NURSE PRACTITIONER-POST DISCHARGE CLINIC

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Company: LifeBridge Health

Location: Baltimore, MD 21215

Description:

This is a split position between Carroll Hospital and Sinai Hospital.

Summary-Provide direct patient care and consultation in the Disease Management function, including use and analysis of tele-monitoring processes and community outreach. Provide education in support of function's services.

Care Solutions (Disease Management) Consult: Provider will provide consultation on patients with chronic conditions such as COPD, CHF, and others. Disease Management NP will review patient charts daily for correlation with clinical guidelines (Project RED/Hospital Discharge Checklist). Related responsibilities include:
Collaborate with the attending/PCP/care team
Participation in multi-disciplinary rounds on Project RED units
Visit patient at bedside to assess education/follow up needs
Provide education to patients about CHF
Educate patients and providers about the Care Solutions program
Evaluate for appropriateness of tele-monitoring program. or if patient meets criteria for tele-monitoring, the NP will educate patient on how to use equipment and will consult with PCP to develop a care plan to manage the patient and alerts.

Care Solutions Clinic: Provide hospital discharge follow-up care to patients as scheduled. Support community providers in the management of patients with chronic conditions

Telemonitoring Program: NP will:
  • Assess patients for appropriateness of program
  • Assess cognitive and functional capability
  • Obtain patient consent
  • Educate patient about the program including expectations
  • Set patients up in the portal
  • Provide patient with equipment or place order for collaborating agency to install/de-install equipment
  • Consult with PCP to discuss and develop care/treatment plans
  • Monitor the portal
  • Collaborate with cognizant call center nurses to manage alerts and interventions
  • Potentially visit patients at home (if nurse is secured) within 48 hours of discharge Director and NP will educate providers, case managers, nursing and community on program


Requirements: Graduate of a NP program (Acute Care or Family Nurse Practitioner). Must have over 2 years of APP experience to be considered for this role. MBON APP experience

BLS required.

#APP

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