Advanced Nurse Practitioner JD October 2013 East Cheshire Hospice HK

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1 EAST CHESHIRE HOSPICE (ECH) JOB DESCRIPTION JOB TITLE: DEPARTMENT: ADVANCED NURSE PRACTITIONER CLINICAL SERVICES PROFESSIONALLLY ACCOUNTABLE TO: HEAD OF CLINICAL & OPERATIONAL SERVICES BAND: 6 / 7 DEPENDENT UPON EXPEREINCE AND QUALIFICATIONS DAY TO DAY WORKING RELATIONSHIPS WITH: SENIOR NURSING TEAM, SUNFLOWER CENTRE, MEDICAL AND NURSING TEAM SUMMARY OF POST: To use advanced practice skills to identify, assess, diagnosis, treat and manage patients with palliative needs. The post holder will exercise complex levels of judgment, discretion and decision making in clinical care. He / She will monitor and improve standards of care through goal setting, use of advanced care planning and other best practice tools and measurable outcomes. The post holder will make appropriate use of the latest evidence to supervise practice, audit clinical care, teach and support professional colleagues and to provide skilled professional leadership. He / She will bring a proactive influence to multidisciplinary team meetings. The post holder will be expected to champion innovative practice within the field of hospice and end of life care. They will work closely with the Head of Clinical & Operational Services, the Hospice Director and medical team to develop the advanced practice role. The advanced practitioner will demonstrate and work at an advanced practice level applying their extended knowledge and skills in the principles and practice of palliative care to support patients with the most complex needs. Working as an independent practitioner the post holder is accountable and responsible for their own actions or omissions in line with the Nursing and Midwifery Councils Code and latest guidance on advanced nursing practice. Scope and Accountability The Advanced Nurse Practitioner is a member of the wider hospice team and is required to: Operate in line with the ECH values and principles. Practice within the NMC Code and adheres to all relevant professional, legal and regulatory guidelines.

2 Develop role within the Scope of Professional Practice and guidance on advanced practice. Assume responsibility for own professional development and update and maintain own clinical skills as required for the role. Provide a visible clinical profile, having both an advisory and clinical input into patient care as directed by Hospice Director & Head of Clinical & operational services. Provide specialist advice and support to client group and carers. Acts as a role model professionally and behaviourally. Work with the multi-professional team and clinical/non clinical services team to promote and develop a learning culture within the Hospice Work with the ECH Services Clinical Leadership Group/Management Forum, to co-ordinate all education and training within the Hospice Promote and foster high standards of education and evidence based practice for all staff involved in patient care Work collaboratively to develop an integrated approach to palliative care education and development with all stakeholders. These include CCGs; Social Services; Cheshire East and Central End of Life Care Team: CHE Develop educational programmes that will help to meet the needs identified within the national End of Life Care Strategy and local implementation plans. Work in partnership with all allied Health professionals across ECH, to support and assist with their continued development and learning. Key Tasks and Responsibilities To be responsible for setting, implementing and monitoring standards of patient care in line with the philosophy and principles of palliative care. To contribute to the delivery of the East Cheshire Hospice Mission Statement. Works as part of a Specialist Palliative Care Team, demonstrating expert clinical leadership and practice. Carry out a high standard of clinical assessment using emerging advanced practice knowledge and skills, increasingly determining and providing clinical management plans treatment / interventions, as appropriate. Manages an increasing caseload of patients with supervision from a mentor and increasingly wherever clinical needs require. Maintains clinical records in line with hospice and NMC guidance. To develop with supervised training, advanced clinical judgment to plan, implement and evaluate care for patients with complex palliative needs in clinic, in patient and community settings. Learns to anticipate problems and risks and takes action before crises arise. Gains knowledge and skills, qualifies and registers as an independent prescriber, in order to be able to prescribe safely accordance with local policies, national standards and formularies relating to independent prescribing.

3 Acquire knowledge and skills to influence the setting of standards of practice, and to participate in the monitoring of standards to ensure best practice and the delivery of evidence based and cost effective care. Provides a source of expertise to all health care practitioners, including undertaking joint assessments as required. Identifies clinical issues and incidents within the specialty that may affect the quality of palliative care services. Working with the Ward Manager and Consultant to ensure the delivery of a safe effective service. Ensures Senior Nurse Managers and nursing and therapy colleagues are aware of clinical activity ensuring the role links appropriately with all other nursing and therapy interventions in the best interests of patients In order to meet the objectives the post holder will have responsibilities in four main areas of work as follows: 1. Clinical 2. Managerial 3. Teaching 4. Research Within these areas specific responsibility will be as follows: 1) Clinical Provide clinical excellence and leadership in palliative care, acting as a role model and resource for other staff on the unit. Assess, diagnose, plan and implement programmes of evidence based care and treatment for patients with the support of the medical team. Admit, refer and discharge patients in accordance with hospice policy and procedures. Provide specialist advice and support to patients and carers. Provide a visible clinical profile, having both an advisory and clinical input into patient care thus providing support to the multi-disciplinary team and facilitating the clinical development of registered nurses, health care assistants, other members of the multi-professional team and students on placement. When registered with MDGH Pharmacy the post holder will act as an independent and supplementary prescriber. In undertaking this role the post holder will follow the ECH Independent Nurse Prescribing and Supplementary Prescribing policy and procedures. When registered with MDGH Pharmacy as an Independent Prescriber the post holder will conduct nurse led admissions in line with hospice policy. Encourage practice development utilising research and evidence based findings.

4 Promote a multi-professional approach to care by facilitating communication and co-operation between all East Cheshire Hospice departments. Review the outcomes of treatment and care in conjunction with the other members of the multidisciplinary team. Ensure that the service reflects the Hospice philosophy in accordance with the Mission Statement, underpinned by the Hospice policies and procedures and statutory legislation. Ensure safe custody and administration of drugs in accordance with good practice, Hospice policies and procedures, Nursing and Midwifery Council and regulatory and legal requirements. Ensure that relevant Hospice policies and protocols are up to date and commensurate with evidence based practice, regulatory and legal requirements. Leads medicines management and incident review quarterly meetings providing report and recommendations to clinical governance committee. Maintains links with other Palliative Care Specialists in order to share or learn from examples of good practice. Learns skills to critically evaluate relevant research findings in order to develop current and future practice. 2) Managerial Demonstrate clear, supportive and effective leadership. Ensure all staff are aware of their role and responsibilities. Undertake regular performance review and appraisal and maintain the implementation of personal development plans. Attend, and participate in, appropriate management meetings and other relevant committees as required. Demonstrate vision to develop the services. Seek opportunities to lead and support quality initiatives. Work within the guidelines laid down by the Nursing and Midwifery Council s Code of Professional Conduct. Maintain current registration with the Nursing and Midwifery Council. Lead and monitor new service developments. Maintain own awareness of, and comply with, policies and procedures relating to Health and Safety, whether statutory or Hospice, and assist in ensuring the compliance of other staff. Access clinical supervision and study for own practice with agreement from Service Managers. Manage own time and work effectively to meet the objectives, skills and competencies required for the role. Develop as a proactive member as part of the senior clinical team in ensuring the totality of hospice skills are used to best effect to ensure appropriate and timely responses for patients. Make proactive use of the coordinating Centre and single point of referral to ensure skills, expertise and use of hospice and professional resources are best utilized in the patient s interest. Proactively learns about the local policies of partner organizations with regards to care practices, treatments and prescribing formularies.

5 3) Teaching 4) Research Create and promote a learning environment by maximising teaching and learning opportunities for all nursing and care staff. Participate in education programmes within and outside the Hospice as required. Participates in formal and informal reviews of palliative care. To be aware of professional responsibilities and comply with all policies, standards and guidelines. Understands and complies with guidance surrounding Advanced Practice. To be aware of one s own continuous professional development needs and maintain an annual personal development plan. To work in partnership with local, national and regional palliative forums to enhance practice in palliative and end of life care. Develop knowledge and skills to act as a resource and advisor in relation to Palliative Care Management for Community Trust colleagues, GP s and hospital Trust, care home staff. Assist staff in developing their skills in the understanding and use of research to inform practice. Ensure all clinical decisions are evidence based and to assist staff in bridging the theory/practice gap. Develops further knowledge and understanding of audit and research processes and demonstrates this by application to the delivery of high quality, clinically effective care in practice. Lead on audits and evaluation of work that may be required to develop and improve palliative/end of life care. Communication and key working relationships ECH Director External Head of Clinical & Operational Services Medical Director Work closely with key inpatient and Sunflower service staff to ensure excellent care delivery research based Work closely with the inpatient manager/sisters, allied health professionals across the organisation to provide clinical mentorship/facilitation of learning Multi Professional Team Head of Fundraising Maintains effective communication through clinical governance committee Ensures effective network working relationships and communication with Nursing/ AHP colleagues and relevant organisations, primary care, cancer network and other hospices. General Practitioners

6 District Nurses Community and hospital based Macmillan Nurses Present at professional and public forums regarding the role within specialist palliative care and the organisation as required Professional To practice safely according to all East Cheshire Hospice policies, procedures and competencies. To be responsible for maintaining a personal awareness of professional developments in nursing in general but particularly in palliative care To undertake relevant further personal education and development necessary to performing the role. To be available for professional advice and career development for other practitioners. To assist with Professional Development/Appraisals of staff linking to ECH business objectives Demonstrate a commitment to ECH Core Beliefs and Values Health and Safety Complies with all aspects of the Health and Safety at Work Etc Act 1974 and with ECH current Health and Safety Policies. Under the provisions of the Health and Safety at Work Act 1974, it is the duty of every employee I. To take reasonable care of themselves and others at work II. To co-operate with the ECH as far as is necessary to enable them to carry out their legal duty III. Not to intentionally or recklessly interfere with anything provided, including personal protective equipment, for health and safety or welfare at work. Key Competencies and Skills Requirements Qualifications i) RN1: Adult Nurse, Level 1 on the Nursing and Midwifery Council s Register ii) 5 years post registration experience, two of which should have been in a specialist palliative care setting iii) 2 years management experience iv)courses: Recognised Teaching Mentorship Course Degree in Palliative Care or other relevant subject, if degree is not in palliative care a recognised course in this area Independent and Supplementary Non-Medical Prescribing Principles of Physical Assessment and diagnosis

7 Requirements Education and Qualifications RN1: Adult Nurse, Level 1 on the Nursing and Midwifery Council s Register Relevant degree Recognised palliative care course if degree not in palliative care Recognised teaching/mentorship qualification Independent and supplementary non-medical prescribing Principles of Physical Assessment and Diagnosis Experience 5 years post registration 2 years in specialist palliative care 2 years in management position Demonstrable service development Teaching Demonstrable change management Budgetary awareness/control Experience as Clinical Nurse Specialist Skills, Knowledge and Special Aptitudes Demonstrable advanced clinical nursing skills in palliative care Demonstrable ability to make clinical decisions and to develop others in this area Demonstrable people management skills including: Motivation of staff and team building Decision making Clinical leadership Staff development Conflict and problem solving Expanding skills and knowledge of others Initiating and managing change Team player Understanding of current issues and initiatives relating to palliative care IT skills Cannulation skills

8 Flexibility The post holder is expected to work flexibly to be able to meet the challenges and opportunities of working within East Cheshire Hospice. This job description is a guide to the work you will be required to undertake. It may be changed from time to time to meet changing circumstances. It does not form part of your Contract of Employment.

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