Fresenius Medical Center Renal Home Therapies RN - Wake in Raleigh, North Carolina
PURPOSE AND SCOPE:
Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements.
Functions as a member of the Home Dialysis Team asthe Home Therapy Staff Nurse.Ensures provision of quality Home Dialysis Training and patient care in accordance with FMS policies, procedures and the UltraCare at Home principles.Supports FMCNA’s commitment to the Quality Assessment Performance Improvement Program (QAPI)) and CQI activities, including those related to patient satisfaction.Actively participates in Quality Assessment Performance Improvement (QAPI) process that may enhance the likelihood that patients will achieve established FMCNA Quality Target Goals..
DUTIES / ACTIVITIES :
·Responsible for driving the FMS culture through values and customer service standards
·Accountable for outstanding customer service to all external and internal customers.
·Develops and maintains effective relationships through effective and timely communication.
· Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner.
PRINCIPAL RESPONSIBILITIES AND DUTIES
·Provides safe and effective delivery of home dialysis training and education to patients with End Stage Renal Disease (ESRD) who have selected a home modality as a dialysis therapy.Oversees the delivery of home dialysis therapy to the patient in compliance with standards outlined in the FMS Home Peritoneal Dialysis Policy and Procedure Manual, or/Home Hemodialysis Policy and Procedure Manual , as well as regulations set forth by the Corporation, state and federal agencies. Accountable for providing outstanding quality of patient care, as defined by FMS quality goals and standards.
·Assists in the identification, evaluation and selection of Home Dialysis training candidates, and Home Partners as appropriate for the FMS Home Dialysis Program,
· Educates the patient/Home Partner and family regarding ESRD and the availability of the FMS Treatment Options Program.(TOP)
·Performs assessment of the Home Dialysis training candidate’s home environment for suitability in the ongoing delivery of home dialysis therapy
·Assesses the Home Dialysis patient and Home Partner/family readiness and potential ability to perform dialysis treatments at home.
·Admits all new home patients and documents the appropriate processes as required by policy and procedure.
· Trains the home dialysis candidate/Home Partner as appropriate on the safe and effective operation and maintenance of all home dialysis equipment and treatment supplies through an organized and formalized Home Dialysis Training Program.
·Provides ongoing education to patients regarding their renal dialysis, peritoneal or vascular access and home dialysis therapy, and other related health conditions.Assesses and manages patients’ response to home dialysis training and treatment therapy by following prescribed predetermined protocols.Communicates patient related issues to the physician as needed.
·Reports adverse patient events at home or in the clinic, as well as equipment and technology related problems to the Clinical Manager/Home Therapy Program Manager, and physician including the correct documentation of such events.
·Coordinates the transfer or discharge of patients to the hemodialysis or transplant clinic when needed and appropriate.
·Reviews, transcribes, and enters physician lab orders accurately into Proton, AMI or eCube medical information systems as appropriate.Follows company policies and government regulations related to the collection, packaging, and delivery of lab specimens and reporting of results.
·Participates in policy updates and ensures all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented.
·Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in the event of a cardiac and/or respiratory arrest when the patient is in the dialysis facility.
·Administers medications as prescribed including following prescribed algorithms (as appropriate), and documents appropriate medical justification if indicated and maintains records on controlled substances as required by law.
·Documents all relevant data including physician orders, lab results, vital signs, and treatment parameters, and patient status and any treatment related data appropriately, and enters into the appropriate medical information system.
·Completes all monthly and annual reporting as required by FMS policies and government regulations.
·Submits CQI information to Clinical Manager or Program Manager for completion of HT QAI Template for inclusion in facility QAPI review process.Participates in all monthly QAPI meetings and all required staff meetings as scheduled.
· Rotates coverage with other licensed staff to ensure reliable and adequate coverage, and participates in 24/7 on-call coverage as assigned.
· Participates in staff training and orientation of new staff as assigned.
·Maintains appropriate skill level in the operation of all home dialysis therapy-related equipment, including the ability to troubleshoot equipment problems with the patient via telephone.
·Directs patients in the appropriate routine maintenance of home dialysis equipment, including water systems procedures as appropriate, immediatly reporting any water/dialysate problems to the facility Home Dialysis technical support staff.
·Coordinates the ordering and delivery of the patient’s initial dialysis supplies with the FMCNA RTG; the ordering of the patient’s dialysis equipment as appropriate at the initiation of the training program; and the on-going operation and preventative maintenance of all home dialysis equipment through facility Technical support staff, or through the appropriate equipment vendor as required.
·Other duties as assigned.
ADDENDUM - ULTRACARE HOME THERAPIES RN 2
Essential Nursing Functions with descriptions of expected behaviors:
POSITION SUMMARY :
The nephrology ULTRACARE HOME THERAPIES RN 2 is responsible for all of the essential functions and expected behaviors of ULTRACARE HOME THERAPIES RN 1, and the additional responsibilities of ULTRACARE HOME THERAPIES RN 2. The registered professional nephrology nurse (ULTRACARE HOME THERAPIES RN 2) is accountable and responsible for the provision and coordination of clinically competent care for an assigned group of patients that includes assessment, nursing diagnoses, outcomes identification, planning, intervention and evaluation.The ULTRACARE HOME THERAPIES RN 2 is a competent nephrology nurse and has the knowledge and skills to provide quality care.The ULTRACARE HOME THERAPIES RN 2 is able to make independent decisions guided by experience as well as policies and standards; however the ULTRACARE HOME THERAPIES RN 2 continues to consult with other members of the End Stage Renal Disease (ESRD) health care team when the need for assistance is identified. The ULTRACARE HOME THERAPIES RN 2 begins to exhibit clinical leadership as a resource for ULTRACARE HOME THERAPIES RN 1 development and the clinical guidance of the patient care technician.The ULTRACARE HOME THERAPIES RN 2 promotes exemplary patient care through integration of quality improvement strategies in clinical practice.
1) Assessment and Nursing Diagnoses: Performs ongoing, systematic collection and analysis of patient data
a)Assesses patient/family/care partner’s complex learning needs upon admission and throughouthome care related to diagnosis and treatment
b)Identifies implications of patient status that vary from normal and discusses with MD and appropriate members of the interdisciplinary team
c)Identifies barriers (e.g., psychosocial, financial, cultural, language, and educational) to effectively communicate and makes appropriate adaptations
d)Derives the nursing diagnoses or issues based on assessment data
e)Validates the diagnoses or issues with patient, family/care partner and other interdisciplinary team when appropriate
f)Applies ethical, legal, and privacy guidelines and policies to the collection, maintenance, use, and dissemination of data and information
g)Documents relevant data in a retrievable format and documents diagnoses or issues in a manner that facilitates the determination of the expected outcomes and plan
2) Outcomes Identification and Planning: Identifies expected outcomes and develops a Plan of Care that prioritizes care using an interdisciplinary approach
a)Involves the patient, family/care partner and interdisciplinary team in formulating expected outcomes and plan of care when possible and appropriate
b)Derives culturally appropriate expected outcomes from the diagnoses
c)Includes a time estimate for attainment of expected outcomes
d)Documents expected outcomes as measurable goals
e)Develops expected outcomes in addition to FMS quality metrics that provide direction for continuity of care
f)Modifies expected outcomes based on changes in the status of the patient or evaluation of the situation
g)Reflects current nursing practice for Chronic Kidney Disease 5 (CKD 5) care in the plan and provides for continuity of care
h)Defines the plan to reflect current statutes, rules and regulations, and standards
i)Provides patient and family/care partner education based on learning needs assessment, utilizing suitable instructional materials and methods
3) Implementation and Coordination of Care: Implements nursing and prescribed medical interventions identified in the plan of care and evaluates patient/family/care partner response to treatment
a)Promotes continuity of care by working collaboratively with the interdisciplinary team, utilizing identified resources to
provide optimum patient care and treatment options
b)Collaborates and coordinates with the interdisciplinary team to implement plan of care
c)Accurately documents all identified interventions, and evaluates patient/family /care partner response to plan of care
d)Implements and utilizes approved educational plan to meet patient/family /care partner needs
e)Anticipates emergencies and takes immediate and appropriate action
4) Evaluation: Evaluates the patient’s progress toward attainment of goals
a)Evaluates, in partnership with the patient and the interdisciplinary team, the effectiveness of plan of care and interventions in relation to patient responses and the attainment of the expected outcomes
b)Disseminates the results to patient and the interdisciplinary team and others involved in the care or situation, as appropriate, in accordance with HIPPA and other related regulations
c)Assists interdisciplinary team with a systematic ongoing and criterion- based evaluation of outcomes in relation to structures and processes prescribed by the plan and the indicated timeline
d)Assists interdisciplinary team in re-evaluating the appropriateness of the currentmodality, ability for self-care, referral to vocational and physical rehabilitation services, and all other criteria mandated by the CMS Conditions for Coverage and Interpretive Guidelines for healthcare consumers undergoing Kidney Replacement Therapies (KRT)
e)Utilizes retention focused tools and programs to transition patient within home therapy options, as appropriate
f)Provides health teaching that addresses such topics as healthy lifestyles, risk-reducing behaviors, developmental needs, activities of daily living and preventive self-care
5) Teamwork: Contributes to teamwork within the facility
a)Identifies potential conflict situations and facilitates resolution using established communication channels
b)Participates in the formation, implementation and evaluation of quality and facility goals
c)Participates in management of facility as a team leader, as delegated
d)Serves as a resource to new staff, students and other FMS personnel, this may include participation in formal preceptor program
6) Promotion of quality care: Participates in Quality Enhancement Program processes
a) Identifies issues in compliance with standards set by regulatory groups such as CMS, Renal Network, State Department of Health, OSHA, with regard to patient care and technical practices, and notifies manager and/or QAI team
b) Assumes responsibility for meeting mandatory requirements
7) Leadership: Manages patient care by appropriately prioritizing and delegating tasks following an assessment of the facility/unit needs
a)Follows up with individuals to ascertain that assigned duties are completed in safe and efficient manner
b)Keeps Manager informed of pertinent events
c)Reports malfunctioning equipment immediately and facilitates replacement of equipment and/or servicing process while ensuring patient safety
d)Informs leadership of risk management situations, conflict, and physician concerns
e)Performs accurate documentation on above situations
f)Communicates identified patient care problems to Manager
g)Serves as a resource to family and interdisciplinary team
h)Collaborates with the business development and home therapy leadership teams to incorporate business strategies to market home therapy services within the community
8) Physician Collaboration: Acknowledges the physician’s plan of care and practices in a collaborative relationship with the physician
a)Consistently partners with physicians during patient clinic days
b)Communicates patient’s condition and progress, collaborating on the plan of care
c)Organized and prepared when seeking physician’s input via phone or in person, i.e., chart available, questions organized, etc.
d) Seeks guidance and uses proper discretion when notifying physicians of patient condition change
Graduate of an accredited School of Nursing (R.N.)
Current appropriate state licensure
Education and Training qualifications per ULTRACARE CAP program requirements
EXPERIENCE AND REQUIRED SKILLS
· Minimum of one year nursing experience required.
· Minimum of three months (twelve weeks) Home Dialysis Training experience required.
· Experience must be specific to the modality of Home Dialysis Training that the staff member will be providing, ie; Peritoneal Dialysis (PD) or Home Hemodialysis.
· Must have successfully completed a training course in the theory and practice of dialysis therapy/ hemodialysis or PD
· Medical-surgical nursing experience and ICU experience preferred but not required..
· Competent at operating all Home Dialysis related equipment.
· Successfully complete CPR certification with maintenance as required.
·Icd-9 coding TrainingDemonstrated teaching abilities using Adult Learning principles
EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity