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KEY RESPONSIBILITIES

1. PATIENT CARE, CLINICAL EXPERTISE AND CASE MANAGEMENT.

1.1 Manage a caseload of patients within the speciality in an inpatient and outpatient setting.

1.2 Work alongside the band 7 specialist nurses and medical team to provide individualised and personalised care. This will include assessing and accepting pleural referrals from the emergency department, clinical decisions unit and GP practice as well as UHL wards and community hospitals / hospice.

1.3 Provide clinical expertise, specialist advice and support across the whole spectrum of the pleural service to include tending a pleural helpline for advice as well as the pleural mailbox for electronic referrals.

1.3 Adopt a range of the Chief Nursing Officer 10 key roles appropriate to client group in order to improve and streamline patient care and patient experience. Be actively involved in chest drain management on ward 29 and within UHL.

1.4 Demonstrate an in depth specialist knowledge, skills and innovative practice in the specialist area, ensuring the delivery of appropriate evidence based care. Assist the band 7 specialist nurses in becoming a key worker for patients and their carers in relation to pleural disease.

1.5 Support, assist and encourage the multi-disciplinary team in resolving complex patient problems, by the provision of new and innovative models of case management. Attend and assist in coordination of the pleural triage meeting and liaise with other relevant MDT groups.

1.6 Demonstrate appropriate expert practice and specialist advice in the assessment, planning, implementation and evaluation of patient care. This will necessitate high levels of autonomy and advocacy and will involve pleural clinic, nurse led clinics, ward attenders and day case admissions.

2. PATIENT AND PUBLIC INVOLVEMENT AND EXPERIENCE

2.1 Promote the philosophy of patient centred care and establish and maintain a supportive relationship with the patient and their family at all times. Act as a key worker for patient’s, their carer’s and families as well as other specialities.

2.2 Promote patient and public involvement. Enhance their experience by supporting and implementing new initiatives relating to patient centred care. Assist in obtaining electronic feedback for the team via easy to read patient satisfaction surveys.

2.3 Contribute to the CMG and service strategies for raising the profile of the pleural service via a variety of communication methods.

3. PROMOTE AND ESTABLISH EFFECTIVE TEAM WORKING AND COMMUNICATION

3.1 Take responsibility for ensuring effective communication between all service providers within the pleural speciality. Act as a resource and point of contact for community services for patients with IPC chest drains in place or patients who are under the care of the pleural service.

3.2 Establish and maintain good positive working relationships with the Heads of Nursing/Deputy HON, Matrons Sister / Charge Nurse and their teams, Education and Practice Development Lead, Matrons, relevant Clinicians, Service Managers and CMG Management team.

3.3 In collaboration with the Education and Practice Development Teams / Nurse Specialist Lead, develop and promote working partnerships between the Trust and academic staff at local Universities involved in the provision of nursing and multi professional programmes of education.

3.4 Actively participate in local, national and international networking to maintain and develop expert level of knowledge in the pleural and respiratory speciality.

3.5 Ensure that the importance and implications of education, research, and ideas are raised in appropriate forums. Collaborate with relevant research personnel when undertaken related pleural research.

3.6 Establish a good level of team working within MDT, maintaining communications across specialities.

4. EDUCATION, TRAINING AND PRACTICE DEVELOPMENT

4.1 Provide specialist education and training to all members of the clinical team and nursing staff within the CMG in collaboration with the Education and Practice Development Lead teams. This will include training in chest drain management and pleural devices. Assist in assessing nursing staff in chest drain management and relevant competencies.

4.2 Actively participate in life- long learning and personal development through appraisal, development plans and revalidation.

4.3 Promote and implement patient focused education and up to date information giving to include IPC counselling and signposting to resources both printed and electronic.

4.4 Work with the Band 7 Pleural Specialist Nurses / Education and Practice Development Lead to ensure that specialist education and training meets the needs of the service, multi-professional clinical teams, patients and carers.

4.5 Demonstrate continuous evaluation of practice and make changes where appropriate, within the pleural speciality.

4.6 Use Education forums and Networks proactively sharing good practice and innovation with others.

4.7 Liaise with other groups and assist with the delivery of multi-professional and inter-professional learning.

4.8 Provide specialist education teaching, learning and mentoring for pre and post registration students when required and actively contribute to the delivery of the Universities curriculum.

5. CLINICAL GOVERNANCE, AUDIT AND RESEARCH

5.1 Contribute to policy making and clinical guidelines internally and externally, necessary to support the pleural service.

5.2 Actively participate in pleural audit and research benchmarking activities to ensure effective safe and evidence based practice.

5.3 Provide and promote clinical excellence that reflects the Trust’s Clinical Governance Strategies to include meeting Becoming the Best.

5.5 Promote the speciality by publishing and presenting innovations and research findings locally and nationally.

5.6 Actively promote the specialist service throughout the Trust by establishing robust networks and links with Quality and Safety and Audit teams.

5.7 Act on relevant pleural audit and research findings to inform and change practice as appropriate.

6. RISK MANAGEMENT AND PATIENT SAFETY

6.1 Use specialist knowledge, skills and innovative practice in order to provide a high standard of patient care and maintain patient safety.

6.2 Actively promote infection prevention and control awareness using best practice to reduce the potential for cross infection.

6.3 Use programmes of effective and relevant education to promote staff compliance with policies, practices and patient safety.

6.4 Deliver new ways of working practice that benefits patient safety and the patient user experience.

6.5 As a clinical expert provide advice and support to assist with the management of complaints relating to the pleural speciality and implement action plans or change of practices.

6.6 Maintain adequate pleural equipment stock control levels in order to provide safe and effective patient care.

7. PROMOTE EFFECTIVE CLINICAL LEADERSHIP

7.1 A visible, accessible and assertive clinical expert to which staff and users can turn to for assistance, expert advice and support.

7.2 Provide a high level of professional leadership in the development, management and promotion of the pleural service. Foster links and share best practice with other pleural centres.

7.3 Actively contribute to operational developments relating to the pleural service, so that a high quality patient focused service is promoted at all times.

8. SPECIALITY SPECIFIC

Core clinical skills

8.1 Competency in aseptic non touch technique

8.2 Able to interpret blood results to ensure safe pleural procedures

8.3 Able to complete pre procedure safety checklist

8.4 Able to assess respiratory status of patients with pleural disease to support appropriate triage for intervention/ further clinical review.

8.5 Assist the primary operator in pleural procedures

8.6 Ability to recognise and initiate management of symptomatic breathlessness and signpost to appropriate palliative care services

8.7 Assessment of performance status and clinical frailty score

Core clinical skills: working towards

8.8 Thoracic ultrasound level 1 operator

8.9 Ability to independently perform :

Talc slurry via an intercostal chest drain or IPC

Drainage of an IPC including taking a diagnostic sample

Administration of fibrinolytic therapy

Intercostal chest drain and IPC flush with normal saline

Intercostal chest drain removal

Pleural vent removal

Attachment of a Heimlich valve/ bag to an intercostal chest drain / IPC (for outpatient management)

Thoracentesis diagnostic and therapeutic

Knowledge and training /experience

8.10 Contribute to inpatient care following pleural procedures.

8.11 Able to give safety netting advice to ambulatory pneumothorax patients

8.12 Attend board round on ward 29 GGH and contribute to the management plan / decision making for pleural patients.

8.13 Ensure patients are safely and adequately prepared for medical thoracoscopy.

8.14 Undertake GCP training and contribute to relevant pleural research.