Calorie Booster Revision. Melissa Misley

Transcription

1 Calorie Booster Revision Melissa Misley

2 Previous calorie booster handouts Included these tips = Recipe included on new handout

3 Previous calorie booster handouts

4 Included serving size and calories Previous calorie booster handouts

5 Previous calorie booster handouts

6 New Handout

7 Highlights of new handout Updated design Calorie/serving size information included Emphasis on foods lower in saturated fat (included a couple additional ones such as olives and shredded coconut) Included 12 quick snack ideas trying to utilize as many WIC foods as possible.

8 Reference Sheets for Assigning Risks Emily Cook

9 Reference Sheets: What s that? These guidelines are cheat sheets for when clients should be referred to an RD based on risk assignments They are color-coded by infants/children and women

10 Reference Sheets: What do they look like? (Infants/Children)

11 Reference Sheets: What do they look like? (Women)

12 Reference Sheets: How do they work? All risks listed on these sheets are risks the state policy considers Medium or High All clients listed as High must be referred to the RD

13 How do they work: Assigning Risks Explains what is required to assign the risk in TWIST Most risks require MD diagnosis, cannot be self-reported by the client It is the certifier s responsibility to ask if the client has been Dx d by an MD The examples given are of the most common medical conditions, but not all If the client doesn t qualify for the risk, it may still be important and helpful to document in Progress Notes so the next certifier is aware

14 How do they work: Assigning Risks

15 How do they work: Clarifications Examples are given when not to assign the risk Explains when State-required documentation is needed if risk is assigned These risks require a note in Progress Notes, otherwise considered out of compliance with the State This required documentation is usually an explanation/clarification as to what prompted you to assign the specific risk

16 Reference Sheets: How do they work? There are some items that are highlighted: Highlighted items are Medium risks according to state policy, however, Washington County policy may differ so please refer to clarifications for exceptions

17 Reference Sheets: Highlighted Risks

18 Reference Sheets: How do they work? There are some items highlighted in RED: be sure to pay extra attention to the clarifications for those risks This is to highlight when the local policy goes above and beyond the State s policy for RD referral Certifier must manually change the risk level in TWIST to High

19 Reference Sheets: Paying attention to the RED

20 Ready to try it out?

21 Case Study #1 Emily Cook

22 Client Profile Glenda is pregnant with her third child and came into the WIC clinic for her initial WIC certification in July. Today (October) she is here for her F3 appointment and she is 21 weeks along. She plans to BF this baby because she was successful with her first child for 12 mo and second child for 11 mo

23 Client Profile Glenda reports that her MD diagnosed her with gestational diabetes (GDM) and hypertension (HTN) during the first pregnancy in 2010, so she thinks she must have GDM during this one, too. Because of the education she received about GDM during her first pregnancy, she is carb-counting and generally following a gestational diabetic diet, but hasn t had a glucose tolerance test or been started on meds yet.

24 Question 1 What risk(s) do you think TWIST would assign this client?

25 Question 1 Answer What risk(s) do you think TWIST would assign this client? Answer: None

26 Question 2 What risk(s) would a certifier assign this client?

27 Question 2 Answer What risk(s) would a certifier assign this client? Answer: None

28 Question 3 What, if any, documentation is required?

29 Question 3 Answer What, if any, documentation is required? Answer: None, however it would be nice to have progress notes regarding hx of GDM & HTN from first pregnancy & info on client s current diet habits

30 Question 4 What type of education would you give during the appointment in October?

31 Question 4 Answer What type of education would you give during this appointment in October? Answer: GDM & HTN prevention diets.

32 Question 5 Does this client need to see the RD?

33 Question 5 Answer Does this client need to see the RD? Answer: No

34 Question 6 What are the next steps with this client?

35 Question 6 Answer What are the next steps with this client? Answer: Schedule her into the Baby Talk Class

36 Case Study #2 Melissa Misley

37 Client Profile Elsa is a 2.5 year old child and comes in for her recertification. She has always met with a Nutrition Technician and has no serious health or feeding issues. She has always been lively and active. She has a good appetite and her mother reports she is much less picky than her two older siblings were at this age.

38 Client Profile Her BMI is consistent and is tracking on the 7 th percentile. Her mother doesn t seem worried about her weight as she is a good eater, very active and, will just be small like the rest of the women in the family.

39 Question 1 What risk(s) do you think TWIST would assign this client?

40 Question 1Answer What risk(s) do you think TWIST would assign this client? Risk 103 high Underweight/At Risk of Underweight

41 Question 2 What risk(s) would a certifier assign this client?

42 Question 2 Answer What risk(s) would a certifier assign this client? None

43 Question 3 What, if any, documentation is required?

44 Question 3 Answer What, if any, documentation is required? None

45 Question 4 What type of education would you provide during this visit?

46 Question 4 Answer What type of education would you provide during this visit? Education on Elsa s growth pattern she s slim, but growing consistently. Bonus Question Does this child need information on calorie boosters?

47 Question 5 Does this client need to see the RD?

48 Question 5 Answer Does this client need to see the RD? Yes

49 Question 6 What are the next steps with this client?

50 Question 6 Answer What are the next steps with this client? FD referral