Getting It Right First Time (GIRFT) is a national programme designed to improve the treatment and care of patients through in-depth review of services and benchmarking, and the presentation of a data-driven evidence base to support change. GIRFT has just finished a review of gastroenterology, and as gastroenterologists are responsible for the provision of many specialist nutrition services, the report includes a number of key findings for the nutrition community.
The review has found that the provision of nutrition support varies across Trusts:
- One in six Trusts has no nutrition support team at all
- 25% of Trusts have no dedicated nutrition specialist nurses
- Only 9% of gastroenterology specialist nurses are nutrition specialist nurses
These findings are extremely disappointing. The NICE clinical guideline CG32 on nutrition support for adults states that all acute hospital Trusts should employ at least one nutrition specialist nurse.
The GIRFT review also revealed variation in how Trusts screen patients to identify those who are suffering from or at risk of malnutrition. One of their recommendations was that Trusts should carry out screening more consistently.
The review also examined complications in nutrition support, namely PEG and TPN, and found variations in complications, mortality, and infection rates.
The GIRFT recommendations include improving nutrition support infrastructure, the use of dedicated vascular access nurses or nutrition specialist nurses to look after vascular access devices, and upskilling ward nurses, as well as co-locating patients needing parenteral support in a dedicated area of a ward or nutrition unit where practical.
The full GIRFT – Gastroenterology report is available to read here.