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Registered Dietitians: Attitudes and Perceptions Regarding Bachelor's Degree in Nutrition and Dietetics
SUNDAY, OCTOBER 22
Poster Session: Professional Skills; Nutrition Assessment & Diagnosis; Medical Nutrition Therapy Proportion of Heart Failure Patients who Meet Criteria for Malnutrition upon Hospital Admission Based on ASPEN Guidelines
Registered Dietitians Report Their Training Adequacy and Use of NutritionRelated Lab Testing
Author(s): C. Hanson1, S. Carpenter1, A. Anderson Berry1, R. Thomas2, G. Woscyna1; 1University of Nebraska Medical Center, 2Nebraska Medicine
Author(s): M. Schaufel1, D. Sullivan2, J. Goetz Wiltse1, H. Gibbs2; 1University of Kansas Medical Center, 2Department of Dietetics and Nutrition, University of Kansas Medical Center
Learning Outcome: The participant will describe the malnutrition criteria most commonly used in a population of malnourished heart failure patients. Background: Current studies suggest an association between nutrition interventions and positive patient outcomes in heart failure (HF) patients. It has been estimated that approximately 50% of HF patients can be classified as malnourished, however this has not been evaluated using the American Society of Parenteral and Enteral Nutrition (ASPEN) standardized diagnostic criteria. Objective: The purpose of this study was to determine the proportion of patients with a diagnosis of HF who met criteria for malnutrition upon admission based on ASPEN guidelines, and the most common criteria components leading to the malnutrition diagnosis. Methods: A retrospective chart review of 100 patients was conducted. The patients were categorized as “malnourished” or “not malnourished” based on ASPEN guidelines. Clinical characteristics were collected to determine if significant differences between the groups exist. Subject characteristics were compared using independent samples T-tests or Chi-squared tests. Statistical significance was set at p-value < 0.05. Results: Overall, 39% of participants were categorized as malnourished. The largest percentage of patients met diagnosis due to the ASPEN criteria of decreased functional status (85%) and fluid accumulation (69%). There was a significantly larger percentage of females in the malnourished group as compared to the non-malnourished group (46% vs 26% respectively, p¼0.04). Conclusion: A high percentage of patients with HF are malnourished according to the ASPEN criteria. As the most common criteria for identifying malnutrition in this patient population were functional status and fluid accumulation, clinicians may benefit from continued training on the assessment of these parameters. Funding Disclosure: None
Learning Outcome: Participants will be able to discuss the evidence for increasing training opportunities for practicing dietitians on nutrition-related lab testing. Purpose: This study aimed to investigate RDN use of nutrition-related lab testing as a potential advanced clinical skill, and to describe RDN perceptions of the adequacy of training for nutrition-related lab testing. Methods: A 40-item survey was sent electronically by email to 4990 randomly selected RDNs who have maintained dietetic registration with the Commission on Dietetic Registration three years. Reminders were sent weekly for the first three weeks, and the survey was open for five weeks. Answers to 10 questions on professional training and practice were used to assign participants into beyond-entry-level (BEL) or advanced-practice-eligible (AP) groups, according to AND and CDR definitions. Descriptive statistics and differences (Mann Whitney U or Chi-square) between BEL and AP groups were analyzed, and significance was defined as P<.05. Results: Out of 805 participants, 64% of whom were categorized as BEL, 649 surveys were completed. A majority (85%) reported use of laboratory testing where a comprehensive metabolic panel was the most frequently used test and genetic testing the most infrequently used test. There were no differences between BEL or AP groups for use of laboratory testing except in the case of nutrient status testing, where the AP group reported significantly more frequent use (p¼.02). The BEL group rated their professional training as more adequate for their current level of practice (p¼.03). AP RDNs more often identified the most useful training method as self-teaching (34% vs 21%, p<.001). Conclusions: Nutrition-related lab testing represents a potential gap in training for advanced level clinical practice. Funding Disclosure: None
Registered Dietitians Improve LDL, BMI, A1C, Adherence as Diabetes Case Managers
Registered Dietitians: Attitudes and Perceptions Regarding Bachelor’s Degree in Nutrition and Dietetics
Author(s): M. McClarney1, E. Lyden2, A. Anderson Berry2, G. Woscyna2, C. Hanson2; 1Nebraska Medicine, 2University of Nebraska Medical Center
Author(s): A. Wagle1, C. Holmquist2, P. Fifield2, L. McProud1; 1San Jose State University, 2 University of New England
Learning Outcome: The learner will be able to describe outcomes and compare the role of the registered dietitian (RD) diabetes case manager (DCM) compared to traditional diabetes education.
Learning Outcome: Identify one impacting factor that may affect the perception and
Background: Diabetes self-management training (DSMT) traditionally utilizes an education team, including an RD. RDs may also provide DSMT as diabetes case managers (DCMs), but research is needed to describe the role and efficacy of RD as case managers vs. the more traditional model. Research Outcome: Investigate the efficacy of RD DCMs compared to RDs in the traditional DSMT model at an outpatient endocrinology clinic. Methods: Cross sectional retrospective review of patients with diabetes (n¼946), receiving traditional RD education (n¼445) and DCM (n¼501) were matched for age, diagnosis and gender. BMI, Lipids, A1C and total visits were compared from 0 to 12 months. Descriptive statistics were calculated and independent samples t-test was used to test means between groups. Regression analysis was performed to assess predictive relationships among significant variables. Results: Both groups were efficacious in lowering lab values. The DCM group demonstrated more efficacy in lowering LDL (p¼0.002) and A1C (p¼0.01) between 0 and 12 months compared to the traditional group. The DCM group also had a larger decrease in BMI (p¼0.03). Number of visits (p¼0.001) were higher in DCM group. Conclusions: RDs provided DCM with outcomes equal to traditional RD education and increased patient visits. Further studies should analyze costbenefits of this model. Funding Disclosure: Karen Goldstein Memorial Grant
attitude of registered dietitians with bachelor’s degrees regarding the transition to the master’s degree requirement as the entry-level requirement for registered dietitians’ (RDs) to practice.
Background: The profession of dietetics is transitioning to the master’s degree (MS) as the entry-level requirement for registered dietitians’ (RDs) to practice. Purpose: This quantitative study examined the attitudes and perceptions of RDs with bachelor’s degrees (BS, RD’s) regarding the transition and impacting factors such as years of practice, professional status, scope and type of practice. Method: A cross-sectional, 46 question comprehensive survey using Qualtrix was completed by 107 BS, RDs comprising of 99 (92.5%) females and 8 (7.5%) males. Results: Fifty-six percent of participants (n¼60) were between the ages of 30-39 years and 88.0% (n¼94) reported working in California. Participants expressed greater support for the one-year transitional master’s degree (tMS) rather than the traditional two-year MS degree, and findings indicated lack of support for the universal degree requirement of the MS degree for practice. The MS degree was perceived to improve the RD’s ability to apply research in clinical practice and clinical reasoning skills, however, the degree would not alter the role of the RD, lead to a more defined type and scope of practice, improve the quality of health care for the patients, improve leadership skills or enhance professionalism. Younger RDs with fewer years of practice were more supportive of the transition and willing to enroll in the MS degree programs, however support decreased with increase in age and years of practice. Participants who believed that the transition was a positive change were found to favor the MS degree and willing to enroll in the tMS degree, and preferred the “online” mode of instruction.
Conclusion: This study provided valuable insight into some attitudes of BS, RDs toward the educational changes in the profession. Funding Disclosure: None
A-32
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2017 Suppl 1—Abstracts Volume 117 Number 9
Poster Session: Professional Skills; Nutrition Assessment & Diagnosis; Medical Nutrition Therapy Proportion of Heart Failure Patients who Meet Criteria for Malnutrition upon Hospital Admission Based on ASPEN Guidelines
Registered Dietitians Report Their Training Adequacy and Use of NutritionRelated Lab Testing
Author(s): C. Hanson1, S. Carpenter1, A. Anderson Berry1, R. Thomas2, G. Woscyna1; 1University of Nebraska Medical Center, 2Nebraska Medicine
Author(s): M. Schaufel1, D. Sullivan2, J. Goetz Wiltse1, H. Gibbs2; 1University of Kansas Medical Center, 2Department of Dietetics and Nutrition, University of Kansas Medical Center
Learning Outcome: The participant will describe the malnutrition criteria most commonly used in a population of malnourished heart failure patients. Background: Current studies suggest an association between nutrition interventions and positive patient outcomes in heart failure (HF) patients. It has been estimated that approximately 50% of HF patients can be classified as malnourished, however this has not been evaluated using the American Society of Parenteral and Enteral Nutrition (ASPEN) standardized diagnostic criteria. Objective: The purpose of this study was to determine the proportion of patients with a diagnosis of HF who met criteria for malnutrition upon admission based on ASPEN guidelines, and the most common criteria components leading to the malnutrition diagnosis. Methods: A retrospective chart review of 100 patients was conducted. The patients were categorized as “malnourished” or “not malnourished” based on ASPEN guidelines. Clinical characteristics were collected to determine if significant differences between the groups exist. Subject characteristics were compared using independent samples T-tests or Chi-squared tests. Statistical significance was set at p-value < 0.05. Results: Overall, 39% of participants were categorized as malnourished. The largest percentage of patients met diagnosis due to the ASPEN criteria of decreased functional status (85%) and fluid accumulation (69%). There was a significantly larger percentage of females in the malnourished group as compared to the non-malnourished group (46% vs 26% respectively, p¼0.04). Conclusion: A high percentage of patients with HF are malnourished according to the ASPEN criteria. As the most common criteria for identifying malnutrition in this patient population were functional status and fluid accumulation, clinicians may benefit from continued training on the assessment of these parameters. Funding Disclosure: None
Learning Outcome: Participants will be able to discuss the evidence for increasing training opportunities for practicing dietitians on nutrition-related lab testing. Purpose: This study aimed to investigate RDN use of nutrition-related lab testing as a potential advanced clinical skill, and to describe RDN perceptions of the adequacy of training for nutrition-related lab testing. Methods: A 40-item survey was sent electronically by email to 4990 randomly selected RDNs who have maintained dietetic registration with the Commission on Dietetic Registration three years. Reminders were sent weekly for the first three weeks, and the survey was open for five weeks. Answers to 10 questions on professional training and practice were used to assign participants into beyond-entry-level (BEL) or advanced-practice-eligible (AP) groups, according to AND and CDR definitions. Descriptive statistics and differences (Mann Whitney U or Chi-square) between BEL and AP groups were analyzed, and significance was defined as P<.05. Results: Out of 805 participants, 64% of whom were categorized as BEL, 649 surveys were completed. A majority (85%) reported use of laboratory testing where a comprehensive metabolic panel was the most frequently used test and genetic testing the most infrequently used test. There were no differences between BEL or AP groups for use of laboratory testing except in the case of nutrient status testing, where the AP group reported significantly more frequent use (p¼.02). The BEL group rated their professional training as more adequate for their current level of practice (p¼.03). AP RDNs more often identified the most useful training method as self-teaching (34% vs 21%, p<.001). Conclusions: Nutrition-related lab testing represents a potential gap in training for advanced level clinical practice. Funding Disclosure: None
Registered Dietitians Improve LDL, BMI, A1C, Adherence as Diabetes Case Managers
Registered Dietitians: Attitudes and Perceptions Regarding Bachelor’s Degree in Nutrition and Dietetics
Author(s): M. McClarney1, E. Lyden2, A. Anderson Berry2, G. Woscyna2, C. Hanson2; 1Nebraska Medicine, 2University of Nebraska Medical Center
Author(s): A. Wagle1, C. Holmquist2, P. Fifield2, L. McProud1; 1San Jose State University, 2 University of New England
Learning Outcome: The learner will be able to describe outcomes and compare the role of the registered dietitian (RD) diabetes case manager (DCM) compared to traditional diabetes education.
Learning Outcome: Identify one impacting factor that may affect the perception and
Background: Diabetes self-management training (DSMT) traditionally utilizes an education team, including an RD. RDs may also provide DSMT as diabetes case managers (DCMs), but research is needed to describe the role and efficacy of RD as case managers vs. the more traditional model. Research Outcome: Investigate the efficacy of RD DCMs compared to RDs in the traditional DSMT model at an outpatient endocrinology clinic. Methods: Cross sectional retrospective review of patients with diabetes (n¼946), receiving traditional RD education (n¼445) and DCM (n¼501) were matched for age, diagnosis and gender. BMI, Lipids, A1C and total visits were compared from 0 to 12 months. Descriptive statistics were calculated and independent samples t-test was used to test means between groups. Regression analysis was performed to assess predictive relationships among significant variables. Results: Both groups were efficacious in lowering lab values. The DCM group demonstrated more efficacy in lowering LDL (p¼0.002) and A1C (p¼0.01) between 0 and 12 months compared to the traditional group. The DCM group also had a larger decrease in BMI (p¼0.03). Number of visits (p¼0.001) were higher in DCM group. Conclusions: RDs provided DCM with outcomes equal to traditional RD education and increased patient visits. Further studies should analyze costbenefits of this model. Funding Disclosure: Karen Goldstein Memorial Grant
attitude of registered dietitians with bachelor’s degrees regarding the transition to the master’s degree requirement as the entry-level requirement for registered dietitians’ (RDs) to practice.
Background: The profession of dietetics is transitioning to the master’s degree (MS) as the entry-level requirement for registered dietitians’ (RDs) to practice. Purpose: This quantitative study examined the attitudes and perceptions of RDs with bachelor’s degrees (BS, RD’s) regarding the transition and impacting factors such as years of practice, professional status, scope and type of practice. Method: A cross-sectional, 46 question comprehensive survey using Qualtrix was completed by 107 BS, RDs comprising of 99 (92.5%) females and 8 (7.5%) males. Results: Fifty-six percent of participants (n¼60) were between the ages of 30-39 years and 88.0% (n¼94) reported working in California. Participants expressed greater support for the one-year transitional master’s degree (tMS) rather than the traditional two-year MS degree, and findings indicated lack of support for the universal degree requirement of the MS degree for practice. The MS degree was perceived to improve the RD’s ability to apply research in clinical practice and clinical reasoning skills, however, the degree would not alter the role of the RD, lead to a more defined type and scope of practice, improve the quality of health care for the patients, improve leadership skills or enhance professionalism. Younger RDs with fewer years of practice were more supportive of the transition and willing to enroll in the MS degree programs, however support decreased with increase in age and years of practice. Participants who believed that the transition was a positive change were found to favor the MS degree and willing to enroll in the tMS degree, and preferred the “online” mode of instruction.
Conclusion: This study provided valuable insight into some attitudes of BS, RDs toward the educational changes in the profession. Funding Disclosure: None
A-32
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2017 Suppl 1—Abstracts Volume 117 Number 9