Registered Nurse - Home Care - Peabody, Danvers area

Site: Mass General Brigham Home Care, Inc.

 

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

 

 

Job Summary

The position to which you are applying is represented by a collective bargaining unit, Massachusetts Nurses Association.

Mass General Brigham Healthcare at Home serves patients from rehabilitation after illness or injury, to chronic disease management. We are dedicated to providing the highest quality specialized care designed to meet the patients’ unique needs with the goal of optimizing independence and quality of life. Our clinicians are highly skilled and able to function both independently and as part of an interdisciplinary team.

Provide quality, clinical services to patients in various settings in the community. Patient care is delivered within organizational philosophy, policy and standards of community health practice. The admissions process and case management responsibilities are performed in accordance with PHH policies and standards of practice, utilizing thorough and timely electronic documentation and interdisciplinary communications. Skilled nursing care is provided in the form of assessment, teaching, treatment, documentation, and care coordination demonstrating high quality customer service, and financial awareness.

 

Qualifications

******$15,000 Sign On Bonus Available******     

                     **Excellent Benefits**

Key Responsibilities

• Care is provided with a focus on effective utilization and accepted standards of care that result in quality outcomes.
• Initial assessments and visit notes accurately reflect medical necessity, home-bound status, provision of skilled services, vital signs, patient education/comprehension to ensure optimal reimbursement and high-quality patient care in accordance with agency standards and compliance with legal and regulatory requirements.
• Plan of care is developed and periodically updated to address patient-specific needs, preferences, hospital readmission and infection risk, home safety and clinical conditions to ensure optimal patient safety and outcomes.  Care plan goals are patient-specific, updated and resolved in a timely manner.
• Patient information and change in status/plan of care is communicated to physician and documented in a timely manner in accordance with agency standards.
• Medications are reconciled accurately at SOC, ROC and Transfer, and changes are integrated into the plan of care.  Medications are reviewed at each visit.
• Medical supplies are ordered according to allowable guidelines and wound supplies are managed in consultation with the WOCN.
• Patient schedule is established and submitted timely.  Schedules are routinely adjusted and communicated timely with the Clinical Manager and the Scheduler to meet patient and agency needs.
• Point of Care standards are adhered to for submission of data no later than midnight of the day of the visit/admission, including closed and sync’d encounters (exceptions to this standard must be reported to Clinical Manager or designee in the same time period).
• Software is updated by maintaining the latest version of software applications as defined by the IS Department.
• Patient information is prepared and effectively communicated to appropriate departments and team members in accordance with agency standards
• Referrals are made to other disciplines and to appropriate community resources to meet patient-specific needs and maximize patient safety and outcomes.
• Patients are identified for multi-disciplinary case conferences as needed after Start of Care.
• Patient education is provided in the patient’s preferred language and format from time of admission and evaluated on an ongoing basis to meet the needs and abilities of patients and families and is appropriate to the care and treatment provided.  Teaching and pt/cg response is clearly documented in the medical record.
• Discharge planning (that includes the primary physician, family, and patient and accesses community resources) is initiated at Start of Care and evaluated on an ongoing basis for optimal patient safety and outcomes and is evident on review of the medical record.
• All patient consent/notification forms are completed as required by Agency policy, law, and regulations, and submitted to the office within 24 hours.