Candidate Advanced Nurse Practitioner Alpha 1 Anti-trypsin Deficiency.

Beaumont Hospital is the designated National Centre for excellence in Alpha 1 Anti-Trypsin Deficiency (AATD) and houses the HSE funded National Targeted Detection (NTD) programme. It is recognised worldwide as a major centre for the diagnosis, treatment and research in AATD. Any patient who has a positive result on testing is offered the opportunity to attend Beaumont Hospital specialist AATD clinic where they will receive expert assessment, including lifestyle advice, genetic counselling, and determination of the severity of their condition and its trajectory and allow access to new therapies being considered for AATD. The appointment of a candidate ANP in AATD will be the first of its kind in delivering highly specialised care for patient with AATD, with the focus on the MZ (moderate disease) group of patients with AATD.

The main purpose of the post is to develop the role and supporting documentation under the direction of the Health Care Provider’s Advanced Practice Stakeholder Governance Group, to enable the individual nurse to meet the Nursing and Midwifery Board of Ireland (NMBI) Criteria for Registration as an Advanced Nurse Practitioner as set out in Advanced Practice (Nursing) Standards and Requirements (NMBI, 2017).

The individual will have undertaken the academic preparation and developed the clinical and leadership skills, competencies and knowledge required to meet the criteria to be registered as a candidate Advanced Nurse Practitioner (cRANP) with NMBI.

The value of the nursing contribution as a distinct profession must be safeguarded and articulated in the development of new services led by advanced nurse practitioners, complementing rather than replacing current services delivered by doctors (NMBI 2017 p.9).

The overall purpose of the post is to provide safe, timely, evidenced based nurse-led care to patients at an advanced nursing level .This involves undertaking and documenting a complete episode of patient care (assess, diagnose, plan, treat and discharge patients) according to collaboratively agreed protocols and scope of practice in the clinical setting; demonstrating advanced clinical and theoretical knowledge, critical thinking, clinical leadership and decision making skills.

The advanced practice role demonstrates a high degree of knowledge, skill and experience that is applied within the nurse-patient/client relationship to achieve optimal outcomes through critical analysis, problem solving and accurate decision-making (NMBI, 2017).

Central to this is the provision of quality care, a safe environment and processes for patients using evidence based clinical guidelines that address patient expectations, promote wellness and evaluate care given.

The role will provide clinical leadership and professional scholarship in order to develop nursing practice and health policy at local, regional and national level.

The role will contribute to nursing research to shape and advance nursing practice, education and health care policy at local, national and international levels.

The cANP for Respiratory will gain increased competence in applying ethically sound solutions to complex issues related to individuals and populations by:

• Demonstrating accountability and responsibility for professional practice as a lead healthcare professional in the care of patients with AATD.

• Collaborating with his/her supervisor and local stakeholder group to scope the caseload and scope of practice for the cANP AATD.

• Collaborating with his/her supervisor and local stakeholder group to determine the exclusion criteria for the cANP AATD.

• Articulating safe boundaries and engaging in timely referral and collaboration for those areas outside his/her scope of practice, experience, and competence by establishing, in collaboration with key stakeholders, referral pathways and locally agreed policies, procedures, protocols and guidelines to support and guide the Respiratory service.

• Demonstrating leadership by practising compassionately to facilitate, optimise, promote and support the health, comfort, quality of life and wellbeing of persons whose lives are affected by AATD.• Selecting a professional practice model that provides him/her latitude to control his/her own practice, focusing on person centred care, interpersonal interactions and the promotion of healing environments.

• The chosen professional practice model for nursing will emphasise a caring therapeutic relationship between the cANP Alpha 1 Anti-Trypsin deficiency (AATD)and his/her patients, recognising that cANP AATD work in partnership with their multidisciplinary colleagues.

• Articulating and promoting the advanced practice nursing service in clinical, political and professional contexts {for example presenting key performance outcomes locally and nationally; contributing to the service’s annual report; participating in local and national committees to ensure best practice as per the relevant national clinical and integrated care programme}.

The cANP AATD will enhance his/her advanced knowledge, skills, and abilities to engage in senior clinical decision-making by increasing his/her capability to:

• Conduct a comprehensive holistic health assessment using evidenced based frameworks, policies, procedures, protocols and guidelines to determine diagnoses and inform autonomous advanced nursing care.

• Synthesise and interpret assessment information particularly history including prior treatment outcomes, physical findings and diagnostic data to identify normal, at risk and subnormal states of health.

• Demonstrate timely use of diagnostic investigations / additional evidence-based advanced assessments to inform clinical-decision making.

• Exhibit comprehensive knowledge of therapeutic interventions including pharmacological and non-pharmacological advanced nursing interventions, supported by evidence-based policies, procedures, protocols, and guidelines, relevant legislation, and relevant professional regulatory standards and requirements.

• Initiate and implement health promotion activities and self-management plans in accordance with the wider public health agenda.

• Discharge patients from the service as per an agreed supporting policy, procedure, protocols, guidelines and referral pathways.

The cANP AATD will actively contribute to the professional body of knowledge related to his/her area of advanced practice by enhancing his/her capability to:

• Provide leadership in the translation of new knowledge to clinical practice (for example teaching sessions; journal clubs; case reviews; facilitating clinical supervision to other members of the team).

• Educate others using an advanced expert knowledge base derived from clinical experience, on-going reflection, clinical supervision and engagement in continuous professional development.

• Demonstrate a vision for advanced practice nursing based on service need and a competent expert knowledge base that is developed through research, critical thinking, and experiential learning.

• Demonstrate accountability in considering access, cost and clinical effectiveness when planning, delivering and evaluating care (for example key performance areas, key performance indicators, metrics).

The cANP AATD will negotiate and advocate with other health professionals to ensure the beliefs, rights and wishes of the person are respected by gaining increased competence and capability to:

• Communicate effectively with the healthcare team through sharing of information in accordance with legal, professional and regulatory requirements as per established referral pathways.

• Demonstrate leadership in professional practice by using professional language (verbally and in writing) that represents the plan of care, which is developed in collaboration with the person and shared with the other members of the inter-professional team as per the organisation’s policies, procedures, protocols and guidelines.

• Facilitate clinical supervision and mentorship through utilising one’s expert knowledge and clinical competences.

• Utilise information technology, in accordance with legislation and organisational policies, procedures, protocols and guidelines to record all aspects of advanced nursing care.

The cANP AATD will manage risk to those who access the service through collaborative risk assessments and promotion of a safe environment by:

• Promoting a culture of quality care.

• Proactively seeking feedback from persons receiving care, families and staff on their experiences and suggestions for improvement.

• Implementing practice changes using negotiation and consensus building, in collaboration with the multidisciplinary team and persons receiving care.

The cANP AATD will lead in multidisciplinary team planning for transitions across the continuum of care by enhancing his/her competence and capability to:

• Demonstrate clinical leadership in the design and evaluation of services (for example findings from research, audit, metrics, new evidence).

• Engage in health policy development, implementation, and evaluation (for example key performance indicators from national clinical and integrated care programme/HSE national service plan/ local service need to influence and shape the future development and direction of advanced practice in Respiratory.• Identify gaps in the provision of care and services pertaining to his/her area of advanced practice and expand the service to enhance the quality, effectiveness and safety of the service in response to emerging healthcare needs.

• Lead in managing and implementing change.

Performance Indicators (PI’s) are required to evaluate nursing interventions and implement initiatives to improve quality and quantity of the nursing care provided. They should have a clinical nursing focus as well as a breakdown of activity, including patients seen and treated. In addition, they identify areas of good practice that must be recognised and celebrated (HSE 2015).

The Department of Health (2017) Framework for National Performance Indicators for Nursing and Midwifery provides a guiding framework for the development of Nursing and Midwifery PI’s.

In collaboration with the Director of Nursing, the cANP will identify and develop Nursing PI’s for their area of practice, collect and collate data which will provide evidence of the impact and effectiveness of the interventions undertaken.

The cANP AATD will evaluate audit results and research findings to identify areas for quality improvement in collaboration with nursing management and multidisciplinary team colleagues (primary and secondary care).

The cANP AATD will practice nursing according to:

• Professional clinical guidelines

• National Health Policy• Local policies, procedures, protocols and guidelines

• Current legislation

• Values for Nursing and Midwifery – Care, Compassion and Commitment (DoH, 2016).

The cANP AATD will:

• Contribute to service development through appropriate continuous education, research initiatives, keeping up to date with nursing literature, recent nursing research and new developments in nursing practice, education and management.

• Provide support and advice to those engaging in continuous professional development in his/her area of advanced nursing practice.

The cANP must develop a professional practice portfolio, incorporating evidence of learning from continuing professional development, clinical supervision, reflective practice and review of his/her own scope of practice in accordance with regulatory requirements and service need.

Name: Yvonne WhelanTitle: Directorate Nurse Manager Email address: Yvonnewhelan@beaumont.ieTelephone: 01 852 8197

  If an appointee has previously been employed in the Civil or Public Service and that appointee is entitled to or in receipt of a pension from the Civil or Public Service or where a Civil/ Public Service pension comes into payment during the appointee’s re-employment that pension will be subject to abatement in accordance with Section 52 of the Public Service Pensions (Single Scheme and other Provisions) Act 2012. Please note: In applying for this position you are acknowledging that you understand that the abatement provisions, where relevant, will apply. It is not envisaged that the employing Department/ Office/ Body will support an application for an abatement waiver in respect of appointments to this position. Please be aware that Beaumont Hospital will never ask candidates to pay money at any stage of the recruitment process. Any requests for payment, bank details, or financial information in connection with a job application should be treated as fraudulent. If you receive such a request claiming to be from Beaumont Hospital, please do not respond and report to the recruitment department immediately 

Selection criteria outline the qualifications, skills, knowledge and/or experience that the successful candidate would need to demonstrate for successful discharge of the responsibilities of the post.

Applications will be assessed on the basis of how well candidates satisfy these criteria.