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Improving a School Environment through the Healthier US School Challenge
MONDAY, SEPTEMBER 26
POSTER SESSION: SCIENCE/EDUCATION/MANAGEMENT/FOODSERVICES/CULINARY/RESEARCH Household Food Supplies: How Prepared Are Families for Emergency Situations?
Improving a School Environment through the Healthier US School Challenge
Author(s): C. Byrd-Bredbenner,1 C. Bredbenner2; 1Nutritional Sciences, Rutgers University, Hillsborough, NJ, 2The Nutrition Company, Long Valley, NJ
Author(s): R. M. Fournet, A. H. Roberts; College of Nursing, University of Louisiana, Lafayette, Lafayette, LA
Learning Outcome: To describe household calorie availability and nutrient density at baseline and changes that could occur when emergencies (e.g., natural disasters) restrict replenishment of food supplies, and disrupt water and/or electrical power.
Learning Outcome: To identify the components and requirements of the Healthy US School Challenge and steps taken to implement a healthier school menu, a six week nutrition education curriculum, and the incorporation of daily physical activity.
Little is known about the nutrient and calorie content of home food supplies (HFSs) and the extent to which HFSs could sustain families during emergencies and relief efforts. The HFSs of 100 food-secure families with young children were inventoried during a non-emergency period using diet analysis software (FoodWorks) adapted to link UPCs with nutrient data (Gladson Interactive). Each food was categorized according to whether it required refrigeration/freezing, cooking, and/or water for preparation. Foods not needing refrigeration/freezing were further categorized according typical shelf-life length. Total household days available at 100% Daily Value (HDA100%DV) were calculated by dividing total calories or nutrients (i.e., fat, saturated fat, cholesterol, sodium, carbohydrate, fiber, sugar, protein, vitamin A, vitamin C, calcium, iron) available in each HFS by their respective DV, then dividing the result by total household members (children ⬍12years⫽0.73 adult equivalents). HDA100%DV for calories was 33.2⫾22.0SD. About one-fifth of households would deplete their HFSs in 15 days if all members ate 2000kcal/d and supplies were not replenished. Lack of water or energy for cooking would render 28% or 35% of total HDA100%DV for calories unusable, or 38% if both were unavailable. Loss of refrigeration/freezing for ⱖ5 days would reduce availability of HDA100%DV for calories by 27%. Loss of water and ⬎5 day power outage would make 55% of household calories unavailable. Interestingly, HFS nutrient density fluctuates little as calorie availability declines. Findings from this study could assist families in preparing for emergency situations as well as organizations planning and delivering disaster relief services. Funding Disclosure: Canned Food Alliance, Gladson Interactive, FoodFacts.com, The Nutrition Company
The Healthier US School Challenge (HUSSC) recognizes schools participating in the National School Lunch Program that have created healthier school environments through promotion of nutrition and physical activity. University Professor and Dietetic Interns developed and assisted in implementing a healthier school menu which met the HUSSC requirements, included a six week nutrition education curriculum, and incorporated daily physical activity. The Dietetic Interns worked closely with the School Foodservice workers in incorporating more whole grain products, different fruits and vegetables every day, and dried beans at least once a week into the menu. They also worked with teachers in the school teamteaching structured nutrition classes, creating lesson plans and used Eating Right Around the Clock lessons, which linked the classroom and school cafeteria to the home. Parental involvement was also enriched by including home-learning activities. Art work, food displays, posters, student journaling, book readings, taste testing, and games are a few of the methods of education embraced during nutrition education. Physical activity was a component of the grant structured for 15 minutes every day in each of the classrooms. Nutrition components of health were also highlighted during physical activity sessions. Plate waste studies were conducted by the Dietetic Interns, which revealed an overall acceptance to the menu improvements and an increase in the consumption of healthy food items. A healthier school environment was created by the careful selection of competitive foods being sold or brought into the school by the children. Funding Disclosure: Team Nutrition
An Alliance with Nursing to Avoid Incidence of Diet Orders “Lost In Transcription”
Comparison of the Environmental Impact of a Tray Versus a Trayless Delivery System in a University Dining Hall
Author(s): J. M. Wong, N. Chankitwanit ; Nutrition, Morrison Healthcare Specialist, Inc. at LAC⫹USC Healthcare Network, Los Angeles, CA
Author(s): V. M. Getty,1 K. Thiagarajah,1 S. A. Fowler2; 1Applied Health Science, Indiana University, Bloomington, IN, 2Residential Programs and Services, Indiana University, Bloomington, IN
Learning Outcome: To improve accuracy of transcribing diet orders from physician’s written orders to electronic meal order system where nursing/clerical staffs struggle to identify handwritten order and select from limited options in electronic ordering system. Objective: To improve accuracy of transcribing diet orders from physician’s written orders to electronic meal order system where nursing/clerical staffs struggle to identify handwritten order and select from limited options in the electronic ordering system. Methods: Dietitians of Morrison Management at LAC⫹USC audited diet orders transcribed into electronic order system (Affinity) on randomly selected dates/ meals monthly over 2 years. The dietitians worked closely with nursing/clerical staff to correct transcription errors immediately. The Clinical Nutrition Manager compiled monthly data, analyzed and identified problems. Audit results were shared with nurse managers to coordinate training and revise/upgrade programs to become users friendly. Audit results were also presented to the Nursing Quality Assurance Manager, hospital administration, and the network Nutrition Committee. Results were incorporated into nursing scorecards. Results: The baseline diet order transcription accuracy averaged 72% (588/820) in 2008. Through the joint efforts of nursing and nutrition departments, the accuracy of diet order transcription improved to 79% (3982/5016) in 2009 and subsequently increased to 88% (4090/4646) in 2010. Conclusion: Diet order transcription may appear simple and easy from a dietitian perspective. However, compared to many complicated tasks performed by the nursing/clerical staff, diet order transcription can be confusing. Through close collaboration with nursing/clerical staff, improved communication, taking ownership, and assigning accountability, we can provide more accurate and appropriate care to patients. Funding Disclosure: None
Learning Outcome: Participants will be able to discuss the potential advantages and disadvantages of implementing a trayless food delivery system in a university dining hall in relation to environmental impact and customer/employee satisfaction. A potential strategy for environmental stewardship in foodservice is trayless dining. The purpose of this study is to compare the environmental impact of using a standard tray delivery system vs. a trayless system in a buffet-style university dining hall. Both liquid and solid plate waste were collected and measured for one week with the existing tray system and again after a new trayless system was implemented. The investigators calculated waste per person for the two systems and used a paired t-test to examine the significance of the difference in waste. Also, students who use the dining hall were invited to participate in an online survey about their attitudes and experiences with the trayless system, and foodservice staff were invited to participate in a focus group to assess the impact of the change on their jobs. Results indicate a significant decrease in solid waste per person (0.8 oz., p⫽.002) in switching from the tray to the trayless system (4.38⫾0.22 oz. vs. 3.58⫾0.08 oz per person). A significant but smaller change was observed with liquid waste (50.24⫾3.19 vs. 46.36⫾4.51 ml, p ⫽ .047). About 500 students eat at any given meal, but only 25 participated in the survey; over 70% of those disapproved of the trayless system. Most of the employees, however, prefer the trayless system. The study supports the conclusion that trayless dining reduces food waste and can therefore contribute to improved environmental practices in foodservice systems. Funding Disclosure: None
Journal of the AMERICAN DIETETIC ASSOCIATION / A-59
POSTER SESSION: SCIENCE/EDUCATION/MANAGEMENT/FOODSERVICES/CULINARY/RESEARCH Household Food Supplies: How Prepared Are Families for Emergency Situations?
Improving a School Environment through the Healthier US School Challenge
Author(s): C. Byrd-Bredbenner,1 C. Bredbenner2; 1Nutritional Sciences, Rutgers University, Hillsborough, NJ, 2The Nutrition Company, Long Valley, NJ
Author(s): R. M. Fournet, A. H. Roberts; College of Nursing, University of Louisiana, Lafayette, Lafayette, LA
Learning Outcome: To describe household calorie availability and nutrient density at baseline and changes that could occur when emergencies (e.g., natural disasters) restrict replenishment of food supplies, and disrupt water and/or electrical power.
Learning Outcome: To identify the components and requirements of the Healthy US School Challenge and steps taken to implement a healthier school menu, a six week nutrition education curriculum, and the incorporation of daily physical activity.
Little is known about the nutrient and calorie content of home food supplies (HFSs) and the extent to which HFSs could sustain families during emergencies and relief efforts. The HFSs of 100 food-secure families with young children were inventoried during a non-emergency period using diet analysis software (FoodWorks) adapted to link UPCs with nutrient data (Gladson Interactive). Each food was categorized according to whether it required refrigeration/freezing, cooking, and/or water for preparation. Foods not needing refrigeration/freezing were further categorized according typical shelf-life length. Total household days available at 100% Daily Value (HDA100%DV) were calculated by dividing total calories or nutrients (i.e., fat, saturated fat, cholesterol, sodium, carbohydrate, fiber, sugar, protein, vitamin A, vitamin C, calcium, iron) available in each HFS by their respective DV, then dividing the result by total household members (children ⬍12years⫽0.73 adult equivalents). HDA100%DV for calories was 33.2⫾22.0SD. About one-fifth of households would deplete their HFSs in 15 days if all members ate 2000kcal/d and supplies were not replenished. Lack of water or energy for cooking would render 28% or 35% of total HDA100%DV for calories unusable, or 38% if both were unavailable. Loss of refrigeration/freezing for ⱖ5 days would reduce availability of HDA100%DV for calories by 27%. Loss of water and ⬎5 day power outage would make 55% of household calories unavailable. Interestingly, HFS nutrient density fluctuates little as calorie availability declines. Findings from this study could assist families in preparing for emergency situations as well as organizations planning and delivering disaster relief services. Funding Disclosure: Canned Food Alliance, Gladson Interactive, FoodFacts.com, The Nutrition Company
The Healthier US School Challenge (HUSSC) recognizes schools participating in the National School Lunch Program that have created healthier school environments through promotion of nutrition and physical activity. University Professor and Dietetic Interns developed and assisted in implementing a healthier school menu which met the HUSSC requirements, included a six week nutrition education curriculum, and incorporated daily physical activity. The Dietetic Interns worked closely with the School Foodservice workers in incorporating more whole grain products, different fruits and vegetables every day, and dried beans at least once a week into the menu. They also worked with teachers in the school teamteaching structured nutrition classes, creating lesson plans and used Eating Right Around the Clock lessons, which linked the classroom and school cafeteria to the home. Parental involvement was also enriched by including home-learning activities. Art work, food displays, posters, student journaling, book readings, taste testing, and games are a few of the methods of education embraced during nutrition education. Physical activity was a component of the grant structured for 15 minutes every day in each of the classrooms. Nutrition components of health were also highlighted during physical activity sessions. Plate waste studies were conducted by the Dietetic Interns, which revealed an overall acceptance to the menu improvements and an increase in the consumption of healthy food items. A healthier school environment was created by the careful selection of competitive foods being sold or brought into the school by the children. Funding Disclosure: Team Nutrition
An Alliance with Nursing to Avoid Incidence of Diet Orders “Lost In Transcription”
Comparison of the Environmental Impact of a Tray Versus a Trayless Delivery System in a University Dining Hall
Author(s): J. M. Wong, N. Chankitwanit ; Nutrition, Morrison Healthcare Specialist, Inc. at LAC⫹USC Healthcare Network, Los Angeles, CA
Author(s): V. M. Getty,1 K. Thiagarajah,1 S. A. Fowler2; 1Applied Health Science, Indiana University, Bloomington, IN, 2Residential Programs and Services, Indiana University, Bloomington, IN
Learning Outcome: To improve accuracy of transcribing diet orders from physician’s written orders to electronic meal order system where nursing/clerical staffs struggle to identify handwritten order and select from limited options in electronic ordering system. Objective: To improve accuracy of transcribing diet orders from physician’s written orders to electronic meal order system where nursing/clerical staffs struggle to identify handwritten order and select from limited options in the electronic ordering system. Methods: Dietitians of Morrison Management at LAC⫹USC audited diet orders transcribed into electronic order system (Affinity) on randomly selected dates/ meals monthly over 2 years. The dietitians worked closely with nursing/clerical staff to correct transcription errors immediately. The Clinical Nutrition Manager compiled monthly data, analyzed and identified problems. Audit results were shared with nurse managers to coordinate training and revise/upgrade programs to become users friendly. Audit results were also presented to the Nursing Quality Assurance Manager, hospital administration, and the network Nutrition Committee. Results were incorporated into nursing scorecards. Results: The baseline diet order transcription accuracy averaged 72% (588/820) in 2008. Through the joint efforts of nursing and nutrition departments, the accuracy of diet order transcription improved to 79% (3982/5016) in 2009 and subsequently increased to 88% (4090/4646) in 2010. Conclusion: Diet order transcription may appear simple and easy from a dietitian perspective. However, compared to many complicated tasks performed by the nursing/clerical staff, diet order transcription can be confusing. Through close collaboration with nursing/clerical staff, improved communication, taking ownership, and assigning accountability, we can provide more accurate and appropriate care to patients. Funding Disclosure: None
Learning Outcome: Participants will be able to discuss the potential advantages and disadvantages of implementing a trayless food delivery system in a university dining hall in relation to environmental impact and customer/employee satisfaction. A potential strategy for environmental stewardship in foodservice is trayless dining. The purpose of this study is to compare the environmental impact of using a standard tray delivery system vs. a trayless system in a buffet-style university dining hall. Both liquid and solid plate waste were collected and measured for one week with the existing tray system and again after a new trayless system was implemented. The investigators calculated waste per person for the two systems and used a paired t-test to examine the significance of the difference in waste. Also, students who use the dining hall were invited to participate in an online survey about their attitudes and experiences with the trayless system, and foodservice staff were invited to participate in a focus group to assess the impact of the change on their jobs. Results indicate a significant decrease in solid waste per person (0.8 oz., p⫽.002) in switching from the tray to the trayless system (4.38⫾0.22 oz. vs. 3.58⫾0.08 oz per person). A significant but smaller change was observed with liquid waste (50.24⫾3.19 vs. 46.36⫾4.51 ml, p ⫽ .047). About 500 students eat at any given meal, but only 25 participated in the survey; over 70% of those disapproved of the trayless system. Most of the employees, however, prefer the trayless system. The study supports the conclusion that trayless dining reduces food waste and can therefore contribute to improved environmental practices in foodservice systems. Funding Disclosure: None
Journal of the AMERICAN DIETETIC ASSOCIATION / A-59