Dietitian and Nutrition Manager Roles and Work Hours in BC Adult Community Care Facilities

Dietitian and Nutrition Manager Roles and Work Hours in BC Adult Community Care Facilities

In February 2002, licensing nutritionists and community nutritionists with licensing responsibilities in British Columbia conducted a province-wide survey to examine the roles and hours of dietitians and nutrition managers working in adult (seniors) community care facilities licensed for 25 beds or more. It was hoped that the results would provide useful baseline information that could be used to monitor change over time and to help establish standards for best practice. Changes to the Adult Care Regulations were imminent and it was anticipated that the workload of both the dietitians and the nutrition managers would be impacted.

Currently, a community care facility licensed for 25 beds or more must provide the services of a dietitian, and at 50 beds or more, the added services of a nutrition manager must be provided. It is possible for the dietitian also to assume the role of the nutrition manager.

Findings re: registered dietitians/nutritionists (RDN)

A total of 102 dietitians and 75 nutrition managers participated in the survey. Facility size varied from 30 to 120 licensed beds, with an average of 94 beds. In the survey, the average number of minutes of dietitian time spent was reported as 11 minutes per resident per week. In the Adult Care Regulation, Section 7.1 Guidelines, although there is no specification for hours, the British Columbia Dietitians’ and Nutritionists’ Association (BCDNA) recommends a minimum of registered dietitian/nutritionist time of 15 minutes per resident per week. Nine of 102 dietitians worked in their facilities full time. These were often the dietitians working both as the clinical dietitian and the nutrition manager. All others worked part time. For dietitians who reported overseeing other departments, on average, 77 % of their time was spent on clinical nutrition functions, 19.3 % was spent on food service administration and 3.7 % of time was spent on other support service areas.

The top five activities of the dietitian were as follows: participation in care conferencing, liaison with nursing, liaison with care staff, nutrition care planning and monitoring, liaison with administration.

Findings re: nutrition managers

Of the 75 nutrition managers (non-dietitians) surveyed, 50% worked full time; the average number of hours was 33.1 per week. Of those hours, 78.4 % of time was spent managing foodservice administration, and 24.4 % overseeing other services such as laundry, housekeeping and maintenance. Fifty percent of the nutrition managers surveyed felt they had adequate time to manage and supervise food services. The reported number of minutes of nutrition manager time was 21 minutes per resident per week. However, many facilities produced extra meals for their broader community such as Meals-on-Wheels programs and congregate meals for seniors.

What we learned in the process

We had a terrific response rate to our survey and thus we ended up with lots of data! In fact, we ended up with too much data to handle. In hindsight, we realize that facility issues are very complex and that a complex survey is unable to elicit the information that we wanted to access. We should have gone with the KISS model. If we were to do a similar survey in the future, we would enlist the assistance of a statistician and a clerical support person. We would be very specific about objectives, choosing one or two very clear objectives. We would design a limited number of simple questions to get at those few objectives. We realized too late that there are so many unusual circumstances in facilities that it was difficult to answer complex questions, and that what we assumed in writing a question was not the same as what the person filling out the survey might assume! We would also pilot the survey with a select few facilities, revise and then survey the larger group. We would also not ask dietetic interns to collate the data; rather we would try to recruit a graduate student with a background in statistics. The main reason is that there was a lot of data and it needed someone with a statistical background to go through it. Thank you to the two Gerontology Nutrition Society dietetic interns 2002, Ginni Budlong and Mary Jessome for their efforts to summarize the data. We can’t begin to thank Liang Ting (Joyce) Chang, MSc (Human Nutrition) who volunteered countless hours analyzing our results and organizing it in a manner that made sense to us. Finally, a special thank you to all the dietitians and nutrition managers who took the time to complete the survey and provide us with this much needed information.

Submitted by Community Nutritionists Council of British Columbia Standing Committee on Licensing.

Contact Information:

Christine Chou, RDN

Fraser Health Authority

Delta, BC

(604) 507-5481

Copyright Dietitians of Canada Spring 2004

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