Clinical Nurse Manager, Deteriorating Patients, University Hospital

Details of Service

Cork University Hospital (CUH) has approximately 800 beds and this will increase further to 1,000 beds on completion of the transfer of additional services to the CUH campus. CUH currently employs approximately 4,571 (WTE) staff of multiple professions and is the primary teaching hospital for the Faculty of Health and Science in University College Cork (UCC). UCC is the Academic partner of the South/South West Hospital Group. CUH has very strong relationships with each of the six schools within the Science Faculty of UCC and this is a key area for future development to maximise the opportunities for both the service and academia.

CUH is a recommended Major Trauma Centre for the Republic of Ireland due to the wide range of specialties delivered by the hospital – including Neurosciences, Cardiac Services, Orthopaedics, General Surgery, Renal, Internal Medicine, Vascular, Ophthalmology, Urology, Plastic Surgery, Maxillary-Facial, Paediatrics, Intensive Care, Oncology, Haematology, Obstetrics, Gynaecology, Neonatology and Emergency Medicine.

CUH is the tertiary referral centre for the HSE Southern area, and the supra regional area of Limerick, Clare, Tipperary, Waterford and Kilkenny. CUH therefore acts as a regional centre for secondary and tertiary care for the catchment population of approx. 550,000 served by the HSE Southern area and a supra-regional centre for a total a population of 1.2 million.

Six Health Regions have been established within the HSE, on the basis of the geographical boundaries agreed by the Government in July 2019 and they will be operational from 2024.

Each Health Region will be tasked with population specific planning resourcing and delivery of health and social care services for the needs of its unique population. This will result in improved accountability and governance in terms of finance and performance, while also bringing decision-making closer to the frontline.

Health Regions will enable and empower staff to provide services that are:

• Integrated, locally planned and delivered

• Easier to access and navigate

• Available closer to home

Health Regions are geographically-based units with clearly defined populations. They align community and hospital services within specific areas. The HSE will retain a strong but leaner central organisation, with more service provision developed at a local level.

The HSE South West health region will manage and deliver all public health and social care services in Cork and Kerry. HSE South West includes all hospital and community healthcare services in the region.

This includes:

• South / South West Hospital Group S/SWHG

• Cork Kerry Community Healthcare CKCH

• Midlands Louth Meath Community Health Organisation

• Community Healthcare Organisation Dublin North City and County

The Department of Population and Public Health is also now aligned with this health region

Services in the South West health region:

HSE Services working within this region include:

• Acute Hospitals

• Primary care services

• Community services

• Social care services

• Health and social care professionals

• Voluntary sector services

South / South West Hospital Group and Cork Kerry Community Healthcare will become part of HSE South West health region from 3rd March 2025 and the transition to the new structures will be taking place throughout 2025.

Purpose of the Post

The post of CNM 2 has a pivotal role in service planning, co-ordinating, and managing activity and resources within the clinical area. The main responsibilities are: quality assurance, resource management, staffing and staff development, practice development, facilitating communication and professional / clinical leadership and mentorship.

Deteriorating Patient Service CUH

The HSE’s Deteriorating Patient Improvement Programme aims to ensure a standardised and systematic approach to the recognition and management of deteriorating patients through the use of National Early Warning Systems (NEWS). The programme involves the implementation of specific early warning charts like INEWS and PEWS, staff training, audits, and a focus on early detection and emergency response to prevent adverse outcomes such as cardiac arrest or death.

Key components of the Deteriorating Patient Service

· Clinical Observation: Continuous monitoring of patients vital signs

· Escalation: A clear process for escalating concerns when a patient’s condition worsens

· Support for Staff: Provision of support to hospital teams in implementing and using these quality improvement methodologies

· Patient and Family Involvement: Recognising the value of family knowledge in detecting a deteriorating patient

Sepsis

Sepsis directly leads to patient deterioration by triggering a life-threatening, dysregulated inflammatory response to an infection, which can cause organ dysfunction and failure. Patients experiencing deterioration show early warning signs, and identifying these signs can help in recognising and treating sepsis promptly to improve outcomes. Sepsis is a major cause of clinical deterioration and early recognition is crucial, as it’s a time-critical medical emergency.

The post holder will facilitate staff to adopt an integrated approach to the use of NEWS and Sepsis screening, promoting a more efficient approach to earlier interventions in the management of the acutely ill patient.

The attainment of this outcome demands a significant cultural shift in how teams work within all acute wards/units. A more collaborative approach between doctors and nurses in relation to all aspects of patient care is fundamental. A sharing of practice interventions to ensure timeliness and a more prompt escalation to senior members of medical/surgical teams demands that the members of the nursing team are empowered.

Culture changes demand more than educational input. It requires resources in the form of support, feedback, regular auditing and facilitation of team reviews. These supports must be sustained over time. The post holder will have a pivotal role in providing these supports.

Informal Enquiries

We welcome enquiries about the role.

Contact Siobhan Scanlon –Assistant Director of Nursing, siobhan.scanlon@hse.ie /086 7872209- for further information about the role

Contact Ann-Marie O’Keeffe- People Resourcing, annmarie.okeeffe2@hse.ie – for enquiries relating to the recruitment process