Restricted Activities for Registered Dietitians and Registered Nutritionists

The government defines a restricted activity as a procedure or service that requires specific professional competence to be performed safely. The College is responsible for regulating the safe performance of restricted activities by its regulated members. We establish the competencies, standards and guidelines for the performance of restricted activities, and determine how competence will be demonstrated and maintained. The College also authorizes regulated members to perform restricted activities.

The Health Professions Act recognizes that one or more professions can have the competence necessary to perform the same restricted activity. The term “restricted” means that only competent health care practitioners may perform these activities, not that they are restricted to a particular profession.

The restricted activities that have been authorized in regulation by the government for Registered Dietitians and Registered Nutritionists are listed below:

• 10(1)(a) “to insert or remove instruments, devices, fingers or hands beyond the point in the nasal passages where they normally narrow or beyond the pharynx for the purposes of inserting or removing nasoenteric tubes, if in the provision of nutrition support the regulated member is providing enteral nutrition.”
• 10(1)(b) “to insert instruments, devices, fingers or hands into or remove them from an artificial opening in the body if, in the provision of nutrition support, the regulated member provides enteral nutrition to patients and inserts or removes gastrostomy or jejunostomy tubes.”
• 10(1)(c) “to prescribe a Schedule 1 drug within the meaning of the Pharmaceutical Profession Act for the purpose of providing nutrition support.”
• 10(1)(d) “to prescribe parenteral nutrition if the regulated member is providing nutrition support and the member is authorized to prescribe a schedule 1 drug within the meaning of the Pharmaceutical Profession Act.”
• 10(1)(e) “to prescribe and administer oral diagnostic imaging contrast agents if in the provision of medical nutrition therapy a regulated member performs a video fluoroscopic swallowing study or assists with the study.”
• 10(1)(g) “to distribute without payment, for the purposes of nutritional support or medical nutrition therapy, drugs regulated by a schedule to the Pharmaceutical Profession Act and pursuant to a prescription, if required by the Pharmaceutical Profession Act.”

Registered Dietitians and Registered Nutritionists require special authorization from the College to perform these restricted activities. If you want to know if a Registered Dietitian or Registered Nutritionist is authorized to perform any restricted activities, you can ask to see their practice permit, which lists their authorized restricted activities, you can access the Public Register which lists restricted activities for regulated members, or you can contact the College office for verification.

Authorization

Restricted activities may only be performed by regulated members who have been authorized by the College to perform them. Regulated members can contact the College to obtain the required forms. To receive authorization, the following must be submitted to the College of Dietitians of Alberta:

1. Notification and Supervision Consent Form (at onset of training)
2. Competency Indicator Checklist and Verification Form
3. Restricted Activity Application Fee of $25.00

Regulated members are encouraged to read the restricted activities chapter within the Regulated Member’s Handbook for information on performance of restricted activities, roles and responsibilities and development of competence.

Update – Psychosocial Intervention

• 10(1)(f) “to perform psychosocial intervention if a regulated member is providing psychonutrition therapy in the treatment of disordered eating patterns.”

Following a review of the Restricted Activity of Psychosocial Intervention, the College of Dietitians of Alberta concluded that Dietitians do not perform restricted psychosocial interventions (i.e. psychotherapy) when working with clients/patients with disordered eating or eating disorder diagnoses.

Dietitians are not performing psychotherapy or other therapies with the intention to treat the underlying psychopathology, in particular with acute or grossly impaired clients/patients. Although Dietitians use medical nutrition therapy, various supportive behaviour modification techniques, strategies and psychosocial interventions that are not considered restricted psychosocial interventions, according to the government’s definitions, performing psychotherapy is not within the scope of Registered Dietitians.

Effective December 1, 2017, Dietitians will no longer be required to seek authorization from the College to work with eating disorder clients/patients.