1. Default Section. 1. Gender: 2. Credentials (mark all that apply):

Transcription

1 1. Default Section 1. Gender: Male Female 2. Credentials (mark all that apply): RD LD/CDN Master s PhD RN CSR CDE CNSC 3. How long have you been practicing as a Registered Dietitian? (If you are not currently a Registered Dietitian you may discontinue taking this survey). 0 to 1 year >1 to 3 years >3 to 7 years >7 to 10 years >10 to 15 years >15+ years * 4. In which USRDS Renal Network do you practice? (go to if you are not sure). Page 1

2 5. How long have you worked with dialysis patients? (hemodialysis or peritoneal dialysis) I have not worked with dialysis patients 0 to 1 year >1 to 3 years >3 to 7 years >7 to 10 years >10 to 15 years >15+ years 6. How long have you worked as a transplant dietitian? 0 to 1 year >1 to 3 years >3 to 7 years >7 to 10 years >10 to 15 years >15+ years 7. What organ transplants do you cover as a transplant dietitian? (check all that apply) Kidney Liver Pancreas Heart Lung Intestine 8. What percentage of your full-time employee status (FTE, or 40 hours/week) is devoted to your center s kidney transplant program? <25% 25% to 50% 51% to 100% Page 2

3 9. Who funds that part of your FTE that is devoted to kidney transplant? (check all that apply) Food and Nutrition Services (or Dietary Department) Transplant Program Department of Surgery Outpatient Clinics 10. If you are involved in pre-transplant medical nutrition therapy (MNT) for kidney transplant candidates, describe the areas of your practice. I am not involved in pre-transplant MNT Nutrition component of pre-transplant evaluation Pre-transplant class MNT for weight management MNT for chronic kidney disease (CKD) MNT for DM and/or heart healthy diet 11. How are you involved in immediate post-transplant MNT for kidney transplant recipients (0-2 months post-op)? MNT inpatient for post-transplant patients MNT for weight management MNT for chronic kidney disease (CKD) MNT for DM and/or heart healthy diet I am not involved in immediate post-transplant MNT Page 3

4 12. How are you involved in long-term post-transplant MNT for kidney transplant recipients (>2 months post-op)? Per referral or patient/family request MNT for weight management MNT for chronic kidney disease (CKD) MNT for DM and/or heart healthy diet I am not involved in long-term MNT 13. Describe the perceived role of the dietitian on your kidney transplant team: 5 6 Page 4

5 2. Transplant-Related Questions 1. How are you involved in pre-transplant evaluations for kidney transplant candidates? I am not involved in pre-transplant evaluations I attend the transplant team's selection conference By communicating via charting my recommendations and/or nutritional assessment of the candidate Other way you convey your pre-transplant evaluation to the team: 2. Which measurement(s) does your kidney transplant team record during pretransplant evaluations (and who performs each measurement)? Measurement not RN RD Technician Medical Assistant MD used State height Stated weight Measured height Measured weight BMI Waist circumference Hip circumference Waist/hip ratio Bio-impedance analysis (BIA) Dual energy Xray absorptiometry (DEXA) 3. Which of these measurements are you using to determine obesity? BMI Waist circumference Hip circumference Waist/hip ratio Bio-impedance analysis (BIA) Dual energy Xray absorptiometry (DEXA) Page 5

6 4. Based on your answer to question 3 (above), what numerical value will ABSOLUTELY EXCLUDE a candidate from consideration for transplantation? BMI Waist circumference Hip circumference Waist/hip ratio Bio-impedance analysis (BIA) Dual energy Xray absorptiometry (DEXA) Other 5. Based on question 3 (above), what numerical value would serve as a RELATIVE CONTRAINDICATION for transplantation when considered with comorbidities? BMI Waist circumference Hip circumference Waist/hip ratio Bio-impedance analysis (BIA) Dual energy Xray absorptiometry (DEXA) Other Page 6