Dietetics:NutritionCare/Prioritizing a Caseload 2018

Creative Commons photo courtesy of Unsplash user Helloquence

Relevance of topic to dietetics student learning

Within an interdisciplinary health care team, a Registered Dietitian (R.D.) has an important role and subsequently there is often a consistently high workload, in which a dietitian is unable to see each and every patients on the ward. Thus, the ability to efficiently screen patients and appropriately prioritize care is an important skill within Dietetics practice. In many cases, prioritizing care can help an RD assess risks and provide care to patients more effectively. This topic covers the following Integrated Competencies of Dietetics Education and Practice (ICDEP) listed below:

1. Professional Practice
1.06 c) Demonstrate knowledge of approaches to obtain and interpret evidence to inform decision making
* 1.06 d) Demonstrate knowledge of contextual factors that may influence decision making

3. Nutrition Care
* 3.01 a) Demonstrate knowledge of principles for selection and use of nutrition risk screening strategies
* 3.01 b) Use appropriate nutrition risk screening strategies
3.01 d) Identify relevant assessment data to collect
3.01 g) Demonstrate knowledge of principles for obtaining and interpreting a medical history
3.01 i) Obtain and interpret medical history
* 3.02 a) Demonstrate knowledge of principles for prioritization of nutrition care goals based on risk and available resources
* 3.02 b) Prioritize nutrition care goals based upon risk and available resources
3.03 c) Identify the roles of team members in supporting the implementation of a care plan
3.04 a) Evaluate client progress in achieving plan outcomes

4. Population and Public Health
* 4.01 h) Obtain and interpret health status data

*key ICDEPs covered

Disclaimer: This document and the following resources were created by 4th year dietetics students. This Wiki page should be only used as a point of reference. The information from this page was compiled from interviews and resources with the assistance of pre-selected Dietitians and Dietetics Interns specifically for this topic. They have also graciously provided us with program specific responsibility (PSR) guidelines, which we have summarized in creating our page. These PSRs are unit and health authority specific therefore, they may differ depending on the area you work in. For more in-depth resources, please refer to other evidence-based papers.

A Prezi: Screening Patients & Prioritizing Care

Click here for: Screening Patients and Prioritizing Care Prezi

A prezi was created to engage our audience and deliver content that highlights key ideas in an engaging manner. The goal for the presentation was to capture content using a spatial context so that our audience could stay focused on slides that were not static. It is important to note that the Prezi presentation is intended to provide a general understanding of screening and prioritizing nutrition care; however the extent of the information provided is dependent on specific practice settings.

Using samples of prioritization tools provided by dietitians at three different sites, we have compared and contrasted guidelines for priorities within care by sorting them into high, moderate and low via this chart: File:Prioritizing Care Summary Chart.pdf
Please note: The information from the prioritization tools are specific to the practices of the dietitians who have generously provided their resources and may vary depending on your practice setting.
It should be noted that one should follow the guidelines according to the specific area of practice, ward, hospital or care facility that you are in.

An RD Interview: Screening Patients & Prioritizing Care

We interviewed several Registered Dietitians in various health care settings with the purpose to gain a well-rounded understanding of different perspectives within screening patients and prioritizing care.
Please note: The perspectives and advice on screening and prioritizing are specific to the practices of the dietitians who have generously provided their insights and may vary depending on your practice setting.
It should be noted that one should follow the guidelines according to the specific area of practice, ward, hospital or care facility that you are in.

This interview features:
1) Angel Luk (R.D.)
• Bariatric surgery (Outpatient) at Vancouver General Hospital
• Contract Sports Dietitian at Richmond Olympic Oval
• Previous experience in ICU

2) James Song (R.D.)
• Medical & Surgery Ward at Richmond Hospital
• HIV & Hepatitis C at Gilwest Clinic (RH)

3) Amanda Tucker (R.D.)
• Acute Care at Ponderosa (Island Health Authority)
• Rehabilitation Program at Pathways to Home
• Previous experience in residential care

We have also summarized key questions that R.D.s were asked during this interview into the following chart: File:Screening & Prioritization - Summary of RD Interviews.pdf

Summary of Key Principles

Prioritization should be individualized

• Case dependent
• High, moderate, and lower priority lists provided are not comprehensive

Follow the guidelines of the healthcare authority and preceptor

• Every healthcare authority have different guidelines, protocols and procedures
• Preceptors may share pertinent information from experience and expertise

Every one has their own style

• Follow preceptor's style in the beginning of internship to get comfortable
• You can develop your own style with time and experience

Online resources for further learning

UBC Dietetics: Prioritizing a Caseload (2017)
http://wiki.ubc.ca/Dietetics:Prioritizing_a_Caseload

For further resources to support your learning and more practice on screening and prioritizing a patient caseload, the UBC Dietetics class of 2018 have also created a helpful Wiki page to guide you through this process.
Credits: Abby Hsiao, Alyssa Ramanzin, Brianne Davidson, Elizabeth Yu, and Emily Harris

This page includes:
1) Prioritization Flowchart Infographic

2) Considerations When Prioritizing

3) Powtoon - Practice Case Study on Transitioning into Clinical Practice

Authors

Student Authors

Suzanna Su
Betty Sung
Emily Hou
Carla Centola
Lan Nguyen
Julia Chien

Special thank you to the following RDs for their contributions:

Kelly Picard
Karalee Boschung
James Song
Amanda Turner
Angel Luk
Karen Parinas
Dianne Sonneveld

Special thank you to the following Interns for their contributions:

Paige Courtice
Sophia Kalil

Date developed: April 5th, 2018