Job responsibilities
PRINCIPAL
DUTIES & AREAS OF RESPONSIBILITY
CLINICAL
PRACTICE
Take, where appropriate, delegated
responsibility for the delivery of a highly specialist perfusion service,
ensuring the service is effective and well-coordinated.
Offer and undertake a range of
highly specialised perfusion techniques during routine and emergency
cardiopulmonary bypass.
Assess patients relevant medical
history, pathology and diagnosis and make appropriate decisions concerning
conduct of cardiopulmonary bypass procedures.
Advise clinicians on the
suitability of equipment and suggest to clinicians appropriate courses of action.
Set up, prime and run the
cardiopulmonary bypass machine to maintain life support for the period of
cardiopulmonary bypass according to broad occupational and clinical policies
as well as recent scientific evidence, seeking advice when necessary.
Regularly undertake By-pass
initiation and termination which requires a high level of hand eye and
sensory coordination, similar to that required for suturing/intubation.
Take personal responsibility for
simultaneously monitoring and making fine adjustments to 43 patient
parameters on the bypass machine and to clinically respond and react to any
changes in the patients condition. This requires intense concentration for
the duration of individual cases which can last up to 12 hours.
Sample, analyse and interpret
arterial/venous blood gases and patient coagulation status in the form of
Activated clotting times and Thromboelastograph.
Administer drugs, including colloid
/ crystalloid fluids, vasoactive drugs, cardioplegia solution, potassium,
anticoagulants, haemostatic drugs, sodium bicarbonate and osmotic diuretics
as clinically indicated.
Monitor a wide range of highly
complex and routinely conflicting clinical information on a minute-to-minute
basis such as blood oximetry; cardiac output; systemic vascular resistance;
ventilation; anticoagulation; renal status and blood glucose levels, and take
appropriate autonomous action in both alpha and pH stat blood management.
Manipulate on a second-to-second
basis the patients cardiovascular system whilst on cardiopulmonary bypass.
Determine requirement for, and
perform where clinically indicated, haemofiltration and blood transfusion
during cardiopulmonary bypass,
including modified ultrafiltration in neonates.
Set up and manage, where appropriate,
antegrade/retrograde cerebral perfusion; deep hypothermic circulatory arrest;
vacuum assisted venous drainage; mechanical support devices; extracorporeal
membrane oxygenation, Intra-aortic balloon pumping.
Provide one to one care to acutely
ill children with life threatening conditions. This involves shifts of up to
12 hours over a period of 2 weeks. This requires the post holder to provide a
high level of emotional support to parents and other relatives over a
sustained and repeated period.
Ensure quality control,
calibration, cleaning, maintenance and safe use of expensive complex medical
equipment in Clinical Perfusion
Frequent direct exposure to
uncontained patient blood.
Participate fully in the Clinical
Perfusion 24hr on-call cover.
MANAGERIAL
Liaise with other members of the
surgical, anaesthetic and nursing teams.
Manage and prioritise own
caseload/workload independently.
Be responsible for supervision of
students, involving judging competence levels and organising suitable activity.
Complete a training record and
casebook.
Discuss and sensitively deal with
any highlighted problems that have arisen during supervision. This may
involve providing reassurance where necessary or discussing problems with
senior colleagues or staff
Respect the confidentiality of all
matters that may relate to colleagues employment and that of other members
of staff. All staff are expected to respect the requirements of the Data
Protection Act.
Take leading roles, delegated by
the Clinical Perfusion Manager in organising the departmental on call rota
and daily activity planner. Write protocols and liaise any changes to staff
in an appropriate forum. Order stock and organise its delivery, ensuring
expiry dates are noted and stock rotated to ensure no stock wastage. Organise
mandatory training for all perfusion staff to ensure training is kept up to
date. Input files onto the departmental auditing database.
Plan staff rosters, equipment,
supplies and maintenance of equipment with external contractors at least 5
weeks in advance and specifically in response to the planned elective list
profile.
To reallocate work, staff, supplies
equipment and recalibrate that equipment in response to acute cardiac surgery
which makes up 50 % of the activity on a daily basis and/or in response to
hot acute surgery demands (response time 1 hour).
Attend monthly audit meetings and
contribute to the sessions by offering specialist knowledge and experience
and feedback any relevant information discussed at the meetings.
Deputising in the absence of the
Clinical Perfusion Manager.
Research
and Development
Develop specialised techniques and
protocols.
Participate in developing and
implementing protocols and procedures within Clinical Perfusion. When
impacting on other professional groups discuss with appropriate associate to
encourage co-operation and to negotiate a favourable outcome.
Be responsible for personal update
of knowledge on areas surrounding policies and ensure that relevant
information is distributed to the appropriate individuals.
Evaluate, research and audit
perfusion equipment testing as part of routine work.
Evaluate and contribute to changes
in practice to improve quality of patient care.
Offer advice on research and
development within the Directorate to promote perfusion research within a
multidisciplinary team.
Liaise, co-ordinate and comply with
other appropriate authorities and departments regarding the instigation of
research projects, e.g., medical staff, R & D, Ethics committee,
suppliers and both internal and external laboratories.
Critically review current
literature to reflect current thinking regarding principles and practices of
cardiopulmonary bypass that may ultimately lead to improvement in patient
care.
Ensure that all duties are carried
out in accordance with policies, practices and procedures of the Trust.
Comply with corporate governance
structure in keeping with the principles and standards set out by the Trust.
Undertake equipment testing of new
equipment.
Gather and collate research data in
relation to the use of new equipment and protocols in relation to mortality
and morbidity, to influence and implement evidence-based practice across the
perfusion service.
Present research data at the
Directorate Audit Meetings in the absence of the Chief Perfusionist.
Health
and Safety/Risk Management
All
staff are responsible for working with their colleagues to maintain and
improve the quality of services provided to our patients and other service
users. This includes complying at all
times with the Leeds Teaching Hospitals NHS Trust Policies, including Health
and Safety policies, in particular by following agreed safe working
procedures, and reporting incidents using the Trust Incident Reporting
system.
Infection
Control
The
jobholder must comply at all times with the Leeds Teaching Hospitals NHS
Trust Infection Control policies, in particular by practising Universal
Infection Control Precautions. Hand hygiene must be performed before and
after contact with patients and their environment.
Equality
and Diversity
The
jobholder must comply with all policies and procedures designed to ensure
equality of employment and that services are delivered in ways that meet the
individual needs of patients and their families. No person whether they are staff, patient
or visitor should receive less favourable treatment because of their gender,
ethnic origin, age, disability, sexual orientation, religion etc.
Patient
and Public Involvement
The
Trust has a statutory duty to involve patients and public in evaluating and
planning services. All staff have a
responsibility to listen to the views of patients and to contribute to
service improvements based on patient feedback.
Training
and Personal Development Continuous Professional Development
The
jobholder must take responsibility in agreement with his/her line manager for
his/her own personal development by ensuring that Continuous Professional
Development remains a priority. The
jobholder will undertake all mandatory training required for the role.
Respect
for Patient Confidentiality
The
jobholder should respect patient confidentiality at all times and not divulge
patient information unless sanctioned by the requirements of the role.
