Kent State Interns

This article combines two interesting things we have learned about this semester. It talks about healthcare providers working as a team and outcomes measurement to improve overall care. According the this article from the Harvard Business Review, with the future of health care hanging in the balance of "Obama-care" and other health care ideas, it is more important than ever to make sure that hospitals are "achieving the best outcomes at the lowest cost". Cleveland Clinic has actually been a ground-breaker in taking large steps to make their outcomes as high as possible while still keeping cost to stockholders, insurance, and patients as low as possible. This was done by instituting IPUs. IPUs (Integrated Practice Units) should be made up of anyone who had a hand in the healthcare of the patient including but not limited to doctors, surgeons, dietitians, nurses, and pharmacists. The unit is usually in one place, or is very close to a central location so that the pat...

This article discusses the important role of dietitians in hospitals and food service. Although most of us are familiar with this, it is a great review of all the roles that an RD is able to take part in to help with patient care. This article would be a good resource to help explain the role of a dietitian to the general population when trying to promote services such as outpatient programs.    Another unique aspect of this article is that it talks about methods this hospital uses to find potential employee for these positions such as college fairs and social media. As a clinical nutritional manager, it is important to pay attention to the hiring trends of dietitians. This article was found on job search site, which may not be the first place that a CNM may look for this information. But it is important for CNMS that play a role in hiring to see what information is available to those that are looking for jobs. The link below provides more information on the article: ...

     CNM's or leaders are often given a chance to broaden their skills in management. Barbara Pyper's article on Leadership: a recipe for success,  expands not only on how to be an excellent leader but the opportunities that are available to leaders. During the Kent State internship The Leadership Challenge is a large part of the curriculum and it was very nice to see others in the Nutrition and Dietetics field using this book. Leaders have responsibility to their employees and an excellent leader can use these 3 principles to be an excellent leader: 1) 100% responsibility, 2) responsiveness to others and 3) clarity. It is very important for leaders to take responsibility to solve goals, respond well to others with respect and to make sure that you are clear in your goals. Pyper goes over the top 15 leadership characteristics: 1) Honesty 2) Competent 3) Inspirational 4) Intellectual 5) Fair-Minded 6) Broad-minded 7)Creative 8) Integrity 9) Harness and Enable Talent 1...

In 2001, the University of Mississippi decided to work on improving quality in school nutrition services in the area. They wanted to get away from old and outdated procedures, improve and empower their employees work process, and really blow away customers with their product. To do this, they created a six step process called the Continuous Quality Improvement Process (CQI). To use the CQI process, a team needs to be assembled. This team should include each part of the food service team (school nutrition managers, supervisors, and staff). As time goes on, others can be added to the team. They recommend principles, students, teachers, parents, or custodians as possible members. In this six step process, the team needs to figure out what can be improved on and what really needs to be changed. The following questions are suggested to find areas of improvement: -What is the problem? - When does the problem occur? - Where does the problem occur? - Why does the problem occur? - Who do...

New research from Duke University shows telehealth sessions may help reduce symptoms associated with chronic obstructive pulmonary disease, or COPD, and improve quality of life. The study, INSPIRE-II, was conducted over a 5 year period at Duke University Health System and The Ohio State University. One group of 147 patients with COPD was provided with counseling by a psychologist over the phone on stress management and relaxation techniques. A second (control) group of 151 patients with COPD received only medication and nutrition counseling. According to the article on the website Pharmacy Times, “by the conclusion of the study, those who received information on managing reactions to stressful events reported improvements in depression, anxiety, fatigue, and shortness of breath compared with control subjects” (Pharmacy Times, 2014). The article goes on to say that there was no difference in hospitalization or deaths caused by COPD between the two groups of patients. Although t...

Earlier in October, the United States Preventative Services Task Force amended its recommendations on screening for diabetes. Under the new recommendations, screening for diabetes and prediabetes would be performed on all adults over age 45. The recommendations also encouraged uniform insurance coverage for these screenings in order to help families have access to such life-changing services. It's no secret that detecting diabetes early enough can help patients get the diet and lifestyle education they need, which could possibly reverse the course of the disease. Early detection and medical nutrition therapy from Certified Diabetes Educators has also been proven to save significant taxpayer dollars and cut health care spending. This focus on preventative medicine is a trend that isn't going to go away anytime soon, and dietitians are fortunate to be on the forefront of providing such preventative care. As future clinical nutrition managers and clinical dietitians, justi...

Today is Food Day , the 4th annual celebration of real food and a day to encourage a push for improved food policies. Food Day was started by the Center for Science in the Public Interest, but it has since expanded to include organizations from all sectors that are interested in food and nutrition. The 2014 Food Day advisory board includes senators and members of the House of Representatives, chefs, professors, public health officials, and Pat Babjak, the CEO of the Academy of Nutrition and Dietetics.  This year, some of Food Day's national priorities aim to promote safe and healthier diets and to reduce hunger, which are two things that future dietitians should have no problem getting behind. We always encourage patients and clients to choose whole foods over processed meals and dietary supplements, which is one of the hallmarks of Food Day. Additionally, it's a good reminder for us to stay involved in public policy, as laws and regulations can have a resounding impact...

United Nations delegates met last week for the Committee on World Food Security, and rumors were swirling about a proposed agency to promote nutrition worldwide. Turns out, they really were just rumors , and right now, the plan is to work on creating a more established and connected nutrition network out of the committees that already exist, rather than forming a new agency entirely. Despite this story ultimately turning out to be false, I think it raises some interesting points for us in the field. Should there be an agency dedicated solely to nutrition? And if so, who would serve as members? I would hope that dietitians and clinical nutrition managers would be adequately represented, as well as public health officials and other healthcare professionals. We always talk about how important it is to be advocates for what we do, and certainly no agency that would position itself as a leader in nutrition information would be complete without the input of dietitians across the world....

In class, we've been talking a lot about the importance of having a clear and communicated mission and/or vision, as it helps define who you are as an organization now and in the future. While I was searing for articles to blog about, I came across the Mission and Vision of the Clinical Nutrition Managers practice group from the Academy, and I thought I would share it below: The CNM DPG is a dynamic group of leaders who strive to improve the quality of nutrition care in the health industry. We pride ourselves in offering guidance and sharing resources with one another. CNM members work in a variety of settings including acute care, community services, long-term care, private practice, and government services among others. It is this varied background that enables our members to offer many perspectives and resources. We are at an exciting juncture for our group. We have plans to develop and expand our member benefits in the coming year. So, it’s a rewarding time to be a CNM m...

A recent article on CNN, “ New Large-Scale Study Will Look at How Nutrition Can Help Keep Patients from Returning to the Hospital ,” discusses a new prospective study by Abbott Nutrition and Advocate Health Care that is going to research the effect nutrition has on hospital readmission rates for 3,000 adults. According to Tom Summerfelt, Ph.D., Vice President, Research and Innovation (Advocate Health Care), Advocate Health Care, located in Illinois, is one of the largest health care systems in the Midwestern United States. Four hospitals are going to be used in the study; two hospitals will provide quick nutritional care, and the other two hospitals will provide nutritional care as is normally done. Upon admission at the quick nutritional care hospitals, patients are going to be nutritionally screened, and those assessed as high-risk will immediately receive a nutritional supplement. Furthermore, these patients will be given added education and receive a discharge plan and discharge ...

“ Mediterranean Diet Leads to Better Heart Health” http://www.courierpostonline.com/story/life/2014/10/19/mediterranean-diet-leads-better-heart-health/17546953/      Although as future dietitians, I think it's important to remain neutral concerning specific diets, it's hard to deny the amount of information supporting the Mediterranean diet and its benefits for a myriad of diseases. This article discusses the Mediterranean diet's ability to reverse Metabolic Syndrome, characterized by three or more of the following risk factors: Low HDL, high triglycerides, large waist, high blood pressure and high blood sugar.      The research compared a low-fat diet to a Mediterranean diet (whole grains, vegetables, fruits, fish, legumes), supplemented with extra fats from either extra virgin olive oil or nuts. The research, which was conducted on 6,000 men and women at increased risk for heart disease in Spain, found that although the Mediterra...

The recently established Centers for Medicare and Medicaid Services (CMS) rule that will allow registered dietitians to place therapeutic diet orders will be beneficial for dietitians, the medical team, and hospitals alike. By RDs gaining order writing privileges, the medical team will save time, hospitals are projected to save large amounts of money, and there will hopefully be a decrease in inappropriate diets ordered. In an article titled “CMS Final Rule on Therapeutic Diet Orders Means New Opportunities for RDNs,” in the Journal of the Academy of Nutrition and Dietetics, Brian Boyce discusses the opportunities this new rule will create for dietitians. In the article, Boyce (2014) makes an especially interesting point in relation to ordering privileges and CMS guidelines: “CMS has a long-standing interpretive guideline that hospitals may technically hire non-RDNs with sufficient qualifications for dietary and nutrition services. Under the new rule regarding therapeutic diet ord...

As a nutrition manager, it is essential to not only handle the day-to-day challenges that your facility faces, it is also necessary to stay on top of the trends and innovations in the field. An article featured on SupermarketGuru, a publication centered around "smarter shopping, healthier eating, and better living," discusses the need for supermarkets to differentiate themselves in the competitive grocery store scene. This article suggests that entrepreneurs generally have the freedom to be creative because they are not tied down by a structured buying or selling system. Grocery stores, on the other hand, may lack this creativity because they often don't have the time or mindset to look creatively at the future. The central question from this publication is "How can retailers innovate - and integrate worthwhile finds - without impending their ability to compete today?". This question is challenging, and one that may lay on the footsteps of a manager of dieti...

As a nutrition manager in any field, the impact that new technology has on practice is important to consider. Big technology companies including Apple, Google, Samsung and the like, are inventing products that are making news in the healthcare scene. Healthcare practitioners are left wondering how to appropriately incorporate these technologies into their practice. New products to hit the shelf like Apple's iWatch can track blood pressure levels and activity throughout the day. Innovative apps on the iPhone can help patients track their blood glucose levels and record their food intake. Nike's Fitbit can track a person's energy expenditure via calories burned during everyday activity. How reliable are these new tools? Have they been tested and proven to be accurate? As a nutrition manager, this is an issue that must be thought out. One healthcare facility mentioned in this article is predicting that doctors may be able to tap into some of these apps that track blood glu...

In the past several years, many rigorous guidelines have been adopted by the National School Lunch Program due to federal regulation. Going even further than remodeling school lunches and snacks, one local school district is now banning birthday cake. The PTA helped to push the ban on sugary snacks at birthday celebrations. Non-food rewards are still acceptable like pencils, erasers, small toys, etc. Teachers were having a difficult time covering everything that needed to be taught after so many of these celebrations. They also felt that students were increasingly distracted by the junk-food and that it decreased their attention. School officials are concerned with the rate of obesity and how they can help to control it during the school day. As a school foodservice manager, how should this situation be handled? This local school district was flooded with phone calls from angry parents wondering why their child is no longer able to bring in a treat to share with their classmates fo...

One of the top-trending diets today is gluten-free. Approximately 1% of the population has been identified as having Celiac Disease and another 6% have a gluten intolerance. The only cure for these conditions is a life-long gluten-free diet. Seeing that this diet is more than a trend, but rather a necessity for these affected individuals, many restaurants have developed a gluten-free menu and are doing everything they can to accommodate this population. The challenge comes in implementing a gluten-free menu. Whereas in facilities such as hospitals and long-term care facilities, dietitians are present to assist with going gluten-free, many restaurant managers do not have this luxury- or the educational background to be familiar with the extensive precautions that need be taken. Many don't realize the extensive changes that must be implemented to go "gluten-free". Not only can the menu items labeled as gluten-free not contain any wheat, rye, or barley; they also cannot ...

With Facebook’s continuing growth and a vast amount of health “advice” from different sources available to the public, there is talk about linking healthcare to Facebook or developing an app owned by them but under a different name. An example they give of this linking would be to offer support groups and education to those diagnosed with certain conditions such as type 2 diabetes. The hope is to provide support and evidence based advice from medical experts in that area. As nutrition managers, it is good to be aware of current trends with technology. This could bring opportunities to the dietetics department such as possible new forms of outpatient counseling. With expanding technology trends comes the opportunity to become more creative and expand beyond the traditional methods. For more information visit: www.telegraph.co.uk/technology/facebook/11139606/Facebook-plots-first-steps-into-healthcare.html       -AA

We have all heard the saying that, "Breakfast is the most important meal of the day." Just how true is that saying? According to a recent study breakfast especially high in protein can help to control cravings of high fat foods throughout the day. This would reduce the amount of high fat foods we consume daily. Teenagers are the most likely to skip breakfast thinking they are reducing the calories they are consuming when in reality they are increasing their chances of overeating, leading to eventual weight gain. Statistics have shown that teens struggling with obesity have quadrupled in the last thirty years. MU researchers have found that by eating breakfast especially rich in protein increases the brian chemical associated with feelings of reward, which may lead to reduced food cravings and less overeating throughout the day. Understanding how the brain chemicals work with food cravings could provide a lot of information about preventing overeating and improving obesity pre...

An article in the Journal of the Academy of Nutrition and Dietetics, “Competency-Based Hiring: The Key to Recruiting and Retaining Successful Employees,” sheds light on how transitioning from a traditional job description and interviewing process to a competency-based process can potentially save employers time and money. According to Tony Peregrin, a traditional job description outlines or lists job responsibilities or duties where a competency-based description emphasizes the skills and abilities an employee of a specific position will need to be successful. There are three types of competencies that are commonly seen in competency-based job descriptions: skills, knowledge, and behavior. Competencies may also fall into the groupings of position-specific and organizational depending on what an employer is assessing. Northwestern University has defined the competencies as follows: Skills - Abilities needed to execute job duties, such as software and computer proficiency, interpe...

The Ebola virus has hit Northeast Ohio a lot sooner than anyone thought.   During the summer, the coverage of the Ebola virus was minimal.   Now that there have been a few cases of Ebola identified in the US, it seems as though you can not avoid hearing or reading about Ebola.   The Ebola Virus Disease has devastated many communities in West Africa.   Malnutrition was and continues to be prevalent in West Africa.   When an individual is malnourished their immune system is compromised.   Therefore proper nutrition may play a vital role in combating the deadly Ebola virus.               The UN World Food Program (WFP) has a mission to feed over one million people in West Africa where Ebola has already killed thousands, and hunger and malnutrition is present.   Denise Brown, the Director of WFP states, “containing the virus requires a comprehensive care package including food...

“Eating Disorders Could Start as Early as Elementary School” http://www.medicalnewstoday.com/articles/283632.php               Children as young as 8-12 years who are difficult eaters could actually be experiencing eating disorders typically associated with teenagers and young adults according to researchers from the University of Montreal in Canada and the CHU Sainte-Justine children’s hospital. The National Institute of Mental Health (NIMH) defines an eating disorder as “An illness that causes significant disturbances to an individual's everyday diet. This can include eating very small amounts of food or severely overeating.” Researchers studied 215 children who had eating problems and it was found that “95% had restrictive eating behaviors, 69.4% were afraid of putting on weight and 46.6% described themselves as fat.”   Additionally, the study revealed that “15.5% of the children occasionally made th...

The Centers for Medicare and Medicaid Services (CMS) approve final rule authorizing ordering of therapeutic diets in hospitals. Previously the CMS rule gave dietitians authority to provide nutrition services for patients based on physician orders. This process often caused a delay in nutrition management. In this case dietitians were not able to “provide [patients with] timely, cost-effective and evidenced-based nutrition services” (Rumsey, 2014) including vitamin prescriptions, certain diets or nutrition support. Under the new rule (effective May of this year), the registered dietitian nutritionist (RDN) or qualified nutrition professional may write the diet without direct approval from the physician. The final rule also provides clarification that privileges related to writing diet orders and ordering labs pertinent to nutritional status must be granted. Dietitians will only gain diet ordering privileges as determined by medical staff recommendations. Clinical authority for ordering...

Supermarket RDs Becoming More Popular Although some grocery stores have been employing RDs since the late 80s, it has become increasingly popular within the last few years.  Many grocery store chains have at least a few dietitians on staff through corporate, regional or contract. A survey completed last year by Progressive Grocer showed that 40% of all grocery stores have at least one dietitian on staff and finds it is a growing trend to employ RDS.  This article talks about the importance of having an RD working in a supermarket, by giving conventional grocery stores a competitive edge to the more specialized health food store.  As people becoming increasingly more aware of the link between a healthy diet and chronic disease they seek out more information on well-balanced diets.  In addition, people typically only see their doctors a couple times each year, and are often told to follow certain therapeutic diets.  To have an RD available while these people ...

Being able to have conversations with other people is a necessary skill in many different settings from the clinic to the soccer field to a business dinner. As a clinician, connecting with patients and creating a relationship of trust is important.   It is equally important to be able to talk to strangers at a networking event.   In preparation for FNCE the Food and Nutrition Magazine published an article titled “The art of talking to strangers”.   A few tips from the article, is to make personal connections at networking events, re-introduce yourself to people- do not assume they remember you, welcome others to join your conversation, and don’t be a complainer.   This article has many helpful ideas not only for networking events at conferences, but also as a guide for all social interactions.   To read more follow this link:   http://www.foodnutrimag-digital.com/foodnutrimag/fnce_2014?sub_id=tovk3pDhF8it&folio=10#pg12 AW

A challenge that many food service directors face is accommodating those with food allergies. This is especially an issue in schools, hospitals, and university dining halls. Allergies are becoming more and more common. I have been interning at a school for the last few weeks, and food allergies are a frequent problem that the food service director faces. It is important for food service directors and staff to understand the details of food allergies, because severe reactions to food allergies may even result in death. MenuTrinfo is a company from Colorado that is working with food service businesses to help teach them more about food allergies. MenuTrinfo offers a certification called AllerTrain U, which is a training course that teaches food service employees how to better accommodate for food allergies and celiac disease. Food service staff are provided with a clear understanding of food allergies, intolerances and sensitivities. MenuTrinfo is currently providing training to col...

           Over a five year period, 25% of fatalities resulting from food allergy anaphylaxis occurred while dining out. An estimated 15 million food allergic individuals in the United States and therefore restaurants have a greater responsibility to protect their patrons with food allergies. Restaurants are taking more responsibility by taking advantage of various education and training opportunities to become more informed and ensure consumer safety. National legislation requiring restaurants to follow standardized food allergy management policies does not exist; however activists have been lobbying for these requirements at state and local levels. Massachusetts was the first state to sign into law specific food allergy legislation in 2009 in conjunction with Food Allergy & Education. Rhode Island followed suit in 2013 and they are still implementing laws. New York City and St. Paul, Minnesota require restaurants to hang poster...

Though this article was issued in 2013 the information presented remains relevant. In this article, Denise Baird Schwartz, MS, RD, FADA, CNSC explored the effects of preventive ethics and impact of intravenous nutrition therapy at the end-of-life. Schwartz also discussed various strategies RDs can implement into their practices as a way to promote better healthcare delivery. Some examples of these strategies are illustrated below: 1.      Incorporate ethics in the decision-making process 2.      Promote conversations about nutrition with patients and their families 3.      Learn about cue-based patient/family discussion as a way to educate them about nutrition therapies 4.      Become aware of cultural diversity and health literacy 5.      Utilize the teach-back method to improve health literacy 6.      Practice preventive ethics to avoid future conflict...