Job Description

Utilizes the nursing process for assessment, planning, implementation, and evaluation to provide safe, therapeutic care. Functions as a member of the interdisciplinary and nursing teams; carries out established nursing procedures and performs related duties as required; performs nursing care for patients with more complex needs with assistance and supervision. Assists with the management of patient care administered by other members of the nursing team.

The Pediatric Physical Medicine and Rehabilitation (PM&R) Nurse Navigator and Peds Ortho serves in a resource role and delivers direct patient care to Pediatric PM&R and Peds Ortho population. This clinician is experienced and highly skilled with an in-depth knowledge and understanding of related conditions and diagnoses, the major treatment modalities, symptom management, supportive care, and patient education for PM & R and ortho in the pediatric population.

At this operational level, the nurse proactively embraces the Orthopaedic Society/Standards of Orthopaedic Nursing practice to utilize the nursing process for assessment, planning, implementation and evaluation to provide safe, therapeutic care. The nurse utilizes an interdisciplinary approach across the continuum of care with adherence to National Patient Safety Goals set forth by regulatory requirements. The nurse is recognized and utilized as a clinical resource and demonstrates investment in the overall forward movement of the unit/clinic and the organization. The nurse is responsible for bringing together the multidisciplinary efforts of the Attendings, Advanced Health Practitioners, Clinic Staff, Residents, Fellows, IP Nursing Staff, PT/OT, Case Management, Pharmacy, Practice Coordinators, Analysts, and all other ancillary and support departments to ensure a high quality, coordinated, and satisfying experience for the patient. The Nurse Navigator will be involved with the department and Health System quality metrics.

Responsibilities

DUTIES & ESSENTIAL JOB FUNCTIONS

The Pediatric PM&R Nurse Navigator/Peds Ortho nurse is working as a member of the multidisciplinary team, will:

• Coordinate all new patients by conducting phone intake, triaging according to practice guidelines and appropriateness criteria (including communicating these criteria to referring providers), and ensuring that all necessary information is obtained prior to new patient appointments.
• Provide/coordinate ongoing care for established patients by performing nursing assessments, managing patients' overall care plan, providing nursing interventions for disease/symptom management and interacting with third party payors to provide rationale for proposed treatment plans. Will answer phone calls and triage.
• Provide counseling regarding patients/families' overall responses to potential or actual health problems related to PM&R both in person or by telephone.
• Act as a referral liaison with other services, departments, and external services to assist in the coordination of care among multiple health care providers and community agencies, and across healthcare settings, including inpatient, post-acute care, and ambulatory settings.
• Develop more efficient procedures and policies to improve new and established patient care flow, accessibility to services, and patient education including symptom management and treatment resources.
• Develop and implement care management plans to improve patient health. This will involve working closely with patients' primary care physicians and other health care providers.
• To enhance patient engagement and promote appropriate patient expectations through implementation of shared decision-making tools, including decision and communication aids.

of time

Essential Function (Yes/No)

Key Responsibilities

(To be completed by Supervisor)

20

Y
CLINICAL KNOWLEDGE/SKILLS MANAGEMENT

A. Clinical Knowledge

1. Assesses, plans, implements, and evaluates appropriate interventions for Pediatric PM&R and Peds Ortho patients.
2. Integrates nursing theory, research, and knowledge of Pediatric PM&R and Peds Ortho.
3. Maintains knowledge base consistent with the advances in treatment related to Pediatric PM&R and Peds Ortho.

B. Clinical Skill

1. Performs priority technical procedures required by the practice assignment and does so safely, legally, effectively, and efficiently.
2. Utilizes computer technology for, and maintains confidentiality of data collection, documentation, communication and research. Proficient in Apex.
3. Assists in informed consent process, screening potential patients for clinical trials, assurance of adherence to protocol inclusion and exclusion criteria.
4. Performs casting and splinting activities.

C. Clinical Organization

1. Manages clinical situations with advanced skills, ensuring the incorporations of patients/families' physical, psychosocial, and cultural needs.
2. Utilizes the nursing process in providing care for a group of patients in accordance with all Medical Center and Ambulatory Services Policies and Procedures.
3. Establishes and/or revise priorities for job/patient care activities based on acuity, visit volume, resource availability, patient/family preference, and scheduled procedures.
4. Seeks consultation, supervision, and/or assistance when unable to perform procedures effectively, safely, or independently.

D. Patient Care Management

1. Functions as patient advocate and facilitate patient/family participation in decisions regarding their care. Is a resource to patients and families.
2. Supervises patient care and delegates appropriate components in a manner that promotes efficiency, teamwork and optimal patient care outcomes.
3. Evaluates and provides consistent and timely feedback to members of the health care team and Practice Director regarding the quality of patient care.

care agencies

1. Functions as contact person to triage patient care requests and referrals to clinic.
2. For hospitalized patients, follow the patient while hospitalized, escalate long stay/high cost cases per format and communication process and actively engage in potential disposition changes to assure an appropriate discharge.
3. For post index stay patients, provide timely ongoing contact and follow-up with patient to ensure understanding of condition/clinical status, procedure, plan of care, and need for follow-up care.
4. For post index stay patients, conduct ongoing contact and follow-up with post-acute care providers and other providers on a timely basis and notify providers or readmissions and significant clinical status changes as appropriate.
5. Coordinates California Children's Services (CCS)

20
Y
NURSING PROCESS/DOCUMENTATION

Meets Medical Center documentation standards as evidence by documentation of the following:

A. Assessment

1. Screens and assesses patients for pain. Contributes to or participates in pain management plan. Coordinates with IP staff, Pharmacy, APP's.
2. Screens and assesses patients at risk for nutritional and functional problems. Identifies and reports instances of dependent adult abuse/neglect, and domestic violence in accordance with Medical Center policies.
3. Screens and assesses patients for complications.

B. Planning

1. Prioritizes patient needs and helps patient formulate plan of care.
2. In response to data indicating potential or actual risk to individual's health, initiates action to correct, reduce or prevent the risk.
3. Assists members of health care team in the formulation and implementation of the patient's plan of care.
4. Provides and documents a rationale for actions or decisions based on scientific principles, standards of nursing practice, previous experience, and/or clinical judgment.

C. Implementing

1. Prepares patients for and instructs them about specific diagnostic and therapeutic procedures and treatments.
2. Performs patient care procedures required by scope of clinical assignment and in accordance with the Medical Center and Ambulatory Services policies and procedures.
3. Responds and participates in the management of emergency clinical issues.
4. Administers medications safely.

D. Evaluating

1. Documents patient outcomes and responses to nursing interventions.
2. Utilizes theoretical knowledge and clinical skill to develop alternate approaches to patient and family care.

E. Teaching

1. Identifies patient, family and/or patient's caregiver learning needs and potential barriers to learning and documents on teaching records or on flow sheets.
2. Identifies patient, family and/or patient's caregiver teaching interventions specific to patient's diagnosis and ability to learn, collaborating with other disciplines as appropriate.
3. Involves patient, family, and/or the patient's caregiver in teaching.
4. Participates in the evaluation and revision of patient education materials.
5. Evaluates the patient, family and/or patient caregiver's response to teaching.

20
Y
COMMUNICATION

1. Responds to the emotional needs of patients, families and/or caregivers by demonstrating a sensitivity to their sociocultural dynamics.
2. Interacts with patients, families, caregivers and staff in a supportive, calm, and therapeutic manner.
3. Demonstrates courtesy, common sense and follow through in all telephone communications, maintaining the telephone standards established be the Medical Center.
4. Listens respectfully to the ideas, opinions and feelings of others.
5. Demonstrates sensitivity, respect, tact and diplomacy in all interactions.
6. Communicates and accepts constructive feedback in a manner that promotes a positive outcome and supportive work environment.
7. Utilizes advanced interpersonal skills to facilitate problem resolution with members of the health care team, patients and their families.
8. Utilizes appropriate chain of command in problem resolution, as identified in the organizational chart and Administrative manual.
9. Responds to patients, providers and care team phone calls, emails, In-Baskets, in a prompt manner. Documentation is thorough and timely.

20
Y
PROFESSIONALISM

A. Professional Development

1. Identifies and meets own educational needs to enhance area of practice.

B. Work Related Policies

1. Maintains current California RN license, CPR and specialty certification and present proof prior to expiration, per policy.
2. Meets annual review requirements.
3. Meets annual PPD or chest exam requirements.
4. Meets work schedule commitment.
5. Follows practice guidelines regarding attendance.
6. Maintains flexibility in relation to patient assignments, shift assignment and work assignment.
7. Adheres to dress code, including appropriate identification.
8. Complies with practice related policies.
9. Knowledgeable about and complies with all applicable infection control, health and safety policies and procedures as implemented by the Ambulatory Services and the Medical Center.

C. Professional Reliability

1. Articulates practice/departmental goals and philosophy.
2. Participates in practice/department committees, including Performance Improvement.
3. Complies with activities mandated by JCAHO/Title 22.
4. Maintains knowledge of and adheres to established clinical and administrative policies and procedures.
5. Ensures protection of patient rights and confidentiality.
6. Attends any required conferences and meetings.
7. Supports Medical Center cost containment efforts.
8. Attends and participates in at least 75% of staff meetings.
9. Reads meeting materials and other departmental communications and integrates practice.
10. Promotes and participates in research activities to enhance patient care.

20
Y
LEADERSHIP

A. Uses an Effective Approach with Patient and Unit-related Problems

1. Identifies actual and potential problems and participates in formulation/implementation of a plan for resolution of problems using appropriate resources.
2. Reports unresolved patient and practice related problems to appropriate individual(s) and/or department.
3. Acts as a resource to other staff members in problem identification/resolution and current issues in own clinical area.
4. Delegates duties and guides personnel in patient care delivery to ensure safe and individualized patient care.

B. Fosters a Collaborative Approach to patient and Staff-related Issues

1. Acts as a reliable and approachable role model/mentor for staff and students at a level appropriate to own stage of professional development.
2. Incorporates new procedures/policies, knowledge of equipment and medical products into one's own and other's clinical practice.

100%

(To update total %, enter the amount of time in whole numbers (without the % symbol - e.g., 15, 20) then highlight the total sum (e.g., 1%) at the bottom of the column and press F9. The total sum should add up to 100%.)

LIVING PRIDE STANDARDS

Service Excellence

• Demonstrates service excellence by following the Everyday PRIDE Guide with the UCSF Medical Center standards and expectations for communication and behavior. These standards and expectations convey specific behavior associated with the Medical Center's values: Professionalism, Respect, Integrity, Diversity and Excellence, and provide guidance on how we communicate with patients, visitors, faculty, staff, and students, virtually everyone, every day and with every encounter. These standards include, but are not limited to: personal appearance, acknowledging and greeting all patients and families, introductions using AIDET, managing up, service recovery, managing delays and expectations, phone standards, electronic communication, team work, cultural sensitivity and competency.
• Uses effective communication skills with patients and staff; demonstrates proper telephone techniques and etiquette; acts as an escort to any patient or family member needing directions; shows sensitivity to differences of culture; demonstrates a positive and supportive manner in which patients / families/ colleagues perceive interactions as positive and supportive. Exhibits team work skills to posi