The CNS Stroke Care ESD post will deliver care in line with the five core concepts of the role, as set out in the Framework for the Establishment of CNS, 4th edition, by the National Council for the Professional Development of Nursing and Midwifery (NCNM), 2008.
Develop and deliver care in line with the National Clinical Programme for Stroke and the National Stroke Strategy 2022-2027, as well as future guiding documents from the HSE and the Clinical Programme.
Caseload
The CNS Stroke Care ESD will work primarily with patients with a diagnosis of new stroke, who experience mild to moderate functional limitations post stroke. Rehabilitation will take place mainly within the person's usual residence, typically their own home, but may also involve temporary accommodation, residential care, or an outpatient setting as needed.
The evidence base, local population health principles, risk management, and local service implementation will guide patient selection processes for care from the CNS.
The core concepts of the CNS role are:
* Clinical Focus (Direct and Indirect Care)
* Patient/client Advocacy
* Education and Training
* Audit and Research
* Consultancy (including leadership in clinical practice)
* The post holder will support the principle that care of the patient comes first at all times and will approach their work with the flexibility and enthusiasm necessary to make this principle a reality for every patient to the most significant possible degree
* Maintain awareness of the patient's primacy about all hospital activities.
* Performance management systems are part of the role, and you will be required to participate in the Group’s performance management programme
Clinical Focus
The CNS will be supported to:
Develop a strong patient focus whereby the speciality 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 encompasses the assessment, planning, delivery, and evaluation of care to the patient, their family, and/or carer. Indirect care relates to activities that influence and support the provision of direct care.
Direct Care
The CNS will:
* Provide a specialist nursing service for patients with a diagnosis of Stroke who require support and treatment through the continuum of care to discharge.
* Undertake comprehensive patient assessment in the most appropriate environment for the patient, including physical, psychological, social, and spiritual elements of care, using best evidence-based practice in Stroke care.
* Use the outcomes from nursing assessment to develop and implement plans of care/patient group management to contribute to the plans of patients, their families/carers and the MDT
* Monitor and evaluate the patient’s response to treatment, and adjust the plan of care accordingly in collaboration with the multidisciplinary team (MDT), the patient, their family, and/or carer as appropriate.
* Make alterations to the management of patient conditions in collaboration with the MDT and the patient, in line with the nursing aspects of agreed-upon pathways, policies, procedures, protocols, and guidelines (PPPGs).
* Accept appropriate referrals from MDT colleagues
* Co-ordinate investigations, treatment therapies and patient follow-up
* Communicate with patients, family and/or carer as appropriate, to assess patient needs and provide relevant support, information, education, advice and counselling as required
* Where appropriate, work collaboratively with MDT colleagues across Primary and Secondary Care to provide a seamless service delivery to the patient, family and/or carer as appropriate
* 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 the patient with appropriate self-management strategies and escalation pathways
* Manage nurse-led Stroke clinics in collaboration with the MDT
* Identify health promotion priorities for the patient, family, and/or caregiver, and support the patient in self-care, based on the best available evidence. This will include the provision of educational and health promotion material which is comprehensive, easy to understand and meets patients’ needs
Indirect Care
The CNS will:
* Identify and agree on appropriate referral pathways for patients
* Participate in patients' case reviews with MDT colleagues
* Use a case management approach to patient complex needs in collaboration with the MDT in both Primary and Secondary Care as appropriate
* Take a proactive role in formulating and providing evidence-based PPPGs related to the role of the CNS.
* Take a lead role in ensuring the nursing service for patients with Stroke is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012)
Patient/Client Advocate
The CNS will:
* Communicate, negotiate and represent patient, family and/or carer values and decisions about their condition to MDT colleagues in both Primary and Secondary Care as appropriate
* Develop and support the concept of advocacy, particularly about 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 carers
* Establish, maintain and improve procedures for nursing collaboration and cooperation between Acute Services, Primary Care and Voluntary Organisations as appropriate
* Proactively challenge any interaction, whether nursing or otherwise, that fails to deliver a high quality of service to the patient and their family.
Education & Training
The CNS will:
* Maintain clinical competence in patient management within stroke 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, education, and other supportive interventions to increase their knowledge, skills, confidence, and autonomy in managing their condition.
* Contribute to the design, development and implementation of education programmes and resources for the patient, family and/or carer about stroke to enable them to 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.
* Create opportunities for exchanging learning within the MDT about evidence-based stroke nursing delivery through journal clubs, conferences, and other means.
* Develop and maintain links with Regional Centres for Nursing and Midwifery Education (RCNMEs), the Nursing and Midwifery Planning and Development Units (NMPDUs), and relevant third-level Higher Education Institutions (HEIs) in the design, development, and delivery of nursing educational programmes.
* In tandem with the line management structure, be responsible for addressing one's own continuing professional development (CPD) needs to maintain competencies required for the role.
* Utilise agreed-upon protected time for research, education, and professional development.
* In collaboration with the line manager, utilise the Professional Development Planning (CPD) Framework for Nurses and Midwives to plan and self-assess additional continuing professional development (CPD) needs.
Audit & Research
The CNS will:
* Establish and maintain a register of patients within the caseload of the CNS role.
* Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPI’s) as directed and advised by the DoN Services in conjunction with the senior clinical decision maker.
* Identify, initiate and conduct nursing audit and research relevant to the area of practice and take part in MDT audit and research.
* Identify, critically analyse, disseminate, and integrate into practice the best evidence relating to patient care.
* Contribute to nursing research on all aspects of stroke care in early supportive discharge within the stroke service.
* Use the outcomes of the audit to improve nursing service provision and advocate, when appropriate, for improvement of non-nursing services.
* Contribute to service planning and budgetary processes through the 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 nursing practice.
Audit expected outcomes, including:
* Collate data (for example, the Irish National Audit of Stroke) that will provide evidence of the effectiveness of CNS interventions. Refer to the National KPIs associated. KPIs should have a clinical nursing focus, as well as a breakdown of activities, including the number of patients seen and treated.
* Evaluate nursing audit results and research findings to identify areas for quality improvement in collaboration with nursing management and multidisciplinary team (MDT) colleagues across integrated care areas.
Consultant (including leadership in clinical practice)
The CNS will:
* Understand leadership in clinical practice to act as a resource and role model for nursing stroke practice.
* Contribute to expanding nursing knowledge/expertise in the development of clinical standards and guidelines, and support implementation
* Use growing specialist knowledge to support and enhance own nursing practice and the practice of colleagues.
* Develop collaborative working relationships with local Stroke CNS, Registered Advanced Nurse Practitioners, and MDT colleagues as appropriate, contributing to person-centred care pathways to promote an integrated model of care delivery.
* With the support of the DoN line manager, 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 ongoing delivery of the National Clinical and Integrated Programme model of care.
* Network with other CNSs in Early Supportive Discharge for Stroke Service and related clinical and professional areas of practice.
The above Job Description 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.
* Please Note CV’s will not be accepted for this campaign ******
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Please ensure you read the instructions for the completion of this Application Form and complete all areas, in full. Failure to complete all areas of the Application Form will result in you not being brought forward to the interview stage of the selection process. #J-18808-Ljbffr