Clinical Nurse Specialist (CNS) Job Specification & Terms and Conditions Job Title: Grade CNM2 Health and Chronic Disease Management for Adults with an Intellectual Disability Remuneration The salary scale for the post is: Duration of Post If the post is awarded as CNM2 in Health and Chronic Disease Management, the successful candidate is required to progress to Clinical Nurse Specialist Grade within 2 years of commencement of this post and formally apply for entry onto the ONMSD CNS database. Location of Post/ Organisational Area The CNS/CNM2 Health and Chronic Disease Management operates within St John of God Community Services North East Residential Service. The service provides residential care across multiple locations within Counties Louth, Meath and Monaghan, supporting adults with intellectual disabilities. The CNM2 Health and Chronic Disease Management role will providing clinical nursing care, advise and leadership in the residential houses across the 3 Counties. Key Service Components: Residential care facilities in Counties Louth, Meath, & Monaghan Integration with broader disability services networks The CNM2 Health and Chronic Disease Management position is strategically placed within this organisational structure to: Provide clinical leadership across multiple care settings Provide clinical nursing care and advise across care settings Develop and implement service improvements Lead clinical governance initiatives within the Organisation Foster and maintain working relationships with acute and primary care services Informal Enquiries Paula Doyle Details of Service: St John of God Community Services North East provides specialised residential and day services for adults with intellectual disabilities. The CNS/CNM2 Health and Chronic Disease Management delivers expert clinical care, advice and leadership across both residential and day settings, ensuring comprehensive health management and person-centered support. The service caters to adults (18+ years) with intellectual disabilities requiring residential and/or day support. The CNS/CNM2 Health and Chronic Disease Management provides specialised nursing care &/or advice for individuals with an intellectual disability, addressing complex health needs and promoting optimal wellbeing. Team Structure: Regional Director Director of Nursing Care and Support Assistant Director of Nursing Nursing Practice Development Coordinator Advanced Nurse Practitioner Clinical Nurse Specialists Clinical Nurse Managers Social Care Managers Staff Nurses Social Care Workers Healthcare Assistants Support Services Staff Multidisciplinary Team including: Physiotherapist Occupational Therapist Speech and Language Therapist Social Workers Future Developments: Enhancement of person-centered care models through CNS/CNM2 Health and Chronic Disease Management -led initiatives Development of evidence-based practice guidelines specific to Intellectual Disability Nursing Enhancement of staff training and development programs Implementation of quality improvement initiatives focused on individuals we support. Reporting Relationship Is professionally accountable to the Nursing Practice Development Coordinator and clinically accountable to the Director of Nursing Care and Support. Key Working Relationships to include but not limited to The CNS/CNM2 in Health and Chronic Disease Management will work collaboratively with a range of internal and external stakeholders including: Director of Nursing Care and Support Assistant Director of Nursing Nurse Practice Development Co-ordinator Registered Advanced Nurse Practitioner (ANP) Clinical Nurse Managers and Social Care Managers All Nursing Grades Prescribing site Co-ordinator Medical colleagues Interprofessional colleagues Individuals we support their families and/or carers Nursing and Midwifery Board of Ireland Higher Education Institution Nursing and Midwifery Planning and Development Unit Centres of Nursing and Midwifery Education National Clinical and Integrated Care Programme National Clinical Leadership Centre Other relevant statutory and non-statutory organisations Purpose of the Post: The post holder will be enabled to deliver care in line with the five core concepts of the role set out in the Framework for the Establishment of Clinical Nurse/Midwife Specialist Posts, 4th edition, National Council for the Professional Development of Nursing and Midwifery (NCNM) 2008. The postholder will focus initially on the following individual groups: Residents of St John of God Community Services North East. The concepts are: Clinical Focus (Direct and Indirect Care) Individual Advocacy Education and Training Audit and Research Consultancy (including leadership in clinical practice) Principle Duties and Responsibilities Clinical Focus The CNS/CNM2 in Health and Chronic Disease Management will be supported to: Develop a strong individual 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 individual, their family and/or carer. Indirect care relates to activities that influence and support the provision of direct care. The Clinical Nurse Specialist/CNM2 in Health and Chronic Disease Management will: Provide a specialist nursing service for individuals we support with a diagnosis of a chronic condition/disease who require support and treatment through the continuum of care Undertake comprehensive individual assessment to include physical, psychological, social and spiritual elements of care using best evidence-based practice. Use the outcomes of nursing assessment to develop and implement plans of care, individual group management to contribute to the plans of individuals we support, their families/carers and the MDT Monitor and evaluate the individuals we support response to treatment and amend the plan of care accordingly in collaboration with the MDT and the individual, family and/or carer as appropriate. Make alterations in the management of the individual's condition in collaboration with the MDT and the individual in line with the nursing aspect of agreed pathways and policies, procedures, protocols and guidelines (PPPG's). Accept appropriate referrals from MDT colleagues Co-ordinate investigations, treatment therapies and the individual's follow-up Communicate with individuals we support, family and/or carer as appropriate, to assess their 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 individual we support their family and/or carer as appropriate Participate in medication reconciliation taking cognisance of poly-pharmacy 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 individuals with appropriate self-management strategies and escalation pathways Manage nurse led clinics in collaboration with the MDT Identify health promotion priorities for individuals their family and/or carer and support their 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 their needs Indirect Care The Clinical Nurse Specialist/CNM2 in Health and Chronic Disease Management will: Identify and agree appropriate referral pathways for individuals with chronic conditions/disease Participate in individual case reviews with MDT colleagues Use a case management approach to the individuals' 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 the role. Take a lead role in ensuring the nursing service for individuals we support is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012) Service user/Client Advocate The Clinical Nurse Specialist/CNM2 in Health and Chronic Disease Management will: Communicate, negotiate and represent individuals, their family and/or carer values and decisions in relation to their condition to MDT colleagues in both Primary and Secondary Care as appropriate Develop and support the concept of advocacy, particularly in relation to individuals' participation in decision making, thereby enabling informed choice of treatment options Respect and maintain the privacy, dignity and confidentiality of the individual, 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, nursing or otherwise, which fails to deliver a good quality service to the individuals we support. Education & Training The Clinical Nurse Specialist/CNM2 in Health and Chronic Disease Management will: Maintain clinical competence in the management of health and chronic disease nursing, keeping up-to-date with relevant research to ensure the implementation of evidence-based practice. Provide the individual, their, family and/or carer with appropriate information, education and other supportive interventions to increase their knowledge, skill and confidence and autonomy in managing their health and/or condition. Contribute to the design, development and implementation of education programmes and resources for the individual, their family and/or carer in relation to their individual health needs to enable them to manage their own condition. Provide mentorship and preceptorship for nursing colleagues as appropriate. Participate in training programmes for nursing, MDT colleagues and key stakeholders as appropriate. Create exchange of learning opportunities within the MDT in relation to evidence-based nursing 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 nursing educational programmes in health and chronic disease management care In tandem with the line management structure, be responsible for addressing own continuing professional development (CPD) needs to maintain competencies required for the role. Use agreed protected time for research, education and professional development. With the line manager, use the Professional Development Planning Framework for Nurses and Midwives to plan and self-assess additional CPD needs. Audit & Research The Clinical Nurse Specialist/CNM2 in Health and Chronic Disease Management will: Establish and maintain a register of individuals we support with chronic disease/conditions within the CNS/CNM2 caseload. 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, best evidence relating to care in health and chronic disease management. Contribute to nursing research on health and chronic disease management care. Use the outcomes of audit to improve nursing service provision and advocate, when appropriate, for improvement of non-nursing services 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 nursing practice Audit expected outcomes including: Collate data which will provide evidence of the effectiveness of the CNS/CNM2 Health and Chronic Disease Management interventions. Refer to National KPIs associated with the specialty. KPI's should have a clinical nursing focus as well as a breakdown of activity - patients seen and treated. Evaluate nursing audit results and research findings to identify areas for quality improvement in collaboration with nursing management and MDT colleagues (Primary and Secondary Care). Consultant (including leadership in clinical practice) The Clinical Nurse Specialist/CNM2 in Health and Chronic Disease Management will: Understand leadership in clinical practice with the aim of acting as a resource and role model for nursing practice. Use specialist knowledge to support and enhance generalist nursing practice Generate and contribute to the development of clinical standards and guidelines and support implementation Use growing specialist knowledge to support and enhance own nursing practice and practice of colleagues. Develop collaborative working relationships with local CNS, Registered Advanced Nurse Practitioner/MDT colleagues as appropriate, contributing to person centered care pathways to promote the 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 individuals we support in the community. Liaise with other health service providers in the development and on-going delivery of the National Clinical and Integrated Programme model of care. Network with other CNS or CNM2s in Health and Chronic Disease Management and in related clinical and professional areas of practice. Health and 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. 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. 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 Adequately identifies, assesses, manages and monitors risk within their area of responsibility 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, Peer Audits specified by St John of God Community Services or other regulatory authority Initiate, support and implement nursing quality improvement initiatives in their area which are in keeping with local organisational quality, risk and safety requirement Contribute specialist expertise to the development of PPPGs and safe professional practice and adhere to relevant legislation, regulations and standards Comply with St John of God Community Services Complaints Policy Respond immediately and appropriately to ensure the safety of any individual that you are aware has been put at risk 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 CNS role. 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 one's 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: The Clinical Nurse Specialist/CNM2 in Health and Chronic Disease Management will: Provide an efficient, effective and high-quality nursing service, respecting the needs of each individual. Effectively manage time and caseload to meet changing and developing service needs. Continually monitor the nursing service to ensure it reflects current individual needs and organisational needs. Implement and manage identified changes. Ensure that confidentiality in relation to individual records. Understand the need to represent the specialist nursing service at local, national and international fora as required. Maintain accurate and contemporaneous records and data on all matters pertaining to the planning, management, delivery and evaluation of nursing specialist 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 Director of Nursing and Nurse Practice Development Co-ordinator 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 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 them from time to time and to contribute to the development of the post while in office. Eligibility Criteria Qualifications and/or experience Candidates must have at the latest date of application: 1. Professional Qualifications, Experience, etc i) Be a registered nurse/midwife on the active Register of Nurses and Midwives held by An Bord Altranais and Cnimhseachais na hireann (Nursing and Midwifery Board of Ireland) or be eligible to be so registered. And ii) Be registered in the division(s) of the Nursing and Midwifery Board of Ireland (Bord Altranais agus Cnimhseachais na hireann) Register for which the application is being made or be entitled to be so registered. And (iii) Have a minimum of 2 years' post registration full time experience or an aggregate of 1 years' full-time experience in the division of the register in which the application is being made (taking into account (ii)) And (iv) Have a minimum of 2 years' experience or an aggregate of 1 years' full-time experience in specialist area of Health and Chronic Disease Management Care delivery. And (v) Have successfully completed a post registration programme of study, as certified by the education provider which verifies that the applicant has achieved a Quality and Qualifications Ireland (QQI), National Framework of Qualifications (NFQ) major academic Level 9 or higher award that is relevant to the specialist area of care (equivalent to 60 ECTS or above), and in line with the requirements for specialist practice as set out by the National Council for Nursing and Midwifery 4th ed (2008). Alternatively provide written evidence from the Higher Education Institute that they have achieved the number of ECTS credits equivalent to a Level 9 or higher standard, relevant to the specialist area of care (equivalent to 60 ECTS or above), and in line with the requirements for specialist practice as set out by the National Council for Nursing and Midwifery 4th ed (2008). (See **Note below). OR If the successful applicant does not possess the relevant QQI NFQ Level 9 qualification the post will be awarded as a CNM2 in Health and Chronic Disease Management, the applicant will be required to undertake the postgraduate education, at QQI NFQ level 9 qualification (equivalent to 60 ECTS or above) relevant to the specialist area within a 2-year timeframe. All of the above must be achieved within 2 years for this pathway. And (vi) Be required to demonstrate that they have continuing professional development (CPD) relevant to the specialist area. And Have the ability to practice safely and effectively fulfilling his/her professional responsibility within his/her scope of practice **Note 1: For Nurses/Midwives who express an interest in CNS roles and who currently hold a level 8 educational qualification in the specialist area (equivalent to 60 ECTS or above), this qualification will be recognised up to September 2026. 2. Annual registration (i) Practitioners must maintain live annual registration on the appropriate/relevant Division of the register of Nurses and Midwives maintained by the Nursing and Midwifery Board of Ireland (Bord Altranais agus Cnimhseachais na hireann) for the role. And (ii) Confirm annual registration with NMBI to the HSE by way of the annual Service user Safety Assurance Certificate (PSAC). 3. Health Candidates for and any person holding the office must be fully competent and capable of undertaking the duties attached to the office and be in a state of health such as would indicate a reasonable prospect of ability to render regular and efficient service. 4. Character Candidates for and any person holding the office must be of good character. Please note that appointment to and continuation in posts that require statutory registration is dependent upon the post holder maintaining annual registration in the relevant division of the register maintained by Bord Altranais agus Cnimhseachais na hireann (Nursing & Midwifery Board of Ireland) by way of the Service user Safety Assurance Certificate (PSAC) Post Specific Requirements, additional qualifications and or experience required The organisation will consider the post specific requirements or experience required in developing the specific CNS/CNM2 in Health and Chronic Disease Management service. For example: Demonstrate depth and breadth of Nursing experience in the specialist area of Health and Chronic Disease Management. Formally apply for entry onto the Interim ONMSD CNS database Essential Skills, competencies and/or knowledge Professional Knowledge and Experience The CNS/CNM2 Health and Chronic Disease Management will: Practice in accordance with relevant legislation and with regard to The Scope of Nursing & Midwifery Practice Framework (Nursing and Midwifery Board of Ireland, 2015) and the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (Nursing and Midwifery Board of Ireland, 2021) Maintain a high standard of professional behaviour and be professionally accountable for actions/omissions. Take measures to continuously develop and maintain the competences required for specialist practice Adhere to the Nursing & Midwifery values of Care, Compassion and Commitment (DoH, 2016) Adhere to national, regional and local HSE PPPGs Demonstrate practitioner competence and professionalism as it related to CNS. Demonstrate an awareness of current and emerging nursing strategies and policy in relation to the clinical/specialist area. Demonstrate the ability to relate nursing research to nursing practice. Demonstrate an awareness of HR policies and procedures including disciplinary procedures. Demonstrate an awareness of relevant legislation and policy e.g., health and safety, infection control etc. Demonstrate a commitment to continuing professional development. Possess IT skills relevant to the role. Demonstrate: An in-depth knowledge of the role of the CNS/CNM2 in Health and Chronic Disease Management. In-depth knowledge of the pathophysiology of Health and Chronic Disease Management. The ability to undertake a comprehensive assessment of the patient with including taking an accurate history of their Health and Chronic Disease Management condition and presenting problem. The ability to employ appropriate diagnostic interventions to support clinical decision making and the patients' self- management planning. The ability to formulate a plan of care based on findings and evidence-based standards of care and practice guidelines. The ability to follow up and evaluate a plan of care. Knowledge of health promotion principles/coaching/self-management strategies that will enable individuals to take greater control over decisions and actions that affect their health and wellbeing. An understanding of the principles of clinical governance and risk management as they apply directly to the CNS/CNM2 role and the wider health service. Evidence of teaching in the clinical area. A working knowledge of audit and research processes. Evidence of computer skills including use of Microsoft Word, Excel, E- mail, PowerPoint. Communication and Interpersonal Skills Demonstrate: Emotionally intelligent communication skills Ability to build and maintain relationships particularly in the context of personal and team relationships Ability to present information in a clear and concise manner Ability to provide constructive feedback to encourage future learning Demonstrates the ability to influence others effectively. Organisation and Management Skills: Demonstrate: Evidence of effective organisational skills including awareness of appropriate resource management and the importance of value for money Ability to plan and organise effectively Ability to attain designated nursing service targets, manage deadlines and multiple activities Ability to work autonomously A willingness to be flexible in response to changing local/organisational requirements. 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