Clinical Nurse Manager, Hepatology

Purpose of the Post

The Clinical Nurse Manager 2 post holder will deliver care in line with the five core concepts of the role set out in the Framework for the Establishment of Clinical Nurse/Midwife Specialist Posts, 4th edition, National Council for the Professional Development of Nursing and Midwifery (NCNM) 2008.

Clinical Focus

The Clinical Nurse Manager 2 (CNM2) will be supported to:

Develop a strong service user focus whereby the specialty defines itself as nursing/midwifery and subscribes to the overall purpose, functions and ethical standards of nursing/midwifery.

The clinical practice role may be divided into direct and indirect care. Direct care comprises the assessment, planning, delivery and evaluation of care to the service user, family and/or carer. Indirect care relates to activities that influence and support the provision of direct care.

Direct Care

• Provide a specialist nursing service for service users with liver disorders who require support and treatment through the continuum of care.
• Use the outcomes ofnursing assessment to develop and implement plans of care/service user group management to contribute to the plans of service users, their families/carers and the MDT.
• Monitor and evaluate the service user’s response to treatment and amend the plan of care accordingly in collaboration with the MDT and service user, family and/or carer as appropriate.
• Make alterations in the management of service user condition in collaboration with the MDT and the service user in line with the nursing/midwifery aspect of agreed pathways and policies, procedures, protocols and guidelines (PPPG’s).
• Accept appropriate referrals from MDT colleagues.
• Co-ordinate investigations, treatment therapies and service user follow-up.
• Communicate with service users, family and/or carer as appropriate, to assess service user needs and provide relevant support, information, education, advice and counselling as required.
• Where appropriate, work collaboratively with MDT colleagues across Primary and Secondary Care to provide a seamless service delivery to the service user, family and/or carer as appropriate.
• Participate in medication reconciliation taking cognisance of poly-pharmacy and support medical and pharmacy staff with medication reviews and medication management.
• Identify and promote specific symptom management strategies as well as the identification of triggers, which may cause exacerbation of symptoms. Provide service user with appropriate self-management strategies and escalation pathways.
• Manage nurse/midwife led Specialist Hepatologyclinics in collaboration with the MDT.
• Identify health promotion priorities for the service user, family and/or carer and support service user self-care in line with best evidence. This will include the provision of educational and health promotion material which is comprehensive, easy to understand and meets service user’ needs.

Indirect Care

• Identify and agree appropriate referral pathways for service user with Liver disorders.
• Co-Management of individuals on hepatitis B and C treatments.
• Participate in service user case reviews with MDT colleagues.
• Use a case management approach to service user complex needs in collaboration with MDT in both Primary and Secondary Care as appropriate.
• Take a proactive role in the formulation and provision of evidence based PPPGs relating to hepatology care.
• Take a lead role in ensuring the nursing/midwifery service for service user with Liver disorders are in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012).

Service User/Client Advocate

• Communicate, negotiate and represent service user, family and/or carer values and decisions in relation to their conditionto MDT colleagues in both Primary and Secondary Care as appropriate.
• Develop and support the concept of advocacy, particularly in relation to service user participation in decision making, thereby enabling informed choice of treatment options.
• Respect and maintain the privacy, dignity and confidentiality of the service user, family and/or carers.
• Establish, maintain and improve procedures for nursing/midwifery collaboration and cooperation between Acute Services, Primary Care and Voluntary Organisations as appropriate.
• Proactively challenge any interaction, nursing/midwifery or otherwise, which fails to deliver a good quality service to service user.

Audit & Research

• Establish and maintain a register of service users with Liver conditions within the Clinical Nurse Manager 2 Caseload.
• Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPI’s) as directed and advised by the DoN/M/Services in conjunction with the senior clinical decision maker.
• Identify, initiate and conduct nursing/midwifery audit and research relevant to the area of practice and take part in MDT audit and research.
• Identify, critically analyse, disseminate and integrate into practice, best evidence relating to care in hepatology.
• Contribute to nursing/midwifery research on patients with haemochromatosis & specific liver conditions.
• Use the outcomes of audit to improve nursing/midwifery service provision and advocate, when appropriate, for improvement of non-nursing/midwifery services.
• Contribute to service planning and budgetary processes through use of audit data and specialist knowledge.
• Monitor, access, utilise and disseminate current relevant research to advise and ensure the provision of informed evidence-based nursing/midwifery practice.

Management/Administration

• Provide an efficient, effective and high-quality nursing/midwifery service, respecting the needs of each service user, family and/or carer.
• Effectively manage time and caseloadin order to meet changing and developing service needs.
• Continually monitor the nursing/midwifery service to ensure it reflects current service user and organisational needs.
• Implement and manage identified changes.
• Ensure that confidentiality in relation to service user records is maintained.
• Understand the need to represent the specialist nursing/midwifery service at local, national and international fora as required.
• Maintain accurate and contemporaneous records and data on all matters pertaining to the planning, management, delivery and evaluation of nursing/midwifery specialist care and ensure that this service is in line with HSE requirements.
• Contribute to the service planning process as appropriate and as directed by the Director of Nursing/Midwifery/Line Manager.