About Dietitians

Standards of Practice

The Standards of Practice describe the standards that must be met by all registered with the College of Dietitians of Manitoba.

Standard 1. Assessment and Interventions

Standard
Dietitians competently select and interpret assessment data, develop and/or implement goals/plans/tools, and implement appropriate interventions in the provision of client-centred, professional services.

Expected Outcome:
Clients can expect that Dietitians assess relevant data, develop goals/plans, implement, and evaluate client-centred interventions.

To demonstrate this standard, Dietitians will:

a) Obtain client consent for professional services.
b) Obtain, review, and interpret relevant assessment data.
c) Collaborate and communicate with client to determine goals/plans and interventions.
d) Implement, coordinate, and document the impact of interventions.
e) Monitor, evaluate, and document the impact of interventions in achieving identified outcomes, proposing alternative interventions if goals have not been achieved.
f) Continue to offer professional services until either the client is transferred, discharged, self-managing, declines care, another provider has assumed responsibility, or the Dietitian deems further services are not required.

Standard 2. Boundaries

Standard
Dietitians maintain clear and appropriate professional boundaries with clients and team members.

Expected Outcome:
Clients can expect Dietitians to maintain clear and appropriate professional boundaries at all times.

To demonstrate this standard, Dietitians will:

a) Be sensitive to their position of relative power or influence in professional relationships and not use this status to take physical, emotional, sexual, financial, or other types of advantage of clients and team members.
b) Establish and maintain appropriate professional boundaries in relationships with clients and team members.
c) Respect, establish, and manage effectively, the boundaries that separate their personal and professional relationships/roles in all contexts (e.g., face-to-face, virtual dietetic practice, social media).
d) Obtain consent prior to touching a client.
e) Refrain from entering professional relationships when current or previous personal, financial, employment, and/or legal affiliations would compromise professional services or integrity.
f) Minimize the risk of boundary violations when boundary crossings cannot be avoided (e.g., treatment of family/friend in specialized or rural practice), by reporting the boundary crossing to the appropriate authority (e.g., manager, team leader) and by documenting management strategies (e.g., in the client file, record).
g) When professional boundaries cannot be maintained, take necessary action as required (e.g., end professional relationships with clients, transfer care), and document how the situation was managed.

Standard 3. Client-Centred Services

Standard
Dietitians provide professional services that recognize and respect the unique needs, goals, values, and circumstances of clients.

Expected Outcome
Clients can expect that their goals and values will be incorporated into the Dietitian’s provision of client-centred services.

To demonstrate this standard, Dietitians will:

a) Acknowledge and respect the rights, dignity, and uniqueness of each client (e.g., ethnic/cultural background, religion, age, gender, social status, marital status, sexual orientation, political beliefs, physical/mental ability, corporate mission, and values).
b) Collaborate with clients to identify and develop goals, plans, and interventions to meet their unique needs.
c) Acknowledge and respect clients’ rights to autonomy and decision making over their own health.
d) Advocate for and guide changes on behalf of clients to support their health and well-being when required.
e) Manages available resources effectively and efficiently in meeting the needs of the client.

Standard 4. Collaborative Practice

Standard
Dietitians partner with clients and team members in the collaborative and coordinated provision of professional services.

Expected Outcome
Clients can expect Dietitians to provide collaborative, professional, client-centred services.

To demonstrate this standard, Dietitians will:

a) Contribute professional knowledge to discussions and interactions with clients and team members.
b) Clarify and explain their professional roles and responsibilities in discussions with clients and team members.
c) Respect clients’ and team members’ perspectives and responsibilities, while acknowledging overlapping roles and scopes of practice.
d) Consult with and/or refer as required, when the needs of clients may be more appropriately met by another Dietitian or team member.
e) Effectively manage conflict with clients and team members.
f) Communicate clearly and respectfully with clients and team members, at all times to facilitate collaboration.
g) Use discussion with colleagues as a means to resolve or interpret ethical issues and conflicts in practice.

Standard 5. Communication

Standard
Dietitians communicate effectively, respectfully, and in compliance with applicable legislative and regulatory requirements when providing professional services.

Expected Outcome
Clients can expect Dietitians to communicate respectfully and effectively.

To demonstrate this standard, Dietitians will:

a) Be clear and respectful in all verbal, nonverbal, and written communication.
b) Maintain clients’ privacy and confidentiality in all forms of communication.
c) Use strategies to promote effective communication (e.g., active listening, empathy).
d) Adapt communication to the needs of clients and minimize barriers by incorporating relevant supports as available (e.g., interpreters, visual aids, technology, appropriate language, culturally appropriate resources).
e) Use strategies to facilitate clients’ comprehension and learning (e.g., opportunity for questions, teach back, appropriate literacy levels).
f) Communicate with professional integrity and maintain appropriate boundaries in all communication formats at all times.
g) Document professional communications accurately and in a timely manner as required.

Standard 6. Competence

Standard
Dietitians are responsible and accountable for their continuing competence in order to provide safe, ethical, professional services.

Expected Outcome
Clients can expect Dietitians to be competent to provide safe, ethical, professional services.

To demonstrate this standard, Dietitians will:

a) Provide professional services within the limits of their qualifications and personal level of competence.
b) Evaluate their own practice and participate in continuing professional development to identify and address learning needs.
c) Identify practice situations beyond their personal level of competence and consult, refer, and/or obtain further knowledge and skills to provide professional services.
d) Maintain competence in present area(s) of practice, incorporating evidence into professional services.
e) Acquire the knowledge and skills to practice competently in emerging practice areas as required.
f) Comply with the CDM continuing competence program, adhering to all applicable legislative and regulatory requirements.
g) Voluntarily withdraw from practice if they self-identify that they are no longer able to provide safe, competent, ethical services (e.g., illness, substance use disorder).

Standard 7. Conflict of Interest

Standard
Dietitians will avoid real or perceived conflicts of interest in which professional integrity, professional independence or the provision of professional services could be compromised. Conflict of interests which cannot be avoid must be disclosed and managed.

Expected Outcome
Clients can expect Dietitians to provide professional services that are in the client’s best interests and to disclose and manage any conflicts of interest.

To demonstrate this standard, Dietitians will:

a) Recognize any situations in which a conflict of interest could have an impact on their professional judgment.
b) Avoid any conflict of interest in which professional services could be compromised.
c) When a conflict of interest cannot be avoided, disclose to the appropriate authority (e.g., manager, team leader), manage the situation, and/or discontinue professional services.
d) Document any conflict of interest, the efforts to manage it, and the outcome(s).
e) Provide options for the provision of services and/or products when a conflict of interest exists.
f) Refrain from accepting personal incentives from service and/or product sponsors when the Dietitian stands to profit personally and/or financially.
g) Refrain from offering incentives to clients that places the Dietitian’s personal gain above their professional responsibilities.

Standard 8. Consent

Standard
Dietitians obtain appropriate client consent in the provision of professional services.

Expected Outcome
Clients can expect Dietitians to obtain consent in the provision of professional services.

To demonstrate this standard, Dietitians will:

a) Provide clients with complete and objective information regarding the options for treatment and/or professional services and their respective risks and benefits as appropriate.
b) Obtain client consent prior to the provision of services and document as required.
c) Take all reasonable steps to ensure that consent is given freely, without evidence of coercion.
d) Inform clients in a timely manner of proposed changes to the agreed-upon intervention plan and/or provide new information relevant to consent.
e) Respect clients’ rights to: make choices, consult, and request additional information; refuse proposed interventions; and withdraw previously provided consent at any time.
f) Obtain approval from the appropriate research ethics board and consent from clients prior to participating in research studies.

Standard 9. Evidence-Informed Practice

Standard
Dietitians provide professional services using an evidence-informed approach.

Expected Outcome
Clients can expect Dietitians to use an evidence-informed approach in the provision of professional services.

To demonstrate this standard, Dietitians will:

a) Access and critically appraise current and applicable evidence.
b) Incorporate evidence, using critical thinking and professional judgment, when providing client-centred, professional services.
c) Initiate and/or participate in evaluation and continuous quality improvement activities (e.g., client questionnaires, chart audits, population health data review) to assess new and/or ongoing professional services, products, and programs.
d) Use the feedback obtained from continuous quality improvement activities to improve professional services.
e) Contribute to new knowledge, by participating in data collection and practice-based research as feasible, conforming to applicable research ethics guidelines and processes.

Standard 10. Fees and Billing

Standard
Dietitians ensure that fees and billing for professional services and/or products are fair, transparent, and in compliance with legislative and regulatory requirements.

Expected Outcome
Clients can expect that the fee and billing practices of Dietitians are fair and transparent.

To demonstrate this standard, Dietitians will:

a) Be responsible and accountable for all billing under their registration number.
b) Ensure that fees charged for professional services and/or products are fair, reasonable, and justifiable.
c) Disclose fee schedules for all applicable professional services and/or products including accepted methods of payment, potential additional fees (e.g., cancellation fees, photocopying, mailing), and the process for fee dispute resolution, prior to provision of professional services.
d) Maintain comprehensive records regarding the provision of professional services and/or sale of products.

Standard 11. Privacy/Confidentiality

Standard
Dietitians uphold and protect clients’ rights to privacy and confidentiality of information collected during the provision of professional services by complying with applicable legislative and regulatory requirements.

Expected Outcome
Clients can expect Dietitians to keep their information private and secure.

To demonstrate this standard, Dietitians will:

a) Ensure client consent is obtained prior to collecting or disclosing personal, organizational, and/or business information, unless duty to report obligations is required.
b) Access and collect only the client information that is essential to carry out the provision of safe, competent, ethical services.
c) Use physical, technical, and administrative safeguards (e.g., locked filing cabinets, passwords, encrypting documents, laptops and PCs) to protect paper-based, audio, video, electronic or other client information.
d) Avoid conversations about clients and/or professional services provided that can be overheard and/or breach privacy and confidentiality.

Standard 12. Professional Practice Obligations

Standard
Dietitians protect the public by providing professional services in compliance with applicable legislative and regulatory requirements.

Expected Outcome
Clients can expect Dietitians to provide professional services in compliance with legislative and regulatory requirements.

To demonstrate this standard, Dietitians will:

a) Accept as their primary professional obligation, to protect and serve the public interest according to CDM Code of Ethics.
b) Hold a valid license and practice in compliance with applicable legislative and regulatory requirements.
c) Maintain a level of personal and professional conduct that upholds the integrity and dignity of the profession and sustains public confidence.
d) Comply with duty to report requirements in accordance with applicable legislation, regulations, and/or organization/employer policies.
e) Report abuse, incapacity, incompetence or unprofessional conduct to the appropriate authority, in accordance with applicable legislation, regulations, and/or organization/employer policies.
f) Take responsibility and be accountable to practice within their personal level of competence.
g) Provide supervision, mentoring, and direction to those under their supervision (e.g., students, dietetic interns, staff, volunteers).
h) Accurately represent their professional qualifications, experience, knowledge, and skills.
i) Voluntarily withdraw themselves from professional practice when circumstances exist that impair their professional judgment, impact competence, or that may cause harm to
j) Ensure they have the appropriate license to deliver services by virtual dietetic practice.
k) Use provincially protected titles.
l) Hold required professional liability insurance prior to providing professional services.
m) Comply with continuing competence program requirements.

Standard 13. Promotion/Advertising

Standard
Dietitians provide information and advertise their professional services and/or products in compliance with applicable legislative and regulatory requirements.

Expected Outcome
Clients can expect Dietitians to advertise professional services and/or products in an accurate and ethical manner.

To demonstrate this standard, Dietitians will:

a) Engage in advertising that is truthful, objective, and accurate.
b) Adhere to the CDM Code of Ethics and refrain from using advertising that directly or indirectly:

i. creates unjustified expectations about the results;

ii. may mislead or misinform the public (e.g., use of testimonials);

iii. compares the ability, quality, and/or cost of professional services with that of other Dietitians;

iv. takes advantage physically, emotionally or financially of clients; and

v. endorses, promotes or recommends exclusive use of a product/brand used/sold as a component of professional services, unless supported by evidence.

Standard 14. Record Keeping

Standard
Dietitians document and manage client records and/or other data in compliance with applicable legislative, regulatory, and/or organizational/employer requirements.

Expected Outcome
Clients can expect Dietitians to document professional services clearly, accurately, and in a timely manner, while maintaining privacy and confidentiality.

To demonstrate this standard, Dietitians will:

a) Document, sign, and date complete, accurate, timely records related to professional services.
b) Maintain, retain, share, transport, store, and dispose of all paper and/or electronic documentation and records in compliance with applicable legislative, regulatory, and organizational/employer requirements.
c) Secure all personal client information through appropriate use of physical, technical, and electronic safeguards to protect the privacy and confidentiality of client information.
d) Maintain complete and accurate financial records for all relevant professional services.
e) Maintain equipment service records (e.g., preventative maintenance logs) according to applicable legislative, organizational/employer, and manufacturer recommendations.
f) Plan for and ensure the transfer or disposition of records when leaving a position or ceasing to practice.

Standard 15. Safety and Risk Management

Standard
Dietitians adhere to occupational health and safety legislation, and infection prevention and control practices to provide safe, competent and ethical professional services.

Expected Outcome
Clients can expect Registered Dietitians to provide professional services in a healthy and safe environment.

To demonstrate this standard, Dietitians will:

a) Comply with occupational health and safety legislation, best practices in infection prevention and control, and organization/employer policies and procedures.
b) Maintain certification(s) related to infection prevention and control, and occupational health/workplace safety, as applicable.
c) Contribute to and comply with risk management activities/requirements to promote a safe environment (e.g., working alone, environmental hazards, threats to personal safety).
d) Comply with reporting and follow up procedures related to adverse events, emergency situations, and/or incidents involving workplace safety.
e) Comply with food safety standards in the provision of professional services.
f) Participate, as required, in continuous quality improvement activities to promote and support safe, competent, ethical professional services (e.g., questionnaires, chart audits).

 

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