Home Dialysis RN

Description

The Home Dialysis Nurse (HDN), as qualified by federal and state regulations, will provide patient training and ongoing support for all patients choosing a home dialysis modality. The HDN will be responsible for providing quality care, clinical management, and documentation following established NRC standards and practices.  

Duties

• Knowledge of and comply with facility approved policies and procedures, federal, state, local laws and regulations, including health care professionals practice act requirements as they pertain to home dialysis program and patient care requirements. 
• Initiate dialysis treatment to assigned patients, according to NRC procedures, using fistula needles, central line catheters, and peritoneal dialysis catheters.
• Maintain clinical records with accurate and legible documentation. Train patients (and/or care partner) the practice of Peritoneal Dialysis or Hemodialysis upon meeting federal and state regulations governing registered nurse qualifications. Ensuring competence of trainee before allowing them to perform the job independently.
• Periodically re-assessing patient’s skills and competence and re-training if needed
• Make contact with the home dialysis patient at least monthly by phone or during clinic visits.
• Maintain a schedule that ensures each patient receives a clinic visit monthly.
• Provide the patient with 24 hour on-call system and ensure patients have access to nursing support at all times. 
• Obtain routine and non-routine laboratory tests ordered and communicate critical lab values and urgent patient needs to the responsible physician or physician extender in a timely manner. 
• Conduct home visits to assess the patient’s home environment per policy, initially and minimally annually thereafter. Routinely evaluate patient performance and assess the home environment more frequently as needed to improve care.
• Communicate results of patient assessment, reassessment, and ongoing monitoring to the physician, team members, and others as appropriate to the individual needs of the patient.
• Communicate with appropriate interdisciplinary team members on a regular basis and refer patient needs, as necessary.
• Develop and implement the patient plan of care with the interdisciplinary team.
• Establish and maintain a patient chart which ensures continuity of care. Accurate collection of patient treatment home data on a monthly basis and address issues of non-adherence during clinic visits and CIPA/POC.
• Ensure through a contract agreement, proper management of equipment including installation, maintenance, tracking and retrieval of equipment when required.
• Understand vendor product delivery methods and associated fees. Teach patients the importance of proper and timely order placement that ensures the patients receive all supplies in a timely manner to not disrupt care. 
• Ensure clinic and patient supply inventory and usage is appropriate for patient prescriptions and place orders in a timely manner to avoid fees and penalties.
• Document all nursing services in the Electronic Medical Record including but not limited to training sessions, routine and non-routine in-person interactions and phone conversations. Documentation should accurately reflect the patient status and nursing interventions and be written to ensure continuity of care. 
• Complete and document monthly review of patient medication profiles. Administer medications as ordered by the physician.
• Continually seek to improve patient and quality outcomes through tracking and trending of program and patient performance, use of critical thinking skills and root cause analysis to improve patient and quality outcomes. Assist in obtaining data for the continuous quality improvement activities and participate in the QAPI meeting monthly
• Review and demonstrate effective management of program labor and supply cost monthly.
• Participate in and support NRC initiatives that promote improved care and promote growth of the home program such as coordinating with outpatient CKD clinics and in-center clinics through education of treatment options. 
• May cross-train as in-center Hemo nurse to meet the patient care and/or facility’s operational needs.  
• Be familiar with emergency equipment and all emergency operational procedures. Communicate and regularly review Emergency Preparedness procedures with all home patients, including but not limited to emergency disconnection from dialysis equipment, what to do and who to contact if displaced from home.
• Participate in infection control monitoring, implementation, and recording as necessary.
• Participate in staff meetings as required. Attend in-services and continuing education sessions in compliance with company policy and procedure.
• Assist with staff training as requested.
• Participate in team concepts and promote a team effort, perform duties in accordance with company policies and procedures. May delegate tasks to competent licensed and unlicensed staff per applicable state practice act.
• Other duties as assigned

Home Hemodialysis Only:

• Coordinate home evaluation with the technical services department to ensure that the necessary electrical, plumbing and drainage requirements for proper equipment operation are met prior to patient acceptance into home program.
• Ensure required and appropriate water sampling is complete per policy and product requirements. Monitor and report water sample and culture results.
• Other duties as assigned

Requirements

• RN license in relevant state. License must be maintained as current and in good standing.
• Current CPR certification required prior to patient care assignment. Certification must be maintained as current. 
• Must meet any practice requirement(s) for the relevant state.
• Must have at least 12 months experience in providing nursing care and an additional 6 months of experience in the specific modality for which the nurse will provide home dialysis training, except in states with a more stringent requirement. 
• Confirmation of ability to differentiate primary colors.
• Demonstrated working knowledge of the English language and ability to communicate in writing as well as verbally.
• Must have basic computer skills; proficiency in all NRC clinical applications required within 90 days of hire.
• Must be able to organize time and tasks well.
• Must successfully complete Home Dialysis Nurse Orientation Program and maintain annual demonstration of skills and competency applicable for the modality assigned.
• Ability to meet minimum NRC hiring standards which may include additional background clearances and orientation requirements if applicable to the program assigned to for employment