Connections UPDATE! Volume 13, Number 3, Spring 2012

FROM THE CHAIR Dear Members: We have chosen this issue of the UPDATE! to highlight our involvement as dietitians in emergency planning. I am sure each of us has a story to tell, each of us has been in a situation where we had to move forward quickly with planning and crisis management. If you have not, unfortunately one day you will need the skills and insight these two articles

talk about. Frequently on our member email Forum, questions are asked about emergency menus, planning and staffing. These two articles give you information about those processes. Our latest edition of the Pocket Resource for Management, 2011 edition includes a chapter on Emergency and Disaster Planning. This chapter includes information on types of disasters, menus, resources and suggested emergency supplies. This tool can be purchased on our website. The Executive Committee (EC) has determined that this is such an important topic that our Chair-Elect Barbara Wakeen, MA, RD, LD, CCFP.CCHP, has planned the pre-FNCE workshop to include a session on Disaster Planning and a panel on actual experiences and lessons learned. My own experiences in emergency planning and disaster management have spanned many years and have included floods, electrical outages, hurricane evacuations, and losses by forest fires. I have learned that I still don’t know everything; that each year, twice a year we spend time with facility staff about water storage, emergency food, in-services on simulated disasters and cooking. I suggest you find other communication systems besides calling on cell phones- texting often works better, walkie- talkies are invaluable. Make sure all staff understands that in an emergency it is “all hands on deck.” The care and safety of our residents and patients come first. If that means we wash dishes, cook or transport water, these are things we do. Be prepared that staff will say, I can come, but I need to bring my children or my parent. Decide if you need their help and can handle the extra burden of children or older parents in a safe room; don’t make staff decide between your residents or patients and/or their family in disaster situations. Plan your emergency supplies to include the extra water and food supplies for staff and families (if needed). In Texas, we have learned that we must be prepared to evacuate a large number of people over large distances to get them out of the way of approaching hurricanes. Be prepared for these evacuations by having individual portions of soft foods, pureed foods, water and snacks available for use in buses and vans. Work with nursing to plan for portable tube feeding choices that include water, formula and products. Search your state’s website for regulations about emergency planning, check the Governor’s Office website, look at sites other than long term care and hospital regulations for state and federal updates. We would like to thank Blue Bunny for sponsoring this issue of UPDATE! The EC hopes that this information will be useful to you and you will add it to your references. We wish you well. Cynthia Piland, MS, RD, CSG, LD Chair, Dietetics in Health Care Communities

You can serve NUTRIplus™ Supplemental Ice Cream directly from the freezer (no waiting) or at room temperature, where it takes on a pudding consistency to aid swallowing. Either way the goodness of real ice cream loaded with nutrients will boost your patients’ nutrition and their spirits.

Learn more at foodservice.bluebunny.com or call 1-800-807-8221.

IntroducIng nutrIplus™ Supplemental Ice cream

How can SometHIng tHIS good be tHIS good?

™

© 2011 Wells’ Dairy, Inc. All rights reserved.Cherry Chocolate

Are you ready for Disaster? Kim Fremont, MS, RD, LD

All consultants fear that call, "A disaster has occurred: we've been flooded, hit by a tornado or a hurricane is coming". In the past 5 years, multiple disasters of significant proportions have hit our country and healthcare facilities. Hurricane Katrina flooded healthcare facilities as did the floods in Indiana just 2 years ago. Last year Joplin, MO, was hit by an F-5 tornado that destroyed one hospital, 3 long term care (LTC) facilities and damaged many more. Facilities were suddenly thrust into the position of either evacuating or taking in a sudden influx of residents.

Not long ago our office received an urgent call for help. One of our client facilities was quickly being overtaken by rising waters. They described themselves as a castle surrounded by a moat. No one could get in or out. They suddenly had a critical situation on their hands; how they would feed and provide water to staff and residents until help could arrive.

The time to decide how you will handle a crisis or disaster is before it strikes not after. Good planning can go a long way to minimize the stress and keep everyone safe.

"The United States Centers for Disease Control (CDC) determined that the elderly accounted for only 15% of New Orleans’ 2005 population, but 70% of the deaths from Hurricane Katrina. In addition, at least 139 storm-related fatalities were reported from nursing homes as a result of Katrina. The disastrous storms of 2004-05 highlighted the consequences of the planning failure to integrate nursing homes into a national disaster response system." from: Caring for Vulnerable Elders During a Disaster: National Findings of the 2007 Nursing Home Hurricane Summit May 21 - 22, 2007 St. Petersburg Beach, Florida, convened by the Florida Health Care Association.

This clearly points out that all LTC facilities must plan for any type of disaster. Planning guides give these critical steps for proper planning:

1. Communication systems to all personnel

2. Staffing planning for a reduced workforce

3. Emergency supply planning

4. Emergency menu planning

5. Identification of resources and suppliers for an emergency

6. Comprehensive policies and training of all staff on roles and responsibilities in an emergency

Step one: Set Up a Communications System

In the first step, identify all the types of communication systems that will be needed. This usually starts with the formation of a committee to develop the crisis management plan.

ServSafe® recommends to first identify the types of crisis/disasters that could affect the food service operation. For example, the Midwest is prone to floods and tornados but does not have to worry about a hurricane or a tsunami. All facilities should be prepared for flu, pandemics and possible tampering of the food supply.

Next identify a list of contacts for the following:

Staff Food suppliers Emergency agencies: Federal Emergency Management Agency (FEMA), Red Cross, health

department etc.

The crisis management committee should write a plan on how staff will be notified in the event of a disaster, and identify each staff member’s roles and responsibilities. Dining services should determine a chain of command (COC) to run operations in the event of an emergency and provide a checklist of items "to do" if an emergency were to occur. To insure coordination (remember during an emergency events change quickly and it is a chaotic environment; even simple decisions can be hard to facilitate. The COC of dining services would report to the overall command of the facility.

Food and water are basic survival needs and communication is vital to insure proper use of resources. There is no more dramatic example of this than Hurricane Katrina. No one will ever forget the images of so many people in hospitals, shelters and the like without basic food and water needed for survival.

Step Two: Identify Staff Resources Available In an Emergency

In the second step, identify staff available to work to keep basic functions running. For example a disaster at night (when there is less staff at the building) will require mobilization of available staff to be called in vs. a disaster during the day when most staff are already at the facility. Pandemic illness may mean that many in the work force might also be affected; therefore not available, so plans for staffing must include how to cope with a drastically reduced work force. Each type of disaster should be evaluated for the anticipated amount of staff available along with a contingency plan for a drastically reduced force.

Step Three: Evaluate What Resources for Food, Water and Power Would Be Available During an Emergency

The third step is to plan for the resources of food and supplies. The evaluations should review what is routinely available on hand in normal supplies plus evaluate for each type of emergency/disaster what would be needed in a secure, dedicated emergency supply. The question is, does the facility have enough food, potable water, chemicals and paper supplies to be self sufficient for three (3 )days? A checklist can be used to answer the question what resources do you have?

Disaster Preparedness Plan Template for Long Term Care Facilities EMERGENCY CHECKLIST DIETARY/FOOD SERVICES DATE: _______________________ TIME: ___________________ Completed Initials _________ ______ 1. Check water and food for contamination. _________ ______ 2. Check refrigeration loss if refrigerator or food lockers are not on emergency power circuit. _________ ______ 3. Recommend 7 – 10 day supply of food storage for residents and staff. _________ ______ 4. Ensure availability of special resident menu requirements. _________ ______ 5. Assess needs for additional food stocks. _________ ______ 6. Secure dietary cart in sub-dining room or small, enclosed area. _________ ______ 7. Assemble required food and water rations to move to evacuation site, as necessary.

Signature:_______________________(Source: Missouri Department of Health: Disaster Planning)

Make a grid for the supplies on hand for each type of disaster. Also have access to what type of power is available for each type of disaster and the implications on the staffing, cooking and menu that will be needed for that type of disaster.

Kitchen Resource Survey Form (Adapted from Public Health Agency of Canada: Emergency Food Service Manual) Facility:_____________________________________________________ Address of __________________________________________________ Telephone __________________________________________________ In Case of Emergency _________________________________________ Manager - Name ______________________________________________ Address - Telephone ___________________________________________ Personnel Number Maximum Capacity for Meals Prepared per Hour - cooks _______________ 1- 50 _______________ - assistant cooks _______________ 50- 100 _______________ - servers _______________ 200- 500 _______________ - dishwashers _______________ 800- 1000 _______________ - cleaners _______________ 1000+ _______________ Energy Sources Capacity Functional Kitchen Equipment Electricity Gas - ovens - steamers - hot plates - coffee urn - kitchen range (stove) Warehouse Quantity Capacity Functional - reserve (dried foods) - refrigerators - cold rooms - freezers Food Service - meal covers - serving utensils - counters - serving tables - trays - miscellaneous Type of Seating ________________________________________________________________ Maximum Capacity (seating) __________________________________________________________________

Date: __________ Signature:__________________________________________

Most facilities contract to have an outside agency supply water in the event of a loss of potable water supply. However, as our client facility and Hurricane Katrina demonstrated, some disasters will prevent help or suppliers from getting to the facility quickly. Federal and State Disaster planning manuals seem to agree that 1 gallon of water per person per day (resident and staff and any ancillary guests or personnel must be accounted for) is needed for drinking. Bottled water should be kept on site in a safe, cool location and rotated every 6 months or in accordance to dating on the container. A back up plan would be to be prepared to purify or boil water to create potable (water that is safe to drink) water. Remember in the event of a disaster that interrupts the water lines all ice should be considered contaminated and to plan for a three (3) day supply.

Water Purification: Boiling (From Missouri Disaster Guide for LTC)

Contaminated water should be allowed to sit before boiling to permit suspended particles to settle to the bottom. The water should then be filtered using several layers of paper towels or clean cloth.

Boiling is the safest method of purifying water and ensures destruction of bacteria and some protozoan organisms such as Giardia and Cryptosporidium that are resistant to chemical sanitizers.

Water should be brought to a rolling boil for ten (10) minutes and allowed to cool. Water should be dispensed promptly into clean, sanitized containers and tightly sealed.

Caution: If water has been contaminated by a chemical spill disaster, boiling will not remove chemicals.

Water Purification: Chlorine It is not necessary to treat water for storage, if the water comes from a safe water supply. If stored properly, this water should have an indefinite shelf-life, but you may want to rotate and replace this water every 6-12 months with fresh, safe water.

To kill and prevent the growth of microorganisms, purify water with liquid bleach that contains 5.25 percent sodium hypochlorite and no soap. Some containers warn, “Not for Personal Use.” You can disregard these warnings if the label states sodium hypochlorite is the only active ingredient and if you use only the small quantities in these instructions.

Purification of Drinking Water With Chlorine Bleach*

Type of Water

Chlorine Bleach Amount of ChlorineBleach to Purify

Time Requiredfor Treatment

Clear/Cloudy 5.25% 4 drops/quart 30 minutes

Waterbed 5.25% 1/4 cup / 120 gallons 30 minutes

*Chlorine bleach should have sodium hypochlorite (5.25%) as the only active ingredient.

Water Purification: Iodine Iodine is available as tablets and as “Tincture of Iodine.” Use one (1) iodine tablet per quart of water; two (2) tablets per quart if water is cloudy. “Tincture of Iodine” should have 2% U.S.P. iodine (read label). If concentration is weaker or stronger than 2%, adjust amount to be added by the following formula: Drops of Iodine = 80 per GALLON (%tincture of iodine)

Purification of Water With Iodine - 2 Percent U.S.P.

Type of Water

Amount of 2%U.S.P. Iodine per Gallon

Time Requiredfor Treatment

Clear Water 2 drops 30 minutes

Cloudy Water 40 drops 30 minutes

Seal container holding iodine-treated water, let stand 30 minutes. This water supply is safe for an indefinite period. Avoid recontamination after opening.

Step Four: Plan a Menu for No Power and No Water

The fourth step is to have a menu for each type of disaster. The menu must be planned to account for special needs such as allergies, textures and special diets for example: gluten free that cannot be suspended during a crisis. The stock for this menu should be kept in a secure place, labeled and rotated every 6 months. Some facilities use the changing of the clocks for daylight savings time as a reminder to rotate the emergency supply stock. The stock should be isolated from regular supplies and clearly labeled that it is for "emergency use only." Sources vary on the amount of supplies needed from one day to three days. The Federal Homeland Security Agency recommends that all health care facilities prepare to be self sufficient for a minimum of three (3) days. In the event of a crisis that interrupts the power supply the general rule is to use all cold foods in the refrigerator first. Temperature of potentially hazardous foods should be verified as less than 41° or if above 41° not for more than 4 hours. If there is any doubt or it cannot be verified that cold foods have been out of the danger zone for 4 hours or less they should not be used and be discarded. Supplies from the freezer are used next after performing the same temperature and safety check, and last the emergency supply is used. At a minimum, menus are generally written to assume no power no water. The water supply for cooking will come from the emergency supplies unless safety of the facility water source is assured. If there is power or water, the menu can easily be prepared using the available resources or by using normal everyday working supplies. Sample policies and menu are available in the DHCC "Survival Skills for Nutrition Services" 2006, page 156-162. Step Five: Identify Emergency Suppliers In this step the facility will identify suppliers that will provide additional water, food, refrigeration equipment and paper and chemical supplies in the event of an emergency. It is customary to have a main supplier and back up to use if the main supplier is compromised during the emergency. Step Six: Plan Out Policies and Train All Staff on Roles and Responsibilities During an Emergency This might be the last step but is the most critical. Panels of experts that have studied crisis situation such as Katrina found problems with lack of planning and training that led to poor outcomes during the crisis. The time to plan is before the crisis hits. Dry runs and inservice education on a periodic basis are vital. A trained work force using a practiced and well thought out plan can minimize additional stress, injury and even deaths in the event of a natural or man made emergency. A disaster plan is not a book on a shelf but a document that every staff member should have a working knowledge of where to locate the plan and how to execute their role. There are many sources on the web to assist in creating a comprehensive disaster plan including the following: Red Cross: Preparedness Tips http://www.redcross.org/preparedness/cdc_english/foodwater-1.asp Building an Emergency Kit: FEMA http://www.ready.gov/build-a-kit Spring into action, dust off that manual, and make sure the facility has a working and comprehensive plan for any type of disaster. Wondering what would be a good inservice this spring? How about a simulated disaster and put that emergency menu into use. This will quickly demonstrate how prepared the staff is to confront a crisis. Hopefully it will never be needed but as recent events have shown, a well thought out and

executed plan can literally save lives. So the question is are you ready for a disaster? Now is the time to find out! References: FNS Disaster Assistance http://www.fns.usda.gov/disasters/disaster.htm National Food Safety Council: National Recommendations for Disaster Food Handling http://fycs.ifas.ufl.edu/foodsafety/HTML/tn001.htm FEMA: How do I get food, water in a disaster http://www.fema.gov/rebuild/recover/foodandwater.shtm RD411 Checklist for Disaster Planning www.RD411.com Servsafe: Crisis Management Servsafe Essentials: Fourth Edition pages 10-12 to 10-18 Kim Fremont currently serves as Vice President of Health Technologies, Inc. and is responsible for all aspects of nutritional consulting to 820 long term care facilities and hospitals in multiple states and 125 registered dietitians. She can be reached at kfremont@ht-ss.com.

“The Corrections Survey” Joe Montgomery, MS, RD, LDN, CCFP. DHCC – Chair of Corrections Sub-Unit

A perceived wide variety of techniques and methods utilized in the development and review of correctional menus over a period of time (especially in contract feeding) has led to a desire to see if there were any prominent commonalities evident which would lend themselves to the development of common standards being used in the development and analysis of nutritionally adequate correctional menus. In an effort to develop a method to review this issue, members of the Dietetics in Health Care Communities Dietetic Practice Group (DHCC), through the Corrections Sub-Unit members, Association of Correctional Food Service Affiliates (ACFSA) Dietitians in Corrections members and many others worked hard to develop the “Menu and Nutrition Standards Survey” this past summer and fall. The support and sponsorship of Dietetics in Health Care Communities (DHCC) helped to get this survey disseminated with the electronic support from Survey Monkey. The primary goal was to review the findings to see if there were and strong commonalities present that would help in the development of a review tool to evaluate the standards and methods used in creating and reviewing of menus utilized in the correctional setting at any jurisdictional level. During survey development the survey scope took on an expanded role and became much larger than originally anticipated with questions dealing with operations as well as nutrition. The full article can be found at: http://www.dhccdpg.org/about-dhcc/corrections-subunit/

Good Night Irene and Everything In Between – One Nursing Home Company’s Hurricane Experience Kathy Weigand, RD, LD/N Corporate Director of Nutrition Services Consulate Management Company

Having lived in Florida for almost 20 years – and being employed in long term care for most of that time - I have learned much about preparation for, and dealing with, the inevitable hurricanes. Working for a nursing home chain with multiple facilities in Florida, Virginia and Delaware (among other locations), it was only a matter of time before potential disaster came knocking on the door. In August of 2011, Hurricane Irene made her way to the East Coast of the United States. The company rejoiced when it appeared that Irene was going to bypass the state of Florida; however, it soon became apparent that facilities in the Tidewater area of Virginia would not be so lucky. In the early morning hours of August 27th, Irene made landfall on the Outer Banks of North Carolina, then headed up the coast to the Norfolk, VA area. Consulate operates several facilities in the Eastern VA/Tidewater area, but as we watched the hurricane track and gathered the reports from NOAA every 4 hours, it appeared that the two locations in Norfolk had the greatest chance of being directly affected. Envoy of Thornton Hall, with 60 skilled and 12 assisted living beds, sits very close to the water with those residents determined to be at greatest risk. We, therefore, made plans to evacuate as the storm grew closer. Complicating things was the fact that the main routes out of Norfolk are through tunnels under the water which would soon be closed by the state. After numerous conference calls involving the Florida-based corporate staff, Virginia regional staff and facility personnel, arrangements were made for transportation for residents and supplies to a sister facility farther inland. This had to be accomplished very quickly once the final decision was made, in order to avoid the congestion on the roads. We did not want our frail residents to spend hours on uncomfortable buses if the trip could be made more expediently. The actual evacuation and transport of residents went fairly smoothly, with residents excited about their “adventure.” The dietary staff, led by the Regional and Multi-Facility Dietitians, prepared sack lunches for residents to take with them on the bus. Nursing personnel accompanied the residents to attend to their immediate needs, while other staff followed in their personal vehicles. The Dietitians transported the emergency non-perishable food supply in their SUVs. Once the residents arrived at the receiving facility, they were settled in the common areas (dining room, rehab gym, etc.), and made as comfortable as possible, where they rode out the storm that night. The Dietary Manager and several of staff drove their personal vehicles and stayed with the residents to ensure that they were properly fed and hydrated. (The company later presented these staff members with recognition awards for this dedication). Unfortunately, the receiving facility lost power that night due to the high winds. The emergency generator supplies power to the resident rooms, but not to the common areas where the visiting residents were housed which created very warm conditions. The staff was vigilant and offered hydration continuously from the facility’s beverage supply and the emergency water that had been brought along from Thornton Hall. The next day, Sunday, August 28th, the storm had passed and was moving up the coast toward New Jersey. Plant Operations staff checked on the Thornton Hall building and discovered it in good shape. The water

had not reached the building and the structure was intact. Residents were brought back to their home as quickly as possible. The whole “adventure” lasted not much longer than 24 hours. In retrospect, the company could have taken the chance and not evacuated this facility. Irene had decreased from a Category 3 storm to Category 1 by the time she made landfall in Virginia. However, we felt that we had made the best possible choice at the time given the information we had and the potential for greater damage if things had gone differently. It was wonderful to watch the teamwork that just naturally occurred when everyone was informed of the plan. Nursing, Dietary, Plant Operations, Regional and Corporate Staff all working together to ensure resident safety in the face of a disaster. Not one resident suffered any harm or injury during the transport and time away from their home. Everyone involved was commended for a job well done. With this being said, here are some tips and recommendations for those living in geographical areas with the potential for a hurricane situation:

- Have enough non-perishable food on hand to feed residents an adequate diet for as many days as your state requires. Virginia requires 3 days; Florida 7 days. The Federal and State regulations specify non-perishable food, although many do use the food in their refrigerator and freezer for the first 1-2 days, if able. * Remember that this food must be transported with the residents in an evacuation situation.

- Have a pre-planned menu, with food quantities calculated for the census. Foods should be items that can be eaten cold if cooking facilities are not available. While the main object is to nourish residents, the emergency food supply should be edible and palatable. It is OK to have some repetition if you are serving foods that residents will truly consume.

- If you don’t have the required amount of non-perishable food on hand, obtain what you need during the hurricane watch period. This is one of the few disaster situations for which we actually have warning/time to prepare. * Keep in mind that the trucks that transport food from the distributors (i.e.: U.S. Foods, Sysco, Gordon Food Service) are not permitted to be on the roads if the winds are greater than 45 mph.

- Include canned pureed meats and vegetables in your emergency food supply. Most food distributors stock these or they are available as special order items. * Another way of having pureed food on hand is to prepare in advance and store in the freezer or refrigerator in plastic food storage bags.

- Think about the type of milk/dairy you include in your emergency food supply. Powdered dry milk and evaporated milk will require some of your emergency water for reconstitution. The canned, shelf stable (i.e., Parmalat™, etc.) milk is a good option, as it is usable straight out of the can, without the need for dilution.

- Make sure you have enough disposables (plates, Styrofoam trays, plastic utensils, cups, etc.) for the entire 3 or 7 day period. Because these items come in large, hard to store, boxes, many people tend to skimp and not have enough of these items immediately on hand.

- Know which areas and equipment are connected to the emergency generator and will still be operable when the power goes out. If you are lucky, the walk-in cooler and freezer will be in this category. * Know also how many “red plugs” you have in the kitchen. These are outlets that are powered by the generator. You may be able to use your food processor, toaster and other small equipment by plugging them into these outlets.

- Know how much emergency water is required by your state or area. Each county emergency management office can generally tell you the minimum requirement per resident in your geographical location. It is a good practice to have a portion of the total required water physically on hand, with a specific plan in place to obtain the rest, i.e., from your dairy company, foodservice distributor, or water company. Water “bladders” are available, ranging from 5 to 25 gallons that can be filled in advance. If you have a clear-cut water plan or policy that is communicated to all staff, there should be no confusion or shortage when a disaster strikes. Having the partial supply on hand will ensure resident hydration in the event of an unexpected water issue and will give you time to obtain more from a supplier or local store.

- Each facility should have an “A” and “B” team designated. The staff on the “A” team assists with the preparation as the hurricane is approaching. These individuals also stay with the residents, either in their facility or accompanying them to the evacuation site. The “B” team staff relieves the “A” team once the immediate storm/danger is passed and assists with the cleanup and aftermath.

- Remember to include the staff that will be staying with the residents in your calculations for emergency food and water as well as their family members if the facility allows them to be there.

- Finally, one piece of non-food advice: Have extra towels or linens on hand for placement on hallway floors that will become slick with condensation when the air conditioning is non-functioning. During this time, staff safety should be part of the thought process.

Kathy Weigand is Corporate Director of Nutrition Services for Consulate Management Company, overseeing food and nutrition services for 191 skilled and assisted living facilities in 20 states. She can be reached at magic54@msn.com.

Nutrition Informatics: The Intersection of Information, Nutrition, and Technology Health care reform and patient care delivery are on the fast track in the United States because of recent legislation and several landmark documents. As a result, health care professionals, including registered dietitians (RDs) and diet technicians registered (DTRs), as well as vendors, government organizations, and many associations, such as Academy of Nutrition and Dietetics (formerly the American Dietetic Association [ADA]), are stepping on the gas to keep up with all the changes that are taking place. Nutrition education resources, the ability to search for information, and technology skills have seen significant changes since the time when computer systems were introduced many decades ago. As other professions began to recognize the importance of “informatics” as it applied to their area of practice, so did ours. In 2007, ADA formed the Nutrition Informatics Work Group, which defined “nutrition informatics.” The formal definition, based on an established definition for biomedical informatics, is:

In 2010, in recognition of the importance of ongoing work in this area, the Nutrition Informatics Work Group became the Nutrition Informatics Committee (NIC). The NIC translated this formal definition into a simple line, 140 characters in length: Even before the formation of the Nutrition Informatics Work Group and NIC, ADA was taking steps to position the dietetics profession in the informatics arena. Beginning in 2002, the International Dietetics and Nutrition Terminology standardized language for nutrition professionals, the Nutrition Care Process and Model, and the Evidence Analysis Library were developed, all reflecting the use and value of nutrition informatics in dietetics practice. Present Implications This is an exciting time as health care professionals look at the ways informatics will impact their profession and individual areas of practice. In fact, many dietitians – whether educators, researchers, businesspersons, or consultants--already use informatics without even realizing it. Here are some examples:

Clinical dietitians use electronic health records (EHRs) to assess, diagnose, and implement appropriate care plans and track outcomes

Management dietitians use informatics to manage personnel, budgets, food procurement, production, inventory, and delivery of meals

Community dietitians use databases to provide up-to-the-minute global public health surveillance and to monitor disease outbreaks around the world

Businesses and consultants take advantage of social media to brand themselves, their services, and their products, using blogs, portals, and tweets on a daily basis

“The effective retrieval, organization, storage, and optimum use of information, data, and knowledge for food and nutrition related problem solving and decision making.” 

“Nutrition informatics is the intersection of information, nutrition, and technology.” 

Researchers use informatics for accessing databases, developing protocols, capturing data, and submitting research

Educators have access to online applications and networking, with simulation and newer technologies replacing PowerPoints and lectures in the classroom

Health care is moving toward “data following the patient” and the expectation of “interoperability” of data between and within EHRs. However, as health care professionals witness the exciting changes that are taking place, they also must recognize the importance of protecting individuals’ privacy and security. Like all health care providers, it is necessary to abide by the Health Insurance Portability and Accountability Act (HIPAA) regulations, sharing a person’s information only through secure, encrypted, and/or password-protected means of communication. Future Implications Health care professionals are not the only ones who will use information and technology to diagnose and treat illness. Portable electronic devices and other forms of mobile health (mHealth) help patients play an active role in their care. Sensors are available to allow individuals to report important information about their blood pressure or blood glucose directly to their health care provider. They even can enter information about the lunch they just consumed and send it to their dietitian via a picture or a portal. Resources All of these changes will require collaboration at all levels of health care and education. Just keeping up with the vocabulary alone can seem overwhelming. Legislation and initiatives like the Health Information Technology for Economic and Clinical Health (HITECH) Act, Technology Informatics Guiding Educational Reform (TIGER), and Meaningful Use may not have seemed relevant to dietetics practice at first. RDs and DTRs are quickly learning how important each of these is to our profession and how critical it is to keep up with the latest developments. More and more Academy members are regularly reading Eat Right Weekly so they don’t miss important and timely updates. To help keep you on the fast track, the Academy has many resources available. Here are just a few:

Nutrition Informatics Blog

Nutrition Informatics On-Line Community

Academy/AMIA 10x10 introductory biomedical informatics course

EHR Toolkits Summary The United States is moving toward an electronic health care system at an extremely rapid pace. Because of their education and experience in many areas of practice, RDs and DTRs are well positioned to participate in this exciting transformation. The Academy also is working at many levels to help RDs and DTRs embrace the idea of nutrition informatics. The intersection of nutrition, information, and technology will provide the opportunity for RDs and DTRs to help reduce costs, reduce errors, and provide better care, regardless of area of practice. Academy members are welcome to join the on-line Nutrition Informatics Community, where sharing of information and ideas is welcomed and encouraged.

WEBINAR UPDATE

You asked and we listened! Respondents to the member survey asked for an evening webinar. Response was overwhelming!

Nutrition Care Process will be the topic in May; Home care will be the topic in June—further details will be sent in an e-blast from DHCC as well as being posted on the Web site.

Missed a webinar? Don’t forget that archived webinars can be viewed at any time. Topics include

Taking Care of Family-Being a Partner

Pressure Ulcers: Are They Avoidable and More

Challenges and Benefits of Nutrition in Home Care

Gluten Free

Technology, Informatics, EMR/PHR and Apps…Here Comes the Wave

MDS 3.0: Where Are We Now and What Changes Are Coming?

Good Communication: The Key To Successful Management

 

 

 

 

 

DHCC EVENTS AT FNCE

As always, DHCC will be busy at FNCE in Philadelphia, PA, with activities for members. More details will be forthcoming as they become available. Watch for more information! Saturday, October 6 – DHCC PreFNCE Workshop: Are You Ready? Sunday, October 7, 6-9 pm – Joint Member Reception aboard the Spirit of Philadelphia with the Renal Dietitians DPG Sunday through Tuesday - DHCC Booth on the Exhibit Floor Monday, October 8, 10:30 am – 1 pm - DPG/MIG Showcase at the Convention Center Dates to be determined for Corrections Sub-unit Meeting, Home Care Sub-unit Meeting and CMS Meeting  

 

DHCC Member Awards

Do you know an exceptional DHCC member who deserves recognition? DHCC sponsors awards to recognize these members. The application deadline for all is May 1, 2012 unless otherwise noted. Applications may be found on the DHCC Web site www.dhccdpg.org (sign in), Self-nominations are accepted. Abbott Leadership Award The Abbott Leadership Award is one of the highest honors the practice group can grant to members never having served on the DHCC Executive Committee. The honor is awarded for outstanding contributions to their profession and the clients they serve. Only one Award totaling $1,000 may be made annually. DHCC DISTINGUISHED MEMBER AWARD The Distinguished member award may be given annually to a DHCC Member who has made significant contributions to the profession and organization. Up to 3 Distinguished Member Awards may be selected each year.

DHCC “UP & COMING” MEMBER OF THE YEAR The DHCC Up & Coming Member of the Year award recognizes the competence and activities of members who have been in practice for 10 years or less and who have been members of Dietetics in Health Care Communities (DHCC) DPG #31 of the American Dietetic Association for at least three (3) years. The purpose of this recognition is to encourage their continued participation in DHCC and identify potential leadership for DHCC at the district, state, and national levels. DHCC may recognize one (1) member each year in each of the three (3) following areas:

1. Long-term care 2. Corrections 3. Homecare

DEADLINE JULY 1 2011 DHCC Chair’s Scholarship - Sponsored by Medical Nutrition USA, Inc Purpose: To provide funding for one DHCC member to attend either the ADA Public Policy Workshop or the ADA Leadership Institute annually. The focus will be to provide a new educational experience and promote leadership within the organization. Award: Up to $1500.00* will be awarded to provide transportation, lodging, and per diem, to either the 2011 Public Policy Workshop or the ADA 2011 Leadership Institute.