Fresenius Medical Center Home Therapies RN CAP 1 in Albany, New York
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.
The registered professional nurse (UltraCare Home Therapies RN 1) is accountable and responsible for the provision and coordination of clinically competent care for an assigned group of patients that includes assessment, planning, intervention and evaluation.As a part of the End Stage Renal Disease (ESRD) health care team, the UltraCare Home Therapies RN 1 participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations.The UltraCare Home Therapies RN 1 relies on the experience, judgment and support of others while developing knowledge in CKD nursing practice. The UltraCare Home Therapies RN 1 performs all essential functions under the direction of the Clinical Manager/Home Therapy Program Manager (HTPM) and with the guidance from the Educator, Preceptor or an UltraCare Home Therapies RN 2, 3, 4 or 5.
1. Assessment: Performs ongoing, systematic collection and analysis of Patient Data
a.)Assesses patient status on admission and throughout patient’s treatment during training to obtain data that integrates patient’s CKD 5 diagnoses, physical/psychosocial findings, patient/family perceptions of illness and cultural value systems
b.)Assesses patient/family’s basic learning needs upon admission and throughout outpatient care related to diagnosis and treatment
c.)Collects pertinent data in a systematic and ongoing process using appropriate evidence based assessment techniques, instruments, monitors and tools
d.)Involves and educates the patient in data collection and includes the family/care partner as appropriate
e.)Prioritization of data collection activities is determined by the patient’s immediate condition or anticipated needs
f.)Recognizes aspects of patient status that vary from normal and reports to appropriate health team members for input
g.)Documents relevant data in a retrievable format
2. Outcomes Identification and Planning: Develops a Plan of Care that prioritizes care using an interdisciplinary approach
a.) Utilizes basic knowledge of current nursing practice in CKD 5 to carry out developed care plan and provides for continuity of care
b.) Relies on FMS Quality Enhancement Program metrics to establish expected outcomes from the diagnoses
c.) Develops daily treatment plan in conjunction with patient and interdisciplinary team, as appropriate
d.) Documents the plan in a retrievable format
3. Implementation: Implements nursing and prescribed medical interventions identified in the plan of care and evaluates patient/family response to treatment
a.)Delivers safe, effective care in a timely and efficient manner
b.)Communicates pertinent patient/family/care partner information to members of the interdisciplinary team timely and efficiently
c.)Documents interventions and any modifications of the identified plan of care in a clear, concise and timely manner
4. Evaluation: Evaluates the patient’s progress toward attainment of goals, ( the UltraCare Home Therapies RN 1 may seek assistance from the CM/HTPM and or UltraCare Home Therapies RN levels 2-5 )
a)Evaluates effectiveness of plan of care and interventions in relation to progress toward identified outcomes
b)Uses ongoing assessment data to revise outcomes and the plan of care as appropriate
c)Involves the patient, family/care partner and the interdisciplinary team in the evaluation process, as appropriate
d)Documents the results of the evaluation
5. Time Management: Process of planning exercising conscious control over the amount of time spent on certain activities, to increase effectiveness, efficiency or productivity
a.)Gives organized, concise reports to the home therapy and interdisciplinary teams
b.)Utilizes down time for the promotion of patient and company goals
c.)Ability to accomplish work within the assigned shift
d.) Organizes and prioritizes assigned workload and care of the patients