Training for nutrition support dietitians

Abstract

Nutrition support dietitians have expanded their scope of practice steadily over the last 20 y.’ Technological advances, economic retrenchment, and evolving practice patterns will dictate continued changes over the next decade. These changes will offer abundant opportunities for dietitians who display creativity, continue to be adaptable, and are well trained. Advances in nutrition support knowledge have already resulted in complex guidelines to optimize nutrient intake.2*3 In addition, pharmacologic doses of nutrients are being used to treat or modify the response to disease. Detailed monitoring of nutrient intake will be needed as patients receive increasingly complex, multimodal nutrition therapy. As the demand for multi skilled health care workers increases, dietitians are expanding their skills. Dietitians are currently being trained to perform physical examinations and to insert feeding tubes.4 Other skills will be acquired as needed to provide comprehensive nutrition care. To meet the current economic challenges in health care, hospitals are implementing standard patient care protocols sometimes called clinical pathways or critical pathways.5 As pharmacists have used these vehicles to achieve greater autonomy, 6~7 so too will dietitians. As hospitals reduce physician training programs, dietitians may take advantage of the opportunity to adopt the physician extender’ model pioneered by nurses. To prepare for these challenges, dietitians will need advanced-level nutrition support skills. However, training dietitians in advanced-level nutrition support