LPN, CCS - Home Health

Develops, maintains, and provides expert level of knowledge and skills related to nursing services, treatments, diagnostic and preventative procedures to patients consistent with agency policy, state practice acts, Oregon/Washington State Nurse Practice Act and applicable state and federal regulations working under the direction of a registered nurse. Facilitates and completes follow-up duties on patients plan of care as directed by clinician to include but not limited to: processing of prescriptions and forms; reminder of screening/diagnostic tests that are due; scheduling/staging of procedures, tests, referrals, and/or return appointments; and obtaining and inputting patient data to monitor progress into the electronic medical record.

Participates with the Health Care Team in delivering quality and customer focused care to patients in a manner which reflects Kaiser Permanentes organizational and nursing mission, vision and values.  Provides nursing and administrative support to clinicians and other health care team members to offer a variety of health care services to patients.  Clinical duties involve both direct (in person) and indirect (via phone or on-line) patient care activities requiring both simple to complex nursing knowledge and skills.  As appropriate to the LPNs scope of practice, the LPN is expected to have competent focused/limited nursing assessment and triage skills on routine or self-limiting health conditions, critical thinking, communication, problem-solving and decision-making skills in order to meet patient needs and contribute to a positive care experience and work environment.  Performs clinical tasks and procedures under the direction of a clinician, within the scope of the LPNs professional training and individual competency.  Works under the clinical supervision of the clinician or registered nurse and under the general direction of the designated supervisor.

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• Clinical Tasks:  These job tasks provide patient care and are to be performed competently, consistently, accurately and according to established regional/departmental clinical protocols, policies and procedures and standards.  They are:
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  • Prepares and organizes patients office visit for known reason/procedure by ensuring that all appropriate tests, clinical information (e.g. diagnostic test results, consultation reports, outside reports, etc.) and order entries are ready for clinician review prior to appointment time.
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  • Performs focused/limited nursing assessment and triage on routine or self-limiting medical conditions as directed by RN/clinician. .  Recognizes when to defer to and/or assist with comprehensive assessment for complex medical conditions by RN/clinician.
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  • Utilizes standardized tools (e.g. PST, health maintenance alerts) to identify and address health maintenance/care gaps with patient and alerts clinician on those that require his/her attention.
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  • Recognizes signs and symptoms of common and routine medical conditions/illnesses, abnormal versus new/existing and implements planned nursing and medical interventions as delegated by RN/clinician.
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  • Contributes to the development, implementation or modification of the individualized patients plan of care under the direction of the RN/clinician.
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  • Prepares patient for actual visit/procedure prior to clinicians exam during rooming-in process.
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  • Assures exam/procedure room contains appropriate supplies, equipment, forms and educational materials are available and ready for use during visit/procedure. Checks equipment are in safe working order and cleans room after use.
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  • Provides health teaching/education or advice on routine or self-limiting medical conditions, procedures, tests, surgeries, self-injections, etc.
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  • Utilizes standardized tools to determine patients level of engagement in self-care as directed by RN.
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  • Uses KP HealthConnect and other information systems to document all pertinent data and outcomes of nursing care according to standardized procedures and policies such as and not limited to the use of SBAR, SOAP or APIE, KP HealthConnect smarttools, etc. Updates demographic/historical clinical data gathered in electronic medical record.
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  • Clinical Procedures:
  • Performs diagnostic tests, therapies and procedures within scope of practice competently and with maintenance of proficiency according to: a) specific department standards on core clinical tasks (see departments list of core skills); b) application of knowledge and skills appropriate to developmental age of patient; and c) established policies such as and not limited to patient safety, aseptic and sterile techniques and infection control.  Examples of categories of clinical tasks are:
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  • Screening tests - e.g. vital signs, vision, hearing, developmental, LOPS, pain, etc.
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  • Diagnostic tests - e.g. urine dips and drug, spirometry/PFT,  bladder scan, O2 saturation rate, allergy skin testing, treadmill assist, etc.
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  • Medication administration via oral, topical, otic, rectal, vaginal, IM, SubQ, intradermal, IV (includes insertion & d/c of peripheral line, use of pump), ophthalmic, bladder, inhalation and nasal routes.
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  • Wound care - e.g. routine and complex dressing changes, staple/suture removal, ostomy, drains management, etc.
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  • Therapies - e.g. photo, laser, foot care, etc.
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  • Application and/or removal of orthopedic appliances and other devices - e.g. splints, slings, orthotics, cast, crutch management, anti-embolic stockings measurement, procedural safety restraints, etc.
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  • Tube insertions/care - e.g. urinary catheterization, NG tube, suctioning, tracheotomy, etc.
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  • Minor surgical procedures assist - e.g. biopsies, excisions, insertion of devices, D&C, etc.
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  • Medical procedures assist - e.g. PAP, colonoscopies, sigmoidoscopies, colposcopies, joint aspirations, lumbar puncture, etc.
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  • Lab specimens collection and labeling - e.g. nasopharyngeal, wound, throat, etc.
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  • Irrigations - e.g. eye, ear, bladder, wound.
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  • Instrument/equipment set-up, cleaning and processing (sterile and non-sterile) - e.g. scopes, cryogun, O2 tank, procedural trays, etc.
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  • Ambulate/transfer of patient using lift equipment.
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  • Other procedures outlined in the core skills checklist as attached.
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  • Practice Management Activities: These job tasks are primarily indirect patient care (i.e. non face-to-face) to be performed competently, accurately and consistently according to established regional/departmental clinical protocols, policies and procedures and standards.  They are:
  • Maintains and adjusts clinicians patient schedule for efficient patient that facilitate appointed visits and overbooks.
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  • Answers and responds to in-coming messages/requests via telephone, mail or kp.org from patient or other department(s) by collecting and communicating pertinent data requiring clinicians review and input.  Responds to messages on routine medical concerns that can be addressed by giving advice or health instructions.
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  • Facilitates and completes follow-up duties on patients plan of care as directed by clinician to include but not limited to: processing of prescriptions and forms; reminder of screening/diagnostic tests that are due; scheduling/staging of procedures, tests, referrals, and/or return appointments; and obtaining and inputting patient data to monitor progress into the electronic medical record.
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  • Assists in coordinating patient care to support patient with complex health needs in navigating easily through the health care system as directed by clinician/RN.
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  • Sorts and prioritizes mail containing patient and/or clinical information requiring clinicians review and attention.
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  • Provides population-based care outreach activities to include health maintenance screening as directed by clinician.
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  • Teamwork, Leadership and Professional Development Activities:
  • Performs appropriate daily activities to start workflow in work area per team agreements and procedures.  Demonstrates flexibility and ability to reprioritize workflow to handle urgent/emergent demands of the team effectively.
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  • Responds and assists with medical emergencies as directed by clinician/RN.
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  • Serve as a clinic resource for other team members and assists with mentoring, coaching or training peers.
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  • Reports errors, near misses or other hazards in a timely manner per established procedures.
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  • Obtains instruction, supervision and consultation as necessary before implementing new or unfamiliar procedures or techniques which are within his/her scope of practice.
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  • Completes annual competency assessments and trainings by meeting organizational standards and expectations.
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  • Demonstrates and maintains clinical knowledge and skills related to departments clinical area and contributes new ideas to assist team in achieving departmental/regional quality and service goals/initiatives.
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  • Other duties as assigned consistent with job description.
  
  
  Basic Qualifications:
  Experience
  • Minimum one (1) year experience as a licensed practical nurse in home care or the acute care setting (preferably medical/surgical). Will consider other experience with ability to demonstrate critical thinking and clinical skills.
  • Per the National Agreement, current KP Coalition employees have this experience requirement waived.
  Education
  • Graduate of Accredited School of Nursing
  License, Certification, Registration

  • Practical Nurse License (Washington) within 3 months of hire OR Compact License: Practical Nurse within 3 months of hire

  • Practical Nurse License (Oregon)
     

  • Drivers License (in location where applicable)
     

  • Basic Life Support within 0.5 months of hire
     
  Additional Requirements:
  • Demonstrated clinical nursing skills.
  • Demonstrated interpersonal and customer service skills (Assessment required for external candidates).
  • Demonstrated communication (written and oral) skills.
  • Demonstrated literacy in using computers and keyboarding.
  • Skills in problem-solving, setting priorities and using good judgment for decisions.
  • Ability to work independently and efficiently under pressure.
  • For the purposes of Home Care the LPN does not perform assessments but evaluates patient condition. The LPN does not do any delegation in the home setting.
  • Clinical Care:
  • Under direct and indirect supervision of the RN:
  • Provides nursing services, treatments, diagnostic and preventative procedures within their scope of practice.
  • Develops, maintains, and provides expert level of knowledge and skills related to nursing services, treatments, diagnostic and preventative procedures to patients consistent with agency policy, state practice acts, Oregon/Washington State Nurse Practice Act and applicable state and federal regulations working under the direction of a registered nurse.
  • Provides direct patient care following established plan of care by registered nurse. Uses standard precautions in providing all patient care.
  • Evaluates and provides patient and family/caregiver education and information pertinent to plan of care.
  • Assist patient/caregiver in learning self-care techniques and disease process education.
  • Uses equipment and supplies effectively and efficiently. Participates in coordination of home health services, reporting changes and identified needs to appropriate clinicians, registered nurse/ public health nurse and clinical supervisor. Participates in multi-disciplinary team conferences and inputs as appropriate to provide quality patient care for services.
  • Advocate for the patient and family, as well as the healthcare system to optimize utilization of resources. This includes acting on behalf of the member to ensure they are informed of their financial obligations and understand their appeal rights.
  • Demonstrates ability to identify and solve problems.
  • Ensure regulatory and compliance standards are met in collaboration with others in the inter-disciplinary health care team.
  • Must be able to work in a Labor/Management Partnership environment.
  Preferred Qualifications:
  • Ability to stand, sit, walk, crawl, climb, bend, stoop, squat, twist, and drive a vehicle throughout assigned shift hours.
  • Lifting and carrying:
  • Able to lift and carry at least 25 pounds.
  • Able to assist in the movement of patients and/or equipment whose weight may range from 100-300 pounds. May occasionally be required to provide care to patients exceeding 300 pounds.
  • Bending: Able to bend frequently throughout assigned shift at both the waist and knees.
  • Standing/walking: Able to stand/walk on a variety of surfaces ranging from carpet to concrete when transitioning between outside environment and patient residences.
  • Sitting: Able to sit for several hours per shift when completing paperwork and driving to and from patient residences.
  • Arm/hand use: Constant arm/hand use is required when performing patient care, charting, and driving. Ability to manipulate small objects involved in patient care (catheters, needles, point of care testing equipment, etc.).
  • Pushing/pulling (It is recommended that patients or objects not be pulled):
  • Able to assist patients reposition in bed.
  • Push patients in wheelchairs with weight ranges as listed above.
  • Able to assist with patient transfers for patients with weight ranges as listed above.
  • Climbing/Crawling:
  • Able to climb stairs on a daily basis.
  • Able to crawl on rare occasions to retrieve dropped items.
  • Driving: Able to drive an average of 60-72 miles per shift to and from patient residences in varying times of day or night; varying traffic settings; and inclement weather conditions. Note: Employees are required to follow all prescribed safety precautions and procedures in order to avoid accidents or exposure to illness. Two (2) or more years of nursing experience in assigned departments clinical area (e.g. Pediatrics, FP/IM, OB/Gyn, Surgery, Allergy, Dermatology, Urology, etc.) within an ambulatory care setting.
  • Four years experience as a licensed practical nurse in the acute care setting, medical/surgical setting.
  • One year working in a hospice, palliative care or home care program.
  • IV therapy experience or recent certification.
  • Familiarity in documenting in an electronic medical record system.
  • Current working knowledge and clinical skills in providing routine care, education and advice in assigned departments clinical area OR successful completion of appropriate competencies for assigned primary/specialty care department. Additional physical requirements for home care:
  • Employees are required to follow all prescribed safety precautions and procedures in order to avoid accidents, exposure to illness, or placing themselves in situations of high risk for injury. When mobilizing patients it is recommended that staff elicit assistance of caregivers in the home and adaptive equipment as appropriate for the patient. When caregivers or equipment are not available to assist, then have discussion with a Supervisor to discuss alternative care arrangements for the patient. Employees are strongly encouraged to discuss any concerns regarding any physical limitations with the Supervisor to prevent injuries, accidents, and exposures to illness. The requirements listed below do not fully reflect all physical elements of the job, but represent the most often performed physical activities associated with this position. Reasonable accommodations may be made to enable individuals with limitations or disabilities to perform the essential functions.Physical requirements include:
  Notes:
  • Variable shifts/days/weekends/holidays