entities) guidance in comprehending and using a scope of practice in nutrition and dietetics. Following are guidance offered by the Academy of Nutrition and Dietetics:


› Scope of Practice for RDNs10 and for NDTRs11


› Standards of Practice in Nutrition Care and Standards of Professional Perfor- mance (SOP/SOPP) for RDNs12


and for NDTRs13


› Focus Area Standards for RDNs Collection14 › Focus Area Standards for CDR Specialist Credentials15 The SOP/SOPP document for RDNs12


provides the framework for self-evaluation


and for determining the education and skills needed to advance an individual’s level of practice. These are used to further develop the Focus Area Standards specific to an area of dietetic practice, such as nephrology nutrition or sports nutrition.14,15


The


SOP and SOP/SOPP are not regulations themselves but are often used by regu- latory agencies such as state dietetic licensure boards to develop statutory scopes of practice that are actual regulations. CNMs must be familiar with the SOP and SOP/SOPP for RDNs and NDTRs (if


NDTRs are employed at their facility). They should also be familiar with the focus area SOP/SOPP for RDNs in clinical nutrition management16


and any other areas


relevant to services provided at their facility. For example, if RDNs are providing nutrition support (enteral and parenteral nutrition) management in the hospital, the CNM should read and apply the focus area SOP/SOPP for RDNs in nutrition support.17 See Box 10.1 for a practical example of how the SOP and SOP/SOPP for RDNs and the focus area SOP/SOPP for RDNs in Diabetes Care can be used to determine tasks that may be performed by an RDN.10,12,18


provided a helpful Scope of Practice Decision Algorithm19 CNMs in performing this analysis.


The Academy of Nutrition and Dietetics has also that can assist RDNs and


BOX 10.1 Practical Application of the Registered Dietitian Nutritionist Scope of Practice, and Standards of Practice and Standards of Professional Performance10,12,18


As the clinical nutrition manager (CNM), you have been asked to provide registered dietitian nutritionist (RDN) staffing to conduct medical nutrition therapy visits for pregnant patients with gestational diabetes mellitus in the outpatient obstetrics clinic run by the hospital. As part of these visits, the clinic manager wants the RDN to instruct the patients on how to use their glucose monitors. How do you determine if this is within the scope of practice of an RDN?


Step 1. Read the most recent version of the Academy of Nutrition and Dietetics Scope of Practice for RDNs10 and Revised Standards of Practice in Nutrition Care and Standards of Professional Performance (SOP/SOPP) for RDNs.12


Both documents refer to tasks that may be performed by RDNs throughout the Nutrition Care Process


(NCP), and refers to three tiers of practice: competent, proficient, or expert. Step 2. Read the most recently published SOP/SOPP for RDNs in Diabetes Care.18


This document states that


RDNs who are at the proficient or expert level of diabetes care may do the following activities within the Nutrition Intervention domain of the NCP:


» Plan and review selection and initiation of glucose monitoring equipment (eg, blood glucose meters, continuous glucose monitoring [CGM] systems, and sensor-augmented pumps).


» Provide education and training with required continuous subcutaneous insulin infusion and CGM certification according to institution or organization protocol or approved clinical privileges.


continued on next page


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EFFECTIVE LEADERSHIP & MANAGEMENT IN NUTRITION & DIETETICS


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