The Nurse Coordinator for Lung Transplant Program(s) provides direct care to patients with multiple, often complicated acute and chronic medical problems. The Nurse Coordinator is the primary point for the program in all phases of the transplant process and works closely with the multidisciplinary transplant team and multiple UCSF departments. The primary responsibilities (as assigned) of the Nurse Coordinator will be to coordinate pre-transplant services to evaluate candidacy for advanced therapies, coordinate follow-up patient care both pre- and post-transplantation and provide ongoing patient and support education throughout all phases of transplantation in both the inpatient and/or outpatient setting. . Under general direction and in collaboration with the multidisciplinary transplant team, the nurse coordinator provides expert nursing care for transplant patients, including candidates (pre-transplant), recipients (post-transplant) and/or living donors with a variety of complex treatment options. The nursing coordinator serves as a contact point for transplant patients, family members, referring physicians, staff as well as contact point for the coordination and facilitation of the care of the patient in specialty areas. The nurse coordinator provides leadership for collaborative and multidisciplinary patient care with emphasis on education and continuity of patient care for the entire period of care including inpatient, outpatient or both. The transplant nurse coordinator is responsible for monitoring and coordinating the care of transplant patients to ensure they reach their maximum health potential before and/or after transplant. This position will support the transplant team by communicating with patients on behalf of providers. Respond to changes in patient condition as exhibited in signs, symptoms and lab values in collaboration with the provider. The nurse will make changes to medication and treatment plans as delegated by the provider. The nurse coordinator will educate patient on any changes and document in the EHR.
% of time Essential Function (Yes/No)
Key Responsibilities
(To be completed by Supervisor)
90% YES
Pre and/or Post Transplant Coordinator:
- Coordinate the efforts of the multidisciplinary transplant team, consulting services and nursing staff on behalf of the transplant candidate, donor, or recipient.
- Provide transplant-specific nursing care for pre- and/or post- transplant patients who have a variety of complex medical issues.
- Provides ongoing patient education for the transplant patient and family.
- Serves as multidisciplinary contact point for all patient requests, studies, and other needs.
- On behalf of the patient, serves as primary point of contact for phone calls, requests, inquiries by patient, family members, and outside care providers.
- Facilitates labs, diagnostic studies, such as ultrasound, x-rays, interventional radiology procedures, nuclear medicine scans, and urology procedures. Obtain the results of studies done at other centers. Notifies provider of results as appropriate.
- Initiates MD consultations and referrals for the transplant patient as requested by provider.
- Assesses subjective and objective data and escalates appropriately.
- Reviews patient charts and medication profiles to confirm compliance to treatment regimen and protocols as established by transplant providers. Provides ongoing patient education of treatment plan.
- Communicate lab results and medication changes to patients by telephone under the direction of the transplant provider.
- Documents clearly and thoroughly; documentation includes but is not limited to patient records, requisitions, referrals and billing. Utilizes electronic medical record for documentation.
- Exhibit independence, self-direction and accountability to the patient, family and transplant team
Post-Transplant:
- Follows immunosuppression drug levels and make dose changes as requested by transplant providers. Notifies patients of dose changes, and ensures patient understanding of medication changes.
- Review prescription refill requests, present to APP for approval, call to pharmacy when necessary. Communicates accurately and professionally with pharmacies.
- Assist in completion of medication prior authorization forms.
- Assist in completion of disability, return to work and other patient forms.
- Provide back-up support to the LVN during times of absence or high volume emergencies appointments
ADDITONAL DUTIES:
Facilitation and attendance at weekly heart or lung transplant patient selection meetings including documentation in EPIC/UNOS of all patients approved for wait listing and following up on all actions identified during the weekly meeting. Attends and participates in team meetings.
Perform clinical assessments, perform examinations, lung assessment, procedures such as nasal swab, staple/suture removal, 6 min walk, home spirometry training and assessment, facilitate telehealth visits (THV), medication reconciliation, supports MD/NP in all clinic care onsite and/or THV, other clinical duties relevant to patient care.
Manages logistics of donor offers for Heart and/or Lung transplant patients during regular working hours. On occasion, may cover donor offers after hours, Holidays and weekends.
Coordinates all teaching for pre/post Heart or Lung transplant patients. Provides cross coverage to other pre/post Heart or Lung Transplant coordinators for vacations and sick leave
Assists with the maintenance and development of the Heart and Lung Database(s)
10% YES Support in preparation for regulatory surveys by UNOS and CMS as requested.
As appropriate, stays abreast of changes in Federal, State or Local Regulatory Agency requirements related to transplant services and reporting. Keeps a working knowledge of UCSF Policies and Procedures, follows guidelines appropriately and contributes to the maintenance of documents.
Obtains necessary information for all registries
Insurance authorization – assisting financial counselors in obtaining authorizations by providing patient information to insurance companies for certification of treatment modalities.
Assists with the collection and participation in all supported research protocols
100%
REQUIRED QUALIFICATIONS
- Recent five (5) years of adult solid organ transplant nursing employment experience as an outpatient or inpatient Transplant Coordinator
- Recent five (5) years of RN experience in end stage organ specific disease, transplantation and immunosuppressive therapy and management of end stage organ failure patients.
- Understanding contraindications to transplant as well as common post-transplant complications.
- Proven organizational skills with the ability to accept full responsibility for a defined and delegated area
- Proven ability to work effectively with physicians and other support staff
- Excellent communication skills (written & verbal) and professional conduct
- Computer literate (esp. MS Word, Outlook and internet use) and willingness/ability to learn all EHRs as needed
- Strong MS Office computer skills (word, excel, power point), databases
- Excellent organizational skills, proficiency in meeting deadlines, ability to work independently and prioritize workload and manage numerous concurrent tasks in high stress environment
- Demonstrated clinical competence including effective leadership, teaching, and communication skills or an equivalent combination of education and experience
- This position requires flexibility to orient and work at all UCSF Health locations
PREFERRED QUALIFICATION
- Five (5) years of adult solid organ transplant nursing employment experience as an outpatient or inpatient Transplant Coordinator
- Five (5) years of RN experience in end stage organ specific disease, and transplantation and immunosuppressive therapy and management of end stage organ failure patients.
- Understanding contraindications to transplant as well as common post-transplant complications.
- Proven organizational skills with the ability to accept full responsibility for a defined and delegated area
- Proven ability to work effectively with physicians and other support staff
- Excellent communication skills (written & verbal) and professional conduct
- Computer literate (esp. MS Word, Outlook and internet use) and willingness/ability to learn all EHRs as needed
- Strong MS Office computer skills (word, excel, power point), databases
- Excellent organizational skills, proficiency in meeting deadlines, ability to work independently and prioritize workload and manage numerous concurrent tasks in high stress environment
- Demonstrated clinical competence including effective leadership, teaching, and communication skills or an equivalent combination of education and experience
- This position requires flexibility to orient and work at all UCSF Health locations
REQUIRED LICENSES/CERTIFICATIONS
- Active Registered Nurse (RN) licensure in the State of California
- Active American Heart Association BLS certification
