Specialty Dietitian – (Stroke)

Detailed job description and main responsibilities

PRINCIPLE DUTIES AND RESPONSIBILITIES

1.       To provide a high quality and comprehensive nutrition and dietetic service to the acute stroke and complex medicine units (and in patients homes, where appropriate, for those under the early supportive discharge service).

2.       To support the provision of General Outpatient clinic cover by triaging referrals, delivering clinics when required and supervision of the Band 5 cover for the general clinics

3.       To liaise closely with other members of the multi disciplinary teams – actively contributing to a coordinated, evidence based and multidisciplinary approach to patient care.

4.       Contribute to the delivery of the stroke care pathway in Oxfordshire. Work closely with other dietitians working in this clinical area across the county linking in closely with other specialist stroke dietitians

5.       To be a resource/contact for other dietitians/nurses in the areas of nutrition support in medicine, elderly care / frailty and stroke.

6.       To contribute to the development of the nutrition policy, protocols and guidelines for this clinical area.

7.       To clinically supervise the Stroke Nutritional Assistant, Therapies Assistant and Band 5 Dietitians, along with other dietitians and S&LT

8.       To audit practice, produce progress reports and make recommendations for the future development of the clinical areas.

9.       To be actively involved in teaching / training sessions to medical/nursing staff and other health professionals.

10.   To be actively contribute to the delivery of dietetic student training

11.   To actively participate in reflective practice.

12.   Attend regular ward rounds, multidisciplinary team meetings and clinical governance meetings.

13.   To initiate research / quality improvement projects as agreed with the Team Leader and MDT.

14.   Be involved in other general cover as required for annual leave etc.

15.   To participate in medical/medical student teaching programme.

16.   To produce new teaching materials and update/modify diet sheets and education packages.

CLINICAL

Work as an integral member of the multidisciplinary team to ensure a holistic approach to patient care.  This involves attending ward rounds, case conferences and regular team meetings. 

Organise own workload: prioritising and balancing patient-related and professional demands and contributing to the effectiveness of the team.

To judge and determine the appropriateness of referrals made by members of the multidisciplinary team in order to ensure effective use of time and resources.

Assess patient’s diagnosis, medical care and biochemistry making decisions as to who needs dietary management.

Obtain and analyse relevant information from different sources including:  electronic patient records, the client, ward staff and/or carer’s, in order to make a comprehensive assessment of the patient’s 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.

Interpret and monitor biochemical data.

To have a detailed understanding of medical conditions/drugs and nutritional implications.

Calculate nutritional requirements using specific assessment tools and calculations.  To remain up to date with the literature and ensure that this is an evidence based process and clinically relevant to the acute stroke and complex medical patient groups.

Advise on appropriate artificial feeding routes for patients both via the enteral and parenteral routes.

Formulate individualised patient care plans, artificial feeding regimens and parenteral nutrition prescriptions, taking into consideration factors which may affect requirements or help/hinder provision of nutrition support such as:  prescribed drugs, biochemical derangements etc.  Within the care plan this would include nutritional supplements, specialist feeds, need for added micronutrients.

Evaluate the effectiveness of nutritional goals and modify these goals and care plans as necessary based on ongoing analysis, assessment of information available and changing patient needs.

Be involved in discharge planning of patients to other facilities e.g. acute hospitals outside Oxfordshire, community hospital, district general hospital, nursing home, or to their own home. 

Advising members of staff - nursing, dietetic and catering staff on dietary modifications or nutritional support

Use communication techniques i.e. behavioural change and motivational interviewing to work with patients.

Communicate effectively and sensitively with patients, carers and other health professionals.  Skills of persuasion, motivation, explanation and gaining consent may be used in a wide variety of different, sometimes sensitive, situations.  It is important to be able to communicate complex information at an appropriate level.  Barriers to communication may be evident e.g. loss of sight, loss of hearing, lack of English, both written and spoken, requiring the use of translators. 

To be sensitive to the religious and ethnic needs of patients' dietary requirements and have an understanding of foods eaten by multicultural populations and how they impact on hospital catering.

Liaise and advise catering staff for meal and snack provision appropriate for your patient group.  This can involve multicultural requirements and/or other dietary needs for example, gluten free.

To be actively involved with the development of evidence based, trust-wide guidelines - to be a resource to other dietitians, writing and compiling diet sheets, protocols and advice.

To cover for other dietitians when sickness or leave necessitates.

To be an active member of the bank holiday on-call service

Any other duties that may from time to time be allocated by the Team Leader and Acute Dietetic Service Manager, including cross-site cover, where services require.

PROFESSIONAL

To be accountable for own actions within the professional, ethical and legal framework for dietetics set out in the Health Care Professions Councils code of practice for Dietitians and the British Dietetic Association’s professional standards for Dietitians, and within the scope of your own practice.

To take responsibility for own continuing professional development and providing 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.

Participate in annual appraisal, identifying own developmental and training needs and setting personal developmental objectives.

To participate in departmental audits and initiate audit within own work area in order to monitor and evaluate whether local/national/international standards are being met and make recommendations for change.  To be involved with the planning of departmental clinical effectiveness and audit strategies.

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

To provide specialist advice, teaching and training to all members of the multidisciplinary team, regarding the nutritional management of patients.  This involves participation in in-house training courses e.g. new staff nurses orientation program and advanced nursing courses.  Also to participate in external training/teaching when requested.

Mentor and train qualified dietitians on rotations to further their experiences and understanding of stroke and complex medical dietetics.

Please review the attached job description for further information.