Arrhythmia Nurse Specialist

Detailed job description and main responsibilities

Support early discharges 

Prevent re-admissions 

Share specialist cardiac knowledge & skills  

Collaborate with community teams   

Lead and manage DCCV lists 

Facilitate in the delivery of rapid access arrhythmia/AF, Complex CRM Device Eligibility and ILR implant services 

Work with the wider arrhythmia team to develop an effective syncope service

Create standardised inpatient pathways for arrhythmia/AF, Complex CRM devices, ILR implants & syncope 

To be a point of contact and clinical expert for patients, relatives and clinician colleagues in conjunction and with the full support of the Consultant Cardiologists. 

The post holder will be expected to ensure that the patient receives the highest possible standard of evidence based care in line with NICE guidance on :- 

Atrial Fibrillation (2021) 

Implantable cardioverter defibrillators and cardiac resynchronisation therapy for arrhythmias and heart failure (2014) 

The recommended use of atrial-based pacing over ventricular-based pacing in patients with sinus node disease in 2005 

Recommended implantation rates (per million population) for all categories of Cardiac Device – pacemakers, ICDs and CRT devices (in conjunction with HRUK)   

The management of patients with Transient Loss of Consciousness (syncope) in 2014 (pathway updated Dec 2020) 

To work with the arrhythmia team to develop and deliver improve integrated diagnostic, referral and treatment care pathways for arrhythmia patients admitted to Medway Hospital to enable compliance with the required standards. Including nurse-led/consultant-supported, dedicated specialist syncope and device pre-assessment clinics. 

To work with the Specialist and other cardiology consultants, nurses and the MDT team to deliver care along agreed clinical pathways, including ambulatory care pathways providing admission avoidance interventions where appropriate and agreed. 

To be an expert cardiac arrhythmia practitioner to triage, comprehensively assess and manage a range of presentations. This will include assessment, management and counselling support for patients requiring specialist interventions including complex heart devices and invasive electrophysiology procedures. 

To work as an independent nurse prescriber. Training and support will be provided to acquire and certification to achieve this. As an Independent nurse prescriber you will adhere to the Department of Health policy restricting their prescribing to control drugs and work within the Trust non-medical prescribing policy. 

To undertake a caseload of new and complex patients developing a plan for treatment and intervention either delivering directly, as an autonomous practitioner, or supporting others to do so through delegation, mentoring and support and to attend and present cases at frequent MDT meetings. 

To develop and maintain the knowledge and skills required to practice at an advanced level and to use an extended scope of practice, including referral for and interpretation of investigations such as blood tests, ECG’s, X-rays and scans, as well as independent prescribing. 

To formulate and implement treatment plans based on current evidence and expert clinical reasoning with a comprehensive understanding of available treatments including education, skills development/rehabilitation and compensatory techniques or use of medical devices or environmental adaptations to support an improvement in quality of life and or independence. To review the effectiveness of treatments through monitoring and interpretation of clinical indicators and make adjustments / recommendations ton treatment plans and onward referral as appropriate.  

To communicate appropriate complex information, effectively to patients and/or carers. To inform them of the benefits and risks of suggested treatment options.  

Assess patient understanding of treatment proposals, gain informed consent and have the capacity to work within a legal framework with patients who lack capacity to consent to treatment. 

To support the educational, emotional and practical needs of people with arrhythmias including relatives and carers. Providing counselling and support to patients with defibrillators (both locally implanted and repatriated patients implanted elsewhere). You may provide a point of contact for their concerns regarding defibrillators (physical and psychological) and actively work with the pacemaker cardiac physiologists to provide a holistic clinical experience.  

To promote self-care skills and be able to teach patients and carers self-care strategies, for example commencement of rescue medication 

To maintain accurate and up-to-date records and reports of patients being treated in line with departmental standards and the appropriate professional body. Guidelines and standards for record keeping (2000) or NMC. 

To be professionally, legally responsible and accountable for all aspects of your activities; working within relevant codes of practise and professional guidelines. Managerial  

Work with the arrhythmia lead to develop, implement and evaluate the service, guidelines, protocols and policies, taking responsibility for identified specific areas of development 

To take delegated responsibility for ensuring the collection and collation of team activity data in agreed format and be responsible for the interpretation and reporting of the data as required by the Associate Director of Operations.  

To support the team leader in the day-to-day supervision and line management of the junior members of the team including administrative staff.  

To manage clinical risk within own caseload and that of the team. Training and Supervisory  

Develop patient education programmes and promote health education particularly in line with NICE guidance. 

To act as a teaching and educational resource through the training, teaching and mentoring of individual staff or groups.  

Actively participate in team, departmental and multi-professional in-service training and clinical governance including supervision. 

You will provide on-going support, education and advice for patients undergoing investigations and treatment for arrhythmias. Provide spontaneous and planned advice, instruction and teaching for relatives, carers and other professionals to support understanding of the aims of the patient management and to ensure consistent holistic approach to care.  

To participate in the staff appraisal scheme and be responsible for maintenance and development of own competency. Service Development 

To lead and advise on clinical service developments, policy and guidelines development and review, quality improvement activities, identifying gaps in current service provision and working with the team lead in developing and delivering innovative services to meet users’ needs and local and national priorities.  

To work with the specialist cardiology consultant to develop a clear integrated atrial fibrillation and arrhythmia care pathway for inpatients admitted to Medway Maritime Hospital encompassing; 

Early referral following identification of an arrhythmia on any inpatient or following admission with an arrhythmia - you will be the point of referral for all inpatients identified as having AF or other arrhythmia early during their inpatient stay so that patients receive specialist input early in their journey thereby improving the quality of care delivered to patients with arrhythmia. 

Co-ordinating the clinical management (under cardiologist-leadership) of inpatients with arrhythmia, working closely with the medical and cardiology teams and ward nursing staff to ensure appropriate and efficient use of our diagnostic resources. 

Early use of the most appropriate antiarrhythmic therapies and appropriate anticoagulation therapies  

Early identification and risk stratification of patients likely to benefit from evidence-based cardiac device therapies (PPM/ICD/CRT) 31. reduced length of stay through the above measures and through effective discharge planning and close collaboration with primary care

To work in a one-stop CRT and ICD pre-assessment clinic, in conjunction with the specialist heart failure nurses. You will also actively lead the DC cardioversion, syncope and ILR implant service. 

To work in close collaboration with the hospital and community cardiac nurses and service to optimise the arrhythmia management of heart failure patients with CRT and ICD devices. 

To establish and deliver a nurse-led implantable loop recorder (ILR) implantation service.  

To participate in relevant clinical governance projects and audits within the service  

To be responsible for the evaluation and measurement of own and team’s practice through the use and implementation of appropriate outcome measures, audit, patient and referrer surveys. To recommend and work with the lead to implement findings.

Participate in appropriate new developments and research; undertaking own projects as well as within the team.