NURSE PRACTITIONER, COPD/ ASTHMA & SLEEP CARE, PULMONARY SECTION, Boston Medical Center
December 15, 2017
The Nurse Practitioner (NP) is a key member of the Adult Pulmonary, Allergy, and Sleep Program team. She/He will provide comprehensive care to patients with asthma, COPD, and sleep disorders across the continuum, from outpatient to inpatient settings with a primary objective of coordinating and providing patient care to minimize readmissions for patients with COPD and asthma. This will include identifying patients admitted with COPD and providing comprehensive bedside education about medical management, risk reduction, and coordinating care by telephone and ensuring prompt follow‐up in our outpatient clinic. There will be close collaboration and support from the high risk readmission team including case workers and social work.
The NP will also see their own patients in our Sleep Disorders Clinic alongside dedicated Sleep Medicine experts with a focus on monitoring and encouraging adherence in patients with obstructive sleep apnea(OSA).
Both COPD/Asthma and Sleep care will involve patient visits and care coordination, with 5 clinical sessions a week in the clinic and inpatient/coordination care during the balance of the time. If available, s/he will serve as a resource to Emergency Department staff when patients present in acute exacerbation to assist with coordinating prompt follow‐up in the clinic. After a period of training and supervision, it is expected that the NP will function independently seeing his/her own patients while working collaboratively with other clinicians in the Pulmonary, Allergy, and Sleep Section including being available for urgent visits of other clinicians' patients.
Work collaboratively and independently with Pulmonary clinicians and clinic staff (RNs, practice assistants, team coordinator) and BMC strategy team, using advanced clinical skills to effectively manage a caseload of adult patients with COPD/asthma and obstructive sleep apnea. Identify, educate, and coordinate care of higher risk asthma/COPD inpatients, including comprehensive outpatient follow-up, to minimize hospital readmission. The following highlights core responsibilities, and may evolve based on patient care needs.
Using the BMC Readmission Risk Assessment tool, manage a rolling inventory of ED observation and inpatients with COPD and asthma that are high risk and/or high utilizers.
Provide comprehensive face to face patient education on inpatients about optimal medical disease management including technique of properly using medications, avoidance of triggers, medication adherence, and bedside assessment of pulmonary function.
Counsel and teaches available family members about disease process and expected outcomes.
Document clinical status, medical regimen, and key data in the medical record per hospital guidelines. Bill for services as appropriate.
Coordinate with primary inpatient medical team regarding outpatient follow‐up planning including identifying whether patients have an existing pulmonary specialist; contact specialist about admission with offer to see patient if so desired, and document follow‐up plan.
Serve as a resource to the clinic nurses, inpatient Pulmonary Consultation Service, and outpatient pulmonary clinicians to provide care management and coordinate services with social work, case management, pulmonary rehab, and smoking cessation programs, as needed.
Provide appropriate discharge planning including providing continuity of care specifically by scheduling a clinic visit within 7 days of discharge and ensuring pulmonary medications ar available at discharge. Primary discharge planning responsibilities will reside with the primary inpatient team.
Contact patients by telephone prior to follow‐up to assess adherence and clinical status.
Attend 5 clinical sessions in the Pulmonary, Allergy, and Sleep Clinic.
Three sessions will be dedicated to COPD/asthma patients
Urgent visits as needed for asthma/COPD patients from other Section clinicians
Two sessions will be dedicated to management of patients with obstructive sleep apnea, focusing on patient education and adherence with positive airway pressure (PAP) therapy.
Maintain registry of COPD/asthma patients seen on inpatient service and use key clinical characteristics of disease severity and risk factors to improve care of patients through population health approach, including tracking clinical status and readmission.
Collaborate with Quality Improvement Leads and Pulmonary Clinicians to refine and improve approaches to inpatient education and outpatient care, and participate in research endeavors of quality improvement projects.
Master's degree in nursing required. Completion of an accredited educational program for nurse practitioners required.
Current license to practice as a registered nurse in the Commonwealth of Massachusetts authorization by the Board of Registration in nursing to practice in an expanded role (ANP, FNP).
Registered with the ANCC or other accrediting organization for Nurse Practitioners (e.g. AANP).
Registered with the State of Massachusetts and DEA for prescription writing privileges.
Current BLS certification (ACLS Certification preferred)
Experience, Knowledge and Skills
Ability to conduct physical examinations and health assessments required. Strong expertise in managing complex cases with minimal supervision.
Two years clinical advanced practice nurse experience with demonstrated clinical competence in patient care, teaching and management of complex patients required, or comparable, relevant experience.
Preferred one year experience in management of pulmonary disorders with a focus on chronic disease management
Demonstrated clinical competency, effective leadership and teaching skills required.
Demonstrated written and verbal communication skills with excellent analytical thinking/ problem‐solving skills.
Strong interpersonal skills and the ability to work independently with an 'entrepreneurial spirit' required.
Strong organizational skills required.
Proficiency in the use of computers, especially Microsoft Office and electronic medical records.
DO NOT APPLY THROUGH THE HR WEBSITE
Candidates should send cover letter and CV via email to Raquel McDonald, Pulmonary Administrative
Director, at firstname.lastname@example.org.
Internal Number: 9901/L1417
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