Purpose of Your Job Position

Responsible for implementing the Wound Prevention and Treatment Program in the facility. Works closely with the Unit Managers, and Staff Development Coordinator to assure that all nursing staff is educated in the principles of wound prevention. Collaborates with the Wound Care Team to determine appropriate wound prevention. Implements treatment modalities as assigned.

Delegation of Authority

As the Treatment Nurse, you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties. In the absence of the Medical Director, you are charged with carrying out the resident care policies established by this facility.

Job Functions

Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, is an essential function of the position or as needed for the administration of the facility.

Duties and Responsibilities

Administrative Functions

• Assess skin condition on all new admissions using standardized assessment tool.

• Obtains physicians’ orders for treatment modalities as determined in collaboration with the Wound Care Team.

• Implements treatment plan on all residents as assigned by the Director of Nursing.

• Appropriately documents on all residents receiving treatments, reviewing previous documentation and assuring consistency in documentation.

• Completes weekly wound summary.

• Respects rights of residents regarding freedom of choice, consent for care and services, refusals of treatments. Promptly consults with Unit Manager and Social Worker if unsure of proper course of action that respects resident’s rights, complies with facility policies and procedures and that is consistent with State and Federal laws and regulations.

• Participates with the Interdisciplinary Team, including the Wound Care Team in weekly wound rounds and the Wound Committee.

• Works with Restorative Nursing to make sure staff is following through with active measures to prevent skin breakdown and that all residents who are at risk for skin breakdown are identified.

• Works with Nursing Staff to assure that all resident have appropriate pressure reducing devices.

• Work with Nursing Staff to assure that all residents have appropriate pressure reducing measures.

• Updates Care Plans as needed for residents who are sick as well as residents with skin breakdown.

• Problem solves with staff to resolve problems that arise in preventing and treating skin breakdown.

• Works closely with Physical and Occupational Therapy to assure proper use of pressure reducing devices.

• Works with Central Supply and vendor to provide appropriate mattresses for residents with Stage III, Stage IV, and multiple Stage II pressure sores.

• Informs residents and responsible parties of any changes in skin integrity, deterioration of wound, changes in care and treatment of wound.

• Reports relevant information to the Unit Manager including change in any resident’s skin status, deterioration of a wound, failure of an individual staff to provide appropriate pressure reducing measures.

• Reports all injuries to self or others to supervisor immediately.

• Attends in-service education programs as assigned. Applies information to job tasks.

Committee Functions

• Serve on, participate in, and attend various committees of the facility (i.e., Infection Control, Policy Advisory, Pharmaceutical, Budget, Quality Assessment and Assurance, etc.) as required, and as appointed by the Administrator.

• Provide written and/or oral reports of the nursing service programs and activities as required, or as may be directed by such committee(s).

• Assist the Pharmaceutical Services Committee in developing, maintaining, implementing, and periodically updating written policies and procedures for the administration, storage, and control of medications and supplies.

• Schedule, attend, and participate in developing the agenda for Care Plan Committee meetings as necessary.

• Participate in regularly scheduled reviews of the Discharge Plans and make such plans available to the Care Plan Committee as required or as may be necessary.

• Evaluate and implement recommendations from established committees as they may pertain to nursing services.

• QAPI

• Knowledgeable in data collection, data analysis methodology, and performance improvement methods needed to support and lead performance improvement projects

• Collaborate with the quality committee and senior leaders to prioritize and develop QAPI efforts

• Lead performance improvement projects and provide education and coaching in order to build needed skills in others to lead PIPs

• Participate in multidisciplinary QAPI activities

• Knowledge of current Performance Improvement Initiatives

Personnel Functions

• Determine the staffing needs of the nursing service department necessary to meet the total nursing needs of the residents.

• Recommend the number and level of nursing personnel to be employed.

• Assist the Administrator and/or the Personnel Director in the recruitment and selection of nursing service personnel.

• Ensure that all nursing assistants are enrolled in or have graduated from an approved training program.

• Assign a sufficient number of licensed practical and/or registered nurses for each tour of duty to ensure that quality care is maintained.

• Assign a sufficient number of certified nursing assistants for each tour of duty to ensure that routine nursing care is provided to meet the daily nursing care needs of each resident.

• Ensure that all nurse aide trainees are under the direct supervision of a licensed nurse.

• Develop work assignments and schedule duty hours, and/or assist nursing supervisory staff in completing and performing such tasks.

• Delegate to nursing service supervisory personnel the administrative authority, responsibility, and accountability necessary to perform their assigned duties.

• Assist the Personnel Director in developing performance evaluation schedules, criteria, and annual reviews for the nursing service department (e.g., RNs, LPNs, CNAs, medication aides, etc.).

• Make daily rounds of the nursing service department to ensure that all nursing service personnel are performing their work assignments in accordance with acceptable nursing standards.

• Monitor absenteeism to ensure that an adequate number of nursing care personnel are on duty at all times.

• Develop, maintain, and periodically update the written procedure for ensuring that professional nursing personnel, including private duty nurses, have valid and current licenses as required by this State.

• Review complaints and grievances made or filed by department personnel.

• Provide complaint/grievance reports to the Administrator as required or as may be necessary.

• Ensure that departmental disciplinary action is administered fairly and without regard to race, color, creed, national origin, age, sex, religion, handicap, or marital status.

• Assist the Infection Preventionist in establishing a TB management program for employees.

• Report occupational exposures to blood, body fluids, infectious materials, and hazardous chemicals in accordance with the facility's policies and procedures governing accidents and incidents.

• Perform background checks on Nursing Service personnel in accordance with established procedures.

• Ensure that all CNA's credentials are verified through the State Nurse Aide Registry.

• Ensure that appropriate adverse personnel actions relative to CNA's employment criteria are reported to the State Nurse Aide Registry.

Nursing Care Functions

• Participate in the interviewing and selection of residents for admission to the facility, including PASARR screenings.

• Provide the Administrator with information relative to the nursing needs of the resident and the nursing service department's ability to meet those needs.

• Inform nursing service personnel of new admissions, their expected time of arrival, room assignment, etc.

• Ensure that rooms are ready for new admissions.

• Greet newly admitted residents upon admission. Escort to room as necessary.

• Make rounds with physicians as necessary. Schedule physician visits as necessary.

• Encourage attending physicians to record and sign progress notes, physicians' orders, etc., on a timely basis and in accordance with current regulations.

• Ensure that direct nursing care be provided by a licensed nurse, a CNA, and/or a nurse aide trainee qualified to perform the procedure.

• Review nurses' notes to ensure that they are informative and descriptive of the nursing care being provided, that they reflect the resident's response to the care, and that such care is provided in accordance with the resident's wishes.

• Schedule daily rounds to observe residents and to determine if nursing needs are being met in accordance with the resident's request.

• Monitor medication passes and treatment schedules to ensure that medications are being administered as ordered and that treatments are provided as scheduled.

• Provide direct nursing care as necessary.

• Authorize the use of restraints when necessary and in accordance with our established policies and procedures.

• Ensure that residents who are unable to call for help are checked frequently.

Staff Development

• Develop and participate in the planning, conducting, and scheduling of timely in-service training classes that provide instructions on "how to do the job," and ensure a well-educated nursing service department.

• Develop, implement, and maintain an effective orientation program that orients the new employee to the facility, its policies and procedures, and to his/her job position and duties.

• Provide leadership training that includes the administrative and supervisory principles essential for Nurse Supervisors/Charge Nurses.

• Encourage the nursing supervisory staff to attend and participate in outside training programs. Schedule times as appropriate.

• Assist the Administrator in developing and revising the nursing assistant training curriculum used by the facility. Submit to state agency for approval as required.

• Assist the Clinical Educator in developing annual OSHA and CDC in-service training programs for hazard communication, TB management, and bloodborne pathogens standard.

• Assist the Clinical Educator in developing advance directive in-service training programs for the staff and community.

• Assist support services in developing, implementing, and conducting in-service training programs that relate to the nursing service department.

• Assist the Clinical Educator in the development of in-service training programs for the nursing staff. Ensure that these programs meet the continuing education requirements which allow licensed personnel (e.g., RNs, LPNs, CNAs, etc.) to keep their licenses on an active status.

• Attend and participate in continuing educational programs designed to keep you abreast of changes in your profession, as well as to maintain your license on a current status.

• Assist the Infection Control Coordinator in the development of a TB management program.

Safety and Sanitation

• Assist the Safety Officer in developing safety standards for the nursing service department.

• Ensure that the department's policy and procedure manuals identify safety precautions and equipment to use when performing tasks that could result in bodily injury.

• Assist the Infection Preventionist in identifying, evaluating, and classifying routine and job-related functions to ensure that tasks in which potential exposure to blood/body fluids are properly identified and recorded.

• Ensure that all personnel performing tasks that involve potential exposure to blood/body fluids participate in appropriate in-service training programs prior to performing such tasks.

• Ensure that adequate supplies of personal protective equipment are on hand and are readily available to personnel who perform procedures that involve exposure to blood or body fluids.

• Monitor nursing service personnel to ensure that they are following established safety regulations in the use of equipment and supplies.

• Ensure that nursing service work areas (i.e., nurses' stations, medicine preparation rooms, etc.) are maintained in a clean and sanitary manner.

• Ensure that all resident care rooms, treatment areas, etc., are maintained in a clean, safe, and sanitary manner.

• Ensure that all nursing service personnel follow established departmental policies and procedures, including appropriate dress codes.

• Ensure that nursing service personnel participate in and conduct all fire safety and disaster preparedness drills in a safe and professional manner.

• Assist the Infection Control Committee in the development, implementation, and revising of written aseptic and isolation techniques.

• Develop, implement and maintain a program for monitoring communicable and/or infectious diseases, including TB, among the residents and personnel.

• Ensure that nursing service personnel follow established infection control procedures when isolation precautions become necessary.

• Develop, implement, and maintain a procedure for reporting hazardous conditions or equipment.

• Ensure that personnel wear and/or use safety equipment and supplies (e.g., back brace, mechanical lifts, etc.) when lifting or moving residents.

• Report missing/illegible labels and MSDSs to the safety officer or other designated person.

Equipment and Supply Functions

• Recommend to the Administrator the equipment and supply needs of the department.

• Ensure that a stock level of medications, medical supplies, equipment, etc., is maintained on premises at all times to adequately meet the needs of the resident.

• Assist the Maintenance Director in developing a preventive maintenance program for maintaining the nursing service department's equipment and supplies in a safe and operable manner.

• Develop and implement procedures for the safe operation of all nursing service equipment.

• Ensure that only trained and authorized personnel operate the department's equipment.

• Ensure that all personnel operate nursing service equipment in a safe manner.

• Develop and implement procedures that ensure nursing service supplies are used in an efficient manner to avoid waste.

• Ensure that personal protective equipment used in the handling of infectious materials are available and easily accessible to nursing service personnel.

• Ensure that appropriate MSDSs are on file for hazardous chemicals used in the nursing service department.

Care Plan and Assessment Functions

• Assist in the development of preliminary and comprehensive assessments of the nursing needs of each resident.

• Develop a written plan of care (preliminary and comprehensive) for each resident that identifies the problems/needs of the resident, indicates the care to be given, goals to be accomplished, and which professional service is responsible for each element of care.

• Encourage the resident and his/her family to participate in the development and review of the resident's plan of care.

• Assist the Resident Assessment/Care Plan Coordinator in the scheduling of care plans and assessments to be presented and discussed at each committee meeting.

• Ensure that all personnel involved in providing care to the resident are aware of the resident’s care plan. Ensure that nursing personnel refer to the resident's care plan prior to administering daily care to the resident.

• Review nurses' notes to determine if the care plan is being followed.

• Assist the Resident Assessment/Care Plan Coordinator in planning, scheduling, and revising the MDS, including the implementation of RAPs and Triggers.

• Review and revise care plans and assessments as necessary, but at least quarterly.

• Develop and maintain a good rapport with all services involved with the care plan to ensure that a team effort is achieved in developing a comprehensive plan of care.

• Ensure that medical and nursing care is administered in accordance with the resident's wishes, including the implementation of advance directives.

Budget and Planning Functions

• Prepare and plan the nursing service department's budget and submit to the Administrator for his/her review, recommendations, and/or approval.

• Keep abreast of economic conditions/situations, and recommend to the Administrator adjustments in nursing services that ensure the continued ability to provide quality care.

• Recommend to the Administrator the equipment and supply needs of the nursing service department.

Resident Rights

• Maintain the confidentiality of all resident care information.

• Monitor nursing care to ensure that all residents are treated fairly, and with kindness, dignity, and respect.

• Ensure that all nursing care is provided in privacy and that nursing service personnel knock before entering the resident's room.

• Ensure that all nursing service personnel are knowledgeable of the residents' responsibilities and rights including the right to refuse treatment.

• Review complaints and grievances made by the resident and make a written/oral report to the Administrator indicating what action(s) were taken to resolve the complaint or grievance. Follow facility's established procedures.

• Maintain a written record of the resident's complaints and/or grievances that indicates the action taken to resolve the complaint and the current status of the complaint.

• Ensure that appropriate notices are given to residents before their room or roommate is changed.

• Report and investigate all allegations of resident abuse and/or misappropriation of resident property.

• Ensure that nursing staff personnel honor the resident's refusal of treatment request. Ensure that such requests are in accordance with the facility's policies governing advance directives.

• Ensure that the facility's policies and procedures governing advance directives are reviewed with the resident and/or representative.

• Assist the Infection Control Coordinator in developing and implementing a resident TB management program.

Working Conditions

• Works in office area(s) as well as throughout the nursing service area (i.e., drug rooms, nurses' stations, resident rooms, etc.).

• Moves intermittently during working hours.

• Is subject to frequent interruptions.

• Is involved with residents, personnel, visitors, government agencies/personnel, etc., under all conditions and circumstances.

• Is subject to hostile and emotionally upset residents, family members, personnel, and visitors.

• Communicates with the medical staff, nursing personnel, and other department supervisors.

• Works beyond normal working hours and on weekends and holidays when necessary. On call 24 hours per day, 7 days per week.

• Is subject to call-back during emergency conditions (e.g., severe weather, evacuation, post-disaster, etc.).

• Is involved in community/civic health matters/projects as appropriate.

• Attends and participates in continuing educational programs.

• Is subject to injury from falls, burns from equipment, odors, etc., throughout the work day, as well as to reactions from dust, disinfectants, tobacco smoke, and other air contaminants.

• Is subject to exposure to infectious waste, diseases, conditions, etc., including TB and the AIDS and Hepatitis B viruses.

• May be subject to the handling of and exposure to hazardous chemicals.

• Maintains a liaison with the residents, their families, support departments, etc., to adequately plan for the residents' needs.

Education Requirements

• Graduate of accredited School of Nursing.

• License: RN or LPN

Experience

• Must have, as a minimum, one year(s) of experience as a supervisor in a hospital, long-term care facility, or other related health care facility.

• Must have experience in rehabilitative and restorative nursing practices.

Specific Requirements

• Knowledge of geriatric and general chronic care nursing principles and professional standards of nursing practice and ability to apply to resident specific circumstances. Able to identify, implement and evaluate appropriate objectives and interventions for residents.

• Demonstrated competency in clinical skills needed for facility resident population.

• Demonstrated competency in physical, behavioral and functional capacity assessment of long term care residents (to individual level of licensure).

• Working knowledge of laws and regulations that influence provision of care and services in nursing facilities.

• Working knowledge and ability to interpret and demonstrate facility policies, procedures to direct care staff.

• Sufficient organizational and interpersonal skills to assign, motivate staff, elicit work output, improve quality and interact effectively with residents, families, interdisciplinary team members, administration, government officials, consultants and others in addition to staff.

• Carries out all duties in accord with the facility mission and philosophy.

• Demonstrates knowledge of and respect for the rights, dignity and individuality of each resident in all interactions. Demonstrated competency in the protection and promotion of Residents Rights.

• Appreciates the importance of maintaining confidentiality of resident and facility information.

• Demonstrates honesty and integrity at all times in the care and use of resident and facility property.

• Able to understand and to follow written and verbal directions. Able to express self adequately, accurately in written and/or oral communication (including documentation in clinical records) with direct care staff, interdisciplinary team members, administration, and government officials.

• Knowledge of emergency and disaster procedures of facility. Able to locate nearest exit to understand and respond to written or oral instruction in case of emergency.

• Sufficient mobility, and strength to move freely through the building, to assure resident safety at all times and to assist, transfer or otherwise move residents of facility out of danger in case of emergency.

• Demonstrates respect for co-workers and responds to needs of residents by complying with facility policies on attendance and punctuality and dress code. Able to arrive and to begin work on time and to report for duty on all shifts, weekends and holidays.

• Working knowledge and ability to comply with facility policies and procedures for workplace safety including infection control procedures, application of universal precautions for blood borne pathogens, use of personal protective equipment and handling of hazardous materials.

• Demonstrates ability to prioritize tasks/responsibilities and complete duties/projects within allotted time.

• Able to respond to change productively and to handle additional tasks/projects as assigned.

• Knowledge of and ability to apply facility personnel policies to job actions without regard to race, religion, age, sex, national origin or disability.

• Able to carry out the essential functions of this job (with or without reasonable accommodation) without posing specific, current risk of substantial harm to health and safety of self and others

Physical and Sensory Requirements

(With or Without the Aid of Mechanical Devices)

• Must be able to move intermittently throughout the workday.

• Must be able to speak and write the English language in an understandable manner.

• Must be able to cope with the mental and emotional stress of the position.

• Must be able to see and hear or use prosthetics that will enable these senses to function adequately to ensure that the requirements of this position can be fully met.

• Must function independently, and have flexibility, personal integrity, and the ability to work effectively with residents, personnel, and support agencies.

• Must meet the general health requirements set forth by the policies of this facility which include a medical and physical examination.

• Must be able to relate to and work with the ill, disabled, elderly, emotionally upset, and at times hostile people within the facility.

• Must be able to push, pull, move, lift and carry.

• May be necessary to assist in the evacuation of residents during emergency situations.

Regulatory Compliance - QAPI

• Recognize your role as part of the QAPI efforts of your organization.

• Attend trainings to build understanding and capacity to undertake QAPI work.

• Carry out QAPI roles and responsibilities as assigned.

• Follow established policies and procedures in support of QAPI efforts.

• Look for and share with leadership ideas for improvement in the organization.

• Communicate to leadership upon witnessing a positive outcome of a QAPI project or detecting barriers preventing project success.

• Support QAPI efforts both verbally and non-verbally (i.e., via actions and attitude), including adjusting performance and practice in accordance with QAPI initiatives and findings.