Nutrition Consults CE
Case-based, patient-focused learning for healthcare providers

Ensuring Optimal Outcomes for Patients with Cancer:
Have We Considered Nutritional Status?

Mary Marian, MS, RD, CSO

OVERVIEW

Maintaining nutrition as a fundamental part of caring for patients with cancer is associated with a multitude of positive outcomes. However, up to 85% of cancer patients develop clinical malnutrition and up to 55% of cancer patients develop cachexias, both of which negatively affect therapy responsiveness, tolerance to cancer treatment side effects, and overall patient survival. Early and appropriate nutritional screening and intervention can mitigate the personal and healthcare burdens of malnutrition in cancer patients. Additionally, clinician training with regards to these screening procedures. as well as risk assessment, and diagnosis of malnutrition and cachexia, can assist in curbing the rates of malnutrition. Providing treating physicians with the latest evidence-based guidelines and clinical research to help the implementation of nutritional support therapy regimens is essential into supporting positive outcomes for patients with cancer.

GOAL

To provide oncologists, oncology nurses, dietitians, oncology pharmacists, and other oncology care providers with up-to-date information and education on the diagnosis and management of malnutrition in patients undergoing treatment for cancer.

TARGET AUDIENCE

This activity has been designed to meet the educational needs of oncologists, oncology nurses, dietitians, oncology pharmacists, and other healthcare providers who treat and manage patients with cancer.

LEARNING OBJECTIVES

After completing this activity, the participant will demonstrate the ability to:
  • EXPLAIN the relationship between nutrition, cancer, and patient outcomes.
  • RECOGNIZE malnutrition and cachexia in cancer patients using clinical screening and diagnostic tools.
  • DETERMINE individualized nutritional requirements of diverse cancer patients.
  • ASSESS oral nutrition and enteral nutrition for nutritional support therapy in cancer patients.
  • EVALUATE the use of parenteral nutrition in cancer patients.
The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing take responsibility for the content, quality, and scientific integrity of this CME/CNE activity.

CE INFORMATION

Accreditation Statements:
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing. The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Institute for Johns Hopkins Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Credit Designation Statements:
The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

After reviewing this online activity, participants may receive a certificate by receiving a score of 70% or higher on the CME test and completing an evaluation. A certificate of participation will be available online immediately following successful completion of the activity.

This 1.0 contact hour educational activity is provided by The Institute for Johns Hopkins Nursing. Claim only those contact hours actually spent in the activity. Statements will be awarded for this educational activity until March 7, 2016.

CDR_logojAKH Inc., Advancing Knowledge in Healthcare is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR). Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 1.0 continuing professional education unit (CPEU) for completion of this program/material. CDR Accredited Provider #AN008. The focus of this activity is rated Level 2. Learners may submit evaluations of program/materials quality to the CDR at www.cdrnet.org.


acpe logoAKH Inc., Advancing Knowledge in Healthcare is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. AKH Inc. approves this knowledge-based activity for 1.0 contact hour (0.1 CEU).
UAN 0077-9999-14-014-H04-P
Initial Release Date: 4/17/2014

The estimated time to complete this activity: 60 minutes.

Release date: March, 7, 2014. Expiration date: March, 7, 2016.

PARTICIPATING FACULTY

Gerard E. Mullin, MD (Course Director and Planner)
Associate Professor of Medicine
Johns Hopkins University School of Medicine
Director, Integrative GI Nutrition Services
The Johns Hopkins Hospital
Baltimore, Maryland

Mary Marian, MS, RD, CSO (Faculty Author)
Clinical Nutrition Specialist
College of Medicine and Arizona Cancer Center
University of Arizona
Tucson, Arizona

Renay D. Tyler DNP, RN, ACNP, CNSC (Nurse Reviewer)
Senior Director of Nursing
Ambulatory Services
The Johns Hopkins Hospital
Baltimore, Maryland

AKH STAFF/REVIEWERS

Dorothy Caputo, MA, BSN, RN (Lead Nurse Planner)

Dorothy A. Duffy, B.S. Pharmacy (Pharmacy Reviewer)


DISCLOSURE POLICIES

Full Disclosure Policy Affecting CME Activities:
As a provider approved by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine Office of Continuing Medical Education (OCME) to require signed disclosure of the existence of financial relationships with industry from any individual in a position to control the content of a CME activity sponsored by OCME. Members of the Planning Committee are required to disclose all relationships regardless of their relevance to the content of the activity. Faculty are required to disclose only those relationships that are relevant to their specific presentation.

Policy on Faculty and Provider Disclosure
It is the policy of The Institute for Johns Hopkins Nursing to require our continuing nursing education faculty and planning committee members to disclose any financial relationships with companies providing program funding or manufacturers of any commercial products discussed in the educational activity.

Participating Faculty Disclosures
No speaker has indicated that they have any financial interests or relationships with a commercial entity whose products or services are relevant to the content of their presentation(s). The following relationships have been reported for this activity:

Planner Disclosures
No planner has indicated that they have any financial interests or relationships with a commercial entity.
AKH planners and reviewers have no relevant financial relationships to disclose.

Note: Grants to investigators at The Johns Hopkins University are negotiated and administered by the institution that receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s).

Non-Endorsement of Products
The Institute for Johns Hopkins Nursing and the American Nurses Credentialing Center do not endorse the use of any commercial products discussed or displayed in conjunction with this educational activity.

Off-Label Product Discussion
No faculty member has indicated that their presentation will include information on off-label products.

DISCLAIMER

The opinions and recommendations expressed by faculty and other experts whose input is included in this activity are their own. This activity is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects before administering pharmacologic therapy to patients.

CONFIDENTIALITY DISCLAIMER FOR CME ACTIVITY PARTICIPANT

I certify that I am participating in this Johns Hopkins University School of Medicine activity for CME-accredited training and/or educational purposes.

I understand that while I am participating in this capacity, I may be exposed to "protected health information," as that term is defined and used in Johns Hopkins policies and in the federal HIPAA privacy regulations (the "Privacy Regulations"). Protected health information is information about a person’s health or treatment that identifies the person. I also understand that while I am participating in this capacity I will be treated as a temporary member of Johns Hopkins for purposes of the Privacy Regulations only.

I pledge and agree to use and disclose any of this protected health information only for the training and/or educational purposes of my visit and to keep the information confidential.

I understand that I may direct to the Johns Hopkins Privacy Officer any questions I have about my obligations under this Confidentiality Pledge or under any of the Hopkins policies and procedures and applicable laws and regulations related to confidentiality. The contact information is: Johns Hopkins Privacy Officer, telephone: 410-735-6509, e-mail: HIPAA@jhmi.edu.

“The Office of Continuing Medical Education at the Johns Hopkins University School of Medicine, as sponsor of this activity, has relayed information with the CME attendees/participants and certify that the visitor is here for training, education and/or observation purposes only.”

Johns Hopkins University School of Medicine
Office of Continuing Medical Education
720 Rutland Avenue/ Turner 20
Baltimore, Maryland 21205-2195
Reviewed & Approved by: General Counsel, Johns Hopkins Medicine (4/1/09)

HARDWARE & SOFTWARE REQUIREMENTS

Pentium 800 processor or greater, Windows 98/NT/200/XP or Mac OS 9/X or later, Microsoft Internet Explorer, Safari, Firefox, Windows Media Player 9.0 or later Flash player, 128 MB of RAM Monitor settings: High color at 800 x 600 pixels, Sound card and speakers, Adobe Acrobat Reader.

Click here to download the references for this educational activity.

ACTIVITY

Instructions
The following is an interactive case simulation designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: an unaccredited pre-test, an interactive case study, and a CME post-test and evaluation. All 3 sections must be completed to receive CME credit. A certificate of participation will be available online immediately following successful completion of the activity.

Pre-Test

Ensuring Optimal Outcomes for Patients with Cancer:
Have We Considered Nutritional Status?

Mary Marian, MS, RD, CSO


Post-Test


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