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AfC number (2097) JOB DESCRIPTION & PERSON SPEC 1 JOB DETAILS Job Title: Advanced Practitioner Reports to: Matron Accountable to: Chief Nurse Band: Band 8a (subject to review at 12 months) Unit/Department: Directorate: Location: AfC Job No: 2 2097 JOB PURPOSE The Advanced Practitioner (AP) will use specialist knowledge and skills to provide healthcare independently to patients. The AP is accountable for the total episode of care for patients with undifferentiated and undiagnosed needs. The post holder will act as a role model, delivering advanced practice and promoting clinical effectiveness in care. He / she will be required to work autonomously in delivering independent assessment, clinical examination, diagnosis, clinical decision making and planning of care and treatment, diagnosis, prescribing, health promotion and safe discharge of patients. The post holder will work closely with all members of the multidisciplinary team and will play an integral role in the operational/strategic development of the service. The post holder will promote and facilitate evidence based practice and clinical audit and research within the Trust. 3 JOB DIMENSIONS The job holder will work as an autonomous practitioner within a defined clinical area, delivering all aspects of management and care to a wide range of patients with varying needs. The Trust reserves the right to require employees to work either temporarily or permanently at or from any other of the Trust’s establishments at any time AfC number (2097) 4 ORGANISATIONAL CHART Divisional General Manager Medical Director Chief Nurse Directorate Manager Professional Lead Clinical Director Advanced Practitioner THIS POST Matron Professional Lead Trainee Advanced Practitioner 8a The Trust reserves the right to require employees to work either temporarily or permanently at or from any other of the Trust’s establishments at any time AfC number (2097) 5 KNOWLEDGE, SKILLS AND EXPERIENCE REQURIED Qualifications and Training Registered with relevant professional body Degree-level registration qualification or equivalent post-registration award Masters Degree in Advanced Practice, or relevant Higher Level degree plus PG Diploma in Advanced Practice Life Support qualifications (or alternative profession specific clinically determined qualifications) Relevant teaching qualification. Non-medical prescribing Experience Evidence of continuous professional development and the practical application of new skills to the work place. Evidence of strong teaching background. Evidence of significant practical contributions to the development of the specific service within the past 2- years. Managerial responsibilities. Direct supervision of junior staff, in all professional groups. Supervision of students Evidence of lead for or contribution to audit programmes within practice Change Management experience and direct involvement of redesign within a service, including promoting evidence based practice. Skills/Knowledge Documented evidence of advanced clinical skills competencies Ability to motivate individuals and teams. Advanced oral and written communication skills and confidence to discuss patient management with other members of the MDT. High level of capability using outcome measures and audit. Confidence and ability to accurately assess and manage complex patient presentations to a high professional standard. Ability to critique own practice to an advanced level ln-depth knowledge in their specialist clinical field. Ability to manage time and workload effectively and to work in a high pressure environment. Excellent liaison and negotiation skills. Commitment to Staff Development and Training. Self-motivated and able to work independently and autonomously both within the Trust and with partner organisations. Evidence of managing complex patients in stressful and emotional situations where life-changing events are being communicated and clinically managed. Personal Attributes Inspirational, with ability to motivate a team. Flexible, positive, problem solving approach to issues. Ability to work autonomously and within a team. The Trust reserves the right to require employees to work either temporarily or permanently at or from any other of the Trust’s establishments at any time AfC number (2097) Professional and patient focused, with a strong commitment to providing high quality care. Able to remain calm and polite under pressure Flexible and adaptable, able to work all shifts throughout 24 hour period. Capable of lateral thinking with well developed assertiveness skills, able to successfully initiate, manage and sustain change. Excellent interpersonal skills with effective oral and written communication skills. 6. THE LEEDS WAY VALUES Our values are part of what make us different from other trusts, so we see this as a strength, as well as a responsibility. They have been developed by our staff and set out what they see as important to how we work. Our five values are: Patient-centred Collaborative Fair Accountable Empowered All our actions and endeavours will be guided and evaluated through these values Additionally the following are core values which relate specifically to this post: 7 CORE VALUES Commitment to providing high quality evidence based care to patients and their carers. Commitment to working in a multidisciplinary team (both primary and secondary care providers). Commitment to the clinical area, valuing the contribution of all team members, encouraging a positive and creative working environment. Commitment to own development and the development of all staff within the unit. 8 CORE BEHAVIOUR AND SKILLS Advanced clinical practice Teaching and assessing skills Communication skills Time management skills Organisational skills Preceptorship skills Understanding of research based practice – research conscious Team player Ability to act professionally at all times Understanding of the process of change. The Trust reserves the right to require employees to work either temporarily or permanently at or from any other of the Trust’s establishments at any time AfC number (2097) 9 CORE KNOWLEDGE AND UNDERSTANDING An understanding of the organisational structure and working practices of the NHS. Understanding the local and national nursing agenda. Awareness of Leeds Teaching Hospitals Trust guidelines and policies. 10 PRINCIPAL DUTIES AND AREA OF RESPONSIBILITY Clinical practice Practice as an autonomous professional in a self-directed manner, with confidence, authority and expertise, undertaking comprehensive range of clinical procedures. Have direct responsibility for patient caseload, ensuring all patients have an accurate plan of care, which reflects the assessment undertaken and incorporate the issues and recommendations made. Work within the frequently challenging clinical environments with high levels of physical and mental effort Assess individuals, families and populations holistically using a range of different assessment methods. Have a health promotion and prevention orientation and comprehensively assess patients for risk factors and early signs of illness. Interpret and analyse highly complex clinical and non-clinical facts to form accurate diagnoses, prognoses for a wide range of conditions, to recommend / deliver the best course of intervention including the development of comprehensive packages of care. Initiate pharmacological intervention, using non-medical prescribing or patient group directives and administer medications as prescribed by others in accordance with the Leeds Teaching Hospitals policies Accurately request radiological and pathology investigations and make clinical decisions based upon the results. Provide specialist advice and support to patients, their families and other healthcare professionals following assessment, diagnosis and through treatment. Plan, manage and complete episodes of care, working in partnership with others and delegating and referring as appropriate to optimise health outcomes and resource use, as well as providing direct support to patients and clients. Use professional judgement in managing complex and unpredictable care events and capture the learning from these experiences to improve patient care and service delivery. The Trust reserves the right to require employees to work either temporarily or permanently at or from any other of the Trust’s establishments at any time AfC number (2097) Organise complex activities or programmes for patients, drawing on an appropriate range of multi-disciplinary and inter-professional resources in practice. Supervise and where necessary, work in collaboration with nursing, medical and AHP team members, demonstrating expert clinical practice to the ward team. To be included on medical rotas as required by clinical role Maintain a high standard of patient focused care in accordance with Leeds Teaching Hospitals Trust guidelines and policies. Actively involve service users in providing feedback of their experience of the current service and suggestions for improvements. Appropriately define the boundaries of own practice. Leadership and Collaborative Practice Identify and implement systems to promote their contribution and demonstrate the impact of advanced level practice to the healthcare team and the wider health and social care sector. Provide consultancy services to own area and to other professions on therapeutic interventions, practice and service development. Be resilient and determined and demonstrate leadership in contexts that are unfamiliar, complex and unpredictable. Engage stakeholders and use high-level negotiating and influencing skills to develop and improve practice. Work across professional, organisational and system boundaries and proactively develop and sustain new partnerships and networks to influence and improve health, outcomes and healthcare delivery systems. Develop practice and roles that are appropriate to patient and service need through understanding the implications of epidemiological, demographic, social, political and professional trends and developments. Contribute positively to the leadership within the care group acting as an effective role model. Improving Quality and Developing Practice The Trust reserves the right to require employees to work either temporarily or permanently at or from any other of the Trust’s establishments at any time AfC number (2097) Work within the NMC/HPC Code of Professional Conduct and Guidelines, the Leeds Teaching Hospitals NHS Trust policies and guidelines, COSHH, the Mental Health Act and other instruments of statutory legislation to ensure safe and effective professional working practices for self and others. Be involved proactively in developing strategies and undertaking activities that monitor and improve the quality of healthcare and the effectiveness of their own and others’ practice. Strive constantly to improve practice and health outcomes so that they are consistent with or better than national and international standards through initiating, facilitating and leading change at individual team, organisational and system levels. Continually evaluate and audit own practice and that of others at individual and systems levels, selecting and applying valid and reliable approaches and methods which are appropriate to needs and context, and acting on the findings. Responsible for the generation and collation of reports on own practice and that of team on service delivery and local and national targets, and monthly reporting to the Directorate Management Team and quarterly Divisional Clinical Governance Forum. Continually assess and monitor risk in own and others’ practice and challenge others about wider risk factors. Contribute to and at times lead the development of multidisciplinary research and clinical audit in urgent care Critically appraise and synthesise the outcomes of relevant research, evaluations and audits and apply the information when seeking to improve practice. Participate in and contribute to any regional and national research to evaluate the effectiveness of care strategies related to the patient experience within urgent care Alert appropriate individuals to gaps in evidence and/or practice knowledge and support and conduct research that is likely to enhance practice. Use financial acumen in patient/client, team, organisation and system level decision making and demonstrate appropriate strategies to enhance quality, productivity and value. Developing Self and Others Actively seek and participate in peer review of own practice. The Trust reserves the right to require employees to work either temporarily or permanently at or from any other of the Trust’s establishments at any time AfC number (2097) Directly responsible for the development and delivery of trainee advanced practitioners and junior members of the multidisciplinary team. Enable patients/clients to learn by designing and co-ordinating the implementation of evidence based plans appropriate to their preferred approach to learning, motivation and developmental stage. Develop robust governance systems by contributing to the development and implementation of evidence-based protocols, documentation processes, standards, policies and clinical guidelines through interpreting and synthesising information from a variety of sources and promoting their use in practice. Work in collaboration with others to plan and deliver interventions to meet the learning and development needs of own and other professions. Involvement in the development and delivery of training and education programmes that cross traditional professional boundaries. Advocate and contribute to the development of an organisational culture that supports continuous learning and development, evidence-based practice and succession planning. Have high level communication skills and contribute to the wider development of those working in the area of clinical practice by publicising and disseminating work through presentations at conference and articles in the professional press. Undertake continuous professional and clinical opportunities to enhance own knowledge and skills. development, seeking Health and Safety/Risk Management All staff are responsible for working with their colleagues to maintain and improve the quality of services provided to our patients and other service users. This includes complying at all times with the Leeds Teaching Hospitals NHS Trust Policies, including Health and Safety policies, in particular by following agreed safe working procedures, and reporting incidents using the Trust Incident Reporting system. Infection Prevention and Control The jobholder must comply at all times with the Leeds Teaching Hospitals NHS Trust Infection Control policies, in particular by practising Universal Infection Control Precautions. Hand hygiene must be performed before and after contact with patients and their environment. Equality and Diversity The jobholder must comply with all policies and procedures designed to ensure equality of employment and that services are delivered in ways that meet the individual needs of patients and their families. No person whether they are staff, patient or visitor should receive less favourable treatment because of their The Trust reserves the right to require employees to work either temporarily or permanently at or from any other of the Trust’s establishments at any time AfC number (2097) disability, gender reassignment, religion or belief, race, sex, sexual orientation, pregnancy or breast feeding, or age. Patient and Public Involvement The Trust has a statutory duty to involve patients and public in evaluating and planning services. All staff have a responsibility to listen to the views of patients and to contribute to service improvements based on patient feedback. Training and Development Personal Development – Continuous Professional The jobholder must take responsibility, in agreement with his/her line manager, for his/her own personal development by ensuring that Continuous Professional Development remains a priority. The job holder will undertake all mandatory training required for the role. Respect for Patient Confidentiality The job holder should respect patient confidentiality at all times and not divulge patient information unless sanctioned by the requirements of the role. 11 COMMUNICATION & WORKING RELATIONSHIPS Patients & carers Matron Ward sister/Charge Nurse Junior, middle grade and consultant medical staff Radiology & pathology Pharmacist In-patient placement team Primary care teams (GPs, ICT, social work, etc). 12 SPECIAL WORKING CONDITIONS Physical Effort Working in a hospital ward or department environment, with highly developed physical skills including the requirement to perform clinical consultations and examinations, intubation, suturing, arterial lines, PICC and central lines, joint aspirations. Undertake clinical procedures which will require movement of patients from trolley/bed to standing and to chair, and back to trolley/bed. Mental Effort Work in a clinical environment where there is a frequent requirement for concentration for long periods of the day on clinical consultations and decision making and with frequent interruptions that require a change in activity in order to respond to emergency patient needs. Emotional Effort Working with patients with a wide range of physical, emotional and spiritual needs. Daily exposure to patients presenting with serious, life threatening The Trust reserves the right to require employees to work either temporarily or permanently at or from any other of the Trust’s establishments at any time AfC number (2097) conditions and injuries, including dealing with patients with severely challenging behaviour. Working Conditions Working in an urgent care department, with daily exposure to blood, body fluids severely injured patients etc. 13 Job Description Agreement Jobholder’s Signature: ……………………………… Date:……………………… Head of Department’s Signature: …………………… Date:……………………… Head of Department’s Name and Job Title: ……………………………………… ……… The Trust reserves the right to require employees to work either temporarily or permanently at or from any other of the Trust’s establishments at any time