12 days old

CNA-Cardiac-Stepdown

SSM Health
St Louis, MO 63112
**This shift is 7:00 p.m. - 7:00 a.m.**

Care Partners are responsible for meeting the basic needs of patients by providing skilled levels of bedside patient care under the direction of the Registered Nurse. Care Partners also perform clerical duties necessary to the functioning of the nursing unit.

POSITION ACCOUNTABILITIES AND PERFORMANCE CRITERIA (% of Time)

Essential Functions: The following are essential job accountabilities and performance criteria:

1) General Patient Care:

Criteria

A) Carries out the patients plan of care as it relates to the patients physical needs under the direction of the Registered Nurse.

B) Delivers care requiring broad knowledge of aseptic technique, medical terminology and equipment.

C) Assists nurses and physicians with procedures.

D) Maintains knowledge of and operates equipment used in patient care safely.

E) Retrieves patient care items that are not routinely available on the unit.

F) Retrieves, recovers or follows up on patient care needs.

G) Completed unit clerical duties including the coordination of designated unit activities, transcription of orders, medical record maintenance and serving as a unit receptionist.

H) Prepares rooms prior to admissions and following discharges. Completes patients belongings list on admission and transfer.

I) Directs prompt and courteous attention to the needs of patients, families, and visitors.

J) Rounds with purpose.

K) Engages in service recovery activities referring unusual problems to Nurse Manager/ Designate.

L) Rounds after dietary trays are passed to ensure all meals are appropriate or as required for patient satisfaction /care needs.

M) Takes appropriate action when necessary including the resolution of issues related to late or wrong trays.

N) Feeds and sets up trays as needed.

O) Recognizes needs and initiates appropriate action in regard to maintaining supplies and equipment

P) Notifies appropriate department in order to maintain a clean safe environment (housekeeping, maintenance, dietary, etc.)

Q) Functions as a resource person to co-workers, patients/families, medical staff, and ancillary personnel.

2) Safety and Comfort

Criteria

A) Correctly places restraints; observes for constriction of circulation, changes to skin integrity, adequate breathing; knows when and how to change position; provides range of motion (ROM) and skin care, toileting, and opportunities for socialization.

B) Operates Cardiac Monitor i.e.

1. On/off switch

2. Alarms/stand-by

3. Obtaining strip

4. Lead placement

3) Vital Signs/Measurement

Criteria

A) Completes Point of Care Testing as approved by hospital and competency

B) Obtains vital signs including temperature

C) Measures abdominal girth

D) Weighs patients

E) Measures intake and output

4) Mobility and Exercise:

Criteria

A) Applies Pneumatic Air Stockings / Ted Hose

B) Ambulates, turns and positions patients.

5) Respiratory Care

Criteria

A) Assists with incentive spirometry and cough / deep breath.

B) Sets up oxygen therapy such as, nasal cannula or mask as directed by Registered Nurse.

C) Monitors pulse oximetry

D) Completes tracheostomy care

E) Performs suctioning

1. Oral

2. Tracheal: When the patient is assessed by the Registered Nurse to be stable.

6) Wound Care

Criteria

A) Places patient on specialty bed

B) Performs dressing changes (sterile and clean)

C) Cares for pin care site after assessment has been completed by the Registered Nurse. Assists in monitoring that traction weights are hanging freely and in good alignment.

7) Bowel and Bladder Elimination

Criteria

A) Administers enemas

B) Performs straight catheterization. Provides catheter care.

8) Hygiene

Criteria

A) Provides:

1. Hygiene and grooming daily

2. Mouth care (including dentures) at least twice/day.

3. Fresh water at 0800, 1600, 2400 and as needed

4. Perineal care

5. Toileting

9) Specimen Collection

Criteria

A) Obtains:

1. Midstream (clean-voided) urine specimen.

2. Timed urine specimen

3. Sterile urine specimen from an indwelling catheter

4. Urine specific gravity (5 South and 5 ICU only)

5. Urine pH

6. Expectorated sputum specimens

7. Blood specimens by venipuncture

8. Stool specimens

10) Clerical

Criteria

A) Answers phone within 3 rings identifying self, title and nursing unit. Does not keep person on hold for extended periods.

B) Provides directions to physicians, hospital personnel, and visitors to patients room.

C) Notifies the physician and nursing staff of new patients arrival to unit.

D) Assists in the receiving of articles brought to the nursing unit.

E) Answers pneumatic tube promptly and returns carriers to the appropriate area.

F) Prepares a daily worksheet and confirms all appointments concerning daily work (including blood work) and updates worksheet on each shift.

G) Verifies census sheet, maintains and updates as necessary.

H) Informs Admitting Department of all transfers, discharges, admissions, room changes, and deaths through the computer. Includes disposition of appropriate paperwork.

I) Informs staff/charge nurses / nurse manager of nursing unit activities: return of patients to the floor, physician stat orders, new admissions, etc.

J) Assist nursing staff and ancillary personnel to ensure appropriate and complete specimen labels/requisition orders.

K) Reports critical lab values to appropriate personnel.

L) Initiates and completes secretarial portion of the pre-op checklist.

M) Completes the administrative data screen for all new admissions and updates daily.

N) Assists the nursing staff with paperwork involved in the patient transfer and discharge procedure to include movement of medications.

O) Gives a full report to the oncoming person. (Leaves a written report if unable to give verbal). Informs the Charge Nurse if additional orders are left for the night shift.

P) Checks patient chart periodically throughout the shift for stat, flagged and un-flagged orders.

Q) Checks physician orders daily for unsigned verbal/telephone orders and places appropriate flag.

R) Enters orders into the computer accurately.

S) Calls departments to order tests, procedures, and consults which cannot be ordered through the computer.

T) Transcribes orders for tests/procedures/consults onto the TESTS/PROCEDURES section of the profile.

U) Ensures labels are correctly placed on all forms

V) Transcribes medication orders to the medication administration record accurately.

W) Places all physician orders in pharmacy bin. Faxes all physician orders to pharmacy during night shift.

X) Signs orders to indicate orders were taken off with date, time, signature and title

Y) Utilizes appropriate backup systems in the event of computer downtime.

Z) Ensures that stat and timed orders are transcribed promptly.

AA) Initiates and assembles charts

BB) Keeps chart in order; thins chart as needed and places in appropriate file.

CC) Obtains old charges from Medical Records through the computer.

DD) Ensures that Medical Records picks up old charts by placing them in assigned pick up area on day of discharge.

EE) Completes medical record checklist and ensures that the complete chart is sent to Medical Records within 24 hours of discharge and immediately upon patient death.

FF) Sends complete chart including thinned chart and old chart on transfer to patient.

GG) Ensures allergy, and isolation cards are posted in charts when indicated.

HH) Completes and signs secretarial portion of death summary.

11) Safety/Infection Control: Performs job in accordance with safety and infection control policies. (5,8) 5%

Criteria

A) Practices standard precautions and disposes of hazardous wastes per established guidelines.

B) Maintains a safe, clean, comfortable, and therapeutic environment for patients / families / employees in accordance to hospital standards.

1. Maintains clutter free environment.

2. Keeps personal conversations/background noise to a minimum.

3. Adheres to dress code.

C) Reports risk management concerns.

D) Assumes responsibility for completing all annual mandatory requirements:

1. Yearly TB Screening

2. Annual Ethics Training (Initial Ethics, if new employee)

3. Annual Safety Training

4. Required Information Security course

5. Required Abuse & Neglect course

6. Annual Blood Borne Pathogens training (if required)

7. Coursework as assigned for .edu

8. Annual competency

9. Age/Population specific competency (if applicable)

10. Orientation competency (if new hire)

11. Unit Specific

E) Obtains report from Registered Nurse and informs nurse of changes in patients condition.

F) Communicates concerns or patient complaints to Registered Nurse and other team members as appropriate.

G) Documents all procedures and care concisely and legibly on chart forms according to chart form guidelines.

H) Identifies problems, gathers pertinent data, suggests solutions, communicates using appropriate lines of authority, and works toward problem resolution.

I) Empties soiled linen containers.

12) Service: Provides service excellence to the customers of Saint Louis University Hospital by delivering timely, high quality care in a courteous, and respectful manner. (1, 2, 3, 4, 5) 10%

Criteria

A) Demonstrates care and courtesy

1. Provides prompt, respectful, courteous service.

2.Meets physical, spiritual, psychological and emotional needs of patients and families as directed by Registered Nurse.

3. Responds to call lights promptly.

4. Apologizes for mix-up and delay.

B) Communicates effectively and maintains confidentiality

1. Listens to staff/patient / family concerns and addresses needs within scope of responsibility.

2. Explains procedures and all education in a manner that staff / patient/ family understands.

3. Allows time for questions.

C) Demonstrates competence and collaboration

1. Provides accurate change of shift report.

2. Provides quality care in accordance to standards.

3. Shares knowledge with other departments to facilitate work flow and continuity.

D) Provides cost effect services

1. Uses resources wisely.

2. Recommends changes in practice that increases efficiency and minimizes waste.

13) Personal Accountability: Demonstrates accountability for own job performance. (6) 5%

Criteria

A) Adheres to and incorporates all customer service standards in patient care and work practices.

B) Participates in additional learning experiences to increase competence including:

1. Staff meetings

2. Mandatory in-services and educational programs

3. Evaluation of self-performance by identifying strengths and areas for improvement.

C) Assists in identifying and implementing nursing unit goals.

14) Performance Improvement (PI): Incorporates Performance Improvement into one's job performance. (6) 5%

Criteria

A) Identifies problems, participation in data collection when requested, suggests solutions, communicates using appropriate lines of authority and works toward problem resolution.

B) Participates in the performance / process improvement process.

1. Assists in developing unit based PI plan.

2. Participates in discussion of PI outcomes.

3. Collaborates in developing and implementing action plans.

C) Incorporates Performance Improvement and Commitment to Quality (C2Q) results into job performance

D) Offers suggestions for improvement of unit activities.

E) Participates in discussion of PI C2Q data outcomes.

F) Collects PI C2Q data as assigned

G) Participates in research activities on the nursing unit as appropriate.

15) Age Appropriate Care: Provides age-appropriate care to:

____Infant ___Child ____Adolescent _____Adult _____Geriatric

Criteria

A) Demonstrates knowledge and skills of normal growth & development necessary to provide services to the age of the patient served by the department.

B) Demonstrates ability to assess and interpret age specific data to identify patient needs.

C) Utilizes communication skills necessary to interpret age specific responses to service and interaction.

D) Involves family or significant other in decision making related to services provided.

E) Demonstrates ability to provide service needed for the age groups routinely served by the department assigned.

F) Position specific: Need to enter those responsibilities specific for position

16) Specialized Care: Provides specialized care to patients at high risk for injury.

(1, 2, 4, 5, 8) <1%

Criteria

A) Restraint Care

1. Initiates/evaluates alternatives to restraint prior to application.

2. Applies restraints consistent with the approved procedure.

3. Monitors and assesses patients response throughout the restraint period at the appropriate intervals.

4. Provides specified patient care (toileting, skin care, hydration, feeding, etc.) on a timely basis.

5. Provides for trail release and removal of restraint as soon as possible.

B) Pain Management

1. Follows pain management plan of care, e.g.: repositioning, message, immobilization, music therapy etc.

2. Reports patient complaints of pain to the nursing staff and/or physician.

C) Abuse Assessment

1. Is aware of abuse recognition criteria and incorporates it into assessments.

2. Reports signs of possible abuse/neglect to the physician & Risk Management, and recommends appropriate consultations (psychiatric, Social Work) for evaluation.

DISCLAIMER: Performs other related duties as assigned or requested.

Rationale for Essential Functions:

1) The performance of this function is the reason the job exists.

2) There are limited employees among whom the performance of this function can be distributed.

3) This function occupies a great deal of the employees time.

4) This function is highly specialized. Employees are hired for the skill/ability to perform this function.

5) Failure to perform this function may have serious consequences.

6) The function was performed by past employees, and is performed by current employees.

7) Exposure to blood borne pathogens that require the use of protective equipment

8) Exposure to tuberculosis that requires the use of protective equipment

"Work requiring the knowledge and skills necessary to provide direct patient care appropriate to patient population of specialty":

Job Specifications

MINIMUM EDUCATION: High School graduate or GED equivalent and at least 18 years of age. Post High School vocational/specialized training preferred.

MINIMUM EXPERIENCE: None

REQUIRED COURSE: Completion of learning program with 80% passing score on written and skills performance examination.

WORKING CONDITIONS:

+ Regular exposure to the risk of blood-borne diseases.
+ Contact with patients under wide variety of circumstances.
+ Exposure to unpleasant elements (accidents, injuries, illness).
+ Subject to trying and unpredictable situations.
+ May perform emergency care.
+ Subject to irregular hours.
+ Pressure due to multiple competing demands.

PHYSICAL REQUIREMENTS:

+ Prolonged, extensive, or considerable standing/walking.
+ Lifts, positions, pushes, and/or transfers patients.
+ Lifts supplies/equipment.
+ Considerable reaching, stooping, bending, kneeling, crouching, lifting, pushing, pulling 100+ pounds.

Employee___________________________________________Date____________

Supervisor__________________________________________Date_____________

Department Director __________________________________Date_____________

Administration________________________________________Date_____________

The above statements are intended to describe the general nature and level of work being performed. They are not to be construed, as an exhaustive list of all duties, responsibilities, and skills required of personnel so classified. An individual working in their job classification must also perform specific tasks upon request by supervisor personnel. Furthermore, the duties and responsibilities for this job classification are subject to change at the discretion of the medical center.

**Practice Agreement**

**For Nursing Staff**

**_Please read the below standards and expectations._**

**Standard (I understand that)**

Our patients deserve care that sets the standard for excellence and meets the needs of each and every patient whose care is our primary purpose and mission. (Quality)

**Expectations (So I will)**

Achieve Excellence in Infection Control By:

+ Isolating per policy.
+ Consistently adhering to proper infection control practices and I will educate patients and visitors of the same.
+ Taking responsibility to read, learn, follow, enforce and remain up to date on Saint Louis University Hospital policies and procedures.
+ Practicing excellent hand washing technique - Wash or gel my hands when going into and coming out of patient rooms and between glove use, especial when it relates to dressing changes, suctioning, etc.
+ Change dressings when they need to be changed now rather than later and maintain all invasive lines as directed by policy.
+ Vaccinate per policy.
+ Notify my supervisor if I see anyone or anything that puts my patient at risk.
+ Utilizing safe practices during crisis situations (i.e. codes) and transport to other departments, e.g. masks, 02 tanks.

Achieve Excellence in Nursing Practice By:

+ Contributing in a positive way to the functioning of the patient care team.
+ Taking an active role in practice development through participation in unit based and hospital committees.
+ Ensuring that documentation of patient care is consistently thorough and legible.
+ Rounding with a purpose on each patient.
+ Modeling practice excellence to new employees.
+ Ensuring that licensure, certifications, and other mandatory requirements are completed within assigned deadlines.

Own and Respect My Environment By:

+ Maintaining proper care of and treat all equipment with respect (clean up after using the microwave, not hit the walls with beds etc.).
+ Maintaining a neat, clean and organized work environment.
+ Keeping the nursing station, bathroom, and break room neat and clean.
+ Leaving my patients room in good order, with supplies in place, and ready for the next shift and my work area in the same condition as I would like to see when I return.
+ If I see something out of order I will pick it up, fix it, or call to have it repaired. I will not assume that someone else will do it.
+ Giving hand-off report to another nurse before I leave the unit with another patient or for any other errand.

**Standard (I understand that)**

Treating my colleagues, our patients, visitors, and business partners with respect and dignity is necessary to create an environment where excellence in caring and nursing practice can thrive. (People)

**Expectations (So I will)**

+ Show empathy to every patient and communicate my commitment to assist in their comfort, safety, and restoration to health.
+ Demonstrate my respect to my colleagues and co-workers through effective communication about patients condition and concerns, mentoring new employees, resolving conflicts constructively, and proactively scheduling shifts to meet unit needs.
+ Come to work with a positive attitude.
+ Offer constructive criticism to co-workers when addressing concerns, praising in public and criticizing in private when necessary.
+ Be part of the solution not part of the problem.
+ Not complain to or complain in front of my patients/families and staff (i.e. too busy or short staffed, no lunch).
+ Follow up on patient concerns every time to the appropriate person.
+ Respond promptly to patient requests.
+ Always refer to physicians as Dr. ____.
+ Make sure that my patients are checked at least every 01 hour 0 30 minutes 0 15 minutes per clinical standard and as appropriate.

**Standard (I understand that)**

Patients and their families are scared and vulnerable. It is my responsibility to communicate through verbal and non-vernal means that I am here to help. (Service)

**Expectations (So I will)**

+ Introduce myself to all my patients and family members.
+ Take time to tell them what to expect and keep them informed.
+ Answer lights promptly to meet a patients needs and prevent patient falls.
+ Respect the patients privacy and modesty close curtains, cover patient, reduce traffic in patients room during procedures.
+ Explain all procedures, test, medications and monitoring equipment, etc to each patient and discuss plan of care for the day/shift with patient and family.
+ Be compassionate and empathetic to their concerns at all times.

The intent of this agreement is not to provide a complete list of job responsibilities. Its intent rather is to be a positive statement of concrete actions which will ensure that nursing practice at Saint Louis University Hospital sets the benchmark for excellence in service, quality, and people.

As a member of the nursing staff at Saint Louis University Hospital, I understand that on behalf of my hospital, our patients and my co-workers I will conduct myself according to this agreement at all times.

_______________________________________________________________________________

Staff Signature Print Name Date

_______________________________________________________________________________

Manager Signature Print Name DateSSM Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex

Categories

Posted: 2020-05-19 Expires: 2020-06-18

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CNA-Cardiac-Stepdown

SSM Health
St Louis, MO 63112

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