Job responsibilities
PRINCIPAL DUTIES & AREAS OF RESPONSIBILITY
CLINICAL PRACTICE
a. Take, where appropriate, delegated responsibility for the delivery of a highly specialist perfusion service, ensuring the service is effective and well coordinated.
b. Offer and undertake a range of highly specialised perfusion techniques during routine and emergency cardiopulmonary bypass.
c. Assess patients relevant medical history, pathology and diagnosis and make appropriate decisions concerning conduct of cardiopulmonary bypass procedures.
d. Advise clinicians on the suitability of equipment and suggest to clinicians appropriate courses of action.
e. 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.
f. 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.
g. 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.
h. Sample, analyse and interpret arterial/venous blood gases and patient coagulation status in the form of activated clotting times and Thromboelastograph.
i. Administer drugs, including colloid/crystalloid fluids, vasoactive drugs, cardioplegia solution, potassium, anticoagulants, haemostatic drugs, sodium bicarbonate and osmotic diuretics as clinically indicated.
j. 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.
k. Manipulate on a second-to-second basis the patients cardiovascular system whilst on cardiopulmonary bypass.
l. Determine requirement for, and perform where clinically indicated, haemofiltration and blood transfusion during cardiopulmonary bypass including modified ultrafiltration in neonates.
m. 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.
n. 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.
o. Ensure quality control, calibration, cleaning, maintenance and safe use of expensive complex medical equipment in Clinical Perfusion.
p. Frequent direct exposure to uncontained patient blood
q.Participate fully in the Clinical Perfusion 24hr on-call cover.
MANAGERIAL
a.Liaise with other members of the surgical, anaesthetic and nursing teams.
b.Manage and prioritise own caseload /workload independently.
c.Supervision of students, involving judging competence levels for routine adult procedures and assisting Senior Clinical Perfusionist with suitable training activity.
d.Complete a training record and casebook.
e.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.
f.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.
g.Assist Senior Clinical Perfusionist with the development of protocols and liaise any changes to staff in an appropriate forum. Assist with stock rotation and maintenance of stock levels including identification of stock requirements Input data on to the departmental database with regard to stock management and case auditing.
h.Reduce waste of disposable by ensuring correct equipment used and stock rotation.
i. Assist Clinical Perfusion Manager to budget and improve expenditure by suggesting cost saving techniques specifically on the £650k consumable cost type.
j.Ensure safe storage of consumables to the value in excess of £100,000. Paying particular attention to usage and short shelf life.
k.Attend monthly audit meetings and contribute to the sessions by offering specialist knowledge and experience and feedback any relevant information discussed at the meetings.
EDUCATIONAL AND TRAINING
a. Assist Senior Clinical Perfusionist with the organization and implementation of education and training programmes for student Clinical Perfusionists and other staff members.
b. Provide teaching to doctors, nurses and other Allied health professional give an insight into cardiopulmonary bypass.
c. Encourage and support staff development and training.
d.Attend post-graduate courses, seminars and conferences to facilitate continual professional development.
e.Act as a supervisor to training staff and identify development needs through the use of feedback and discussion, creating an environment of support and growth.
f.Assist the development of problem solving skills for all staff within the scope of the in house training and clinical skills workshops.
RESEARCH AND DEVELOPMENT
a. Assist with the development of specialised techniques and protocols.
b. Participate in developing and implementing protocols and procedures alongside Senior Clinical Perfusionists. When impacting on other professional groups discuss with appropriate associate to encourage co-operation and to negotiate a favourable outcome.
c. Be responsible for personal update of knowledge on areas surrounding policies and ensure that relevant information is distributed to the appropriate individuals.
d. Evaluate, research and audit perfusion equipment testing as part of routine work.
e. Evaluate and contribute to changes in practice to improve quality of patient care.
f. Liaise 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.
g. Critically review current literature to reflect current thinking regarding principles and practices of cardiopulmonary bypass that may ultimately lead to improvement in patient care.
h. Ensure that all duties are carried out in accordance with policies, practices and procedures of the Trust.
i. Comply with corporate governance structure in keeping with the principles and standards set out by the Trust.
J. 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.
FREEDOM TO ACT
a. Draw on knowledge of a range of theories to inform practice. Assist in developing strategies for the management and delivery of care to the patient.
b. Work as an autonomous practitioner, taking responsibility for organising and delegating, where appropriate, the delivery of multiple techniques required during a single procedure, e.g., cardiopulmonary bypass; cell salvage; blood gas analysis and Thromboelastography.
c. Take initiative, manage and prioritise own caseload/workload independently.
d. Monitor and evaluate own service delivery and that of others in the team.
e. Be accountable for own professional action and recognise own professional boundaries through interpretation of clinical/ professional policies.
f. Work within defined departmental and national protocols / policies and professional code of conduct.
g. Work independently accessing appraisal within an individual performance framework at pre-determined intervals.
h. Act on own initiative according to clinical evidence and as clinical circumstances indicate.
i.Administer selective cardiovascular and controlled drugs as clinically indicated and determined.
COMMUNICATION
a. Communicate in an effective, clear, concise and exact manner as a core member of the cardiothoracic surgical team, providing and receiving complex and contentious information to ensure positive patient outcomes.
b. Communicate in a proactive manner. This is particularly important in an emergency situation.
c. Routinely relay sensitive information to members of staff and Clinical Perfusion Manager to ensure appropriate continuation of care of the patient.
d. Participate in discussions with clinicians within and outside immediate surgical team as a means of devising an appropriate care pathway for patients. This is particularly important when patients exhibit underlying pathology that is relatively incompatible with cardiopulmonary bypass.
d.Convey information that is frequently highly complex via various media to a broad range of audiences to promote understanding of a unique specialty.
e.Demonstrate good negotiation skills in the management of conflict across a range of clinical situations.
