APP Cardiothoracic ICU

Seeking an APP to provide care in the Cardio-Thoracic Intensive Care Unit.  Reasonable for the management of post op cardiac surgery patients, heart transplants, lung transplants, temporary and durable mechanical circulatory devices including but not limited to ECMO and LVAD’s. 

1.  Assessment of Health Status
Performs and documents in the medical record a complete history and physical examination for acute and complex chronically ill patients.
Orders and collects data using appropriate assessment techniques, relevant supporting diagnostic information and diagnostic procedures where indicated.
Assesses for risks associated with the care of the acute and complex chronically ill patient including: medication side effects, immobility, impaired nutrition, fluid and electrolyte imbalance, immunocompetence, invasive interventions and diagnostic procedures.
Coordinates report with day team, presents 24-hour patient report, collaborates in plan of care, and follows assigned patient population throughout the shift.

2.  Diagnosis
Collaborates with interdisciplinary health care team in making diagnoses of acute and complex chronic conditions.
Manages diagnostic tests through ordering, interpretation, performance, and supervision.
Formulates differential diagnoses by priority.
Diagnoses complications and orders appropriate interventions.

3. Formulates Plan of Care
Identifies expected outcomes from diagnosis, and formulates and documents a plan of care to address complex acute and chronic health care needs.
Utilizes evidenced based practice guidelines or protocols in an individualized, dynamic plan of care that can be applied across the continuum.
Recognizes deviations from normal in the physical and formulates appropriate treatment plans for health problems and follow-up.

4. Implements and modifies plan of care
Prescribes diagnostic strategies and therapeutic interventions pharmacologic, non-pharmacologic and surgical, needed to achieve expected outcomes.
Writes prescriptions for medication, blood products based upon laboratory results, routine diagnostic and follow-up studies, therapeutic measures, and post-discharge care in accordance with written practice protocols.
Manages further diagnostic tests through ordering, interpretation, performance, and supervision.
May perform advanced procedures consistent with privileges and competency validation including placement of small bore feeding tubes, central lines and intubations.

5. Communication and Collaboration
Maintains ongoing communication and collaboration with interdisciplinary health care team.
Facilitates and communicates with patient, family and staff to promote continuity of care across the inpatient and outpatient continuum of care.
Assists in the management of family dynamics and coping mechanisms during acute and chronic phases of patient care.

6. Documentation.
Documents key components of patient's progress via daily progress note, transfer, and discharge summary. (H&P, daily progress notes, plan of care, problem lists, procedure notes, acute event note, discharge summaries, in medical record per specific patient unit or service, death summary)
Documentation is timely, meets acute care compliance standards and captures patient acuity.

7. Professional Practice
Demonstrates Professional Practice behaviors including preceptor/mentoring, education and instruction of students, nursing staff, nurses, graduate and novice nurse practitioners.
Seeks opportunities for active engagement in research and the analysis of evidenced based practice.
Actively participates in Grand Rounds, APN council meetings, faculty and unit meetings, M&M presentations.
Maintains CEUs, and membership in a professional organization.