Nutrition Management Department

Kobe City Medical Center General Hospital
Director Nutrition Management Department
Toshio Iwakura

Overview Nutrition Management Department

For inpatients

At the pre-hospitalization preparation center, we check food allergies, food type, whether or not you need a diet, etc., and on the day of admission,
We strive to provide appropriate meals from the first meal onwards. If there is a risk of malnutrition, Registered Dietitian in charge of the ward will discuss the matter in detail and make any necessary adjustments to the diet.

In the case of emergency hospitalization, the registered Registered Dietitian in charge of the emergency ward exchanges information with doctor and nurses, and considers ways to secure the necessary amount of nutrition.

Upon discharge, nutritional counselling is provided if necessary.

For outpatients

If you need to undergo dietary therapy at home due to lifestyle-related diseases, cancer, or other illnesses, you can receive nutritional counseling under the instructions of your doctor.

To everyone in the area

Anyone can participate in classes such as lifestyle-related diseases and digestive diseases.

Activities of the Nutrition Management Department

<Nutrition consultation>

Nutritional counseling is provided in the nutrition counseling room on the second floor or in the wards.
Since patients with various diseases visit our hospital, the nutritional consultations cover a wide range of topics. When providing nutritional consultations, we try to explain things as clearly as possible using food models and materials.

<Meal adjustment by registered Registered Dietitian >

For patients who are unable to take in food orally due to anorexia, etc., Registered Dietitian will talk to them in the ward and proactively adjust their diet. We also work with other professionals to make adjustments regarding the type of food, such as food for those who are unable to swallow. We also consider the appropriate dosage and method of administration for patients receiving tube feeding.

Staff introduction

Nutrition Management Department staff

job title Full name
Director (doctor) Toshio Iwakura
Deputy Director (doctor) Hiroaki Nishioka
Deputy Director (doctor) Toru Nagano
Deputy Director (Registered Dietitian) Masako Iwamoto

21 Registered Dietitian (including 1 deputy Director, 1 chief, 2 directors, 4 residents, and 3 part-timers)

Number of Certified Qualified Persons in Specialized Fields (Registered Dietitian Only)

NST Professional Therapist 7 (including concurrent posts)
diabetes educator 3 people (including concurrent positions)
Registered Dietitian specializing in pathophysiological nutrition 6 people
Pediatric Allergy Educator 2 people (including concurrent positions)
Registered Registered Dietitian specializing in cancer pathology nutrition 2 people
Nutritional Therapist
(Perioperative and emergency intensive care specialist)
2 people
heart failure educator 2 people
Nephrology educator 1 person
Certified by The Japanese Society of Dysphagia Rehabilitation 1 person
Hyogo Prefecture Hepatitis Medical Coordinator 1 person

clinical service

1. Nutrition Care Management (NCM)

  • We conduct nutritional assessments of all inpatients and provide advice on nutritional supplementation methods, etc., in order to correct and improve the nutritional status of those who require nutritional intervention. All wards, including the emergency room and ICU, have registered Registered Dietitian in charge of the wards.
  • During hospitalization, patients may lose their appetite due to the effects of the disease or side effects of treatment, but in such cases we adjust the menu and provide easy-to-eat dishes, and suggest supplementary meals. In addition, there are times when patients are unable to eat by mouth and must receive nutrients through tubes injected into the nose or stomach, or through intravenous drips, and in such cases we select appropriate nutrients and consider injection methods.
  • We hold nutrition conferences at each ward as needed, but if it is difficult for the ward to respond, we ask the NST(Nutrition Support Team) to examine nutrition and strive to implement appropriate nutritional management.
Click here for more information on NST
  • Participating in various conferences and rounds as team medical care support, providing advice and information on nutrition.
(1) NST conferences and rounds 1 time/week
②NST Satellite Team Conference by each ward
③Diabetes conferences and rounds 1 time/week
④Kidney disease conferences and rounds 1 time/week
⑤ Cardiac Rehabilitation Conference 1 time/week
⑥ Heart failure conference 2 times/month
7. Eating and swallowing conference 1 time/week
⑧ Swallowing working Irregular
⑨VF (VIDEO FLUOROGRAPHY) Conference 1 time/week
⑩Pressure ulcer conferences and rounds 1 time/week
⑪ Palliative Care Conference 1 time/week
⑫ Palliative care rounds 3 times/week
⑬E-ICU rounds every day
⑭G-ICU rounds every day
⑮C-HCU Rounds 1 time/week
⑯SCU Conference 3 times/week
Gastroenterology conferences and rounds 1 time/week
Hematology Transplant Conference 1 time/week
⑲Allergy team conference Irregular
⑳CIFT Rounds 1 time/week
21. General Medicine Conference 1 time/week
22. Rheumatology Conference 1 time/week

2.Individual nutrition consultation

We provide nutritional consultations on diet and appropriate nutrition for various diseases, including diabetes, heart disease, and kidney disease. Reservations are required, so please tell your doctor your preferred date and time. If there are available reservations on the day you visit, you may be able to receive nutritional consultations on the same day.

Time: Monday to Friday 9:00 to 16:30 (until 15:30 on Tuesday), about 30 minutes each time.
Location: 2nd floor nutrition consultation room (located diagonally in front of Tully's, look for the apple mark)

If you are a hospitalized patient and would like to talk about nutrition and diet therapy after discharge, we may talk in the ward at a date and time that is convenient for you and your family.

3.Group nutrition dietary guidance

We provide group nutritional counseling for hospitalized patients. We talk about the basics of diet and nutritional therapy for various illnesses. Reservations are required.
*In all cases, you will receive individual nutritional consultations before being discharged from the hospital.

Dietary Guidance for Group Nutrition for Diabetes

Time: Every Tuesday from 14:00 for about 1 hour

cardiac rehabilitation

Time: Every Thursday from 14:00 for about 1 hour

others

  • Guidance of clinical intern trainees
  • Implementation of the nutrition management committee, correspondence and coordination of various committees
  • Implementation of health education (general public, other departments, other facilities, medical intern, Nursing Department, sales staff, etc.)
  • Coordinating facility tours

Meals during hospitalization

Meals during hospitalization

  • Providing safe meals
  • Provision of Appropriate Meals
  • Providing meals that enhance QOL
  • Event meal
  • Personal order correspondence
  • Thorough hygiene management
  • Provision of meals according to nutritional components suitable for diseases
  • Introduction of selection menus, serving on reheating carts
  • Providing seasonal meals for monthly events
  • Dealing with loss of appetite, difficulty in eating and swallowing, food allergies, etc. associated with treatment

About meal types

Meals during hospitalization are divided into general meals and special medical meals, and are served on a 28-day cycle. In general, the attending physician will determine the meal contents based on the patient's illness, but if the type of food does not suit the patient or if food intake has decreased, Registered Dietitian will adjust the meal contents. Weekly adult menus are posted in each ward, so please refer to them.

general diet

There are adult diets and senior diets, and there are liquid diets and soft vegetarian diets. There are no special nutritional restrictions, but we are able to take in nutrients in a well-balanced manner. For those who can't eat much, there is a half meal for each.

Other than the general diet, it is a special therapeutic diet. Adjust the diet based on the doctor 's instructions, which is directly involved in the treatment of the disease.

《Special meal non-additional meal》 Pediatric diet, maternity/delivery diet, liquid diet after surgery such as ulcer diet, etc.
《Additional meals for special meals》 Of the special therapeutic meals, this is a therapeutic meal that can be calculated as an addition to the inpatient meal allowance. Diets for kidney disease, liver disease, diabetes, gastric ulcer, pancreatic disease, and dyslipidemia are mainly targeted.
medical fee general diet special diet
non-additive
  • Adult meal (large/medium/small)
  • senior diet
  • Obstetrics food (maternity food, delivery food)
  • children's food
  • Soft vegetarian diet
  • 7 minutes dish
  • 5 minutes dish
  • 3 minutes dish
  • Liquid diet
  • mixer food
  • Dysphagia diet (1, 2, 3, 4, 5)
  • Food load test diet (weaning, infants, children, growth period)
  • iodine limit
  • low residue diet
  • Lipid control diet (F liquid diet)
  • Postoperative meal (OP liquid diet)
  • After gastrectomy (G liquid diet)
  • Ulcer diet (U liquid diet)
  • Clone diet (C fluid)
  • Concentrated liquid diet
  • Chemotherapy diet [hydrangea diet (A, B, C)]
  • emergency food
  • high protein diet
  • Individual order meal
Special meal addition  
  • energy control diet
  • Energy-salt control diet
  • energy protein control diet
  • protein control diet
  • Liver failure diet (L1/L2)
  • Lipid control diet (F3 minutes, 5 minutes, soft vegetables, regular food)
  • Postoperative meal (OP 3 minutes, 5 minutes, 7 minutes, soft vegetables)
  • After gastrectomy (G3 minutes, 5 minutes, 7 minutes, soft vegetables)
  • Ulcer food (U 3 minutes, 5 minutes, 7 minutes, soft vegetables)
  • Clone food (C3 minutes, 5 minutes, 7 minutes, soft vegetables)
  • Skewered food A (ES4), B (E4), C (P12)
  • Low-residue diet *Depends on condition

About serving meals

Our hospital uses a new cook-chill system, where food is cooked, refrigerated, and then reheated in a reheating cart before being served. Half of the meal trays are hot dishes (mainly staple foods, soups, main dishes, etc.), and the other half are cold dishes (mixed dishes, salads, desserts, drinks, bread, etc.), and each dish is served to the patient at the appropriate temperature for eating.

About special correspondence

We provide special support for those who have difficulty eating regular meals.

bite size

A side dish such as fish or meat is cut into easy-to-eat bite-sized pieces, and can be eaten by sticking it with a fork.

Bite large thickness

It is a bite-sized meal, and it is a meal with thickened juices and liquid parts.

Skewered food

This is a meal in which all the food is skewered to make it easier to eat when you need to rest after an examination, or when you are in pain and can only eat while lying down.

supplementary food

Dietary supplements, jelly, etc., added to meals to provide nutritional supplements for those who cannot eat enough, or who are eating but lacking in nutrients.

forbidden food

In addition to responding to prohibited foods for food allergies, we also provide meals that exclude ingredients and dishes that are difficult to eat if you have a decreased appetite.

swallowing food

This meal is for people who have difficulty swallowing food or drinks due to post-cerebral infarction, neurological disease, surgery, etc. There are 5 stages of meals, such as jelly food, paste food, and extremely chopped thick food.

Hydrangea food

Meals for those who find it difficult to eat due to treatments such as chemotherapy, radiation therapy, and post-surgery.

《Hydrangea Food A》 It is a meal prepared only with dashi stock. It is suitable for those who feel all flavors strongly.
《Hydrangea food B》 Curry and rice, okonomiyaki, hamburgers, and other dishes with strong flavors are available.
《Hydrangea food C》 冷しゃぶの梅ポン酢、おろしうどんなど、さっぱりした料理を中心としたお食事です。食欲不振や悪心があり、酸味などのさっぱりした味付けを希望される方に向いています。

About selective diet

Target food species Adult food, maternity food, childbirth food
Implementation day Wednesdays, Thursdays, and Fridays (excluding holidays and event food days)
Deadline time/place If you wish, fill in the application form and submit it to the collection box in the ward by 14:00 on Tuesday.

Please note that changes cannot be made after selection. In addition, we may not be able to meet your request due to changes in the date and time of hospitalization or the type of food you eat after hospitalization. note that.

About event meals

Every month, we provide meals that match seasonal events.

(example)

About Classes by Pathology

The Diabetes Class started disseminating information on its website. The Cardiology Department has started disseminating information on its website. The Kidney Disease Class has started disseminating information on its website.

Pathological Classroom

Nutritional diet plays an important role in the treatment and management of disease. The following classes are held to ensure proper treatment. There are many people who participate for treatment, prevention of onset, or for study. No reservations or participation fees are required. For details, please refer to the page of each classroom.

  subject content Attendant
Diabetes class Inpatient/outpatient and family About diabetes
diet, life, medicine, self-monitoring of blood glucose
doctor, Registered Dietitian, nurses,
Pharmacists, clinical laboratory technicians, physical therapists
cardiology classroom About heart disease
diet, medicine, exercise
doctor, Registered Dietitian, Pharmacist, Physical Therapist
Kidney disease class About kidney disease
food, medicine
doctor, Registered Dietitian, Pharmacist, Physical Therapist
Digestive disease class About digestive diseases
(liver, pancreas, etc.), food, medicine
doctor, Registered Dietitian, pharmacist
Easy Breathing Class Respiratory rehabilitation, respiratory disease and nutrition doctor, nurses, physiotherapists,
Occupational therapist, Registered Dietitian, pharmacist
Cancer Class Stories about cancer doctor, nurses, physiotherapists,
Pharmacists, Registered Dietitian, etc.

clinical research

Research subject name Explanatory text
(PDF)
The reality of early nutrition intervention in ICU PDF
Examination of the effectiveness of prehospital nutrition screening for inpatients PDF

About the resident system

About the resident system

At our hospital, we have adopted a resident system for registered Registered Dietitian.
The purpose is to develop Registered Dietitian who can practice clinical nutrition work corresponding to advanced acute medical care and team medical care through lectures and clinical practical training based on practical experience. Of course, you can also acquire the ability to deal with chronic diseases.

We are looking for people who want to work at a hospital in the future, who want to acquire advanced knowledge and practical skills, and the ability to communicate with patients and medical staff, and who want to play an active role immediately after that, or who are currently working in a hospital or medical field. For those who want to acquire a wider range of specialized knowledge and practical skills.

education system

The training in the resident system is carried out for two years. The general program is listed below, but the content may change slightly depending on the individual's work experience. In addition, during the training period for residents, we are asking them to assist with school lunches as staff assistants.

1st year (general field) Acquisition of records in SOAP format, procedures for nutritional guidance, methods for formulating nutritional management plans, etc.
Ward nutrition management Students rotate around each ward (including ICU and emergency ward) every two to three weeks to learn how to deal with various diseases and conditions. At that time, the registered Registered Dietitian in charge of each ward provides detailed guidance on how to intervene in nutrition. Participate in conferences and rounds of clinical departments in rotating wards.
nutritional guidance

nutritional guidance

Individual: Responsible for 1 to 2 slots per week (1 slot is 4 hours in the morning or afternoon).

Group: Responsible for diabetes and cardiac rehabilitation in rotation.

Once a week, we have a preparatory lesson about nutrition guidance and patient intervention in the ward with a registered Registered Dietitian in charge of resident education, and we also have time to reflect on cases that were difficult to deal with. In the last week of each month, we ask them to present their achievements and reflections for the current month and their goals for the following month.
2nd year (specialized field)

Responsible for 1-2 wards, acquire the ability to practice more specialized nutrition management and team medical care in the acute phase, critical care department, and other pathologies. The ward you will be in charge of will meet your wishes to some extent according to your future course and qualifications you want to acquire. I will continue to provide nutritional guidance.

I will continue to spend time with the resident education staff once a week, but I will continue to gain experience by educating junior residents.
Resident Program Overview

Career path of seniors

Hospital employment, graduate school, university teacher, etc.