Cystic Fibrosis Dietitian (Paediatric & Adult Joint Post)

Detailed job description and main responsibilities

Principle Duties
Work as an integral member of the multidisciplinary team to ensure a holistic approach to patient care. This involves reviewing patients jointly with the Paediatric/Adult CF consultant and/or Paediatric/Adult CF specialist nurse during out patient appointments, on the ward or in the patient’s own home.

To maximise clinical outcomes for all children and adults with cystic fibrosis by matching dietetic management of cystic fibrosis related diabetes with optimisation of insulin therapy and optimising those with pancreatic insufficiency with pancreatic replacement therapy and practical skills for each individual.

Work as an integral member of relevant MDTs to ensure a holistic approach to patient care. This involves regular liaison with individual team members regarding specific issues of patient care e.g. discussion with clinicians and clinical nurse specialists (CNS) regarding treatment plans/symptom management or enteral feeding tube placements and tube after care.

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, reported symptoms and other methods of nutritional assessment as appropriate.

Obtain and analyse relevant information from different sources in order to make a comprehensive assessment for each patient, including social, medical, drug, diagnosis, prognosis and recommend an appropriate dietetic treatment plan.

To formulate individualised advice on appropriate foods, fluids and/or artificial feeding regimens in liaison with patients, carers or relatives considering factors which may affect requirements or help/hinder provision of nutrition support such as: treatment side-effects, prescribed drugs, biochemical derangements, financial and social situation.

Work effectively within the paediatric and adult  CF and other multi-disciplinary teams to contribute to the holistic care of the child and family, and potentially in circumstances that may be difficult and distressing.

To monitor nutritional and fluid intake, the effectiveness of nutritional goals and modify as necessary based on ongoing analysis and assessment of information available, such as weight and blood electrolyte/micronutrient monitoring, changing medical condition.

Effectively use clinical judgement and reasoning when calculating and estimating children’s and adults nutritional requirements and advising on possible routes of feeding, to ensure provision of appropriate nutritional interventions.

Plan dietetic input to patients in own care and alter or revise treatment plans according to patient’s blood results or progress of disease/condition.

Monitor and evaluate outcomes to ensure to ensure that goals and objectives of nutritional care plans have been achieved.

To organise and coordinate supplies of supplements, enteral feed and plastics as required for patients living locally or out of area, and patient follow-up liaising with appropriate community staff (e.g. home delivery companies, G.P, dietetic colleagues, district nurses).

Liaise with Catering to ensure that age appropriate nutritionally adequate meals are available within the Children’s Hospital and advising on the selection, provision and use of therapeutic products (special feeds and formulas).

 Refer patients to other specialists as appropriate, e.g. Speech and Language Therapists, clinical nurse specialists, community children’s nurses

To adhere to Trust referral guidelines to ensure effective use of time and resources and review in collaboration with the changing demands of the service.

To work closely with all Trust dietitians– sharing /covering workload where necessary and keeping each other up to date.

Communication

To communicate effectively and at an appropriate level with patients, carers/relatives and other health professionals. Skills of empathy, motivation, explanation are used in a wide variety of different, often sensitive situations. 

Attend multidisciplinary team meetings, case conferences and ward rounds as necessary

Liaise and communicate with dietetic colleagues in other hospitals regionally and nationally with regard to patient care, both on discharge from the Children’s Hospital and those having shared care; also to seek advice and information on dietary management of patients from other centres of expertise as necessary.

To attend and participate in regular department and team meetings.

Service Development and Delivery

To initiate and participate in audits r research and make recommendations for change in order to improve patient care/outcomes; and to disseminate results via reports, abstracts, posters or presentations.

To provide specialist advice, teaching and training to all members of the MDT, clinicians, dietetic colleagues regarding the nutritional management of gastro/neuro patients.

To be actively involved with the development of evidence based, trust-wide guidelines, feeding protocols and other resources such as diet sheets and patient information, working in partnership with patients and the relevant MDT as required

To be involved with a cross-county specialist dietetic network for shared CF care

To provide specialist training and supervision of dietetic colleagues and students using skills of reflective practice.

Planning & Organisational

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

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

To maintain accurate and up to date documentation of patient interventions on electronic patient records with consideration for confidentiality and data protection legislation.

To be involved with setting agenda items, chairing and taking minutes for departmental and team meetings, on a rotational basis.

Arrange cover with the CF team lead dietitian’s during periods of annual leave, sickness absence or study leave, and provide this as necessary. Be part of the paediatric and adult on-call service to cover Bank Holidays.

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

Contribute to the collation of audit data on the outcomes of CF care for the Cystic Fibrosis trust.  

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 including insulin dose changes, equipment updates, 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

Other Duties
Undertake any other duties requested as appropriate to the banding.