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Practices in accordance with the philosophy, policies, procedures and standards of Nationwide Children's Hospital (NCH); functions within the NNP scope of practice, current standards of care and NNP practice guidelines agreed upon by the medical staff and Patient Care Services departments; performs all patient management activities in conjunction with the collaborating physician/s in accordance with their Standard Care Arrangement (SCA). Assesses, plans, implements and evaluates an appropriate plan of care including diagnostic and therapeutic interventions, in accordance with scope of practice of an NNP, current standards of care NNP practice guidelines and in conjunction with the collaborating physician/s. Completes daily management and continuous care for a caseload of medically complex neonates in both the acute and recovery phases of their illnesses. Demonstrates competencies defined in NNP responsibilities in providing age-appropriate care to neonates from birth to the age of two years corrected gestational age. Provides family-centered care to meet such family needs as psycho-social support, education, and discharge planning in conjunction with the Case Manager, RN Care Manager, and other related disciplines. Initiates and participates in education, research, professional, and organizational activities that contribute to improving patient care, the scientific knowledge base of Neonatology/neonatal nursing, NNP program operation, or the NNP's own professional development.
Candidates must have experience as an NNP for at least 3 years.
Shift: Rotates day - night, every other weekend.
1. Patient Management: functions within the scope of practice of an NNP, current standards of neonatal care and NNP practice guidelines agreed upon by the medical and patient care services divisions and in conjunction with the collaborating physician according to the Standard Care Arrangement.
2. Elicits, records, and interprets a complete health history and notes its significance for the care of the neonate.
3. Performs a complete standard newborn physical examination, assesses gestational age and distinguishes between normal and abnormal findings.
4. Selects and orders tests and procedures necessary to augment physical findings, and distinguishes between normal and abnormal findings. These tests/orders may include but are not limited to: radiographs, arterial blood gas monitoring, blood chemistries; blood, urine, and spinal fluid cultures; urinalysis; and viral titers.
5. Performs diagnostic and therapeutic procedures, according to established protocols, as necessary for care of the patient. Such procedures include, but are not limited to: endotracheal intubation; administration of emergency medications; placement of umbilical artery and venous catheters; lumbar puncture; closed chest needle aspirations; insertion of chest tubes; venipunctures; arterial punctures; initiation and management of nutrition support; interpretation of blood gases and determination of oxygen requirement; determination of need for respiratory assistance, selection of appropriate technique and initiation of appropriate therapy; administration of blood products.
6. An NNP who holds a Certificate to Prescribe (including an externship CTP) may prescribe medications as allowed by Formulary established by the Committee on Prescriptive Governance (CPG Formulary) and made available by the Ohio Board of Nursing (www.state.oh.us/nur). The APN may prescribe within his/her scope of practice as indicated by educational preparation and/or training. Any ability of APN to prescribe drugs with non-FDA approved indications and not listed in NCH Formulary be indicated in an addendum to the SCA. The NNP cannot write for, or phone in, a prescription unless they have a prior written or verbal order from a collaborating physician, or if the NNP holds a Certificate to Prescribe from the State of Ohio. Office or hospital protocols cannot give the APN legal authority to prescribe. Verbal medication orders must be documented in the patient record by the APN.
7. Documents and effectively communicates the plan of care and patient progress in daily medical rounds and in the medical record.
8. Initiates consults to other services at the direction of the attending Neonatologist and or the collaborating physician.
9. Nursing Care: functions in collaborative role with the professional nursing staff and other care providers.
10. In conjunction with the RN Care Manager:
a. Meets patient/family needs identified in the nursing care plan and contributes to the nursing care plan as appropriate.
b. Meets specific emotional/support needs of families and facilitates resolution of the parents psychosocial concerns, initiating interdisciplinary involvement as indicated.
c. Participates in family teaching and discharge planning as necessary.
d. Communicates with the case manager and RN Care Managers concerning data relevant to patient and or family needs.
11. Assists in assessing the continuing education needs of the neonatal health care team including resident physicians, respiratory care, clinical pharmacists, dietitians, and particularly the nursing staff of the NICU.
12. Maintains clinical competency, participates in yearly advanced skills recertification, and stays informed of current trends in Neonatology and nursing practice.
13. Participates in planning and presenting educational programs for the neonatal health care team, NNP educational program, and other community agencies.
14. Plans and participates in the orientation of new neonatal nurse practitioners.
15. Remains informed of current research specific to the care of high risk infants and families, making this data available to nursing staff and applying it as appropriate to clinical practice.
16. Identifies patient problems suitable for research, and cooperates with research activities at the unit level
17. Establishes professional objectives, evaluates self, and shares progress periodically with the NNP program supervisor.
18. Maintains involvement with professional nursing organizations to promote collegiality and networking.
19. Participates in unit, section, and hospital committees pertinent to care of the neonate and family; assists in the development and evaluation of quality management program, patient care standards, and section/unit objectives.
20. Participates in peer review processes to evaluate patient care and NNP competency.
21. Communicates and interprets the expanded role of nursing in the NICU to other members of the health care professions and interested lay groups.
22. The Advanced Practice Nurse (APN) assumes other duties and responsibilities as assigned.
KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
1. Doctorate in Nursing Practice or PhD preferred.
2. Master of Science Degree in Nursing required.
3. Certificate to Prescribe or Certificate to Prescribe Externship.
4. National Certification as an NNP by an Ohio Board of Nursing approved organization.
5. Registered Nurse with current licensure to practice nursing in the State of Ohio.
6. Certificate of Authority to practice as an Advanced Practice Nurse in the State of Ohio.
7. Minimum of three years nursing experience, of which at least two are in a level II or III neonatal intensive care unit.
8. Current credentials to practice at NCH in accordance with Patient Care Service Administrative Policy #12, required.
9. Demonstrates nursing competence with specific clinical skills and knowledge in the area of neonatal intensive care.
10. Demonstrates leadership, interpersonal skills, teaching ability, advanced level of critical thinking and decision making.
11. Excellent verbal and written communication skills.
MINIMUM PHYSICAL REQUIREMENTS
Note frequency as Constantly (67-100%)
Frequently (34-66%) and Occasionally (0-33%) for each requirement.
Also note any lifting requirements with pound limit.
Sitting Talking on phone/in person Typing on a keyboard Standing/walking.
The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individual so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under his/her supervision.