RN In Home Services

Job Summary: Under the direction of the In- Home Services Supervisor, provides in-home care to the participants of St. Paul’s PACE, Performs initial, semi/annual assessments of participants in their home care environment and coordinates plan of care with appropriate resources. Reviews plan of care and evaluate participant compliance. Provides skilled assessments, treatments and health education for participants in their homes, according to physician’s order. Maintains the participants’ medical record with thorough documentation. Communicates participants’ changes and progress to appropriate staff.

Qualifications and Requirements:

Education - Graduate of a school of professional nursing. Current California Registered Nurses License, CPR certification required, BSN preferred. Shall be at least 18 years of age.

 Experience – A minimum of one year’s experience in working with the frail or elderly population required. Shall have either training or related experience in the job assigned.

Skills/Knowledge 

• Broad knowledge base of health care problems of the frail elderly.
• Knowledge of medical equipment and instruments. 
• Knowledge of common safety hazards and precautions to establish a safe working environment.
• Skilled in identifying problems and recommending solutions.
• Skilled in preparing and maintaining records and writing reports, and responding to correspondence.
• Skilled in developing and maintaining department quality assurance. 
• Skilled in establishing and maintaining effective working relationships with participants, medical staff, staff members and family caregivers.
• Ability to react calmly and effectively in emergency situations. 
•  Knowledge of home care services nursing principles and practices, with particular reference to the elderly.

Physical Demands and Working Conditions:

Physical Requirements - Shall be in good mental and physical health, and capable of performing assigned tasks. Requires a full range of motion including handling and lifting patients, manual and finger dexterity and eye-hand coordination. Requires standing, walking, pushing, bending, kneeling and reaching at arms length and overhead in clinic, rehab department and in community for prolonged periods of time. Must be able to transfer participants needing maximum assist of one. Requires the ability to lift/carry up to 50 pounds and push or pull objects exceeding 150 pound, using appropriate body mechanics.

Visual, Hearing and Communication Requirements - Requires corrected vision and hearing to normal range, with or without reasonable accommodation. Must be able to document care provided in participants’ service records. Must be able to communicate verbally with participants their treatment plan, team members and participants caregivers. Pressure Factor - Requires working under stressful conditions. Working conditions may be noisy and crowded and fluctuating indoor temperatures. Moderate pressure to meet scheduled appointments while dealing with frail and confused participants. Subject to participants that may have the potential for verbal or physical aggression.

 Environmental Conditions - May be exposed to a risk of bodily injury through contact with moving instrumentation, toxic substances, medicinal preparation, bodily fluids, communicable diseases and any other conditions common in the clinic environment. Subject to unpleasant odors and living conditions of participants.

Duties and Responsibilities:

• Shall attend in-service education program, including orientation, skill training and continuing education.
• Shall receive in-service training in first aid and in cardiopulmonary resuscitation within the first six months of employment.
• Performs initial assessments of participants’ in their home environment to determine their individual needs and coordinates plan of care with care-giving resources. Coordinates with the interdisciplinary team to develop care plan for each participant.
• Performs annual re-assessments of all St. Paul's PACE participants to determine that appropriate in-home services are provided and that participants are in the least restrictive environment. 
• At the direction of the In-Home Services Supervisor performs supervisor visits to Home Services CNA’s and PCA’s.
• Provides skilled supportive and restorative nursing care to participants as ordered, re-evaluating their care plan and health status on an on-going basis.
• Maintains participants’ medical record and fulfills agency charting and reporting requirements. Minimally provision of Quarterly narrative nursing note, unless a participant’s condition requires a more frequent note, indicating participants progress toward achieving health goals.
• Provision of emergency care including arrangements for transportation.
• Notification of the physician of any marked change in the participant’s condition
• Re-evaluates the In Home Services care plan and monitors participants’ health status in home.
• Provides skilled supportive and restorative nursing care to participants as ordered/ requested.
• Serves as a member of the Multi-disciplinary Team, attends meetings as appropriate  Monitors medication compliance, administers medications and provides training in self-administration of all non-scheduled meds. Records all medications and treatments administered.
• Provides health counseling to participants and their families on an individual or group basis.
• Participates in the coordination of personal care activities of all participants in the home.
• Follows all St. Paul's PACE Policies and Procedures and OSHA safety guidelines.
• Maintains the confidentiality of all company procedures, results, and information about participants, clients or families.
• Practices Universal precautions and follows all appropriate Infection Control procedures.
• Maintains safe working environment.
• Follows St. Paul's PACE Safety Policies and Procedures.
• Participates in continuing education classes and any required staff and training meetings. Maintains professional affiliations and any required certifications. 
• Performs other duties as required or requested. 

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