SUBFUNCTION DEFINITION: Advanced Practice Providers (APPs) are Advanced Practice Registered Nurse (APRN), Physician Assistant (PA), Nurse Anesthetist (CRNA), Clinical Nurse Specialist (CNS) or Certified Nurse Midwife (CNM) providing clinical services including diagnosis of illness, development and management of treatment plans, prescription of medication. APPs may see patients independently or as part of the health care team.
Scope for subspecialty role will not exceed the scope of the collaborating or supervising MD
- Patient Care
Perform history and/or physical exams on patients presenting for care in area of expertise. Assess and diagnose illnesses, including chronic and acute conditions. Formulate, document and monitor a treatment plan. Order and monitor therapeutic interventions including but not limited to diets, laboratory, radiological and diagnostic tests as deemed necessary by patient history and/or physical exam. Provide clinical consultation, order interdisciplinary consults. Professional practice including but not limited to prescription of medications in accordance with Federal and State Law & Rules and CCHMC policy. Attains and maintains competency in subspecialty practice, skills and procedures in accordance with Joint Commission standards for focused (FPPE) and ongoing (OPPE) professional practice evaluation.
- Outcomes Identification and Planning
Develops outcomes as measurable goals that provide direction for continuity of care & continuity of care & consistency among providers. Develops, prioritizes, evaluates & modifies an individualized comprehensive plan of care. Addresses each diagnosis or issue, as appropriate. Derives outcomes & plans of care that involve the patient/family/caregiver when possible & are realistic to the patient/family/caregiver capabilities & resources. Considers risks/benefits, costs, clinical effectiveness, current scientific evidence/clinical guidelines & clinical expertise to formulate interventions, treatments & outcomes. Incorporates new knowledge & strategies to initiate change in practice if desired outcomes not achieved. Maintains documentation & updates accordingly outcomes, goals & the plan of care.
- Professional Practice
Maintain professional behaviors aligned with core values and care standards, participate in quality improvement activities or research to improve the care delivery process & patient care outcomes. Participate in lifelong learning and professional development activities that improves skills & competence in clinical practice/role performance. Serve as preceptor, role model, or mentor; Contribute to the professional development of peers/colleagues to improve pediatric health care & to foster the professions growth. Integrate ethical considerations & research findings into practice; Provide leadership by participating on committees or in professional organizations, or writing/publishing/presenting. Advocate for the pediatric patient/family/caregiver. Serve as a leader, influencing both healthcare/APP practice & policy.
- Care Management
Maintains competency in skills/procedures; Promotes self-management & family centered care; Employs diverse & complex strategies, interventions, & teaching to promote health & a safe environment; Provides leadership in care management to achieve optimal quality, cost-effective care; Documents & communicates with healthcare team members to achieve an integrated delivery of pediatric care services; Delegates appropriate monitoring, assessment, & interventions according to the patient and scope of practice of the caregiver; Provides consultation to influence the identified plan of care, to enhance the abilities of others to provide health care, and to effect change in the healthcare system; Makes appropriate referrals and discusses recommendations with patient/family/caregiver; Orders and/or performs appropriate treatments, therapies, & procedures that are based on current knowledge, research, & practice; Provides patient/family/caregiver with diagnostic & laboratory results as well as actual/potential benefits, limitations, & adverse effects of proposed therapies.
Uses a systematic, ongoing evaluation of the assessment data & outcomes to revise or resolve the diagnoses, outcomes, the plan of care, & the implementation as needed; Evaluates the accuracy of the diagnosis, effectiveness of the interventions & the plan of care strategies in relation to attainment of expected outcomes; Includes the patient/family/caregiver & other healthcare providers; Bases the evaluation process on advanced knowledge, practice, research, & documents appropriately; Utilizes the results of the evaluation to determine the impact on the patient/family/caregiver, organization, & system to make/recommend process or structural changes including policy, procedure, or protocols as appropriate.
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