Sen LVN Women's Health Primary Care

Job description

JOB SUMMARY
The Primary Care LVN utilizes the nursing process to assess and identify the individual needs of patients through observation of disease symptoms, emotional state, laboratory reports, cultural and socio economic background and response to medical regimen and treatment. Additionally, s/he is required to learn and apply the Patient Centered Medical Home Standards. In collaboration with the Medical Home health care providers, nurses, and medical assistants the LVN will also assume clinical responsibility for administration of medications/vaccines, lab result review and monitoring, treatments and procedures pertinent to adult primary care such as ear irrigations, wound care and urethral catheterization, as well as patient education. This individual will utilize their excellent customer service and communication skills on a daily basis via phone and electronic communication and personal contact with both internal and external customers. This employee will utilize computer skills in Epic/APeX and other UCSF computerized programs. This individual supports the standards of the policies and procedures of the practice, and is responsible for maintaining current knowledge of pharmacology and competency in modes of administration, and complies with all Ambulatory Services and Medical Center policies and procedures for infection control, safety, and administrative and clinical practice. S/he is required to adhere to the Telephone and House Standards as adopted by the Medical Center, as well as demonstrating UCSF's PRIDE values and the AIDET fundamentals of communication in all patient care.
DUTIES & ESSENTIAL JOB FUNCTIONS
Identify the functions or tasks that employees in the job perform. The essential functions should state the purpose of the work and the results to be accomplished, rather than how the function is performed. Of the tasks listed , what percentage of time is devoted to each? The more time employees spend on a function, the more likely it is that the function is essential. Generally, include those functions that account for 10% or more of the work, i.e., key items that contribute significantly to the achievement of the job. The functions should add up to 100%.
of time
Essential Function (Yes/No)
Key Responsibilities
(To be completed by Supervisor)
10%
Yes
Assessment:
A. Identifies the needs and responses of patients to medical regimen and treatment through observation of symptoms, emotional state, and cultural and socioeconomic backgrounds.
B. Identifies the needs and responses of patients to medical regimen and treatment through observation of symptoms, emotional state, and cultural and socioeconomic backgrounds.
10%
Yes
Planning:
A. Works cooperatively and participates with the health care team to discuss patient's alternatives to health care services and to develop short and long range goals to meet the patient's needs.
B. Plans as appropriate for the needs of patient using knowledge of physical and emotional processes as well as cultural and socioeconomic backgrounds.
C. Identifies appropriate resources ( e.g., family, significant others, monetary, community organizations) in planning for patient care.
20%
Yes
Implementation /Evaluation:
A. Provides individualized nursing care that responds to the growth and developmental needs of patients and demonstrates an understanding of the range of treatment required by the patient.
B. Demonstrates ability to provide appropriate care based on the needs of a specific individual, including that individual's age. Check age­specific group(s):
[x]Adult (19 - 64 years)
[x]Geriatric (65+ years)
C. Sets up exam room and performs intake process, documenting vital signs, medications, allergies and other relevant information in electronic health record. Provides for physical and emotional privacy.
D. Prepares for and instructs patients about specific diagnostic and therapeutic procedures and treatments.
E. Assists as needed with diagnostic and therapeutic procedures and treatments.
F. Administers injections including immunizations and medications such as vaccines and PPDs.
G. Uses appliances and equipment correctly and maintains safe practice.
H. Evaluates and documents patients' responses to nursing care, including pre/post procedures and treatments. Uses knowledge of cognitive, physical, emotional and chronological maturation process in evaluating care for all ages of patients.
I. Administers and clearly documents the administration of medication in electronic health record while maintaining current knowledge of pharmacology and competency in modes of administration.
J. Performs CLIA lab waived testing and other chart or log audits.
K. Responds appropriately in emergencies. Is knowledgeable about the contents of the code blue cart, automated external defibrillator (AED),. and/or.the. emergency.kits, and.can .initiate .and. assist in CPR. Understands the procedures for medical emergencies, code blue and other emergency/ disaster situations.
L. Complies with all Ambulatory Services and Medical Center policies and procedures for infection control, safety, administrative and clinical practice. Complies with activities mandated by Joint Commission/Title 22/NCQA to include disinfection of patient care areas.
M. Completes annual competency testing as specified by the individual practice.
N. Assists patients with limited mobility to transfer from wheelchair to exam table, chair, or toilet.
O. Removes expired supplies from patient care area
15%
Yes
Coordination/ Continuity/ Communication:
A. Organizes activities based on the needs of patients while maintaining the effective flow of patients through the practice. Adjusts clinical support activities to reflect changes in priorities during practice sessions.
B. Maintains open communication and facilitates continuity of care for patients and/or family with members of the health care team through phone contact, verbal interaction and/or written reports including UCSF MyChart Patient Portal and APeX In Basket messaging. Utilizes electronic chart information (i.e., labs, appointments) to contribute to patient care.
C. Maintains accurate, legible, current, properly signed records and documentation which include patient complaints, nursing observations, interventions and care plan, nursing actions/teaching performed and patient response to the action.
D. Obtains, records, and conveys information clearly and concisely.
E. Demonstrates courtesy, common sense, and follow-through in all telephone communications, maintaining the Telephone Standards as established by UCSF Medical Center.
F. Fosters/maintains positive public relations (patients, family, visitors and staff). Uses effective communication skills with patients and staff; demonstrates proper telephone techniques and etiquette; shows sensitivity to differences of culture; demonstrates a positive and supportive manner in which patients perceive interactions as positive and supportive.
G. Participates in in-reach/outreach health care maintenance projects as directed.
10%
Yes
Advocacy/ Education:
A. Participates in identifying the educational needs of patients.
B. Provides patients with the necessary information to make informed decisions utilizing available resources and making referrals appropriately. Informs patients/families about services available at UCSF Medical Center and in the community. Utilizes and maintains updated educational resources.
C. Provides and reinforces patient health teaching by utilizing language which patient and family can understand.
D. Verifies patient/family understanding through talk/back return demonstration, verbal, physical or written.
E. Utilizes available educational resources. Participates in review and/or revision of educational materials.
10%
Yes
Performance Improvement:
A. Participates in Performance Improvement (Pl) activities.
B. Makes recommendations regarding PI topics or problems; and assists in data collection.
C. Reports and follows up on issues that effect environment and safety.
D. Maximizes resources by seeking assistance from appropriate support, effectively using supplies, making suggestions for improved approaches, assisting in cost effective practices.
10%
Yes
Self-Development/Professionalism:
A. Attends classes, conferences, workshops, and staff meetings applicable to practice needs. Shares information from programs attended.
B. Attends and participates in staff meetings.
C. Complies with work related policies, including license renewal, annual PPD, CPR certification, use of benefit time, and dress code including identification policy.
D. Contributes to the orientation and learning experiences of other members of the health care team.
E. Complies with departmental scheduling guidelines; i.e., starts work at times scheduled, completes work in a timely manner.
F. Must be flexible with schedule, including lunch schedule, and work earlier or later in the day shift as needed.
15%
Yes
Electronic Health Record:
Utilizes Electronic Health Record (APeX/Epic) for documentation within the scope of practice of a Licensed Vocational Nurse which may include but not limited to:
A. Documentation of vital signs, height, weight, and pain scale.
B. Enter patient chief complaint and history (i.e. tobacco/family history /med/surg/social).
C. Enter patient reported medications, allergies, and immunizations.
D. Order & sign point of care test (POCT) with signed protocol.
E. Documentation of point of care test results.
F. Enter & "pend" scripted orders from provider.
G. Open a Medication Refill Encounter for provider.
H. Scheduling laboratory, radiology and other testing with written order from provider.
I. Open Telephone encounters.
J. Open Staff messages.
K. Close Encounters and enter level of service.
L. Build dot phrases to assist with efficient charting and messaging.
M. Complete all clinic collect orders.
N. Cross cover other nursing In Baskets as needed.
0. Pend patient orders in advance of patient office visit as part of in-reach and outreach activities.
0%
(To update total %, enter the amount of time in whole numbers (without the % symbol - e.g., 15, 20) then highlight the total sum (e.g., 1%) at the bottom of the column and press F9. The total sum should add up to 100%.)
Required qualifications:
• Minimum of 3 years of experience as an LVN
• Demonstrated ability to work in a fast-paced environment
• Two years related experience in similar environment
• Knowledge and abilities essential to the successful performance of the duties assigned to the position, including demonstrated excellent communication skills, problem-solving ability, and high comfort level with learning new technology/systems
• Basic computer/keyboarding skills
• Prior experience with electronic systems/records
• This position requires flexibility to orient and work at all UCSF Medical Center locations

Preferred qualifications:
• 1-2 years of experience using an Electronic Medical Record system
• Experience in a primary care or geriatric outpatient clinic

License/Certifications:
• Licensed as a Vocational Nurse in the State of California
• Current American Heart Association BLS