Pre-Operative Assessment Specialist Triage Lead

The main purpose of this role is to improve elective surgical waiting list patient triage quality and quantity by effective, knowledgeable, safe, reliable and consistent triage leadership. It is pivotal in increasing the pool of elective surgical waiting list patients who can be safely dated for surgery by Central Booking. This will increase theatre productivity and reduce overall patient cancellations. The role will incorporate using specialist pre-operative triage skills to triage elective waiting list surgical patients, both independently and by supporting the education of the assessment nurse team, to become skilled in effective patient triaging. This role will identify the triage learning and development needs of the pre-operative assessment nurses and provide the appropriate mechanisms for these to be met. The role will work closely with the Care Co-Ordinator Pre-Screening team, supporting them in early triage and aiding appropriate skill expansion and education. This role will track triage effectiveness through regular audit, focusing on quality of clinical decision-making, quantity of triaged patients (reflected in how much of the elective surgical waiting list has been triaged), overall team triage skill improvement, team effectiveness and consistent reliability of triage rates. The role will actively look at ways to improve the triage service using collected data to support the need for future development.

Job description

Please see attached Job description and person specification for full details of roles and responsibilities.

The main purpose of this role is to improve elective surgical waiting list patient triage quality and quantity by effective, knowledgeable, safe, reliable and consistent triage leadership.

It is pivotal in increasing the pool of elective surgical waiting list patients who can be safely dated for surgery by Central Booking. This in turn will increase theatre productivity and reduce overall patient cancellations.

This role will incorporate using specialist pre-operative triage skills to triage elective waiting list surgical patients both independently and by supporting the education of the assessment nurse team to become skilled in effective patient triaging.

This role will identify the triage learning and development needs of the pre-operative assessment nurses and provide the appropriate mechanisms for these to be met.

This role will work closely with the Care Co-Ordinator Pre-Screening team, supporting them in early triage and aiding appropriate skill expansion and education.

This role will track triage effectiveness through regular audit, focusing on quality of clinical decision-making, quantity of triaged patients (reflected in how much of the elective surgical waiting list has been triaged), overall team triage skill improvement, team effectiveness and consistent reliability of triage rates.

This role will actively look at ways to improve the triage service using collected data to support the need for future development.

This role will work as an accountable and autonomous practitioner to prioritise the best interests of patients at all times. This will include taking personal responsibility for your actions and decisions.

This role will be responsible for patient assessment, planning and giving of care, supervising safe and compassionate care, and evaluating the effectiveness of care.

This role will demonstrate strong leadership qualities and be open, transparent and trustworthy.

This role will act with integrity and uphold the values and beliefs of the Trust and the NMC Code of Conduct.

This role will use skills to identify potential risk and coordinate the care of complex patients ensuring that case management outcomes are followed. This will include referring to other colleagues and clinicians for support and advice as necessary in order to promote safe care outcomes.

This role will also support new starters through their induction, building on and consolidating knowledge gained through this period to support their triage skills.

Information resources: You must document care given, supervise the documentation others record and in adherence to the NMC standards for record keeping ensure patient records are accurate.

Training of others: As an NMC registrant you will continue to develop yourself, support, mentor, supervise and teach junior staff and others including nursing assistants, pre and post registration students and newly appointed staff. Through this teaching you will identify a range of development opportunities that will enable you to lead on the creation and subsequent delivery of training packages designed to upskill the workforce. Such training programmes and training events will also provide you with the opportunity to promote new ways of working that futureproof the unit.

Human Resources: You will actively seek feedback on your performance, contribute to your appraisal and provide constructive feedback to those you supervise as part of their performance review. You will keep staff records up to date. As a senior member of the unit you will develop a good understanding of HR processes in order to manage the performance of yourself and contribute to the management of individuals and the team. You will participate in recruitment and attendance management processes and disciplinary and grievance matters.

Financial and physical resources: You will observe a personal duty of care in relation to equipment and resources used in the course of your work and ensure efficient use of resources. You will develop a good understanding of the unit budget, establishment and contribute to efficient roster management. You will be able to assess the skill mix required to run the unit safely. You will also where necessary order supplies, assist in the management of the electronic staff rota, finalise bank shifts, and authorise overtime/excess hours for nursing and support staff.

Communication and relationship skills

Provide and receive complex and sensitive information which may require reassurance, tact or persuasion. Recognise where there are barriers to communication and work to establish effective communication within the multidisciplinary team. You will be required to communicate effectively with:

Service users their family and carers

Members of your unit team

Members of the wider multi-professional team, frequently with anaesthetists and consultant surgeons, cardiologists and haematologists

Theatres and Surgical Admission Lounge

Theatre booking team

Ward teams

General Practitioners

Primary and secondary care providers

Infection prevention and control team

All staff within the organisation

All visitors to the organisation

Patient/Client Care

Ensure that pre-operative elective surgical care planning and delivery is managed according to national and local evidence-based guidelines.

Supervise and monitor care delivery within the Unit ensuring care is delivered by all staff and students with kindness, compassion and respect. You will be mindful of standards at all times and if you have concerns you will know how manage them or to raise them to the Senior Sister, Matron or HON.

Assist with the development of assessment and referral protocols and guidelines with medical/anaesthetic/nursing staff.

Obtain and document an accurate and appropriate medical history and nursing assessment.

Provide patients with appropriate pre-operative advice and support and initiate referrals as appropriate to other members of the multi-disciplinary team.

Organise relevant pre-operative investigations as per hospital protocol and NICE guidelines.

Exercise clinical judgement, and decision making in terms of the patients risk and suitability for surgery consulting Clinicians as necessary for advice and support in order to maintain patient safety.

Liaise and/or refer to primary or secondary care providers to ensure pre-operative health is optimised.

Promote health education and lifestyle changes to patients, as indicated, e.g., weight loss, smoking cessation and reduction of alcohol intake as appropriate.

Be responsible for recording all appropriate outcome measurement scores.

Providing clinical advice to other multi-professional team members in the area of pre-operative assessment.

Ensure evidence based written patient/carer information is available for patients to access to facilitate an understanding of the proposed surgery and anticipated post-operative recovery.

Participate with the informed consent process by ensuring patients are aware of the risks and benefits of the procedure.

Facilitate in timely discharge planning by identifying any potential problems that may delay discharge prior to admission. Provide patient and carer with realistic estimate length of hospital stay and advice on arranging home circumstances following discharge.

Refer to appropriate primary and secondary services, as necessary. To support and promote an integrated approach to quality

Create and utilise opportunities to promote the health and well-being of your patients, clients and groups.

Undertake and document a comprehensive, systematic and accurate nursing assessment of the physical, psychological, social and spiritual needs of your patients, clients and communities.

Based on the best available evidence, apply knowledge and an appropriate range of skills indicative of safe nursing practice.

Deliver compassionate nursing care which takes account of social, cultural, spiritual, legal, political and economic influences. You will ensure patients dignity and privacy is maintained at all times.

Recognise a patients health is deteriorating and take appropriate action to manage the patient or escalate your concerns.

Evaluate and document the outcomes of nursing and other interventions.

Demonstrate sound clinical judgement across a range of differing professional and care delivery contexts.

Provide timely, relevant, accurate and concise information to other Health Care Professionals, both internal and external to the organisation, who are involved with the provision of care.

Person specification

Essential

Essential

• First level registered nurse with a Diploma, Advanced Diploma or Degree in Nursing and/or evidence of continuing professional development equivalent to post-graduate diploma level.
• Evidence of: Extended advanced study and/or Extended scope of practice Such as: HAPE Enhanced Clinical Assessment Nurse Prescriber Future ACP role.
• Able to Triage > 30 patients daily.
• Minimum of 3 years' experience at Band 5 working in an acute environment. Knowledge and recent experience within pre-operative assessment care
• Demonstrate expert knowledge of POAU policies / resources/ knowledge base/ both practical and theoretical skills.
• Experience of providing educational support to junior staff and students

Desirable

• Involvement in service improvement projects relevant to clinical area and role.
• Experience of providing formal feedback to junior colleagues and / or learners in practice.

About the employer

Salisbury NHS Foundation Trust (SFT) is an innovative hospital with a proud heritage and over 250 years of experience behind us. Here we're driven to deliver an outstanding experience for everyone and have been well regarded for the quality of care and treatment we continue to provide for our patients and also our staff.

We are an acute Trust, rated "Good" by the CQC, with a track record of high performance providing regional and super regional specialist services such as: Burns, Plastics & Reconstructive Surgery, Wessex Regional Genetics Laboratory, Wessex Rehabilitation, Spires Cleft Centre and the Duke of Cornwall Spinal Treatment Centre. We have about 470 beds and employ over 4000 staff.

We support flexible working and will consider requests taking into account the needs of the service. We think working here is pretty rewarding. You can access a range of NHS discounts, receive a minimum of 35 days paid holiday (pro rata), and we offer a generous pension scheme. On-site benefits include car parking (fee applies), leisure centre, day nursery and holiday play scheme.

Salisbury is an attractive place to live and work and really gives you the best of everything. With easy access to London and local airports, the city of Southampton is only a short train or car journey away or if you prefer the sea, Bournemouth is also accessible. Don't just take our word for it, why not explore what Salisbury has to offer by visiting www.experiencesalisbury.co.uk