|
TABLE OF CONTENTS
|
| 2 | Guest Editor's Perspective
Kathy M Logan Coughlin, MS, RD, LD, CNSD
Our nutrition support team had the recent misfortune of having one of
our own members become ill, undergo surgery, and require parenteral
nutrition (PN). Unfortunately, he even required home PN. Awkward as the
situation could have been, we were happy to care for our colleague and
elated to see him transition to oral feedings. |
| 2 | Chair's Column
Cindy Hamilton, MS, RD, LD, CNSD
Dietitians in Nutrition Support (DNS) representation at this year's American
Dietetic Association (ADA) Food & Nutrition Conference & Expo (FNCE) in
San Diego, CA, was really superb! Many of you came by our booth during
the DPG/MIG Showcase event just to say hello, voice your support of DNS
initiatives and services, and offer suggestions for future venues. |
| 3 | Complications of Home Parenteral Nutrition in Adults
Mandy L Corrigan, MPH, RD, LD, CNSC
Complications associated with parenteral
nutrition (PN) can be both short- and longterm.
Metabolic complications can develop
with the initiation of PN in the hospital, but
hypo- and hyperglycemia are potential
problems associated with long-term home
PN (HPN) administration. Alterations in
hydration status can develop in those
receiving HPN, as can deficiencies in
vitamins, minerals, and trace elements.
Metabolic bone disease is a significant longterm
complication of PN, and the incidence
of PN-associated liver disease appears to
increase with the duration of HPN. Finally,
nutrition support registered dietitians (RDs)
must monitor patients for infectious and
noninfectious catheter complications. |
| 13 | Compounding Compatibility, Stability, and Safety in Parenteral Nutrition
Ning-Tsu Kuo, PharmD, PhD
Since the early 1960s, parenteral nutrition
(PN) has been used as a primary source of
nutrition for patients who are unable to use
their gastrointestinal tracts. Over the years,
clinical experience and research have
improved patient care during nutrition
support that includes an interdisciplinary
approach to address and closely monitor
each patient's individual nutrition needs.
The uniqueness of PN solutions for each
patient not only increases the complexity
of solution compounding but necessitates
that all clinicians, including physicians,
dietitians, pharmacists, pharmacy
technicians, and nurses, work closely
together. The role of pharmacists is
especially important in overseeing issues of
composition, compatibility, stability, sterility,
and safety during PN preparation. Additional
issues involve proper storage conditions
and intravenous (IV) delivery. This article
highlights the chemical properties important
for chemical compatibility and stability of PN
admixtures and the regulations set by the
United State Pharmacopeia (USP) Chapter
797 for personnel and facilities where PN
admixtures are compounded. Safety issues
related to ordering and compounding PN
prescriptions also are addressed and examples of fatal mistakes in units of
weight or volume are provided. |
| 21 | Developing and Implementing Competencies for Nutrition Support Dietitians
Lindsay Dowhan, MS, RD, Robert DeChicco, MS, RD, LD, CNSC
Competencies can be used to assess
whether employees possess the necessary
skills and abilities to perform their duties
and as a basis for designing educational,
performance evaluation, and compensation
programs. The roles of different disciplines
in medicine often overlap, and standards of
practice are constantly evolving based on
new evidence and advances in technology.
Organization-specific competencies can be
developed by reviewing standards of
practice from professional organizations,
role delineation studies, and competencies
from other organizations and by
conducting surveys, reviewing existing job
descriptions, observing employees during the
performance of their duties, and interviewing
managers and employees. Competencies
should be integrated into an overall strategy
to attract, develop, evaluate, and
compensate employees and establish clear
and measurable expectations for job
performance. Developing and implementing
competencies for nutrition support dietitians
(NSDs) can increase the knowledge, skills,
and abilities of individual registered
dietitians (RDs); expand scope of practice;
and maintain the relevancy of RDs as part of
the health care team. |
Copyright 2011 Dietitians in Nutrition Support, ADA.
All material appearing in SUPPORT LINE is covered by copyright and may be
photocopied or otherwise reproduced for noncommercial scientific or educational
purposes only, provided the source is acknowledged. Written consent from the
managing editor is required for any other purpose.
Viewpoints and statements in these materials do not necessarily reflect
the policies and/or official positions of The American Dietetic Association or DNS.
SUPPORT LINE (ISSN 1067-3768) is published bi-monthly. $60 for individual
non-member subscriptions, $120 for institutions per year (plus postage surcharges
for international subscriptions). Newsletter subscriptions are available to interested
parties who are ineligible for ADA membership. Published by Dietitians in
Nutrition Support, a dietetic practice group of The American Dietetic Association
(ADA), 120 S. Riverside Plaza, Suite 2000, Chicago, IL 60606. For address changes: Please submit name and
address changes directly to the Membership Team of the American Dietetic
Association using the address change card in the Journal of the American Dietetic
Association. SUPPORT LINE is indexed in the Cumulative Index to Nursing and
Allied Health Literature.
|
FOR THIS ISSUE: EditorSusan Roberts, MS, RD, LD, CNSD
3911 Kramar Court
Arlington, TX 76016
214/820-6751
Managing EditorDeborah K. Kuhlman
921 N. Western Avenue
Park Ridge, IL 60068
847/692-3407
Associate EditorsDema Esper, MS, RD, LD
Kathy Logan Coughlin,, MS, RD, CNSD
Associate Editor, Continuing Education:Neha Parekh, MS, RD, CNSD
Associate Editor, Writer's Mentoring:Rebecca Brody, PhD, RD, LD, CNSC
Contributing Editor, Inquire Here:Gail Cresci, PhD, RD, CNSD
Membership/Subscriptions:Cheryl Thompson, PhD, RD, CNSD
|
