Job Summary:
In accordance with the Mission, Vision and Values, and strategic directions of Provincial Health Services Authority patient safety is a priority and a responsibility shared by everyone at PHSA, and as such, the requirement to continuously improve quality and safety is inherent in all aspects of this position. The Dietitian provides clinical nutrition services to support the nutritional management of assigned areas through the assessment, planning, implementation and evaluation of nutritional goals and care plans. Functioning in an interprofessional environment works collaboratively with the health care team, identifies patients at risk for nutritional sequelea; provides teaching and develops education resources; participates in research and in ongoing quality assurance and risk management programs.

Duties/Accountabilities:

1. Conducts nutrition assessment of critical care patients utilizing standards and guidelines, physical nutrition assessment, identification of relevant laboratory and other data and advanced clinical techniques such as extensive knowledge of nutrition management of co-morbidities and organ failure, interpretation of laboratory parameters, nutrient and drug interactions and nutritional implications of a variety of disease states.

2. Provides recommendations based upon assessment and treatment intervention to health care team regarding nutrition support regime (oral, enteral, parenteral) and route of feeding. Develops and implements age-appropriate nutritional goals and care plans appropriate to feeding regime. Prescribes multi-parameter modified diets, including calculating enteral and parenteral nutrition support, as appropriate.

3. Monitors patient for tolerance to nutrition intervention through methods such as reviewing laboratory and growth parameters, nutrient intake records, and organ function. Adjusts care plans, nutrition orders, and recommendations including breastfeeding, breastmilk, fortification, infant and enteral formula orders, parenteral nutrition recommendations and diet orders as required. Consults with physicians, health care professionals and family as appropriate regarding the patient’s response to the nutrition care plan and ability to meet goals. Makes recommendations to the team and/or family for changes or adjustments as required.

4. Documents nutrition care plan and recommendations at each stage of the nutrition care process according to established format and policy, time-lines, and legal requirements. Charts recommendations in the patient health record including suggested nutrition support/diet order changes.

5. Facilitates implementation of the nutrition care plan by communicating nutrition orders and parenteral nutrition recommendations to designated staff. Provides input on infant and enteral formula selection, parenteral nutrition solutions, micronutrient supplementation, diet criteria and feeding guidelines, based on patient specific requirements.

6. Provides counselling to patients/families on nutrition care plans and recommendations including route and method of feeding, formula selections and supporting continuation of lactation as appropriate.

7. Communicates with interdisciplinary team and participates in rounds, patient care conferences, education events and program meetings as required.

8. Develops, implements, evaluates and revises nutrition care guidelines and clinical pathways based on current literature/research and in collaboration with the team and other pediatric centres/agencies as appropriate.

9. Communicates nutrition care principles to health care professionals, colleagues, peers and students through in-service education and orientation/training sessions, rounds and continuing education programs. Serves on discipline/program committees or represents the discipline/program on external committees or initiatives as required.

10. Acts as a resource person to the interdisciplinary team, and other health care professionals throughout the hospital, as well as receiving hospitals and community health care professionals and agencies to enhance continuity of care.

11. Utilizes and promotes evidence-based care and integrates research findings into current practice. Participates in the planning, development, implementation and evaluation of clinical research proposals, projects and surveys regarding the nutritional management of patients. Disseminates research and clinical findings through publications and presentations.

12. Participates in hospital, program, discipline and university programs related to teaching. Provides dietetic interns and students with learning opportunities in the nutritional care of patients in assigned work areas.

13. Provides input and feedback to discipline and/or program regarding strategic planning initiatives and effective use of resources. Collects and submits workload measurement and other data according to established guidelines.

14. Participates in discipline and/or program based quality assurance/improvement initiatives by methods such as collecting data and monitoring variances to expected outcomes. Makes recommendations to the team, Program Manager and/or Professional Practice Leader for change based on findings. As a team member, provides input into interdisciplinary protocol development utilizing evidence-based practice.

15. Performs other related duties as assigned.

Qualifications:
Education, Training and Experience

• Graduation from an academic program in dietetics approved by the College of Dietitians of British Columbia.
• Three (3) years recent, related clinical experience in pediatric nutrition and nutrition support in an acute care setting plus Nutrition Support Certification for Clinicians (CNSC) from the American Society of Enteral and Parenteral Nutrition (ASPEN) or an equivalent combination of education, training and experience
• Full registration in the College of Dietitians of British Columbia, with Restricted Activity A, B, C.

Skills and Abilities

• Broad knowledge of pediatric nutrition theory and feeding practices in health and disease.
• Broad knowledge of the Standards of Practice established by the College of Dietitians of B.C.
• Broad knowledge of ASPEN Standards of Care for pediatric nutrition support and nutrition support practice guidelines.
• Ability to design, implement and monitor pediatric therapeutic diets delivered via oral, enteral and parenteral routes.
• Ability to plan and implement nutrition care plans in relation to critical care treatment modalities and underlying co-morbidities.
• Broad knowledge of research processes and methodology.
• Ability to work collaboratively and effectively within an inter-professional environment.
• Ability to plan, organize and prioritize work in a high volume/high acuity setting.
• Ability to teach and provide effective consultation.
• Effective verbal and written communication skills.
• Ability to communicate with, and to deal effectively with co-workers, physicians, other health care professionals, patients and their families, and external agencies.
• Ability to operate the equipment used to perform the duties of the position
• Physical ability to perform duties of the position.