Outpatient Licensed Practical Nurse - LPN LVN

PURPOSE AND SCOPE:

Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the organization Quality Enhancement Goals (QEP).

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Patient Related

Education:

• Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access.

Treatment:

• Welcome assigned patients and inquire as to their wellbeing since their last treatment.
• Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law.
• Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment
• Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD).
• Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed.
• Monitor patients’ response to dialysis therapy.
• Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document.
• Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure
• Obtain Hemostasis and apply appropriate dressings.
• Evaluate the patient prior to discharge.
• Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification
• Responsible for calculating and entry of individual patients’ dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed.
• Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160.
• Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification
• Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes.
• Report any significant information and/or change in patient condition directly to the registered nurse or supervisor.
• Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor.
• Perform and document any intervention for unusual patient status and document patients' response to intervention.
• Evaluate patients’ vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor.
• Obtain all prescribed laboratory testing and prepare specimens for collection.
• Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy.
• Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage.
• Monitors patients performing self-care under the supervision of RN.

Staff Related

• Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse.

Education/Communication:

• Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices
• Maintain environmental integrity and aesthetics - ensure all areas are safe and clean.
• Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy.
• Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT).
• Initiate Solution Delivery System (SDS) system.

RECORD KEEPING:

• Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities.
• Enters all treatment data into the designated clinical application in an accurate and timely manner.
• Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure

omitted entries are completed or corrected by appropriate staff.

• Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart.
• Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination.
• Collect, label, appropriately prepare and store lab samples according required laboratory specifications.
• Ensure collection of lab specimens by appropriate lab courier.

INFECTION CONTROL:

• Assists in collecting information for infection control audits.
• Supports staff and patient Adherence to infection control practices.
• Follows infection control Policies and Procedures
• Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law.

TRANSITIONAL CARE UNIT:

• Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care
• Reinforces all education and care related matters as it relates to the new patient as allowed by state law
• Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan.
• Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them.
• Sets and preforms a treatment on all machines used in the transitional care unit.
• Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up.
• Assists with coordination of transition to patient’s modality choice.
• Assists with supply ordering and inventory for TCU

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.
• Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made.
• 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
• 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 push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and material assist devices for the heavier items.

EDUCATION AND LICENSES:

• High School diploma or G.E.D. required.
• Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline.
• All appropriate state licensure, education, and training (if any) required.
• Demonstrated commitment to organization culture, values, and customer service standards

EXPERIENCE AND REQUIRED SKILLS

• Previous patient care experience in a hospital setting or a related facility preferred.
• Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification.

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