Background: Registered dietitian nutritionists (RDNs) use the Nutrition Care Process and its Terminology (NCP/T) to generate outcomes and demonstrate the impact of medical nutrition therapy. Despite integration into education in 2009, many RDNs continue to face challenges in its application. Objective: This study aimed to identify barriers and enablers to NCP/T use to better understand how adoption can be improved, and to assess whether qualitative feedback from practicing RDNs aligns with quantitative findings from the 2017 International Nutrition Care Process and Terminology Implementation Survey (INIS). Design: An explanatory sequential mixed-methods approach was used. Quantitative data was from United States based RDNs who participated in the 2017 INIS. The focus group discussion questions were informed by the INIS study and grounded in the Theory of Planned Behavior (13). Zoom technology (14) was used and all the discussions were audio recorded. Only participants and the interviewer were present on the call. Qualitative data from the focus group discussions included RDNs in clinical, community, and academic settings. Semantic thematic analysis was conducted to identify themes related to barriers and enablers to using NCP/T. Participants/setting: INIS study recruitment utilized email lists, e-newsletters, and social media groups; responses from 4,426 active RDNs were analyzed. Focus group inclusion criterion was active RDNs based in the US; 38 RDNs participated in the focus groups. Statistical analyses performed: Cross-tabulation identified correlations between barriers/enablers and characteristics such as years of practice and practice setting ( p < 0.05). Results: INIS data showed an association between practice area, years of experience, and NCP/T use ( p < 0.001). Enablers included peer support (59% of clinical RDNs, 60.3% of RDNs with 0–5 practice years) and job requirements (52.9% of clinical RDNs, 55.2% of those with 0–5 years). Barriers included limited time (28.9% of clinical RDNs, 29.4% with >16 years) and insufficient education (25% of clinical RDNs, 29.8% with >16 years). Focus groups identified additional enablers, such as integrating NCP/T into Electronic Health Records, and barriers, including eNCPT subscription access. Conclusion: The INIS study and focus groups revealed consistent barriers and enablers, underscoring the need for authoritative state-of-the-art training to address these factors and enhance NCP/T utilization.

The purpose of this study was to compare differences in Nutrition Care Process (NCP) confidence and documentation quality across two different undergraduate student cohorts. This quasi-experimental trial was conducted with n = 29 total undergraduate dietetic students (2023 cohort), then compared with results from the previous years’ (2022) cohort (n = 43). NCP confidence was measured before and after students completed traditional case studies (time 1 and time 2) and after completing an ANDHII case study using an electronic and interactive NCP documentation platform (time 3) for each cohort, then compared between cohorts. Documentation quality was measured using a validated audit tool. In the 2023 cohort, confidence increased from time 1 to time 3 (p = 0.003). Comparison of the 2022 and 2023 cohorts found no significant difference in confidence scores. In the 2023 cohort, documentation quality was higher for the ANDHII (obesity) case study compared to the traditional (anemia) case study.

The objective of this study was to explore if using ANDHII improves NCP confidence and documentation quality. This quasi-experimental trial was conducted with n = 43 undergraduate dietetic students. NCP confidence was measured before and after a traditional case study, and after an ANDHII case study. Documentation quality was measured using a validated quality audit tool. Confidence increased from time 1 to time 2 (p = 0.008), and from time 2 to time 3 (p = 0.003). Documentation quality was higher for the ANDHII documentation compared to the non-ANDHII documentation (p < 0.001) but lower when compared to the traditional ADIME (p = 0.03). Familiarizing students with ANDHII improved NCP confidence. Opportunities exist to improve ANDHII functionality and positively impact documentation quality.