Nutrition Counselling Presentation

Haliburton Highlands

Family Health Team

Nutrition Counselling Development

Haliburton Highlands Family Health Team

March 2, 2007


Family Health Team

Big Picture

Nutrition Counselling:

• Integral part of the health care system– provides primary, secondary and tertiary

prevention.

• offers nutrition education and medical nutrition therapy – reduces the risk and impact of diseases and

illnesses

• Impacts positively management or prevention of many diseases and illnesses


Family Health Team Roles of the FHT Dietitian

• Individual Client Consultation/Education– physician-referred, self-referred, walk-ins

• Group Education– community workshops etc.

• Information and Resources for Health Professionals and clients– Developing workshops, and resources (i.e. handouts)

• Interdisciplinary Planning– program development

• Interdisciplinary Teaching– Physicians, allied health professionals, nurses, nursing

students/residents and dietetic interns


Family Health Team

Documentation

• Dietition Notes can be accessed through the Care Plan button in the Master Record of a client.

• By clicking the Care Plan button you will be able to locate encounters by date and description – example: Mar 20, 2007…...…Dietition Initial Consult

Apr 3, 2007……...…Dietitian Follow Up

• Direct client care documented using templates:– Assessment Template for initial consultations– SOAP for follow-up appointments

• Telephone appointments documented as above or by internal email to family physician / FHT member


Family Health Team

Who Do I Refer?

• Cardiovascular Disease– CAD, stroke, hyperlipidemia, hypertension

• Celiac Disease

• Diverticulosis

• Food Allergies and Intolerances

• Inflammatory Bowel Disease– Crohn’s, Ulcerative Colitis

• Irritable Bowel Syndrome

• Nephropathy

• Weight Management– Overweight, obese, underweight


Family Health Team

Cardiovascular Disease

Counselling consists of:– Dietary Fats: Saturate, Trans, Poly- and

Mono- unsaturated fats– Reducing Cholesterol intake– Increasing Fiber: Insoluble, and Soluble– Reduction of Sodium– Dietary Approaches to Stop

Hypertension (DASH) diet for appropriate clients to reduce BP (this will happen automatically for all appropriate clients referred to the Health Living Program for HTN)


Family Health Team

Celiac Disease

Counselling consists of:– Modifying diet to relieve symptoms,

prevent nutrient deficiencies and to maintain good health of the intestinal tract

– Adherence to a gluten-free diet


Family Health Team

Diverticulosis

Counselling consists of:– Dietary fiber: soluble and insoluble– Low residue or elemental diets– Importance of increased fluid intake– Fiber supplements if appropriate– Healthy eating guidelines


Family Health Team Food Allergies & Intolerances

Counselling consists of:– Determining foods that provoke

symptoms and hidden forms of these foods

– Avoidance of foods that cause the reaction

– Replacement of trigger food(s) with other foods that provide the missing nutrients


Family Health Team Inflammatory Bowel Syndrome

Counselling consists of:– Adjustment of eating pattern– Determining the foods that aggravate

symptoms– Increased fiber intake, psyllium fiber or

fiber supplements to relieve diarrhea– Determining the need for multivitamins– Importance of physical activity– Management of stress


Family Health Team Irritable Bowel Syndrome

Counselling consists of:– Review of the client’s diet to determine

foods that may trigger symptoms– Increasing dietary fiber– Healthy eating guidelines– Determining the need to increase

physical activity– Management of Stress


Family Health Team

Nephropathy

Counselling consists of:– review of biochemical data to determine

the need to adjust intake of:•Calcium•Phosphorus•Potassium•Sodium•Protein


Family Health Team

Weight Management

Counselling consists of:– Health risks– Healthy weights– Healthy eating guidelines and dietary

modifications– How to set realistic goals(Above will be coordinated with counselling on physical

activity, stress management and other lifestyle behaviours provided by Healthy Living RN)


Family Health Team

Email Referral

To Dietitian

Em

ail Referral

To D

ietitian

Appro

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te se

lf-re

ferr

al

forw

arde

d to T

eam

Supp

ort f

or a

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Walk-in Physician ReferralRosteredAffiliated

Unattached

FHT Program ReferralRosteredAffiliated

Enrolled in FHT programming

Primary Practitioner ReferralRosteredAffiliated

Inpatient (to be discharged)

Email Referrals:Client NameIndication for referralReason for consultationAttach Patient HistoryLab results as indicatedLevel of UrgencyWho to follow-up with if different than Referring Physician (ie. Resident) Registered Dietitian

Encounter

Direct

Telephone

.Dietitian documents encounter in client electronic medical record using Careplan template:

Assessment Information / Resources Provided Recommendations Referral to other (if any) Dietitian Follow-up (if any)

2. Dietitian will send Email to Referring and / or Primary Care Practitioner with notice of client encounter.

1. If Documentation required:Same actions as Direct Encounter.2. If Documentation not required:Email to Referring and / or Primary Care Practitioner with notice of telephone encounter and attach email to client electronic medical record: using Careplan template Assessment Information / Resources Provided Referral to other (if any) Dietitian Follow-up (if any)

Will coordinate Client careplan as appropriate with other health professional(s)(ie. Healthy Living RN)

Nutrition Counselling Presentation

Health & Medicine

Transcript of Nutrition Counselling Presentation