Band 6 trainee CNS in Critical Care Outreach Harefield Hospital

Detailed job description and main responsibilities

PATIENT/CUSTOMER CARE

To perform physical examination and assessment of the patient to formulate an appropriate care management plan

To accept referral of patients, following Critical Care Outreach Referral Criteria

To participate in the admission and discharge of patients, liaising with theatres, ward areas, other hospitals and patient families

To provide daily review of all patients meeting the Outreach inclusion criteria

To provide daily review of all referred patients until discharge from Outreach management

To provide specific patient management related to the following for all patients outside Level 3:

• patients with a tracheostomy insitu [including mini-tracheostomy]
• patients requiring intermittent Continuous Positive Airway Pressure [CPAP] or Bilevel Positive Airway Pressure [BiPAP]
• patients requiring inotropic support
• patients requiring mechanical support i.e. IABP, VAD
• patients who are pacing dependent

To provide advice and support for the management of all patients requiring Renal Replacement Therapy outside the Level 3 area

To provide assessment and follow up all long-term Level 3 patients

To manage all Critical Care Outreach patients in collaboration with the multidisciplinary colleague

To actively support the development of critical care skills for staff in L2 – L0 areas

To provide direct patient care within the Intensive Therapy Unit to maintain critical care skills (1/3 of contracted hours)

To provide a high standard of patient care following Trust / departmental clinical guidelines/policies/protocols

To participate as an active member of the Critical Care team to ensure optimal patient care and enhance patient outcomes

To act as part of the Hospital Resuscitation team, carrying the Cardiac Arrest bleep and actively contributing to patient management in arrest scenarios

To deliver care consistent with the values associated with the 6Cs of nursing

COMMUNICATION

To work autonomously and liaise directly with the Intensive Care Consultant in regard to management of critically ill patients outside the Level 3 area

To act as a triage for calls made overnight to the senior nurse on call. To liaise with the senior nurse on call out of hours to ensure that appropriate senior input is available for clinical and managerial issues

To liaise with the bed manager in order to ensure that patient flows are optimized and patient pathways adhered to

To act as shift leader on ITU / Recovery / HDU when required

To actively participate in the orientation of new critical care staff

To act as a resource in critical care nursing for other professionals and patients

To actively participate in informal and formal teaching sessions in the ward areas

To actively participate in departmental seminars, conferences and educational programs

To monitor, promote and participate in patient and family education including participation in long-term patient case conferences

RESOURCE MANAGEMENT

To monitor resource needs/demands to ensure appropriate skill mix of staff to deliver patient care across the Harefield site

To ensure the effective use of Bank/Agency resources in all wards

To actively promote a cost effective culture within critical care and beyond

To anticipate requirements when clinical activity increases/decreases

To actively contribute to forward planning of nursing resources

To provide overall management of the Critical Care Outreach service when required

PEOPLE MANAGEMENT

To enable and support the clinical development of nurses within critical care , including intensive care and ward areas

To perform appraisals for band 5 and 6 nursing colleagues

To seek expert advice and assistance when required

To demonstrate effective time management skills

To take responsibility for their own continued academic and professional development

To co-ordinate Critical Care Academic day programmes for senior nursing staff

To deliver formal and informal teaching sessions to a variety of disciplines/grades

To participate in their own performance review with Service Manager

To actively encourage and support a learning environment

To act as mentor to students undertaking post-registration specialist courses

To mentor newly appointed Outreach staff, and disseminate progress with senior members of staff

To ensure that designated team members have objectives set within 3 months of commencing employment, objectives reviewed every 6 months, and have annual appraisals completed

POLICY DEVELOPMENT

To have knowledge of, and to work within, the nursing policies and objectives.

To play a lead role in the implementation of relevant guidelines (eg NICE 50)

To ensure that Outreach related policies and practices are responsive to changes within the associated services

To use best evidence to support clinical guidelines and integrate research into their clinical practice

To participate in presentations of related research/audit

To contribute to publication of related research/audit

To encourage other staff to recognise the need for nurse-led research and to encourage   participation in audit and research projects

SERVICE DEVELOPMENT

To identify potential areas of nursing research and actively participate in clinical research projects

To contribute to the development of long-term critical care patient clinic

To support the safe delivery of seven day services on the Harefield site

To actively contribute to service development and future directives of the Critical Care Outreach Service ensuring that the service is responsive and tailored to the needs of Harefield’s patients

To develop selection and interview skills through active participation in the recruitment process of new staff

To actively contribute to the on-going development of critical care education through the Critical Care Outreach study day program, critical care skills labs and ALERT courses

To conduct route cause analysis and adverse incident investigations in a timely and thorough manner

To actively contribute to development of 24/7 Outreach service

To support and contribute to the development of nursing competencies and related training packages

To actively participate in the ongoing development and objectives of the Critical Care Outreach Service and the Adult Intensive Care Unit

INFORMATION MANAGEMENT

To contribute to the ongoing Critical Care Outreach clinical audit and research program

To contribute to and present Outreach quality / activity metrics at the Harefield Quality and Safety group meeting

To participate in the Trusts Clinical Governance Program.

To contribute to the Critical Care Outreach Report and present at Critical Care Management Meeting

To identify appropriate responses to data trends thereby ensuring that the service is responsive to quantitative sources of information

To ensure that full documentation is made of all patient reviews/assessments and that relevant data is entered into the Outreach database

To continually review Outreach database content to ensure that all data entered is useful and relevant

To act as a role model with regard to the use of the intranet/email and other IT systems