03 Jun 2020

Dietitian Julie Walker from Hertfordshire Community NHS Trust describes how she and her team adapted to provide support to patients and the community during the COVID-19 pandemic. 

At the start of the COVID-19 pandemic the Hertfordshire Community Trust’s Nutrition and Dietetic Service was divided, to enable part of the team to support the Community Nursing team. The aim was to work with a group of home enteral feeding patients who were unable to manage their own feed or feeding tube and did not have any other family support who could do this for them. This freed up time for the Community Nursing team so they could work with more challenging patients.

This team of dietitians were trained by the Abbott Nurse Advisors who work in Hertfordshire, on techniques such as checking and changing balloon gastrostomy water, advancing and rotating gastrostomy tubes and hanging feeds. This team then visits a cohort of people at home to carry out these procedures.

Let's take just one example of how this approach has made a significant impact on the quality of life of one of our patients. An older gentleman was having additional water via the feeding pump. His other issues included being unable to care for his feet and a hearing aid that was not working. Very quickly the team worked to access a chiropodist, an Occupational Therapist bathing assessment and arranged to have his hearing aid fixed.  

During this period the whole Nutrition and Dietetic team have been paying particular attention to those patients discharged home following a critical care or ward admission with COVID-19. The team has also supported patients identified as being at risk of malnutrition in their own home, as part of the prevention of admission team, by providing advice and support virtually.

Care Homes are being proactively contacted to ensure they are supported; with a particular focus on residents who have lost weight, who are having respiratory difficulties and those with taste changes. Alongside this we have created a series of posters to support the advice we are giving. These posters have gone out to other stake holders in Hertfordshire so they can be adapted and used across the County.

It has been a challenging time for the team and been a huge learning curve for all of us. 

The hands on gastrostomy care work has highlighted a number of issues which would never have been highlighted had we not had eyes on the ground. These issues have led to improvements around equipment provision.

But most of all, this pandemic has shown our team to be flexible, supportive and resilient. Hats off to the HCT Dietitians and all of my fellow Dietitians out there working to provide excellent and innovative care in such difficult circumstances.

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Julie Walker RD

Intermediate Care Lead for Dietetics, Hertfordshire Community NHS Trust