AIM
To develop training and expertise in the core principles of nutritional support & management of intestinal failure.
This is mandatory for all trainees following the Gastroenterology 2010 curriculum.
PERIOD OF TRAINING
This training will take place over a 3-6 month period in an accredited unit.
REQUIREMENTS OF AN ACCREDITED UNIT
Accredited core nutrition training centres should have as a minimum:
- At least one consultant with an interest in nutrition;
- A nutrition steering committee, with senior multi-professional representation, which meets regularly;
- A multi-professional nutrition support team, which meets at least weekly and which should include a doctor, dietician, nurse and pharmacist.
The chosen accredited unit for HEE NE which fulfills the above criteria is the Freeman Hospital
REQUIREMENTS DURING THE MODULE
During this module, trainees should become an integral member of the nutrition support team and fulfil the following roles:
- Attend weekly nutrition ward rounds
- Review patients between ward rounds and provide clinical input at ward rounds
- Assess patients for consideration of gastrostomy placement
- Assess patients for consideration of parenteral nutrition (PN)
Trainees will be expected to maintain a portfolio, which should contain the following and be included for review at their ARCP:
- Evidence of WPBAs as detailed in ARCP decision grid
- At least nine reflective ward round patient lists
- Report from supervising Consultant
CURRICULUM COVERED & ARCP DECISION AID FOR NUTRITION
Please see pages 72 – 75 of the gastroenterology 2010 curriculum which illustrates which part of the curriculum this will cover
ASSESSMENT CRITERIA & DOCUMENTATION ON EPORTFOLIO
This will be assessed at the ARCP in the year following this 6 month placement
In the E-portfolio Personal Library please make a folder labeled for example ‘ARCP (and year)’ please make a subfolder labeled ‘Nutrition’ and place all the following evidence in this folder
THE REQUIRMENTS WILL BE:
1. A report from the supervising consultant (Dr Thompson or Dr Mountford at Freeman).
Please complete report Nutrition Placement Educational Supervisor Report and upload in to personal library in the following years ARCP folder, labeled as ‘Nutrition Placement Supervisors Report’
2. Completion in e-portfolio the following WPBAs
3 mini CEX
3 DOPs
6 CBD
These are in addition to the usual WPBAs for that year
Note: Please check with the curriculum parts of it which are most appropriate for each of these assessments eg if you look through the curriculum it states that the following can be assessed with a DOPs:
- Performs a nutritional assessment
- Inserts enteral feeding tubes ng and peg
- Can take a relevant history from patients with IF and perform a relevant clinical examination - including inspection of abdominal wounds, fistulas and at the stoma/fistula outputs, and inspecting any tubes/catheters and appliances
- Understands the principles of feeding into bowel that is not in continuity (fistuloclysis)
- Be able to feed into defunctioned gut (fistuloclysis) when appropriate
- Can feed into defunctioned gut (fistuloclysis) when appropriate
- Can insert a venting gastrostomy tube
- Knows how to assess the nutritional / fluid requirements and prescribe appropriate amounts
- Can safely insert parenteral feeding lines (PICC and Tunnelled central lines) using the jugular, subclavian and femoral central routes
- Can access a parenteral feeding line using aseptic technique (to take blood and blood cultures)
- Can remove a cuffed feeding line
- Can insert NJ tubes at the bedside and endoscopically
- Able to insert a PEGJ and PEJ
3. Nine reflective ward round patient lists