Hassan W E
J Am Diet Assoc. 1977 Apr;70(4):355-60.
Malpractice is today's sword of Damocles threatening not only physicians but the entire health care community. For dietitians--clinical and administrative alike--there are a number of areas which could be sources of litigation involving negligence or lack of competency. Is the right therapeutic diet served to the right patient at the right time? A word to the wise would be: Always have records to substantiate professional judgments and actions, even though this means increased paper work. Another potential pitfall--which could result in revocation of licensure or accreditation--involves the standards of the Joint Commission on Accreditation of Hospitals (JCAH). Is scrupulous attention being paid to the JCAH's principles and four standards for dietetic practice? Violation of, for instance, Standard II relating to sanitation practices could bring about sanctions by the local or state health agency. Labor laws, too, have implications for dietitians. The recent change in the Taft-Hartley law brings hospitals under the jurisdiction of the National Labor Relations Board. Care must be taken not to violate its regulations. The federal Occupational Safety and Health Act is also concerned with sanitary and working conditions of employees. In contrast to such restrictive legislation, however, is the Health Professions Educational Assistance Act of 1976 which opens up new educational opportunities from which dietitians could benefit.
医疗事故如今犹如达摩克利斯之剑，不仅威胁着医生，也威胁着整个医疗保健界。对于营养师——无论是临床营养师还是行政营养师——有许多领域都可能成为涉及疏忽或能力不足的诉讼源头。是否在正确的时间为正确的患者提供了正确的治疗饮食？给明智者的一句话是：始终要有记录来证实专业判断和行动，尽管这意味着文书工作会增加。另一个潜在的陷阱——可能导致执照或认证被吊销——涉及医院评审联合委员会（JCAH）的标准。是否严格遵守了JCAH的原则和饮食实践的四项标准？例如，违反与卫生规范相关的标准II可能会受到地方或州卫生机构的制裁。劳动法对营养师也有影响。塔夫脱-哈特利法案最近的变化将医院纳入了国家劳动关系委员会的管辖范围。必须注意不要违反其规定。联邦《职业安全与健康法》也关注员工的卫生和工作条件。然而，与这种限制性立法形成对比的是1976年的《卫生专业人员教育援助法》，该法案为营养师带来了可以从中受益的新教育机会。
