The Complex Continuing Care and Complex Rehabilitation and Transition Care (CRTC) team is an in-patient service that provides care to clients from birth to age 18 with a variety of medically complex conditions that require intensive monitoring, life sustaining technologies, active re/habilitation needs and care coordination/navigation. The CCC team assists children and youth to acquire functional mobility, movement and life skills, and provides support services for families to care for their child and transition to their home and community.
The Nurse Practitioner (NP) as a member of the CCC team, provides leadership and promotes excellence in pediatric, client and family-centered nursing care through the key domains of practice (i.e. Clinical practice; Inter-professional Collaboration, Consultation and Referral; Leadership, and Scholarly Activities - Research, Education & Mentorship). The NP integrates in-depth knowledge of advanced nursing practice and theory, health management, health promotion, disease/illness /injury prevention and other relevant biomedical and psychosocial theories to provide comprehensive health services.
The NP works in collaboration with their clients and families and other inter-professional health-care providers in the provision and coordination of high quality client and family-centred care. The NP provides autonomous direct care and clinical leadership for defined populations of children and youth. The specific population(s) will be determined in collaboration with the medical team (Canadian Nursing Association, 2010). The NP will be registered as a Nurse Practitioner and work to full scope of practice within the current legislative framework.
Key Responsibilities
Clinical Practice:
Provides direct care to clients and families within Complex Continuing Care who are transitioning to the community with medical complexity
Provides comprehensive health assessment to diagnose health/illness conditions, and to treat and manage acute and chronic illness within a holistic model of care
Orders and interprets appropriate screening and diagnostic tests and performs therapeutic procedures
Prescribes pharmacologic agents and therapeutic measures in accordance with federal/provincial legislation and policy
Communicates effectively with clients and families and health care team members
Coordinates care to ensure smooth transitions for clients and families between and across services
Participates in and/or leads complex admission and transition planning processes
Monitors, evaluates and revises the plan of care and therapeutic interventions based on current evidence and on client goals, preferences, health status and outcomes
Participates in systems improvement and innovations to ensure access and efficient use of clinical services
Inter-professional Collaboration/Consultation/Referral:
Consults and collaborates with inter-professional team members, clients and families as well as community healthcare providers and agencies to achieve the best health outcome for clients and families
Consults with and/or refers clients to other health-care providers (e.g., physicians, specialists) when appropriate and when the client`s condition is not within the NP scope of practice
Collaborates and participates in planning, promoting, implementing and evaluating new ideas, concepts, and interventions to facilitate care to clients and families
Provides consultation to health care team regarding clinical situations within expertise area
Build collaborative relationships with key partners (e.g. SickKids, UHN - Toronto Rehab Institute)
Leadership:
The CCC team NP will use strength based leadership to develop themselves and engage others, build partnerships and networks to achieve results, and use systems/critical thinking to champion and orchestrate change.
Provides leadership in the management of clinical care and is a resource person and role model
Guides, initiates and provides leadership in the development/revision of standards, practice guidelines, protocols, policies, and quality improvements, education and research initiatives
Participates in professional, program and hospital-wide initiatives
Actively promotes professional role through participation in external forums such as the Nurse Practitioner Association of Ontario, Toronto Academic Health Science Network (TAHSN) NP community of practice
Advocates to influence health care practice, health services, policy and outcomes
Examines current processes, identifies opportunities for change and provides recommendations for improvements
Serves as a resource and consultant in strategic program planning, decision-making, and problem-solving within the program team and the organization
Research, Education, Mentorship & Scholarly Activities:
Uses evidence in practice, develops and uses clinical practice guidelines, pathways and protocols in care provision
Critically reviews, analyses, interprets and applies evidence to clinical practice
Participates in the generation of new knowledge through active engagement in research initiatives and partnership with the Bloorview Research Institute and Centres for Leadership,
Acts as a change agent through knowledge translation and dissemination of new knowledge that may include formal presentations, publication, seminars, and the development of clinical practice guidelines and policies.
Functions as a content expert and resource person in their specialized field of practice, and takes advantage of informal learning opportunities to educate the interprofessional team
Participates in the academic community by providing education, clinical supervision and mentorship through university cross-appointment
Educates clients, families, members of the health care team, referring facilities and other community providers
Enhances personal and professional development through reflective practice and by attending educational opportunities and /or conferences in clinical specialty, research & scholarship, and/or leadership topics
Qualifications
Education
Graduate degree from an approved and accredited Nurse Practitioner Program
Current registration with the College of Nurses of Ontario - Registered Nurse (Extended Class)
Eligible for cross-appointment with the University of Toronto
Basic Life Support (BLS) for Healthcare Providers
Experience
Minimum 3 years pediatric and family nursing experience required
NP experience within an Academic Health Science environment preferred
NP preferred with experience in both acute care (inpatient/PICU/NICU) and post acute/chronic care (outpatient/community care/hospice) environments
NP preferred with experience working as a member of a Complex Care team
Evidence of active involvement/participation in scholarly activities
Skills
Excellent conceptual and theoretical understanding of evidence-based practice and ability to articulate the concepts as they relate to advanced nursing practice
Superior clinical decision-making, ethical practice, assessment, diagnostic, and therapeutic management skills
Demonstrated problem-solving and critical thinking skills
Effective communication and presentation skills (both verbal and written)
Demonstrated leadership skills and effectiveness in collaborative relationship development
Proven ability to work independently, and as part of an interprofessional team
Demonstrated ability to identify and meet own learning needs in pursuit of ongoing professional development
* Able to use computer software such as MS Office applications, email and web applications
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