06 Apr 2020

1. Agree a discharge stock plan with your linked acute services. Plan contingency options if the take-home (TTO) stock is lower than normal best practice.

2. Ensure all patients have one-week buffer stock.

3. There is significant national demand for enteral feeding pumps. It will be important to make as many pumps available for use by those who will need them. Ensure uplift of any pumps from people who have passed away or have as a spare pump. Consider if any patients currently on pump feeding could be safely transferred to bolus feeding.

4. Prioritise patients on your caseload, transfer to bolus feeding for those who you consider will tolerate. Any dual fed patients that could transfer to day bolus regimen and free up overnight pump.

5. Stay safe - refer to your local NHS Trusts PPE policy for community visits. Only review patients at home if you are delivering essential care.

6. Ensure using screening questions when visiting patients (asked on phone and again at the doorstep). These could include asking patients if they currently have any COVID-19 symptoms; if they have a diagnosis of COVID-19; if they have recently been in contact with anyone with suspected/confirmed COVID-19.

7. Prioritise development of stoma saving device protocol.

8. Clarify local plans for managing tube displacement, such as clean 1 in 1 out acute hospital clinic provision with your nutrition nurse colleagues.

9. Prioritise NG management protocol development, examples of these may be shared on the HEF virtual group

10. Consider where can extend role e.g. resolving tube complications, changing devices where contract nurses have withdrawn this service.

11. Extend hours available to manage tube complications. Consider provision of an evening and weekend on-call service.

12. Ensure patients are aware of local restrictions of service. Ensure your patients have adequate stock and spare tube parts; educate on self-management of tube complications with the focus on avoiding burden to A&E.

13. Should you have any queries about feed delivery for registered patients contact your local contract manager

14. Join the PENG Virtual Group at  https://www.peng.org.uk/hcp-forums/hef-group.php for peer support from across the UK, and for an excellent source of shared resources.