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I) Job Purpose
The purpose of this position is to utilize nursing judgement and critical thinking skills to provide nursing leadership to the team of Registered Nurses, LVN, and Support Specialist in Provider Intermediate Care Facility (ICF) START Resource Center and Dayhab Services by working collaboratively with all members of the team. The RN will provide training, consultation, supervision and evaluation of nurses with a goal to promote and improve the healthcare needs of individuals with intellectual and developmental disabilities (IDD) living or receiving services in MHMR facilities. The RN is responsible for developing and maintaining a standardized environment to meet ICF standards consisting of patient focused care, defining standards for evidence based quality patient care, managing and developing a positive nursing environment.
A) Provides direct supervision and training to an assigned team of Registered Nurses, LVN, and Support Specialist in Provider Intermediate Care Facility (ICF) START Resource Center and Dayhab Services
1. Responsible for interviewing, training and developing new nurses.
2. Ensures that RNs are completing job functions within Provider ICF, START, and Dayhab guidelines.
3. Develops and provides training to ICF Residential Home Managers and Direct Support Professionals (DSP)s on an as needed basis.
4. Provide instruction and guidance-from orientation to ongoing informal and formal teaching sessions-to staff nurses.
5. Develops and coordinates the on-call process for nurses.
6. Maintains nursing operations by initiating, coordinating, and enforcing program, operational, and personnel policies and procedures.
7. Updates and/or develops Disability Services nursing guidelines and desktop procedures on an as needed basis.
8. Evaluates nursing team and focus on ways to improve services to individuals served.
9. Evaluates the effectiveness of the care given by the interdisciplinary care team and identifies problems and guides team members to their solution.
10. Evaluates nurses to include processes, job performance and patient relations (annual observation)
11. Assess nurse competency – ongoing.
12. Address problems involving nursing staff.
13. Determine nurse staffing levels needed in Disability Services.
14. Report significant issues to the Chief Nursing Officer.
15. Utilizes data, in person supervision and quality review of charts to track and evaluate performance of RNs on a monthly basis
16. Provides feedback to the Chief of DS and Director of ICF, START, and Dayhab Programs
B) Provides direct nursing services to individuals that participate in the Provider ICF, START, and Dayhab Programs
1. Medical monitoring of individuals, including documentation and review of medical records.
2. Provides nursing support including home visits and telehealth as needed
3. Ensure all enrolled individuals have a current nursing assessment/plan of care.
4. Identify interventions and document interventions.
C) Perform MHMR nursing policies and procedures for all services rendered
1. Implement MHMR of Tarrant County Nursing Philosophy with nursing staff and when providing nursing care for individuals.
2. Knowledge and ability to effectively apply the nursing care functions of assessment, planning, facilitation, advocacy, care coordination as described in numbers 3-9 below
3. Assessment: Identification of individuals for care management; comprehensive collection of individual's information and medical status; continued comprehensive collection of individual's information and medical status; and continued evaluation of an established plan of care.
4. Planning: Collaboration with the individual, MHMR UAPs , primary provider and other members of the health care team for developing an effective plan of care.
5. Facilitation: Care coordination and communication among all involved parties.
6. Advocacy: Support for the individual and MHMR unlicensed assistive personnel (UAP) to ensure identified education and appropriate, timely care is received.
7. Coordinates care through a continuum and facilitates the achievement of optimal outcomes in relation to clinical care, quality and cost effectiveness.
8. Facilitates identification, adoption, implementation and utilization of standardized clinical practice guidelines and protocols for care management of individuals served.
9. Identifies, develops and executes appropriate disease management activities and interventions such as, but not limited to individual and/or group contacts
D) Conducts a thorough evaluation of the individual's current physical, psychosocial and health status. Documents treatment plans and then matches level of individual's care to clinical risk, readiness to change and health literacy.
1. Promote understanding and self-management of health issues.
2. Medication reconciliation and management.
3. Guides the individual and MHMR UAPs through the healthcare system, maximizing use of resources.
4. Care coordination between physicians and others to individuals with IDD and MHMR UAPs .
5. Facilitate appointments for follow up with primary care physicians and specialists.
6. Address barriers and facilitate accountability.
7. Provide specific training to MHMR UAPs in the IDD population
E) Travel within the community to attend office visits and medical appointments as an advocate
1. Considerable independence in performing job related duties requiring a great deal of personal initiative and self-discipline to ensure that all of the individuals' needs are met.
2. Strong organizational, interpersonal and decision-making skills.
3. This position may require temporary or permanent re-assignment to any MHMR of Tarrant County facility or program as determined by program needs or the Division Chief or Director of ICF
F) Extensive documentation, time management and continuity of care responsibilities exist as well. Job performance is evaluated through review of the timeliness and thoroughness of submitted reports and documentation, knowledge of the developmental disability field, organizational, interpersonal and decision making skills and effectiveness in working with the MHMR UAPs and individuals on their caseload
1. Updating and maintaining all required information for each individual.
2. Perform other related job duties or responsibilities as requested or required, whether or not specifically mentioned in the job description.
3. Exhibits a willingness to assume additional duties; seeks the guidance of supervisor prior to beginning an unfamiliar assignment.
G) Meetings, Committees & other information.
1. Develop and run nursing meetings for DS provider nurses.
2. Provide nursing input and presence at Division level meetings regarding professional nursing practice, staffing and clinical excellence.
3. Develop and implement policy and procedures .
4. Participates on organizational-wide and nursing committees while balancing responsibilities at this service site as schedule permits.
5. Communicates with clinical supervisor regarding complex clinical or ethical issues, each time they arise.
6. Carries out measures to prevent exposure to and transmission of pathogens in accordance with agency standards on infection control at all times.
7. Participates in identification and monitoring of measurable quality care for those individuals served at this location.
H) Maintains a professional and ethical code of behavior.
1. The RN always maintains confidentiality of all individuals served, including agency related information within and outside the program setting.
2. The RN contributes to the learning experience of new employees, students and other agency personnel.
3. The RN maintains neat and professional appearance.
4. The RN addresses individuals served in the community and at the site, visitors and co-workers in a pleasant and respectful manner.
I) Shows evidence of continuing professional growth.
1. Nurse will complete all MHMR Tarrant agency training requirements within first 60 days of employment and will complete all annual training updates as required.
2. In-services or continuing nursing education programs will be attended which benefit nurse’s knowledge and client care. These must be approved by the supervisor. Will provide a copy of the attendance roster for verification.
3. Nurse will maintain continuing nursing education units to comply with standards set by the Texas Board of Nursing, as evidenced by and proof of attendance.
4. Evidence of all outside training as well as any upgrades in credentials will be forwarded to the Training Department and/or the employees Personnel File/Human Resources.
5. Scheduled nursing meetings will be attended to facilitate networking, professional growth and information dissemination, as scheduled.
K) Performance standards are performed as applicable with MHMR’s We CARE values “We Connect People in Our Community. We Provide Access to Services. We Link People to Resources. We Empower People.”
L) Perform other job duties or responsibilities as requested or assigned.
II) Knowledge of Laws, Regulations, Policies/Procedures, Skills, and Abilities
A) Texas Board of Nursing Practice Act including RN Scope of Practice Standards
1. Texas Administrative Code
2. Texas Health and Human Services Rules and Statutes
3. ICF Standards
4. DDNA Standards of Developmental Disabilities Nursing practice
5. MHMR Tarrant Policies and Procedures
6. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
7. International Statistical Classification of Diseases and Related Health Problems, 10th Edition (ICD-10)
8. ANA Code of Ethics for Nurses
9. Labor Laws
10. Pharmacy Laws
11. Medicaid, Medicare, Managed Care and Private Insurance Billing Requirements
B) Considerable knowledge of developmental disabilities
C) Considerable knowledge of behavioral management techniques and interventions
D) Knowledge of psychotropic medications used to treat behavioral disorders
E) Ability to maintain a full caseload
F) Ability to communicate effectively with others verbally and in writing, using clear and concise case notes using proper grammatical form and practice
G) Ability to interact with individuals, UAPs and resource personnel in a sensitive and objective manner
H) Ability to react to emergency and/ or crisis situations in an appropriate manner and reduce the likelihood of further escalation or danger to the involved parties
I) Ability to develop realistic and appropriate goals and objectives for all individuals on their caseload
J) Ability to create and maintain detailed notes and observations of individual's progress toward established objectives
K) Ability to conduct effective and informative training sessions for individuals and UAPs
L) Ability to plan and organize all personal activities to meet all workload demands, established deadlines and reporting requirements
M) Ability to perform the physically demanding aspects of the job in a variety of weather conditions
N) Skill in supervising staff and providing clear expectations to ensure operational goals are met
O) Skill in diffusing potentially volatile situations and intervening in emergency and/or crisis situations
P) Excellent computer skills; must be knowledgeable about use of laptops and hot spots
Q) Must be proficient with Microsoft Outlook, Excel, Word and other software as applicable
R) Strong organizational, interpersonal and decision-making skills
III) Internal & External Customer Service
A) Extensive internal and external contact is required. The employee will demonstrate advanced written and verbal skills while maintaining a positive and professional image.