Clinical Ethics and Nutrition Support Practice: Implications for Practice Change and Curriculum Development

Schwartz, Denise B.; Armanios, Nader; Monturo, Cheryl; Frankel, Eric H.; Wesley, John R.; Patel, Mayur B.; Goldman, Bruce D.; Kliger, Gustavo; Schwartz, Emily

doi:10.1016/j.jand.2016.01.009

Cited by 10 publications

(9 citation statements)

References 45 publications

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“…Nutrition support clinicians and the importance of incorporating ethics into clinical practice have been documented in the literature . Nutrition support clinician participation on both the intensive care unit (ICU) interprofessional rounds, family meetings, and the bioethics committee adds to the understanding of decision‐making complexity in cases dealing with nutrition concerns.…”

Section: Nutrition Support Clinicians and Ethicsmentioning

confidence: 99%

Role of the Nutrition Support Clinician on a Hospital Bioethics Committee

2019

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Hospital bioethics committees comprise a diverse group of healthcare professionals to deal with ethical issues within the institution that arise during patient care. The nutrition support clinicians (NSCs) have an important role on a bioethics committee because of their knowledge and expertise of different nutrition routes and the benefits vs burdens and risks of these modalities, both enteral and parenteral nutrition. Ethics expertise is built on an understanding of ethical principles, when applied in clinical ethics, using critical thinking to prevent ethical dilemmas and to assist in healthcare decision making with a focus on patient-centered care. The NSCs have the opportunity to address ethics during direct patient care with their participation in the intensive care unit interprofessional rounds, family meetings, and surrogate meetings. Evident in ethical dilemmas is often the lack of advance care planning by patients and their family members concerning healthcare wishes for when the individual is unable to communicate their preferences for lifesustaining therapies, including nutrition support. NSCs, as hospital bioethics committee members, are able to support the initiative of National Healthcare Decisions Day to help educate other healthcare clinicians and the public about the importance of advance care planning with communication of healthcare wishes and completion of an advance directive. Components addressed in the article are incorporated into a comprehensive ethics case study, highlighting the role of NSCs. (Nutr Clin Pract. 2019;34:869-880) From the

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Section: Nutrition Support Clinicians and Ethicsmentioning

confidence: 99%

Role of the Nutrition Support Clinician on a Hospital Bioethics Committee

2019

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“…Are responsible for clinical ethics awareness involving lifesustaining therapies including nutrition interventions, reflecting evidence-based guidelines that evaluate the potential benefits and risks/burdens of therapeutic nutrition support (enteral and intravenous nutrition) in myriad of clinical situations. 67,68 Communicate with the patient/ client, family, guardians, and/or advocate 15 regarding benefits and risks/burdens of nutrition intervention options. [67][68][69][70] Preventive Care, Wellness, and Weight Management…”

Section: Nutrition Informaticsmentioning

confidence: 99%

Academy of Nutrition and Dietetics: Revised 2017 Scope of Practice for the Registered Dietitian Nutritionist

Andersen¹,

Baird²,

Bates³

et al. 2018

Journal of the Academy of Nutrition and Dietetics

103

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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-registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs). RDNs integrate research, professional development, and practice to stimulate innovation and discovery; collaborate to solve the greatest food and nutrition challenges now and in the future; focus on systemswide impact across the food, wellness, and health sectors; have a global impact in eliminating all forms of malnutrition; and amplify the contribution of nutrition and dietetics practitioners and expand workforce capacity and capability. The Revised 2017 Scope of Practice for the RDN reflects the position of the Academy on the essential role of the RDN in the direction and delivery of food and nutrition services. The scope of practice for the RDN is composed of education and credentialing, practice resources, Academy Standards of Practice and 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 RDN is used in conjunction with the Revised 2017 Standards of Practice (SOP) in Nutrition Care and the Standards of Professional Performance (SOPP) for RDNs. The SOP address activities related to direct patient and client care. The SOPP address behaviors related to the professional role of RDNs. These standards reflect the minimum competent level of nutrition and dietetics practice and professional performance for RDNs. A companion document addresses the scope of practice for the NDTR.

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“…The physician, RDN, or registered nurse is ultimately responsible for communicating to the patient/client, family, guardians, and advocates the risks/burdens of nutrition intervention options and maintaining clinical ethics awareness involving life-sustaining therapies, such as nutrition interventions. [45][46][47] NDTRs:…”

Section: Nutrition Informaticsmentioning

confidence: 99%

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

Andersen¹,

Baird²,

Bates³

et al. 2018

Journal of the Academy of Nutrition and Dietetics

View full text Add to dashboard Cite

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.

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Clinical Ethics and Nutrition Support Practice: Implications for Practice Change and Curriculum Development

Cited by 10 publications

References 45 publications

Role of the Nutrition Support Clinician on a Hospital Bioethics Committee

Role of the Nutrition Support Clinician on a Hospital Bioethics Committee

Academy of Nutrition and Dietetics: Revised 2017 Scope of Practice for the Registered Dietitian Nutritionist

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

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