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LAGB Adjustments

LAGB Adjustments

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LAGB Adjustments

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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