Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Oncology Nutrition

Abstract

Oncology nutrition encompasses nutrition care for individuals along the cancer care continuum. Nutrition is a vital component of prevention, treatment, and healthy survivorship. The practice of an oncology registered dietitian nutritionist (RDN) reflects the setting and population served with diverse cancer diagnoses, including expanded roles and responsibilities reflecting the RDN's interests and organization's activities. Provision of nutrition services in oncology requires that RDNs have advanced knowledge in the focus area of oncology nutrition. Thus, the Oncology Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance as tools for RDNs currently in practice or interested in working in oncology nutrition, to address their current skill level and to identify areas for additional professional development in this practice area. The Standards of Practice address and apply the Nutrition Care Process and workflow elements, which are screening, assessment, diagnosis, intervention, evaluation/monitoring, and discharge planning and transitions of care. The Standards of Professional Performance consist of the following six domains of professionalism including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements and describe three skill levels (competent, proficient, and expert) for RDNs working in oncology nutrition.

Using the Internet: Nutrition Information-Seeking Behaviours of Lay People Enrolled in a Massive Online Nutrition Course

“…This research found that only 5% of food and nutrition-related information shared by learners was written by nutrition professionals, such as Registered Dietitians and Registered Nutritionists. Dietitians are experts in nutrition and dietetics due to the extensive evidence-based nutrition training, assessment and accreditation they undergo, and, from this, expect to be perceived as experts by the public and their credentials valued accordingly [36,37]. Additionally, dietetic and nutrition professional associations educate the public on the expertise and role of nutrition professionals [38,39].…”

Assessing Adherence, Competence and Differentiation in a Stepped-Wedge Randomised Clinical Trial of a Complex Behaviour Change Intervention

“…This is important since eliciting and reinforcing intrinsic client motivation is central to the role of MI in facilitating positive behaviour change [ 38 ]. In contrast, despite self-monitoring and structured meal plans being evidence based strategies in nutrition counselling [ 39 , 40 ], whose frequency improved after training, fewer than half of the week five sessions sampled demonstrated evidence of a written nutrition planner, and even fewer reviewed client progress toward previously developed plans. Surprisingly, empirical evidence for dietitian implementation of this evidence-based nutrition strategy is lacking.…”

Structured Review of the Value Added by the Registered Dietitian to the Care of Gastrointestinal Cancer Patients

“…They understand the pathophysiology of cancers and how they impact the body's ability to take in nutrition and utilize it (or not). Dietitians also spend time conducting a nutrition‐focused assessment and ensure that the patient understands the education/intervention being provided 33 . They offer custom recommendations that incorporate current evidence‐based information to increase the likelihood of compliance to the nutrition prescription.…”

“…They offer custom recommendations that incorporate current evidence‐based information to increase the likelihood of compliance to the nutrition prescription. Particularly in the study setting, the dietitian is the only team member that has the time and mandate to sit down with the patient and family and understand how to tailor nutrition interventions to their needs 33,34 . The data suggest that nutrition interventions result in improved outcomes; however, it is unclear from these studies what the mechanism of this benefit is and which particular interventions most effectively enhance outcomes.…”