Advanced Clinical Practitioner - Acute Frailty SDEC/UCR
The Advanced Clinical Practitioner in Acute Frailty and Urgent Community Response (UCR) will be a highly experienced, knowledgeable, and educated member of the team who is able to work autonomously making high level decisions to treat health needs. Advanced level practice encompasses all four pillars including of clinical, education, research and management, but role is firmly grounded in direct care provision and clinical work with patients’ families and populations. The post holder will be an experienced Advanced Clinical Practitioner who, acting within their professional boundaries, will provide care for the presenting patient, from initial history taking, clinical assessment, diagnosis, treatment and evaluation of care. They will demonstrate safe, clinical decision-making and expert care, including assessment and diagnostic skills, for frail elderly population on Same day emergency care and within UCR. The post holder will also rotate into the CHFT Urgent Community Response team in order to meet service needs and to provide care closer to home, as part of this transformational role. Assess individuals, families and carers holistically, using a range of different methods, such as physical assessment, history taking, ordering and interpreting diagnostic tests or advanced health needs assessments Communicate effectively with patients, family and carers, and the multidisciplinary team. Use expert knowledge and clinical judgement to decide whether to refer patients for investigations and make diagnoses. Decide and carry out treatment, which may include the prescribing of medicines, or referring patients to an appropriate specialist. Ensure the provision of continuity of care. Assess and evaluate, with patients and /or carers, the effectiveness of the treatment and care provided and make changes as needed. Work autonomously within a wider health care team and as a lone practitioner. Work across professional, organisational and system boundaries and proactively develop and sustain new partnerships and networks to influence and improve health, outcomes and healthcare delivery systems. Work as senior decision maker to support clinical decision and pathways of care We employ more than 6,500 staff who deliver compassionate care from our two main hospitals, Calderdale Royal Hospital and Huddersfield Royal Infirmary as well as in community sites, health centres and in patients’ homes. We also are incredibly proud to have almost 150 volunteers here at CHFT. We provide a range of services including urgent and emergency care; medical; surgical; maternity; gynaecology; critical care; children’s and young people’s services; end of life care and outpatient and diagnostic imaging services. We provide community health services, including sexual health services in Calderdale from Calderdale Royal and local health centres. These include Todmorden Health Centre and Broad Street Plaza. We continue to modernise and invest in our health services to build on our strong reputation. Foundation trusts are public leaders in improving quality in health services. They are part of the NHS – yet decisions about what they do and how they do it are driven by independent boards. Boards listen to their Council of Governors and respond to the needs of their members – patients, staff and the local community. Foundation trusts provide what the health service wants, yet are also free to invest quickly in the changes to the local community needs, in striving to be the best, and in putting their patients first. Post specific Criteria: Lead the management of patients from arrival to discharge demonstrating through audit and data collection improvements in patient pathways and experience. Be responsible for the assessment and management of patients presenting with undifferentiated and undiagnosed illnesses and injuries. Assess and manage patients across the age spectrum and within scope of practice. Provide expert clinical care, including appropriate investigations and initiation of necessary interventions. Work with internal and external agencies/teams to effectively manage the care episode, including discharge. Work collaboratively as part of the multidisciplinary team to ensure patients are assessed and have all appropriate investigations required to make diagnostic and treatment decisions. Liaise effectively with referrers to ensure timely and appropriate patient admission and discharge. Monitor rate of readmission/re-attendance, identifying any trends and working within the multidisciplinary team including virtual wards to address these Work in the multidisciplinary team to develop practice, research and audit. Develop and review policies, guidelines integrated care pathways and patient information, as necessary. Develop nurse-led clinical audit and research within the service, undertaking regular reviews of practice to continually improve the quality of care. Clinical Duties Practice as an autonomous professional in a self-directed manner, with confidence, authority and expertise, undertaking comprehensive range of clinical procedures. Have direct responsibility for patient case load, ensuring all patients have an accurate plan of care, which reflects the assessment undertaken and incorporate the issues and recommendations made. Work clinically to optimise health and well being, through comprehensive history taking and physical assessment of patients. Drawing on a diverse range of knowledge and skill, determine appropriate therapeutic interventions, Plan, prioritise and manage complete episodes of care, for patients presenting with undifferentiated and undiagnosed conditions. Be proactive in clinical decision making, underpinned by an advanced level of theoretical and practical knowledge and be able to demonstrate improved patient care outcomes Accurately request radiological and pathology investigations and make clinical decisions based upon the results. Provide specialist advice and support to patients, their families and other healthcare professionals following assessment, diagnosis, treatment and discharge/admission. Work in partnership with others, delegating and referring as appropriate to optimise health outcomes and resource use,. Use professional judgement in managing complex and unpredictable clinical care. Draw upon an appropriate range of multi-agency and inter-professional resources in their practice. Appropriately define boundaries of practice and access support or advice where appropriate. Communicate effectively to develop and sustain partnership working with individuals, groups, communities and agencies. Actively plan for patient discharge, working across organisational and professional boundaries to establish robust therapeutic plans Maintain adequate patient documentation requirements for the whole patient episode To be responsible and accountable for own decisions, actions and omissions at this level of practice. Demonstrating a critical understanding of own level of responsibility and autonomy and the limits of own competence and professional scope of practice, including when working with complexity, risk, uncertainty and incomplete information To prescribe and review medication (as an independent prescriber) for therapeutic effectiveness appropriate to patient need and in accordance with best/evidence-based practice and national and local protocols and within the roles scope of practice and legal framework Demonstrate a high level of knowledge in relation to pattern of disease or disorder, markers of condition progression and range of treatment available at each stage of disorder or condition. Be able to assess critically and re-evaluate the clinical situation as the patient’s condition changes. Anticipating likely potential physical and psychological problems caused either by the condition or by treatment for individuals living with frailty. To be responsible for the delivery of a detailed, accurate and potentially complex clinical handover and to produce detailed and accurate written information within the medical notes regarding all clinical assessments, investigations completed and requested, and treatments administered. Education / Training: Act as a source of clinical and theoretical knowledge for all grades and disciplines of staff as well as patients and their significant others, providing support and clinical advice in specialist areas, based on evidenced based research Promote a learning environment within the clinical area of responsibility in which individuals take ownership for their professional development. Take an active role in undertaking staff training needs analysis as appropriate. Critically assess and address own learning needs, negotiating a personal development plan that reflects the breadth of on-going professional development across the four pillars of advanced clinical practice, ensuring own appropriate and on-going clinical support Continually develop personal theoretical knowledge and maintain high standards of clinical competence through on-going self-directed study and attendance at in-house training. Complete specialist field competencies, including advanced life support training, within timeframe agreed with clinical supervision Access ongoing clinical supervision to identify and address educational needs Develop and maintain a peer network of support, information and learning with other ACPs at a local and National level. Maintain own professional portfolio. Lead the development and acquisition of specialist knowledge and skills to enhance and extend the practice of themselves, other nurses and health care professionals within the service and beyond Identify and address the educational needs of patients, families, carers and staff involved in the delivery of this service. Contribute to the teaching and support of staff from the multi professional team within relevant educational programmes. Provide an appropriate learning environment, including mentorship, coaching, supervision and preceptorship. Organise and contribute to relevant educational programmes and in house study days. Improving quality and developing practice: Coordinate and participate in on-going service review and evaluation, including seeking and monitoring patient experience and outcomes. Participate in research, audit and quality improvement projects to generate new evidence in area of speciality. Evaluate clinical practice in relation to its evidence base and clinical effectiveness including policy and guidance. Identify areas of risk and poor quality, and address these through appropriate governance structures and forums. Participate and actively seek peer review in practice and sound evidence for assurance purposes. Managerial Duties Work collaboratively with the Matron, Directorate Manager, Operational Service Manager, Clinical Director, Lead Clinicians and Senior Nurses to ensure the efficient operational management of the service and that Strategic aims are met within agreed budgets. Identify and implement systems to promote their contribution and demonstrate the impact of advanced level practice to the healthcare team and the wider health and social care sector. Provide support to the Matron and the other senior nurses within the directorate. Collaborate with the multi-professional team to develop a shared vision of the service. Act as a role model and provide consultancy to own and other areas in expert clinical evidence based practice. Work collaboratively with colleagues to develop effective documentation, pathways, protocols and guidelines for care. Demonstrate a commitment to share expertise and disseminate information. Contribute to the development of the team and the service to continuously improve patient care. Participate in implementing national standards and frameworks at a local level Network locally, regionally, nationally and internationally and seek opportunities to develop the ACP role. Have an understanding of budgetary constraints and manage budgets effectively including active participation in cost improvement programmes. Use effective change management skills to initiate and implement service and practice development, making the best use of resources to improve practice and health outcomes. Participate in the selection, interviewing, appraisal and professional development of team members. Maintain involvement and active input in multidisciplinary meetings and appropriate local bodies / forums to contribute to practice and service development Financial Duties Ensure safe, cost effective care managed through allocated budget
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