What Are Clinical Dietitians?
The "Clinical Nutritionist Exam" is a national unified exam organized by the National Medical Examination Center for the industry standards of clinical nutrition and related sub-disciplinary personnel.
Clinical nutritionist exam
The "Clinical Nutritionist Exam" is a national unified exam organized by the National Medical Examination Center for the industry standards of clinical nutrition and related sub-disciplinary personnel.
Exam registration personnel must pass
Nutrition science is an
In 1985,
Clinical nutritionist (medicine)
Registration requirements: A serving physician in the nutrition department who is qualified as a clinical, public health or Chinese medicine practitioner.
Examination requirements: Passed strict professional theoretical and technical training and passed the examination; mastered various nutritional metabolic diseases, causes and mechanisms of nutritional and metabolic abnormalities under different physiological and pathological conditions (including diseases and iatrogenic factors), clinical Performance, and principles and methods of nutrition diagnosis and nutrition treatment and monitoring; master working methods of clinical evaluation and nutrient intake calculation of commonly used nutrition evaluation methods and nutrition testing indicators; master physical and chemical properties of common nutrients, nutritional treatment effects, lack of And the clinical manifestations and the nutrient requirements of the population and the principles of individualized treatment; master the parenteral and parenteral nutrition administration route, its indications, contraindications; master the clinical nutrition education knowledge of various diseases and special groups.
Clinical Nutritionist (Technical)
Registration requirements: On- the-job technicians or junior nurses and above in the nutrition department of each medical institution
Exam requirements: skilled in physical measurement of human body, laboratory biochemical test technology related to nutrition and metabolism, immune test technology, metabolic analysis technology, organ function measurement technology, including: anthropometric measurement, body composition analysis, determination of human metabolic rate, nutrients Level measurement (eg
Since the establishment of general hospitals in developed countries in Europe and America in the early 19th century, the Ministry of Nutrition has always existed as the basic discipline of the hospital. It is also known as the "troika" with the Department of Nursing and Pharmacy. . The main treatment of the Ministry of Nutrition is to provide natural diet-based therapeutic diets to patients with clinically significant nutritional deficiencies.
Since the 1980s, with the development of the clinical nutrition discipline and the enrichment of treatment methods, especially parenteral preparations have begun to be used in the clinic, firstly in the clinical department, a nutrition support group is set up surgically. Since the beginning of this century, it has gradually replaced the nutrition support group with a complete nutrition department system and opened corresponding nutrition wards.
(1) The setting of the nutrition department of general hospitals owned by the government.
The general hospitals affiliated with federal governments in most European countries and the United States do not independently set up nutrition departments, but set up multiple nutrition support groups in each clinical department. The group members include licensed physicians and registered dietitians who have obtained parenteral preparation qualifications. (Nutrition technician), nurse, pharmacist, inspector. Nutritionists (nutrition technicians) do not have the right to prescribe medicines, perform nutrition assessments, nutrient calculations, and nutrition follow-ups on patients, and work in nutrition support groups. The dietitian (nutrition technician) is responsible for the treatment of diet and the use of enteral nutrition (medical food).
In some Asian countries and regions, such as Japan, Taiwan, and Hong Kong, the general hospitals affiliated to the medical government have independent nutrition departments or nutritionists (nutrition technicians) who do not have the right to formulate drugs.
The Brazilian government-owned general hospital has independent clinical nutrition departments, nutrition clinics, and multiple nutrition support groups based on the nature of clinical departments. The group members include nutrition practitioners, nutritionists (nutrition technicians), pharmacists, and nutrition nurses. Nutrition practitioners dispose of enteral and parenteral nutrition.
Japan, Hong Kong, Taiwan and other Asian countries and regions have independent nutrition departments (sections) in general hospitals. Nutritionists (nutrition technicians) do not have the right to formulate medicines, and their business scope is basically the same as that of European and American countries.
(2) Ratio of nutrition doctors (nutrition technicians) to beds in general hospitals of the government.
Europe, the United States, and Japan, the situation is different in each country, the ratio of nutritionists (nutrition technicians) to beds is between 1:20 to 1:60, while Taiwan in China is between 1:80 to 1: 100.
(3) Clinical nutrition work model.
The working model of clinical nutrition in the United States includes clinical nutrition support groups and nutrition departments (hospital meals); the working model of clinical nutrition in the United States includes clinical nutrition support groups and community prevention and treatment (nutritionists); the working model of clinical nutrition in Canada and Taiwan in China is nutrition Departments, including the clinical nutrition group (outpatient, ward, community) and diet management group.
Under different clinical nutrition work models, clinical nutrition practitioners and their clinical (social) roles in different countries are different (see Table 1), but they all guide clinical nutrition treatment through clinical nutrition screening of inpatients.
| Table 1 List of clinical nutrition work models in the United States, Japan, Canada and Taiwan |
| United States | Japan | Canada / Taiwan |
| Operating mode | Nutrition Support Team Nutrition (Hospital Meal) | Nutrition Support Team Community Control (Nutritionist) | Nutrition Department: Includes clinical nutrition group (outpatient, ward, community) and diet management group |
| Practitioners | The nutrition support team consists of physicians, nurses, registered dietitians (nutrition technicians), pharmacists, and social workers; it is divided into nutritionists (nutrition technicians) (1: 60 beds) and dietitians (nutrition technicians) (1: 120) number of beds) | 400,000 nutritionists (2.4 times as much as clinicians), about 1:20 households, divided into management nutritionists (patient nutrition guidance) and nutritionists (community nutrition guidance) | Nutritionist (Nutrition Technician) 1: 100 beds; Bachelor degree or above, registration after clinical rotation is required |
| Clinical (social) role | Screening and assessment of nutritional risks; Develop and provide safe, reasonable and effective nutrition support programs | Parenteral and enteral nutrition support; community nutrition consultation, chronic disease prevention; nutrition-related disease surveillance | Screening and assessment of nutritional risks; formulating and providing safe, reasonable and effective nutrition support programs; community nutrition consultation, prevention of chronic diseases (4) talent training models for medical practitioners (nutrition), nutritionists (nutrition technicians). |
(4) Talent training model for practicing physicians (nutrition) and nutritionists (nutrition technicians).
Higher education institutions in major countries and regions around the world have set up nutrition majors to enroll undergraduate, master, and doctoral students. After graduation, students are certified by nutrition associations or related industry associations to obtain nutritionist qualifications and enter medical institutions to practice. After being certified by the Physician's Association, a licensed physician is qualified to use parenteral nutrition preparations and can enter the practice of a nutrition therapy group.
(5) Use of medical food.
Most countries abroad call enteral nutrition preparations medical foods or special purpose foods. Out-of-hospital patients purchase from the supermarket or pharmacy, medical insurance will not be reimbursed; the hospital is handled by a nutritionist (nutrition technician), and paid by medical insurance.
There is no classification of medical food in China. For some special reasons, very few foreign-funded enterprises have registered enteral nutrition preparations as medicines for sale in hospitals. There are a small number of domestic companies producing medical foods, which are treated by the nutrition department according to ordinary food through the canteen in the hospital.
| Table 2 Utilization of medical foods and payment of medical insurance in the United States, European Union, Japan, Canada and Taiwan |
| United States | EU | Japan | Taiwan / Canada |
| Name | Medical food (Medical foods) | Dietary foods for special purposes | Food for patients | Special nutrition food |
| Use range | | Foods specially designed to meet special nutritional requirements in special diseases, pathological disorders and medical conditions, such products must be used under the supervision of medical staff. | Used by nutritionists | Infant formula Patient foods, including protein, amino acid, fat or mineral foods, low-sensitivity, weight-replacement meals, tube feeding |
| Medical insurance benefits | The compensation system for hospital patients, nursing center patients, and home patients is not completely consistent; Some states only pay for tube feeding patients, while others also pay for oral enteral nutrition. | Inpatients: enteral nutrition and oral nutritional supplements are borne by the hospital; Home patient / care: paid by the medical insurance agency and only pays for tube feeding nutrition treatment and medically indicated oral nutritional supplements. | Enteral nutrition is a medicine used by physicians. Like food for patients, it can be reimbursed in hospitals and nursing centers for most, if not all. | Only pay for tube feeding nutrition treatment / tube feeding diet |
