Nurse Practitioner

Job description

Job responsibilities

2. Job Purpose

• To participate in providing a Nurse-led standardised level of support and care for Nursing, Residential and Learning Disability Care Homes in Kingston, working in partnership with care home providers. Focusing on promoting proactive care delivery and development of evidenced based clinical policies to improve standards and raise levels of knowledge and skills through education and support.
• Being part of the Urgent Community Response Service, to provide an urgent care service to care homes enabling residents to be assessed, diagnosed and receive appropriate treatment reducing unnecessary A/E attendance.
• To participate in working with care home staff to manage residents with complex or long-term conditions, clinically assessing and prescribing to prevent admission to hospital and advising on nursing intervention to avoid deterioration.
• To participate in case management of patients with exacerbation of long-term condition/complex conditions where appropriate under the guidance of an Advanced Nurse Practitioner enabling care homes to prevent crisis situations arising, thereby avoiding inappropriate hospital admissions
• Participate in working in partnership with the care home to improve the quality of care by providing enhanced clinical assessment, intervention and diagnostics

3. Dimensions

Monitor hospital admission, A&E attendance & ambulance call rates for individual care homes in the Kingston borough, targeting support to care staff in homes where emergency admission rates are high.

Assist in providing advice, support and clinical input to residents.

Assist in identifying complex patients requiring case management.

Assist in providing guidance on safe practice for individual residents to prevent unnecessary emergency hospital admissions, particularly in relation to end of life care.

Participate in training and support to care homes to encourage them to provide high-quality care to residents with complex needs and those approaching the end of life.

Support care homes in identifying training needs and recommend/sign post to appropriate training for staff.

Assist in providing training & support on a range of subjects alongside the Clinical practice educator. Provide developmental training programmes for care homes to adopt which would embed nationally recognised care practice (i.e. NICE Guidance) for long term conditions.

Work in collaboration with other Health Care Professionals services for patients identified at risk of admission e.g. SALT, Dietician, Diabetes Nurse Specialist, Tissue Viability Nurse Specialist, Continence Nurse Specialist and Extended Scope Practitioner Lead Respiratory Physiotherapist

Participate in supporting care homes, linked G.Ps and Adult Services to work collaboratively to achieve effective communication and provision of proactive medical/nursing/therapeutic care to prevent unnecessary hospital admissions.

Assist in collecting data as required supporting audit focusing on health outcomes and reduction of acute hospital emergency bed days.

4. Key Result Areas

Clinical

• Use clinical reasoning and physical assessment to assess, diagnose and treat the physical and psycho-social needs of residents with complex needs or those at risk of hospital admission. Participate in working with the care home to instigate therapeutic treatments based on best available evidence to improve health outcomes.
• Use skills and clinical knowledge to assist in supporting the care home staff in identifying and monitoring subtle changes in the condition of residents/patients and in taking appropriate action to prevent/manage exacerbation of disease wherever possible.
• Assist in working with the care home staff to recognise and interpret cues, signs and symptoms, instigate investigations and interpret results to formulate a diagnosis. Use skills and knowledge to make both a comprehensive and focussed assessment.
• Order investigations as necessary.
• Assist in supporting the homes in developing personal care plans and crisis management plans with residents carers, relatives and health professionals based on full assessment of medical, nursing and social care needs.
• Participate in providing expert clinical care support and health promotion interventions.
• Participate in providing support with the implementation of evidenced based clinical policies to underpin effective and consistent care management.
• Use knowledge and skill to provide advice to patients and their carers on medicines management.
• Work in partnership with GPs.
• Assist in co-ordinating the seamless transfer of residents to appropriate services. Negotiate and agree with the patient, carers and other care professionals, individual roles and responsibilities with actions to be taken and outcomes to be achieved, referring on to other services or professionals as appropriate.

Provide multi-disciplinary team (MDT) support for the development and maintenance of personalised care and support plans for care home residents, empowering residents with capacity to make choices about their healthcare.

Contribute to MDT meetings as part of the integrated system regarding individual residents and support a co-ordinated response from health and social care

• Challenge professional and organisational boundaries which prevent delivery of integrated health and social care to prevent health deterioration or hospital admission.
• Participate in identifying areas for skill/knowledge development and apply these to practice to provide continuity and high-quality patient-centred health care.
• Participate in mobilising additional support as needed, e.g. palliative care, colleagues in the Joint Service Directorate, Adults Services and Carers Support Service.
• To assist in establishing a network that can be used to streamline care pathways, working in partnership with other agencies.
• Ensure effective co-ordination of care for individual residents within the care home setting under the guidance of the Advanced Nurse Practitioner/service Lead
• Assist in ensuring that care homes provide baseline health data if the resident is admitted to hospital to support integrated, consistent care and facilitate discharge.
• Work with the multi-disciplinary team to plan and implement high quality care.
• Contribute Influencing, developing and pioneering changes in practice within care homes.
• Participate in identifying patients who have complex care needs to formulate appropriate management
• Participate in developing integrated care pathways between care homes, and A&E staff teams.
• Champion Older People's issues in a variety of settings and Professional groups.
• To work in partnership with the Advanced Nurse Practitioner to Initiate actions/recommendations relating to care homes to help reduce hospital admissions and delayed transfers to underpin the Care Closer to Home and Unscheduled Care Programmes.

Educator

• Assist care home staff and other Professionals to enable competence and development of skills/roles in accordance with DH principles.
• To participate in working with and teaching residents and carers to identify subtle changes in condition that may precipitate acute exacerbation of underlying condition or illness and assist in advising on the action to be taken ensuring care plans reflect this.
• To participate in developing training packages for residents, informal carers and care staff to promote independence; plan for unavoidable progression in conditions and educate in the areas identified as causes for A/E admissions e.g. UTI, dehydration, falls, chest infections/ aspirational pneumonia, palliative care and enhance dementia care practice.

Communicator

• Use a high level of interpersonal, IT and communication skills to communicate effectively with residents and care home staff, including communication of sensitive and complex information about individual condition.
• Participate in preparing residents and their families for changes in condition and support choice about end of life care in partnership with palliative care team
• Effectively communicate at all levels of the organisation with a variety of health professionals, users and carers to provide the best health and social care outcomes for older people.
• Assist in providing the interface between hospital and Primary, Community & Social Care and Care Home settings.
• Maintain a high level of performance and be goal and outcome focussed when faced with opposition or when working under conditions of pressure.
• Keep accurate timely documentation and up to date care plans.
• Provide high quality written reports and any other written documentation as necessary.
• Listen and empathise with the needs and wishes of users and their carers.

Researcher

• Contribute to evaluation of the project particularly in relation to impact on avoiding hospital admission.
• Participate in identifying the population at risk within the care homes using local data and information from a variety of sources.
• Critically evaluate and interpret evidence-based research finding from diverse sources making informed judgements about their implications for changing and/or developing services and clinical practice.
• Continually evaluate and audit the quality and effectiveness of the practice of self and others, selecting and applying a wide range of valid and reliable approaches and methods that are appropriate to needs and context.

Person Specification

Other factors

Essential

• Valid driving license
• Must be a car driver and have use of car

Qualifications

Essential

• Registered Level 1 Nurse
• Diploma/Degree in Nursing Studies
• Clinical reasoning in Physical assessment (or working towards completion)

Desirable

• V300 Non-Medical Prescriber

Experience

Essential

• Demonstrate broad experience post registration within a variety of core areas e.g.
• Continence/catheterisation management
• Tissue viability
• PEG Management
• Palliative Care
• Long term conditions
• IV Management
• Experience of assessment and delivery of care to people with complex needs
• Negotiating and working across organisational boundaries
• Working as part of a multi disciplinary team
• Mentoring students and other health care professionals
• Experience of lone working and decision making

Desirable

• Experience of working in a community setting

Knowledge

Essential

• Knowledge of NMC Code
• Understanding of national policy governing the delivery of adults and older peoples services
• Awareness of current developments in health and social care
• Knowledge of clinical governance/ risk management and reporting
• An understanding of the implications of cultural difference for service delivery
• Knowledge and understanding of audit and research

Desirable

• Awareness of issues surrounding care homes

Skills and abilities

Essential

• Evidence of up-to-date based knowledge and skill
• Evidence of ability to maintain high standards of care
• Evidence of professional development and knowledge
• Able to analyse situations and problem solve as necessary
• Ability to develop and maintain partnership working
• Ability to motivate staff
• Report writing skills
• Teaching carers, residents and staff
• IT Skills

Personal qualities

Essential

• Able to work under pressure
• Self-motivated
• Innovative
• Enthusiastic
• Able to work alone

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

Your Healthcare CIC

Address

Hollyfield House, 22 Hollyfield Road

Surbiton

KT5 9AL

Employer's website

http://www.yourhealthcare.org (Opens in a new tab)