busy week…
May 26, 2008
two weeks down, 10 to go…
last week was incredibly busy due to an increased patient load for my preceptor (MP). it’s hard to tell whether MP had an increased load or if i was simply slowing her down.
i also attended the Nutrition and Food Service (NFS) Department meeting as well as the pediatric RD meeting.
overall, the NFS department seems to have high employee satisfaction scores, except among the dietitians. chief complaint: they want more help. the good news: the hospital bigwigs have just approved a new budget that includes monies toward the hiring of new registered dietitians (RDs). this made everyone happy.
last week I worked on two calorie counts. a calorie count is simply a tally of a patient’s intake (usually kept by the nurse or the patient’s caregiver for 2-3 days). it’s the RD’s job to calculate the total calories and protein consumed and make recommendations regarding whether or not the patient is meeting or exceeding her needs.
i was surprised by how much estimation the RDs use. for example, the calorie count might list “four waffle fries” without any indication of whether the fries came from inside the hospital or if they were smuggled in by a family member. because the nutrient density of a french fry can change depending on what oil it was fried in, how thick the potato was cut, etc., estimation can lead to a less precise nutrient analysis.
MP mainly used Calorie King to estimate the kcal and protein in items that may have varying nutrient contents (like french fries); however, she used the exchange system to analyze items that have standardized contents (e.g. 8 oz. of whole milk has 150 kcal and 8 grams of protein. period.).
one has to assume there is a better way to calculate total intake, especially at a hospital that uses computrition. i assume the hospital’s computrition system knows exactly how many calories and grams of protein are in the waffle fries the kitchen pumps out. perhaps this would be a better way to handle calorie counts for foods produced within the hospital?
more to come!
