Dialysis Access Lead

Job description

Job responsibilities

Key Dimensions:

Co-ordinate access referrals to the surgical team and liaise with the vascular team regarding reviewing of scans, Identification of access required, and surgical date booked.

Undertake access clinic to ensure monitoring of access post operatively, arranging follow-up scans and arranging intervention as required.

Provide expert management of patients undergoing dialysis access. Participate in assisting access.

clinical procedures.

Working in line with GIRFT recommendations for dialysis access and the south-west network.

PRIMARY DUTIES & AREAS OF RESPONSIBILITY

Managerial

Develop and maintain effective networks within the surgical and renal medical teams, radiology and clinical measurements.

Co-ordinate timely access to surgical teams. Arrange and facilitate regular dialysis access meetings.

Act as a change initiator, to implement solutions and when problems have been identified to improve the quality-of-service provision.

Develop specialist protocols/guidelines to improve the quality in renal vascular access.

Keep clear and concise records in terms of patient assessment and renal venous access device placement, including audit trail for infection rates for all the devices placed within the renal and a quarterly report for the Infection Control Department.

To regularly monitor activity and waiting times for vascular access against NICE guidelines, reporting to the lead dialysis nurse on monthly basis. To alert the lead dialysis nurse to potential problems before they arise.

Ensure the effective use of physical and financial resources.

Professional Development

Work within the Nursing Midwifery Council Code of Conduct

Facilitate the development of other nurses within the renal nursing.

To take part in annual development review and meet regularly with the lead dialysis nurse.

Work in a way that promotes health and safety of patients, colleagues, and staff.

Be aware of and follow Trust policies and national guidelines.

Demonstrate motivation and enthusiasm in the role and its development.

Maintain and improve own professional knowledge, experience, and competence in line with national practice.

Treat all patient information with confidentiality in accordance with relevant legislation.

Undertake learning by maintaining own professional development and knowledge.

Development of others by undertaking PDRs

Act as a role model.

The post holder will be required to work within defined deadlines for projects, will need to have a flexible approach to tasks and be able to cope with changing priorities.

Clinical

Co-ordinate a renal access specialist pathway for pre-operative assessment of patients for dialysis vascular access, working in conjunction with pre-dialysis, surgical and nephrology teams and within agreed protocols.

Provide dialysis access clinic to provide post operative care and identify whether the access is working, identify complications, arrange duplex scans and re-listing of patients where necessary following agreed protocols.

Provide individualised information to the patient about the vascular access process.

Arrange timely pre-operative duplex vein mapping of patients needing access.

Review patients duplex scans and all relevant patient information in conjunction with a member of the surgical team formulate an individual and management care pathway.

Undertake arterial-venous (AV) fistula/graft flow measurements and re-circulation using a specialized transonic monitor in all haemodialysis patients, interprets results and refers on, if required to vascular scanning, interventional radiology, or vascular surgeons.

Identify complex cases and flag up to surgical and nephrology team.

Assist Consultants with CVC or Tenchkoff insertions.

Education

Attend relevant clinic and multi-professional meetings, seminars, and conferences.

Organise educational events to disseminate relevant quality service information and changes for venous catheter care.

Train identified nursing staff in the use of transonic monitoring to provide quality assurance for all vascular access patients.

To deliver formal and informal education programmes to junior staff, postgraduate and undergraduate education departments to disseminate relevant quality service information ad changes regarding vascular dialysis access.

To develop and produce relevant Patient Information Leaflets on dialysis access.

To liaise with the Clinical Practice Educator about developments, the recommended changes of practice in renal access and to collaborate on developing competency and policy documents.

Demonstrate a commitment to continuing education and evidence-based practice.

Research and Audit

Lead the clinical audit of vascular access by collecting, recording, and storing relevant information to monitor and improve the standard of care for central venous catheters.

e.g., Infection rates and long-term patency rates. This will include the presentation of data at audit and clinical nephrology meetings.

Appraise recent research / audit evidence interpret results and make recommendations and directives to improve service development.

In collaboration with the Infection Control Team monitor and audit infection rates for central venous catheters and arterio-venous grafts and fistulas.

Seek out new knowledge of renal nursing and health by reading, enquiring, and participating in relevant education / clinical / professional / multi-professional meeting, seminars, and conferences.

To develop and maintain an up-to-date vascular access database to enable audit of outcome for future planning of access.

To ensure an evidence-based nursing service, through regular literature review and update of Trust guidelines.

Implement the nursing elements relating to vascular access with the Renal National Service Framework, Renal GIRFT Report and NICE Guidelines.

COMMUNICATIONS & WORKING RELATIONSHIPS

Liaise with all members of the of the multidisciplinary team including the renal ward, main haemodialysis unit and peritoneal dialysis unit.

Share experience of expertise with the wider audience of inter-professional groups, both nationally and internationally.

The post holder must be an effective communicator and able to work collaboratively with patients, relatives / carers, and the multidisciplinary team.

The post holder will be an energetic professional capable of fostering an effective working relationship across a range of professional levels.

OTHER

Maintain patient confidentiality as all times.

Act as a resource for advice and information for patient, renal and surgical staff re the vascular access pathway, providing point of contact within the department for renal access.

Ensure patient records are up to date and reflect the planning, delivery and evaluation of care in relation to access, maintaining confidentiality at all times.

Establish information technology (IT) links to facilitate communication within the renal unit and Trust.

Acquire appropriate knowledge and skills to implement IT-based systems for example to create and update databases.

Document in a timely fashion, all vascular access events using IT as required.

Be aware of Health and Safety and Infection control requirements for the clinical area. Participate in joint Infection Control/Renal meetings.

Contribute, as appropriate to Trust and Unit wide Clinical Governance Initiatives including multi-professional audit.

Provide in-going emotional support to patients and their carers with a chronic illness whilst adapting to new or changing condition and implication this has for their life.

Regular use of phlebotomy and cannulation skills, frequent exposure to clinical sharps.

The post holder will be a car driver as will need to travel to other clinical units based on the hospital site.

All Managers are responsible for

• Assessing risks and implementing the necessary actions to minimise these risks within their sphere of responsibility. They must also enable staff to attend the relevant statutory and essential training.

• Managing attendance in accordance with the Trusts Attendance Management Policy.

Note

This job description is neither definitive nor exhaustive and is not intended to be totally comprehensive. It may be reviewed in the light of changing circumstances following consultation with the post holder. This job description is to be read in conjunction with all current Plymouth Hospitals NHS Trust policies, procedures & guidelines.

Person Specification

Knowledge and experience

Essential

• oMinimum of 5 years in post registration experience in a renal specialty. oBand 6 management experience. oKnowledge of up-to-date practice within renal nursing. oEvidence of experience in renal vascular access devices and assisting in vascular access processes. oEvidence of research and audit skills and an understanding. oKnowledge of interpreting scan reports and escalating potential issues where required.

Desirable

• oIrmer trained. oTeaching qualification specialist training or be willingness to undertake.

Qualifications

Essential

• o1st Level Registered Nurse (Adult) oRenal Course oDegree in Nursing oProfessional knowledge acquired through degree level study. oNon-medical prescribing Course.

Desirable

• oEvidence of study at master's level.

Apptitude and abilities

Essential

• oAbility and evidence of working and communicating across a multi-professional team. oAbility to analyse, interpret and initiate appropriate specialist nursing practice within the service. oAbility to manage own clinical caseload and work independently as required. oKnowledge of current frameworks, documents, guidelines, and standards in relation to renal disease. oUnderstanding of renal dialysis vascular access.

Disposition/ Motivation and attitude

Essential

• oMaintains professionalism in all aspects of role. oDemonstrates good communication skills in all aspects of role. oEnthusiastic, highly motivated, flexible, and committed to developing a service. oAbility to be assertive when necessary and remain calm in stressful situations. oAbility to work constructively within a multi-disciplinary team. oExcellent communication and negotiating skills. oCommitted to developing the renal service. oTakes responsibility for own professional development. oEvidence of implementing change in clinical practice.

Other factors

Essential

• oCar owner and full driving licence. oAbility to use IT systems for renal patient care. e.g., Vital Data, Insignia, Microsoft Word, Microsoft Outlook, Excel, and PowerPoint.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

University Hospitals Plymouth NHS Trust

Address

University Hospitals Plymouth NHS Trust

184 Plymbridge Road, Estover,

Plymouth

PL6 7FL

Employer's website

https://www.plymouthhospitals.nhs.uk/ (Opens in a new tab)