Clinical Nurse Specialist (CNS)
Chronic Obstructive Pulmonary Disease (COPD) Outreach
Job Specification, Terms & Conditions
Job Title and
Grade
Campaign
Reference
Closing Date
Clinical Nurse Specialist (COPD Outreach)(Grade Code 2632 )
Proposed
Interview Date(s)
Organisational
Area
Week commencing 18th June 2012
Taking up
appointment
To be indicated at job offer stage.
Location of Post
Please note this campaign will create a recruitment panel to fill current and future vacancies in all
HSE areas.
NRS0677
Thursday, 17th May 2012 at 5:00pm
HSE Dublin Mid-Leinster
HSE Dublin North East
HSE South
HSE West
The following initial vacancies currently exist in:
Louth/Meath Integrated Service Area – HSE DNE
 Cavan General Hospital
 Our Lady of Lourdes Hospital
Sligo/Leitrim/West Cavan & Donegal Integrated Service Area – HSE West
 Letterkenny General Hospital
Details of Service
The person appointed to this post will work in the COPD Outreach Service which is a newly
developed service within the overall respiratory service in one of the 8 hospital sites. COPD
Outreach is a four pronged service offering early supported discharge, assisted discharge,
admission prevention, case management and pulmonary rehabilitation to COPD patients. The
post holder will work as part of a multidisciplinary team delivering coordinated evidence based
care for patients with COPD.
Please note a significant portion of the appointees work will be carried out “off site”. This means
that the appointee will travel to patient’s home/ place of residence to perform duties related to the
role.
Please note more post specific information on services provided, team structures, possible future
developments etc will be provided to candidates at the ‘expression of interest’ stage of the
recruitment process.
Reporting
Relationship
Purpose of the
Post
The post holder:

Is professionally accountable to the Director of Nursing (DON) or designated officer as
required and works in partnership with the multidisciplinary team.

Will report to the Asst. DON or designated officer as required on operational matters.

Is clinically accountable to the Clinical Director (lead consultant overseeing the outreach
service).
The role of the CNS in COPD Outreach is to provide initial post discharge, person centred care
and ongoing management of patients with COPD in the home/normal place of residence. The
post holder will be a key member of the multidisciplinary team, required to provide a specialist
nursing resource within the governance structure created for the programme. He/She will provide
physical, psychological and emotional support to an agreed caseload of COPD Outreach patients
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and their families throughout their COPD trajectory.
The post holder will act as a liaison between Respiratory Services, Primary Care Teams,
Community Care Teams and other agencies to deliver effective evidenced based care, using
resources efficiently to achieve the best possible outcomes in keeping with the COPD
Programme model of care and HIQA standards.
The post holder will develop COPD Outreach services in line with the COPD National Clinical
Programme Model of Care document and associated guidance (HSE 2011).
The post holder will be offered the opportunity to advance to Registered nurse Prescriber (RNP).
The post holder will be offered the opportunity to complete the Nurse Prescribing of Ionising
Radiation (X-Ray) Certificate.
Principal Duties
and
Responsibilities
Professional Responsibilities
The Clinical Nurse Specialist (COPD Outreach) will:

Practice nursing according to the Code of Professional Conduct and the Scope of Practice
Framework as laid down by the Nursing Board (An Bórd Altranais) and the National Clinical
Guidelines for COPD Outreach.

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 (COPD Outreach) will:
 Monitor and ensure maintenance of adequate and effective discharge planning for patients
returning to their own homes
 Accept referrals for COPD Outreach inclusion from members of the multidisciplinary team and
other allied health professionals; and maintain records of such referrals in line with Code of
Practice for Integrated Discharge Planning and audit requirements.
 Admit patients to COPD Outreach service ensuring pre-agreed inclusion/exclusion criteria are
adhered too
 Work in collaboration with other members of the multidisciplinary team to assess, plan, implement
and evaluate care for patients within COPD Outreach service in a person centred manner. This
will include:
1. Titration of prescribed medicines within agreed protocols
2. If a Registered Nurse Prescriber (RNP) the nurse must work within the scope of
her/is collaborative practice agreement and adhere to the regulations set down by
ABA pertaining to this role and, local policy requirements.
3. Evaluate clinical problems using objective measurement tools e.g. Spirometry in
conjunction with other team members, co-ordinate investigations, therapies and patient
follow-up
4. Develop an individualised home exercise programme or refer to pulmonary
rehabilitation Programme if available with each patient.
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 Effectively manage time and caseload in order to meet the needs of an evolving service
 Arrange referrals to other appropriate specialist services as deemed necessary
 Provide psychological support for patients and their families. Refer for further psychological
support if felt necessary or requested by the patient and/or their family.
 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 Respiratory Services
 Work closely with colleagues across services in order to provide a seamless integrated
service for the patient
 Contribute to the development and implementation of information sharing protocols, audit
systems, referral pathways, individual care plans and shared care arrangements through
regular collaboration/meetings with COPD Outreach and respiratory nurses nationally.
 Identify and utilise professional and voluntary resources and facilities at local and
national level by direct and indirect referral
 Refer to relevant services to assist with procurement of domiciliary equipment
 Participate in the Departmental Clinical Governance processes, working in partnership with
the Head of Department, CNM3, Clinical Governance lead and local COPD Outreach
governance group.
 Ensure that effective clinical governance procedures are maintained and evolve according to
defined needs and demands in COPD Outreach care.
 Maintain professional standards including patient and data confidentiality in line with HSE
policy
Patient Advocate
The Clinical Nurse Specialist (COPD Outreach) will:
 Act as patient advocate, this involves communicating, negotiating and representing COPD
outreach patients values and decisions in collaboration with other members of the MDT.
 Contribute to weekly case conferencing meetings with supporting outreach consultant and other
members of the MDT
 Develop and support the concept of advocacy particularly in relation to patients' participation
in decision making thereby enabling informed choice of treatment options.
 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 cooperation between Acute
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 inhibit the effective provision of effective care.
Education and Training
The Clinical Nurse Specialist (COPD Outreach) will:
 Maintain clinical, nursing and managerial competence in current developments, in the field of
COPD management to include keeping up to date with relevant research to ensure evidencebased practice.
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 Keep abreast of current trends in nursing through reading, attending seminars and having
thorough knowledge of nursing policy and standards.
 Address the educational needs of nursing and other professionals by participating in training
programmes for all members of the MDT.
 Use every opportunity for discussion, demonstrations and teaching for both patients and staff
 Liaise and foster good communications with the Centres of Nursing and Midwifery Education
(CNMEs)
 Participate in the orientation programmes of all new staff within the department and in-service
programmes
 Attend meetings as required
 Assist or participate in new projects relating to respiratory care
 Maintain and develop personal practice standards and keep abreast of progress in the field of
Respiratory Nursing
 Seek advice and assistance with assigned cases which prove to be beyond the scope of his or
her professional competence.
 Offer comprehensive education to patients with COPD that provides them with effective
strategies that will enable them to self-manage their condition/disease.
Audit and Research
The Clinical Nurse Specialist (COPD Outreach) will:
 Contribute to the management the COPD Outreach register
 Maintain records of COPD Outreach service in line with minimum data set programme
requirements
 Present three monthly audit reports to local governance team and national clinical care
directorate, as part of the COPD Outreach team.
 Implement and manage changes identified by audit and research and required within COPD
Outreach services
 Promote individual best practice interventions in accordance with the identified needs of
patients
 Participate and promote nursing research and associated research in this specialist area,
identifying nursing topics and issues, involving presentations and collaboration with the MDT.
 Ensure the views of all consumers are effectively sought, channelled and acted upon as
appropriate
 Contribute to the development of key performance indicators and monitoring of same within
COPD Outreach services.
Consultant
The Clinical Nurse Specialist (COPD Outreach) will:
 Act as resource in providing specialist knowledge, expertise and care in liaison with the MDT
 Promote the role of the COPD Outreach services amongst all 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 COPD Outreach patients through
regular formal and informal education.
 Represent the unit at local, national and international meetings as required
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Health & Safety
The Clinical Nurse Specialist (COPD Outreach) 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, e.g. Standards for
Healthcare, National Standards for the Prevention and Control of Healthcare Associated
Infections, Hygiene Standards etc.

Ensure a lone worker policy is in place and adhered to within your organisation/unit.
Administration
The Clinical Nurse Specialist (COPD Outreach) will:

Contribute to policy development and formulation, performance monitoring, business
planning and budgetary control.

Ensure that records are safeguarded and managed as per HSE 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.

Requisition with due economy

Ensure that equipment is maintained according to Hospital Policy

Undertake other duties as required by the Director of Nursing or his / her designate

Support the return of the KPI’s for the service to the HSE Clinical Strategy and Programmes
Directorate as indicated in the COPD Outreach Programme model of care document.
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 General division of the register
in which the applicant is currently practising
And

Have a minimum of 2 years experience in the specialist area of adult respiratory care
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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 (or equivalent) relevant to the specialist area of adult respiratory care
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
Demonstrate experience in adult chronic lung disease and COPD.
In order to develop effective and more efficient services, in line with the COPD Outreach Model
of care, the post holder is required to:
 Have undertaken or be willing to complete a Certificate in Spirometry (IARS or equivalent).
The timeframe for the attainment of the above requirement should be agreed with your local
employer on commencement of the post and is recommended it is achieved within 2 years
Other
requirements
specific to the
post
Essential Skills,
competencies
and/or knowledge
Access to own transport as a significant portion of the appointees work will be carried out “off
site”. This means that the appointee will travel to patient’s home/ place of residence to perform
duties related to the role.
 Demonstrate practitioner competence and professionalism in order to carry out the duties and
responsibilities of the role to include an understanding of the COPD Outreach National Clinical
Programme – its aims, governance, model and service philosophy and the contribution of
nursing to achieving the aims.
 Display evidence-based clinical knowledge in making decisions regarding client care
 Displays the ability to anticipate, by using expert knowledge, changes in patient's condition in
the COPD outreach 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 Peak Flow and Spirometry 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.)
 Functions autonomously, without direct supervision in specialist nursing practice
 Demonstrate a commitment to continuing professional development
 Demonstrate evidence of effective planning and organising skills
 Demonstrate the ability to build and maintain relationships including the ability to work
effectively as part of a multi disciplinary team.
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 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 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 in and develop IT skills relevant to the role
 Adopts and develops the concept of customer care and challenges any interaction which fails
to deliver a safe, quality service to internal and external customers.
Campaign
Specific Selection
Process
Ranking /
Shortlisting /
Interview
Code of Practice
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/ short listing 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 list and will be called to interview in ‘bands’ depending on the service needs of the
organisation.
The Health Service Executive will run this campaign in compliance with the Code of Practice
prepared by the Commissioners 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, feedback
facilitates for 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.
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 (COPD Outreach)
Terms and Conditions of Employment
Tenure
The initial vacancies for this post are permanent, whole-time. This post is pensionable. A panel
will be formed from this recruitment campaign and future permanent or specified purpose
vacancies of whole-time or part-time duration will be filled from this panel. The tenure of these
posts will be indicated at "expression of interest" stage.
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.
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
The annual leave associated with the post is to be confirmed at job offer stage.
Superannuation
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.
Confidentiality
In the course of your employment you may have access to, or hear information concerning the
medical or personal affairs of patients and/or staff, or other health service business. Such records
and information are strictly confidential and, unless acting on the instructions of an authorised
officer on no account must information concerning staff, patients or other health service business
be divulged or discussed except in the performance of normal duty. In addition, records must
never be left in such a manner that unauthorised persons can obtain access to them and must be
left in safe custody when no longer required.
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.
Infection Control
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