Homecare RN - Northfield - Centers for Dialysis Care

Description

BASIC PURPOSE:
The Home Care RN functions as a patient advocate. He/she delivers care based on the nursing practice guidelines. The Home Care RN provides leadership through coordination of scheduling, training, clinic visits, home supervision, and monthly QA/Ops meetings. She/he performs direct patient care according to CDC patient care policies and procedures. Assures all the team participates and communicates pertinent clinical information to each other and remains in compliance with all CDC personnel policies and procedures as outlined in the Employee Handbook. Performs other related duties as assigned.
Utilizes the nursing process to provide comprehensive care. Establishes a therapeutic relationship with patient and families.

• Assesses patients effectively recognizing needs and utilizes the appropriate nursing skills and resources to meet those needs
• Develops a plan of care for each patient based on the medical plan and nursing diagnosis
• Implements the plan of care
• Evaluates and documents the patient response to the plan of care
• Performs review of primary patient lab work and plans responses as necessary
• Completes primary patient documentation according to CDC standards and timeline
• Schedules and leads patient care conferences to assure an interdisciplinary approach to patient plan of care and annual treatment modality review
• Provides and oversees all new patient training in home care programs
• Assures patient competency in home training and encourages patients to follow the prescribed dialysis treatment plan
• Demonstrates competency with special procedures or equipment
• Demonstrates and adheres to aseptic technique, universal precautions guidelines
• Demonstrates an understanding of the medication utilized for the ESRD population
• Maintains patient confidentiality and professional boundary guidelines
• Reviews and transcribes all verbal orders given by the physician for safety, completeness and efficacy
• Documents verbal orders according to CDC guidelines in the EMR
• Follows CDC hospital discharge policy for review of orders
• Follows manufacturer's guidelines and CDC policy for the administration of medications at CDC
• Adheres to CDC and blood bank standards in the ordering administration, and documentation of blood transfusions

Provides leadership in management of the home care program through supervision of training and development of the program policy procedure

• Assesses patients for competency and acceptance to the home care program of their choice
• Communicates with the MD to coordinate new patient training and transfer to a home program
• Directs the activity of the RN, LPN or PCT that are working with the home program
• Schedules monthly patient clinic visits in conjunction with the MD
• Coordinates the involvement of the interdisciplinary team in the care of the patient at clinic visits and communicates effectively with all members of the health care team to provide continuous quality care
• Utilizes effective problem solving
• Delegates and maintains accountability for standard of care
• Participates in problem identification and the resolution of program issues
• Serves as a resource nurse in the area of home training for the interdisciplinary team and to CDC as an organization
• Woks collaboratively to develop and update policies and procedures to operate the home care modalities
• Serves as a role model in following policy and procedure
• Demonstrates an understanding of the legal ramifications of documentation
• Schedules and facilitates monthly QA and Operations meetings with the home care team
• Demonstrates flexibility and availability in scheduling and response to patient at home/ training needs
• Schedules and coordinates coverage of the home care pager to assure patient needs are met in emergent off-hour patient care situations
• Adheres to all CDC personnel policies including attendance control policies
• Oversees lab work and procedures scheduled to assure all patients in the program have lab work and procedures performed as needed and reschedules as necessary
• Appropriately enacts CDC's policy and procedure on maintaining positive patient and staff relationships
• Demonstrates excellent customer service skills with patients, staff and physicians
• Understands CDC's drug free work place program and utilizes procedures when appropriate
• Reviews and assure appropriate documentation and follow-up of all employee/patient injuries occurring in their program

Provides for an on-going professional growth and development

• Completes a yearly self-evaluation
• Maintains CEU's and licensure requirements to practice in the state of Ohio
• Formulates goals for personal and professional growth
• Participates in the preceptor program
• Identifies learning needs and seeks resources to meet these
• Shares knowledge and experience with peers
• Completes CDC ongoing education requirements including Healthstream modules as assigned
• Continues to enhance understanding of home care modalities by attending programs and courses focused on these areas

Adheres to nursing and CDC policy and procedures to ensure quality patient care and safety

• Administers care according to CDC policy and procedure
• Demonstrates knowledge of CDC's Disaster and Hazmat plans
• Assesses patients in crisis and initiates emergency response plan as necessary including CPR measures
• Provides reporting on home care quality indicators and leads the quality team in addressing quality are related issues
• Provides day to day management of vascular access issues and provides patient education when needed
• Demonstrates a basic knowledge and understanding of the importance of water treatment for dialysis and its safety
• Monitors the use of anticoagulation therapy on all patients assigned and utilizes nursing judgment to hold doses or contact the MD for dose adjustment when necessary
• Share in the responsibility of promoting CDC as a center of quality
• Maintains a professional appearance and demeanor at all times

Manages CDC resources in an efficient fiscally responsible manner

• Follows protocols for equipment supply use and evaluation of new equipment/supplies
• Utilizes supplies in a cost conscious manner
• Assures CDC practices are designed to enhance efficiency in practice
• Provides all necessary documentation to support billing for patient training, medication administration and home therapy
• Assures the home care supply budget is managed in a fiscally responsible manner
• Schedules ancillary staff in the program in a cost effective manner
• Works with non-compliant patient and the business to remedy financial issues in relation to their care and determine patient need for discharge based on failure to obtain payment or compliance
• Oversees the adherence to CDC salary and non-salary budgets

Assists with the maintenance of physiologic functions through the conscientious training, initiation, monitoring, and discontinuation of CAPD or home hemo therapy

• Demonstrates a basic knowledge and understanding of the objectives of home dialysis therapy
• Provides CAPD and home hemodialysis one on one training with patients
• Oversees training provided to home care patients by ancillary staff i.e. PCT or LPN to assure patient competency is achieved
• Troubleshoots machine alarm states and cannulation difficulties
• Troubleshoots emergent CAPD issues i.e. infections or failure to drain
• Demonstrates assessment skills of the home care patient throughout delivery of either modality
• Administers, dates and signs off all medications as ordered
• Assures thorough documentation of all patient competency checklists and training assessments
• Documents all pertinent data per CDC documentation standards
• Communicates with all staff involved in the program to assure smooth operations
• Records treatment information pertinent observations and data onto the electronic medical record or flow sheet accurately and legibly

EDUCATION, EXPERIENCE TRAINING AND LICENSES/REGISTRATIONS:

• Graduate from an accredited school of nursing
• Current Ohio licensure
• Current CPR certification
• Independent decision-making skills
• Good leadership and interpersonal qualities
• Home Care in the ESRD field preferred