PURPOSE AND SCOPE:

The professional registered nurse Outpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 criteria or attained through advancement from RN CAP 1. This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention, and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs, and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state, and federal regulations.

• Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses.
• Performs ongoing, systematic collection and analysis of patient data pre – during – post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed.
• Assesses, collaborates, and documents patient/family’s basic learning needs to provide initial and ongoing education to patients and family.
• Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients.
• Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness.
• Initiates or assists with emergency response measures.
• Serves as a resource, leader, coach, mentor and role model for new and incumbent employees by setting examples of appropriate behavior, work habits and attitudes towards patients, co-workers, supervisors and the company at the facility, and area level. 
• Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections.
• Identifies expected outcomes, documents, and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team.
• Ensures patient awareness related to transplant and treatment modality options.
• Participates in education and quality improvement projects at the facility and area level as directed by Supervisor.
• May serve as a Preceptor to new employees.
• Required to complete CAP requirements to maintain or advance.
• Performs all other duties as assigned by Supervisor.

PHYSICAL DEMANDS AND WORKING CONDITIONS:

The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. 
• This position requires frequent, prolonged periods of standing and the employee must be able to bend over.
• The employee may occasionally be required to move, with assistance, machines, and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. 
• The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. 
• May be exposed to infectious and contagious diseases/materials.
• Day to day work includes desk work, computer work and interaction with patients, facility/hospital staff and physicians.
• The position may require travel to training sites or other facilities.
• May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above.

SUPERVISION:

• Assigned oversight of Patient Care Technicians//LVN/LPNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following:
  •  Successful completion of all FKC education and training requirements for new employees.
  •  Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN.

EDUCATION and LICENSURE:

• Graduate of an accredited School of Nursing.
• Current appropriate state licensure.
• Current or successful completion of CPR BLS Certification
• Must meet the practice requirements in the state in which he or she is employed.

EXPERIENCE AND REQUIRED SKILLS:

• Entry level for RNs with minimum of 2 years of Nephrology Nursing experience

ACKNOWLEDGEMENT:

I acknowledge that I have read and accepted this job description. I understand what is expected of me in this position, and I am able to perform the essential functions as outlined with or without reasonable accommodation. Furthermore, I understand that the duties and responsibilities listed in this job description are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. If I have any questions about duties and responsibilities not specified in this job description that I am asked to perform, I should discuss them with my immediate Supervisor or my Human Resources representative.

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ADDENDUM(S):

Clinical Advancement Program (CAP) Quality

• Competency demonstrated through fostering a Culture of Patient Safety and quality as evidenced by Improved Patient Health Outcomes
• Promotes, facilitates, and collaborates with all members of the interdisciplinary team (IDT) and patient care team on the application of quality improvement principles, activities in the delivery of care, identification of risk areas and opportunities for improvement, and root cause analysis (RCA)
• Promotes, advances, and assists with implementation of FKC clinical, educational, and quality initiatives.
• Mentors and trains team members to monitor the effectiveness of their daily processes.
• Ensures documentation in eQUIP and utilization of data, benchmarking, and graphical representations in performance improvement activities.
  • Analyzes, manages, and reports data as needed to identify improvement opportunities and measure the progress of improvement projects.
  • Use quality improvement tools to ensure adherence to QAI activities.
• Facilitates program and annual regulatory review audits
• Collaborates with Regulatory to identify and recommend systems and practices that would improve outcomes

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Clinical Advancement Program (CAP) Preceptor

• Maintains direct supervision of the new nurse until graduated from new employee training
• Collaborates with team members to identify learning opportunities
• Communicates and collaborates with supervisor and Education Department regarding progress of new nurse
• Continues to mentor and support new nurses once released to work independently
• Mentors new RN Preceptors

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Clinical Advancement Program (CAP) Multi-modality Cross Trained

• Cross trained to deliver patient care across multiple modalities
• Responsible for maintaining skill set in each cross-trained modality for the delivery of safe and effective patient care
  • Communicates and collaborates with operational and clinical leaders to support maintenance of skills
• Ensures the provision of safe and comprehensive care of patients within the chosen modalities in accordance with all company policies and procedures
• Embraces a commitment to patient satisfaction and actively seeks opportunities to improve the overall patient experience in alignment with established quality and regulatory standards

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Transitional Care

In some designated programs, RNs who have achieved a CAP 2 status may participate in our Transitional Care Program.

That program entails the following:

• Following all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care
• Coordinating all education and care related matters as it relates to the new patient; liaisons with appropriate FKC staff members to provide the best patient experience and education to include making sure all disciplines are scheduled to see patient according to plan
• Demonstrating and education on home dialysis products to ensure patient understands the benefits of home and how home dialysis can work for them

• Ability to set and perform a treatment on all machines used in the transitional care unit. This includes being able to demonstrate peritoneal dialysis set up

• Coordinate transition to patient’s permanent modality choice

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EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity

Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.

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