The Home Based Primary Care (HBPC) Clinical Dietitian is a Dietitian serving as the medical nutrition expert. The clinical dietitian is responsible for independently planning, developing, and directing all nutritional care activities by applying evidenced-based nutrition practice guidelines for all assigned Veterans, including those with complex medical and nutritional needs.

Duties

The clinical dietitian will be involved in the professional practice of nutrition in accordance with the guidance set forth in Nutrition and Food Services (NFS) directives, policies and procedures, and VA regulations governing the practice of nutrition. The clinical dietitian may be scheduled and assigned to any nutrition practice area, and must possess the required knowledge and skills to perform the following functions: Nutritional Care: 1. Conducts a comprehensive nutrition assessment utilizing the Nutrition Care Process (NCP) for assigned patients. 2. Develops and implements an individualized plan for Medical Nutrition Therapy (MNT) to address the nutrition diagnosis in accordance with the patient's medical program goals and objectives. Documents MNT in the medical record using the Assessment, Diagnosis, Intervention, Monitoring, Evaluation (ADIME) format. 3. Performs a Nutrition Focused Physical Exam (NFPE) during assessments to determine risk and/or degree of malnutrition. 4. Calculates nutrient requirements (calories, protein, carbohydrates, lipids, vitamins, electrolytes and fluids) and necessary diet restrictions or food/drug interactions to each individual patient. 5. Evaluates patterns and relationships among data obtained and possible root causes for nutrition problems. 6. Tailors diet prescription to each individual patient according to physical and metabolic needs. With an understanding of the patient's health condition, designs the nutritional treatment plan with consideration for psychosocial, behavioral, physical activity, ethnic and cultural factors to obtain desirable outcomes and promote long term adherence to a medical nutrition care plan. 7. Prioritizes the importance of nutrition problems for optimal health, recovery from illness, management of chronic disease or disease prevention. Nutrition Education and Coordination of Care: 1. Assesses educational needs and provides nutrition education/counseling for individuals and groups, incorporating a learning approach that considers the cultural, religious, educational and medical situation of the patient. Includes information regarding budgeting, menu planning, food purchasing and preparation, food storage and sanitation. 2. Utilizes motivational interviewing techniques to evaluate patient and/or caregiver's readiness to learn and potential for changing behaviors. 3. Evaluates achievement of learning objectives by the patient and/or family. Adapts nutrition education materials and counseling techniques to the patient's level of understanding, which frequently involves simplifying complex dietary restrictions. 4. Identifies drug-nutrient interactions and drug-drug incompatibilities and counsels / communicates with the patient regarding the impact on nutrition status and/or nutrient utilization. 5. Utilizes virtual care technology such as VA Video Connect (VVC) and Secure Messaging (SM) to improve access to nutrition care. 6. Provides follow-up nutrition education/counseling in accordance with the patient's treatment goals and determines when a problem requires consultation or referral to another provider or service. Business Functions 1. Maintains productivity standards. Practices effective time management and prioritizing of tasks to ensure efficient workflow in assigned area. 2. Ensures completion of consult management tasks by reviewing assigned nutrition consults. Ensures appropriate scheduling and timely completion of all assigned consults. Participation as a Member of the Health Care Team: 1. Serves as the medical nutrition expert for medical staff on the nutritional management of patients. 2. Communicates and influences treatment interventions determined by the medical team through interdisciplinary meetings, team rounds, medical conferences and nutrition-related in-services. 3. Presents seminars, workshops, and lectures to convey current nutrition information on new and changing concepts. This includes the development and participation of in- service educational programs directed to members of interdisciplinary teams, various students, interns and Veterans and their family members. 4. Coordinates care with colleagues in a variety of medical and home settings to ensure appropriate transitions of care are addressed to meet the patient's needs. Professional Development 1. Maintains Registered Dietitian Nutritionist registration and continuing education requirements. 2. Interprets current clinical knowledge, standards of care, and research to improve patient care. Work Schedule: Monday - Friday, 8:00am to 4:30pm Telework: May be available with supervisor and Service approval Virtual: This is not a virtual position. Functional Statement #: 436-56609-A, 436-56610-A, 436-56611-A Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required.

Requirements

Qualifications

Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Registered Dietitian Nutritionist (RDN) or Registered Dietitian (RD) - Must be registered with the Commission on Dietetic Registration (CDR) the credentialing branch of the Academy of Nutrition and Dietetics formerly known as the American Dietetic Association (ADA). Exception for GS-07 and GS-09 Only: Dietitians who do not possess the RDN/RD credential. Non-credentialed Dietitians who otherwise meet the basic qualification requirements and have fulfilled the requirements below, but do not possess the RDN credential, may be given a full-time temporary appointment not to exceed one year under the authority of 38 U.S.C. § 7405(c)(2). May only be appointed at the GS-07 or GS-09 level and may not be promoted/converted until they obtain their RDN credential. Non-credentialed Dietitians must have fulfilled each of the following: Earned a bachelor's or higher degree from a U.S. regionally accredited college or university or foreign equivalent. Foreign Education: To be creditable, college and/or university degrees earned outside the U.S and its territories must be evaluated by ACEND® and meet ACEND®'s International Dietitian Education standards which are designed to provide graduates with the knowledge and competencies to sit for the CDR credentialing exam. ~AND~ Completed an ACEND® accredited experiential or supervised practice program and provide a verification statement from the program director that conveys eligibility to take the CDR registration exam as a prospective RDN. A list of ACEND® accredited programs are located on the ACEND® website or at ACEND Accredited Programs Directory. Current VHA Dietitians that qualify based on being covered by the Grandfathering Provision may not be promoted to a higher grade if they do not meet the current RDN/RD requirements. Grade Determinations: Grade Determinations: Dietitian (Clinical), GS-07. Experience or Education. None beyond the basic requirements. Dietitian (Clinical), GS-09. Experience. At least one year of experience equivalent to the next lower grade level. OR Education. Master's degree from a regionally accredited university or college. AND Knowledge, Skills and Abilities. In addition to the experience or education above, the candidate must demonstrate the following KSAs: (a) Knowledge of various accrediting and regulatory requirements. (b) Knowledge of virtual technology to provide nutrition care. (c) Ability to deliver patient care using the NCP (e.g., assessment, diagnosis, intervention, monitoring and evaluation). (d) Ability to apply evidence-based nutrition practices to improve patient outcomes. (e) Ability to develop patient-centered goals. (f) Ability to collect data for performance improvement studies. (g) Ability to collaborate with stakeholders. Dietitian (Clinical), GS-11. Experience. At least one year of experience as an RDN equivalent to the next lower grade. AND Knowledge, Skills and Abilities. In addition to the experience above, the candidate must demonstrate the following KSAs: (a) Skill in delivering patient care using the NCP (e.g., assessment, diagnosis, intervention, monitoring and evaluation). (b) Skill in interpreting research to apply evidence-based nutrition practices to improve patient outcomes. (c) Skill in developing patient-centered goals. (d) Skill in analyzing data for performance improvement studies. (e) Skill in collaborating with stakeholders. (f) Ability to comply with various accrediting, regulatory and agency authorities. References: VA Handbook 5005 Part II Appendix G20 Physical Requirements: Refer to VA Handbook 5019 for pre-placement examination requirements. Dietitian (Clinical) providing HBPC must possess a current, valid, and unrestricted drivers license in order to operate a government owned vehicle.

Education

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

ACEND® accredited programs are located on the ACEND® website or at ACEND Accredited Programs Directory.

Contacts

• Address Fort Harrison VA Medical Center 3687 Veterans Drive Fort Harrison, MT 59636 US
• Name: Luis Fuentes Jr.
• Phone: 801-582-1565 X4405
• Email: [email protected]