Two clinical dietitians at the Royal Adelaide Hospital (RAH) have become the first dietitians in Australia to their knowledge to be qualified to place post-pyloric feeding tubes for patients in intensive care.
The approved extension to their scope of practice allows Dr Lee-anne Chapple and Ms Julia Gallagher to perform the procedure, benefiting patients, staff and the hospital.
What are post-pyloric feeding tubes?
Critically ill patients in intensive care units usually receive liquid nutrition via a thin rubber tube placed through the nose and down into the stomach.
However, for some patients this nutrition doesn’t move through the stomach effectively which can cause nutrition to enter the lungs and increasing the risk of pneumonia. Post-pyloric feeding tubes bypass the stomach and deliver nutrition directly to the small bowel for nutrients to be absorbed more safely.
The process of placing post-pyloric feeding tubes is usually performed by intensive care doctors, taking time away from other tasks or delaying tube placement.
Benefits of the extended scope of practice
Having clinical dietitians in the ICU trained and permitted to place post-pyloric feeding tubes provides benefits for patients, staff and the hospital.
It improves nutrition delivery to patients as these ICU based dietitians are available to quickly insert a post-pyloric feeding tube at short notice without the need for the treating clinician to be present. Having Dietitians, who focus on providing optimal nutrition to patients, taking on this role it frees up treating medical staff for other roles.
Julia Gallagher, one of the RAH’s newly credentialed dietitians says “nutrition is a vital aspect of patient care and we believe that those patients who receive better nutrition are likely to have better recovery”
“We’re pleased to be able to provide this new skill set to support the wider ICU team and to benefit our patients with our extended scope of practice.”
The training process
Dr Chapple and Ms Gallagher are grateful for the support of the RAH’s ICU medical staff who provided training and the Dietetics Management team for their support in obtaining extended scope of practice approvals.
The process included observing treating physicians placing the tubes, as well as the chance for the dietitians to be supervised in conducting the procedure themselves.
Having now set a precedent, Julia Gallagher believes the process will be simpler for clinical dietitians to become credentialed elsewhere in Australia, with interstate colleagues having expressed huge interest.
By expanding their scope of practice, Dr Chapple and Ms Gallagher, have embodied the ideas driven value of the Central Adelaide LHN and are sure to provide benefit to the outcomes of their patients.