Purpose of the Post
The purpose of this role is to deliver specialist nursing care in line with the five core concepts set out in the Framework for the Establishment of Clinical Nurse Specialist posts (4th edition), National Council for the Professional Development of Nursing and Midwifery
(NCNM), 2008. The successful candidate will work as a member of the multidisciplinary team providing a patient centred quality and seamless service.
The Pre-Assessment Clinic operates in accordance with evidence-based policies and protocols, including guidelines on anticoagulation bridging, consent, safe site surgery, and preoperative assessment. Additionally, it adheres to all relevant hospital policies that support best practices.
The CNS provides leadership within the unit, working in close collaboration with visiting and in-house consultants, the anaesthesia department, the Day Surgery Unit, and outpatient departments. This multidisciplinary approach ensures the optimal utilization of day care facilities and enhances patient care.
In this role, the CNS is responsible for conducting comprehensive pre-operative nursing assessments for patients undergoing a range of surgical procedures. This includes performing detailed evaluations, obtaining baseline outcome measurements, and ensuring all necessary investigations and results are reviewed before admission to determine the patient’s suitability for general anaesthesia or sedation.
The CNS in Pre-Assessment collaborates closely with Anaesthesiologists and Surgeons to address any medical concerns related to anaesthesia and surgical procedures. They also liaise with General Practitioners (GPs) and other healthcare professionals to facilitate appropriate referrals, ensuring the patient’s pre-operative health is fully optimized. Additionally, the Pre-Assessment Nurse oversees the seamless coordination of care both before and during the patient’s admission, enhancing patient safety and surgical outcomes.
Principal Duties and Responsibilities
The purpose of the Registered Clinical Nurse Specialist (CNS) post is 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 CNS has been established to benefit both patients and the perioperative service by improving outcomes and providing timely access to appropriate services. The CNS will have the expertise and specialist knowledge to help optimise patients and deliver pre-operative care to patients who will undergo surgeries.
The post holder’s practice is based on the five core concepts of the CNS 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 CNS 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 CNS will:
• To provide specialist knowledge, expertise and care to all patients undergoing surgical procedures requiring anaesthesia. This will be at a higher level of autonomy and decision-making in patient management as defined by protocols.
• Provide a specialist nursing service for pre-operative patients 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 in preoperative care.
• Use the outcomes of patient assessment to develop and implement plans of
care/case management in conjunction with the multidisciplinary 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).
• 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 the
patient’s 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 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 patients with appropriate self-management strategies and escalation pathways.
• Manage nurse/midwife led pre-assessment clinics with MDT input.
• 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 patients’ needs.
Indirect Care
• Identify and agree appropriate referral pathways for pre-operative patients.
• Participate in case review with MDT colleagues.
• Use a case management approach to patients with complex needs in collaboration with the MDT in both Primary and Secondary Care as appropriate.
• Take a proactive role in the formulation and provision of evidence based PPPGs relating to pre-operative care.
• Take a lead role in ensuring the service for pre-operative patients is in line with best
practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012) or the relevant National Clinical Care Programme.
Patient/Client Advocate
• 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
• Maintain clinical competence in patient management within the pre-assessment
clinics, 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 condition.
Contribute to the design, development, and implementation of education
programmes and resources for the patient, family, and/or carer 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.
• Create exchange of learning opportunities within the MDT in relation to evidence
based pre-operative care delivery through journal clubs, conferences etc.
• 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 Institutes (HEIs) in the design,
development, and delivery of educational programmes.
• Be responsible for addressing own continuing professional development needs.
Audit & Research
• Establish and maintain a register of patients within the CNS service.
• Maintain a record of clinically relevant data aligned to National Key Performance
Indicators (KPIs) as directed and advised by the ADON/DON/Lead Consultant.
• Identify, initiate, and conduct nursing/midwifery and MDT audit and research projects relevant to the area of practice.
• Identify, critically analyse, disseminate, and integrate best evidence relating to preassessment into practice.
• Contribute to nursing/midwifery research on all aspects of pre-operative 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.
Audit expected outcomes including:
• Collate data such as number of patients pre-assessed, proportion of patients
requiring face-to-face assessment, referral to treatment time, and other data as
dictated by clinical guidance which will provide evidence of the effectiveness of the
CNS interventions undertaken - Refer to the National Council for the Professional
Development of Nursing and Midwifery 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 National KPIs associated with the speciality.
They should have a clinical nursing/midwifery focus as well as a breakdown of
activity - patients seen and treated.
• 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).
Quality, Risk, and Safety responsibilities
It is the responsibility of the CNS 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 specified by the HSE or other regulatory authority.
• Initiate, support, and implement nursing/midwifery 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 the Hospital Complaints Policy.
• Respond immediately and appropriately to ensure the safety of any service user that
he/she/they 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 in Pre-Assessment
Clinics care.
• Participate and cooperate with legislative and regulatory requirements in relation to
Health and Safety as outlined in the Safety, Health and Welfare Act 2005 and the
Hospital Safety Statement.
Consultant
• Provide leadership in clinical practice and act as a resource and role model for preassessment practice.
• Generate and contribute to the development of clinical standards and guidelines and
support implementation.
• Use specialist knowledge to support and enhance generalist nursing/midwifery
practice.
• Develop collaborative working relationships with local pre-assessment CNS,
Registered Advanced Nurse/Midwife Practitioner/MDT colleagues as appropriate,
developing person centred care pathways to promote the integrated model of care
delivery.
• With the support of the ADON, 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 model of care.
• Network with other CNS in Pre-Assessment Clinics and in related professionals
associations.
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 them from time to time and to contribute to the development of the post while in office. This Role Profile will be subject to review in the light of changing circumstances.
Eligibility Criteria
Qualifications and/ or experience
Each candidate must, at the latest date for receipt of completed applications for the post:
1. Professional Qualifications & Experience
· Be registered in the General Division of the Register of Nurses maintained by Bord Altranais agus Cnáimhseachais na hÉireann (Nursing and Midwifery Board of Ireland) or be entitled to be so registered
AND
· Have a minimum of 1 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.
AND
· Have a minimum of 1 years’ experience or an aggregate of 1 years’ full time experience in specialist area of perioperative care.
AND
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).
OR
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) pre-assessment care prior to application (**See note below).
AND
• 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/their professional responsibility within his/her/their scope of practice.
AND
• Candidates must possess the requisite knowledge and ability, including a high
standard of suitability and clinical, leadership, managerial, and administrative capacity for the proper discharge of the duties of the office.
**Note: 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.
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: An Bord Altranais agus Cnáimhseachais na hÉireann (Nursing Midwifery Board Ireland)
Health
A candidate 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.
Character
Each candidate for and any person holding the office must be of good character.
Post Specific Requirements
Demonstrate extensive experience and expertise in delivering pre-assessment services within an acute hospital setting, ensuring high standards of patient evaluation and perioperative care relevant to the role.
Other requirements specific to the post
A flexible approach to working hours is required.
Skills, competencies and/or knowledge
Candidates must:
• Demonstrate the ability to work on own initiative
• Demonstrate the ability to lead on clinical practice and service quality.
• Demonstrate promotion of evidence-based decision-making.
• Demonstrate practitioner competence and professionalism.
• Demonstrate the ability to plan and organise effectively.
• Demonstrate the ability to build, lead and manage a team.
• Demonstrate strong interpersonal skills including the ability to build and maintain
relationships.
• Demonstrate strong communication and influencing skills.
• Demonstrate initiative and innovation in the delivery of service.
• Demonstrate resilience and composure.
• Demonstrate openness to change.
• Demonstrate integrity and ethical stance.
• Demonstrate a commitment to continuing professional development.
• Demonstrate the ability to relate nursing research to nursing practice.
• Demonstrate knowledge of quality assurance practices and their application to
nursing procedures.
• Demonstrate an awareness of Clinical Programmes / Initiatives relevant to Pre- assessment / Pre-admission services, the National Clinical Programme for Anaesthesia - Model of Care for Pre-admission
•Demonstrate an awareness of HR policies and procedures including disciplinary procedures, managing attendance etc.
•Demonstrate an awareness of relevant legislation and policy e.g. legislation relevant to the service area, health and safety, infection control etc.
•Demonstrate an awareness of current and emerging nursing strategies and policies in relation to the clinical / designated area.
•Demonstrate an awareness of the Health Service Transformation Programme.
Demonstrate an awareness of the HSE Model of Care for Elective Surgery
•Demonstrate a willingness to develop IT skills relevant to the role.
•Flexibility to move to various areas to maintain continuity of patient care.
Campaign Specific Selection Process
Ranking/Shortlisting / Interview
A ranking and or shortlisting exercise may be carried out on the basis of information supplied in your application form. The criteria for ranking and or shortlisting are based on the requirements of the post as outlined in the eligibility criteria and skills, competencies and/or knowledge section of this job specification. Therefore it is very important that you think about your experience in light of those requirements.
Failure to include information regarding these requirements may result in you not progressing to the next stage of the selection process.
Those successful at the ranking stage of this process, (where applied,) will be placed on an order of merit and will be called to interview in ‘bands’ depending on the service needs of the organisation.
Diversity, Equality and Inclusion
The HSE is an equal opportunities employer.
Employees of the HSE bring a range of skills, talents, diverse thinking and experience to the organisation. The HSE believes passionately that employing a diverse workforce is central to its success – we aim to develop the workforce of the HSE so that it reflects the diversity of HSE service users and to strengthen it through accommodating and valuing different perspectives. Ultimately this will result in improved service user and employee experience.
The HSE is committed to creating a positive working environment whereby all employees inclusive of age, civil status, disability, ethnicity and race, family status, gender, membership of the Traveller community, religion and sexual orientation are respected, valued and can reach their full potential. The HSE aims to achieve this through development of an organisational culture where injustice, bias and discrimination are not tolerated.
The HSE welcomes people with diverse backgrounds and offers a range of supports and resources to staff, such as those who require a reasonable accommodation at work because of a disability or long-term health condition.
Read more about the HSE’s commitment to Diversity, Equality and Inclusion
Code of Practice
The Health Service Executive will run this campaign in compliance with the Code of Practice prepared by the Commission for Public Service Appointments (CPSA).
The CPSA is responsible for establishing the principles to be followed when making an appointment. These are set out in the CPSA Code of Practice. The Code outlines the standards to be adhered to at each stage of the selection process and sets out the review and appeal mechanisms open to candidates should they be unhappy with a selection process.
Read the CPSA Code of Practice.
The reform programme outlined for the health services may impact on this role, and as structures change the Job Specification may be reviewed.
This Job Specification is a guide to the general range of duties assigned to the post holder. It is intended to be neither definitive nor restrictive and is subject to periodic review with the employee concerned.
CVs Will not be accepted for this positon, please complete and upload the application form attached to the job advert
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