The Cerebrovascular APP serves as an integral member of the cerebrovascular and neurointerventional surgery team, providing continuity of care across inpatient, procedural, and outpatient settings.
Clinical Responsibilities
Inpatient and Consultative Services (Monday-Friday)
Performs daily rounding on neurovascular inpatients, including post-procedural patients, stroke admissions, and SAH/ICH cases requiring longitudinal monitoring
Evaluates and manages new inpatient consultations for cerebrovascular pathology, including unruptured aneurysms, AVMs, dural arteriovenous fistulas, carotid stenosis, and acute ischemic stroke with large vessel occlusion
Conducts focused neurological assessments, reviews imaging, and synthesizes clinical data to formulate and communicate care plans in collaboration with the attending neuroendovascular surgeon
Coordinates multidisciplinary care with neurosurgery, neurocritical care, neurology, vascular surgery, and rehabilitation services
Manages transitions of care including discharge planning, medication reconciliation, post-procedure instructions, and timely outpatient follow-up scheduling
Procedural Support
Provides direct peri-procedural support for neuroendovascular cases including diagnostic cerebral angiography, mechanical thrombectomy, aneurysm coiling/stenting, carotid artery stenting, and AVM/dAVF embolization
Scrubs and first-assists during neuroendovascular procedures within defined scope and demonstrated proficiency
Performs pre-procedure history, ensures informed consent documentation, and manages pre-procedural medication protocols (e.g., dual antiplatelet loading, P2Y12 assay coordination)
Oversees immediate post-procedural recovery including groin/access site management, neurological status monitoring, and complication surveillance
Outpatient Clinic (Four Half-Days Per Week 9AM-12PM)
Conducts new patient evaluations and follow-up visits for cerebrovascular conditions including carotid stenosis, intracranial aneurysms, stroke prevention, and post-procedural surveillance and ischemic stroke hospital follow-ups.
Orders and interprets relevant diagnostic studies (CTA, MRA, carotid duplex, vessel wall imaging) and triages findings with the attending physician
Provides patient and family education on disease process, treatment options, risk factor modification, and procedural expectations
Manages longitudinal cerebrovascular care plans including antiplatelet/anticoagulation management and imaging surveillance schedules
Care Coordination and Program Development
Serves as the primary point of contact for referring physicians, emergency departments, and transfer centers regarding cerebrovascular consultations and case coordination.
Facilitates timely triage of emergent and urgent referrals to optimize door-to-treatment intervals for time-sensitive conditions
Assists with patient recruitment and protocol adherence for active clinical research studies within the cerebrovascular program
Nationally certified Advanced Practice Provider who provides primary and/or specialty care in a variety of healthcare settings. Functions in collaboration with the health care team in accordance with certification and licensure. Practice emphasizes health promotion, disease prevention and the diagnosis and treatment of acute and chronic health problems. Responsible for dissemination of knowledge through instructing, leading and developing educational programs.
Additional Responsibilities:
Conducts thorough medical histories, performs complete physical examinations (where indicated), initiates appropriate lab, radiology tests or other special tests required for evaluation of illness, and scrutinizes lab data to establish a record of the patient's current health status and to develop a working diagnosis and treatment plan. Works in collaboration with the health care team.
Performs and interprets common laboratory, radiologic, cardiographic and other routine diagnostic procedures used to identify pathophysiologic processes as credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals.
Performs routine and specialized procedures as credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals.
May prescribe and monitor medications as allowed by license through applicable state board and Cleveland Clinic policies.
Educates patients and answers questions regarding their disease, treatments, related drug and treatment side effects and hazards.
Participates in medical team rounds; collaborates with nursing, medical and other healthcare team members regularly to ensure quality patient care.
Refers patients to specialists as appropriate for consultation or for specialized health resources and treatment.
Ensures continuity of care by serving as a liaison between patient and other members of the multi-disciplinary care team or with other specialty areas as necessary.
Participates in quality monitoring thru the review of records and treatment plans for patient outcomes on a periodic basis to assure quality care.
Facilitates appropriate length of stay, discharge planning and compliance with regulatory standards for inpatient management.
Supports professional development of the health care team.
Promotes translation of evidence-based practices, guidelines, and research.
May conduct research studies. May assists in data collection and analysis.
May serve as clinical preceptor for students. May onboard new caregivers.
Other duties as assigned.
Education:
APRN
Effective 05/01/2014: MSN required upon hire or within 3 years of hire for external hires and internal hires moving from a non-APRN licensed role to an APRN licensed role.
Graduate of an accredited APRN program.
If in neonatal care service area Master’s Degree is required upon hire.
PA
Graduate of an A.R.C. approved Physician Assistant Program.
Master’s degree in Physician Assistant Studies and/or higher degree obtained from a program recognized by their practicing states Licensing Board.
Certifications:
NP
Currently licensed as a Nurse Practitioner in applicable state(s).
Must be licensed as an RN in applicable state(s).
National certification as a Nurse Practitioner by nationally accredited organization recognized by state Board of Nursing.
Basic Life Support (BLS) through the American Heart Association (AHA) required.
Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) through the American Heart Association (AHA); or Neonatal Resuscitation Program (NRP) through the American Academy of Pediatrics (AAP) may be required based upon work setting.
Must have arrangements with at least one physician in accordance with requirements set forth by the State Board of Nursing in applicable states.
Must be credentialed and privileged by the Medical Executive Committee and the Governing Body
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