Provides individualized nursing care as needed in accordance with the Individualized Service Plan (ISP) or Person-Directed Plan (PDP) and current nursing standards of care, including but not limited to administering and monitoring medications for efficacy, adverse effects, precautions, contraindications and potential interactions with other medications as well as monitoring vital signs and the overall health status of the person supported.
Performing procedures as ordered by the physician and by in accordance with state law and standard nursing practices.
Maintaining medical records to reflect timely, accurate, legible and complete documentation.
Communicate as needed with families, conservators, guardians, case service managers/QIDPs, service coordinators, direct support staff, physicians and other medical, counseling and therapeutic professionals to ensure the coordination of nursing care.
Provide training as needed to persons supported, staff, family members, guardians or other significant persons based on the person supported’s individual needs, including but not limited to training on their special needs, diagnoses, medications, treatment, nutritional requirements, medical and adaptive equipment and other health related issues.
Perform and document timely focused assessment(s) of person supported’s after emergency department/urgent care treatment or discharge from hospitalization and as needed thereafter. Document and report any and all significant concerns or changes in person supported’s conditions to the proper personnel.
Ensure that all medical and adaptive equipment continue to be appropriate and are in safe working order, reporting any and all defects immediately to appropriate administrative staff.
Ensure that all medical and therapy appointments are scheduled and completed.
Ensure that all staff, family members, or other persons in contact with the person supported receive instructions to prevent the spread of infectious diseases.
Performing all job duties in adherence to state and federal laws concerning confidentiality, including HIPAA Privacy Laws.
Ensure that all physician orders are current for all medications and treatments.
Ensure that all medications, treatments and therapies are performed and received in a timely manner according to current regulations and applicable standards.
Ensure that all Medication Administration Records (“MARs”) are current, correct and properly completed by all staff.
Review all post hospital orders and records and update person supported medical records accordingly.
Under direction from Lead RN and/or supervising RN, provide care and complete/submit in a timely manner all documentation supporting services as outlined in the assessments and IPC utilizing the back-office-web and/or other system of record.
Ensure all medications are labeled, stored and secured properly according to current standards and guidelines.
Meet with assigned RN for routine periodic clinical and administrative supervision in accordance with BON standards for licensed vocational nursing.
ADDITIONAL DUTIES AND RESPONSIBILITIES
Ensure the timely completion of all required nursing documentation including but not limited to health assessments, billable and non-billable nursing logs, as well as information required to be entered and updated electronically into the company data base.
Ensure the timely completion of all required nursing documentation including but not limited to health assessments, as well as information required to be entered and updated electronically into the company data base.
Must be available to work any shift in any home to support the nursing schedule when needed.
Must have the ability to support with education/mentoring of field LPN staff when needed.
Must have the ability to audit medical information while on duty.
Must be able to support office needs as assigned.
Must have the ability to deal tactfully with others, to exercise good judgment, to understand and follow written and oral instructions, and to express ideas clearly, both verbally and in writing, in English.
Must be able to safely lift, transport, and transfer persons supported, which may include but not be limited to lifting and transferring in and out of a vehicle, bed or wheelchair, as appropriate and needed to assist with the person supported’s assisted daily living skills.
Under the direction from the Lead RN, support the Area in meeting designated Key Performance Indicator (KPI) for revenue/nursing labor costs
Physically able to perform the essential functions of the job as described in the essential duties and responsibilities sections including; walking, bending, stooping, kneeling, squatting, sitting, reaching overhead and lifting up to fifty (50) pounds.
Must be able to safely lift, transport, and transfer persons supported, which may include but not be limited to lifting and transferring in and out of a bathtub, vehicle, bed or wheelchair, as appropriate and needed to assist with the person supported’s assisted daily living skills.
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