L Clinical Nurse Specialist Candidate Diabetes

Purpose of the Post

The Policy on the Development of Graduate to Advanced Nursing and Midwifery Practice (DOH, 2019) outlines a pathway to support a change for specialist practice to develop and meet service need, including the revised eligibility criteria for CNS as follows:

· A minimum of 1 years’ experience in practice prior to completing the required post graduate qualification in the specialist area at Quality and Qualifications Ireland (QQI), National Framework of Qualifications (NFQ) major academic Level 9 or higher award that is relevant to the specialist area of care (equivalent to 60 ECTS or above)

· Recognition as a CNS/CMS to meet service needs therefore requires the completion of a postgraduate qualification together with a minimum of 1 years’ specialist experience

· This is in addition to meeting the requirements set by the HSE to ensure the delivery of safe, effective practice to meet service demands

In response to an identified service need a candidate CNS pathway has been established and sets out the following:

1. Nurses/Midwives currently employed as Staff Nurses/Midwives (SN/SMs) and Enhanced Nurses/Midwives (EN/EMs) and any other nursing/midwifery grades who have a minimum of 1 years clinical experience and who express an interest in CNS/CMS roles could be supported to progress on a candidate CNS/CMS pathway as follows:

A recruitment campaign will be organised by the IHA/Health Region between local HR and services.

Nurses/midwives who are successful at interview for candidate CNS/CMS posts will:

· be offered a contract for a candidate CNS post (Diabetes) at CNM1/CMM1 grade with a job description outlining the cCNS/cCMS competencies to be achieved.

· be required to demonstrate their specialist experience or if they do not possess the relevant specialist experience, they will be supported to attain one year’s clinical specialist experience

· be required to demonstrate that they have completed the required postgraduate education, or agree and are supported to undertake the required postgraduate education, at QQI, NFQ Level 9 qualification (equivalent to 60 ECTS or above) relevant to the specialist area.

· be required to demonstrate that they have continuing professional development (CPD) relevant to the specialist area or will be supported to obtain the required CPD.

All the above must be achieved within 2 years from appointment for this pathway.

2. For Nurses/Midwives who express an interest in CNS/CMS roles and who currently hold a QQI, NFQ Level 8 educational qualification in the specialist area (equivalent to 60 ECTS or above), this qualification will be recognised up to September 2026.

The clinical experience requirements for this cohort of nurses/midwives remain consistent with the DoH (2019) policy, i.e. a minimum of 1 years’ experience in practice and a minimum of 1 years’ experience in the specialist area and they could be supported to progress on a candidate CNS/CMS Pathway.

The above pathway is valid from May 2023 to September 2026

As outlined in this job description, the cCNS pathway will facilitate the post holder to be supported to professionally and clinically develop the skills and knowledge required to achieve the competencies of the CNS role.

The cCNS post holder will be enabled to 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.

The cCNS clinical role is based on the core concepts and associated competencies for the CNS/CMS (adapted from NCNM 4th edition 2008) The concepts are:

· Clinical Focus (Direct and Indirect Care)

· Service user/Service User Advocacy

· Education and Training

· Audit and Research

Consultancy (including leadership in clinical practice)

cCNS Patient Caseload

· The cCNS Diabetes will assist in the care for patients over 16 years old and work alongside the Diabetes Clinical nursing and medical team to delivery holistic care which is focused on individual needs.

Principal Duties and Responsibilities

The post holder’s practice is based on the five core concepts of the CNS role as defined by the NCNM 4th edition (2008) in order to fulfil the role. The concepts are:

• Clinical Focus
• Patient/Client Advocate
• Education and Training
• Audit and Research
• Consultant

Clinical Focus

· Clinical Nurse Specialist (Diabetes) will have a strong patient focus whereby the specialty defines itself as Nursing and subscribes to the overall purpose, functions and ethical standards of Nursing.

· 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 patient, family and/or carer.

· Indirect care relates to activities that influence and support the provision of direct care.

Direct Care

Through the agreed pathway, the cCNS in Diabetes will:

· Be enabled to provide a specialist nursing service for patients with a diagnosis of diabetes who require support and treatment through the continuum of care.

· Undertake comprehensive patient assessment to include physical, psychological, social and spiritual elements of care using best evidence-based practice in diabetes care.

· Use the outcomes of patient assessment to develop and implement plans of care/case management in conjunction with the multi-disciplinary team (MDT) and the patient, family and/or carer as appropriate.

· Monitor and evaluate the patient's response to treatment and amend the plan of care accordingly in conjunction with the MDT and patient, family and/or carer as appropriate.

· Make alterations in the management of patient's condition in collaboration with the MDT and the patient in line with agreed pathways and policies, procedures, protocols and guidelines (PPPG's),

· Accept appropriate referrals from MDT colleagues.

· Co-ordinate investigations, treatment therapies and patient follow-up.

· Communicate with patients, family and /or carer as appropriate, to assess patient's 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 patient, 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 patients with appropriate self-management strategies and escalation pathways.

· Manage nurse led clinics with Multidisciplinary team input

· Identify health promotion priorities for the patient, family and/or carer and support patient 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 patient's needs.

Indirect Care

Through the agreed pathway the cCNS in Diabetes will:

• Identify and agree appropriate referral pathways for patients with diabetes.
• Participate in case review with MDT colleagues.
• Use a case management approach to patients with 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 diabetic care.
• Take a lead role in ensuring the service for patients with diabetes is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012).

Patient/Client Advocate

Through the agreed pathway the cCNS in Diabetes will:

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

Education & Training:

Through the agreed pathway, the cCNS in Diabetes will:

• Develop clinical competence in patient management within Diabetic Nursing, keeping up-to-date with relevant research to ensure the implementation of evidence-based practice.
• Provide the patient, family and/or carer with appropriate information and other supportive interventions to increase their knowledge, skill and confidence in managing their diabetes.
• Contribute to the design, development and implementation of education programmes and resources for the patient, family and/or carer in relation to diabetes thus empowering them to self-manage their condition.
• Participate in training programmes for Nursing, MDT colleagues and key stakeholders as appropriate.
• Create exchange of learning opportunities within the MDT in relation to evidence based diabetic care delivery through journal clubs, conferences, etc.
• Develop and maintain links with Regional Centres for Nursing & Midwifery
• Education (RCNMEs), the Nursing and Midwifery Planning and Development Units (NMPDUs) and relevant third level Higher Education Institutes (HEIs) in the design, development and delivery of educational programmes in diabetic care.
• Be responsible for addressing own continuing professional development needs

Audit & Research:

Through the pathway, the cCNS in Diabetes will be enabled to develop the specific knowledge, skills and competencies to::

· Establish and maintain a register of service users with diabetes within the cCNS caseload

· Maintain clinically relevant data aligned to National KPIs as directed by DoN/M

· Identify, initiate and conduct nursing audit and research relevant to practice and participate in MDT audit and research

· Identify, critically analyse, disseminate and integrate best evidence related to diabetes

· Contribute to nursing research on diabetes

· Use audit outcomes to improve nursing service provision and advocate for improvements in non-nursing services as appropriate

· Contribute to service planning and budgetary processes using audit data and specialist knowledge

· Monitor, access, utilise and disseminate current research to ensure evidence-based practice

Audit expected outcomes including:

· Collation of relevant data (agreed KPIs/clinical targets) to provide baseline audit, demonstrate effectiveness of cCNS interventions and show activity (service users seen and treated)

· Evaluation of audit results and research findings to identify areas for quality improvement in collaboration with nursing management and MDT colleagues

Consultant (including leadership in clinical practice):

Through the agreed pathway, the cCNS in Diabetes Service will:

• Will be enabled to provide leadership in clinical practice and act as a resource and role model for diabetes practice.
• Generate and contribute to the development of clinical standards and guidelines and support implementation.
• Use specialist knowledge to support and enhance generalist nursing practice.
• Develop collaborative working relationships with local Clinical Nurse Specialist (Diabetes)'s/Registered Advanced Midwife Practitioner/MDT colleagues as appropriate, developing person centred care pathways to promote the integrated model of care delivery with the support of the Director of Nursing, attend integrated care planning meetings as required
• Where appropriate develop and maintain relationships with specialist services in voluntary organisations which support patients in the community.
• Liaise with other health service providers in the development and on-going delivery of the National Clinical Programme model of care.

· Network with other cCNSs and CNSs (Diabetes)'s in related professional associations

Management / Administration

Throughout the agreed pathway, the cCNS (Diabetes) will be enabled to develop the specific knowledge, skills and competencies to:

· 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 caseload in order to meet changing and developing service need

· Continually monitor the nursing service to ensure it reflects current 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 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/Line Manager

· To support, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.

The above Job Description is not intended to be a comprehensive list of all duties involved and consequently, the post holder may be required to perform other duties as appropriate to the post which may be assigned to them from time to time and to contribute to the development of the post while in office

****** Please Note CV’s will not be accepted for this campaign ******

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Please ensure you read the instructions for the completion of this Application Form and complete all areas, in full. Failure to complete all areas of the Application Form will result in you not being brought forward to the interview stage of the selection process.