We need more volunteers for all the Working parties - email us to join and help shape your profession!
Stroke
This group, started in March 2021, is looking for dietitians with experience working within the stroke pathway and who are motivated to improve dietetic care within stroke services.
The working group meets virtually as required. In addition to responding to various requests for dietetic expertise, members of the group volunteer to work on discreet projects. For example, a group is currently developing competencies for stroke dietitians.
This working party is open to anyone who is passionate about improving care for those affected by stroke regardless of experience level, all we ask is that you are ready and keen to work on ideas that can improve dietetic care for those after a stroke.
This working party is led by Cara Lewis, BDA representative on the Intercollegiate Stroke Working Party, and Elle Wiliams, on behalf of the NSG. Please email us at [email protected] if you would like further information on or would like to join this group.
MND
The NSG has worked with our partner the MND Association closely for many years, and they are keen to continue to develop resources.
Gastrostomy tube – Is it for me? Web-based support tool
This tool to support people living with MND to consider whether to have a gastrostomy tube fitted is now availble.
Gastrostomy tube – Is it for me? is the result of the DiaMoND research project led by Southampton University, funded by the MND Association and Marie Curie. It aims to help people living with MND choose whether they want to have a gastrostomy tube fitted now. If they decide not to go ahead, they can revisit the decision later.
You can access the tool here https://gastrostomychoice.co.uk/
MND Risk Assessment Tool
The BDA Neuroscience Specialist Group have worked on a risk assessment tool to support dietitians to deliver a multidisciplinary approach to care for patients with motor neurone disease. Here is an introduction to the risk assessment tool.
The overarching principle behind the risk assessment tool is that, whilst conducting an assessment in your professional capacity, you are supported to identify signs that you and your MDT colleagues need to know, and really make every contact count.
Colleagues across the MDT were asked to idenitfy the symptom presentations that they would like to know about a patient if a colleague had spotted them. The risk assessment tool lays these out. You are not making an assessment of symptoms outside your area of expertise - just observing them, noting them and raising awareness and referring as necessary.
To help you make a holistic appraisal of a patient, the risk assessment tool gives examples of indicators to look for, as well as useful probing questions. These are aimed to help you gather the information needed in an unobtrusive way, within your usual discussions.
When identifying what they were interested in, MDT colleagues also ranked the urgency of presenting symptoms: classifying them as gree, amber or red. So, if for example, you were to see a patient presenting with a symptom ranked as red - this would suggest a need for an urgent referral to the relevant MDT colleagues if not already involved and actively engaged with the patient.
You can find the MND Risk Assessment Tool here.
Only NSG members can download the tool from the website - if you need a copy sending to you, or have feedback, contact us at [email protected]
The NSG has worked with the Motor Neurone Disease Association to support the establishment of their MND Professional's Community of Practice (https://www.mndassociation.org/professionals/community-of-practice/); this is a peer led group of health and social care professionals encouraging and supporting the development of good care for people living with, or affected by, MND.
The Community of Practice is supported by an 'Expert Core'; this is an invited group of experienced, knowledgable professionals, who provide the professional guidance to the Community and are responsible for steering its development. The NSG is represented on this group.
Outcomes
To further the work started a few years ago, when we piloted the Dietetic TOMS – we have had lots of enquiries about this area across the membership, and it fits well with the recent central BDA work on Outcomes
Multiple Sclerosis
The Alternative diets Policy Statement is overdue for review, so this will be the first area to look at. NICE is also currently revising its clinical guideline ‘Multiple sclerosis in adults: management (CG186)
Nutritional Requirements in Neuro
Development of Consensus statements – this suggestion was made by many members who attended the recent study day, following the presentation about the updated PENG guidance. We asked PENG to collaborate with us on this working party and following an initial discussion with PENG, we agreed that it will be more useful to focus on doing worked examples of Neuro related patient to show how the new nutritional requirements may be used in practice.
Thank you to those members who have contributed to this working party so far.
In 2019 PENG published a comprehensive review of the literature to date and provided disease specific estimations of nutritional requirements. This reflects the level of evidence in peer reviewed literature and where there is insufficient evidence to make recommendations. This presents challenges to providing evidenced based recommendations.
Clinical judgement remains critical to providing appropriate nutritional management for patients. Where there are gaps in disease specific recommendations we rely on consensus guidelines, such as 20-30kcal/kgbw. These may show the range of recommendations, but are not specific to neurological patients.
We are really keen to know more about the uses of guidelines and clinical judgement from Neuro Dietitians, such as;
- Who uses PENG guidance?
- What other guidelines are used for Neuro patients?
- How disease specific and consensus based guidelines are interpreted?
- Is the application of nutritional requirements reviewed/ audited?
- What resources are there, or could there be, to help interpret nutritional requirements?
If you have time please fill in our questionnaire and tell us your thoughts (https://www.surveymonkey.co.uk/r/ZCHX5CW)
Worked examples
Following discussions with PENG, it will be more useful to focus on worked examples of Neuro related patients to show how the new nutritional requirements may be used in practice.
We will be updating this section in the coming weeks so please check back soon.
If you would like to volunteer to take part in any of the working parties or have any suggestions for additional ones, please email us [email protected]