ࡱ> jlghiq` objbjqPqP s::f$@P8@]ZhX,,,YYYYYYY$[h-^ZZ,,hZ,,YY/7, X!ܷ#Z2PQ$-Z0]Z2^<^7^7>,$*ZZ6X]Z@@@$hdnR@@@dn@@@Z MACMILLAN SPECIALIST PALLIATIVE CARE NURSE (full outline) JOB PROFILE Post:- Macmillan Community Clinical Nurse Specialist Palliative Care (Band 6) Accountable to:- Director of Clinical Services Responsible to:- Community Services Manager Job Summary To work within the policy framework of the hospice in its provision of specialist palliative and supportive care by supporting the team in ensuring that the aims and objectives are met. In collaboration with designated cluster teams provide Specialist Palliative and End of Life Care for patients within Salford PCT. Work towards 7 day/24 hour working as recommended by NICE Supportive & Palliative Care Guidance. Assess, plan, implement and evaluate, programmes of evidenced-based nursing care. (KSF Dimension. HWB2 Level 3) Provide expert advice and clinical practice. (KSF Dimension HWB5 Level 4) Participate in the education and development of other staff members. (KSF Dimension C2 Level 3) Work collaboratively and co-operatively with Community Services Manager and clinical colleagues to develop services and quality of care delivered. (KSF Dimension C1 & C5 Levels 3) Participate in the development of clinical services within the specialist field inline with national guidance which includes the NHS Cancer Plan and NICE Supportive and Palliative Care Guidance, Darzi Report and End of Life Care Strategy. (KSF Dimension C4 Level 3) Work towards the compliance and maintenance of the (2004) Cancer Measures and National Cancer Targets. (KSF Dimension C4 Level 3) Although this is a comprehensive job description, you may be required to undertake other duties assigned by your manager. * indicates final gateway objectives Core/ SpecificNo.DimensionLevelIndicatorsJob Description and Areas of ApplicationCoreC1Communication3The worker: identifies the range of people likely to be involved in the communication, any potential communication differences and relevant contextual factors communicates with people in a form and manner that: Is consistent with their level of understanding, culture, background and preferred ways of communicating Is appropriate to the purpose of the communication and the context in which it is taking place Encourages the effective participation of all involved. recognises and reflects on barriers to effective communication and modifies communication in response provides feedback to other workers on their communication at appropriate times keeps accurate and complete records of activities and communications consistent with legislation, policies and procedures communicates in a manner that is consistent with relevant legislation, policies and procedures. To foster good working relationships with hospital and primary care and social care colleagues. Collaborate with other members of the multi disciplinary team in the delivery of high standards of effective healthcare within best practice guidelines. To provide specialist palliative care advice to effectively communicate with a wide range of people across health and social care. To encourage others to seek advice and solutions to problems. Communication should at all times be in a manner consistent with individuals level of understanding, culture and background, to explore complex issues and make complex decisions. To be empathetic and reassuring when communicating highly sensitive condition related information and advice to patients, carers, relatives and colleagues. To agree the arrangements for communication with the patient/family/carer and clinical team and document these in accordance with Hospice policy and the patients right to confidentiality. To ensure effective handover of patient information from weekend working to relevant health care professional. To competently receive sensitive information concerning patients medical condition. To use a range of skills to adapt the delivery of information through changing the environment, methods of communication, or delivery of content using persuasive, reassuring skills as required, e.g. breaking bad news/special needs/dealing with anxious relatives. To identify and manage challenging behaviours.Core C2 Personal & People 3The worker: reflects on and evaluates how well s/he is applying knowledge and skills to meet current and emerging work demands and the requirements of the KSF outline for his/her post. identifies own development needs and sets own personal development objectives in discussion with his/her reviewer takes responsibility for own personal development and maintains own personal development portfolio makes effective use of learning opportunities within and outside the workplace, evaluating their effectiveness and feeding back relevant information enables others to develop and apply their knowledge and skills in practice contributes to the development of others in a manner that is consistent with legislation, policies and procedures contributes to developing the workplace as a learning environment.Maintain own professional development to facilitate the provision of evidence-based practice. Actively participate in the Hospice Individual Performance Review process to identify own learning needs and take necessary steps in order to reach personal/professional objectives and meet the demands of the role. Utilise staff support systems, e.g. clinical supervision. Practice in accordance with the Code of Conduct relevant to your professional organisation and ensure that your professional registration with NMC is maintained. To inspire others and encourage them to seek advice and solutions to palliative care problems. Support the development of a learning organisation, alerting manager to resource issues which may affect this. CoreC3 C3 (cont) Health, Safety & Security2The worker: identifies and assesses the potential risks involved in work activities and processes for self and others identifies how best to manage the risks undertakes work activities consistent with: legislation, policies and procedures the assessment and management of risk takes the appropriate action to manage an emergency, summoning assistance immediately when this is necessary reports actual or potential problems that may put health, safety and security at risk and suggests how they might be addressed supports others in maintaining health, safety and security.Work in accordance with Hospice information, policies and procedures, e.g. lone worker policy. Attend organisational mandatory training as required by your manager relevant to your role. Actively engage in the organisational incident reporting. Ensure incident reporting is expedited promptly and appropriate action plans completed. In collaboration with the Infection Control Nurse, promote an environment that supports infection prevention and control policies and procedures. Ensure that staff are conversant with these and practice according to them. To maintain health, safety and security of self and others in own work area. To identify and assess potential risks in work activities and how to manage these risks appropriately including that of challenging behaviour. To work within legislation and Hospice procedures on risk management. To work within Primary Care Trust policies and guidelines. where appropriate CoreC4 C4 (cont.) Service Improvement 3The worker: identifies and evaluates areas for potential service improvement discuses and agrees with others: how services should be improved as a result of suggestions, recommendations and directives how to balance and prioritise competing interests how improvements will be taken forward and implemented constructively undertakes own role in improving services as agreed and to time, supporting others effectively during times of change and working with others to overcome problems and tensions as they arise maintains and sustains direction, policies and strategies until they are firmly embedded in the culture inspiring others with values and a vision of the future whilst acknowledging traditions and backgrounds enables and encourages others to: understand and appreciate the influences on services and the reasons why improvements are being made offer suggestions, ideas and views for improving services and developing direction, policies and strategies alter their practice in line with agreed improvements share achievements challenge tradition evaluates with others the effectiveness of service improvements and agrees that further action is required to take them forward appraises draft policies and strategies for their effect on users and the public and makes recommendations for improvement Contribute to and participate in organisational service development. To evaluate current service provision and identify how this impacts on generic and specialist roles, the clinical environment, district nursing services, multidisciplinary and interagency working. To identify outcomes of service and offer constructive views on how services should change/develop. Following systematic evaluation in implementing new initiatives thus improving the effectiveness and efficiency of the CSPCT and ensuring the maintenance of high clinical standards. To be aware of organisational strategic direction and future issues pertaining to the provision of specialist palliative and supportive care. To contribute to the development of palliative care protocols, standards and guidelines. To promote patient and public involvement activities in the specialist area, leading to service improvement. To ensure that users of the service are able to give feedback using organisational systems. In agreement with your line manager participate in local, Network wide, regional and national groups related to palliative care.CoreC5 Quality3The worker: acts consistently with legislation, policies, procedures and other quality approaches and promotes the value of quality approaches to others understands own role in the organisation and its scope and identifies how this may develop over time works as an effective and responsible team member and enables others to do so prioritises own workload and organises and carries out own work in a manner that maintains and promotes quality evaluates the quality of own and others work and raises quality issues and related risks with the relevant people takes the appropriate action when there are persistent quality problems Positively and proactively contribute to team working. Prioritise own work load, support others where appropriate enhancing the quality and efficacy of the service. Ensure own clinical practice is evidence-based, effective in clinical outcome and is patient-centred. Ensure compliance with policies, procedures and clinical guidelines for self and others and participate in the development of same. To be aware of, and work in adherence to the national and network standards and requirements of The Healthcare Commission. Continually monitor standards of care and participate in the improvement of care, through benchmarking, audit and research. With your service manager and identified others, contribute to the identification practices relevant to your role that could improve service delivery outcomes through: Audit Research Evaluation Education/training User involvement e.g. patient satisfaction survey. To provide support in the setting and maintenance of optimal standards of palliative care across St Anns Hospice and Salford PCT. To keep up to date and act consistently with quality standards and guidelines across St Anns Hospice, Salford PCT and Greater Manchester and Cheshire Cancer Network. CoreC6 Equality & Diversity3The worker: interprets equality, diversity and rights in accordance with legislation, policies, procedures and relevant standards evaluates the extent to which legislation is applied in the culture and environment of own sphere of activity identifies patterns of discrimination and takes action to overcome discrimination and promote diversity and equality of opportunity enables others to promote equality and diversity and a non-discriminatory culture supports people who need assistance in exercising their rights.Promote peoples equality, diversity and rights. To promote and demonstrate awareness of anti-discriminatory practice in accordance with the organisational policies and current legislation. Demonstrate enhanced knowledge and understanding of organisational objectives related to equality and diversity. Play a key role in providing an environment and service which reflects the diversity of individual needs. Promote a culture which respects and recognises diversity, challenging behaviour which infringes the rights of others.SpecificHWB2 HWB2 (cont.) Assessment & care planning to meet health and wellbeing needs3The worker: plans the assessment of peoples health and wellbeing needs and prepares for it to take place explains clearly to people: own role, responsibilities and accountability the information that is needed from the assessment and who might have access to it the benefits and risks of the assessment process and alternative approaches respects peoples dignity, wishes and beliefs; involves them in shared decision making, and obtains their consent uses assessment methods and processes of reasoning that are based on available evidence are appropriate for the people concerned obtain sufficient information for informed decision making s/he has the knowledge, skills and experience to use effectively are consistent with legislation, policies and procedures considers and interprets all of the information available and makes a justifiable assessment of peoples health and wellbeing, related needs and risks and explains the outcomes to those concerned develops and records care plans that are appropriate to the people concerned and: are consistent with the outcomes of assessing their health and wellbeing needs identify the risks that need to be managed have clear goals involve other practitioners and agencies when this is necessary to meet peoples health and wellbeing needs and risks are consistent with the resources available note peoples wishes and needs that it was not possible to meet monitors the implementation of care plans and makes changes to meet peoples needs. Act as a Keyworker as identified within the (2004) Cancer Measures and in accordance with the CSPCT operational policy. With the support of the MDT utilise specialist knowledge to enable colleagues to develop their competence in using different interventions in palliative and end of life care across a range of diagnostic groups. To support generic and specialist staff in caring for the patient and family, promoting respect for the need of privacy and dignity. To discuss with patients implications of their programme of care, including end of life care utilising end of life tools where appropriate e.g. Preferred Priorities of Care. Assess complex holistic needs of patients, families and carers across a range of diagnostic groups. Develop and review care management plans to meet identified needs utilising Hospice documentation. Act as a resource of specialised knowledge and clinical expertise to promote the delivery of care that is appropriate and optimal, enabling recognition of condition changes. To undertake and evaluate the effectiveness of generic and specialist palliative care interventions which are consistent with evidence-based practice, transferring and applying that knowledge and skills to meet the patients needs. To analyse and rigorously review all aspects of the patients management plan interpreting information provided and using knowledge and judgement to provide specialist advice to recommend a new course of action where necessary. SpecificHWB4 Enablement to address health and wellbeing needs4The worker: respects peoples dignity, wishes and beliefs; involves them in shared decision making, and obtains their consent identifies with the people concerned: Goals for the specific activities to be undertaken within the context of their overall care plan and their complex health and wellbeing needs the form different activities should take the involvement of other people and/or agencies relevant evidence-based practice risks enables people to realise and maintain their potential in a manner that is consistent with: evidence-based practice legislation, policies and procedures the management of risk applying own skills, knowledge and experience and using considered judgement to support peoples different needs takes the appropriate action to address any issues or risks evaluates the effectiveness of work with people and makes any necessary modifications provides effective feedback to inform the overall care plan makes complete records of the work undertaken, peoples health and wellbeing needs and related risks.With patient/carer identify their specific goals in relation to specialist palliative and supportive care to promote and maintain independence wherever possible. Refer to other specialists when needs are beyond your professional scope, or longer term support is required. Ensure care within the CSPCT is consistent with principles of the Mental Capacity Act Code of Practice (2007). Be conversant with processes that are in place to support patients and carers to make informed choices about their care and ensure they are utilised effectively. Ensure necessary steps are taken to enable patients to make their own decisions about treatment and care in order to maximise their potential. Act as an advocate to ensure that the patients perspective is heard within the Hospice multi disciplinary team and Gold Standards Framework meetings with General Practitioners and/or District Nurses. To provide support, information and advice to patients, families, colleagues and other healthcare professional agencies including the service provision of specialist palliative care at weekends. SpecificHWB5 HWB5 (cont.) Provision of care to meet health and wellbeing needs4The worker: respects peoples dignity, wishes and beliefs; involves them in shared decision making; and obtains their consent identifies with the people concerned: goals for the specific activities to be undertaken within the context of their overall care plan and their complex health and wellbeing needs the nature of the different aspects of care needed to meet their complex needs the involvement of other people and/or agencies relevant evidence-based practice and/or clinical guidelines how to manage possible risks undertakes care in a manner that is consistent with: evidence-based practice and/or clinical guidelines multi disciplinary team working his/her own knowledge, skills and experience legislation, policies and procedures applying own skills, knowledge and experience and using considered judgement to meet peoples different care needs Takes the appropriate action to address any issues or risks evaluates the effectiveness of care and makes any necessary modifications provides effective feedback to inform the overall care plan makes complete records of the work undertaken, peoples health and wellbeing needs and related risks. Support the delivery of specialist palliative care through assessment of complex needs. With patient/carer identify their specific goals in relation to specialist palliative and supportive care needs that may require input from health and social care teams. Refer to other specialists when needs are beyond your own professional scope, or longer term support is required. Specific HWB7 HWB7 (cont.)Interventions and Treatments4The worker: respects individuals dignity, wishes and beliefs; involves them in shared decision making; and obtains their consent identifies with the people concerned: goals for the specific interventions/treatments to be undertaken within the context of the overall treatment plan and the individuals physiological and/or psychological functioning the nature of the different interventions/treatments given the complexity of the issues and/or the seriousness of the illness relevant care pathways the involvement of other people and/or agencies relevant evidence-based practice and/or clinical guidelines/theories and models any specific precautions or contraindications to the proposed interventions/treatment and takes the appropriate action how to manage potential risks undertakes interventions/treatments in a manner that is consistent with: evidence-based practice and/or clinical guidelines/theories and models multidisciplinary team working his/her own knowledge, skills and experience legislation, policies and procedures applying own skills, knowledge and experience and using considered judgement to meet individuals complex needs takes the appropriate action to address any issues or risks evaluates the effectiveness of the interventions/treatments and makes any necessary modifications provides effective feedback to inform the overall treatment plan makes complete records of the interventions/treatments undertaken, peoples health and wellbeing, needs and related risks responds to, records and reports any adverse events or incidents relating to the intervention/treatment with an appropriate degree of urgency. Become proficient in non-medical prescribing, engaging in assessment via clinical history, clinical examinations and diagnostics. * Prescribe medications in line with Salford PCT, and Hospice policies, utilising palliative care guidelines and algorithms. * Monitor effectiveness of treatment and act in accordance with findings. Ensure robust communication systems are in place to advise GPs of Macmillan involvement in prescribing. * Provide specialist, expert clinical knowledge to clinical colleagues, patients and carers/relatives. * indicates final gateway objectivesSpecific G1 Learning & Development 2The worker: agrees with the team the purpose, aims and content of the learning and development and own role in the process prepares thoroughly for own role, addressing any issues in advance supports learning: recognising individuals particular needs, interests and styles using the agreed methods and approaches in a manner that stimulates individuals interest, promotes development and encourages their involvement by developing an environment that supports learning consistent with legislation, policies and procedures gains feedback from learners and relevant others on the effectiveness of learning and development and their ideas for how it can be improved reflects on and evaluates the effectiveness of learning and development using feedback from learners and others discusses own evaluation with the team and agrees how learning and development might be improved in the future. Actively participate in student placements and staff training within the organisation. Contribute to the provision of an effective learning environment for students of all disciplines on clinical placements. In consultation with the line manager to contribute to the internal/external hospice education and conference programmes. To contribute to the provision of end of life care education and training programmes. (Gold Standards Framework, Liverpool Integrated Care Pathway, Preferred Priorities for Care and Advanced Care Planning).  Macmillan Specialist Palliative Care Nurse Level for PostLevel of CompetenceGap?1 Communication123412342 Personal and people development123412343 Health, safety and security123412344 Service improvement123412345 Quality123412346 Equality, diversity and rights12341234HWB2 Assessment and care planning to meet health and wellbeing needs12341234HWB4 Enablement to address health and wellbeing needs12341234HWB5 Provision of care to meet health and wellbeing needs12341234HWB7 Interventions and treatments12341234G1 Learning and development12341234 Person Specification Post: Macmillan Community Palliative Care Clinical Nurse Specialist Band 6 Department: Community Services Responsible to: Community Services Manager Accountable to: Director of Clinical Services Essential DesirableIdentified ByQualification/Practice1st level registration. Evidence of recent study. Evidence of personal development. Diploma of Nursing/Health profession. Recordable Oncology/Palliative qualification. 2 years experience at Band 5 or above.1st level degree Teaching qualificationApplication form InterviewIntellectual SkillsDemonstrates ability to set and establish priorities. Excellent communication skills with the ability to work across. a range of services. Ability to take on board new concepts. Able to problem solve. Strategic awareness.Application form InterviewSpecialist Skills AptitudesDemonstrate ability to work autonomously and as part of a team. Knowledge and skills to evaluate research and ensure evidence based practice. Awareness of issues relating to clinical governance. Basic IT skills. Ability to establish good working relationships to promote best practice. Able to take responsibility for caseload of patients. Ability to manage and participate in change at clinical level. Demonstrate experience and understanding of current issues in palliative care, Oncology/Palliative Care Patients. Demonstrate comprehensive understanding of community nursing issues. Ability to manage self and meet deadlines.Experience in auditApplication form Interview PresentationTeaching and Educational Activities Demonstrate ability to teach multiprofessional team. Good presentation skills with teaching ability. Aware of self responsibility and own professional development.Personal AttributesSelf awareness of own personal development needs and a commitment to undertake relevant educational activity. Friendly and caring manner. Car driver/owner.InterviewPhysicalProfessional. Good appearance. No health problems which would interfere with role. Excellent attendance record. Application form Interview     PAGE  VF DATE \* MERGEFORMAT 01/10/2008  FILENAME \p \* MERGEFORMAT C:\Documents and Settings\hgveemx\Desktop\KSF Mac Bnd 6 Outline 08 07 08 (2).docPage  PAGE 6 of  NUMPAGES 16  (*;<>?KLV`y L   r s t y  ) - . s Ų}w}q}k}q}q}q}} hpCJ h(0CJ h}CJ hCJ hLCJ hgCJ hWCJ hcwCJhE5>*CJ hL5CJ hcw5CJ hE5CJhWh)VhLhE hECJhE5CJaJh(5CJaJh5CJaJhg5>*CJaJh{5>*CJaJ*<=>?KL K L ! l m gd}gdcwgdEgdEgdE$a$gdu7no FfJ $Ifgd $Ifgd/ $$Ifa$gdgIZ $$Ifa$gd $h^ha$gd$a$gdgd}s  %&'(345}ſvnfhNCJaJhhw?CJaJhdh^6CJaJhdhd6CJaJhu7h^CJaJh^CJaJh^5CJaJhu7h^5CJaJhhu7CJ h~[CJ hCJhh5CJ h5CJ h3MCJh}h}CJh}hLCJ h(0CJ hCJ&&(4da* & F $If^`gd/  & F $If^gd/ H$If^Hgd/ $$Ifa$gdgIZ $$Ifa$gdu7}cdz>T`ab)*+  JnܤyqqfhXLh>YCJaJhCJaJhTCJaJh%vCJaJh3MCJaJhpCJaJhu7hhw?CJaJhCJaJhuX]CJaJhh>*CJaJhCJaJhhi>*CJaJhiCJaJhhw?CJaJhdCJaJhhdI>*CJaJhdICJaJ( JUN & F P<$If^`Pgdp H$If^Hgd/ npUNOfizVWXbx+,-   YҺڮҞzzzqhzhX >*CJaJhhw?>*CJaJhcwhcw>*CJaJhX hcw>*CJaJhcwhSZ>*CJaJhhw?CJaJhHCJaJhHhH6CJaJhcwCJaJhTCJaJhby?CJaJh^CJaJhu7h^CJaJhXLh>YCJaJh(0CJaJhCJaJ(NOTUVW:.... $$Ifa$gdu7kdc$$Iflֈ$ ,$8X8d t044 laWXYZ[\]^_`abcfghijklmnopqrs$<$Ifa$gd $$Ifa$gdu7stuvwxyz{ $$Ifa$gdgIZ$<$Ifa$gdX $<$Ifa$gdW, ~01H<$If^Hgd>Y & F <$If^gd%v & F$Ifgd/ $Ifgd/ $$Ifa$gdu7Y~WϿϷϤϬyqi]TLh%CJaJhj6CJaJhX hk6CJaJhX CJaJhjKCJaJhCJaJhby?CJaJh^CJaJhu7h^CJaJh2hCJaJhgCJaJhXLh>YCJaJh>YCJaJhWSCJaJhFnCJaJh%vCJaJhcwhcw>*CJaJhcwCJaJhhw?CJaJhX hcw>*CJaJ:. $<$Ifa$gd $$Ifa$gdu7kd$$Iflֈ$ ,$8X8d t044 la <$Ifgd/ $$Ifa$gdu7 $$Ifa$gdgIZ <$IfgdK$<$Ifa$gdWc !}!!"k"J##&$l$$$ <$Ifgd & F <$If^gdp & F 8$If^gd/ & F $Ifgd/ WXc d !!!E!d!"J###%$l$$$$$$$$$$$$ʾwld\dhDCJaJh^CJaJhu7h^CJaJhCJaJhXLB*CJaJphhXLh>YCJaJh>YCJaJh}DCJaJh_yCJaJhlCJaJh._'CJaJh:hX >*CJaJh:>*CJaJhhw?>*CJaJhNnyhNny>*CJaJhNnyCJaJh%CJaJhhw?CJaJ$$$$$8,$<$Ifa$gdgIZ $$Ifa$gdu7kd$$Iflֈ$ ,$8X8d t044 la$$$$$$$$$$$$$$$$$$$$$$$$$<$Ifa$gd1$<$Ifa$gd'$<$Ifa$gd$<$Ifa$gdgIZ$$$%%%%%)%P%Q%j%p%%%%%5&6&7&E&'''2'<'''''Y(Z(#),)s)))ɽഩ࡙എࡃ{s{sgs^sh*>*CJaJh*h*>*CJaJh*CJaJhH0oCJaJhH0ohH0oCJaJhJhJCJaJhCJaJhL2CJaJhJhL2CJaJhJ>*CJaJhL2h^6CJaJhL2hL26CJaJhu7h^CJaJhJCJaJhCJaJh^CJaJh'CJaJ$$$$$$$$$$$%%%%%Q%r%%% & F <$If^`gd/  & F<$Ifgd/ J<$If^Jgd/ $$Ifa$gdu7$<$Ifa$gd'$<$Ifa$gdgIZ%6&'''Z((()#))**d*)++C,, & F <$If^gd_y <$Ifgd/  & F h<$If^gd/  & F<$Ifgd/  & F <$If^`gd/ ))***c*d**(+)++,*---t.u.~...........'/෯ড়xld\P\hOZhtW$>*CJaJhtW$CJaJh><CJaJhlLh^6CJaJhlLhlL6CJaJhCJaJhi0CJaJh^CJaJhu7h^CJaJh2hCJaJhgCJaJhXLh[@CJaJhXLh&FCJaJhXLh>YCJaJhQ,CJaJh_yCJaJhbCJaJh*CJaJhL2CJaJ,*---t. & F <$If^gd_yt.u.z.}.:. $<$Ifa$gdgIZ $$Ifa$gdu7kd$$Iflֈ$ ,$8X8d t044 la}.~...........(///K0011 & F<$Ifgd/ H<$If^Hgd/ $$Ifa$gdu7 <$Ifgdi0$<$Ifa$gd zo$<$Ifa$gdgIZ'/(///////0J0K0}00001111!1"1=1>11222233s4455s5~5555555˻umh^CJaJhu7h^CJaJh2hCJaJh >CJaJhXLh zoCJaJhlCJaJhgCJaJh_yCJaJhPCJaJhCJaJhq9CJaJhpCJaJh>*CJaJhOZhtW$>*CJaJhtW$CJaJhCJaJhRCJaJ)1>11223354;4D4O4b4s44555 H$If^Hgd zo & F $If^gd2h d$If^dgd zo & F $If^gd_y & F $If^gdp5555:. $<$Ifa$gdgIZ $$Ifa$gdu7kd7$$Iflֈ$ ,$8X8d t044 la555555555555j66\777 & F HH<$If^Hgd/  & F<$Ifgd/ H<$If^Hgd/ $$Ifa$gdu7$<$Ifa$gd zo$<$Ifa$gdgIZ55555555516R6i6j6k666\7]77777777888899 ::::!:.:A:ŹհŰşwog_hjKCJaJhi$CJaJh1z<CJaJhXrCJaJhVCJaJh&4CJaJh0(lCJaJh zoCJaJhKCJaJhl>*CJaJh>*CJaJhQhdwl>*CJaJhdwlCJaJhCJaJhCJaJhu7h^CJaJh^CJaJhi0CJaJh'CJaJ%788999 & F <$If^gd0(l99: ::. $<$Ifa$gdgIZ $$Ifa$gdu7kd$$Iflֈ$ ,$8X8d t044 la ::::::::::::::::::: :!:&:.:/:0:$<$Ifa$gdjK$<$Ifa$gdi$$<$Ifa$gdgIZ0:1:2:3:4:5:6:7:8:9:::;:<:=:>:?:@:A:B::::J<$If^Jgd/ $$Ifa$gdu7$<$Ifa$gdgIZ <$Ifgd'$<$Ifa$gdjKA:B::::::::::; ;5;7;;;;;F<G<L<^<<<<<==C=D=X=}=~=>>A>B> ??????ŽwwooohwCJaJhhI>*CJaJhhICJaJhIjh>*CJaJhCJaJhIjCJaJhZCJaJh\CJaJh@,>*CJaJh@,CJaJh\h^6CJaJh\h\6CJaJhu7h^CJaJh4CJaJh^CJaJhi$CJaJ+::;6;;;G<<<<=D=~=B>>>????@U@V@ <$Ifgd4 & F <$If^`gd/  & F<$Ifgd/ ?S@T@U@V@@@YAZA]AxAyA}A~AAABBRBXBBBBBBCCC'C(C:C;CGCNC^ClCwCCDLDDEcEEEEFءȡ؎ȎȎȎ~~~~hm6CJaJhLCJaJhCJaJhXLh/CJaJh/CJaJhXLh zoCJaJh zoB*CJaJphh zoCJaJhlCJaJhJUCJaJhCJaJhRCJaJhVCJaJhi0CJaJhhICJaJ-V@@A)BB;CCLD3EFFH<$If^HgdL & F <$If^gd FF"F'F:. $<$Ifa$gdgIZ $$Ifa$gdu7kd$$Iflֈ$ ,$8X8d t044 laFF'F+F^FiFjFkFFFFuGGGGGGG H HHHGHlHmHnHHHHHHH2I3IhImInIoIIIJJeJŽŽŽŽŽŽʼnʼnʼnymyyyhChk3,>*CJaJhk3,CJaJhCCJaJh9FCJaJhi@:h9F>*CJaJhi@:hi@:>*CJaJhi@:hU >*CJaJhX%CJaJhU CJaJhi@:CJaJhX%h^6CJaJhX%hX%6CJaJh)CJaJh^CJaJhu7h^CJaJ*'F(F)F*F+F\F^FjFFGGGG HHmHHH & F <$If^`gd/  & F<$Ifgd/ J<$If^Jgd/ $$Ifa$gdu7 <$Ifgd zo$<$Ifa$gdgIZHH2InIIJfJKwKKLMMNNH<$If^Hgd=u & F <$If^gd/ <$Ifgd/  & F<$Ifgd/ <$If^gd/  & F <$If^`gd/ eJfJJKKK9KKKhKtKwKfMnMMM7N8NWNNNNNNNNNNNOO#O$O%Oźŧ|th\ThcvCJaJh"ah^6CJaJh"ah"a6CJaJh CJaJh,CJaJh{CJaJh.CJaJh;&CJaJhu7h^CJaJhibCJaJhXLh zoCJaJhXLh=uCJaJhXLh?~ICJaJhgCJaJh?~ICJaJh^CJaJhgCJaJh/CJaJhXCJaJ NNNN:. $<$Ifa$gdgIZ $$Ifa$gdu7kdS$$Iflֈ$ ,$8X8d t044 laNNNNNNNNNNNNNNNNNNNNNNNNNNN$<$Ifa$gd{$<$Ifa$gdgIZNNNNNNNNNNOO$OOOJP & F <$If^`gd/  & F <$Ifgd/ <$Ifgd/ $$Ifa$gdu7$<$Ifa$gd $<$Ifa$gdgIZ$<$Ifa$gd{%OOOOO0PJPKPrPPPPPPQQQ!Q"Q#QVQWQXQQQQQQQQQnRoRRRRRRR1S2SSSSYTTTTTT U U U Uܼܱh;CJaJhibCJaJh2 CJaJh/CJaJh=uCJaJh{h CJaJhbCJaJhcvh9~>*CJaJhcvhcv>*CJaJh9~CJaJhcvh"a>*CJaJhcvCJaJh"aCJaJ5JPPPQ"QWQQQQQoRRR1SSS <$Ifgd/ <$If^gd/  & F <$If^`gd/  & F <$Ifgd/  & F <$If^`gd/ SST U UH<$If^Hgd=u & F <$If^gd/ UUUU:. $<$Ifa$gd $$Ifa$gdkd $$Iflֈ$ ,$8X8d t044 la UUU?U^UjUV5V`XeXBYfY[[[A\C\r\t\x\\\\\\\\\\\] ]r]s]t]]]]^^^ ^!^)^F^{{{hCJaJhV_hCJaJhu7h CJaJ hW5CJhWCJaJhq9CJaJh=uCJaJh{CJaJhhCJaJh>*CJaJhCJaJh 6CJaJhZrzCJaJh CJaJhu7h^CJaJ,UUU U!U"U#U$U%U&U'U(U)U*U+U,U-U.U/U0U1U2U7U?U\U^U $$Ifa$gd$<$Ifa$gd $<$Ifa$gd^UjUUVV:WQWWWHXfXXXYBYgYY<$If^gd/  & F <$If^`gd/  & F<$Ifgd/  & F <$If^`gd/  & F<$Ifgd/ J<$If^Jgd/ YZuZZ0[[[D\\ ]t]]]]H<$If^Hgdq9 & F <$If^gdq9 & F <$If^gd=u <$Ifgd/  & F<$Ifgd/ ]^ ^ ^ ^ ^:.... $$Ifa$gd=3kd $$Iflֈ$ ,$8X8d t044 la ^ ^^^^^^^^^^^^^^^^^ ^!^"^#^$^%^ <$Ifgd=3$<$Ifa$gd?$<$Ifa$gd=3 $$Ifa$gd=3%^&^'^(^)^@^A^B^C^D^E^G^S^^__X___`R`` & F <$Ifgd/  & F <$Ifgd/ J<$If^Jgd/ $$Ifa$gd=3$<$Ifa$gd=3F^G^S^aa c_cccccccccc d d4dEdWdzddddddde%e7e}eeeef%fHfZfwffffƾζwkhqhRb55CJaJhRb5CJaJh %CJaJhHh %5CJaJhHh %5CJaJhHhCJaJhCJaJhh{CJaJhg'`CJaJhgCJaJhlCJaJhdhCJaJhCJaJh)h6CJaJhu7hCJaJ*`Oaaabb cccH<$If^HgdFn & F <$If^gd=3 <$Ifgd/  & F <$Ifgd/ cccc d:22% ^`gd $a$gdkdo $$Iflֈ$ ,$8X8d t044 la d d dd.d3d d$Ifgd~(gd3d4dEd." d$Ifgd~(kd# $$Ifl\@%)x@ @   t(0|)644 lap(EdGdIdKdMdOdQdSdUdVdWdzd|d~dddddddddddddFfFf d$Ifgd~($d$Ifa$gd~(ddddddddddddddddddddddddddFfFf3 d$Ifgd~($d$Ifa$gd~(ddeee%e'e)e+e-e/e1e3e5e6e7e}eeeeeee $$Ifa$gd~( $Ifgd~(FfFfM d$Ifgd~($d$Ifa$gd~(eeeeeeeeeeeeeeeefffffff!f#f$fFf+&Ff}" $Ifgd~( $$Ifa$gd~($f%fHfJfLfNfPfRfTfVfXfYfZfwfyf{f}ffffffffFfK1Ff-$d$Ifa$gd~( d$Ifgd~(Ff)ffffffgg;gjCJOJQJhmHnHu h4CJOJQJhmHnHujhd~CJOJQJUhhd~CJOJQJh=PP1h0:pz= /!7"7#7$n% 21h:p~(/ =!8"n#7$% H$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl4  t<,5X585555dp<kd$$Ifl4ֈ$ ,$8X8d  t<044 lap<$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl t5X585555d$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl t5X585555d$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl t5X585555d$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl t5X585555d$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl t5X585555d$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl t5X585555d$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl t5X585555d$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl t5X585555d$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl t5X585555d$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl t5X585555d$$If!vh5X585555d#vX#v8#v#v#v#vd:Vl t5X585555d$$If!vh5x5@ 5@ 5#vx#v@ #v:Vl  t(|)65x5@ 5ap($$If!v h5x55555555 5 #vx#v #v :Vl  t(fff|)65x5 5 ap(fffkd $$Ifl p@"%)x  t(fff0|)6((((44 lap(fff$$If!v h5x55555555 5 #vx#v #v :Vl  t(fff|)65x5 5 ap(fffkd$$Ifl p@"%)x  t(fff0|)6((((44 lap(fff$$If!v h5x55555555 5 #vx#v #v :Vl  t```|)65x5 5 ap```mkd6$$Ifl p@"%)x  t```0|)6((((44 lap```$$If!v h5x55555555 5 #vx#v #v :Vl  t(```|)65x5 5 ap(```kd$$Ifl p@"%)x  t(```0|)6((((44 lap(```$$If!v h5x55555555 5 #vx#v #v :Vl  t(```|)65x5 5 ap(```kd:$$Ifl p@"%)x  t(```0|)6((((44 lap(```$$If!v h5x55555555 5 #vx#v #v :Vl  t(```|)65x5 5 ap(```kd$$Ifl p@"%)x  t(```0|)6((((44 lap(```$$If!v h5x55555555 5 #vx#v #v :Vl  t(```|)65x5 5 ap(```kdj!$$Ifl p@"%)x  t(```0|)6((((44 lap(```'$$If!v h5x55555555 5 #vx#v #v :Vl  t2```|)65x5 5 ap2```kd%$$Ifl p@"%)x  t2```0|)6((((44 lap2```'$$If!v h5x55555555 5 #vx#v #v :Vl  t2```|)65x5 5 ap2```kd($$Ifl p@"%)x  t2```0|)6((((44 lap2```'$$If!v h5x55555555 5 #vx#v #v :Vl  t2```|)65x5 5 ap2```kd,$$Ifl p@"%)x  t2```0|)6((((44 lap2```$$If!v h5x55555555 5 #vx#v #v :Vl  t```|)65x5 5 ap```mkdN0$$Ifl p@"%)x  t```0|)6((((44 lap```$$If!vh5y 5I 55z #vy #vI #v#vz :Vl  t(65y 5I 55z p($$If!vh5y 5I 55z #vy #vI #v#vz :Vl t65y 5I 55z $$If!vh5y 5I 55z #vy #vI #v#vz :Vl t65y 5I 55z $$If!vh5y 5I 55z #vy #vI #v#vz :Vlp t65y 5I 55z $$If!vh5y 5I 55z #vy #vI #v#vz :Vl t65y 5I 55z $$If!vh5y 5I 55z #vy #vI #v#vz :Vl t65y 5I 55z $$If!vh5y 5I 55z #vy #vI #v#vz :Vl t65y 5I 55z L@L i$Normal$CJOJQJ^J_HaJmH sH tH P@P E Heading 1$$@&a$5>*CJ^JaJtH H@H E Heading 2$@&5CJ^JaJtH DA@D Default Paragraph FontRi@R  Table Normal4 l4a (k(No Listj@j u7 Table Grid7:V04@4 <<Header  !4 @4 <<Footer  !.)@!. EK Page NumberH2H 4 Balloon TextCJOJQJ^JaJ>B> rgp Footnote TextCJaJ@&Q@ rgpFootnote ReferenceH*[g?<=>?KL  KL !lm&(4da * J UNOTUVWXYZ[\]^_`abcfghijklmnopqrstuvwxyz{W, ~01Wc}kJ&lQr6Z !#!!""d")##C$$*%%%t&u&z&}&~&&&&&&&&&&&('''K(())>))**++5,;,D,O,b,s,,-----------------j..\///0011112 2222222222222222222 2!2&2.2/202122232425262728292:2;2<2=2>2?2@2A2B2222236333G44445D5~5B66677778U8V889)::;;;L<3=>>>">'>(>)>*>+>\>^>j>>???? @@m@@@@2AnAABfBCwCCDEEFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFGG$GGGJHHHI"IWIIIIIoJJJ1KKKKL M MMMMMM M!M"M#M$M%M&M'M(M)M*M+M,M-M.M/M0M1M2M7M?M\M^MjMMNN:OQOOOHPfPPPQBQgQQRuRR0SSSDTT UtUUUUV V V V V VVVVVVVVVVVVVVVVV V!V"V#V$V%V&V'V(V)V@VAVBVCVDVEVGVSVVWWXWWWXRXXOYYYZZ [[[[[[ \ \ \\.\3\4\E\G\I\K\M\O\Q\S\U\V\W\z\|\~\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\]]]%]'])]+]-]/]1]3]5]6]7]}]]]]]]]]]]]]]]]]]]]]]]^^^^^^^!^#^$^%^H^J^L^N^P^R^T^V^X^Y^Z^w^y^{^}^^^^^^^^^^^^^__;_<_j_l_m_w_x________"`P`w```````aZaaaaaaaaa'bubbbc?KL  KL !lm&(4da * J NOTUVWXYZ[\]^_`abcfghijklmnopqrstuvwxyz{W, ~0Wc}kJ&lQr6Z !#!!""#C$*%%%t&u&z&}&~&&&&&&&&&&&('''K(())>))**++5,;,D,O,b,,-----------------j..\///011112 2222222222222222222 2!2&2.2/202122232425262728292:2;2<2=2>2?2@2A2B2222236333G44445D5~5B66677778U8V889)::;;;L<3=>>>">'>(>)>*>+>\>^>j>>???? @@m@@@@2AnAABfBCwCCDEEFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFGG$GGGJHHHI"IWIIIIIoJJJ1KKKKL M MMMMMM M!M"M#M$M%M&M'M(M)M*M+M,M-M.M/M0M1M2M7M?M\M^MjMMNN:OQOOOHPfPPPQBQgQQRuRR0SSSDTT UtUUUUV V V V V VVVVVVVVVVVVVVVVV V!V"V#V$V%V&V'V(V)V@VAVBVCVDVEVGVSVVWWXWWWXRXXOYYYZZ [[[[[[ \3\4\V\W\\\\\\\]]6]7]]]]]$^%^Y^Z^^^^^^^^w_x_____``aa|c3d^dddfege"f#ffffffffffgg@0@0@0@0 @0@0@@0@@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@ 0M@ 0MA 0MA 0MA 0M@ 0M@ 0M@ 0M@ 0M@0M@0M@0M@0M@0M@0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@0M @0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@ 0M@ 0M@ 0MA 0MA 0M@ 0M@ 0M@ 0M@ 0M@ 0 M@ 0 M@ 0 M@ 0 M@ 0 M@ 0M@ 0M@ 0M@0M@0M @0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@ 0M@ 0MA 0MA 0MA 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@0M @0M @0M@0M@0M@0M@0M@0M@0M@0M@0M @0M @0M @0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0MA 0'MA 0'MA 0'MA 0'MA 0'M@ 0M@ 0M@ 0M@0M @0M @0M@0M@0M@0M@0M@0M@0M@0M @0M@0M @0M @0M@ 0M@ 0M@ 0M@ 0M@0M@ 0M@ 0M@ 0M@ 0M@0M @0M @0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M @0M @0M @0M@ 0M@ 0MA 0MA 0MA 0M@ 0M@ 0MA 0MA 0MA 0MA 0 MA 0 M@ 0M@ 0MA 0 MA 0 MA 0 MA 0MA 0MA 0M@ 0M @0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@0M @0M@0M @0M@0M@0M@0M@0M @0M @0M @0M@ 0M@ 0MA 0MA 0MA 0MA 0MA 0M@ 0MA 0MA 0MA 0M@0M@ 0M@ 0M@ 0M@0M @ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@ 0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@ 0M@ 0MA 0MA 0MA 0MA 0MA 0M@ 0MA 0MA 0MA 0 MA 0!M@0M@ 0M@ 0M@ 0M@ 0M@0M@ 0M@ 0M@ 0 M@0M@0M@0M @0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M@0M