Clinical Nurse Specialist, Dementia, Cork University Hospital

Details of Service Cork University Hospital (CUH) has approximately 800 beds and this will increase further to 1,000 beds on completion of the transfer of additional services to the CUH campus.

CUH currently employs approximately 4,571 (WTE) staff of multiple professions and is the primary teaching hospital for the Faculty of Health and Science in University College Cork (UCC).

UCC is the Academic partner of the South / South West Hospital Group.

CUH has very strong relationships with each of the six schools within the Science Faculty of UCC and this is a key area for future development to maximise the opportunities for both the service and academia.

CUH is a recommended Major Trauma Centre for the Republic of Ireland due to the wide range of specialties delivered by the hospital – including Neurosciences, Cardiac Services, Orthopaedics, General Surgery, Renal, Internal Medicine, Vascular, Ophthalmology, Urology, Plastic Surgery, Maxillary-Facial, Paediatrics, Intensive Care, Oncology, Haematology, Obstetrics, Gynaecology, Neonatology and Emergency Medicine.

CUH is the tertiary referral centre for the HSE Southern area, and the supra regional area of Limerick, Clare, Tipperary, Waterford and Kilkenny.

CUH therefore acts as a regional centre for secondary and tertiary care for the catchment population of approx.

550,000 served by the HSE Southern area and a supra-regional centre for a total a population of 1.2 million.

Six Health Regions have been established within the HSE, on the basis of the geographical boundaries agreed by the Government in July 2019 and they will be operational from 2024.

Each Health Region will be tasked with population specific planning resourcing and delivery of health and social care services for the needs of its unique population.

This will result in improved accountability and governance in terms of finance and performance, while also bringing decision-making closer to the frontline.

Health Regions will enable and empower staff to provide services that are :

• Integrated, locally planned and delivered
• Easier to access and navigate
• Available closer to home

Health Regions are geographically-based units with clearly defined populations.

They align community and hospital services within specific areas.

The HSE will retain a strong but leaner central organisation, with more service provision developed at a local level.

The HSE South West health region will manage and deliver all public health and social care services in Cork and Kerry.

HSE South West includes all hospital and community healthcare services in the region.

This includes :

The Department of Population and Public Health is also now aligned with this health region

Services in the South West health region : HSE Services working within this region include :

South / South West Hospital Group and Cork Kerry Community Healthcare will become part of HSE South West health region from 3rd March 2025.

Dementia Strategy The Irish National Dementia Strategy (2014) seeks to enable people with dementia to maintain their identity, resilience and dignity and by recognising that they remain valued, independent citizens who, along with their carers, have the right to be fully included as active citizens in society.

Dementia is a common health condition in the older population with a higher prevalence in older people living with frailty.

Its management is complicated as it is a progressive condition with symptoms having a physical, behavioural, emotional and psychological impact.

It is often experienced alongside other co-morbidities.

Although dementia is not a normal part of the ageing process, age is the main risk factor.

Therefore, alongside population ageing, the number of people living with the condition is expected to increase.

If current trends continue this will mean a rise from 48,000 people in 2011 to 94,042 by 2031 (Pierce, Cahill and O'Shea, 2014).

A key objective of the National Dementia Strategy is that people with dementia should be facilitated to remain living in their own homes for as long as possible, supported by the wider community along with primary, secondary and community care services.

The success of specialist nurses in other fields suggests an opportunity for specialists in dementia care to support their nursing colleagues and others in delivering high quality and safe care (RCN, 2013)[i] Nurses currently lack the specialist knowledge and skills required (RCN, 2013) to meet the high level of complex care needs of those living with dementia.

In addition, the financial cost of dementia is high.

One of the reasons for this is the high rates of hospitalisation of people with dementia.

For example, it is estimated that up to 25% of older patients have dementia, with only one third of this group having a previous formal diagnosis (Timmons et al, 2015).

People with dementia and other neurological conditions, once admitted to hospital, often have poorer care outcomes, such as longer lengths of stay, increased use of antipsychotic medication, loss of independence, increased risk of falls and hospital acquired infections and an increase in discharges to long stay settings.

Part of the solution to address this problem is to avoid unnecessary admissions to hospital, as many admissions are for conditions that could be treated in the community with early intervention or the provision of alternative services (Alzheimer's Society 2009).

When admission to acute care is necessary, people with dementia should be treated and supported in an expeditious manner, using the principles of person-centred dementia care.

Early identification of dementia and person-centred care planning is essential in the management of such patients in the acute setting, with early supported discharge planning back into the community.

Screening for cognitive impairment provides an opportunity to diagnose or rule out dementia when a diagnosis has not been formalised in the community or outpatient setting.

Recognising dementia is important as patients with cognitive impairment are more likely to represent to the Emergency Department (ED) after discharge and are in greater need of enhanced supports both as inpatients and after discharge to the community setting.

The CNS (Dementia) will provide nursing expertise, education and management service to patients with dementia, their families and carers and nursing staff, in the promotion of a patient-centred approach to patients and their families.

Purpose of the Post There is strong evidence that the position of a CNS (Dementia), with the application of specialty focused knowledge and skills, would have a positive impact on the outcomes for patients with dementia.

The benefits of this type of intervention are reduced length of stay, better recovery, more successful rehabilitation and less transfer to institutional care (RCN, 2013).

The post holder will be required to work as a key member of the relevant specialist team, in many cases this will be the geriatric team but not always.

They will provide comprehensive physical, psychological and emotional assessment and support to people with dementia and their families / carers throughout their disease trajectory.

The appointment of the CNS (Dementia) is an essential element in the provision of effective, high quality, seamless integrated care for people with dementia.

The appointment of the CNS (Dementia) is an essential element in the provision of effective high quality care for people with dementia.

The CNS (Dementia) will develop a person centred approach to care which will aim to improve the quality of life for patients with dementia.

Informal Enquiries We welcome enquiries about the role.

Contact Nora Twomey –Assistant Director of Nursing,

Contact Ann- Marie O'Keeffe- People Resourcing,