TTP/ITP Clinical Nurse Specialist

Job overview

The B7 TTP and ITP CNS is a leadership role responsible for the development of innovative nursing practice within the specialty, and contributing to strategic and operational decision making. The post holder will influence the development of the services to ensure it is high quality, patient-centred, safe, efficient and in line with the appropriate Department of Health Standards. They will manage a clinical caseload providing highly specialist nursing input, support and continuity of care to patients with TTP and ITP; from the time of a suspected diagnosis, through assessment, treatment and continuing care. This patient group requires immediate intensive therapies in hospital so inpatient input is essential to establish continuing care and a link for patients to access when discharged. The post holder will support the Apheresis team, and the CNS will have an important role in co-ordinating patient care and liaising between the in-patient and haematology daycase nursing teams. The aim is to co-ordinate a seamless approach to patient care and management, providing support and guidance to hospital and community services and staff. The CNS is a specialist educational resource to all members of the MDT and external agencies and will be expected to facilitate the professional development of junior nursing colleagues. The role will require education, support and coordination of activities for junior nursing staff in the team.

Main duties of the job

• Be based at Nottingham City Hospital
• Be a strong clinical leader, easily identifiable, highly visible and accessible to patients, carers and staff
• Work alongside the consultant team to support the strategic development and commissioning of the East Midlands TTP service, and the strategic development of the ITP Clinical Centre in Nottingham.
• Review the current apheresis service currently offered across UHL and the requirements necessary to enable to trust to fulfil its apheresis requirements.
• Deliver apheresis services in line with local policies.
• Deliver training to and ensure ongoing appropriate training/education of apheresis practitioners.
• Support the clinical lead for TTP and ITP to develop the necessary protocols and procedures.
• Ensure the advancement of patient focused care and support through a collaborative approach with all members of the multidisciplinary team.
• Be responsible for the follow up of a caseload of patients and will be required to have some specialist knowledge of both Thrombotic Thrombocytopenic Purpura (TTP) and Immune Thrombocytopenia (ITP).
• As a lead within the Clinical Haematology team, make a significant contribution to developing existing services, providing education, support and advice to patients, their families and professionals involved in the diagnosis and care of patients with Thrombotic Thrombocytopenic Purpura (TTP) or Immune Thrombocytopenia (ITP)

Working for our organisation

Our values are: Caring and helpful; Safe and Vigilant for our patients and colleagues; Being Clinically Excellent and driving innovation to meet the needs of our patients; Using our Resources wisely whilst; Providing Quality products, services and experiences for staff and patients.

Immune thrombocytopenia (ITP) and Thrombotic thrombocytopenic purpura (TTP) are non-malignant haematological conditions which affect a significant number of patients each year. Patients with TTP in England are managed in one of the 8 specialist TTP centres commissioning by NHS England, and Nottingham University Hospitals (NUH) NHS Trust leads the East Midlands TTP service which looks after these patients in our region alongside colleagues at University Hospitals Leicester (UHL) NHS Trust.

Patients with ITP are managed in most hospitals with a Clinical Haematology department, but there are a small number of specialist ITP Clinical Centres designated by the UK ITP Forum, and NUH will be added to this list in the coming months. Patients with both of these conditions benefit from multi-disciplinary support, including Consultants with expertise in the field, Clinical Nurse Specialist and Clinical Psychology.

Detailed job description and main responsibilities

Assist patients in resuming their lives after diagnosis; address early the psychological impact of their experience; teach disease and long term follow up surveillance; provide counselling; empower patients to self monitor; promote good health; appropriate and prompt referral to specialist services.

Participate in consultant led outpatient clinics where patients with a diagnosis of Thrombotic Thrombocytopenic Purpura (TTP) or Immune Thrombocytopenia (ITP) are reviewed

Participate in nurse led telephone clinic for patients with a diagnosis of Immune Thrombocytopenia (ITP) alongside an Advanced Pharmacy Practitioner.

Provide support and advice to patients, carers and staff looking after inpatients and outpatients with known diagnosis of Thrombotic Thrombocytopenic Purpura (TTP) or Immune Thrombocytopenia (ITP).

Co-ordinate follow up and regular monitoring of ADAMTS13 activity in patients with a diagnosis of acquired Thrombotic Thrombocytopenic Purpura (TTP).

Participate in monthly regional Thrombotic Thrombocytopenic Purpura (TTP) MDT meeting, and co-ordinate and participate in the quarterly regional Immune Thrombocytopenia (ITP) MDT meeting.

Support the development and distribution of patient information materials related to Thrombotic Thrombocytopenic Purpura (TTP) and Immune Thrombocytopenia (ITP).

Refer patients newly diagnosed with Thrombotic Thrombocytopenic Purpura (TTP) to Clinical Psychology, as well as any patients with a previous diagnosis of Thrombotic Thrombocytopenic Purpura (TTP) who require ongoing support.

Support with research and clinical trials for patients with Thrombotic Thrombocytopenic Purpura (TTP) and Immune Thrombocytopenia (ITP).

Prescribe medications used for the treatment of Thrombotic Thrombocytopenic Purpura (TTP) and Immune Thrombocytopenia (ITP).

Support the apheresis team within the Clinical Haematology department in performing plasma exchange.

Support the Apheresis service at times of high activity and during periods of leave in the care of patients who are undergoing therapeutic apheresis treatment, including the assessment, planning, implementation and evaluation of that care, to ensure continuity of service. This includes the ‘on call’ out of hours Apheresis service.

Assist in developing and maintaining the ethos of the apheresis service and the delivery of a standard approach to excellent nursing care.

Assist in the preparation process prior to internal/external peer review visits.

Assist the Apheresis Lead Nurse in data entry and maintaining the national apheresis patient registry.

Act as an expert resource for patients/relatives/colleagues relating to the care of their caseload of patients.

Maintain patient’s confidentiality, privacy, dignity, religious and cultural needs at all times.

Supply and administer medicines according to Patient Group Directions/ protocols and / or prescribe drugs as a non-medical independent prescriber following suitable qualification.

Maintain an environment for safe and effective patient care in accordance with the Trust Risk Management Policy.

Work effectively within the Trust’s adult multidisciplinary haematology team as required ensuring an individualised, evidence based optimum service for each patient and their family.

Act as advocate for TTP and ITP patients, enabling them to express their needs effectively when dealing with the multidisciplinary team.

Promote collaborative relationships with other health care professionals for the benefit of quality patient care.

Maintain effective channels of communication within the multidisciplinary team and promote effective interpersonal skills.

Be aware of the legal implications of all patient-related records.