Advertised role location: Knockbreda Health and Well Being Centre
Official document: Band 7 Community Respiratory Nurse Specialist Job Description 15 (docx)
JOB DESCRIPTION

Title of Post: Community Respiratory Nurse Specialist

Base: Multidisciplinary Respiratory Team
Any location within the Belfast Health and Social Care Trust

Band: Band 7

Reports To: Senior Respiratory Nurse Specialist

Responsible To: Respiratory Nurse Consultant

Professionally Accountable to: Divisional Nurse

Role Summary:

The post holder will be responsible for providing clinical management and professional leadership in the delivery and development of respiratory services.

The post holder will be responsible for the provision of expert advice in respiratory nursing including all matters relating to respiratory disease management. Supporting patients at home during exacerbations of their condition, and safely avoiding hospital admission, therefore reducing pressures on unscheduled care services. Delivering palliative and supportive care to these complex respiratory patients with multiple co-morbidities, their families and carers.

The post holder is designated to work as part of the respiratory multidisciplinary team to provide an enhanced service to patients with chronic lung disease and to participate in programmes of focused case-finding and accurate diagnosis, smoking cessation, early supported discharge, case management, oxygen assessment and review, oxygen therapy, health promotion and pulmonary rehabilitation, non-invasive ventilation and palliative care.

The post holder will act as a clinical resource to nursing colleagues and other health workers across the Trust and primary care, providing educational support, leading to implementation of evidence based practice. Providing support, education and self-management advice to patients and carers is an essential feature of the role.

The post holder will work collaboratively with all members of the multidisciplinary team to promote, develop and evaluate the clinical respiratory service in the Trust thus ensuring the delivery of high quality specialist patient care.

The post holder will have shared responsibility for setting standards, assessing, planning, implementation and evaluation of programmes of care in relation to respiratory patients.

PRINCIPLE DUTIES

CLINICAL

To contribute to the development of flexible and innovative approaches to care for respiratory patients, which provides an alternative to hospital admission, monitor these interventions using agreed measures including patient/carer experiences in accordance with the Trust’s policies and procedures and the NMC code of Professional Conduct.

To work within an extended expanding specialist role, providing holistic, patient-centered approach to complex respiratory patients with multiple co-morbidities, including assessment, diagnosis, planning and implementation, practicing within agreed guidelines and protocols to deliver high quality patient care.

In collaboration with the multi-professional team, the post holder will contribute to the development, implementation and audit of integrated care pathways for patients with chronic lung disease across the acute and community interface.

Enhance the dissemination to and implementation of major respiratory guidelines, (The British Thoracic Society (BTS), Global Initiative for Chronic Obstructive Lung Disease GOLD), National Institute for Health and Care Excellence (NICE) to General Practitioner, Practice Nurse and other health care professionals, both internal and external to the organisation. Have an extensive understanding of the evidence base of pharmacological and non-pharmacological treatments available.

In collaboration with the multi-professional team, the post holder will ensure that policies, procedures, guidelines, clinical governance arrangements are in place, are appropriate and are well communicated to staff to ensure safe clinical service delivery.

The post holder will be involved in practitioner lead services/clinics within defined protocols, working closely with all members of the community and acute sector based multidisciplinary teams. Assessments of patients in a timely manner either at home or at clinic as appropriate. To review and optimise treatments, encourage self-management and onward referral to pulmonary rehabilitation, home exercise, clinical psychology, dietetics, occupational therapist as appropriate.

Assist in the development of a database to enable the electronic storage of patient related information and the collection of statistical data pertaining to the service.

The post holder will work in collaboration with the multidisciplinary Respiratory team and primary care colleagues and other strategic and voluntary groups relating to respiratory care. Establish and develop links with local and regional respiratory forums and appropriate voluntary organisations.

In collaboration with the Multidisciplinary Respiratory Team, the post holder will participate in research, audit, project planning and evaluation pertaining to the respiratory service. Co-ordinate and develop the respiratory services. Develop protocols in accordance with agreed standards and audit the service to improve standards of care.

Provide specialist support during in-patient stay and post-discharge support in the form of telephone contact or home visit. Provide a seamless service of specialist post-discharge follow up of respiratory patients to monitor treatment plans promote continued improvement and to prevent hospital re –admission.

Develop a service that offers individualised treatment plans where prescribing is appropriately tailored to an accurate respiratory diagnosis. Managing highly complex/acutely unwell patients at home, providing specialist support and working collaboratively with patient/carer, GP and consultants to facilitate patient’s wishes and provide optimal respiratory care.

Provide expert advice for patients with respiratory disease and their relatives / carers, through delivery of information and supervision of treatment programmes.

Autonomous Specialist decision making following clinical assessment, to recommend treatment/management plan. On-going monitoring of treatments using advanced level of analytical and judgement of patient’s physical and psychological response to ensure individualised patient care.

Maintain seven-day service, providing continuity and seamless care for palliative patient support, facilitate early discharge, exacerbation management, preventing hospital admission and thus reducing unscheduled care pressures for complex respiratory patients with multiple co-morbidities. Supporting Out-of-Hours General Practitioner with direct access to the respiratory team with telephone support and review.

Manage admission on to and discharge from own caseload. Identifying frequency of review depending on clinical need as per respiratory framework. Responding to acute calls, from patients or General Practioner and factoring this into planed working day.

Apply theoretical, clinical knowledge and skill to undertake Arterial blood gas (ABG) sampling and Capillary Gas Sampling. Interpretation of results as per protocol and treatment recommendations including adjusting oxygen prescription and titration as per guidelines.

Undertake oxygen assessment and review. Including risk assessment, education on safe use of equipment, act as resource for the patient, carer, multidisciplinary and primary care team. Effective communication with British Oxygen Company regarding equipment requests, faults and identified risks.

Will be responsible for holding ambulance support phone to triage and respond to emergency referrals from Northern Ireland Ambulance Service (NIAS), preventing hospital admissions, thus reducing pressure on unscheduled care services

Support in the management of individuals on long term Non-invasive ventilation (NIV) including ongoing education, review and liaison with hospital staff in future development of treatment plans for these individuals

Provide direct and accessible contact for patients with respiratory disease from the time of diagnosis through to palliative care and bereavement support for families and carers.

Act as a resource of specialist advice throughout the Trust on respiratory related issues, to include education, support and upskilling of nursing home staff and independent sector.

To promote and participate in improving multidisciplinary team working within the community and hospital settings.

To contribute to on-going evaluation and redevelopment of the respiratory nursing practice using to ensure quality improvement and future service development and ensure patient care is continually improved.

To communicate and collaborate with primary and community health care teams regarding the patient’s clinical diagnosis, management and patient care issues. Establish and maintain effective communication and clinical relationships with primary and secondary healthcare teams, regarding the patient’s clinical diagnosis, management and patient care issues. Working collaboratively with secondary care where deterioration is recognised and further specialist medical input is required, facilitating and arranging assessment/treatment pathways

PATIENT AND CARER INVOLVEMENT
To ensure specialist information provided for respiratory patients and their carers is accurate, adheres to guidelines, is timely, easily accessible and easy to understand.

Engage patients and or carers in redesigning services to support improved chronic disease management for patients with respiratory disease.

Undertake a specialist holistic assessment of patients’ needs encompassing physical, emotional, social and spiritual issues, including the needs of the family and carers.

Empower the patient to make informed choices about their treatment and care, assisting them to cope with the effects of their disease and the treatments through improving their understanding of their respiratory condition and its management. To encourage involvement of the patient and carers in decision-making, identifying their need, providing education and devising self- management plans to manage their chronic illness.

Acting as a patient advocate within the wider health service, ensuring patient’s wishes are communicated, and that the patient and family are provided with the information they require.

Using expert communication skills to assist and educate patients with smoking cessation and general health promotion to optimise their condition. Signposting to relevant statutory and voluntary agencies. Fostering empowerment and independent living of patients as much as possible.

Carry out specialist psychological assessment using approved assessment tools (Generalised Anxiety Disorder assessment and Patient Health Questionnaire). Initiating and completing referral and discussion with the Respiratory Clinical Psychologist, implementing psychological approaches as recommended, depending on level of upskill.

Identify transition of patient disease trajectory, through review and assessment. Giving support to patient and carer during their palliative care assessment and advanced care planning.

Advanced level of communication to discuss sensitive information with patient and carers, palliative care input, disease progression, initiation or removal oxygen.

Effectively communicate all relevant information to the multidisciplinary team involved with each patient.

EDUCATION, RESEARCH AND PRACTICE DEVELOPMENT

The post holder will be expected to work with the Practice Development Co-ordinators, Managers and Nurse Consultant to identify and meet the learning needs of staff within the Trust and support the work required to match staff skills to identified services and organisational requirements as they relate to the delivery of clinical services for patients with chronic lung disease.

The post holder will be responsible for implementing and evaluating the respiratory training and education of professionals in the hospital and community including GP’s, nursing staff and allied health professionals.

Contribute to the planning and delivery of programmes of education to student nurses, all levels of nursing staff, medical staff and members of the multidisciplinary team. Complete Future Nurse Future Midwife training, supporting nursing students, both undergraduate and those undertaking Specialist Practice.

To participate in the induction and orientation of new staff to the trust.

The post holder will be responsible for promoting ways of improving the understanding of chronic lung disease through health promotion advice and implementation of health promotion strategies, development of pulmonary rehabilitation programmes and other nurse-led clinics, smoking cessation advice and support and the development of patient information/education packs.

The post holder will be responsible for educating, supporting and counselling respiratory patients and their carers according to assessed need, including participation in pulmonary rehabilitation education sessions

The post holder will be expected to act as a specialist nursing resource for all health professionals, offering advice and guidance on respiratory nursing standards and policies. Have an understanding of all services available to patients with chronic lung disease and be able to refer patients to these services as appropriate.

The post holder will be expected to develop good clinical relationships and networks with key professionals to facilitate the development of the Respiratory Nursing service within the Trust. To be key contact within community respiratory team for a group of GP practices, to aid communication and collaboration.

The post holder will be expected to initiate, develop, implement and evaluate evidence-based practice, policies, procedure and integrated care pathways in line with needs of the service.

Work in conjunction with respiratory nurse specialists in other trusts and practice nurses to develop policies and protocols, ensuring continuity of care, through the Regional Respiratory Nurse Specialist Forum.

As new developments occur, will be expected to update clinical skills to meet this demand. Attend lectures, meetings and conferences as appropriate.

The post holder will be expected to undertake, participate and evaluate research to develop the service and quality improvement. Regular audit of service to gain patient feedback and determine where improvement necessary. Use of reflection on practice during clinical supervision

The post holder will be expected to maintain their own personal and professional development in accordance with the NMC Code of Professional Conduct within the Scope of Professional Practice. Accept responsibility for their own professional development.

The post holder will assist in the evaluation of the service and identifying needs for future service developments. To work in collaboration with the Quality Improvement and clinical Audit Department and participate in the coordination of nursing audit within the Respiratory Service.

Devise and implement quality improvement projects and disseminate learning and improvements across the team and health sector.

Participate in research and project planning, actively participate in clinical governance process.

MANAGEMENT RESPONSIBILITIES

The post holder will be expected to be involved in the strategic development of the Respiratory Service within the Trust.

The post holder will manage a defined caseload and allocated responsibilities, maintain an open referral system and identify priorities for action within the Respiratory Service. Maintain, manage and be responsible for own caseload of 60-90 respiratory patients, ensuring timely and appropriate, assessment, diagnosis, management planning and review.

The post holder will be responsible for the assessing, planning, implementation and evaluation of patient centered programs of care to meet assessed needs of the patient/career. Triage and timely assessment of respiratory referrals, prioritising of clinical need and action required, using experiential clinical decision-making.

The post holder will be expected to review clinical, educational and management responsibilities of the post determine priorities and organise their own work programme.

Review the organisation plan and establish level of service for which their responsible, to ensure that each is consistent with achieving objectives and recommend change where appropriate.

The post holder will be responsible for appropriate delegation to other staff consistent with effective decision- making whilst retaining overall responsibility and accountability for results.

To maintain accurate and concise records that provide the necessary data for the purpose of evaluating and developing the service

To develop a database for respiratory patients and assist in data collection for performance management and quality measurements.

Be willing to participate as required in the selection and appointment of staff in accordance with procedures laid down and approved by the DHSS.

Maximize the use and capability of IT resources to enhance communication between primary, community and secondary care. Contribute to the development of encompass for the respiratory pathway

The post holder will be expected to utilise resources effectively and advise on the suitability of equipment for purchase, staff training implications and ensuring that procedures are in place for delivery, collection, tracking and maintenance of all equipment.

The post holder will be responsible for ensuring the health and safety of staff/patient/clients by adhering to the Trust’s policies, procedures and guidelines and the Health and Safety at Work Act in all areas.

The post holder will be expected to minimise clinical risk by ensuring that clinical practices adheres to DHSSPS guidelines and Trust’s policies, procedures and guidelines and that areas of risk in relation to caseload or team management are promptly reported.

The post holder will adhere to DHSSPS and Trust guidelines in relation to the safe handling, administration, storage, disposal and custody of medicinal products.

The post holder will have responsibility for ensuring compliance with all Trust policies, procedure and guidelines such as reporting/investigation of complaints, management of absenteeism, disciplinary procedure and confidentiality.

Provide reports for contract monitoring and service evaluation.

GENERAL RESPONISBILTIES

Employees of the Trust are required to promote and support the mission and vision of the service for which they are responsible and:

At all times provide a caring service and to treat those with whom they come into contact in a courteous and respectful manner.

Demonstrate their commitment by their regular attendance and the efficient completion of all tasks allocated to them.

Comply with the Trust’s Smoke Free Policy.

Carry out their duties and responsibilities in compliance with the Health and Safety Policies and Statutory Regulations.

Adhere to Equality and Good Relations duties throughout the course of their employment.

Ensure the ongoing confidence of the public in-service provision.

Maintain high standards of personal accountability.

Comply with the HPSS Code of Conduct.

Records Management

All employees of Belfast Health & Social Care Trust are legally responsible for all records held, created or used as part of their business within the Belfast Health and Social Care Trust, including patient/client, corporate and administrative records whether paper based or electronic and also including e-mails. All such records are public records and are accessible to the general public, with limited exceptions, under the Freedom of Information Act 2000, the Environment Regulations 2004 and Data Protection Act 1998. Employees are required to be conversant with the Belfast Health and Social Care Trust policy and procedure on records management and to seek advice if in doubt.

Environmental Cleaning Strategy

The Trusts Environmental Cleaning Strategy recognizes the key principle that “Cleanliness matters is everyone’s responsibility, not just the cleaners” Whilst there are staff employed who are responsible for cleaning services, all Trust staff have a responsibility to ensure a clean, comfortable, safe environment for patients, clients, residents, visitors, staff and members of the general public.

Infection Prevention and Control

The Belfast Trust is committed to reducing Healthcare associated infections (HCAIs) and all staff have a part to play in making this happen. Staff must comply with all policies in relation to Infection Prevention and Control and with ongoing reduction strategies. Standard Infection Prevention and Control Precautions must be used at all times to ensure the safety of patients and staff.
This includes:-
Cleaning hands either with soap and water or a hand sanitiser at the appropriate times (WHO ‘5 moments’);
Using the correct ‘7 step’ hand hygiene technique;
Being ‘bare below the elbows’ when in a clinical environment;
Following Trust policies and the Regional Infection Control Manual (found on intranet);
Wearing the correct Personal Protective Equipment (PPE);
Ensuring correct handling and disposal of waste (including sharps)  and laundry;
Ensuring all medical devices (equipment) are decontaminated appropriately ie. cleaned, disinfected and/or sterilized;
Ensuring compliance with High Impact Interventions.

Values:

The Belfast Trust aims to recruit staff not only with the right skills but also with the right values to ensure the delivery of excellent patient care and experience. Staff will be expected to be committed to provide safe, effective, compassionate and person centred care by:-

Treating Everyone with Dignity and Respect

Displaying Openness and Trust

Being Accountable

Being Leading Edge

Maximizing Learning and Development

By embedding the above values we will make a significant contribution to the delivery of the Trust’s Vision.

Personal Public Involvement

Staff members are expected to involve patients, clients, carers and the wider community where relevant, in developing, planning and delivering our services in a meaningful and effective way, as part of the Trust’s ongoing commitment to Personal Public Involvement (PPI).

Please use the link below to access the PPI standards leaflet for further information.

http://www.publichealth.hscni.net/sites/default/files/PPI_leaflet.pdf

Clause: This job description is not meant to be definitive and may be amended to meet the changing needs of the Belfast Health and Social Care Trust.

PERSONNEL SPECIFICATION

Title of Post: Community Respiratory Nurse Specialist

Grade: Band 7

Reports To: Senior Respiratory Nurse Specialist

Responsible To: Respiratory Nurse Consultant

Professionally Accountable to: Divisional Nurse

_________________________________________________________

ESSSENTIAL CRITERIA:
Ref No: <to be inserted by HR> <Month & Year>

Notes to applicants:
You must clearly demonstrate on your application form under each question, how you meet the required criteria as failure to do so may result in you not being shortlisted. You should clearly demonstrate this for both the essential and desirable criteria.
Shortlisting will be carried out on the basis of the essential criteria set out in Section 1 below, using the information provided by you on your application form. Please note the Trust reserves the right to use any desirable criteria outlined in Section 3 at shortlisting. You must clearly demonstrate on your application form how you meet the desirable criteria.
Proof of qualifications and/or professional registration will be required if an offer of employment is made – if you are unable to provide this, the offer may be withdrawn.

ESSENTIAL CRITERIA


SECTION 1: The following are ESSENTIAL criteria which will initially be measured at shortlisting stage although may also be further explored during the interview/selection stage. You should therefore make it clear on your application form whether or not you meet these criteria. Failure to do so may result in you not being shortlisted. The stage in the process when the criteria will be measured is stated below.

Factor
Criteria
Ideally no more than 6-8 criteria in this section
Method of Assessment

Experience

Minimum of 5 years post registration experience, including 3 years as band 6 in Respiratory.

Shortlisting by Application Form

Qualifications/ Registration
Registered Nurse on Part 1, (Adult) of the live NMC Register.

Have or be prepared to work towards a Post-Grad Specialist Qualification in Respiratory Nursing, Diploma or equivalent

Have or be prepared to work towards a qualification in non-medical prescribing V300.


Shortlisting by Application Form

Experience qualifications
Further post graduate study & evidence of professional development of courses related to respiratory care

Previous experience of working as a clinical respiratory nurse specialist



SECTION 2: The following are ESSENTIAL criteria which will be measured during the interview/ selection stage:

Knowledge/
Skills / Abilities
Must have a Full Driving License valid in the UK and have access to a car. The criteria will be waived in the case of an applicant whose disability prohibited driving but who is able to organise suitable alternative transport arrangements.
Demonstrates ability to work autonomously with complex respiratory patients with multiple co-morbidities in various health care settings as part of a multidisciplinary integrated respiratory service
Ability to undertake comprehensive holistic assessments and manage complex respiratory patients with multiple co-morbidities
Ability to deal with complex and difficult emotional situations
Well–developed interpersonal skills, good oral and written communication skills.
Working knowledge of IT and patient care systems
Teaching , mentoring, supervising, assessment and presentation skills for nursing and Multi-disciplinary team members
Organization and negotiation skills
Leadership and motivational skills
Flexible attitude to working and flexibility in working patterns
Experience in undertaking audit activity , implementing the findings and its implication for health care setting
Knowledge of quality improvement metholodolgy and ability to implement quality improvement projects within and across teams
Experience in report writing
Work with external stake holders (ie; BOC, Respicare)
Acting as patient advocate
Ability to lead and influence change
Knowledge of current issues in HSC and awareness of how these issues impact on the delivery of Respiratory services

Interview

Knowledge
Knowledge of current changes in HPSS and awareness of the impact changes have on the department and hospital environment.


Interview

As part of the Recruitment & Selection process it may be necessary for the Trust to carry out an Enhanced Disclosure Check through Access NI before any appointment to this post can be confirmed.

THE TRUST IS AN EQUAL OPPORTUNITIES EMPLOYER

Successful applicants may be required to attend for a Health Assessment

All staff are required to comply with the Trust’s Smoke Free Policy

HSC Values
Whilst employees will be expected to portray all the values, particular attention is drawn to the following values for this role