Fresenius Medical Center PCT III Preceptor in Richmond, Virginia
PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMC Quality Enhancement Goals (QEP). PRINCIPAL DUTIES AND RESPONSIBILITIES: STAFF RELATED: Participates in the recruitment process for new clinical staff. Assists with clinical orientation and on-going training of all appropriate direct patient care personnel as well as the orientation of all facility staff to FMS. Functions as preceptor in direct patient care training programs to support the delivery of quality patient care as per the standards set forth in the FMS Clinical Services Clinical Training Manual(s), FMS policies and procedures, and FMS training standards. Delivers and maintains on-going competency evaluations/audits to ensure ongoing performance of other PCT’s. Collaborates with the Clinical Manager and Education Coordinator in driving FMS quality standards through education regarding all ESRD regulatory and legal requirements and the practice of Continuous Quality Improvement. Assists in training of applicable direct patient care staff on appropriate programs. Provides coaching and developmental support to applicable clinical and facility staff. Education/Communication: Partners with RN and IDT staff to educate the appropriate personnel regarding the integrity and safety of the facility water systems, as allowed by local regulations. Partners with RN and IDT staff to educate the appropriate personnel regarding the maintenance of environmental integrity, including patient and staff safety, of the facility. Ensures a strong communication process between the Clinical Managers, Education Coordinators, direct patient care staff, and all support staff at the facility regarding appropriate training and organizational development programs and initiatives. Participates in implementing and potentially designs creative educational programs for PCT staff including contests and other team-based programs. Collaborates with Clinical Managers and Education Coordinators in the scheduling and implementation of training programs and processes as directed. Monitors processes in the delivery of patient care through regular Continuous Quality Improvement (CQI) activities. Ensures all FMS business policies, procedures and systems are incorporated into training, including compliance with ethical business practices. PATIENT RELATED: Education: Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access. Treatment: Welcome assigned patients and inquire as to their wellbeing since their last treatment. Evaluate vascular access for patency. Obtain necessary pre and post treatment vital signs and weight. Perform vascular access evaluation pre-treatment. Perform vascular access cannulation. Perform administration of Heparin as delegated or as allowed by state law. Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. Monitor patients’ response to dialysis therapy. Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. Discontinue dialysis treatment according to established procedures. Evaluate patient prior to termination of venous access - standing & sitting blood pressure. Obtain Hemostasis and apply appropriate dressings. Evaluate the patient prior to discharge. Perform and record Pre and Post dialysis evaluation, weight and vital signs with initial identification. Responsible for calculating and entry of individual patients’ dialysis machine programming for Ultrafiltration (UF) goal; treatment time; Sodium (Na) modeling; and UF modeling as prescribed. Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160. Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification. Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes. Report any significant information and/or change in patient condition directly to the nurse supervisor. Observe patient, and conduct machine safety checks according to facility policy. Report any change or unusual findings to the nurse supervisor. Perform and document any intervention for unusual patient status and document patients' response to intervention. Evaluate patients’ vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the nurse supervisor. Obtain all prescribed laboratory testing and prepare specimens for collection. INFECTION CONTROL SPECIALIZATION: Assists with facility QAI infection control audits. Acts as a change agent for infection control practices within clinic. Under the direction of the CM or designee monitors staff and patient adherence to infection control practices. Reinforces new hire employee adherence to infection control Policies and Procedures. Supports ongoing staff and patient engagement on infection control practices under the direction of CM or designee for example participation in patient lobby days and staff meetings to reinforce infection control practice. Quarterly and under the direction of the CM reinforces patient and staff adherence to infection control Policies and Procedures through visual media such as posters, flyers or bulletin boards. Under the direction of the Education Dept. participates in education response to internal and external facility surveys. Participates in and reinforces infection control education of new patients and families under the direction of the CM or designee. MAINTENANCE/TECHNICAL: Maintain environmental integrity and aesthetics - ensure all areas are safe and clean. Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate. Perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). Initiate Solution Delivery System (SDS) system. Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage. RECORD KEEPING: Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. Enters all treatment data into the designated clinical application in an accurate and timely manner. Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected where appropriate. Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. Prepare lab requisitions for prescribed or stat Lab specimens according to laboratory destination. Collect, label, appropriately prepare and store lab samples according required laboratory specifications. Ensure collection of lab specimens by appropriate lab courier.