Committee & SIG Updates

British Intestinal Failure Alliance (BIFA)

Jeremy Nightingale, Chair BIFA

Email: jeremy.nightingale@nhs.net

Website: www.bapen.org.uk/about-bapen/committees-and-groups/bapen-special-interest-groups/bifa

BIFA promotes the best practice for the care of patients with type 2 intestinal failure (IF) and those receiving home parenteral nutrition (HPN). It does this by providing a multidisciplinary forum for communication, education and shaping the development of national IF/HPN services. It provides guidelines on the care of these patients and has representatives from the committee involved with national IF/HPN service developments.

Key outputs 2016/2017

1. British Intestinal Failure Alliance (BIFA) Position Statement on Home Parenteral Nutrition (HPN) – click here.
2. Spot audit of Hospital IF in the UK presented as poster at ESPEN. Culkin A, Gabe SM, Nightingale JM, on behalf of the British Intestinal Failure Alliance. (2016). Point prevalence of intestinal failure and home parenteral nutrition in the UK. How are patients getting home? Clin Nutr Suppl.; 35(1): S61.
3. Two sessions at Annual BAPEN meeting in Brighton. One presentation was from Ursula Peaple of NHS England.
4. Input into HPN framework and NHS National Framework Agreement for the Supply of Home Parenteral Nutrition (HPN) Stakeholder group (agrees contracts between NHS England and the Home care company providers for HPN in England).
5. Input into the IF Service Review Clinical Working Group.

Documents to complete and future work

1. Finalising documents ‘Home parenteral nutrition (HPN) for patients with advanced malignancy’ and ‘Use of peptide growth factors to treat patients with intestinal failure’.
2. Producing a guideline about the use of high dose loperamide in patients with a short bowel in view of the recent awareness of cardiac problems with high doses.
3. To write for ‘In Touch’ a series of ‘Top tips’ for common parenteral nutrition/IF situations. For example, Management of a high output stoma, abnormal liver function tests, re-entering a hostile abdomen, central vein thrombosis, how to send a patient home on HPN, how to maintain growth in children, catheter-related sepsis and small bowel transplantation.
4. BIFA has two sessions at the BAPEN meeting one on catheter-related sepsis with a debate about catheter salvage, and the other on Hot topics (includes EDS hypermobility) and a case discussion.

BIFA always welcomes opinions and views about IF/HPN and on future projects that it may undertake on behalf of BAPEN.

 

Nasogastric Tube Special Interest Group (NG SIG)

Mia Small, Chair NG SIG

Email: mia.small@nhs.net

Website: www.bapen.org.uk/about-bapen/committees-and-groups/bapen-special-interest-groups/ng-sig

The NG SIG is now a year old. It is co-chaired by Dr Trevor Smith, Consultant Gastroenterologist (Southampton) and Mia Small, Nurse Consultant (St Mark’s). The core committee comprises physicians, nurses and dietitians, and there is representation from adult and paediatric practice, acute and community, and also Scotland and Wales.

Since its first formal meeting in March 2017, committee members have been working on three workstreams:

1. Clinical evidence group
2. Thematic analysis of Never Events (UK).
3. Novel technologies and equipment evaluation (utilising NICE Technologies Appraisal Guidance).

There will be an update on the groups work at the BAPEN Conference in November 2017, where the results of a Survey Monkey into NG practice will be shared. Questions included what pH cut off value trusts use and whether or not single or double checking is undertaken. There will also be the presentation of some in-depth analysis on pH indicators in light of the Merck indicators no longer being distributed. This includes inter rater reliability and also if the time taken to read the indicator affects the result obtained.

The planned thematic analysis of Never Events is taking longer than anticipated, but the group hope to be able to share the findings early in 2018.

In addition, the development of novel technology to assess pH measurement is reaching the stage of being able to be evaluated alongside standard practice in the clinical arena which, if successful, would provide a more objective assessment of determining if the pH value of an aspirate was within the acceptable range to use a tube.

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