Section III: Oncology Nutrition Services
Oncology Nutrition Services consist of:
A. Nutritional Care for Individuals
B. Nutrition Education for Groups
C. Management of Practice
A. NUTRITIONAL CARE FOR INDIVIDUALS
STANDARD 17 - Access to Services
Referrals for Oncology Nutrition Services are accepted from clients, family members/caregivers, health care providers or community agencies.
STANDARD 18 - Nutrition Screening
Oncology dietitians collaborate with other health care providers to ensure the organization has a nutrition screening mechanism to identify clients at nutritional risk.
STANDARD 19 - Nutrition Consultation
a. provide nutrition intervention in a proactive manner.
b. perform nutrition assessment (considering diagnosis; treatment; other co-morbidities; diet history; physical examination; laboratory data; medications; clinical symptoms; and psychosocial, cultural, and educational factors affecting nutritional status).
c. develop client-centered nutrition care goals based on assessment findings and formulate individualized nutrition care plans.
d. provide appropriate follow up, and modify nutrition goals and care plans based on clients' changing nutritional needs and expectations.
e. consult with interdisciplinary team members regarding nutritional care.
STANDARD 20 - Nutrition Counselling and/or Education
a. collaborate with clients to determine goals and objectives of nutrition counselling and/or education sessions, and select strategies most appropriate for achieving learning/ behavioural goals.
b. ensure nutrition counselling and/or education is/are integrated into nutrition care plans based on assessment of clinical, educational and psychosocial parameters.
c. ensure that nutrition counselling and/or education is/are provided in suitable physical environments with minimal distractions.
d. conduct counselling and/or education sessions utilizing appropriate interpersonal and communication skills.
e. select appropriate education materials suited to client learning needs (see Relevance of Education Materials in Standard 22 - Nutrition Education for Groups).
f. communicate the plan for nutrition counselling and/or education to the health care team.
STANDARD 21 - Continuity of Care
Oncology dietitians work in partnership with health care and community resources to provide continuity of nutrition services for clients and their families across the cancer continuum.
B. NUTRITION EDUCATION FOR GROUPS
STANDARD 22 – Group Nutrition Education
a. identify learning needs of clients and/or their families/caregivers, community groups, governing bodies, students, and dietetic colleagues.
b. advise clients and/or community groups of the availability of nutrition education programs and resources.
c. ensure nutrition education programs and resources are tailored to the diversity of intended learners.
C. MANAGEMENT OF PRACTICE
Management of Practice refers to oncology dietitians' management of daily activities that ensure responsible, competent practice and facilitate achievement of clinical responsibilities.
STANDARD 23 - Administrative Responsibilities
a. establish priorities for nutrition care delivery based on the urgency and complexity of nutrition intervention.
b. develop and implement standards of practice, clinical practice guidelines, screening practices, protocols, and clinical pathways in conjunction with health care teams and key stake-holders.
c. communicate changes in oncology nutrition policies and practices to relevant committees in health care facilities.
d. maintain and monitor clinical and non-clinical nutrition services workload measures.
e. develop and maintain needs-based education materials and tools for clients and families (individual and group sessions).
f. maintain nutrition product formularies through collaborative approaches involving clinical and management staff.
g. ensure that nutrition education programs and resources are assessed for effectiveness and relevance (per Section VI, Evaluation of Programs and Services).
STANDARD 24 - Health Care Team Members
a. provide oncology nutrition knowledge and expertise to the health care team.
b. incorporate the role of nutrition services into the care pathways of relevant tumour site teams.
c. advocate for the provision of nutrition services within comprehensive cancer care.
d. act as client advocates.
STANDARD 25 - Community Liaison
a. identify appropriate community partnerships.
b. ensure the progression of client care into the community is seamless and respectful of client well-being and governmental policies.
c. facilitate communication with community partners regarding pertinent clinical and administrative issues.
Section IV: Research
STANDARD 26 - Supportive Research Environment
Oncology nutrition programs:
a. value and encourage research, and facilitate collaboration between dietitians, clinicians and researchers.
b. develop linkages with other cancer care facilities, hospitals, universities and research organizations.
c. dedicate time for clinicians to participate in research activities.
d. integrate research findings into clinical practice.
STANDARD 27 - Promotion of and Participation in Research
a. critically evaluate and apply research findings to assess, provide, and improve patient care, manage services, and educate clients, health care professionals, and others.
b. identify and develop research-based policies, procedures, and clinical pathways as a basis for nutritional care.
c. perform or collaborate to conduct oncology nutrition research (may identify research issues, participate in designing and implementing research projects, facilitate research activities, or disseminate research findings through publications and/or presentations).
d. present research findings at professional meetings, to health care administrators, and the public.
Section V: Education and Training
STANDARD 28 – Participation in Education and Training
a. actively participate in facility-related continuing education and training activities regarding oncology issues and practices.
b. provide needs-based education programs within the dietetic community (dietitians, undergraduate and graduate dietetics/nutrition students, dietetic interns), and health professionals to promote quality oncology nutritional care.
c. supervise or mentor dietitians and other health professionals pursuing theses, dissertations, fellowships or other training.
d. evaluate the effectiveness of educational activities.
Section VI: Evaluation of Programs and Services
STANDARD 29 – Evaluation of oncology nutrition programs and services
Evaluation of oncology nutrition programs and services is integrated into the oncology nutrition program.
a. systematically evaluate the quality, effectiveness/outcomes and relevance of Oncology Nutrition Services and revise practice as needed.
b. conduct meta-evaluation, involving the ongoing reassessment of priorities and Standards of Practice to support quality practice and provision of services (Joint Committee on Standards for Educational Evaluation, 1994).