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Practice Nurse Position Description

Post: Practice Nurse (part-time)

Hours: Up to 25 hours per week, days to be agreed

Meetings: Team meetings most Wednesdays (clinical team, nursing team, full team)

Necessary Qualifications:

Nursing Council of NZ Registered Nurse

Current Annual Practising Certificate

Authorised Vaccinator (or ability to enrol on course soon)

CPR Certificate

Smear Taker   

Accountability: to the GP Principals and Practice Manager.

General: undertake duties and responsibilities of a Practice Nurse as part of our dedicated team that provides high quality modern health care in an environment where patients feel comfortable and respected regardless of age, gender, ethnic or cultural background. This will involve working closely with the GPs and collaborating with the other nurses. We expect the nurses to work in cooperation with the team, and to be flexible in increasing their hours when appropriate to cover for each other’s leave (we also have two casual nurses available to provide cover). These duties and responsibilities include but are not limited to the following:

Reactive Care:

The assessment and management of patients as they present either with acute problems or as booked patients and providing services such as:

1. Triage of emergency cases, assessing their immediacy of need for medical care, putting them in a suitable location for observation and assessment and liaising with Doctors as appropriate.
2. Dressing and redressing wounds
   Removal of sutures
   Immunisations as part of National Schedule and Travel Schedules
   ECG’s
   BP measurement
   Injections of Vitamin B12 and Depo-Provera following the practice
   Protocol, and administering other medications by injection as required
   Liquid Nitrogen treatment
   Implementing the Cellulitis and UTI Procedure as necessary

Referred Care

Receive referrals from the GPs to provide appropriate nursing services, including those outlined in 2) above and administration of bronchodilator therapy and immunisations.

Assistive Care

• Assist the GPs with care of certain patients – e.g. wound management, venepuncture, Zolendronate infusion, Insulin Initiation, Contraceptive implant insertion, minor surgery, Mirena and IUD insertion.
• To act as a chaperone as appropriate when requested

Delegated Care

Acting under standing orders and practice procedure for tasks such as immunisations, warfarin monitoring, Adrenaline administration and Depo-provera and Myocrisin administration.

Emergency Care:

Coordinating and administering emergency treatment as needed including Cardiopulmonary Resuscitation including Automatic External Defibrillation operation, Oxygen therapy and Adrenaline for anaphylaxis either in conjunction with the GPs or independently if no GP is on the premises.

Proactive Care

• Screening – ensure practice screening programmes for cervical smears, mammography and the like are kept up to date and recalls put in place; performing and following up cervical smears if adequately trained.
• Immunisations – ensure that children do not miss out on their vaccinations using appropriate recall methods. Administering and updating the National Immunisation Register as necessary.
• Manage patients on warfarin as per the practice protocol.
• Health promotion – by example and discussion with patients promote a healthy lifestyle including appropriate dietary modification, exercise, smoking and alcohol intake; sending out health assessment invitations and information to age cohorts.
• Diabetes and Impaired Glucose Tolerance – assessment and lifestyle counselling.
• Training – e.g. inhaler technique; blood glucose monitoring.
• Recall management – appropriate management of patient recalls.

 Liaison

• Act as a two-way link between patients and the doctors.
• Being accessible by phone to patients for prescription requests and health queries.
• Contacting patients at the request of the Doctor to follow them up or to follow laboratory and x-ray results.
• Contacting the laboratory and hospital when necessary.

 Education

• Helping with training of Nursing and Medical Students who are attached to the practice from time to time.
• Supporting GP registrars in their training.

Cold Chain Responsibility

The nurse that is responsible for the oversight of the Amity Cold Chain process as it sits inside the national Cold Chain process. This covers the maintenance of temperatures between +2^oC to +8^oC from the place of manufacture to the point of safe vaccine administration. This includes:

• fulfilling the requirements of the National and Amity Health Centre Cold Chain procedures.
• ordering vaccines.
• vaccine fridge maintenance.
• overseeing daily, monthly, 6 monthly, and annual audits.
• maintaining regular Cold Chain Accreditation.

Administration

• Cold-chain maintenance including vaccination fridge monitoring.
• Stock control – Treatment room dressings, vaccinations and equipment, medication, lab supplies ordering and monitoring.
• Sterilisation and disinfection of equipment to current standards.
• Stocking of Drs rooms with equipment/supplies/linen.
• Medical Waste Disposal including Sharps Containers and Expired Drugs.
• Audits – undertaking and partaking in appropriate audits of work with the aim of improving quality of care.
• PHO targets – undertaking to work to help improve the practice’s performance against PHO targets.
• PHO Liaison – where appropriate liaising with the PHO to aid Practice and PHO population healthcare.

Computer

Using Medtech Evolution system to make records of all patient consultations, immunisations etc; administering recall programme for screening and vaccinations; putting charges through for patients; communication with Drs and patients.

Quality

Along with the other members of the Amity team, seeking opportunities for improving quality of care and systems especially but not exclusively those required for Cornerstone Reaccreditation.

Professional Development

• Taking an active part in professional development including training and refresher courses on an individual basis or as organised within the practice e.g. Annual Planning Days and combined team training.
• Meeting the requirements of the Nursing Council in terms of maintaining professional development and reflection.

Part of the team

• Attending monthly staff and clinical meetings and monthly nurse meetings.
• To feel and be part of the Amity team helping out and being helped out where appropriate, especially helping Reception with phone calls as required.
• Other duties that may arise from time to time at the request of the GPs or Practice Manger.

Infection Control Responsibility

The nurse nominated as Infection Control Officer takes responsibility for maintaining standards according to the practice Infection Control Policy and updating this as necessary in line with National Standards as they change. This includes:

• reviewing the Amity Infection control policy annually and amending and updating as required.
• Orientation of new staff and updating existing staff on their responsibilities in maintaining good infection control policies.
• Carry out the necessary auditing of Amity Health Centre’s processes.
• Liaise as necessary with cleaning staff when necessary to maintain a reasonable standard of cleanliness and hygiene in the premises.

Stores Ordering/Stocktaking Responsibility

The nurse responsible for maintaining appropriate stock levels of clinical supplies has duties that include the following

• Regular weekly check of current level of stocks using the stores order form;
• Creating stores order from the above checks and the nurses’ notebook where any stores needed are noted;
• Liaising with the Office Manager who does the ordering on-line;
• Monitoring equipment in the Health Centre and discussing with the clinical team any new equipment that is required/desirable;
• Liaising with nursing team regarding new dressing materials/products which have been shown to be beneficial in patient care and are used elsewhere as part of “best practice;
• Bringing new ideas for patient management as they arise; and
• to the attention of the doctors

Significant Event Meeting Nurse Representative

The duties of this role include:

• Attendance at the monthly meetings with a Doctor rep and Receptionist rep to discuss reported significant events that have been reported since the last meeting and to review the progress made with any actions that have been taken to reduce recurrence.
• Categorising the events into sub-headings to try and identify trends.
• Analysis of the events to seek root cause; potential outcomes arising from the event from the other party (e.g. Patient) point of view and from Amity’s point of view; action to be taken e.g. where to be discussed next; and when to be reviewed if needed.
• Formulation of a report to be presented to the next meetings of Receptionists, Nurses, Doctors, Clinical Team and Staff Team.