FOR JOINING AN ESTABLISHED NUTRITION SUPPORT TEAM FOR INTRODUCING A NUTRITIONAL SUPPORT SERVICE
This information has been produced in response to many individual requests for help. We hope you will find it useful. If you would like to make any comments about it please send them to:
Dr Sheldon Cooper
Chairman: Education and Training Committee
BAPEN
Sovereign Conference
Secure Hold Business Centre
Studley Road
Redditch
Worestershire B98 7LG
1. LOCAL NETWORKING
1.1 What should you join?
Nutrition Steering Committee - if one exists
1.2 Who should you contact and/or arrange to meet?
Chief Dietitian and/or Nutritional Support Dietitian and/or Chief Pharmacist responsible for parenteral nutrition
Clinicians
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gastroenterologist
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intensivist
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general physicians (consultants)
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general surgeons (consultants)
Nurses
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Directors of Nursing (Acute and Community Service)
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Senior Nurse
Clinical effectiveness and audit team
Medical librarian
Catering manager
Business manager
Laboratory staff
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biochemistry
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microbiology
BAPEN Regional Representatives
1.3 What should you consider?
What your involvement with these key staff will be
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How you can optimise communication
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What you can (realistically) offer each other
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Whether a ‘team’ away-day and/or SWOT analysis might be useful to discuss roles and activities
2. LOCAL INFORMATION
2.1 You should obtain any local policies, procedures, guidelines or careplans related to
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Screening for malnutrition
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Nutritional assessment
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Food handling/hygiene
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Feeding patients in hospital
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Enteral nutrition
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Parenteral nutrition (including policies for catheter insertion/use)
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Nutritional monitoring
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Antibiotic policy
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Infection control policy
2.2 It will be helpful for you to know the following
How is enteral feeding organised in the hospital?
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what products are used
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solutions
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delivery equipment
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feeding tubes
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pumps etc
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how they are reviewed
How is parenteral nutrition organised?
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what products are used
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solutions
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catheters
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pumps etc
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how they are reviewed
Who holds the budget in both the hospital and the community
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for enteral tube feeding
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for parenteral solutions
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for delivery systems
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for ancillaries
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for feeding lines/tubes
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for pumps
Who passes fine bore enteral tubes and what procedures are used
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hospital
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community
Who inserts PEG’s and replacements and what procedures are used
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hospital
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community
Who inserts parenteral feeding lines
Which meetings are important to attend
Whether any problems have been identified in the management of the artificial nutritional support service
3. RESOURCES
You would be well advised to find out what is available in terms of the following
clerical support
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access to computer facilities
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educational support (to attend meetings either as a team or individually)
4. ACTIVITIES
4.1 Start meeting regularly - if the team is not already doing this. If it is, make sure that you attend all the team meetings.
4.2 Collect data/information. Again, this may already be a team function. It is important to audit what you are doing with the aim of improving practice. Remember
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to keep it simple
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to share your results
5. USEFUL CONTACT INFORMATION
BAPEN
Chairman: Education and Training Committee
Dr Sheldon Cooper
Tel: 01384 244074
Email: Dr Sheldon Cooper
BAPEN office
Sovereign Conference
Secure Hold Business Centre
Studley Road
Redditch
Worcestershire
B98 7LG
Tel: +44 (0)1527 518777
Fax: +44 (0)1527 518718
Regional Representatives:
CLINICAL NUTRITION AND METABOLISM GROUP (CMNG) OF THE NUTRITION SOCIETY
The Nutrition Society
10, Cambridge Court
210, Shepherds Bush Road
London W6 7NJ
Tel: +44 (0)171 602 0228
Fax: +44 (0)171 602 1756
NB. Application forms can be downloaded from the website: www.nutsoc.org.uk
PARENTERAL AND ENTERAL NUTRITION (PEN) GROUP OF THE BRITISH DIETETIC ASSOCIATION
Membership Secretary
Ms Vera Todorovic (Secretary Judith Beeston)
Department of Nutrition & Dietetics
Bassettlaw District General Hospital
Kilton Hill
Workshop, Notts S81 0BD
Tel: +44 (0)1909 500990
NATIONAL NURSES’ NUTRITION GROUP (NNNG)
Chairman: Lynne Colagiovanni
Nutrition Nurse Specialist
Queen Elizabeth Hospital
Dept. of Nursing
University Hospitals
Edgebaston
Birmingham B15 2TH
Tel: +44 (0)121 472 1311 ext-2094
Pager: 1144
Email: lynne.colagiovanni@uhb.nhs.uk
or
Membership Secretary: Dawn Bromley
Nutrition Nurse Specialist
Medical Directorate
Ipswich Hospital
Heath Road
Ipswich
Suffolk IP4 5PD
Tel: +44 (0)1473 704218 (DDI & a'phone)
Pager: +44 (0)1473 712233 - bleep 517
Email: dawn.bromley@ipsh-tr.anglox.nhs.uk
PATIENTS ON INTRAVENOUS AND NASOGASTRIC NUTRITION (PINNT) THERAPY
Membership Secretary
Jackie Huff
5 Swansholme Gardens
Sandy
Bedfordshire SG19 1HJ
Tel: +44 (0)1767 225631
Email: pinntjackie@hotmail.com
BRITISH PHARMACEUTICAL NUTRITION GROUP (BPNG)
Rebecca White
Directorate Pharmacist
Surgery, Gastroenterology & Hepatology
Pharmacy Dept
Middlesex Hospital
Mortimer Street
London , W1T 3A
Tel: 0207 636 1195
Email: rebecca.white@uclh.org or rebecca@bpng.co.uk
6. BACKGROUND READING
You may want to read these in depth or just "dip" into them for general information.
6.1 Reports on various aspects of nutritional support
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Lennard-Jones J 1992
A positive approach to nutrition as treatment
Kings Fund, London -
Association of Community 1997
Hungry in Hospital?
Health Councils Association of Community Health Councils
30, Drayton Park
London N5 1PB -
BAPEN reports (all available from BAPEN, PO Box 922, Maidenhead, Berkshire SL6 4SH)
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Elia M 1994 - Enteral and parenteral nutrition in the community
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Lennard-Jones J 1998 - Ethical and legal aspects of clinical hydration and nutrition
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Pennington C R 1996 - Current perspectives on parenteral nutrition in adults
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Silk D B A 1994 - Organisation of nutritional support in hospitals
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Sizer T 1996 - Standards and guidelines for nutritional support of patients in hospital
6.2 Key Literature
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Bastow M D, Rawlings J, Allison S P
Benefits of supplementary tube feeding after fractured neck of femur: a randomised controlled trial
BMJ 1983 287 1589 - 1592 -
McWhirter J P, and Pennington C R
Incidence and recognition of malnutrition in hospital
BMJ 1994 308 945 - 948 -
Lennard-Jones J E, Arrowsmith H, Davidson C et al
Screening by nurses and junior doctors to detect malnutrition when patients are first assessed in hospital
Clinical Nutrition 1995 14 336 - 340
6.3 Text books, teaching packs
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Bond S - Eating matters
The Centre for Health Services Research
Newcastle upon Tyne, 1997
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Payne-James J , Grimble G, Silk D - Artificial Nutritional Support in Clinical Practice
Pub: Edward Arnold
London, 1995 -
Taylor S, Goodinson-McLaren SMG - Nutritional support: A team approach
Pub: Woolfe Publishing Limited
London, 1992 -
Todorovic V, Micklewright A - A pocket guide to clinical nutrition
Pub: British Dietetic Association
1997