Knowledge, Competencies, Skills and Roles of RDNs and DTRs in Emergency Preparedness

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Knowledge, Competencies, Skills and Roles of RDNs and DTRs in Emergency Preparedness RDs and DTRs are uniquely qualified to aid in a disaster, especially assisting individuals with special needs (i.e., elderly, children, the disabled, special nutritional needs). Our training and skills allow us to play key roles in times of disasters by being aware of our environment, knowing our community, population groups and state/local resources, being prepared in the event of a disaster and participating in the coordination and delivery of relief to those affected. To help members understand possible roles in emergency response, Dietetic Practice Groups have been categorized into three primary focus areas: Clinical Nutrition Public Health/Community Nutrition Food Management. Each focus area includes a listing of major knowledge, competencies, skills and roles. These charts are designed to guide members on what they need to know and what they may need to do in the event of a disaster. DPG s were categorized in a primary focus as a starting point and in consideration of typical professional work positions and/or roles in the community. All members are encouraged to review all of the major knowledge, competencies, skills and roles as they may be utilized in an atypical or unfamiliar environment As educators and researchers may practice with a specific focus, the Dietetics Educators of Practitioners and Research DPG s are listed in all three areas. In addition to the Clinical Focus, Pediatric Nutrition is listed under Public Health/Community due to the large number of public health and community health providers serving this population. It is critical that we prepare ourselves so that we are able to demonstrate that we have the knowledge and competencies necessary to contribute in times of disaster. The basic Federal Emergency Management Agency Independent Study Program (FEMA - ISP) Training Courses (www.training.fema.gov/is/crslist.asp ) will provide the additional knowledge and competencies so that others look to us for our food and nutrition skills. One fact is known following a disaster, members may be expected to function outside of their practice area and to do any and all tasks.

The Advance Registration of Health Professionals is an important issue for members to understand (www.phe.gov/esarvhp/pages/default.aspx). It is important to note that not everyone will have a role in disaster preparedness or response at the levels outlined below. But, for those interested in disaster preparedness and response, additional knowledge will be very beneficial. It is important that we have a broad understanding of the context in which we are operating in order to be seen as a valuable resource. Dietetic Practice Groups, Member Interest Groups, affiliates and their district associations are encouraged to use this information to support and motivate member education in a variety of ways including print-internet communications and program planning. For example, DPG newsletters could include highlights of member response during a disaster or a section on an affiliate web site could inform members on the local registration requirements for the advance registration of volunteer health professionals. Members are encouraged to utilize this document and make specific additions to their organizational plans.

Knowledge/Competencies/Skills/Roles Knowledge/Competencies: 1. Completed the basic FEMA Independent Study Program training courses for emergency preparedness (IS-100, 200, 700, 800). 2. Utilized basic and advanced dietetics skills within competency level. 3. Described the National Response Framework and the role of Emergency Support Function (ESF) #8 Health and Medical Response www.fema.gov/pdf/emergency/nrf/nrf-esf-08.pdf, 4. Articulated what the Incident Command System (ICS) is and appropriate roles within that context during an emergency event. 5. Articulated what the National Incident Management System (NIMS) is in the context of their setting. 6. Understood their role in mitigation, preparedness, response and recovery of an emergency situation. Skills/Roles: 1. Established or participated in the development of a clinical emergency operation plan. 2. Provided clinical services during a biologic, man-made or natural disaster. 3. Participated in evacuation exercises. 4. Knowledgeable of the volunteer programs in the area where their services could be utilized (Emergency System for Advance Registration of Volunteer Health Professionals - ESAR-VHP, Medical Reserve Corps - MRC, Disaster Medical Assistance Team - DMAT, etc.). 5. Provided counseling on diet modifications for textures, allergies, alternative therapies, parenteral nutrition or for tube feedings etc. 6. Utilized MNT, counseling and food-drug interactions. 7. Contributed to diet management for a variety of tube fed and other patients needing enteral or parenteral nutrition products. 8. Counseled special needs populations (age specific or medical condition). Clinical Nutrition Focus Dietetic Practice Groups: *Clinical Nutrition Management * Behavioral Health Nutrition * Dietetics in Healthcare Communities * Dietitians in Integrative and Functional Medicine * Dietetic Technicians in Practice * Dietitians in Nutrition Support * Infectious Diseases Nutrition * Medical Nutrition Practice * Nutrition and Dietetic Educators and Preceptors (NDEP) * Nutrition Educators of Health Professionals * Oncology Nutrition * Pediatric Nutrition (both clinical and public health) * Renal Dietitians * Research * Sports, Cardiovascular, and Wellness Nutrition * Vegetarian Nutrition * Weight Management

Knowledge/Competencies/Skills/Roles Knowledge/Competencies: 1. Completed the basic FEMA Independent Study Program training courses for emergency preparedness (IS-100, 200, 700, 800). 2. Utilized basic and advanced dietetics skills within competency level. 3. Described the National Response Framework and the role of Emergency Support Function (ESF) #8 Health and Medical Response www.fema.gov/pdf/emergency/nrf/nrf-esf-08.pdf. 4. Articulated what the Incident Command System (ICS) is and appropriate roles within that context during an emergency event. 5. Articulated what the National Incident Management System (NIMS) is in the context of their setting. 6. Understood their role in mitigation, preparedness, response and recovery of an emergency situation. 7. Knowledgeable of the volunteer programs in the area where their services could be utilized (Emergency System for Advance Registration of Volunteer Health Professionals - ESAR-VHP, Medical Reserve Corps - MRC, Disaster Medical Assistance Team - DMAT, etc.). 8. Knowledgeable of health and nutrition data sources that can be used in identifying most at risk, disparate populations for pre-event planning. Public Health/Community Nutrition Focus Dietetic Practice Groups: * Diabetes Care and Education (DCE) * Healthy Aging * Infectious Diseases Nutrition * Hunger & Environmental Nutrition (HEN) * Nutrition Education for the Public (NEP) * Nutrition Entrepreneurs (NE) * Nutrition and Dietetic Educators and Preceptors (NDEP) * Public Health/Community Nutrition (PHCN) * Pediatric Nutrition (PNPG) * Research * Women s Health (WH) Skills/Roles: 1. Established or participated in a public health/community nutrition setting during a biologic, man-made or natural disaster. 2. Provided nutrition counseling for special needs populations who may be displaced from their normal health care setting. 3. Assured food safety standards are in place (e.g. at shelters serving food). 4. Provided assistance in obtaining access to nutrition programs and services (i.e. WIC, food stamps, HIV services, diabetic care, food banks, etc.) as appropriate. 5. Participated in local and/or statewide preparedness planning. 6. Participated in local and/or statewide preparedness training and exercises. 7. Developed partnerships with government and private emergency food providers including Memorandums of Understanding. 8. Educated community on readiness planning/resources for family and home settings.

9. Participated in public health/community nutrition coalitions. 10. Assessed program/work site for possible early surveillance indicators (e.g., high no-show rates for WIC participants that can be used for monitoring disease outbreaks.

Knowledge/Competencies/Skills/Roles Knowledge/Competencies: 1. Completed the basic FEMA Independent Study Program training courses for emergency preparedness (IS-100, 200, 700, 800). 2. Utilized basic and advanced dietetics skills within competency level. 3. Described the National Response Framework and the role of Emergency Support Function (ESF) #8 Health and Medical Response www.fema.gov/pdf/emergency/nrf/nrf-esf-08.pdf. 4. Articulated what the Incident Command System (ICS) is and appropriate roles within that context during an emergency event. 5. Articulated what the National Incident Management System (NIMS) is in the context of their setting. 6. Understood their role in mitigation, preparedness, response and recovery of an emergency situation. Food Management Focus Dietetic Practice Groups: * Dietitians in Business and Communications (DBC) * Food and Culinary Professionals * Management in Food and Nutrition Systems * Nutrition and Dietetic Educators and Preceptors (NDEP) * Research * School Nutrition Services Skills/Roles: 1. Established or participated in a food service operation during a biological, man-made or natural disaster. 2. Provided food to multiple groups in cooperation with emergency providers. 3. Participated in emergency preparedness exercises. 4. Knowledgeable of the volunteer programs in the area where their services could be utilized (Emergency System for Advance Registration of Volunteer Health Professionals - ESAR-VHP, Medical Reserve Corps - MRC, Disaster Medical Assistance Team - DMAT, etc.). 5. Participated with food security coalitions. 6. Conducted CARVER plus Shock Vulnerability Assessment Tool www.fsis.usda.gov/pdf/carver.pdf to determine vulnerability of certain food systems or processing plants. 7. Established partnerships with food industry including Memorandums of Understanding. 8. Developed menus and recipes based on resource constraints including personnel, space, equipment, energy, food.