Code of Practice for Records Management NHSLA Risk Management Standards Contributes to Care Quality Commission: Outcome 4

Transcription

1 Cardiac Nurse Practitioner Clinical Operational Policy Policy Register No: Public Developed in response to: Information Governance Toolkit Code of Practice for Records Management NHSLA Risk Management Standards Contributes to Care Quality Commission: Outcome 4 Consulted With Post/Committee/Group Date Debbie Whitfield Lead Nurse, Cardiology October 2014 Gerald Clesham Consultant Cardiologist October 2014 Professionally Approved By Cathy Geddes, Chief Nurse October 2014 Version Number 2.0 Issuing Directorate Medicine Ratified by: Document Ratification Group Ratified on: 23rd October 2014 Trust Executive Board Sign Off Date November 2014 Implementation Date 27th October 2014 Next Review Date October 2017 Author/Contact for Information Angela Richardson/Fiona Robinson Policy to be followed by (target staff) All Staff Distribution Method Intranet & Website Related Trust Policies (to be read in conjunction with) Infection Control, Mandatory Training, Manual Handling, Fire Safety, IT, Patient Safety, Record Keeping, Risk Management Document Review History Review No Authored /Reviewed by Review Date 1. Angela Richardson/Fiona Robinson ratified by Margaret 4th January 2010 Blackett, Chief Operating Officer 2. Angela Richardson/Fiona Robinson 23 October

2 Index 1. Purpose 2. Aims of the Service 3. Scope of the Service 4. Work Flows 5. Key Relationships 6. Staffing 7. Equipment Requirements 8. Infection Prevention 9. Equality and Diversity 10. Contingency 11. Breach Reporting 12 Auditing this Policy 13. Responsibilities 14. References 2

3 1. Purpose of Document 1.1 To define the service provided by the Cardiac Nurse Practitioners at Mid-Essex Health Trust (MEHT). 2. Aims of the Service 2.1 To provide a high quality patient centred care as part of Cardiology service. The service is flexible to the changing needs of the population of Mid-Essex, serving both inpatient and outpatient activity. 2.2 The service provides access to Consultant Cardiologists, Nuclear Medicine, cardiological investigations and specialist nurse services, via MEHT inpatient and outpatient settings. 2.3 The service is responsive, accepting inpatient consultation requests from other clinical teams within MEHT to enable and facilitate appropriate specialist management of cardiological conditions and expedite patient discharge within 72 hours. This service is compliant with: National Institute of Clinical Excellence (NICE) European Society of Cardiology National Prescribing Centre 3. Scope of the Service 3.1 The Cardiac Nurse Practitioners: Work across professional and organisational boundaries Provide expert nursing practice for all patients admitted under the spectrum of ACS and other cardiological conditions Provide better outcomes for patients admitted with ACS and other cardiac anomalies by improving service, quality and access to investigations and medicines Provide professional leadership and support to junior nursing staff Work with patients within a clearly defined area of clinical practice Involved in service strategy development NICE, networking with local cardiac services Assist in stream lining the patient s pathway and reduce inpatient length of stay by expediting early discharge of low risk cardiac patients, ensuring OP follow up. Run nurse led Myocardial Perfusion Scan clinic in conjunction with Nuclear Medicine to provide service to local population. Assist and review of patients in OP cardiology clinic Develop and implement service improvement initiatives where appropriate Review and update clinical pathways Follow up of all troponin positive Cardiology patients Review of all cardiac admissions to Emergency Assessment Unit (EAU) and Emergency Short Stay (ESS) 3

4 Liaise with EAU and ESS to identify appropriate patients requiring cardiological investigations and referral Liaise with Cardiology Consultants and Specialist Nurse Team when and where appropriate Provide rapid assessment of Arrhythmias in consultation with admitting Consultant to identify those patients requiring cardiological investigation and review as out patient Provide Myocardial Perfusion Scans, Exercise Tolerance Tests Involvement in in-house education programmes 3.2 Inclusion Criteria Adult population of Mid-Essex requiring review by Cardiac Nurse Practitioners 3,3 Exclusion Criteria No paediatric intervention or investigation is undertaken within this service. 4. Work Flows 4.1 Patients access the service via the emergency and elective pathways. 5. Key Relationships Cardiologists A&E Consultants Medical Physicians Nursing Staff Cardiac Rehabilitation Radiologists Nuclear Medicine Specialists Cardiac Technicians Cardiac Physiologists Pharmacists 5.1 Key Operational Requirements Office space required adjacent to Emergency Admission and Assessment areas to allow rapid assessment and management of patient Allocated appointment times to enable patients to return for out patient cardiology investigations within a specified timeframe 5.2 Key Relationship with other Departments A&E EAU/ESS Phlebotomy Pharmacy Pathology Nuclear Medicine/Radiology Waiting List Cardiac Department 4

5 Wards and Critical areas Outpatients Department Infection Control Team Audit Department Bed Management Angio Suite Medical Records Portering Services Coding Data Quality 5.3 Key Requirements for Facilities Management This service is predominately delivered through host departments and therefore does not have any specific requirement Each host department has a service level agreement for domestic services and access to the Estates and Facilities department via the non stock requisition line Consumables for the service are provided by the host department or ordered via the Commercial Services Department. 5.4 Environmental Requirements As previously stated this service is delivered in host departments i.e. Cardiac Centre Environmental requirements have been addressed within the department in their Clinical Operation policy. 5.5 Way Finding All out-patients attending this service are advised to follow the signage to the Cardiac Department This signage is available at all points of entry to the Hospital. Patients using this service via the in-patient setting are couriered to the Department by the portering team which is accessed via the pager system Patients arriving for Myocardial Perfusion scanning are advised to present to The Cardiac Centre. 5.6 Security Requirements Data Security The service will be delivered in accordance with and compliance to the Trust s IT Security and Information Governance policies Data sharing agreements will be drawn up to cover all data sharing outside the Trust in accordance with the Trust data sharing policy Hospital information/patient data will only be downloaded onto devices provided by the Trust which are encrypted Databases will be registered on the Trust database of databases 5

6 A data mapping form will be completed for all routine data flows leaving the Trust Patient identifiable information will only be sent out of the Trust from an nhs.net account or other secure route (never from an nhs.uk account) Security for Patients The service will be delivered in accordance with and compliance to the Trust s Patient Safety Policies Security for Staff The service will be delivered in accordance with and compliance to the Trust s Lone Worker and Security/Risk Management Policies Medical Record Security All patients medical records will be managed confidentially at all times and stored securely in locked office or out patient facility whilst not in use All movement of patient s records will be accurately tracked in accordance with the Trust s Case note Tracking Policy. All new documentation will be secured into the folder prior to it leaving the Department 5.7 Manual Handling The service will be delivered in accordance with and compliant to the Trust s Manual Handling Policies 5.8 Fire Safety The service will be compliant with the Trust s Fire Safety Policy, Fire Evacuation Policy and other local fire plans and procedures. (The detail of these items will then be developed as part of the separate Fire Safety Work Programme, as led by the Trust s Fire Officer.) 5.9 ICT Requirements 2 x PC s with office based software 1 x Samsung MultiXpress Fax/Copier/Scanner Telephone Database Access to the following IT systems: PAS IMPAX MEHT Review MINAP NICOR 6

7 TomCat Extramed Infoflex Encrypted memory stick Windows MAPS Network Referrals 6. Staffing 6.1 Staffing Profile This service has a funded establishment of 1.8 WTE Band 7. Grade Cardiac Nurse Practitioner 1.0 Cardiac Nurse Practitioner 0.8 Funded 6.2 Training and Education It is the responsibility of the Cardiac Nurse Practitioner to have undertaken the following mandatory training and update as necessary Corporate Induction Equality and Diversity Fire Training Blood Transfusion Risk Reporting Information Governance Moving and Handling Infection Prevention/Hand Hygiene ANTT Safeguarding Children Administration of Medicines Domestic Abuse Awareness ILS Dementia Waste Management Sharps The Cardiac Nurse Practitioner should have a current ILS and maintain their own requirements for continuous development and be able to demonstrate requirements of the NMC. The Cardiac Nurse Practitioners must have been deemed competent to work under Patient Group Directions and to practice myocardial perfusion preparation as agreed by the lead Cardiology Consultant. 7

8 6.3 Facilities The Cardiac Nurse Practitioners will require access to washrooms, lockers for personal items and refreshment facilities. These facilities are currently available in the Cardiac Centre. 7. Equipment Requirements 7.1 Specific items required for the Cardiac Nurse Practitioner service are Alaris and Braun Infusion Devices to administer Adenosine and Dobutamine. 8. Infection Prevention 8.1 The service will be delivered in accordance with and compliant to the Trust s Infection Control Policies. 9. Equality and Diversity 9.1 The Trust is committed to commit to the provision of a service that is fair, accessible and meets the needs of all individuals. The service allows access for disabled users. 10. Contingency 10.1 CNS clinic activity is scheduled to allow for annual leave requirements whilst still maintaining the 18 week targets 10.2 In the event of sickness during annual leave, perfusion clinics may need to be cancelled. In the event of Major Incident, CNS activity may cease as directed to support Hospital during the incident In the event of IT failure, paper documentation will be completed and uploaded when IT systems are re-established In the event of Pathology Review being unavailable, urgent results can be obtained from the Pathology Department via the telephone system 11. Breach Reporting 11.1 It is the responsibility of the Cardiac Nurse Practitioner to identify incidents and report risks, using the Trust risk management strategy policy 12 Auditing this Policy 12.1 This policy will be audited by the Cardiac Nurse Practitioners. Updating of this policy will be undertaken by the Cardiac Nurse Practitioners following audit. A revised policy will be submitted to the Document Ratification Accreditation Group and submitted to the Trust Board as required. Audit information will be shared at the Emergency Care Bilateral. 8

9 13. Responsibilities 13.1 The Head of Nursing for Acute Medicine is operationally and financially accountable for service delivery. The Clinical Team will remain professionally accountable for their actions and report professionally to the Chief Nurse. The Clinical Team will work in conjunction with the Lead Nurse to ensure that the service is delivered within the confines of the agreed budget and operational requirements. Chief Nurse Head of Nursing, Acute Medicine Lead Nurse, Cardiac Nurse Practitioners 14. References National Institute for Clinical Excellence, NHS 2002 Nurse Led Care, Clinics and Services in Cardiology, Walker D, National Clinical Lead, NHS Heart Improvement Programme,