Barriers and Enablers to Delegating Malnutrition Care Activities to Dietitian Assistants

Alita Rushton, Judith Bauer, Adrienne Young, Heather Keller, Jack Bell

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)


Delegation of malnutrition care to dietitian assistants can positively influence patient, healthcare, and workforce outcomes. However, nutrition care for hospital inpatients with or at risk of malnutrition remains primarily individually delivered by dietitians—an approach that is not considered sustainable. This study aimed to identify barriers and enablers to delegating malnutrition care activities to dietitian assistants. This qualitative descriptive study was nested within a broader quality assurance activity to scale and spread systematised and interdisciplinary malnutrition models of care. Twenty-three individual semi-structured interviews were completed with nutrition and dietetic team members across seven hospitals. Inductive thematic analysis was undertaken, and barriers and enablers to delegation of malnutrition care to dietitian assistants were grouped into four themes: working with the human factors; balancing value and risk of delegation; creating competence, capability, and capacity; and recognizing contextual factors. This study highlights novel insights into barriers and enablers to delegating malnutrition care to dietitian assistants. Successful delegation to dietitian assistants requires the unique perspectives of humans as individuals and in their collective healthcare roles, moving from words to actions that value delegation; engaging in processes to improve competency, capability, and capacity of all; and being responsive to climate and contextual factors.

Original languageEnglish
Article number1037
Number of pages13
Issue number5
Publication statusPublished - 1 Mar 2022


  • Allied health personnel
  • Assistants
  • Delegation
  • Delivery of healthcare
  • Hospitals
  • Malnutrition
  • Nutritional support
  • Professional
  • Qualitative research

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