Hospice Case Manager, RN, Home Visits

Department

39109 Heyman Hospice Care of Floyd - Hospice

Full time

Yes

40

M- F 8am-5pm with occasional on-call.

$35.50 - $53.25

• Professional Performance Standards
• Performs preadmit visits, admission visits, scheduled and non-scheduled routine home visits, pronouncement visits, supervises home health aides and manages patient plan of care.
• Responds to all calls, medical and emotional crises and/or patient deaths. Makes home visits to provide direct care as appropriate. Utilizes other Case Managers, Social Workers, Physicians, and Administrator for assistance as needed. Performs thorough and accurate assessments of patient physical status. Gathers relevant data on coping strategies, support system and learning needs of patient and family. Based on assessment, identifies problems that may be resolved, diminished, or prevented through nursing and/or interdisciplinary intervention.
• Creates individualized care plans based on identified problems and documents in a manner that facilitates the determination and measurement of expected outcomes.
• Derived from identified problems
• Mutually formulated with patient and family and other members of the interdisciplinary team
• Realistic in relation to patient and family current and potential capabilities and choices
• Attainable in relation to patient prognosis and resources available to patient and family
• Documents interventions on the nursing plan of care to attain identified goals. Interventions are consistent with standards of hospice nursing practice.
• Evaluates the effectiveness of interventions in relation to identified goals.
• Documents patient and family response to interventions and communicates to members of the interdisciplinary team.
• Documents and communicates to all other members of the interdisciplinary team revisions in problems, goals and interventions in the plan of care.
• Plans and documents care to carry out planned interventions. Continues to provide planned care until a reason to discontinue is documented.
• Maintains up-to-date patient records so that problems, plans, actions and goals are accurately and clearly stated and changes are reflected as they occur.
• Accepts responsibility for coordinating physical care of patient by teaching primary caregivers, volunteers and employed caregivers how to perform tasks essential to patient care.
• Shares with primary caregivers, employed caregivers and volunteers information on disease process, symptom management and progression of disease process, symptom management and progression of disease process as appropriate.
• Assesses safety status of medical equipment and immediately reports any problems to the vendor. Provides appropriate support at the time of death.
• Interdisciplinary Team Collaboration Standards
• Informs Social Worker of unusual or potentially problematic patient/family issues.
• Communicates with attending physician concerning changes in patient symptoms and disease progression needing interventions
• Utilizes input from primary nurse reports regarding patient plan of care.
• Quality Standards
• Participates in performance/quality monitoring activities as assigned.
• Participates in Process Improvement activities as assigned.
• Adheres to principles of infection control in performing direct patient care.
• Demonstrates understanding of medications most commonly used in palliative care and acceptable dosage titration principles.
• Provides age-appropriate care, as evidenced by performance with applicable standards.
• Demonstrates competency in technical skills related to specialty-based populations.
• Demonstrates competency in critical thinking skills related to specialty-based populations as evidenced by:
• Completes Discipline-Specific tests with passing grades
• Completes applicable education day tests with passing grades
• Observed in the practice of patient care
• Demonstrates familiarity with and adherence to policies of the program and rules and regulations of State, Federal and Private
• Agencies which aid in determining policies.
• Customer Satisfaction Standards
• Consistently addresses the individual needs of each patient and family.
• Assists and…