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ארועים עתידיים

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סמינר המכון לביוכימיה

תאריך: 
ה', 24/11/201611:00
מיקום: 
מועדון הסגל

שלום רב,

הנכם מוזמנים לסמינר המכוני, אשר יתקיים ביום חמישי 24/11/2016, במועדון הסגל:

סמינר המכון לביוכימיה מדעי המזון ותזונה

Biochemistry and Nutrition-Upcoming Seminar
Note-a different hour than usual

Thursday, November 24th 2016
MOADON SEGEL at 11:00
PhD lecture: Shelly Rachman-Elbaum

Advisors: Dr. Aliza H. Stark, Dr. Bat-Sheva Porat-Katz
Will lecture on

Development, Instruction and Implementation of a Uniform System to Document Dietetic Care in Geriatric Facilities; a Pilot Study

Student: Shelly Rachman-Elbaum

Advisors: Dr. Aliza H. Stark, Dr. Bat-Sheva Porat-Katz

The lecture will be given in Hebrew

Abstract

Use of Electronic Health Records (EHRs) facilitates sharing of patient information across national and international entities and requires a systematic and standardized diagnostic terminology for each health care discipline. That ‘same language’ nutrition terminology was first developed by U.S. Registered Dietitians (RDs) in 2003 and is now known as the Nutrition Care Process and Model (NCP). The four steps of the NCP include assessment, nutrition diagnosis, intervention, monitoring and evaluation. The nutrition-related diagnoses and documentation entitled the International Dietetic and Nutrition Terminology (IDNT) is a single set terminology applied across all patient populations. However, RDs report difficulty with the IDNT because it is challenging to apply generic nutrition diagnoses in specific patient sectors. Currently, Israel has no systematic NCP and has not established consistent documentation terminology. The extensive use of EHR in Israel has exposed an urgent need for such a documentation system.

We propose a novel, patient-sector approach for documentation of dietetic care among Israeli RDs. We chose to demonstrate our sectoral approach in the geriatric field of nutritional practice because this patient population has a wide range of medical and nutritional problems – including high incidence of malnutrition – and provides an ideal sample for developing and implementing our innovative approach for standardized documentation.

The three objectives of this project were: (1) to build a patient sector dietetic care practice (DCP) tool with input from experts in geriatrics, (2) to train Israeli RDs working in geriatric practice to use the tool, and (3) to assess the ability to use the tool in clinical practice.

In Phase I, the proposed DCP documentation tool compatible with EHRs was developed by a team of professionals and was compliant with Israeli Ministry of Health standards for dietetic care in geriatric practice. Twelve experienced RDs (median years of practice =23.0; SD = 8.8 and median years of practice in geriatric populations 13.0, SD = 8.5) provided expert evaluation of the tool and deemed it highly appropriate for documenting the DCP by Israeli RDs.

In Phase II 80 RDs working in geriatric practice completed an eight week online training course, the first of its kind in Israel, of the proposed DCP tool and demonstrated significant improvements in pre to post-test knowledge scores t(67) = -9.007, p = .000; 95% CI [-26.713, -17.019]. Age, education, geographic location and previous experience with online courses were not correlated with academic performance, suggesting demographic characteristics did not impact training.

In Phase III three months following completion of the training, participating RDs were asked to submit actual patient cases or complete sample case studies in order to assess utilization of the proposed DCP model in their clinical practice. Fifty-four (77%) provided completed cases, over 80% reported every step of the proposed novel documenting tool with 83% reporting the nutrition diagnosis, a concept first introduced to Israeli RDs in this project.

Conclusions: Our results suggest that RDs who practice in specific patient sectors can benefit from a novel, patient population dietetic care standardized reporting method. We believe our proposed system has major implications for Israel and other countries attempting to implement a standardized nutritional documentation system. The patient-sector approach provides a solution to emerging difficulties and has potential for adaptation by other health-care disciplines.