Introduction
The Nutrition Care Process is a well-known framework used in dietetic practice, which focuses on systematic problem-solving to assist with the development of evidenced-based nutrition interventions.1 Despite many benefits associated with this framework, there are numerous barriers to the successful implementation of nutrition care process terminology (NCPT).2

Objectives
The primary research question was to determine the main barriers and facilitators for implementing NCPT in dietetic practice. The secondary objective was to provide recommendations to improve support for NCPT implementation and evaluation.

Methods
A literature search was conducted from November to December 2018 using the following databases: PubMed, Scopus, and OVID Medline. The inclusion criteria was research focusing on the implementation and/or evaluation of NCPT. Exclusion criteria included non-English articles and papers published before 2005, as this was the year that the Academy of Nutrition and Dietetics invited Canada to adopt the NCPT framework.1 Studies were organized based on inclusion of NCPT implementation, evaluation, or both. Key barriers and facilitators to NCPT implementation and future recommendations were summarized.

Results
•  12 studies met the inclusion criteria: U.S.A (n=6), Australia (n=3), Sweden (n=2), Switzerland (n=1)
•  Main facilitators were project champions with change management experience and group-based learning.
•  Major barriers included a lack of support, time, and knowledge related to NCPT implementation.
•  Recommendations for improvements were ongoing training and education for registered dietitians (RDs) to improve the quality of their documentation, and additional research to evaluate the impact of NCPT on nutrition care outcomes.

Conclusions
Continual education is required to support RDs with effectively incorporating NCPT into their practice. Moreover, further research is warranted to justify the validity and reliability of NCPT application, particularly in the Canadian healthcare context.

Significance to the Field of Dietetics
The present study may help enhance current NCPT implementation strategies, and serve as a guide for subsequent research to evaluate the impact of NCPT on patient care.

Barriers and Facilitators to the Implementation of Nutrition Care Process Terminology in Dietetic Practice