Date : 15 th July 2014 Job Title : Clinical Nurse Specialist Department : Laboratory Services Location : North Shore and Waitakere Hospital Reporting To : Laboratory Services Manager for meeting performance objectives as regards financial, team/people management and clinical service strategies Clinical Leader of Haematology for collaborative achievement of service strategic plan Head of Division Nursing Surgery for the safety of professional practice performance to the highest standard possible. Direct Reports : None Functional Relationships with : Internal Haematologists, Blood Bank and laboratory staff, Nursing staff, Midwifery Staff, Anaesthetic Technicians, Anaesthetists, SMO s, RMO s, House Surgeons, Quality team, Clinical Nurse Educators Clinical Nurse Specialists, Charge Nurse Managers, Patients, Operations Managers External Blood Service (NZBS), Transfusion Nurse Specialists (CMDHB/ADHB), GPs, CSL, LTA (Lab Tests Auckland), Lead Maternity Carers, North Harbour Southern Cross, Community Hospice, Naval Base Committees / Groups CNS Group, WDHB Hospital Transfusion Committee Australian New Zealand Society of Blood Transfusion (ANZSBT) Team Leader Core Laboratory Head of Division Nursing: Surgery Clinical Director Haematology & Laboratory Transfusion Safety Specialist Related roles Waitemata District Health Board -JOB DESCRIPTION - Page 1
Purpose : To promote a safer and more efficient use of blood. Increase clinical staff awareness via education and development of policies and procedures. Provide support for clinical staff, patients and their families and act as a liaison between the Blood Bank and clinical areas. Monitor and audit the safe, appropriate and cost efficient use of blood components and products KEY TASKS Practices nursing to demonstrate professional responsibility Communication Cultural Safety Management of Nursing Care Management of the Environment Technical competence in clinical practice Management of nursing care to the highest professional standard possible to provide patient focused care Clinical Effectiveness To promote excellence in the practice of transfusion medicine by provision of specialist knowledge, quality activities and staff education Clinical and Professional Leadership Interpersonal relationships Interprofessional health care and quality improvement EXPECTED OUTCOMES Undertakes clinical assessment with patients requiring or receiving transfusion using advanced assessment skills, liaises closely with the specialists and implements plan of care in a collaborative way. Uses advanced skills to assess, plan, implement and evaluate patients/clients/family/whanau needs. Ensures that patients requiring ongoing care are referred appropriately. Makes appropriate referral to other team members in a timely and thorough manner using the referral pathway. Recognise the need of patients requiring further examination. Identifies situations of clinical risk and take appropriate actions to ensure a safe environment of patients/clients, families/whanau and staff. Collaborates with interdisciplinary team to coordinate/ manage care for best health outcomes. Identifies/removes barriers to discharge. Explains/manages variance to clinical pathway and monitors length of stay utilising data collection tools. Develops and monitors key outcomes. Co-ordinates/attends interdisciplinary team meetings and relevant clinical meetings. Works co-operatively with medical staff in follow-up of patients with transfusion problems. Documentation is professional, accurate and transparent Provides consistent best practice treatment for patient. Monitors for outcome of care and takes appropriate action through use of standing orders and protocols. Applies critical reasoning and professional judgement to nursing practice issues / decisions. Collates information regarding client outcomes and presents this formally to the clinical team for review. Documentation of caseload and outcome statistics is reviewed. Documentation is professional, accurate and transparent. Waitemata District Health Board -JOB DESCRIPTION - Page 2
KEY TASKS Team relationships Quality Improvement Contribution to the team and clinical work setting Clinical and Professional Leadership, continued Education and Clinical Teaching Quality Improvement EXPECTED OUTCOMES Works collaboratively with the medical teams to achieve effective teamwork and positive relationships. Addresses issues with them so that they receive advice and recommendations constructively. Critiques and uses national/international research findings. Fosters inquiry, critical thinking and research skill acquisition among the nursing workforce to advance nursing practise and patients/client care. Works in collaboration with senior nursing team and multidisciplinary team to develop a workforce and culture that fosters the provision of positive patient/client outcomes. Monitors standards of nursing and clinical practice and presents issues to the Transfusion Committee Fosters the implementation of WDHB goals and values. Promotes WDHB as a centre of excellence of nursing practice. Leads professional conduct by example. Provides professional leadership to the nursing team with clear expectations of client outcomes and standards expected. Documentation of caseload statistics is maintained and reviewed e.g. databases. Participates in nursing practice research in the field of specialty and presents findings in articles and conference papers. Identifies and addresses learning needs across the WDHB in transfusion practice and risk management. This includes input at study days and one on one teaching at the bed side. Facilitates the development of staff competence appropriate for WDHB and specialty area. Role models and maintains own clinical expertise in specialty area. Shares knowledge with staff so that they emulate best practice. Supports nursing practice to ensure specialty care is delivered appropriately. Provides expert advice and best practice recommendations to staff across the WDHB in specialty. Provides clinical supervision to specialty area ensuring a system of the feedback is utilised to address deficits. Acts as a clinical resource for all clinical staff. Facilitates and/or participates in critical incidents debriefing. Contributes to continuous quality improvement in the workplace: undertakes audits, makes Waitemata District Health Board -JOB DESCRIPTION - Page 3
KEY TASKS Interprofessional health care and quality improvement Professional Development and Clinical Competency Practices nursing to demonstrate professional responsibility EXPECTED OUTCOMES clear recommendations for improvement. Works in collaboration with Blood Bank to minimise blood product/component wastage Works in collaboration with the Laboratory Clinical Director and Management team to reduce the number of unnecessary laboratory test requests. Addresses risk and privacy requirements. Risks are identified and remedial action taken to address issues in a prompt manner. Maintains knowledge of / updates / develops WDHB policies/procedures and resources in clinical area. Contributes professionally to multidisciplinary clinical discussion and decision as appropriate. Peer review is well established. Develops and maintains quality systems and professional standards. Standards are contemporary, evidence-based and complied with. Quality indicators are monitored and remedial action taken. Reports are well presented and demonstrate appropriate follow-up of target groups and secondary referrals. Leads evidence based nursing practices across the service. Leads clinical audit, policy review and change processes to ensure contemporary practice in specialty. Identifies barriers to patient/client, family or whanau satisfaction and addresses same. Identify and manage areas of non-compliance with standards and procedures for transfusion Practises in accordance with best practice legal, ethical and professional standard. Maintains own clinical expertise and knowledge in current specialty to facilitate clinical teaching. Establishes annual goals, objectives, performance targets and strategies to meet these. Maintains a portfolio annually and submits for formal assessment 3 yearly. Develops and improves own post registration qualifications and advanced practice in relation to role. Proactively participates in own performance development and review. Identifies and promotes staff development based on knowledge of service needs and WDHB strategic direction. Waitemata District Health Board -JOB DESCRIPTION - Page 4
KEY TASKS Culturally sensitive practice Workplace Health and Safety EXPECTED OUTCOMES Actively participate in professional transfusion nursing groups Establish and maintain effective local, regional, national and international networks. Critiques research findings and use these as a basis for expert nursing practice. Attends educational opportunities/conferences relevant to nurse Specialist role and scope of practice Shows understanding of and commitment to the principles of the Treaty of Waitangi (partnership, protection, participation) and importance of Whare Tapa Wha (the four cornerstones of health) te taha wairua (spiritual aspects); te taha hinegaro (mental and emotional aspects) ; te taha whanau (family and community aspects); and te taha tinana (physical aspects). Recognises culturally appropriate and safe practice in the nursing workforce and assists in initiatives developed to reduce inequalities and positively impact on Maori health status Assists in the leadership and management of projects to improve Maori access to healthcare services. Company health and safety policies are read and understood and relevant procedures applied to their own work activities. Workplace hazards are identified and reported, including self-management of hazards where appropriate. Can identify health and safety representative for area. Statutory & Treaty of Waitangi obligations Ensures the professional and political integrity of WDHB by carrying out all functions in compliance of the Treaty of Waitangi and by demonstrating a serious commitment to keeping the treaty alive. To recognise Individual Responsibility for Workplace Health and Safety under the Health and Safety in Employment Act 1992 Shows sensitivity to cultural complexity in the workforce and patient population Company health and safety policies are read and understood and relevant procedures applied to their own work activities Workplace hazards are identified and reported, including self management of hazards where appropriate Can identify health and safety representative for area Waitemata District Health Board -JOB DESCRIPTION - Page 5
Our Purpose, Values and Standards At the heart of Waitemata DHB is our promise of better care for everyone. This promise statement is the articulation of our three-fold purpose to: 1. promote wellness, 2. prevent, cure and ameliorate ill health and 3. relieve the suffering of those entrusted to our care. At the heart of our values is the need for all of us to reflect on the intrinsic dignity of every single person that enters our care. It is a privilege to be able to care for patients, whānau and our community, a privilege that is sometimes overlooked in our day to day work. Our standards and behaviours serve as a reminder to us all about how we are with our patients and with each other. Note: This job description forms part of an individual s contract of employment with WDHB and must be attached to that contract. Waitemata District Health Board -JOB DESCRIPTION - Page 6
PERSON SPECIFICATION POSITION TITLE: Clinical Nurse Specialist Qualification Minimum NZ Registered Nurse with a current practicing certificate Consistent practice at Level III or greater Post graduate certificate in Nursing Preferred Post graduate diploma leading to Masters in Nursing On-going commitment to continuing education Experience 5+ years experience post registration Skills/Knowledge/Behaviour Extensive nursing knowledge at level 3 or 4 Highly competent in dealing with complex clinical presentations Highly proficient, technically competent in core nursing practices e.g. advanced assessment skills, sound clinical judgement, collaborative prescribing and application of treatment protocols Understanding of the patient care processes and can map a more efficient service Reputation for positive manner and ability to work with patients, nurses and medical staff in a collaborative way to achieve Knowledge of nursing professional development issues Project management experience Research skills including data analysis and critical appraisal skills and clinical audit Experience in multi-disciplinary clinical teaching Waitemata District Health Board -JOB DESCRIPTION - Page 7
best patient outcomes Competent computer skills for data management and clinical care management Proven skills in researching, accessing and synthesizing information and ability to produce reports Ability to effectively share clinical knowledge with others Seeks guidance and advice from medical associates when necessary Committed to continuous quality improvements and policy requirements for WDHB Excellent communicator intelligent, positive, realistic and inclusive Excellent interpersonal and customer services practices Understanding of and commitment to the principles of the Treaty of Waitangi Initiative and innovation in practice and project management Waitemata District Health Board -JOB DESCRIPTION - Page 8