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Journal of Nutrition Education and... Aug 2022To understand if a culinary medicine training program increases food literacy, culinary skills, and knowledge among practicing registered dietitian nutritionists (RDN).
OBJECTIVE
To understand if a culinary medicine training program increases food literacy, culinary skills, and knowledge among practicing registered dietitian nutritionists (RDN).
METHODS
Prepost study design evaluating pilot test of RDN train-the-trainer curriculum from September, 2019 to January, 2020.
RESULTS
On average, results indicate an increase in culinary nutrition skills (mean difference, 6.7 ± 4.4; P < 0.001; range, 10-30) and a significant increase in 5 of the 8 food literacy factors. Through process evaluation, RDNs rated the training as extremely useful to their practice (mean, 4.4 ± 0.3).
CONCLUSIONS AND IMPLICATIONS
Registered dietitian nutritionist participants increased culinary nutrition skills with statistically significant scores across all individual measures. This study describes an RDN training curriculum in culinary medicine across a diverse group of practicing RDNs from a large county health care system. Culinary medicine shows a promising impact on promoting nutrition skills and confidence; however, it warrants further assessment.
Topics: Clinical Competence; Curriculum; Dietetics; Humans; Literacy; Nutritional Status; Nutritionists
PubMed: 35644786
DOI: 10.1016/j.jneb.2022.04.001 -
Journal of the Academy of Nutrition and... Jan 2020The US health care system has been undergoing substantial changes in reimbursement for medical and nutrition services. These changes have offered opportunities and...
The US health care system has been undergoing substantial changes in reimbursement for medical and nutrition services. These changes have offered opportunities and challenges for registered dietitian nutritionists (RDNs) to bill for medical nutrition therapy and other nutrition-related services. During the past 10 years, the Academy of Nutrition and Dietetics has periodically surveyed RDNs providing medical nutrition therapy in ambulatory care settings to learn about their knowledge and patterns of coding, billing, and payment for their services. In 2018, the Academy of Nutrition and Dietetics conducted the latest iteration of this survey. This article compares the results of the 2008, 2013, and 2018 surveys to examine changes in RDNs' knowledge of billing code use and reimbursement patterns over time; understand the potential influences on coding and billing practices in a changing health care environment; and understand the effects of newer practice settings and care delivery models on billing and reimbursement for medical nutrition therapy services. Results from these surveys demonstrate that during the past 10 years RDNs' knowledge of billing and coding has been stable and very low for RDNs not in supervisory roles or private practice. RDNs reported an increase in providing medical nutrition therapy services to patients with multiple conditions. Since 2013, a dramatic increase was noted in the reported proportion of reimbursement from private/commercial health insurance plans. Results also indicate that most RDNs are not aware of changes in health care payment. Individual RDNs need to understand and be held accountable for the business side of practice and their value proposition in today's health care environment.
Topics: Adult; Clinical Coding; Delivery of Health Care; Dietetics; Female; Humans; Insurance, Health, Reimbursement; Knowledge; Male; Middle Aged; Nutrition Therapy; Nutritionists; Surveys and Questionnaires; United States
PubMed: 31353317
DOI: 10.1016/j.jand.2019.05.008 -
Journal of Allied Health 2022To explore the perspectives of dietitian assistants in a tertiary teaching hospital in Sydney, Australia, following the implementation of a formal competence and...
OBJECTIVE
To explore the perspectives of dietitian assistants in a tertiary teaching hospital in Sydney, Australia, following the implementation of a formal competence and professional development program.
METHODS
All currently employed dietitian assistants at a tertiary teaching hospital in Sydney were eligible to participate. Semi-structured interviews were undertaken by two student dietitians. Transcripts were returned to participants for interviewee transcript review and further clarification of information. Transcripts were qualitatively described.
RESULTS
A total of 9 dietitian assistants participated in interviews in October 2019. The average age of participants was 45.11 yrs (range 29-59) and 90% were female (n=8). The average length of employment was 197 months (range 3-516). Three themes emerged including: (a) new job satisfaction, (b) positive influence of the dietitian assistant educator, and (c) challenges of new processes and responsibilities.
CONCLUSION
A supported structured competence and professional development program has provided dietitian assistants with new skills and renewed job satisfaction. Further research should consider the impact of the newly developed skills of dietitian assistants on patient care and outcome measures.
Topics: Adult; Australia; Female; Humans; Middle Aged; Nutritionists
PubMed: 35239759
DOI: No ID Found -
PloS One 2023This study compares documentation and reimbursement rates before and after provider education in nutritional status documentation. Our study aimed to evaluate accurate...
This study compares documentation and reimbursement rates before and after provider education in nutritional status documentation. Our study aimed to evaluate accurate documentation of nutrition status between registered dietitian nutritionists and licensed independent practitioners before and after the implementation of a dietitian-led Nutrition-Focused Physical Exam intervention at an academic medical center in the southeastern US. ICD-10 codes identified patients from 10/1/2016-1/31/2018 with malnutrition. The percentage of patients with an appropriate diagnosis of malnutrition and reimbursement outcomes attributed to malnutrition documentation were calculated up to 24 months post-intervention. 528 patients were analyzed. Pre-intervention, 8.64% of patients had accurate documentation compared to 46.3% post-intervention. Post-intervention, 68 encounters coded for malnutrition resulted in an estimated $571,281 of additional reimbursement, sustained at 6, 12, 18, and 24 months. A multidisciplinary intervention improved physician documentation accuracy of malnutrition status and increased reimbursement rates.
Topics: Humans; Quality Improvement; Malnutrition; Nutritional Status; Physicians; Documentation; Nutritionists
PubMed: 37561733
DOI: 10.1371/journal.pone.0287124 -
Journal of the Academy of Nutrition and... Mar 2022No systematic, universally accepted method of diagnosing malnutrition in hospitalized patients exists, which may contribute to underdiagnosis, undertreatment, and poorer...
Academy of Nutrition and Dietetics Nutrition Research Network: Rationale and Protocol for a Study to Validate the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Consensus-Derived Diagnostic Indicators For Adult And Pediatric Malnutrition and to Determine...
No systematic, universally accepted method of diagnosing malnutrition in hospitalized patients exists, which may contribute to underdiagnosis, undertreatment, and poorer patient outcomes. To address this issue, the Academy of Nutrition and Dietetics is conducting a cohort study to: assess the predictive validity of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition indicators for the diagnosis of adult and pediatric malnutrition in hospital settings; assess the interrater reliability of the indicators for the diagnosis of adult and pediatric malnutrition; and quantify the level of registered dietitian nutritionist care needed to improve patient outcomes. Up to 60 adult and 60 pediatric hospital sites will collect data to estimate level of registered dietitian nutritionist care, along with patient medical history and Malnutrition Screening Tool (adult) or STRONGkids (pediatric) results. A subset of 600 adult and 600 pediatric patients (∼1:1 screened as high- or low-risk for malnutrition) will be randomly selected for the indicators for the diagnosis of adult and pediatric malnutrition and Nutrition Focused Physical Exam data collection; 100 adult and 100 pediatric patients in this group will also undergo a bioelectrical impedance analysis measurement. Additional nutrition care and medical outcomes (eg, mortality and length of stay) will be collected for a 3-month period after the initial nutrition encounter. Multilevel linear, logistic, Poisson, or Cox regression models will be used to assess indicators for the diagnosis of adult and pediatric malnutrition validity and registered dietitian nutritionist staffing levels as appropriate for each medical outcome. Validation results will allow US clinicians to standardize the way they diagnose malnutrition in hospitalized patients, and the staffing data will support advocacy for available registered dietitian nutritionist-delivered malnutrition treatment to improve patient outcomes.
Topics: Humans; Academies and Institutes; Cohort Studies; Hospitalization; Inpatients; Malnutrition; Medical Staff, Hospital; Nutrition Therapy; Nutritionists; Outcome Assessment, Health Care; Reproducibility of Results; Societies, Medical; Workforce; Observational Studies as Topic; Multicenter Studies as Topic
PubMed: 33962901
DOI: 10.1016/j.jand.2021.03.017 -
Nutrition, Metabolism, and... Apr 2022It is well accepted by the medical literature that polycystic ovary syndrome (PCOS) is an extremely heterogeneous condition and that a multidisciplinary approach,...
It is well accepted by the medical literature that polycystic ovary syndrome (PCOS) is an extremely heterogeneous condition and that a multidisciplinary approach, involving gynecologists, endocrinologists, primary healthcare providers, mental health professionals, and nutritional professionals, especially dietitians, is fundamental to provide an immediate care and to counteract long-term risk factors related to the comorbidity of PCOS. Although lifestyle modifications are the first step intervention in the treatment of PCOS, unfortunately, the involvement of dietitian in clinical practice remains sporadic. The goal of this viewpoint is to put a greater emphasis on the role of dietitian in the management of PCOS by highlighting frequently faced difficulties in the clinical settings and the importance of a three-step nutritional care: accurate assessment; lifestyle, nutritional, and supplementary intervention; long-term follow-up. The intention is to raise awareness among dietitians themselves and other health providers as well as to express an exceeding necessity of evidence-based guidelines formulated specifically for nutritional professionals, which would allow a uniform approach with respect to heterogeneity and complexity of PCOS at the international level.
Topics: Endocrinologists; Female; Humans; Life Style; Motivation; Nutritionists; Polycystic Ovary Syndrome
PubMed: 35168829
DOI: 10.1016/j.numecd.2022.01.003 -
Journal of the Academy of Nutrition and... Jun 2020The Academy of Nutrition and Dietetics (Academy) develops and maintains foundational documents that apply to all registered dietitian nutritionists (RDNs) and nutrition...
The Academy of Nutrition and Dietetics (Academy) develops and maintains foundational documents that apply to all registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs): Scope of Practice for the RDN and NDTR; Standards of Practice in Nutrition Care and Standards of Professional Performance for RDNs and NDTRs; and the Academy and the Commission on Dietetic Registration Code of Ethics for the Nutrition and Dietetics Profession. The Quality Management Committee of the Academy has developed resources that assist RDNs and NDTRs in understanding how to work to the fullest extent of their individual scope of practice to increase professional satisfaction, achieve future employment and position goals, and provide safe and reliable services. These resources are the definition of terms list, practice tips and case studies, and scope of practice decision algorithm, which build on Academy foundational documents. They support quality practice by answering questions such as "how can I become more autonomous in my practice" and "how can I use telehealth technology in my practice?" The foundational Academy documents and practice application resources assist all RDNs and NDTRs in recognizing their individual competence and practicing within their scope of practice.
Topics: Academies and Institutes; Clinical Competence; Codes of Ethics; Dietetics; Humans; Nutrition Therapy; Nutritionists; Standard of Care
PubMed: 32446565
DOI: 10.1016/j.jand.2020.03.003 -
Journal of the Academy of Nutrition and... Nov 2022Only 13.1% of US registered dietitian nutritionists and 27.8% of students enrolled in US dietetics education programs identify as racially/ethnically diverse... (Review)
Review
Only 13.1% of US registered dietitian nutritionists and 27.8% of students enrolled in US dietetics education programs identify as racially/ethnically diverse individuals. National demographic trends show increasing percentages of racially/ethnically diverse individuals within the broader US and college student populations; however, these changes have not been mirrored within dietetics. Dietetics educators have an ethical and professional mandate to address diversity, equity, and inclusion within their programs. This paper reviews key terminology related to diversity, equity, and inclusion in the context of dietetics education, and describes a new framework to transform dietetics education based on the principles of cultural humility and culturally sustaining teaching. Strategies are presented to facilitate recruitment, admissions, retention, and mentorship for racially/ethnically diverse students and faculty, and to improve diversity, equity, and inclusion within curricula and classrooms. Lastly, this paper provides clear practice applications, including recommendations for program policy change and training/skill building activities for dietetics students, educators, and preceptors.
Topics: Humans; Dietetics; Nutritionists; Students; Food; Faculty; Cultural Diversity
PubMed: 34366238
DOI: 10.1016/j.jand.2021.06.302 -
Journal of the Academy of Nutrition and... Nov 2019
Topics: Career Choice; Dietetics; Family; Humans; Nutritionists
PubMed: 31655716
DOI: 10.1016/j.jand.2019.09.002 -
Journal of Renal Nutrition : the... Nov 2023Recent surveys highlight gross workforce shortage of dietitians in global kidney health and significant gaps in renal nutrition care, with disparities greater in... (Review)
Review
BACKGROUND
Recent surveys highlight gross workforce shortage of dietitians in global kidney health and significant gaps in renal nutrition care, with disparities greater in low/low-middle income countries.
OBJECTIVE
This paper narrates ground experiences gained through the Palm Tocotrienols in Chronic Hemodialysis (PaTCH) project on kidney nutrition care scenarios and some Asian low-to-middle-income countries namely Bangladesh, India, and Malaysia.
METHOD
Core PaTCH investigators from 3 universities (USA and Malaysia) were supported by their postgraduate students (n = 17) with capacity skills in kidney nutrition care methodology and processes. This core team, in turn, built capacity for partnering hospitals as countries differed in their ability to deliver dietitian-related activities for dialysis patients.
RESULTS
We performed a structural component analyses of PaTCH affiliated and nonaffiliated (Myanmar and Indonesia) countries to identify challenges to kidney nutrition care. Deficits in patient-centered care, empowerment processes and moderating factors to nutrition care optimization characterized country comparisons. Underscoring these factors were some countries lacked trained dietitians whilst for others generalist dietitians or nonclinical nutritionists were providing patient care. Resolution of some challenges in low-to-middle-income countries through coalition networking to facilitate interprofessional collaboration and task sharing is described.
CONCLUSIONS
We perceive interprofessional collaboration is the way forward to fill gaps in essential dietitian services and regional-based institutional coalitions will facilitate culture-sensitive capacity in building skills. For the long-term an advanced renal nutrition course such as the Global Renal Internet Course for Dietitians is vital to facilitate sustainable kidney nutrition care.
Topics: Humans; Nutritional Status; Delivery of Health Care; Surveys and Questionnaires; Renal Dialysis; Kidney; Nutritionists
PubMed: 37597574
DOI: 10.1053/j.jrn.2023.08.003