NURSE PRACT PD

The incumbent will serve as a high level professional whose activities will span the interface between the physicians and primary nurses who manage inpatients on the Liver Transplant Services at Moffitt-Long Medical Center, UCSF. The Nurse Practitioner will act as a full member of the Liver Transplant Team, taking primary responsibility for the safe delivery of care to inpatients in consultation with attending physicians, fellows and residents. This team member will meet productivity expectations as set forth by the Chief of Transplantation, and performs any duties related to patient care activities that are appropriate and clearly delineated.

The incumbent will be responsible for the inpatient care of patients admitted to the liver transplant service. The incumbent must have excellent communication skills and be able to work with a multidisciplinary team that includes attending surgeons and physicians, resident physicians, medical students, pharmacists, and social workers.

The person in this position complements and assists the work of the surgical residents and the attending staff. All activities will be performed as a part of the physician team and under direct or indirect supervision.

• Independently (independent APP encounter) or collaboratively (shared physician and APP encounter) evaluates and manages patients.

• Includes taking histories, performing physical examinations, responding to changes in patient status, performing consults, ordering or furnishing medications/diagnostic tests/treatments/therapies/consultations/referrals/durable medical equipment (DME)/home health services.

• Care provided must be documented in the electronic medical record in accordance with the UCSF Rules and Regulations.

• Provider services must be billed to reflect the performing provider and comply with the APP Billing Policy 3.08.01.

• APPs must respond to clinical documentation integrity inquiries from the Department of Quality and Patient Safety within 3 days.

• Performs procedures granted to them via privileges/standardized procedures.

• Identifies patients with acute decompensation or failure and responds to the hospital plan of care and reviews with physician.

• Initiates consultations as indicated.

• Documents independent assessment findings and recommends appropriate treatments.

• Participates in service rounds and patient evaluation and treatment planning. 

•  Reviews lab tests, x-rays, and other diagnostic tests, and initiates appropriate team plans.

• Evaluates complex cases, establishes individualized plans of care for disposition to a lower level of care.

• Interprets and acts upon completed tests, procedures, and radiographic studies.

• Completes clinically relevant paperwork/electronic health record (EHR) documentation, including but not limited to ordering medications, completing episodic care notes and discharge summaries in accordance with the UCSF Rules and Regulations.

• Effectively communicates findings, treatment options, and care plans with patients and their families 

• May first assist in the operating room if privileged to do so through OMAG after completing the required certification and proctoring.

• Monitors and evaluates patients for discharge. Sets parameters and guidelines for continuum of care with multi-disciplinary team. This includes evaluating and defining discharge regimen.

• Discharges patients including prescribing/furnishing medications, ordering DME, and recommending or referring for ongoing follow up care, providing discharge teaching, and completing discharge summaries.

• Coordinates care throughout the continuum including hospital admission, care coordination with staff and consulting services, and hospital discharge planning.

• Coordinates episodic care and determines timing of routine clinic follow up.

• Participates in huddles with clinic/hospital staff and anticipates patients who require close management or intervention.

• Consults with nursing staff on plan and implementation of individualized nursing care plans. 

• Independently provides case summaries for disability, insurance agencies, workers compensation, work releases, and medical supply agencies.

• Formulates and implements protocols to improve quality and efficiency and control waste in the clinical specialty.

Minimum License/Certification:

1. California Registered Nurse (RN) License without restriction
2. California Certified Nurse Practitioner (NP) without restriction
3. California Nurse Practitioner Furnishing Number including Schedule II furnishing privileges
4. NP national board certification from an accepted certifying agency aligned with the patient population and clinical role. Adult Inpatient: (ACNP-BC, AGACNP-BC, ACNPC-AG, ACNPC). 
5. California Driver License (if required for position)
6. Drug Enforcement Administration (DEA) Registration with Schedules 2, 2N, 3, 3N, 4, and 5 registered to a California address
7. American Heart Association (AHA) Basic Life Support (BLS) certification
8. Additional required AHA certifications: ACLS
9. Additional required certifications (such as ENLS): none

Minimum Education/Experience:

Graduation from a California Board of Registered Nursing approved or verified school of nursing with a master’s degree in nursing or a Doctor of Nursing Practice (DNP).

• Minimum of one  (1) year of clinical experience as an NP in the same specialty and setting.
   

Minimum Knowledge, Skills and Abilities (KSA):

1. Excellent verbal and written communication skills 
2. Judgement skills to effectively meet the needs of patients
3. Self-direction and organizational skills to function in an independent role
4. Ability to cope with personal stress experienced by health care providers and team members
5. Ability to meet minimum standards for hospital credentialing and billing standards as a billable provider
6. Submit health plan (Medicare, Medicaid, and commercial for all APPs; also, CCS for pediatric providers) enrollment by first clinical day 
7. At all times, must adhere to the UCSF Medical Staff Bylaws, Rules and Regulations, Code of Conduct, PRIDE values, and applicable medical center/campus/departmental policies and procedures
8. At all times, must adhere to all UCSF policies regarding HIPPA, privacy, communication, documentation, encounter closure, and billing
9. Mandatory attendance at the Office of Advanced Practice Providers Orientation Sessions
10. Mandatory attendance at the APP Onboarding Committee APP Onboarding Series
11. This position requires flexibility for the APP to work at all UCSF Health facilities/locations
12. Performs other duties as assigned
 

Preferred Qualifications/Experience:

• Two years or greater NP experience in ICU or inpatient transplant within the past five years

Preferred Knowledge, Skills and Abilities (KSA):

• Able to manage critically ill inpatients

Special Conditions of Employment:

1. This position requires flexibility to work at all UCSF Health facilities/locations
2. This position may require the ability to work flexible hours to meet operational needs
3. This position may require other duties to meet operational needs
4. Peer references are expected to reflect an overall meet or exceeds