Job Summary:

In accordance with the Purpose, Vision, Values and Coast Salish Teachings, and strategic direction of PHSA, safety, including both patient and employee safety, is a priority and a responsibility shared by everyone at PHSA. As such, the requirement to continuously improve quality and safety is inherent in all aspects of this position.

The Dietitian provides a broad spectrum of clinical nutrition services to patients of the Multi-Organ Transplant Program.  Applies extensive knowledge, skill and clinical experience to assess, plan, implement, and evaluate nutrition goals and plans throughout all stages of the transplant process.  In addition utilizes advanced clinical techniques such as knowledge of transplant treatment modalities and principles of nutrition support.  In consultation with Professional Practice Leader participates in the development of nutrition care guidelines and procedures for the hospital and provincial agencies.  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 patients referred to the Multi-Organ Transplant (MOT) Program   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 multi-system organ failure, laboratory parameters, nutrient and drug interactions.

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, and calculating enteral and parenteral nutrition support, as appropriate.     

3.    Monitors patient for tolerance to nutrition support through methods such as reviewing metabolic parameters, nutrient intake records, anthropometrics, growth and gut/organ function.  Adjusts care plans including enteral and parenteral nutrition orders, formula and diet orders including diet modifications related to acute and end-stage organ failure 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 both pre- and post-transplant.  Makes recommendations to the team and/or family for changes or adjustments as required.

4.    Liaises with referring centre and/or hospital dietitians to ensure continuity of care and communicates with out of province transplant centre dietitians on patient specific nutrition care plans during the acute transplant phase of care.  Collaborates with the adult MOT program to develop plans for transitioning teens to the new care.   

5.    Considering factors such as quality of life, normal growth and development, and treatment modality provides comprehensive nutrition and self-care counseling to patients in the inpatient and clinic setting.  Addresses post-transplant chronic nutrition related problems, such as obesity, hyperlipidemia, impaired glucose tolerance and steroid related osteoporosis.  Prescribes modified diets as required and educates on prevention strategies.

6.    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.  

7.    Facilitates implementation of the nutrition care plan by communicating infant and enteral formula prescriptions, parenteral nutrition orders and diet information to designated staff.  Provides input on infant and enteral formula selection, parenteral nutrition solutions, micronutrient supplementation, diet criteria and feeding guidelines, based on the requirements of transplant patients.

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

9.    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.

10.    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 as required by the employer.  Serves on discipline/program committees or represents the discipline/program on external committees or initiatives as required.

11.    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, on the nutritional management of pediatric transplant candidates or recipients to enhance continuity of care.  

12.    Utilizes and promotes evidence-based care and integrates research findings into current practice and collegially shares information with interprofessional team.  Participates in the planning, development, implementation and evaluation of clinical research proposals, projects and surveys regarding the nutritional management of pediatric transplant patients.  Disseminates research and clinical findings through publications and presentations.

13.    Participates in hospital, program, discipline and university programs related to teaching.  Provides suggestions for dietetic intern experiences and provides students with learning opportunities in the nutritional care of transplant patients.

14.    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.

15.    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 leadership and/or Professional Practice Leader for change based on findings.  As a team member, provides input into interdisciplinary protocol development utilizing evidence-based practice.

16.    Performs other related duties as assigned.

Qualifications:

Education, Training and Experience

• Graduation from an academic program in dietetics approved by the College of Health and Care Professionals of BC.
• 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
• Current full registration as a Dietitian with the College of Health and Care Professionals of BC.

Skills and Abilities

• Broad knowledge of pediatric nutrition theory and feeding practices in health and disease.
• Broad knowledge of the standards of practice and guidelines for clinical practitioners established by the College of Health and Care Professionals of BC.  
• Broad knowledge of ASPEN Standards of Care for Pediatric Nutrition Support and nutrition support practice guidelines.
• Comprehensive ability to design, implement and monitor pediatric therapeutic diets for single or multi-organ failure when delivered via oral, enteral and parenteral routes.
• Comprehensive knowledge and ability to plan and implement overall nutrition care plans to meet the needs of children requiring transplantation throughout the acute and chronic phase of care.
• 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.
• 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.