Academy of Nutrition and Dietetics: Revised 2017 Scope of Practice for the Nutrition and Dietetics Technician, Registered

Abstract

The Academy of Nutrition and Dietetics (Academy) is the world's largest organization of food and nutrition professionals and the association that represents credentialed nutrition and dietetics practitioners-nutrition and dietetics technicians, registered (NDTRs) and registered dietitian nutritionists (RDNs). An NDTR's scope of practice in nutrition and dietetics has flexible boundaries to capture the depth and breadth of the individual's practice. The NDTR's practice expands with advances in many areas, including nutrition, food production, food safety, food systems management, health care, public health, community health, and information and communication technology. The Revised 2017 Scope of Practice for the NDTR reflects the position of the Academy on the essential role of the NDTR in the management and delivery of food and nutrition services. The scope of practice for the NDTR is composed of education and credentialing, practice resources, Academy Standards of Practice and Standards of Professional Performance, codes of ethics, accreditation standards, state and federal regulations, national guidelines, and organizational policy and procedures. The Revised 2017 Scope of Practice for the NDTR is used in conjunction with the Revised 2017 Standards of Practice in Nutrition Care and the Standards of Professional Performance for NDTRs. The Standards of Practice address activities related to direct patient and client care. The Standards of Professional Performance address behaviors related to the technical role of NDTRs. These standards reflect the minimum competent level of nutrition and dietetics practice and professional performance for NDTRs. A companion document addresses the scope of practice for the RDN.

Dietitian assistant opportunities within the nutrition care process for patients with or at risk of malnutrition: a systematic review

“…Additional research describing scale and spread of delegation activities relevant to diagnosis and monitoring and evaluation is required. Whilst this highlights an opportunity for further exploration and study, a key factor influencing assessment and diagnosis is the requirement that dietitians and/or medical staff document malnutrition diagnosis for coding and case‐based reimbursement purposes 16,25,29 . It is also unclear as to why delegation is or is not occurring.…”

“…Further investigation of opportunities for de‐implementation of low‐value activities and alternative value‐based models of care are vital to ensure nutrition care practices progress in accordance with healthcare reform 10,21‐24 . To support this shift in practice, opportunities may exist for delegating or skill‐sharing components of the nutrition care process (NCP) to the dietitian assistant workforce; how these opportunities are enacted will be dependent on local and country‐specific factors 25‐30 . Used internationally as a guide to providing nutrition care, the NCP has four steps: nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation 28 .…”

“…Incorporating the dietitian assistant workforce into models of care has been shown to contribute positively to service delivery, workforce flexibility, teamwork and improved patient outcomes 10,26 . Several governing structures and frameworks have been developed to ensure safe and effective delegation, although the full or expanded scope of practice for dietitian assistants is individually, locally and country context specific 13,25,29,33‐37 . Dietetic professionals may have access to dietitian assistants (also known as nutrition assistants, dietetic assistant; nutrition and dietetic technicians, dietary aides, allied health assistant staff) to delegate various components of the NCP 25,29,30 .…”

“…Several governing structures and frameworks have been developed to ensure safe and effective delegation, although the full or expanded scope of practice for dietitian assistants is individually, locally and country context specific 13,25,29,33‐37 . Dietetic professionals may have access to dietitian assistants (also known as nutrition assistants, dietetic assistant; nutrition and dietetic technicians, dietary aides, allied health assistant staff) to delegate various components of the NCP 25,29,30 . The proportion of dietitian assistants to dietitians in Australia and internationally is largely unknown; however, findings from a recent dietetics program suggest a maximum ratio of less than one dietitian assistant to five dietitians across Queensland hospitals (unpublished data).…”

Dietitians' perspectives on patient barriers and enablers to weight management: An application of the social‐ecological model

“…10 In Canada, Registered Dietitians (RDs) are regulated health professionals who specialise in conducting nutrition assessments, identifying nutrition problems as well as performing nutrition counselling and monitoring, based on clients' unique needs. 11,12 Their interventions have been shown to have significant benefits compared to standard care from a primary care provider [13][14][15][16] and their involvement in healthcare teams was found to lead to more sustainable behavioural changes. 16 This can be attributed to the individualised approach that is used by dietitians which is based on the relevant food and nutrition-related problem(s) identified, and the targeted goal towards healthy behaviours rather than solely weight loss.…”