British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients (GIFTASUP)
Published 2008 (updated 2011), Chair: Jeremy Powell-Tuck
On behalf of BAPEN Medical (a core group of BAPEN), the Association for Clinical Biochemistry, the Association of Surgeons of Great Britain and Ireland, the Society of Academic and Research Surgery, the Renal Association and the Intensive Care Society.
Nutritional Support for Adults and Children. A handbook for hospital practice.
Published: 2004; Editor: Tim Bowling
This book was written in response to a brief from BAPEN Council to practical support in clinical nutrition and addresses the dearth of knowledge about clinical nutrition and nutrition support in hospitals. It is aimed at all professions involved in a nutrition support (dietitians, doctors, nurses and pharmacists).
Home Parenteral Nutrition in the United Kingdom. A Position Paper
Published: 2003; Dr Barry JM Jones, Home Parenteral Nutrition Officer, BAPEN
Guidance on drug administration via enteral feeding tubes
Administering Drugs via Enteral Feeding Tubes. A Practical Guide
Published: 2003 (updated 2004)
The A3 poster is suitable for use on the ward or in clinics. The flow diagram provides a step by step guide for safe drug administration via this route. The poster also includes basic information on legal implications, health and safety and drug interactions.
Current Perspectives on Paediatric Parenteral Nutrition
Published: 2000; Chairman and Editor: Professor PJ Milla
This report provided up to date information on current practice in paediatric parenteral nutrition.
Issues covered included:
- the role of, and indications for, parenteral nutrition in childhood
- constituents of PN, micronutrient requirements and pharmaceutical considerations
- routes of delivery of nutrients
- complications and monitoring, with particular reference to the role of the nutrition support team
- organisation of home parenteral nutrition
Current Perspectives on Enteral Nutrition in Adults
Published: 1999; Chairman and Editor: CA McAtear
This document was released to provide up-to-date information on current practice in enteral feeding with the aim of assisting the development of local policies and procedures.
Issues covered include:
- why patients should be fed enterally
- which patients should be fed enterally
- how to estimate a patient’s nutritional requirements
- route and tube options for enteral feeding
- the types of feed available for enteral feeding and when each should be used
- monitoring patients on enteral feeding
- complications of enteral feeding and and recommendations for management
Hospital Food as Treatment
Published: 1999; Chairman and Editor: Dr SP Allison
Ethical and Legal Aspects of Clinical Hydration and Nutritional Support
Published: 1998; Chairman and Editor: Professor J Lennard-Jones
Current Perspectives on Parenteral Nutrition in Adults
Published: 1996; Chairman and Editor: Dr CR Pennington
Standards & Guidelines for Nutritional Support of Patients in Hospitals
Published: 1996; Chairman and Editor: T Sizer
Home Parenteral Nutrition - Quality Criteria for Clinical Services and the Supply of Nutrient Fluids and Equipment
Organisation of Nutritional Support in Hospitals. Nutrition steering committee and nutrition support teams – needs, structure and roles
Published: 1994; Chairman and Editor: Dr DBA Silk
Enteral & Parenteral Nutrition in the Community
Published: 1994; Chairman and Editor: Dr M Elia
Accreditation of meetings
Assignments of “Educational Merit” for Courses/Events Related to Nutritional Support
Education is a discipline with its own curriculum. Any organisation wishing to assign educational "value" to its activities must, therefore, conform with existing guidance and regulations to attract academic credibility. The following descriptions provide an insight to the various options that are currently available.
Continuing professional development (CPD) is an important component of clinical practice. A number of profession al bodies (nursing, medicine, professions allied to medicine, pharmacy) are now setting criteria for the level of professional development that must be achieved by individuals to maintain registration.
Implicit to CPD are educational courses and events which may be categorised as shown below:
- Accredited by an academic Institution and leading to a relevant academic award e.g. BSC, MSC, MPhil., PhD
- Normally provided by a higher/further education institution to provide a recognised academic award/qualification e.g. validated modules at identified levels for NVQ
Provided by an appropriate organisation to update general knowledge and skills. This does not necessarily contribute to any academic award but can be noted as having educational merit.
- By another organisation, for example,
- a professional organisation (BDA, UKCC)
- a local NHS Trust
- By the individual delegate
These are clearly structured with identified academic levels, aims and learning outcomes. There are also, unusually, an identified number of learning hours which is identified by the level for the final award.
These validated courses are either:
1. Complete in themselves e.g. full time MSc in Clinical Nutrition or
2. Structured on a modular and/or part-time basis. Each module will be individually validated and, by building up a number of modules within an identified time, a higher degree qualification can be obtained.
The validation process is undertaken by the academic institution using a validation panel which will include experts in both education and the particular clinical speciality. It is, obviously, important that any such organisation is recognise to have credibility in the area in which validation is so conferred and this will all ensure that the quality of the course reflects the award.
Normally these are much shorter in duration are often organised in response to an identified need e.g. clinical developments, new techniques. They are also used to raise awareness, explore new approaches an update delegates’ knowledge and skills.
It is important to make sure that such events are educationally well organised and structured. This means that learning outcomes should be clearly defined and that, if possible, a variety of teaching techniques should be used by a range of teachers. An element of reflection on the delegates’ current practice should also be included.
‘One-off’ study days are a useful means of sharing information. These may have a significant educational component (e.g. if devised as a part of a continuing professional development programme) or they may be less rigorously structured to reflect more local and timely needs. These will, generally, carry an ‘endorsement’ or ‘recognition’ categorisation.
Informal courses can either be ‘accredited’, ‘endorsed’ or ‘recognised’.
Accreditation is usually awarded by an organisation with degree awarding powers or which has credibility in a particular area e.g. nutritional support. It does not usually confer academic merit although there is often and element of pre-and post-course work which may be formatively or summatively assessed – thus encouraging a continuing learning, process. In most cases the course organisers will have to provide a great deal of information about course content, delivery and expected learning outcomes. The nature of accreditation awarded will be identified and specific education al out comes will also be clearly identified.
Endorsement is a less involved process whereby course organisers can show that basic principles have been followed to demonstrate that the event has educational merit although it need not necessarily contribute to an academic award. The endorsing organisation will need to satisfy itself that the courses described objectives will be met. This is the level of award which will often be sought by nurses, dietitians and pharmacists who are pursuing formal programmes of continuing professional development.
Recognition is a simply way of showing that an event has topical value in terms of updating specific areas of knowledge or skills. The educational content is still important but is not so fundamental in terms of academic credibility.
The Process of Gaining Recognition or Endorsement
BAPEN is committed to continuing professional development and is delivering high quality educational programmes. It also has an important role in encouraging other organisations to devise courses/educational events which will meet identified educational needs related to nutritional support. BAPEN will consider recognising or endorsing informal short courses provided identified criteria are met. Ideally courses should be organised on a multi-professional basis (reflecting the ethos of BAPEN) but this does not preclude the recognition or endorsement of uni-professional events. The attached form should be completed and sent the Chairman of the Education and the Training Committee by e-mail and educational merit will then be assigned conditionally upon meeting the identified criteria.
Points to note:
- Applications for endorsement should be submitted at least 3 months before the proposed event. Whenever possible/practical applications will be processed within 3-4 weeks provided that all the necessary supporting information is received.
- Endorsement will be valid for a period of 2 years after which a new application must be made
- Applications for recognition should be submitted at least 4 weeks before the proposed event. These will be processed as quickly as possible/practical.
- Recognition will be valid for a period of 1 year after which a new application must be made.
Once BAPEN endorsement/recognition has been agreed the course organisers can:
- Advertise this in the course material using BAPEN logo
- Request BAPEN stationary to support the course
- Provide delegates with BAPEN-approved certificates of attendance on completion of the course (these can be supplied on request)
Other organisations may also be prepared to endorse/accredit short courses e.g. British Dietetic Association, College of Pharmacy Practice . Courses organisers may want to pursue theses options to attract more delegates and some useful addresses are provided in Appendix 2 along with the relevant certificates of attendance.
Application for BAPEN Endorsement of Educational Events
Professional Evidence of Attendance at Educational Events to Fulfil the Requirements of Continuing Professional Development
The CPD registration/attendance forms are available from:
BAPEN CPD Officer
Tel: +44 (0)1527 518777
Fax: +44 (0)1527 518718
Record of attendance/evaluation sheets are available from:
The British Dietetic Association
7th Floor, Elizabeth House
Suffolk Street Queensway
Birmingham B1 1LJ
Tel: +44 (0)121 631 4551
There are no formal forms although nursing delegates will probably ask for a certificate of attendance and organisational information
Certificates of attendance are available from:
The College of Pharmacy Practice
University of Warwick Science Park
Barclays Venture Centre
Sir William Lyons Road
Coventry CV4 7EZ
Tel: +44 (0)1203 692 5400
Newcastle Clinical Nutrition Course
This annual 3 day course provides a broad grounding in clinical nutrition and allows delegates to develop an increased awareness of the appropriate assessment and management of patients with malnutrition.
Whilst primarily targeted at medical and surgical trainees, we expect that the programme will carry broader appeal to a wider range of healthcare professionals.
The course covers all aspects of the JRCPTB Gastroenterology curriculum for higher specialty trainees and the General Surgical Curriculum related to nutrition.
Teaching includes small group workshops and case discussions (maximum 25 delegates).
University of Surrey
The University of Surrey currently offers three undergraduate degree programmes ( BSc Hons Nutrition, BSc Hons Nutrition and Food Science, and BSc Hons Nutrition/Dietetics), an MSc in Nutritional Medicine and research degrees. The MSc is modular, part-time programme and so accessible to those in full-time employment, consisting of three-day taught periods at the University, preceded by preparatory study and followed by consolidation and assessment. It is also possible to take modules as standalone courses.
University of Roehampton, London
The University of Roehampton offers an MSc/PGDip/PGCert Clinical Nutrition targeted at all members of a nutrition support team and can be undertaken a either a full-time or part-time course.
University of Glasgow
The Department of Human Nutrition at the University of Glasgow offers research training leading to an MSc, PhD or MD and a taught MSc in Clinical Nutrition that can be undertaken a either a full-time or part-time course.
University College London (UCL)
UCL offers an MSc in Clinical and Public Health Nutrition aimed at all professionals with an interest in Clinical Nutrition. This MSc is particularly suitable for candidates who wish to pursue a life-long career in the field of cutting edge translational research and the practice of nutrition therapy in the health services of the UK or other countries or in the clinical nutrition industry. The full MSC also includes a research project lasting about 6 months.
Leeds Nutrition Course in Clinical Nutrition
Venue: University of Leeds, UK.
Intestinal Failure Study Day & Workshop in Home Parenteral Nutrition
Venue: St Mark’s Hospital and Academic Institute, London
Academy of Medical Royal Colleges Intercollegiate Group on Nutrition
The group runs an annual course on Human Nutrition aimed at doctors. Click here for more information
The ESPEN Life Long Learning (LLL) programme in Clinical Nutrition and Metabolism is an extremely effective educational programme for doctors and all health professionals with an interest in clinical nutrition. It offers on-line training modules and live courses which can lead to the award of a Diploma in Clinical Nutrition and Metabolism.
The LLL programme in Clinical Nutrition and Metabolism is based on an Educational curriculum offering 120 training modules (90 are already available on-line) created and peer reviewed by recognized European experts. The on-line modules are freely accessible on-line and consist of an up to date review of the topic, clinical cases, self-assessment tests and a grading quiz.
Live courses provide intensive training and certification. The annual schedule of live courses is available on the ESPEN website.
Credits are awarded at live courses and for on-line training. Participation in a live course on one topic provides 3 CME credits. Each topic taken on-line provides up to 4 CME credits according to activities undertaken. A total of 120 credits are required to obtain the ESPEN Diploma in Clinical Nutrition and Metabolism.
You need 100 credits (50-60 from the on-line modules and 40-50 from live courses) to be eligible to sit the final LLL exam. Passing the exam gives the final 20 credits required to be awarded the Diploma.
The LLL Programme in Nutrition and Metabolism is a global effort of ESPEN supported by the EU to provide post-graduate qualifications in Clinical Nutrition and thus to improve daily practice. It was developed as the project BG-03-B-F-PP-166039 of Leonardo da Vinci Programme by ESPEN and a number of European universities with the support of European Union. The LLL Programme in Nutrition and Metabolism is accredited by Union Européenne des Médecins Spécialistes.
BAPEN Medical has run 2 LLL modules in the UK to date, with plans for a further module on Nutrition in Respiratory Disease in December 2012.
BAPEN Medical and the BAPEN Clinical Guidance and Education Committee are working together to enable further LLL modules to be run in the UK to make it easier for UK trainees in all professions to obtain a recognised qualification in Clinical Nutrition and Metabolism.
Click here to go to the LLL website and start now!