+ All Categories
Home > Documents > Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and...

Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and...

Date post: 30-Dec-2016
Category:
Upload: lamnhan
View: 213 times
Download: 0 times
Share this document with a friend
17
Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians The Academy Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee R EGISTERED DIETITIANS (RDs) are credentialed practitioners specifically trained and quali- fied to provide nutrition and dietetics services and are accountable and responsible for their practice and service. The Academy of Nutrition and Dietetics (Academy) leads the profes- sion of nutrition and dietetics by developing standards against which the quality of practice and performance of RDs can be evaluated. The Academy’s Scope of Practice in Nutrition and Dietet- ics, 1 the 2012 Standards of Practice (SOP) in Nutrition Care and Standards of Pro- fessional Performance (SOPP) for Regis- tered Dietitians, along with the Code of Ethics 2 and the 2012 Scope of Practice for the Registered Dietitian, 3 guide the prac- tice and performance of RDs in all set- tings. The standards and indicators found within the SOP and SOPP reflect the min- imum competent level of nutrition and dietetics practice and professional per- formance for RDs. The SOP in Nutrition Care is composed of four standards rep- resenting the four steps of the Nutrition Care Process as applied to the care of pa- tients/clients. 4 The SOPP for RDs consists of standards representing six domains of professionalism. This article represents the 2012 update of the Academy’s SOP in Nutrition Care and SOPP for Registered Dietitians (Figures 1 and 2). How Does the Academy’s Scope of Practice in Nutrition and Dietetics, Code of Ethics, and the Scope of Practice for the Registered Dietitian Guide the Practice and Performance of RDs in All Settings? The Scope of Practice in Nutrition and Di- etetics is composed of statutory and indi- vidual components; includes the Code of Ethics; and encompasses the range of roles, activities, and regulations within which nutrition and dietetics practitioners per- form. For credentialed practitioners, scope of practice is typically established within the practice act and interpreted and con- trolled by the agency or board that regu- lates the practice of the profession in a given state. 1 An RD’s statutory scope of practice can delineate the services that an RD is authorized to perform in a state where a practice acts or certification exists. The RD’s individual scope of prac- tice is determined by education, training, credentialing, and demon- strated and documented competence to practice. Individual scope of prac- tice in nutrition and dietetics has flexible boundaries to capture the breadth of the individual’s profes- sional practice. The Scope of Practice Decision Tool, which is an online in- teractive tool, permits an RD to an- swer a series of questions to deter- mine whether a particular activity is within his or her scope of practice. The tool is designed to allow for an RD to critically evaluate his or her knowl- edge, skill, and demonstrated compe- tence with criteria resources. Why Were the Standards Revised? There is a scheduled 5-year review pro- cess for Academy documents. Regular re- views are indicated to consider changes in health care and other business seg- ments, public health initiatives, new re- search that guides evidence-based prac- tice and best practices, consumer interests, technological advances, and emerging practice environments. Ques- tions from credentialed practitioners, federal and state regulations, accredita- tion standards, and other factors necessi- tated review and revision of the 2008 Core SOP in Nutrition Care and SOPP for the RD and Dietetic Technician, Regis- tered (DTR) to assure safety, quality, and competence in practice. 5 How Were the Standards Revised? The members of the Quality Manage- ment Committee and its Scope of Prac- tice Subcommittee utilized collective experience and consensus in reviewing statements to support safe, quality practice and desirable outcomes. The review focused on definition of terms, illustrative figures and tables, lists of services and activities in current prac- tice, and enhancements to support fu- ture practice and advancement. The standards, rationales, and indicators Approved November 2012 by the Quality Management Committee of the Academy of Nutrition and Dietetics (Academy) and the Academy House of Delegates. Sched- uled review date: November 2017. Questions regarding the Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Perfor- mance for Registered Dietitians may be addressed to the Academy Quality Man- agement Staff: Karen Hui, RD, LDN, man- ager, Practice Standards; and Sharon M. McCauley, MS, MBA, RD, LDN, FADA, di- rector, Quality Management at quality@ eatright.org. Statement of Potential Conflict of Interest: The authors have no potential conflict of interest to disclose. 2212-2672/$36.00 doi: 10.1016/j.jand.2012.12.007 Available online 28 February 2013 FROM THE ACADEMY Standards of Practice & Professional Performance © 2013 by the Academy of Nutrition and Dietetics. JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS S29
Transcript
Page 1: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMYStandards of Practice & Professional Performance

Academy of Nutrition and Dietetics: Revised 2012Standards of Practice in Nutrition Care andStandards of Professional Performance forRegistered Dietitians

The Academy Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee

REGISTERED DIETITIANS (RDs)are credentialed practitionersspecifically trained and quali-fied to provide nutrition and

dietetics services and are accountableand responsible for their practice andservice. The Academy of Nutrition andDietetics (Academy) leads the profes-sion of nutrition and dietetics bydeveloping standards against whichthe quality of practice and performanceof RDs can be evaluated. The Academy’sScope of Practice inNutrition andDietet-ics,1 the 2012 Standards of Practice (SOP)in Nutrition Care and Standards of Pro-fessional Performance (SOPP) for Regis-tered Dietitians, along with the Code ofEthics2 and the2012Scopeof Practice forthe Registered Dietitian,3 guide the prac-tice and performance of RDs in all set-tings.The standards and indicators found

within the SOP and SOPP reflect themin-imum competent level of nutrition anddietetics practice and professional per-formance for RDs. The SOP in NutritionCare is composed of four standards rep-resenting the four steps of the NutritionCare Process as applied to the care of pa-tients/clients.4 The SOPP for RDs consistsof standards representing six domains ofprofessionalism. This article representsthe 2012 update of the Academy’s SOP inNutrition Care and SOPP for RegisteredDietitians (Figures 1 and 2).

Statement of Potential Conflict of Interest:The authors have no potential conflict ofinterest to disclose.

2212-2672/$36.00doi: 10.1016/j.jand.2012.12.007

Available online 28 February 2013

© 2013 by the Academy of Nutrition and Dietetics.

How Does the Academy’s Scope ofPractice in Nutrition and Dietetics,Code of Ethics, and the Scopeof Practice for the RegisteredDietitian Guide the Practice andPerformance of RDs in All Settings?The Scope of Practice in Nutrition and Di-etetics is composed of statutory and indi-vidual components; includes the Code ofEthics;andencompassestherangeofroles,activities, and regulations within whichnutrition and dietetics practitioners per-form. For credentialed practitioners, scopeof practice is typically established withinthe practice act and interpreted and con-trolled by the agency or board that regu-lates the practice of the profession in agiven state.1 An RD’s statutory scope ofpractice can delineate the services that anRD is authorized to perform in a statewhereapracticeactsorcertificationexists.The RD’s individual scope of prac-

tice is determined by education,training, credentialing, and demon-strated and documented competenceto practice. Individual scope of prac-tice in nutrition and dietetics hasflexible boundaries to capture thebreadth of the individual’s profes-sional practice. The Scope of PracticeDecision Tool, which is an online in-teractive tool, permits an RD to an-swer a series of questions to deter-mine whether a particular activity iswithin his or her scope of practice.The tool is designed to allow for an RDto critically evaluate his or her knowl-edge, skill, and demonstrated compe-tence with criteria resources.

Why Were the Standards Revised?There is a scheduled 5-year review pro-

cess forAcademydocuments. Regular re-

JOURNAL OF THE ACAD

views are indicated to consider changesin health care and other business seg-ments, public health initiatives, new re-search that guides evidence-based prac-tice and best practices, consumerinterests, technological advances, andemerging practice environments. Ques-tions from credentialed practitioners,federal and state regulations, accredita-tion standards, andother factors necessi-tated review and revision of the 2008Core SOP in Nutrition Care and SOPP forthe RD and Dietetic Technician, Regis-tered (DTR) to assure safety, quality, andcompetence in practice.5

How Were the Standards Revised?The members of the Quality Manage-ment Committee and its Scope of Prac-tice Subcommittee utilized collectiveexperience and consensus in reviewingstatements to support safe, qualitypractice and desirable outcomes. Thereview focused on definition of terms,illustrative figures and tables, lists ofservices and activities in current prac-tice, and enhancements to support fu-ture practice and advancement. The

Approved November 2012 by the QualityManagement Committee of the Academyof Nutrition and Dietetics (Academy) andthe Academy House of Delegates. Sched-uled review date: November 2017.

Questions regarding the Revised 2012Standards of Practice in Nutrition Careand Standards of Professional Perfor-mance for Registered Dietitians may beaddressed to the Academy Quality Man-agement Staff: Karen Hui, RD, LDN, man-ager, Practice Standards; and Sharon M.McCauley, MS, MBA, RD, LDN, FADA, di-rector, Quality Management at [email protected].

standards, rationales, and indicators

EMY OF NUTRITION AND DIETETICS S29

Page 2: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 1. Standards of Practice for Registered Dietitians in Nutrition Care.

S30 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS June 2013 Suppl 2 Volume 113 Number 6

Page 3: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 1. (continued) Standards of Practice for Registered Dietitians in Nutrition Care.

June 2013 Suppl 2 Volume 113 Number 6 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS S31

Page 4: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 1. (continued) Standards of Practice for Registered Dietitians in Nutrition Care.

S32 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS June 2013 Suppl 2 Volume 113 Number 6

Page 5: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 1. (continued) Standards of Practice for Registered Dietitians in Nutrition Care.

June 2013 Suppl 2 Volume 113 Number 6 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS S33

Page 6: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 1. (continued) Standards of Practice for Registered Dietitians in Nutrition Care.

S34 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS June 2013 Suppl 2 Volume 113 Number 6

Page 7: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 1. (continued) Standards of Practice for Registered Dietitians in Nutrition Care.

June 2013 Suppl 2 Volume 113 Number 6 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS S35

Page 8: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 2. Standards of Professional Performance for Registered Dietitians. Note: The term customer is used in this evaluationresource as a universal term. Customer could also mean client/patient, client/patient/customer, participant, consumer, or any

individual, group, or organization to which the RD provides service.

S36 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS June 2013 Suppl 2 Volume 113 Number 6

Page 9: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 2. (continued) Standards of Professional Performance for Registered Dietitians. Note: The term customer is used in thisevaluation resource as a universal term. Customer could also mean client/patient, client/patient/customer, participant, consumer,

or any individual, group, or organization to which the RD provides service.

June 2013 Suppl 2 Volume 113 Number 6 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS S37

Page 10: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 2. (continued) Standards of Professional Performance for Registered Dietitians. Note: The term customer is used in thisevaluation resource as a universal term. Customer could also mean client/patient, client/patient/customer, participant, consumer,

or any individual, group, or organization to which the RD provides service.

S38 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS June 2013 Suppl 2 Volume 113 Number 6

Page 11: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 2. (continued) Standards of Professional Performance for Registered Dietitians. Note: The term customer is used in thisevaluation resource as a universal term. Customer could also mean client/patient, client/patient/customer, participant, consumer,

or any individual, group, or organization to which the RD provides service.

June 2013 Suppl 2 Volume 113 Number 6 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS S39

Page 12: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 2. (continued) Standards of Professional Performance for Registered Dietitians. Note: The term customer is used in thisevaluation resource as a universal term. Customer could also mean client/patient, client/patient/customer, participant, consumer,

or any individual, group, or organization to which the RD provides service.

S40 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS June 2013 Suppl 2 Volume 113 Number 6

Page 13: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 2. (continued) Standards of Professional Performance for Registered Dietitians. Note: The term customer is used in thisevaluation resource as a universal term. Customer could also mean client/patient, client/patient/customer, participant, consumer,

or any individual, group, or organization to which the RD provides service.

June 2013 Suppl 2 Volume 113 Number 6 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS S41

Page 14: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

for the 2012 standards were updatedusing information from questions re-ceived by the Academy’s QualityMan-agement Department, discussionswith Dietetic Practice Groups, Mem-ber Interest Groups, and membercomments through focus area SOPand SOPP development.This document was presented to and

reviewed by the Academy’s House ofDelegates Leadership Team and theHouse of Delegates (includes represen-tation from state affiliates and DieteticPractice Groups). This provided an op-portunity to refine the document andgain consensus from members repre-senting diverse practice and geo-graphic perspectives. Comments re-ceived were considered by the QualityManagement Committee and its Scopeof Practice Subcommittee. The reviseddraft document was reviewed and ap-proved by the House of Delegates inNovember 2012.

What Are the Standards ofPractice in Nutrition Care?The SOP in Nutrition Care:

• incorporate the Nutrition CareProcess as a method to managenutrition care activities;

• apply to RDs who have directcontact with individual patients/clients in acute and extendedhealth care settings, publichealth, home-based services, andambulatory care settings;

• are formatted according to thefour steps of the Nutrition CareProcess (ie, nutrition assessment,nutrition diagnosis, nutrition in-tervention, and nutrition moni-toring and evaluation); and

• reflect the training, responsibil-ity, and accountability of the RD.

What Are the Standards ofProfessional Performance?The SOPP:

• apply to RDs in all practice set-tings;

• are formatted according to sixdomains of professional behavior(ie, quality in practice, compe-tence and accountability, provi-sion of services, application ofresearch, communication andapplication of knowledge, andutilization and management of

resources); and

S42 JOURNAL OF THE ACADEMY OF NUTRITI

• reflect the training, responsibil-ity, and accountability of the RD.

The SOP and SOPP comprehensivelydepict the minimum expectation forcompetent care of the patient/client orother customer and professional be-havior for the RD. The term customer isused in this evaluation resource as auniversal term. Customer could alsomean client/patient, client/patient/customer, participant, consumer, orany individual, group, or organizationto which the RD provides service.

How Do the SOP in NutritionCare, the SOPP, and Focus AreaStandards Relate to Each Other?The Academy’s SOP and SOPP serve asblueprints for the development of fo-cus area SOP and SOPP for the RD. Im-plementation of the Dietetics CareerDevelopmentGuide in January 2011 re-vised the terminology from practice-specific to focus area of practice and des-ignated levels of practice for focus areaSOP and SOPP as competent, proficient,and expert.6 The 2012 standards willcontinue to serve as the blueprint forfuture focus area standards. As of 2012,there are 14 published focus area SOPSOPPs for RDs that can be accessed ontheAcademy’swebsiteatwww.eatright.org/sop:

• Behavioral Health Care;• Clinical Nutrition Management;• Diabetes Care;• Disordered Eating and Eating

Disorders;• Education of Dietetics Practitio-

ners;• Extended Care Settings;• Integrative and Functional Medi-

cine;• Intellectual and Developmental

Disabilities;• Management of Food and Nutri-

tion Systems;• Nephrology Care;• Nutrition Support;• Oncology Nutrition Care;• Pediatric Nutrition; and• Sports Dietetics.

What Is the Relationship of theRD and DTR?In direct patient/client care, the RD andDTR work as a team utilizing the Nutri-tion Care Process4 and StandardizedLanguage,7 a structured method for

guiding nutrition care activities, pro-

ON AND DIETETICS

viding consistency in documentation,and monitoring and evaluating prog-ress.8 The RDdevelops and oversees thesystem for delivery of nutrition care ac-tivities, often with the input of others,including the DTR. Components of thenutrition care delivery system can in-clude the following: policies and proce-dures, standards of care, forms, docu-mentation standards, and roles andresponsibilities of support and techni-cal personnel participating in theNutri-tion Care Process. The RD is responsibleto complete the nutrition assessment,determine the nutrition diagnosis(es),implement the nutrition intervention,and evaluate the patient’s/client’s re-sponse.7 The RD supervises the activi-ties of support and technical personnelassisting with the patient’s/client’scare.The DTR is an integral contributor to

the nutrition care of patients/clients.The DTR is often the first staff from thenutrition team that a patient or clientmeets; serves as a conduit of nutritioncare information to RDs, nurses, andothers at meetings and care conferen-ces; and contributes to the continuumof care by facilitating communicationbetween staff providing nutrition careand staff providing nursing care.The RD assigns duties to the DTR that

are consistentwith theDTR’s individualscope of practice. For example, the DTRmight initiate standard procedures,such as completing and following up onnutrition screening for assigned units/patients; performing routine activitiesbased ondiet order, policies, and proce-dures; completing the intake processfor a new clinic client; and reporting tothe RD when a patient’s/client’s datasuggest the need for a nutrition assess-ment. The DTR actively participatesin nutrition care by contributing infor-mation and observations, guidingpatients/clients in menu selections,providing nutrition education on pre-scribed diets, and reporting to the RDon the patient’s/client’s response, in-cluding documenting outcomes or pro-viding evidence signifying the need toadjust the nutrition care plan.The RD is responsible for supervising

any patient/client care activities as-signed to other administrative andtechnical staff, including the DTR, andcan be held accountable to the patient/clients and others for services ren-

dered. This description of “supervision”

June 2013 Suppl 2 Volume 113 Number 6

Page 15: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

Figure 3. Flow chart on how to use the Standards of Practice and Standards of Professional Performance.1,5 aRD�registered

dietitian. bDTR�dietetic technician, registered. cCDR�Commission on Dietetic Registration.

June 2013 Suppl 2 Volume 113 Number 6 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS S43

Page 16: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

as it relates to the RD/DTR teams is notsynonymous with managerial supervi-sion or oversight, clinical supervision(eg, peer-to-peer), supervision of provi-sional licensees, and/or supervision ofdietetic interns and students. Clinicalsupervision is used inmedicine and themental health fields for the purposes ofcase review and professional develop-ment.9 The following resources provideadditional information about the rolesand practice of DTRs: Scope of Practicefor the Dietetic Technician, Regis-tered,10 the Standards of Practice inNutrition Care and Standards of Profes-sional Performance for Dietetic Techni-cians, Registered,11 Practice Tips: TheRD/DTR Team,12 and Practice Tips:What Is Meant by “Under the Supervi-sion of the RD?”9

In What Other Settings Do DTRsProvide Services?AlthoughmanyDTRswork inclinical set-tings, career opportunities for DTRs arebroader thanclinical settings. The role foraDTRinproviding foodandnutritionser-vices in nonclinical settingswhere an RDmightnot bedirectly involved in thepro-gram/activity is guidedby theDTR’s indi-vidual scope of practice and require-ments contained in regulations,employer or organizational policies andprocedures, and state statutes and statepracticeacts. Thesesettings includecom-munity nutrition programs, fitness cen-ters, school nutrition, child nutritionpro-grams, and foodservice systemsmanagement outside of health care set-tings. The SOPP11 and the Scope of Prac-tice for the Dietetic Technician, Regis-tered10 clearly delineate expanded rolesand opportunities for DTRs.

Why Are the Standards Importantfor RDs?The standards promote:

• safe, effective, and efficient food,nutrition, dietetic, and relatedservices;

• evidence-basedpractice andbestpractices;

• improved health-related out-comes and cost-reduction meth-ods;

• quality assurance and perfor-mance improvement;

• ethical business and billing prac-tices13,14;

• practitioner competence and qua-

lification verification because state

S44 JOURNAL OF THE ACADEMY OF NUTRITI

departments of health and fed-eral regulatory agencies, such asthe Centers for Medicare andMedicaid Services, look to pro-fessional organizations to createand maintain standards of prac-tice15,16;

• consistency in practice and per-formance;

• dietetics research, innovation,and practice development; and

• individual advancement.

The standards provide:• minimum competent levels of

practice and performance;• common indicators for self-eval-

uation;• activities for which RDs are ac-

countable;• a description of the role of nutri-

tion and dietetics and the uniqueservices that RDs offer within thehealth care team and in practicesettings outside of health care;and

• guidance for policies and proce-dures, job descriptions, compe-tence assessment tools, and aca-demic objectives for educationprograms.

How Are the StandardsStructured?A standard is a brief description of thecompetent level of nutrition anddietet-ics practice. A rationale is a descriptionof the intent, purpose, and importanceof the standard. An indicator is an ac-tion statement illustrating how eachstandard can be applied in practice. Ex-amples of outcomes are also includedthat depict measurable results that re-late indicators to practice.Each standard is equal in relevance

and importance. The content for stan-dard, rationale, and indicator descrip-tions in the SOP in Nutrition Care isadapted from the Academy’s Interna-tional Dietetics & Nutrition Terminology(IDNT) Reference Manual: StandardizedLanguage for the Nutrition Care Process.7

How Can I Use the Standards toEvaluate and Advance MyPractice and Performance?The standards can be used as part of theCommission on Dietetic RegistrationProfessional Development PortfolioProcess17 to develop goals and focus

continuing-education efforts. The Pro-

ON AND DIETETICS

fessional Development Portfolio en-courages RDs to engage in reflection,self-assessment, and goal setting,which are the critical components ofCommission on Dietetic Registrationrecertification (Figure 3 presents a flowchart for applying the 2012 SOP in Nu-trition Care and the SOPP into an RD’spractice. Self-assessment using the SOPand SOPP can identify learning needsand opportunities for advancement forindividual practitioners).RDs might not apply every indicator

and achieve every outcome at once; RDsare not limited to the indicators and ex-amples of outcomes provided; and all in-dicators might not be applicable to allRDs. The standards are written in broadterms to allow for individual practitio-ner’s handling of nonroutine situations.The standards are geared toward typicalsituations and toward practitioners withthe RD credential. Strictly adhering tostandards does not in and of itself consti-tute best care and service. It is the re-sponsibility of individual practitioners torecognize and interpret situations and toknowwhat standards apply and in whatways they apply.18

SUMMARYRDs face complex situations every day.Competently addressing the uniqueneeds of each situation and applyingstandards appropriately is essential toproviding safe, timely, person-centeredquality care and service. All RDs are ad-vised to conduct their practice based onthe most recent edition of the Acade-my’s Code of Ethics2 and the Scope ofPractice in Nutrition and Dietetics,1 theScope of Practice for the Registered Di-etitian,3 the 2012 Standards of Practicein Nutrition Care and Standards of Pro-fessional Performance for RDs, and theapplicable focus area SOP and SOPP forRDs. These resources provideminimumstandards and tools for demonstratingcompetence and safe practice, and areused collectively to gauge and guide anRD’s performance in nutrition and di-etetics practice. The SOP and SOPP forthe RD are self-evaluation tools thatpromote quality assurance and perfor-mance improvement. Self-assessmentprovides opportunities to identify areasfor enhancement, new learning, andskill development, and to encourageprogression of career growth.All RDs are advised to have in their

personal libraries the most recent copy

June 2013 Suppl 2 Volume 113 Number 6

Page 17: Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians

FROM THE ACADEMY

of the Academy’s Scope of Practice inNutrition and Dietetics1 and its compo-nents: The 2012 Academy Standards ofPractice in Nutrition Care and Stan-dards of Professional Performance forRegistered Dietitians; applicable focusarea SOP and SOPP; the Code of Ethics2;and the Scope of Practice for the Regis-tered Dietitian.3

To ensure that credentialed dieteticspractitioners always have access to themost current materials, each resourceis maintained on the Academy’s web-site. The documents will continue to bereviewed and updated as new trends inthe profession of nutrition and dieteticsand external influences emerge.

References1. Academy of Nutrition and Dietetics Qual-

ity Management Committee and Scope ofPractice Subcommittee of the Quality

These standards have been formulated tobe used for individual self-evaluation andthe development of practice guidelines,but not for institutional credentialing orfor adverse or exclusionary decisions re-garding privileging, employment oppor-tunities or benefits, disciplinary actions,or determinations of negligence or mis-conduct. These standards do not consti-tute medical or other professional advice,and should not be taken as such. Theinformation presented in these standardsis not a substitute for the exercise of pro-fessional judgment by the health careprofessional. The use of the standards forany other purpose than that for whichthey were formulated must be under-taken with the sole authority and discre-tion of the user.

Management Committee. Academy of Nu-trition and Dietetics: Scope of Practice in

June 2013 Suppl 2 Volume 113 Number 6

Nutrition and Dietetics. J Acad Nutr Diet.2013;113(6 suppl 2):S11-S16.

2. American Dietetic Association/Commis-sion on Dietetic Registration. Code ofethics for the profession of dietetics andprocess for consideration of ethical is-sues. J Am Diet Assoc. 2009;109(8):1461-1467.

3. Academy of Nutrition and Dietetics Qual-ity Management Committee and Scope ofPractice Subcommittee of the QualityManagement Committee. Academy of Nu-trition and Dietetics: Scope of Practice forthe Registered Dietitian. J Acad Nutr Diet.2013;113(6 suppl 2):S17-S28.

4. Writing Group of the Nutrition Care Pro-cess/Standardized Language Committee.Nutrition care process and model part I:The 2008 update. J Am Diet Assoc. 2008;108(7):1113-1117.

5. American Dietetic Association QualityManagement Committee. American Di-etetic Association Revised 2008 Standardsof Practice for Registered Dietitians in Nu-trition Care; Standards of ProfessionalPerformance for Registered Dietitians;Standards of Practice for Dietetic Techni-cians, Registered, in Nutrition Care; andStandards of Professional Performance forDietetic Technicians, Registered. J Am DietAssoc. 2008;108(9):1538-1542e9.

6. Academy of Nutrition and Dietetics. Ca-reer development guide. http://www.eatright.org/futurepractice/. AccessedMarch 12, 2012.

7. Academy of Nutrition and Dietetics. Inter-national Dietetics and Nutrition Terminol-ogy (IDNT) Reference Manual: StandardizedLanguage for the Nutrition Care Process. 4thed. Chicago, IL: Academy of Nutrition andDietetics; 2012.

8. Academy of Nutrition and Dietetics. Prac-tice tips: DTR scope of practice & the nu-trition care process. http://www.eatright.org/scope/. Accessed March 12, 2012.

9. Academy of Nutrition and Dietetics. Prac-tice tips: What is meant by “under the su-pervision of the RD”. http://www.eatright.org/scope/. Accessed March 12, 2012.

10. Academy of Nutrition and Dietetics Qual-

ity Management Committee and Scope ofPractice Subcommittee of the Quality

JOURNAL OF THE ACADE

Management Committee. Academy ofNutrition and Dietetics: Scope of Practicefor the Dietetic Technician, Registered. JAcad Nutr Diet. 2013;113(6 suppl 2):S46-S55.

11. Academy of Nutrition and Dietetics Qual-ity Management Committee and Scope ofPractice Subcommittee of the QualityManagement Committee. Academy of Nu-trition and Dietetics: Revised 2012 Stan-dards of Practice in Nutrition Care andStandards of Professional Performance forDietetic Technicians, Registered. J AcadNutr Diet. 2013;113(6 suppl 2):S56-S71.

12. Academy of Nutrition and Dietetics. Prac-tice tips: RD/DTR team. http://www.eatright.org/scope/. Accessed March 12,2012.

13. Hodorowicz MA, White JV. Ethics in ac-tion. Elements of ethical billing for nutri-tion professionals. J Acad Nutr Diet. 2012;112(3):432-435.

14. Grandgenett R, Derelian D. Ethics in ac-tion. Ethics in business practice. J Am DietAssoc. 2010;110(7):1103-1104.

15. US Department of Health and Human Ser-vices, Centers for Medicare and MedicaidServices. State operationsmanual. Appen-dix A-Survey protocol, regulations and in-terpretive guidelines for hospitals (Rev.37, 10-17-08); Section 482.28 Food andDietetic Services (pp. 287-294). http://www.cms.gov/manuals/downloads/som107ap_a_hospitals.pdf. Accessed March 14,2012.

16. US Department of Health and Human Ser-vices, Centers for Medicare and MedicaidServices. State Operations Manual. Ap-pendix PP-Guidance to surveyors for longterm care facilities (Rev. 26, 08-17-07);Section 483.35 Dietary Services. http://www.cms.gov/CFCsAndCoPs/Downloads/som107ap_pp_guidelines_ltcf.pdf Ac-cessed March 14, 2012.

17. Weddle DO. The professional develop-ment portfolio process: Setting goals forcredentialing. J Am Diet Assoc. 2002;102(10):1439-1444.

18. Gates G. Ethics opinion: Dietetics profes-sionals are ethically obliged to maintain

personal competencies in practice. J AmDiet Assoc. 2003;103(5):633-635.

AUTHOR INFORMATIONMembers of the Academy Quality Management Committee 2010-2011, 2011-2012, 2012-2013 and Scope of Practice Subcommittee of theQuality Management Committee 2010-2011, 2011-2012, 2012-2013: Joyce A. Price, MS, RD, LDN–Chair 2010-2011; Sue Kent, MS, RD, LD–Chair2011-2012; Marsha R. Stieber, MSA, RD–Chair 2012-2013; Valaree M. Williams, MS, RD, LDN–Vice Chair 2012-2013; Joanne B. Shearer, MS, RD,LN; Charlotte B. Oakley, PhD, RD, FADA; Sharon A. Cox, MA, RD, LD; Mary J. Marian, MS, RD, CSO; Elise A. Smith, MA, RD, LD; Pamela Charney,PhD, RD; M. Patricia Fuhrman, MS, RD, LD, FADA; Isabel M. Parraga, PhD, RD, LD; Doris V. Derelian, JD, PhD, RD, FADA; Terry L. Brown, MPH, RD,CNSC, LD; Susan L. Smith, MBA, RD; Barbara J. Kamp, MS, RD; Gretchen Y. Robinson, MS, RD, LD, FADA; Margaret J. Tate, MS, RD; Carol J. Gilmore,MS, RD, LD, FADA; Patricia L. Steinmuller, MS, RD, CSSD, LN; Jean A. Anderson, MS, RD; Lois J. Hill, MS, RD, CSR, LD; Sandra J. McNeil, MA, RD,CDN, FADA; Bethany L. Daugherty, MS, RD, CD; Pauline Williams, PhD, MPA, RD, CD; Melissa N. Church, MS, RD, LD; Karen Hui, RD, LDN; andSharon M. McCauley, MS, MBA, RD, LDN, FADA.

ACKNOWLEDGEMENTSThe Academy Quality Management Committee and its Scope of Practice Subcommittee thank the following Academy members for theirassistance with manuscript preparation: COL George A. Dilly, PhD, RD, LD, US Army; LTC Dianne T. Helinski, MHPE, RD, LD, US Army; MartinYadrick, MBA, MS, RD, FADA; Elaine Ayres, MS, RD, FAC-PPM; Christina Ferroli, PhD, RD; Connie Mueller, MS, RD, SNS; Diane Duncan-Goldsmith,MS, RD, LD; Angie Tagtow, MS, RD, LD; Deborah Canter, PhD, RD, LD; Glenna McCollum, DMOL, MPH, RD; and Lindsay Hoggle, MS, RD, PMP.

MY OF NUTRITION AND DIETETICS S45


Recommended