Clinical Nurse Manager 2 TVN

Overview Post Title: Clinical Nurse Specialist / Clinical Nurse Manager II - Tissue Viability Post Status: Specified Purpose (Full Time) Department: Department of Nursing, Surgical Directorate Location: Beaumont Hospital, Dublin 9 Reports to: Directorate Nurse Manager in the Surgical DirectorateSalary: Appointment will be made on Clinical Nurse Manager 2 Grade payscale (€ 62,699 - € 79,227 LSI)Closing Date: :00

Please note the hospital reserves the right to close the competition early should a substantial number of applications be received.

Position Summary:

Tissue Viability is an umbrella term, which refers broadly to prevention and management of tissue damage, in patients, which may include acute and chronic wounds. The role of the Clinical Nurse Specialist in Tissue Viability is to take into account the advancing age of the population with ever increasing wound care factors, escalating costs, technological advances, evolution of innovative treatments and rapid expansion of knowledge base, in developing a service for the prevention and management of tissue damage for in-patients in an acute hospital setting. The role and responsibilities of the Tissue Viability Nurse continue evolving to develop and maintain an efficient tissue viability service for patients, families, and all members of the multidisciplinary team to prevent potential tissue damage as well as advice on current wounds.

Responsibilities Principal Duties and Responsibilities:

Clinical Focus Specialist tasks: Provides expert knowledge, clinical skills, and advice on wound management /pressure ulcer prevention and treatment. Recommends and advises multidisciplinary team on appropriate, evidenced based treatment regimens i.e. Compression therapy, Dressing selection, Doppler Assessment and Topical Negative Pressure (TNP) therapy. Refers patients to appropriate members of the multidisciplinary team's when necessary. Clinically treat wounds requiring specialist knowledge and skills.

Direct Care The Clinical Nurse Specialist in Tissue Viability provides clinical leadership by advising and assisting with the assessment, planning, implementation and evaluation of care on prevention and treatment of tissue damage for in-patients. The TVN also receives referrals from Nurses, NCHD's Consultants, and Occupational Therapists.

Wound management Act as a clinical role-model through the provision of professional leadership and demonstration of competent practice of all matters concerning wound care. Assists the multidisciplinary team to assess, plan, implement, and evaluate care for tissue damage. Makes expert recommendations and advises multidisciplinary team's on appropriate, evidenced based treatment regimes. Liaise with Medical teams to ensure the correct diagnosis and investigations are carried out before treatment. (Example. Ankle brachial pressure Indices necessary before commencing compression therapy and sinogram to detect extent of cavity wounds) Clinically treat difficult wounds that require specialist skills. E.g. Larvae therapy. All notes are recorded electronically and printouts recorded in patient's case notes and are available to all team members to access. Update the Tissue Viability Web page so that the guidelines are available on the Intranet to assist staff in the appropriate assessment and management of all wounds using evidence based practices. Implements and reviews the wound assessment documentation for the hospital that ensures the provision of continuity of the assessment, planning, implementation and evaluation of wound care.

Pressure area management To lead on the provision of expert opinion and advice, on pressure sore risk assessment, pressure relieving /reducing supports and correct implementation of the prevention/management policy for individual patients. Works with information technology department and clinical staff regarding implementing Waterlow assessment tool electronically, to identify the risk of pressure ulcer development on computerised nursing system. To act as clinical lead on mattress tender negotiations. The Tissue Viability Nurse provides continuous monitoring and education to staff on wards regarding Mattress selection and use. The TVN develops and updates a mattress selection flowchart, using valid assessment tools, to assist clinical staff in choosing appropriate mattresses for the patient. To update the pressure sore prevention policy for the clinical areas. To investigate all incidents of pressure ulcers reported, on the pressure ulcer incident report form. Ensuring appropriate treatment and for legal documentation.

Indirect care Identify and plan, with support from the Director of Nursing and the Nursing Practice Development Co-ordinator the development requirements for the tissue viability service. To trial new equipment, products and recommend subsequent purchases. To improve the care of patients/clients by developing and managing services relating to the prevention of pressure ulcers and improving all aspects of tissue viability. To maintain a system for the effective use of pressure redistribution equipment. To prepare detailed monthly reports of current usage of mattress use on wards. To develop the system for reporting of pressure ulcers, to investigate the underlying causative factors of the ulcer and to address any individual learning needs of staff as appropriate. Involvement in Hospital Procurement Services Group (HPSG) TNP contract. Usage and distribution/approval/and appropriate use is monitored by Tissue Viability Nurse. Liaison with Supplies, regarding appropriate dressing/product ordering from clinical areas in order to ensure economic use of resources.

Patient/Staff advocate All members of the healthcare team are involved in providing good wound management to their patients. However nurses are the healthcare professionals who manage wound care and to an increasing extent are being recognised as the key professional advocate for these patients.(Field 1996)

The Clinical Nurse Specialist in Tissue Viability with expert clinical knowledge and experience acts as a patient advocate, communicating wound management issues on behalf of the patient to medical ward staff and other allied health professionals. The Clinical Nurse Specialist in Tissue Viability chairs Hospital Wound Management Committee which is an interdisciplinary committee which make decisions on wound management issues within the hospital. This committee has Public Health Nurse Representatives to aid the development of close links with the community, and to ensure a more seamless for patient transfer to and from the community. Review and assess referred patients taking into account the patients opinions and decisions. Communicate, negotiate and represent the plan of care for the patient, with clinical nursing and medical staff. Communicate effectively with all grades of staff within the organisation and in the community in relation to all areas of tissue damage. Responsible for ensuring confidentiality and safe-keeping of records. Identify key patient groups and ensure adequate service is provided for them. Identify areas with potential risk and address the issues with Risk management team.

Education and Training The Clinical Nurse Specialist in Tissue Viability role in education and training is to participate in formulating a comprehensive educational strategy to support clinical practice in relation to all aspects of tissue viability management. This consists of structured and impromptu educational sessions which facilitate staff development and patient education. These education sessions include nursing staff, public health nurses and allied health professionals. To identify the educational needs of staff, patients and carers in relation to pressure sore prevention/management and all aspects of wound care occurs on an individual patient basis. To promote patient /carer independence through the relevant teaching and support. Information leaflets are developed and distributed to patients e.g. Leg ulcers, pressure ulcers. To provide education for all grades/ disciplines of clinical staff to maintain their knowledge and skills in the management of wounds, to facilitate a proper assessment and cost effective use of wound care products. To develop the link nurse programme. To facilitate student nurses and post graduates on placement for one day.

Professional Development Keep up-to-date on developments in research based tissue viability practice, An Bord Altranais guidelines, nurse educational needs, and professional issues through participation in and attendance at seminars, conferences and journal clubs. Report back from seminars and conferences to colleagues on topics discussed relevant to changes in tissue viability issues or any other matters with implications for nursing. Develop and maintain nursing practice skills in relation to tissue viability. Discusses present performance and future needs with Nursing Practice Development Co-Ordinator using job performance review. Maintain a personal record of professional development, using a portfolio. Have a creative outlook enabling progress to be made towards the ultimate objective reaching standards of excellence in the provision of wound care and pressure area management for nursing services. Maintain membership of relevant specialists associations in relation to all aspects of tissue viability. (European Wound Management Association EWMA , European Pressure Ulcer Management Association EPUAP and Tissue Viability Nurse Association TVNA). Establish an appropriate network with other clinical nurse specialists and incorporate national and local initiative and standards of practice where appropriate.
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