Provides primary patient care for a specific caseload of patients, to include assessments, care planning, evaluation and education of patients receiving infusion therapy and/or other nursing services in accordance with the care matrices and best demonstrated practices in the home or alternate site setting.
Provides the majority, if not all of the direct care for a specific caseload of patients, to include initiation and maintenance of all communications with appropriate care team members, to include pharmacists, physicians, dietitians, home patient representatives and any appropriate community resource staff members.
Utilizes the Drug Deliver Decision algorithm and communicates with the patient/care partner, pharmacist and physician to choose the best method of therapy administration.
Evaluates and educations patient/care partner to safely administer the home infusion therapy and provides additional instruction as indicated.
Applies appropriate ethical, legal, confidentiality and advocacy principles to the planning and deliver of patient care.
Evaluates the home environment where the care is to be provided and identifies interventions that my by required to render the home environment safe and appropriate for the prescribed care. These interventions are communicated directly to the appropriate team member.
Completes all documentation, including Initial Patient Assessment (IPA), Plans of Treatment (POT), teaching checklists, Clinical Monitoring Reports (CMR), Discharge Summaries and Telephone Communication Reports (TC) during each visit.
Utilizes the appropriate document retrieval system on a daily basis as a mechanism to paperwork to the branch in a timely fashion.
Develops, in conjunction with other clinical team members, each patient's Care Map and evaluates patient's response to therapy during each home visit or encounter.
Appropriately discharges primary patients and completes discharge summary within seven days of discharge.
Maintains home chart to include the referral form, the IPA, the most recent POT, any orders after the recent POT and the last five CMR's.
Develops and maintains caseload scheduling and communications on a weekly and monthly basis and updates schedule with changes.
Qualifications Minimum Qualifications:
Associate's Degree in Nursing required
Current Missouri RN license
Valid driver's license required
CPR certification required
1 years of experience in an IV environment
1 years of experience required as an RN
RN Bachelor's Degree
Acute care experience
1 years of Home Health or Hospice RN experience
Requires effective oral and written communication skills to communicate with customers. Requires good decision making and problem solving skills. This position requires daily travel to patient homes and meeting locations, the ability to operate a vehicle in a safe and lawful manner is an essential function of the job. Additionally, access to a vehicle in good working condition required.
About SSM Health at Home
SSM Health at Home offers highly skilled and experienced caregivers to help patients through difficult times. Services include extended at-home care, help managing pain or special support during terminal illnesses. SSM Health at Home is located in Illinois, Missouri and Oklahoma.
You’ve known us as many names throughout St. Louis, and now, we’re bringing our hospitals, doctors, home care and other services together under one name – SSM Health. With seven hospitals, 350+ physicians, more than 40 physician locations and 12,000 employees, we are part of something bigger and better. We’re connected to a wealth of resources, expertise and advance technology to help you, your fa...mily and our community live long, healthy lives.
We’ve grown and changed a lot over our 143-year history. Our name may be changing but our mission remains the same