***********PLEASE COMPLETE THE APPLICATION FORM FULLY, CV'S ARE NOT ACCEPTED************* Principal Duties and Responsibilities The post holder's practice is based on the five core concepts of Clinical Nurse Specialist (BowelScreen Endoscopy) role as defined by the NCNM 4th edition in order to fulfil the role.
The concepts are:
• Clinical Focus
• Patient/Client Advocate
• Education and Training
• Audit and Research
• Consultant
Clinical Focus Clinical Nurse Specialist (BowelScreen Endoscopy) will have a strong patient focus whereby the specialty defines itself as Nursing and subscribes to the overall purpose, functions and ethical standards of Nursing.
The clinical practice role may be divided into direct and indirect care.
Direct care comprises the assessment, planning, delivery and evaluation of care to the patient, family and/or carer.
Indirect care relates to activities that influence and support the provision of direct care.
Direct Care Clinical Nurse Specialist (BowelScreen Endoscopy) will: Provide a specialist Nursing service for patients participating in the BowelScreen programme who require support and treatment through the continuum of care. Undertake comprehensive patient assessment to include physical, psychological, social and spiritual elements of care using best evidence-based practice for patients participating in the BowelScreen
programme. Undertake pre-assessment for BowelScreen patients to determine each patient/family needs and to plan and initiate care in collaboration with the patient. Use the outcomes of patient assessment to develop and implement plans of care/case management in conjunction with the multi-disciplinary team (MDT) and the patient, family and/or carer as appropriate. Monitor and evaluate the patient's response to treatment and amend the plan of care accordingly in conjunction with the MDT and patient, family and/or carer as appropriate. Make alterations in the management of patient's condition in collaboration with the MDT and the patient in line with agreed pathways and policies, procedures, protocols and guidelines (PPPGs). Co-ordinate investigations, treatment therapies and patient follow-up. Communicate with patients, family and /or carer as appropriate, to assess patient's needs and provide relevant support, information, education, advice and counselling as required. Be available to attend BowelScreen MDTs and liaise where appropriate with MDT colleagues across Primary and Secondary Care regarding any aspect of patient care, to provide a seamless service delivery to the patient, family and/or carer as appropriate. Provide specialist advice to patients on appropriate products to meet their needs. Participate in medication reconciliation taking cognisance of polypharmacy and support medical and pharmacy staff with medication reviews and medication management. Identify and promote specific symptom management strategies as well as the identification of triggers which may cause exacerbation of symptoms. Provide patients with appropriate self-management strategies and escalation pathways. Manage nurse led BowelScreen polyp conferences with BowelScreen approved endoscopists and histopathologists. Identify health promotion priorities for the patient, family and/or carer and support patient self-care in line with best evidence.
This will include the provision of educational and health promotion material, which is comprehensive, easy to understand and meets patient's needs. Indirect Care Clinical Nurse Specialist (BowelScreen Endoscopy) will: Input and maintain data on the BowelScreen IT system known as COR for all BowelScreen clients. Complete and maintain relevant documentation in a thorough and accurate manner. Provide patients/carers with advice, support and reassurance via telephone calls. Identify and agree appropriate referral pathways for patients participating in the BowelScreen programme. Maintain effective and appropriate communication and collaboration with other departments, members of the MDT, other agencies, colleagues, personnel, patients and their relatives and carers. Participate in case review of BowelScreen patients with MDT colleagues. Use a case management approach to patients with complex needs in collaboration with MDT in both Primary and Secondary Care as appropriate. Take a proactive role in the formulation and provision of evidence based PPPGs relating to BowelScreen care. Take a lead role in ensuring the service for patients with colorectal condition is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, Patient/Client Advocate Clinical Nurse Specialist (BowelScreen Endoscopy) will: Communicate, negotiate and represent patient's family and/or carer values and decisions in relation to their condition in collaboration with MDT colleagues in both Primary and Secondary Care as appropriate. Develop and support the concept of advocacy, particularly in relation to patient participation in decision making, thereby enabling informed choice of treatment options Respect and maintain the privacy, dignity and confidentiality of the patient, family and/or carer. Establish, maintain and improve procedures for collaboration and cooperation between Acute Services, Primary Care and Voluntary Organisations as appropriate. Proactively challenge any interaction which fails to deliver a quality service to patients. Education & Training: Clinical Nurse Specialist (BowelScreen Endoscopy) will: Maintain clinical competence in patient management within BowelScreen nursing, keeping up-to-date with relevant research to ensure the implementation of evidence based practice. Provide the patient, family and/or carer with appropriate information and other supportive interventions to increase their knowledge, skill and confidence in managing their colorectal condition. Contribute to the design, development and implementation of education programmes and resources for the patient, family and/or carer in relation to colorectal disease thus empowering them to self-manage their condition. Provide mentorship and preceptorship for nursing colleagues as appropriate. Participate in training programmes for nursing, MDT colleagues and key stakeholders as appropriate.
Plan and deliver staff teaching in relation to individual setting. Create exchange of learning opportunities within the MDT in relation to evidence based colorectal care delivery through journal clubs, conferences, etc. Develop and maintain links with Regional Centres for Nursing & Midwifery Education (RCNMEs), the Nursing and Midwifery Planning and Development Units (NMPDUs) and relevant third level Higher Education Institutes (HEIs) in the design, development and delivery of educational programmes in colorectal care. Be self-directed in his/her learning to ensure continued professional credibility.
Identify own Continuing Professional Development (CPD) needs and engage accordingly. Audit & Research: Clinical Nurse Specialist (BowelScreen Endoscopy) will: Establish and maintain a register of patients with colorectal disease within Clinical Nurse Specialist Caseload. Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPI's) as directed and advised by the DoN. Identify, initiate and conduct Nursing and MDT audit and research projects relevant to the area of practice. Identify, critically analyse, disseminate and integrate best evidence relating to colorectal disease into practice. Develop and promote research awareness among all staff in relation to colorectal disease.
Contribute to nursing research on all aspects of care. Use the outcomes of audit to improve service provision. Contribute to service planning and budgetary processes through use of audit data and specialist knowledge. Monitor, access, utilise and disseminate current relevant research to advise and ensure the provision of informed evidence-based practice. Review local policies, procedures, guidelines and protocols in relation to the colorectal and BowelScreen service to ensure they are continually updated in line with best practice evidence. Assist with the co-ordination of BowelScreen Service Provider Audits.
Provide reports, audits, local policies and updates to BowelScreen as required. Support JAG accreditation initiatives for the endoscopy service. Audit expected outcomes including: Collate data which will provide evidence of the effectiveness of the Clinical Nurse Specialist (BowelScreen Endoscopy) interventions undertaken to include a breakdown of activity (e.g.
patients seen and treated). Refer to the National Council for the Professional Development of Nursing and Nursing final report - Evaluation of Clinical Nurse and Midwife Specialist and Advanced Nurse and Midwife Practitioner roles in Ireland (SCAPE Report, 2010) and refer to the Guidelines for the Implementation of National GI Endoscopy Quality Improvement Programme and BowelScreen Standards for QA in Colorectal Screening, 3rd edition and other National KPIs associated with the speciality. Evaluate audit results and research findings to identify areas for quality improvement in collaboration with nursing management and MDT colleagues (Primary and Secondary Care). Clinical Nurse Specialist (BowelScreen Endoscopy) will: Provide leadership in clinical practice and act as a resource and role model for BowelScreen practice. Contribute to nursing quality assurance by assisting in identification of recurring nursing problems and data collection. Generate and contribute to the development of clinical standards and guidelines and support implementation. Use specialist knowledge to support and enhance generalist nursing practice. Develop collaborative working relationships with local Clinical Nurse Specialist's/CNMII/Registered Advanced Nurse Practitioner/MDT colleagues as appropriate, developing person centred care pathways to promote the integrated model of care delivery. With the support of the Director of Nursing/ relevant Assistant Director of Nursing, attend integrated care planning meetings as required. Where appropriate develop and maintain relationships with specialist services in voluntary organisations which support patients in the community. Liaise with other health service providers in the development and on-going delivery of the National Clinical Programme's model of care. Health & Safety: These duties must be performed in accordance with local organisational and the HSE health and safety polices.
In carrying out these duties the employee must ensure that effective safety procedures are in place to comply with the Health, Safety and Welfare at Work Act
Staff must carry out their duties in a safe and responsible manner in line with the local policy documents and as set out in the local safety statement, which must be read and understood.
Quality, Risk and Safety Responsibilities It is the responsibility of all staff to:
Participate and cooperate with legislative and regulatory requirements with regard to quality, risk and safety. Participate and cooperate with local quality, risk and safety initiatives as required. Participate and cooperate with internal and external evaluations of the organisation's structures, services and processes as required, including but not limited to, BowelScreen, The National Hygiene Audit, National Decontamination Audit, Health and Safety Audits and other audits specified by the HSE or other regulatory authorities. Initiate, support and implement quality improvement initiatives in their area which are in keeping with local organisational quality, risk and safety requirements. Contribute to the development of PPPGs and safe professional practice and adhere to relevant legislation, regulations and standards. Comply with Health Service Executive (HSE) Complaints Policy. Ensure completion of incident/near miss forms and clinical risk reporting. Adhere to department policies in relation to the care and safety of any equipment supplied and used to carry out the responsibilities of the role of Clinical Nurse Specialist in colorectal care. Specific Responsibility for Best Practice in Hygiene Hygiene is defined as: "The practice that serves to keep people and environments clean and prevent infection.
It involves the study of preserving ones health, preventing the spread of disease, and recognising, evaluating and controlling health hazards.
In the healthcare setting it incorporates the following key areas: environment and facilities, hand hygiene, catering, management of laundry, waste and sharps, and equipment" (HIQA, 2008; P2).
It is the responsibility of all staff to ensure compliance with local organisational hygiene standards, guidelines and practices. Management/Administration: Clinical Nurse Specialist (BowelScreen Endoscopy) will work with the BowelScreen team to
Management of referrals in line with agreed colonoscopy numbers. Provide an efficient, effective and high-quality service, respecting the needs of each patient, family and/or carer. Effectively manage time and caseload in order to meet changing and developing service needs. Continually monitor the service to ensure it reflects current needs. Implement and manage identified changes.
Reporting these to BowelScreen Programme in a timely manner. Ensure that confidentiality in relation to patient records is maintained. Represent the specialist service at local, national and international forum as required. Maintain accurate and contemporaneous records and data on all matters pertaining to the planning, management, delivery and evaluation of care and ensure that this service is in line with HSE requirements. Contribute to the service planning process as appropriate and as directed by the DoN. Have a working knowledge of the Health Information and Quality Authority (HIQA) Standards as they apply to the role for example, Standards for Healthcare, National Standards for the Prevention and Control of Healthcare Associated Infections, Hygiene Standards etc and comply with associated HSE protocols for implementing and maintaining these standards as appropriate to the role. To support, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service. Participate in departmental audits that are required to maintain JAG Accreditation in the endoscopy unit and meet BowelScreen Standards for QA in Colorectal Screening. The above Job Specification is not intended to be a comprehensive list of all duties involved and consequently, the post holder may be required to perform other duties as appropriate to the post which may be assigned to him/her from time to time and to contribute to the development of the post while in office.