Scope of practiceand controlled Acts

The Dietetic Scope of Practice Statement as defined in the Dietetics Act, 1991 is: “The practice of dietetics is the assessment of nutrition and nutritional conditions and the treatment and prevention of nutrition related disorders by nutritional means.”

The Scope of practice of dietetics includes the area of expertise of dietitians as a profession. This reflects what dietitians are trained to do through their educational programs and, to a lesser extent, the evolution of the profession as its role develops. The dietetic scope of practice includes the activities that dietitians as a profession are legally permitted to do under the Dietetics Act, 1991 and the Regulated Health Professions Act, 1991 and an individual dietitian’s area of competence.

CONTROLLED ACTS

The 14 Controlled Acts Under the RHPA

Controlled acts are health care actions that are considered potentially harmful if performed by unqualified persons. The Regulated Health Professions Act, 1991, sets out fourteen controlled acts that should only be performed by someone with the legal authority to do so. Dietitians have been granted the legal authority under the Dietetics Act, 1991 to perform only one controlled act, skin pricking, which falls within the controlled act of performing a procedure below the dermis. This authority allows RDs to take blood samples by skin pricking for the purpose of monitoring capillary blood readings while practising dietetics:

Authorized Act

"3.1 In the course of engaging in the practice of dietetics, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to take blood samples by skin pricking for the purpose of monitoring capillary blood readings. 2009, c. 26, s. 7. 2"

Standards & Guidelines

Definition of Practising Dietetics

College's Definition of Practising Dietetics

DELEGATION OF CONTROLLED ACTS

The authority to perform most of the controlled acts can be delegated to another person including a regulated health professional as long as the delegation is made "in accordance with any applicable regulations under the health profession Act governing the member's profession" (Regulated Health Professions Act, 1991, 1991, S28. (1))

Dietitians can also be given the authority to order diagnostic procedures (e.g. laboratory tests) and treatments. This authority is transferred through a medical directive.

The College of Dietitians of Ontario supports the delegation of controlled acts to Registered Dietitians and the development of medical directives giving them additional authorities as long as the dietitians have the competencies to perform the controlled acts or other authorized tasks safely.

Delegation, Directives and Orders

Reg Talks Webinar— Delegation Standard (March 2021)

assessMENT OF Roles and tasks

Acting as an Evaluator

 Dysphagia

Insulin Adjustments

Psychotherapy

Recommending vs Prescribing

Scenarios