PURPOSE AND SCOPE:

Provides nutritional services for the facility’s in-center and home patients as applicable in order to maximize the patient’s nutritional status and improve clinical outcomes. Functions as a member of the interdisciplinary healthcare team, supporting the FMCNA commitment to the Quality Enhancement Program (QEP) and Quality Assessment and Performance Improvement (QAI) activities. Actively participates in process improvement activities that enhance the likelihood that patients will achieve their individualized patient-specific goals as determined by the patient’s physician. 

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Assesses patient’s knowledge of diet and kidney disease and provides education appropriate to patient’s learning needs regarding the relationship of diet and kidney disease and the impact on the treatment process.
• Provides patient specific detailed education to patient/family/caregiver regarding nutritional status, adequacy measures and results, fluid status, and all nutrition related lab parameters pertaining to their disease process.

• Completes nutritional assessment and participates in the interdisciplinary comprehensive assessments.
• Participates with the interdisciplinary team in the development of a written, individualized comprehensive plan of care that specifies the services necessary to address the patient’s needs, in accordance with established Federal and, where applicable, state licensure guidelines.

• Calculates diet prescription according to standard of practice.
• Completes progress notes on all chronic dialysis patients according to established FMCNA guidelines. Maintains complete and accurate documentation of all appropriate information in medical record according to established FMCNA policies and Federal and state regulations.
• Provides patient with ongoing nutrition assessment and outcome-oriented nutrition counseling necessary to assist patient in achieving and sustaining an effective nutritional status.
• Identifies malnourished patients as well as patients at risk for malnutrition and works collaboratively with interdisciplinary team to identify appropriate interventions, resources or solutions. Reviews each patient’s albumin level and body weight at least monthly. Implements plan of care with involvement of patient/family/caregiver.
• Monitors adherence and response to nutrition therapy, adjusts therapy as needed to achieve and sustain an effective nutritional status, documents why the patient was unable to achieve the goals and implements the plan of care to address issues impacting the patient’s ability to achieve the goals.
• Collaborates with the interdisciplinary team on Urea Kinetic Modeling recommendations to achieve the physician’s prescription of Kt/V.
• Collaborates with the interdisciplinary team on management and recommendations for mineral metabolism and renal bone disease, anemia and iron status, nutritional status, psychosocial status, vascular access, modality, rehabilitation status and sodium/volume control.
• Adheres to FMCNA algorithm and medical record policies.
• Reports on nutrition QAI results and participates in the interdisciplinary QAI program.  
• Collaborates and coordinates with team members in provision of Pre-ESRD education as appropriate.
• When appropriate, works with Case Manager to coordinate plan of care for patient education and identifies candidates to refer to physician for nutritional supplements, as per disease management agreements.

• Reviews nutrition related lab results:

• Counsels patient and/or caregiver and formulates appropriate action.
• Recommends treatment changes to the interdisciplinary team as appropriate.
• Communicates with physician and/or facility staff regarding lab results as appropriate.
• Communicates lab results and recommended treatment changes to providers of patient care in nursing facilities (i.e., hospitals, short term and long-term care facilities). 

• Participates in pertinent staff meetings (i.e., general staff, quality improvement), Care plan meetings, and others as applicable.
• Consults with FMS Corporate Dietitian regarding nutrition concerns as needed.
• Maintains and improves knowledge and skills for a competent and innovative practice.
• Maintains dietetic registration and continuing education hours as specified by American Dietetic Association and state licensure regulations where applicable.
• Collaborates with interdisciplinary team, ensuring that all work areas are safe and clean.

• Other nutrition management duties as assigned.

• Performs other related duties as assigned.

PHYSICAL DEMANDS AND WORKING CONDITIONS:

• The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials.
  • Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians.
  • The position requires travel between assigned facilities and various locations within the community.  Travel to regional, Business Unit and Corporate meetings may be required.

SUPERVISION:

• None

EDUCATION AND REQUIRED CREDENTIALS:

• Registered Dietitian as per Commission on Dietetic Registration  
• Board Certified Specialist in Renal Nutrition encouraged.
• Current state licensure if applicable.

EXPERIENCE AND SKILLS:          

• Minimum of 1-year professional work experience in clinical nutrition as a Registered Dietitian.
• Previous renal experience preferred.
• Demonstrated leadership competencies and skills for the position, including ability to teach, strong organizational skills, excellent communication, customer service, relationship development, results orientation, team building and decision making.
• Able to perform responsibilities with minimum supervision.
• Basic computer skills required.

Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.