International Journal of Science and Research (IJSR), India Online ISSN: 2319-7064

The Role of Dietitian in Nutrition Service at King

Khalid Hospital: Case Study
Shadia Mohamed Idris1, Nada Al Jannakl2
1, 2
University of Hail/KSA

Abstract: Purpose: this study aim to identify and evaluate the role of dietitian in nutrition service at king Khalid hospital and set
recommendation related to nutrition. Method: 2 questionnaires summated to collect information concern the role of dietitian from King
Khalid hospital. Result: There are no enough dietitians in hail to manage the disease that have relation to nutrition. Conclusion: this
study concludes that the role of dietitian is very important. Hail community over (600.000 ppl) need more qualified dietitian to provide
proper nutrition services at hospital and even in the community health.

Keywords: Dietitian, Nutrition services, Community, Health

1. Introduction Nutritionists develop nutrition programs, supervise the

preparation of meals and ensure that the proper meals are
Dietitians are experts in food and nutrition. They advise served, according to the Bureau of Labor and Statistics.
people on what to eat in order to lead a healthy lifestyle or Besides providing guidance on what to eat, nutritionists also
achieve a specific health-related goal. Dietitians work in recommend what not to eat to prevent diet-related
various capacities in the field of healthcare, foodservice, conditions like obesity and heart disease. Most states require
corporate setting, and educational arenas. (1) nutritionists to become certified. Nutritionists can attain
certification through the Clinical Nutrition Certification
1.1 Roles of Dietitians Board. (3)

A dietitian has numerous roles to fill. No matter what your 1.3 Types of Dietitians
interests are surrounding food and nutrition, there is a career
in dietetics that is right for you. A career in dietetics will 1.3.1 Clinical Dietitians
enable you to use your strengths and skills everyday in order Clinical dietitians help hospital patients and the elderly in
to teach others about the importance of healthy eating and nursing care facilities by determining their nutritional needs.
good nutrition. They work in team with doctors and healthcare
a) Identifying nutrition problems and assessing the professionals to develop appropriate nutritional
nutritional status of patients in a clinical setting. programming for patients.
b) Developing diet plans and counseling patients on
special diet modifications. Clinical dietitians help hospital patients and the elderly in
c) Assessing, promoting, protecting, and enhancing the nursing care facilities by determining their nutritional needs.
health of the general public in a community setting and A clinical dietitian may also work at correctional or
providing strategies for prevention of nutrition-related psychiatric institutions. They work in tandem with doctors
diseases. and healthcare professionals to develop appropriate
d) Managing a cost effective food production operation, nutritional programming for patients, track their progress
distributing high quality meals/snacks, and monitoring and report important findings. If you experience a stay in a
sanitation and safety standards in a food service hospital or nursing care setting, that stay will likely include
setting. a meeting with the facility's nutritionist. Clinical
e) Operating private consulting practices to provide nutritionists are responsible for planning dietary treatment
expertise in nutrition, as well as promote health and programs for patients in hospitals, nursing homes,
prevent disease retirement communities, prisons and ambulatory facilities
f) Working with individuals, groups, workplaces and and providing therapeutic nutritional care, education and
media to provide dietary advice for healthy living. counseling in accordance with established procedures and
g) Working with food and pharmaceutical companies to regulatory requirements. States have specific laws regarding
provide research, develop products, educate requirements for education, registration, certification and
consumers, and promote and market better food and licensure to practice as a clinical nutritionist. You may
nutritional products in a business setting. specialize in enteral and parenteral nutrition, diabetes,
h) Teaching nutrition, food chemistry, or food service cancer, kidney disease or other conditions. (5)
administration to students in any health profession and
at all levels of education. (2) (3) 1.3.1.1 Nutritional Counseling

1.2 Main Role The primary role of a clinical nutritionist is to counsel

patients on their nutritional health and advise them of
The role of a nutritionist is to advise and work closely with dietary changes to make to manage their medical conditions.
individuals or groups on planning what foods to eat. Clinical nutritionists are part of a health team and confer
with physicians on the diagnosis and treatment protocol
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prescribed to determine what diet is most appropriate. 1.3.3 Community Dietitians

Communication is a key skill required to provide services. Community dietitians work closely with individuals and
Clinical nutritionists who can speak multiple languages, community groups to promote healthy lifestyles and help
especially Spanish, are in biggest demand among health care prevent diseases. They typically work for community health
organizations nationwide. (6) care organizations or in-home health agencies, which cater
to the disabled and the elderly. Community dietitians can
1.3.1.2 Nutritional Assessment review and evaluate your dietary needs, and then help with
Nutritional assessment is a critical part of the job because setting grocery shopping lists and teaching you how to
morbidity and mortality increase when an ill patient is prepare nutritious meals in the home.(13)
malnourished or has a deficiency or excess of one or more
nutrients, impaired absorption of nutrients or imbalance of 1.3.4 Consultant Dietitians
nutrients. A routine nutritional assessment involves Consultant dietitians operate on a freelance basis and are
determining the patient's diet; medical and family history; contracted by individuals, groups or health care
and data such as height, weight, fat and lean muscle organizations. Many consultant dietitians operate their own
composition, and blood pressure. A more in-depth clinic, where they can perform nutrition screenings and run
nutritional assessment involves performing a physical exam a number of dietary tests to help determine the needs of their
and conducting and evaluating a series of biological tests patients. (15)
that may include blood sugar, cholesterol, fat, proteins, such
as liver enzymes, vitamins and minerals. Clinical Much of a consultant dietitian's work focuses on weight-
nutritionists may also review laboratory tests ordered by the loss-oriented programming. As a consultant, a dietitian can
physician.(6) (7) also work with food service companies to evaluate sanitary
conditions and develop a menu.
1.3.1.3 Diet Recommendations
After conducting and evaluating a nutritional assessment of
Dietitian is a term sometimes used to describe dietitians who
the patient, the clinical nutritionist is able to identify
work under contract with health care facilities or in private
nutritional problems and recommend a dietary meal plan to
practice, such as used in Canada and the United States. The
coincide with the physician's treatment protocol. The dietary
term 'consultant' in this case should not be confused with the
meal plan includes the amount of calories from proteins,
identical title reserved for certain medical doctors in
carbohydrates and fats, the types and quantities of foods and
countries such as the United Kingdom and Ireland. (14) (16)
portion sizes. The clinical nutritionist discusses these
recommendations with the patient and physician before
prescribing the diet and sharing the plan with the food Consultant dietitians contract independently to provide
service manager of the institution who is responsible for nutrition services and educational programs to individuals
preparation and the meal service. The American Dietetic and health care facilities as well as sports teams, fitness
Association encourages clinical nutritionists, particularly clubs, supermarkets, and other health and nutrition-related
those who provide care for the aging population, to businesses. (19)
implement an individualized nutrition intervention plan that
balances the patient's desires for food preferences with 1.3.5 Community Dietitians
medical needs and focuses on patient quality of life, Community dietitians work closely with individuals and
according to research by registered dietitian Kathleen community groups to promote healthy lifestyles and help
Niedert, published in the "Journal of the American Dietetic prevent diseases. They typically work for community health
Association" in 2005. Clinical nutritionists may adjust the care organizations or in-home health agencies, which cater
diet plan as the patient's health progresses or if certain foods to the disabled and the elderly.
may interfere with any prescribed drugs. (10)
Community dietitians work with wellness programs, public
1.3.1.4 Supplement Recommendations health agencies, home care agencies, and health
Clinical nutritionists may also prescribe nutritional maintenance organizations. These dietitians apply and
supplements for patients who are deficient in a particular distribute knowledge about food and nutrition to individuals
nutrient or who benefit from the supplement in the and groups of specific categories, life-styles and geographic
management of their condition. Clinical nutritionists discuss areas in order to promote health. (19)
this with the physician and pharmacist to determine any
potential adverse interactions with drug therapy. Patient They often focus on the needs of the elderly, children, or
response to supplements prescribed is monitored throughout other individuals with special needs or limited access to
the course of treatment. (11) healthy food. Some community dietitians conduct home
visits for patients who are too physically ill to attend
1.3.2 Management Dietitian consultations in health facilities in order to provide care and
Management dietitians work for large organizations, such as instruction on grocery shopping and food preparation.
schools, prisons and company cafeterias, planning and
overseeing food preparation. These dietitians hire and train 1.3.6 Management dietitians
other dietitians and food service workers. They are Management dietitians work for large organizations, such as
responsible keeping a budget and purchasing the food, schools, prisons and company cafeterias, planning and
equipment and supplies. They must make sure the sanitary overseeing food preparation. These dietitians hire and train
and safety regulations are met. (11) (12). other dietitians and food service workers. They are
responsible keeping a budget and purchasing the food,
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equipment and supplies. They must make sure the sanitary Dietitians' expertise in nutrition is often solicited in the
and safety regulations are met. (17) media — for example providing expert guest opinion on
television and radio news or cooking shows, columnist for a
1.3.7 Gerontological dietitians newspaper or magazine, or resource for restaurants on
Gerontological dietitians are specialist in nutrition and recipe development and critique. Business dietitians may
aging. They work in nursing homes, community-based aged author books or corporate newsletters on nutrition and
care agencies, government agencies in aging policy, and in wellness. They also work as sales representatives for food
higher education in the field of gerontology (the study of manufacturing companies that provide nutritional
aging). supplements and tube feeding supplies. (12) (18)

1.3.8 Neonatal dietitians 1.4 Required Qualifications and Professional

Neonatal dietitians provide individualized medical nutrition Associations
therapy for critically ill premature newborns. They are
considered a part of the Neonatal Intensive Care Unit's In most countries, competent performance as a dietitian
medical team. The neonatal dietitian performs clinical requires formal training at a higher educational institution in
assessment of patients, designs nutrition protocols and food and nutritional science, nutrition education, dietetics,
quality improvement initiatives with the medical team, or a related field. Their education in health science involves
develops enteral and parenteral regimens, helps establish scientific based knowledge in anatomy, chemistry,
and promote lactation/breastfeeding guidelines and often biochemistry, biology, and physiology.
oversees the management of infection prevention in the
handling, storage, and delivery of nutritional products.(10) While the specific academic and professional requirements
to becoming a fully qualified dietitian differ across countries
1.3.9 Pediatric dietitians and jurisdictions, as these are adapted to the needs of the
Pediatric dietitians provide nutrition and health advice for individual countries and the opportunities available,
infants, children, and adolescents. They focus on early common academic routes include:
nutritional needs, and often work closely with doctors,  A Bachelor degree in Dietetics which typically requires
school health services, clinics, hospitals and government four years of postsecondary studies; or
agencies, in developing and implementing treatment plans  A Bachelor of Science degree and a postgraduate
for children with eating disorders, food allergies, or any diploma or master's degree in Dietetics.
condition where a child’s diet factors into the equation, such
as childhood obesity.(10) In addition, dietitians may be required to undergo an
internship to learn counseling skills and aspects of
1.3.10 Research Dietitians psychology. The internship process differs across countries
Research dietitians are involved with dietetics-related and jurisdictions. (19) (21). Associations for dietetics
research conducted in hospitals, universities, government professionals exist in many countries on every continent
agencies, food and beverage companies, and the
pharmaceutical industry. They may conduct research in
2. Results and Discussion
clinical aspects of nutrition, for example, the effects of diet
on cancer treatment. They may focus on social sciences or
Table 1: Socio-demographic characteristics of respondents
health services research, for example, investigate the impact
(n) %
of health policies or behaviour change, or evaluate program
effectiveness. They may survey foodservice systems
Characteristics Total
management in order to guide quality improvement. Some Sample Size 2(100%)
research dietitians study the biochemical aspects of nutrient Age Groups (year) 35-45 2
interaction within the body. In universities, they also may Sex Male 0
have teaching responsibilities. Some clinical dietitians' roles Female 2
involve research in addition to their patients care workload. Education Higher education 0
(20) University 2 (100%)
Specialization Clinical nutrition 2
1.3.11 Administrative Dietitians Experience 10/More 2
Administrative or management dietitians oversee and direct
all aspects of food policy and large-scale meal service Table 1: Show the Socio-demographic characteristics of
operations in hospitals, government agencies, company respondents in this study their age between (35-45yrs) were
cafeterias, prisons, and schools. They recruit, train and female, with education up to university, specialized on
supervise employees of dietetics departments including clinical nutrition, more than ten experiences in their work.
dietitians and other personnel. They set department goals,
policies and procedures; purchase food, equipment and 3. Interview
supplies; maintain safety and sanitation standards in food
preparation and storage; and keep records to monitor areas This is results when the researcher interviews the two
such as budget control and client information. (18) dietitians in King Khalid hospital. According to the type of
work, both of them work as clinical dietitian on the hospital.
1.3.12 Business Dietitians Clinical dietitians help hospital patients and the elderly in
Business dietitians serve as resource people in food and nursing care facilities by determining their nutritional needs.
nutrition through business, marketing and communications. They work in team with doctors and healthcare
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 International Journal of Science and Research (IJSR), India Online ISSN: 2319-7064

professionals to develop appropriate nutritional [2] U.S. Bureau of Labor Statistics: Occupational Outlook
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Nutritionists..
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[19] International Confederation of Dietetic Associations.
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 Increase number of employed dietitian in the hospital Author Profile

 Providing advance training courses for dietitian in the
hospital Shadia Mohamed Idriss Bakheit received the B.Sc., M.Sc., PhD,
 Enable dietitian to participate on researches. degree in Home Science/Nutrition from Ahfad university for
women, university of Khartoum-Sudan, 1989, 1997, and 2000,
respectively. She worked at Khartoum Teaching Hospital Sudan
References 1990-1997, University of Juba, College of Community Studies &
Rural Development 1997-2011, University of Bahri-Sudan 2011.
[1] World Health Organization. Classifying health She worked now, as Assistant professor at university of Hail-
workers. Geneva, World Health Organization, 2010. Saudi Arabia-department of clinical nutrition

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