POSITION ACCOUNTABILITIES AND PERFORMANCE CRITERIA (% of time)
Essential Functions: The following are essential job accountabilities and performance criteria:
1) Patient Care: Delivers patient care before, during and after invasive cardiovascular procedures. Requires a broad knowledge of nursing skills with emphasis on cardiac anatomy and physiology, knowledge of aseptic technique, and cardiac related criteria
(1, 2, 3, 4, 5, 8) 45%
A) Performs a complete procedure-specific assessment of the patient upon admission to the Cardiac Catheterization Laboratory. This includes, but is not limited to, assessment of baseline vitals, review of medical history, allergy history, level of consciousness, pain assessment, physical, spiritual, cultural and psychological needs, and peripheral vascular status.
B) Performs appropriate nursing care of the patient undergoing invasive, peripheral vascular, and cardiovascular procedures. This includes initiation for parenteral therapy, moderate sedation administration and monitoring, patient teaching and instruction, assessment of condition during the procedure with appropriate evaluation and intervention.
C) Provides timely ongoing patient reassessment by making frequent rounds on all patients noting condition, requests, and environment and documenting pertinent observations according to the care plan.
D) Performs and evaluates basic ECG and 12-lead ECG while noting any changes in the patient's baseline rhythm throughout the procedure.
E) Assist physicians with invasive peripheral vascular and cardiovascular procedures.
F) Utilizes special assessments (abuse, fall risk, skin care, etc.) when appropriate.
G) Monitors lab results: serum electrolytes, coagulation times, arterial blood gases and other labs as ordered, and communicates results to physicians.
2) Technical Support: 15% Performs technical support before, during and after invasive peripheral vascular and cardiovascular procedures.
A) Accurately connects patients to ECG monitors.
B) Establishes arterial/venous line set-up prior to procedure.
C) Operates technical equipment necessary and demonstrates proficiency:
• Hemodynamic monitor/recorder
• Video/imaging system
• Contrast injectors
• Cardiac output units
• Oxygen consumption monitors
• Quantitative analysis software
• Intravascular ultrasound units
• Doppler blood flow velocity unit
• Intra-aortic balloon pump
• Fractional Flow Reserve
D) Maintains supplies and equipment:
• Ensures equipment/supplies are available and stored appropriately
• Empties full trash/soiled linen containers
• Changes full needle boxes
• Notifies appropriate department in order to maintain a clean and safe environment (housekeeping, maintenance, dietary, etc.).
3) Assessment and Plan of Care: 5% Performs patient assessment upon admission to the department.
A) Completes assessment of new admission to the laboratory within 1 hour of arrival to cath lab holding area.
B) Documents assessment as outlined on the nursing assessment form.
C) Documents observations and events as outlined in the department planning and provision of care.
D) Provides pre and post procedure education/instructions and documents in notes.
E) Notifies the physician as assessment findings warrant.
4) Implementation: 5%Provides and documents nursing interventions based on assessed patient needs, plan of care, and changes in patient condition.
A) Coordinates, communicates and documents patient care with other disciplines making necessary referrals.
B) Provides and documents patient/family education and discharge planning.
C) Transcribes and initiates physician orders in an accurate and timely manner.
D) Recognizes changes in patient's condition, take appropriate nursing action.
E) Adheres to medication/parenteral therapy administration and documentation per policy guidelines.
F) Performs blood drawing technique to obtain lab specimens including blood cultures.
5) Evaluation: 5% Documents effectiveness of nursing care and modifies plan of care as patient progresses toward expected outcomes (2, 3, 4, 5)
A) Performs and documents ongoing evaluation of effectiveness of care, nursing interventions, patient response to medications, treatments, and procedures while patient is in the department.
B) Evaluates and documents effectiveness of patient/family education including level of understanding utilizing the Patient Education Plan.
C) Evaluates plan of care and modifies as indicated while patient is in the department.
6) Performs catheter and sheath removal after invasive procedures (1, 3, 5, 6, 8) 5%
A) Assess groin site and peripheral pulses.
B) Check vital signs prior to sheath removal.
C) Determines which method of compression is optimal for sheath removal based on assessment.
E) Compresses artery and/or vein for prescribed length of time.
F) Assesses site after hemostasis is obtained.
G) Gives patient instructions regarding post-procedural activity.
7) Safety/Infection Control: Abides by hospital safety and infection control policies. (1, 2, 3, 4, 5) 5%
A) Practices universal precautions and disposes of hazardous wastes per established guidelines.
B) Maintains a safe, clean, comfortable and therapeutic environment for patients/families/employees in accordance with hospital standards.
1. Maintains clutter free environment.
2. Keeps conversations and background noise to a minimum.
3. Adheres to dress code.
C) Reports risk management concerns.
D) Assumes responsibility for completing all annual mandatory requirements as assigned by hospital and department.
8) Service Standards: Provides service excellence to the customers of Saint Louis University Hospital by delivering timely, high quality care in a courteous and respectful manner. (1, 3, 6) 10%
A) Demonstrates Care and Courtesy.
• Provides prompt, respectful, and courteous service.
• Meets physical, spiritual, psychological, and emotional needs of patients and families.
B) Communicates Effectively and Maintains Confidentiality.
• Listens to patient/family concerns and addresses needs.
• Explains procedures and all education in a manner that patient and family understand.
• Allows time for questions.
C) Demonstrates Competence and Collaboration.
• Provides quality care in accordance to standards.
• Assist with other departments to facilitate workflow and continuity.
D) Provides Cost Effective Services.
• Uses resources wisely.
• Recommends changes in practice that increase efficiency and minimize waste.
9) Performance Improvement: Incorporates Quality Assessment into one's daily work. (1, 2, 3, 4, 5) 5%
A) Assists in deploying unit-based PI plan.
B) Collects PI data as assigned.
C) Collaborates in developing and implementing action plans.
D) Participates in research activities in the department.
10) Age Appropriate Care: Provides age-appropriate care to:
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 and/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.
11) Specialized Nursing Care: Provides specialized care to patients at high risk for injury. (1, 2, 4, 5, 8) <1%
A) Restraint Care
1) Initiates/evaluates alternatives to restraint prior to application.
2) Applies restraints consistent with the approved procedure.
3) Monitors and assesses patient's 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 trial release and removal of restraint as soon as possible.
B) Pain Management (licensed personnel)
1) Assess patient for presence of pain on admission and during assessments/reassessments.
2) Incorporates patient's cultural/spiritual beliefs regarding pain into pain management plan.
3) Implement pain management techniques. Focus on prevention rather than treatment.
4) Include patient and/or family members in developing a pain management plans.
5) Consider other methods of pain control when developing plan of care: massage, repositioning, immobilization, and music therapy.
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.
D) Moderate Sedation
1) Recognizes situations in which patient is at risk.
2) Performs monitoring of patients consistent with procedure/physician's orders.
3) Assesses and documents the patient's response to moderate sedation and procedure.
The following job accountabilities may be reassigned.
1) Telephone communication
2) Routine patient care activities (i.e., ambulation, bathing, bed changes, feeding patient)
3) Portions of on-going assessment
4) Medication administration in accordance with professional licensure
5) Specific data collection activities
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 employee's 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.
MINIMUM EDUCATION: Graduate of an accredited School of Nursing and current Nursing License Nursing.
MINIMUM EXPERIENCE: Cardiac Catheterization, ER, Critical Care experience preferred. The work requires the knowledge and skills necessary to provide patient care appropriate to the patient population served.
REQUIRED COURSE: BLS and ACLS.
WORKING CONDITIONS: Regularly exposed to the risk of blood borne diseases and radiation. Requires wearing protective apparel such as lead aprons, eye protection, sterile and non-sterile medical gloves and masks. Contact with patients under a wide variety of circumstances. Exposure to unpleasant elements and unpredictable situations. Handles emergencies or crisis situations. May perform emergency care. Subject to irregular hours.
PHYSICAL REQUIREMENTS: Prolonged standing/walking. Lifts, positions, pushes, and/or transfers patients. Considerable reaching, stooping, bending, kneeling, and/or crouching. Must be able to lift a minimum of 25 pounds.
Department Director __________________________________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.