The program aims to deliver the essential knowledge and skills to deliver the specialized nutrition support (SNS) including Enteral Nutrition (EN) and parenteral nutrition (PN) to different hospitalized cases and prepare our candidates to pass the board exam to be board-certified nutrition support pharmacist (BCNSP) which is one of the potentially required job position in all of the hospitals.
Domain : Clinical Practice:Provision of Patient-Centered Nutrition Support Tasks (67% of the exam)Tasks related to the comprehensive management of a patient requiring specialized nutrition support including collecting, interpreting, and integrating pertinent clinical data; and designing, implementing, monitoring, and modifying patient-specific plans of care for patients requiring specialized nutrition support in collaboration with the healthcare team.
Task 1: Interview the patient and/or designated caregiver to obtain medical, surgical, nutrition, medication, allergy, psychosocial, cultural, and socioeconomic history.
Task 2: Evaluate relevant medical, surgical, and nutrition history along with physical, laboratory, and radiologic findings to determine nutrition status.
Task 3: Obtain appropriate nutrition assessment parameters for evaluating clinical and nutrition status.
Task 4: Evaluate appropriate indications for nutrition support, including suitability and feasibility.
Task 5: Evaluate reimbursement eligibility for nutrition support (e.g., diagnosis, formulations, services, supplies, duration).
Task 6: Define the goals for nutrition support.
Task 7: Determine the preferred route and access device(s) for nutrition support.
Task 8: Identify and address clinically significant interactions between drugs, dietary supplements, andnutrients. Task 9: Estimate micronutrients, macronutrients, fluid and electrolyte requirements
Task 10: Select an appropriate feeding formulation and delivery system.
Task 11: Select the administration method for feeding formulation (e.g., bolus, intermittent, continuous, cyclic).
Task 12: Select appropriate adjunctive pharmacologic therapies.
Task 13: Individualize the therapeutic plan of care based on safety, ethical, cultural, legal, economic, quality-of-life issues.
Task 14: Design a monitoring plan to ensure safety and efficacy of the nutrition care plan.
Task 15: Recognize and manage complications of nutrition support.
Task 16: Modify the patient's therapeutic plan of care based on clinical status and progress toward therapeutic goals (includes discontinuation of nutrition therapy).
Task 17: Collaborate as members of the interprofessional team to communicate essential information regarding the patients’ status and nutrition care plan.
Task 18: Communicate the nutrition support plan across transitions of care.
Task 19 Document the nutrition support plan in the medical record.
Task 20: Educate the patient and caregivers regarding the patient's nutrition care plan and available resources.
Knowledge of:1. Components of a nutritionally adequate diet (e.g., dietary reference intake)
2. Anatomy, physiology, and metabolism related to nutrition support
3. Normal ingestion, digestion, absorption, metabolism, and excretion of nutrients
4. Disease states, clinical conditions, and therapies that affect ingestion, digestion, absorption, metabolism, or excretion of nutrients
5. Relationship between nutrient intake, requirements (e.g., maintenance, repletion, weight loss), and nutrition status across the age spectrum and in health and disease
6. Effects of psychosocial and socioeconomic factors on nutrition status
7. Ethical, cultural, legal, economic, quality of life, safety issues, language, language proficiency, education level, comprehension, home environment, and disabilities impact on nutrition support and related educational needs for patients and their caregivers
8. Diagnostic tests and clinical findings used to assess nutrition status (e.g., malnourished, nutritionally at-risk)
9. Physical assessment techniques and clinical findings used to evaluate nutrition status
10. Effects of disease states, clinical conditions, or altered metabolism on nutrition status. 11. Effects of medical and/or surgical therapies on nutrition status (e.g., renal replacement therapies, cardiopulmonary bypass, mechanical ventilation, bowel resection, bariatric surgery)
12. Interactions between drugs, dietary supplements, and nutrients
13. Therapeutic, stability, and compatibility considerations for the concomitant administration of drugs or other therapies with nutrition support
14. Effects of drugs and dietary supplements on nutrition status
15. Effects of nutrition status or nutrition support on drug pharmacokinetics and pharmacodynamics
16. Indications, risks, complications (e.g., mechanical, metabolic, infectious, gastrointestinal, psychosocial), benefits, limitations, and contraindications for the use of nutrition support
17. Guidelines for nutrient requirements
18. Methods to determine patient-specific nutrient requirements (e.g., indirect calorimetry)
19. Effects of disease states, clinical conditions, and altered metabolism on the determination of patient-specific nutrient requirements
20. Types of devices, supplies (e.g., pumps, bags, tubing, filters), and optimal placement of access devices to administer nutrition support
21. Indications for and limitations of vascular and enteral access devices used to administer nutrition support
22. Selection of vascular and enteral access devices based on patient-specific considerations (e.g., current or previous access, history of complications, device type, anticipated duration of therapy)
23. Regulations and guidelines for eligibility, coverage, and reimbursement for nutrition support
24. Perform calculations related to the ordering and verification of nutrition support orders.
25. Influence of disease states, clinical conditions, and therapies that affect the type of nutrition support selected
26. Methods to initiate, advance, modify, and discontinue nutrition support
27. Appropriate methods for administering nutrition support (e.g., bolus, intermittent, continuous, cyclic)
28. Indications, limitations, and contraindications for the use of parenteral nutrition components (e.g., amino acids, dextrose, fluid, electrolytes, injectable lipid emulsion, minerals, vitamins, other additives)
29. Composition and physical and chemical properties of parenteral nutrition formulations30. Appropriate selection of enteral nutrition formulations31. Composition and physical and chemical properties of enteral nutrition formulations (e.g., protein, carbohydrate, fat, water, vitamins, minerals, osmolality)32. Markers of response to nutrition support
33. Outcome indicators of nutrition support (e.g., nutrition status, morbidity, mortality, wound healing, length of stay, length of intensive care unit stay, number of ventilator days, patient adherence)
34. Sources and use of nutrition support education materials for patients, caregivers, and the healthcare team
35. Regulations and strategies to ensure privacy in communications with patients and their caregivers
36. Fluid, electrolyte, and acid-base management
37. Methods to monitor and manage a nutrition support care plan based on the patient’s response to nutrition support (e.g., metabolic, nutrition, and clinical)
38. Methods to prevent, monitor, and manage complications associated with nutrition support
39. Methods to prevent, monitor, and manage interactions between drugs, dietary supplements, and nutrients
40. Effective methods to document and communicate essential components of a patient-specific nutrition support care plan.