Emergency Advanced Practice Provider; NP or PA – Bedford

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Emergency Medicine Community

The Advanced Practice Provider (APP) within the acute care hospital setting works in collaboration with, and is an integral member of, a multidisciplinary health care team. The APP functions primarily as a hospitalist in an inpatient setting, managing the care of acute/complex chronically ill patients. The APP is typically on a service aligned team managing the patient care from step down to discharge.

The APP may have responsibilities for same patient population during follow up outpatient visits. The APP has a strong foundation in evidence‑based practice/education and provides an environment of safe quality care. The APP demonstrates an advanced level of medical and nursing knowledge, clinical/technical competence, sound clinical judgment, professional communication skills, timely and compliant documentation, and is responsible for professional development and competency validation.

• Assessment of Health Status

  Performs and documents in the medical record a complete history and physical examination for acute and complex chronically ill patients. Orders and collects data using appropriate assessment techniques, relevant supporting diagnostic information and diagnostic procedures where indicated.

• The Physician Assistant may serve as the first responder for both nursing and house staff in the event of patient status changes, orders, and in situations requiring procedural and resuscitative interventions.
• Assesses for risks associated with the care of the acute and complex chronically ill patient including: medication side effects, immobility, impaired nutrition, fluid and electrolyte imbalance, immunocompetence, invasive interventions and diagnostic procedures.
• Coordinates daily rounds with the Attending physician teams, presents 24‑hour patient report, collaborates in plan of care, and follows assigned patient population throughout the day.
• Diagnosis: collaborates with interdisciplinary health care team in making diagnoses of acute and complex chronic conditions; manages diagnostic tests through ordering, interpretation, performance, and supervision; formulates differential diagnoses by priority; diagnoses complications and orders appropriate interventions.
• Plan of Care: identifies expected outcomes from diagnosis, and formulates and documents a plan of care to address complex acute and chronic health care needs; utilizes evidence‑based practice guidelines or protocols in an individualized, dynamic plan of care that can be applied across the continuum; implements and modifies plan of care; prescribes diagnostic strategies and therapeutic interventions both pharmacologic, non‑pharmacologic and surgical, needed to achieve expected outcomes;
  
  may perform advanced procedures consistent with privileges and competency validation including minor suturing, complex wound management, line and tube placements and removals.
• Communication and
  
  Collaboration:
  
  maintains ongoing communication and collaboration with interdisciplinary health care team; facilitates and communicates with patient, family and staff to promote continuity of care across the inpatient and outpatient continuum of care.
• Documentation: documents/dictates key components of patient’s progress via daily progress note, transfer, and discharge summary, and or clinic note where…