Thrombosis and Anticoagulation Clinical Nurse Specialist
University Hospitals Sussex NHS Foundation Trust (279)
Provide expert care and advice within the remit of VTE and Anticoagulation for our service users, Trust professionals and external care stakeholders.
Review complex Emergency Department (ED) discharges of VTE, ideally within 48 hours from ED discharge, in order to manage the safe anticoagulation and follow up of this client group. You will work closely with both the lead VTE consultant and lead Haematology Consultant for this service. Working in conjunction with the haematology consultant and anticoagulation pharmacists, the CNS provides an anticoagulation dosing and advice service for patients on Vitamin K Antagonists and direct oral anticoagulants for a variety of prothrombotic conditions. As an anticoagulation specialist you will be expected to manage complex anticoagulation patient cases and take part in Anticoagulation and VTE MDT meetings. You will be responsible for autonomously running the bi-weekly anticoagulation clinics and also running any VTE follow up clinics in the outpatient department. Liaise with the community health professionals regarding the care of your patients and provide education on venous thromboembolism and anticoagulation for patients and other health care practitioners as required.
Main duties of the job
1. Running and maintaining a week day specialist VTE and Anticoagulation advice service, Trust wide and to external stakeholders as required.
2. Triage and accept suitable VTE referrals into the thrombosis and anticoagulation service, evaluate their suitability for outpatient management and facilitate anticoagulant management within locally agreed protocols.
3. Review patients requiring anticoagulation in an outpatient clinic following locally agreed protocols and seek support from or refer to appropriate clinician if any problems are identified.
4. Provide face to face and telephone anticoagulation counselling to patients and effectively communicate anticoagulation dosing advice by telephone.
About us
At UHSussex, diversity is our strength, and we want you to feel included to help us always put the Patient First. Your uniqueness and experiences will be part of our creative and innovative community where everyone is encouraged to succeed. We have a range of Staff Networks to help break down barriers, and can offer a buddy to help new members settle in. We're proud to be a Disability Confident Employer (Level 2) and a Veteran Aware Trust.
We treat our patients and staff with the same compassion and empathy we expect for ourselves. We're here for them when they need us, and we go above and beyond to meet their needs. This can be seen in our Wellbeing Programme for staff which is extensive and designed to support you when you need it, including where possible, flexible working to support work life balance - because we know that to look after others we must first look after ourselves.
As a university trust and a leader in healthcare research, we value learning, teaching and training so that we can be the best that we can be. From the moment you start with us and throughout your career we will help you to grow and develop. We hope that in choosing UHSussex you are choosing a long and happy career where you will be able to see the difference you make and feel valued for all that you do.
We look forward to receiving your application and the start of your journey with UHSussex.
Job responsibilities
Management: Running and maintaining a week day specialist VTE and Anticoagulation advice service, Trust wide and to external stakeholders as required. To be responsible for policy implementation throughout the Trust, liaising with other sites where appropriate and working closely and effectively with them and all other stakeholders. To implement coping strategies as appropriate where the work pattern is unpredictable, unplanned or disrupted. To participate in management initiatives and strategic development issues. To be responsible for the running of the service in the absence of the lead or deputy lead VTE nurse specialist, in liaison with the Band 6 Administration manager. To facilitate and assist with study sessions relevant to this specialist service.
Clinical: Able to work in an autonomous and unsupervised manner, making clinical decisions within the boundaries of specialist knowledge and expertise. Be an expert source of advice, guidance and support for other healthcare providers on the management of VTE and anticoagulation. Triage and accept suitable VTE referrals into the thrombosis and anticoagulation service, evaluate their suitability for outpatient management and facilitate anticoagulant management within locally agreed protocols. Review patients requiring anticoagulation in an outpatient clinic following locally agreed protocols and seek support from or refer to appropriate clinician if any problems are identified. Provide face to face and telephone anticoagulation counselling to patients and effectively communicate anticoagulation dosing advice by telephone. Identify and refer appropriate patients to the community pharmacy anticoagulation team or the GP for ongoing anticoagulation management. Familiarity with or willingness to learn to use DAWN anticoagulation dosing software to ensure that patients receive appropriate anticoagulation dosing advice within agreed protocols, including adjustment of VKA dose and supply and/or administration of low molecular weight heparin / Vitamin K that may be appropriate.
Perform point of care INR testing and follow clinic guidelines to teach patients to self-test using home POC testing device. Identify the specific health promotion/educational needs of individual patients and carers and facilitate meeting those needs through the provision of specialist education, care and support. Liaise with GP and the wider multidisciplinary team as necessary regarding patients anticoagulation plan and appropriate follow up. Request blood tests and perform venepuncture and review results, within locally agreed protocols. Be responsible for ethical decision making. Demonstrate sound understanding and application of relevant policies, including professional nurse codes of conduct and NICE guidelines. Ensure the use of clinical governance framework.
Leadership and professional conduct: Encourage best practice within the management of VTE and anticoagulation by acting as a professional expert and role model. Promote a positive working environment. Safeguard the health, safety and welfare of staff, patients and visitors. Be aware of trust policy regarding resolution of grievances, disputes and complaints and reporting of unsafe practice and incidents via the DATIX system, and use these systems to report and resolve issues, seeking manager support where appropriate. Exhibit professional behaviour and attitudes and demonstrate excellent customer care skills. Comply with policies, procedures and clinical guidelines for self and others. Adapt own practice in line with changes and developments of the service.
Education and Training: Be part of a team who provides both formal and informal education and support on VTE and anticoagulation to all levels of staff within the trust. Maintain knowledge base that reflects contemporary issues and development in anticoagulation and VTE management to enable selection and application of the most appropriate treatment. Be able to source and critically appraise information obtained from research papers and other sources.
Personal and professional Development and Competence: Be fully accountable for practice and take every reasonable opportunity to sustain and improve knowledge and professional competence. Develop and maintain clinical and practical skills in patient assessment within this specialist field through attending study days, conferences, meetings and training relevant to the service. Use excellent professional judgement skills in the analysis, interpretation and comparison of a range of options. Be accountable with the ability to take action based on interpretation of broad clinical and professional policies where necessary. Be accountable for your practice and maintain your own professional development in accordance with your annual performance review and personal development plan. Be capable of working within a team but equally be able to work autonomously. Ensure that you practice in accordance with the NMC code of professional conduct and other appropriate NMC and statutory guidelines. Be computer literate with the ability to utilise all Trust wide NHS databases, spreadsheets, word, PowerPoint and clinical support systems as appropriate to the role. Ensure all mandatory training is updated as required.
Communication: Utilise excellent communication skills with patients and other healthcare professionals to provide and receive highly complex, sensitive or contentious information. Also to work sensitively at different levels of understanding to provide advice and counselling to the patients about their illness and on impending therapies and treatment. Communicate regularly with other clinical nurse specialists working in this field, sharing knowledge and experience. Ensure that confidentiality and adherence to the Data Protection Act in relation to own practice is maintained in full and accurate records of relevant information is documented in the patients medical notes. Liaise with and advise other members of the multidisciplinary team and service stakeholders, in the care of patients with a VTE or receiving anticoagulation therapy ensuring that treatment is delivered safely and any follow up care is provided. Provide advice and support to patients regarding VTE and anticoagulation and encourage adherence with treatment, while respecting patients autonomy to make informed choices. Take personal responsibility for ensuring that your communication and conduct with patients and staff is in line with the trust values.
Service Delivery and Improvement: Work with Consultants, Service Leads and other key personnel identifying areas that will lead to improved quality of clinical pathways and sustainable workforce/data quality/financial improvements. Contribute to improved ways of working leading to improvement of service and data quality standard.
Information Resources: Developing and maintaining a broad-based knowledge of the DAWN Patient Management System and the clinic processes to ensure best practice in using the dosing system. Liaising directly with IT to report and resolve any problems. Follow contingency planning guidance as set out in the anticoagulation clinic guidelines.
Person Specification
* Previous anticoagulation and thrombosis experience
Equality, Diversity and Inclusion
* Evidence of having championed diversity in previous roles (as appropriate to role).
* Evidence of having undertaken own development to improve understanding of equalities issues.
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.
University Hospitals Sussex NHS Foundation Trust (279)
Deputy lead VTE / anticoagulation nurse specialist
£37,338 to £44,962 a year per annum pro rata
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