JOB DESCRIPTION
Clinical Nurse Specialist – Renal Access Nurse
Renal Service
Position Title:
Renal Access Clinical Nurse Specialist
Organization Unit:
Northland District Health Board
Location:
Renal Service, Whangarei Hospital, Northland District Health
Board
Responsible to:
Nurse Manager – Renal Service, Northland District Health Board
Primary Functions of
the Position:
Provide clinical expertise and leadership within the Renal
Service, to ensure timely planning of all vascular and peritoneal
access for patients.
To ensure the delivery of an effective, appropriate and
personalized pre admission service to patients requiring dialysis
access.
To co-ordinate all patient referrals for Vascular access, PD
access, assessment and interventional radiological procedures.
To demonstrate advanced nursing practice. Improve patient care
and future outcomes with reference to greater access survival.
To work in partnership with patients/ whanau, medical, nursing,
radiology, allied staff, other DHB personnel e.g. CNS ADHB to
ensure optimal patient care in relation to dialysis access.
To assist Renal CNE and CNM’s with staff and patient education
with reference to dialysis access and best practice guidelines.
Functional Relationships
The Vascular Access Clinical Nurse Specialist will develop and maintain excellent
relationships with:
Internal
External
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All relevant clinical staff, Service
Managers and support services
throughout the organisation
All relevant individuals. Agencies and
services
Key Responsibilities and Expected Outcomes
Northland District Health Board has established a set of values by which the organisation will
respond, in part, to achieving its goals and objectives through their workforce. The following
Values and supporting statements are expected behaviours of each individual employed with
NDHB:
Values
Supporting Statement
People First
Tangata I te tuatahi
Respect
Whakaute (tuku mana)
Caring
Manaaki
Communication
Whakawhitiwhiti korero
Excellence
Taumata teitei (hirangi)
People are central to all we do
We treat others as we would like to be treated
We nurture those around us, and treat all with dignity and
compassion
We communicate safely, openly and with respect to promote clear
understanding
Our attitude of excellence inspires success, competence,
confidence and innovation
The position of Vascular Access Clinical Nurse Specialist encompasses the following major
functions or key result areas:
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Clinical Leadership
Clinical Practice
Education
Quality Assurance
Professional Development (Staff and Self)
Treaty of Waitangi
Health and Safety
The outcome requirements of the above key responsibility areas are outlined below:
Key Responsibility Area
Expected Outcomes
Clinical Leadership
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Provide clinical leadership across the care continuum by
providing support and development to other staff providing
direct care delivery
Provide a focus upon provision of safe, effective and
appropriate care delivery, using knowledge and skills gained
from professional education and practical experience.
Act as an effective role model by demonstrating high levels
of clinical competence and expertise with specific reference
to dialysis access
Co-ordinate the assessment and planning of all vascular and
PD access referrals
Co-ordinate the assessment and planning of all referrals for
assessment and interventional radiology
Evaluate nursing care and practice within the renal vascular
access patients. Develop policies, protocols, and clinical
guidelines to ensure best practice.
Advocate on behalf of patient/whanau/colleagues as
appropriate and in a culturally safe manner
Participate in service, nursing and education planning
processes
Provide advice in complex clinical issues relating to dialysis
access across settings and disciplines
Key Responsibility Area
Expected Outcomes
Clinical Practice
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Education
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Establish and implement in liaison with the Renal
Consultants, Renal CNE and CNM, access care plans,
which include patient history/diagrams/problems/events
history
In liaison with Renal Consultants co-ordinate/ perform all pre
admission processes for patients requiring Vascular and PD
access
In liaison with Renal Consultants, Renal CNE and CNM
develop clinical pathway for monitoring vascular access
Identify high risk or difficult fistula/graft/CVC. In liaison with
Renal Consultants, Renal CNE and CNM develop and
implement an active management plan / pathway
Promote innovative and creative clinical nursing practice and
ensure that it is validated with best practice and research
activities.
Perform dialysis access assessments postoperatively.
Review at 1 and 4 weeks and report/document findings,
identify problems.
Develop and provides expert resources to patients, whanau,
nurses and multidisciplinary teams across the patient
journey in planning and evaluating care
Work collaboratively with all members of the health care
team to ensure staff receive high quality educational input
and support. This is to be facilitated in partnership with the
Renal CNE.
Provide clinical expertise in the planning and delivery of
relevant patient education including haemodialysis training
programme
Work alongside staff at all NDHB Renal facilities to
practically demonstrate/teach in conjunction with Renal CNE
management for needling of and care for new and difficult
AVF
Identify deficits in clinical and professional competencies
and works in liaison with Renal CNE, CNM and Renal Nurse
Manager to resolve these concerns.
Provides direct and/or indirect clinical support and
contributes to the orientation process of new staff in liaison
with Renal CNE.
Key Responsibility Area
Expected Outcomes
Quality Assurance
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Professional
Development
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Contribute to the development of standards of practice,
protocols and policies for the renal service.
In liaison with Renal CNE develop appropriate clinical
pathway/s, protocols, policies and guidelines for cannulation
of a new AV Fistula or graft utilizing best practice guidelines
In liaison with Renal CNE develop an AVF cannulation
competency for all Haemodialysis Nurses
Ensure that all the NDHB policies, procedures and
guidelines related to vascular access can be accessed and
complied with and that staff are familiar with these
Initiate and/or contribute to forums that critique current
practice and debate topical issues
Contribute to the identification of possible research/quality
projects and participate in the development, implementation
and evaluation of proposals
Perform service specific access audits as requested by
Renal Consultants and Nurse Manager
Establish and maintain a VA database
Perform national access audits as requested from NZRAB
Standard and Audits Committee
Contribute to the identification of specifications, trials and
purchase of new equipment
Comply with NZNC and organizational legislative
requirements
Fosters quality and safe practice in line with risk
management policies
To actively contribute to risk management within the service
Maintains and updates own knowledge base related to
clinical and/or educational specialty
Identify educational needs, demonstrating a commitment to
ongoing learning
Complete annual performance appraisal including setting
goals, objectives and strategies to complete theses
Attend educational opportunities and conferences relevant
to the role and scope of practice and incorporates this
knowledge to improve practice
Actively participates in relevant professional organizations.
Proactively contributes to presentation and the publication of
issues related to clinical practice
Critique research findings and utilizes these as a basis for
best practice
Key Responsibility Area
Expected Outcomes
Treaty of Waitangi
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Health & Safety
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Contribute to the promotion of the principles of Treaty of
Waitangi and the involvement if Maori within the decision
making process for their health and independence, within
District Health Board management processes and
procedures
Include the principles of the Treaty of Waitangi within all
aspects of the role and its outcomes
Ensure that consultation and engagement processes include
appropriate mechanisms to meet the need of Maori in a
culturally appropriate and safe manner
Attend the Northland District Health Board Treaty of
Waitangi Training
Ensure compliance with designated responsibilities detailed
in Northland District Health Board’s Health and Safety Policy
Promote an environment of physical, occupational, cultural,
ethical and legal safety
Observe safe work practices, rules and instructions relating
to work, and be pro-active in hazard management
Willingly co-operate in the achievement of all health and
safety goals and initiatives by:
 Practicing and observing safe work methods;
 The use of safety equipment;
 Reporting unsafe conditions or equipment; and
 Reporting and documenting all accidents or incidents
Attend Good Stuff Day annually
Is involved in health and safety though participation and
consultation
Variation of Duties
Duties and responsibilities described above should not be construed as a complete and
exhaustive list as it is not the intention to limit in any way the scope or functions of the
position. Duties and responsibilities can be amended from time to time either by additional,
deletion or straight amendment by the Nurse Manager - Renal to meet any changing
conditions.
Person Specification
Education and Qualifications
Essential
 Registered Nurse/Registered
Comprehensive Nurse with current
practicing certificate
 Committed to further Post Graduate
study and progression towards Clinical
Masters in Nursing
 Working knowledge of Outlook, MS
Word, Power Point and Excel
applications
Desirable
 Adult teaching experience / qualification
Experience
Essential
 A minimum of 8 years post graduate
clinical experience, 3 of which are in
Renal Nursing with Haemodialysis and/or
Peritoneal Dialysis experience
 Advanced knowledge and experience in
Renal Nursing specialty area
 Endorsed at or commitment to work
upon achieving Expert level PDRP
Desirable
 Knowledge of current issues within
Nursing and Renal as a specialty
 Detailed knowledge of vascular anatomy
 Evidence of adult teaching skills e.g.
Completion of Adult Education Certificate
 Preceptorship Skills and experience
Awareness and Understanding of
Essential
 The Treaty of Waitangi and its application
to the health setting
 Privacy Act (1993) and Health
Information Privacy Code (1994)
 Health and Safety in Employment Act
(1992)
 Understands the significance of the
Treaty of Waitangi as validated in Expert
PDRP portfolio
Desirable
 Health and Disability Commissioner
(Code of Health and Disability Services
Consumers’ Rights) Regulations (1996)
 New Zealand Council of Healthcare
Standards
Skills & Personal Attributes
Skills
 A commitment to quality and excellence, with a proven ability to contribute to process
improvement.
 Experience in problem solving, priority setting and planning.
 Excellent organization and time management skills
 Ability to self evaluate and reflect on practice
 Ability to critique research and use it to underpin practice.
 Ability to facilitate and manage change at a local level
 Computer literate
 Current endorsed driver’s license and preparedness to travel to satellite units to support
staff development and perform patient assessments.
Personal Attributes
 The ability to work autonomously and also be an effective team member
 Clinical role model with a high degree of maturity, stability and self confidence
 A commitment to the development of nursing within the NDHB
 The ability to communicate effectively with all levels of staff and develop relevant
networks.
 Seeks out opportunities to support others in achieving goals
 Actively contributes to and accepts consensus decision
 Sets high personal standards and strives to achieving goals
 Can work to deadlines and achieve outcomes
 Ability to adapt and work effectively within a variety of situations
Performance Development Review
An initial review of performance will be conducted after three months, with an annual review
thereafter.
An individual Development Plan will be developed to reflect the contribution this position is
expected to make towards achieving the team’s objectives and measures. Key result areas
will be developed and agreed at this time.
Authorised by:
Signature:
Date:
Acceptance
Acceptance of the position implies acceptance of this position description.
Position Title:
Signature of employee:
Date: