PURPOSE AND SCOPE:

Functions as a member of the home dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a registered nurse both in a home therapies (HT) facility and in a patient’s home in accordance with Fresenius Medical Care (FME) policies, procedures, training, and in compliance with regulations set forth by the corporation, state, and federal agencies. Provides training for new HT LPN/LVNs and/or Home Therapies Patient Care Technicians (PCTs) under in person direct supervision of a registered nurse in either a HT facility or patient’s home. Assists with clinical orientation, precepting, and on-going training of all appropriate direct patient care personnel as well as orientating facility staff to FME. Participates in the implementation and evaluation of patient care. Promotes and assists in the maintenance of a safe and clean working environment. Supports FME commitment to the Quality Enhancement Program (QEP) and Quality Assurance Indicator (QAI) activities, including those related to patient satisfaction, and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FME Quality Enhancement Goals (QEP).

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Staff Related

• Participates in the recruitment process and training of new clinical staff.
• Assists with clinical orientation and on-going training of all appropriate direct patient care personnel as well as the orientation of all facility staff to FME.
• Functions as a preceptor in direct patient care training programs to support the delivery of quality patient care as per the standards set forth in the FME Clinical Services Clinical Training Manual(s), FME policies, procedures, and training standards.
• Delivers and maintains on-going competency evaluations/audits to ensure ongoing performance of other HT LPNs/LVNs and HT PCTs.
• Collaborates with the manager and Education in driving FME quality standards through education regarding all chronic kidney disease (CKD) and acute kidney disease (AKI-D) regulatory and legal requirements and the practice of Continuous Quality Improvement.
• Assists in training of applicable direct patient care staff on appropriate programs.
• Provides coaching and developmental support to applicable clinical and facility staff.

Education/Communication:

• Partners with RN and Interdisciplinary Team (IDT) to educate the appropriate personnel regarding the integrity and safety of the facility water systems as applicable, and as allowed by local regulations.
• Partners with RN and IDT staff to educate the appropriate personnel regarding the maintenance of environmental integrity, including patient and staff safety of the facility.
• Ensures a strong communication process between the managers and Education, direct patient care staff, and all support staff at the facility regarding appropriate training and organizational development programs and initiatives.
• Participates in implementing and potentially designs creative educational programs for direct patient care staff including contests and other team-based programs.
• Monitors processes in the delivery of patient care through regular Quality Assurance Indicator (QAI) activities.
• Ensures all FME business policies, procedures and systems are incorporated into the training of staff, including compliance with ethical business practices.

Patient Related

• Provides direct patient care for assigned patients in accordance with physicians’ orders and state nurse practice laws.
• Administers intravenous medications and performs laboratory specimen collection using phlebotomy in accordance with physicians’ orders and state nursing practice laws.
• Assists Home Therapies Manager in the identification, evaluation, and training of employee candidates for the home dialysis program.
• Reinforces patient training content introduced by the qualified home therapies training nurse as appropriate.
• Responsible for accurate documentation of information related to the patients’ training and treatment.
• Ensures the information is documented appropriately in the individual patient record and entered into the Medical Information System.
• Responsible for ongoing monitoring, assessment, and intervention for home patients including home visits, clinical appointments, additional training sessions or reviews, lab studies and annual studies such as x-ray and EKG.

• Responsible for addressing problems or emergencies within scope of practice.
• Responsible for assisting with patient supply procedures, appropriate documentation and ensuring maintenance of FME durable medical equipment, i.e. preventative maintenance, water analysis.
• Performs monthly chart audits and reports results to supervisor.
• Reports the outcomes to the attending physician(s), the Quality Assurance Committee, and Home Therapies Management.
• Under the direction of the Home Therapies Supervisor responsible for making changes in patient treatment plans in conjunction with the physician.
• Schedules back-up treatments when necessary, in collaboration with Home Therapies Supervisor and physician.
• Participates in education of pre-dialysis and existing ESRD patients regarding treatment options.

Infection Control Specialization:

• Assists with facility Quality Assurance Indicators (QAI) infection control audits.
• Acts as a change agent for infection control practices within clinic. Under the direction of the manager or designee, monitors staff and patient adherence to infection control practices.
• Reinforces new hire employee adherence to infection control policies and procedures.

• Supports ongoing staff and patient engagement on infection control practices under the direction of manager or designee
• Quarterly and under the direction of the Clinical Manager (CM) reinforces patient and staff adherence to infection control policies and procedures through visual media such as posters, flyers or bulletin boards.
• Under the direction of the Education Department, participates in an education response to internal and external facility surveys.
• Participates in and reinforces infection control education of new patients and families under the direction of the CM or designee.

Maintenance/Technical:

• Maintains environmental integrity and aesthetics; ensures all areas are safe and clean.
• Cleans and disinfects dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy.
• Conducts all tasks necessary for preparation for dialysis treatment and document where appropriate.
• Ensures that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy.
• Prepares, organizes, and efficiently utilizes supplies and equipment to prevent wastage.

Recordkeeping:

• Completes and documents ongoing participation in Quality Assurance Indicators (QAI) activities.
• Enters all treatment data into the designated clinical application in an accurate and timely manner.
• Reviews treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected where appropriate.
• Prepares initial patient chart for admission and compile paperwork for appropriate placement in chart.
• Prepares lab requisitions for prescribed or stat Lab specimens according to laboratory destination.
• Collects, labels, appropriately prepares and stores lab samples according to required laboratory specifications.
• Ensures collection of lab specimens by appropriate lab courier.

PHYSICAL DEMANDS AND WORKING CONDITIONS:

• The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required.
• The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials.
• Position may require travel between assigned facilities and various locations within the community. Travel to regional meetings or trainings may be required.
• The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. up as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items.

EDUCATION AND LICENSES:

• Graduate of an accredited School of Practical Nursing (LPN, LVN)
• Current appropriate state licensure
• Attendance and active participation in all applicable preceptor training programs as established by FME.
• Attends FME and publicly offered skill-based training as assigned by Clinical Manager
• History of high performance as measured by no lower than a commendable performance evaluation rating on reviews with no recent corrective actions
• Participation in our Leading with Values and Patient Experience workshops desired

EXPERIENCE AND REQUIRED SKILLS:

• At least five years patient care experience in a hospital setting or a related facility preferred
• Employees must meet the necessary requirements of Ishihara's Color Blindness test as a condition of employment
• Continued employment is dependent on successful completion of the FME dialysis training program and successful completion of CPR certification
• Intravenous Certification if required by State Nurse Practice Act
• Excellent communication skills – both verbal and written

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.