Care Partner/CNA - Ortho Trauma - Nights
Company: SSM Health
Location: Saint Louis
Posted on: July 19, 2021
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Job Description:
This shift is 7:00 p.m. - 7:00 a.m. 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 patient’s plan of care as it relates to the
patient’s 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 patient’s 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 patient’s room. C) Notifies the physician and nursing staff of new patient’s
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 patient’s 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 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 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 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 "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: PHYSICAL REQUIREMENTS:
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: Achieve Excellence in Nursing Practice By: Own and Respect My Environment By: 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…) 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…) 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
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Name
Date
_______________________________________________________________________________ Manager Signature
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Name
Date
Keywords: SSM Health, St. Louis , Care Partner/CNA - Ortho Trauma - Nights, Other , Saint Louis, Missouri
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