MONDAY, OCTOBER 23
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; Research
Nutrition Guidelines in Bariatric Surgery: Recent Advancements
Author: J. Parrott; Formulas for Fitness, Private Practice Centrastate Medical
Center, Health Awareness Center and Population Health
Learning Outcome: Dietitians practicing in bariatric surgery need to be aware
of the latest research. Dietitians will be able to better care for patients pre and
post bariatric surgery. This information will improve patient care by helping
to prevent micronutrient deciencies in bariatric surgery. RDN will be more
likely to be consulted for their knowledge and expertise regarding nutrition
in bariatric surgery.
Background: Three sets of guidelines are currently used in the care of patients
with bariatric surgery: 2013 AACE/TOS/ASMBS Bariatric Surgery Clinical
Practice Guidelines, 2013 A.S.P.E.N. Clinical Guidelines: Nutrition Support of
Hospitalized Adult Patients With Obesity and 2008 ASMBS Allied Health
Nutritional Guidelines for the Surgical Weight Loss Patient. Inconsistencies
between recommendations will be discussed and claried.
Method: The guideline updates are based on the systematic review and
recommendation process described in the 2013 joint ASMBS/Obesity Society/
American Association of Clinical Endocrinologists guidelines.
Results: The 2016 update focuses on screening, supplementation and reple-
tion of vitamins B1, B12, folate, iron, vitamins A, D, E, K, calcium, copper, and
zinc. Comparisons between guideline recommendations are discussed.
Conclusions: The 2016 update of the ASMBS micronutrient guidelines for
bariatric surgery patients includes many new and updated recommendations.
Additionally, the updated guidelines represent a marked methodological
improvement over the previous guidelines.
Funding Disclosure: None
Patient and Public Involvement in Evidence-based Nutrition Practice Resource Development
Author(s): L. Moloney, D. Handu, T. Acosta, F. Cheng, M. Rozga; Academy of Nutrition and
Dietetics
Learning Outcome: Practitioners will understand the importance of patient and public
involvement in the development of evidence-based resources that can help improve pa-
tient centered care. Members will be able to describe how the Academys EAL is improving
the quality of evidence-based resources through patient and public involvement.
Background: Per the IOM, patient-centered care is dened as providing care that is
respectful of and responsive to individual patient preferences, needs, and values and
ensuring the patient values guide all clinical decisions. Healthcare has shifted to patient-
centered care and resources must follow suit. Patient and public involvement (PPI) is a
standard of quality in the development of evidence-based systematic reviews (SR),
guidelines, editorials and research articles. Previously, the Evidence Analysis Library (EAL)
incorporated stakeholder involvement through member participation on workgroups, and
member and non-member feedback during external review. To improve the quality of EAL
SRs and guidelines, the EAL is working to further incorporate PPI.
Objectives: Identify efcient and effective methods to incorporate PPI throughout the
EALs guideline and SR development.
Methods: Draw upon participant and consultant experiences from the patient advocate
EAL PPI pilot, search and identify resources for PPI, and provide examples of how PPI is
utilized in external organizations.
Results: Experiences drawn from the patient advocate pilot project highlighted facilitators
and barriers to PPI. Several resources for PPI were identied, specically the Guideline
International Network PPI Toolkit, and publications from the IOM. The need for procedures
in the following areas have been identied: patient advocate recruitment, selection, and
nomination; level and degree of PPI on each step of systematic review and guideline
development, solicitation of patients and the public to serve as external reviewers.
Conclusions: PPI can be efcient and effective in improving the quality of EAL guidelines
and supporting systematic reviews, and patient centered care.
Funding Disclosure: None
September 2017 Suppl 1Abstracts Volume 117 Number 9
Pulse Consumption in Relation to Race and Reason among Louisiana Residents
Author(s): W. McCarty1, K. Anguah2, D. Erickson2, J. Pope2; 1
Morrison
Healthcare, 2Louisiana Tech University
Learning Outcome: Learn about pulses, their benets, and their part in the
diets of Louisiana residents.
Pulses are any leguminous crop that are harvested solely for their dried grain
or seeds that are recommended as a healthy source of protein and dietary
ber. This study analyzed pulse intake (quantity and frequency) and reason
for consumption among Louisiana residents. The data were collected through
Market Research (a data collection rm) from Louisiana residents (n206).
The data were categorical in nature and were analyzed using IBM SPSS to
analyze quantity of pulses consumed weekly, frequency of pulse consump-
tion, and reasons for pulse consumption. The mean age of subjects was 37.9
10.2 years; 73 (35.4%) were male and 132 (64%) were female. The respondents
were 70% White, 22% African Americans, and 8% other races. There were no
signicant differences in weekly pulse consumption based on race nor in
pulse consumption frequency among races. There was a signicant difference
in pulse consumption amount based on pulse consumption reason. More
participants (57%) chose to eat pulses because they were a healthy choice
than any other reason. Despite this choice, 85% of respondents consumed the
recommended amount of pulses from the USDA Dietary Guidelines for
Americans. The results suggest that the participants reason for eating pulses
impacts the amount of pulses they eat on a weekly basis. Limitations of the
study include the categorical nature of the data. Further study in this area
should explore the reasons why Louisiana residents consume pulses and
identify strategies to implement more pulses into their diets.
Funding Disclosure: None
RDN Productivity Benchmarks for Long Term Care Facilities
Author(s): W. Phillips1, M. Janowski2; 1
Morrison Healthcare, 2
Morrison/
Compass
Learning Outcome: Participants will understand how to establish a produc-
tivity monitoring system for long term care facilities.
Background: Due to pressure in long term care (LTC) facilities to manage and
evaluate resources effectively, nutrition managers need benchmarks against
which to compare dietitian stafng. Regulatory agencies do not require
certain stafng ratios for RDNs, but they must now report RDN hours cen-
trally along with the other facility staff. This data will be publicly available in
the future.
Objective: Establish productivity benchmarks for RDN stafng in LTC facilities.
Design: Dietitians tracked daily activities on a standardized productivity log
over a 6 month period. Participants/setting: LTC facilities with similar policies
and expectations for RDN stafng were included. Census ranged from 10 to
749 residents. Hours worked in rehab or sub-acute units were excluded.
Results: RDNs completed 3.41 interventions/hour spent in direct patient care,
with 1.73 residents seen/hour spent (more than one intervention was
completed per resident). Since not all RDN time was spent in direct care
activities, the number of interventions/total hour worked was 1.89 and res-
idents seen/total hour worked was 1.01. RDNs spent an average of 24% of time
in indirect care activities, 17% in Direct Care Meetings/Rounds, and 59% of
time in direct resident care.
Conclusions/Discussion: A standardized productivity system should track RDN
activities to establish benchmarks for internal and external comparison,
especially as RDN stafng in LTC facilities will become more visible through
public reporting. This report contributes to the sparse literature about RDNs
activities in LTC facilities, which can guide decisions for resource allocations.
Future research should determine optimal RDN stafng for improving patient
outcomes.
Funding Disclosure: None
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS A-47