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Nancy M Lewis

Publications and source records attributed to Nancy M Lewis.

7 recordsLinked to original sources
PubMed2006

Validity and reliability of a quantitative food frequency questionnaire measuring n-3 fatty acid intakes in cardiac patients in the Midwest: a validation pilot study.

The purpose of this pilot study was to test the validity and reliability of a quantitative n-3 fatty acid food frequency questionnaire (FFQ) for later use with larger groups of individuals. A convenience sample of heart patients provided dietary data via three 24-hour food recalls and FFQs. Participants were women (n=17) and men (n=11), 43 to 77 years of age. The association of mean daily intake of n-3 fatty acids obtained using food recalls and the FFQ was assessed by Pearson correlation. The reliability of the FFQ was assessed using coefficient alpha. Correlation of n-3 fatty acid intake using the food recalls and the FFQ was r=0.42 (P<0.05). The coefficient alpha for the test-retest of the FFQ was .83. The top two foods, walnuts and flaxseed, contributed 58% of the n-3 fatty acid intake, and the third food, salmon, contributed 5%. This quantitative n-3 FFQ is a valid instrument for use in place of food recalls for estimating n-3 fatty acid intakes in heart patients and is a reliable instrument to estimate n-3 fatty acid intakes from plant, animal, and seafood sources. The FFQ should be tested in a larger population. Registered dietitians can use this FFQ to screen for intakes, educate patients on food sources, and measure change in intakes after nutrition intervention.

Adult↗
PubMed2006

Using initiative to achieve autonomy: a model for advanced practice in medical nutrition therapy.

The purpose of this research was to generate a model of advanced medical nutrition therapy (MNT) practice based on descriptions of their clinical activities provided by advanced-level MNT practitioners. A qualitative approach using grounded theory methodology was employed. The model of advanced MNT practice was based on interviews with 21 credentialed advanced practice registered dietitians from across the United States and Canada. Verbatim transcripts of the interviews were coded for aggregation into themes and subthemes. The resulting model included a single overarching theme: using initiative to achieve autonomy. The five subthemes are aptitude, attitude, expertise, context, and approach. The model provides a richer picture of advanced MNT practice than was previously available and is presented for discussion and debate. Validation of the model is required before incorporation into education or practice.

Attitude↗
PubMed2006

Clinical registered dietitians, employers, and educators are interested in advanced practice education and professional doctorate degrees in clinical nutrition.

A subset of registered dietitians (RDs) is known to practice at an advanced level, but a clear educational pathway supporting advanced medical nutrition therapy practice has not been identified. Thus, an electronic survey was designed to investigate interest of clinical RDs, employers, and educators in advanced practice competencies and professional doctorate degree programs in clinical nutrition. Usable responses were obtained from 440 of 978 (45%) RDs, 61 of 107 (57%) employers, and 76 of 114 (67%) educators. Mean interest (5 = very interested, 1 = very uninterested) in obtaining advanced practice education was highest among RDs (3.93+/-1.01) and was significantly different (P < 0.01) from employers (3.74 +/-1.28) and educators (2.76+/-1.33). Interest in completing a professional doctorate in clinical nutrition was significantly (P < 0.01) different among RDs (3.05+/-1.28), employers (3.18+/-1.30), and educators (2.3+/-1.34). Employers' mean interest score for hiring RDs with a professional doctorate in clinical nutrition was 4.02+/-0.93. A subset of clinical RDs appears to be interested in obtaining advanced practice competency and enrolling in professional doctorate degrees in clinical nutrition. Clinical nutrition managers in academic medical centers may be interested in hiring advanced practice clinical RDs with professional doctorate degrees. Opportunities exist for educators to develop advanced practice educational experiences and professional doctorate degree programs.

Chi-Square Distribution↗
PubMed2005

A look at the educational preparation of the health-diagnosing and treating professions: do dietitians measure up?

Basic educational requirements for dietitians were developed almost 80 years ago and remain largely unchanged. In the interim, other health professions have increased their academic standards. A review of the educational preparation of 16 health-diagnosing and treating professions was undertaken to better understand the standards for dietetics education within a larger context. Educational standards for each profession were obtained and reviewed for types of degrees; duration of post-secondary, college-level education; division of didactic and clinical education; and presence of accredited post-professional education. Findings reveal that at least 11 of the professions studied offer first professional degrees. Differences were noted in duration and sequencing of undergraduate education, didactic or classroom education, and especially supervised practice. Models to facilitate comparison between educational standards were developed. The current educational model in dietetics is designed to prepare entry-level practitioners and academics who comprise less than 20% of the profession. This review supports the need to investigate educational opportunities for beyond-entry-level dietitians, and to develop educational programs that amplify the existing models for educating dietitians.

Accreditation↗
PubMed2005

Orientation to nutrition care process standards improves nutrition care documentation by nutrition practitioners.

OBJECTIVE: To compare documentation of two groups of clinical nutrition practitioners for evidence of the nutrition care process. DESIGN: This study used a comparative descriptive design. A retrospective chart review was conducted on all nutrition documentation in closed patient records. Documentation of two groups of nutrition practitioners (institution A=practitioners who received initial orientation and routine reinforcement in use of nutrition care process standards; institution B=practitioners who received orientation in use of a further assessment and medical nutrition therapy intervention procedure) was compared for evidence of a six-step nutrition care process. SAMPLE/SETTING: The sample consisted of randomly selected patient records (N=60). A total of 15 oncology and 15 chronic renal failure patient records from each of two Midwestern tertiary-care hospitals were reviewed. MAIN OUTCOME MEASURES: Outcome measures were number of nutrition care process steps documented, appropriate relationships among documented steps in the nutrition care process, and the number of complete, incomplete, and interrupted chains. STATISTICAL ANALYSES: Two-sample t tests and chi(2) analyses were used. RESULTS: Nutrition practitioners at institution A documented approximately three times as many nutrition care process steps per patient per chain that demonstrated appropriate relationships as did nutrition practitioners at institution B (2.69+/-1.15 and 0.80+/-0.62, respectively [mean+/-standard deviation]) (P<.001). There were no outcome judgments related to goals documented in chains at either institution and because of this there were no completed nutrition care process chains at either institution. CONCLUSIONS: Nutrition practitioners with orientation to nutrition care process standards documented more related nutrition care process steps than practitioners without this orientation. Providing nutrition practitioners with ongoing education and clinical experiences in use and documentation of the nutrition care process and a standardized language may be indicated to increase the number of completed nutrition care process chains and improve documentation of nutrition care and patient outcomes.

Chi-Square Distribution↗
PubMed2004

A standardized nutrition care process and language are essential components of a conceptual model to guide and document nutrition care and patient outcomes.

Documentation of clinical services within health care systems has become increasingly significant because greater amounts of information are now required by accrediting agencies, third-party payers, researchers, and others in their evaluation of patient care and because of the increasing emphasis on patient outcomes. Given the multiple users who depend on health care information in the patient record, it is imperative that clinical nutrition practitioners implement a standardized nutrition care process and language to document comprehensively and communicate meaningful information concerning their role in improving patient outcomes. A body of work has led to the development and adoption of a standardized nutrition care process for the dietetics profession. A standardized nutrition care process consistent with the scientific method and a standardized language are two essential components required to articulate a conceptual model for clinical nutrition practice and documentation and distinguish clinical dietetics' unique body of knowledge. The conceptual model serves as an organizing framework to standardize and guide nutrition practitioners' clinical judgments or critical thinking processes and document information linking nutrition care to patient outcomes.

Cost-Benefit Analysis↗