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KEY DUTIES 

• Demonstrate the ability to maintain a comprehensive database of patient with a confirmed diagnosis of COPD

• The post holder will perform a Specialised Respiratory assessment, initiate diagnostic testing including interpretation of results to ensure patient are diagnosed correctly, optimised, managed safely at home to prevent in appropriate hospital admissions and provided with a safe effective supported discharge.

• Demonstrate a proactive approach to identifying patients who attend secondary care but do not require a hospital admission, assess, plan, evaluate care and facilitate discharge for patients, developing a clear understanding of referral pathways and early supported discharge criteria’s to ensure safe effective discharge.

• The post holder will demonstrate Specialised Triaging making differential diagnosis, developing a care plan and treatment; negotiating with the patient on an appropriate management plan.
• The post holder must develop specialised skills and work autonomously to prioritising work load to maintain patient safety across primary and secondary care                    
• Specialist nurse led telephone consultations will be perform in the community; utilising history taking and interpretation of diagnostic testing to ensure appropriate follow up is arrange in the community.   
•  Specialised skill are developed to direct patients to self-management and start

• appropriate treatment under the direction of the specialist nurse (supplementary or independent prescribing) developing care plans over the phone for appropriate patients to follow prevent hospital admission in line with national and local guidelines

• Working autonomously across primary and secondary care to ensure appropriate service delivery and daily case management of all patient under the rapid response team

• The post holder will demonstrate knowledge and skills to draw on a diverse range of experience in decision making to determine evidence based practise interventions, treatment planning, reviewing medication and actively monitoring interventions to maintain patient safety, initiating new medication and monitoring side effects

• Demonstrate advanced clinical knowledge & skills to obtain a respiratory assessment including a full problem orientated medical assessment as an advanced practitioner to assess, diagnose, considering differential diagnosis and instigate a treatment plan, developing skill to prescribe appropriately with competencies as a non-medical prescriber as required. Involve patients, carers and relatives in the planning and delivery of care.

• The post holder will develop competencies and adhere to trust policies utilising patient group direction to instigate treatment for patient experiencing and exacerbation of COPD

• The post holder will provide education to your patient regarding their disease to assist them to develop self-management skills at home, to prevent hospital admission; in line with national and local guidelines

• The post holder will perform assessments of patient, nursing and social needs in line with service policies. Plan, implement and evaluate evidence based care delivery according to changing health care needs.

• The post holder will make a specialised clinical decisions to prevent hospital admissions at home and obtain blood gases interpret results ; recognising Chronic and acute oxygen needs to maintain patient safety taking over all responsibility to maintain that patient safety, and a robust treatment plan and care package developed adhering to local guidelines.

• Demonstrate specialised skill to support hypoxic patient at home who refuse hospital admission, communicating with the GP and monitors signs of deterioration; encouraging hospital admission to maintain patient safety at all time working outside of national and local guidelines to maintain patient safety

• Identify appropriate resources for individual patient needs, referring to appropriate multi-disciplinary teams to prevent unnecessary hospital admissions and any further deterioration.

• The post holder must optimise patient treatment to ensure improvement in quality of life and reduce exacerbations through independent or supplementary prescribing

• Identify patient who are at risk of admission and monitor patient at home to reduce 30 day readmissions

• Identify patient suitable for early supported discharge and facilitate discharges at home adhering to service inclusion and exclusion criteria
• Demonstrate specialised skill in assessment, obtaining diagnostic tests and interpretation of result to facilitate nurse led oxygen clinics and prescribes domiciliary oxygen for patients.

• Exercise judgement, discretion and decision making in clinical practice, across all aspect of the role within primary and secondary care and the delivery of oxygen clinics, undertake arterial and capillary blood gas sampling in hospital and community settings in accordance with trust guidelines and protocols, interpreting results, prescribing and titrating oxygen for individual patient needs as per national guidelines.

• Demonstrate specialised skills in prescribing oxygen and register as a part B Home oxygen ordering Form (HOOF) across primary and secondary care for Long term oxygen therapy (LTOT) Ambulatory oxygen therapy ( AOT) and short burst oxygen therapy (SBOT) oxygen therapy to ensure delivery of oxygen clinics and appropriate follow up for all oxygen patient referred to the service.

• Identify patient with a history of type 2 respiratory failure and ensure appropriate follow up; Type 2 respiratory packs are provided appropriately and a computerised audit of patients provided with a pack is accurately maintained and reviewed to ensure replacement packs are replaced as required.

• Demonstrate skills in performing risk assessment on patient in oxygen to prevent serious untoward incidents, obtaining consent for oxygen and identifying patient who may require withdrawal of oxygen.

• Demonstrate the ability to escalate serious untoward incident and support the removal of oxygen to protect the public at large following local guidance, liaising with key service including fire service, police and North West Regional Lead.

• Adhere to trust and service policies and standard operating procedures

• Impart specialist knowledge, advice and support to colleagues, patients, carers and relatives across primary and secondary care & use the expertise and knowledge of professional colleagues acknowledging the boundaries of different roles.

• Provide formal and informal teaching sessions to community & secondary care staff involved in the care of patient with COPD.

• Establish and maintain continuing relationships with patients, carers and relatives which are essential to providing effective long term care.

• Provide sensitive, complex information to patients, carers, relatives and professionals across health and social services.

• The post holder must deliver education session at the pulmonary rehabilitation session as part of a multidisciplinary team

• The post holder must develop advance communication identifying patient entering end stage COPD, discussing end of life issues with patients, identify patient suitable for gold standard framework; specialised skills in the management of end stage COPD to palliate respiratory patient; relieve debilitating symptoms of breathlessness symptoms and complete preferred preference of care documentation, referring to specialist palliative care services and district nurses for end of life support. Demonstrate the ability to facilitate complex communication skills supporting the patient and families through diagnosis and disease progression, this includes end of life discussion and breaking bad news

• The post holder Attend national training programme to obtain qualifications as an independent non-medical prescriber adhering to nation and local policies and make treatment recommendation to the GP as supplementary prescriber

• The post holder must obtain certification ARTP Level 3 spirometry; demonstrate the ability to, request diagnostic testing, interpret results in sputum routine bloods, spirometry and pulmonary function tests to ATRP standards, attend Radiology Chest X-ray training and ensure appropriate radiology imaging is requesting and followed up with appropriate management plan; discussing abnormal results with consultants in MDT.

• Demonstrate the ability to facilitate weekly MDT and action outcomes for patients effectively and efficiently.

• Maintain comprehensive computerised equipment asset lists including a list of patient who has loan compressors (short term and long term) to ensure retrievable of short term nebulisers and support patient’s long term nebulisers to reduce infection control risks.

• Demonstrate the ability to assess, optimise, implement, monitor and evaluate effectively of inhaled and nebulised therapy; evaluating the effectiveness and appropriateness of treatment.

• Responsible for ensuring all service compressors adhere to infection control cleaning, replacement mask & filters and serviced in line with Medical engineering and manufacturers recommendations.

CLINICAL & PROFESSIONAL RESPONSIBILITIES

• To assist the Lead Nurse to meet the commissioned targets whilst ensuring optimum care for patient.

• To be aware and adhere to NMC guidelines for the Administration of Medicines Act 1992 and misuse of Drugs Act 1991.

• Adhere to lone working policy & carry lone working devices each shift to maintain safety, activating the device each day to ensure satellite recording of staff location in line with trust policy

• To work within trust guidelines and national guidance education, use and distribution of drugs under patient group directives within the service, attending education and use of Patient group directives.

• Attend national training programme to obtain qualifications and practice as a non-medical prescriber, adhering to national and local policies

• To observe the provisions of and adhere to all Trust policies and procedures and standard operating procedures.

• To be aware of the confidential aspects of the post. Breaches of confidentiality will result in disciplinary action that may involve dismissal. The post holder should also be aware that, regardless of any action taken by the employing authority, breaches of confidentiality could result in civil action for damages.

• All employees must fully comply with the relevant sections of the Health and Safety at Work. They must also understand and implement St Helens and Knowsley Hospitals NHS Hospitals

• Trust “Statement of Policy on Health and Safety at Work” and the Trust corporate “Health and Safety Policies and Procedures”. You are required to follow all applicable rules and procedures relating to Health and Safety at Work and to take all responsible precautions to avoid actions

• All staff will be treated with respect by management, colleagues, patients and visitors and equally staff will treat management, colleagues, patients and visitors with the same level of respect. Staff will be supported to challenge any discriminatory behaviour that may be based on differences in race, disability, language, culture, religion, sexuality, age, and gender or employment status.

• St. Helens & Knowsley Hospitals NHS Trust has a ‘No Smoking’ Policy and smoking is not permitted in Trust buildings or vehicles.

• All employees are individually responsible for the prevention and control of infection within their own area. The employee must attend Infection Control Induction training and mandatory Infection control training. The employee must follow all, Trust policies, procedures and guidelines relating to Infection Control.

• To adhere to relevant Code of Practice of Professional body and Maintain Professional Registration and revalidate 3 yearly.

• The duties contained in this job description are not intended to be exhaustive. The tasks and responsibilities of this post are likely to evolve in line with the Trust’s continued organisational development.

• The post holder must be flexible in the duties performed and it is expected that similar duties, not specifically listed above, will be carried out as required and may be cross site. Any such variation will be agreed in advance between the post holder and their Manager as part of the continuing process of management review and development.

• Maintain Professional Registration

• Adhere to relevant Code of Practice of Professional body

ADMINISTRATIVE RESPONSIBILITIES 

• Ensure appropriate affective service delivery; maintain an accurate service database, and filing systems; ensure that all activity is recorded accurately to support accurate reporting to CCG.
• Maintain, clear, concise. Legible and contemporaneous patient records at all times in line with Trust policy and The Standard for Recording Keeping (NMC April 2015

TEACHING & TRAINING RESPONSIBILITIES 

• To act as a resource; providing education and training across primary and secondary care regarding the administration, delivery of oxygen and management of COPD for students and clinical staff.

• To raise awareness of respiratory issues by teaching and providing education across the organisation.

• Provide education and development for others within a multi-disciplinary framework.
• To facilitate and appropriate learning/practice environment for students across primary and secondary care, facilities education on the role of the COPD nurse within local universities.

• Demonstrate critical thinking and reflective skills to ensure own professional development in line with revalidation.

• Attend annual appraisal to identify and agree training and development needs as part of a Personal Development Plan.

• Attend all statutory/mandatory training sessions, identifying when training is required and discussing with line manager

LINE MANAGEMENT/SUPERVISORY RESPONSIBILITIES 

·       Coordinate service delivery in the absence of the Lead Nurse

·       Assist in the evaluation of service delivery, identify areas of improvement and initiate changes.

·       Ensure effective and efficient use of physical and financial resources within the service

·       To support the development of assistant practitioner and junior staff; supporting the line management and annual appraisal and to allocate assistant practitioners and junior staff works load each shift.

·       Participate fully in Clinical Supervision sessions arranged by the Lead Nurse and Clinical Supervisor.

·       Work collaboratively with the professional agencies to ensure patient needs are met and especially in relation to on-going care and informed discharge with self-management skills.

·       Exercise judgement, discretion and decision making in clinical care.

·       Support the Service Manager to evaluate and improve service provision. Identify areas of improvement, initiate and embed change.

·       Ensure effective and efficient use of physical and financial resources within the service.

·       Monitor health, safety and security of self and others to promote best practice.

·       Ensure effective delivery of multi-disciplinary  weekly team meetings

·       Coordinate with the Trust Practice education facilitator (PEF) to ensure delivery of appropriate student mentorship; attend annual mentorship updates as per trust policy

RESEARCH & AUDIT

·       Continually monitor standards of care and participate in the improvement of care through benchmarking/audit/research.

·       Promote patient and public involvement activities in specialist area leading to service improvement.

·       Support the development and delivery of annual patient satisfaction survey to monitor patient satisfaction across the service