This position is working in our Cardiac Surgery ICU department.

In this position the APP will Round with a multidisciplinary team and create a plan for assigned patients. The APP will execute plans and follow up, as well as communicate with ICU attending and Surgical Teams. The APP will be involved with procedures as needed.

The primary procedures in the CSICU p include Central line, Chest tube, ALine, Pulmonary Artery Catheter, Bonchoscopy, Balloon Pump Removal, moderate sedation.

Summary Under general supervision, responsible for diagnosing and treating patients in collaboration with physician colleagues. Provide continuity of patient care by facilitating and coordinating communication between the health care team, patient and patient's family. Coordinate care to ensure quality, cost effective care; appropriate length of stay; and patient safety. Serves as link integrating relevant research and best practices.

Principal Responsibilities

The following statements are designed to describe the general nature and level of work being performed by the provider assigned to this classification. This description is not intended to be an exhaustive list of all job responsibilities performed by this individual.

A detailed description specific to performance functions will be described in the Nurse Practitioner's collaborative written agreement.

1. Clinical Responsibilities
   • In collaboration with the attending physician, provides day to day organizational and clinical direction and leadership of the healthcare provider team.
   • Performs comprehensive history and physical assessment for patients admitted/scheduled to service/practice setting.
   • Orders, obtains and interprets appropriate diagnostic tests.
   • Establishes medical diagnosis based on history, assessment, and diagnostic findings.
   • Designs, orders and documents appropriate treatment plans/plans of care including prescriptions of medications based on a comprehensive review of HPI and diagnostic results.
   • Initiates protocols/clinical pathways, evaluates the plan of care ensuring timely intervention.
   • Performs invasive procedures.
   • Collaborates with attendings and residents regarding admission, discharge and transfer decisions.
   • Presents patients in the nurse practitioner's caseload on rounds.
   • Communicates plan of care with appropriate providers including the collaborative physician, the primary care provider, the referring provider, the nursing staff, and the case manager.
   • Communicates plan of care with the patients and family members. Provides patient and family instruction related to the plan of care, disease process, new treatment plans, and medication regimens.
   • Counsels and educates patients and family members in disease process, health maintenance and health promotion activities. Provides primary, secondary, and tertiary preventive care services.
   • Initiates appropriate referrals and specialty consultations or other agency involvement as needed.
   • Facilitates patient flow. Collaborates with the multidisciplinary team including case management ensuring appropriate and timely discharge.
   • Provides specialty consultation.
   • Advocates for patients ensuring patient/family participation in care, knowledge of treatment options, and understanding of patient rights.
   • Considers the holistic needs of patients and orchestrates resources (i.e. Pain service, palliative care)
   • Performs other activities as delineated in individual nurse practitioner written agreements.
2. Education Responsibilities
   • Provides formal and informal educational programs for other members of the health care team consistent with evidence-based practice standards.
   • Participates in mentoring activities. Precepts students.
   • Promotes understanding of disease processes in area of specialty/program.
   • Functions as a clinical resource for other team members including but not limited to interns, residents, fellows, nurses, and medical students.
   • Provides community education, health promotion and outreach.
   • Acts as a community health resource for specialty disease entity.
3. Clinical Leadership/Outcomes
   • Is responsible for coordinating adequate nurse practitioner coverage on their service. Works with the physician and nurse practitioner staff to assure this coverage.
   • Works with physician leaders and hospital administration to achieve service specific outcome targets for key metrics including clinical outcomes, LOS, cost of care and patient satisfaction.
   • Participates in performance improvement activities aimed at improving clinical outcomes and minimizing variation.
   • In collaboration with physician leadership and the multidisciplinary team, develops clinical pathways.
   • Participates in and leads quality assurance activities (i.e., chart reviews, peer review) and establishes standard of practice.
   • Advances the patient care delivery process through the application of research, evidence-based practice standards, and industry best practices.
   • Advises and influences hospital level policy and procedure that improves the delivery of care.
   • Introduces and evaluates new patient care delivery systems, models of care and therapeutic and preventive interventions that target patient needs not met by current care delivery strategies.
   • Actively participates and contributes to various department and division meetings and organizational initiatives.
   • Maintains compliance and regulatory documentation for administrative purposes and reimbursement for services.
   • Participates in accreditation readiness.
   • Supervises ancillary staff including completing annual reviews.
4. Customer Service
   • Models and upholds a customer service focus to all internal and external customers.
   • Demonstrates respect for all people in the work environment.
   • Ensures confidentiality of patient information.
5. Professional Development and Organizational Leadership
   • Serves on department, hospital and community committees.
   • Maintains professional licensure, certification, and collaborative agreement as required by the Maryland State Board of Nursing and national certifying organizations
   • Participates in department educational opportunities (i.e. journal clubs, grand rounds, etc.).
   • Participates in and presents at local, regional, and national professional organizations.
   • Pursues educational opportunities for professional growth (i.e. CEUs, update conferences).
   • Promotes the organization to all customers. Acts as a loyal and supportive informed spokesperson for the hospital.
6. Research Responsibilities
   • Serves as a clinical trial sub investigator participating in or coordinating all phases of industry sponsored research.
   • Doctorally prepared nurse practitioners are expected to conduct nursing research as the principle investigator adding to the body of knowledge in the nursing domain.