LAGBAdjustments Extended Role Fiona Sim Bariatric Dietitian Aberdeen
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 .
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
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
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
How? • Follow BDA protocol • Find surgical support • Find suitable course • Ensure adequate supervision to • Achieve and maintain competency
My Experience • Find a mentor • Find training course • Get supervision • Show competency
Practical Tips! • Practice touching patients • Hep B jab • Warm hands/short fingernails • Although you may fail to adjust band you may identify a problem!
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
Advantages of extended role • Enhanced patient treatment, opportunity to offer dietetic advice with adjustment • Flexible • Improved outcomes • Time saving • Cost saving
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.
Questions ??????????? Fiona Sim Bariatric Dietitian Aberdeen Royal Infirmary firstname.lastname@example.org