ENDOSCOPY
dependent patient procedure at ALL times and that in itself can be a challenge in gaining agreement to fund against what are essentially seen as not the routine but the ‘what ifs’ and ‘maybe’s’ that evolve from complex and even routine procedures. When staffing within inpatient services are stretched the outcome is that endoscopy staff are utilised to backfill staffing levels on wards and then are not available for the ‘what if’s’ and ‘maybe’s’ affecting morale and culture and endangering quality and safety. A balance is required in achieving what is a movable feast in a climate where all services and not just endoscopy have restricted funding and their own staffing challenges.
The decision on skill mix
The diversity and change in skill mix has been the focus of many of the challenges within endoscopy when looking at safe staffing levels. The evolving role of the unregistered practitioner within endoscopy led to initial delays in reviewing and updating guidance. Now that these roles have become embedded within endoscopy and examining their varying responsibilities, the conclusion of the working party was that skill mix is dependent on individual legislative boundaries of practice, professional codes of practice, the personal characteristics of the individual in applying knowledge and judgement and demonstrable competency. This when sat alongside what we do know about staffing endoscopy as already discussed gives the strongest basis for recruitment, training and retention of an appropriate workforce.
Training and education
Nurses are a key part of any service which delivers patient care, and we as individuals need to ensure we continue ongoing training and education to fulfil the requirements to maintain safe care, delivery and revalidation. The endoscopy unit nurse manager and the clinical lead hold key roles and responsibilities for service delivery by
About the authors
Laura Dwyer is the lead hepatobiliary nurse at Aintree University Hospital. She manages a very busy tertiary ERCP service and also has the role of nurse endosocopist specialising in biliary endoscopic ultrasound. Dwyer delivers nurse led HPB clinics managing patients with primary sclerosing cholangitis and has a keen interest in training within ERCP. She has been directly involved with the setup of national training courses for nurses through to consultant level ERCP training programmes. Dwyer was the lead nurse for ENDOLIVE UK. She is a trainer for upper GI endoscopy for both the medical and nursing workforce. She manages a team of specialist HPB nurses and is involved with all aspects
of hepatobiliary service provision. Laura is the chairperson of the BSGNA and nurse representative of UKI EUS users group.
Dr Helen Griffiths is a retired nurse consultant with 27 years’ experience in
gastroenterology. She continues to work part time as an endoscopist and trainer at Wye Valley NHS Trust. Doctorate and special interest is in Barrett’s oesophagus, supporting master classes and training in this area. Appointed as deputy head of assessors for JAG in April 2017, Dr Griffiths has worked as a JAG assessor and latterly lead assessor since 2007. Dr Griffiths is the decontamination advisor for the
54 I
WWW.CLINICALSERVICESJOURNAL.COM
BSG, working with decontamination bodies and industry to drive up standards by improving quality and access to training and education. Represents nurses on a number of working parties for BSG clinical guidelines and guidance documents, including decontamination, consent, workforce and quality standards in upper GI Endoscopy. She lectures nationally and internationally in gastroenterology and advanced nursing practice, with associated
publications including a book on the care and management of coeliac disease. Dr Griffiths represents the profession and specialty on a number of medical and nursing committees.
SEPTEMBER 2017
Nurses are a key part of any service which delivers patient care, and we as individuals need to ensure we continue ongoing training and education to fulfil the requirements to maintain safe care, delivery and revalidation.
ensuring staff remain motivated and trained to deliver appropriate patient care that is up to date and evidence based. Endoscopy safety is complex. It comprises of a balance of service provision, effective training, safe staffing levels and team work, efficient processes and a systems approach to error prevention. There are huge pressures on NHS services to deliver more care despite real term cuts to funding. Only by setting the foundation of safety and building towards high quality can we aspire to achieve excellence in endoscopy. A reduction in personal development funding for many services means that nurses will have to look further afield for training opportunities. With
this in mind, The BSGNA is focusing on nurse education delivered through regional study groups. This approach to education is affordable and sustainable if regional groups are established and effective networks developed within GI nursing. However, we need engagement from GI nurses and the support of our industry partners if we are to make a success of this education programme.
CSJ
If you would like further information about the workforce document or would like to get involved with regional group education please contact Laura Dwyer at
Laura.dwyer@aintree.nhs.uk
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72
