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CDR Connection— Winter 2020

Commission on Dietetic Registration
Chair / Advanced Practitioner in Clinical Nutrition Representative
Beth Taylor, DCN, RDN-AP, LDN, CNSC, FCCM
Vice Chair
Kathryn Lawson, MS, RDN, CD
Public Member
Micheal W Giles, BA, MA, PhD

Members
Elizabeth (Lisa) S Abbay, RDN, LDN, FAND
Nancy DiMarco, PhD, RDN, CSSD, FACSM
LeGreta Hudson, MS, RDN, LD, CDE
Kellene Isom, MS, RD, LDN
Young Hee Kim, MS, RD, LDN, CNSC, FAND
Valaree Williams, MS, RD, CSO, LDN, FAND
CDR DTR Representative
Amanda R Coufal, BS, NDTR
Newly Credentialed Practitioner Representative 
Samantha Reilly, MS,  RD
Board Certified Specialist Representative
D. Travis Thomas, PhD, RDN, CSSD, LD, FAND

The Commission on Dietetic Registration is pleased to share this Winter 2020 edition of its newsletter, CDR Connection: Power Your Future! In this issue we are highlighting:

  • CDR National Election
  • New Case Studies in Health and Wellness Coaching and Telehealth
  • New Critical Thinking Tool Self-study Requirement
  • Obtaining an National Practitioner Identification Number
  • And More!

We hope that you find this newsletter informative and helpful!

To view past issues go to cdrnet.org/connection

Beth Taylor, Chair
Commission on Dietetic Registration

 

Remember To Vote!

All CDR credentialed practitioners are eligible to vote

The 2020 Election will be held February 1–15, 2020. 

CDR's 2020 Commissioner Slate of Candidates can be viewed hereLearn more about the qualifications and skill sets for the CDR positions by clicking here.

As a reminder, candidates are able to begin campaigning January 18, 2020. The Academy’s National Campaign Rules can be viewed here.  Academy Nominating Committee members, Eileen Myers and Mary Russell, presented a webinar on December 10 to inform members about the changes to the campaign rules and how to take an active role in the election process. For those of you who were unable to attend the live webinar, you may view the recorded session on the election website.

CDR credentialed practitioners, RDs and DTRs, elect CDR Commissioners for three-year terms on an annual basis. Every year the CDR Nominating Committee distributes a call for nominations to all CDR credentialed practitioners. The Nominating Committee reviews all nominations and develops a slate of candidates. The candidate slate is distributed to all CDR credentialed practitioners in February of each year. Election results are reported annually in late February. As a credentialed practitioner it is very important that you participate in the election process.

Since 1990, an elected DTR member has served on the Commission. A Board Certified Specialist and an Advanced Practitioner in Clinical Nutrition credentialed practitioner are also included on CDR's board since the implementation of these certification programs. A public representative has held an appointed position on CDR since 1984 and has full rights and privileges. Beginning in June 2006, a newly credentialed registered dietitian serves in an appointed position on the Commission for a two-year term. In all, the Commission currently consists of 9 members, 10 who are RDs, 1 of whom is newly credentialed, 1 DTR and 1 public representative.


Did You Know?

NEW Case Studies in Health and Wellness Coaching and Telehealth

CDR has collaborated with the Academy Quality Management Committee to provide funding in support of five case studies.   Case Studies are tools for credentialed nutrition and dietetics practitioners to use for reference in applying the scope of practice to promote quality nutrition and dietetics practice. Case studies provide the necessary guidance, resources, and options that can be used to evaluate whether the RDN or NDTR can safely and effectively provide care and services. The five (5) new open access case studies in health and wellness coaching and telehealth are:

  • RDNs and Health and Wellness Coaching- explores whether health and wellness coaching is within a Private Practice RDN’s scope of practice as well as incorporating coaching techniques into MNT counseling is within his or her scope of practice. 
  • NDTRs and Health and Wellness Coaching- outlines an Outpatient NDTR’s discovery on whether health and wellness coaching is within his or her scope of practice. Overviews items such as RDN supervision, and NDTR autonomy.
  • RDNs Delivering Telehealth Nutrition-Related Services in Hospital Outpatient Setting- follows a Hospital Outpatient RDN unearthing whether providing MNT via telehealth is within his or her scope of practice. This Case Study also provides Role Examples of RDNs practicing telehealth such as Private Practice RDN, Veteran Affairs RDN, and International RDN.
  • RDNs Delivering Telehealth Diabetes Care and Education-Related Services- investigates whether a Hospital System RDN, CDE’s ability to see patients through telehealth is within his or her scope of practice.
  • NDTRs Delivering Telehealth Nutrition-Related Services- walks through if providing nutrition education via telehealth is within an Outpatient NDTR’s scope of practice. Reviews topics such as RDN supervision, and NDTR autonomy.

Find the NEW Case Studies here.


CDR News Highlights

PDP Essential Practice Competencies Webinars

The CDR Competency Assurance Panel collaborated with the Academy’s Quality Management Committee on the development of dietetics practice competencies and performance indicators. These competencies and performance indicators replaced the current learning need codes for the Professional Development Portfolio recertification system in 2015 beginning with new registrants whose registration begins on or after June 2, 2015 and current registrants beginning their June 1, 2016 recertification cycle. An article describing the development and validation of the practice competencies was published in the June 2015 Journal of the Academy of Nutrition and Dietetics.

The Competency Assurance Panel is currently reviewing and revising the Practice Competencies. The revised competencies will be validated over the coming year and implemented in June 2021.

  • Register for the February 7, 2020 Essential Practice Competencies   webinar, at  this link: https://eatright.webex.com/eatright/onstage/g.php?MTID=e810b799c6b6d62329426d37e2c1ef061
  • Future Webinar Dates (the link to register will be sent via email & will be posted on the website a month prior to the webinar):
    • February 7, 2020 – 12: 00 pm to 1:30 pm CT
    • March 5, 2020 – 12:00 pm to 1:30 pm CT
    • April 17, 2020 – 12:00 pm to 1:30 pm CT

To access past recorded webinars, go to the “Essential Practice Competencies Information for Practitioners” page on CDR’s website at the following link https://www.cdrnet.org/competencies-for-practitioners

This page also includes other practice competencies related resources for students, educators and practitioners.


NEW! CDR Critical Thinking Tool Self-Study Requirement

Since the inception of CDR’s continuing professional education registration maintenance program in the early 1970’s the approval criteria for continuing professional education has included a requirement that continuing professional education be beyond entry-level for the profession. This has been interpreted to exclude activities targeted to the lay public. CDR recognized that although professionals may learn new information from a variety of resources including those originally designed for a lay audience, they must employ critical thinking skills in order to evaluate and apply new learning to enhance their practice competency.

After communications with providers regarding appeals related to the beyond entry-level requirement, the Commission on Dietetic Registration Competency Assurance Panel (CAP) made the motion to remove the language that all CPE activities be “beyond entry-level” from the current CPE approval criteria and replace it with “relevant to knowledge, skills, behavior and attitudes of professional dietetics practice.” In order to assess that CPE activities are meeting the new standards, CAP motioned to modify the current Self-Study criteria to include a requirement for a separate critical thinking tool for all self-study products.  The critical thinking tool includes that practitioners record how they will apply what they learned to improve knowledge, skills, behavior and attitudes.

Providers must include CDR's Critical Thinking Tool as a required component of all prior approved self-study products and self-study products offered by CDR Accredited Providers, effective for programs approved or re-approved on or after January 1, 2020. Practitioners will be required to include the Critical Thinking Tool in their audit materials for recertification cycles that start on or after June 2, 2020.


Obtaining an National Practitioner Identification Number (NPI)

The NPI is a unique, 10-digit, identification number for health care providers, practitioners, and suppliers of health care services. The NPI is an important means of demonstrating a viable workforce of qualified providers and practitioners to payors and other external stakeholders.

All credentialed nutrition and dietetics practitioners (RDNs and NDTRs) should have an individual NPI regardless of work environment, employment status, or whether claims are submitted to payers.

The NPI can be used everywhere, so if an individual works at more than one practice location or setting, that individual does not need to get two NPIs. An NPI does not expire or deactivate, unless the individual deactivates it.

For more information go to the following link: Obtaining an National Practitioner Identification Number


CMS Approves Inclusion of Malnutrition Quality Measures

Once again, the Academy of Nutrition and Dietetics has exciting news to share about the Malnutrition Quality Improvement Initiative (MQii)!  We are pleased to announce a significant win for registered dietitian nutritionists and the Academy. The Centers for Medicare & Medicaid Services has approved inclusion of the Malnutrition Quality Measures into two Qualified Clinical Data Registries (QCDRs) for RDNs to participate for 2020 in the Merit-Based Incentive Payment System (MIPS). Malnutrition Quality Measures included in the Premier Clinician Performance Registry and the U.S. Wound Registry will promote health care team collaboration with measures for physician and RDN reporting.  The measure includes physicians reporting with the referral to an RDN of preoperative patients who are identified to be at risk for malnutrition and appropriate diagnoses of malnutrition; RDNs directly report completed nutrition assessments with recommendations/interventions for patients identified to be at risk for malnutrition. Increasing the availability of measures that are relevant for RDN reporting in the QCDR MIPS documents standardized malnutrition care tying performance to Medicare payments and recognizes Malnutrition Quality Measures as vital in advancing evidence-based, high-quality care.  More information will be available in early 2020.


Special Journal Supplement on Malnutrition

As a complement to the Academy's September Spotlight on Malnutrition, the September issue of the Journal of the Academy of Nutrition and Dietetics features a special supplement on the prevention and treatment of malnutrition, ‘Malnutrition Quality Improvement Initiative Yields Value for Interdisciplinary Patient Care and Clinical Nutrition Practice’. Articles describe opportunities to improve the overall quality of patient care, enhance quality clinical outcomes and reduce health care costs. Much of the information was provided by the Malnutrition Quality Improvement Initiative, a project of the Academy, Avalere Health and other stakeholders.  Access the Malnutrition - MQii Supplement


NEW Quality Improvement Practice Tips and Infographic 

The Quality Strategies Infographic brochure provides an overview of six Quality Strategies resources as well as key information about the National Quality Strategy and its aims and opportunities for RDN and NDTR involvement.  The Practice Tips: Getting Started with Quality Improvement is a comprehensive step-by-step guide for RDNs and NDTRs to implement quality improvement in practice settings. The 7 steps review quality improvement basics, tools, case studies and Quickinars. Quickinars or QI Virtual Huddles are presented by our Academy Quality Leader Alliance (QLA) members who utilize Virtual Huddles for networking on quality initiatives.  A “Quickinar” was designed to present QLA members’ QI projects in a 30 minute timeframe. The following six (6) Quickinars on various topics are available detailing the application to RDNs and NDTRs and their roles in various practice areas.  Learn more

  1. A Multidisciplinary Quality Improvement Project Nutritional Status in Adults with Cystic Fibrosis
  2. Improving Nutritional Screening in an Acute Care Hospital
  3. Establishing RD Baseline and Continued Competence
  4. Implementation of an RD Job Ladder
  5. Implementation of Malnutrition Documentation in an Academic Medical Center
  6. Enculturing Bedside Shift Report Using PDSA Methodology

Being Added in 2020 to the ‘Quickinar’ collection are:

  • Malnutrition Diagnosis and Documentation by MDs
  • International Dysphagia Diet Standardization Initiative (IDDSI) Journey from Plan to Implementation
  • Increasing Percentage of Pediatric Patients with Diabetes Who See an Outpatient Dietitian Annually
  • Optimizing Use of a Patient Safety Event Reporting System to Include Data from Root Cause Analyses

Updated Definition of Terms List

The Definition of Terms List (DoT List) was updated in September 2019. The Academy definitions serve as standardized language for RDNs and NDTRs to guide individual scope of practice and to apply in various practice settings. The list now includes revised terms, definitions, and key considerations for: Credentialed Nutrition and Dietetics Practitioner, Evidence-Based Practice, and Evidence-Based Dietetics Practice. The Academy Definition of Terms List is located on the Academy webpage www.eatrightpro.org/scope.


NEW! Scope of Practice Decision Algorithm

The Scope of Practice Decision Algorithm is an open access self-evaluation resource that provides a series of questions for RDNs and NDTRs to answer to determine if a desired activity is within his or her individual scope of practice. Resources with links are included to help inform decision-making. The Algorithm replaces the Scope of Practice Decision Tool. Find at www.eatrighpro.org/scope.  


Advanced Practitioner in Clinical Nutrition Certification- because clinical nutrition is who you are and not just what you do

The perfect opportunity to advance your credential is right around the corner with the April 2020 exam administration. Online eligibility applications are due March 2, 2020.

Last year, CDR made several changes to the Advanced Practitioner in Clinical Nutrition certification program:


Update to CDR’s Approved Certifications Claimed for Continuing Education

CDR awards CPE credit for professional certifications (not RD or DTR) offered by CDR or other recognized certification providers.

CDR has revised criteria for determining the number of CPE credits awarded for the completion of an approved certification. CPE credits are now assigned  based on the minimum degree and/or credential required for eligibility to obtain the certification. The full listing of certifications can be found here.

Minimum Credential and/or Education Requirements for Other Certifications Other Certification Maintenance Requirement – (by re-examination or CPE) CPEUs Awarded for CDR Recognized Professional Credentials
RD and/or MS  Re-examination
every five years
75 CPEUs
RD and/or MS CPE 50 CPEUs
BS or BA CPE  40 CPEUs
HS or AS CPE 25 CPEUs

This change will be phased in over five years beginning with the CDR recertification cycle starting June 2, 2019. CDR credentialed practitioners will be able to log the assigned CPE credits for the approved certifications towards consecutive CDR recertification cycles. Please note that all CDR credentialed practitioners must also complete one CPE credit addressing ethics in addition to the certification.

This new policy will affect RDs and DTRs beginning with recertification cycles listed below:

New RDs and DTRs

  1. Beginning June 2, 2019–Ending May 31, 2025

Recertifying RDs and DTRs

  1. Beginning June 1, 2020–Ending May 31, 2025
  2. Beginning June 1, 2021–Ending May 31, 2026
  3. Beginning June 1, 2022–Ending May 31, 2027
  4. Beginning June 1, 2023–Ending May 31, 2028
  5. Beginning June 1, 2024–Ending May 31, 2029

Continuing Professional Education Approval Criteria

CDR has revised the current continuing professional education approval criteria to require that all continuing professional education activity types (excluding academic coursework) addressing diet and nutrition topics, include an RD or DTR in program planning*. This policy change is effective for continuing professional activities offered on or after June 1, 2018 and for CDR credentialed practitioners recertifying beginning a new recertification cycle on or after June 2, 2018.

*Academic Coursework, and CPE activities offered by American Board of Medical Specialties (ABMS), American Academy of Family Physicians (AAFP), American Academy of Nurse Practitioners (AANP), American Academy of Physician Assistants (AAPA), Organizations accredited by the Accreditation Council for Continuing Medical Education (ACCME), Organizations accredited by the Accreditation Council for Pharmacy Education (ACPE), American Nurses Credentialing Center (ANCC), American Psychiatric Association (APA), American Psychological Association (APA), American Public Health Association (APHA), pharmacy, dentistry, and speech language pathology societies and associations are excluded from this requirement.


New Online Assess and Learn Module

A new online Assess & Learn module entitled, The Role of Nutrition in Health Promotion and Prevention, is now available at www.cdrcampus.com. In this module there are five case scenarios, each addressing one of the five levels of the social ecological model. The scenarios are interrelated to reinforce the concept that CDR credentialed practitioners can address primary prevention of overweight and obesity through many diverse approaches. The scenarios also demonstrate the interconnectedness of RDs’ work across a community and the need for RDs to be players and leaders at all levels and in all sectors of society. The content provided for any one level is not intended to be a comprehensive assessment of competencies for that level, but the knowledge, competencies and skills assessed across all five levels will give CDR credentialed practitioners a good sense of their role in the social ecological approach to nutrition in health promotion and disease prevention.

Cost: $64.99 for 7 CPEUs.

Questions? Please email cdrcampus@eatright.org


Ethics CPE Requirement

What is the ethics requirement?

As a part of their recertification, RDs and DTRs are required to complete at least 1 hour of continuing education related to the topic of ethics during each 5-year cycle.

There is no one single activity that you must complete to satisfy this requirement, as long as a continuing education program's content is primarily about a matter of professional ethics and how it relates to your practice. This can be either a live or self-study activity though one should be mindful that all self-study activities must be either: CDR Prior Approved, offered by a CDR Accredited Program Provider, or have approval from a similar credentialing body, such as the ACCME or the ANCC (click here for a full list).

You will be unable to submit your Activity Log without including at least 1 CPEU of Ethics.

Some helpful links:

You can find ethics-related activities by searching the CPE Online Database, which compiles all activities that have been prior approved, or offered by CDR Accredited Providers.

If you are a member of the Academy of Nutrition and Dietetics you will be able to access some complimentary CPEUs by reading the following ethics-related articles from the Journal of the Academy of Nutrition and DieteticsClick here to access ethics resources.


Dietetic Technician, Registered Marketing Initiative

CDR has initiated a marketing initiative to promote the value of the DTR credential to employers and Didactic Program in Dietetics (DPD) program directors. During focus groups with educators and dietetic technicians, DPD program directors were identified as a primary target audience for the bachelor’s degree, DPD program graduate. A promotional poster highlighting the many practice roles for credentialed dietetic technicians and promotional brochures highlighting the dietetic technician role in different practice settings, school nutrition, public health, acute care and long-term care are available via PDF on CDR’s website (cdrnet.org/opportunities) or by contacting CDR at 800/877-1600, 5500 to request copies.

Dietetic Technician registry growth statistics have remained static in 2018 and 2019 after seven years of steady growth. CDR is hopeful that this marketing effort will positively impact registry growth. Please visit the CDR website at the following link for more information cdrnet.org/opportunities.


Upcoming Certificate of Training Programs

Certificate of Training in Obesity Interventions for Adults

May 14-15, 2020
Rochester, New York

For registration information and to view the certificate requirements, timeline, and registration deadlines: cdrnet.org/obesity-interventions

Certificate of Training in Childhood and Adolescent Weight Management

March 16-18, 2020
New Orleans, Louisiana

For registration information and to view the certificate requirements, timeline, and registration deadlines: https://www.cdrnet.org/weight-management-childhood-adolescent-program

If you are unable to attend one of these live programs, why not check out one of our Obesity Intervention Self-Study products. Learn more

Coming in June 2020, newly aligned pediatric and adult weight management program

Certificate of Training in Obesity in Pediatrics

Certificate of Training in Obesity in Adults

June 24-26, 2020
Portland, Oregon

October 14-16, 2020 (Pre-FNCE 2020)
Indianapolis, Indiana 

Visit the CDR website in February 2020 for an update.


Don't forget to check out the "Resources" tab on our website for free information for all credentialed practitioners!

Activities listed in CDR’s CPE Online Database are all prior-approved by CDR.


Commission on Dietetic Registration
Staff Contact Information - 1/800-877-1600

Christine Reidy, RD - Executive Director, ext. 4857

Pearlie Johnson-Freeman, MBA - Director, Credentialing Services, ext. 4849

Kay Manger-Hague, RD - Director - Credentialing Operations, ext. 4777

Rebecca Beavers – Sr. Manager, Registration Eligibility Services, ext. 4781

Elaine Butler - Sr.  Manager, Credentialing Services, ext. 4718

Chris Kralik - Sr. Manager, Monitoring and Compliance, ext. 1742

Jessica Rapey, RD - Sr. Manager of Professional Assessment, ext. 4816

Samantha Sullivan - Sr. Manager of Professional Development, ext. 4715

Kim White, RD - Sr. Manager of Professional Assessment, ext. 4758

Marka Ambrose - Manager, Credentialing Services, ext. 4849

Sean Asberry - Manager, Communications Technology & Applications, ext. 4706

Hallee Brennan - Manager, Professional Development, ext. 1739

Alyssa De La Pena, RD - Manager, Professional Development, ext. 4741

Tracy Strong - Manager, Examination & Licensure, ext. 4859

Kelly Kim - Manager, Professional Development, ext. 4830

Julie Gyondla-Wood, RD - Manager, Professional Assessment, ext. 4724

Roxanne Way Carter - Manager, Credentialing Operations, ext. 4749

Tiffany Welch - Manager, Registration Eligibility Services, ext. 4764