Inside Landmark: Interview with a Dietitian

At Landmark, we have an excellent dietitian who helps with the clinical monitoring of our TPN Patients and she also teaches Patients about their specific home infusion therapies in the hospital before they are discharged. We interviewed her to get her perspective on several frequently asked questions.

What type of training did you go through to become a registered dietitian?

"I was required to obtain my bachelor’s degree in nutrition as well as complete a year long dietetic internship which involved rotating through multiple fields of nutrition. I also have a Master’s degree in Sports Nutrition and an advanced practice certification in nutrition support, called a CNSC (Certified Nutrition Support Clinician)."

What are your goals when teaching patients about their home infusion therapy?

"My primary goal is to provide individualized education to my patients and empower them to become an advocate for their own health journey."

What can a patient expect to learn or get from you when you visit them in the hospital before they are discharged?

"As a patient educator, I instruct patients on how to administer their home infusion in a safe and effective manner. As a dietitian, I am available by consult to any patient who is struggling nutritionally or has nutrition-related questions while on our services. More specifically, I follow up weekly will all patients on IV nutrition, also known as TPN (total parenteral nutrition)."

What can a patient do to have a successful transition to home infusion?

"I think confidence in oneself is a huge component for a successful transition to home infusion. Landmark will provide you with the resources and education you need, and we would not recommend home infusion to anyone who we do not know has the tools to be successful. We are your team members in this and will support you along the way!"

What are some of the most frequent questions you get asked from patients on home infusion?

"Because I see such a diverse population of patients and act within two roles in the company (a dietitian and a patient educator), I get an assortment of questions. Most questions are simply reinforcement from the education previously provided, but some other questions involve dose scheduling and symptom management where I can refer to pharmacists as needed."

For Patients on TPN therapy, how do you help with the clinical monitoring of those Patients?

"With help from a nutrition support pharmacist and a team of other pharmacists and technicians, we review labs weekly and adjust macro- and micro-nutrients in patients’ TPN formulations with the guidance from the patient’s following physician. As a dietitian, I also track weight trends, monitor oral intake (if applicable) and obtain subjective nutrition assessments from our TPN patients to tailor the TPN formulations to meet the individual patient needs."

For Patients on non-TPN home infusion therapies, what tips can you give them regarding their diet?

"I encourage most of our patients to follow the MyPlate guidelines which include filling half of your plate with fruit and vegetables, including a lean protein and complex carbohydrate with each meal (see www.myplate.gov for more information). Complex carbohydrates include wheat bread, brown rice, whole fruits with skin and beans/legumes. I would highly recommend limiting simple carbohydrates (such as white bread/rice, juices, sweets, etc.) and eliminating sugar-sweetened beverages."

What is your favorite part about working in the home infusion/home health industry?

"I have a passion for nutrition support, which encompasses enteral nutrition (tube feeds) and parenteral nutrition (TPN). I feel that when patients are unable to eat by mouth, they view nutrition as even more important to their overall health, and I love being a part of their journey in optimizing their nutritional status. I also truly enjoy connecting with patients and empowering them through education. It is a joy to see patient success stories."