Critical Care Outreach Practitioner

Job description

Job responsibilities

1. Clinical Practice:

Develop competence in conducting history and physical assessments utilising primary and secondary information

Develop sound analytical and judgmental skills to evaluate the effectiveness of interventions and treatments consistent with evidence-based research. Re-assess at appropriate intervals to optimise patient wellbeing and outcome

Request and interpret appropriate investigations (e.g. CXR, Bloods, ABGs, 12 lead ECG). Suggest other investigations that may assist in the diagnosis and management of acutely unwell patients in consultation with the medical team

Perform clinical skills such as but not limited to phlebotomy, male catheterisation, arterial blood gas sampling, ultrasound guided cannulation, in accordance with Trust policies.

Support prescribers with safe prescription, and/or independently prescribe medications accordance with the Trust medications management policy, NMC/HCPC standards and the RPS Competency Framework for all prescribers.

Facilitate timely referral and transfer to ICU in partnership with medical and nursing and multidisciplinary teams.

Work collaboratively with the intensive care team to ensure patients are safely discharged from ICU/HDU. Follow-up all patients from ICU/HDU.

Provide psychological support for patients and relatives experiencing or recovering from critical illness and support the rehabilitation from critical illness pathway.

Competently facilitate safe intra-hospital transfer of the critically ill patient from the ward to other critical care areas

Liaise with the clinical site managers to co-ordinate safe allocation of critically ill ward patients in suitable areas.

Provide technical knowledge and expertise on the set up and maintenance of a variety of medical devices (e.g. CPAP, NIV, Optiflow, invasive haemodynamic monitoring, humidification systems) to non-critical care settings

Develop expertise and skills in managing and coordinating all aspects of care for patient with tracheostomies and participate in Tracheostomy MDT rounds.

Provide support in the discussion and decisions around DNA-CPR and/or treatment escalation planning

At all times act in a collaborative manner with the multi-disciplinary team, apply rational, clear decision making and problem solving judgments to achieve optimal patient outcomes. Where appropriate liaise directly with Consultants.

Support all ward staff practically and professionally and act as a credible role model

• Act with autonomy within current professional guidelines, demonstrating advanced clinical decision-making skills and clinical practice

Aware of current legislation surrounding consent, Do Not Attempt Resuscitation, The Human Rights Act, Mental Capacity Act, Mental Health Act and the Coroners Act

Forms part of the hospital cardiac arrest team, attends all emergency calls except Obstetrics, Paediatrics, A&E unless requested to do so.

Undertakes active role in the Major incident response team.

Activates the Clinical Decisions Support Group in-hours and out-of-hours for urgent referrals

Attend to Marthas Rule activated referrals, following its pathway according to the SOP

Consult ward multidisciplinary team to ensure that complex communications regarding patient management plans are disseminated to all involved in caring for the patient

Directly refer patients to specialist teams e.g. Physiotherapy and Speech and Language services.

Manage a caseload of patients requiring admission to and review by the outreach service. Respond to changing clinical conditions and adapt priorities according to changing patient need/ workload.

On receiving a referral for assistance respond within a reasonable time frame as per the trust escalation policy or refer to another healthcare practitioner if unable to attend.

2. Leadership and Management:

Lead where appropriate, support and advise colleagues during complex discussions regarding end of life decisions, withdrawal of treatment, breaking bad news and DNA-CPR orders.

Develop advanced communication and negotiating skills to manage and lead complex interactions as well as diffusing tense clinical situations and inter-professional conflict.

Communicate with patients and relatives in a sensitive manner appropriate to the situation providing information and reassurance.

Communicate in a consistent and effective manner, understanding and developing strategies to overcome barriers to effective communication and improved patient outcome and team working.

Collaborate with the CCOT Lead to assess the need for specific equipment or resources required to be purchased.

Actively undertakes and promotes clinical supervision within the team, offering supervision, guidance and support to team members.

Participate in change management/patient centred service improvement plans.

Contribute to appropriate Trust governance groups, meetings and working parties to facilitate the integration of the outreach service and to improve the critical care service.

Assists in the development and dissemination of Trust wide protocols, integrated care bundles, patient group directives, policies and evidence-based clinical guidelines.

Develop relationships with consultants and senior colleagues to promote a culture of safety, reducing risk to the patient, reducing cardiac arrests and preventable deaths.

Identify adverse incidents/situations and discuss/investigate with the CCOT Lead and initiate a plan to minimise/eliminate risk in partnership with the clinical nurse leads.

Report incidences via Trust incident reporting mechanisms. Out of hours liaise with the clinical site managers in reducing/managing the risk to ensure patient/staff safety.

Demonstrate awareness of and follow principles within Trust Clinical Governance and Research Governance frameworks.

Responsible for the on duty roster and completion of annual leave and sick records.

With support from line manager develop strategies to manage emotional and physical impact of work. Develop awareness of stressors and seek to minimise impact.

3. Education:

Creates learning opportunities for others and promotes the workplace as a learning environment.

Act as a mentor and assessor for nursing, medical and AHP students and those shadowing CCOT.

Liaise with the CCOT Lead to identify areas for continuing development through frameworks including but not limited to S.W.O.T framework. Facilitates the development of clinical skills throughout the Trust for ward staff using a variety of teaching methods.

Able to teach appropriate clinical skills to all grades of staff and is familiar with basic teaching techniques.

Supports competency-based assessments for ward staff, e.g. Tracheostomy and NIV competency.

In collaboration with the CCOT Lead, deliver face-face or virtual courses including but not limited to ALERT, BEACH, NIV and Tracheostomy courses for all professionals.

Provide ad-hoc virtual and face-face teaching sessions for healthcare professionals on topics related to the care and management of deteriorating patients (e.g. sepsis, NEWS2)

Act as a knowledgeable resource. Share information and seek new information for dissemination to all staff across the Trust as appropriate.

In collaboration with the CCOT Lead and ward managers assist with the ongoing development and training of basic critical care skills and knowledge

Develop confidence in public speaking and coordinating the NIV, Tracheosotomy ALERT and BEACH courses.

In collaboration with the CCOT Lead, assist in the dissemination, implementation and evaluation of adherence to the NEWS2 for the early detection, management and escalation of deteriorating patient policy to all adult clinical areas.

Develop acute critical care knowledge, diagnostic and analytical skills to become an advanced critical care outreach nurse practitioner, according to the national competency framework set out by the National Outreach Forum (2022).

Undertake the essential CCOT courses including but not limited to advanced assessment skills, IRMER and Independent and Supplementary Non-Medical Prescribing Course

Develop a Professional Portfolio to identify individual development needs and maintain a record of advanced clinical practice according to the Multi-professional framework for advanced clinical practice in England (HEE 2017)and requirements for professional bodys revalidation.

Develops and agrees individual personal development plan with line manager.

Maintain critical care skills and clinical expertise by spending clinical time in the critical care areas of the Trust as required.

Undertakes Advanced Life Support course and maintains skills as required by Trust policy.

Act in accordance with the NMC/HCPC Code of Professional Practice and guide others to do the same.

Conversant with and maintains local Trust policies e.g. fire, manual handling, sick policy, major incident policy.

Maintains up-to-date evidenced-based practice

PLEASE SEE JOB DESCRIPTION FOR FULL DETAILS OF THE POST

Person Specification

Education and Qualifications

Essential

• Professional (NMC/HCPC) registration
• Intensive Care Course (or equivalent)
• Teaching and/or Mentorship qualification (or equivalent)
• Advanced Life Support Provider

Desirable

• Advanced Physical Assessment Course (or equivalent)
• Undertaking / Completed Master's Degree
• Independent and Supplementary Non-Medical Prescribing Course

Experience

Essential

• Substantial experience within Intensive Care
• Teaching / Mentoring Experience

Desirable

• Critical Care Outreach Experience

Skills and Knowledge

Essential

• Competent in the management of Tracheostomies
• Competent with all types of non-invasive ventilation therapy
• Intra-hospital transfer trained / competent
• IT & Database knowledge and skills
• Good communication skills and demonstration of customer service standards

Desirable

• Ultrasound-guided cannulation

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.

UK Registration

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

Employer details

Employer name

Chelsea and Westminster Hospital NHS Foundation Trust

Address

West Middlesex Hospital

Twickenham Road

London

TW76AF

Employer's website

https://www.chelwest.nhs.uk/ (Opens in a new tab)