|Title||High Quality Clinical Care Engineering|
By the end of this module the Clinical Scientist in HSST will be able to analyse and synthesise their understanding of the provision of high quality clinical care and effective communication with specific emphasis on the care pathways followed by patients requiring clinical interventions. The Clinical Scientist in HSST will be expected to apply their knowledge in a range of clinical setting and to evaluate their own response to both normal and complex situations using the professional attributes and insights required of a Consultant Clinical Scientist. A particular emphasis of this module is effective communication with a range of health professionals and multi-professional teams. The outcomes of this module must be set in the context of the scope of practice of the Clinical Biomedical Engineer and within the context of the multi-professional team approach to care.
Knowledge and understanding
By the end of this module the Clinical Scientist in HSST will be able to analyse, synthesise and critically apply their knowledge as they develop and extend their clinical practice including the following elements including:
- care pathways, particularly those that relate to patients requiring rehabilitation interventions, for example:
- spinal and head injury pathways
- stroke pathways
- multiple sclerosis
- amputee management
- in-patients pathways requiring rehabilitation support e.g. Critical Care episodes
- the practices of clinical medicine including clinical needs and perspectives including:
- the importance of emphasis to be placed on the whole patient
- long-term conditions
- role of community care
- treating the patient as the centre of care within a consultation
- differential diagnosis and formulation of management plans
- how to review an initial diagnosis, refining problem lists and planning appropriate strategies for investigation and management
- the structure of patient history taking and examination utilising all relevant sources of information–
- the process of performing accurate physical examinations within the scope of practice including physical signs
- how to present a patient history and findings succinctly and accurately.
- how to recognise and manage the acutely ill patient, including how to:
- promptly assesses the acutely ill, collapsed or unconscious patient
- respond to acutely abnormal physiology
- manage patients with impaired consciousness, including seizures
- manage pain
- manage resuscitation events within the protocols of the clinical environment
- provide end of life care and appropriate use of Do Not Attempt Resuscitation (DNAR) orders/advance decisions
- the importance of recording and noting changes in physiological score
- planning appropriate action to try to prevent deterioration in vital signs
- managing long-term conditions during episodes of acute care
- how to review acute presentations in context of long-term disease progression and symptom control
- how to recognise new complications of long-term illness(es)
- the principles underpinning the delivery of high-quality reliable care in accordance with clinical care pathways, care bundles, protocols and consultant prescription
- the limitations of clinical pathways in certain individual patient circumstances
- the impact of acute illness on the acute exacerbation of a long-term disease
- how to manage patients with long-term conditions and supporting patient decision making
- the process underpinning integrated discharge planning
- the role of health promotion, patient education and public health in clinical care pathways
- the interplay between long-term physical illness, psychological factors and mental disorder, and the implications for both management and outcomes
- the role of other healthcare professionals in the management of long-term diseases including the multi-professional team
- the indications for a range of therapeutic interventions including physiotherapy and occupational therapy for inpatients with long-term mobility problems
- the criteria for specialist rehabilitation, care home placement and respite care and arranges appropriate assessment
- the potential impact of long-term conditions on patients, family and friends
- the impact on the activities of daily living on long-term conditions e.g. epilepsy and communicates these to the patients and carers
- the implications of the wider determinants of health including:
- ultra violet (UV) radiation especially the harmful effects of sunlight
- lack of exercise
- weight management
- alcohol intake
- the impact of inequality and deprivation on the health of patients and populations
- the impact of chronic disability on patients during an acute illness or injury.
Additionally the Clinical Scientist in HSST must be aware of the interface with different specialties and with other professionals, including:
- the importance of the entire healthcare team.
- the importance of effective communication with colleagues in other disciplines
- shared care arrangements.
- the challenges of providing care within a variety of clinical settings and potential difficulties of navigating boundaries between different professionals and specialties.
- the strengths and weaknesses of guided care pathways and networks of care.
- how to make a referral across care boundaries.
- guided care pathways between teams and primary and secondary care.
Technical and clinical skills
By the end of this module the Clinical Scientist in HSST will be expected to critically reflect and apply in practice a range of clinical and communication skills to advise and communicate effectively with patients, relevant clinicians, patients and the public and other healthcare professionals and, within their scope of practice and the multi-professional team, will:
- make appropriate differential diagnosis and formulate a management plan
- review initial diagnosis, refine problem lists and plan appropriate strategies for investigation and management
- obtain accurate patient history and examination utilising all relevant sources of information
- perform accurate physical examination and elicits physical signs
- present the patient history and findings succinctly and accurately.
- within the multiprofessional team contribute to the management of long-term conditions during episodes of acute care.
- delivers high-quality reliable care in accordance with clinical care pathways, care bundles, protocols and consultant prescription.
- accurately summarises and document the main points of patients’ diagnoses, active and potential problems, and management plans recording and note findings in accordance with good practice guidelines.
- monitors treatment plans refining appropriate strategies for investigation and management.
- leads regular reviews of treatment response to oversee patients’ progress along treatment plan.
- discusses management options with patients and recognises patients’ expertise about their care.
- arranges secondary care (or primary care) follow-up when appropriate.
- anticipates when management of a long-term problem may impact on treatment of an acute problem and vice versa e.g. drug interactions, fluid balance.
Attitudes and behaviours
By the end of this module the Clinical Scientist in HSST will be expected to evaluate their own response to both normal and complex situations demonstrating the professional attributes and insights required of a Consultant Clinical Scientist working within the limits of professional competence referring as appropriate to senior staff and will:
- ensure that examination, whilst clinically appropriate and within the constraints of the role of Consultant Clinical Scientist, considers social, cultural and religious boundaries; appropriately communicate findings and make alternative arrangements where necessary.
- recognise that patients may have unspoken concerns and communicates in an empathic manner to elicit and address these.
- recognise that the acute illness may be an acute exacerbation of a long-term disease.
- work in partnership with patients in an open and transparent manner.
- treat patients as individuals and respects their perspective/views on their own treatment.
- work with patients and colleagues to develop sustainable individual care plans to manage patients’ acute and long-term conditions.
- consider the patient as a whole, respecting their individual needs, dignity and right to privacy, autonomy and confidentiality.
- respect patients’ views and encourage patients with knowledge of their condition to make appropriately informed decisions about their care.
- consider care pathways and the process of care from patients’ perspectives.
- communicate effectively and with understanding and empathy.
- strive to provide high quality patient centred care treating patients with compassion.