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About Duke University Hospital

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Duke University Hospital

The Birth Center APP is a CNM, WHNP/FNP or PA-C who provides direct patient care services for antepartum, intrapartum, postpartum and gynecology patients. This practice includes primary as well as specialized care provided in multiple locations including inpatient units and OB triage in the Duke Birthing Center, Duke Regional and outpatient clinics. The Birthing Center APP performs physical exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications and coordinates the care and discharge of patients.

The APP contributes to excellence in patient care, research, teaching and provides leadership to the organization.

• Collaborate with attending physician(s) and healthcare team to assess, diagnose, plan, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care.
• Provide /coordinate clinical practice for patients at Duke Hospital and Duke Regional Hospital being followed on the OB service through established protocols.
• Round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of obstetrical patient care;
• Provide evidence-based clinical care by actively engaging in review of literature
• Assess patients for change in status and institute appropriate interventions. Initiate emergency interventions in an effort to stabilize the patient until physician support arrives.
• Communicate verbally and in writing all pertinent patient information to supervising MD, referring MD, nursing staff, home health, and other relevant healthcare providers.
• Document in patient’s chart all relevant data including but not limited to results of diagnostic tests; laboratory results; patient’s condition and response to therapies/interventions; communications with supervising MD.
• Provide leadership and coordination of care and services for the OB‑GYN Service.
• Utilize prescriptive privileges for identified patient population and in accordance with Duke and NC Board of Nursing regulations.
• Role model competence in advance nursing skills and provides evidence‑based practice.
• May order and/or perform the following procedures:
• Order Laboratory and or diagnostic procedures for
• Term labor
• Preterm labor
• Cesarean delivery
• Postpartum care (including insertion and removal of intrauterine devices and Nexplanon)
• Gynecological care/Primary care including pap smears and STD testing
• Insertion and interpretation of external and internal fetal monitoring (CNM only)
• Insertion and interpretation of tocodynamotor and intrauterine pressure catheter (CNM only)
• Identification of vaginal and perineal lacerations including degree of tear. (CNM only)
• Identify common vaginal infections using microscopy
• Neonatal circumcision
• Assist attending in the OR
• Limited obstetrical ultrasound

• Assess educational needs of the Duke nursing staff and healthcare team members and provide one‑on‑one as well as formal education as needed
• Implement and evaluate appropriate educational programs for nursing staff, MDs, and other healthcare providers as appropriate.
• Role model and precept healthcare learners through contractual agreements.
• Assess educational needs of patients/families and provide culturally‑sensitive patient/family interventions as indicated. Use non‑technical language when educating patients/families. Document educational interventions in the patient’s medical record.

• Utilize current research and evidence‑based decision‑making in all clinical practice.
• Incorporate clinical research finding in the development and implementation of standards of care.
• Support IRB approved clinical research/trials though a…