Clinical practice

Assess and triage patients, including same day triage, and as appropriate provide definitive treatment (including prescribing medications following policy, patient group directives, NICE (national) and local clinical guidelines and local care pathways) or make necessary referrals to other members of the primary care team
Implement and evaluate treatment/interventions and care for patients presenting with an undifferentiated diagnosis
Clinically examine and assess patient needs from a physiological and psychological perspective, and plan clinical care accordingly
Assess, diagnosis, plan, implement and evaluate interventions/treatments for patients with complex needs. Proactively identify, diagnose, and manage treatment plans for patients at risk of developing a long-term condition (as appropriate)
Diagnose and manage both acute and chronic conditions, integrating both drug- and non-drug-based treatment methods into a management plan
Use complex decision making to inform the diagnosis, investigation, complete management of episodes of care within a broad scope of practice
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
Work with patients in order to support compliance with and adherence to prescribed treatments. Provide information and advice on prescribed or over-the-counter medication on medication regimens, side-effects and interactions
Prioritise health problems and intervene appropriately to assist the patient in complex, urgent or emergency situations, including initiation of effective emergency care
Support patients to adopt health promotion strategies that promote healthy lifestyles, and apply principles of self-care. Support and manage health needs of women presenting for family planning, cervical cytology, or sexual health consultation
Assess, identify, and refer patients presenting with mental health needs in accordance with the NSF for Mental Health Implement and participate in vaccination and immunisation programmes for both adults and children
Advise, support, and administer vaccinations for patients travelling abroad, where appropriate
Promote and deliver evidence-based care for patients presenting with aural conditions
Meet the needs of patients presenting for opportunistic wound care
Undertake minor surgery as appropriate to competence
Actively take a personalised care approach and population centred care approach to enable shared decision making with the presenting person

Communication

Utilise and demonstrate sensitive communication styles, to ensure patients are fully informed and consent to treatment
Communicate with and support patients who are receiving ‘bad news’
Communicate effectively with patients and carers, recognising the need for alternative methods of communication to overcome different levels of understanding, cultural background, and preferred ways of communicating
Anticipate barriers to communication and take action to improve communication
Maintain effective communication within the practice environment and with external stakeholders
Act as an advocate for patients and colleagues
Ensure awareness of sources of support and guidance (eg PALS) and provide information in an acceptable format to all patients, recognising any difficulties and referring where appropriate

Delivering a quality service

Recognise and work within own competence and professional code of conduct as regulated by the NMC
Produce accurate, contemporaneous, and complete records of patient consultation, consistent with legislation, policies and procedures
Prioritise, organise, and manage own workload in a manner that maintains and promotes quality
Deliver care according to NSF, NICE guidelines, and evidence-based care
Assess effectiveness of care delivery through self and peer review, benchmarking, and formal evaluation
Initiate and participate in the maintenance of quality governance systems and processes across the organisation and its activities
Utilise the audit cycle as a means of evaluating the quality of the work of self and the team, implementing improvements where required
In partnership with other clinical teams, collaborate on improving the quality of health care responding to local and national policies and initiatives as appropriate
Evaluate patients’ response to health care provision and the effectiveness of care
Support and participate in shared learning across the practice and wider organisation
Use a structured framework (eg root-cause analysis) to manage, review and identify learning from patient complaints, clinical incidents and near-miss events
Assess the impact of policy implementation on care delivery
Working with the practice management monitor and develop the performance of the GPN team in accordance with local policies
Contribute to the appraisal of the performance of the team, providing feedback as appropriate. Complete the relevant training in order to provide multi-professional clinical practice and CPD supervision to other roles within primary care, for example first contact practitioners and the personalised care roles
Understand and apply legal issues that support the identification of vulnerable and abused children and adults, and be aware of statutory child/vulnerable patients health procedures and local guidance
Working with practice management to ensure the whole team have skills and knowledge regarding domestic violence, vulnerable adults, substance abuse and addictive behaviour. Provide guidance and support to ensure appropriate referral if required

Leadership – personal and people development

Act as a clinical leader in the delivery of practice nursing services ensuring that the needs of the patient are a priority
Take responsibility for own learning and performance including participating in clinical supervision and acting as a positive role model
Support staff development in order to maximise potential
Actively promote the workplace as a learning environment, encouraging everyone to learn from each other and from external good practice
Encourage others to make realistic self-assessment of their application of knowledge and skills, challenging any complacency or actions that are not in the interest of the public and/or users of services
Critically evaluate and review innovations and developments that are relevant to the area of work
Enlist support and influence stakeholders and decision-makers in order to bring about new developments in the provision of services
Work with practice management to ensure sufficient staff of appropriate ability, quality and skill-mix are available to meet current and future service delivery, that selection and recruitment processes are effective and that equality of treatment of the team incorporates quality HR principles and processes
Contribute to the development of local guidelines, protocols, and standards
Maintain effective communication with those responsible for the overall commissioning and procurement process
Maintain active involvement in the planning and processes of practice-based commissioning or similar initiatives
Promote the role of the advanced nurse practitioner in general practice

Team working

Understand own role and scope and identify how this may develop over time
Work as an effective and responsible team member, supporting others and exploring the mechanisms to develop new ways of working
Delegate clearly and appropriately, adopting the principles of safe practice and assessment of competence
Create clear referral mechanisms to meet patient need
Prioritise own workload and ensure effective time-management strategies are embedded within the culture of the team
Work effectively with others to clearly define values, direction and policies impacting upon care delivery
Discuss, highlight, and work with the team to create opportunities to improve patient care
Manage and lead on the delivery of specifically identified services or projects as agreed with the practice management team
Agree plans and outcomes by which to measure success

Management of risk

Manage and assess risk within the areas of responsibility, ensuring adequate measures are in place to protect staff and patients
Monitor work areas and practices to ensure they are safe and free from hazards and conform to health, safety and security legislation, policies, procedures, and guidelines
Ensure appropriate supervision of safe storage, rotation and disposal of vaccines and drugs. Oversee the monitoring, stock control and documentation of controlled drug usage according to legal requirements where appropriate
Working with the practice management, ensure the nursing team has access to and undertakes mandatory and statutory training requirements
Apply infection-control measures within the practice according to local and national guidelines
Advocate for policies that reduce environmental health risks, are culturally sensitive and increase access to health care for all
Interpret national strategies and policies into local implementation strategies that are aligned to the values and culture of general practice

Managing information

Use technology and appropriate software as an aid to management in planning, implementation, and monitoring of care, presenting and communicating information
Review and process data using accurate Read codes in order to ensure easy and accurate information retrieval for monitoring and audit processes
Manage information searches using the internet and local library databases
Understand responsibility of self and others to the practice and primary care trust regarding the Freedom of Information Act
Collate, analyse, and present clinical data and information to the team
Communicate essential financial restraints with the team and discuss with them ideas for effective and efficient working within these constraints
Manage, if agreed, the nursing budget within financial principles

Learning and development

Undertake mentorship for more junior staff, assessing competence against set standards
Disseminate learning and information gained to other team members in order to share good practice and inform others about current and future developments (eg courses and conferences)
Assess own learning needs and undertake learning as appropriate
Provide an educational role to patients, carers, families, and colleagues in an environment that facilitates learning

Equality and diversity

Identify patterns of discrimination and take action to overcome this and promote diversity and equality of opportunity
Enable others to promote equality and diversity in a non-discriminatory culture
Support people who need assistance in exercising their rights
Monitor and evaluate adherence to local chaperoning policies
Act as a role model in the observance of equality and diversity good practice
Accept the rights of individuals to choose their care providers, participate in care and refuse care
Assist patients from marginalised groups to access quality care

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