Practice Nurse

Registered Practitioner Practice Nurse Qualifications Registered Nurse Training Additional specific training and education to diploma level (level 2) to fulfil competency for role. Experience One year working post Registration Preferably one year working in the community as a nurse. Has undertaken specific training relevant to Practice Nurse eg Diabetes or Asthma management. Accountability Professionally: to patients under UKCC Code of Conduct Managerially: to GPs, Senior Nurse and practice manager. Special Functions Provides care directly to patients without referral via another nurse or doctor. Develops Practice Protocols. Appropriate as a lead nurse within a practice with practice nursing experience. Main Responsibilities Clinical Nursing Practice Wound Management o Provide the diagnosis, management plan and treatment of leg ulcers using Doppler assessment. o Perform wound care using aseptic technique o Undertake dressings. o Suture and clip removal o Assist with minor surgery Screening o Undertake opportunistic screening-BP checks, height, weight, BMI, urinalysis, smoking status. o Carry out new patient checks. o Undertake over 75 checks o Undertake opportunistic venepuncture Health Promotion o Recognise patients readiness to change in supporting their attempts to change their unhealthy behaviour. o Provide healthy eating advice to individuals or to groups, including the underweight. o Provide smoking cessation advice individually in opportunistic consultations. o Provide individual advice to patients about increasing activity or exercise. o Offer advice on recommended safe limits for alcohol consumption. o Develop and maintain the health promotion material within the practice and the waiting room notice board. o Refer as appropriate. Vaccinations and Immunisations o Provide and adult and childhood immunisation service. o Maintain a call and recall of patients. o Develop practice protocols. o Administer injections under an individualised prescription or Patient Group Direction. o Ensure safe storage, rotation and disposal of vaccines and drugs. Ear Care o Undertake ear syringing after the patient has been assessed by GP or senior nurse o Advise patients about safe ear care. Infection Control o Support patients and colleagues in adopting sound infection control measures. o Apply infection control measures within the practice according to local and national guidelines. This includes: o Universal hygiene precautions. o The collection and handling of laboratory specimens. o Segregation and disposal of waste materials. o Decontamination of instruments and clinical equipment. o Reporting and treatment of sharps injuries. o Dealing with blood and bodily fluid spillages. o Educate colleagues in adopting sound infection control measures. Emergency Management o Is competent in anaphylaxis and resuscitation techniques. Child Health/Child Protection o Recognise the signs, symptoms and categories of child abuse. o Understand the importance of recognition, observation, documentation and communication. o Is aware of child health procedures, statutory local procedures and points of referral. o Has knowledge of other practitioners and agencies roles. o Understand basic legal issues around child abuse. Mental Health o Recognise and is aware of appropriate referral mechanisms for family violence, vulnerable adults, substance abuse and addictive behaviours. o Recognise psychological needs of patients presenting with depression or suicidal tendency. Care and Programme Management Mens Health Raise awareness and give basic advice on issues covering: o Initiates opportunistic consultations with patients to cover issues of mens health. o Testicular self examination. o Incontinence and prostatic disease. o Family Planning. o Sexual Health. o Make appropriate referrals. Family Planning o Advise patients on available methods of contraception and refer patients as appropriate. o Support patients attending for emergency contraception and refer as appropriate. o Perform interval health checks for patients using hormonal contraception. o Teach patients correct condom use. o Advise patients on reducing risk of sexually transmitted diseases and refer patients appropriately. Womens Health o Advise patients on national and local Cervical Cytology and mammography screening programmes. o Undertake a programme of cervical cytology sampling under supervision until competent. o Audit a minimum of twenty consecutive smears each year to demonstrate adequate sampling rates. o Promote breast self-awareness, demonstrate breast self-examination and provide support literature. o Advise patients about reducing the risk of sexually transmitted diseases and make appropriate referrals. o Take swabs for microscopy as directed. o Give patients basic advice about peri-menopausal and menopausal symptoms and make appropriate referrals. o Advise on increased peri-menopausal and post-menopausal risk of osteoporosis and heart disease. Offer health promotion/lifestyle advice to patients. o Advise on basic continence management and make appropriate referrals. All Nurses should have minimum training and understanding of Diabetes. Diabetes o Initiates the process of diagnosis on patients with suspected diabetes. o Manages patients newly diagnosed with diabetes under protocols. o Undertakes annual review of patients understanding and ability to self manage. o Provides the management of patients converting to or commencing insulin within protocols. o Refers to dietician, chiropodist and diabetes and specialist nurses. o Support patients in the management of non insulin dependant diabetes. o Undertake opportunistic screening for the diagnosis of diabetes. o Support and provide education for diabetic patients. o Provide emergency treatment for hypo/hyperglycaemic emergencies. o Make appropriate referrals. o Contribute to the maintenance of the practice diabetic register. o Audits outcomes of care against standards and initiate changes as necessary. Respiratory Disease Management o Manages newly diagnosed patients with asthma and COPD o Has a sound understanding of asthma care; its diagnosis, asthma treatments and the principles of self-management. o Use a spirometer to aid the diagnosis and management of COPD o Know the factors which contribute to the development of COPD. o Contribute to the management of patients within the framework of national and local guidelines for asthma and COPD. o Manage emergency treatment of asthma attacks. o Advise patients on their asthma control including the use of self-management plans. o Teach and advise patients how to use various inhalers and peak flow meters. o Contribute to the maintenance of the practice respiratory register. o Make appropriate referrals. o Work within agreed local/BTS guidelines and patient group directions to manage patients with asthma, aiding diagnosis, reviewing inhaler technique and advising on treatment changes. Cardiovascular Disease o Contribute to the implementation of the National Service framework. o Contribute to the maintenance of the practice CHD register. o Works within agreed protocols when managing risk factors to enable patients to manage their own disease. o Provides psychological support by discussing interventions and treatments. o Advise patients on lifestyle management and drug compliance for reducing the risk factors of: Hypertension Angina Myocardial Infarction Cerebrovascular Disease Travel Health Advice o Offer a holistic approach to travel health including comprehensive advice for patients prior to travel including: Vaccinations and medication Malaria prophylaxis and bite avoidance Safe sex Food Hygiene Sun Protection First aid and emergency medication Health insurance Clinical Practice Leadership o Monitor and maintain the consistency of professional standards set. o Take appropriate action if standards are not being met. o Recognises the development needs of others and take appropriate action. o Lead a team towards common objectives. o Assist in clinical audit and the setting and monitoring of standards of care. o Teach and direct others in clinical setting, including unqualified staff. o Act as an assessor/mentor and teacher to other staff. o Work effectively in the team. Clinical Practice Development o Participate in evidence based practice. o Be aware of current evidence based approaches to patient care and demonstrate this in practice. o Demonstrate clinical expertise in practice. o Ensure clinical supervision is in place for nursing staff.