Nebraska Revised Statute 38-1821

Chapter 38


Licensed dietitian nutritionist; licensed nutritionist; practice requirements; authorized activities; limitations.

(1) A licensed dietitian nutritionist or a licensed nutritionist, unless otherwise exempt, shall:

(a) Provide medical nutrition therapy using evidence-based practice and the nutrition-care services process for patients and clients in clinical and community settings for the purpose of treatment or management of a diagnosed medical disease or medical condition. The nutrition-care services process involves application of the scientific method to medical nutrition therapy and consists of four distinct, but interrelated, steps of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation;

(b) Use specialized knowledge and skill to apply the systematic problem-solving method to make diagnostic judgments when providing medical nutrition therapy for safe, effective, and high-quality care; and

(c) Use critical thinking to collect relevant data, determine nutrition diagnosis based upon interpreted data, establish patient and client goals, determine a nutrition plan and interventions to solve the problem, and evaluate the effectiveness of interventions and progress toward the desired goals or outcomes.

(2) A licensed dietitian nutritionist or a licensed nutritionist may:

(a) Accept or transmit written, verbal, delegated, or electromagnetically transmitted orders from a referring provider consistent with the Medical Nutrition Therapy Practice Act and rules and regulations adopted and promulgated pursuant to the act and with any controlling protocols established to implement medical nutrition therapy;

(b) Recommend and order patient diets, including therapeutic diets, oral nutrition supplements, and dietary supplements, in accordance with the Medical Nutrition Therapy Practice Act and the rules and regulations adopted and promulgated pursuant to the act. Therapeutic diets may include oral, enteral, or parenteral nutrition therapy. Enteral and parenteral nutrition therapy consists of enteral feedings or specialized intravenous solutions and associated nutrition-related services as part of a therapeutic diet and shall only be ordered, initiated, or performed by a licensed dietitian nutritionist or licensed nutritionist who also meets one of the following criteria:

(i) The licensee is a registered dietitian nutritionist;

(ii) The licensee is a certified nutrition support clinician certified by the National Board of Nutrition Support Certification; or

(iii) The licensee meets other requirements demonstrating competency as determined by the board in evaluating and ordering enteral and parenteral therapy and administering enteral therapy;

(c) Order medical or laboratory tests related to nutritional therapeutic treatments;

(d) Implement prescription drug dose adjustments for specific disease treatment protocols within the limits of such licensee's knowledge, skills, judgment, and clinical practice guidelines pursuant to any applicable and controlling facility-approved protocol and as approved and delegated by the licensed prescriber, physician, or other authorized health care provider who prescribed the drug or drugs to be adjusted. Nothing in this subdivision shall be construed to permit individuals licensed under the Medical Nutrition Therapy Practice Act to independently prescribe or initiate drug treatment. A licensed dietitian nutritionist or a licensed nutritionist may recommend and order or discontinue vitamin and mineral supplements; and

(e) Develop, implement, and manage nutrition-care services systems and evaluate, change, and maintain appropriate standards of quality in food and nutrition-care services.

(3)(a) Nothing in this section shall be construed to limit the ability of any other licensed health care professional to order therapeutic diets if ordering therapeutic diets falls within the scope of practice of the licensed health care professional.

(b) Nothing in this section shall be construed to limit the ability of persons who are not licensed dietitian nutritionists or licensed nutritionists from providing services which they are lawfully able to provide.