri, 17 Jul 2009 09:25:44 -0400
Subject: [Cnm] Dietary aides and Dishroom
In-Reply-To: <8CBD46B78BA77DB-1764-44@webmail-dx16.sysops.aol.com>
References: <8CBD46B78BA77DB-1764-44@webmail-dx16.sysops.aol.com>
Message-ID: <4A604378.DF60.000C.0@lakelandregional.org>

Our staff flexes in this way also.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>>  7/16/2009 4:31 PM >>>
Hi All,

We are working on changing our meal service system. The new system will 
winvolve the dietary aides who assemble trays and deliver them to work 
in the dishroom scraping and loading dirty dishes or removing clean 
ones from the machine.  Does any other facilitie do this?  Are there 
any infeciton control issues.  I was under the impression that as long 
as you don't load the dirty and take off the clean dishes during the 
same meal period.

Any advice or if you could share how your facility handles washing the 
serviceware would be very helpful!

Thanks in Advance
Diana

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
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From julie.mclaughlin at hotmail.com  Fri Jul 17 07:53:19 2009
From: julie.mclaughlin at hotmail.com (Julie McLaughlin)
Date: Fri, 17 Jul 2009 10:53:19 -0400
Subject: [Cnm] TJC
In-Reply-To: 
References: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F88F5DFF5@NADCWPMSGCMS10.hca.corpad.net>

Message-ID: 

During the employee file review yesterday, the surveyor looked at licensure and registration online verification, competencies, annual TB test and then asked to see proof of recent CEU or training hours in something specific to the clinicians' area of coverage.

She did not consider recent hospital required training topics on medication errors or anticoag tx applicable or attendance at Trauma Grand Rounds.  This RD had not had any CEUs logged since 2007.  I did not say this to the surveyor, I just stated that RDs need to complete 75 CEUs every 5 years and they log the info on the ADA site.  Funny as I have had many discussions about this employee and her clinical requirements with HR recently.  She covers CCU, CVICU and a telemetry floor.  I had heard the buzz on this listserv that the question of training specific to the clinicians' area of coverage has come up multiple times.  Don't know what TJC will end up saying about this...

Julie McLaughlin, RD, LD/N
Assistant Director, Patient Services
Broward General Medical Center
Ft. Lauderdale, FL 33316

From: julie.mclaughlin at hotmail.com
To: valerie.peters1 at hcahealthcare.com; cnm at lists.my180.net
Date: Wed, 15 Jul 2009 16:18:40 -0400
Subject: Re: [Cnm] TJC

They are at our facility right now!  I will give more detail next week, but for right now, they have involved nutrition quite a bit.

They have requested the RD at every unit visit.
The first day, they asked the RD about why she had not seen a particular pt. (They had not met any of our screening criteria and we had not received any consults).  The RD explained the nursing initial nutrition screen and our screening criteria.  She then asked about time frames for seeing pts.  2 RDs have been asked this same info.

We have one surveyor who sits the whole team down and then reviews the chart page by page.  We are mostly paper charting except for nursing, MAR, lab.  When looking at a pt in PICU, he asked the RD, "has this pt always been underweight?"  The pt was a chronically ill pt, so she explained yes, and what she was doing for him.  This same surveyor is also very particular with refrigerators and asked the RD if we followed the National Food Code 1999.  She said, "yes, we do!"  ????!!  I looked after the fact at the 2005 recs and it's just regular food about refrigerator temps, holding, cooling/reheating, etc. 

They have asked our traypasser to locate the fire ext on her unit and then what would she do in case of a fire.

They asked to see the RD worksheets and while looking at them, saw the notes that the RDs type to each other in CBORD about making a recommendation.  She then asked about how often the physician's take our recs and what do we do if they don't.

She also asked us to find a pt on a renal or fluid restricted diet.  She spoke with the pt, reviewed the record and then came to the diet office to see how we receive orders, modify menus (everything is automated), prepare trays.  She asked how we ensure accuracy of trays.  She asked, with the automated system, does it ever get confused with complicated diets and not know what to give.  She also if the traypassers were involved in documenting or communicating meal consumption.

More to come!

Julie McLaughlin, RD, LD/N
Assistant Director, Patient Services
Broward General Medical Center
Ft. Lauderdale, FL 33316

From: Valerie.Peters1 at hcahealthcare.com
To: cnm at lists.my180.net
Date: Wed, 15 Jul 2009 14:48:35 -0500
Subject: [Cnm] TJC

Hi all-
  If anyone has any hospital wide conversations/questions from recent JCAHO inspections please forward.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

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From fns at abbgen.net  Fri Jul 17 08:21:04 2009
From: fns at abbgen.net (Annette Doucet)
Date: Fri, 17 Jul 2009 10:21:04 -0500
Subject: [Cnm] Dietary aides and Dishroom
In-Reply-To: <4A604378.DF60.000C.0@lakelandregional.org>
References: <8CBD46B78BA77DB-1764-44@webmail-dx16.sysops.aol.com>
	<4A604378.DF60.000C.0@lakelandregional.org>
Message-ID: <001401ca06f2$34e11920$02be7878@local.abbgen.net>

We are a small hospital, JC-accredited,  and our aides have always assembled
and delivered trays as well as picking up soiled trays and scrapping, in
addition to removing clean dishes and putting them away.  The important
thing to do is to always appropriately wash their hands between clean and
dirty dishes.  We have a conveniently located lavatory for that purpose in
the dishroom.  The aides also wear disposable gloves when picking up soiled
trays and handling soiled dishware.  They still have to wash their hands
each time the gloves are removed.  

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Lisa Dalgleish
Sent: Friday, July 17, 2009 8:26 AM
To: dianac226 at aol.com; Cnm at lists.my180.net
Subject: Re: [Cnm] Dietary aides and Dishroom

Our staff flexes in this way also.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>>  7/16/2009 4:31 PM >>>
Hi All,

We are working on changing our meal service system. The new system will 
winvolve the dietary aides who assemble trays and deliver them to work 
in the dishroom scraping and loading dirty dishes or removing clean 
ones from the machine.  Does any other facilitie do this?  Are there 
any infeciton control issues.  I was under the impression that as long 
as you don't load the dirty and take off the clean dishes during the 
same meal period.

Any advice or if you could share how your facility handles washing the 
serviceware would be very helpful!

Thanks in Advance
Diana

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

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From SabaSassouni at IamMorrison.com  Fri Jul 17 12:43:04 2009
From: SabaSassouni at IamMorrison.com (Sassouni, Saba)
Date: Fri, 17 Jul 2009 15:43:04 -0400
Subject: [Cnm] Cnm Digest, Vol 32, Issue 61
References: 
Message-ID: 

It was brought to my attention that RD's are now not allowed to down grade diets because facilities were cited for that.  I never heard of this and was wondering if this is accurate.  Please let me know; DOH will be here any day now.  Thank you.

Saba Sassouni, MS, RD, CDN
Silvercrest Nursing & Rehab
718-480-4092 (office)
SabaSassouni at IamMorrison.com

________________________________

From: cnm-bounces at lists.my180.net on behalf of cnm-request at lists.my180.net
Sent: Fri 7/17/2009 3:00 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 32, Issue 61

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

To subscribe or unsubscribe via the World Wide Web, visit
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        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: Dietary aides and Dishroom (Lisa Dalgleish)
   2. Re: TJC (Julie McLaughlin)
   3. Re: Dietary aides and Dishroom (Annette Doucet)

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

Message: 1
Date: Fri, 17 Jul 2009 09:25:44 -0400
From: "Lisa Dalgleish" 
Subject: Re: [Cnm] Dietary aides and Dishroom
To: ,
Message-ID: <4A604378.DF60.000C.0 at lakelandregional.org>
Content-Type: text/plain; charset="us-ascii"

Our staff flexes in this way also.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>>  7/16/2009 4:31 PM >>>
Hi All,

We are working on changing our meal service system. The new system will
winvolve the dietary aides who assemble trays and deliver them to work
in the dishroom scraping and loading dirty dishes or removing clean
ones from the machine.  Does any other facilitie do this?  Are there
any infeciton control issues.  I was under the impression that as long
as you don't load the dirty and take off the clean dishes during the
same meal period.

Any advice or if you could share how your facility handles washing the
serviceware would be very helpful!

Thanks in Advance
Diana

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

Message: 2
Date: Fri, 17 Jul 2009 10:53:19 -0400
From: Julie McLaughlin 
Subject: Re: [Cnm] TJC
To: , CNM List Serve

Message-ID: 
Content-Type: text/plain; charset="windows-1252"

During the employee file review yesterday, the surveyor looked at licensure and registration online verification, competencies, annual TB test and then asked to see proof of recent CEU or training hours in something specific to the clinicians' area of coverage.

She did not consider recent hospital required training topics on medication errors or anticoag tx applicable or attendance at Trauma Grand Rounds.  This RD had not had any CEUs logged since 2007.  I did not say this to the surveyor, I just stated that RDs need to complete 75 CEUs every 5 years and they log the info on the ADA site.  Funny as I have had many discussions about this employee and her clinical requirements with HR recently.  She covers CCU, CVICU and a telemetry floor.  I had heard the buzz on this listserv that the question of training specific to the clinicians' area of coverage has come up multiple times.  Don't know what TJC will end up saying about this...

Julie McLaughlin, RD, LD/N
Assistant Director, Patient Services
Broward General Medical Center
Ft. Lauderdale, FL 33316

From: julie.mclaughlin at hotmail.com
To: valerie.peters1 at hcahealthcare.com; cnm at lists.my180.net
Date: Wed, 15 Jul 2009 16:18:40 -0400
Subject: Re: [Cnm] TJC

They are at our facility right now!  I will give more detail next week, but for right now, they have involved nutrition quite a bit.

They have requested the RD at every unit visit.
The first day, they asked the RD about why she had not seen a particular pt. (They had not met any of our screening criteria and we had not received any consults).  The RD explained the nursing initial nutrition screen and our screening criteria.  She then asked about time frames for seeing pts.  2 RDs have been asked this same info.

We have one surveyor who sits the whole team down and then reviews the chart page by page.  We are mostly paper charting except for nursing, MAR, lab.  When looking at a pt in PICU, he asked the RD, "has this pt always been underweight?"  The pt was a chronically ill pt, so she explained yes, and what she was doing for him.  This same surveyor is also very particular with refrigerators and asked the RD if we followed the National Food Code 1999.  She said, "yes, we do!"  ????!!  I looked after the fact at the 2005 recs and it's just regular food about refrigerator temps, holding, cooling/reheating, etc.

They have asked our traypasser to locate the fire ext on her unit and then what would she do in case of a fire.

They asked to see the RD worksheets and while looking at them, saw the notes that the RDs type to each other in CBORD about making a recommendation.  She then asked about how often the physician's take our recs and what do we do if they don't.

She also asked us to find a pt on a renal or fluid restricted diet.  She spoke with the pt, reviewed the record and then came to the diet office to see how we receive orders, modify menus (everything is automated), prepare trays.  She asked how we ensure accuracy of trays.  She asked, with the automated system, does it ever get confused with complicated diets and not know what to give.  She also if the traypassers were involved in documenting or communicating meal consumption.

More to come!

Julie McLaughlin, RD, LD/N
Assistant Director, Patient Services
Broward General Medical Center
Ft. Lauderdale, FL 33316

From: Valerie.Peters1 at hcahealthcare.com
To: cnm at lists.my180.net
Date: Wed, 15 Jul 2009 14:48:35 -0500
Subject: [Cnm] TJC

Hi all-
  If anyone has any hospital wide conversations/questions from recent JCAHO inspections please forward.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

 Life is a gift. Live it well.
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Message: 3
Date: Fri, 17 Jul 2009 10:21:04 -0500
From: "Annette Doucet" 
Subject: Re: [Cnm] Dietary aides and Dishroom
To: "'Lisa Dalgleish'" ,
        ,    
Message-ID: <001401ca06f2$34e11920$02be7878 at local.abbgen.net>
Content-Type: text/plain; charset="us-ascii"

We are a small hospital, JC-accredited,  and our aides have always assembled
and delivered trays as well as picking up soiled trays and scrapping, in
addition to removing clean dishes and putting them away.  The important
thing to do is to always appropriately wash their hands between clean and
dirty dishes.  We have a conveniently located lavatory for that purpose in
the dishroom.  The aides also wear disposable gloves when picking up soiled
trays and handling soiled dishware.  They still have to wash their hands
each time the gloves are removed. 

  _____ 

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Lisa Dalgleish
Sent: Friday, July 17, 2009 8:26 AM
To: dianac226 at aol.com; Cnm at lists.my180.net
Subject: Re: [Cnm] Dietary aides and Dishroom

Our staff flexes in this way also.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>>  7/16/2009 4:31 PM >>>
Hi All,

We are working on changing our meal service system. The new system will
winvolve the dietary aides who assemble trays and deliver them to work
in the dishroom scraping and loading dirty dishes or removing clean
ones from the machine.  Does any other facilitie do this?  Are there
any infeciton control issues.  I was under the impression that as long
as you don't load the dirty and take off the clean dishes during the
same meal period.

Any advice or if you could share how your facility handles washing the
serviceware would be very helpful!

Thanks in Advance
Diana

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

End of Cnm Digest, Vol 32, Issue 61
***********************************

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From Shannon.Jackson at wilmed.org  Fri Jul 17 14:02:57 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Fri, 17 Jul 2009 17:02:57 -0400
Subject: [Cnm] Clear Liquid Test Diets
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F498B@wmhcs03.wmh.org>

Hello,

What do others send for Clear Liquid Test Diets?
Any reason why sugar wouldn't be allowed.

Thanks
Shannon

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  

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From sdehoog at u.washington.edu  Fri Jul 17 14:36:03 2009
From: sdehoog at u.washington.edu (susan)
Date: Fri, 17 Jul 2009 14:36:03 -0700 (PDT)
Subject: [Cnm] web page
Message-ID: 

Hi all

We are in the process of designing a web page for clinical dietetics in our hospital.

If any of you have an existing web page, please advise and how I can look at it.  Looking for ideas.

thanks

susan

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 JEdwards at hfmhealth.org  Fri Jul 17 15:02:23 2009
From: JEdwards at hfmhealth.org (Jeanne Edwards)
Date: Fri, 17 Jul 2009 17:02:23 -0500
Subject: [Cnm] web page
In-Reply-To: 
Message-ID: <1E611D0D82010049A4E087DFA59CA442097D831E@holy1.hfmhealth.com>

This is easier than mailing
I am sending it as an attachment.
We have our hospital cafeteria menu listed
On another web page, but could be easily be listed
On here. 

Jeanne Edwards MS RD
Clinical Dietitian 
Holy Family Memorial 
Manitowoc, WI
jedwards at hfmhealth.org

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of susan
Sent: Friday, July 17, 2009 4:36 PM
To: clinical nutrition managers
Subject: [Cnm] web page

Hi all

We are in the process of designing a web page for clinical dietetics in
our hospital.

If any of you have an existing web page, please advise and how I can
look at it.  Looking for ideas.

thanks

susan

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

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Cnm at lists.my180.net
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From Psutor at emhc.org  Fri Jul 17 15:57:35 2009
From: Psutor at emhc.org (Pat Sutor)
Date: Fri, 17 Jul 2009 17:57:35 -0500
Subject: [Cnm] Malnutrition coding
Message-ID: <4A60BB8F.2064.0034.0@emhc.org>

Hi,
I have seen previous discussion on this list related to malnutrition coding but did not keep a folder, so now I need to ask again.
We are looking to purpose such a program to our VP's. My Director has asked if I could locate a site that has data on the revenue that was generated for your facility based upon implementing malnutrition coding.
If you have any data that you can share please let me know. We are having a meeting on Wed with 2 of our VP's. 
Thanks, Pat 
psutor at emhc.org 
630-833-1400,44911

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. 
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From DrNCollins at aol.com  Fri Jul 17 22:43:55 2009
From: DrNCollins at aol.com (DrNCollins at aol.com)
Date: Sat, 18 Jul 2009 01:43:55 EDT
Subject: [Cnm] First National Nutrition Benchmarking Event
Message-ID: 

The first annual nutritionDay in the U.S. is planned for  November 5, 2009. 
This event is the first annual single-day audit aimed at  improving patient 
care and helping to reduce healthcare costs by documenting  patient 
nourishment (and related outcomes) in hospitals across the country. In  addition to 
RD411.com, official partners for the event include ASPEN and ESPEN  
(European Society of Parenteral and Enteral Nutrition), and SCCM (Society for  
Critical Care Medicine).  
The U.S. event is patterned after ongoing nutritionDay in Europe  audits 
which, in 2008, involved more than 45,000 patients in nearly 1600 units  in 30 
countries. Each participating U.S. hospital will receive a report showing  
the current status of its unit compared with the same specialty in all  
participating units. Subsequent nutritionDay studies will enable participants to 
 identify successes resulting from improvements made. Don?t miss the 
opportunity  to participate in this important November 5th benchmarking 
initiative! If you  haven?t already, register your facility now. Contact nutritionDay 
in the U.S.  National Project Coordinator Gail Gewirtz, MS, RD at 
_nutritiondayus at ymail.com_ (mailto:nutritiondayus at ymail.com)  or 847-254-2034. 
Dr. Nancy  Collins, PhD, RD, LD/N, FAPWCA
President/Executive  Director
RD411.com, Inc. Where Healthcare Professionals Go for  Information
318 Indian Trace, Suite 126
Weston, FL 33326
Office:  954-349-2198
Fax: 954-349-2197
NCtheRD at aol.com
_www.RD411.com_ (http://www.rd411.com/) 

Follow me on  Twitter _www.twitter.com/RD411_ 
(http://www.twitter.com/RD411) 

**************Can love help you live longer? Find out now. 
(http://personals.aol.com/articles/2009/02/18/longer-lives-through-relationships/?ncid=emlweu
slove00000001)
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From mansishah79 at gmail.com  Sat Jul 18 10:18:03 2009
From: mansishah79 at gmail.com (Mansi Shah)
Date: Sat, 18 Jul 2009 10:18:03 -0700
Subject: [Cnm] FW: definition of refeeding syndrome
In-Reply-To: <402812FB7659469DA3738587DD39A672@ANNALYNN>
References: <402812FB7659469DA3738587DD39A672@ANNALYNN>
Message-ID: 

Annalynn,

Since refeeding is preventable, our efforts are always to identify risk for
refeeding and avoid it. So in my facility, we identify patients that are at
risk (prolonged NPO or inadequate intake, presence/type of IVF) and when
recommending start of nutrition support (especially TPN), the recommended
rate on 1st day is 50% of the final volume with close monitoring of Na, K,
Phos, Mg, adequate repletion and then increasing to goal.

We don't have any PI measures in place for incidence/prevelance of
refeeding, but if it were to be, we would measure potential risk using NPO
status and electroylte values prior to starting the feeding and then post
feeding.
We would also include whether pt was receiving IVF with/without dextrose
during the period prior to starting feeds. If adequate dextrose was
provided, risk of refeeding would ideally be less.

I am not sure if this is the answer you were looking for.

Mansi Shah, RD, CNSD
Clinical Nutrition Manager
Olympia Medical Center
Los Angeles, CA

On Fri, Jul 10, 2009 at 5:21 AM, Annalynn Skipper <
Annalynn_Skipper at comcast.net> wrote:

>  Does anyone use a clinically measurable definition of refeeding syndrome
> in their practice?  If so, I would be grateful if you could share that
> definition.  A related question is whether you measure the incidence and/or
> prevalence of refeeding syndrome in your practice/facility?
>
>
>
> Thanks and have a great weekend.
>
>
>
> 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.
>
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
>
>
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From eedwards at skmc.gov.ae  Sat Jul 18 21:48:05 2009
From: eedwards at skmc.gov.ae (Ellen Edwards)
Date: Sun, 19 Jul 2009 08:48:05 +0400
Subject: [Cnm] Physician led Nutrition Services Teams
Message-ID: <9A99F98786F9254597C0A0C62685FB5A08757AD0DF@AHA-MAIL.skmc.gov.ae>

Hello:
We are going to a facility wide nutrition services team that will be physician led. We have some concerns on the lack of information available for bench marking - if you have worked in this scenario, please provide information on how you set it up, how it worked - didn't work, what can you advise us for this set up. I do have the ASPEN guide on "Nutrition Support Teams: an anthology". However, the physicians are not working with our department yet and didn't want this guide. They are setting mission - vision etc independently.

Any feedback is welcome

Thank you

Ellen Edwards, RD LD
Head, Clinical Dietetics
Chief Clinical Dietitian
Sheikh Khalifa Medical City (SKMC)
Managed by Cleveland Clinic
P.O. Box 51900
Abu Dhabi, United Arab Emirates
Direct:  +971 2 610-2024
Fax:  +971 2 610-2577
Mobile:  +971 050-661-7297
Email: eedwards at skmc.gov.ae

________________________________
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From fns at abbgen.net  Mon Jul 20 07:25:12 2009
From: fns at abbgen.net (Annette Doucet)
Date: Mon, 20 Jul 2009 09:25:12 -0500
Subject: [Cnm] Hand hygiene for the patients
In-Reply-To: 
References: 
Message-ID: <000101ca0945$e590b5a0$02be7878@local.abbgen.net>

We do provide one hand sanitizer on each meal tray. The dietary worker
delivering the tray tells the pt there is one and offers to open it, if it
is an elderly pt.  We have many pts who would struggle to open the
individually wrapped hand wipe.  Most of our pts are using it.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Christine Schwartz
Sent: Monday, July 13, 2009 3:19 PM
To: cnm at lists.my180.net
Subject: [Cnm] Hand hygiene for the patients

Do you provide any kind of hand wipe on patient meal trays so they can clean
their hands before meals or is there another process to get patients
involved in hand hygiene?  They are encouraged, if appropriate, to get to
the bathroom and wash their hands, but we all know it is insufficient.
Nursing is asking us to get the individual packages of hand wipes to put on
the trays, which actually sounds like a pretty good idea IF the patients
actually use them and can open the packaging.  The push is related to TJC's
Nat'l Patient Safety Goals and getting patients more involved.

I look forward to your feedback.  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

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17:57:00

From jross at jaycountyhospital.com  Mon Jul 20 08:43:27 2009
From: jross at jaycountyhospital.com (Julayne Ross)
Date: Mon, 20 Jul 2009 11:43:27 -0400
Subject: [Cnm] favorite website
Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D0220B4A5@EX1.jaycountyhospital.com>

What website do you tell someone about... not for any diet in
particular, just healthy eating and exercise?  I am doing a newsletter
article and wanted to list a few favorites that are recommended.

I know I can use American Dietetic Association... with nutrition tip of
the day and tip of the month.

Calorie King is good for info on any fast food.

I like sparkpeople since someone can log in and track what they are
eating and set realistic goals for themselves.  It has diet, exercise
and motivational aspects....sends e-mail to the person with recipes,
exercise of the day....etc.

If you could send me one you love with some of the good aspects of the
sight it would be helpful!

Thanks so much,

Julayne

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From Janet.Hiser at danhosp.org  Mon Jul 20 09:43:10 2009
From: Janet.Hiser at danhosp.org (Hiser, Janet D.)
Date: Mon, 20 Jul 2009 12:43:10 -0400
Subject: [Cnm] RD Staffing survey
Message-ID: <4865A403D47CFA419916A9082054AB62DFAAA7@dhsiexch03.danhosp.priv>

Would you please take a few minutes to fill out this very short survey
to assess staffing needs.  I will post results.

http://www.surveymonkey.com/s.aspx?sm=dyaa_2bwMRR6su4AloA8IO5A_3d_3d

Thank You

Janet D. Hiser, M.O.E., R.D., CD-N
Chief Dietitian/Dietetic Internship Director 

Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810
V: (203) 739-7216 | F: (203) 739-7619 | janet.hiser at danhosp.org
http://www.danburyhospital.org

P Please consider the environment before printing this e-mail

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From Julie.Hockenberry at va.gov  Mon Jul 20 09:49:00 2009
From: Julie.Hockenberry at va.gov (Hockenberry, Julie)
Date: Mon, 20 Jul 2009 12:49:00 -0400
Subject: [Cnm] Favorite website
In-Reply-To: 
References: 
Message-ID: 

I would recommend mypyramid.gov

Julie L. Hockenberry MSRD, CDN

VA Western New York Health Care System

Clinical Nutrition Manager

3495 Bailey Avenue

Buffalo, NY 14215-1199

Phone: 716-862-7358

Fax: 716-862-6374

-----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, July 20, 2009 12:43 PM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 32, Issue 65

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 annasheridan1 at verizon.net  Mon Jul 20 09:52:24 2009
From: annasheridan1 at verizon.net (Anna Sheridan)
Date: Mon, 20 Jul 2009 12:52:24 -0400
Subject: [Cnm] Favorite Websites
Message-ID: <4517F481-A4B7-40A9-A90D-2C5F8C7DF8C5@verizon.net>

In addition to websites...  The Apple iphone has an application titled  
"Lose It!"  It allows the user to enter food intake and exercise.  It  
will also calculate nutritional needs.  However, I'm not sure how  
accurate that portion of the program is but the other features look  
appropriate.  I do not know if the application is available on other  
phones.

Anna Sheridan
Asst Dir Clinical Nutrition
Hebrew Home at Riverdale
Riverdale, NY 10471

From pcharney at mac.com  Mon Jul 20 10:29:10 2009
From: pcharney at mac.com (Pam Charney)
Date: Mon, 20 Jul 2009 10:29:10 -0700
Subject: [Cnm] Favorite Websites
In-Reply-To: <4517F481-A4B7-40A9-A90D-2C5F8C7DF8C5@verizon.net>
References: <4517F481-A4B7-40A9-A90D-2C5F8C7DF8C5@verizon.net>
Message-ID: 

The app store now has hundreds of food and nutrition apps available.  
The apps do not work on other platforms. However, a few weeks ago I  
saw a prototype of an interactive, patient-focused exercise and  
symptom management tool designed to be used by COPD patients. This was  
created for use on a smart phone.

So, there's got to be more out there. Maybe we should create a space  
to share these tools as we find them.

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
http://www.linkedin.com/in/pamcharney

"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jul 20, 2009, at 9:52 AM, Anna Sheridan wrote:

> In addition to websites...  The Apple iphone has an application titled
> "Lose It!"  It allows the user to enter food intake and exercise.  It
> will also calculate nutritional needs.  However, I'm not sure how
> accurate that portion of the program is but the other features look
> appropriate.  I do not know if the application is available on other
> phones.
>
>
> Anna Sheridan
> Asst Dir Clinical Nutrition
> Hebrew Home at Riverdale
> Riverdale, NY 10471
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

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From sheila.walsh at nahealth.com  Mon Jul 20 11:34:29 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Mon, 20 Jul 2009 11:34:29 -0700
Subject: [Cnm] need some suggestions for a turtle
In-Reply-To: <4517F481-A4B7-40A9-A90D-2C5F8C7DF8C5@verizon.net>
References: <4517F481-A4B7-40A9-A90D-2C5F8C7DF8C5@verizon.net>
Message-ID: <4A64564502000001000AD317@nahsmtp.nah1.com>

Dear list,
I have a turtle dietitian.  She is not able to chart on more than one patient per hour and that is pushing it.  I am committed to helping her speed up or retire.  Any suggestions for monitoring her?  She is very gracious and really does want to go home on time....

TIA,
Sheila

>>> "Anna Sheridan"  7/20/2009 9:52 AM >>>
In addition to websites...  The Apple iphone has an application titled  
"Lose It!"  It allows the user to enter food intake and exercise.  It  
will also calculate nutritional needs.  However, I'm not sure how  
accurate that portion of the program is but the other features look  
appropriate.  I do not know if the application is available on other  
phones.

Anna Sheridan
Asst Dir Clinical Nutrition
Hebrew Home at Riverdale
Riverdale, NY 10471

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

From JUnderwood at jflusvi.org  Mon Jul 20 11:58:18 2009
From: JUnderwood at jflusvi.org (Underwood, Jennifer)
Date: Mon, 20 Jul 2009 14:58:18 -0400
Subject: [Cnm] nutrition care manual -compliance of standard
Message-ID: 

What are the specific standards the Nutrition Care Manual  is meeting for...

CMS

Joint Commission

The website makes a general statement but I know my VP will ask for
specifics.

Any help would be appreciated.

JU

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From ehamil69 at aol.com  Mon Jul 20 13:01:09 2009
From: ehamil69 at aol.com (Elaina Hamill, RD, New York)
Date: Mon, 20 Jul 2009 16:01:09 -0400
Subject: [Cnm] carbohydrate consistent diets and weight loss diets
In-Reply-To: 
References: 
Message-ID: <8CBD78BF5356114-1410-2CD9@WEBMAIL-MZ13.sysops.aol.com>

For those of you using carbohydrate consistent diets, what type of 
diets are you using for weight loss? Would a low fat diet be more 
appropriate for weight loss versus a low carbohydrate consistent diet?

Thanks in advance!

Elaina Hamill, RD
New York

From ADDRDD at aol.com  Mon Jul 20 13:51:25 2009
From: ADDRDD at aol.com (ADDRDD at aol.com)
Date: Mon, 20 Jul 2009 16:51:25 EDT
Subject: [Cnm] Dietary aides and Dishroom
Message-ID: 

We also had them wear disposable plastic aprons when working in the  
dishroom to protect their uniforms.  Plastic not cloth!
In a message dated 7/17/2009 10:24:11 A.M. Central Daylight Time,  
fns at abbgen.net writes:

We are a small  hospital, JC-accredited,  and our aides have always 
assembled and  delivered trays as well as picking up soiled trays and scrapping, in 
addition  to removing clean dishes and putting them away.  The important 
thing to  do is to always appropriately wash their hands between clean and 
dirty  dishes.  We have a conveniently located lavatory for that purpose in the 
 dishroom.  The aides also wear disposable gloves when picking up soiled  
trays and handling soiled dishware.  They still have to wash their hands  
each time the gloves are removed.  

____________________________________
 From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]  On 
Behalf Of Lisa Dalgleish
Sent: Friday, July 17, 2009 8:26  AM
To: dianac226 at aol.com; Cnm at lists.my180.net
Subject: Re:  [Cnm] Dietary aides and Dishroom

Our staff flexes in this way also.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland  HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269)  983-8674  work phone
(269) 982-4313   fax
ldalgleish at lakelandregional.org

>>>   7/16/2009 4:31 PM >>>
Hi All,

We  are working on changing our meal service system. The new system will  
winvolve the dietary aides who assemble trays and deliver them to work  
in the dishroom scraping and loading dirty dishes or removing clean  
ones from the machine.  Does any other facilitie do this?  Are  there 
any infeciton control issues.  I was under the impression that  as long 
as you don't load the dirty and take off the clean dishes during  the 
same meal period.

Any advice or if you could share how your  facility handles washing the 
serviceware would be very  helpful!

Thanks in  Advance
Diana

_______________________________________________
Cnm  mailing list
Cnm at lists.my180.net
_http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net_ 
(http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net) 

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

**************An Excellent Credit Score is 750. See Yours in Just 2 Easy 
Steps! 
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From apirozek at hotmail.com  Mon Jul 20 13:52:05 2009
From: apirozek at hotmail.com (amy pirozek)
Date: Mon, 20 Jul 2009 16:52:05 -0400
Subject: [Cnm] NCP policy
Message-ID: 

Does anyone have a policy and procedure they would be willing to share that includes NCP, etc. 

Thanks

Amy 

_________________________________________________________________
Windows Live? Hotmail?: Search, add, and share the web?s latest sports videos. Check it out.
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From fns at abbgen.net  Mon Jul 20 13:52:42 2009
From: fns at abbgen.net (Annette Doucet)
Date: Mon, 20 Jul 2009 15:52:42 -0500
Subject: [Cnm] Dietary aides and Dishroom
In-Reply-To: 
References: 
Message-ID: <000801ca097c$07435b90$02be7878@local.abbgen.net>

Yes.  We do that also.

  _____  

From: ADDRDD at aol.com [mailto:ADDRDD at aol.com] 
Sent: Monday, July 20, 2009 3:51 PM
To: fns at abbgen.net; LDALGLEISH at lakelandregional.org; DianaC226 at aol.com;
Cnm at lists.my180.net
Subject: Re: [Cnm] Dietary aides and Dishroom

We also had them wear disposable plastic aprons when working in the dishroom
to protect their uniforms.  Plastic not cloth!
In a message dated 7/17/2009 10:24:11 A.M. Central Daylight Time,
fns at abbgen.net writes:

We are a small hospital, JC-accredited,  and our aides have always assembled
and delivered trays as well as picking up soiled trays and scrapping, in
addition to removing clean dishes and putting them away.  The important
thing to do is to always appropriately wash their hands between clean and
dirty dishes.  We have a conveniently located lavatory for that purpose in
the dishroom.  The aides also wear disposable gloves when picking up soiled
trays and handling soiled dishware.  They still have to wash their hands
each time the gloves are removed.  

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Lisa Dalgleish
Sent: Friday, July 17, 2009 8:26 AM
To: dianac226 at aol.com; Cnm at lists.my180.net
Subject: Re: [Cnm] Dietary aides and Dishroom

Our staff flexes in this way also.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org

>>>  7/16/2009 4:31 PM >>>
Hi All,

We are working on changing our meal service system. The new system will 
winvolve the dietary aides who assemble trays and deliver them to work 
in the dishroom scraping and loading dirty dishes or removing clean 
ones from the machine.  Does any other facilitie do this?  Are there 
any infeciton control issues.  I was under the impression that as long 
as you don't load the dirty and take off the clean dishes during the 
same meal period.

Any advice or if you could share how your facility handles washing the 
serviceware would be very helpful!

Thanks in Advance
Diana

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

Checked by AVG - www.avg.com
Version: 8.5.387 / Virus Database: 270.13.18/2243 - Release Date: 07/17/09
06:08:00

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

  _____  

An Excellent Credit Score is 750. See
 Yours in Just 2 Easy Steps!

Checked by AVG - www.avg.com
Version: 8.5.387 / Virus Database: 270.13.20/2250 - Release Date: 07/20/09
06:16:00

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From mpappo at montefiore.org  Mon Jul 20 14:01:11 2009
From: mpappo at montefiore.org (Miriam Pappo)
Date: Mon, 20 Jul 2009 17:01:11 -0400
Subject: [Cnm] carbohydrate consistent diets and weight loss diets
Message-ID: 

we have the ability to incorporate certain lower cal restrictions within
any diet order.
we have 1200 or 1500 plans-- which are really just balanced eating. 
Often the RD will just take away foods from CBORD until it achieves the
amt of kcals desired/recommended for an inpt who desires wt loss.

Our carb consistent diet is automatically high fiber and lower in
fat/sat fat.

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>> "Elaina Hamill, RD, New York"  07/20/09 4:01 PM
>>>
For those of you using carbohydrate consistent diets, what type of 
diets are you using for weight loss? Would a low fat diet be more 
appropriate for weight loss versus a low carbohydrate consistent diet?

Thanks in advance!

Elaina Hamill, RD
New York

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
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From sandradeewells at yahoo.com  Mon Jul 20 14:46:14 2009
From: sandradeewells at yahoo.com (Sandra Wells)
Date: Mon, 20 Jul 2009 14:46:14 -0700 (PDT)
Subject: [Cnm] nutrition care manual -compliance of standard
Message-ID: <55403.500.qm@web57701.mail.re3.yahoo.com>

Hi Jennifer,
?
Did my last reply not meet your needs? :
?
"
Good Morning Jennifer,
?
This?is?Sandra Beil, the NCM Sales Manager.
?
When I have spoken to people about Joint Commission, the?Standard 2009 IM.03.01.01 has been mentioned. 
?
"Knowledge-based information resources are available, current, and authoritative.
?
"The hospital provides access to knowledge-based information resources 24 hours a day, 7 days a week."
?
ADA is the authority,?having NCM online allows access 24/7 and we update & review the information every year.
?
If you need anything else, please let me know. 
?
Sandra D. Beil
Nutrition Care Manual? Sales Manager
sbeil at eatright.org 
Direct:? 312-899-4795
Toll Free: 800-877-1600 x4795

--- On Mon, 7/20/09, Underwood, Jennifer  wrote:

From: Underwood, Jennifer 
Subject: [Cnm] nutrition care manual -compliance of standard
To: cnm at lists.my180.net
Date: Monday, July 20, 2009, 1:58 PM

What are the specific standards the Nutrition Care Manual ?is meeting for?
CMS
Joint Commission
?
The website makes a general statement but I know my VP will ask for specifics.
Any help would be appreciated.
?
?
JU
?
-----Inline Attachment Follows-----

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

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From Carol.Gilmore at LMH.ORG  Mon Jul 20 15:47:16 2009
From: Carol.Gilmore at LMH.ORG (Carol Gilmore)
Date: Mon, 20 Jul 2009 17:47:16 -0500
Subject: [Cnm] nutrition care manual -compliance of standard
In-Reply-To: <55403.500.qm@web57701.mail.re3.yahoo.com>
References: <55403.500.qm@web57701.mail.re3.yahoo.com>
Message-ID: <70FA01E603A1BE4BAE587F1FDF3FBA43AE8BB4@FORCE.LMH.ORG>

The CMS Standard is 482.28(b)(3) A current therapeutic diet manual
approved by the dietitian and medical staff must be readily available to
all medical, nursing, and food service personnel. 

 Access the State Operations Manual at this link and locate the standard
and the interpretive guidelines in the Appendix.
http://cms.hhs.gov/manuals/Downloads/som107ap_a_hospitals.pdf

Carol Gilmore, RD, LD
Assistant Director, Food & Nutrition Services
Lawrence Memorial Hospital
325 Maine Street, Lawrence KS 66044
Office: 785-505-3040
carol.gilmore at lmh.org

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sandra Wells
Sent: Monday, July 20, 2009 4:46 PM
To: cnm at lists.my180.net; JenniferUnderwood
Subject: Re: [Cnm] nutrition care manual -compliance of standard

Hi Jennifer,

Did my last reply not meet your needs? :

"

Good Morning Jennifer, 

This is Sandra Beil, the NCM Sales Manager. 

When I have spoken to people about Joint Commission, the Standard 2009
IM.03.01.01 has been mentioned. 

"Knowledge-based information resources are available, current, and
authoritative. 

"The hospital provides access to knowledge-based information resources
24 hours a day, 7 days a week." 

ADA is the authority, having NCM online allows access 24/7 and we update
& review the information every year. 

If you need anything else, please let me know. 

Sandra D. Beil
Nutrition Care Manual(r) Sales Manager
sbeil at eatright.org 
Direct:  312-899-4795
Toll Free: 800-877-1600 x4795

--- On Mon, 7/20/09, Underwood, Jennifer  wrote:

	From: Underwood, Jennifer 
	Subject: [Cnm] nutrition care manual -compliance of standard
	To: cnm at lists.my180.net
	Date: Monday, July 20, 2009, 1:58 PM

	What are the specific standards the Nutrition Care Manual  is
meeting for...

	CMS

	Joint Commission 

	The website makes a general statement but I know my VP will ask
for specifics. 

	Any help would be appreciated. 

	JU 

	-----Inline Attachment Follows-----

	_______________________________________________
	Cnm mailing list
	Cnm at lists.my180.net

	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

LMH 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.
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From Margaret.Chaffin at hcahealthcare.com  Tue Jul 21 06:29:54 2009
From: Margaret.Chaffin at hcahealthcare.com (Chaffin Meg)
Date: Tue, 21 Jul 2009 08:29:54 -0500
Subject: [Cnm] Hand hygiene
Message-ID: 

Does anyone have a quick inservice/presentation on hand hygiene they would be willing to share?

Thanks,
Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Centers
(229)434-2394

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From mpappo at montefiore.org  Tue Jul 21 07:37:28 2009
From: mpappo at montefiore.org (Miriam Pappo)
Date: Tue, 21 Jul 2009 10:37:28 -0400
Subject: [Cnm] nutrition care manual -compliance of standard
Message-ID: 

As the NCM is electronic, can anyone share how they prove it's approved
by the medical staff now ?

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager
>>> "Carol Gilmore"  07/20/09 6:47 PM >>>
The CMS Standard is 482.28(b)(3) A current therapeutic diet manual
approved by the dietitian and medical staff must be readily available to
all medical, nursing, and food service personnel. 

 Access the State Operations Manual at this link and locate the standard
and the interpretive guidelines in the Appendix.
http://cms.hhs.gov/manuals/Downloads/som107ap_a_hospitals.pdf

Carol Gilmore, RD, LD
Assistant Director, Food & Nutrition Services
Lawrence Memorial Hospital
325 Maine Street, Lawrence KS 66044
Office: 785-505-3040
carol.gilmore at lmh.org

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sandra Wells
Sent: Monday, July 20, 2009 4:46 PM
To: cnm at lists.my180.net; JenniferUnderwood
Subject: Re: [Cnm] nutrition care manual -compliance of standard

Hi Jennifer,

Did my last reply not meet your needs? :

"

Good Morning Jennifer, 

This is Sandra Beil, the NCM Sales Manager. 

When I have spoken to people about Joint Commission, the Standard 2009
IM.03.01.01 has been mentioned. 

"Knowledge-based information resources are available, current, and
authoritative. 

"The hospital provides access to knowledge-based information resources
24 hours a day, 7 days a week." 

ADA is the authority, having NCM online allows access 24/7 and we update
& review the information every year. 

If you need anything else, please let me know. 

Sandra D. Beil
Nutrition Care Manual(r) Sales Manager
sbeil at eatright.org 
Direct:  312-899-4795
Toll Free: 800-877-1600 x4795

--- On Mon, 7/20/09, Underwood, Jennifer  wrote:

	From: Underwood, Jennifer 
	Subject: [Cnm] nutrition care manual -compliance of standard
	To: cnm at lists.my180.net
	Date: Monday, July 20, 2009, 1:58 PM

	What are the specific standards the Nutrition Care Manual  is
meeting for...

	CMS

	Joint Commission 

	The website makes a general statement but I know my VP will ask
for specifics. 

	Any help would be appreciated. 

	JU 

	-----Inline Attachment Follows-----

	_______________________________________________
	Cnm mailing list
	Cnm at lists.my180.net

	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

LMH 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 Jul 21 07:30:29 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 21 Jul 2009 09:30:29 -0500
Subject: [Cnm] nutrition care manual -compliance of standard
In-Reply-To: 
References: 
Message-ID: <5330B54133B6194BA13930BDEFE9A30E0491C958@rhcexch3.reshealthcare.org>

minutes of the P+T Committee and the Med Exec Committee.  alternatively,
a letter signed by you, the chair of P+T and MEC works.  Leslee 

Leslee R. Carver, MSPH, RD, LDN
Clinical Nutrition Manager
Saint Joseph Hospital
2900 N. Lake Shore Dr.
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.  All personal messages express
view 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

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Miriam Pappo
Sent: Tuesday, July 21, 2009 9:37 AM
To: JUnderwood at jflusvi.org; cnm at lists.my180.net; Carol.Gilmore at LMH.ORG;
sandradeewells at yahoo.com
Subject: Re: [Cnm] nutrition care manual -compliance of standard

As the NCM is electronic, can anyone share how they prove it's approved
by the medical staff now ?

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager
>>> "Carol Gilmore"  07/20/09 6:47 PM >>>
The CMS Standard is 482.28(b)(3) A current therapeutic diet manual
approved by the dietitian and medical staff must be readily available to
all medical, nursing, and food service personnel. 

 Access the State Operations Manual at this link and locate the standard
and the interpretive guidelines in the Appendix.
http://cms.hhs.gov/manuals/Downloads/som107ap_a_hospitals.pdf

Carol Gilmore, RD, LD
Assistant Director, Food & Nutrition Services
Lawrence Memorial Hospital
325 Maine Street, Lawrence KS 66044
Office: 785-505-3040
carol.gilmore at lmh.org

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sandra Wells
Sent: Monday, July 20, 2009 4:46 PM
To: cnm at lists.my180.net; JenniferUnderwood
Subject: Re: [Cnm] nutrition care manual -compliance of standard

Hi Jennifer,

Did my last reply not meet your needs? :

"

Good Morning Jennifer, 

This is Sandra Beil, the NCM Sales Manager. 

When I have spoken to people about Joint Commission, the Standard 2009
IM.03.01.01 has been mentioned. 

"Knowledge-based information resources are available, current, and
authoritative. 

"The hospital provides access to knowledge-based information resources
24 hours a day, 7 days a week." 

ADA is the authority, having NCM online allows access 24/7 and we update
& review the information every year. 

If you need anything else, please let me know. 

Sandra D. Beil
Nutrition Care Manual(r) Sales Manager
sbeil at eatright.org 
Direct:  312-899-4795
Toll Free: 800-877-1600 x4795

--- On Mon, 7/20/09, Underwood, Jennifer  wrote:

	From: Underwood, Jennifer 
	Subject: [Cnm] nutrition care manual -compliance of standard
	To: cnm at lists.my180.net
	Date: Monday, July 20, 2009, 1:58 PM

	What are the specific standards the Nutrition Care Manual  is
meeting for...

	CMS

	Joint Commission 

	The website makes a general statement but I know my VP will ask
for specifics. 

	Any help would be appreciated. 

	JU 

	-----Inline Attachment Follows-----

	_______________________________________________
	Cnm mailing list
	Cnm at lists.my180.net

	http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

LMH 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

From sandradeewells at yahoo.com  Tue Jul 21 08:02:26 2009
From: sandradeewells at yahoo.com (Sandra Wells)
Date: Tue, 21 Jul 2009 08:02:26 -0700 (PDT)
Subject: [Cnm] nutrition care manual -compliance of standard
Message-ID: <740075.79843.qm@web57704.mail.re3.yahoo.com>

The Home page of the NCM has a sample "Diet Manual Approval Form" as well.
http://www.nutritioncaremanual.org/files/NCMApprovalForm.pdf
?
?
Sandra D. Beil
Nutrition Care Manual? Sales Manager
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, Illinois 60606-6995
Direct:? 312-899-4795
Toll Free: 800-877-1600 x4795
Fax: 312-899-5339 

--- On Tue, 7/21/09, Carver, Leslee  wrote:

From: Carver, Leslee 
Subject: RE: [Cnm] nutrition care manual -compliance of standard
To: "Miriam Pappo" , JUnderwood at jflusvi.org, cnm at lists.my180.net, Carol.Gilmore at LMH.ORG, sandradeewells at yahoo.com
Date: Tuesday, July 21, 2009, 9:30 AM

minutes of the P+T Committee and the Med Exec Committee.? alternatively,
a letter signed by you, the chair of P+T and MEC works.? Leslee 

Leslee R. Carver, MSPH, RD, LDN
Clinical Nutrition Manager
Saint Joseph Hospital
2900 N. Lake Shore Dr.
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.? All personal messages express
view 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

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Miriam Pappo
Sent: Tuesday, July 21, 2009 9:37 AM
To: JUnderwood at jflusvi.org; cnm at lists.my180.net; Carol.Gilmore at LMH.ORG;
sandradeewells at yahoo.com
Subject: Re: [Cnm] nutrition care manual -compliance of standard

As the NCM is electronic, can anyone share how they prove it's approved
by the medical staff now ?

Miriam Pappo, MS, RD, CDN
Director -? Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager
>>> "Carol Gilmore"  07/20/09 6:47 PM >>>
The CMS Standard is 482.28(b)(3) A current therapeutic diet manual
approved by the dietitian and medical staff must be readily available to
all medical, nursing, and food service personnel. 

Access the State Operations Manual at this link and locate the standard
and the interpretive guidelines in the Appendix.
http://cms.hhs.gov/manuals/Downloads/som107ap_a_hospitals.pdf

Carol Gilmore, RD, LD
Assistant Director, Food & Nutrition Services
Lawrence Memorial Hospital
325 Maine Street, Lawrence KS 66044
Office: 785-505-3040
carol.gilmore at lmh.org

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Sandra Wells
Sent: Monday, July 20, 2009 4:46 PM
To: cnm at lists.my180.net; JenniferUnderwood
Subject: Re: [Cnm] nutrition care manual -compliance of standard

Hi Jennifer,

Did my last reply not meet your needs? :

"

Good Morning Jennifer, 

? 

This is Sandra Beil, the NCM Sales Manager. 

? 

When I have spoken to people about Joint Commission, the Standard 2009
IM.03.01.01 has been mentioned. 

? 

"Knowledge-based information resources are available, current, and
authoritative. 

? 

"The hospital provides access to knowledge-based information resources
24 hours a day, 7 days a week." 

? 

ADA is the authority, having NCM online allows access 24/7 and we update
& review the information every year. 

? 

If you need anything else, please let me know. 

? 
Sandra D. Beil
Nutrition Care Manual(r) Sales Manager
sbeil at eatright.org 
Direct:? 312-899-4795
Toll Free: 800-877-1600 x4795

--- On Mon, 7/20/09, Underwood, Jennifer  wrote:

??? From: Underwood, Jennifer 
??? Subject: [Cnm] nutrition care manual -compliance of standard
??? To: cnm at lists.my180.net
??? Date: Monday, July 20, 2009, 1:58 PM
??? 
??? 

??? What are the specific standards the Nutrition Care Manual? is
meeting for...

??? CMS

??? Joint Commission 

??? ? 

??? The website makes a general statement but I know my VP will ask
for specifics. 

??? Any help would be appreciated. 

??? ? 

??? ? 

??? JU 

??? ? 

??? -----Inline Attachment Follows-----
??? 
??? 
??? _______________________________________________
??? Cnm mailing list
??? Cnm at lists.my180.net

??? http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
??? 

LMH 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

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From LDALGLEISH at lakelandregional.org  Tue Jul 21 08:40:39 2009
From: LDALGLEISH at lakelandregional.org (Lisa Dalgleish)
Date: Tue, 21 Jul 2009 11:40:39 -0400
Subject: [Cnm] nutrition care manual -compliance of standard
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E0491C958@rhcexch3.reshealthcare.org>
References: 
	<5330B54133B6194BA13930BDEFE9A30E0491C958@rhcexch3.reshealthcare.org>
Message-ID: <4A65A918.DF60.000C.0@lakelandregional.org>

We use a signature sheet.  I send out a memo with NCM updates each year and ask the PNT chair and med staff chief to sign the sheet.  I pull the updates from the NCM--updates are usually summarized nicely on the home page.  I keep the signature sheet in my files.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> "Carver, Leslee"  7/21/2009 10:30 AM >>>
minutes of the P+T Committee and the Med Exec Committee.  alternatively,
a letter signed by you, the chair of P+T and MEC works.  Leslee 

Leslee R. Carver, MSPH, RD, LDN
Clinical Nutrition Manager
Saint Joseph Hospital
2900 N. Lake Shore Dr.
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.  All personal messages express
view 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

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] 
On Behalf Of Miriam Pappo
Sent: Tuesday, July 21, 2009 9:37 AM
To: JUnderwood at jflusvi.org; cnm at lists.my180.net; Carol.Gilmore at LMH.ORG;
sandradeewells at yahoo.com 
Subject: Re: [Cnm] nutrition care manual -compliance of standard

As the NCM is electronic, can anyone share how they prove it's approved
by the medical staff now ?

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager
>>> "Carol Gilmore"  07/20/09 6:47 PM >>>
The CMS Standard is 482.28(b)(3) A current therapeutic diet manual
approved by the dietitian and medical staff must be readily available to
all medical, nursing, and food service personnel. 

Access the State Operations Manual at this link and locate the standard
and the interpretive guidelines in the Appendix.
http://cms.hhs.gov/manuals/Downloads/som107ap_a_hospitals.pdf 

Carol Gilmore, RD, LD
Assistant Director, Food & Nutrition Services
Lawrence Memorial Hospital
325 Maine Street, Lawrence KS 66044
Office: 785-505-3040
carol.gilmore at lmh.org 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] 
On Behalf Of Sandra Wells
Sent: Monday, July 20, 2009 4:46 PM
To: cnm at lists.my180.net; JenniferUnderwood
Subject: Re: [Cnm] nutrition care manual -compliance of standard

Hi Jennifer,

Did my last reply not meet your needs? :

"

Good Morning Jennifer, 

This is Sandra Beil, the NCM Sales Manager. 

When I have spoken to people about Joint Commission, the Standard 2009
IM.03.01.01 has been mentioned. 

"Knowledge-based information resources are available, current, and
authoritative. 

"The hospital provides access to knowledge-based information resources
24 hours a day, 7 days a week." 

ADA is the authority, having NCM online allows access 24/7 and we update
& review the information every year. 

If you need anything else, please let me know. 

Sandra D. Beil
Nutrition Care Manual(r) Sales Manager
sbeil at eatright.org 
Direct:  312-899-4795
Toll Free: 800-877-1600 x4795

--- On Mon, 7/20/09, Underwood, Jennifer  wrote:

From: Underwood, Jennifer 
Subject: [Cnm] nutrition care manual -compliance of standard
To: cnm at lists.my180.net 
Date: Monday, July 20, 2009, 1:58 PM

What are the specific standards the Nutrition Care Manual  is
meeting for...

CMS

Joint Commission 

The website makes a general statement but I know my VP will ask
for specifics. 

Any help would be appreciated. 

JU 

-----Inline Attachment Follows-----

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 

http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net 

LMH 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 

_______________________________________________
Cnm mailing list
Cnm at lists.my180.net 
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net
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From Heberle-Heather at aramark.com  Tue Jul 21 10:10:01 2009
From: Heberle-Heather at aramark.com (Heberle, Heather N.)
Date: Tue, 21 Jul 2009 12:10:01 -0500
Subject: [Cnm] nutrition care manual -compliance of standard
In-Reply-To: 
References: 
Message-ID: <2CE759BA-F9C0-47A2-8DFD-61F9E6F23E8F@mimectl>

We have a signature page with the hospital CEO, Medical Staff Director, Nutrition Services Director, and Director of Patient Care.  We keep it in our Policy & Procedures Manual.  It is resigned on a yearly basis.

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
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From stovallj at hotmail.com  Tue Jul 21 11:02:06 2009
From: stovallj at hotmail.com (jen stovall)
Date: Tue, 21 Jul 2009 14:02:06 -0400
Subject: [Cnm] Albumin as an indicator of nutrition risk
Message-ID: 

Does anyone know of a good reference to back up a policy change on Albumin not being an indicator of nutrition risk? Our current policy states all patients with an Albumin of <3 should be seen by a dietitian. P and T committee will want proof before I change this.

Thanks in advance

Jen Brennan, RD, CDN

(212) 434-2491

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From KHorvath at swgeneral.com  Tue Jul 21 11:26:27 2009
From: KHorvath at swgeneral.com (Horvath, Karen)
Date: Tue, 21 Jul 2009 14:26:27 -0400
Subject: [Cnm] Albumin as an indicator of nutrition risk
In-Reply-To: 
References: 
Message-ID: <0BD69CE7EFA7F74A9500CD83C2ADC67902269296@SWEXCHANGE.swgeneral.corp>

There was an article written by  Pamela Charney, PhD, RD, CNSD in
Support Line Feb. 2007 vol 29 No. 1 called Nutrition Assessment in the
Intensive Care Unit: Prealbumin, C-reactive Protein, or None of the
Above.

Also from this list serve there was an article in Practical
Gastroenterology.October 2006 called Serum Proteins as Markers of
Nutrition: What Are We Treating by Le Banh, MS, RD, CNSD

Hope that helps

Karen Horvath MA RD LD

SWGMC Middleburg Heights, Ohio

1-440-816-8845

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of jen stovall
Sent: Tuesday, July 21, 2009 2:02 PM
To: cnm at lists.my180.net
Subject: [Cnm] Albumin as an indicator of nutrition risk

Does anyone know of a good reference to back up a policy change on
Albumin not being an indicator of nutrition risk? Our current policy
states all patients with an Albumin of <3 should be seen by a dietitian.
P and T committee will want proof before I change this.

Thanks in advance

Jen Brennan, RD, CDN
(212) 434-2491

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From tfreeden at somerset-healthcare.com  Tue Jul 21 12:01:17 2009
From: tfreeden at somerset-healthcare.com (Freeden, Theresa)
Date: Tue, 21 Jul 2009 15:01:17 -0400
Subject: [Cnm] cultural or religious food pref
Message-ID: 

How is the food service dept. notified of cultural/religious food preferences at your hospitals? 
We had a case where the patient does not eat pork but because it wasn't a true "allergy" is was not entered in the computer. 
Patient was sent pork for the first meal until someone from our dept. visited him.
Thanks

Theresa Freeden, MS, RD
Clinical Nutrition Manager 
Somerset Medical Center
110 Rehill Ave.
Somerville, NJ 08876
908 704-2758

CONFIDENTIALITY NOTICE
This message and any included attachments are from 
Somerset Medical Center and are intended only for the addressee.
The information contained in this message is confidential 
and may contain privileged, confidential, proprietary and/or 
trade secret information entitled to protection and/or exemption 
from disclosure under applicable law. Unauthorized forwarding, 
printing, copying, distribution, or use of such information is 
strictly prohibited and may be unlawful. If you are not the 
addressee, please promptly delete this message and notify 
the sender of the delivery error by e-mail or you may call 
Somerset Medical Center's computer Help Desk at 
908-685-2200, ext. 4050. 
-------------------------------------------------------------- 
Somerset Medical Center is the recipient of the 
2009 Orthopedic Surgery Excellence Award(tm) from HealthGrades,
the nation's leading health care ratings company.

Visit Somerset Medical Center's Web site 
- www.somersetmedicalcenter.com - 
for news, event listings, health information and more.

Join the Discussion: 
Facebook: www.somersetmedicalcenter.com/fb
Twitter: www.twitter.com/SomersetMedCtr
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From Michael.Smith at LPNT.net  Tue Jul 21 12:54:45 2009
From: Michael.Smith at LPNT.net (Smith Michael - Palestine)
Date: Tue, 21 Jul 2009 14:54:45 -0500
Subject: [Cnm] Albumin as an indicator of nutrition risk
In-Reply-To: <0BD69CE7EFA7F74A9500CD83C2ADC67902269296@SWEXCHANGE.swgeneral.corp>
References: 
	<0BD69CE7EFA7F74A9500CD83C2ADC67902269296@SWEXCHANGE.swgeneral.corp>
Message-ID: 

LOOK AT THIS FROM RD411.
http://www.rd411.com/article.php?ID=173

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 Horvath, Karen
Sent: Tuesday, July 21, 2009 1:26 PM
To: jen stovall; cnm at lists.my180.net
Subject: Re: [Cnm] Albumin as an indicator of nutrition risk

There was an article written by  Pamela Charney, PhD, RD, CNSD in Support Line Feb. 2007 vol 29 No. 1 called Nutrition Assessment in the Intensive Care Unit: Prealbumin, C-reactive Protein, or None of the Above.
Also from this list serve there was an article in Practical Gastroenterology.October 2006 called Serum Proteins as Markers of Nutrition: What Are We Treating by Le Banh, MS, RD, CNSD
Hope that helps
Karen Horvath MA RD LD
SWGMC Middleburg Heights, Ohio
1-440-816-8845

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of jen stovall
Sent: Tuesday, July 21, 2009 2:02 PM
To: cnm at lists.my180.net
Subject: [Cnm] Albumin as an indicator of nutrition risk

Does anyone know of a good reference to back up a policy change on Albumin not being an indicator of nutrition risk? Our current policy states all patients with an Albumin of <3 should be seen by a dietitian. P and T committee will want proof before I change this.

Thanks in advance

Jen Brennan, RD, CDN
(212) 434-2491

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From Sandra.Harrison at lrmc.com  Tue Jul 21 13:56:13 2009
From: Sandra.Harrison at lrmc.com (Sandra Harrison)
Date: Tue, 21 Jul 2009 16:56:13 -0400
Subject: [Cnm] nutrition policy
Message-ID: <4A65F32C.B0D7.000E.0@lrmc.com>

Does anyone have a nutrition care policy regarding the NCP that you are willing to share?

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."
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From eedwards at skmc.gov.ae  Tue Jul 21 22:41:27 2009
From: eedwards at skmc.gov.ae (Ellen Edwards)
Date: Wed, 22 Jul 2009 09:41:27 +0400
Subject: [Cnm] study guides for DTR
Message-ID: <9A99F98786F9254597C0A0C62685FB5A08757AD599@AHA-MAIL.skmc.gov.ae>

Hello:
Some of my international staff are now eligible to take the diet tech registered exam. Are there study guides available for them to use?

Also, for the RD exam is there a preferred study guide? Some of our Pilipino staff have received approval from CDR to take the RD exam as well

Thank you

Ellen Edwards, RD LD
Head, Clinical Dietetics
Chief Clinical Dietitian
Sheikh Khalifa Medical City (SKMC)
Managed by Cleveland Clinic
P.O. Box 51900
Abu Dhabi, United Arab Emirates
Direct:  +971 2 610-2024
Fax:  +971 2 610-2577
Mobile:  +971 050-661-7297
Email: eedwards at skmc.gov.ae

________________________________
Confidentiality Note: This message and any included attachments are intended for the exclusive use of the individual or entity that is the named addressee and may contain information that is privileged or confidential or otherwise legally exempt from disclosure. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please contact the sender immediately and destroy the material in its entirety, whether electronic or hard copy. Thank you.
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From eedwards at skmc.gov.ae  Tue Jul 21 22:43:50 2009
From: eedwards at skmc.gov.ae (Ellen Edwards)
Date: Wed, 22 Jul 2009 09:43:50 +0400
Subject: [Cnm] cultural or religious food pref
In-Reply-To: 
References: 
Message-ID: <9A99F98786F9254597C0A0C62685FB5A08757AD59D@AHA-MAIL.skmc.gov.ae>

Hello:
Here we do not serve pork at all- that solved it for several religions
For our Hindu, etc vegetarians - we send a vegetarian diet

It may be easiest for you to consider having pork off of the patient menu- it will prevent some complaints to the quality department etc.
Are we more simplistic then other facilities?
Regards

Ellen Edwards, RD LD
Head, Clinical Dietetics
Chief Clinical Dietitian
Sheikh Khalifa Medical City (SKMC)
Managed by Cleveland Clinic
P.O. Box 51900
Abu Dhabi, United Arab Emirates
Direct:  +971 2 610-2024
Fax:  +971 2 610-2577
Mobile:  +971 050-661-7297
Email: eedwards at skmc.gov.ae

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Freeden, Theresa
Sent: Tuesday, July 21, 2009 11:01 PM
To: Cnm (E-mail)
Subject: [Cnm] cultural or religious food pref

How is the food service dept. notified of cultural/religious food preferences at your hospitals?
We had a case where the patient does not eat pork but because it wasn't a true "allergy" is was not entered in the computer.

Patient was sent pork for the first meal until someone from our dept. visited him.
Thanks

Theresa Freeden, MS, RD
Clinical Nutrition Manager
Somerset Medical Center
110 Rehill Ave.
Somerville, NJ 08876
908 704-2758

Important news about our email communications.
------------------------------------------------------------------------------------------------------------

In our commitment to maintain privacy in all our electronic communications, we are proud to announce the rollout of a new hospital-wide security project, which will enable us to protect confidential information sent externally via email through the use of encryption.

When an encrypted email is sent to you, you will receive a Secure Message with a link to view your message.  First-time recipients will be asked to create a password before given access to the Message Center to open the message.

To learn more about our email encryption solution, please go to:
http://userawareness.zixcorp.com/sites/index.php?b=411&type=1&p=0

________________________________
CONFIDENTIALITY NOTICE
This message and any included attachments are from
Somerset Medical Center and are intended only for the addressee.
The information contained in this message is confidential
and may contain privileged, confidential, proprietary and/or
trade secret information entitled to protection and/or exemption
from disclosure under applicable law. Unauthorized forwarding,
printing, copying, distribution, or use of such information is
strictly prohibited and may be unlawful. If you are not the
addressee, please promptly delete this message and notify
the sender of the delivery error by e-mail or you may call
Somerset Medical Center's computer Help Desk at
908-685-2200, ext. 4050.
--------------------------------------------------------------
Somerset Medical Center is the recipient of the
2009 Orthopedic Surgery Excellence Award(tm) from HealthGrades,
the nation's leading health care ratings company.

Visit Somerset Medical Center's Web site
- www.somersetmedicalcenter.com -
for news, event listings, health information and more.

Join the Discussion:
Facebook: www.somersetmedicalcenter.com/fb
Twitter: www.twitter.com/SomersetMedCtr

________________________________
Confidentiality Note: This message and any included attachments are intended for the exclusive use of the individual or entity that is the named addressee and may contain information that is privileged or confidential or otherwise legally exempt from disclosure. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please contact the sender immediately and destroy the material in its entirety, whether electronic or hard copy. Thank you.
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From Lyn.Haft at rexhealth.com  Wed Jul 22 05:18:50 2009
From: Lyn.Haft at rexhealth.com (Haft, Lyn)
Date: Wed, 22 Jul 2009 08:18:50 -0400
Subject: [Cnm] nutrition policy
In-Reply-To: <4A65F32C.B0D7.000E.0@lrmc.com>
Message-ID: <6C5C5FBEE636A043BC7466A8CAE0732F0B6DC9CF@exchmail1.rexhealth.com>

please post

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 Sandra Harrison
Sent: Tuesday, July 21, 2009 4:56 PM
To: cnm at lists.my180.net
Subject: [Cnm] nutrition policy

Does anyone have a nutrition care policy regarding the NCP that you are
willing to share?

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." 

----- 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 
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From Catherine.McIsaac at vtmednet.org  Wed Jul 22 05:36:51 2009
From: Catherine.McIsaac at vtmednet.org (McIsaac, Catherine L.)
Date: Wed, 22 Jul 2009 08:36:51 -0400
Subject: [Cnm] cultural or religious food pref
In-Reply-To: <9A99F98786F9254597C0A0C62685FB5A08757AD59D@AHA-MAIL.skmc.gov.ae>
References: 
	<9A99F98786F9254597C0A0C62685FB5A08757AD59D@AHA-MAIL.skmc.gov.ae>
Message-ID: 

We have room services, so typically we are able to capture cultural preferences from the beginning. We are removing pork from all of our menus, retail included, because of environmental/sustainability reasons, but I suppose that could be considered a cultural preference as well!

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.

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ellen Edwards
Sent: Wednesday, July 22, 2009 1:44 AM
To: Freeden, Theresa; Cnm (E-mail)
Subject: Re: [Cnm] cultural or religious food pref

Hello:
Here we do not serve pork at all- that solved it for several religions
For our Hindu, etc vegetarians - we send a vegetarian diet

It may be easiest for you to consider having pork off of the patient menu- it will prevent some complaints to the quality department etc.
Are we more simplistic then other facilities?
Regards

Ellen Edwards, RD LD
Head, Clinical Dietetics
Chief Clinical Dietitian
Sheikh Khalifa Medical City (SKMC)
Managed by Cleveland Clinic
P.O. Box 51900
Abu Dhabi, United Arab Emirates
Direct:  +971 2 610-2024
Fax:  +971 2 610-2577
Mobile:  +971 050-661-7297
Email: eedwards at skmc.gov.ae

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Freeden, Theresa
Sent: Tuesday, July 21, 2009 11:01 PM
To: Cnm (E-mail)
Subject: [Cnm] cultural or religious food pref

How is the food service dept. notified of cultural/religious food preferences at your hospitals?
We had a case where the patient does not eat pork but because it wasn't a true "allergy" is was not entered in the computer.

Patient was sent pork for the first meal until someone from our dept. visited him.
Thanks

Theresa Freeden, MS, RD
Clinical Nutrition Manager
Somerset Medical Center
110 Rehill Ave.
Somerville, NJ 08876
908 704-2758

Important news about our email communications.
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________________________________
CONFIDENTIALITY NOTICE
This message and any included attachments are from
Somerset Medical Center and are intended only for the addressee.
The information contained in this message is confidential
and may contain privileged, confidential, proprietary and/or
trade secret information entitled to protection and/or exemption
from disclosure under applicable law. Unauthorized forwarding,
printing, copying, distribution, or use of such information is
strictly prohibited and may be unlawful. If you are not the
addressee, please promptly delete this message and notify
the sender of the delivery error by e-mail or you may call
Somerset Medical Center's computer Help Desk at
908-685-2200, ext. 4050.
--------------------------------------------------------------
Somerset Medical Center is the recipient of the
2009 Orthopedic Surgery Excellence Award(tm) from HealthGrades,
the nation's leading health care ratings company.

Visit Somerset Medical Center's Web site
- www.somersetmedicalcenter.com -
for news, event listings, health information and more.

Join the Discussion:
Facebook: www.somersetmedicalcenter.com/fb
Twitter: www.twitter.com/SomersetMedCtr

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Confidentiality Note: This message and any included attachments are intended for the exclusive use of the individual or entity that is the named addressee and may contain information that is privileged or confidential or otherwise legally exempt from disclosure. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please contact the sender immediately and destroy the material in its entirety, whether electronic or hard copy. Thank you.
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From kfeldberkowitz at jhha.org  Wed Jul 22 05:39:32 2009
From: kfeldberkowitz at jhha.org (Feld-Berkowitz, Kathy)
Date: Wed, 22 Jul 2009 08:39:32 -0400
Subject: [Cnm] Cnm Digest, Vol 32,
	Issue 70- Food Service Supervisor looking for a position
In-Reply-To: 
References: 
Message-ID: 

A Food Service Supervisor with health care experience is looking for a
position in the Boston, Mass area.  Is anyone aware of any positions? 

Kathy Feld Berkowitz MS, RD, CDE, CDN
Assistant Director Food and Nutrition Services
Jewish Home Lifecare
Bronx Division
100 W Kingsbridge Road
Bronx, NY 10468
(718) 410-1522
kfeldberkowitz at jhha.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: Wednesday, July 22, 2009 1:44 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 32, Issue 70

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. cultural or religious food pref (Freeden, Theresa)
   2. Re: Albumin as an indicator of nutrition risk
      (Smith Michael - Palestine)
   3. nutrition policy (Sandra Harrison)
   4. study guides for DTR (Ellen Edwards)
   5. Re: cultural or religious food pref (Ellen Edwards)

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

Message: 1
Date: Tue, 21 Jul 2009 15:01:17 -0400
From: "Freeden, Theresa" 
Subject: [Cnm] cultural or religious food pref
To: "Cnm (E-mail)" 
Message-ID:

Content-Type: text/plain; charset="utf-8"

How is the food service dept. notified of cultural/religious food
preferences at your hospitals? 
We had a case where the patient does not eat pork but because it wasn't
a true "allergy" is was not entered in the computer. 
Patient was sent pork for the first meal until someone from our dept.
visited him.
Thanks

Theresa Freeden, MS, RD
Clinical Nutrition Manager 
Somerset Medical Center
110 Rehill Ave.
Somerville, NJ 08876
908 704-2758

CONFIDENTIALITY NOTICE
This message and any included attachments are from 
Somerset Medical Center and are intended only for the addressee.
The information contained in this message is confidential 
and may contain privileged, confidential, proprietary and/or 
trade secret information entitled to protection and/or exemption 
from disclosure under applicable law. Unauthorized forwarding, 
printing, copying, distribution, or use of such information is 
strictly prohibited and may be unlawful. If you are not the 
addressee, please promptly delete this message and notify 
the sender of the delivery error by e-mail or you may call 
Somerset Medical Center's computer Help Desk at 
908-685-2200, ext. 4050. 
-------------------------------------------------------------- 
Somerset Medical Center is the recipient of the 
2009 Orthopedic Surgery Excellence Award(tm) from HealthGrades,
the nation's leading health care ratings company.

Visit Somerset Medical Center's Web site 
- www.somersetmedicalcenter.com - 
for news, event listings, health information and more.

Join the Discussion: 
Facebook: www.somersetmedicalcenter.com/fb
Twitter: www.twitter.com/SomersetMedCtr
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Message: 2
Date: Tue, 21 Jul 2009 14:54:45 -0500
From: Smith Michael - Palestine 
Subject: Re: [Cnm] Albumin as an indicator of nutrition risk
To: "Horvath, Karen" , jen stovall
	, "cnm at lists.my180.net"

Message-ID:

Content-Type: text/plain; charset="us-ascii"

LOOK AT THIS FROM RD411.
http://www.rd411.com/article.php?ID=173

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 Horvath, Karen
Sent: Tuesday, July 21, 2009 1:26 PM
To: jen stovall; cnm at lists.my180.net
Subject: Re: [Cnm] Albumin as an indicator of nutrition risk

There was an article written by  Pamela Charney, PhD, RD, CNSD in
Support Line Feb. 2007 vol 29 No. 1 called Nutrition Assessment in the
Intensive Care Unit: Prealbumin, C-reactive Protein, or None of the
Above.
Also from this list serve there was an article in Practical
Gastroenterology.October 2006 called Serum Proteins as Markers of
Nutrition: What Are We Treating by Le Banh, MS, RD, CNSD
Hope that helps
Karen Horvath MA RD LD
SWGMC Middleburg Heights, Ohio
1-440-816-8845

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of jen stovall
Sent: Tuesday, July 21, 2009 2:02 PM
To: cnm at lists.my180.net
Subject: [Cnm] Albumin as an indicator of nutrition risk

Does anyone know of a good reference to back up a policy change on
Albumin not being an indicator of nutrition risk? Our current policy
states all patients with an Albumin of <3 should be seen by a dietitian.
P and T committee will want proof before I change this.

Thanks in advance

Jen Brennan, RD, CDN
(212) 434-2491

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Message: 3
Date: Tue, 21 Jul 2009 16:56:13 -0400
From: "Sandra Harrison" 
Subject: [Cnm] nutrition policy
To: 
Message-ID: <4A65F32C.B0D7.000E.0 at lrmc.com>
Content-Type: text/plain; charset="us-ascii"

Does anyone have a nutrition care policy regarding the NCP that you are
willing to share?

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
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Message: 4
Date: Wed, 22 Jul 2009 09:41:27 +0400
From: Ellen Edwards 
Subject: [Cnm] study guides for DTR
To: "cnm at lists.my180.net" 
Message-ID:

<9A99F98786F9254597C0A0C62685FB5A08757AD599 at AHA-MAIL.skmc.gov.ae>
Content-Type: text/plain; charset="us-ascii"

Hello:
Some of my international staff are now eligible to take the diet tech
registered exam. Are there study guides available for them to use?

Also, for the RD exam is there a preferred study guide? Some of our
Pilipino staff have received approval from CDR to take the RD exam as
well

Thank you

Ellen Edwards, RD LD
Head, Clinical Dietetics
Chief Clinical Dietitian
Sheikh Khalifa Medical City (SKMC)
Managed by Cleveland Clinic
P.O. Box 51900
Abu Dhabi, United Arab Emirates
Direct:  +971 2 610-2024
Fax:  +971 2 610-2577
Mobile:  +971 050-661-7297
Email: eedwards at skmc.gov.ae

________________________________
Confidentiality Note: This message and any included attachments are
intended for the exclusive use of the individual or entity that is the
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responsible for delivering the message to the intended recipient, you
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Message: 5
Date: Wed, 22 Jul 2009 09:43:50 +0400
From: Ellen Edwards 
Subject: Re: [Cnm] cultural or religious food pref
To: "Freeden, Theresa" , "Cnm
	(E-mail)"	
Message-ID:

<9A99F98786F9254597C0A0C62685FB5A08757AD59D at AHA-MAIL.skmc.gov.ae>
Content-Type: text/plain; charset="us-ascii"

Hello:
Here we do not serve pork at all- that solved it for several religions
For our Hindu, etc vegetarians - we send a vegetarian diet

It may be easiest for you to consider having pork off of the patient
menu- it will prevent some complaints to the quality department etc.
Are we more simplistic then other facilities?
Regards

Ellen Edwards, RD LD
Head, Clinical Dietetics
Chief Clinical Dietitian
Sheikh Khalifa Medical City (SKMC)
Managed by Cleveland Clinic
P.O. Box 51900
Abu Dhabi, United Arab Emirates
Direct:  +971 2 610-2024
Fax:  +971 2 610-2577
Mobile:  +971 050-661-7297
Email: eedwards at skmc.gov.ae

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Freeden, Theresa
Sent: Tuesday, July 21, 2009 11:01 PM
To: Cnm (E-mail)
Subject: [Cnm] cultural or religious food pref

How is the food service dept. notified of cultural/religious food
preferences at your hospitals?
We had a case where the patient does not eat pork but because it wasn't
a true "allergy" is was not entered in the computer.

Patient was sent pork for the first meal until someone from our dept.
visited him.
Thanks

Theresa Freeden, MS, RD
Clinical Nutrition Manager
Somerset Medical Center
110 Rehill Ave.
Somerville, NJ 08876
908 704-2758

Important news about our email communications.
------------------------------------------------------------------------
------------------------------------

In our commitment to maintain privacy in all our electronic
communications, we are proud to announce the rollout of a new
hospital-wide security project, which will enable us to protect
confidential information sent externally via email through the use of
encryption.

When an encrypted email is sent to you, you will receive a Secure
Message with a link to view your message.  First-time recipients will be
asked to create a password before given access to the Message Center to
open the message.

To learn more about our email encryption solution, please go to:
http://userawareness.zixcorp.com/sites/index.php?b=411&type=1&p=0

________________________________
CONFIDENTIALITY NOTICE
This message and any included attachments are from
Somerset Medical Center and are intended only for the addressee.
The information contained in this message is confidential
and may contain privileged, confidential, proprietary and/or
trade secret information entitled to protection and/or exemption
from disclosure under applicable law. Unauthorized forwarding,
printing, copying, distribution, or use of such information is
strictly prohibited and may be unlawful. If you are not the
addressee, please promptly delete this message and notify
the sender of the delivery error by e-mail or you may call
Somerset Medical Center's computer Help Desk at
908-685-2200, ext. 4050.
--------------------------------------------------------------
Somerset Medical Center is the recipient of the
2009 Orthopedic Surgery Excellence Award(tm) from HealthGrades,
the nation's leading health care ratings company.

Visit Somerset Medical Center's Web site
- www.somersetmedicalcenter.com -
for news, event listings, health information and more.

Join the Discussion:
Facebook: www.somersetmedicalcenter.com/fb
Twitter: www.twitter.com/SomersetMedCtr

________________________________
Confidentiality Note: This message and any included attachments are
intended for the exclusive use of the individual or entity that is the
named addressee and may contain information that is privileged or
confidential or otherwise legally exempt from disclosure. If the reader
of this message is not the intended recipient or the employee or agent
responsible for delivering the message to the intended recipient, you
are hereby notified that any dissemination, distribution or copying of
this communication is strictly prohibited. If you have received this
communication in error, please contact the sender immediately and
destroy the material in its entirety, whether electronic or hard copy.
Thank you.
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------------------------------

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

End of Cnm Digest, Vol 32, Issue 70
***********************************

From apirozek at hotmail.com  Wed Jul 22 06:51:38 2009
From: apirozek at hotmail.com (amy pirozek)
Date: Wed, 22 Jul 2009 09:51:38 -0400
Subject: [Cnm] NCP policy
Message-ID: 

Lyn and Sandra, I posted the same question Monday. The response I got privately was that there is one from about 7 years ago on the ADA website. I however was unable to find it. Please let me know if you find anything..

_________________________________________________________________
Bing? brings you maps, menus, and reviews organized in one place. Try it now.
http://www.bing.com/search?q=restaurants&form=MLOGEN&publ=WLHMTAG&crea=TXT_MLOGEN_Local_Local_Restaurants_1x1
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From MarcelleKarustis at catholichealth.net  Wed Jul 22 07:07:09 2009
From: MarcelleKarustis at catholichealth.net (Karustis, Marcelle)
Date: Wed, 22 Jul 2009 08:07:09 -0600
Subject: [Cnm] NCP policy
In-Reply-To: 
References: 
Message-ID: <17B38BCEA6E6F24D9300FA8CFE81F425DC7A28@chimsx015.CHI.catholichealth.net>

Took me a while to dig this up but... is this the sample policy from ADA
that you are looking for?

Marcelle Karustis MS RD RN LDN

Clinical Nutrition Manager

ext 2487

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of amy pirozek
Sent: Wednesday, July 22, 2009 9:52 AM
To: cnm at lists.my180.net
Subject: [Cnm] NCP policy

Lyn and Sandra, I posted the same question Monday. The response I got
privately was that there is one from about 7 years ago on the ADA
website. I however was unable to find it. Please let me know if you find
anything..

________________________________

Bing(tm) brings you maps, menus, and reviews organized in one place. Try
it now.

DISCLAIMER: The information contained in this electronic mail transmission is privileged and confidential. It is intended for the sole use and viewing of the addressee(s). If you are not the addressee(s), you are hereby notified that any disclosure, distribution, or other use of the information contained herein, other than deletion, is strictly prohibited. Violation of this prohibition may result in civil or criminal liability.

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From CJoiner at bwmc.umms.org  Wed Jul 22 07:21:50 2009
From: CJoiner at bwmc.umms.org (Joiner, Catherine)
Date: Wed, 22 Jul 2009 10:21:50 -0400
Subject: [Cnm] Monitors for JCT Standard
Message-ID: 

Can anyone share what monitors you are using for JCT Standard
PC.02.02.03?  Particularly with accommodating cultural/religious
preferences and offering substitutes of equal nutritional value when
patients refuse food.  We have several QA monitors in place and are
trying to fit them to each element in this standard.  Just wanted to see
what other people were using to measure.  Thanks!

Catherine Joiner, MS RD LDN CNSC

Clinical Nutrition Manager

Baltimore Washington Medical Center

301 Hospital Drive

Glen Burnie, MD 21061

410-787-4379

Fax: 410-595-1984

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From LDALGLEISH at lakelandregional.org  Wed Jul 22 07:47:18 2009
From: LDALGLEISH at lakelandregional.org (Lisa Dalgleish)
Date: Wed, 22 Jul 2009 10:47:18 -0400
Subject: [Cnm] Monitors for JCT Standard
In-Reply-To: 
References: 
Message-ID: <4A66EE15.DF60.000C.0@lakelandregional.org>

Our monitor for cultural/religious preferences has been to ensure our 'house' meals are < 10% of the total meals served.  The rationale is that if patients are making their own selections then their preferences are being met.  

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> "Joiner, Catherine"  7/22/2009 10:21 AM >>>

Can anyone share what monitors you are using for JCT Standard PC.02.02.03?  Particularly with accommodating cultural/religious preferences and offering substitutes of equal nutritional value when patients refuse food.  We have several QA monitors in place and are trying to fit them to each element in this standard.  Just wanted to see what other people were using to measure.  Thanks!

Catherine Joiner, MS RD LDN CNSC
Clinical Nutrition Manager
BaltimoreWashington Medical Center
301 Hospital Drive
Glen Burnie, MD 21061
410-787-4379
Fax: 410-595-1984

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From jonessl at upmc.edu  Wed Jul 22 08:03:42 2009
From: jonessl at upmc.edu (Jones, Sherri)
Date: Wed, 22 Jul 2009 11:03:42 -0400
Subject: [Cnm] NCP policy
In-Reply-To: 
References: 
Message-ID: <928A945F630BBA4D8145A788E444649B4013B30E@MSXMBXNSPRD03.acct.upmchs.net>

I currently sit on the ADA NCP-SL Committee and want to make you aware that the NCP Policy and Procedure as posted on the ADA website is in the process of being updated and revised. I'm not sure when the new version will be available on the website. But wanted to make you aware, so you can check back in the future.

Sherri
Sherri L. Jones, MS, MBA, RD, LDN
Clinical Nutrition Manager
UPMC Shadyside
Phone: (412) 623-1629
Pager: (412) 263-8518
Fax: (412) 623-2429
jonessl at upmc.edu
________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of amy pirozek
Sent: Wednesday, July 22, 2009 9:52 AM
To: cnm at lists.my180.net
Subject: [Cnm] NCP policy

Lyn and Sandra, I posted the same question Monday. The response I got privately was that there is one from about 7 years ago on the ADA website. I however was unable to find it. Please let me know if you find anything..
________________________________
Bing(tm) brings you maps, menus, and reviews organized in one place. Try it now.
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From LAltenburger5 at matherhospital.org  Wed Jul 22 09:16:23 2009
From: LAltenburger5 at matherhospital.org (Altenburger, Linda)
Date: Wed, 22 Jul 2009 12:16:23 -0400
Subject: [Cnm] Calculation of Lipid Content in PN
Message-ID: 

Hello there.  We are trying to come to a consensus among our RD's
regarding what is the correct kcals per gram to use when calculating a
lipid emulsion when a patient is on PN.  Some have used 9 kcals/gram
(however, others felt this is only correct with pure fat); others are
using 10 kcals/gram and yet another source made reference to 11 kcals
per gram.  Would anyone care to share what they use and perhaps what
source you adapted it from  ie) ASPEN or other. 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

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From Mary-Anne.Flowers at HCAhealthcare.com  Wed Jul 22 11:21:26 2009
From: Mary-Anne.Flowers at HCAhealthcare.com (Flowers Mary-Anne)
Date: Wed, 22 Jul 2009 13:21:26 -0500
Subject: [Cnm] Tube Feeding recommendations for 1 year old With SMA type I
In-Reply-To: 
References: 
Message-ID: 

I am seeing a one year old baby with SMA1, if there are any dietitians on this list serve that can add their expertise to tube feeding this type of child I would appreciate their input - or if you can provide me with contact info for pediatric dietitians experienced with this I would appreciate any help.

Mary-Anne Flowers RD
Oak Hill Hospital
11375 Cortez Blvd., Brooksville, FL, 34613
mary-anne.flowers at hcahealthcare.com

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From MKELLEY8 at PARTNERS.ORG  Wed Jul 22 11:24:51 2009
From: MKELLEY8 at PARTNERS.ORG (Kelley, Marissa E.)
Date: Wed, 22 Jul 2009 14:24:51 -0400
Subject: [Cnm] Calculation of Lipid Content in PN
In-Reply-To: 
References: 
Message-ID: 

Please post to list - we all have different theory's too!

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf
Of Altenburger, Linda
Sent: Wednesday, July 22, 2009 12:16 PM
To: cnm at lists.my180.net
Subject: [Cnm] Calculation of Lipid Content in PN

Hello there.  We are trying to come to a consensus among our RD's regarding what
is the correct kcals per gram to use when calculating a lipid emulsion when a
patient is on PN.  Some have used 9 kcals/gram (however, others felt this is
only correct with pure fat); others are using 10 kcals/gram and yet another
source made reference to 11 kcals per gram.  Would anyone care to share what
they use and perhaps what source you adapted it from  ie) ASPEN or other. 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

The information in this e-mail is intended only for the person to whom it is
addressed. If you believe this e-mail was sent to you in error and the e-mail
contains patient information, please contact the Partners Compliance HelpLine at
http://www.partners.org/complianceline . If the e-mail was sent to you in error
but does not contain patient information, please contact the sender and properly
dispose of the e-mail.
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From mpappo at montefiore.org  Wed Jul 22 11:52:09 2009
From: mpappo at montefiore.org (Miriam Pappo)
Date: Wed, 22 Jul 2009 14:52:09 -0400
Subject: [Cnm] Calculation of Lipid Content in PN
Message-ID: 

>From the ASPEN Nutrition Support Core Curriculum 2007 "Each gram of fat
provides 9kcal; however, the glycerol in IVFE adds calories such that
each gram of fat in IVFE 10% is equivalent to 11kcal while each gram of
fat in IVFE 20% and 30% is equivalent to 10kcal."  Here, in adults, we
use 20% IVFE.

Jennifer Controne, RD, CDN, CNSC
Critical Care Dietitian
Montefiore Medical Center
The University Hospital for the 
Albert Einstein College of Medicine 
Moses Division
111 East 210th Street
Bronx, NY 10467

Office (718) 920-2436
Pager (917) 218-0734

>>> "Altenburger, Linda"  07/22/09
12:16 PM >>>

Hello there.  We are trying to come to a consensus among our RD's
regarding what is the correct kcals per gram to use when calculating a
lipid emulsion when a patient is on PN.  Some have used 9 kcals/gram
(however, others felt this is only correct with pure fat); others are
using 10 kcals/gram and yet another source made reference to 11 kcals
per gram.  Would anyone care to share what they use and perhaps what
source you adapted it from  ie) ASPEN or other. 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

From Michael.Smith at LPNT.net  Wed Jul 22 11:57:55 2009
From: Michael.Smith at LPNT.net (Smith Michael - Palestine)
Date: Wed, 22 Jul 2009 13:57:55 -0500
Subject: [Cnm] Calculation of Lipid Content in PN
In-Reply-To: 
References: 

Message-ID: 

10% LIPIDS = 1.1 CALORIES/mL
20% lipids = 2.0 calories/mL

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 Kelley, Marissa E.
Sent: Wednesday, July 22, 2009 1:25 PM
To: Altenburger, Linda; cnm at lists.my180.net
Subject: Re: [Cnm] Calculation of Lipid Content in PN

Please post to list - we all have different theory's too!

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Altenburger, Linda
Sent: Wednesday, July 22, 2009 12:16 PM
To: cnm at lists.my180.net
Subject: [Cnm] Calculation of Lipid Content in PN

Hello there.  We are trying to come to a consensus among our RD's regarding what is the correct kcals per gram to use when calculating a lipid emulsion when a patient is on PN.  Some have used 9 kcals/gram (however, others felt this is only correct with pure fat); others are using 10 kcals/gram and yet another source made reference to 11 kcals per gram.  Would anyone care to share what they use and perhaps what source you adapted it from  ie) ASPEN or other. 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

The information in this e-mail is intended only for the person to whom it is

addressed. If you believe this e-mail was sent to you in error and the e-mail

contains patient information, please contact the Partners Compliance HelpLine at

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From Jennifer.DeHart at stvhs.com  Wed Jul 22 12:05:15 2009
From: Jennifer.DeHart at stvhs.com (DeHart, Jennifer)
Date: Wed, 22 Jul 2009 14:05:15 -0500
Subject: [Cnm] comonly used tubes for feeding (brands, sizes)
Message-ID: <790BE6DACA733D45A2EFE7875E03CC7C01743236@ahcmascdc024.DS.SJHS.COM>

My facility has historically only stocked NGT's appropriate for suction
such as in post-op patients and small lumen tubes such as 8-Fr Keofeeds
with no larger lumen nasogastric feeding tube.  We are interested in
adding such a tube - any information regarding brands, sizes, etc. for
the most commonly used naso/oro-gastric (for suction and for feeding) as
well as nasojejunal feeding tubes would be much appreciated.

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

P.S. I will be running the Nike Women's Marathon in San Francisco on
October 18th to raise funds for the Leukemia and Lymphoma Society. To
make a donation or to learn more, please visit my fundraising website at
http://pages.teamintraining.org/al/nikesf09/jdehart

Confidentiality Notice: This e-mail message, including any attachments
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recipient, please contact the sender by reply e-mail and destroy all
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P Please consider the environment before printing this e-mail

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From LAltenburger5 at matherhospital.org  Thu Jul 23 06:47:27 2009
From: LAltenburger5 at matherhospital.org (Altenburger, Linda)
Date: Thu, 23 Jul 2009 09:47:27 -0400
Subject: [Cnm] holding of TF for PT?
Message-ID: 

Our Physicial Therapy Director has contacted me to see what other
facilities are doing when a patient is receiving continuous TF and they
have PT.  Could you share with us your protocol/policy as to whether the
TF is put on hold or not and if rate is adjusted to make sure patient
still meets their TF goals nutritionally.   Thank you 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

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From LCarver at Reshealthcare.org  Thu Jul 23 06:54:19 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Thu, 23 Jul 2009 08:54:19 -0500
Subject: [Cnm] holding of TF for PT?
In-Reply-To: 
References: 
Message-ID: <5330B54133B6194BA13930BDEFE9A30E0497B9BB@rhcexch3.reshealthcare.org>

On our Rehab unit, we use virtually all overnight tube feedings as the
pts are in PT/OT, etc and off their units significant parts of the day.
Elsewhere, the tube feeding usually keeps going unless positioning would
make it an aspiration risk.  

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Altenburger, Linda
Sent: Thursday, July 23, 2009 8:47 AM
To: cnm at lists.my180.net
Subject: [Cnm] holding of TF for PT?

Our Physicial Therapy Director has contacted me to see what other
facilities are doing when a patient is receiving continuous TF and they
have PT.  Could you share with us your protocol/policy as to whether the
TF is put on hold or not and if rate is adjusted to make sure patient
still meets their TF goals nutritionally.   Thank you 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

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From esmerl21 at aol.com  Thu Jul 23 06:58:12 2009
From: esmerl21 at aol.com (esmerl21 at aol.com)
Date: Thu, 23 Jul 2009 09:58:12 -0400
Subject: [Cnm] RD "eligible"
Message-ID: <8CBD9B4C078664D-17A8-1353@webmail-mh15.sysops.aol.com>

Does anyone know the guidelines for co-signing (or not)?notes/MDS for Dietitians who have completed all of the requirements for registration, but have not taken the test yet.? This would be for a LTC facility in NY.
Thanks,
Erika Schmerl, MS, RD
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From LAltenburger5 at matherhospital.org  Thu Jul 23 07:02:54 2009
From: LAltenburger5 at matherhospital.org (Altenburger, Linda)
Date: Thu, 23 Jul 2009 10:02:54 -0400
Subject: [Cnm] holding of TF for PT?
In-Reply-To: <4A680A3A.7147.00AE.0@ah.org>
Message-ID: 

Yes, thank you. This is what we are currently doing. 

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

-----Original Message-----
From: Clare Hicks [mailto:HicksCM at ah.org] 
Sent: Thursday, July 23, 2009 9:59 AM
To: Altenburger, Linda
Subject: Re: [Cnm] holding of TF for PT?

I don't think we have an official policy for this, but our PT's just
leave the tube feeding connected/running while they do the therapy.
Generally, if a patient is in the hospital the PT is not too strenuous
(it's not like they're running on a treadmill or anything). The PT's
will walk a patient down the hallway or do exercises in the room with
their tube feeding and IV's going.

Hope this helps,
Clare Hicks, RD
Sonora Regional Medical Center
Sonora, CA

>>> "Altenburger, Linda"  07/23/2009
06:47 >>>

Our Physicial Therapy Director has contacted me to see what other
facilities are doing when a patient is receiving continuous TF and they
have PT.  Could you share with us your protocol/policy as to whether the
TF is put on hold or not and if rate is adjusted to make sure patient
still meets their TF goals nutritionally.   Thank you 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

From LCarver at Reshealthcare.org  Thu Jul 23 07:03:08 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Thu, 23 Jul 2009 09:03:08 -0500
Subject: [Cnm] RD "eligible"
In-Reply-To: <8CBD9B4C078664D-17A8-1353@webmail-mh15.sysops.aol.com>
References: <8CBD9B4C078664D-17A8-1353@webmail-mh15.sysops.aol.com>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E0497B9C7@rhcexch3.reshealthcare.org>

we don't allow anyone who is not registered and licensed to sign the
MDS.  at least in Illinois this would be a major problem.  

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of esmerl21 at aol.com
Sent: Thursday, July 23, 2009 8:58 AM
To: cnm at lists.my180.net
Subject: [Cnm] RD "eligible"

Does anyone know the guidelines for co-signing (or not) notes/MDS for
Dietitians who have completed all of the requirements for registration,
but have not taken the test yet.  This would be for a LTC facility in
NY.
Thanks,
Erika Schmerl, MS, RD 

________________________________

One-click access to hundreds of free games. Get the Games.com Toolbar
 . 
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From mpappo at montefiore.org  Thu Jul 23 07:07:06 2009
From: mpappo at montefiore.org (Miriam Pappo)
Date: Thu, 23 Jul 2009 10:07:06 -0400
Subject: [Cnm] holding of TF for PT?
Message-ID: 

please share with all, as this is PI initiative for us.

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>> "Altenburger, Linda"  07/23/09
9:47 AM >>>

Our Physicial Therapy Director has contacted me to see what other
facilities are doing when a patient is receiving continuous TF and
they
have PT.  Could you share with us your protocol/policy as to whether
the
TF is put on hold or not and if rate is adjusted to make sure patient
still meets their TF goals nutritionally.   Thank you 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

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From msohal at frhg.org  Thu Jul 23 08:32:55 2009
From: msohal at frhg.org (Sohal, Manjit)
Date: Thu, 23 Jul 2009 08:32:55 -0700
Subject: [Cnm] Changing Department Name
Message-ID: <5E3E345918590D4D86333A4FCCF51A90019A4DBB@EXCHVS.frhg.org>

We have changed our department name several years ago from "Dietary" to
"Nutrition Services".  However, we have been told that the name Dietary
has to used in department budgets due to it's a universally used
hospital department name.  

Has anyone else had this issue?

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   

Exceptional Care, Close to Home 

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From Sandra.Harrison at lrmc.com  Thu Jul 23 08:33:02 2009
From: Sandra.Harrison at lrmc.com (Sandra Harrison)
Date: Thu, 23 Jul 2009 11:33:02 -0400
Subject: [Cnm] NCP
Message-ID: <4A684A6E.B0D7.000E.0@lrmc.com>

We are in the process of implementing the NCP in our faciity and my staff are struggling with the standard terminology with the monitoring and intervention.  Are other facilities having any problems with implementing?

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."
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From m-rodrig at msmc.com  Thu Jul 23 08:58:19 2009
From: m-rodrig at msmc.com (Maritza Rodriguez)
Date: Thu, 23 Jul 2009 11:58:19 -0400
Subject: [Cnm] NCP
In-Reply-To: <4A684A6E.B0D7.000E.0@lrmc.com>
References: <4A684A6E.B0D7.000E.0@lrmc.com>
Message-ID: <32EDCA3D1F5C4C41B7E1A4573DFACCC6021180AB@SVIPEXC1.msmc.com>

Does any of you know if the sodium in sunflowers- seeds (Frito lay or
Lance brand) count only for the seed or it includes the sodium in the
shell? 

Maritza Rodriguez, RD LDN

Mount Sinai Medical Center

Miami Beach, Florida 33140

Tel: 305-674-2121 Ext. 56181

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
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From mpappo at montefiore.org  Thu Jul 23 09:05:09 2009
From: mpappo at montefiore.org (Miriam Pappo)
Date: Thu, 23 Jul 2009 12:05:09 -0400
Subject: [Cnm] Changing Department Name
Message-ID: 

no.  never heard of this at all.  

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>> "Sohal, Manjit"  07/23/09 11:32 AM >>>
We have changed our department name several years ago from "Dietary"
to
"Nutrition Services".  However, we have been told that the name
Dietary
has to used in department budgets due to it's a universally used
hospital department name.  

Has anyone else had this issue?

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   

Exceptional Care, Close to Home 

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From mpappo at montefiore.org  Thu Jul 23 09:18:55 2009
From: mpappo at montefiore.org (Miriam Pappo)
Date: Thu, 23 Jul 2009 12:18:55 -0400
Subject: [Cnm] sunflower seeds
Message-ID: 

The sodium is from the added salt.
According to Calorieking.com   unsalted roasted sunflower seeds w/ the
shell has 0 mg Sodium. 

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>> "Maritza Rodriguez"  07/23/09 11:58 AM >>>
Does any of you know if the sodium in sunflowers- seeds (Frito lay or
Lance brand) count only for the seed or it includes the sodium in the
shell? 

Maritza Rodriguez, RD LDN

Mount Sinai Medical Center

Miami Beach, Florida 33140

Tel: 305-674-2121 Ext. 56181

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."
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From MHager at eatright.org  Thu Jul 23 09:31:22 2009
From: MHager at eatright.org (Mary Hager)
Date: Thu, 23 Jul 2009 11:31:22 -0500
Subject: [Cnm] Changing Department Name
In-Reply-To: 
References: 
Message-ID: 

Hi,

I would like to jump in on the use of "Dietary."  Federal regulations (AKA administrative law) defines the service as follows: 

CMS Hospital Rules

?482.28 Condition of Participation: Food and Dietetic Services

The hospital must have organized dietary services that are directed and staffed by adequate qualified personnel.

CMS Nursing Facility Rules

42 CFR 483.35(a)(1)(2), F361, Dietary Services

State facility rules as well tend to use the same terminology.  

Regards,

Mary

Mary H. Hager, PhD, RD, FADA

Director, Regulatory Affairs

American Dietetic Association

1120 Connecticut Avenue NW

Washington, DC 20036

202-775-8277, ext. 6007

fax:  202-775-8284

mhager at eatright.org

www.eatright.org

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Miriam Pappo
Sent: Thursday, July 23, 2009 12:05 PM
To: msohal at frhg.org; cnm at lists.my180.net
Subject: Re: [Cnm] Changing Department Name

no.  never heard of this at all.  

Miriam Pappo, MS, RD, CDN

Director -  Department of Clinical Nutrition Montefiore Medical Center

111 E. 210 St.

Bronx, NY 10467

718-920-4253 Moses (M, W, Th)

718-904-2724 Weiler (Tu, F)

917-641-3736 pager

>>> "Sohal, Manjit"  07/23/09 11:32 AM >>>

We have changed our department name several years ago from "Dietary"

to

"Nutrition Services".  However, we have been told that the name Dietary has to used in department budgets due to it's a universally used hospital department name.  

Has anyone else had this issue?

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   

Exceptional Care, Close to Home 

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From MELLINGTON at wakemed.org  Thu Jul 23 09:31:42 2009
From: MELLINGTON at wakemed.org (MARTHA ELLINGTON)
Date: Thu, 23 Jul 2009 12:31:42 -0400
Subject: [Cnm] Changing Department Name
In-Reply-To: <5E3E345918590D4D86333A4FCCF51A90019A4DBB@EXCHVS.frhg.org>
References: <5E3E345918590D4D86333A4FCCF51A90019A4DBB@EXCHVS.frhg.org>
Message-ID: 

We changed our name from Dietary to Food and Nutrition services over 10 years ago, but it took years for budget folks to get us changed in their system.  After years and probably a new IS system our financial reports match our correct name.  This had nothing to do with "standards" it was just trying to change the bureaucracy around here.  I know very few departments that call themselves Dietary any more, but most TJC surveyors still refer to Dietary on every survey.  Old habits die hard.  When our "Environmental Services Director" calls us" Dietary", I just refer to them as "House Keeping" and he gets the hint.  That, however, would not work with a surveyor.
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 Sohal, Manjit
Sent: Thursday, July 23, 2009 11:33 AM
To: cnm at lists.my180.net
Subject: [Cnm] Changing Department Name

We have changed our department name several years ago from "Dietary" to "Nutrition Services".  However, we have been told that the name Dietary has to used in department budgets due to it's a universally used hospital department name.

Has anyone else had this issue?

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

Exceptional Care, Close to Home

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

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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.  
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From Bonnie.Meehan at ssfhs.org  Thu Jul 23 09:51:51 2009
From: Bonnie.Meehan at ssfhs.org (Meehan Bonnie)
Date: Thu, 23 Jul 2009 12:51:51 -0400
Subject: [Cnm] FW: Changing Department Name
Message-ID: <28281606.363274.1248367912009.JavaMail.root@oailxiron1.ssfhs.org>

We changed our dept name to Food & Nutrition years ago too.  I kept wondering why it would show up as "Dietary" on some things and found out this was because Finance had us coded that way.  We then worked with our Finance Dept to get our name officially changed on their reports.  It was not a hard nor time consuming thing to do.  Good look with this.--Bonnie Meehan, Indpls, IN

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of MARTHA ELLINGTON
Sent: Thursday, July 23, 2009 12:32 PM
To: Sohal, Manjit; cnm at lists.my180.net
Subject: Re: [Cnm] Changing Department Name

We changed our name from Dietary to Food and Nutrition services over 10 years ago, but it took years for budget folks to get us changed in their system.  After years and probably a new IS system our financial reports match our correct name.  This had nothing to do with "standards" it was just trying to change the bureaucracy around here.  I know very few departments that call themselves Dietary any more, but most TJC surveyors still refer to Dietary on every survey.  Old habits die hard.  When our "Environmental Services Director" calls us" Dietary", I just refer to them as "House Keeping" and he gets the hint.  That, however, would not work with a surveyor.
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 Sohal, Manjit
Sent: Thursday, July 23, 2009 11:33 AM
To: cnm at lists.my180.net
Subject: [Cnm] Changing Department Name

We have changed our department name several years ago from "Dietary" to "Nutrition Services".  However, we have been told that the name Dietary has to used in department budgets due to it's a universally used hospital department name.

Has anyone else had this issue?

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

Exceptional Care, Close to Home

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

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.

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

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From Virginia.Carney at STJUDE.ORG  Thu Jul 23 10:03:53 2009
From: Virginia.Carney at STJUDE.ORG (Carney, Virginia H)
Date: Thu, 23 Jul 2009 12:03:53 -0500
Subject: [Cnm] Changing Department Name
In-Reply-To: <28281606.363274.1248367912009.JavaMail.root@oailxiron1.ssfhs.org>
Message-ID: <6EAE916704479E4BB6AB5A133BA224F72795A4BD07@SJMEMXMBS11.stjude.sjcrh.local>

This is one of my pet peeves....especially since my department is separate from Food Services. I used to be asked what was in the cafeteria for lunch, as if I had been in the kitchen all morning stirring a pot..I wanted people to understand that dietitians do much more than cook, supervise the cooks, or plan menus.

 I made a point to make sure our JC specialist in the hospital knew that there were 2 departments, not one.  I am hoping that this terminology will eventually change since our practice area has really changed since the beginning of JC and they may need to divide up what Food Services will be responsible for and what Clinical Nutrition Services will be responsible for.

Ginger

Virginia Carney, RD, LDN, IBCLC, RLC, FILCA
Director, Clinical Nutrition
St. Jude Children's Research Hospital
262 Danny Thomas Place, Mail Stop 732
Memphis, TN 38105-3678
901-595-3315 (office)
pager 595-3578, PIN# 0838
virginia.carney at stjude.org

[cid:367145816 at 23072009-0D73]
[cid:367145816 at 23072009-0D73]
Finding cures.  Saving children.
www.stjude.org

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Meehan Bonnie
Sent: Thursday, July 23, 2009 11:52 AM
To: 'cnm at lists.my180.net'
Subject: [Cnm] FW: Changing Department Name

We changed our dept name to Food & Nutrition years ago too.  I kept wondering why it would show up as "Dietary" on some things and found out this was because Finance had us coded that way.  We then worked with our Finance Dept to get our name officially changed on their reports.  It was not a hard nor time consuming thing to do.  Good look with this.--Bonnie Meehan, Indpls, IN

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of MARTHA ELLINGTON
Sent: Thursday, July 23, 2009 12:32 PM
To: Sohal, Manjit; cnm at lists.my180.net
Subject: Re: [Cnm] Changing Department Name

We changed our name from Dietary to Food and Nutrition services over 10 years ago, but it took years for budget folks to get us changed in their system.  After years and probably a new IS system our financial reports match our correct name.  This had nothing to do with "standards" it was just trying to change the bureaucracy around here.  I know very few departments that call themselves Dietary any more, but most TJC surveyors still refer to Dietary on every survey.  Old habits die hard.  When our "Environmental Services Director" calls us" Dietary", I just refer to them as "House Keeping" and he gets the hint.  That, however, would not work with a surveyor.
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 Sohal, Manjit
Sent: Thursday, July 23, 2009 11:33 AM
To: cnm at lists.my180.net
Subject: [Cnm] Changing Department Name

We have changed our department name several years ago from "Dietary" to "Nutrition Services".  However, we have been told that the name Dietary has to used in department budgets due to it's a universally used hospital department name.

Has anyone else had this issue?

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

Exceptional Care, Close to Home

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

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.

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

________________________________
The information contained in this e-mail and any accompanying documents 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. If you are not the intended recipient(s), please contact the sender by e-mail and destroy all copies of the original message. Thank you.

________________________________
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From mpappo at montefiore.org  Thu Jul 23 10:23:13 2009
From: mpappo at montefiore.org (Miriam Pappo)
Date: Thu, 23 Jul 2009 13:23:13 -0400
Subject: [Cnm] Changing Department Name
Message-ID: 

Does that mean, in your interpretation, that the use of the word  "dietary" must be in the dept title?

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>> "Mary Hager"  07/23/09 12:31 PM >>>
Hi,

I would like to jump in on the use of "Dietary."  Federal regulations (AKA administrative law) defines the service as follows: 

CMS Hospital Rules

?482.28 Condition of Participation: Food and Dietetic Services

The hospital must have organized dietary services that are directed and staffed by adequate qualified personnel.

CMS Nursing Facility Rules

42 CFR 483.35(a)(1)(2), F361, Dietary Services

State facility rules as well tend to use the same terminology.  

Regards,

Mary

Mary H. Hager, PhD, RD, FADA

Director, Regulatory Affairs

American Dietetic Association

1120 Connecticut Avenue NW

Washington, DC 20036

202-775-8277, ext. 6007

fax:  202-775-8284

mhager at eatright.org 

www.eatright.org 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Miriam Pappo
Sent: Thursday, July 23, 2009 12:05 PM
To: msohal at frhg.org; cnm at lists.my180.net 
Subject: Re: [Cnm] Changing Department Name

no.  never heard of this at all.  

Miriam Pappo, MS, RD, CDN

Director -  Department of Clinical Nutrition Montefiore Medical Center

111 E. 210 St.

Bronx, NY 10467

718-920-4253 Moses (M, W, Th)

718-904-2724 Weiler (Tu, F)

917-641-3736 pager

>>> "Sohal, Manjit"  07/23/09 11:32 AM >>>

We have changed our department name several years ago from "Dietary"

to

"Nutrition Services".  However, we have been told that the name Dietary has to used in department budgets due to it's a universally used hospital department name.  

Has anyone else had this issue?

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   

Exceptional Care, Close to Home 

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From Pamela.Beanum at HCAhealthcare.com  Thu Jul 23 10:26:44 2009
From: Pamela.Beanum at HCAhealthcare.com (Beanum Pamela)
Date: Thu, 23 Jul 2009 12:26:44 -0500
Subject: [Cnm] Enteral Protocols
Message-ID: <19833324B774F042B1FE1C34A79695BA258EDF77CE@NADCWPMSGCMS07.hca.corpad.net>

We are interested in establishing standard orders/protocols for enteral feedings, including order sets for new PEG/J tubes.  Does anyone have something already in place they would be willing to share?

Thanks!

Pamela Beanum, RD
Clinical Nutrition/Catering Manager
804-254-9823 (phone)
804-254-5538 (fax)
Retreat Doctors' Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave
Richmond VA 23220
pamela.beanum at hcahealthcare.com

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From Pamela.Beanum at HCAhealthcare.com  Thu Jul 23 10:27:57 2009
From: Pamela.Beanum at HCAhealthcare.com (Beanum Pamela)
Date: Thu, 23 Jul 2009 12:27:57 -0500
Subject: [Cnm] MD Questions
Message-ID: <19833324B774F042B1FE1C34A79695BA258EDF77D2@NADCWPMSGCMS07.hca.corpad.net>

We have some doctors interested in making some changes related to TF residuals...the question has become has anyone else STOPPED checking for residuals?  If so, how did you go about making the change?

Thanks!

Pamela Beanum, RD
Clinical Nutrition/Catering Manager
804-254-9823 (phone)
804-254-5538 (fax)
Retreat Doctors' Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave
Richmond VA 23220
pamela.beanum at hcahealthcare.com

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From MHager at eatright.org  Thu Jul 23 10:34:48 2009
From: MHager at eatright.org (Mary Hager)
Date: Thu, 23 Jul 2009 12:34:48 -0500
Subject: [Cnm] Changing Department Name
In-Reply-To: 
References: 
Message-ID: 

No, that doesn't mean it (the term dietary) must be in the title of the department that your facility chooses to use.  

It only means that the term is likely to go away, no matter how much we all dislike it.  It is universally understood term.  Also, accrediting organizations use as Joint Commission and others also use it, because their standards are linked to the regulations.

Regards,

Mary

Mary H. Hager, PhD, RD, FADA
Director, Regulatory Affairs
American Dietetic Association
1120 Connecticut Avenue NW
Washington, DC 20036
202-775-8277, ext. 6007
fax:  202-775-8284
mhager at eatright.org
www.eatright.org

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Miriam Pappo
Sent: Thursday, July 23, 2009 1:23 PM
To: Mary Hager; msohal at frhg.org; cnm at lists.my180.net
Subject: Re: [Cnm] Changing Department Name

Does that mean, in your interpretation, that the use of the word  "dietary" must be in the dept title?

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>> "Mary Hager"  07/23/09 12:31 PM >>>
Hi,

I would like to jump in on the use of "Dietary."  Federal regulations (AKA administrative law) defines the service as follows: 

CMS Hospital Rules

?482.28 Condition of Participation: Food and Dietetic Services

The hospital must have organized dietary services that are directed and staffed by adequate qualified personnel.

CMS Nursing Facility Rules

42 CFR 483.35(a)(1)(2), F361, Dietary Services

State facility rules as well tend to use the same terminology.  

Regards,

Mary

Mary H. Hager, PhD, RD, FADA

Director, Regulatory Affairs

American Dietetic Association

1120 Connecticut Avenue NW

Washington, DC 20036

202-775-8277, ext. 6007

fax:  202-775-8284

mhager at eatright.org 

www.eatright.org 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Miriam Pappo
Sent: Thursday, July 23, 2009 12:05 PM
To: msohal at frhg.org; cnm at lists.my180.net
Subject: Re: [Cnm] Changing Department Name

no.  never heard of this at all.  

Miriam Pappo, MS, RD, CDN

Director -  Department of Clinical Nutrition Montefiore Medical Center

111 E. 210 St.

Bronx, NY 10467

718-920-4253 Moses (M, W, Th)

718-904-2724 Weiler (Tu, F)

917-641-3736 pager

>>> "Sohal, Manjit"  07/23/09 11:32 AM >>>

We have changed our department name several years ago from "Dietary"

to

"Nutrition Services".  However, we have been told that the name Dietary has to used in department budgets due to it's a universally used hospital department name.  

Has anyone else had this issue?

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   

Exceptional Care, Close to Home 

From cohmart at mainehospital.org  Thu Jul 23 10:38:54 2009
From: cohmart at mainehospital.org (Cece Ohmart)
Date: Thu, 23 Jul 2009 13:38:54 -0400 (EDT)
Subject: [Cnm] Changing Department Name
In-Reply-To: <5E3E345918590D4D86333A4FCCF51A90019A4DBB@EXCHVS.frhg.org>
References: <5E3E345918590D4D86333A4FCCF51A90019A4DBB@EXCHVS.frhg.org>
Message-ID: <20090723133854.AFW14867@mail.mainehospital.org>

Our facility calls the food service department "Dietary". The clinical nutrition service is called "Nutrition Services".  We are two separate departments that interact with each other very frequently.
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 hgreenw2 at fairview.org  Thu Jul 23 10:39:59 2009
From: hgreenw2 at fairview.org (Greenwaldt, Heidi J)
Date: Thu, 23 Jul 2009 12:39:59 -0500
Subject: [Cnm] MD Questions
In-Reply-To: <19833324B774F042B1FE1C34A79695BA258EDF77D2@NADCWPMSGCMS07.hca.corpad.net>
Message-ID: <59F3EAD5C3376A42B3CD083F034A6127056770E4@digsmxmbx06.Fairview.org>

We are still checking residuals. There is information on residuals in
the new ASPEN/SCCM guidelines that just came out. Unfortunately I left
my journal at home and don't remember the specifics. We have a protocol
if residuals are >200 but I know some places that use >500. 

Heidi Jo Greenwaldt MS, RD, LD, CNSD
Clinical Nutrition Manager
University of Minnesota Medical Center, Fairview

Phone 612-273-3216
Pager 612-539-7451

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Beanum Pamela
Sent: Thursday, July 23, 2009 12:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] MD Questions

We have some doctors interested in making some changes related to TF
residuals...the question has become has anyone else STOPPED checking for
residuals?  If so, how did you go about making the change?  

Thanks!

Pamela Beanum, RD 
Clinical Nutrition/Catering Manager 
804-254-9823 (phone)

804-254-5538 (fax)
Retreat Doctors' Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave 
Richmond VA 23220 
pamela.beanum at hcahealthcare.com

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From m-rodrig at msmc.com  Thu Jul 23 10:55:33 2009
From: m-rodrig at msmc.com (Maritza Rodriguez)
Date: Thu, 23 Jul 2009 13:55:33 -0400
Subject: [Cnm] Changing Department Name
In-Reply-To: <20090723133854.AFW14867@mail.mainehospital.org>
References: <5E3E345918590D4D86333A4FCCF51A90019A4DBB@EXCHVS.frhg.org>
	<20090723133854.AFW14867@mail.mainehospital.org>
Message-ID: <32EDCA3D1F5C4C41B7E1A4573DFACCC6021180AD@SVIPEXC1.msmc.com>

Our is "Food and Nutrition Services" covering both areas.

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.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Cece Ohmart
Sent: Thursday, July 23, 2009 1:39 PM
To: Sohal, Manjit; cnm at lists.my180.net
Subject: Re: [Cnm] Changing Department Name

Our facility calls the food service department "Dietary". The clinical
nutrition service is called "Nutrition Services".  We are two separate
departments that interact with each other very frequently.
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.

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

From SRassekh at stfranciscare.org  Thu Jul 23 10:57:06 2009
From: SRassekh at stfranciscare.org (Rassekh, Shoreh)
Date: Thu, 23 Jul 2009 13:57:06 -0400
Subject: [Cnm] Enteral Protocols
In-Reply-To: <19833324B774F042B1FE1C34A79695BA258EDF77CE@NADCWPMSGCMS07.hca.corpad.net>
Message-ID: <0AB0670D124B96418F1D6AAFB11D5C31012A402E@SFH15110MV23.sfhad.stfranciscare.org>

I am interested as well.

Shoreh
Shoreh Rassekh M.S., R.D., CD-N
Clinical Nutrition Manager
860-714-5512 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Beanum Pamela
Sent: Thursday, July 23, 2009 1:27 PM
To: cnm at lists.my180.net
Subject: [Cnm] Enteral Protocols

We are interested in establishing standard orders/protocols for enteral
feedings, including order sets for new PEG/J tubes.  Does anyone have
something already in place they would be willing to share?

Thanks!

Pamela Beanum, RD 
Clinical Nutrition/Catering Manager 
804-254-9823 (phone)

804-254-5538 (fax)
Retreat Doctors' Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave 
Richmond VA 23220 
pamela.beanum at hcahealthcare.com

NOTICE: This email and/or attachments may contain confidential or proprietary information which may be legally privileged. It is intended only for the named recipient(s). If an addressing or transmission error has misdirected this email, please notify the author by replying to this message. If you are not the named recipient, you are not authorized to use, disclose, distribute, make copies or print this email, and should immediately delete it from your computer system. Saint Francis Care has scanned this email and its attachments for malicious content. However, the recipient should check this email and any attachments for the presence of viruses. Saint Francis Care accepts no liability for any damage caused by any virus transmitted by this email.

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From JKrzeminski at Reshealthcare.org  Thu Jul 23 13:42:16 2009
From: JKrzeminski at Reshealthcare.org (Krzeminski, Janet)
Date: Thu, 23 Jul 2009 15:42:16 -0500
Subject: [Cnm] MD Questions
In-Reply-To: <19833324B774F042B1FE1C34A79695BA258EDF77D2@NADCWPMSGCMS07.hca.corpad.net>
References: <19833324B774F042B1FE1C34A79695BA258EDF77D2@NADCWPMSGCMS07.hca.corpad.net>
Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F2CDC769@rhcexch3.reshealthcare.org>

I would follow the newest ASPEN guidelines.
I gave copies of these to the key physicians here.

Janet K
Chicago, IL

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Beanum Pamela
Sent: Thursday, July 23, 2009 12:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] MD Questions

We have some doctors interested in making some changes related to TF
residuals...the question has become has anyone else STOPPED checking for
residuals?  If so, how did you go about making the change?  

Thanks!

Pamela Beanum, RD 
Clinical Nutrition/Catering Manager 
804-254-9823 (phone)

804-254-5538 (fax)
Retreat Doctors' Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave 
Richmond VA 23220 
pamela.beanum at hcahealthcare.com

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From horlowsk at ppmh.org  Thu Jul 23 14:06:24 2009
From: horlowsk at ppmh.org (Orlowski, Hannah)
Date: Thu, 23 Jul 2009 17:06:24 -0400
Subject: [Cnm] MD Questions
In-Reply-To: <59F3EAD5C3376A42B3CD083F034A6127056770E4@digsmxmbx06.Fairview.org>
Message-ID: <0DAF44B706E29940A409E32DC69005C0078426B5@exchange1.phoebe.com>

We listen to the new guidelines today from ASPEN and they are saying >500.  If any of you have a Nestle rep- they sponsored it and it was very good.  We also received CEU 1.5 hrs.

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Greenwaldt, Heidi J
Sent: Thursday, July 23, 2009 1:40 PM
To: Beanum Pamela; cnm at lists.my180.net
Subject: Re: [Cnm] MD Questions

We are still checking residuals. There is information on residuals in the new ASPEN/SCCM guidelines that just came out. Unfortunately I left my journal at home and don't remember the specifics. We have a protocol if residuals are >200 but I know some places that use >500. 

Heidi Jo Greenwaldt MS, RD, LD, CNSD
Clinical Nutrition Manager
University of Minnesota Medical Center, Fairview

Phone 612-273-3216
Pager 612-539-7451

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Beanum Pamela
Sent: Thursday, July 23, 2009 12:28 PM
To: cnm at lists.my180.net
Subject: [Cnm] MD Questions

We have some doctors interested in making some changes related to TF residuals...the question has become has anyone else STOPPED checking for residuals?  If so, how did you go about making the change?  

Thanks!

Pamela Beanum, RD 
Clinical Nutrition/Catering Manager 
804-254-9823 (phone)

804-254-5538 (fax)
Retreat Doctors' Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave 
Richmond VA 23220 
pamela.beanum at hcahealthcare.com

The information transmitted in this e-mail is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material, including 'protected health information'. If you are not the intended recipient, you are hereby notified that any review, retransmission, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please destroy and delete this message from any computer and contact us immediately by return e-mail. 

-----------------------------------------
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From ehamil69 at aol.com  Thu Jul 23 18:01:09 2009
From: ehamil69 at aol.com (Elaina Hamill, RD, New York)
Date: Thu, 23 Jul 2009 21:01:09 -0400
Subject: [Cnm] Heart Healthy Diet
In-Reply-To: <928A945F630BBA4D8145A788E444649B4013B30E@MSXMBXNSPRD03.acct.upmchs.net>
References: 
	<928A945F630BBA4D8145A788E444649B4013B30E@MSXMBXNSPRD03.acct.upmchs.net>
Message-ID: <8CBDA115D7355DB-D94-1B25@WEBMAIL-MB16.sysops.aol.com>

Does anybody have or use a heart healthy diet pattern that you would be 
willing to share?  I would like to develop one at my facility but would 
like to see what others have done.  Is it usually based on a 2,000 
calorie level at less than 30% fat? what about sodium? I used to have 
in my previous facility that was 3-4 grams of sodium and about 300 
grams cholesterol.

thanks in advance,
Elaina Hamill, RD
New York

From jlworden at att.net  Thu Jul 23 19:43:20 2009
From: jlworden at att.net (Jo Lynn Worden)
Date: Thu, 23 Jul 2009 21:43:20 -0500
Subject: [Cnm] Nutrition diagnosis
Message-ID: <00b801ca0c08$81e17ab0$85a47010$@net>

I think this has been discussed before but I can't remember the thread of
replies. 

Consider the following nutrition diagnosis:

Inadequate energy intake 

Inadequate oral food/beverage intake. 

My thought is that inadequate energy intake may be the one to use when a
patient is intubated "Inadequate energy intake related to inability to take
food orally as evidenced by intubation"

Inadequate oral/food beverage intake is more in line with  the fact that
patient is able to take food orally but is not taking enough due to nausea,
taste changes, etc. 

What is anyone using for a diagnosis if patient is intubated or if TPN is
initiated due to altered GI function? 

Thanks

k

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From Valerie.Peters1 at hcahealthcare.com  Tue Jul 21 05:44:38 2009
From: Valerie.Peters1 at hcahealthcare.com (Peters Valerie - Charleston)
Date: Tue, 21 Jul 2009 07:44:38 -0500
Subject: [Cnm] Malnutrition coding
In-Reply-To: <4A60BB8F.2064.0034.0@emhc.org>
References: <4A60BB8F.2064.0034.0@emhc.org>
Message-ID: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F8B2C2CF5@NADCWPMSGCMS10.hca.corpad.net>

Please forward any attachments, thanks

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

________________________________
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Pat Sutor
Sent: Friday, July 17, 2009 6:58 PM
To: cnm at lists.my180.net
Subject: [Cnm] Malnutrition coding

Hi,
I have seen previous discussion on this list related to malnutrition coding but did not keep a folder, so now I need to ask again.
We are looking to purpose such a program to our VP's. My Director has asked if I could locate a site that has data on the revenue that was generated for your facility based upon implementing malnutrition coding.
If you have any data that you can share please let me know. We are having a meeting on Wed with 2 of our VP's.
Thanks, Pat
psutor at emhc.org
630-833-1400,44911

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.
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From Linda.Woods at healthall.com  Fri Jul 24 05:26:01 2009
From: Linda.Woods at healthall.com (Woods, Linda)
Date: Fri, 24 Jul 2009 08:26:01 -0400
Subject: [Cnm] Changing Department Name
In-Reply-To: <5E3E345918590D4D86333A4FCCF51A90019A4DBB@EXCHVS.frhg.org>
References: <5E3E345918590D4D86333A4FCCF51A90019A4DBB@EXCHVS.frhg.org>
Message-ID: <2B1106A6A593B147A65BD5A8939D3E11D3CA1555F5@MAIL-C.healthall.com>

No.  Our department is Food and Nutrition Services and that's how it appears on our budget.

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 Sohal, Manjit
Sent: Thursday, July 23, 2009 11:33 AM
To: cnm at lists.my180.net
Subject: [Cnm] Changing Department Name

We have changed our department name several years ago from "Dietary" to "Nutrition Services".  However, we have been told that the name Dietary has to used in department budgets due to it's a universally used hospital department name.

Has anyone else had this issue?

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

Exceptional Care, Close to Home

________________________________
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From Annalynn_Skipper at Comcast.net  Fri Jul 24 06:17:35 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Fri, 24 Jul 2009 08:17:35 -0500
Subject: [Cnm] Nutrition diagnosis
In-Reply-To: <00b801ca0c08$81e17ab0$85a47010$@net>
References: <00b801ca0c08$81e17ab0$85a47010$@net>
Message-ID: 

I'm not sure anyone has the final answer to this question.  However, I teach
to think of the reason a patient needs a tube feeding.  Can't Eat! Won't
Eat! Can't Eat Enough.  Since eating is in all three indications, and unless
there are other issues, people eat oral foods, it seems as if inadequate
oral food and beverage intake accurately describes the problem.  This
diagnosis also gives us a long term diagnosis (for the duration of the
enteral feedings) in case we need to modify the rate, strength, and
composition of the feeding.  

Interested in whether you think this makes sense.  Other views no doubt
exist, and I'm relatively sure this is a different view than what I've held
previously.  

Have a great weekend.  

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: Jo Lynn Worden [mailto:jlworden at att.net] 
Sent: Thursday, July 23, 2009 9:43 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition diagnosis

I think this has been discussed before but I can't remember the thread of
replies. 

Consider the following nutrition diagnosis:

Inadequate energy intake 

Inadequate oral food/beverage intake. 

My thought is that inadequate energy intake may be the one to use when a
patient is intubated "Inadequate energy intake related to inability to take
food orally as evidenced by intubation"

Inadequate oral/food beverage intake is more in line with  the fact that
patient is able to take food orally but is not taking enough due to nausea,
taste changes, etc. 

What is anyone using for a diagnosis if patient is intubated or if TPN is
initiated due to altered GI function? 

Thanks

k

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From Shannon.Jackson at wilmed.org  Fri Jul 24 06:26:13 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Fri, 24 Jul 2009 09:26:13 -0400
Subject: [Cnm] Fiber Restricted Diet
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A38@wmhcs03.wmh.org>

Hello,

Will someone send me their patient menus for fiber restricted diet?
We are struggling with what to put on this menu for patients.
Thanks
Shannon

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  

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From LDALGLEISH at lakelandregional.org  Fri Jul 24 08:14:21 2009
From: LDALGLEISH at lakelandregional.org (Lisa Dalgleish)
Date: Fri, 24 Jul 2009 11:14:21 -0400
Subject: [Cnm] Fiber Restricted Diet
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A38@wmhcs03.wmh.org>
References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A38@wmhcs03.wmh.org>
Message-ID: <4A69976C.DF60.000C.0@lakelandregional.org>

Here is ours.

Lisa Dalgleish, RD
Clinical Nutrition Supervisor
Lakeland HealthCare
1234 Napier Avenue
St. Joseph, MI  49085
(269) 983-8674  work phone
(269) 982-4313  fax
ldalgleish at lakelandregional.org 

>>> "Shannon Byrd Jackson"  7/24/2009 9:26 AM >>>
Hello,

Will someone send me their patient menus for fiber restricted diet?
We are struggling with what to put on this menu for patients.
Thanks
Shannon

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/ )

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From DPeterson at greenehealth.org  Fri Jul 24 08:24:11 2009
From: DPeterson at greenehealth.org (Peterson, Dina)
Date: Fri, 24 Jul 2009 11:24:11 -0400
Subject: [Cnm] Clear liquid diet trays
Message-ID: 

We just finished a study that indicates our Boost Breeze is being thrown away instead of patients actually consuming. It has been suggested that we stock the clear liquid supplement in the patient refrigerators and have it readily available instead of placing directly on tray.  My concern would be the decrease in provided calories in an already calorie deficient tray.  Does anyone have specific guidelines for this or any suggestions? 

    Dina

Dina J Peterson MS, RD, LD
Director of Nutrition Services
Greene Memorial Hospital

Office  937-352-2372
Pager   937-220-3528
Fax     937-352-3370

"Every job is a self-portrait of the person who does it - Autograph your work with excellence." -- Unknown

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From rtripp at PINNACLEHEALTH.org  Fri Jul 24 08:53:42 2009
From: rtripp at PINNACLEHEALTH.org (Roberta Tripp)
Date: Fri, 24 Jul 2009 11:53:42 -0400
Subject: [Cnm] Clear liquid diet trays
In-Reply-To: 
Message-ID: <7375E17267B3DB4583032BDEFDA2D76E090300A9@mailphs.pinnaclehealth.org>

Maybe if you can show the average number of meals a pt is on a clear
liquid and if it is not over 5 days, (or whatever you decide is
acceptable at your facility) that advancing the diet would be more
advantageous to the patient from a nutritional perspective than trying
to get the pts to consume the clear liquid supplement?

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  

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Peterson, Dina
Sent: Friday, July 24, 2009 11:24 AM
To: cnm at lists.my180.net
Subject: [Cnm] Clear liquid diet trays

We just finished a study that indicates our Boost Breeze is being thrown
away instead of patients actually consuming. It has been suggested that
we stock the clear liquid supplement in the patient refrigerators and
have it readily available instead of placing directly on tray.  My
concern would be the decrease in provided calories in an already calorie
deficient tray.  Does anyone have specific guidelines for this or any
suggestions? 

    Dina

Dina J Peterson MS, RD, LD
Director of Nutrition Services
Greene Memorial Hospital

Office  937-352-2372
Pager   937-220-3528
Fax     937-352-3370

"Every job is a self-portrait of the person who does it - Autograph your
work with excellence." -- Unknown

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.
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From jlworden at att.net  Fri Jul 24 16:10:45 2009
From: jlworden at att.net (Jo Lynn Worden)
Date: Fri, 24 Jul 2009 18:10:45 -0500
Subject: [Cnm] Nutrition diagnosis
In-Reply-To: 
References: <00b801ca0c08$81e17ab0$85a47010$@net>

Message-ID: <003501ca0cb3$f9bf8d00$ed3ea700$@net>

Sounds reasonable, Annalynn - so what is the indication for use of
"inadequate energy intake."  ?

From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] 
Sent: Friday, July 24, 2009 8:18 AM
To: 'Jo Lynn Worden'; cnm at lists.my180.net
Subject: RE: [Cnm] Nutrition diagnosis

I'm not sure anyone has the final answer to this question.  However, I teach
to think of the reason a patient needs a tube feeding.  Can't Eat! Won't
Eat! Can't Eat Enough.  Since eating is in all three indications, and unless
there are other issues, people eat oral foods, it seems as if inadequate
oral food and beverage intake accurately describes the problem.  This
diagnosis also gives us a long term diagnosis (for the duration of the
enteral feedings) in case we need to modify the rate, strength, and
composition of the feeding.  

Interested in whether you think this makes sense.  Other views no doubt
exist, and I'm relatively sure this is a different view than what I've held
previously.  

Have a great weekend.  

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: Jo Lynn Worden [mailto:jlworden at att.net] 
Sent: Thursday, July 23, 2009 9:43 PM
To: cnm at lists.my180.net
Subject: [Cnm] Nutrition diagnosis

I think this has been discussed before but I can't remember the thread of
replies. 

Consider the following nutrition diagnosis:

Inadequate energy intake 

Inadequate oral food/beverage intake. 

My thought is that inadequate energy intake may be the one to use when a
patient is intubated "Inadequate energy intake related to inability to take
food orally as evidenced by intubation"

Inadequate oral/food beverage intake is more in line with  the fact that
patient is able to take food orally but is not taking enough due to nausea,
taste changes, etc. 

What is anyone using for a diagnosis if patient is intubated or if TPN is
initiated due to altered GI function? 

Thanks

k

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From ESCOTTSTUMPS at ecu.edu  Fri Jul 24 18:22:56 2009
From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia)
Date: Fri, 24 Jul 2009 21:22:56 -0400
Subject: [Cnm] FW: DPG List Serve Posting - On The Pulse Summary
In-Reply-To: 
References: 
Message-ID: 

Regards,

College of Human Ecology

Enriching Lives.  Enhancing Communities.

Sylvia Escott-Stump, MA, RD, LDN
CNM Legislative Chair
252-328-1352
Fax 252-328-4276

________________________________
From: Elizabeth Hasiak [EHasiak at eatright.org]
Sent: Friday, July 24, 2009 4:47 PM
Cc: Dana Whitley
Subject: DPG List Serve Posting - On The Pulse Summary

Dear DPG leader,

Attached is this week?s On The Pulse summary document for your DPG list-serve.  Please post it as soon as
possible.  The complete version of the Pulse will be available at www.eatright.org on Monday for your
members to access.

Thank you for your continued cooperation in posting this weekly newsletter.

Sincerely,

M. Stephanie Patrick
Vice President
Policy Initiatives & Advocacy
American Dietetic Association
spatrick at eatright.org
800/877-877
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From MAHTRedF at aol.com  Sat Jul 25 11:53:25 2009
From: MAHTRedF at aol.com (MAHTRedF at aol.com)
Date: Sat, 25 Jul 2009 14:53:25 EDT
Subject: [Cnm] Calculation of Lipid Content in PN
Message-ID: 

For any product I would go with what the manufacturer provides.   Also, FDA 
provides indepth information on all of these products.  I would  use these 
numbers rather than what someone else uses.  
Hopefully your RDs and MDs can agree on this so that there is  consistency. 

Example from the manufacturer for Intralipid: 
"Each mL of Intralipid 10% contains 4.6 kJ (1.1 kcal),  each mL of 
Intralipid 20% contains 8.4 kJ (2.0 kcal)" 

Example from FDA: 
Intralipid? 20% (A 20% I.V. Fat Emulsion) has an osmolality of  
approximately 350 mOsmol/kg water (which represents 260 mOsmol/liter of  emulsion) and 
contains emulsified fat particles of approximately 0.5 micron  size. The 
total caloric value, including fat, phospholipid and glycerin, is 2.0  kcal per 
mL of Intralipid? 20%. The  phospholipids present contribute 47 milligrams 
or approximately 1.5 mmol of  phosphorus per 100 mL of the 
emulsion............ and lots more  information............

thanks

M Hagerty, MS,RD   
**************A bad credit score is 600 & below. Checking won't affect your 
score. See now! 
(http://pr.atwola.com/promoclk/100126575x1222585106x1201462830/aol?redir=http://www.freecreditreport.com/pm/default.aspx?sc=668072&hmpgI
D=62&bcd=JulyBadfooterNO62)
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From peggymsrdld at cox.net  Sun Jul 26 15:55:22 2009
From: peggymsrdld at cox.net (Peggy Turner)
Date: Sun, 26 Jul 2009 17:55:22 -0500
Subject: [Cnm] Favorite Websites
In-Reply-To: 
References: <4517F481-A4B7-40A9-A90D-2C5F8C7DF8C5@verizon.net>

Message-ID: 

Pam,

Is this something we could create a wiki for?

Peggy Turner
On Jul 20, 2009, at 12:29 PM, Pam Charney wrote:

> The app store now has hundreds of food and nutrition apps available.  
> The apps do not work on other platforms. However, a few weeks ago I  
> saw a prototype of an interactive, patient-focused exercise and  
> symptom management tool designed to be used by COPD patients. This  
> was created for use on a smart phone.
>
> So, there's got to be more out there. Maybe we should create a space  
> to share these tools as we find them.
>
> 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
> http://www.linkedin.com/in/pamcharney
>
> "The person who says it can't be done should not
> interrupt the person doing it" - Ethel Kennedy
>
> On Jul 20, 2009, at 9:52 AM, Anna Sheridan wrote:
>
>> In addition to websites...  The Apple iphone has an application  
>> titled
>> "Lose It!"  It allows the user to enter food intake and exercise.  It
>> will also calculate nutritional needs.  However, I'm not sure how
>> accurate that portion of the program is but the other features look
>> appropriate.  I do not know if the application is available on other
>> phones.
>>
>>
>> Anna Sheridan
>> Asst Dir Clinical Nutrition
>> Hebrew Home at Riverdale
>> Riverdale, NY 10471
>>
>>
>> _______________________________________________
>> 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

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From Margaret.Chaffin at hcahealthcare.com  Mon Jul 27 08:18:05 2009
From: Margaret.Chaffin at hcahealthcare.com (Chaffin Meg)
Date: Mon, 27 Jul 2009 10:18:05 -0500
Subject: [Cnm] Inpatient bariatric diet
Message-ID: 

Looking for inpatient diets for lap banders if anyone is willing to share what they use. Our surgeon is aware that most will be on clear liquids postop but he wants a diet for his patients who may be admitted for other issues but have progressed beyond the clear liquid stage. I already have information from ADA. Thanks in advance.

Meg

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Centers
(229)434-2394

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From JHook at Lifespan.org  Mon Jul 27 09:36:31 2009
From: JHook at Lifespan.org (Hook, Janet)
Date: Mon, 27 Jul 2009 12:36:31 -0400
Subject: [Cnm] NCP Monitoring and Evaluation Step
Message-ID: <130E8991F210424096EFC6F42EA33B2404D3ABED@LSCOEXCH1.lsmaster.lifespan.org>

I am trying to develop a documentation form for follow-up notes based on
NCP standardized language and methodology.  I have referred to the IDNT
Reference Manual but am still unsure of the best way to outline
follow-ups.  If anyone has designed a form specifically for the
monitoring and evaluation step of the NCP, I would appreciate your ideas
and suggestions.  Thank-you in advance.

Janet V. Hook, MS, RD, LDN

Senior Clinical Dietitian

Bradley Hospital

1011 Veterans Memorial Parkway

East Providence, RI  02915

(401)432-1190

Pager (401)350-4337

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From pcharney at mac.com  Mon Jul 27 09:44:23 2009
From: pcharney at mac.com (Pam Charney)
Date: Mon, 27 Jul 2009 09:44:23 -0700
Subject: [Cnm] NCP Monitoring and Evaluation Step
In-Reply-To: <130E8991F210424096EFC6F42EA33B2404D3ABED@LSCOEXCH1.lsmaster.lifespan.org>
References: <130E8991F210424096EFC6F42EA33B2404D3ABED@LSCOEXCH1.lsmaster.lifespan.org>
Message-ID: <2B346E92-1783-47C0-B2B0-C2B271A9C739@mac.com>

Janet,
I've worked with a lot of folks who are beginning to use the dietetics  
terminology in practice. I've found that the best place to start is to  
look at your current workflow in addition to all of the forms and  
documentation formats you use now. Quite often there is very little  
tweaking that needs to happen. I think some folks make this all seem  
much harder than it has to be!

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
http://www.linkedin.com/in/pamcharney

"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jul 27, 2009, at 9:36 AM, Hook, Janet wrote:

> I am trying to develop a documentation form for follow-up notes  
> based on NCP standardized language and methodology.  I have referred  
> to the IDNT Reference Manual but am still unsure of the best way to  
> outline follow-ups.  If anyone has designed a form specifically for  
> the monitoring and evaluation step of the NCP, I would appreciate  
> your ideas and suggestions.  Thank-you in advance.
>
> Janet V. Hook, MS, RD, LDN
> Senior Clinical Dietitian
> Bradley Hospital
> 1011 Veterans Memorial Parkway
> East Providence, RI  02915
> (401)432-1190
> Pager (401)350-4337
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

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From Annalynn_Skipper at Comcast.net  Mon Jul 27 10:50:44 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Mon, 27 Jul 2009 12:50:44 -0500
Subject: [Cnm] NCP Monitoring and Evaluation Step
In-Reply-To: <130E8991F210424096EFC6F42EA33B2404D3ABED@LSCOEXCH1.lsmaster.lifespan.org>
References: <130E8991F210424096EFC6F42EA33B2404D3ABED@LSCOEXCH1.lsmaster.lifespan.org>
Message-ID: <31A6FA14BCF54DCAB3D1836D16C730A5@ANNALYNN>

Janet, 

Pam has a good idea.  Another thought is to look at the signs and symptoms
for the diagnosis and monitor them for change to see if the intervention
improved them.  

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: Hook, Janet [mailto:JHook at Lifespan.org] 
Sent: Monday, July 27, 2009 11:37 AM
To: cnm at lists.my180.net
Subject: [Cnm] NCP Monitoring and Evaluation Step

I am trying to develop a documentation form for follow-up notes based on NCP
standardized language and methodology.  I have referred to the IDNT
Reference Manual but am still unsure of the best way to outline follow-ups.
If anyone has designed a form specifically for the monitoring and evaluation
step of the NCP, I would appreciate your ideas and suggestions.  Thank-you
in advance.

Janet V. Hook, MS, RD, LDN

Senior Clinical Dietitian

Bradley Hospital

1011 Veterans Memorial Parkway

East Providence, RI  02915

(401)432-1190

Pager (401)350-4337

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From Laura.Hill2 at Mercy.Net  Mon Jul 27 11:24:50 2009
From: Laura.Hill2 at Mercy.Net (Hill, Laura L)
Date: Mon, 27 Jul 2009 13:24:50 -0500
Subject: [Cnm] nutritional analysis for patient menus
Message-ID: <0D52666873E5914EBC179207FAC7A054100A02@stl-pmailrsgp02.smrcy.com>

We're currently updating our patient menus and I am in the process of
analyzing the nutritional content of these menus.
Is it required to have printed analysis for all of the various diets
(regular, low fat, diabetic, CL, FL etc)?
Also, when calculating the nutrition analysis, should I include the
condiments as well or just the foods/beverages?
Thanks,
Laura

Laura Hill PhD, RD, LD, CDE
Clinical Manager
Nutrition Services Department
Mercy Medical Center of NWA
2170 Rife Medical Lane
Rogers, AR 72758
(479) 338-3279

This e-mail contains information which (a) may be PROPRIETARY IN NATURE OR
OTHERWISE PROTECTED BY LAW FROM DISCLOSURE, and (b) is intended only for the
use of the addressee(s) named above. If you are not the addressee, or the
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From Shannon.Jackson at wilmed.org  Mon Jul 27 11:56:42 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Mon, 27 Jul 2009 14:56:42 -0400
Subject: [Cnm] FW: Immune-Enhancing formulas
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A75@wmhcs03.wmh.org>

Are other facilities listing any immune-enhancing formulas on their enteral
formularies?  If so, do they have any specific protocol or have a particular
"order set" to identify patients appropriate for administration? 

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  

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From Valerie.Peters1 at hcahealthcare.com  Mon Jul 27 14:06:32 2009
From: Valerie.Peters1 at hcahealthcare.com (Peters Valerie - Charleston)
Date: Mon, 27 Jul 2009 16:06:32 -0500
Subject: [Cnm] hi pro jello
Message-ID: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F8BAFE150@NADCWPMSGCMS10.hca.corpad.net>

Hi all-
    Anyone recommendations on where to obtain?  Company we have been using has closed its doors.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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From Lyn.Haft at rexhealth.com  Tue Jul 28 04:51:40 2009
From: Lyn.Haft at rexhealth.com (Haft, Lyn)
Date: Tue, 28 Jul 2009 07:51:40 -0400
Subject: [Cnm] Pressure Ulcer Triggers
Message-ID: <6C5C5FBEE636A043BC7466A8CAE0732F0B6DCAF4@exchmail1.rexhealth.com>

Good morning, would you please let me know what your facilities are
coming up with (policies/procedures and nutrition screening triggers) to
help identify patients who may be at risk for the development of
pressure ulcers.  
A team of about 5 nurses here is deciding we need to add to our
nutrition screening things like Nausea/Vomiting/Diarrhea, eating less
than 75%, Braden scale less than 18, they were also thinking immobility,
certain surgeries, and diseases.  They looked at what other institutions
are doing and decided we should add all the triggers.  

Some of the above we have taken off our screen as they led to many false
positives and much time wasted.  At the moment we are quite busy and of
course cannot add FTEs.
Thanks for you help

Lyn Haft
Clinical Nutrition Manager
Rex Healthcare
4420 Lake Boone Trail
Raleigh, NC 27607 
919-784-3162

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From Susan_R_Paredez at uhs.org  Tue Jul 28 04:58:37 2009
From: Susan_R_Paredez at uhs.org (Susan_R_Paredez at uhs.org)
Date: Tue, 28 Jul 2009 07:58:37 -0400
Subject: [Cnm] Billing for GI Lab Services
Message-ID: 

Good Morning All,

Our GI lab consults us to educate patients who are having PEG tubes placed.
I was told that we can bill for these outpatient services.  Is anyone doing
this and receiving reimbursement for it?

Susan Paredez
Clinical Nutrition Coordinator
UHS Hospitals
Susan_R_Paredez at UHS.org
607-763-6600
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This message and any attachments may contain information that is protected by law as privileged and confidential, and is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient, you are hereby notified that any use, dissemination, copying or retention of this e-mail or the information contained herein is strictly prohibited. If you have received this e-mail in error, please immediately notify the sender by e-mail, and permanently delete this e-mail.
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From LAltenburger5 at matherhospital.org  Tue Jul 28 06:00:42 2009
From: LAltenburger5 at matherhospital.org (Altenburger, Linda)
Date: Tue, 28 Jul 2009 09:00:42 -0400
Subject: [Cnm] Sorian/CBORD
Message-ID: 

For those facilities that use Sorian, does it have diet office
capabilities eliminating the need for a separate diet office system?  If
not and you have CBORD, are you pleased with how they interact? Thank
you 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

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From Pamela.Beanum at HCAhealthcare.com  Tue Jul 28 06:26:22 2009
From: Pamela.Beanum at HCAhealthcare.com (Beanum Pamela)
Date: Tue, 28 Jul 2009 08:26:22 -0500
Subject: [Cnm] PCOS
Message-ID: <19833324B774F042B1FE1C34A79695BA258EF7A5B1@NADCWPMSGCMS07.hca.corpad.net>

Does anyone have any good nutrition materials for PCOS patients?

Thanks!

Pamela Beanum, RD
Clinical Nutrition/Catering Manager
804-254-9823 (phone)

804-254-5538 (fax)
Retreat Doctors' Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave
Richmond VA 23220
pamela.beanum at hcahealthcare.com

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From jbaye at mail.mcg.edu  Tue Jul 28 06:28:18 2009
From: jbaye at mail.mcg.edu (Jessica Baye)
Date: Tue, 28 Jul 2009 09:28:18 -0400
Subject: [Cnm] Teaching Hospitals & TPN's
Message-ID: <4A6EC4B2.E045.0010.0@mail.mcg.edu>

Good Morning

I'm looking for some feedback on how other teaching hospitals are handling TPN order writing.  Currently my staff of 5 inpatient RD's write about 6-10 TPN orders per day.  And when I say "write" I mean we TO them.  We do not have order writing privileges.  We also do not have a nutrition support service so we don't bill for this activity...we just do it out of the kindness of our hearts.  Recently I had a discussion with an RD who is employed by the surgical service at our hospital.  She told me that she does not write any of those TPN's.  She teaches a class on TPN's once a month and serves as a resource to the MD's only.  
I'm very conflicted.  Part of me wants to give back the TPN's - since it takes up so much of our time.  Part of me says keep writing the TPN orders since as dietitians we are the best trained.

I would appreciate input

Thanks in advance
Jessica

Jessica Baye, RD, LD
Clinical Nutrition Manager
Food & Nutrition Services
MCG Health System
BA1565
1120 15th Street
Augusta, GA  30912
706.721.3202 (office)
706.533.3313 (cell)
706.721.7243 x1405 (pager)
jbaye at mcg.edu 

From Pamela.Beanum at HCAhealthcare.com  Tue Jul 28 06:28:24 2009
From: Pamela.Beanum at HCAhealthcare.com (Beanum Pamela)
Date: Tue, 28 Jul 2009 08:28:24 -0500
Subject: [Cnm] GB Patient
Message-ID: <19833324B774F042B1FE1C34A79695BA258EF7A5CD@NADCWPMSGCMS07.hca.corpad.net>

Had a patient yesterday, s/p GB x10y ago.  She claims to be "addicted" to salt, drinking the juice from pickle jars & olive jars; eating handfuls of salt...has anyone seen this?  Anyone have any good recommendations?  I told pt to f/u with her doctor & try changing her current eating habits (eats sausage biscuit for breakfast) & she also can't seem to get more then 24oz H20 in a day...

Pamela Beanum, RD
Clinical Nutrition/Catering Manager
804-254-9823 (phone)
804-254-5538 (fax)
Retreat Doctors' Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave
Richmond VA 23220
pamela.beanum at hcahealthcare.com

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From aimeenut at yahoo.com  Tue Jul 28 06:54:23 2009
From: aimeenut at yahoo.com (aimee crant)
Date: Tue, 28 Jul 2009 06:54:23 -0700 (PDT)
Subject: [Cnm] Sorian/CBORD
In-Reply-To: 
References: 
Message-ID: <289995.27252.qm@web52603.mail.re2.yahoo.com>

We have Soarian, but not CBORD.? We use Common Cents/Gemserve.? Afte alot of work, it interfaced well.
?Aimee Crant-Oksa MS, RD
Clinical Nutrition Manager
Centrastate Medical Center
tel: 732-294-2767
email: acrantok at centrastate.com 

________________________________
From: "Altenburger, Linda" 
To: cnm at lists.my180.net
Sent: Tuesday, July 28, 2009 9:00:42 AM
Subject: [Cnm] Sorian/CBORD

For those facilities that use Sorian, does it have diet office capabilities eliminating the need for a separate diet office system?? If not and you have CBORD, are you pleased with how they interact? Thank you in advance. Linda
?
Linda Altenburger, RD, CDN
Clinical Nutrition Manager
John. T. Mather Memorial Hospital
75 North Country Road
(631) 473-1320 ext 4176
laltenburger5 at matherhospital.org
fax:631-473-8752
Port Jefferson , NY ? 11777

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From Christine.Zirpoli at med.navy.mil  Tue Jul 28 07:05:17 2009
From: Christine.Zirpoli at med.navy.mil (Zirpoli, Christine F. (CIV))
Date: Tue, 28 Jul 2009 10:05:17 -0400
Subject: [Cnm] Cnm Digest, Vol 32, Issue 86
In-Reply-To: 
References: 
Message-ID: <891B0FCEC3CAED41976C938D2A1084EFE8654E@NMCP-EX-VS-01.nmed.ds.med.navy.mil>

For the TPN orders in Teaching Hospitals, I do a lecture once a month to
the ICU interns on writing orders.  When I assess the patient I put my
recommendations in the note for macronutrients and electrolytes.  If I
notice that their order is way off my recs, I contact Pharmacy and the
Intern.  I'll write the order if the MD asks me to do it (we can do
this).  I think patient safety is the highest priority, teaching the
interns to be self sufficient is second.  I recently had a new TPN order
written by an intern with 544 g dex, 500 ml 20% lipids, the total kcals
were 39/kg adj weight on an obese, bed rest patient who had a mesentery
thrombosis.  The intern also ordered no electrolytes "because he is
getting other IV fluids" After contacting him once he insisted this is
what he wanted.  We went to the Resident next and the order was changed.

For the Bariatric patient, I haven't heard of the sodium issue often,
but If you have any labs, I'd look at the serum osmolality, urine
sodium, the total fluid intake of the patient, are they exercising
excessively and sweating profusely?  They can get out of balance fairly
easily.

Chris

Christine Zirpoli, RD, CNSD
Division Officer, Nutrition Management 
Naval Medical Center, Portsmouth
620 John Paul Jones Circle
Portsmouth, VA 23708
FAX 757-953-3257
Phone 757-953-2630 
-----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, July 28, 2009 9:28 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 32, Issue 86

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

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

Today's Topics:

   1. hi pro jello (Peters Valerie - Charleston)
   2. Pressure Ulcer Triggers (Haft, Lyn)
   3. Billing for GI Lab Services (Susan_R_Paredez at uhs.org)
   4. Sorian/CBORD (Altenburger, Linda)
   5. PCOS (Beanum Pamela)
   6. Teaching Hospitals & TPN's (Jessica Baye)
   7. GB Patient (Beanum Pamela)

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

Message: 1
Date: Mon, 27 Jul 2009 16:06:32 -0500
From: Peters Valerie - Charleston 
Subject: [Cnm] hi pro jello
To: "cnm at lists.my180.net" 
Message-ID:

<0A3A1CCAD5E650408BE6DF56FB3F6D4D6F8BAFE150 at NADCWPMSGCMS10.hca.corpad.ne
t>

Content-Type: text/plain; charset="us-ascii"

Hi all-
    Anyone recommendations on where to obtain?  Company we have been
using has closed its doors.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or
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Message: 2
Date: Tue, 28 Jul 2009 07:51:40 -0400
From: "Haft, Lyn" 
Subject: [Cnm] Pressure Ulcer Triggers
To: 
Message-ID:

<6C5C5FBEE636A043BC7466A8CAE0732F0B6DCAF4 at exchmail1.rexhealth.com>
Content-Type: text/plain; charset="us-ascii"

Good morning, would you please let me know what your facilities are
coming up with (policies/procedures and nutrition screening triggers) to
help identify patients who may be at risk for the development of
pressure ulcers.  
A team of about 5 nurses here is deciding we need to add to our
nutrition screening things like Nausea/Vomiting/Diarrhea, eating less
than 75%, Braden scale less than 18, they were also thinking immobility,
certain surgeries, and diseases.  They looked at what other institutions
are doing and decided we should add all the triggers.  

Some of the above we have taken off our screen as they led to many false
positives and much time wasted.  At the moment we are quite busy and of
course cannot add FTEs.
Thanks for you help

Lyn Haft
Clinical Nutrition Manager
Rex Healthcare
4420 Lake Boone Trail
Raleigh, NC 27607
919-784-3162

----- 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
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Message: 3
Date: Tue, 28 Jul 2009 07:58:37 -0400
From: Susan_R_Paredez at uhs.org
Subject: [Cnm] Billing for GI Lab Services
To: CNM at lists.my180.net
Message-ID:

Content-Type: text/plain; charset="us-ascii"

Good Morning All,

Our GI lab consults us to educate patients who are having PEG tubes
placed.
I was told that we can bill for these outpatient services.  Is anyone
doing
this and receiving reimbursement for it?

Susan Paredez
Clinical Nutrition Coordinator
UHS Hospitals
Susan_R_Paredez at UHS.org
607-763-6600
---
Think before you print.

This message and any attachments may contain information that is
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Message: 4
Date: Tue, 28 Jul 2009 09:00:42 -0400
From: "Altenburger, Linda" 
Subject: [Cnm] Sorian/CBORD
To: 
Message-ID:

Content-Type: text/plain; charset="us-ascii"

For those facilities that use Sorian, does it have diet office
capabilities eliminating the need for a separate diet office system?  If
not and you have CBORD, are you pleased with how they interact? Thank
you 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

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Message: 5
Date: Tue, 28 Jul 2009 08:26:22 -0500
From: Beanum Pamela 
Subject: [Cnm] PCOS
To: "cnm at lists.my180.net" 
Message-ID:

<19833324B774F042B1FE1C34A79695BA258EF7A5B1 at NADCWPMSGCMS07.hca.corpad.ne
t>

Content-Type: text/plain; charset="us-ascii"

Does anyone have any good nutrition materials for PCOS patients?

Thanks!

Pamela Beanum, RD
Clinical Nutrition/Catering Manager
804-254-9823 (phone)

804-254-5538 (fax)
Retreat Doctors' Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave
Richmond VA 23220
pamela.beanum at hcahealthcare.com

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Message: 6
Date: Tue, 28 Jul 2009 09:28:18 -0400
From: "Jessica Baye" 
Subject: [Cnm] Teaching Hospitals & TPN's
To: 
Message-ID: <4A6EC4B2.E045.0010.0 at mail.mcg.edu>
Content-Type: text/plain; charset=US-ASCII

Good Morning

I'm looking for some feedback on how other teaching hospitals are
handling TPN order writing.  Currently my staff of 5 inpatient RD's
write about 6-10 TPN orders per day.  And when I say "write" I mean we
TO them.  We do not have order writing privileges.  We also do not have
a nutrition support service so we don't bill for this activity...we just
do it out of the kindness of our hearts.  Recently I had a discussion
with an RD who is employed by the surgical service at our hospital.  She
told me that she does not write any of those TPN's.  She teaches a class
on TPN's once a month and serves as a resource to the MD's only.  
I'm very conflicted.  Part of me wants to give back the TPN's - since it
takes up so much of our time.  Part of me says keep writing the TPN
orders since as dietitians we are the best trained.

I would appreciate input

Thanks in advance
Jessica

Jessica Baye, RD, LD
Clinical Nutrition Manager
Food & Nutrition Services
MCG Health System
BA1565
1120 15th Street
Augusta, GA  30912
706.721.3202 (office)
706.533.3313 (cell)
706.721.7243 x1405 (pager)
jbaye at mcg.edu 

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

Message: 7
Date: Tue, 28 Jul 2009 08:28:24 -0500
From: Beanum Pamela 
Subject: [Cnm] GB Patient
To: "cnm at lists.my180.net" 
Message-ID:

<19833324B774F042B1FE1C34A79695BA258EF7A5CD at NADCWPMSGCMS07.hca.corpad.ne
t>

Content-Type: text/plain; charset="us-ascii"

Had a patient yesterday, s/p GB x10y ago.  She claims to be "addicted"
to salt, drinking the juice from pickle jars & olive jars; eating
handfuls of salt...has anyone seen this?  Anyone have any good
recommendations?  I told pt to f/u with her doctor & try changing her
current eating habits (eats sausage biscuit for breakfast) & she also
can't seem to get more then 24oz H20 in a day...

Pamela Beanum, RD
Clinical Nutrition/Catering Manager
804-254-9823 (phone)
804-254-5538 (fax)
Retreat Doctors' Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave
Richmond VA 23220
pamela.beanum at hcahealthcare.com

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

End of Cnm Digest, Vol 32, Issue 86
***********************************
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From MZito at stpetershealthcare.org  Tue Jul 28 07:20:11 2009
From: MZito at stpetershealthcare.org (Zito, Maureen)
Date: Tue, 28 Jul 2009 10:20:11 -0400
Subject: [Cnm] (no subject)
Message-ID: 

I was wondering if anyone would be willing to share their Bariatric
Protocol.  Thanks.  

i.e. diet guidelines, education 

Thanks.

Maureen Zito, MS,RD, CNSD

Clinical Nutrition Manager 

St. Peter's Hospital

Albany, New York 12208

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 
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From Annalynn_Skipper at Comcast.net  Tue Jul 28 07:24:14 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Tue, 28 Jul 2009 09:24:14 -0500
Subject: [Cnm] Pressure Ulcer Triggers
In-Reply-To: <6C5C5FBEE636A043BC7466A8CAE0732F0B6DCAF4@exchmail1.rexhealth.com>
References: <6C5C5FBEE636A043BC7466A8CAE0732F0B6DCAF4@exchmail1.rexhealth.com>
Message-ID: <1A7BDD109F284933BD8D6F74A9562D65@ANNALYNN>

There are no validated nutrition "triggers" for pressure ulcer risk other
than a nutrition subscale score of 2 or less on the Braden scale.  (This is
provided that their Braden scale duplicates the original exactly and that
all nurses complete it exactly as intended.)  As you have noted, including
these other things will only increase the number of false positives.
Ferguson et al. showed this clearly in their studies supporting the
Malnutrition Screening Tool (See the ADA's Evidence Analysis Library
screening topic for details).  

Within the last 2 years, national and international guidelines for pressure
ulcer staging, prevention and intervention have been revised.  You might
obtain copies and share them with your nursing colleagues.  In general, they
state that the risk for pressure ulcers is increased if patients eat
inadequately.  

Given the current focus on evidence-based practice, it is appropriate to ask
for documentation (in the form of meta analyses, studies, or evidence based
guidelines, not nursing textbooks, workshop handouts, product literature or
articles in non peer-reviewed journals, or sources that predate new
guidelines) that recommendations will result in even minimal improvement in
care.  

The documents above should be a starting point for the discussion on what is
needed to predict pressure ulcer risk.  

Regards and good luck,  

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: Haft, Lyn [mailto:Lyn.Haft at rexhealth.com] 
Sent: Tuesday, July 28, 2009 6:52 AM
To: cnm at lists.my180.net
Subject: [Cnm] Pressure Ulcer Triggers

Good morning, would you please let me know what your facilities are coming
up with (policies/procedures and nutrition screening triggers) to help
identify patients who may be at risk for the development of pressure ulcers.

A team of about 5 nurses here is deciding we need to add to our nutrition
screening things like Nausea/Vomiting/Diarrhea, eating less than 75%, Braden
scale less than 18, they were also thinking immobility, certain surgeries,
and diseases.  They looked at what other institutions are doing and decided
we should add all the triggers.  

Some of the above we have taken off our screen as they led to many false
positives and much time wasted.  At the moment we are quite busy and of
course cannot add FTEs.

Thanks for you help 

Lyn Haft 
Clinical Nutrition Manager 
Rex Healthcare 
4420 Lake Boone Trail 
Raleigh, NC 27607 
919-784-3162 

----- 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)

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From rtripp at PINNACLEHEALTH.org  Tue Jul 28 07:15:37 2009
From: rtripp at PINNACLEHEALTH.org (Roberta Tripp)
Date: Tue, 28 Jul 2009 10:15:37 -0400
Subject: [Cnm] Sorian/CBORD
In-Reply-To: 
Message-ID: <7375E17267B3DB4583032BDEFDA2D76E090300F0@mailphs.pinnaclehealth.org>

We have Soarian and CBORD and they work together well.

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  

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Altenburger, Linda
Sent: Tuesday, July 28, 2009 9:01 AM
To: cnm at lists.my180.net
Subject: [Cnm] Sorian/CBORD

For those facilities that use Sorian, does it have diet office
capabilities eliminating the need for a separate diet office system?  If
not and you have CBORD, are you pleased with how they interact? Thank
you 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

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From Margaret.Chaffin at hcahealthcare.com  Tue Jul 28 08:16:43 2009
From: Margaret.Chaffin at hcahealthcare.com (Chaffin Meg)
Date: Tue, 28 Jul 2009 10:16:43 -0500
Subject: [Cnm] Bariatric diets
Message-ID: 

I didn't get much response to my post for a hospital bariatric diet so I thought I would repost and be more specific. Our surgeon performs the lap band procedure and wants a diet in house (I think this may be needed to become a COE which is what they are trying to accomplish) that may be ordered for his patients who are admitted for issues unrelated to the gastric banding. This could mean anything from 1 month postop to several months postop. My GI soft allows soft cooked meats including pork and beef (doc does not want this) and sugars and sweetened desserts and beverages, so I need  to make changes and develop a bariatic soft diet. When reviewing material from the ADA NCM the meal plan is blended/pureed whereas he wants soft cooked foods consistent with our soft diet but without the sugar. Here are my questions to you as I am not accustomed to routinely working with this patient population:

If others have bariatric diets in place are yours blended?

Do you have 2 different bariatric diets for the different stages -- i.e.bariatric blended and bariatric soft

Do milk products need to be lactose free?

Is peanut butter allowed?

How much liquid are you allowing per tray? I was thinking of 8 oz. protein supplement and 8 oz sugar-free beverage/tray, but how can I insure they will wait 30 minutes out to drink and not drink the full 16 oz. at one time, and if this is the case do you deliver liquids between meals instead and have them more on a 3 meal, 3 snack program?

What kinds of meats do you serve?

We no longer recognize "ADA clear liquids" so do I need to develop a bariatric clear liquid diet for those who are postop?

What protein supplements do you serve? I was thinking about using low CHO slimfast.

Sorry to be so winded, but any feedback from the group would be appreciated.

Thanks,
Meg

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Centers
(229)434-2394

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From pcharney at mac.com  Tue Jul 28 08:40:42 2009
From: pcharney at mac.com (Pam Charney)
Date: Tue, 28 Jul 2009 08:40:42 -0700
Subject: [Cnm] Pressure Ulcer Triggers
In-Reply-To: <6C5C5FBEE636A043BC7466A8CAE0732F0B6DCAF4@exchmail1.rexhealth.com>
References: <6C5C5FBEE636A043BC7466A8CAE0732F0B6DCAF4@exchmail1.rexhealth.com>
Message-ID: 

I suppose that theoretically we're all at risk for a pressure ulcer if  
we sit in front of our computers long enough. Your nurses are doing  
something called "case finding". If they look long enough, surely one  
or more patients in each category would get a pressure ulcer, and then  
they can say "see, these patients are at risk".

However, this behavior costs a lot of money. For each pressure ulcer  
found using this method, someone's going to have to screen a lot of  
patients, which is costly.

You could do a bit of investigative reporting. If you are using an  
EMR, query the database for folks with pressure ulcers that develop  
during admission and then see what similarities they have. Or,  
alternatively, you could say that each of the issues listed really  
boils down to not eating enough. The malnutrition screening tool,  
which is discussed in ADA's evidence library, addresses not eating  
enough.

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
http://www.linkedin.com/in/pamcharney

"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jul 28, 2009, at 4:51 AM, Haft, Lyn wrote:

> Good morning, would you please let me know what your facilities are  
> coming up with (policies/procedures and nutrition screening  
> triggers) to help identify patients who may be at risk for the  
> development of pressure ulcers.
>
> A team of about 5 nurses here is deciding we need to add to our  
> nutrition screening things like Nausea/Vomiting/Diarrhea, eating  
> less than 75%, Braden scale less than 18, they were also thinking  
> immobility, certain surgeries, and diseases.  They looked at what  
> other institutions are doing and decided we should add all the  
> triggers.
>
> Some of the above we have taken off our screen as they led to many  
> false positives and much time wasted.  At the moment we are quite  
> busy and of course cannot add FTEs.
>
> Thanks for you help
>
> Lyn Haft
> Clinical Nutrition Manager
> Rex Healthcare
> 4420 Lake Boone Trail
> Raleigh, NC 27607
> 919-784-3162
>
>
>
>
>
>
> ----- 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)
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

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From LCarver at Reshealthcare.org  Tue Jul 28 08:26:38 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 28 Jul 2009 10:26:38 -0500
Subject: [Cnm] Bariatric diets
In-Reply-To: 
References: 
Message-ID: <5330B54133B6194BA13930BDEFE9A30E0497C46D@rhcexch3.reshealthcare.org>

I can only answer a few of your questions - see below.  I am attaching
our cliq/full liq bariatric diets.

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Chaffin Meg
Sent: Tuesday, July 28, 2009 10:17 AM
To: cnm at lists.my180.net
Subject: [Cnm] Bariatric diets

I didn't get much response to my post for a hospital bariatric diet so I
thought I would repost and be more specific. Our surgeon performs the
lap band procedure and wants a diet in house (I think this may be needed
to become a COE which is what they are trying to accomplish) that may be
ordered for his patients who are admitted for issues unrelated to the
gastric banding. This could mean anything from 1 month postop to several
months postop. My GI soft allows soft cooked meats including pork and
beef (doc does not want this) and sugars and sweetened desserts and
beverages, so I need  to make changes and develop a bariatic soft diet.
When reviewing material from the ADA NCM the meal plan is blended/pureed
whereas he wants soft cooked foods consistent with our soft diet but
without the sugar. Here are my questions to you as I am not accustomed
to routinely working with this patient population:

If others have bariatric diets in place are yours blended? 

Do you have 2 different bariatric diets for the different stages --
i.e.bariatric blended and bariatric soft

Do milk products need to be lactose free?   no - 

Is peanut butter allowed?

How much liquid are you allowing per tray? I was thinking of 8 oz.
protein supplement and 8 oz sugar-free beverage/tray, but how can I
insure they will wait 30 minutes out to drink and not drink the full 16
oz. at one time, and if this is the case do you deliver liquids between
meals instead and have them more on a 3 meal, 3 snack program?   per our
bariatric service RD, the nurse is responsible for controlling the
volume (for our post-op pts).  you would need some agreement w/ the
surgeon (I'd get it in writing) that pts have been educated and can
manage the appropriate volumes of fluids).   

What kinds of meats do you serve?

We no longer recognize "ADA clear liquids" so do I need to develop a
bariatric clear liquid diet for those who are postop?   yes - at least
per our protocol 

What protein supplements do you serve? I was thinking about using low
CHO slimfast.   we use Optisource by Nestle post-op.   

Sorry to be so winded, but any feedback from the group would be
appreciated. 

Thanks,
Meg

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Centers
(229)434-2394

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From RBijold1 at smdc.org  Tue Jul 28 09:03:14 2009
From: RBijold1 at smdc.org (Bijold, Roxanne M.)
Date: Tue, 28 Jul 2009 11:03:14 -0500
Subject: [Cnm] GB Patient
In-Reply-To: <19833324B774F042B1FE1C34A79695BA258EF7A5CD@NADCWPMSGCMS07.hca.corpad.net>
References: <19833324B774F042B1FE1C34A79695BA258EF7A5CD@NADCWPMSGCMS07.hca.corpad.net>
Message-ID: <42A90F8376E770489AF180BC11195B05010DFCBF@BOREAL.ntcampus.smdc.org>

Is she anemic?  Iron-deficiency anemia is quite common in GB patient who
are over 3 years out from surgery, especially if they have gotten sloppy
with taking their supplements.  I have seen the anemia manifested with
some strange food cravings.

Roxanne

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" 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Beanum Pamela
Sent: Tuesday, July 28, 2009 8:28 AM
To: cnm at lists.my180.net
Subject: [Cnm] GB Patient

Had a patient yesterday, s/p GB x10y ago.  She claims to be "addicted"
to salt, drinking the juice from pickle jars & olive jars; eating
handfuls of salt...has anyone seen this?  Anyone have any good
recommendations?  I told pt to f/u with her doctor & try changing her
current eating habits (eats sausage biscuit for breakfast) & she also
can't seem to get more then 24oz H20 in a day...

Pamela Beanum, RD 
Clinical Nutrition/Catering Manager 
804-254-9823 (phone)

804-254-5538 (fax)
Retreat Doctors' Hospital: A Campus of Henrico Doctors' Hospital
2621 Grove Ave 
Richmond VA 23220 
pamela.beanum at hcahealthcare.com

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. 

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From LAltenburger5 at matherhospital.org  Tue Jul 28 09:10:40 2009
From: LAltenburger5 at matherhospital.org (Altenburger, Linda)
Date: Tue, 28 Jul 2009 12:10:40 -0400
Subject: [Cnm] soy and whey free supplement
Message-ID: 

Would anyone know of a po nutritional supplement for a patient who is
"no soy and no whey"? Thanks.

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

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From JDoley at carondelet.org  Tue Jul 28 09:03:08 2009
From: JDoley at carondelet.org (Doley, Jennifer A.)
Date: Tue, 28 Jul 2009 11:03:08 -0500
Subject: [Cnm] Pressure Ulcer Triggers
In-Reply-To: <6C5C5FBEE636A043BC7466A8CAE0732F0B6DCAF4@exchmail1.rexhealth.com>
References: <6C5C5FBEE636A043BC7466A8CAE0732F0B6DCAF4@exchmail1.rexhealth.com>
Message-ID: <48585A0648A4814EAF7E868254E3FB028EABC8@ahcmascdc014.DS.SJHS.COM>

This is an issue in my facility.  Without input from our department, the
skin care team decided that all patients with a Braden of 18 or less
should get a nutrition consult.  Needless to say, we get a lot of
inappropriate consults, especially in our ortho unit where patients are
perfectly well nourished and eating great, but are immobile.  We are
tracking these consults by noting which are appropriate and which are
not (our definition of appropriate is that the patient has a nutrition
diagnosis which may put them at greater risk for a pressure ulcer, i.e.
malnutrition, inadequate oral intake, etc.)

So far, only ~ 45% of these consults are appropriate, so obviously this
isn't a very effective screening tool.  I plan to take this data and
literature to the team, and may propose that we only get nutrition
consults for a low nutrition subscore.

Jennifer Doley, MBA, RD, CNSD

Regional Clinical Nutrition Manager and

Dietetic Internship Director

Morrison Management Specialists

St. Mary's Hospital, Tucson, Az

office: 520-872-6109

cell: 520-204-7795

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Haft, Lyn
Sent: Tuesday, July 28, 2009 4:52 AM
To: cnm at lists.my180.net
Subject: [Cnm] Pressure Ulcer Triggers

Good morning, would you please let me know what your facilities are
coming up with (policies/procedures and nutrition screening triggers) to
help identify patients who may be at risk for the development of
pressure ulcers.  

A team of about 5 nurses here is deciding we need to add to our
nutrition screening things like Nausea/Vomiting/Diarrhea, eating less
than 75%, Braden scale less than 18, they were also thinking immobility,
certain surgeries, and diseases.  They looked at what other institutions
are doing and decided we should add all the triggers.  

Some of the above we have taken off our screen as they led to many false
positives and much time wasted.  At the moment we are quite busy and of
course cannot add FTEs.

Thanks for you help 

Lyn Haft 
Clinical Nutrition Manager 
Rex Healthcare 
4420 Lake Boone Trail 
Raleigh, NC 27607 
919-784-3162 

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belonging
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To report abuse or inappropriate use, please email
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From RBijold1 at smdc.org  Tue Jul 28 09:17:13 2009
From: RBijold1 at smdc.org (Bijold, Roxanne M.)
Date: Tue, 28 Jul 2009 11:17:13 -0500
Subject: [Cnm] Bariatric diets
In-Reply-To: 
References: 
Message-ID: <42A90F8376E770489AF180BC11195B05010DFCC0@BOREAL.ntcampus.smdc.org>

A lap band patient is not going to experience dumping, so the only
rationale for limiting sugar is calorie control.  Also, if the patient
is at least two weeks past band placement, he or she should be able to
eat soft, solid foods.  We teach our lap band patients not to drink
liquids with their solid food, so I would not send liquids at all on the
trays.

Basically, you want to think of the lap band patients as eating a soft,
low calorie diet (1000 - 1200 calories) that focuses on protein and
produce.  A low calorie, high protein supplement may be offered to boost
protein, but we discourage eating between meals.

A post-op diet for lap band is not that complicated, as these patients
are not at high risk for nutrient deficiencies, and can tolerate most
foods, if they eat slowly and chew well.

Hope that helps.

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" 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Chaffin Meg
Sent: Tuesday, July 28, 2009 10:17 AM
To: cnm at lists.my180.net
Subject: [Cnm] Bariatric diets

I didn't get much response to my post for a hospital bariatric diet so I
thought I would repost and be more specific. Our surgeon performs the
lap band procedure and wants a diet in house (I think this may be needed
to become a COE which is what they are trying to accomplish) that may be
ordered for his patients who are admitted for issues unrelated to the
gastric banding. This could mean anything from 1 month postop to several
months postop. My GI soft allows soft cooked meats including pork and
beef (doc does not want this) and sugars and sweetened desserts and
beverages, so I need  to make changes and develop a bariatic soft diet.
When reviewing material from the ADA NCM the meal plan is blended/pureed
whereas he wants soft cooked foods consistent with our soft diet but
without the sugar. Here are my questions to you as I am not accustomed
to routinely working with this patient population:

If others have bariatric diets in place are yours blended? 

Do you have 2 different bariatric diets for the different stages --
i.e.bariatric blended and bariatric soft

Do milk products need to be lactose free?

Is peanut butter allowed?

How much liquid are you allowing per tray? I was thinking of 8 oz.
protein supplement and 8 oz sugar-free beverage/tray, but how can I
insure they will wait 30 minutes out to drink and not drink the full 16
oz. at one time, and if this is the case do you deliver liquids between
meals instead and have them more on a 3 meal, 3 snack program?

What kinds of meats do you serve?

We no longer recognize "ADA clear liquids" so do I need to develop a
bariatric clear liquid diet for those who are postop?

What protein supplements do you serve? I was thinking about using low
CHO slimfast.

Sorry to be so winded, but any feedback from the group would be
appreciated. 

Thanks,
Meg

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Centers
(229)434-2394

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. 

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From debyepstein at yahoo.com  Tue Jul 28 09:43:08 2009
From: debyepstein at yahoo.com (Debra Epstein)
Date: Tue, 28 Jul 2009 09:43:08 -0700 (PDT)
Subject: [Cnm] Pressure Ulcer Triggers
Message-ID: <462212.94171.qm@web57514.mail.re1.yahoo.com>

This is an issue in my facility as well.? We also have a large ortho and rehab service. 
My staff is required to see any patient with a Braden Score of 17 or less.?I am fairly new to the institution and?I did some data collection for about 3 months and found that 69% of patients with a Braden of < 17 were not at Nutrition risk.? I also found that the of the 31% that were at Nutrition Risk 92% of these patients would screen in by some other Nutrition Screening Trigger.? Therefore, we are wasting much valuable time, doing assessments on patients that may not need them.
?
We are now working to have the Braden Score removed as a Nutrition Screening Trigger although are certainly getting some push back from nursing.
?
Regards,
Debbie Epstein
Chief Clinical Dietitian
North Shore LIJ - Glen Cove Hospital
Glen Cove, NY

--- On Tue, 7/28/09, Doley, Jennifer A.  wrote:

From: Doley, Jennifer A. 
Subject: Re: [Cnm] Pressure Ulcer Triggers
To: "Haft, Lyn" , cnm at lists.my180.net
Date: Tuesday, July 28, 2009, 12:03 PM

This is an issue in my facility.? Without input from our department, the skin care team decided that all patients with a Braden of 18 or less should get a nutrition consult.? Needless to say, we get a lot of inappropriate consults, especially in our ortho unit where patients are perfectly well nourished and eating great, but are immobile.? We are tracking these consults by noting which are appropriate and which are not (our definition of appropriate is that the patient has a nutrition diagnosis which may put them at greater risk for a pressure ulcer, i.e. malnutrition, inadequate oral intake, etc.)
?
So far, only ~ 45% of these consults are appropriate, so obviously this isn?t a very effective screening tool.? I plan to take this data and literature to the team, and may propose that we only get nutrition consults for a low nutrition subscore.
?

Jennifer Doley, MBA, RD, CNSD
Regional Clinical Nutrition Manager and
Dietetic Internship Director
Morrison Management Specialists
St. Mary's Hospital, Tucson , Az
office: 520-872-6109
cell: 520-204-7795

From: cnm-bounces at lists.my180.net [mailto: cnm-bounces at lists.my180.net ] On Behalf Of Haft, Lyn
Sent: Tuesday, July 28, 2009 4:52 AM
To: cnm at lists.my180.net
Subject: [Cnm] Pressure Ulcer Triggers
?
Good morning, would you please let me know what your facilities are coming up with (policies/procedures and nutrition screening triggers) to help identify patients who may be at risk for the development of pressure ulcers.? 
A team of about 5 nurses here is deciding we need to add to our nutrition screening things like Nausea/Vomiting/Diarrhea, eating less than 75%, Braden scale less than 18, they were also thinking immobility, certain surgeries, and diseases.? They looked at what other institutions are doing and decided we should add all the triggers.? 
Some of the above we have taken off our screen as they led to many false positives and much time wasted.? At the moment we are quite busy and of course cannot add FTEs.
Thanks for you help 
Lyn Haft 
Clinical Nutrition Manager 
Rex Healthcare 
4420 Lake Boone Trail 
Raleigh, NC 27607 
919-784-3162 

-----?Confidentiality?Notice?-----
This?e-mail?and?any?attached?documents?contain?confidential?information?belonging
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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?
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or?destruction?of?this?information.

To?report?abuse?or?inappropriate?use,?please?email?abuse at rexhealth.com.(b)
?CONFIDENTIALITY NOTICE: 
This email message and any accompanying data or files is confidential and may
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From Liz.Anthony at milfordhospital.org  Tue Jul 28 09:57:37 2009
From: Liz.Anthony at milfordhospital.org (Anthony Liz)
Date: Tue, 28 Jul 2009 12:57:37 -0400
Subject: [Cnm] Pressure Ulcer Triggers
In-Reply-To: <462212.94171.qm@web57514.mail.re1.yahoo.com>
Message-ID: 

We get triggered for all pts with a Braden Scale score less than 15, and for all pts with a pressure ulcer (stage 1-4).

Liz Anthony
Milford Hospital

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Debra Epstein
Sent: Tuesday, July 28, 2009 12:43 PM
To: LynHaft; cnm at lists.my180.net; Jennifer A.Doley
Subject: Re: [Cnm] Pressure Ulcer Triggers

This is an issue in my facility as well.  We also have a large ortho and rehab service.
My staff is required to see any patient with a Braden Score of 17 or less. I am fairly new to the institution and I did some data collection for about 3 months and found that 69% of patients with a Braden of < 17 were not at Nutrition risk.  I also found that the of the 31% that were at Nutrition Risk 92% of these patients would screen in by some other Nutrition Screening Trigger.  Therefore, we are wasting much valuable time, doing assessments on patients that may not need them.

We are now working to have the Braden Score removed as a Nutrition Screening Trigger although are certainly getting some push back from nursing.

Regards,
Debbie Epstein
Chief Clinical Dietitian
North Shore LIJ - Glen Cove Hospital
Glen Cove, NY

--- On Tue, 7/28/09, Doley, Jennifer A.  wrote:

From: Doley, Jennifer A. 
Subject: Re: [Cnm] Pressure Ulcer Triggers
To: "Haft, Lyn" , cnm at lists.my180.net
Date: Tuesday, July 28, 2009, 12:03 PM
This is an issue in my facility.  Without input from our department, the skin care team decided that all patients with a Braden of 18 or less should get a nutrition consult.  Needless to say, we get a lot of inappropriate consults, especially in our ortho unit where patients are perfectly well nourished and eating great, but are immobile.  We are tracking these consults by noting which are appropriate and which are not (our definition of appropriate is that the patient has a nutrition diagnosis which may put them at greater risk for a pressure ulcer, i.e. malnutrition, inadequate oral intake, etc.)

So far, only ~ 45% of these consults are appropriate, so obviously this isn?t a very effective screening tool.  I plan to take this data and literature to the team, and may propose that we only get nutrition consults for a low nutrition subscore.

Jennifer Doley, MBA, RD, CNSD
Regional Clinical Nutrition Manager and
Dietetic Internship Director
Morrison Management Specialists
St. Mary's Hospital, Tucson , Az
office: 520-872-6109
cell: 520-204-7795
  _____

From: cnm-bounces at lists.my180.net [mailto: cnm-bounces at lists.my180.net ] On Behalf Of Haft, Lyn
Sent: Tuesday, July 28, 2009 4:52 AM
To: cnm at lists.my180.net
Subject: [Cnm] Pressure Ulcer Triggers

Good morning, would you please let me know what your facilities are coming up with (policies/procedures and nutrition screening triggers) to help identify patients who may be at risk for the development of pressure ulcers.
A team of about 5 nurses here is deciding we need to add to our nutrition screening things like Nausea/Vomiting/Diarrhea, eating less than 75%, Braden scale less than 18, they were also thinking immobility, certain surgeries, and diseases.  They looked at what other institutions are doing and decided we should add all the triggers.
Some of the above we have taken off our screen as they led to many false positives and much time wasted.  At the moment we are quite busy and of course cannot add FTEs.
Thanks for you help
Lyn Haft
Clinical Nutrition Manager
Rex Healthcare
4420 Lake Boone Trail
Raleigh, NC 27607
919-784-3162

----- 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
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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)

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
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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.

-----Inline Attachment Follows-----
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From Jennifer.DeHart at stvhs.com  Tue Jul 28 10:00:02 2009
From: Jennifer.DeHart at stvhs.com (DeHart, Jennifer)
Date: Tue, 28 Jul 2009 12:00:02 -0500
Subject: [Cnm] FW:  Pressure Ulcer Triggers
Message-ID: <790BE6DACA733D45A2EFE7875E03CC7C017A1E73@ahcmascdc024.DS.SJHS.COM>

I've had to deal with the concept of "consult the RD for all patients
with a Braden of 18 or less" as well - lots of patients with no
nutrition problem.  Our facility screening process is done on daily as
well as on admission, so there's a mechanism to alert the dietitian when
a patient meets those nutrition triggers such as poor intake later in
the admission.  Showing our Pressure Ulcer committee that the
auto-consults based on Braden score were a poor use of resources has
been effective.  All patients have the Braden scale done on admission
and daily, and we have a nursing "bundle" that's implemented in response
to a Braden score of 18 or less (reminders for the nurses to make sure
the patient is on the appropriate surface, turn q 2 hours, manage
incontinence, and be aware of nutrition (encourage meal intake, offer
fluids frequently, alert the dietitian if the patient is not eating
well).   I've had to continually push to make sure that the "nutrition"
section of the nursing bundle is actually nursing interventions as noted
rather than just auto-consulting the RD  - so far this seems to be
working well. 

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

P.S. I will be running the Nike Women's Marathon in San Francisco on
October 18th to raise funds for the Leukemia and Lymphoma Society. To
make a donation or to learn more, please visit my fundraising website at
http://pages.teamintraining.org/al/nikesf09/jdehart

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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Doley, Jennifer A.
Sent: Tuesday, July 28, 2009 11:03 AM
To: Haft, Lyn; cnm at lists.my180.net
Subject: Re: [Cnm] Pressure Ulcer Triggers

This is an issue in my facility.  Without input from our department, the
skin care team decided that all patients with a Braden of 18 or less
should get a nutrition consult.  Needless to say, we get a lot of
inappropriate consults, especially in our ortho unit where patients are
perfectly well nourished and eating great, but are immobile.  We are
tracking these consults by noting which are appropriate and which are
not (our definition of appropriate is that the patient has a nutrition
diagnosis which may put them at greater risk for a pressure ulcer, i.e.
malnutrition, inadequate oral intake, etc.)

So far, only ~ 45% of these consults are appropriate, so obviously this
isn't a very effective screening tool.  I plan to take this data and
literature to the team, and may propose that we only get nutrition
consults for a low nutrition subscore.

Jennifer Doley, MBA, RD, CNSD

Regional Clinical Nutrition Manager and

Dietetic Internship Director

Morrison Management Specialists

St. Mary's Hospital, Tucson, Az

office: 520-872-6109

cell: 520-204-7795

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Haft, Lyn
Sent: Tuesday, July 28, 2009 4:52 AM
To: cnm at lists.my180.net
Subject: [Cnm] Pressure Ulcer Triggers

Good morning, would you please let me know what your facilities are
coming up with (policies/procedures and nutrition screening triggers) to
help identify patients who may be at risk for the development of
pressure ulcers.  

A team of about 5 nurses here is deciding we need to add to our
nutrition screening things like Nausea/Vomiting/Diarrhea, eating less
than 75%, Braden scale less than 18, they were also thinking immobility,
certain surgeries, and diseases.  They looked at what other institutions
are doing and decided we should add all the triggers.  

Some of the above we have taken off our screen as they led to many false
positives and much time wasted.  At the moment we are quite busy and of
course cannot add FTEs.

Thanks for you help 

Lyn Haft 
Clinical Nutrition Manager 
Rex Healthcare 
4420 Lake Boone Trail 
Raleigh, NC 27607 
919-784-3162 

----- 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)

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 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 
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From Christine.Zirpoli at med.navy.mil  Tue Jul 28 10:07:06 2009
From: Christine.Zirpoli at med.navy.mil (Zirpoli, Christine F. (CIV))
Date: Tue, 28 Jul 2009 13:07:06 -0400
Subject: [Cnm] Bariatric diets
In-Reply-To: 
References: 
Message-ID: <891B0FCEC3CAED41976C938D2A1084EFE86555@NMCP-EX-VS-01.nmed.ds.med.navy.mil>

We have a stage 2 (sugar free clear liquids) and stage 3 diet (yogurt,
cottage cheese, pureed fruits, vegetables) for the immediate post op
diet for the gastric bypass. I included the meal tickets for this.  For
the band we are using a full liquid diet immediately post op. (2 weeks)
then to stage 3 diet.  We will use a no added sugar carnation instant
breakfast or glucerna for the full liquid.  They are only here for a
very short time, so this works for us.

If patients are admitted later, we generally will give them a no
concentrated sweets diet, provide a menu for them to select what they
can tolerate.  We'll make tuna, chicken or egg salad (mayo only- no
onion etc), chopped chicken or turkey with gravy, mashed potatoes, soft
cooked vegetables, canned fruits if they are less than 6 weeks out.  We
will send the CIB for between meals or 1% milk.  If they are lactose
intolerant we have soy milk.  We have so few admitted post op, I don't
have a separate supplement for them.

If they are several mos or years out-we'll use the regular menu,
alternate menu and let them select what they can tolerate. Not
everything on these menus are suitable, but I explain that to them.

Christine Zirpoli, RD, CNSD
Division Officer, Nutrition Management 
Naval Medical Center, Portsmouth
620 John Paul Jones Circle
Portsmouth, VA 23708
FAX 757-953-3257
Phone 757-953-2630 
-----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, July 28, 2009 11:42 AM
To: cnm at lists.my180.net
Subject: Cnm Digest, Vol 32, Issue 88

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

Today's Topics:

   1. Re: Sorian/CBORD (Roberta Tripp)
   2. Bariatric diets (Chaffin Meg)
   3. Re: Pressure Ulcer Triggers (Pam Charney)
   4. Re: Bariatric diets (Carver, Leslee)

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

Message: 1
Date: Tue, 28 Jul 2009 10:15:37 -0400
From: "Roberta Tripp" 
Subject: Re: [Cnm] Sorian/CBORD
To: "Altenburger, Linda" ,

Message-ID:

<7375E17267B3DB4583032BDEFDA2D76E090300F0 at mailphs.pinnaclehealth.org>
Content-Type: text/plain; charset="us-ascii"

We have Soarian and CBORD and they work together well.

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  

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Altenburger, Linda
Sent: Tuesday, July 28, 2009 9:01 AM
To: cnm at lists.my180.net
Subject: [Cnm] Sorian/CBORD

For those facilities that use Sorian, does it have diet office
capabilities eliminating the need for a separate diet office system?  If
not and you have CBORD, are you pleased with how they interact? Thank
you 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

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Message: 2
Date: Tue, 28 Jul 2009 10:16:43 -0500
From: Chaffin Meg 
Subject: [Cnm] Bariatric diets
To: "cnm at lists.my180.net" 
Message-ID:

Content-Type: text/plain; charset="us-ascii"

I didn't get much response to my post for a hospital bariatric diet so I
thought I would repost and be more specific. Our surgeon performs the
lap band procedure and wants a diet in house (I think this may be needed
to become a COE which is what they are trying to accomplish) that may be
ordered for his patients who are admitted for issues unrelated to the
gastric banding. This could mean anything from 1 month postop to several
months postop. My GI soft allows soft cooked meats including pork and
beef (doc does not want this) and sugars and sweetened desserts and
beverages, so I need  to make changes and develop a bariatic soft diet.
When reviewing material from the ADA NCM the meal plan is blended/pureed
whereas he wants soft cooked foods consistent with our soft diet but
without the sugar. Here are my questions to you as I am not accustomed
to routinely working with this patient population:

If others have bariatric diets in place are yours blended?

Do you have 2 different bariatric diets for the different stages --
i.e.bariatric blended and bariatric soft

Do milk products need to be lactose free?

Is peanut butter allowed?

How much liquid are you allowing per tray? I was thinking of 8 oz.
protein supplement and 8 oz sugar-free beverage/tray, but how can I
insure they will wait 30 minutes out to drink and not drink the full 16
oz. at one time, and if this is the case do you deliver liquids between
meals instead and have them more on a 3 meal, 3 snack program?

What kinds of meats do you serve?

We no longer recognize "ADA clear liquids" so do I need to develop a
bariatric clear liquid diet for those who are postop?

What protein supplements do you serve? I was thinking about using low
CHO slimfast.

Sorry to be so winded, but any feedback from the group would be
appreciated.

Thanks,
Meg

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Centers
(229)434-2394

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Message: 3
Date: Tue, 28 Jul 2009 08:40:42 -0700
From: Pam Charney 
Subject: Re: [Cnm] Pressure Ulcer Triggers
To: "Haft, Lyn" 
Cc: cnm at lists.my180.net
Message-ID: 
Content-Type: text/plain; charset="us-ascii"

I suppose that theoretically we're all at risk for a pressure ulcer if
we sit in front of our computers long enough. Your nurses are doing
something called "case finding". If they look long enough, surely one or
more patients in each category would get a pressure ulcer, and then they
can say "see, these patients are at risk".

However, this behavior costs a lot of money. For each pressure ulcer
found using this method, someone's going to have to screen a lot of
patients, which is costly.

You could do a bit of investigative reporting. If you are using an EMR,
query the database for folks with pressure ulcers that develop during
admission and then see what similarities they have. Or, alternatively,
you could say that each of the issues listed really boils down to not
eating enough. The malnutrition screening tool, which is discussed in
ADA's evidence library, addresses not eating enough.

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
http://www.linkedin.com/in/pamcharney

"The person who says it can't be done should not interrupt the person
doing it" - Ethel Kennedy

On Jul 28, 2009, at 4:51 AM, Haft, Lyn wrote:

> Good morning, would you please let me know what your facilities are 
> coming up with (policies/procedures and nutrition screening
> triggers) to help identify patients who may be at risk for the 
> development of pressure ulcers.
>
> A team of about 5 nurses here is deciding we need to add to our 
> nutrition screening things like Nausea/Vomiting/Diarrhea, eating less 
> than 75%, Braden scale less than 18, they were also thinking 
> immobility, certain surgeries, and diseases.  They looked at what 
> other institutions are doing and decided we should add all the 
> triggers.
>
> Some of the above we have taken off our screen as they led to many 
> false positives and much time wasted.  At the moment we are quite busy

> and of course cannot add FTEs.
>
> Thanks for you help
>
> Lyn Haft
> Clinical Nutrition Manager
> Rex Healthcare
> 4420 Lake Boone Trail
> Raleigh, NC 27607
> 919-784-3162
>
>
>
>
>
>
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Message: 4
Date: Tue, 28 Jul 2009 10:26:38 -0500
From: "Carver, Leslee" 
Subject: Re: [Cnm] Bariatric diets
To: "Chaffin Meg" ,

Message-ID:

<5330B54133B6194BA13930BDEFE9A30E0497C46D at rhcexch3.reshealthcare.org>
Content-Type: text/plain; charset="us-ascii"

I can only answer a few of your questions - see below.  I am attaching
our cliq/full liq bariatric diets.

Leslee R. Carver, MSPH, RD, LDN
Clinical Nutrition Manager
Saint Joseph Hospital
2900 N. Lake Shore Dr. 
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.  All personal messages express
view solely of the sender, which are not to be attributed to
Resurrection Health Care. Unauthorized review, use, disclosure or
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please contact the sender by reply e-mail and destroy all copies of the
original message

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Chaffin Meg
Sent: Tuesday, July 28, 2009 10:17 AM
To: cnm at lists.my180.net
Subject: [Cnm] Bariatric diets

I didn't get much response to my post for a hospital bariatric diet so I
thought I would repost and be more specific. Our surgeon performs the
lap band procedure and wants a diet in house (I think this may be needed
to become a COE which is what they are trying to accomplish) that may be
ordered for his patients who are admitted for issues unrelated to the
gastric banding. This could mean anything from 1 month postop to several
months postop. My GI soft allows soft cooked meats including pork and
beef (doc does not want this) and sugars and sweetened desserts and
beverages, so I need  to make changes and develop a bariatic soft diet.
When reviewing material from the ADA NCM the meal plan is blended/pureed
whereas he wants soft cooked foods consistent with our soft diet but
without the sugar. Here are my questions to you as I am not accustomed
to routinely working with this patient population:

If others have bariatric diets in place are yours blended? 

Do you have 2 different bariatric diets for the different stages --
i.e.bariatric blended and bariatric soft

Do milk products need to be lactose free?   no - 

Is peanut butter allowed?

How much liquid are you allowing per tray? I was thinking of 8 oz.
protein supplement and 8 oz sugar-free beverage/tray, but how can I
insure they will wait 30 minutes out to drink and not drink the full 16
oz. at one time, and if this is the case do you deliver liquids between
meals instead and have them more on a 3 meal, 3 snack program?   per our
bariatric service RD, the nurse is responsible for controlling the
volume (for our post-op pts).  you would need some agreement w/ the
surgeon (I'd get it in writing) that pts have been educated and can
manage the appropriate volumes of fluids).   

What kinds of meats do you serve?

We no longer recognize "ADA clear liquids" so do I need to develop a
bariatric clear liquid diet for those who are postop?   yes - at least
per our protocol 

What protein supplements do you serve? I was thinking about using low
CHO slimfast.   we use Optisource by Nestle post-op.   

Sorry to be so winded, but any feedback from the group would be
appreciated. 

Thanks,
Meg

Meg Chaffin MA,RD,LD
Clinical Nutrition Manager
Palmyra Medical Centers
(229)434-2394

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

_______________________________________________
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End of Cnm Digest, Vol 32, Issue 88
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From kristin.schiller at gmail.com  Tue Jul 28 12:26:37 2009
From: kristin.schiller at gmail.com (Kristin Schiller)
Date: Tue, 28 Jul 2009 13:26:37 -0600
Subject: [Cnm] Nutrition support protocols/algorithms
Message-ID: 

Would anyone be willing to post a copy of any nutrition support protocols,
nutrition support decsion trees or nutrition support algorithms? I am in the
process of developing a new Nutrition Protocol based on the new
ASPEN/SCCM and Canadian Clinical Practice Guidelines for our ICU patients.
My goal is to start early EN on pts who are malnourished, at risk of
malnourished or who may benefit from early EN based on medical diagnosis
(severe pancreatitis, vented pts etc).

Thank you in advance,

K. Schiller MS, RD
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From m-rodrig at msmc.com  Tue Jul 28 12:36:30 2009
From: m-rodrig at msmc.com (Maritza Rodriguez)
Date: Tue, 28 Jul 2009 15:36:30 -0400
Subject: [Cnm] Peptamen AF for ARDS
In-Reply-To: 
References: 
Message-ID: <32EDCA3D1F5C4C41B7E1A4573DFACCC6021180D3@SVIPEXC1.msmc.com>

Do any of you use Peptamen AF for ARDS patients?  Our nutrition support
pharmacists have bring the idea of use it for that purpose based on its
content, given the fact that our primary vendor for enteral products is
Nestle, and a remote possibility of obtaining Oxepa for pricing
issues...  Any suggestion will be appreciated.

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

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From Rosanne.Leibhart at crozer.org  Tue Jul 28 12:52:18 2009
From: Rosanne.Leibhart at crozer.org (Leibhart, Rosanne)
Date: Tue, 28 Jul 2009 15:52:18 -0400
Subject: [Cnm] Meals
In-Reply-To: 
Message-ID: <1904FBE1EFD42940AA44982E67B5B44E06CFF0BE@exchange02.CKHSAD.CROZER.ORG>

I am wondering how other facilities determine "meal equivlants".
Do you use the total patient trays served or do you use average daily census?
We currently use the tray line totals, adding in the late trays and tray requests from short procedure and ER.  THis does not capture the NPOs or tube fed patients (enterals are under our budget). 
We use total census for production estimates so we are thinking we should use total census for "meal equivalents".
WHat are others doing?
THanks,
Rosanne Leibhart, RD

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From cwatters at ualberta.ca  Tue Jul 28 13:31:42 2009
From: cwatters at ualberta.ca (cwatters at ualberta.ca)
Date: Tue, 28 Jul 2009 14:31:42 -0600
Subject: [Cnm] Nutrition support protocols/algorithms
In-Reply-To: 
References: 
Message-ID: <20090728143142.902346qvscr4xmio@webmail.ualberta.ca>

Check out Critical Care Nutrition website (Cdn Clinical Practice  
Guidelines originators website) www.criticalcarenutrition.com. and  
look under the left tab of  Quality Improvement Tools.

Corilee Watters, MSc, RD, PhD

Quoting "Kristin Schiller" :

> Would anyone be willing to post a copy of any nutrition support protocols,
> nutrition support decsion trees or nutrition support algorithms? I am in the
> process of developing a new Nutrition Protocol based on the new
> ASPEN/SCCM and Canadian Clinical Practice Guidelines for our ICU patients.
> My goal is to start early EN on pts who are malnourished, at risk of
> malnourished or who may benefit from early EN based on medical diagnosis
> (severe pancreatitis, vented pts etc).
>
> Thank you in advance,
>
> K. Schiller MS, RD
>

From Shannon.Jackson at wilmed.org  Tue Jul 28 13:40:33 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Tue, 28 Jul 2009 16:40:33 -0400
Subject: [Cnm] Patient Select Menu
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A9D@wmhcs03.wmh.org>

Hello,

Do any others write a name of a FNS rep or RD on their Select Patient Menu? 

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  

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From janet.fletcher at eamc.org  Tue Jul 28 13:49:03 2009
From: janet.fletcher at eamc.org (Jan Fletcher)
Date: Tue, 28 Jul 2009 15:49:03 -0500
Subject: [Cnm] Patient Select Menu
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A9D@wmhcs03.wmh.org>
References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A9D@wmhcs03.wmh.org>
Message-ID: <8AF41BE5480EB240A37098F30EA04FD605BA0584@max.AD.EAMC.ORG>

No, not here.

Jan Fletcher, M.S., R.D., L.D.

Clinical Nutrition Manager

East Alabama Medical Center

Auburn/Opelika, Al.

334-528-1878

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Tuesday, July 28, 2009 3:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Patient Select Menu

Hello,

Do any others write a name of a FNS rep or RD on their Select Patient
Menu? 

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  

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.

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From TRISH.HUNTER at mmch.org  Tue Jul 28 13:51:05 2009
From: TRISH.HUNTER at mmch.org (TRISH HUNTER)
Date: Tue, 28 Jul 2009 16:51:05 -0400
Subject: [Cnm] question regarding meals for night shift
In-Reply-To: 
References: 

Message-ID: <3100CE2D25C3A94F9AEED5E9D56E32EF1E01D6044C@mmch-email.MMCH.LOCAL>

We are a critical access hospital with only about 25-30 team members working at night. We continue to get requests for meal service from them and I am trying to gather ideas from other facilities regarding food service for third shift. Thanks in advance!

Trish

Trish Hunter, RD
Food and Nutrition Services Manager
Margaret Mary Community Hospital
321 Mitchell Avenue
Batesville, IN 47006
812-933-5265
trish.hunter at mmch.org

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From bhomola at comhs.org  Tue Jul 28 13:51:14 2009
From: bhomola at comhs.org (Bobbi Homola)
Date: Tue, 28 Jul 2009 15:51:14 -0500
Subject: [Cnm] Patient Select Menu
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A9D@wmhcs03.wmh.org>
Message-ID: 

no

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 Shannon Byrd Jackson
Sent: Tuesday, July 28, 2009 3:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Patient Select Menu

Hello,

Do any others write a name of a FNS rep or RD on their Select Patient
Menu? 

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  

____________________________________

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from disclosure under applicable law. If you are not the addressee, or authorized to receive this on 
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the sender by e-mail and delete this information and all attachments from your computer and network. 
Thank you.
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From sheila.walsh at nahealth.com  Tue Jul 28 14:03:38 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Tue, 28 Jul 2009 14:03:38 -0700
Subject: [Cnm] question regarding meals for night shift
In-Reply-To: <3100CE2D25C3A94F9AEED5E9D56E32EF1E01D6044C@mmch-email.MMCH.LOCAL>
References: 	
	<3100CE2D25C3A94F9AEED5E9D56E32EF1E01D6044C@mmch-email.MMCH.LOCAL>
Message-ID: <4A6F053A.485B.0001.0@nahealth.com>

We give third shift employees free coffee and a cup of soup at 1am.

Sheila A. Walsh, MPH, RD
Clinical Nutrition Manager
Flagstaff Medical Center
Where patients are our purpose.
<\__~
/ \

>>> "TRISH HUNTER"  7/28/2009 1:51 PM >>>

We are a critical access hospital with only about 25-30 team members working at night. We continue to get requests for meal service from them and I am trying to gather ideas from other facilities regarding food service for third shift. Thanks in advance!

Trish

Trish Hunter, RD
Food and Nutrition Services Manager
Margaret Mary Community Hospital
321 Mitchell Avenue
Batesville, IN 47006
812-933-5265
trish.hunter at mmch.org

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From LCarver at Reshealthcare.org  Tue Jul 28 14:44:19 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 28 Jul 2009 16:44:19 -0500
Subject: [Cnm] Patient Select Menu
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A9D@wmhcs03.wmh.org>
References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A9D@wmhcs03.wmh.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E0497C654@rhcexch3.reshealthcare.org>

no.

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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
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view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Tuesday, July 28, 2009 3:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Patient Select Menu

Hello,

Do any others write a name of a FNS rep or RD on their Select Patient
Menu? 

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  

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From LCarver at Reshealthcare.org  Tue Jul 28 14:44:56 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Tue, 28 Jul 2009 16:44:56 -0500
Subject: [Cnm] question regarding meals for night shift
In-Reply-To: <3100CE2D25C3A94F9AEED5E9D56E32EF1E01D6044C@mmch-email.MMCH.LOCAL>
References: 
	<3100CE2D25C3A94F9AEED5E9D56E32EF1E01D6044C@mmch-email.MMCH.LOCAL>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E0497C655@rhcexch3.reshealthcare.org>

we only have vending machines until the cafe opens at 6:30 am. 

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of TRISH HUNTER
Sent: Tuesday, July 28, 2009 3:51 PM
To: CNM
Subject: [Cnm] question regarding meals for night shift

We are a critical access hospital with only about 25-30 team members
working at night. We continue to get requests for meal service from them
and I am trying to gather ideas from other facilities regarding food
service for third shift. Thanks in advance!

Trish

Trish Hunter, RD

Food and Nutrition Services Manager

Margaret Mary Community Hospital

321 Mitchell Avenue

Batesville, IN 47006

812-933-5265

trish.hunter at mmch.org

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From nlromanick at yahoo.com  Tue Jul 28 16:24:47 2009
From: nlromanick at yahoo.com (Nancy Romanick)
Date: Tue, 28 Jul 2009 16:24:47 -0700 (PDT)
Subject: [Cnm] Changing Department Name
In-Reply-To: <2B1106A6A593B147A65BD5A8939D3E11D3CA1555F5@MAIL-C.healthall.com>
References: <5E3E345918590D4D86333A4FCCF51A90019A4DBB@EXCHVS.frhg.org>
	<2B1106A6A593B147A65BD5A8939D3E11D3CA1555F5@MAIL-C.healthall.com>
Message-ID: <744262.24416.qm@web111807.mail.gq1.yahoo.com>

Our System - Banner Health System has recently changed from Food and Nutrition Services to "Culinary and Nutrition Services"? It is very common for everyone to still say "Dietary"? I don't think it will change much!! I think we will always be "Dietary"? 

________________________________
From: "Woods, Linda" 
To: "Sohal, Manjit" ; "cnm at lists.my180.net" 
Sent: Friday, July 24, 2009 5:26:01 AM
Subject: Re: [Cnm] Changing Department Name

No.? Our department is Food and Nutrition Services and that's how it appears on our budget.
?
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 Sohal, Manjit
Sent: Thursday, July 23, 2009 11:33 AM
To: cnm at lists..my180.net
Subject: [Cnm] Changing Department Name
?
We have changed our department name several years ago from ?Dietary? to ?Nutrition Services?.? However, we have been told that the name Dietary has to used in department budgets due to it?s a universally used hospital department name.? 
?
Has anyone else had this issue?
?
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 
?
Exceptional Care, Close to Home
?
________________________________
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From pcharney at mac.com  Tue Jul 28 16:35:31 2009
From: pcharney at mac.com (Pam Charney)
Date: Tue, 28 Jul 2009 16:35:31 -0700
Subject: [Cnm] Teaching Hospitals & TPN's
In-Reply-To: <4A6EC4B2.E045.0010.0@mail.mcg.edu>
References: <4A6EC4B2.E045.0010.0@mail.mcg.edu>
Message-ID: 

I've worked in similar situations where we've developed a  
collaborative practice with all involved. That way the house staff see  
a united front, are taught using a consistent manner, and there's  
stronger communication. Would that be a possibility for you. I'd hate  
to see you give up such a valuable service.

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
http://www.linkedin.com/in/pamcharney

"The person who says it can't be done should not
interrupt the person doing it" - Ethel Kennedy

On Jul 28, 2009, at 6:28 AM, Jessica Baye wrote:

> Good Morning
>
> I'm looking for some feedback on how other teaching hospitals are  
> handling TPN order writing.  Currently my staff of 5 inpatient RD's  
> write about 6-10 TPN orders per day.  And when I say "write" I mean  
> we TO them.  We do not have order writing privileges.  We also do  
> not have a nutrition support service so we don't bill for this  
> activity...we just do it out of the kindness of our hearts.   
> Recently I had a discussion with an RD who is employed by the  
> surgical service at our hospital.  She told me that she does not  
> write any of those TPN's.  She teaches a class on TPN's once a month  
> and serves as a resource to the MD's only.
> I'm very conflicted.  Part of me wants to give back the TPN's -  
> since it takes up so much of our time.  Part of me says keep writing  
> the TPN orders since as dietitians we are the best trained.
>
> I would appreciate input
>
> Thanks in advance
> Jessica
>
> Jessica Baye, RD, LD
> Clinical Nutrition Manager
> Food & Nutrition Services
> MCG Health System
> BA1565
> 1120 15th Street
> Augusta, GA  30912
> 706.721.3202 (office)
> 706.533.3313 (cell)
> 706.721.7243 x1405 (pager)
> jbaye at mcg.edu
>
>
>
>
>
> _______________________________________________
> Cnm mailing list
> Cnm at lists.my180.net
> http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

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From DOurs at memorialcare.org  Tue Jul 28 16:41:27 2009
From: DOurs at memorialcare.org (Daira Ours)
Date: Tue, 28 Jul 2009 16:41:27 -0700
Subject: [Cnm] Changing Department Name
In-Reply-To: <744262.24416.qm@web111807.mail.gq1.yahoo.com>
References: <5E3E345918590D4D86333A4FCCF51A90019A4DBB@EXCHVS.frhg.org>
	<2B1106A6A593B147A65BD5A8939D3E11D3CA1555F5@MAIL-C.healthall.com>
	<744262.24416.qm@web111807.mail.gq1.yahoo.com>
Message-ID: 

Our department is Food and Nutrition Services as well. 

Daira Ours, MS, RD
Clinical Nutrition Manager
Long Beach Memorial Medical Center & Miller Children's Hospital
2801 Atlantic Ave
Long Beach CA 90801
(562) 933 0525

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Nancy Romanick
Sent: Tuesday, July 28, 2009 4:25 PM
To: Woods, Linda; Sohal, Manjit; cnm at lists.my180.net
Subject: Re: [Cnm] Changing Department Name

Our System - Banner Health System has recently changed from Food and
Nutrition Services to "Culinary and Nutrition Services"  It is very
common for everyone to still say "Dietary"  I don't think it will change
much!! I think we will always be "Dietary"  

________________________________

From: "Woods, Linda" 
To: "Sohal, Manjit" ; "cnm at lists.my180.net"

Sent: Friday, July 24, 2009 5:26:01 AM
Subject: Re: [Cnm] Changing Department Name

No.  Our department is Food and Nutrition Services and that's how it
appears on our budget.

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 Sohal, Manjit
Sent: Thursday, July 23, 2009 11:33 AM
To: cnm at lists.my180.net
Subject: [Cnm] Changing Department Name

We have changed our department name several years ago from "Dietary" to
"Nutrition Services".  However, we have been told that the name Dietary
has to used in department budgets due to it's a universally used
hospital department name.  

Has anyone else had this issue?

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   

Exceptional Care, Close to Home 

________________________________

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copies of the original message.

______________________________________________________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for 
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From mrogard at charter.net  Wed Jul 29 02:48:41 2009
From: mrogard at charter.net (mrogard at charter.net)
Date: Wed, 29 Jul 2009 2:48:41 -0700
Subject: [Cnm] FW:  Pressure Ulcer Triggers
In-Reply-To: <790BE6DACA733D45A2EFE7875E03CC7C017A1E73@ahcmascdc024.DS.SJHS.COM>
Message-ID: <20090729054841.GLG6V.2588282.root@mp11>

We had the same problem with receiving false positives when using the Braden Scale -even when we lowered it th a score of 14.  Many of the truly positive results were picked up by other triggers such as wtl loss. We have adjusted screen to identify patients admitted with non-healing wounds/decubiti and the nursing skin maintenance form has a check off for nutrition consult which automatically triggers a nutrition consult in the EMR.
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

---- "DeHart wrote: 
> I've had to deal with the concept of "consult the RD for all patients
> with a Braden of 18 or less" as well - lots of patients with no
> nutrition problem.  Our facility screening process is done on daily as
> well as on admission, so there's a mechanism to alert the dietitian when
> a patient meets those nutrition triggers such as poor intake later in
> the admission.  Showing our Pressure Ulcer committee that the
> auto-consults based on Braden score were a poor use of resources has
> been effective.  All patients have the Braden scale done on admission
> and daily, and we have a nursing "bundle" that's implemented in response
> to a Braden score of 18 or less (reminders for the nurses to make sure
> the patient is on the appropriate surface, turn q 2 hours, manage
> incontinence, and be aware of nutrition (encourage meal intake, offer
> fluids frequently, alert the dietitian if the patient is not eating
> well).   I've had to continually push to make sure that the "nutrition"
> section of the nursing bundle is actually nursing interventions as noted
> rather than just auto-consulting the RD  - so far this seems to be
> working well. 
> 
> 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
> 
>  
> 
> P.S. I will be running the Nike Women's Marathon in San Francisco on
> October 18th to raise funds for the Leukemia and Lymphoma Society. To
> make a donation or to learn more, please visit my fundraising website at
> http://pages.teamintraining.org/al/nikesf09/jdehart
>  
> 
>  
> 
> 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
> 
>  
> 
>   
> 
> ________________________________
> 
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Doley, Jennifer A.
> Sent: Tuesday, July 28, 2009 11:03 AM
> To: Haft, Lyn; cnm at lists.my180.net
> Subject: Re: [Cnm] Pressure Ulcer Triggers
> 
>  
> 
> This is an issue in my facility.  Without input from our department, the
> skin care team decided that all patients with a Braden of 18 or less
> should get a nutrition consult.  Needless to say, we get a lot of
> inappropriate consults, especially in our ortho unit where patients are
> perfectly well nourished and eating great, but are immobile.  We are
> tracking these consults by noting which are appropriate and which are
> not (our definition of appropriate is that the patient has a nutrition
> diagnosis which may put them at greater risk for a pressure ulcer, i.e.
> malnutrition, inadequate oral intake, etc.)
> 
>  
> 
> So far, only ~ 45% of these consults are appropriate, so obviously this
> isn't a very effective screening tool.  I plan to take this data and
> literature to the team, and may propose that we only get nutrition
> consults for a low nutrition subscore.
> 
>  
> 
> Jennifer Doley, MBA, RD, CNSD
> 
> Regional Clinical Nutrition Manager and
> 
> Dietetic Internship Director
> 
> Morrison Management Specialists
> 
> St. Mary's Hospital, Tucson, Az
> 
> office: 520-872-6109
> 
> cell: 520-204-7795
> 
> ________________________________
> 
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Haft, Lyn
> Sent: Tuesday, July 28, 2009 4:52 AM
> To: cnm at lists.my180.net
> Subject: [Cnm] Pressure Ulcer Triggers
> 
>  
> 
> Good morning, would you please let me know what your facilities are
> coming up with (policies/procedures and nutrition screening triggers) to
> help identify patients who may be at risk for the development of
> pressure ulcers.  
> 
> A team of about 5 nurses here is deciding we need to add to our
> nutrition screening things like Nausea/Vomiting/Diarrhea, eating less
> than 75%, Braden scale less than 18, they were also thinking immobility,
> certain surgeries, and diseases.  They looked at what other institutions
> are doing and decided we should add all the triggers.  
> 
> Some of the above we have taken off our screen as they led to many false
> positives and much time wasted.  At the moment we are quite busy and of
> course cannot add FTEs.
> 
> Thanks for you help 
> 
> Lyn Haft 
> Clinical Nutrition Manager 
> Rex Healthcare 
> 4420 Lake Boone Trail 
> Raleigh, NC 27607 
> 919-784-3162 
> 
>  
> 
> 
> 
> ----- Confidentiality Notice -----
> This e-mail and any attached documents contain confidential information
> belonging
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> 
>  
> 
>  
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> Receipt by anyone other than the named recipient(s) is not a waiver of any 
> attorney-client, work product, or other applicable privilege.

From johnstonj at wvuh.com  Wed Jul 29 05:52:09 2009
From: johnstonj at wvuh.com (Johnston, Jill L)
Date: Wed, 29 Jul 2009 08:52:09 -0400
Subject: [Cnm] question regarding meals for night shift
In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E0497C655@rhcexch3.reshealthcare.org>
References: <3100CE2D25C3A94F9AEED5E9D56E32EF1E01D6044C@mmch-email.MMCH.LOCAL>
	<5330B54133B6194BA13930BDEFE9A30E0497C655@rhcexch3.reshealthcare.org>
Message-ID: 

Our cafeteria is open from 2-4 am.  We are also a 530 bed Level 1Trauma
center so that makes a difference in the amount of staff on night shift.

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Carver, Leslee
Sent: Tuesday, July 28, 2009 5:45 PM
To: TRISH HUNTER; CNM
Subject: Re: [Cnm] question regarding meals for night shift

we only have vending machines until the cafe opens at 6:30 am. 

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of TRISH HUNTER
Sent: Tuesday, July 28, 2009 3:51 PM
To: CNM
Subject: [Cnm] question regarding meals for night shift

We are a critical access hospital with only about 25-30 team members
working at night. We continue to get requests for meal service from them
and I am trying to gather ideas from other facilities regarding food
service for third shift. Thanks in advance!

Trish

Trish Hunter, RD

Food and Nutrition Services Manager

Margaret Mary Community Hospital

321 Mitchell Avenue

Batesville, IN 47006

812-933-5265

trish.hunter at mmch.org

-----------------------------------------
Confidentiality Notice: This e-mail message, including any
attachments, is for the sole use of the intended recipient(s) and
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From tfreeden at somerset-healthcare.com  Wed Jul 29 06:07:53 2009
From: tfreeden at somerset-healthcare.com (Freeden, Theresa)
Date: Wed, 29 Jul 2009 09:07:53 -0400
Subject: [Cnm] Patient Select Menu
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A9D@wmhcs03.wmh.org>
Message-ID: 

We visit patients using bedside menu entry in which they must introduce themselves. If patients are out of the room they do leave a card with their name and the diet office phone number to call to make selections.

Theresa Freeden, MS, RD

Clinical Nutrition Manager 

Somerset Medical Center

110 Rehill Ave.

Somerville, NJ 08876

908 704-2758

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Shannon Byrd Jackson
Sent: Tuesday, July 28, 2009 4:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Patient Select Menu

Hello,

Do any others write a name of a FNS rep or RD on their Select Patient Menu? 

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

CONFIDENTIALITY NOTICE
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addressee, please promptly delete this message and notify 
the sender of the delivery error by e-mail or you may call 
Somerset Medical Center's computer Help Desk at 
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From Annalynn_Skipper at Comcast.net  Wed Jul 29 06:15:21 2009
From: Annalynn_Skipper at Comcast.net (Annalynn Skipper)
Date: Wed, 29 Jul 2009 08:15:21 -0500
Subject: [Cnm] FW:  Pressure Ulcer Triggers
In-Reply-To: <20090729054841.GLG6V.2588282.root@mp11>
References: <790BE6DACA733D45A2EFE7875E03CC7C017A1E73@ahcmascdc024.DS.SJHS.COM>
	<20090729054841.GLG6V.2588282.root@mp11>
Message-ID: <71E9FBBA8960415593EAAA889603DF36@ANNALYNN>

If there were a way to document this with a study published in NCP, JADA or
one of the wound journals, this would be such a help to all of us.  It would
be quite simple to do and a good collaborative project for the practice
group I would think. 

Regards to all.    

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: mrogard at charter.net [mailto:mrogard at charter.net] 
Sent: Wednesday, July 29, 2009 4:49 AM
To: DeHart, Jennifer; cnm at lists.my180.net
Subject: Re: [Cnm] FW: Pressure Ulcer Triggers

We had the same problem with receiving false positives when using the Braden
Scale -even when we lowered it th a score of 14.  Many of the truly positive
results were picked up by other triggers such as wtl loss. We have adjusted
screen to identify patients admitted with non-healing wounds/decubiti and
the nursing skin maintenance form has a check off for nutrition consult
which automatically triggers a nutrition consult in the EMR.
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

---- "DeHart wrote: 
> I've had to deal with the concept of "consult the RD for all patients
> with a Braden of 18 or less" as well - lots of patients with no
> nutrition problem.  Our facility screening process is done on daily as
> well as on admission, so there's a mechanism to alert the dietitian when
> a patient meets those nutrition triggers such as poor intake later in
> the admission.  Showing our Pressure Ulcer committee that the
> auto-consults based on Braden score were a poor use of resources has
> been effective.  All patients have the Braden scale done on admission
> and daily, and we have a nursing "bundle" that's implemented in response
> to a Braden score of 18 or less (reminders for the nurses to make sure
> the patient is on the appropriate surface, turn q 2 hours, manage
> incontinence, and be aware of nutrition (encourage meal intake, offer
> fluids frequently, alert the dietitian if the patient is not eating
> well).   I've had to continually push to make sure that the "nutrition"
> section of the nursing bundle is actually nursing interventions as noted
> rather than just auto-consulting the RD  - so far this seems to be
> working well. 
> 
> 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
> 
>  
> 
> P.S. I will be running the Nike Women's Marathon in San Francisco on
> October 18th to raise funds for the Leukemia and Lymphoma Society. To
> make a donation or to learn more, please visit my fundraising website at
> http://pages.teamintraining.org/al/nikesf09/jdehart
>  
> 
>  
> 
> 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
> 
>  
> 
>   
> 
> ________________________________
> 
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Doley, Jennifer A.
> Sent: Tuesday, July 28, 2009 11:03 AM
> To: Haft, Lyn; cnm at lists.my180.net
> Subject: Re: [Cnm] Pressure Ulcer Triggers
> 
>  
> 
> This is an issue in my facility.  Without input from our department, the
> skin care team decided that all patients with a Braden of 18 or less
> should get a nutrition consult.  Needless to say, we get a lot of
> inappropriate consults, especially in our ortho unit where patients are
> perfectly well nourished and eating great, but are immobile.  We are
> tracking these consults by noting which are appropriate and which are
> not (our definition of appropriate is that the patient has a nutrition
> diagnosis which may put them at greater risk for a pressure ulcer, i.e.
> malnutrition, inadequate oral intake, etc.)
> 
>  
> 
> So far, only ~ 45% of these consults are appropriate, so obviously this
> isn't a very effective screening tool.  I plan to take this data and
> literature to the team, and may propose that we only get nutrition
> consults for a low nutrition subscore.
> 
>  
> 
> Jennifer Doley, MBA, RD, CNSD
> 
> Regional Clinical Nutrition Manager and
> 
> Dietetic Internship Director
> 
> Morrison Management Specialists
> 
> St. Mary's Hospital, Tucson, Az
> 
> office: 520-872-6109
> 
> cell: 520-204-7795
> 
> ________________________________
> 
> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
> On Behalf Of Haft, Lyn
> Sent: Tuesday, July 28, 2009 4:52 AM
> To: cnm at lists.my180.net
> Subject: [Cnm] Pressure Ulcer Triggers
> 
>  
> 
> Good morning, would you please let me know what your facilities are
> coming up with (policies/procedures and nutrition screening triggers) to
> help identify patients who may be at risk for the development of
> pressure ulcers.  
> 
> A team of about 5 nurses here is deciding we need to add to our
> nutrition screening things like Nausea/Vomiting/Diarrhea, eating less
> than 75%, Braden scale less than 18, they were also thinking immobility,
> certain surgeries, and diseases.  They looked at what other institutions
> are doing and decided we should add all the triggers.  
> 
> Some of the above we have taken off our screen as they led to many false
> positives and much time wasted.  At the moment we are quite busy and of
> course cannot add FTEs.
> 
> Thanks for you help 
> 
> Lyn Haft 
> Clinical Nutrition Manager 
> Rex Healthcare 
> 4420 Lake Boone Trail 
> Raleigh, NC 27607 
> 919-784-3162 
> 
>  
> 
> 
> 
> ----- Confidentiality Notice -----
> This e-mail and any attached documents contain confidential information
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> attorney-client, work product, or other applicable privilege.

From mrogard at charter.net  Wed Jul 29 06:32:00 2009
From: mrogard at charter.net (mrogard at charter.net)
Date: Wed, 29 Jul 2009 6:32:00 -0700
Subject: [Cnm] Thickened beverage survey ends Friday
Message-ID: <20090729093200.FLWVV.2573401.root@mp20>

Members of the listserv: 

Just a quick reminder that the participation period for the survey about thickened beverages ends this Friday (July 31st) at midnight. Your participation is greatly appreciated. Please click on the Web address (URL) below or copy and paste it into your browser. 

https://surveys.ksu.edu/TS?offeringId=135867 

--
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

From fns at abbgen.net  Wed Jul 29 07:01:54 2009
From: fns at abbgen.net (Annette Doucet)
Date: Wed, 29 Jul 2009 09:01:54 -0500
Subject: [Cnm] question regarding meals for night shift
In-Reply-To: <3100CE2D25C3A94F9AEED5E9D56E32EF1E01D6044C@mmch-email.MMCH.LOCAL>
References: 
	<3100CE2D25C3A94F9AEED5E9D56E32EF1E01D6044C@mmch-email.MMCH.LOCAL>
Message-ID: <007301ca1055$218db4c0$02be7878@local.abbgen.net>

Only vending, one cold food, microwave,and one snack machine available for
third shift.  There are coffee brewers at all nursing stations, so free
coffee is available at all times. 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of TRISH HUNTER
Sent: Tuesday, July 28, 2009 3:51 PM
To: CNM
Subject: [Cnm] question regarding meals for night shift

We are a critical access hospital with only about 25-30 team members working
at night. We continue to get requests for meal service from them and I am
trying to gather ideas from other facilities regarding food service for
third shift. Thanks in advance!

Trish

Trish Hunter, RD

Food and Nutrition Services Manager

Margaret Mary Community Hospital

321 Mitchell Avenue

Batesville, IN 47006

812-933-5265

trish.hunter at mmch.org

No virus found in this incoming message.
Checked by AVG - www.avg.com
Version: 8.5.392 / Virus Database: 270.13.35/2270 - Release Date: 07/29/09
06:12:00

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From Shannon.Jackson at wilmed.org  Wed Jul 29 07:39:29 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Wed, 29 Jul 2009 10:39:29 -0400
Subject: [Cnm] Abscess
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4AAC@wmhcs03.wmh.org>

Hello,

For patients with Incision and Drainage of large abscesses, are others
automatically assessing these patients? The patient is 400 lbs, eating
75-100%. We are in an acute hospital. 

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  

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From JKrzeminski at Reshealthcare.org  Wed Jul 29 07:22:28 2009
From: JKrzeminski at Reshealthcare.org (Krzeminski, Janet)
Date: Wed, 29 Jul 2009 09:22:28 -0500
Subject: [Cnm] Patient Select Menu
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A9D@wmhcs03.wmh.org>
References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A9D@wmhcs03.wmh.org>
Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F2D3CF55@rhcexch3.reshealthcare.org>

No.  Not here.
Janet K
Chicago, IL

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Tuesday, July 28, 2009 3:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Patient Select Menu

Hello,

Do any others write a name of a FNS rep or RD on their Select Patient
Menu? 

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  

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From kwyne at barlow2000.org  Wed Jul 29 08:39:40 2009
From: kwyne at barlow2000.org (Wyne, Kateri)
Date: Wed, 29 Jul 2009 08:39:40 -0700
Subject: [Cnm] Changing Department Name
In-Reply-To: <744262.24416.qm@web111807.mail.gq1.yahoo.com>
References: <5E3E345918590D4D86333A4FCCF51A90019A4DBB@EXCHVS.frhg.org><2B1106A6A593B147A65BD5A8939D3E11D3CA1555F5@MAIL-C.healthall.com>
	<744262.24416.qm@web111807.mail.gq1.yahoo.com>
Message-ID: 

Could the issue be the name of our profession? If we are dietitians
isn't the logical to categorize us as dietary and therefore think of
food prep? 

I think Physician Assistant have a similar problem. They get referred to
as Physician's Assistants which focuses people on the assistant portion
of their title and confuses them with medical assistants two very
different professions and levels of education.

Just a thought. 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Nancy Romanick
Sent: Tuesday, July 28, 2009 4:25 PM
To: Woods, Linda; Sohal, Manjit; cnm at lists.my180.net
Subject: Re: [Cnm] Changing Department Name

Our System - Banner Health System has recently changed from Food and
Nutrition Services to "Culinary and Nutrition Services"  It is very
common for everyone to still say "Dietary"  I don't think it will change
much!! I think we will always be "Dietary"  

________________________________

From: "Woods, Linda" 
To: "Sohal, Manjit" ; "cnm at lists.my180.net"

Sent: Friday, July 24, 2009 5:26:01 AM
Subject: Re: [Cnm] Changing Department Name

No.  Our department is Food and Nutrition Services and that's how it
appears on our budget.

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 Sohal, Manjit
Sent: Thursday, July 23, 2009 11:33 AM
To: cnm at lists.my180.net
Subject: [Cnm] Changing Department Name

We have changed our department name several years ago from "Dietary" to
"Nutrition Services".  However, we have been told that the name Dietary
has to used in department budgets due to it's a universally used
hospital department name.  

Has anyone else had this issue?

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   

Exceptional Care, Close to Home 

________________________________

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From MarcelleKarustis at catholichealth.net  Wed Jul 29 09:05:09 2009
From: MarcelleKarustis at catholichealth.net (Karustis, Marcelle)
Date: Wed, 29 Jul 2009 10:05:09 -0600
Subject: [Cnm] Generic Formulary
Message-ID: <17B38BCEA6E6F24D9300FA8CFE81F425E7FD81@chimsx015.CHI.catholichealth.net>

I have seen prior posts regarding generic formularies.

However, I have never seen an example of this type of listing.

I was wondering if anyone has one they would care to share?

Would be ever so appreciative!

Thanks

Marcelle Karustis MS RD RN LDN

Clinical Nutrition Manager

St. Joseph Medical Center - Bern Campus

P.O. Box 316

Reading, PA 19601

www.thefutureofhealthcare.org

610 378-2487

Fax 610 378-2178

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From lrichter at notes.cc.sunysb.edu  Wed Jul 29 09:17:00 2009
From: lrichter at notes.cc.sunysb.edu (lrichter at notes.cc.sunysb.edu)
Date: Wed, 29 Jul 2009 12:17:00 -0400
Subject: [Cnm] Standards of Care
Message-ID: 

I am evaluating our standards of care and was wondering if anyone would be
willing to share their Level of Care Policy?

If the nurse completes the nutrition screen in their initial nursing
assessment , how many hours does the nurse have to complete the assessment?
If the nutrition screen triggers a consult, how many hours does the
dietitian have to complete the consult?

If a patient is admitted and placed on a Therapeutic diet by the LIP, but
the patient is not at high nutritional risk, how long does the dietitian
have to complete an assessment?

Lisa L. Richter, MS, RD
Clinical Nutrition Manager
Stony Brook University Hospital
Stony Brook, New York  11794-7012

******************************************************************************

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is for the sole use of the intended recipient(s) and may
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From Charleen.Sibley at southernregional.org  Wed Jul 29 09:28:17 2009
From: Charleen.Sibley at southernregional.org (Charleen Sibley)
Date: Wed, 29 Jul 2009 12:28:17 -0400
Subject: [Cnm] Standards of Care
In-Reply-To: 
References: 
Message-ID: <4A70405F.1CC1.0077.0@southernregional.org>

FYI
Here the screen must be completed within 12 hours of admission & consult completed in 24 hours from receipt of consult/referral
If screened by nursing  "not at nutrition risk" then pt seen for LOS by day 6 on floors & day 4 in critical care areas.  
Charleen

Charleen Sibley, MS,RD,LD, CNSD
Clinical Nutrition Manager, Food & Nutrition Services 
Phone 770-991-8053
Fax 770-991-8690
Southern Regional Medical Center
11 Upper Riverdale Road, SW
Riverdale, GA 30274
Email charleen.sibley at southernregional.org 

>>>  7/29/2009 12:17 PM >>>

I am evaluating our standards of care and was wondering if anyone would be willing to share their Level of Care Policy?

If the nurse completes the nutrition screen in their initial nursing assessment , how many hours does the nurse have to complete the assessment?
If the nutrition screen triggers a consult, how many hours does the dietitian have to complete the consult?

If a patient is admitted and placed on a Therapeutic diet by the LIP, but the patient is not at high nutritional risk, how long does the dietitian have to complete an assessment?

Lisa L. Richter, MS, RD
Clinical Nutrition Manager
Stony Brook University Hospital
Stony Brook, New York 11794-7012

******************************************************************************
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
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From Marianne_L_Merrick at ssmhc.com  Wed Jul 29 09:35:42 2009
From: Marianne_L_Merrick at ssmhc.com (Marianne_L_Merrick at ssmhc.com)
Date: Wed, 29 Jul 2009 11:35:42 -0500
Subject: [Cnm] Standards of Care
In-Reply-To: <4A70405F.1CC1.0077.0@southernregional.org>
Message-ID: 

We have the same..

-Marianne

Marianne Merrick, RD,CD
Clinical Nutrition Manager

St. Mary's Hospital
Food + Nutrition Services
700 S. Park St.
Madison, WI  53715

Ph:  608.258.6608
pager:  608.376.5620

"Charleen Sibley"  
Sent by: cnm-bounces at lists.my180.net
07/29/2009 11:28 AM

To
, 
cc

Subject
Re: [Cnm] Standards of Care

FYI
Here the screen must be completed within 12 hours of admission & consult 
completed in 24 hours from receipt of consult/referral
If screened by nursing  "not at nutrition risk" then pt seen for LOS by 
day 6 on floors & day 4 in critical care areas. 
Charleen

Charleen Sibley, MS,RD,LD, CNSD
Clinical Nutrition Manager, Food & Nutrition Services 
Phone 770-991-8053
Fax 770-991-8690
Southern Regional Medical Center
11 Upper Riverdale Road, SW
Riverdale, GA 30274
Email charleen.sibley at southernregional.org

>>>  7/29/2009 12:17 PM >>>
I am evaluating our standards of care and was wondering if anyone would be 
willing to share their Level of Care Policy?

If the nurse completes the nutrition screen in their initial nursing 
assessment , how many hours does the nurse have to complete the 
assessment?
If the nutrition screen triggers a consult, how many hours does the 
dietitian have to complete the consult?

If a patient is admitted and placed on a Therapeutic diet by the LIP, but 
the patient is not at high nutritional risk, how long does the dietitian 
have to complete an assessment?

Lisa L. Richter, MS, RD
Clinical Nutrition Manager
Stony Brook University Hospital
Stony Brook, New York 11794-7012

******************************************************************************
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 e-mail and destroy all copies of the original.
******************************************************************************
_______________________________________________
Cnm mailing list
Cnm at lists.my180.net
http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net

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From lizvan at hollandhospital.org  Wed Jul 29 11:18:47 2009
From: lizvan at hollandhospital.org (Liz Deater)
Date: Wed, 29 Jul 2009 14:18:47 -0400
Subject: [Cnm] Tube Feeding Question
Message-ID: <4A705A47.F420.00DE.0@hollandhospital.org>

Dear Colleagues,

I'm wondering what best practice is for the amount of formula you can hang (volume) at a time when a closed system is not an option. I have an ICU patient with 4 foot of small bowel, no large bowel. We are starting Peptamen with her (trophic rate). Our policy says 8-12 hours worth of volume at a time then rinse the bag. Is this still a current practice?

Thanks a lot.

Liz

Elizabeth J. Deater, RD
Clinical Nutrition Manager
Holland Hospital
602 Michigan Ave
Holland, MI 49423

(616)-394-3498

Confidentiality Notice: The information contained in this e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information, or Protected Health Information as such term is defined under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Any unauthorized review, use, disclosure, copying or distribution is prohibited and may be unlawful. If you believe you have received this e-mail in error, please contact the sender by reply e-mail and delete all copies of the original message, including attachments.

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From JKrzeminski at Reshealthcare.org  Wed Jul 29 11:29:22 2009
From: JKrzeminski at Reshealthcare.org (Krzeminski, Janet)
Date: Wed, 29 Jul 2009 13:29:22 -0500
Subject: [Cnm] Tube Feeding Question
In-Reply-To: <4A705A47.F420.00DE.0@hollandhospital.org>
References: <4A705A47.F420.00DE.0@hollandhospital.org>
Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F2D3D073@rhcexch3.reshealthcare.org>

We mostly use closed system.
Tubing gets changed every 24 hrs - this is our hospital policy.  The
Manufacturer's is 36 but our Nursing staff wants to stay consistent with
IV tubing changes.
I would imagine "rinsing bag" is not a sanitary practice and should be
discontinued.

Janet K
Chicago, IL

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Liz Deater
Sent: Wednesday, July 29, 2009 1:19 PM
To: cnm at lists.my180.net
Subject: [Cnm] Tube Feeding Question

Dear Colleagues,

I'm wondering what best practice is for the amount of formula you can
hang (volume) at a time when a closed system is not an option. I have an
ICU patient with 4 foot of small bowel, no large bowel. We are starting
Peptamen with her (trophic rate). Our policy says 8-12 hours worth of
volume at a time then rinse the bag. Is this still a current practice?

Thanks a lot.

Liz

Elizabeth J. Deater, RD
Clinical Nutrition Manager
Holland Hospital
602 Michigan Ave
Holland, MI 49423

(616)-394-3498

Confidentiality Notice: The information contained in this e-mail
message, including any attachments, is for the sole use of the intended
recipient(s) and may contain confidential and privileged information, or
Protected Health Information as such term is defined under the Health
Insurance Portability and Accountability Act of 1996 (HIPAA). Any
unauthorized review, use, disclosure, copying or distribution is
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From LCarver at Reshealthcare.org  Wed Jul 29 11:28:57 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Wed, 29 Jul 2009 13:28:57 -0500
Subject: [Cnm] Tube Feeding Question
In-Reply-To: <4A705A47.F420.00DE.0@hollandhospital.org>
References: <4A705A47.F420.00DE.0@hollandhospital.org>
Message-ID: <5330B54133B6194BA13930BDEFE9A30E0497C8B2@rhcexch3.reshealthcare.org>

our practice is 8 hrs.  check w/ your Nestle rep for written guidelines.

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Liz Deater
Sent: Wednesday, July 29, 2009 1:19 PM
To: cnm at lists.my180.net
Subject: [Cnm] Tube Feeding Question

Dear Colleagues,

I'm wondering what best practice is for the amount of formula you can
hang (volume) at a time when a closed system is not an option. I have an
ICU patient with 4 foot of small bowel, no large bowel. We are starting
Peptamen with her (trophic rate). Our policy says 8-12 hours worth of
volume at a time then rinse the bag. Is this still a current practice?

Thanks a lot.

Liz

Elizabeth J. Deater, RD
Clinical Nutrition Manager
Holland Hospital
602 Michigan Ave
Holland, MI 49423

(616)-394-3498

Confidentiality Notice: The information contained in this e-mail
message, including any attachments, is for the sole use of the intended
recipient(s) and may contain confidential and privileged information, or
Protected Health Information as such term is defined under the Health
Insurance Portability and Accountability Act of 1996 (HIPAA). Any
unauthorized review, use, disclosure, copying or distribution is
prohibited and may be unlawful. If you believe you have received this
e-mail in error, please contact the sender by reply e-mail and delete
all copies of the original message, including attachments. 

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From sheila.walsh at nahealth.com  Wed Jul 29 11:45:09 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Wed, 29 Jul 2009 11:45:09 -0700
Subject: [Cnm] Standards of Care
In-Reply-To: <4A70405F.1CC1.0077.0@southernregional.org>
References: 
	<4A70405F.1CC1.0077.0@southernregional.org>
Message-ID: <4A703645.485B.0001.0@nahealth.com>

we changed or consult response time to up to 48 hours.  This way we do not have to work on Sundays.

Sheila A. Walsh, MPH, RD
Clinical Nutrition Manager
Flagstaff Medical Center
Where patients are our purpose.
<\__~
/ \

>>> "Charleen Sibley"  7/29/2009 9:28 AM >>>
FYI
Here the screen must be completed within 12 hours of admission & consult completed in 24 hours from receipt of consult/referral
If screened by nursing  "not at nutrition risk" then pt seen for LOS by day 6 on floors & day 4 in critical care areas.  
Charleen

Charleen Sibley, MS,RD,LD, CNSD
Clinical Nutrition Manager, Food & Nutrition Services 
Phone 770-991-8053
Fax 770-991-8690
Southern Regional Medical Center
11 Upper Riverdale Road, SW
Riverdale, GA 30274
Email charleen.sibley at southernregional.org 

>>>  7/29/2009 12:17 PM >>>

I am evaluating our standards of care and was wondering if anyone would be willing to share their Level of Care Policy?

If the nurse completes the nutrition screen in their initial nursing assessment , how many hours does the nurse have to complete the assessment?
If the nutrition screen triggers a consult, how many hours does the dietitian have to complete the consult?

If a patient is admitted and placed on a Therapeutic diet by the LIP, but the patient is not at high nutritional risk, how long does the dietitian have to complete an assessment?

Lisa L. Richter, MS, RD
Clinical Nutrition Manager
Stony Brook University Hospital
Stony Brook, New York 11794-7012

******************************************************************************
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 e-mail and destroy all copies of the original.
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From me_merrell at yahoo.com  Wed Jul 29 12:58:12 2009
From: me_merrell at yahoo.com (Monica Merrell)
Date: Wed, 29 Jul 2009 12:58:12 -0700 (PDT)
Subject: [Cnm] blue dye and TF
Message-ID: <883789.65551.qm@web36501.mail.mud.yahoo.com>

Does anyone have current information on adding blue?dye to TF???I have a doctor that wants to do this and will proceed w/o documentation that isn't appropriate.
?
Thanks,Monica Stewart, RD, LD
Clinical Nutrition Manager
Washington Regional Medical Center
3215 N. North Hills Blvd.
Fayetteville, AR 72703
479-463-7198 

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From MKELLEY8 at PARTNERS.ORG  Wed Jul 29 13:02:40 2009
From: MKELLEY8 at PARTNERS.ORG (Kelley, Marissa E.)
Date: Wed, 29 Jul 2009 16:02:40 -0400
Subject: [Cnm] blue dye and TF
In-Reply-To: <883789.65551.qm@web36501.mail.mud.yahoo.com>
References: <883789.65551.qm@web36501.mail.mud.yahoo.com>
Message-ID: 

Please post to list!

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf
Of Monica Merrell
Sent: Wednesday, July 29, 2009 3:58 PM
To: cnm at lists.my180.net
Subject: [Cnm] blue dye and TF

Does anyone have current information on adding blue dye to TF?  I have a doctor
that wants to do this and will proceed w/o documentation that isn't appropriate.

Thanks,

Monica Stewart, RD, LD
Clinical Nutrition Manager
Washington Regional Medical Center
3215 N. North Hills Blvd.
Fayetteville, AR 72703
479-463-7198 

The information in this e-mail is intended only for the person to whom it is
addressed. If you believe this e-mail was sent to you in error and the e-mail
contains patient information, please contact the Partners Compliance HelpLine at
http://www.partners.org/complianceline . If the e-mail was sent to you in error
but does not contain patient information, please contact the sender and properly
dispose of the e-mail.
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From POTTERM at fauquierhealth.org  Wed Jul 29 13:19:11 2009
From: POTTERM at fauquierhealth.org (Potter, MARY)
Date: Wed, 29 Jul 2009 16:19:11 -0400
Subject: [Cnm] blue dye and TF
In-Reply-To: <883789.65551.qm@web36501.mail.mud.yahoo.com>
Message-ID: <8ECF425A281B4A4D88E99F028700A3AA038E38AD@fh-excbe01.fauquierhospital.org>

In addition to the attached abstract, here are some resources that may
help:

* the ADA's Evidence Library states "Blue dye should not be added to EN
for detection of aspiration. The risk of using blue dye outweighs any
perceived benefit".   And, it goes on to list risks/harms associated w/
using blue dye.    Check out all the info on-line.

*"Food Dye Use in Enteral Feedings:  A Review and a Call for a
Moratorium".   Nutrition in Clinical Practice 17: 169-181, June 2002.  

* on http://vm.cfsan.fda.gov/~dms.col-ltr2.html there's an FDA Public
Health Advisory on "reports of blue discoloration and death in patients
receiving enteral feedings tinted with the dye, FD&C Blue No.1".
Emphasized is how the FDA has never evaluated the use of blue food dye
for safety, and that serious complications have been associated w/ it. 

Hope this helps!

Beth Potter, RD
Clinical Nutrition Manager
Fauquier Health|500 Hospital Dr. Warrenton,VA 20186
540-316-4406
potterm at fauquierhealth.org  

** Note my new email address is potterm at fauquierhealth.org
  and new phone number is
540-316-4406**

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Monica Merrell
Sent: Wednesday, July 29, 2009 3:58 PM
To: cnm at lists.my180.net
Subject: [Cnm] blue dye and TF

Does anyone have current information on adding blue dye to TF?  I have a
doctor that wants to do this and will proceed w/o documentation that
isn't appropriate.

Thanks,

Monica Stewart, RD, LD
Clinical Nutrition Manager
Washington Regional Medical Center
3215 N. North Hills Blvd.
Fayetteville, AR 72703
479-463-7198 

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From me_merrell at yahoo.com  Wed Jul 29 13:28:33 2009
From: me_merrell at yahoo.com (Monica Merrell)
Date: Wed, 29 Jul 2009 13:28:33 -0700 (PDT)
Subject: [Cnm] blue dye and TF
In-Reply-To: <8ECF425A281B4A4D88E99F028700A3AA038E38AD@fh-excbe01.fauquierhospital.org>
References: <8ECF425A281B4A4D88E99F028700A3AA038E38AD@fh-excbe01.fauquierhospital.org>
Message-ID: <901448.37071.qm@web36508.mail.mud.yahoo.com>

Thanks to all who responded!? I found great info and the MD has decided?not to use?=-)
?
Thanks,Monica Stewart, RD, LD
Clinical Nutrition Manager
Washington Regional Medical Center
3215 N. North Hills Blvd.
Fayetteville, AR 72703
479-463-7198 

________________________________
From: "Potter, MARY" 
To: Monica Merrell ; cnm at lists.my180.net
Sent: Wednesday, July 29, 2009 3:19:11 PM
Subject: RE: [Cnm] blue dye and TF

In addition to the attached abstract, here are some resources that may help:
* the ADA?s Evidence Library states ?Blue dye should not be added to EN for detection of aspiration. The risk of using blue dye outweighs any perceived benefit?.?? And, it goes on to list risks/harms associated w/ using blue dye.??? Check out all the info on-line.
?
*?Food Dye Use in Enteral Feedings:? A Review and a Call for a Moratorium?.?? Nutrition in Clinical Practice 17: 169-181, June 2002.? 
?
* on http://vm.cfsan.fda.gov/~dms.col-ltr2.html there?s an FDA Public Health Advisory on ?reports of blue discoloration and death in patients receiving enteral feedings tinted with the dye, FD&C Blue No.1?.?????? Emphasized is how the FDA has never evaluated the use of blue food dye for safety, and that serious complications have been associated w/ it. 
?
Hope this helps!
?
Beth Potter, RD
Clinical Nutrition Manager
Fauquier Health|500 Hospital?Dr. Warrenton,VA 20186
540-316-4406
potterm at fauquierhealth.org
** Note my new email address is potterm at fauquierhealth.org and new phone number is 540-316-4406**
-----Original Message-----
From: cnm-bounces at lists.my180.net[mailto:cnm-bounces at lists.my180.net] On Behalf Of Monica Merrell
Sent: Wednesday, July 29, 2009 3:58 PM
To: cnm at lists.my180.net
Subject: [Cnm] blue dye and TF
?
Does anyone have current information on adding blue?dye to TF???I have a doctor that wants to do this and will proceed w/o documentation that isn't appropriate.
?
Thanks,
Monica Stewart, RD, LD
Clinical Nutrition Manager
Washington Regional Medical Center
3215 N. North Hills Blvd.
Fayetteville, AR 72703
479-463-7198 
?

-----Inline Attachment Follows-----

LWWOnline??|??LOGIN??|??eALERTS??|??REGISTER??|??CUSTOMER SUPPORT ?   
Home   Search   Current Issue   Archive   
July/September 2006, 21:3 > Use of Colored Dyes in Enteral... < Previous??|?? Next > 
ARTICLE LINKS:
Fulltext??|??PDF (93?K)
Use of Colored Dyes in Enteral Formulas. 
>
>REVIEW ARTICLE Topics in Clinical Nutrition. 21(3):226-233, July/September 2006.
>Radich, Kimberly MS, RD, CNSD; Hildebrandt, Leslie A. PhD, RD 
>Abstract: 
>Colored food dyes, including methylene blue and FD&C Blue No. 1, are added to enteral formula by healthcare professionals to monitor patient aspiration. However, many enteral patients have impaired gastrointestinal tract integrity and food dyes could be absorbed. Tinting enteral formula has been found to cause allergic reactions, mitochondrial toxicity, skin discoloration, and hemolytic anemia. There are also accounts of infection and contamination by unsanitary practices related to dye administration. Case reports describe FD&C Blue No. 1 absorption by critically ill patients, and in some instances resulting in death. Instead of tinting enteral formula, aspiration prevention should be emphasized. 
>(C) 2006 Lippincott Williams & Wilkins, Inc. 

________________________________
Copyright ? 2007, Lippincott Williams & Wilkins. All rights reserved.
Published by Lippincott Williams & Wilkins.
Copyright/Disclaimer Notice? Privacy Policy
?Subscribe to RSS feed  
utrdc-pt02
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From Rachel.Baar at allina.com  Wed Jul 29 13:47:20 2009
From: Rachel.Baar at allina.com (Baar, Rachel)
Date: Wed, 29 Jul 2009 15:47:20 -0500
Subject: [Cnm] shift work
Message-ID: 

Does anyone have information/handouts on weight loss specifically for
patients who work evening/night shift?  Thanks much!

Rachel Baar, MS, RD, LD
Clinical Nutrition Manager
Mercy Hospital
rachel.baar at allina.com
763.236.8705 (office)
612.654.0095 (pager)
763.236.8710 (fax)

This message contains information that is confidential and may be privileged.  Unless you are the addressee (or authorized to receive for the addressee), you may not use, copy or disclose to anyone the message or any information contained in the message.  If you have received the message in error, please advise the sender by reply e-mail and delete the message.

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From LCarver at Reshealthcare.org  Wed Jul 29 13:56:16 2009
From: LCarver at Reshealthcare.org (Carver, Leslee)
Date: Wed, 29 Jul 2009 15:56:16 -0500
Subject: [Cnm] shift work
In-Reply-To: 
References: 
Message-ID: <5330B54133B6194BA13930BDEFE9A30E049E8E4A@rhcexch3.reshealthcare.org>

here you go.  we used this for a night shift health fair.  

Leslee R. Carver, MSPH, RD, LDN 
Clinical Nutrition Manager 
Saint Joseph Hospital 
2900 N. Lake Shore Dr. 
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.  All personal messages express
view 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

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Baar, Rachel
Sent: Wednesday, July 29, 2009 3:47 PM
To: cnm at lists.my180.net
Subject: [Cnm] shift work

Does anyone have information/handouts on weight loss specifically for
patients who work evening/night shift?  Thanks much!

Rachel Baar, MS, RD, LD
Clinical Nutrition Manager
Mercy Hospital
rachel.baar at allina.com
763.236.8705 (office)
612.654.0095 (pager)
763.236.8710 (fax)

This message contains information that is confidential and may be
privileged. Unless you are the addressee (or authorized to receive for
the addressee), you may not use, copy or disclose to anyone the message
or any information contained in the message. If you have received the
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From sas9114 at nyp.org  Wed Jul 29 14:18:57 2009
From: sas9114 at nyp.org (Sarah Jaffe Spool)
Date: Wed, 29 Jul 2009 17:18:57 -0400
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets
Message-ID: <26621_1248902312_0KNK00GFUB6WWQ70_4A70BCC1.5030101@nyp.org>

Hi Everyone,
Our hospital, New York Presbyterian, uses the Press Ganey Patient Survey 
to measure patient satisfaction. There is currently a custom question on 
the survey which asks discharged patients if their special/restricted 
diet was explained. Because all of our patients do not see RDs and 
because all our patients are not all on "special/restricted diets", this 
question is confusing. It does not highlight the care the patient 
received from the RD.
My question to you is threefold:
1. Do you use Press Ganey in your hospitals?
2. If you do, does your hospital include this custom question on their 
questionnaires?
3. If you use this question on the questionnaire, what types of 
performance improvement projects have you developed to help 
increase/maintain high-level satisfaction scores?
Thanks in advance for your help with this. Any additional information 
around this question is also welcome!

Sarah

Sarah Spool, MS, RD, CDE, CDN
New York Presbyterian Hospital
The University Hospital of Columbia and Cornell
212-305-2742

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

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.

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From Linda.Woods at healthall.com  Wed Jul 29 14:46:26 2009
From: Linda.Woods at healthall.com (Woods, Linda)
Date: Wed, 29 Jul 2009 17:46:26 -0400
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets
In-Reply-To: <26621_1248902312_0KNK00GFUB6WWQ70_4A70BCC1.5030101@nyp.org>
References: <26621_1248902312_0KNK00GFUB6WWQ70_4A70BCC1.5030101@nyp.org>
Message-ID: <2B1106A6A593B147A65BD5A8939D3E11D3CA15566F@MAIL-C.healthall.com>

see responses below

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 Sarah Jaffe Spool
Sent: Wednesday, July 29, 2009 5:19 PM
To: cnm at lists.my180.net
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets

Hi Everyone,
Our hospital, New York Presbyterian, uses the Press Ganey Patient Survey to measure patient satisfaction. There is currently a custom question on the survey which asks discharged patients if their special/restricted diet was explained. Because all of our patients do not see RDs and because all our patients are not all on "special/restricted diets", this question is confusing. It does not highlight the care the patient received from the RD.
My question to you is threefold:
1. Do you use Press Ganey in your hospitals?  Yes.
2. If you do, does your hospital include this custom question on their questionnaires?  Not now.  We had that question several years ago but dropped it.  Experienced the same difficulties as you and many others have described.
3. If you use this question on the questionnaire, what types of performance improvement projects have you developed to help increase/maintain high-level satisfaction scores?
Thanks in advance for your help with this. Any additional information around this question is also welcome!

Sarah

Sarah Spool, MS, RD, CDE, CDN
New York Presbyterian Hospital
The University Hospital of Columbia and Cornell
212-305-2742

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

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.

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 Jul 29 15:25:26 2009
From: sheila.walsh at nahealth.com (Sheila Walsh)
Date: Wed, 29 Jul 2009 15:25:26 -0700
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets
In-Reply-To: <26621_1248902312_0KNK00GFUB6WWQ70_4A70BCC1.5030101@nyp.org>
References: <26621_1248902312_0KNK00GFUB6WWQ70_4A70BCC1.5030101@nyp.org>
Message-ID: <4A7069E6.485B.0001.0@nahealth.com>

See answers below.

Sheila A. Walsh, MPH, RD
Clinical Nutrition Manager
Flagstaff Medical Center
Where patients are our purpose.
<\__~
/ \

>>> "Sarah Jaffe Spool"  7/29/2009 2:18 PM >>>
Hi Everyone,
Our hospital, New York Presbyterian, uses the Press Ganey Patient Survey 
to measure patient satisfaction. There is currently a custom question on 
the survey which asks discharged patients if their special/restricted 
diet was explained. Because all of our patients do not see RDs and 
because all our patients are not all on "special/restricted diets", this 
question is confusing. It does not highlight the care the patient 
received from the RD.
My question to you is threefold:
1. Do you use Press Ganey in your hospitals?  No
2. If you do, does your hospital include this custom question on their 
questionnaires?  No,  I had it removed from P-G at a previous hospital.
3. If you use this question on the questionnaire, what types of 
performance improvement projects have you developed to help 
increase/maintain high-level satisfaction scores?  We do scripting and our Nutrition Assistants give the patients a pamphlet with a one paragraph explanation of their special diet, if they want one.  This has skyrocketed our scores in the past year:  scripting and giving a pamphlet explanation.
Thanks in advance for your help with this. Any additional information 
around this question is also welcome!

Sarah

Sarah Spool, MS, RD, CDE, CDN
New York Presbyterian Hospital
The University Hospital of Columbia and Cornell
212-305-2742

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

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.

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From bhomola at comhs.org  Thu Jul 30 05:28:50 2009
From: bhomola at comhs.org (Bobbi Homola)
Date: Thu, 30 Jul 2009 07:28:50 -0500
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets
In-Reply-To: <26621_1248902312_0KNK00GFUB6WWQ70_4A70BCC1.5030101@nyp.org>
Message-ID: 

SEE BELOW

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 Sarah Jaffe Spool
Sent: Wednesday, July 29, 2009 4:19 PM
To: cnm at lists.my180.net
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets

Hi Everyone,

Our hospital, New York Presbyterian, uses the Press Ganey Patient Survey

to measure patient satisfaction. There is currently a custom question on

the survey which asks discharged patients if their special/restricted 

diet was explained. Because all of our patients do not see RDs and 

because all our patients are not all on "special/restricted diets", this

question is confusing. It does not highlight the care the patient 

received from the RD.

My question to you is threefold:

1. Do you use Press Ganey in your hospitals? YES

2. If you do, does your hospital include this custom question on their 

questionnaires? NO - FOUGHT HARD AGAINST IT....GLAD WE DID FOR THE SAME
REASONS AS YOU'VE DESCRIBED.

3. If you use this question on the questionnaire, what types of 

performance improvement projects have you developed to help 

increase/maintain high-level satisfaction scores?

Thanks in advance for your help with this. Any additional information 

around this question is also welcome!

Sarah

Sarah Spool, MS, RD, CDE, CDN

New York Presbyterian Hospital

The University Hospital of Columbia and Cornell

212-305-2742

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

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.

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From Charleen.Sibley at southernregional.org  Thu Jul 30 05:37:24 2009
From: Charleen.Sibley at southernregional.org (Charleen Sibley)
Date: Thu, 30 Jul 2009 08:37:24 -0400
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets
In-Reply-To: <2B1106A6A593B147A65BD5A8939D3E11D3CA15566F@MAIL-C.healthall.com>
References: <26621_1248902312_0KNK00GFUB6WWQ70_4A70BCC1.5030101@nyp.org>
	<2B1106A6A593B147A65BD5A8939D3E11D3CA15566F@MAIL-C.healthall.com>
Message-ID: <4A715BC3.1CC1.0077.0@southernregional.org>

Hi Linda.  See the article attached.    Explains the reasoning for the ""special diet" question.  I am not sure how old this article.  Take care
Charleen

Charleen Sibley, MS,RD,LD, CNSD
Clinical Nutrition Manager, Food & Nutrition Services 
Phone 770-991-8053
Fax 770-991-8690
Southern Regional Medical Center
11 Upper Riverdale Road, SW
Riverdale, GA 30274
Email charleen.sibley at southernregional.org 

>>> "Woods, Linda"  7/29/2009 5:46 PM >>>
see responses below

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 Sarah Jaffe Spool
Sent: Wednesday, July 29, 2009 5:19 PM
To: cnm at lists.my180.net 
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets

Hi Everyone,
Our hospital, New York Presbyterian, uses the Press Ganey Patient Survey to measure patient satisfaction. There is currently a custom question on the survey which asks discharged patients if their special/restricted diet was explained. Because all of our patients do not see RDs and because all our patients are not all on "special/restricted diets", this question is confusing. It does not highlight the care the patient received from the RD.
My question to you is threefold:
1. Do you use Press Ganey in your hospitals?  Yes.
2. If you do, does your hospital include this custom question on their questionnaires?  Not now.  We had that question several years ago but dropped it.  Experienced the same difficulties as you and many others have described.
3. If you use this question on the questionnaire, what types of performance improvement projects have you developed to help increase/maintain high-level satisfaction scores?
Thanks in advance for your help with this. Any additional information around this question is also welcome!

Sarah

Sarah Spool, MS, RD, CDE, CDN
New York Presbyterian Hospital
The University Hospital of Columbia and Cornell
212-305-2742

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

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.

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
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From roconnor at noblehealth.org  Thu Jul 30 05:57:12 2009
From: roconnor at noblehealth.org (O'Connor, Ruth)
Date: Thu, 30 Jul 2009 08:57:12 -0400
Subject: [Cnm] Patient Select Menu
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A9D@wmhcs03.wmh.org>
References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4A9D@wmhcs03.wmh.org>
Message-ID: 

We have the names and extensions of the Nutrition and Food Service Team
on each tray ticket, not the menu. The team includes the FSD,
supervisor, Chef and RD/DTR assigned to the floor.

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Tuesday, July 28, 2009 4:41 PM
To: cnm at lists.my180.net
Subject: [Cnm] Patient Select Menu

Hello,

Do any others write a name of a FNS rep or RD on their Select Patient
Menu? 

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  

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From Shannon.Jackson at wilmed.org  Thu Jul 30 06:50:05 2009
From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson)
Date: Thu, 30 Jul 2009 09:50:05 -0400
Subject: [Cnm] Salary info
Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4AD3@wmhcs03.wmh.org>

Hello,

Does anyone know where you can get salary info for RDs/Clinical Nutrition
Managers? 

Thanks,
SBJ

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  

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From lambert at sehosp.org  Thu Jul 30 07:04:34 2009
From: lambert at sehosp.org (Lee Ann Lambert)
Date: Thu, 30 Jul 2009 09:04:34 -0500
Subject: [Cnm] Salary info
Message-ID: <29DC3A8593BBC94E90775FD7BFC68ACB0380B4DD@SE-EXCHANGE.sehosp.org>

The ADA website has a salary calculator, I would check that out.

Lea Anne Lambert RD, LD
Clinical Nutrition Manager
Southeast Missouri Hospital
573-651-5530

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Shannon Byrd Jackson
Sent: Thursday, July 30, 2009 8:50 AM
To: cnm at lists.my180.net
Subject: [Cnm] Salary info

Hello,

Does anyone know where you can get salary info for RDs/Clinical
Nutrition Managers? 

Thanks,
SBJ

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  

-----------------------------------------
The materials in this e-mail are private and may contain Protected
Health Information. If you are not the intended recipient, be
advised that any unauthorized use, disclosure, copying,
distribution or the taking of any action in reliance on the
contents of this information is strictly prohibited. If you have
received this email in error, please immediately notify the sender
via telephone or by return e-mail.

www.southeastmissourihospital.com
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From tfreeden at somerset-healthcare.com  Thu Jul 30 07:51:37 2009
From: tfreeden at somerset-healthcare.com (Freeden, Theresa)
Date: Thu, 30 Jul 2009 10:51:37 -0400
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets
In-Reply-To: <4A715BC3.1CC1.0077.0@southernregional.org>
Message-ID: 

So if it's the perception of how the "team" communicates with the patient- why does the burden always fall on the dietitians?
Administrators to not see it that way. They wonder why the patient has not been seen by the RD? 
So I'm also curious from those hospitals that choose to keep that question, how they manage it. 
Also if it is not a measure of how well the RD explained the "special diet" then maybe a question like...

Did you feel that your diet changes were communicated to you through out your hospitalization? or something along those lines..Diet orders can change several times a day without patients being notified. 

just a thought...

Theresa Freeden, MS, RD

Clinical Nutrition Manager 

Somerset Medical Center

110 Rehill Ave.

Somerville, NJ 08876

908 704-2758

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Charleen Sibley
Sent: Thursday, July 30, 2009 8:37 AM
To: Linda Woods; cnm at lists.my180.net; 'Sarah Jaffe Spool'
Subject: Re: [Cnm] Press Ganey Question on Special/Restricted Diets

Hi Linda.  See the article attached.    Explains the reasoning for the ""special diet" question.  I am not sure how old this article.  Take care
Charleen

Charleen Sibley, MS,RD,LD, CNSD
Clinical Nutrition Manager, Food & Nutrition Services 
Phone 770-991-8053
Fax 770-991-8690
Southern Regional Medical Center
11 Upper Riverdale Road, SW
Riverdale, GA 30274
Email charleen.sibley at southernregional.org

>>> "Woods, Linda"  7/29/2009 5:46 PM >>>
see responses below

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 Sarah Jaffe Spool
Sent: Wednesday, July 29, 2009 5:19 PM
To: cnm at lists.my180.net
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets

Hi Everyone,
Our hospital, New York Presbyterian, uses the Press Ganey Patient Survey to measure patient satisfaction. There is currently a custom question on the survey which asks discharged patients if their special/restricted diet was explained. Because all of our patients do not see RDs and because all our patients are not all on "special/restricted diets", this question is confusing. It does not highlight the care the patient received from the RD.
My question to you is threefold:
1. Do you use Press Ganey in your hospitals?  Yes.
2. If you do, does your hospital include this custom question on their questionnaires?  Not now.  We had that question several years ago but dropped it.  Experienced the same difficulties as you and many others have described.
3. If you use this question on the questionnaire, what types of performance improvement projects have you developed to help increase/maintain high-level satisfaction scores?
Thanks in advance for your help with this. Any additional information around this question is also welcome!

Sarah

Sarah Spool, MS, RD, CDE, CDN
New York Presbyterian Hospital
The University Hospital of Columbia and Cornell
212-305-2742

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

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.

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

CONFIDENTIALITY NOTICE
This message and any included attachments are from 
Somerset Medical Center and are intended only for the addressee.
The information contained in this message is confidential 
and may contain privileged, confidential, proprietary and/or 
trade secret information entitled to protection and/or exemption 
from disclosure under applicable law. Unauthorized forwarding, 
printing, copying, distribution, or use of such information is 
strictly prohibited and may be unlawful. If you are not the 
addressee, please promptly delete this message and notify 
the sender of the delivery error by e-mail or you may call 
Somerset Medical Center's computer Help Desk at 
908-685-2200, ext. 4050. 
-------------------------------------------------------------- 
Somerset Medical Center is the recipient of the 
2009 Orthopedic Surgery Excellence Award(tm) from HealthGrades,
the nation's leading health care ratings company.

Visit Somerset Medical Center's Web site 
- www.somersetmedicalcenter.com - 
for news, event listings, health information and more.

Join the Discussion: 
Facebook: www.somersetmedicalcenter.com/fb
Twitter: www.twitter.com/SomersetMedCtr
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From mpappo at montefiore.org  Thu Jul 30 08:10:24 2009
From: mpappo at montefiore.org (Miriam Pappo)
Date: Thu, 30 Jul 2009 11:10:24 -0400
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets
Message-ID: 

I agree w/ Theresa. It needs to be rephrased. 
And it wouldnt hurt to either place it elsewhere or immediately after
the "were you on a special diet" background question (P-G said it cant
do that).  
Or re-emphasize "do not answer if you were not on a special diet" 
(something along those lines.)

We have found that this question correlates to Meal Satisfaction
regardless of what we do.
We eliminated the question for adults, but have kept it in our
Children's Hospital.
Using a CBORD print out, I have nutrition students providing a handout
w/script to all pts/parents not seen by the RD. 
It helped at first, but now the scores are down again.  Even tho the
student is now seeing pts 4 days/wk. 

I like the idea of each pt getting a little handout, but we are not
able to do that now that Food Service Advocates' roles have changed, and
they can longer see each pt. 

I would love to hear everyone else's ideas.

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>> "Freeden, Theresa"  07/30/09
10:51 AM >>>

So if it's the perception of how the "team" communicates with the
patient- why does the burden always fall on the dietitians?
Administrators to not see it that way. They wonder why the patient has
not been seen by the RD? 
So I'm also curious from those hospitals that choose to keep that
question, how they manage it. 
Also if it is not a measure of how well the RD explained the "special
diet" then maybe a question like...

Did you feel that your diet changes were communicated to you through
out your hospitalization? or something along those lines..Diet orders
can change several times a day without patients being notified. 

just a thought...

Theresa Freeden, MS, RD

Clinical Nutrition Manager 

Somerset Medical Center

110 Rehill Ave.

Somerville, NJ 08876

908 704-2758

-----Original Message-----
From: cnm-bounces at lists.my180.net
[mailto:cnm-bounces at lists.my180.net]On Behalf Of Charleen Sibley
Sent: Thursday, July 30, 2009 8:37 AM
To: Linda Woods; cnm at lists.my180.net; 'Sarah Jaffe Spool'
Subject: Re: [Cnm] Press Ganey Question on Special/Restricted Diets

Hi Linda.  See the article attached.    Explains the reasoning for the
""special diet" question.  I am not sure how old this article.  Take
care
Charleen

Charleen Sibley, MS,RD,LD, CNSD
Clinical Nutrition Manager, Food & Nutrition Services 
Phone 770-991-8053
Fax 770-991-8690
Southern Regional Medical Center
11 Upper Riverdale Road, SW
Riverdale, GA 30274
Email charleen.sibley at southernregional.org 

>>> "Woods, Linda"  7/29/2009 5:46 PM >>>
see responses below

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 Sarah Jaffe Spool
Sent: Wednesday, July 29, 2009 5:19 PM
To: cnm at lists.my180.net 
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets

Hi Everyone,
Our hospital, New York Presbyterian, uses the Press Ganey Patient
Survey to measure patient satisfaction. There is currently a custom
question on the survey which asks discharged patients if their
special/restricted diet was explained. Because all of our patients do
not see RDs and because all our patients are not all on
"special/restricted diets", this question is confusing. It does not
highlight the care the patient received from the RD.
My question to you is threefold:
1. Do you use Press Ganey in your hospitals?  Yes.
2. If you do, does your hospital include this custom question on their
questionnaires?  Not now.  We had that question several years ago but
dropped it.  Experienced the same difficulties as you and many others
have described.
3. If you use this question on the questionnaire, what types of
performance improvement projects have you developed to help
increase/maintain high-level satisfaction scores?
Thanks in advance for your help with this. Any additional information
around this question is also welcome!

Sarah

Sarah Spool, MS, RD, CDE, CDN
New York Presbyterian Hospital
The University Hospital of Columbia and Cornell
212-305-2742

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

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.

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 

CONFIDENTIALITY NOTICE
This message and any included attachments are from 
Somerset Medical Center and are intended only for the addressee.
The information contained in this message is confidential 
and may contain privileged, confidential, proprietary and/or 
trade secret information entitled to protection and/or exemption 
from disclosure under applicable law. Unauthorized forwarding, 
printing, copying, distribution, or use of such information is 
strictly prohibited and may be unlawful. If you are not the 
addressee, please promptly delete this message and notify 
the sender of the delivery error by e-mail or you may call 
Somerset Medical Center's computer Help Desk at 
908-685-2200, ext. 4050. 
-------------------------------------------------------------- 
Somerset Medical Center is the recipient of the 
2009 Orthopedic Surgery Excellence Award(tm) from HealthGrades,
the nation's leading health care ratings company.

Visit Somerset Medical Center's Web site 
- www.somersetmedicalcenter.com - 
for news, event listings, health information and more.

Join the Discussion: 
Facebook: www.somersetmedicalcenter.com/fb 
Twitter: www.twitter.com/SomersetMedCtr
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From julie.haase at wfhc.org  Thu Jul 30 08:39:45 2009
From: julie.haase at wfhc.org (Haase, Julie H.)
Date: Thu, 30 Jul 2009 10:39:45 -0500
Subject: [Cnm] Department web site
Message-ID: <3DD3BD5FD259654ABBA8DC218993A5120CB8408D@WFEXBE01.wfsi.priv>

I just had my IS team develop a clinical nutrition web site for our
internal use.   We have features such as a discussion board, employee
profiles, a shared calendar, and the ability to post documents, and
links.
I'm going to be working with my staff (15 RDs & DTRs) to set some
parameters, such as "rules" for online discussions, how frequently they
are expected to check the site, who can post documents (right now, I am
the only one with access), etc.
If you have set up a similar site, I'd appreciate any advice!

Thanks in advance, 
Julie

Julie Haase, RD, CD
Supervisor, Clinical Nutrition
Wheaton Franciscan Healthcare - St. Joseph
Milwaukee, Wisconsin
Phone: (414)447-3685

Privileged/Confidential information may be contained in this message.  The information contained in this message is intended only for the use of the recipient(s) named above and their co-workers who are working on the same matter.  The recipient of this information is prohibited from disclosing the information to any other party unless this disclosure has been authorized in advance. 

 If you are not intended recipient of this message or any agent responsible for delivery of the message to the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of this message is strictly prohibited.  You should immediately destroy this message and kindly notify the sender by reply E-Mail.  Please advise immediately if you or your employer does not consent to Internet E-Mail for messages of this kind.  Opinions, conclusions and other information in this message that do not relate to the official business of the firm shall be understood as neither given nor endorsed by it.
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From Marianne_L_Merrick at ssmhc.com  Thu Jul 30 09:36:24 2009
From: Marianne_L_Merrick at ssmhc.com (Marianne_L_Merrick at ssmhc.com)
Date: Thu, 30 Jul 2009 11:36:24 -0500
Subject: [Cnm] Salary info
In-Reply-To: <29DC3A8593BBC94E90775FD7BFC68ACB0380B4DD@SE-EXCHANGE.sehosp.org>
Message-ID: 

Salaries.com is another source.

-Marianne

Marianne Merrick, RD,CD
Clinical Nutrition Manager

St. Mary's Hospital
Food + Nutrition Services
700 S. Park St.
Madison, WI  53715

Ph:  608.258.6608
pager:  608.376.5620

"Lee Ann Lambert"  
Sent by: cnm-bounces at lists.my180.net
07/30/2009 09:04 AM

To
"Shannon Byrd Jackson" , 
cc

Subject
Re: [Cnm] Salary info

The ADA website has a salary calculator, I would check that out.

Lea Anne Lambert RD, LD
Clinical Nutrition Manager
Southeast Missouri Hospital
573-651-5530

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On 
Behalf Of Shannon Byrd Jackson
Sent: Thursday, July 30, 2009 8:50 AM
To: cnm at lists.my180.net
Subject: [Cnm] Salary info

Hello,

Does anyone know where you can get salary info for RDs/Clinical Nutrition 
Managers? 

Thanks,
SBJ

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

The materials in this e-mail are private and may contain Protected Health 
Information. If you are not the intended recipient, be advised that any 
unauthorized use, disclosure, copying, distribution or the taking of any 
action in reliance on the contents of this information is strictly 
prohibited. If you have received this email in error, please immediately 
notify the sender via telephone or by return e-mail.

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

Confidentiality Notice: This email message, including any
attachments, is for the sole use of the intended recipient(s) and
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From rossjanv at fuse.net  Thu Jul 30 09:41:13 2009
From: rossjanv at fuse.net (Janet V. Ross)
Date: Thu, 30 Jul 2009 12:41:13 -0400
Subject: [Cnm] Salary info
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4AD3@wmhcs03.wmh.org>
Message-ID: <07.89.09581.E2DC17A4@gwout2>

http://www.payscale.com  

This site was recommended to me by a job coach-you enter your anonymous info
and they provide you with other anonymous info.  Worth checking out.

Janet V. Ross, MBA, RD, LD

rossjanv at fuse.net

 4615 Joana Pl

 Cincinnati, OH 45238

 513-478-0135

http://www.linkedin.com/in/rossjanv

My mind is quiet. I listen. In the silence, ideas present themselves. They
are ideas that reflect my soul's greatest desires for wisdom, health,
abundance, and harmony. 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Shannon Byrd Jackson
Sent: Thursday, July 30, 2009 9:50 AM
To: cnm at lists.my180.net
Subject: [Cnm] Salary info

Hello,

Does anyone know where you can get salary info for RDs/Clinical Nutrition
Managers? 

Thanks,

SBJ

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

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From Marianne_L_Merrick at ssmhc.com  Thu Jul 30 09:50:07 2009
From: Marianne_L_Merrick at ssmhc.com (Marianne_L_Merrick at ssmhc.com)
Date: Thu, 30 Jul 2009 11:50:07 -0500
Subject: [Cnm] Salary info
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4AD3@wmhcs03.wmh.org>
Message-ID: 

RD411 website also has a salary calculator.

-Marianne

Marianne Merrick, RD,CD
Clinical Nutrition Manager

St. Mary's Hospital
Food + Nutrition Services
700 S. Park St.
Madison, WI  53715

Ph:  608.258.6608
pager:  608.376.5620

"Shannon Byrd Jackson"  
Sent by: cnm-bounces at lists.my180.net
07/30/2009 08:50 AM

To

cc

Subject
[Cnm] Salary info

Hello,

Does anyone know where you can get salary info for RDs/Clinical Nutrition 
Managers? 

Thanks,
SBJ

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

Confidentiality Notice: This email message, including any
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From mpappo at montefiore.org  Thu Jul 30 10:46:23 2009
From: mpappo at montefiore.org (Miriam Pappo)
Date: Thu, 30 Jul 2009 13:46:23 -0400
Subject: [Cnm] Peptamen AF for ARDS
Message-ID: 

Our Nestle's rep is trying to get us to use it but my contention is that
ASPEN recommends borage oil found only in Oxepa.  That is what  the
evidence shows & we are supposed to be evidence based.
We're trialing Oxepa now ..You're right. The cost is making Food
Service upset. 
However, Pharmacy always considers the overall treatment of pts when
choosing to allow a drug tx, not just the cost of the drug.  We should
do the same.

I'd like to hear what others are doing too.

Miriam

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>> "Maritza Rodriguez"  07/28/09 3:36 PM >>>
Do any of you use Peptamen AF for ARDS patients?  Our nutrition
support
pharmacists have bring the idea of use it for that purpose based on
its
content, given the fact that our primary vendor for enteral products
is
Nestle, and a remote possibility of obtaining Oxepa for pricing
issues...  Any suggestion will be appreciated.

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 

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From hgreenw2 at fairview.org  Thu Jul 30 11:04:15 2009
From: hgreenw2 at fairview.org (Greenwaldt, Heidi J)
Date: Thu, 30 Jul 2009 13:04:15 -0500
Subject: [Cnm] Peptamen AF for ARDS
In-Reply-To: 
Message-ID: <59F3EAD5C3376A42B3CD083F034A612705677195@digsmxmbx06.Fairview.org>

We are not using Oxepa due to the high fat content (and our pts are
always on propofol longer than they should be) and the low protein
content. Plus, the studies with Oxepa compare it to Pulmocare which is
very high in omega 6 content. Wonder what the results would have been if
it would have been compared against a product like Peptamen AF or
Crucial. There was a study started examining that question  - 4 arms 1)
borage/fish oil; 2) borage oil; 3) fish oil; 4) standard. Unfortunately
there was an "error" in randomization and they had to stop the arm
evaluating the borage/fish oil formula due to high mortality rate. 

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 Miriam Pappo
Sent: Thursday, July 30, 2009 12:46 PM
To: cnm at lists.my180.net; m-rodrig at msmc.com
Subject: Re: [Cnm] Peptamen AF for ARDS

Our Nestle's rep is trying to get us to use it but my contention is that
ASPEN recommends borage oil found only in Oxepa.  That is what  the
evidence shows & we are supposed to be evidence based.
We're trialing Oxepa now ..You're right. The cost is making Food Service
upset. 
However, Pharmacy always considers the overall treatment of pts when
choosing to allow a drug tx, not just the cost of the drug.  We should
do the same.

I'd like to hear what others are doing too.

Miriam

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>> "Maritza Rodriguez"  07/28/09 3:36 PM >>>
Do any of you use Peptamen AF for ARDS patients?  Our nutrition support
pharmacists have bring the idea of use it for that purpose based on its
content, given the fact that our primary vendor for enteral products is
Nestle, and a remote possibility of obtaining Oxepa for pricing
issues...  Any suggestion will be appreciated.

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 

From vchaffin at queens.org  Thu Jul 30 11:14:12 2009
From: vchaffin at queens.org (VICKY CHAFFIN)
Date: Thu, 30 Jul 2009 08:14:12 -1000
Subject: [Cnm] Peptamen AF for ARDS
In-Reply-To: 
References: 
Message-ID: <4A7156540200002000000BE1@gwia1dom.queens.org>

We have both Oxepa and Peptamen AF. The problem I have is that the evidence shows that the benefit in the   use of Borage oil is dose dependent and we find a very high rate of intolerance ( they don't get past 20 ml/hr).  We have more success with Peptamen AF- so at least they are getting more Omega 3 fat then if we were using something else- or TPN. Also with the high protein we don't need modulars
Vicky Chaffin MPH, RD, CNSD
Queen's Medical Center 

>>> "Miriam Pappo"  07/30/09 7:46 AM >>>
Our Nestle's rep is trying to get us to use it but my contention is that
ASPEN recommends borage oil found only in Oxepa.  That is what  the
evidence shows & we are supposed to be evidence based.
We're trialing Oxepa now ..You're right. The cost is making Food
Service upset. 
However, Pharmacy always considers the overall treatment of pts when
choosing to allow a drug tx, not just the cost of the drug.  We should
do the same.

I'd like to hear what others are doing too.

Miriam

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>> "Maritza Rodriguez"  07/28/09 3:36 PM >>>
Do any of you use Peptamen AF for ARDS patients?  Our nutrition
support
pharmacists have bring the idea of use it for that purpose based on
its
content, given the fact that our primary vendor for enteral products
is
Nestle, and a remote possibility of obtaining Oxepa for pricing
issues...  Any suggestion will be appreciated.

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 

From dlquirk at lexhealth.org  Thu Jul 30 11:33:57 2009
From: dlquirk at lexhealth.org (Donna Quirk)
Date: Thu, 30 Jul 2009 14:33:57 -0400
Subject: [Cnm] Peptamen AF for ARDS
In-Reply-To: <4A7156540200002000000BE1@gwia1dom.queens.org>
References: 
	<4A7156540200002000000BE1@gwia1dom.queens.org>
Message-ID: 

I happen to be sitting here comparing the same formulas and questioning
their potential benefit for our patient population.  ARDS/ALI is an
infrequent diagnosis here, but sepsis is not.  We are currently using
Peptamen AF to avoid arginine in the septic patient.  I am not convinced
this is necessary.  I would be interested in hearing others thoughts on
this, please share references etc.

Thanks,

Donna 

Donna Quirk MBA RD LD 
Clinical Nutrition Manager
Lexington Medical Center
2720 Sunset Blvd
West Columbia, SC 29169
803-791-2248

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of VICKY CHAFFIN
Sent: Thursday, July 30, 2009 2:14 PM
To: cnm at lists.my180.net; Miriam Pappo; m-rodrig at msmc.com
Subject: Re: [Cnm] Peptamen AF for ARDS

We have both Oxepa and Peptamen AF. The problem I have is that the
evidence shows that the benefit in the   use of Borage oil is dose
dependent and we find a very high rate of intolerance ( they don't get
past 20 ml/hr).  We have more success with Peptamen AF- so at least they
are getting more Omega 3 fat then if we were using something else- or
TPN. Also with the high protein we don't need modulars
Vicky Chaffin MPH, RD, CNSD
Queen's Medical Center 

>>> "Miriam Pappo"  07/30/09 7:46 AM >>>
Our Nestle's rep is trying to get us to use it but my contention is that
ASPEN recommends borage oil found only in Oxepa.  That is what  the
evidence shows & we are supposed to be evidence based.
We're trialing Oxepa now ..You're right. The cost is making Food
Service upset. 
However, Pharmacy always considers the overall treatment of pts when
choosing to allow a drug tx, not just the cost of the drug.  We should
do the same.

I'd like to hear what others are doing too.

Miriam

Miriam Pappo, MS, RD, CDN
Director -  Department of Clinical Nutrition
Montefiore Medical Center
111 E. 210 St.
Bronx, NY 10467
718-920-4253 Moses (M, W, Th)
718-904-2724 Weiler (Tu, F)
917-641-3736 pager

>>> "Maritza Rodriguez"  07/28/09 3:36 PM >>>
Do any of you use Peptamen AF for ARDS patients?  Our nutrition
support
pharmacists have bring the idea of use it for that purpose based on
its
content, given the fact that our primary vendor for enteral products
is
Nestle, and a remote possibility of obtaining Oxepa for pricing
issues...  Any suggestion will be appreciated.

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 

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

______________________________________________________________________
PRIVILEGED AND CONFIDENTIAL: This electronic message and any attachments are confidential property of the sender. The information is intended only for the use of the person to whom it was addressed. Any other interception, copying, accessing, or disclosure of this message is prohibited. The sender takes no responsibility for any unauthorized reliance on this message. If you have received this message in error, please immediately notify the sender and purge the message you received. Do not forward this message without permission.

From jbaye at mail.mcg.edu  Thu Jul 30 11:57:25 2009
From: jbaye at mail.mcg.edu (Jessica Baye)
Date: Thu, 30 Jul 2009 14:57:25 -0400
Subject: [Cnm] Renal Transplant Criteria
Message-ID: <4A71B4D5.E045.0010.0@mail.mcg.edu>

I have been asked to sit in on a renal transplant selection committee.  Since many of our patients come from great distances we do not have the option of setting up an out patient appointment with our dietitian.  I am looking to put together a questioner for the patient - or the patients dialysis dietitian to help guide me in making a decision.
 Anyone out there sit on a committee like this?  If so I'm looking for examples of criteria that would help you make the decision "is this patient appropriate for a kidney transplant".

TIA

Jess

Jessica Baye, RD, LD
Clinical Nutrition Manager
Food & Nutrition Services
MCG Health System
BA1565
1120 15th Street
Augusta, GA  30912
706.721.3202 (office)
706.533.3313 (cell)
706.721.7243 x1405 (pager)
jbaye at mcg.edu 

From Valerie.Peters1 at hcahealthcare.com  Thu Jul 30 12:27:16 2009
From: Valerie.Peters1 at hcahealthcare.com (Peters Valerie - Charleston)
Date: Thu, 30 Jul 2009 14:27:16 -0500
Subject: [Cnm] Question
Message-ID: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F8BC9C8F7@NADCWPMSGCMS10.hca.corpad.net>

Hi all-
   I have been asked to do two presentations, one on "decoding food labels"    and one on the how tos of maintaining weight loss.  Does anyone have a presentation(s), preferably in .ppt, they would be willing to share?  Thank you in advance for the expertise on this listserv.

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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From Linda.Bartholomay at meritcare.com  Thu Jul 30 12:49:25 2009
From: Linda.Bartholomay at meritcare.com (Linda Bartholomay)
Date: Thu, 30 Jul 2009 14:49:25 -0500
Subject: [Cnm] Sorian/CBORD
In-Reply-To: <7375E17267B3DB4583032BDEFDA2D76E058E4DF2@mailphs.pinnaclehealth.org>
References: <7375E17267B3DB4583032BDEFDA2D76E090300F2@mailphs.pinnaclehealth.org>
	<7375E17267B3DB4583032BDEFDA2D76E058E4DF2@mailphs.pinnaclehealth.org>
Message-ID: <4A71B2F5.309B.00D0.0@meritcare.com>

Does anyone have a real-time height and weight feed (interface between Sorian and Cbord) from any system into Cbord.  We have been told that it is a limitation of Cbord that it cannot accept real-time revision records if weights are updated in our current Siemen's system?  Currently, we only get an updated weight across the interface from Siemen's into Cbord when a diet order is entered.

Thanks in advance!!
Linda

Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer

>>> "Tina Hornberger"  7/28/2009 12:06 PM >>>

Linda,
We get daily reports from Soarian of all patients on TPN, on Warfarin, pt?s with INR >5, anyone on an MAO, and anyone on procalamine.  We also have a report that shows any patients with allergies that are not interfaced to CBORD.  Some locations receive daily reports of specific lab values (albumin, prealbumin).  We have diet order reports that show any recent diet orders entered in Soarian from a specific time that are also helpful.  We?ve found our information services department has been very helpful in providing the specific info that we request.
Let me know if you have any other questions.
Tina 

From: Roberta Tripp 
Sent: Tuesday, July 28, 2009 12:53 PM
To: Tina Hornberger
Cc: 'linda.bartholomay at meritcare.com'
Subject: FW: [Cnm] Sorian/CBORD

    Tina, can you respond to Linda?

Thanks.

Roberta

From: Linda Bartholomay [mailto:Linda.Bartholomay at meritcare.com] 
Sent: Tuesday, July 28, 2009 10:54 AM
To: Roberta Tripp
Subject: Re: [Cnm] Sorian/CBORD
Roberta,
Have you made any reports (ie: custom reports) that use data from both systems for patient information/screening??
We find the Cbord reports to be pretty limited for our needs.
Linda

Linda Bartholomay, LRD
Manager, Nutrition Therapy
MeritCare Health Systems
Linda.Bartholomay at meritcare.com
(701) 234-6166
Strengths:  Arranger, Ideation, Adaptability, Empathy, Maximizer

>>> "Roberta Tripp"  7/28/2009 9:15 AM >>>
We have Soarian and CBORD and they work together well.

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

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Altenburger, Linda
Sent: Tuesday, July 28, 2009 9:01 AM
To: cnm at lists.my180.net
Subject: [Cnm] Sorian/CBORD
For those facilities that use Sorian, does it have diet office capabilities eliminating the need for a separate diet office system?  If not and you have CBORD, are you pleased with how they interact? Thank you 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

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. 
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,
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in error, please contact the sender and delete the material
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From tfreeden at somerset-healthcare.com  Thu Jul 30 12:53:29 2009
From: tfreeden at somerset-healthcare.com (Freeden, Theresa)
Date: Thu, 30 Jul 2009 15:53:29 -0400
Subject: [Cnm] patient rounding
Message-ID: 

Hi all-
We are looking to develop a multidisciplinary team to do rounding to address patient room comfort/needs, etc.
If anyone is on such a team- what type of format are you using or questions do you ask the patients to improve patient satisfaction? Do you use a form to record any data/follow up? 
Thanks
Theresa

Theresa Freeden, MS, RD
Clinical Nutrition Manager 
Somerset Medical Center
110 Rehill Ave.
Somerville, NJ 08876
908 704-2758

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the sender of the delivery error by e-mail or you may call 
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From Valerie.Peters1 at hcahealthcare.com  Thu Jul 30 13:03:51 2009
From: Valerie.Peters1 at hcahealthcare.com (Peters Valerie - Charleston)
Date: Thu, 30 Jul 2009 15:03:51 -0500
Subject: [Cnm] Another one
Message-ID: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F8BC9CA17@NADCWPMSGCMS10.hca.corpad.net>

Hi all,
   Also looking for the following for a CHF group:  heart healthy handouts, Hypertension, DASH, low sodium dining, etc.  Any websites, powerpoints.....appreciated, thanks

Best,

Valerie

_________________________
Valerie L. Peters, MS, RD, LD
Supervisor
Nutrition Therapy Department
Trident Health System
9330 Medical Plaza Drive
Charleston, SC     29406-9195
(843) 847-4570
Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well.
This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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From SRassekh at stfranciscare.org  Thu Jul 30 13:14:07 2009
From: SRassekh at stfranciscare.org (Rassekh, Shoreh)
Date: Thu, 30 Jul 2009 16:14:07 -0400
Subject: [Cnm] Another one
In-Reply-To: <0A3A1CCAD5E650408BE6DF56FB3F6D4D6F8BC9CA17@NADCWPMSGCMS10.hca.corpad.net>
Message-ID: <0AB0670D124B96418F1D6AAFB11D5C31012E5F34@SFH15110MV23.sfhad.stfranciscare.org>

Please include me in the responses.

Thank you. 

Shoreh Rassekh M.S., R.D., CD-N
Clinical Nutrition Manager
860-714-5512 

________________________________

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Peters Valerie - Charleston
Sent: Thursday, July 30, 2009 4:04 PM
To: cnm at lists.my180.net
Subject: [Cnm] Another one

Hi all,

   Also looking for the following for a CHF group:  heart healthy
handouts, Hypertension, DASH, low sodium dining, etc.  Any websites,
powerpoints.....appreciated, thanks

Best,

Valerie

_________________________

Valerie L. Peters, MS, RD, LD

Supervisor

Nutrition Therapy Department

Trident Health System

9330 Medical Plaza Drive

Charleston, SC     29406-9195

(843) 847-4570

Valerie.Peters1 at hcahealthcare.com

Life is a gift. Live it well. 
This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of
its attachments, please be advised that you have received this email in
error and that any use, dissemination, distribution, forwarding,
printing, or copying of this email or any attached files is strictly
prohibited. If you have received this email in error, please immediately
purge it and all attachments and notify the sender by reply email or
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From tfreeden at somerset-healthcare.com  Fri Jul 31 05:44:10 2009
From: tfreeden at somerset-healthcare.com (Freeden, Theresa)
Date: Fri, 31 Jul 2009 08:44:10 -0400
Subject: [Cnm] sending supplements w/o md order
Message-ID: 

Hi All-
Is there anyone in NJ who has the RD sending supplements w/o an MD order? 

Thanks
Theresa

Theresa Freeden, MS, RD
Clinical Nutrition Manager 
Somerset Medical Center
110 Rehill Ave.
Somerville, NJ 08876
908 704-2758

CONFIDENTIALITY NOTICE
This message and any included attachments are from 
Somerset Medical Center and are intended only for the addressee.
The information contained in this message is confidential 
and may contain privileged, confidential, proprietary and/or 
trade secret information entitled to protection and/or exemption 
from disclosure under applicable law. Unauthorized forwarding, 
printing, copying, distribution, or use of such information is 
strictly prohibited and may be unlawful. If you are not the 
addressee, please promptly delete this message and notify 
the sender of the delivery error by e-mail or you may call 
Somerset Medical Center's computer Help Desk at 
908-685-2200, ext. 4050. 
-------------------------------------------------------------- 
Somerset Medical Center is the recipient of the 
2009 Orthopedic Surgery Excellence Award(tm) from HealthGrades,
the nation's leading health care ratings company.

Visit Somerset Medical Center's Web site 
- www.somersetmedicalcenter.com - 
for news, event listings, health information and more.

Join the Discussion: 
Facebook: www.somersetmedicalcenter.com/fb
Twitter: www.twitter.com/SomersetMedCtr
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From skonruff at rehabhospitalwi.com  Fri Jul 31 06:10:14 2009
From: skonruff at rehabhospitalwi.com (Sallie Konruff)
Date: Fri, 31 Jul 2009 08:10:14 -0500
Subject: [Cnm] Stroke Program
In-Reply-To: 
References: 
Message-ID: 

Hello;

We are developing a stroke program at our rehab facility.  I need to put
together a self learning module and power point presentation for all
hospital staff.  I'm wondering if anyone has done this at their facility
and might be willing to share as a starting point.  Here is our outline
which was shared by our administrative lead of the committee developing
the program.

i)        Nutrition Services Education

(1)   Assessment

(a)   Malnutrition/Nutrition Risk

(i)     Altered Consciousness

(ii)   Dysphagia

(iii) 

Sallie

Jackie

Sensory/Perceptual Deficits

(iv) Reduced morbidity

(v)   Depression

(b)   Monitoring Intake

(c)    Body Weight

(d)   Urinary and Fecal output

(e)   Calorie counts

(f)     Levels of serum proteins, electrolytes, blood counts

(2)   Treatment

2)      Mission

3)      Purpose

4)      Scope of the Stroke  Program

i)        

1.	Overview:

-Kris

2.	Breakouts:

      -Nsg

      -OT

      -PT

      -ST

      -Pharm.

      -Neuro

      -Nutrition 

      -CSM

      3. Med. Management

                  -DVT - JCAHO

Intensity of Services

5)      Team Members and Education

a)      Team Members

i)        Program Medical Director

ii)       Medical Specialties

iii)     Nursing

iv)     Physical Therapy

v)      Speech Language Pathology

vi)     Occupational Therapy

vii)   Recreational Therapy

viii)  Psychology and/or Neuropsychology

ix)     Pharmacy

x)      Dietician

xi)     Pastoral Care

xii)   Case Management

6)      Admission Criteria-Stroke  Program

a)      Admission Criteria

b)      Prioritization of Patients Admitted to the Stroke  Unit

7)      Expected Outcomes

a)       Benchmarks:  CMI, LOS Efficiency, FIM Change, Discharge to
Community

b)      Outcomes

8)       Education and Competencies

i)        All staff Overviews

(1)   Anatomy and Physiology

(a)   Anatomy

(b)   Physiology of Stroke

(c)    Aphasia

(d)   Dysarthria

(e)   Apraxia etc

(f)     Sensory Deficits

(g)   Visual Perceptual

(h)   Cognitive

(i)     Motor Impairment

(2)   FIM training/certification - (George, Amy)

(3)   NIH Stroke Scale - (Randy/Suzie F.)

(4)   Fall Prevention (can also be whole separate program) -
(Randy/Kris)

(5)   Psychosocial:  adjustment and emotional lability-added 7.2.09

(6)   NDT for OT, PT, SLP, Nursing-current literature on Stroke Journal
is neutral (General Approach to Neuro - Randy/Kris)

*Documentation = Jodi

(7)    Pain

(a)   

Kristin/Steve

Assessment

(b)   Treatment

(8)   Bowel and Bladder:  overview -

(9)    Management of Spasticity (Add Ashworth per Dr. Kohli)

(a)   

Dr. Wilson

Sam

Kasi

Jo

Positioning

(b)   ROM

(c)    Stretching

(d)   Splinting

(e)   Co-morbidity (Dr. Kohli) i.e UTI, fecal impact

(f)     Serial Casting

(g)   Surgical - Dr. Zhu (foot/ortho surgeon=OAW)

(h)   

Speech/Voice/

Swallowing

Jodi

Janel

Pharmacology approaches - See Pharmacy section

(i)     Pump Management-Deb Swarangin (Jan Pfaff), also speech:
voice/swallowing

(10)                        Dysphagia-

(a)   Overview: anatomy/physiology

(b)   Assessment

(c)     Treatment

(10)Integrative Medicine

Jodi

      (a) Guided Imagery

      (b) Essential Oils

      (c) Treatment

ii)        Nursing Education

(1)   CRRN

(2)   Morse Scale

(3)   Braden Scale

(4)   Patient Assessment/Treatment-Nursing

(i)     Medical Issues

(ii)   Cognition

(iii) Perception

(iv) Mental Health Issues

1.      Depression

2.      Mood Disturbances

(v)   

Steve

Kristin

Speech and Hearing

1.      Aphasia

2.      Dysarthria

3.      Apraxia

(vi) Nutrition and Hydration

1.      Swallow Assessment

(vii)                       Motor Function

(viii)                     Perception

(ix)  Skin Integrity

(x)   Visual Effects

1.      Hemianopsia

2.      Diplopia

(xi) Bowel and Bladder

1.      Assessment: bladder scan and or on/out catherization

2.      

Steve

Kristin cont.

 Measurements of urinary frequency, volume and control

3.      Assessment for presence of dysuria

4.      Treatment

a.      Removal of foley within 48 hrs to avoid UTI

b.      Silver alloy catheters when needed

c.       Develop bladder training program

iii)    Therapy Education:

(1)   

Kris

Randy

Shana-Address Pain

 Assessment

(a)   Tone:

(i)     Modified Ashworth Scale

(ii)   Tardieum Scale as applicable

(iii) OT?  

(b)    Balance

a. Tinnetti

Kris

            b. Berg

            c. Sitting Functional Reach

            d. Timed get up and go

            e. Dynamic Gait Index

      f. CTSIB Balance Test

 (c)  Sensory Testing

            a. Tactile

            b. Auditory

PT/OT

Ann/Amy

            c. Gustatory

            d. Visual Perceptual

            e. Vibration

            f. Proprioception

            g. Somatosensory       

d. Gait

            i. Dynamic Gait Index

            ii. 6 minute walk

e.      Strength/Motor control

f.         Cognition assessment-

a. learning, memory, visual neglect, attention, apraxia, problem
solving, reasoning, executive functions

g.      

Jodi/Jane

Communication assess 

a. auditory/visual comprehension, verbal/written expression, pragmatics

h.      Swallowing assess

i.        Seating and positioning (Randy, Sam, Linda)

iv)    Therapy Treatment 

(1)   Tone

(a)   

Randy/Kris Coordinate

Pharmacology management (Botox)

(b)   E-Stim

(c)    Orthotics/splinting

(d)   Aquatics

(2)    Balance

(a)   Wii Fit

(b)   Sensory retraining

(3)   Sensory

(a) Visual/perceptual

(4)   Gait

(a)   Liko lift/lite gait

(b)   E-stim

(i)     walk aide

(ii)   

Randy/Kris Cont.

Bioness

(c)    Metronome for pacing 

(d)   Surfaces- level/unlevel, textures

(e)   Orthotics

(5)   Strength and Motor control

(a)   Constraint Induced Therapy

(b)   NDT

(c)    Aquatics

(d)   Task specific training

(e)   Aerobic Conditioning

(f)     E-stim

(i)     Walk aide

(ii)   Bioness UE/LE

(6)    Cognition

(7)   Communication

(a) Technology

(8)   Swallowing

(a)   

Jodi

Janel

Dysphagia Strategies and Precautions

(b)   Diet modification

(c)    Videofluoroscopy

(d)   Vital Stim

(e)   DPNS

(f)     Strengthening

(g)   Sensory

(9)   Seating/Positioning

(a)   Wheel chairs

(b)   Cushions

(10)                       Home management (OT: Jo Meek)

1.      include d/c checklist and home checklist 7.2.09

(11)                       Driver's Training program or referral (OT's:
Sharon Benson)

1.      Include car transfers and training for all team members
including nursing for community re-entry.  7.2.09

(12)                       Therapeutic Outtrips (Teresa)

(13)                       Therapeutic Group Therapy for the Patients
with Stroke

(Brent/Amy/Neuro Psych) 

 iv) Neuropsych Education

a.      Psychosocial assess

Matt/Pam

-PLF, Family/caregiver, resources, spiritual leisure, caregiver
understanding

 -Rx planning based on Dx (Dr. Kohli)

-Referral to discipline

b.      

Matt/Pam

Cont.

Treatment:

i.   Mood Disturbance: Depression and emotionalism    

     including psychotherapy and pharmacology

ii.  Cognitive remediation

v)      Nutrition Services Education

(1)   Assessment

(a)   Malnutrition/Nutrition Risk

(i)     Altered Consciousness

(ii)   Dysphagia

(iii) 

Sallie

Jackie

Sensory/Perceptual Deficits

(iv) Reduced morbidity

(v)   Depression

(b)   Monitoring Intake

(c)    Body Weight

(d)   Urinary and Fecal output

(e)   Calorie counts

(f)     Levels of serum proteins, electrolytes, blood counts

(2)   Treatment

vi)     Pharmacy Education

a.      DVT protocol

b.      Secondary prevention - ACE inhibitors, HTN control,
anti-platelette therapy, lipid therapy, smoking cessation, diabetes
control, CAD, PVD,atrial fib.

c.       

Lynne

Bill

Spasticity Management: Pharmacology Rx: oral Baclofen, Tizanidine and
Dantrolene. Don't recommend Benodiazepines (Diazepam). Recommend Botox
over Phenol. Baclofen pumps recommended

d.      Pain management - centrally acting analgesics at low doses
recommended

e.      Management of Mood Disturbance

f.        Controversial Pharmacology Approaches - (weak evidence) -
neurotransmitting agents, CNS stimulants

g.      Not recommended - neuroleptics, barbituates, benzodiazepines,
anticonvulsants, clonadines, prazosin - are all associated with poor
outcomes

 vii)Case Management/social services

a.      

Al

Brent

Audrey

Prior level of function, Family/caregiver, resources, spiritual,
leisure, caregiver understanding - expectation/prognosis

b.      Education

c.       D/C planning

d.      Community re-education/resources

9)        Education for Patients and Support System/Patient and Family
Education Guide

i)        

Group

Adjustment to stroke

(1)   Emotional lability

(2)   Confabulation

(3)   Sexuality issues

ii)       Medical Passport-record of medications, treatments, etc.
Access to emergency care and communication with care providers.

iii)     Home modifications and home safety

iv)       

Case Mgrs

Health risks and prevention strategies

(1)   Signs and symptoms of recurrent stroke

(2)   Primary and secondary prevention of stroke (smoking cessation,
hypertension management, weight loss, etc.)

(3)   

All Staff

Prevention of complications

(a)    Deep venous thrombosis

(b)   Aspiration pneumonia

(c)    Pressure ulcers

(d)   Urinary tract infections

(e)    Shoulder pain

v)      Caregiver support = psychosocial support for caregiver

(rec video from Kris)

vi)     Community Resources and self advocacy

(1)   Recreational Therapy

(a)   Transportation

(b)   

Teresa

Travel (TSA Screenings)

(c)    Senior Rec Programs

(d)   Adaptive Rec Programs

(e)    Adult Day Care

(f)     Aquatic Programs (Jen)

vii)   Medication Management

viii)  Nutrition

10)  Discharge Planning

i)        Support Systems

ii)       Alternative Placements

iii)     Medical/Physiological Issues

iv)     

All Staff

Al/Brent/Audrey

OT/PT/ST

Nsg

Pharm

Functional Issues

v)      Psychological Issues

vi)     Age-Specific Consideration

vii)   Education and Self Management

viii)  Equipment needs

ix)     Community Reintegration

(1)   Independent Living Apartment 

(2)   Self Medication Program

(3)   Community Outings

(4)   Home Evaluation

x)      Follow up

11)  Discharge Criteria

(Al, Brent, Audrey, Jodi, D/C planning therapists and Nursing)

-FIM score = 100

-NIH Stroke scale

-Falls/Balance measures

12)  

Sue

Community Resources

i)        Outpatient programs 

ii)       

Brent

Al

Cherrie

 Support groups

(WMH, stroke, coord.)

Day Programs -Adult Day Care

                          -Home Health Support

                          -Westwood Program

                          -Universities

________________________________

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CONFIDENTIALITY NOTICE
This message and any included attachments are from 
Somerset Medical Center and are intended only for the addressee.
The information contained in this message is confidential 
and may contain privileged, confidential, proprietary and/or 
trade secret information entitled to protection and/or exemption 
from disclosure under applicable law. Unauthorized forwarding, 
printing, copying, distribution, or use of such information is 
strictly prohibited and may be unlawful. If you are not the 
addressee, please promptly delete this message and notify 
the sender of the delivery error by e-mail or you may call 
Somerset Medical Center's computer Help Desk at 
908-685-2200, ext. 4050. 
-------------------------------------------------------------- 
Somerset Medical Center is the recipient of the 
2009 Orthopedic Surgery Excellence Award(tm) from HealthGrades,
the nation's leading health care ratings company.

Visit Somerset Medical Center's Web site 
- www.somersetmedicalcenter.com - 
for news, event listings, health information and more.

Join the Discussion: 
Facebook: www.somersetmedicalcenter.com/fb
Twitter: www.twitter.com/SomersetMedCtr 

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From fns at abbgen.net  Fri Jul 31 07:09:03 2009
From: fns at abbgen.net (Annette Doucet)
Date: Fri, 31 Jul 2009 09:09:03 -0500
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets
In-Reply-To: <26621_1248902312_0KNK00GFUB6WWQ70_4A70BCC1.5030101@nyp.org>
References: <26621_1248902312_0KNK00GFUB6WWQ70_4A70BCC1.5030101@nyp.org>
Message-ID: <006601ca11e8$76f80110$02be7878@local.abbgen.net>

We use Press Ganey, but do not use that question.  It is an optional
question that your hospital can either choose or not choose to use. 

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Sarah Jaffe Spool
Sent: Wednesday, July 29, 2009 4:19 PM
To: cnm at lists.my180.net
Subject: [Cnm] Press Ganey Question on Special/Restricted Diets

Hi Everyone,
Our hospital, New York Presbyterian, uses the Press Ganey Patient Survey to
measure patient satisfaction. There is currently a custom question on the
survey which asks discharged patients if their special/restricted diet was
explained. Because all of our patients do not see RDs and because all our
patients are not all on "special/restricted diets", this question is
confusing. It does not highlight the care the patient received from the RD.
My question to you is threefold:
1. Do you use Press Ganey in your hospitals?
2. If you do, does your hospital include this custom question on their
questionnaires?
3. If you use this question on the questionnaire, what types of performance
improvement projects have you developed to help increase/maintain high-level
satisfaction scores?
Thanks in advance for your help with this. Any additional information around
this question is also welcome!

Sarah

Sarah Spool, MS, RD, CDE, CDN
New York Presbyterian Hospital
The University Hospital of Columbia and Cornell
212-305-2742

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

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the named recipient, please notify us immediately by contacting the sender
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05:58:00

From fns at abbgen.net  Fri Jul 31 07:15:33 2009
From: fns at abbgen.net (Annette Doucet)
Date: Fri, 31 Jul 2009 09:15:33 -0500
Subject: [Cnm] Salary info
In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4AD3@wmhcs03.wmh.org>
References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4AD3@wmhcs03.wmh.org>
Message-ID: <006701ca11e9$5ebf2dc0$02be7878@local.abbgen.net>

ADA does salary surveys every few years.  Think they are in the process of
doing one now.  Check ADA publications for the last one published.  Also, if
your state has Civil Service positions for these jobs, check your state
site.  That would be public information.  Your state dietetic association
may also have information.  Maybe, your human resource dept has surveyed
area-wide for a variety of job positions and may have information.

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On
Behalf Of Shannon Byrd Jackson
Sent: Thursday, July 30, 2009 8:50 AM
To: cnm at lists.my180.net
Subject: [Cnm] Salary info

Hello,

Does anyone know where you can get salary info for RDs/Clinical Nutrition
Managers? 

Thanks,
SBJ

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

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From bkchambers at msn.com  Fri Jul 31 08:19:56 2009
From: bkchambers at msn.com (Belinda Chambers)
Date: Fri, 31 Jul 2009 09:19:56 -0600
Subject: [Cnm] Menus
Message-ID: 

Hello,
I am wondering how other facilities do their menus. Is there a particular software that is better than another, or are you purchasing menus? Thanks
Belinda Chambers
Have a great day! Belinda "Life begins at the end of your comfort zone" Neale Donald Walsch

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From horlowsk at ppmh.org  Fri Jul 31 08:27:32 2009
From: horlowsk at ppmh.org (Orlowski, Hannah)
Date: Fri, 31 Jul 2009 11:27:32 -0400
Subject: [Cnm] Menus
In-Reply-To: 
Message-ID: <0DAF44B706E29940A409E32DC69005C007842751@exchange1.phoebe.com>

Please list to post

-----Original Message-----
From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Belinda Chambers
Sent: Friday, July 31, 2009 11:20 AM
To: cnm at lists.my180.net
Subject: [Cnm] Menus

Hello,
I am wondering how other facilities do their menus. Is there a particular software that is better than another, or are you purchasing menus? Thanks
Belinda Chambers
Have a great day! Belinda "Life begins at the end of your comfort zone" Neale Donald Walsch

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From cindy at harperjobs.com  Fri Jul 31 10:40:55 2009
From: cindy at harperjobs.com (Cindy Krainen)
Date: Fri, 31 Jul 2009 13:40:55 -0400
Subject: [Cnm] Career Opportunity-Director of Dietetics: Dallas, Texas
Message-ID: <3C3AE5DDEB5B45688E115A340877074B@hprdomain.local>

Director of Dietetics-Dallas, Texas

Terrific opportunity available for a Registered Dietitian with a successful
track record as a Director of Food and Nutrition 

in an acute care hospital at least 300 beds.   All inquiries will remain
confidential.  

Send resume in a Word attachment to:

Cindy Krainen RD

Harper Associates

31000 Northwestern Highway, Suite 240

Farmington Hills, MI 48334

248-932-3662   800-933-1170 ext. 106

Fax:248-932-1214

www.harperjobs.com  

cindy at harperjobs.com  

Harper Associates proudly 

celebrated its 40th year in 2008!

Join Dietitian Jobs Network on Linkedin

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From DrNCollins at aol.com  Fri Jul 31 12:46:11 2009
From: DrNCollins at aol.com (DrNCollins at aol.com)
Date: Fri, 31 Jul 2009 15:46:11 EDT
Subject: [Cnm] Expert Witness
Message-ID: 

Hi there,

As many of you know, I specialize in litigation involving dietitians and  
various nutritional issues. I have a case now that is somewhat out of my area 
of  expertise so I am looking for an expert witness who can work on this. 
The case  involves a pregnant woman with hyperemesis and Wernicke's on TPN. 
If you are a  practicing dietitian with experience in the nutritional needs 
of pregnancy and  knowledgeable about TPN, please keep reading. 

Expert witness work requires one to be detail oriented, personable,  
confident in their nutrition knowledge and persuasive. 

If you feel you can work on this, please send a CV and letter of  
introduction to me at _NCtheRD at aol.com_ (mailto:NCtheRD at aol.com)    I will pass on 
all qualified candidates to the attorney for follow up. 

Thanks,
NANCY

Nancy Collins, PhD,  RD, LD/N, FAPWCA 
Founder and  Executive Director 
_www.RD411.com_ (http://www.rd411.com/)  
 (mailto:Nancy at RD411.com) Every RD can now  have his/her own page on RD411 
in the personal directory! 

**************A bad credit score is 600 & below. Checking won't affect your 
score. See now! 
(http://pr.atwola.com/promoclk/100126575x1222846709x1201493018/aol?redir=http://www.freecreditreport.com/pm/default.aspx?sc=668072&hmpgI
D=62&bcd=JulyBadfooterNO62)
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From jross at jaycountyhospital.com  Fri Jul 31 13:27:39 2009
From: jross at jaycountyhospital.com (Julayne Ross)
Date: Fri, 31 Jul 2009 16:27:39 -0400
Subject: [Cnm] iron supplement
Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D0224B667@EX1.jaycountyhospital.com>

Someone recently named a new timed release OTC iron supplement that is
not hard on the stomach... and I forgot it.

Thanks,

Julayne

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From sadiecat14 at verizon.net  Fri Jul 31 16:13:29 2009
From: sadiecat14 at verizon.net (Deborah Gore)
Date: Fri, 31 Jul 2009 19:13:29 -0400
Subject: [Cnm] In NJ?? Dinged for sending supplements without MD order??
References: 
Message-ID: <9BA43AB1D1B74F17AD8E6AAF8588367D@owner84d523d58>

If anyone of could share info about any acute care hospitals in New Jersey that were dinged in 2008 or 2009 by CMS or The Joint Commission
for adding supplements such as Ensure Plus without specific written physician diet orders please e-mail
me privately. (Of course if you would like to share with the list as a learning experience that would be great).

At my facility the dietitians find it impossible to believe this could happen. I have copied them list discussions about
California surveyors - but I thought I read that this occurred in NJ also.  

Appreciate any supporting evidence that I can share,

Deborah Gore, RD, CNSD
Cape Regional Medical Center
Cape May, NJ  08204
609-463-2009

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From jross at jaycountyhospital.com  Fri Jul 31 13:10:33 2009
From: jross at jaycountyhospital.com (Julayne Ross)
Date: Fri, 31 Jul 2009 16:10:33 -0400
Subject: [Cnm] Another one
Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D0224B658@EX1.jaycountyhospital.com>

The ppt was from the list that I modified for the CHF support group

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Rassekh, Shoreh
Sent: Thursday, July 30, 2009 4:14 PM
To: Peters Valerie - Charleston; cnm at lists.my180.net
Subject: Re: [Cnm] Another one

Please include me in the responses.

Thank you. 

Shoreh Rassekh M.S., R.D., CD-N
Clinical Nutrition Manager
860-714-5512 

  _____  

From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]
On Behalf Of Peters Valerie - Charleston
Sent: Thursday, July 30, 2009 4:04 PM
To: cnm at lists.my180.net
Subject: [Cnm] Another one

Hi all,

   Also looking for the following for a CHF group:  heart healthy
handouts, Hypertension, DASH, low sodium dining, etc.  Any websites,
powerpoints.....appreciated, thanks

Best,

Valerie

_________________________

Valerie L. Peters, MS, RD, LD

Supervisor

Nutrition Therapy Department

Trident Health System

9330 Medical Plaza Drive

Charleston, SC     29406-9195

(843) 847-4570

Valerie.Peters1 at hcahealthcare.com

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