Nurse Practitioner

SUMMARY

• The Nurse Practitioner (NP) is responsible for primary care to an assigned panel of participants at PACE SEMI. As such, they are responsible for participant acute and chronic care management under direction and supervision of the center Physician-In-Charge (PIC).
• Specific
• DUTIES
• AND
• FUNCTIONS: Chronic Disease Management Responsible for performing monthly quota of comprehensive annual and semi-annual assessments Chronic Care Management visits done every 3 months Changes in chronic disease or new diagnoses, and updating management and treatment plans accordingly Conferring with the Physician and other clinical team members with changes in participant status Pharmacy Prescribing including controlled substances, Schedule 3- Schedule 5 medications, that the supervising physician has delegated Specialty and diagnostic referrals with staff physician guidance Initiating appropriate diagnostic studies, such as laboratory, x-ray and other specialty procedures with physician approval/oversight Interdisciplinary Collaboration- Coordinates care with the IDT , PCT, UM, and other PACE services communicating participant changes to the interdisciplinary team Preventative Care Services
• Acute
• Care
• Management and
• Treatment
• Patient
• Education
• Documentation: Documents in the medical record in the “SOAP Format”, Completion of notes with full assessment preferably within 24 hours but no later than 72 hours, Facilitates Coding capture of Hierarchical Chronic Conditions Utilization
• Management -
• Contributes to
• Utilization
• Management
• Goals of
• Care: Facilitates Advanced Directives, Facilitates Goals of
• Care and
• End-of
• Life
• Discussions with participants and families: Facilitates Advanced Directives, Manages end-of-life with support of consulting hospice service.
• Location of
• Care: Clinic (mostly), Participants Home, Nursing Facility and Telemedicine After-Hours Call- May participate in after hours on-call medical assistance on a rotating basis via telephone triage or after-hours home visits to participants as needed. Participation in Monthly Education Conference SCOPE OF PRACTICE In accordance to Michigan law, an NP may practice independently within his/her scope of practice per professional license; specifically, a Nurse Practitioner may practice independent per RN licensing scope. However, outside of that scope, he/she must practice under the supervising physician’s scope of practice per his/her delegation.