Nutrition

Nutrition Support Team

The LPCH nutrition support team -- in operation since 1994 -- runs under the direction of John Kerner, MD. To ensure the successful development of this team, Dr. Kerner and Dr. Robert Poole (Director of the LPCH Pharmacy) spearheaded site visits to four top U.S. nutrition support teams, bringing with them representatives from nursing, nutrition and administration. Today the team includes Drs. Kerner and Poole, Amy Andolina-Fisher, R.N. (Nutrition Support Team Nurse), and key dieticians: Stephanie Little, R. D.; Lisa Schultz, R.D.; Monica Holt, R.D.; Grace Shih, R.D.; and Tanya Wapenski, R.D.

The team makes formal rounds every Tuesday reviewing every patient at LPCH who has started parenteral nutrition since the last meeting, as well as any complex or “problem” patients. The TPN on average logs more than 10,000 patient days per year. Any recommendations to improve current orders are written in a note placed in the patient’s chart. In addition, the dieticians write consultation notes upon initiation of parenteral nutrition and then approximately every 5 days. The team has performed and published many clinical research studies. It has also written a textbook, numerous chapters, reviews and case reports on nutrition support in pediatrics. A compilation of the Nutrition Support Team’s publications was given the highest possible honor by a recent JCAHO visit -- the bound book was designated a "Best Practice” and is on display at JCAHO National Headquarters.

Children’s Home Pharmacy

Established in 1992, the Children's Home Pharmacy runs under the supervision of medical director John Kerner, MD, and pharmacy director Fred Nishioka, Pharm. D. Marisa NG, Pharm. D., supervises the pediatric program. The pharmacy provides both enteral and parenteral nutrition supplies to a diverse LPCH population requiring aggressive home nutrition support. It also supplies intravenous antibiotics, antiviral, antifungal and other medicines. As a result of these services, many patients requiring enteral and parenteral nutrition are able to avoid a prolonged hospital stay and return to the comfort of their homes. Recognized for its expertise, the Home Pharmacy team has published chapters and original research.

Clinical research by Pediatric GI Fellow Matthew Riley, MD, investigates trends in the diagnosis and management of childhood obesity and the causes and treatment of non-alcoholic fatty liver disease in children. Dr. Riley interfaces with the LPCH Pediatric Obesity Program.

The nutrition support team, using a protocol written by Terri Lim, Pharm. D., is evaluating intravenous line life in patients receiving parenteral nutrition with varying osmolality levels.