NOCSPEN Newsletter: January 2019
Here’s what happened last year:
Our membership grew from 41 to 59!
Obtained tax-exempt status
Facebook page & LinkedIn page established. Connect with us!
Hosted happy hour events in San Francisco, Sacramento, and Oakland.
Hosted CE dinners in San Francisco and Sacramento.
Next event: to be decided. All ideas and suggestions welcome!
I have been an ASPEN member and a CNSC for about 6 years. My personal involvement with ASPEN started out as a member of the Maryland Chapter of ASPEN. At their chapter meetings, I met a group of dietitians, nurses and physicians who are passionate in leading the development and training of nutrition support therapy. I was inspired by the latest nutrition innovations presented in those formal and informal events. Serving as the program planning chair had taught me numerous things about event planning and project management. Now, I have a few “subject-matter experts” on a speed-dial for a variety of emergency situations – e.g. PN stability question, difficulty troubleshooting a clogged feeding tube or the urgent need of a colorectal surgery (just kidding!). I hope to unite nutrition support clinicians in NorCal together. I have grown so much and made so many friends since I joined ASPEN. The benefits of joining and supporting a local chapter are simply immeasurable. Join now and volunteer with NOCSPEN to build member value for you and your colleagues in ASPEN.
I look forward to meeting you at the ASPEN conference in March 2019 or our coming local meetings. Thank you for your support of NOCSPEN!
— Evelyn Tsui, RD, CNSC
January 23: Event - Food Nutrition for People on Feeding Tubes
Location: Skates on the Bay 100 Seawall Dr. Berkeley, CA 94710
Time: 6 pm
Complimentary dinner and 1 CEU credit for RDs. Topics include:
Formula Intolerance Symptoms
The importance of nutritional variety in enteral diets
Review of clinical evidence supporting real food
Taking a mealtime approach to tube feeding
If you work with enteral patients (Kids or Adults), you won’t want to miss this presentation on the benefits and how to's of including real food in their diets.
Please RSVP to Mary Beth Wells, RDN, MBA at MWells@RealFoodBlends.com
January 23: Webinar - Nutrition Support and the EHR
Cost: Free for ASPEN members!
Time: 4:00 - 5:00 PM ET
This informational webinar, presented by the ASPEN Clinical Nutrition Informatics Committee, will present the recommendations from a multi-organizational publication on parenteral nutrition ordering and management and Electronic Health Records Systems.
Click here for more information and to register.
March 23-26: The ASPEN Nutrition Science & Practice Conference
Location: Phoenix, AZ
Cost: Varies depending on attendance option - pricing details here
Every day you deal with vital patient issues. Every day there is new information and new research that brings changes to the way you provide patient care. The ASPEN 2019 Nutrition Science & Practice Conference (ASPEN19) brings together the leaders in clinical nutrition, providing the premier forum to keep you up-to-date in your field. Join us for:
Evidence-Based Clinical Updates
Continuing education for dietitians, nurses, pharmacists, and physicians
Networking with the experts and more!
Click here for more information and to register.
Summary: Continuing Education Event on Blenderized Tube Feeding
Evelyn Tsui, RD, CNSC
Have you ever been asked “Can I put this smoothie down in my feeding tube?” In recent years, there has been an increased interest in using real food via feeding tube instead of commercial formulas. At our last education dinner in November, our speaker Mary-Beth Wells, RD, MBA from Real Food Blends ® shared to with us on the pros and cons of using blenderized tube feed (BTF) and clinical evidence supporting benefits of using BTF over commercial formulas.
Often, patients express reasons for wanting to use BTF as it is “more natural” and they “like eating what family does.” We know there is a psychological burden that comes with inability to eat by mouth. Tube-fed persons are often excluded from family meal times, cooking and social bonding of eating meals together. In addition, there is a great debate on the ingredients in formula, as they are often derived from synthetic sources (e.g. corn maltodextrin) versus real food. Studies support some benefits in using BTF. One study suggested outcome benefits for using pureed food by gastrostomy tube for children with fundoplication with reported decrease in gagging and retching incidents. Another study found a decrease in reported emesis and a decrease use of acid suppressing medications reported.
However, there are some important considerations before starting BTF:
Since diet must be individualized, access to an experienced dietitian is required
Patient has a 14 french or larger G tube.
Patient must be age 1 or older.
Homemade BTF requires refrigeration, which can be a barrier for traveling.
Homemade BTF requires a time investment to blend food each day→ aware of caregiver burnout
Resources for more information:
[Book] Homemade Blended Formula Handbook by Marsha Dunn Klein, Suzanne Evans Morris
[Book] Complete Tubefeeding by Eric Aadhar O’Gorman
Do you have any experience in using BTF? Share it with us at NOCSPENchapter@gmail.com
Get Involved with NOCSPEN
If you have general inquiries, questions or feedback for our chapter, or you would like to join the board or attend a board meeting, please let us know at NOCSPENchapter@gmail.com.
This year, we are looking for Student Coordinators / Representatives from Dietetic Internships/ Universities (1 year term).
In This Issue
Message from the President
Latest in the News
Get Involved with NOCSPEN
Message from the President
It is my great pleasure to greet you as the new president of NOCSPEN. It was an honor to accept this position from our past president, Chloe Sasakado. Under her leadership, our NOCSPEN board members and volunteers worked tirelessly to re-establish a chapter that was once in hiatus. Currently, our membership includes members in the San Francisco Bay Area, Silicon Valley and greater Sacramento area. On behalf of the NOCSPEN board, I thank everyone who helped us in ways big or small.
We have plans to include two written articles for each quarterly newsletter. Each article will be 500 words.
We also have plans to have subject matter experts to help review articles for evidence and content.
Our theme schedule for 2019 will be:
April - Enteral Nutrition
July - Parenteral Nutrition
October - Protein Calorie Malnutrition
If you have an interest to write and/or be involved as a subject matter expert, contact us!
Latest In the News
Neha Shah, MPH, RD, CNSC
I have been a Registered Dietitian for 15 years and spent 14 years specializing in the areas of gastroenterology, hepatology, nutrition support intestinal rehabilitation and intestinal transplant. I am currently at the Digestive Health Center at Stanford Health Care, where I inaugurated and built Nutrition Services for both the GI and liver clinics. I was honored last year to receive the Clinical Expert in Nutrition award and the C-I-CARE Spotlight Award from Stanford Health Care. I joined NOCSPEN to increase my collaborative partnerships with local interdisciplinary providers that have similar professional goals related to increasing the visibility and evidence based practice of nutrition support. In my free time, I enjoy hiking and traveling.
Katie Kelly, MS, RD, CNSC
I have been a Registered Dietitian for nine years and have worked in various settings. I spent nearly seven years working as an inpatient clinical dietitian at Stanford ValleyCare Medical Center, as well as worked as a Corporate Wellness dietitian in the Silicon Valley. Currently, I live and work in the San Francisco Bay Area as an Infusion Dietitian with Coram CVS. I’ve been an ASPEN member for seven years currently volunteering with NOCSPEN in order to enhance my knowledge and support growth of research and information for the field of nutrition support. In my free time you’ll find me running the trails throughout the East Bay, exploring new areas and trying new foods.
Brenda Hansen, RD, CNSC
I’ve been calling myself an Infusion Dietitian since passing the CNSD exam in 1990. I decided to take the exam while covering the Neonatal, Pedi, Surgical, Cardiac and Neuro ICUs at a University hospital as I was living daily with ASPEN reference materials. I have since provided patient care at a Pediatric hospital; ran my own Home Health RD Consulting practice; worked in an HMO covering all floors as an on-call RD. I’ve worked at Optioncare, a Home Infusion Pharmacy for 20+ years. I’m a proud feeding tube / connector identification nerd. With a nimble purchaser and flexible pharmacist, I optimize nutrition delivery through any shortage of electrolytes, amino acids or lipids. My greatest satisfaction is assisting people transition off PN/EN. ASPEN has given me access to mentors vital in the acquisition of expertise. NOCSPEN is my chance to pay it forward locally. I can be found covered with dirt in my organic garden in Oakland.
Rachel Parker, RD, CNSC
I have been a Registered Dietitian for three years and a CNSC for one year. I completed my dietetic internship at UC Davis Medical Center in 2015. Currently, I live in the San Francisco Bay Area and work at both Sutter Delta Medical Center and Kaiser Oakland. I enjoy covering a wide range of inpatient services in my current positions. I am volunteering with NOCSPEN to connect with other nutrition support professionals and continue to build my knowledge of nutrition support. In my free time, I enjoy exploring the Bay Area, trying new foods, and catching up on my favorite podcasts.
San Francisco VA Healthcare - Per Diem
San Francisco VA Healthcare is recruiting for a per diem dietitian with critical care experience to cover a six-month Family Leave. The Critical Care Dietitian is responsible for the coordination, monitoring and evaluation of medical nutrition therapy of highly complex patients requiring nutrition support. The dietitian participates in the multidisciplinary team rounds and engages in quality improvement projects in the ICU. If interested, please send your resume to Elaine Chuang, at Elaine.Chuang2@va.gov.
Omegaven® Now Available in the U.S. from Fresenius Kabi
Omegaven® is an intravenous lipid emulsion that provides calories and fatty acids for pediatric patients with parenteral nutrition-associated cholestasis, or PNAC. Omegaven is the first and only FDA-approved fish oil lipid emulsion for this condition. It is available as a 5 g/50 mL and 10 g/100 mL (0.1 g/mL) injectable emulsion in a single-dose bottle. See the full prescribing information.
ASPEN Recommendations on Appropriate Dosing for Parenteral Nutrition
Persistent shortages of parenteral nutrition (PN) components have led to a tendency of practitioners providing less than adequate dosing, which can lead to nutrient deficiencies and impair growth and healing. Clinicians who have entered practice within the last 10 years may have never cared for patients receiving PN therapy without a shortage of PN components. This document, provided by ASPEN for prescribers, lists the requirements and recommendations for dosing of nutrients for a complete PN prescription. Please share with your colleagues.
Have an interesting article or news to share? Please send it to us at
Do you know an individual that you wish to spotlight their achievements? We will spotlight two individuals each newsletter. Contact us if you know of an individual, whether it is a dietitian, a nurse, a pharmacist or a physician.
For now, we are going to spotlight the newsletter committee!