Courses

From Silos to Synergy: Enhancing Care Transitions to Improve Patient Outcomes in Home Enteral Nutrition (Part 2)

What are the best practices for transitioning enteral nutrition care from hospital to home?

Presenter(s): Manpreet S Mundi, MD, FASPEN; Cynthia Reddick, RDN, CNSC; Donna Wixted, MS, RD

Program Date: 13 May 2025

Publication Date: 05 December 2025

Continuing Education Credits: Nurse Contact 1.0 CE; Dietitian 1.0 CPEU

Course Description:

This course reviews the transitional care of a patient recovering from a cerebrovascular accident. Using a case-based approach, participants will explore the inpatient dietitian’s role in discharge planning and learn practical strategies for collaborating with the interdisciplinary team. The presenters highlight real-world challenges and solutions to ensure the continuity of enteral nutrition from hospital to home. Originally presented as a live webinar on 13 May 2025.

Course Objectives:
  • Identify the responsibilities and impact of inpatient dietitians in post-discharge nutrition planning for patients on enteral nutrition.
  • Discuss effective interdisciplinary communication techniques that can enhance collaboration between the inpatient care team, discharge planning, and home health care professionals.
  • Use a case-study approach to determine strategies and tools to support a seamless transition of enteral nutrition care from hospital to home.
Key Takeaways:
  • Ensuring adequate protein and caloric intake for patients following a cerebrovascular accident—both during hospitalization and after discharge—is essential for preserving lean body mass and reducing mortality risk.
  • A seamless transition from hospital to home requires homecare-friendly prescriptions and coordination to guarantee formula availability, insurance coverage, and ongoing monitoring for nutritional adequacy.

Performance Indicators: 3.3.4, 5.1.5, 11.5.5

Activity Code: 190638

Related Questions:
  • How does nutrition impact recovery after a cerebrovascular accident?
    Nutrition plays a pivotal role in recovery following a cerebrovascular accident by addressing increased metabolic demands and supporting tissue repair. During the acute phase, patients typically require approximately 10% more energy than predicted by standard equations, and inadequate intake can lead to rapid muscle loss and impaired functional recovery. Sufficient protein and caloric provision help preserve lean body mass, modulate inflammation, and promote neuroplasticity and angiogenesis—key processes for regaining function. 
  • How can healthcare professionals advocate for early enteral nutrition in hospitalized patients?
    Healthcare professionals can advocate for early enteral nutrition by highlighting its role in meeting increased metabolic demands, preserving muscle mass, and reducing complications during the acute phase of stroke. Building strong relationships with surgeons, physicians, and nursing staff is essential, along with being prepared to present evidence-based data showing how early nutrition positively impacts recovery. Collaborative, individualized nutrition plans ensure patients receive adequate protein and calories from the start of hospitalization.

Course Instructor Bio(s)

Manpreet S Mundi, MD, FASPEN

Medical Director, Home Enteral Nutrition Program
Chair/Medical Director, Nutrition Support Services 
Professor of Medicine, Mayo Clinic
Rochester, MN, USA

Dr Mundi graduated from the University of California, San Diego with majors in Psychology and Chemistry. He obtained his MD from the University of Southern California. Dr Mundi completed a residency program in Internal Medicine followed by a fellowship in Endocrinology at the Los Angeles County-University of Southern California Medical Center. He then joined the Mayo Clinic Division of Endocrinology as an NIH training grant fellow with a research focus on fatty acid metabolism and obesity. Dr Mundi subsequently joined the clinical staff at Mayo Clinic as a consultant in the Division of Endocrinology, Nutrition Core Group. His clinical focus is obesity, bariatric surgery, malnutrition, and nutrition support in home and inpatient settings, with a special interest in supporting patients on parenteral and enteral nutrition.

Dr Mundi is currently a Professor of Medicine and holds leadership positions as Inpatient Nutrition Core Group Chair, Medical Director of Clinic Dietetics, member of the ASPEN Board of Directors, and Medical and Science Advisor for the Oley Foundation. He is also the medical director of the Home Enteral Nutrition program and the associate program director of the Home Parenteral and Enteral Nutrition program. Within the HPEN program, Dr Mundi takes a very active role in research to continue to improve the quality of nutrition support.

Cynthia Reddick, RD, CNSC

Home Tube Feeding Expert, Educator, and Strategist
HEN Consultant
Sacramento, CA, USA 

Cynthia is a home tube feeding expert, educator, and strategist, having worked in home care for 23 years and passionately facilitating patients’ successful transitions from hospital to home on tube feeding. She works to promote positive clinical outcomes and believes a patient’s positive relationship with their feeding tube impacts compliance and quality of life. She developed her passion for nutrition support during her internship at City of Hope National Medical Center in Southern California. Most recently, she worked for Coram/CVS Specialty Infusion Services as their National Tube Feeding Manager. Today, she works as a consultant in home tube feeding and enteral innovation. She enjoys presenting round tables, clinical posters, webinars, and case studies in the area of home care tube feeding. She has been a guest speaker for the Oley Foundation, CMSA, NHIA, ASPEN, and the Academy of Nutrition and Dietetics on a variety of topics related to home tube feeding.

Donna Wixted, MS, RD

Clinical Nutrition Manager, ICU Dietitian
Virtua Health
Marlton, NJ, USA

Donna Wixted is the Clinical Nutrition Manager at Virtua Health System’s Marlton division, with almost 19 years of experience. Her role also includes covering an 18-bed Intensive Care Unit and serving as an active member of the Nutrition Support Committee, the Falls team, and the Pressure Injury Council. She collaborates with healthcare staff in the revision, development, and implementation of department- and hospital-wide nutritional policies and procedures, and works closely with Virtua’s IT department, assisting with the success of recent projects, including the implementation of the Nutritional MAR and IDDSI diet profiles in Epic. Donna is a registered dietitian with a Bachelor of Science in Nutrition from Montclair State University, a Master of Science joint degree in Health Administration & Health Education from St. Joseph’s University.

Carley Rusch, PhD, RDN, LDN

Adult Medical Science Liaison
Medical Affairs & Research
Abbott Nutrition 
Gainesville, FL, USA

Carley Rusch serves as a Medical Science Liaison in Medical Affairs & Research at Abbott, specializing in Adult Therapeutic Nutrition. Prior to joining Abbott, Dr Rusch completed her bachelor’s degree in Food Science and Human Nutrition at the University of Florida (UF), specializing in Dietetics. She earned her master’s degree and completed her dietetic internship through the MS-DI program at UF. During her dietetic training, she also served as a research coordinator on a variety of study protocols, including topics on gastrointestinal dysfunction, inflammation, pre- and probiotics, and the gut microbiome. She then went on to work as an inpatient dietitian at AdventHealth Orlando and served as a preceptor for their dietetic internship program. Her clinical experience spans a variety of disease states, such as cancer, gastrointestinal and neurological disorders, malnutrition, and critical care.

Following her time working in clinical practice, Dr Rusch completed her PhD in Nutritional Sciences at UF. Her doctoral research investigated the effect of the Mediterranean diet on improving constipation and intestinal inflammation in Parkinson’s disease. During her graduate programs, she has taught multiple undergraduate and graduate courses on nutrition, metabolism, and research methods. In 2020, she was awarded Recognized Young Dietitian of the Year by the Florida Academy of Nutrition and Dietetics. Dr Rusch has several publications in peer-reviewed journals and has been invited to present at national and international conferences.

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Highlighted References:
  • Kleindorfer DO, et al. Stroke. 2021;52(7):e364-e467.
  • Irisa K, Shichita T. Inflamm Regen. 2025;45(1):7.
  • Finestone H, et al. Stroke. 2003;34(2):502-507. 
  • Kawakami M, et al. Cerebrovasc Dis. 2015;39(3-4):170-175. 
  • Coveney S, et al. Int J Stroke. 2022;17(2):163-171.
  • Ago T, et al. Neurology. 2018;90(17):e1470-e1477. 
  • Gungor L, et al. Clin Nutr. 2023;42(3):431-439. 
  • Zhao J, et al. Lancet Neurol. 2022;21(4):319-328. 
  • Schuetz P, et al. Lancet. 2019;393(10188):2312-2321. 
  • Merker M, et al. JAMA Netw Open. 2020;3(3):e200663.
  • Wischmeyer PE, et al. Nutr Clin Pract. 2021;36(2):275-281..

Abbott Nutrition’s Provider Statement for Nursing CEs:

Abbott Nutrition Health Institute is an approved provider of continuing nursing education by the California Board of Registered Nursing Provider #CEP 11213.

Abbott Nutrition’s Statement for Dietitian CPEUs:

This educational activity has been prior-approved by the Commission on Dietetic Registration (CDR). CDR credentialed practitioners will receive the specified continuing professional education units (CPEUs) for completion of this program/material.