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DIETARY MANAGERS TRAINING PROGRAM REVIEW SESSION Becky Rude, MS, RD, CDM, CFPP University of North Dakota

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Presentation on theme: "DIETARY MANAGERS TRAINING PROGRAM REVIEW SESSION Becky Rude, MS, RD, CDM, CFPP University of North Dakota"— Presentation transcript:

1 DIETARY MANAGERS TRAINING PROGRAM REVIEW SESSION Becky Rude, MS, RD, CDM, CFPP University of North Dakota beckyrude@mail.und.edu

2 What the Exam Includes Management of food services – 35% Nutrition – 22% Management of Personnel – 19% Sanitation – 24%

3 Be Prepared Know what to expect –Test outline Refer to the exam application booklet Know the percentages for each area –Resources needed Calculator, pencils, test admission letter, ID, etc. –Review your textbooks Practice the multiple choice questions at the end of each chapter

4 Test Taking Strategies Relax Be physically ready Be mentally ready Pace yourself –Dont spend a large amount of time on one question. Circle it, and go back later If in doubt – go with your first instinct Take a deep breath every now and then

5 Medical Nutrition Therapy Nutrients –CHO –Protein –Fat –Vitamins –Minerals –Water

6 Calculating Calories Chicken AlfredoC P F –4 oz. chicken breast 0 28 12 –1 cup pasta 30 6 0 –¼ c. alfredo sauce 0 0 10 Calculate kilocalories Calculate % Kcal from CHO, Pro, and Fat

7 Assessment Clinical Laboratory Anthropometric Diet Medical / Social hx (history)

8 Assessment Timeline New admission –Assessment – 5 day ; 14 day; 30 day –Care Plan –21 days Quarterly Annually Changing conditions Monthly weights

9 Triggers Significant weight loss Taste alterations TPN / IV / TF Mechanical altered diet Therapeutic diet > 25% food left Pressure ulcers (decubitus ulcers)

10 Calculate Nutrient Needs Kcal (Kilocalories) –Male1 Kcal/kg body weight x 24 hours –Female 0.9 Kcal/kg body weight x 24 hours –Plus activity –Plus stress (injury factor) Protein (0.8 g, x kg. body weight) Fluids ( 30 ml c kg. body wt.) (1cc per Kcal)

11 Case Study 77 y.o. female –CC: productive cough and weakness –Alert and oriented x 3 –Dx: pneumonia –Ht. 65, wt. 135#. UBW = 145# (1 mo ago) –Nutrition related labs: hgb – 10.9 Hct – 32.1% –PMHx: HTN and colon CA –Diet Order; NAS

12 Healthy Body Weight 65 client –100# + (5# x 5) = 100 + 25 = 125# –Large frame: + 10% 125# + 13# = 138# –% healthy body weight: 135# / 138# = 0.98% –% weight change: 145# - 135# = 10# 10# / 145# = 0.07 or 7%

13 Estimated Needs BMR135# / 2.2 = 61.36 kg. 61.36 kg. X 0.9 kcal / kg x 24 hours = 1325 kcal Maintenance 1325 kcal x (activity factor) x (stress factor) Protein 61.36 kg. X 0.8 g. Pro / kg. = 49 g. Pro Fluids 61.36 kg. X 30 ml. / kg = 1841 ml./day

14 Diet Diet Order: NAS Diet Hx C P F 1 c. coffee 0 0 0 1 slice toast / 1 t. marg. 15 3 5 ½ Roast Beef Sandwich 15 14 10 ½ c. water packed pears 15 0 0 1 c. cornflakes 15 3 0 ½ c. skim milk 6 4 0

15 Diet Analysis TotalsC PF 66 2415 Kcal: 264 + 96 + 135 = 495 Kcal Percentages: Food Guide Pyramid Deficiencies?

16 Applications Appropriateness of diet / menu modifications Religious preferences Individualized care plan Tray accuracy Supplemental feedings Food acceptability

17 Education Assess needs / knowledge base-goal oriented Identify resources Adapt teaching materials Home care

18 Documentation Appropriate format Section K Other sources Confidentiality

19 Review - High Sodium Foods High Potassium Foods High Calcium Foods High Protein Foods

20 Review High Cholesterol Foods Gluten containing foods Lactose containing foods Common allergens / foods

21 Review 1 t. = _____ ml 1 oz. = _______ ml 8 oz. = ________ ml 1# = ______ oz. 1 c. = _____T. 1 T. = _____t. 1 qt = _____ c. 1 gal = ____ qt. #8 scoop = _____ cup # 16 scoop = _____ cup 1 T. = _____ ml 1 qt.= _____ ml 1 qt. = _____ oz. 1 c. = ______ oz.

22 Quiz 1 – Sample Exam Nutrition

23 Foodservice Operation Centralized Decentralized Menu Planning / Recipe conversion

24 Recipes Adjustment – new yield / old yield Standardized recipe components Proper cooking techniques Calculate nutrition content / cost Design new recipe –Criteria –Client acceptance

25 Example: Meatloaf Ingredients: 3# ground beef1 egg ¼ c. chopped onion1 c. bread crumbs 1 t. ground mustard1 c. tomato sauce 1 T. worcestershire sauce Yield: 12 – 3 oz. portions Bake: 350 ° F. for one hour

26 Scaling Original yield: 12 – 3 oz. portions New yield: 57 – 3 oz. portions 57 / 12 = 4.75 (factor) AP = 16 oz. EP = 12 oz. 12 / 16 = 0.75 or 75%

27 Recipe Costing Ground Beef$2.29 / lb. Egg 1.79 / doz Onion.35 / cup Ground Mustard.05 / t. Worcestershire Sc.05 / T. Bread crumbs.45 / c. Tomato sauce.79 / c.

28 Workflow Configuration –U- shaped –Galley Workflow –Placement of equipment –Work simplification –Ergonomics

29 Production Production Sheet Forecast Menu Items / substitutions Portion control / food waste Tray line systems Productivity

30 Purchasing Specifications Menu Space and utilities Material (NSF / UL) Cleaning Maintenance Repair vs. replacement

31 Specifications Evaluate existing equipment Evaluate replacement equipment Budget justification Vendor / product comparison –Can cutting Vendor / product selection

32 Budget Cafeteria – gross receipt Raw food cost – beginning inventory $ 5000.00 + purchases 8000.00 -Ending inventory 3000.00 Raw food cost 10,000.00 Meals served8250 Cost per meal (10,000 / 8250) = $1.21

33 Cost per unit Cost a catered event Cost menu Calculate daily cost per client

34 Calculate Variance Actual money spent$66,250 - budget - 64,751 ___________ 1499 Divide by budget 1499 ÷ 64,751 = 0.023 x 100 = 2.3% over-budget

35 Quiz 2 – Sample Exam Foodservice Management

36 Human Resources / Personnel Implement change Identify personnel needs –Job analysis / specifications / description Orient / motivate Present work procedures / plans Teach / coach employees Set goals

37 Management Styles Authoritative Participative Proactive

38 Employees Communicate Schedules Calculate FTEs Work assignments Define needs Performance evaluation US Department of Labor

39 Professional Interactions Organizational Chart Patient Care Conferences Meet community needs Audits

40 Quiz 3 – Sample Exam Personnel Management

41 Sanitation Contaminants / Hazards –Biological –Chemical –Physical Symptoms of foodborne illness

42 Personal Hygiene Hand washing Diseases transmitted by people –Universal precautions Training

43 HACCP Purchasing / receiving –Purchase order –Grade / inspection –Rejection process –Verify order –Signs of contamination –Storage temps –FIFO

44 Ground Beef Purchasing Inventory –Security –Perpetual –Physical –Cost control

45 Preparation Cross contamination Safe thawing

46 Cooking Critical control points End point cooking temps (critical limits) Temperatures Service Cooling Re-heating

47 Continued Corrective action Record keeping Verify 7 steps of HACCP

48 Materials Easy to clean Equipment maintenance schedule Preventative maintenance Proper cleaning technique Training –Right to know –MDS

49 IPM Clean vs. Sanitary –Temperatures in dishwashing Safety inspection checklist OSHA

50 Crisis Management Emergency contact Call list Secure inventory Alternate menu Potable water

51 Review TDZ TCS foods –A. –B. –C. Thawing –A. –B. –C. Temps –Beef –Pork –Chicken –Grd Beef (meats) –Eggs –Fish –Reheating

52 Quiz 4 – Sample Exam Sanitation

53 Questions???

54 Best Wishes Thank you for your attendance, and best wishes on your credentialing exam, and in your career as a CDM,CFPP. I am looking forward to having you as a colleague in our profession. Becky Rude beckyrude@mail.und.edu


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