What Does a Registered Dietitian Nutritionist (RDN) Really Do in the Hospital? More Than You Realize!
When you think of an RDN in a hospital, what comes to mind? Are they crunching numbers and counting macros? Are they in the kitchen whipping up gourmet meals? Or are they focused on food safety and regulations? While an RDN can absolutely be involved in all these areas, their role in today's hospital setting is so much more dynamic — and it’s growing rapidly!
Over the years, the role of the RDN has expanded to not only improve patient outcomes but also enhance hospital profitability and boost patient satisfaction. This transformation is not just a win for patients — it’s a win for the entire healthcare team!
So, What’s Changed? The Modern RDN Role Explained
The world of healthcare has become more complicated, and with it, the responsibilities of RDNs. At Sodexo, we’re committed to ensuring RDNs are empowered to practice at the top of their credentials, allowing them to step into new roles that benefit both patients and the healthcare facility. From improving patient care to reducing burdens on overworked staff, here's how RDNs are making a significant impact in the hospital:
1. Nutrition Focused Physical Examinations (NFPE): Directly Identifying Malnutrition
Malnutrition is a medical complication that increases severity of illness, expected risk of adverse outcomes, and cost of care. RDNs identify this medical condition with evidenced-based criteria that includes a physical assessment of the patient. RDNs are uniquely trained in conducting the NFPE to evaluate all areas of the patient’s body for fat and muscle loss as well as clinical signs of nutrient deficiency. Along with a comprehensive assessment of a patient’s food intake and weight changes over time, the NFPE conducted by the RDN strengthens the credibility of the malnutrition diagnosis. RDN documentation is necessary to support the diagnosis of malnutrition and billing processes.
2. Bedside Swallow Evaluations: More Than Just Food
Did you know RDNs can perform bedside swallow evaluations? This is an essential part of identifying swallowing difficulties early, which can prevent dangerous conditions like aspiration pneumonia, malnutrition, and dehydration. By detecting swallowing problems sooner, RDNs can quickly recommend modified diets, texture changes, or refer patients to a speech-language pathologist for further treatment. This timely intervention helps patients heal faster and stay safe while eating.
3. Placing Feeding Tubes: Quick, Efficient, and Effective
In many hospitals, RDNs are trained to place feeding tubes* when the need for enteral nutrition is identified. Feeding tube placement is within the scope of RDN professional practice and can reduce the care burden of registered nurses and physicians given their limited time, heavy patient loads, and frequent staffing shortages.1 This allows the nurses and physicians to concentrate on other areas of medical treatment that require their specialized training. It also means there are fewer delays in critical interventions, improving patient care. When RDNs lead in the placement and monitoring of tube feedings, there’s better coordination of care, ensuring consistency in nutrition therapy for patients.
4. Nutrition Informatics: Applying Technology to Improve Clinical Outcomes
Patient nutrition software, used to manage and place patient meal orders, is an essential patient safety tool. It aligns food provision with individual patient medical needs including current diet orders, food allergies, nutrition supplements, and restrictions (such as fluids and nutrients). Information Technology (IT) RDNs have an understanding of the complexities of computer software programs along with clinical nutrition principles. This ensures the proper nutrition components are met to transmit crucial patient information to the frontline teams in real time. The IT RDNs are important members of a healthcare facility’s clinical, operational, and patient safety teams.
The evolving RDN role brings a comprehensive approach to patient care. It's not just about the meals - it’s about the entire nutrition care process.
RDNs in these expanded roles are not just “one more team member” — they’re integral to the success of the entire healthcare team.
Their ability to quickly assess and intervene in nutrition-related issues helps to lighten the load for nurses, doctors, and other specialists, fostering more collaboration and less stress on the medical staff.
Bedside NFPE assessments for malnutrition directly impact recovery through timely nutrition interventions, contributing to better patient outcomes and quicker discharge.
With RDNs performing key roles like swallow evaluations and feeding tube placement, healthcare facilities benefit from cost savings due to fewer delays and reduced need for specialized tests.
IT RDNs are at the forefront of technological advancements, ensuring the highest standards of patient safety for nutrition provision.
The Bottom Line: A Win for Patients, RDNs, and Healthcare facilities
The role of the RDN in today’s healthcare setting is about much more than food—it’s about delivering timely, targeted care that directly impacts patient outcomes, improves hospital profitability and enhances the overall healthcare experience. Whether it's preventing aspiration pneumonia, placing feeding tubes, or providing nutritional guidance, RDNs are at the forefront of improving both patient satisfaction and hospital efficiency.
In short, hospital nutrition care is being transformed by the expanded role of the RDN. This greatly benefits the patient, the RDN, and the entire healthcare system.
References:
- Yeganehjoo M, Johanek J. Role of registered dietitians in nasoenteric feeding tube placement. Nutr Clin Pract. 2023;38(6):1225-1234. doi:10.1002/ncp.11071
- Powers J, Brown B, Lyman B, et al. Development of a competency model for placement and verification of nasogastric and nasoenteric feeding tubes for adult hospitalized patients. Nutr Clin Pract. 2021;36:517–533. https://doi.org/10.1002/ncp.10671
*Depending on state licensure and institutional privileges. Clinician competency is essential and ranges from proficient to expert level RDNs.2