Specialist Clinical Care

Details

Title

Specialist Clinical Care

Type

Stage One

Module code

HPE405

Requirement

Compulsory

Module objective

This module outlines specialist areas of therapeutic innovative practice in Reconstructive Science. By the end of this module the Clinical Scientist in HSST will be able to analyse, synthesise, evaluate and apply knowledge of appropriate Reconstructive Science therapeutic interventions relevant to clinical practice, including non- medication-based therapies and preventative interventions within the scope of practice of a Consultant Clinical Scientist in Reconstructive Science. Interventions will include therapeutic splinting for skin anomalies and innovative invasive procedures such as micro-pigmentation and surface laser ablation.

Clinical Scientists in HSST are not currently permitted to issue prescriptions as either supplementary or independent prescribers. However, there are circumstances known as patient-specific directions whereby medicines can be given by another professional following the directions of an approved prescriber. Provider organisations should have arrangements in place that enable these legal requirements to be implemented. This therapeutics module is included in this Reconstructive Science curriculum to provide the underpinning knowledge and understanding of a limited range of therapeutics utilised within Reconstructive Science to support the Clinical Scientist in HSST to work with other clinicians and healthcare professionals as part of a MDT.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will analyse, synthesise, critically evaluate and apply their knowledge with respect to the:

• underlying anatomy and physiology;
• relevant medical history that might impact the delivery of treatment, e.g. diabetic patient with compromised blood supply;
• impact of the treatment and possible adverse effects on the patient, relating these to the patient, recording them and gaining the required patient consent;
• correct use of medical devices during active treatment or monitoring phase, making sure that the appropriate guidance is given and supported by patient information leaflets for safe use.

Therapeutic Splinting

Principles of functional (applied pressure/movement) and non-functional (protective) splinting and patient management in various innovative settings, including specialist areas such as:

• epidermolysis bullosa (EB) management;
• craniofacial stenosis splints;
• nasal septal obturators;
• chondrodermatitus helices, ear cushions;
• ear deformity repositioning splints;
• sleep apnoea mandibular positioning devices.

Therapeutic devices can only be administered and applied in conjunction with the MDT and the correct referral from the prescribing dental or medical consultant.

Administered Therapeutics

When patient-specific directions have been given by an independent prescriber and the correct training competencies have been undertaken, the Clinical Scientist in Reconstructive Science will promote patient safety in prescribing limited topical and direct therapeutic treatments. This will include:

• local ‘patient-specific direction’ applications relevant to Reconstructive Science, e.g. application of topical antibacterial agents to manage implant soft tissue interface or silicone gel sheets;
• administration of local anaesthetic eye drop for invasive haptic shell impressions;
• the effects of age, body size, environment and illness or disease factors to the application of specialist therapies and prescribed medication;
• electronic clinical record systems and other IT systems to manage patient pathways and assess effectiveness of treatments, e.g. audit;
• roles of regulatory agencies involved in drug use, monitoring and licensing, e.g. Royal College Clinical Guidelines, Medical Device Directorate (MDD), NICE, Committee on Safety of Medicines (CSM), Medicines and Healthcare Products Regulatory Agency (MHRA) and hospital formulary committees.

Clinical Therapies

• micro-pigmentation to enhance the reconstructed defect site, e.g. nipple areola complex skin re-colouration;
• surface laser treatments for skin abrasion/disruption of scar formation;
• the range of clinical pathways for patients using the services delivered in the area(s) of expertise;
• the patient treatment expectations, physical requirements, cultural and environmental sensitivities and aspirations;
• local and national policies, regulatory and scope of practice boundaries relating to the services provided by Reconstructive Science, innovation and development, and their impact on current and future patient pathways;
• implications of patient access to records and clinical information for inter- professional practice and multidisciplinary care;
• complementary health and care services currently used by or available for relevant patient groups and the underpinning evidence base;
• remain up to date with therapeutic alerts and respond appropriately.

Technical and clinical skills

By the end of this module the Clinical Scientist in HSST will be expected to reflect critically on their practice and knowledge of therapeutic devices and prescribed topical treatments used in Reconstructive Science. They will be expected to apply in practice a range of clinical and communication skills to advise and communicate effectively with patients, carers, medical and dental clinicians and other healthcare professionals within the MDT and will:

Therapeutic Splinting

• identify where therapeutic treatment may, in conjunction with the patient choice, offer benefits to the patient, and apply a full and focused patient assessment;
• use problem solving and innovation to offer individual solutions to meet specific patient treatment needs;
• recognise the importance of the correct dental or medical pathway/assessment prior to any functional treatments from the Consultant Clinical Sciencist in Reconstructive Science, e.g. dental assessment prior to provision of a mandibular advancement device;
• inform the MDT of the treatment and make contemporaneous records;
• follow up and record the progress of any treatment and outcomes;
• take the findings of the treatment back to the MDT for peer review;
• identify any breakthrough treatments, disseminate and promote best practice throughout the NHS;
• develop correct patient pathways to provide the best care for the patient;
• work within clinical boundaries, competencies and the professional code of practice.

Administered Therapeutics

• review and report any adverse drug interactions or long-term effects from the administered patient group directive medications where relevant and within their scope of practice;
• deliver information in a clear manner to stress the importance of and to improve patient compliance, including monitoring and recording treatment progress and outcome;
• provide comprehensible explanations for the use of drugs to the patient and to carers when relevant and within their scope of practice;
• utilise non-medication-based therapeutic interventions and preventative health interventions within the scope of practice;
• remain open to advice from other health professionals on medication issues and respond appropriately.

Clinical Therapies

They will also be able to select, use, interpret and adapt if necessary a range of tools and processes to ensure patient care is safe, effective and meets the needs of the service users and will:

• analyse qualitatively and quantitatively the performance of devices and services, using tools such as:
  • quality of life indices;
  • clinical audit;
  • performance indicators, e.g. national patient safety dashboard indicators;
• analyse and critically appraise changes to services and interventions carried out or supported by Reconstructive Science, considering the perspective of patients, carers and service users affected;
• explain and justify the current clinical interventions, identifying where Reconstructive Science services may be used or changed to improve the patient journey;
• plan, develop and critically evaluate modified or improved clinical investigations, producing valid comparative data with existing procedures, and involving the views of patients, carers and the MDT;
• collect feedback directly from patients, carers and service users, utilising interview or surveys, analyse the feedback and use the feedback to adjust services, ensuring patients are aware of the proposed actions;
• discuss the follow-up, further investigation and/or appropriate treatment of individual patients based on the outcomes of clinical investigations and current best practice/evidence;
• carry out research and development activities in relation to patient pathways and the patient experience.