24-Hour RN - NSPG Anticoagulation Management Service (CACP Preferred)
North Shore Physicians Group(NSPG)

Peabody, Massachusetts

About Us:

North Shore Physicians Group (NSPG), the largest multispecialty group north of Boston, has a singular focus: the patient. We have a total of 27 locations across the North Shore, with more than 350 board-certified physicians, nurse practitioners, and other health care professionals working as one to provide exceptional care.

We are a national leader in improving care delivery, patient health and satisfaction. Through our partnership with North Shore Medical Center and our affiliation with Massachusetts General Hospital and Partners HealthCare, we offer such advances as EMRs, shared medical appointments, online access and remote patient monitoring. Our success is built on team-based practices, collaborative environments and the importance of work-life balance.

Bring your exceptional skills to our innovative practices and join us in driving medicine forward!

General Overview:

We are seeking an RN or NP to join our Anticoagulation Management Service team.

The Anticoagulation Management Service (AMS) uses a primary nurse model to assess and intervene to best meet the educational needs of patients and families while striving to optimize day-to-day outcomes of anticoagulation management. Primary nurses partner with patients and families and multiple disciplines to manage long-term outpatient anticoagulation therapy while coordinating transitions of care across the continuum as needed.

Major components of the role include patient and family education, short and long-term management of anticoagulation consistent with both NSPG and AMS Policies and Procedures.


• Provides a plan for anticoagulation management for patients receiving induction, bridging, and maintenance therapies.
• Is accountable to the patient and family for the initial and ongoing assessment and development of a patient-specific plan of care.
• Educates patients during initial assessment and teaching session(s) and ongoing as needed.
• Informs patients how and when to communicate with the AMS staff.
• Collaborates with referring providers to assure that an anticoagulation plan of care appropriate to patient specific risk is established.
• Uses NSPG and AMS Policy and Procedure to optimize anticoagulation management.
• Schedules and receives INR results for warfarin patients at intervals appropriate to anticoagulation status from clinical laboratories, home care providers, and/or patients.
• Evaluates warfarin dose response based on INR results and relevant clinical and behavioral characteristics that influence patterns of absorption, distribution, metabolism, and elimination of warfarin.
• Determines warfarin dosing using established protocols.
• Monitors dosing and patient clinical response to therapeutic bridging medications and discontinues use per NSPG protocols.
• Monitors anticoagulant drug supply, reviews pertinent laboratory values to guide therapeutic decisions.
• Collaborates with referring providers on agent selection and initiation
• Provides transitions to and from warfarin and other oral anticoagulants
• Provides outpatient oversight for peri-procedural management of all anticoagulants
• Provides oversight and collaboration concerning population specific dosing related to renal dysfunction, drug interactions or extremes of body weight.
• Provides medication adherence monitoring and assessment.
• Acts in the same capacity and is held to the same standards of clinical and professional performance when performing job duties in the AMS clinic.
• The AMS Nurse Director should be notified immediately of any high-risk event including but not limited to; significant patient injury related to their anticoagulation therapy resulting in hospitalization or death or any issue that may require reporting.
• Communicates effectively
• Maintains documentation in the anticoagulation electronic record
• Uses electronic workflow management tools to monitor and manage work.
• Provides verbal and/or written communication of dose instruction to patients or providers as needed.
• Provides assessment and triage of information to and from patients and other providers including issues related to drug-drug interactions, life style, compliance, procedures and complications
• Seeks physician guidance in situations where care decisions and clinical concerns arise and follows up as needed.
• Provides oversight and appropriate follow up for all patients for such issues as missed appointments and non-compliance, critical results, contact of physician and other health care providers.
• Facilitates implementation of anticoagulation standards of care across clinical services
• Educates and supports providers to anticoagulation guidelines and protocols
• Participates in education of clinical staff; nursing grand rounds, patient care conferences, CEU offerings
• Participates as active members of the AMS Practice Committee and AMS Quality and Safety Committee
• Participates in data collection, evaluation of program outcomes, and the development of action plans to continuously improve clinical practice related to:

• Patient and staff satisfaction
• Quality metrics
• Complications
• Nursing research questions



• The ability to make clinical decisions based on a strong knowledge base.
• A high level of interpersonal and communication skills.
• Basic computer skills



• Relevant anticoagulation experience



• Bachelor's Degree in Nursing



• Current licensure as a registered nurse in the Commonwealth of Massachusetts OR Current Massachusetts state license as a registered nurse practitioner


• CACP certification

EEO Statement
North Shore Physicians Group is an Equal Opportunity Employer & by embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law.

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