Advanced Nurse Practitioner Epilepsy

Confined Competition - Internal Applicants Only

Overview of Post

The Nursing and Midwifery Board of Ireland (NMBI) sets out the criteria for registration as an Advanced Nurse Practitioner as set out in Advanced Practice (Nursing) Standards and Requirements (NMBI, 2017).

Registered Advanced Nurse Practitioners (RANPs) provide expert nursing skills and interventions which transcend traditional nursing roles and responsibilities. RANPs have significant experience, knowledge, and have received training to be able to competently deliver care and skills which serve as an adjunct to, instead of a replacement of, the work of medical colleagues. The overall purpose of the post is to provide safe, timely, evidenced based nurse-led care to patients at an advanced nursing level .This involves undertaking and documenting a complete episode of patient care (assess, diagnose, plan, treat and discharge patients) according to collaboratively agreed protocols, working within a scope of practice and demonstrating advanced clinical and theoretical knowledge. Critical thinking, clinical leadership, and decision making skills are added skills within this role.

The role will provide clinical leadership and professional scholarship in order to develop nursing practice and health policy at a local, regional and national level. The role will contribute to nursing research to shape and advance nursing practice, education and health care policy at local, national and international levels.

Epilepsy is a chronic disease characterized by unpredictable, sometimes lifelong, often dangerous seizures which result in involuntary alterations in behaviour and consciousness. The condition affects about one in every 100 people and is second only to stroke as the commonest chronic neurological disorder in Europe. Of the 40,000 people with epilepsy (PWE) in Ireland (10,000 of whom are under 16 years), approximately 70% are well controlled on medication
whilst it is estimated that 12-15,000 people who have uncontrolled seizures and are in regular contact with secondary and tertiary hospital services.

The Core Objectives of the National Epilepsy Clinical Care programme in the Republic of Ireland are (2014):

1. Improving Access to expert care and Information
2. Improving the Quality of Care across the Healthcare spectrum from prevention thorough managed primary care to complex surgical care for difficult epilepsy
3. Improving value conscious care by shifting care where possible from expensive hospital based care to the Community

The RANP Epilepsy will be responsible for local delivery of quality epilepsy care at Beaumont Hospital, and the RANP will be clinically accountable to Consultant Neurologists.

Key Working Relationships

Clinical Consultant Lead for the Epilepsy Service
Director of Nursing/Directorate Nurse Manager
RANPs and other nursing grades
Nurse Practice Development Co-ordinator
Prescribing site co-ordinator(s)
Medical colleagues
Inter-professional colleagues
Patients/service users/families and/or carers
Nursing and Midwifery Board of Ireland
Higher Education Institution
Nursing and Midwifery Planning and Development Unit
Centres of Nursing and Midwifery Education
National Clinical and Integrated Care Programme
National Leadership and Innovation Centre
Other relevant statutory and non-statutory organisations

Principal Duties and Responsibilities:

The post holder’s practice is based on the six domains of competences as defined by the Nursing and Midwifery Board of Ireland’s (Bord Altranais agus Cnáimhseachais na hÉireann) Advanced Practice (Nursing) Standards and Requirements (NMBI 2017).

The domains are:

• Professional Values and Conduct
• Clinical-Decision Making
• Knowledge and Cognitive Competences
• Communication and Interpersonal Competences
• Management and Team Competences
• Leadership and Professional Scholarship Competences

Domain 1: Professional Values and Conduct

The RANP will gain increased competence in applying ethically sound solutions to complex issues related to individuals and populations by:

• Demonstrating accountability and responsibility for professional practice as a lead healthcare professional in the care of patients within their specialty
• Collaborating with his/her supervisor and local stakeholder group to scope the caseload and remit of practice for the RANP role by defining inclusion and exclusion criteria
• Articulating safe boundaries and engaging in timely referral and collaboration for those areas outside his/her scope of practice, experience, and competence by establishing, in collaboration with key stakeholders, referral pathways and locally agreed policies, procedures, protocols and guidelines to support and guide the RANP service
• Demonstrating leadership by practising compassionately to facilitate, optimise, promote and support the health, comfort, quality of life and wellbeing of persons whose lives are affected by altered health, chronic disorders, disability, distress or life-limiting conditions
• Selecting a professional practice model that provides him/her latitude to control his/her own practice, focusing on person centred care, interpersonal interactions and the promotion of healing environments
• Emphasising a caring therapeutic, relationship between the RANP and his/her patients, recognising that RANPs work in partnership with their multidisciplinary team (MDT) colleagues.
• Articulating and promoting the advanced practice nursing service in clinical, political and professional contexts (e.g. presenting key performance outcomes locally and nationally, contributing to the service’s annual report, participating in local and national committees to ensure best practice as per the relevant national clinical and integrated care programme)

• Acting as a clinical leader and initiating and implementing changes in health services in response to the needs of patients
• Articulating and communicating a vision for nursing practice in the area of epilepsy disease care and management that can be developed beyond the current scope of practice
• Contributing to strategic and innovative development of the epilepsy management services to ensure the constant provision of effective, high quality nursing care to patients with neurological conditions.
• Providing leadership in clinical practice and acting as a resource and role model for advanced nursing practice, sharing knowledge and expertise with colleagues
• Advocating for advanced nursing practice in the area of epilepsy by undertaking teaching in the clinical area, classroom, and the wider multidisciplinary/patient community
• Will ensure that recommendations for travel with use of own vehicle are consistent with recommendations with national HSE policy for travel and subsistence (available online)

Domain 2: Clinical-Decision Making Competences

The RANP will enhance his/her advanced knowledge, skills, and abilities to engage in senior clinical decision-making by increasing his/her capability to:

• Conduct a comprehensive holistic health assessment using evidenced based frameworks, policies, procedures, protocols and guidelines to determine diagnoses and inform autonomous, advanced nursing care
• Synthesise and interpret assessment information (particularly history) including prior treatment outcomes, physical findings and diagnostic data to identify normal, at risk and subnormal states of health
• Demonstrate timely use of diagnostic investigations / additional evidence-based advanced assessments to inform clinical-decision making
• Exhibit comprehensive knowledge of therapeutic interventions including pharmacological and non-pharmacological advanced nursing interventions, supported by evidence-based policies, procedures, protocols, and guidelines, relevant legislation, and relevant professional regulatory standards and requirements
• Initiate and implement health promotion activities and self-management plans in accordance with the wider public health agenda
• Discharge patients from the service as per an agreed supporting policy, procedure, protocols, guidelines and referral pathways
• Manage a caseload - the RANP has the authority to manage an independent and autonomous caseload of patients that falls within a collaboratively agreed scope of practice
• Assess referrals for Psychiatry or Psychology as required and expedite relevant referrals to supportive services

Domain 3: Knowledge and Cognitive Competences

The RANP will actively contribute to the professional body of knowledge related to his/her area of advanced practice by enhancing his/her capability to:

• Provide leadership in the translation of new knowledge to clinical practice (for example teaching sessions; journal clubs; case reviews; facilitating clinical supervision to other members of the team)
• Educate others using an advanced expert knowledge base derived from clinical experience, on-going reflection, clinical supervision, and engagement in continuous professional development
• Demonstrate a vision for advanced practice nursing based on service need and a competent expert knowledge base that is developed through research, critical thinking, and experiential learning
• Demonstrate accountability in considering access, cost, and clinical effectiveness when planning, delivering and evaluating care (for example key performance areas, key performance indicators, metrics)
• Participate in development and continuous evaluation of Integrated Care Pathways, Standard Operating Procedures (SOPs), and Key Performance Indicators (KPIs)
• Articulate and demonstrate the concept of advanced nursing practice within the framework of relevant legislation, the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (NMBI, 2025) and the Scope of Nursing and Midwifery Practice Framework (NMBI, 2015)
• Develop advanced knowledge of the pharmacodynamics of medications for epilepsy, drug interactions for specific groups, and maintain awareness of teratogenicity issues for women

• Contribute to the professional body of nursing knowledge both nationally and internationally by presenting at conferences, seminars, and workshops
• Maintain expertise in clinical practice supported through ongoing clinical encounter, case discussions, clinics, journal clubs, and other mediums

Domain 4: Communication and Interpersonal Competences

The RANP will negotiate and advocate with other health professionals to ensure the beliefs, rights and wishes of the person are respected by gaining increased competence and capability to:

• Communicate effectively with the healthcare team through sharing of information in accordance with legal, professional and regulatory requirements as per established referral pathways
• Demonstrate leadership in professional practice by using professional language (verbally and in writing) that represents the plan of care, which is developed in collaboration with the patient and shared with the other members of the inter-professional team as per the organisation’s policies, procedures, protocols and guidelines
• Facilitate clinical supervision and mentorship through utilising one’s expert knowledge and clinical competences
• Utilise information technology, in accordance with legislation and organisational policies, procedures, protocols, and guidelines to record all aspects of advanced nursing care
• Function as an expert, educator, advocate, researcher, and leader in the area of their specialty management to patients, families and the MDT
• Implement health promotion strategies for the patient group in accordance with the public health quality and safety agenda
• Demonstrate appropriate use of electronic records and other forms of medical records in clinical settings with respect for data protection and collection
• Liaise and develop strong links with charities and external agencies
• Collaborate and coordinate the patient’s journey with MDT partnership. Acknowledge the input and role of MDT team both in Beaumont Hospital and community services
• Improve and enhance community links with primary care services, GPs, other referring hospitals, local pharmacies and organisations
• Manage and promote liaisons with internal and external bodies as appropriate, for example; intra-hospital service, community services, or voluntary organisations.
• Maintain and create audits which support the surveillance of service delivery effectiveness and lead on initiatives to manage key performance indicators

Domain 5: Management and Team Competences

The RANP will manage risk to those who access the service through collaborative risk assessments and promotion of a safe environment by:

• Promoting a culture of quality care
• Proactively seeking feedback from persons receiving care, families and staff on their experiences and suggestions for improvement
• Implementing practice changes using negotiation and consensus building, in collaboration with the multidisciplinary team and persons receiving care
• Engaging in forums which evaluate quality and standards in clinical practice and lead the promotion of effective clinical standards
• Promoting an understanding of the role of the RANP and increase awareness
of other healthcare colleagues and service users of the scope of practice of the RANP
• Providing a visible, accessible advanced nurse service as well as delivery of formal and informal teaching and knowledge sharing initiatives.
• Responding to untoward events or incidents, determine the root cause of these through investigation, reporting on these events, and instigating remedial action to prevent these from happening again
• Contributing to professional and healthcare policy at local, regional and national level
• Support leadership and management functions of more junior colleagues in their team

• Facilitating communication and enhancing networks with healthcare teams and supportive services both internally and externally
• Promoting a culture that values diversity and respect in the workplace
• Contributing to the strategic management and planning process
• Formulating service plans and budgets in co-operation with the wider healthcare team

Domain 6: Leadership and Professional Scholarship Competences

The RANP will lead in multidisciplinary team planning for transitions across the continuum of care by enhancing his/her competence and capability to:

• Demonstrate clinical leadership in the design and evaluation of services (for example findings from research, audit, metrics, new evidence)
• Engage in health policy development, implementation, and evaluation (for example key performance indicators from national, clinical, and integrated care programmes/HSE national service plan/ local service need to influence and shape the future development and direction of advanced practice in epilepsy management)
• Identify gaps in the provision of care and services pertaining to his/her area of advanced practice and expand the service to enhance the quality, effectiveness and safety of the service in response to emerging healthcare needs
• Lead in managing and implementing change

Research

The RANP has a professional responsibility to deliver the highest standard of evidenced based care to patients with neurological conditions. Therefore, the RANP will participate in the research process to develop and contribute to the existing body of knowledge in this area by:

• Identifying research priorities pertaining to the best practice relating to their specialty
• Leading, conducting, disseminating, and publishing nursing research which shapes and advances nursing practice, education, the wider health policy and patient safety agenda
• Identifying, critically analysing, disseminating and integrating nursing research and other evidence into this specialist area of clinical practice
• Contributing to service planning and budgetary processes through the use of audit data and specialist knowledge
• Initiating, participating, evaluating, and coordinating clinical audits and research, reviewing process, interventions and outcomes in the area of epilepsy management.
• Recording pertinent data relating patient care in data base format where the outcomes of this data can be extrapolated
• Continuously reviewing clinical practice guidelines/protocols in collaboration with the MDT and Consultants
• Proactively forge links with academic institutions in order to participate and collaborate in research studies/forums in the area of epilepsy in line with the RCSI hospital group

Clinical Governance

Clinical Governance is an integral part of the RANP role whereby healthcare professionals and teams demonstrate accountability for the quality, safety, and satisfaction of the delivery of care to patients with
epilepsy. Clinical Governance supports the provision of the right care, at the right time, from the right person in a safe, caring environment (Health Service Executive, HSE 2012). In conjunction with reporting relationships discussed above, the RANP has an operational responsibility to the Clinical Lead for their service.

The RANP will demonstrate adherence to the Clinical Governance agenda by:

• Participating in the organisation’s clinical governance programme as defined by the Directorate Nurse Manager, the Directorate Business Manager, and the Clinical Director• Initiating and contributing to the development of KPIs and outcome measures relevant to epilepsy management
• Assisting in the monitoring of KPIs and responding to performance improvement initiatives as required
• Taking appropriate action on clinical matters identified as being detrimental to the care and wellbeing of patients, families and staff which may be inhibiting the safe and efficient provision of care
• Ensuring adherence to the organisation’s policies, procedures and protocols on patient safety, infection control, medication prescribing and the provision, storage and use of medicinal products
• Ensuring compliance with the quality and risk safety framework programme
• Establishing a feedback mechanism with the organisation risk advisors and reporting any risk issues to the Directorate Nurse Manager as appropriate.
• Participating in accreditation programmes external and internal to the Health Service Executive
• Ensuring adherence to hospital policies in relation to the care and safety of equipment utilised in the fulfilment of clinical duty

Clinical Supervision and Practice Portfolio

The RANP will develop a professional practice portfolio, incorporating evidence of learning from continuing professional development, clinical supervision, reflective practice, and review of his/her own scope of practice in accordance with regulatory requirements and service need.

The RANP engages in on-going clinical supervision as per a Service Level Agreement. The structure, process and outcome of clinical supervision must be explicit. The RANP maintains a record of clinical supervision in his/her professional practice portfolio.

Legislation, Regulation, Policy, and Guidelines

The RANP practises nursing according to:

• The Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (NMBI 2025)
• Scope of Nursing and Midwifery Practice Framework (NMBI 2015)
• Values for Nurses and Midwives in Ireland – Care, Compassion and Commitment (Department of Health 2016)
• Advanced Practice Nursing Standards and Requirements (NMBI 2017)
• National Health Policies and Procedures
• Local policies, procedures, protocols and guidelines
• Current legislation

The job description represents the main functions of the role and is subject to review and amendment to reflect changing practice in the service.

Selection Criteria:

Selection criteria outline the qualifications, skills, knowledge and/or experience that the successful candidate requires for successful discharge of the responsibilities of the post

Mandatory Criteria (Registered Advanced Nurse Practitioners):

1. Statutory Registration, Professional Qualifications, Experience, etc
(a) Eligible applicants will be those who on the closing date for the competition:
(i) Are registered in the Advanced Nurse Practitioner division of the Nursing
and Midwifery Board of Ireland Register maintained by the Nursing &
Midwifery Board of Ireland [NMBI] (Bord Altranais agus
Cnáimhseachais na hÉireann).
Or
(ii) Be eligible to register in the Advanced Nurse Practitioner division of the
Nursing and Midwifery Board of Ireland Register maintained by the
Nursing & Midwifery Board of Ireland [NMBI] (Bord Altranais agus
Cnáimhseachais na hÉireann) by meeting the criteria for registration as
an Advanced Nurse Practitioner as specified www.nmbi.ie

(iii) Have a broad base of clinical experience relevant to the advanced field of
practice

(iv) Demonstrates the competences relevant to the specialist area of advanced
practice

(b) Candidates must possess the requisite knowledge and ability including a high
standard of suitability and clinical, professional and administrative capacity to
properly discharge the functions of the role.

2. Annual registration
(i) On appointment, practitioners must maintain live annual registration on
the Advanced Nurse Practitioner Division of the register of Nurses and
Midwives maintained by the Nursing and Midwifery Board of Ireland
(Bord Altranais agus Cnáimhseachais na hÉireann) for the role

(ii) Practitioners must confirm annual registration with NMBI to the HSE
by way of the annual Patient Safety Assurance Certificate (PSAC).

3. Health
Candidates 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.

4. Character
Candidates for and any person holding the office must be of good character.

Desirable Skills:
• Level 8 (or above) or equivalent Post Graduate Qualification in the Specialty
• A recognised management qualification