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CLINICAL

Be professionally and legally accountable for own work and caseload.

Work autonomously as the clinical specialist, in the provision of a comprehensive nutrition and dietetic service to the Upper Gastrointestinal Unit at the OUH. This will include patients’ groups such as: OG, HPB, Pancreatitis, oncology, surgical patients post ICU etc.

Lead and coordinate dietetic provision to ensure a comprehensive specialised dietetic service is provided to UGI ward. This will include:

-          Early appropriate management of nutritionally related surgical issues to improve patient outcomes, reduce costs, reduce hospital length of stay and prevent avoidable readmissions.

-          Early dietetic assessment and appropriate individualised nutrition therapy/interventions for patient pre-, peri- and post operatively, and those at risk or/with disease-related malnutrition

-          A dietetic presence at OG & HBP ward rounds for early identification of patients requiring nutrition therapy/interventions, obtaining early referrals, direct appropriate nutritional care, facilitate appropriate and timely referrals to services to instigate nutritional plans (e.g. tube placement referrals, TPN referrals), and facilitate safe discharge planning and patient flow

-          A dietetic presence at MDT meetings and case conferences to provide accurate information on nutritional status, progress and plans; and facilitate safe discharge planning and patient flow

-          Facilitate improved partnerships with UGI staff and the wider MDT to enable safe and efficient patient discharges and improve patient flow.

Lead and coordinate dietetic provision to ensure a comprehensive specialised dietetic service is provided to benign HPB outpatients.

To assess the nutritional status of individual patients based on anthropometric measurements e.g. weight, height, weight history as well as biochemical parameters, diet history and other validated methods of nutritional assessment as appropriate.

Obtain and analyse relevant information from different sources including: electronic patient records, the patient and their carers, ward staff etc, in order to make a comprehensive assessment of the patients needs, condition, prognosis and treatment plans so that a decision on the most appropriate dietetic treatment to support this can be made in the short and long term.

Attend regular team meetings when patient care is reviewed, liaison meetings with other multi-disciplinary teams where patients joint care is planned and reviewed, case conferences, ward rounds and governance meetings.

Along with the Team Lead and Clinical Lead, to have responsibility for all organisation, liaison and monitoring of the dietetic aspect of this service.

To communicate effectively with patients, carers, family and other health professionals. Skills of negotiation, motivation, explanation and gaining consent will be used in a wide variety of and sometimes sensitive situations. The ability to communicate complex information at an appropriate level to allow understanding is essential. Barriers to communication may be evident e.g. loss of hearing, receptive and expressive problems with the formulation and understanding of language or difficulties with speaking. The use of communication aids such as letter/picture boards or games may be necessary.

Participate in research and audit undertaken by the ward/unit and/or Dietetic team.  Presentation of audit or research results at national or international conferences to promote practise and share expertise with colleagues.

To provide specialist advice, teaching and training to all members of the multidisciplinary team, regarding the nutritional management of UGI patients. This involves regular participation in in-house training of clinicians and both specialist and ward nursing staff

Organisational

To collect data as required by the department, trust and outside agencies.

Collation of audit data on the outcomes of surgical patients managed in the dietetic service

To determine priorities for own work area based on clinical need and balance patient caseload with professional demands.

To maintain accurate and up-to-date documentation of patient interventions on dietetic record cards/electronic patient records. To communicate any changes in day to day management and dietetic interventions to appropriate members of the multidisciplinary team.  This is achieved by documenting within nursing/medical notes or by means of generating a letter/report and/or updating any patient database.

Management and professional responsibilities:

Be accountable for own actions working within the professional, ethical and legal framework for dietetics set out in the Health Profession Councils Dietitians’ Standards of Conduct, Performance and Ethics and the British Dietetic Association’s Professional Standards for Dietitians and Code of Professional Conduct.

To remain up to date with the relevant literature and ensure that this informs evidence based practice which will optimise the long term outcomes for each individual patient.

Clinically supervise Band 6 Dietitian and Band 4 Dietetic Support Worker. Provision supervision for Rotational Band 5 Dietitians.

PROFESSIONAL

To initiate and lead discussions on organisational, professional and clinical issues relevant to the service area. Along with the Service Managers, to be responsible for the dietetic service provided to their clinical area and its development.

To continue to develop own knowledge and skills and contribute to the development of colleagues within the MDT and the Dietetic Service. This involves:

a)       taking responsibility for own continuing professional development (CPD) and provide evidence for this by maintaining a CPD portfolio. CPD involves critical evaluation of scientific papers, attending professional development meetings, working as a reflective practitioner and attending relevant internal/external courses.

b)      Participating in own annual appraisal, identifying own development and training needs and setting personal development objectives with line manager.

c)       Undertaking all relevant statutory and mandatory training

d)      Involvement in the dietetic student training programme

e)      Providing specialist education and advice to dietetic colleagues in the area of allergy via regular departmental professional update meetings

f)        Attending and representing the department and lead area of work at the regional and national meetings as appropriate.

To be responsible for communicating effectively and working collaboratively with the Dietetic team, line managers, other health professionals within the MDT and other organisations to ensure a co-ordinated and evidence based approach to the delivery of dietetic care.

To have responsibility for and lead the development, promotion and delivery of the new specialist dietetic post for patients on UGI ward. This involves

a)       Developing dietetic practice to ensure evidence based practice and an equitable service delivery

b)      Applying legislation, policies and procedures and making appropriate recommendations for service delivery

c)       Managing development projects relevant to the clinical area, the dietetic service and the NHS organisations involved

d)      Making recommendations and managing service improvement

e)      Evaluating own work and that of the team, including clinical audit

f)        Recognising the need to seek appropriate support

g)       Active involvement in multidisciplinary team meetings, dietetic departmental meetings and discussions

To demonstrate risk management skills and a sound understanding of clinical governance and apply to the work situation.

Education and professional development responsibility:

To keep a portfolio providing evidence of continual professional development (C.P.D.).  This may include critical evaluation of scientific papers, attending professional development meetings, working as a reflective practitioner and attending relevant internal/external courses.

Participate in annual appraisal, identifying own development and training needs and setting personal development objectives within an Annual Report

Actively participate in the dietetic student training program, facilitating the development of skills and knowledge, being involved in the assessment process and acting as a mentor.