Job Details

REGISTERED NURSE (University of Michigan, Clinical Nurse Outpatient Facilitator, In-Center Hemodialysis)

Job Opening ID: 181128
Work Location: Michigan Medicine - Health Sys
Full Time/Part Time: Full-Time
Regular/Temporary: Regular
FLSA Status: Nonexempt
Organizational Group: Um Hospital
Department: U of M Livonia Dialysis Center
Posting Begin/End Date: 11/18/2019 11/24/2019
Salary:
Paid Time Off: Yes
Career Interest: Nursing- All Nursing
Nursing- Ambulatory Care and Clinics
Nursing- Procedural Services
Nursing- Dialysis

Job Summary

1. Position Title

Clinical Nurse, Outpatient Facilitator, In-center Hemodialysis

2. Purpose

To provide nursing care and support to the adult in-center hemodialysis patient with acute kidney injury (AKI) or end stage renal disease (ESRD). To maintain clinical expertise within this unique population requiring specialized renal therapies. To provide nursing advice and consultation to other health care team members.

Utilize the nursing process to provide nursing care to facilitate the attainment and maintenance of an optimal level of health for patients and families. To collaborate with other health care team members and utilize associated resources to provide continuity in patient care and participate with healthcare team members for problem solving.

In addition to staff nursing duties, the Dialysis In-Center Patient Facilitator is responsible for the hospitalized dialysis patient's smooth transition from the hospital to their next step in recovery involving in-center hemodialysis. This may include an inpatient assessment of the appropriateness of the patient tolerating outpatient dialysis level of care. As part of the interdisciplinary patient care team, the In-Center Patient Facilitator would follow up on care plans, anemia management, medication reconciliation, medical appointments, dialysis treatments, education toward self-care management, coordination of community services, communication between patient, dialysis facility, family, and other established services.

The objective of the Dialysis In-Center Patient Facilitator is to prevent re-hospitalization by communication and coordinating care between the patient, family, dialysis team, PCP, and established community services. This will be an active role in a team approach to patient centered care. The Dialysis In-Center Patient Facilitator will guide the patient and their families toward attainable goals through motivational interviewing, patient activation assessments, and literacy surveys. Through partnership and respect, the goal is an increased likelihood of a desired health outcome decreasing fragmentation and discontinuity. Education and goals will include chronic disease information and management. Contact between the Dialysis In-Center Patient Coordinator and patient may be at the hospital, dialysis unit, and by telephone. Number of contacts, frequency, and service time will be determined by patient need.

3. Organizational Relationships
   1. General supervision is received from Clinical Nursing Director, Clinical Nursing Supervisor and Medical Director.
   2. Functional supervision may be exercised over assistive personnel in collaboration with the charge nurse.

Mission Statement
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Why Join Michigan Medicine?
Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan medicine is comprised of over 26,000 employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world's most distinguished academic health systems. In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good.

What Benefits can you Look Forward to?Nursing at Michigan offers a competitive salary with excellent benefits!

• Salary range for Registered Nurses- $65,840.24 - $104,150.85
• Evening Shift Differential- $2.45 per hour
• Night Shift Differential- $3.30 per hour
• Weekend Differential- $1.75 per hour

The benefit package includes:

• Excellent medical, dental and vision coverage
• 2:1 Match on retirement savings and immediate vesting
• Generous Paid Time Off Allowances
• Robust Tuition and Certification support programs
• Large offering of no cost CEs and professional development for advancement.

Responsibilities*

1. Patient Assessment
   1. Collect health information as needed, researching hospital records, assess
   2. Review medications, labs, upcoming appointments, dialysis orders and self-care abilities.
   3. Work closely with the social worker to assess patients formal and informal support systems, including caregiver resources and involvement as well as available benefits and/or community resources.
   4. Assure patients insurance has been approved prior to accepting any patient into the program.
2. Regulatory duties
   1. Create the care plan based on patient needs to reach positive patient centered outcomes or work with primary RN to create a care plan, including objectives, goals and actions designed to meet patient's needs.
   2. Identify problems, goals and interventions designed to meet the patient's needs, including prioritized goals that consider the patient/caregivers goals, preferences and desired level of involvement in the care plan.
   3. Monitor the plan of care to ensure the effectiveness ad appropriateness of services and positive outcomes.
   4. Evaluate the patient's progress toward goal achievement, including identification and evaluation of barriers to meeting of complying with plan.
   5. Participate in multidisciplinary meetings.
   6. Coordinate and attend care plan meetings.
   7. Participate and attend monthly QAPI meetings.
   8. Complete anemia management
3. Staff Related
   1. Collaborate with the Patient Care Technician's (PCT) provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by the corporation, state, and federal agencies.
   2. Delegates tasks as needed to all direct patient care staff/co-workers including but not limited to PCTs.
   3. Assesses daily care needs and develops appropriate patient plan of care.
   4. Routinely deliver patient care using appropriate techniques and adherence to facility policy and procedures.
   5. Participates in staff training and orientation of new staff as assigned.
   6. Participates in all required staff meetings as scheduled.
4. Patient Care
   1. Provides safe and effective delivery of care to patients with AKI and ESRD.
   2. Accurately implements treatment prescriptions as indicated.
   3. Assess patients' response to hemodialysis treatment therapy, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician. Communicates problems or concerns to the Charge Nurse, physician or Lead PCT.
   4. Identifies and communicates patient related issues to Charge Nurse or physician.
   5. Completes Initial and Annual Nursing Assessment, and ongoing evaluation and documentation of patient care needs according to Michigan Medicine Policies and Procedures.
   6. Actively participates in the pre evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment therapy according to established policies.
   7. Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues as identified by OLC/AMP yellow lights.
   8. Monitors hemodialysis access care according to established procedures.
   9. Ensures accurate and complete documentation by PCT on the Electronic Hemodialysis Treatment Sheet.
   10. Ensures provision of appropriate vaccinations, immunizations and Tuberculosis testing.
   11. Administers medications as prescribed and completes appropriate documentation of assessment of effectiveness.
   12. Provides clinical expertise regarding specialized renal therapies to other team members in various clinical settings as necessary.
   13. Safely provide IV therapy and venipuncture.
   14. Participate in patient care conferences with the multidisciplinary team.
   15. Provide patient education.
   16. When assigned, participate in all aspects of the charge nurse duties
   17. Safely and effectively manage planned and emergent disruptions of specialized renal therapies.
   18. Complete patient safety checks and assuring all medications are labeled appropriately.
   19. Document accurately and complete all patient orders according to policy/protocol set forth by Michigan Dialysis Services.
5. Patient Education
   1. Ensures educational needs of patients and families are met regarding renal disease.
   2. Provides ongoing education to patients regarding their renal disease, vascular access and dialysis therapy and other related health conditions.
   3. Discusses with patient and records education related to diet/fluid and medication compliance, and collaborate with the Dietician staff in the center.
   4. Ensures transplant awareness, modality awareness and drive catheter reduction.
   5. Educates patients regarding laboratory values and the relationship to adequate dialysis therapy, compliance with treatment schedule, medications and fluid.
6. Laboratory
   1. Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System and ensure labs are directed and delivered to appropriate labs.
   2. Ensures correct labs tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately for all lab samples.
   3. Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient according to company policies and procedures.
   4. Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material
   5. Reports abnormal lab results to appropriate physician and ensures lab results are reported to the appropriate physician.
7. Infection Prevention
   1. Ensures a clean, safe and sanitary environment in the dialysis facility treatment area.
   2. Ensures competency in the operation of all dialysis related equipment safely and effectively.
   3. Ensures patient station, including all surfaces, dialysis machine, chair, and all supplies in the patient station are clean and free of blood and placed appropriately.
   4. Ensures all blood spills are immediately addressed according to Michigan Medicine Blood Borne Pathogen Control Policies.
8. Medical Records and Documentation
   1. Ensures all relevant data including physician orders, lab results, vital signs and treatment parameters, and patient status are documented appropriately and entered into Medical Information System.
   2. Ensures all appropriate patient related treatment data is entered into the Electronic Medical Information System.
   3. Ensures all Michigan Medicine policies regarding dialysis patient admission, transfer and discharge are appropriately implemented.
   4. Ensures and verify accuracy of Patient Care Technician documentation.
   5. Requirements
      1. Daily

1. Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets.
2. Ensures that all appropriate procedures are followed regarding opening and closing procedures, inclusive of monitoring that the staff and patient have safely left the premises.

b. Monthly

i. Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports.

ii. Completes monthly nurses' progress note in the electronic health record.

iii. Ensures patient medical records are complete with correct-required information and documentation.

iv. Reviews transplant status and follows established procedure regarding appropriate action to be taken.

v. Completes patient care plans for new patients within the initial 30 days or any patients deemed unstable requiring monthly patient care plans.

vi. Completes any long-term programs that are due.

c. Annual requirements

i. Completes initial and annual Nursing History and Physical Assessment.

ii. Ensures completion of Annual Standing Order Review with each physician as required.

1. Professionalism
   1. Enforces policies and procedures, as well as regulations set forth by state and federal agencies and departments.
   2. Maintains overall shift operation in a safe, efficient, and effective manner.
   3. Act as a resource for other staff members.
   4. Routinely meets with leadership to discuss personnel and patient care status, issues, and information.
   5. Collaborate and communicate with physicians and other members of the healthcare team to interpret, adjust and coordinate care provided to the patient.
   6. Provides assistance as needed to patients regarding prescription refills according to Michigan Medicine Policies.
   7. Ensures all physician orders are transcribed and entered into the Medical Information system in a timely manner.
   8. Oversees all documentation of patient information.
   9. Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in the event of a cardiac and/or respiratory arrest.
   10. Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification if indicated.
   11. Ensures verification and availability of adequate emergency equipment.
   12. Assists with the coordination of patient transportation if necessary.
   13. Interface with outside laboratories, pharmacies and dialysis clinics.
   14. Delegate appropriate duties to assistive personnel.
   15. Assist in research studies and quality assurance activities.
   16. Participate in performance improvement program activities.
10. Performs additional duties assigned by leadership.
11. Professional Development/Education for Staff
    1. Successful completion of peritoneal dialysis training with satisfactory performance.
    2. Contributes to the professional growth of peers and other interdisciplinary team members.
    3. Demonstrates a willingness to share knowledge formally and informally.
    4. Assumes the role of resource person/mentor for new staff members.
    5. Documents professional educational activities for yearly review.
    6. Participation in unit committees on a rotation basis.
    7. Maintains clinical expertise within the unique patient population which require specialized renal therapies.
12. Professional Development/Educational Standard for Patients and Families.
    1. Assess patient/families understanding of disease processes including medications, diet and treatment modality options.
    2. Assess patient/families readiness to learn and tailors teaching to meet individual needs by allowing adequate time to discuss progress, voice questions and verbalize anxieties.
    3. Makes appropriate referrals to other resources for assistance in the teaching/learning process (i.e. social work, dietary, National Kidney Foundation, etc.).
    4. Documents patients' education and evaluation of learning appropriately.
13. Leadership
    1. Responsible for driving the Michigan Dialysis Center culture through values and customer service standards.
    2. Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner.
    3. Develops and maintains effective professional relationships through effective and timely communication.
    4. Able to make appropriate independent nursing decisions and delegate responsibilities when necessary.
    5. Promotes outstanding quality patient care in a collaborative, cost effective manner by assessing the diverse needs of the unit and implementing change accordingly.
    6. Document on the daily time sheet tardiness and when leaving early.
14. Communication
    1. Promote teamwork by functioning as a resource to peers, other units and various team members involved in the care of patients requiring peritoneal dialysis.
    2. Effectively interacts willingly and professionally with peers, patients, families and interdisciplinary team members.
    3. Communicate with appropriate physician as patient condition warrants.
    4. Communicate incidental information which may enhance clinical practice.
    5. Demonstrate support of peers by giving positive recognition of behaviors and accomplishments.
    6. Identify conflict and gossip, and seek opportunities to promote resolution.
15. Confidentiality
    1. Maintain and protect patient confidentiality.
    2. Maintain confidentiality around sensitive issues that arise for staff.

Nursing Specific Info
Salary & Nursing Framework Level:This UMPNC RN posting is posted as Nursing Framework LEVEL C.Actual Nursing Framework LEVEL and salary will be determined at time of hire.Nursing Framework levels range from Level A to Level F.

Required qualifications must be met by the candidate in order to be interviewed and considered for the position. Posting may be filled after the initial 5-day posting period. Applicants who have left the UMPNC bargaining unit must include on their resume dates of past employment including months and years of service along with effort. Positions less than 20 hours/week may be combined.

If you have questions regarding this posting or would like assistance with nursing opportunities please contact Nurse Recruitment at (734) 936-5183.

Required Qualifications*

1. Registered Nurse with current license to practice in the state of Michigan
2. Minimum 3 years' recent outpatient hemodialysis experience, with primary nurse knowledge
3. Current ESRD, CMS regulatory knowledge and experience
4. BCLS certified
5. Flexible schedule, including Saturdays, days and evenings to cover all dialysis shifts
6. Ability to push, lift and move heavy equipment
7. Ability to lift, move and position patients

?NOTE:

Required qualifications must be met by the candidate in order to be interviewed and considered for the position.RESUME REQUIRED (for both internal & external applicants):You must attach a complete and accurate resume to be fully considered for this position.

Desired Qualifications*
Work Schedule
Hours: 40 hours per weekShift: Day/ Evening rotation; shifts will vary and may be 8-hour shifts up to 10-hour shifts. Two Saturdays per schedule is requiredLocation: Livonia Center for Specialty Care: Chronic Hemodialysis

Note: All new employees will be expected to float to a designated unit(s) in times of low census.

Union Affiliation
This position is covered under the collective bargaining agreement between the U-M and the Michigan Nurses Association and the U-M Professional Nurse Council union, which contains and settles all matters with respect to wages, benefits, hours and other terms and conditions of employment.

Background Screening
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Selection Process
Michigan Medicine seeks to recruit and retain a diverse workforce as a reflection of our commitment to serve the diverse people of Michigan and to maintain the excellence of the University. We welcome applications from anyone who would bring additional dimensions to the University's research, teaching, and clinical mission, including women, members of minority groups, protected veterans, and individuals with disabilities. The Department of Nursing, like the University of Michigan as a whole, is committed to a policy of nondiscrimination and equal opportunity for all persons and will not discriminate against any individual because of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender expression, disability, religion, height, weight, or veteran status.

U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.


To apply, visit https://careers.umich.edu/job_detail/181128/registered_nurse_university_of_michigan_clinical_nurse_outpatient_facilitator_in-center_hemodialysis





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