Dietetic Internship Curriculum: Clinical Nutrition
Our 35 clinical nutritionists/registered dietitians and nutrition technicians provide nutrition care on a daily basis to inpatients and outpatients. Overall the hospital maintains 477 private rooms for inpatient care and operates over 80 primary care and specialty clinics for outpatients. The majority of registered dietitians on staff are Master's prepared. Staff work in specialized medical care including oncology, organ transplant, cardiac surgery, pediatrics and critical care.
The Clinical Nutrition staff is responsible for the nutritional care of all patients, whether their nutrient intake is provided via the oral, enteral or parenteral route. The basic philosophy of the Clinical Nutrition staff is that individualized nutrition care be provided throughout each patient's hospitalization and appropriate follow-up care be offered upon discharge. To accomplish this goal, the nutritional status of each patient is screened within 24 hours of admission with in-depth nutritional assessment for patients with nutritional risk.
As appropriate, a nutritional care plan is developed and monitored daily. Recommendations and evaluations of the nutritional care plan are provided and documented in the patient's problem-oriented medical record. Clinical nutritionists are actively involved in the development of realistic nutritional care plans. A cooperative network is maintained between each patient and the members of his or her health care team in order to promote patient satisfaction as well as optimal medical attention.
Organization and Communication
Both intradepartmental and interdepartmental communication is enhanced through computer systems. Clinical nutritionists and nutrition technicians utilize computer applications for patient ADT and order entry information, menu selection and food service operations.
Palm pilots assist with coordination of patient care, patient meal selections and nutrition calculations. WISCR-IT, a computerized medical record, provides online access to pertinent patient information, thereby optimizing patient care. Additionally, medical research teams have also requested detailed nutrient analysis of dietary intakes. Members of the Clinical Nutrition team, including the dietetic interns, are provided with access to Nutritionist V to complete the analysis.
Education is an integral part of the philosophy of the Clinical Nutrition Services Department. This creates an environment conducive to continuing education and research related to improvement in the daily operation of the department.
Routine monitoring of performance in the clinical department, as well as administrative areas of the department has been outlined in a comprehensive quality improvement program. Orientation of new employees, in-service education of all employees, professional staff development and the Dietetic Internship Program are all examples of this commitment to continued learning.
Clinical Nutrition Experience
The clinical nutrition experience consists of nine rotations for a total of 24 weeks. During clinical rotations, interns:
- Screen patients for nutritional risk
- Supervise and assess nutritional status of patients with uncomplicated and complex medical conditions
- Interpret laboratory data and learn appropriate medical terminology
- Develop knowledge of disease states and procedures
- Investigate nutritional implications of drug therapy
- Function as members of healthcare teams
- Serve as nutrition resources for other health care professionals
- Supervise and determine nutritional care plans, including continuity of care plans for patients with uncomplicated and complex medical conditions
- Document recommendations in problem-oriented medical records for all patients assessed
- Monitor the effectiveness of nutrition services provided
In addition to the experiences with normal nutrition and diet therapy, interns are responsible for parenteral and enteral support of critically-ill patients.
Each intern advances through the following clinical nutrition rotations:
- Internal medicine
- Cardiovascular medicine
- Renal disease and dialysis
- Cardiac transplant
- Trauma and life support/burn
- Clinical staff relief
Each intern prepares and presents a one-hour clinical case study to fellow interns, clinical nutritionists, dietitians, medical staff and researchers.