Advanced Practice Provider - Clinical Decision Unit, Emergency

Overview

The Advanced Practice Practitioner in Emergency Care works as an educator, advocate and care provider and is responsible for the care and well-being of patients in the Michael and Susan Smith Emergency Department by functioning as a direct provider of emergency services

Responsibilities

SUPPLEMENTAL JOB FUNCTIONS:

• Assess and triages a patient’s condition by obtaining a focused and pertinent history, identifying risk factors, performing an appropriate focused/complete physical examination, and by ordering and/or providing preventive or diagnostic procedures.• Develops a differential diagnosis and/or diagnoses of both life threatening and non-life threatening conditions by utilizing critical thinking while simultaneously synthesizing andanalyzing patient data. ENPs establish a differential diagnosis based on the patient’s medical history, physical exam findings, interpretation of diagnostic studies, while continually establishing priorities to meet the needs of the patient, their family, and or the community.• Utilize critical thinking during medical screenings and diagnostic processes by synthesizing and analyzing the data to execute a plan of care including stabilization, resuscitation of unstable conditions and the transfer of care when appropriate.• Provides medical screening evaluations in accordance with the EMTALA. This includes:o Documentation of the chief complaint and pertinent history incorporating health risk factorso Physical exam findingso Interpretation of diagnostic data including the rationale for the medical necessity of testso Medical decision making with differential diagnosiso On-going evaluation of patient progress and response to treatment to determine the plan of care.• Collaborates with staff of affiliated institutional facilities to provide care for patients receiving care in the Michael and Susan Smith Emergency Department• Collaborates with transitional support team, inpatient teams, physical therapy and other health care providers to ensure a seamless transition to inpatient units or care within the community.• Determines most appropriate patient disposition• Confers with patient’s primary care provider as needed• Communicates via Epic outstanding patient problems and issues requiring follow up care• Management of patient health/illness statuso Triages patients’ health needs/problemso Completes EMTALA-specified medical screening examinationso Responds to the rapidly changing physiological status of emergency care for the assessment, treatment, and disposition of acute and chronically ill and injured emergency patients.o Specifically assesses and initiates appropriate interventions for violence, neglect and abuse.o Specifically assess and initiates appropriate interventions and disposition for suicide risko Participates in internal and external emergencies, disasters, and pandemics.o Maintains awareness of known causes of mass casualty incidents and treatment modalities required for emergency care.

The following may be done independently based on scope of practice and credentialing or in partnership with the ER staff physician:o Assess and manages a patient in cardiopulmonary arresto Assess and obtain advanced circulatory accesso Ultraviolet examination of skin and secretionso Treat skin lesionso Injects local anestheticso Nail trephinationo Toe nail removalo Nail bed closureo Wound revision for closureo Debridement of wounds/ minor burnso Incision, drainage, irrigation of wounds and packing.o Eye dilatationo Tonometry to asses intraocular pressureo Slit lamp examinationo Cerumen impaction curettageo Control epistaxiso Needle thoracotomy for life threatening conditions in emergency situations.o Replace gastrostomy tubeo Assess and manage cervical spine injurieso Lumbar punctureo Incise and drain Bartholin’s cysto Assist with imminent childbirth and post-delivery maternal careo Fecal impaction removalo Incision of thrombosed hemorrhoidso Digital nerve blocko Reduction of fractures of small boneso Reduction of fractures of large bones with vascular compromise (ie. traction splint)o Application of immobilization deviceso Remove castso Arthrocentesis (knee/elbow)

Qualifications

• ACLS certification• Additional privileging as requested to perform procedures independently:o Arterial line placemento Arthrocentesiso Nerve blocko Fracture reductiono Lumbar puncture.o Cast and splinto Chest tube placement/removalo Chest x-ray reviewo Digital, hematoma, and intraarticular blockso Central and femoral venous catheter placement/removalo Joint aspirationo Joint injection: tendon sheaths, ligaments, trigger points, ganglion cysts, bursao Paracentesiso Taping and bracingo Fracture reduction• Maintains competency in area of expertise• Specialty certification if available/eligible