job description

JOB TITLE: Discharge Co-ordinator /Facilitator (CNM2/CMM2)

DEPARTMENT:Neonatal Unit
REPORTS TO:CMM III for the Neonatal Unit and the Assistant Directors of Midwifery/Nursing.
Clinically accountable to the CMM III and the Director of Neonatology
RESPONSIBLE TO:Director of Midwifery & Nursing

QUALIFICATION:Essential

1. Registered General Nurse or Registered Midwife or Registered Sick Children’s Nurse.

2. Certificate or Diploma in Neonatal Intensive Care Nursing

3. Five years post-registration experience of which two must be in the specialty or related area.

The main purpose of the role is to ensure that infants are discharged as soon as safely possible. (There is a need for this in view of the excessively high census at times for the N.I.C.U. area and the inability to accept postnatal admissions at times). The post holder is to provide quality family centred care of the high-risk neonate while in the hospital and in the community following discharge. This will require the application of specially focused knowledge and skills with a clear clinical focus involving assessment, planning, delivery and evaluation of care given to patients/clients and to their families in hospital, community and outpatients.

Early parental involvement has a positive effect on parenting skills thus ensuring that parents are able to assume responsibility for their baby’s care at home with the necessary specialised support.

The Discharge Co-ordinator will work closely with the Medical, paramedical, nursing, A.N.P’s and other hospital staff to ensure interdisciplinary and multidisciplinary teamwork.

Main Responsibilities of the Post

  • To co-ordinate the assessment, planning, delivery and evaluation of discharge home for babies and their families who are eligible for neonatal transition home care.
  • Prepare infant for discharge home in liaison with the community services before and after discharge and as required.
  • Identify high risk and long stay neonates (e.g.<1kg) early in their stay to establish rapport early and to identify potential barriers to discharge and to ease the transition for families from the Neonatal Unit to home.
  • Maintain Baby Friendly Hospital Accreditation Standards.
  • Facilitate early parental involvement in the care of their baby to enhance parenting skills and empower parents.
  • Review Clinical status on an ongoing basis, which will include growth and nutritional status using approved Policies and Guidelines.
  • Identify and document the discharge planning requirements in collaboration with the multidisciplinary team to include the Public Health Nurse, General Practitioner, Social Work and other relevant support groups. This will include vaccinations, eye checks, audiology review, hip check and cerebral ultrasound scans.
  • Ensure the supply and delivery of home oxygen and monitor in the relevant cases.
  • Provide relevant parent education and support to assist an understanding of their baby’s health related problems.
  • Support parents in their adaptation to their baby’s unique needs.
  • Actively contribute and ensure compliance with the key areas as identified in the National/Hygiene Schemes.
  • To ensure direct parental education by nursing and medical staff to include formal and informal sessions for a safe and timely discharge to include the following: -

Baby bathing

Expressing and storage of breast milk

Breastfeeding the baby with special needs

Preparation of bottle feeds and bottle feeding

Baby Resuscitation

Administration of medications

Immunisations / selection for Immunisation against R.S.V. based on agreed protocols

Care of the baby on home oxygen

Education regarding the use of home monitor as appropriate

Recognition of changes in baby’s clinical status at home and the appropriate intervention and action

Health Promotion

Safety in the home related issues.

Arrange specialists review and follow –up appointments as indicated

  • Acts as a resource for families included in the Neonatal Transition Home Scheme acknowledging that transition to home of the medically fragile infant poses unique needs and concerns for parents.
  • Co-ordinates discharge planning with Neonatal Department Staff, families and relevant community care staff ensuring that supports necessary are in place and follow-up appointments are co-ordinated.
  • An assessment of the home environment pre-discharge is an integral part of the neonatal transition home scheme to ensure adequate facilities are in place to meet the individualized needs of the baby on discharge. This assessment is done in collaboration with the Community Services, Social Worker and Public Health Nurse. For the present, home visits will only take place very occasionally and in unusual circumstances and at the request of the discharging consultant.
  • The first home visit takes place on the day after discharge and this involves:-
  • Assessment of baby’s well-being, feeding, weight gain, respiratory status, oxygen saturation, behaviour and review of medications.
  • Review of parents coping skills.
  • Ensure that all community links established prior to discharge are being maintained.
  • Plan for further visits based on this assessment or referrals to hospital services where necessary.
  • Communication is maintained between parents and Discharge Co-ordinator as required and in her absence Senior Neonatal Nursing Staff.
  • Act as a role model in the clinical area.
  • Participate in and develop neonatal education and training programmes for parents, all grades of staff and disciplines of staff.
  • Plan and implement appropriate specialists in-put to induction and orientation programmes for new staff.
  • Ensure that appropriate and up-to-date information is readily available for parents, families and staff.
  • Maintain high standards of clinical skills and knowledge by continually reflecting on practice and accessing appropriate education.
  • Initiate and facilitate developments in Nursing Care including family integrated care, with particular reference to discharge planning and evidence based safe practices to shorten length of stay, within the speciality.
  • Lead in the evaluation of neonatal nursing care in this care group.
  • Lead in the development of multidisciplinary and neonatal standards of care, protocols and guidelines for neonatal transition home care scheme.
  • Lead in the development of databases, collection of data and prepare an Annual Report.
  • Present collected data and results both locally and nationally.
  • Improve the quality of service for babies and families by implementing evidence based care and the use of audits.
  • Contribute to neonatal service planning and budgetary processes through the use of audit and specialist knowledge.
  • Initiate research where appropriate and in collaboration with the relevant neonatal and medical staff.
  • To establish and maintain regular liaison between the interdisciplinary and multidisciplinary team both within the hospital and outside the service.
  • To co-ordinate multidisciplinary meetings to discuss and communicate plans of care for relevant cases.
  • To co-ordinate and participate in regular care evaluation and plan meetings with the consultants and other members of the multidisciplinary team.
  • Promote the role of Specialist in Neonatal Transition Home Care among appropriate Health Care Professionals throughout the Hospital.
  • Promote the development of this service by facilitating visiting healthcare staff from other institutions and participating in national conferences.

Each appointment is subject to a hospital contract:

Roster:

Full-time39 hours per week (average exclusive of meal times)

Annual Leave and Public Holidays:As approved by the Department of Health and Children

Salaries:As approved by the Department of Health and Children

This job description is subject to review by the hospital authority from time to time. This is a description of the principal responsibilities of the post and is not a comprehensive list of duties.

November 2017