Cardiac Rehabilitation Clinical Nurse Specialist

Key Result Areas:

Expertise & Excellence in Clinical Practice

Provide support to patients with cardiac conditions and their families, in line with the National Institute for Clinical Excellence (NICE) Guidelines for Heart Failure and the British Society for Cardiovascular Prevention and Rehabilitation Standards (BACPR). 

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

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.

Act as an accessible professional for the multi-disciplinary team (MDT) supporting the management of a clinical caseload for at least 80% - 85% of the role.  This will necessitate a degree of autonomy and advocacy to ensure the delivery of appropriate care.

15% - 20% of role will contribute to the development of patient/staff education and information specific to cardiac rehabilitation along with policies and protocols (SOPs) to guide others involved in the care of this diverse client group. These policies and protocols will relate to patients within our department but also extend throughout the Trust.

Plan programmes for cardiac rehabilitation including heart failure, co-ordinating staff, venues and patients.

Timely and appropriately recruit patients to exercise programme. Contact patients individually referred for rehabilitation.

Undertake a comprehensive assessment of patients following a cardiac event, who may have complex conditions including multi-pathology.

Use well developed clinical reasoning and departmental/local guidelines to needs assess, risk assess and advise on treatment and lifestyle changes.

Manage group sessions, providing clinical monitoring and education.

Report to and/or refer onto other agencies and health professionals, patients following participation in cardiac rehabilitation programme.

To educate and mentor less experienced members of the cardiology nursing team.

Work autonomously within scope of practice to make clinical decisions and judgements regarding patient management as per local/national and international guidelines.

Undertakes risk assessments regarding patient condition and environment to ensure patient and staff safety. 

The post holder must be able to give a full explanation of the patient’s condition and proposed management to the patient and discuss expected outcomes with them.

The post holder is required to educate patients on an individual and group basis.

Ensure the patient understands and agrees to therapy plan and to set realistic timescales for achieving goals. 

To ensure that within the group setting each patient exercises within their agreed individual exercise prescription and is monitored at each session. To act independently to changes in the patients status and modify treatment accordingly.

In conjunction with exercise specialist, undertake an individual risk assessment for exercise, based on cardiac history and current medical conditions. Taking into consideration both cardiac and physical risk of exercise allowing safe exercise prescription and adaptations of exercise programmes. 

Agreed functional capacity tests to be performed as part of the patient’s initial assessment and again at the completion of the programme in order to contribute towards monitoring and audit of patient related outcome measure.

Support patients to self-manage their condition where deemed appropriate. Provide education for those who will need guided support to self-manage and those who will need on-going face to face support.

Contribute to the management of a caseload of patients within specialty and prioritise workload to meet patient and service need, including MDT clinics.

Management & Leadership

Act as a role model demonstrating high standards of holistic care and provide clinical leadership to others across the organisation.

Participate in the recruitment and selection of staff where required.

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.

Participate in operational and strategic planning for the development and delivery of the service.  Support service improvement activities.

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

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. 

Work in partnership with patients, relatives and carers to obtain complex information.

Create a climate in which patients are empowered to make informed choices.

Ensure all clinical practice is documented appropriately in patient records ensuring that the NMC guidelines for documentation are adhered to.

Informally manage complaints with the aim of a satisfactory resolution.  Ensure appropriate escalation when this is not achieved. 

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 occasionally imparting significant news or supporting patients and carers during and following such consultations.

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.

Education

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

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.

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.

Act as a mentor/clinical supervisor as appropriate.

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 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.

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

Support and deliver local and national audits relevant to the speciality.

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.

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.