
We offer a comprehensive range of nutritional services including full enteral and parenteral (TPN) support services.
There are two nutrition nurses in the trust, a nurse consultant in nutrition and a clinical nurse specialist in nutrition. Both nurses cover the Royal Liverpool & Broadgreen Hospitals. In addition to this they provide a service to the patients requiring enteral nutrition via gastrostomy/jejunostomy tubes at Liverpool Heart & Chest Hospital.
The nutrition nurses are part of a larger hospital nutrition team consisting of two consultants, senior dietitian, a team of middle grade doctors (specialist registrars in Clinical Chemistry) and a senior pharmacist. The trust also has a Nutrition Group and Nutrition Steering Committee.
Outpatient and Inpatient Services
The role of the nutrition nurses is to assess all patients referred for artificial nutritional support to decide on the most appropriate method and route for feeding. The Nutrition team (including the Nutrition Nurses, TPN Pharmacist, Senior Dietitian and Clinical Chemist) review all patients requiring parenteral nutrition on a daily basis.
The RLBUHT compound all the parenteral nutrition feeds for our inpatients and for the majority of our outpatients. Patients require daily blood monitoring when an in patient in ensure the parenteral nutrition fulfils there nutrition and hydration needs
The infection rate for parenteral nutrition lines in 1998 was between 15-20% (approximate as limited data available). Within two years the infection rate for parenteral nutrition was down to 3.5% which has further decreased in the year 2009.
One of the main reasons for this was the development of skills and training in IV access device placement. As a team the Nutrition Nurses assess and place lines in 99% of patient requiring parenteral nutrition with the other 1% of patients’ who go onto have more invasive IV access devices such as skin tunnelled catheters (which Alison is training to do) or an implantable port.
The Nutrition Nurse team place over 300 peripherally inserted central catheters and peripheral midlines for TPN and IV access annually (with or without ultra sound guidance)and have developed extensive skills in the management of these devices.
At the RLBUHT we have a large group of patients requiring Home Parenteral Nutrition whom the Nutrition Nurses manage and support.
The development of the enteral side of the service is ongoing. Not only do the Nutrition Nurses place PEG tubes they have developed skills in placement of all gastrostomy devices including direct PEJ tubes. Nasal Bridle placement has been done by the Nutrition Nurses very successfully for the past 18 months. Practice is currently being audited which on a brief overview indicates an appropriate management of patients requiring nutritional support.
The Nutrition Nurses also have an excellent relationship with the intervention radiology department who support the Nutrition Nurses with the placement of radiologically inserted gastrostomies as required.
The Nutrition Nurse service is available 5 days a week from 7am-4pm Monday to Friday. We see patients at the Royal Liverpool Hospital, Broadgreen Hospital, the Liverpool Heart and Chest Hospital and from the community. We are contactable on our bleeps or via our direct line 0151 706 3650.
We have built strong links with the PCT commissioners and all the community teams providing regular meetings, training and education.
In addition to providing a nutrition nurse service, our roles also include general gastroenterology clinics (Monday pm) and upper endoscopy (Monday am and Friday am).
Summary of services
Service provided |
Description |
Lead |
Contact Details |
Nasogastric Tube Placement |
This service is for situations where staff have been unable to place a NG tube. The Nutrition Nurses can be contacted for advise and support |
Alison Young Lisa Leedham |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Nasal Bridle Placement |
For patients who have self removed 3 or more nasogastric tubes |
Alison Young Lisa Leedham |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Nasojejunal tube placement |
For patients who are unable to tolerate nasogastric feeding. Self propelling device placed on the ward. Requires abdominal x-ray post procedure to assess tip position. |
Alison Young Lisa Leedham |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Endoscopic placement of Nasojejunal Tubes |
For patients who are unable to tolerate nasogastric feeding in whom blind placement is deemed not appropriate. Place available on the endoscopy list daily (Monday-Friday). Naso-jejunal tubes come in a range of types, single, dual and triple lumen depending on the patient’s need. |
Alison Young Lisa Leedham Dr O’Toole Dr Smart |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Percutaneous Endoscopic Gastrostomy Tube assessment |
Long term device for patients requiring enteral nutrition for more than 4 weeks. Place available on the endoscopy list daily (Monday-Friday) |
Alison Young Lisa Leedham |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Gastrostomy tube assessment and placement |
Regular review of gastrostomy tubes as inpatient/outpatient. Appointments available Mon/Fri 8-4pm |
Alison Young Lisa Leedham |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Low Profile gastrostomy device placement |
An alternative device for patients requiring long term nutritional support via the enteral route. Inpatient/outpatient appointments available Mon/Fri 8-4pm |
Alison Young Lisa Leedham |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Gastrojejunostomy Placement |
Placement of a gastrostomy device with integral jejunal extension. Placed using endoscopy or in intervention radiology. |
Alison Young Lisa Leedham |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Percutaneous Endoscopic Gastrostomy Tube with jejunal extension |
For patients intolerant of gastric feeding or having issues with aspiration pneumonia. Place available on the endoscopy list daily (Monday-Friday) |
Alison Young Lisa Leedham |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Direct Percutaneous Endoscopic Jejunostomy (PEJ) |
Placement of a feeding device directly into the small bowel. Place available on the endoscopy list once a week Dr O’Toole or Dr Smart’s list. |
Alison Young Dr Paul O’Toole Dr Howard Smart |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Radiologically Placed Gastrostomy |
For patients who are unable to have a PEG, a radiologically placed device is indicated. Referrals should be sent on ICE to intervention radiology and also to the nutrition nurses for assessment pre procedure. |
Dr Jonathan Evans |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Parenteral Nutrition Assessment and management |
Patients with a non functioning gut should be referred to the nutrition team for assessment for parenteral nutrition. These patients are reviewed daily by the nutrition team. |
Alison Young Lisa Leedham Helen Campbell Peter Turner Dr Eileen Marks |
Refer via ICE 0151 706 2000 Bleep 4595, 4024, 4530 or 4134 |
Peripheral Midline insertion |
The decision regarding which IV access device is appropriate for the proposed therapy is decided by the nutrition nurses. A peripheral midline is ideal for patients requiring short term IV therapy, up to 6 weeks. |
Alison Young Lisa Leedham |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Peripherally Inserted Central Catheters (PICC) |
The decision regarding which IV access device is appropriate for the proposed therapy is decided by the nutrition nurse. A PICC line provides IV access for weeks/months. PICC lines are single, dual or triple lumen depending on the clients needs. |
Alison Young |
Refer via ICE 0151 706 2000 Bleep 4595 or 4024 |
Skin tunnelled Catheter insertion |
The decision regarding which IV access device is appropriate for the proposed therapy is decided by the nutrition nurse. A skin tunnelled catheter provides IV access for weeks/months. Skin tunnelled catheters are single or dual lumen depending on the clients needs. These devices are ideal for patients with long term conditions for self management at home. |
Sue Benton Intervention radiology department |
Refer via ICE 0151 706 2748 |
Nutrition Clinic |
Every alternate Friday morning. Outpatients clinic for patients requiring home nutritional support. Based on ward 2C |
Alison Young Eileen Marks Pete Turner |
0151 706 4304 |
Education & Training |
Education and Training in all areas of nutritional support/IV access management is provided by the nutrition nurses. The nutrition nurses deliver regular training at the education centre (RLBUHT), John Moores University, Edge Hill University, and Liverpool University. |
Alison Young |
0151 706 3650 |
Nutrition is about the right food to keep your body healthy.
Our Nutritional Services give people help with getting the right food for their medical condition.
This page gives you information about:
This service is for situations where staff have been unable to place a NG tube. The Nutrition Nurses can be contacted for advise and support.
Alison Young - Refer via ICE
Lisa Leedham - 0151 706 2000 Bleep 4595 or 4024
For patients who have self removed 3 or more nasogastric tubes.
Alison Young - Refer via ICE
Lisa Leedham - 0151 706 2000 Bleep 4595 or 4024
For patients who are unable to tolerate nasogastric feeding. Self propelling device placed on the ward. Requires abdominal x-ray post procedure to assess tip position.
Alison Young - Refer via ICE
Lisa Leedham - 0151 706 2000 Bleep 4595 or 4024
For patients who are unable to tolerate nasogastric feeding in whom blind placement is deemed not appropriate. Place available on the endoscopy list daily (Monday-Friday). Naso-jejunal tubes come in a range of types, single, dual and triple lumen depending on the patient’s need.
Alison Young - Refer via ICE
Lisa Leedham - 0151 706 2000 Bleep 4595 or 4024
Dr O’Toole
Dr Smart
Long term device for patients requiring enteral nutrition for more than 4 weeks. Place available on the endoscopy list daily (Monday-Friday).
Alison Young - Refer via ICE
Lisa Leedham - 0151 706 2000 Bleep 4595 or 4024
Regular review of gastrostomy tubes as inpatient/outpatient. Appointments available Mon/Fri 8-4pm.
Alison Young - Refer via ICE
Lisa Leedham - 0151 706 2000 Bleep 4595 or 4024
An alternative device for patients requiring long term nutritional support via the enteral route. Inpatient/outpatient appointments available Mon/Fri 8-4pm.
Alison Young - Refer via ICE
Lisa Leedham - 0151 706 2000 Bleep 4595 or 4024
Placement of a gastrostomy device with integral jejunal extension. Placed using endoscopy or in intervention radiology.
Alison Young - Refer via ICE
Lisa Leedham - 0151 706 2000 Bleep 4595 or 4024
For patients intolerant of gastric feeding or having issues with aspiration pneumonia. Place available on the endoscopy list daily (Monday-Friday).
Alison Young - Refer via ICE
Lisa Leedham - 0151 706 2000 Bleep 4595 or 4024
Placement of a feeding device directly into the small bowel. Place available on the endoscopy list once a week Dr O’Toole or Dr Smart’s list.
Alison Young - Refer via ICE
Dr Paul O’Toole - 0151 706 2000 Bleep 4595 or 4024
Dr Howard Smart
For patients who are unable to have a PEG, a radiologically placed device is indicated. Referrals should be sent on ICE to intervention radiology and also to the nutrition nurses for assessment pre procedure.
Dr Jonathan Evans - Refer via ICE
0151 706 2000 Bleep 4595 or 4024
Patients with a non functioning gut should be referred to the nutrition team for assessment for parenteral nutrition. These patients are reviewed daily by the nutrition team.
Alison Young
Lisa Leedham
Helen Campbell
Peter Turner
Dr Eileen Marks
Refer via ICE
0151 706 2000 Bleep 4595, 4024, 4530 or 4134
The decision regarding which IV access device is appropriate for the proposed therapy is decided by the nutrition nurses. A peripheral midline is ideal for patients requiring short term IV therapy, up to 6 weeks.
Alison Young
Lisa Leedham
Refer via ICE
0151 706 2000 Bleep 4595 or 4024
The decision regarding which IV access device is appropriate for the proposed therapy is decided by the nutrition nurse. A PICC line provides IV access for weeks/months. PICC lines are single, dual or triple lumen depending on the clients needs.
Alison Young
Refer via ICE
0151 706 2000 Bleep 4595 or 4024
The decision regarding which IV access device is appropriate for the proposed therapy is decided by the nutrition nurse. A skin tunnelled catheter provides IV access for weeks/months. Skin tunnelled catheters are single or dual lumen depending on the clients needs. These devices are ideal for patients with long term conditions for self management at home.
Sue Benton
Intervention radiology department
Refer via ICE
0151 706 2748
Every alternate Friday morning. Outpatients clinic for patients requiring home nutritional support. Based on ward 2C.
Alison Young
Eileen Marks
Pete Turner
0151 706 4304
Education and Training in all areas of nutritional support/IV access management is provided by the nutrition nurses. The nutrition nurses deliver regular training at the education centre (RLBUHT), John Moores University, Edge Hill University, and Liverpool University.
Alison Young
0151 706 3650
Alison Young - Nurse Consultant - Email Alison here
Lisa Leedham - Specialist Nurse - Email Lisa here