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Registered Nurse

Location : Staten Island
Job Type : Temp/Contract
Reference Code : OPD01:17322
Start Date : 07/28/2022
End Date : 06/27/2024
Hours : Full Time
Travel : No
Relocation : No

Job Description :

New York State Agency OPWDD






Qualifications & Scope of Work


 


 The homes are residences of a developmentally disabled population including some individuals who are medically or physically disabled, as well as some who are confined to wheelchairs. 


 


I.                    Qualifications for ALL Registered Nurses (RN) Case Management and Registered Nurses (RN)


 


A.     OPWDD Required Pre-Employment Background Checks


 


1.       Per NYS Social Service Law #11, it is the responsibility of the OPWDD to protect people with special needs. The OPWDD has set up a process by which all potential outside Contractor staff are given pre-employment background checks to insure the safety of individuals while in the Contractor’s care.


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RN Case Management Services


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II.                 RN Case Management Duties to Be Performed


 


A.     Assess individual’s needs and provide nursing care as indicated:


 


1.       Weekly:  visits each individual’s home as assigned; assesses their health care needs and follows-up accordingly.


2.       Provides hands on nursing care as required.


3.       When providing back-up nursing coverage during medical leaves/vacations; includes a weekly contact to ensure these individuals’ needs are met (contact should be on-site but can be via telephone when time does not allow on-site visit).


B.       Monitors individuals’ health progress and provides required documentation:


 


1.       Documents individual’s health care status objectively, clearly and concisely.  Documents whenever there is a change in the individual’s status, and their response to care.


2.       Documentation requirements include but are not limited to:


 


i.        On-going continuing notes, quarterly nursing assessments(ICF); annual nursing assessments (IRA); semi-annual drug regimen reviews(IRA), pressure ulcer assessments; charts – weight; bowel; menses; client specific med sheets; medical information sheets.  All documentation is to be done in time frame specified by nursing policy and procedure.


ii.      Reviews and initials consultation reports and discusses the follow-up course of action with the primary MD in a timely manner.


iii.    Annually evaluates each individual’s capability to self-administer medication. In conjunction with the treatment team, develops goals as indicated to reach their maximum potential for independence.   


 


C.     Coordinates and oversees the scheduling of medical/health appointments to meet individual’s needs:


 


1.       Utilizes and keeps current medical tracking forms.


2.       Works with designated house staff to ensure that medical appointments are scheduled as indicated and adhered to in a timely manner.


3.       Provides a completed, comprehensive consultation report for the staff to take on the medical appointment.


4.       Reviews the consult recommendations and discusses with the primary MD as indicated in a timely manner.


 


D.      Meets the Medication/Pharmaceutical requirements of individuals:


 


1.       Reviews MD orders monthly and verifies accuracy on MAR. Compares new MAR against previous month to ensure changes are carried over. Initials the MD orders and MAR denoting accuracy.


2.       Weekly, reviews the MARs for accuracy and completeness.  Initials MAR at the end of the month and files into consumer chart after verifying that it is accurate and complete.  Follows up when discrepancies noted.


3.       Ensures that medication is ordered by staff in a timely manner.


4.       Ensures that a med inventory is conducted and maintained in accordance with nursing policy.


5.       Establishes and maintains a complete, clean medication station with adequate supplies.


6.       Ensures that meds are logged in and checked upon pharmacy receipt and reports any pharmaceutical dispensing errors to the NPC.


7.       Provides information to the AMAPs on the medication prescribed; their expected effects and possible side effects (client specific medication sheet).


 


E.       Medication Certification of AMAPS:


 


1.       Oversees the clinical competency of AMAPs and documents accordingly.


2.       Provides annual med recertification to AMAPs which includes a written test, observation of medication pour, review of medication administration policies including but not limited to; verification of new orders, transcription of orders, documentation, discrepancy in meds, reordering meds; vital sign competency, health emergency protocol, and nurse on-call procedure.


3.       Follows the Nursing Policy & Procedure with regard to medication errors


 


 


F.      Interdisciplinary Team Member:


 


1.       Keeps team aware of individual’s health status.


2.       Participates at case reviews (ICF = quarterly; IRA = semiannual); provides documentation when attendance at review not possible.


3.       Attends monthly Res. Hab. meetings (provides information should attendance at meeting not be possible).


4.       Advocates for individuals in reference to prioritization of treatment needs


5.       Participates at Surrogate Decision Making Committee meetings.


6.       Communicates changes in medical/nursing treatment &/or health status to staff, assuring information is comprehensive, understood and timely.


 


G.      Training/Supervision of Staff = Direct Care:


 


1.       Develops and maintains information on health conditions and nursing plans of care for individuals residing in each home.


2.       Ensures that staff is trained on individual’s health conditions/nursing plans of care and oversees this on a routine basis.


3.       Is available for consultation with staff, families, community consultants regarding individual’s health care needs.


4.       Ensures that staff is kept aware of universal precautions (infection control standards).


5.       Provides annual medication recertification and ongoing oversight (see III., E.).


H.     Infection Control Surveillance:


 


1.       Notifies Infection Control Nurse of any infectious disease processes e.g. antibiotic therapy, TB conversions, exposure incidents in the residence or at day program.


2.       Reviews and maintains immunization standards for individuals; documents updates on the immunization record and Medical Information Summary.


3.       Adheres to & practices standards as set forth in Infection Control Guidelines


 


I.         Completes all nursing tasks in a comprehensive and timely manner:


 


1.       Completes assignments in an efficient manner and consistent with the time frames allotted.


2.       Provides back up nursing coverage when primary nurse is off duty and contacts the home(s) to determine health care needs at least weekly.


3.       Maintains a current Nursing Policy and Procedure Manual; ensures its accessibility to staff within assigned homes.


4.       Maintains certification in CPR.


5.       Maintains current RN license.


6.       Maintains certification in Infection Control for Health Care Workers.


7.       RN’s must complete all on-line and classroom OPWDD mandated training.  RN’s must also attend 2-day OPWDD mandated Orientation training before their hire date.


 


 


 


 


J.        Medications and tube feeding task as explained in Exhibit B.


 


K.     RN case-manager’s positions require a 40 hrs. per week commitment to be able to comply with NYS practice Act as it applies to nurses in OPWDD.  


L.      RN Case Management is a specialized and highly-skilled component of patient care management. 


 


M.   RN Case Management has an accepted and recognized role in the coordination of care required by patients with chronic, catastrophic or complex high-risk or high-cost health care issues. 


 


N.    RN Case Management also has a recognized role in the coordination of care required by patients with developmental disabilities.


 


O.     Care Management is a set of activities designed to assist developmentally disabled and their support systems in managing medical and mental health conditions and related psychosocial problems more effectively, with the goal of:


 


1.       Improving functional health status and quality of life or dignified dying.


2.       Enhancing the coordination of care


3.       Eliminating the duplication of services


4.       Reducing the need for expensive health care services.


 


P.      The RN Case Manager may have a case load of 24 to 26 individuals based on the acuity of illness, geographical area and/or other factors that may impact care. 


 


 


RN Services


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III.              RN Duties to Be Performed         


 


A.     Provide skilled nursing care to patients requiring short timeframe professional nursing services.


 


B.      Assess, plans and implements client care by following Plan of Care or Doctor’s orders.  Doctor’s orders may consist of:


 


1.       Dressing changes


2.       Insertion and irrigation of urinary catheters


3.       Oxygen administration by mask or cannula.


4.       Ventilator, tracheostomy care and endotracheal suctioning


5.       Gastrostomy tube feedings


6.       Gastrostomy/Jejunum tube medication and flushes.


7.       SQ or IM injections


8.       Insulin administration


9.       Obtain Specimens including blood samples


10.   Nephrostomy tube flushes


11.   Colostomy care and/or irrigation


12.   Administers CPR and other emergency procedures as necessary. 


 


C.     RN’s may have to take the role of camp nurse, clinic nurse, staff development nurse and nurses who perform episodic nurse duties in times of need.


 


D.     RN’s may need to step in and perform LPN duties when needed.


 


E.      RN’s need to Supervise all LPN’s clinically.


 


F.      There is a need for short term/short time nursing that would come under private duty nursing or visiting nurses. These nurses would perform specialized services such as Diabetes Care (injection of insulin), wound care (complex wounds/wound VAC/pressure ulcers), Tube feedings, Trach care and many short term services that take a few hours or less.


 


G.     Completes all nursing tasks in a comprehensive and timely manner:


 


1.       Completes assignments in an efficient manner and consistent with the time frames allotted.


2.       Provides back up nursing coverage when primary nurse is off duty and contacts the home(s) to determine health care needs at least weekly.


3.       Maintains a current Nursing Policy and Procedure Manual; ensures its accessibility to staff within assigned homes.


4.       Maintains certification in CPR.


5.       Maintains current RN license.


6.       Maintains certification in Infection Control for Health Care Workers.


7.       RN’s must complete all on-line and classroom OPWDD mandated training.  RN’s must also attend 2-day OPWDD mandated Orientation training before their hire date.


 


 


Exhibit A.


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Exhibit B.


 


CONTRACT NURSE TUBE FEEDING SKILL SET DOCUMENTATION










































































MEDICATIONS/ TUBE FEEDING TASK



INITIALS/


DATE



 



 



Reviews individual’s MD order.  Notes frequency, type and amount of formula.



 



Gathers additional fluid requirement (flush and hydration).



 



Assembles equipment.



 



Positions individual sitting upright or semi-reclining with head of bed or chair at a 45-degree angle and locks chair.



 



Uses standard precautions throughout the entire procedure.  Washes hands and applies gloves.



 



Observes stoma and skin around gastrostomy for bleeding sores or leakage.



 



Verifies Placement.



 



If checking residual was ordered, aspirates all of stomach contents and notes amount; then re-instills all of the aspirate.  If quantity of residual is greater than physician ordered, DO NOT FEED.



 



Bolus:  Unclamps the tube, allows air bubbles to escape; fills the syringe with feeding solution or attaches prepared feeding bag containing solution (room temperature).  Allows the feeding to flow by gravity, adding solution slowly as contents empty, keeping solution in the syringe all times.



 



Bag/Gravity:  Positions bag at height slightly above individual’s head.  For continuous feeding with pump, places tubing into pump mechanism and set for flow ordered.



 



Maintains flow of formula.



 



Adds prescribed amount of water into syringe or feeding bag (flush).



 



Clamps the tube just above the stoma before the water has completely cleared the tubing.



 



Washes syringe with soap and water; rinse thoroughly and allow to air dry.



 



Can verbalize tolerance and complications associated with tube feeds.  Documents procedure.



 



 


                                                                                               


Contract Nurse Signature                              Date


 


______________________________                _____________


RN Signature                          Date


 


 


Required Qualifications :
Licensed New York State Register Nurse.
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