Clinical Nurse Specialist (Stroke Care)
Job Specification, Terms & Conditions
Job Title and
Grade
Competition
Reference
Closing Date
Clinical Nurse Specialist (Stroke Care) (Grade Code 2632)
Proposed
Interview Date(s)
Taking up
Appointment
Location of Post
5th September 2011
Organisational
Area
Details of Service
To be advised at ‘Expression of Interest’ stage
Reporting
Relationship
The post holder:

Is professionally accountable to the Director of Nursing (DON) or designated officer as
required and works in partnership with the multi disciplinary team.

Will report to the Asst. DON or designated officer as required on operational matters.
Purpose of the
Post
The role of the Clinical Nurse Specialist in Stroke Care is to provide for the care and on-going
management of patients with stroke. The post holder will be required to work as a key member
of the multi-disciplinary team in the hospital providing physical, psychological and emotional
support to stroke patients and their families throughout their stroke disease trajectory. She / he
may act as a liaison between Stroke Services, Primary Care Teams, Community Care Teams
and other agencies. The post holder will work as part of the multi disciplinary team to achieve
the strategic objectives of the Stroke Service.
Principal Duties
and
Responsibilities
Professional Responsibilities
NRS0419
12th August 2011
To be agreed at job offer stage
To be advised at ‘Expression of Interest’ stage
Information about specific sites will be provided at Expression of Interest stage including
information on services provided, team structures, possible future developments etc.
The Clinical Nurse Specialist (Stroke Care) will:

Practice nursing according to the Code of Professional Conduct and the Scope of Practice
Framework as laid down by the Irish Nursing Board (An Bórd Altranais) and the National
Clinical Guidelines for Stroke

Adhere to national, regional and local Health Service Executive (HSE) guidelines, policies,
protocols and legislation

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

Be aware of ethical policies and procedures which pertain to their area of practice

Respect and maintain the privacy, dignity and confidentiality of the patient

Follow appropriate lines of authority within the Nurse Management structure.
Clinical Practice
The Clinical Nurse Specialist (Stroke Care) will:

Work in collaboration with other members of the multidisciplinary team in assessing, planning,
implementing and evaluating an individualised plan of care for patients with stroke and stroke
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related illnesses which meets each patient's 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 Clinical Nurse Specialist (Stroke Care) will work closely
alongside the multidisciplinary team (MDT) and within agreed protocol driven
guidelines to develop individualised a plan of care
-
Delivery of patient care through patient/family education, nurse led-secondary
prevention clinics
-
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.

Provide 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 and
rapid access TIA referrals, 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, TIA assessment and 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

Make variations in prescribed clinical options, within agreed protocols

Provide nurse led secondary prevention clinics in conjunction with the Consultant thus helping
to formulate future care and treatment plans

Monitor and ensure maintenance of adequate and effective discharge planning for patients
returning to their own homes or residential care

Arrange referrals to other appropriate specialist services in consultation with the consultant

Provide psychological support for patients and their families

Communicate with patients, families and friends, assess needs and provide relevant support,
information, education, advice and counselling when and where necessary

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 the community

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 stroke governance group

Ensure that effective clinical governance procedures are maintained and evolve according
to defined needs and demands in stroke service.
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Patient Advocate
The Clinical Nurse Specialist (Stroke Care) 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

Provide and advocate for appropriate assessments, supports and strategies for patients
with disease related changes and difficulties

Establish, maintain and improve procedures for collaboration and co-operation between
acute hospital services, community services, primary care and voluntary organisations

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
Education and Training – patient, self and others
The Clinical Nurse Specialist (Stroke Care) will:

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.
Audit and Research
The Clinical Nurse Specialist (Stroke Care) will:

Manage 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

Promote individual best practice interventions in accordance with the identified needs of
patients
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
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
Consultant
The Clinical Nurse Specialist (Stroke Care) 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.
Health & Safety
The Clinical Nurse Specialist (Stroke Care) 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

Attend mandatory Health and Safety training

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.
Administration
The Clinical Nurse Specialist (Stroke Care) will:

Ensure the efficient action of complaints in accordance with HSE Policy

Contribute to policy development and formulation, performance monitoring, business
planning and budgetary control

Ensure that records are safeguarded and managed as per HSE / 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 requirements
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
Requisition with due economy. Ensure that equipment is maintained according to Hospital
Policy

Assist in the implementation of Information Technology developments

Undertake other duties as required by the Director of Nursing or his / her designate
The above Job Specification is not intended to be a comprehensive list of all duties
involved and consequently, the post holder may be required to perform other duties as
appropriate to the post which may be assigned to him / her from time to time and to
contribute to the development of the post while in office.
Eligibility Criteria
Qualifications
and/ or
experience
Candidates must, at the latest date for receipt of completed applications for the post:

Be registered in the General Division of the Register of Nurses kept by An Bord
Altranais or be entitled to be so registered
and

Have at least 5 years post registration experience in the division of the register in
which the applicant is currently practising
and

Have a minimum of 2 years experience in the specialist area
and

Have the ability to practice safely and effectively fulfilling his/her professional
responsibility within his/her scope of practice
and

Demonstrate evidence of continuing professional development
and

Have a level 8 post-registration National Qualifications Authority of Ireland major
academic award relevant to the specialist area
Age
No age restriction shall apply to a candidate except where he/she is not classified as a new
entrant (within the meaning of the Public Service Superannuation (Miscellaneous Provisions)
Act, 2004). In this case the candidate must be under 65 years of age on the first day of the
month in which the latest date for receiving completed application forms for the office occurs.
Health
A candidate 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.
Character
Each candidate for and any person holding the office must be of good character.
Post Specific
Requirements
Essential skills,
competencies
and/or knowledge
Candidates must:
Have undertaken or agree to undertake, within an agreed timeframe, the Nurse Prescribing of
Medicinal Products Certificate.

Demonstrate practitioner competence and professionalism in order to carry out the
duties and responsibilities of the role

Display evidence-based clinical knowledge in making decisions regarding client care
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
Displays the ability to anticipate, by using expert knowledge, changes in patient's
condition in the Stroke Care environment. (This includes the skills and competence to
identify both adverse reactions to treatment and subtle deterioration in condition,
intervening appropriately, interpreting and analysing blood/investigative results and
clinical symptoms to inform diagnosis, modifying treatment/care regimes accordingly,
requesting further tests, reporting and making recommendations to the appropriate
member of the multidisciplinary team and implement the appropriate actions required.)

Demonstrate a commitment to continuing professional development

Demonstrate evidence of effective planning and organising skills

Demonstrate empowering and enabling leadership skills

Demonstrate commitment to providing a quality service

Demonstrate the ability to build and maintain relationships including the ability to work
effectively as part of a multi disciplinary team

Demonstrate effective analytical, problem solving and decision making skills

Demonstrate evidence of ability to empathise with and treat patients, relatives and
colleagues with dignity and respect

Demonstrates excellent communication skills, including sufficient command of the
English language so as to effectively carry out the duties and responsibilities of the role

Demonstrates an awareness of legislation and standards relevant to the role

Demonstrate an awareness of developments within the HSE

Demonstrate a willingness to engage and develop IT skills relevant to the role

Other
requirements
specific to the
post
Campaign
Specific Selection
Process
Ranking /
Shortlisting /
Interview
Adopts and develops the concept of customer care and challenges any interaction
which fails to deliver a quality service to internal and external customers.
To develop stroke services in line with the Stroke Care National Clinical Programme Model of
Care and associated guidance.
A ranking and / or shortlisting exercise may be carried out on the basis of information supplied
in your application form. The criteria for ranking and / or shortlisting are based on the
requirements of the post as outlined in the eligibility criteria and skills, competencies and / or
knowledge section of this job specification. Therefore it is very important that you think about
your experience in light of those requirements.
Failure to include information regarding these requirements may result in you not being called
forward to the next stage of the selection process.
Those successful at the ranking stage of this process (where applied) will be placed on an
order of merit and will be called to interview in ‘bands’ depending on the service needs of the
organisation.
Code of Practice
The Health Service Executive will run this campaign in compliance with the Code of Practice
prepared by the Commission for Public Service Appointments (CPSA). The Code of Practice
sets out how the core principles of probity, merit, equity and fairness might be applied on a
principle basis. The Code also specifies the responsibilities placed on candidates, facilities for
feedback to applicants on matters relating to their application when requested, and outlines
procedures in relation to requests for a review of the recruitment and selection process and
review in relation to allegations of a breach of the Code of Practice. Additional information on
the HSE’s review process is available in the document posted with each vacancy entitled
“Code of Practice, information for candidates”.
Codes of practice are published by the CPSA and are available on www.hse.ie/eng/staff/jobs in
the document posted with each vacancy entitled “Code of Practice, information for candidates
or on www.cpsa.ie.
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The reform programme outlined for the Health Services may impact on this role and as structures change the
job specification may be reviewed.
This job specification is a guide to the general range of duties assigned to the post holder. It is intended to
be neither definitive nor restrictive and is subject to periodic review with the employee concerned.
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Clinical Nurse Specialist (Stroke Care)
Terms and Conditions of Employment
Tenure
This appointment is permanent / specified purpose, whole-time / part-time and pensionable.
Appointment as an employee of the Health Service Executive is governed by the Health Act 2004
and the Public Service Management (Recruitment and Appointment) Act 2004.
Remuneration
The Salary Scale (as at 01/01/10) for the post is:
Euro 47,089 – 47,886 – 48,559 – 49,659 – 50,874 – 52,067 – 53,260 – 54,604 – 55,852 (pro rata)
Working Week
The standard working week applying to the post is 37.5 hours (pro rata)
HSE Circular 003-2009 “Matching Working Patterns to Service Needs (Extended Working Day /
Week Arrangements); Framework for Implementation of Clause 30.4 of Towards 2016” applies.
Under the terms of this circular, all new entrants and staff appointed to promotional posts from
Dec 16th 2008 will be required to work agreed roster / on call arrangements as advised by their
line manager. Contracted hours of work are liable to change between the hours of 8am-8pm over
seven days to meet the requirements for extended day services in accordance with the terms of
the Framework Agreement (Implementation of Clause 30.4 of Towards 2016).
Annual Leave
Superannuation
The annual leave associated with the post is to be confirmed at job offer stage.
Membership of the HSE Employee Superannuation Scheme applies to this appointment.
Existing Members who transferred to the HSE on 1st January 2005 pursuant to Section 60 of the
Health Act 2004 are entitled to superannuation benefit terms under the HSE Scheme which are
no less favourable to those to which they were entitled at 31 st December 2004.
Appointees to posts in the Mental Health Services which formerly attracted fast accrual of service
should note that the terms of Section 65 of the Mental Treatment Act 1945 do not apply to New
Entrant Public Servants as defined by Section 12 of the Public Service Superannuation
(Miscellaneous Provisions) Act 2004.
Probation
Every appointment of a person who is not already a permanent officer of the Health Service
Executive or of a Local Authority shall be subject to a probationary period of 12 months as
stipulated in the Department of Health Circular No.10/71.
Protection of
Persons Reporting
Child Abuse Act
1998
As this post is one of those designated under the Protection of Persons Reporting Child Abuse
Act 1998, appointment to this post appoints one as a designated officer in accordance with
Section 2 of the Act. You will remain a designated officer for the duration of your appointment to
your current post or for the duration of your appointment to such other post as is included in the
categories specified in the Ministerial Direction. You will receive full information on your
responsibilities under the Act on appointment.
Infection Control
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.
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