The Royster Group is seeking a contract Nurse Practitioner (NP) to provide healthcare support for Ireland Army Health Clinic (IRAHC), Fort Knox, KY. The contractor shall provide the services of a Nurse Practitioner licensed to perform services of the nature and scope described for the IRAHC, Fort Knox, KY. The contract NP shall provide services to eligible beneficiaries of the military health care system who present themselves to the Medical Treatment Facility (MTF) for treatment. The contract NP will work in conjunction with other health care providers, professionals, an non-contract personnel.
- Master’s or Doctoral Level degree in nursing.
- Graduate from a National League for Nursing approved college or university
- Shall have and maintain a valid, unrestricted license in any state and be able to obtain clinical privileges to practice medicine at the Military Treatment Facility (MTF) where services are provided.
- Must have current Drug Enforcement Agency (DEA) registration number (certification).
- Must be nationally certified through the American Nurses Credentialing Center (ANCC) or American Academy of Nurse Practitioners (AANP).
- Minimum of 2 years of experience within the last 3 years routinely practicing in rendering primary care medicine (e.g., Family Practice, General Medicine, Internal Medicine).
- Have and maintain a current Basic Life Support (BLS) certification. Acceptable programs are the American Heart Association Basic Life Support for Healthcare Providers or the American Red Cross “CPR/AED for the Professional Rescuer” as the content-equivalent. (Advanced Cardiac Life Support (ACLS) or other advanced certification does not supersede BLS certification).
The Contract Nurse Practitioner shall perform the following procedures, as required, and in strict compliance with standing orders and protocols set forth by the MTF to include, but will not necessarily be limited to the following:
Medical Records Maintenance:
- Provide medical care and treatment of diseases and/or injuries.
- Review medical histories and progress of patients.
- Examine patients, make diagnosis of disease or injury, and treat patient or prescribe a course of treatment.
- Abide by all facility rules, regulations, and policies.
- Conserve the health of patients through the application of diversified knowledge of preventive, diagnostic, and therapeutic medical procedures.
- Seek advice of consultants, when appropriate.
- Oversee and monitor other medical personnel in the care and treatment of patients to include non-therapeutic services such as physical examinations.
- Initiate requests for tests, x-rays, and admissions to the MTF as appropriate.
- Follow-up on abnormal reports. Abnormal x-ray and lab reports received on patients seen by the HCPs shall be reviewed by the HCP within five days of its receipt.
- Prescribe medications, as appropriate, and in accordance with the privileges, hospital rules, and regulations.
- Prepare documentation of all treatment provided in accordance with hospital directives, ensuring that all documentation and reports are legible and complete.
- Utilize the appropriate electronic medical record system for patient encounters.
- Refer all requests for patient/hospital information that cannot be handled by clinic personnel to the Patient Administration Division. After normal duty hours, requests should be referred to the Administrative Officer of the Day (AOD) or appropriate authorized personnel. Neither the Contractor nor HCPs shall release medical information without prior coordination with the AOD.
- Adhere to the Center for Disease Control guidelines concerning universal precautions and the MTF Infection Control Program at all times while providing services under this contract.
- Perform all duties in such a manner that they all meet JC standards.
- Maintain proper medical records on beneficiaries to whom treatment is provided in accordance with Army Regulation 40-66, Medical Record Administration. Medical records completed by the Contract Nurse Practitioner shall be subject to review by the DCCS or his/her designated representative, and a medical records review committee established by the MTF. The Nurse Practitioner shall be notified of deficiencies in his/her entries into the medical records and shall be instructed to correct the deficiencies. All records generated in the performance of duties under this delivery order will remain the property of, and subject to exclusive control of, the Government.
- Complete each outpatient encounter in AHLTA customarily by the end of the shift and/or within 3 business days. TCONs are to be closed within 24 hours of encounter. The HCP shall be responsible for completing patient records in accordance with Army regulations and IRAHC policies. Investigate patient/population healthcare management information/needs for a Comprehensive Care Plan (CCP) status and prepare/initiate documentation in AHLTA.
- Use the Composite Health Care System (CHCS) and CHCS II for keeping records, ordering of ancillary procedures, ordering medications, and performing other required patient record functions at the discretion of the MTF. The Contract Nurse Practitioner shall receive CHCS training prior to commencing services.
- Contract Nurse Practitioners shall not introduce new medical procedures or services without prior recommendation to, and written approval of, the MTF Commander and the Contracting Officer.
- Verify the content and correctness of all prepared and transcribed reports by affixing his/her own signature and stamp to all copies of the document and validating its contents.
- Use only those abbreviations as listed in the MTF’s official abbreviation book.
- Provide and document appropriate history, physical examination, required laboratory and x-ray examinations, and preliminary diagnosis prior to the performance of any healthcare treatment.
- Authorize no referrals to a civilian practitioner when care can be received at the MTF. Contract Nurse Practitioners shall not, while performing services under this contract, advise, recommend, or suggest to persons eligible to receive medical care at Government expense that such persons should receive care from the Contractor at any place other than that at the Government MTF. Also, Contract Nurse Practitioners will not refer patients to any company or service with which they may be directly or indirectly involved (including partnership programs and ancillary services not offered by the MTF).
- Attend and participate in IRAHC orientation, refresher training, team conferences, professional staff conferences, meetings, and other appropriate professional activities as determined by the DCCS or his/her designated representative, as workload permits during scheduled duty hours. Such participation may include active and full participation in all areas of the Quality Improvement, Risk Management, and Utilization Management Programs.
- The Contract Nurse Practitioners shall be responsible for regularly appointed clinic, compatible with workload and, in addition, provide immediate evaluation and management of emergent problems as they occur.
- Collect and record, in proper format, medical and social historical data appropriate to the patient’s condition.
- Perform a general physical examination. Record the findings in proper format and determine medical qualification for various purposes.
- Select the most appropriate diagnosis and treat in cases of uncomplicated common illnesses and injuries (refer when necessary):
|Acute Sprained Ankle
||Low Back Pain
|Acute Wrist Trauma
||Stress Fractures of Foot
||Wound Infection, Soft Tissue
||Otitis, Media, and/or External
|Closed Fracture, Forearm
- Recognize those more complicated cases, initiate treatment (if appropriate), and refer to a higher level medical expertise for diagnosis and/or treatment:
||Chronic Draining Ear
||Nerve Root Disorders
||Peripheral Nerve Disorders
|Acute Myocardial Infarction
||Cerebral Vascular Accident
||Chronic Hearing Loss
||Peripheral Vascular Insufficiency
||Closed Head Injury
||Sub-acute Bacterial Endocarditis
|Benign Prostatic Hypertrophy
||Cerebral Vascular Accident
||Congestive Cardiac Failure
||Testicular or Scrotal Mass
||Penetrating Injury of Eye Globe
||Rheumatic Heart Disease
SPECIFIC TASKS:The following tasks apply to all Nurse Practitioners providing services under this contract.
- Plan and initiate proper treatment within the HCP's defined privileges and the scope of practice of the facility.
- Identify and report those situations and individual cases, which have public health significance and carry out effective control measures.
- Clearly communicate to other health personnel either orally or in writing the findings, diagnosis, and planned treatment regimen.
- Stabilize and manage a patient in a medical or surgical emergency and/or transfer to physician care.
- Determine appropriate means of evacuation of emergency patients, prepare patients for evacuation, and arrange for evacuation support.
- Perform the following blocks: Digital, Local Infiltration, and Intercostal. Initiate management in an emergency in accordance with ACLS and BLS training.
- General surgical procedures:
- Remove, reapply "wet-to-dry" dressings
- I & D Paronychia
- I & D Abscess
- Perform scrub, glove and gown
- Open sterile packing
- Drape minor sterile field
- Insert Nasogastric Tube
- Urological procedures:
- Perform an adequate urinalysis to include recognition of RBC, WBC, and casts on microscopic exam, and use of dipstick for glucose and protein.
- Stain and independently identify C.C. in urethral discharge
- Catheterization - urethral only
- Instruct patient to collect acceptable non-catheter urine
- Specimen for culture
- Maintain inpatient and outpatient medical records in accordance with MTF procedures.
- Write consults referring patients to specialty clinics. In accordance with scope of practice, administer treatment and therapy in those cases which are minor and simple to the degree that ambulatory, short term treatment is sufficient such as head and chest colds, influenza, uncomplicated gastrointestinal and skin disorders, cuts, burns, wounds, sprains, suturing minor lacerations, draining abscesses, etc.
- Independently prescribe medications from approved formulary. Administer intramuscular medication. Issue temporary profiles according to hospital policy.
- Provide and document appropriate history, physical examination, and required laboratory and x-ray examinations, as required. Treatment of patients shall be performed for IRAHC except in unusual instances when patients are referred to other institutions for performance of special diagnostic procedures or definitive care not offered at IRAHC.
- Contract Nurse Practitioners shall become familiar with the hospital formulary. HCPs authorized to prescribe pharmaceuticals shall do so according to the availability of drugs listed therein. The pharmacy service will provide instructions to all prescribing practitioners on substitutability of generic drugs for prescribed drugs.Drugs not on the formulary or approved by the Pharmacy and Therapeutics Committee will not be utilized unless a new drug request is submitted and approved. The HCPs shall use computer order entry to order prescriptions, or use prescription forms DD 1289 in accordance with local policy.
HOURS OF PERFORMANCE
- The Contract HCPs shall prepare all documentation to meet or exceed established standards of the MTF to include but not limited to: timeliness, legibility, accuracy, content, and signature. Only MTF and Army approved abbreviations may be used for documentation of care in the health care record.
- Contract HCPs shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships.
- Shall complete all MTF training and education prior to the first scheduled duty day, and participate in quarterly and annual training.
- Contract HCP shall advise the COR of any problems encountered in connection with meeting the needs of patients, including problems with IRAHC personnel.
- Complete all documentation of care provided in the MTF computer programs for which training was/is provided.
- The HCPs performing under this contract shall be able to read, write, speak and understand English well enough, and enunciate with sufficient clarity to effectively communicate with all patients and other health care providers.
- Any contract HCP personnel found to be unacceptable in administering skills required by the contract shall be immediately released from duty by the Contracting Officer's Representative (COR). The COR will immediately notify the Contracting Officer.
- The Contractor HCP shall assume additional administrative or clinical operations and compliance with JC standards to include upholding established patient care and practice standards and participating in all mandatory training. HCPs may be assigned to other clinics in the IRAHC footprint on a temporary basis as needed or for additional on-the-job training.
- Verify the content and correctness of all prepared reports by affixing his/her own signature and stamp to all copies of the document and validating contents.
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- Contract personnel may be assigned to any clinic within IRAHC, Fort Knox.
- Generally, schedule will be 8-hour work days, Monday-Friday, anywhere between the hours of 6am to 5pm. These hours will vary in accordance with the mission.
- The contract HCP will not exceed 40 hours per week.
- No overtime