Re: Diet Manuals / Menus / JCAHO

[Guest guest]

My facility is JCAHO-accredited acute care hospital.

We currently use the ADA online manual but previously used

the hard copy manual- we didn't put one on each nursing unit-

we had them posted in the diet office, clinical office, ER and

then one in a nursing administration area that is accessable 24/7.

This non RD/CDM person that wrote the menus- does she have the

nutritional analysis to back them up? An RD still has to

to review/sign off on diets & they have to be in line with your

hospital-approved diet manual.

Holly Mistler, RD/LD

Mercy Health Center

OKC,OK

>

>

> Hello to all:

>

> One of my parttime jobs is 2 days a week in a LTACH (Long Term

Acute Care

> Hospital). It is a new facility and is now a stand alone

hospital. It used to

> be in another hospital. With that setup the dietitians were part

of the

> larger hospital staff and were contracted to provide clinical

care.

>

> The other RD and I (both new to the LTACH) are struggling some

because

> Administration is really unaware of some of the requirements for

patient care

> since the contracted dietitians and their department at the larger

hospital took

> care of all the things.

>

> We are going through many of the challenges of starting up a new

facility.

> I have a couple of questions.

>

> Diet Manuals: What are the interpretations of the current

regulations

> regarding Diet Manuals and how many are needed? We plan to

eventually go to the

> ADA Diet Manual but cannot do it yet because the facility

computer

> infrastructure is not there yet. We are due for JCAHO inspection

soon and we are being

> questioned by administration why we are requesting a copy of the

purchased

> diet manual for each Nursing unit. The nursing units are

separate units and

> each have other policy and procedure manuals, a copy at each

unit. Some of the

> nursing and pharmacy manuals are available on the company

Intranet and can

> be accessed at each nursing unit. Is the interpretation for Diet

Manuals

> still 1 per unit? We have 3 separate units of 24 beds each and

an 8 bed ICU

> unit.

>

> Menu Approval: The clinical dietitians do not work for the

Dietary

> Department but work for Nursing Services. It is a little unusual

but that is how it

> is organized at this facility. The Food Service Director is not

a CDM nor

> has she been clinically trained. She wrote the original menus

including

> modified diets without the guidance and sign off of an RD. Now,

she is questioning

> why she needs to have her menus reviewed by and approved by an

RD. Part of

> her questioning is now that we have an approved Diet Manual she

does not seem

> to want to change her menus to meet the standards of the manual.

Isn't that

> still the interpretation of how menus should be handled? Menus

with the

> modified diets should meet the Diet Manual guidelines and the

menus should be

> approved by an RD?

>

> I would appreciate any comments from others. Please identify

whether you

> are in a JCAHO approved facility and if you with a LTACH. I

would appreciate

> any help.

>

>

>

>

> Giles Walters, MMSc, RD, LD, FADA

> Consulting Dietitian

> Augusta, GA

>

>

>

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