LPN Ambulatory Care

PURPOSE AND SCOPE:
Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for assigned patients in accordance with FMCNA policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Patient Related:
Provides patient care under the direct supervision of Hemodialysis Registered Nurse for assigned patient(s) in the acute setting excluding Intensive Care Units as permitted by state requirements.
Performs all technical aspects of dialysis procedures for assigned patients as prescribed to administer and monitor treatments in accordance with current treatment plan under the direction of the Hemodialysis RN. Responsible for reporting and documenting all new and unusual incidences, information, complaints, or problems to the RN.
Provides treatments for assigned patients as assigned to promote and assist in the maintenance of a safe and clean working environment. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and Quality Assessment and Performance Improvement (QAI) Activities; including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMCNA Quality Enhancement Goals (QEP).
With documented competency and proficiency, the LPN/LVN may set up and prime equipment as directed by the Hemodialysis RN for renal replacement therapies (hemodialysis, continuous renal replacement, and peritoneal dialysis therapies).
Evaluates vascular access for patency; obtains necessary pre and post treatment vital signs and weight; performs vascular access cannulation as defined by the state and reports any difficulties or unusual findings to the Hemodialysis RN.
Responsible for accurate documentation of information related to the patient treatment. This information is documented appropriately in the individual patient record to include the hospital Electronic Medical System (EMS) and the Acute Care Electronic System (ACES).
Responsible for reporting any significant information, change in patient condition, or equipment problems to the Hemodialysis RN.
Responsible for ensuring appropriate safety alarms are being used for every treatment.
Records accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment recorded in the EMS and ACES.
Initiates renal replacement treatment according to prescribed orders including setting blood flow rate (QB) and dialysate flow rate (QD).
Collects, labels specimens and ensures timely delivery of laboratory per facility policy.
Identifies intradialytic problems and provides intervention as prescribed by physician’s order or as directed by Hemodialysis RN.
Performs and documents any interventions for the patient, documents patients’ response to intervention, and reports any changes or unusual findings to the Hemodialysis RN.
Evaluates patient’s vascular access during treatment including arterial and venous monitoring pressures, provides appropriate intervention as needed, documents, discontinues dialysis treatment according to established procedures and reports any unusual findings to the Hemodialysis RN.
Evaluates patient prior to termination of venous access – obtains blood pressure prior to termination of venous access; obtains hemostasis and applies appropriate dressings; evaluates the patient prior to discharge and reports any unusual findings to the Hemodialysis RN.
Performs pre and post dialysis evaluation, weight and vital signs with initial identification and reports findings to RN for documentation and any necessary follow up.
~ Initiates basic CPR measures in the event of cardiac and/or pulmonary arrest and respond to emergency situations related to dialysis treatment. Responsible for re-enforcing education the patients received by the RN.

Technical:
Safely operates dialysis related equipment according to the proper procedures.
Provides trouble shooting when necessary.
Ensures a clean, safe and sanitary environment in the dialysis facility treatment area.
Ensures blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies.
Operates all emergency equipment effectively and efficiently in accordance to the standard operation procedures.
Staff Related:
Participates in staff meetings as scheduled.
Participates in staff training and orientation of new employees as assigned.
Acquires information and knowledge in current practice related to dialysis principals and technique by participating in scheduled in-service classes.
Additional:
~ Performs additional duties as assigned by Program Manager.

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.
Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians.
This position requires frequent, prolonged periods of standing and the employee must be able to bend over.
The position provides direct patient care that regularly involves heavy lifting and moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. 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.
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.
The position requires travel between assigned locations and various locations within the community.
Travel to meetings may be required.
SUPERVISION:
~ None

EDUCATION:
~ Current appropriate state licensure.

EXPERIENCE AND REQUIRED SKILLS :
Minimum of one year medical-surgical nursing experience. Six months of hemodialysis experience preferred but not required.
Successful completion of a training course in theory and practice of hemodialysis.
Successful completion of CPR Certification.
Certified Clinical Hemodialysis Certification preferred or obtained within first year of employment.
Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made.
Effective communication skills – both verbal and written.
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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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