Physician Assistant - Pediatric Cardiac Stepdown Unit

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About Duke University Hospital

Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of Duke Health s four hospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

Duke University Hospital

The Duke Hospital Pediatric Critical Care Medicine Cardiac Stepdown Advanced Practice Provider (APP), including both Nurse Practitioner (NP) and/or Physician Assistant (PA), provides direct patient care services for critically ill pediatric patients aged 0-21 with acute, complex, and chronic illness across a variety of care settings. It is appropriate for the NP to provide care for an aging pediatric patient beyond the age of 21 with a pediatric condition for a limited period of time.

Pediatric Cardiac Stepdown APPs will be a part of the Pediatric Critical Care Medicine team and will care for patients on the stepdown unit.

Utilizing acquired knowledge of physiology, pathophysiology and pharmacology, the PCCM APP exercises independent decision making in the assessment, diagnosis and development of the plan of care for patients on the PCCM service. In collaboration and consultation with the supervising physician, the PCCM APP contributes to excellence in patient care. As an advanced practice provider, the PCCM APP is additionally involved in education, consultation, research and leadership throughout the Duke Health System, organization and profession.

Clinical Expert

• In collaboration with attending(s) and/or fellow/residents, round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care.
• Provide and coordinate clinical care for service specific patients through established protocols and under the supervising physician or back up physician who is either on site or available by pager.
• Collaborate with the residents, fellows, attending, other APP colleagues, nurses, and other staff to formulate treatment plans and monitor patient progress.
• Perform procedures specific to the work environment after demonstrated competency and within the guidelines of scope of practice and credentialing protocols.
• Assess patients for change in status and institute appropriate interventions. Initiate emergency interventions in an effort to stabilize the patient
• Postoperative stabilization and management.
• Develop patient care pathways, protocols and guidelines for the management of specific problems in conjunction with physicians and other members of the health care team.
• Analyze clinical practice patterns to provide the best medical care and to increase effectiveness and efficiency.
• Communicate verbally and in writing all pertinent patient information to supervising MD, nursing staff, patient resource manager, home health agency, and other relevant healthcare providers.
• Document in the patients  medical record all relevant data including but not limited to results of diagnostic tests; laboratory results; patients  condition and response to therapies/interventions; communications with supervising MD.
• Utilize prescriptive privileges only for identified patient population.
• Prescriptive authority for prescribing, ordering, and or administering drugs; including (but not limited to) schedule II, III, IV, and V drugs and necessary medical devices.
• Role model competence in all nurse practitioner / physician assistant advanced skills.
• Give daily handoff to appropriate attending, APP, fellow, resident and/or intern at the end of the shift.
• Provide evidence base clinical care to pediatric patients cared for by the division of PCCM
• Gather pertinent information systematically and skillfully from all sources:
  History, diagnostic tests, comprehensive physical exams, behavioral and developmental assessments.
• Bill appropriately for all APP services.

Educator

• Assess educational needs of the patient-care staff and provide one-on-one as well as formal education as needed.
• Assess educational needs of the patients / families and provide culturally-sensitive patient/family education interventions as indicated. Use non-technical language when educating patients and families. Document all education in patients  medical record.
• Implement and evaluate appropriate educational programs for DUHS patient care staff and other healthcare providers as appropriate.
• Role model and precept healthcare learners through contractual agreements.

Research Utilization and Investigation

• Utilize current research and evidence-based decision-making in all clinical practice.
• Incorporate clinical…