Mrs Kim Lunardi1, Ms Natalie Simmance1
1St Vincent’s Public Hospital, Melbourne , Fitzroy, Australia
Driving Improvement for Head and Neck Cancer Patients with Gastrostomy Tubes through Advanced Practice in Dietetics
Many patients with head and neck (HN) cancer require gastrostomy feeding tubes (G-tubes) during their treatment. Poor consumer experience and model of care mapping identified opportunities to improve service provision. This project aims to describe the development of an advanced scope of practice (ASP) dietitian role to improve patient experience and outcomes.
An ASP credentialing program in G-tube management for HN Dietitians was developed, informed by a literature search and key stakeholder engagement to meet local clinical governance requirements. Service and patient events were measured and patient feedback obtained via staff logbooks and surveys.
Up until October 2018, four Dietitians have been credentialed, enabling provision of stoma site care and procedures to change G-tubes, activities historically undertaken by other professions. Of the 50 G-tube changes completed by ASP Dietitians, 26 (52%) were for patients from the HN unit. A dietitian-led hospital “Gastrostomy Consult” service has provide 97 service events, of which 64 (66%) were for patients from the HN unit. Patient outcomes include reduced wait time to care (2 months to 0-2 days) and reduction in unnecessary appointments, with no adverse events recorded. For consumers, satisfaction with the new service model is high.
Significance of the findings to Allied Health:
This novel ASP Dietitian role has been successfully imbedded into the hospital workforce and enables comprehensive, timely, safe and patient-centred care for patients with HN cancer.
Kim Lunardi is an Accredited Practicing Dietitian with more than 10 years experience, specialising in Head and Neck surgical oncology and Advanced Nutrition Support. She leads the St Vincent’s Hospital Melbourne Advanced scope of practice and competency development portfolio and has work published in this area.