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AMS Nurse, NSPG Anticoagulation Management Service

Company: North Shore Medical Center
Location: Peabody
Posted on: February 12, 2020

Job Description:

The Anticoagulation Management Service (AMS) uses a primary nurse model to assess and intervene to best meet the educational needs of patients and families while striving to optimize day-to-day outcomes of anticoagulation management. Primary nurses partner with patients and families and multiple disciplines to manage long-term outpatient anticoagulation therapy while coordinating transitions of care across the continuum as needed.

Major components of the role include patient and family education, short and long-term management of anticoagulation consistent with both NSPG and AMS Policies and Procedures.


--- Provides a plan for anticoagulation management for patients receiving induction, bridging, and maintenance therapies.

--- Is accountable to the patient and family for the initial and ongoing assessment and development of a patient-specific plan of care.

--- Educates patients during initial assessment and teaching session(s) and ongoing as needed.

--- Informs patients how and when to communicate with the AMS staff.

--- Collaborates with referring providers to assure that an anticoagulation plan of care appropriate to patient specific risk is established.

--- Uses NSPG and AMS Policy and Procedure to optimize anticoagulation management.

--- Schedules and receives INR results for warfarin patients at intervals appropriate to anticoagulation status from clinical laboratories, home care providers, and/or patients.

--- Evaluates warfarin dose response based on INR results and relevant clinical and behavioral characteristics that influence patterns of absorption, distribution, metabolism, and elimination of warfarin.

--- Determines warfarin dosing using established protocols.

--- Monitors dosing and patient clinical response to therapeutic bridging medications and discontinues use per NSPG protocols.

--- Monitors anticoagulant drug supply, reviews pertinent laboratory values to guide therapeutic decisions.

--- Collaborates with referring providers on agent selection and initiation

--- Provides transitions to and from warfarin and other oral anticoagulants

--- Provides outpatient oversight for peri-procedural management of all anticoagulants

--- Provides oversight and collaboration concerning population specific dosing related to renal dysfunction, drug interactions or extremes of body weight.

--- Provides medication adherence monitoring and assessment.

--- Carries and ensures appropriate sign in and function of pager during assigned call hours

--- Is accountable to find coverage and communicate all changes in coverage whenever unable to complete some or all assigned on-call hours

--- The on-call AMS RN promptly returns paged calls, collects results and/or pertinent information from callback contact, conducts assessment or the presenting problem, facilitates triage of patients as required and/or provides education, instruction as needed and performs other responsibilities consistent with scope of practice and documented policy and procedure.

--- The AMS RN acts in the same capacity and is held to the same standards of clinical and professional performance while on-call as when performing job duties in the AMS clinic.

--- The on-call AMS RN is not required to travel back to the clinic or hospital site in any situation during call hours and is compensated at the on-call rate for all on-call hours. Any consideration of the need to return to the hospital should be made in collaboration with the AMS Nurse Director.

--- The AMS Nurse Director should be notified immediately of any high-risk event including but not limited to; significant patient injury related to their anticoagulation therapy resulting in hospitalization or death or any issue that may require reporting.

--- The on-call AMS RN is responsible for ensuring the he/she has access to ALL electronic information systems required in the care of AMS patients and that all interactions are documented and followed up as necessary during business hours

--- Communicates effectively

--- Maintains documentation in the anticoagulation electronic record

--- Uses electronic workflow management tools to monitor and manage work.

--- Provides verbal and/or written communication of dose instruction to patients or providers as needed.

--- Provides assessment and triage of information to and from patients and other providers including issues related to drug-drug interactions, life style, compliance, procedures and significant bleeding and clotting events.

--- Seeks physician guidance in situations where care decisions and clinical concerns arise and follows up as needed.

--- Provides oversight and appropriate follow up for all patients for such issues as missed appointments and non-compliance, critical results, contact of physician and other health care providers.

--- Facilitates implementation of anticoagulation standards of care across clinical services

--- Educates and supports providers to anticoagulation guidelines and protocols

--- Participates in education of clinical staff; nursing grand rounds, patient care conferences, CEU offerings

--- Participates as active members of the AMS Practice Committee and AMS Quality and Safety Committee

--- Participates in data collection, evaluation of program outcomes, and the development of action plans to continuously improve clinical practice related to;

--- Patient and staff satisfaction

--- Quality metrics

--- Complications

--- Nursing research questions



--- The ability to make clinical decisions based on a strong knowledge base.

--- A high level of interpersonal and communication skills.

--- Basic computer skills


--- Relevant anticoagulation experience


--- Bachelor's Degree in Nursing



--- Current licensure as a registered nurse in the Commonwealth of Massachusetts


--- CACP certification

Keywords: North Shore Medical Center, Peabody , AMS Nurse, NSPG Anticoagulation Management Service, Executive , Peabody, Massachusetts

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