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Standardized Nutrition Language Used in an Electronic Health Record
SUNDAY, SEPTEMBER 30
POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY Title: ONLINE COURSE BUILDS CAPACITY OF DIETITIANS TO USE AN ECOLOGICAL APPROACH TO ADDRESS CHILDHOOD OBESITY Author(s): C. Stark, W. Wolfe, C. Devine, J. Dollahite, C. Olson; Nutritional Sciences, Cornell University, Ithaca, NY Learning Outcome: Describe changes in dietitians’ and health professionals’ knowledge, skills, confidence, and intended behavior resulting from the online course Preventing Childhood Obesity: An Ecological Approach. Text: Dietitians have a key role to play in addressing childhood obesity. Prevention efforts have traditionally focused on individual behavior change, which is necessary but not sufficient to address this epidemic. An ecological approach focuses on changes needed at the community level to support healthy eating and active living. While an ecological approach may be more effective than targeting individual behavior, many dietitians are unfamiliar with it. Online education provides an efficient way to build the capacity of dietitians to use this approach in community settings in which they work. Preventing Childhood Obesity: An Ecological Approach is a six-week course offered as part of the Cornell NutritionWorks online professional development program. Based on the PRECEDEPROCEED model, the facilitated course helps participants assess and prioritize local factors related to childhood obesity and develop an action plan for community intervention. Twenty two participants completed the first session of the course in Fall 2006, and additional sessions are underway. Half of course enrollees have been RDs. The course evaluation showed positive changes in knowledge, skills, confidence, and intended behavior. For example, 92% of those who completed the post-course evaluation (n ⫽ 20) felt fairly or extremely confident in their ability to develop effective collaborations, identify appropriate intervention strategies, and develop a community-based action plan to address childhood obesity compared to 15% at baseline. In addition, 95% intended to apply what they learned to their work, and 75% intended to implement all or part of the action plan they developed in the course.
Title: STANDARDIZED NUTRITION LANGUAGE USED IN AN ELECTRONIC HEALTH RECORD Author(s): W. I. Swan; Food and Nutrition, Anne Arundel Medical Center, Annapolis, MD Learning Outcome: Describe implementation of standardized nutrition languages for nutrition diagnoses and interventions into an electronic health record. Text: Documentation for dietetic practice was reconfigured in an electronic health record (EHR) to include standardized nutrition languages for nutrition diagnoses (ND) and nutrition interventions (NI). Descriptions of an EHR for dietetics are rare. Inpatient dietetic practice at Anne Arundel Medical Center (AAMC) has ten years of EHR documentation experience. The use of query response dictionaries, examples of language standardization, was supported by the EHR operating platform, was in use, and was appreciated by dietitians to promote efficient documentation. Published ND and NI taxonomies required slight modifications to satisfy dictionary format parameters. Information system analysts, experts on the EHR software, created the specified ND and NI documentation. Preexisting documentation was also reworked to support the Nutrition Care Process (NCP). Testing the new documentation prior to live implementation facilitated comprehensive training of dietitians in the NCP. Unanticipatedly, the new documentation generated a simple, electronic or printed, document that communicates a patient’s nutrition prescription, diagnoses, and interventions to the AAMC care team and to other care settings. Examples of the reconfigured dietetic practice documentation in the AAMC EHR are shown. Funding Disclosure: None
Funding Disclosure: USDA (Hatch and Smith Lever) and Cornell University Title: EAT SMART, BE FIT: WEB-BASED NUTRITION EDUCATION FOR LIMITED INCOME FAMILIES
Title: ELECTRONIC PORTFOLIOS: MARKETING YOURSELF COMPETITIVELY IN THE TWENTY-FIRST CENTURY
Author(s): J. Walker,1 P. Fatzinger McShane,1 A. Billing,2 N. Atkinson,2 S. LaTouche,2 J. Tian,2 R. Gold2; 1Department of Nutrition and Food Science, Dietetic Internship, University of Maryland, College Park, MD, 2 Department of Public and Community Health, Public Health Informatics Research Laboratory, University of Maryland, College Park, MD
Author(s): R. K. Smith,1 C. Scarpero2; 1Dietetic Internship, Department of Nutrition and Food Science, University of Maryland College Park, College Park, MD, 2Food and Nutrition Information Center, USDA National Agricultural Library, Beltsville, MD
Learning Outcome: Describe how web-based interventions can be used to promote positive health behaviors with low literate audiences Text: Goals of the Food Stamp Nutrition Education (FSNE) program include helping limited income individuals and families make healthy food choices, develop food preparation and budgeting skills, and increase their physical activity. Recognizing the Internet as an information source to the entire population, including limited income individuals, one state’s FSNE program developed the “Eat Smart, Be Fit” website as part of a research project to promote healthy living. This website targets limited income adult women with school-age children and provides online nutrition, food budgeting, and physical activity information. Website users register, complete three health behavior profiles and “surf” through a collection of health-related information. Interactive resources and tools were developed at a 6th grade or lower reading level to promote FSNE goals. Website development began following a comprehensive needs assessment conducted in five counties, with content, message and usability testing to inform the process. In 2006, a statewide media and information campaign began to promote wider usage. The site has been evaluated for effectiveness and continues to undergo further testing to ensure its appropriateness, relevance, and navigability to the target population. Dietetic interns gather monthly county resource updates and participate in statewide website dissemination efforts. This involvement improves interns’ understanding of issues faced by limited income families and enhances their grasp of available community resources. It also allows them to interact with clients to “see” the issues faced by these individuals. This presentation will provide information on the project background and current findings, a website tour, and statewide dissemination efforts. Funding Disclosure: Funding for the Food Stamp Nutrition Education (FSNE) Program’s “Eat Smart, Be Fit” Website is provided by USDA in cooperation with the Maryland Department of Human Resources and the University of Maryland.
Learning Outcome: To describe how an e-portfolio can market an entry level dietitian Text: Dietitians emerging from similar undergraduate and internship experiences enter a workplace that demands they distinguish themselves if they want to be selected for competitive positions and move up the career ladder. In one internship, dietetic interns market and distinguish themselves via the development of an electronic portfolio (e-portfolio) utilizing html coding. E-portfolios are innovative and increasingly seen in the marketplace. An Internet search demonstrated e-portfolio training in universities, Internet encyclopedias, industry, and other sites outside of dietetics. Eportfolios harness Internet capabilities to provide a more efficient, timely and extensive portrayal of applicant skills. Unlike static projects, they can be developed to describe educational progression over time. E-portfolios can be utilized to demonstrate what the individual has learned, along with reflections on that learning and presentation skills. E-portfolios allow potential employees to present self-advocating information in a structured, easily accessible manner. Instead of simply telling about skills and professed abilities, potential employees can post specific projects and useful links on their eportfolio site to demonstrate their qualifications in an innovative manner. While each portfolio is unique, sections such as educational background, work experience, project samples and site linkages are commonly present. Further, an e-portfolio can evolve over ones career. This dynamic aspect is essential because what is important for an entry level position may not be included five years later in an advanced job search strategy. E-portfolios offer dietitians an opportunity to market themselves to the local and global marketplace. Funding Disclosure: None
Journal of the AMERICAN DIETETIC ASSOCIATION / A-17
POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY Title: ONLINE COURSE BUILDS CAPACITY OF DIETITIANS TO USE AN ECOLOGICAL APPROACH TO ADDRESS CHILDHOOD OBESITY Author(s): C. Stark, W. Wolfe, C. Devine, J. Dollahite, C. Olson; Nutritional Sciences, Cornell University, Ithaca, NY Learning Outcome: Describe changes in dietitians’ and health professionals’ knowledge, skills, confidence, and intended behavior resulting from the online course Preventing Childhood Obesity: An Ecological Approach. Text: Dietitians have a key role to play in addressing childhood obesity. Prevention efforts have traditionally focused on individual behavior change, which is necessary but not sufficient to address this epidemic. An ecological approach focuses on changes needed at the community level to support healthy eating and active living. While an ecological approach may be more effective than targeting individual behavior, many dietitians are unfamiliar with it. Online education provides an efficient way to build the capacity of dietitians to use this approach in community settings in which they work. Preventing Childhood Obesity: An Ecological Approach is a six-week course offered as part of the Cornell NutritionWorks online professional development program. Based on the PRECEDEPROCEED model, the facilitated course helps participants assess and prioritize local factors related to childhood obesity and develop an action plan for community intervention. Twenty two participants completed the first session of the course in Fall 2006, and additional sessions are underway. Half of course enrollees have been RDs. The course evaluation showed positive changes in knowledge, skills, confidence, and intended behavior. For example, 92% of those who completed the post-course evaluation (n ⫽ 20) felt fairly or extremely confident in their ability to develop effective collaborations, identify appropriate intervention strategies, and develop a community-based action plan to address childhood obesity compared to 15% at baseline. In addition, 95% intended to apply what they learned to their work, and 75% intended to implement all or part of the action plan they developed in the course.
Title: STANDARDIZED NUTRITION LANGUAGE USED IN AN ELECTRONIC HEALTH RECORD Author(s): W. I. Swan; Food and Nutrition, Anne Arundel Medical Center, Annapolis, MD Learning Outcome: Describe implementation of standardized nutrition languages for nutrition diagnoses and interventions into an electronic health record. Text: Documentation for dietetic practice was reconfigured in an electronic health record (EHR) to include standardized nutrition languages for nutrition diagnoses (ND) and nutrition interventions (NI). Descriptions of an EHR for dietetics are rare. Inpatient dietetic practice at Anne Arundel Medical Center (AAMC) has ten years of EHR documentation experience. The use of query response dictionaries, examples of language standardization, was supported by the EHR operating platform, was in use, and was appreciated by dietitians to promote efficient documentation. Published ND and NI taxonomies required slight modifications to satisfy dictionary format parameters. Information system analysts, experts on the EHR software, created the specified ND and NI documentation. Preexisting documentation was also reworked to support the Nutrition Care Process (NCP). Testing the new documentation prior to live implementation facilitated comprehensive training of dietitians in the NCP. Unanticipatedly, the new documentation generated a simple, electronic or printed, document that communicates a patient’s nutrition prescription, diagnoses, and interventions to the AAMC care team and to other care settings. Examples of the reconfigured dietetic practice documentation in the AAMC EHR are shown. Funding Disclosure: None
Funding Disclosure: USDA (Hatch and Smith Lever) and Cornell University Title: EAT SMART, BE FIT: WEB-BASED NUTRITION EDUCATION FOR LIMITED INCOME FAMILIES
Title: ELECTRONIC PORTFOLIOS: MARKETING YOURSELF COMPETITIVELY IN THE TWENTY-FIRST CENTURY
Author(s): J. Walker,1 P. Fatzinger McShane,1 A. Billing,2 N. Atkinson,2 S. LaTouche,2 J. Tian,2 R. Gold2; 1Department of Nutrition and Food Science, Dietetic Internship, University of Maryland, College Park, MD, 2 Department of Public and Community Health, Public Health Informatics Research Laboratory, University of Maryland, College Park, MD
Author(s): R. K. Smith,1 C. Scarpero2; 1Dietetic Internship, Department of Nutrition and Food Science, University of Maryland College Park, College Park, MD, 2Food and Nutrition Information Center, USDA National Agricultural Library, Beltsville, MD
Learning Outcome: Describe how web-based interventions can be used to promote positive health behaviors with low literate audiences Text: Goals of the Food Stamp Nutrition Education (FSNE) program include helping limited income individuals and families make healthy food choices, develop food preparation and budgeting skills, and increase their physical activity. Recognizing the Internet as an information source to the entire population, including limited income individuals, one state’s FSNE program developed the “Eat Smart, Be Fit” website as part of a research project to promote healthy living. This website targets limited income adult women with school-age children and provides online nutrition, food budgeting, and physical activity information. Website users register, complete three health behavior profiles and “surf” through a collection of health-related information. Interactive resources and tools were developed at a 6th grade or lower reading level to promote FSNE goals. Website development began following a comprehensive needs assessment conducted in five counties, with content, message and usability testing to inform the process. In 2006, a statewide media and information campaign began to promote wider usage. The site has been evaluated for effectiveness and continues to undergo further testing to ensure its appropriateness, relevance, and navigability to the target population. Dietetic interns gather monthly county resource updates and participate in statewide website dissemination efforts. This involvement improves interns’ understanding of issues faced by limited income families and enhances their grasp of available community resources. It also allows them to interact with clients to “see” the issues faced by these individuals. This presentation will provide information on the project background and current findings, a website tour, and statewide dissemination efforts. Funding Disclosure: Funding for the Food Stamp Nutrition Education (FSNE) Program’s “Eat Smart, Be Fit” Website is provided by USDA in cooperation with the Maryland Department of Human Resources and the University of Maryland.
Learning Outcome: To describe how an e-portfolio can market an entry level dietitian Text: Dietitians emerging from similar undergraduate and internship experiences enter a workplace that demands they distinguish themselves if they want to be selected for competitive positions and move up the career ladder. In one internship, dietetic interns market and distinguish themselves via the development of an electronic portfolio (e-portfolio) utilizing html coding. E-portfolios are innovative and increasingly seen in the marketplace. An Internet search demonstrated e-portfolio training in universities, Internet encyclopedias, industry, and other sites outside of dietetics. Eportfolios harness Internet capabilities to provide a more efficient, timely and extensive portrayal of applicant skills. Unlike static projects, they can be developed to describe educational progression over time. E-portfolios can be utilized to demonstrate what the individual has learned, along with reflections on that learning and presentation skills. E-portfolios allow potential employees to present self-advocating information in a structured, easily accessible manner. Instead of simply telling about skills and professed abilities, potential employees can post specific projects and useful links on their eportfolio site to demonstrate their qualifications in an innovative manner. While each portfolio is unique, sections such as educational background, work experience, project samples and site linkages are commonly present. Further, an e-portfolio can evolve over ones career. This dynamic aspect is essential because what is important for an entry level position may not be included five years later in an advanced job search strategy. E-portfolios offer dietitians an opportunity to market themselves to the local and global marketplace. Funding Disclosure: None
Journal of the AMERICAN DIETETIC ASSOCIATION / A-17