Jacksonville, FL 32205
Under the supervision of the PACE Clinical Manager, assist with the flow of clinic or home care services ensuring high quality standards. Performs duties such as delivering participant care, administering treatments, monitoring vital signs, performing tests, handling medical emergencies, recording participant behavior and all additional participant care services performed in the home. May be asked to be present for the daily IDT (Interdisciplinary Team) Meeting and coordinated services with primary care team. Assesses and monitors participants’ health status, provides nursing care, administers prescribed medications, educates and counsels participants and families, in collaboration with primary care physician and other team members.
As needed, conducts initial assessments, start of care assessments, and periodic reassessments, plan of care, coordination of 24-hour care delivery, regularly informing the Interdisciplinary Team (IDT) of the medical, functional, and psychosocial condition of each participant, remaining alert to pertinent input from other team members, participants caregivers, as well as documenting changes in a participant’s medical record consistent with documentation policies established by the Clinical Manager or Medical Director. May provide care at the PACE Clinic, participant’s home, and in a facility during short term care/ respite. Participates in nurse on-call rotation to cover after hours clinical needs of participants.
Duties and Responsibilities:
- Perform clinical nursing duties with high integrity and quality
- Oversight of a patient care team; providing clinical nurse care management to all aspects of the participant care needs and collaboration with the Inter-Disciplinary Team
- Conduct nursing visits which may include, but not limited to wound care, assessments, injections, urine, pill counts, TB tests, etc. (as directed by providers)
- Ensure participants are seen on a timely basis
- Perform basic in-house lab tests; obtain and process specimens for outside laboratories, when applicable
- Take and record vital signs, recognize any variances, outliers, or red flags, and take appropriate action
- Conducts an in person comprehensive initial nursing assessment with new PACE Partners enrollees
- According to PACE Partners policies and/or as directed by the Medical Director or Clinical Manager, provide medications, and conduct medication reconciliation
- As directed, participate in the Intake and Assessment meetings
- Completes the nursing assessment form on visitors and on participants at assigned schedule as needed
- Provide participant triage and assessment and obtain health information and relevant data
- Observes, records, and reports participant’s condition and reaction to drugs and treatments to Clinical Manager and Medical Director
- Implements orders written by the Medical Director
- Notify the Medical Director of any marked change in the participant’s condition
- Provision of emergency care including arrangements for transportation
- Instructs and educates participants and family regarding medications and treatment instructions
- Maintains and reviews participant records, charts, and other pertinent information
- Documents test and examination results
- Ensure narrative nursing notes are documented in a timely manner (within 24-hours)
- Ensures that appropriate staff maintains a list of medical supplies
- Develops and implements an individualized "self-administration of medications" education program for participants
- Demonstrates positive interpersonal relations in dealing with fellow employees, managers, and other department employees to maximize positive employee relations and productivity
- Maintains a clean, safe, home environment, promotes accident prevention, and reports potential hazards
- Demonstrates professional practice in participant care by use of established standards in planning, organizing, implementing, and evaluating
- Maintains current, written records in compliance with regulatory standards; prepare a variety of written reports and correspondence
- Perform duties in accordance with Code of Professional Nurses
- Acts only within the scope of his or her authority to practice
- Demonstrates the ability to obtain information and interpret information in terms of participants’ needs
- Demonstrates knowledge of growth and development
- Exhibits appropriate communication skills necessary for ages served (adult/geriatric)
- Proactively involves the healthcare team in the care of the participant
- The quality of the assessment allows for anticipated changes in the participant’s condition/status
- Makes suggestions that positively impact the delivery of care
- Be a leader and role model in the planning and provision of participant education.
- Works collaboratively with interdisciplinary teams to meet the needs of the participant and family
- Consistently demonstrates superior communication skills and developmental knowledge of the geriatric population
- Ensures HIPPA compliance in maintenance and storage of medical records.
- Communicate effectively with members of the IDT as appropriate to keep them abreast of any issues or concerns
- Communicate with weekend and after hour staff, following up appropriately
- Manage and review participants’ records, charts, pertinent information, and staff’s documentation
- Document as needed in medical records according to PACE Partners Program standards
- Perform general skilled nursing care to participants.
- Perform or supervise the administration of prescribed medications and treatments in accordance with nursing standards
- Assist in treatment, examination and testing of participants
- Educate participants, family and caregivers in care, medications, treatments, and all other aspects of health education as needed
- Educate staff in care and treatment of the elderly as needed
- Follow all PACE Partners Program Policies and Procedures and OSHA safety guidelines
- Protect privacy and maintain confidentiality of all company procedures and information about employees, participants, and families
- Handle potentially infectious specimens with established biohazard precautions and practice standard precautions
- Participate in and supports Quality Improvement initiatives
Qualifications and Requirements:
Education
- Associates Nursing Degree required; Bachelor’s degree in nursing preferred
- Registered Nurse license
- BLS Certification required
- ACHA Background Level II
Experience
- Have 1 year of experience working with a frail or elderly population OR, if the individual has less than 1 year of experience but meets all other job requirements, the candidate must receive appropriate training from the PACE organization on working with a frail or elderly population upon hiring.
- Meet a standardized set of competencies for the specific position description established by the PACE organization before working independently.
- Two-years nursing experience in a hospital, nursing home, or community-based setting, preferred
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