Advanced Practice Provider - Critical Care

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** ICU Advanced Practice Provider (APP)
Each APP should have a strong foundation in evidenced based practice and ensuring an environment of safe, quality care. They should also demonstrate an advanced level of medical knowledge, clinical/technical competence, solid clinical decision making, critical thinking skills, professional communication skills, timely and complete documentation, and are responsible for personal and professional development with competency validation.

APPs  provide quality patient and family centered care as a member of the health care team in accordance with SCHS mission, philosophy, policies, and procedures;
They provide specialty medical care within defined scope of practice under the supervision of a licensed physician, are responsible for daily patient flow in the ICU setting, and use critical skills to make appropriate patient health assessments and that should align with the physician’s plan of care. APPs do not directly manage any other caregivers.
* Round on every patient in ICU with the ICU care team (ICU physician, pharmacy, RNs, dietitian, etc)
* Document a comprehensive list of changes to each day’s plan of care
* Update hospital course progression/daily and significant events in the “Care Coordination Note”
* Keep “Problem List” updated (only have current problems in active problem list)
* Ensure labs/imaging ordered for that day or the future (i.e. next morning’s labs) when appropriate
* Place orders while on rounds (i.e. medications, labs, imaging, communication orders)
* Consult specialists
* Be able to answer critical and non-critical patient questions from RN/RT/staff and place orders when necessary
* Teach staff and families about treatment plans
* Facilitate family meetings and goals of care, in collaboration with the attending physician
* Participate in multidisciplinary rounds
* Take Histories and Review of Systems from ICU patients/families, performs physical exams
* Review outside records, completes full H&P’s, orders appropriate diagnostic studies and coordinates among providers.
* Write H&Ps, Consults, progress notes, discharge summaries on ICU patients
* Sign death certificates
* Evaluate each emergency department consults for admission and place admission orders with each admission to ICU, in collaboration with attending physician
* Perform procedures (i.e. central lines, arterial lines, etc) that are consistent with medical staff privileges and individual capabilities
* Discharge patients from ICU while providing discharge orders, summary, medications and prescriptions, proper follow up
* Transfer patients and call “sign out” to hospitalists when a patient transfers out of ICU to the medical floor, PCU, etc.
* Update sign out patient list daily under “Pulmonary sign outs” drive → “ICU sign out” and print for night ICU physician
* Call patient families daily with updates on patient care and answer family questions
* Clinical preceptor for PA and NP students rotating through the ICU
* Provide targeted assessment and evaluation, including diagnostic impression and functional status on presenting problem(s).
* Examine, diagnose, and treat acute and chronic medical  collaboration with the Attending Intensivist
* Effectively utilize team-based care model, leveraging expertise of all members of multi-disciplinary team.
* Share knowledge with other team members and patients both formally (in-services, consult responses) and informally (hallway conversations).
* Collaborate in education with residents and medical students.
* Monitor effectiveness of plan of care.
* Educate patients and families on diagnoses and treatment plans.
* Collaborate and/or consults with physicians and other health care providers as appropriate.
* Help to provide ICU care in collaboration with the attending Critical Care Physician Intensivist: including daily rounds, fielding post-operative patients/admits/transfers, and continuous medical management.
* Document all patient care within the Electronic Medical Record (EMR) and complete all necessary tasks in compliance with health system policies and regulatory agencies to ensure timely and accurate billing.
* Be familiar with the SCHS organization…