Day 1BREAKFAST

8:15 am - 9:15 amGeneral Session PlenaryTitle: Optimal Protein Dose during Critical Illness: Are We Trapped in a State of Clinical Equipoise?Speaker Name: Jayshil Patel, MDSpeaker Organization: Medical College of WisconsinLearning Objectives:

1. Describe trajectories and outcomes of critical care survivors.2. Identify the ‘current state’ of prescribed and received protein during critical illness3. Outline barriers to achieving prescribed protein during critical illness4. Identify and appraise current evidence favoring lower protein dose during critical illness5. Identify and appraise current evidence favoring higher protein dose during critical illness6. Cogitate on clinical equipoise and the need for a stronger evidentiary base for protein dose.7. Discuss the role of exercise and protein supplementation in optimizing post critical care physical function

outcomes.Speaker Bio:

Jayshil Patel, MD is currently as associate professor of medicine at the Medical College of Wisconsin. Jayshil cares for patients, teach, and conduct research in academic medical ICU. Jayshil’s current research focuses on identifying optimal protein in critically ill patients, identifying best nutrition practices for critically ill patients in septic shock, and evaluating micronutrients as therapy in septic shock.

9:15 am - 10:15 amGeneral Session PlenaryTitle: Implementing an Enhanced Recovery after Surgery (ERAS) PathwaySpeaker Name: Josh Newman, CRNASpeaker Organization: Passavant Area Memorial HospitalSession Summary:

Enhanced recovery is a multidisciplinary, evidence- based approach to the care for the surgical patient. These pathways emphasize holistic interventions that accelerate recovery by reducing stress. Now considered the standard of care, it is important that providers within the perioperative continuum be knowledgeable and engaged in the pathways for optimum outcomes.

Learning Objectives: 1. Review the history and benefits of enhanced recovery pathways2. Detail the interventions included in enhanced recovery pathways3. Discuss implementation strategies

Speaker Bio:Joshua Newman, CRNA is the anesthesia manager and clinical anesthetist at Passavant Area Hospital. At Passavant, Josh has led the enhanced recovery program for multiple specialties. He also serves as chair of the American Society for Enhanced Recovery CRNA committee and American Association of Nurse Anesthetists Enhanced Recovery Shared Interest Group.

BREAK

10:45 am - 11:30 amBreakout Session 1Title: Practical Aspects of Micronutrient Assessment and Replacement

Speaker Name: Andrea JeVenn, MEd, RD, LD, CNSCSpeaker Organization: The Cleveland ClinicSession Summary:

This program will use a case-based approach to identify and treat various micronutrient deficiencies in patients who require nutrition support. Emphasis will be placed on correctly interpreting laboratory data, using physical signs and symptoms to substantiate abnormalities, and connecting these to the underlying conditions that result in such manifestations. Participants will be provided tools to develop nutrition interventions to address micronutrient deficiencies. This program assumes that participants come to this session with a well-developed understanding of micronutrient functionality, as well as clinical signs and symptoms of abnormalities.

Learning Objectives: 1. Learners will understand causes of micronutrient deficiencies in patients who commonly require nutrition support 2. Learners will use critical thinking skills to evaluate nutrition assessment data and corroborate the existence of micronutrient deficiencies3. Learners will employ practical tactics to appropriately address deficiencies

Speaker Bio:Andrea JeVenn, MEd, RD, LD, CNSC has worked on an interdisciplinary Nutrition Support Team at the Cleveland Clinic since 2008 and recently completed a Masters in Education in Health Professions Education. She has traveled the country teaching professionals about malnutrition nutrition-focused physical exams, as well as co-authoring several publications about malnutrition including: Evaluation of Muscle and Fat Loss as Diagnostic Criteria for Malnutrition (in Nutrition in Clinical Practice) and Nutrition-Focused Physical Exam: An Illustrated Handbook. Andrea is also an active member of DNS as the Director for the new Advanced Practice Residency in Nutrition Support for Adults.

10:45 am - 11:30 amBreakout Session 2Title: Malnutrition Etiology Assessment: Strengthening Your Diagnostic SkillsSpeaker Name: Christan Bury, MS, RD, LD, CNSC

Speaker Organization: The Cleveland ClinicSession Summary:

This session will review the process to diagnosing malnutrition using the six characteristics, and a major focus will be on the first step of determining an etiology. The presentation has a large focus on the literature explaining inflammation and how it relates to a malnutrition diagnosis. We will also discuss how a patient’s etiology can change over time as well as review common inflammatory processes associated with acute, chronic and social/environmental circumstance. The lecture will also discuss coding, billing and reimbursement for malnutrition.

Learning Objectives: 1. Recognize the differences between acute and chronic inflammation as it relates to identifying malnutrition2. Apply practical tactics to help consistently identify an appropriate etiology as a framework for recognizing

malnutrition3. Demonstrate how documentation can be used to beneficially support diagnostic recommendations4. Understand how variations in malnutrition severity during a patient’s hospitalization impacts

billing/reimbursementSpeaker Bio:

Christan Bury, MS, RD, LD, CNSC currently works at the Cleveland Clinic as a critical care dietitian where she has practiced the last 6.5 years. She has completed research using bedside ultrasound to assess lean body mass in surgical ICU patients. She also led an enterprise-wide re-training program on using etiology to diagnose malnutrition. She lives in University Heights, OH with her husband and children, 2.5 year old boy/girl twins and a newly welcomed infant son.

10:45 am - 11:30 amBreakout Session 3Title: Parenteral Nutrition Indications: When and How?Speaker Name: Jennifer Lefton, MS, RD-AP, CNSC, FANDSpeaker Organization: Washington Hospital CenterSession Summary:

This presentation will review evidence based indications for the use of PN for adult patients. Case examples from the speaker’s experience will be referred to throughout the presentation. Using case studies, the speaker will walk attendees through next steps to get PN started. This will include evaluation of line access, steps to calculate PN formulas and basic guidelines for electrolyte management.

Learning Objectives: 1. Determine when PN is indicated2. Understand appropriate steps to take when initiating PN3. Calculate macronutrient formulas for PN4. Review pertinent guidelines related to PN safety

Speaker Bio:Jennifer Lefton, MS, RD-AP, CNSC, FAND has been a nutrition support dietitian for over 20 years. Most recently she has worked as part of the TPN team at Washington Hospital Center in Washington, DC. Her experience covers a wide range from trauma, burn, transplant, surgical, oncology, neurosurgical, and more.

REPEAT BREAOUT SESSIONSLUNCH

1:15 pm - 2:00 pmSkills Breakout 1Title: Muscle, Fat and Fluid Assessment in the ICU patient: Does It Change Based on Age or Size?Speaker Name: Beth Taylor, DCN, RDN-AP, CNSC, FCCMSpeaker Organization: Barnes-Jewish HospitalSession Summary:

This session will be a combination of didactic and hands-on training to provide the attendee the tools needed to perform a NFPE for muscle, fat and fluid assessment in a critically ill patient.

Learning Objectives: 1. Recognize physical, ultrasound and CT indications of muscle wasting or fat loss.2. Perform an assessment to determine degree of edema and be able to state potential causes of edema in the

ICU setting.3. Understand impact of obesity and advancing age when interpreting physical signs of malnutrition.

Speaker Bio:Dr. Beth Taylor, DCN, RDN-AP, CNSC, FCCM has been practicing in nutrition support over 30 years and is a past chair of DNS. She began placing feeding tubes at bedside in 2001 and has lead workshops and lectured extensively on NFPE. Beth was one of the lead co-authors of the ASPEN/SCCM Guidelines for nutrition in ICU patients. Recently, Beth put her doctorate to use and moved into a research role, where she continues to study benefits of nutrition in critically ill patients.

1:15 pm - 2:00 pmSkills Breakout 2Title: Identifying Micronutrient Deficiencies through Nutrition-Focused Physical ExaminationSpeaker Name: Stephanie Dobak, MS, RD, LDN, CNSC

Speaker Organization: Thomas Jefferson University HospitalSession Summary:

Multiple factors increase the risk for developing a micronutrient deficiency, including surgical weight loss, acute and chronic diseases, and parenteral nutrient shortages. Micronutrient deficiencies can be identified on physical examination and in conjunction with a medical and nutrition history. This session will review physical examination techniques involved in identifying micronutrient deficiencies. Case studies will be used to help participants apply knowledge.

Learning Objectives: 1. Understand the components in conducting a head-to-toe nutrition-focused physical examination.2. List risk factors for the development of micronutrient abnormalities.3. Identify signs and symptoms of micronutrient deficiencies and toxicities using a nutrition-focused physical

examination.Speaker Bio:

Stephanie Dobak, MS, RD, LDN, CNSC is a clinical dietitian at Thomas Jefferson University Hospital in Philadelphia where she practices in the neuro-intensive care unit and inpatient rehabilitation center. She received her BS in Nutrition and Food Science from Auburn University, completed her dietetic internship at the Medical University of South Carolina, and achieved her MS in Biomedical Sciences from Thomas Jefferson University. She has held positions on the boards of multiple local dietetic associations, and is an avid volunteer with the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. Stephanie is currently the Executive Coordinator for the Dietitians in Nutrition Support DPG. Her research focuses on optimizing enteral nutrition for patients in the neuro-ICU and those receiving therapeutic hypothermia.

1:15 pm - 2:00 pmSkills Breakout 3Title: Interpretation of Radiology: Abdominal FilmsSpeaker Name: Gail Cresci, PhD, RD, LD, CNSCSpeaker Organization: The Cleveland ClinicSession Summary:

This session will review important anatomical landmarks seen on abdominal and chest radiographs. Through a series of case studies, the attendee will become confident in identifying proper feeding tube placement and interpreting abdominal radiographs for ileus and bowel obstruction to assist with implementation of enteral feeding.

Learning Objectives: 1. Identify anatomical features of the gastrointestinal tract using and abdominal radiograph.2. Compare and contrast ileus vs bowel obstruction, gastric vs small bowel feeding tube placement when

critiquing an abdominal radiograph.3. Apply knowledge obtained during the critique of abdominal radiographs to promote safety and efficacy

during the initiation of enteral feeding.Speaker Bio:

Gail Cresci, PhD, RD, LD, CNSC is Faculty/Staff in the Departments of Pediatric Gastroenterology, Cleveland Clinic Children’s Hospital and Inflammation & Immunity, Lerner Research Institute, as well as Director for Nutrition Research within the Center for Human Nutrition, Digestive Disease and Surgery Institute at the Cleveland Clinic. Additionally she is the Nutrition Thread Director within the Cleveland Clinic Lerner College of Medicine. Dr. Cresci completed her doctorate degree in Biochemistry and Molecular Biology at the Medical College of Georgia, Master of Science degree in Nutrition at Rosalind Franklin University of Health Sciences, and Bachelor of Science Degree in Dietetics at the University of Akron. Dr. Cresci’s research focus is on the gut microbiome with a particular focus on its metabolic byproducts in health and disease. Dr. Cresci has published numerous peer-reviewed manuscripts and book chapters and edited a textbook in critical care nutrition. She has received

numerous awards for her clinical and research endeavors including the 2018 Stanley Dudrick Research Scholar Award from the American Society for Parenteral and Enteral Nutrition; 2018 Outstanding Research Dietitian Award from the Ohio Academy of Nutrition and Dietetics; 2014 Excellence in Practice Research Award from the Academy of Nutrition and Dietetics; 2010 Distinguished Nutrition Support Dietitian Advanced Clinical Practice Award from the American Society of Parenteral and Enteral Nutrition; and the 2009 Excellence in Practice Clinical Nutrition Award from the American Dietetic Association. She is past-chair of DNS as well currently the Chair of the Research Committee.

REPEAT SKILLS WORKSHOPBREAK

REPEAT SKILLS WORKSHOP

4:15 pm - 5:15 pmGeneral Session PlenaryTitle: Case Study - Tying Things TogetherSpeaker Name: Beth Taylor, DCN, RDN-AP, CNSC, FCCMSpeaker Organization: Barnes-Jewish HospitalSession Summary:

This session will ask the leaders of the day’s session to come to the stage and be presented with case studies. The leaders and audience will answer questions surrounding the patient cases. The goal would be to organize the ability for participation via online responses and instant results and words of wisdom from the experts.

Learning Objectives: 1. Translate the knowledge and skills learned during the workshop into patient care decisions.

Speaker Bio:Dr. Beth Taylor, DCN, RDN-AP, CNSC, FCCM has been practicing in nutrition support over 30 years and is a past chair of DNS. She began placing feeding tubes at bedside in 2001 and has lead workshops and lectured extensively on NFPE. Beth was one of the lead co-authors of the ASPEN/SCCM Guidelines for nutrition in ICU patients. Recently, Beth put her doctorate to use and moved into a research role, where she continues to study benefits of nutrition in critically ill patients.

NETWORKING RECEPTION – POSTERS AND EXHIBITS

Day 2EXHIBITS AND BREAKFAST

8:15 am - 9:15 amGeneral Session PlenaryTitle: The Microbiome and Critical IllnessSpeaker Name: Gail Cresci, PhD, RD, LD, CNSCSpeaker Organization: The Cleveland ClinicSession Summary:

This session will overview what is currently known regarding the gut microbiome composition health in contrast to what we are learning occurs during critical illness. Discussions will include impact of medical interventions and feeding methods. Review of research investigating prebiotics and probiotics will be presented.

Learning Objectives:1. Describe what is currently known about the human gut microbiome2. Describe the gut microbiome in critical illness in comparison to healthy conditions.3. Discuss means to modify the gut microbiome in critical illness

Speaker Bio:Gail Cresci, PhD, RD, LD, CNSC is Faculty/Staff in the Departments of Pediatric Gastroenterology, Cleveland Clinic Children’s Hospital and Inflammation & Immunity, Lerner Research Institute, as well as Director for Nutrition Research within the Center for Human Nutrition, Digestive Disease and Surgery Institute at the Cleveland Clinic. Additionally she is the Nutrition Thread Director within the Cleveland Clinic Lerner College of Medicine. Dr. Cresci completed her doctorate degree in Biochemistry and Molecular Biology at the Medical College of Georgia, Master of Science degree in Nutrition at Rosalind Franklin University of Health Sciences, and Bachelor of Science Degree in Dietetics at the University of Akron. Dr. Cresci’s research focus is on the gut microbiome with a particular focus on its metabolic byproducts in health and disease. Dr. Cresci has published numerous peer-reviewed manuscripts and book chapters and edited a textbook in critical care nutrition. She has received numerous awards for her clinical and research endeavors including the 2018 Stanley Dudrick Research Scholar Award from the American Society for Parenteral and Enteral Nutrition; 2018 Outstanding Research Dietitian Award from the Ohio Academy of Nutrition and Dietetics; 2014 Excellence in Practice Research Award from the Academy of Nutrition and Dietetics; 2010 Distinguished Nutrition Support Dietitian Advanced Clinical Practice Award from the American Society of Parenteral and Enteral Nutrition; and the 2009 Excellence in Practice Clinical Nutrition Award from the American Dietetic Association. She is past-chair of DNS as well currently the Chair of the Research Committee.

9:15 am - 10:15 amGeneral Session PlenaryTitle: Malnutrition Success Stories -Adult and PediatricsSpeaker Names: Beth Smith, MA, RD, LDN - Children’s Hospital of Philadelphia & Wendy Phillips, MS, RD, CNSC, CLE, NWCC, FAND - Morrison HealthcareSession Summary:

This session will provide a brief overview of the impact malnutrition identification, documentation, and coding can have on hospital payment and the quality dashboard. Audience members will receive practical implementation steps to track these quality metrics at their own facilities.

Learning Objectives: 1. Identify quality improvement initiatives that can be implemented at their own facility to treat adult and

pediatric malnutrition2. Develop an effective discharge plan to communicate the malnutrition diagnosis to each care setting3. Describe strategies to efficiently utilize the Electronic Health Record in identifying and documenting

malnutritionSpeaker Bios:

Wendy Phillips, MS RD CD CNSC CLE NWCC FAND is a Division Director of Clinical Nutrition for Morrison Healthcare, supporting the provision of clinical services in hospitals, rehab and long term care facilities, and outpatient settings. She has served on the DNS Board as a Reimbursement Representative and Communications/Marketing Director. She serves on the PNPG board as an associate editor for Building Blocks for Life.

Beth Smith, MA, RD, LDN, is a Clinical Nutrition Manager at the Children’s Hospital of Philadelphia, currently managing the inpatient operations for the departments of staff of 85 clinicians. Beth’s was one of the author’s for the Pediatric Malnutrition Consensus Statement in 2014, and has presented and published widely on the topic. Beth is currently involved with malnutrition quality improvement work at both the patient care and national level in her roles with PNPG. Beth received her Bachelor’s in Dietetics from the University of Connecticut, and a Masters of Arts in Communication from Johns Hopkins University.

EXHIBITS AND BREAK

10:45 am - 11:30 amBreakout Session 1Title: Food in a Tube - Blended Choices for Adult and Pediatric Enteral Nutrition Consumers

Speaker Name: Theresa Fessler, MS, RDN, CNSC - Morrison Healthcare, University of Virginia (UVA) Health System & Sara Tutor, MS, RDN, CNSC, CLC - Michigan Medicine, University of MichiganSession Summary

This presentation aims to provide attendees with considerations and guidelines for preparation of blenderized enteral feedings in the hospital and home setting. Food safety guidelines and application to enteral feeding preparation will be discussed, as well as applicable studies.

Learning Objectives from Sara: 1. Potential risks of blenderized enteral nutrition 2. Guidelines for preparation and storage of blenderized enteral nutrition3. Tools to support and address blenderized enteral nutrition in the inpatient and outpatient settings1. Three benefits of using blenderized food for tube feeding (BTF)2. Three potential risks of BTF use.3. At least three ways that registered dietitians can provide support to consumers who use BTF.

Speaker Bios: Theresa Fessler, MS, RDN, CNSC works on the Nutrition Support Surgery service at the University of Virginia Health System and is also the home nutrition support dietitian for UVA's Continuum Home Infusion company in Charlottesville, VA. She has practiced for over 29 years, the past 17 of which have been at UVA. She worked previously at Truman Medical Center and St Luke's Hospital of Kansas City, Mo. She earned her Master of Science degree from University of Kansas and bachelors degree from University of Illinois.

Sara Tutor, MS, RDN, CNSC, CLC has a Master of Science in Human Nutrition from Eastern Michigan University. Sara is the Associate Director of Patient Food Service at Michigan Medicine, and led the implementation of a blenderized tube feeding policy at C.S. Mott Childen's Hospital. She is the recent co-author of the new blenderized tube feeding chapter in "Infant and Pediatric Feedings: Guidelines for Preparation of Human Milk and Formula in Healthcare Facilities, 3rd Ed."

10:45 am - 11:30 amBreakout Session 2Title Bridging the Gap from Pediatric to Adult Healthcare and Nutritional Care of the AdolescentSpeaker Name: Kelly Green Corkins, MS, RD-AP, CSP, LDN, FAND

Speaker Organization: LeBonheur Children's HospitalSession Summary:

Improved medical and surgical management and advancements in parenteral and enteral nutrition support of patients with pediatric onset chronic conditions has resulted in an increase of number of children with special health care and nutritional needs living well into adulthood. These patients need to transition from pediatric healthcare services to adult healthcare. Healthcare transition and transfer of care occurs during adolescence, a developmental stage of accelerated growth and increased nutritional needs. There is a higher risk of non-compliance during adolescence. Without adequate emotional and nutritional support during the transition process and ultimately the transfer of care, there is increased risk for inadequate follow up, poor self-management and growth issues leading to poorer quality of life for the patient with increased hospitalizations, increased re-hospitalizations and increased health care costs. This presentation will review key factors related to the transition process and discuss the changing nutritional needs of the adolescent/emerging adult.

Learning Objectives: 1. Become familiar with the process of transitioning care including key components of a success transfer of

care.2. Be able to incorporate some of the process into the transitioning of nutrition support services.3. Understand the physical changes occurring in the adolescent and how this impacts nutritional needs

above the specialized nutrition needs of the pediatric onset chronic condition the adolescent may have.

Speaker Bio:Kelly Green Corkins, MS, RD-AP, CSP, LDN, FAND received her undergraduate degree in Clinical Dietetics from the University of North Carolina – Greensboro and completed a Master of Science in Human Nutrition and Food Systems Management at Winthrop University in Rock Hill, S.C. She currently works as a Pediatric Clinical Dietitian III in the Cardiovascular ICU at LeBonheur Children’s Hospital in Memphis, TN. Kelly has presented at local, regional and national conferences/symposiums and authored several reviews and book chapters on a variety of pediatric nutrition topics. She is active in both the Academy of Nutrition and Dietetics and the American Society of Parenteral and Enteral Nutrition, serving on and chairing national committees and is a trainer for NFPE with the Academy. In addition, Kelly is married to Mark Corkins, a pediatric gastroenterologist and nutrition support specialist.

10:45 am - 11:30 amBreakout Session 3Title: Best Practices for Preparation of Human Milk and Formula in Health Care FacilitiesSpeaker Name: Caroline Steele, MS, RD, CSP, IBCLC, FANDSpeaker Organization: Children's Hospital of Orange CountySession Summary:

This session will review current best practices for handling human milk and formula within the hospital setting as outlined in the newly released 3rd edition of the PNPG publication Infant and Pediatric Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities.

Learning Objectives: 1. Outline risks associated with HM & formula handling in the hospital setting2. Summarize regulatory standards and recommendations3. Identify opportunities for change & implementation strategies within your organization

Speaker Bio:Caroline Steele, MS, RD, CSP, IBCLC, FAND is the Director of Clinical Nutrition and Lactation at Children’s Hospital of Orange County. Caroline is a pediatric registered dietitian with over 26 years of experience. She is a Board Certified Specialist in Pediatric Nutrition, an International Board Certified Lactation Consultant, and a Fellow of the Academy of Nutrition & Dietetics. Caroline has many professional publications and is a frequent lecturer on a variety of topics including breastmilk and formula handling, parenteral nutrition, and malnutrition documentation. She is also the co-editor and an author of the 2019 3rd edition of the PNPG publication "Infant and Pediatric Feedings: Guidelines for Breastmilk and Formula Preparation in Health Care Facilities" and was an author in the 2nd edition of the publication.

10:45 am - 11:30 amBreakout Session 4Title: How to Manage Shortages in Parenteral NutritionSpeaker Name: Kris Mogensen, MS, RD-AP, LDN, CNSCSpeaker Organization: Brigham & Women's HospitalSession Summary:

Parenteral product shortages, including intravenous fluids, have been a recurrent problem for many years. It is important for dietitians to understand the causes of product shortages to help other clinicians understand the scope and consequences of this challenging issue. This session will review causes of product shortages and approaches to managing parenteral product and intravenous fluid shortages. Guidelines published by the American Society for Parenteral and Enteral Nutrition (ASPEN) will be reviewed. Imported products from outside of the United States will be discussed and unique considerations for these products will be addressed. A case based discussion will be used to highlight key points.

Learning Objectives: 1. Identify two contributors to product shortages2. Develop an approach to addressing hydration needs during intravenous fluid shortage3. Apply ASPEN guidelines for managing macronutrient, electrolyte, and trace mineral shortages

Speaker Bio:Kris Mogensen, MS, RD-AP, LDN, CNSC is a team leader dietitian specialist at Brigham and Women's Hospital and an instructor in nutrition at Boston University. She has over 25 years of experience in clinical nutrition, with the majority of her career focusing in nutrition support.

REPEAT BREAKOUT SESSIONS

12:15 pm - 1:15 pmLunch and PlenaryTitle Nutrition at the End of Life: Not So Black and White Speaker Name: Stephanie Dobak, MS, RD, LDN, CNSCSpeaker Organization: Thomas Jefferson University HospitalSession Summary:

Artificial nutrition and hydration (ANH) can serve as a life-preserving therapy. However, the provision of ANH is not always beneficial, particularly at the end of life (EoL). This session aims to equip RDNs with the knowledge base and communication skills needed to effectively navigate conversations surrounding nutrition support at the EoL. A case study and pediatric panel will be used to help participants apply knowledge.

Learning Objectives: 1. Understand the physiological impact of ANH at EoL. 2. Combat common myths surrounding ANH at EoL. 3. Utilize effective communication skills in conversations surrounding nutrition at EoL. 4. Apply a case study example to real life RDN-patient scenarios.

Speaker Bio: Stephanie Dobak, MS, RD, LDN, CNSC is a clinical dietitian at Thomas Jefferson University Hospital in Philadelphia where she practices in the neuro-intensive care unit and inpatient rehabilitation center. She received her BS in Nutrition and Food Science from Auburn University, completed her dietetic internship at the Medical University of South Carolina, and achieved her MS in Biomedical Sciences from Thomas Jefferson University. She has held positions on the boards of multiple local dietetic associations, and is an avid volunteer with the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. Stephanie is currently the Executive Coordinator for the Dietitians in Nutrition Support DPG. Her research focuses on optimizing enteral nutrition for patients in the neuro-ICU and those receiving therapeutic hypothermia.

1:15 pm - 2:00 pmSkills Breakout 1Title: Handgrip Strength Examination for Adult and Pediatric Nutrition PracticeSpeaker Name: Terese Scollard, MBA, RD, LD, FANDSpeaker Organization: Providence Health & ServicesSession Summary:

The handgrip strength examination and methodology, as recommended by the American Society of Hand Therapists, provides a recognized method to measure a patient’s functional ability when influenced by protein-calorie malnutrition. This session discusses the background, strengths, weaknesses, methods and application of the grip strength exam in the context of clinical malnutrition, for adult and pediatric patients. Attendees will practice basics briefly during the presentation and will receive handouts and materials to start learning. Further in-depth self-training using an online Grip Strength Toolkit training program through the respective DPG websites will be shared.

Learning Objectives: 1. Gain insight into the history and applications of handgrip strength measurement which brings value in

evaluation of nutrition status in adults and children.2. Apply handgrip strength examination methodology and assessment in clinical practice.

3. Learn the correct methodology, patient and examiner positions, practice basics as seated and documentation of results; provide access to resources that support competency of RDNs.

Speaker Bio:

1:15 pm - 2:00 pmSkills Breakout 2Title: Energy balance across the ages -using indirect calorimetry to target nutrition interventions in adults and childrenSpeaker Names: Sarah Peterson, PhD, RDN - Rush University Medical Center & Lori Bechard, PhD, MEd, RDN - Boston Children’s HospitalSession Summary:

This session will provide an up-to-date review of energy expenditure as a tool in advanced nutrition assessments, including measurement technique, patient selection, interpretation of studies, and research gaps.

Learning Objectives: 1. Explain the benefit of measured vs. estimated energy expenditure (EEE) in a nutrition assessment2. Summarize the results of resting energy expenditure (REE) studies in a selection of patients across various

age groups3. Identify appropriate indications for indirect calorimetry (IC) in hospitalized patients

Speaker Bios:Sarah Peterson, PhD, RDN is a registered dietitian who specialized in adult critical care within the medical ICU at Rush University Medical Center for the first 10 years of her career. She is now an assistant professor in the College of Health Science at Rush University. Her research interests include examining outcomes associated with nutrition support exposure among hospitalized patients and describing changes in body composition.

Dr. Lori Bechard is a clinical nutrition researcher and registered dietitian nutritionist specializing in the investigation of nutrition interventions and assessment techniques for children with chronic and critical illnesses. She has wide-ranging expertise in clinical nutrition research and specialized pediatric clinical practice. Lori is the author of many publications in highly regarded peer-reviewed journals and educates dietitians, physicians and other health care providers on these topics. She is an active member of the Academy and several committees in ASPEN, and is the current chair-elect of the Pediatric Nutrition Practice Group.

1:15 pm - 2:00 pmSkills Breakout 3Title: Dysphagia, Thickeners and DevicesSpeaker Name: Sarah Studley, MS CCC-SLPSpeaker Organization: UNC HospitalsSession Summary:

This discourse offers an opportunity for hands on learning focused on the remediation of oro-pharyngeal dysphagia.

Learning Objectives: 1. When to utilize thickening agents for treatment of oro-pharyngeal dysphagia2. How to choose the best thickener for your patient3. Understanding different resources/methods available to manage dysphagia

Speaker Bio:Sarah Studley, MS, SLP-CCC graduated from the Medical University of South Carolina with a Masters in Communication Sciences and Disorders with High Honors. She started her career at the Medically Fragile Children’s Center in Columbia, SC and then transferred to Palmetto Health Richland, a level 1 trauma hospital, and worked with a variety of patients of all ages from the NICU to end of life care. Sarah joined the UNC Feeding Team at the NC Children’s Hospital in January of 2015.

1:15 pm - 2:00 pmSkills Breakout 4Title: The ABC’s of Managing Electrolytes: An Interactive Approach

Speaker Name: Ainsley Malone, MS, RDN, LD, CNSC, FAND, FASPEN

Speaker Organization: American Society for Parenteral and Enteral NutritionSession Summary:

Understanding the basics of electrolyte management in those receiving nutrition support will enhance your contribution to patient care. Expertise in managing electrolytes in both the uncomplicated and complex patient is enhanced through learning basic principles coupled with repetition and practice. This session will offer a brief background on the key electrolytes, sodium, potassium, phosphorous, magnesium and calcium followed by multiple interactive case studies to assist the attendee in gaining skills in this important aspect of nutrition support management.

Learning Objectives: 1. Outline the basic pathophysiology of key electrolytes: sodium, potassium, phosphorous, magnesium and

calcium.2. List the contributors to abnormalities in key electrolytes and how these abnormalities can be managed.3. Practice managing electrolytes in enteral and parenteral nutrition via patient case studies.

Speaker Bio:Ainsley Malone, MS, RDN, LD, CNSC, FAND, FASPEN is a Dietitian member of the Nutrition Support Team at Mt. Carmel Grove City Hospital in Columbus, Ohio where she is involved in managing nutrition care in patients who require enteral and parenteral nutrition. In addition, Ms. Malone serves as a Clinical Practice Specialist for the American Society for Parenteral and Enteral Nutrition (ASPEN) where she works to guide clinical practice activities for the organization. In addition to her clinical practice activities, Ms. Malone has authored multiple nutrition support related peer reviewed articles and book chapters. Including managing editor of the ASPEN Parenteral Nutrition Order Writing Workbook.

REPEAT SKILLS WORKSHOPEXHIBITS AND BREAK

REPEAT SKILLS WORKSHOP

4:15 pm - 5:15 pmGeneral Session PlenaryTitle: Academy UpdateSpeaker Name: Mary Russell, MS, RDN, LDN, FANDSpeaker Organization: BaxterSpeaker Bio:

Mary Russell, MS, RDN, LDN, FAND is a Medical Science Liaison, U.S. Nutrition Medical Affairs, at Baxter Healthcare and a lecturer at the Chicago Medical School. Previously, she was director of the department of clinical nutrition at the University of Chicago Medical Center and the director of nutrition services at Duke University Hospital, where she had been served for nearly 10 years as an adult nutrition support team dietitian clinician. She is president of the Academy of Nutrition and Dietetics through May 2019 and a Fellow of the Academy of Nutrition and Dietetics. She is a past member of the Academy House of Delegates and the Academy Foundation’s Board; past chair of the Dietitians in Nutrition Support dietetic practice group; and past president of the North Carolina Dietetic Association. She has authored journal articles and book chapters, and has spoken nationally and internationally on nutrition support and on ethics. She earned a bachelor of science in Medical

Technology from Marquette University and Master of Science in Nutritional Sciences from the University of Wisconsin-Madison.

Day 3BREAKFAST

8:15 am - 9:15 amGeneral Session PlenaryTitle: Feeding Approaches in the First YearSpeaker Name: Jill Castle, MS, RDNSpeaker Organization: Jill Castle Nutrition LLC

Session Summary: The foundation of future health is laid in the early years of childhood. Starting solids is an important transition as parents determine which foods to feed their little ones, how to do it most effectively, and why establishing a responsive relationship is important for future food preferences, eating habits and self-regulation of food intake. Castle explores food, nutrients, feeding methods and other concerns in the first year of life.

Learning Objectives: 1. Develop a sound, evidence-based, goal-oriented approach for nourishing babies 6 months to a year of age.2. Identify two feeding recommendations to promote self-regulation, normal eating skills and optimal

nutrition.3. Name five key nutrients needed in the first year of life when developing a plan for food selection and

optimal nutritional status, growth and development.Speaker Bio:

Jill Castle, MS, RDN is one of the nation’s premier childhood nutrition experts. Known as a paradigm shifter who blends current research, practical application and common sense, Jill inspires audiences to think differently about feeding kids. From babies to teens, Jill takes a unique, “whole-child” approach to showcase food, feeding and childhood development as the secret ingredients to raising a healthy child.

9:15 am - 10:15 amGeneral Session PlenaryTitle: Adverse Reactions to Foods: From Allergies to IntoleranceSpeaker Name: Alison Cassin, MS, RD, CSP, LDSpeaker Organization: Cincinnati Children's Hopital Medical CenterSession Summary:

Adverse reactions to foods can manifest in several forms, from reactions to proteins in food -in the case offood allergies and EoE, to intolerances- such as IBS stemming from incomplete digestion of carbohydrates like FODMAPs.

Learning Objectives: 1. Differentiate food allergies from intolerances2. Discuss food allergies and elimination diets for eosinophilic esophagitis (Eo E) 3. Define FODMAPs and discuss their role in irritable bowel syndrome

Speaker Bio:Alison Cassin, MS, RD, CSP, LD is a Registered Dietitian and Board Certified Specialist in Pediatric Nutrition at Cincinnati Children’s Hospital Medical Center, where she counsels patients with food allergies and eosinophilic

gastrointestinal disorders. Previously a bench chemist, she left the laboratory to pursue a Master’s degree in Nutrition at the University of Cincinnati. Since joining the Cincinnati Center for Eosinophilic Disorders in 2012, she has contributed to this field with regional, national, and international presentations and authored and co-authored journal articles, book chapters, and patient education materials. Due to Alison’s service to her patients and families, in 2018 she earned the title, Melanie Hunt Registered Dietitian of the Year.

BREAK

10:45 am - 11:30 amBreakout Session 1Title: 2017 Guidelines for Nutrition Support in Pediatric Critical Illness – Rationale and Practical Applications Speaker Name: Katelyn Ariagno, RD, LDN, CNSC - Boston Children's Hospital/Boston & Lori Bechard, PhD, MEd, RDN - Boston Children’s HospitalSession Summary:

This session will review the research supporting the 2017 SCCM/ASPEN pediatric critical care guidelines for nutrition support, including the methods, results, limitations and areas for future investigations. Practice applications will be discussed with case scenarios provided.

Learning Objectives: 1. Examine the findings of the 2017 joint publication by SCCM and ASPEN, “Guidelines for the Provision and

Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient”2. Explore research gaps in pediatric critical care nutrition3. Evaluate the association between energy and protein intake and clinical outcomes 4. Identify challenges to achieving optimal nutrition in the PICU

Speaker Bio:Katelyn Ariagno RD, LDN, CNSC received her bachelors degree in Nutritional Sciences at the University of Connecticut and completed her internship at NewYork Presbyterian. She has been the lead clinical dietitian in the medical/surgical PICU at Boston Children's Hospital for the past 10 years. She has been recognized both locally and nationally for her experience in the clinical and research areas specific to the critically ill child.

Dr. Lori Bechard is a clinical nutrition researcher and registered dietitian nutritionist specializing in the investigation of nutrition interventions and assessment techniques for children with chronic and critical illnesses. She has wide-ranging expertise in clinical nutrition research and specialized pediatric clinical practice. Lori is the author of many publications in highly regarded peer-reviewed journals and educates dietitians, physicians and other health care providers on these topics. She is an active member of the Academy and several committees in ASPEN, and is the current chair-elect of the Pediatric Nutrition Practice Group.

10:45 am - 11:30 amBreakout Session 2Title: Mixed Oil Lipid Emulsions in the NICU and Short Gut PopulationsSpeaker Name: Stephanie Merlino Barr, MS, RDN, LDSpeaker Organization: MetroHealth Medical CenterSession Summary:

Mixed oil lipid emulsions are rapidly becoming standard of care in neonatal and pediatric populations who are at risk for parenteral nutrition-associated cholestasis (PNAC) and intestinal failure-associated liver disease (IFALD). This session will review what we know, and what we don’t know about on mixed oil lipid emulsions use in these high-risk patient populations. A practical perspective on clinical indications and implementation of mixed oil lipid emulsion use will also be discussed.

Learning Objectives: 1. Understand lipid biochemistry and metabolism and its role in PNAC and IFALD. 2. Determine indications of mixed oil lipid emulsion use and important clinical aspects to monitor for practical

implementation in neonatal and pediatric populations.3. Identify research gaps in mixed oil lipid emulsion use in neonatal and pediatric populations.

Speaker Bio:

Stephanie Merlino Barr, MS, RDN, is a neonatal nutritionist and adjunct lecturer, Case Western Reserve University at MetroHealth Medical Center. She has embraced neonatal nutrition as her area of practice and is an enthusiastic young investigator. Stephanie's research interests include impact of early life nutrition on long term health and body composition outcomes.

10:45 am - 11:30 amBreakout Session 3Title: Lactoengineering Human MilkSpeaker Name: Sharon Groh-Wargo, PhD, RD, LDSpeaker Organization: MetroHealth Medical Center - Department of PediatricsSession Summary:

Human milk is the preferred feeding for nearly all babies but requires fortification for very low birthweight infants. The use of human milk for high risk newborns will be reviewed along with a discussion of human milk analysis and options for individualizing fortification both in the neonatal intensive care unit and following hospital discharge.

Learning Objectives: 1. Review use of human milk for VLBW infants2. Discuss human milk analysis3. List options for individualizing fortification

Speaker Bio: Dr. Sharon Groh-Wargo, PhD, RD, LD is the senior neonatal nutritionist in the Department of Pediatrics at MetroHealth Medical Center and Professor, Nutrition and Pediatrics, at Case Western Reserve University in Cleveland, Ohio. She has over 40 years of experience in neonatal nutrition, is an editor of both editions of the Academy's Pocket Guide to Neonatal Nutrition and authored a new chapter for the 3rd edition of "Infant and Pediatric Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities" entitled "Lactoengineering".

REPEAT BREAKOUT SESSIONS

12:15 pm - 1:15 pmLunch and PlenaryTitle: Holistic Integrative NutritionSpeaker Name: Merideth Miller, RD, CSP, LDSpeaker Organization: Cleveland Clinic Children’s Hospital for RehabilitationLearning Objectives:

1. Discuss holistic and integrative nutritional changes to benefit different disease states2. Discuss dietary supplements that may benefit different disease states3. Understand different food allergy testing and elimination diets

Speaker Bio: Merideth Miller, RD, CSP, LD has been a pediatric dietitian for almost 18 years and a certified specialist in pediatrics since 2011. She am currently the pediatric nephrology and dialysis dietitian at Cleveland Clinic Children's. Other specialties include pediatric chronic pain program, integrative medicine, chronic medical needs and rehabilitation nutrition.

1:15 pm - 2:00 pmGeneral Session PlenaryTitle: The Newest CDR Certification: Certified Specialist in Pediatric Critical Care (CSPCC)Speaker Name: Linda Heller, MS, RD, CSP, CLC, FAND

Speaker Organization: Children’s Hospital, Los AngelesSession Summary:

This program will provide an overview of the new Certified Specialist in Pediatrics Critical Care (CSPCC) board certification offered by the Commission on Dietetics Registration (CDR) and launched in 2018. Learn how and why this certification was developed, the experience that qualifies the RD to take the exam, and the references used to develop the questions. Time will be generously allowed for any questions and shared experiences.

Learning Objectives: 1. The participant will become familiar with the development of a new certification through the Commission

on Dietetic Registration2. The participant will understand the requirements necessary to take the new CSPCC certification. 3. The participant will understand scope of the new CSPCC certification and how best to prepare to take the

exam. Speaker Bio:

Linda Heller, MS, RD, CSP, CLC, FAND has been the Clinical Nutrition Manager for Clinical Nutrition Services at Children’s Hospital Los Angeles since 2000. She is a board certified specialist in Pediatrics (CSP) and serves as a test developer/examiner for the CSP exam for the Commission on Dietetics Registration. . Linda was the House of Delegates representative for the Pediatric Nutrition Practice Group of the Academy of Nutrition and Dietetics and has served intermittently on the executive board of the PNPG as treasurer and nominations chair. She currently serves as the Specialist Commissioner for the Commission on Dietetics Registration for the Academy of Nutrition and Dietetics.

2:00 pm - 3:00 pmGeneral Session PlenaryTitle: Pediatric Nutrition Screening: A Review of the EvidenceSpeaker Name: Patricia Becker, MS RDN CSP CNSCSpeaker Organization: Dayton Children’s HospitalLearning Objectives:

1. Highlight the difference between a nutrition screen for malnutrition and a nutrition assessment for malnutrition

2. Describe the evidence analysis library pediatric nutrition screening project3. Assess and analyze validity and reliability evidence to determine the most appropriate screening tool to

identify those at risk for malnutrition in pediatric populations4. Describe next steps for the pediatric nutrition professional in assessing use of screening tools

Speaker Bio:2018 PNPG Outstanding member of the year. 2018-19 PNPG Chair. Chair of the EAL Pediatric Nutrition Screening Project. Chair of the PNPG Malnutrition Committee. 2019 Ohio Recognized Dietitian of the Year.

BREAK

3:30 pm - 4:15 pmGeneral Session PlenaryTitle: Changing the Conversation: Transitioning from Pediatric Weight Management to Eating Disorder PreventionSpeaker Name: Leslie Schilling, MA, RDN, CSSD, CEDRD-SSpeaker Organization: Schilling Nutrition LLCSession Summary:

Recommendations around speaking to children about weight have changed in recent years yet many in health professions continue to focus on the numbers. This presentation will review the American Academy of Pediatrics guidelines for discussing weight (or not) with children and adolescents in addition to how parental concerns around weight impact their children. When we help our clients feel confident about fueling their unique selves, we can help prevent disordered eating behaviors for years to come. From misguided recommendations and the use of BMI in schools to family meals and self-regulation, this session will provide case examples of how to navigate these tough conversations with other practitioners, parents, and children.

Learning Objectives: 1. Participants will become aware of current recommendations about discussing weight with children and why

they have changed in recent years.2. Participants will learn to recognize parental behaviors that negatively and positively impact their children’s

nutritional intake and ability to self-regulate.3. Participants will gain counseling skills and tools that help support parents promote healthful relationships with

food and body in their children.Speaker Bio:

Leslie Schilling, MA, RDN, CEDRD-S, CSCS owns a Las Vegas-based coaching practice, specializing in nutrition counseling for families, those of all ages with disordered eating concerns, and professional athletes and performers. In addition to running her practice, Leslie serves as a performance nutrition consultant for Cirque du Soleil® and an eating disorder specialist and supervisory consultant for eating disorder treatment centers in Nevada. With her warm, compassionate, and entertaining personality, Leslie been featured in media outlets like Women’s Health, Self, Pregnancy Magazine, The Yoga Journal, Bicycling, BuzzFeed, the Huffington Post, US News & World Report, and on HGTV. You may know her best as the creator of the Born To Eat® approach and co-author of the award-winning book, Born To Eat.

4:15 pm - 5:00 pmGeneral Session PlenaryTitle: Tying It All Together: Case Study Application