APRN - TELE-ICU
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values—integrity, patient-centered, respect, accountability, and compassion—must guide what we do, as individuals and professionals, every day.
The tele-ICU APRN will be a core member of a collaborative team responsible for providing telemedicine to a diverse population of critically ill adults across multiple ICUs. The tele-ICU APRN practices as an adjunctive nurse during overnight hours, collaborating with patients, families, unit managers and clinical staff, and peers to detect warning signs of clinical deterioration and facilitate the coordination of patient care at the unit level. The tele-ICU APRN demonstrates leadership through the assessment, planning, implementation and evaluation of 25 to 40 critical care patients from the tele-ICU monitoring center, under the supervision of the tele-ICU intensivist, the tele-ICU Medical Director, and the Director of Specialty Services. The APRN will be a champion of, and cheerleader for, the tele-ICU service, while working to achieve common tele-ICU goals, including enhanced clinical outcomes and best practice compliance. Patient rounding will occur via remote electronic monitoring; as such, the APRN must be facile with communications technology, be able to master technological platforms (electronic medical record, patient acuity scoring system, etc.) and be comfortable communicating with units via text, audio, and video channels during times of stress. The APRN must demonstrate excellent teamwork and customer service skills, presenting a great (virtual) first impression and building strong relationships with unit-based stakeholders to ensure shared ownership of patient care. The APRN must thrive in a teaching environment, share experience and knowledge, and guide unit based nurses and residents to follow established best practices. The APRN must be able to adapt to new and changing requirements/activities, be outgoing and friendly, be dedicated to patient and family centered care, and remain calm under pressure.
- 1. 1. Clinical Practice 1.1. Assumes secondary, and at times primary, patient care responsibility for tele-ICU patients under the supervision of the tele-ICU physician. 1.2. Identifies patient?s health care needs and assesses health status of patient/family during inpatient hospitalization, providing continuity of care to achieve optimal patient outcomes and satisfaction. 1.3. In collaboration with the tele-ICU physician and the unit ICU physicians/staff, continually evaluates and modifies the plan of care in accordance with agreed upon protocols. 1.4. On a nightly basis, assume administrative leadership role by introducing tele-ICU care team, attending nightly Nursing rounds/handoffs, and ensuring all unit staff are available via assigned technological devices. 1.5. Prevents clinical problems from occurring through direct observation via tele-monitoring and tele-conferencing, proactive surveillance of adverse physiological trends, assurance of appropriate ordered prophylactic strategies, medical chart review, and appropriate reaction to alarms. 1.6. Communicates patient status information and documents progress in the Epic EMR. Enters admission orders, orders appropriate tests and therapy; interprets results and outcomes, and discusses appropriate interventions in collaboration with the tele-ICU physician. 1.7. Assists in educating patients and families about treatment plans, discharge plans, and end of life/supportive services when indicated.
- 2. 2. Education: 2.1. Serves as a resource for residents, fellows, and respiratory therapists, and as a role model for nurses and advanced practice nursing students. Maximizes opportunities in the clinical setting for informal education of staff, patients, and families. 2.2. Physically spends time on tele-ICU units pre and post go-live to establish a positive rapport, understand clinical and cultural and practices, participate in and/or lead training activities, and become a trusted member of the bedside team. 2.3. Is knowledgeable of national clinical and operational trends in telemedicine and tele-ICU services. 2.4. Works both independently and with other healthcare departments/disciplines in developing, implementing, and evaluating educational programs for tele-ICU and bedside professionals. 2.5. Assists in the development of patient education materials regarding telemedicine and the tele-ICU service. 2.6. Identifies learning needs of team members, patients and families. Provides remote bedside teaching and supervision of procedures as indicated. 2.7. Continually identifies learning opportunities for both tele-ICU and bedside staff. 2.8. Lectures at conferences and seminars for health care professionals.
- 3. 3. Research: 3.1. May support the research mission through collaboration with investigators and protocol personnel. 3.2. May promote research utilization through the dissemination of existing and new research findings in the clinical practice setting. 3.3. May promote specialty clinical trials, both in-house and through cooperative groups.
- 4. 4. Quality Improvement 4.1. Participates in the evaluation of tele-ICU metrics, including performance against clinical aims. 4.2. Participates in the evaluation of patient, family, and bedside staff feedback and assists in responding to concerns and developing improvement strategies. 4.3. Partners with unit Nursing leaders to disseminate and review unit metrics on a regular basis. Works to enhance unit collaboration, tighten workflows, and ensure ongoing commitment to achieving high quality clinical standards. Assists clinical and administrative leaders in crafting remediation strategies when indicated.
Master?s Degree required with graduation from an approved Nurse Practitioner program or Physician Assistant program. Licensed and currently registered in the State of CT. ANA certification and prescriptive authority required. Current BLS for the Healthcare Provider. Advanced Cardiac Life Support certification (ACLS) issued by the American Heart Association (AHA ).
At least 3 years of experience in an adult ICU. Previous experience in an advanced practice role or tele-ICU center preferred.
Licensed and currently registered in the State of CT
Demonstrates excellent clinical, interpersonal, communication and conflict resolution skills. Demonstrates rapport with department team members and physicians in a variety of specialties. Proficient with Windows-based computer applications, electronic medical records (Epic preferred), and personal communications technology (e.g. texting and calling via cell phone, navigating tablet-based devices). Preceptor and mentor experiences or other activities demonstrating commitment to continuous development of staff strongly preferred. Must be able to handle multiple demands simultaneously. Must demonstrate sound decision-making and communication skills. Knowledgeable of research methods.
Remote tele-ICU center operates from 7pm -7am, seven days per week. Weekend and holidays hours per organization policies . Office (radiology reading room) environment, with moderate stress related to constant patient monitoring and bedside communication and coordination.
Tele-Intensive Care Service
A unique opportunity for a seasoned ICU APRN to be a member of our exciting ICU initiative to build the program which started 2015, and impact the care of critically ill patients in two different acute care settings, Yale-New Haven Hospital and Greenwich Hospital. The remote Tele-ICU center is located on the York St Campus in a newly rennovated state-of-the-art work area referred to as the "bunker".
What Tele-Intensive Care Service does?
Tele-Intensive Care allows APRNs, RNs, physicians, and advanced practice providers who specialize in intensive care to constantly monitor patients’ vital signs and other data from a control center at the hospital’s information technology headquarters on the York St Campus. From there, the Tele-Intensive Care team can alert physicians and nurses at the patient’s bedside if a patient’s condition changes and work with bedside care providers or other specialists in the hospital to determine the most appropriate care.
How does it work?
The Tele-Intensive Care control center operates overnight, from 7 pm through 7 am, seven days a week, providing an extra level of monitoring and support, particularly when bedside physicians are not immediately able to be in the patient’s room. The Tele-Intensive Care control center connects with devices monitoring patients’ blood pressure, heart rate and other vital signs and can access patients’ electronic medical records to view medical history, medications, test results, physicians’ notes and other important information. A two-way audio and video system allows the Tele-Intensive Care team members to evaluate and talk with patients, bedside physicians and nurses in real time.
Who Will Be Successful In This Role?
The successful Tele-ICU Advanced Practice Provider will be someone who thrives in a teaching environment, shares experience and knowledge, and guides and mentors unit based nurses and residents to follow established best practices. In addition, the candidate will have the following:
- EDUCATION: Master’s Degree required with graduation from an approved Nurse Practitioner program or Physician Assistant program. Licensed and currently registered in the State of CT. ANA certification and prescriptive authority required. Current BLS for the Healthcare Provider. Advanced Cardiac Life Support certification (ACLS) issued by the American Heart Association (AHA ).
- EXPERIENCE: Have at least three (3) years of experience in an adult ICU. (Experience can be a combination of RN and APRN experience.) Previous experience in an advanced practice role or tele-ICU center preferred. CCRN certification preferred, CCRN-e certification preferred.
- SPECIAL SKILLS: Demonstrates excellent clinical, interpersonal, communication and conflict resolution skills. Demonstrates rapport with department team members and physicians in a variety of specialties. Proficient with Windows-based computer applications, electronic medical records (Epic preferred), and personal communications technology (e.g. texting and calling via cell phone, navigating tablet-based devices). Preceptor and mentor experiences or other activities demonstrating commitment to continuous development of staff strongly preferred. Must be able to handle multiple demands simultaneously. Must demonstrate sound decision-making and communication skills. Knowledgeable of research methods.
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