Clinical Nurse Specialist Stroke Early Supported Discharge

Principal duties and Responsibilities

Practice nursing according to the Code of Professional Conduct and the Scope of Practice Framework as stated by the Nursing Board of Ireland and the National Clinical Guidelines for Stroke
Work within their scope of practice and take measures to develop and maintain the competence necessary for professional practice
Maintain a high standard of professional behaviour and be accountable for their practice. Ensure the provision of a high standard of care to the patient and families is consistent with the mission vision values and strategic plan of the Hospital
Be aware of ethical policies and procedures which pertain to their area of practice
Follow appropriate lines of authority within the Nurse Management structure
It is essential that the applicant for this role hold a recognised Irish Driving Licence
Comply with all existing Hospital policies

1. Clinical Role
The CNM 2 Acute Stroke and Endovascular Thrombectomy will:

Primary Role - Thrombectomy Service
Develop stroke services in line with the Stroke Care National Clinical Programme Model of Care and associated guidelines with reference to the thrombectomy service

Work in collaboration with other members of the multidisciplinary team in assessing planning implementing and evaluating plan of care for patients with stroke and stroke related illnesses which meets each patients needs. This will encompass

- Nursing assessment of patient care e.g. Function- Barthel Index Cognition-MMSE neurological status-NIHSS / GCS Pre-morbid status-mRS etc.
- Planning patient care - the CNM 2 (Stroke Care) will work closely alongside the multidisciplinary team (MDT) and within agreed protocol driven guidelines to develop individualised a plan of care

- Evaluation of patient care -through audit and research to evaluate quality of patient care. Outcomes of audit / research should also contribute to the service plan of care to the stroke patients / clients and families in the hospital community and outpatient settings.

Make variations in prescribed clinical options within agreed protocols

Develop close working links with other stroke services and actively participate in stroke networks

Actively promote the liaison and co-ordination of care for patients between stroke services the hospital and other hospitals

Contribute to the development and implementation of information sharing protocols audit systems referral pathways individual care plans and shared care arrangements through regular meetings and liaison with stroke nurse specialists nationally alongside IHF and the HSE

Identify and utilise professional and voluntary resources and facilities at local and national level by direct or indirect referral

Participate in the Departmental Clinical Governance processes working in partnership with the Head of Department Assistant Director of Nursing / CNM3 Clinical Governance lead and local and national stroke governance group

Ensure that effective clinical governance procedures are maintained and evolve according to defined needs and demands in stroke service.

Secondary Role- wider stroke service
Contribute to the provision of an efficient effective and high quality service respecting the needs of each patient e.g. same day assessment of stroke patients including rapid tPA assessment establishing a history from the family and patient management of acute complications and providing information and education to both patient staff and family

Effectively manage time and caseload e.g. same day referral assessment and education of stroke patient weekly inpatient education OPD stroke secondary prevention and MDT meetings and staff / other education.

Accept appropriate referrals from members of the multidisciplinary team and other allied health professionals

In collaboration with Consultant staff with other members of the multidisciplinary team refer stroke patients for diagnostic tests and investigations which have been agreed within set protocols e.g. U/S Carotids CT Brain Holter Echo Fasting bloods for risk factors BP Monitor Smoking Cessation and referral to other members of the MDT as agreed

2. Patient Advocate Role

The CNM2 Acute Stroke and Endovascular Thrombectomy will:

Act as patient advocate involving communication negotiation and representation of stroke patients values and decisions in collaboration with other members of the MDT

Liaise with other health service providers in the development and ongoing delivery of this service by co-ordinating weekly MDT meetings

Develop and support the concept of advocacy particularly in relation to patients participation in decision making thereby enabling informed choice of treatment options through education and information

Establish maintain and improve procedures for collaboration and co-operation between acute hospital services

Take appropriate action on any matter identified as being detrimental to staff and / or service user care or well being which may be inhibiting the efficient provision of care

3. Educational role

Maintain clinical nursing and managerial competence in current developments in the field of stroke care to include keeping up to date with relevant research to ensure evidence-based practice and research utilisation

Keep abreast of current trends in nursing through reading attending seminars and having thorough knowledge of nursing policy and standards

Identify the educational needs of patients their carers other professionals and students and participate in training programmes as required

Work with and supervise the care given by student nurses and provide for their personal and professional development

Co-operate with colleagues in providing learning opportunities for all staff and students

Assist in the educational programme of all staff who may care for patients affected by stroke including student nurses

Use every opportunity for discussion demonstrations and teaching for both patients and staff

Liaise and foster good communications with the Nurse Education Centre

Participate in the orientation programmes of all new staff within the department and
in-service programmes

Educate and provide supportive care to the patient and their family through all stages of stroke disease trajectory.

4. Consultant

The CNM2 Acute Stroke and Endovascular Thrombectomy will:

Act as resource in providing specialist knowledge expertise and care in liaison with the multidisciplinary team

Promote the role of the Stroke Care Nursing Services among health care staff

Work with support advise and help build up the knowledge and expertise of the other healthcare professionals involved in providing care for stroke patients through regular formal and informal education.

Act as a resource to hospitals who have received care of patients post thrombectomy procedure with regard to education and advice

Ensure Guidelines are developed agreed and circulated with regards to the National Emergency Thrombectomy Service (in collaboration with the MDT Stroke Team)

5. Audit and Research

The CNM2 Acute Stroke and Endovascular Thrombectomy will:

Manage the information required for the Stroke Register keeping an up-to date monthly account of stroke service statistics that will include data on referrals total number of stroke patients tPA figures age LOS discharge destinations mortality and OPD numbers to audit and plan services

National Thrombectomy Data collection for ongoing detailed service audit and thrombectomy component of HIPE portal / stroke Register inclusive to include phonecall follow up to record outcome measures at agreed intervals

Promote individual best practice interventions in accordance with the identified needs of patients

Undertake and lead in clinical and organisational audit to continually evaluate the effectiveness of the service provided against established research / evidence

Participate and promote nursing research and associated research in this specialist area identifying nursing topics and issues involving the MDT through presentations

Ensure the views of all consumers are effectively sought channelled and acted upon

Implement and manage changes identified by audit and research and required within stroke services

Contribute to the development of key performance indicators and monitoring of same within stroke services

6. Health & Safety Managers

The CNM2 Acute Stroke and Endovascular Thrombectomy will:

Comply with the policies procedures and safe professional practice of the Irish Healthcare System by adhering to relevant legislation regulations and standards

Document appropriately and report any near misses hazards and accidents and bring them to the attention of relevant / designated individual(s) in line with best practice

Work in a safe manner with due care and attention to the safety of self and others

Be aware of risk management issues identify risks and take appropriate action

Comply with department procedures with regard to assessment recommendation and / or manufacturing of all assistive devices

Promote a culture that values diversity and respect

Have a working knowledge of HIQA Standards as they apply to the role for example Standards for Healthcare National Standards for the Prevention and Control of Healthcare Associated Infections Hygiene Standards etc.

7. Administration

The CNM2 Acute Stroke and Endovascular Thrombectomy will:

Ensure the efficient action of complaints in accordance with Beaumont hospital Policy

Contribute to policy development and formulation performance monitoring business planning and budgetary control

Ensure that records are safeguarded and managed as per local policy and in accordance with relevant legislation

Maintain accurate and contemporaneous records / data on all matters pertaining to the planning management delivery and evaluation of this service in line with Health Service Executive / Beaumont Hospital requirements

Participate in the implementation of Information Technology developments

Undertake other duties as required by the Director of Nursing or his / her designate

Selection Criteria:
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.

Mandatory:

1. Statutory Registration Professional Qualifications Experience etc
(a) Eligible applicants will be those who on the closing date for the competition:
(i) Be a registered nurse/midwife on the active Register of Nurses and Midwives
held by An Bord Altranais and Cnáimhseachais na hÉireann (Nursing and
Midwifery Board of Ireland) or be eligible to be so registered.

(ii) Be registered in the division(s) of the Nursing and Midwifery Board of Ireland
(Bord Altranais agus Cnáimhseachais na hÉireann) Register for which the
application is being made or be entitled to be so registered.

(iii) In exceptional circumstances which will be assessed on a case by case basis
be registered in another Division of the register of Nurses and Midwives.

(iv) Have a minimum of 1 years post registration full time experience or an
aggregate of 1 years full time experience in the division of the register in which
the application is being made (taking into account (ii) (iii) if relevant)

(v) Have a minimum of 1 years experience or an aggregate of 1 years full time
experience in specialist area of Stroke care.

(vi) Have successfully completed a post registration programme of study as
certified by the education provider which verifies that the applicant has achieved
a 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) and in line with the requirements
for specialist practice as set out by the National Council for Nursing and
Midwifery 4th ed (2008).

Alternatively provide written evidence from the Higher Education Institute that
they have achieved the number of ECTS credits equivalent to a Level 9 or higher
standard relevant to the specialist area of care (equivalent to 60 ECTS or
above) and in line with the requirements for specialist practice as set out by the
National Council for Nursing and Midwifery 4th ed (2008). Endocrine of
care prior to application* (See **Note 1 below).

(vii) Be required to demonstrate that they have continuing professional development
(CPD) relevant to the specialist area.

(viii) Have the ability to practice safely and effectively fulfilling his/her professional
responsibility within his/her scope of practice

**Note 1: For Nurses/Midwives who express an interest in CNS/CMS roles and who
currently hold a level 8 educational qualification in the specialist area
(equivalent to 60 ECTS or above) this qualification will be recognised up to
September 2026.

(b) Candidates must possess the requisite knowledge and ability including a high standard of
suitability and clinical leadership managerial and administrative capacity for the proper
discharge of the duties of the office.

2. Annual registration
(i) Practitioners must maintain live annual registration on the appropriate/relevant Division
of the register of Nurses and Midwives maintained by the Nursing and Midwifery Board
of Ireland (Bord Altranais agus Cnáimhseachais na hÉireann) for the role.

(ii) Practitioners must confirm annual registration with NMBI to the HSE by way of the
annual Service user Safety Assurance Certificate (PSAC).

3. Health
Candidates for and any person holding the office must be fully competent and capable of
undertaking the duties attached to the office and be in a state of health such as would indicate a
reasonable prospect of ability to render regular and efficient service.

4. Character
Candidates for and any person holding the office must be of good character.

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 appointees 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