What Clinical Activities Do Advanced-Practice Registered Dietitian Nutritionists Perform? Results of a Delphi Study
Abstract Activities performed by advanced-practice registered dietitian nutritionists (RDNs) have yet to be clearly elucidated. The study aimed to gain consensus on the practice activities of advanced-practice RDNs who provide direct clinical nutrition care. A three-round Delphi study was conducted....
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| Veröffentlicht in: | Journal of the Academy of Nutrition and Dietetics 2014-05, Vol.114 (5), p.718-733 |
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| container_title | Journal of the Academy of Nutrition and Dietetics |
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| creator | Brody, Rebecca A., PhD, RD, LD Byham-Gray, Laura, PhD, RD Touger-Decker, Riva, PhD, RD, FADA Passannante, Marian R., PhD Rothpletz Puglia, Pamela, EdD, RD O'Sullivan Maillet, Julie, PhD, RD, FADA |
| description | Abstract Activities performed by advanced-practice registered dietitian nutritionists (RDNs) have yet to be clearly elucidated. The study aimed to gain consensus on the practice activities of advanced-practice RDNs who provide direct clinical nutrition care. A three-round Delphi study was conducted. Purposive sampling identified 117 RDN experts working as clinicians and/or managers in direct care settings that met inclusion criteria for advanced-level practice. In Round 1, 85 experts provided open-ended advanced-level practice activities linked to the Nutrition Care Process sections. Using content analysis, the responses were coded into activity statements. In Round 2, experts rated the essentiality of these activities. In Round 3, experts re-rated statements not reaching consensus while viewing their previous rating, the group median, and comments. Median ratings of 1.0 to 3.0 were defined as essential, 4.0 were neither essential nor nonessential, and 5.0 to 7.0 were nonessential. Consensus was reached when the interquartile range of responses to each question was |
| doi_str_mv | 10.1016/j.jand.2014.01.013 |
| format | Article |
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Results of a Delphi Study</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Brody, Rebecca A., PhD, RD, LD ; Byham-Gray, Laura, PhD, RD ; Touger-Decker, Riva, PhD, RD, FADA ; Passannante, Marian R., PhD ; Rothpletz Puglia, Pamela, EdD, RD ; O'Sullivan Maillet, Julie, PhD, RD, FADA</creator><creatorcontrib>Brody, Rebecca A., PhD, RD, LD ; Byham-Gray, Laura, PhD, RD ; Touger-Decker, Riva, PhD, RD, FADA ; Passannante, Marian R., PhD ; Rothpletz Puglia, Pamela, EdD, RD ; O'Sullivan Maillet, Julie, PhD, RD, FADA</creatorcontrib><description>Abstract Activities performed by advanced-practice registered dietitian nutritionists (RDNs) have yet to be clearly elucidated. The study aimed to gain consensus on the practice activities of advanced-practice RDNs who provide direct clinical nutrition care. A three-round Delphi study was conducted. Purposive sampling identified 117 RDN experts working as clinicians and/or managers in direct care settings that met inclusion criteria for advanced-level practice. In Round 1, 85 experts provided open-ended advanced-level practice activities linked to the Nutrition Care Process sections. Using content analysis, the responses were coded into activity statements. In Round 2, experts rated the essentiality of these activities. In Round 3, experts re-rated statements not reaching consensus while viewing their previous rating, the group median, and comments. Median ratings of 1.0 to 3.0 were defined as essential, 4.0 were neither essential nor nonessential, and 5.0 to 7.0 were nonessential. Consensus was reached when the interquartile range of responses to each question was <2.0. Seventy-six (89.4%) experts completed all rounds. From 770 comments, 129 activity statements were generated. All statements reached consensus: 97.7% as essential; 0.8% as nonessential; and 1.5% as neither. Of essential activities, 67.5% were highly essential with limited variability (median=1.0; interquartile range≤2.0). Advanced-practice RDNs' tasks are patient-centered and reflect complex care; involve a comprehensive and discriminating approach; are grounded in advanced knowledge and expertise in clinical nutrition; include use of advanced interviewing, education, and counseling strategies; and require communication with patient, families, and the health care team. The high-level of consensus from experts suggest advanced-level clinical nutrition practice exists and can be defined.</description><identifier>ISSN: 2212-2672</identifier><identifier>EISSN: 2212-2680</identifier><identifier>DOI: 10.1016/j.jand.2014.01.013</identifier><identifier>PMID: 24630681</identifier><language>eng</language><publisher>New York, NY: Elsevier</publisher><subject>Adult ; Biological and medical sciences ; Clinical Competence ; Consensus ; Delphi Technique ; Dietetics - standards ; Evidence-Based Practice ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Gastroenterology and Hepatology ; Humans ; Internal Medicine ; Male ; Middle Aged ; Motor Activity ; Nutrition Assessment ; Nutritionists ; Patient Care Management - methods ; Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><ispartof>Journal of the Academy of Nutrition and Dietetics, 2014-05, Vol.114 (5), p.718-733</ispartof><rights>Academy of Nutrition and Dietetics</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c388t-789e563dd121dd275cb131f844f115c85fe4a2e6839b2d6e5497771730021bce3</citedby><cites>FETCH-LOGICAL-c388t-789e563dd121dd275cb131f844f115c85fe4a2e6839b2d6e5497771730021bce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28513918$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24630681$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brody, Rebecca A., PhD, RD, LD</creatorcontrib><creatorcontrib>Byham-Gray, Laura, PhD, RD</creatorcontrib><creatorcontrib>Touger-Decker, Riva, PhD, RD, FADA</creatorcontrib><creatorcontrib>Passannante, Marian R., PhD</creatorcontrib><creatorcontrib>Rothpletz Puglia, Pamela, EdD, RD</creatorcontrib><creatorcontrib>O'Sullivan Maillet, Julie, PhD, RD, FADA</creatorcontrib><title>What Clinical Activities Do Advanced-Practice Registered Dietitian Nutritionists Perform? Results of a Delphi Study</title><title>Journal of the Academy of Nutrition and Dietetics</title><addtitle>J Acad Nutr Diet</addtitle><description>Abstract Activities performed by advanced-practice registered dietitian nutritionists (RDNs) have yet to be clearly elucidated. The study aimed to gain consensus on the practice activities of advanced-practice RDNs who provide direct clinical nutrition care. A three-round Delphi study was conducted. Purposive sampling identified 117 RDN experts working as clinicians and/or managers in direct care settings that met inclusion criteria for advanced-level practice. In Round 1, 85 experts provided open-ended advanced-level practice activities linked to the Nutrition Care Process sections. Using content analysis, the responses were coded into activity statements. In Round 2, experts rated the essentiality of these activities. In Round 3, experts re-rated statements not reaching consensus while viewing their previous rating, the group median, and comments. Median ratings of 1.0 to 3.0 were defined as essential, 4.0 were neither essential nor nonessential, and 5.0 to 7.0 were nonessential. Consensus was reached when the interquartile range of responses to each question was <2.0. Seventy-six (89.4%) experts completed all rounds. From 770 comments, 129 activity statements were generated. All statements reached consensus: 97.7% as essential; 0.8% as nonessential; and 1.5% as neither. Of essential activities, 67.5% were highly essential with limited variability (median=1.0; interquartile range≤2.0). Advanced-practice RDNs' tasks are patient-centered and reflect complex care; involve a comprehensive and discriminating approach; are grounded in advanced knowledge and expertise in clinical nutrition; include use of advanced interviewing, education, and counseling strategies; and require communication with patient, families, and the health care team. The high-level of consensus from experts suggest advanced-level clinical nutrition practice exists and can be defined.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Clinical Competence</subject><subject>Consensus</subject><subject>Delphi Technique</subject><subject>Dietetics - standards</subject><subject>Evidence-Based Practice</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Gastroenterology and Hepatology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Motor Activity</subject><subject>Nutrition Assessment</subject><subject>Nutritionists</subject><subject>Patient Care Management - methods</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><issn>2212-2672</issn><issn>2212-2680</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkc1u1DAQgC0EolXpC3BAviBxyeKxE8e5gFa7_EkVVBTE0fLaE-qQTba2s9K-TZ-lT4ajXYo1kkcz38zhG0JeAlsAA_m2W3RmcAvOoFwwyCGekHPOgRdcKvb0Ma_5GbmMsWP5SSaEYs_JGS-lYFLBOZl-3ZpEV70fvDU9Xdrk9z55jHQ90qXbm8GiK66DyQ2L9Dv-9jFhQEfXHlMmzUC_TinkbBxyK9JrDO0Ytu8zG6c-F8b24d483K-x3916epMmd3hBnrWmj3h5-i_Iz48ffqw-F1ffPn1ZLa8KK5RKRa0arKRwDjg4x-vKbkBAq8qyBaisqlosDUepRLPhTmJVNnVdQy0Y47CxKC7Im-PeXRjvJoxJb3202PdmwHGKGirIgirZyIzyI2rDGGPAVu-C35pw0MD0bFx3ejauZ-OaQQ6Rh16d9k-bLbrHkX9-M_D6BJiY_bYh-_TxP6cqEA2ozL07cpht7D0GbU8n-YMHjN04hSGL0qAj10zfzMedbwslY8CEEn8BB36gdg</recordid><startdate>20140501</startdate><enddate>20140501</enddate><creator>Brody, Rebecca A., PhD, RD, LD</creator><creator>Byham-Gray, Laura, PhD, RD</creator><creator>Touger-Decker, Riva, PhD, RD, FADA</creator><creator>Passannante, Marian R., PhD</creator><creator>Rothpletz Puglia, Pamela, EdD, RD</creator><creator>O'Sullivan Maillet, Julie, PhD, RD, FADA</creator><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140501</creationdate><title>What Clinical Activities Do Advanced-Practice Registered Dietitian Nutritionists Perform? Results of a Delphi Study</title><author>Brody, Rebecca A., PhD, RD, LD ; Byham-Gray, Laura, PhD, RD ; Touger-Decker, Riva, PhD, RD, FADA ; Passannante, Marian R., PhD ; Rothpletz Puglia, Pamela, EdD, RD ; O'Sullivan Maillet, Julie, PhD, RD, FADA</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c388t-789e563dd121dd275cb131f844f115c85fe4a2e6839b2d6e5497771730021bce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Clinical Competence</topic><topic>Consensus</topic><topic>Delphi Technique</topic><topic>Dietetics - standards</topic><topic>Evidence-Based Practice</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Gastroenterology and Hepatology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Motor Activity</topic><topic>Nutrition Assessment</topic><topic>Nutritionists</topic><topic>Patient Care Management - methods</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brody, Rebecca A., PhD, RD, LD</creatorcontrib><creatorcontrib>Byham-Gray, Laura, PhD, RD</creatorcontrib><creatorcontrib>Touger-Decker, Riva, PhD, RD, FADA</creatorcontrib><creatorcontrib>Passannante, Marian R., PhD</creatorcontrib><creatorcontrib>Rothpletz Puglia, Pamela, EdD, RD</creatorcontrib><creatorcontrib>O'Sullivan Maillet, Julie, PhD, RD, FADA</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the Academy of Nutrition and Dietetics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brody, Rebecca A., PhD, RD, LD</au><au>Byham-Gray, Laura, PhD, RD</au><au>Touger-Decker, Riva, PhD, RD, FADA</au><au>Passannante, Marian R., PhD</au><au>Rothpletz Puglia, Pamela, EdD, RD</au><au>O'Sullivan Maillet, Julie, PhD, RD, FADA</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>What Clinical Activities Do Advanced-Practice Registered Dietitian Nutritionists Perform? Results of a Delphi Study</atitle><jtitle>Journal of the Academy of Nutrition and Dietetics</jtitle><addtitle>J Acad Nutr Diet</addtitle><date>2014-05-01</date><risdate>2014</risdate><volume>114</volume><issue>5</issue><spage>718</spage><epage>733</epage><pages>718-733</pages><issn>2212-2672</issn><eissn>2212-2680</eissn><abstract>Abstract Activities performed by advanced-practice registered dietitian nutritionists (RDNs) have yet to be clearly elucidated. The study aimed to gain consensus on the practice activities of advanced-practice RDNs who provide direct clinical nutrition care. A three-round Delphi study was conducted. Purposive sampling identified 117 RDN experts working as clinicians and/or managers in direct care settings that met inclusion criteria for advanced-level practice. In Round 1, 85 experts provided open-ended advanced-level practice activities linked to the Nutrition Care Process sections. Using content analysis, the responses were coded into activity statements. In Round 2, experts rated the essentiality of these activities. In Round 3, experts re-rated statements not reaching consensus while viewing their previous rating, the group median, and comments. Median ratings of 1.0 to 3.0 were defined as essential, 4.0 were neither essential nor nonessential, and 5.0 to 7.0 were nonessential. Consensus was reached when the interquartile range of responses to each question was <2.0. Seventy-six (89.4%) experts completed all rounds. From 770 comments, 129 activity statements were generated. All statements reached consensus: 97.7% as essential; 0.8% as nonessential; and 1.5% as neither. Of essential activities, 67.5% were highly essential with limited variability (median=1.0; interquartile range≤2.0). Advanced-practice RDNs' tasks are patient-centered and reflect complex care; involve a comprehensive and discriminating approach; are grounded in advanced knowledge and expertise in clinical nutrition; include use of advanced interviewing, education, and counseling strategies; and require communication with patient, families, and the health care team. The high-level of consensus from experts suggest advanced-level clinical nutrition practice exists and can be defined.</abstract><cop>New York, NY</cop><pub>Elsevier</pub><pmid>24630681</pmid><doi>10.1016/j.jand.2014.01.013</doi><tpages>16</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Clinical Competence Consensus Delphi Technique Dietetics - standards Evidence-Based Practice Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology Gastroenterology and Hepatology Humans Internal Medicine Male Middle Aged Motor Activity Nutrition Assessment Nutritionists Patient Care Management - methods Vertebrates: anatomy and physiology, studies on body, several organs or systems |
| title | What Clinical Activities Do Advanced-Practice Registered Dietitian Nutritionists Perform? Results of a Delphi Study |
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