Practice Nurse

1. PROFESSIONAL RESPONSIBILITIES OF THE POST In accordance with the NMC code of conduct the post holder will assess, plan, develop, implement and evaluate nursing care to promote health and wellbeing, and prevent adverse effects. The post holder will be deemed competent in tasks undertaken following suitable induction, training, assessment and confirmation of competence where appropriate. The post holder is responsible for ensuring that competence is achieved prior to practice. The practice is responsible for providing the support and resources to achieve competence 2. MAIN DUTIES OF THE POST a) Long Term Conditions With appropriate training, participate in the annual care needs of patients with known long-term conditions based on the quality outcome framework (QOF). This may include diabetes, COPD and asthma, hypertension, cardio vascular disease, cancer, chronic kidney disease, epilepsy, osteoporosis, rheumatoid arthritis, thyroid disease and chronic heart disease. Support patients to adopt health promotion strategies that encourage patients to live healthily and apply principles of self-care. In addition to carrying out basic reviews, the Practice Nurse may also manage long term conditions at the following levels of competency: 1) Competent nurse 2) Experienced or proficient nurse 3) Senior practitioner or expert nurse b) Quality Outcomes Framework Support the practice to achieve the General Medical Services contract by ensuring that Quality Outcome Framework (QOF) prompts are addressed and documentation incudes appropriate Read Codes. c) Integrated MDT working In order to reduce fragmentation of care for patients, the post holder is expected to promote and participate in integrated multi-disciplinary team working whereby colleagues from health and social care communicate and work in collaboration. The post holder is expected to liaise and make appropriate referrals to the wider MDT and attend multi-disciplinary team meetings and events within the community which promote and facilitate integrated MDT working. Ensure appropriate knowledge of other local support services and ways of referring for example healthy living, and carers support. d) Information Technology Have a working knowledge of the SystmOne clinical system including chronic disease registers and templates. Maintain computerised patient records at the time of consultation. Review and process data using correct Read codes to ensure easy and accurate retrieval for monitoring and audit processes. Use technology as an aid to management in planning, implementation monitoring, presenting and communicating information. e) Health Promotion and Screening Identify, and manage as appropriate, treatment plans for patients at risk of developing a long-term condition with appropriate screening and prevention strategies e.g. stopping smoking, maintaining a healthy weight, safe alcohol consumption. Deliver appropriate opportunistic health promotion and screening wherever possible during all contact. This may include maintenance of notice boards and ordering of appropriate health promotion materials. Participate in planned health promotion such as new-patient medicals, NHS health checks as per practice policy and opportunistic blood pressure (BP) checks. Manage information searches using the internet and local library databases, for example, the retrieval of relevant information for patients on their condition. Provide information on the avoidance of slips, trips and falls. Promote the uptake of NHS screening programmes for example cervical cytology, bowel cancer screening and breast screening or any other new programmes as they arise. Advise patients to carry out appropriate self-checks such as breast and testicular self-examination. Support and manage health needs of women presenting for cervical cytology consultations. f) Emergencies Prioritise health problems and intervene appropriately to assist the patient in complex, urgent or emergency situations, including initiation of effective emergency care such as seizure, collapse, cardiac arrest, respiratory distress, and anaphylaxis. Carry out regular checks of emergency equipment if delegated this task. g) Injections Administer intra dermal, subcutaneous, intramuscular and depo injections under an individualised prescription or Patient Group Direction as per practice protocol and best practice guidelines which may include: vaccinations, B12, depo-provera, neuroleptic drugs, GOLD, Zoladex. h) Immunisations Implement and participate in all vaccination and immunisation programmes for both adults and children as per national immunisation programmes ensuring use of PGDs or PSDs as appropriate. Ensure safe storage, rotation and disposal of all vaccines and drugs. Participate in the regular refrigeration checks required to ensure maintenance of the cold chain and report immediately any breaks in this chain. i) Wound Care Management Promote wound avoidance by providing information on skin integrity and pressure relief; offer an assessment of vulnerable pressure areas in patients who may be at risk. Promote leg ulcer prevention by encouraging the use of hosiery and facilitating supply of stockings. Carry out dressings of wounds as per best practice guidelines and wound care formulary taking care to observe for poor healing or infection and ensure timely referral to GP or tissue viability specialist including the leg ulcer clinic. Facilitate other investigations as may be appropriate in poor healing for example diabetes screening. Carry out the removal of sutures and clips as directed by the clinician. Carry out Doppler assessments and perform multilayer bandaging for patients assessed with venous ulceration and ensure onward referral where appropriate. Support the health care assistants trained in wound care to carry out dressings where appropriate. j) Ear Care Promote and deliver evidence-based care for patients presenting with aural conditions and advise patients about safe ear care. k) Assisting Minor Surgery Assist senior practitioners in providing minor-surgery sessions and other procedures such as fitting of coils and implants. l) Cervical Cytology Undertake a programme of cervical cytology sampling under supervision until competent. Audit a minimum of 20 consecutive smears each year to demonstrate adequate sampling rates. m) Venepuncture Carry out venepuncture as per practice protocol. n) ECGs Carry out ECGs as per practice protocol. o) Travel Health Advice and Vaccinations Offer holistic approach to travel health including comprehensive advice and risk assessment. Assess, advise, support and where appropriate, administer vaccinations for patients travelling abroad. p) Supplies Assist in the ordering and maintenance and checking of supplies and equipment as required by the practice and ensure stock rotation. q) Teaching and mentor support Participate in the mentorship of new or junior colleagues and students as required. r) Change management To have a positive attitude to the management of change and work in collaboration with the practice to create change to benefit the practice and patients. S) Prescribing (for nurses with a recognised prescribing qualification) Prescribe medications in accordance with NMC standards. Prescribe and review medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidence-based practice and national and practice protocols, and within scope of practice. Ensure local medicines management policies are adhered to, annual declaration, ongoing training, updates and professional development. Maintain a professional portfolio. Ensure regular audit, review and appraisal of prescribing. Ensure any significant events or errors relating to prescribing are dealt with in an appropriate manner Dorset HealthCare University NHS Foundation Trust #J-18808-Ljbffr