Band 6 Vascular Access & OPAT Nurse Practitioner

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MAIN DUTIES AND RESPONSIBILITIES

1.    CLINICAL RESPONSIBILITIES

• To function as an autonomous practitioner providing expert level of care in the assessment of needs, provision of care, ordering investigations and obtaining written consent
• To be proficient in the use of ultrasonography in identification of venous anatomy for the intended procedure
• To assess and evaluate patients’ venous access and selecting appropriate Vascular Access Device
• To be proficient at peripheral venous cannulation
• To be proficient at inserting Midlines & PICCs using Ultrasound guidance
• To be proficient at cannulating using ultrasound guidance
• To be proficient at venepuncture using ultrasound guidance
• After a period of training, to be competent in the use of Tip Location Systems (TLS) for confirming CVAD placement.
• To train staff in ultrasonography vein localisation techniques
• To provide expert guidance and supervision to aid problem solving and clinical decision making.
• To be a mentor and clinically supervise nurses and doctors as necessitated in Vascular Access
• To participate in the delivery of informal and formal teaching on CVADs & OPAT across the Trust
• To ensure that accurate and timely nursing records are maintained, standards monitored and appropriate corrective action taken
• To be willing to train to acquire expertise in the safe insertion of a variety of CVADs
• To manage the referrals for CVADs & OPAT

• To plan, order, interpret and act upon the results of tests and investigations for CVADs & OPAT and liaising with the relevant clinical colleagues where appropriate.
• To undertake CVAD & OPAT reviews as part of the audit trail
• To be point of contact for those accessing the OPAT team both internal and external.
• To carry an ongoing caseload of OPAT patients working with the team to facilitate care for this cohort of patients.
• To develop professional and collaborative relationships with key members of supportive services (e.g., haematologists, microbiologists, infection control, radiologists, pharmacists, intensivists, anaesthetists, surgeons, matrons, ward managers, specialist nurses)
• To identify one’s own limitations and refer complex cases or complications to Lead Nurse and other appropriate clinicians.
• To organise and coordinate complex patient referrals to other appropriate departments as deemed necessary e.g., radiology, theatres, anaesthetics and participate in the procedure where necessary.
• To obtain informed consent, in accordance with Trust policy prior to undertaking any clinical procedure. This includes, but is not limited to, the provision of patient information leaflets.
• To maintain communication with patients, relatives and carers being courteous and sensitive to their needs
• To always maintain privacy and dignity of the patients
• To be an effective role model ensuring a friendly, caring, and supportive environment at all times.
• To ensure that patients, relatives, and carers have access to appropriate information to support the ongoing care of the VAD.
• To ensure that the patients and their families/next of kin are provided with both verbal and written information about their planned procedure.
• To ensure procedures are patients centred.
• To continually review the setting of staffing levels/skill mix in accordance with the changing needs of the service and informing the Lead Nurse and Senior Matron of any problems that may arise.
• To be proactive in the prevention and management of complaints and when they do occur to investigate and respond in accordance with the Trust complaints and concerns policy and procedures.
• To ensure stocks are replenished in a timely manner.

2.    RESPONSIBILITY FOR POLICY AND SERVICE DEVELOPMENT

• To act as an expert to assist in policies related to area of care.
• To work within, and promote the competencies, policies and guidance of Advanced Nursing Practice for the whole trust.
• Use research and collaborate with peers to establish and evaluate nurse-led innovations.
• Ongoing audit and service review
• To deliver services in accordance with national and international guidelines
• Keep abreast of current trends in vascular access & OPAT nationally, promoting evidence based, best practice locally.
• Challenge and review poor practice, identify learning deficits and implement improvements to nursing practice regarding vascular access & OPAT in collaboration with link nurses, practice educator and infection control.
• To contribute to the development and update of protocols and guidelines to support nurse-led services and ensure that such work is approved via the agreed channels within the trust.
• Cross cover for the Lead Nurse in, as required, to ensure consistency of service provision is maintained.
• To work collaboratively with the Matrons and Ward Sister/Charge Nurses trust-wide to continually develop the service.
• Provide clinical leadership and maintain credibility through practice and professional update.

3.    RESPONSIBILITY FOR FINANCIAL AND PHYSICAL RESOURCES

• Responsible for managing and ordering supplies in a cost effective manner.
• Be aware of the principles of ward and departmental budgeting and support the development of efficiency strategies.
• Ensure service design is process driven so that care is not compromised by post holders’ absence.
• Actively participate in business planning for clinical and human resources as required.
• Develop appropriate strategies to make use of technology in the interests of patients and clients. Attend and be an active participant in relevant clinical and managerial groups at divisional trust levels.

4.    RESPONSIBILITY FOR LEADING AND MANAGING

• To foster a supportive working environment, to maintain staff morale, facilitate good and effective communications.
• To participate in personnel management supporting the Lead Nurse
• To maintain a safe environment for all staff, patients, and members of the public by ensuring an awareness of health and safety legislation and hospital policies which relate to health, safety, smoking, radiation protection, fire, and other emergencies.
• To identify hazards and areas of risk that requires immediate attention and activate appropriate support services as necessary.
• Monitor the number of untoward incidents e.g., accidents, clinical errors and complaints that occur and to initiate the appropriate action according to hospital policies.
• Under the leadership of TASS nurse managers, evaluate and strengthen the available services.
• Be aware of the principles of ward and department budgeting and support the development of efficiency strategies.
• To effectively organise and manage own work and practice.
• Actively support quality assurance programmes designed to measure standards of care and provide information as requested on the service delivered by this post holder.
• Demonstrates best practice at all times.
• Continually assess and monitor risk in own and others practice and challenge practice where appropriate.
• Devise and deliver education package for nurses to promote effective management and surveillance of vascular access & OPAT.
• Demonstrate appropriate level of seniority in emergencies/as required not necessarily relating to speciality.
• Use clinical expertise to provide practical strategies to solve problems identified by colleagues at all levels.
• Respond appropriately to complaints and demonstrate commitment to service improvement.

5.    RESPONSIBILITY FOR INFORMATION RESOURCES

• To safeguarding at all times confidentiality of information relating to patients and staff.
• To record activity to demonstrate the effectiveness of the service.
• Record all clinical activity electronically, maintaining professional accountability and transparency.
• Maintain records in accordance with the NMC code of conduct.
• Maintain confidentiality in accordance with the Trust’s information governance policy.
• Manage the vascular access & OPAT email accounts, responding, referring and disseminating as appropriate.
• Actively participate in national and international audits related to CVADs & OPAT
• To ensure that there is effective communication systems in place to allow staff to keep abreast of developments in the organisation including unit meetings.

6.    RESPONSIBILITY FOR RESEARCH AND DEVELOPMENT

• To utilise research findings in the delivery and disseminate relevant information to staff.
• To participate in nursing research studies wherever possible and publish outcomes.
• To audit service provision and identify and prioritise areas for development, implementing action plans and involving members of the MDT.
• Develop and maintain up to date vascular access & OPAT database to enable audit of outcomes for future planning.
• Maintain a working understanding of national and international guidelines related to CVADs & OPAT
• In collaboration with infection control team monitor and audit CVADs yearly to implement and promote appropriate changes to practice in the Trust
• To be aware of the research process and current trends
• Through the appraisal system, ensures own training needs are identified and mandatory training is kept up to date.

GENERAL RESPONSIBILITIES

Infection Control

Infection control is everyone’s responsibility. All staff, both clinical and nonclinical, are required to adhere to the Trust’s Infection Prevention and Control policies and procedures and the Health Act (2006) Code of Practice for the prevention and control healthcare associated infections and make every effort to maintain high standards of infection control at all times thereby reducing the risk of Healthcare Associated infections.