Nurse Practitioner, Cardiology and Structural Heart - per Diem

Position Summary

The Cardiac Surgery and Valve Clinic Nurse Practitioner is responsible for the care for patients with a variety of complex cardiac diseases, and those patients who will undergo (or who have undergone) treatment or therapy for valvular heart disease within the scope of their Advanced Practice Provider privileges. 

The Nurse Practitioner will provide patient education and continuity of patient care for the entire period of care from referral to post procedure on both inpatients and outpatients.

The Nurse Practitioner will be responsible for preoperative and postoperative patient examination and assessment, diagnosis and planning; treatment implementation coordination and continuity; development of practice protocols and evaluation of quality of care; education of patients, families and other health care practitioners.

The per diem NP shall submit at least one weekday shift availability per week and one weekend availability per month. In addition to performing the essential functions listed below, may also be assigned other duties as required.

Statement of Accountability

Reports to:  The Assistant Director of Cardiovascular Services and works collaboratively with the Structural Heart Interventionalist, Cardiac Surgeons and Cardiac Surgery PA-C’s. Works under the direct supervision of the Structural Heart Interventionalist and Medical Director. The Nurse Practitioner is accountable for their own practice as defined by the Nurse Practice Act and under the general direction of the Medical Staff Bylaws. 

Qualifications

• Education
• Licensure
• Work Experience
• Skills/computer/ specific technical
• Other qualifications, miscellaneous

Specify if qualifications are Required or Preferred

1. Current licensure to practice as a Registered Professional Nurse in the State of California.
2. At least five years of experience in critical care nursing with an emphasis on cardiac disease preferred
3. BCLS required.
4. ACLS required.
5. MSN in Nursing
6. NP or Advanced Practice Provider license in the state of California.
7. NP National Certification
8. Demonstrated oral and writing skills (English).
9. Proficient in Word, excel, and Power Point.

Achieving Results

Key Components: assess, plan, evaluate, demonstrate initiative, quality of work, productivity

1. Management and coordination of patients cared for as part of a multidisciplinary heart team including being a contact point for patients, referring physicians and staff, coordination and facilitation of the care of the patients.

1. In collaboration with the Director of Cardiac and Vascular Surgery Program, promotes and assures philosophy, goals and objectives directed at achieving high quality patient care and service in accordance with the mission and strategic plan of the organization develops.
2. Provide leadership with emphasis on education and continuity of patient care for the entire continuum of care ( from referral to 1 year post TAVR procedure)
3. Performs assessment and data collection related to problems or outcomes according to the TAVR registry/ CMS requirements.
4. As an Advanced Practitioner, creates an atmosphere of mutual trust, recognition, and respect in which high quality care and professionalism are prioritized.

Demonstrates Skill

Key Components: competency, job knowledge, organizational skills, analytical skill, management of information, employee & patient safety

1. Possesses exceptional organization skills
2. Self-motivated to achieve goals
3. Functions as a clinical resource for managers, staff, P.A.’s, and physicians, demonstrating competency in administrative judgment, selected technical skills, and appropriate knowledge base.
4. Assures that the nursing process is utilized in the delivery of patient care and directs staff in its application.
5. Informs the Director of Cardiac and Vascular Surgery Program of needs and problems within areas of responsibility.
6. Assumes responsibility for committees and task forces as directed and participates and represents defined specialty areas and Division on various hospital and medical committees.

Planning & Coordinating

Key Components: delegates, decision making, problem solving, management of resources

1. Manages new patient referral process to the Structural Heart Clinic for appropriateness including inpatient and outpatients.
2. As primary point of contact for patients and their families, develop trusting relationship to help in navigating all testing and procedures throughout course of evaluation and treatment.
3. Maintains open channels of communication between team and patient regarding status, process and realistic expectations.
4. Educates patient and family about the treatment options, disease process and the procedure recommended for them.   
5. Perform functional assessments and evaluate patients’ health status and clinical needs.
6. Facilitates the development of clinically appropriate multi-disciplinary TAVR case conferences
7. Enters orders for any necessary additional diagnostics and testing into EPIC and facilitate changes in medications, hospitalizations and procedures.
8. Develops and implements dashboard or appropriate quality and service metrics
9. Communicates and coordinates with physician leaders, Managers, Supervisors and Charge Nurses to promote staff education

Professionalism

Key Components: dependability, interpersonal skills, teamwork, patient first ethic, customer service, communication skills, punctuality/attendance, receptiveness to criticism, judgment, confidentiality

1. Acts as the patient’s advocate by initiating action to improve healthcare by educating the patient, and by giving them the opportunity to make informed decisions about healthcare before it is provided.
2. Demonstrates awareness and sensitivity to patients' rights and the patient first ethic.
3. Assures that strict confidentiality guidelines are adhered to by all staff members, both intra and inter-departmentally.
4. Demonstrates consistent and effective communication skills using interest based communication and following chain of command.
5. Demonstrates professional responsibility by developing, maintaining and following Hospital, Divisional, and unit-based policies and procedures, and Memorandums of Understanding.
6. Promotes professional and clinical growth and technical expertise of all staff members within areas of responsibility.
7. Demonstrates effective leadership skills including organization, coordination, and delegation in managing assigned duties.
8. Participates in community-based activities representing the interests of WHHS.
9. Role model integrity and fosters teamwork among colleagues and staff.

Improving the Organization

Key Components: performance improvement, quality initiatives

1. Plans, coordinates and participates in multidisciplinary performance improvement activities and unit based quality assurance and improvement activities.
2. Respond appropriately to customer compliments and complaints.  Follows up on customer feedback. 
3. Seeks to improve operations with cost containment in mind.
4. Maintaining accurate records and evaluating effectiveness of actions.

Self-Development

Key Components: maintain license/certification, education and training

1. Demonstrates an awareness of self-responsibility and accountability for improving own level of practice.
2. Stays current with best practice and scientific evidence related to areas of responsibility. 

Regulatory Compliance

Key Components: JCAHO, Title 22, OIG, HIPAA, State/Federal laws, hospital policies

1. Demonstrates awareness of and compliance with patient safety, regulatory and licensing standards; i.e., JCAHO, Title 22, Title 17, OSHA, EMTALA, HIPAA and other service specific regulations.
2. Demonstrates awareness of legal issues in all aspects of patient care, promoting safe practice in order to reduce risk.
3. Assures that regulatory/evaluative agency standards are met.

Prepared by:

Lynda Antes, Director Cardiac and Vascular Surgery Program

Date:

6/24/2020

Approved by:

Ed Fayen

Title:

EVP & COO

Date:

Personnel Office Review:

Date:

Revised Date:

Lifting Objects and or Moving Patients

Back Injuries, Hernias

Understand anatomy of back, causes of back pain, preventive approaches, and use of aids when lifting. Proper lifting and moving of patients and objects. Exercises to strengthen back. Preventive measures when lifting and use of aids when lifting. Exercises to strengthen back.

Slip/Trip/Falls/Use of Ladders

Contusions, Sprains, Strains

Avoid undue speed. Use handrails. Clean up spills immediately. Pick up dropped items. Keep walkways clear of clutter. Correct tripping hazards. If using ladders, use ladder in good repair. Follow department safety guidelines for use of ladders.

Fires & Natural Disasters

Burns & All Types of Injuries

Recognize possible causes of fires: smoking materials, faulty equipment, etc. and educate patients.  Workers need to be familiar with disaster plans and know exit routes.

Electrical Hazards

Shocks & Burns

Report and remove from use, unsafe equipment and appliances.  Unplug equipment by pulling on plugs not cords. Complete electrical safety education and seek assistance if any unsafe conditions are noted.

Assaults

Minor Injury to Death

Employees need to be aware of potential dangers to ensure safety.  Awareness of existing security measures and defensive behavior can protect employee from assaults.

Needle and Sharp Injuries

Cuts, Punctures, Lacerations

Sharps should be discarded in designated containers as soon after use as possible.  Employees should exam & handle soiled linens & similar items as if they contained sharp items.

Obstacles & Broken Objects

Abrasions, Contusions, Lacerations, and Falls

Arrange furniture to allow free movement about rooms and hallways.  Keep doors & drawers closed when not in use.  Clean/discard broken objects properly (i.e. broken glass should be swept up - not picked up with fingers). Remove all broken items from service.

Exposure to Communicable and Other Diseases

Infection – minor to death

Use Infection Control procedures as defined in Infection Control manual for specific diseases.  These include handwashing, personal protective equipment, knowing the risks.  Label linens and wastes properly. Use Standard Precautions with all patients. Keep environment clean.

Exposure to Chemical Agents

Burns, inhalation injuries, etc. See individual MSDS.

Employees should be familiar with chemicals in their departments. Employees should follow procedures as outlined in their department Hazardous Material training and refer to MSDS's before using/handling any chemical.  Do not use any chemical without proper labeling. Wear personal protective equipment as required by department and manufacturer’s directions.

Possible exposure to radiation

Sterility, Cancer, Shortened Life Expectancy

When appropriate, employees should wear film badges (they are monitored routinely) and use shielding, lead aprons, and/or gloves.  Identify and appropriately manage radiation therapy patients and their secretions.

Latex

Dermatitis to death

Alert manager if you feel that you are allergic to latex materials. Use non-latex gloves for all procedures requiring gloves. Read labels to check for latex content.

Soaps, Detergents, Cleaning Solutions

Dermatitis

Follow departmental procedures.  Personal protective equipment is available if department is unable to substitute agents that do not cause dermatitis. Read and follow manufacturer’s directions for use.

Ergonomic Problems

Wide Variety of Musculoskeletal or nerve disorders

Follow safe body mechanics and ergonomic practices as described in hospital education.  Maintain a safe, neat, uncluttered environment. Practices include keeping file drawers closed, walkways clear, not reaching overhead and twisting, etc.  Seek assistance from department manager if a task is causing physical problems.  If work site evaluation is desired, discuss with department manager.             

Possible Exposure to Chemotherapeutic Agents

Burns, reproductive harm, other injuries

Employees who administer chemotherapy must undergo training in: preparation, use, and spill cleanup of chemotherapeutic agents, disposal of equipment and supplies in proper containers, and care of patients receiving chemotherapy according to procedure.

Exposure to Video Display Terminals

Eye strain & stress in addition to ergonomic complaints

It is unknown if significant visual dysfunction results from long-term use of VDT's.  Problems may be reduced with control of lighting, glare, and color contrast. Workers should have adequately corrected vision.  If a VDT evaluation is desired discuss with department manager.             

Possible exposure to patient medications during administration. 

Allergy, adverse drug reaction, other unknown injury

Refer to specific drug information for proper handling to avoid unintended exposure.

Exposure Microwave Radiation

Radiation Effects

Ensure regular maintenance of machine.  Clean all spills. Report and remove from use, unsafe appliances.  Unplug equipment by pulling on plugs not cords.

Injury from Compressed Gas and/or Cylinders

All types of injuries

Compressed gasses are flammable & under pressure so must be handled with care. All compressed gas cylinders must be secured in storage or during use. Use proper connections for tanks. Know how to change connectors. Complete safety education on unit.

Possible exposure to Waste Anesthetic Gases

Health Effects per drug/gas information

Use scavenger systems in anesthetizing locations. Be cognizant of hazards of anesthetic gases and follow procedures as outlined in department training. Acute exposure is in the immediate post-op period. Avoid close proximity to exhaled breath of patient who received anesthetic gases.

Sterilization Equipment, Steam and Chemical

Burns, Chemical Exposure

Complete training and orientation for steam and chemical sterilization equipment. Use appropriate heat resistant materials to handle hot trays or instruments. Be aware of sources of steam. Use appropriate personal protective equipment as described by manufacturer.