P.349 Obtaining department-wide competency in transplant documentation through development and implementation of guidelines and an online testing module in a large pediatric transplant center
Monday May 06, 2019 from 17:00 to 18:00
Exhibit-Poster Area
Presenter

Jessica B Leonard, United States

Clinical Nutrition Specialist II

Division of GI, Nutrition, and Hepatology; Center for Nutrition

Boston Childrens Hospital

Abstract

Obtaining department-wide competency in transplant documentation through development and implementation of guidelines and an online testing module in a large pediatric transplant center

Jessica Leonard1, Caroline Brantley1, Rachel Damiani1, Tina Sun1.

1Department of Gastroenterology, Hepatology and Nutrition; Center for Nutrition, Boston Children's Hospital, Boston, MA, United States

Background: The Centers for Medicare & Medicaid Services (CMS) outlines in the Interpretive Guidelines for the Organ Transplant Conditions of Participation1 nutritional services are standard-of-care and transplant centers must make nutritional assessments and diet counseling services, furnished by a qualified dietitian, available for all transplant patients and living donors. Boston Children’s Hospital (BCH) policy requires dietitian participation and documentation during, the pre-transplant evaluation, transplant admission, and transplant discharge phases of solid organ transplant.

Objective: To improve the solid organ transplant nutrition documentation guidelines and online test module for inpatient Registered Dietitians (RDs) at BCH to achieve department-wide competency.

Methods: In Jan. 2017 the RD Transplant Committee reviewed the nutrition department guideline and accompanying online test module for solid organ transplant. These material’s focus areas were: solid organ transplant documentation requirements, food safety in the post-transplant period, and nutritional management of the solid organ transplant patient. To prioritize compliance with BCH policy on nutrition documentation in the three phases of solid organ transplant, nutritional management was removed and incorporated into in-person staff training. The guideline revision was categorized into the three phases of solid organ transplant: pre-transplant evaluation, transplant admission, and transplant discharge planning. A step-by-step process was written for the required documentation in the dietitian’s written notes and forms within the electronic medical record. The online test module revision consisted of five cases with multiple-choice questions, testing knowledge and comprehension. A score of >/= 80% designated competency. Both the written guideline and online module were reviewed for compliance with the transplant documentation requirements of the Pediatric Transplant Center at BCH.

Results: The revised guideline and online test module launched in April 2018. Currently 33 inpatient RDs are responsible for completing the module annually. Since the launch, anecdotally RDs have reported improved clarity in the guidelines and less confusion when completing the online test module. One hundred percent of RDs who have completed the module have scored >/= 80%, indicating competency. The updated materials and test were presented to the transplant coordinators at BCH to provide transparency on the training process and competency assessment beyond the primary transplant RDs.

Conclusion: Through a systematic review of solid organ transplant nutrition-training materials a more effective organizational structure was identified and content was condensed to focus on key concepts and policies. The use of written and visual components in the revision addressed multiple learning styles, improving comprehension and competency of RDs who don’t care for solid organ transplant patients regularly.

References:

[1] Advance Copy – Interpretive Guidelines for the Organ Transplant Conditions of Participation (CoPs) In. Baltimore, MD: Centers for Medicare & Medicaid Services 2016:103.


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