Navigation Team Advanced Practical Nurse

A Description
Calgary Foothills Primary Care Network (CFPCN) is a group of family physicians in North West Calgary and Cochrane collaborating with Alberta Health Services – Calgary Zone to deliver the best possible primary care.
CFPCN brings together physicians and other primary health care providers to achieve efficiencies, assess and meet patient needs and cooperate on special programs that serve the Calgary Foothills area. The network operates in partnership with Alberta Health and Wellness, Alberta Health Services - Calgary Zone and the Alberta Medical Association.
CFPCN has established a team environment where individuals are encouraged to take initiative, be creative and contribute to ongoing decision-making.
The advanced practice nurse provides essential health services to patients with specialized and complex needs of physicians who belong to CFPCN based on enhanced clinical knowledge and skills in collaboration with family physicians and interdisciplinary team members.
B Key Responsibilities
Key aspects of the position may include, but are not limited to:
Clinical
-Provides comprehensive client care as a central member of the navigation team
-Demonstrates competency to perform comprehensive assessment, intervention management, referral and evaluation of client care across the continuum of health care services
-Provides home visits to clients as needed
-Performs comprehensive health assessment based on a thorough history, physical examination, and additional assessment strategies individualized to client needs and capacities
-Identifies health needs and capacities
-Communicates with clients about health findings and /or diagnosis and discusses health outcomes and prognosis.
-Collaborates with the client and/or caregiver to identify and choose treatment or care options
-Supports and councils clients regarding their personal responses to disease, disorders or conditions, while creating an environment in which effective learning can take place.
-Recognizes determinants of health affecting clients and supports health protection interventions that promote healthy environments
-Anticipates and recognizes rapidly changing urgent and emergent situations
-Appropriately and intentionally includes health promotion, illness prevention and capacity building in client relationships and responses to health needs
-Utilizes critical thinking skills in decisions related to the use of clinical and diagnostic investigations, interventions and the management of care
-Demonstrates evidence-based clinical decision-making through the critical examination and application of evidence from clinical research integrated with clinical expertise, patient input and existing resources.
-Performs therapeutic interventions as required
-Promotes continuity of client care through assessment and evaluation, communication with family physician and other members of the Navigation Team
-Requests consultation from, and initiates referrals to, physicians and other health care professionals and services
-Coordinates activities and functions regarding the care, progress and outcomes of the client
-Exercises flexibility in clinical decision-making depending on need to negotiate with other healthcare provider(s)
-Determines a course of action for the client in the absence of other resources or providers
-Engages in creative brainstorming and problem solving for client health issues
Professional
1) Maintains standards of care and addresses quality improvement and risk management issues by using best practice processes
2) Adheres to the Canadian Nurses Association Code of Ethics for Registered Nurses and performs activities and care within the full scope of practice as defined under the Health Professions Act
3) Responsible for maintaining continuing competencies through ongoing professional development including participation in education programs, research and continuous quality improvement activities
4) Pursues continual learning by participating in education opportunities, in-services and/or training programs
5) Facilitates ongoing change by acting as a positive role model /change agent to all staff
6) Clarifies relevant research questions, collaborates, initiates, participates and /or disseminates research findings
7) Provides leadership in the assessment, development, implementation and evaluation of evidence-based practice
8) Promotes the use of research to evaluate outcomes of care
9) Participates in the education of health care professionals
10) Serves as a resource for staff education as well as to the interdisciplinary team and other providers of care
11) Serves as a role model for evidence-based practice
12) Contributes clinical leadership by participating in program, corporate or regional committees.
13) Mentors Registered Nurses as needed
General
1) Implements and actively promotes a collaboration interdisciplinary approach to client care within the primary health care model
2) Provides leadership for, and actively participates in program development and evaluation, research and educational activities
3) Participates in the development or revision of policies by providing feedback and suggestions
4) Adheres to all infection control practices and procedures
5) Ensure an environment and resources which nurture spirituality
6) Maintains confidentiality on issues related to clients, employee matters and GSS information according to FOIP, PIP and HIA GSS
7) Proactively builds healthy relationships with clients, families, staff, volunteers and external contacts
8) Demonstrates dependability by reporting for work on time and as scheduled
9) Participates in quality improvement and risk management activities
D Qualifications
Formal Education
-CNA Certificate of competence within specialty Gerontological Nursing preferred
-Licensed with College of Registered Nurses Association of Alberta as a practicing member
Experience
-Advanced clinical nursing skills in geriatrics with a collaborative, responsive and flexible community based approach
-Experience in primary health care, health promotion and prevention of disease, injury and chronic disease management
-Experience in a leadership role employing full scope of practice
-Advanced preparation and experience in a variety of health care settings; preferably with a focus on care of seniors with complex health issues
Knowledge, Skills, Abilities
-Advanced clinical nursing skills to care for medically complex geriatric clients
-Strong interpersonal communication skills
-Competent assessment skills in the geriatric population (MMSE, MOCA, Dementia Caregiver's Toolbox)
-An ability to deal effectively with conflict in a diplomatic and professional manner
-Advanced written and oral communication skills with internal and external agencies
-Exhibits open and sincere approach by demonstrating respect and compassion for clients, partners, care givers and colleagues
-Maintains an individual's dignity and self worth during all interactions
-Excellent active listening skills
-Demonstrates flexibility and responsiveness by accommodating schedule according to complex client needs
-Accepts, implements and evaluates change with a positive attitude
-Must possess a valid driver's license and have access to a vehicle

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