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JOB DESCRIPTION JOB TITLE: Band 7 Fetal Monitoring/Better Births Specialist Midwife Women Services DIVISION: SALARY BAND: REPORTING TO/RESPONSIBLE TO: Women & Children’s BAND 7 Consultant Midwife ACCOUNTABLE TO: Head of Midwifery and Gynaecology HOURS PER WEEK: 15 MANAGES: Directly: Indirectly: Nil Nil JOB SUMMARY: The postholder will lead on the implementation of the ‘Stillbirth Bundle’, improving standards of fetal heart rate monitoring, interpretation, escalation and appropriate management of care, reporting to the Consultant Midwife. Working with the multidisciplinary team they will work closely with the Consultant Midwife to take on a lead role in promoting normality for women in labour, in line with the Better Births vision for maternity services. As part of the Midwifery Education Team the postholder will support cardiotocography interpretation and training throughout the unit. The successful candidate will specifically lead in promoting and supporting the department’s programme of education for cardiotocography, increasing uptake and compliance in competency assessments in interpretation to achieve better birth outcomes for our service users. The postholder will be able to demonstrate expertise in cardiotography interpretation both in the clinical context with educational evidence of further cardiotography training. The postholder will be responsible for supporting midwifery staff, within the practice environment, to be competent in fetal heart rate monitoring and use of ‘Fresh Eyes’ and ‘Fresh Ears’ whilst delivering care in line with the Better Births vision of choice and continuity of care. In particular, they will also assist in the development and implementation of further fetal monitoring training and support, working with the Consultant Midwife and multidisciplinary team in both implementing the Stillbirth Bundle and demonstrating the impact of this. Key to this role, the post holder will lead and facilitate a programme aimed at equipping midwives to increase and improve their knowledge and competence in cardiotocography and assessing fetal well-being within the practice environment, identifying potential fetal compromise and actual fetal compromise in all clinical settings and improve clinical decision making. The post holder will be an expert in the assessment, planning and implementation of all areas of midwifery care for women throughout the childbirth continuum. They will work closely with other health professionals aligned to midwifery to ensure continuity of care. The post holder will be required to provide support within a 24/7 shift work system including day and night duty. The role will be based predominantly in the clinical environment (>90% clinical, <10% non clinical). D:\478163153.Doc MAIN DUTIES AND RESPONSIBILITIES 1. RESPONSIBILITIES Assess competence in the assessment and management of cardiotocography Support staff in clinical practice to consolidate clinical skills learning and skill development. As part of the midwifery Education Team, reporting to and working closely with the Consultant Midwife to develop a robust communication network between clinical teams, practice development and management to ensure effective support systems are in place. The post holder will lead and facilitate the departments approved programme aimed at equipping midwives to increase their knowledge and competence in both intermittent auscultation and cardiotocography training. Ensure that midwives are compliant in their assessments of competency in their training/updating in fetal heart rate monitoring to demonstrate an increased in their knowledge and competence in both the assessment of fetal well-being and identification of potential fetal compromise. Ensure that midwives are supported in their development of clinical decision making in cases such as actual fetal compromise in all clinical settings. Work in collaboration with the consultant midwife, midwifery education team, labour ward coordinators, and obstetricians, to develop the departments comprehensive training and competency assessment package to give assurance that all midwifery staff responsible for fetal assessment and wellbeing are competent With the midwifery education team, lead obstetrician, labour ward manager build on the current competency assessment to assess the knowledge and skills of all staff providing intrapartum care including practical assessments and sign-off Ensure that all midwives and obstetricians providing antenatal care whether in the antenatal ward, clinic, day assessment unit and or triage undertake the competency test in assessing fetal wellbeing Provide teaching and support for staff who need to repeat competency tests/assessments or where further support is identified as required for individual practitioners (eg through Risk management) Lead cardiotocography workshops, maintaining and submitting (to the Consultant Midwife and Practice Development Midwife) attendance registers to submit to ensure compliance to the mandatory requirement for midwives and medical staff. Disseminate learning. Work with the Midwifery Education Team to organise the cardiotocography master classes ensuring the attendance of all eligible staff Act as a resource for evidence based knowledge for practice development for all staff. Ensure that individuals specific learning needs are addressed, related to clinical placements, skill development and teaching. Maintain a database of staff skills and competencies in fetal heart rate monitoring. In clinical practice act as a role model and provide advice on evidence based practice with a focus on fetal heart rate monitoring (cardiotocography and intermittent auscultation). Support the development and implementation of the Divisional governance plan. Work in conjunction with the midwifery management and education team towards achieving corporate standards as well as meeting the relevant criteria as described in the standards set by the Care Quality Commission and any other National or local performance frameworks. Identify problems, variations or areas of concern relating to clinical practice and liaise with the lead professionals to agree remedial action where appropriate and assist in the setting and maintaining of standards. Reporting to the Consultant Midwife and as part of the midwifery education team, work with the Lead Clinicians, Senior Midwives and Specialists to ensure the implementation of the ‘Stillbirth Bundle’. Facilitate, perform and implement risk assessments on an ongoing basis and work with staff to identify and resolve problems. Identify and feedback learning from risks identified relating to fetal heart rate monitoring identifying themes and learning from cases on an ongoing basis as well as provide feedback to individuals as required. D:\478163153.Doc Identify own training and development needs and undertake appropriate training/education as required, supported by regular PDP. Maintain professional PREP requirements for midwifery registration. 2. RESPONSIBILITY FOR PATIENTS Reporting to the Consultant Midwife, take on a lead role in the promotion women centred care in line with the vision set out in ‘Better Births’ Promote normality whilst providing ante, intra partum care, which is reflective of research-based evidence in an appropriate setting. Act as an advocate for women and their families and make appropriate referral where necessary. Liaise with other appropriate multidisciplinary teams and organisations for effective collaborative care as appropriate. Promote and lead on the introduction of any new initiatives such as ‘Fresh Eyes and Fresh Ears’ to ensure staff are assessing fetal well-being in the context of the woman's individual risk assessment inclusive of her health, pregnancy, gestation and stage of labour. Develop midwives' competence in undertaking intermittent auscultation of the fetal heart in low risk women as per NICE guidelines. Support staff in enhancing their skills in reducing risk within clinical practice. Communicate sensitive and complex information effectively and support the care pathway. Identify and offer appropriate services to women and babies who are high risk. To assist the Directorate Management team in the provision and use of information available from all the relevant sources in such a way so that patient care improves. In particular, attend Divisional meetings and provide a summary report on clinical issues. 3. RESPONSIBILITY FOR POLICY AND SERVICE DEVELOPMENT a) Training Ensure attendance at training as appropriate to the needs of the role. Maintain comprehensive training records of who has been trained in fetal monitoring, submitting this to the midwifery education team, and where appropriate provide exception reporting where there are concerns identified. Actively participate in local and corporate induction training with a lead role in provision of fetal heart rate training. Support the delivery of the departments approved fetal heart rate monitoring training. Practice within agreed policies and protocols of Luton and Dunstable Hospital and adhere to the NMC Professional Code of Conduct, Standards and guidelines Maintain an awareness of professional and organisational developments attending professional and operational meetings as agreed and insure own professional development. Link the development of knowledge, ideas and work practice to the role of the midwife and midwifery support worker roles. b) Administrative Management Ensure the security and confidentiality of patient information is maintained at all times Produce high quality documentation in the agreed timescale to support staff by using appropriate Microsoft software. c) Professional Ensure that at all times duties are carried out in a safe manner in order to maintain a high standard of midwifery practice for all women and their babies by: o Being responsible for maintaining PREPP requirements. o Being conversant with all documentation issued by NMC. o Practicing within the NMC rules and codes of conduct. D:\478163153.Doc o o o o o o Being guided by clinical guidelines and adhere to policies of the Trust and to be aware of any changes that affect midwifery practice. Maintaining contemporaneous records in an accurate and legible manner. Being aware of all current child protection procedures. Making appropriate judgments on a range of complex midwifery and child protection issues, which require assessing, analysing, investigation and action. Actively participating in clinical governance strategy, audit and risk management. Notifying his/her intention to practice annually to her/his Supervisor of Midwives and meet with named Supervisor of Midwives for annual review. (Remove from JD after 31.03.2017) d) Audit Work closely with the audit and guidelines midwife/team to implement changes in practice and measure the extent to which quality has been improved in fetal heart rate monitoring on a quarterly basis Ongoing audit of educational initiatives related to the implementation and monitoring of action plans in order to achieve and maintain educational objectives. Provide regular written report of progress to local management team Contribute effectively to evaluation studies (e.g patient evaluation surveys) Present findings locally and nationally as requested by line manager. Produce action from Fetal heart rate/CTG quality initiatives and programmes e) Partnership Working/Service Development Adhere to and evaluate current policies and procedures and identify the impact they have within their clinical environment and midwifery service Maintain close links with the midwifery education team and the clinical skill facilitators/preceptors and contribute to the development of programmes across the department. Evaluate the fetal heart rate monitoring education programmes, identify outcomes and offer constructive advice on how the service could improve. Take an active role in the implementation of the emerging Nursing & Midwifery agenda. Work closely with the lead Midwife for Public Health to embrace the public health agenda and support the delivery of local plans as appropriate, leading on the implementation of the Stillbirth Bundle. Implement and propose changes to policies and practices in the midwifery unit in line with evidence based practice. Implement Clinical Governance initiatives by acting as a change agent and taking a proactive role in the service development. Work closely with the clinical risk management lead and be actively involved in clinical risk management issues and investigations, particularly with issues relating to featl heart rate monitoring. f) Better Births With a key focus on the vision set out in Better Births, identify and promote the key themes in the standards of provision of care: o personalised care- ensure that personalised care planning is promoted o promotion of continuity of carer with joined up care o safer care- ensure women are informed of risks and are supported to make decisions which would keep them as safe as possible o better postnatal and perinatal mental health care- ensure postnatal care is in place in line with individualised needs o multi-professional working- promote and work with the midwifery education team to develop multi-professional training o working across boundaries- participate in the planning and development of services D:\478163153.Doc o payment system- where appropriate/required, support the departments planning for funding arrangements of maternity care. 4. RESPONSIBILITY FOR FINANCIAL AND PHYSICAL RESOURCES Work in a way which is efficient and effective and adds value to the organisation Support budget holders by providing information as required 5. RESPONSIBILITY FOR LEADING AND MANAGING Supporting lead clinicians in the clinical areas Supporting clinical staff in their management/decision making of fetal heart rate monitoring in all clinical areas Take on a lead role in coordinating/supporting clinical areas in accordance with the needs of the service and in line with a Band 7 midwifery role Managing administrative staff as appropriate 6. RESPONSIBILITY FOR INFORMATION RESOURCES Ensure the processes are in place to identify, collect and evaluate information in order to support clinical decision-making Undertake data collection/input effectively using the agreed systems. 7. RESPONSIBILITY FOR RESEARCH AND DEVELOPMENT To work in partnership with others to ensure continuous improvement and best practice. To identify opportunities for shared learning from incident investigation and analysis GENERAL RESPONSIBILITIES Personal Development All staff are required to be appraised by their line managers at least once a year at a personal development review meeting where progress made over the last year is discussed and agreed. Focus on the following year’s departmental and personal objectives will be identified, discussed and agreed. Where necessary, help and support will be provided and development opportunities agreed in line with service provision and knowledge and skills competency framework. AMENDING THE JOB DESCRIPTION: As this is a newly created role and it is expected that as the organisation develops and changes, it may be necessary to vary the tasks and/or the responsibilities of the postholder. This will be done in consultation by the Consultant Midwife with the postholder and it is hoped that agreement can be reached to any reasonable changes. Mandatory Trust Responsibilities Infection Control Infection control is everyone’s responsibility. All staff, both clinical and non-clinical, are required to adhere to the Trust’s Infection Prevention and Control policies and procedures and the Health Act (2006) Code of Practice for the prevention and control healthcare associated infections and make every effort to maintain high standards of infection control at all times thereby reducing the risk of Healthcare Associated infections. D:\478163153.Doc It is the duty of every member of staff to take personal responsibility for the prevention and control of infection, as laid down in the Trust’s policies and procedures which reflect the statutory requirements of the Hygiene Code. To work in close collaboration with the Infection Control Team. To ensure that monitoring of clinical practice is undertaken at the agreed frequency. To ensure that the ward environments are cleaned and maintained to the highest standards; ensuring that shortfalls are rectified, or escalate as necessary. To ensure that all relevant monitoring data and issues are provided to the Directorate’s Governance structures. To ensure that all staff are released to attend infection control-related educational sessions and staff with specialist roles, e.g. link practitioners, are released to undertake their duties. Health and Safety at Work The post holder is required to: Take reasonable care for the health and safety of himself/herself and other persons who may be affected by their actions or omissions at work. Co-operate with the employer in ensuring that all statutory and other requirements are complied with. Confidentiality & Data Protection The post holder has a responsibility to comply with the Data Protection Act 1998 and maintain confidentiality of staff, patients and Trust business. If you are required to process information, you should do so in a fair and lawful way, ensuring accuracy is maintained. You should hold information only for the specific registered purpose and not use or disclose it in any way incompatible with such a purpose. You should disclose information only to authorised persons or organisations as instructed. Breaches of confidentiality in relation to information will result in disciplinary action, which may include dismissal. Employees are expected to comply with all Trust policies and procedures and to work in accordance of the Data Protection Act 1998. For those posts where there is management or supervision of other staff it is the responsibility of that employee to ensure that their staff receive appropriate training (e.g. HISS induction, organising refresher sessions for staff when necessary.) The postholder must at all times maintain a complete confidentiality of the material and information that they handle. Any matters of a confidential nature, or in particular, information relating to diagnoses and treatment of patients and individual staff records must not, under any circumstances, be divulged or passed on to any unauthorised person or persons. The postholder must respect patient named confidentiality in keeping with “Caldicott principles”. Conflict of Interest The Trust is responsible for ensuring that the services for patients in its care meet the highest standards. Equally, it is responsible for ensuring that staff do not abuse their official position, to gain or benefit themselves, their family or friends. Equality and Diversity The Trust values equality and diversity in employment and in the services we provide. It is committed to promoting equality and diversity in employment and will keep under review our policies and procedures to ensure that the job related needs of all staff working in the Trust are recognised. The Trust aims to ensure that all job applicants, employees or clients are treated fairly and valued equally regardless of sex, marital status, domestic circumstances, age, race, colour, disablement, ethnic or national origin, social background or employment status, sexual orientation, religion, beliefs, HIV status, gender reassignment, political affiliation or trade union membership. Selection for training and development and promotion will be on the basis of the individual’s ability to meet the requirements for the job. You are responsible for ensuring that the Trust’s policies, procedures and obligation in respect of promoting equality and diversity are adhered to in relation to both staff and services. D:\478163153.Doc Vulnerable Groups To carry out responsibilities in such a way as to minimise risk of harm to children, young people and vulnerable adults and to promote their welfare in accordance with the Children Act 2004, Working Together to Safeguard Children (2006) and No Secrets guidance (DH 2000). To demonstrate an understanding of and adhere to the trust’s child protection policies. Policies and Procedures The postholder will be expected to comply with all statutory legislation, Trust Financial Framework Guidance and approved national and local policy. The postholder is also expected to be aware of the Trust’s Risk Management Strategy which includes the responsibilities placed on them by the Health & Safety at Work etc Act (1974) and the Clinical Governance Framework. All employees are expected to comply with all Trust Policies and Procedures. GENERAL: To comply at all times with any regulations issued by the Trust, especially those governing Health and Safety at work and to ensure that any defects which may affect safety at work are brought to the attention of the appropriate manager. It is the responsibility of all staff to minimise the Trust's environmental impact by recycling wherever possible, switching off lights, computers, monitors and equipment when not in use, minimising water usage and reporting faults promptly. This job description reflects the present requirements and objectives of the post. As the duties of the post change and develop the job description will be reviewed and will be subject to amendment, in consultation with the postholder. PROFESSIONAL STANDARDS: Professional healthcare staff are responsible for complying with the relevant standards set by their regulatory or professional bodies (for example the GMC’s Good Medical Practice, and for nurses and midwives, the NMC’s Code of Professional Conduct). A breach of such standards may lead to action by NHS bodies independent of any taken by the regulatory or professional body concerned. It would be investigated fairly, and appropriate steps taken to prevent a recurrence and address any wider causes. SAFEGUARDING CHILDREN AND VULNERABLE ADULTS: All employees and volunteers working within the Trust have a responsibility for safeguarding and promoting the welfare of children and vulnerable adults. INFORMATION GOVERNANCE: (This includes Patient Confidentiality, IT Security, Data Protection and Freedom of Information) You are required to respect the confidentiality of all patients, carers and staff, by not sharing any information (including data) obtained during the course of your duties. You have an obligation to report any non compliance through the Trusts Incident Reporting process. D:\478163153.Doc All staff MUST comply with the legal obligations and statutory requirements of the Data Protection Act 1998, the Trusts IT Security and Information Governance Policies, Codes of Conduct and Best Practice Guidelines. These are available on the staff Intranet site. INFECTION CONTROL: You are required to comply with the Trust’s strategy regarding infection control, as set out in the document “Principles and Responsibilities for Delivering No Avoidable Infections”, a copy of which is available on the intranet. DISCLOSURE REQUIREMENTS: A risk assessment has indicated that a Disclosure and Barring Services “Disclosure” is both proportionate and relevant to this position. Any person who is conditionally offered this post will be required to undertake a criminal records check in this respect. The Trust guarantees that this information will be seen only by those who need to see it as part of the recruitment process. The Trust ensures that an open and measured discussion will take place on the subject of any offences or other matter that might be relevant to this position. Failure to reveal information that is directly relevant to the position sought could lead to a withdrawal of an offer of employment. We undertake to discuss any matter revealed in a Disclosure with the subject of that Disclosure before withdrawing a conditional offer of employment. Having a criminal record will not necessarily bar you from working with us. This will depend on the nature of the position or circumstances and background of your offence. Please be aware that the Trust has a Policy containing a more detailed Code Of Practice that meets the standards specified by the Disclosure and Barring Service relating to the fair use of criminal record information and the appointment of persons having a criminal record. A copy of The Luton & Dunstable Hospital NHS Foundation Trust’s Code can be obtained from the Human Resources Department. Note: Failure by an applicant to provide accurate and truthful information is considered to be a serious matter. Where it is found that a person has recklessly provided inaccurate information or withheld information relevant to their position, this may disqualify them from appointment. It may also result in dismissal or disciplinary action and referral to the appropriate professional registration body. If you would like to discuss what effect any criminal record or fitness to practise proceeding might have on your application, you may telephone the Recruitment Team Leader in the Human Resources Department on 01582 497241, in confidence, for advice. Functional Aspects of this post. This information leaflet is to help clarify what this post might involve in terms of mental and physical effort etc. This may help you decide if the role is one you would be interested in. D:\478163153.Doc Your recruiting manager will have ticked key, functional, characteristics of the job (left hand column) and on the right hand column there is a brief description of health conditions that might affect those duties, or vice versa. Please remember that these criteria are not used in the selection process. Whilst these descriptions are intended to be representative of the functional aspects of the role you have applied for they are not comprehensive. If you need any clarification please contact: Stella Roberts Functional requirement Health conditions that might impact on work √ Direct regular contact with If you have reduced, or low immunity e.g. HIV, steroid medication, and cancer treatment etc you might be more vulnerable to infection, particularly in certain clinical areas. This does not necessarily mean that you cannot work in those areas, but some restrictions/adjustments might be recommended. patients and/or specimens e.g. blood, or other bodily fluids etc. √Direct, regular contact with immunosuppressed patients, pregnant women and young babies √Exposure prone procedure (EPP) work e.g. operating theatres, A&E, obstetric delivery suite. It is important that you attend OHWS as soon as possible after your start date for a vaccination update to help protect you from infections. Patients in this group are at greater risk from infections including those that might be transmitted by healthcare workers. You will need to comply with vaccination/immunity requirements or if unable to meet these, consideration of redeployment to another role might be necessary. The Department of Health requires that all healthcare workers performing EPP must not be infected with the bloodborne viruses HIV, hepatitis B or C. You must be willing to be screened for HIV, hepatitis B and hepatitis C. At the moment HIV infected healthcare workers cannot perform EPP work, but from April 2014 this is likely to change so long as certain criteria can be met. Certain additional blood tests might be required if you are hepatitis B, or C positive. Should any test prove positive, it may still be possible, with restrictions, to allow you to work. √ Ability to undertake general physically demanding work including regularly moving/handling patients, lifting or moving loads > 5kg, frequent walking (or running in an emergency) √Resilience to workplace pressures including working to deadlines or in stressful environments. D:\478163153.Doc If you have a musculoskeletal problems e.g. with your back, shoulders, knees etc or have a condition that weakens the strength of your arms/legs e.g. multiple sclerosis, you may find some aspects of this type of work more difficult. As a rough guide, if you have problems performing normal day to day activities e.g. cleaning, cooking and shopping etc. or require frequent rest-breaks from them this might indicate potential problems with the physical requirements of this role. Working in the health service is rewarding, but at times can be demanding due to time constraints or might be distressing if dealing with seriously ill or dying patients and their families. Mental health conditions e.g. depression, bipolar illness, anxiety, schizophrenia etc might make you more vulnerable to feelings of stress or your condition might become worse. Certain physical conditions might also be exacerbated by stress and these include epilepsy and diabetes. √ Regular night work including on-calls □ Working alone, in confined Gastro-intestinal or heart conditions, epilepsy, diabetes and sleep disorders. spaces or at heights Various health conditions may prevent you from being able to safely undertake work involving one or more of these tasks e.g. panic attacks, claustrophobia, vertigo, epilepsy, diabetes. □ Ability to drive Trust Musculoskeletal conditions, vision problems, epilepsy, diabetes. vehicles √ Activities requiring good hand strength, or dexterity √ Regular computer-based work or desk-based work √ Good hearing, vision and speech including accurate colour vision. Musculoskeletal conditions arm / shoulder/wrist/hand problems, or neurological conditions such as multiple sclerosis and Parkinson’s disease. Musculoskeletal conditions arm/ shoulder/wrist/hand problems, or neurological conditions such as multiple sclerosis and Parkinson’s disease. Please ensure you let the OHWS know if you have, or have had any ‘repetitive strain’ type problems in the past. Uncorrected sensory problems e.g. eye conditions not corrected by spectacles, or hearing loss not corrected by a hearing aid. Dyslexia Speech impairments e.g. following a stroke. √ Working with chemicals, Dermatitis/eczema, psoriasis or other skin conditions. substances or work processes that can affect the skin or respiratory tract. Asthma or other breathing problems. D:\478163153.Doc