M-9, r. 12.0001 - Regulation respecting certain professional activities that may be engaged in by dietitians

Updated to 24 September 2020

This document has official status.

chapter M-9, r. 12.0001

Regulation respecting certain professional activities that may be engaged in by dietitians

Medical Act

(chapter M-9, s. 19, 1st par., subpar. b).

DIVISION I PURPOSE

O.C. 1167-2018, Div. I.

1. The purpose of this Regulation is to determine, among the professional activities that may be engaged in by physicians, those that, under certain prescribed terms and conditions, may be engaged in by dietitians.

O.C. 1167-2018, s. 1.

DIVISION II AUTHORIZED ACTIVITIES

O.C. 1167-2018, Div. II.

2. Dietitians may, where a prescription indicates that nutrition is a determining factor in the treatment of an illness, as part of the determination of the nutritional treatment plan, prescribe

(1)  nutritional formulas, vitamins and minerals to ensure the nutritional needs are met;

(2)  enteral feeding material necessary in the nutritional treatment plan; and

(3)  the pancreatic enzyme solution used to restore the functionality of a feeding tube.

Dietitians engage in the activities provided for in the first paragraph in accordance with the provisions applicable to individual prescriptions provided for in the Règlement sur les normes relatives aux ordonnances faites par un médecin (chapter M-9, r. 25.1).

O.C. 1167-2018, s. 2.

3. Dietitians may administer, according to a prescription, medications or other substances, orally or enterally, as part of the determination of the nutritional treatment plan and during the monitoring of the nutritional status of persons whose nutritional treatment plan has been determined.

O.C. 1167-2018, s. 3.

4. Before prescribing nutritional formulas, vitamins and minerals or administering a prescribed medication, dietitians must

(1)  ensure that there are no contra-indications or drug interactions; and

(2)  ensure to obtain the medical assessment of the patient’s state of health.

O.C. 1167-2018, s. 4.

5. Dietitians must enter in the patient’s record the nutritional formula, vitamins and minerals, enteral feeding material or pancreatic enzyme solution prescribed and the reasons for which they are prescribed or for which the dosage is changed. They must also enter the name of the prescribed medications they administer.

Dietitians must also enter in the record the follow-up required following their interventions.

O.C. 1167-2018, s. 5.

6. Dietitians must communicate, to the attending physician or professionals concerned who are responsible for the follow-up of the patient’s condition, the name of the nutritional formulas, vitamins and minerals and the pancreatic enzyme solution they prescribed.

In the absence of an attending physician, dietitians must establish, before their interventions, the follow-up and management of the patient.

O.C. 1167-2018, s. 6.

7. Dietitians may permanently remove a feeding tube under a prescription.

O.C. 1167-2018, s. 7.

DIVISION III TRAINING

O.C. 1167-2018, Div. III.

8. To engage in the activities referred to in this Regulation, dietitians must, as the case may be, meet the following conditions:

(1)  for the purpose of prescribing the nutritional formulas, vitamins and minerals referred to in section 2, hold an attestation issued by the Ordre professionnel des diététistes-nutritionnistes du Québec according to which they have successfully completed 15 hours of theoretical training on

(a)  indications for the prevention and treatment of conditions that require nutritional formulas, vitamins and minerals;

(b)  drug and nutritional interactions and contra-indications;

(c)  dietary reference intakes (DRIs) and tolerable upper intake levels (UL) of vitamins and minerals; and

(d)  the standards for writing a prescription;

(2)  for the purposes of the permanent removal of the feeding tube referred to in section 7, hold an attestation issued by the Ordre professionnel des diététistes-nutritionnistes du Québec according to which they have successfully completed 15 hours of training on

(a)  theoretical training on

i.  the types of tubes, sterile material and removal methods;

ii.  the immediate contra-indications for removing a tube;

iii.  the interventions and follow-up required after the removal of the tube, including referral to another professional where required;

iv.  the potential complications associated with the removal of a tube and the associated signs and symptoms;

(b)  practical training on

i.  tube removal methods;

ii.  hygiene and application of a clean method;

iii.  monitoring and identification of signs and symptoms of potential complications;

(3)  where dietitians do not practise in the clinical nutrition sector or have not acquired competence in that sector of activity, they must take refresher training whose content and number of hours are determined by the Ordre professionnel des diététistes-nutritionnistes du Québec.

O.C. 1167-2018, s. 8.

9. (Omitted).

O.C. 1167-2018, s. 9.

REFERENCES

O.C. 1167-2018, 2018 G.O. 2, 4462

S.Q. 2020, c. 15, s. 73