JOB DESCRIPTION Safe, compassionate, effective care provided to our communities with a transparent, open approach.

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1 JOB DESCRIPTION Safe, compassionate, effective care provided to our communities with a transparent, open approach. JOB TITLE: GRADE: BASE: MANAGED BY: Advanced Neonatal Nurse Practitioner Band 8a Homerton University Hospital Divisional Head of Nursing (Professional/Management) Consultant Neonatologist (Clinical/Developmental) JOB SUMMARY: The ANNP role encompasses that of expert clinician, educator, researcher and developer. The ANNP works strategically and in collaboration with the Senior Nurse in Neonatal Service and Consultant Neonatologists. The ANNP maintains highly specialist knowledge of neonates across a range of clinical issues, underpinned by the theory and practice acquired through an ANNP education programme at Masters Level, ensuring clinical excellence by providing expert clinical care at an advanced level to neonates and their families. MAIN RESPONSIBILITIES: Make complex autonomous diagnosis and management decisions about patient care using advanced skills, knowledge and expert practice Manage the unpredictable workload and multidisciplinary team within the neonatal service Work interchangeably with junior grade medical staff, working across role boundaries to ensure neonates receive the most appropriate expert specialist care Have responsibility for the assessment of care needs, development, implementation and evaluation of highly specialised medical care to sick neonates Act as a role model and provide leadership, clinical support and expert advice to medical, nursing/midwifery staff, students and other staff in the multidisciplinary team Take the lead role in providing advanced neonatal resuscitation across a range of settings Develop and deliver specialist education and training programmes for health care professionals and other professional groups dealing with neonates across the network

2 Lead on research, clinical audit, quality practice development and clinical governance issues pertinent to the wellbeing of neonates and their families and the provision of neonatal services Provide expert knowledge and advice at a strategic level both locally and nationally Offer support and development to a designated group of senior nurses and ANNPs within the Neonatal Unit identifying their educational and training requirements via appraisal, personal development plan and supervision POSTHOLDER: 1. Works autonomously across professional boundaries, being accountable to the Consultant Neonatologists 2. Participates in the junior (ST1-3) grade medical rota 3. Carries the junior medical trainee bleep covering NICU, Labour ward, postnatal ward. 4. Is responsible for assessment, investigation, diagnosis, prescription and undertaking initial assessment and formulation of management plans 5. Work autonomously to provide first line quality clinical, emergency and supportive care in the management of neonates and their families in dynamic and stressful situations 6. Attend all clinical emergencies specifics to neonates. This takes place in different environments throughout the following designated areas; NICU, Neonatal Transport Service, Labour Ward, Postnatal and Antenatal wards, Accident &Emergency Resuscitation requiring collaboration with multiple staff groups 7. Works autonomously within the nursing structure, developing the service, critically appraising and undertaking research and audit to ensure best practice and standards The ANNP will: 1. Attend high risk deliveries ensuring that neonates receive safe and effective resuscitation in accordance with carrying the emergency neonatal bleep as the junior responder 2. Use highly developed specialist knowledge and advanced clinical skills to undertake a comprehensive health history and examination of any neonate in order to diagnose and treat the neonate (including prescribing drugs as necessary). 3. Assess health related needs of babies and families by identifying and initiating appropriate steps for effective care using neonatal clinical guidelines with senior support 4. Initiate further investigations and treatment plans from a range of options, analysing response and altering plans as necessary as further data becomes available to ensure care is safe and effective 5. Develop comprehensive medical and nursing patient management plans for a caseload of neonates that delivers a holistic approach to their care from admission to discharge 6. Recognise abnormalities, early signs of illness and or deterioration and act accordingly, ensuring appropriate and full range of investigations instigated and follow up action taken including evaluation of care

3 7. Carries out non-medical prescribing including calculating prescribing, administering and evaluating the effects of drugs and fluid therapies in accordance with local policies 8. Order and interpret X-rays and diagnostic investigations to ensure accurate diagnosis and treatment of the neonate 9. Interpret and act on results and develop pertinent management plans 10. Perform procedures for ill and premature neonates when required 11. Be involved in the stabilisation, transfer and admission of extremely ill neonate to or from the Neonatal Unit, including complex life support therapies 12. Attend traumatic neonatal resuscitations where there is a poor outcome or dealing with a sudden collapse of a previously well baby within the neonatal unit or postnatal ward 13. Deal on a daily basis with distressing or highly emotive situations involving neonate, parents, siblings, the extended family (for example) death of a neonate, breaking bad news, 14. Convey distressing news and dealing with very challenging behaviours of parents/carers 15. Frequently support parents/staff who may be emotionally fragile 16. Maintain and build on effective communication with parents/carers, relatives and other members of the multidisciplinary team to ensure appropriate information is shared and the needs if babies and their families are met 17. Participate in the palliative care for neonates leading to a pain free dignified ending to life 18. Provide intensive support for families of neonates who are receiving terminal care 19. Act as a resource for the MDT 20. Communicate with various individuals, specialities and professionals on complex neonatal matters to ensure effective coordination of clinical treatment 21. Involved in antenatal discussions regarding care of mother and neonate when abnormality of pregnancy is identified 22. Write discharge and referral letters to GPs and speciality consultants EXPECTED COMPETENCY IN THE FOLLOWING PROCEDURES: Maintenance of neonatal airways (resuscitation and intubation) Management of all ventilation modalities (with senior supervision) Insertion of long lines, umbilical venous and arterial catheters Radial arterial lines/arterial punctures Prescribing of drugs and fluid therapies Cannulation and venipuncture Needle thoracentesis Chest drain insertion and removal (with supervision) Lumbar punctures Blood cultures Suprapubic bladder aspiration Insertion of urinary catheters Arterial blood gas sampling/monitoring

4 MANAGEMENT AND LEADERSHIP 1. Collaborate with nursing and medical colleagues to ensure effective use of resources 2. Comply with policies relating to child protection instigating actions and developing management plans 3. Share responsibility with senior clinicians and managers for clinical governance issues including clinical risk management and staff governance 4. Attend or take a lead in local and national meetings to promote development of neonatal services and disseminate information to colleagues 5. Liaise with colleagues and managers to ensure that sufficient resources are available to meet clinical need 6. Promote equality and diversity 7. Share responsibility for clinical and staff governance with senior nurses and medical staff 8. Input data into patient records (paper and electronic) ensuring quality of records are maintained. 9. Use electronic databases to source information and maintain records PROFESSIONAL 1. Comply with local and national guidelines and policies 2. Is an accountable and responsible professional managing self, his/her own practice and that of others within an ethical and legal framework that ensures the interest of the neonates and their families come first 3. Act as an ambassador for the Neonatal Unit, ANNP s and the neonatal speciality 4. Ensures that written nursing and medical documentation is clear, concise and up to date and complies with NMC standards of record and record keeping. 5. Conveys the role of ANNP to staff and parents 6. Network with consultant nurses and ANNPs nationally ensuring advanced practice and national guidelines are comparative and research based across regions and networks EDUCATION 1. Identify own educational and training support needs 2. Maintain a professional development portfolio 3. Devise personal and professional development packages for colleagues undertaking appraisals and role progression 4. In collaboration with unit management, develop, update and evaluate service training plan 5. Participate in teaching and supervising of ANNPs, medical trainees, midwives and nurses 6. Act as an expert practitioner to provide a supportive learning environment which promotes continuous professional development and lifelong learning

5 7. Participate in national meetings and conferences, delivering presentations to audiences 8. Teach specialist neonatal skills to staff and parent carers 9. Act as a formal clinical supervisor for colleagues undertaking professional development programmes RESEARCH AND DEVELOPMENT 1. Create an environment conducive to research and evidence based neonatal care and ensure relevant changes are implemented 2. Initiate audit and research within the neonatal unit and supervise others to undertake audits. Use the results to facilitate change s to practice where indicated 3. In line with GCP standards (good consent practice), seek consent from parents and recruit neonates to multicentre randomised controlled trials and other research projects 4. Initiate, develop and implement and review specific guidelines and clinical management plans ensuring standards are maintained, monitored, and reviewed in adherence with local, national and NMC guidelines 5. Initiate evidence based changes in clinical practice which deliver advance levels of neonatal care 6. Lead practice development initiatives through participation in clinical working groups in NICU and the network 7. Develop and continually review clinical guidelines to promote best practice in neonatal care 8. Use it systems to generate proposals and reports leading to practice development initiatives 9. Seek the views of families and carers to improve the health care experience for service users This job description outlines the current main responsibilities of the post. However the duties of the post may change and develop over time and this job description may, therefore be amended in consultation with the postholder. The Homerton University Hospital NHS Foundation Trust sits in the middle of one of the most diverse locations in the world. To this end we are committed to and champion equality and diversity in all aspects of our employment practice and service delivery. All employees are expected to understand and respect this commitment and work with us to promote equality and diversity in the course of their work. All employees are required to have the appropriate level of English language competence to enable them to effectively carry out their role, deliver safe care and enhance the patient experience. Employees, in line with the Trust s commitment to the Health and Social Care Act 2008 (Previously known as the Hygiene Code ), improving infection control and health and safety are individually required to ensure that they make every effort to contribute to making the Homerton Hospital a clean and safe environment within which to work and receive care.

6 All employees of the Trust are required to observe legislation, Trust policies, standards and guidelines relating to Risk Management, Equal Opportunities, Confidentiality, Data Protection, Freedom of Information and the Trust Code of Behaviour. It is the responsibility of each member of staff to be aware of, and work in in accordance with, the Trust s safeguarding children and adults policies and procedures. This includes ensuring that they undertake statutory and mandatory safeguarding children and adult training appropriate for their role. In addition to acquiring safeguarding knowledge and skills, each member of staff must be competent and maintain their knowledge and skills in clinical practice to safeguard the health and wellbeing of children and adults. All staff have a responsibility to prevent and control infection within Homerton Hospital. This includes ensuring personal and team compliance with the Hygiene Code (Health and Social Care Act 2008) and all relevant policies including Hand Hygiene, Homerton Dress Code, MRSA screening and Infection Control. It is the responsibility of leaders of the Trust to demonstrate and foster the Trust s commitment to environmental sustainability and corporate social responsibility by acting as a role model and enabling others. It is the responsibility of all staff to minimise the Trust s environmental impact by recycling wherever possible, switching off lights, computers, monitors and equipment when not in use, minimising water wastage and reporting faults promptly. Living Our Values How We at the Homerton Work Safe We will do everything we can to make our services as safe as possible and create a positive learning environment. We will do this by: being open and honest when we get things wrong, and doing all we can to correct and learn from our mistakes listening to our staff, patients, service users and their carers and using their feedback to improve services ensuring that we have the right staff, with the right skills, caring for each patient constantly monitoring standards of care and responding quickly if there are concerns Responsibility We will take responsibility for our actions and any problems that we come across we lead by example. We will do this by: being open and transparent about our performance and setting challenging improvement targets thinking differently and looking for new and innovative ways of working ensuring our care is evidence based and follows best practice doing the right thing, even when it is difficult Personal We will provide care which addresses individual needs and focuses on our patients, service users, their families and carers, and our staff. We will do this by: ensuring that relationships with patients and service users are founded on compassion, empathy and kindness appreciating each person as an individual and addressing their specific needs

7 actively listening to and involving patients and service users in decisions about their care providing continuity of care through good communication and teamwork Respectful We will treat others as we would expect ourselves or our families to be treated and cared for. We will do this by: treating everyone with dignity and respect listening to others and valuing their contribution providing services that meet the diverse needs of our communities valuing and supporting the health and wellbeing of all our staff

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