POSITION DESCRIPTION
COLUMBUS REGIONAL HEALTHCARE SYSTEM
JOB TITLE / ASSISTANT DIRECTORJOB CODE / 0120
DEPARTMENT / TELEMETRY/CCU
FLSA (Exempt/Non-Exempt) / NON-EXEMPT
DEPARTMENT DIRECTOR SIGNATURE
ADMINISTRATIVE V. P. SIGNATURE
V. P. HUMAN RESOURCES SIGNATURE
EFFECTIVE DATE / 11/13/94
REVISION DATE / 08/25/10
DESCRIPTION SUMMARY: Organizes and directs the operations and human resources of the department in conjunction with the Department Director and assumes responsibilities at his/her direction. Performs assessments of patient upon arrival to the Telemetry Department/CCU and provides professional nursing care to patients while on the Telemetry Department/CCU as needed.
EDUCATION, CREDENTIALS AND TRAINING:
Required: Graduate of accredited school of professional nursing. Current RN license from NC State Board of Nursing or compact state.. ACLS, PALS and BCLS certified. Incumbent will be required to demonstrate competence in the performance of duties specific to the age groups of the patients for whom s/he will be assigned.
Preferred: Baccalaureate Degree in Nursing. Supervisory training and development.
EXPERIENCE: A minimum of two years of critical care nursing experience is required. Demonstrated supervisory and administrative potential. Supervisory experience preferred. Given training and on-the-job experience incumbent should be proficient in the basic aspects of the job within 3 months.
OTHER: Verbal communication skills. Interpersonal skills. Self directed and motivated. Organizational skills. Problem-solving and decision making skills. Leadership skills.
ORGANIZATIONAL RELATIONSHIPS:
Supervises: RNs, LPNs, Monitor Technicians, Unit Assistants, Nursing Assistants and Unit Secretaries
Reports To: Nurse Director, Critical Care and Telemetry Department
COMMUNICATIONS: Required to communicate frequently with physicians, departmental personnel, patients and patients’ escorts. Routine communications with other healthcare team members and hospital personnel providing services in support of the department. Routine communications with family and friends of patients. Purpose includes giving and receiving information, explaining services, rules or procedures, or providing instructions or directives regarding policies or standards of care. Involves authority to make decisions or counsel others. Requires extensive communication skills, tact and discretion in order to obtain cooperation and understanding, discuss and resolve problems, make recommendations and maintain goodwill.
WORKING HOURS AND OVERTIME STATUS: Works a rotating shift as scheduled to include weekends and holidays. May be required to work alternate schedules or additional hours as the workload demands. Classified as non-exempt for purposes of overtime.
DRESS POLICY: Approved departmental uniform
WORKING ENVIRONMENT: Spends majority of time in light and temperature controlled patient rooms. Routinely exposed to somewhat unpleasant odors. Routinely handles sharp objects and contaminated or potentially infectious materials, supplies and equipment. Potential exposure to air and blood borne pathogens. Occasionally interacts with combative patients. Potential danger of injury during defibrillations.
EXPOSURE DETERMINATION: OSHA requires an exposure determination concerning which employees may incur occupational exposure to blood or other potentially infectious materials. The exposure determination is made without regard to the use of personal protective equipment (i.e. employees are considered to be exposed even if they wear personal protective equipment.) This exposure determination is required to list all job classifications in which all employees may be expected to incur such occupational exposure, regardless of frequency. It is the department’s responsibility to perform exposure determination for all employees and to list job classifications in one of three categories.
Category 1 includes employees who are routinely exposed to blood borne pathogens
Category 2 includes employees who are not usually exposed, but for whom contact with infectious materials can be reasonably anticipated during the course of their duties.
Category 3 is for employees who are not exposed to infectious materials during the normal operations of their job duties.
This job is rated as a category __1___ (1, 2, or 3).
BIOHAZARDOUS DRUGS: As a health care facility which dispenses drugs, some of which have been identified as hazardous by NIOSH, our goal is to provide training and where necessary, personal protective equipment (PPE) to insure employee safety. *See list of hazardous drugs in Pharmacy Policy Manual, Chemotherapy Preparation section. Warning labels will be used to identify drugs requiring special handling or waste disposal procedures. It is the department’s responsibility to train in safe handling and disposal. It is the employee’s responsibility to follow policies and procedures, and to report situations and/or make recommendations to improve safety.
It is also the department’s responsibility to perform exposure determination for all employees and to list job classifications in one of three categories.
Category 1 includes employees who are routinely exposed to hazardous drugs.
Category 2 includes employees who are not usually exposed, but for whom contact with hazardous drugs can be reasonably anticipated during the course of their duties.
Category 3 is for employees who are not exposed to hazardous drugs during the normal operations of their job duties.
This job is rated as a category ___1__ (1, 2, or 3).
WORK AIDS: Crash cart. EKG Machine. IV Pumps. Pyxis. Cardiac monitor. Defibrillator. Ventilation equipment. Bi-Pap machine. Oxygen tanks. Suctioning equipment. Accu check. Feeding pump. Pulse oximeter. Infusion pump. Cold therapy equipment. Hypothermia blanket. Blood pressure equipment. Thermometer. Stethoscope. Traction. Bed scales. Feeding pumps. Other medical supplies, instruments and equipment. Telephone/fax. Patient charts. Employee records. Administrative supplies, records and reports. Reference books and materials.
Key Elements: assistant DirectorEnsures compliance with legal, regulatory and policy requirements pertaining to assigned operational and human resources responsibilities, with no more than 1-2 noted exceptions, and with no litigation or sanctions resulting in adverse outcomes for the hospital.
Effectively prioritizes and coordinates the provision of care for all patients, so that nursing and physician orders are accomplished in accordance with established schedule or protocol, as evidenced in 9 of 10 random audits and no more than 2-3 otherwise noted exceptions on average per assigned nurse.
Ensures that medications are administered in accordance with physicians' orders, and established policy and procedures and techniques, as evidenced by accumulating no more than 11-20 points on average per assigned nurse, using the established tracking system, with no exceptions resulting in the need for medical intervention.
Ensures that clinical and technical treatments and procedures are performed in accordance with established policy and procedure, with no more than 2-3 noted exceptions on average per patient care employee, and no exceptions resulting in the need for medical intervention.
Ensures that the nursing care and education process is effectively applied from admission through discharge, as evidenced in 9 of 10 random audits, and no more than 2-3 otherwise noted exceptions on average per assigned nurse.
JOB ACCOUNTABILITIES
1. Assists with the administrative direction of the department in collaboration with the Department Director.
- Provides input into budget planning
- Provides input into the establishment and maintenance of new/revised policies and procedures
- Evaluates new products, services and equipment
- Oversees compliance with designated JCAHO and other regulatory requirements
- Oversees quality assurance activities
a. Provides timely input into budget planning process for equipment, supplies and staffing, ensuring that requests are properly substantiated, reflect thorough research and are cost effective.
b. Routinely recommends new or revised policies and procedures, as needed to stay current with the state-of-the-art and with regulatory requirements, and so that activities can be accomplished in less time, with less effort, or with better quality, without prompting.
c. Ensures that designated JCAHO and other regulatory requirements are met on an on-going basis.
d. Ensures compliance with an approved quality assurance program, monitoring outcomes, and following through as warranted to correct deficiencies and improve quality of services rendered.
e. Stays abreast of new developments in the field, and routinely evaluates new products, services and equipment, making budget recommendations for their incorporation where applicable and feasible.
2. Directs personnel assigned to the department, under the general supervision of the Department Director
- Orients, and trains assigned employees
- Makes recommendations for continuing education and professional growth needs of staff
- Prepares work schedules and approves time off
- Assigns and checks work results for quality, accuracy and timeliness
- Investigates complaints, errors and other operational or equipment problems, and takes corrective action
- Develops employee performance capabilities, and provides input into performance reviews of assigned staff
- Recommends counseling or disciplinary action for employees with performance or behavioral problems
- Makes recommendations regarding transfers and promotions
a. Provides for the orientation and on-going training of assigned personnel, ensuring that documentation systems are established and maintained, so that status, progress and participation can be easily monitored.
b. Routinely provides for "on-the-spot" in-services for assigned staff when minor deficiencies are observed, so that problems do not persist or grow worse.
c. Establishes and implements an effective in-service training plan to address new/revised policies, procedures, equipment, techniques and advances in technology.
d. Contributes to the professional development of assigned personnel, by observing work, tracking performance indicators, answering questions, explaining proper procedures, demonstrating techniques, and intervening as warranted to correct deficiencies or help resolve problems.
e. Continuously assesses employee performance, documenting significant achievements and/or deficiencies, and coaching or counseling, as appropriate, to achieve maximum employee satisfaction and performance.
f. Ensures that assigned staff complies with hospital and department policies, providing timely notification, interpretation and instruction, and as appropriate, recommending disciplinary action.
g. Ensures the quality and timeliness of services provided by assigned personnel, intervening as appropriate to resolve problems or correct deficiencies.
h. Discusses, records and submits documented performance results and notes with/to Director on an on-going basis.
i. Effectively resolves staffing problems due to absences or fluctuations in workload, so that significant delays in service do not occur.
3. Performs patient assessments, formulates nursing diagnoses, and develops/documents nursing care plans.
a. Initiates admission chief complaint assessment documentation and takes vital signs immediately upon admission to CCU and within 30 minutes upon admission to Telemetry, and initiates database within 4 hours of admission in CCU and 8 hours in the Telemetry Department.
b. Makes complete and appropriate nursing assessment upon patient admission, and as frequently as warranted by patient's condition, ensuring documented data is amended or confirmed at least once every 4 hours for CCU and at least once each 12-hour shift on Telemetry floor.
c. Initiates and documents nursing diagnosis and care plan within 4 hours of admission to CCU and 8 hours for Telemetry, ensuring inclusion of individualized nursing interventions based on the assessment, expected outcomes following intervention, utilization of available resources, efforts for inclusion of patient/family from initiation of plan to discharge and discharge needs.
4. Implements care plans and makes revisions accordingly.
a. Patient care provided correlates to the nursing care plan, as documented.
b. Updates, modifies or reviews all aspects of the care plan for short and long term stays to appropriately reflect the status of patient needs at least once every 12 hours shift.
5. Evaluates patient care outcomes.
a. Performs evaluations, via telephone, 24-48 hours post discharge, ensuring appropriate intervention when problems or abnormalities are detected.
b. Effectively researches and resolves patient care problems, and routinely provides input into the establishment of department procedures/policy in response to situations or patient care problems.
c. Routinely evaluates patient outcomes, and discusses unusual or difficult patient care experiences with peers in an effort to improve patient care planning and care provided.
6. Accomplishes assigned aspects of the physician's treatment plan
a. Accomplishes all orders, and in accordance with scheduled time frames.
b. Takes and transcribes verbal orders from physicians only under circumstances prescribed by policy, ensuring that they are accurately recorded, dated and signed with name and title.
7. Collaborates with physicians and other members of the health care team.
a. Accompanies physician on rounds to promote collaboration, by giving and receiving communications on patient regimens, status, progress and concerns.
b. Effectively collaborates with team members, physicians and other pertinent personnel, as warranted, ensuring that communications are professional, clear and timely.
c. Accurately and appropriately documents and communicates to physician or other appropriate personnel, reactions and status changes in patient's response to care as they occur, and of results of any updated lab reports.
d. Provides thorough, but concise, reports to oncoming shift for all assigned patients.
8. Performs clinical and technical patient care procedures, and assists physicians with treatments and procedures.
- Monitors vital signs and observes for adverse reactions.
- Operates/implements equipment such as oxygen, infusion pumps, catheters, and pressure monitoring equipment.
- Performs clinical and technical tasks, treatments and procedures as approved by department policy
- Assists physicians with treatments and special procedures.
- Administers medications, orally, by injection, or by IV push.
- Starts, manages and discontinues intravenous infusions to include blood and blood components.
- Responds to "codes" and initiates CPR and other life support measures as necessary.
- Collects blood, urine, fecal and other specimens.
- Monitors telemetry readings and interprets rhythm strips
- Recognizes, interprets and documents cardiac arrhythmias and other life threatening problems
- Intervenes and administers emergency drugs necessary for initial management of cardiac and other emergencies
- Administers thrombolytic therapy
- Monitors epidural patients and provides appropriate care
- Prepares and sends patients to OR from the department for emergency surgeries
- Cares for patients during ambulance transfers
- Obtains hemodynamic data and calculates cardiac output
- Assists physician with insertion of and care for invasive lines
a. Ensures the proper identification of patient prior to performing any care.
b. Selects and applies appropriate procedures, techniques, equipment and communications based on the age/developmental status of the patient.
c. Accurately implements clinical and technical aspects of nursing care in accordance with prescribed policies, procedures and techniques.
d. Accurately prepares and administers medications in accordance with policy, procedure and technique.
e. Accurately administers, monitors and manages intravenously delivered fluids, blood and blood products in accordance with prescribed policy, procedure and technique.
f. Accurately follows instructions and/or carries out established procedures or protocols, when assisting physicians with treatments and examinations.