Critical Care Outreach Lead Nurse

Job responsibilities

Job Title: Critical Care Outreach Team Lead Nurse

Directorate / Service: Theatres, anaesthetics, Critical Care and Pre-op Care Group

AfC Band: 8a

Professionally Accountable to: Divisional Director of Nursing

Responsible to: Assistant Director of Nursing

Job Summary

The Critical care outreach team at Aintree site offer a specialist follow up service for patients discharged from critical care to step down areas. They support acute, deteriorating patients and function as part of the Medical Emergency Team (MET) within daytime hours. They are also responsible for the surveillance and review of patients alerting with Acute Kidney Injury (AKI) and Sepsis as part of the Trust Avoidable Mortality Reduction Programme.

The Critical Care outreach lead nurse will be wholly responsible for the daily management and strategic direction of the Critical Care Outreach Team, ensuring alignment with both Corporate and Divisional objectives. The role will require administrative and clinical leadership and will also offer support to the MET team Lead nurse to deliver this service effectively across the trust.

The Lead Nurse for the Critical Care Outreach Team will be accountable for the leadership, performance management, service development, and maintaining high standards and quality of care within the service and the team.

The lead nurse will function as a specialist nurse within the Critical Care Outreach/Medical Emergency Teams. Being responsible for;

• Managing patients who have recently stepped down from Critical Care to general wards, providing the highest standard of assessment, planning, implementation and evaluation of individualised holistic patient care for acutely ill/deteriorating ward-based patients in conjunction with the wider MDT.
• Support psychological after care and rehabilitation of long-term Critical Care patients
• Reviewing deteriorating patients on wards who have been referred for Critical Care input and review.
• Provide Trust wide screening and surveillance for Sepsis and AKI allowing prompt treatment and decisive medical management
• Attend MET calls within the scope of working hours, functioning as an ALS provider, leading early intervention with appropriate assessment, observation and treatment for seriously ill patients on general wards.

Key responsibilities

• Act as the Lead Nurse for the Critical Care Outreach Team (CCOT)
• Hold strategic responsibility for the development and coordination of the CCOT in relation to the requirements of the Trust, maintaining relevant policy and guidelines.
• Accountable for the leadership, management and development of the staff employed within the CCOT.
• Provide clinical leadership and support to the staff employed within the CCOT and the Medical Emergency Team.
• Provide clinical input and specialist skills to all clinical areas in Aintree University Hospital (AUH), establishing and maintaining effective communications between Critical Care, CCOT, MET and the wards/departments, making operational judgements and managing conflicting views where necessary.
• Acts as a role model in achieving excellence in the care of critically ill/highly dependent patients.
• Perform autonomous comprehensive assessments of deteriorating and critically ill patients. Plan, implement, and evaluate care delivery according to changing health needs and varying levels of complexity.
• Active member of ward-based MDT working to rehabilitate critical care step down patients.
• Responds as part of Aintree Medical Emergency Team.
• Coordinates the inter hospital transfer of acutely ill level 1,2 and 3 patients for investigation or to an area for a higher level of monitoring
• Oversee the surveillance and review of patients alerting with Acute Kidney Injury (AKI) and Sepsis as part of the Trust Avoidable Mortality Reduction Programme
• Leads in the delivery of education, training and development of staff throughout the general/cohort wards on tracheostomy and laryngectomy care, having responsibility as author of the Trust wide Tracheostomy guideline to ensure training and education and patient care is delivered in line with relevant National Tracheostomy Safety guidelines.
• Directly support the Lead Nurse for the Multi- Professional Medical Emergency Team (MET) in ensuring that the Trust complies with national guidelines and recommendations around rapid response and recognition of deterioration. This may involve support with data collection, input and reporting, as well as ordering and maintaining MET equipment.

Clinical Responsibility

• Inform and co-ordinate clinical service delivery provided by the CCOT, providing clinical leadership and demonstrating specialist clinical skills based on current best practice and evidence-based guidelines and relevant National competencies for Outreach and rapid response teams.
• Perform comprehensive assessments of critically ill patients, implement and evaluate care delivery according to changing health needs, level of dependency and complexity of condition.
• Interprets diagnostic information and provides a service within the expanded role of the Nurse Practitioner including analysis of blood results and ECGS, venepuncture, arterial blood gas sampling and interpretation of results, cannulation and provision/use of Intra osseous access.
• Provides Trust wide spirometry assessment for patients identified by Critical Care and acute medical teams.
• Initiate appropriate expert care, treatment and monitoring in ward areas/departments if admission to Critical Care is not available or appropriate including invasive monitoring and care of relevant intravascular devices.
• Function as a resource for ward personnel providing clinical leadership and support.
• Communicate complex and sensitive information to staff, patients and relatives including discussions around ceilings of care and DNACPR decision making
• Ensures patients views are sought and taken into account in the decision-making process and ensure due regard is given to patients customs, values and spiritual beliefs.
• Establish and maintain effective communications between Medical/Surgical Doctors, CCOT, MET and ward/departments managing conflicting views where necessary.
• Respond to requirements with flexibility and empathy, always ensuring patient safety is a priority.
• Respond to referrals for acutely ill patients and emergency situations throughout the hospital as part of the Trust MET and co-ordinates best use of MET resources and skills at calls.
• Reviews and analyses blood results and clinical data from Trust database for Sepsis and AKI to highlight at risk patients, ensuring prompt assessment and recognition of deterioration.
• Liaises with patients parent Clinical teams to ensure appropriate AKI and sepsis care bundles are implemented, instigating and initiating emergency and follow up treatment when required, recognising the associated complications and how to monitor for and treat these.
• Responds to referrals from Critical Care Medical Team to review acutely ill/deteriorating patients in ward areas
• Maintain ALS provider status and act as Team Coordinator at cardiac arrest and emergency calls.
• Provide expert advice on the management of the acutely ill patient in relation to NEWS.
• Ensures appropriate handover of deteriorating patients to Medical and Critical Care Teams- attending relevant Clinical handovers.
• Represents CCOT in MDT meetings relating to complex discharges from Critical Care to wards or for discharge planning from ward to home
• Reviewing the patients Critical Care journey using their patient diary as a starting point for psychological follow up and support.
• Plans care with MDT in relation to rehabilitation after Critical Care and assists with patient reviews and support at Critical Care follow up clinics
• Take responsibility for own clinical workload. Prioritise work and case load according to clinical need, assessing and treating patients according to their individual requirements following clinical examination, building in flexibility to deal with emergency calls and unforeseen demands on time and resources
• Ensures that the CCOT always comply with the Hospital Infection Control and Prevention Policy.

Strategic/Leadership role

• Act and lead on service improvements in line with the Trusts strategic vision.
• Lead and develop the CCOT creating a climate that encourages teamwork, maximises individual contribution and supports innovation.
• Lead CCOT in provision of avoidable mortality reduction surveillance work around AKI and Sepsis.
• Responsible for disseminating information relating to the CCOT to other disciplines at all levels internally and externally of the Trust.
• Support the Critical Care Matron/Coordinator and bed management teams to ensure best use of clinical resources and safe and effective patient flow.
• Responsible for informing, developing and implementing policies in relation to areas of responsibility that impact across the organisation
• Responsible for CCOT audit data collection and reporting,monitoring team activity and workload, new admissions and readmissions to Critical Care viaCCOT/MET and levels of activity and patient dependency across the Trust
• Assists the Lead Nurse in responsibility for MET audit data reporting
• Allocate staff in order to achieve the most effective use of resources, identifying manpower needs and regularly reviewing skill mix.
• Monitor and evaluate health, safety and security of self and others and implement best practice in the ward/department areas.
• Act on concerns reported by team members or service users.
• Ensure that any reports of poor practice are reported and managed in accordance with Trust policy.
• Act as a role model for patient safety and support staff to deliver safe and effective care

Qualifications

Essential

• Registered NMC Nurse (RN)
• Post Registration qualification relevant to Critical Care
• Educated to 1st Degree level or equivalent experience
• Completion of Clinical Examination and Clinical Diagnostics courses
• Advanced Life Support Provider (ALS)
• Advanced Clinical Skills
• Teaching and assessing qualification

Desirable

• Leadership/Management qualification

Experience

Essential

• Significant clinical experience within a Critical Care setting
• Experience of leading and managing a team
• Experience of leading and delivering a clinical service
• Experience of leading and managing change
• Significant clinical experience in assessing, planning and delivering patient care autonomously using advanced clinical skills
• Experience in planning, facilitating and delivering teaching in a variety of settings.

Desirable

• Experience in the development of Strategies, Policies and Procedures

Knowledge

Essential

• Evidence of continuous professional development
• Able to demonstrate and apply specialist knowledge gained through clinical experience
• Knowledge of current professional and local and National NHS related issues

Skills

Essential

• Ability to interpret, develop and propose changes to policy or service development at local level
• Highly developed problem-solving, critical appraisal and decision-making skills
• Highly developed motivational skills and strong commitment to staff involvement and empowerment
• Strong analytical and judgement skills, able to handle complex, contentious, and conflicting information and identify the appropriate course of action
• Able to influence and resolve conflict, overcome resistance through application of advanced communication skills
• Able to present information to professional groups at all levels
• Exemplary leadership skills
• Assertiveness skills and ability to motivate, inspire and enthuse others
• Able to plan, prioritise and coordinate clinical workload across the team
• Able to perform advanced clinical skills in patient assessment and treatments
• Ability to work under pressure, prioritise and meet deadlines
• Ability to understand and manage the stress of others
• Good level of IT skills in word processing, spread sheets, e-mail and power-point presentations

Desirable

• Knowledge of, and participation in, financial management and budget control

Other

Essential

• Willingness to work flexibly and at other sites when required
• Ability and willingness to undertake further training as necessary

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).