Registered Food & Nutrition Dietitian - Transplant Services - FT Days

Department:

11903 Aurora St. Lukes Medical Center - Food and Nutrition

Status:

Full time

Benefits Eligible:

Yes

Hou rs Per Week:

40

Schedule Details/Additional Information:

Monday through Friday

The RD serves as the primary nutrition provider for AHFT candidates and recipients across care settings. This role evaluates all LVAD and heart transplant candidates (inpatient and outpatient), delivers pre-, peri-, and post-transplant nutrition care, participates in required transplant meetings, supports pre-habilitation, provides heart failure nutrition therapy to non-transplant patients, and offers cross-coverage for the abdominal transplant RD.

Core Workflow (Inpatient & Outpatient)

• •Initial Evaluations: completes nutrition evaluations for candidates identified for LVAD/heart transplant options
• •Assess dietary patterns and any barriers to adequate PO intake (appetite, nausea, chew/swallow difficulties, budget, cooking access).
• •Conducts standardized nutrition-focused physical exam (NFPE).
• •Diagnoses malnutrition per AND/ASPEN when criteria met.
• •Provides individualized nutrition interventions and education, coordinates care with interdisciplinary team.
• •Documents readiness for transplant from a nutrition standpoint (nourished, at risk for malnutrition, malnourished)

• •Perioperative Care:
• •Presents patient’s risks/updates in Patient Selection Committee
• •Follows evaluated patients through their inpatient stay. Follow ups pending nutrition risk/hospital protocol
• •Escalate nutrition interventions pending nutritional status/clinical status (oral nutrition supplements, consider EN if intake is inadequate)
• •Collaborate with care team to support glycemic control, refeeding risk, wound-healing supplementation

• •Post HTx/LVAD:
• •Nutrition discharge education: Food safety deep-dive; infection risk mitigation, nutrition for wound healing, low sodium/fluid restriction nutrition therapy
• •Long-term cardiometabolic management; physical activity nutrition support (coordinate with PT/rehab).

• •Heart Failure Patient (non-transplant, Outpatient):
• •Provide 1:1 clinic visits or consider development of group class curriculum to support non-transplant patients and support clinical outcomes.

• •Required Meetings: (average 2 hours/week)
• •Weekly Patient Selection Committee
• •Bi-Monthly Clinical Practice/Quality Meeting
• •Quarterly Protocol Meeting
• •Quarterly Organ Transplant Advisory Committee Meeting (alternate with ABD TX RD)
• •Quarterly Transplant Overview Course (alternate with ABD TX RD)
• •Quarterly heart failure meeting

Pay Range:

$30.70 - $46.05

Major Responsibilities

• •Daily, provides ongoing Medical Nutrition Therapy (MNT) care for entire hospital inpatient census, through screening, prioritizing, assessing, and recommending interventions. Adapts daily workflow to accommodate fluctuations in patient load due to daily census variations, consults, acuity, staffing challenges. Develops and implements a plan of care for patients based on an expert assessment of life cycle- and diagnosis-specific nutritional needs. Assessment includes reviews of medical history and laboratory data, patient interviews, and physical examinations to determine the current nutritional status of inpatients and/or outpatients. Based on the assessment, the Clinical Dietitian develops and implements individualized nutrition plan of care interventions. Documents medical nutrition therapy plan of care in the electronic medical record supporting system clinical documentation and coding standards to maximize reimbursement rates.
• •Prescribes enteral and parenteral nutrition support orders by assessing the patient and calculating macronutrients and/or micronutrients, fluid, and electrolytes. Evaluates patient tolerance and effectiveness of formulas and manages initiation or modifications to enteral/parenteral regimen orders. The Clinical Dietitian demonstrates extensive knowledge of specialized nutrition support (parenteral and enteral) and triages issues and concerns through collaboration with physicians and pharmacy. Constant, secure communication with system level Pharmacy Integrated Clinical Services (PICS) team to manage and order Total Parental Nutrition (TPN) infusions for critically ill patients in the hospital.
• •The Clinical Dietitian prescribes orders for therapeutic diets, oral nutrition supplements, and nutrition support regimens, including vitamins/minerals, fluid management, and lab work as indicated within the scope of the Medical Nutrition Therapy (MNT) protocol. Utilizes order-writing privileges to implement nutrition related orders. Collaborates with Food and Nutrition patient services team to ensure patient intake aligns with nutrition prescription and interdisciplinary plan of care. Partners with site patient services team to identify and recommend appropriate clinical nutrition formula and supplement substitutions during supply chain disruptions to reduce and eliminate significant disruptions to patient care. Partners with physicians, nursing, and nutrition patient services to ensure diet restrictions, allergy restrictions, supplement preferences and tube feedings are consistent with patient needs and personal, religious, and cultural preferences. Develops patient-specific menus for patients admitted with complex dietary needs (e.g., multiple food allergies, numerous diet restrictions, and/or low-use, high risk diet orders).
• •Leads efforts to identify, treat and prevent malnutrition. Performs Nutrition Focused Physical Examinations of high-risk patients to evaluate the loss of specific muscles and subcutaneous body fat to determine the presence of and degree of malnutrition. Communicates findings to the medical team through medical record documentation to ensure maximized reimbursement. Provides medical nutrition therapy education to patients identified with moderate or severe malnutrition to improve patient outcomes and to positively impact inpatient readmission rates.
• •Routinely documents elements of the Global Malnutrition Composite Score (GMCS) for Medicare and Medicaid Services’ (CMS) Nutrition Electronic Quality Indicators. Participates in Quality Assessment Performance Improvement (QAPI) efforts to ensure nutrition care is safe and effective for patients. Maintains regulatory readiness. Supports department clinical initiatives to ensure compliance with safety initiatives, policies, and procedures, DNV regulations, and department standards.
• •Identifies and documents billable nutrition diagnosis with supporting documentation. May provide clinical support to various hospital-based outpatient medical destination programs (e.g., cancer center, transplant clinic, digestive health programs, bariatric, cardiac rehab, heart failure, etc.) Enters charges for outpatient nutrition charge capture in electronic medical record.
• •Supports partnerships with local didactic programs by precepting dietetic graduate students in clinical nutrition and/or foodservice management. Directs and monitors interns’ progress both daily and at designated touchpoints and provides feedback for growth and development. Communicates regularly with didactic program coordinator. Also, precepts medical residents and provides nutrition orientation as applicable. Provides nutrition lectures to medical residents for internal medicine, trauma, NICU/Peds, and family practice, as applicable.
• •Collaborates routinely with discharge planners, home health, physicians, pharmacy, and other interdisciplinary teams to address the full scope of the system-established priority points protocol for inpatient care. Participates in interdisciplinary team rounds, meetings, and care conferences to coordinate and collaborate on nutrition goals. Assists with transition to home or outside facilities by partnering with Care Management and/or Home Health to coordinate home enteral and/or parenteral nutrition needs.
• •Provides medical nutrition therapy education to patients on prescribed diet, per establish