Intestinal Failure Unit

Pioneering unit sets the standard for patient care

Salford Royal’s pioneering Intestinal Failure Unit continues to set the standard in the care of patients who need intravenous feeding.

A common complication of this is a blood stream infection but a review of more than 500 patients cared for at Salford Royal has shown the lowest rates of these infections ever recorded worldwide. The data came from 559 patients over the five years from 2012 to 2016.

Patients travel from all over the UK and beyond to the Intestinal Failure Unit, the first specialist centre of its kind in the UK for patients whose intestines cannot absorb the nutrition that the body needs. This could be because of conditions such as Crohn’s disease or other bowel illnesses, or complications from other surgeries on the abdomen.

These patients rely on intravenous feeding for survival and some spend the rest of their lives being fed through a catheter into a vein in their chest, a process also known as home parenteral nutrition.

Preventing catheter-related blood stream infections is a key focus of specialists in the unit and they’ve carried out a number of projects aimed at improving care for patients.

The Unit’s Lead Physician is Professor Simon Lal. He explained: “Home parenteral nutrition has been part of clinical practice for about 50 years and ours was one of the first units in the world to offer this. We currently have around 280 patients on home parenteral nutrition, one of the largest groups worldwide.

“Making sure patients can look after their catheter themselves at home is very important and we have always had a detailed training programme to help them with this. Previously this took place while they were in the unit but since 2012 we’ve offered this training in their own homes with daily sessions over two to four weeks. This cuts the length of time patients have to stay in hospital and we’ve also found patients prefer the training at home. Reducing the length of stay also helps to cut waiting times for admissions.

“Our recent research shows that there’s no difference in the rates of infections whether patients are trained at home or in hospital. We recorded rates of just over 0.3 infections per 1,000 catheter days where patients or their carers were managing the catheter and an even lower rate of 0.27 infections per 1,000 catheter days where a trained home care nurse was involved.”