Clinical Nurse Specialist Haematology

Purpose of the Post

The purpose of the CNS Haematology is to deliver specialist haematological nursing care in line with the five core concepts of the role set out in the Framework for the Establishment of Clinical Nurse/Midwife Specialist Posts, 4th Edition, National Council for the Professional Development of Nursing and Midwifery (NCNM) 2008.

Core Concepts of the CNS role

· Clinical Focus

· Patient/Client Advocate

· Education and Training

· Audit and Research

· Consultant

CNS Patient Caseload

The CNS Haematology will care for patients over 18 years old and work alongside the Haematology Clinical nursing and medical team to delivery holistic care which is focused on individual needs. There are two strands to Haematology nursing care – malignant and non-malignant. Treatments for haematological malignancies can vary significantly in intensity from surveillance, through outpatient chemotherapy and immunotherapy, to complex inpatient therapy up to the level of allogeneic stem cell transplantation. The non-malignant also require treatment and care.

Patient referred to the CNS Haematology service will be through established referral systems.

Principal Duties and Responsibilities

· The post holder is required to support the principle that the care of the patient comes first at all times and will approach their work with the flexibility, clinical knowledge and skills and enthusiasm necessary to make this principle a reality for every patient to the greatest possible degree..

· The post holder will maintain the primacy of the patient in relation to all hospital activities.

· The post holder will participate in performance management systems and processes and the CNS will be required to participate in the group’s performance management programme.

Clinical Focus

The CNS Haematology will have a strong patient focus whereby the specialty defines itself as nursing and subscribes to the overall purpose, functions and ethical standards of nursing. The clinical practice role may be divided into direct and indirect care. Direct care comprises the assessment, planning, delivery and evaluation of care to the patient, family and/or carer. Indirect care relates to activities that influence and support the provision of direct care.

Direct Care

The CNS will:

· Provide a specialist nursing service for patients who require support and treatment through the continuum of care, demonstrating specialist knowledge of and clinical expertise in the delivery of patient care.

· Undertake a comprehensive patient assessment to include physical, psychological, social and spiritual elements of care using best evidenced based care in the specialist area of nursing practice.

· Use the outcomes of patient assessment to develop, coordinate and implement plan of care and treatment in conjunction with clinical team, the patient and family as appropriate. Attend multidisciplinary team meetings, ward rounds etc. as required.

· Contribute to and support the use of patient review through the use of virtual technology/telephone nurse led review. Provide a point of telephone contact for patient experiencing disease/treatment related symptoms and assess patients using the UKONS telephone triage system.

· Actively participate in planning and carrying out of unscheduled review of patients presenting unwell to the Haematology services with disease/treatment related side effects and escalating in line with local care pathways .

· Provide support to the family/ significant other, through listening, problem solving and education.

· Provide outreach support for the patient at home.

· Assess patients regarding their need for referral to specialist cancer services. Report such patient need promptly to the consultant/ clinical leader and discuss referral.

· Participate in ongoing patient/family education in relation to management of disease and treatment related side effects.

· Foster good working relationships with all members of the clinical team, which are both professional and supportive.

· Maintain accurate clinical records complying with legislation and best practice.

· Demonstrate leadership ability and good communication skills in all aspects of the CNS role and responsibilities.

Indirect Care

The CNS will:

• Identify, contribute to, agree and develop appropriate referral pathways for Haematology patients who are experiencing a disease or treatment related complication in collaboration with the Team.

• Participate in case review with MDT colleagues.

• Use a person-centred approach to patients with complex needs in collaboration with MDT in both Primary and Secondary Care as appropriate.

· Take a proactive role in the formulation and provision of evidence based PPPGs relating to care. Be actively involved in the preparation and implementation of policies and nursing guidelines in relation to the management of care to the Haematology patients.

· Be aware and adhere to all hospital policies and procedures and collaborate with other health care professionals to ensure that these are observed.

• Take a lead role in ensuring the service for haematology patients experiencing disease or treatment related complication is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012) and all other relevant guideline, policies and procedures.

Patient/Client Advocate

The CNS will:

• Communicate, negotiate and represent patient’s family and/or carer values and decisions in relation to their condition in collaboration with MDT colleagues in both Primary and Secondary Care as appropriate

• Develop and support the concept of advocacy, particularly in relation to patient participation in decision making, thereby enabling informed choice of treatment options.

• Proactively challenge any interaction which fails to deliver a quality service to patients
• Respect and maintain the privacy, dignity and confidentiality of the patient, family and/or carer
• Establish, maintain and improve procedures for collaboration and cooperation between Acute Services, Primary Care and Voluntary Organisations as appropriate

· Be aware of existing resources/ services, which help patients and their family/ significant others, e.g. social services, support groups, entitlements. Facilitate development of information leaflets for patients and families.

· Act as a resource/ contact person for Haematology patients attending other departments within the hospital or outside the hospital for treatment.

· Provide patients and family/ significant others with contact details for acute haematology nurse specialist and advise for out of hours contact

Education & Training:

The CNS will:

• Maintain clinical competence in patient management within the specialist area of practice and wider nursing, keeping up-to-date with relevant research to ensure the implementation of evidence based practice.
• Provide the patient, family and/or carer with appropriate information and other supportive interventions to increase their knowledge, skill and confidence in relation to their clinical condition.
• Contribute to the design, development and implementation of education programmes and resources for the patient, family and/or carer, thus empowering them in relation to their condition.
• Provide mentorship and preceptorship for nursing/midwifery colleagues as appropriate. Participate in training programmes for nursing/midwifery, MDT colleagues and key stakeholders as appropriate
• Create exchange of learning opportunities within the MDT through journal clubs, conferences etc.
• Develop and maintain links with Regional Centres for Nursing & Midwifery Education (RCNMEs), the Nursing and Midwifery Planning and Development Units (NMPDUs) and relevant third level Higher Education Institutes (HEIs) in the design, development and delivery of educational programmes inhaematology care.
• Be responsible for addressing own continuing professional development needs

Audit & Research:

The CNS will:

• Contribute to maintaining a register of patients within the CNS Caseload.
• Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPI’s) as directed and advised by the DoN/M/ DON/ Clinical Team.
• Identify, initiate and conduct nursing and MDT audit and research projects relevant to the area of practice, utilise the outcomes to influence service delivery based on best evidence from a nursing and MDT/Service perspective.
• Identify, critically analyse, disseminate and integrate best evidence relating to haematology nursing care and wider perspectives into practice
• Contribute to service planning and budgetary processes through use of audit data and specialist knowledge
• Ensure own practice is compliant and up to date with “best practice”, which is reflected in research and development.
• Collect and maintain accurate data in relation to this service improvement initiative and the impact of the role within the haematology service as determined and developed nationally
• Participate in the regular audit of own clinical practice
• Set objectives and develop policies, procedures and standards for the cancer nursing services based on current nursing research and relevant research from other disciplines.
• Identify areas within the specialty relevant to nursing practice, which would benefit from research. Promote an awareness of research-based practice amongst staff.

Audit expected outcomes including:

• Evaluate audit results and research findings to identify areas for quality improvement in collaboration with nursing management and MDT colleagues

• Contribute to, maintain and report outcome measures locally and to the NCCP and relevant agencies on activity levels from source of referral to management and follow up.

Consultant:

The CNS will:

· Provide leadership in clinical practice and act as a resource and role model for cancer services within the area of practice and wider.

· Generate and contribute to the development of clinical standards and guidelines, having regard to national and international advancements in cancer nursing.

· Establish collegial partnerships and in the context of cancer care, contribute to the professional development of students, peers, colleagues and others through consultation, education, leadership, mentorship and coaching.

• Work with, support, advise and help build up knowledge of expertise of the primary care team in providing an appropriate system of care to meet the needs of the patient and their family/carers.
• Develop and maintain good collaborative working relationships and communication with all members of the speciality’s MDT and other health care professionals within and outside the service.

· Participate in the implementation of the national clinical care programmes and their agreed models of care for patients and their families as they relate to the role.

• Use specialist knowledge to support and enhance the care and management of unscheduled care patients ensuring the prompt, correct management of these patients and consequently reduced bed days

Health & Safety:

These duties must be performed in accordance with local organisational and the HSE health and safety polices. In carrying out these duties the employee must ensure that effective safety procedures are in place to comply with the Health, Safety and Welfare at Work Act (2005). Staff must carry out their duties in a safe and responsible manner in line with the local policy documents and as set out in the local safety statement, which must be read and understood.

Quality, Risk and Safety Responsibilities

It is the responsibility of all staff to:

· Participate and cooperate with legislative and regulatory requirements with regard to quality, risk and safety.

· Participate and cooperate with local quality, risk and safety initiatives as required.

· Participate and cooperate with internal and external evaluations of the organisation’s structures, services and processes as required, including but not limited to, The National Hygiene Audit, National Decontamination Audit, Health and Safety Audits and other audits specified by the NCCP/HSE or other regulatory authorities.

· Initiate, support and implement quality improvement initiatives in their area which are in keeping with local organisational quality, risk and safety requirements.

· Contribute to the development of PPPGs and safe professional practice and adhere to relevant legislation, regulations and standards.

· Comply with Health Service Executive (HSE) Complaints Policy.

· Ensure completion of incident/near miss forms and clinical risk reporting.

· Adhere to department policies in relation to the care and safety of any equipment supplied and used to carry out the responsibilities of the role

Specific Responsibility for Best Practice in Hygiene

Hygiene is defined as: “The practice that serves to keep people and environments clean and prevent infection. It involves the study of preserving one’s health, preventing the spread of disease, and recognising, evaluating and controlling health hazards. In the healthcare setting it incorporates the following key areas: environment and facilities, hand hygiene, catering, management of laundry, waste and sharps, and equipment” (HIQA, 2008; P2). It is the responsibility of all staff to ensure compliance with local organisational hygiene standards, guidelines and practices.

Management/Administration:

The CNS will:

• Provide an efficient, effective and high quality service, respecting the needs of each patient, family and/or carer.

• Effectively manage time and caseload in order to meet changing and developing service needs.

• Continually monitor the service to ensure it reflects current needs.

• Implement and manage identified changes.

• Ensure that confidentiality in relation to patient records is maintained.

• Represent the specialist service at local, national and international fora as required.

• Maintain accurate and contemporaneous records and data on all matters pertaining to the planning, management, delivery and evaluation of care and ensure that this service is in line with NCCP/HSE requirements.

• Contribute to the service planning process as appropriate and as directed by the DoN.

• Have a working knowledge of the Health Information and Quality Authority (HIQA) Standards as they apply to the role for example, Standards for Healthcare, National Standards for the Prevention and Control of Healthcare Associated Infections, Hygiene Standards etcand comply with associated HSE protocols for implementing and maintaining these standards as appropriate to the role.

• To support, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.

General:

• Be accountable for the provision of your work and perform in a manner that is efficient, effective and of the highest standard.

• Conduct his /herself in a manner that ensures safe care.

• In accordance with Health and Safety at Work policy, it is each staff members responsibility to observe all rules relating to Health and Safety and Conduct at Work and to use any equipment and chemicals provided for cleaning in a safe and responsible manner.

• Report any incident or potential incident which may compromise the health and safety of patient, staff or visitors and take appropriate action.

• In line with public Health (Tobacco) amendment Act 2004-smoking on the hospital campus is prohibited.

• Comply with all Hygiene requirements –including use of appropriate Personal Protective Equipment required to comply with Infection Prevention and Control.

• Hospital Uniform Policy must be adhered to.

• Attend training courses as required e.g. Hand Hygiene, Health and Safety, Manual Handling, Chemical safety, Fire Prevention etc
• Report any equipment faults to person in charge and ensure all equipment is stored safely.
• The post holder is expected to carry out his/her duties with compassion, respect and consideration for both patients and other staff.
• Maintain the confidentiality of all information made available to him / her during the course of his / her work.
• Support and promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.

Risk Management, Infection Control, Hygiene Services and Health & Safety

The management of risk infection control hygiene services and Health and safety is the responsibility of everyone and will be achieved within a progressive, honest and open environment.

The post holder must be familiar with the necessary education, training and support to enable them to meet this responsibility

The post holder has a duty to familiarise themselves with the relevant organisational policies procedures and standards and attend training as appropriate in the following areas

· Continuous quality improvement initiatives.

· Document control Information Management Systems

· Risk Management strategies and policies

· Hygiene related police procedures and standards

· Decontamination codes of practice

· Infection Control Policies and guidelines

· Safety statement, Health and safety policies and fire policies

· Data protection and confidentiality policies

· The post holder is responsible for ensuring that they become familiar with the requirements stated within the risk management strategy and that they comply with the group risk management Incident/near miss reporting policies and procedures.

· The post holder is responsible for ensuring that they comply with hygiene service requirements in their areas of responsibility. Hygiene service incorporates environment and facilities, hand hygiene, catering, management of laundry, waste sharps and equipment.

· The post holder must foster and support a quality improvement culture throughout their area of responsibility in relation to hygiene services.

· It is the post holders specific responsibility for quality and risk management, hygiene services and Health and safety management and this will be clarified to you in the induction process and by your line manager.

· The post holder must take reasonable care for his or her own actions and the effect these may have upon the safety of others.

· The post holder must cooperate with management, attend Health and safety related training and not undertake any task for which they have not been authorised or adequately trained.

· The post holder is required to bring to the attention of a responsible person any perceived shortcomings in safety arrangements or any defects in work equipment.

The above Job Specification is not intended to be a comprehensive list of all duties involved and consequently, the post holder may be required to perform other duties as appropriate to the post which may be assigned to him/her from time to time and to contribute to the development of the post while in office.

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