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39 112 : 1< = > Position Title Classification Award Department Responsible to Hours of Work OVERVIEW: Nurse Practitioner - Aged Care Registered Nurse Division 1, Grade 6 (NBV authorised NP - substantive salary for NP candidate) Nurses (Victoria) Award Across all RNH Campus and Wards Director of Nursing As per individual contract in line with Department rosters or hours of operation 4 A Nurse Practitioner is a registered nurse educated and authorised to function autonomously and collaboratively in an advanced and extended clinical role. The Nurse Practitioner role includes assessment and management of clients using Nursing knowledge and skills and may include but is not limited to, the direct referral of patients to other health care professionals, prescribing medications and ordering diagnostic investigations. The Nurse Practitioner role is grounded in the nursing profession s values, knowledge, theories and practise and provides innovative and flexible health care delivery that complements other health care providers. The core role and practice standards for the NP build upon existing standards of advanced practice nursing and relate to three core areas: Dynamic practice that incorporates application of high level knowledge and skills in extended practice across stable, unpredictable and complex situations. Professional efficacy whereby extended practice is structured in a nursing model and enhanced by autonomy and accountability. Clinical leadership that influences and progresses clinical care, policy and collaboration through all levels of health service. The nurse practitioner is a clinical leader with a readiness and an obligation to advocate for their client base and their profession at the systems level of health care. The NP candidate role aims to prepare the nurse for endorsement as a NP with the Nurses Board of Victoria in these domains. There is a significant ageing population with in the RNH catchment with 41-50% of the Yarriambiack Shires population predicted to be over 65 Australian Nursing and Midwifery Council (ANMC) (2006). National Competency Standards for the Nurse Practitioner..&

40 years of age by 2016 (ABS). RNH has 93 aged care beds and many frail aged living at home in the community. ROLE: The primary purpose of the Aged Care NP is to ensure the provision of appropriate accessible, timely and comprehensive assessment, diagnosis, treatment and co-ordinated care planning for the ageing population of RNH community, across the continuum of care 5. The Aged Care Nurse Practitioner, acting within their scope of practice, will provide high level specialised knowledge in aged care and to work collaboratively to meet the needs of this ageing population. Provide a collaborative practitioner to address the therapeutic need. Order a pre-determined range of diagnostic tests and interpret results Prescribe a pre-determined range of medication to ensure timely treatment is commenced Admit and transfer clients to enhance timely appropriate treatment Provide comprehensive assessment, develop multi-disciplinary care plans and provide career education and support, to sustain ageing in place. Develop a consultation role to other members of the multidisciplinary team Mentor and deliver ongoing staff education (nursing, medical, allied health) to build up the knowledge, understanding and evidence base of practice for caring for the aged across the continuum of care. Provide and support the management of high level, comprehensive, multi disciplinary cycles of care for the aged. To identify and manage programs to address adverse events that can be prevented and/or detected early such as pressure areas, pain, falls, dehydration, unexplained weight loss and others related to geriatric syndromes. KEY SELECTION CRITERIA: QUALIFICATIONS/EXPERIENCE EsEssential Division 1 Registered Nurse holding registration with Nurse Board Victoria or eligible for same Post Graduate Qualifications relevant to specialty area (aged care nursing) Continuum of care is the provision of care that includes primary level care beginning with the promotion of good health and keeping people healthy and at home; secondary level care, focused on the early detection of disease and prompt response; and finally tertiary level care which focuses on timely intervention to treat disease and limit any progression,. The continuum of care encompasses the principles of improving, maintaining and enhancing health, wellbeing and quality of life for the population.

41 Desirable Minimum 3-5 years post graduate experience in the defined specialty area deemed relevant to the NP category for which endorsement will be sought (aged care nursing) Unit in Pharmacology in advanced clinical practice (Flinders) OR Therapeutic medication management Unit/Education program (Monash/ Melbourne) or equivalent OR willingness to undertake same Masters in clinical specialty OR willingness to undertake same OR willingness to undertake Masters of Nursing (Nurse Practitioner). NP credentialing with relevant professional nursing organisation OR working towards same Highly developed communication, liaison, interpersonal and negotiation skills. Demonstrated ability and willingness to work within a multidisciplinary service delivery framework Sound advanced level clinical knowledge, skills and experience Strong leadership skills and the demonstrated ability to lead a team Demonstrated working knowledge and understanding of relevant Aged Care Acts and legislation Membership of professional nursing organisation Competence in utilising computer technology Experience in undertaking quality assurance and/or research projects Experience in developing and delivering education Current drivers licence and ability to undertake travel across the Wimmera-Mallee region KNOWLEDGE: SKILLS: Knowledge of clinical practice issues in gerontic nursing Evidence of ongoing professional development since qualification Knowledge of aged care and other industry accreditation standards Knowledge of nursing standards and scope of practice Knowledge of customer service principles Ability to communicate (written and oral) Ability to make significant contribution to, facilitate and enhance the interdisciplinary team, including the ability to supervise other direct care staff Ability to assist with the resolution of conflict Ability to problem solve, confront issues and provide effective feedback to other staff Demonstrated organisational and time management skills '

42 Ability to work with individuals and groups to achieve common goals Ability to maintain professional standards and to evaluate own professional practice BEHAVIOURS: EMPLOYEE OBLIGATIONS: INDUSTRY STANDARDS: PERFORMANCE APPRAISAL: A positive approach to all aspects of patient and resident care A positive approach to ongoing self education and skill development A flexible and team orientated approach A positive approach to managing change Respect for diversity in values, customs and beliefs Willingness to teach and guide other staff Understand and adhere to Rural Northwest Health policy, in particular, confidentiality, security, OH&S, mandatory training, infection control and quality improvement Understand and adhere to relevant industry Standards, Acts and Regulations. Three month post appointment and then each year Compiled: 5 January 2009 Issue No: 1 Authorised: DON Review Date: March 2011 Re-issue Date: March 2008

43 KEY RESPONSIBILITIES / PERFORMANCE INDICATORS Nurse Practitioner performance objectives and performance indicators based on ANMC competency standards for NPs 6 Performance Objectives Performance Indicators To provide accessible, appropriate, timely and comprehensive specialised aged care services for the ageing community of RNH across the continuum of care. Service provision includes assessment of health status, diagnosis, multi-disciplinary treatment and care planning, ongoing management, discharge planning and referral to other professionals and community agencies; for the aged in acute wards, aged care facilities and primary care programs. STANDARD 1 Dynamic practice that incorporates application of high-level knowledge and skills in extended practice across stable, unpredictable and complex situations Competency 1.1 Conducts advanced, comprehensive and holistic health assessment relevant to a specialist field of nursing practice 1.1 Performance indicators Demonstrates advanced knowledge of human sciences and extended skills in diagnostic reasoning Differentiates between normal, variation of normal and abnormal findings in clinical assessment Rapidly assesses a patient s unstable and complex health care problem through synthesis and prioritisation of! Australian Nursing and Midwifery Council (ANMC) (2006). National Competency Standards for the Nurse Practitioner. Accessed July 2008 from

44 historical and available data Makes decisions about use of investigative options that are judicious, patient focused and informed by clinical findings Demonstrates confidence in own ability to synthesise and interpret assessment information including client/patient history, physical findings and diagnostic data to identify normal and abnormal states of health and differential diagnoses Makes informed and autonomous decisions about preventive, diagnostic and therapeutic responses and interventions that are based on clinical judgment, scientific evidence, and patient determined outcomes Competency 1.2 Demonstrates a high level of confidence and clinical proficiency in carrying out a range of procedures, treatments and interventions that are evidence based and informed by specialist knowledge 1.2 Performance indicators Consistently demonstrates a thoughtful and innovative approach to effective clinical management planning in collaboration with the patient/client Exhibits a comprehensive knowledge of pharmacology and pharmacokinetics related to a specific field of clinical practice Selects/prescribes appropriate medication, including dosage, routes and frequency pattern, based upon accurate knowledge of patient characteristics and concurrent therapies Is knowledgeable and creative in selection and integration of both pharmacological and nonpharmacological treatment interventions into the management plan in consultation with the patient/client Rapidly and continuously evaluates the patient/client/ s condition and response to therapy and modifies the management plan when necessary to achieve desired patient/client outcomes Is an expert clinician in the use of therapeutic interventions specific to, and based upon, their expert knowledge of specialty practice Collaborates effectively with other health professionals and agencies and makes and accepts referrals as appropriate to specific model of practice Evaluates treatment/intervention regimes on completion of the episode of care, in accordance with patient/client determined outcomes

45 Competency 1.3 Has the capacity to use the knowledge and skills of extended practice competencies in complex and unfamiliar environments 1.3 Performance indicators Actively engages community/public health assessment information to inform interventions, referrals and coordination of care Demonstrates confidence and self-efficacy in accommodating uncertainty and managing risk in complex patient care situations Demonstrates professional integrity, probity and ethical conduct in response to industry marketing strategies when prescribing drugs and other product. Uses critical judgment to vary practice according to contextual and cultural influences Confidently integrates scientific knowledge and expert judgment to assess and intervene to assist the person in complex and unpredictable situations Competency 1.4 Demonstrates skills in accessing established and evolving knowledge in clinical and social sciences, and the application of this knowledge to patient care and the education of others STANDARD 2 Professional efficacy whereby practice is structured in a nursing model and enhanced by autonomy and accountability Competency 2.1 Applies extended practice competencies within a nursing model of practice 1.4 Performance indicators Critically appraises and integrates relevant research findings in decision making about health care management and patient interventions Demonstrates the capacity to conduct research/quality audits as deemed necessary in the practice environment Demonstrates an open-minded and analytical approach to acquiring new knowledge Demonstrates the skills and values of lifelong learning and relates this to the demands of extended clinical practice 2.1 Performance indicators Readily identifies the values intrinsic to nursing that inform nurse practitioner practice and an holistic approach to patient/client/community care Communicates a calm, confident and knowing approach to patient care that brings comfort and emotional support to the client and their family Demonstrates the ability and confidence to apply

46 extended practice competencies within a scope of practice that is autonomous and collaborative Creates a climate that supports mutual engagement and establishes partnerships with patients/carer/family Readily articulates a coherent and clearly defined nurse practitioner scope of practice that is characterised by extensions and parameters Competency 2.2 Establishes therapeutic links with the patient/client/community that recognise and respect cultural identity and lifestyle choices Competency 2.3 Is proactive in conducting clinical service that is enhanced and extended by autonomous and accountable practice 2.2 Performance indicators Demonstrates respect for the rights of people to determine their own journey through a health/illness episode while ensuring access to accurate and appropriately interpreted information on which to base decisions Demonstrates cultural competence by incorporating cultural beliefs and practices into all interactions and plans for direct and referred care Demonstrates respect for differences in cultural and social responses to health and illness and incorporates health beliefs of the individual/community into treatment and management modalities 2.3 Performance indicators Establishes effective, collegial relationships with other health professionals that reflect confidence in the contribution that nursing makes to client outcomes Readily uses creative solutions and processes to meet patient/client /community defined health care outcomes within a frame of autonomous practice Demonstrates accountability in considering access, clinical efficacy and quality when making patient-care decisions Incorporates the impact of the nurse practitioner service within local and national jurisdictions into the scope of practice Advocates for expansion to the nurse practitioner model of service that will improve access to quality, cost-effective health care for specific populations STANDARD 3 Clinical leadership that influences and progresses!

47 clinical care, policy and collaboration through all levels of health service Competency 3.1 Engages in and leads clinical collaboration that optimise outcomes for patients/clients/communities Competency 3.2 Engages in and leads informed critique and influence at the systems level of health care 3.1 Performance indicators Actively participates as a senior member and/or leader of relevant multidisciplinary teams Establishes effective communication strategies that promote positive multidisciplinary clinical partnerships Articulates and promotes the nurse practitioner role in clinical, political and professional contexts Monitors their own practice as well as participating in intra- and inter-disciplinary peer supervision and review 3.2 Performance indicators Critiques the implication of emerging health policy on the nurse practitioner role and the client population Evaluates the impact of social factors (such as literacy, poverty, domestic violence and racial attitudes) on the health of individuals and communities and acts to moderate the influence of these factors on the specific population/individual Maintains current knowledge of financing of the health care system as it affects delivery of care Influences health care policy and practice through leadership and active participation in workplace and professional organisations and at state and national government levels Actively contributes to and advocates for the development of specialist, local and national, health service policy that enhances nurse practitioner practice and the health of the community Training and Development Recognises the need for ongoing commitment to personal and professional development Keeps informed about current clinical practice and research in mental health care Maintains competence Occupational Health and Safety Demonstrates evidence of ongoing education Attends all mandatory training sessions as deemed necessary for the position. Completes mandatory competencies Maintains Nurse Practitioner credentialing with relevant professional body Maintains up-to-date evidence based practice clinical practice guidelines Ensures compliance with Workcover regulations and Recognises the need for self care and acts to promote $

48 other occupational health and safety legislation / initiatives Maintains current knowledge of RNH emergency procedures same Attends annual fire and evacuation training Reports any incidents / matters which affect the health and safety of the work environment Organisational Improvement Embraces the RNH s Mission, Vision and Value statements to direct work practices Contributes to achieving the RNH Strategic Plan Promotes a quality culture within the organisation highlighting the values of customer service Acts to positively promote RNH both internally and externally Participates in annual development of a quality plan Identifies achievements and outcomes annually for reporting in department business Seeks feedback from clients of service and follows up all related complaints Actively contributes to the accreditation program Risk Management Complies with the RNH risk management policy Participates with the implementation of strategies to reduce risks / potential risk in the work setting Identify potentially harmful situations arising from caring for clients/resident/patients within the relevant environments Reports any identified or potential risks Keeps informed about RNH policies and procedures Complies with all relevant legislation Participates in critical incident reviews Implements remedial actions in response to potentially harmful situations arising from caring for clients Information Management Maintains appropriate communication channels Utilises effective written and verbal communication methods Ensures medical records are maintained and kept safely and utilized in accordance with legislative requirements, RNH policy and procedure and the Australian Standards for Medical Records Collect and provide data as required within the Health Service agreed targets and Key Performance Indicators (KPI s) Attends scheduled committee and other meetings as required. Provides verbal/written reports to committee meetings and as identified Provides data related to targets and KPI s 3

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