Nursing Services

Nursing integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence. Nursing is the diagnosis and treatment of human responses and advocacy in the care of individuals, families, groups, communities, and populations in recognition of the connection of all humanity.

ANA (2021). Nursing: Scope and Standards of Practice, Fourth Edition, p. 1.

Nursing is a component of the Department of Disability and Aging (DDA) system to protect and promote the health and well-being of individuals and communities across all generations—be they children, adults, or the elderly through consultation and assistance for internal and external partners consistent with department policy, rules and regulations, and the standards of nursing practice.

Essential Functions of DDA Nursing Services: 

• Administrative Support – Nursing provides administrative support of the medication administration program and the Death Reporting and Comprehensive Death Review process.
• Case Management - Nursing serves in a consultative role for Case Managers supporting individuals in the Self-Determination Waiver or on the waiting list for services.
• Clinical Supports - Nursing provides consultation and technical assistance to providers and regional office staff, participates in regional and statewide interdisciplinary groups, identifies individual and systemic issues, collects clinical data, monitors clinical providers, and provides health related training.
• Health and Safety - Nursing identifies and triages health and safety issues through agency visits, person-centered consultation visits, medical and psychiatric hospital visits, skilled nursing facility visits, Reportable Event follow-up, education for preventative health practices and frequently occurring conditions, and initiation of interdisciplinary referral or collaboration as needed.    
• Compliance – Nursing participates in compliance monitoring across all settings through Quality Assurance at the state, regional, and local levels, serves as a health resource related to TennCare, licensure, medication administration, reportable events, health and safety, death reporting and comprehensive death review.
• Intake - Nursing serves in a consultative role for case-by-case review to determine health and/or mental health needs, and interdisciplinary information sharing for eligibility determination.  
• Person-Centered Practice - Nursing utilizes evidenced-based practice and interdisciplinary collaboration to support person-centered facilitation for individuals/families with complex issues, barriers to service delivery, and/or high rates of behavioral/medical events.
  
• Protection From Harm – Nursing provides information to investigators on general health and nursing issues, participates in investigations as needed, provides investigation recommendation follow-up, reviews reportable events, and provides recommendations and/or training as needed.
• Provider Development – Nursing reviews and makes recommendations for new nursing provider applications.
• Provider Technical Assistance - Nursing provides initial nursing orientation, on-going support, general and QA indicator specific technical assistance, and Provider Manual and licensure regulation guidance for all community providers.
• Provider Training - Nursing provides health relate training for regional office staff, providers, and direct support staff that includes train-the-trainer courses and coordination of specialty training, participates in development of training curriculums, maintains monthly medication administration class schedules, and provides remedial assistance and training for incident management, as needed.  The Medication Administration Program trains approximately 5,000 direct support staff annually.
• Service Authorization – Nursing provides Plan of Care (POC) review and pre-authorization of Nursing Services, medical necessity review, and practitioner notification for adverse actions.
• TN-START Assessment and Stabilization – Nursing collaborates with TN START AST staff to support individuals with complex behavioral or mental health needs to optimize independence, treatment, and community living.
• Transition - Nursing participates in service planning, monitoring, and reporting throughout the transition process.