Nutrition Management Department

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

Overview Nutrition Management Department

For inpatients

At the pre-hospital preparation center, if special consideration is required regarding meals and nutrition during hospitalization, a registered Registered Dietitian will directly confirm this, and from the first meal on the day of admission, we will provide meals that suit the patient. If there is a risk of malnutrition, the registered Registered Dietitian in charge of the ward will listen to you in detail and make the necessary dietary adjustments.

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.

When you are discharged from the hospital, we will provide you with nutritional guidance as needed, focusing on your meals during your hospital stay.

For outpatients

If you require dietary therapy at home due to lifestyle-related diseases, cancer, or other illnesses, you can receive nutritional guidance under the direction 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>

Nutrition counseling is provided in the nutrition counseling room on the 2nd floor or in the hospital ward. Since patients with various diseases come to our hospital, the content of nutritional counseling is wide-ranging. When providing nutritional consultations, I try to explain things in an easy-to-understand manner using food models and materials.

<Meal adjustment by registered Registered Dietitian >

For patients whose oral intake is not progressing due to poor appetite, Registered Dietitian consults with them in the ward and proactively adjusts their diet. We provide meals while considering the form of the meal, including swallowing. We are also considering the appropriate dosage and administration method 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

20 Registered Dietitian (including 1 Director, 1 chief examiner, 2 chiefs, 3 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 5 (including concurrent positions)
Registered Dietitian specializing in pathophysiological nutrition Five people
Pediatric Allergy Educator 1 person (including concurrent posts)
Registered Registered Dietitian specializing in cancer pathology nutrition 1 person
Clinical Nutrition Metabolism Therapist 2 people
heart failure educator 2 people
Nephrology educator 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 illness or side effects of treatment. In addition, there are times when you cannot eat orally and you have to inject nutritional supplements through your nose or stomach, or take nutrition through a drip. I am
  • 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) Swallowing rounds 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 4 times/week
⑬E-ICU rounds every day
⑭G-ICU rounds every day
Gastroenterology Conference/Round 1 time/week
Hematology Transplantation Conference 1 time/week
⑰ Allergy Team Conference Irregular
⑱ CIFT rounds 1 time/week
⑲Comprehensive General Medicine conference 1 time/week

2.Individual nutrition consultation

We provide nutrition and diet counseling for patients who need nutrition and diet therapy regarding diet and proper nutrition according to various diseases, including diabetes, heart disease, and kidney disease. Since it is an appointment system, please inform your doctor of your desired date and time. If there are vacancies on the day of your outpatient appointment, it is possible to receive a nutritional and meal consultation on the day of your outpatient visit.

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 nutrition and dietary guidance for hospitalized patients. We talk about the basics of diet and nutritional therapy for various diseases. Reservations are required. *In each case, you will receive an individual nutritional and dietary consultation before you are 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 treatment-related anorexia, difficulty swallowing, food allergies, etc.

About meal types

Meals during hospitalization are divided into general diets and special therapeutic diets, and are a 28-day cycle menu. Basically, your doctor will decide the contents of your meal according to your disease, but if you do not have the form of meals or if the amount of food intake is low, the registered Registered Dietitian will decide the contents of the meal. I will adjust. Please refer to the weekly menu of adult meals posted in each ward.

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

At our hospital, we have adopted a new cook chill system that reheats and serves chilled food in a reheating cart before serving. Half of the meal tray is for hot serving (mainly staple food, soup, main dish, etc.), and the other half is for cold serving (marinated dish, salad, dessert, drink, bread, etc.). It is served to the patient at the appropriate temperature.

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》 It is a meal in which all dishes are served cold. It is suitable for those who are concerned about the smell of food and those who cannot eat hot food due to stomatitis.

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

Some classes have been canceled to prevent the spread of the new coronavirus infection.

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 Registered Dietitian, nurses, pharmacists, clinical laboratory technologists, 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, physical therapists, occupational therapists, registered Registered Dietitian, pharmacists

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 course) 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.
Second year (specialized course)

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.
1st year course annual schedule example

Career path of seniors

Hospital employment, graduate school, university teacher, etc.