Written by: Nicole Micallef
At the 10th Australasian Cystic Fibrosis Conference (17th-20th August 2013) an observation from an international keynote speaker and respiratory specialist was that “in Australia and New Zealand CF dietitians are taking over”. When you look at the achievements of this dynamic group, it is not hard to see why! The promotion of excellence that encouraged such a statement includes:
-The launch of the Australian and New Zealand CF dietitian vision ‘constant improvement in cystic fibrosis (CF) nutrition through Collaboration! Consensus! And Currency! (2013)
-A pioneering spirit evidenced by CF dietitians:
o Forming the first interest group (1995), which promotes collaboration between dietitians at specialist and regional CF centres across Australia and New Zealand.
o First to evaluate their practice through a series of Trans-Tasman surveys (1996, 2005, and 2010), achieving standardisation in nutritional management (e.g., pancreatic enzyme replacement therapy).
o First to create Australian and New Zealand discipline specific clinical practice guidelines (2006).
o This group also plans on being the first Australian/New Zealand group to contribute to international online evidence based dietitian pathways (coordinated in Canada).
-A commitment to continual improvement and up-skilling:
o Throughout 2012 and 2013, CF dietitians participated in a series of workshops on synthesising and critiquing evidence, reaching consensus, and how to write scientifically. Several of these workshops were run by members of the Dietitian Connection advisory board.
o Establishment of a mentoring program (2013). Formal agreement to create leadership group to provide CF specific mentoring to clinicians working in the field.
o Constant improvement in nutritional parameters (i.e., body mass index) for children and adults with CF between 1998 and 2012.
-Recognition of service achievements in 2013:
o Australian CF dietitians winning three out of four multidisciplinary conference awards.
•Christie Graham, Cystic Fibrosis Australia New Investigator Award $1000, best oral abstract presentation at conference
•Jodi Gurnert, 1st Place 2013 $7000, Cystic Fibrosis Australia Abbie Fennessy Memorial Fellowship – sponsored by Technipro Pulmomed
•Dr Audrey Tierney, 2nd Place 2013 $4000, Cystic Fibrosis Australia Abbie Fennessy Memorial Fellowship – sponsored by Technipro Pulmomed
Christie Graham, APD
Christie is the current Deputy Manager of Nutrition and Dietetics at the Children’s Hospital at Westmead (CHW) and has worked as a dietitian in Australia and the United Kingdom for nearly 13 years. She has worked as a paediatric CF dietitian for 8 years, in a number of major centres including the Royal Children’s Hospital in Melbourne, Manchester Children’s Hospital, the Royal Children’s Hospital, the Royal London Hospital and most recently at the CHW. She has actively worked to improve nutrition care in CF through her involvement as; a member of the writing group for the Australasian Clinical Practice Guidelines (2003-2005); convenor of the DAA CF Interest Group (2009-2011); a mentor for dietitians new to CF and an author of a number of published papers in CF.
The aim of the quality improvement (QI) activity completed by Christie and her team was to improve the nutritional outcomes of CF patients aged 2-18 years through 1) the introduction of a nutrition screening tool, 2) communication with the CF team and regular dietetic review of high risk patients, 3) employment of a Nutrition Education Assistant, and 4) increased focus on the importance of nutrition. At the completion of this QI strategy, a significant difference was seen in the proportion of patients in Nutrition Failure. Significantly fewer patient patients were requiring immediate and frequent dietetic review. Positive changes in BMI Z score were also significant. Incorporation of the multidisciplinary team including the employment of a Nutrition Education Assistant was vital in the success of this project. For more information email [email protected]
Jodi Grunert, APD
Jodi is a paediatric dietitian currently working in the areas of cystic fibrosis (CF), respiratory and home enteral nutrition at the Women’s and Children’s Hospital, Adelaide. She has been working as a dietitian for 8 years in various roles both in South Australia and London, UK. Currently Jodi is a steering committee member and section leader for the revision of the Australian and New Zealand CF Nutrition guidelines. She is passionate about continuous quality improvement and recently had 3 abstracts accepted at the 2013 Australasian CF conference for poster presentations to share some of her recent projects. Jodi will use her travel scholarship to attend the 2013 North American CF conference and to visit CF dietitians at North American CF centres with the aim of furthering her knowledge and skills to work towards improving the nutritional status and outcomes of the CF patients at her centre.
Dr Audrey Tierney, PhD, APD
Audrey graduated from Trinity College Dublin (TCD) in 2003 with a BSc (Hons) in Human Nutrition and Dietetics and began her dietetic career in St James Hospital Dublin, Ireland working in General Respiratory. Audrey completed her PhD studies in 2008 in the Department of Clinical Medicine in TCD taking part in a pan-European Dietary Intervention Study focussing on nutrition and genomics. After a post-doctoral year at the School of Public Health and Population Sciences, University College Dublin (UCD), Audrey moved to Melbourne in March 2009 where she began working at the Alfred Hospital in Cystic Fibrosis (CF) and Respiratory Medicine. Audrey was appointed Research Fellow with the Alfred and Monash University in August 2011. She has been awarded grant funding to undertake several clinical projects including research to compare indirect calorimetry versus standard practice in the ICU population, the effects of CF on pregnancy, exploring glycaemic variability in the adult CF population using a continuous glucose monitor and a project investigating the nutritional status and dietary intake in adults with cystic fibrosis – a 15 year follow up study. Audrey’s research interests span nutrition in cystic fibrosis and lung transplantation, obesity, metabolic syndrome, nutrigenomics and critical care nutrition. Audrey has been involved in the Australasian CF Nutrition guidelines review and has presented at national and international conferences in the area of Nutrition and CF. Audrey was recently appointed Senior Lecturer at La Trobe University in the Faculty of Health Sciences. Audrey used her travel scholarship to attend at the 10th Australasian Cystic Fibrosis Conference in Auckland, including participating in CF dietitian interest group activities.