*********PLEASE COMPLETE THE APPLICATION FORM FULLY, CV'S ARE NOT ACCEPTED********** Principal Duties and Responsibilities The Clinical Nurse/Midwife Specialist (Infant Feeding/Lactation) practice will be based on the five core concepts of the CNSp/CMSp role as defined by the NCNM 4th edition(2008) in order to fulfil the role.
The concepts are:
Clinical Focus Patient/Client Advocate Education and Training Audit and Research Consultant Clinical Focus The Clinical Nurse/Midwife Specialist (Infant Feeding/Lactation) will have a strong patient focus whereby the specialty defines itself as nursing/midwifery and subscribes to the overall purpose, functions and ethical standards of nursing/midwifery.
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 The Clinical Nurse/Midwife Specialist (Infant Feeding/Lactation)will: Articulate and demonstrate the concept of nursing and midwifery specialist practice within the framework of relevant legislation, the Scope of Nursing & Midwifery Practice Framework (NMBI, 2015), The Code of Professional Conduct and Ethics (NMBI 2021) and Midwives Practice Standards 2022. Provide a specialist nursing/midwifery breastfeeding resource to mothers who are breastfeeding and expectant mothers. Accept referrals from midwifery, nursing, dieticians, pharmacists, social workers and medical staff in the hospital and community including those working in the Antenatal Clinic, Antenatal ward, Midwifery led Unit, Postnatal Ward, Special Care Baby Unit, Children's Ward, Midwifery Led Unit and Gynaecology Ward.
These mothers will have specific lactation concerns and breastfeeding needs. Following referral, the CMSp/CNSp in collaboration with other members of the team, will assess, plan, implement and evaluate an individualised plan of care to meet each mother's and baby's needs using best evidence based practice. Use the outcomes of assessment to develop and implement plans of care / case management in conjunction with the multi-disciplinary (MDT) and the mother and family as appropriate. Undertake feeding assessments, monitor and evaluate the response to care/ interventions and amend the plan of care accordingly in conjunction with the MDT and the mother and family as appropriate. Make alterations to plan of care in collaboration with the MDT and the mother, and family as appropriate, in line with agreed pathways and policies, procedures, protocols and guidelines (PPPG's). Anticipate the varied needs of mothers' breastfeeding for the first time.
Devise and implement strategy to meet these needs and evaluate their effectiveness. Be responsible for providing support for breastfeeding mothers such as nurse/midwife led drop in clinics, outreach services, phone services and follow-up. Communicate with breastfeeding mothers and families as appropriate to assess their individual needs and provide relevant support, information, education, advice and counselling as required. Integrate cultural, psychosocial, nutritional and pharmacological aspects of breastfeeding in lactation consultations. Work collaboratively with professional colleagues across services and maintaining links with primary care services to provide a seamless service delivery to the mother, baby and family. Identify health promotion priorities for the mother, baby and family and support 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 patients' needs Manage a nurse/midwife led breastfeeding clinic Coordinate and provide lactation support for the ENT tongue tie clinic Participate in medication reconciliation taking cognisance of poly-pharmacy and support medical and pharmacy staff with medication reviews and medication management Ensure that the dignity and confidentiality of the mother and baby is maintained at all times. Provide clinical support to midwives, nurses and medical staff in the protection, promotion and support of breastfeeding. Indirect Care The Clinical Nurse/Midwife Specialist (Infant Feeding/Lactation) will: Identify and agree appropriate referral pathways for mothers with complex needs Participate in case review with MDT colleagues Participate in the maternity Multidisciplinary and clinical governance committees Use a case management approach to patients with complex needs in collaboration with MDT in both Primary and Secondary Care as appropriate Take a lead role in ensuring the service for mothers and babies and expectant mothers is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012) and National Standards for Safer Better Maternity Services (HIQA, 2016) Ensure the service provided meets the standards as set out nationally and internationally, as they apply to the role, for example o National Standards for Infant Feeding in Maternity Services 2022
o Maternity Strategy DOH(2016)
o National Standards for Safer Better Maternity Services (HIQA, 2016)
o National Standards for Safer Better Healthcare (HIQA, 2022)
o National Standards for the Prevention and Control of Healthcare Associated Infections (2017)
Comply with associated HSE protocols for implementing and maintaining these standards. Develop policies and clinical guidelines in breastfeeding management and in related areas based on best available evidence and research. Implement health promotion strategies for patient / client groups in accordance with the public health agenda Implement relevant actions of the HSE Breastfeeding in a Healthy Ireland Health Service Breastfeeding Action Plan 2016 – 2021 (HSE, 2016). Take a proactive role in the formulation and provision of evidence based PPPGs relating to breastfeeding Patient Advocate The Clinical Nurse/Midwife Specialist (Infant Feeding/Lactation) will: Respect and maintain the privacy, dignity and confidentiality of the patient, family and/or carer Develop and support the concept of advocacy by enabling patients / clients, families and communities to participate in decisions about their health needs by providing them evidence based information enabling them to make informed choices. Articulate, negotiate and represent patient / client interests, values and decisions in collaboration with the multidisciplinary team in both primary and secondary care as appropriate. Implement changes in healthcare service in response to patient / client need and service demand. Seek adequate facilities for breastfeeding mothers in hospital and community. 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 Negotiate supports for breastfeeding staff in line with the relevant policies. Education and Training The Clinical Nurse/Midwife Specialist (Infant Feeding/Lactation) will: Maintain clinical competence in lactation/infant feeding, 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 breastfeeding. Contribute to the design, development and implementation of education programmes and resources for the patient, family and/or carer in relation to breastfeeding thus empowering them.
Provide needs-led education for patients/clients and families in relation to breastfeeding. Provide mentorship, preceptorship, teaching, facilitation and professional supervisory skills for nurses and midwives, other healthcare workers including medical nursing and midwifery students relevant to the role.
This is to include provision of breastfeeding skills based training and refresher courses, orientation courses and short teaching sessions. Identify specialist training needs required across the service and deliver such training. Create exchange of learning opportunities within the MDT in relation to evidence based care and practices relating to breastfeeding and human lactation. 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 breastfeeding. Identify own continuing professional development needs and engage accordingly. Engage with the Professional Development Portfolio process Audit and Research The Clinical Nurse/Midwife Specialist (Infant Feeding/Lactation) will: Establish and maintain a register of mothers requiring support within the CNSp/CMSp caseload. Identify, critically analyse, disseminate and integrate nursing/midwifery and other evidence into the area of specialist practice. Introduce, implement and disseminate appropriate audit and research findings. Promote, encourage and participate in research studies relating to lactation issues in midwifery / medical and lactation related care. Participate in organisational audit, to continually evaluate the effectiveness of the service provided against best available evidence and policy. Collate statistics for key performance indicators and monitor adherence to targets by the hospital. Populate the Irish Maternity Indicator System (IMIS) with Infant feeding statistics Use the outcomes of audit to improve service provision. Contribute to service planning and budgetary processes through use of audit data and specialist knowledge. Audit expected outcomes including: Initiate and participate in regular clinical audits in order to address and implement the National Standards for Infant Feeding in Maternity Services 2022 Monitor adherence to statutory and voluntary codes regarding the marketing of infant products. Provide annual reports on Infant feeding and baby friendly Initiative as required by the hospital and hospital group. Evaluate audit results and research findings to identify areas for quality improvement in collaboration with nursing/midwifery management and MDT colleagues (Primary and Secondary Care) Consultant The Clinical Nurse/Midwife Specialist (Infant Feeding/Lactation) will: Provide leadership in clinical practice and act as a resource and role model for specialist practice in infant feeding/lactation, (In some complex cases, mothers and babies may be working towards breastfeeding or using combination of feeding e.g.
pre term or ill infants on specialised feeds and fortifiers in breast milk while mothers are expressing) Generate and contribute to the development of clinical standards of practice and guidelines and support implementation. Use specialist knowledge to support and enhance generalist nursing/midwifery practice. Develop collaborative working relationships with local CNSp/CMSp's/Registered Advanced Nurse/Midwife Practitioner/MDT colleagues as appropriate, developing person centred care pathways Serve on hospital / group /National committees to plan and coordinate activities in relation to National Standards for Infant Feeding in Maternity Services 2022 Serve on Infant Feeding/Baby Friendly committees to include maternity hospital, primary care and voluntary/community representatives. Liaise with service providers in primary care and voluntary/community sector. Where appropriate develop and maintain relationships with specialist services in voluntary organisations which support patients in the community. Network with other CNSp/CMSp's in infant feeding/Lactation and in related professional associations. 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 (2005).
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 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, 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/Midwife Specialist (Infant Feeding/Lactation). Management / Administration The Clinical Nurse/Midwife Specialist (Infant Feeding/Lactation) will: Provide an efficient, effective, and high quality service, respecting the needs of each patient / client. Effectively manage time and caseload in order to meet the needs of a changing and developing service. Continually monitor the service to ensure it reflects current needs. Implement and manage identified changes. Ensure that confidentiality in relation to patient /client records is maintained. Maintain accurate and up to date statistics of the service provided, including audit of patient / client contacts. Represent the specialist service at local, national and international meetings as required. Maintain accurate and contemporaneous records / data on all matters pertaining to the planning, management, delivery and evaluation of this service in line with HSE requirements. Contribute to the service planning process as appropriate and as directed by the DoN/M. 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. 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.