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Advance Practitioner

1. JOB IDENTIFICATION (DRAFT AND INCOMPLETE)

Job Title: ADVANCE PRACTITIONER

Responsible to (insert job title): NURSE CONSULTANT

Department(s):

Directorate:

Operating Division:

Job Reference:

No of Job Holders:

Last Update (insert date):

2. JOB PURPOSE

To provide expert clinical case management to children and young people, adults, carers, families and communities within a defined population.

To undertake advanced level assessment in order to address complex health care needs by using expert knowledge and clinical judgement to diagnose, initiating interventions and refer appropriately.

To strategically lead the co-ordination of care, working with partner agencies and key stake holders to ensure effectiveness of outcomes.

To ensure that services are delivered effectively and efficiently against predetermined clinical performance targets.

This will be achieved by working within the seven core elements of nursing in the community; Working directly with individuals and carers, adopting public health approaches to protecting the public, co-ordinating services, supporting self care, multi-disciplinary and multi-agency team working, meeting the health needs of communities and supporting anticipatory care. It will be further enhanced by using a proactive approach to promoting health and wellbeing, detection and prevention of vulnerability, preventing illness, reacting and responding to existing or potential ill health issues and contributing to reduction in unplanned hospital admissions

3. DIMENSIONS

The post holder will be accountable and responsible for the clinical case management of a defined population.

The post-holder will initiate and lead the delivery of planned programmes of care to individuals, families and communities in a variety of settings as part of a multi-disciplinary/multi-agency team.

The post-holder will collaborate with a wide range of statutory and voluntary organisations to maximise the nursing contribution in health improvement, planning and delivery of care to individuals, families and communities.

Ø Population profile to include

Ø Number of practices, AHPs and any Community Hospitals, Care Homes and Social care/specialist

Ø Number and level of staff within team

Ø Budget size and responsibilities

Ø Participate in the activity of the CHP

4. ORGANISATIONAL POSITION

Example

Advanced Practitioner

CHN

Community staff Nurses X

Health Care Assistants X

CHP

Organisational structures

Nurse Consultant



5. ROLE OF DEPARTMENT

The community nursing service forms part of the services provided by (name of CHP) Community Health Partnership. (Name of CHP). The CHP covers (describe the area)


The CHP provides services to around ……………….. people across ………… square miles and includes:

The main functions and objectives of the Community Health Nursing service are to:

Ø Identify, anticipate promote the health care needs of the local population in partnership with colleagues, individuals, families, carers and the local community.

Ø Collaboratively plan and agree interventions through joint decision making with stakeholders.

Ø Evaluate outcomes of planned programmes of care and support.

This will be addressed by a public health approach to the health and well being of individuals, families and communities and within a robust clinical governance framework in line with local needs, priorities and national strategies.

6. KEY RESULT AREAS

Clinical Leadership

Provide strategic clinical leadership in relation to area of speciality, working as an autonomous practitioner.

Work with community nursing team and colleagues to develop, implement and evaluate a clinical case management strategy and actively seek out individuals, families and communities who will benefit from clinical case management.

Lead the co-ordination of the care for people on a defined caseload, demonstrating advance competence in highly complex decision making, assessment and the management of clinical needs within specialist area of practice and refer to specialist services as appropriate.

Provide clinical leadership in workforce planning and skills profiling targeting resources to meet the needs of individuals, families and communities.

Develop effective partnerships and positive working relationships with a variety of internal and external agencies in order to support seamless care provision across all agencies.

Lead appraisal process and PDP in line with the KSF framework and address performance management issues, provide and participate in clinical and peer supervision.

Health Needs Assessment

Undertake age appropriate advanced physical and psychosocial assessment, interpreting clinical and diagnostic findings in order to determine a diagnosis and develop an evidence based plan of care.

Instigate therapeutic interventions and treatments aimed at improving health outcomes and promoting self care, evaluate the effectiveness of interventions, modifying plans for optimal outcomes.

Develop an extensive knowledge of disease processes and consequences and provides expert clinical advice to colleagues, individuals, families and communities.

Provide high level anticipatory care through the early identification of disease exacerbation in order to reduce the likelihood of acute illness, risks and prevent hospital admission.

Applies principles of epidemiology and demography in clinical practice recognising risks, patterns of disease

and work collaboratively with a variety of stakeholders to develop health promotion strategies and reduce health inequalities.

Actively initiate and lead medicine management, review, prescription and adjustment of medicines, facilitating understanding and concordance of patients and their families.

Practice Development:

Lead the development, maintenance and monitoring of service standards ensuring clinical and non clinical practice interventions are based on the most recent evidence available and findings are incorporated into nursing practice.

Demonstrate advanced clinical and non clinical interventions and act as an advisor and educator to

colleagues and a variety of learners in area of speciality.

Supervise and teach learners staff in the community working in collaboration with education providers and other key stakeholders

Ensure expert knowledge, skills and competency are updated and maintained through appropriate CPD, training and development opportunities to enable effective care to be delivered in line with current research based evidence and practice.

Clinical Governance

Initiate and contribute towards research in area of expertise and critically appraise, evaluate and apply knowledge of theoretical frameworks, evidence and research findings within specialist area of practice.

Lead the development of service standards and policy and ensure compliance with legislation, policies and protocols and identify opportunities for the development of service.

Undertake strategic risk assessments and co-ordinate risk management plans that will safeguard protection of public and staff in line with policy.

Maintain contemporaneous and accurate clinical records, recording all patient related activity on the clinical systems /databases in accordance with NMC, national legislation and local and national standards...

Patient and Public Experience:

Develop high level communication strategies to engage individuals, families and communities in an inclusive approach which encourages joint decision making in service delivery, developments and design.

Use extensive practice experience to provide highly skilled competent care to individuals, families and communities displaying sensitivity in enabling them to be competent in self care through education and learning .

Act as an advocate by working in partnership with patients and carers at all levels of care delivery through empowerment and enablement strategies.

Develop systems to signpost, refer, individuals, families, carers and communities to the most appropriate services and agencies.

Review patient and public experience/ feedback and complaints and ensure that outcomes of suggestions and recommendations inform the development of a quality evidence based nursing service.

7a. EQUIPMENT AND MACHINERY and use

Insert as appropriate to work area

Examples:

Child Development assessment /equipment and charts

Scales, hearing equipment, Doppler, Leicester Height Measures, Urinalysis, Vision charts, Specimens, digital camera,

Toys play equipment

Aids and adaptations

Mobile hoists, Beds, rails, lever, wheelchairs, pressure relieving equipment, trolley's, commodes

Treatment equipment

needles and syringes/ drivers

7b. SYSTEMS

  • Community Health Nurse Team Assessment tools and records
  • Joint assessment tools and records with social work and other partners
  • Personally generated notes
  • Electronic and paper record systems
  • Activity recording systems - ISD
  • Workload and staffing profiles
  • Analysis and input SPARRA data
  • Clinical, financial and staff governance audit tools
  • Patient group directives
  • National prescribing centre
  • E-LIBRARY
  • ScotPHO website
  • Intranet Assessment tools and records

8. ASSIGNMENT AND REVIEW OF WORK

The post holder will be responsible for the day-to day prioritisation and organisation of their work and clinical case management of a defined population.

The post holder will work within the broad principles of the seven elements of community health nursing practice and RCN Domains of practice to respond to the needs of the local population, taking into account the strategic priorities of the NHS Board and CHP.

The post holder will be responsible for agreeing key objectives, reviewing performance and supporting professional development.

The Nurse Consultant and local operational manager will be responsible for agreeing key objectives, reviewing performance and supporting professional development.

Workload will be generated by individual, families and community need, self referral, GP's, hospital teams, other health care professionals and other agencies based in the community

9. DECISIONS AND JUDGEMENTS

  • Autonomous practitioner uses expert knowledge and clinical judgment skills to plan and provide advanced nursing
  • practice.
  • Advanced level physical and psychosocial assessment skills to inform diagnosis and interventions.
  • Interprets highly complex information with the support of relevant tools to inform service delivery, development and
  • design.
  • Uses high level decision to inform use of financial resources, efficacy and quality of service provision
  • Reviews best practice and disseminates and promotes the development of evidence based practice.
  • Strategically negotiates and collaborates with a wide range of stakeholders to enable joint planning, decision making and interventions in the best interests of the service and service users.
  • Ensures caseload activity work across the seven elements of practice
  • Recognises limitations and determines when to refer or signpost to other healthcare professionals and statutory

and independent services.

10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB

  • Demonstrating advance competence in highly complex decisions
  • Interpret highly complex information
  • Assessing and developing plans to address the health needs of people in complex care situations.
  • Being able to co-ordinate high quality care in a range of settings
  • Develop an extensive knowledge of disease processes
  • Provide expert clinical advice to colleagues, individuals, families and communities. .
  • Applies principles of epidemiology and demography in clinical practice
  • Change management, management of people, facilitating good performance and conduct
  • Co-ordinating complex care packages with colleagues in other health, and social and educational services
  • Complex case conference for vulnerable children and adults.
  • Working with vulnerable people and their families
  • Meeting health challenges and inequalities of the community
  • Ensuring a proactive way of working within finite resources allocated
  • Dealing with complex, sensitive or contentious situations
  • Remote and rural working
  • Lone working

11. COMMUNICATIONS AND RELATIONSHIPS

Internal

Primary Health Care Team

CHP/LHP staff

Specialist Services

Child Protection Services

Vulnerable Adults Services

Child and Young people Health Services

Midwifery Services

Mental Health

Learning Disability Services

Allied Health Professionals

Health improvement Team

Addiction Services

Community hospitals

Nurse Director/s

NHS QIS

Acute Directorates

occupational Health Service

HR dept

NES

Health Scotland

External

Higher Education Institutes

Local Authorities (Social work, Education and Housing

Individuals, families, communities

Immigration

Church groups

Counselling services/Brook advisory

Community Groups and organisations

Professional organisations and representatives

Other health and social care providers e.g nursing homes, Nurseries, Family centres

12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB

Physical:

Moving and handling individuals

Risk assess homes and ensure safe working environment for self and staff

Restrictive movement in environments in terms of some clinical interventions

Fine motor skills and dexterity

Mental

Variety of assessment approaches and interpretation of findings sometimes complex

Concentration and decision making in terms of competing demands and priorities.

Lone working in the community, risk assessment, concentration in driving in a variety of environments

Ability to calculate drug dosages

Ability to organise and manage workforce and workload

Negotiation and influencing skills

Motivating others

conflict management

Interpret data and use findings to inform service delivery

Dealing with challenging behaviour

Concentration to deal with highly complex facts or situations requiring analysis, interpretation and comparison of a range of options

Emotional

Individual, family, community and team dynamics

Supporting in terms of individual, family and community crisis/ major incident

Supporting and enabling self care when individuals, family and community may not be motivated to do so

Coping with unpleasant surroundings, environments,

Caring for terminally ill

Balancing the support for carers with the protection of vulnerable groups

Coping with management of complaints

Providing episodes of care that challenge individual beliefs and values

Emotional resilience

13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB

Qualifications:

Registered Nurse

1st Degree

Masters Degree

Training and Experience:

5 years post registration experience, at least 3 years specialist community practitioner with evidence of professional/educational/ organisational change experience.

Independent Nurse Prescriber

Mandatory training such as moving and handling, child protection

Evidence of relevant on-going professional development

Experience of working in collaboration with other professionals across

organisational boundaries.

Experience or working with children and young people, adults, families, carers and communities

Experience of developing and implementing creative/complex packages

Knowledge and Skills:

Knowledge and skills to lead a community health nursing team

Capable in a range of clinical skills

Ability to direct and coordinate programmes of care working collaborative and autonomously.

Knowledge and skills to work in a collaborative manner with other key stakeholders

Knowledge and ability to interpret and apply public health agenda and research based evidence in all aspects of community health nursing practice.

Knowledge and understanding of policy and guideline implementation, review, monitoring and evaluation

Knowledge and understanding of involvement of patient and public in service delivery, development and design

Knowledge, understanding and experience of service improvement and redesign and managing change

Basic IT skills

Ability to demonstrate effective verbal and written communication.

Decision making and prioritisation

Clinical audit

Presentation

Problem solving skills

Teaching, supervising, mentoring and supporting junior staff

Car driver

14. JOB DESCRIPTION AGREEMENT:

Job Holder's Signature:

Head of Department Signature

Page updated: Tuesday, April 15, 2008