From LAltenburger5 at matherhospital.org Thu Oct 1 05:12:20 2009 From: LAltenburger5 at matherhospital.org (Altenburger, Linda) Date: Thu, 1 Oct 2009 08:12:20 -0400 Subject: [Cnm] Soarian In-Reply-To: Message-ID: Please post.....also curious about how the diet orders interface with multiple orders. 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 ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Vicki Brown Sent: Wednesday, September 30, 2009 5:07 PM To: cnm at lists.my180.net Subject: [Cnm] Soarian It sounds like our institution is going to be making the switch over to Soarian Clinicals for our EMR. For those of you currently work with this system and/or if you've recently made the change to this system do you have any words of advice or opinions of the nutrition assessments/aspects of it? We are several weeks away from getting to see the actual assessments that they have available for us to "tweak" but I wanted to get some feedback that I can evaluate/use as we move forward with this process. Thanks in advance and wish us luck - change always goes over well!! Vicki Brown, RD, LMNT, CDE Clinical Coordinator of Nutrition Services Faith Regional Health Services This communication, along with any attachments, is covered by federal and state law governing electronic communications and may contain confidential and legally privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution, use or copying of this message is strictly prohibited. If you have received this in error, please reply immediately to the sender and delete this message. Thank you. Circular 230 Disclosure: To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication (including any attachments) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code, or (ii) promoting, marketing or recommending to another party any matters addressed herein. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/647815fc/attachment.html From mpappo at montefiore.org Thu Oct 1 05:35:57 2009 From: mpappo at montefiore.org (Miriam Pappo) Date: Thu, 01 Oct 2009 08:35:57 -0400 Subject: [Cnm] Therapeutic Diet Defined (UNCLASSIFIED) Message-ID: I agree. In general, texture to me is not therapeutic. Even for pt safety, I do not see it as "therapeutic". 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 >>> "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" 10/01/09 1:44 AM >>> Classification: UNCLASSIFIED Caveats: NONE Karen, I'd look at this as almost a "preference" thing. If the diet order is at one level and you are in essence making it MORE restrictive vs LESS (not taking away the intent of the MD order), I think you are OK. Giving a patient ground meat--that is both therapeutic, and honoring his preferences; ditto w. Ensure or a snack. Unless it contradicts the diet order (eg, giving an extra snack on a calorie controlled diet), I don't see this as a problem. I'd be interested in other opinions, though. Heidi -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karen Higgins Sent: Wednesday, September 30, 2009 11:02 PM To: cnm at lists.my180.net Subject: [Cnm] Therapeutic Diet Defined Upon discussion with my staff about the definition of "Therapeutic Diet " orders, the following questions came up as to what degree are we allowed to make changes without it being considered "Therapeutic Diet" ordering? 1. An elderly patient always eats three small meals with in-between snacks, can we provide this (with appropriate foods that meet the physician-ordered diet) without getting a doctor's order for 6 small meals or between meal snacks? 2. A patient gets hungry between meals and wants a milkshake or snack. If it is not a "medical food supplement/ product", can we provide this (with appropriate foods that meet the physician-ordered diet) without it being considered a "Therapeutic Diet Order" change? 3. A patient drinks Ensure at home, is on a regular diet, and wants it in the hospital. Can we provide it as a patient preference without getting it entered as a physician order? 4. A patient is ordered "2gm Na Diet", has no teeth and always eats ground meat. Can we arrange for ground meat as a patient preference, within a 2gm Na diet restriction, without it being considered a "Therapeutic Diet Order" change to a 2gm Na Mechanical Soft diet? Years ago we used professional judgment as the nutrition expert working with the patient, and made these changes directly in the computer and/or behind the scenes. I then felt there should be a more "Official" process when making these changes so we developed an "Order-writing" protocol/policy to downgrade consistencies, add snacks and/or supplements, in order to have it noted in the physician orders and apparent to all. Now, we are told no changing anything without a physician's order. So can we go back to making these minor changes behind the scenes, and is it enough to have it documented in our notes without it being part of the diet order? HELP - Frustrated In Florida! Karen Higgins Manager, Medical Nutrition Services "The best way to predict the future is to create it!".........Jason Kaufmann The views expressed in this e-mail are the views of the sender and do not necessarily represent the views of University Community Health. This e-mail message and its attachments are for the sole use of the intended recipients. They may contain confidential information or other information subject to legal protection and/or restrictions. If you are not the intended recipient of this message, please do not read, copy, use or disclose this message or its attachments. Please notify the sender by replying to this message and delete or destroy all copies of this message and attachments in all media. Thank you. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Classification: UNCLASSIFIED Caveats: NONE _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From horlowsk at ppmh.org Thu Oct 1 05:41:29 2009 From: horlowsk at ppmh.org (Orlowski, Hannah) Date: Thu, 1 Oct 2009 08:41:29 -0400 Subject: [Cnm] Recipe Nutrient Analysis software question In-Reply-To: <5005163.388638.1254357588964.JavaMail.root@oailxiron1.ssfhs.org> Message-ID: <0DAF44B706E29940A409E32DC69005C007842BFC@exchange1.phoebe.com> Please list to post. I am also looking. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Meehan Bonnie Sent: Wednesday, September 30, 2009 8:40 PM To: 'cnm at lists.my180.net' Subject: [Cnm] Recipe Nutrient Analysis software question CNM Members, For those of you who have researched this topic and/or are using a system that you are happy with, which one would you recommend? I need to find a system quickly to analyze home and cafeteria recipes and print labels and do not have a lot of time to research it. I'm not exactly sure what all I need it to do, but think the below is a good start. If you are not sure about what all the capabilities are of the one you have, just tell me what brand it is and what you like or do not like about it. What is the advantage of buying one like Nutribase or ESHA versus downloading a free one from the Internet? If you are familiar with the major brands, which one do you like better? Would like one that: --Overall easy to learn and use --Easy input of recipe data --Good reputable database of foods and some brand names --Can expand home sized recipe to accurate institutional sized recipe with quantities applicable to large quantities (like cups vs. teaspoons) --Can give info on desired serving sizes --Can analyze up to 10 nutrients by normal unit of measure (gm, mg, etc.) and give % DRV based on 2,000 or 2,500 calorie diet --Can print food labels for above nutrients (or just ones you want to see) --Is not cost prohibitive to buy and to maintain up to date database and upgrades --Could work on individual computer or web (if you wanted to expand use of this on a corporate LAN to all employees) --Good customer support --Might include other wellness features--though this part is not necessary Many Thanks for whatever guidance you can provide.--Bonnie Bonnie Meehan, RD, CD Chief Clinical Dietitian St. Francis Hospital & Health Centers 1600 Albany St. Beech Grove, IN 46107 317-782-6007 _____ 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. 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If you the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, please notify us immediately and destroy the related message. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/ca6294ce/attachment.html From andrea.johnson at bassett.org Thu Oct 1 06:09:04 2009 From: andrea.johnson at bassett.org (Johnson, Andrea) Date: Thu, 1 Oct 2009 09:09:04 -0400 Subject: [Cnm] pediatric needs In-Reply-To: <20090930011331.ST4WG.215863.root@cdptpa-web04-z02> Message-ID: <9B90EC6A1B880E4A9D9A859E062A04751E8332D2@ex2.bassett.org> We are small community/teaching hospital and we don't see that many complicated pediatric patients. But we do see a few. What caloric formulations and protein needs are other places using for their pediatric populations? Any help would be most appreciated. Thanks, Andrea Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/e20a45b8/attachment-0001.html -------------- next part -------------- A non-text attachment was scrubbed... Name: Johnson, Andrea.vcf Type: text/x-vcard Size: 145 bytes Desc: Johnson, Andrea.vcf Url : /pipermail/cnm_lists.my180.net/attachments/20091001/e20a45b8/attachment-0001.vcf From hpatronik at shorehealth.org Thu Oct 1 06:27:21 2009 From: hpatronik at shorehealth.org (Holly Patronik) Date: Thu, 1 Oct 2009 09:27:21 -0400 Subject: [Cnm] Prader Willi Message-ID: I have a patient with prader Willi whose MD is requesting 800kcal/day. I'm not familiar with working with this condition - is this a normal recommendation - any suggestions?? Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/e567eb39/attachment.html From Hollie_Colle at ssmhc.com Thu Oct 1 07:14:27 2009 From: Hollie_Colle at ssmhc.com (Hollie_Colle at ssmhc.com) Date: Thu, 1 Oct 2009 09:14:27 -0500 Subject: [Cnm] Dietary Delivering Trays - ANSWERS Message-ID: Thank you all for your responses. This has been very helpful! Looks like there's alot of great procedures out there. Each facility is answered in a different color. Thanks Again!!! 1. How do you coordinate with nursing? Does nursing have all pre-meal vitals, accu-checks, and patient set up, etc before tray trucks make it to the floor? We have room service so it may be different if you don?t. Pt?s on diabetic diets, full liq, clear liq, pureed and Dysphagia do get their trays at a set time on each unit. The nurses know the time the trays are scheduled to be delivered. And should have accu checks competed. They do not always have the patients set up which can be a problem. No formal procedure in place. The floors do know the approximate time of tray delivery so may coordinate that in some way Clinical nutrition mgr met with unit nurse managers initially to set up and refine the process as needed. Tray Host/hostess arrives on the floor in advance of the food carts (2 for 30 bed units) to get ice into glasses (since kitchen doesn't have the ability to send glasses with ice already on the trays) and pass sanihandwipes to pts. We have asked nursing to continue to assist with tray pass and to handle ALL isolation trays and feeders. Nursing supposed to set up pt- setups vary with activity on the floor, emergencies, physicians rounding, etc. Agreement was that nursing was going to clear off traytables and get patients ready for meal service (have them sit up in bed, etc.) We implemented the Nutrition Host program about 2 years ago; and it took us a while to learn that no one is going to get the patients ready for us. -The Hosts end up moving tray tables, tubes, wires or whatever else is in the way to move the tray table including URINALS. -The Hosts open up cartons for those that need assistance. Not always but the meals are delivered at approximately the same time daily. We supply each floor with the estimate serving time to each floor so they know when to expect us. 2. Does dietary record Intake %? If so, where? We do not do I&0?s Yes, leave menu marked with % eaten next to each item in an envelope on patient door. It doesn't work well. No- Dietary doesn't pickup the trays - only passes Initially the hosts recorded all intake on paper nursing I/O sheets (nursing uses this sheet daily to document I/O throughout day and then enter into computer system). - However, what we found was that when physicians or dietitians asked the nurse how their patient was eating, they would say ?I don?t know, the hosts pick up the trays.? In addition, even though the hosts would document %meal and mls fluid pt consumed on the paper I/O sheet ---- there was hardly any documentation of it in our computer system. - Therefore, just recently (about 6 months ago), we stopped having hosts pick up meal trays and record intake. Documentation in computer is still an issue; however, more nurses are able to answer the question about how their patient is eating. In the computerized medical record or bedside chart. We only deliver trays, nursing picks up dirty trays and they record I/O's 3. Does dietary deliver to isolation patients? If not, how is nursing notified to deliver? We do not deliver isolation trays to the patient but take them to the nursing unit to let them know they need to be delivered. Contact isolation = yes, Respiratory isolation = No NO- nursing should be assisting with meal tray delivery (at least one nurse aide or nurse) and they are asked to handle isolations. - The hosts do not deliver to isolation patients. After the hosts check the food cart against the nursing diet list, they let the nursing station know that there?s x number of isolation trays for nursing to pass. No - List to clerk when cart is finished. We deliver to all isolation patients except for airborne and radiation rooms. 4. What is your patient to tray delivery staff ratio? When we initially started room service it was 65-70 to 1, now we are about 40-45 to 1. 435 Bed Med Center, delivery ~325 trays/meal with 11 Meal Hosts deliverying trays 1 per 60 pts. They handle "same day" menus (diet changes & new admits) in am along with passing next day menus, do lunch pass and f/up for last minute needs or pt. requests before taking lunch break, then do complimentary Mercy Cookie and local elem school hand-made get well card pass and do some TLC vistation and rounding while collecting next day menu selections before they come down to the kitchen to prepare for evening meal carts and tray pass. Diet office staff assist with some menu keying of selections and kitchen supervisor spends about 1 hr daily in afternoon calling isolation patients for menu selections to allow host/hostess more time with patients. - Not as good as I?d like. We have 2 hosts delivering up to 90 trays per meal. They are quite rushed from floor to floor. We have the 2 hosts work together on each floor and then move to the next, etc. 20-35 patients on days with stocking, cleaning, and menu responsibilities. 30-45 on nights We do not pass ICU or Labor and Delivery or Psych We expect each server to serve up to 50 patients. 5. What barriers/challenges did you face implementing a joint dept venture (continuity between nursing and dietary staff) We have been delivering trays for a very long time. Nursing was very glad to give the chore to us. One advantage about food service delivery is that you have better control over how long the trays sit. I think the biggest challenge is what you mentioned earlier is not having patients set up. Nursing is suppose to clear the bedside table but actually this doesn't happen. Not sure how to fix that, it is just reality. Nursing is inconsistent from day to day and unit to unit on how much help they provide. - When the program first started, some nurses were complaining that they still have to go into the room and feed patient and were telling the hosts there?s no point to have them on the floor. While there were some nurses that just loved it. (You will always have those that complain) - Most of the hosts (including any other foodservice staff) don?t feel comfortable communicating with nursing; they feel intimidated and because the hosts don?t know nurses well or the nursing station dynamics, etc. issues arise and teamwork between nursing and hosts has been a challenge. Isolation trays are always delivered promptly. Nursing wants late trays to passed also and this is difficult. Process improves patient satisfaction and communication. Other Notes: Note: we began this on only 4 units (about 1/2 of hospital beds) 2 months ago and have seen a huge jump in hospital-wide pt. sat. for "meals" on Press Ganey. So far we attributing the increase housewide to the program on 4 units since it is the only thing we are doing different! Believe that a single caring person assigned for the day can impact overall satisfaction greatly and assist nursing some with non-clinical care. If Environmental Services can spare 1-2 FTEs by relinquishing some of the "light" housekeeping (trash removal, etc.) we are hoping we might add another 1-2 hosts/hostesses on the remaining units. The patients LOVE the hosts. We recruited staff that were strong in customer service skills and therefore, these hosts bring great smiles and customer service to our patients ? so it?s definitely worth it!!! I would recommend including nurse managers/directors in the design of the program so that there is buy in and support from nursing. I worked with one of the nurse managers to create a flyer to inform nursing of the new program and what it meant for them; including the need for teamwork! Hollie Colle, MS, RD, LDN Clinical Nutrition Manager St. Mary's Good Samaritan, Inc. Mount Vernon IL 62864 (618) 241-2356 Centralia IL 62801 (618) 436-8897 Confidentiality Notice: This email message, 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 email and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/09653966/attachment.html From Linda.Woods at healthall.com Thu Oct 1 07:32:40 2009 From: Linda.Woods at healthall.com (Woods, Linda) Date: Thu, 1 Oct 2009 10:32:40 -0400 Subject: [Cnm] Dietary Delivering Trays In-Reply-To: References: Message-ID: <2B1106A6A593B147A65BD5A8939D3E1101065B3410BD@MAIL-C.healthall.com> Responses below Linda Woods, RD, LD Clinical Nutrition Coordinator Food and Nutrition Services UC Health - University Hospital 234 Goodman Street Cincinnati, OH 45219-2316 Office: 513-584-4534 Pager: 513-577-0948 linda.woods at healthall.com www.uchealthnow.com [cid:image001.jpg at 01CA427E.35DA9370] [cid:image002.png at 01CA427E.35DA9370] From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Hollie_Colle at ssmhc.com Sent: Wednesday, September 30, 2009 1:13 PM To: cnm at lists.my180.net Subject: [Cnm] Dietary Delivering Trays I would appreciate any guidance from those whose nutrition services department delivers patient trays. We have a timeline to implement this by the 2nd qtr of 2010, so any input is greatly appreciated. Also please feel free to share what worked and didn't. 1. How do you coordinate with nursing? Does nursing have all pre-meal vitals, accu-checks, and patient set up, etc before tray trucks make it to the floor? We have a routine schedule of meal delivery times for each patient unit and nursing plans accordingly for tasks such as pre-meal vitals, accu-checks, etc. It is also nursing's responsibility to have the patient ready for meals (position them in bed/chair, assist w/hygiene, etc) and to have the overbed table cleared for placement of the tray, but it's a constant struggle for nursing to follow through with these tasks. 2. Does dietary record Intake %? If so, where? Nursing records intake 3. Does dietary deliver to isolation patients? If not, how is nursing notified to deliver? Food & Nutrition delivers to patients in Contact and Droplet isolation, but not into Airborne isolation rooms. The traypasser places the tray on the isolation cart outside of the room for patients in Airborne isolation and notifies nursing that the tray is there. 4. What is your patient to tray delivery staff ratio? Each traypasser delivers trays to the bedside for approx 50 patients. In addition, each has 1-2 critical care units where they just deliver the meal cart to the unit and nursing takes the trays to the bedside. 5. What barriers/challenges did you face implementing a joint dept venture (continuity between nursing and dietary staff) --Communicating to Food & Nutrition when patients will be out for test/procedures. --As stated earlier, patients not always prepared for their meal, hence, the tray sits and gets cold. --Overbed tables cluttered with anything and everything, including bedpans and urinals. Thanks! Hollie Colle, MS, RD, LDN Clinical Nutrition Manager St. Mary's Good Samaritan, Inc. Mount Vernon IL 62864 (618) 241-2356 Centralia IL 62801 (618) 436-8897 Confidentiality Notice: This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. ________________________________ Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/838c489c/attachment-0001.html -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 4000 bytes Desc: image001.jpg Url : /pipermail/cnm_lists.my180.net/attachments/20091001/838c489c/attachment-0001.jpg -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.png Type: image/png Size: 7843 bytes Desc: image002.png Url : /pipermail/cnm_lists.my180.net/attachments/20091001/838c489c/attachment-0001.png From LAURAF at dmhhs.org Thu Oct 1 07:46:14 2009 From: LAURAF at dmhhs.org (ETCHASON,LAURA) Date: Thu, 01 Oct 2009 09:46:14 -0500 Subject: [Cnm] Therapeutic Diet Defined (UNCLASSIFIED) In-Reply-To: References: Message-ID: <4AC47A66.21B0.00A0.0@dmhhs.org> I agree that some of these are patients preferences, but to me many are still therapeutic. If a pt drinks Ensure in addition to eating, it usually is to maintain wt/gain wt. If the pt did not drink it, then wt maintenance/gain would not happen so to me it is therapeutic. If a pt needs a texture change to chew or swallow better and if there wasn't one, the patient could not eat the food, then to me it is therapeutic. I was taught at a conference that any diet order other than regular was considered therapeutic (including adding any supplements). My example for a pt preference diet is as follows: If a pt does not like salt or salty foods and asks to be on a low Na diet, but does not have any other illnesses that would entail ordering a low Na diet, then it is pt preference. Thank you, Laura Laura A. Etchason, MS, RD, LDN Clinical Nutrition Manager Decatur Memorial Hospital 2300 N. Edward Street Decatur, IL 62526 217-876-5306 (office line and voice mail) 217-876-5305 (fax) 217-876-5301 (general line) lauraf at dmhhs.org Developer, Harmony, Maximizer, Individualization, Belief >>> "Miriam Pappo" 10/1/2009 7:35 AM >>> I agree. In general, texture to me is not therapeutic. Even for pt safety, I do not see it as "therapeutic". 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 >>> "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" 10/01/09 1:44 AM >>> Classification: UNCLASSIFIED Caveats: NONE Karen, I'd look at this as almost a "preference" thing. If the diet order is at one level and you are in essence making it MORE restrictive vs LESS (not taking away the intent of the MD order), I think you are OK. Giving a patient ground meat--that is both therapeutic, and honoring his preferences; ditto w. Ensure or a snack. Unless it contradicts the diet order (eg, giving an extra snack on a calorie controlled diet), I don't see this as a problem. I'd be interested in other opinions, though. Heidi -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karen Higgins Sent: Wednesday, September 30, 2009 11:02 PM To: cnm at lists.my180.net Subject: [Cnm] Therapeutic Diet Defined Upon discussion with my staff about the definition of "Therapeutic Diet " orders, the following questions came up as to what degree are we allowed to make changes without it being considered "Therapeutic Diet" ordering? 1. An elderly patient always eats three small meals with in-between snacks, can we provide this (with appropriate foods that meet the physician-ordered diet) without getting a doctor's order for 6 small meals or between meal snacks? 2. A patient gets hungry between meals and wants a milkshake or snack. If it is not a "medical food supplement/ product", can we provide this (with appropriate foods that meet the physician-ordered diet) without it being considered a "Therapeutic Diet Order" change? 3. A patient drinks Ensure at home, is on a regular diet, and wants it in the hospital. Can we provide it as a patient preference without getting it entered as a physician order? 4. A patient is ordered "2gm Na Diet", has no teeth and always eats ground meat. Can we arrange for ground meat as a patient preference, within a 2gm Na diet restriction, without it being considered a "Therapeutic Diet Order" change to a 2gm Na Mechanical Soft diet? Years ago we used professional judgment as the nutrition expert working with the patient, and made these changes directly in the computer and/or behind the scenes. I then felt there should be a more "Official" process when making these changes so we developed an "Order-writing" protocol/policy to downgrade consistencies, add snacks and/or supplements, in order to have it noted in the physician orders and apparent to all. Now, we are told no changing anything without a physician's order. So can we go back to making these minor changes behind the scenes, and is it enough to have it documented in our notes without it being part of the diet order? HELP - Frustrated In Florida! Karen Higgins Manager, Medical Nutrition Services "The best way to predict the future is to create it!".........Jason Kaufmann The views expressed in this e-mail are the views of the sender and do not necessarily represent the views of University Community Health. This e-mail message and its attachments are for the sole use of the intended recipients. They may contain confidential information or other information subject to legal protection and/or restrictions. If you are not the intended recipient of this message, please do not read, copy, use or disclose this message or its attachments. Please notify the sender by replying to this message and delete or destroy all copies of this message and attachments in all media. Thank you. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Classification: UNCLASSIFIED Caveats: NONE _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/34278684/attachment.html From knannini at azkrmc.com Thu Oct 1 07:55:17 2009 From: knannini at azkrmc.com (Kathy Nannini) Date: Thu, 1 Oct 2009 07:55:17 -0700 Subject: [Cnm] meal rounds Message-ID: <0613BF27181C264D9FE3CDC4005DB39B0697B40A@vexchange.azkrmc.org> RDs do meal rounds here, but not necessarily at meal times. We are a small facility (235 bed capacity, with average census 130-=/- 10 with winter months up to 160).We do not have a DTR, but would like to have one on staff. Meal rounds may only take 10 minutes a day. I think that we all have 10-15 minutes in a day to spare. They are each to see 25 patients per week. Yes, I even do meal rounds. No RD is to be on meal break while tray line is running, which generally concludes by 12:15-12:30 PM. Each RD also does a test tray 1 time a week minimum- all meals, including weekends are looked at. Our nursing staff are involved to provide us with their subjective opinion on taste, appearance, etc. This has greatly helped since nurses and CNSs now know that "hospital food" has greatly improved and are better equipped to encourage their patients to eat. This 'free advertising" has also helped increase our Caf? business with more staff eating from the caf? menu. If our Press Ganey Scores start to drop we pump up the "meal rounds" to more patients, more frequently until we get a handle on what may be going wrong. Also we then do 2 test trays a week. When case load is high and they do not "have the time" but they are seeing the patient anyway, why not ask some quick questions as to the quality of the food, etc. Meal rounds are a great opportunity for teaching the patient about their diet since you have the tray right in front of the patient as a tool. Our Meal Hosts also ask their patients about the quality of food when getting meal selections and such. If a patient is frequently asking for foods not allowed on a particular diet, they will refer the patient to the RD for further education. This seems to work for us, since our Press Ganey Scores have been consistently 90% or better for patient meal satisfaction the past 4 quarters. -----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, September 29, 2009 12:00 PM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 34, Issue 102 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: Critical Care PES (Pam Charney) 2. Critical Care NCP results (Jessica Baye) 3. Re: meal rounds (susan) ---------------------------------------------------------------------- Message: 1 Date: Tue, 29 Sep 2009 11:24:51 -0700 From: Pam Charney Subject: Re: [Cnm] Critical Care PES To: Miriam Pappo Cc: cnm at lists.my180.net, jbaye at mail.mcg.edu, SHEPPERN at trinity-health.org Message-ID: Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes No. If that were the case, then you wouldn't be starting tube feedings. Tube feedings are started to address a given problem. In the past, we never really articulated the problem (thus gave away our knowledge to others). We let someone else say what was wrong. So it's naturally a bit difficult to put into words what we always thought or felt or diagnosed. Pam Charney pcharney at mac.com On Sep 29, 2009, at 5:56 AM, Miriam Pappo wrote: > Is anybody against tweaking it a bit and --as the pt has only been NPO > for 1 day writing: > "Aniticipated inadequate oral food/beverage intake d/t inability to > swallowing AEB endotrachial tube in place...(or recent initiation of > ventilator support) ? > > 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 > >>>> "Nancy Shepperly" 09/28/09 3:14 PM >>>> > I would say something like this: > > Inadequate oral food/beverage intake d/t swallowing difficulty AEB > endotrachial tube in place...(or recent initiation of ventilator > support) > However, I'm not sure if this is right, there are probably better ways > to say it. I'd like to see other examples, too. > > Nancy > > Please let me know if there is anything else I can do for you... > > Nancy Shepperly, RD > Battle Creek Health System > 269-660-3891 > > This message may contain confidential information protected by law > through attorney-client privilege or professional peer review/quality > evaluation privilege. It is intended only for the individual or entity > named above. It is prohibited for anyone else to disclose, copy, > distribute or use the contents of this message. If you received this > message in error, please notify the BCHS Privacy/Integrity Office at > privacy_integrity at trinity-health.org or (269) 966-8347. > > > > > >>>> "Jessica Baye" 09/28/2009 2:59 PM >>> > Would anyone be willing to give me a sample PES statement for the > following: > > ICU patient - recently intubated for hypoxia. Well nourished PTA. > OGT > in place. TF not yet started - pending recommendations from RD. > > We have a large trauma center and 48 ICU beds. We really struggle > with > PES statements in this population. Any feedback is appreciated. > > Thanks > 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 > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net ------------------------------ Message: 2 Date: Tue, 29 Sep 2009 14:35:15 -0400 From: "Jessica Baye" Subject: [Cnm] Critical Care NCP results To: Message-ID: <4AC21B23.E045.0010.0 at mail.mcg.edu> Content-Type: text/plain; charset="us-ascii" Increased nutrient needs related to acute phase stress response to trauma as evidenced by decreasing albumin and hyperglycemia" (assuming those conditions are present) Inadequate protein/energy intake r/t patient unable to consume foods orally AEB intubated state Inadequate oral food and beverage intake r/t patient unable to consume foods orally AEB intubated state The related to is always supposed to be something you can do something about. Inadequate oral food and beverage intake r/t intubation status AEB NPO- In my goals I would put <3-5days. OR Chewing and swallowing issues r/t intubation AEB NPO status. Inadequate oral food/beverage intake r/t swallowing difficulty AEB endotrachial tube in place...(or recent initiation of ventilator support) Inadequate oral intake r/t intubated AEB ogt placed, awaiting tube feeding Inadequate protein/energy intake related to intubation as evidence by no nutrition x 2 days Inadequate protein/energy intake related to no nutrition therapy initiated as evidence by pt getting 300 kcal from dextrose and 400 kcal from lipids from IVF/IV Meds. For a while we were using "Inadequate oral food/beverage intake" but realized that was incorrect because the patient was not being offered anything PO. Inadequate protein/energy intake related to delay in initiating enteral feeding as evidenced by <25% of estimated nutritional needs met. (This is the one I used) Inadequate protein/energy intake r/t enteral feeding on hold pending recommendations as evidenced by 0% of estimated nutritional needs met. Thank you to everyone who responded 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 -------------- next part -------------- A non-text attachment was scrubbed... Name: criticall ill ncp.doc Type: application/msword Size: 27136 bytes Desc: not available Url : /pipermail/cnm_lists.my180.net/attachments/20090929/31424f36/attachment-0001.doc ------------------------------ Message: 3 Date: Tue, 29 Sep 2009 11:55:21 -0700 (PDT) From: susan Subject: Re: [Cnm] meal rounds To: Katie Farver Cc: clinical nutrition managers Message-ID: Content-Type: TEXT/PLAIN; charset=US-ASCII; format=flowed Hi all I agree with Katie plus we have never done meal rounds here. susan > We do not require our Dietitians to do meal rounds. Meal Service issues are addressed by the dietetic technicians or the Meal Hosts serving trays. The Foodservice Manager and/or Supervisor can be called in for difficult situations. When the Dietetic Technicians have time, they do meal rounds. > > I would wonder if conducting meal rounds it is a cost-effective use of RD time, unless it was in a managerial role looking for improvement opportunities. > > Also, I was wondering where you work as you don't have that information in your signature line. Could you share? > > Katie Farver RD, CD, CNSD > Director, Clinical Nutrition Services > Department of Hospitality > BWH 68 > Harborview Medical Center > University of Washington Academic Medical Center > > Affiliate Assistant Professor > School of Pharmacy > University of Washington > > 325 Ninth Ave - Box 359790 > Seattle, WA 98104 > > VM: 206-663-4636 > kef at u.washington.edu > Fax: 206-744-8540 > > Priviledged, confidential or patient identifiable information may be contained in this message. This information is meant only for the use of the intended recipients. If you are not the intended receipient, or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission. Instead, please notifiy the send by reply e-mail, and then destroy all copies of the message and any attachments > ----- Original Message ----- > From: Jo Lynn Worden > To: cnm at lists.my180.net > Sent: Monday, September 28, 2009 7:28 PM > Subject: [Cnm] meal rounds > > > How many meal rounds with patients do you require dietitians to complete? > > > > Do the dietitians who may not work much with an "eating population" also participate? i.e. NICU, ICU. > > > > If so, do those dietitians do fewer meal rounds than the others - or do they all do the same based on FTEs. > > > > Thanks, hoping for some replies. > > j > > > > ------------------------------------------------------------------------------ > > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > Susan DeHoog Associate Director Food and Nutrition University of Washington Medical Center BOX 356057 Seattle Washington 98195 (206) 598-4533 email sdehoog at u.washington.edu FAX (206) 598-8105 pager (206)540-8874 ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 34, Issue 102 ************************************ From SDeer at ecommunity.com Thu Oct 1 08:00:45 2009 From: SDeer at ecommunity.com (Deer, Stephanie M) Date: Thu, 1 Oct 2009 11:00:45 -0400 Subject: [Cnm] infection control kitchen audit Message-ID: <7095479F0371FC4C8810CC0E874DD15E01D83931@EXCL06.chi.ecommunity.com> Does any facility work with hospital's infection control nurse to complete a kitchen audit monthly, quarterly, yearly? If so, would you share this audit? I would greatly appreciate any help. Thank you! Stephanie Deer Community Hospitals of Indianapolis Assistant Director of Patient Services 7150 Clearvista Drive Indianapolis, IN 46256 -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/7865f34c/attachment.html From mpappo at montefiore.org Thu Oct 1 08:09:08 2009 From: mpappo at montefiore.org (Miriam Pappo) Date: Thu, 01 Oct 2009 11:09:08 -0400 Subject: [Cnm] Therapeutic Diet Defined (UNCLASSIFIED) Message-ID: I completely understand what you are saying & know that this may be the prevailing opinion, but I disagree. Ensure is therapeutic. But is adding an extra sandwich for wt gain ? I also see a difference between therapeutic and safety and prefs. Where can I get view the new mandates? I may have missed that email. I appreciate it. It's very concerning. 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 >>> "ETCHASON,LAURA" 10/01/09 10:46 AM >>> I agree that some of these are patients preferences, but to me many are still therapeutic. If a pt drinks Ensure in addition to eating, it usually is to maintain wt/gain wt. If the pt did not drink it, then wt maintenance/gain would not happen so to me it is therapeutic. If a pt needs a texture change to chew or swallow better and if there wasn't one, the patient could not eat the food, then to me it is therapeutic. I was taught at a conference that any diet order other than regular was considered therapeutic (including adding any supplements). My example for a pt preference diet is as follows: If a pt does not like salt or salty foods and asks to be on a low Na diet, but does not have any other illnesses that would entail ordering a low Na diet, then it is pt preference. Thank you, Laura Laura A. Etchason, MS, RD, LDN Clinical Nutrition Manager Decatur Memorial Hospital 2300 N. Edward Street Decatur, IL 62526 217-876-5306 (office line and voice mail) 217-876-5305 (fax) 217-876-5301 (general line) lauraf at dmhhs.org Developer, Harmony, Maximizer, Individualization, Belief >>> "Miriam Pappo" 10/1/2009 7:35 AM >>> I agree. In general, texture to me is not therapeutic. Even for pt safety, I do not see it as "therapeutic". 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 >>> "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" 10/01/09 1:44 AM >>> Classification: UNCLASSIFIED Caveats: NONE Karen, I'd look at this as almost a "preference" thing. If the diet order is at one level and you are in essence making it MORE restrictive vs LESS (not taking away the intent of the MD order), I think you are OK. Giving a patient ground meat--that is both therapeutic, and honoring his preferences; ditto w. Ensure or a snack. Unless it contradicts the diet order (eg, giving an extra snack on a calorie controlled diet), I don't see this as a problem. I'd be interested in other opinions, though. Heidi -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karen Higgins Sent: Wednesday, September 30, 2009 11:02 PM To: cnm at lists.my180.net Subject: [Cnm] Therapeutic Diet Defined Upon discussion with my staff about the definition of "Therapeutic Diet " orders, the following questions came up as to what degree are we allowed to make changes without it being considered "Therapeutic Diet" ordering? 1. An elderly patient always eats three small meals with in-between snacks, can we provide this (with appropriate foods that meet the physician-ordered diet) without getting a doctor's order for 6 small meals or between meal snacks? 2. A patient gets hungry between meals and wants a milkshake or snack. If it is not a "medical food supplement/ product", can we provide this (with appropriate foods that meet the physician-ordered diet) without it being considered a "Therapeutic Diet Order" change? 3. A patient drinks Ensure at home, is on a regular diet, and wants it in the hospital. Can we provide it as a patient preference without getting it entered as a physician order? 4. A patient is ordered "2gm Na Diet", has no teeth and always eats ground meat. Can we arrange for ground meat as a patient preference, within a 2gm Na diet restriction, without it being considered a "Therapeutic Diet Order" change to a 2gm Na Mechanical Soft diet? Years ago we used professional judgment as the nutrition expert working with the patient, and made these changes directly in the computer and/or behind the scenes. I then felt there should be a more "Official" process when making these changes so we developed an "Order-writing" protocol/policy to downgrade consistencies, add snacks and/or supplements, in order to have it noted in the physician orders and apparent to all. Now, we are told no changing anything without a physician's order. So can we go back to making these minor changes behind the scenes, and is it enough to have it documented in our notes without it being part of the diet order? HELP - Frustrated In Florida! Karen Higgins Manager, Medical Nutrition Services "The best way to predict the future is to create it!".........Jason Kaufmann The views expressed in this e-mail are the views of the sender and do not necessarily represent the views of University Community Health. This e-mail message and its attachments are for the sole use of the intended recipients. They may contain confidential information or other information subject to legal protection and/or restrictions. If you are not the intended recipient of this message, please do not read, copy, use or disclose this message or its attachments. Please notify the sender by replying to this message and delete or destroy all copies of this message and attachments in all media. Thank you. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Classification: UNCLASSIFIED Caveats: NONE _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An embedded and charset-unspecified text was scrubbed... Name: Miriam Pappo1.vcf Url: /pipermail/cnm_lists.my180.net/attachments/20091001/e2854fc8/attachment.pl From LAURAF at dmhhs.org Thu Oct 1 08:20:51 2009 From: LAURAF at dmhhs.org (ETCHASON,LAURA) Date: Thu, 01 Oct 2009 10:20:51 -0500 Subject: [Cnm] Therapeutic Diet Defined (UNCLASSIFIED) In-Reply-To: References: Message-ID: <4AC48283.21B0.00A0.0@dmhhs.org> I think you have to view the "extra" sandwich as it would apply to your goals. Are you trying to have the patient eat more calories or gain wt? If so, it's therapeutic because it would then be part of your intervention to have food served between meals. If they just want an extra sandwich which does not interfere with any nutrition recommendation, then it's just an extra sandwich. I'll have to get back with you on the conference (it was either a teleconference or a webinar) since it was several months ago and I'm not near my portfolio right now. Thanks, Laura Laura A. Etchason, MS, RD, LDN Clinical Nutrition Manager Decatur Memorial Hospital 2300 N. Edward Street Decatur, IL 62526 217-876-5306 (office line and voice mail) 217-876-5305 (fax) 217-876-5301 (general line) lauraf at dmhhs.org Developer, Harmony, Maximizer, Individualization, Belief >>> "Miriam Pappo" 10/1/2009 10:09 AM >>> I completely understand what you are saying & know that this may be the prevailing opinion, but I disagree. Ensure is therapeutic. But is adding an extra sandwich for wt gain ? I also see a difference between therapeutic and safety and prefs. Where can I get view the new mandates? I may have missed that email. I appreciate it. It's very concerning. 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 >>> "ETCHASON,LAURA" 10/01/09 10:46 AM >>> I agree that some of these are patients preferences, but to me many are still therapeutic. If a pt drinks Ensure in addition to eating, it usually is to maintain wt/gain wt. If the pt did not drink it, then wt maintenance/gain would not happen so to me it is therapeutic. If a pt needs a texture change to chew or swallow better and if there wasn't one, the patient could not eat the food, then to me it is therapeutic. I was taught at a conference that any diet order other than regular was considered therapeutic (including adding any supplements). My example for a pt preference diet is as follows: If a pt does not like salt or salty foods and asks to be on a low Na diet, but does not have any other illnesses that would entail ordering a low Na diet, then it is pt preference. Thank you, Laura Laura A. Etchason, MS, RD, LDN Clinical Nutrition Manager Decatur Memorial Hospital 2300 N. Edward Street Decatur, IL 62526 217-876-5306 (office line and voice mail) 217-876-5305 (fax) 217-876-5301 (general line) lauraf at dmhhs.org Developer, Harmony, Maximizer, Individualization, Belief >>> "Miriam Pappo" 10/1/2009 7:35 AM >>> I agree. In general, texture to me is not therapeutic. Even for pt safety, I do not see it as "therapeutic". 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 >>> "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" 10/01/09 1:44 AM >>> Classification: UNCLASSIFIED Caveats: NONE Karen, I'd look at this as almost a "preference" thing. If the diet order is at one level and you are in essence making it MORE restrictive vs LESS (not taking away the intent of the MD order), I think you are OK. Giving a patient ground meat--that is both therapeutic, and honoring his preferences; ditto w. Ensure or a snack. Unless it contradicts the diet order (eg, giving an extra snack on a calorie controlled diet), I don't see this as a problem. I'd be interested in other opinions, though. Heidi -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karen Higgins Sent: Wednesday, September 30, 2009 11:02 PM To: cnm at lists.my180.net Subject: [Cnm] Therapeutic Diet Defined Upon discussion with my staff about the definition of "Therapeutic Diet " orders, the following questions came up as to what degree are we allowed to make changes without it being considered "Therapeutic Diet" ordering? 1. An elderly patient always eats three small meals with in-between snacks, can we provide this (with appropriate foods that meet the physician-ordered diet) without getting a doctor's order for 6 small meals or between meal snacks? 2. A patient gets hungry between meals and wants a milkshake or snack. If it is not a "medical food supplement/ product", can we provide this (with appropriate foods that meet the physician-ordered diet) without it being considered a "Therapeutic Diet Order" change? 3. A patient drinks Ensure at home, is on a regular diet, and wants it in the hospital. Can we provide it as a patient preference without getting it entered as a physician order? 4. A patient is ordered "2gm Na Diet", has no teeth and always eats ground meat. Can we arrange for ground meat as a patient preference, within a 2gm Na diet restriction, without it being considered a "Therapeutic Diet Order" change to a 2gm Na Mechanical Soft diet? Years ago we used professional judgment as the nutrition expert working with the patient, and made these changes directly in the computer and/or behind the scenes. I then felt there should be a more "Official" process when making these changes so we developed an "Order-writing" protocol/policy to downgrade consistencies, add snacks and/or supplements, in order to have it noted in the physician orders and apparent to all. Now, we are told no changing anything without a physician's order. So can we go back to making these minor changes behind the scenes, and is it enough to have it documented in our notes without it being part of the diet order? HELP - Frustrated In Florida! Karen Higgins Manager, Medical Nutrition Services "The best way to predict the future is to create it!".........Jason Kaufmann The views expressed in this e-mail are the views of the sender and do not necessarily represent the views of University Community Health. This e-mail message and its attachments are for the sole use of the intended recipients. They may contain confidential information or other information subject to legal protection and/or restrictions. If you are not the intended recipient of this message, please do not read, copy, use or disclose this message or its attachments. Please notify the sender by replying to this message and delete or destroy all copies of this message and attachments in all media. Thank you. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Classification: UNCLASSIFIED Caveats: NONE _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/9e87e848/attachment-0001.html From JKrzeminski at Reshealthcare.org Thu Oct 1 08:11:49 2009 From: JKrzeminski at Reshealthcare.org (Krzeminski, Janet) Date: Thu, 1 Oct 2009 10:11:49 -0500 Subject: [Cnm] Full Liquid Diet In-Reply-To: <96B8F4BB7A614F43B33A6397ADCCECC2792034@ahcmascdc020.DS.SJHS.COM> Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F201171F31@rhcexch3.reshealthcare.org> I understand your stance on being evidence-based, however physician-RD relations, and working with Physicians to increase THEIR satisfaction is an ongoing PI here in our System. Outcomes of patients becomes more of a key role in our hospital than studies in certain instances. And procedures that work for improving a patient outcome in conjunction with what the physicians order should be one thing that I would recommend that you look at with perhaps an interdisciplinary team, or with one of your key physicians. Some of my peers in my system created an adjunct to the NCM, including full liquid and clear liquid diets... Janet K Chicago, IL ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of RICAFORT, Christina Sent: Wednesday, September 30, 2009 3:42 PM To: cnm at lists.my180.net Subject: [Cnm] Full Liquid Diet I recently omitted the Full Liquid diet from our menu based on the information in the NCM and the literature addressing this issue. Our surgeons are very angry about not having this available and demands that I explain the whole rationale. I do have the studies to cite but if anyone out there has a better approach to this, please share with me so I can convince them that this is evidence based. Please share your experience as well. Thanks. Hope to hear from you soon. Tina C. Ricafort MA., RD., CD. Manager, Clinical Dietetics Saint John's Health System 2015 Jackson St. Anderson, IN 46016 tcricafo at sjhsnet.org (765)646-8197 (765)646-8780 fax CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/a951cd52/attachment.html From MELLINGTON at wakemed.org Thu Oct 1 08:31:46 2009 From: MELLINGTON at wakemed.org (MARTHA ELLINGTON) Date: Thu, 1 Oct 2009 11:31:46 -0400 Subject: [Cnm] Long term vent patients In-Reply-To: <4AB8DF6F0200002700005D74@iadomvs.nychhc.org> References: <850F6C2F598EF84F8FA5BEF9CC0CC96D03F0B6D7@EXCEBW2K325.msnyuhealth.org> <4AB8DF6F0200002700005D74@iadomvs.nychhc.org> Message-ID: We have several "Step down units" on one medical floor that tend to have Vent patients that are here "just hanging out" until they can be placed in a LTC facility that takes ventilated patients. Naturally they are on tube feedings and have many Dr's involved with their care. These patients can be stable for awhile then (usually on the weekends) something crops up and they want the dietitian to "fix" a problem that can take 2 hours to track down through all the history. You never really get the real story because all the players are not available. My questions are: What is your policy for involvement with patients that are in an acute facility waiting for placement in a LTC for vent patients? If you work in one of these LTC that can take vents, what is your level of involvement? Thanks for any wisdom you can give. 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 dmc209 at yahoo.com Thu Oct 1 10:46:25 2009 From: dmc209 at yahoo.com (Denise Conforti) Date: Thu, 1 Oct 2009 10:46:25 -0700 (PDT) Subject: [Cnm] Recipe Nutrient Analysis software question In-Reply-To: <0DAF44B706E29940A409E32DC69005C007842BFC@exchange1.phoebe.com> Message-ID: <246203.55846.qm@web31910.mail.mud.yahoo.com> Please post...I am also looking for software that does recipe analysis and has food labeling capabilities. I have narrowed the search to Nutribase and Nutritionist Pro Food Labeling software (this is a separate purchase?from the Diet Analysis software). ? Does anyone have experience with the Nutritionist Pro?Food Labeling software??Is it user friendly? Thanks in advance! Denise M. Conforti, MS, RD, LDN Clinical Nutrition Manager Dietetic Internship Director Mount Auburn?Hospital 330 Mount Auburn Street Cambridge, MA 02138 Phone: 617.499.5665 Ext. 3059 Pager: 617.499.5110 Pager 6777 --- On Thu, 10/1/09, Orlowski, Hannah wrote: From: Orlowski, Hannah Subject: Re: [Cnm] Recipe Nutrient Analysis software question To: "Meehan Bonnie" , cnm at lists.my180.net Date: Thursday, October 1, 2009, 8:41 AM Please list to post.? I am also looking. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Meehan Bonnie Sent: Wednesday, September 30, 2009 8:40 PM To: 'cnm at lists.my180.net' Subject: [Cnm] Recipe Nutrient Analysis software question CNM Members, ? For those of you who have researched this topic and/or are using a system that you are happy with, which one would you recommend?? I need to find a system quickly to analyze home and cafeteria recipes and print labels and do not have a lot of time to research it.? I'm not exactly sure what all I need it to do, but think the below is a good start.? If you are not sure about what all the capabilities are of the one you have, just tell me what brand it is and what you like or do not like about it.? What is the advantage of buying one like Nutribase or ESHA versus downloading a free one from the Internet?? If you are familiar with the major brands, which one do you like better? ? Would like one that: --Overall easy to learn and use --Easy input of recipe data --Good reputable database of foods and some brand names --Can expand home sized recipe to accurate institutional sized recipe with quantities applicable to large quantities (like cups?vs. teaspoons) --Can give info on desired serving sizes --Can analyze up to 10 nutrients by normal unit of measure (gm, mg, etc.) and give % DRV based on 2,000 or 2,500 calorie diet --Can print food labels for above nutrients (or just ones you want to see) --Is not cost prohibitive to buy and to maintain up to date database and upgrades --Could work on individual computer or web (if you wanted to expand use of this on a corporate LAN to all employees) --Good customer support --Might include other wellness features--though this part is not necessary ? Many Thanks for whatever guidance you can provide.--Bonnie ? Bonnie Meehan, RD, CD Chief Clinical Dietitian St. Francis Hospital & Health Centers 1600 Albany St. Beech Grove, IN?? 46107 317-782-6007 ? 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. Disclaimer: The HIPAA Final Privacy Rule requires covered entities to safeguard certain Protected Health Information (PHI) related to a person's healthcare. Information being faxed to you may include PHI after appropriate authorization from the patient or under circumstances that do not require patient authorization. You, the recipient, are obligated to maintain PHI in a safe and secure manner. You may not re-disclose without additional patient consent or as required by law. Unauthorized re-disclosure or failure to safeguard PHI could subject you to penalties described in federal (HIPAA) and state law. If you the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, please notify us immediately and destroy the related message. -----Inline Attachment Follows----- _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/c08e7909/attachment.html From ekvalls at ucmail.uc.edu Thu Oct 1 11:15:41 2009 From: ekvalls at ucmail.uc.edu (Ekvall, Shirley (ekvalls)) Date: Thu, 1 Oct 2009 14:15:41 -0400 Subject: [Cnm] Prader Willi In-Reply-To: References: Message-ID: <1C36990389E31A42996A3F73DE5DBE685257C96E24@UCMAILBE2.ad.uc.edu> Please take a look at the chapter on Prader Willi in our book Pediatric Nutrition in Chronic Diseases and Developmentnal Disorders, published by Oxford University Press, www.oup.com. You may find it in the library. I have worked with these clients with very low calorie counts. You need to almost lock the refrigerator and find other activities as they have a ravenous appetite. We also have a 35 credit self study ($89.50) to go with the book. We do have a growth chart for these children in the book too. Good Luck. Let me know if I can be of further help. shirley.ekvall at uc.edu ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Holly Patronik [hpatronik at shorehealth.org] Sent: Thursday, October 01, 2009 9:27 AM To: cnm at lists.my180.net Subject: [Cnm] Prader Willi I have a patient with prader Willi whose MD is requesting 800kcal/day. I'm not familiar with working with this condition - is this a normal recommendation - any suggestions?? Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/7f31973f/attachment.html From ekvalls at ucmail.uc.edu Thu Oct 1 11:21:26 2009 From: ekvalls at ucmail.uc.edu (Ekvall, Shirley (ekvalls)) Date: Thu, 1 Oct 2009 14:21:26 -0400 Subject: [Cnm] pediatric needs In-Reply-To: <9B90EC6A1B880E4A9D9A859E062A04751E8332D2@ex2.bassett.org> References: <20090930011331.ST4WG.215863.root@cdptpa-web04-z02>, <9B90EC6A1B880E4A9D9A859E062A04751E8332D2@ex2.bassett.org> Message-ID: <1C36990389E31A42996A3F73DE5DBE685257C96E25@UCMAILBE2.ad.uc.edu> Please take a look at the chapter and charts on Nutritional Assessment in our book Pediatric Nutrition in Chronic Diseases and Developmental Disorders, published by Oxford University Press, www.oup.com which you may find in your med library. The promotion code for discount is 24095 if ordering it. We also have a 35 ADA credit self study to go along with it. You can contact me for the self study ($89.50) or for both if needed. shirley.ekvall at uc.edu Good Luck ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea [andrea.johnson at bassett.org] Sent: Thursday, October 01, 2009 9:09 AM To: cnm at lists.my180.net Subject: [Cnm] pediatric needs We are small community/teaching hospital and we don't see that many complicated pediatric patients. But we do see a few. What caloric formulations and protein needs are other places using for their pediatric populations? Any help would be most appreciated. Thanks, Andrea Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- NOTICE OF CONFIDENTIALITY This electronic message, including attachments, is for the sole use of the named recipient and may contain confidential or privileged information protected by New York State, and Federal regulations. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. If you are not the intended recipient or have received this communication in error please contact the sender or email.security at bassett.org and destroy all copies of the original message. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/1c9fa022/attachment-0001.html From SLewis at mercycare.org Thu Oct 1 11:36:53 2009 From: SLewis at mercycare.org (Lewis, Suzanne) Date: Thu, 1 Oct 2009 13:36:53 -0500 Subject: [Cnm] Ideal Protein In-Reply-To: <1C36990389E31A42996A3F73DE5DBE685257C96E25@UCMAILBE2.ad.uc.edu> Message-ID: <63A81A57A6254849B538D2FF4F1D539904C5BC82@VS01EXC01.mercycare.org> Has anyone heard of or used the Ideal Protein Diet? Have you seen this offered through hospitals? What have been your experiences with it? Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/19deb0b5/attachment.html From Linda.Bartholomay at meritcare.com Thu Oct 1 11:43:08 2009 From: Linda.Bartholomay at meritcare.com (Linda Bartholomay) Date: Thu, 01 Oct 2009 13:43:08 -0500 Subject: [Cnm] Prader Willi In-Reply-To: References: Message-ID: <4AC4B1EC.309B.00D0.0@meritcare.com> Holly, you may find this to be of help - - especially in dealing with Prader Willi. It is from our Pediatric dietitian - - Dr. Cathy Breedon: Cathy Breedon PhD, RD, CSP, FADA Prenatal/Pediatric Nutrition Specialist Clinical Nutrition Specialist MeritCare Medical Center, Dept. of Pediatrics and Clinical Associate Professor of Pediatrics UND School of Medicine, Fargo, ND http://www.meritcare.com/healtheducation/speakers/cathy_breedon/pdfs/Carnitine.pdf I think this is worth a shot to see if it can help manage the ravenous appetite these patients demonstrate. Linda Bartholomay, LRD Manager, Nutrition Therapy MeritCare Health Systems Linda.Bartholomay at meritcare.com (701) 234-6166 Strengths: Arranger, Ideation, Adaptability, Empathy, Maximizer >>> "Holly Patronik" 10/1/2009 8:27 AM >>> I have a patient with prader Willi whose MD is requesting 800kcal/day. I'm not familiar with working with this condition - is this a normal recommendation - any suggestions?? Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited This e-mail message is intended only for the named recipient(s) above and is covered by the Electronic Communications Privacy Act 18 U.S.C. Section 2510-2521. This e-mail is confidential and may contain information that is privileged or exempt from disclosure under applicable law. If you have received this message in error please immediately notify the sender by return e-mail and delete this e-mail message from your computer. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/39606ed6/attachment.html From JEdwards at hfmhealth.org Thu Oct 1 13:57:46 2009 From: JEdwards at hfmhealth.org (Jeanne Edwards) Date: Thu, 1 Oct 2009 15:57:46 -0500 Subject: [Cnm] Paying for license to use NCP language In-Reply-To: Message-ID: <1E611D0D82010049A4E087DFA59CA442097D84D7@holy1.hfmhealth.com> You do not have to pay for using the NCP language if you handwrite the document. See the response below, from ADA in regards to this question. Jeanne Edwards MS RD Holy Family Memorial Manitowoc WI Jedwards at hfmhealth.org ------------------------------------------------------------ Yes, the $150 annual fee for one hospital grants you permission to use the terms in an EHR, gives you and IT the terms with 15 character abbreviations, 2 IDNT reference manuals, and entitles you to automatic updates with new terms, abbreviations and manuals when the terms are updated. Typing in all of the terms is an option that ADA does not endorse because of the potential for missing or compromised QI data if staff have typos in their notes and lost staff time, much greater than $150 (> 11 hours per year per one FTE dietitian to type eight diagnosis statements per day). Handwritten/paper documentation does not require a license. Donna onna G. Pertel, MEd, RD - American Dietetic Association - NCP Business Manager and Consultant - ncpslpermissions at eatright.org - 203-314-9462 - 312-899-5344 fax ----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Heberle, Heather N. Sent: Tuesday, September 22, 2009 11:24 AM To: cnm at lists.my180.net Subject: Re: [Cnm] Cnm Digest, Vol 34, Issue 74 You must have the licensure approved/paid for to use the language whether or not you have an EMR or not. Go to the www.eatright.org and it is all under the NCP tab on the left. The licensure cost $150 per year per facility. Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 ________________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of cnm-request at lists.my180.net [cnm-request at lists.my180.net] Sent: Tuesday, September 22, 2009 11:16 AM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 34, Issue 74 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. NCP (Leslie Collier) 2. Food Allergies (Kaskel, Phyllis) 3. Re: NCP (Hollie_Colle at ssmhc.com) 4. Re: NCP (UNCLASSIFIED) (Clark, Heidi L MAJ MIL USAF MEDCOM LRMC) 5. Re: NCP (UNCLASSIFIED) (Clark, Heidi L MAJ MIL USAF MEDCOM LRMC) 6. Re: NCP (UNCLASSIFIED) (Pam Charney) 7. cyclic parenteral nutrition (Cece Ohmart) 8. Formula Preparation Room Staffing and Productivity (Sue Teske) ---------------------------------------------------------------------- Message: 1 Date: Tue, 22 Sep 2009 09:49:52 -0500 From: "Leslie Collier" Subject: [Cnm] NCP To: Message-ID: <1BA09AF1C1B5E5499D62240E020C24760162AF16 at MMHEVS1.mmh.local> Content-Type: text/plain; charset="us-ascii" Hi all...were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood...I can't believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090922/1507b27a/attachment- 0001.html ------------------------------ Message: 2 Date: Tue, 22 Sep 2009 10:55:13 -0400 From: "Kaskel, Phyllis" Subject: [Cnm] Food Allergies To: Message-ID: <850F6C2F598EF84F8FA5BEF9CC0CC96D03F0B6D7 at EXCEBW2K325.msnyuhealth.org> Content-Type: text/plain; charset="us-ascii" Does anyone have a Food Allergy policy they would be willing to share? Thanks. P Phyllis Kaskel, MA, RD, CDN Director, Clinical Nutrition Mount Sinai Hospital and Faculty, Department of Preventive Medicine Mount Sinai School of Medicine ------------------------------ Message: 3 Date: Tue, 22 Sep 2009 09:59:20 -0500 From: Hollie_Colle at ssmhc.com Subject: Re: [Cnm] NCP To: "Leslie Collier" Cc: cnm at lists.my180.net, cnm-bounces at lists.my180.net Message-ID: Content-Type: text/plain; charset="iso-8859-1" I didn't know we had to pay. I just thought you had to buy the IDNT standardized lang. book. How do you pay? Is there a contract? Hollie Colle, MS, RD, LDN Clinical Nutrition Manager St. Mary's Good Samaritan, Inc. Mount Vernon IL 62864 (618) 241-2356 Centralia IL 62801 (618) 436-8897 "Leslie Collier" Sent by: cnm-bounces at lists.my180.net 09/22/2009 09:49 AM To cc Subject [Cnm] NCP Hi all?were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood?I can?t believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" _______________________________________________ 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 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 email and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090922/d10fe9d2/attachment- 0001.html ------------------------------ Message: 4 Date: Tue, 22 Sep 2009 16:59:32 +0200 From: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" Subject: Re: [Cnm] NCP (UNCLASSIFIED) To: "Leslie Collier" , Message-ID: <9AB53CB10B46784794F4F6D3AD82344F2F6EA9 at AMEDERMCBE041.eur.amed.ds.army.m il> Content-Type: text/plain; charset="us-ascii" Classification: UNCLASSIFIED Caveats: NONE Oh, no--you did not misunderstand at all. The language is copyrighted and ADA has put out guidance for single users, or those who use an electronic medical record--putting the onus on the EMR company to get permission from them, same way that they may get permission from the AMA for using other specific language. This is the link: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/governance_13838_ENU_HTM L.htm (scroll down to the very bottom--has some FAQ's, more than they used to several months ago, when it was just a form to fill out and then they'd tell you how much you owe) I have a TON of comments--already sent my editorial letter to the ADA, and got a nice response telling me that they didn't have enough $$ to manage the NCP language/do updates/etc w/o charging for it's use; and they wanted to manage who used it. I understand the idea of intellectual property, and also the idea of managing who uses the language (don't want Jane "nutritionist" and Joe chiropractor using the NCP...), but this seems onerous. It's like the proposed soda-pop tax only in reverse--let's charge people extra who want to do the right thing! Sorry, I have several soap boxes and this is one of them. Heidi Clark, MS, RD Landstuhl Regional Medical Center -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Leslie Collier Sent: Tuesday, September 22, 2009 4:50 PM To: cnm at lists.my180.net Subject: [Cnm] NCP Hi all...were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood...I can't believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" Classification: UNCLASSIFIED Caveats: NONE ------------------------------ Message: 5 Date: Tue, 22 Sep 2009 17:03:19 +0200 From: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" Subject: Re: [Cnm] NCP (UNCLASSIFIED) To: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" , "Leslie Collier" , Message-ID: <9AB53CB10B46784794F4F6D3AD82344F2F6EAC at AMEDERMCBE041.eur.amed.ds.army.m il> Content-Type: text/plain; charset="us-ascii" Classification: UNCLASSIFIED Caveats: NONE I should clarify--my understanding is that it is when you use the NCP language in an electronic medical record (eg, drop downs or check boxes or electronic algorithms). We have an EMR at my facility, and have a specific nutrition note, but we free text in all the language. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Clark, Heidi L MAJ MIL USAF MEDCOM LRMC Sent: Tuesday, September 22, 2009 5:00 PM To: Leslie Collier; cnm at lists.my180.net Subject: Re: [Cnm] NCP (UNCLASSIFIED) Classification: UNCLASSIFIED Caveats: NONE Oh, no--you did not misunderstand at all. The language is copyrighted and ADA has put out guidance for single users, or those who use an electronic medical record--putting the onus on the EMR company to get permission from them, same way that they may get permission from the AMA for using other specific language. This is the link: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/governance_13838_ENU_HTM L.htm (scroll down to the very bottom--has some FAQ's, more than they used to several months ago, when it was just a form to fill out and then they'd tell you how much you owe) I have a TON of comments--already sent my editorial letter to the ADA, and got a nice response telling me that they didn't have enough $$ to manage the NCP language/do updates/etc w/o charging for it's use; and they wanted to manage who used it. I understand the idea of intellectual property, and also the idea of managing who uses the language (don't want Jane "nutritionist" and Joe chiropractor using the NCP...), but this seems onerous. It's like the proposed soda-pop tax only in reverse--let's charge people extra who want to do the right thing! Sorry, I have several soap boxes and this is one of them. Heidi Clark, MS, RD Landstuhl Regional Medical Center -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Leslie Collier Sent: Tuesday, September 22, 2009 4:50 PM To: cnm at lists.my180.net Subject: [Cnm] NCP Hi all...were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood...I can't believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" Classification: UNCLASSIFIED Caveats: NONE _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Classification: UNCLASSIFIED Caveats: NONE ------------------------------ Message: 6 Date: Tue, 22 Sep 2009 08:40:22 -0700 From: Pam Charney Subject: Re: [Cnm] NCP (UNCLASSIFIED) To: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" Cc: cnm at lists.my180.net Message-ID: <4012A0A2-4450-4437-A299-8F43A3643824 at mac.com> Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes There is much misunderstanding regarding the licensing fees for the terminology. It is correct that there is no fee associated with using a care process. Let's remember that the NCP and the terminology are two separate and distinct entities. Any care process is simply a structured way of thinking; it'd be hard to license thinking. There are licensing fees for using the terminology in a proprietary electronic system. This is the same thing as the fee you pay to install most software (non share ware) on your computer. I'm sure we're all aware that we are not purchasing the code for that software. We are buying the right to install and use the software. That's why some programs allow "multi-user" options. You install the same software on a designated number of computers based on the number of licenses you have purchased. There are many healthcare terminologies that have associated licensing fees. Most EMR vendors are now using a reference terminology known as SNOMED, which includes terms from many different terminologies, including several that have licensing fees. Therefore, when the vendor uses SNOMED, the fees are paid somewhere else down the line so the purchaser of the EMR product doesn't see the bill for the licenses. It is worth the small amount for the license to have the terminology included in your database. Free text does not allow for accurate, reliable capture of the work of dietetics. I"d be happy to answer other questions regarding terminology and the EMR offline. I'm sure the folks at ADA can answer other questions specific to the IDNT. Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 22, 2009, at 8:03 AM, Clark, Heidi L MAJ MIL USAF MEDCOM LRMC wrote: > Classification: UNCLASSIFIED > Caveats: NONE > > I should clarify--my understanding is that it is when you use the NCP > language in an electronic medical record (eg, drop downs or check > boxes or electronic algorithms). We have an EMR at my facility, and > have a specific nutrition note, but we free text in all the language. > > -----Original Message----- > From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] > On Behalf Of Clark, Heidi L MAJ MIL USAF MEDCOM LRMC > Sent: Tuesday, September 22, 2009 5:00 PM > To: Leslie Collier; cnm at lists.my180.net > Subject: Re: [Cnm] NCP (UNCLASSIFIED) > > Classification: UNCLASSIFIED > Caveats: NONE > > Oh, no--you did not misunderstand at all. The language is copyrighted > and ADA has put out guidance for single users, or those who use an > electronic medical record--putting the onus on the EMR company to get > permission from them, same way that they may get permission from the > AMA for using other specific language. This is the link: > > http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/governance_13838_ENU_HTM > L.htm (scroll down to the very bottom--has some FAQ's, more than > they > used to several months ago, when it was just a form to fill out and > then they'd tell you how much you owe) > > I have a TON of comments--already sent my editorial letter to the ADA, > and got a nice response telling me that they didn't have enough $$ to > manage the NCP language/do updates/etc w/o charging for it's use; and > they wanted to manage who used it. I understand the idea of > intellectual property, and also the idea of managing who uses the > language (don't want Jane "nutritionist" and Joe chiropractor using > the NCP...), but this seems onerous. It's like the proposed soda-pop > tax only in reverse--let's charge people extra who want to do the > right thing! > > Sorry, I have several soap boxes and this is one of them. > > Heidi Clark, MS, RD > Landstuhl Regional Medical Center > > -----Original Message----- > From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] > On Behalf Of Leslie Collier > Sent: Tuesday, September 22, 2009 4:50 PM > To: cnm at lists.my180.net > Subject: [Cnm] NCP > > Hi all...were you all aware that we have to PAY to use the NCP for > charting!?! Please tell me I have misunderstood...I can't believe > that we are being encouraged to use standardized language and then > have to PAY to do so. Anyone have any comments? > > > > Leslie Collier, RD/LD > > Clinical Nutrition Manager > > Midland Memorial Hospital > > 2200 West Illinois > > Midland, TX 79701 > > > > leslie.collier at midland-memorial.com > > > > > (432) 685-4206 > > (432) 685-6991 (fax) > > (432) 742-0087 (pager) > > > > "Dance like no one is watching, eat like someone is!" > > > > Classification: UNCLASSIFIED > Caveats: NONE > > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > Classification: UNCLASSIFIED > Caveats: NONE > > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net ------------------------------ Message: 7 Date: Tue, 22 Sep 2009 11:46:20 -0400 (EDT) From: Cece Ohmart Subject: [Cnm] cyclic parenteral nutrition To: cnm at lists.my180.net Message-ID: <20090922114620.AGN30918 at mail.mainehospital.org> Content-Type: text/plain; charset=ISO-8859-1 Hi, Does anyone have a policy/procedure regarding cyclic parenteral nutrition? Thanks, Cece This message is intended for the use of the addressee only and may contain information that is privileged and confidential. If you are not the intended recipient of this message, be notified that any dissemination or use of this message is strictly prohibited. Un-intended transmission does not constitute waiver of attorney-client privilege or any other privilege. If you have received this message in error, please delete all copies of the message and its attachments and notify the sender immediately. Thank you. ------------------------------ Message: 8 Date: Tue, 22 Sep 2009 11:18:45 -0500 From: "Sue Teske" Subject: [Cnm] Formula Preparation Room Staffing and Productivity To: "Clinical List" Message-ID: <3D0B6F497247834CAC5FF0C30ED7A5C402495864 at chexmain.chsys.org> Content-Type: text/plain; charset="us-ascii" As part of a group that is working on updating the ADA publication "Infant Feedings: Guidelines for Preparation of Formula dn Breastmilk in Health Care Facilities", I would greatly appreciate your participation in this survey. 1. Do you have a formula preparation room? 2. How many patient care units are served by formula room? a. Number of beds per patient care unit? 3. What is the estimated average distance (for the delivery of feedings) from the formula room to the patient care units served by the formula room? 4. How many deliveries are made each day from the formula room? a. Batch deliveries b. Single order deliveries (e.g.: new, prn or stat) 5. Who delivers the formula? a. Formula room staff b. Central transportation staff c. Other (please specify): ___________________ 6. What are the hours of operation of the formula room? 7. How many FTEs are dedicated to the formula room? a. Formula techs b. Direct supervision c. Other (please specify): ___________________ 8. How many units of formula are produced per day (average)? a. Bulk supply (24h volume in bulk containers) b. Unit dose 9. How many units of ready-to-use formula (closed systems or rtf formula bottles) are dispensed per day (average) from the formula room? 10. What other duties are assigned (e.g.: cleaning of formula refrigeration/freezers, inventory control/ordering supplies, monitor refrigerator temperatures, etc.) to the employees who staff the formula room? 11. Do you have a separate breastmilk bank or area for dispensing/preparation of breastmilk? a. If yes, who staffs that area? b. How many FTEs are dedicated to the breastmilk bank/preparation room? c. How many units of breastmilk are dispensed per day? d. How many units of breastmilk are prepared with the addition of a fortifier or other additive? i. Bulk supply (24h volume in bulk containers) ii. Unit dose 12. How do you measure the productivity of your formula room staff? Thank you for your time! Susan C. Teske, MS, RD, LD, CNSD Director, Dept. of Clinical Nutrition and Lactation Services Children's Health System 1600 7th Ave. South 3rd Floor hospital, Room 334 Birmingham, AL 35233 (205) 939-9203 Office (205) 939-6047 Fax susan.teske at chsys.org Confidentiality Notice: The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material. Any review, retransmission dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. 20090416 -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090922/0dae8f82/attachment. html ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 34, Issue 74 *********************************** _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From TTaylor at dmc-sp.org Thu Oct 1 16:01:37 2009 From: TTaylor at dmc-sp.org (Taylor, Tracy) Date: Thu, 1 Oct 2009 16:01:37 -0700 Subject: [Cnm] Full Liquid Diet References: Message-ID: <222E81132BE3E54584CB9A5DB1CDD7E280DE0D@bks-emx001.dmc-sp.org> Mt version of the NCM has a full liquid diet: Indications The traditional indication for the full liquid diet is for short term use as a transition step between the clear liquid and soft diets following gastrointestinal surgery I don't remember this on the previous NCM version we had and at that time we toyed with idea of omitting, but to keep our customers, in this case the surgeons, satisfied we left it in as an addendum. And now we have it on the online version as well. best Tracy Tracy Taylor RD, CDE Director: Diabetes Management/Outpatient Nutrition Programs Clinical Nutrition Manager Doctors Medical Center San Pablo 2000 Vale Rd San Pablo, CA 94806 phone: 510-970-5344 fax: 510-970-5739 email: ttaylor at dmc-sp.org CONFIDENTIAL AND PRIVILEGED: May contain materials protected by law. This communication contains information intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged and/or confidential. If you are not the intended recipient or an employee or agent responsible for delivering the communication to the intended recipient, you are hereby notified that any disclosure, copying, distribution, or use of its contents is prohibited. If you have received this communication in error, please notify me immediately by telephone at (510) 970-5344, return the original communication by reply e-mail, and permanently delete the communication from your system. Thank you. "A year from now you will wish you had started today." --Karen Lamb -----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: Thursday, October 01, 2009 11:19 AM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 4 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: Full Liquid Diet (Krzeminski, Janet) 2. Long term vent patients (MARTHA ELLINGTON) 3. Re: Recipe Nutrient Analysis software question (Denise Conforti) 4. Re: Prader Willi (Ekvall, Shirley (ekvalls)) 5. Re: pediatric needs (Ekvall, Shirley (ekvalls)) ---------------------------------------------------------------------- Message: 1 Date: Thu, 1 Oct 2009 10:11:49 -0500 From: "Krzeminski, Janet" Subject: Re: [Cnm] Full Liquid Diet To: "RICAFORT, Christina" , Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F201171F31 at rhcexch3.reshealthcare.org> Content-Type: text/plain; charset="us-ascii" I understand your stance on being evidence-based, however physician-RD relations, and working with Physicians to increase THEIR satisfaction is an ongoing PI here in our System. Outcomes of patients becomes more of a key role in our hospital than studies in certain instances. And procedures that work for improving a patient outcome in conjunction with what the physicians order should be one thing that I would recommend that you look at with perhaps an interdisciplinary team, or with one of your key physicians. Some of my peers in my system created an adjunct to the NCM, including full liquid and clear liquid diets... Janet K Chicago, IL ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of RICAFORT, Christina Sent: Wednesday, September 30, 2009 3:42 PM To: cnm at lists.my180.net Subject: [Cnm] Full Liquid Diet I recently omitted the Full Liquid diet from our menu based on the information in the NCM and the literature addressing this issue. Our surgeons are very angry about not having this available and demands that I explain the whole rationale. I do have the studies to cite but if anyone out there has a better approach to this, please share with me so I can convince them that this is evidence based. Please share your experience as well. Thanks. Hope to hear from you soon. Tina C. Ricafort MA., RD., CD. Manager, Clinical Dietetics Saint John's Health System 2015 Jackson St. Anderson, IN 46016 tcricafo at sjhsnet.org (765)646-8197 (765)646-8780 fax CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/a951cd52/attachment- 0001.html ------------------------------ Message: 2 Date: Thu, 1 Oct 2009 11:31:46 -0400 From: MARTHA ELLINGTON Subject: [Cnm] Long term vent patients To: "cnm at lists.my180.net" Message-ID: Content-Type: text/plain; charset="us-ascii" We have several "Step down units" on one medical floor that tend to have Vent patients that are here "just hanging out" until they can be placed in a LTC facility that takes ventilated patients. Naturally they are on tube feedings and have many Dr's involved with their care. These patients can be stable for awhile then (usually on the weekends) something crops up and they want the dietitian to "fix" a problem that can take 2 hours to track down through all the history. You never really get the real story because all the players are not available. My questions are: What is your policy for involvement with patients that are in an acute facility waiting for placement in a LTC for vent patients? If you work in one of these LTC that can take vents, what is your level of involvement? Thanks for any wisdom you can give. 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 ------------------------------ Message: 3 Date: Thu, 1 Oct 2009 10:46:25 -0700 (PDT) From: Denise Conforti Subject: Re: [Cnm] Recipe Nutrient Analysis software question To: cnm at lists.my180.net Message-ID: <246203.55846.qm at web31910.mail.mud.yahoo.com> Content-Type: text/plain; charset="iso-8859-1" Please post...I am also looking for software that does recipe analysis and has food labeling capabilities. I have narrowed the search to Nutribase and Nutritionist Pro Food Labeling software (this is a separate purchase?from the Diet Analysis software). ? Does anyone have experience with the Nutritionist Pro?Food Labeling software??Is it user friendly? Thanks in advance! Denise M. Conforti, MS, RD, LDN Clinical Nutrition Manager Dietetic Internship Director Mount Auburn?Hospital 330 Mount Auburn Street Cambridge, MA 02138 Phone: 617.499.5665 Ext. 3059 Pager: 617.499.5110 Pager 6777 --- On Thu, 10/1/09, Orlowski, Hannah wrote: From: Orlowski, Hannah Subject: Re: [Cnm] Recipe Nutrient Analysis software question To: "Meehan Bonnie" , cnm at lists.my180.net Date: Thursday, October 1, 2009, 8:41 AM Please list to post.? I am also looking. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Meehan Bonnie Sent: Wednesday, September 30, 2009 8:40 PM To: 'cnm at lists.my180.net' Subject: [Cnm] Recipe Nutrient Analysis software question CNM Members, ? For those of you who have researched this topic and/or are using a system that you are happy with, which one would you recommend?? I need to find a system quickly to analyze home and cafeteria recipes and print labels and do not have a lot of time to research it.? I'm not exactly sure what all I need it to do, but think the below is a good start.? If you are not sure about what all the capabilities are of the one you have, just tell me what brand it is and what you like or do not like about it.? What is the advantage of buying one like Nutribase or ESHA versus downloading a free one from the Internet?? If you are familiar with the major brands, which one do you like better? ? Would like one that: --Overall easy to learn and use --Easy input of recipe data --Good reputable database of foods and some brand names --Can expand home sized recipe to accurate institutional sized recipe with quantities applicable to large quantities (like cups?vs. teaspoons) --Can give info on desired serving sizes --Can analyze up to 10 nutrients by normal unit of measure (gm, mg, etc.) and give % DRV based on 2,000 or 2,500 calorie diet --Can print food labels for above nutrients (or just ones you want to see) --Is not cost prohibitive to buy and to maintain up to date database and upgrades --Could work on individual computer or web (if you wanted to expand use of this on a corporate LAN to all employees) --Good customer support --Might include other wellness features--though this part is not necessary ? Many Thanks for whatever guidance you can provide.--Bonnie ? Bonnie Meehan, RD, CD Chief Clinical Dietitian St. Francis Hospital & Health Centers 1600 Albany St. Beech Grove, IN?? 46107 317-782-6007 ? 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. Disclaimer: The HIPAA Final Privacy Rule requires covered entities to safeguard certain Protected Health Information (PHI) related to a person's healthcare. Information being faxed to you may include PHI after appropriate authorization from the patient or under circumstances that do not require patient authorization. You, the recipient, are obligated to maintain PHI in a safe and secure manner. You may not re-disclose without additional patient consent or as required by law. Unauthorized re-disclosure or failure to safeguard PHI could subject you to penalties described in federal (HIPAA) and state law. If you the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, please notify us immediately and destroy the related message. -----Inline Attachment Follows----- _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/c08e7909/attachment- 0001.html ------------------------------ Message: 4 Date: Thu, 1 Oct 2009 14:15:41 -0400 From: "Ekvall, Shirley (ekvalls)" Subject: Re: [Cnm] Prader Willi To: Holly Patronik , "cnm at lists.my180.net" Message-ID: <1C36990389E31A42996A3F73DE5DBE685257C96E24 at UCMAILBE2.ad.uc.edu> Content-Type: text/plain; charset="iso-8859-1" Please take a look at the chapter on Prader Willi in our book Pediatric Nutrition in Chronic Diseases and Developmentnal Disorders, published by Oxford University Press, www.oup.com. You may find it in the library. I have worked with these clients with very low calorie counts. You need to almost lock the refrigerator and find other activities as they have a ravenous appetite. We also have a 35 credit self study ($89.50) to go with the book. We do have a growth chart for these children in the book too. Good Luck. Let me know if I can be of further help. shirley.ekvall at uc.edu ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Holly Patronik [hpatronik at shorehealth.org] Sent: Thursday, October 01, 2009 9:27 AM To: cnm at lists.my180.net Subject: [Cnm] Prader Willi I have a patient with prader Willi whose MD is requesting 800kcal/day. I'm not familiar with working with this condition - is this a normal recommendation - any suggestions?? Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/7f31973f/attachment- 0001.html ------------------------------ Message: 5 Date: Thu, 1 Oct 2009 14:21:26 -0400 From: "Ekvall, Shirley (ekvalls)" Subject: Re: [Cnm] pediatric needs To: "Johnson, Andrea" , "cnm at lists.my180.net" Message-ID: <1C36990389E31A42996A3F73DE5DBE685257C96E25 at UCMAILBE2.ad.uc.edu> Content-Type: text/plain; charset="iso-8859-1" Please take a look at the chapter and charts on Nutritional Assessment in our book Pediatric Nutrition in Chronic Diseases and Developmental Disorders, published by Oxford University Press, www.oup.com which you may find in your med library. The promotion code for discount is 24095 if ordering it. We also have a 35 ADA credit self study to go along with it. You can contact me for the self study ($89.50) or for both if needed. shirley.ekvall at uc.edu Good Luck ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea [andrea.johnson at bassett.org] Sent: Thursday, October 01, 2009 9:09 AM To: cnm at lists.my180.net Subject: [Cnm] pediatric needs We are small community/teaching hospital and we don't see that many complicated pediatric patients. But we do see a few. What caloric formulations and protein needs are other places using for their pediatric populations? Any help would be most appreciated. Thanks, Andrea Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- NOTICE OF CONFIDENTIALITY This electronic message, including attachments, is for the sole use of the named recipient and may contain confidential or privileged information protected by New York State, and Federal regulations. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. If you are not the intended recipient or have received this communication in error please contact the sender or email.security at bassett.org and destroy all copies of the original message. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/1c9fa022/attachment. html ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 4 ********************************** From Sandra.Miller at CHW.edu Thu Oct 1 17:20:26 2009 From: Sandra.Miller at CHW.edu (Miller, Sandra - MMC) Date: Thu, 1 Oct 2009 17:20:26 -0700 Subject: [Cnm] PES Statements In-Reply-To: <924902E5-2E8C-4C0D-B3B9-5E5610B5AA1E@mac.com> References: <77A34688299A4A75AA616D9A0DC2A011@universi33f5a5> <7E3C6171-10E3-485B-A363-5D5D8B33F732@mac.com> <924902E5-2E8C-4C0D-B3B9-5E5610B5AA1E@mac.com> Message-ID: <607AD24EFC85B14B956CF6AAA4F0E188061A7881FA@chw-msg-824.chw.edu> Nice to see we are all trying to incorporate correct terminology into our PES statements. So I have a question to post How do you determine what is better to use in an acute care case: inadequate food and beverage versus Inadequate protein- energy? I have been using protein -energy because I feel I can not monitor food groups in the hospital very well as I mainly have to rely on % intake recorded by the nursing staff of that I have no idea - only the meat, balanced intake. etc.Is this thinking correct? Sandra Miller MS, RD, CDE Clinical Nutrition Manager French Hospital Medical Center email: sandra.miller at chw.edu Phone: (805) 542-6229 ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Pam Charney Sent: Wednesday, September 30, 2009 8:17 AM To: JulieRambo Cc: Aida Miles; cnm at lists.my180.net Subject: Re: [Cnm] PES statement for ICU patient Unfortunately, in the case described, there is no problem with GI function. You just can't get to the GI tract due to the endotracheal tube. Altered GI function would not be the correct nutrition diagnosis unless there is some underlying condition that was not divulged in the history given to us. The etiology you describe here, "only 500 kcal per day" points to not getting enough of some important nutrient, thus inadequate intake of something. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 29, 2009, at 5:12 PM, JulieRambo wrote: I use : Altered GI function (NC-1.4) related to intubation as evidenced by only 500 calories per day (interject whatever calories from Diprivan and/or D5). This sets up the goal: to meet est needs (where I specify calorie, protein and fluid needs) and then the intervention to initiate TF via OGT (specify formula and rate). Goal is met when nutrition plan of care is implemented by the LIP. Julie Rambo, MSRDLD From: Pam Charney Sent: Tuesday, September 29, 2009 2:23 PM To: Aida Miles Cc: cnm at lists.my180.net Subject: Re: [Cnm] PES statement for ICU patient See below p Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 29, 2009, at 5:39 AM, Aida Miles wrote: Pam and other experts, Could you elaborate a little bit more on the PES statement and, perhaps, help some of us learn the process through this example? This is the PES statement suggested: Inadequate oral food/beverage intake d/t swallowing difficulty AEB endotrachial tube in place...(or recent initiation of ventilator support) Here the etiology is: swallowing difficulty I would disagree. There's nothing to tell me that the patient has an intrinsic, pathophysiologic problem with swallowing. Having a tube in one's throat does indeed create a problem with swallowing food, but not with the swallow mechanism itself. And the signs/symptoms are: endotrachial tube in place (or recent initiation of ventilator support)Also I would disagree. The whole NCP/P-E-S thing makes more sense if the S relates directly to the P. Therefore if you diagnose an intake problem the S should say how bad intake is. In this case, the patient is NPO, I'm assuming. Then the S might say "NPO" or current intake <25% estimated requirements" or how ever you usually communicate that calculation. My understanding is that your Intervention is geared toward the etiology (if possible). If that is true, I would feel stuck trying to "intervene" on swallowing difficulty. Personally I might have said "inability to eat/swallow", and then my intervention would be to start the tube feeding. Is this OK???? I like this much better. Maybe "inability to eat". You don't have to say much more. Everyone who walks into the unit can see that big old endotrachial tube. Can't miss it! Then Monitoring and Evaluation are geared toward the signs and symptoms (if possible). I don't think I want to monitor or evaluate an endotrachial tube or initiation of vent support.... I would evaluate tolerance to tube feedings, reaching goal calories, nutrients, etc. So, could the signs/symptoms be something like "patient being NPO"... or something like that? See above. YOu're one step ahead of me here. I am wondering if I am being too "literal" here. No, you're using critical thinking and common sense. That's a great combination! Also, looking at the IDNT Second edition - The Definition, Etiology and Signs and Symptoms for "Inadequate Food and Beverage Intake" (pages 218-219) do not state (that I can find) that this term can be used for an intubated patient, but it seems to fit. Is this the type of feedback the committee would want (to include this in the etiology/ signs and symptoms) in future editions? Just because it's not there doesn't mean you can't use it. The text cannot include a comprehensive list of all possible etiologies. The ones there are suggestions! I don't know if I am "over-thinking" the NCP, but I thought this would be a perfect opportunity for some of us to hear from true experts and learn! :) Aida Aida Miles, MMSc, RD, CSP, LD Director, Coordinated Masters Program in Nutrition University of Minnesota School of Public Health, Epidemiology & Community Health 1300 South Second Street, Suite 300 Minneapolis, MN 55454 612-625-5865 (voice mail) 651-829-0660 (cell) miles081 at umn.edu -----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, September 28, 2009 6:19 PM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 34, Issue 97 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: Critical Care PES (Nancy Shepperly) 2. Re: Critical Care PES (Pam Charney) 3. TF question (Holly Patronik) 4. Re: Prealbumin as predictor of clinical malnutrition? (Greenwaldt, Heidi J) ---------------------------------------------------------------------- Message: 1 Date: Mon, 28 Sep 2009 15:14:24 -0400 From: "Nancy Shepperly" > Subject: Re: [Cnm] Critical Care PES To: >,"Jessica Baye" > Message-ID: <4AC0D2CF.204A.000F.0 at trinity-health.org> Content-Type: text/plain; charset=US-ASCII I would say something like this: Inadequate oral food/beverage intake d/t swallowing difficulty AEB endotrachial tube in place...(or recent initiation of ventilator support) However, I'm not sure if this is right, there are probably better ways to say it. I'd like to see other examples, too. Nancy Please let me know if there is anything else I can do for you... Nancy Shepperly, RD Battle Creek Health System 269-660-3891 This message may contain confidential information protected by law through attorney-client privilege or professional peer review/quality evaluation privilege. It is intended only for the individual or entity named above. It is prohibited for anyone else to disclose, copy, distribute or use the contents of this message. If you received this message in error, please notify the BCHS Privacy/Integrity Office atprivacy_integrity at trinity-health.org or (269) 966-8347. >>> "Jessica Baye" > 09/28/2009 2:59 PM >>> Would anyone be willing to give me a sample PES statement for the following: ICU patient - recently intubated for hypoxia. Well nourished PTA. OGT in place. TF not yet started - pending recommendations from RD. We have a large trauma center and 48 ICU beds. We really struggle with PES statements in this population. Any feedback is appreciated. Thanks 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: 2 Date: Mon, 28 Sep 2009 12:22:50 -0700 From: Pam Charney > Subject: Re: [Cnm] Critical Care PES To: Nancy Shepperly > Cc: cnm at lists.my180.net, Jessica Baye > Message-ID: <120CF810-78F3-4D87-94D0-EC06ABCA9096 at mac.com> Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes Since each patient is different, it would be impossible to craft one nutrition diagnosis that fits all. However, in many cases Nancy's diagnosis of inadequate oral food/beverage intake might fit, depending on the patient and the surrounding circumstances. The etiology and signs/symptoms would depend on the situation facing the clinician. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 28, 2009, at 12:14 PM, Nancy Shepperly wrote: > I would say something like this: > > Inadequate oral food/beverage intake d/t swallowing difficulty AEB > endotrachial tube in place...(or recent initiation of ventilator > support) > However, I'm not sure if this is right, there are probably better > ways to say it. I'd like to see other examples, too. > > Nancy > > Please let me know if there is anything else I can do for you... > > Nancy Shepperly, RD > Battle Creek Health System > 269-660-3891 > > This message may contain confidential information protected by law > through attorney-client privilege or professional peer review/ > quality evaluation privilege. It is intended only for the individual > or entity named above. It is prohibited for anyone else to disclose, > copy, distribute or use the contents of this message. If you > received this message in error, please notify the BCHS Privacy/ > Integrity Office at privacy_integrity at trinity-health.org or (269) > 966-8347. > > > > > >>>> "Jessica Baye" > 09/28/2009 2:59 PM >>> > Would anyone be willing to give me a sample PES statement for the > following: > > ICU patient - recently intubated for hypoxia. Well nourished PTA. > OGT in place. TF not yet started - pending recommendations from RD. > > We have a large trauma center and 48 ICU beds. We really struggle > with PES statements in this population. Any feedback is appreciated. > > Thanks > 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 ------------------------------ Message: 3 Date: Mon, 28 Sep 2009 16:26:44 -0400 From: "Holly Patronik" > Subject: [Cnm] TF question To: > Message-ID: > Content-Type: text/plain; charset="us-ascii" The Manager of our ICU asked me today if there was type of protocol we could initiate for TF patients in the ICU. She feels that the diarrhea r/t tf necessitates too many rectal tubes. Was wondering what others are doing to prevent diarrhea in TF patients and if you have any type of protocol for use of lacto bacillus type products?? She didn't buy the thought that TF aren't the cause of the diarrhea. Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090928/440c03ac/attachment-0001.html ------------------------------ Message: 4 Date: Wed, 23 Sep 2009 15:47:23 -0500 From: "Greenwaldt, Heidi J" > Subject: Re: [Cnm] Prealbumin as predictor of clinical malnutrition? To: "Maritza Rodriguez" >, > Message-ID: <59F3EAD5C3376A42B3CD083F034A61270567776F at digsmxmbx06.Fairview.org> Content-Type: text/plain; charset="us-ascii" Definitely true that it is not a good indicator for clinical malnutrition. The new ASPEN guidelines have the information. I attached it. 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 Maritza Rodriguez Sent: Wednesday, September 23, 2009 3:35 PM To: cnm at lists.my180.net Subject: [Cnm] Prealbumin as predictor of clinical malnutrition? I recently read somewhere that prealbumin level is probably not such a good indicator for clinical malnutrition. Have any of you heard about this? Do you know an official and reliable source of reference for this topic? Thanks in advance. Maritza Rodriguez Maritza Rodriguez, RD LDN Clinical Nutrition Manager Mount Sinai Medical Center Tel: 305-674-2121 X 56181 m-rodrig at msmc.com -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090923/dc1119be/attachment.html -------------- next part -------------- A non-text attachment was scrubbed... Name: Nutrition Support in the Critically Ill Guidelines.pdf Type: application/pdf Size: 315208 bytes Desc: Nutrition Support in the Critically Ill Guidelines.pdf Url : /pipermail/cnm_lists.my180.net/attachments/20090923/dc1119be/attachment.pdf ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 34, Issue 97 *********************************** _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/18844281/attachment-0001.html From ambrd at live.com Thu Oct 1 17:32:33 2009 From: ambrd at live.com (A Bresciami) Date: Thu, 1 Oct 2009 17:32:33 -0700 Subject: [Cnm] NICU Message-ID: I know this question has been asked before however, I am trying to have pharmacy or nursing take over the responsibility of mixing the formulas NICU uses (currently we are mixing the formulas here in the kitchen). Before Administration would agree with making a change they asked me to try to find out what other facilities are doing. For those of you who have NICU's : Who is responsible for measuring and mixing whatever powdered formulas the NICU uses? Thanks in advance and sorry for the repost. Regards, Amy Bresciami, R.D. Operations Manager/CNM Food & Nutrition Services Office: 714.456.3840 Pager: 714.506.5920 Fax: 714.456.7174 abrescia at uci.edu _________________________________________________________________ Microsoft brings you a new way to search the web. Try Bing? now http://www.bing.com?form=MFEHPG&publ=WLHMTAG&crea=TEXT_MFEHPG_Core_tagline_try bing_1x1 -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/af55e4bf/attachment.html From Bonnie.Meehan at ssfhs.org Thu Oct 1 18:28:39 2009 From: Bonnie.Meehan at ssfhs.org (Meehan Bonnie) Date: Thu, 1 Oct 2009 21:28:39 -0400 Subject: [Cnm] CNM Archives Message-ID: <14375697.412258.1254446920207.JavaMail.root@oailxiron1.ssfhs.org> CNM Members, Kerry Harrison from Baltimore, MD was kind enough to share the CNM Archieve link with me several years ago. For those of you who need it, see the attached link. You will probably want to save it to your favorites http://lists.my180.net/pipermail/cnm_lists.my180.net My question for those of you who are familiar with it, does it include a search function? If yes, can you explain how to use it, as I don't see it. I've been going in by the month and organizing by subject data, but thought there might be an easier way that I am not familiar with. Was looking for info on nutritional analysis software as I'm sure this must have been discussed on the listserve at some time in the past. If there is not a search function, this would be a great thing to add in the future. Would like to be able to type in a word and see all items that contain that word in the title. Thanks, Bonnie Bonnie Meehan, RD, CD Chief Clinical Dietitian St. Francis Hospital & Health Centers 1600 Albany St. Beech Grove, IN 46107 317-782-6007 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/7222b512/attachment.html From dianac226 at aol.com Thu Oct 1 19:42:56 2009 From: dianac226 at aol.com (dianac226 at aol.com) Date: Thu, 01 Oct 2009 22:42:56 -0400 Subject: [Cnm] nutrient content of foods on therapeutic diets Message-ID: <8CC11212E49682B-448C-EF0A@webmail-d009.sysops.aol.com> Hi All, I am new to a facility and we are planning on revising the patient menu. Before we make any changes I wanted to see what other facilities were using as a guideline to determine which foods should be eliminated from 2gm Na and 2gm K diets. Thank You Diana From Annalynn_Skipper at Comcast.net Fri Oct 2 05:00:22 2009 From: Annalynn_Skipper at Comcast.net (Annalynn Skipper) Date: Fri, 2 Oct 2009 07:00:22 -0500 Subject: [Cnm] PES Statements In-Reply-To: <607AD24EFC85B14B956CF6AAA4F0E188061A7881FA@chw-msg-824.chw.edu> References: <77A34688299A4A75AA616D9A0DC2A011@universi33f5a5><7E3C6171-10E3-485B-A363-5D5D8B33F732@mac.com><924902E5-2E8C-4C0D-B3B9-5E5610B5AA1E@mac.com> <607AD24EFC85B14B956CF6AAA4F0E188061A7881FA@chw-msg-824.chw.edu> Message-ID: Sandra, I may be barging in on a private conversation here, but when we developed the definitions, signs and symptoms of the inadequate oral food and beverage intake, I'm not at all sure that we were thinking of measuring it in terms of food groups alone. I believe were thinking about a total amount of food and fluid. Food groups provide one way of estimating or describing intake as do numbers and sizes of servings, and actual weights and measures of volume. The choice of what to use is up to the individual RD based on what is available. The question in distinguishing whether to use oral food and beverage intake vs. protein energy intake is whether the percentage of food consumed that the nurses record is more easily or accurately divided expressed in terms of food groups or kcal and protein. If we follow up on the percentage recorded on the patient's flow sheet with a question for the nurse or patient, would it be something like "Did you (your patient) eat your eggs, vegetables, and xxx, xxx, xxxx" or would it be more reasonable to ask "Did you (your patient) eat your energy and protein?" There may not be an easy answer to this question, and I admit that my critical care bias is showing here because I think of energy in kcal, protein in grams, and food and beverages in servings. Of course any accurate assessment of intake using a percentage of intake presupposes that we know the nutrient content of what is served. In many institutions, the energy and protein content of all recipes is available, so that part is easy. If we have a select menu, then we have to work a bit harder to convert that percentage into a meaningful number. Again, I apologize for barging in, but your question is a thought provoking one. 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: Miller, Sandra - MMC [mailto:Sandra.Miller at CHW.edu] Sent: Thursday, October 01, 2009 7:20 PM To: 'Pam Charney'; JulieRambo Cc: Aida Miles; cnm at lists.my180.net Subject: [Cnm] PES Statements Nice to see we are all trying to incorporate correct terminology into our PES statements. So I have a question to post How do you determine what is better to use in an acute care case: inadequate food and beverage versus Inadequate protein- energy? I have been using protein -energy because I feel I can not monitor food groups in the hospital very well as I mainly have to rely on % intake recorded by the nursing staff of that I have no idea - only the meat, balanced intake. etc.Is this thinking correct? Sandra Miller MS, RD, CDE Clinical Nutrition Manager French Hospital Medical Center email: sandra.miller at chw.edu Phone: (805) 542-6229 _____ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Pam Charney Sent: Wednesday, September 30, 2009 8:17 AM To: JulieRambo Cc: Aida Miles; cnm at lists.my180.net Subject: Re: [Cnm] PES statement for ICU patient Unfortunately, in the case described, there is no problem with GI function. You just can't get to the GI tract due to the endotracheal tube. Altered GI function would not be the correct nutrition diagnosis unless there is some underlying condition that was not divulged in the history given to us. The etiology you describe here, "only 500 kcal per day" points to not getting enough of some important nutrient, thus inadequate intake of something. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 29, 2009, at 5:12 PM, JulieRambo wrote: I use : Altered GI function (NC-1.4) related to intubation as evidenced by only 500 calories per day (interject whatever calories from Diprivan and/or D5). This sets up the goal: to meet est needs (where I specify calorie, protein and fluid needs) and then the intervention to initiate TF via OGT (specify formula and rate). Goal is met when nutrition plan of care is implemented by the LIP. Julie Rambo, MSRDLD From: Pam Charney Sent: Tuesday, September 29, 2009 2:23 PM To: Aida Miles Cc: cnm at lists.my180.net Subject: Re: [Cnm] PES statement for ICU patient See below p Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 29, 2009, at 5:39 AM, Aida Miles wrote: Pam and other experts, Could you elaborate a little bit more on the PES statement and, perhaps, help some of us learn the process through this example? This is the PES statement suggested: Inadequate oral food/beverage intake d/t swallowing difficulty AEB endotrachial tube in place...(or recent initiation of ventilator support) Here the etiology is: swallowing difficulty I would disagree. There's nothing to tell me that the patient has an intrinsic, pathophysiologic problem with swallowing. Having a tube in one's throat does indeed create a problem with swallowing food, but not with the swallow mechanism itself. And the signs/symptoms are: endotrachial tube in place (or recent initiation of ventilator support)Also I would disagree. The whole NCP/P-E-S thing makes more sense if the S relates directly to the P. Therefore if you diagnose an intake problem the S should say how bad intake is. In this case, the patient is NPO, I'm assuming. Then the S might say "NPO" or current intake <25% estimated requirements" or how ever you usually communicate that calculation. My understanding is that your Intervention is geared toward the etiology (if possible). If that is true, I would feel stuck trying to "intervene" on swallowing difficulty. Personally I might have said "inability to eat/swallow", and then my intervention would be to start the tube feeding. Is this OK???? I like this much better. Maybe "inability to eat". You don't have to say much more. Everyone who walks into the unit can see that big old endotrachial tube. Can't miss it! Then Monitoring and Evaluation are geared toward the signs and symptoms (if possible). I don't think I want to monitor or evaluate an endotrachial tube or initiation of vent support.... I would evaluate tolerance to tube feedings, reaching goal calories, nutrients, etc. So, could the signs/symptoms be something like "patient being NPO". or something like that? See above. YOu're one step ahead of me here. I am wondering if I am being too "literal" here. No, you're using critical thinking and common sense. That's a great combination! Also, looking at the IDNT Second edition - The Definition, Etiology and Signs and Symptoms for "Inadequate Food and Beverage Intake" (pages 218-219) do not state (that I can find) that this term can be used for an intubated patient, but it seems to fit. Is this the type of feedback the committee would want (to include this in the etiology/ signs and symptoms) in future editions? Just because it's not there doesn't mean you can't use it. The text cannot include a comprehensive list of all possible etiologies. The ones there are suggestions! I don't know if I am "over-thinking" the NCP, but I thought this would be a perfect opportunity for some of us to hear from true experts and learn! :-) Aida Aida Miles, MMSc, RD, CSP, LD Director, Coordinated Masters Program in Nutrition University of Minnesota School of Public Health, Epidemiology & Community Health 1300 South Second Street, Suite 300 Minneapolis, MN 55454 612-625-5865 (voice mail) 651-829-0660 (cell) miles081 at umn.edu -----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, September 28, 2009 6:19 PM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 34, Issue 97 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: Critical Care PES (Nancy Shepperly) 2. Re: Critical Care PES (Pam Charney) 3. TF question (Holly Patronik) 4. Re: Prealbumin as predictor of clinical malnutrition? (Greenwaldt, Heidi J) ---------------------------------------------------------------------- Message: 1 Date: Mon, 28 Sep 2009 15:14:24 -0400 From: "Nancy Shepperly" Subject: Re: [Cnm] Critical Care PES To: ,"Jessica Baye" Message-ID: <4AC0D2CF.204A.000F.0 at trinity-health.org> Content-Type: text/plain; charset=US-ASCII I would say something like this: Inadequate oral food/beverage intake d/t swallowing difficulty AEB endotrachial tube in place...(or recent initiation of ventilator support) However, I'm not sure if this is right, there are probably better ways to say it. I'd like to see other examples, too. Nancy Please let me know if there is anything else I can do for you... Nancy Shepperly, RD Battle Creek Health System 269-660-3891 This message may contain confidential information protected by law through attorney-client privilege or professional peer review/quality evaluation privilege. It is intended only for the individual or entity named above. It is prohibited for anyone else to disclose, copy, distribute or use the contents of this message. If you received this message in error, please notify the BCHS Privacy/Integrity Office atprivacy_integrity at trinity-health.org or (269) 966-8347. >>> "Jessica Baye" 09/28/2009 2:59 PM >>> Would anyone be willing to give me a sample PES statement for the following: ICU patient - recently intubated for hypoxia. Well nourished PTA. OGT in place. TF not yet started - pending recommendations from RD. We have a large trauma center and 48 ICU beds. We really struggle with PES statements in this population. Any feedback is appreciated. Thanks 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: 2 Date: Mon, 28 Sep 2009 12:22:50 -0700 From: Pam Charney Subject: Re: [Cnm] Critical Care PES To: Nancy Shepperly Cc: cnm at lists.my180.net, Jessica Baye Message-ID: <120CF810-78F3-4D87-94D0-EC06ABCA9096 at mac.com> Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes Since each patient is different, it would be impossible to craft one nutrition diagnosis that fits all. However, in many cases Nancy's diagnosis of inadequate oral food/beverage intake might fit, depending on the patient and the surrounding circumstances. The etiology and signs/symptoms would depend on the situation facing the clinician. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 28, 2009, at 12:14 PM, Nancy Shepperly wrote: > I would say something like this: > > Inadequate oral food/beverage intake d/t swallowing difficulty AEB > endotrachial tube in place...(or recent initiation of ventilator > support) > However, I'm not sure if this is right, there are probably better > ways to say it. I'd like to see other examples, too. > > Nancy > > Please let me know if there is anything else I can do for you... > > Nancy Shepperly, RD > Battle Creek Health System > 269-660-3891 > > This message may contain confidential information protected by law > through attorney-client privilege or professional peer review/ > quality evaluation privilege. It is intended only for the individual > or entity named above. It is prohibited for anyone else to disclose, > copy, distribute or use the contents of this message. If you > received this message in error, please notify the BCHS Privacy/ > Integrity Office at privacy_integrity at trinity-health.org or (269) > 966-8347. > > > > > >>>> "Jessica Baye" 09/28/2009 2:59 PM >>> > Would anyone be willing to give me a sample PES statement for the > following: > > ICU patient - recently intubated for hypoxia. Well nourished PTA. > OGT in place. TF not yet started - pending recommendations from RD. > > We have a large trauma center and 48 ICU beds. We really struggle > with PES statements in this population. Any feedback is appreciated. > > Thanks > 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 ------------------------------ Message: 3 Date: Mon, 28 Sep 2009 16:26:44 -0400 From: "Holly Patronik" Subject: [Cnm] TF question To: Message-ID: Content-Type: text/plain; charset="us-ascii" The Manager of our ICU asked me today if there was type of protocol we could initiate for TF patients in the ICU. She feels that the diarrhea r/t tf necessitates too many rectal tubes. Was wondering what others are doing to prevent diarrhea in TF patients and if you have any type of protocol for use of lacto bacillus type products?? She didn't buy the thought that TF aren't the cause of the diarrhea. Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090928/440c03ac/attachment-0001 .html ------------------------------ Message: 4 Date: Wed, 23 Sep 2009 15:47:23 -0500 From: "Greenwaldt, Heidi J" Subject: Re: [Cnm] Prealbumin as predictor of clinical malnutrition? To: "Maritza Rodriguez" , Message-ID: <59F3EAD5C3376A42B3CD083F034A61270567776F at digsmxmbx06.Fairview.org> Content-Type: text/plain; charset="us-ascii" Definitely true that it is not a good indicator for clinical malnutrition. The new ASPEN guidelines have the information. I attached it. 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 Maritza Rodriguez Sent: Wednesday, September 23, 2009 3:35 PM To: cnm at lists.my180.net Subject: [Cnm] Prealbumin as predictor of clinical malnutrition? I recently read somewhere that prealbumin level is probably not such a good indicator for clinical malnutrition. Have any of you heard about this? Do you know an official and reliable source of reference for this topic? Thanks in advance. Maritza Rodriguez Maritza Rodriguez, RD LDN Clinical Nutrition Manager Mount Sinai Medical Center Tel: 305-674-2121 X 56181 m-rodrig at msmc.com -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090923/dc1119be/attachment.html -------------- next part -------------- A non-text attachment was scrubbed... Name: Nutrition Support in the Critically Ill Guidelines.pdf Type: application/pdf Size: 315208 bytes Desc: Nutrition Support in the Critically Ill Guidelines.pdf Url : /pipermail/cnm_lists.my180.net/attachments/20090923/dc1119be/attachment.pdf ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 34, Issue 97 *********************************** _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091002/7f7e4539/attachment-0001.html -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 170 bytes Desc: not available Url : /pipermail/cnm_lists.my180.net/attachments/20091002/7f7e4539/attachment-0001.gif From nfdziak at metrohealth.org Fri Oct 2 06:46:33 2009 From: nfdziak at metrohealth.org (Nancy Farmer-Dziak) Date: Fri, 02 Oct 2009 09:46:33 -0400 Subject: [Cnm] CNM Archives In-Reply-To: <14375697.412258.1254446920207.JavaMail.root@oailxiron1.ssfhs.org> References: <14375697.412258.1254446920207.JavaMail.root@oailxiron1.ssfhs.org> Message-ID: <4AC5CBF9.6228.0033.0@metrohealth.org> There is a way to search for a topic by a word or phrase. In addition to viewing messages by thread, subject or date, there is a Downloadable Version. Click on "Gzip'd text", then choose 'Edit' from the gray bar at the top. Then click on 'Find on this Page' from the drop down list, which will bring up a search box where you can put in whatever you are looking for. I would suggest trying different words for a topic since individuals may use different terms when asking questions. The archive link you listed is correct but it does require a backslash at the end to actually bring up the archives. http://lists.my180.net/pipermail/cnm_lists.my180.net/ ( http://lists.my180.net/pipermail/cnm_lists.my180.net/ ) Nancy Nancy Farmer Dziak Director, Clinical Nutrition The MetroHealth System 2500 MetroHealth Dr Cleveland, OH 44109 (216) 778-5203 e-mail: nfdziak at metrohealth.org >>> Meehan Bonnie 10/1/2009 9:28 PM >>> >>> Meehan Bonnie 10/1/2009 9:28 PM >>> CNM Members, Kerry Harrison from Baltimore, MD was kind enough to share the CNM Archieve link with me several years ago. For those of you who need it, see the attached link. You will probably want to save it to your favorites http://lists.my180.net/pipermail/cnm_lists.my180.net My question for those of you who are familiar with it, does it include a search function? If yes, can you explain how to use it, as I don't see it. I've been going in by the month and organizing by subject data, but thought there might be an easier way that I am not familiar with. Was looking for info on nutritional analysis software as I'm sure this must have been discussed on the listserve at some time in the past. If there is not a search function, this would be a great thing to add in the future. Would like to be able to type in a word and see all items that contain that word in the title. Thanks, Bonnie Bonnie Meehan, RD, CD Chief Clinical Dietitian St. Francis Hospital & Health Centers 1600 Albany St. Beech Grove, IN 46107 317-782-6007 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. 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 Practices, please visit:http://www.metrohealth.org/general/privacy.asp -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091002/3742ae08/attachment.html From Heberle-Heather at aramark.com Fri Oct 2 07:27:07 2009 From: Heberle-Heather at aramark.com (Heberle, Heather N.) Date: Fri, 2 Oct 2009 10:27:07 -0400 Subject: [Cnm] Cnm Digest, Vol 35, Issue 6 In-Reply-To: References: Message-ID: Does anyone know if it is a TJC regulation to have a documented consult sent to the dietitians when a patient has a positive nutrition screen on admission? Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 ________________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of cnm-request at lists.my180.net [cnm-request at lists.my180.net] Sent: Thursday, October 01, 2009 7:18 PM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 6 Send Cnm mailing list submissions to cnm at lists.my180.net To subscribe or unsubscribe via the World Wide Web, visit http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net or, via email, send a message with subject or body 'help' to cnm-request at lists.my180.net You can reach the person managing the list at cnm-owner at lists.my180.net When replying, please edit your Subject line so it is more specific than "Re: Contents of Cnm digest..." Today's Topics: 1. Paying for license to use NCP language (Jeanne Edwards) 2. Re: Full Liquid Diet (Taylor, Tracy) 3. PES Statements (Miller, Sandra - MMC) ---------------------------------------------------------------------- Message: 1 Date: Thu, 1 Oct 2009 15:57:46 -0500 From: "Jeanne Edwards" Subject: [Cnm] Paying for license to use NCP language To: "Heberle, Heather N." , Message-ID: <1E611D0D82010049A4E087DFA59CA442097D84D7 at holy1.hfmhealth.com> Content-Type: text/plain; charset="us-ascii" You do not have to pay for using the NCP language if you handwrite the document. See the response below, from ADA in regards to this question. Jeanne Edwards MS RD Holy Family Memorial Manitowoc WI Jedwards at hfmhealth.org ------------------------------------------------------------ Yes, the $150 annual fee for one hospital grants you permission to use the terms in an EHR, gives you and IT the terms with 15 character abbreviations, 2 IDNT reference manuals, and entitles you to automatic updates with new terms, abbreviations and manuals when the terms are updated. Typing in all of the terms is an option that ADA does not endorse because of the potential for missing or compromised QI data if staff have typos in their notes and lost staff time, much greater than $150 (> 11 hours per year per one FTE dietitian to type eight diagnosis statements per day). Handwritten/paper documentation does not require a license. Donna onna G. Pertel, MEd, RD - American Dietetic Association - NCP Business Manager and Consultant - ncpslpermissions at eatright.org - 203-314-9462 - 312-899-5344 fax ----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Heberle, Heather N. Sent: Tuesday, September 22, 2009 11:24 AM To: cnm at lists.my180.net Subject: Re: [Cnm] Cnm Digest, Vol 34, Issue 74 You must have the licensure approved/paid for to use the language whether or not you have an EMR or not. Go to the www.eatright.org and it is all under the NCP tab on the left. The licensure cost $150 per year per facility. Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 ________________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of cnm-request at lists.my180.net [cnm-request at lists.my180.net] Sent: Tuesday, September 22, 2009 11:16 AM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 34, Issue 74 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. NCP (Leslie Collier) 2. Food Allergies (Kaskel, Phyllis) 3. Re: NCP (Hollie_Colle at ssmhc.com) 4. Re: NCP (UNCLASSIFIED) (Clark, Heidi L MAJ MIL USAF MEDCOM LRMC) 5. Re: NCP (UNCLASSIFIED) (Clark, Heidi L MAJ MIL USAF MEDCOM LRMC) 6. Re: NCP (UNCLASSIFIED) (Pam Charney) 7. cyclic parenteral nutrition (Cece Ohmart) 8. Formula Preparation Room Staffing and Productivity (Sue Teske) ---------------------------------------------------------------------- Message: 1 Date: Tue, 22 Sep 2009 09:49:52 -0500 From: "Leslie Collier" Subject: [Cnm] NCP To: Message-ID: <1BA09AF1C1B5E5499D62240E020C24760162AF16 at MMHEVS1.mmh.local> Content-Type: text/plain; charset="us-ascii" Hi all...were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood...I can't believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090922/1507b27a/attachment- 0001.html ------------------------------ Message: 2 Date: Tue, 22 Sep 2009 10:55:13 -0400 From: "Kaskel, Phyllis" Subject: [Cnm] Food Allergies To: Message-ID: <850F6C2F598EF84F8FA5BEF9CC0CC96D03F0B6D7 at EXCEBW2K325.msnyuhealth.org> Content-Type: text/plain; charset="us-ascii" Does anyone have a Food Allergy policy they would be willing to share? Thanks. P Phyllis Kaskel, MA, RD, CDN Director, Clinical Nutrition Mount Sinai Hospital and Faculty, Department of Preventive Medicine Mount Sinai School of Medicine ------------------------------ Message: 3 Date: Tue, 22 Sep 2009 09:59:20 -0500 From: Hollie_Colle at ssmhc.com Subject: Re: [Cnm] NCP To: "Leslie Collier" Cc: cnm at lists.my180.net, cnm-bounces at lists.my180.net Message-ID: Content-Type: text/plain; charset="iso-8859-1" I didn't know we had to pay. I just thought you had to buy the IDNT standardized lang. book. How do you pay? Is there a contract? Hollie Colle, MS, RD, LDN Clinical Nutrition Manager St. Mary's Good Samaritan, Inc. Mount Vernon IL 62864 (618) 241-2356 Centralia IL 62801 (618) 436-8897 "Leslie Collier" Sent by: cnm-bounces at lists.my180.net 09/22/2009 09:49 AM To cc Subject [Cnm] NCP Hi all?were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood?I can?t believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" _______________________________________________ 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 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 email and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090922/d10fe9d2/attachment- 0001.html ------------------------------ Message: 4 Date: Tue, 22 Sep 2009 16:59:32 +0200 From: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" Subject: Re: [Cnm] NCP (UNCLASSIFIED) To: "Leslie Collier" , Message-ID: <9AB53CB10B46784794F4F6D3AD82344F2F6EA9 at AMEDERMCBE041.eur.amed.ds.army.m il> Content-Type: text/plain; charset="us-ascii" Classification: UNCLASSIFIED Caveats: NONE Oh, no--you did not misunderstand at all. The language is copyrighted and ADA has put out guidance for single users, or those who use an electronic medical record--putting the onus on the EMR company to get permission from them, same way that they may get permission from the AMA for using other specific language. This is the link: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/governance_13838_ENU_HTM L.htm (scroll down to the very bottom--has some FAQ's, more than they used to several months ago, when it was just a form to fill out and then they'd tell you how much you owe) I have a TON of comments--already sent my editorial letter to the ADA, and got a nice response telling me that they didn't have enough $$ to manage the NCP language/do updates/etc w/o charging for it's use; and they wanted to manage who used it. I understand the idea of intellectual property, and also the idea of managing who uses the language (don't want Jane "nutritionist" and Joe chiropractor using the NCP...), but this seems onerous. It's like the proposed soda-pop tax only in reverse--let's charge people extra who want to do the right thing! Sorry, I have several soap boxes and this is one of them. Heidi Clark, MS, RD Landstuhl Regional Medical Center -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Leslie Collier Sent: Tuesday, September 22, 2009 4:50 PM To: cnm at lists.my180.net Subject: [Cnm] NCP Hi all...were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood...I can't believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" Classification: UNCLASSIFIED Caveats: NONE ------------------------------ Message: 5 Date: Tue, 22 Sep 2009 17:03:19 +0200 From: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" Subject: Re: [Cnm] NCP (UNCLASSIFIED) To: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" , "Leslie Collier" , Message-ID: <9AB53CB10B46784794F4F6D3AD82344F2F6EAC at AMEDERMCBE041.eur.amed.ds.army.m il> Content-Type: text/plain; charset="us-ascii" Classification: UNCLASSIFIED Caveats: NONE I should clarify--my understanding is that it is when you use the NCP language in an electronic medical record (eg, drop downs or check boxes or electronic algorithms). We have an EMR at my facility, and have a specific nutrition note, but we free text in all the language. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Clark, Heidi L MAJ MIL USAF MEDCOM LRMC Sent: Tuesday, September 22, 2009 5:00 PM To: Leslie Collier; cnm at lists.my180.net Subject: Re: [Cnm] NCP (UNCLASSIFIED) Classification: UNCLASSIFIED Caveats: NONE Oh, no--you did not misunderstand at all. The language is copyrighted and ADA has put out guidance for single users, or those who use an electronic medical record--putting the onus on the EMR company to get permission from them, same way that they may get permission from the AMA for using other specific language. This is the link: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/governance_13838_ENU_HTM L.htm (scroll down to the very bottom--has some FAQ's, more than they used to several months ago, when it was just a form to fill out and then they'd tell you how much you owe) I have a TON of comments--already sent my editorial letter to the ADA, and got a nice response telling me that they didn't have enough $$ to manage the NCP language/do updates/etc w/o charging for it's use; and they wanted to manage who used it. I understand the idea of intellectual property, and also the idea of managing who uses the language (don't want Jane "nutritionist" and Joe chiropractor using the NCP...), but this seems onerous. It's like the proposed soda-pop tax only in reverse--let's charge people extra who want to do the right thing! Sorry, I have several soap boxes and this is one of them. Heidi Clark, MS, RD Landstuhl Regional Medical Center -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Leslie Collier Sent: Tuesday, September 22, 2009 4:50 PM To: cnm at lists.my180.net Subject: [Cnm] NCP Hi all...were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood...I can't believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" Classification: UNCLASSIFIED Caveats: NONE _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Classification: UNCLASSIFIED Caveats: NONE ------------------------------ Message: 6 Date: Tue, 22 Sep 2009 08:40:22 -0700 From: Pam Charney Subject: Re: [Cnm] NCP (UNCLASSIFIED) To: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" Cc: cnm at lists.my180.net Message-ID: <4012A0A2-4450-4437-A299-8F43A3643824 at mac.com> Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes There is much misunderstanding regarding the licensing fees for the terminology. It is correct that there is no fee associated with using a care process. Let's remember that the NCP and the terminology are two separate and distinct entities. Any care process is simply a structured way of thinking; it'd be hard to license thinking. There are licensing fees for using the terminology in a proprietary electronic system. This is the same thing as the fee you pay to install most software (non share ware) on your computer. I'm sure we're all aware that we are not purchasing the code for that software. We are buying the right to install and use the software. That's why some programs allow "multi-user" options. You install the same software on a designated number of computers based on the number of licenses you have purchased. There are many healthcare terminologies that have associated licensing fees. Most EMR vendors are now using a reference terminology known as SNOMED, which includes terms from many different terminologies, including several that have licensing fees. Therefore, when the vendor uses SNOMED, the fees are paid somewhere else down the line so the purchaser of the EMR product doesn't see the bill for the licenses. It is worth the small amount for the license to have the terminology included in your database. Free text does not allow for accurate, reliable capture of the work of dietetics. I"d be happy to answer other questions regarding terminology and the EMR offline. I'm sure the folks at ADA can answer other questions specific to the IDNT. Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 22, 2009, at 8:03 AM, Clark, Heidi L MAJ MIL USAF MEDCOM LRMC wrote: > Classification: UNCLASSIFIED > Caveats: NONE > > I should clarify--my understanding is that it is when you use the NCP > language in an electronic medical record (eg, drop downs or check > boxes or electronic algorithms). We have an EMR at my facility, and > have a specific nutrition note, but we free text in all the language. > > -----Original Message----- > From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] > On Behalf Of Clark, Heidi L MAJ MIL USAF MEDCOM LRMC > Sent: Tuesday, September 22, 2009 5:00 PM > To: Leslie Collier; cnm at lists.my180.net > Subject: Re: [Cnm] NCP (UNCLASSIFIED) > > Classification: UNCLASSIFIED > Caveats: NONE > > Oh, no--you did not misunderstand at all. The language is copyrighted > and ADA has put out guidance for single users, or those who use an > electronic medical record--putting the onus on the EMR company to get > permission from them, same way that they may get permission from the > AMA for using other specific language. This is the link: > > http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/governance_13838_ENU_HTM > L.htm (scroll down to the very bottom--has some FAQ's, more than > they > used to several months ago, when it was just a form to fill out and > then they'd tell you how much you owe) > > I have a TON of comments--already sent my editorial letter to the ADA, > and got a nice response telling me that they didn't have enough $$ to > manage the NCP language/do updates/etc w/o charging for it's use; and > they wanted to manage who used it. I understand the idea of > intellectual property, and also the idea of managing who uses the > language (don't want Jane "nutritionist" and Joe chiropractor using > the NCP...), but this seems onerous. It's like the proposed soda-pop > tax only in reverse--let's charge people extra who want to do the > right thing! > > Sorry, I have several soap boxes and this is one of them. > > Heidi Clark, MS, RD > Landstuhl Regional Medical Center > > -----Original Message----- > From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] > On Behalf Of Leslie Collier > Sent: Tuesday, September 22, 2009 4:50 PM > To: cnm at lists.my180.net > Subject: [Cnm] NCP > > Hi all...were you all aware that we have to PAY to use the NCP for > charting!?! Please tell me I have misunderstood...I can't believe > that we are being encouraged to use standardized language and then > have to PAY to do so. Anyone have any comments? > > > > Leslie Collier, RD/LD > > Clinical Nutrition Manager > > Midland Memorial Hospital > > 2200 West Illinois > > Midland, TX 79701 > > > > leslie.collier at midland-memorial.com > > > > > (432) 685-4206 > > (432) 685-6991 (fax) > > (432) 742-0087 (pager) > > > > "Dance like no one is watching, eat like someone is!" > > > > Classification: UNCLASSIFIED > Caveats: NONE > > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > Classification: UNCLASSIFIED > Caveats: NONE > > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net ------------------------------ Message: 7 Date: Tue, 22 Sep 2009 11:46:20 -0400 (EDT) From: Cece Ohmart Subject: [Cnm] cyclic parenteral nutrition To: cnm at lists.my180.net Message-ID: <20090922114620.AGN30918 at mail.mainehospital.org> Content-Type: text/plain; charset=ISO-8859-1 Hi, Does anyone have a policy/procedure regarding cyclic parenteral nutrition? Thanks, Cece This message is intended for the use of the addressee only and may contain information that is privileged and confidential. If you are not the intended recipient of this message, be notified that any dissemination or use of this message is strictly prohibited. Un-intended transmission does not constitute waiver of attorney-client privilege or any other privilege. If you have received this message in error, please delete all copies of the message and its attachments and notify the sender immediately. Thank you. ------------------------------ Message: 8 Date: Tue, 22 Sep 2009 11:18:45 -0500 From: "Sue Teske" Subject: [Cnm] Formula Preparation Room Staffing and Productivity To: "Clinical List" Message-ID: <3D0B6F497247834CAC5FF0C30ED7A5C402495864 at chexmain.chsys.org> Content-Type: text/plain; charset="us-ascii" As part of a group that is working on updating the ADA publication "Infant Feedings: Guidelines for Preparation of Formula dn Breastmilk in Health Care Facilities", I would greatly appreciate your participation in this survey. 1. Do you have a formula preparation room? 2. How many patient care units are served by formula room? a. Number of beds per patient care unit? 3. What is the estimated average distance (for the delivery of feedings) from the formula room to the patient care units served by the formula room? 4. How many deliveries are made each day from the formula room? a. Batch deliveries b. Single order deliveries (e.g.: new, prn or stat) 5. Who delivers the formula? a. Formula room staff b. Central transportation staff c. Other (please specify): ___________________ 6. What are the hours of operation of the formula room? 7. How many FTEs are dedicated to the formula room? a. Formula techs b. Direct supervision c. Other (please specify): ___________________ 8. How many units of formula are produced per day (average)? a. Bulk supply (24h volume in bulk containers) b. Unit dose 9. How many units of ready-to-use formula (closed systems or rtf formula bottles) are dispensed per day (average) from the formula room? 10. What other duties are assigned (e.g.: cleaning of formula refrigeration/freezers, inventory control/ordering supplies, monitor refrigerator temperatures, etc.) to the employees who staff the formula room? 11. Do you have a separate breastmilk bank or area for dispensing/preparation of breastmilk? a. If yes, who staffs that area? b. How many FTEs are dedicated to the breastmilk bank/preparation room? c. How many units of breastmilk are dispensed per day? d. How many units of breastmilk are prepared with the addition of a fortifier or other additive? i. Bulk supply (24h volume in bulk containers) ii. Unit dose 12. How do you measure the productivity of your formula room staff? Thank you for your time! Susan C. Teske, MS, RD, LD, CNSD Director, Dept. of Clinical Nutrition and Lactation Services Children's Health System 1600 7th Ave. South 3rd Floor hospital, Room 334 Birmingham, AL 35233 (205) 939-9203 Office (205) 939-6047 Fax susan.teske at chsys.org Confidentiality Notice: The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material. Any review, retransmission dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. 20090416 -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090922/0dae8f82/attachment. html ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 34, Issue 74 *********************************** _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net ------------------------------ Message: 2 Date: Thu, 1 Oct 2009 16:01:37 -0700 From: "Taylor, Tracy" Subject: Re: [Cnm] Full Liquid Diet To: Message-ID: <222E81132BE3E54584CB9A5DB1CDD7E280DE0D at bks-emx001.dmc-sp.org> Content-Type: text/plain; charset="us-ascii" Mt version of the NCM has a full liquid diet: Indications The traditional indication for the full liquid diet is for short term use as a transition step between the clear liquid and soft diets following gastrointestinal surgery I don't remember this on the previous NCM version we had and at that time we toyed with idea of omitting, but to keep our customers, in this case the surgeons, satisfied we left it in as an addendum. And now we have it on the online version as well. best Tracy Tracy Taylor RD, CDE Director: Diabetes Management/Outpatient Nutrition Programs Clinical Nutrition Manager Doctors Medical Center San Pablo 2000 Vale Rd San Pablo, CA 94806 phone: 510-970-5344 fax: 510-970-5739 email: ttaylor at dmc-sp.org CONFIDENTIAL AND PRIVILEGED: May contain materials protected by law. This communication contains information intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged and/or confidential. If you are not the intended recipient or an employee or agent responsible for delivering the communication to the intended recipient, you are hereby notified that any disclosure, copying, distribution, or use of its contents is prohibited. If you have received this communication in error, please notify me immediately by telephone at (510) 970-5344, return the original communication by reply e-mail, and permanently delete the communication from your system. Thank you. "A year from now you will wish you had started today." --Karen Lamb -----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: Thursday, October 01, 2009 11:19 AM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 4 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: Full Liquid Diet (Krzeminski, Janet) 2. Long term vent patients (MARTHA ELLINGTON) 3. Re: Recipe Nutrient Analysis software question (Denise Conforti) 4. Re: Prader Willi (Ekvall, Shirley (ekvalls)) 5. Re: pediatric needs (Ekvall, Shirley (ekvalls)) ---------------------------------------------------------------------- Message: 1 Date: Thu, 1 Oct 2009 10:11:49 -0500 From: "Krzeminski, Janet" Subject: Re: [Cnm] Full Liquid Diet To: "RICAFORT, Christina" , Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F201171F31 at rhcexch3.reshealthcare.org> Content-Type: text/plain; charset="us-ascii" I understand your stance on being evidence-based, however physician-RD relations, and working with Physicians to increase THEIR satisfaction is an ongoing PI here in our System. Outcomes of patients becomes more of a key role in our hospital than studies in certain instances. And procedures that work for improving a patient outcome in conjunction with what the physicians order should be one thing that I would recommend that you look at with perhaps an interdisciplinary team, or with one of your key physicians. Some of my peers in my system created an adjunct to the NCM, including full liquid and clear liquid diets... Janet K Chicago, IL ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of RICAFORT, Christina Sent: Wednesday, September 30, 2009 3:42 PM To: cnm at lists.my180.net Subject: [Cnm] Full Liquid Diet I recently omitted the Full Liquid diet from our menu based on the information in the NCM and the literature addressing this issue. Our surgeons are very angry about not having this available and demands that I explain the whole rationale. I do have the studies to cite but if anyone out there has a better approach to this, please share with me so I can convince them that this is evidence based. Please share your experience as well. Thanks. Hope to hear from you soon. Tina C. Ricafort MA., RD., CD. Manager, Clinical Dietetics Saint John's Health System 2015 Jackson St. Anderson, IN 46016 tcricafo at sjhsnet.org (765)646-8197 (765)646-8780 fax CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/a951cd52/attachment- 0001.html ------------------------------ Message: 2 Date: Thu, 1 Oct 2009 11:31:46 -0400 From: MARTHA ELLINGTON Subject: [Cnm] Long term vent patients To: "cnm at lists.my180.net" Message-ID: Content-Type: text/plain; charset="us-ascii" We have several "Step down units" on one medical floor that tend to have Vent patients that are here "just hanging out" until they can be placed in a LTC facility that takes ventilated patients. Naturally they are on tube feedings and have many Dr's involved with their care. These patients can be stable for awhile then (usually on the weekends) something crops up and they want the dietitian to "fix" a problem that can take 2 hours to track down through all the history. You never really get the real story because all the players are not available. My questions are: What is your policy for involvement with patients that are in an acute facility waiting for placement in a LTC for vent patients? If you work in one of these LTC that can take vents, what is your level of involvement? Thanks for any wisdom you can give. 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 ------------------------------ Message: 3 Date: Thu, 1 Oct 2009 10:46:25 -0700 (PDT) From: Denise Conforti Subject: Re: [Cnm] Recipe Nutrient Analysis software question To: cnm at lists.my180.net Message-ID: <246203.55846.qm at web31910.mail.mud.yahoo.com> Content-Type: text/plain; charset="iso-8859-1" Please post...I am also looking for software that does recipe analysis and has food labeling capabilities. I have narrowed the search to Nutribase and Nutritionist Pro Food Labeling software (this is a separate purchase?from the Diet Analysis software). ? Does anyone have experience with the Nutritionist Pro?Food Labeling software??Is it user friendly? Thanks in advance! Denise M. Conforti, MS, RD, LDN Clinical Nutrition Manager Dietetic Internship Director Mount Auburn?Hospital 330 Mount Auburn Street Cambridge, MA 02138 Phone: 617.499.5665 Ext. 3059 Pager: 617.499.5110 Pager 6777 --- On Thu, 10/1/09, Orlowski, Hannah wrote: From: Orlowski, Hannah Subject: Re: [Cnm] Recipe Nutrient Analysis software question To: "Meehan Bonnie" , cnm at lists.my180.net Date: Thursday, October 1, 2009, 8:41 AM Please list to post.? I am also looking. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Meehan Bonnie Sent: Wednesday, September 30, 2009 8:40 PM To: 'cnm at lists.my180.net' Subject: [Cnm] Recipe Nutrient Analysis software question CNM Members, ? For those of you who have researched this topic and/or are using a system that you are happy with, which one would you recommend?? I need to find a system quickly to analyze home and cafeteria recipes and print labels and do not have a lot of time to research it.? I'm not exactly sure what all I need it to do, but think the below is a good start.? If you are not sure about what all the capabilities are of the one you have, just tell me what brand it is and what you like or do not like about it.? What is the advantage of buying one like Nutribase or ESHA versus downloading a free one from the Internet?? If you are familiar with the major brands, which one do you like better? ? Would like one that: --Overall easy to learn and use --Easy input of recipe data --Good reputable database of foods and some brand names --Can expand home sized recipe to accurate institutional sized recipe with quantities applicable to large quantities (like cups?vs. teaspoons) --Can give info on desired serving sizes --Can analyze up to 10 nutrients by normal unit of measure (gm, mg, etc.) and give % DRV based on 2,000 or 2,500 calorie diet --Can print food labels for above nutrients (or just ones you want to see) --Is not cost prohibitive to buy and to maintain up to date database and upgrades --Could work on individual computer or web (if you wanted to expand use of this on a corporate LAN to all employees) --Good customer support --Might include other wellness features--though this part is not necessary ? Many Thanks for whatever guidance you can provide.--Bonnie ? Bonnie Meehan, RD, CD Chief Clinical Dietitian St. Francis Hospital & Health Centers 1600 Albany St. Beech Grove, IN?? 46107 317-782-6007 ? 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. Disclaimer: The HIPAA Final Privacy Rule requires covered entities to safeguard certain Protected Health Information (PHI) related to a person's healthcare. Information being faxed to you may include PHI after appropriate authorization from the patient or under circumstances that do not require patient authorization. You, the recipient, are obligated to maintain PHI in a safe and secure manner. You may not re-disclose without additional patient consent or as required by law. Unauthorized re-disclosure or failure to safeguard PHI could subject you to penalties described in federal (HIPAA) and state law. If you the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, please notify us immediately and destroy the related message. -----Inline Attachment Follows----- _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/c08e7909/attachment- 0001.html ------------------------------ Message: 4 Date: Thu, 1 Oct 2009 14:15:41 -0400 From: "Ekvall, Shirley (ekvalls)" Subject: Re: [Cnm] Prader Willi To: Holly Patronik , "cnm at lists.my180.net" Message-ID: <1C36990389E31A42996A3F73DE5DBE685257C96E24 at UCMAILBE2.ad.uc.edu> Content-Type: text/plain; charset="iso-8859-1" Please take a look at the chapter on Prader Willi in our book Pediatric Nutrition in Chronic Diseases and Developmentnal Disorders, published by Oxford University Press, www.oup.com. You may find it in the library. I have worked with these clients with very low calorie counts. You need to almost lock the refrigerator and find other activities as they have a ravenous appetite. We also have a 35 credit self study ($89.50) to go with the book. We do have a growth chart for these children in the book too. Good Luck. Let me know if I can be of further help. shirley.ekvall at uc.edu ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Holly Patronik [hpatronik at shorehealth.org] Sent: Thursday, October 01, 2009 9:27 AM To: cnm at lists.my180.net Subject: [Cnm] Prader Willi I have a patient with prader Willi whose MD is requesting 800kcal/day. I'm not familiar with working with this condition - is this a normal recommendation - any suggestions?? Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/7f31973f/attachment- 0001.html ------------------------------ Message: 5 Date: Thu, 1 Oct 2009 14:21:26 -0400 From: "Ekvall, Shirley (ekvalls)" Subject: Re: [Cnm] pediatric needs To: "Johnson, Andrea" , "cnm at lists.my180.net" Message-ID: <1C36990389E31A42996A3F73DE5DBE685257C96E25 at UCMAILBE2.ad.uc.edu> Content-Type: text/plain; charset="iso-8859-1" Please take a look at the chapter and charts on Nutritional Assessment in our book Pediatric Nutrition in Chronic Diseases and Developmental Disorders, published by Oxford University Press, www.oup.com which you may find in your med library. The promotion code for discount is 24095 if ordering it. We also have a 35 ADA credit self study to go along with it. You can contact me for the self study ($89.50) or for both if needed. shirley.ekvall at uc.edu Good Luck ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea [andrea.johnson at bassett.org] Sent: Thursday, October 01, 2009 9:09 AM To: cnm at lists.my180.net Subject: [Cnm] pediatric needs We are small community/teaching hospital and we don't see that many complicated pediatric patients. But we do see a few. What caloric formulations and protein needs are other places using for their pediatric populations? Any help would be most appreciated. Thanks, Andrea Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- NOTICE OF CONFIDENTIALITY This electronic message, including attachments, is for the sole use of the named recipient and may contain confidential or privileged information protected by New York State, and Federal regulations. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. If you are not the intended recipient or have received this communication in error please contact the sender or email.security at bassett.org and destroy all copies of the original message. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/1c9fa022/attachment. html ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 4 ********************************** ------------------------------ Message: 3 Date: Thu, 1 Oct 2009 17:20:26 -0700 From: "Miller, Sandra - MMC" Subject: [Cnm] PES Statements To: 'Pam Charney' , JulieRambo Cc: Aida Miles , "cnm at lists.my180.net" Message-ID: <607AD24EFC85B14B956CF6AAA4F0E188061A7881FA at chw-msg-824.chw.edu> Content-Type: text/plain; charset="us-ascii" Nice to see we are all trying to incorporate correct terminology into our PES statements. So I have a question to post How do you determine what is better to use in an acute care case: inadequate food and beverage versus Inadequate protein- energy? I have been using protein -energy because I feel I can not monitor food groups in the hospital very well as I mainly have to rely on % intake recorded by the nursing staff of that I have no idea - only the meat, balanced intake. etc.Is this thinking correct? Sandra Miller MS, RD, CDE Clinical Nutrition Manager French Hospital Medical Center email: sandra.miller at chw.edu Phone: (805) 542-6229 ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Pam Charney Sent: Wednesday, September 30, 2009 8:17 AM To: JulieRambo Cc: Aida Miles; cnm at lists.my180.net Subject: Re: [Cnm] PES statement for ICU patient Unfortunately, in the case described, there is no problem with GI function. You just can't get to the GI tract due to the endotracheal tube. Altered GI function would not be the correct nutrition diagnosis unless there is some underlying condition that was not divulged in the history given to us. The etiology you describe here, "only 500 kcal per day" points to not getting enough of some important nutrient, thus inadequate intake of something. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 29, 2009, at 5:12 PM, JulieRambo wrote: I use : Altered GI function (NC-1.4) related to intubation as evidenced by only 500 calories per day (interject whatever calories from Diprivan and/or D5). This sets up the goal: to meet est needs (where I specify calorie, protein and fluid needs) and then the intervention to initiate TF via OGT (specify formula and rate). Goal is met when nutrition plan of care is implemented by the LIP. Julie Rambo, MSRDLD From: Pam Charney Sent: Tuesday, September 29, 2009 2:23 PM To: Aida Miles Cc: cnm at lists.my180.net Subject: Re: [Cnm] PES statement for ICU patient See below p Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 29, 2009, at 5:39 AM, Aida Miles wrote: Pam and other experts, Could you elaborate a little bit more on the PES statement and, perhaps, help some of us learn the process through this example? This is the PES statement suggested: Inadequate oral food/beverage intake d/t swallowing difficulty AEB endotrachial tube in place...(or recent initiation of ventilator support) Here the etiology is: swallowing difficulty I would disagree. There's nothing to tell me that the patient has an intrinsic, pathophysiologic problem with swallowing. Having a tube in one's throat does indeed create a problem with swallowing food, but not with the swallow mechanism itself. And the signs/symptoms are: endotrachial tube in place (or recent initiation of ventilator support)Also I would disagree. The whole NCP/P-E-S thing makes more sense if the S relates directly to the P. Therefore if you diagnose an intake problem the S should say how bad intake is. In this case, the patient is NPO, I'm assuming. Then the S might say "NPO" or current intake <25% estimated requirements" or how ever you usually communicate that calculation. My understanding is that your Intervention is geared toward the etiology (if possible). If that is true, I would feel stuck trying to "intervene" on swallowing difficulty. Personally I might have said "inability to eat/swallow", and then my intervention would be to start the tube feeding. Is this OK???? I like this much better. Maybe "inability to eat". You don't have to say much more. Everyone who walks into the unit can see that big old endotrachial tube. Can't miss it! Then Monitoring and Evaluation are geared toward the signs and symptoms (if possible). I don't think I want to monitor or evaluate an endotrachial tube or initiation of vent support.... I would evaluate tolerance to tube feedings, reaching goal calories, nutrients, etc. So, could the signs/symptoms be something like "patient being NPO"... or something like that? See above. YOu're one step ahead of me here. I am wondering if I am being too "literal" here. No, you're using critical thinking and common sense. That's a great combination! Also, looking at the IDNT Second edition - The Definition, Etiology and Signs and Symptoms for "Inadequate Food and Beverage Intake" (pages 218-219) do not state (that I can find) that this term can be used for an intubated patient, but it seems to fit. Is this the type of feedback the committee would want (to include this in the etiology/ signs and symptoms) in future editions? Just because it's not there doesn't mean you can't use it. The text cannot include a comprehensive list of all possible etiologies. The ones there are suggestions! I don't know if I am "over-thinking" the NCP, but I thought this would be a perfect opportunity for some of us to hear from true experts and learn! :) Aida Aida Miles, MMSc, RD, CSP, LD Director, Coordinated Masters Program in Nutrition University of Minnesota School of Public Health, Epidemiology & Community Health 1300 South Second Street, Suite 300 Minneapolis, MN 55454 612-625-5865 (voice mail) 651-829-0660 (cell) miles081 at umn.edu -----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, September 28, 2009 6:19 PM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 34, Issue 97 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: Critical Care PES (Nancy Shepperly) 2. Re: Critical Care PES (Pam Charney) 3. TF question (Holly Patronik) 4. Re: Prealbumin as predictor of clinical malnutrition? (Greenwaldt, Heidi J) ---------------------------------------------------------------------- Message: 1 Date: Mon, 28 Sep 2009 15:14:24 -0400 From: "Nancy Shepperly" > Subject: Re: [Cnm] Critical Care PES To: >,"Jessica Baye" > Message-ID: <4AC0D2CF.204A.000F.0 at trinity-health.org> Content-Type: text/plain; charset=US-ASCII I would say something like this: Inadequate oral food/beverage intake d/t swallowing difficulty AEB endotrachial tube in place...(or recent initiation of ventilator support) However, I'm not sure if this is right, there are probably better ways to say it. I'd like to see other examples, too. Nancy Please let me know if there is anything else I can do for you... Nancy Shepperly, RD Battle Creek Health System 269-660-3891 This message may contain confidential information protected by law through attorney-client privilege or professional peer review/quality evaluation privilege. It is intended only for the individual or entity named above. It is prohibited for anyone else to disclose, copy, distribute or use the contents of this message. If you received this message in error, please notify the BCHS Privacy/Integrity Office atprivacy_integrity at trinity-health.org or (269) 966-8347. >>> "Jessica Baye" > 09/28/2009 2:59 PM >>> Would anyone be willing to give me a sample PES statement for the following: ICU patient - recently intubated for hypoxia. Well nourished PTA. OGT in place. TF not yet started - pending recommendations from RD. We have a large trauma center and 48 ICU beds. We really struggle with PES statements in this population. Any feedback is appreciated. Thanks 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: 2 Date: Mon, 28 Sep 2009 12:22:50 -0700 From: Pam Charney > Subject: Re: [Cnm] Critical Care PES To: Nancy Shepperly > Cc: cnm at lists.my180.net, Jessica Baye > Message-ID: <120CF810-78F3-4D87-94D0-EC06ABCA9096 at mac.com> Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes Since each patient is different, it would be impossible to craft one nutrition diagnosis that fits all. However, in many cases Nancy's diagnosis of inadequate oral food/beverage intake might fit, depending on the patient and the surrounding circumstances. The etiology and signs/symptoms would depend on the situation facing the clinician. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 28, 2009, at 12:14 PM, Nancy Shepperly wrote: > I would say something like this: > > Inadequate oral food/beverage intake d/t swallowing difficulty AEB > endotrachial tube in place...(or recent initiation of ventilator > support) > However, I'm not sure if this is right, there are probably better > ways to say it. I'd like to see other examples, too. > > Nancy > > Please let me know if there is anything else I can do for you... > > Nancy Shepperly, RD > Battle Creek Health System > 269-660-3891 > > This message may contain confidential information protected by law > through attorney-client privilege or professional peer review/ > quality evaluation privilege. It is intended only for the individual > or entity named above. It is prohibited for anyone else to disclose, > copy, distribute or use the contents of this message. If you > received this message in error, please notify the BCHS Privacy/ > Integrity Office at privacy_integrity at trinity-health.org or (269) > 966-8347. > > > > > >>>> "Jessica Baye" > 09/28/2009 2:59 PM >>> > Would anyone be willing to give me a sample PES statement for the > following: > > ICU patient - recently intubated for hypoxia. Well nourished PTA. > OGT in place. TF not yet started - pending recommendations from RD. > > We have a large trauma center and 48 ICU beds. We really struggle > with PES statements in this population. Any feedback is appreciated. > > Thanks > 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 ------------------------------ Message: 3 Date: Mon, 28 Sep 2009 16:26:44 -0400 From: "Holly Patronik" > Subject: [Cnm] TF question To: > Message-ID: > Content-Type: text/plain; charset="us-ascii" The Manager of our ICU asked me today if there was type of protocol we could initiate for TF patients in the ICU. She feels that the diarrhea r/t tf necessitates too many rectal tubes. Was wondering what others are doing to prevent diarrhea in TF patients and if you have any type of protocol for use of lacto bacillus type products?? She didn't buy the thought that TF aren't the cause of the diarrhea. Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090928/440c03ac/attachment-0001.html ------------------------------ Message: 4 Date: Wed, 23 Sep 2009 15:47:23 -0500 From: "Greenwaldt, Heidi J" > Subject: Re: [Cnm] Prealbumin as predictor of clinical malnutrition? To: "Maritza Rodriguez" >, > Message-ID: <59F3EAD5C3376A42B3CD083F034A61270567776F at digsmxmbx06.Fairview.org> Content-Type: text/plain; charset="us-ascii" Definitely true that it is not a good indicator for clinical malnutrition. The new ASPEN guidelines have the information. I attached it. 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 Maritza Rodriguez Sent: Wednesday, September 23, 2009 3:35 PM To: cnm at lists.my180.net Subject: [Cnm] Prealbumin as predictor of clinical malnutrition? I recently read somewhere that prealbumin level is probably not such a good indicator for clinical malnutrition. Have any of you heard about this? Do you know an official and reliable source of reference for this topic? Thanks in advance. Maritza Rodriguez Maritza Rodriguez, RD LDN Clinical Nutrition Manager Mount Sinai Medical Center Tel: 305-674-2121 X 56181 m-rodrig at msmc.com -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090923/dc1119be/attachment.html -------------- next part -------------- A non-text attachment was scrubbed... Name: Nutrition Support in the Critically Ill Guidelines.pdf Type: application/pdf Size: 315208 bytes Desc: Nutrition Support in the Critically Ill Guidelines.pdf Url : /pipermail/cnm_lists.my180.net/attachments/20090923/dc1119be/attachment.pdf ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 34, Issue 97 *********************************** _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/18844281/attachment.html ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 6 ********************************** From Margaret.Chaffin at hcahealthcare.com Fri Oct 2 08:05:49 2009 From: Margaret.Chaffin at hcahealthcare.com (Chaffin Meg) Date: Fri, 2 Oct 2009 10:05:49 -0500 Subject: [Cnm] ICU/nutrition support question Message-ID: Do you all include calories provided from you protein modulars when adding up your total calorie delivery in the ICU? I have a patient with a BMI of > 40 and I am second guessing my TF regimen. She is receiving hypocaloric feedings (right now glucerna 1.2 at 25ml/h because she is getting ~ 920 cal/day from diprivan). I'm not sure how to get adequate protein in her. We use promod and she would need A LOT to meet her high protein needs and if I count kcal from promod then she will end up being overfed calories. She has been in our ICU for about a week now, on vent support for respiratory failure. Other issues -- DM, morbid obesity, HTN. Renal status good. Chemistries look good, except Trig are 226. Am I overthinking this? Any suggestions? Thanks, Meg Meg Chaffin MA,RD,LD Clinical Nutrition Manager Palmyra Medical Centers (229)434-2394 -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091002/8faaf598/attachment.html From Terese.Scollard at providence.org Fri Oct 2 08:35:44 2009 From: Terese.Scollard at providence.org (Scollard, Terese) Date: Fri, 2 Oct 2009 08:35:44 -0700 Subject: [Cnm] nutrient content of foods on therapeutic diets In-Reply-To: <8CC11212E49682B-448C-EF0A@webmail-d009.sysops.aol.com> References: <8CC11212E49682B-448C-EF0A@webmail-d009.sysops.aol.com> Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A051C96A5@wn1221.or.providence.org> It depends on your base menu and how much manipulation you can do with portion sizes. We use the US dietary guidelines for our general diet (with some few exceptions) so most of the foods are allowed and we alter portions on some, and some we do not allow. You would need to have the recipes analyzed and your purchasing folks and purchase contracts of available foods built into your recipes. We use Computrition, and there are other companies also who have software that helps with these situations and modeling. So it is not simply a matter of eliminating foods, (other than the obvious ones). Terese Scollard -----Original Message----- From: dianac226 at aol.com [mailto:dianac226 at aol.com] Sent: Thursday, October 01, 2009 7:43 PM To: cnm at lists.my180.net Subject: [Cnm] nutrient content of foods on therapeutic diets Hi All, I am new to a facility and we are planning on revising the patient menu. Before we make any changes I wanted to see what other facilities were using as a guideline to determine which foods should be eliminated from 2gm Na and 2gm K diets. Thank You Diana This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. From miles081 at umn.edu Fri Oct 2 08:55:17 2009 From: miles081 at umn.edu (Aida Miles) Date: Fri, 2 Oct 2009 10:55:17 -0500 Subject: [Cnm] Prader Willi Syndrome In-Reply-To: References: Message-ID: Linda, Children/people with Prader Willi Syndrome (PWS) have extreme hunger, are ravenous and cannot control their urge to eat. This is related to their chromosomal abnormality. They also have intellectual disability (= what used to be called mental retardation), thus traditional counseling techniques do not necessarily work as their ability to reason is limited. 800 cal/day depends on the child's size. Recommended calories are about 8.5 cal/cm. PWS individuals usually have short stature thus utilizing cal/cm is more appropriate. They have hypotonia, which may account for decreased energy needs. Usual recommendations and NEEDS include locking food and putting a lock on the refrigerator. The family/caretakers must be gatekeepers, the child/person will eat whatever is accessible to them and will go to any extreme to get food. For a child, the school also has to have food out of reach and monitor as the child will "steal" food from other plates if he can. Hope this helps. :) Aida Aida Miles, MMSc, RD, CSP, LD Director, Coordinated Masters Program in Nutrition University of Minnesota, School of Public Health Division of Epidemiology and Community Health 1300 South Second Street, Suite 300 Minneapolis, MN 55454 612-625-5865 651-829-0660 (cell) miles081 at umn.edu -----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: Thursday, October 01, 2009 2:00 PM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 5 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. Ideal Protein (Lewis, Suzanne) 2. Re: Prader Willi (Linda Bartholomay) ---------------------------------------------------------------------- Message: 1 Date: Thu, 1 Oct 2009 13:36:53 -0500 From: "Lewis, Suzanne" Subject: [Cnm] Ideal Protein To: Message-ID: <63A81A57A6254849B538D2FF4F1D539904C5BC82 at VS01EXC01.mercycare.org> Content-Type: text/plain; charset="us-ascii" Has anyone heard of or used the Ideal Protein Diet? Have you seen this offered through hospitals? What have been your experiences with it? Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/19deb0b5/attachment-0001 .html ------------------------------ Message: 2 Date: Thu, 01 Oct 2009 13:43:08 -0500 From: "Linda Bartholomay" < > Subject: Re: [Cnm] Prader Willi To: ,"Holly Patronik" Message-ID: <4AC4B1EC.309B.00D0.0 at meritcare.com> Content-Type: text/plain; charset="us-ascii" Holly, you may find this to be of help - - especially in dealing with Prader Willi. It is from our Pediatric dietitian - - Dr. Cathy Breedon: Cathy Breedon PhD, RD, CSP, FADA Prenatal/Pediatric Nutrition Specialist Clinical Nutrition Specialist MeritCare Medical Center, Dept. of Pediatrics and Clinical Associate Professor of Pediatrics UND School of Medicine, Fargo, ND http://www.meritcare.com/healtheducation/speakers/cathy_breedon/pdfs/Carniti ne.pdf I think this is worth a shot to see if it can help manage the ravenous appetite these patients demonstrate. Linda Bartholomay, LRD Manager, Nutrition Therapy MeritCare Health Systems Linda.Bartholomay at meritcare.com (701) 234-6166 Strengths: Arranger, Ideation, Adaptability, Empathy, Maximizer >>> "Holly Patronik" 10/1/2009 8:27 AM >>> I have a patient with prader Willi whose MD is requesting 800kcal/day. I'm not familiar with working with this condition - is this a normal recommendation - any suggestions?? Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited This e-mail message is intended only for the named recipient(s) above and is covered by the Electronic Communications Privacy Act 18 U.S.C. Section 2510-2521. This e-mail is confidential and may contain information that is privileged or exempt from disclosure under applicable law. If you have received this message in error please immediately notify the sender by return e-mail and delete this e-mail message from your computer. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/39606ed6/attachment-0001 .html ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 5 ********************************** From pcharney at mac.com Fri Oct 2 10:04:19 2009 From: pcharney at mac.com (Pam Charney) Date: Fri, 02 Oct 2009 10:04:19 -0700 Subject: [Cnm] ICU/nutrition support question In-Reply-To: References: Message-ID: Meg, I appreciate your dilemma, but a calorie is a calorie. Ignoring it because it comes from protein is breaking the laws of physics. Regards, pam Pam Charney pcharney at mac.com On Oct 2, 2009, at 8:05 AM, Chaffin Meg wrote: > Do you all include calories provided from you protein modulars when > adding up your total calorie delivery in the ICU? I have a patient > with a BMI of > 40 and I am second guessing my TF regimen. She is > receiving hypocaloric feedings (right now glucerna 1.2 at 25ml/h > because she is getting ~ 920 cal/day from diprivan). I'm not sure > how to get adequate protein in her. We use promod and she would need > A LOT to meet her high protein needs and if I count kcal from promod > then she will end up being overfed calories. She has been in our ICU > for about a week now, on vent support for respiratory failure. Other > issues -- DM, morbid obesity, HTN. Renal status good. Chemistries > look good, except Trig are 226. Am I overthinking this? Any > suggestions? > > Thanks, > Meg > > Meg Chaffin MA,RD,LD > Clinical Nutrition Manager > Palmyra Medical Centers > (229)434-2394 > > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091002/77d780a2/attachment.html From pcharney at mac.com Fri Oct 2 09:23:57 2009 From: pcharney at mac.com (Pam Charney) Date: Fri, 02 Oct 2009 09:23:57 -0700 Subject: [Cnm] PES Statements In-Reply-To: References: <77A34688299A4A75AA616D9A0DC2A011@universi33f5a5> <7E3C6171-10E3-485B-A363-5D5D8B33F732@mac.com> <924902E5-2E8C-4C0D-B3B9-5E5610B5AA1E@mac.com> <607AD24EFC85B14B956CF6AAA4F0E188061A7881FA@chw-msg-824.chw.edu> Message-ID: <3C4D8736-EEF7-43B5-A163-C7A5DE0A3522@mac.com> Greetings, It is thought provoking and reminds me that there is much work to be done on the terminology. Originally, the two terms were used to delineate those folks who were consuming nutrients that the RD could "control" and probably aimed at those receiving nutrition support. The food/beverage was a more global term given that it's difficult to ascertain the exact nutrient content of "food/beverage", so it leaves the clinician the option of giving a broader estimate of intake. However, when we focus only on protein and energy in nutrition support, that leaves out all the other nutrients. Generally, depending on the formula and feeding route, in many patient populations energy and protein will be inadequate while micronutrient intake would remain adequate for some time (assuming we're looking at a sort of typical formula that provides the DRI in 1000 - 1400 ml or so). Annalynn and I both have critical care backgrounds and so we tend to think along the same lines, thus I would totally agree with her description below. The final diagnosis is of course, dependent on the clinician. This dilemma happens in other areas of healthcare. If you were to ask MDs from different specialties to diagnose based on say, a chest x-ray or maybe blood cultures alone, we'd get responses that are in agreement maybe 99% of the time with the last person coming very close and diagnosing something similar. That's where expertise and clinical judgement come into play. The RD who is looking at the patient has to determine where one diagnosis rules out and another rules in. We would hope that, as in the medical example, that we're 99% in agreement. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 2, 2009, at 5:00 AM, Annalynn Skipper wrote: > Sandra, > > I may be barging in on a private conversation here, but when we > developed the definitions, signs and symptoms of the inadequate oral > food and beverage intake, I?m not at all sure that we were thinking > of measuring it in terms of food groups alone. I believe were > thinking about a total amount of food and fluid. Food groups > provide one way of estimating or describing intake as do numbers and > sizes of servings, and actual weights and measures of volume. The > choice of what to use is up to the individual RD based on what is > available. > > The question in distinguishing whether to use oral food and beverage > intake vs. protein energy intake is whether the percentage of food > consumed that the nurses record is more easily or accurately divided > expressed in terms of food groups or kcal and protein. If we follow > up on the percentage recorded on the patient?s flow sheet with a > question for the nurse or patient, would it be something like ?Did > you (your patient) eat your eggs, vegetables, and xxx, xxx, xxxx? or > would it be more reasonable to ask ?Did you (your patient) eat your > energy and protein?? There may not be an easy answer to this > question, and I admit that my critical care bias is showing here > because I think of energy in kcal, protein in grams, and food and > beverages in servings. > > Of course any accurate assessment of intake using a percentage of > intake presupposes that we know the nutrient content of what is > served. In many institutions, the energy and protein content of all > recipes is available, so that part is easy. If we have a select > menu, then we have to work a bit harder to convert that percentage > into a meaningful number. > > Again, I apologize for barging in, but your question is a thought > provoking one. > > 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: Miller, Sandra - MMC [mailto:Sandra.Miller at CHW.edu] > Sent: Thursday, October 01, 2009 7:20 PM > To: 'Pam Charney'; JulieRambo > Cc: Aida Miles; cnm at lists.my180.net > Subject: [Cnm] PES Statements > > Nice to see we are all trying to incorporate correct terminology > into our PES statements. So I have a question to post > How do you determine what is better to use in an acute care case: > inadequate food and beverage versus Inadequate protein- energy? > I have been using protein -energy because I feel I can not monitor > food groups in the hospital very well as I mainly have to rely on % > intake recorded by the nursing staff of that I have no idea - only > the meat, balanced intake. etc.Is this thinking correct? > Sandra Miller MS, RD, CDE > Clinical Nutrition Manager > French Hospital Medical Center > email: sandra.miller at chw.edu > Phone: (805) 542-6229 > > > From: cnm-bounces at lists.my180.net [mailto:cnm- > bounces at lists.my180.net] On Behalf Of Pam Charney > Sent: Wednesday, September 30, 2009 8:17 AM > To: JulieRambo > Cc: Aida Miles; cnm at lists.my180.net > Subject: Re: [Cnm] PES statement for ICU patient > > Unfortunately, in the case described, there is no problem with GI > function. You just can't get to the GI tract due to the endotracheal > tube. Altered GI function would not be the correct nutrition > diagnosis unless there is some underlying condition that was not > divulged in the history given to us. > > The etiology you describe here, "only 500 kcal per day" points to > not getting enough of some important nutrient, thus inadequate > intake of something. > > Regards, > pam > > Pam Charney, PhD, RD > Affiliate Associate Professor > Pharmacy > > MS Student > Clinical Informatics and Patient Centered Technology > School of Nursing > > University of Washington > Seattle, WA > pcharney at mac.com > http://www.linkedin.com/in/pamcharney > > > > On Sep 29, 2009, at 5:12 PM, JulieRambo wrote: > > > I use : Altered GI function (NC-1.4) related to intubation as > evidenced by only 500 calories per day (interject whatever calories > from Diprivan and/or D5). This sets up the goal: to meet est needs > (where I specify calorie, protein and fluid needs) and then the > intervention to initiate TF via OGT (specify formula and rate). Goal > is met when nutrition plan of care is implemented by the LIP. > > Julie Rambo, MSRDLD > > > From: Pam Charney > Sent: Tuesday, September 29, 2009 2:23 PM > To: Aida Miles > Cc: cnm at lists.my180.net > Subject: Re: [Cnm] PES statement for ICU patient > > See below > > p > Pam Charney, PhD, RD > Affiliate Associate Professor > Pharmacy > > MS Student > Clinical Informatics and Patient Centered Technology > School of Nursing > > University of Washington > Seattle, WA > pcharney at mac.com > http://www.linkedin.com/in/pamcharney > > > > On Sep 29, 2009, at 5:39 AM, Aida Miles wrote: > > > Pam and other experts, > Could you elaborate a little bit more on the PES statement and, > perhaps, help some of us learn the process through this example? > This is the PES statement suggested: > Inadequate oral food/beverage intake d/t swallowing difficulty AEB > endotrachial tube in place...(or recent initiation of ventilator > support) > Here the etiology is: swallowing difficulty I would disagree. > There's nothing to tell me that the patient has an intrinsic, > pathophysiologic problem with swallowing. Having a tube in one's > throat does indeed create a problem with swallowing food, but not > with the swallow mechanism itself. > > > And the signs/symptoms are: endotrachial tube in place (or recent > initiation of ventilator support)Also I would disagree. The whole > NCP/P-E-S thing makes more sense if the S relates directly to the P. > Therefore if you diagnose an intake problem the S should say how bad > intake is. In this case, the patient is NPO, I'm assuming. Then the > S might say "NPO" or current intake <25% estimated requirements" or > how ever you usually communicate that calculation. > My understanding is that your Intervention is geared toward the > etiology (if possible). If that is true, I would feel stuck trying > to "intervene" on swallowing difficulty. Personally I might have > said "inability to eat/swallow", and then my intervention would be > to start the tube feeding. Is this OK???? I like this much better. > Maybe "inability to eat". You don't have to say much more. Everyone > who walks into the unit can see that big old endotrachial tube. > Can't miss it! > Then Monitoring and Evaluation are geared toward the signs and > symptoms (if possible). I don't think I want to monitor or evaluate > an endotrachial tube or initiation of vent support.... I would > evaluate tolerance to tube feedings, reaching goal calories, > nutrients, etc. So, could the signs/symptoms be something like > ?patient being NPO?? or something like that? See above. YOu're one > step ahead of me here. > I am wondering if I am being too ?literal? here. No, you're using > critical thinking and common sense. That's a great combination! > Also, looking at the IDNT Second edition ? The Definition, Etiology > and Signs and Symptoms for ?Inadequate Food and Beverage > Intake? (pages 218-219) do not state (that I can find) that this > term can be used for an intubated patient, but it seems to fit. Is > this the type of feedback the committee would want (to include this > in the etiology/ signs and symptoms) in future editions? Just > because it's not there doesn't mean you can't use it. The text > cannot include a comprehensive list of all possible etiologies. The > ones there are suggestions! > I don?t know if I am ?over-thinking? the NCP, but I thought this > would be a perfect opportunity for some of us to hear from true > experts and learn! > J > Aida > Aida Miles, MMSc, RD, CSP, LD > Director, Coordinated Masters Program in Nutrition > University of Minnesota > School of Public Health, Epidemiology & Community Health > 1300 South Second Street, Suite 300 > Minneapolis, MN 55454 > 612-625-5865 (voice mail) > 651-829-0660 (cell) > miles081 at umn.edu > -----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, September 28, 2009 6:19 PM > To: cnm at lists.my180.net > Subject: Cnm Digest, Vol 34, Issue 97 > 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: Critical Care PES (Nancy Shepperly) > 2. Re: Critical Care PES (Pam Charney) > 3. TF question (Holly Patronik) > 4. Re: Prealbumin as predictor of clinical malnutrition? > (Greenwaldt, Heidi J) > ---------------------------------------------------------------------- > Message: 1 > Date: Mon, 28 Sep 2009 15:14:24 -0400 > From: "Nancy Shepperly" > Subject: Re: [Cnm] Critical Care PES > To: ,"Jessica Baye" > Message-ID: <4AC0D2CF.204A.000F.0 at trinity-health.org> > Content-Type: text/plain; charset=US-ASCII > I would say something like this: > Inadequate oral food/beverage intake d/t swallowing difficulty AEB > endotrachial tube in place...(or recent initiation of ventilator > support) > However, I'm not sure if this is right, there are probably better > ways to say it. I'd like to see other examples, too. > Nancy > Please let me know if there is anything else I can do for you... > Nancy Shepperly, RD > Battle Creek Health System > 269-660-3891 > This message may contain confidential information protected by law > through attorney-client privilege or professional peer review/ > quality evaluation privilege. It is intended only for the individual > or entity named above. It is prohibited for anyone else to disclose, > copy, distribute or use the contents of this message. If you > received this message in error, please notify the BCHS Privacy/ > Integrity Office atprivacy_integrity at trinity-health.org or (269) > 966-8347. > >>> "Jessica Baye" 09/28/2009 2:59 PM >>> > Would anyone be willing to give me a sample PES statement for the > following: > ICU patient - recently intubated for hypoxia. Well nourished PTA. > OGT in place. TF not yet started - pending recommendations from RD. > We have a large trauma center and 48 ICU beds. We really struggle > with PES statements in this population. Any feedback is appreciated. > Thanks > 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: 2 > Date: Mon, 28 Sep 2009 12:22:50 -0700 > From: Pam Charney > Subject: Re: [Cnm] Critical Care PES > To: Nancy Shepperly > Cc: cnm at lists.my180.net, Jessica Baye > Message-ID: <120CF810-78F3-4D87-94D0-EC06ABCA9096 at mac.com> > Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes > Since each patient is different, it would be impossible to craft one > nutrition diagnosis that fits all. However, in many cases Nancy's > diagnosis of inadequate oral food/beverage intake might fit, depending > on the patient and the surrounding circumstances. The etiology and > signs/symptoms would depend on the situation facing the clinician. > Regards, > pam > Pam Charney, PhD, RD > Affiliate Associate Professor > Pharmacy > MS Student > Clinical Informatics and Patient Centered Technology > School of Nursing > University of Washington > Seattle, WA > pcharney at mac.com > http://www.linkedin.com/in/pamcharney > On Sep 28, 2009, at 12:14 PM, Nancy Shepperly wrote: > > I would say something like this: > > > > Inadequate oral food/beverage intake d/t swallowing difficulty AEB > > endotrachial tube in place...(or recent initiation of ventilator > > support) > > However, I'm not sure if this is right, there are probably better > > ways to say it. I'd like to see other examples, too. > > > > Nancy > > > > Please let me know if there is anything else I can do for you... > > > > Nancy Shepperly, RD > > Battle Creek Health System > > 269-660-3891 > > > > This message may contain confidential information protected by law > > through attorney-client privilege or professional peer review/ > > quality evaluation privilege. It is intended only for the individual > > or entity named above. It is prohibited for anyone else to disclose, > > copy, distribute or use the contents of this message. If you > > received this message in error, please notify the BCHS Privacy/ > > Integrity Office at privacy_integrity at trinity-health.org or (269) > > 966-8347. > > > > > > > > > > > >>>> "Jessica Baye" 09/28/2009 2:59 PM >>> > > Would anyone be willing to give me a sample PES statement for the > > following: > > > > ICU patient - recently intubated for hypoxia. Well nourished PTA. > > OGT in place. TF not yet started - pending recommendations from RD. > > > > We have a large trauma center and 48 ICU beds. We really struggle > > with PES statements in this population. Any feedback is > appreciated. > > > > Thanks > > 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 > ------------------------------ > Message: 3 > Date: Mon, 28 Sep 2009 16:26:44 -0400 > From: "Holly Patronik" > Subject: [Cnm] TF question > To: > Message-ID: > > > Content-Type: text/plain; charset="us-ascii" > The Manager of our ICU asked me today if there was type of protocol we > could initiate for TF patients in the ICU. She feels that the > diarrhea > r/t tf necessitates too many rectal tubes. Was wondering what others > are doing to prevent diarrhea in TF patients and if you have any > type of > protocol for use of lacto bacillus type products?? She didn't buy the > thought that TF aren't the cause of the diarrhea. > Holly Patronik, RD, LDN > Clinical Nutrition Manager, Sodexo > 219 South Washington Street > Easton, Maryland 21601 > 410-822-1000, ext 5624 > 410-819-0989 (fax) > *** The information contained in this transmission is confidential > and is intended only for the individual named above. If you have > received this information in error, please notify the sender > immediately and delete this message. If the reader of this message > is not the intended recipient, you are hereby notified that any > disclosure, dissemination, distribution, or copying of the > communication or its contents is strictly prohibited > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: /pipermail/cnm_lists.my180.net/attachments/20090928/440c03ac/ > attachment-0001.html > ------------------------------ > Message: 4 > Date: Wed, 23 Sep 2009 15:47:23 -0500 > From: "Greenwaldt, Heidi J" > Subject: Re: [Cnm] Prealbumin as predictor of clinical malnutrition? > To: "Maritza Rodriguez" , > Message-ID: > <59F3EAD5C3376A42B3CD083F034A61270567776F at digsmxmbx06.Fairview.org > > > Content-Type: text/plain; charset="us-ascii" > Definitely true that it is not a good indicator for clinical > malnutrition. The new ASPEN guidelines have the information. I > attached > it. > 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 Maritza Rodriguez > Sent: Wednesday, September 23, 2009 3:35 PM > To: cnm at lists.my180.net > Subject: [Cnm] Prealbumin as predictor of clinical malnutrition? > I recently read somewhere that prealbumin level is probably not such a > good indicator for clinical malnutrition. Have any of you heard about > this? Do you know an official and reliable source of reference for > this > topic? Thanks in advance. > Maritza Rodriguez > Maritza Rodriguez, RD LDN > Clinical Nutrition Manager > Mount Sinai Medical Center > Tel: 305-674-2121 X 56181 > m-rodrig at msmc.com > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: /pipermail/cnm_lists.my180.net/attachments/20090923/dc1119be/ > attachment.html > -------------- next part -------------- > A non-text attachment was scrubbed... > Name: Nutrition Support in the Critically Ill Guidelines.pdf > Type: application/pdf > Size: 315208 bytes > Desc: Nutrition Support in the Critically Ill Guidelines.pdf > Url : /pipermail/cnm_lists.my180.net/attachments/20090923/dc1119be/ > attachment.pdf > ------------------------------ > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > End of Cnm Digest, Vol 34, Issue 97 > *********************************** > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > > > -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091002/22e56ae5/attachment-0001.html From RBijold1 at smdc.org Fri Oct 2 11:32:51 2009 From: RBijold1 at smdc.org (Bijold, Roxanne M.) Date: Fri, 2 Oct 2009 13:32:51 -0500 Subject: [Cnm] NICU In-Reply-To: References: Message-ID: <42A90F8376E770489AF180BC11195B0501B17A71@BOREAL.ntcampus.smdc.org> We do ours in Nutrition Services 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 A Bresciami Sent: Thursday, October 01, 2009 7:33 PM To: cnm at lists.my180.net Subject: [Cnm] NICU I know this question has been asked before however, I am trying to have pharmacy or nursing take over the responsibility of mixing the formulas NICU uses (currently we are mixing the formulas here in the kitchen). Before Administration would agree with making a change they asked me to try to find out what other facilities are doing. For those of you who have NICU's : Who is responsible for measuring and mixing whatever powdered formulas the NICU uses? Thanks in advance and sorry for the repost. Regards, Amy Bresciami, R.D. Operations Manager/CNM Food & Nutrition Services Office: 714.456.3840 Pager: 714.506.5920 Fax: 714.456.7174 abrescia at uci.edu ________________________________ Microsoft brings you a new way to search the web. Try Bing(tm) now This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. As required by federal and state laws, you need to hold this information as privileged and confidential. If you have received this communication in error, please notify the sender and destroy all copies of this communication and any attachments. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091002/a3cb8747/attachment.html From Susan_R_Paredez at uhs.org Fri Oct 2 11:38:25 2009 From: Susan_R_Paredez at uhs.org (Susan_R_Paredez at uhs.org) Date: Fri, 2 Oct 2009 14:38:25 -0400 Subject: [Cnm] NICU In-Reply-To: Message-ID: The dietitians mix it on the unit except for holidays. We have tried to get the nursing staff to mix it more often, but didn't get overall support for this. We inserviced the staff and left instructions on how to mix. Infection control okayed it. But, the nurse mgr. is not supportive of her staff doing it. Susan Paredez Clinical Nutrition Coordinator UHS Hospitals Susan_R_Paredez at UHS.org 607-763-6600 A Bresciami Sent by: To cnm-bounces at lists .my180.net cc Subject 10/01/2009 08:32 [Cnm] NICU PM I know this question has been asked before however, I am trying to have pharmacy or nursing take over the responsibility of mixing the formulas NICU uses (currently we are mixing the formulas here in the kitchen). Before Administration would agree with making a change they asked me to try to find out what other facilities are doing. For those of you who have NICU's : Who is responsible for measuring and mixing whatever powdered formulas the NICU uses? Thanks in advance and sorry for the repost. Regards, Amy Bresciami, R.D. Operations Manager/CNM Food & Nutrition Services Office: 714.456.3840 Pager: 714.506.5920 Fax: 714.456.7174 abrescia at uci.edu Microsoft brings you a new way to search the web. Try Bing? now _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net --- 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. --- 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. o2 -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091002/e56873c8/attachment.html -------------- next part -------------- A non-text attachment was scrubbed... Name: graycol.gif Type: image/gif Size: 105 bytes Desc: not available Url : /pipermail/cnm_lists.my180.net/attachments/20091002/e56873c8/attachment.gif -------------- next part -------------- A non-text attachment was scrubbed... Name: pic19954.gif Type: image/gif Size: 1255 bytes Desc: not available Url : /pipermail/cnm_lists.my180.net/attachments/20091002/e56873c8/attachment-0001.gif -------------- next part -------------- A non-text attachment was scrubbed... Name: ecblank.gif Type: image/gif Size: 45 bytes Desc: not available Url : /pipermail/cnm_lists.my180.net/attachments/20091002/e56873c8/attachment-0002.gif From Laura.Leciejewski at stalexius.net Fri Oct 2 11:42:04 2009 From: Laura.Leciejewski at stalexius.net (Laura Leciejewski) Date: Fri, 02 Oct 2009 13:42:04 -0500 Subject: [Cnm] NICU In-Reply-To: <42A90F8376E770489AF180BC11195B0501B17A71@BOREAL.ntcampus.smdc.org> References: <42A90F8376E770489AF180BC11195B0501B17A71@BOREAL.ntcampus.smdc.org> Message-ID: <4AC6032C020000BA0004464C@alexian.net> Nutrition Services mixing in the NICU. We have a designated area. Laura C. Leciejewski, MS, RD, LDN, CNSD Clinical Nutrition Manager St. Alexius Medical Center 1555 Barrington Rd Hoffman Estates, IL 60194 847-843-2000 ext 6591 pager # 711 >>> "Bijold, Roxanne M." 10/2/2009 1:32 PM >>> We do ours in Nutrition Services 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 A Bresciami Sent: Thursday, October 01, 2009 7:33 PM To: cnm at lists.my180.net Subject: [Cnm] NICU I know this question has been asked before however, I am trying to have pharmacy or nursing take over the responsibility of mixing the formulas NICU uses (currently we are mixing the formulas here in the kitchen). Before Administration would agree with making a change they asked me to try to find out what other facilities are doing. For those of you who have NICU's : Who is responsible for measuring and mixing whatever powdered formulas the NICU uses? Thanks in advance and sorry for the repost. Regards, Amy Bresciami, R.D. Operations Manager/CNM Food & Nutrition Services Office: 714.456.3840 Pager: 714.506.5920 Fax: 714.456.7174 abrescia at uci.edu ________________________________ Microsoft brings you a new way to search the web. Try Bing(tm) now 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. 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 HicksCM at ah.org Fri Oct 2 12:28:33 2009 From: HicksCM at ah.org (Clare Hicks) Date: Fri, 02 Oct 2009 12:28:33 -0700 Subject: [Cnm] ICU/nutrition support question In-Reply-To: References: Message-ID: <4AC5F1E9.7147.00AE.0@ah.org> What about using a protein modular that does not have the extra carb in it that ProMod does? We have used Beneprotein before as a modifier in a hypocaloric feeding. Of course, it provides extra calories, but much fewer than ProMod because it does not have any carb in it. Just an idea.... Clare Hicks, RD Sonora Regional Medical Center Sonora, CA >>> Pam Charney 10/02/2009 10:04 >>> Meg, I appreciate your dilemma, but a calorie is a calorie. Ignoring it because it comes from protein is breaking the laws of physics. Regards, pam Pam Charney pcharney at mac.com On Oct 2, 2009, at 8:05 AM, Chaffin Meg wrote: > Do you all include calories provided from you protein modulars when > adding up your total calorie delivery in the ICU? I have a patient > with a BMI of > 40 and I am second guessing my TF regimen. She is > receiving hypocaloric feedings (right now glucerna 1.2 at 25ml/h > because she is getting ~ 920 cal/day from diprivan). I'm not sure > how to get adequate protein in her. We use promod and she would need > A LOT to meet her high protein needs and if I count kcal from promod > then she will end up being overfed calories. She has been in our ICU > for about a week now, on vent support for respiratory failure. Other > issues -- DM, morbid obesity, HTN. Renal status good. Chemistries > look good, except Trig are 226. Am I overthinking this? Any > suggestions? > > Thanks, > Meg > > Meg Chaffin MA,RD,LD > Clinical Nutrition Manager > Palmyra Medical Centers > (229)434-2394 > > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From Jennifer.DeHart at stvhs.com Fri Oct 2 13:03:40 2009 From: Jennifer.DeHart at stvhs.com (DeHart, Jennifer) Date: Fri, 2 Oct 2009 15:03:40 -0500 Subject: [Cnm] FW: ICU/nutrition support question Message-ID: <790BE6DACA733D45A2EFE7875E03CC7C01AB3EDF@ahcmascdc024.DS.SJHS.COM> How long has she been on the propofol? If it's been more than a few days, it wouldn't be inappropriate to ask whether transitioning to another med for sedation would be feasible. Also, if you have Glucerna 1.2 I assume your formulary is Abbott - we use Promote frequently with patients on propofol because it has more protein per kcal (so you'd need less modular). Good luck! 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 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Clare Hicks Sent: Friday, October 02, 2009 2:29 PM To: Chaffin Meg; Pam Charney Cc: 'cnm at lists.my180.net' Subject: Re: [Cnm] ICU/nutrition support question What about using a protein modular that does not have the extra carb in it that ProMod does? We have used Beneprotein before as a modifier in a hypocaloric feeding. Of course, it provides extra calories, but much fewer than ProMod because it does not have any carb in it. Just an idea.... Clare Hicks, RD Sonora Regional Medical Center Sonora, CA >>> Pam Charney 10/02/2009 10:04 >>> Meg, I appreciate your dilemma, but a calorie is a calorie. Ignoring it because it comes from protein is breaking the laws of physics. Regards, pam Pam Charney pcharney at mac.com On Oct 2, 2009, at 8:05 AM, Chaffin Meg wrote: > Do you all include calories provided from you protein modulars when > adding up your total calorie delivery in the ICU? I have a patient > with a BMI of > 40 and I am second guessing my TF regimen. She is > receiving hypocaloric feedings (right now glucerna 1.2 at 25ml/h > because she is getting ~ 920 cal/day from diprivan). I'm not sure > how to get adequate protein in her. We use promod and she would need > A LOT to meet her high protein needs and if I count kcal from promod > then she will end up being overfed calories. She has been in our ICU > for about a week now, on vent support for respiratory failure. Other > issues -- DM, morbid obesity, HTN. Renal status good. Chemistries > look good, except Trig are 226. Am I overthinking this? Any > suggestions? > > Thanks, > Meg > > Meg Chaffin MA,RD,LD > Clinical Nutrition Manager > Palmyra Medical Centers > (229)434-2394 > > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege. From dlquirk at lexhealth.org Fri Oct 2 13:17:11 2009 From: dlquirk at lexhealth.org (Donna Quirk) Date: Fri, 2 Oct 2009 16:17:11 -0400 Subject: [Cnm] Meditech MedDietary In-Reply-To: <790BE6DACA733D45A2EFE7875E03CC7C01AB3EDF@ahcmascdc024.DS.SJHS.COM> References: <790BE6DACA733D45A2EFE7875E03CC7C01AB3EDF@ahcmascdc024.DS.SJHS.COM> Message-ID: Is anyone using Meditech's MedDietary? If so, I would like to hear about your experiences with it, how you use it, etc. Thanks, Donna Quirk MBA RD LD Clinical Nutrition Manager Lexington Medical Center 2720 Sunset Blvd West Columbia, SC 29169 803-791-2248 ______________________________________________________________________ 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 Linda.Woods at healthall.com Fri Oct 2 13:30:22 2009 From: Linda.Woods at healthall.com (Woods, Linda) Date: Fri, 2 Oct 2009 16:30:22 -0400 Subject: [Cnm] Cnm Digest, Vol 35, Issue 6 In-Reply-To: References: Message-ID: <2B1106A6A593B147A65BD5A8939D3E1101065B3410F4@MAIL-C.healthall.com> I don't know that it's actually stated that way in the standards, but a documented consult can serve as an audit trail that the communication/referral between disciplines has occurred. We require it here and our TJC surveyors a few years liked it. Linda Woods, RD, LD Clinical Nutrition Coordinator Food and Nutrition Services UC Health - University Hospital 234 Goodman Street Cincinnati, OH 45219-2316 Office: 513-584-4534 Pager: 513-577-0948 linda.woods at healthall.com www.uchealthnow.com -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Heberle, Heather N. Sent: Friday, October 02, 2009 10:27 AM To: cnm at lists.my180.net Subject: Re: [Cnm] Cnm Digest, Vol 35, Issue 6 Does anyone know if it is a TJC regulation to have a documented consult sent to the dietitians when a patient has a positive nutrition screen on admission? Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 ________________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of cnm-request at lists.my180.net [cnm-request at lists.my180.net] Sent: Thursday, October 01, 2009 7:18 PM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 6 Send Cnm mailing list submissions to cnm at lists.my180.net To subscribe or unsubscribe via the World Wide Web, visit http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net or, via email, send a message with subject or body 'help' to cnm-request at lists.my180.net You can reach the person managing the list at cnm-owner at lists.my180.net When replying, please edit your Subject line so it is more specific than "Re: Contents of Cnm digest..." Today's Topics: 1. Paying for license to use NCP language (Jeanne Edwards) 2. Re: Full Liquid Diet (Taylor, Tracy) 3. PES Statements (Miller, Sandra - MMC) ---------------------------------------------------------------------- Message: 1 Date: Thu, 1 Oct 2009 15:57:46 -0500 From: "Jeanne Edwards" Subject: [Cnm] Paying for license to use NCP language To: "Heberle, Heather N." , Message-ID: <1E611D0D82010049A4E087DFA59CA442097D84D7 at holy1.hfmhealth.com> Content-Type: text/plain; charset="us-ascii" You do not have to pay for using the NCP language if you handwrite the document. See the response below, from ADA in regards to this question. Jeanne Edwards MS RD Holy Family Memorial Manitowoc WI Jedwards at hfmhealth.org ------------------------------------------------------------ Yes, the $150 annual fee for one hospital grants you permission to use the terms in an EHR, gives you and IT the terms with 15 character abbreviations, 2 IDNT reference manuals, and entitles you to automatic updates with new terms, abbreviations and manuals when the terms are updated. Typing in all of the terms is an option that ADA does not endorse because of the potential for missing or compromised QI data if staff have typos in their notes and lost staff time, much greater than $150 (> 11 hours per year per one FTE dietitian to type eight diagnosis statements per day). Handwritten/paper documentation does not require a license. Donna onna G. Pertel, MEd, RD - American Dietetic Association - NCP Business Manager and Consultant - ncpslpermissions at eatright.org - 203-314-9462 - 312-899-5344 fax ----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Heberle, Heather N. Sent: Tuesday, September 22, 2009 11:24 AM To: cnm at lists.my180.net Subject: Re: [Cnm] Cnm Digest, Vol 34, Issue 74 You must have the licensure approved/paid for to use the language whether or not you have an EMR or not. Go to the www.eatright.org and it is all under the NCP tab on the left. The licensure cost $150 per year per facility. Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 ________________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of cnm-request at lists.my180.net [cnm-request at lists.my180.net] Sent: Tuesday, September 22, 2009 11:16 AM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 34, Issue 74 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. NCP (Leslie Collier) 2. Food Allergies (Kaskel, Phyllis) 3. Re: NCP (Hollie_Colle at ssmhc.com) 4. Re: NCP (UNCLASSIFIED) (Clark, Heidi L MAJ MIL USAF MEDCOM LRMC) 5. Re: NCP (UNCLASSIFIED) (Clark, Heidi L MAJ MIL USAF MEDCOM LRMC) 6. Re: NCP (UNCLASSIFIED) (Pam Charney) 7. cyclic parenteral nutrition (Cece Ohmart) 8. Formula Preparation Room Staffing and Productivity (Sue Teske) ---------------------------------------------------------------------- Message: 1 Date: Tue, 22 Sep 2009 09:49:52 -0500 From: "Leslie Collier" Subject: [Cnm] NCP To: Message-ID: <1BA09AF1C1B5E5499D62240E020C24760162AF16 at MMHEVS1.mmh.local> Content-Type: text/plain; charset="us-ascii" Hi all...were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood...I can't believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090922/1507b27a/attachment- 0001.html ------------------------------ Message: 2 Date: Tue, 22 Sep 2009 10:55:13 -0400 From: "Kaskel, Phyllis" Subject: [Cnm] Food Allergies To: Message-ID: <850F6C2F598EF84F8FA5BEF9CC0CC96D03F0B6D7 at EXCEBW2K325.msnyuhealth.org> Content-Type: text/plain; charset="us-ascii" Does anyone have a Food Allergy policy they would be willing to share? Thanks. P Phyllis Kaskel, MA, RD, CDN Director, Clinical Nutrition Mount Sinai Hospital and Faculty, Department of Preventive Medicine Mount Sinai School of Medicine ------------------------------ Message: 3 Date: Tue, 22 Sep 2009 09:59:20 -0500 From: Hollie_Colle at ssmhc.com Subject: Re: [Cnm] NCP To: "Leslie Collier" Cc: cnm at lists.my180.net, cnm-bounces at lists.my180.net Message-ID: Content-Type: text/plain; charset="iso-8859-1" I didn't know we had to pay. I just thought you had to buy the IDNT standardized lang. book. How do you pay? Is there a contract? Hollie Colle, MS, RD, LDN Clinical Nutrition Manager St. Mary's Good Samaritan, Inc. Mount Vernon IL 62864 (618) 241-2356 Centralia IL 62801 (618) 436-8897 "Leslie Collier" Sent by: cnm-bounces at lists.my180.net 09/22/2009 09:49 AM To cc Subject [Cnm] NCP Hi all?were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood?I can?t believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" _______________________________________________ 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 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 email and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090922/d10fe9d2/attachment- 0001.html ------------------------------ Message: 4 Date: Tue, 22 Sep 2009 16:59:32 +0200 From: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" Subject: Re: [Cnm] NCP (UNCLASSIFIED) To: "Leslie Collier" , Message-ID: <9AB53CB10B46784794F4F6D3AD82344F2F6EA9 at AMEDERMCBE041.eur.amed.ds.army.m il> Content-Type: text/plain; charset="us-ascii" Classification: UNCLASSIFIED Caveats: NONE Oh, no--you did not misunderstand at all. The language is copyrighted and ADA has put out guidance for single users, or those who use an electronic medical record--putting the onus on the EMR company to get permission from them, same way that they may get permission from the AMA for using other specific language. This is the link: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/governance_13838_ENU_HTM L.htm (scroll down to the very bottom--has some FAQ's, more than they used to several months ago, when it was just a form to fill out and then they'd tell you how much you owe) I have a TON of comments--already sent my editorial letter to the ADA, and got a nice response telling me that they didn't have enough $$ to manage the NCP language/do updates/etc w/o charging for it's use; and they wanted to manage who used it. I understand the idea of intellectual property, and also the idea of managing who uses the language (don't want Jane "nutritionist" and Joe chiropractor using the NCP...), but this seems onerous. It's like the proposed soda-pop tax only in reverse--let's charge people extra who want to do the right thing! Sorry, I have several soap boxes and this is one of them. Heidi Clark, MS, RD Landstuhl Regional Medical Center -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Leslie Collier Sent: Tuesday, September 22, 2009 4:50 PM To: cnm at lists.my180.net Subject: [Cnm] NCP Hi all...were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood...I can't believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" Classification: UNCLASSIFIED Caveats: NONE ------------------------------ Message: 5 Date: Tue, 22 Sep 2009 17:03:19 +0200 From: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" Subject: Re: [Cnm] NCP (UNCLASSIFIED) To: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" , "Leslie Collier" , Message-ID: <9AB53CB10B46784794F4F6D3AD82344F2F6EAC at AMEDERMCBE041.eur.amed.ds.army.m il> Content-Type: text/plain; charset="us-ascii" Classification: UNCLASSIFIED Caveats: NONE I should clarify--my understanding is that it is when you use the NCP language in an electronic medical record (eg, drop downs or check boxes or electronic algorithms). We have an EMR at my facility, and have a specific nutrition note, but we free text in all the language. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Clark, Heidi L MAJ MIL USAF MEDCOM LRMC Sent: Tuesday, September 22, 2009 5:00 PM To: Leslie Collier; cnm at lists.my180.net Subject: Re: [Cnm] NCP (UNCLASSIFIED) Classification: UNCLASSIFIED Caveats: NONE Oh, no--you did not misunderstand at all. The language is copyrighted and ADA has put out guidance for single users, or those who use an electronic medical record--putting the onus on the EMR company to get permission from them, same way that they may get permission from the AMA for using other specific language. This is the link: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/governance_13838_ENU_HTM L.htm (scroll down to the very bottom--has some FAQ's, more than they used to several months ago, when it was just a form to fill out and then they'd tell you how much you owe) I have a TON of comments--already sent my editorial letter to the ADA, and got a nice response telling me that they didn't have enough $$ to manage the NCP language/do updates/etc w/o charging for it's use; and they wanted to manage who used it. I understand the idea of intellectual property, and also the idea of managing who uses the language (don't want Jane "nutritionist" and Joe chiropractor using the NCP...), but this seems onerous. It's like the proposed soda-pop tax only in reverse--let's charge people extra who want to do the right thing! Sorry, I have several soap boxes and this is one of them. Heidi Clark, MS, RD Landstuhl Regional Medical Center -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Leslie Collier Sent: Tuesday, September 22, 2009 4:50 PM To: cnm at lists.my180.net Subject: [Cnm] NCP Hi all...were you all aware that we have to PAY to use the NCP for charting!?! Please tell me I have misunderstood...I can't believe that we are being encouraged to use standardized language and then have to PAY to do so. Anyone have any comments? Leslie Collier, RD/LD Clinical Nutrition Manager Midland Memorial Hospital 2200 West Illinois Midland, TX 79701 leslie.collier at midland-memorial.com (432) 685-4206 (432) 685-6991 (fax) (432) 742-0087 (pager) "Dance like no one is watching, eat like someone is!" Classification: UNCLASSIFIED Caveats: NONE _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Classification: UNCLASSIFIED Caveats: NONE ------------------------------ Message: 6 Date: Tue, 22 Sep 2009 08:40:22 -0700 From: Pam Charney Subject: Re: [Cnm] NCP (UNCLASSIFIED) To: "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" Cc: cnm at lists.my180.net Message-ID: <4012A0A2-4450-4437-A299-8F43A3643824 at mac.com> Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes There is much misunderstanding regarding the licensing fees for the terminology. It is correct that there is no fee associated with using a care process. Let's remember that the NCP and the terminology are two separate and distinct entities. Any care process is simply a structured way of thinking; it'd be hard to license thinking. There are licensing fees for using the terminology in a proprietary electronic system. This is the same thing as the fee you pay to install most software (non share ware) on your computer. I'm sure we're all aware that we are not purchasing the code for that software. We are buying the right to install and use the software. That's why some programs allow "multi-user" options. You install the same software on a designated number of computers based on the number of licenses you have purchased. There are many healthcare terminologies that have associated licensing fees. Most EMR vendors are now using a reference terminology known as SNOMED, which includes terms from many different terminologies, including several that have licensing fees. Therefore, when the vendor uses SNOMED, the fees are paid somewhere else down the line so the purchaser of the EMR product doesn't see the bill for the licenses. It is worth the small amount for the license to have the terminology included in your database. Free text does not allow for accurate, reliable capture of the work of dietetics. I"d be happy to answer other questions regarding terminology and the EMR offline. I'm sure the folks at ADA can answer other questions specific to the IDNT. Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 22, 2009, at 8:03 AM, Clark, Heidi L MAJ MIL USAF MEDCOM LRMC wrote: > Classification: UNCLASSIFIED > Caveats: NONE > > I should clarify--my understanding is that it is when you use the NCP > language in an electronic medical record (eg, drop downs or check > boxes or electronic algorithms). We have an EMR at my facility, and > have a specific nutrition note, but we free text in all the language. > > -----Original Message----- > From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] > On Behalf Of Clark, Heidi L MAJ MIL USAF MEDCOM LRMC > Sent: Tuesday, September 22, 2009 5:00 PM > To: Leslie Collier; cnm at lists.my180.net > Subject: Re: [Cnm] NCP (UNCLASSIFIED) > > Classification: UNCLASSIFIED > Caveats: NONE > > Oh, no--you did not misunderstand at all. The language is copyrighted > and ADA has put out guidance for single users, or those who use an > electronic medical record--putting the onus on the EMR company to get > permission from them, same way that they may get permission from the > AMA for using other specific language. This is the link: > > http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/governance_13838_ENU_HTM > L.htm (scroll down to the very bottom--has some FAQ's, more than > they > used to several months ago, when it was just a form to fill out and > then they'd tell you how much you owe) > > I have a TON of comments--already sent my editorial letter to the ADA, > and got a nice response telling me that they didn't have enough $$ to > manage the NCP language/do updates/etc w/o charging for it's use; and > they wanted to manage who used it. I understand the idea of > intellectual property, and also the idea of managing who uses the > language (don't want Jane "nutritionist" and Joe chiropractor using > the NCP...), but this seems onerous. It's like the proposed soda-pop > tax only in reverse--let's charge people extra who want to do the > right thing! > > Sorry, I have several soap boxes and this is one of them. > > Heidi Clark, MS, RD > Landstuhl Regional Medical Center > > -----Original Message----- > From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] > On Behalf Of Leslie Collier > Sent: Tuesday, September 22, 2009 4:50 PM > To: cnm at lists.my180.net > Subject: [Cnm] NCP > > Hi all...were you all aware that we have to PAY to use the NCP for > charting!?! Please tell me I have misunderstood...I can't believe > that we are being encouraged to use standardized language and then > have to PAY to do so. Anyone have any comments? > > > > Leslie Collier, RD/LD > > Clinical Nutrition Manager > > Midland Memorial Hospital > > 2200 West Illinois > > Midland, TX 79701 > > > > leslie.collier at midland-memorial.com > > > > > (432) 685-4206 > > (432) 685-6991 (fax) > > (432) 742-0087 (pager) > > > > "Dance like no one is watching, eat like someone is!" > > > > Classification: UNCLASSIFIED > Caveats: NONE > > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > Classification: UNCLASSIFIED > Caveats: NONE > > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net ------------------------------ Message: 7 Date: Tue, 22 Sep 2009 11:46:20 -0400 (EDT) From: Cece Ohmart Subject: [Cnm] cyclic parenteral nutrition To: cnm at lists.my180.net Message-ID: <20090922114620.AGN30918 at mail.mainehospital.org> Content-Type: text/plain; charset=ISO-8859-1 Hi, Does anyone have a policy/procedure regarding cyclic parenteral nutrition? Thanks, Cece This message is intended for the use of the addressee only and may contain information that is privileged and confidential. If you are not the intended recipient of this message, be notified that any dissemination or use of this message is strictly prohibited. Un-intended transmission does not constitute waiver of attorney-client privilege or any other privilege. If you have received this message in error, please delete all copies of the message and its attachments and notify the sender immediately. Thank you. ------------------------------ Message: 8 Date: Tue, 22 Sep 2009 11:18:45 -0500 From: "Sue Teske" Subject: [Cnm] Formula Preparation Room Staffing and Productivity To: "Clinical List" Message-ID: <3D0B6F497247834CAC5FF0C30ED7A5C402495864 at chexmain.chsys.org> Content-Type: text/plain; charset="us-ascii" As part of a group that is working on updating the ADA publication "Infant Feedings: Guidelines for Preparation of Formula dn Breastmilk in Health Care Facilities", I would greatly appreciate your participation in this survey. 1. Do you have a formula preparation room? 2. How many patient care units are served by formula room? a. Number of beds per patient care unit? 3. What is the estimated average distance (for the delivery of feedings) from the formula room to the patient care units served by the formula room? 4. How many deliveries are made each day from the formula room? a. Batch deliveries b. Single order deliveries (e.g.: new, prn or stat) 5. Who delivers the formula? a. Formula room staff b. Central transportation staff c. Other (please specify): ___________________ 6. What are the hours of operation of the formula room? 7. How many FTEs are dedicated to the formula room? a. Formula techs b. Direct supervision c. Other (please specify): ___________________ 8. How many units of formula are produced per day (average)? a. Bulk supply (24h volume in bulk containers) b. Unit dose 9. How many units of ready-to-use formula (closed systems or rtf formula bottles) are dispensed per day (average) from the formula room? 10. What other duties are assigned (e.g.: cleaning of formula refrigeration/freezers, inventory control/ordering supplies, monitor refrigerator temperatures, etc.) to the employees who staff the formula room? 11. Do you have a separate breastmilk bank or area for dispensing/preparation of breastmilk? a. If yes, who staffs that area? b. How many FTEs are dedicated to the breastmilk bank/preparation room? c. How many units of breastmilk are dispensed per day? d. How many units of breastmilk are prepared with the addition of a fortifier or other additive? i. Bulk supply (24h volume in bulk containers) ii. Unit dose 12. How do you measure the productivity of your formula room staff? Thank you for your time! Susan C. Teske, MS, RD, LD, CNSD Director, Dept. of Clinical Nutrition and Lactation Services Children's Health System 1600 7th Ave. South 3rd Floor hospital, Room 334 Birmingham, AL 35233 (205) 939-9203 Office (205) 939-6047 Fax susan.teske at chsys.org Confidentiality Notice: The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material. Any review, retransmission dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. 20090416 -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090922/0dae8f82/attachment. html ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 34, Issue 74 *********************************** _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net ------------------------------ Message: 2 Date: Thu, 1 Oct 2009 16:01:37 -0700 From: "Taylor, Tracy" Subject: Re: [Cnm] Full Liquid Diet To: Message-ID: <222E81132BE3E54584CB9A5DB1CDD7E280DE0D at bks-emx001.dmc-sp.org> Content-Type: text/plain; charset="us-ascii" Mt version of the NCM has a full liquid diet: Indications The traditional indication for the full liquid diet is for short term use as a transition step between the clear liquid and soft diets following gastrointestinal surgery I don't remember this on the previous NCM version we had and at that time we toyed with idea of omitting, but to keep our customers, in this case the surgeons, satisfied we left it in as an addendum. And now we have it on the online version as well. best Tracy Tracy Taylor RD, CDE Director: Diabetes Management/Outpatient Nutrition Programs Clinical Nutrition Manager Doctors Medical Center San Pablo 2000 Vale Rd San Pablo, CA 94806 phone: 510-970-5344 fax: 510-970-5739 email: ttaylor at dmc-sp.org CONFIDENTIAL AND PRIVILEGED: May contain materials protected by law. This communication contains information intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged and/or confidential. If you are not the intended recipient or an employee or agent responsible for delivering the communication to the intended recipient, you are hereby notified that any disclosure, copying, distribution, or use of its contents is prohibited. If you have received this communication in error, please notify me immediately by telephone at (510) 970-5344, return the original communication by reply e-mail, and permanently delete the communication from your system. Thank you. "A year from now you will wish you had started today." --Karen Lamb -----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: Thursday, October 01, 2009 11:19 AM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 4 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: Full Liquid Diet (Krzeminski, Janet) 2. Long term vent patients (MARTHA ELLINGTON) 3. Re: Recipe Nutrient Analysis software question (Denise Conforti) 4. Re: Prader Willi (Ekvall, Shirley (ekvalls)) 5. Re: pediatric needs (Ekvall, Shirley (ekvalls)) ---------------------------------------------------------------------- Message: 1 Date: Thu, 1 Oct 2009 10:11:49 -0500 From: "Krzeminski, Janet" Subject: Re: [Cnm] Full Liquid Diet To: "RICAFORT, Christina" , Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F201171F31 at rhcexch3.reshealthcare.org> Content-Type: text/plain; charset="us-ascii" I understand your stance on being evidence-based, however physician-RD relations, and working with Physicians to increase THEIR satisfaction is an ongoing PI here in our System. Outcomes of patients becomes more of a key role in our hospital than studies in certain instances. And procedures that work for improving a patient outcome in conjunction with what the physicians order should be one thing that I would recommend that you look at with perhaps an interdisciplinary team, or with one of your key physicians. Some of my peers in my system created an adjunct to the NCM, including full liquid and clear liquid diets... Janet K Chicago, IL ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of RICAFORT, Christina Sent: Wednesday, September 30, 2009 3:42 PM To: cnm at lists.my180.net Subject: [Cnm] Full Liquid Diet I recently omitted the Full Liquid diet from our menu based on the information in the NCM and the literature addressing this issue. Our surgeons are very angry about not having this available and demands that I explain the whole rationale. I do have the studies to cite but if anyone out there has a better approach to this, please share with me so I can convince them that this is evidence based. Please share your experience as well. Thanks. Hope to hear from you soon. Tina C. Ricafort MA., RD., CD. Manager, Clinical Dietetics Saint John's Health System 2015 Jackson St. Anderson, IN 46016 tcricafo at sjhsnet.org (765)646-8197 (765)646-8780 fax CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/a951cd52/attachment- 0001.html ------------------------------ Message: 2 Date: Thu, 1 Oct 2009 11:31:46 -0400 From: MARTHA ELLINGTON Subject: [Cnm] Long term vent patients To: "cnm at lists.my180.net" Message-ID: Content-Type: text/plain; charset="us-ascii" We have several "Step down units" on one medical floor that tend to have Vent patients that are here "just hanging out" until they can be placed in a LTC facility that takes ventilated patients. Naturally they are on tube feedings and have many Dr's involved with their care. These patients can be stable for awhile then (usually on the weekends) something crops up and they want the dietitian to "fix" a problem that can take 2 hours to track down through all the history. You never really get the real story because all the players are not available. My questions are: What is your policy for involvement with patients that are in an acute facility waiting for placement in a LTC for vent patients? If you work in one of these LTC that can take vents, what is your level of involvement? Thanks for any wisdom you can give. 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 ------------------------------ Message: 3 Date: Thu, 1 Oct 2009 10:46:25 -0700 (PDT) From: Denise Conforti Subject: Re: [Cnm] Recipe Nutrient Analysis software question To: cnm at lists.my180.net Message-ID: <246203.55846.qm at web31910.mail.mud.yahoo.com> Content-Type: text/plain; charset="iso-8859-1" Please post...I am also looking for software that does recipe analysis and has food labeling capabilities. I have narrowed the search to Nutribase and Nutritionist Pro Food Labeling software (this is a separate purchase?from the Diet Analysis software). ? Does anyone have experience with the Nutritionist Pro?Food Labeling software??Is it user friendly? Thanks in advance! Denise M. Conforti, MS, RD, LDN Clinical Nutrition Manager Dietetic Internship Director Mount Auburn?Hospital 330 Mount Auburn Street Cambridge, MA 02138 Phone: 617.499.5665 Ext. 3059 Pager: 617.499.5110 Pager 6777 --- On Thu, 10/1/09, Orlowski, Hannah wrote: From: Orlowski, Hannah Subject: Re: [Cnm] Recipe Nutrient Analysis software question To: "Meehan Bonnie" , cnm at lists.my180.net Date: Thursday, October 1, 2009, 8:41 AM Please list to post.? I am also looking. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Meehan Bonnie Sent: Wednesday, September 30, 2009 8:40 PM To: 'cnm at lists.my180.net' Subject: [Cnm] Recipe Nutrient Analysis software question CNM Members, ? For those of you who have researched this topic and/or are using a system that you are happy with, which one would you recommend?? I need to find a system quickly to analyze home and cafeteria recipes and print labels and do not have a lot of time to research it.? I'm not exactly sure what all I need it to do, but think the below is a good start.? If you are not sure about what all the capabilities are of the one you have, just tell me what brand it is and what you like or do not like about it.? What is the advantage of buying one like Nutribase or ESHA versus downloading a free one from the Internet?? If you are familiar with the major brands, which one do you like better? ? Would like one that: --Overall easy to learn and use --Easy input of recipe data --Good reputable database of foods and some brand names --Can expand home sized recipe to accurate institutional sized recipe with quantities applicable to large quantities (like cups?vs. teaspoons) --Can give info on desired serving sizes --Can analyze up to 10 nutrients by normal unit of measure (gm, mg, etc.) and give % DRV based on 2,000 or 2,500 calorie diet --Can print food labels for above nutrients (or just ones you want to see) --Is not cost prohibitive to buy and to maintain up to date database and upgrades --Could work on individual computer or web (if you wanted to expand use of this on a corporate LAN to all employees) --Good customer support --Might include other wellness features--though this part is not necessary ? Many Thanks for whatever guidance you can provide.--Bonnie ? Bonnie Meehan, RD, CD Chief Clinical Dietitian St. Francis Hospital & Health Centers 1600 Albany St. Beech Grove, IN?? 46107 317-782-6007 ? 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. Disclaimer: The HIPAA Final Privacy Rule requires covered entities to safeguard certain Protected Health Information (PHI) related to a person's healthcare. Information being faxed to you may include PHI after appropriate authorization from the patient or under circumstances that do not require patient authorization. You, the recipient, are obligated to maintain PHI in a safe and secure manner. You may not re-disclose without additional patient consent or as required by law. Unauthorized re-disclosure or failure to safeguard PHI could subject you to penalties described in federal (HIPAA) and state law. If you the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, please notify us immediately and destroy the related message. -----Inline Attachment Follows----- _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/c08e7909/attachment- 0001.html ------------------------------ Message: 4 Date: Thu, 1 Oct 2009 14:15:41 -0400 From: "Ekvall, Shirley (ekvalls)" Subject: Re: [Cnm] Prader Willi To: Holly Patronik , "cnm at lists.my180.net" Message-ID: <1C36990389E31A42996A3F73DE5DBE685257C96E24 at UCMAILBE2.ad.uc.edu> Content-Type: text/plain; charset="iso-8859-1" Please take a look at the chapter on Prader Willi in our book Pediatric Nutrition in Chronic Diseases and Developmentnal Disorders, published by Oxford University Press, www.oup.com. You may find it in the library. I have worked with these clients with very low calorie counts. You need to almost lock the refrigerator and find other activities as they have a ravenous appetite. We also have a 35 credit self study ($89.50) to go with the book. We do have a growth chart for these children in the book too. Good Luck. Let me know if I can be of further help. shirley.ekvall at uc.edu ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Holly Patronik [hpatronik at shorehealth.org] Sent: Thursday, October 01, 2009 9:27 AM To: cnm at lists.my180.net Subject: [Cnm] Prader Willi I have a patient with prader Willi whose MD is requesting 800kcal/day. I'm not familiar with working with this condition - is this a normal recommendation - any suggestions?? Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/7f31973f/attachment- 0001.html ------------------------------ Message: 5 Date: Thu, 1 Oct 2009 14:21:26 -0400 From: "Ekvall, Shirley (ekvalls)" Subject: Re: [Cnm] pediatric needs To: "Johnson, Andrea" , "cnm at lists.my180.net" Message-ID: <1C36990389E31A42996A3F73DE5DBE685257C96E25 at UCMAILBE2.ad.uc.edu> Content-Type: text/plain; charset="iso-8859-1" Please take a look at the chapter and charts on Nutritional Assessment in our book Pediatric Nutrition in Chronic Diseases and Developmental Disorders, published by Oxford University Press, www.oup.com which you may find in your med library. The promotion code for discount is 24095 if ordering it. We also have a 35 ADA credit self study to go along with it. You can contact me for the self study ($89.50) or for both if needed. shirley.ekvall at uc.edu Good Luck ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea [andrea.johnson at bassett.org] Sent: Thursday, October 01, 2009 9:09 AM To: cnm at lists.my180.net Subject: [Cnm] pediatric needs We are small community/teaching hospital and we don't see that many complicated pediatric patients. But we do see a few. What caloric formulations and protein needs are other places using for their pediatric populations? Any help would be most appreciated. Thanks, Andrea Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- NOTICE OF CONFIDENTIALITY This electronic message, including attachments, is for the sole use of the named recipient and may contain confidential or privileged information protected by New York State, and Federal regulations. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. If you are not the intended recipient or have received this communication in error please contact the sender or email.security at bassett.org and destroy all copies of the original message. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091001/1c9fa022/attachment. html ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 4 ********************************** ------------------------------ Message: 3 Date: Thu, 1 Oct 2009 17:20:26 -0700 From: "Miller, Sandra - MMC" Subject: [Cnm] PES Statements To: 'Pam Charney' , JulieRambo Cc: Aida Miles , "cnm at lists.my180.net" Message-ID: <607AD24EFC85B14B956CF6AAA4F0E188061A7881FA at chw-msg-824.chw.edu> Content-Type: text/plain; charset="us-ascii" Nice to see we are all trying to incorporate correct terminology into our PES statements. So I have a question to post How do you determine what is better to use in an acute care case: inadequate food and beverage versus Inadequate protein- energy? I have been using protein -energy because I feel I can not monitor food groups in the hospital very well as I mainly have to rely on % intake recorded by the nursing staff of that I have no idea - only the meat, balanced intake. etc.Is this thinking correct? Sandra Miller MS, RD, CDE Clinical Nutrition Manager French Hospital Medical Center email: sandra.miller at chw.edu Phone: (805) 542-6229 ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Pam Charney Sent: Wednesday, September 30, 2009 8:17 AM To: JulieRambo Cc: Aida Miles; cnm at lists.my180.net Subject: Re: [Cnm] PES statement for ICU patient Unfortunately, in the case described, there is no problem with GI function. You just can't get to the GI tract due to the endotracheal tube. Altered GI function would not be the correct nutrition diagnosis unless there is some underlying condition that was not divulged in the history given to us. The etiology you describe here, "only 500 kcal per day" points to not getting enough of some important nutrient, thus inadequate intake of something. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 29, 2009, at 5:12 PM, JulieRambo wrote: I use : Altered GI function (NC-1.4) related to intubation as evidenced by only 500 calories per day (interject whatever calories from Diprivan and/or D5). This sets up the goal: to meet est needs (where I specify calorie, protein and fluid needs) and then the intervention to initiate TF via OGT (specify formula and rate). Goal is met when nutrition plan of care is implemented by the LIP. Julie Rambo, MSRDLD From: Pam Charney Sent: Tuesday, September 29, 2009 2:23 PM To: Aida Miles Cc: cnm at lists.my180.net Subject: Re: [Cnm] PES statement for ICU patient See below p Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 29, 2009, at 5:39 AM, Aida Miles wrote: Pam and other experts, Could you elaborate a little bit more on the PES statement and, perhaps, help some of us learn the process through this example? This is the PES statement suggested: Inadequate oral food/beverage intake d/t swallowing difficulty AEB endotrachial tube in place...(or recent initiation of ventilator support) Here the etiology is: swallowing difficulty I would disagree. There's nothing to tell me that the patient has an intrinsic, pathophysiologic problem with swallowing. Having a tube in one's throat does indeed create a problem with swallowing food, but not with the swallow mechanism itself. And the signs/symptoms are: endotrachial tube in place (or recent initiation of ventilator support)Also I would disagree. The whole NCP/P-E-S thing makes more sense if the S relates directly to the P. Therefore if you diagnose an intake problem the S should say how bad intake is. In this case, the patient is NPO, I'm assuming. Then the S might say "NPO" or current intake <25% estimated requirements" or how ever you usually communicate that calculation. My understanding is that your Intervention is geared toward the etiology (if possible). If that is true, I would feel stuck trying to "intervene" on swallowing difficulty. Personally I might have said "inability to eat/swallow", and then my intervention would be to start the tube feeding. Is this OK???? I like this much better. Maybe "inability to eat". You don't have to say much more. Everyone who walks into the unit can see that big old endotrachial tube. Can't miss it! Then Monitoring and Evaluation are geared toward the signs and symptoms (if possible). I don't think I want to monitor or evaluate an endotrachial tube or initiation of vent support.... I would evaluate tolerance to tube feedings, reaching goal calories, nutrients, etc. So, could the signs/symptoms be something like "patient being NPO"... or something like that? See above. YOu're one step ahead of me here. I am wondering if I am being too "literal" here. No, you're using critical thinking and common sense. That's a great combination! Also, looking at the IDNT Second edition - The Definition, Etiology and Signs and Symptoms for "Inadequate Food and Beverage Intake" (pages 218-219) do not state (that I can find) that this term can be used for an intubated patient, but it seems to fit. Is this the type of feedback the committee would want (to include this in the etiology/ signs and symptoms) in future editions? Just because it's not there doesn't mean you can't use it. The text cannot include a comprehensive list of all possible etiologies. The ones there are suggestions! I don't know if I am "over-thinking" the NCP, but I thought this would be a perfect opportunity for some of us to hear from true experts and learn! :) Aida Aida Miles, MMSc, RD, CSP, LD Director, Coordinated Masters Program in Nutrition University of Minnesota School of Public Health, Epidemiology & Community Health 1300 South Second Street, Suite 300 Minneapolis, MN 55454 612-625-5865 (voice mail) 651-829-0660 (cell) miles081 at umn.edu -----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, September 28, 2009 6:19 PM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 34, Issue 97 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: Critical Care PES (Nancy Shepperly) 2. Re: Critical Care PES (Pam Charney) 3. TF question (Holly Patronik) 4. Re: Prealbumin as predictor of clinical malnutrition? (Greenwaldt, Heidi J) ---------------------------------------------------------------------- Message: 1 Date: Mon, 28 Sep 2009 15:14:24 -0400 From: "Nancy Shepperly" > Subject: Re: [Cnm] Critical Care PES To: >,"Jessica Baye" > Message-ID: <4AC0D2CF.204A.000F.0 at trinity-health.org> Content-Type: text/plain; charset=US-ASCII I would say something like this: Inadequate oral food/beverage intake d/t swallowing difficulty AEB endotrachial tube in place...(or recent initiation of ventilator support) However, I'm not sure if this is right, there are probably better ways to say it. I'd like to see other examples, too. Nancy Please let me know if there is anything else I can do for you... Nancy Shepperly, RD Battle Creek Health System 269-660-3891 This message may contain confidential information protected by law through attorney-client privilege or professional peer review/quality evaluation privilege. It is intended only for the individual or entity named above. It is prohibited for anyone else to disclose, copy, distribute or use the contents of this message. If you received this message in error, please notify the BCHS Privacy/Integrity Office atprivacy_integrity at trinity-health.org or (269) 966-8347. >>> "Jessica Baye" > 09/28/2009 2:59 PM >>> Would anyone be willing to give me a sample PES statement for the following: ICU patient - recently intubated for hypoxia. Well nourished PTA. OGT in place. TF not yet started - pending recommendations from RD. We have a large trauma center and 48 ICU beds. We really struggle with PES statements in this population. Any feedback is appreciated. Thanks 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: 2 Date: Mon, 28 Sep 2009 12:22:50 -0700 From: Pam Charney > Subject: Re: [Cnm] Critical Care PES To: Nancy Shepperly > Cc: cnm at lists.my180.net, Jessica Baye > Message-ID: <120CF810-78F3-4D87-94D0-EC06ABCA9096 at mac.com> Content-Type: text/plain; charset=US-ASCII; format=flowed; delsp=yes Since each patient is different, it would be impossible to craft one nutrition diagnosis that fits all. However, in many cases Nancy's diagnosis of inadequate oral food/beverage intake might fit, depending on the patient and the surrounding circumstances. The etiology and signs/symptoms would depend on the situation facing the clinician. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Sep 28, 2009, at 12:14 PM, Nancy Shepperly wrote: > I would say something like this: > > Inadequate oral food/beverage intake d/t swallowing difficulty AEB > endotrachial tube in place...(or recent initiation of ventilator > support) > However, I'm not sure if this is right, there are probably better > ways to say it. I'd like to see other examples, too. > > Nancy > > Please let me know if there is anything else I can do for you... > > Nancy Shepperly, RD > Battle Creek Health System > 269-660-3891 > > This message may contain confidential information protected by law > through attorney-client privilege or professional peer review/ > quality evaluation privilege. It is intended only for the individual > or entity named above. It is prohibited for anyone else to disclose, > copy, distribute or use the contents of this message. If you > received this message in error, please notify the BCHS Privacy/ > Integrity Office at privacy_integrity at trinity-health.org or (269) > 966-8347. > > > > > >>>> "Jessica Baye" > 09/28/2009 2:59 PM >>> > Would anyone be willing to give me a sample PES statement for the > following: > > ICU patient - recently intubated for hypoxia. Well nourished PTA. > OGT in place. TF not yet started - pending recommendations from RD. > > We have a large trauma center and 48 ICU beds. We really struggle > with PES statements in this population. Any feedback is appreciated. > > Thanks > 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 ------------------------------ Message: 3 Date: Mon, 28 Sep 2009 16:26:44 -0400 From: "Holly Patronik" > Subject: [Cnm] TF question To: > Message-ID: > Content-Type: text/plain; charset="us-ascii" The Manager of our ICU asked me today if there was type of protocol we could initiate for TF patients in the ICU. She feels that the diarrhea r/t tf necessitates too many rectal tubes. Was wondering what others are doing to prevent diarrhea in TF patients and if you have any type of protocol for use of lacto bacillus type products?? She didn't buy the thought that TF aren't the cause of the diarrhea. Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090928/440c03ac/attachment-0001.html ------------------------------ Message: 4 Date: Wed, 23 Sep 2009 15:47:23 -0500 From: "Greenwaldt, Heidi J" > Subject: Re: [Cnm] Prealbumin as predictor of clinical malnutrition? To: "Maritza Rodriguez" >, > Message-ID: <59F3EAD5C3376A42B3CD083F034A61270567776F at digsmxmbx06.Fairview.org> Content-Type: text/plain; charset="us-ascii" Definitely true that it is not a good indicator for clinical malnutrition. The new ASPEN guidelines have the information. I attached it. 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 Maritza Rodriguez Sent: Wednesday, September 23, 2009 3:35 PM To: cnm at lists.my180.net Subject: [Cnm] Prealbumin as predictor of clinical malnutrition? I recently read somewhere that prealbumin level is probably not such a good indicator for clinical malnutrition. Have any of you heard about this? Do you know an official and reliable source of reference for this topic? Thanks in advance. Maritza Rodriguez Maritza Rodriguez, RD LDN Clinical Nutrition Manager Mount Sinai Medical Center Tel: 305-674-2121 X 56181 m-rodrig at msmc.com -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20090923/dc1119be/attachment.html -------------- next part -------------- A non-text attachment was scrubbed... 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URL: /pipermail/cnm_lists.my180.net/attachments/20091001/18844281/attachment.html ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 6 ********************************** _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. From dietitiandarcy at yahoo.com Fri Oct 2 13:56:14 2009 From: dietitiandarcy at yahoo.com (Darcy Butler) Date: Fri, 2 Oct 2009 13:56:14 -0700 (PDT) Subject: [Cnm] Down Time Procedure Message-ID: <498341.98377.qm@web57409.mail.re1.yahoo.com> I am looking for a sample down time procedures or policies for Diet Techs and Dietitians. Any information you can provide will be appreciated. Thank you! Darcy From ESCOTTSTUMPS at ecu.edu Fri Oct 2 14:23:30 2009 From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia) Date: Fri, 2 Oct 2009 17:23:30 -0400 Subject: [Cnm] FW: On the Pulse - October 2, 2009 In-Reply-To: References: Message-ID: Great On the Pulse update this week! Sylvia Escott-Stump, MA, RD, LDN 252-328-1352 Fax 252-328-4276 ________________________________________ From: On the Pulse [pulse at eatright.org] Sent: Friday, October 02, 2009 2:09 PM To: Escott-Stump, Sylvia Subject: On the Pulse - October 2, 2009 Having trouble viewing this e-mail? View it in your browser. ADA Policy Initiatives and Advocacy Report [http://www.eatright.org/newsletters/eatright.png] On the Pulse 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, October 2, 2009 * ADAPAC ranks in the top 20 of health care professional PACs * Health reform moves one step closer * Ryan White reauthorization passes the Senate committee * Nutrition Evidence Library to support work of 2010 Dietary Guidelines committee * $120 million available to states for community prevention and wellness initiative * Medicare-Medicaid Advanced Primary Care Demonstration Initiative for states * CDC appropriations for physical activity and nutrition * Medicaid Enrollment on the rise * Safe routes to school grants * Upcoming ADAPAC ranks in the top 20 of health care professional PACs ?Thank You? for making ADA?s Political Action Committee ? ADAPAC ? number 19 among the top 60 health care PACs list. Because of your generous gifts, ADAPAC contributed $129,000 to 50 candidates for Congress. Thus far, health care professional political action committees have contributed over $5,334,684 to federal candidates ?$3,597,286 to Democrats and $1,724,898 to Republicans. To learn more about ADAPAC, please visit us at www.ADAPAC.org , and don?t forget to stop by the Grassroots and Advocacy booth at FNCE. Health reform moves one step closer The Senate Finance Committee returned this week to more serious debates over the hundreds of amendments to Chairman Max Baucus? health reform proposal. Among those accepted by the committee was an amendment from Ranking Member Charles Grassley (R-IA) that attempts to narrow the Medicare payment disparity between rural and urban practitioners. The committee did not pass two amendments that would offer a public option. Sen. Baucus has said that he believes he has enough votes in the committee to pass a bill out of the committee. That vote could come as early as Friday, October 2 or early the following week. New reports, however, show that Senate Majority Leader Harry Reid (D-NV) has already begun merging the Senate Finance bill with the Senate Health, Education, Labor and Pensions committee bill. This bill is expected to bring heated, multi-week long debate on the Senate Floor. Reid has some tough decisions ahead, among them whether or not to add a public option. Reid expects the Senate to begin deliberations the week of Oct 12. House leaders also met Tuesday to determine what they should cut from H.R. 3200, with the goal of trimming down the cost from $1.1 trillion to $900 billion. Speaker Nancy Pelosi (D-CA) says the leadership is close to finalizing 90 percent of the bill. House staff expects that the full House will take up H.R. 3200 mid-October. ADA is currently working with congressional staff to strengthen the language in the House bill to include dietitians. You too can get involved by reaching out to your U.S. Representative and ask to strengthen the preventive services provisions by specifically including nutrition counseling and the services of a registered dietitian. Please go to ADA?s website and send a letter using Grassroots Manager and reach out to your public policy coordinator to get involved. Ryan White reauthorization passes Senate committee On Wednesday, the Senate Health, Education, Labor and Pensions Committee passed its proposal to reauthorize the Ryan White program for four years. The House Energy and Commerce is still negotiating behind closed doors on its version of Ryan White proposals. The intent from both chambers is to pass identical bills and expedite passage of the reauthorization. Because Ryan White was set to expire September 30, both the Senate and House have passed continuing resolutions to extend Ryan White funding through October. ADA continues to advocate for protection of medical nutrition therapy as a core medical service. If you would like to learn more about this issue, please contact Jennifer Teters at jteters at eatright.org. If you work in a Ryan White funded clinic and want to get more involved in securing funding for MNT, join us for a discussion at FNCE on Tuesday, October 20, from 10-11am. The discussion will take place at the Grassroots and Advocacy booth and will be led by Infectious Disease Nutrition PDG leaders. USDA Nutrition Evidence Library to support work of 2010 dietary guidelines committee The U.S. Department of Education Center for Nutrition Policy and Promotion?s Director of the Evidence Analysis Division, Joanne Spahn, MS, RD, FADA, introduced the Nutrition Evidence Library called NEL to a group of DC stakeholders and the press. NEL is a prototype of ADA?s Evidence Analysis Library and relies on volunteers who have undergone ADA training to abstract articles that meet specific inclusion criteria to answer questions posed by the 2010 dietary guidelines advisory committee. In addition to basic human nutrition research, NEL will include applied science research on consumer behavior to inform education and social marketing programs that support the dietary guidelines. Spahn gave special recognition to ADA and all the volunteers who are making this massive project possible. Medicare-Medicaid Advanced Primary Care demonstration initiative for states U.S. Department of Health and Human Services Secretary Kathleen Sebelius and the White House announced that the Centers for Medicare & Medicaid Services will establish a state-based, Advanced Primary Care demonstration program for Medicare, Medicaid and private insurers. The Advanced Primary Care model is an outgrowth of the patient-centered medical home concept, with a shift from current episodic care to holistic patient care. The APC emphasizes prevention, use of health information technology, care coordination and shared decision making among patients and their healthcare providers. Starting fall 2009, CMS will solicit applications from states who meet the program requirements, which must include services to beneficiaries from Medicare and Medicaid and individuals covered through private payers. APCs must provide services that emphasize wellness and prevention. Since nutrition is an important component of prevention and management of chronic diseases, RDs are being recognized as essential members of the medical home team. While RDs are not able to individually apply for the demonstration project, it will be important to investigate whether your state will coordinate an APC among federal and private payers in your area. A list of state Medicaid agencies is available at State Medicaid Agencies. CMS hopes to implement the APC program in early 2010. Addition details are available at http://healthreform.gov/newsroom/factsheet/medicalhomes.html CDC appropriations for physical activity and nutrition The Labor-HHS-Education Appropriations bill, which funds CDC, has been passed by the full House and Senate Appropriations Committees, but still needs to pass on the Senate floor. Once the Senate passes this bill, it will move on to a conference committee comprised of members from both chambers. Presently, leaders in the House decided that they will attach a government-wide, month-long Continuing Resolution (CR) to the Legislative Branch Appropriations bill. This would fund CDC current programs. However, starting at the beginning of FY 2010 (October 1), the Labor-HHS-Education Appropriations bill will continue to fund CDC?s Division of Nutrition, Physical Activity and Obesity (DNPAO) at nearly $44.3 million. These funds are used to support the mission of DNPAO by supporting people?s efforts to exercise, eat healthy and take personal responsibility for their health. In addition, DNPAO programs address multiple causes for obesity. As a steering committee member of the National Alliance for Nutrition and Activity, ADA is committed to working to help strengthen and expand funding to promote healthy eating and physical activity and to reduce obesity through the CDC?s DNPAO. Although the increase in funding for nutrition, physical activity and obesity programs is minimal, there are many new resource materials for the public at nutrition, physical activity and tobacco for communities. $120 million available to states for community prevention and wellness initiative The U.S. Department of Health and Human Services (HHS) this week announced the release of $120 million in American Recovery and Reinvestment Act (ARRA) funds for prevention and wellness programs for U.S. states and territories, building on the recent announcement of the $373 million funding opportunity for communities and tribes around the country. In all, the comprehensive Communities Putting Prevention to Work initiative will make $650 million available for public health efforts to address obesity, increase physical activity, improve nutrition, and decrease smoking. The $120 million in cooperative agreements will be awarded to states and territories for three components: statewide policy and environmental change, tobacco cessation through media campaigns, and special initiatives to create health-promoting policies and environments. ?State health departments are the backbone of the public health system and are uniquely positioned to support and leverage local efforts for chronic disease prevention and control,? said Thomas Frieden, M.D., M.P.H., director of the Centers of Disease Control and Prevention (CDC). Medicaid Enrollment on the rise The State Medicaid Directors and Uninsured annual survey concludes that Medicaid enrollment has increased largely due to the recession. Across the country, Medicaid enrollment grew by an average of 5.4 percent this year, the highest rate in six years. And, by the beginning of 2010, enrollment will reach 6.6 percent. The good news is that Medicaid has not been hit as hard as other federal assistance programs because of the support of federal aid in the stimulus package. However, Medicaid directors worry that there may be a cut in services, which could include nutritional services. Safe routes to school grants The goal of Safe Routes to School (SRTS) programs is to enable and encourage children to safely walk and bicycle to school. SRTS programs are implemented nationwide by parents, schools, community leaders, and local, state, and tribal governments. The goal is to promote physical activity. The National Center for Safe Routes to School is now accepting applications for 20 mini-grants, up to $1,000 each. The goal of the mini-grants is to use student creativity and leadership skills to increase safe walking and bicycling to school. Successful applications will include one or more of the following: student-led activities, concern for the environment, and/or promotion of physical activity. Funded activities must be part of a new or existing SRTS program. For more information, see www.saferoutesinfo.org/minigrants. The application deadline is October 30, 2009. Upcoming: * Registration and housing reservations for FNCE are now open. More information is available on the FNCE Web site. * USDA's Food Safety and Inspection Service will partner with the nonprofit public health organization NSF International to host a food safety education conference March 23-26, 2010, titled "Advancements in Food Safety Education: Trends, Tools and Technologies." * Save the date: ADA?s Public Policy Workshop will begin Monday, March 22, 2010. Government Relations Contacts Nutrition Policy Jennifer Weber jweber at eatright.org Stephanie Saullo ssaullo at eatright.org Regulatory Issues Mary Hager mhager at eatright.org Congressional & Political Affairs 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 Information Elizabeth Hasiak ehasiak at eatright.org You are receiving On the Pulse because you are an active subscriber to this e-newsletter. If you prefer not to receive future e-mails, simply follow this link to unsubscribe. You are currently subscribed as: escottstumps at ecu.edu Headquarters | American Dietetic Association 120 South Riverside Plaza | Suite 2000 | Chicago, Illinois 60606-6995 Copyright American Dietetic Association 2009. All Rights Reserved. From hgreenw2 at fairview.org Fri Oct 2 15:09:25 2009 From: hgreenw2 at fairview.org (Greenwaldt, Heidi J) Date: Fri, 2 Oct 2009 17:09:25 -0500 Subject: [Cnm] pancreatic enzymes with closed system TF Message-ID: <59F3EAD5C3376A42B3CD083F034A612704CDCDE4@digsmxmbx06.Fairview.org> Wondering what other sites are doing when they have patients on closed system tubefeeding and they need to receive pancreatic enzymes? We have tried flushing but some nurses are saying it is clogging. If the patient is getting a gastric feed and can take meds orally we go that route. What are people doing for pts that cannot take meds orally or if they are being fed with a J-tube. Thanks! Heidi Heidi Greenwaldt MS, RD, LD, CNSD Clinical Nutrition Manager University of Minnesota Medical Center, Fairview Phone 612-273-3216 Pager 612-539-7451 -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091002/41ab7727/attachment.html From tadams at saint-lukes.org Fri Oct 2 21:47:11 2009 From: tadams at saint-lukes.org (Adams, Tamara) Date: Fri, 2 Oct 2009 23:47:11 -0500 Subject: [Cnm] Plate waste....how do you?.... In-Reply-To: <4ABC7C11.485B.0001.0@nahealth.com> References: <674081.14435.qm@web111815.mail.gq1.yahoo.com> <4ABC7C11.485B.0001.0@nahealth.com> Message-ID: We are a non-select menu and we just started putting juice and milk on top of the cart on ice and nursing is to ask the patient if they would like the milk or juice. Not only is this saving mo aney b/c we can reuse the products b/c they have never entered the room, but we also have cold milk, which has always been an issue. I know some may say what about those patients on diabetic diets that should get the carbs, we look at it this way if they say do not want it then they are just going to let it sit on their tray anyway. Hope this helps. Tammy Adams Clinical Nutrition Manager, SLH ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Sheila Walsh Sent: Friday, September 25, 2009 10:15 AM To: cnm at lists.my180.net Subject: Re: [Cnm] Plate waste....how do you?.... Dear list, We conducted a plate waste study, recently, and discovered that most non-select trays had wasted beverages on them. How do you do beverage service for non-select trays? We found we were throwing out lots of hot water and coffee in the dishroom. tia, Sheila A. Walsh, MPH, RD Clinical Nutrition Manager Flagstaff Medical Center Where patients are our purpose. <\__~ / \ Saint Luke's Health System Confidentiality Notice: This message is for the designated recipient only and may contain privileged, proprietary or otherwise private information and is legally protected. If you have received it in error, please notify the sender immediately and delete the original. Any other use of the email by you is prohibited. Saint Luke's is the one heart care leader in Kansas City. To learn more, or to find a Saint Luke's location near you, call NurseLine at (816) 932-6220 or go to saintlukeshealthsystem.org. Please consider our environment before printing this e-mail. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091002/4bed0860/attachment.html From Lori.Zimmerman at ministryhealth.org Sat Oct 3 09:54:22 2009 From: Lori.Zimmerman at ministryhealth.org (Zimmerman, Lori A) Date: Sat, 3 Oct 2009 11:54:22 -0500 Subject: [Cnm] NICU In-Reply-To: <4AC6032C020000BA0004464C@alexian.net> References: <42A90F8376E770489AF180BC11195B0501B17A71@BOREAL.ntcampus.smdc.org> <4AC6032C020000BA0004464C@alexian.net> Message-ID: We mix ours in the Feeding Prep area of the kitchen. Lori A. Zimmerman MS, RD, CD -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Laura Leciejewski Sent: Friday, October 02, 2009 1:42 PM To: cnm at lists.my180.net; A Bresciami; Roxanne M. Bijold Subject: Re: [Cnm] NICU Nutrition Services mixing in the NICU. We have a designated area. Laura C. Leciejewski, MS, RD, LDN, CNSD Clinical Nutrition Manager St. Alexius Medical Center 1555 Barrington Rd Hoffman Estates, IL 60194 847-843-2000 ext 6591 pager # 711 >>> "Bijold, Roxanne M." 10/2/2009 1:32 PM >>> We do ours in Nutrition Services 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 A Bresciami Sent: Thursday, October 01, 2009 7:33 PM To: cnm at lists.my180.net Subject: [Cnm] NICU I know this question has been asked before however, I am trying to have pharmacy or nursing take over the responsibility of mixing the formulas NICU uses (currently we are mixing the formulas here in the kitchen). Before Administration would agree with making a change they asked me to try to find out what other facilities are doing. For those of you who have NICU's : Who is responsible for measuring and mixing whatever powdered formulas the NICU uses? Thanks in advance and sorry for the repost. Regards, Amy Bresciami, R.D. Operations Manager/CNM Food & Nutrition Services Office: 714.456.3840 Pager: 714.506.5920 Fax: 714.456.7174 abrescia at uci.edu ________________________________ Microsoft brings you a new way to search the web. Try Bing(tm) now 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. 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 e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation. From RODR at phin.org Mon Oct 5 05:01:34 2009 From: RODR at phin.org (Rodney, Rachel) Date: Mon, 5 Oct 2009 08:01:34 -0400 Subject: [Cnm] tpn help Message-ID: <149E946FB3E25C4F92AAC2B02F93CC4D02F662EC@mail.corp.svhc.net> HI, I hope someone can help me. It's been a few years since I've done TPN. I have a patient who I want to recommend TPN for. She is 64 kg, has lost 30# in 3 months. Recent colostomy for diverticulitis and also has diabetes. Blood sugars controlled, Alb 2.3, no PAB. My question is with max dextrose load. For someone with DM the max dex is 5.6mg/kg/day. I calculated her max as 126. Is this correct? This seems like a very low amount. Can someone help me with this calculation? What would you recommend for a tpn prescription for her? I calculated her needs as 1890kcal and 82g pro/day (based on 1.3g/kg) with 1900 cc fluid/day. Would you increase protein kcal to meet her needs? We only use 20% lipids here also. Thanks in advance!! Rachel Rodney Rachel Rodney RD, CD, CDE Southwestern Vermont Medical Center 100 Hospital Drive Bennington, VT 05201 802-447-5577 (office) 802-742-8599 (pager) rodr at phin.org DISCLAIMER: The information contained in this electronic message is legally privileged and confidential under applicable law and is intended for a particular addressee(s). If it is not clear that you are the intended recipient, you are hereby notified that you have received this transmittal in error; any review, copying or distribution or dissemination is strictly prohibited. If you suspect that you have received this transmittal in error, please notify Southwestern VT Health Care Corporation immediately by return email reply to (helpdesk at phin.org), and immediately delete the transmittal and any attachments without making any copy or distribution. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/3bf00961/attachment.html From Liz.Anthony at milfordhospital.org Mon Oct 5 05:54:22 2009 From: Liz.Anthony at milfordhospital.org (Anthony Liz) Date: Mon, 5 Oct 2009 08:54:22 -0400 Subject: [Cnm] Meditech MedDietary In-Reply-To: Message-ID: I was recently told that it is no longer available to new account and that they are only supporting existing accounts. Please advise if you hear otherwise. Liz Anthony Milford Hospital -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Donna Quirk Sent: Friday, October 02, 2009 4:17 PM To: cnm at lists.my180.net Subject: [Cnm] Meditech MedDietary Is anyone using Meditech's MedDietary? If so, I would like to hear about your experiences with it, how you use it, etc. Thanks, Donna Quirk MBA RD LD Clinical Nutrition Manager Lexington Medical Center 2720 Sunset Blvd West Columbia, SC 29169 803-791-2248 ______________________________________________________________________ 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. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From sconnell at atriumhealthcare.net Mon Oct 5 07:10:46 2009 From: sconnell at atriumhealthcare.net (Susie Connell) Date: Mon, 5 Oct 2009 09:10:46 -0500 Subject: [Cnm] Passing trays in ICU Message-ID: Good Morning! We have an ongoing problem with trays being passed in timely manner in ICU. A lot of it is due to the higher acuity level and timing of meals in relation to patient care. However, there are times that it does not appear related at all. Our ICU rarely has a patient tech to pass trays, which leaves it up to nursing. Consequently, when the food is served, it is often reheated food. Or the tray has sat for so long it is no longer safe, so the patient gets a snack and waits until the next meal. Any suggestions for addressing or improving this issue is appreciated. Susie Connell, MS, RD, LD Clinical Nutrition Manager Atrium Medical Center 3305 Corinth Parkway Corinth , Texas 76208 940-270-4196 sconnell at atriumhealthcare.net EMAILING FOR THE GREATER GOOD Join me -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/cf5a75a9/attachment.html From Heidi.Clark at AMEDD.ARMY.MIL Mon Oct 5 07:28:32 2009 From: Heidi.Clark at AMEDD.ARMY.MIL (Clark, Heidi L MAJ MIL USAF MEDCOM LRMC) Date: Mon, 5 Oct 2009 16:28:32 +0200 Subject: [Cnm] Passing trays in ICU (UNCLASSIFIED) In-Reply-To: References: Message-ID: <9AB53CB10B46784794F4F6D3AD82344F362B1D@AMEDERMCBE041.eur.amed.ds.army.mil> Classification: UNCLASSIFIED Caveats: NONE Please send to the list--this is a common problem here, too! -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Susie Connell Sent: Monday, October 05, 2009 4:11 PM To: cnm at lists.my180.net Subject: [Cnm] Passing trays in ICU Good Morning! We have an ongoing problem with trays being passed in timely manner in ICU. A lot of it is due to the higher acuity level and timing of meals in relation to patient care. However, there are times that it does not appear related at all. Our ICU rarely has a patient tech to pass trays, which leaves it up to nursing. Consequently, when the food is served, it is often reheated food. Or the tray has sat for so long it is no longer safe, so the patient gets a snack and waits until the next meal. Any suggestions for addressing or improving this issue is appreciated. Susie Connell, MS, RD, LD Clinical Nutrition Manager Atrium Medical Center 3305 Corinth Parkway Corinth , Texas 76208 940-270-4196 sconnell at atriumhealthcare.net i'm EMAILING FOR THE GREATER GOOD Join me Classification: UNCLASSIFIED Caveats: NONE From sw1979 at nahealth.com Mon Oct 5 08:26:03 2009 From: sw1979 at nahealth.com (Sheila Walsh) Date: Mon, 5 Oct 2009 08:26:03 -0700 Subject: [Cnm] Passing trays in ICU In-Reply-To: References: Message-ID: <4AC9AD9B.485B.0001.0@nahealth.com> The six million dollar question!!! It seems universal that nurses do not think about feeding their patients...... >>> "Susie Connell" 10/5/2009 7:10 AM >>> Good Morning! We have an ongoing problem with trays being passed in timely manner in ICU. A lot of it is due to the higher acuity level and timing of meals in relation to patient care. However, there are times that it does not appear related at all. Our ICU rarely has a patient tech to pass trays, which leaves it up to nursing. Consequently, when the food is served, it is often reheated food. Or the tray has sat for so long it is no longer safe, so the patient gets a snack and waits until the next meal. Any suggestions for addressing or improving this issue is appreciated. Susie Connell, MS, RD, LD Clinical Nutrition Manager Atrium Medical Center 3305 Corinth Parkway Corinth , Texas 76208 940-270-4196 sconnell at atriumhealthcare.net EMAILING FOR THE GREATER GOOD Join me -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/e2d223d5/attachment.html -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 962 bytes Desc: not available Url : /pipermail/cnm_lists.my180.net/attachments/20091005/e2d223d5/attachment.gif From pcharney at mac.com Mon Oct 5 08:48:06 2009 From: pcharney at mac.com (Pam Charney) Date: Mon, 05 Oct 2009 08:48:06 -0700 Subject: [Cnm] tpn help In-Reply-To: <149E946FB3E25C4F92AAC2B02F93CC4D02F662EC@mail.corp.svhc.net> References: <149E946FB3E25C4F92AAC2B02F93CC4D02F662EC@mail.corp.svhc.net> Message-ID: <873058B6-BD84-4CE0-AF67-78C325FBA012@mac.com> Good morning, What is the GI pathology that prevents enteral feedings? Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 5, 2009, at 5:01 AM, Rodney, Rachel wrote: > HI, > I hope someone can help me. It?s been a few years since I?ve done > TPN. > > I have a patient who I want to recommend TPN for. She is 64 kg, has > lost 30# in 3 months. Recent colostomy for diverticulitis and also > has diabetes. Blood sugars controlled, Alb 2.3, no PAB. > > My question is with max dextrose load. For someone with DM the max > dex is 5.6mg/kg/day. I calculated her max as 126. Is this > correct? This seems like a very low amount. > > Can someone help me with this calculation? What would you recommend > for a tpn prescription for her? I calculated her needs as 1890kcal > and 82g pro/day (based on 1.3g/kg) with 1900 cc fluid/day. Would > you increase protein kcal to meet her needs? We only use 20% lipids > here also. Thanks in advance!! > Rachel Rodney > > > Rachel Rodney RD, CD, CDE > Southwestern Vermont Medical Center > 100 Hospital Drive > Bennington, VT 05201 > 802-447-5577 (office) > 802-742-8599 (pager) > rodr at phin.org > > DISCLAIMER: The information contained in this electronic message is > legally privileged and confidential under applicable law and is > intended > for a particular addressee(s). If it is not clear that you are the > intended > recipient, you are hereby notified that you have received this > transmittal > in error; any review, copying or distribution or dissemination is > strictly > prohibited. If you suspect that you have received this transmittal in > error, please notify Southwestern VT Health Care Corporation > immediately by return email reply to (helpdesk at phin.org), and > immediately delete the transmittal and any attachments without making > any copy or distribution. Thank you. > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/77ed986b/attachment.html From Hollie_Colle at ssmhc.com Mon Oct 5 08:54:26 2009 From: Hollie_Colle at ssmhc.com (Hollie_Colle at ssmhc.com) Date: Mon, 5 Oct 2009 10:54:26 -0500 Subject: [Cnm] childhood obesity program Message-ID: Our hospital is starting a wellness center in conjunction with a local recreation complex. There is funding from an outside source that will fund the first 3 years. The agreement is that if we can successfully implement a program each quarter for 3 years this funding source will fund provide a large endowment to fund the wellness center indefinitely. Unfortunately, this is last minute. We are to implement the first program by Nov 09!!! The first program is for childhood obesity. They have asked that we (the hosp RDs, PT, exercise instructors, behav health, case mgr) design this program however we choose. We are to decide what and how we educate. Does anyone have any program or materials they'd be willing to share. We are purchasing the ADA "Counseling Overweight and Obese Children and Teens: Health Care Reference and Client Education Handouts" reference book. We do know that the local pediatricians will be referring the children to the program. The children enrolled in the program will also be using the rec complex for physical activity. If you have a program: 1. Are you able to charge for the service? 2. Do you see children/parents indiv or in group settings? 3. How long are they involved in the program? 4. Are you providing indiv diet plans? 5. Are you providing exercise plans? 6. How long does the program last? Any help would be greatly appreciated. Thanks! Hollie Colle, MS, RD, LDN Clinical Nutrition Manager St. Mary's Good Samaritan, Inc. Mount Vernon IL 62864 (618) 241-2356 Centralia IL 62801 (618) 436-8897 Confidentiality Notice: This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/394ee2cd/attachment-0001.html From pcharney at mac.com Mon Oct 5 09:11:45 2009 From: pcharney at mac.com (Pam Charney) Date: Mon, 05 Oct 2009 09:11:45 -0700 Subject: [Cnm] Passing trays in ICU In-Reply-To: <4AC9AD9B.485B.0001.0@nahealth.com> References: <4AC9AD9B.485B.0001.0@nahealth.com> Message-ID: Susie, I'm sure you didn't mean your statement to imply that ICU nurses don't think about the nutritional requirements of their patients. I have 20+ years experience in critical care nutrition in both adult and pediatric practice. ICU nurses tend to be some of the most dedicated, smart and caring folks around. They are also quite often stretched to the breaking point. Just as we feel that patients are sicker and sicker, these folks are on the front lines with us. Unfortunately, passing meal trays just falls a bit lower on the totem pole of things to do for the RN who typically might have "only" one assigned patient but in reality is covering for his/her colleague who is out with another patient at x-ray or whatnot, and often "watching" another for a colleague who might be involved in a code. On the other hand, if patients are able to eat, perhaps it's time to transfer out of the unit! Maybe this is an opportunity to work on facilitating transfers. Obviously that would depend on the facility, staffing and other issues. But, if this is something to work on as an interdisciplinary team, everyone wins and your facility saves some money in the process. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 5, 2009, at 8:26 AM, Sheila Walsh wrote: > The six million dollar question!!! It seems universal that nurses > do not think about feeding their patients...... > > >>> "Susie Connell" 10/5/2009 7:10 > AM >>> > Good Morning! > > We have an ongoing problem with trays being passed in timely manner > in ICU. > A lot of it is due to the higher acuity level and timing of meals in > relation to patient care. > However, there are times that it does not appear related at all. > Our ICU rarely has a patient tech to pass trays, which leaves it up > to nursing. > > Consequently, when the food is served, it is often reheated food. > Or the tray has sat for so long it is no longer safe, so the patient > gets a snack and waits until the next meal. > > Any suggestions for addressing or improving this issue is appreciated. > > > > Susie Connell, MS, RD, LD > Clinical Nutrition Manager > Atrium Medical Center > 3305 Corinth Parkway > Corinth , Texas 76208 > 940-270-4196 > sconnell at atriumhealthcare.net > > > > > > > > EMAILING FOR THE GREATER GOOD > Join me > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/944461ff/attachment.html From WellsK at armc.sbcounty.gov Mon Oct 5 09:24:02 2009 From: WellsK at armc.sbcounty.gov (Wells, Khongmany ARMC-Nutrition Services) Date: Mon, 5 Oct 2009 09:24:02 -0700 Subject: [Cnm] Policy regarding Weights Message-ID: <4411CB5C30A2674CB4708C0CA3CBB966025A653E@sbc-exmsg5.sbcounty.gov> Hello Everyone, I've presented my findings regarding weights to QMC. They wanted us to review our policy regarding weights and to have clearer standards established for obtaining admit weights and follow-up weights on patient. I would appreciate it if someone can share with me their policies regarding admit weights and follow-up weights. Do you include it as a nursing policy or a nutrition policy? Thank you, Khongmany Wells, RD, MPH, CNSD Clinical Nutrition Manager Arrowhead Regional Medical Center (909) 580-2466 -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/dfbc0c06/attachment.html From lmerrima at nyp.org Mon Oct 5 09:36:59 2009 From: lmerrima at nyp.org (Louise R. Merriman) Date: Mon, 05 Oct 2009 12:36:59 -0400 Subject: [Cnm] Policy regarding Weights In-Reply-To: <4411CB5C30A2674CB4708C0CA3CBB966025A653E@sbc-exmsg5.sbcounty.gov> References: <4411CB5C30A2674CB4708C0CA3CBB966025A653E@sbc-exmsg5.sbcounty.gov> Message-ID: <9466_1254760621_0KR10009DVHNXAE0_4ACA20AB.6070203@nyp.org> Nursing policy Wells, Khongmany ARMC-Nutrition Services wrote: > Hello Everyone, > I've presented my findings regarding weights to QMC. They wanted us to > review our policy regarding weights and to have clearer standards > established for obtaining admit weights and follow-up weights on > patient. I would appreciate it if someone can share with me their > policies regarding admit weights and follow-up weights. Do you include > it as a nursing policy or a nutrition policy? > Thank you, > Khongmany Wells, RD, MPH, CNSD > Clinical Nutrition Manager > Arrowhead Regional Medical Center > (909) 580-2466 > > > > > ------------------------------------------------------------------------ > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > -------------------- This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message. Thank you. From Hesse.Lynda at hunterdonhealthcare.org Mon Oct 5 09:40:15 2009 From: Hesse.Lynda at hunterdonhealthcare.org (Lynda Hesse) Date: Mon, 05 Oct 2009 12:40:15 -0400 Subject: [Cnm] Clinical Ladder Message-ID: <4AC9E92F.A4E2.00CD.0@hunterdonhealthcare.org> Dear Colleagues, We are in the process of making our pitch to the human resources department to provide additional compensation to dietitians with advanced degrees and/or certification. I would love to hear from other facilities that have successfully put a clinical ladder in place. Additionally, it would be greatly appreciated if you would share the strategy that you used which led to your success and justification for the increase in pay. Thank you for your assistance. Lynda Hesse Notice: The information contained in this email is intended only for the use of the person(s) identified above. This communication may contain work product which is privileged and confidential, and may contain content which is regulated by Federal law. If you are not an intended recipient or the employee or agent responsible to deliver this to the intended recipient, you have received this message in error and any review, distribution or copying of it by you is prohibited. If you have received this message in error, please notify the sender immediately, and delete the message. E-mail and communication system messages generated by members of the Hunterdon Healthcare workforce may not necessarily reflect the views of Hunterdon Healthcare, its officers, directors or management. From lmerrima at nyp.org Mon Oct 5 09:48:21 2009 From: lmerrima at nyp.org (Louise R. Merriman) Date: Mon, 05 Oct 2009 12:48:21 -0400 Subject: [Cnm] Clinical Ladder In-Reply-To: <4AC9E92F.A4E2.00CD.0@hunterdonhealthcare.org> References: <4AC9E92F.A4E2.00CD.0@hunterdonhealthcare.org> Message-ID: <30560_1254761302_0KR1007QDW0LHIB0_4ACA2355.20505@nyp.org> Retention and recruitment + comparison with other professional groups in our organization. We provide differentials for advanced degrees relevant to the RD's area of practice and specified certifications. Lynda Hesse wrote: > Dear Colleagues, > We are in the process of making our pitch to the human resources department to provide additional compensation to dietitians with advanced degrees and/or certification. I would love to hear from other facilities that have successfully put a clinical ladder in place. Additionally, it would be greatly appreciated if you would share the strategy that you used which led to your success and justification for the increase in pay. > Thank you for your assistance. > Lynda Hesse > > Notice: The information contained in this email is intended only for the use of the person(s) identified above. This communication may contain work product which is privileged and confidential, and may contain content which is regulated by Federal law. If you are not an intended recipient or the employee or agent responsible to deliver this to the intended recipient, you have received this message in error and any review, distribution or copying of it by you is prohibited. If you have received this message in error, please notify the sender immediately, and delete the message. E-mail and communication system messages generated by members of the Hunterdon Healthcare workforce may not necessarily reflect the views of Hunterdon Healthcare, its officers, directors or management. > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > -------------------- This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message. Thank you. From Linda.Woods at healthall.com Mon Oct 5 09:52:19 2009 From: Linda.Woods at healthall.com (Woods, Linda) Date: Mon, 5 Oct 2009 12:52:19 -0400 Subject: [Cnm] Policy regarding Weights In-Reply-To: <4411CB5C30A2674CB4708C0CA3CBB966025A653E@sbc-exmsg5.sbcounty.gov> References: <4411CB5C30A2674CB4708C0CA3CBB966025A653E@sbc-exmsg5.sbcounty.gov> Message-ID: <2B1106A6A593B147A65BD5A8939D3E1101065B341102@MAIL-C.healthall.com> Nursing policy Linda Woods, RD, LD Clinical Nutrition Coordinator Food and Nutrition Services UC Health - University Hospital 234 Goodman Street Cincinnati, OH 45219-2316 Office: 513-584-4534 Pager: 513-577-0948 linda.woods at healthall.com www.uchealthnow.com [cid:image001.jpg at 01CA45BA.ACD256E0] [cid:image002.png at 01CA45BA.ACD256E0] From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Wells, Khongmany ARMC-Nutrition Services Sent: Monday, October 05, 2009 12:24 PM To: Cnm at lists.my180.net Subject: [Cnm] Policy regarding Weights Hello Everyone, I've presented my findings regarding weights to QMC. They wanted us to review our policy regarding weights and to have clearer standards established for obtaining admit weights and follow-up weights on patient. I would appreciate it if someone can share with me their policies regarding admit weights and follow-up weights. Do you include it as a nursing policy or a nutrition policy? Thank you, Khongmany Wells, RD, MPH, CNSD Clinical Nutrition Manager Arrowhead Regional Medical Center (909) 580-2466 ________________________________ Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/d3787b82/attachment-0001.html -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 4000 bytes Desc: image001.jpg Url : /pipermail/cnm_lists.my180.net/attachments/20091005/d3787b82/attachment-0001.jpg -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.png Type: image/png Size: 7843 bytes Desc: image002.png Url : /pipermail/cnm_lists.my180.net/attachments/20091005/d3787b82/attachment-0001.png From cfoner at dupageco.org Mon Oct 5 10:02:12 2009 From: cfoner at dupageco.org (Foner, Carole) Date: Mon, 5 Oct 2009 12:02:12 -0500 Subject: [Cnm] Policy regarding Weights References: <4411CB5C30A2674CB4708C0CA3CBB966025A653E@sbc-exmsg5.sbcounty.gov> Message-ID: Please post. Thanks! Carole :-) 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 Wells, Khongmany ARMC-Nutrition Services Sent: Monday, October 05, 2009 11:24 AM To: Cnm at lists.my180.net Subject: [Cnm] Policy regarding Weights Hello Everyone, I've presented my findings regarding weights to QMC. They wanted us to review our policy regarding weights and to have clearer standards established for obtaining admit weights and follow-up weights on patient. I would appreciate it if someone can share with me their policies regarding admit weights and follow-up weights. Do you include it as a nursing policy or a nutrition policy? Thank you, Khongmany Wells, RD, MPH, CNSD Clinical Nutrition Manager Arrowhead Regional Medical Center (909) 580-2466 -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/35f92134/attachment.html From kahill at numc.edu Mon Oct 5 10:08:01 2009 From: kahill at numc.edu (Kathy Hill) Date: Mon, 5 Oct 2009 13:08:01 -0400 Subject: [Cnm] Screening/Assessment parameters In-Reply-To: <4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org> References: <39C024B8791C1943BAA07F35FFA8D6F90C79C3775C@SLHMAIL.slh.stlukes.com> <4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org> Message-ID: Those of you who have psych units in your facilities; would you be willing to share what your policy is regarding RD evaluation of these patients? Does anyone use the same criteria for psych as you do for your acute care patients? Up until now, the dietitians at my facility only saw psych patients on a consult basis. Now we/dietitians have been directed by a new Administrator at our hospital to see all psych patients! Also, has anyone had a discussion with a TJC surveyor regarding the necessity of a nutrition evaluation of all psych patients? I really need to convince this administrator that there is no other facility where the RD sees psych patients on a regular basis and that consult only is the general rule. So please give me some feedback. In advance, thank you for your assistance. Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ann berzinsky Sent: Wednesday, September 30, 2009 10:22 AM To: Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Our policy states patients will be seen within 48hrs. Does anyone in PA know if there are state regulations that patients must be seen within 24hrs? Thank you Anne Berzinsky, RD, LDN St Clair Hospital Pittsburgh, PA ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J Sent: Tuesday, September 29, 2009 9:50 PM To: denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We completed our CMS survey and the surveyors rolled it into a State visit as well. The citations received in the CMS visit were duplicated in the state visit. Of interest to us was the state citations specified Missouri specific standards that were different than the "CMS State Guidelines Manual" given to us by the surveyor. The Missouri State manual actually indicates that all patients with a positive nutrition screen for malnutrition must have a "Comprehensive Nutrition Assessment" completed within 24 hours. This was news to us. This was not indicated in the manual originally given to us. It does appear this is a fairly new change (approx. 1 1/2 years ago). Needless to say, we did have to change our weekend schedule. We did have RDs on call on Sundays and had 48 hours to respond to consults to accommodate this. ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of denisedacey at verizon.net [denisedacey at verizon.net] Sent: Tuesday, September 29, 2009 8:27 PM To: cnm at lists.my180.net Subject: [Cnm] Screening/Assessment parameters Could anyone share their nutrition screening/assessment parameters, time frames for various risk levels?per JC standards. Our facility recently had a 'Mock Survey' and the consultant had some comments re RD timliness of assessements, 24 vs 48 hrs. We have a coordinated screening mechanism with nursing within 24 hrs, with high risk pts having a comprehensive nutrition assessment within 48 hrs. Just want to make sure we are compliant with Joint Commission Standards. Appreciate any feedback Denise Dacey RD,CDE, LDN DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. Email contains Privileged & Confidential Information intended only for the recipient named. Dissemination or copying of email is strictly prohibited. If you have received this in error, notify St. Clair Hospital & return or destroy original. Information in this email is confidential & protected by state & federal law. Further disclosure is strictly prohibited. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/ac99bede/attachment.html From mdoyle1 at tuftsmedicalcenter.org Mon Oct 5 10:09:02 2009 From: mdoyle1 at tuftsmedicalcenter.org (Doyle, Marcia) Date: Mon, 5 Oct 2009 13:09:02 -0400 Subject: [Cnm] Clinical Ladder In-Reply-To: <4AC9E92F.A4E2.00CD.0@hunterdonhealthcare.org> Message-ID: check salary calculator on ADA web site...just search for it on the site. I was able to increase staff salary and give 5% for those with advanced degrees. Marcia Doyle Marcia Doyle, MS,RD,LDN Clinical Nutrition and Business Operations Mger Pediatric Critical Care Dietitian Frances Stern Nutrition Center Tufts Medical Center 800 Washington Street Box #783 Boston, MA 02111 T 617-636-5275 mdoyle1 at tuftsmedicalcenter.org www.tuftsmedicalcenter.org -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Lynda Hesse Sent: Monday, October 05, 2009 12:40 PM To: cnm at lists.my180.net Subject: [Cnm] Clinical Ladder Dear Colleagues, We are in the process of making our pitch to the human resources department to provide additional compensation to dietitians with advanced degrees and/or certification. I would love to hear from other facilities that have successfully put a clinical ladder in place. Additionally, it would be greatly appreciated if you would share the strategy that you used which led to your success and justification for the increase in pay. Thank you for your assistance. Lynda Hesse Notice: The information contained in this email is intended only for the use of the person(s) identified above. This communication may contain work product which is privileged and confidential, and may contain content which is regulated by Federal law. If you are not an intended recipient or the employee or agent responsible to deliver this to the intended recipient, you have received this message in error and any review, distribution or copying of it by you is prohibited. If you have received this message in error, please notify the sender immediately, and delete the message. E-mail and communication system messages generated by members of the Hunterdon Healthcare workforce may not necessarily reflect the views of Hunterdon Healthcare, its officers, directors or management. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From mpappo at montefiore.org Mon Oct 5 10:13:59 2009 From: mpappo at montefiore.org (Miriam Pappo) Date: Mon, 05 Oct 2009 13:13:59 -0400 Subject: [Cnm] Policy regarding Weights Message-ID: Nursing policy >>> "Foner, Carole" 10/05/09 1:02 PM >>> Please post. Thanks! Carole :-) 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 Wells, Khongmany ARMC-Nutrition Services Sent: Monday, October 05, 2009 11:24 AM To: Cnm at lists.my180.net Subject: [Cnm] Policy regarding Weights Hello Everyone, I've presented my findings regarding weights to QMC. They wanted us to review our policy regarding weights and to have clearer standards established for obtaining admit weights and follow-up weights on patient. I would appreciate it if someone can share with me their policies regarding admit weights and follow-up weights. Do you include it as a nursing policy or a nutrition policy? Thank you, Khongmany Wells, RD, MPH, CNSD Clinical Nutrition Manager Arrowhead Regional Medical Center (909) 580-2466 From sconnell at atriumhealthcare.net Mon Oct 5 10:23:56 2009 From: sconnell at atriumhealthcare.net (Susie Connell) Date: Mon, 5 Oct 2009 12:23:56 -0500 Subject: [Cnm] Passing trays in ICU In-Reply-To: References: <4AC9AD9B.485B.0001.0@nahealth.com> Message-ID: Pam, I'm not quite sure how you read that into my post. I work in ICU every day myself and know the very reason there is a problem is because of all the things you so clearly pointed out. We (the nurses and myself) try to come up with soultions and I just thought I would put it out on the listserv to see if anyone else had some ideas. Maybe take some of the onus off of nursing to leave them to things higher on the totem pole. Susie Connell, MS, RD, LD Clinical Nutrition Manager Atrium Medical Center 3305 Corinth Parkway Corinth , Texas 76208 940-270-4196 sconnell at atriumhealthcare.net EMAILING FOR THE GREATER GOOD Join me CC: cnm at lists.my180.net; sw1979 at nahealth.com From: pcharney at mac.com To: sconnell at atriumhealthcare.net Subject: Re: [Cnm] Passing trays in ICU Date: Mon, 5 Oct 2009 09:11:45 -0700 Susie, I'm sure you didn't mean your statement to imply that ICU nurses don't think about the nutritional requirements of their patients. I have 20+ years experience in critical care nutrition in both adult and pediatric practice. ICU nurses tend to be some of the most dedicated, smart and caring folks around. They are also quite often stretched to the breaking point. Just as we feel that patients are sicker and sicker, these folks are on the front lines with us. Unfortunately, passing meal trays just falls a bit lower on the totem pole of things to do for the RN who typically might have "only" one assigned patient but in reality is covering for his/her colleague who is out with another patient at x-ray or whatnot, and often "watching" another for a colleague who might be involved in a code. On the other hand, if patients are able to eat, perhaps it's time to transfer out of the unit! Maybe this is an opportunity to work on facilitating transfers. Obviously that would depend on the facility, staffing and other issues. But, if this is something to work on as an interdisciplinary team, everyone wins and your facility saves some money in the process. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 5, 2009, at 8:26 AM, Sheila Walsh wrote: The six million dollar question!!! It seems universal that nurses do not think about feeding their patients...... >>> "Susie Connell" 10/5/2009 7:10 AM >>> Good Morning! We have an ongoing problem with trays being passed in timely manner in ICU. A lot of it is due to the higher acuity level and timing of meals in relation to patient care. However, there are times that it does not appear related at all. Our ICU rarely has a patient tech to pass trays, which leaves it up to nursing. Consequently, when the food is served, it is often reheated food. Or the tray has sat for so long it is no longer safe, so the patient gets a snack and waits until the next meal. Any suggestions for addressing or improving this issue is appreciated. Susie Connell, MS, RD, LD Clinical Nutrition Manager Atrium Medical Center 3305 Corinth Parkway Corinth , Texas 76208 940-270-4196 sconnell at atriumhealthcare.net EMAILING FOR THE GREATER GOOD Join me_______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/7c7bf611/attachment-0001.html From Linda.Woods at healthall.com Mon Oct 5 10:27:59 2009 From: Linda.Woods at healthall.com (Woods, Linda) Date: Mon, 5 Oct 2009 13:27:59 -0400 Subject: [Cnm] Screening/Assessment parameters In-Reply-To: References: <39C024B8791C1943BAA07F35FFA8D6F90C79C3775C@SLHMAIL.slh.stlukes.com> <4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org> Message-ID: <2B1106A6A593B147A65BD5A8939D3E1101065B341104@MAIL-C.healthall.com> From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Kathy Hill Sent: Monday, October 05, 2009 1:08 PM To: Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Those of you who have psych units in your facilities; would you be willing to share what your policy is regarding RD evaluation of these patients? Does anyone use the same criteria for psych as you do for your acute care patients? Up until now, the dietitians at my facility only saw psych patients on a consult basis. Now we/dietitians have been directed by a new Administrator at our hospital to see all psych patients! Also, has anyone had a discussion with a TJC surveyor regarding the necessity of a nutrition evaluation of all psych patients? I really need to convince this administrator that there is no other facility where the RD sees psych patients on a regular basis and that consult only is the general rule. So please give me some feedback. In advance, thank you for your assistance. Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ann berzinsky Sent: Wednesday, September 30, 2009 10:22 AM To: Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Our policy states patients will be seen within 48hrs. Does anyone in PA know if there are state regulations that patients must be seen within 24hrs? Thank you Anne Berzinsky, RD, LDN St Clair Hospital Pittsburgh, PA ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J Sent: Tuesday, September 29, 2009 9:50 PM To: denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We completed our CMS survey and the surveyors rolled it into a State visit as well. The citations received in the CMS visit were duplicated in the state visit. Of interest to us was the state citations specified Missouri specific standards that were different than the "CMS State Guidelines Manual" given to us by the surveyor. The Missouri State manual actually indicates that all patients with a positive nutrition screen for malnutrition must have a "Comprehensive Nutrition Assessment" completed within 24 hours. This was news to us. This was not indicated in the manual originally given to us. It does appear this is a fairly new change (approx. 1 1/2 years ago). Needless to say, we did have to change our weekend schedule. We did have RDs on call on Sundays and had 48 hours to respond to consults to accommodate this. ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of denisedacey at verizon.net [denisedacey at verizon.net] Sent: Tuesday, September 29, 2009 8:27 PM To: cnm at lists.my180.net Subject: [Cnm] Screening/Assessment parameters Could anyone share their nutrition screening/assessment parameters, time frames for various risk levels?per JC standards. Our facility recently had a 'Mock Survey' and the consultant had some comments re RD timliness of assessements, 24 vs 48 hrs. We have a coordinated screening mechanism with nursing within 24 hrs, with high risk pts having a comprehensive nutrition assessment within 48 hrs. Just want to make sure we are compliant with Joint Commission Standards. Appreciate any feedback Denise Dacey RD,CDE, LDN DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. Email contains Privileged & Confidential Information intended only for the recipient named. Dissemination or copying of email is strictly prohibited. If you have received this in error, notify St. Clair Hospital & return or destroy original. Information in this email is confidential & protected by state & federal law. Further disclosure is strictly prohibited. ________________________________ Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/5c367a98/attachment.html From Julie.Finney at csauh.com Mon Oct 5 10:28:02 2009 From: Julie.Finney at csauh.com (Finney, Julie) Date: Mon, 5 Oct 2009 13:28:02 -0400 Subject: [Cnm] Screening/Assessment parameters In-Reply-To: References: <39C024B8791C1943BAA07F35FFA8D6F90C79C3775C@SLHMAIL.slh.stlukes.com><4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org> Message-ID: Our psych patients are screened by nursing using the same criteria as the acute patients. They rarely screen as a positive nutrition problem other than poor intake for >7 days prior to admission for those with Major depression. We will usually make a brief note on some of those referrals but rarely a full-blown assessment. Good luck! Julie Finney Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Kathy Hill Sent: Monday, October 05, 2009 1:08 PM To: Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Those of you who have psych units in your facilities; would you be willing to share what your policy is regarding RD evaluation of these patients? Does anyone use the same criteria for psych as you do for your acute care patients? Up until now, the dietitians at my facility only saw psych patients on a consult basis. Now we/dietitians have been directed by a new Administrator at our hospital to see all psych patients! Also, has anyone had a discussion with a TJC surveyor regarding the necessity of a nutrition evaluation of all psych patients? I really need to convince this administrator that there is no other facility where the RD sees psych patients on a regular basis and that consult only is the general rule. So please give me some feedback. In advance, thank you for your assistance. Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ann berzinsky Sent: Wednesday, September 30, 2009 10:22 AM To: Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Our policy states patients will be seen within 48hrs. Does anyone in PA know if there are state regulations that patients must be seen within 24hrs? Thank you Anne Berzinsky, RD, LDN St Clair Hospital Pittsburgh, PA ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J Sent: Tuesday, September 29, 2009 9:50 PM To: denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We completed our CMS survey and the surveyors rolled it into a State visit as well. The citations received in the CMS visit were duplicated in the state visit. Of interest to us was the state citations specified Missouri specific standards that were different than the "CMS State Guidelines Manual" given to us by the surveyor. The Missouri State manual actually indicates that all patients with a positive nutrition screen for malnutrition must have a "Comprehensive Nutrition Assessment" completed within 24 hours. This was news to us. This was not indicated in the manual originally given to us. It does appear this is a fairly new change (approx. 1 1/2 years ago). Needless to say, we did have to change our weekend schedule. We did have RDs on call on Sundays and had 48 hours to respond to consults to accommodate this. ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of denisedacey at verizon.net [denisedacey at verizon.net] Sent: Tuesday, September 29, 2009 8:27 PM To: cnm at lists.my180.net Subject: [Cnm] Screening/Assessment parameters Could anyone share their nutrition screening/assessment parameters, time frames for various risk levels?per JC standards. Our facility recently had a 'Mock Survey' and the consultant had some comments re RD timliness of assessements, 24 vs 48 hrs. We have a coordinated screening mechanism with nursing within 24 hrs, with high risk pts having a comprehensive nutrition assessment within 48 hrs. Just want to make sure we are compliant with Joint Commission Standards. Appreciate any feedback Denise Dacey RD,CDE, LDN DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. Email contains Privileged & Confidential Information intended only for the recipient named. Dissemination or copying of email is strictly prohibited. If you have received this in error, notify St. Clair Hospital & return or destroy original. Information in this email is confidential & protected by state & federal law. Further disclosure is strictly prohibited. ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/dcde3734/attachment-0001.html From mpappo at montefiore.org Mon Oct 5 10:32:52 2009 From: mpappo at montefiore.org (Miriam Pappo) Date: Mon, 05 Oct 2009 13:32:52 -0400 Subject: [Cnm] Clinical Ladder Message-ID: based on the salary calculator or other comparisons? Are you talking about advanced degrees or for certifications? I would like to incresase salaries based on specialty certifications. 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 >>> "Doyle, Marcia" 10/05/09 1:09 PM >>> check salary calculator on ADA web site...just search for it on the site. I was able to increase staff salary and give 5% for those with advanced degrees. Marcia Doyle Marcia Doyle, MS,RD,LDN Clinical Nutrition and Business Operations Mger Pediatric Critical Care Dietitian Frances Stern Nutrition Center Tufts Medical Center 800 Washington Street Box #783 Boston, MA 02111 T 617-636-5275 mdoyle1 at tuftsmedicalcenter.org www.tuftsmedicalcenter.org -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Lynda Hesse Sent: Monday, October 05, 2009 12:40 PM To: cnm at lists.my180.net Subject: [Cnm] Clinical Ladder Dear Colleagues, We are in the process of making our pitch to the human resources department to provide additional compensation to dietitians with advanced degrees and/or certification. I would love to hear from other facilities that have successfully put a clinical ladder in place. Additionally, it would be greatly appreciated if you would share the strategy that you used which led to your success and justification for the increase in pay. Thank you for your assistance. Lynda Hesse Notice: The information contained in this email is intended only for the use of the person(s) identified above. This communication may contain work product which is privileged and confidential, and may contain content which is regulated by Federal law. If you are not an intended recipient or the employee or agent responsible to deliver this to the intended recipient, you have received this message in error and any review, distribution or copying of it by you is prohibited. If you have received this message in error, please notify the sender immediately, and delete the message. E-mail and communication system messages generated by members of the Hunterdon Healthcare workforce may not necessarily reflect the views of Hunterdon Healthcare, its officers, directors or management. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An embedded and charset-unspecified text was scrubbed... Name: Miriam Pappo.vcf Url: /pipermail/cnm_lists.my180.net/attachments/20091005/37cc2631/attachment.pl From LCarver at Reshealthcare.org Mon Oct 5 10:35:42 2009 From: LCarver at Reshealthcare.org (Carver, Leslee) Date: Mon, 5 Oct 2009 12:35:42 -0500 Subject: [Cnm] Screening/Assessment parameters In-Reply-To: References: <39C024B8791C1943BAA07F35FFA8D6F90C79C3775C@SLHMAIL.slh.stlukes.com><4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org> Message-ID: <5330B54133B6194BA13930BDEFE9A30E05161B6B@rhcexch3.reshealthcare.org> we use the same screening criteria as w/ the rest of the house. on geri psyche we re-screen low risk at 7 days and on adult psych at 14 days. 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 Kathy Hill Sent: Monday, October 05, 2009 12:08 PM To: Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Those of you who have psych units in your facilities; would you be willing to share what your policy is regarding RD evaluation of these patients? Does anyone use the same criteria for psych as you do for your acute care patients? Up until now, the dietitians at my facility only saw psych patients on a consult basis. Now we/dietitians have been directed by a new Administrator at our hospital to see all psych patients! Also, has anyone had a discussion with a TJC surveyor regarding the necessity of a nutrition evaluation of all psych patients? I really need to convince this administrator that there is no other facility where the RD sees psych patients on a regular basis and that consult only is the general rule. So please give me some feedback. In advance, thank you for your assistance. Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ann berzinsky Sent: Wednesday, September 30, 2009 10:22 AM To: Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Our policy states patients will be seen within 48hrs. Does anyone in PA know if there are state regulations that patients must be seen within 24hrs? Thank you Anne Berzinsky, RD, LDN St Clair Hospital Pittsburgh, PA ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J Sent: Tuesday, September 29, 2009 9:50 PM To: denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We completed our CMS survey and the surveyors rolled it into a State visit as well. The citations received in the CMS visit were duplicated in the state visit. Of interest to us was the state citations specified Missouri specific standards that were different than the "CMS State Guidelines Manual" given to us by the surveyor. The Missouri State manual actually indicates that all patients with a positive nutrition screen for malnutrition must have a "Comprehensive Nutrition Assessment" completed within 24 hours. This was news to us. This was not indicated in the manual originally given to us. It does appear this is a fairly new change (approx. 1 1/2 years ago). Needless to say, we did have to change our weekend schedule. We did have RDs on call on Sundays and had 48 hours to respond to consults to accommodate this. ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of denisedacey at verizon.net [denisedacey at verizon.net] Sent: Tuesday, September 29, 2009 8:27 PM To: cnm at lists.my180.net Subject: [Cnm] Screening/Assessment parameters Could anyone share their nutrition screening/assessment parameters, time frames for various risk levels?per JC standards. Our facility recently had a 'Mock Survey' and the consultant had some comments re RD timliness of assessements, 24 vs 48 hrs. We have a coordinated screening mechanism with nursing within 24 hrs, with high risk pts having a comprehensive nutrition assessment within 48 hrs. Just want to make sure we are compliant with Joint Commission Standards. Appreciate any feedback Denise Dacey RD,CDE, LDN DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. Email contains Privileged & Confidential Information intended only for the recipient named. Dissemination or copying of email is strictly prohibited. If you have received this in error, notify St. Clair Hospital & return or destroy original. Information in this email is confidential & protected by state & federal law. Further disclosure is strictly prohibited. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/76740fc5/attachment.html From kahill at numc.edu Mon Oct 5 10:41:46 2009 From: kahill at numc.edu (Kathy Hill) Date: Mon, 5 Oct 2009 13:41:46 -0400 Subject: [Cnm] Screening/Assessment parameters In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E05161B6B@rhcexch3.reshealthcare.org> References: <39C024B8791C1943BAA07F35FFA8D6F90C79C3775C@SLHMAIL.slh.stlukes.com><4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org> <5330B54133B6194BA13930BDEFE9A30E05161B6B@rhcexch3.reshealthcare.org> Message-ID: Hi Leslie, What criteria do you use for an initial assessment? Do you only assess those who have been referred to you by the nurse when he/she completes the nutrition screen? We are being asked to see all Psych pt's by the 6th day of admission regardless of whether they were triggered by the nurse on the nutrition screen. Does anyone automatically see Psych pt's based on a certain # of days of their admission? Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: Carver, Leslee [mailto:LCarver at Reshealthcare.org] Sent: Monday, October 05, 2009 1:36 PM To: Kathy Hill; Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: RE: [Cnm] Screening/Assessment parameters we use the same screening criteria as w/ the rest of the house. on geri psyche we re-screen low risk at 7 days and on adult psych at 14 days. 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 Kathy Hill Sent: Monday, October 05, 2009 12:08 PM To: Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Those of you who have psych units in your facilities; would you be willing to share what your policy is regarding RD evaluation of these patients? Does anyone use the same criteria for psych as you do for your acute care patients? Up until now, the dietitians at my facility only saw psych patients on a consult basis. Now we/dietitians have been directed by a new Administrator at our hospital to see all psych patients! Also, has anyone had a discussion with a TJC surveyor regarding the necessity of a nutrition evaluation of all psych patients? I really need to convince this administrator that there is no other facility where the RD sees psych patients on a regular basis and that consult only is the general rule. So please give me some feedback. In advance, thank you for your assistance. Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ann berzinsky Sent: Wednesday, September 30, 2009 10:22 AM To: Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Our policy states patients will be seen within 48hrs. Does anyone in PA know if there are state regulations that patients must be seen within 24hrs? Thank you Anne Berzinsky, RD, LDN St Clair Hospital Pittsburgh, PA ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J Sent: Tuesday, September 29, 2009 9:50 PM To: denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We completed our CMS survey and the surveyors rolled it into a State visit as well. The citations received in the CMS visit were duplicated in the state visit. Of interest to us was the state citations specified Missouri specific standards that were different than the "CMS State Guidelines Manual" given to us by the surveyor. The Missouri State manual actually indicates that all patients with a positive nutrition screen for malnutrition must have a "Comprehensive Nutrition Assessment" completed within 24 hours. This was news to us. This was not indicated in the manual originally given to us. It does appear this is a fairly new change (approx. 1 1/2 years ago). Needless to say, we did have to change our weekend schedule. We did have RDs on call on Sundays and had 48 hours to respond to consults to accommodate this. ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of denisedacey at verizon.net [denisedacey at verizon.net] Sent: Tuesday, September 29, 2009 8:27 PM To: cnm at lists.my180.net Subject: [Cnm] Screening/Assessment parameters Could anyone share their nutrition screening/assessment parameters, time frames for various risk levels?per JC standards. Our facility recently had a 'Mock Survey' and the consultant had some comments re RD timliness of assessements, 24 vs 48 hrs. We have a coordinated screening mechanism with nursing within 24 hrs, with high risk pts having a comprehensive nutrition assessment within 48 hrs. Just want to make sure we are compliant with Joint Commission Standards. Appreciate any feedback Denise Dacey RD,CDE, LDN DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. Email contains Privileged & Confidential Information intended only for the recipient named. Dissemination or copying of email is strictly prohibited. If you have received this in error, notify St. Clair Hospital & return or destroy original. Information in this email is confidential & protected by state & federal law. Further disclosure is strictly prohibited. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/546db88a/attachment-0001.html From LCarver at Reshealthcare.org Mon Oct 5 10:51:06 2009 From: LCarver at Reshealthcare.org (Carver, Leslee) Date: Mon, 5 Oct 2009 12:51:06 -0500 Subject: [Cnm] Screening/Assessment parameters In-Reply-To: References: <39C024B8791C1943BAA07F35FFA8D6F90C79C3775C@SLHMAIL.slh.stlukes.com><4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org> <5330B54133B6194BA13930BDEFE9A30E05161B6B@rhcexch3.reshealthcare.org> Message-ID: <5330B54133B6194BA13930BDEFE9A30E05161B7A@rhcexch3.reshealthcare.org> we use the same screening criteria as w/ the rest of the hospital - wt loss, muscle wasting, etc. w/ the same scoring criteria and same turn-around time. the % of "at risk pts" via those criteria is probably <10% exc. for the seniors. otherwise, it is referrals, and LOS. LOS is strictly for re-screening, not assmt unless the screen indicates a need. 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: Kathy Hill [mailto:kahill at numc.edu] Sent: Monday, October 05, 2009 12:42 PM To: Carver, Leslee; Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: RE: [Cnm] Screening/Assessment parameters Hi Leslie, What criteria do you use for an initial assessment? Do you only assess those who have been referred to you by the nurse when he/she completes the nutrition screen? We are being asked to see all Psych pt's by the 6th day of admission regardless of whether they were triggered by the nurse on the nutrition screen. Does anyone automatically see Psych pt's based on a certain # of days of their admission? Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: Carver, Leslee [mailto:LCarver at Reshealthcare.org] Sent: Monday, October 05, 2009 1:36 PM To: Kathy Hill; Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: RE: [Cnm] Screening/Assessment parameters we use the same screening criteria as w/ the rest of the house. on geri psyche we re-screen low risk at 7 days and on adult psych at 14 days. 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 Kathy Hill Sent: Monday, October 05, 2009 12:08 PM To: Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Those of you who have psych units in your facilities; would you be willing to share what your policy is regarding RD evaluation of these patients? Does anyone use the same criteria for psych as you do for your acute care patients? Up until now, the dietitians at my facility only saw psych patients on a consult basis. Now we/dietitians have been directed by a new Administrator at our hospital to see all psych patients! Also, has anyone had a discussion with a TJC surveyor regarding the necessity of a nutrition evaluation of all psych patients? I really need to convince this administrator that there is no other facility where the RD sees psych patients on a regular basis and that consult only is the general rule. So please give me some feedback. In advance, thank you for your assistance. Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ann berzinsky Sent: Wednesday, September 30, 2009 10:22 AM To: Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Our policy states patients will be seen within 48hrs. Does anyone in PA know if there are state regulations that patients must be seen within 24hrs? Thank you Anne Berzinsky, RD, LDN St Clair Hospital Pittsburgh, PA ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J Sent: Tuesday, September 29, 2009 9:50 PM To: denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We completed our CMS survey and the surveyors rolled it into a State visit as well. The citations received in the CMS visit were duplicated in the state visit. Of interest to us was the state citations specified Missouri specific standards that were different than the "CMS State Guidelines Manual" given to us by the surveyor. The Missouri State manual actually indicates that all patients with a positive nutrition screen for malnutrition must have a "Comprehensive Nutrition Assessment" completed within 24 hours. This was news to us. This was not indicated in the manual originally given to us. It does appear this is a fairly new change (approx. 1 1/2 years ago). Needless to say, we did have to change our weekend schedule. We did have RDs on call on Sundays and had 48 hours to respond to consults to accommodate this. ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of denisedacey at verizon.net [denisedacey at verizon.net] Sent: Tuesday, September 29, 2009 8:27 PM To: cnm at lists.my180.net Subject: [Cnm] Screening/Assessment parameters Could anyone share their nutrition screening/assessment parameters, time frames for various risk levels?per JC standards. Our facility recently had a 'Mock Survey' and the consultant had some comments re RD timliness of assessements, 24 vs 48 hrs. We have a coordinated screening mechanism with nursing within 24 hrs, with high risk pts having a comprehensive nutrition assessment within 48 hrs. Just want to make sure we are compliant with Joint Commission Standards. Appreciate any feedback Denise Dacey RD,CDE, LDN DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. Email contains Privileged & Confidential Information intended only for the recipient named. Dissemination or copying of email is strictly prohibited. If you have received this in error, notify St. Clair Hospital & return or destroy original. Information in this email is confidential & protected by state & federal law. Further disclosure is strictly prohibited. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/c3b278a3/attachment.html From bhaine at Elliot-HS.org Mon Oct 5 11:39:33 2009 From: bhaine at Elliot-HS.org (Haine, Barbara) Date: Mon, 5 Oct 2009 14:39:33 -0400 Subject: [Cnm] Screening/Assessment parameters In-Reply-To: References: <39C024B8791C1943BAA07F35FFA8D6F90C79C3775C@SLHMAIL.slh.stlukes.com><4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org> Message-ID: We see patients on consult only for our locked psych unit. Geriatric psych we see everyone. Barbara Haine MEd, RD, LD Clinical Nutrition Manager Elliot Hospital Manchester NH From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Kathy Hill Sent: Monday, October 05, 2009 1:08 PM To: Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Those of you who have psych units in your facilities; would you be willing to share what your policy is regarding RD evaluation of these patients? Does anyone use the same criteria for psych as you do for your acute care patients? Up until now, the dietitians at my facility only saw psych patients on a consult basis. Now we/dietitians have been directed by a new Administrator at our hospital to see all psych patients! Also, has anyone had a discussion with a TJC surveyor regarding the necessity of a nutrition evaluation of all psych patients? I really need to convince this administrator that there is no other facility where the RD sees psych patients on a regular basis and that consult only is the general rule. So please give me some feedback. In advance, thank you for your assistance. Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ann berzinsky Sent: Wednesday, September 30, 2009 10:22 AM To: Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Our policy states patients will be seen within 48hrs. Does anyone in PA know if there are state regulations that patients must be seen within 24hrs? Thank you Anne Berzinsky, RD, LDN St Clair Hospital Pittsburgh, PA ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J Sent: Tuesday, September 29, 2009 9:50 PM To: denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We completed our CMS survey and the surveyors rolled it into a State visit as well. The citations received in the CMS visit were duplicated in the state visit. Of interest to us was the state citations specified Missouri specific standards that were different than the "CMS State Guidelines Manual" given to us by the surveyor. The Missouri State manual actually indicates that all patients with a positive nutrition screen for malnutrition must have a "Comprehensive Nutrition Assessment" completed within 24 hours. This was news to us. This was not indicated in the manual originally given to us. It does appear this is a fairly new change (approx. 1 1/2 years ago). Needless to say, we did have to change our weekend schedule. We did have RDs on call on Sundays and had 48 hours to respond to consults to accommodate this. ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of denisedacey at verizon.net [denisedacey at verizon.net] Sent: Tuesday, September 29, 2009 8:27 PM To: cnm at lists.my180.net Subject: [Cnm] Screening/Assessment parameters Could anyone share their nutrition screening/assessment parameters, time frames for various risk levels?per JC standards. Our facility recently had a 'Mock Survey' and the consultant had some comments re RD timliness of assessements, 24 vs 48 hrs. We have a coordinated screening mechanism with nursing within 24 hrs, with high risk pts having a comprehensive nutrition assessment within 48 hrs. Just want to make sure we are compliant with Joint Commission Standards. Appreciate any feedback Denise Dacey RD,CDE, LDN DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. Email contains Privileged & Confidential Information intended only for the recipient named. Dissemination or copying of email is strictly prohibited. If you have received this in error, notify St. Clair Hospital & return or destroy original. Information in this email is confidential & protected by state & federal law. Further disclosure is strictly prohibited. ----------------------------------------- **** CONFIDENTIAL COMMUNICATION - PLEASE READ PRIVACY NOTICE **** This communication is confidential and may be read only by its intended recipient(s). It may contain legally privileged and protected information. If you believe you have received this communication in error, please "Reply" to the Sender and so indicate or call (603) 663-2800. Then, please promptly "Delete" this communication from your computer. This communication, and any information contained herein, may only be forwarded, printed, disclosed, copied or disseminated by those specifically authorized to do so. UNAUTHORIZED DISCLOSURE MAY RESULT IN LEGAL LIABILITY FOR THOSE PERSONS RESPONSIBLE. -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/a9e41b75/attachment-0001.html From julie.mclaughlin at hotmail.com Mon Oct 5 11:52:40 2009 From: julie.mclaughlin at hotmail.com (Julie McLaughlin) Date: Mon, 5 Oct 2009 14:52:40 -0400 Subject: [Cnm] Screening/Assessment parameters In-Reply-To: References: <39C024B8791C1943BAA07F35FFA8D6F90C79C3775C@SLHMAIL.slh.stlukes.com><4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org> Message-ID: We have the same screening criteria as the rest of the hospital that nursing completes and then refers prn. We do however then complete a "rescreen" or Assessment as needed, at LOS. We define LOS as 1 day greater than the average LOS, but use a different LOS than the rest of the hospital. For example, our hospital side LOS is 5.6 days -- add 1 day and the RDs/DTR will seen a pt who has not otherwise been referred on LOS day 7. Our psych units LOS is 12.8 days -- add 1 day and the RDs/DTR (mainly DTR) will see pts on LOS day 14 and f/u q 14 days. I had worked at a facility prior to this one with a very large psych population. We had 5 childrens units (ages 5-17+) and 1 adult unit. We also saw patients there depending on the units LOS. Some of the units were "short" term ~ 10 days and others were long term (pts could be there for months to a year). On the short term units, we saw pts on day 7, on the long term units, I think we saw them on Day 30 (or 1 month) and f/u quarterly. Julie McLaughlin, RD, LD/N Assistant Director, Patient Services Broward General Medical Center Ft. Lauderdale, FL 33316 Date: Mon, 5 Oct 2009 13:41:46 -0400 From: kahill at numc.edu To: LCarver at Reshealthcare.org; Ann.berzinsky at stclair.org; Debra.Jeske at stlukes-stl.com; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Hi Leslie, What criteria do you use for an initial assessment? Do you only assess those who have been referred to you by the nurse when he/she completes the nutrition screen? We are being asked to see all Psych pt?s by the 6th day of admission regardless of whether they were triggered by the nurse on the nutrition screen. Does anyone automatically see Psych pt?s based on a certain # of days of their admission? Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu From: Carver, Leslee [mailto:LCarver at Reshealthcare.org] Sent: Monday, October 05, 2009 1:36 PM To: Kathy Hill; Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: RE: [Cnm] Screening/Assessment parameters we use the same screening criteria as w/ the rest of the house. on geri psyche we re-screen low risk at 7 days and on adult psych at 14 days. 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 Kathy Hill Sent: Monday, October 05, 2009 12:08 PM To: Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Those of you who have psych units in your facilities; would you be willing to share what your policy is regarding RD evaluation of these patients? Does anyone use the same criteria for psych as you do for your acute care patients? Up until now, the dietitians at my facility only saw psych patients on a consult basis. Now we/dietitians have been directed by a new Administrator at our hospital to see all psych patients! Also, has anyone had a discussion with a TJC surveyor regarding the necessity of a nutrition evaluation of all psych patients? I really need to convince this administrator that there is no other facility where the RD sees psych patients on a regular basis and that consult only is the general rule. So please give me some feedback. In advance, thank you for your assistance. Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ann berzinsky Sent: Wednesday, September 30, 2009 10:22 AM To: Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Our policy states patients will be seen within 48hrs. Does anyone in PA know if there are state regulations that patients must be seen within 24hrs? Thank you Anne Berzinsky, RD, LDN St Clair Hospital Pittsburgh, PA From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J Sent: Tuesday, September 29, 2009 9:50 PM To: denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We completed our CMS survey and the surveyors rolled it into a State visit as well. The citations received in the CMS visit were duplicated in the state visit. Of interest to us was the state citations specified Missouri specific standards that were different than the "CMS State Guidelines Manual" given to us by the surveyor. The Missouri State manual actually indicates that all patients with a positive nutrition screen for malnutrition must have a "Comprehensive Nutrition Assessment" completed within 24 hours. This was news to us. This was not indicated in the manual originally given to us. It does appear this is a fairly new change (approx. 1 1/2 years ago). Needless to say, we did have to change our weekend schedule. We did have RDs on call on Sundays and had 48 hours to respond to consults to accommodate this. From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of denisedacey at verizon.net [denisedacey at verizon.net] Sent: Tuesday, September 29, 2009 8:27 PM To: cnm at lists.my180.net Subject: [Cnm] Screening/Assessment parameters Could anyone share their nutrition screening/assessment parameters, time frames for various risk levels?per JC standards. Our facility recently had a 'Mock Survey' and the consultant had some comments re RD timliness of assessements, 24 vs 48 hrs. We have a coordinated screening mechanism with nursing within 24 hrs, with high risk pts having a comprehensive nutrition assessment within 48 hrs. Just want to make sure we are compliant with Joint Commission Standards. Appreciate any feedback Denise Dacey RD,CDE, LDNDISCLAIMER:The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. Email contains Privileged & Confidential Information intended only for the recipient named. Dissemination or copying of email is strictly prohibited. If you have received this in error, notify St. Clair Hospital & return or destroy original. Information in this email is confidential & protected by state & federal law. Further disclosure is strictly prohibited. _________________________________________________________________ Hotmail: Powerful Free email with security by Microsoft. http://clk.atdmt.com/GBL/go/171222986/direct/01/ -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/d15b65ee/attachment.html From NuckollJ at methodisthealth.org Mon Oct 5 12:01:33 2009 From: NuckollJ at methodisthealth.org (Jane Nuckolls) Date: Mon, 05 Oct 2009 14:01:33 -0500 Subject: [Cnm] Screening/Assessment parameters In-Reply-To: References: <39C024B8791C1943BAA07F35FFA8D6F90C79C3775C@SLHMAIL.slh.stlukes.com><4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org> Message-ID: <4AC9FC3D020000EE00072BA6@methodisthealth.org> Hello- we have the electronic medical record and nursing completes the admission screen. We use the same criteria for our behavioral health patients as for all patients. We also receive notification for a LOS consult for anyone who has been in the hospital for > 7 days, including behavioral health. The Greely Company is our hospital's TJC consulting partner- and they recommended we add substance abuse to our admission screen- both alcohol and drugs are included. We added those criteria to our screens and receive consults for substance abuse both in the hospital and behavioral health units. Hope this helps Jane Nuckolls, MA, RD, LDN Methhodist University Hospital Memphis, Tennessee >>> "Finney, Julie" 10/05/09 12:28 PM >>> Our psych patients are screened by nursing using the same criteria as the acute patients. They rarely screen as a positive nutrition problem other than poor intake for >7 days prior to admission for those with Major depression. We will usually make a brief note on some of those referrals but rarely a full-blown assessment. Good luck! Julie Finney Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Kathy Hill Sent: Monday, October 05, 2009 1:08 PM To: Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Those of you who have psych units in your facilities; would you be willing to share what your policy is regarding RD evaluation of these patients? Does anyone use the same criteria for psych as you do for your acute care patients? Up until now, the dietitians at my facility only saw psych patients on a consult basis. Now we/dietitians have been directed by a new Administrator at our hospital to see all psych patients! Also, has anyone had a discussion with a TJC surveyor regarding the necessity of a nutrition evaluation of all psych patients? I really need to convince this administrator that there is no other facility where the RD sees psych patients on a regular basis and that consult only is the general rule. So please give me some feedback. In advance, thank you for your assistance. Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ann berzinsky Sent: Wednesday, September 30, 2009 10:22 AM To: Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Our policy states patients will be seen within 48hrs. Does anyone in PA know if there are state regulations that patients must be seen within 24hrs? Thank you Anne Berzinsky, RD, LDN St Clair Hospital Pittsburgh, PA ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J Sent: Tuesday, September 29, 2009 9:50 PM To: denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We completed our CMS survey and the surveyors rolled it into a State visit as well. The citations received in the CMS visit were duplicated in the state visit. Of interest to us was the state citations specified Missouri specific standards that were different than the "CMS State Guidelines Manual" given to us by the surveyor. The Missouri State manual actually indicates that all patients with a positive nutrition screen for malnutrition must have a "Comprehensive Nutrition Assessment" completed within 24 hours. This was news to us. This was not indicated in the manual originally given to us. It does appear this is a fairly new change (approx. 1 1/2 years ago). Needless to say, we did have to change our weekend schedule. We did have RDs on call on Sundays and had 48 hours to respond to consults to accommodate this. ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of denisedacey at verizon.net [denisedacey at verizon.net] Sent: Tuesday, September 29, 2009 8:27 PM To: cnm at lists.my180.net Subject: [Cnm] Screening/Assessment parameters Could anyone share their nutrition screening/assessment parameters, time frames for various risk levels?per JC standards. Our facility recently had a 'Mock Survey' and the consultant had some comments re RD timliness of assessements, 24 vs 48 hrs. We have a coordinated screening mechanism with nursing within 24 hrs, with high risk pts having a comprehensive nutrition assessment within 48 hrs. Just want to make sure we are compliant with Joint Commission Standards. Appreciate any feedback Denise Dacey RD,CDE, LDN DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. Email contains Privileged & Confidential Information intended only for the recipient named. Dissemination or copying of email is strictly prohibited. If you have received this in error, notify St. Clair Hospital & return or destroy original. Information in this email is confidential & protected by state & federal law. Further disclosure is strictly prohibited. ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. From hargenlisa at hotmail.com Mon Oct 5 15:09:59 2009 From: hargenlisa at hotmail.com (Lisa Trombley) Date: Mon, 5 Oct 2009 15:09:59 -0700 Subject: [Cnm] Passing trays in ICU In-Reply-To: References: Message-ID: While I used to fight having foodservice hosts/hostesses add more units to their areas of responsibility, I have noticed a significant improvement in timeliness of patient meal delivery when this has happened which means more palatable food and potentially an increased intake for the patient. At my current facility, foodservice staff deliver to isolation & psychiatric patients & we are discussing transitioning to the ICU as well. Foodservice staff at Los Alamitos Medical Center & Fountain Valley Regional Hospitals in California have delivered to the ICU patient bedside for many years. It takes strong communication with nursing but can be very successful. Lisa Trombley, MA, RD, CNSD LAC+USC Medical Center Morrison Healthcare Food Service, Inc. hargenlisa at hotmail.com From: sconnell at atriumhealthcare.net To: cnm at lists.my180.net Date: Mon, 5 Oct 2009 09:10:46 -0500 Subject: [Cnm] Passing trays in ICU Good Morning! We have an ongoing problem with trays being passed in timely manner in ICU. A lot of it is due to the higher acuity level and timing of meals in relation to patient care. However, there are times that it does not appear related at all. Our ICU rarely has a patient tech to pass trays, which leaves it up to nursing. Consequently, when the food is served, it is often reheated food. Or the tray has sat for so long it is no longer safe, so the patient gets a snack and waits until the next meal. Any suggestions for addressing or improving this issue is appreciated. Susie Connell, MS, RD, LD Clinical Nutrition Manager Atrium Medical Center 3305 Corinth Parkway Corinth , Texas 76208 940-270-4196 sconnell at atriumhealthcare.net EMAILING FOR THE GREATER GOOD Join me _________________________________________________________________ Hotmail: Trusted email with Microsoft?s powerful SPAM protection. http://clk.atdmt.com/GBL/go/177141664/direct/01/ -------------- next part -------------- An HTML attachment was scrubbed... URL: /pipermail/cnm_lists.my180.net/attachments/20091005/cb02f5f9/attachment.html From cwatters at ualberta.ca Mon Oct 5 23:17:47 2009 From: cwatters at ualberta.ca (cwatters at ualberta.ca) Date: Tue, 06 Oct 2009 00:17:47 -0600 Subject: [Cnm] Dietitian Career Fair In-Reply-To: <222E81132BE3E54584CB9A5DB1CDD7E280DE0D@bks-emx001.dmc-sp.org> References: <222E81132BE3E54584CB9A5DB1CDD7E280DE0D@bks-emx001.dmc-sp.org> Message-ID: <20091006001747.66586njt8pmvbqck@webmail.ualberta.ca> Hi everyone, Looking for suggestions for a hands on activity for a dietitian career fair = this is for prospective university students (ie undergrads) who may be interested in working as a dietitian. Given that 60% of dietitians work clinically, it would be great to have a clinically related suggestion for a booth display. Thanks, Corilee From Beverly.Hernandez at piedmont.org Tue Oct 6 05:48:28 2009 From: Beverly.Hernandez at piedmont.org (Beverly Hernandez) Date: Tue, 06 Oct 2009 08:48:28 -0400 Subject: [Cnm] Passing trays in ICU Message-ID: Lisa Thank you for your valued comments. Good leadership demands that we think out of the box, learn from past practices and do things differently and more inventively. So we also deliver isolation trays with the best results for our patients and a more unified relationship with our nursing staff. We've also worked with our NST to assist in transitioning patients out of the ICU as soon as possible once they can eat; while they are there however, we do allow them to participate in room service. The format for this was discussed and agreed upon through meetings with ICU staff nurses, room service representatives, ICU Clinical directors and I. Since we all created the process, we work to support it's success at every level. Beverly J.D. Hernandez, M.S.,R.D.,L.D.,CDN Clinical Nutrition Mgr. Piedmont Hospital 1968 Peachtree R.D N W Atlanta, GA 30309 404-605-1746 Beverly.Hernandez at Piedmont.org "We are not imprisoned by our circumstances, our setbacks, our history, our mistakes, or even staggering defeats along the way. We are freed by our choices." Jim Collins >>> Lisa Trombley 10/5/2009 6:09 PM >>> While I used to fight having foodservice hosts/hostesses add more units to their areas of responsibility, I have noticed a significant improvement in timeliness of patient meal delivery when this has happened which means more palatable food and potentially an increased intake for the patient. At my current facility, foodservice staff deliver to isolation & psychiatric patients & we are discussing transitioning to the ICU as well. Foodservice staff at Los Alamitos Medical Center & Fountain Valley Regional Hospitals in California have delivered to the ICU patient bedside for many years. It takes strong communication with nursing but can be very successful. Lisa Trombley, MA, RD, CNSD LAC+USC Medical Center Morrison Healthcare Food Service, Inc. hargenlisa at hotmail.com From: sconnell at atriumhealthcare.net To: cnm at lists.my180.net Date: Mon, 5 Oct 2009 09:10:46 -0500 Subject: [Cnm] Passing trays in ICU Good Morning! We have an ongoing problem with trays being passed in timely manner in ICU. A lot of it is due to the higher acuity level and timing of meals in relation to patient care. However, there are times that it does not appear related at all. Our ICU rarely has a patient tech to pass trays, which leaves it up to nursing. Consequently, when the food is served, it is often reheated food. Or the tray has sat for so long it is no longer safe, so the patient gets a snack and waits until the next meal. Any suggestions for addressing or improving this issue is appreciated. Susie Connell, MS, RD, LD Clinical Nutrition Manager Atrium Medical Center 3305 Corinth Parkway Corinth , Texas 76208 940-270-4196 sconnell at atriumhealthcare.net EMAILING FOR THE GREATER GOOD Join me _________________________________________________________________ Hotmail: Trusted email with Microsoft?s powerful SPAM protection. http://clk.atdmt.com/GBL/go/177141664/direct/01/ From julie.mclaughlin at hotmail.com Tue Oct 6 06:45:02 2009 From: julie.mclaughlin at hotmail.com (Julie McLaughlin) Date: Tue, 6 Oct 2009 09:45:02 -0400 Subject: [Cnm] someone from Florida requested an Assessment form..? Message-ID: I feel terrible, but I must have deleted an email. Someone, I believe from Florida, requested examples of our forms/chart notes using NCP. I'm not sure how this person got my email address as it was directed to me and not the listserv, but I thought I would submit it here anyway. If this sounds familiar to anyone, please resend your prior email. Julie McLaughlin, RD, LD/N Assistant Director, Patient Services Broward General Medical Center Ft. Lauderdale, FL 33316 _________________________________________________________________ Hotmail: Trusted email with Microsoft?s powerful SPAM protection. http://clk.atdmt.com/GBL/go/177141664/direct/01/ -------------- next part -------------- An HTML attachment was scrubbed... URL: From KFW3W at hscmail.mcc.virginia.edu Tue Oct 6 08:20:04 2009 From: KFW3W at hscmail.mcc.virginia.edu (Willcutts, Kate F *HS) Date: Tue, 6 Oct 2009 11:20:04 -0400 Subject: [Cnm] Calorie count orders Message-ID: What are the regulations regarding ordering calorie counts? Does the order need to come from a Licensed Independent Practitioner? Kate Willcutts, MS, RD, CNSD Surgery Nutr. Support/Assistant Clinical Nutrition Manager University of Virginia Healthsystem Assistant Professor, School of Nursing Charlottesville, VA 22908 (434)-243-9837 kfw3w at virginia.edu From tggilbert at att.net Tue Oct 6 08:21:46 2009 From: tggilbert at att.net (Theresa Gilbert) Date: Tue, 6 Oct 2009 08:21:46 -0700 (PDT) Subject: [Cnm] job opening Message-ID: <521977.75863.qm@web81203.mail.mud.yahoo.com> Chief, Clinical Dietitian Vacancy-closes Tues, 20 Oct 09 Seeking progressive, innovative, energetic dietitian to lead benchmark nutrition care for one of the Air Force's largest medical facilities located in Dayton, OH.? Wright Patterson Medical Center is a 65 bed acute care facility including a critical care unit, teaching program and 30 member nutrition department.? The majority of nutrition programming is targeted towards outpatient programs with focus on chronic disease (diabetes, hyperlipidemia) and obesity. Responsibilities also include oversight of inpatient-related clinical & foodservice operations.? Prior experience supervising dietetic personnel, developing & implementing nutrition services is highly desired.? Certification in weight management a plus.? Outstanding salary (67,385.00 - 132,019.00 USD /year) and benefits to include paid continuing education, holidays, vacation and sick leave.? Please go to the following website for more information and to apply.? FYI:? please follow directions & complete application carefully...your pkg may be rejected without warning if items are missing or incomplete. Go to www.usajobs.org? and search for RPA #717442? or enter "dietitian" & "Dayton, Ohio." Theresa Gilbert, RD, LD -------------- next part -------------- An HTML attachment was scrubbed... URL: From tggilbert at att.net Tue Oct 6 08:25:36 2009 From: tggilbert at att.net (Theresa Gilbert) Date: Tue, 6 Oct 2009 08:25:36 -0700 (PDT) Subject: [Cnm] Dayton job opening correction to website to apply Message-ID: <384201.72067.qm@web81206.mail.mud.yahoo.com> ?Chief, Clinical Dietitian Vacancy-closes Tues, 20 Oct 09 Seeking progressive, innovative, energetic dietitian to lead benchmark nutrition care for one of the Air Force's largest medical facilities located in Dayton, OH.? Wright Patterson Medical Center is a 65 bed acute care facility including a critical care unit, teaching program and 30 member nutrition department.? The majority of nutrition programming is targeted towards outpatient programs with focus on chronic disease (diabetes, hyperlipidemia) and obesity. Responsibilities also include oversight of inpatient-related clinical & foodservice operations.? Prior experience supervising dietetic personnel, developing & implementing nutrition services is highly desired.? Certification in weight management a plus.? Outstanding salary (67,385.00 - 132,019.00 USD /year) and benefits to include paid continuing education, holidays, vacation and sick leave.? Please go to the following website for more information and to apply.? FYI:? please follow directions & complete application carefully...your pkg may be rejected without warning if items are missing or incomplete. Go?to: ? and search for RPA #717442? or enter "dietitian" & "Dayton, Ohio." Theresa Gilbert, RD, LD -------------- next part -------------- An HTML attachment was scrubbed... URL: From RiddifordR at childrensdayton.org Tue Oct 6 08:51:32 2009 From: RiddifordR at childrensdayton.org (Rachel Riddiford) Date: Tue, 6 Oct 2009 11:51:32 -0400 Subject: [Cnm] Urgent: Expiration of prepkgd materials Message-ID: <09E2B22E8D76B04280E994018E133C51100189D530@PEXCHNG2.cmc-dayton.org> JCAHO is here. Question: how do we know if the small individual packages of saltines, mustard, etc sent to the nursing floors are expired. The answer is not coming to me at the moment and am hoping one of you can help! Thank you!!! Rachel G Riddiford, MS, RD, LD Clinical Dietetics Manager The Children's Medical Center of Dayton One Children's Plaza Dayton, Ohio 45404-1815 Office Number: 937-641-5933 Pager Number: 937-334-3182 Fax Number: 937-641-5122 E-mail: riddifordr at childrensdayton.org http://www.childrensdayton.org [cid:image002.gif at 01CA467B.59477F20] [cid:image003.png at 01CA467B.59477F20] ________________________________ NOTICE: The information contained in this e-mail and any accompanying documents or files is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited and possibly a violation of federal/state law or regulations. If you received this information in error, please notify The Children's Medical Center of Dayton immediately via telephone at (937) 641-5293, or via electronic mail cmcconfidentiality at childrensdayton.org and promptly destroy the original message. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.png Type: image/png Size: 307 bytes Desc: image001.png URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.gif Type: image/gif Size: 5280 bytes Desc: image002.gif URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image003.png Type: image/png Size: 6041 bytes Desc: image003.png URL: From MarcelleKarustis at catholichealth.net Tue Oct 6 09:05:34 2009 From: MarcelleKarustis at catholichealth.net (Karustis, Marcelle) Date: Tue, 6 Oct 2009 10:05:34 -0600 Subject: [Cnm] Urgent: Expiration of prepkgd materials In-Reply-To: <09E2B22E8D76B04280E994018E133C51100189D530@PEXCHNG2.cmc-dayton.org> References: <09E2B22E8D76B04280E994018E133C51100189D530@PEXCHNG2.cmc-dayton.org> Message-ID: <17B38BCEA6E6F24D9300FA8CFE81F4250133DAC9@chimsx015.CHI.catholichealth.net> Some products use the Julian dating system. http://en.wikipedia.org/wiki/Julian_day I know this is on the thickened juices. Not sure about other products. 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 Rachel Riddiford Sent: Tuesday, October 06, 2009 11:52 AM To: cnm at lists.my180.net Subject: [Cnm] Urgent: Expiration of prepkgd materials JCAHO is here. Question: how do we know if the small individual packages of saltines, mustard, etc sent to the nursing floors are expired. The answer is not coming to me at the moment and am hoping one of you can help! Thank you!!! Rachel G Riddiford, MS, RD, LD Clinical Dietetics Manager The Children's Medical Center of Dayton One Children's Plaza Dayton, Ohio 45404-1815 Office Number: 937-641-5933 Pager Number: 937-334-3182 Fax Number: 937-641-5122 E-mail: riddifordr at childrensdayton.org http://www.childrensdayton.org ________________________________ NOTICE: The information contained in this e-mail and any accompanying documents or files is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited and possibly a violation of federal/state law or regulations. If you received this information in error, please notify The Children's Medical Center of Dayton immediately via telephone at (937) 641-5293, or via electronic mail cmcconfidentiality at childrensdayton.org and promptly destroy the original message. Thank you. 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 4467 bytes Desc: image006.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 5280 bytes Desc: image005.gif URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 1268 bytes Desc: image004.jpg URL: From RiddifordR at childrensdayton.org Tue Oct 6 09:09:29 2009 From: RiddifordR at childrensdayton.org (Rachel Riddiford) Date: Tue, 6 Oct 2009 12:09:29 -0400 Subject: [Cnm] Urgent: Expiration of prepkgd materials In-Reply-To: <17B38BCEA6E6F24D9300FA8CFE81F4250133DAC9@chimsx015.CHI.catholichealth.net> References: <09E2B22E8D76B04280E994018E133C51100189D530@PEXCHNG2.cmc-dayton.org> <17B38BCEA6E6F24D9300FA8CFE81F4250133DAC9@chimsx015.CHI.catholichealth.net> Message-ID: <09E2B22E8D76B04280E994018E133C51100189D537@PEXCHNG2.cmc-dayton.org> You guys are FABULOUS - thank you! My Director wasn't available when the question came through...now he is. Of course he has it under control and now I don't have to worry. Meanwhile, a bunch of our wonderful colleagues emailed me, advising me on what we actually do (but I didn't know that): Keep track of the label on the box the individual items came in - discard anything that might expire before we'd ever use it (for us, a month) Deliver product to units often Use first in/first out THANK YOU!!! - for being there and for helping so quickly. ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Rachel Riddiford Sent: Tuesday, October 06, 2009 11:52 AM To: cnm at lists.my180.net Subject: [Cnm] Urgent: Expiration of prepkgd materials JCAHO is here. Question: how do we know if the small individual packages of saltines, mustard, etc sent to the nursing floors are expired. The answer is not coming to me at the moment and am hoping one of you can help! Thank you!!! Rachel G Riddiford, MS, RD, LD Clinical Dietetics Manager The Children's Medical Center of Dayton One Children's Plaza Dayton, Ohio 45404-1815 Office Number: 937-641-5933 Pager Number: 937-334-3182 Fax Number: 937-641-5122 E-mail: riddifordr at childrensdayton.org http://www.childrensdayton.org [cid:image002.gif at 01CA467D.DAF05400] [cid:image003.jpg at 01CA467D.DAF05400] ________________________________ NOTICE: The information contained in this e-mail and any accompanying documents or files is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited and possibly a violation of federal/state law or regulations. If you received this information in error, please notify The Children's Medical Center of Dayton immediately via telephone at (937) 641-5293, or via electronic mail cmcconfidentiality at childrensdayton.org and promptly destroy the original message. Thank you. 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. ________________________________ NOTICE: The information contained in this e-mail and any accompanying documents or files is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited and possibly a violation of federal/state law or regulations. If you received this information in error, please notify The Children's Medical Center of Dayton immediately via telephone at (937) 641-5293, or via electronic mail cmcconfidentiality at childrensdayton.org and promptly destroy the original message. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 1268 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.gif Type: image/gif Size: 5280 bytes Desc: image002.gif URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image003.jpg Type: image/jpeg Size: 4467 bytes Desc: image003.jpg URL: From JCrowley at shorememorial.org Tue Oct 6 09:45:42 2009 From: JCrowley at shorememorial.org (JCrowley at shorememorial.org) Date: Tue, 6 Oct 2009 12:45:42 -0400 Subject: [Cnm] Competencies Message-ID: Good Afternoon Recently there has been much discussion about maintaining documentation of RD competencies (specific for hospital inpatient RD's) - and many of you reported that keeping the CDR Learning Plan and Activity Log in each RD's folder met TJC standards. I am wondering specifically if you are still keeping records for department specific competencies? Thank you for discussing. -Jennifer 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Shannon.Jackson at wilmed.org Tue Oct 6 10:50:43 2009 From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson) Date: Tue, 6 Oct 2009 13:50:43 -0400 Subject: [Cnm] Post Peg Placement Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4FEC@wmhcs03.wmh.org> Hello, For PEG/PEJ placement, how long do others wait before starting tube feeding? Our orders are NPO for 6 hours post procedure, except flushes.. 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Jennifer.DeHart at stvhs.com Tue Oct 6 10:48:03 2009 From: Jennifer.DeHart at stvhs.com (DeHart, Jennifer) Date: Tue, 6 Oct 2009 12:48:03 -0500 Subject: [Cnm] Utilizing "assessment" standardized language Message-ID: <790BE6DACA733D45A2EFE7875E03CC7C01B143DB@ahcmascdc024.DS.SJHS.COM> We've been working hard and making great strides in educating our staff on the NCP, incorporating the Nutrition Diagnosis piece, and working toward incorporating the standardized language for the Intervention, Monitoring & Evaluation phases into our chart notes (although the actual language for M/E feels very cumbersome). While we get the concept of standards for assessment, we're having significant difficulty translating that into a concise, readable chart note. Any suggestions, examples, etc. would be GREATLY appreciated! We're currently charting long-hand in the record, but will be moving toward EMR documentation in the next couple of years (McKesson/Horizon Clinicals). Thank you so much!! 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 CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege. -------------- next part -------------- An HTML attachment was scrubbed... URL: From LAURAF at dmhhs.org Tue Oct 6 11:10:43 2009 From: LAURAF at dmhhs.org (ETCHASON,LAURA) Date: Tue, 06 Oct 2009 13:10:43 -0500 Subject: [Cnm] Post Peg Placement In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4FEC@wmhcs03.wmh.org> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4FEC@wmhcs03.wmh.org> Message-ID: <4ACB41D2.21B0.00A0.0@dmhhs.org> Our protocol is 4 hours. Laura Laura A. Etchason, MS, RD, LDN Clinical Nutrition Manager Decatur Memorial Hospital 2300 N. Edward Street Decatur, IL 62526 217-876-5306 (office line and voice mail) 217-876-5305 (fax) 217-876-5301 (general line) lauraf at dmhhs.org Developer, Harmony, Maximizer, Individualization, Belief >>> "Shannon Byrd Jackson" 10/6/2009 12:50 PM >>> Hello, For PEG/PEJ placement, how long do others wait before starting tube feeding? Our orders are NPO for 6 hours post procedure, except flushes.. Thanks, Shannon B. Jackson, RD, LDN Clinical Dietitian Supervisor Wilson Medical Center 1705 Tarboro Street SW Wilson, NC 27893-3428 (252) 399-8768 www.wilmed.org ( http://www.wilmed.org/ ) -------------- next part -------------- An HTML attachment was scrubbed... URL: From mpappo at montefiore.org Tue Oct 6 11:52:28 2009 From: mpappo at montefiore.org (Miriam Pappo) Date: Tue, 06 Oct 2009 14:52:28 -0400 Subject: [Cnm] Competencies Message-ID: I am keeping comps on specialty assignments/units as well. The comps are now part of/ included in our Annual Performance Appraisals and therefore individualized for Onc, Renal, Peds, critical care, cardiology, etc etc. 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 >>> 10/06/09 12:45 PM >>> Good Afternoon Recently there has been much discussion about maintaining documentation of RD competencies (specific for hospital inpatient RD's) - and many of you reported that keeping the CDR Learning Plan and Activity Log in each RD's folder met TJC standards. I am wondering specifically if you are still keeping records for department specific competencies? Thank you for discussing. -Jennifer 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 -------------- next part -------------- A non-text attachment was scrubbed... Name: Miriam Pappo.vcf Type: application/octet-stream Size: 170 bytes Desc: not available URL: From m-rodrig at msmc.com Tue Oct 6 12:10:50 2009 From: m-rodrig at msmc.com (Maritza Rodriguez) Date: Tue, 6 Oct 2009 15:10:50 -0400 Subject: [Cnm] Enteral Feeding Policy Message-ID: <32EDCA3D1F5C4C41B7E1A4573DFACCC602118290@SVIPEXC1.msmc.com> We are in the process to update our Enteral Nutrition Policy. For those who have been in this task recently, what new topics did you add based on the new critical nutrition guidelines? Are you willing to share yours? Maritza Rodriguez Maritza Rodriguez, RD LDN Miami Heart Institute -------------- next part -------------- An HTML attachment was scrubbed... URL: From RBijold1 at smdc.org Tue Oct 6 12:42:35 2009 From: RBijold1 at smdc.org (Bijold, Roxanne M.) Date: Tue, 6 Oct 2009 14:42:35 -0500 Subject: [Cnm] Enteral Feedings through Pharmacy In-Reply-To: <521977.75863.qm@web81203.mail.mud.yahoo.com> References: <521977.75863.qm@web81203.mail.mud.yahoo.com> Message-ID: <42A90F8376E770489AF180BC11195B0501B17A94@BOREAL.ntcampus.smdc.org> I would be interested in hearing from anyone whose facility stocks and dispenses their enteral feeding products through their pharmacy department, rather than Nutrition Services. Thank you. Roxanne Bijold, MSE, RD, LD Clinical Nutrition Manager SMDC Health System 400 E 3rd Street Duluth, MN 55807 218-786-4669 rbijold1 at smdc.org "Nutrition Services: Nourishing Your Body and Soul" This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. As required by federal and state laws, you need to hold this information as privileged and confidential. If you have received this communication in error, please notify the sender and destroy all copies of this communication and any attachments. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Suzanne_Mach at CHS.net Tue Oct 6 13:57:10 2009 From: Suzanne_Mach at CHS.net (Suzanne_Mach at CHS.net) Date: Tue, 6 Oct 2009 16:57:10 -0400 Subject: [Cnm] Unopened TF product on nursing floors Message-ID: Does anyone have a process or policy about how unopened/unused TF product is returned to the nutrition department after a patient is discharged? 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 -------------------------------------------------------------------------- Disclaimer: This electronic message may contain information that is Proprietary, Confidential, or legally privileged or protected. It is intended only for the use of the individual(s) and entity named in the message. If you are not an intended recipient of this message, please notify the sender immediately and delete the material from your computer. Do not deliver, distribute or copy this message and do not disclose its contents or take any action in reliance on the information it contains. -------------- next part -------------- An HTML attachment was scrubbed... URL: From MAHTRedF at aol.com Tue Oct 6 17:07:09 2009 From: MAHTRedF at aol.com (MAHTRedF at aol.com) Date: Tue, 6 Oct 2009 20:07:09 EDT Subject: [Cnm] NICU Message-ID: Food and Nutrition is responsible. M Hagerty, MS,RD CNM, CEdars-Sinai Medical Center Los Angeles, CA 90048 -------------- next part -------------- An HTML attachment was scrubbed... URL: From jlworden at att.net Tue Oct 6 19:55:52 2009 From: jlworden at att.net (Jo Lynn Worden) Date: Tue, 6 Oct 2009 21:55:52 -0500 Subject: [Cnm] Enteral Feeding Policy In-Reply-To: <32EDCA3D1F5C4C41B7E1A4573DFACCC602118290@SVIPEXC1.msmc.com> References: <32EDCA3D1F5C4C41B7E1A4573DFACCC602118290@SVIPEXC1.msmc.com> Message-ID: <000c01ca46f9$af3b4aa0$0db1dfe0$@net> Post to list - we will be working with our nursing staff on this very soon, also. j From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Maritza Rodriguez Sent: Tuesday, October 06, 2009 2:11 PM To: cnm at lists.my180.net Subject: [Cnm] Enteral Feeding Policy We are in the process to update our Enteral Nutrition Policy. For those who have been in this task recently, what new topics did you add based on the new critical nutrition guidelines? Are you willing to share yours? Maritza Rodriguez Maritza Rodriguez, RD LDN Miami Heart Institute -------------- next part -------------- An HTML attachment was scrubbed... URL: From Julie.Finney at csauh.com Wed Oct 7 05:28:57 2009 From: Julie.Finney at csauh.com (Finney, Julie) Date: Wed, 7 Oct 2009 08:28:57 -0400 Subject: [Cnm] Unopened TF product on nursing floors In-Reply-To: References: Message-ID: We don't have a policy, but our feedings are delivered by FNS to the nursing unit and kept in a central location on the unit. We do a "floor sweep" twice a week to pick up feedings that are no longer being used due to transfers or discharges. Nursing units tend not to send feedings back after a patient is discharged because they like to have it on hand "just in case." We try to be as efficient as possible with our feeding distribution and ordering so that we avoid outdated products and don't order products unnecessarily. When I converted from canned products to Ready-to-Hang, I learned just how much product was being squirreled away up on the units as it took nearly 5 weeks longer to use up the canned products than I had projected simply because of all of the products we found on the units. Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Suzanne_Mach at CHS.net Sent: Tuesday, October 06, 2009 4:57 PM To: cnm at lists.my180.net Subject: [Cnm] Unopened TF product on nursing floors Does anyone have a process or policy about how unopened/unused TF product is returned to the nutrition department after a patient is discharged? 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 ------------------------------------------------------------------------ -- Disclaimer: This electronic message may contain information that is Proprietary, Confidential, or legally privileged or protected. It is intended only for the use of the individual(s) and entity named in the message. If you are not an intended recipient of this message, please notify the sender immediately and delete the material from your computer. Do not deliver, distribute or copy this message and do not disclose its contents or take any action in reliance on the information it contains. ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Shannon.Jackson at wilmed.org Wed Oct 7 06:06:40 2009 From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson) Date: Wed, 7 Oct 2009 09:06:40 -0400 Subject: [Cnm] I AM EATING BANANAS!!! Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F5002@wmhcs03.wmh.org> Thought I'd share this with you all.... ________________________________ I AM EATING BANANAS!!! A professor at CCNY for a physiological psych class told his class about bananas. He said the expression "going bananas" is from the effects of bananas on the brain. Read on: Never, put your banana in the refrigerator!!! This is interesting. After reading this, you'll never look at a banana in the same way again.. Bananas contain three natural sugars - sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world's leading athletes. But energy isn't the only way a banana can help us keep fit. It can also help overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet.. Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier. PMS: Forget the pills - eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood. Anemia : High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia. Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, making it perfect to beat blood pressure. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit's ability to reduce the risk of blood pressure and stroke. Brain Power: 200 students at a Twickenham (Middlesex) school ( England ) were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert. Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives. Hangovers: One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system. Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief. Morning Sickness: Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation. Nerves: Bananas are high in B vitamins that help calm the nervous system. Overweight and at work? Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and chips. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high-pressure jobs. The report concluded that, to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady. Ulcers: The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over-chronicler cases. It also neutralizes over-acidity and reduces irritation by coating the lining of the stomach.. Temperature control: Many other cultures see bananas as a "cooling" fruit that can lower both the physical and emotional temperature of expectant mothers.. In Thailand , for example, pregnant women eat bananas to ensure their baby is born with a cool temperature. Seasonal Affective Disorder (SAD): Bananas can help SAD sufferers because they contain the natural mood enhancer tryptophan. Smoking &Tobacco Use: Bananas can also help people trying to give up smoking. The B6, B12 they contain, as well as the potassium and magnesium found in them, help the body recover from the effects of nicotine withdrawal. Stress: Potassium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body's water balance.. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack. Strokes: According to research in The New England Journal of Medicine, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%! Warts: Those keen on natural alternatives swear that if you want to kill off a wart, take a piece of banana skin and place it on the wart, with the yellow side out. Carefully hold the skin in place with a plaster or surgical tape! So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrate, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is one of the best value foods around So maybe its time to change that well-known phrase so that we say, "A banana a day keeps the doctor away!" PASS IT ON TO YOUR FRIENDS PS: Bananas must be the reason monkeys are so happy all the time! I will add one here; want a quick shine on our shoes?? Take the INSIDE of the banana skin, and rub directly on the shoe...polish with dry cloth. Amazing fruit !!! ________________________________ No virus found in this incoming message. Checked by AVG - www.avg.com Version: 8.5.409 / Virus Database: 270.14.2/2408 - Release Date: 10/01/09 18:23:00 ________________________________ Your E-mail and More On-the-Go. Get Windows Live Hotmail Free. Sign up now. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... 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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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From khiggins at mail.uch.org Wed Oct 7 07:05:03 2009 From: khiggins at mail.uch.org (Karen Higgins) Date: Wed, 07 Oct 2009 10:05:03 -0400 Subject: [Cnm] Meal Service Temps Message-ID: <4ACC67CE.08B2.000F.0@mail.uch.org> Does anyone know what an expected or average loss of temp should be from trayline to patient - i.e. would one degree/minute be an acceptable degree loss? Thank you. Karen Higgins Manager, Medical Nutrition Services "The best way to predict the future is to create it!".........Jason Kaufmann The views expressed in this e-mail are the views of the sender and do not necessarily represent the views of University Community Health. This e-mail message and its attachments are for the sole use of the intended recipients. They may contain confidential information or other information subject to legal protection and/or restrictions. If you are not the intended recipient of this message, please do not read, copy, use or disclose this message or its attachments. Please notify the sender by replying to this message and delete or destroy all copies of this message and attachments in all media. Thank you. From bhaine at Elliot-HS.org Wed Oct 7 08:15:13 2009 From: bhaine at Elliot-HS.org (Haine, Barbara) Date: Wed, 7 Oct 2009 11:15:13 -0400 Subject: [Cnm] I AM EATING BANANAS!!! In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F5002@wmhcs03.wmh.org> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F5002@wmhcs03.wmh.org> Message-ID: What happens to a refrigerated banana? I put mine in the freezer and add them to smoothies. From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Shannon Byrd Jackson Sent: Wednesday, October 07, 2009 9:07 AM To: cnm at lists.my180.net Subject: [Cnm] I AM EATING BANANAS!!! Thought I'd share this with you all.... ________________________________ I AM EATING BANANAS!!! A professor at CCNY for a physiological psych class told his class about bananas. He said the expression "going bananas" is from the effects of bananas on the brain. Read on: Never, put your banana in the refrigerator!!! This is interesting. After reading this, you'll never look at a banana in the same way again.. Bananas contain three natural sugars - sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world's leading athletes. But energy isn't the only way a banana can help us keep fit. It can also help overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet.. Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier. PMS: Forget the pills - eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood. Anemia : High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia. Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, making it perfect to beat blood pressure. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit's ability to reduce the risk of blood pressure and stroke. Brain Power: 200 students at a Twickenham (Middlesex) school ( England ) were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert. Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives. Hangovers: One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system. Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief. Morning Sickness: Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation. Nerves: Bananas are high in B vitamins that help calm the nervous system. Overweight and at work? Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and chips. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high-pressure jobs. The report concluded that, to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady. Ulcers: The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over-chronicler cases. It also neutralizes over-acidity and reduces irritation by coating the lining of the stomach.. Temperature control: Many other cultures see bananas as a "cooling" fruit that can lower both the physical and emotional temperature of expectant mothers.. In Thailand , for example, pregnant women eat bananas to ensure their baby is born with a cool temperature. Seasonal Affective Disorder (SAD): Bananas can help SAD sufferers because they contain the natural mood enhancer tryptophan. Smoking &Tobacco Use: Bananas can also help people trying to give up smoking. The B6, B12 they contain, as well as the potassium and magnesium found in them, help the body recover from the effects of nicotine withdrawal. Stress: Potassium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body's water balance.. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack. Strokes: According to research in The New England Journal of Medicine, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%! Warts: Those keen on natural alternatives swear that if you want to kill off a wart, take a piece of banana skin and place it on the wart, with the yellow side out. Carefully hold the skin in place with a plaster or surgical tape! So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrate, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is one of the best value foods around So maybe its time to change that well-known phrase so that we say, "A banana a day keeps the doctor away!" PASS IT ON TO YOUR FRIENDS PS: Bananas must be the reason monkeys are so happy all the time! I will add one here; want a quick shine on our shoes?? Take the INSIDE of the banana skin, and rub directly on the shoe...polish with dry cloth. Amazing fruit !!! ________________________________ No virus found in this incoming message. Checked by AVG - www.avg.com Version: 8.5.409 / Virus Database: 270.14.2/2408 - Release Date: 10/01/09 18:23:00 ________________________________ Your E-mail and More On-the-Go. Get Windows Live Hotmail Free. Sign up now. ----------------------------------------- **** CONFIDENTIAL COMMUNICATION - PLEASE READ PRIVACY NOTICE **** This communication is confidential and may be read only by its intended recipient(s). It may contain legally privileged and protected information. If you believe you have received this communication in error, please "Reply" to the Sender and so indicate or call (603) 663-2800. Then, please promptly "Delete" this communication from your computer. This communication, and any information contained herein, may only be forwarded, printed, disclosed, copied or disseminated by those specifically authorized to do so. UNAUTHORIZED DISCLOSURE MAY RESULT IN LEGAL LIABILITY FOR THOSE PERSONS RESPONSIBLE. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 18216 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 11156 bytes Desc: image002.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 632 bytes Desc: image003.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 25607 bytes Desc: image004.jpg URL: From Heidi.Clark at AMEDD.ARMY.MIL Wed Oct 7 08:33:39 2009 From: Heidi.Clark at AMEDD.ARMY.MIL (Clark, Heidi L MAJ MIL USAF MEDCOM LRMC) Date: Wed, 7 Oct 2009 17:33:39 +0200 Subject: [Cnm] Meal Service Temps (UNCLASSIFIED) In-Reply-To: <4ACC67CE.08B2.000F.0@mail.uch.org> References: <4ACC67CE.08B2.000F.0@mail.uch.org> Message-ID: <9AB53CB10B46784794F4F6D3AD82344F363374@AMEDERMCBE041.eur.amed.ds.army.mil> Classification: UNCLASSIFIED Caveats: NONE Please reply to all; that's a good question. Is it acceptable total loss--or acceptable end result temperature (eg, is the temperature still in an acceptable range at the anticipated time it arrives to the patient)? -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karen Higgins Sent: Wednesday, October 07, 2009 4:05 PM To: cnm at lists.my180.net Subject: [Cnm] Meal Service Temps Does anyone know what an expected or average loss of temp should be from trayline to patient - i.e. would one degree/minute be an acceptable degree loss? Thank you. Karen Higgins Manager, Medical Nutrition Services "The best way to predict the future is to create it!".........Jason Kaufmann The views expressed in this e-mail are the views of the sender and do not necessarily represent the views of University Community Health. This e-mail message and its attachments are for the sole use of the intended recipients. They may contain confidential information or other information subject to legal protection and/or restrictions. If you are not the intended recipient of this message, please do not read, copy, use or disclose this message or its attachments. Please notify the sender by replying to this message and delete or destroy all copies of this message and attachments in all media. Thank you. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Classification: UNCLASSIFIED Caveats: NONE From SLewis at mercycare.org Wed Oct 7 09:23:17 2009 From: SLewis at mercycare.org (Lewis, Suzanne) Date: Wed, 7 Oct 2009 11:23:17 -0500 Subject: [Cnm] Urgent: Expiration of prepkgd materials In-Reply-To: <17B38BCEA6E6F24D9300FA8CFE81F4250133DAC9@chimsx015.CHI.catholichealth.net> Message-ID: <63A81A57A6254849B538D2FF4F1D539904DD67C4@VS01EXC01.mercycare.org> Along this same line. we are being asked by our Infection Control department to not store anything in cardboard boxes - ie - pc's, crackers, etc. I am trying to find out if anyone else is having this problem/concern and how it's been addressed. What do you have listed in your policies regarding storage? Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karustis, Marcelle Sent: Tuesday, October 06, 2009 11:06 AM To: Rachel Riddiford Cc: cnm at lists.my180.net Subject: Re: [Cnm] Urgent: Expiration of prepkgd materials Some products use the Julian dating system. http://en.wikipedia.org/wiki/Julian_day I know this is on the thickened juices. Not sure about other products. 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 Rachel Riddiford Sent: Tuesday, October 06, 2009 11:52 AM To: cnm at lists.my180.net Subject: [Cnm] Urgent: Expiration of prepkgd materials JCAHO is here. Question: how do we know if the small individual packages of saltines, mustard, etc sent to the nursing floors are expired. The answer is not coming to me at the moment and am hoping one of you can help! Thank you!!! Rachel G Riddiford, MS, RD, LD Clinical Dietetics Manager The Children's Medical Center of Dayton One Children's Plaza Dayton, Ohio 45404-1815 Office Number: 937-641-5933 Pager Number: 937-334-3182 Fax Number: 937-641-5122 E-mail: riddifordr at childrensdayton.org http://www.childrensdayton.org ________________________________ NOTICE: The information contained in this e-mail and any accompanying documents or files is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited and possibly a violation of federal/state law or regulations. If you received this information in error, please notify The Children's Medical Center of Dayton immediately via telephone at (937) 641-5293, or via electronic mail cmcconfidentiality at childrensdayton.org and promptly destroy the original message. Thank you. 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 1268 bytes Desc: image004.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 5280 bytes Desc: image005.gif URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 4467 bytes Desc: image006.jpg URL: From bethegan at memphis.edu Wed Oct 7 11:07:03 2009 From: bethegan at memphis.edu (Beth Egan (bethegan)) Date: Wed, 7 Oct 2009 13:07:03 -0500 Subject: [Cnm] Holly Patronik Message-ID: <68DD13B3B69A5E4FB203A25BCBAC1BD5161B1772A9@itexbe5.uom.memphis.edu> Will you please contact me? Beth M. Egan, MS, RD Clinical Coordinator Dietetic Internship and Residency Program University of Memphis Health and Sport Sciences 161A3 Field House http://coe.memphis.edu/hss/MS-ClinicalNutrition.htm Memphis, TN 38152 Office: (901) 678-4054 Fax: (901) 678-3591 -------------- next part -------------- An HTML attachment was scrubbed... URL: From jross at jaycountyhospital.com Wed Oct 7 11:15:07 2009 From: jross at jaycountyhospital.com (Julayne Ross) Date: Wed, 7 Oct 2009 14:15:07 -0400 Subject: [Cnm] Meal Service Temps (UNCLASSIFIED) Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D02411C65@EX1.jaycountyhospital.com> I was told by our Board of Health Surveyor that if we check temps on the trayline and the tray does not sit for more than 2 hours, then it is all about patient preference. Was it pleasing to the patient...etc. Not sure if that helps or not. Julayne -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Clark, Heidi L MAJ MIL USAF MEDCOM LRMC Sent: Wednesday, October 07, 2009 11:34 AM To: Karen Higgins; cnm at lists.my180.net Subject: Re: [Cnm] Meal Service Temps (UNCLASSIFIED) Classification: UNCLASSIFIED Caveats: NONE Please reply to all; that's a good question. Is it acceptable total loss--or acceptable end result temperature (eg, is the temperature still in an acceptable range at the anticipated time it arrives to the patient)? -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karen Higgins Sent: Wednesday, October 07, 2009 4:05 PM To: cnm at lists.my180.net Subject: [Cnm] Meal Service Temps Does anyone know what an expected or average loss of temp should be from trayline to patient - i.e. would one degree/minute be an acceptable degree loss? Thank you. Karen Higgins Manager, Medical Nutrition Services "The best way to predict the future is to create it!".........Jason Kaufmann The views expressed in this e-mail are the views of the sender and do not necessarily represent the views of University Community Health. This e-mail message and its attachments are for the sole use of the intended recipients. They may contain confidential information or other information subject to legal protection and/or restrictions. If you are not the intended recipient of this message, please do not read, copy, use or disclose this message or its attachments. Please notify the sender by replying to this message and delete or destroy all copies of this message and attachments in all media. Thank you. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Classification: UNCLASSIFIED Caveats: NONE _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From lneuhaus at chsbuffalo.org Wed Oct 7 11:22:23 2009 From: lneuhaus at chsbuffalo.org (Neuhaus, Lisa) Date: Wed, 7 Oct 2009 14:22:23 -0400 Subject: [Cnm] Urgent: Expiration of prepkgd materials In-Reply-To: <63A81A57A6254849B538D2FF4F1D539904DD67C4@VS01EXC01.mercycare.o rg> References: <17B38BCEA6E6F24D9300FA8CFE81F4250133DAC9@chimsx015.CHI.catholic health.net><63A81A57A6254849B538D2FF4F1D539904DD67C4@VS01EXC01.mercycare.or g> Message-ID: <3E6DC8D8B3285C449C883257CA6012D75EB27BD415@CHEXCHANGE01.ad.wnychs.org> We were asked a few years back not to store anything in cardboard on the patient units in the pantries. In our dry storeage areas and coolers and freezer it is not problem but on patient units we are not allowed to have any cardboard. It would be virtually impossible to take everything out of the case it arrived in for storage and that packaging has a lot of the dating and labeling information on it as well. Lisa Neuhaus MS RD CNSD Director, Food & Nutrition Services Buffalo Mercy Hospital 565 Abbott Road Buffalo, NY 14220 716-828-2106 [cid:image001.png at 01CA4759.968CC5F0] From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Lewis, Suzanne Sent: Wednesday, October 07, 2009 12:23 PM Cc: cnm at lists.my180.net Subject: Re: [Cnm] Urgent: Expiration of prepkgd materials Along this same line. we are being asked by our Infection Control department to not store anything in cardboard boxes - ie - pc's, crackers, etc. I am trying to find out if anyone else is having this problem/concern and how it's been addressed. What do you have listed in your policies regarding storage? Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karustis, Marcelle Sent: Tuesday, October 06, 2009 11:06 AM To: Rachel Riddiford Cc: cnm at lists.my180.net Subject: Re: [Cnm] Urgent: Expiration of prepkgd materials Some products use the Julian dating system. http://en.wikipedia.org/wiki/Julian_day I know this is on the thickened juices. Not sure about other products. 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 Rachel Riddiford Sent: Tuesday, October 06, 2009 11:52 AM To: cnm at lists.my180.net Subject: [Cnm] Urgent: Expiration of prepkgd materials JCAHO is here. Question: how do we know if the small individual packages of saltines, mustard, etc sent to the nursing floors are expired. The answer is not coming to me at the moment and am hoping one of you can help! Thank you!!! Rachel G Riddiford, MS, RD, LD Clinical Dietetics Manager The Children's Medical Center of Dayton One Children's Plaza Dayton, Ohio 45404-1815 Office Number: 937-641-5933 Pager Number: 937-334-3182 Fax Number: 937-641-5122 E-mail: riddifordr at childrensdayton.org http://www.childrensdayton.org [cid:image003.gif at 01CA4759.968CC5F0] [cid:image004.jpg at 01CA4759.968CC5F0] ________________________________ NOTICE: The information contained in this e-mail and any accompanying documents or files is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited and possibly a violation of federal/state law or regulations. If you received this information in error, please notify The Children's Medical Center of Dayton immediately via telephone at (937) 641-5293, or via electronic mail cmcconfidentiality at childrensdayton.org and promptly destroy the original message. Thank you. 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. ------------------------- CONFIDENTIALITY NOTICE: This message is confidential, intended only for the named recipient(s) and may contain information that is privileged, or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender by reply e-mail, delete this e-mail from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege. This message and all contents may be reviewed by authorized parties of the Catholic Health System other than those named in the message header. The contents of this message do not bind the Catholic Health System to any contract, position, or course of action unless the sender is specifically authorized to enter into contracts on behalf of the Catholic Health System. The contents of this message do not necessarily constitute an official representation of the Catholic Health System. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.png Type: image/png Size: 6801 bytes Desc: image001.png URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.jpg Type: image/jpeg Size: 1268 bytes Desc: image002.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image003.gif Type: image/gif Size: 5280 bytes Desc: image003.gif URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image004.jpg Type: image/jpeg Size: 4467 bytes Desc: image004.jpg URL: From KHorvath at swgeneral.com Wed Oct 7 12:32:36 2009 From: KHorvath at swgeneral.com (Horvath, Karen) Date: Wed, 7 Oct 2009 15:32:36 -0400 Subject: [Cnm] EMR Message-ID: <0BD69CE7EFA7F74A9500CD83C2ADC67906E12E70@SWEXCHANGE.swgeneral.corp> For those hospitals with the EMR and both dietitians and diet techs how are the tasks divided? Assessments, follow ups and education. Thanks! Karen Horvath MA RD LD Southwest General - HEALTH is our passion, QUALITY is our focus, COMPASSION is our way 18697 Bagley Road | Middleburg Heights, Ohio | 44130-3497 | Tel: 440-816-8000 | http://www.swgeneral.com/ -------------------------------------------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended only for use by the person(s) to whom it is addressed. Southwest General and its affiliates disclaim any responsibility for unauthorized disclosure of this information by persons receiving this information. If you receive this information in error, please notify the sender immediately by reply e-mail or notify Southwest General's Privacy Officer at 440-816-6704. Also, if you are not the intended recipient, any dissemination, distribution or duplication of this transmission is strictly prohibited and please delete or destroy all copies of this message. If this e-mail contains any patient medical information, please note that federal and Ohio law protect patient medical information, including psychiatric diagnosis, (HIV) test results, AIDs-related conditions, alcohol and/or drug dependence or abuse. Unless otherwise permitted by specific law, you are prohibited from disclosing this information to anyone else without the specific written consent of the person to whom it pertains. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 5048 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 1578 bytes Desc: image002.gif URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 5581 bytes Desc: not available URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 3246 bytes Desc: not available URL: From JCrowley at shorememorial.org Wed Oct 7 12:44:03 2009 From: JCrowley at shorememorial.org (JCrowley at shorememorial.org) Date: Wed, 7 Oct 2009 15:44:03 -0400 Subject: [Cnm] Responses to Competencies question Message-ID: Thank you to all who responded. I am continually thankful for this portal into so many great minds! As requested, here is a copy of responses to the posting listed below. Good Afternoon Recently there has been much discussion about maintaining documentation of RD competencies (specific for hospital inpatient RD's) - and many of you reported that keeping the CDR Learning Plan and Activity Log in each RD's folder met TJC standards. I am wondering specifically if you are still keeping records for department specific competencies? Thank you for discussing. -Jennifer The responses received were as follows: I create a list with the competencies for each dietitian and mark as they are completed. I include department-specific (but I have exempted the dietitians from many of the competencies) and it is a single page. We still do dept specific competencies. TJC was just here this summer and recommended we have orientation competencies specific to the job description. So we continue yearly dept specific competencies that vary from year to year. yes, HR wanted us to do so. SZ I am keeping comps on specialty assignments/units as well. The comps are now part of/ included in our Annual Performance Appraisals and therefore individualized for Onc, Renal, Peds, critical care, cardiology, etc etc. I am planning to use the CDR plan and activity log ? but I also count competency by doing chart audits and printing off the RDs notes when there is a particularly good assessment done or a case is challenging or illustrates the RDs work with a culturally diverse patient??that kind of stuff. I also get a representation of ages, an observation of their nutrition counseling ability, and keep those kinds of things in their files. If they don?t normally do peds ? sometimes I just encourage them to assess a pediatric patient just so we have it for their files, or I set up some kind of CEU with Ross or Novartis who usually has a CEU they can provide. Hope this helps. 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From MELLINGTON at wakemed.org Wed Oct 7 12:48:45 2009 From: MELLINGTON at wakemed.org (MARTHA ELLINGTON) Date: Wed, 7 Oct 2009 15:48:45 -0400 Subject: [Cnm] Urgent: Expiration of prepkgd materials In-Reply-To: <63A81A57A6254849B538D2FF4F1D539904DD67C4@VS01EXC01.mercycare.org> References: <17B38BCEA6E6F24D9300FA8CFE81F4250133DAC9@chimsx015.CHI.catholichealth.net> <63A81A57A6254849B538D2FF4F1D539904DD67C4@VS01EXC01.mercycare.org> Message-ID: We are having our TJC survey as we speak. The only thing the life safety person got us on was too many combustibles by and exit door. Naturally we cleared these shelves out and it was corrected on site. These were card board boxes with cereal, hinge trays, napkins, and condiments that the hostesses need close by for patient trays. We are working on obtaining plastic containers but will need big ones for things like potato chips and cereal. Basically we are trying to get away from cardboard in our "day storage" areas in the kitchen. It does not seem to be an issue in the big storeroom. They will be here 3 more days. Clinical areas have been fairly benign so far. I will let the list know if anything interesting happens. 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 Lewis, Suzanne Sent: Wednesday, October 07, 2009 12:23 PM Cc: cnm at lists.my180.net Subject: Re: [Cnm] Urgent: Expiration of prepkgd materials Along this same line. we are being asked by our Infection Control department to not store anything in cardboard boxes - ie - pc's, crackers, etc. I am trying to find out if anyone else is having this problem/concern and how it's been addressed. What do you have listed in your policies regarding storage? Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karustis, Marcelle Sent: Tuesday, October 06, 2009 11:06 AM To: Rachel Riddiford Cc: cnm at lists.my180.net Subject: Re: [Cnm] Urgent: Expiration of prepkgd materials Some products use the Julian dating system. http://en.wikipedia.org/wiki/Julian_day I know this is on the thickened juices. Not sure about other products. 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 Rachel Riddiford Sent: Tuesday, October 06, 2009 11:52 AM To: cnm at lists.my180.net Subject: [Cnm] Urgent: Expiration of prepkgd materials JCAHO is here. Question: how do we know if the small individual packages of saltines, mustard, etc sent to the nursing floors are expired. The answer is not coming to me at the moment and am hoping one of you can help! Thank you!!! Rachel G Riddiford, MS, RD, LD Clinical Dietetics Manager The Children's Medical Center of Dayton One Children's Plaza Dayton, Ohio 45404-1815 Office Number: 937-641-5933 Pager Number: 937-334-3182 Fax Number: 937-641-5122 E-mail: riddifordr at childrensdayton.org http://www.childrensdayton.org [cid:image002.gif at 01CA4765.68C28D10] [cid:image003.jpg at 01CA4765.68C28D10] ________________________________ NOTICE: The information contained in this e-mail and any accompanying documents or files is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited and possibly a violation of federal/state law or regulations. If you received this information in error, please notify The Children's Medical Center of Dayton immediately via telephone at (937) 641-5293, or via electronic mail cmcconfidentiality at childrensdayton.org and promptly destroy the original message. Thank you. 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 1268 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.gif Type: image/gif Size: 5280 bytes Desc: image002.gif URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image003.jpg Type: image/jpeg Size: 4467 bytes Desc: image003.jpg URL: From Julie.Finney at csauh.com Wed Oct 7 14:01:33 2009 From: Julie.Finney at csauh.com (Finney, Julie) Date: Wed, 7 Oct 2009 17:01:33 -0400 Subject: [Cnm] Information Request Message-ID: To those of you who are using Blackberries in your practice, what are some of the resources that you are able to utilize via this device? Any references that you could point me to? (I know that I have seen this information in the past, but my search abilities have deserted me at this moment.) Thanks, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From rossjanv at fuse.net Wed Oct 7 16:31:28 2009 From: rossjanv at fuse.net (Janet V. Ross) Date: Wed, 7 Oct 2009 19:31:28 -0400 Subject: [Cnm] Urgent: Expiration of prepkgd materials In-Reply-To: <63A81A57A6254849B538D2FF4F1D539904DD67C4@VS01EXC01.mercycare.org> Message-ID: <37.8A.23671.8D42DCA4@ecout2> We took these small non-perishable items up to the units in "box lunch" type boxes or ziplock bags. Labeled the box or the bag with an expiration date (3-6 months depending on the item) and then discarded everything left in the box/bag when the date arrived. It worked-if you could convince staff not to "add' to the top of the top of the box. At least it would convince surveyors that we had a system. 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 Lewis, Suzanne Sent: Wednesday, October 07, 2009 12:23 PM Cc: cnm at lists.my180.net Subject: Re: [Cnm] Urgent: Expiration of prepkgd materials Along this same line. we are being asked by our Infection Control department to not store anything in cardboard boxes - ie - pc's, crackers, etc. I am trying to find out if anyone else is having this problem/concern and how it's been addressed. What do you have listed in your policies regarding storage? Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org _____ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karustis, Marcelle Sent: Tuesday, October 06, 2009 11:06 AM To: Rachel Riddiford Cc: cnm at lists.my180.net Subject: Re: [Cnm] Urgent: Expiration of prepkgd materials Some products use the Julian dating system. http://en.wikipedia.org/wiki/Julian_day I know this is on the thickened juices. Not sure about other products. 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 Rachel Riddiford Sent: Tuesday, October 06, 2009 11:52 AM To: cnm at lists.my180.net Subject: [Cnm] Urgent: Expiration of prepkgd materials JCAHO is here. Question: how do we know if the small individual packages of saltines, mustard, etc sent to the nursing floors are expired. The answer is not coming to me at the moment and am hoping one of you can help! Thank you!!! LineNoText.bmp Rachel G Riddiford, MS, RD, LD Clinical Dietetics Manager The Children's Medical Center of Dayton One Children's Plaza Dayton, Ohio 45404-1815 Office Number: 937-641-5933 Pager Number: 937-334-3182 Fax Number: 937-641-5122 E-mail: riddifordr at childrensdayton.org http://www.childrensdayton.org http://www.childrensdayton.org/images/logo_childrens.gif TextWLine.bmp _____ NOTICE: The information contained in this e-mail and any accompanying documents or files is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited and possibly a violation of federal/state law or regulations. If you received this information in error, please notify The Children's Medical Center of Dayton immediately via telephone at (937) 641-5293, or via electronic mail cmcconfidentiality at childrensdayton.org and promptly destroy the original message. Thank you. 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 1268 bytes Desc: not available URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 5280 bytes Desc: not available URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 4467 bytes Desc: not available URL: From rdconnect at yahoo.com Wed Oct 7 17:08:54 2009 From: rdconnect at yahoo.com (Jean Harnisch) Date: Wed, 7 Oct 2009 17:08:54 -0700 (PDT) Subject: [Cnm] unsubscribe595289 Message-ID: <504179.65431.qm@web62002.mail.re1.yahoo.com> Jean Harnisch -------------- next part -------------- An HTML attachment was scrubbed... URL: From Heidi.Clark at AMEDD.ARMY.MIL Wed Oct 7 23:16:14 2009 From: Heidi.Clark at AMEDD.ARMY.MIL (Clark, Heidi L MAJ MIL USAF MEDCOM LRMC) Date: Thu, 8 Oct 2009 08:16:14 +0200 Subject: [Cnm] cool link--DRI calculator (UNCLASSIFIED) Message-ID: <9AB53CB10B46784794F4F6D3AD82344F363418@AMEDERMCBE041.eur.amed.ds.army.mil> Classification: UNCLASSIFIED Caveats: NONE http://fnic.nal.usda.gov/interactiveDRI/ Cool interactive link to estimate DRI's for an individual. Heidi L. Clark, MS, RD Maj, USAF, BSC Chief, Medical Nutrition Therapy Branch Nutrition Care Division Landstuhl Regional Medical Center Email: Heidi.Clark at amedd.army.mil DSN: 486-8809 COM: 06371-86-8809 COM from the US: 011 49 6371 86 8809 Classification: UNCLASSIFIED Caveats: NONE From kef at u.washington.edu Mon Oct 5 13:31:17 2009 From: kef at u.washington.edu (Katie Farver) Date: Mon, 5 Oct 2009 13:31:17 -0700 Subject: [Cnm] Screening/Assessment parameters References: <39C024B8791C1943BAA07F35FFA8D6F90C79C3775C@SLHMAIL.slh.stlukes.com><4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org><5330B54133B6194BA13930BDEFE9A30E05161B6B@rhcexch3.reshealthcare.org> Message-ID: <006101ca45fa$cb0eb640$7b928e8c@amc.uwmedicine.org> We do screen all Psych Patients however, we rarely find a patient needing MNT. This obviously is an unproductive use of labor. We are evaluating this process so this discussion will be helpful. I have also attached our protocol. ICU - Nursing does an initial screen within 24 hours and the RDs complete a full assessment by Day 2 of admit Acute Care - Nursing does an initial screen within 24 hours and if patients is not determined to need MNT, the patient is rescreened every 7-10 days by the RD (we have had the DT do this in the past but find it much more efficient for the RD to rescreen as the RD attend rounds on all patients on their floor. Also RD is much better at picking up subtle problems). Psych - Nursing does an initial screen within 24 hours and if patient is not determined to need MNT, the patient is rescreened by the DT every 14 days. Katie Farver RD, CD, CNSD Director, Clinical Nutrition Services Department of Hospitality BWH 68 Harborview Medical Center University of Washington Academic Medical Center Affiliate Assistant Professor School of Pharmacy University of Washington 325 Ninth Ave - Box 359790 Seattle, WA 98104 VM: 206-663-4636 kef at u.washington.edu Fax: 206-744-8540 Priviledged, confidential or patient identifiable information may be contained in this message. This information is meant only for the use of the intended recipients. If you are not the intended receipient, or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission. Instead, please notifiy the send by reply e-mail, and then destroy all copies of the message and any attachments ----- Original Message ----- From: Kathy Hill To: Carver, Leslee ; Ann berzinsky ; Jeske, Debra J ; denisedacey at verizon.net ; cnm at lists.my180.net Sent: Monday, October 05, 2009 10:41 AM Subject: Re: [Cnm] Screening/Assessment parameters Hi Leslie, What criteria do you use for an initial assessment? Do you only assess those who have been referred to you by the nurse when he/she completes the nutrition screen? We are being asked to see all Psych pt's by the 6th day of admission regardless of whether they were triggered by the nurse on the nutrition screen. Does anyone automatically see Psych pt's based on a certain # of days of their admission? Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ------------------------------------------------------------------------------ From: Carver, Leslee [mailto:LCarver at Reshealthcare.org] Sent: Monday, October 05, 2009 1:36 PM To: Kathy Hill; Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: RE: [Cnm] Screening/Assessment parameters we use the same screening criteria as w/ the rest of the house. on geri psyche we re-screen low risk at 7 days and on adult psych at 14 days. 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 Kathy Hill Sent: Monday, October 05, 2009 12:08 PM To: Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Those of you who have psych units in your facilities; would you be willing to share what your policy is regarding RD evaluation of these patients? Does anyone use the same criteria for psych as you do for your acute care patients? Up until now, the dietitians at my facility only saw psych patients on a consult basis. Now we/dietitians have been directed by a new Administrator at our hospital to see all psych patients! Also, has anyone had a discussion with a TJC surveyor regarding the necessity of a nutrition evaluation of all psych patients? I really need to convince this administrator that there is no other facility where the RD sees psych patients on a regular basis and that consult only is the general rule. So please give me some feedback. In advance, thank you for your assistance. Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ------------------------------------------------------------------------------ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ann berzinsky Sent: Wednesday, September 30, 2009 10:22 AM To: Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Our policy states patients will be seen within 48hrs. Does anyone in PA know if there are state regulations that patients must be seen within 24hrs? Thank you Anne Berzinsky, RD, LDN St Clair Hospital Pittsburgh, PA ------------------------------------------------------------------------------ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J Sent: Tuesday, September 29, 2009 9:50 PM To: denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We completed our CMS survey and the surveyors rolled it into a State visit as well. The citations received in the CMS visit were duplicated in the state visit. Of interest to us was the state citations specified Missouri specific standards that were different than the "CMS State Guidelines Manual" given to us by the surveyor. The Missouri State manual actually indicates that all patients with a positive nutrition screen for malnutrition must have a "Comprehensive Nutrition Assessment" completed within 24 hours. This was news to us. This was not indicated in the manual originally given to us. It does appear this is a fairly new change (approx. 1 1/2 years ago). Needless to say, we did have to change our weekend schedule. We did have RDs on call on Sundays and had 48 hours to respond to consults to accommodate this. ------------------------------------------------------------------------------ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of denisedacey at verizon.net [denisedacey at verizon.net] Sent: Tuesday, September 29, 2009 8:27 PM To: cnm at lists.my180.net Subject: [Cnm] Screening/Assessment parameters Could anyone share their nutrition screening/assessment parameters, time frames for various risk levels?per JC standards. Our facility recently had a 'Mock Survey' and the consultant had some comments re RD timliness of assessements, 24 vs 48 hrs. We have a coordinated screening mechanism with nursing within 24 hrs, with high risk pts having a comprehensive nutrition assessment within 48 hrs. Just want to make sure we are compliant with Joint Commission Standards. Appreciate any feedback Denise Dacey RD,CDE, LDN DISCLAIMER:The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital.Email contains Privileged & Confidential Information intended only for the recipient named. Dissemination or copying of email is strictly prohibited. If you have received this in error, notify St. Clair Hospital & return or destroy original. Information in this email is confidential & protected by state & federal law. Further disclosure is strictly prohibited. ------------------------------------------------------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: N2P01106a Scope of Assessment-Screening Algorithms.DOC Type: application/msword Size: 373248 bytes Desc: not available URL: From mltphd at mindspring.com Thu Oct 8 06:02:34 2009 From: mltphd at mindspring.com (Mary Litchford) Date: Thu, 8 Oct 2009 09:02:34 -0400 Subject: [Cnm] I AM EATING BANANAS!!! Message-ID: <384-2200910481323446@mindspring.com> What an interesting email about bananas circulating on several list servs- too bad it is full of half truths & fibs. I have pasted below the Nutrient Analysis Labs profile of a 7 inch banana. You will see that compared to the DRI, bananas are not rich in iron, B12, B6, magnesium or tryptophan. They do contain 3 gm of fiber per banana, or about 10% of the total fiber recommened (25-30 g/d). Bananas, raw Refuse: 36% (Skin) Scientific Name: Musa acuminata Colla NDB No: 09040 (Nutrient values and weights are for edible portion) Nutrient Units Value per 100 grams 1.00 X 1 medium (7" to 7-7/8" long) ------- 118g Proximates Water g74.9188.39 Energy kcal89105 Protein g1.091.29 Total lipid (fat) g0.330.39 Carbohydrate, by difference g22.8426.95 Fiber, total dietary g2.63.1 Sugars, total g12.2314.43 Sucrose g2.392.82 Glucose (dextrose) g4.985.88 Fructose g4.855.72 Lactose g0.000.00 Maltose g0.010.01 Galactose g0.000.00 Starch g5.386.35 Minerals Calcium, Ca mg56 Iron, Fe mg0.260.31 Magnesium, Mg mg2732 Phosphorus, P mg2226 Potassium, K mg358422 Sodium, Na mg11 Zinc, Zn mg0.150.18 Copper, Cu mg0.0780.092 Manganese, Mn mg0.2700.319 Fluoride, F mcg2.22.6 Selenium, Se mcg1.01.2 Vitamins Vitamin C, total ascorbic acid mg8.710.3 Thiamin mg0.0310.037 Riboflavin mg0.0730.086 Niacin mg0.6650.785 Pantothenic acid mg0.3340.394 Vitamin B-6 mg0.3670.433 Folate, total mcg2024 Folic acid mcg00 Folate, food mcg2024 Folate, DFE mcg_DFE2024 Choline, total mg9.811.6 Betaine mg0.10.1 Vitamin B-12 mcg0.000.00 Vitamin B-12, added mcg0.000.00 Vitamin A, RAE mcg_RAE34 Retinol mcg00 Carotene, beta mcg2631 Carotene, alpha mcg2530 Cryptoxanthin, beta mcg00 Vitamin A, IU IU6476 Lycopene mcg00 Lutein + zeaxanthin mcg2226 Vitamin E (alpha-tocopherol) mg0.100.12 Tocopherol, beta mg0.000.00 Tocopherol, gamma mg0.020.02 Tocopherol, delta mg0.010.01 Vitamin D (D2 + D3) mcg0.00.0 Vitamin D IU00 Vitamin K (phylloquinone) mcg0.50.6 Lipids Fatty acids, total saturated g0.1120.132 Fatty acids, total monounsaturated g0.0320.038 Fatty acids, total polyunsaturated g0.0730.086 Cholesterol mg00 Phytosterols mg1619 Amino acids Tryptophan g0.0090.011 Threonine g0.0280.033 Isoleucine g0.0280.033 Leucine g0.0680.080 Lysine g0.0500.059 Methionine g0.0080.009 Cystine g0.0090.011 Phenylalanine g0.0490.058 Tyrosine g0.0090.011 Valine g0.0470.055 Arginine g0.0490.058 Histidine g0.0770.091 Alanine g0.0400.047 Aspartic acid g0.1240.146 Glutamic acid g0.1520.179 Glycine g0.0380.045 Proline g0.0280.033 Serine g0.0400.047 Mary Litchford PhD, RD, LDN mltphd at mindspring.com www.casesoftware.com CASE Software & Books your source for advanced level books & CE courses. ----- Original Message ----- From: Shannon Byrd Jackson To: cnm at lists.my180.net Sent: 10/7/2009 9:12:20 AM Subject: [Cnm] I AM EATING BANANAS!!! Thought I'd share this with you all.... I AM EATING BANANAS!!! A professor at CCNY for a physiological psych class told his class about bananas. He said the expression "going bananas" is from the effects of bananas on the brain. Read on: Never, put your banana in the refrigerator!!! This is interesting. After reading this, you'll never look at a banana in the same way again.. Bananas contain three natural sugars - sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world's leading athletes. But energy isn't the only way a banana can help us keep fit. It can also help overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet.. Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier. PMS: Forget the pills - eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood. Anemia : High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia. Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, making it perfect to beat blood pressure. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit's ability to reduce the risk of blood pressure and stroke. Brain Power: 200 students at a Twickenham (Middlesex) school ( England ) were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert. Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives. Hangovers: One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system. Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief. Morning Sickness: Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation. Nerves: Bananas are high in B vitamins that help calm the nervous system. Overweight and at work? Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and chips. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high-pressure jobs. The report concluded that, to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady. Ulcers: The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over-chronicler cases. It also neutralizes over-acidity and reduces irritation by coating the lining of the stomach.. Temperature control: Many other cultures see bananas as a "cooling" fruit that can lower both the physical and emotional temperature of expectant mothers.. In Thailand , for example, pregnant women eat bananas to ensure their baby is born with a cool temperature. Seasonal Affective Disorder (SAD): Bananas can help SAD sufferers because they contain the natural mood enhancer tryptophan. Smoking &Tobacco Use: Bananas can also help people trying to give up smoking. The B6, B12 they contain, as well as the potassium and magnesium found in them, help the body recover from the effects of nicotine withdrawal. Stress: Potassium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body's water balance.. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack. Strokes: According to research in The New England Journal of Medicine, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%! Warts: Those keen on natural alternatives swear that if you want to kill off a wart, take a piece of banana skin and place it on the wart, with the yellow side out. Carefully hold the skin in place with a plaster or surgical tape! So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrate, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is one of the best value foods around So maybe its time to change that well-known phrase so that we say, "A banana a day keeps the doctor away!" PASS IT ON TO YOUR FRIENDS PS: Bananas must be the reason monkeys are so happy all the time! I will add one here; want a quick shine on our shoes?? Take the INSIDE of the banana skin, and rub directly on the shoe...polish with dry cloth. Amazing fruit !!! No virus found in this incoming message. Checked by AVG - www.avg.com Version: 8.5.409 / Virus Database: 270.14.2/2408 - Release Date: 10/01/09 18:23:00 Your E-mail and More On-the-Go. Get Windows Live Hotmail Free. Sign up now. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 18216 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 11156 bytes Desc: image002.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 632 bytes Desc: image001(1).jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 25607 bytes Desc: image004.jpg URL: From Shannon.Jackson at wilmed.org Thu Oct 8 06:04:11 2009 From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson) Date: Thu, 8 Oct 2009 09:04:11 -0400 Subject: [Cnm] I AM EATING BANANAS!!! In-Reply-To: <384-2200910481323446@mindspring.com> References: <384-2200910481323446@mindspring.com> Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F5032@wmhcs03.wmh.org> That is very interesting- good example of how you have to double check everything these days.. Thanks for bringing up the facts- something I didn't take time to do. Have a great day! sbj ________________________________ From: Mary Litchford [mailto:mltphd at mindspring.com] Sent: Thursday, October 08, 2009 9:03 AM To: Shannon Byrd Jackson; cnm at lists.my180.net Subject: RE: [Cnm] I AM EATING BANANAS!!! What an interesting email about bananas circulating on several list servs- too bad it is full of half truths & fibs. I have pasted below the Nutrient Analysis Labs profile of a 7 inch banana. You will see that compared to the DRI, bananas are not rich in iron, B12, B6, magnesium or tryptophan. They do contain 3 gm of fiber per banana, or about 10% of the total fiber recommened (25-30 g/d). Bananas, raw Refuse: 36% (Skin) Scientific Name: Musa acuminata Colla NDB No: 09040 (Nutrient values and weights are for edible portion) Nutrient Units Value per 100 grams 1.00 X 1 medium (7" to 7-7/8" long) ------- 118g Proximates Water g 74.91 88.39 Energy kcal 89 105 Protein g 1.09 1.29 Total lipid (fat) g 0.33 0.39 Carbohydrate, by difference g 22.84 26.95 Fiber, total dietary g 2.6 3.1 Sugars, total g 12.23 14.43 Sucrose g 2.39 2.82 Glucose (dextrose) g 4.98 5.88 Fructose g 4.85 5.72 Lactose g 0.00 0.00 Maltose g 0.01 0.01 Galactose g 0.00 0.00 Starch g 5.38 6.35 Minerals Calcium, Ca mg 5 6 Iron, Fe mg 0.26 0.31 Magnesium, Mg mg 27 32 Phosphorus, P mg 22 26 Potassium, K mg 358 422 Sodium, Na mg 1 1 Zinc, Zn mg 0.15 0.18 Copper, Cu mg 0.078 0.092 Manganese, Mn mg 0.270 0.319 Fluoride, F mcg 2.2 2.6 Selenium, Se mcg 1.0 1.2 Vitamins Vitamin C, total ascorbic acid mg 8.7 10.3 Thiamin mg 0.031 0.037 Riboflavin mg 0.073 0.086 Niacin mg 0.665 0.785 Pantothenic acid mg 0.334 0.394 Vitamin B-6 mg 0.367 0.433 Folate, total mcg 20 24 Folic acid mcg 0 0 Folate, food mcg 20 24 Folate, DFE mcg_DFE 20 24 Choline, total mg 9.8 11.6 Betaine mg 0.1 0.1 Vitamin B-12 mcg 0.00 0.00 Vitamin B-12, added mcg 0.00 0.00 Vitamin A, RAE mcg_RAE 3 4 Retinol mcg 0 0 Carotene, beta mcg 26 31 Carotene, alpha mcg 25 30 Cryptoxanthin, beta mcg 0 0 Vitamin A, IU IU 64 76 Lycopene mcg 0 0 Lutein + zeaxanthin mcg 22 26 Vitamin E (alpha-tocopherol) mg 0.10 0.12 Tocopherol, beta mg 0.00 0.00 Tocopherol, gamma mg 0.02 0.02 Tocopherol, delta mg 0.01 0.01 Vitamin D (D2 + D3) mcg 0.0 0.0 Vitamin D IU 0 0 Vitamin K (phylloquinone) mcg 0.5 0.6 Lipids Fatty acids, total saturated g 0.112 0.132 Fatty acids, total monounsaturated g 0.032 0.038 Fatty acids, total polyunsaturated g 0.073 0.086 Cholesterol mg 0 0 Phytosterols mg 16 19 Amino acids Tryptophan g 0.009 0.011 Threonine g 0.028 0.033 Isoleucine g 0.028 0.033 Leucine g 0.068 0.080 Lysine g 0.050 0.059 Methionine g 0.008 0.009 Cystine g 0.009 0.011 Phenylalanine g 0.049 0.058 Tyrosine g 0.009 0.011 Valine g 0.047 0.055 Arginine g 0.049 0.058 Histidine g 0.077 0.091 Alanine g 0.040 0.047 Aspartic acid g 0.124 0.146 Glutamic acid g 0.152 0.179 Glycine g 0.038 0.045 Proline g 0.028 0.033 Serine g 0.040 0.047 Mary Litchford PhD, RD, LDN mltphd at mindspring.com www.casesoftware.com CASE Software & Books your source for advanced level books & CE courses. ----- Original Message ----- From: Shannon Byrd Jackson To: cnm at lists.my180.net Sent: 10/7/2009 9:12:20 AM Subject: [Cnm] I AM EATING BANANAS!!! Thought I'd share this with you all.... ________________________________ I AM EATING BANANAS!!! A professor at CCNY for a physiological psych class told his class about bananas. He said the expression "going bananas" is from the effects of bananas on the brain. Read on: Never, put your banana in the refrigerator!!! This is interesting. After reading this, you'll never look at a banana in the same way again.. Bananas contain three natural sugars - sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world's leading athletes. But energy isn't the only way a banana can help us keep fit. It can also help overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet.. Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier. PMS: Forget the pills - eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood. Anemia : High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia. Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, making it perfect to beat blood pressure. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit's ability to reduce the risk of blood pressure and stroke. Brain Power: 200 students at a Twickenham (Middlesex) school ( England ) were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert. Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives. Hangovers: One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system. Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief. Morning Sickness: Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation. Nerves: Bananas are high in B vitamins that help calm the nervous system. Overweight and at work? Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and chips. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high-pressure jobs. The report concluded that, to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady. Ulcers: The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over-chronicler cases. It also neutralizes over-acidity and reduces irritation by coating the lining of the stomach.. Temperature control: Many other cultures see bananas as a "cooling" fruit that can lower both the physical and emotional temperature of expectant mothers.. In Thailand , for example, pregnant women eat bananas to ensure their baby is born with a cool temperature. Seasonal Affective Disorder (SAD): Bananas can help SAD sufferers because they contain the natural mood enhancer tryptophan. Smoking &Tobacco Use: Bananas can also help people trying to give up smoking. The B6, B12 they contain, as well as the potassium and magnesium found in them, help the body recover from the effects of nicotine withdrawal. Stress: Potassium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body's water balance.. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack. Strokes: According to research in The New England Journal of Medicine, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%! Warts: Those keen on natural alternatives swear that if you want to kill off a wart, take a piece of banana skin and place it on the wart, with the yellow side out. Carefully hold the skin in place with a plaster or surgical tape! So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrate, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is one of the best value foods around So maybe its time to change that well-known phrase so that we say, "A banana a day keeps the doctor away!" PASS IT ON TO YOUR FRIENDS PS: Bananas must be the reason monkeys are so happy all the time! I will add one here; want a quick shine on our shoes?? Take the INSIDE of the banana skin, and rub directly on the shoe...polish with dry cloth. Amazing fruit !!! ________________________________ No virus found in this incoming message. Checked by AVG - www.avg.com Version: 8.5.409 / Virus Database: 270.14.2/2408 - Release Date: 10/01/09 18:23:00 ________________________________ Your E-mail and More On-the-Go. Get Windows Live Hotmail Free. Sign up now. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 18216 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 11156 bytes Desc: image002.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 632 bytes Desc: image001(1).jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 25607 bytes Desc: image004.jpg URL: From Melissa.Kaplan at jhsmiami.org Thu Oct 8 06:10:50 2009 From: Melissa.Kaplan at jhsmiami.org (Kaplan, Melissa) Date: Thu, 8 Oct 2009 09:10:50 -0400 Subject: [Cnm] Cnm Digest, Vol 35, Issue 30 In-Reply-To: References: Message-ID: <5B0F52B34655384DB15E39376A17CEF601663774@JEX03.um-jmh.org> Whats the deal w/ the rec to not refrigerate them? Melissa Kaplan, RD, LD/N Jackson Memorial Hospital 1611 NW 12th Ave. DTC Room: DB21J Miami, Florida 33136 ph: 305.585.8603 ph ext: 6-2291 fax: 305.585.8928 pgr: 1057 P Think Green! Please do not print this e-mail unless necessary. -----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: Thursday, October 08, 2009 9:03 AM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 30 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: I AM EATING BANANAS!!! (Mary Litchford) ---------------------------------------------------------------------- Message: 1 Date: Thu, 8 Oct 2009 09:02:34 -0400 From: "Mary Litchford" Subject: Re: [Cnm] I AM EATING BANANAS!!! To: "Shannon Byrd Jackson" , cnm at lists.my180.net Message-ID: <384-2200910481323446 at mindspring.com> Content-Type: text/plain; charset="us-ascii" What an interesting email about bananas circulating on several list servs- too bad it is full of half truths & fibs. I have pasted below the Nutrient Analysis Labs profile of a 7 inch banana. You will see that compared to the DRI, bananas are not rich in iron, B12, B6, magnesium or tryptophan. They do contain 3 gm of fiber per banana, or about 10% of the total fiber recommened (25-30 g/d). Bananas, raw Refuse: 36% (Skin) Scientific Name: Musa acuminata Colla NDB No: 09040 (Nutrient values and weights are for edible portion) Nutrient Units Value per 100 grams 1.00 X 1 medium (7" to 7-7/8" long) ------- 118g Proximates Water g74.9188.39 Energy kcal89105 Protein g1.091.29 Total lipid (fat) g0.330.39 Carbohydrate, by difference g22.8426.95 Fiber, total dietary g2.63.1 Sugars, total g12.2314.43 Sucrose g2.392.82 Glucose (dextrose) g4.985.88 Fructose g4.855.72 Lactose g0.000.00 Maltose g0.010.01 Galactose g0.000.00 Starch g5.386.35 Minerals Calcium, Ca mg56 Iron, Fe mg0.260.31 Magnesium, Mg mg2732 Phosphorus, P mg2226 Potassium, K mg358422 Sodium, Na mg11 Zinc, Zn mg0.150.18 Copper, Cu mg0.0780.092 Manganese, Mn mg0.2700.319 Fluoride, F mcg2.22.6 Selenium, Se mcg1.01.2 Vitamins Vitamin C, total ascorbic acid mg8.710.3 Thiamin mg0.0310.037 Riboflavin mg0.0730.086 Niacin mg0.6650.785 Pantothenic acid mg0.3340.394 Vitamin B-6 mg0.3670.433 Folate, total mcg2024 Folic acid mcg00 Folate, food mcg2024 Folate, DFE mcg_DFE2024 Choline, total mg9.811.6 Betaine mg0.10.1 Vitamin B-12 mcg0.000.00 Vitamin B-12, added mcg0.000.00 Vitamin A, RAE mcg_RAE34 Retinol mcg00 Carotene, beta mcg2631 Carotene, alpha mcg2530 Cryptoxanthin, beta mcg00 Vitamin A, IU IU6476 Lycopene mcg00 Lutein + zeaxanthin mcg2226 Vitamin E (alpha-tocopherol) mg0.100.12 Tocopherol, beta mg0.000.00 Tocopherol, gamma mg0.020.02 Tocopherol, delta mg0.010.01 Vitamin D (D2 + D3) mcg0.00.0 Vitamin D IU00 Vitamin K (phylloquinone) mcg0.50.6 Lipids Fatty acids, total saturated g0.1120.132 Fatty acids, total monounsaturated g0.0320.038 Fatty acids, total polyunsaturated g0.0730.086 Cholesterol mg00 Phytosterols mg1619 Amino acids Tryptophan g0.0090.011 Threonine g0.0280.033 Isoleucine g0.0280.033 Leucine g0.0680.080 Lysine g0.0500.059 Methionine g0.0080.009 Cystine g0.0090.011 Phenylalanine g0.0490.058 Tyrosine g0.0090.011 Valine g0.0470.055 Arginine g0.0490.058 Histidine g0.0770.091 Alanine g0.0400.047 Aspartic acid g0.1240.146 Glutamic acid g0.1520.179 Glycine g0.0380.045 Proline g0.0280.033 Serine g0.0400.047 Mary Litchford PhD, RD, LDN mltphd at mindspring.com www.casesoftware.com CASE Software & Books your source for advanced level books & CE courses. ----- Original Message ----- From: Shannon Byrd Jackson To: cnm at lists.my180.net Sent: 10/7/2009 9:12:20 AM Subject: [Cnm] I AM EATING BANANAS!!! Thought I'd share this with you all.... I AM EATING BANANAS!!! A professor at CCNY for a physiological psych class told his class about bananas. He said the expression "going bananas" is from the effects of bananas on the brain. Read on: Never, put your banana in the refrigerator!!! This is interesting. After reading this, you'll never look at a banana in the same way again.. Bananas contain three natural sugars - sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world's leading athletes. But energy isn't the only way a banana can help us keep fit. It can also help overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet.. Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier. PMS: Forget the pills - eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood. Anemia : High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia. Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, making it perfect to beat blood pressure. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit's ability to reduce the risk of blood pressure and stroke. Brain Power: 200 students at a Twickenham (Middlesex) school ( England ) were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert. Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives. Hangovers: One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system. Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief. Morning Sickness: Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation. Nerves: Bananas are high in B vitamins that help calm the nervous system. Overweight and at work? Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and chips. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high-pressure jobs. The report concluded that, to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady. Ulcers: The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over-chronicler cases. It also neutralizes over-acidity and reduces irritation by coating the lining of the stomach.. Temperature control: Many other cultures see bananas as a "cooling" fruit that can lower both the physical and emotional temperature of expectant mothers.. In Thailand , for example, pregnant women eat bananas to ensure their baby is born with a cool temperature. Seasonal Affective Disorder (SAD): Bananas can help SAD sufferers because they contain the natural mood enhancer tryptophan. Smoking &Tobacco Use: Bananas can also help people trying to give up smoking. The B6, B12 they contain, as well as the potassium and magnesium found in them, help the body recover from the effects of nicotine withdrawal. Stress: Potassium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body's water balance.. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack. Strokes: According to research in The New England Journal of Medicine, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%! Warts: Those keen on natural alternatives swear that if you want to kill off a wart, take a piece of banana skin and place it on the wart, with the yellow side out. Carefully hold the skin in place with a plaster or surgical tape! So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrate, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is one of the best value foods around So maybe its time to change that well-known phrase so that we say, "A banana a day keeps the doctor away!" PASS IT ON TO YOUR FRIENDS PS: Bananas must be the reason monkeys are so happy all the time! I will add one here; want a quick shine on our shoes?? Take the INSIDE of the banana skin, and rub directly on the shoe...polish with dry cloth. Amazing fruit !!! No virus found in this incoming message. Checked by AVG - www.avg.com Version: 8.5.409 / Virus Database: 270.14.2/2408 - Release Date: 10/01/09 18:23:00 Your E-mail and More On-the-Go. Get Windows Live Hotmail Free. Sign up now. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 18216 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 11156 bytes Desc: image002.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 632 bytes Desc: image001(1).jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 25607 bytes Desc: image004.jpg URL: ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 30 *********************************** From Leanne.Littrell at hma.com Thu Oct 8 06:13:26 2009 From: Leanne.Littrell at hma.com (Littrell, Leanne) Date: Thu, 8 Oct 2009 09:13:26 -0400 Subject: [Cnm] Contents of Cnm digest... In-Reply-To: References: Message-ID: <4E3FEB15613D694A9CE182702F53959B03739FAA@atl-ex1.hma.com> Nutrition RX--- software from Hightech nutrition, outlook calendar, mobile windows word, excel, work email. Thanks Leanne Pearson Littrell, MS, RD, LD Director of Nutrition Services Peace River Regional Medical Center 2500 Harbor Blvd Port Charlotte, FL 33952 941-766-4228 Fax-941-766-4218 Cell 941-769-1774 leanne.littrell at hma.com -----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, October 07, 2009 7:32 PM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 28 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. Information Request (Finney, Julie) 2. Re: Urgent: Expiration of prepkgd materials (Janet V. Ross) ---------------------------------------------------------------------- Message: 1 Date: Wed, 7 Oct 2009 17:01:33 -0400 From: "Finney, Julie" Subject: [Cnm] Information Request To: Message-ID: Content-Type: text/plain; charset="us-ascii" To those of you who are using Blackberries in your practice, what are some of the resources that you are able to utilize via this device? Any references that you could point me to? (I know that I have seen this information in the past, but my search abilities have deserted me at this moment.) Thanks, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: ------------------------------ Message: 2 Date: Wed, 7 Oct 2009 19:31:28 -0400 From: "Janet V. Ross" Subject: Re: [Cnm] Urgent: Expiration of prepkgd materials To: "'Lewis, Suzanne'" Cc: cnm at lists.my180.net Message-ID: <37.8A.23671.8D42DCA4 at ecout2> Content-Type: text/plain; charset="us-ascii" We took these small non-perishable items up to the units in "box lunch" type boxes or ziplock bags. Labeled the box or the bag with an expiration date (3-6 months depending on the item) and then discarded everything left in the box/bag when the date arrived. It worked-if you could convince staff not to "add' to the top of the top of the box. At least it would convince surveyors that we had a system. 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 Lewis, Suzanne Sent: Wednesday, October 07, 2009 12:23 PM Cc: cnm at lists.my180.net Subject: Re: [Cnm] Urgent: Expiration of prepkgd materials Along this same line. we are being asked by our Infection Control department to not store anything in cardboard boxes - ie - pc's, crackers, etc. I am trying to find out if anyone else is having this problem/concern and how it's been addressed. What do you have listed in your policies regarding storage? Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org _____ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karustis, Marcelle Sent: Tuesday, October 06, 2009 11:06 AM To: Rachel Riddiford Cc: cnm at lists.my180.net Subject: Re: [Cnm] Urgent: Expiration of prepkgd materials Some products use the Julian dating system. http://en.wikipedia.org/wiki/Julian_day I know this is on the thickened juices. Not sure about other products. 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 Rachel Riddiford Sent: Tuesday, October 06, 2009 11:52 AM To: cnm at lists.my180.net Subject: [Cnm] Urgent: Expiration of prepkgd materials JCAHO is here. Question: how do we know if the small individual packages of saltines, mustard, etc sent to the nursing floors are expired. The answer is not coming to me at the moment and am hoping one of you can help! Thank you!!! LineNoText.bmp Rachel G Riddiford, MS, RD, LD Clinical Dietetics Manager The Children's Medical Center of Dayton One Children's Plaza Dayton, Ohio 45404-1815 Office Number: 937-641-5933 Pager Number: 937-334-3182 Fax Number: 937-641-5122 E-mail: riddifordr at childrensdayton.org http://www.childrensdayton.org http://www.childrensdayton.org/images/logo_childrens.gif TextWLine.bmp _____ NOTICE: The information contained in this e-mail and any accompanying documents or files is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited and possibly a violation of federal/state law or regulations. If you received this information in error, please notify The Children's Medical Center of Dayton immediately via telephone at (937) 641-5293, or via electronic mail cmcconfidentiality at childrensdayton.org and promptly destroy the original message. Thank you. 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... 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Name: not available Type: image/jpeg Size: 4467 bytes Desc: not available URL: ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 28 *********************************** From bhomola at comhs.org Thu Oct 8 06:49:17 2009 From: bhomola at comhs.org (Bobbi Homola) Date: Thu, 8 Oct 2009 08:49:17 -0500 Subject: [Cnm] Cnm Digest, Vol 35, Issue 30 In-Reply-To: <5B0F52B34655384DB15E39376A17CEF601663774@JEX03.um-jmh.org> Message-ID: They turn black. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Kaplan, Melissa Sent: Thursday, October 08, 2009 8:11 AM To: cnm at lists.my180.net Subject: Re: [Cnm] Cnm Digest, Vol 35, Issue 30 Whats the deal w/ the rec to not refrigerate them? Melissa Kaplan, RD, LD/N Jackson Memorial Hospital 1611 NW 12th Ave. DTC Room: DB21J Miami, Florida 33136 ph: 305.585.8603 ph ext: 6-2291 fax: 305.585.8928 pgr: 1057 P Think Green! Please do not print this e-mail unless necessary. -----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: Thursday, October 08, 2009 9:03 AM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 30 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: I AM EATING BANANAS!!! (Mary Litchford) ---------------------------------------------------------------------- Message: 1 Date: Thu, 8 Oct 2009 09:02:34 -0400 From: "Mary Litchford" Subject: Re: [Cnm] I AM EATING BANANAS!!! To: "Shannon Byrd Jackson" , cnm at lists.my180.net Message-ID: <384-2200910481323446 at mindspring.com> Content-Type: text/plain; charset="us-ascii" What an interesting email about bananas circulating on several list servs- too bad it is full of half truths & fibs. I have pasted below the Nutrient Analysis Labs profile of a 7 inch banana. You will see that compared to the DRI, bananas are not rich in iron, B12, B6, magnesium or tryptophan. They do contain 3 gm of fiber per banana, or about 10% of the total fiber recommened (25-30 g/d). Bananas, raw Refuse: 36% (Skin) Scientific Name: Musa acuminata Colla NDB No: 09040 (Nutrient values and weights are for edible portion) Nutrient Units Value per 100 grams 1.00 X 1 medium (7" to 7-7/8" long) ------- 118g Proximates Water g74.9188.39 Energy kcal89105 Protein g1.091.29 Total lipid (fat) g0.330.39 Carbohydrate, by difference g22.8426.95 Fiber, total dietary g2.63.1 Sugars, total g12.2314.43 Sucrose g2.392.82 Glucose (dextrose) g4.985.88 Fructose g4.855.72 Lactose g0.000.00 Maltose g0.010.01 Galactose g0.000.00 Starch g5.386.35 Minerals Calcium, Ca mg56 Iron, Fe mg0.260.31 Magnesium, Mg mg2732 Phosphorus, P mg2226 Potassium, K mg358422 Sodium, Na mg11 Zinc, Zn mg0.150.18 Copper, Cu mg0.0780.092 Manganese, Mn mg0.2700.319 Fluoride, F mcg2.22.6 Selenium, Se mcg1.01.2 Vitamins Vitamin C, total ascorbic acid mg8.710.3 Thiamin mg0.0310.037 Riboflavin mg0.0730.086 Niacin mg0.6650.785 Pantothenic acid mg0.3340.394 Vitamin B-6 mg0.3670.433 Folate, total mcg2024 Folic acid mcg00 Folate, food mcg2024 Folate, DFE mcg_DFE2024 Choline, total mg9.811.6 Betaine mg0.10.1 Vitamin B-12 mcg0.000.00 Vitamin B-12, added mcg0.000.00 Vitamin A, RAE mcg_RAE34 Retinol mcg00 Carotene, beta mcg2631 Carotene, alpha mcg2530 Cryptoxanthin, beta mcg00 Vitamin A, IU IU6476 Lycopene mcg00 Lutein + zeaxanthin mcg2226 Vitamin E (alpha-tocopherol) mg0.100.12 Tocopherol, beta mg0.000.00 Tocopherol, gamma mg0.020.02 Tocopherol, delta mg0.010.01 Vitamin D (D2 + D3) mcg0.00.0 Vitamin D IU00 Vitamin K (phylloquinone) mcg0.50.6 Lipids Fatty acids, total saturated g0.1120.132 Fatty acids, total monounsaturated g0.0320.038 Fatty acids, total polyunsaturated g0.0730.086 Cholesterol mg00 Phytosterols mg1619 Amino acids Tryptophan g0.0090.011 Threonine g0.0280.033 Isoleucine g0.0280.033 Leucine g0.0680.080 Lysine g0.0500.059 Methionine g0.0080.009 Cystine g0.0090.011 Phenylalanine g0.0490.058 Tyrosine g0.0090.011 Valine g0.0470.055 Arginine g0.0490.058 Histidine g0.0770.091 Alanine g0.0400.047 Aspartic acid g0.1240.146 Glutamic acid g0.1520.179 Glycine g0.0380.045 Proline g0.0280.033 Serine g0.0400.047 Mary Litchford PhD, RD, LDN mltphd at mindspring.com www.casesoftware.com CASE Software & Books your source for advanced level books & CE courses. ----- Original Message ----- From: Shannon Byrd Jackson To: cnm at lists.my180.net Sent: 10/7/2009 9:12:20 AM Subject: [Cnm] I AM EATING BANANAS!!! Thought I'd share this with you all.... I AM EATING BANANAS!!! A professor at CCNY for a physiological psych class told his class about bananas. He said the expression "going bananas" is from the effects of bananas on the brain. Read on: Never, put your banana in the refrigerator!!! This is interesting. After reading this, you'll never look at a banana in the same way again.. Bananas contain three natural sugars - sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world's leading athletes. But energy isn't the only way a banana can help us keep fit. It can also help overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet.. Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier. PMS: Forget the pills - eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood. Anemia : High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia. Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, making it perfect to beat blood pressure. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit's ability to reduce the risk of blood pressure and stroke. Brain Power: 200 students at a Twickenham (Middlesex) school ( England ) were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert. Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives. Hangovers: One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system. Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief. Morning Sickness: Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation. Nerves: Bananas are high in B vitamins that help calm the nervous system. Overweight and at work? Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and chips. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high-pressure jobs. The report concluded that, to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady. Ulcers: The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over-chronicler cases. It also neutralizes over-acidity and reduces irritation by coating the lining of the stomach.. Temperature control: Many other cultures see bananas as a "cooling" fruit that can lower both the physical and emotional temperature of expectant mothers.. In Thailand , for example, pregnant women eat bananas to ensure their baby is born with a cool temperature. Seasonal Affective Disorder (SAD): Bananas can help SAD sufferers because they contain the natural mood enhancer tryptophan. Smoking &Tobacco Use: Bananas can also help people trying to give up smoking. The B6, B12 they contain, as well as the potassium and magnesium found in them, help the body recover from the effects of nicotine withdrawal. Stress: Potassium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body's water balance.. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack. Strokes: According to research in The New England Journal of Medicine, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%! Warts: Those keen on natural alternatives swear that if you want to kill off a wart, take a piece of banana skin and place it on the wart, with the yellow side out. Carefully hold the skin in place with a plaster or surgical tape! So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrate, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is one of the best value foods around So maybe its time to change that well-known phrase so that we say, "A banana a day keeps the doctor away!" PASS IT ON TO YOUR FRIENDS PS: Bananas must be the reason monkeys are so happy all the time! I will add one here; want a quick shine on our shoes?? Take the INSIDE of the banana skin, and rub directly on the shoe...polish with dry cloth. Amazing fruit !!! No virus found in this incoming message. Checked by AVG - www.avg.com Version: 8.5.409 / Virus Database: 270.14.2/2408 - Release Date: 10/01/09 18:23:00 Your E-mail and More On-the-Go. Get Windows Live Hotmail Free. Sign up now. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 18216 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 11156 bytes Desc: image002.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... 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Name: not available Type: image/jpeg Size: 25607 bytes Desc: image004.jpg URL: ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 30 *********************************** _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From Rosanne.Leibhart at crozer.org Thu Oct 8 08:11:53 2009 From: Rosanne.Leibhart at crozer.org (Leibhart, Rosanne) Date: Thu, 8 Oct 2009 11:11:53 -0400 Subject: [Cnm] RDs in Diet Office In-Reply-To: <4E3FEB15613D694A9CE182702F53959B03739FAA@atl-ex1.hma.com> Message-ID: <1904FBE1EFD42940AA44982E67B5B44E06CFF1C0@exchange02.CKHSAD.CROZER.ORG> Hi All I have a director who insists that RDs cover the diet office daily, during the breakfast line and dinner line. We are answering phones, filling requests for nourishments, late trays etc. AND, he would like us to do trayline on occasion.I should build this into the productivity model. His philosophy is that we are all part of the same team. I am having a hard time with this. In a pinch, we all are willing to help. But to be spending 2 hours of clinical time in diet office daily isn't a good use of resources in my opinion. We are a small hospital, average census of 115- 120. Can you all please share with me weather or not diet office &/or trayline coverage is a routine part of the RDs day? Thank you, Rosanne Leibhart, RD From cfoner at dupageco.org Thu Oct 8 08:18:59 2009 From: cfoner at dupageco.org (Foner, Carole) Date: Thu, 8 Oct 2009 10:18:59 -0500 Subject: [Cnm] RDs in Diet Office References: <1904FBE1EFD42940AA44982E67B5B44E06CFF1C0@exchange02.CKHSAD.CROZER.ORG> Message-ID: It seems wasteful to spend a dietitian's salary on clerical tasks... Carole P Please consider the environment before printing this e-mail -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Leibhart, Rosanne Sent: Thursday, October 08, 2009 10:12 AM To: cnm at lists.my180.net Subject: [Cnm] RDs in Diet Office Hi All I have a director who insists that RDs cover the diet office daily, during the breakfast line and dinner line. We are answering phones, filling requests for nourishments, late trays etc. AND, he would like us to do trayline on occasion.I should build this into the productivity model. His philosophy is that we are all part of the same team. I am having a hard time with this. In a pinch, we all are willing to help. But to be spending 2 hours of clinical time in diet office daily isn't a good use of resources in my opinion. We are a small hospital, average census of 115- 120. Can you all please share with me weather or not diet office &/or trayline coverage is a routine part of the RDs day? Thank you, Rosanne Leibhart, RD _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From Heidi.Clark at AMEDD.ARMY.MIL Thu Oct 8 08:03:28 2009 From: Heidi.Clark at AMEDD.ARMY.MIL (Clark, Heidi L MAJ MIL USAF MEDCOM LRMC) Date: Thu, 8 Oct 2009 17:03:28 +0200 Subject: [Cnm] recipes? (UNCLASSIFIED) Message-ID: <9AB53CB10B46784794F4F6D3AD82344F39BD53@AMEDERMCBE041.eur.amed.ds.army.mil> Classification: UNCLASSIFIED Caveats: NONE Hello, We are revising our dining facility menu, and with it the items offered on patient trays. Of course, the most popular items are all high in fat/sodium/cholesterol. Does anyone have any great, customer-favorite recipes that are also appropriate for patients on heart healthy/diabetic diet restrictions? Or, resources for finding some good recipes. We have a few, but I'd like more options. Thanks! Heidi L. Clark, MS, RD Chief, Medical Nutrition Therapy Branch Landstuhl Regional Medical Center Classification: UNCLASSIFIED Caveats: NONE From LCarver at Reshealthcare.org Thu Oct 8 08:23:41 2009 From: LCarver at Reshealthcare.org (Carver, Leslee) Date: Thu, 8 Oct 2009 10:23:41 -0500 Subject: [Cnm] RDs in Diet Office In-Reply-To: <1904FBE1EFD42940AA44982E67B5B44E06CFF1C0@exchange02.CKHSAD.CROZER.ORG> References: <4E3FEB15613D694A9CE182702F53959B03739FAA@atl-ex1.hma.com> <1904FBE1EFD42940AA44982E67B5B44E06CFF1C0@exchange02.CKHSAD.CROZER.ORG> Message-ID: <5330B54133B6194BA13930BDEFE9A30E051CE9AC@rhcexch3.reshealthcare.org> It is not but how many RD's do you have on an average census day? Perhaps the staffing model needs work - you are certainly overpaying for clerical work and risking very low RD staff morale. 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 Leibhart, Rosanne Sent: Thursday, October 08, 2009 10:12 AM To: cnm at lists.my180.net Subject: [Cnm] RDs in Diet Office Hi All I have a director who insists that RDs cover the diet office daily, during the breakfast line and dinner line. We are answering phones, filling requests for nourishments, late trays etc. AND, he would like us to do trayline on occasion.I should build this into the productivity model. His philosophy is that we are all part of the same team. I am having a hard time with this. In a pinch, we all are willing to help. But to be spending 2 hours of clinical time in diet office daily isn't a good use of resources in my opinion. We are a small hospital, average census of 115- 120. Can you all please share with me weather or not diet office &/or trayline coverage is a routine part of the RDs day? Thank you, Rosanne Leibhart, RD _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From sdehoog at u.washington.edu Thu Oct 8 08:49:43 2009 From: sdehoog at u.washington.edu (susan) Date: Thu, 8 Oct 2009 08:49:43 -0700 (PDT) Subject: [Cnm] RDs in Diet Office In-Reply-To: <1904FBE1EFD42940AA44982E67B5B44E06CFF1C0@exchange02.CKHSAD.CROZER.ORG> Message-ID: Absolutely not Ask when you can expect RD coverage/help since you all are part of the same time. > > Hi All > I have a director who insists that RDs cover the diet office daily, > during the breakfast line and dinner line. We are answering phones, > filling requests for nourishments, late trays etc. AND, he would like us > to do trayline on occasion.I should build this into the productivity > model. His philosophy is that we are all part of the same team. I am > having a hard time with this. In a pinch, we all are willing to help. > But to be spending 2 hours of clinical time in diet office daily isn't a > good use of resources in my opinion. We are a small hospital, average > census of 115- 120. > Can you all please share with me weather or not diet office &/or > trayline coverage is a routine part of the RDs day? > Thank you, > Rosanne Leibhart, RD > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > 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 Hollie_Colle at ssmhc.com Thu Oct 8 08:49:50 2009 From: Hollie_Colle at ssmhc.com (Hollie_Colle at ssmhc.com) Date: Thu, 8 Oct 2009 10:49:50 -0500 Subject: [Cnm] RDs in Diet Office In-Reply-To: <1904FBE1EFD42940AA44982E67B5B44E06CFF1C0@exchange02.CKHSAD.CROZER.ORG> Message-ID: It would seem difficult to make sure all patients are assessed according to TJC/hospital standards when losing 2 hours clinical time daily. Are the RDs able to get their clinical work finished? Hollie Colle, MS, RD, LDN Clinical Nutrition Manager St. Mary's Good Samaritan, Inc. Mount Vernon IL 62864 (618) 241-2356 Centralia IL 62801 (618) 436-8897 "Leibhart, Rosanne" Sent by: cnm-bounces at lists.my180.net 10/08/2009 10:11 AM To cc Subject [Cnm] RDs in Diet Office Hi All I have a director who insists that RDs cover the diet office daily, during the breakfast line and dinner line. We are answering phones, filling requests for nourishments, late trays etc. AND, he would like us to do trayline on occasion.I should build this into the productivity model. His philosophy is that we are all part of the same team. I am having a hard time with this. In a pinch, we all are willing to help. But to be spending 2 hours of clinical time in diet office daily isn't a good use of resources in my opinion. We are a small hospital, average census of 115- 120. Can you all please share with me weather or not diet office &/or trayline coverage is a routine part of the RDs day? Thank you, Rosanne Leibhart, RD _______________________________________________ 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 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 email and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From khiggins at mail.uch.org Thu Oct 8 08:58:29 2009 From: khiggins at mail.uch.org (Karen Higgins) Date: Thu, 08 Oct 2009 11:58:29 -0400 Subject: [Cnm] RDs in Diet Office In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E051CE9AC@rhcexch3.reshealthcare.org> References: <4E3FEB15613D694A9CE182702F53959B03739FAA@atl-ex1.hma.com> <1904FBE1EFD42940AA44982E67B5B44E06CFF1C0@exchange02.CKHSAD.CROZER.ORG> <5330B54133B6194BA13930BDEFE9A30E051CE9AC@rhcexch3.reshealthcare.org> Message-ID: <4ACDD3E3.08B2.000F.0@mail.uch.org> I think this is absurd. RD's do not get specialty degrees to clerk and work trayline. IF the RD's are salary, as most are, I feel it is a way for the FNS Director to get cheap labor and coverage knowing the RD's can just stay longer to complete their clinical work without having to pay extra. What's next, put on a white uniform and hairnet and have the RD's serve food in the cafeteria also? If we don't take stands to protect our practice as clinical professionals, we will never make strides ahead. Have you considered going to the VP of Patient Care and requesting the clinical nutrition staff move under that division? This is one of the few ways we can show our strength as part of the patient care team. Of course we will always be the link to foodservice and the patients, and can offer much service to them without working in the kitchen. These are my opinions only. Karen Higgins Manager, Medical Nutrition Services "The best way to predict the future is to create it!".........Jason Kaufmann >>> "Carver, Leslee" 10/8/2009 11:23 AM >>> It is not but how many RD's do you have on an average census day? Perhaps the staffing model needs work - you are certainly overpaying for clerical work and risking very low RD staff morale. 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 Leibhart, Rosanne Sent: Thursday, October 08, 2009 10:12 AM To: cnm at lists.my180.net Subject: [Cnm] RDs in Diet Office Hi All I have a director who insists that RDs cover the diet office daily, during the breakfast line and dinner line. We are answering phones, filling requests for nourishments, late trays etc. AND, he would like us to do trayline on occasion.I should build this into the productivity model. His philosophy is that we are all part of the same team. I am having a hard time with this. In a pinch, we all are willing to help. But to be spending 2 hours of clinical time in diet office daily isn't a good use of resources in my opinion. We are a small hospital, average census of 115- 120. Can you all please share with me weather or not diet office &/or trayline coverage is a routine part of the RDs day? Thank you, Rosanne Leibhart, RD _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net The views expressed in this e-mail are the views of the sender and do not necessarily represent the views of University Community Health. This e-mail message and its attachments are for the sole use of the intended recipients. They may contain confidential information or other information subject to legal protection and/or restrictions. If you are not the intended recipient of this message, please do not read, copy, use or disclose this message or its attachments. Please notify the sender by replying to this message and delete or destroy all copies of this message and attachments in all media. Thank you. From mpappo at montefiore.org Thu Oct 8 09:39:42 2009 From: mpappo at montefiore.org (Miriam Pappo) Date: Thu, 08 Oct 2009 12:39:42 -0400 Subject: [Cnm] recipes? (UNCLASSIFIED) Message-ID: please share with all. Always needed info. 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 >>> "Clark, Heidi L MAJ MIL USAF MEDCOM LRMC" 10/08/09 11:03 AM >>> Classification: UNCLASSIFIED Caveats: NONE Hello, We are revising our dining facility menu, and with it the items offered on patient trays. Of course, the most popular items are all high in fat/sodium/cholesterol. Does anyone have any great, customer-favorite recipes that are also appropriate for patients on heart healthy/diabetic diet restrictions? Or, resources for finding some good recipes. We have a few, but I'd like more options. Thanks! Heidi L. Clark, MS, RD Chief, Medical Nutrition Therapy Branch Landstuhl Regional Medical Center Classification: UNCLASSIFIED Caveats: NONE _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An embedded and charset-unspecified text was scrubbed... Name: Miriam Pappo.vcf URL: From KBOEHME at meriter.com Thu Oct 8 09:44:10 2009 From: KBOEHME at meriter.com (Boehme, Karen) Date: Thu, 8 Oct 2009 11:44:10 -0500 Subject: [Cnm] Anti Diarrhea diet Message-ID: <8CFCAB1537E1964AB1BAB60E81B019B683DE3852@EXVS1.meriter.com> I'm looking for recommendations for an anti-diarrheal diet. Our hospital has hired some new Hospitalists with pediatric specialties and they are wanting to have some type of diet they can order for kids with diarrhea. What are others using? We currently have the BRAT diet (banana, applesauce, rice, and toast or tea) but neither physician seems to be entirely satisfied with it. They mentioned avoidance of sorbitol by removing fruit juices but I don't believe our juices have sorbitol except perhaps for the low cal cranberry. Do I need to remove fruit juices because of fructose? Do you routinely add gaterade, pedialyte or powerade? What are other hospitals doing for this problem? Thanks, Karen Karen Boehme Manager, Clinical Nutrition Meriter Health Services Phone: (608) 417-6452 kboehme at meriter.com -------------- next part -------------- An HTML attachment was scrubbed... URL: From andrea.johnson at bassett.org Thu Oct 8 09:50:57 2009 From: andrea.johnson at bassett.org (Johnson, Andrea) Date: Thu, 8 Oct 2009 12:50:57 -0400 Subject: [Cnm] RDs in Diet Office In-Reply-To: Message-ID: <9B90EC6A1B880E4A9D9A859E062A04751E833303@ex2.bassett.org> We had this same request and I didn't see how this time could be worked into our day. I declined on the basis of patient needs and better utilization of time and expertise. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of susan Sent: Thursday, October 08, 2009 11:50 AM To: Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office Absolutely not Ask when you can expect RD coverage/help since you all are part of the same time. > > Hi All > I have a director who insists that RDs cover the diet office daily, > during the breakfast line and dinner line. We are answering phones, > filling requests for nourishments, late trays etc. AND, he would like us > to do trayline on occasion.I should build this into the productivity > model. His philosophy is that we are all part of the same team. I am > having a hard time with this. In a pinch, we all are willing to help. > But to be spending 2 hours of clinical time in diet office daily isn't a > good use of resources in my opinion. We are a small hospital, average > census of 115- 120. > Can you all please share with me weather or not diet office &/or > trayline coverage is a routine part of the RDs day? > Thank you, > Rosanne Leibhart, RD > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > Susan DeHoog Associate Director Food and Nutrition University of Washington Medical Center BOX 356057 Seattle Washington 98195 (206) 598-4533 email sdehoog at u.washington.edu FAX (206) 598-8105 pager (206)540-8874 _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- A non-text attachment was scrubbed... Name: Johnson, Andrea.vcf Type: text/x-vcard Size: 145 bytes Desc: Johnson, Andrea.vcf URL: From Virginia.Carney at STJUDE.ORG Thu Oct 8 10:29:27 2009 From: Virginia.Carney at STJUDE.ORG (Carney, Virginia H) Date: Thu, 8 Oct 2009 12:29:27 -0500 Subject: [Cnm] RDs in Diet Office In-Reply-To: <9B90EC6A1B880E4A9D9A859E062A04751E833303@ex2.bassett.org> Message-ID: <6EAE916704479E4BB6AB5A133BA224F72886B91A0A@SJMEMXMBS11.stjude.sjcrh.local> Very well put----good for you. I totally agree. Ginger Carney, RD, LDN, IBCLC, RLC, FILCA Director, Clinical Nutrition St. Jude Children's Research Hospital Memphis, TN -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea Sent: Thursday, October 08, 2009 11:51 AM To: 'susan'; Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office We had this same request and I didn't see how this time could be worked into our day. I declined on the basis of patient needs and better utilization of time and expertise. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of susan Sent: Thursday, October 08, 2009 11:50 AM To: Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office Absolutely not Ask when you can expect RD coverage/help since you all are part of the same time. > > Hi All > I have a director who insists that RDs cover the diet office daily, > during the breakfast line and dinner line. We are answering phones, > filling requests for nourishments, late trays etc. AND, he would like > us to do trayline on occasion.I should build this into the > productivity model. His philosophy is that we are all part of the same > team. I am having a hard time with this. In a pinch, we all are willing to help. > But to be spending 2 hours of clinical time in diet office daily isn't > a good use of resources in my opinion. We are a small hospital, > average census of 115- 120. > Can you all please share with me weather or not diet office &/or > trayline coverage is a routine part of the RDs day? > Thank you, > Rosanne Leibhart, RD > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > Susan DeHoog Associate Director Food and Nutrition University of Washington Medical Center BOX 356057 Seattle Washington 98195 (206) 598-4533 email sdehoog at u.washington.edu FAX (206) 598-8105 pager (206)540-8874 _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Email Disclaimer: www.stjude.org/emaildisclaimer From andrea.johnson at bassett.org Thu Oct 8 10:33:56 2009 From: andrea.johnson at bassett.org (Johnson, Andrea) Date: Thu, 8 Oct 2009 13:33:56 -0400 Subject: [Cnm] RDs in Diet Office In-Reply-To: <6EAE916704479E4BB6AB5A133BA224F72886B91A0A@SJMEMXMBS11.stjude.sjcrh.local> Message-ID: <9B90EC6A1B880E4A9D9A859E062A04751E833304@ex2.bassett.org> I and my staff RDs actually report to the VP of Nursing and Patient Care Services not the Foodservice Director which is the reason I was able to politely decline. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: Carney, Virginia H [mailto:Virginia.Carney at STJUDE.ORG] Sent: Thursday, October 08, 2009 1:29 PM To: Johnson, Andrea; 'susan'; Leibhart, Rosanne Cc: clinical nutrition managers Subject: RE: [Cnm] RDs in Diet Office Very well put----good for you. I totally agree. Ginger Carney, RD, LDN, IBCLC, RLC, FILCA Director, Clinical Nutrition St. Jude Children's Research Hospital Memphis, TN -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea Sent: Thursday, October 08, 2009 11:51 AM To: 'susan'; Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office We had this same request and I didn't see how this time could be worked into our day. I declined on the basis of patient needs and better utilization of time and expertise. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of susan Sent: Thursday, October 08, 2009 11:50 AM To: Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office Absolutely not Ask when you can expect RD coverage/help since you all are part of the same time. > > Hi All > I have a director who insists that RDs cover the diet office daily, > during the breakfast line and dinner line. We are answering phones, > filling requests for nourishments, late trays etc. AND, he would like > us to do trayline on occasion.I should build this into the > productivity model. His philosophy is that we are all part of the same > team. I am having a hard time with this. In a pinch, we all are willing to help. > But to be spending 2 hours of clinical time in diet office daily isn't > a good use of resources in my opinion. We are a small hospital, > average census of 115- 120. > Can you all please share with me weather or not diet office &/or > trayline coverage is a routine part of the RDs day? > Thank you, > Rosanne Leibhart, RD > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > Susan DeHoog Associate Director Food and Nutrition University of Washington Medical Center BOX 356057 Seattle Washington 98195 (206) 598-4533 email sdehoog at u.washington.edu FAX (206) 598-8105 pager (206)540-8874 _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Email Disclaimer: www.stjude.org/emaildisclaimer -------------- next part -------------- A non-text attachment was scrubbed... Name: Johnson, Andrea.vcf Type: text/x-vcard Size: 145 bytes Desc: Johnson, Andrea.vcf URL: From DrNCollins at aol.com Thu Oct 8 10:45:50 2009 From: DrNCollins at aol.com (DrNCollins at aol.com) Date: Thu, 8 Oct 2009 13:45:50 EDT Subject: [Cnm] Lean Body Mass Program Message-ID: Hi there, Here is information on a new, free 1 CEU teleseminar entitled Essential Lean Body Mass: Vital for Life, Recovery and Healing. There is no cost for this program but pre-registration is required. All the info is here: _http://www.rd411.com/newsletter/newsrd3.html_ (http://www.rd411.com/newsletter/newsrd3.html) Have a great day, NANCY 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) -------------- next part -------------- An HTML attachment was scrubbed... URL: From JDoley at carondelet.org Thu Oct 8 12:10:07 2009 From: JDoley at carondelet.org (Doley, Jennifer A.) Date: Thu, 8 Oct 2009 14:10:07 -0500 Subject: [Cnm] Screening/Assessment parameters In-Reply-To: <006101ca45fa$cb0eb640$7b928e8c@amc.uwmedicine.org> References: <39C024B8791C1943BAA07F35FFA8D6F90C79C3775C@SLHMAIL.slh.stlukes.com><4ABD8017E8D7754C8E3025F84083A650016DB88B@MAIL01.stclair.org><5330B54133B6194BA13930BDEFE9A30E05161B6B@rhcexch3.reshealthcare.org> <006101ca45fa$cb0eb640$7b928e8c@amc.uwmedicine.org> Message-ID: <48585A0648A4814EAF7E868254E3FB0243C836@ahcmascdc014.DS.SJHS.COM> For those that have L&D, can you share with me your nutrition screening criteria? Does anyone have any evidence based literature regarding nutrition screening for L&D? At one of my accounts, L&D has started consulting us for lots of patients (DM, obesity, 18 yo or younger) even though 99% of these patients are in active labor. Do you think this is appropriate? Thanks, Jennifer Doley, MBA, RD, CNSD Regional Clinical Nutrition Manager and Dietetic Internship Director Morrison Management Specialists St. Mary's Hospital Tucson, Az ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Katie Farver Sent: Monday, October 05, 2009 1:31 PM To: Kathy Hill; Carver, Leslee; Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We do screen all Psych Patients however, we rarely find a patient needing MNT. This obviously is an unproductive use of labor. We are evaluating this process so this discussion will be helpful. I have also attached our protocol. ICU - Nursing does an initial screen within 24 hours and the RDs complete a full assessment by Day 2 of admit Acute Care - Nursing does an initial screen within 24 hours and if patients is not determined to need MNT, the patient is rescreened every 7-10 days by the RD (we have had the DT do this in the past but find it much more efficient for the RD to rescreen as the RD attend rounds on all patients on their floor. Also RD is much better at picking up subtle problems). Psych - Nursing does an initial screen within 24 hours and if patient is not determined to need MNT, the patient is rescreened by the DT every 14 days. Katie Farver RD, CD, CNSD Director, Clinical Nutrition Services Department of Hospitality BWH 68 Harborview Medical Center University of Washington Academic Medical Center Affiliate Assistant Professor School of Pharmacy University of Washington 325 Ninth Ave - Box 359790 Seattle, WA 98104 VM: 206-663-4636 kef at u.washington.edu Fax: 206-744-8540 Priviledged, confidential or patient identifiable information may be contained in this message. This information is meant only for the use of the intended recipients. If you are not the intended receipient, or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission. Instead, please notifiy the send by reply e-mail, and then destroy all copies of the message and any attachments ----- Original Message ----- From: Kathy Hill To: Carver, Leslee ; Ann berzinsky ; Jeske, Debra J ; denisedacey at verizon.net ; cnm at lists.my180.net Sent: Monday, October 05, 2009 10:41 AM Subject: Re: [Cnm] Screening/Assessment parameters Hi Leslie, What criteria do you use for an initial assessment? Do you only assess those who have been referred to you by the nurse when he/she completes the nutrition screen? We are being asked to see all Psych pt's by the 6th day of admission regardless of whether they were triggered by the nurse on the nutrition screen. Does anyone automatically see Psych pt's based on a certain # of days of their admission? Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: Carver, Leslee [mailto:LCarver at Reshealthcare.org] Sent: Monday, October 05, 2009 1:36 PM To: Kathy Hill; Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: RE: [Cnm] Screening/Assessment parameters we use the same screening criteria as w/ the rest of the house. on geri psyche we re-screen low risk at 7 days and on adult psych at 14 days. 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 Kathy Hill Sent: Monday, October 05, 2009 12:08 PM To: Ann berzinsky; Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Those of you who have psych units in your facilities; would you be willing to share what your policy is regarding RD evaluation of these patients? Does anyone use the same criteria for psych as you do for your acute care patients? Up until now, the dietitians at my facility only saw psych patients on a consult basis. Now we/dietitians have been directed by a new Administrator at our hospital to see all psych patients! Also, has anyone had a discussion with a TJC surveyor regarding the necessity of a nutrition evaluation of all psych patients? I really need to convince this administrator that there is no other facility where the RD sees psych patients on a regular basis and that consult only is the general rule. So please give me some feedback. In advance, thank you for your assistance. Kathy Hill, RD, Chief Dietitian Nassau University Medical Center East Meadow, NY 11554 Email: kahill at numc.edu ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Ann berzinsky Sent: Wednesday, September 30, 2009 10:22 AM To: Jeske, Debra J; denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters Our policy states patients will be seen within 48hrs. Does anyone in PA know if there are state regulations that patients must be seen within 24hrs? Thank you Anne Berzinsky, RD, LDN St Clair Hospital Pittsburgh, PA ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J Sent: Tuesday, September 29, 2009 9:50 PM To: denisedacey at verizon.net; cnm at lists.my180.net Subject: Re: [Cnm] Screening/Assessment parameters We completed our CMS survey and the surveyors rolled it into a State visit as well. The citations received in the CMS visit were duplicated in the state visit. Of interest to us was the state citations specified Missouri specific standards that were different than the "CMS State Guidelines Manual" given to us by the surveyor. The Missouri State manual actually indicates that all patients with a positive nutrition screen for malnutrition must have a "Comprehensive Nutrition Assessment" completed within 24 hours. This was news to us. This was not indicated in the manual originally given to us. It does appear this is a fairly new change (approx. 1 1/2 years ago). Needless to say, we did have to change our weekend schedule. We did have RDs on call on Sundays and had 48 hours to respond to consults to accommodate this. ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of denisedacey at verizon.net [denisedacey at verizon.net] Sent: Tuesday, September 29, 2009 8:27 PM To: cnm at lists.my180.net Subject: [Cnm] Screening/Assessment parameters Could anyone share their nutrition screening/assessment parameters, time frames for various risk levels?per JC standards. Our facility recently had a 'Mock Survey' and the consultant had some comments re RD timliness of assessements, 24 vs 48 hrs. We have a coordinated screening mechanism with nursing within 24 hrs, with high risk pts having a comprehensive nutrition assessment within 48 hrs. Just want to make sure we are compliant with Joint Commission Standards. Appreciate any feedback Denise Dacey RD,CDE, LDN DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. Email contains Privileged & Confidential Information intended only for the recipient named. Dissemination or copying of email is strictly prohibited. If you have received this in error, notify St. Clair Hospital & return or destroy original. Information in this email is confidential & protected by state & federal law. Further disclosure is strictly prohibited. ________________________________ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege. -------------- next part -------------- An HTML attachment was scrubbed... URL: From NuckollJ at methodisthealth.org Thu Oct 8 12:40:12 2009 From: NuckollJ at methodisthealth.org (Jane Nuckolls) Date: Thu, 08 Oct 2009 14:40:12 -0500 Subject: [Cnm] R.S. in Diet Office In-Reply-To: <9B90EC6A1B880E4A9D9A859E062A04751E833304@ex2.bassett.org> References: <6EAE916704479E4BB6AB5A133BA224F72886B91A0A@SJMEMXMBS11.stjude.sjcrh.local> <9B90EC6A1B880E4A9D9A859E062A04751E833304@ex2.bassett.org> Message-ID: <4ACDF9CC020000EE00073130@methodisthealth.org> Our department reports to the VP of Nursing as well- it has made a huge difference regarding our role as clinical dietitians. We work closely with food service, but do not have any food service responsibilities. Jane Nuckolls, MA, RD, LDN Methodist LeBonheur Healthcare Memphis, Tennessee >>> "Johnson, Andrea" 10/08/09 12:33 PM >>> I and my staff RDs actually report to the VP of Nursing and Patient Care Services not the Foodservice Director which is the reason I was able to politely decline. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: Carney, Virginia H [mailto:Virginia.Carney at STJUDE.ORG] Sent: Thursday, October 08, 2009 1:29 PM To: Johnson, Andrea; 'susan'; Leibhart, Rosanne Cc: clinical nutrition managers Subject: RE: [Cnm] RDs in Diet Office Very well put----good for you. I totally agree. Ginger Carney, RD, LDN, IBCLC, RLC, FILCA Director, Clinical Nutrition St. Jude Children's Research Hospital Memphis, TN -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea Sent: Thursday, October 08, 2009 11:51 AM To: 'susan'; Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office We had this same request and I didn't see how this time could be worked into our day. I declined on the basis of patient needs and better utilization of time and expertise. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of susan Sent: Thursday, October 08, 2009 11:50 AM To: Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office Absolutely not Ask when you can expect RD coverage/help since you all are part of the same time. > > Hi All > I have a director who insists that RDs cover the diet office daily, > during the breakfast line and dinner line. We are answering phones, > filling requests for nourishments, late trays etc. AND, he would like > us to do trayline on occasion.I should build this into the > productivity model. His philosophy is that we are all part of the same > team. I am having a hard time with this. In a pinch, we all are willing to help. > But to be spending 2 hours of clinical time in diet office daily isn't > a good use of resources in my opinion. We are a small hospital, > average census of 115- 120. > Can you all please share with me weather or not diet office &/or > trayline coverage is a routine part of the RDs day? > Thank you, > Rosanne Leibhart, RD > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > Susan DeHoog Associate Director Food and Nutrition University of Washington Medical Center BOX 356057 Seattle Washington 98195 (206) 598-4533 email sdehoog at u.washington.edu FAX (206) 598-8105 pager (206)540-8874 _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Email Disclaimer: www.stjude.org/emaildisclaimer From andrea.johnson at bassett.org Thu Oct 8 12:43:38 2009 From: andrea.johnson at bassett.org (Johnson, Andrea) Date: Thu, 8 Oct 2009 15:43:38 -0400 Subject: [Cnm] R.S. in Diet Office In-Reply-To: <4ACDF9CC020000EE00073130@methodisthealth.org> Message-ID: <9B90EC6A1B880E4A9D9A859E062A04751E83330C@ex2.bassett.org> Do any of you have diet technicians? If so do they report to you or to foodservice. We have techs and they report to Food Services and it causes a disconnect. They continue to report to FS because of some of their food service responsibilities like filling in for clerks etc when needed. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: Jane Nuckolls [mailto:NuckollJ at methodisthealth.org] Sent: Thursday, October 08, 2009 3:40 PM To: Johnson, Andrea; Rosanne Leibhart; Virginia H' 'Carney; 'susan' Cc: clinical nutrition managers Subject: Re: [Cnm] R.S. in Diet Office Our department reports to the VP of Nursing as well- it has made a huge difference regarding our role as clinical dietitians. We work closely with food service, but do not have any food service responsibilities. Jane Nuckolls, MA, RD, LDN Methodist LeBonheur Healthcare Memphis, Tennessee >>> "Johnson, Andrea" 10/08/09 12:33 PM >>> I and my staff RDs actually report to the VP of Nursing and Patient Care Services not the Foodservice Director which is the reason I was able to politely decline. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: Carney, Virginia H [mailto:Virginia.Carney at STJUDE.ORG] Sent: Thursday, October 08, 2009 1:29 PM To: Johnson, Andrea; 'susan'; Leibhart, Rosanne Cc: clinical nutrition managers Subject: RE: [Cnm] RDs in Diet Office Very well put----good for you. I totally agree. Ginger Carney, RD, LDN, IBCLC, RLC, FILCA Director, Clinical Nutrition St. Jude Children's Research Hospital Memphis, TN -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea Sent: Thursday, October 08, 2009 11:51 AM To: 'susan'; Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office We had this same request and I didn't see how this time could be worked into our day. I declined on the basis of patient needs and better utilization of time and expertise. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of susan Sent: Thursday, October 08, 2009 11:50 AM To: Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office Absolutely not Ask when you can expect RD coverage/help since you all are part of the same time. > > Hi All > I have a director who insists that RDs cover the diet office daily, > during the breakfast line and dinner line. We are answering phones, > filling requests for nourishments, late trays etc. AND, he would like > us to do trayline on occasion.I should build this into the > productivity model. His philosophy is that we are all part of the same > team. I am having a hard time with this. In a pinch, we all are willing to help. > But to be spending 2 hours of clinical time in diet office daily isn't > a good use of resources in my opinion. We are a small hospital, > average census of 115- 120. > Can you all please share with me weather or not diet office &/or > trayline coverage is a routine part of the RDs day? > Thank you, > Rosanne Leibhart, RD > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > Susan DeHoog Associate Director Food and Nutrition University of Washington Medical Center BOX 356057 Seattle Washington 98195 (206) 598-4533 email sdehoog at u.washington.edu FAX (206) 598-8105 pager (206)540-8874 _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Email Disclaimer: www.stjude.org/emaildisclaimer -------------- next part -------------- A non-text attachment was scrubbed... Name: Johnson, Andrea.vcf Type: text/x-vcard Size: 145 bytes Desc: Johnson, Andrea.vcf URL: From Bonnie.Meehan at ssfhs.org Thu Oct 8 12:49:45 2009 From: Bonnie.Meehan at ssfhs.org (Meehan Bonnie) Date: Thu, 8 Oct 2009 15:49:45 -0400 Subject: [Cnm] ADA Meeting Message-ID: <21505040.527056.1255031385486.JavaMail.root@oailxiron1.ssfhs.org> CNM Members, Could someone who is going to ADA this year, please consider visiting the vendor exhibits and conducting a user analysis of the computer software programs that exist for recipe nutritional analysis, recipe contraction / expansion and label printing? Particulary interested in Nutribase, Food Processor, and Nutritionist PRO as well as any others that look good. This could also be a great project for a dietetic intern attending ADA. Posting results would be very helpful to us, as well as to anyone else currently looking for software. Some possible topics to analyze: --Ease of learning the program --Ease of using the program --Customer Support --Up front cost --Frequency and Cost of on-going updates --Able to share license --Able to put on hospital network for other RDs and/or employees to use? --Prints labels --# prebuilt foods in database --Source of prebuilt food database --Able to easily add other foods --Easily expands and/or contracts recipes using measures appropriate for size of recipe (i.e., cups or gallons) --Other Wellness aspects? --Pros and Cons --Why you would or would not buy it --Other items that you feel should be considered --Overall ranking from 1-10 with 10 being high Thanks in advance to anyone who is able to do this. Greatly appreciate your time and assistance.--Thanks, Bonnie Bonnie Meehan, RD, CD Chief Clinical Dietitian St. Francis Hospital & Health Centers 1600 Albany St. Beech Grove, IN 46107 317-782-6007 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: From NuckollJ at methodisthealth.org Thu Oct 8 12:51:51 2009 From: NuckollJ at methodisthealth.org (Jane Nuckolls) Date: Thu, 08 Oct 2009 14:51:51 -0500 Subject: [Cnm] R.S. in Diet Office In-Reply-To: <9B90EC6A1B880E4A9D9A859E062A04751E83330C@ex2.bassett.org> References: <4ACDF9CC020000EE00073130@methodisthealth.org> <9B90EC6A1B880E4A9D9A859E062A04751E83330C@ex2.bassett.org> Message-ID: <4ACDFC87020000EE00073138@methodisthealth.org> We have a tech that is purely clinical, provides nutrition ed, etc. and she has been great! >>> "Johnson, Andrea" 10/08/09 2:43 PM >>> Do any of you have diet technicians? If so do they report to you or to foodservice. We have techs and they report to Food Services and it causes a disconnect. They continue to report to FS because of some of their food service responsibilities like filling in for clerks etc when needed. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: Jane Nuckolls [mailto:NuckollJ at methodisthealth.org] Sent: Thursday, October 08, 2009 3:40 PM To: Johnson, Andrea; Rosanne Leibhart; Virginia H' 'Carney; 'susan' Cc: clinical nutrition managers Subject: Re: [Cnm] R.S. in Diet Office Our department reports to the VP of Nursing as well- it has made a huge difference regarding our role as clinical dietitians. We work closely with food service, but do not have any food service responsibilities. Jane Nuckolls, MA, RD, LDN Methodist LeBonheur Healthcare Memphis, Tennessee >>> "Johnson, Andrea" 10/08/09 12:33 PM >>> I and my staff RDs actually report to the VP of Nursing and Patient Care Services not the Foodservice Director which is the reason I was able to politely decline. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: Carney, Virginia H [mailto:Virginia.Carney at STJUDE.ORG] Sent: Thursday, October 08, 2009 1:29 PM To: Johnson, Andrea; 'susan'; Leibhart, Rosanne Cc: clinical nutrition managers Subject: RE: [Cnm] RDs in Diet Office Very well put----good for you. I totally agree. Ginger Carney, RD, LDN, IBCLC, RLC, FILCA Director, Clinical Nutrition St. Jude Children's Research Hospital Memphis, TN -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea Sent: Thursday, October 08, 2009 11:51 AM To: 'susan'; Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office We had this same request and I didn't see how this time could be worked into our day. I declined on the basis of patient needs and better utilization of time and expertise. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of susan Sent: Thursday, October 08, 2009 11:50 AM To: Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office Absolutely not Ask when you can expect RD coverage/help since you all are part of the same time. > > Hi All > I have a director who insists that RDs cover the diet office daily, > during the breakfast line and dinner line. We are answering phones, > filling requests for nourishments, late trays etc. AND, he would like > us to do trayline on occasion.I should build this into the > productivity model. His philosophy is that we are all part of the same > team. I am having a hard time with this. In a pinch, we all are willing to help. > But to be spending 2 hours of clinical time in diet office daily isn't > a good use of resources in my opinion. We are a small hospital, > average census of 115- 120. > Can you all please share with me weather or not diet office &/or > trayline coverage is a routine part of the RDs day? > Thank you, > Rosanne Leibhart, RD > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > Susan DeHoog Associate Director Food and Nutrition University of Washington Medical Center BOX 356057 Seattle Washington 98195 (206) 598-4533 email sdehoog at u.washington.edu FAX (206) 598-8105 pager (206)540-8874 _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Email Disclaimer: www.stjude.org/emaildisclaimer From mpappo at montefiore.org Thu Oct 8 13:13:48 2009 From: mpappo at montefiore.org (Miriam Pappo) Date: Thu, 08 Oct 2009 16:13:48 -0400 Subject: [Cnm] R.S. in Diet Office Message-ID: Lucky. I had a powerhouse Tech who could see 17 pts / day. She's now a manager in the cafeteria. (more money). Miriam >>> "Jane Nuckolls" 10/08/09 3:51 PM >>> We have a tech that is purely clinical, provides nutrition ed, etc. and she has been great! >>> "Johnson, Andrea" 10/08/09 2:43 PM >>> Do any of you have diet technicians? If so do they report to you or to foodservice. We have techs and they report to Food Services and it causes a disconnect. They continue to report to FS because of some of their food service responsibilities like filling in for clerks etc when needed. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: Jane Nuckolls [mailto:NuckollJ at methodisthealth.org] Sent: Thursday, October 08, 2009 3:40 PM To: Johnson, Andrea; Rosanne Leibhart; Virginia H' 'Carney; 'susan' Cc: clinical nutrition managers Subject: Re: [Cnm] R.S. in Diet Office Our department reports to the VP of Nursing as well- it has made a huge difference regarding our role as clinical dietitians. We work closely with food service, but do not have any food service responsibilities. Jane Nuckolls, MA, RD, LDN Methodist LeBonheur Healthcare Memphis, Tennessee >>> "Johnson, Andrea" 10/08/09 12:33 PM >>> I and my staff RDs actually report to the VP of Nursing and Patient Care Services not the Foodservice Director which is the reason I was able to politely decline. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: Carney, Virginia H [mailto:Virginia.Carney at STJUDE.ORG] Sent: Thursday, October 08, 2009 1:29 PM To: Johnson, Andrea; 'susan'; Leibhart, Rosanne Cc: clinical nutrition managers Subject: RE: [Cnm] RDs in Diet Office Very well put----good for you. I totally agree. Ginger Carney, RD, LDN, IBCLC, RLC, FILCA Director, Clinical Nutrition St. Jude Children's Research Hospital Memphis, TN -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea Sent: Thursday, October 08, 2009 11:51 AM To: 'susan'; Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office We had this same request and I didn't see how this time could be worked into our day. I declined on the basis of patient needs and better utilization of time and expertise. Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of susan Sent: Thursday, October 08, 2009 11:50 AM To: Leibhart, Rosanne Cc: clinical nutrition managers Subject: Re: [Cnm] RDs in Diet Office Absolutely not Ask when you can expect RD coverage/help since you all are part of the same time. > > Hi All > I have a director who insists that RDs cover the diet office daily, > during the breakfast line and dinner line. We are answering phones, > filling requests for nourishments, late trays etc. AND, he would like > us to do trayline on occasion.I should build this into the > productivity model. His philosophy is that we are all part of the same > team. I am having a hard time with this. In a pinch, we all are willing to help. > But to be spending 2 hours of clinical time in diet office daily isn't > a good use of resources in my opinion. We are a small hospital, > average census of 115- 120. > Can you all please share with me weather or not diet office &/or > trayline coverage is a routine part of the RDs day? > Thank you, > Rosanne Leibhart, RD > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > Susan DeHoog Associate Director Food and Nutrition University of Washington Medical Center BOX 356057 Seattle Washington 98195 (206) 598-4533 email sdehoog at u.washington.edu FAX (206) 598-8105 pager (206)540-8874 _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Email Disclaimer: www.stjude.org/emaildisclaimer _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From rossjanv at fuse.net Thu Oct 8 13:59:39 2009 From: rossjanv at fuse.net (Janet V. Ross) Date: Thu, 8 Oct 2009 16:59:39 -0400 Subject: [Cnm] RDs in Diet Office In-Reply-To: <1904FBE1EFD42940AA44982E67B5B44E06CFF1C0@exchange02.CKHSAD.CROZER.ORG> Message-ID: On one hand it is wasteful, on the other, it is good for the RD's to understand the entire food service process--it should help them provide better care. The only way to get out of this is to be supportive about what a great opportunity it is, but then to document the opportunity cost wasted--ie the dollars of RD time that need to be replaced on the floors or the things that are not being done. 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. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Leibhart, Rosanne Sent: Thursday, October 08, 2009 11:12 AM To: cnm at lists.my180.net Subject: [Cnm] RDs in Diet Office Hi All I have a director who insists that RDs cover the diet office daily, during the breakfast line and dinner line. We are answering phones, filling requests for nourishments, late trays etc. AND, he would like us to do trayline on occasion.I should build this into the productivity model. His philosophy is that we are all part of the same team. I am having a hard time with this. In a pinch, we all are willing to help. But to be spending 2 hours of clinical time in diet office daily isn't a good use of resources in my opinion. We are a small hospital, average census of 115- 120. Can you all please share with me weather or not diet office &/or trayline coverage is a routine part of the RDs day? Thank you, Rosanne Leibhart, RD _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From Joann.Gruner at utoledo.edu Thu Oct 8 14:26:24 2009 From: Joann.Gruner at utoledo.edu (Gruner, Joann) Date: Thu, 8 Oct 2009 17:26:24 -0400 Subject: [Cnm] McKesson Electronic Medical Record Message-ID: <2802A3B28CCDF241AD93E059FBC3290901A5BFF5@MSG02CV01.utad.utoledo.edu> Our facility is working on building the computer screens for the EMR using McKesson. I am looking for tips on implementing the NCP using McKesson and viewing sample screen shots. Any information you can share is greatly appreciated. Thank you, Joann Gruner, RD, LD The University of Toledo Medical Center 3000 Arlington Ave Toledo, OH 43614 419-383-3840 email: joann.gruner at utoledo.edu -------------- next part -------------- An HTML attachment was scrubbed... URL: From cbergin3 at comcast.net Thu Oct 8 17:22:58 2009 From: cbergin3 at comcast.net (Carol Bergin) Date: Thu, 8 Oct 2009 20:22:58 -0400 Subject: [Cnm] Asessment/Reassessment Algorithm Message-ID: <006001ca4876$a7b1ab20$f7150160$@net> Hi, Will the person who e-mailed the algorithm today e-mail it to me personally, please? I deleted it by mistake and would like to save it. Thanks. Carol -------------- next part -------------- An HTML attachment was scrubbed... URL: From kmershon at bak.rr.com Thu Oct 8 22:28:02 2009 From: kmershon at bak.rr.com (Kathleen Mershon) Date: Thu, 08 Oct 2009 22:28:02 -0700 Subject: [Cnm] Time frame to implementation of Room Service In-Reply-To: <3E6DC8D8B3285C449C883257CA6012D75EB20B691B@CHEXCHANGE01.ad.wnychs.org> References: <3E6DC8D8B3285C449C883257CA6012D75EB20B691B@CHEXCHANGE01.ad.wnychs.org> Message-ID: <4ACEC9E2.70400@bak.rr.com> We implemented an alternative to room service using a foodservice concierge program. We piloted a study on one unit in March 2009. Asked to validate our results on another unit, which we did in April. Presented to our Exec Admin in May (and ASHFA now merged with HFM). Program was approved in June. We began implementation in July rolling out one unit every two weeks. Full implementation completed by end of August. So five months. Recruiting, hiring, training, and finding right fit staff are the limiting factors, and then there is nursing education. We already had the equipment but if you have to purchase could take longer. Plan, Plan, Plan. Fail to plan...plan to fail. So I highly recommend phasing in unit-by-unit. Was a great way for our hospital to adjust, build anticipation and excitement, and get on board by not wanting to be left out...and allowed me to hire the right staff and make sure they knew their assignment tasks as well as their Code of Conduct. We call our program "At Your Service. Kathleen Mershon, MS, RD Clinical Nutrition Manager San Joaquin Community Hospital Bakersfield, CA 93301 Neuhaus, Lisa wrote: > > I would like to get an idea of the time frame involved from the > planning stages to the actual go live date that it has taken > facilities to implement either tray passing or room service or a > modified version of either of these two processes. If anyone can > comment it would be much appreciated. Thank you, > > > > > > Lisa Neuhaus MS RD CNSD > > Director, Food & Nutrition Services > > Buffalo Mercy Hospital > > 565 Abbott Road > > Buffalo, NY 14220 > > 716-828-2106 > > > > MCj04395920000[1] > > > > > > ------------------------- > > CONFIDENTIALITY NOTICE: This message is confidential, intended only > for the named recipient(s) and may contain information that is > privileged, or exempt from disclosure under applicable law. If you are > not the intended recipient(s), you are notified that the > dissemination, distribution or copying of this message is strictly > prohibited. If you receive this message in error, or are not the named > recipient(s), please notify the sender by reply e-mail, delete this > e-mail from your computer, and destroy any copies in any form > immediately. Receipt by anyone other than the named recipient(s) is > not a waiver of any attorney-client, work product, or other applicable > privilege. This message and all contents may be reviewed by authorized > parties of the Catholic Health System other than those named in the > message header. > > The contents of this message do not bind the Catholic Health System to > any contract, position, or course of action unless the sender is > specifically authorized to enter into contracts on behalf of the > Catholic Health System. The contents of this message do not > necessarily constitute an official representation of the Catholic > Health System. > > ------------------------------------------------------------------------ > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/png Size: 6801 bytes Desc: not available URL: From kmershon at bak.rr.com Thu Oct 8 22:35:24 2009 From: kmershon at bak.rr.com (Kathleen Mershon) Date: Thu, 08 Oct 2009 22:35:24 -0700 Subject: [Cnm] Time frame to implementation of Room Service In-Reply-To: <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1D4F@EXCH4.wellspan.org> References: <3E6DC8D8B3285C449C883257CA6012D75EB20B691B@CHEXCHANGE01.ad.wnychs.org> <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1D4F@EXCH4.wellspan.org> Message-ID: <4ACECB9C.1040003@bak.rr.com> Yes. We have a modified version of providing service using the A la Cart Dual Temp 120 v delivery carts and a newly implemented foodservice concierge program. The carts are hot holding and refrigeration and we plug them in on each nursing unit. Our hosts spend 95% of their time on the nursing floor, personalize the service and are able to deliver the meal in far less wait time than room service requires. And...no kitchen renovation. Kathleen Mershon, MS, RD Clinical Nutrition Manager San Joaquin Community Hospital Bakersfield, CA 93301 Ketterman-Hopkins, Cindra wrote: > > I would like to piggy back onto this question and ask if any of you > have implemented room service without doing any kitchen renovations? > 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) > > ------------------------------------------------------------------------ > > *From:* cnm-bounces at lists.my180.net > [mailto:cnm-bounces at lists.my180.net] *On Behalf Of *Neuhaus, Lisa > *Sent:* Wednesday, September 09, 2009 11:31 > *To:* cnm at lists.my180.net > *Subject:* [Cnm] Time frame to implementation of Room Service > > > > I would like to get an idea of the time frame involved from the > planning stages to the actual go live date that it has taken > facilities to implement either tray passing or room service or a > modified version of either of these two processes. If anyone can > comment it would be much appreciated. Thank you, > > > > > > Lisa Neuhaus MS RD CNSD > > Director, Food & Nutrition Services > > Buffalo Mercy Hospital > > 565 Abbott Road > > Buffalo, NY 14220 > > 716-828-2106 > > > > MCj04395920000[1] > > > > > > > ______________________________________________________________________ > This e-mail has been scanned by MCI Managed Email Content Service, > using Skeptic(tm) technology powered by MessageLabs. For more > information on MCI's Managed Email Content Service, visit > http://www.mci.com. > ______________________________________________________________________ > > > ______________________________________________________________________ > This e-mail has been scanned by MCI Managed Email Content Service, > using Skeptic(tm) technology powered by MessageLabs. For more > information on MCI's Managed Email Content Service, visit > http://www.mci.com. > ______________________________________________________________________ > > CONFIDENTIALITY NOTICE: > > This email may contain confidential health information that is legally > privileged. This information is intended for the use of the named > recipient(s). The authorized recipient of this information is > prohibited from disclosing this information to any party unless > required to do so by law or regulation and is required to destroy the > information after its stated need has been fulfilled. If you are not > the intended recipient, you are hereby notified that any disclosure, > copying, distribution, or action taken in reliance on the contents of > this email is strictly prohibited. If you receive this e-mail message > in error, please notify the sender immediately to arrange disposition > of the information. > > ------------------------- > > CONFIDENTIALITY NOTICE: This message is confidential, intended only > for the named recipient(s) and may contain information that is > privileged, or exempt from disclosure under applicable law. If you are > not the intended recipient(s), you are notified that the > dissemination, distribution or copying of this message is strictly > prohibited. If you receive this message in error, or are not the named > recipient(s), please notify the sender by reply e-mail, delete this > e-mail from your computer, and destroy any copies in any form > immediately. Receipt by anyone other than the named recipient(s) is > not a waiver of any attorney-client, work product, or other applicable > privilege. This message and all contents may be reviewed by authorized > parties of the Catholic Health System other than those named in the > message header. > > The contents of this message do not bind the Catholic Health System to > any contract, position, or course of action unless the sender is > specifically authorized to enter into contracts on behalf of the > Catholic Health System. The contents of this message do not > necessarily constitute an official representation of the Catholic > Health System. > > ------------------------------------------------------------------------ > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 1835 bytes Desc: not available URL: From kmershon at bak.rr.com Thu Oct 8 22:38:32 2009 From: kmershon at bak.rr.com (Kathleen Mershon) Date: Thu, 08 Oct 2009 22:38:32 -0700 Subject: [Cnm] Time periods In-Reply-To: <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1BD6@EXCH4.wellspan.org> References: <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1BD6@EXCH4.wellspan.org> Message-ID: <4ACECC58.7090003@bak.rr.com> Don't know about TJC but the state generally has regs. In CA it is 14 hours for acute care, and 15 hours for assisted living according to our CA Title XXII. Kathleen Mershon, MS, RD Clinical Nutrition Manager San Joaquin Community Hospital Bakersfield, CA 93301 Ketterman-Hopkins, Cindra wrote: > > Hi Everyone -- Has anyone seen anything new in the JCAHO standards re > maximum time frame between meals. I've been in practice long enough > to remember the days when JACHO did specify maximum hours between meal > service but I thought that went away 10 or 15 or 20 years ago! Our PI > person for the department thinks he remembers seeing it somewhere but > I can't find any such news. > > > > For those of you working in PA, do you know if the PA DOH regs > identify a time frame. I was unsuccessful in locating anything about > it on their website also. 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. > > ------------------------------------------------------------------------ > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > -------------- next part -------------- An HTML attachment was scrubbed... URL: From kmershon at bak.rr.com Thu Oct 8 22:46:17 2009 From: kmershon at bak.rr.com (Kathleen Mershon) Date: Thu, 08 Oct 2009 22:46:17 -0700 Subject: [Cnm] Training for FNS Staff In-Reply-To: <00d201ca1bb7$fdc917a0$f95b46e0$@net> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F4B75@wmhcs03.wmh.org> <00d201ca1bb7$fdc917a0$f95b46e0$@net> Message-ID: <4ACECE29.7030408@bak.rr.com> Our dedicated foodservice concierge program where each unit has their own assigned host/ess who get to know their patients, provide 1:1 TLC, carry spectralink phones so they are reachable 7 a - 7 p, wear tuxedo uniforms, and use phrases like "hot and fresh." Our staff have taste tested the trays are able to "talk it up" and rave about our chef. Kathleen Mershon, MS, RD Clinical Nutrition Manager San Joaquin Community Hospital Bakersfield, CA 93301 Jo Lynn Worden wrote: > > Please post to list any suggestions. I would like to hear what others > are doing also. > > > > *From:* cnm-bounces at lists.my180.net > [mailto:cnm-bounces at lists.my180.net] *On Behalf Of *Shannon Byrd Jackson > *Sent:* Wednesday, August 12, 2009 8:41 AM > *To:* cnm at lists.my180.net > *Subject:* [Cnm] Training for FNS Staff > > > > Hi, > > > > What strategies are others using to increase patient satisfaction > (related to food service)? > > > > For example, we use key words when passing trays, we use select menus > and practice role-playing at our dept meetings. Does anyone have any > other ideas that have worked w/ their staff? What methods/practices do > others use for training FNS staff? > > > > Also, Chick Fil-A always seems to have the best customer service (at > least the Chick Fil-A's I have visited).. Does anyone know what > training techniques they use? > > > > 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 > > > > ------------------------------------------------------------------------ > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > -------------- next part -------------- An HTML attachment was scrubbed... URL: From kmershon at bak.rr.com Thu Oct 8 22:51:18 2009 From: kmershon at bak.rr.com (Kathleen Mershon) Date: Thu, 08 Oct 2009 22:51:18 -0700 Subject: [Cnm] Training for FNS Staff In-Reply-To: <1904FBE1EFD42940AA44982E67B5B44E06CFF10B@exchange02.CKHSAD.CROZER.ORG> References: <1904FBE1EFD42940AA44982E67B5B44E06CFF10B@exchange02.CKHSAD.CROZER.ORG> Message-ID: <4ACECF56.8010207@bak.rr.com> We were having the same issue but changed the way we asked the questions i.e. we said on a scale of 1 to 5 with 5's being our goal for excellence, how would your rate (and ask your question). We also instructed (and monitored) our staff to tell the patient their meal was hot and fresh with every delivery. One would think patients would know this when the food is hot and tastes fresh but our surveys didn't reflect this until we started telling them. I would investigate (using our internal surveys) why a patient didn't mark the food as hot when our A la Cart Dual Temp delivery carts hold the food at an ambient temp of 180 - 200 and food temps at 160 - 180. There is no question the food is hot. So when I asked patients who had just scored our internal surveys low, I would get answers like "Well you know it is hospital food." It took my concierges telling our patients the food was hot and fresh to move the scores...but move it did :>) Kathleen Mershon, MS, RD Clinical Nutrition Manager San Joaquin Community Hospital Bakersfield, CA 93301 Leibhart, Rosanne wrote: > > We also are challenged with patient satisfaction (Press Ganey). We had > recently revamped menus for greater selection and the Press Ganey > score dropped 1 full point. When we do meal rounds, patients say they > are satisfied but then when surveys come back, we get some very > interesting comments and the scores don't reflect what the patient > tells us while they are here. > > We don't have room service and likely will not in near future. > > I too would like to hear any success stories for improving patient > satisfaction. > > Thank you! > > Rosanne Leibhart, RD > > > > ------------------------------------------------------------------------ > > *From:* cnm-bounces at lists.my180.net > [mailto:cnm-bounces at lists.my180.net] *On Behalf Of *Jo Lynn Worden > *Sent:* Wednesday, August 12, 2009 9:47 PM > *To:* 'Shannon Byrd Jackson'; cnm at lists.my180.net > *Subject:* Re: [Cnm] Training for FNS Staff > > > > Please post to list any suggestions. I would like to hear what others > are doing also. > > > > *From:* cnm-bounces at lists.my180.net > [mailto:cnm-bounces at lists.my180.net] *On Behalf Of *Shannon Byrd Jackson > *Sent:* Wednesday, August 12, 2009 8:41 AM > *To:* cnm at lists.my180.net > *Subject:* [Cnm] Training for FNS Staff > > > > Hi, > > > > What strategies are others using to increase patient satisfaction > (related to food service)? > > > > For example, we use key words when passing trays, we use select menus > and practice role-playing at our dept meetings. Does anyone have any > other ideas that have worked w/ their staff? What methods/practices do > others use for training FNS staff? > > > > Also, Chick Fil-A always seems to have the best customer service (at > least the Chick Fil-A's I have visited).. Does anyone know what > training techniques they use? > > > > 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 > > > > ------------------------------------------------------------------------ > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > -------------- next part -------------- An HTML attachment was scrubbed... URL: From msohal at frhg.org Thu Oct 8 14:39:40 2009 From: msohal at frhg.org (Sohal, Manjit) Date: Thu, 8 Oct 2009 14:39:40 -0700 Subject: [Cnm] Patient not in room at meal delivery time Message-ID: <5E3E345918590D4D86333A4FCCF51A9002F326C5@EXCHVS.frhg.org> We are having difficulty delivering meal trays to patients that are off the floor for a procedure. The meal tray is delivered in the cart and if the patient is off floor or NPO at time of meal delivery; our hosts destroy the trays to ensure the tray won't be served to the patient with unsafe food temps. However, nursing wants trays for patients gone to x-ray to stay on the floor so they can serve them when patient returns because they are claiming that it only takes 15 minutes for patient to go to x-ray, have x-ray taken and return. However, there's no guarantee that the patient will be back quick enough for the food to be served hot. Another issue is if patient is off floor during meal service and the tray is destroyed, a late tray must be ordered when patient returns, however, the late-tray will be an across the board tray. If patient had selected special food items for that meal, patient would not receive it. How do other facilities deal with these issues? Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home -------------- next part -------------- An HTML attachment was scrubbed... URL: From Rosanne.Leibhart at crozer.org Fri Oct 9 06:23:40 2009 From: Rosanne.Leibhart at crozer.org (Leibhart, Rosanne) Date: Fri, 9 Oct 2009 09:23:40 -0400 Subject: [Cnm] RDs in Diet Office In-Reply-To: Message-ID: <1904FBE1EFD42940AA44982E67B5B44E06CFF1CD@exchange02.CKHSAD.CROZER.ORG> Thanks to all who responded to my question. 28 said there is no routine scheduling of RDs in diet office or trayline. 2 said there was...in one case an RD had to split her job and be supervisor 50% of time, another case, RD cover call center on weekend for 1.5 hours. I can't be insubordinate and refuse to do this but at least I know that should I chose to leave, not all places have RDs doing diet office as my director would like me to think. Thanks again for all your responses and many helpful suggestions. Rosanne Leibhart, RD -----Original Message----- From: Janet V. Ross [mailto:rossjanv at fuse.net] Sent: Thursday, October 08, 2009 5:00 PM To: Leibhart, Rosanne; cnm at lists.my180.net Subject: RE: [Cnm] RDs in Diet Office On one hand it is wasteful, on the other, it is good for the RD's to understand the entire food service process--it should help them provide better care. The only way to get out of this is to be supportive about what a great opportunity it is, but then to document the opportunity cost wasted--ie the dollars of RD time that need to be replaced on the floors or the things that are not being done. 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. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Leibhart, Rosanne Sent: Thursday, October 08, 2009 11:12 AM To: cnm at lists.my180.net Subject: [Cnm] RDs in Diet Office Hi All I have a director who insists that RDs cover the diet office daily, during the breakfast line and dinner line. We are answering phones, filling requests for nourishments, late trays etc. AND, he would like us to do trayline on occasion.I should build this into the productivity model. His philosophy is that we are all part of the same team. I am having a hard time with this. In a pinch, we all are willing to help. But to be spending 2 hours of clinical time in diet office daily isn't a good use of resources in my opinion. We are a small hospital, average census of 115- 120. Can you all please share with me weather or not diet office &/or trayline coverage is a routine part of the RDs day? Thank you, Rosanne Leibhart, RD _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From horlowsk at ppmh.org Fri Oct 9 06:49:49 2009 From: horlowsk at ppmh.org (Orlowski, Hannah) Date: Fri, 9 Oct 2009 09:49:49 -0400 Subject: [Cnm] McKesson Electronic Medical Record References: <2802A3B28CCDF241AD93E059FBC3290901A5BFF5@MSG02CV01.utad.utoledo.edu> Message-ID: <0DAF44B706E29940A409E32DC69005C007B35B99@exchange1.phoebe.com> Please list to post. We are starting McKesson soon. ________________________________ From: cnm-bounces at lists.my180.net on behalf of Gruner, Joann Sent: Thu 10/8/2009 5:26 PM To: cnm at lists.my180.net Subject: [Cnm] McKesson Electronic Medical Record Our facility is working on building the computer screens for the EMR using McKesson. I am looking for tips on implementing the NCP using McKesson and viewing sample screen shots. Any information you can share is greatly appreciated. Thank you, Joann Gruner, RD, LD The University of Toledo Medical Center 3000 Arlington Ave Toledo, OH 43614 419-383-3840 email: joann.gruner at utoledo.edu ----------------------------------------- Disclaimer: The HIPAA Final Privacy Rule requires covered entities to safeguard certain Protected Health Information (PHI) related to a person's healthcare. Information being faxed to you may include PHI after appropriate authorization from the patient or under circumstances that do not require patient authorization. You, the recipient, are obligated to maintain PHI in a safe and secure manner. You may not re-disclose without additional patient consent or as required by law. Unauthorized re-disclosure or failure to safeguard PHI could subject you to penalties described in federal (HIPAA) and state law. If you the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, please notify us immediately and destroy the related message. From kahutton at mmci.org Fri Oct 9 07:42:23 2009 From: kahutton at mmci.org (Karen Hutton) Date: Fri, 09 Oct 2009 09:42:23 -0500 Subject: [Cnm] McKesson Electronic Medical Record Message-ID: Here are a few print screens from our program that is up and running. We put in all the possible choices (from the IDNT book) for each section under diagnosis, intervention, etc. Good luck Karen Hutton, RD, MA, LDN Patient Services Manager Food and Nutrition Services Methodist Medical Center of Illinois 221 NE Glen Oak, Peoria, IL 61636 309-672-4957 work 309-672-4953 fax 309-589-3892 pager >>> "Orlowski, Hannah" 10/9/2009 8:49 AM >>> Please list to post. We are starting McKesson soon. ________________________________ From: cnm-bounces at lists.my180.net on behalf of Gruner, Joann Sent: Thu 10/8/2009 5:26 PM To: cnm at lists.my180.net Subject: [Cnm] McKesson Electronic Medical Record Our facility is working on building the computer screens for the EMR using McKesson. I am looking for tips on implementing the NCP using McKesson and viewing sample screen shots. Any information you can share is greatly appreciated. Thank you, Joann Gruner, RD, LD The University of Toledo Medical Center 3000 Arlington Ave Toledo, OH 43614 419-383-3840 email: joann.gruner at utoledo.edu ----------------------------------------- Disclaimer: The HIPAA Final Privacy Rule requires covered entities to safeguard certain Protected Health Information (PHI) related to a person's healthcare. Information being faxed to you may include PHI after appropriate authorization from the patient or under circumstances that do not require patient authorization. You, the recipient, are obligated to maintain PHI in a safe and secure manner. You may not re-disclose without additional patient consent or as required by law. Unauthorized re-disclosure or failure to safeguard PHI could subject you to penalties described in federal (HIPAA) and state law. If you the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, please notify us immediately and destroy the related message. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net NOTICE: This message is a PRIVATE communication. This e-mail may contain confidential or proprietary information that may be considered legally privileged. It is intended only for the named recipient(s). If an addressing or transmission error has misdirected the e-mail, please notify the author by replying to this message. If you are not the named recipient, you are not authorized to use, disclose, distribute, copy, print, or rely on this e-mail, and should immediately delete it from your computer system. Thank you for your assistance with this matter. -------------- next part -------------- A non-text attachment was scrubbed... Name: nutrition tx screen print in Word 2009.doc Type: application/msword Size: 180224 bytes Desc: not available URL: From Virginia.Carney at STJUDE.ORG Fri Oct 9 08:01:58 2009 From: Virginia.Carney at STJUDE.ORG (Carney, Virginia H) Date: Fri, 9 Oct 2009 10:01:58 -0500 Subject: [Cnm] Salaried RDs working too much! In-Reply-To: <4ACECF56.8010207@bak.rr.com> Message-ID: <6EAE916704479E4BB6AB5A133BA224F72886B91B54@SJMEMXMBS11.stjude.sjcrh.local> I don't know if anyone else has this problem, but a few of my RDs on staff work very long hours even though they are salaried. I think it may be the "perfectionistic" personality of the typical RD that drives them to stay in rounds for hours, and then begin their assessments, consults, educations, etc. Then they come to the office to document their electronic chart notes. An average day for them is at least 9-10 hours everyday. This leaves no time for their own professional development, research, and sometimes they even cut out on our own staff meetings because they have to go "take care of patients." ! A bigger thing may be that burnout will set in (if it hasn't already). They say that it takes this much time to provide quality care (we are 100% pediatrics). I know it takes longer to take care of babies and children, and we are not necessarily understaffed, but can anyone relate to this, and how did you handle it? TIA, 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) (901)595-3202 (fax) pager 595-3578, PIN# 0838 virginia.carney at stjude.org [cid:348435414 at 09102009-29C0] [cid:348435414 at 09102009-29C0] Finding cures. Saving children. www.stjude.org ________________________________ Email Disclaimer: www.stjude.org/emaildisclaimer -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: St. Jude logo.gif Type: image/gif Size: 43 bytes Desc: St. Jude logo.gif URL: From Julie.Finney at csauh.com Fri Oct 9 08:37:51 2009 From: Julie.Finney at csauh.com (Finney, Julie) Date: Fri, 9 Oct 2009 11:37:51 -0400 Subject: [Cnm] Salaried RDs working too much! In-Reply-To: <6EAE916704479E4BB6AB5A133BA224F72886B91B54@SJMEMXMBS11.stjude.sjcrh.local> References: <4ACECF56.8010207@bak.rr.com> <6EAE916704479E4BB6AB5A133BA224F72886B91B54@SJMEMXMBS11.stjude.sjcrh.local> Message-ID: There may be a couple of things going on here. Indeed, the perfectionist personality can lead you to work extra-ordinary hours. So too can the inability to organize work appropriately. One of my best performers often works 9 or more hours, however she also does some activities over and above her clinical assignments that she likes to do and refuses to give up. Her argument is that as long as she is getting her clinical work done, if she chooses to do this additional activity that should be fine. She will also assist others as needed when they are having a bad day - as I said - she is one of my best employees. One of my poorest performers also works 10 hours or more in a day. Her co-workers get frustrated because her observed lack of organization creates some of the additional work that she feels that she must do. One time, in a conference when I was reviewing her work, she attributed the error that she had made to the long hours that she was working. That was my opportunity to suggest that long hours didn't equate to quality hours and that all of us reach a maximum level of productivity during the day and that perhaps she was better to go home on time and let her brain rest than to second-guess her work for an additional two or three hours. I think I would look at case load, where time is being spent and if there are some "extras" that aren't really part of the program and then you will need to decide if the hours worked are a problem or a symptom of another problem. Good luck, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carney, Virginia H Sent: Friday, October 09, 2009 11:02 AM To: cnm at lists.my180.net Subject: [Cnm] Salaried RDs working too much! I don't know if anyone else has this problem, but a few of my RDs on staff work very long hours even though they are salaried. I think it may be the "perfectionistic" personality of the typical RD that drives them to stay in rounds for hours, and then begin their assessments, consults, educations, etc. Then they come to the office to document their electronic chart notes. An average day for them is at least 9-10 hours everyday. This leaves no time for their own professional development, research, and sometimes they even cut out on our own staff meetings because they have to go "take care of patients." ! A bigger thing may be that burnout will set in (if it hasn't already). They say that it takes this much time to provide quality care (we are 100% pediatrics). I know it takes longer to take care of babies and children, and we are not necessarily understaffed, but can anyone relate to this, and how did you handle it? TIA, 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) (901)595-3202 (fax) pager 595-3578, PIN# 0838 virginia.carney at stjude.org Finding cures. Saving children. www.stjude.org ________________________________ Email Disclaimer: www.stjude.org/emaildisclaimer ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 43 bytes Desc: image001.gif URL: From losowski at shieldhealthcare.com Fri Oct 9 09:06:50 2009 From: losowski at shieldhealthcare.com (Lisa Osowski) Date: Fri, 9 Oct 2009 09:06:50 -0700 Subject: [Cnm] Salaried RDs working too much! Message-ID: <9E9D0D0FC4D1CC40AF9BE49A7940F67D06DE8542@exchsrv.shc.net> My perspective is...... work efficiently during the 8 hour shift and don't pad your productivity by working longer hours. It works against the RD staff's ability to obtain raises and/or more total RD staffing hours. Administration should have an accurate picture of the productively results for a true 8 hours of RD labor. If there are too many patients not seen after all your RDs work efficiently for 8 hours, you have justification for either.... more RDs or justification to narrow your "To be seen lists" to high acuity patients only. Benchmarking efficiency and showing improvements should be rewarded with salary increases. Don't you think when RDs pretend can see 20 patients and attend 2 hours of meetings in a 8 hour day (when in reality they see 14 and spent 20 minutes at 2 meetings within the first 8 hours), we are selling our profession short? Lisa Osowski MS, RD | SHIELD HEALTHCARE | Corporate Registered Dietitian | Phone 661-294-4298 | Fax 661-294-4269 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Finney, Julie Sent: Friday, October 09, 2009 8:38 AM To: Carney, Virginia H; cnm at lists.my180.net Subject: Re: [Cnm] Salaried RDs working too much! There may be a couple of things going on here. Indeed, the perfectionist personality can lead you to work extra-ordinary hours. So too can the inability to organize work appropriately. One of my best performers often works 9 or more hours, however she also does some activities over and above her clinical assignments that she likes to do and refuses to give up. Her argument is that as long as she is getting her clinical work done, if she chooses to do this additional activity that should be fine. She will also assist others as needed when they are having a bad day - as I said - she is one of my best employees. One of my poorest performers also works 10 hours or more in a day. Her co-workers get frustrated because her observed lack of organization creates some of the additional work that she feels that she must do. One time, in a conference when I was reviewing her work, she attributed the error that she had made to the long hours that she was working. That was my opportunity to suggest that long hours didn't equate to quality hours and that all of us reach a maximum level of productivity during the day and that perhaps she was better to go home on time and let her brain rest than to second-guess her work for an additional two or three hours. I think I would look at case load, where time is being spent and if there are some "extras" that aren't really part of the program and then you will need to decide if the hours worked are a problem or a symptom of another problem. Good luck, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com _____ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carney, Virginia H Sent: Friday, October 09, 2009 11:02 AM To: cnm at lists.my180.net Subject: [Cnm] Salaried RDs working too much! I don't know if anyone else has this problem, but a few of my RDs on staff work very long hours even though they are salaried. I think it may be the "perfectionistic" personality of the typical RD that drives them to stay in rounds for hours, and then begin their assessments, consults, educations, etc. Then they come to the office to document their electronic chart notes. An average day for them is at least 9-10 hours everyday. This leaves no time for their own professional development, research, and sometimes they even cut out on our own staff meetings because they have to go "take care of patients." ! A bigger thing may be that burnout will set in (if it hasn't already). They say that it takes this much time to provide quality care (we are 100% pediatrics). I know it takes longer to take care of babies and children, and we are not necessarily understaffed, but can anyone relate to this, and how did you handle it? TIA, 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) (901)595-3202 (fax) pager 595-3578, PIN# 0838 virginia.carney at stjude.org Finding cures. Saving children. www.stjude.org _____ Email Disclaimer: www.stjude.org/emaildisclaimer _____ The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 43 bytes Desc: image001.gif URL: From msohal at frhg.org Fri Oct 9 07:05:20 2009 From: msohal at frhg.org (Sohal, Manjit) Date: Fri, 9 Oct 2009 07:05:20 -0700 Subject: [Cnm] McKesson Electronic Medical Record In-Reply-To: <0DAF44B706E29940A409E32DC69005C007B35B99@exchange1.phoebe.com> References: <2802A3B28CCDF241AD93E059FBC3290901A5BFF5@MSG02CV01.utad.utoledo.edu> <0DAF44B706E29940A409E32DC69005C007B35B99@exchange1.phoebe.com> Message-ID: <5E3E345918590D4D86333A4FCCF51A9002F326CB@EXCHVS.frhg.org> We are using McKesson EMR. However, I don't know how to send screen shots from it. I will check with our IS dept. Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Orlowski, Hannah Sent: Friday, October 09, 2009 6:50 AM To: Gruner, Joann; cnm at lists.my180.net Subject: Re: [Cnm] McKesson Electronic Medical Record Please list to post. We are starting McKesson soon. ________________________________ From: cnm-bounces at lists.my180.net on behalf of Gruner, Joann Sent: Thu 10/8/2009 5:26 PM To: cnm at lists.my180.net Subject: [Cnm] McKesson Electronic Medical Record Our facility is working on building the computer screens for the EMR using McKesson. I am looking for tips on implementing the NCP using McKesson and viewing sample screen shots. Any information you can share is greatly appreciated. Thank you, Joann Gruner, RD, LD The University of Toledo Medical Center 3000 Arlington Ave Toledo, OH 43614 419-383-3840 email: joann.gruner at utoledo.edu ----------------------------------------- Disclaimer: The HIPAA Final Privacy Rule requires covered entities to safeguard certain Protected Health Information (PHI) related to a person's healthcare. Information being faxed to you may include PHI after appropriate authorization from the patient or under circumstances that do not require patient authorization. You, the recipient, are obligated to maintain PHI in a safe and secure manner. You may not re-disclose without additional patient consent or as required by law. Unauthorized re-disclosure or failure to safeguard PHI could subject you to penalties described in federal (HIPAA) and state law. If you the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, please notify us immediately and destroy the related message. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From msohal at frhg.org Fri Oct 9 07:07:19 2009 From: msohal at frhg.org (Sohal, Manjit) Date: Fri, 9 Oct 2009 07:07:19 -0700 Subject: [Cnm] Patient not in room at meal delivery time Message-ID: <5E3E345918590D4D86333A4FCCF51A9002F326CC@EXCHVS.frhg.org> We are having difficulty delivering meal trays to patients that are off the floor for a procedure. The meal tray is delivered in the cart and if the patient is off floor or NPO at time of meal delivery; our hosts destroy the trays to ensure the tray won't be served to the patient with unsafe food temps. However, nursing wants trays for patients gone to x-ray to stay on the floor so they can serve them when patient returns because they are claiming that it only takes 15 minutes for patient to go to x-ray, have x-ray taken and return. However, there's no guarantee that the patient will be back quick enough for the food to be served hot. Another issue is if patient is off floor during meal service and the tray is destroyed, a late tray must be ordered when patient returns, however, the late-tray will be an across the board tray. If patient had selected special food items for that meal, patient would not receive it. How do other facilities deal with these issues? Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home -------------- next part -------------- An HTML attachment was scrubbed... URL: From MAHTRedF at aol.com Fri Oct 9 09:41:08 2009 From: MAHTRedF at aol.com (MAHTRedF at aol.com) Date: Fri, 9 Oct 2009 12:41:08 EDT Subject: [Cnm] RDs in Diet Office Message-ID: I am presuming that your director is a non-RD? I have heard this scenario so many times and as a clinical RD it just makes my stomach heave. If you are a small institution, its reasonable to have some food service responsibility but I believe it should stop at the door of the diet office. When any of the accrediting bodies walk in your doors, what do they focus on? Timeliness of care was one big factor where I work. When our RDs were involved in food service the timeliness of care was not good - in the 80% area. Now our focus is on getting patients seen as soon as possible. This is what impresses surveyors in my experience and its what the institution expects. Can you get some of your MDs on side? What is not getting done clinically that would be done if you didn't have the food service duties? You are also a member of the interdisciplinary team and I believe that needs to be a focus when it comes to patient care. Good luck! Margaret Hagerty, MS,RD -------------- next part -------------- An HTML attachment was scrubbed... URL: From Terese.Scollard at providence.org Fri Oct 9 09:50:48 2009 From: Terese.Scollard at providence.org (Scollard, Terese) Date: Fri, 9 Oct 2009 09:50:48 -0700 Subject: [Cnm] Salaried RDs working too much! In-Reply-To: <9E9D0D0FC4D1CC40AF9BE49A7940F67D06DE8542@exchsrv.shc.net> References: <9E9D0D0FC4D1CC40AF9BE49A7940F67D06DE8542@exchsrv.shc.net> Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A0524DF83@wn1221.or.providence.org> I think I would approach it by being concerned about burn out for them, but appreciative of their commitment. Talk about the need to have accurate data for productivity and staffing to reality so dept doesn't "shoot itself in the foot". And then talk about balance in their life. Maybe bring in some kind of materials/speaker/HR person about balance and time management. I had also checked with our HR dept because we do not have this problem (except with myself), and HR said that they do not address unless there are consistently over 45 hours per week worked by an exempt status person. Could there be a culture of martyrdom going on too?, if one is staffed reasonably and there is a competition among the players for trying to be viewed that way. Another thought is that we all have to figure out how to manage our time, and just let it go along and talk to people privately about it so they deal with it personally at their own pace of learning to manage their own time at their own rate. Terese Scollard From: Lisa Osowski [mailto:losowski at shieldhealthcare.com] Sent: Friday, October 09, 2009 9:07 AM To: Finney, Julie; Carney, Virginia H; cnm at lists.my180.net Subject: Re: [Cnm] Salaried RDs working too much! My perspective is...... work efficiently during the 8 hour shift and don't pad your productivity by working longer hours. It works against the RD staff's ability to obtain raises and/or more total RD staffing hours. Administration should have an accurate picture of the productively results for a true 8 hours of RD labor. If there are too many patients not seen after all your RDs work efficiently for 8 hours, you have justification for either.... more RDs or justification to narrow your "To be seen lists" to high acuity patients only. Benchmarking efficiency and showing improvements should be rewarded with salary increases. Don't you think when RDs pretend can see 20 patients and attend 2 hours of meetings in a 8 hour day (when in reality they see 14 and spent 20 minutes at 2 meetings within the first 8 hours), we are selling our profession short? Lisa Osowski MS, RD | SHIELD HEALTHCARE | Corporate Registered Dietitian | Phone 661-294-4298 | Fax 661-294-4269 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Finney, Julie Sent: Friday, October 09, 2009 8:38 AM To: Carney, Virginia H; cnm at lists.my180.net Subject: Re: [Cnm] Salaried RDs working too much! There may be a couple of things going on here. Indeed, the perfectionist personality can lead you to work extra-ordinary hours. So too can the inability to organize work appropriately. One of my best performers often works 9 or more hours, however she also does some activities over and above her clinical assignments that she likes to do and refuses to give up. Her argument is that as long as she is getting her clinical work done, if she chooses to do this additional activity that should be fine. She will also assist others as needed when they are having a bad day - as I said - she is one of my best employees. One of my poorest performers also works 10 hours or more in a day. Her co-workers get frustrated because her observed lack of organization creates some of the additional work that she feels that she must do. One time, in a conference when I was reviewing her work, she attributed the error that she had made to the long hours that she was working. That was my opportunity to suggest that long hours didn't equate to quality hours and that all of us reach a maximum level of productivity during the day and that perhaps she was better to go home on time and let her brain rest than to second-guess her work for an additional two or three hours. I think I would look at case load, where time is being spent and if there are some "extras" that aren't really part of the program and then you will need to decide if the hours worked are a problem or a symptom of another problem. Good luck, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carney, Virginia H Sent: Friday, October 09, 2009 11:02 AM To: cnm at lists.my180.net Subject: [Cnm] Salaried RDs working too much! I don't know if anyone else has this problem, but a few of my RDs on staff work very long hours even though they are salaried. I think it may be the "perfectionistic" personality of the typical RD that drives them to stay in rounds for hours, and then begin their assessments, consults, educations, etc. Then they come to the office to document their electronic chart notes. An average day for them is at least 9-10 hours everyday. This leaves no time for their own professional development, research, and sometimes they even cut out on our own staff meetings because they have to go "take care of patients." ! A bigger thing may be that burnout will set in (if it hasn't already). They say that it takes this much time to provide quality care (we are 100% pediatrics). I know it takes longer to take care of babies and children, and we are not necessarily understaffed, but can anyone relate to this, and how did you handle it? TIA, 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) (901)595-3202 (fax) pager 595-3578, PIN# 0838 virginia.carney at stjude.org Finding cures. Saving children. www.stjude.org ________________________________ Email Disclaimer: www.stjude.org/emaildisclaimer ________________________________ The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 43 bytes Desc: image001.gif URL: From Terese.Scollard at providence.org Fri Oct 9 09:54:20 2009 From: Terese.Scollard at providence.org (Scollard, Terese) Date: Fri, 9 Oct 2009 09:54:20 -0700 Subject: [Cnm] Patient not in room at meal delivery time In-Reply-To: <5E3E345918590D4D86333A4FCCF51A9002F326C5@EXCHVS.frhg.org> References: <5E3E345918590D4D86333A4FCCF51A9002F326C5@EXCHVS.frhg.org> Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A0524DF8A@wn1221.or.providence.org> Go to "Room Service"-only way to solve this problem. Terese Scollard From: Sohal, Manjit [mailto:msohal at frhg.org] Sent: Thursday, October 08, 2009 2:40 PM To: cnm at lists.my180.net Subject: [Cnm] Patient not in room at meal delivery time We are having difficulty delivering meal trays to patients that are off the floor for a procedure. The meal tray is delivered in the cart and if the patient is off floor or NPO at time of meal delivery; our hosts destroy the trays to ensure the tray won't be served to the patient with unsafe food temps. However, nursing wants trays for patients gone to x-ray to stay on the floor so they can serve them when patient returns because they are claiming that it only takes 15 minutes for patient to go to x-ray, have x-ray taken and return. However, there's no guarantee that the patient will be back quick enough for the food to be served hot. Another issue is if patient is off floor during meal service and the tray is destroyed, a late tray must be ordered when patient returns, however, the late-tray will be an across the board tray. If patient had selected special food items for that meal, patient would not receive it. How do other facilities deal with these issues? Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Terese.Scollard at providence.org Fri Oct 9 09:58:08 2009 From: Terese.Scollard at providence.org (Scollard, Terese) Date: Fri, 9 Oct 2009 09:58:08 -0700 Subject: [Cnm] RDs in Diet Office In-Reply-To: <1904FBE1EFD42940AA44982E67B5B44E06CFF1CD@exchange02.CKHSAD.CROZER.ORG> References: <1904FBE1EFD42940AA44982E67B5B44E06CFF1CD@exchange02.CKHSAD.CROZER.ORG> Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A0524DF90@wn1221.or.providence.org> Suggestion: investigate and work on getting a computerized diet office/call center, room service and pursue malnutrition recognition and reimbursement. I do think it is really important for the clinical staff to support the food systems processes so they are not in an ivory tower, however, at some point, that is certainly keeping the staff away from more role specific activities, and is pretty antiquated and needs to be put into a more modern approach. Terese Scollard -----Original Message----- From: Leibhart, Rosanne [mailto:Rosanne.Leibhart at crozer.org] Sent: Friday, October 09, 2009 6:24 AM To: cnm at lists.my180.net Subject: Re: [Cnm] RDs in Diet Office Thanks to all who responded to my question. 28 said there is no routine scheduling of RDs in diet office or trayline. 2 said there was...in one case an RD had to split her job and be supervisor 50% of time, another case, RD cover call center on weekend for 1.5 hours. I can't be insubordinate and refuse to do this but at least I know that should I chose to leave, not all places have RDs doing diet office as my director would like me to think. Thanks again for all your responses and many helpful suggestions. Rosanne Leibhart, RD -----Original Message----- From: Janet V. Ross [mailto:rossjanv at fuse.net] Sent: Thursday, October 08, 2009 5:00 PM To: Leibhart, Rosanne; cnm at lists.my180.net Subject: RE: [Cnm] RDs in Diet Office On one hand it is wasteful, on the other, it is good for the RD's to understand the entire food service process--it should help them provide better care. The only way to get out of this is to be supportive about what a great opportunity it is, but then to document the opportunity cost wasted--ie the dollars of RD time that need to be replaced on the floors or the things that are not being done. 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. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Leibhart, Rosanne Sent: Thursday, October 08, 2009 11:12 AM To: cnm at lists.my180.net Subject: [Cnm] RDs in Diet Office Hi All I have a director who insists that RDs cover the diet office daily, during the breakfast line and dinner line. We are answering phones, filling requests for nourishments, late trays etc. AND, he would like us to do trayline on occasion.I should build this into the productivity model. His philosophy is that we are all part of the same team. I am having a hard time with this. In a pinch, we all are willing to help. But to be spending 2 hours of clinical time in diet office daily isn't a good use of resources in my opinion. We are a small hospital, average census of 115- 120. Can you all please share with me weather or not diet office &/or trayline coverage is a routine part of the RDs day? Thank you, Rosanne Leibhart, RD _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. From MarcelleKarustis at catholichealth.net Fri Oct 9 11:19:30 2009 From: MarcelleKarustis at catholichealth.net (Karustis, Marcelle) Date: Fri, 9 Oct 2009 12:19:30 -0600 Subject: [Cnm] Patient not in room at meal delivery time In-Reply-To: <37ABAEB17B0B5B40AA0B6118E57CF59A0524DF8A@wn1221.or.providence.org> References: <5E3E345918590D4D86333A4FCCF51A9002F326C5@EXCHVS.frhg.org> <37ABAEB17B0B5B40AA0B6118E57CF59A0524DF8A@wn1221.or.providence.org> Message-ID: <17B38BCEA6E6F24D9300FA8CFE81F4250133E36D@chimsx015.CHI.catholichealth.net> Amen! Just what I was going to say! 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 Scollard, Terese Sent: Friday, October 09, 2009 12:54 PM To: Sohal, Manjit; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time Go to "Room Service"-only way to solve this problem. Terese Scollard From: Sohal, Manjit [mailto:msohal at frhg.org] Sent: Thursday, October 08, 2009 2:40 PM To: cnm at lists.my180.net Subject: [Cnm] Patient not in room at meal delivery time We are having difficulty delivering meal trays to patients that are off the floor for a procedure. The meal tray is delivered in the cart and if the patient is off floor or NPO at time of meal delivery; our hosts destroy the trays to ensure the tray won't be served to the patient with unsafe food temps. However, nursing wants trays for patients gone to x-ray to stay on the floor so they can serve them when patient returns because they are claiming that it only takes 15 minutes for patient to go to x-ray, have x-ray taken and return. However, there's no guarantee that the patient will be back quick enough for the food to be served hot. Another issue is if patient is off floor during meal service and the tray is destroyed, a late tray must be ordered when patient returns, however, the late-tray will be an across the board tray. If patient had selected special food items for that meal, patient would not receive it. How do other facilities deal with these issues? Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. DISCLAIMER: 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. -------------- next part -------------- An HTML attachment was scrubbed... URL: From MELLINGTON at wakemed.org Fri Oct 9 13:14:40 2009 From: MELLINGTON at wakemed.org (MARTHA ELLINGTON) Date: Fri, 9 Oct 2009 16:14:40 -0400 Subject: [Cnm] TJC "Dietary" tracer In-Reply-To: <63A81A57A6254849B538D2FF4F1D539904DD67C4@VS01EXC01.mercycare.org> References: <17B38BCEA6E6F24D9300FA8CFE81F4250133DAC9@chimsx015.CHI.catholichealth.net> <63A81A57A6254849B538D2FF4F1D539904DD67C4@VS01EXC01.mercycare.org> Message-ID: So Friday morning of our survey I get a call that a surveyor wants to tour the kitchen. What she really wanted was to do at "dietary tracer" because CMS has requested that they do more of them. They did not trace a chart during the week that had an issue with diet so she wanted me to find a patient on a Renal diet that also had a Fluid Restriction. I found one in our Computiriton system and showed her how the menu system worked and what the menu would look like. Then she went to the floor and talked to the hostess and the nurse. She drilled the nurse about the fluid restrictions and how they keep up with what the patient drinks. Then since the patient was in dialysis we went there and she talked to the nurse and the patient. She wanted to know if the patient had triggered a nutrition consult and they had not. They came in on Wednesday and was going to be discharges this PM. Then she went back to the kitchen and observed the beginning of the meal service. She was very nice and down to earth. I guess they will be doing more of these. It did let the staff know that all the training and drilling was important. We just got out of the wrap up conference and we did very well. I am going home. 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From fns at abbgen.net Fri Oct 9 13:11:05 2009 From: fns at abbgen.net (Annette Doucet) Date: Fri, 9 Oct 2009 15:11:05 -0500 Subject: [Cnm] Patient not in room at meal delivery time In-Reply-To: <17B38BCEA6E6F24D9300FA8CFE81F4250133E36D@chimsx015.CHI.catholichealth.net> Message-ID: We have a lot of elderly patients who would have problems calling their menu in, if we used room service. What do you do for that type of patient? _____ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karustis, Marcelle Sent: Friday, October 09, 2009 1:20 PM To: Scollard, Terese; Sohal, Manjit; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time Amen! Just what I was going to say! 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 Scollard, Terese Sent: Friday, October 09, 2009 12:54 PM To: Sohal, Manjit; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time Go to "Room Service"-only way to solve this problem. Terese Scollard From: Sohal, Manjit [mailto:msohal at frhg.org] Sent: Thursday, October 08, 2009 2:40 PM To: cnm at lists.my180.net Subject: [Cnm] Patient not in room at meal delivery time We are having difficulty delivering meal trays to patients that are off the floor for a procedure. The meal tray is delivered in the cart and if the patient is off floor or NPO at time of meal delivery; our hosts destroy the trays to ensure the tray won't be served to the patient with unsafe food temps. However, nursing wants trays for patients gone to x-ray to stay on the floor so they can serve them when patient returns because they are claiming that it only takes 15 minutes for patient to go to x-ray, have x-ray taken and return. However, there's no guarantee that the patient will be back quick enough for the food to be served hot. Another issue is if patient is off floor during meal service and the tray is destroyed, a late tray must be ordered when patient returns, however, the late-tray will be an across the board tray. If patient had selected special food items for that meal, patient would not receive it. How do other facilities deal with these issues? Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home _____ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. DISCLAIMER: 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Julie.Finney at csauh.com Fri Oct 9 13:21:21 2009 From: Julie.Finney at csauh.com (Finney, Julie) Date: Fri, 9 Oct 2009 16:21:21 -0400 Subject: [Cnm] Patient not in room at meal delivery time In-Reply-To: References: <17B38BCEA6E6F24D9300FA8CFE81F4250133E36D@chimsx015.CHI.catholichealth.net> Message-ID: If a patient is not able to participate they may be made non-select and trays come up to the unit at pre-determined times. We also visit non-select patients to take their orders via tablets and finally, family members are encouraged to call in and order for their family member. Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Annette Doucet Sent: Friday, October 09, 2009 4:11 PM To: 'Karustis, Marcelle'; 'Scollard, Terese'; 'Sohal, Manjit'; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time We have a lot of elderly patients who would have problems calling their menu in, if we used room service. What do you do for that type of patient? ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karustis, Marcelle Sent: Friday, October 09, 2009 1:20 PM To: Scollard, Terese; Sohal, Manjit; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time Amen! Just what I was going to say! 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 Scollard, Terese Sent: Friday, October 09, 2009 12:54 PM To: Sohal, Manjit; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time Go to "Room Service"-only way to solve this problem. Terese Scollard From: Sohal, Manjit [mailto:msohal at frhg.org] Sent: Thursday, October 08, 2009 2:40 PM To: cnm at lists.my180.net Subject: [Cnm] Patient not in room at meal delivery time We are having difficulty delivering meal trays to patients that are off the floor for a procedure. The meal tray is delivered in the cart and if the patient is off floor or NPO at time of meal delivery; our hosts destroy the trays to ensure the tray won't be served to the patient with unsafe food temps. However, nursing wants trays for patients gone to x-ray to stay on the floor so they can serve them when patient returns because they are claiming that it only takes 15 minutes for patient to go to x-ray, have x-ray taken and return. However, there's no guarantee that the patient will be back quick enough for the food to be served hot. Another issue is if patient is off floor during meal service and the tray is destroyed, a late tray must be ordered when patient returns, however, the late-tray will be an across the board tray. If patient had selected special food items for that meal, patient would not receive it. How do other facilities deal with these issues? Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. DISCLAIMER: 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Lori.Zimmerman at ministryhealth.org Fri Oct 9 13:36:24 2009 From: Lori.Zimmerman at ministryhealth.org (Zimmerman, Lori A) Date: Fri, 9 Oct 2009 15:36:24 -0500 Subject: [Cnm] Patient not in room at meal delivery time In-Reply-To: <1f8275f3-6ec9-41a0-ad2f-7821212bc0be@EXMHCHUBCAS01.ministryhealth.net> References: <17B38BCEA6E6F24D9300FA8CFE81F4250133E36D@chimsx015.CHI.catholichealth.net> <1f8275f3-6ec9-41a0-ad2f-7821212bc0be@EXMHCHUBCAS01.ministryhealth.net> Message-ID: We have 3 Protocols for room service "Calls, Assist and Fill In". For those elderly patients who can not call our Ambassadors visit them, usually after lunch and get their choices for Supper, Breakfast and Lunch. When the patient is set as an Assist they assign meal times and record them on the white boards in the pt room so nursing staff when their meals are scheduled as some of these also need help eating. Those patients who are really confused we fill in using a standard meal rotation. Lori A. Zimmerman MS, RD, CD ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Annette Doucet Sent: Friday, October 09, 2009 3:11 PM To: 'Karustis, Marcelle'; 'Scollard, Terese'; 'Sohal, Manjit'; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time We have a lot of elderly patients who would have problems calling their menu in, if we used room service. What do you do for that type of patient? ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karustis, Marcelle Sent: Friday, October 09, 2009 1:20 PM To: Scollard, Terese; Sohal, Manjit; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time Amen! Just what I was going to say! 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 Scollard, Terese Sent: Friday, October 09, 2009 12:54 PM To: Sohal, Manjit; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time Go to "Room Service"-only way to solve this problem. Terese Scollard From: Sohal, Manjit [mailto:msohal at frhg.org] Sent: Thursday, October 08, 2009 2:40 PM To: cnm at lists.my180.net Subject: [Cnm] Patient not in room at meal delivery time We are having difficulty delivering meal trays to patients that are off the floor for a procedure. The meal tray is delivered in the cart and if the patient is off floor or NPO at time of meal delivery; our hosts destroy the trays to ensure the tray won't be served to the patient with unsafe food temps. However, nursing wants trays for patients gone to x-ray to stay on the floor so they can serve them when patient returns because they are claiming that it only takes 15 minutes for patient to go to x-ray, have x-ray taken and return. However, there's no guarantee that the patient will be back quick enough for the food to be served hot. Another issue is if patient is off floor during meal service and the tray is destroyed, a late tray must be ordered when patient returns, however, the late-tray will be an across the board tray. If patient had selected special food items for that meal, patient would not receive it. How do other facilities deal with these issues? Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. DISCLAIMER: 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. ________________________________ CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation. -------------- next part -------------- An HTML attachment was scrubbed... URL: From pcharney at mac.com Fri Oct 9 14:24:50 2009 From: pcharney at mac.com (Pam Charney) Date: Fri, 09 Oct 2009 14:24:50 -0700 Subject: [Cnm] Salaried RDs working too much! In-Reply-To: <6EAE916704479E4BB6AB5A133BA224F72886B91B54@SJMEMXMBS11.stjude.sjcrh.local> References: <6EAE916704479E4BB6AB5A133BA224F72886B91B54@SJMEMXMBS11.stjude.sjcrh.local> Message-ID: Obviously there are many issues here, but I noticed you said they come in to do asynchronous electronic documentation in the office. That signals me that they've got a poor work flow. They should be completing documentation at the time of service. Have you done a work flow analysis? In order to really pinpoint the problem, it's important to know what they do every step of the way, what the issues are that are keeping them from completing their work and what are the tools you have to facilitate work flow. What disciplines are at the rounds? Do they have the same issues with their staff? Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 9, 2009, at 8:01 AM, Carney, Virginia H wrote: > I don't know if anyone else has this problem, but a few of my RDs on > staff work very long hours even though they are salaried. I think > it may be the "perfectionistic" personality of the typical RD that > drives them to stay in rounds for hours, and then begin their > assessments, consults, educations, etc. Then they come to the > office to document their electronic chart notes. An average day for > them is at least 9-10 hours everyday. This leaves no time for their > own professional development, research, and sometimes they even cut > out on our own staff meetings because they have to go "take care of > patients." ! A bigger thing may be that burnout will set in (if it > hasn't already). They say that it takes this much time to provide > quality care (we are 100% pediatrics). I know it takes longer to > take care of babies and children, and we are not necessarily > understaffed, but can anyone relate to this, and how did you handle > it? > > TIA, > 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) > (901)595-3202 (fax) > pager 595-3578, PIN# 0838 > virginia.carney at stjude.org > > > > Finding cures. Saving children. > www.stjude.org > > > > Email Disclaimer: www.stjude.org/emaildisclaimer > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From Terese.Scollard at providence.org Fri Oct 9 15:50:03 2009 From: Terese.Scollard at providence.org (Scollard, Terese) Date: Fri, 9 Oct 2009 15:50:03 -0700 Subject: [Cnm] Patient not in room at meal delivery time In-Reply-To: References: <17B38BCEA6E6F24D9300FA8CFE81F4250133E36D@chimsx015.CHI.catholichealth.net> <1f8275f3-6ec9-41a0-ad2f-7821212bc0be@EXMHCHUBCAS01.ministryhealth.net> Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A052AB32C@wn1221.or.providence.org> What Lori describes is similar to what we do. We have Computrition's Hospitality Suite, and the hosts run a report that says who has not yet eaten, the hosts have to find each patient and learn (and make a note on report) why they have not, help the pt if they need help or tell the RN if pt refuses. We keep all the records and track the patients so no one is missed. The reports are great. I am sure other room service computer systems have similar reports/options. We also require that the hosts and clinical staff have a quick verbal check in every day by around noon to make sure they stay in touch. Terese Scollard From: Zimmerman, Lori A [mailto:Lori.Zimmerman at ministryhealth.org] Sent: Friday, October 09, 2009 1:36 PM To: 'Annette Doucet'; 'Karustis, Marcelle'; Scollard, Terese; 'Sohal, Manjit'; 'cnm at lists.my180.net' Subject: RE: [Cnm] Patient not in room at meal delivery time We have 3 Protocols for room service "Calls, Assist and Fill In". For those elderly patients who can not call our Ambassadors visit them, usually after lunch and get their choices for Supper, Breakfast and Lunch. When the patient is set as an Assist they assign meal times and record them on the white boards in the pt room so nursing staff when their meals are scheduled as some of these also need help eating. Those patients who are really confused we fill in using a standard meal rotation. Lori A. Zimmerman MS, RD, CD ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Annette Doucet Sent: Friday, October 09, 2009 3:11 PM To: 'Karustis, Marcelle'; 'Scollard, Terese'; 'Sohal, Manjit'; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time We have a lot of elderly patients who would have problems calling their menu in, if we used room service. What do you do for that type of patient? ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Karustis, Marcelle Sent: Friday, October 09, 2009 1:20 PM To: Scollard, Terese; Sohal, Manjit; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time Amen! Just what I was going to say! 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 Scollard, Terese Sent: Friday, October 09, 2009 12:54 PM To: Sohal, Manjit; cnm at lists.my180.net Subject: Re: [Cnm] Patient not in room at meal delivery time Go to "Room Service"-only way to solve this problem. Terese Scollard From: Sohal, Manjit [mailto:msohal at frhg.org] Sent: Thursday, October 08, 2009 2:40 PM To: cnm at lists.my180.net Subject: [Cnm] Patient not in room at meal delivery time We are having difficulty delivering meal trays to patients that are off the floor for a procedure. The meal tray is delivered in the cart and if the patient is off floor or NPO at time of meal delivery; our hosts destroy the trays to ensure the tray won't be served to the patient with unsafe food temps. However, nursing wants trays for patients gone to x-ray to stay on the floor so they can serve them when patient returns because they are claiming that it only takes 15 minutes for patient to go to x-ray, have x-ray taken and return. However, there's no guarantee that the patient will be back quick enough for the food to be served hot. Another issue is if patient is off floor during meal service and the tray is destroyed, a late tray must be ordered when patient returns, however, the late-tray will be an across the board tray. If patient had selected special food items for that meal, patient would not receive it. How do other facilities deal with these issues? Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. DISCLAIMER: 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. If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. ________________________________ 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. ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From sadiecat14 at verizon.net Fri Oct 9 16:03:26 2009 From: sadiecat14 at verizon.net (Deborah Gore) Date: Fri, 09 Oct 2009 19:03:26 -0400 Subject: [Cnm] TJC "Dietary" tracer References: <17B38BCEA6E6F24D9300FA8CFE81F4250133DAC9@chimsx015.CHI.catholichealth.net> <63A81A57A6254849B538D2FF4F1D539904DD67C4@VS01EXC01.mercycare.org> Message-ID: When we were surveyed 9/15 - 9/18/09 the surveyor told everyone that TJC was going to be doing "dietary tracers" in 2010. What she explained is exactly what you experienced. I immediately sent a note to this CMN list but no one who replied had heard about his. I did receive a reply from someone, sorry I do not have the post at home, whose facility contacted the SIG and received a reply that TJC was NOT doing dietary/nutrition specific tracers in 2010 - this must have been the surveyor's opinion. Deborah Gore, RD, CNSD Cape Regional Medical Center Cape May, NJ -------------- next part -------------- An HTML attachment was scrubbed... URL: From marsha.schofield at att.net Fri Oct 9 18:09:33 2009 From: marsha.schofield at att.net (Marsha Schofield) Date: Fri, 9 Oct 2009 21:09:33 -0400 Subject: [Cnm] Act Now - Input on CNM's Draft Strategic Plan 2010-2012 by October 15 Message-ID: <347E690A-799C-4C7C-83E1-20E4C4AAC7B6@att.net> Dear CNM members, The CNM Executive Committee has been working hard on the next iteration of the DPG's Strategic Plan (2010-2012). We appreciate the input you provided earlier this year as we began the planning process. Your input provided a valuable foundation for our work. Now, we need your input again. Before moving forward, we need to hear from you, our members, as to your support of our general direction. If you click on the link below, you will be directed to the CNM DPG website. After you log-in as a member, on the right side of the page you'll find a link to the Draft Strategic Plan (2010-2012) as well as a link to a brief survey. Please take a few minutes to review the plan and respond to the survey. Keep in mind that the proposed goals and strategies provide an overall framework for the DPG?s efforts over the next 3 years. Specific tactics are being developed to help us achieve our goals. At this point in time, we just need to know if we are heading in the right direction. The CNM Executive Committee will be meeting in Denver on October 17. At that time, we hope to approve the draft plan and begin the next steps towards implementation. If possible, we'd like your feedback by October 15. We realize this is a quick turn-around time, but hope you will find a small piece of time in your day to respond. The survey includes only 5 questions and should not take long to complete. Thank you, in advance, for your response. We believe we are moving in the right direction and need to hear if you agree. Marsha Schofield Strategic Planning Facilitator Mary Jane Rogalski CNM Chair Click here to begin: http://www.cnmdpg.org/MemIndex_300.cfm -------------- next part -------------- An HTML attachment was scrubbed... URL: From ESCOTTSTUMPS at ecu.edu Sat Oct 10 05:59:35 2009 From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia) Date: Sat, 10 Oct 2009 08:59:35 -0400 Subject: [Cnm] CNM posting In-Reply-To: <025C75578D13B14EBEFD7EF74F9FC5D43938D74D8A@ecumb2.intra.ecu.edu> References: , <025C75578D13B14EBEFD7EF74F9FC5D43938D74D8A@ecumb2.intra.ecu.edu> Message-ID: This is a job here where I live in Greenville, NC. Large tertiary care teaching hospital affiliated with our Brody School of Medicine. Great opportunity!! Sylvia Escott-Stump, MA, RD, LDN Dietetic Internship Director East Carolina University 252-328-1352 Fax 252-328-4276 ________________________________________ This is an excellent opportunity for a young but not entry level professional.. we are poised at PCMH to really put clinical nutrition on the map.. not just for PCMH but for the whole system. Please share with those who might be interested.. or know of folks interested. Kathryn M Kolasa PhD, RD, LDN Professor Department of Family Medicine; of Pediatrics Brody School of Medicine at East Carolina University Greenville, NC 27834 252.744.5462 252.744.3040 Fax kolasaka at ecu.edu ________________________________________ Clinical Nutrition Manager - Greenville, NC - 52939 Description ARAMARK is one of America's largest employers of dietitians, and is currently the only professional services company to become an American Dietetic Association (ADA) Partner. The ADA is the nation's largest organization of food and nutrition professionals. ARAMARK was ranked number one in its industry in the 2007 FORTUNE 500 survey and has consistently ranked since 1998 as one of the top three in its industry among FORTUNE's "America's Most Admired Companies." Understanding that clinical excellence and the environment are interdependent, ARAMARK Healthcare makes an impact by helping nearly 1,300 partners across North America deliver the optimal healthcare experience for patients and their families and the physicians and nurses who care for them. As a Clinical Nutrition Manager at Pitt County Memorial Hospital you will plan, coordinate and manage all patient/resident nutrition care activities complying with the standards established by ARAMARK, regulatory agencies and client. You will develop and implement cost effective, profit-generating nutrition programs, function as a member of the multidisciplinary health care team to implement nutrition care plans, and establish and maintain policies, standards and programs for the provision of optimal, cost-effective nutrition care to patients/residents. This includes coordinating and directing all clinical activities and determining and implementing appropriate staffing levels. Qualifications Ideal candidates will possess a Bachelor's degree in Nutrition or Dietetics plus 2 years experience as a Clinical Dietitian. Registered Dietitian with the American Dietetic Association and Licensed Dietitian status is required if residing in a state with licensure. Excellent communication, management and leadership skills are essential. Job: Nutrition/Dietetics Primary Location: US-NC-Greenville Organization: HC - Midsouth From kmershon at bak.rr.com Sat Oct 10 10:28:04 2009 From: kmershon at bak.rr.com (Kathleen Mershon) Date: Sat, 10 Oct 2009 10:28:04 -0700 Subject: [Cnm] Passing trays in ICU In-Reply-To: References: Message-ID: <4AD0C424.8000709@bak.rr.com> We send our trays on a dual temp meal delivery cart that holds food hot and cold foods cold, for several hours allowing nursing to deliver a palatable meal when they have the time and the patient is ready. We pull the cart from the unit and return it to trayline just before the next trayline, in time to clean out and start again. Small carts 10 trays cost around $8 - $10 k. We just have the larger 20 tray carts and they run around $14 k. Kathleen Mershon, MS, RD Clinical Nutrition Manager San Joaquin Community Hospital Bakersfield, CA 93301 Susie Connell wrote: > Good Morning! > > We have an ongoing problem with trays being passed in timely manner in > ICU. > A lot of it is due to the higher acuity level and timing of meals in > relation to patient care. > However, there are times that it does not appear related at all. > Our ICU rarely has a patient tech to pass trays, which leaves it up to > nursing. > > Consequently, when the food is served, it is often reheated food. > Or the tray has sat for so long it is no longer safe, so the patient > gets a snack and waits until the next meal. > > Any suggestions for addressing or improving this issue is appreciated. > > > > */Susie Connell, MS, RD, LD > Clinical Nutrition Manager > /**/Atrium Medical Center > 3305 Corinth Parkway > Corinth , Texas 76208/* > */940-270-4196/* > */sconnell at atriumhealthcare.net > > > /* > > > > > i'm EMAILING FOR THE GREATER GOOD > Join me > > > ------------------------------------------------------------------------ > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > -------------- next part -------------- An HTML attachment was scrubbed... URL: From kmershon at bak.rr.com Sat Oct 10 10:33:00 2009 From: kmershon at bak.rr.com (Kathleen Mershon) Date: Sat, 10 Oct 2009 10:33:00 -0700 Subject: [Cnm] Patient not in room at meal delivery time In-Reply-To: <5E3E345918590D4D86333A4FCCF51A9002F326C5@EXCHVS.frhg.org> References: <5E3E345918590D4D86333A4FCCF51A9002F326C5@EXCHVS.frhg.org> Message-ID: <4AD0C54C.7020103@bak.rr.com> Well not sure what the CNM sessions in April are going to be but I did submit a proposal to share my presentation of what our hospital is doing to address this very problem using our At Your Service program and dual temp meal delivery carts. Kathleen Mershon, MS, RD Clinical Nutrition Manager San Joaquin Community Hospital Bakersfield, CA 93301 Sohal, Manjit wrote: > > We are having difficulty delivering meal trays to patients that are > off the floor for a procedure. The meal tray is delivered in the cart > and if the patient is off floor or NPO at time of meal delivery; our > hosts destroy the trays to ensure the tray won't be served to the > patient with unsafe food temps. However, nursing wants trays for > patients gone to x-ray to stay on the floor so they can serve them > when patient returns because they are claiming that it only takes 15 > minutes for patient to go to x-ray, have x-ray taken and return. > However, there's no guarantee that the patient will be back quick > enough for the food to be served hot. > > > > Another issue is if patient is off floor during meal service and the > tray is destroyed, a late tray must be ordered when patient returns, > however, the late-tray will be an across the board tray. If patient > had selected special food items for that meal, patient would not > receive it. > > > > How do other facilities deal with these issues? > > > > Manjit Sohal, MS, RD > Manager, Clinical Nutrition > Nutrition Services Department > *Fremont-Rideout Health Group* > 725 Fourth Street > Marysville, CA 95901 > Ph: 530.749.4336 > Pgr: 530.740.9992 > Fax: 530.749.4337 > www.frhg.org > > *Exceptional Care, Close to Home* > > > > ------------------------------------------------------------------------ > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > -------------- next part -------------- An HTML attachment was scrubbed... URL: From kmershon at bak.rr.com Sat Oct 10 10:33:41 2009 From: kmershon at bak.rr.com (Kathleen Mershon) Date: Sat, 10 Oct 2009 10:33:41 -0700 Subject: [Cnm] Patient not in room at meal delivery time In-Reply-To: <17B38BCEA6E6F24D9300FA8CFE81F4250133E36D@chimsx015.CHI.catholichealth.net> References: <5E3E345918590D4D86333A4FCCF51A9002F326C5@EXCHVS.frhg.org> <37ABAEB17B0B5B40AA0B6118E57CF59A0524DF8A@wn1221.or.providence.org> <17B38BCEA6E6F24D9300FA8CFE81F4250133E36D@chimsx015.CHI.catholichealth.net> Message-ID: <4AD0C575.4090003@bak.rr.com> Or use an alternative modified approach to room service. Kathleen Mershon, MS, RD Clinical Nutrition Manager San Joaquin Community Hospital Bakersfield, CA 93301 Karustis, Marcelle wrote: > > Amen! Just what I was going to say! > > > > 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 *Scollard, Terese > *Sent:* Friday, October 09, 2009 12:54 PM > *To:* Sohal, Manjit; cnm at lists.my180.net > *Subject:* Re: [Cnm] Patient not in room at meal delivery time > > > > Go to "Room Service"---only way to solve this problem. > > Terese Scollard > > > > *From:* Sohal, Manjit [mailto:msohal at frhg.org] > *Sent:* Thursday, October 08, 2009 2:40 PM > *To:* cnm at lists.my180.net > *Subject:* [Cnm] Patient not in room at meal delivery time > > > > We are having difficulty delivering meal trays to patients that are > off the floor for a procedure. The meal tray is delivered in the cart > and if the patient is off floor or NPO at time of meal delivery; our > hosts destroy the trays to ensure the tray won't be served to the > patient with unsafe food temps. However, nursing wants trays for > patients gone to x-ray to stay on the floor so they can serve them > when patient returns because they are claiming that it only takes 15 > minutes for patient to go to x-ray, have x-ray taken and return. > However, there's no guarantee that the patient will be back quick > enough for the food to be served hot. > > > > Another issue is if patient is off floor during meal service and the > tray is destroyed, a late tray must be ordered when patient returns, > however, the late-tray will be an across the board tray. If patient > had selected special food items for that meal, patient would not > receive it. > > > > How do other facilities deal with these issues? > > > > Manjit Sohal, MS, RD > Manager, Clinical Nutrition > Nutrition Services Department > *Fremont-Rideout Health Group* > 725 Fourth Street > Marysville, CA 95901 > Ph: 530.749.4336 > Pgr: 530.740.9992 > Fax: 530.749.4337 > www.frhg.org > > *Exceptional Care, Close to Home* > > > > > > ------------------------------------------------------------------------ > > This message is intended for the sole use of the addressee, and may > contain information that is privileged, confidential and exempt from > disclosure under applicable law. If you are not the addressee you are > hereby notified that you may not use, copy, disclose, or distribute to > anyone the message or any information contained in the message. If you > have received this message in error, please immediately advise the > sender by reply email and delete this message. > > > DISCLAIMER: 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. If you have received this > electronic mail in error, please notify the sender by way of reply. > Thank you for your consideration. > > > > ------------------------------------------------------------------------ > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > -------------- next part -------------- An HTML attachment was scrubbed... URL: From kmershon at bak.rr.com Sat Oct 10 10:34:16 2009 From: kmershon at bak.rr.com (Kathleen Mershon) Date: Sat, 10 Oct 2009 10:34:16 -0700 Subject: [Cnm] Patient not in room at meal delivery time In-Reply-To: <1C.10.16179.64A9FCA4@cdptpa-mxlb.mail.rr.com> References: <1C.10.16179.64A9FCA4@cdptpa-mxlb.mail.rr.com> Message-ID: <4AD0C598.5050304@bak.rr.com> Have the host or nursing aide assist. Kathleen Mershon, MS, RD Clinical Nutrition Manager San Joaquin Community Hospital Bakersfield, CA 93301 Annette Doucet wrote: > > We have a lot of elderly patients who would have problems calling > their menu in, if we used room service. What do you do for that type > of patient? > > > > ------------------------------------------------------------------------ > > *From:* cnm-bounces at lists.my180.net > [mailto:cnm-bounces at lists.my180.net] *On Behalf Of *Karustis, Marcelle > *Sent:* Friday, October 09, 2009 1:20 PM > *To:* Scollard, Terese; Sohal, Manjit; cnm at lists.my180.net > *Subject:* Re: [Cnm] Patient not in room at meal delivery time > > > > Amen! Just what I was going to say! > > > > 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 *Scollard, Terese > *Sent:* Friday, October 09, 2009 12:54 PM > *To:* Sohal, Manjit; cnm at lists.my180.net > *Subject:* Re: [Cnm] Patient not in room at meal delivery time > > > > Go to "Room Service"---only way to solve this problem. > > Terese Scollard > > > > *From:* Sohal, Manjit [mailto:msohal at frhg.org] > *Sent:* Thursday, October 08, 2009 2:40 PM > *To:* cnm at lists.my180.net > *Subject:* [Cnm] Patient not in room at meal delivery time > > > > We are having difficulty delivering meal trays to patients that are > off the floor for a procedure. The meal tray is delivered in the cart > and if the patient is off floor or NPO at time of meal delivery; our > hosts destroy the trays to ensure the tray won't be served to the > patient with unsafe food temps. However, nursing wants trays for > patients gone to x-ray to stay on the floor so they can serve them > when patient returns because they are claiming that it only takes 15 > minutes for patient to go to x-ray, have x-ray taken and return. > However, there's no guarantee that the patient will be back quick > enough for the food to be served hot. > > > > Another issue is if patient is off floor during meal service and the > tray is destroyed, a late tray must be ordered when patient returns, > however, the late-tray will be an across the board tray. If patient > had selected special food items for that meal, patient would not > receive it. > > > > How do other facilities deal with these issues? > > > > Manjit Sohal, MS, RD > Manager, Clinical Nutrition > Nutrition Services Department > *Fremont-Rideout Health Group* > 725 Fourth Street > Marysville, CA 95901 > Ph: 530.749.4336 > Pgr: 530.740.9992 > Fax: 530.749.4337 > www.frhg.org > > *Exceptional Care, Close to Home* > > > > > > ------------------------------------------------------------------------ > > This message is intended for the sole use of the addressee, and may > contain information that is privileged, confidential and exempt from > disclosure under applicable law. If you are not the addressee you are > hereby notified that you may not use, copy, disclose, or distribute to > anyone the message or any information contained in the message. If you > have received this message in error, please immediately advise the > sender by reply email and delete this message. > > > > > DISCLAIMER: 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. > > If you have received this electronic mail in error, please notify the sender by way of reply. Thank you for your consideration. > > > > ------------------------------------------------------------------------ > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > -------------- next part -------------- An HTML attachment was scrubbed... URL: From aimeenut at yahoo.com Mon Oct 12 06:41:50 2009 From: aimeenut at yahoo.com (aimee crant) Date: Mon, 12 Oct 2009 06:41:50 -0700 (PDT) Subject: [Cnm] Ukranian diet materials Message-ID: <200202.94549.qm@web52608.mail.re2.yahoo.com> Does anyone have or know where to download a diet in Ukranian for soidum, potassium and phosphorus restrictions?? Thanks ?Aimee Crant-Oksa MS, RD Clinical Nutrition Manager Centrastate Medical Center tel: 732-294-2767 email: acrantok at centrastate.com From JEdwards at hfmhealth.org Mon Oct 12 07:10:25 2009 From: JEdwards at hfmhealth.org (Jeanne Edwards) Date: Mon, 12 Oct 2009 09:10:25 -0500 Subject: [Cnm] Ukranian diet materials Message-ID: http://monarch.gsu.edu/multiculturalhealth/handouts Have you tried this ? I am not sure if it has the restrictions You are looking for. I have another web page for Russian info, but believe that is Different from Ukranian. If you want that, let me know. Jeanne Edwards MS RD 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 aimee crant Sent: Monday, October 12, 2009 8:42 AM To: cnm at lists.my180.net Cc: acrantok at centrastate.com; thall at centrastate.com Subject: [Cnm] Ukranian diet materials Does anyone have or know where to download a diet in Ukranian for soidum, potassium and phosphorus restrictions?? Thanks ?Aimee Crant-Oksa MS, RD Clinical Nutrition Manager Centrastate Medical Center tel: 732-294-2767 email: acrantok at centrastate.com _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From Neelam.Verma2 at HCAHealthcare.com Mon Oct 12 07:55:51 2009 From: Neelam.Verma2 at HCAHealthcare.com (Verma Neelam) Date: Mon, 12 Oct 2009 09:55:51 -0500 Subject: [Cnm] (no subject) Message-ID: <4CC8675C05743E44A5A85E744D11215D569C28E618@FWDCWPMSGCMS06.hca.corpad.net> Please take me off the list from 10/12 --10/20/09 Thanks Neelam.verma 2 @ hcahealthcare.com -------------- next part -------------- An HTML attachment was scrubbed... URL: From fns at abbgen.net Mon Oct 12 08:16:02 2009 From: fns at abbgen.net (Annette Doucet) Date: Mon, 12 Oct 2009 10:16:02 -0500 Subject: [Cnm] Passing trays in ICU In-Reply-To: <4AD0C424.8000709@bak.rr.com> Message-ID: What brand cart are you using? Do your hospital participate in Press Ganey pt satisfaction surveys? Do you mind sharing what your scores are running as far as quality of food, hot food hot and cold food cold? Our hospital has a board directive of achieving 90% satisfaction. We are using Dinex carts and the Smart Therm induction heating units. _____ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Kathleen Mershon Sent: Saturday, October 10, 2009 12:28 PM To: Susie Connell Cc: cnm at lists.my180.net Subject: Re: [Cnm] Passing trays in ICU We send our trays on a dual temp meal delivery cart that holds food hot and cold foods cold, for several hours allowing nursing to deliver a palatable meal when they have the time and the patient is ready. We pull the cart from the unit and return it to trayline just before the next trayline, in time to clean out and start again. Small carts 10 trays cost around $8 - $10 k. We just have the larger 20 tray carts and they run around $14 k. Kathleen Mershon, MS, RD Clinical Nutrition Manager San Joaquin Community Hospital Bakersfield, CA 93301 Susie Connell wrote: Good Morning! We have an ongoing problem with trays being passed in timely manner in ICU. A lot of it is due to the higher acuity level and timing of meals in relation to patient care. However, there are times that it does not appear related at all. Our ICU rarely has a patient tech to pass trays, which leaves it up to nursing. Consequently, when the food is served, it is often reheated food. Or the tray has sat for so long it is no longer safe, so the patient gets a snack and waits until the next meal. Any suggestions for addressing or improving this issue is appreciated. Susie Connell, MS, RD, LD Clinical Nutrition Manager Atrium Medical Center 3305 Corinth Parkway Corinth , Texas 76208 940-270-4196 sconnell at atriumhealthcare.net i'mEMAILING FOR THE GREATER GOOD Join me _____ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From ESCOTTSTUMPS at ecu.edu Thu Oct 8 04:19:35 2009 From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia) Date: Thu, 8 Oct 2009 07:19:35 -0400 Subject: [Cnm] (no subject) Message-ID: Public policy is on everyone's mind these days. Here are slides you might use to discuss the importance of getting involved by your team. College of Human Ecology Enriching Lives. Enhancing Communities. Sylvia Escott-Stump, MA, RD, LDN Legislative Chair, CNM 252-328-1352 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: Mary_Hager_ADA_Resources.pdf Type: application/pdf Size: 92164 bytes Desc: Mary_Hager_ADA_Resources.pdf URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: HealthCareReform.ppt Type: application/vnd.ms-powerpoint Size: 298496 bytes Desc: HealthCareReform.ppt URL: From marissa.hofman at ucdmc.ucdavis.edu Mon Oct 12 09:29:29 2009 From: marissa.hofman at ucdmc.ucdavis.edu (Marissa Hofman) Date: Mon, 12 Oct 2009 09:29:29 -0700 Subject: [Cnm] Question for Nevada RDs Message-ID: To practice dietetics in Nevada, are there any Licensure requirements? Our Transplant Center located in CA will be taking on patients in Reno, NV for another hospital. Since care will be provided across state lines, are there any unique state regs I need to consider for the RD to provide phone and telemed consults? Thank you. Marissa Hofman, MS, RD Clinical Nutrition Manager UC Davis Medical Center Food & Nutrition Dept. 2315 Stockton Blvd Sacramento, CA 95817 Phone: (916) 734-5100 Fax: (916)734-3154 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Melissa.Tewes at wchsys.org Fri Oct 9 08:33:23 2009 From: Melissa.Tewes at wchsys.org (Melissa Tewes) Date: Fri, 9 Oct 2009 11:33:23 -0400 Subject: [Cnm] Standards of Care Message-ID: Does anyone have a policy that you are willing to share regarding use of the ADA manual for standards of care? Thanks Melissa Tewes RD, LDN Clinical Nutrition Manager Washington County Hospital 251 E. Antietam St. Hagerstown, MD 21774 Direct Line: 301-790-8085 Fax: 301-790-8535 Melissa.Tewes at wchsys.org ________________________________ ***** CONFIDENTIALITY NOTICE ***** This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Amy.Childress at sodexo.com Mon Oct 12 09:52:02 2009 From: Amy.Childress at sodexo.com (Childress, Amy) Date: Mon, 12 Oct 2009 12:52:02 -0400 Subject: [Cnm] dating saltine crackers Message-ID: <24089FC2EA149A4693BAEEE1A69F26E603108504@nausbf-exmb01.na.sdxcorp.net> ?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????'????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????:)???????????????????????????????:)????????????????????????? ________________________________ Confidentiality Notice: This electronic message transmission contains information from Sodexo, Inc. which may be confidential and/or proprietary. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic transmission in error, please let us know by reply and then delete it from your system. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Julie.Finney at csauh.com Mon Oct 12 10:31:43 2009 From: Julie.Finney at csauh.com (Finney, Julie) Date: Mon, 12 Oct 2009 13:31:43 -0400 Subject: [Cnm] dating saltine crackers In-Reply-To: <24089FC2EA149A4693BAEEE1A69F26E603108504@nausbf-exmb01.na.sdxcorp.net> References: <24089FC2EA149A4693BAEEE1A69F26E603108504@nausbf-exmb01.na.sdxcorp.net> Message-ID: Oh my. We don't date our crackers or peanut butter either and I certainly don't want to start. I guess if a par level is established by each nursing unit that permits rapid turnover of floor stock items you would be able to say that due to turnover of product, you don't worry about expiration dates. Also, my HAACP training book lists cookies and crackers as having a 1 - 6 months shelf life. Surely the crackers that you send to the unit and gone in a month and certainly are gone in 6 months! Good luck, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Childress, Amy Sent: Monday, October 12, 2009 12:52 PM To: cnm at lists.my180.net Subject: [Cnm] dating saltine crackers Hello everyone, a question was asked by one of our nursing managers regarding their floor stock - "how do we know if the saltine crackers are expired?" Also, considering graham crackers, peanut butter, syrup - any of those little things are taken out of the original case and delivered. Does anyone have a system in place for this? I am trying to avoid dating each individual item house wide - thanks, Amy Amy Childress, RD Clinical Nutrition Manager Good Samaritan Hospital P: 213.977.2075 F: 213.977.2072 ________________________________ Confidentiality Notice: This electronic message transmission contains information from Sodexo, Inc. which may be confidential and/or proprietary. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic transmission in error, please let us know by reply and then delete it from your system. ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Michael.Smith at LPNT.net Mon Oct 12 11:32:29 2009 From: Michael.Smith at LPNT.net (Smith Michael - Palestine) Date: Mon, 12 Oct 2009 13:32:29 -0500 Subject: [Cnm] dating saltine crackers In-Reply-To: <24089FC2EA149A4693BAEEE1A69F26E603108504@nausbf-exmb01.na.sdxcorp.net> References: <24089FC2EA149A4693BAEEE1A69F26E603108504@nausbf-exmb01.na.sdxcorp.net> Message-ID: If I'm going to "date" a cracker I would rather date a Ritz. ; > ) 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 Childress, Amy Sent: Monday, October 12, 2009 11:52 AM To: cnm at lists.my180.net Subject: [Cnm] dating saltine crackers Hello everyone, a question was asked by one of our nursing managers regarding their floor stock - "how do we know if the saltine crackers are expired?" Also, considering graham crackers, peanut butter, syrup - any of those little things are taken out of the original case and delivered. Does anyone have a system in place for this? I am trying to avoid dating each individual item house wide - thanks, Amy Amy Childress, RD Clinical Nutrition Manager Good Samaritan Hospital P: 213.977.2075 F: 213.977.2072 ________________________________ Confidentiality Notice: This electronic message transmission contains information from Sodexo, Inc. which may be confidential and/or proprietary. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic transmission in error, please let us know by reply and then delete it from your system. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Shannon.Jackson at wilmed.org Mon Oct 12 11:35:52 2009 From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson) Date: Mon, 12 Oct 2009 14:35:52 -0400 Subject: [Cnm] Oncology Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F50A2@wmhcs03.wmh.org> Hi, What strategies are others using on their oncology units to help with meal satisfaction and patient tolerance of foods? Any specific menu items others are offering? 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Shannon.Jackson at wilmed.org Mon Oct 12 13:19:04 2009 From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson) Date: Mon, 12 Oct 2009 16:19:04 -0400 Subject: [Cnm] Coordinator/Diet Office Supervisor Meeting Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F50AC@wmhcs03.wmh.org> Hello: Does anyone have any tools/suggestions for conducting meetings for FNS Coordinators/Diet Office Supervisors? We have one Coordinator who has been here for 30 years, and it is very difficult to get her to change. Sometimes it seems as if she has tuned out and doesn't do what is asked of her. The coordinators have a lot of responsibility being added due to the pressure to improve patient satisfaction scores. We have also recently implemented Select Menus which has added more work for them. I am having a coordinator's meeting this week and would appreciate any ideas or tools to help with this meeting. Thanks in advance, 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From marissa.hofman at ucdmc.ucdavis.edu Mon Oct 12 14:18:59 2009 From: marissa.hofman at ucdmc.ucdavis.edu (Marissa Hofman) Date: Mon, 12 Oct 2009 14:18:59 -0700 Subject: [Cnm] Pediatric Assessment/Follow-up Time frames Message-ID: I'm curious what criteria other Children's Hospitals are using for timeframes of care for infants & pediatrics. Are time frames based on age of the patient (ie: 0-12 mos, > 1 year etc..) or are they consistent regardless of age? Thank you. Marissa Hofman, MS, RD Clinical Nutrition Manager UC Davis Medical Center Food & Nutrition Dept. 2315 Stockton Blvd Sacramento, CA 95817 Phone: (916) 734-5100 Fax: (916)734-3154 -------------- next part -------------- An HTML attachment was scrubbed... URL: From rossjanv at fuse.net Mon Oct 12 14:18:43 2009 From: rossjanv at fuse.net (Janet V. Ross) Date: Mon, 12 Oct 2009 17:18:43 -0400 Subject: [Cnm] dating saltine crackers In-Reply-To: Message-ID: <9E.D7.23671.34D93DA4@ecout2> We would send these items to the floor in a ziplock or small "box lunch" box-with a date on the outside. When the bag expired, everything in it was assumed to have expired. To make it really work, you need to teach staff not to consolidate bags when cleaning up the kitchen. 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 Finney, Julie Sent: Monday, October 12, 2009 1:32 PM To: Childress, Amy; cnm at lists.my180.net Subject: Re: [Cnm] dating saltine crackers Oh my. We don't date our crackers or peanut butter either and I certainly don't want to start. I guess if a par level is established by each nursing unit that permits rapid turnover of floor stock items you would be able to say that due to turnover of product, you don't worry about expiration dates. Also, my HAACP training book lists cookies and crackers as having a 1 - 6 months shelf life. Surely the crackers that you send to the unit and gone in a month and certainly are gone in 6 months! Good luck, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com _____ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Childress, Amy Sent: Monday, October 12, 2009 12:52 PM To: cnm at lists.my180.net Subject: [Cnm] dating saltine crackers Hello everyone, a question was asked by one of our nursing managers regarding their floor stock - "how do we know if the saltine crackers are expired?" Also, considering graham crackers, peanut butter, syrup - any of those little things are taken out of the original case and delivered. Does anyone have a system in place for this? I am trying to avoid dating each individual item house wide - thanks, Amy Amy Childress, RD Clinical Nutrition Manager Good Samaritan Hospital P: 213.977.2075 F: 213.977.2072 _____ Confidentiality Notice: This electronic message transmission contains information from Sodexo, Inc. which may be confidential and/or proprietary. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic transmission in error, please let us know by reply and then delete it from your system. _____ The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From rossjanv at fuse.net Mon Oct 12 14:25:22 2009 From: rossjanv at fuse.net (Janet V. Ross) Date: Mon, 12 Oct 2009 17:25:22 -0400 Subject: [Cnm] Coordinator/Diet Office Supervisor Meeting In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F50AC@wmhcs03.wmh.org> Message-ID: <8A.5D.15141.1DE93DA4@ecout1> My experience has been that correcting one person's deficiency in a group meeting is pointless. Your good folks dig in and work even harder. Your problem folks look around and say I guess everyone else is goofing off more than I am. Meet with the problem person one-on-one before the meeting. What works for me is to have written guidelines-in extreme detail. Every time we have a conflict or pt dissatisfaction, that issue gets added to the guidelines. In that way, new folks can be oriented and trained OR it can be used to have an intervention / evaluation with the ones who are not getting the job done. No one really reads these guidelines on a day to day basis, but in this way you assure that all are consistent and you have something to hold over your problem child. 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: Monday, October 12, 2009 4:19 PM To: cnm at lists.my180.net Subject: [Cnm] Coordinator/Diet Office Supervisor Meeting Hello: Does anyone have any tools/suggestions for conducting meetings for FNS Coordinators/Diet Office Supervisors? We have one Coordinator who has been here for 30 years, and it is very difficult to get her to change. Sometimes it seems as if she has tuned out and doesn't do what is asked of her. The coordinators have a lot of responsibility being added due to the pressure to improve patient satisfaction scores. We have also recently implemented Select Menus which has added more work for them. I am having a coordinator's meeting this week and would appreciate any ideas or tools to help with this meeting. Thanks in advance, 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From ESCOTTSTUMPS at ecu.edu Mon Oct 12 14:47:46 2009 From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia) Date: Mon, 12 Oct 2009 17:47:46 -0400 Subject: [Cnm] All-Member On the Pulse Message-ID: As noted below, Health Care Reform is a hot topic in D.C. these days! College of Human Ecology Enriching Lives. Enhancing Communities. Sylvia Escott-Stump, MA, RD, LDN Dietetic Internship Director East Carolina University 252-328-1352 Fax 252-328-4276 Internship website: http://www.ecu.edu/che/nutr/dieteticinternship.html ________________________________ From: Mary Hager [MHager at eatright.org] Sent: Monday, October 12, 2009 2:40 PM To: Escott-Stump, Sylvia Subject: RE: [Cnm] (no subject) Hi Sylvia, I encourage you to invite the CNM membership to read the Wednesday all-member health care reform updates. Since HCR is a rapidly moving target, we are making every effort to help ADA members follow the issues and be involved advocates. Thank you for taking on the task of communicating the importance of health care reform. Best 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 [cid:image001.jpg at 01CA4B49.EF1AD790] From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Escott-Stump, Sylvia Sent: Thursday, October 08, 2009 7:20 AM To: CNM Subject: [Cnm] (no subject) Public policy is on everyone's mind these days. Here are slides you might use to discuss the importance of getting involved by your team. College of Human Ecology Enriching Lives. Enhancing Communities. Sylvia Escott-Stump, MA, RD, LDN Legislative Chair, CNM 252-328-1352 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 3751 bytes Desc: image001.jpg URL: From RODR at phin.org Tue Oct 13 04:47:32 2009 From: RODR at phin.org (Rodney, Rachel) Date: Tue, 13 Oct 2009 07:47:32 -0400 Subject: [Cnm] PES statements Message-ID: <149E946FB3E25C4F92AAC2B02F93CC4D02F6635C@mail.corp.svhc.net> Can someone explain what you do when you see a patient that is not at nutritional risk? How do you write a PES statement on them? Or, maybe the question should be: do you write a PES statement or give a nutrition dx on these patients? I know this has been addressed before, but what resources would you recommend to help me learn the NCP? Thanks in advance! Rachel Rodney Rachel Rodney RD, CD, CDE Southwestern Vermont Medical Center 100 Hospital Drive Bennington, VT 05201 802-447-5577 (office) 802-742-8599 (pager) rodr at phin.org DISCLAIMER: The information contained in this electronic message is legally privileged and confidential under applicable law and is intended for a particular addressee(s). If it is not clear that you are the intended recipient, you are hereby notified that you have received this transmittal in error; any review, copying or distribution or dissemination is strictly prohibited. If you suspect that you have received this transmittal in error, please notify Southwestern VT Health Care Corporation immediately by return email reply to (helpdesk at phin.org), and immediately delete the transmittal and any attachments without making any copy or distribution. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From pcharney at mac.com Tue Oct 13 05:07:12 2009 From: pcharney at mac.com (Pam Charney) Date: Tue, 13 Oct 2009 05:07:12 -0700 Subject: [Cnm] PES statements In-Reply-To: <149E946FB3E25C4F92AAC2B02F93CC4D02F6635C@mail.corp.svhc.net> References: <149E946FB3E25C4F92AAC2B02F93CC4D02F6635C@mail.corp.svhc.net> Message-ID: Greetings, You don't diagnose a nutrition problem (i.e., write a PES statement) if the patient has no nutrition problem. I've taught a number of workshops on the Nutrition Care Process and learning diagnostic skills, as have a number of others on this list. Your affiliate may have offered sessions, as well as sessions at FNCE and other meetings. Annalynn Skipper and I have taught symposiums at FNCE as well as Clinical Nutrition Week. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 13, 2009, at 4:47 AM, Rodney, Rachel wrote: > Can someone explain what you do when you see a patient that is not > at nutritional risk? How do you write a PES statement on them? Or, > maybe the question should be: do you write a PES statement or give a > nutrition dx on these patients? > > I know this has been addressed before, but what resources would you > recommend to help me learn the NCP? > > Thanks in advance! > Rachel Rodney > > Rachel Rodney RD, CD, CDE > Southwestern Vermont Medical Center > 100 Hospital Drive > Bennington, VT 05201 > 802-447-5577 (office) > 802-742-8599 (pager) > rodr at phin.org > > DISCLAIMER: The information contained in this electronic message is > legally privileged and confidential under applicable law and is > intended > for a particular addressee(s). If it is not clear that you are the > intended > recipient, you are hereby notified that you have received this > transmittal > in error; any review, copying or distribution or dissemination is > strictly > prohibited. If you suspect that you have received this transmittal in > error, please notify Southwestern VT Health Care Corporation > immediately by return email reply to (helpdesk at phin.org), and > immediately delete the transmittal and any attachments without making > any copy or distribution. Thank you. > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From rdallosta at mcvh-vcu.edu Tue Oct 13 06:15:23 2009 From: rdallosta at mcvh-vcu.edu (Regine Dallosta) Date: Tue, 13 Oct 2009 09:15:23 -0400 Subject: [Cnm] Position Description and Performance Plan for a CDE In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F50AC@wmhcs03.wmh.org> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F50AC@wmhcs03.wmh.org> Message-ID: An HTML attachment was scrubbed... URL: From kmonahan at sjmh.org Tue Oct 13 07:02:09 2009 From: kmonahan at sjmh.org (Monahan, Kristi) Date: Tue, 13 Oct 2009 10:02:09 -0400 Subject: [Cnm] Adjusted Body Weight Message-ID: Hello, Curious, heard through the grapevine that adjusted body weight in no longer appropriate to use in a LTC setting. Is this true??? Thanks, Kristi Monahan, RD Confidentiality Notice: This email, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please reply to the sender that you have received the message in error, then delete this message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From cketterman at wellspan.org Tue Oct 13 08:46:46 2009 From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra) Date: Tue, 13 Oct 2009 11:46:46 -0400 Subject: [Cnm] Soy Allergy Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1F4B@EXCH4.wellspan.org> Hi everyone - How are you handling soy allergies for inpatients? Our chefs have such a high reliance on bases - beef base, chicken base, vegetable base (they even have a clam base) - that they add them to everything. So, when we have a soy allergy we end up giving them plain everything. I'd like to see us give up the bases - does your production staff have this great attachment to bases? 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. ______________________________________________________________________ -------------- next part -------------- An HTML attachment was scrubbed... URL: From clinut at marianhospital.org Tue Oct 13 09:15:21 2009 From: clinut at marianhospital.org (Coppola, Nicole) Date: Tue, 13 Oct 2009 12:15:21 -0400 Subject: [Cnm] health fair Message-ID: <024BA7AC01FC694CBFC3B9E4510A1AA90F913C@ITSSSXM01V4.one.ads.che.org> I am doing a health fair next month in a college setting, but for the general public. Just wondering if anyone had any ideas for topics to cover? I would like to do something different/interesting. Any input is greatly appreciated! Nicole Coppola, MS RD LDN Clinical Nutrition Manager Marian Community Hospital (570) 281-1024 Confidentiality Notice: This email, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please reply to the sender that you have received the message in error, then delete this message. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 5314 bytes Desc: image001.gif URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 978 bytes Desc: image002.gif URL: From LCarver at Reshealthcare.org Tue Oct 13 09:17:47 2009 From: LCarver at Reshealthcare.org (Carver, Leslee) Date: Tue, 13 Oct 2009 11:17:47 -0500 Subject: [Cnm] Soy Allergy In-Reply-To: <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1F4B@EXCH4.wellspan.org> References: <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1F4B@EXCH4.wellspan.org> Message-ID: <5330B54133B6194BA13930BDEFE9A30E051CF591@rhcexch3.reshealthcare.org> we only use the bases for soups. we also do not use soy oil in cooking. 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 Ketterman-Hopkins, Cindra Sent: Tuesday, October 13, 2009 10:47 AM To: cnm at lists.my180.net Subject: [Cnm] Soy Allergy Hi everyone - How are you handling soy allergies for inpatients? Our chefs have such a high reliance on bases - beef base, chicken base, vegetable base (they even have a clam base) - that they add them to everything. So, when we have a soy allergy we end up giving them plain everything. I'd like to see us give up the bases - does your production staff have this great attachment to bases? 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Leanne.Littrell at hma.com Tue Oct 13 09:29:57 2009 From: Leanne.Littrell at hma.com (Littrell, Leanne) Date: Tue, 13 Oct 2009 12:29:57 -0400 Subject: [Cnm] Questions on what are you using for screening criteria for OB, Pediatrics and NICU Message-ID: <4E3FEB15613D694A9CE182702F53959B037A6089@atl-ex1.hma.com> We are updating and revising policies and wanted some Feedback on what you are using for screening criteria for OB, NICU-level II, and Pediatrics? Thanks Leanne Pearson Littrell, MS, RD, LD Director of Nutrition Services Peace River Regional Medical Center 2500 Harbor Blvd Port Charlotte, FL 33952 941-766-4228 Fax-941-766-4218 Cell 941-769-1774 leanne.littrell at hma.com -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 917 bytes Desc: image001.gif URL: From CKeinath at chs-mi.com Tue Oct 13 09:34:11 2009 From: CKeinath at chs-mi.com (CKeinath at chs-mi.com) Date: 13-Oct-2009 12:34:11 EDT Subject: [Cnm] large equipment preventative maintenance An HTML attachment was scrubbed... URL: From Leanne.Littrell at hma.com Tue Oct 13 09:33:05 2009 From: Leanne.Littrell at hma.com (Littrell, Leanne) Date: Tue, 13 Oct 2009 12:33:05 -0400 Subject: [Cnm] question on dating single service items such as crackers Message-ID: <4E3FEB15613D694A9CE182702F53959B037A6092@atl-ex1.hma.com> I sent this question to JCAHO in May 2008 The following is the response I received: Items such as single serve peanut butter (1 oz), individual packets of crackers, individual sugars or artificial sweetener, catsup, mustard, tea bags do they need to be individually marked with the expiration date? Leanne, Our standards are silent related to marking 1 ounce packages with expiration dates. You need to check with the manufacturer regarding shelf life and check with the State licensing agency to see if they require this. Our standards do not require this. Billie Klesch-Sheeran Joint Commission Standards Interpretation Group Phone: 630-792-5900 Thanks Leanne Pearson Littrell, MS, RD, LD Director of Nutrition Services Peace River Regional Medical Center 2500 Harbor Blvd Port Charlotte, FL 33952 941-766-4228 Fax-941-766-4218 Cell 941-769-1774 leanne.littrell at hma.com -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 917 bytes Desc: image001.gif URL: From LCarver at Reshealthcare.org Tue Oct 13 09:53:51 2009 From: LCarver at Reshealthcare.org (Carver, Leslee) Date: Tue, 13 Oct 2009 11:53:51 -0500 Subject: [Cnm] Questions on what are you using for screening criteria for OB, Pediatrics and NICU In-Reply-To: <4E3FEB15613D694A9CE182702F53959B037A6089@atl-ex1.hma.com> References: <4E3FEB15613D694A9CE182702F53959B037A6089@atl-ex1.hma.com> Message-ID: <5330B54133B6194BA13930BDEFE9A30E051CF5E9@rhcexch3.reshealthcare.org> see attached 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 Littrell, Leanne Sent: Tuesday, October 13, 2009 11:30 AM To: cnm at lists.my180.net Subject: [Cnm] Questions on what are you using for screening criteria for OB,Pediatrics and NICU We are updating and revising policies and wanted some Feedback on what you are using for screening criteria for OB, NICU-level II, and Pediatrics? Thanks Leanne Pearson Littrell, MS, RD, LD Director of Nutrition Services Peace River Regional Medical Center 2500 Harbor Blvd Port Charlotte, FL 33952 941-766-4228 Fax-941-766-4218 Cell 941-769-1774 leanne.littrell at hma.com -------------- next part -------------- An HTML attachment was scrubbed... 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Name: Nutritional Screen - SCN 2008.doc Type: application/msword Size: 70656 bytes Desc: Nutritional Screen - SCN 2008.doc URL: From Annalynn_Skipper at Comcast.net Tue Oct 13 10:02:32 2009 From: Annalynn_Skipper at Comcast.net (Annalynn Skipper) Date: Tue, 13 Oct 2009 12:02:32 -0500 Subject: [Cnm] Adjusted Body Weight In-Reply-To: References: Message-ID: <1EF707847BEE4AD4A3B17155AD79FF7F@ANNALYNN> The weight used is based on the equation selected rather than by the setting where it is used. If the patient's needs would be best predicted by the Mifflin-St. Jeor (obese or regular weight healthy/outpatient adults), the Penn State (obese or critically ill adults) or the Ireton-Jones equations (obese, burned, and/or critically ill adults) then actual weight is preferred. If you are using other equations, you might look up the original studies to see the weight used during development. Otherwise, you risk decreasing the accuracy of the equations, which is already quite poor. 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: Monahan, Kristi [mailto:kmonahan at sjmh.org] Sent: Tuesday, October 13, 2009 9:02 AM To: cnm at lists.my180.net Subject: [Cnm] Adjusted Body Weight Hello, Curious, heard through the grapevine that adjusted body weight in no longer appropriate to use in a LTC setting. Is this true??? Thanks, Kristi Monahan, RD Confidentiality Notice: This email, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please reply to the sender that you have received the message in error, then delete this message. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 170 bytes Desc: not available URL: From addrdd at aol.com Tue Oct 13 12:44:24 2009 From: addrdd at aol.com (addrdd at aol.com) Date: Tue, 13 Oct 2009 15:44:24 -0400 Subject: [Cnm] Cnm Digest, Vol 35, Issue 30 In-Reply-To: Message-ID: <8CC1A54B3837905-4E94-102C@webmail-d062.sysops.aol.com> Skins turn black but the banana stays good if not refrigerated more than a few days. They turn black. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Kaplan, Melissa Sent: Thursday, October 08, 2009 8:11 AM To: cnm at lists.my180.net Subject: Re: [Cnm] Cnm Digest, Vol 35, Issue 30 Whats the deal w/ the rec to not refrigerate them? Melissa Kaplan, RD, LD/N Jackson Memorial Hospital 1611 NW 12th Ave. DTC Room: DB21J Miami, Florida 33136 ph: 305.585.8603 ph ext: 6-2291 fax: 305.585.8928 pgr: 1057 P Think Green! Please do not print this e-mail unless necessary. -----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: Thursday, October 08, 2009 9:03 AM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 30 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: I AM EATING BANANAS!!! (Mary Litchford) ---------------------------------------------------------------------- Message: 1 Date: Thu, 8 Oct 2009 09:02:34 -0400 From: "Mary Litchford" Subject: Re: [Cnm] I AM EATING BANANAS!!! To: "Shannon Byrd Jackson" , cnm at lists.my180.net Message-ID: <384-2200910481323446 at mindspring.com> Content-Type: text/plain; charset="us-ascii" What an interesting email about bananas circulating on several list servs- too bad it is full of half truths & fibs. I have pasted below the Nutrient Analysis Labs profile of a 7 inch banana. You will see that compared to the DRI, bananas are not rich in iron, B12, B6, magnesium or tryptophan. They do contain 3 gm of fiber per banana, or about 10% of the total fiber recommened (25-30 g/d). Bananas, raw Refuse: 36% (Skin) Scientific Name: Musa acuminata Colla NDB No: 09040 (Nutrient values and weights are for edible portion) Nutrient Units Value per 100 grams 1.00 X 1 medium (7" to 7-7/8" long) ------- 118g Proximates Water g74.9188.39 Energy kcal89105 Protein g1.091.29 Total lipid (fat) g0.330.39 Carbohydrate, by difference g22.8426.95 Fiber, total dietary g2.63.1 Sugars, total g12.2314.43 Sucrose g2.392.82 Glucose (dextrose) g4.985.88 Fructose g4.855.72 Lactose g0.000.00 Maltose g0.010.01 Galactose g0.000.00 Starch g5.386.35 Minerals Calcium, Ca mg56 Iron, Fe mg0.260.31 Magnesium, Mg mg2732 Phosphorus, P mg2226 Potassium, K mg358422 Sodium, Na mg11 Zinc, Zn mg0.150.18 Copper, Cu mg0.0780.092 Manganese, Mn mg0.2700.319 Fluoride, F mcg2.22.6 Selenium, Se mcg1.01.2 Vitamins Vitamin C, total ascorbic acid mg8.710.3 Thiamin mg0.0310.037 Riboflavin mg0.0730.086 Niacin mg0.6650.785 Pantothenic acid mg0.3340.394 Vitamin B-6 mg0.3670.433 Folate, total mcg2024 Folic acid mcg00 Folate, food mcg2024 Folate, DFE mcg_DFE2024 Choline, total mg9.811.6 Betaine mg0.10.1 Vitamin B-12 mcg0.000.00 Vitamin B-12, added mcg0.000.00 Vitamin A, RAE mcg_RAE34 Retinol mcg00 Carotene, beta mcg2631 Carotene, alpha mcg2530 Cryptoxanthin, beta mcg00 Vitamin A, IU IU6476 Lycopene mcg00 Lutein + zeaxanthin mcg2226 Vitamin E (alpha-tocopherol) mg0.100.12 Tocopherol, beta mg0.000.00 Tocopherol, gamma mg0.020.02 Tocopherol, delta mg0.010.01 Vitamin D (D2 + D3) mcg0.00.0 Vitamin D IU00 Vitamin K (phylloquinone) mcg0.50.6 Lipids Fatty acids, total saturated g0.1120.132 Fatty acids, total monounsaturated g0.0320.038 Fatty acids, total polyunsaturated g0.0730.086 Cholesterol mg00 Phytosterols mg1619 Amino acids Tryptophan g0.0090.011 Threonine g0.0280.033 Isoleucine g0.0280.033 Leucine g0.0680.080 Lysine g0.0500.059 Methionine g0.0080.009 Cystine g0.0090.011 Phenylalanine g0.0490.058 Tyrosine g0.0090.011 Valine g0.0470.055 Arginine g0.0490.058 Histidine g0.077 0.091 Alanine g0.0400.047 Aspartic acid g0.1240.146 Glutamic acid g0.1520.179 Glycine g0.0380.045 Proline g0.0280.033 Serine g0.0400.047 Mary Litchford PhD, RD, LDN mltphd at mindspring.com www.casesoftware.com CASE Software & Books your source for advanced level books & CE courses. ----- Original Message ----- From: Shannon Byrd Jackson To: cnm at lists.my180.net Sent: 10/7/2009 9:12:20 AM Subject: [Cnm] I AM EATING BANANAS!!! Thought I'd share this with you all.... I AM EATING BANANAS!!! A professor at CCNY for a physiological psych class told his class about bananas. He said the expression "going bananas" is from the effects of bananas on the brain. Read on: Never, put your banana in the refrigerator!!! This is interesting. After reading this, you'll never look at a banana in the same way again.. Bananas contain three natural sugars - sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world's leading athletes. But energy isn't the only way a banana can help us keep fit. It can also help overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet.. Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier. PMS: Forget the pills - eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood. Anemia : High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia. Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, makin g it perfect to beat blood pressure. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit's ability to reduce the risk of blood pressure and stroke. Brain Power: 200 students at a Twickenham (Middlesex) school ( England ) were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert. Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives. Hangovers: One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system. Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief. Morning Sickness: Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation. Nerves: Bananas are high in B vitamins that help calm the nervous system. Overweight and at work? Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and chips. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high-pressure jobs. The report concluded that, to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady. Ulcers: The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over-chronicler cases. It also neutralizes over-acidity and reduces irritation by coating the lining of the stomach.. Temperature control: Many other cultures see bananas as a "cooling" fruit that can lower both the physical and emotional temperature of expectant mothers.. In Thailand , for example, pregnant women eat bananas to ensure their baby is born with a cool temperature. Seasonal Affective Disorder (SAD): Bananas can help SAD sufferers because they contain the natural mood enhancer tryptophan. Smoking &Tobacco Use: Bananas can also help people trying to give up smoking. The B6, B12 they contain, as well as the potassium and magnesium found in them, help the body recover from the effects of nicotine withdrawal. Stress: Potassium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body's water balance.. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack. Strokes: According to research in The New England Journal of Medicine, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%! Warts: Those keen on natural alternatives swear that if you want to kill off a wart, take a piece of banana skin and place it on the wart, with the yellow side out. Carefully hold the skin in place with a plaster or surgical tape! So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrate, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is one of the best value foods around So maybe its time to change that well-known phrase so that we say, "A banana a day keeps the doctor away!" PASS IT ON TO YOUR FRIENDS PS: Bananas must be the reason monkeys are so happy all the time! I will add one here; want a quick shine on our shoes?? Take the INSIDE of the banana skin, and rub directly on the shoe...polish with dry cloth. Amazing fruit !!! No virus found in this incoming message. Checked by AVG - www.avg.com Version: 8.5.409 / Virus Database: 270.14.2/2408 - Release Date: 10/01/09 18:23:00 Your E-mail and More On-the-Go. Get Windows Live Hotmail Free. Sign up now. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 18216 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 11156 bytes Desc: image002.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... 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Name: not available Type: image/jpeg Size: 25607 bytes Desc: image004.jpg URL: ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 30 *********************************** _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cn m_lists.my180.net _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -----Original Message----- From: Bobbi Homola To: Kaplan, Melissa ; cnm at lists.my180.net Sent: Thu, Oct 8, 2009 8:49 am Subject: Re: [Cnm] Cnm Digest, Vol 35, Issue 30 They turn black. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Kaplan, Melissa Sent: Thursday, October 08, 2009 8:11 AM To: cnm at lists.my180.net Subject: Re: [Cnm] Cnm Digest, Vol 35, Issue 30 Whats the deal w/ the rec to not refrigerate them? Melissa Kaplan, RD, LD/N Jackson Memorial Hospital 1611 NW 12th Ave. DTC Room: DB21J Miami, Florida 33136 ph: 305.585.8603 ph ext: 6-2291 fax: 305.585.8928 pgr: 1057 P Think Green! Please do not print this e-mail unless necessary. -----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: Thursday, October 08, 2009 9:03 AM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 30 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: I AM EATING BANANAS!!! (Mary Litchford) ---------------------------------------------------------------------- Message: 1 Date: Thu, 8 Oct 2009 09:02:34 -0400 From: "Mary Litchford" Subject: Re: [Cnm] I AM EATING BANANAS!!! To: "Shannon Byrd Jackson" , cnm at lists.my180.net Message-ID: <384-2200910481323446 at mindspring.com> Content-Type: text/plain; charset="us-ascii" What an interesting email about bananas circulating on several list servs- too bad it is full of half truths & fibs. I have pasted below the Nutrient Analysis Labs profile of a 7 inch banana. You will see that compared to the DRI, bananas are not rich in iron, B12, B6, magnesium or tryptophan. They do contain 3 gm of fiber per banana, or about 10% of the total fiber recommened (25-30 g/d). Bananas, raw Refuse: 36% (Skin) Scientific Name: Musa acuminata Colla NDB No: 09040 (Nutrient values and weights are for edible portion) Nutrient Units Value per 100 grams 1.00 X 1 medium (7" to 7-7/8" long) ------- 118g Proximates Water g74.9188.39 Energy kcal89105 Protein g1.091.29 Total lipid (fat) g0.330.39 Carbohydrate, by difference g22.8426.95 Fiber, total dietary g2.63.1 Sugars, total g12.2314.43 Sucrose g2.392.82 Glucose (dextrose) g4.985.88 Fructose g4.855.72 Lactose g0.000.00 Maltose g0.010.01 Galactose g0.000.00 Starch g5.386.35 Minerals Calcium, Ca mg56 Iron, Fe mg0.260.31 Magnesium, Mg mg2732 Phosphorus, P mg2226 Potassium, K mg358422 Sodium, Na mg11 Zinc, Zn mg0.150.18 Copper, Cu mg0.0780.092 Manganese, Mn mg0.2700.319 Fluoride, F mcg2.22.6 Selenium, Se mcg1.01.2 Vitamins Vitamin C, total ascorbic acid mg8.710.3 Thiamin mg0.0310.037 Riboflavin mg0.0730.086 Niacin mg0.6650.785 Pantothenic acid mg0.3340.394 Vitamin B-6 mg0.3670.433 Folate, total mcg2024 Folic acid mcg00 Folate, food mcg2024 Folate, DFE mcg_DFE2024 Choline, total mg9.811.6 Betaine mg0.10.1 Vitamin B-12 mcg0.000.00 Vitamin B-12, added mcg0.000.00 Vitamin A, RAE mcg_RAE34 Retinol mcg00 Carotene, beta mcg2631 Carotene, alpha mcg2530 Cryptoxanthin, beta mcg00 Vitamin A, IU IU6476 Lycopene mcg00 Lutein + zeaxanthin mcg2226 Vitamin E (alpha-tocopherol) mg0.100.12 Tocopherol, beta mg0.000.00 Tocopherol, gamma mg0.020.02 Tocopherol, delta mg0.010.01 Vitamin D (D2 + D3) mcg0.00.0 Vitamin D IU00 Vitamin K (phylloquinone) mcg0.50.6 Lipids Fatty acids, total saturated g0.1120.132 Fatty acids, total monounsaturated g0.0320.038 Fatty acids, total polyunsaturated g0.0730.086 Cholesterol mg00 Phytosterols mg1619 Amino acids Tryptophan g0.0090.011 Threonine g0.0280.033 Isoleucine g0.0280.033 Leucine g0.0680.080 Lysine g0.0500.059 Methionine g0.0080.009 Cystine g0.0090.011 Phenylalanine g0.0490.058 Tyrosine g0.0090.011 Valine g0.0470.055 Arginine g0.0490.058 Histidine g0.077 0.091 Alanine g0.0400.047 Aspartic acid g0.1240.146 Glutamic acid g0.1520.179 Glycine g0.0380.045 Proline g0.0280.033 Serine g0.0400.047 Mary Litchford PhD, RD, LDN mltphd at mindspring.com www.casesoftware.com CASE Software & Books your source for advanced level books & CE courses. ----- Original Message ----- From: Shannon Byrd Jackson To: cnm at lists.my180.net Sent: 10/7/2009 9:12:20 AM Subject: [Cnm] I AM EATING BANANAS!!! Thought I'd share this with you all.... I AM EATING BANANAS!!! A professor at CCNY for a physiological psych class told his class about bananas. He said the expression "going bananas" is from the effects of bananas on the brain. Read on: Never, put your banana in the refrigerator!!! This is interesting. After reading this, you'll never look at a banana in the same way again.. Bananas contain three natural sugars - sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world's leading athletes. But energy isn't the only way a banana can help us keep fit. It can also help overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet.. Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier. PMS: Forget the pills - eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood. Anemia : High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia. Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, makin g it perfect to beat blood pressure. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit's ability to reduce the risk of blood pressure and stroke. Brain Power: 200 students at a Twickenham (Middlesex) school ( England ) were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert. Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives. Hangovers: One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system. Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief. Morning Sickness: Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation. Nerves: Bananas are high in B vitamins that help calm the nervous system. Overweight and at work? Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and chips. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high-pressure jobs. The report concluded that, to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady. Ulcers: The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over-chronicler cases. It also neutralizes over-acidity and reduces irritation by coating the lining of the stomach.. Temperature control: Many other cultures see bananas as a "cooling" fruit that can lower both the physical and emotional temperature of expectant mothers.. In Thailand , for example, pregnant women eat bananas to ensure their baby is born with a cool temperature. Seasonal Affective Disorder (SAD): Bananas can help SAD sufferers because they contain the natural mood enhancer tryptophan. Smoking &Tobacco Use: Bananas can also help people trying to give up smoking. The B6, B12 they contain, as well as the potassium and magnesium found in them, help the body recover from the effects of nicotine withdrawal. Stress: Potassium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body's water balance.. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack. Strokes: According to research in The New England Journal of Medicine, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%! Warts: Those keen on natural alternatives swear that if you want to kill off a wart, take a piece of banana skin and place it on the wart, with the yellow side out. Carefully hold the skin in place with a plaster or surgical tape! So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrate, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is one of the best value foods around So maybe its time to change that well-known phrase so that we say, "A banana a day keeps the doctor away!" PASS IT ON TO YOUR FRIENDS PS: Bananas must be the reason monkeys are so happy all the time! I will add one here; want a quick shine on our shoes?? Take the INSIDE of the banana skin, and rub directly on the shoe...polish with dry cloth. Amazing fruit !!! No virus found in this incoming message. Checked by AVG - www.avg.com Version: 8.5.409 / Virus Database: 270.14.2/2408 - Release Date: 10/01/09 18:23:00 Your E-mail and More On-the-Go. Get Windows Live Hotmail Free. Sign up now. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 18216 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 11156 bytes Desc: image002.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 632 bytes Desc: image001(1).jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 25607 bytes Desc: image004.jpg URL: ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 30 *********************************** _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cn m_lists.my180.net _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From hpatronik at shorehealth.org Tue Oct 13 12:48:21 2009 From: hpatronik at shorehealth.org (Holly Patronik) Date: Tue, 13 Oct 2009 15:48:21 -0400 Subject: [Cnm] carafate Message-ID: what are others doing in regards to holding TF for carafate?? Holly Patronik, RD, LDN Clinical Nutrition Manager, Sodexo 219 South Washington Street Easton, Maryland 21601 410-822-1000, ext 5624 410-819-0989 (fax) *** The information contained in this transmission is confidential and is intended only for the individual named above. If you have received this information in error, please notify the sender immediately and delete this message. If the reader of this message is not the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of the communication or its contents is strictly prohibited -------------- next part -------------- An HTML attachment was scrubbed... URL: From Heberle-Heather at aramark.com Tue Oct 13 13:16:08 2009 From: Heberle-Heather at aramark.com (Heberle, Heather N.) Date: Tue, 13 Oct 2009 16:16:08 -0400 Subject: [Cnm] Macular Degeneration Message-ID: Has anyone heard anything about a new diet for macular degeneration? Does anyone have any good reference materials? Thanks. Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 From smcadoo1 at jhmi.edu Wed Oct 14 05:44:18 2009 From: smcadoo1 at jhmi.edu (Sylvia McAdoo) Date: Wed, 14 Oct 2009 08:44:18 -0400 Subject: [Cnm] Johns Hopkins Pediatric Conference - APN 2009 in Annapolis, Maryland Message-ID: THE 9TH ADVANCES IN PEDIATRIC NUTRITION, Presented by Johns Hopkins University School of Medicine November 2-3, 2009 in Annapolis, Maryland. See website below for full conference information and to download the brochure for registration. http://www.hopkinscme.edu/CourseDetail.aspx/80022087 APN 2009 Program Monday, Nov 2 7:00-8:00 Registration and Breakfast 8:00-8:30 Welcome and Introduction Maria Oliva-Hemker, MD 8:30-9:30 Human milk for the premature infant: evidence and practice Paula Meier, RN, DNSc, FAAN 9:30-9:45 Break 9:45-10:45 Food Allergy update Robert Wood, MD 10:45-11:45 Functional foods in digestive orders Gerald Mullin, MD, MHS, CNSP 11:45-1:00 Lunch with the Experts 1:00-2:00 Workshop I (Choose One) A. Nutrition hot topics: facts vs fiction with popular pediatric diets. Zahava Turner, RD, CSP B. Kidney disease conundrums: case studies in renal replacement therapy. Laura Postin, MS, RD C. Fueling the pediatric athlete. Mary Sheehan, RD D. Special Considerations for Managing Multiple Severe Food Allergies Tiffani Hays, MS, RD, CDE 2:00-3:00 Workshop I Repeated Monday Evening Program 6:00-7:00PM Cocktail Reception 7:00-8:30PM Keynote Speaker & Dinner Vitamin D- who needs it and how much? Michael Holick, PhD, MD Tuesday, Nov 3 7:15-7:55AM Breakfast 7:55 Announcements 8:00-8:30 Bariatric Surgery in Pediatric Patients Shelly Kirk, PhD, RD 8:30-9:00 genetic disorders of obesity Ann Scheimann, MD, MBA 9:00-9:30 Pediatric Obesity: preventative measures and medical interventions Alan Lake, MD 9:30-10:00 Panel Discussion Moderator - Jenifer Hampsey, MS,RD, CSP 10:00-10:30 Break 10:30-11:30 Workshop II A. Strategies to optimize the nutrition status of oncology patients Amy Schwartz, RD, CNSC, CSP B. Winning at losing: successful strategies for pediatric weight management. Michelle Demuele-Hayes, MS, RD, CSP C. Early childhood feeding: Can it improve long-term health? Amanda Leonard, MPH, RD, CDE D. Innovations in infant formulas Jennifer Dorward, RD, CSP 11:30-12:30 Workshop II Repeated 12:30-1:45 Luncheon & lecture: Tackling pediatric eating behaviors * GI issues in autism disorders Carol Redel, MD * New developments in infant feeding behaviors Jenny Fischer, PhD 1:45-2:00 Closing Ann Scheimann, MD, MBA & Tiffani Hays, MS, RD, CDE Sylvia McAdoo, MS, RD, LDN Director of Pediatric Nutrition Division of Pediatric Gastroenterology and Nutrition Johns Hopkins Children's Center 600 N. Wolfe Street, Brady 304 Baltimore, MD 21287 Phone: (410) 955-5177 Fax: (410) 502-9029 -------------- next part -------------- An HTML attachment was scrubbed... URL: From dlquirk at lexhealth.org Wed Oct 14 05:57:06 2009 From: dlquirk at lexhealth.org (Donna Quirk) Date: Wed, 14 Oct 2009 08:57:06 -0400 Subject: [Cnm] Arixtra Message-ID: Should patients on Arixtra receive education on Vitamin K food sources? If not, are there any food-drug interactions? We have not been able to identify any education requirements but want to confirm. Thanks, Donna Donna Quirk MBA RD LD Clinical Nutrition Manager Lexington Medical Center 2720 Sunset Blvd West Columbia, SC 29169 803-791-2248 ______________________________________________________________________ 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: From fynan-carla at CooperHealth.edu Wed Oct 14 06:13:13 2009 From: fynan-carla at CooperHealth.edu (Fynan, Carla) Date: Wed, 14 Oct 2009 09:13:13 -0400 Subject: [Cnm] Epic and NCP Message-ID: <77F33794DD223B40BF24AB3D379302501997A78564@mxmbx01.chsmail.root.cooperhealth.edu> Good Morning! We now have Epic Electronic Health Records for Physicians and Nursing. Phase 2 will include Food & Nutrition. We will be building the assessments, etc. and I would like to initiate the NCP at the same time. Has anyone done this in the past few years that could give me any pointers? Thank you and Make it a Great Day! Carla Fynan, RD Clinical Nutrition Manager Food & Nutrition Department Cooper University Hospital One Cooper Paza Camden, NJ 08103 (856) 342-2320 **************************************************************** This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed. If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited. If you received this email in error, please notify the sender by replying to this message and delete this email immediately. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Annalynn_Skipper at Comcast.net Wed Oct 14 06:17:16 2009 From: Annalynn_Skipper at Comcast.net (Annalynn Skipper) Date: Wed, 14 Oct 2009 08:17:16 -0500 Subject: [Cnm] clinical order writing privileges book announcement Message-ID: <628B40C096BF4F43BE9D6528A30FB709@ANNALYNN> Since this has been such a hot topic, I thought I would let you all know that a new book A Comprehensive Guide to Obtaining Order Writing Privileges by Silver, Skipper and Moreland has been published. At FNCE, you can see a copy in the Member Product Marketplace (Sunday only) at the Helm Publishing booth. Further information about the book is available at the link above. 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 170 bytes Desc: not available URL: From bhomola at comhs.org Wed Oct 14 06:22:24 2009 From: bhomola at comhs.org (Bobbi Homola) Date: Wed, 14 Oct 2009 08:22:24 -0500 Subject: [Cnm] Epic and NCP In-Reply-To: <77F33794DD223B40BF24AB3D379302501997A78564@mxmbx01.chsmail.root.cooperhealth.edu> Message-ID: We are in the same boat. Please share with the list. Thank you, Bobbi Bobbi Homola, MPA, RD, CD Clinical Manager, Food and Nutrition Services St. Mary Medical Center / St. Catherine Hospital 1500 South Lake Park Avenue Hobart, IN 46342 219-947-6048 / 219-392-7081 219-947-6049 fax bhomola at comhs.org -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Fynan, Carla Sent: Wednesday, October 14, 2009 8:13 AM To: CNM Mailing List (Cnm at lists.my180.net) Subject: [Cnm] Epic and NCP Good Morning! We now have Epic Electronic Health Records for Physicians and Nursing. Phase 2 will include Food & Nutrition. We will be building the assessments, etc. and I would like to initiate the NCP at the same time. Has anyone done this in the past few years that could give me any pointers? Thank you and Make it a Great Day! Carla Fynan, RD Clinical Nutrition Manager Food & Nutrition Department Cooper University Hospital One Cooper Paza Camden, NJ 08103 (856) 342-2320 **************************************************************** This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed. If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited. If you received this email in error, please notify the sender by replying to this message and delete this email immediately. -------------- next part -------------- An HTML attachment was scrubbed... URL: From bhaine at Elliot-HS.org Wed Oct 14 06:32:51 2009 From: bhaine at Elliot-HS.org (Haine, Barbara) Date: Wed, 14 Oct 2009 09:32:51 -0400 Subject: [Cnm] Epic and NCP In-Reply-To: <77F33794DD223B40BF24AB3D379302501997A78564@mxmbx01.chsmail.root.cooperhealth.edu> References: <77F33794DD223B40BF24AB3D379302501997A78564@mxmbx01.chsmail.root.cooperhealth.edu> Message-ID: We have Epic and utilize the NCP. Our senior dietitian is a credentialed Epic trainer and is a real expert with the program. I will cc her and see what she can offer. Barbara Haine Elliot Hospital Manchester NH From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Fynan, Carla Sent: Wednesday, October 14, 2009 9:13 AM To: CNM Mailing List (Cnm at lists.my180.net) Subject: [Cnm] Epic and NCP Good Morning! We now have Epic Electronic Health Records for Physicians and Nursing. Phase 2 will include Food & Nutrition. We will be building the assessments, etc. and I would like to initiate the NCP at the same time. Has anyone done this in the past few years that could give me any pointers? Thank you and Make it a Great Day! 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. ----------------------------------------- **** CONFIDENTIAL COMMUNICATION - PLEASE READ PRIVACY NOTICE **** This communication is confidential and may be read only by its intended recipient(s). It may contain legally privileged and protected information. If you believe you have received this communication in error, please "Reply" to the Sender and so indicate or call (603) 663-2800. Then, please promptly "Delete" this communication from your computer. This communication, and any information contained herein, may only be forwarded, printed, disclosed, copied or disseminated by those specifically authorized to do so. UNAUTHORIZED DISCLOSURE MAY RESULT IN LEGAL LIABILITY FOR THOSE PERSONS RESPONSIBLE. -------------- next part -------------- An HTML attachment was scrubbed... URL: From keiden at lumc.edu Wed Oct 14 06:25:52 2009 From: keiden at lumc.edu (Kelly Eiden) Date: Wed, 14 Oct 2009 08:25:52 -0500 Subject: [Cnm] Epic and NCP In-Reply-To: References: <77F33794DD223B40BF24AB3D379302501997A78564@mxmbx01.chsmail.root.cooperhealth.edu> Message-ID: <4AD58931.2CB5.0017.0@lumc.edu> We have the diagnostic terminology in the Doc Flowsheet and created a template for assessment and f/u notes in the ADIME format. EPIC allows drop downs to make it more time efficient for charting. If you fill out the flowsheet first then the diagnostic statement can populate into your note into a PES statement automatically and you can fill in the RT and AEB. Good Luck! Kelly Kelly Eiden, MS, RD, LDN Director, Clinical Nutrition Services Loyola University Medical Center Phone: 708-216-0434 Email: keiden at lumc.edu >>> "Bobbi Homola" 10/14/2009 8:22 AM >>> We are in the same boat. Please share with the list. Thank you, Bobbi Bobbi Homola, MPA, RD, CD Clinical Manager, Food and Nutrition Services St. Mary Medical Center / St. Catherine Hospital 1500 South Lake Park Avenue Hobart, IN 46342 219-947-6048 / 219-392-7081 219-947-6049 fax bhomola at comhs.org -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Fynan, Carla Sent: Wednesday, October 14, 2009 8:13 AM To: CNM Mailing List (Cnm at lists.my180.net) Subject: [Cnm] Epic and NCP Good Morning! We now have Epic Electronic Health Records for Physicians and Nursing. Phase 2 will include Food & Nutrition. We will be building the assessments, etc. and I would like to initiate the NCP at the same time. Has anyone done this in the past few years that could give me any pointers? Thank you and Make it a Great Day! 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. From Heberle-Heather at aramark.com Wed Oct 14 06:30:21 2009 From: Heberle-Heather at aramark.com (Heberle, Heather N.) Date: Wed, 14 Oct 2009 09:30:21 -0400 Subject: [Cnm] Carafate Message-ID: Try as hard as we can to get it DC'd. If they absolutely refuse, we are holding at least 2 hr before and 2 hr after administration of Carafate. Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 From CSteele at CHOC.ORG Wed Oct 14 08:02:40 2009 From: CSteele at CHOC.ORG (Caroline Steele) Date: Wed, 14 Oct 2009 08:02:40 -0700 Subject: [Cnm] Lactation Questions Message-ID: <4AD585A0.42E0.00CC.0@CHOC.ORG> I have 2 lactation questions for the group: 1. Does anyone at a free standing children's hospital with NO adult hospital affiliation use nurse practitioners as lactation consultants? If you do, do your NPs prescribe meds (such as galactogogues, antidepressants for PP depression, etc) for moms? We are wondering if our NPs cannot prescribe meds for moms because the mom is not our patient (as we are a children's hospital). Curious if any other children's hospital lactation programs are having this problem. 2. Is anyone doing crematocrits in their lactation programs? If so, do you know if there is a CPT code or some way to bill? Thanks! Caroline Caroline Steele, MS, RD, CSP, IBCLC Manager, Clinical Nutrition & Lactation Services CHOC Children's Hospital 455 South Main Street Orange, CA 92868 Office: 714-204-3023 Fax: 714-289-4023 csteele at choc.org "EMF " made the following annotations. ------------------------------------------------------------------------------ 10/14/09, 08:00:44 This email message and any files transmitted are sent with confidentiality in mind and contain privileged or copyright information. You must not present this message to another party without gaining permission from the sender. If you are not the intended recipient you must not copy, distribute or use this email or the information contained in it for any purpose other than to notify Children's Hospital of Orange County. Any views expressed in this message are those of the sender, except where the sender specifically states them to be the views of Children's Hospital of Orange County. If you have received this message in error, please notify the sender immediately, and delete this email from your system. We do not guarantee that this material is free from viruses or any other defects although due care has been taken to minimize the risk. ============================================================================== From sdehoog at u.washington.edu Wed Oct 14 09:56:14 2009 From: sdehoog at u.washington.edu (susan) Date: Wed, 14 Oct 2009 09:56:14 -0700 (PDT) Subject: [Cnm] clinic order form Message-ID: Hi all Am looking for sample(s) you all may have for Medical Nutrition Therapy in your outpatient area. we are trying to get the MDs to write clear succinct orders for MNT. so any forms you are willing to share will be much appreciated. 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 Jennifer.Schwallie at hcahealthcare.com Wed Oct 14 11:14:52 2009 From: Jennifer.Schwallie at hcahealthcare.com (Schwallie Jennifer) Date: Wed, 14 Oct 2009 13:14:52 -0500 Subject: [Cnm] Hepatic Diets Message-ID: <2EF59A62B4346A419766B497490EF5C5C06CCA48@NADCWPMSGCMS10.hca.corpad.net> Hello, We occassionally have MDs writing orders for "hepatic diets". We run into an issue when this happens on a Sunday, and we do not see the patient until Monday at which point we can write our recommendations. Does anyone have orders being written for hepatic diets? And if so, what do you instruct your diet clerks to do? We currently have them modifying a renal and cardiac diet until we can assess the patient. I realize protein restriction is no longer warranted and the only restrictions may be fat and/or sodium, again depending on the individual patient. Thanks in advance, Jennifer Schwallie, RD, LDN Clinical Nutrition Manager Northside Hospital St. Petersburg, FL (727) 521-5191 (727) 521-5101 -------------- next part -------------- An HTML attachment was scrubbed... URL: From LCarver at Reshealthcare.org Wed Oct 14 11:37:44 2009 From: LCarver at Reshealthcare.org (Carver, Leslee) Date: Wed, 14 Oct 2009 13:37:44 -0500 Subject: [Cnm] Hepatic Diets In-Reply-To: <2EF59A62B4346A419766B497490EF5C5C06CCA48@NADCWPMSGCMS10.hca.corpad.net> References: <2EF59A62B4346A419766B497490EF5C5C06CCA48@NADCWPMSGCMS10.hca.corpad.net> Message-ID: <5330B54133B6194BA13930BDEFE9A30E05245DAF@rhcexch3.reshealthcare.org> I would suggest you get together the evidenced based recommendations from the ADA then do one of 2 things (or both): discuss w/ your staff what you think the interpretation should be and present to your Pharmacy and Therapeutics committee for approval. The other option is to meet w/ a couple of the ordering physicians, ask them what their intent is and discuss that Vs. the evidenced based literature. Come to a consensus, write it up and then present to P+T. (we did that a # of years ago for the "renal" diet w/ the section chief - it took a while to convince him we couldn't do high protein plus 800 mg Phos with real food but the diet interpretation has stuck and we have it as an addendum to the ADA nutr 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 Schwallie Jennifer Sent: Wednesday, October 14, 2009 1:15 PM To: cnm at lists.my180.net Subject: [Cnm] Hepatic Diets Hello, We occassionally have MDs writing orders for "hepatic diets". We run into an issue when this happens on a Sunday, and we do not see the patient until Monday at which point we can write our recommendations. Does anyone have orders being written for hepatic diets? And if so, what do you instruct your diet clerks to do? We currently have them modifying a renal and cardiac diet until we can assess the patient. I realize protein restriction is no longer warranted and the only restrictions may be fat and/or sodium, again depending on the individual patient. Thanks in advance, Jennifer Schwallie, RD, LDN Clinical Nutrition Manager Northside Hospital St. Petersburg, FL (727) 521-5191 (727) 521-5101 -------------- next part -------------- An HTML attachment was scrubbed... URL: From jross at jaycountyhospital.com Wed Oct 14 11:43:09 2009 From: jross at jaycountyhospital.com (Julayne Ross) Date: Wed, 14 Oct 2009 14:43:09 -0400 Subject: [Cnm] trends for teens Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D024125BC@EX1.jaycountyhospital.com> Anyone have any idea where I can find info on "nutrition" trends for teens right now? We are doing some educational sessions for the freshmen class at our county high-school, and we wanted to start out with that. Also, anyone know of any shocking images for teens (i.e.- teens who have already had poor dexa scans, anorexia, diabetes...etc). Thanks for any ideas... Julayne -------------- next part -------------- An HTML attachment was scrubbed... URL: From KFW3W at hscmail.mcc.virginia.edu Wed Oct 14 12:23:29 2009 From: KFW3W at hscmail.mcc.virginia.edu (Willcutts, Kate F *HS) Date: Wed, 14 Oct 2009 15:23:29 -0400 Subject: [Cnm] Cnm Digest, Vol 35, Issue 53 In-Reply-To: References: Message-ID: We also are working on building our nutrition documentation flowsheets and templates in EPIC. Currently, the EPIC model system they have offered us needs a lot of work to meet our needs. If anyone has worked with EPIC to develop documentation flowsheets and note templates that you would be allowed to share, please let me know. Kate Willcutts, MS, RD, CNSD Surgery Nutr. Support/Assistant Clinical Nutrition Manager University of Virginia Healthsystem Assistant Professor, School of Nursing Charlottesville, VA 22908 (434)-243-9837 kfw3w at virginia.edu -----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, October 14, 2009 2:38 PM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 53 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: Epic and NCP (Bobbi Homola) 2. Re: Epic and NCP (Haine, Barbara) 3. Re: Epic and NCP (Kelly Eiden) 4. Re: Carafate (Heberle, Heather N.) 5. Lactation Questions (Caroline Steele) 6. clinic order form (susan) 7. Hepatic Diets (Schwallie Jennifer) 8. Re: Hepatic Diets (Carver, Leslee) ---------------------------------------------------------------------- Message: 1 Date: Wed, 14 Oct 2009 08:22:24 -0500 From: "Bobbi Homola" Subject: Re: [Cnm] Epic and NCP To: "Fynan, Carla" , Cnm at lists.my180.net Message-ID: Content-Type: text/plain; charset="us-ascii" We are in the same boat. Please share with the list. Thank you, Bobbi Bobbi Homola, MPA, RD, CD Clinical Manager, Food and Nutrition Services St. Mary Medical Center / St. Catherine Hospital 1500 South Lake Park Avenue Hobart, IN 46342 219-947-6048 / 219-392-7081 219-947-6049 fax bhomola at comhs.org -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Fynan, Carla Sent: Wednesday, October 14, 2009 8:13 AM To: CNM Mailing List (Cnm at lists.my180.net) Subject: [Cnm] Epic and NCP Good Morning! We now have Epic Electronic Health Records for Physicians and Nursing. Phase 2 will include Food & Nutrition. We will be building the assessments, etc. and I would like to initiate the NCP at the same time. Has anyone done this in the past few years that could give me any pointers? Thank you and Make it a Great Day! Carla Fynan, RD Clinical Nutrition Manager Food & Nutrition Department Cooper University Hospital One Cooper Paza Camden, NJ 08103 (856) 342-2320 **************************************************************** This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed. If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited. If you received this email in error, please notify the sender by replying to this message and delete this email immediately. -------------- next part -------------- An HTML attachment was scrubbed... URL: ------------------------------ Message: 2 Date: Wed, 14 Oct 2009 09:32:51 -0400 From: "Haine, Barbara" Subject: Re: [Cnm] Epic and NCP To: "Fynan, Carla" , Cc: "Savage, Lynda" Message-ID: Content-Type: text/plain; charset="us-ascii" We have Epic and utilize the NCP. Our senior dietitian is a credentialed Epic trainer and is a real expert with the program. I will cc her and see what she can offer. Barbara Haine Elliot Hospital Manchester NH From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Fynan, Carla Sent: Wednesday, October 14, 2009 9:13 AM To: CNM Mailing List (Cnm at lists.my180.net) Subject: [Cnm] Epic and NCP Good Morning! We now have Epic Electronic Health Records for Physicians and Nursing. Phase 2 will include Food & Nutrition. We will be building the assessments, etc. and I would like to initiate the NCP at the same time. Has anyone done this in the past few years that could give me any pointers? Thank you and Make it a Great Day! 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. ----------------------------------------- **** CONFIDENTIAL COMMUNICATION - PLEASE READ PRIVACY NOTICE **** This communication is confidential and may be read only by its intended recipient(s). It may contain legally privileged and protected information. If you believe you have received this communication in error, please "Reply" to the Sender and so indicate or call (603) 663-2800. Then, please promptly "Delete" this communication from your computer. This communication, and any information contained herein, may only be forwarded, printed, disclosed, copied or disseminated by those specifically authorized to do so. UNAUTHORIZED DISCLOSURE MAY RESULT IN LEGAL LIABILITY FOR THOSE PERSONS RESPONSIBLE. -------------- next part -------------- An HTML attachment was scrubbed... URL: ------------------------------ Message: 3 Date: Wed, 14 Oct 2009 08:25:52 -0500 From: "Kelly Eiden" Subject: Re: [Cnm] Epic and NCP To: "Bobbi Homola" , "Carla Fynan" , Message-ID: <4AD58931.2CB5.0017.0 at lumc.edu> Content-Type: text/plain; charset=US-ASCII We have the diagnostic terminology in the Doc Flowsheet and created a template for assessment and f/u notes in the ADIME format. EPIC allows drop downs to make it more time efficient for charting. If you fill out the flowsheet first then the diagnostic statement can populate into your note into a PES statement automatically and you can fill in the RT and AEB. Good Luck! Kelly Kelly Eiden, MS, RD, LDN Director, Clinical Nutrition Services Loyola University Medical Center Phone: 708-216-0434 Email: keiden at lumc.edu >>> "Bobbi Homola" 10/14/2009 8:22 AM >>> We are in the same boat. Please share with the list. Thank you, Bobbi Bobbi Homola, MPA, RD, CD Clinical Manager, Food and Nutrition Services St. Mary Medical Center / St. Catherine Hospital 1500 South Lake Park Avenue Hobart, IN 46342 219-947-6048 / 219-392-7081 219-947-6049 fax bhomola at comhs.org -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Fynan, Carla Sent: Wednesday, October 14, 2009 8:13 AM To: CNM Mailing List (Cnm at lists.my180.net) Subject: [Cnm] Epic and NCP Good Morning! We now have Epic Electronic Health Records for Physicians and Nursing. Phase 2 will include Food & Nutrition. We will be building the assessments, etc. and I would like to initiate the NCP at the same time. Has anyone done this in the past few years that could give me any pointers? Thank you and Make it a Great Day! 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. ------------------------------ Message: 4 Date: Wed, 14 Oct 2009 09:30:21 -0400 From: "Heberle, Heather N." Subject: Re: [Cnm] Carafate To: "cnm at lists.my180.net" , "hpatronik at shorehealth.org" Message-ID: Content-Type: text/plain; charset="us-ascii" Try as hard as we can to get it DC'd. If they absolutely refuse, we are holding at least 2 hr before and 2 hr after administration of Carafate. Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 ------------------------------ Message: 5 Date: Wed, 14 Oct 2009 08:02:40 -0700 From: "Caroline Steele" Subject: [Cnm] Lactation Questions To: cnm at lists.my180.net Message-ID: <4AD585A0.42E0.00CC.0 at CHOC.ORG> Content-Type: text/plain; charset=us-ascii I have 2 lactation questions for the group: 1. Does anyone at a free standing children's hospital with NO adult hospital affiliation use nurse practitioners as lactation consultants? If you do, do your NPs prescribe meds (such as galactogogues, antidepressants for PP depression, etc) for moms? We are wondering if our NPs cannot prescribe meds for moms because the mom is not our patient (as we are a children's hospital). Curious if any other children's hospital lactation programs are having this problem. 2. Is anyone doing crematocrits in their lactation programs? If so, do you know if there is a CPT code or some way to bill? Thanks! Caroline Caroline Steele, MS, RD, CSP, IBCLC Manager, Clinical Nutrition & Lactation Services CHOC Children's Hospital 455 South Main Street Orange, CA 92868 Office: 714-204-3023 Fax: 714-289-4023 csteele at choc.org "EMF " made the following annotations. ------------------------------------------------------------------------------ 10/14/09, 08:00:44 This email message and any files transmitted are sent with confidentiality in mind and contain privileged or copyright information. You must not present this message to another party without gaining permission from the sender. If you are not the intended recipient you must not copy, distribute or use this email or the information contained in it for any purpose other than to notify Children's Hospital of Orange County. Any views expressed in this message are those of the sender, except where the sender specifically states them to be the views of Children's Hospital of Orange County. If you have received this message in error, please notify the sender immediately, and delete this email from your system. We do not guarantee that this material is free from viruses or any other defects although due care has been taken to minimize the risk. ============================================================================== ------------------------------ Message: 6 Date: Wed, 14 Oct 2009 09:56:14 -0700 (PDT) From: susan Subject: [Cnm] clinic order form To: clinical nutrition managers Message-ID: Content-Type: TEXT/PLAIN; charset=US-ASCII; format=flowed Hi all Am looking for sample(s) you all may have for Medical Nutrition Therapy in your outpatient area. we are trying to get the MDs to write clear succinct orders for MNT. so any forms you are willing to share will be much appreciated. 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 ------------------------------ Message: 7 Date: Wed, 14 Oct 2009 13:14:52 -0500 From: Schwallie Jennifer Subject: [Cnm] Hepatic Diets To: "cnm at lists.my180.net" Message-ID: <2EF59A62B4346A419766B497490EF5C5C06CCA48 at NADCWPMSGCMS10.hca.corpad.net> Content-Type: text/plain; charset="iso-8859-1" Hello, We occassionally have MDs writing orders for "hepatic diets". We run into an issue when this happens on a Sunday, and we do not see the patient until Monday at which point we can write our recommendations. Does anyone have orders being written for hepatic diets? And if so, what do you instruct your diet clerks to do? We currently have them modifying a renal and cardiac diet until we can assess the patient. I realize protein restriction is no longer warranted and the only restrictions may be fat and/or sodium, again depending on the individual patient. Thanks in advance, Jennifer Schwallie, RD, LDN Clinical Nutrition Manager Northside Hospital St. Petersburg, FL (727) 521-5191 (727) 521-5101 -------------- next part -------------- An HTML attachment was scrubbed... URL: ------------------------------ Message: 8 Date: Wed, 14 Oct 2009 13:37:44 -0500 From: "Carver, Leslee" Subject: Re: [Cnm] Hepatic Diets To: "Schwallie Jennifer" , Message-ID: <5330B54133B6194BA13930BDEFE9A30E05245DAF at rhcexch3.reshealthcare.org> Content-Type: text/plain; charset="us-ascii" I would suggest you get together the evidenced based recommendations from the ADA then do one of 2 things (or both): discuss w/ your staff what you think the interpretation should be and present to your Pharmacy and Therapeutics committee for approval. The other option is to meet w/ a couple of the ordering physicians, ask them what their intent is and discuss that Vs. the evidenced based literature. Come to a consensus, write it up and then present to P+T. (we did that a # of years ago for the "renal" diet w/ the section chief - it took a while to convince him we couldn't do high protein plus 800 mg Phos with real food but the diet interpretation has stuck and we have it as an addendum to the ADA nutr 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 Schwallie Jennifer Sent: Wednesday, October 14, 2009 1:15 PM To: cnm at lists.my180.net Subject: [Cnm] Hepatic Diets Hello, We occassionally have MDs writing orders for "hepatic diets". We run into an issue when this happens on a Sunday, and we do not see the patient until Monday at which point we can write our recommendations. Does anyone have orders being written for hepatic diets? And if so, what do you instruct your diet clerks to do? We currently have them modifying a renal and cardiac diet until we can assess the patient. I realize protein restriction is no longer warranted and the only restrictions may be fat and/or sodium, again depending on the individual patient. Thanks in advance, Jennifer Schwallie, RD, LDN Clinical Nutrition Manager Northside Hospital St. Petersburg, FL (727) 521-5191 (727) 521-5101 -------------- next part -------------- An HTML attachment was scrubbed... URL: ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 53 *********************************** From rtripp at PINNACLEHEALTH.org Wed Oct 14 13:31:26 2009 From: rtripp at PINNACLEHEALTH.org (Roberta Tripp) Date: Wed, 14 Oct 2009 16:31:26 -0400 Subject: [Cnm] trends for teens In-Reply-To: <10DE3A7624A2BD48B81AFE4E90A5094D024125BC@EX1.jaycountyhospital.com> Message-ID: <7375E17267B3DB4583032BDEFDA2D76E0C3494B1@mailphs.pinnaclehealth.org> Apparently there are a proliferation of "pro ana", "thinspo", and "bones thinspo" sites on the internet There are even sites for "wannarexia" (want to be anorexic) So sad 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 Julayne Ross Sent: Wednesday, October 14, 2009 2:43 PM To: cnm at lists.my180.net Subject: [Cnm] trends for teens Anyone have any idea where I can find info on "nutrition" trends for teens right now? We are doing some educational sessions for the freshmen class at our county high-school, and we wanted to start out with that. Also, anyone know of any shocking images for teens (i.e.- teens who have already had poor dexa scans, anorexia, diabetes...etc). Thanks for any ideas... Julayne -------------- next part -------------- An HTML attachment was scrubbed... URL: From bmueth at memhosp.com Wed Oct 14 13:56:01 2009 From: bmueth at memhosp.com (bmueth at memhosp.com) Date: Wed, 14 Oct 2009 15:56:01 -0500 Subject: [Cnm] tv dinners Message-ID: Nursing is requesting that we have tv dinners available on their units to give patients. We currently send turkey sandwiches for the diet changes/admissions after the kitchen is closed. Is anyone else doing this? Are you able to buy these from your distributor? thanks. Beth Beth Mueth, RD LDN Chief Clinical Dietitian Memorial Hospital 618-257-5386 -------------- next part -------------- An HTML attachment was scrubbed... URL: From sheila.walsh at nahealth.com Wed Oct 14 14:11:46 2009 From: sheila.walsh at nahealth.com (Sheila Walsh) Date: Wed, 14 Oct 2009 14:11:46 -0700 Subject: [Cnm] tv dinners In-Reply-To: References: Message-ID: <4AD5DC22.485B.0001.0@nahealth.com> The TV dinners are not used at our facility. They rapidly become outdated. >>> 10/14/2009 1:56 PM >>> Nursing is requesting that we have tv dinners available on their units to give patients. We currently send turkey sandwiches for the diet changes/admissions after the kitchen is closed. Is anyone else doing this? Are you able to buy these from your distributor? thanks. Beth Beth Mueth, RD LDN Chief Clinical Dietitian Memorial Hospital 618-257-5386 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Lori.Zimmerman at ministryhealth.org Wed Oct 14 14:29:03 2009 From: Lori.Zimmerman at ministryhealth.org (Zimmerman, Lori A) Date: Wed, 14 Oct 2009 16:29:03 -0500 Subject: [Cnm] tv dinners In-Reply-To: References: Message-ID: We make our own "TV dinners" using Healthy Choice or Lean Cuisine entrees. We add a starch and vegetable that are allowed on all diets. Lori A. Zimmerman MS, RD, CD ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of bmueth at memhosp.com Sent: Wednesday, October 14, 2009 3:56 PM To: cnm at lists.my180.net Subject: [Cnm] tv dinners Nursing is requesting that we have tv dinners available on their units to give patients. We currently send turkey sandwiches for the diet changes/admissions after the kitchen is closed. Is anyone else doing this? Are you able to buy these from your distributor? thanks. Beth Beth Mueth, RD LDN Chief Clinical Dietitian Memorial Hospital 618-257-5386 ________________________________ CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation. -------------- next part -------------- An HTML attachment was scrubbed... URL: From lily.hong at ahmchealth.com Wed Oct 14 14:58:57 2009 From: lily.hong at ahmchealth.com (Hong, Lily) Date: Wed, 14 Oct 2009 14:58:57 -0700 Subject: [Cnm] tv dinners Message-ID: <45EACF0250433144B0BB6CD944C2E908E32C70@sgvmc-msg-01.ahmchealth.net> Hi Lori, Do you put the entrees and sides in a special container? We are looking into "Food saver" and hope to make the late tray nicer. Thanks, Lily Hong MPH, RD ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Zimmerman, Lori A Sent: Wednesday, October 14, 2009 2:29 PM To: 'bmueth at memhosp.com'; 'cnm at lists.my180.net' Subject: Re: [Cnm] tv dinners We make our own "TV dinners" using Healthy Choice or Lean Cuisine entrees. We add a starch and vegetable that are allowed on all diets. Lori A. Zimmerman MS, RD, CD ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of bmueth at memhosp.com Sent: Wednesday, October 14, 2009 3:56 PM To: cnm at lists.my180.net Subject: [Cnm] tv dinners Nursing is requesting that we have tv dinners available on their units to give patients. We currently send turkey sandwiches for the diet changes/admissions after the kitchen is closed. Is anyone else doing this? Are you able to buy these from your distributor? thanks. Beth Beth Mueth, RD LDN Chief Clinical Dietitian Memorial Hospital 618-257-5386 ________________________________ CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Karen.Auwaerter at chw.edu Wed Oct 14 15:14:13 2009 From: Karen.Auwaerter at chw.edu (Auwaerter, Karen - MSJ) Date: Wed, 14 Oct 2009 15:14:13 -0700 Subject: [Cnm] tv dinners In-Reply-To: References: Message-ID: <891DC7E14FC0F449874219D643CB1CA8063D0AE7@CHW-MSG-403.chw.edu> We stock Healthy Choice frozen dinners on certain units (including ED). We buy them from our grocery vendor (US Foodservice) and we stock one chicken and one beef variety. We haven't had any problems with them and it gives the nurses an option during the night and after our late tray cut-off times. Karen Auwaerter, RD Manager, Nutrition and Food Services Mercy San Juan Medical Center Greater Sacramento Area 916 537 5104 phone 916 859 1238 fax "Eat food. Mostly plants. Not too much." --Michael Pollan Confidentiality Notice: This e-mail transmission, and any documents, files or previous e-mail messages attached to it may contain confidential information that is legally privileged. If you are not the intended recipient, or a person responsible for delivering it to the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of any of the information contained in or attached to this transmission is STRICTLY PROHIBITED. If you have received this transmission in error, please immediately notify me by reply e-mail and destroy the original transmission and its attachments without reading or saving in any manner. ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Zimmerman, Lori A Sent: Wednesday, October 14, 2009 2:29 PM To: 'bmueth at memhosp.com'; 'cnm at lists.my180.net' Subject: Re: [Cnm] tv dinners We make our own "TV dinners" using Healthy Choice or Lean Cuisine entrees. We add a starch and vegetable that are allowed on all diets. Lori A. Zimmerman MS, RD, CD ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of bmueth at memhosp.com Sent: Wednesday, October 14, 2009 3:56 PM To: cnm at lists.my180.net Subject: [Cnm] tv dinners Nursing is requesting that we have tv dinners available on their units to give patients. We currently send turkey sandwiches for the diet changes/admissions after the kitchen is closed. Is anyone else doing this? Are you able to buy these from your distributor? thanks. Beth Beth Mueth, RD LDN Chief Clinical Dietitian Memorial Hospital 618-257-5386 ________________________________ CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation. -------------- next part -------------- An HTML attachment was scrubbed... URL: From LCarver at Reshealthcare.org Thu Oct 15 07:24:01 2009 From: LCarver at Reshealthcare.org (Carver, Leslee) Date: Thu, 15 Oct 2009 09:24:01 -0500 Subject: [Cnm] "T&A diets" In-Reply-To: <628B40C096BF4F43BE9D6528A30FB709@ANNALYNN> References: <628B40C096BF4F43BE9D6528A30FB709@ANNALYNN> Message-ID: <5330B54133B6194BA13930BDEFE9A30E05246023@rhcexch3.reshealthcare.org> we have just started using the Nutr Suite in CBORD and are having some issues w/ MD ordered T&A diets. do your facilities have these diet orders and, if so, how are they interpreted? (per my diet office, they are either clear or full liquid - cold liquids only). 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 ________________________________ -------------- next part -------------- An HTML attachment was scrubbed... URL: From Susan_R_Paredez at uhs.org Thu Oct 15 08:15:57 2009 From: Susan_R_Paredez at uhs.org (Susan_R_Paredez at uhs.org) Date: Thu, 15 Oct 2009 11:15:57 -0400 Subject: [Cnm] Biggest Loser Message-ID: Hello All, Some of our staff want to do a type of Biggest Loser contest outside of work. They want to know how to judge the wt. loss so it is equitable. For ex., it may be easier for a 200 lb. person to lose more wt. than a 150 lb. person. Should it be based on percentage lost, BMI? Any ideas? Thanks. 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 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. --- 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. o1 -------------- next part -------------- An HTML attachment was scrubbed... URL: From aimeenut at yahoo.com Thu Oct 15 08:57:26 2009 From: aimeenut at yahoo.com (aimee crant) Date: Thu, 15 Oct 2009 08:57:26 -0700 (PDT) Subject: [Cnm] Biggest Loser In-Reply-To: References: Message-ID: <916019.70737.qm@web52610.mail.re2.yahoo.com> Biggest loser bases on percentage ?Aimee Crant-Oksa MS, RD Clinical Nutrition Manager Centrastate Medical Center tel: 732-294-2767 email: acrantok at centrastate.com ________________________________ From: "Susan_R_Paredez at uhs.org" To: CNM at lists.my180.net Sent: Thu, October 15, 2009 11:15:57 AM Subject: [Cnm] Biggest Loser Hello All, Some of our staff want to do a type of Biggest Loser contest outside of work. They want to know how to judge the wt. loss so it is equitable. For ex., it may be easier for a 200 lb. person to lose more wt. than a 150 lb. person. Should it be based on percentage lost, BMI? Any ideas? Thanks. 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 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. --- 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. o1 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Debra.Jeske at stlukes-stl.com Thu Oct 15 09:22:48 2009 From: Debra.Jeske at stlukes-stl.com (Jeske, Debra J) Date: Thu, 15 Oct 2009 11:22:48 -0500 Subject: [Cnm] Percent eaten at meals Message-ID: <39C024B8791C1943BAA07F35FFA8D6F90C799E3A02@SLHMAIL.slh.stlukes.com> How are your RNs or techs documenting the meal intake on their shift assessments? Currently our PCT document the percent eaten. This is often misleading as it could be 100% of coffee for one person and 25% of a feast for another. We are wanting to remove the percent and just have appetite but would really like a feel for how other facilities are documenting. Debbie Jeske, MS, RD, LD, CNSD Manager, Clinical Nutrition and Patient Services St. Luke's Hospital Phone 314-205-6975 Beeper 314-855-7048 DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. -------------- next part -------------- An HTML attachment was scrubbed... URL: From LAURAF at dmhhs.org Thu Oct 15 09:50:12 2009 From: LAURAF at dmhhs.org (ETCHASON,LAURA) Date: Thu, 15 Oct 2009 11:50:12 -0500 Subject: [Cnm] Percent eaten at meals In-Reply-To: <39C024B8791C1943BAA07F35FFA8D6F90C799E3A02@SLHMAIL.slh.stlukes.com> References: <39C024B8791C1943BAA07F35FFA8D6F90C799E3A02@SLHMAIL.slh.stlukes.com> Message-ID: <4AD70C74.21B0.00A0.0@dmhhs.org> We have a category for how the patient feels his/her appetite is, how the nurse feels the pt's appetite is, and how the pt's family feels the pt's appetite is. We do still record the % of po intake on certain patients. We (the RDs) put an order in for po intake to be recorded. We put an order through just so we can formulate a query for our host/hostesses (tray passers) so they know which pt's to record. It significantly decreased the amount of recording the tray passers were doing. We are computerized here so it doesn't take much effort to look up what foods the patient ordered. However, I definitely feel (as you likely do too) that talking w/ the patient, nurse, and family members about intake seems to be the best method as food may be brought in from home, a pt may say appetite is poor, but he/she still eats adequately, etc. Thank you, Laura Laura A. Etchason, MS, RD, LDN Clinical Nutrition Manager Decatur Memorial Hospital 2300 N. Edward Street Decatur, IL 62526 217-876-5306 (office line and voice mail) 217-876-5305 (fax) 217-876-5301 (general line) lauraf at dmhhs.org Developer, Harmony, Maximizer, Individualization, Belief >>> "Jeske, Debra J" 10/15/2009 11:22 AM >>> How are your RNs or techs documenting the meal intake on their shift assessments? Currently our PCT document the percent eaten. This is often misleading as it could be 100% of coffee for one person and 25% of a feast for another. We are wanting to remove the percent and just have appetite but would really like a feel for how other facilities are documenting. Debbie Jeske, MS, RD, LD, CNSD Manager, Clinical Nutrition and Patient Services St. Luke's Hospital Phone 314-205-6975 Beeper 314-855-7048 DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. -------------- next part -------------- An HTML attachment was scrubbed... URL: From lpettet at sfmc.net Thu Oct 15 11:18:25 2009 From: lpettet at sfmc.net (Lori Pettet) Date: Thu, 15 Oct 2009 13:18:25 -0500 Subject: [Cnm] We had a mock Joint Commission survey this week and during the summation, the surveyor talked about a Dietary Tracer for Cardiac Pts. I was out sick the day they conducted this tracer and did not get to talk to the surveyor. Has anyone had one of these before? Message-ID: <4AD72121.7C48.00C7.0@sfmc.net> We had a mock Joint Commission survey this week and during the summation, the surveyor talked about a Dietary Tracer for Cardiac Pts. I was out sick the day they conducted this tracer and did not get to talk to the surveyor. Has anyone had one of these before? thanks for any insight, Lori Lori Pettet, MA, RD, LD, CDE Assistant Manager, Nutrition Services Saint Francis Medical Center 211 St. Francis Dr. Cape Girardeau, MO 63703 Phone: 331-5145 LPettet at sfmc.net This email transmittal is intended only for the use of the individual or entity to which it is addressed. It may contain Protected Health Information, which is privileged and confidential. Protected Health Information may only be used or disclosed in accordance with law and you may be subject to penalties under law for improper use or further disclosure of the Protected Health Information in this email. If you are not the intended recipient of this email, you may not read, copy, distribute or otherwise use or disclose the information contained in this email. If you received this email in error, please notify the sender immediately and request instructions on return or destruction of the information in this email. From mpappo at montefiore.org Thu Oct 15 12:51:54 2009 From: mpappo at montefiore.org (Miriam Pappo) Date: Thu, 15 Oct 2009 15:51:54 -0400 Subject: [Cnm] Biggest Loser Message-ID: consider doing it in teams too. We did this years ago & it was a lot of fun. >>> aimee crant 10/15/09 11:57 AM >>> Biggest loser bases on percentage Aimee Crant-Oksa MS, RD Clinical Nutrition Manager Centrastate Medical Center tel: 732-294-2767 email: acrantok at centrastate.com ________________________________ From: "Susan_R_Paredez at uhs.org" To: CNM at lists.my180.net Sent: Thu, October 15, 2009 11:15:57 AM Subject: [Cnm] Biggest Loser Hello All, Some of our staff want to do a type of Biggest Loser contest outside of work. They want to know how to judge the wt. loss so it is equitable. For ex., it may be easier for a 200 lb. person to lose more wt. than a 150 lb. person. Should it be based on percentage lost, BMI? Any ideas? Thanks. 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 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. --- 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. o1 From SemmensE at monhealthsys.org Thu Oct 15 14:40:19 2009 From: SemmensE at monhealthsys.org (Elizabeth Semmens) Date: Thu, 15 Oct 2009 17:40:19 -0400 Subject: [Cnm] neutropenic diets Message-ID: A question recently came up concerning our Neutropenic/low microbial diets. We are wondering how many facilities wrap their Neutropenic side items (i.e. canned fruit salads, baked goods, etc.) sit saran wrap or other self contained serving dish before placing it on the tray. We are verifying that the items are remaining in the correct temperature range, but wonder if we need to be concerned about cross contamination in the unwrapped state. Thank you, Beth Semmens -------------- next part -------------- An HTML attachment was scrubbed... URL: From Nicole.Biederman at sodexo.com Thu Oct 15 14:41:32 2009 From: Nicole.Biederman at sodexo.com (Biederman, Nicole) Date: Thu, 15 Oct 2009 17:41:32 -0400 Subject: [Cnm] Percent eaten at meals In-Reply-To: <39C024B8791C1943BAA07F35FFA8D6F90C799E3A02@SLHMAIL.slh.stlukes.com> References: <39C024B8791C1943BAA07F35FFA8D6F90C799E3A02@SLHMAIL.slh.stlukes.com> Message-ID: <0596739EBF84774A99C18C096CCAC11808BC6744A6@nausbf-exmb11.na.sdxcorp.net> We have a point system where the nurses count the number of items on the tray (excluding sugar/water, etc) and divide the number of items consumed by the total number of items to get a percentage. Nicole M. Biederman M.S., R.D. Clinical Nutrition Manager Bishop Mugavero Center for Geriatric Care Sodexo Senior Services 718-694-6101 nicole.biederman at sodexo.com ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Jeske, Debra J [Debra.Jeske at stlukes-stl.com] Sent: Thursday, October 15, 2009 12:22 PM To: 'CNM at lists.my180.net' Subject: [Cnm] Percent eaten at meals How are your RNs or techs documenting the meal intake on their shift assessments? Currently our PCT document the percent eaten. This is often misleading as it could be 100% of coffee for one person and 25% of a feast for another. We are wanting to remove the percent and just have appetite but would really like a feel for how other facilities are documenting. Debbie Jeske, MS, RD, LD, CNSD Manager, Clinical Nutrition and Patient Services St. Luke's Hospital Phone 314-205-6975 Beeper 314-855-7048 DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. ________________________________ Confidentiality Notice: This electronic message transmission contains information from Sodexo, Inc. which may be confidential and/or proprietary. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic transmission in error, please let us know by reply and then delete it from your system. -------------- next part -------------- An HTML attachment was scrubbed... URL: From msohal at frhg.org Thu Oct 15 13:03:33 2009 From: msohal at frhg.org (Sohal, Manjit) Date: Thu, 15 Oct 2009 13:03:33 -0700 Subject: [Cnm] Biggest Loser In-Reply-To: References: Message-ID: <5E3E345918590D4D86333A4FCCF51A9002F32710@EXCHVS.frhg.org> Our Loyalty Committee puts a Biggest Loser contest annually that lasts I believe about 6 months. People form teams and our Caf? has a special low fat "Biggest Loser Meal" everyday to help the teams succeed. Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Miriam Pappo Sent: Thursday, October 15, 2009 12:52 PM To: CNM at lists.my180.net; Susan_R_Paredez at uhs.org; aimee crant Subject: Re: [Cnm] Biggest Loser consider doing it in teams too. We did this years ago & it was a lot of fun. >>> aimee crant 10/15/09 11:57 AM >>> Biggest loser bases on percentage Aimee Crant-Oksa MS, RD Clinical Nutrition Manager Centrastate Medical Center tel: 732-294-2767 email: acrantok at centrastate.com ________________________________ From: "Susan_R_Paredez at uhs.org" To: CNM at lists.my180.net Sent: Thu, October 15, 2009 11:15:57 AM Subject: [Cnm] Biggest Loser Hello All, Some of our staff want to do a type of Biggest Loser contest outside of work. They want to know how to judge the wt. loss so it is equitable. For ex., it may be easier for a 200 lb. person to lose more wt. than a 150 lb. person. Should it be based on percentage lost, BMI? Any ideas? Thanks. 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 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. --- 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. o1 _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From roconnor at noblehealth.org Fri Oct 16 06:05:20 2009 From: roconnor at noblehealth.org (O'Connor, Ruth) Date: Fri, 16 Oct 2009 09:05:20 -0400 Subject: [Cnm] Med dietary Message-ID: Is anyone using the med dietary nutrition assessment module and if so could you give me your contact information as I have some questions. Thanks. -------------- next part -------------- An HTML attachment was scrubbed... URL: From skonruff at rehabhospitalwi.com Fri Oct 16 06:39:32 2009 From: skonruff at rehabhospitalwi.com (Sallie Konruff) Date: Fri, 16 Oct 2009 08:39:32 -0500 Subject: [Cnm] Interdisciplinary Responsiblities In-Reply-To: <0596739EBF84774A99C18C096CCAC11808BC6744A6@nausbf-exmb11.na.sdxcorp.net> References: <39C024B8791C1943BAA07F35FFA8D6F90C799E3A02@SLHMAIL.slh.stlukes.com> <0596739EBF84774A99C18C096CCAC11808BC6744A6@nausbf-exmb11.na.sdxcorp.net> Message-ID: Hello; I'm looking to network with an RD working in a free standing physical rehab facility. The interdisciplinary expectations seem much different than in other hospitals I've worked at. After attending a care planning meeting where the director of nursing stated we are expected to know each disciplines problems and goals for the patient I'm struggling to figure out how this is possible. I would think it makes sense that each discipline understands what each other does and where to find the care plan for OT, RT, PT, nursing or SLP etc. But to read each disciplines care plan, and some disciplines have many plans, seems like a nice to know thing not necessary to know. I trust that each discipline is the expert in their area and don't feel I have anything to give or gain and perhaps may confuse a patient if I as the RD start to reinforce PT or OT goals or management of a non nutrition problem. From a time management perspective I don't know how this will be possible. I am also managing the food service staff so need to be very protective how I prioritize tasks. Confidentiality Notice: This message, and any attachments, may contain information that is confidential, privileged, and/or protected from disclosure under state and federal laws that deal with the privacy and security of medical information. If you received this message in error or through inappropriate means, please reply to this message to notify the Sender that the message was received by you in error, and then permanently delete this message from all storage media, without forwarding or retaining a copy. -------------- next part -------------- An HTML attachment was scrubbed... URL: From debiasse at bu.edu Fri Oct 16 08:29:49 2009 From: debiasse at bu.edu (Michele A. DeBiasse) Date: Fri, 16 Oct 2009 11:29:49 -0400 Subject: [Cnm] student seeking a "food service management practicum" Message-ID: <9B3C51A5312D44CDA0CB6545976AC69D@ad.bu.edu> Dear Colleagues: I have a graduate student in our program that is looking for an opportunity to complete a practicum in foodservice management - ideally over the summer. She has no problem traveling for this experience. Additionally, she is open to either paid or unpaid experiences. Do any of you offer or know of such a practicum site? Regards, Michele Michele A. DeBiasse, MS, RD, CNSD Clinical Assistant Professor Boston University College of Health & Rehabilitation Sciences: Sargent Department of Health Sciences 635 Commonwealth Ave, Rm 433 Boston, MA 02215 Ph: 617.358.5479 Fax: 617.353.7567 Lecturer Tufts University School of Medicine 136 Harrison Ave Boston, MA 02111 The opinion(s) contained in this communication is/are solely that/those of the author and should not be considered the opinion(s) of Boston University/College of Health and Rehabilitation Sciences or Tufts University School of Medicine. -------------- next part -------------- An HTML attachment was scrubbed... URL: From jross at jaycountyhospital.com Fri Oct 16 08:47:40 2009 From: jross at jaycountyhospital.com (Julayne Ross) Date: Fri, 16 Oct 2009 11:47:40 -0400 Subject: [Cnm] Biggest Loser Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D02412903@EX1.jaycountyhospital.com> We did a contest in the past and definitely % weight loss is more fair. Julayne -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Sohal, Manjit Sent: Thursday, October 15, 2009 4:04 PM To: Miriam Pappo; CNM at lists.my180.net; Susan_R_Paredez at uhs.org; aimee crant Subject: Re: [Cnm] Biggest Loser Our Loyalty Committee puts a Biggest Loser contest annually that lasts I believe about 6 months. People form teams and our Caf? has a special low fat "Biggest Loser Meal" everyday to help the teams succeed. Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Miriam Pappo Sent: Thursday, October 15, 2009 12:52 PM To: CNM at lists.my180.net; Susan_R_Paredez at uhs.org; aimee crant Subject: Re: [Cnm] Biggest Loser consider doing it in teams too. We did this years ago & it was a lot of fun. >>> aimee crant 10/15/09 11:57 AM >>> Biggest loser bases on percentage Aimee Crant-Oksa MS, RD Clinical Nutrition Manager Centrastate Medical Center tel: 732-294-2767 email: acrantok at centrastate.com ________________________________ From: "Susan_R_Paredez at uhs.org" To: CNM at lists.my180.net Sent: Thu, October 15, 2009 11:15:57 AM Subject: [Cnm] Biggest Loser Hello All, Some of our staff want to do a type of Biggest Loser contest outside of work. They want to know how to judge the wt. loss so it is equitable. For ex., it may be easier for a 200 lb. person to lose more wt. than a 150 lb. person. Should it be based on percentage lost, BMI? Any ideas? Thanks. 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 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. --- 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. o1 _______________________________________________ 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 Leanne.Littrell at hma.com Fri Oct 16 09:29:42 2009 From: Leanne.Littrell at hma.com (Littrell, Leanne) Date: Fri, 16 Oct 2009 12:29:42 -0400 Subject: [Cnm] Reply Regarding recording percentages of meals; I and O Message-ID: <4E3FEB15613D694A9CE182702F53959B038369DA@atl-ex1.hma.com> Our Nutrition Department Hosts record the number of cc's consumed at each meal and then we use the picture that Ross (Abbott) has to determine percentages as a comparison. Nursing records the I and O for all isolation patients. Thanks Leanne Pearson Littrell, MS, RD, LD Director of Nutrition Services Peace River Regional Medical Center 2500 Harbor Blvd Port Charlotte, FL 33952 941-766-4228 Fax-941-766-4218 Cell 941-769-1774 leanne.littrell at hma.com -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 917 bytes Desc: image001.gif URL: From loydg at andersonhospital.org Fri Oct 16 12:20:30 2009 From: loydg at andersonhospital.org (Gayle S. Loyd) Date: Fri, 16 Oct 2009 14:20:30 -0500 Subject: [Cnm] Obese patients Message-ID: Fellow RD's I have a question regarding obese patients, esp. those with a BMI>40. We have been invited to the Nursing Quality counsel monthly meeting with the agenda to discuss care planning for obese patients. We are reviewing patients >40 BMI and making an admission note on them for coding, but IF that is the only reason to see them, we are not doing assessments and care planning. Our reasoning is that obesity alone is not a risk factor during an acute admission. And it is not the environment for wt loss counseling, etc. As the rest of you--- we are stretched to the limit. Have you been approached by nursing etc. to care plans on obese patients without other risk factors. What are your thoughts, etc. Thank you Gayle Loyd RD LDN Anderson Hospital/Sodexo Maryville, IL -------------- next part -------------- An HTML attachment was scrubbed... URL: From Leanne.Littrell at hma.com Fri Oct 16 13:10:02 2009 From: Leanne.Littrell at hma.com (Littrell, Leanne) Date: Fri, 16 Oct 2009 16:10:02 -0400 Subject: [Cnm] Questions on revising our pt. menu Message-ID: <4E3FEB15613D694A9CE182702F53959B03836BAF@atl-ex1.hma.com> We use the ADA Nutrition Care Manual and feel a few foods are up to interpretation Do you allow bacon on a soft/ low residue diet? Do you allow juice on a carbohydrate controlled diet at breakfast? I will summarize and send back to the list. Thanks Leanne Pearson Littrell, MS, RD, LD Director of Nutrition Services Peace River Regional Medical Center 2500 Harbor Blvd Port Charlotte, FL 33952 941-766-4228 Fax-941-766-4218 Cell 941-769-1774 leanne.littrell at hma.com -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 917 bytes Desc: image001.gif URL: From Sue.Teske at chsys.org Fri Oct 16 13:25:25 2009 From: Sue.Teske at chsys.org (Sue Teske) Date: Fri, 16 Oct 2009 15:25:25 -0500 Subject: [Cnm] Nutrition Risk Screening in Outpatient Clinics Message-ID: <3D0B6F497247834CAC5FF0C30ED7A5C403966C6B@chexmain.chsys.org> Does anyone screen for nutrition risk in outpatient clinics? If so, what screening criteria do you use? Thanks in advance for the feedback!! Susan C. Teske, MS, RD, LD, CNSD Director, Dept. of Clinical Nutrition and Lactation Services Children's Health System 1600 7th Ave. South 3rd Floor hospital, Room 334 Birmingham, AL 35233 (205) 939-9203 Office (205) 939-6047 Fax susan.teske at chsys.org Confidentiality Notice: The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material. Any review, retransmission dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. 20090416 -------------- next part -------------- An HTML attachment was scrubbed... URL: From KBOEHME at meriter.com Fri Oct 16 13:53:55 2009 From: KBOEHME at meriter.com (Boehme, Karen) Date: Fri, 16 Oct 2009 15:53:55 -0500 Subject: [Cnm] Questions on revising our pt. menu In-Reply-To: <4E3FEB15613D694A9CE182702F53959B03836BAF@atl-ex1.hma.com> References: <4E3FEB15613D694A9CE182702F53959B03836BAF@atl-ex1.hma.com> Message-ID: <8CFCAB1537E1964AB1BAB60E81B019B683DE388A@EXVS1.meriter.com> We do allow bacon on our low residue and our transition diets. We also allow juice on our carb controlled breakfast although we recommend that our gestational diabetics avoid it. Karen ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Littrell, Leanne Sent: Friday, October 16, 2009 3:10 PM To: cnm at lists.my180.net Subject: [Cnm] Questions on revising our pt. menu We use the ADA Nutrition Care Manual and feel a few foods are up to interpretation Do you allow bacon on a soft/ low residue diet? Do you allow juice on a carbohydrate controlled diet at breakfast? I will summarize and send back to the list. Thanks Leanne Pearson Littrell, MS, RD, LD Director of Nutrition Services Peace River Regional Medical Center 2500 Harbor Blvd Port Charlotte, FL 33952 941-766-4228 Fax-941-766-4218 Cell 941-769-1774 leanne.littrell at hma.com -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.gif Type: image/gif Size: 917 bytes Desc: image001.gif URL: From rtripp at PINNACLEHEALTH.org Fri Oct 16 13:55:35 2009 From: rtripp at PINNACLEHEALTH.org (Roberta Tripp) Date: Fri, 16 Oct 2009 16:55:35 -0400 Subject: [Cnm] Obese patients In-Reply-To: Message-ID: <7375E17267B3DB4583032BDEFDA2D76E0C3494D6@mailphs.pinnaclehealth.org> We are doing the same as you and we have been invited to an upcoming meeting of a newly formed "Obesity Task Force" next week. We should find out if they are expecting the same from us. We would surely need more staff since we're no different from the rest of the country as far as the number of obese people in the community. 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 Gayle S. Loyd Sent: Friday, October 16, 2009 3:21 PM To: cnm at lists.my180.net Subject: [Cnm] Obese patients Fellow RD's I have a question regarding obese patients, esp. those with a BMI>40. We have been invited to the Nursing Quality counsel monthly meeting with the agenda to discuss care planning for obese patients. We are reviewing patients >40 BMI and making an admission note on them for coding, but IF that is the only reason to see them, we are not doing assessments and care planning. Our reasoning is that obesity alone is not a risk factor during an acute admission. And it is not the environment for wt loss counseling, etc. As the rest of you--- we are stretched to the limit. Have you been approached by nursing etc. to care plans on obese patients without other risk factors. What are your thoughts, etc. Thank you Gayle Loyd RD LDN Anderson Hospital/Sodexo Maryville, IL -------------- next part -------------- An HTML attachment was scrubbed... URL: From elewis at mdmercy.com Fri Oct 16 14:02:53 2009 From: elewis at mdmercy.com (Lewis, Erin) Date: Fri, 16 Oct 2009 17:02:53 -0400 Subject: [Cnm] Downtime Policy In-Reply-To: References: Message-ID: <291054791EAD1E4DB32893E121BC6FAC67807B@MCC0302.mmcnt.mhs.med> Good Evening All- I am wondering if anyone would have a downtime policy for electronic documentation that they would be willing to share? Thanks in advance, Erin Erin Lewis MS, RD, LDN, CNSC Clinical Nutrition Manager Mercy Medical Center 301 St. Paul Street Baltimore, MD 21202 Voice: 410.332.9307 Fax: 410.332.9881 This email transmission may contain CONFIDENTIAL, PRIVILEGED, and or PROTECTED INFORMATION intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient, please notify the sender by email, do not disseminate or copy and delete immediately. From lpettet at sfmc.net Fri Oct 16 14:16:45 2009 From: lpettet at sfmc.net (Lori Pettet) Date: Fri, 16 Oct 2009 16:16:45 -0500 Subject: [Cnm] Questions on revising our pt. menu In-Reply-To: <4E3FEB15613D694A9CE182702F53959B03836BAF@atl-ex1.hma.com> References: <4E3FEB15613D694A9CE182702F53959B03836BAF@atl-ex1.hma.com> Message-ID: <4AD89C6D.7C48.00C7.0@sfmc.net> We allow bacon only if the pt requests it on a soft diet We do allow juice on a carb controlled diet at breakfast, if w/in the alloted amount Lori Pettet, MA, RD, LD, CDE Assistant Manager, Nutrition Services Saint Francis Medical Center 211 St. Francis Dr. Cape Girardeau, MO 63703 Phone: 331-5145 LPettet at sfmc.net This email transmittal is intended only for the use of the individual or entity to which it is addressed. It may contain Protected Health Information, which is privileged and confidential. Protected Health Information may only be used or disclosed in accordance with law and you may be subject to penalties under law for improper use or further disclosure of the Protected Health Information in this email. If you are not the intended recipient of this email, you may not read, copy, distribute or otherwise use or disclose the information contained in this email. If you received this email in error, please notify the sender immediately and request instructions on return or destruction of the information in this email. >>> "Littrell, Leanne" 10/16/2009 3:10 pm >>> We use the ADA Nutrition Care Manual and feel a few foods are up to interpretation Do you allow bacon on a soft/ low residue diet? Do you allow juice on a carbohydrate controlled diet at breakfast? I will summarize and send back to the list. Thanks Leanne Pearson Littrell, MS, RD, LD Director of Nutrition Services Peace River Regional Medical Center 2500 Harbor Blvd Port Charlotte, FL 33952 941-766-4228 Fax-941-766-4218 Cell 941-769-1774 leanne.littrell at hma.com From Patricia.Booth at ucsfmedctr.org Fri Oct 16 16:04:36 2009 From: Patricia.Booth at ucsfmedctr.org (Booth, Patricia) Date: Fri, 16 Oct 2009 16:04:36 -0700 Subject: [Cnm] Biggest Loser In-Reply-To: <10DE3A7624A2BD48B81AFE4E90A5094D02412903@EX1.jaycountyhospital.com> References: <10DE3A7624A2BD48B81AFE4E90A5094D02412903@EX1.jaycountyhospital.com> Message-ID: For those with experience with a Biggest Loser type program, would you be willing to give more details? 1. What is an optimal size for the teams? 2. Were there any criteria for participation (e.g. BMI or percentage above IBW? 3. Did you collect any data besides weight? (e.g lipid panel, waist:hip ratio) 4. Did RDs participate in providing education, assessment, other activities? If so, how was this funded? 5. Any program management tips -- what worked well, not so well? Thanks! Patricia Booth, MS, RD, FADA Associate Director, Nutrition Services Director, Dietetic Internship Nutrition and Food Services UCSF Medical Center M-294 Box 0212 San Francisco, CA 94143-0212 Office: 415-353-1355 Email: patricia.booth at ucsfmedctr.org This document is intended only for the use of those to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you have received this electronic document in error, please immediately notify me by telephone or email. Thank you. -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Julayne Ross Sent: Friday, October 16, 2009 8:48 AM To: Sohal, Manjit; Miriam Pappo; CNM at lists.my180.net; Susan_R_Paredez at uhs.org; aimee crant Subject: Re: [Cnm] Biggest Loser We did a contest in the past and definitely % weight loss is more fair. Julayne -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Sohal, Manjit Sent: Thursday, October 15, 2009 4:04 PM To: Miriam Pappo; CNM at lists.my180.net; Susan_R_Paredez at uhs.org; aimee crant Subject: Re: [Cnm] Biggest Loser Our Loyalty Committee puts a Biggest Loser contest annually that lasts I believe about 6 months. People form teams and our Caf? has a special low fat "Biggest Loser Meal" everyday to help the teams succeed. Manjit Sohal, MS, RD Manager, Clinical Nutrition Nutrition Services Department Fremont-Rideout Health Group 725 Fourth Street Marysville, CA 95901 Ph: 530.749.4336 Pgr: 530.740.9992 Fax: 530.749.4337 www.frhg.org Exceptional Care, Close to Home -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Miriam Pappo Sent: Thursday, October 15, 2009 12:52 PM To: CNM at lists.my180.net; Susan_R_Paredez at uhs.org; aimee crant Subject: Re: [Cnm] Biggest Loser consider doing it in teams too. We did this years ago & it was a lot of fun. >>> aimee crant 10/15/09 11:57 AM >>> Biggest loser bases on percentage Aimee Crant-Oksa MS, RD Clinical Nutrition Manager Centrastate Medical Center tel: 732-294-2767 email: acrantok at centrastate.com ________________________________ From: "Susan_R_Paredez at uhs.org" To: CNM at lists.my180.net Sent: Thu, October 15, 2009 11:15:57 AM Subject: [Cnm] Biggest Loser Hello All, Some of our staff want to do a type of Biggest Loser contest outside of work. They want to know how to judge the wt. loss so it is equitable. For ex., it may be easier for a 200 lb. person to lose more wt. than a 150 lb. person. Should it be based on percentage lost, BMI? Any ideas? Thanks. 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 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. --- 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. o1 _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From ESCOTTSTUMPS at ecu.edu Fri Oct 16 18:12:36 2009 From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia) Date: Fri, 16 Oct 2009 21:12:36 -0400 Subject: [Cnm] FW: Clinical Managers DPG In-Reply-To: References: <767F60777AE0324F875E3F381E9A80D601C9AFDB0545@bhsexc11.bhs.org> , Message-ID: Hi all-- Karen Stein is writing an article on how RDs have implemented cultural competency. If you have done so, please respond directly to her at: karenbstein at gmail.com College of Human Ecology Enriching Lives. Enhancing Communities. Sylvia Escott-Stump, MA, RD, LDN East Carolina University 252-328-1352 ________________________________ My article has somewhat of a clinical emphasis, as it deals with cultural competency models and how to implement them into practice. My deadline for the article is October 30. At present, I am most interested in answers to the following questions: What has been your experience with using models to incorporate cultural competence? If you used your own process, how did you determine how you were going to do so? If you used an established model, which did you use and why? For practitioners in institutions/large health care practices, how is implementation monitored and success measured? How might individuals in private practice measure and monitor their own success in implementing culturally competent care? Given the increasing brevity of clinical encounters, what would you say to individuals who argue that there is insufficient time to participate in such activities? Please give potential participants my email address (karenbstein at gmail.com). Thank you so much for your help on this! Karen Stein -------------- next part -------------- An HTML attachment was scrubbed... URL: From jlworden at att.net Sat Oct 17 11:37:19 2009 From: jlworden at att.net (Jo Lynn Worden) Date: Sat, 17 Oct 2009 13:37:19 -0500 Subject: [Cnm] Soy Allergy In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E051CF591@rhcexch3.reshealthcare.org> References: <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B1F4B@EXCH4.wellspan.org> <5330B54133B6194BA13930BDEFE9A30E051CF591@rhcexch3.reshealthcare.org> Message-ID: <001801ca4f58$dbfb8250$93f286f0$@net> Just now getting around to reading this. I have been uncertain about this - is it soy protein that a person is allergic to - or does soy oil count also? I have seen product ingredient lists with soy oil but they have not identified soy in the list of allergens present. I supposed it was because to be soy allergy - it had to be soy flour, etc. Thanks for any references anyone can provide. j From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee Sent: Tuesday, October 13, 2009 11:18 AM To: Ketterman-Hopkins, Cindra; cnm at lists.my180.net Subject: Re: [Cnm] Soy Allergy we only use the bases for soups. we also do not use soy oil in cooking. 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 Ketterman-Hopkins, Cindra Sent: Tuesday, October 13, 2009 10:47 AM To: cnm at lists.my180.net Subject: [Cnm] Soy Allergy Hi everyone - How are you handling soy allergies for inpatients? Our chefs have such a high reliance on bases - beef base, chicken base, vegetable base (they even have a clam base) - that they add them to everything. So, when we have a soy allergy we end up giving them plain everything. I'd like to see us give up the bases - does your production staff have this great attachment to bases? 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Leslie.Hornick at dmh.mo.gov Sat Oct 17 13:27:34 2009 From: Leslie.Hornick at dmh.mo.gov (Hornick, Leslie G.) Date: Sat, 17 Oct 2009 15:27:34 -0500 Subject: [Cnm] NCP In-Reply-To: <24089FC2EA149A4693BAEEE1A69F26E603108501@nausbf-exmb01.na.sdxcorp.net> References: <4F21268C197FF8408219D0D6B7614AEE0332D33F2B@EXCHANGE2.trmc.us> <24089FC2EA149A4693BAEEE1A69F26E603108501@nausbf-exmb01.na.sdxcorp.net> Message-ID: <69DD80845D7F524BB1C8C59479ED0625024BA1CF@exchsvfulton01.mx.state.mo.us> We are not using it, but are looking at case studies and discussing... Leslie Hornick, RD, LD Chief Clinical Dietitian FSH CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. The designated recipients are prohibited from redisclosing this information to any other party without authorization and are required to destroy the information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited by federal or state law. If you have received this communication in error, please notify me immediately by telephone at 573-592-2059, and destroy all copies of this communication and any attachments. From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Childress, Amy Sent: Wednesday, September 23, 2009 10:45 AM To: Sandra Moretz Cc: cnm at lists.my180.net Subject: Re: [Cnm] NCP We are not using it here - planning for 2010 Amy Childress, RD Clinical Nutrition Manager Good Samaritan Hospital P: 213.977.2075 F: 213.977.2072 ________________________________ From: cnm-bounces at lists.my180.net on behalf of Sandra Moretz Sent: Tue 9/22/2009 12:38 PM To: cnm at lists.my180.net Subject: [Cnm] NCP I'm curious as to how many readers of this email are NOT using the NCP? Please reply if you ARE or ARE NOT using it and I will be glad to post a summary of the responses. Thanks, Sandra Moretz, RD, LD Clinical Nutrition Manager Tift Regional Medical Center Tifton, Georgia 229-353-6017 229-353-6673 ________________________________ This e-mail and any files transmitted with it may contain PRIVILEDGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the e-mail or any of its attachments, please be advised that you have received this e-mail in error and that use, dissemination, distribution, forwarding, printing, or copying of this e-mail or any attached files is strictly prohibited. If you have received this e-mail in error, please immediately purge it and all attachments and notify the sender by reply e-mail. From SCJ520 at aol.com Sun Oct 18 15:00:15 2009 From: SCJ520 at aol.com (SCJ520 at aol.com) Date: Sun, 18 Oct 2009 18:00:15 EDT Subject: [Cnm] NCP Message-ID: We are using the NCP. Sandra Cruz-Jute, MSEd, RD, CDN Clinical Nutrition Manager Good Samaritan Hospital Medical Center West Islip, NY 11795 In a message dated 10/17/2009 4:28:44 P.M. Eastern Daylight Time, Leslie.Hornick at dmh.mo.gov writes: We are not using it, but are looking at case studies and discussing? Leslie Hornick, RD, LD Chief Clinical Dietitian FSH CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. The designated recipients are prohibited from redisclosing this information to any other party without authorization and are required to destroy the information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited by federal or state law. If you have received this communication in error, please notify me immediately by telephone at 573-592-2059, and destroy all copies of this communication and any attachments. From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Childress, Amy Sent: Wednesday, September 23, 2009 10:45 AM To: Sandra Moretz Cc: cnm at lists.my180.net Subject: Re: [Cnm] NCP We are not using it here - planning for 2010 Amy Childress, RD Clinical Nutrition Manager Good Samaritan Hospital P: 213.977.2075 F: 213.977.2072 ____________________________________ From: cnm-bounces at lists.my180.net on behalf of Sandra Moretz Sent: Tue 9/22/2009 12:38 PM To: cnm at lists.my180.net Subject: [Cnm] NCP I?m curious as to how many readers of this email are NOT using the NCP? Please reply if you ARE or ARE NOT using it and I will be glad to post a summary of the responses. Thanks, Sandra Moretz, RD, LD Clinical Nutrition Manager Tift Regional Medical Center Tifton, Georgia 229-353-6017 229-353-6673 ____________________________________ This e-mail and any files transmitted with it may contain PRIVILEDGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the e-mail or any of its attachments, please be advised that you have received this e-mail in error and that use, dissemination, distribution, forwarding, printing, or copying of this e-mail or any attached files is strictly prohibited. If you have received this e-mail in error, please immediately purge it and all attachments and notify the sender by reply e-mail. From SRassekh at stfranciscare.org Mon Oct 19 05:17:25 2009 From: SRassekh at stfranciscare.org (Rassekh, Shoreh) Date: Mon, 19 Oct 2009 08:17:25 -0400 Subject: [Cnm] Obese patients In-Reply-To: Message-ID: <0AB0670D124B96418F1D6AAFB11D5C3101451095@SFH15110MV23.sfhad.stfranciscare.org> Please include me in responses. Thank you Shoreh Rassekh MS,RD, CD-N Saint Francis Hospital Hartford Ct ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Gayle S. Loyd Sent: Friday, October 16, 2009 3:21 PM To: cnm at lists.my180.net Subject: [Cnm] Obese patients Fellow RD's I have a question regarding obese patients, esp. those with a BMI>40. We have been invited to the Nursing Quality counsel monthly meeting with the agenda to discuss care planning for obese patients. We are reviewing patients >40 BMI and making an admission note on them for coding, but IF that is the only reason to see them, we are not doing assessments and care planning. Our reasoning is that obesity alone is not a risk factor during an acute admission. And it is not the environment for wt loss counseling, etc. As the rest of you--- we are stretched to the limit. Have you been approached by nursing etc. to care plans on obese patients without other risk factors. What are your thoughts, etc. Thank you Gayle Loyd RD LDN Anderson Hospital/Sodexo Maryville, IL 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: From EZENTZ at hancockregional.org Mon Oct 19 08:27:10 2009 From: EZENTZ at hancockregional.org (ELIZABETH ZENTZ) Date: Mon, 19 Oct 2009 11:27:10 -0400 Subject: [Cnm] Information on Cystic Fibrosis Message-ID: <0975EFA81EDB074F9418DBF07B3560620230E5D6@EXCHANGE.hmhhs.org> Please send to list serve. I have a 35 yo male who has cystic fibrosis. He has been in in the past and has always done pretty well. This time he has had bowel resection and is underweight (92% of IBW) with 10# wt loss. He is receiving TPN. I am having trouble finding Any calorie/pro needs for an adult with cystic fibrosis. Can anyone give me any ideas? I have recommended right now for 35 cal/kg and 1.5 gm pro/kg at IBW. Any suggestions? Thanks for your help. Liz Elizabeth Zentz, RD, CD Clinical Coordinator Hancock Regional Hospital The preceding message, including all attachments, is intended only for the addressee and may contain information that is privileged and confidential. If you are not the intended recipient, do not read, copy, retain or disseminate this message or any attachment. If you have received this message in error, please notify the sender immediately and delete all copies of the message and attachment. Neither the transmission of this message or any attachment, nor any error in transmission or misdelivery shall constitute waiver of any applicable legal privilege. ___________________________________________________ Important news about our email communications Hancock Regional Hospital has implemented a revised policy for secure email. To learn more about this policy, please click on the link below. http://userawareness.zixcorp.com/sites/index.php?b=433&type=1&p=2 -------------- next part -------------- An HTML attachment was scrubbed... URL: From DerrickK at health.missouri.edu Mon Oct 19 08:57:44 2009 From: DerrickK at health.missouri.edu (Derrick, Karen) Date: Mon, 19 Oct 2009 10:57:44 -0500 Subject: [Cnm] Information on Cystic Fibrosis In-Reply-To: <0975EFA81EDB074F9418DBF07B3560620230E5D6@EXCHANGE.hmhhs.org> References: <0975EFA81EDB074F9418DBF07B3560620230E5D6@EXCHANGE.hmhhs.org> Message-ID: <064B342B3641F04DA0FC21C0B79734B00A29CB0F@UM-EMAIL02.um.umsystem.edu> Hi, The dietitian covering the cystic fibrosis program is out for the North American Cystic Fibrosis conference this week. See attached for my cheat sheets. I've had these sheets for quite awhile so I'll check with her when she returns to make sure they are the current recommendations. Karen Derrick, MA,RD,LD,CDE University of Missouri Health Care Nutrition and Food Service Assistant Manager Clinical Nutrition 573-882-2251 (office) 573-499-7070 (pager) 573-884-4990 (fax) 573-999-4484 (cell) ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of ELIZABETH ZENTZ Sent: Monday, October 19, 2009 10:27 AM To: cnm at lists.my180.net Subject: [Cnm] Information on Cystic Fibrosis Please send to list serve. I have a 35 yo male who has cystic fibrosis. He has been in in the past and has always done pretty well. This time he has had bowel resection and is underweight (92% of IBW) with 10# wt loss. He is receiving TPN. I am having trouble finding Any calorie/pro needs for an adult with cystic fibrosis. Can anyone give me any ideas? I have recommended right now for 35 cal/kg and 1.5 gm pro/kg at IBW. Any suggestions? Thanks for your help. Liz Elizabeth Zentz, RD, CD Clinical Coordinator Hancock Regional Hospital The preceding message, including all attachments, is intended only for the addressee and may contain information that is privileged and confidential. If you are not the intended recipient, do not read, copy, retain or disseminate this message or any attachment. If you have received this message in error, please notify the sender immediately and delete all copies of the message and attachment. Neither the transmission of this message or any attachment, nor any error in transmission or misdelivery shall constitute waiver of any applicable legal privilege. ____________________________________________________________ Important news about our email communications Hancock Regional Hospital has implemented a revised policy for secure email. To learn more about this policy, please click on the link below. ZixCorp User Awareness -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: 2009_10_19_CF.pdf Type: application/pdf Size: 165774 bytes Desc: 2009_10_19_CF.pdf URL: From SLewis at mercycare.org Mon Oct 19 09:57:31 2009 From: SLewis at mercycare.org (Lewis, Suzanne) Date: Mon, 19 Oct 2009 11:57:31 -0500 Subject: [Cnm] H1N1 - Meal Service Message-ID: <63A81A57A6254849B538D2FF4F1D539904DD73D1@VS01EXC01.mercycare.org> What type of changes, if any, are you being asked to make in your cafeterias in regard to H1N1? If you have self serve salad bars, etc, in your Caf?'s are you being asked to stopped this type of service? We are trying to define what is appropriate and where to draw the line. Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. -------------- next part -------------- An HTML attachment was scrubbed... URL: From sheila.walsh at nahealth.com Mon Oct 19 10:39:22 2009 From: sheila.walsh at nahealth.com (Sheila Walsh) Date: Mon, 19 Oct 2009 10:39:22 -0700 Subject: [Cnm] H1N1 - Meal Service In-Reply-To: <63A81A57A6254849B538D2FF4F1D539904DD73D1@VS01EXC01.mercycare.org> References: <63A81A57A6254849B538D2FF4F1D539904DD73D1@VS01EXC01.mercycare.org> Message-ID: <4ADC41DA.485B.0001.0@nahealth.com> We are trying to divert H1N1 patients from coming to the hospital unless they are admitted. We have a triage site off campus. We are sending sick employees home (fever). We do not allow children to visit patients this time of year. We have far more isolation rooms than we have flu patients because it takes over a day to determine if a patient has the flu. Our Nutrition Assistants are being "Fit tested" so they can still take meal trays into all patient rooms. They are required to wash/sanitize their hands before they go into each room. We are not doing anything differently to our cafeteria food. fwiw, Sheila A. Walsh, MPH, RD Clinical Nutrition Manager Flagstaff Medical Center Where patients are our purpose. <\__~ / \ >>> "Lewis, Suzanne" 10/19/2009 9:57 AM >>> What type of changes, if any, are you being asked to make in your cafeterias in regard to H1N1? If you have self serve salad bars, etc, in your Caf?'s are you being asked to stopped this type of service? We are trying to define what is appropriate and where to draw the line. Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Jryan at holyredeemer.com Mon Oct 19 10:40:51 2009 From: Jryan at holyredeemer.com (Jeanie Ryan) Date: Mon, 19 Oct 2009 13:40:51 -0400 Subject: [Cnm] Menus in Long Term Care Message-ID: We have always posted our menus in long term care for the residents 2 weeks in advance. I thought that there was a regulation regarding the posting of menus. Is this still a regulation? Can anyone give me reg#, web site etc. regarding this? 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 --------------------------------------------------------------------------------- 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 1325 bytes Desc: image001.gif URL: From TYUSF at ccf.org Mon Oct 19 13:20:22 2009 From: TYUSF at ccf.org (Tyus, Frances) Date: Mon, 19 Oct 2009 16:20:22 -0400 Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite Message-ID: Please respond to the following: 1. Do all your diet orders interface? How do get info on a tube feeding How do get a tube feeding report from NSS or the EMR 2. Do allergies interface? 3. How do you receive consults - interfaced or printed requisition - other please explain 4. Are you a centralized or decentralized kitchen? Frances J. Tyus, MS, RD, LD |Systems Manager | Digestive Disease Institute Nutrition Therapy/M17 Cleveland OH 44195 Telephone - 216-444-46103 Fax - 216-444-9415 =================================== P Please consider the environment before printing this e-mail Cleveland Clinic is ranked one of the top hospitals in America by U.S. News & World Report (2008). Visit us online at http://www.clevelandclinic.org for a complete listing of our services, staff and locations. Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 23312 bytes Desc: image001.jpg URL: From rossjanv at fuse.net Mon Oct 19 15:08:17 2009 From: rossjanv at fuse.net (Janet V. Ross) Date: Mon, 19 Oct 2009 18:08:17 -0400 Subject: [Cnm] enteral formula selection for new jejunostomy Message-ID: I should have been paying better attention and not hit the delete button so fast and so often with this group. As a new acute care RD, I would like advice on the parameters for selecting the correct tube feeding for a patient with a new jejunostomy. His needs are about 2200 calories and 100 g protein. He has a gastric mass and PEJ was just placed today. He will go home with a pump. * How do I choose the best product for him? * What products are contraindicated? * What is the highest rate at which he can be fed? * Can he be eventually transitioned to just nocturnal feedings? Jan 513-478-0135 rossjanv at fuse.net 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: From RODR at phin.org Tue Oct 20 05:46:38 2009 From: RODR at phin.org (Rodney, Rachel) Date: Tue, 20 Oct 2009 08:46:38 -0400 Subject: [Cnm] low protein diet Message-ID: <149E946FB3E25C4F92AAC2B02F93CC4D02F663C9@mail.corp.svhc.net> First, I want to thank everyone for their responses to my previous questions. This listserve is fantastic! I work with a gastroenterologist who recommends a 30g protein diet for all of our patients with high NH4 levels. First of all, 30g protein is so little. Does anyone know of any research (or have any articles you can share-before I reinvent the wheel) which shows that low protein diets are not necessary? This patient has liver disease and her NH4 is approx 80. I just can't understand how anyone can eat that little protein without becoming malnourished. Thanks so much for any assistance! Rachel Rachel Rodney RD, CD, CDE Southwestern Vermont Medical Center 100 Hospital Drive Bennington, VT 05201 802-447-5577 (office) 802-742-8599 (pager) rodr at phin.org DISCLAIMER: The information contained in this electronic message is legally privileged and confidential under applicable law and is intended for a particular addressee(s). If it is not clear that you are the intended recipient, you are hereby notified that you have received this transmittal in error; any review, copying or distribution or dissemination is strictly prohibited. If you suspect that you have received this transmittal in error, please notify Southwestern VT Health Care Corporation immediately by return email reply to (helpdesk at phin.org), and immediately delete the transmittal and any attachments without making any copy or distribution. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Amy.Gendron at cvmc.org Tue Oct 20 06:04:30 2009 From: Amy.Gendron at cvmc.org (Gendron, Amy L.) Date: Tue, 20 Oct 2009 09:04:30 -0400 Subject: [Cnm] low protein diet In-Reply-To: <149E946FB3E25C4F92AAC2B02F93CC4D02F663C9@mail.corp.svhc.net> Message-ID: Hi Rachel I've seen information in quite a few places. I recommend this Practical Gastroenterology article from University of Virginia Health Systems: http://www.healthsystem.virginia.edu/internet/digestive-health/nutritionarticles/jun03krenitskyarticle.pdf Do you subscribe to the ADA online Nutrition Care Manual? I think it covers it there also with some links to articles. I also have an article from ASPEN in the Nutrition in Clinical Practice June 2006 Vol. 21, No. 3 "Nutrition in Alcoholic Liver Disease" - I could fax it to you if you want me to. I deal with this problem often and sometimes the best I can get out of a doctor is to agree to just keep the patient on a protein restricted diet (40-60g, never lower than that) for only a few days and I try to prove that it wasn't excessive protein that got the patient encephalopathic to begin with - it's usually an infection of some sort. Effective December 31, 2008 my email address changed. Please see below. Amy Gendron, RD Senior Inpatient Dietitian Central Vermont Medical Center ph: 802-371-4143 fax: 802-371-5376 amy.gendron at cvmc.org -----Original Message----- From: Rodney, Rachel [mailto:RODR at phin.org] Sent: Tuesday, October 20, 2009 8:47 AM To: cnm at lists.my180.net Subject: [Cnm] low protein diet First, I want to thank everyone for their responses to my previous questions. This listserve is fantastic! I work with a gastroenterologist who recommends a 30g protein diet for all of our patients with high NH4 levels. First of all, 30g protein is so little. Does anyone know of any research (or have any articles you can share-before I reinvent the wheel) which shows that low protein diets are not necessary? This patient has liver disease and her NH4 is approx 80. I just can't understand how anyone can eat that little protein without becoming malnourished. Thanks so much for any assistance! Rachel Rachel Rodney RD, CD, CDE Southwestern Vermont Medical Center 100 Hospital Drive Bennington, VT 05201 802-447-5577 (office) 802-742-8599 (pager) rodr at phin.org DISCLAIMER: The information contained in this electronic message is legally privileged and confidential under applicable law and is intended for a particular addressee(s). If it is not clear that you are the intended recipient, you are hereby notified that you have received this transmittal in error; any review, copying or distribution or dissemination is strictly prohibited. If you suspect that you have received this transmittal in error, please notify Southwestern VT Health Care Corporation immediately by return email reply to (helpdesk at phin.org), and immediately delete the transmittal and any attachments without making any copy or distribution. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From jbaye at mail.mcg.edu Tue Oct 20 07:31:11 2009 From: jbaye at mail.mcg.edu (Jessica Baye) Date: Tue, 20 Oct 2009 10:31:11 -0400 Subject: [Cnm] Full time oncology position at the Medical College of Georgia Message-ID: <4ADD916F.E045.0010.0@mail.mcg.edu> If there is anyone out there looking to relocate I have a full time outpatient Oncology position available. This is a great opportunity to start a program from the ground up. This is a Sodexo position - so you will have to apply for the job on the Sodexo website. Feel free to email me if you have any questions about the position 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 aimeenut at yahoo.com Tue Oct 20 07:53:14 2009 From: aimeenut at yahoo.com (aimee crant) Date: Tue, 20 Oct 2009 07:53:14 -0700 (PDT) Subject: [Cnm] residual & flushing guidelines Message-ID: <213978.32230.qm@web52602.mail.re2.yahoo.com> What guidelines are being used for flushing of TF and checking residuals?? We are looking to update our protocol.? Thanks Aimee Crant-Oksa MS, RD Clinical Nutrition Manager Centrastate Medical Center tel: 732-294-2767 email: acrantok at centrastate.com From me_merrell at yahoo.com Tue Oct 20 08:20:01 2009 From: me_merrell at yahoo.com (Monica Merrell) Date: Tue, 20 Oct 2009 08:20:01 -0700 (PDT) Subject: [Cnm] rinsed cottage cheese Message-ID: <462602.43167.qm@web36506.mail.mud.yahoo.com> Does anyone have nutrition information on rinsed cottage cheese?? Specifically, what?does the sodium content change to once you rinse it? ? Thanks,Monica Stewart, RD, LD Clinical Nutrition Manager Washington Regional Medical Center 3215 N. North Hills Blvd. Fayetteville, AR 72703 479-463-7198 -------------- next part -------------- An HTML attachment was scrubbed... URL: From JEdwards at hfmhealth.org Tue Oct 20 08:37:30 2009 From: JEdwards at hfmhealth.org (Jeanne Edwards) Date: Tue, 20 Oct 2009 10:37:30 -0500 Subject: [Cnm] residual & flushing guidelines Message-ID: If you go to this web site, the Aspen guidelines Are available in a PDF file for download. It's the 2009 Enteral Nutrition Practice Recommendations. http://www.nutritioncare.org/wcontent.aspx?id=2078 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 aimee crant Sent: Tuesday, October 20, 2009 9:53 AM To: cnm at lists.my180.net Cc: acrantok at centrastate.com Subject: [Cnm] residual & flushing guidelines What guidelines are being used for flushing of TF and checking residuals?? We are looking to update our protocol.? Thanks Aimee Crant-Oksa MS, RD Clinical Nutrition Manager Centrastate Medical Center tel: 732-294-2767 email: acrantok at centrastate.com _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From Michael.Smith at LPNT.net Tue Oct 20 08:59:54 2009 From: Michael.Smith at LPNT.net (Smith Michael - Palestine) Date: Tue, 20 Oct 2009 10:59:54 -0500 Subject: [Cnm] NCM Message-ID: Is anyone else unable to get the online nutrition care manual to launch since the recent update? Michael Smith RD LD Palestine Regional Medical Center Palestine, Texas -------------- next part -------------- An HTML attachment was scrubbed... URL: From bhomola at comhs.org Tue Oct 20 09:23:11 2009 From: bhomola at comhs.org (Bobbi Homola) Date: Tue, 20 Oct 2009 11:23:11 -0500 Subject: [Cnm] NCM In-Reply-To: Message-ID: Ours is operational now. Thank you, Bobbi Bobbi Homola, MPA, RD, CD Clinical Manager, Food and Nutrition Services St. Mary Medical Center / St. Catherine Hospital 1500 South Lake Park Avenue Hobart, IN 46342 219-947-6048 / 219-392-7081 219-947-6049 fax bhomola at comhs.org -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Smith Michael - Palestine Sent: Tuesday, October 20, 2009 11:00 AM To: cnm at lists.my180.net Subject: [Cnm] NCM Is anyone else unable to get the online nutrition care manual to launch since the recent update? Michael Smith RD LD Palestine Regional Medical Center Palestine, Texas ____________________________________ This message and attachment(s), if any, is intended for the sole use of the individual and/or entity of which it is addressed, and may contain information that is privileged,confidential and prohibited from disclosure under applicable law. If you are not the addressee, or authorized to receive this on behalf of the addressee, you are hereby notified that you may not use, copy, disclose or distribute to anyone this message or any part thereof. If you have received this in error, please immediately advise the sender by e-mail and delete this information and all attachments from your computer and network. Thank you. ____________________________________ -------------- next part -------------- An HTML attachment was scrubbed... URL: From JCrowley at shorememorial.org Tue Oct 20 09:38:08 2009 From: JCrowley at shorememorial.org (JCrowley at shorememorial.org) Date: Tue, 20 Oct 2009 12:38:08 -0400 Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite In-Reply-To: Message-ID: See below 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 "Tyus, Frances" Sent by: cnm-bounces at lists.my180.net 10/19/2009 04:20 PM To cnm at lists.my180.net cc Subject [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite Please respond to the following: 1. Do all your diet orders interface? No, none of our orders interface. Every diet is manually entered into CBORD How do get info on a tube feeding Diet office clerks calculate how much is needed per hourly order (put into EHR) and place that into CBORD How do get a tube feeding report from NSS or the EMR From NSS 2. Do allergies interface? No, manual 3. How do you receive consults ? interfaced or printed requisition ? other please explain Printed requisition 4. Are you a centralized or decentralized kitchen? Centralized Frances J. Tyus, MS, RD, LD |Systems Manager | Digestive Disease Institute Nutrition Therapy/M17 Cleveland OH 44195 Telephone ? 216-444-46103 Fax ? 216-444-9415 =================================== P Please consider the environment before printing this e-mail Cleveland Clinic is ranked one of the top hospitals in America by U.S. News & World Report (2008). Visit us online at http://www.clevelandclinic.org for a complete listing of our services, staff and locations. Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this 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. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 23312 bytes Desc: not available URL: From Julie.Finney at csauh.com Tue Oct 20 09:39:47 2009 From: Julie.Finney at csauh.com (Finney, Julie) Date: Tue, 20 Oct 2009 12:39:47 -0400 Subject: [Cnm] NCM In-Reply-To: References: Message-ID: Yes, we had the same difficulty. We had to re-set the ranges for our IP address. I was able to get into the administrator's page and it listed the error. My IT department assisted in fixing the error. Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Smith Michael - Palestine Sent: Tuesday, October 20, 2009 12:00 PM To: cnm at lists.my180.net Subject: [Cnm] NCM Is anyone else unable to get the online nutrition care manual to launch since the recent update? Michael Smith RD LD Palestine Regional Medical Center Palestine, Texas ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From mpappo at montefiore.org Tue Oct 20 09:49:04 2009 From: mpappo at montefiore.org (Miriam Pappo) Date: Tue, 20 Oct 2009 12:49:04 -0400 Subject: [Cnm] NCM Message-ID: Our still requires a user name/ password where it didnt before. NCM said they are aware of this problem and are working to fix it. In the meantime we can access it without a user name/ pw by using an URL address they will give you individualized to your facility. 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 >>> Smith Michael - Palestine 10/20/09 11:59 AM >>> Is anyone else unable to get the online nutrition care manual to launch since the recent update? Michael Smith RD LD Palestine Regional Medical Center Palestine, Texas -------------- next part -------------- A non-text attachment was scrubbed... Name: Miriam Pappo.vcf Type: application/octet-stream Size: 170 bytes Desc: not available URL: From Amy.Childress at sodexo.com Tue Oct 20 09:55:34 2009 From: Amy.Childress at sodexo.com (Childress, Amy) Date: Tue, 20 Oct 2009 12:55:34 -0400 Subject: [Cnm] FW: dating/labeling question References: <24089FC2EA149A4693BAEEE1A69F26E603108508@nausbf-exmb01.na.sdxcorp.net> Message-ID: <24089FC2EA149A4693BAEEE1A69F26E60310850A@nausbf-exmb01.na.sdxcorp.net> ?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? From TYUSF at ccf.org Tue Oct 20 10:00:19 2009 From: TYUSF at ccf.org (Tyus, Frances) Date: Tue, 20 Oct 2009 13:00:19 -0400 Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite Message-ID: Thank you for responding to my inquiry. I have summarized the responses for those that may be interested. Total responses 12 1. Do all your diet orders interface? All - 2 Some 9 None 1 How do get info on a tube feeding Requisitions Interfaced - 2 (both have Cerner) How do get a tube feeding report from NSS or the EMR NSS 10 EMR 2 2. Do allergies interface? Not interfaced -5 Some - 3 All -1 List of allergies 2 3. How do you receive consults - interfaced or printed requisition - other please explain Requisitions 10 Online 2 4. Are you a centralized or decentralized kitchen? Centralized - 11 Frances J. Tyus, MS, RD, LD |Systems Manager | Digestive Disease Institute Nutrition Therapy/M17 Cleveland OH 44195 Telephone - 216-444-46103 Fax - 216-444-9415 =================================== P Please consider the environment before printing this e-mail Cleveland Clinic is ranked one of the top hospitals in America by U.S. News & World Report (2008). Visit us online at http://www.clevelandclinic.org for a complete listing of our services, staff and locations. Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 23312 bytes Desc: image001.jpg URL: From Kathy.Kesling at ssfhs.org Tue Oct 20 10:06:27 2009 From: Kathy.Kesling at ssfhs.org (Kesling Kathy) Date: Tue, 20 Oct 2009 13:06:27 -0400 Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite In-Reply-To: Message-ID: <6002851.710866.1256058388718.JavaMail.root@oailxiron1.ssfhs.org> Please see responses below ... Thanks, Kathy Kesling ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Tyus, Frances Sent: Monday, October 19, 2009 3:20 PM To: cnm at lists.my180.net Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite Please respond to the following: 1. Do all your diet orders interface? Most do through Computrition. Do not interface NPO, tube feedings, fluid restrictions, renal diet (due to calculating protein and calories based on weight) How do get info on a tube feeding - Order placed in EMR and requisition prints in diet office. How do get a tube feeding report from NSS or the EMR Computrition report 2. Do allergies interface? No 3. How do you receive consults - interfaced or printed requisition - other please explain Requisition 4. Are you a centralized or decentralized kitchen? Centralized [cid:581220317 at 20102009-3529] Frances J. Tyus, MS, RD, LD |Systems Manager | Digestive Disease Institute Nutrition Therapy/M17 Cleveland OH 44195 Telephone - 216-444-46103 Fax - 216-444-9415 =================================== P Please consider the environment before printing this e-mail Cleveland Clinic is ranked one of the top hospitals in America by U.S. News & World Report (2008). Visit us online at http://www.clevelandclinic.org for a complete listing of our services, staff and locations. Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this 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. 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 23312 bytes Desc: image001.jpg URL: From Laura.Hill2 at Mercy.Net Tue Oct 20 10:08:02 2009 From: Laura.Hill2 at Mercy.Net (Hill, Laura L) Date: Tue, 20 Oct 2009 12:08:02 -0500 Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite In-Reply-To: References: Message-ID: <0D52666873E5914EBC179207FAC7A054022FB170@stl-pmailrsgp02.smrcy.com> See Below 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 ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Tyus, Frances Sent: Monday, October 19, 2009 3:20 PM To: cnm at lists.my180.net Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite Please respond to the following: We have EPIC EMR 1. Do all your diet orders interface? yes How do get info on a tube feeding via Epic interface into CBORD How do get a tube feeding report from NSS or the EMR CBORD has a tube feeding report 2. Do allergies interface? yes 3. How do you receive consults - interfaced or printed requisition - other please explain interface 4. Are you a centralized or decentralized kitchen? centralized Frances J. Tyus, MS, RD, LD |Systems Manager | Digestive Disease Institute Nutrition Therapy/M17 Cleveland OH 44195 Telephone - 216-444-46103 Fax - 216-444-9415 =================================== P Please consider the environment before printing this e-mail Cleveland Clinic is ranked one of the top hospitals in America by U.S. News & World Report (2008). Visit us online at http://www.clevelandclinic.org for a complete listing of our services, staff and locations. Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this 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. 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 person responsible for delivering this to the addressee(s), you are notified that reading, copying or distributing this e-mail is prohibited. If you have received this e-mail in error, please contact the sender immediately. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 23312 bytes Desc: image001.jpg URL: From Melissa.Tewes at wchsys.org Tue Oct 20 10:13:51 2009 From: Melissa.Tewes at wchsys.org (Melissa Tewes) Date: Tue, 20 Oct 2009 13:13:51 -0400 Subject: [Cnm] Cnm Digest, Vol 35, Issue 68 In-Reply-To: References: Message-ID: We have CBORD and an EMR Melissa Tewes RD, LDN Clinical Nutrition Manager Washington County Hospital 251 E. Antietam St. Hagerstown, MD 21774 Direct Line: 301-790-8085 Fax: 301-790-8535 Melissa.Tewes at wchsys.org ________________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of cnm-request at lists.my180.net [cnm-request at lists.my180.net] Sent: Tuesday, October 20, 2009 1:08 PM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, Issue 68 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: Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite (Kesling Kathy) 2. Re: Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite (Hill, Laura L) ---------------------------------------------------------------------- Message: 1 Date: Tue, 20 Oct 2009 13:06:27 -0400 From: Kesling Kathy Subject: Re: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite To: "'Tyus, Frances'" , "cnm at lists.my180.net" Message-ID: <6002851.710866.1256058388718.JavaMail.root at oailxiron1.ssfhs.org> Content-Type: text/plain; charset="us-ascii" Please see responses below ... Thanks, Kathy Kesling ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Tyus, Frances Sent: Monday, October 19, 2009 3:20 PM To: cnm at lists.my180.net Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite Please respond to the following: 1. Do all your diet orders interface? Most do through Computrition. Do not interface NPO, tube feedings, fluid restrictions, renal diet (due to calculating protein and calories based on weight) How do get info on a tube feeding - Order placed in EMR and requisition prints in diet office. How do get a tube feeding report from NSS or the EMR Computrition report 2. Do allergies interface? No 3. How do you receive consults - interfaced or printed requisition - other please explain Requisition 4. Are you a centralized or decentralized kitchen? Centralized [cid:581220317 at 20102009-3529] Frances J. Tyus, MS, RD, LD |Systems Manager | Digestive Disease Institute Nutrition Therapy/M17 Cleveland OH 44195 Telephone - 216-444-46103 Fax - 216-444-9415 =================================== P Please consider the environment before printing this e-mail Cleveland Clinic is ranked one of the top hospitals in America by U.S. News & World Report (2008). Visit us online at http://www.clevelandclinic.org for a complete listing of our services, staff and locations. Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this 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. 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 23312 bytes Desc: image001.jpg URL: ------------------------------ Message: 2 Date: Tue, 20 Oct 2009 12:08:02 -0500 From: "Hill, Laura L" Subject: Re: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite To: "Tyus, Frances" , Message-ID: <0D52666873E5914EBC179207FAC7A054022FB170 at stl-pmailrsgp02.smrcy.com> Content-Type: text/plain; charset="us-ascii" See Below 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 ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Tyus, Frances Sent: Monday, October 19, 2009 3:20 PM To: cnm at lists.my180.net Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite Please respond to the following: We have EPIC EMR 1. Do all your diet orders interface? yes How do get info on a tube feeding via Epic interface into CBORD How do get a tube feeding report from NSS or the EMR CBORD has a tube feeding report 2. Do allergies interface? yes 3. How do you receive consults - interfaced or printed requisition - other please explain interface 4. Are you a centralized or decentralized kitchen? centralized Frances J. Tyus, MS, RD, LD |Systems Manager | Digestive Disease Institute Nutrition Therapy/M17 Cleveland OH 44195 Telephone - 216-444-46103 Fax - 216-444-9415 =================================== P Please consider the environment before printing this e-mail Cleveland Clinic is ranked one of the top hospitals in America by U.S. News & World Report (2008). Visit us online at http://www.clevelandclinic.org for a complete listing of our services, staff and locations. Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this 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. 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 person responsible for delivering this to the addressee(s), you are notified that reading, copying or distributing this e-mail is prohibited. If you have received this e-mail in error, please contact the sender immediately. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 23312 bytes Desc: image001.jpg URL: ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 68 *********************************** ***** CONFIDENTIALITY NOTICE ***** This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. From Cathy.Poquette at stjoe.org Tue Oct 20 10:19:00 2009 From: Cathy.Poquette at stjoe.org (Cathy Poquette) Date: Tue, 20 Oct 2009 10:19:00 -0700 Subject: [Cnm] Percent eaten at meals In-Reply-To: <4AD70C74.21B0.00A0.0@dmhhs.org> Message-ID: The PCT (CNA) records PO intake at all meals here at our facility. We developed a tool to standardize how they calculate and record overall PO intake at a given meal. I have attached the tool we use. We teach this in both new-hire Orientation for PCT's and also have them demonstrate competence at a skills lab for PCT's. We take trays to the skills lab with varying amounts of food eaten and have them document what they calculate the % intake to be using our standardized tool. We have the correct answer laminated and turned over on the tray - show them when we discuss the answer. Cathy Poquette, M.S., R.D. Clinical Nutrition Operations Manager St. Jude Medical Center 101 E. Valencia Mesa Drive Fullerton, CA 92835 (714) 992-3000, ext. 3897 Pager: (714) 490-8030 ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of ETCHASON,LAURA Sent: Thursday, October 15, 2009 9:50 AM To: 'CNM at lists.my180.net'; Debra J Jeske Subject: Re: [Cnm] Percent eaten at meals We have a category for how the patient feels his/her appetite is, how the nurse feels the pt's appetite is, and how the pt's family feels the pt's appetite is. We do still record the % of po intake on certain patients. We (the RDs) put an order in for po intake to be recorded. We put an order through just so we can formulate a query for our host/hostesses (tray passers) so they know which pt's to record. It significantly decreased the amount of recording the tray passers were doing. We are computerized here so it doesn't take much effort to look up what foods the patient ordered. However, I definitely feel (as you likely do too) that talking w/ the patient, nurse, and family members about intake seems to be the best method as food may be brought in from home, a pt may say appetite is poor, but he/she still eats adequately, etc. Thank you, Laura Laura A. Etchason, MS, RD, LDN Clinical Nutrition Manager Decatur Memorial Hospital 2300 N. Edward Street Decatur, IL 62526 217-876-5306 (office line and voice mail) 217-876-5305 (fax) 217-876-5301 (general line) lauraf at dmhhs.org Developer, Harmony, Maximizer, Individualization, Belief >>> "Jeske, Debra J" 10/15/2009 11:22 AM >>> How are your RNs or techs documenting the meal intake on their shift assessments? Currently our PCT document the percent eaten. This is often misleading as it could be 100% of coffee for one person and 25% of a feast for another. We are wanting to remove the percent and just have appetite but would really like a feel for how other facilities are documenting. Debbie Jeske, MS, RD, LD, CNSD Manager, Clinical Nutrition and Patient Services St. Luke's Hospital Phone 314-205-6975 Beeper 314-855-7048 DISCLAIMER: The contents of this e-mail, including any attachments, contain information which may be confidential, legally privileged, proprietary in nature, or otherwise protected by law from disclosure, and is solely for the use of the intended recipient(s). If you are not the intended recipient, any use, disclosure or copying of this e-mail, including any attachments, is unauthorized and strictly prohibited. If you have received this e-mail in error, please notify us via return e-mail and immediately delete all copies of it from your system. Any opinions either expressed or implied in this e-mail and all attachments, are those of its author only, and do not necessarily reflect those of St. Luke's Hospital. CONFIDENTIAL: This email message and any attachments are for the sole use of the intended recipient(s) and may contain HIGHLY CONFIDENTIAL PERSONAL HEALTH INFORMATION. It is to be used only to aid in providing specific healthcare services to this patient. Any unauthorized review,use, disclosure, or distribution is a violation of Federal Law (HIPAA) and will be reported as such. If you are not the intended recipient or a person responsible for delivering this message to an intended recipient, please contact the sender by reply email and destroy all copies of the original message immediately. ________________________________ Notice from St. Joseph Health System: Please note that the information contained in this message may be privileged and confidential and protected from disclosure. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: Scoring Tool for Documenting % Meal Intake.doc Type: application/msword Size: 38400 bytes Desc: Scoring Tool for Documenting % Meal Intake.doc URL: From CShipman at baymedical.org Tue Oct 20 10:22:20 2009 From: CShipman at baymedical.org (Shipman, Cindy) Date: Tue, 20 Oct 2009 12:22:20 -0500 Subject: [Cnm] CMS Guidlelines and Diet Orders In-Reply-To: <0D52666873E5914EBC179207FAC7A054022FB170@stl-pmailrsgp02.smrcy.com> Message-ID: <28C9A616766126479E11A1BC4DDA43B20576D9FF@BMCEXCHVS2.corp.baymedical.org> We are setting up our electronic MR so that MDs can order the diets, etc. To comply with CMS guidelines we are not using Diet as Tolerated, Advance as Tolerated as orders that can be entered. Are any of you dealing with this issue and has anyone found a good solution? Thank you for your input. Cindy Shipman, RD Bay Medical Center Panama City, FL . -------------------------------------------------------- Confidentiality Notice: The information contained in this e-mail is intended solely for the person(s) to whom it is addressed. This information is the property of Bay Medical Center and may be confidential. If you are not the intended addressee, you should not distribute, copy or disclose this e-mail. Please notify the sender immediately if you received this e-mail by mistake and delete this email from your system and destroy all printed copies. -------------- next part -------------- An HTML attachment was scrubbed... URL: From MELLINGTON at wakemed.org Tue Oct 20 11:00:43 2009 From: MELLINGTON at wakemed.org (MARTHA ELLINGTON) Date: Tue, 20 Oct 2009 14:00:43 -0400 Subject: [Cnm] H1N1 - Meal Service In-Reply-To: <63A81A57A6254849B538D2FF4F1D539904DD73D1@VS01EXC01.mercycare.org> References: <63A81A57A6254849B538D2FF4F1D539904DD73D1@VS01EXC01.mercycare.org> Message-ID: We do not allow children to visit who are under 18. This has cut down on kids in the hospital. We are going to get one of those free standing hand hygiene foam machines to place at the salad and self serve bar for ease of use. We have not been told to D/C self serve. 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 Lewis, Suzanne Sent: Monday, October 19, 2009 12:58 PM To: cnm at lists.my180.net Subject: [Cnm] H1N1 - Meal Service What type of changes, if any, are you being asked to make in your cafeterias in regard to H1N1? If you have self serve salad bars, etc, in your Caf?'s are you being asked to stopped this type of service? We are trying to define what is appropriate and where to draw the line. Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. -------------- next part -------------- An HTML attachment was scrubbed... URL: From aimeenut at yahoo.com Tue Oct 20 11:35:09 2009 From: aimeenut at yahoo.com (aimee crant) Date: Tue, 20 Oct 2009 18:35:09 +0000 (GMT) Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite In-Reply-To: <6002851.710866.1256058388718.JavaMail.root@oailxiron1.ssfhs.org> References: <6002851.710866.1256058388718.JavaMail.root@oailxiron1.ssfhs.org> Message-ID: <347411.32954.qm@web52607.mail.re2.yahoo.com> see below ?Aimee Crant-Oksa MS, RD Clinical Nutrition Manager Centrastate Medical Center tel: 732-294-2767 email: acrantok at centrastate.com ________________________________ From: Kesling Kathy To: "Tyus, Frances" ; "cnm at lists.my180.net" Sent: Tue, October 20, 2009 1:06:27 PM Subject: Re: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite Please see responses below ... Thanks, Kathy Kesling ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Tyus, Frances Sent: Monday, October 19, 2009 3:20 PM To: cnm at lists.my180.net Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite Please respond to the following: 1. Do all your diet orders interface???Through Soarian to Gemserve (common cents solutions)??????????? How do get info on a tube feeding? - TF also interfaces, but labels are printed through Soarian and all other infor from EMR? ??????????? How do get a tube feeding report from NSS or the EMR? EMR? 2. Do allergies interface???Yes? 3. How do you receive consults ? interfaced or printed requisition ? other please explain? Requisition? 4. Are you a centralized or decentralized kitchen?? Centralized? ? ? Frances J. Tyus, MS, RD, LD? |Systems Manager | Digestive Disease Institute ? Nutrition Therapy/M17? Cleveland OH 44195 ??? Telephone ? 216-444-46103 Fax ? 216-444-9415 ? =================================== P Please consider the environment before printing this e-mail Cleveland Clinic is ranked one of the top hospitals in America by U.S. News & World Report (2008). Visit us online at http://www.clevelandclinic.org for a complete listing of our services, staff and locations. Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this 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. ________________________________ 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 23312 bytes Desc: image001.jpg URL: From knannini at azkrmc.com Tue Oct 20 12:04:35 2009 From: knannini at azkrmc.com (Kathy Nannini) Date: Tue, 20 Oct 2009 12:04:35 -0700 Subject: [Cnm] Pediatric Question Need Help Message-ID: <0613BF27181C264D9FE3CDC4005DB39B06B54493@vexchange.azkrmc.org> SLP is working with a toddler in the out patients setting who will be 3 in November. She is trying to promote PO intakes. She has provided me with the following information. Not being an expert in Pediatrics, nor do we have a high pediatric population of this acuity level, can anyone help us out? History includes: failure to thrive, hydrocephalus, hyperinsulism, PEG tube feedings, esophageal eosinophilia. (spelling doesn't count today :-) ) and sensory deficits which have been treated (and the treatment is ongoing). He had a full panel allergy workup and results indicated he was allergic to the Pediasure. The rest of the test was normal. He currently is on a bolus feed via PEG of 205ml of Alacare 5X/day. Is eating solids including crackers (honey grahams are his favorite), Vienna sausages with mustard, some chili, spaghetti sauce, ravioli, ice cream, and yogurt. He has declined in his P.O. tolerance since the pancreatic surgery but appears to be improving this week. Some days he eats fair and other days he will eat absolutely nothing. Any ideas to promote P.O. intake would be greatly appreciated. Kathy Kathy Nannini, MS, RD Clinical Nutrition Manager Kingman Regional Medical Center 3269 Stockton Hill Road Kingman, AZ 86409-3619 Direct Phone: (928) 692-4153 Hospital: (928) 757-2101 Ext. 1153 FAX: (928) 692-2734 Email: knannini at azkrmc.com -------------- next part -------------- An HTML attachment was scrubbed... URL: From JScully at lawrencehealth.org Tue Oct 20 13:16:18 2009 From: JScully at lawrencehealth.org (Scully, Jennifer) Date: Tue, 20 Oct 2009 16:16:18 -0400 Subject: [Cnm] New member Message-ID: Hello all, I wanted to introduce myself- I am new to this listserv. I am excited to learn from all of you and hopefully be able to share my ideas and experiences. Jen Jennifer Scully, RD, CDN Clinical Nutrition Manager Lawrence Hospital Center Bronxville, NY 11109 (914) 787-5089 ph (914) 787-5093 fax ##################################################################################### This message is for the named person's use only. It may contain confidential, proprietary or legally privileged information. No confidentiality or privilege is waived or lost by any mistransmission. If you receive this message in error, please immediately delete it and all copies of it from your system, destroy any hard copies of it and notify the sender. You must not, directly or indirectly, use, disclose, distribute, print, or copy any part of this message if you are not the intended recipient. STELLARIS HEALTH and any of its subsidiaries each reserve the right to monitor all e-mail communications through its networks. Any views expressed in this message are those of the individual sender, except where the message states otherwise and the sender is authorized to state them to be the views of any such entity. ##################################################################################### -------------- next part -------------- An HTML attachment was scrubbed... URL: From FREED_KATHARINE at GUTHRIE.ORG Tue Oct 20 13:26:06 2009 From: FREED_KATHARINE at GUTHRIE.ORG (FREED_KATHARINE at GUTHRIE.ORG) Date: Tue, 20 Oct 2009 16:26:06 -0400 Subject: [Cnm] Open Position Message-ID: We have a part time (~ 20 hrs/week) position open, if you know of a registered or registry eligible dietitian looking for a position in the southern tier of New York/northeast PA region. Guthrie Healthcare System/Corning Hospital/HealthWorks is recruiting for a half time outpatient dietitian. Requirements include a BS degree in Food & Nutrition/Dietetics and registered or registry eligible with CDR. Experience in an outpatient setting with Cardiac Rehab, Weight Reduction and Diabetes Education preferred. Recent internship grads with no experience will be considered. Potential candidates who would enjoy practicing dietetics in an outpatient Fitness/Rehab setting as a member of a team with PTs, OTs, Exercise Physiologist and RN, CDE are encouraged to apply. If you are interested or would like more information, contact Jennifer L. Yartym, MSPT, Director of HealthWorks and Rehabilitation Services, Corning Hospital, 176 Denison Parkway East, Corning, NY 14830, Phone: (607)937-4808 / 7446, Fax: (607)937-4888 / 7865, Yartym_Jennifer at Guthrie.org. Thanks, Kait Freed Katharine Ward Freed, MS, RD, LDN, CDE Clinical Supervisor Food & Nutrition Dept. Robert Packer Hospital One Guthrie Square Sayre, PA 18840 Tel 570-882-4297 Fax 570-882-5122 Email: "freed_katharine at guthrie.org" CONFIDENTIALITY NOTICE: This e-mail, including attachments, may include confidential, restricted, protected health and/or proprietary information, and may be used only for the person or entity to which it is addressed. If the reader of this e-mail is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution or copying of this e-mail is prohibited. If you have received this e-mail in error, please notify the sender by replying to this message and delete this e-mail immediately. Notice: The disclosure of medical information is strictly prohibited by federal regulation. Unauthorized release of medical information may result in administrative, civil and criminal sanctions. -------------- next part -------------- An HTML attachment was scrubbed... URL: From JScully at lawrencehealth.org Tue Oct 20 13:32:34 2009 From: JScully at lawrencehealth.org (Scully, Jennifer) Date: Tue, 20 Oct 2009 16:32:34 -0400 Subject: [Cnm] Cnm Digest, Vol 35, Issue 65 In-Reply-To: Message-ID: Hi Frances, I answered your questions below. Give me a call or send me an email if you would like further information. 1. Do all your diet orders interface? YES How do get info on a tube feeding From NSS and the EMR; a requisition is printed to our diet office each time a new diet, supplement, or tube feeding is ordered. We have Personal Choice Dining here, so our Ambassadors (called hosts/hostesses at other facilities) can either check each requisition and enter the tube feeding in CBORD or they can print a report from CBORD with the tube feedings. Either way, we are manually entering the tube feeding under the supplements section in CBORD. How do get a tube feeding report from NSS or the EMR See above 2. Do allergies interface? YES, we have an AL7 interface, so allergies come across. 3. How do you receive consults - interfaced or printed requisition - other please explain We receive consults as printed requisitions. But, we found that the consults sometimes got lost in the huge pile of diet order reqs, so we created a report that generates each morning automatically with a list of the consults for that day and the previous day 4. Are you a centralized or decentralized kitchen? Centralized Jen Jennifer Scully, RD, CDN Clinical Nutrition Manager Lawrence Hospital Center Bronxville, NY (914) 787-5089 ph (914) 787-5093 fax jscully at lawrencehealth.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: Tuesday, October 20, 2009 8:47 AM To: cnm at lists.my180.net Subject: Cnm Digest, Vol 35, 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..." Today's Topics: 1. Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite (Tyus, Frances) 2. enteral formula selection for new jejunostomy (Janet V. Ross) 3. low protein diet (Rodney, Rachel) ---------------------------------------------------------------------- Message: 1 Date: Mon, 19 Oct 2009 16:20:22 -0400 From: "Tyus, Frances" Subject: [Cnm] Please respond if you have an Electronic medical record and CBORD Nutrition Service Suite To: cnm at lists.my180.net Message-ID: Content-Type: text/plain; charset="us-ascii" Please respond to the following: 1. Do all your diet orders interface? How do get info on a tube feeding How do get a tube feeding report from NSS or the EMR 2. Do allergies interface? 3. How do you receive consults - interfaced or printed requisition - other please explain 4. Are you a centralized or decentralized kitchen? Frances J. Tyus, MS, RD, LD |Systems Manager | Digestive Disease Institute Nutrition Therapy/M17 Cleveland OH 44195 Telephone - 216-444-46103 Fax - 216-444-9415 =================================== P Please consider the environment before printing this e-mail Cleveland Clinic is ranked one of the top hospitals in America by U.S. News & World Report (2008). Visit us online at http://www.clevelandclinic.org for a complete listing of our services, staff and locations. Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 23312 bytes Desc: image001.jpg URL: ------------------------------ Message: 2 Date: Mon, 19 Oct 2009 18:08:17 -0400 From: "Janet V. Ross" Subject: [Cnm] enteral formula selection for new jejunostomy To: Message-ID: Content-Type: text/plain; charset="us-ascii" I should have been paying better attention and not hit the delete button so fast and so often with this group. As a new acute care RD, I would like advice on the parameters for selecting the correct tube feeding for a patient with a new jejunostomy. His needs are about 2200 calories and 100 g protein. He has a gastric mass and PEJ was just placed today. He will go home with a pump. * How do I choose the best product for him? * What products are contraindicated? * What is the highest rate at which he can be fed? * Can he be eventually transitioned to just nocturnal feedings? Jan 513-478-0135 rossjanv at fuse.net 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: ------------------------------ Message: 3 Date: Tue, 20 Oct 2009 08:46:38 -0400 From: "Rodney, Rachel" Subject: [Cnm] low protein diet To: Message-ID: <149E946FB3E25C4F92AAC2B02F93CC4D02F663C9 at mail.corp.svhc.net> Content-Type: text/plain; charset="us-ascii" First, I want to thank everyone for their responses to my previous questions. This listserve is fantastic! I work with a gastroenterologist who recommends a 30g protein diet for all of our patients with high NH4 levels. First of all, 30g protein is so little. Does anyone know of any research (or have any articles you can share-before I reinvent the wheel) which shows that low protein diets are not necessary? This patient has liver disease and her NH4 is approx 80. I just can't understand how anyone can eat that little protein without becoming malnourished. Thanks so much for any assistance! Rachel Rachel Rodney RD, CD, CDE Southwestern Vermont Medical Center 100 Hospital Drive Bennington, VT 05201 802-447-5577 (office) 802-742-8599 (pager) rodr at phin.org DISCLAIMER: The information contained in this electronic message is legally privileged and confidential under applicable law and is intended for a particular addressee(s). If it is not clear that you are the intended recipient, you are hereby notified that you have received this transmittal in error; any review, copying or distribution or dissemination is strictly prohibited. If you suspect that you have received this transmittal in error, please notify Southwestern VT Health Care Corporation immediately by return email reply to (helpdesk at phin.org), and immediately delete the transmittal and any attachments without making any copy or distribution. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: ------------------------------ _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net End of Cnm Digest, Vol 35, Issue 65 *********************************** ##################################################################################### This message is for the named person's use only. It may contain confidential, proprietary or legally privileged information. No confidentiality or privilege is waived or lost by any mistransmission. If you receive this message in error, please immediately delete it and all copies of it from your system, destroy any hard copies of it and notify the sender. You must not, directly or indirectly, use, disclose, distribute, print, or copy any part of this message if you are not the intended recipient. STELLARIS HEALTH and any of its subsidiaries each reserve the right to monitor all e-mail communications through its networks. Any views expressed in this message are those of the individual sender, except where the message states otherwise and the sender is authorized to state them to be the views of any such entity. ##################################################################################### -------------- next part -------------- An HTML attachment was scrubbed... URL: From TYUSF at ccf.org Tue Oct 20 15:32:01 2009 From: TYUSF at ccf.org (Tyus, Frances) Date: Tue, 20 Oct 2009 18:32:01 -0400 Subject: [Cnm] NCM In-Reply-To: References: Message-ID: I am not ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Smith Michael - Palestine Sent: Tuesday, October 20, 2009 12:00 PM To: cnm at lists.my180.net Subject: [Cnm] NCM Is anyone else unable to get the online nutrition care manual to launch since the recent update? Michael Smith RD LD Palestine Regional Medical Center Palestine, Texas =================================== P Please consider the environment before printing this e-mail Cleveland Clinic is ranked one of the top hospitals in America by U.S. News & World Report (2008). Visit us online at http://www.clevelandclinic.org for a complete listing of our services, staff and locations. Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: From JScully at lawrencehealth.org Wed Oct 21 05:38:34 2009 From: JScully at lawrencehealth.org (Scully, Jennifer) Date: Wed, 21 Oct 2009 08:38:34 -0400 Subject: [Cnm] Comfort foods Message-ID: How are you handling patients on Palliative Care service? Our NP for Palliative Care (who is wonderful!) is requesting that we build a special diet- "Comfort Foods only". She usually only wants fruit ice, yogurt, ice pops, mashed potato, etc for these patients. My concern is the adequacy of these diets. Although these patients may be at the end of their life, that end could be 2-3 months away. Keeping someone on full liquids, although also nutritionally inadequate, is usually only for 2-3 days. Our practice now is to keep the diet that is ordered (regular, puree, etc), manually remove most of the items on the menu and add the items that the Palliative Care NP is requesting. Any thoughts on how to handle this? Thanks! Jen Jennifer Scully, RD, CDN Clinical Nutrition Manager Lawrence Hospital Center (914) 787-5089 ph (914) 787-5093 fax ##################################################################################### This message is for the named person's use only. It may contain confidential, proprietary or legally privileged information. No confidentiality or privilege is waived or lost by any mistransmission. If you receive this message in error, please immediately delete it and all copies of it from your system, destroy any hard copies of it and notify the sender. You must not, directly or indirectly, use, disclose, distribute, print, or copy any part of this message if you are not the intended recipient. STELLARIS HEALTH and any of its subsidiaries each reserve the right to monitor all e-mail communications through its networks. Any views expressed in this message are those of the individual sender, except where the message states otherwise and the sender is authorized to state them to be the views of any such entity. ##################################################################################### -------------- next part -------------- An HTML attachment was scrubbed... URL: From Melissa.Tewes at wchsys.org Wed Oct 21 05:58:29 2009 From: Melissa.Tewes at wchsys.org (Melissa Tewes) Date: Wed, 21 Oct 2009 08:58:29 -0400 Subject: [Cnm] Diet Tech Message-ID: Are any of you utilizing diet techs? If so, in what capacity? Patient care? Diet education? I'm not sure what exactly they are allowed to do...any info on scope of practice? Benefits/Drawbacks? Thanks in advance Melissa Tewes RD, LDN Clinical Nutrition Manager Washington County Hospital 251 E. Antietam St. Hagerstown, MD 21774 Direct Line: 301-790-8085 Fax: 301-790-8535 Melissa.Tewes at wchsys.org ________________________________ ***** CONFIDENTIALITY NOTICE ***** This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. -------------- next part -------------- An HTML attachment was scrubbed... URL: From SLewis at mercycare.org Wed Oct 21 06:22:21 2009 From: SLewis at mercycare.org (Lewis, Suzanne) Date: Wed, 21 Oct 2009 08:22:21 -0500 Subject: [Cnm] H1N1 - Meal Service In-Reply-To: <4ADC41DA.485B.0001.0@nahealth.com> Message-ID: <63A81A57A6254849B538D2FF4F1D539904F7D47B@VS01EXC01.mercycare.org> Here's a listing of the responses received regarding Cafe service - Added or have hand sanitizer available at self serve bars - 6 Replace utensils more frequently - 2 No changes - 2 Visitors are being limited, often to no one under the age of 18 and employees being sent home if have fever or other symptoms. Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org ________________________________ From: Sheila Walsh [mailto:sheila.walsh at nahealth.com] Sent: Monday, October 19, 2009 12:39 PM To: cnm at lists.my180.net; Lewis, Suzanne Subject: Re: [Cnm] H1N1 - Meal Service We are trying to divert H1N1 patients from coming to the hospital unless they are admitted. We have a triage site off campus. We are sending sick employees home (fever). We do not allow children to visit patients this time of year. We have far more isolation rooms than we have flu patients because it takes over a day to determine if a patient has the flu. Our Nutrition Assistants are being "Fit tested" so they can still take meal trays into all patient rooms. They are required to wash/sanitize their hands before they go into each room. We are not doing anything differently to our cafeteria food. fwiw, Sheila A. Walsh, MPH, RD Clinical Nutrition Manager Flagstaff Medical Center Where patients are our purpose. <\__~ / \ >>> "Lewis, Suzanne" 10/19/2009 9:57 AM >>> What type of changes, if any, are you being asked to make in your cafeterias in regard to H1N1? If you have self serve salad bars, etc, in your Caf?'s are you being asked to stopped this type of service? We are trying to define what is appropriate and where to draw the line. Thanks, Suzanne Lewis, RD, LD Assistant Director of Nutrition Services Mercy Medical Center Cedar Rapids, Iowa 52403-1292 Office - 319-398-6093 Cell - 319-533-4140 slewis at mercycare.org Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. Confidentiality Notice: This message and any attachments may contain confidential and privileged information that is protected by law. The information contained herein is transmitted for the sole use of the intended recipient(s). If you are not the intended recipient or designated agent of the recipient of such information, you are hereby notified that any use, dissemination, copying or retention of this email or the information contained herein is strictly prohibited and may subject you to penalties under federal and/or state law. If you received this email in error, please notify the sender immediately and permanently delete this email. -------------- next part -------------- An HTML attachment was scrubbed... URL: From jross at jaycountyhospital.com Wed Oct 21 09:38:19 2009 From: jross at jaycountyhospital.com (Julayne Ross) Date: Wed, 21 Oct 2009 12:38:19 -0400 Subject: [Cnm] Vit D - obesity & CHF Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D0245652F@EX1.jaycountyhospital.com> Just curious if anyone requests VIt D levels with an overweight client or someone w/CHF? I was watching Dr. Oz... and he stated all their overweight people so far have been Vit D deficient. Also, just read a story about CHF and vit D Deficiency. Any thoughts? Thanks, Julayne -------------- next part -------------- An HTML attachment was scrubbed... URL: From Heberle-Heather at aramark.com Wed Oct 21 10:10:38 2009 From: Heberle-Heather at aramark.com (Heberle, Heather N.) Date: Wed, 21 Oct 2009 13:10:38 -0400 Subject: [Cnm] Basic Nutrition Talk Message-ID: I am doing a basic nutrition talk for an electric co-op in 2 weeks. It is a 45 minute presentation. Does anyone already have something along these lines? I am wanting to cover basics and making healthy choices regarding vending machines, etc. Thanks. Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 From jbaye at mail.mcg.edu Wed Oct 21 10:45:16 2009 From: jbaye at mail.mcg.edu (Jessica Baye) Date: Wed, 21 Oct 2009 13:45:16 -0400 Subject: [Cnm] Metabolic Cart Policy Message-ID: <4ADF106C.E045.0010.0@mail.mcg.edu> For hospitals that have metabolic carts - do you have a policy/protocol as to which patients qualify for testing and also what is the frequency of testing. Thanks 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 jross at jaycountyhospital.com Wed Oct 21 11:11:22 2009 From: jross at jaycountyhospital.com (Julayne Ross) Date: Wed, 21 Oct 2009 14:11:22 -0400 Subject: [Cnm] Holiday cartoons Message-ID: <10DE3A7624A2BD48B81AFE4E90A5094D02456582@EX1.jaycountyhospital.com> I am doing a Holiday Cooking presentation in November for a Cardiac and Diabetic group combined. I thought it would be cute to have Holiday and other diet type cartoons going behind me on powerpoint as I am talking/cooking. I would greatly appreciate any that you have... Thanks, Julayne Ross -------------- next part -------------- An HTML attachment was scrubbed... URL: From KHorvath at swgeneral.com Wed Oct 21 11:36:12 2009 From: KHorvath at swgeneral.com (Horvath, Karen) Date: Wed, 21 Oct 2009 14:36:12 -0400 Subject: [Cnm] Holiday cartoons In-Reply-To: <10DE3A7624A2BD48B81AFE4E90A5094D02456582@EX1.jaycountyhospital.com> References: <10DE3A7624A2BD48B81AFE4E90A5094D02456582@EX1.jaycountyhospital.com> Message-ID: <0BD69CE7EFA7F74A9500CD83C2ADC67906E12E7D@SWEXCHANGE.swgeneral.corp> Please include me in this as I am also doing a cooking light for the holidays presentation in November. Thanks! Karen Horvath khorvath at swgeneral.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Julayne Ross Sent: Wednesday, October 21, 2009 2:11 PM To: cnm at lists.my180.net Subject: [Cnm] Holiday cartoons I am doing a Holiday Cooking presentation in November for a Cardiac and Diabetic group combined. I thought it would be cute to have Holiday and other diet type cartoons going behind me on powerpoint as I am talking/cooking. I would greatly appreciate any that you have... Thanks, Julayne Ross Southwest General - HEALTH is our passion, QUALITY is our focus, COMPASSION is our way 18697 Bagley Road | Middleburg Heights, Ohio | 44130-3497 | Tel: 440-816-8000 | http://www.swgeneral.com/ -------------------------------------------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended only for use by the person(s) to whom it is addressed. Southwest General and its affiliates disclaim any responsibility for unauthorized disclosure of this information by persons receiving this information. If you receive this information in error, please notify the sender immediately by reply e-mail or notify Southwest General's Privacy Officer at 440-816-6704. Also, if you are not the intended recipient, any dissemination, distribution or duplication of this transmission is strictly prohibited and please delete or destroy all copies of this message. If this e-mail contains any patient medical information, please note that federal and Ohio law protect patient medical information, including psychiatric diagnosis, (HIV) test results, AIDs-related conditions, alcohol and/or drug dependence or abuse. Unless otherwise permitted by specific law, you are prohibited from disclosing this information to anyone else without the specific written consent of the person to whom it pertains. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 5581 bytes Desc: not available URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 3246 bytes Desc: not available URL: From POTTERM at fauquierhealth.org Wed Oct 21 12:10:06 2009 From: POTTERM at fauquierhealth.org (Potter, MARY) Date: Wed, 21 Oct 2009 15:10:06 -0400 Subject: [Cnm] student "shadows" Message-ID: <8ECF425A281B4A4D88E99F028700A3AA038E3AB6@fh-excbe01.fauquierhospital.org> For those of you that have students (either high schoolers who are exploring career options, or college kids majoring in dietetics), what are the requirements that student has to meet in order to "shadow" the dietitians? Our HR department has very stringent guidelines regarding not only immunizations, and awareness of HIPAA, but, requires students to be knowledgeable about the hospital's mission, core values, etc. I can understand having that for students that may be here for longer than a couple of days, just to see what a dietitian does (like for nursing students, or pharmacy students, etc). Just was curious how other hospitals are handling their student "shadows". Thanks! 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** Legal Notice: This electronic message transmission and any attachments contain information from Fauquier Health System which may be confidential or privileged. This e-mail is intended only for the addressee. If you are not the intended recipient, be aware that any disclosure, copying, forwarding, distribution, or use of the contents of this transmission is prohibited. If you have received this electronic transmission in error, please notify the sender immediately and delete the original message from your system. Fauquier Health System makes no warranty that this e-mail is error or virus free. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Julie.Finney at csauh.com Wed Oct 21 12:19:48 2009 From: Julie.Finney at csauh.com (Finney, Julie) Date: Wed, 21 Oct 2009 15:19:48 -0400 Subject: [Cnm] student "shadows" In-Reply-To: <8ECF425A281B4A4D88E99F028700A3AA038E3AB6@fh-excbe01.fauquierhospital.org> References: <8ECF425A281B4A4D88E99F028700A3AA038E3AB6@fh-excbe01.fauquierhospital.org> Message-ID: We have different requirements depending on the length of the placement. At the moment we are not permitting any shadows under the age of 18-years. This will be effect until March. Our volunteer office handles the scheduling of student shadows. For the one-day experience they don't have to do the immunizations and safety training, but for our longer placements that training is required. There is a permission slip that the manager signs stating the experience that the student will have and then there is a statement that advises the student that they must respect confidentiality for the one-day shadow. Sometimes requirements are made steep so that the demand isn't very high to provide the service. Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Potter, MARY Sent: Wednesday, October 21, 2009 3:10 PM To: cnm at lists.my180.net Subject: [Cnm] student "shadows" For those of you that have students (either high schoolers who are exploring career options, or college kids majoring in dietetics), what are the requirements that student has to meet in order to "shadow" the dietitians? Our HR department has very stringent guidelines regarding not only immunizations, and awareness of HIPAA, but, requires students to be knowledgeable about the hospital's mission, core values, etc. I can understand having that for students that may be here for longer than a couple of days, just to see what a dietitian does (like for nursing students, or pharmacy students, etc). Just was curious how other hospitals are handling their student "shadows". Thanks! 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** Legal Notice: This electronic message transmission and any attachments contain information from Fauquier Health System which may be confidential or privileged. This e-mail is intended only for the addressee. If you are not the intended recipient, be aware that any disclosure, copying, forwarding, distribution, or use of the contents of this transmission is prohibited. If you have received this electronic transmission in error, please notify the sender immediately and delete the original message from your system. Fauquier Health System makes no warranty that this e-mail is error or virus free. Thank you. ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From kpersyn at nixhealth.com Wed Oct 21 12:21:54 2009 From: kpersyn at nixhealth.com (Karen Persyn) Date: Wed, 21 Oct 2009 14:21:54 -0500 Subject: [Cnm] Comfort foods Message-ID: <1729F310410D5E4EB94EECCD8661CA562A3D990F84@datacenter3> I agree with you. Stick with the diet ordered and modify to patient's preferences. I don't know that one can accurately generalize what is considered comfort foods. This would need to be individualized to each patient. Just my thoughts. Karen Persyn, RD, LD Clinical Nutrition Manager NIX Health Care System (210) 579-3149 Message: 2 Date: Wed, 21 Oct 2009 08:38:34 -0400 From: "Scully, Jennifer" Subject: [Cnm] Comfort foods To: Message-ID: Content-Type: text/plain; charset="us-ascii" How are you handling patients on Palliative Care service? Our NP for Palliative Care (who is wonderful!) is requesting that we build a special diet- "Comfort Foods only". She usually only wants fruit ice, yogurt, ice pops, mashed potato, etc for these patients. My concern is the adequacy of these diets. Although these patients may be at the end of their life, that end could be 2-3 months away. Keeping someone on full liquids, although also nutritionally inadequate, is usually only for 2-3 days. Our practice now is to keep the diet that is ordered (regular, puree, etc), manually remove most of the items on the menu and add the items that the Palliative Care NP is requesting. Any thoughts on how to handle this? Thanks! Jen Jennifer Scully, RD, CDN Clinical Nutrition Manager Lawrence Hospital Center (914) 787-5089 ph (914) 787-5093 fax -------------- next part -------------- An HTML attachment was scrubbed... URL: From LCarver at Reshealthcare.org Wed Oct 21 12:33:54 2009 From: LCarver at Reshealthcare.org (Carver, Leslee) Date: Wed, 21 Oct 2009 14:33:54 -0500 Subject: [Cnm] Comfort foods In-Reply-To: <1729F310410D5E4EB94EECCD8661CA562A3D990F84@datacenter3> References: <1729F310410D5E4EB94EECCD8661CA562A3D990F84@datacenter3> Message-ID: <5330B54133B6194BA13930BDEFE9A30E052C1A49@rhcexch3.reshealthcare.org> In my world what constitutes "comfort food" varies from pt to pt. Yes, there are some common over-laps but chicken soup would not be a comfort food to a long term vegetarian and many people hate yogurt. we have a very multi-cultural population here so that affects my perspective, but I think individualizing for each pt is the most respectful thing to do. (if you sent my mother mashed potatoes at the end of her life she would have rallied long enough to throw them at you!) I am frankly less concerned w/ the nutr adequacy then w/ the respect for individual preferences. perhaps you can promise a visit or a call from the diet office to get preferences? 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 Karen Persyn Sent: Wednesday, October 21, 2009 2:22 PM To: cnm at lists.my180.net Subject: [Cnm] Comfort foods I agree with you. Stick with the diet ordered and modify to patient's preferences. I don't know that one can accurately generalize what is considered comfort foods. This would need to be individualized to each patient. Just my thoughts. Karen Persyn, RD, LD Clinical Nutrition Manager NIX Health Care System (210) 579-3149 Message: 2 Date: Wed, 21 Oct 2009 08:38:34 -0400 From: "Scully, Jennifer" Subject: [Cnm] Comfort foods To: Message-ID: Content-Type: text/plain; charset="us-ascii" How are you handling patients on Palliative Care service? Our NP for Palliative Care (who is wonderful!) is requesting that we build a special diet- "Comfort Foods only". She usually only wants fruit ice, yogurt, ice pops, mashed potato, etc for these patients. My concern is the adequacy of these diets. Although these patients may be at the end of their life, that end could be 2-3 months away. Keeping someone on full liquids, although also nutritionally inadequate, is usually only for 2-3 days. Our practice now is to keep the diet that is ordered (regular, puree, etc), manually remove most of the items on the menu and add the items that the Palliative Care NP is requesting. Any thoughts on how to handle this? Thanks! Jen Jennifer Scully, RD, CDN Clinical Nutrition Manager Lawrence Hospital Center (914) 787-5089 ph (914) 787-5093 fax -------------- next part -------------- An HTML attachment was scrubbed... URL: From RachelFlores at sach.org Wed Oct 21 13:27:40 2009 From: RachelFlores at sach.org (Flores, Rachel) Date: Wed, 21 Oct 2009 13:27:40 -0700 Subject: [Cnm] student "shadows" Message-ID: At our facility anyone who wants to volunteer or shadow an RD has to go through the volunteer's dept, which means, background check, immunizations, an orientation including HIPPA, etc. We require a commitment of a certain number of hours (I think the minimum is 100 hours). My understanding is that this is not just for confidentiality and JC standards, but for liability and worker's comp issues as well. I often get requests to shadow staff, and I refer them to the Volunteers office. I have never had anyone actually go through the whole process. Rachel Flores, RD, CNSC Clinical Nutrition Manager San Antonio Community Hospital (909) 985-2811 x24430 _____ From: Potter, MARY [mailto:POTTERM at fauquierhealth.org] Sent: Wednesday, October 21, 2009 12:10 PM To: cnm at lists.my180.net Subject: [Cnm] student "shadows" For those of you that have students (either high schoolers who are exploring career options, or college kids majoring in dietetics), what are the requirements that student has to meet in order to "shadow" the dietitians? Our HR department has very stringent guidelines regarding not only immunizations, and awareness of HIPAA, but, requires students to be knowledgeable about the hospital's mission, core values, etc. I can understand having that for students that may be here for longer than a couple of days, just to see what a dietitian does (like for nursing students, or pharmacy students, etc). Just was curious how other hospitals are handling their student "shadows". Thanks! Beth Potter, RD Clinical Nutrition Manager Fauquier Health|500 Hospital Dr. Warrenton,VA 20186 540-316-4406 potterm @fauquierhealth.org ** Note my new email address is potterm at fauquierhealth.org and new phone number is 540-316-4406** Legal Notice: This electronic message transmission and any attachments contain information from Fauquier Health System which may be confidential or privileged. This e-mail is intended only for the addressee. If you are not the intended recipient, be aware that any disclosure, copying, forwarding, distribution, or use of the contents of this transmission is prohibited. If you have received this electronic transmission in error, please notify the sender immediately and delete the original message from your system. Fauquier Health System makes no warranty that this e-mail is error or virus free. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From rossjanv at fuse.net Wed Oct 21 13:28:50 2009 From: rossjanv at fuse.net (Janet V. Ross) Date: Wed, 21 Oct 2009 16:28:50 -0400 Subject: [Cnm] student "shadows" In-Reply-To: <8ECF425A281B4A4D88E99F028700A3AA038E3AB6@fh-excbe01.fauquierhospital.org> Message-ID: <6E.96.20754.11F6FDA4@ecout1> Same as a volunteer. I send them through the volunteer dept-and require them to do something for me in addition to shadowing for them. 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 Potter, MARY Sent: Wednesday, October 21, 2009 3:10 PM To: cnm at lists.my180.net Subject: [Cnm] student "shadows" For those of you that have students (either high schoolers who are exploring career options, or college kids majoring in dietetics), what are the requirements that student has to meet in order to "shadow" the dietitians? Our HR department has very stringent guidelines regarding not only immunizations, and awareness of HIPAA, but, requires students to be knowledgeable about the hospital's mission, core values, etc. I can understand having that for students that may be here for longer than a couple of days, just to see what a dietitian does (like for nursing students, or pharmacy students, etc). Just was curious how other hospitals are handling their student "shadows". Thanks! Beth Potter, RD Clinical Nutrition Manager Fauquier Health|500 Hospital Dr. Warrenton,VA 20186 540-316-4406 potterm @fauquierhealth.org ** Note my new email address is potterm at fauquierhealth.org and new phone number is 540-316-4406** Legal Notice: This electronic message transmission and any attachments contain information from Fauquier Health System which may be confidential or privileged. This e-mail is intended only for the addressee. If you are not the intended recipient, be aware that any disclosure, copying, forwarding, distribution, or use of the contents of this transmission is prohibited. If you have received this electronic transmission in error, please notify the sender immediately and delete the original message from your system. Fauquier Health System makes no warranty that this e-mail is error or virus free. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From mpappo at montefiore.org Wed Oct 21 14:21:30 2009 From: mpappo at montefiore.org (Miriam Pappo) Date: Wed, 21 Oct 2009 17:21:30 -0400 Subject: [Cnm] student "shadows" Message-ID: Our student volunteers also need to complete full Volunteer requirements / orientation as mentioned by other CNMs. It takes ~ 3 wks to complete the medical clearance,etc so to date we dont have simple "shadows" any longer. Our students who need to complete 100 hrs Fieldwork go thru this process and also provide me with some PI service that I need in addition to shadowing a RD. 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 >>> "Flores, Rachel" 10/21/09 4:27 PM >>> At our facility anyone who wants to volunteer or shadow an RD has to go through the volunteer's dept, which means, background check, immunizations, an orientation including HIPPA, etc. We require a commitment of a certain number of hours (I think the minimum is 100 hours). My understanding is that this is not just for confidentiality and JC standards, but for liability and worker's comp issues as well. I often get requests to shadow staff, and I refer them to the Volunteers office. I have never had anyone actually go through the whole process. Rachel Flores, RD, CNSC Clinical Nutrition Manager San Antonio Community Hospital (909) 985-2811 x24430 _____ From: Potter, MARY [mailto:POTTERM at fauquierhealth.org] Sent: Wednesday, October 21, 2009 12:10 PM To: cnm at lists.my180.net Subject: [Cnm] student "shadows" For those of you that have students (either high schoolers who are exploring career options, or college kids majoring in dietetics), what are the requirements that student has to meet in order to "shadow" the dietitians? Our HR department has very stringent guidelines regarding not only immunizations, and awareness of HIPAA, but, requires students to be knowledgeable about the hospital's mission, core values, etc. I can understand having that for students that may be here for longer than a couple of days, just to see what a dietitian does (like for nursing students, or pharmacy students, etc). Just was curious how other hospitals are handling their student "shadows". Thanks! Beth Potter, RD Clinical Nutrition Manager Fauquier Health|500 Hospital Dr. Warrenton,VA 20186 540-316-4406 potterm @fauquierhealth.org ** Note my new email address is potterm at fauquierhealth.org and new phone number is 540-316-4406** Legal Notice: This electronic message transmission and any attachments contain information from Fauquier Health System which may be confidential or privileged. This e-mail is intended only for the addressee. If you are not the intended recipient, be aware that any disclosure, copying, forwarding, distribution, or use of the contents of this transmission is prohibited. If you have received this electronic transmission in error, please notify the sender immediately and delete the original message from your system. Fauquier Health System makes no warranty that this e-mail is error or virus free. Thank you. From Cathy.Poquette at stjoe.org Wed Oct 21 15:34:41 2009 From: Cathy.Poquette at stjoe.org (Cathy Poquette) Date: Wed, 21 Oct 2009 15:34:41 -0700 Subject: [Cnm] student "shadows" In-Reply-To: <6E.96.20754.11F6FDA4@ecout1> Message-ID: We do the same- Volunteer training first and then volunteer for us - make copies of diet education materials, deliver late trays, process phone calls, collect data for PI Quality checks; and then allow some shadowing of RDs. Cathy Poquette, M.S., R.D. Clinical Nutrition Operations Manager St. Jude Medical Center 101 E. Valencia Mesa Drive Fullerton, CA 92835 (714) 992-3000, ext. 3897 Pager: (714) 490-8030 ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Janet V. Ross Sent: Wednesday, October 21, 2009 1:29 PM To: 'Potter, MARY'; cnm at lists.my180.net Subject: Re: [Cnm] student "shadows" Same as a volunteer. I send them through the volunteer dept-and require them to do something for me in addition to shadowing for them. 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 Potter, MARY Sent: Wednesday, October 21, 2009 3:10 PM To: cnm at lists.my180.net Subject: [Cnm] student "shadows" For those of you that have students (either high schoolers who are exploring career options, or college kids majoring in dietetics), what are the requirements that student has to meet in order to "shadow" the dietitians? Our HR department has very stringent guidelines regarding not only immunizations, and awareness of HIPAA, but, requires students to be knowledgeable about the hospital's mission, core values, etc. I can understand having that for students that may be here for longer than a couple of days, just to see what a dietitian does (like for nursing students, or pharmacy students, etc). Just was curious how other hospitals are handling their student "shadows". Thanks! 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** Legal Notice: This electronic message transmission and any attachments contain information from Fauquier Health System which may be confidential or privileged. This e-mail is intended only for the addressee. If you are not the intended recipient, be aware that any disclosure, copying, forwarding, distribution, or use of the contents of this transmission is prohibited. If you have received this electronic transmission in error, please notify the sender immediately and delete the original message from your system. Fauquier Health System makes no warranty that this e-mail is error or virus free. Thank you. ________________________________ Notice from St. Joseph Health System: Please note that the information contained in this message may be privileged and confidential and protected from disclosure. -------------- next part -------------- An HTML attachment was scrubbed... URL: From lbuckle at valleyhealth.com Thu Oct 22 05:46:10 2009 From: lbuckle at valleyhealth.com (Linda Buckley) Date: Thu, 22 Oct 2009 08:46:10 -0400 Subject: [Cnm] Please respond if you have an Electronic medical recordand CBORD Nutrition Service Suite In-Reply-To: References: Message-ID: <4AE01BD1.3F4C.0021.0@gw.valleyhealth.com> We have CBORD and Meditech. 1. All our diet orders interface, and so do tube feedings. We don't get a separate tube feeding report. 2. Allergies don't interface, we enter them manually. 3. Consults are also interfaced. We have a centralized kitchen. Linda Buckley, MS, RD, CDE Clinical Nutrition Supervisor The Valley Hospital Ridgewood NJ 201-447-8000 x 2460, pager 0391 From loydg at andersonhospital.org Thu Oct 22 06:07:10 2009 From: loydg at andersonhospital.org (Gayle S. Loyd) Date: Thu, 22 Oct 2009 08:07:10 -0500 Subject: [Cnm] CHF Message-ID: Good Morning, How are you handing CHF patients? Are they automatically seen because of dx? Our CHF committee -(same nurse managers who wanted all obese patients seen and educated last week)-now want all CHF patients seen and educated (even those with hx of CHF) Thanks for your input Gayle Loyd RD LDN Anderson Hospital Maryville, Il 62062 618-391-5241 -------------- next part -------------- An HTML attachment was scrubbed... URL: From bhomola at comhs.org Thu Oct 22 06:35:01 2009 From: bhomola at comhs.org (Bobbi Homola) Date: Thu, 22 Oct 2009 08:35:01 -0500 Subject: [Cnm] student "shadows" In-Reply-To: <8ECF425A281B4A4D88E99F028700A3AA038E3AB6@fh-excbe01.fauquierhospital.org> Message-ID: It has become increasingly difficult to do these. We, too take them through the Volunteer orientation, etc. This works well for those students that we will have for awhile, ie.... for the summer, etc. But, obviously, this deters those "one day experiences". Thank you, Bobbi Bobbi Homola, MPA, RD, CD Clinical Manager, Food and Nutrition Services St. Mary Medical Center / St. Catherine Hospital 1500 South Lake Park Avenue Hobart, IN 46342 219-947-6048 / 219-392-7081 219-947-6049 fax bhomola at comhs.org -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Potter, MARY Sent: Wednesday, October 21, 2009 2:10 PM To: cnm at lists.my180.net Subject: [Cnm] student "shadows" For those of you that have students (either high schoolers who are exploring career options, or college kids majoring in dietetics), what are the requirements that student has to meet in order to "shadow" the dietitians? Our HR department has very stringent guidelines regarding not only immunizations, and awareness of HIPAA, but, requires students to be knowledgeable about the hospital's mission, core values, etc. I can understand having that for students that may be here for longer than a couple of days, just to see what a dietitian does (like for nursing students, or pharmacy students, etc). Just was curious how other hospitals are handling their student "shadows". Thanks! 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** Legal Notice: This electronic message transmission and any attachments contain information from Fauquier Health System which may be confidential or privileged. This e-mail is intended only for the addressee. If you are not the intended recipient, be aware that any disclosure, copying, forwarding, distribution, or use of the contents of this transmission is prohibited. If you have received this electronic transmission in error, please notify the sender immediately and delete the original message from your system. Fauquier Health System makes no warranty that this e-mail is error or virus free. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From bhaine at Elliot-HS.org Thu Oct 22 06:40:10 2009 From: bhaine at Elliot-HS.org (Haine, Barbara) Date: Thu, 22 Oct 2009 09:40:10 -0400 Subject: [Cnm] CHF In-Reply-To: References: Message-ID: It's part of the heart failure core measure. We are now doing the same thing - big increase in our education consults. Barbara Haine MEd, RD, LD Clinical Nutrition Manager Elliot Hospital Manchester, NH From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Gayle S. Loyd Sent: Thursday, October 22, 2009 9:07 AM To: cnm at lists.my180.net Subject: [Cnm] CHF Good Morning, How are you handing CHF patients? Are they automatically seen because of dx? Our CHF committee -(same nurse managers who wanted all obese patients seen and educated last week)-now want all CHF patients seen and educated (even those with hx of CHF) Thanks for your input Gayle Loyd RD LDN Anderson Hospital Maryville, Il 62062 618-391-5241 ----------------------------------------- **** CONFIDENTIAL COMMUNICATION - PLEASE READ PRIVACY NOTICE **** This communication is confidential and may be read only by its intended recipient(s). It may contain legally privileged and protected information. If you believe you have received this communication in error, please "Reply" to the Sender and so indicate or call (603) 663-2800. Then, please promptly "Delete" this communication from your computer. This communication, and any information contained herein, may only be forwarded, printed, disclosed, copied or disseminated by those specifically authorized to do so. UNAUTHORIZED DISCLOSURE MAY RESULT IN LEGAL LIABILITY FOR THOSE PERSONS RESPONSIBLE. -------------- next part -------------- An HTML attachment was scrubbed... URL: From m-rodrig at msmc.com Thu Oct 22 06:48:53 2009 From: m-rodrig at msmc.com (Maritza Rodriguez) Date: Thu, 22 Oct 2009 09:48:53 -0400 Subject: [Cnm] Integrative Nutrition Message-ID: <32EDCA3D1F5C4C41B7E1A4573DFACCC602118311@SVIPEXC1.msmc.com> Hi there, Does the ADA or any other health agency support any evidence- based guidelines for the practice of integrative nutrition as complementary care? If yes, where I can find them? Thank you in advance, Maritza Rodriguez Maritza Rodriguez, RD LDN Clinical Nutrition Manager Mount Sinai Medical Center Tel: 305-674-2121 X 56181 m-rodrig at msmc.com -------------- next part -------------- An HTML attachment was scrubbed... URL: From VSupron at medcentral.org Thu Oct 22 06:56:30 2009 From: VSupron at medcentral.org (Supron, Valerie) Date: Thu, 22 Oct 2009 09:56:30 -0400 Subject: [Cnm] Joint Commission PC.02.02.03; EP 10 Message-ID: <01125CAB79609B4484D86765985CE41F0CAFC9B4@EXCHANGE2K3.medcentral.org> How are facilities handling this standard? "When a patient refuses food, the hospital offers substitutes of equal nutritional value." Are supplements being used as meal replacements? This standard requires "Measurements of Success". How are you measuring? Thanks! Valerie Supron, RD, LD Assistant Director of Food & Nutrition MedCentral Health System 335 Glessner Avenue Mansfield, OH 44903 (419) 526-8068 vsupron at medcentral.org Confidentiality Notice: This message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution may be prohibited by Federal regulation (42 CFR Part 2). If you are NOT the intended recipient, please notify the sender of the error and destroy all copies of the message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Heberle-Heather at aramark.com Thu Oct 22 07:12:09 2009 From: Heberle-Heather at aramark.com (Heberle, Heather N.) Date: Thu, 22 Oct 2009 10:12:09 -0400 Subject: [Cnm] CHF Patients Message-ID: As part of core measure, pt with CHF should be educated prior to discharge. We have developed a discharge packet for CHF patients that includes diet information. It is not the most specific info, but it gets them started. We ask if they want more specific education, they send us a consult prior to DC. Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 From LAURAF at dmhhs.org Thu Oct 22 07:38:15 2009 From: LAURAF at dmhhs.org (ETCHASON,LAURA) Date: Thu, 22 Oct 2009 09:38:15 -0500 Subject: [Cnm] CHF In-Reply-To: References: Message-ID: <4AE02807.21B0.00A0.0@dmhhs.org> We see them all here. It is a question on our nutrition screen that nurses perform. We get notified that way in case it is not the primary diagnosis. We provide the "Heart Failure" education from the on-line manual. For our repeat patients, we just offer the ed and document it if the patient refuses it. We do not do a full assessment unless there is another nutritional trigger. Thank you, Laura Etchason Laura A. Etchason, MS, RD, LDN Clinical Nutrition Manager Decatur Memorial Hospital 2300 N. Edward Street Decatur, IL 62526 217-876-5306 (office line and voice mail) 217-876-5305 (fax) 217-876-5301 (general line) lauraf at dmhhs.org Developer, Harmony, Maximizer, Individualization, Belief >>> "Gayle S. Loyd" 10/22/2009 8:07 AM >>> Good Morning, How are you handing CHF patients? Are they automatically seen because of dx? Our CHF committee -(same nurse managers who wanted all obese patients seen and educated last week)?now want all CHF patients seen and educated (even those with hx of CHF) Thanks for your input Gayle Loyd RDLDN AndersonHospital Maryville, Il 62062 618-391-5241 -------------- next part -------------- An HTML attachment was scrubbed... URL: From KHorvath at swgeneral.com Thu Oct 22 07:43:08 2009 From: KHorvath at swgeneral.com (Horvath, Karen) Date: Thu, 22 Oct 2009 10:43:08 -0400 Subject: [Cnm] CHF Patients In-Reply-To: References: Message-ID: <0BD69CE7EFA7F74A9500CD83C2ADC67906E12E81@SWEXCHANGE.swgeneral.corp> We also get consults for all CHF patients due to the core measures, but as part of the heart failure nurses packet there is a small amount of diet information they provide. So we educate all new CHF patients and those patients that have questions. Here is our policy. Karen Horvath MA RD LD -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Heberle, Heather N. Sent: Thursday, October 22, 2009 10:12 AM To: cnm at lists.my180.net; loydg at andersonhospital.org Subject: Re: [Cnm] CHF Patients As part of core measure, pt with CHF should be educated prior to discharge. We have developed a discharge packet for CHF patients that includes diet information. It is not the most specific info, but it gets them started. We ask if they want more specific education, they send us a consult prior to DC. Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Southwest General - HEALTH is our passion, QUALITY is our focus, COMPASSION is our way 18697 Bagley Road | Middleburg Heights, Ohio | 44130-3497 | Tel: 440-816-8000 | http://www.swgeneral.com/ -------------------------------------------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended only for use by the person(s) to whom it is addressed. Southwest General and its affiliates disclaim any responsibility for unauthorized disclosure of this information by persons receiving this information. If you receive this information in error, please notify the sender immediately by reply e-mail or notify Southwest General's Privacy Officer at 440-816-6704. Also, if you are not the intended recipient, any dissemination, distribution or duplication of this transmission is strictly prohibited and please delete or destroy all copies of this message. If this e-mail contains any patient medical information, please note that federal and Ohio law protect patient medical information, including psychiatric diagnosis, (HIV) test results, AIDs-related conditions, alcohol and/or drug dependence or abuse. Unless otherwise permitted by specific law, you are prohibited from disclosing this information to anyone else without the specific written consent of the person to whom it pertains. -------------- next part -------------- A non-text attachment was scrubbed... Name: CHF CAD Policy.doc Type: application/msword Size: 46592 bytes Desc: CHF CAD Policy.doc URL: From Lori.Zimmerman at ministryhealth.org Thu Oct 22 17:49:27 2009 From: Lori.Zimmerman at ministryhealth.org (Zimmerman, Lori A) Date: Thu, 22 Oct 2009 19:49:27 -0500 Subject: [Cnm] Comfort foods In-Reply-To: <5330B54133B6194BA13930BDEFE9A30E052C1A49@rhcexch3.reshealthcare.org> References: <1729F310410D5E4EB94EECCD8661CA562A3D990F84@datacenter3> <5330B54133B6194BA13930BDEFE9A30E052C1A49@rhcexch3.reshealthcare.org> Message-ID: We keep the diet as ordered. If the diet order is restrictive we will request the order be changed to gives us the ability to send whatever is requested. We have Room Service and most often it is family that is ordering and the pt might eat a bite or two and then the family finishes which is fine with us. Lori A. Zimmerman MS, RD, CD ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Carver, Leslee Sent: Wednesday, October 21, 2009 2:34 PM To: Karen Persyn; cnm at lists.my180.net Subject: Re: [Cnm] Comfort foods In my world what constitutes "comfort food" varies from pt to pt. Yes, there are some common over-laps but chicken soup would not be a comfort food to a long term vegetarian and many people hate yogurt. we have a very multi-cultural population here so that affects my perspective, but I think individualizing for each pt is the most respectful thing to do. (if you sent my mother mashed potatoes at the end of her life she would have rallied long enough to throw them at you!) I am frankly less concerned w/ the nutr adequacy then w/ the respect for individual preferences. perhaps you can promise a visit or a call from the diet office to get preferences? 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 Karen Persyn Sent: Wednesday, October 21, 2009 2:22 PM To: cnm at lists.my180.net Subject: [Cnm] Comfort foods I agree with you. Stick with the diet ordered and modify to patient's preferences. I don't know that one can accurately generalize what is considered comfort foods. This would need to be individualized to each patient. Just my thoughts. Karen Persyn, RD, LD Clinical Nutrition Manager NIX Health Care System (210) 579-3149 Message: 2 Date: Wed, 21 Oct 2009 08:38:34 -0400 From: "Scully, Jennifer" Subject: [Cnm] Comfort foods To: Message-ID: Content-Type: text/plain; charset="us-ascii" How are you handling patients on Palliative Care service? Our NP for Palliative Care (who is wonderful!) is requesting that we build a special diet- "Comfort Foods only". She usually only wants fruit ice, yogurt, ice pops, mashed potato, etc for these patients. My concern is the adequacy of these diets. Although these patients may be at the end of their life, that end could be 2-3 months away. Keeping someone on full liquids, although also nutritionally inadequate, is usually only for 2-3 days. Our practice now is to keep the diet that is ordered (regular, puree, etc), manually remove most of the items on the menu and add the items that the Palliative Care NP is requesting. Any thoughts on how to handle this? Thanks! Jen Jennifer Scully, RD, CDN Clinical Nutrition Manager Lawrence Hospital Center (914) 787-5089 ph (914) 787-5093 fax ________________________________ CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation. -------------- next part -------------- An HTML attachment was scrubbed... URL: From DrNCollins at aol.com Thu Oct 22 20:23:50 2009 From: DrNCollins at aol.com (DrNCollins at aol.com) Date: Thu, 22 Oct 2009 23:23:50 EDT Subject: [Cnm] Lean Body Mass Program Message-ID: Hi there, Here is information on a new, free 1 CEU teleseminar entitled Essential Lean Body Mass: Vital for Life, Recovery and Healing. There is no cost for this program but pre-registration is required. All the info is here: _http://www.rd411.com/newsletter/newsrd3.html_ (http://www.rd411.com/newsletter/newsrd3.html) Have a great day, NANCY 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) -------------- next part -------------- An HTML attachment was scrubbed... URL: From KBOEHME at meriter.com Fri Oct 23 07:40:19 2009 From: KBOEHME at meriter.com (Boehme, Karen) Date: Fri, 23 Oct 2009 09:40:19 -0500 Subject: [Cnm] CMS question Message-ID: <8CFCAB1537E1964AB1BAB60E81B019B683DE38B8@EXVS1.meriter.com> CMS states "The hospital should have written policies and procedures that address at least the following........"guidelines for acceptable hygiene practices of food service personnel". I cannot believe it but I cannot find any reference to hygiene practice in any of our policies. What should be stated and where should this be included? We have a hospital-wide Infection Control Policy, we have Patient Care Policies which include staff-related policies which document dress codes for patient care staff, we have department policies which cover food preparation and storage and we have a department handbook which covers employee hygiene and safety. Does anyone have a policy that covers Food service hygiene? Thanks! Karen Enthusiasm, like measles, mumps and the common cold, is highly contagious. Emory Ward Karen Boehme Manager, Clinical Nutrition Meriter Health Services Phone: (608) 417-6452 kboehme at meriter.com -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: TechTool.gif Type: image/gif Size: 2074 bytes Desc: TechTool.gif URL: From LAltenburger5 at matherhospital.org Fri Oct 23 09:27:52 2009 From: LAltenburger5 at matherhospital.org (Altenburger, Linda) Date: Fri, 23 Oct 2009 12:27:52 -0400 Subject: [Cnm] TJC survey Message-ID: Hello All: We were surveyed by TJC about 3 weeks ago and I apologize that this has taken me this long to send out. Our department had no direct or indirect hits and overall our hospital did very well. I attached some notes I took which you may find helpful in your survey preparation. Myself and 2 of my RDs were involved in tracers whereby they asked about our assessments and how we are notified. There was one patient where they were concerned about follow up with MD when RD makes recommendations. In this case patient had been encountering nausea (intermittent) and RD made rec for MD to consider med for such and when JC reviewed chart there was nothing from MD on this. We had told them (which was true) that this patient was due for another follow up note "today" and of course RD spoke w/nurse on this patient who then put call to MD for order for pain med prn. TJC was very pleased when they revisited this case. During summation our administration told us that the surveyors commented about how calm everyone was and confident. They further commented about the harmonious relationships between the various departments being very evident. Hope you find this info helpful. Linda Linda Altenburger, RD, CDN Clinical Nutrition Manager John. T. Mather Memorial Hospital 75 North Country Road Port Jefferson, NY 11777 (631) 473-1320 ext 4176 laltenburger5 at matherhospital.org fax:631-473-8752 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 2743 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: TJC SurveyJTM09.doc Type: application/msword Size: 29696 bytes Desc: TJC SurveyJTM09.doc URL: From LAltenburger5 at matherhospital.org Fri Oct 23 09:36:04 2009 From: LAltenburger5 at matherhospital.org (Altenburger, Linda) Date: Fri, 23 Oct 2009 12:36:04 -0400 Subject: [Cnm] vma test diet and citric acid Message-ID: Hello All: here is a follow up to a question earlier this week regarding the VMA test diet. The below replies were from our Lab Director and he spoke to our reference lab (Lab Corp) and he was told that this diet is necessary to insure accuracy of test results. See below. For those of you who still use the VMA diet, do you restrict anything and everything that contains citric acid too? Citric acid is in so many unsuspecting things. Thanks. Linda Linda Altenburger, RD, CDN Clinical Nutrition Manager John. T. Mather Memorial Hospital 75 North Country Road Port Jefferson, NY 11777 ________________________________ From: Geiger, Ernest Sent: Friday, October 23, 2009 12:13 PM To: Altenburger, Linda Subject: RE: vma test diet Hi Linda, This is every thing I can tell you about VMA testing. Ernie * Please avoid these foods and medications for three (3) days before and during the collection of these samples. FOOD AND DRINKS Amines - Bananas, Walnuts, Avocados, Fava beans, Cheese, Beer and Red wine Caffeine - Coffee, Tea, Cocoa (Hot Chocolate),Pepsi, Coke, Orange soda, etc.) Any foods or fluids with Vanilla (ice cream, pudding, cake etc.). Citrus fruits and Juices. (Yes, Tomato is a fruit.) (V-8, Tomato, Pineapple, Oranges, Lemons and Limes, etc.) Alcoholic beverages (All forms) Eggplant Plums Walnuts Licorice DRUGS Aspirin Cough syrup or tablets Nicotine (Tobacco) Many medicines may change the results of this test. Be sure to tell your doctor about all prescription and nonprescription medicines you take. DO NOT ingest any of the above items in any form. Please get adequate rest during the preparation and collection period and avoid strenuous exercise (running, etc.). Lack of sleep and physical exercise increase VMA. ________________________________ From: Altenburger, Linda Sent: Friday, October 23, 2009 10:01 AM To: Geiger, Ernest Subject: RE: vma test diet Thanks Ernie for your checking into this further. We will of course continue to implement the VMA test diet here with its restrictions to insure accurate results. We were encountering a debate down here however as in the past we have eliminated citrus (ie, oranges, grapefruit and the juices of such), then it was pointed out that "citric acid" may potentially need to be eliminated from the diet as well. Seems citric acid is in everything from our jelly to soups and canned foods. Would you know if citric acid can also impact the validity of the VMA test for sure? Thanks so much. 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: Geiger, Ernest Sent: Friday, October 23, 2009 9:54 AM To: Altenburger, Linda Subject: RE: vma test diet Hi Linda, We checked with our reference lab "LabCorp" and they said that the VMA diet is required to test VMA accurately. Lab Corp is one of the biggest lab in the country. The other Nation wide lab is Quest Diagnostics, they also require a VMA diet. Many foods have high amounts of Vanillymandelic Acid such as bananas, chocolate, vanilla, tomatoes, coffee, tea, cola drinks. They must be avoided for three days prior to the start of the VMA specimen. In addition many meds such as aspirin, Nicotine (Tobacco) and alcohol (All forms even beer) should be avoided for three days prior to collection along with strenuous exercise. If other institutions are not restricting diet prior to VMA collection, then they are not reporting accurate laboratory results. Ernie ________________________________ From: Altenburger, Linda Sent: Friday, October 23, 2009 7:58 AM To: Geiger, Ernest Subject: FW: vma test diet From: Altenburger, Linda Sent: Thursday, October 15, 2009 12:47 PM To: Geiger, Ernest Subject: vma test diet Dear Ernie: by chance, would you know any more on whether a VMA "diet" is truly needed.? Please see below. A handful of facilities are saying that they no longer use such. Thanks in advance. Linda Linda Altenburger, RD, CDN Clinical Nutrition Manager ________________________________ From: Boehme, Karen [mailto:KBOEHME at meriter.com] Sent: Friday, December 12, 2008 1:38 PM To: Altenburger, Linda Subject: RE: [Cnm] vma test diet I haven't seen or heard about a VMA diet for YEARS! Karen Karen Boehme RD, CD Madison, Wi -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Altenburger, Linda Subject: [Cnm] vma test diet Curious how many of you still have Physicians ordering the VMA diet? We just had an MD request such; however, I thought I recalled reading that with our more sophisticated lab techniques, there is no longer a need for restricting the diet before this test. Thanks for any feedback. Linda Linda Altenburger, RD, CDN Clinical Nutrition Manager John. T. Mather Memorial Hospital 75 North Country Road Port Jefferson, NY 11777 (631) 473-1320 ext 4176 laltenburger5 at matherhospital.org fax:631-473-8752 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 2743 bytes Desc: image001.jpg URL: From Becky.Caldwell at BMHCC.org Fri Oct 23 12:44:03 2009 From: Becky.Caldwell at BMHCC.org (Becky Caldwell) Date: Fri, 23 Oct 2009 14:44:03 -0500 Subject: [Cnm] Exclusive breast milk feeding Message-ID: <38AD1C7BDCA23F4F87C9E9421259C78CC208AE@tnucexch.ad.bmhcc.org> Happy Friday, What are other hospitals doing in regards to the TJC collection of data on breast feeding during hospital postnatal period. I think this is an effort to encourage an "exclusive breast milk feeding" OB(but not for sure). Presently we offer a little "take home" basket with baby things in it including a 4 pack of formula, we thought about removing it and not offering it in hopes that would make the moms less likely to give formula when it is easiest. And we are concerned about the formula companies not providing the "freebies" if we stop providing the samples??? Just wondering what others are doing And any comments on what you are doing to encourage moms to breast feed if you have an "exclusive breast milk feeding" OB dept would be a great help. Thanks in advance. Becky Caldwell M.S. R.D. L.D.N. Clinical Dietitian Baptist Memorial Hospital - Union City Union City, TN 38261 731-884-8574 becky.caldwell at bmhcc.org "Strength is the capacity to break a chocolate bar into four pieces with your bare hands- and then eat just one of the pieces" - Judith Viorst Becky Caldwell M.S. R.D. L.D.N. Clinical Dietitian Baptist Memorial Hospital - Union City Union City, TN 38261 731-884-8574 becky.caldwell at bmhcc.org "Strength is the capacity to break a chocolate bar into four pieces with your bare hands- and then eat just one of the pieces" - Judith Viorst This message and any files transmitted with it may contain legally privileged, confidential, or proprietary information. If you are not the intended recipient of this message, you are not permitted to use, copy, or forward it, in whole or in part without the express consent of the sender. Please notify the sender of the error by reply email, disregard the foregoing messages, and delete it immediately. ----------------------------------------- Smart Medicine. Inspired Care. And the awards to prove it. Recognized as a Top 50 Healthcare Network. To learn about other recognition and awards Baptist has earned, visit: http://www.bmhcc.org/aboutus/awards/index.asp This message and any files transmitted with it may contain legally privileged, confidential, or proprietary information. If you are not the intended recipient of this message, you are not permitted to use, copy, or forward it, in whole or in part without the express consent of the sender. Please notify the sender of the error by reply email, disregard the foregoing messages, and delete it immediately. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 5675 bytes Desc: Clear Day Bkgrd.JPG URL: From Virginia.Carney at STJUDE.ORG Fri Oct 23 13:04:07 2009 From: Virginia.Carney at STJUDE.ORG (Carney, Virginia H) Date: Fri, 23 Oct 2009 15:04:07 -0500 Subject: [Cnm] Exclusive breast milk feeding In-Reply-To: <38AD1C7BDCA23F4F87C9E9421259C78CC208AE@tnucexch.ad.bmhcc.org> Message-ID: <6EAE916704479E4BB6AB5A133BA224F72886F1F8B2@SJMEMXMBS11.stjude.sjcrh.local> Becky, By all means take out the formula in your give away. This has been shown to decrease the chances of exclusive breastfeeding. Check out the website www.banthebags.org. It will give you all the information you need to support this. You may also want to look at the "Ten Steps to Successful Breastfeeding" to see why being "Baby-Friendly" means not accepting "freebies" from formula manufacturers. Here is the website for that: http://www.babyfriendlyusa.org/eng/10steps.html These 10 steps are EXTREMELY important in proving that you are encouraging exclusive breastfeeding. Do you have an IBCLC on staff at your hospital? I suggest that you work strongly with her to accomplish what you are trying to do. All the best, 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) (901)595-3202 (fax) pager 595-3578, PIN# 0838 virginia.carney at stjude.org [cid:387235619 at 23102009-249D] [cid:387235619 at 23102009-249D] Finding cures. Saving children. www.stjude.org ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Becky Caldwell Sent: Friday, October 23, 2009 2:44 PM To: cnm at lists.my180.net Subject: [Cnm] Exclusive breast milk feeding Happy Friday, What are other hospitals doing in regards to the TJC collection of data on breast feeding during hospital postnatal period. I think this is an effort to encourage an "exclusive breast milk feeding" OB(but not for sure). Presently we offer a little "take home" basket with baby things in it including a 4 pack of formula, we thought about removing it and not offering it in hopes that would make the moms less likely to give formula when it is easiest. And we are concerned about the formula companies not providing the "freebies" if we stop providing the samples??? Just wondering what others are doing And any comments on what you are doing to encourage moms to breast feed if you have an "exclusive breast milk feeding" OB dept would be a great help. Thanks in advance. Becky Caldwell M.S. R.D. L.D.N. Clinical Dietitian Baptist Memorial Hospital - Union City Union City, TN 38261 731-884-8574 becky.caldwell at bmhcc.org "Strength is the capacity to break a chocolate bar into four pieces with your bare hands- and then eat just one of the pieces" - Judith Viorst Becky Caldwell M.S. R.D. L.D.N. Clinical Dietitian Baptist Memorial Hospital - Union City Union City, TN 38261 731-884-8574 becky.caldwell at bmhcc.org "Strength is the capacity to break a chocolate bar into four pieces with your bare hands- and then eat just one of the pieces" - Judith Viorst This message and any files transmitted with it may contain legally privileged, confidential, or proprietary information. If you are not the intended recipient of this message, you are not permitted to use, copy, or forward it, in whole or in part without the express consent of the sender. Please notify the sender of the error by reply email, disregard the foregoing messages, and delete it immediately. ________________________________ Smart Medicine. Inspired Care. And the awards to prove it. Recognized as a Top 50 Healthcare Network. To learn about other recognition and awards Baptist has earned, visit: http://www.bmhcc.org/aboutus/awards/index.asp This message and any files transmitted with it may contain legally privileged, confidential, or proprietary information. If you are not the intended recipient of this message, you are not permitted to use, copy, or forward it, in whole or in part without the express consent of the sender. Please notify the sender of the error by reply email, disregard the foregoing messages, and delete it immediately. ________________________________ Email Disclaimer: www.stjude.org/emaildisclaimer -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: Clear Day Bkgrd.JPG Type: image/jpeg Size: 5675 bytes Desc: Clear Day Bkgrd.JPG URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: St. Jude logo.gif Type: image/gif Size: 43 bytes Desc: St. Jude logo.gif URL: From Psutor at emhc.org Fri Oct 23 13:13:07 2009 From: Psutor at emhc.org (Pat Sutor) Date: Fri, 23 Oct 2009 15:13:07 -0500 Subject: [Cnm] Isolation trays Message-ID: <4AE1C805.2064.0034.0@emhc.org> I am re-sending this question since we are starting to experience more admissions that are requiring contact isolation. What type of trays (disposable or reusable products) are other facilities using for Isolation precaution? We are currently delivering all isolation on styrofoam disposable products as there is a significant concern regarding reusable being brought outside the patients room (even in a food cart). We are concerned the patient satisfaction, presentation and cost of disposables. Interested to know what other facilities are doing to address this. Pat psutor at emhc.org The information contained in this electronic mail transmittal is protected by law and is intended only for the use of the designated recipient(s) named above. If the reader of this transmission is not the intended recipient(s), you are notified that any disclosure, dissemination, distribution or duplication of its contents is strictly prohibited. If you have received this transmittal in error, please notify the sender by return e-mail and delete the transmittal immediately. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From jmack at tanner.org Fri Oct 23 13:14:53 2009 From: jmack at tanner.org (Jessica Mack) Date: Fri, 23 Oct 2009 16:14:53 -0400 Subject: [Cnm] Neonatal/Pediatric assessment forms Message-ID: <138AE4B62F86AC4D9BC23F0168F1065511228648@EXCHCLUSTER.ths.local> Hello. I am in the process of revising our assessment forms. Does anyone have pediatric and/or neonatal assessment forms they are willing to share? You may contact me via email below. Jessica D. Mack MS,RD,LD,CNSC System Clinical Nutrition Manager Tanner Medical Center 705 Dixie Street Carrollton, GA 30117 Phone: 770-838-8879 Fax: 770-836-9148 jmack at tanner.org P Please consider the environment before printing this email -------------------------------------------------------------------------------------------------------------------- This e-mail and any files or attachments transmitted with it contain information that is confidential and privileged. This information is intended only for the use of the individual(s) and entit(ies) to whom it is addressed. If you are not the intended recipient, any disclosure, copying, printing, or use of this information is strictly prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please contact the sender immediately and destroy all copies of this communication. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 2950 bytes Desc: image001.jpg URL: From Julie.Finney at csauh.com Fri Oct 23 13:17:02 2009 From: Julie.Finney at csauh.com (Finney, Julie) Date: Fri, 23 Oct 2009 16:17:02 -0400 Subject: [Cnm] Isolation trays In-Reply-To: <4AE1C805.2064.0034.0@emhc.org> References: <4AE1C805.2064.0034.0@emhc.org> Message-ID: We do not use disposable dishes or trays for any patient in precautions excepting all Behavioral patients. This has been approved by our infection control staff. However, nursing personnel deliver the trays to rooms where patients are in precautions, we deliver to all other rooms. Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Pat Sutor Sent: Friday, October 23, 2009 4:13 PM To: cnm at lists.my180.net Subject: [Cnm] Isolation trays I am re-sending this question since we are starting to experience more admissions that are requiring contact isolation. What type of trays (disposable or reusable products) are other facilities using for Isolation precaution? We are currently delivering all isolation on styrofoam disposable products as there is a significant concern regarding reusable being brought outside the patients room (even in a food cart). We are concerned the patient satisfaction, presentation and cost of disposables. Interested to know what other facilities are doing to address this. Pat psutor at emhc.org 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. ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From hgreenw2 at fairview.org Fri Oct 23 13:37:09 2009 From: hgreenw2 at fairview.org (Greenwaldt, Heidi J) Date: Fri, 23 Oct 2009 15:37:09 -0500 Subject: [Cnm] Isolation trays In-Reply-To: <4AE1C805.2064.0034.0@emhc.org> Message-ID: <59F3EAD5C3376A42B3CD083F034A612705C5BB07@digsmxmbx06.Fairview.org> We only use disposables for radiation precautions. All other patients receive reusables. Heidi 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 Pat Sutor Sent: Friday, October 23, 2009 3:13 PM To: cnm at lists.my180.net Subject: [Cnm] Isolation trays I am re-sending this question since we are starting to experience more admissions that are requiring contact isolation. What type of trays (disposable or reusable products) are other facilities using for Isolation precaution? We are currently delivering all isolation on styrofoam disposable products as there is a significant concern regarding reusable being brought outside the patients room (even in a food cart). We are concerned the patient satisfaction, presentation and cost of disposables. Interested to know what other facilities are doing to address this. Pat psutor at emhc.org The information contained in this electronic mail transmittal is protected by law and is intended only for the use of the designated recipient(s) named above. If the reader of this transmission is not the intended recipient(s), you are notified that any disclosure, dissemination, distribution or duplication of its contents is strictly prohibited. If you have received this transmittal in error, please notify the sender by return e-mail and delete the transmittal immediately. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From JKrzeminski at Reshealthcare.org Fri Oct 23 13:41:43 2009 From: JKrzeminski at Reshealthcare.org (Krzeminski, Janet) Date: Fri, 23 Oct 2009 15:41:43 -0500 Subject: [Cnm] Isolation trays In-Reply-To: <4AE1C805.2064.0034.0@emhc.org> References: <4AE1C805.2064.0034.0@emhc.org> Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F2012F9ECC@rhcexch3.reshealthcare.org> We do not use disposables for patient trays except Behavioral Health. Staff are instructed to use Universal precautions, with proper handwashing and proper glove use when retrieving all dirty trays. This procedure is also approved by our Infection Control Committee, so my suggestion would be to write your policy and get on the agenda for your Next IC Meeting to get your policy approved. Janet K Chicago, IL ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Pat Sutor Sent: Friday, October 23, 2009 3:13 PM To: cnm at lists.my180.net Subject: [Cnm] Isolation trays I am re-sending this question since we are starting to experience more admissions that are requiring contact isolation. What type of trays (disposable or reusable products) are other facilities using for Isolation precaution? We are currently delivering all isolation on styrofoam disposable products as there is a significant concern regarding reusable being brought outside the patients room (even in a food cart). We are concerned the patient satisfaction, presentation and cost of disposables. Interested to know what other facilities are doing to address this. Pat psutor at emhc.org The information contained in this electronic mail transmittal is protected by law and is intended only for the use of the designated recipient(s) named above. If the reader of this transmission is not the intended recipient(s), you are notified that any disclosure, dissemination, distribution or duplication of its contents is strictly prohibited. If you have received this transmittal in error, please notify the sender by return e-mail and delete the transmittal immediately. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From LAURAF at dmhhs.org Fri Oct 23 14:01:35 2009 From: LAURAF at dmhhs.org (ETCHASON,LAURA) Date: Fri, 23 Oct 2009 16:01:35 -0500 Subject: [Cnm] Isolation trays In-Reply-To: <59F3EAD5C3376A42B3CD083F034A612705C5BB07@digsmxmbx06.Fairview.org> References: <4AE1C805.2064.0034.0@emhc.org> <59F3EAD5C3376A42B3CD083F034A612705C5BB07@digsmxmbx06.Fairview.org> Message-ID: <4AE1D35F.21B0.00A0.0@dmhhs.org> Same here. However, the nursing staff puts the tray in a plastic bag before removing it from the room and putting on the FS cart. Laura A. Etchason, MS, RD, LDN Clinical Nutrition Manager Decatur Memorial Hospital 2300 N. Edward Street Decatur, IL 62526 217-876-5306 (office line and voice mail) 217-876-5305 (fax) 217-876-5301 (general line) lauraf at dmhhs.org Developer, Harmony, Maximizer, Individualization, Belief >>> "Greenwaldt, Heidi J" 10/23/2009 3:37 PM >>> We only use disposables for radiation precautions. All other patients receive reusables. Heidi 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 Pat Sutor Sent: Friday, October 23, 2009 3:13 PM To: cnm at lists.my180.net Subject: [Cnm] Isolation trays I am re-sending this question since we are starting to experience more admissions that are requiring contact isolation. What type of trays (disposable or reusable products) are other facilities using for Isolation precaution? We are currently delivering all isolation on styrofoam disposable products as there is a significant concern regarding reusable being brought outside the patients room (even in a food cart). We are concerned the patient satisfaction, presentation and cost of disposables. Interested to know what other facilities are doing to address this. Pat psutor at emhc.org 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. 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Pat.Morris at johnmuirhealth.com Fri Oct 23 15:01:10 2009 From: Pat.Morris at johnmuirhealth.com (Pat Morris) Date: Fri, 23 Oct 2009 15:01:10 -0700 Subject: [Cnm] Isolation trays In-Reply-To: References: <4AE1C805.2064.0034.0@emhc.org> Message-ID: <91D8C0CAEDE6664BA94B78AC06967F0002B5ADF2@exch2.hsys.local> Same for us. From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Finney, Julie Sent: Friday, October 23, 2009 1:17 PM To: Pat Sutor; cnm at lists.my180.net Subject: Re: [Cnm] Isolation trays We do not use disposable dishes or trays for any patient in precautions excepting all Behavioral patients. This has been approved by our infection control staff. However, nursing personnel deliver the trays to rooms where patients are in precautions, we deliver to all other rooms. Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Pat Sutor Sent: Friday, October 23, 2009 4:13 PM To: cnm at lists.my180.net Subject: [Cnm] Isolation trays I am re-sending this question since we are starting to experience more admissions that are requiring contact isolation. What type of trays (disposable or reusable products) are other facilities using for Isolation precaution? We are currently delivering all isolation on styrofoam disposable products as there is a significant concern regarding reusable being brought outside the patients room (even in a food cart). We are concerned the patient satisfaction, presentation and cost of disposables. Interested to know what other facilities are doing to address this. Pat psutor at emhc.org 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. ________________________________ The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From RachelFlores at sach.org Fri Oct 23 15:05:22 2009 From: RachelFlores at sach.org (Flores, Rachel) Date: Fri, 23 Oct 2009 15:05:22 -0700 Subject: [Cnm] Neonatal/Pediatric assessment forms Message-ID: I will also be revising forms soon, and would like to be copied on any e-mails, please. Thanks, Rachel Flores, RD, CNSC Clinical Nutrition Manager San Antonio Community Hospital (909) 985-2811 x24430 _____ From: Jessica Mack [mailto:jmack at tanner.org] Sent: Friday, October 23, 2009 1:15 PM To: cnm at lists.my180.net Subject: [Cnm] Neonatal/Pediatric assessment forms -------------- next part -------------- An HTML attachment was scrubbed... URL: From DDuardo at humed.com Sat Oct 24 06:33:45 2009 From: DDuardo at humed.com (Duardo, Donna) Date: Sat, 24 Oct 2009 09:33:45 -0400 Subject: [Cnm] Please respond if you have an Electronicmedical recordand CBORD Nutrition Service Suite In-Reply-To: <4AE01BD1.3F4C.0021.0@gw.valleyhealth.com> Message-ID: We have CBORD and IDX Lastword at the moment. We will be switching our hospital system to Epic. Our diet orders interface, our allergies are currently interfacing if entered with the diet order. Once Epic is here, we should also be able to interface allergies. We don't receive tube feedings as our department does not distribute them. They all come from our distribution department. Our consults don't interface with CBORD but the RD's are able to view a worklist on IDX Lastword to see if any consults have been entered for them. The patients identified at nutrition risk upon admission during the nursing screen automatically are placed on another report that is posted. The RD's have access to view this report. We have a centralized kitchen for the main hospital and another kitchen for our Women & Childrens' Hospital. Donna Duardo, MA, RD Hackensack University Medical Center Hackensack, NJ 201-996-2239 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Linda Buckley Sent: Thursday, October 22, 2009 8:46 AM To: Frances Tyus; cnm at lists.my180.net; JCrowley at shorememorial.org Subject: Re: [Cnm] Please respond if you have an Electronicmedical recordand CBORD Nutrition Service Suite We have CBORD and Meditech. 1. All our diet orders interface, and so do tube feedings. We don't get a separate tube feeding report. 2. Allergies don't interface, we enter them manually. 3. Consults are also interfaced. We have a centralized kitchen. Linda Buckley, MS, RD, CDE Clinical Nutrition Supervisor The Valley Hospital Ridgewood NJ 201-447-8000 x 2460, pager 0391 _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net *** HUMC's Proactive Security and Virus Scanner has scanned this email for malicious content and it is safe to use*** ************************************************************************************************** From mrogard at charter.net Sun Oct 25 06:16:46 2009 From: mrogard at charter.net (mrogard at charter.net) Date: Sun, 25 Oct 2009 9:16:46 -0400 Subject: [Cnm] Isolation trays In-Reply-To: <4AE1C805.2064.0034.0@emhc.org> Message-ID: <20091025091646.IP8D7.7616308.root@mp13> We do not use disposables and this practice is stated in our hospital infection control policies. Policy based on CDC guidelines. 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: maryjane.rogalski at baystatehealth.org Professional email: mrogard at charter.net ---- Pat Sutor wrote: > I am re-sending this question since we are starting to experience more admissions that are requiring contact isolation. > > What type of trays (disposable or reusable products) are other facilities using for Isolation precaution? We are currently delivering all isolation on styrofoam disposable products as there is a significant concern regarding reusable being brought outside the patients room (even in a food cart). > > We are concerned the patient satisfaction, presentation and cost of disposables. Interested to know what other facilities are doing to address this. > Pat > psutor at emhc.org > > > 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. From JUnderwood at jflusvi.org Sun Oct 25 11:11:05 2009 From: JUnderwood at jflusvi.org (Underwood, Jennifer) Date: Sun, 25 Oct 2009 14:11:05 -0400 Subject: [Cnm] standardized recipes Message-ID: Good Day, I am looking for a good resource to obtain standardized recipes. Any help would be GREATLY appreciated. JU -------------- next part -------------- An HTML attachment was scrubbed... URL: From Heidi.Clark at AMEDD.ARMY.MIL Mon Oct 26 00:18:38 2009 From: Heidi.Clark at AMEDD.ARMY.MIL (Clark, Heidi L MAJ MIL USAF MEDCOM LRMC) Date: Mon, 26 Oct 2009 08:18:38 +0100 Subject: [Cnm] Isolation trays (UNCLASSIFIED) In-Reply-To: <4AE1C805.2064.0034.0@emhc.org> References: <4AE1C805.2064.0034.0@emhc.org> Message-ID: <9AB53CB10B46784794F4F6D3AD82344F40ABCB@AMEDERMCBE041.eur.amed.ds.army.mil> Classification: UNCLASSIFIED Caveats: NONE We have the support of our Infection Control Nurse that virtually no true "isolation trays" are sent. We send "isolation trays" (eg, plastic) to our mental health admissions for their safety; we send all disposable including paper plates to patients receiving radioactive iodine therapy (eg, thyroid ablation). Other than that, our policy is to use "universal precautions" and treat ALL trays as if they could be contaminated with an infectious disease--that includes using gloves to handle, the people who unload the carts wear gloves/gowns, we continually monitor the temperature and sanitizing solution concentration in the dishwashing machine, etc etc. This has been changed on a few occasions (with really unusual, nasty germs), but not for MRSA, flu etc. I can't cite the references, but my Infection Control Nurse developed the policy and supports this stance--and I consider her the resident expert. I know it's not popular with nursing in general, and we get random requests for 'isolation trays' that are not according to hospital policy, but infection control always backs me up. Heidi Clark, MS, RD Landstuhl Regional Medical Center -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Pat Sutor Sent: Friday, October 23, 2009 10:13 PM To: cnm at lists.my180.net Subject: [Cnm] Isolation trays I am re-sending this question since we are starting to experience more admissions that are requiring contact isolation. What type of trays (disposable or reusable products) are other facilities using for Isolation precaution? We are currently delivering all isolation on styrofoam disposable products as there is a significant concern regarding reusable being brought outside the patients room (even in a food cart). We are concerned the patient satisfaction, presentation and cost of disposables. Interested to know what other facilities are doing to address this. Pat psutor at emhc.org 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. Classification: UNCLASSIFIED Caveats: NONE From smcadoo1 at jhmi.edu Mon Oct 26 07:07:41 2009 From: smcadoo1 at jhmi.edu (Sylvia McAdoo) Date: Mon, 26 Oct 2009 10:07:41 -0400 Subject: [Cnm] Johns Hopkins Pediatric Conference - APN 2009 in Annapolis, Maryland In-Reply-To: References: Message-ID: THE 9TH ADVANCES IN PEDIATRIC NUTRITION, Presented by Johns Hopkins University School of Medicine November 2-3, 2009 in Annapolis, Maryland. See website below for full conference information and to download the brochure for registration. http://www.hopkinscme.edu/CourseDetail.aspx/80022087 APN 2009 Program Monday, Nov 2 7:00-8:00 Registration and Breakfast 8:00-8:30 Welcome and Introduction Maria Oliva-Hemker, MD 8:30?9:30 Human milk for the premature infant: evidence and practice Paula Meier, RN, DNSc, FAAN 9:30-9:45 Break 9:45-10:45 Food Allergy update Robert Wood, MD 10:45-11:45 Functional foods in digestive orders Gerald Mullin, MD, MHS, CNSP 11:45-1:00 Lunch with the Experts 1:00-2:00 Workshop I (Choose One) A. Nutrition hot topics: facts vs fiction with popular pediatric diets. Zahava Turner, RD, CSP B. Kidney disease conundrums: case studies in renal replacement therapy. Laura Postin, MS, RD C. Fueling the pediatric athlete. Mary Sheehan, RD D. Special Considerations for Managing Multiple Severe Food Allergies Tiffani Hays, MS, RD, CDE 2:00-3:00 Workshop I Repeated Monday Evening Program 6:00-7:00PM Cocktail Reception 7:00-8:30PM Keynote Speaker & Dinner Vitamin D- who needs it and how much? Michael Holick, PhD, MD Tuesday, Nov 3 7:15-7:55AM Breakfast 7:55 Announcements 8:00-8:30 Bariatric Surgery in Pediatric Patients Shelly Kirk, PhD, RD 8:30-9:00 genetic disorders of obesity Ann Scheimann, MD, MBA 9:00-9:30 Pediatric Obesity: preventative measures and medical interventions Alan Lake, MD 9:30-10:00 Panel Discussion Moderator - Jenifer Hampsey, MS,RD, CSP 10:00-10:30 Break 10:30-11:30 Workshop II A. Strategies to optimize the nutrition status of oncology patients Amy Schwartz, RD, CNSC, CSP B. Winning at losing: successful strategies for pediatric weight management. Michelle Demuele-Hayes, MS, RD, CSP C. Early childhood feeding: Can it improve long-term health? Amanda Leonard, MPH, RD, CDE D. Innovations in infant formulas Jennifer Dorward, RD, CSP 11:30-12:30 Workshop II Repeated 12:30-1:45 Luncheon & lecture: Tackling pediatric eating behaviors ? GI issues in autism disorders Carol Redel, MD ? New developments in infant feeding behaviors Jenny Fischer, PhD 1:45-2:00 Closing Ann Scheimann, MD, MBA & Tiffani Hays, MS, RD, CDE Sylvia McAdoo, MS, RD, LDN Director of Pediatric Nutrition Division of Pediatric Gastroenterology and Nutrition Johns Hopkins Children's Center 600 N. Wolfe Street, Brady 304 Baltimore, MD 21287 Phone: (410) 955-5177 Fax: (410) 502-9029 From stovallj at hotmail.com Mon Oct 26 08:18:35 2009 From: stovallj at hotmail.com (jen stovall) Date: Mon, 26 Oct 2009 11:18:35 -0400 Subject: [Cnm] Nutrition Care process question Message-ID: Hi all- A collegue of mine asked me the following question because she is staring NCP at her facilty and we are already actively using it. However, I wasn't sure how to answer: If you are doing a follow up on a patient and you think a "better" nutrition diagnosis could be used because: 1.the original is not the best diagnosis or 2. a different more important problem has arisen. How do you handle this? (i.e.) The original diagnosis said "altered nutrition related lab values r/t diagnosis AEB lab profile and inadeaquate oral intake". Clearly this is not the best use of the NCP for a variety of reasons. However, labs are still out of wack and the issue is not resolved. It is evident the patient would better be suited for a diagnosis of inadequate oral intake..... Can you say...New nutrition diagnosis???? Thanks for your help! Jen Brennan, RD, CDN -------------- next part -------------- An HTML attachment was scrubbed... URL: From pcharney at mac.com Mon Oct 26 08:33:58 2009 From: pcharney at mac.com (Pam Charney) Date: Mon, 26 Oct 2009 08:33:58 -0700 Subject: [Cnm] Nutrition Care process question In-Reply-To: References: Message-ID: If the original is not the best diagnosis, what do you mean; is it wrong or perhaps secondary to the primary problem. Annalynn Skipper and I have an ongoing discussion regarding the use of the lab values diagnosis. We do think that it's vastly overused and most of the time used incorrectly. Simply having an abnormal lab value does not mean there is a nutrition diagnosis. In fact, 9 times out of 10, it's not a nutrition problem, or might be one that is so fleeting as to be nonexistent. Abnormal labs do mean that the RD must think critically as to the cause of the problem and quite honestly, I think many do not go that route, preferring to simply diagnose a problem and move on. That said, the medical record is not the place to say there was a misdiagnosis. If we are to be held responsible, we must carefully document what happened. So, After having some discussion regarding the importance of diagnostic skills with the RD in question, it seems from the statement below that there might have actually been an intake problem. What do you mean by "labs are still out of whack and the issue is not resolved"? What is the "issue"? Is that the correct nutrition diagnosis? You could state that the lab values were not improved through the intervention the RD implemented so the RD will now discuss that with the MD to be sure that someone is addressing them. Since that can of worms was opened, someone has to close it. Then reassess and diagnose correctly. Obviously, all depends on your policies for documentation and communication. Let us know what happens! I'm sure others have experienced the same problem. Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 26, 2009, at 8:18 AM, jen stovall wrote: > Hi all- > > A collegue of mine asked me the following question because she is > staring NCP at her facilty and we are already actively using it. > However, I wasn't sure how to answer: > > If you are doing a follow up on a patient and you think a "better" > nutrition diagnosis could be used because: 1.the original is not the > best diagnosis or 2. a different more important problem has > arisen. How do you handle this? > > (i.e.) The original diagnosis said "altered nutrition related lab > values r/t diagnosis AEB lab profile and inadeaquate oral intake". > Clearly this is not the best use of the NCP for a variety of > reasons. However, labs are still out of wack and the issue is not > resolved. It is evident the patient would better be suited for a > diagnosis of inadequate oral intake..... > > Can you say...New nutrition diagnosis???? > > Thanks for your help! > > Jen Brennan, RD, CDN > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From Shannon.Jackson at wilmed.org Mon Oct 26 08:34:55 2009 From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson) Date: Mon, 26 Oct 2009 11:34:55 -0400 Subject: [Cnm] Patients in Hospital Cafeteria Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> Hi, Due to the H1NI Virus, etc, are others restricting patients from entering their hospital cafeterias? If so, what kind of signage are you using to notify customers and patients? Thanks in advance, 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Melissa.Tewes at wchsys.org Mon Oct 26 09:25:56 2009 From: Melissa.Tewes at wchsys.org (Melissa Tewes) Date: Mon, 26 Oct 2009 12:25:56 -0400 Subject: [Cnm] NCM Formulary Calculator Message-ID: Has anyone had an issue with not being able to upgrade the tube fee3ding calculator? Ive customized the formulary to include all but cannot see them on the calculator?? Melissa Tewes RD, LDN Clinical Nutrition Manager Washington County Hospital 251 E. Antietam St. Hagerstown, MD 21774 Direct Line: 301-790-8085 Fax: 301-790-8535 Melissa.Tewes at wchsys.org ________________________________ ***** CONFIDENTIALITY NOTICE ***** This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. -------------- next part -------------- An HTML attachment was scrubbed... URL: From LAURAF at dmhhs.org Mon Oct 26 09:39:58 2009 From: LAURAF at dmhhs.org (ETCHASON,LAURA) Date: Mon, 26 Oct 2009 11:39:58 -0500 Subject: [Cnm] Patients in Hospital Cafeteria In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> Message-ID: <4AE58A8E.21B0.00A0.0@dmhhs.org> We are not. Laura A. Etchason, MS, RD, LDN Clinical Nutrition Manager Decatur Memorial Hospital 2300 N. Edward Street Decatur, IL 62526 217-876-5306 (office line and voice mail) 217-876-5305 (fax) 217-876-5301 (general line) lauraf at dmhhs.org Developer, Harmony, Maximizer, Individualization, Belief >>> "Shannon Byrd Jackson" 10/26/2009 10:34 AM >>> Hi, Due to the H1NI Virus, etc, are others restricting patients from entering their hospital cafeterias? If so, what kind of signage are you using to notify customers and patients? Thanks in advance, Shannon B. Jackson, RD, LDN Clinical Dietitian Supervisor Wilson Medical Center 1705 Tarboro Street SW Wilson, NC 27893-3428 (252) 399-8768 www.wilmed.org ( http://www.wilmed.org/ ) -------------- next part -------------- An HTML attachment was scrubbed... URL: From JKrzeminski at Reshealthcare.org Mon Oct 26 10:36:38 2009 From: JKrzeminski at Reshealthcare.org (Krzeminski, Janet) Date: Mon, 26 Oct 2009 12:36:38 -0500 Subject: [Cnm] Patients in Hospital Cafeteria In-Reply-To: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F2012FA112@rhcexch3.reshealthcare.org> We have alcohol-based gels at both cashier stations - similarly there are many stations posted around the hospital with warnings. 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: Monday, October 26, 2009 10:35 AM To: cnm at lists.my180.net Subject: [Cnm] Patients in Hospital Cafeteria Hi, Due to the H1NI Virus, etc, are others restricting patients from entering their hospital cafeterias? If so, what kind of signage are you using to notify customers and patients? Thanks in advance, 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Shannon.Jackson at wilmed.org Mon Oct 26 10:40:53 2009 From: Shannon.Jackson at wilmed.org (Shannon Byrd Jackson) Date: Mon, 26 Oct 2009 13:40:53 -0400 Subject: [Cnm] Patients in Hospital Cafeteria In-Reply-To: <1177D84FA0F8AD4CA9370B01EABC55F2012FA112@rhcexch3.reshealthcare.org> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> <1177D84FA0F8AD4CA9370B01EABC55F2012FA112@rhcexch3.reshealthcare.org> Message-ID: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51F3@wmhcs03.wmh.org> Hi Janet, Our Cafeteria Manager isn't too happy about patients coming in all the time. This morning a patient came in with IV Poles and wrapped in her blanket. She was on a restricted diet but purchased exactly what she wanted.... Trying to keep patients out of the cafeteria for various reasons, including the safety of everyone who may be eating in the cafeteria.. SBJ ________________________________ From: Krzeminski, Janet [mailto:JKrzeminski at Reshealthcare.org] Sent: Monday, October 26, 2009 1:37 PM To: Shannon Byrd Jackson; cnm at lists.my180.net Subject: RE: [Cnm] Patients in Hospital Cafeteria We have alcohol-based gels at both cashier stations - similarly there are many stations posted around the hospital with warnings. 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: Monday, October 26, 2009 10:35 AM To: cnm at lists.my180.net Subject: [Cnm] Patients in Hospital Cafeteria Hi, Due to the H1NI Virus, etc, are others restricting patients from entering their hospital cafeterias? If so, what kind of signage are you using to notify customers and patients? Thanks in advance, 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Julie.Finney at csauh.com Mon Oct 26 10:52:18 2009 From: Julie.Finney at csauh.com (Finney, Julie) Date: Mon, 26 Oct 2009 13:52:18 -0400 Subject: [Cnm] Cardiac Diets Message-ID: I am looking at making some changes in our diet dictionary. How many of you continue to have diets defined by the components (Cholesterol, Sodium and so on) or are you just using the DASH diet or TLC diets in your terminology? Does everyone on a cardiac diet have their sodium restricted (because it's good for them) or what is your practice? Thanks, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ----------------------------------------- The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From RHartings at mercer-health.com Mon Oct 26 10:59:59 2009 From: RHartings at mercer-health.com (Renee Hartings) Date: Mon, 26 Oct 2009 13:59:59 -0400 Subject: [Cnm] Patients in Hospital Cafeteria References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> Message-ID: <1E97410A99AEDB4B9DC8E1539E25C3DE016B7EC3@mcch03.mcch.local> We never allow patients in the cafeteria. If they want cafeteria food, they must request it through their nurse (and must comply with their diet). Renee Hartings, RD, LD, CLC Director of Nutrition Services Mercer Health 800 W Main St Coldwater OH 45828 419-678-5106 ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Shannon Byrd Jackson Sent: Monday, October 26, 2009 11:35 AM To: cnm at lists.my180.net Subject: [Cnm] Patients in Hospital Cafeteria Hi, Due to the H1NI Virus, etc, are others restricting patients from entering their hospital cafeterias? If so, what kind of signage are you using to notify customers and patients? Thanks in advance, 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Marianne_L_Merrick at ssmhc.com Mon Oct 26 11:39:48 2009 From: Marianne_L_Merrick at ssmhc.com (Marianne_L_Merrick at ssmhc.com) Date: Mon, 26 Oct 2009 13:39:48 -0500 Subject: [Cnm] Cardiac Diets In-Reply-To: Message-ID: We have room service style and offer a cardiac diet with Na restriction. -Marianne Marianne Merrick, RD, CD Clinical Nutrition Manager St. Mary's Hospital 700 South Park Street Madison, WI 53715 office: 608-258-6608 pager: 608-376-5620 The Journey Is the Reward ! "Finney, Julie" Sent by: cnm-bounces at lists.my180.net 10/26/2009 12:52 PM To cc Subject [Cnm] Cardiac Diets I am looking at making some changes in our diet dictionary. How many of you continue to have diets defined by the components (Cholesterol, Sodium and so on) or are you just using the DASH diet or TLC diets in your terminology? Does everyone on a cardiac diet have their sodium restricted (because it?s good for them) or what is your practice? Thanks, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. _______________________________________________ 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 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 email and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From JKrzeminski at Reshealthcare.org Mon Oct 26 11:53:09 2009 From: JKrzeminski at Reshealthcare.org (Krzeminski, Janet) Date: Mon, 26 Oct 2009 13:53:09 -0500 Subject: [Cnm] Cardiac Diets In-Reply-To: References: Message-ID: <1177D84FA0F8AD4CA9370B01EABC55F2012FA168@rhcexch3.reshealthcare.org> We use the terminology in the NCM. I believe it is "Heart Healthy" I met with the Department of Cardiology and did a presentation on the Heart Healthy diet tied in with the Mediterranean diet and what I was trying to accomplish with their patients once admitted to our hospital... Janet K Chicago, IL ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Finney, Julie Sent: Monday, October 26, 2009 12:52 PM To: cnm at lists.my180.net Subject: [Cnm] Cardiac Diets I am looking at making some changes in our diet dictionary. How many of you continue to have diets defined by the components (Cholesterol, Sodium and so on) or are you just using the DASH diet or TLC diets in your terminology? Does everyone on a cardiac diet have their sodium restricted (because it's good for them) or what is your practice? Thanks, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Terese.Scollard at providence.org Mon Oct 26 12:01:32 2009 From: Terese.Scollard at providence.org (Scollard, Terese) Date: Mon, 26 Oct 2009 12:01:32 -0700 Subject: [Cnm] Patients in Hospital Cafeteria In-Reply-To: <1E97410A99AEDB4B9DC8E1539E25C3DE016B7EC3@mcch03.mcch.local> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> <1E97410A99AEDB4B9DC8E1539E25C3DE016B7EC3@mcch03.mcch.local> Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A053AADFD@wn1221.or.providence.org> We are not always successful, but also do not allow for the same reasons. Terese Scollard Providence Health & Services Portland Oregon From: Renee Hartings [mailto:RHartings at mercer-health.com] Sent: Monday, October 26, 2009 11:00 AM To: Shannon Byrd Jackson; cnm at lists.my180.net Subject: Re: [Cnm] Patients in Hospital Cafeteria We never allow patients in the cafeteria. If they want cafeteria food, they must request it through their nurse (and must comply with their diet). Renee Hartings, RD, LD, CLC Director of Nutrition Services Mercer Health 800 W Main St Coldwater OH 45828 419-678-5106 ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Shannon Byrd Jackson Sent: Monday, October 26, 2009 11:35 AM To: cnm at lists.my180.net Subject: [Cnm] Patients in Hospital Cafeteria Hi, Due to the H1NI Virus, etc, are others restricting patients from entering their hospital cafeterias? If so, what kind of signage are you using to notify customers and patients? Thanks in advance, 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 message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From S.Anderson at nvrh.org Mon Oct 26 12:22:50 2009 From: S.Anderson at nvrh.org (Anderson, Sharon) Date: Mon, 26 Oct 2009 15:22:50 -0400 Subject: [Cnm] Temperatures for hot beverages Message-ID: <7F2114C6CC143048BE2C6B666B23B21D35763D@perry.nvrh.local> What would be a safe temperature to deliver hot beverages so that a patient cannot get scalded but so that the quality of the product is acceptable to most people? How do people deal with this? Sharon Anderson, RD,CD Northeastern Vermont Regional Hospital 1315 Hospital Drive, PO Box 905 Saint Johnsbury, VT 05819 802-748-7490 -------------- next part -------------- An HTML attachment was scrubbed... URL: From johnstonj at wvuh.com Mon Oct 26 13:02:12 2009 From: johnstonj at wvuh.com (Johnston, Jill L) Date: Mon, 26 Oct 2009 16:02:12 -0400 Subject: [Cnm] taking RD exam In-Reply-To: References: Message-ID: <7D582764C2C476429C35CB7716EA720F025A5596@NT-EXCHANGE.wvuh.wvuhs.com> I have a question to pose to the list that I hope I can receive some quick answers on. How long do you allow a new graduate or RD eligible employee to work before passing the RD exam? My situation--I have in my RD eligible job description that I allow 3 months after hire to take and pass the RD exam.(must have provisional licensure also) I currently have an employee who has failed it twice. She was hired at the end of May and took it the first time in August. She had to wait the 45 days and reschedule and did not pass this weekend. I am inquiring if I need to rethink my time frame and any advice on this situation. My director and I have discussed it and we have some options but wanted to see what the group had to say. I appreciate any input!! Jill Johnston, MS, RD, LD Clinical Nutrition Manager/ Dietetic Internship Director West Virginia University Hospital (304) 598-4105 johnstonj at wvuh.com ----------------------------------------- Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. From Cathy.Poquette at stjoe.org Mon Oct 26 13:13:08 2009 From: Cathy.Poquette at stjoe.org (Cathy Poquette) Date: Mon, 26 Oct 2009 13:13:08 -0700 Subject: [Cnm] taking RD exam In-Reply-To: <7D582764C2C476429C35CB7716EA720F025A5596@NT-EXCHANGE.wvuh.wvuhs.com> Message-ID: We only allow them to take it once. If they do not pass, we do not allow them to work until they have passed. Cathy Poquette, M.S., R.D. Clinical Nutrition Operations Manager St. Jude Medical Center 101 E. Valencia Mesa Drive Fullerton, CA 92835 (714) 992-3000, ext. 3897 Pager: (714) 490-8030 -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Johnston, Jill L Sent: Monday, October 26, 2009 1:02 PM To: cnm at lists.my180.net Subject: [Cnm] taking RD exam I have a question to pose to the list that I hope I can receive some quick answers on. How long do you allow a new graduate or RD eligible employee to work before passing the RD exam? My situation--I have in my RD eligible job description that I allow 3 months after hire to take and pass the RD exam.(must have provisional licensure also) I currently have an employee who has failed it twice. She was hired at the end of May and took it the first time in August. She had to wait the 45 days and reschedule and did not pass this weekend. I am inquiring if I need to rethink my time frame and any advice on this situation. My director and I have discussed it and we have some options but wanted to see what the group had to say. I appreciate any input!! Jill Johnston, MS, RD, LD Clinical Nutrition Manager/ Dietetic Internship Director West Virginia University Hospital (304) 598-4105 johnstonj at wvuh.com ----------------------------------------- Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net Notice from St. Joseph Health System: Please note that the information contained in this message may be privileged and confidential and protected from disclosure. From pcharney at mac.com Mon Oct 26 13:27:41 2009 From: pcharney at mac.com (Pam Charney) Date: Mon, 26 Oct 2009 13:27:41 -0700 Subject: [Cnm] Patients in Hospital Cafeteria In-Reply-To: <37ABAEB17B0B5B40AA0B6118E57CF59A053AADFD@wn1221.or.providence.org> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> <1E97410A99AEDB4B9DC8E1539E25C3DE016B7EC3@mcch03.mcch.local> <37ABAEB17B0B5B40AA0B6118E57CF59A053AADFD@wn1221.or.providence.org> Message-ID: <33828459-5F17-4144-B430-5662626355B4@mac.com> At risk for being the lone voice in the wilderness, I'm all in favor of patients eating in the cafeteria! Having spent some time in various healthcare facilities from the patient perspective, I can say that you probably see weirder things coming in from the outside. I mean, it is a hospital, right? If you walk down the hall, you're gonna see IV poles. Getting up out of bed and wandering down to the cafeteria can be seen as the patient as a positive aspect of healing and I'm all for that. I have never tried to keep patients out of the cafeteria. We aren't the food police. If patients on restricted diets know what they're supposed to do, assuming we've done our job, why not use the cafeteria experience as a test of learning? At least it's a semi-controlled environment. You are probably at higher risk for H1N1 from folks coming in from the outside as well as your own employees (assuming that the patient doesn't have H1N1). Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 26, 2009, at 12:01 PM, Scollard, Terese wrote: > We are not always successful, but also do not allow for the same > reasons. > Terese Scollard > Providence Health & Services > Portland Oregon > > From: Renee Hartings [mailto:RHartings at mercer-health.com] > Sent: Monday, October 26, 2009 11:00 AM > To: Shannon Byrd Jackson; cnm at lists.my180.net > Subject: Re: [Cnm] Patients in Hospital Cafeteria > > We never allow patients in the cafeteria. If they want cafeteria > food, they must request it through their nurse (and must comply with > their diet). > > Renee Hartings, RD, LD, CLC > Director of Nutrition Services > Mercer Health > 800 W Main St > Coldwater OH 45828 > 419-678-5106 > From: cnm-bounces at lists.my180.net [mailto:cnm- > bounces at lists.my180.net] On Behalf Of Shannon Byrd Jackson > Sent: Monday, October 26, 2009 11:35 AM > To: cnm at lists.my180.net > Subject: [Cnm] Patients in Hospital Cafeteria > > Hi, > > Due to the H1NI Virus, etc, are others restricting patients from > entering their hospital cafeterias? > If so, what kind of signage are you using to notify customers and > patients? > > Thanks in advance, > > 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 message is intended for the sole use of the addressee, and may > contain information that is privileged, confidential and exempt from > disclosure under applicable law. If you are not the addressee you > are hereby notified that you may not use, copy, disclose, or > distribute to anyone the message or any information contained in the > message. If you have received this message in error, please > immediately advise the sender by reply email and delete this message. > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From Terese.Scollard at providence.org Mon Oct 26 13:40:09 2009 From: Terese.Scollard at providence.org (Scollard, Terese) Date: Mon, 26 Oct 2009 13:40:09 -0700 Subject: [Cnm] Patients in Hospital Cafeteria In-Reply-To: <33828459-5F17-4144-B430-5662626355B4@mac.com> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> <1E97410A99AEDB4B9DC8E1539E25C3DE016B7EC3@mcch03.mcch.local> <37ABAEB17B0B5B40AA0B6118E57CF59A053AADFD@wn1221.or.providence.org> <33828459-5F17-4144-B430-5662626355B4@mac.com> Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A053AAF15@wn1221.or.providence.org> We have a different and opposite experience with patients--- running their hands thru the strawberries (with a Hepatitis DX), codes, bare behinds for other guests to enjoy, escapees with TB and other known communicable diseases, food allergies, equipment and its malfunctions and blocking traffic flow with employees tearing through, etc., etc., it is a terrible safety burden for our food service workers to have to confront and figure out how to handle. We have over 2000 people thru daily in one of our locations. The irony of fall statistics and other data collection safety features stopping at the cafeteria door is just too much. The hospital is still accountable-?. We serve cafeteria food to bored patients, but it is a very unsafe place for patient entertainment...I think there should be a safe area that does not burden the food service workers that will enable patients to get out of their room. Terese Scollard ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Hollie_Colle at ssmhc.com Mon Oct 26 13:45:49 2009 From: Hollie_Colle at ssmhc.com (Hollie_Colle at ssmhc.com) Date: Mon, 26 Oct 2009 15:45:49 -0500 Subject: [Cnm] PI Message-ID: I wanted to start a thread to see what everyone is going to monitor for PI in 2010. Just looking for new ideas... Hollie Colle, MS, RD, LDN Clinical Nutrition Manager St. Mary's Good Samaritan, Inc. Mount Vernon IL 62864 (618) 241-2356 Centralia IL 62801 (618) 436-8897 Confidentiality Notice: This email message, 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 email and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From pcharney at mac.com Mon Oct 26 13:50:32 2009 From: pcharney at mac.com (Pam Charney) Date: Mon, 26 Oct 2009 13:50:32 -0700 Subject: [Cnm] Patients in Hospital Cafeteria In-Reply-To: <37ABAEB17B0B5B40AA0B6118E57CF59A053AAF15@wn1221.or.providence.org> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> <1E97410A99AEDB4B9DC8E1539E25C3DE016B7EC3@mcch03.mcch.local> <37ABAEB17B0B5B40AA0B6118E57CF59A053AADFD@wn1221.or.providence.org> <33828459-5F17-4144-B430-5662626355B4@mac.com> <37ABAEB17B0B5B40AA0B6118E57CF59A053AAF15@wn1221.or.providence.org> Message-ID: <7EFD7662-E5C2-4E24-9F7B-05107BB37E03@mac.com> Hi Terese, I'd probably counter with similar experiences with employees (well, maybe not the bare behinds) and have never barred employees in any of the facilities I've been associated with in my career, which range from 35 bed rural facility to 500 bed academic medical centers, both military and civilian. While sometimes difficult to do in practice, one can certain steer away folks who are behaving inappropriately while not barring those who simply want a meal someplace besides their room! In the past I've participated in patient/family advocacy groups and often hear of the need to find ways to get patients out of rooms and mobile as they heal. Anything we can do to support that is to their benefit! Come to think of it, I once did encounter a bare behind; not an employee but a guest. Pam Charney pcharney at mac.com On Oct 26, 2009, at 1:40 PM, Scollard, Terese wrote: > We have a different and opposite experience with patients--- running > their hands thru the strawberries (with a Hepatitis DX), codes, bare > behinds for other guests to enjoy, escapees with TB and other known > communicable diseases, food allergies, equipment and its > malfunctions and blocking traffic flow with employees tearing > through, etc., etc., it is a terrible safety burden for our food > service workers to have to confront and figure out how to handle. We > have over 2000 people thru daily in one of our locations. The irony > of fall statistics and other data collection safety features > stopping at the cafeteria door is just too much. The hospital is > still accountable??. We serve cafeteria food to bored patients, > but it is a very unsafe place for patient entertainment?I think > there should be a safe area that does not burden the food service > workers that will enable patients to get out of their room. > Terese Scollard > > > > This message is intended for the sole use of the addressee, and may > contain information that is privileged, confidential and exempt from > disclosure under applicable law. If you are not the addressee you > are hereby notified that you may not use, copy, disclose, or > distribute to anyone the message or any information contained in the > message. If you have received this message in error, please > immediately advise the sender by reply email and delete this message. > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From Terese.Scollard at providence.org Mon Oct 26 14:00:26 2009 From: Terese.Scollard at providence.org (Scollard, Terese) Date: Mon, 26 Oct 2009 14:00:26 -0700 Subject: [Cnm] Patients in Hospital Cafeteria In-Reply-To: <7EFD7662-E5C2-4E24-9F7B-05107BB37E03@mac.com> References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> <1E97410A99AEDB4B9DC8E1539E25C3DE016B7EC3@mcch03.mcch.local> <37ABAEB17B0B5B40AA0B6118E57CF59A053AADFD@wn1221.or.providence.org> <33828459-5F17-4144-B430-5662626355B4@mac.com> <37ABAEB17B0B5B40AA0B6118E57CF59A053AAF15@wn1221.or.providence.org> <7EFD7662-E5C2-4E24-9F7B-05107BB37E03@mac.com> Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A053AAF47@wn1221.or.providence.org> I know... it is a tough issue, but it is just so unsafe for patients and other customers and such a burden for our food service employees, that I think that all would be better served by an alternative place for patients to be able to go-to address that issue clearly. I know some hospitals have gardens, etc that can help so much-I am all for ways to help patients who need to be out of their rooms...just do not feel that the cafeteria is the best place to get that need met due to the safety issues that arise. People are sicker in the hospital than in an outside public retail area. It puts the food service workers (with little or no power in the organization) into the position of judging who is okay to be there and who is not, and does not seem right for organizations to support that situation. Terese From: Pam Charney [mailto:pcharney at mac.com] Sent: Monday, October 26, 2009 1:51 PM To: Scollard, Terese Cc: cnm at lists.my180.net Subject: Re: [Cnm] Patients in Hospital Cafeteria Hi Terese, I'd probably counter with similar experiences with employees (well, maybe not the bare behinds) and have never barred employees in any of the facilities I've been associated with in my career, which range from 35 bed rural facility to 500 bed academic medical centers, both military and civilian. While sometimes difficult to do in practice, one can certain steer away folks who are behaving inappropriately while not barring those who simply want a meal someplace besides their room! In the past I've participated in patient/family advocacy groups and often hear of the need to find ways to get patients out of rooms and mobile as they heal. Anything we can do to support that is to their benefit! Come to think of it, I once did encounter a bare behind; not an employee but a guest. Pam Charney pcharney at mac.com On Oct 26, 2009, at 1:40 PM, Scollard, Terese wrote: We have a different and opposite experience with patients--- running their hands thru the strawberries (with a Hepatitis DX), codes, bare behinds for other guests to enjoy, escapees with TB and other known communicable diseases, food allergies, equipment and its malfunctions and blocking traffic flow with employees tearing through, etc., etc., it is a terrible safety burden for our food service workers to have to confront and figure out how to handle. We have over 2000 people thru daily in one of our locations. The irony of fall statistics and other data collection safety features stopping at the cafeteria door is just too much. The hospital is still accountable-?. We serve cafeteria food to bored patients, but it is a very unsafe place for patient entertainment...I think there should be a safe area that does not burden the food service workers that will enable patients to get out of their room. Terese Scollard ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Beverly.Hernandez at piedmont.org Mon Oct 26 14:14:20 2009 From: Beverly.Hernandez at piedmont.org (Beverly Hernandez) Date: Mon, 26 Oct 2009 17:14:20 -0400 Subject: [Cnm] Patients in Hospital Cafeteria Message-ID: We've gained support from both risk management and our hospital's safety committee to prevent "patients on isolation" from coming into the cafeteria. Agreed, we do not know what a visitor is plagued with when coming in from the outside. Yet allowing that patient in yellow gown, mask, and with known MRSA, for example, to possibly hang around the salad bar seems less than responsible on our part. It is my opinion that the leadership/safety action would be to also avoid harm (decrease risk) to care givers and other family members who trust us to create an overall safe environment. Beverly J.D. Hernandez, M.S.,R.D.,L.D.,CDN Clinical Nutrition Mgr. Piedmont Hospital 1968 Peachtree R.D N W Atlanta, GA 30309 404-605-1746 Beverly.Hernandez at Piedmont.org "We are not imprisoned by our circumstances, our setbacks, our history, our mistakes, or even staggering defeats along the way. We are freed by our choices." Jim Collins >>> Pam Charney 10/26/2009 4:27 PM >>> At risk for being the lone voice in the wilderness, I'm all in favor of patients eating in the cafeteria! Having spent some time in various healthcare facilities from the patient perspective, I can say that you probably see weirder things coming in from the outside. I mean, it is a hospital, right? If you walk down the hall, you're gonna see IV poles. Getting up out of bed and wandering down to the cafeteria can be seen as the patient as a positive aspect of healing and I'm all for that. I have never tried to keep patients out of the cafeteria. We aren't the food police. If patients on restricted diets know what they're supposed to do, assuming we've done our job, why not use the cafeteria experience as a test of learning? At least it's a semi-controlled environment. You are probably at higher risk for H1N1 from folks coming in from the outside as well as your own employees (assuming that the patient doesn't have H1N1). Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 26, 2009, at 12:01 PM, Scollard, Terese wrote: > We are not always successful, but also do not allow for the same > reasons. > Terese Scollard > Providence Health & Services > Portland Oregon > > From: Renee Hartings [mailto:RHartings at mercer-health.com] > Sent: Monday, October 26, 2009 11:00 AM > To: Shannon Byrd Jackson; cnm at lists.my180.net > Subject: Re: [Cnm] Patients in Hospital Cafeteria > > We never allow patients in the cafeteria. If they want cafeteria > food, they must request it through their nurse (and must comply with > their diet). > > Renee Hartings, RD, LD, CLC > Director of Nutrition Services > Mercer Health > 800 W Main St > Coldwater OH 45828 > 419-678-5106 > From: cnm-bounces at lists.my180.net [mailto:cnm- > bounces at lists.my180.net] On Behalf Of Shannon Byrd Jackson > Sent: Monday, October 26, 2009 11:35 AM > To: cnm at lists.my180.net > Subject: [Cnm] Patients in Hospital Cafeteria > > Hi, > > Due to the H1NI Virus, etc, are others restricting patients from > entering their hospital cafeterias? > If so, what kind of signage are you using to notify customers and > patients? > > Thanks in advance, > > 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 message is intended for the sole use of the addressee, and may > contain information that is privileged, confidential and exempt from > disclosure under applicable law. If you are not the addressee you > are hereby notified that you may not use, copy, disclose, or > distribute to anyone the message or any information contained in the > message. If you have received this message in error, please > immediately advise the sender by reply email and delete this message. > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net From Virginia.Carney at STJUDE.ORG Mon Oct 26 14:10:35 2009 From: Virginia.Carney at STJUDE.ORG (Carney, Virginia H) Date: Mon, 26 Oct 2009 16:10:35 -0500 Subject: [Cnm] Patients in Hospital Cafeteria In-Reply-To: <33828459-5F17-4144-B430-5662626355B4@mac.com> Message-ID: <6EAE916704479E4BB6AB5A133BA224F72886F1FAB1@SJMEMXMBS11.stjude.sjcrh.local> I happen to agree with Pam. We allow our patients in the cafeteria too so that our pediatric cancer patients and their families know that we support them and feel that they are all part of our hospital family. 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) (901)595-3202 (fax) pager 595-3578, PIN# 0838 virginia.carney at stjude.org [cid:774240821 at 26102009-0A11] [cid:774240821 at 26102009-0A11] Finding cures. Saving children. www.stjude.org ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Pam Charney Sent: Monday, October 26, 2009 3:28 PM To: Scollard, Terese Cc: cnm at lists.my180.net; Shannon Byrd Jackson; Renee Hartings Subject: Re: [Cnm] Patients in Hospital Cafeteria At risk for being the lone voice in the wilderness, I'm all in favor of patients eating in the cafeteria! Having spent some time in various healthcare facilities from the patient perspective, I can say that you probably see weirder things coming in from the outside. I mean, it is a hospital, right? If you walk down the hall, you're gonna see IV poles. Getting up out of bed and wandering down to the cafeteria can be seen as the patient as a positive aspect of healing and I'm all for that. I have never tried to keep patients out of the cafeteria. We aren't the food police. If patients on restricted diets know what they're supposed to do, assuming we've done our job, why not use the cafeteria experience as a test of learning? At least it's a semi-controlled environment. You are probably at higher risk for H1N1 from folks coming in from the outside as well as your own employees (assuming that the patient doesn't have H1N1). Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 26, 2009, at 12:01 PM, Scollard, Terese wrote: We are not always successful, but also do not allow for the same reasons. Terese Scollard Providence Health & Services Portland Oregon From: Renee Hartings [mailto:RHartings at mercer-health.com] Sent: Monday, October 26, 2009 11:00 AM To: Shannon Byrd Jackson; cnm at lists.my180.net Subject: Re: [Cnm] Patients in Hospital Cafeteria We never allow patients in the cafeteria. If they want cafeteria food, they must request it through their nurse (and must comply with their diet). Renee Hartings, RD, LD, CLC Director of Nutrition Services Mercer Health 800 W Main St Coldwater OH 45828 419-678-5106 ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Shannon Byrd Jackson Sent: Monday, October 26, 2009 11:35 AM To: cnm at lists.my180.net Subject: [Cnm] Patients in Hospital Cafeteria Hi, Due to the H1NI Virus, etc, are others restricting patients from entering their hospital cafeterias? If so, what kind of signage are you using to notify customers and patients? Thanks in advance, 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 message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net ________________________________ Email Disclaimer: www.stjude.org/emaildisclaimer -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: St. Jude logo.gif Type: image/gif Size: 43 bytes Desc: St. Jude logo.gif URL: From Terese.Scollard at providence.org Mon Oct 26 14:11:52 2009 From: Terese.Scollard at providence.org (Scollard, Terese) Date: Mon, 26 Oct 2009 14:11:52 -0700 Subject: [Cnm] Patients in Hospital Cafeteria In-Reply-To: References: Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A053AAF6B@wn1221.or.providence.org> We had that too (MRSA) at one of our sites. Terese -----Original Message----- From: Beverly Hernandez [mailto:Beverly.Hernandez at piedmont.org] Sent: Monday, October 26, 2009 2:14 PM To: Pam Charney; Scollard, Terese Cc: cnm at lists.my180.net; Renee Hartings; Shannon Byrd Jackson Subject: Re: [Cnm] Patients in Hospital Cafeteria We've gained support from both risk management and our hospital's safety committee to prevent "patients on isolation" from coming into the cafeteria. Agreed, we do not know what a visitor is plagued with when coming in from the outside. Yet allowing that patient in yellow gown, mask, and with known MRSA, for example, to possibly hang around the salad bar seems less than responsible on our part. It is my opinion that the leadership/safety action would be to also avoid harm (decrease risk) to care givers and other family members who trust us to create an overall safe environment. Beverly J.D. Hernandez, M.S.,R.D.,L.D.,CDN Clinical Nutrition Mgr. Piedmont Hospital 1968 Peachtree R.D N W Atlanta, GA 30309 404-605-1746 Beverly.Hernandez at Piedmont.org "We are not imprisoned by our circumstances, our setbacks, our history, our mistakes, or even staggering defeats along the way. We are freed by our choices." Jim Collins >>> Pam Charney 10/26/2009 4:27 PM >>> At risk for being the lone voice in the wilderness, I'm all in favor of patients eating in the cafeteria! Having spent some time in various healthcare facilities from the patient perspective, I can say that you probably see weirder things coming in from the outside. I mean, it is a hospital, right? If you walk down the hall, you're gonna see IV poles. Getting up out of bed and wandering down to the cafeteria can be seen as the patient as a positive aspect of healing and I'm all for that. I have never tried to keep patients out of the cafeteria. We aren't the food police. If patients on restricted diets know what they're supposed to do, assuming we've done our job, why not use the cafeteria experience as a test of learning? At least it's a semi-controlled environment. You are probably at higher risk for H1N1 from folks coming in from the outside as well as your own employees (assuming that the patient doesn't have H1N1). Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 26, 2009, at 12:01 PM, Scollard, Terese wrote: > We are not always successful, but also do not allow for the same > reasons. > Terese Scollard > Providence Health & Services > Portland Oregon > > From: Renee Hartings [mailto:RHartings at mercer-health.com] > Sent: Monday, October 26, 2009 11:00 AM > To: Shannon Byrd Jackson; cnm at lists.my180.net > Subject: Re: [Cnm] Patients in Hospital Cafeteria > > We never allow patients in the cafeteria. If they want cafeteria > food, they must request it through their nurse (and must comply with > their diet). > > Renee Hartings, RD, LD, CLC > Director of Nutrition Services > Mercer Health > 800 W Main St > Coldwater OH 45828 > 419-678-5106 > From: cnm-bounces at lists.my180.net [mailto:cnm- > bounces at lists.my180.net] On Behalf Of Shannon Byrd Jackson > Sent: Monday, October 26, 2009 11:35 AM > To: cnm at lists.my180.net > Subject: [Cnm] Patients in Hospital Cafeteria > > Hi, > > Due to the H1NI Virus, etc, are others restricting patients from > entering their hospital cafeterias? > If so, what kind of signage are you using to notify customers and > patients? > > Thanks in advance, > > 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 message is intended for the sole use of the addressee, and may > contain information that is privileged, confidential and exempt from > disclosure under applicable law. If you are not the addressee you > are hereby notified that you may not use, copy, disclose, or > distribute to anyone the message or any information contained in the > message. If you have received this message in error, please > immediately advise the sender by reply email and delete this message. > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. From cindy at harperjobs.com Mon Oct 26 14:16:00 2009 From: cindy at harperjobs.com (Cindy Krainen) Date: Mon, 26 Oct 2009 17:16:00 -0400 Subject: [Cnm] Career Opportunity-RD-CDE-California Message-ID: <17E9D78B831B4740B846DB1066FC8720@hprdomain.local> RD-CDE: Clinical Diabetes Educator Exciting non-traditional opportunity! California-involves travel! Unique Diabetes Educator position working in the field representing a Diabetes Management program to primary care physician practices. Responsibilities will involve teaching educational programs and coordinating these with the office staff members and implementing new programs to keep current staff updated. Outstanding communication and interpersonal skills are essential for success in this role. Candidates living within the territory are preferred, as no relocation allowance is offered. Territory is large and includes the central Valley, Salinas, Ventura, Bakersfield, Santa Barbara, etc. This is a full-time field position which will involve extensive daily travel, and a minimum of 8 overnights/month. Lucrative base salary and bonus potential, along with car allowance, gas and other perks. The selected candidate will work from their own home, with laptop and business equipment provided. RD (or RN) and CDE credentials are required, no exceptions will be made. More details will be provided once a qualified resume is submitted. All inquiries will remain confidential. Email resume to: Cindy Krainen RD Harper Associates 31000 Northwestern Highway, Suite 240 Farmington Hills, MI 48334 248-932-3662 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Rachel.Baar at allina.com Mon Oct 26 14:21:11 2009 From: Rachel.Baar at allina.com (Baar, Rachel) Date: Mon, 26 Oct 2009 16:21:11 -0500 Subject: [Cnm] MNT services In-Reply-To: <6EAE916704479E4BB6AB5A133BA224F72886F1FAB1@SJMEMXMBS11.stjude.sjcrh.local> Message-ID: Does anyone have analytical evidence (as opposed to anectodal evidence) that patients are better served from an out-of-pocket cost standpoint when MNT services are provided and billed from a clinic based program vs from a hospital-based outpatient program? Our Finance person has stated it is better for patients cost-wise to recieve MNT from a clinic, but several RDs counter that by stating that there are just as many insurance plans that will pay hospital-based charges as there are that will reimburse clinic charges. Who really knows the answer to this one? 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: From kathleenb at fmchealth.org Tue Oct 27 06:11:26 2009 From: kathleenb at fmchealth.org (Kathleen Meyer) Date: Tue, 27 Oct 2009 09:11:26 -0400 Subject: [Cnm] Prealbumin Message-ID: <37BC1F8B840D1F40A11EE5F7F362E5CE0408751E21@EX07.fmchealth.org> Our lab's new "normal" level for prealbumin is now 20... What ranges are other facilities using to classify mild, moderate and sever protein depletion based on prealbumin levels? Thanks! Kathleen Kathleen Meyer, RD, LD Assistant Manager, Dietary Fairfield Medical Center Lancaster, Ohio kathleenb at fmchealth.org Fairfield Medical Center People you know. Care you trust. Visit us at http://www.fmchealth.org or our online store at http://fairfield.thehospitalstore.com "Confidentiality Notice: This e-mail message, including any attachments is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review; use; disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message." -------------- next part -------------- An HTML attachment was scrubbed... URL: From Becky.Caldwell at BMHCC.org Tue Oct 27 06:26:37 2009 From: Becky.Caldwell at BMHCC.org (Becky Caldwell) Date: Tue, 27 Oct 2009 08:26:37 -0500 Subject: [Cnm] PI In-Reply-To: References: Message-ID: <38AD1C7BDCA23F4F87C9E9421259C78CC208B8@tnucexch.ad.bmhcc.org> Diabetic Education and Dept wide we are going to start Room Service so that will be a big QI project Becky Caldwell MS RD LDN Baptist Memorial Hospital-Union City ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Hollie_Colle at ssmhc.com Sent: Monday, October 26, 2009 3:46 PM To: cnm at lists.my180.net Subject: [Cnm] PI I wanted to start a thread to see what everyone is going to monitor for PI in 2010. Just looking for new ideas... Hollie Colle, MS, RD, LDN Clinical Nutrition Manager St. Mary's Good Samaritan, Inc. Mount Vernon IL 62864 (618) 241-2356 Centralia IL 62801 (618) 436-8897 Confidentiality Notice: This email message, 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 email and destroy all copies of the original message. ----------------------------------------- Smart Medicine. Inspired Care. And the awards to prove it. Recognized as a Top 50 Healthcare Network. To learn about other recognition and awards Baptist has earned, visit: http://www.bmhcc.org/aboutus/awards/index.asp This message and any files transmitted with it may contain legally privileged, confidential, or proprietary information. If you are not the intended recipient of this message, you are not permitted to use, copy, or forward it, in whole or in part without the express consent of the sender. Please notify the sender of the error by reply email, disregard the foregoing messages, and delete it immediately. -------------- next part -------------- An HTML attachment was scrubbed... URL: From cketterman at wellspan.org Tue Oct 27 06:47:13 2009 From: cketterman at wellspan.org (Ketterman-Hopkins, Cindra) Date: Tue, 27 Oct 2009 09:47:13 -0400 Subject: [Cnm] VST, CPOE and Cerner Message-ID: <5B32BC7FE9D04B43A8B78CA7A19CBD4E050B202A@EXCH4.wellspan.org> I'm interested in talking to anyone who is using the VST software in their diet office, Cerner Millennium for the EMR and also has CPOE. 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. ______________________________________________________________________ -------------- next part -------------- An HTML attachment was scrubbed... URL: From bhomola at comhs.org Tue Oct 27 07:33:52 2009 From: bhomola at comhs.org (Bobbi Homola) Date: Tue, 27 Oct 2009 09:33:52 -0500 Subject: [Cnm] taking RD exam In-Reply-To: <7D582764C2C476429C35CB7716EA720F025A5596@NT-EXCHANGE.wvuh.wvuhs.com> Message-ID: "Employee may take registration exam three times. If after third attempt, the employee fails, they are terminated. Must be registered within one year of hire." 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 Johnston, Jill L Sent: Monday, October 26, 2009 3:02 PM To: cnm at lists.my180.net Subject: [Cnm] taking RD exam I have a question to pose to the list that I hope I can receive some quick answers on. How long do you allow a new graduate or RD eligible employee to work before passing the RD exam? My situation--I have in my RD eligible job description that I allow 3 months after hire to take and pass the RD exam.(must have provisional licensure also) I currently have an employee who has failed it twice. She was hired at the end of May and took it the first time in August. She had to wait the 45 days and reschedule and did not pass this weekend. I am inquiring if I need to rethink my time frame and any advice on this situation. My director and I have discussed it and we have some options but wanted to see what the group had to say. I appreciate any input!! Jill Johnston, MS, RD, LD Clinical Nutrition Manager/ Dietetic Internship Director West Virginia University Hospital (304) 598-4105 johnstonj at wvuh.com ----------------------------------------- Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From Amy.Gendron at cvmc.org Tue Oct 27 07:36:46 2009 From: Amy.Gendron at cvmc.org (Gendron, Amy L.) Date: Tue, 27 Oct 2009 10:36:46 -0400 Subject: [Cnm] PI In-Reply-To: <38AD1C7BDCA23F4F87C9E9421259C78CC208B8@tnucexch.ad.bmhcc.org> Message-ID: We maybe doing more NCP and counting that towards PI Effective December 31, 2008 my email address changed. Please see below. Amy Gendron, RD Senior Inpatient Dietitian Central Vermont Medical Center ph: 802-371-4143 fax: 802-371-5376 amy.gendron at cvmc.org -----Original Message----- From: Becky Caldwell [mailto:Becky.Caldwell at BMHCC.org] Sent: Tuesday, October 27, 2009 9:27 AM To: Hollie_Colle at ssmhc.com; cnm at lists.my180.net Subject: Re: [Cnm] PI Diabetic Education and Dept wide we are going to start Room Service so that will be a big QI project Becky Caldwell MS RD LDN Baptist Memorial Hospital-Union City ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Hollie_Colle at ssmhc.com Sent: Monday, October 26, 2009 3:46 PM To: cnm at lists.my180.net Subject: [Cnm] PI I wanted to start a thread to see what everyone is going to monitor for PI in 2010. Just looking for new ideas... Hollie Colle, MS, RD, LDN Clinical Nutrition Manager St. Mary's Good Samaritan, Inc. Mount Vernon IL 62864 (618) 241-2356 Centralia IL 62801 (618) 436-8897 Confidentiality Notice: This email message, 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 email and destroy all copies of the original message. ________________________________ Smart Medicine. Inspired Care. And the awards to prove it. Recognized as a Top 50 Healthcare Network. To learn about other recognition and awards Baptist has earned, visit: http://www.bmhcc.org/aboutus/awards/index.asp This message and any files transmitted with it may contain legally privileged, confidential, or proprietary information. If you are not the intended recipient of this message, you are not permitted to use, copy, or forward it, in whole or in part without the express consent of the sender. Please notify the sender of the error by reply email, disregard the foregoing messages, and delete it immediately. -------------- next part -------------- An HTML attachment was scrubbed... URL: From apirozek at hotmail.com Tue Oct 27 07:41:55 2009 From: apirozek at hotmail.com (amy pirozek) Date: Tue, 27 Oct 2009 10:41:55 -0400 Subject: [Cnm] Borrowing Supplements/Formula Message-ID: Does anyone have a form or a contract they use when formula is exchanged or borrowed between hospitals? How do you keep track of this? I would rather not reinvent the wheel. Thanks! _________________________________________________________________ Windows 7: Simplify your PC. Learn more. http://www.microsoft.com/Windows/windows-7/default.aspx?ocid=PID24727::T:WLMTAGL:ON:WL:en-US:WWL_WIN_evergreen1:102009 -------------- next part -------------- An HTML attachment was scrubbed... URL: From CKeinath at chs-mi.com Tue Oct 27 08:06:33 2009 From: CKeinath at chs-mi.com (CKeinath at chs-mi.com) Date: 27-Oct-2009 11:06:33 EDT Subject: [Cnm] hfap standard re: breastmilk and infant formula An HTML attachment was scrubbed... URL: From Susan_R_Paredez at uhs.org Tue Oct 27 07:53:11 2009 From: Susan_R_Paredez at uhs.org (Susan_R_Paredez at uhs.org) Date: Tue, 27 Oct 2009 10:53:11 -0400 Subject: [Cnm] Ped. Wt. Mgmt. Program Message-ID: Good Day All, We received funding to develop a wt. mgmt. program for kids in our community. For those of you who have done this, how did you get kids and parents to attend. What location, time of day, incentives were successful in getting their participation? Thanks. 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 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. --- 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. o1 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Lisa.N.Faucon at kp.org Tue Oct 27 08:43:32 2009 From: Lisa.N.Faucon at kp.org (Lisa.N.Faucon at kp.org) Date: Tue, 27 Oct 2009 08:43:32 -0700 Subject: [Cnm] PES statement for refeeding Message-ID: How would you write a PES statement for refeeding syndrome? Altered nutrition related lab values : Phos 1.7 secondary to refeeding syndrome as evidenced by increase in tube feed rate by 30mL/hr and Phos decrease from 2.8 in 24 hours ??? I'm not really sure....can someone help? Thanks! Lisa N Faucon MS, RD, CNSC Assistant Department Administrator, Nutrition Services Kaiser Permanente 4647 Zion Ave San Diego, CA, 92120 (619) 528-5515 office (619) 528-3024 fax (619) 682-0672 pager NOTICE TO RECIPIENT: If you are not the intended recipient of this e-mail, you are prohibited from sharing, copying, or otherwise using or disclosing its contents. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and permanently delete this e-mail and any attachments without reading, forwarding or saving them. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From ESCOTTSTUMPS at ecu.edu Tue Oct 27 08:48:04 2009 From: ESCOTTSTUMPS at ecu.edu (Escott-Stump, Sylvia) Date: Tue, 27 Oct 2009 11:48:04 -0400 Subject: [Cnm] PES statement for refeeding In-Reply-To: References: Message-ID: Might be more of something like "excessive energy intake related to increased TF rate by 30 mL/hr over X hours as evidenced by altered serum phos (from 2.8 to 1.7 in 24 hrs.)" If there is one nutrient out of sync, you could state "excessive CHO..." College of Human Ecology Enriching Lives. Enhancing Communities. Sylvia Escott-Stump, MA, RD, LDN Dietetic Internship Director East Carolina University 114 Rivers Building Greenville, NC 27858 252-328-1352 Fax 252-328-4276 Internship: http://www.ecu.edu/che/nutr/dieteticinternship.html ________________________________ From: cnm-bounces at lists.my180.net [cnm-bounces at lists.my180.net] On Behalf Of Lisa.N.Faucon at kp.org [Lisa.N.Faucon at kp.org] Sent: Tuesday, October 27, 2009 11:43 AM To: cnm at lists.my180.net Subject: [Cnm] PES statement for refeeding How would you write a PES statement for refeeding syndrome? Altered nutrition related lab values : Phos 1.7 secondary to refeeding syndrome as evidenced by increase in tube feed rate by 30mL/hr and Phos decrease from 2.8 in 24 hours ??? I'm not really sure....can someone help? Thanks! Lisa N Faucon MS, RD, CNSC Assistant Department Administrator, Nutrition Services Kaiser Permanente 4647 Zion Ave San Diego, CA, 92120 (619) 528-5515 office (619) 528-3024 fax (619) 682-0672 pager NOTICE TO RECIPIENT: If you are not the intended recipient of this e-mail, you are prohibited from sharing, copying, or otherwise using or disclosing its contents. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and permanently delete this e-mail and any attachments without reading, forwarding or saving them. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Vach.Ruth at mayo.edu Tue Oct 27 09:14:31 2009 From: Vach.Ruth at mayo.edu (Vach, Ruth F.) Date: Tue, 27 Oct 2009 11:14:31 -0500 Subject: [Cnm] Hospital Guest Trays Message-ID: <4CE3A0ECBDA0DB42935288EF0A4D7D2D0129020D@msgebe18.mfad.mfroot.org> Can anyone shrare with me how inpatient guest trays for visitors are handled at your hospital? Information on how they are charged and what the charge is per meal would be helpful. Thank You. -------------- next part -------------- An HTML attachment was scrubbed... URL: From ckferguson at saint-lukes.org Tue Oct 27 09:57:55 2009 From: ckferguson at saint-lukes.org (Ferguson, Christina) Date: Tue, 27 Oct 2009 11:57:55 -0500 Subject: [Cnm] Hospital Guest Trays In-Reply-To: <4CE3A0ECBDA0DB42935288EF0A4D7D2D0129020D@msgebe18.mfad.mfroot.org> References: <4CE3A0ECBDA0DB42935288EF0A4D7D2D0129020D@msgebe18.mfad.mfroot.org> Message-ID: At our hospital, the Medsurge Director is given a certain number of guest meal (free) passes. She gives them to Nursing and the nursing staff then chooses if there is need for a guest meal pass. They are to be used in rare situations such as, a family member brought a patient in suddenly and does not have their purse or any money, or a patient is on comfort measures, close to passing, and the family member does not want to leave the room. Nursing is constantly requesting a free meal for family members of patients for a variety of reasons. Unfortunately, administration does not allow Dietary to charge for such meals, so we use the free guest meal pass to track how many free meals nursing is giving out. The tickets are only 1 per patient family and only to be used in rare situations (situations listed above). We once only had 11 inpatients (we are only a 25 bed hospital) and 13 requests for guest trays. We put this system in place to try to cut back on the requests and to be able to track how many free meals we are giving away. Christina Ferguson, RD LD Clinical Dietitian Wright Memorial Hospital Trenton, MO 64683 Phone: 660-359-5621 Ext: 460 Saint Lukes System Extension: 35460 Email: ckferguson at saint-lukes.org ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Vach, Ruth F. Sent: Tuesday, October 27, 2009 11:15 AM To: cnm at lists.my180.net Subject: [Cnm] Hospital Guest Trays Can anyone shrare with me how inpatient guest trays for visitors are handled at your hospital? Information on how they are charged and what the charge is per meal would be helpful. Thank You. Saint Luke's Health System Confidentiality Notice: This message is for the designated recipient only and may contain privileged, proprietary or otherwise private information and is legally protected. If you have received it in error, please notify the sender immediately and delete the original. Any other use of the email by you is prohibited. Saint Luke's is the one heart care leader in Kansas City. To learn more, or to find a Saint Luke's location near you, call NurseLine at (816) 932-6220 or go to saintlukeshealthsystem.org. Please consider our environment before printing this e-mail. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Sandra.Miller at CHW.edu Tue Oct 27 10:17:36 2009 From: Sandra.Miller at CHW.edu (Miller, Sandra - MMC) Date: Tue, 27 Oct 2009 10:17:36 -0700 Subject: [Cnm] Use of NCP terminology In-Reply-To: References: Message-ID: <607AD24EFC85B14B956CF6AAA4F0E188061A78826C@chw-msg-824.chw.edu> I got this email and am unsure on how to respond. I know this issue has been discussed in the past. Please clarify so I can forward it on. Hello Everyone, I am contacting you because you are one of the hospitals that have Meditech in place. Can you tell me if you are using the Nutrition Care Process terminology for your nutrition documentation in the Meditech computerized medical record? If you are, the ADA is requiring that a fee be paid annually to use the NCP terminology. The fee is $150 annually, but reduced to $100, if there are three or more facilities using. I would appreciate if you could get back to me. Also I returned from FENCE and attended some of the NCP talks. I was disappointed that some of the talks were scheduled for the same time as I wanted to attend both the Tuesday sessions scheduled at 12:00 - 1:30 I have been using the NCP process and just bought the updated book. I was surprised to see such a large assessment section now and see the sample nutrition assessment, monitoring and evaluation documentation. So now I am confused. How do you use this documentation AND a PES statement? Thanks Sandra Miller RD CDE French Hospital Medical Center NOTICE TO RECIPIENT: If you are not the intended recipient of this e-mail, you are prohibited from sharing, copying, or otherwise using or disclosing its contents. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and permanently delete this e-mail and any attachments without reading, forwarding or saving them. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: From pcharney at mac.com Tue Oct 27 10:26:22 2009 From: pcharney at mac.com (Pam Charney) Date: Tue, 27 Oct 2009 10:26:22 -0700 Subject: [Cnm] Prealbumin In-Reply-To: <37BC1F8B840D1F40A11EE5F7F362E5CE0408751E21@EX07.fmchealth.org> References: <37BC1F8B840D1F40A11EE5F7F362E5CE0408751E21@EX07.fmchealth.org> Message-ID: <898FE368-AF36-435A-B760-B7D602E02DC9@mac.com> Greetings. I would say there is no range for prealbumin that will determine any level of protein depletion. Apples and oranges! Regards, pam Pam Charney pcharney at mac.com On Oct 27, 2009, at 6:11 AM, Kathleen Meyer wrote: > Our lab's new "normal" level for prealbumin is now 20... > What ranges are other facilities using to classify mild, moderate > and sever protein depletion based on prealbumin levels? > > Thanks! > Kathleen > > Kathleen Meyer, RD, LD > Assistant Manager, Dietary > Fairfield Medical Center > Lancaster, Ohio > kathleenb at fmchealth.org > > > > > People you know. Care you trust. > Visit us at http://www.fmchealth.org or our online store at http://fairfield.thehospitalstore.com > > "Confidentiality Notice: This e-mail message, including any > attachments is for the sole use of the intended recipient(s) and may > contain confidential and privileged information. Any unauthorized > review; use; disclosure or distribution is prohibited. If you are > not the intended recipient, please contact the sender by reply e- > mail and destroy all copies of the original message." > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From Annalynn_Skipper at Comcast.net Tue Oct 27 10:52:37 2009 From: Annalynn_Skipper at Comcast.net (Annalynn Skipper) Date: Tue, 27 Oct 2009 12:52:37 -0500 Subject: [Cnm] PES statement for refeeding In-Reply-To: References: Message-ID: <4FEC8D8CDF5745D6A642C1F7788C5BD5@ANNALYNN> I just presented an example of this at FNCE. When the NCP/SLC discussed this issue we recognized that refeeding syndrome is a complex situation involving the relationships between several nutrients and also the patient's recent intake. We also reviewed some of our research which showed that refeeding hypophosphatemia occurs despite an appropriately low carbohydrate intake and the popular, but thoroughly unsubstantiated "low and slow" feeding initiation trend. Thus we wanted a diagnosis that would reflect an imbalance between the amount of macro and micronutrient intake. So, the general form for the PES statement is probably something like Imbalance of nutrients related to increased mineral needs for carbohydrate metabolism as evidenced by declining serum magnesium and phosphorus levels. (You can, of course put in more detail. For example, I'd have my staff put in decline over time for the mg and phos and probably the carbohydrate increase in grams.) In my opinion, the "altered nutrition related lab values" isn't the best choice for this problem because it identifies a problem (declining serum phosphorus) that could be related to nutrition which we can fix, or something else that we cannot fix. This is just my 2 cents, but I've spent about 20 years on all angles of the refeeding topic, so I've given it quite a bit of thought. As always, I'm interested in other viewpoints. Regards, Annalynn Annalynn Skipper Ph.D., R.D., FADA a consultancy devoted to advancing nutrition practice P.O. Box 45 Oak Park, IL 60303 Annalynn_Skipper at Comcast.net Advanced Medical Nutrition Therapy Practice, a 2008 text, is available from Jones and Bartlett. _____ From: Lisa.N.Faucon at kp.org [mailto:Lisa.N.Faucon at kp.org] Sent: Tuesday, October 27, 2009 10:44 AM To: cnm at lists.my180.net Subject: [Cnm] PES statement for refeeding How would you write a PES statement for refeeding syndrome? Altered nutrition related lab values : Phos 1.7 secondary to refeeding syndrome as evidenced by increase in tube feed rate by 30mL/hr and Phos decrease from 2.8 in 24 hours ??? I'm not really sure....can someone help? Thanks! Lisa N Faucon MS, RD, CNSC Assistant Department Administrator, Nutrition Services Kaiser Permanente 4647 Zion Ave San Diego, CA, 92120 (619) 528-5515 office (619) 528-3024 fax (619) 682-0672 pager NOTICE TO RECIPIENT: If you are not the intended recipient of this e-mail, you are prohibited from sharing, copying, or otherwise using or disclosing its contents. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and permanently delete this e-mail and any attachments without reading, forwarding or saving them. Thank you. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 170 bytes Desc: not available URL: From Pam.Wilson at tenethealth.com Tue Oct 27 11:18:51 2009 From: Pam.Wilson at tenethealth.com (Wilson, Pam) Date: Tue, 27 Oct 2009 13:18:51 -0500 Subject: [Cnm] Patients in Hospital Cafeteria References: <8169B6DBE9D5194DA89219B5C5A6AFBA022F51EC@wmhcs03.wmh.org> <1E97410A99AEDB4B9DC8E1539E25C3DE016B7EC3@mcch03.mcch.local> Message-ID: <961F72A713C326438C6698F0AEB2B25504C0B40C@tenhdcthemx15.tenethealth.net> This is our policy as well, although we let them in our courtyard. Appropriate for diet reasons, plus we know the patients are sick. While we can't control who walks in from the outside, we should at least control what we can. It is only fair to other other guests. Many people are not comfortable even being in a hospital, let alone eating next to someone hooked up to an IV pole. Pam Wilson, MS, RD Northern California From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Renee Hartings Sent: Monday, October 26, 2009 11:00 To: Shannon Byrd Jackson; cnm at lists.my180.net Subject: Re: [Cnm] Patients in Hospital Cafeteria We never allow patients in the cafeteria. If they want cafeteria food, they must request it through their nurse (and must comply with their diet). Renee Hartings, RD, LD, CLC Director of Nutrition Services Mercer Health 800 W Main St Coldwater OH 45828 419-678-5106 _____ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Shannon Byrd Jackson Sent: Monday, October 26, 2009 11:35 AM To: cnm at lists.my180.net Subject: [Cnm] Patients in Hospital Cafeteria Hi, Due to the H1NI Virus, etc, are others restricting patients from entering their hospital cafeterias? If so, what kind of signage are you using to notify customers and patients? Thanks in advance, 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Pam.Wilson at tenethealth.com Tue Oct 27 11:49:01 2009 From: Pam.Wilson at tenethealth.com (Wilson, Pam) Date: Tue, 27 Oct 2009 13:49:01 -0500 Subject: [Cnm] Cardiac Diets References: Message-ID: <961F72A713C326438C6698F0AEB2B25504C0B44F@tenhdcthemx15.tenethealth.net> We use Cerner (computer system), where the Cardiac Diet has an alternate synonym of Heart Healthy. It does include a sodium restriction, although I am wondering if it should be automatic or individualized. Pam Wilson, MS, RD Northern California From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Finney, Julie Sent: Monday, October 26, 2009 10:52 To: cnm at lists.my180.net Subject: [Cnm] Cardiac Diets I am looking at making some changes in our diet dictionary. How many of you continue to have diets defined by the components (Cholesterol, Sodium and so on) or are you just using the DASH diet or TLC diets in your terminology? Does everyone on a cardiac diet have their sodium restricted (because it's good for them) or what is your practice? Thanks, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com _____ The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Terese.Scollard at providence.org Tue Oct 27 11:59:36 2009 From: Terese.Scollard at providence.org (Scollard, Terese) Date: Tue, 27 Oct 2009 11:59:36 -0700 Subject: [Cnm] Cardiac Diets In-Reply-To: <961F72A713C326438C6698F0AEB2B25504C0B44F@tenhdcthemx15.tenethealth.net> References: <961F72A713C326438C6698F0AEB2B25504C0B44F@tenhdcthemx15.tenethealth.net> Message-ID: <37ABAEB17B0B5B40AA0B6118E57CF59A053AB38F@wn1221.or.providence.org> We use the Dietary Guidelines our general diet except for allowing 3 to 4 gram sodium without the salt packet. So then separate the low sat fat, low chol from that menu. We require the sodium order separate because of people eating so poorly. Terese Scollard Portland Oregon From: Wilson, Pam [mailto:Pam.Wilson at tenethealth.com] Sent: Tuesday, October 27, 2009 11:49 AM To: Finney, Julie; cnm at lists.my180.net Subject: Re: [Cnm] Cardiac Diets We use Cerner (computer system), where the Cardiac Diet has an alternate synonym of Heart Healthy. It does include a sodium restriction, although I am wondering if it should be automatic or individualized. Pam Wilson, MS, RD Northern California From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Finney, Julie Sent: Monday, October 26, 2009 10:52 To: cnm at lists.my180.net Subject: [Cnm] Cardiac Diets I am looking at making some changes in our diet dictionary. How many of you continue to have diets defined by the components (Cholesterol, Sodium and so on) or are you just using the DASH diet or TLC diets in your terminology? Does everyone on a cardiac diet have their sodium restricted (because it's good for them) or what is your practice? Thanks, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From tadams at saint-lukes.org Tue Oct 27 14:47:18 2009 From: tadams at saint-lukes.org (Adams, Tamara) Date: Tue, 27 Oct 2009 16:47:18 -0500 Subject: [Cnm] Screening in NICU Message-ID: I apologize if this has been discussed before, but would anyone be willing to share if they have a screening tool for NICU? Thanks so much Tammy Adams, MS,RD,LD Clinical Nutrition Manager Saint Lukes Hospital 816-932-5362 (office) 816-440-2695 (pager) Saint Luke's Health System Confidentiality Notice: This message is for the designated recipient only and may contain privileged, proprietary or otherwise private information and is legally protected. If you have received it in error, please notify the sender immediately and delete the original. Any other use of the email by you is prohibited. Saint Luke's is the one heart care leader in Kansas City. To learn more, or to find a Saint Luke's location near you, call NurseLine at (816) 932-6220 or go to saintlukeshealthsystem.org. Please consider our environment before printing this e-mail. -------------- next part -------------- An HTML attachment was scrubbed... URL: From horlowsk at ppmh.org Wed Oct 28 05:24:44 2009 From: horlowsk at ppmh.org (Orlowski, Hannah) Date: Wed, 28 Oct 2009 08:24:44 -0400 Subject: [Cnm] taking RD exam In-Reply-To: Message-ID: <0DAF44B706E29940A409E32DC69005C007842D5C@exchange1.phoebe.com> Two times registered within 6 months -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Bobbi Homola Sent: Tuesday, October 27, 2009 10:34 AM To: Johnston, Jill L; cnm at lists.my180.net Subject: Re: [Cnm] taking RD exam "Employee may take registration exam three times. If after third attempt, the employee fails, they are terminated. Must be registered within one year of hire." 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 Johnston, Jill L Sent: Monday, October 26, 2009 3:02 PM To: cnm at lists.my180.net Subject: [Cnm] taking RD exam I have a question to pose to the list that I hope I can receive some quick answers on. How long do you allow a new graduate or RD eligible employee to work before passing the RD exam? My situation--I have in my RD eligible job description that I allow 3 months after hire to take and pass the RD exam.(must have provisional licensure also) I currently have an employee who has failed it twice. She was hired at the end of May and took it the first time in August. She had to wait the 45 days and reschedule and did not pass this weekend. I am inquiring if I need to rethink my time frame and any advice on this situation. My director and I have discussed it and we have some options but wanted to see what the group had to say. I appreciate any input!! Jill Johnston, MS, RD, LD Clinical Nutrition Manager/ Dietetic Internship Director West Virginia University Hospital (304) 598-4105 johnstonj at wvuh.com ----------------------------------------- Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net ----------------------------------------- Disclaimer: The HIPAA Final Privacy Rule requires covered entities to safeguard certain Protected Health Information (PHI) related to a person's healthcare. Information being faxed to you may include PHI after appropriate authorization from the patient or under circumstances that do not require patient authorization. You, the recipient, are obligated to maintain PHI in a safe and secure manner. You may not re-disclose without additional patient consent or as required by law. Unauthorized re-disclosure or failure to safeguard PHI could subject you to penalties described in federal (HIPAA) and state law. If you the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, please notify us immediately and destroy the related message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From TCRICAFO at sjhsnet.org Wed Oct 28 08:44:27 2009 From: TCRICAFO at sjhsnet.org (RICAFORT, Christina) Date: Wed, 28 Oct 2009 10:44:27 -0500 Subject: [Cnm] Cardiac Diets In-Reply-To: <37ABAEB17B0B5B40AA0B6118E57CF59A053AB38F@wn1221.or.providence.org> References: <961F72A713C326438C6698F0AEB2B25504C0B44F@tenhdcthemx15.tenethealth.net> <37ABAEB17B0B5B40AA0B6118E57CF59A053AB38F@wn1221.or.providence.org> Message-ID: <96B8F4BB7A614F43B33A6397ADCCECC27E57F8@ahcmascdc020.DS.SJHS.COM> We recently updated all our diet terminology to include DASH and TLC. We followed the guidelines set by the NIH of the US Dept. of Health & Human Services and the NHLB Institute publication No. 06-5834 January 2007 in our daily menu. We offer 1% milk, whole grain breads, beans, nuts, fresh fruits etc. across the board. Tina C. Ricafort MA., RD., CD. Manager, Clinical Dietetics Saint John's Health System 2015 Jackson St. Anderson, IN 46016 tcricafo at sjhsnet.org (765)646-8197 (765)646-8780 fax ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Scollard, Terese Sent: Tuesday, October 27, 2009 3:00 PM To: Wilson, Pam; Finney, Julie; cnm at lists.my180.net Subject: Re: [Cnm] Cardiac Diets We use the Dietary Guidelines our general diet except for allowing 3 to 4 gram sodium without the salt packet. So then separate the low sat fat, low chol from that menu. We require the sodium order separate because of people eating so poorly. Terese Scollard Portland Oregon From: Wilson, Pam [mailto:Pam.Wilson at tenethealth.com] Sent: Tuesday, October 27, 2009 11:49 AM To: Finney, Julie; cnm at lists.my180.net Subject: Re: [Cnm] Cardiac Diets We use Cerner (computer system), where the Cardiac Diet has an alternate synonym of Heart Healthy. It does include a sodium restriction, although I am wondering if it should be automatic or individualized. Pam Wilson, MS, RD Northern California From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Finney, Julie Sent: Monday, October 26, 2009 10:52 To: cnm at lists.my180.net Subject: [Cnm] Cardiac Diets I am looking at making some changes in our diet dictionary. How many of you continue to have diets defined by the components (Cholesterol, Sodium and so on) or are you just using the DASH diet or TLC diets in your terminology? Does everyone on a cardiac diet have their sodium restricted (because it's good for them) or what is your practice? Thanks, Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. ________________________________ This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege. -------------- next part -------------- An HTML attachment was scrubbed... URL: From RachelFlores at sach.org Wed Oct 28 09:16:45 2009 From: RachelFlores at sach.org (Flores, Rachel) Date: Wed, 28 Oct 2009 09:16:45 -0700 Subject: [Cnm] taking RD exam Message-ID: Must pass the exam by the end of probation, which is 3 months, and can be extended for an additional 3 months. We have never had an employee not pass on the first attempt. Rachel Flores, RD, CNSC Clinical Nutrition Manager San Antonio Community Hospital (909) 985-2811 x24430 _____ From: Orlowski, Hannah [mailto:horlowsk at ppmh.org] Sent: Wednesday, October 28, 2009 5:25 AM To: Bobbi Homola; Johnston, Jill L; cnm at lists.my180.net Subject: Re: [Cnm] taking RD exam Two times registered within 6 months -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Bobbi Homola Sent: Tuesday, October 27, 2009 10:34 AM To: Johnston, Jill L; cnm at lists.my180.net Subject: Re: [Cnm] taking RD exam "Employee may take registration exam three times. If after third attempt, the employee fails, they are terminated. Must be registered within one year of hire." 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 Johnston, Jill L Sent: Monday, October 26, 2009 3:02 PM To: cnm at lists.my180.net Subject: [Cnm] taking RD exam I have a question to pose to the list that I hope I can receive some quick answers on. How long do you allow a new graduate or RD eligible employee to work before passing the RD exam? My situation--I have in my RD eligible job description that I allow 3 months after hire to take and pass the RD exam.(must have provisional licensure also) I currently have an employee who has failed it twice. She was hired at the end of May and took it the first time in August. She had to wait the 45 days and reschedule and did not pass this weekend. I am inquiring if I need to rethink my time frame and any advice on this situation. My director and I have discussed it and we have some options but wanted to see what the group had to say. I appreciate any input!! Jill Johnston, MS, RD, LD Clinical Nutrition Manager/ Dietetic Internship Director West Virginia University Hospital (304) 598-4105 johnstonj at wvuh.com ----------------------------------------- Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net _____ Disclaimer: The HIPAA Final Privacy Rule requires covered entities to safeguard certain Protected Health Information (PHI) related to a person's healthcare. Information being faxed to you may include PHI after appropriate authorization from the patient or under circumstances that do not require patient authorization. You, the recipient, are obligated to maintain PHI in a safe and secure manner. You may not re-disclose without additional patient consent or as required by law. Unauthorized re-disclosure or failure to safeguard PHI could subject you to penalties described in federal (HIPAA) and state law. If you the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, please notify us immediately and destroy the related message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Sue.Teske at chsys.org Wed Oct 28 11:04:19 2009 From: Sue.Teske at chsys.org (Sue Teske) Date: Wed, 28 Oct 2009 13:04:19 -0500 Subject: [Cnm] Immediate Opening for Full-time Clinical Nutritionist Message-ID: <3D0B6F497247834CAC5FF0C30ED7A5C403966D07@chexmain.chsys.org> Children's Health System in Birmingham, Alabama has an immediate opening for a full-time Clinical Nutritionist. Children's is looking for energetic, innovative, committed, compassionate professionals to fill this immediate opening. The focus of this position is with our cystic fibrosis patient population (inpatient and outpatient care). Voted one of Birmingham's Best of the Best companies for working families, Children's Health System is an ideal place to work! Ideal candidates for clinical nutritionist positions should have a master's degree in nutrition and 12 months clinical work experience, OR a B.S. degree in nutrition plus 2 years clinical work experience with certification in an area of specialization (for example: CSP, CNSD, IBCLC, CSR). Pediatric experience is preferred, but not required. Registration through the CDR and licensure in the state of Alabama is required. Completion of a pediatric nutrition traineeship preferred, but not required. Consideration also may be given to candidates in progress of completing a master's degree or certification. Responsibilities include provision of medical nutrition therapy by assessing, planning, implementing, and monitoring nutritional care appropriate for age and disease state of pediatric patients, and educating patients/families on all aspects of nutrition in disease state management, nutrition support, and preventative nutrition interventions. Use of nutrition support skills is emphasized in nutritionist positions. Our positions offer many opportunities for professional development through the development and evaluation of quality improvement and outcomes-based research projects needed for patient care, and through the education and mentoring of medical staff and hospital staff on pediatric nutrition support and nutritional care in pediatrics. Paid continuing education time, ADA membership dues and state licensure fees are included benefits for benefit-eligible registered staff as available. Qualified candidates can apply on-line at www.chsys.org . Children's Health System is an Equal Opportunity Employer Please contact me directly to answer any questions about our opportunities. Susan C. Teske, MS, RD, LD, CNSD Director, Dept. of Clinical Nutrition and Lactation Services Children's Health System 1600 7th Ave. South 3rd Floor hospital, Room 334 Birmingham, AL 35233 (205) 939-9203 Office (205) 939-6047 Fax susan.teske at chsys.org Confidentiality Notice: The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. The information transmitted is intended only for the person or company to which it is addressed and may contain confidential or privileged material. Any review, retransmission dissemination or other use of, or taking of any action in reliance upon, this information by person or company other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. 20090416 -------------- next part -------------- An HTML attachment was scrubbed... URL: From Karen.A.Rooney at HealthPartners.Com Wed Oct 28 11:50:14 2009 From: Karen.A.Rooney at HealthPartners.Com (Rooney, Karen A) Date: Wed, 28 Oct 2009 13:50:14 -0500 Subject: [Cnm] OB brochure on infant feeding in Spanish Message-ID: <8B87A5872A8B1540A0F3875658276162B46B42051D@HPEMX1.HealthPartners.int> We are looking for a handout/brochure about feeding infants from birth to the first year to give to new Moms in Spanish. We are espeically interested in one that emphasizes breast feeding and then recommendations for adding solid food later on. Does anyone have one to share or know of a website where one could be obtained? Thanks in advance--you can email me directly. Karen A Rooney MPH, RD, CNSD Clinical Nutrition Supervisor Food and Nutrition Services 11102B Regions Hospital 640 Jackson Street St Paul, MN 55101 phone: 651-254-3368 pager 651-629-0100 email: Karen.A.Rooney at HealthPartners.com www.takemetoregions.com ________________________________ This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient or the individual responsible for delivering the e-mail to the intended recipient, please be advised that you have received this e-mail in error and that any use, dissemination, forwarding, printing, or copying of this e-mail is strictly prohibited. If you have received this e-mail in error, please immediately notify the HealthPartners Support Center by telephone at (952) 967-6600. You will be reimbursed for reasonable costs incurred in notifying us. HealthPartners R001.0 -------------- next part -------------- An HTML attachment was scrubbed... URL: From michellehoppman at yahoo.com Wed Oct 28 11:59:41 2009 From: michellehoppman at yahoo.com (michelle hoppman) Date: Wed, 28 Oct 2009 11:59:41 -0700 (PDT) Subject: [Cnm] ADA Recognized Diabetes Education Programs In-Reply-To: <3D0B6F497247834CAC5FF0C30ED7A5C403966D07@chexmain.chsys.org> References: <3D0B6F497247834CAC5FF0C30ED7A5C403966D07@chexmain.chsys.org> Message-ID: <688449.54194.qm@web54001.mail.re2.yahoo.com> Good Afternoon, Does anyone know of ADA Recognized Diabetes Education Programs?in the hospital setting which fall under Nutrition Services or Clinical Nutrition. If so, please reply. Also,?if your program falls under another department please note that as well. Thank you. Michelle ? ? ? ? Michelle Hoppman, LRD, CDE Clinical Nutrition Manager Trinity Hospitals 1 Burdick Expy. Minot, ND 58701 (701) 857-2809 michelle.hoppman at trinityhealth.org ? ? "Risk more than others think is safe, care more than others think is wise, dream more than others think is practical, and expect more than others think is possible." -Cadet maxim -------------- next part -------------- An HTML attachment was scrubbed... URL: From CKeinath at chs-mi.com Wed Oct 28 12:35:22 2009 From: CKeinath at chs-mi.com (CKeinath at chs-mi.com) Date: 28-Oct-2009 15:35:22 EDT Subject: [Cnm] diabetes educ in physician offices An HTML attachment was scrubbed... URL: From cwatters at ualberta.ca Wed Oct 28 12:44:33 2009 From: cwatters at ualberta.ca (cwatters at ualberta.ca) Date: Wed, 28 Oct 2009 13:44:33 -0600 Subject: [Cnm] Native American Dietitians - career promotion In-Reply-To: <6EAE916704479E4BB6AB5A133BA224F72886F1F8B2@SJMEMXMBS11.stjude.sjcrh.local> References: <6EAE916704479E4BB6AB5A133BA224F72886F1F8B2@SJMEMXMBS11.stjude.sjcrh.local> Message-ID: <20091028134433.10733b4e591up3cw@webmail.ualberta.ca> Hi everyone, I have been invited to present at a career night to a group of Native Hawaiians students and parents about becoming a dietitian. I was wondering if there were any resources for Native Americans about dietetics as a career. In Canada, there is a great resource to promote Aboriginal Dietitians and encourage more First Nations and Aboriginal peoples to explore nutrition as a career, and I was looking for similar resources in the US. http://s237636284.onlinehome.us/nutritioncareerinfo/index.php?option=com_content&task=view&id=17&Itemid=34[1] Welcome any suggestions, Thanks, Dr. Corilee Watters, MSc, RD, PhD Asst. Professor Nutrition, University of Hawaii Department of Human Nutrition, Food and Animal Science 1955 East-West Road, Agricultural Science 314 J Honolulu, HI 96822 ph: 808-956-7581 fax: 808-956-4024 e-mail: cwatters at hawaii.edu -------------- next part -------------- An HTML attachment was scrubbed... URL: From fns at abbgen.net Wed Oct 28 12:53:06 2009 From: fns at abbgen.net (Annette Doucet) Date: Wed, 28 Oct 2009 13:53:06 -0600 Subject: [Cnm] ADA Recognized Diabetes Education Programs In-Reply-To: <688449.54194.qm@web54001.mail.re2.yahoo.com> Message-ID: Ours falls under the Education Department and one of our RN's is the coordinator for the program. We work very closely with her and do the Nutrition Education part of DSMT and normally the MD also orders MNT as well as DSMT, so we do both. It could have been coordinated by an RD or an RN. _____ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of michelle hoppman Sent: Wednesday, October 28, 2009 1:00 PM To: Clinical List Subject: [Cnm] ADA Recognized Diabetes Education Programs Good Afternoon, Does anyone know of ADA Recognized Diabetes Education Programs in the hospital setting which fall under Nutrition Services or Clinical Nutrition. If so, please reply. Also, if your program falls under another department please note that as well. Thank you. Michelle Michelle Hoppman, LRD, CDE Clinical Nutrition Manager Trinity Hospitals 1 Burdick Expy. Minot, ND 58701 (701) 857-2809 michelle.hoppman at trinityhealth.org "Risk more than others think is safe, care more than others think is wise, dream more than others think is practical, and expect more than others think is possible." -Cadet maxim -------------- next part -------------- An HTML attachment was scrubbed... URL: From sheila.walsh at nahealth.com Wed Oct 28 13:23:19 2009 From: sheila.walsh at nahealth.com (Sheila Walsh) Date: Wed, 28 Oct 2009 13:23:19 -0700 Subject: [Cnm] OB brochure on infant feeding in Spanish In-Reply-To: <8B87A5872A8B1540A0F3875658276162B46B42051D@HPEMX1.HealthPartners.int> References: <8B87A5872A8B1540A0F3875658276162B46B42051D@HPEMX1.HealthPartners.int> Message-ID: <4AE845C6.485B.0001.0@nahealth.com> Call your local WIC Program. >>> "Rooney, Karen A" 10/28/2009 11:50 AM >>> We are looking for a handout/brochure about feeding infants from birth to the first year to give to new Moms in Spanish. We are espeically interested in one that emphasizes breast feeding and then recommendations for adding solid food later on. Does anyone have one to share or know of a website where one could be obtained? Thanks in advance--you can email me directly. Karen A Rooney MPH, RD, CNSD Clinical Nutrition Supervisor Food and Nutrition Services 11102B Regions Hospital 640 Jackson Street St Paul, MN 55101 phone: 651-254-3368 pager 651-629-0100 email: Karen.A.Rooney at HealthPartners.com www.takemetoregions.com This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient or the individual responsible for delivering the e-mail to the intended recipient, please be advised that you have received this e-mail in error and that any use, dissemination, forwarding, printing, or copying of this e-mail is strictly prohibited. If you have received this e-mail in error, please immediately notify the HealthPartners Support Center by telephone at (952) 967-6600. You will be reimbursed for reasonable costs incurred in notifying us. HealthPartners R001.0 -------------- next part -------------- An HTML attachment was scrubbed... URL: From lynne.kurz at aurora.org Wed Oct 28 14:04:34 2009 From: lynne.kurz at aurora.org (lynne.kurz at aurora.org) Date: Wed, 28 Oct 2009 16:04:34 -0500 Subject: [Cnm] Computerized Physician Order Entry Message-ID: For those of you that are at facilities using computerized physician order entry (CPOE), can you share with me how you have incorporated nutrition orders into this process and how you are handling ordering of oral supplements? Lynne Kurz, MSRDCD Regional Manager, Nutrition Services Aurora St Luke's Medical Center Office: 414-649-6769 Pager: 414-222-6209 Text Message: 414-222-6209 at archwireless.net Fax: 414-649-5091 -------------- next part -------------- An HTML attachment was scrubbed... URL: From pavlinac at ohsu.edu Wed Oct 28 15:24:57 2009 From: pavlinac at ohsu.edu (Jessie Pavlinac) Date: Wed, 28 Oct 2009 15:24:57 -0700 Subject: [Cnm] taking RD exam In-Reply-To: References: Message-ID: <1EF80A84A8477C459680889665C8D98F01B23F2F32@EX-MB04.ohsu.edu> Our policy is that they must pass by the end of their 6 month probation. No extensions., Jessie Pavlinac OHSU, Portland, OR From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Flores, Rachel Sent: Wednesday, October 28, 2009 9:17 AM To: 'Orlowski, Hannah'; Bobbi Homola; Johnston, Jill L; cnm at lists.my180.net Subject: Re: [Cnm] taking RD exam Must pass the exam by the end of probation, which is 3 months, and can be extended for an additional 3 months. We have never had an employee not pass on the first attempt. Rachel Flores, RD, CNSC Clinical Nutrition Manager San Antonio Community Hospital (909) 985-2811 x24430 ________________________________ From: Orlowski, Hannah [mailto:horlowsk at ppmh.org] Sent: Wednesday, October 28, 2009 5:25 AM To: Bobbi Homola; Johnston, Jill L; cnm at lists.my180.net Subject: Re: [Cnm] taking RD exam Two times registered within 6 months -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net]On Behalf Of Bobbi Homola Sent: Tuesday, October 27, 2009 10:34 AM To: Johnston, Jill L; cnm at lists.my180.net Subject: Re: [Cnm] taking RD exam "Employee may take registration exam three times. If after third attempt, the employee fails, they are terminated. Must be registered within one year of hire." 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 Johnston, Jill L Sent: Monday, October 26, 2009 3:02 PM To: cnm at lists.my180.net Subject: [Cnm] taking RD exam I have a question to pose to the list that I hope I can receive some quick answers on. How long do you allow a new graduate or RD eligible employee to work before passing the RD exam? My situation--I have in my RD eligible job description that I allow 3 months after hire to take and pass the RD exam.(must have provisional licensure also) I currently have an employee who has failed it twice. She was hired at the end of May and took it the first time in August. She had to wait the 45 days and reschedule and did not pass this weekend. I am inquiring if I need to rethink my time frame and any advice on this situation. My director and I have discussed it and we have some options but wanted to see what the group had to say. I appreciate any input!! Jill Johnston, MS, RD, LD Clinical Nutrition Manager/ Dietetic Internship Director West Virginia University Hospital (304) 598-4105 johnstonj at wvuh.com ----------------------------------------- Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net ________________________________ Disclaimer: The HIPAA Final Privacy Rule requires covered entities to safeguard certain Protected Health Information (PHI) related to a person's healthcare. Information being faxed to you may include PHI after appropriate authorization from the patient or under circumstances that do not require patient authorization. You, the recipient, are obligated to maintain PHI in a safe and secure manner. You may not re-disclose without additional patient consent or as required by law. Unauthorized re-disclosure or failure to safeguard PHI could subject you to penalties described in federal (HIPAA) and state law. If you the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, please notify us immediately and destroy the related message. -------------- next part -------------- An HTML attachment was scrubbed... URL: From jlworden at att.net Wed Oct 28 19:34:22 2009 From: jlworden at att.net (Jo Lynn Worden) Date: Wed, 28 Oct 2009 21:34:22 -0500 Subject: [Cnm] Computerized Physician Order Entry In-Reply-To: References: Message-ID: <005701ca5840$5302bcc0$f9083640$@net> Please post to list j From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of lynne.kurz at aurora.org Sent: Wednesday, October 28, 2009 4:05 PM To: Clinical Nutrition Management Practice Group Subject: [Cnm] Computerized Physician Order Entry For those of you that are at facilities using computerized physician order entry (CPOE), can you share with me how you have incorporated nutrition orders into this process and how you are handling ordering of oral supplements? Lynne Kurz, MSRDCD Regional Manager, Nutrition Services Aurora St Luke's Medical Center Office: 414-649-6769 Pager: 414-222-6209 Text Message: 414-222-6209 at archwireless.net Fax: 414-649-5091 -------------- next part -------------- An HTML attachment was scrubbed... URL: From cahns at carthageareahospital.com Thu Oct 29 07:27:05 2009 From: cahns at carthageareahospital.com (Dawn Berry, RD) Date: Thu, 29 Oct 2009 10:27:05 -0400 Subject: [Cnm] Gallbladder in Korean Message-ID: <47A5BBB6AF4D471B85D3E1F95A2273EC@CAHNS1> Does anyone have post cholecystectomy diet in Korean they would be willing to send me? Dawn Berry, RD CDN Director of Clinical Nutrition Carthage Area Hospital 1001 West Street Carthage, NY 13619 315-493-1005 ext 3222 cahns at carthageareahospital.com -------------- next part -------------- An HTML attachment was scrubbed... URL: From fynan-carla at CooperHealth.edu Thu Oct 29 07:27:49 2009 From: fynan-carla at CooperHealth.edu (Fynan, Carla) Date: Thu, 29 Oct 2009 10:27:49 -0400 Subject: [Cnm] closed system - MD's ordering ensure Message-ID: <77F33794DD223B40BF24AB3D379302501997F0AB4D@mxmbx01.chsmail.root.cooperhealth.edu> Good Morning, We have a closed system here at our Trauma Hospital with a loose nursing policy saying we use a closed system. We have occasion to use ensure; patient tolerates at home or patient going home on it because of cost. Does anyone have a policy already written on this subject? Thanks in advance! Carla Fynan, RD Clinical Nutrition Manager Food & Nutrition Department Cooper University Hospital One Cooper Paza Camden, NJ 08103 (856) 342-2320 **************************************************************** This email, including attachments, may include confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed. If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email is prohibited. If you received this email in error, please notify the sender by replying to this message and delete this email immediately. -------------- next part -------------- An HTML attachment was scrubbed... URL: From DEmmons at egh.org Thu Oct 29 08:48:04 2009 From: DEmmons at egh.org (Emmons, Deanna S.) Date: Thu, 29 Oct 2009 11:48:04 -0400 Subject: [Cnm] Liposyn II shortage Message-ID: <1C64A214F5A86B4D8CE02F287CC2AD63017477F0@eghs-exch3.egh.org> I was wondering what those of you are doing for lipid intake who use Liposyn II in your PN formulas with the shortage that is coming? Abbott has stopped making Liposyn II, we just found out this morning. We will not be receiving Liposyn III for approximately 1 more month from Abbott. We are unable to get the Intralipid from Baxter anytime soon since we don't normally order from them. I'm concerned about EFA deficiency- mainly for our home care patients. Thank you for your help! Deanna Emmons, RD, CD Clinical Nutrition Manager Elkhart General Hospital 574-523-3296 -------------- next part -------------- An HTML attachment was scrubbed... URL: From kaalp at saintfrancis.com Thu Oct 29 12:56:45 2009 From: kaalp at saintfrancis.com (Alp, Kimberly A) Date: Thu, 29 Oct 2009 14:56:45 -0500 Subject: [Cnm] student "shadows" In-Reply-To: Message-ID: We do not allow high school students. Our education dept says it there is not enough "return on investment" of professional time for anyone not yet in college. We do take college students. They are required to watch a HIPPA video and sign confidentiality statement. Kim Alp, MBA, RD, LD Clinical Nutrition Manager Nutrition and Food Services Saint Francis Hospital Tulsa, OK 918-494-4154 kaalp at saintfrancis.com -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Finney, Julie Sent: Wednesday, October 21, 2009 2:20 PM To: Potter, MARY; cnm at lists.my180.net Subject: Re: [Cnm] student "shadows" We have different requirements depending on the length of the placement. At the moment we are not permitting any shadows under the age of 18-years. This will be effect until March. Our volunteer office handles the scheduling of student shadows. For the one-day experience they don't have to do the immunizations and safety training, but for our longer placements that training is required. There is a permission slip that the manager signs stating the experience that the student will have and then there is a statement that advises the student that they must respect confidentiality for the one-day shadow. Sometimes requirements are made steep so that the demand isn't very high to provide the service. Julie Julie Finney, MS, RD, LD Clinical Nutrition Manager Mercy Medical Center 1320 Mercy Drive, NW Canton, Ohio 44708 330-489-1000 ext. 1600 Julie.Finney at csauh.com ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Potter, MARY Sent: Wednesday, October 21, 2009 3:10 PM To: cnm at lists.my180.net Subject: [Cnm] student "shadows" For those of you that have students (either high schoolers who are exploring career options, or college kids majoring in dietetics), what are the requirements that student has to meet in order to "shadow" the dietitians? Our HR department has very stringent guidelines regarding not only immunizations, and awareness of HIPAA, but, requires students to be knowledgeable about the hospital's mission, core values, etc. I can understand having that for students that may be here for longer than a couple of days, just to see what a dietitian does (like for nursing students, or pharmacy students, etc). Just was curious how other hospitals are handling their student "shadows". Thanks! 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** Legal Notice: This electronic message transmission and any attachments contain information from Fauquier Health System which may be confidential or privileged. This e-mail is intended only for the addressee. If you are not the intended recipient, be aware that any disclosure, copying, forwarding, distribution, or use of the contents of this transmission is prohibited. If you have received this electronic transmission in error, please notify the sender immediately and delete the original message from your system. Fauquier Health System makes no warranty that this e-mail is error or virus free. Thank you. ________________________________ The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. CSAHS/UHHS-Canton, Inc and its affiliates disclaim any responsibility for unauthorized disclosure of this information other than the addressee. Federal and Ohio law protect patient medical information disclosed in this email, including psychiatric disorders, (HIV) test results, AIDs-related conditions, alcohol, and/or drug dependence or abuse. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. -------------- next part -------------- An HTML attachment was scrubbed... URL: From TTaylor at dmc-sp.org Thu Oct 29 15:14:26 2009 From: TTaylor at dmc-sp.org (Taylor, Tracy) Date: Thu, 29 Oct 2009 15:14:26 -0700 Subject: [Cnm] metabolic cart Message-ID: <222E81132BE3E54584CB9A5DB1CDD7E280DEDF@bks-emx001.dmc-sp.org> Is anyone using a metabolic cart to assess energy needs? If so, what do you use? Does the RD or RT perform the test? Any other info you can share would be appreciated! tia Tracy Tracy Taylor RD, CDE Director: Diabetes Management/Outpatient Nutrition Programs Clinical Nutrition Manager Doctors Medical Center San Pablo 2000 Vale Rd San Pablo, CA 94806 phone: 510-970-5344 fax: 510-970-5739 email: ttaylor at dmc-sp.org CONFIDENTIAL AND PRIVILEGED: May contain materials protected by law. This communication contains information intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged and/or confidential. If you are not the intended recipient or an employee or agent responsible for delivering the communication to the intended recipient, you are hereby notified that any disclosure, copying, distribution, or use of its contents is prohibited. If you have received this communication in error, please notify me immediately by telephone at (510) 970-5344, return the original communication by reply e-mail, and permanently delete the communication from your system. Thank you. "A year from now you will wish you had started today." --Karen Lamb -------------- next part -------------- An HTML attachment was scrubbed... URL: From SBeil at eatright.org Thu Oct 29 15:19:29 2009 From: SBeil at eatright.org (Sandra Beil) Date: Thu, 29 Oct 2009 17:19:29 -0500 Subject: [Cnm] NCM References: Message-ID: Hello Everyone, When we upgraded the site, some people who had bookmarked pages on the NCM site need to reset their bookmarks and custom links. If you're unsure of what your custom link is, please contact me, or log in as an administrator and see the bottom of the IP section in the administration page. If you have any other questions, please contact me directly. sbeil at eatright.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 Direct: 312-899-4795 Fax: 312-899-5339 Toll Free: 800-877-1600 x4795 www.eatright.org www.nutritioncaremanual.org From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Tyus, Frances Sent: Tuesday, October 20, 2009 5:32 PM To: Smith Michael - Palestine; cnm at lists.my180.net Subject: Re: [Cnm] NCM I am not ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Smith Michael - Palestine Sent: Tuesday, October 20, 2009 12:00 PM To: cnm at lists.my180.net Subject: [Cnm] NCM Is anyone else unable to get the online nutrition care manual to launch since the recent update? Michael Smith RD LD Palestine Regional Medical Center Palestine, Texas =================================== P Please consider the environment before printing this e-mail Cleveland Clinic is ranked one of the top hospitals in America by U.S. News & World Report (2008). Visit us online at http://www.clevelandclinic.org for a complete listing of our services, staff and locations. Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: From DrNCollins at aol.com Thu Oct 29 18:44:42 2009 From: DrNCollins at aol.com (DrNCollins at aol.com) Date: Thu, 29 Oct 2009 21:44:42 EDT Subject: [Cnm] New Resources for Your Use Message-ID: Hi everyone, I just added 65 new downloadable, customizable, free, peer reviewed resources to RD411.com. There are also new free CE programs on lean body mass and another on nutrigenomics. Click here to read all about it and see a list of what's new :) _http://www.rd411.com/newsletter/rd411_email_4_10.htm_ (http://www.rd411.com/newsletter/rd411_email_4_10.htm) Have a good day, NANCY 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) -------------- next part -------------- An HTML attachment was scrubbed... URL: From LAltenburger5 at matherhospital.org Fri Oct 30 04:30:22 2009 From: LAltenburger5 at matherhospital.org (Altenburger, Linda) Date: Fri, 30 Oct 2009 07:30:22 -0400 Subject: [Cnm] metabolic cart In-Reply-To: <222E81132BE3E54584CB9A5DB1CDD7E280DEDF@bks-emx001.dmc-sp.org> Message-ID: Please post to list 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: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Taylor, Tracy Sent: Thursday, October 29, 2009 6:14 PM To: cnm at lists.my180.net Subject: [Cnm] metabolic cart Is anyone using a metabolic cart to assess energy needs? If so, what do you use? Does the RD or RT perform the test? Any other info you can share would be appreciated! tia Tracy Tracy Taylor RD, CDE Director: Diabetes Management/Outpatient Nutrition Programs Clinical Nutrition Manager Doctors Medical Center San Pablo 2000 Vale Rd San Pablo, CA 94806 phone: 510-970-5344 fax: 510-970-5739 email: ttaylor at dmc-sp.org CONFIDENTIAL AND PRIVILEGED: May contain materials protected by law. This communication contains information intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged and/or confidential. If you are not the intended recipient or an employee or agent responsible for delivering the communication to the intended recipient, you are hereby notified that any disclosure, copying, distribution, or use of its contents is prohibited. If you have received this communication in error, please notify me immediately by telephone at (510) 970-5344, return the original communication by reply e-mail, and permanently delete the communication from your system. Thank you. "A year from now you will wish you had started today." --Karen Lamb -------------- next part -------------- An HTML attachment was scrubbed... URL: From Heberle-Heather at aramark.com Fri Oct 30 06:03:44 2009 From: Heberle-Heather at aramark.com (Heberle, Heather N.) Date: Fri, 30 Oct 2009 09:03:44 -0400 Subject: [Cnm] plate portions Message-ID: Does anyone have a good visible color image of proper plate portions I could use on a company board? Thanks. Heather Heberle, RD, LD Clinical Nutrition Manager Capital Region Medical Center 1125 Madison St Jefferson City, MO 65109 573-632-5192 From kaalp at saintfrancis.com Fri Oct 30 06:31:13 2009 From: kaalp at saintfrancis.com (Alp, Kimberly A) Date: Fri, 30 Oct 2009 08:31:13 -0500 Subject: [Cnm] MNT services In-Reply-To: Message-ID: If you find out definitively, let me know. I've been struggling with this for quite some time. Kim Alp, MBA, RD, LD Clinical Nutrition Manager Nutrition and Food Services Saint Francis Hospital Tulsa, OK 918-494-4154 kaalp at saintfrancis.com -----Original Message----- From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Baar, Rachel Sent: Monday, October 26, 2009 4:21 PM To: cnm at lists.my180.net Cc: Eilertson, Paula A Subject: [Cnm] MNT services Does anyone have analytical evidence (as opposed to anectodal evidence) that patients are better served from an out-of-pocket cost standpoint when MNT services are provided and billed from a clinic based program vs from a hospital-based outpatient program? Our Finance person has stated it is better for patients cost-wise to recieve MNT from a clinic, but several RDs counter that by stating that there are just as many insurance plans that will pay hospital-based charges as there are that will reimburse clinic charges. Who really knows the answer to this one? 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: From andrea.johnson at bassett.org Fri Oct 30 06:45:24 2009 From: andrea.johnson at bassett.org (Johnson, Andrea) Date: Fri, 30 Oct 2009 09:45:24 -0400 Subject: [Cnm] diet technicians In-Reply-To: Message-ID: <9B90EC6A1B880E4A9D9A859E062A04751E833385@ex2.bassett.org> I know this has been discussed before but I am looking for more up to date responses. My question is do you employ diet technicians and in what capacity do you utilize them. Clinical? Administrative? Diet office?, etc Also please state your bed size and how many registered dietitians as well? Do any of your diet technicians practice independently of the RD? Thanks in advance for this information. Andrea Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: Johnson, Andrea.vcf Type: text/x-vcard Size: 145 bytes Desc: Johnson, Andrea.vcf URL: From Julee.Davis at msj.org Fri Oct 30 07:24:44 2009 From: Julee.Davis at msj.org (Julee Davis) Date: Fri, 30 Oct 2009 10:24:44 -0400 Subject: [Cnm] diet technicians In-Reply-To: <9B90EC6A1B880E4A9D9A859E062A04751E833385@ex2.bassett.org> References: <9B90EC6A1B880E4A9D9A859E062A04751E833385@ex2.bassett.org> Message-ID: <92EC335605D0C54A8C4112C06AF0CECB01C299B8@EMAIL2C.MSJ.ORG> Our team has 2 full time diet techs that have worked here for several years; we also have 7 FT RDs. Right now, the techs are assessing and following low risk inpatients; the RDs validate all charting. However, once we have finished implementing the NCP, I plan to have them exclusively screen all inpatients, do low risk education per RD instruction, calorie counts, and possibly interventions per the direction of the RD. Actually, I am not entirely sure how I am going to utilize my diet techs fully. We are approx 800 beds. If you haven't already, check what your state statutes say about the role of the diet tech. North Carolina's only state that they need to be supervised by a licensed dietitian. Julee Julee Davis, RD, LDN Clinical Nutrition Manager Mission Hospitals Asheville, NC 28801 Office 828-213-0251 Fax 828-213-3535 Pager 828-207-7440 julee.davis at msj.org From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea Sent: Friday, October 30, 2009 9:45 AM To: cnm at lists.my180.net Subject: [Cnm] diet technicians I know this has been discussed before but I am looking for more up to date responses. My question is do you employ diet technicians and in what capacity do you utilize them. Clinical? Administrative? Diet office?, etc Also please state your bed size and how many registered dietitians as well? Do any of your diet technicians practice independently of the RD? Thanks in advance for this information. Andrea Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 NOTICE OF CONFIDENTIALITY This electronic message, including attachments, is for the sole use of the named recipient and may contain confidential or privileged information protected by New York State, and Federal regulations. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. If you are not the intended recipient or have received this communication in error please contact the sender or email.security at bassett.org and destroy all copies of the original message. Thank you. ---------------------------------------------------------------------------------------------------- This message and its attachments may contain confidential and/or legally-sensitive information that is intended for the sole use of the addressee(s). Any unauthorized review, use, disclosure, or distribution of the information contained in this message and its attachments is prohibited. If you have received this message or any of its attachments in error, please destroy all originals and copies of the same and notify the sender immediately. -------------- next part -------------- An HTML attachment was scrubbed... URL: From Linda.Woods at healthall.com Fri Oct 30 07:50:33 2009 From: Linda.Woods at healthall.com (Woods, Linda) Date: Fri, 30 Oct 2009 10:50:33 -0400 Subject: [Cnm] diet technicians In-Reply-To: <9B90EC6A1B880E4A9D9A859E062A04751E833385@ex2.bassett.org> References: <9B90EC6A1B880E4A9D9A859E062A04751E833385@ex2.bassett.org> Message-ID: <2B1106A6A593B147A65BD5A8939D3E1101065B341288@MAIL-C.healthall.com> We are a 450 bed teaching hospital, Level 1 Trauma Center. RDs (7 FTEs) follow all patients in critical care units and high risk patients on med/surg and OB units. We have 4.0 FTE Diet Technicians that follow moderate/low risk patients in med/surg and OB. They collaborate and discuss cases with the RDs and the RDs oversee their work. We have not yet implemented NCP but plan to do so over the next 9-12 months. I'm sure that the role of the diet tech will change at that time. Linda Woods, RD, LD Clinical Nutrition Coordinator Food and Nutrition Services UC Health - University Hospital 234 Goodman Street Cincinnati, OH 45219-2316 Office: 513-584-4534 Pager: 513-577-0948 linda.woods at healthall.com www.uchealthnow.com [cid:image001.jpg at 01CA594E.CC79B590] [cid:image002.png at 01CA594E.CC79B590] From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea Sent: Friday, October 30, 2009 9:45 AM To: cnm at lists.my180.net Subject: [Cnm] diet technicians I know this has been discussed before but I am looking for more up to date responses. My question is do you employ diet technicians and in what capacity do you utilize them. Clinical? Administrative? Diet office?, etc Also please state your bed size and how many registered dietitians as well? Do any of your diet technicians practice independently of the RD? Thanks in advance for this information. Andrea Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 NOTICE OF CONFIDENTIALITY This electronic message, including attachments, is for the sole use of the named recipient and may contain confidential or privileged information protected by New York State, and Federal regulations. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. If you are not the intended recipient or have received this communication in error please contact the sender or email.security at bassett.org and destroy all copies of the original message. Thank you. ________________________________ Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 4000 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.png Type: image/png Size: 7843 bytes Desc: image002.png URL: From tadams at saint-lukes.org Fri Oct 30 09:32:47 2009 From: tadams at saint-lukes.org (Adams, Tamara) Date: Fri, 30 Oct 2009 11:32:47 -0500 Subject: [Cnm] diet technicians In-Reply-To: <2B1106A6A593B147A65BD5A8939D3E1101065B341288@MAIL-C.healthall.com> References: <9B90EC6A1B880E4A9D9A859E062A04751E833385@ex2.bassett.org> <2B1106A6A593B147A65BD5A8939D3E1101065B341288@MAIL-C.healthall.com> Message-ID: We are very similiar but do not have the techs do mod to low risk patients we use the techs to do the nutrition screening within 24 hours, just changed b/c we are moving to NCP as well. Thanks Tammy Adams, MS,RD,LD Clinical Nutrition Manager Saint Lukes Hospital 816-932-5362 (office) 816-440-2695 (pager) ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Woods, Linda Sent: Friday, October 30, 2009 9:51 AM To: 'Johnson, Andrea'; cnm at lists.my180.net Subject: Re: [Cnm] diet technicians We are a 450 bed teaching hospital, Level 1 Trauma Center. RDs (7 FTEs) follow all patients in critical care units and high risk patients on med/surg and OB units. We have 4.0 FTE Diet Technicians that follow moderate/low risk patients in med/surg and OB. They collaborate and discuss cases with the RDs and the RDs oversee their work. We have not yet implemented NCP but plan to do so over the next 9-12 months. I'm sure that the role of the diet tech will change at that time. Linda Woods, RD, LD Clinical Nutrition Coordinator Food and Nutrition Services UC Health - University Hospital 234 Goodman Street Cincinnati, OH 45219-2316 Office: 513-584-4534 Pager: 513-577-0948 linda.woods at healthall.com www.uchealthnow.com [cid:881523116 at 30102009-001A] [cid:881523116 at 30102009-0021] From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea Sent: Friday, October 30, 2009 9:45 AM To: cnm at lists.my180.net Subject: [Cnm] diet technicians I know this has been discussed before but I am looking for more up to date responses. My question is do you employ diet technicians and in what capacity do you utilize them. Clinical? Administrative? Diet office?, etc Also please state your bed size and how many registered dietitians as well? Do any of your diet technicians practice independently of the RD? Thanks in advance for this information. Andrea Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 NOTICE OF CONFIDENTIALITY This electronic message, including attachments, is for the sole use of the named recipient and may contain confidential or privileged information protected by New York State, and Federal regulations. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. If you are not the intended recipient or have received this communication in error please contact the sender or email.security at bassett.org and destroy all copies of the original message. Thank you. ________________________________ 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. Saint Luke's Health System Confidentiality Notice: This message is for the designated recipient only and may contain privileged, proprietary or otherwise private information and is legally protected. If you have received it in error, please notify the sender immediately and delete the original. Any other use of the email by you is prohibited. Saint Luke's is the one heart care leader in Kansas City. To learn more, or to find a Saint Luke's location near you, call NurseLine at (816) 932-6220 or go to saintlukeshealthsystem.org. Please consider our environment before printing this e-mail. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 4000 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.png Type: image/png Size: 7843 bytes Desc: image002.png URL: From Lyn.Haft at rexhealth.com Fri Oct 30 11:43:46 2009 From: Lyn.Haft at rexhealth.com (Haft, Lyn) Date: Fri, 30 Oct 2009 14:43:46 -0400 Subject: [Cnm] Subtotal Gastrectomy Question Message-ID: <6C5C5FBEE636A043BC7466A8CAE0732F0C653312@exchmail1.rexhealth.com> Good afternoon. We are having a strange issue, see below. I wondered if any of you are seeing a trend similar to this. We have asked our librarian do a literature search for us. "I've started seeing a trend with one physician ordering Bariatric Medical Nutrition Therapy for all of his subtotal gastrectomy patients. My concern is, the patients reason for subtotal gastrectomy being gastric mass, gastroparesis, etc., we do not want them to lose any weight as current Bariatric MNT suggests. Can you do a search of the current medical nutrition therapy trends for subtotal gastrectomy? Thank you, Angie 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) -------------- next part -------------- An HTML attachment was scrubbed... URL: From DerrickK at health.missouri.edu Fri Oct 30 11:45:17 2009 From: DerrickK at health.missouri.edu (Derrick, Karen) Date: Fri, 30 Oct 2009 13:45:17 -0500 Subject: [Cnm] Comparative Standard question Message-ID: <064B342B3641F04DA0FC21C0B79734B00B4EEAF3@UM-EMAIL02.um.umsystem.edu> Hi, I'm working on revising our EHR documentation form and our staff has requested a drop down box to select the comparative standard. There are so many. Have any of you done this already? Is there a list already developed so I don't have to start from scratch reviewing all of the disease/conditions? Thanks in advance for any advice you have. Karen Derrick, MA,RD,LD,CDE University of Missouri Health Care Nutrition and Food Service Assistant Manager Clinical Nutrition 573-882-2251 (office) 573-499-7070 (pager) 573-884-4990 (fax) 573-999-4484 (cell) -------------- next part -------------- An HTML attachment was scrubbed... URL: From Annalynn_Skipper at Comcast.net Fri Oct 30 11:58:11 2009 From: Annalynn_Skipper at Comcast.net (Annalynn Skipper) Date: Fri, 30 Oct 2009 13:58:11 -0500 Subject: [Cnm] Comparative Standard question In-Reply-To: <064B342B3641F04DA0FC21C0B79734B00B4EEAF3@UM-EMAIL02.um.umsystem.edu> References: <064B342B3641F04DA0FC21C0B79734B00B4EEAF3@UM-EMAIL02.um.umsystem.edu> Message-ID: <652C966FDB9D4AB5BFE4599BBBB3FC90@ANNALYNN> If you use the International Dietetics and Nutrition Terminology, comparative standards are listed with the assessment terms. I imagine you could hone this list to the specifics of your patient population. . 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] Sent: Friday, October 30, 2009 1:45 PM To: cnm at lists.my180.net Subject: [Cnm] Comparative Standard question Hi, I'm working on revising our EHR documentation form and our staff has requested a drop down box to select the comparative standard. There are so many. Have any of you done this already? Is there a list already developed so I don't have to start from scratch reviewing all of the disease/conditions? Thanks in advance for any advice you have. Karen Derrick, MA,RD,LD,CDE University of Missouri Health Care Nutrition and Food Service Assistant Manager Clinical Nutrition 573-882-2251 (office) 573-499-7070 (pager) 573-884-4990 (fax) 573-999-4484 (cell) -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 170 bytes Desc: not available URL: From cathysmith at mhsjvl.org Fri Oct 30 12:00:46 2009 From: cathysmith at mhsjvl.org (Smith, Cathy) Date: Fri, 30 Oct 2009 14:00:46 -0500 Subject: [Cnm] diet technicians References: <9B90EC6A1B880E4A9D9A859E062A04751E833385@ex2.bassett.org> <2B1106A6A593B147A65BD5A8939D3E1101065B341288@MAIL-C.healthall.com> Message-ID: <4973FD77BA585043AC3C49ED6D7B9F8302E230BF@MXV1.mercy.org> We are a 240 bed hospital with 2.3 FTE RDs + 1.5 FTE DTR. The tech screens low/moderate risk patients-refer to the RD as needed. They do education for all levels for sodium, cardiac, post-op, diabetes review etc.. they handle most of the patients in the addictions/psych unit as well. We have them follow up on some high risk patients if it is a matter of tolerance to supplement started etc. We use the NCP. ________________________________ From: cnm-bounces at lists.my180.net on behalf of Adams, Tamara Sent: Fri 10/30/2009 11:32 AM To: 'Woods, Linda'; 'Johnson, Andrea'; cnm at lists.my180.net Subject: Re: [Cnm] diet technicians We are very similiar but do not have the techs do mod to low risk patients we use the techs to do the nutrition screening within 24 hours, just changed b/c we are moving to NCP as well. Thanks Tammy Adams, MS,RD,LD Clinical Nutrition Manager Saint Lukes Hospital 816-932-5362 (office) 816-440-2695 (pager) ________________________________ From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Woods, Linda Sent: Friday, October 30, 2009 9:51 AM To: 'Johnson, Andrea'; cnm at lists.my180.net Subject: Re: [Cnm] diet technicians We are a 450 bed teaching hospital, Level 1 Trauma Center. RDs (7 FTEs) follow all patients in critical care units and high risk patients on med/surg and OB units. We have 4.0 FTE Diet Technicians that follow moderate/low risk patients in med/surg and OB. They collaborate and discuss cases with the RDs and the RDs oversee their work. We have not yet implemented NCP but plan to do so over the next 9-12 months. I'm sure that the role of the diet tech will change at that time. Linda Woods, RD, LD Clinical Nutrition Coordinator Food and Nutrition Services UC Health - University Hospital 234 Goodman Street Cincinnati, OH 45219-2316 Office: 513-584-4534 Pager: 513-577-0948 linda.woods at healthall.com www.uchealthnow.com cid:image003.jpg at 01CA3AEE.A7313D90 cid:image006.png at 01CA3AEE.A7313D90 From: cnm-bounces at lists.my180.net [mailto:cnm-bounces at lists.my180.net] On Behalf Of Johnson, Andrea Sent: Friday, October 30, 2009 9:45 AM To: cnm at lists.my180.net Subject: [Cnm] diet technicians I know this has been discussed before but I am looking for more up to date responses. My question is do you employ diet technicians and in what capacity do you utilize them. Clinical? Administrative? Diet office?, etc Also please state your bed size and how many registered dietitians as well? Do any of your diet technicians practice independently of the RD? Thanks in advance for this information. Andrea Andrea Johnson, MS, RD, CDE Clinical Nutrition Manager Bassett Healthcare One Atwell Road Cooperstown, NY 13326 andrea.johnson at bassett.org 607-547-6665 NOTICE OF CONFIDENTIALITY This electronic message, including attachments, is for the sole use of the named recipient and may contain confidential or privileged information protected by New York State, and Federal regulations. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. If you are not the intended recipient or have received this communication in error please contact the sender or email.security at bassett.org and destroy all copies of the original message. Thank you. ________________________________ 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. Saint Luke's Health System Confidentiality Notice: This message is for the designated recipient only and may contain privileged, proprietary or otherwise private information and is legally protected. If you have received it in error, please notify the sender immediately and delete the original. Any other use of the email by you is prohibited. Saint Luke's is the one heart care leader in Kansas City. To learn more, or to find a Saint Luke's location near you, call NurseLine at (816) 932-6220 or go to saintlukeshealthsystem.org. Please consider our environment before printing this e-mail. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 4000 bytes Desc: image001.jpg URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.png Type: image/png Size: 7843 bytes Desc: image002.png URL: From DerrickK at health.missouri.edu Fri Oct 30 12:07:44 2009 From: DerrickK at health.missouri.edu (Derrick, Karen) Date: Fri, 30 Oct 2009 14:07:44 -0500 Subject: [Cnm] Comparative Standard question In-Reply-To: <652C966FDB9D4AB5BFE4599BBBB3FC90@ANNALYNN> References: <064B342B3641F04DA0FC21C0B79734B00B4EEAF3@UM-EMAIL02.um.umsystem.edu> <652C966FDB9D4AB5BFE4599BBBB3FC90@ANNALYNN> Message-ID: <064B342B3641F04DA0FC21C0B79734B00B4EEAF4@UM-EMAIL02.um.umsystem.edu> Thanks. So would you include the specific references? ________________________________ From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] Sent: Friday, October 30, 2009 1:58 PM To: Derrick, Karen; cnm at lists.my180.net Subject: RE: [Cnm] Comparative Standard question If you use the International Dietetics and Nutrition Terminology, comparative standards are listed with the assessment terms. I imagine you could hone this list to the specifics of your patient population. . Regards, Annalynn Annalynn Skipper Ph.D., R.D., FADA [cid:image001.gif at 01CA596A.59DC0F80] 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] Sent: Friday, October 30, 2009 1:45 PM To: cnm at lists.my180.net Subject: [Cnm] Comparative Standard question Hi, I'm working on revising our EHR documentation form and our staff has requested a drop down box to select the comparative standard. There are so many. Have any of you done this already? Is there a list already developed so I don't have to start from scratch reviewing all of the disease/conditions? Thanks in advance for any advice you have. Karen Derrick, MA,RD,LD,CDE University of Missouri Health Care Nutrition and Food Service Assistant Manager Clinical Nutrition 573-882-2251 (office) 573-499-7070 (pager) 573-884-4990 (fax) 573-999-4484 (cell) -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.gif Type: image/gif Size: 170 bytes Desc: image001.gif URL: From Annalynn_Skipper at Comcast.net Fri Oct 30 12:14:21 2009 From: Annalynn_Skipper at Comcast.net (Annalynn Skipper) Date: Fri, 30 Oct 2009 14:14:21 -0500 Subject: [Cnm] Comparative Standard question In-Reply-To: <064B342B3641F04DA0FC21C0B79734B00B4EEAF4@UM-EMAIL02.um.umsystem.edu> References: <064B342B3641F04DA0FC21C0B79734B00B4EEAF3@UM-EMAIL02.um.umsystem.edu><652C966FDB9D4AB5BFE4599BBBB3FC90@ANNALYNN> <064B342B3641F04DA0FC21C0B79734B00B4EEAF4@UM-EMAIL02.um.umsystem.edu> Message-ID: They should be listed at the bottom of the reference sheets for each standard in the nutrition assessment section of the manual. My memory on the page numbers is faulty, but the assessment section is the first one in the 2008 edition (cranberry colored cover). Hope that helps. 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] Sent: Friday, October 30, 2009 2:08 PM To: 'Annalynn_Skipper at Comcast.net'; cnm at lists.my180.net Subject: Re: [Cnm] Comparative Standard question Thanks. So would you include the specific references? _____ From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] Sent: Friday, October 30, 2009 1:58 PM To: Derrick, Karen; cnm at lists.my180.net Subject: RE: [Cnm] Comparative Standard question If you use the International Dietetics and Nutrition Terminology, comparative standards are listed with the assessment terms. I imagine you could hone this list to the specifics of your patient population. . 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] Sent: Friday, October 30, 2009 1:45 PM To: cnm at lists.my180.net Subject: [Cnm] Comparative Standard question Hi, I'm working on revising our EHR documentation form and our staff has requested a drop down box to select the comparative standard. There are so many. Have any of you done this already? Is there a list already developed so I don't have to start from scratch reviewing all of the disease/conditions? Thanks in advance for any advice you have. Karen Derrick, MA,RD,LD,CDE University of Missouri Health Care Nutrition and Food Service Assistant Manager Clinical Nutrition 573-882-2251 (office) 573-499-7070 (pager) 573-884-4990 (fax) 573-999-4484 (cell) -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 170 bytes Desc: not available URL: From DerrickK at health.missouri.edu Fri Oct 30 12:22:18 2009 From: DerrickK at health.missouri.edu (Derrick, Karen) Date: Fri, 30 Oct 2009 14:22:18 -0500 Subject: [Cnm] Comparative Standard question In-Reply-To: References: <064B342B3641F04DA0FC21C0B79734B00B4EEAF3@UM-EMAIL02.um.umsystem.edu><652C966FDB9D4AB5BFE4599BBBB3FC90@ANNALYNN> <064B342B3641F04DA0FC21C0B79734B00B4EEAF4@UM-EMAIL02.um.umsystem.edu> Message-ID: <064B342B3641F04DA0FC21C0B79734B00B4EEAF7@UM-EMAIL02.um.umsystem.edu> Thanks. I appreciate your help. I'm still debating on whether to include the whole reference or an abbreviated form. Karen ________________________________ From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] Sent: Friday, October 30, 2009 2:14 PM To: Derrick, Karen; cnm at lists.my180.net Subject: RE: [Cnm] Comparative Standard question They should be listed at the bottom of the reference sheets for each standard in the nutrition assessment section of the manual. My memory on the page numbers is faulty, but the assessment section is the first one in the 2008 edition (cranberry colored cover). Hope that helps. Annalynn Annalynn Skipper Ph.D., R.D., FADA [cid:image002.gif at 01CA596C.62A41160] 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] Sent: Friday, October 30, 2009 2:08 PM To: 'Annalynn_Skipper at Comcast.net'; cnm at lists.my180.net Subject: Re: [Cnm] Comparative Standard question Thanks. So would you include the specific references? ________________________________ From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] Sent: Friday, October 30, 2009 1:58 PM To: Derrick, Karen; cnm at lists.my180.net Subject: RE: [Cnm] Comparative Standard question If you use the International Dietetics and Nutrition Terminology, comparative standards are listed with the assessment terms. I imagine you could hone this list to the specifics of your patient population. . Regards, Annalynn Annalynn Skipper Ph.D., R.D., FADA [cid:image002.gif at 01CA596C.62A41160] 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] Sent: Friday, October 30, 2009 1:45 PM To: cnm at lists.my180.net Subject: [Cnm] Comparative Standard question Hi, I'm working on revising our EHR documentation form and our staff has requested a drop down box to select the comparative standard. There are so many. Have any of you done this already? Is there a list already developed so I don't have to start from scratch reviewing all of the disease/conditions? Thanks in advance for any advice you have. Karen Derrick, MA,RD,LD,CDE University of Missouri Health Care Nutrition and Food Service Assistant Manager Clinical Nutrition 573-882-2251 (office) 573-499-7070 (pager) 573-884-4990 (fax) 573-999-4484 (cell) -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.gif Type: image/gif Size: 170 bytes Desc: image002.gif URL: From pcharney at mac.com Fri Oct 30 12:33:24 2009 From: pcharney at mac.com (Pam Charney) Date: Fri, 30 Oct 2009 12:33:24 -0700 Subject: [Cnm] Comparative Standard question In-Reply-To: <064B342B3641F04DA0FC21C0B79734B00B4EEAF7@UM-EMAIL02.um.umsystem.edu> References: <064B342B3641F04DA0FC21C0B79734B00B4EEAF3@UM-EMAIL02.um.umsystem.edu> <652C966FDB9D4AB5BFE4599BBBB3FC90@ANNALYNN> <064B342B3641F04DA0FC21C0B79734B00B4EEAF4@UM-EMAIL02.um.umsystem.edu> <064B342B3641F04DA0FC21C0B79734B00B4EEAF7@UM-EMAIL02.um.umsystem.edu> Message-ID: <5D49E8A6-55A1-4832-B47A-07A9BD0D839B@mac.com> What is your intended use? Can you link the standard to the term: if the clinician selects a given term, then you don't want standards associated with other terms to appear. If the RD is trying to document care, the information presented should be relevant to the situation at hand. That way, you avoid information overload! Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 30, 2009, at 12:22 PM, Derrick, Karen wrote: > Thanks. I appreciate your help. I?m still debating on whether to > include the whole reference or an abbreviated form. > Karen > > From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] > Sent: Friday, October 30, 2009 2:14 PM > To: Derrick, Karen; cnm at lists.my180.net > Subject: RE: [Cnm] Comparative Standard question > > They should be listed at the bottom of the reference sheets for each > standard in the nutrition assessment section of the manual. My > memory on the page numbers is faulty, but the assessment section is > the first one in the 2008 edition (cranberry colored cover). > > Hope that helps. > > 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] > Sent: Friday, October 30, 2009 2:08 PM > To: 'Annalynn_Skipper at Comcast.net'; cnm at lists.my180.net > Subject: Re: [Cnm] Comparative Standard question > > Thanks. So would you include the specific references? > > From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] > Sent: Friday, October 30, 2009 1:58 PM > To: Derrick, Karen; cnm at lists.my180.net > Subject: RE: [Cnm] Comparative Standard question > > If you use the International Dietetics and Nutrition Terminology, > comparative standards are listed with the assessment terms. I > imagine you could hone this list to the specifics of your patient > population. . > > 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] > Sent: Friday, October 30, 2009 1:45 PM > To: cnm at lists.my180.net > Subject: [Cnm] Comparative Standard question > > Hi, > I?m working on revising our EHR documentation form and our staff has > requested a drop down box to select the comparative standard. There > are so many. Have any of you done this already? Is there a list > already developed so I don?t have to start from scratch reviewing > all of the disease/conditions? Thanks in advance for any advice you > have. > > Karen Derrick, MA,RD,LD,CDE > University of Missouri Health Care > Nutrition and Food Service Assistant Manager > Clinical Nutrition > 573-882-2251 (office) > 573-499-7070 (pager) > 573-884-4990 (fax) > 573-999-4484 (cell) > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From DerrickK at health.missouri.edu Fri Oct 30 13:03:37 2009 From: DerrickK at health.missouri.edu (Derrick, Karen) Date: Fri, 30 Oct 2009 15:03:37 -0500 Subject: [Cnm] Comparative Standard question In-Reply-To: <5D49E8A6-55A1-4832-B47A-07A9BD0D839B@mac.com> References: <064B342B3641F04DA0FC21C0B79734B00B4EEAF3@UM-EMAIL02.um.umsystem.edu> <652C966FDB9D4AB5BFE4599BBBB3FC90@ANNALYNN> <064B342B3641F04DA0FC21C0B79734B00B4EEAF4@UM-EMAIL02.um.umsystem.edu> <064B342B3641F04DA0FC21C0B79734B00B4EEAF7@UM-EMAIL02.um.umsystem.edu> <5D49E8A6-55A1-4832-B47A-07A9BD0D839B@mac.com> Message-ID: <064B342B3641F04DA0FC21C0B79734B00B4EEAF9@UM-EMAIL02.um.umsystem.edu> Thanks Pam. The intended use is on the nutrition prescription tab (from the pick list). It will be a drop down box so that you will only see the comparative standard in the documentation. Other than dietitians, I doubt many others will look at this information. But the inpatient dietitians do use this. For example within the past hour an oncology patient was admitted on tube feedings and we could not figure out which standard the outpatient RD used to calculate his calorie and protein needs. The outpatient RD is off today so it would have been nice to see where the information came from to better coordinate care. In regards to the drop down choices, I'm still trying to find a less wordy way to list the reference standard so I'm going to put off until next week. I'd love to hear any other suggestions. Karen ________________________________ From: Pam Charney [mailto:pcharney at mac.com] Sent: Friday, October 30, 2009 2:33 PM To: Derrick, Karen Cc: 'Annalynn_Skipper at Comcast.net'; cnm at lists.my180.net Subject: Re: [Cnm] Comparative Standard question What is your intended use? Can you link the standard to the term: if the clinician selects a given term, then you don't want standards associated with other terms to appear. If the RD is trying to document care, the information presented should be relevant to the situation at hand. That way, you avoid information overload! Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 30, 2009, at 12:22 PM, Derrick, Karen wrote: Thanks. I appreciate your help. I'm still debating on whether to include the whole reference or an abbreviated form. Karen ________________________________ From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] Sent: Friday, October 30, 2009 2:14 PM To: Derrick, Karen; cnm at lists.my180.net Subject: RE: [Cnm] Comparative Standard question They should be listed at the bottom of the reference sheets for each standard in the nutrition assessment section of the manual. My memory on the page numbers is faulty, but the assessment section is the first one in the 2008 edition (cranberry colored cover). Hope that helps. 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] Sent: Friday, October 30, 2009 2:08 PM To: 'Annalynn_Skipper at Comcast.net'; cnm at lists.my180.net Subject: Re: [Cnm] Comparative Standard question Thanks. So would you include the specific references? ________________________________ From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] Sent: Friday, October 30, 2009 1:58 PM To: Derrick, Karen; cnm at lists.my180.net Subject: RE: [Cnm] Comparative Standard question If you use the International Dietetics and Nutrition Terminology, comparative standards are listed with the assessment terms. I imagine you could hone this list to the specifics of your patient population. . 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] Sent: Friday, October 30, 2009 1:45 PM To: cnm at lists.my180.net Subject: [Cnm] Comparative Standard question Hi, I'm working on revising our EHR documentation form and our staff has requested a drop down box to select the comparative standard. There are so many. Have any of you done this already? Is there a list already developed so I don't have to start from scratch reviewing all of the disease/conditions? Thanks in advance for any advice you have. Karen Derrick, MA,RD,LD,CDE University of Missouri Health Care Nutrition and Food Service Assistant Manager Clinical Nutrition 573-882-2251 (office) 573-499-7070 (pager) 573-884-4990 (fax) 573-999-4484 (cell) _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From pcharney at mac.com Fri Oct 30 13:33:10 2009 From: pcharney at mac.com (Pam Charney) Date: Fri, 30 Oct 2009 13:33:10 -0700 Subject: [Cnm] Comparative Standard question In-Reply-To: <064B342B3641F04DA0FC21C0B79734B00B4EEAF9@UM-EMAIL02.um.umsystem.edu> References: <064B342B3641F04DA0FC21C0B79734B00B4EEAF3@UM-EMAIL02.um.umsystem.edu> <652C966FDB9D4AB5BFE4599BBBB3FC90@ANNALYNN> <064B342B3641F04DA0FC21C0B79734B00B4EEAF4@UM-EMAIL02.um.umsystem.edu> <064B342B3641F04DA0FC21C0B79734B00B4EEAF7@UM-EMAIL02.um.umsystem.edu> <5D49E8A6-55A1-4832-B47A-07A9BD0D839B@mac.com> <064B342B3641F04DA0FC21C0B79734B00B4EEAF9@UM-EMAIL02.um.umsystem.edu> Message-ID: <170E3201-2212-4C39-B161-2F3463D9969C@mac.com> Correct, I was referring to the initial data entry. If you present too much information in a pick list, there's the risk that the clinician will simply go with one of the first on the list due to lack of time to wade through choices that aren't germane. Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 30, 2009, at 1:03 PM, Derrick, Karen wrote: > Thanks Pam. The intended use is on the nutrition prescription tab > (from the pick list). It will be a drop down box so that you will > only see the comparative standard in the documentation. Other than > dietitians, I doubt many others will look at this information. But > the inpatient dietitians do use this. For example within the past > hour an oncology patient was admitted on tube feedings and we could > not figure out which standard the outpatient RD used to calculate > his calorie and protein needs. The outpatient RD is off today so it > would have been nice to see where the information came from to > better coordinate care. > In regards to the drop down choices, I?m still trying to find a less > wordy way to list the reference standard so I?m going to put off > until next week. I?d love to hear any other suggestions. > Karen > > From: Pam Charney [mailto:pcharney at mac.com] > Sent: Friday, October 30, 2009 2:33 PM > To: Derrick, Karen > Cc: 'Annalynn_Skipper at Comcast.net'; cnm at lists.my180.net > Subject: Re: [Cnm] Comparative Standard question > > What is your intended use? > > Can you link the standard to the term: if the clinician selects a > given term, then you don't want standards associated with other > terms to appear. If the RD is trying to document care, the > information presented should be relevant to the situation at hand. > That way, you avoid information overload! > > Regards, > pam > > Pam Charney, PhD, RD > Affiliate Associate Professor > Pharmacy > > MS Student > Clinical Informatics and Patient Centered Technology > School of Nursing > > University of Washington > Seattle, WA > pcharney at mac.com > http://www.linkedin.com/in/pamcharney > > > > On Oct 30, 2009, at 12:22 PM, Derrick, Karen wrote: > > > Thanks. I appreciate your help. I?m still debating on whether to > include the whole reference or an abbreviated form. > Karen > > From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] > Sent: Friday, October 30, 2009 2:14 PM > To: Derrick, Karen; cnm at lists.my180.net > Subject: RE: [Cnm] Comparative Standard question > > They should be listed at the bottom of the reference sheets for each > standard in the nutrition assessment section of the manual. My > memory on the page numbers is faulty, but the assessment section is > the first one in the 2008 edition (cranberry colored cover). > > Hope that helps. > > 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] > Sent: Friday, October 30, 2009 2:08 PM > To: 'Annalynn_Skipper at Comcast.net'; cnm at lists.my180.net > Subject: Re: [Cnm] Comparative Standard question > > Thanks. So would you include the specific references? > > From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] > Sent: Friday, October 30, 2009 1:58 PM > To: Derrick, Karen; cnm at lists.my180.net > Subject: RE: [Cnm] Comparative Standard question > > If you use the International Dietetics and Nutrition Terminology, > comparative standards are listed with the assessment terms. I > imagine you could hone this list to the specifics of your patient > population. . > > 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] > Sent: Friday, October 30, 2009 1:45 PM > To: cnm at lists.my180.net > Subject: [Cnm] Comparative Standard question > > Hi, > I?m working on revising our EHR documentation form and our staff has > requested a drop down box to select the comparative standard. There > are so many. Have any of you done this already? Is there a list > already developed so I don?t have to start from scratch reviewing > all of the disease/conditions? Thanks in advance for any advice you > have. > > Karen Derrick, MA,RD,LD,CDE > University of Missouri Health Care > Nutrition and Food Service Assistant Manager > Clinical Nutrition > 573-882-2251 (office) > 573-499-7070 (pager) > 573-884-4990 (fax) > 573-999-4484 (cell) > > _______________________________________________ > Cnm mailing list > Cnm at lists.my180.net > http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net > > -------------- next part -------------- An HTML attachment was scrubbed... URL: From DerrickK at health.missouri.edu Fri Oct 30 13:38:07 2009 From: DerrickK at health.missouri.edu (Derrick, Karen) Date: Fri, 30 Oct 2009 15:38:07 -0500 Subject: [Cnm] Comparative Standard question In-Reply-To: <170E3201-2212-4C39-B161-2F3463D9969C@mac.com> References: <064B342B3641F04DA0FC21C0B79734B00B4EEAF3@UM-EMAIL02.um.umsystem.edu> <652C966FDB9D4AB5BFE4599BBBB3FC90@ANNALYNN> <064B342B3641F04DA0FC21C0B79734B00B4EEAF4@UM-EMAIL02.um.umsystem.edu> <064B342B3641F04DA0FC21C0B79734B00B4EEAF7@UM-EMAIL02.um.umsystem.edu> <5D49E8A6-55A1-4832-B47A-07A9BD0D839B@mac.com> <064B342B3641F04DA0FC21C0B79734B00B4EEAF9@UM-EMAIL02.um.umsystem.edu> <170E3201-2212-4C39-B161-2F3463D9969C@mac.com> Message-ID: <064B342B3641F04DA0FC21C0B79734B00B4EEAFB@UM-EMAIL02.um.umsystem.edu> This makes sense. The RD's are going to let me know which they use most often. Then we can add an "other" option so free text can be added if needed. We are a detailed group so I'm hoping we'll be able to narrow down the options to save time and not use more time. I think I was making this harder than it needs to be. Thanks for the input and have a great weekend. Karen ________________________________ From: Pam Charney [mailto:pcharney at mac.com] Sent: Friday, October 30, 2009 3:33 PM To: Derrick, Karen Cc: 'Annalynn_Skipper at Comcast.net'; cnm at lists.my180.net Subject: Re: [Cnm] Comparative Standard question Correct, I was referring to the initial data entry. If you present too much information in a pick list, there's the risk that the clinician will simply go with one of the first on the list due to lack of time to wade through choices that aren't germane. Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 30, 2009, at 1:03 PM, Derrick, Karen wrote: Thanks Pam. The intended use is on the nutrition prescription tab (from the pick list). It will be a drop down box so that you will only see the comparative standard in the documentation. Other than dietitians, I doubt many others will look at this information. But the inpatient dietitians do use this. For example within the past hour an oncology patient was admitted on tube feedings and we could not figure out which standard the outpatient RD used to calculate his calorie and protein needs. The outpatient RD is off today so it would have been nice to see where the information came from to better coordinate care. In regards to the drop down choices, I'm still trying to find a less wordy way to list the reference standard so I'm going to put off until next week. I'd love to hear any other suggestions. Karen ________________________________ From: Pam Charney [mailto:pcharney at mac.com] Sent: Friday, October 30, 2009 2:33 PM To: Derrick, Karen Cc: 'Annalynn_Skipper at Comcast.net'; cnm at lists.my180.net Subject: Re: [Cnm] Comparative Standard question What is your intended use? Can you link the standard to the term: if the clinician selects a given term, then you don't want standards associated with other terms to appear. If the RD is trying to document care, the information presented should be relevant to the situation at hand. That way, you avoid information overload! Regards, pam Pam Charney, PhD, RD Affiliate Associate Professor Pharmacy MS Student Clinical Informatics and Patient Centered Technology School of Nursing University of Washington Seattle, WA pcharney at mac.com http://www.linkedin.com/in/pamcharney On Oct 30, 2009, at 12:22 PM, Derrick, Karen wrote: Thanks. I appreciate your help. I'm still debating on whether to include the whole reference or an abbreviated form. Karen ________________________________ From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] Sent: Friday, October 30, 2009 2:14 PM To: Derrick, Karen; cnm at lists.my180.net Subject: RE: [Cnm] Comparative Standard question They should be listed at the bottom of the reference sheets for each standard in the nutrition assessment section of the manual. My memory on the page numbers is faulty, but the assessment section is the first one in the 2008 edition (cranberry colored cover). Hope that helps. 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] Sent: Friday, October 30, 2009 2:08 PM To: 'Annalynn_Skipper at Comcast.net'; cnm at lists.my180.net Subject: Re: [Cnm] Comparative Standard question Thanks. So would you include the specific references? ________________________________ From: Annalynn Skipper [mailto:Annalynn_Skipper at Comcast.net] Sent: Friday, October 30, 2009 1:58 PM To: Derrick, Karen; cnm at lists.my180.net Subject: RE: [Cnm] Comparative Standard question If you use the International Dietetics and Nutrition Terminology, comparative standards are listed with the assessment terms. I imagine you could hone this list to the specifics of your patient population. . 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: Derrick, Karen [mailto:DerrickK at health.missouri.edu] Sent: Friday, October 30, 2009 1:45 PM To: cnm at lists.my180.net Subject: [Cnm] Comparative Standard question Hi, I'm working on revising our EHR documentation form and our staff has requested a drop down box to select the comparative standard. There are so many. Have any of you done this already? Is there a list already developed so I don't have to start from scratch reviewing all of the disease/conditions? Thanks in advance for any advice you have. Karen Derrick, MA,RD,LD,CDE University of Missouri Health Care Nutrition and Food Service Assistant Manager Clinical Nutrition 573-882-2251 (office) 573-499-7070 (pager) 573-884-4990 (fax) 573-999-4484 (cell) _______________________________________________ Cnm mailing list Cnm at lists.my180.net http://lists.my180.net/mailman/listinfo/cnm_lists.my180.net -------------- next part -------------- An HTML attachment was scrubbed... URL: From ANNETTE.COLE at CHILDRENS.COM Fri Oct 30 10:17:28 2009 From: ANNETTE.COLE at CHILDRENS.COM (ANNETTE MICA) Date: Fri, 30 Oct 2009 12:17:28 -0500 Subject: [Cnm] MNT services In-Reply-To: References: <6EAE916704479E4BB6AB5A133BA224F72886F1FAB1@SJMEMXMBS11.stjude.sjcrh.local> Message-ID: <4AEAD958.1386.0071.0@childrens.com> We bill both from for our inpatient and outpatient services. I can tell you that our collection % is down for the second quarter due to the economy and a change in our payer mix but that is seen across the board in healthcare not just for nutritional services. Her is our breakdown: Q1 Inpatient 40% Collected Q1 Outpatient 35% Collected Q2 Inpatient 22% Collected Q2 Outpatient 25% Collected Regards, Annette M. Mica MS, RD/LD Clinical Nutrition Director 214-456-2182 (phone) 214-456-6287 (fax) Children's Medical Center Dallas www.childrens.com >>> "Baar, Rachel" 10/26/2009 4:21 PM >>> Does anyone have analytical evidence (as opposed to anectodal evidence) that patients are better served from an out-of-pocket cost standpoint when MNT services are provided and billed from a clinic based program vs from a hospital-based outpatient program? Our Finance person has stated it is better for patients cost-wise to recieve MNT from a clinic, but several RDs counter that by stating that there are just as many insurance plans that will pay hospital-based charges as there are that will reimburse clinic charges. Who really knows the answer to this one? 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. Please consider the environment before printing this e-mail

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-------------- next part -------------- An HTML attachment was scrubbed... URL: From lrichter at notes.cc.sunysb.edu Fri Oct 30 14:14:51 2009 From: lrichter at notes.cc.sunysb.edu (lrichter at notes.cc.sunysb.edu) Date: Fri, 30 Oct 2009 17:14:51 -0400 Subject: [Cnm] Food Service vs. Clinical Services: Message-ID: Food Service vs. Clinical Services: Does anyone have a reporting model where Food Services reports to a different V.P. or Senior Administrator that is not the same person that Clinical Nutrition Services reports to? If so, and it is different, who do they report to? 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. ****************************************************************************** -------------- next part -------------- An HTML attachment was scrubbed... URL: