Syllabus

Master of Science in Applied Nutrition

APN 785: Nutrition Assessment and Application in a Clinical Setting (Summer B 2023)

Credits - 3

Description

This course will emphasize the Nutrition Focused Physical Exam approach to nutrition assessment in the clinical setting. Advanced assessment of dietary, biochemical, and body size and body composition will be included in this course. Students will apply computer skills and use health informatics in the Nutrition Care Process. In addition, the course will examine the impact of complementary and integrative nutrition on drugs, disease, health and wellness.

Materials

Learning Objectives and Outcomes

Program Outcomes

The course will satisfy the following program objectives. You will learn how to:

• Develop and utilize nutrition concepts and best practices for nutrition and health promotion initiatives
• Apply core research principles to measure the nutrition status and environment of individuals and communities
• Interpret and modify explanations of complex nutrition concepts for various audiences
• Research, develop and disseminate evidence-based and theory-driven educational materials and work products at an audience-appropriate level for topics related to nutrition and health promotion

Course Outcomes (ACEND Competencies)

1.5 Applies knowledge of patho-physiology and nutritional biochemistry to physiology, health and disease.

1.5.2 Interprets and analyzes the effect of diet, fluids, electrolytes and nutritional status on the development and progress of the disease process. (S) 

1.7 Integrates the principles of cultural competence within own practice and when directing services.

1.7.3 Identifies challenges that arise when different cultures, values, beliefs and experiences exist between clients/patients and nutrition and dietetics professionals. (D)

1.8 Applies knowledge of pharmacology to recommend, prescribe and administer medical nutrition therapy.

1.8.1 Identifies the classifications of nutraceutical pharmacological agents and the action of the body. (K) 

1.8.2 Demonstrates understanding of pharmacokinetics, absorption, clearance, drug metabolism, latency period, drug and supplement metabolism, accumulation, half life, and routes of administration. (S) 

1.8.3 Identifies potential drug and food interactions based on physiological responses to pharmacological agents and takes appropriate actions. (S)

1.9 Applies an understanding of the impact of complementary and integrative nutrition on drugs, disease, health and wellness.

1.9.1 Critically evaluates evidence-based literature to inform decisions about use of complementary and integrative nutrition. (S) 

1.9.2 Applies an understanding of the impact of complementary and integrative nutrition on drugs, food, disease states and wellness. (S)

1.9.3 Identifies indications, use and contraindications of complementary and integrative nutrition. (K)

1.10 Applies knowledge of math and statistics.

1.10.3 Applies math skills to perform food and nutrition calculations. (S)

1.13 Demonstrates computer skills and uses nutrition informatics in the decision-making process.

1.13.1 Analyzes appropriate data in electronic format to make best decisions related to nutrition and diet. (S) 

1.13.2 Evaluates accuracy and reliability when accessing and evaluating nutrition information in electronic format. (S) 

1.13.3 Operates nutrition informatics systems in practice. (D)

1.13.4 Uses electronic databases to obtain nutrition information and evaluate credible sources in decision making. (D) 

1.13.5 Uses technology and informatics skills proficiently to aggregate data and enhance practice and client/patient care. (D)

1.15  Applies knowledge of nutritional health promotion and disease prevention for individuals, groups and populations.

1.15.1 Recognizes and communicates the cause of disease and nutrition risks. (K) 

1.15.2 Identifies, prioritizes and implements health risk reduction strategies for individuals,  groups and populations. (S) 

2.2 Selects, develops and/or implements nutritional screening tools for individuals,  groups or populations.

2.2.1 Considers all client/patient factors when selecting, developing nutrition screening tools. (D)

2.3  Utilizes the nutrition care process with individuals, groups or populations in a variety of practice settings.

2.3.1 Selects and implements nutrition assessment tools for individuals, groups or populations. (D) 

2.3.2 Interviews client/patient to collect subjective information considering the determinants of health. (D) 

2.3.3 Conducts a nutrition focused physical exam. (D) 

2.3.6 Collects, assesses and interprets anthropometric measures and body composition. (D)

2.3.9 Identifies signs and symptoms of nutrient deficiencies or excesses. (D) 

2.3.10 Determines barriers that might influence a client/patient’s nutritional status. (D) 

2.3.11 Determines accuracy and currency of nutrition assessment data. (D) 

2.3.12 Identifies patient appropriate validated formula and performs calculations to determine nutritional requirements. (D) 

2.3.13 Analyzes and synthesizes nutrition assessment data to inform nutrition diagnosis(es)  and nutritional plan of care. (D) 

2.3.14 Devises PES (problem, etiology and sign symptom) statement and outlines reasons for professional opinion cause and contributing factors. (D) 

2.3.16 Develops an individualized plan of care that addresses nutritional care needs diagnosis and client/patient nutrition goals in collaboration with the client/patient and team members. (D) 

2.3.23 Summarizes impact of nutrition interventions on client/patient’s nutrition outcomes,  considering client/patient-centered care. (D) 

2.3.25 Evaluates the availability of services to support access to nutrition care and to help meet client/patient nutrition goals. (D) 

2.3.26 Documents all elements of the nutrition care process following professional standards and organizational policies. (D) 

2.4 Implements or coordinates nutritional interventions for individuals, groups or populations.

2.4.1 Manages medical nutrition therapy for clients/patients. (D) 

2.4.2 Applies and integrates understanding of foundational sciences to manage medical nutrition therapy, diet and disease management. (D) 

2.4.3 Applies foundational science knowledge and medical nutrition therapy principles to establish, order, manage and evaluate the need for nutrition support when prescribing and administering nutritional oral, enteral and parenteral diets. (D) 

2.4.4 Considers and applies all relevant factors when recommending the use of oral nutritional supplements. (D) 

2.4.10 Translates basic to advanced food and nutrition science knowledge into understandable language tailored to the audience. (D) 

2.4.11 Communicates complex nutrition information to broad and diverse audiences. (D)

2.4.13 Assesses client/patient’s nutritional needs and appropriateness for the recommended counseling or therapy. (D)

2.5 Prescribes, recommends and administers nutrition-related pharmacotherapy.

2.5.1 Applies knowledge of foundational sciences and disease when determining the appropriateness of the therapy. (S) 

2.5.2 Demonstrates awareness of food and drug interactions. (S) 

2.5.3 Assesses client/patient factors to determine the client/patient’s indication for the nutrition-related pharmacotherapy. (S) 

2.5.4 Considers client/patient factors, nutritional impact, indications, side effects,  contraindications, benefits, risks, alternatives and foundational sciences when prescribing, recommending and administering nutrition-related drug therapy. (S) 

2.5.5 Critically analyzes the potential negative effects of the nutrition therapy or supplement and determines the required knowledge, skill and judgment required to manage negative outcomes. (S) 

2.5.6 Prescribes, recommends and administers nutrition-related pharmacotherapy adhering to the professional standards and evidence-informed practice. (S) 

2.5.7 Applies the standard of practice, legislation, organizational policies and evidence informed practices for prescribing. (S) 

2.5.8 Applies the principles of safe drug administration. (S) 

2.5.9 Monitors the response and the effects of the nutrition related drugs on the individual and takes the required action to make modifications or adjustments. (S) 

2.5.10 Consults and refers/transfers client/patient to the appropriate health professional when client/patient’s needs are beyond personal competence or professional scope of practice. (S)

5.1 Demonstrates leadership skills to guide practice.

5.1.6 Understands the mentoring role and practices mentoring and precepting others. (D)

6.2 Applies scientific methods utilizing ethical research practices when reviewing, evaluating and conducting research.

6.2.1 Identifies, explains and applies the steps of the scientific method and processes. (D)

6.2.4 Interprets and applies research ethics and responsible conduct in research. (D)

6.2.5 Collects and retrieves data using a variety of methods (qualitative, quantitative) and technologies. (D) 

6.3  Applies current research and evidence-informed practice to services.

6.3.3 Integrates current research and evidence-informed practice findings into delivery of safe and effective nutrition care. (D) 

6.3.4 Analyzes and formulates a professional opinion based on the current research and evidence-based findings and experiential learning. (D)

7.1 Assumes professional responsibilities to provide safe, ethical and effective nutrition services.

7.1.1 Demonstrates ethical behaviors in accordance to the professional Code of Ethics. (D)

7.1.2 Engages in self-reflective practice activities to develop and maintain ongoing competence and professional behaviors. (D)

7.1.4 Applies client/patient-centered principles to all activities and services. (D)

7.2 Uses effective communication, collaboration and advocacy skills. 

7.2.2 Works with and facilitates intraprofessional and interprofessional collaboration and teamwork. (D) 

7.2.4 Selects mode of communication appropriate to the messaging to meet the needs of the audience. (D)

Required Clinical Learning Experiences

Required Clinical Learning Experiences 3.3 Perform routine health screening assessments including measuring blood pressure, conducting waived point-of-care laboratory testing (such as blood glucose or cholesterol), recommending and/or initiating nutrition-related pharmacotherapy plans (such as modifications to bowel regimens, carbohydrate to insulin ratio, B12 or iron supplementation).

Required Clinical Learning Experiences 3.4 Provide instruction to clients/patients for self-monitoring blood glucose considering diabetes medication and medical nutrition therapy plan.

Required Clinical Learning Experiences 3.5  Explain the steps involved and observe the placement of nasogastric or nasoenteric feeding tubes; if available, assist in the process of placing nasogastric or nasoenteric feeding tubes.

Assignments

Key Assignments

Nutrition-Focused Physical Exam (Week 3)

After learning malnutrition characteristics and documentation, coding for malnutrition, the nutrition care process, and nutrition-focused physical exam skills, you will put that information into practice by conducting a nutrition-focused physical exam on a friend or family member. You will also summarize your NFPE process and reflect on the experience. 

Clinical Nutrition Assessment (Week 5)

The Clinical Nutrition Assessment Assignment brings together your experiences at your clinical supervised experiential learning site and what you have learned so far in this course. If you are not a Dietetics-Focus student, you will need to find a site where you can interview a Registered Dietician to obtain some of this information.

Clinical Case Study: Written Portion and Presentation (Week 6 & Week 7) 

For your clinical case study written report and presentation, you will evaluate a complex clinical patient where you actively participated, working with both the preceptors, patient, and medical team. Based on your experience in a clinical setting, you will compile your findings and recommendations in a comprehensive case study report (due in Week 6), then prepare and record a 10-15-minute presentation of your primary findings, experiences and your recommendations to share with your peers and Faculty (due in Week 7).

Weekly Assignments

You will complete weekly smaller assignments that will help you complete the larger assignments. These assignments include practice quizzes, case studies, short papers, and patient presentations.

Discussion Board

You will be required to participate in discussions. Initial posts are generally due on Sundays, and responses are due by Tuesday. Please be sure to follow the individual directions provided with each Discussion Board Prompt, as the requirements may vary from Discussion Board to Discussion Board. If the initial post and response are not submitted within the discussion week you will be given a zero. Posts submitted after the discussion week will not be graded.

Your success in the course relies on robust discussion, critical thinking, and peer-response. Weekly posts responding to prompts posed are meant to facilitate a deeper understanding of the broader themes of the course as well as enrich the readings, handouts, and lectures. Your initial response should be no less than 400 words. Peer-responses should be no less than 200 words and must be thoughtful, contain compliments as well as constructive criticism, and maintain a professional tone.

Furthermore, in regard to all assignments, please observe the following:

• All assignments must be completed using AMA formatting where appropriate.
• All times refer to Eastern Time (ET).
• All questions about assignments, and all questions in general, should be sent through email.

Grading Policy

Your grade in this course will be determined by the following criteria:

Grade Breakdown

Assignment	Points
Syllabus Contract	1
Weekly Discussions	17
Patient Presentation Discussions (4 @ 4 points each)	16
Tube Feed and TPN Practice Quizzes (5 @ 1 point each)	5
Nutrition Focused Physical Exam Video Quiz	2
Practice Case Studies (4 @ 5 points each)	20
Standard Patient Case Reflection	4
Nutrition Focused Physical Exam Practice assignment	5
Clinical Nutrition Assessment	6
Medication Review	4
Clinical Case Study: Written Portion	8
Clinical Case Study: Video Presentation	8
Final Course Reflection & ePortfolio	4
Total	100