Knows the criteria for assessing the severity and extent of IBD, in
particular recognition of acute severe colitis. Knows treatment options
including aminosalicylates, corticosteroids, and steroid sparing
therapies.
Knows differing methods of delivery for therapy.
Skills
Selects of appropriate treatment for extent and severity of disease,
including timing of immunomodulator therapy and referral for surgery.
Behaviours
Recognises the urgency of treating acutely sick patients, including
multidisciplinary team early, particularly surgeons. Clearly explains
the clinical situation and treatment options to patient and family.
Involves patient and family in decision making about treatment
options.
also....
Knows the complications of IBD including stricturing, fistulae,
extraintestinal manifestations, colon cancer and special situations
such as pregnancy.
Skills
Able to recognise potential complications and take appropriate action
to investigate and alter treatment as necessary including referral for
surgery and involvement of other healthcare professionals
Behaviours
Works with patient to explain complications and options for treatment
Involves the multidisciplinary team especially IBD nurse and surgeon
in management, and tailors treatment to the needs of the patient.
Discusses with colleagues early and appropriately
Also...
Knowledge
Understands the importance of multidisciplinary decision making
including when radiological histopathological and surgical opinions
should be sought
Understands the role of the IBD nurse within the MDT and in
communicating with patients and their relatives
Recognises the importance of other healthcare professionals in
providing high quality care including dieticians and pharmacists
Aware of the surgical options available in IBD and how to access
them
Skills
Has appropriate discussions with other specialties including
surgeons and other healthcare professionals
Can participate in an IBD MDT effectively
Relates well with all other healthcare professionals involved in IBD
patient care especially the IBD Nurse Specialist
Behaviours
Shows commitment to team-working and shows understanding of the
roles of other healthcare professionals with courtesy
Explains decision making process to the patient clearly and
sympathetically
Also...
Knowledge
Knows the different treatment modalities for IBD given the disease
extent activity previous history and complications
Knows the modes of delivery of different drug therapies and their
advantages and disadvantages
Recognises the importance of patient choice in deciding therapy and
in helping to ensure adherence
Understands when surgery is the most appropriate therapeutic option
and to make appropriate referrals
Skills
Demonstrates the ability to identify the possible range of appropriate
treatments for a particular patient and have an appropriate discussion
allowing the patient and doctors to come to a sensible consensus
Behaviours
Effectively communicates the possible treatment options and the
potential benefits complications and side effects of each
Also...
Knowledge
Knows the effect of active IBD drug therapy and surgery on fecundity
and pregnancy specifically issues relating to immune suppressants
biological therapy and surgery
Knows the effect of IBD and its treatment on breast feeding
Knows the effects of the disease and its treatment on the chances of
conception for men with IBD
Skills
Appreciates when to alter treatment to take account of pregnancy and
breast feeding
Can provide accurate advice about the effect of disease treatment
and surgery on fecundity pregnancy and lactation
Behaviours
Can discuss in an appropriate manner the treatment options for
patients wishing to conceive who are already pregnant or who wish
to breast feed
Explains the issues relating to treatment to those patients and their
partners who are planning to conceive so as to enable them to make
informed choices
Also...
Knowledge
Knows the risks relating to a previous history of malignancy or the
development of malignancy in IBD in particular to understand how
this affects treatment options
Knows the risks relating to infection with hepatitis B hepatitis C and
HIV connected with treatment of IBD
Knows the circumstances in which patients should be screened or
immunised for infectious diseases before commencing therapy
Skills
Can identify patients at risk for particular treatment due to concurrent
or pervious medical conditions
Can identify patients who need to be screened or immunised for
infectious diseases prior to therapy
Understands the treatment options available for patients with preexisting medical conditions
Behaviours
Can explain to patients the reasons for screening /immunising
Can explain the way that treatment may be affected by other medical
conditions and to start appropriate treatment
UC Treatment Algorithm
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