BEAUMONT HOSPITAL
DEPARTMENT OF NURSING
In Beaumont Hospital, the Director of Nursing controls and manages the total nursing
services at executive level. The Divisional Nurse Manager is accountable to the Director of
Nursing for the work of Ward/Departmental Clinical Nurse Manager 11 Grades assigned
to his/her division. The Ward/Departmental Clinical Nurse Manager 11 Grades are in
turn accountable to the Divisional Nurse Manager for the performance of Clinical Nurse
Manager 1 Grades, Staff Nurses, Student Nurses and ancillary staff working with Nurses
on Wards or in Departments.
RENAL NURSING SERVICES
JOB TITLE:
Staff Nurse - Regular Haemodialysis Unit
GRADE:
Staff Nurse
REPORTS TO:
Clinical Nurse Manager II - Haemodialysis Services
ACCOUNTABLE TO:
Clinical Nurse Manager III - Haemodialysis Services
CONDITIONS OF APPOINTMENT
QUALIFICATIONS:
1.
To be registered with An Bord Altranais in the General Division of the Register.
2.
To have name maintained on the Live Register with An Bord Altranais.
PARTICULARS OF OFFICE:
DIRECTORATE PROFILE:
The Nephrology/Urology and Transplant Directorate at Beaumont Hospital is the largest referral
centre in Ireland for the specialities of Nephrology, Dialysis and Transplantation.
It is the
National Referral Centre for Renal Transplantation. Investigation and treatment facilities are
provided for patients with various types of Nephrological disorders, including acute tertiary
conditions.
The Directorate has a major commitment to the provision of a fully integrated Programme of
Renal Replacement Therapy. The integrated approach offers several types of dialysis therapy
(in-hospital Regular Haemodialysis, Continuous Ambulatory Peritoneal Dialysis) and a vigorous
Renal Transplantation Programme.
Staff Nurse - Haemodialysis
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HAEMODIALYSIS SERVICES
The Haemodialysis Services at Beaumont Hospital comprise:
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St. Martins Room 1 - Regular Haemodialysis Programme (12 Stations)
St. Martins Room 2 - Regular Haemodialysis Programme (8 Stations)
Acute Haemodialysis Unit - St. Peters (4 Stations)
Intensive Care Unit - Acute Haemodialysis
Plasma Exchange Therapy
Over 34,000 Haemodialysis treatments were carried out in Beaumont Hospital per annum
ST MARTINS
St. Martins Regular Haemodialysis Programme is located on the lower ground floor. The staff
assigned to this unit have continuous responsibility for the care of currently 200 patients who
attend the unit three times weekly for treatment and care. The unit is operational 24 hours/7
days a week. The nursing staff assigned to the regular Haemodialysis Programme are also
accountable for the provision of an acute renal failure service to the Intensive Care Units and the
provision of a backup nursing service for Plasma Exchange Therapy.
ST PETERS
St. Peters Acute Haemodialysis Service is located in St Peters Ward on the fourth floor. Staff
assigned to this unit have continuous responsibility for the care of acute renal failure services at
Beaumont Hospital. Isolation dialysis is also provided in this area.
ROLE SUMMARY:
The post holder is expected to deliver high quality nursing care to the Regular Haemodialysis
Unit, Acute Renal Failure services and Plasma Exchange Therapy at Beaumont Hospital.
The job holder will assist Clinical Nurse Manager I & II with regard to:1.
2.
3.
4.
5.
6.
7.
Maintaining a high standard of professional and ethical responsibility
Carrying out all nursing / clinical practice in accordance with Department of Nursing
and Hospital policies, procedures and clinical guidelines.
Provision of a high quality evidence based nursing service in a multi-disciplinary
environment and to promote the highest attainable standard of safe and effective
patient care.
Development of clinical expertise, team leadership and teaching skills through nursing
practice.
Management of nursing care and the patient’s environment under the direction of the
Clinical Nurse Manager/Charge Nurse.
Maintain effective communication and professional relationships with all members of
the multi-disciplinary team to ensure that a cohesive effective service is provided.
Participate in the development, implementation and evaluation of clinical practice in
accordance with Hospital and Unit nursing policies and clinical guidelines and
contribute to their ongoing development
Staff Nurse - Haemodialysis
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DETAILS OF RESPONSIBILITIES
CLINICAL RESPONSIBILITIES
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
To be an effective Practitioner able to establish and maintain high quality
evidence based nursing service.
To use a framework and a model of nursing which reflects the speciality needs
of Haemodialysis Nursing to undertake a comprehensive assessment preinitiation, during and post Haemodialysis treatment. This assessment (with the
patients where possible) should include the physical, psychological, social
problems of individual patients receiving Haemodialysis therapy and the need
for nursing intervention
Based on pre-assessment needs, collaborate with the Medical Consultant / Team with
regard to the formulation of a haemodialysis treatment plan; assessment of vascular
access; timely placement of arteriovenous fistula, dialysis prescription and general
clinical management issues.
Monitor the patient throughout the Haemodialysis treatment process. Ensures
maintenance of homeostasis by optimal management of fluid balance, blood flow and
dialysis flow; modify dialysis prescription according to patient’s condition within predetermined clinical parameters.
Maintain a strict aseptic technique when assessing the Central venous
catheter/arteriovenous fistula/graft for haemodialysis treatment.
Locate, read & refer to the renal unit guidelines on the care of the CVC & AVF/AVG,
prevention of infection and management of complications.
Recognise situations which require medical consultation / intervention and liaise
closely with the Medical Team.
Carry out a post treatment evaluation of patient wellbeing and effectiveness of the
Haemodialysis treatment, adequacy and provide appropriate post treatment nursing
care.
Examine the patient’s blood results prior to each haemodialysis treatment and liase
with the CNM/Medical team in altering prescriptions.
Locate and refer to the guideline on the management of calcium and phosphate in
ESRF, and the renal anaemia guideline.
Prepare and update the nurse care plans within a nursing framework to include
treatment delegated by medical staff.
Liaise with the medical and nursing team on the ward to communicate the outcome of
care and continuing management post treatment.
Play a role in ensuring that appropriate nursing care and Haemodialysis
treatment is planned for individual patients based on assessment and that each
patient receives appropriate care encompassing medical decisions and in
conformance with established procedures and standards of care.
Collaborate with the medical team with regard to the effectiveness of care and
the adequacy of dialysis. Institute changes in dialysis management, as required,
and implement nursing or medical treatment necessary.
Maintain clear, concise and legible documentation of all nursing care and
changes to treatment.
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16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
Review patient care plans for appropriate patient goals and problems and revise
same based on nursing needs.
Assist patients and their families to make informed decisions regarding the
various aspects of their care.
Promote patient/family participation in care, identifying and meeting the learning
needs of patients and their family.
Ensure the provision of timely and complete information and education for
individual patients aimed at promoting independence, prevention of illness and
promotion of health.
Ensure the provision of psychological support by nursing staff to patient and
families and encourage patients who have ongoing psychological problems to
self-refer to the Nurse Counselling service.
Ensure adequate liaison by nursing staff with patient/family and Patient Care Coordinators with regard to patient's occupational and social needs.
Maintain knowledge and actively participate in the screening, prevention and
management of blood borne viruses according to both Beaumont Hospital’s
Policy and the National Guidelines.
Maintain knowledge, actively participate and contribute hygiene and
decontamination protocols set out by both Beaumont Hospital and Government
agencies.
Be aware of policies set out by Beaumont Hospital for the safer handling and
disposal of waste (including dialysis, clinical and domestic) and sharp disposal.
Be aware of policies set out by Beaumont Hospital for the safer handling
management and disposal of linen.
Maintain knowledge and actively participate in the prevention and reporting of
near misses, incidents, and adverse events involving patients, staff and visitors in
accordance with hospital policy. Report these both verbally and in writing using
the risk management occurrence form in accordance with hospital policy to
Clinical Nurse Manager on duty.
Locates, reads & demonstrates understanding of and adherence to all infection
control & hygiene protocols within the unit.
Ensure the maintenance of a suitable environment for patients and staff with particular
emphasis on Health and Safety, hygiene, decontamination and infection control
Be aware of the Beaumont Hospital’s complaints procedure.
Maintain patient confidentiality at all times.
STANDARDS AND QUALITY OF CARE:
Takes all steps possible to safeguard the welfare of patients through actively participation in:1.
2.
3.
Quality initiatives within the Unit with the aim of improving patient care and
promoting the further development of Nursing within the speciality.
Identifying areas of practice which require review and update and lead in the
development of evidence based practice in consultation with staff.
Participate in new quality improvement initiatives and therapies to improve
patient care within the unit such as cannulation techniques, haemodiafiltration
and home haemodialysis.
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4.
Actively participate in the virology screening and prevention of blood borne
viruses. Liaise with the Renal Virology Nurse with regard to the screening,
vaccination and management of blood borne viral positive patients.
MANAGEMENT OF HAEMODIALYSIS EQUIPMENT
1. Carry out safety checks on all equipment in accordance with operator manuals prior to
use and throughout the dialysis procedure.
2. Be responsible for the preparation, management and aftercare of Haemodialysis
equipment.
3. Carry out all equipment disinfectant procedures in accordance with standards set out in
operator manuals.
4. Initiate prompt action if the water pressure alarm or water quality alarm sounds out of
hours.
5. Liaise with the Renal Technical Staff should any problems arise with both equipment
and water.
6. Advise the Renal Technical Staff of blood soiled dialysis equipment in order for them
to carry out the necessary internal technical checks.
7. Provide supervision of Healthcare Assistant staff who carry out the preparation,
management and aftercare of haemodialysis equipment and dialysis station.
MANAGERIAL
1.
2.
3.
4.
5.
6.
7.
8.
9.
Maintain effective communication and professional relationships within the
Haemodialysis Unit, with all areas of the Renal Unit, and all associated clinical
and administrative areas within Beaumont Hospital.
Promote effective communication with staff in both regional and satellite units,
Inform the Clinical Nurse Manger when staffing levels fall below or are in
excess of that considered adequate to meet the complexity and variations in
workload.
Be willing in an emergency to work other areas of the Directorate or Hospital.
Ensure that the agreed hospital and specialist policies and procedures are known
to and understood by staff and are implemented.
Ensure the maintenance of a suitable environment for patients and staff with
particular emphasis on Health and Safety
Establish communications with non-clinical departments (i.e. catering, contract
cleaning, linen, portering, ward supplies and technical services) to ensure that the
services to the Unit are provided to the highest possible standards which will
ensure economical utilisation of such services.
Ensure that medical waste including Dialysis products are discarded according to
hospital policy.
Ensure the implementation of effective maintenance systems for haemodialysis
equipment and other electron medical equipment in use i.e. maintaining
inventory of equipment, checking equipment before use, ensuring adequate
training of staff in the correct use and care of equipment.
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10.
11.
12.
(a) Ensure that verbal and written nursing reporting systems are accurate and
adequate and that nursing reports accompany patients who are being transferred
to other units / centres.
(b) Ensure the appropriate utilisation of the Renal Clinical Management system
with regard to the management of individual patient’s clinical data, audit and
utilisation of data to establish clinical outcomes, standards of care and to update
clinical practice.
Actively participate in the supervision, support and development of Healthcare
Assistants, Household operatives and Clerical Staff in the Unit.
Participate in regular ward meetings to encourage a positive staff environment
and participation in the development of Haemodialysis Services.
EDUCATION - STAFF DEVELOPMENT
1.
2.
3.
4.
5.
6.
Create and maintain an environment conducive to evidence based teaching, learning and
practice.
Act as an effective role model, mentor and leader of staff i.e. leading by example.
Participate in the training and development of the Healthcare Assistant role in the
Haemodialysis setting in collaboration with Clinical Nurse Managers.
Identify and utilise teaching, learning and practice opportunities in the clinical setting.
Ensure the availability of appropriate information/educational resources for patients and
families aiming to encourage independence, the prevention of illness and the promotion
of health for all Haemodialysis patients.
Actively seek research findings, which will support clinical practice and participate
actively with research opportunities within the Unit.
SELF DEVELOPMENT
1. Have a creative outlook enabling progress to be made towards the ultimate objective of
reaching standards of excellence in the delivery of nursing care and in the co-ordination
of multi-disciplinary care.
2. Maintain and update knowledge of relevant professional development and all current
trends in the speciality of renal nursing, and an awareness of future trends.
3. Develop personal skills in renal nursing with "hands on" nursing commitment.
4. Attend and participate in staff development programmes and represent Renal Nursing
as a speciality at meetings and conferences, as required.
5. Discuss present performance and future needs with Clinical Nurse Manager I or II
using Job Performance Review in accordance with unit policy.
ADMINISTRATIVE
1.
2.
Ensure the correct completion of unit records and reports.
Actively promote the utilisation and further development of clinical and
administrative computerisation.
The job description represents the main functions of the role and is subject to review
and amendment to reflect the needs of the service.
Reviewed: August 2010
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