Jurisprudence Handbook

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NSDA addresses complaints made about a dietitian’s practice. The Act and policies prescribe a process to address the complaints fairly and objectively. Complaints may address incompetence1, incapacity2, or misconduct.

Standards of practice describe competent, collaborative, ethical, and safe practice applicable to dietitians in multiple practice areas and settings. Standards set the minimum expectation which performance can be measured in a complaints process.

Upon receipt of a written complaint, NSDA informs the dietitian about the complaint and requests a written response. The complaint is investigated. Unless the complaint is deemed frivolous or vexatious, the complaint is assessed by the NSDA board of directors. The Board oversees and facilitates an evidence-based, objective, fair, and timely complaints process.

Practice illustration:  

Mrs. Jones sent a written complaint to NSDA about a dietitian named Sally. Mrs. Jones was concerned about the nutritional care Mr. Jones received while admitted for respite in a long-term care facility. While at the facility, Mr. Jones developed an infection and lost weight over a period of two weeks. She believed the dietitian did not develop a nutrition care plan that would have provided enough nourishment.

NSDA sent the written complaint to Sally and asked for a written response. The competencies of care were identified that Sally may have failed to meet.

Assess nutrition-related risks and needs
Develop nutrition care plans.
Manage implementation of nutrition care plans
Evaluate and modify nutrition care plan as appropriate.

NSDA obtained and reviewed Mr. Jones’ medical chart, and interviewed Mr. and Mrs. Jones, and the patient’s physician.

The investigation revealed that the nutrition care assessment and care plan were appropriate, and that the dietitian had appropriately monitored and evaluated the intervention. The dietitian had documented her actions to address that the patient failed to consistently receive the high energy high protein nutritional supplements as ordered.

A panel of the NSDA board of directors who had never worked with Sally nor had any potential bias, assessed the investigation’s findings. They did not find Sally to be incompetent in her practice. The facility was advised of the findings and recommendations to the facility were made.

A written decision was provided to both Mrs. Smith and Sally that outlined the reasons for the board’s decision.

1 Incompetence - the display of lack of knowledge, skill or judgement in the respondent's care of a patient or delivery of dietetic services that, having regard to all the circumstances, rendered the respondent unsafe to practise at the time of such care of the patient or delivery of dietetic services or that renders the respondent unsafe to continue in practice without remedial assistance (Dietitians Act, 2009).

2 Incapacity - the status whereby a respondent, at the time of the subject-matter of a complaint, suffered from a medical, physical, mental or emotional condition, disorder or addiction that rendered the respondent unable to practise with reasonable skill or judgement or that may have endangered the health or safety of patients (Dietitians Act, 2009).