Teri Kilbane

The main purpose of this role is to be an expert practitioner in Nutrition Support for patients who require Artificial Nutrition and Hydration in the hospital setting and Home Parenteral and Enteral Nutrition in the longer term.

I am responsible for providing a high quality holistic service alongside the management, development and co-ordination of a nutrition support service which provides an efficient patient pathway from initial referral, this will include involvement in staff training and development.

Assessment, prioritisation and scheduling of patients from in-patient wards and day case waiting lists for procedures such as NG, NJ, PEG.

My responsibilities also include:

• Documenting and evaluated effectiveness of care plans and interventions.
• Supporting physicians and consultants with tests and procedures.
• Building and maintaining excellent rapport with patients and loved ones.
• Encouraging and supporting appropriate learning opportunities for staff members, promoting best practices for high-quality patient care.
• Providing excellent care with focus on patient safety, comfort and dignity.

Responsibility for the delivery of the nutrition nursing service for patients requiring Artificial Nutrition Support (ANS)

• Be a clinical resource for both patients and NHS staff working across all trust sites and for patients in the community requiring ANS support
• To liaise with the lead consultant and lead nurse and external companies to co-ordinate and provide care to address the needs of individuals arising as a consequence of ANS.

Main duties

• Plan co-ordinate and monitor delivery of the nutrition nursing service across UHCWNHS Trust and relevant community locations
• Monitor/audit for efficient service delivery and disseminate any findings to facilitate change in practices if indicated
• To recruit, manage, co-ordinate, delegate work and review the performance of the nursing team and offer opportunity for individual development
• Be responsible for patient pathways across UHCW NHS Trust ensuring consistency and adherence to individual trust/national quality assurance guidelines
• Develop partnership working relationships with staff in UHCW NHS Trust and external community partners which enables quality issues to be discussed
• Develop effective networking relationships across nutrition services both internal and external to UHCW NHS Trust
• Work with others to aid the implementation of nurse led clinic sessions ensuring facilities are available for data collection and that the process is understood by all involved
• Be responsible for care delivery to meet the needs of all patients who need ANS both long and short term
• Be able to assess patients physical and psychological need, develop and record care plans and monitor there implementation, making adjustments if necessary
• Manage own caseload autonomously including making clinical decisions
• Ensure clear communication pathways are developed to enable continuity of care and seamless transition of patientsrequiring ANS in primary, secondary and outpatient care settings, attending MDT and best interest meetings as necessary
• Responsible for the dissemination of high quality and understandable information, ensuring quity or care by overcoming barriers such as language and disability to assist patient choice
• Use appropriate communication skills when supporting patients and facilitate complex meetings
• To increase patient safety and reduce high levels of anxiety that are known to occur in patients needing ANS by providing timely information, appointments within national guidelines, and telephone support to patients and relatives
• Monitor quality standards in respect of waiting times and patient experience and report and concerns to the lead nurse/lead consultant
• Develop working relationshipd with all stakeholders involved in the delivery of ANS
• Populate and monitor data collection for the Intestinal Failure Network and other local date collection tools and use date for interpreting trends to assist with future service development
• Promote a positive nutrition culture by giving talks and presentations, where appropriate, both locally and nationally and encourage user involvement in service improvements
• Identify need for and undertake research, clinical audit and benchmarking to improve clinical effectiveness
• Competently perform tube insertions including NG, NJ, PEG, PEG-J, BGT and train and educate junior staff including doctors
• Develop a working understanding or the legal and ethical issues that impact ANS
• Deputise for the lead nurse in their absence

• A clinical expert, providing clinical leadership and support for hospital inpatients requiring artificial nutrition support.
• Developing and evaluating best practice within the field of nutrition support.
• Responsible for complex clinical assessment of patients requiring nutritional support, ensuring appropriate care is planned, implemented, and evaluated/audited.
• Undertake highly technical and/or practical skills to ensure optimum patient management including complex patient monitoring; equipment management and frequent administration of invasive tests/procedures. Specific practical skills include insertion of Gastrostomy tubes, Naso-gastric and naso-jejunal tube placement.
• Develop education strategies to support guidelines in-order to educate hospital staff as well as patients and relatives participating in enteral feeding.
• Work in partnership with the community nutrition outreach team, hospital and community dietitians and GPs to ensure a structured pathway for patients going into and leaving hospital.
• Work in partnership with the MDT and be involved in MDT meetings and best interests meetings in order to ensure that all actions/decisions are made in accordance with the Mental Capacity Act and/or the Mental Health Act.