Arranges necessary health-care services for patients requiring nursing services in their homes. Evaluates and executes appropriate treatment for referred patients with emphasis on quality of care, continuity of services, and cost-effectiveness. Conducts initial assessment and establishes a plan of care for patients and provides direct patient care.
Assumes responsibility for caseloads consisting of patients in specialty areas.
Conducts initial assessment to obtain thorough physical, social and environmental data.
Establishes the plan of care in accordance with the physician orders and patient needs.
Provides direct patient care and adjusts nursing care processes as needed. Identifies problems, modifies nursing care plan, and evaluates outcomes within an appropriate time frame. Advises and consults with family and other personnel, as appropriate.
Provides on-going assessment of patient response to treatments and teaching and applies interventions as appropriate. Updates and revises plan of care as indicated.
Completes documentation including visit assessment, OASIS, 485 and verbal orders accurately and promptly and within the standards.
Communicates with physicians to confirm and update patients' plan of care. Provides status updates and ensures ongoing communication with the physician and other members of the health care team.
Facilitates the discharge planning process according to standards and utilizes resources to assure continuity of care after discharge. Participates in developing the discharge plan with the patient/family, physician, social worker, and other staff members as appropriate.
Participates in chart audits and continuous quality improvement activities as requested. Identifies, develops and participates in process improvement opportunities that will enhance the quality of the services provided.
Maintains and updates accurate clinical and patient records according to agency, state, and federal guidelines.Scheduled Hours
Licenses & Certifications
Registered Nurse license issued by the state in which the team member practices, and
Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association (AHA) needs to be obtained within 6 months unless department leader has determined it is not required, and
A valid drivers license issued by the Division of Motor Vehicles, or
Driver license issued by the state of Illinois.
Associate's Degree in Nursing.
Required Functional Experience
Typically requires 3 years of experience in clinical nursing.
Knowledge, Skills & Abilities
Excellent communication skills. Strong interpersonal skills and the ability to work with a variety of clients with patience and respect. Good organizational, analytical and problem solving skills. Demonstrated ability to work well with physicians and other professionals in a direct and positive manner.Proficiency in clinical skills with the ability to work under direction and make sound judgments.Ability to operate the necessary equipment to perform the job, i.e., FAX, computer, copier, telephone system.Ability to assess data reflecting the patient's status and the ability to interpret the appropriate information needed to identify each patient's requirements relative to their specific needs.Must have a tolerance for differences and an appreciation of multi-culturalism and diversity of the patients and their families.Must possess and provide proof of a valid Driver License and a registered, functional car with adequate insurance coverage.