Senior Advanced Neonatal Nurse Practitioner

Job Purpose

The postholder is an experienced Advanced Neonatal

Nurse Practitioner (ANNP) and an integrated member of the neonatal

multidisciplinary team.

They will practise with a high degree of

professional and personal autonomy, working independently with an agreed scope

of practice, with clinical supervision from a Consultant Neonatologist, when

required. Care delivery will be evidence-based, underpinned by advanced

clinical skills and sound clinical reasoning.

In addition to advanced clinical practice

• responsibilities, the post holder will lead a designated service portfolio,
• assuming accountability for the development, implementation, monitoring and
• reporting of associated objectives, standards and service improvement
• initiatives across the neonatal service.
• The postholder will work on the middle grade rota,
• holding the neonatal bleep and will work to an agreed job plan.

Key responsibilities

Exercise

independent judgement to assess, investigate, diagnose, plan, implement and

evaluate the care of premature, sick newborns.

Make

judgements involving complex information, using analysis and interpretation to ensure

safe, effective, and family centred care.

Manage and

coordinate care in complex clinical situations when a neonatal consultant is

not immediately available, escalating appropriately when required.

Act as an

independent non-medical prescriber in line with NMC and professional standards.

Provide

supervision, teaching, and educational support to members of the neonatal team

within the clinical environment.

Participate

in relevant research activity to inform and improve clinical care.

Key Duties

The post holder will

Provide continuity of care by sharing patient and

family information effectively with the rotating neonatal services team.

Coordinate discharge planning including arranging

• medical follow up for complex and/or long-term neonatal patients.
• Provides day-to-day clinical leadership, guidance,
• and mentorship to junior medical staff and ANNPs under the supervision of the
• Neonatal Consultants.

Support the supervision and professional development

of junior ANNPs in clinical practice, including participation in annual

personal development reviews in collaboration with the neonatal lead consultant.

Undertake clinical review of babies in the Neonatal

Unit (NNU), Delivery Suite, Transitional Care Unit, Postnatal ward, and Meadow

Birth Centre under the supervision of the Neonatal Consultant.

Work collaboratively with the multidisciplinary team

including paediatrics, nursing, midwifery, obstetrics, and allied healthcare

professionals to deliver high quality, family integrated care within neonatal

services.

Practices within neonatal guidelines, exercising advanced

clinical judgement to assess, diagnose, plan, implement and evaluate the care

of premature and sick babies and their families.

Demonstrates expertise in advanced neonatal skills

and knowledge in clinical practice.

Supports the education and skills development of

medical, nursing, and allied health professional staff within the neonatal

service.

Contributes to neonatal service improvement by

engaging in audit, quality improvement and guideline development activities.

Assess the clinical need for admission and transfer,

including stabilisation for transport, of preterm or critically ill neonate.

Maintains Nursing and Midwifery Council (NMC)

• registration and revalidation requirements.
• Works in line with the British Association of
• Perinatal Medicine (BAPM) ANNP Capabilities Framework at Senior/Expert level
• (2021).

Holds non-medical prescribing qualification and practise

within NMC and Royal Pharmaceutical Society standards for prescribers.

Main

• Duties and Responsibilities Clinical
• Practice Areas Neonatal
• Unit and Transitional Care UnitDelivery
• Suite including obstetric theatres.Post
• Natal Ward and Meadow Birth Centre
• Local
• Delegated Clinical Responsibilities
• The
• postholder will:

Undertakes

daily responsibilities on the middle grade rota, including holding the bleep.

Participates

in daily neonatal ward rounds, engaging with parents/caregivers, medical and

nursing team members to provide holistic assessment, formulate differential

diagnosis, plan care and evaluate outcomes.

Provide

timely senior review for junior medical staff, ANNPs, nursing/midwifery staff

as required.

Attend

high-risk deliveries and emergency calls to leading the immediate management of

sick or premature infants in line with local protocols.

Use

advanced knowledge and skills to manage emergency situations within neonatal

clinical areas, escalating to the consultant as appropriate.

Apply

clinical reasoning underpinned by a comprehensive understanding of neonatal physiology

and pathophysiology to plan and manage care episodes from birth to discharge.

Assess

• the health status of through physical examination, medical history, and social assessment
• to establish differential diagnosis.
• Plan,
• implement and evaluate care in accordance with best evidence, national guidance,
• and local protocols.

Provide

senior clinical advice regarding admission, transfer, and discharge from

neonatal services to optimise patient safety, acuity management and cot

capacity.

Request

and interpret clinical investigations, acting on results appropriately within

scope of practice.

Refer

to specialist healthcare professionals and centres, seeking guidance from the neonatal

consultant when required.

Liaise

with medical and transport teams for neonates requiring transfer to other

neonatal or childrens hospitals.

Coordinate

the stabilisation of sick and/or extremely preterm neonates for urgent transfer

to tertiary centres in collaboration with the local consultant and tertiary / transport

teams.

Work

with families, neonatal consultants, the multidisciplinary team, community

outreach services and relevant community organisations to facilitate safe and

effective discharge planning.

Lead

discharge planning for complex and/or long-term neonatal patients in

partnership with the neonatal community outreach service and neonatal

consultants.

Identify

and document the psychosocial needs of each family and baby in collaboration

with the multidisciplinary team.

Promote

family centred care through regular communication with parents about their

babys progress and by encouraging active involvement in care planning and

delivery.

Ensure

all aspects of care and communication are documented accurately and contemporaneously

in both written and electronic records.

Practical

Procedures

The

senior ANNP will perform advanced practical and diagnostic procedures, seeking advice

and support from a consultant and in accordance with local and national

clinical guidelines. Procedures will include, but are not limited to:

Initiation

and ongoing management of neonates receiving mechanical ventilation, including

intubation and insertion of alternative airway devices.

Application

of ventilation strategies appropriate to clinical conditions, adjustment of

ventilation settings and extubation.

Administration

of surfactant via endotracheal tube (ETT) or alternative less invasive

techniques.

Investigation

and management of suspected pneumothorax, including needle aspiration, chest

drain placement and removal.

Initiation

and prescribing of treatment, intravenous fluids, and parenteral nutrition

within local and national guidance.

Advanced

resuscitation including emergency drug administration in line with local neonatal

guidelines.

Blood

sampling via capillary, venous, arterial, and indwelling arterial/venous

catheters.

Insertion

and removal of intravenous cannulas and longlines (percutaneous central venous

lines).

Insertion

and removal of peripheral arterial line, umbilical venous lines, and umbilical arterial

lines.

Lumbar

puncture with interpretation and action of results.

Insertion

and removal of urinary catheters and suprapubic aspiration of the bladder when

clinically indicated.

Clinical

• examination and assessment including examination of the newborn.
• Ordering,
• interpretation and acting upon laboratory tests, radiological imaging, and
• other investigations.

Diagnosis

pathophysiology conditions and undertaking dilution and/or exchange transfusion

as appropriate.

Performance

and interpretation of cranial ultrasound. Electrocardiogram (ECG) and cerebral

function monitoring (CFM) recording and interpretation.

Leadership/Management

• The
• senior ANNP fulfils BAPM (2021) Leadership and Management Capabilities
• Framework while working on the middle grade rota providing clinical leadership under
• the supervision of the Neonatal Consultants.