a person is unhealthy if there are no other risk factors, such as high blood pressure, high cho- lesterol, smoking, diabetes, and personal or family medical history. The following is the calculation for determining BMI tables also are available for determining BMI based on weight and height, such as www.nhlbi.nih.gov/guidelines/obesity/bmi_tbl.htm. BMI = = weight (kg)/height (m)2 or BMI = = (weight [lb]/height [in]2) × × 703 The OHN often networks with resources in the community to provide nutritional information for employees. The nurse can collaborate with the health department, the agriculture extension service, community college, or local hospital dietitians to provide educational programs for employees. Employees should be referred to nutritionists or dietitians for information and coun- seling as appropriate. For suspected medical conditions causing inadequate nutrition intake or absorption, refer the employee to a personal health care provider. The OHN also should collaborate with the cafeteria service and the vending machine contrac- tor to ensure that healthy food selections are available to all employees. Subsidizing healthier selections should be considered so that bottled water would cost less than regular sodas or fruit less than chips, for example. The OHN should consult with management regarding foods served at company-sponsored events, encouraging more nutritional options. Eating disorders have received much attention because of their debilitating and potentially fatal consequences. The OHN should be alert for employees with possible eating disorders, such as anorexia nervosa or bulimia nervosa. A collaborative effort between the employee’s health care provider, EAP counselor, dietitian, the OHN, employee, and family is needed in treating an employee suspected of one of these conditions. Nursing Roles Nutritional information should be a vital component during both individual employee counsel- ing and group education programs. It is important to know current recommendations and to dispel myths regarding weight loss and nutritional information. The OHN can apply the nursing process (assessment, planning, implementation, and evaluation) when developing effective nutritional programs. Assessment Obtain a nutritional history, using computerized or standard measuring tools. Discuss results with employees or refer for counseling. Determine employee nutritional needs and interests, as well as company support of nutri- tional programs. Secure management commitment, readiness, and involvement in the program. Assess healthy options available in vending machines and cafeteria. Identify current menu options at company-sponsored events. Determine available resources within the company and community. Planning Establish an employee committee to review data, develop objectives, and design the programs. Develop measurable goals and objectives based on the assessment. Contract with employee regarding goals or behavioral changes. Design the program based on objectives, needs, and available resources. Plan incentives to encourage commitment and maintenance. Implementation Promote healthy eating habits based on current guidelines outlined on page 276. Increase awareness through bulletin boards, newsletters, educational programs, pamphlets, fliers, health fairs, or other promotions. 274 Interdisciplinary Interactions and Collaboration
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