External Lab Testing and Diagnostics SOP
Registered Dietitian Nutritionists play a crucial role in promoting health and well-being through personalized nutrition plans and evidence-based guidance. The scope of practice for RDNs encompasses a wide range of responsibilities aimed at optimizing nutritional intake and supporting overall health outcomes, including:
Assessing laboratory profiles and other medical tests and procedures.
Ordering, recommending, performing, and/or interpreting test results related to nutrition status: blood pressure, anthropometrics, indirect calorimetry, laboratory tests, and waived point-of-care laboratory testing (eg, blood glucose, cholesterol).
Nourish Lab Testing and Diagnostics and Standards of Conduct
Per the Standards of Conduct in the Nourish Handbook (Section 5.1), dietitians affiliated with Nourish are strictly prohibited from profiting directly or indirectly from nutrition intervention recommendations (i.e. recommending third-party testing and diagnostic referrals or services).
Ensure you are qualified to interpret test results. For instance, if you recommend a troponin test, you should understand that it is used to both assess for inflammation as well as to detect heart damage in diagnosing myocardial infarction (MI).
If you are recommending lab tests (outside of what Nourish provides), inform the patient that these tests are provided by third-party companies, and they may receive a bill from those companies. Many patients appreciate that Nourish is covered by most commercial insurance plans, and a bill from a 3rd party might be confusing if they thought there was no patient responsibility.
Coordination of Care with Providers
When recommending laboratory testing—particularly tests not included in the Nourish lab panel—Registered Dietitian Nutritionists must coordinate care with the referring or existing medical provider.
Specifically, RDNs must:
Clearly communicate that laboratory tests require ordering and approval by a licensed medical provider.
Coordinate care with the referring or existing provider by sharing the rationale for recommended testing and how results may inform nutrition care. Please check our best practices for care coordination located here
Document provider coordination and communication in the interventions section of the chart note.
Professional Development
Nourish RDs wishing to increase their understanding of lab testing and diagnostics should:
1. Check the Clinical Reference Guides located in the Nourish portal under “ Internal Resources.” Most of the Guides include information on labs related to a particular disease state.
2. Collaborate with peers in Slack using the Slack Community Guidelines .
3. Collaborate with peers in Case Review Collaboration .
4. Utilize the Nourish Educational Fund to purchase educational materials such as courses, books, seminars, subscriptions or conference admission.