Nurse Practitioner PD - PICU/TCUP (BCH-Mission Bay)

UCSF Benioff Children's Hospital is recognized throughout the world as a leader
in health care, known for innovation, technology and compassionate care. UCSF
has one of the top children's hospitals in the nation, according to a ranking by
U. S. News & World Report. Our 183-bed UCSF Benioff Children's Hospital has more
than 150 specialists in more than 40 areas of medicine.

The Pediatric Intensive Care Unit (PICU) at UCSF Benioff Children's Hospital
provides extraordinary high-level care for children who require continuous
monitoring. The unit has 20 beds for infants and children suffering from a
variety of conditions or recovering from surgery. More than 1,000 children per
year are admitted into the intensive care units at UCSF Benioff Children's
Hospital arriving via ambulance, helicopter and airplane from throughout the
western United States.

The Pediatric Transitional Care Unit (TCUP) is a 16-bed unit for infants and
children suffering from a variety of conditions or recovering from surgery. The
TCU provides care to patients with a moderate to high complexity of disease such
as those recovering from solid organ transplantation, titration of anticoagulant
therapy and other infusion, and post-operative specialty surgery care (ENT,
neurosurgery).  Patients requiring respiratory support including BIPAP, CPAP,
high flow nasal cannula and patients requiring mechanical ventilation with
tracheostomy in place are also routinely admitted to the TCUP.  The Nurse
Practitioner will act as a full member of the team taking responsibility for the
safe delivery of care in collaboration with attending physicians, fellows and
residents. This team member will meet productivity expectations as set forth by
the Division Chief, performing any duties related to patient care activities
that are appropriate and clearly delineated.

Nurse Practitioners on the PICU and TCUP Team provide care in rotating 12h
shifts.

This per diem position includes holidays and weekends with the following MINIMUM
AVAILABILITY REQUIREMENTS:

* Four (4) shifts per eight (8) week schedule or ratio of 2 shifts per 4 weeks
scheduled Weekend/Night Commitment: Must be available and willing to work at
least 4 weekend or 4 night shifts (Saturday or Sunday) per 8-week schedule.

* Holiday Commitment: Must be available to work one major UCSF holiday and one
non-Major UCSF holiday per year (includes the holiday and the day before or
after for a 2 day holiday period):

* Major UCSF Holidays: Thanksgiving, Christmas, New Years, Memorial Day, July
4th or Labor Day

* Non-Major UCSF Holidays: MLK Jr. Day, President’s Day, Juneteenth, Mother’s
Day, Halloween

* May be scheduled for the holiday in addition to the day before or day after
the holiday

* May be scheduled in the PICU or Transitional Care depending on the needs of
each unit

RESPONSIBILITIES

Function

% of time

Duties

Inpatient - Direct Patient Care (may include some or all of the responsibilities
listed)

70

1. Independently (independent APP encounter) or collaboratively (shared
physician and APP encounter) evaluates and manages patients.

2. Includes taking histories, performing physical examinations, responding to
changes in patient status, performing consults, ordering or furnishing
medications/diagnostic
tests/treatments/therapies/consultations/referrals/durable medical equipment
(DME)/home health services.

3. Care provided must be documented in the electronic medical record in
accordance with the UCSF Rules and Regulations
[https://medicalaffairs. ucsf. edu/governing-documents].

4. Provider services must be billed to reflect the performing provider and
comply with the APP Billing Policy 3.08.01
[https://powerdms. com/docs/1339619].

5. APPs must respond to clinical documentation integrity inquiries from the
Department of Quality and Patient Safety within 3 days.

1.2. Performs procedures granted to them via privileges/standardized procedures.

1.3. Identifies patients with acute decompensation or failure and responds to
the hospital plan of care and reviews with physician.

1.4. Initiates consultations as indicated.

1.5. Documents independent assessment findings and recommends appropriate
treatments.

1.6. Participates in service rounds and patient evaluation and treatment
planning.  

1.7. Reviews lab tests, x-rays, and other diagnostic tests, and initiates
appropriate team plans.

1.8. Evaluates complex cases, establishes individualized plans of care for
disposition to a lower level of care.

1.9. Interprets and acts upon completed tests, procedures, and radiographic
studies.

1.10. Completes clinically relevant paperwork/electronic health record (EHR)
documentation, including but not limited to ordering medications, completing
episodic care notes and discharge summaries in accordance with the UCSF Rules
and Regulations [https://medicalaffairs. ucsf. edu/governing-documents].

1.11. Effectively communicates findings, treatment options, and care plans with
patients and their families 

1.12. May first assist in the operating room if privileged to do so through OMAG
after completing the required certification and proctoring.

1.13. Monitors and evaluates patients for discharge. Sets parameters and
guidelines for continuum of care with multi-disciplinary team. This includes
evaluating and defining discharge regimen.

1.14. Discharges patients including prescribing/furnishing medications, ordering
DME, and recommending or referring for ongoing follow up care, providing
discharge teaching, and completing discharge summaries.

Inpatient – Care Coordination (may include some or all of the responsibilities
listed)

30

1.1. Coordinates care throughout the continuum including hospital admission,
care coordination with staff and consulting services, and hospital discharge
planning.
1.2. Coordinates episodic care and determines timing of routine clinic follow
up.
1.3. Participates in huddles with clinic/hospital staff and anticipates patients
who require close management or intervention.
1.4. Consults with nursing staff on plan and implementation of individualized
nursing care plans. 

1.5. Independently provides case summaries for disability, insurance agencies,
workers compensation, work releases, and medical supply agencies.
1.6. Formulates and implements protocols to improve quality and efficiency and
control waste in the clinical specialty.

Outpatient – Independent Encounters (may include some or all of the
responsibilities listed)

1. Evaluates and manages patients in independent APP encounters, including
telehealth.

2. Includes providing care to new, follow-up, acute, routine, and specialty
patients.

3. Includes taking histories, performing physical examinations, interpreting
diagnostic tests, formulating evidence-based assessments and plans,
responding to changes in patient status, and ordering medications/diagnostic
tests/treatments/therapies/consultations/referrals/durable medical equipment
(DME)/home health services.

4. Reviews or collaborates with attending physician as needed.

5. Care provided must be documented in the electronic medical record in
accordance with the UCSF Rules and Regulations
[https://medicalaffairs. ucsf. edu/governing-documents].

6. Provider services must be billed to reflect the performing provider and
comply with the APP Billing Policy 3.08.01
[https://powerdms. com/docs/1339619].

1.2. Performs procedures individually granted to them via standardized
procedures/privileges.
1.3. Identifies high-risk groups and complex cases for review with attending
physician. Initiates consultations as appropriate. 

1.4. Evaluates complex cases, establishes individualized plans of care for
rehabilitation, and facilitates occupational and physical therapy and physical
medicine and rehabilitation consultations.
1.5. Interprets and acts upon the ordered tests, procedures, and radiographic
studies in a timely fashion.

1.6. Completes clinically relevant paperwork/EHR, including but not limited to
ordering medications, completing episodic care notes and telephone encounters.

Outpatient – Shared Encounters with Physician(s) (may include some or all of the
responsibilities listed)

1. Evaluates and manages patients in shared encounters with attending
physician, including telehealth.

2. This should increase clinic access with a goal of doubling clinic volume
since two providers will be sharing the clinic responsibilities.

3. Includes providing care to new, follow-up, acute, routine, and specialty
patients.

4. Includes taking histories, performing physical examinations, interpreting
diagnostic tests, collaborating on evidence-based assessments and plans,
responding to changes in patient status, and ordering medications/diagnostic
tests/treatments/therapies/consultations/referrals/durable medical equipment
(DME)/home health services.

5. Care provided must be documented in the electronic medical record in
accordance with the UCSF Rules and Regulations
[https://medicalaffairs. ucsf. edu/governing-documents]

6. Provider services must be billed to reflect the performing provider and
comply with the APP Billing Policy 3.08.01
[https://powerdms. com/docs/1339619].

1. May first-assist in the operating room if privileged to do so through
OMAG after completing the required certification and proctoring.

1.3. Identifies high-risk groups and complex cases for review with attending
physician. Initiates consultations as appropriate. 

1.4. Evaluates complex cases, establishes individualized plans of care for
rehabilitation, and facilitates occupational and physical therapy and physical
medicine and rehabilitation consultations.
1.5. Interprets and acts upon the ordered tests, procedures, and radiographic
studies in a timely fashion.

1.6. Completes clinically relevant paperwork/EHR, including but not limited to
ordering medications, completing episodic care notes and telephone encounters.

Outpatient – Care Coordination (may include some or all of the responsibilities
listed)