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Enhancing Bariatric Care: Role Expansion for Dietitians

Learn about overcoming challenges in gastric band adjustments and implementing an extended role for dietitians in bariatric care. Gain insights on training, practical tips, and benefits of the extended role.

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Enhancing Bariatric Care: Role Expansion for Dietitians

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  1. LAGBAdjustments Extended Role Fiona Sim Bariatric Dietitian Aberdeen

  2. Background • Initial Pilot in 2004 for 20 gastric bands. • NHS Grampian provided bariatric surgery to patients from NHS Highland, Western Isles, Orkney, and Shetland within local North of Scotland agreement as well as other health boards .

  3. NHS GRAMPIAN

  4. Problems……. • Only radiological done Tuesday afternoons • O/ P appointments on Wednesday on different site! • Transport difficulties for distant patients • Emergency deflations to wait for surgeon/ medical staff

  5. Problems…….. • Request chits for adjustment could only be signed by medical staff • Time delay from request to adjustment could be several weeks • Patients would keep follow-up appointments with surgeon to request adjustment but not attend for dietetic review

  6. How to provide better service? • Train non medical staff to perform fills • Provide adjustments at out-patient clinics • Provide a “local” adjustment service for outlying patients

  7. How? • Follow BDA protocol • Find surgical support • Find suitable course • Ensure adequate supervision to • Achieve and maintain competency

  8. My Experience • Find a mentor • Find training course • Get supervision • Show competency

  9. Practical Tips! • Practice touching patients • Hep B jab • Warm hands/short fingernails • Although you may fail to adjust band you may identify a problem!

  10. Working towards…… • Achieving competency • Adjustments routinely done at O/P clinic • Training other non medical staff • Developing better overall service for patients • Developing an extended role for dietitians

  11. Advantages of extended role • Enhanced patient treatment, opportunity to offer dietetic advice with adjustment • Flexible • Improved outcomes • Time saving • Cost saving

  12. And finally………… To achieve this extended role you will need to… • Have a desire to learn this skill, be determined and willing to find solutions to the inevitable hurdles….. but if you succeed • You will have a skill that will enable you to provide a more efficient and enhanced service for patients.

  13. Questions ??????????? Fiona Sim Bariatric Dietitian Aberdeen Royal Infirmary fionae.sim@nhs.net

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