OPAT Clinical Nurse Specialist

Detailed job description and main responsibilities

KEY RESPONSIBILITIES

Expertise & Excellence in Clinical Practice

Contribute to the delivery of evidence-based personalised and compassionate care which places quality at the heart of specialist practice.  Care will be responsive to individual needs and reflect current local protocols and national guidelines.

To work with a degree of autonomy and advocacy to ensure the delivery of appropriate care.

To be aware of and escalate clinical concerns to an appropriate clinician in a timely manner

Contribute to the clinical management of a caseload of patients within speciality and prioritise workload to meet patient and service need.

Use knowledge of the speciality and treatment to support the development of personalised care pathways for individuals and assist with holistic needs assessment, planning and evaluation of care and all care interventions.

Act as a patient advocate to facilitate the process of shared decision making in respect to health, choice of treatment and care.  Use interpersonal and communication skills where there may be significant barriers in order to build confidence.  Ensure that patients’ individual needs are expressed and valued and individual care plans are understood.

Advise on disease and symptom management for patients within the established OPAT governance structure (appendix one) in both inpatient and outpatient settings.  Evaluate response to interventions and cascade to relevant colleagues.

Support patients to self manage their condition where appropriate, including teaching and assessing the administration of intravenous antibiotics. Provide education for those who will need guided support to self-manage, including supporting wards with this process.  Offer health promotion advice and sign-post as appropriate.

Assist in the development and delivery of nurse led or parallel clinics in line with National guidance and local service need.

Co-ordinate patient care in line with clinical need and professional skill set both in clinic and in the community, maintaining patient safety and increasing service capacity.

Act as a resource providing specialist advice and support across service boundaries to ensure optimum liaison and co-ordination of care.

Undertake clinical competencies relevant to this specialist service to demonstrate expertise in extended nursing roles. 

Assess and assist in managing individual psychological reactions to treatment.

Management & Leadership

Act as a role-model and mentor to junior staff, supporting and developing as required.

Provide clinical leadership to others across the organisation.

Provide support to ensure public and patient involvement is embedded within the sphere of practice.

Assist in setting measurable outcomes for the service and continuous evaluation of practice supporting changes where necessary.

Contribute to the clinical governance agenda.

Support the implementation of service improvement activities and cascade relevant information to appropriate persons.

Attend Trust senior nurse meetings and contribute to the agenda and strategic nursing vision where appropriate.

Represent the Trust by contributing to and participating in meetings locally, regional and nationally relating to the speciality.

Contribute to an annual service review, gathering information to support the annual report.

Communication

Take personal responsibility for ensuring effective communication between all service providers.

Act as a role model for excellent communication skills.  Demonstrate empathetic interpersonal and communication skills in supporting, informing and advising patients and carers through diagnosis, treatment, disease progression, prognosis and supportive and palliative care where applicable.  This will involve supporting patients and carers during and following difficult consultations and sometimes bad news.

Effectively and sensitively communicate complex and sensitive information to emotionally distressed patients and family/carers at key points along the care pathway on a frequent basis.

As a core member of the MDT provide professional advice to OPAT patients and ward based staff, and liaise with the senior OPAT team.

Refer to other health professionals and outside agencies to ensure optimum care and ongoing support for individual patients/carers, and to ensure the seamless transition from primary to secondary care appropriate to patients’ individual needs and circumstance.

Maintain links with local and national organisations, which support the care of patients within this speciality.

Education

Identify and use educational strategies to deliver information to patients and carers.

Participate in the development of patient focused education including training to support self management and health promotion activities.

Support wards in referring patients to OPAT and with self-administration training.

Assist in the development of other professionals by contributing to Trust wide specialist education and training.

Support the delivery of formal and informal teaching initiatives as part of the Trust’s education strategy as agreed with the appropriate senior nurse to ensure practice development, staff empowerment and improved care for patients.

Act as a mentor/clinical supervisor as appropriate.

Take personal responsibility for life-long learning and personal development through clinical supervision and appraisal.  Actively engages with learning and development opportunities needed to work as an advancing practitioner and take appropriate action to ensure these needs are met.

Contribute to promoting educational links with local providers of higher education and deliver lectures on a range of courses.

Quality, Audit, Innovation and Research

Assist in the development of written patient information and use existing appropriate resources to inform users, according to individually assessed need.

Work within the NMC code of professional conduct.

Contribute to the development of policies and clinical guidelines to support the specialist service.

Collaborate with other MDT members to develop and update multi-professional Trust operational policies and guidelines.

Maintain patient records and ensure an effective documentation system to reflect the activity and delivery of specialist nursing care.

Promote the service were applicable.

Use creative reasoning, experience and vision to support advancement of care.

Develop new skills in response to emerging knowledge and techniques.

Supports management of change as required.

Maintain membership and attendance at national and local forums to network and debate issues to inform the specialist nursing role and service delivery where applicable.

Assist with the collation of data to provide evidence of productivity, outcomes and quality through audit and research to identify areas for improvement and work with the senior team to implement change.

Contribute to the identification of patients eligible for trial entry.  Provide support to patients considering entry to clinical trials in relation to informed consent and advocacy.

Participate in clinical research relevant to practice area.

Assist in the development of links and system to seek the views of patient and carers to ensure service development is in line with user need.

Additional Responsibilities

To facilitate the safe and appropriate discharge of patients requiring IV antimicrobial therapy from secondary to primary care

To provide on-going support and care for patients whilst receiving IV therapy at home including home visits, OPAT clinic and a weekly MDT.

To be an expert clinical resource to colleagues and service users by keeping up to date with current research and developments in OPAT and demonstrating best or evidence based practice at all times.

Demonstrate in depth specialist knowledge, skills and innovative practice in the delivery of OPAT.

Support, assist and encourage the multi-disciplinary team in resolving complex patient problems.

To actively participate in the delivery of care to the service caseload where needed

To work in collaboration with local services to assess and make recommendations to improve access to Outpatient Parenteral Antibiotic Therapy

To work flexibly with team members to provide cover to the service, including cross cover of the South Warwickshire Accelerated Transfer Team (SWATT).

To participate in the placement and management of peripherally inserted midlines including line removal where appropriate.

To promote the use of the right line at the right time and where possible be involved in the education of ward based staff in issues surround vascular access device.

To assess and review patients in the hospital to assess suitability for the service and to monitor progress of OPAT patients in the outpatient clinic

To teach patients or their families/carers to safely administer their own intravenous antibiotics and provide on-going support and advice throughout their treatment course

To participate in the monitoring of patient care, by ensuring blood tests are appropriately performed and results checked and acted upon.

To visit patients in their own homes when clinically appropriate.

To assist in the upkeep of the clinical database and regular clinical governance audit

General

To provide short-term cover for colleagues during periods of leave

To ensure that all Trust standards are maintained and monitored to improve the quality of care to all whom come into contact with services provided by South Warwickshire NHS Foundation Trust

Every employee has a duty to take reasonable care of the health and safety of him/herself and of other persons who may be affected by his/her acts or omissions at work, and to co-operate with the South Warwickshire NHS Foundation Trust to ensure that statutory and Trust regulations are complied with

To participate in appraisals and personal reviews and work to achieve agreed set objectives