• | Conducts a nutrition assessment when warranted by a patient’s needs or conditions or warranted by a regulatory requirement including those with dialysis, solid organ transplant, or who are transplant donors. |
• | Selects assessment tools and procedures (matching the assessment method to the situation) and applies assessment tools in valid and reliable ways. |
• | Reviews dietary intake for factors that affect health conditions and nutritional risk. |
• | Utilizes medical history, laboratory data, drug profile, anthropometric measurements, and diet history to evaluate for nutrition-related consequences. |
• | Performs nutrition focused physical exam (NFPE) during assessments on patients to determine risk and/or degree of malnutrition when indicated. |
• | Evaluates psychosocial, functional, and behavioral factors related to food access, selection, preparation; physical activity; and understanding of health condition. |
• | Evaluates patient and family’s knowledge, readiness to learn, and potential for changing behaviors. |
• | Observes patient and family for nonverbal and verbal cues that can guide and prompt effective interviewing methods. |
• | Organizes and categorizes the data in a meaningful framework that is related to nutrition problems. |
• | Determines when a problem requires consultation or referral to another provider or service. |
• | Finds patterns and relationships among the data and possible causes for the nutrition problem. |
• | Prioritizes the relative importance of nutrition problems for optimal patient health, recovery from illness, management of chronic disease, or disease prevention. |
• | Documents the nutrition diagnostic statement in PES (problem, etiology, and signs/symptom) and provides supporting evidence within the progress note. |
• | Formulates and determines a plan of action that is focused on the etiology of the problem and known to be effective based on best current knowledge of evidence from Evidence-Based Nutrition Practice Guidelines. |
• | Provides specialized nutrition care/support to chronically ill, acutely ill, and/or critically ill patient populations and educates patients as appropriate. |
• | Assesses educational needs and provides nutrition counseling based on individual needs, including nutrient requirements, knowledge and abilities, and medical, economic, and social situation. Identifies services that can be completed by the dietetic technician if applicable to area of practice for the RDN |
• | Evaluates achievement of learning objectives by the patient and/or family. Provides appropriate follow-up in accordance with the patient’s treatment goals, referring patients for community or home health services as appropriate. |
• | As needed, delegates or coordinates nutrition plan of care with other healthcare professionals. |
• | Implements the nutrition intervention including communicating the plan of nutrition care to the patient and family, and the patient’s care team. |
• | Attends and participates in multi-disciplinary rounds and meetings as the nutrition expert. |
• | Reviews and communicates drug-nutrient and drug-drug incompatibilities that impact a patient’s nutrition status and/or nutrient utilization. |
• | Provides appropriate follow-up in accordance with the patient’s treatment goals; transitions care, through referral, to other nutrition professionals when appropriate. |
• | Collects data and modifies the plan of care as needed. |
• | Utilizes monitoring and evaluation techniques that consider the patient’s nutrition needs as well as cultural, religious, and ethnic concerns. |
• | Monitors patient’s tolerance to treatment modalities and progress through checking patient understanding and compliance with plan; determines whether the intervention is being implemented as prescribed; provides evidence that the plan/intervention strategy is or is not changing patient behavior or status; identifies other positive or negative outcomes; gathers information indicating reasons for lack of progress; and supports conclusions with evidence. |
• | Measures outcomes through selecting outcome indicators relevant to the nutrition diagnosis, and outcomes and quality management goals and use of standardized indicators. Evaluates the effectiveness and measures progress toward outcomes of nutrition interventions. |
• | Evaluates outcomes by comparing current findings with previous status, intervention goals, and/or reference standards. |
• | Documents relevant, accurate, and timely information performed in steps in the Nutrition Care Process in the patient’s electronic medical record in accordance with department standards. |
• | Determines continuation of care based on whether the patient has met intervention goals or is not at this time able/ready to make needed changes. |
• | Participates in planning and education of home nutrition support when necessary. |
• | Communicates and influences treatment interventions determined by the medical team through interdisciplinary meetings, rounds, medical conferences, and nutrition-related in-services. |
• | Coordinates care with colleagues in a variety of medical and home settings to ensure appropriate transitions of care is addressed to meet patient’s needs. |
• | Serves as an educator and resource to medical staff and allied health personnel on nutrition issues, including nutrition support therapy principles, content, and issues as needed for specific patient populations. |
• | Functions as a clinical preceptor for the dietetic internship program and in a teaching role for other health care professionals, patients and the community, as assigned. |
• | Demonstrates accountability for proper use of patient’s protected health information imposed by regulatory requirements of the health Insurance Portability and Accountability Act (HIPPA) of 1996. |
• | Ensures that care delivered to each patient is in accordance with the state form of dietetics regulations, licensing, certification, or registration. |
• | Assists in achieving compliance with the Joint Commission, or other accrediting agency standards to continuously improve the safety and quality of care to the public and to the organization’s performance improvement. |
• | Complies with federal requirements set forth under the Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (COP) in order to receive Medicare/Medicaid payment. Ensures state and local certifications for health, safety, and quality standards are met. |
• | The RDN uses the Scope of Dietetics Practice Framework (SODPF) to determine scope of practice, established Standards of Practice and Professional Performance (SOP/SOPP) in nutrition care and practice-specfic dietetics, and as available, evidence-based practice protocols/nutrition practice guidelines to help determine nutrition intervention(s). |
• | Develops and teaches nutrition curriculum for community outreach programs and the clinical nutrition service line utilizing evidence-based information and multi-media technology when requested. |
• | Participates in community projects as needed/assigned. |
• | Participates in and completes activities/work projects individually, collaboratively with colleagues, or with other employees and critically evaluates accomplishments as directed. |
• | Maintains productivity standards and practices for effective time management and prioritizing of tasks. |
• | Maintains accurate documentation of time required for patient care activities. |
• | Maintains accurate record-keeping of appointments for scheduling and analysis of revenues from claims and billing reports for medical nutrition therapy services when working in the clinic setting. |
• | Manages resources (time, materials, and staff) in a cost-effective manner. |
• | Understands and complies with third-party payer’s policies and regulations for ambulatory medical nutrition therapy services when assigned to work in the clinic setting. |
• | Works with the Program Manager of the Dietetic Internship to direct workload and plan learning experiences for dietetic interns, while also teaching and evaluating performance. |
• | Participates in the orientation and training of new staff. |
• | Participates in the periodic review of enteral and parenteral nutrition practice and formularies to include best practice, new products, equipment review, and selection and applicable policies and procedures. |
• | Promotes cost effective solutions. |
• | Uses trends in patient satisfaction, effectiveness of therapy and education to implement change to improve personal and organizational performance. |
• | Participates in and/or initiates continuous quality improvement activities for nutrition service line. |
• | Participates in planning and developing nutrition-related policies, procedures, and goals. |
• | Conducts in-services and education presentations to the organization’s staff. |
• | Assists in developing and revising patient education materials, clinical practice guidelines and protocols. |
• | Supports and promotes the organization’s infection control, safety, risk management, and customer/guest relations programs. |
• | Acts as a resource for medical staff on the nutritional management of patients. |
• | Interprets and presents current clinical knowledge, standard of care, and research to improve patient care and the nutrition service line. |
• | Develops and maintains nutrition practice knowledge, motivational interviewing skills, RDN registration and continuing education requirements. |
• | Participates in nutrition research studies and communicates findings through reports, abstracts, presentations, and publication. |
• | Develops and implements an individualized portfolio plan for professional growth and development including participation in professional organizations and activities, workshops, seminars, and staff development programs. |
• | Participates in departmental and interdisciplinary meetings, committees, tasks forces, and projects. |
• | Consults with medical/clinical staff concerning staff learning opportunities and works with them to maximize clinical staff comfort level and competencies in the care of patients with nutrition related diseases. |