Date: December 2016 Job Title : Speciality Nurse - Fracture Liaison Nurse Department : Medicine & Health of Older People Location : Waitemata DHB Reporting To : Operations Manager, Medical subspecialties for meeting performance objectives with regards to management and clinical service strategies Clinical Nurse Director Community & Specialty Practice, for the safety of professional practice performance to the highest standard possible advanced practice performance, practice standards and contribution to service development. Direct Reports : None Functional Relationships with : Internal Clinical Directors Surgeons Outpatient Department Ward/ unit Nursing and Medical colleagues Clinical Nurse Educator Clinical Nurse Specialists Clinical Coach Allied health team External Patients and their families Volunteers and related groups General Practitioners Our DHB 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 en our care. It is a privilege to be able to care for patients, whānau and our community, a privilege that is sometime 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.
Purpose of the role: To identify patients over the age of 50 years who present with a fragility fracture who are at risk of osteoporosis, future falls and secondary fractures. To initiate appropriate screening for osteoporosis, provide patient education on factors that influence bone health, develop treatment pathways in conjunction with senior staff and liaise between patient, GP and medical staff. 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.
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 Nursing Council of New Zealand and PDRP competencies at minimum of RN Level 4 requirements refer generic RN competencies Perceived as a highly effective, progressive, senior nurse, with an interest and knowledge of the diagnosis and management of Osteoporosis and the prevention of secondary fractures. Maintains and develops own clinical competence and complies with the requirements of the Health Practitioners Competency Assurance Act (2004) Demonstrates compliance with WDHBs Professional Development and Recognition Programme (PDRP) and Annual Performance Review processes Professional Leadership and Applies critical reasoning and professional judgement to nursing practice issues and decisions for patients at risk Expertise Provides advanced practice specialty nursing assessment to planning care Acts as a positive role model and presents a professional image Maintains professional development through on-going education, participation in professional groups and attends conferences relevant to scope of practice. Demonstrates an understanding of the concepts of cultural safety and practices nursing in a manner that the client determines as being culturally safe Complies with WDHB Health policies and procedures 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 Clinical Provision: Practices at an advanced practice level Proactively and systematically identify patients over the age of 50 years who present to WDHB with a fragility fracture Complete an Osteoporosis risk assessment and refer patients for appropriate screening tests i.e. DEXA scan, blood tests. Provide patients and family members with information on factors that influence bone health; including lifestyle measures, nutrition, bone protection medications and falls prevention Follow up and review test results (in conjunction with senior staff) to facilitate the commencement of appropriate treatment pathways for those patients who have been diagnosed with osteoporosis or at high risk of future falls and fractures. Develop a long term treatment plan and liaise with patient and GP Refer appropriate patients to other specialist services ( bone clinic, falls prevention) Provide on-going education to medical/nursing staff (updates in osteoporosis Ensure that documentation is accurate, timely and confidentiality is maintained Develops critical thinking and problem solving skills to make effective decisions within appropriate time frames and level of responsibility. Reflects upon, and evaluates with other senior nurses the effectiveness of client management Bases nursing practice on current evidence based research In conjunction with colleagues, assists with clinical audit and research components Contributes to the development and maintenance of policies, procedures and resources within the Fracture Liaison.
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. Establishes a positive partnership /relationship with the client Practices nursing in a negotiated partnership with the client Acts as an advocate to promote client needs and rights. Collaborates and participates with colleagues and members of the health care team to facilitate and coordinate client care and education. Demonstrates clinical and professional leadership through effective teamwork and collaborative relationships Role models advanced therapeutic communication, engages patient and family in care planning for selfcare, improving knowledge of disease/illness, self-management, prevention of complications and promotion of recovery Domain Four Interprofessional 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 Supports Assists in the models of care appropriate to Fracture Liaison clients Professional Activity Self-directed in achieving own learning and development plan, including PDRP responsibilities / current portfolio Actively participates in professional nursing groups, maintains effective local, regional, national and international networks. Attends educational opportunities and conferences sharing new knowledge with colleagues Quality Improvement Contributes in quality & care improvement processes, risk management and resource utilisation review, including trending and auditing and developing appropriate responses educational, policy, advisory at client, nurse and system level Identifies efficiencies through new and innovative ways of working, improves quality of care and client experience Research & Audit; Evidence based practice 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. Implements standards of nursing practice and supports practice improvements. Works to ensure recommended best practice guidelines/policies are research based and relevant across Waitemata DHB Supports other senior nurses to foster inquiry, critical thinking and research skill acquisition to advance nursing practice and client care Confident use of technology. Critiques and uses research findings in practice. 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 Shows sensitivity to cultural complexity in the workforce and patient population
Recognise Individual Responsibility for Workplace Health and Safety under the Health and Safety Act 1992 VERIFICATION: Employee: Manager: Date: Identifies areas of risk and works with service managers to address issues Implements WDHB H&S policies and relevant procedures in the service Reports and develops proposals to manage hazards e.g. safe staffing Note: This job description forms part of an individual s contract of employment and must be attached to that contract
PERSON SPECIFICATION POSITION TITLE: Education and Qualifications Experience Skills/Knowledge/ Behaviour Personal Attributes Fracture Liaison Nurse Specialty Nurse Registered Nurse RCpN, RGON, BHSC with current Annual Practising Certificate with current portfolio/equivalent Post graduate certificate in nursing; must include advanced assessment and diagnostic reasoning skills. Achieved RN Level 4 or equivalent in specialty with current portfolio Reputation for excellence in area of specialty practice 3 years post registration in nursing practice 2 to 3 years minimum experience in haematology nursing Some understanding of Primary Health/Community care contribution Specialty knowledge and knowledge of the care pathways for this patient group Demonstrated operational / care coordination skills Clinical professional role modelling Demonstrated confidence in quality improvement to improve service delivery and patient experience Understands the importance of good relationships A passion for improving haematology nursing practice and standards of care Ability to work as a team member 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