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Duke Health Integrated Practice

Duke Health Integrated Practice comprises more than 110 primary and specialty outpatient clinics, extending the reach of the Duke Health mission across the state of North Carolina.

Duke Nursing Highlights:

• Duke University Health System is designated as a Magnet organization
• Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses.
• Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification.
• Duke University Health System has 6000 + registered nurses
• Quality of Life: Living in the Triangle!
• Relocation Assistance (based on eligibility)

Duke University Hospital

Department of Advanced Clinical Practice

Job Description

Pediatric Pulmonary Hypertension Advanced Practice Provider

Position Summary

The Duke Hospital Pediatric Pulmonary Hypertension Advanced Practice Provider (APP) practices as an integral member of the Pediatric Pulmonary Hypertension team, providing evaluation, treatment, and follow up of children, and adolescents, with pulmonary hypertension.  The APP provides these services through direct clinical care, consultation, collaboration, and coordination of management of patients in both the in-patient and out-patient settings.  These services are rendered under a designated supervising pediatric cardiologist.  The APP works collaboratively with the supervising pediatric cardiologist; with Pediatric Cardiac, Pediatric, and Neonatal Intensive Care Unit teams and Pediatric Pulmonology; with inpatient pediatric and pediatric cardiac clinic teams.  The APP contributes to excellence in patient care, research, teaching, and provides leadership to the organization.

The Duke Hospital Pediatric Pulmonary Hypertension APP will be utilized in the care of patients at Duke University Health System in both the hospital and ambulatory settings.  Practice locations include the Pediatric inpatient units, and outpatient clinics as designated by the Division of Pediatric Cardiology and DUHS.

Position Requirements

Education:

NP:  Work requires completion of accredited graduate level Pediatric-Acute Care Nurse Practitioner program.

PA:  Work requires graduation from a Physician Assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or its predecessor agencies.

Licensure:  

NP:  Current licensure as a Registered Nurse in the state of North Carolina and approval to practice as an NP.

PA: Licensure as a Physician Assistant in the state of North Carolina.

Certification: 

NP:  National certification as an PNP-AC

PA:  National Commission on Certification of PAs (NCCPA) certification is required

Experience:

Experience in pediatrics as an advanced practice provider for at a minimum of 3 years preferred.

Life support:

•    BLS
•    PALS

Hours

Primary hours will be 40 hours per week (1.0 FTE). Opportunities exist for partial FTE coverage depending on interest.

Responsible to

Primary supervising physician and back-up physicians, and to the Duke Hospital Center for Advanced Practice Team Leader and Directors.

Process of Evaluation

Evaluation will be ongoing and will encompass the six general areas of competency as defined by The Joint Commission (patient care, medical/clinical knowledge, practice-based learning & improvement, interpersonal & communication skills, professionalism and systems-based practice). Annual and mid-year evaluations will be conducted in coordination with APP’s primary supervising physician. Ongoing Review of Care and Quality Improvement meetings with supervising physician will be conducted and documented monthly for the first six months, in accordance with Duke University’s and the designated Board’s standards, then at least once every six months.

Specific Job Responsibilities and Standards

Under the direction of the Pediatric Cardiologists the APP’s responsibilities include but are not limited to the following:

Clinical Expert

• Diagnose and treat children and adults with pulmonary hypertension in conjunction with the supervising physician
• Obtain a comprehensive health history and perform and document physical exam findings
• Differentiate between normal findings and those that require treatment, consultation, and/or referral
• Assess patient and family psychosocial, emotional, and physiologic needs
• Perform patient/family teaching with respect to planned treatment.
• Consultation and/or referral with other health care professionals
• Facilitate communication with referring providers.
• Work closely with Patient Resource Managers in care coordination; review medications with parents/patients and provide instructions and answer questions.
• Perform, along with the pediatric cardiologist, all history and physical examinations with ultimate oversight by the attending.
• Participate in multidisciplinary Pulmonary Hypertension clinic.
• Order and schedule laboratory studies and diagnostic procedures; explain necessity, preparation, nature and anticipated effects of scheduled diagnostic and therapeutic procedures to the patient and follow up findings. Check medications during each patient interaction, confirming dosages.
• Obtain prior authorization for medications.
• Assist the nurse clinician in the e-mail/telephone management of all patient problems.
• Assist in fielding phone calls and fax transmissions for pulmonary hypertension patients, including related phone calls during the day from referring physicians, parents and patients.
• Assist cardiology team with arrangements regarding the need for a translator.
• Facilitate communication for patient care procedures
• Work with the inpatient team to provide comprehensive pulmonary hypertension management in a timely manner

Administrative

• Maintain patient database
• Initiate and participate in other safety and quality improvement programs within the division and within the greater health system.
• Participate in teaching medical students, residents, and nursing staff principles of pulmonary hypertension care.
• Attend weekly Intake Conference, Cardiothoracic Surgical Conference and quarterly Morbidity and Mortality Conference, along with catheterization lab specific educational opportunities.
• Participate in the billing process by entering billing codes for appropriate services.
• Perform other related duties incidental to the work described herein.

Educator

• Educate patients and families regarding disease states and treatment regimes including the risks and benefits of treatment application, individual patient’s progress and discharge plan of care.
• Assess educational needs of the Duke Health system nursing staff and healthcare team and develop appropriate educational programs.
• Role model and precept healthcare learners through contractual agreements.
• Participates in mentoring Cardiology Fellows

Research Utilization and Investigation

• Utilize evidence – based, decision- making in all clinical practice.
• Incorporate clinical research findings in the development and implementation of standards of care.
• Support IRB approved clinical research/trials through a variety of activities including but not limited to obtaining consent, ordering diagnostic tests recording laboratory and diagnostic results, administering therapeutic interventions, reporting patient outcomes including toxicities or adverse events.
• Publishes in peer reviewed journals
• Performs clinical research

Consultant

• Develop, implement and evaluate standards of care/practice guidelines/policies and procedures/care maps/ protocols for pediatric cardiovascular patients
• Develop programs and projects in areas of expertise to facilitate the attainment of the goals and objectives of the pediatric cardiovascular program, the Children’s health center, the department of Advanced Clinical Practice and the Duke Health System.

Professional Leadership and Development

• Role model Advanced Clinical Practice through conduct, communication, dress, leadership, ethical decision making, critical thinking and problem solving.
• Participate in minimally one professional organization.
• Enhance the body of knowledge of nursing or pediatric cardiovascular care through written publication, oral presentations, posters or continuing education
• Maintain all professional requirements for licensure and certification.
• Presents at local, national, and international meetings and scientific sessions

Behavioral Standards

Excellence – We strive to achieve excellence in al that we do

• Acts – and makes decisions - in the best interests of patients and their loved ones, and willingly accepts accountability for outcomes
• Improves performance that enhances patient care and advances individual, team and organizational goals
• Effectively uses DUHS resources (time, budget and property) to support optimal patient care and operational performance while adhering to organizational policies and procedures
• Seeks opportunities to improve service provided to patients and their loved ones related to clinical care and support

Safety – We hold each other accountable to constantly improve a culture that ensures the safety and welfare of all patients visitors and staff

• Strictly adheres to all established patient, staff and faculty safety procedures
• Contributes to an environment of safety and security for patients and staff through individual actions
• Speaks up about all risk of harm; reports patient, staff safety or injury events within twenty-four hours of incident or awareness of incident
• Actively participates in all mandatory patient and staff safety training

Integrity – Our decisions, actions and behaviors are based on honesty, trust, fairness and the highest ethical standards

• Is truthful and honest with patients, their loved ones and co-workers, and consistently exhibits actions that reflect our values
• Is accountable for actions and decisions involving patient care or other operational activities, and strives to learn and improve from experience
• Follows through on commitments made to patients, visitors, co-workers and others
• Conducts work positively while doing so in full compliance with all organizational policies, procedures, expectations and patient- centered values

Diversity – We embrace differences among people

• Applies cultural understandings and sensitivities to enhance patient care and improves interactions with people of diverse backgrounds
• Treats all individuals – patients, visitors and co-workers – with courtesy, dignity and respect
• Contributes to a work environment that is welcoming to all – whether patients, visitors, staff or faculty
• Demonstrates a sensitivity and awareness of the needs of a diverse workforce and patient population

Teamwork – We have to depend on each other and work well together with mutual respect to achieve common goals

• Willingly shares expertise and information with others to improve patient care, unit or departmental performance without compromising individual responsibilities
• Celebrates the accomplishments of others in making a difference in the lives of patients and the success of the organization
• Takes ownership of decisions made by specific patient care or project teams and team leaders and the individual role needed to support them
• Manages multiple demands while maintaining quality and courtesy; acknowledges and resolves patient or visitor issues
• Be a flexible problem solver who seeks creative solutions to new challenges

Working conditions

Physical and mental requirements:

• Able to clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant in the state of North Carolina and within the Duke University Health System.
• Able to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others.
• Able to use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up.
• Able to use fine motor skills.
• Able to record activities, document assessments & interventions; prepare reports and presentations.
• Able to use computer and learn new software programs.
• Able to provide leadership in clinical area of expertise and in meeting organizational goals.
• Able to navigate the Hospital and DUHS to provide clinical expertise to specific patient populations.
• Able to withstand prolonged standing and walking with the ability to move or lift at least fifty pounds.
• Able to remain focused and organized.
• Able to independently seek out resources and solve complex problems
• Able to work collaboratively with all levels of personnel

Work Environment:

The work environment involves risk discomforts that are typical of an acute care setting to include working with patients under isolation and universal precautions. It requires safety precautions, ongoing education and health risk monitoring.  Contact with specimens, chemicals, sharps; radiation, technical equipment and fumes are possible.  Employees are required to wear personal protective attire according to hospital policies and OSHA guidelines.  The work activity and patient acuity levels can create a stressful atmosphere. 

The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description