Date August 2015 Job Title : Perioperative Nurse- Anaesthesia [Specialty Nurse] Department : Anaesthesia and Perioperative Medicine Location : Waitemata District Health Board Reporting To : Clinical Director Department of Anaesthesia Unit Manger Theatres {Professional nursing line} Direct Reports : None Functional Relationships : Internal Clinical Director and Members of the Anaesthetic Service Perioperative Nurse Coordinators in other services Business Support Manager Booking & Scheduling Department Outpatient Departments Unit Manager Theatres Theatre staff Charge Nurse Managers Clinical Nurse Specialists Nursing staff Surgeons External Patients and families/carers Primary Care providers including GP s Other DHB providers Ministry of Health 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. Page 1
Purpose Co-ordinate the perioperative process for patients presenting for elective surgery - from FSA through to day of surgery. Specialty Clinical Nurse: Definition under DHBNZ/NZNO titles Works in a narrow field but with more in-depth knowledge and skills than RN Enhance health outcomes for clients by working directly with them to provide assessment, care and education within specific area of practice Contributes to development of pathways, protocols and guidelines in the specific area of practice Works in a defined role using clinical pathways for assessment, referring to senior medical and Nurse Specialists for ongoing care. Page 2
Clinical Care/Care Coordination Professional Leadership and Expertise KEY ACCOUNTABILITIES Domain One Professional responsibility Includes accountabilities for professional, legal, ethical and culturally safe practice. This includes being able to demonstrate advanced critical thinking, judgement and accountability for own actions and decisions Meets all registered nurse PDRP competencies at minimum of RN Level 4 requirements refer generic RN competencies and those described for surgical/perioperative nursing or is committed to apply for recognition at this level Perceived as highly effective, progressive and knowledgeable in surgical and perioperative nursing, according to legal, ethical, cultural safety/ sensitivity and professional standards. Present PDRP self-assessment annually to Unit Manager of Theatres and meets the competency requirements annually / maintains annual practice registration. Completion and submission of a three yearly portfolio is required Plans personal and professional development and planned learning activities. Applies critical reasoning and professional judgement to nursing practice issues and decisions for patients at risk Provides advanced practice specialty gerontology nursing assessment to planning care Acts as a positive role model and presents a professional image Domain Two Management of nursing care at advanced practice level Includes accountability related to patient/client assessment and management of advanced nursing care that is supported by evidence Patient Care management and Peri-operative Co-ordination Contributes to the productive model in North Shore and the delivery of an efficient and effective service. Contributes nursing expertise to the peri-operative and preadmission process through open communication and engagement with patients, the wider multidisciplinary WDHB teams and primary care. Liaise with multi-disciplinary teams and primary care providers to provide an optimal plan of care for patients scheduled for an elective surgery procedure at North Shore Hospital. Liaise with WDHB preadmission service and/or procedural anaesthetist to ensure anaesthetic clearance is complete. Provides assessment and co-ordination for patients presenting for elective surgery. Coordinating patient care from initial referral through to procedure / surgery from an anaesthetic perspective via: Management of nursing care at advanced practice level Anaesthetic "virtual" triage: Receive and review patient health questionnaires Telephone patients as required Make a clinical assessment as to whether patients should attend the anaesthetic outpatient clinic in person or proceed direct to surgery Communicate this decision to surgical booking staff, surgeons and anaesthetists Pass on peri-operative information (e.g. regarding required investigations /epidurals / starvation guidelines and what to do with medications around the time of surgery) to patients Educates and provides information to patients / clients / family / whanau to improve knowledge of disease / illness, self-management, prevention of complications and promotion of recovery. Anaesthetic assessment in the outpatient clinic Role under development physically seeing and assessing patients in person Page 3
Quality Improvement: Guideline and policy development Supports Professional Activity Education and clinical teaching Co-ordination of "challenging patients" Ensuring smooth progress to surgery with minimal delay for complex patients (e.g. those who require investigation / assessment by cardiology prior to surgery). This involves chasing up investigations, specialist clinic outcomes and communicating to surgeons, bookers and the procedural anaesthetist. Co-ordination of Cardio-pulmonary Exercise Testing Handling referrals for this useful investigation and communicating the results to anaesthetic/ ICU/s surgical staff Co-ordination with ICU/HDU for elective surgical admissions processes under development Contributes to WDHB systems and processes to ensure that service and consumer needs are met. Ensures effective multidisciplinary and primary care engagement to ensure consumer needs are achieved in a timely manner. Works collaboratively with interfacing departments and primary care. Works with the CNM s of theatre to ensure effective management of surgery in alignment with WDHB KPI s. Works closely with allied health and pharmacy to ensure appropriate pre-admission activities and packages of care are in place for patients prior to day of surgery /admission. Contributes to the provision of effective customer service and acts as an advocate for the patient and their support, facilitating informed decision making for patients Education (+/-Credentialing) of future anaesthetic and surgical PNC's Formal education of future colleagues is anticipated as well as informal contribution to the peri-operative community of practice Domain Three Interpersonal relationships and enhancing the patient experience Includes accountability for interpersonal and therapeutic communication with clients/patients and members of the health care team. Demonstrates clinical and professional leadership through effective teamwork and collaborative relationships Acts as an advocate to promote patient needs and rights. Collaborates and participates with colleagues and members of the health care team to facilitate and coordinate patient care and education, both within the primary and secondary care settings. Communicates and works with external agencies/educators to ensure continuity of care and best patient outcomes. Role models advanced therapeutic communication, engages patient and family in care planning for self-care, improving knowledge of disease/illness, self-management, prevention of complications and promotion of recovery Domain Four Inter-professional healthcare and quality improvement to deliver organisational objectives Includes accountability for evaluating the effectiveness of care and promotion of nursing perspective within the health care team Provides teaching nursing and medical education; participates in clinical governance activities including audit and research; Administration organisational requirement; contribution to service planning and policy development; professional development Assists in the implementation of nursing practice and models of care appropriate to patient/client population needs Contributes to the development/review of best practice pathways, protocols and guidelines in the specific area of practice that are research based Leads/contributes/collaborates in quality & care improvement processes, risk management and resource utilisation review, including trending and auditing and developing appropriate responses educational, policy, advisory at patient, nurse and system level Identifies efficiencies through new and innovative ways of working, improve quality of care and patients experience Page 4
Statutory & Treaty of Waitangi obligations Workplace Health & Safety Research & Audit; Evidence based practice Service Development Assists with implementing the service strategy in a project or programme of work to enhance the patient experience, access to service. Includes assisting in implementation and management of initiatives to address differential access to healthcare services for Maori. Participates in the development and delivery of the Anaesthesia Quality and Risk management plan and audit program. Develops and implements standards of nursing practice in the specific area of practice and supports practice improvements. Works to ensure recommended best practice guidelines/policies are research based and relevant across Waitemata DHB Supports the Nurse Specialists to fosters inquiry, critical thinking and research skill acquisition to advance nursing practice and patient/client care Confident use of technology. Critiques and uses research findings in practice. Participates in research. Demonstrates ability to access and use available clinical information systems. Is conversant with applications required for specific discipline/role. For example, PIMS, Concerto, Outlook, etc. Relevant data entry to customised database completed in appropriate time frames Audit Clinical and process audit to improve quality of service provided by the department Provides nursing knowledge and skills to assess, plan, implement and evaluate patients / clients / family / whanau health needs. Provides information and education for families and support about preadmission process, admission, hospital episode and discharge. Contributes to the development and update of patient information and resources. Identifies barriers and solutions to access for patient / client, family or whanau. Liaise with multi-disciplinary teams (inclusive of allied health and pharmacy) and primary care providers to provide an optimal plan of care for patients scheduled for an elective surgery procedure. Provides a high standard of service delivery within the framework of WDHB clinical standards and ensures practice reflects recommended best practice. Recognises Individual Responsibility for Workplace Health and Safety under the Health and Safety in Employment Act 1992. Policies are read and understood and relevant procedures applied to their own work activities. Identifying, reporting & self-managing hazards where appropriate Early and accurate reporting of incidents at work 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. Shows sensitivity to cultural complexity in the workforce and patient population Page 5
VERIFICATION: Employee: Manager: Date: Note: This job description forms part of an individual s contract of employment and must be attached to that contract PERSON SPECIFICATION POSITION TITLE: Perioperative Nurse Anaesthesia Education and Qualifications Experience Skills/Knowledge/ Behaviour RCpN, RGON, BHSC Current APC as Registered Nurse in New Zealand Post graduate certificate completed or in progress OR recognised surgical/perioperative specific post graduate qualification. Must include advanced assessment and diagnostic reasoning skills. At least five years post registration practice in the specialty Achieved RN Level 4 or equivalent in specialty with current portfolio Reputation for excellence in specialty practice 3 to 5 years post registration in nursing practice. 2 to 3 years minimum experience in acute surgical nursing Counselling skills Multidisciplinary practice Confident in application of basic computer programs including Microsoft Outlook, Windows and Excel and report writing Experience with the public health Booking and Scheduling systems preferred Advanced physical assessment, history taking, diagnostic reasoning and pharmacology knowledge Demonstrated operational management/care coordination skills Clinical professional leadership Confident multidisciplinary teacher Project management and quality improvement processes Demonstrated confidence in quality improvement to improve service delivery Understands the importance of good relationships in ensuring continuity of care: hospital and community care A passion for improving surgical nursing practice and standards of care Ability to work independently and as a team member Page 6
Personal Attributes Leadership People management Teamwork Cultural safety Self-management Patient/client population focused Communication / interpersonal skills Innovation Flexibility Planning and monitoring Proactive attitude Excellent communicator Articulate, good presentation skills Self directed and motivated Strong teamwork reputation, confident collaboration Resilience Positive professionally mature Able to influence without conflict, accepts constructive feedback Culturally safe practice Page 7