Scope of Work: The TFU Head Nurse is responsible for the overall supervision, coordination, and management of all nursing activities in the TFU, including nursing staff, cleaners, and guards, and ensuring the provision of high-quality nursing and nutritional care for SAM children in accordance with IMAM protocols.
Responsibilities:
Apply medical and nutritional protocols to ensure the care of the IPD SAM children in TFU. Ensure implementation and supervision of Infection Prevention and Control (IPC) measures and patient safety standards within the TFU according to national and WHO guidelines.
Provide nursing care, treatment, and follow-up for children suffering from severe malnutrition with medical complications, according to IMAM treatment protocols, universal hygienic standards, and other procedures, in order to ensure a good delivery of care and improve their nutritional condition.
Providing preventive and curative health care to patients admitted to the TFU:
Admission of children:
Understanding and applying the National admission criteria
In collaboration with the nutrition worker:
• Measuring (MUAC, Z. Score) of the children and detecting the presence of Edema.
• Identifying the degree and types of malnutrition.
• Note admissions in the register with all the requested information.
• Informing mothers of the child's condition and results.
• Drawing up nutritional surveillance forms and milk cards for the children.
• Tracing the children’s weight-target line and noting their temperatures.
• Administering treatment prescriptions after medical consultation.
• Checking the children’s vaccination status, referring them to the vaccination station if necessary.
• Explaining to mothers what hospitalization involves and providing advice if required.
• Ensure proper preparation, administration, and monitoring of therapeutic milk (F-75 and F-100) according to WHO and national IMAM/CMAM guidelines for the management of Severe Acute Malnutrition (SAM).
• Administer therapeutic milk in the correct dosage, frequency, and timing as prescribed, based on the child’s weight and treatment phase.
• Monitor and record the child’s tolerance to therapeutic milk, including vomiting, diarrhea, poor appetite, aspiration risk, or feeding complications, and immediately report abnormalities to the medical doctor.
• Maintain strict hygiene and Infection Prevention and Control (IPC) standards during preparation, handling, storage, and feeding of therapeutic milk.
• Ensure accurate documentation of milk intake/output, feeding schedules, and patient progress in TFU monitoring charts and medical records.
• Ensure safe storage and proper stock management of F-75, F-100, ReSoMal, and feeding materials to avoid contamination, wastage, stock-outs, and expiry.
• Educate caregivers on appropriate feeding practices, breastfeeding support, and nutritional care during the child’s admission and discharge process.
• Participate in routine monitoring of feeding practices and support quality improvement measures within the TFU.
Medical follow-up:
• Ensuring medical parameters are taken (temperature, heart and respiratory rate, weight, weight/height accordance, presence of oedemas, etc.) following the protocols in use, noting the results on the corresponding forms in the patients’ files.
• Taking part in the daily medical round and noting changes in prescriptions according to the patients’ state.
• Checking the prescriptions are signed and dated.
• Distributing treatments according to individual medical prescriptions, following doses, administration methods, and timing, and signaling any problems.
• Ticking off and counter-signing treatments taken in the medical files.
• Ensuring external care and dressing, referring the children for complementary examinations if required.
• Following the rules of hygiene and asepsis during the delivery of all health care (washing hands, sorting waste, management of accidental blood exposure, etc.).
• Detecting all anomalies in the children’s health and behavior, providing first aid whilst waiting for a doctor to arrive.
Nutritional follow-up (in collaboration with the nutrition worker):
• Inserting a naso-gastric tube for feeding, responsible for checking the correct position before feeding, evaluating, and notifying of any complications.
• Establishing the children’s food ration according to their weight and degree of malnutrition.
• Informing mothers about the importance of meals.
• Informing mothers about the children’s diets and the number and frequency of meals.
• Encouraging mothers to continue breastfeeding during hospitalization.
• Inciting mothers to give the children liquid intake.
• With the nutrition worker being present and ensuring that the children eat all their meals correctly.
• Noting the quantities absorbed and any identified problems (vomiting, diarrhea, etc.).
• Watching over the weight curves.
• Ensuring the children's correct and regular growth by examining their weight curves.
• Identifying all anomalies in the curves and informing the doctor in case of weight loss.
• Organizing daily information and education sessions in the TFU.
Discharge of the children from TFU:
• Managing the children’s discharge according to the criteria set out in the protocol and after medical agreement.
• Measuring the children’s brachial perimeters.
• Weighing and measuring the children to calculate weight/height ratios.
• Checking that oedemas have disappeared.
• Reporting all this information on the follow-up forms and noting exits in the register.
• Providing handover notes on each team changeover.
• Informing mothers of measures to be taken and giving them nutritional advice adapted to the state of their children.
• Managing the premises, medicines, and medical equipment.
• Being responsible for the material used.
• Ensuring the follow-up of medicine consumption during the inpatient phase, drawing up an order with the supervisor if needed.
• Ensure safe storage, stock monitoring, and proper management of F-75, F-100, ReSoMal, feeding materials, and related supplies.
• Handing over pharmacy and consumable medical equipment on each team changeover.
• Prepare Oral Rehydration Solution daily, following correct doses, dilution, and storage conditions.
• Ensuring cleanliness of premises and work surfaces.
Communication, teamwork and supervision:
• Introduce yourself to each patient, be polite.
• Explain how to take prescribed treatment and its importance.
• Always respect medical confidentiality.
• Work in collaboration with the medical and paramedical team.
• Supervise nursing staff and ensure correct execution of tasks under your responsibility.
• Coordinate daily work of nurses and support staff.
• Organize and manage training sessions if required.
• Ensure written and oral handovers within the team and between shifts.
• Participate in departmental meetings and ongoing training sessions.
• Use language that the translator can understand.
• Ensure good communication with the team.
• Report problems encountered in the centre or within the team to the TFU Head.
Objective 4: Recording and Reporting
• Being responsible for the correct upkeep of registers and hospitalization forms.
• Participate in daily data collection (admissions, discharges, morbidity, etc.).
• Participate in calculation and analysis of weekly statistics (weight gain, length of stay, etc.) with medical team.
• React as necessary according to results.
• Follow national protocols and guidelines.
• Participate in weekly/monthly reporting of TFU activities.
• Support organization of transfers if needed (transport, documents).
• Supervise accuracy and completeness of nursing data reporting.
