Minutes from the by vuQT1oz

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									GREAT WESTERN HOSPITALS NHS FOUNDATION TRUST

                          Minutes from the
                  TRUST NUTRITION STEERING GROUP
                     Thursday 2nd December 2010




Present:
Dr Mike Colley - Chair      (MC)
Chris Grist                 (CG)
Linda Webb                  (LW)
Carole Crocker              (CC)
Linda Baxter                (LB)
Mandy Parsons               (MB)
Joyce Bishop                (JB)
Hannah Marder               (HM)
Joanne Smith                (JS)
Jade Dobson                 (JD)
Ranju Gopal                 (RG)
Dr Manish Hegde             MH)


Apologies:

Carol Black                 (CB)


                                                                     Action
1. Terms of Reference

        ToR’s redrafted. Quorum should consist of 5 members,
         preferably from different disciplines and ideally include a
         Dietitian.
        The aim is to have a minimum of 3 meetings per year.        MC/LW

2. Meeting Nutritional Needs

    Nutrition Screening (MUST) Compliance
     E-MUST has been trialled on Shalbourne and Falcon and no
        issues arose.       Dietetics to liaise with the Academy re
        attaching the learning tool to Training Tracker.             JD
     Dietetics are getting approximately 190 extra referrals per
        month as the awareness of MUST Screening is raised. Not
        all patients able to be seen before discharge. Added to risk
        register.
     MUST Compliance should be 95%. Patients over 60 should
        be screened within 48 hours of admission.

     Quality of meals/menus
      Menuless meals (patients selecting from trolleys) are being
        trialled on Mercury and Meldon,
      Protected Mealtimes for patients – patients receiving
        emergency treatment during mealtimes should have a
       sandwich lunch provided. Staff can order through the FM
       Helpdesk.

   Enhanced Recovery Programme (ERP)
    Lucy Baker/Helen Jones leading. To be invited to the next
      meeting.
    HM looking at getting all specialities on board           HM

   Policy & Guidelines
    Refeeding Syndrome Guidelines have been reissued and are
        now available on the intranet.
    Parenteral Guidelines for Adults are out for comment.
    Children’s menu now in place and the policy ratified.
        Screening tool for paediatrics to be in place March 2011.

   QIPP (Quality, Innovation, Productivity, Prevention)

      This is a Government initiative with 2/3 items (linked to
       nutrition e.g. screening and use of supplements.
      A sensible plan of action is being implemented in community
       but permanent post needs to be funded by PCT.
       Suggested ideas are giving out food first booklets to patients,
       providing information on fortifying diets, and details of build-
       up drinks/shakes to purchase over the counter.                   LW

       ONS Prescribing Guidelines
      An audit also showed that patients on prescribable
       supplements are not being reviewed and as a result there are
       large wastage costs.
      The Community Dietitians have started a re-audit which is
       already showing savings. Results to be presented at a
       National Audit Conference in London early 2011.
      Other projects in the UK show that savings of between 20 &
       30% could be made by making small changes (i.e. by
       prescribing starter packs of supplements).
      Patients being discharged home with supplements will not
       receive them unless they have been seen by a Dietitian
       during their hospital stay.

   Home NG Pilot
    Looks initially at patients with inflammatory bowel disease. It
      is hoped to build patients up at home prior to being admitted
      for surgery resulting in better post-op outcomes. Patients will
      also be trained on using a nasogastric tube. It is hoped to
      expand this service into other areas in the future.             JD/MH
   Forward Plan

      The group felt it would be beneficial to have a representative
       from the surgical directorate. Invite Mr Richard Payne as
       involved in ERP.                                               LW

3. Any Other Business

      Equality - CG attended an ethnic minority group meeting as
       the new Equality Act 2010 was introduced last month. Many
       attendees felt that the food in hospitals was not very diverse
       and they offered volunteers to work with the Trust in
       designing menus. Also had a request for menu in pictorial
       form for people with learning disabilities.

      IT - CC is looking at options for a system to replace
       Crescendo and is working with David Davies, Head of IT.
       Hand held devices are also being investigated for MUST
       Scoring.

      Comfort Rounds – being reintroduced for patients where they
       should see a member of the nursing team every 2 hours.
                                                                     CC

4. Date of Next Meeting
   March 2011

								
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