BAPEN Conference Review | Event Report
BAPEN Annual Conference 2010
BAPEN
Advancing Clinical Nutrition Registered Charity 1023927
BAPEN
Advancing Clinical Nutrition Registered Charity 1023927
Introduction
After a successful excursion to Wales last year, BAPEN’s 2010 conference returned to Harrogate with 630 delegates keen to learn about the latest developments in clinical nutrition and the importance of quality in nutritional care.
BAPEN – The Movie The conference opened with a short film ‘Malnutrition Matters’ starring BAPEN Chairman Mike Stroud and Professor Marinos Elia. Although they may not get Oscars for their performances, the film is a brilliant summary of the effects of malnutrition and how screening for it can initiate vital treatment. It outlines BAPEN’s initiatives to combat malnutrition including ‘MUST’, the Nutritional Care Toolkit and e-learning. The film can be viewed on the BAPEN website
www.bapen.org.uk and serves as a magnificent introduction to this important issue for anyone involved in healthcare. Mike Stroud and Marinos Elia gave more detail on many of these
initiatives during the opening session ‘Ensuring Quality in Nutritional Care’ as well as mentioning other interesting developments such as ‘MUST’ iphone apps, the ‘MUST’ calculator (available on the BAPEN website), plans to involve GPs in treating malnutrition and setting up an All Party Political Group (APPG) on nutrition and hydration to influence national policy. Dame Jo Williams DBE detailed the role of the Care Quality Commission (CQC) in regulating healthcare to ensure quality and safety, before Dr Ailsa Brotherton talked about driving improvements in nutritional care through a QIPP national improvements programme for England. Although there was a focus on England this year, BAPEN would welcome input from anyone involved in nutrition and quality initiatives with the devolved governments of Northern Ireland, Wales and Scotland for the 2011 conference – just contact the programmes committee through the website. An example of the importance of collecting data in ensuring
quality was provided by Dr James Stewart who outlined the fascinating findings of ‘A Mixed Bag: results of the NCEPOD enquiry into the
quality of care given to hospital patients receiving
parenteral nutrition (PN)’. These included: • Good practice around PN was only identified in 19% of patients • Inadequate consideration was given to enteral nutrition in a third of patients on PN
• PN was administered for an inappropriate indication in 29% of patients
• There were deficiencies in the assessment and monitoring of PN patients in 54% of cases
• Metabolic complications occurred in 40% of PN patients and 49% of these were probably avoidable
Dr Stewart also reported that more patients are referred for PN
on Fridays than any other day – it was a relief to find out that it’s not just some Liverpool consultants who save their most challenging nutritional referrals for the weekend!
Pennington Lecture The Pennington Lecture delivered by Pharmacist Rebecca White continued the quality theme with ‘Quality PN – An Ideal Mixed Bag’. She explained that total parenteral nutrition (TPN) is the most complex prescription only medicine as there is no standard dose, it has many variations in composition and there are problems with its stability. By looking though the history of its development, the problems that have occurred and solutions to them, she explained how we can make PN a safe and effective treatment. Becky’s brilliant review showed that it really isn’t a case of ‘any old bag will do’ when it comes to TPN or delivering a Pennington Lecture!
Symposium 1 This year’s NNNG symposium ‘Options in Enteral Feeding: to PEG or not to PEG, is that the only question?’ was a thought provoking look at access routes for enteral feeding. Dr Sue Cullen reviewed the pros and cons of percutaneous endoscopic gastrostomies (PEGs) and nasogastric (NG) tubes before Nurse Consultant Tracy Earley explained that bridled NG tubes can be used as short to medium term alternative to PEGs in hospital and the community. Her group have placed over 1000 nasal bridles using a simple procedure over the last four years. Take home messages included: • Although a very valuable feeding method, PEGs can be associated with considerable morbidity
• NGs are unsightly, easily displaced and can be uncomfortable but are easily placed and relatively safe
• The use of a bridle can stop NGs being displaced and make them a safe route for short to medium term feeding in any care setting
•
Bridles make NGs more comfortable by stopping movement of the tube and irritation of the nose
• Both PEGs and NGs have their advantages and disadvantages and it really is a case of making sure you are using the most appropriate method for individual patients.
BAPEN
Advancing Clinical Nutrition Registered Charity 1023927
Pete Turner (Specialist Dietitian, Royal Liverpool University Hospital) with contributions from Tony Murphy (BPNG), Carolyn Wheatley (PINNT), Ruth Newton (BPNG) and Dr Ailsa Brotherton (National QIPP Safe Care Programme Director)
Complete Nutrition Vol.10 No.6 December/January 2010/11
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