JOB DESCRIPTION Job Title:- Specialist Practitioner of for Shrewsbury, Telford and surrounding community hospitals. Grade:- Band 7 Line Manager:- Associate Director of Patient Safety Professionally Accountability to:- Associate Director of Patient Safety Base/Department:- Pathology Department, Royal Shrewsbury & Princess Royal Hospital Main Purpose of Job The Blood Practitioner is required to function strategically and operationally as an autonomous cross site specialist, promoting safe and appropriate transfusion practice within the Trust and community hospitals delivering a transfusion service. The post holder will be responsible for assessing the training needs of approximately 5,000 staff within the acute setting, including those in the community hospitals. This will involve maintaining and co-ordinating education programmes, and where necessary, designing, developing and implementing new training ideas for nursing, medical and multidisciplinary staff, in the management of patients requiring and receiving blood and blood components. The post holder will be responsible for managing all aspects of clinical risk in this area and in ensuring that agreed protocols are followed. The post holder will utilise their extensive knowledge and skill base to provide specialist/technical support to the Blood Department, in relation to all aspects of the transfusion process, working in collaboration with the Blood Bank Biomedical Scientist (BMS) staff. This will also involve co-ordinating the Trust-wide response to fulfil Department of Health haemovigilance requirements such as the patient blood management framework, NICE (NG24) recommendations, Blood Safety and Quality Regulations 2005 (enforced by the competent authority of the MHRA), enabling the Trust to meet the requirements of Clinical Governance, the National Patient Safety Agency recommendations, Care Quality Commission regulations andcpa and European directives associated with the transfusion process. Whilst the post holder will be based at RSH, the role is Trust-wide and duties cover all disciplines and community hospitals associated with the transfusion process. Practitioner Organisational Structure Medical Director Associate Director Patient Safety Consultant Haematologist for Regional Service Risk Management Practitioner (HTC secretary) Associate Practitioner Deputy Head BMS in Royal Shrewsbury Hospital Princess Royal Hospital Community Hospitals supplied by SaTH blood banks Student Nurses, Doctors, Midwives Nursing, Midwifery & ODP Staff Ancillary Staff Portering Staff Phlebotomy Staff Medical Staff Blood Bank staff 1
Main tasks/overview of responsibilities Responsibility for patient care (including monitoring, diagnostics + investigations) To act as a resource and provide highly specialist knowledge and expertise in blood transfusion practices and processes for all clinical professionals within the Trust. In collaboration with the Hospital Committee/team (HTC/HTT), to develop evidence-based protocols and guidelines covering all aspects of transfusion of blood and blood components, and implement these within the Trust. To practice clinically by leading, co-ordinating, supervising and evaluating clinical practice. Ensuring that all patients within the Trust have their transfusion needs assessed, that programmes of care are developed to meet these needs and are delivered in accordance with agreed policies and procedures. To participate in direct and indirect patient care which incorporates designing and implementing specialised programmes of care. To monitor care given to patients by regularly auditing transfusion practices within the Trust and using these results, to design, implement and review protocols as appropriate. To identify and undertake risk assessments in specific clinical areas where transfusion practice may be improved and to explore alternative procedures and therapies using research methodology and Best Practice ethos. To actively contribute to the Trust s Clinical Governance programme, update the local database of incidents, and assisting in the production of a quarterly review of untoward transfusion related incidents with recommendations for corrective and preventative measures for the HTT, HTC and Trusts Clinical Governance Committee. To work with specialist nurses, pre-admission teams, outpatients and all other Trust Departments to ensure adequate advice/support is available for all patients across adult and paediatric fields. To develop pre-admission preparation for patients who require advice or co-ordinated care to avoid unnecessary transfusion of blood components, or to meet special transfusion requirements. To maintain and improve detailed knowledge of own clinical specialty demonstrating direct clinical involvement in clinical issues. Physical skills The daily workload of requests from email, post and phone, has an unpredictable variety of activities, which requires differing combinations of sitting, standing, walking and lifting, with frequent and often long periods of computer work. In collaboration with the Blood Bank Biomedical Scientist, assist with unfated components, and be competent in maintaining the ASK manager component of the BloodTrack system The post holder should be competent in the use of medical devices and equipment associated with this post, and have knowledge of drug administration associated with transfusion. The post holder will be required to comply with the Trust policy whilst moving and handling patients and equipment. 2
The post holder will be expected to produce professional documents to a corporate standard, statistical data and presentations and should therefore have the necessary information technology skills to achieve this. Responsibility for Human and Information Resources To assess the training needs of all members of the multidisciplinary team with regards to the safe assessment, prescription and administration of blood and blood components. This trust wide responsibility covers approximately 5,000 staff in the acute area, including nurses in the community hospitals. To promote and ensure that all Trust Policies and Protocols for all medical, nursing and multidisciplinary staff involved with blood transfusion are up to date and validated. Design, develop and facilitate flexible training programmes, based on the National Blood Policy. Deliver these programmes of core training to pre and post registration students, medical and multidisciplinary staff. To participate in staff induction days to propagate best practice for blood components used with in the Trust. Design, develop and maintain staff education, patient and audit records, ensuring links with appropriate departments such as human resources, medical staffing, audit and clinical governance. Responsibilities for physical and financial resources In collaboration with the Pathology Directorate Manager, manage the Blood Product Budget effectively. Demonstrate knowledge of the financial implications of adherence to Trust policies and exercise financial control by ensuring adherence to protocols. To be responsible for initiating and auditing Cost Improvement Programmes in the budget. To monitor and audit the effectiveness of the maximum blood order schedule (MBOS) and to modify as necessary to ensure a cost effective service. Communicate and leadership To support the effective functioning of the Hospital Committee (HTC) and HT team (HTT) maintaining communication and the production and dissemination of formal minutes as necessary. To produce a trust monthly quality and safety report covering the 3 standards of; education, wastage and serious sampling errors. This will be incorporated into the quarterly review of untoward incidents and presented to the Hospital Committee. Any recommendations to be presented to the appropriate group, such as the Trust Clinical Governance Committee. To promote the safe, flexible and efficient use of blood and blood components within the constraints of clinical need and cost, by developing strategies and implementing operational policy. To promote evidence-based practice across the multidisciplinary team, in the prescription and administration of blood and blood components. To report to and liaise with the Serious Hazards of (SHOT) and Serious Adverse Blood Reaction & Events (SABRE) scheme as required, implementing any recommendations for service improvement. To take an active role in ensuring accurate reporting and follow up of clinical incidents, complaints and patient liaison (PALS) interventions relevant to the post. Ensure that any incident, complaint or other undue occurrence is handled and reported in accordance with Trust policy. To design, produce, conduct and deliver a comprehensive multi-professional Trust education programme in all aspects of Blood practice. 3
To Liaise with Trust Training and Development Department in order to develop and implement appropriate educational training programmes. To produce educational material for patients and staff. To provide and maintain an information and resource system for all staff, including maintenance of the blood transfusion section on the hospital intranet. To provide a close link between the wards and the laboratory in managing complaints. Represent the Trust at quarterly regional transfusion meetings. Lead, support and deliver extra training as necessary to a team of multidisciplinary link workers to provide a network of clinically based trainers to meet competency-based practice. Receive and provide highly complex and sensitive information. Utilises often complex processes and ability to communicate this to patients, relatives and staff, offering support and reassurances when required. Planning and organising Ensure adherence to all Trust policies. Produce and implement protocols for the safe administration of blood and blood components in accordance with national guidelines and the Trust Hospital Committee. Oversee the development of an alternative to blood transfusion programme, based on an approved care pathway as recommended by the Department of Health. Develop Clinical Governance systems and processes to ensure provision of a high quality transfusion service, which meets the requirements of the Department of Health s Patient Blood Management Strategy Organise one s own work and practice accordingly and identify and maintain support networks. Be responsible for the implementation of Trust Policy and Care Pathways. Assist in the production of business plans required for developments in the Blood service. Support Directorate Managers in the formulation of long term strategy plans for blood usage across the Trust to ensure adequate supplies of blood and blood components in times of national shortage. Partnership working To provide support to users of the blood transfusion service, both within the acute and community hospitals. To liaise between the blood transfusion laboratory and clinical staff across all specialities on a daily basis. Act as an ambassador and a positive role model for the Trust as a whole, both internally and externally To facilitate the introduction of new policies and procedures in the process of blood and blood component administration. To act as secretary for the Trust Committee, collating reports, papers and agendas for meetings. To participate in regional and national working parties/special interest groups, including the National Blood Service, Association of Better Blood Service, Royal College of Nurses and Serious Hazards of centre. 4
Analysis and data management To keep accurate records of all work undertaken, including the development and maintenance of databases, spreadsheets and paper files using information both personally generated and that generated by others. To provide statistical information, input data, design and produce reports as necessary. To utilise complex facts and situations analytically, in combination with expert clinical skills, to interpret patients acute conditions and take appropriate action. To investigate; report and document adverse incidents/near misses in relation to transfusion procedures and record data in accordance with the Trusts Clinical Governance strategy. To monitor the appropriateness of blood and blood component usage in association with the blood transfusion laboratory and use this data to implement service changes that are effective in both patient management and cost. To support the preparation, provision and presentation of evidence for the assessment of the trust against set standards for transfusion practice. To evaluate the management of patients receiving blood and blood components. To produce reviews of activity and any untoward incidents in relation to blood and blood components. Research, Development and Audit In conjunction with the Trust Hospital Committee, identify areas of research and carry out appropriate audit, including the clinical usage of blood and blood components against national and local guidelines. Facilitate and participate in national comparative audits To ensure that regular audit results of blood transfusion practice are fed back to relevant staff, action plans for improvement developed and implemented. Investigate and develop ways of reducing blood and blood component use in a safe and cost effective manner. Equality and Diversity Help to promote a favourable departmental image by dealing courteously and effectively with patients, members of the public, all staff within the multidisciplinary team and other health professionals from national groups. Comply with Trust policies on equality and diversity. Health and Safety and Risk Management To monitor, investigate and record adverse incidents and near misses on behalf of the Hospital Committee and to report these to SHOT (Serious Hazards of ) / SABRE (Serious Adverse Blood Reaction & Events) and the Trust Clinical Risk Manager. To report any deficiency in health and safety systems, equipment, or documentation, to the Manager of the area concerned and where applicable to the line manager. Co-operate with and attend training for health and safety purposes. Ensure training is delivered to staff when new equipment / procedures are implemented by the post holder. To ensure prompt investigation and notification of any accidents involving staff or visitors and ensure that all appropriate documentation is completed. Attend Occupational Health for surveillance/vaccination following accidents and for monitoring as laid down in Trust procedures. 5
The post holder will be exposed to unpleasant working conditions involving exposure of uncontained body fluids, blood, foul linen etc and should be conversant with infection control policies relating to such exposure. The post holder may be exposed to verbal / physical abuse and should be fully conversant with the Trust policy for dealing with these situations. Freedom to act As the Clinical Practitioner specialising in, the post holder will be accountable for their own professional actions. To be guided by National Policies to develop and implement service developments in and education guidelines for the Trust. This has a service impact across all specialities. Has the freedom to act within the constraints imposed by the role, as described within the job description and supported by the line manager. Mental and Emotional Effort To be able to concentrate for prolonged periods, writing reports, data analysis with frequent unpredictable interruptions. The post holder will actively support staff working with highly distressing / highly emotional levels of illness. The post holder will be directly in contact with patients suffering from serious medical conditions, including surgically life threatening and terminally ill patients. Demonstrate sensitivity in dealing with complex and confidential information from patients, families and colleagues, giving advice and support when necessary. To efficiently manage a workload that is diverse from service development to complex patient interventions. Health & Safety As an employee of the Trust you have a responsibility to: take reasonable care of your own Health and Safety and that of any other person who may be affected by your acts or omissions at work; and co-operate with the Trust in ensuring that statutory regulations, codes of practice, local policies and departmental health and safety rules are adhered to; and not intentionally or recklessly interfere with or misuse anything provided in the interests of health and safety. Infection Prevention and Control The prevention and management of acquired infection is a key priority for the Trust. Any breach of infection control policies is a serious matter which may result in disciplinary action. As an employee of the Trust you have a responsibility to: ensure that your work methods are compliant with the Trust s agreed policies and procedures and do not endanger other people or yourself; and be aware of infection prevention and control policies, practices and guidelines appropriate for your duties and you must follow these at all times to maintain a safe environment for patients, visitors and staff; and maintain an up to date knowledge of infection prevention and control, policies, practices and procedures through attendance at annual mandatory updates and ongoing continuing professional development; and challenge poor infection prevention and control practices of others and to report any breaches, using appropriate Trust mechanisms (e.g. incident reporting policy). 6
Information Governance The Trust is committed to compliance with Information Governance standards to ensure that all information is handled legally, securely, efficiently and effectively. You are required to comply with the Trust s Information Governance policies and standards. Failure to do so may result in action being taken in accordance with the Trust s Disciplinary Procedure. Confidentiality and Security - Your attention is drawn to the confidential nature of information collected within the NHS. Whilst you are employed by the Trust you will come into contact with confidential information and data relating to the work of the Trust, its patients or employees. You are bound by your conditions of service to respect the confidentiality of any information you may come into contact with which identifies patients, employees or other Trust personnel, or business information of the Trust. You also have a duty to ensure that all confidential information is held securely at all times, both on and off site. Disclosure of Information - The unauthorised use or disclosure of information relating to the Trust s activities or affairs, the treatment of patients or the personal details of an employee, will normally be considered a serious disciplinary offence which could result in dismissal. Upon leaving the Trust s employment and at any time thereafter you must not take advantage of or disclose confidential information that you learnt in the course of your employment. Unauthorised disclosure of any of this information may be deemed as a criminal offence. If you are found to have permitted the unauthorised disclosure of any such information, you and the Trust may face legal action. Information Quality and Records Management You must ensure that all information handled by you is accurate and kept up-to-date and you must comply with the Trust s recording, monitoring, validation and improvement schemes and processes. Professional Standards and Performance Review As an employee of the Trust you have a responsibility to: participate in statutory and mandatory training as appropriate for the post; and maintain consistently high personal and professional standards and act in accordance with the relevant professional code of conduct; and take responsibility for the maintenance and improvement of personal and professional competence and to encourage that of colleagues and subordinates; and participate in the Trust s appraisal processes including identifying performance standards for the post, personal objective setting and the creation of a personal development plan in line with the KSF outline for the post. Safeguarding Children and Vulnerable Adults We all have a personal and a professional responsibility within the Trust to identify and report abuse. This may be known, suspected, witnessed or have raised concerns. Early recognition is vital to ensuring the patient is safeguarded; other people (children and vulnerable adults) may be at risk. The Trust s procedures must be implemented, working in partnership with the relevant authorities. The Sharing of Information no matter how small is of prime importance in safeguarding children, young people and vulnerable adults. As an employee of the Trust you have a responsibility to ensure that: o you are familiar with and adhere to the Trusts Safeguarding Children procedures and guidelines. o you attend safeguarding awareness training and undertake any additional training in relation to safeguarding relevant to your role. Social Responsibility The Trust is committed to behaving responsibly in the way we manage transport, procurement, our facilities, employment, skills and our engagement with the local community so that we can make a positive contribution to society. As an employee of the Trust you have a responsibility to take measures to support 7
our contribution and to reduce the environmental impact of our activities relating to energy and water usage, transport and waste. 8