Viral Hepatitis Clinical Nurse Specialist

Detailed job description and main responsibilities

Clinical Practice:

• To provide a specialist nursing service for patients with viral hepatitis internal and external to the trust within an integrated team structure
• To work within the CNS team structure to provide adequate cross cover for nurse led and multi-disciplinary clinics
• To accept responsibility for ensuring that new and follow up patients undergo clinical assessment and have an accurate plan of care in line with team protocols and guidelines; this should reflect individual co-morbidities and lifestyle issues and any recommendations made
• To co-ordinate nurse-led assessments for patients requiring antiviral therapy
• Initiate, monitor and adjust antiviral treatment (AVT) regimes as necessary (depending on experience) and  according to protocols, in conjunction with and under the supervision of the MDT
• To identify and initiate appropriate steps for effective care, including:

• Requesting appropriate investigations to inform diagnosis or disease staging
• Ensuring all patients new to the service are offered a HIV test
• Performing fibroscans (training will be provided) to contribute to clinical decision making
• Sequential monitoring of patients with HBV to identify patients with active disease
• Requesting and interpreting relevant blood tests for patients receiving AVT
• Monitoring on treatment response to inform treatment duration
• The identification of patients who require adjunctive therapies whilst on treatment
• Making and receiving referrals relating to antiviral treatment
• To monitor patients at high risk of developing complications of hepatitis including HCC as per SEL guidelines     

• To impart the results of investigations and treatment outcomes sensitively to patients, implementing evidence based guidelines and clinical management plans
• To ensure continuity of a high standard of evidence-based nursing care, ensuring ongoing assessment of health, health related and nursing needs of patients, their families and other carers
• To provide expert nursing advice and support to patients, their families and other healthcare professionals following diagnosis and through treatment
• To be responsible and accountable for accurate, timely and comprehensive documentation in patient records and on liver ware in accordance with Trust standards
• To be responsible for generating a clinic letter to the patients primary care provider following each patient consultation, ensuring this reflects the content of the consultation, the plan of care and any relevant results
• Maintain patient and carer confidentiality and preserve their dignity and privacy, at all times and in all situations
• To identify, implement and maintain a suitable mechanism for MDT referrals to the Clinical Nurse Specialists
• To participate in Multi-Disciplinary Meetings (MDM) for patients with viral hepatitis to ensure adequate supervision and adherence to clinical governance
• To participate in and deliver a seamless service through enhanced MDT processes and communication
• To work with teams across primary and secondary care to implement and evaluate integrated care pathways, systems of documentation and treatment outcomes
• To actively involve service users in providing feedback of their experience of the current service and suggestions for improvements
• To contribute to the identification and development of clinical protocols and strategies to enhance both the continuity and standard of specialist care
• Deliver safe, effective, evidence-based health care by working within guidelines and using protocols developed for viral hepatitis and, in line with Trust policies and guidelines

Education:

• To provide information for parent, carers, heath professional and the public about all aspects of viral hepatitis using specialist skills and knowledge, in accordance with local guidelines
• To ensure that relevant contemporary information/ literature is accessible to empower patients to make an informed choice regarding the treatment options that are available to them including clinical trials/new therapies
• To ensure that all patients are full informed of the risks and benefits of proposed procedures, contributing to the process of securing informed consent
• To be involved in regular reviews of educational literature, liaising with service users wherever possible
• To participate in relevant fora at Care Group, Trust, PCT, Consortia and National/International Level to represent the service perspective, ensuring appropriate feedback mechanism to the CNS team is in place to disseminate relevant information
• To actively participate in raising awareness and educational events organised by the VHS, Trust and primary care sector
• To work with other clinical staff to identify knowledge gaps and training needs and implement, support and evaluate programmes of education to address any knowledge deficits
• To contribute to the development of nursing practice within the team
• To identify, apply and disseminate research findings relating to specialist nursing practice
• To participate and assist with any Trust approved research projects conducted within the department
• To act as a role model for proficiency in nursing care to other nurses and identify excellence so it can be adopted

Leadership, Planning and Organisation

• To maintain effective links within primary, secondary and tertiary care to ensure effective communication
• To engage with internal and external groups to further develop the Viral Hepatitis service and the CNS role
• To contribute to the development of clinical services across the Trust, through liaison with the Hepatitis Senior CNS
• To have responsibility for the health, safety and welfare of self in the working environment to follow safe working practices and to comply at all times with the Trust’s Health and Safety Policies and Procedures
• To participate in measures to actively manage and reduce risk to patients, ensuring the formal reporting and recording of adverse incidents in line with Trust policy
• To have an awareness of the Trust’s safeguarding adults policy and the procedures for dealing with vulnerable adults across primary and secondary care
• Ensure compliance with the Trust’s Equality and Diversity Policy, supporting the delivery of the Trust’s Race Equality Scheme and the Trust’s duty to positively promote race equality and equality of opportunity for disabled people ensuring services are responsive to the needs of equality groups
• To work with and support the senior nurse specialist and other clinical staff to identify areas where changes to practice are required, identifying where opportunities exist to improve treatment and support for patients
• To assist the development and implementation of policies and guidelines in support of good clinical practice and service development
• Ensure the availability and best use of appropriate resources for patients to provide a cost effective service

Research and Audit: 

• To promote research and evidence based practice relevant to the speciality, raising the profile and enhancing the contribution of nursing to patient care, this includes informing the development of the outreach programme
• Participate in local and/or national research and development initiatives as appropriate
• To maintain links with the research trials team within the care group, ensuring that knowledge of current trials available is up to date and to act as a liaison with the team on behalf of patients
• To ensure that patients entering the liver research tissue bank programme have access to the relevant written information and are consented appropriately
• To utilise and maintain information systems to aid audit and to contribute to the provision of regular activity and analysis reports
• To contribute to clinical audit, in particular ensuring patient experience surveys are completed and action plans developed
• To disseminate audit and activity data verbally and/or in written form to key stakeholders conforming to designated timelines