Table 1.
Members of a nutrition support team36
| Essential member | Roles |
|---|---|
| Clinician | Overall responsibility, coordinated care, may insert enteral and intravenous feeding tubes. Liaises with the patient's primary team. Understands the underlying disease(s) and prognosis. Prescribes the parenteral feeding solution. |
| Nutrition nurse specialist | Teaches and supervises care of tubes and catheters and recognises and manages complications. Places or assists in placement of enteral and parenteral feeding catheters. Acts as the patient's advocate, who also trains patients/carers to manage at home. |
| Dietitian | Nutritional assessment, calculates requirements, designs feeding regimen and monitors nutritional and fluid status. |
| Pharmacist | Responsible for providing enteral feeds and sterile parenteral nutrition solutions (may include compounding). Optimises composition and advises on compatibility/stability issues and drug/nutrient interactions. |
| Other staff in the extended NST and certainly needed for HIFNET sector 3 or 4 centres29 37 38 | |
| Stoma care/tissue viability nurses for stoma/wound management | |
| Surgeon in cases of intestinal failure | |
| Social worker | |
| Physiotherapist | |
| Occupational therapist | |
| Psychiatrist/psychologist | |
| Interventional radiologist to insert some enteral feeding tubes and to insert difficult lines for parenteral nutrition. | |
| Microbiologist to advise on the treatment of and abdominal sepsis in those with intestinal failure. | |
| Speech and language therapist for patients with difficulty swallowing | |
| Other specialists as necessary (eg, haematologist, urologist, gynaecologist, etc) | |
| Community workers (eg, dieticians and nurses) | |
The roles may overlap and all are involved in monitoring progress.
All core personnel need cover for all roles in case time away (courses, holiday sickness etc).
HIFNET, home parenteral nutrition and intestinal failure network; NST, nutrition support team.