Clinical Nurse Specialist, (Respiratory Care – COPD Outreach)

RCSI Hospitals Group
Employment Type
Not disclosed
RCSI Hospitals Group logo


The purpose of this Clinical Nurse Specialist (Respiratory Care – COPD) post is to:

Deliver care in line with the five core concepts of the role set out in the Framework for the Establishment of Clinical Nurse Specialist Posts, 4 th edition, National Council for the Professional Development of Nursing and Midwifery (NCNM) 2008

The post holder will develop COPD Outreach services in line with the COPD National Clinical Programme Model of Care document and associated guidance (HSE, 2011).

The role of the CNS in COPD Outreach is to provide person-centred care post discharge, and ongoing management of patients with COPD in the home/normal place of residence. The post holder will be a key member of the multidisciplinary team, required to provide a specialist nursing resource within the governance structure created for the programme. He/She will provide physical, psychological and emotional support to an agreed caseload of COPD Outreach patients and their families throughout their COPD trajectory.

The post holder will also act as a liaison between Respiratory Services, Primary Care Teams, Community Care Teams and other agencies to deliver effective evidenced based care, using resources efficiently to achieve the best possible outcomes in keeping with the COPD Programme model of care and HIQA standards.

The post holder will carry out clinical and educational duties as required and be responsible for the delivery of high quality nursing care to patients with COPD in line with best professional nursing practice.

As part of the COPD Outreach team the post holder will:

  • Develop, manage and evaluate an early supported discharge programme
  • Plan and implement a care package from home to home
  • Contribute to business planning and business cases
  • Develop and implement guidelines and protocols relating to COPD Outreach
  • Develop and implement strategies as part of the COPD Outreach team for delivering effective COPD care within a changing healthcare environment
  • Engage in projects to raise the profile of the specialist COPD Outreach service and team members
  • Develop and deliver evidence based pulmonary rehabilitation programmes to patients with COPD in individual or group settings.


Patients over 16 years of age with non-complicated COPD or patients with an acute exacerbation of COPD that fit the inclusion/exclusion criteria.

The Clinical Nurse Specialist (Respiratory Care – COPD) will focus on adult patients with non-complicated COPD or who are experiencing an acute exacerbation of COPD.

A panel may be formed from which future permanent & temporary vacancies maybe filled.

Organisational Context

The RCSI Hospital Group includes the following hospitals:

  • Beaumont Hospital
  • Cavan General Hospital
  • Connolly Hospital, Blanchardstown
  • Louth County Hospital
  • Monaghan General Hospital
  • Our Lady of Lourdes Hospital/The Cottage Hospital
  • Rotunda Hospital
  • The Academic Partner for the Group is the RCSI

RCSI Hospital Group provides a national service and a regional service to Dublin and the North East and is committed to the provision of world-class care, exceptional clinical services with respect and compassion.

Key Responsibilities

The Clinical Nurse Specialist (Respiratory Care – COPD) must take a lead role in ensuring the service for patients with COPD is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012) or the relevant National Clinical Care Programme.

The post holder’s practice is based on the five core concepts of Clinical Nurse Specialist (Respiratory Care – COPD) role as defined by the NCNM 4 th edition (2008) in order to fulfil the role. The concepts are:

  • Clinical Focus
  • Patient/Client Advocate
  • Education and Training
  • Audit and Research
  • Consultant

Clinical Focus

Clinical Nurse Specialist ( Respiratory Care – COPD) will have a strong patient focus whereby the specialty defines itself as nursing and subscribes to the overall purpose, functions and ethical standards of nursing. The clinical practice role may be divided into direct and indirect care. Direct care comprises the assessment, planning, delivery and evaluation of care to the patient, family and/or carer. Indirect care relates to activities that influence and support the provision of direct care.

Direct Care

Clinical Nurse Specialist (Respiratory Care – COPD) will:

  • Provide a specialist nursing service for patients with a diagnosis of COPD who require support and treatment through the continuum of care.
  • Undertake comprehensive patient assessment to include physical, psychological, social and spiritual elements of care using best evidence based practice in respiratory care.
  • Use the outcomes of patient assessment to develop and implement plans of care/case management in conjunction with the multi-disciplinary team (MDT) and the patient, family and/or carer as appropriate.
  • Monitor and evaluate the patient’s response to treatment and amend the plan of care accordingly in conjunction with the MDT and patient, family and/or carer as appropriate.
  • Make alterations in the management of patient’s condition in collaboration with the MDT and the patient in line with agreed pathways and policies, procedures, protocols and guidelines (PPPG ‘ s).
  • Accept appropriate referrals from MDT colleagues.
  • Co-ordinate investigations, treatment therapies and patient follow-up.
  • Communicate with patients, family and /or carer as appropriate, to assess patient’s needs and provide relevant support, information, education, advice and counselling as required.
  • Where appropriate work collaboratively with MDT colleagues across Primary and Secondary Care to provide a seamless service delivery to the patient, family and/or carer as appropriate.
  • Participate in medication reconciliation taking cognisance of poly-pharmacy and support medical and pharmacy staff with medication reviews and medication management.
  • Identify and promote specific symptom management strategies as well as the identification of triggers which may cause exacerbation of symptoms. Provide patients with appropriate self-management strategies and escalation pathways.
  • Manage nurse led COPD clinics with MDT
  • Identify health promotion priorities for the patient, family and/or carer and support patient self-care in line with best evidence. This will include the provision of educational and health promotion material which is comprehensive, easy to understand and meets patient’s needs.
  • Provide weekend and on-call service where it is a requirement of the post.

Indirect Care

Clinical Nurse Specialist (Respiratory Care – COPD) will:

  • Identify and agree appropriate referral pathways for patients with
  • Participate in case review with MDT colleagues.
  • Use a case management approach to patients with complex needs in collaboration with MDT in both Primary and Secondary Care as appropriate.
  • Take a proactive role in the formulation and provision of evidence based PPPGs relating to COPD
  • Take a lead role in ensuring the service for patients with COPD is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012).

Patient/Client Advocate

Clinical Nurse Specialist (Respiratory Care – COPD) will:

  • Communicate, negotiate and represent patient’s family and/or carer values and decisions in relation to their condition in collaboration with MDT colleagues in both Primary and Secondary Care as appropriate.
  • Develop and support the concept of advocacy, particularly in relation to patient participation in decision making, thereby enabling informed choice of treatment options.
  • Respect and maintain the privacy, dignity and confidentiality of the patient, family and/or carer.
  • Establish, maintain and improve procedures for collaboration and cooperation between Acute Services, Primary Care and Voluntary Organisations as appropriate.
  • Proactively challenge any interaction which fails to deliver a quality service to patients.

Education & Training:

Clinical Nurse Specialist (Respiratory Care – COPD) will:

  • Maintain clinical competence in patient management within respiratory nursing, keeping up-to-date with relevant research to ensure the implementation of evidence based practice.
  • Provide the patient, family and/or carer with appropriate information and other supportive interventions to increase their knowledge, skill and confidence in managing their COPD.
  • Contribute to the design, development and implementation of education programmes and resources for the patient, family and/or carer in relation to COPD thus empowering them to self-manage their condition.
  • Provide mentorship and preceptorship for nursing colleagues as appropriate.
  • Participate in training programmes for nursing, MDT colleagues and key stakeholders as appropriate.
  • Create exchange of learning opportunities within the MDT in relation to evidence based respiratory care delivery through journal clubs, conferences, etc.
  • Develop and maintain links with Regional Centres for Nursing & Midwifery Education (RCNMEs), the Nursing and Midwifery Planning and Development Units (NMPDUs) and relevant third level Higher Education Institutes (HEIs) in the design, development and delivery of educational programmes in COPD
  • Be responsible for addressing their continuing professional development needs.

Audit & Research:

Clinical Nurse Specialist (Respiratory Care – COPD) will:

  • Establish and maintain a register of patients with COPD within Clinical Nurse Specialist (Respiratory Care) Caseload.
  • Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPIs) as directed and advised by the DoN.
  • Identify, initiate and conduct nursing and MDT audit and research projects relevant to the area of practice.
  • Identify, critically analyse, disseminate and integrate best evidence relating to respiratory care into practice.
  • Contribute to nursing research on all aspects of respiratory
  • Use the outcomes of audit to improve service provision.
  • Contribute to service planning and budgetary processes through use of audit data and specialist knowledge.
  • Monitor, access, utilise and disseminate current relevant research to advise and ensure the provision of informed evidence based practice.

Audit expected outcomes including:

  • Collate data (e.g. number of assessments, discharges, re-admits, home visits, number of COPD reviews within 2 weeks of ESD, number of re-exacerbations, number of patients who failed discharge to EDS, number of COPD referrals etc. Also data relating to agreed national KPIs: e.g. Number of COPD discharges reduced by 20%, mean average length of stay for all COPD discharges decrease by 1 % etc. agreed KPIs/clinical targets) which will provide evidence of the effectiveness of Clinical Nurse Specialist (Respiratory Care) interventions undertaken 3 or 4 – Refer to the National Council for the Professional Development of Nursing and Midwifery final report – Evaluation of Clinical Nurse and Midwife Specialist and Advanced Nurse and Midwife Practitioner roles in Ireland (SCAPE Report, 2010) and refer to the National KPIs associated with the speciality. They should have a clinical nursing focus as well as a breakdown of activity – patients seen and treated.
  • Evaluate audit results and research findings to identify areas for quality improvement in collaboration with nursing management and MDT colleagues (Primary and Secondary Care).


Clinical Nurse Specialist (Respiratory Care – COPD) will:

  • Provide leadership in clinical practice and act as a resource and role model for COPD care
  • Generate and contribute to the development of clinical standards and guidelines and support implementation.
  • Use specialist knowledge to support and enhance generalist nursing practice.
  • Develop collaborative working relationships with local respiratory Clinical Nurse Specialists/Registered Advanced Nurse Practitioner/MDT colleagues as appropriate, developing person centred care pathways to promote the integrated model of care delivery.
  • With the support of the Director of Nursing, attend integrated care planning meetings as required.
  • Where appropriate develop and maintain relationships with specialist services in voluntary organisations which support patients in the community.
  • Liaise with other health service providers in the development and on-going delivery of the National Clinical Programme model of care.
  • Network with other Respiratory Clinical Nurse Specialists and related professional associations.

Health & Safety:

These duties must be performed in accordance with local organisational and the HSE health and safety polices. In carrying out these duties the employee must ensure that effective safety procedures are in place to comply with the Health, Safety and Welfare at Work Act (2005). Staff must carry out their duties in a safe and responsible manner in line with the local policy documents and as set out in the local safety statement, which must be read and understood.

Quality, Risk and Safety Responsibilities

It is the responsibility of all staff to:

  • Participate and cooperate with legislative and regulatory requirements with regard to quality, risk and safety.
  • Participate and cooperate with local quality, risk and safety initiatives as required.
  • Participate and cooperate with internal and external evaluations of the organisation’s structures, services and processes as required, including but not limited to, The National Hygiene Audit, National Decontamination Audit, Health and Safety Audits and other audits specified by the HSE or other regulatory authorities.
  • Initiate, support and implement quality improvement initiatives in their area which are in keeping with local organisational quality, risk and safety requirements.
  • Contribute to the development of PPPGs and safe professional practice and adhere to relevant legislation, regulations and standards.
  • Comply with Health Service Executive (HSE) Complaints Policy.
  • Ensure completion of incident/near miss forms and clinical risk reporting.
  • Adhere to department policies in relation to the care and safety of any equipment supplied and used to carry out the responsibilities of the role of Clinical Nurse Specialist in Respiratory care.

Specific Responsibility for Best Practice in Hygiene

Hygiene is defined as: “The practice that serves to keep people and environments clean and prevent infection. It involves the study of preserving ones health, preventing the spread of disease, and recognising, evaluating and controlling health hazards. In the healthcare setting it incorporates the following key areas: environment and facilities, hand hygiene, catering, management of laundry, waste and sharps, and equipment” (HIQA, 2008; P2). It is the responsibility of all staff to ensure compliance with local organisational hygiene standards, guidelines and practices.


Clinical Nurse Specialist (Respiratory Care – COPD) will:

  • Provide an efficient, effective and high quality service, respecting the needs of each patient, family and/or carer.
  • Effectively manage time and caseload in order to meet changing and developing service needs.
  • Continually monitor the service to ensure it reflects current needs.
  • Implement and manage identified changes.
  • Ensure that confidentiality in relation to patient records is maintained.
  • Represent the specialist service at local, national and international fora as required.
  • Maintain accurate and contemporaneous records and data on all matters pertaining to the planning, management, delivery and evaluation of care and ensure that this service is in line with HSE requirements.
  • Contribute to the service planning process as appropriate and as directed by the
  • Have a working knowledge of the Health Information and Quality Authority (HIQA) Standards as they apply to the role for example, Standards for Healthcare, National Standards for the Prevention and Control of Healthcare Associated Infections, Hygiene Standards etc and comply with associated HSE protocols for implementing and maintaining these standards as appropriate to the role.
  • To support, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.

The above Job Specification is not intended to be a comprehensive list of all duties involved and consequently, the post holder may be required to perform other duties as appropriate to the post which may be assigned to him/her from time to time and to contribute to the development of the post while in office.

Essential Criteria

Candidates must have at the latest date of application:

  1. Professional Qualifications, Experience, etc.


  1. Be a registered nurse/midwife on the active Register of Nurses and Midwives held by An Bord Altranais agus Cnáimhseachais na hÈireann (Nursing and Midwifery Board of Ireland) or be eligible to be so registered.


  1. Be registered in the General Division of the register of Nurses and Midwives


  • Have successfully completed a post registration programme of study, as certified by the education provider, which verifies that the applicant has achieved a Quality and Qualifications Ireland (QQI), National Framework of Qualifications (NFQ) major academic Level 8 award, or higher relevant to the specialist area of respiratory care prior to application.


Can provide written evidence from higher education institute that they have achieved the number of ECTS credits equivalent to a Level 8 award or higher standard, relevant to the specialist area of respiratory care prior to application.


  1. Have a minimum of 5 years post registration full time experience (or an aggregate of 5 years full time experience) in the general division of the register


  1. Have a minimum of 2 years’ full time experience (or an aggregate of 2 years full time experience) in the specialist area of respiratory care .


  1. Demonstrate evidence of continuing professional development.

(b) Have the ability to practice safely and effectively fulfilling his/her professional responsibility within his/her scope of practice.

  1. Annual registration

(i) Practitioners must maintain live annual registration on the appropriate/relevant Division of the register of Nurses and Midwives maintained by the Nursing and Midwifery Board of Ireland (Bord Altranais agus Cnáimhseachais na hÈireann) for the role.


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

  1. Age

Age restriction shall only apply to a candidate where s/he is not classified as a new entrant (within the meaning of the Public Service Superannuation (Miscellaneous Provisions) Act, 2004). A candidate who is not classified as a new entrant must be under 65 years of age on the first day of the month in which the latest date for receiving completed application forms for the office occurs.

  1. 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.

  1. Character

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

Post Specific Requirements:

  • Demonstrate depth and breadth of nursing experience in the specialist area of respiratory care as relevant to the role.
  • Have undertaken or agree to undertake, within an agreed timeframe, the Nurse Prescribing of Medicinal Products Certificate.
  • Have undertaken or agree to undertake, within an agreed timeframe, the Nurse Prescribing of Ionising Radiation Certificate.
  • Access to appropriate transport is necessary to fulfil the role. A significant portion of the appointees work will be carried out “off site”. This means that the appointee will travel to patient’s home/ place of residence in Co. Wexford, to perform duties related to the role.

Skills & Competencies

Professional Knowledge

Clinical Nurse Specialist (Respiratory Care – COPD ) will:

  • Practice in accordance with relevant legislation and with regard to The Scope of Nursing & Midwifery Practice Framework (Nursing and Midwifery Board of Ireland, 2015) and the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (Nursing and Midwifery Board of Ireland, 2014).
  • Maintain a high standard of professional behaviour and be professionally accountable for actions/omissions. Take measures to develop and maintain the competences required for professional practice.
  • Adhere to the Nursing & Midwifery values of Care, Compassion and Commitment (DoH, 2016).
  • Adhere to national, regional and local HSE PPPGs.
  • Adhere to relevant legislation and regulation.
  • Adhere to appropriate lines of authority within the nurse management structure.

Clinical Nurse Specialist (Respiratory Care – COPD) will demonstrate:

  • In-depth knowledge of the role of Clinical Nurse Specialist (Respiratory -COPD Care).
  • In-depth knowledge of the pathophysiology of the respiratory system.
  • The ability to undertake a comprehensive assessment of the patient with respiratory conditions, including taking an accurate history of their overall condition and presenting problem.
  • The ability to employ appropriate diagnostic interventions including (chest auscultation, basic ECG and chest X Ray interpretation, performance of spirometry, venous and arterial blood sampling and interpretation) to support clinical decision making and the patients’ self- management planning .
  • The ability to formulate a plan of care based on findings and evidence based standards of care and practice guidelines.
  • The ability to follow up and evaluate a plan of care.
  • Knowledge of health promotion principles/coaching/self-management strategies that will enable people to take greater control over decisions and actions that affect their health and wellbeing.
  • An understanding of the principles of clinical governance and risk management as they apply directly to Clinical Nurse Specialist (Respiratory – COPD Care) role and the wider health service.
  • Evidence of teaching in the clinical area.
  • A working knowledge of audit and research processes.
  • Evidence of computer skills including use of Microsoft Word, Excel, E-mail, PowerPoint.

Communication and Interpersonal Skills

  • Effective communication skills.
  • Ability to build and maintain relationships particularly in the context of MDT working.
  • Ability to present information in a clear and concise manner.
  • Ability to manage groups through the learning process.
  • Ability to provide constructive feedback to encourage future learning.
  • Effective presentation skills.

Organisation and Management Skills:

  • Evidence of effective organisational skills including awareness of appropriate resource management.
  • Ability to attain designated targets, manage deadlines and multiple tasks.
  • Ability to be self-directed, work on own initiative.
  • A willingness to be flexible in response to changing local/organisational requirements.

Building & Maintaining Relationships including Team and Leadership skills

  • Leadership, change management and team management skills including the ability to work with MDT colleagues.

Commitment to providing a quality service:

  • Awareness and respect for the patient’s views in relation to their care.
  • Evidence of providing quality improvement programmes.
  • Evidence of conducting audit.
  • Evidence of motivation by ongoing professional development.

Analysing and Decision Making

  • Effective analytical, problem solving and decision making skills.