Create and implement a written plan of care that addresses the specific needs and goals of each individual patient, making referrals to other professional services as required. Modifies the plan of care based on reassessment of the patient including observed patient response to treatment/care and evaluation of patient's progress toward goal completion and delegates tasks to team members, as appropriate within their scope of practice. Observe, document, address, and implement planned interventions/care, communicating the plan to all members of the team through accurate and timely documentation in the electronic medical record and, when needed, through verbal reports. Documents accurate patient information in compliance with policies and regulatory requirements. Provide patient care through the performance of selective procedures that include but are not limited to IV starts and restarts, blood administration and phlebotomy tasks, answering call lights and serving as testing personnel under CLIA1988 regulations as they relate to point of care testing. Administer medications, accurately and timely according to physician orders and organizational policy and procedure. Maintains knowledge of medication actions and side effects, recognizing allergic reactions and documenting patients' response to drugs. Successfully transition patients, communicating the most current plan of care, through walking rounds and providing accurate, timely report to incoming staff. Advise physicians, other disciplines, family/significant others of changes in patient's condition or abnormal findings. Communicate clearly and concisely. Provide clear, specific educational and discharge information to each patient and/or patient family member. May precept new employees and oversee other members of the care team. Other duties as assigned.
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Industry
Hospitals
Education Level
No Education Listed
Number of Employees
1,001-5,000 employees