Job Description

Provide advanced, highly specialist nursing care to enterally tube fed patients receiving secondary and tertiary care at LTHT as required, reducing the risks of enteral feeding in these patients. The post holder will be the Adult clinical nurse specialist (CNS) member of the multidisciplinary team responsible for the clinical care of patients requiring enteral feeding within Leeds Teaching Hospital NHS Trust. Clinical input and guidance for complex enteral feeding patients within LTHT as required. Contribute to specialist enteral tube feeding education and training programmes for patients carers and health care professionals, for Leeds Health Economy.



Specialist input into the development of LTHT enteral tube feeding guidelines (which apply in Leeds Community Healthcare i.e. city wide) and care plans. Input into research and audit within specialised clinical area and disseminate findings as applicable to delivering priorities and reducing risk of enteral feeding. Coordinate trust wide implementation of enteral feeding guidelines, care plans and directives.

3. JOB DIMENSIONS The jobholder:

Provide a strong directional role for education of nurses in the administration of safe enteral nutrition. Provide nursing lead in area of enteral tube feeding and role model to nursing teams, by delivering high quality care as an expert practitioner. Further develop own specialist skills in the initial insertion and reinsertion of enteral feeding tubes (naso-gastric, naso-jejunal, gastrostomy tubes (all types) and jejunostomy tubes.



Assess and advise on the management and resolution of complications surrounding enteral feeding tubes e.g. percutaneous or radio logically inserted gastrostomy and jejunostomy tubes that have become infected or displaced. Be a core member of the multidisciplinary care team, liaising with other members of the team to provide integrated nursing care to enterally fed patients. Act as an expert autonomous resource for medical, nursing and other healthcare professionals caring for patients receiving enteral feeding.



Use research findings as the basis of practice. Input to research activities and undertake audit projects within specialised area as applicable to delivering priorities. Be an expert resource within LTHT and the Leeds Health Economy for advising on management of enteral tube feeding problems. KNOWLEDGE, SKILLS AND EXPERIENCE REQUIRED Qualifications Professional nursing registration Recognised teaching qualification/training.



Experience Working knowledge as a specialist with enteral tube feeding. Evidence of obtaining and maintaining enteral tubes placement competencies CPD linked to management of complex nutritional support and artificial feeding Skills Able to work within a team, demonstrating leadership, initiative and confidence. Good written, oral and interpersonal communication skills. Able to demonstrate excellent time management and organisational skills.



Good presentation skills in delivering training to large multidisciplinary groups of staff or members of the public. Knowledge Highly developed specialist knowledge acquired through first level degree in Nursing or equivalent with significant post registration experience and at Band 6 or above of enteral feeding. Personal Attributes Excellent interpersonal skills Innovator Motivator Assertiveness Flexibility, adaptable, capable of lateral thinking Willing to undergo any training as required enabling performance in the job. Proactive in day to day clinical and non-clinical management.



PRINCIPAL DUTIES & AREAS OF RESPONSIBILITY Clinical and professional. Be an autonomous practitioner, clinically, legally and professionally responsible for own caseload. Responsible for undertaking nurse duties in specialised clinical area, managing and prioritising own clinical work load. Collect, analyse and record relevant patient information from clinical and patient sources, to develop effective enteral tube feeding care plans.



Responsible for developing and maintaining own expertise by updating own specialised clinical knowledge and skills. This will include attending local, regional and national professional interest group meetings if appropriate. Participate in the appraisal process as an appraisee, developing a strategy for personal and continuous professional development, encompassing a portfolio-based assessment in line with national legislation. Responsible for implementing clinical governance and risk assessment in respective specialised clinical area as part of continuing quality improvement e.g.



advise patients and staff on infection control issues around enteral feeding. Use research findings to ensure clinical effectiveness and promote evidence based practice, input to research activities and undertake audit projects within specialised area as applicable to delivering priorities and reducing risk of LHO Enteral Feeding Contract and disseminate findings as appropriate. Acts in accordance with the Nursing & Midwifery code of conduct. Undertake any other duties appropriate to the grade as requested by line manager.



Clinical care delivery - Provide a clinical lead and role model to nursing staff by delivering high quality care. - Undertake clinical procedures where dexterity and accuracy are required - Maintain a safe working environment Responsibilities for patient and client care - Assess, plan, implement and evaluate care and treatments using specialist clinical knowledge and clinical skills - Organises own clinical workload. - Receives supervision of clinical care and outcomes from nurse specialist team leader. Freedom to act - Refer patients as appropriate to other members of the multi-disciplinary team - Make clinical assessments and treatment decisions within clearly defined policies and protocols Communication - Maintains accurate clinical and other records using the Leeds Teaching Hospitals Trusts documentation.



Support patients and their families, communicating sensitive condition related information, ensuring they receive required information to enable them to participate in their care delivery - Liaise with Community Services (as appropriate) to ensure seamless provision of care deliver. Education and Training Lead the development of resources used in the education and training of patients, health professionals and the public at local and regional level. Provide postgraduate training on a range of subjects within specialist area to multidisciplinary groups and audiences at local and regional level. This will involve medical, dietetic, nursing staff and other healthcare professionals.

Be an active member of the in-service training programme through delivery of training sessions and tutorials at staff meetings and by attending external courses and demonstrating reflective practice. Develop, implement and audit, innovative methods of delivering education sessions for staff. Provide regular training updates, to ensure continued safety of enteral feeding management within the Trust. Leadership and management - Investigate and respond to accidents, complaints, untoward incidents and other significant events - Maintains record of workload and performance monitoring information and reviews this on a regular basis with team manager.



Work with Team Leader and/or Matron to promote the development of nurses undertaking the CNO Ten Key Roles as considered appropriate - Under the direction of the Team Manager participates in or lead the development of specific elements of nursing practice, reflecting the CMT and Nursing Directorate business plans - Participates in the setting, monitoring and improvement of standards and quality of patient care, including those standards defined in the National Benchmarks for Essential Care - Promote evidence based practice, wherever possible - Engage users and carers views on service delivery and development. - Implement policy and practice guidelines specific to the clinical specialty, proposing changes where appropriate - Contribute to policy and protocol development for speciality area. - - Responsible for the day to day supervision of junior clinical staff and students within the specialist team. - - Exercises a personal duty of care in relation to equipment, resource and stock control utilising equipment and supplies appropriately.

Research and Audit - Contribute to the research agenda - Undertake audit programmes specific to client group, treatments and developments. - Participate in clinical trials as appropriate.