Beyond Bedside

By combatting the transmission of infections, IP nurses play an essential part in promoting a safe and healthy environment, not only for individual patients, but also for visitors and other healthcare workers within their organization.

Sepsis Coordinator

Improving sepsis patients’ chances of survival and recovery.

As most nurses know, sepsis, or septicemia, is a relatively rare but very serious condition in which an infection triggers a severe inflammatory response throughout the body. Without prompt treatment, sepsis can result in organ failure and death.

The role of the sepsis coordinator nurse is to help care teams identify early signs of sepsis, ensure that care follows evidence-based protocols, and then monitor patient progress. The goal is to improve odds of survival and recovery.

“Sepsis is about time,” says Amin Hasan, RN, MSN, a sepsis coordinator at Kaiser Permanente Los Angeles Medical Center. “Initiation of timely interventions has been shown to improve patient outcomes.”

By calling a “Code Sepsis,” coordinators ensure that the correct labs, IV fluids, and antibiotics are ordered to halt the progression of the condition and prevent further deterioration.

Sepsis coordinators educate other healthcare staff on identifying and treating sepsis, analyze case data to identify trends, and develop strategies for sepsis care protocols. Coordinators may also prepare reports for regulatory agencies and facilitate meetings for the organization’s sepsis committee.

A DUAL ROLE

In some hospitals, sepsis coordinators may also coordinate other conditions, such as stroke, where swift intervention is vitally important to patient outcomes. Redlands Community Hospital’s Betsy Mendez, RN, BSN, has a dual role as stroke and sepsis coordinator, looking for ways to more quickly deliver life-saving interventions. She says she and her team have been able to establish “a new process that saves time in the delivery of a clot-busting medication used for eligible stroke patients.”

Hasan and Mendez both emphasize that a strong clinical background is a prerequisite for the coordinator role — she has 10 years of bedside experience, while he was an ED staff nurse for eight years.

Many institutions require coordinators to have a BSN, and an MSN or higher degree is often preferred. For roles that also involve stroke coordination, some organizations may require stroke nursing certification.

While sepsis coordinators typically work a regular daytime schedule in an office setting, their nursing proficiency still directly affects patient care in a life-or-death way. “This job matters because it impacts so many people,” Hasan says.

Utilization Management

Ensuring patients get the care they need while minimizing unnecessary costs

Modern healthcare is a balancing act in the effective use of resources: making sure that patients get the services they need while also minimizing unnecessary costs and satisfying the complex requirements of insurance companies and other payors.

The role of the utilization management (UM) nurse is to review and assess the medical necessity and appropriateness of healthcare services, procedures, and treatments; help to determine the correct level of patient care; and weigh the cost-effectiveness and quality of services.

Jimmy Sariya, RN, BSN, MBA, PHN, PMH-BC, an administrative nurse in the utilization management department of Resnick Neuropsychiatric Hospital at UCLA, says the heart of his job is advocacy. “I am the patient’s voice,” he explains. “I advocate for the patient with the third-party payor and establish alignment between the payor and the treatment team.”

The UM role is particularly important in fields like psychiatric care, where patients’ ability to advocate for themselves may be limited. For example, when a patient is admitted to an inpatient mental health treatment program, they may be grossly impaired, which makes dealing with insurance an impossible task.

Without the UM nurse as a liaison, Sariya says, “their care would be interrupted and fragmented.” Not only could this result in adverse health outcomes for the patient, providers might not get paid for their services.

Sariya explains that the ultimate goal of the UM role is to meet the patients’ needs while limiting their financial burden and controlling healthcare costs, helping to maintain access for others in the community.

UM nurses must be detail-oriented, concise communicators with the ability to work independently. While this isn’t a patient care role, patient care experience is also very important.

“Reaching into my staff nurse experience helps me anticipate the patients’ care trajectory and communicate this effectively,” he says. Familiarity with insurance laws and regulations is also essential, but you can gain this knowledge through training.

The American Nurses Credentialing Center (ANCC) offers case management certification for UM nurses, but if you’re considering pursuing this specialty, Sariya recommends getting certified in your current patient care specialty. “This shows employers you’re serious and provides the expertise you’ll use to advocate for patients’ best interests,“ he explains.

Since utilization management is a desk job, it might not be the best fit if you thrive on adrenaline, but if you have a keen eye for detail and a passion for patient advocacy, this role could be an ideal professional choice.

Direct patient care is rewarding work for many nurses, but if you want (or need) to step away from the bedside, there’s a vast array of opportunities available. The three specialties described in this article are just a few of the unique ways you can embark on the next phase of your nursing career.

TIFFANY SWEDEEN, RN, MSN, CPRC/CPC, works in critical care and as a clinical instructor. Find her at www.recoverandrise.com.

In this Article: Career Advice