VOLUME 26 • NUMBER 2 • SPRING 2017
SCHOOL NURSING:
My Surprising Transition From a Nutrition Support Team
JEANMARIE CAMPANA, BSN, RN
Nurses within the ASPEN community play a
and relationships outside the family, and often make their first
important social contacts with peers.2 With absolutely zero
experience in the pediatric world — other than my experience
as a mother — my new employer provided me with a two-day
educational workshop on topics like lice checks, screening for
child abuse, and routine documentation. People who are hired
for this position are not required to be registered nurses or NSN;
in fact, many of them are licensed practical nurses (LPN) or
medical aides.
vital role in caring for patients that require nutrition support.
These nurses have a unique blend of knowledge and skills
that integrates two healthcare specialties and are instrumental
in patients’ daily care. For this reason, they always need to be
aware of the competencies that make up the standards of care
for nurses who are immersed in nutrition-related activities.1 I
was first exposed to such experiences as a critical care nurse in
a large, acute-care hospital. I was drawn to nutrition support
and eventually introduced to ASPEN, which ultimately lead me
to a leadership role in O.S.P.E.N. I eventually transitioned to a
position on the hospital’s nutrition support team. As a nutrition
support nurse (NSN), I quickly became aware of the differences
in care required among patients in the hospital, those who came
to clinic, and those at home.
My first day’s assignment took me to a school of 400 children, all
of whom were under the age of eight years old. I opened my log
and was surprised to see that some of the first things I had to do
were give tube feedings to a preschooler via a low-profile gastric
tube button and observe a five year old whose needs included
bowel care, as well as catheterization every four hours for urine
output. Suddenly, that orientation workshop, which was intended
to prepare me for my new role, seemed a bit underwhelming. I
also had five children with diabetes who needed assistance with
carbohydrate counting, insulin pump delivery, and coverage
for blood sugars with insulin injections. Another student, who
had an eating disorder and could not eat in front of others,
was scheduled to report to the nurse’s office to eat while facing
the wall. Another student who required tube feedings, was fed
alongside his peers during snack time and lunch time. My biggest
challenge was with a four year old who needed tube feedings
delivered while he was playing.
The standards of practice represent a range of competencies
that should be provided by any NSN within or outside the
context of a formal nutrition support team. The application of
standards for the care of any individual should be determined
by the best judgment of the NSN.1 As a NSN working within
a multidisciplinary team, one of our roles included daily care
of hospitalized patients. This role also extended to home
care patients. Personally, one of my responsibilities included
answering a ‘hot line’ for adult patients. These conversations
addressed questions ranging from concerns about their home
parenteral nutrition care to troubleshooting specific issues.
Sometimes, patients and caregivers simply needed some
reassuring words about their own practice of routine care. Other
times, the patient had to be directed to receive additional care or
to return to the hospital because of a more urgent problem.
Parents, school nurses, and educators all believe that most
children who are medically fragile/technology dependent
(MFTD), should attend school with other children, rather than
relying solely on home-based education programs. Nevertheless,
they also are very aware that there is a real risk associated with
school attendance for this limited population of vulnerable
children; especially when the in-school caregiver may not be
adequately prepared for the needs of these children. Educators
When I retired and became a per diem school nurse, I thought
– Good-bye nutrition support, hello ice packs, Band-Aids, and
the occasional ill child! Little did I know, I was going to be
in for quite the surprise. School is a setting in which children
learn about their own abilities and limitations, explore life
continued on page 2...
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and school nurses rely most heavily on parents for information
about how the child’s healthcare needs should be met.3,4 Even
though I came from a strong nutrition support background and
was familiar with tube feedings and diabetes, children are a very
different population than adults. Thankfully, detailed care plans
(designed by both physician and parents) were in place for me,
plus I had a wonderful supervisor who was able to step in at just
the right time.
Great Job O.S.P.E.N. Members!
In my previous job, many of our patients receiving nutrition
support came to us as adults, and as the result of some adult
disease process or injury. However, there is a community of
young individuals whose first experiences with nutrition, or
elimination, is vastly different than their childhood peers.
Our families and our schools must join together so that all
children are well cared for and can feel comfortable despite
their differences. The schools that I have been fortunate to
be involved with believe in a mission statement that allows
families to direct their medical/non-educational care. If privacy
is needed, the school staff and administration do their best to
provide this environment. My extensive background as a NSN
has been helpful in my new role, even though the environment
that I am now delivering care is so very different. School nursing
is a new area that I have found requires knowledge, a sense of
humor, and total willingness to work with families.
Dr. Donald Kirby, prior O.S.P.E.N. Physician-AtLarge and current director for the Center of Human
Nutrition at the Cleveland Clinic, was recognized for
his exceptional achievement and service to ASPEN and
the field of clinical nutrition with the designation of
FASPEN. He, and the entire class of 2017 FASPEN
recipients, was acknowledged at CNW17 during a
mid-day awards ceremony.
References:
1. DiMaria-Ghalili RA, Gilbert K, Lord L, et al. Standards of
Nutrition Care Practice and Professional Performance for
Nutrition Support and Generalist Nurses. Nutr Clin Pract.
2016;31(4):527-547.
Kristen Izzo, MS, RD, LD, CNSC, received
the ASPEN’s Home and Alternate Site Care New
Practitioner Award during their community forum
meeting at CNW17. Kristen was given this honor in
recognition of her exceptional career achievements thus
far in nutrition support.
2. Rehm RS, Rohr JA. Parents’, nurses’ and educators’
perceptions of risks and benefits of school attendance by
children who are medically fragile/technology dependent. J
Ped Nurs. 2002;17:5.
Cindy Hamilton, MS, RD, LD, FAND, was selected
for service on the 2017-2018 ASPEN Board of
Directors.
3. McCarthy AM, Williams JK, Eidhal L. Children with chronic
conditions: educators’ views. J Ped Health Care. 1996;10:272279.
4. Koenning GM, Todaro AW, Benjamin JE, Curry MR, Spraul
GE, Mayer MC. Health services delivery to students with
special health care needs in Texas public schools. J Sch Health.
1995;65(4):119-23.
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President’s Message
Hello O.S.P.E.N. members!
I hope everyone is having a great 2017 and has enjoyed the
mild Ohio winter we had. Despite the mild weather, it was
still great to attend Clinical Nutrition Week in Orlando,
Florida in February. This year’s conference presented a wide
variety of topics from “The Impact of Diet on the Human
Microbiome and its Relevance to Disease” to “Nutritional
Insufficiency in the Critically Ill: A Common and Debilitating
Condition.” The highlight of my trip though was accepting
the Chapter of the Year Award during the awards ceremony
on center stage! O.S.P.E.N. was awarded this honor for its
quality continuing education programs, member retention
and recruitment, and overall involvement in ASPEN. We
also support education of our members by offering two
continuing education conferences and four scholarships to
Clinical Nutrition Week annually. I am so proud to be part of
such an exceptional chapter.
ASPEN President,
Charlene W.
Compher, PhD,
RD, CNSC, LDN,
FADA, FASPEN, and
O.S.P.E.N. President
Allison Krall, RDN,
LD, CNSC, at the
awards ceremony
during CNW17.
Did you know that O.S.P.E.N. is one of the largest chapters
nationally with close to 100 members? We have many
longstanding members, as well as several new members who
have come to serve on our boards and committees over the
past year. In addition, we have three O.S.P.E.N. members
who have served as president of ASPEN. The leadership
potential in our organization is truly a wonderful member
benefit and we always have room for more involvement from
our members. If you are interested in a role on an O.S.P.E.N.
board or committee, please feel free to contact us. We love
having members involved from all areas across the state of
Ohio.
I continue to look forward to serving as your president over
throughout 2017!
Allison Krall RD, LD, CNSC
President
DNS Symposium Details
This year’s theme: Strategies for Success: From Research to Evidence and
Practice will be packed with cutting-edge science and practicebased presentations. The symposium also includes a didactic and
hands-on physical assessment skills workshop, poster sessions
showcasing new research, and a wine & cheese networking
reception.
Dietitians Mark Your Calendars!
The Academy’s Dietetic Practice Group, Dietitians in Nutrition
Support (DNS) will be conducting a symposium in beautiful
Scottsdale, AZ this June 2-3, 2017! Make plans to attend this
fantastic 2-day educational event (worth 16 CPEUs). This is
also a great way to meet other nutrition support dietitians from
across the nation and network with key leaders and colleagues
who conduct nutrition research and apply evidence into their
nutrition support practices.
Registration for members and nonmembers is open online at
https://www.dnsdpg.org/page/symposium-2017.
EARLY REGISTRATION ENDS MAY 5, 2017!!
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O.S.P.E.N. ProvidedTwo Members with Scholarships to CNW17
Congratulations to our two scholarship recipients: Mallory Karavolis, MS, RD, LD, and Stephanie Bachi de Castro Oliveira,
MD. Both enjoyed trips to sunny Orlando, Florida this past February to attend CNW17. Dr. Bachi’s scholarship letter is featured in
our newsletter (see below left), but you can read more about Mallory’s first CNW experience on our website
http://community.nutritioncare.org/ohiochapter/home
CNW Scholarship Recipient’s
Review of Conference
Are You Working on Research or a
Quality Improvement Project?
I am very grateful for being one of the recipients of the
O.S.P.E.N. Scholarship to attend the 2017 Clinical Nutrition
Week. This was my first time attending this conference and I
have to say that I was very positively impressed, to say the least.
I entered medical school because I wanted to be a pediatrician,
and very early in my medical training I became very interested
in pediatric nutrition. I am a medical graduate from Brazil
and completed my pediatrics residency at the University of
Medicine and Dentistry of New Jersey in 2013. I moved to
Ohio in July 2013 to pursue my fellowship training in Pediatric
Gastroenterology, Hepatology and Nutrition at Cincinnati
Children’s Hospital Medical Center (CCHMC). I completed my
3-year fellowship in 2016, and due to my passion for nutrition I
decided to pursue advanced training in the field. I am now the
inaugural fellow of Advanced Pediatric Nutrition at CCHMC.
I will continue as faculty at CCHMC after completion of my
current fellowship, and now I can call Ohio my second home.
My clinical and research interests are strongly focused on
nutrition and being at CNW17 was overwhelmingly interesting. I
attended extremely high quality clinical and research sessions.
I attended the Parenteral Nutrition (PN) Workshop and couldn’t
be more impressed with the course. The workshop was an
intense, one-day, hands-on training on PN writing.
In my opinion, one of the reasons why the workshop was
outstanding was the fact that it was led by pharmacists and
dietitians of different backgrounds, and directed to a mixed
audience composed of physicians (adult and pediatric care),
dietitians, pharmacists, and nurses – the exchange of knowledge
and experiences was extremely rich! After the workshop, I will
use some of the tools I learned there to develop a PN teaching
program for the Pediatric Gastroenterology fellows at CCHMC.
CNW is a unique conference because it brings together
professionals from the adult and pediatric care worlds —
pharmacists, dietitians, nurses, and physicians (clinicians
and surgeons). This mix of expertise and backgrounds
enriches discussion and promotes a unique environment for
collaboration.
Again, I am very thankful and honored to be the recipient
of this scholarship and for the support to attend this terrific
conference.
Stephanie Bachi de Castro Oliveira, MD
Advanced Pediatric Nutrition Fellow
Division of Pediatric Gastroenterology,
Hepatology and Nutrition
Cincinnati Children’s Hospital Medical Center
Do you have a protocol you are proud of?
DNS wants YOUR ABSTRACTS!
Come present your poster at the Wine & Cheese Networking
Session. Now accepting submissions. Send your 300 (or less) word
abstract by May 22, 2017 to Gail Cresci PhD, RD, LD, CNSC at
[email protected]
And while you’re there — don’t forget to say hello to some of
our O.S.P.E.N. presenters:
Ainsley Malone, MS, RD, LD, CNSC, FAND, FASPEN
Enteral Nutrition: ASPEN 2016 Enteral Safe Practices
Abdominal Exam and Radiology
Cindy Hamilton, MS, RD, LD, FAND
House of Delegates Update
Malnutrition
Sandy Austhof, MS, RD, LD, CNSC
Macro Nutrition Assessment: Muscle and Fat Mass
Assessment and Edema
Jodi Wolff, MS, RD, LD, CNSC, FAND
Micronutrient Assessment
Gail Cresci, PhD, RD, LD, CNSC
The Skinny on Research: Why We Need to Do It and How to
Get Started
Find O.S.P.E.N. on Facebook!
If you have not done so yet,
please make sure to check us
out at www.facebook.com and
send us a friend request! Also,
feel free to contact us directly via
our O.S.P.E.N. email address at
[email protected] if you
do not have a Facebook account.
We are looking forward to hearing from you!
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O.S.P.E.N. Members Make Splash All Over CNW17!
Our Physician-At-Large Dave Evans,
MD, FACS, moderated the Nutrition &
Metabolism Research Paper Sessions for
Enteral Nutrition.
M d C
Mandy
Corrigan,
i
MPH
MPH, RD
RD, LD
LD, CNSC,
CNSC FAND,
FAND Andrea
A d
JeVenn, RD, LD, CNSC, Dr. Donald Kirby, FACP, FACN,
CNSC, FASPEN, Cindy Hamilton, MS, RD, LD, FAND,
and Kristen Izzo, MS, RD, LD, CNSC, meet up at CNW17
between sessions for a quick “Cleveland Clinic crew” photo
opportunity.
Bright and early one morning, Jay
Mirtallo, MS, RPH, BNSP, FASHP,
FASPEN, was seen giving a lecture over
breakfast on Optimizing PN: Advances in
Lipid Emulsions.
Kristen Izzo, MS, RD, LD, CNSC, Gail Cresci, PhD, RD,
LD, CNSC, Dr. Stanley Dudrick, FACS, FASPEN, Sandy
Austhof, MS, RD, LD, CNSC, and Lindsay Dowhan, MS,
RD, LD, CNSC, stopped by to congratulate Dr. Dudrick on his
lifetime achievement award.
Mary Turon-Findley, MS, RD, LD, led
a roundtable event about Assessing and
Feeding a Transgender Patient.
NaSheema Anderson, BS, Dr. Donald Kirby, FACP, FACN,
CNSC, FASPEN, Eileen Hendrickson, PharmD, MBA, and
Toni Neal, RN, CRNI, CNSC, VA-BC, attended the Home
and Alternate Site Care Meeting.
continued on page 6...
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Dr. Stanley Dudrick, MD, FACS, FASPEN, the Father of IV Feeding, was bestowed with the first ASPEN Lifetime Achievement
Award during a special session at CNW17. Dr. Ezra Steiger is seen here interviewing Dr. Dudrick about the experiences, trials, and
successes throughout his career that eventually led to the life-saving therapy that is so common-place for many of our patients today.
Conrad Cole, MD, MPH, MSc,
presented Management of Micronutrients
in a Pediatric Patient Requiring Longterm
PN.
Even Vince Vanek, MD, FACS,
FASPEN, hit the podium to talk about
EHRs — Are They Improving Safety and
efficiency?
If you weren’t able to see them live, some of the
sessions are available for on-demand viewing in the eLearning
Center. Anyone who registered to attend the full conference,
virtual conference, or the preconference sessions can access
these. Simply login with your ASPEN username and password
at: http://www.prolibraries.com/aspen/. On the left side of the
screen, click “Add Conference Code” and enter” CNW17” into
the search box. Any session that was recorded will be in “My
Library.” Complimentary access is granted for 1 year.
Several O.S.P.E.N. members gave their expert
opinions, tips, and tricks during the Pediatric Basic
Skills Lab:
Human Milk and Fortification by Jaqueline Wessel, MEd, RDN,
CNSC, CSP, CLE
Pediatric PN Order Writing by Steve Plogsted, BS, PharmD,
BCNSP, CNSC
Neonatal PN Order Writing was co-presented by M. Petrea
Cober, Pharm D, BCNSP, BCPPPS
The O.S.P.E.N. Access is produced by the
Ohio Society for Parenteral and Enteral Nutrition.
Gail Cresci, PhD, RD, LD, CNSC,
shared her expertise on the gut
microbiota: New Insights in Microbiota in
Critically ill patients: What are they doing
and should we interfere?
Managing Editors:
Andrea JeVenn, RD, CNSC
Kristen Roberts, PhD, RD
Ronelle Mitchell, MA, RD, CNSC
Ashley Bronston, MS, RDN, LD
Layout and Design:
Carol Stokes
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Don’t Forget to Mark Your Calendars for the
Upcoming Spring O.S.P.E.N. Dinner Event!
see map on page 8...
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Passing of an O.S.P.E.N. Member
Lori Jeris, a CNP at the Cleveland Clinic, passed away February 20, 2017.
The majority of Lori’s nursing career was focused on nutrition care. She was a member of the
Cleveland Clinic Nutrition Support Team (NST) for more than 20 years where she trained home
parenteral nutrition techniques to patients and was an expert with vascular access devices. As
PICC lines became more popular for delivering intravenous nutrition, antibiotics, and other
intravenous medications, she left the NST to create another team: the Cleveland Clinic’s PICC
Team in order to serve a wider scope of patients. It was this accomplishment in her career of
which she was most proud.
Lori eventually returned to school to become a Nurse Practitioner. Afterwards, she returned
to the NST to assume a management role, and spent the last years of her career there. Lori
exemplified what it means to be a patient advocate; she always put her patients and their safety
first. She was a kind, calm, and caring person whom everyone highly respected. She was delightful
to work with. She fought her battle with cancer bravely; she always had a smile, even while
undergoing her treatments and had a wonderful sense of humor. Ultimately though, she left
behind her two teenage children, two brothers, a sister, and multiple other family members. We all
lost a dedicated nutrition support colleague and friend and will greatly miss her.
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Continuing Education Through
ASPEN’s Webinar Programs
ASPEN has developed a series of webinars to bring quality, interdisciplinary educational sessions to you and your work place. The
programs are 90 minutes and CEU credits are available. For more information on registering, as well as reviewing previous webinars, visit
http://www.nutritioncare.org/Webinars/.
The upcoming 2017 webinars are as follows:
APRIL 20
Microbiome in the Critically Ill
MAY 3
Micronutrients Part 1:
Assessing and Correcting Micronutrient
Abnormalities in Pediatrics
4:00 - 5:30 PM ET
MAY 16
Micronutrients Part 2:
Assessing and Correcting Micronutrient Abnormalities in Adults
3:00 - 4:30 PM ET
JUNE 27
Nutritional Management of Enterocutaneous Fistulas (ECF)
3:00 - 4:30 PM ET
AUGUST 1 Acid-Base Abnormalities Part 1:
Fluids and Electrolytes
1:00 - 2:30 PM ET
AUGUST 8 Acid-Base Abnormalities Part 2:
Blood Gas Analysis and Acid-Base Disorders
1:00 - 2:30 PM ET
OCTOBER
Parenteral Nutrition: Back to the Basics
Part 1: Writing Parenteral Nutrition — Where do I Start?
Part 2: Writing Parenteral Nutrition — An Art Rather
than a Science
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O.S.P.E.N. Board Members 2017
PRESIDENT
Allison Krall, MS, RD
[email protected]
COMMITTEE ROSTER
PROGRAM PLANNING COMMITTEE
Vince Vanek, MD, FACS, FASPEN
[email protected]
Tiffany Rhoads, RD, CNSC
[email protected]
Ainsley Malone, MS, RD, LD, CNSC
[email protected]
Megan Meek, RD, LD
[email protected]
Michelle Tansy RD, LD, CSP
[email protected]
Monica Schaefer, MS,RD,LD, CNSC
[email protected]
PRESIDENT-ELECT
Jill Fisher RD, LD, CNSC
[email protected]
PAST PRESIDENT
Kim Orben, MS, RD, CSO
[email protected]
SECRETARY
Susan Meyer, MS, RD, CNSC
[email protected]
TREASURER
M. Petrea Cober, PharmD, BCNSP
[email protected]
Mara Lee Beebe, MS, RD, LD, CNSC
[email protected]
Joy Lehman, PharmD, BCNSP
[email protected]
DIETITIAN-AT-LARGE
Sandy Austhof, MS, RD, CNSC
[email protected]
MEMBERSHIP COMMITTEE
Jodie Turosky, RPh
[email protected]
Jenni Keating, RD, LD, CNSC
[email protected]
NURSE-AT-LARGE
Jeanmarie Campana, RN
[email protected]
PHARMACIST-AT-LARGE
Lisa Mostafavifar, PharmD, BCPS
[email protected]
SCHOLARSHIP COMMITTEE
Jamie Davila, RD, CNSC
[email protected]
Denise Konrad, RD, CNSC
[email protected]
PHYSICIAN-AT-LARGE
David Evans, MD
[email protected]
NEWSLETTER AND WEBSITE COMMITTEE
Kristen Roberts, PhD, RD
[email protected]
Andrea JeVenn, RD, CNSC
[email protected]
Ronelle Mitchell, MA, RD, CNSC
[email protected]
Ashley Bronston, MS, RDN, LD
[email protected]
Lisa Moccia, RD, CNSC
[email protected]
Steve Plogsted, PharmD, BCNSP, CNSC
[email protected]
Desiree Gordillo, MS, RD, CNSC
[email protected]
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