Boston Medical Center Boston , MA 02298
Under the direction and supervision of the registered nurse and in accordance with hospital policies, procedures, protocols, and standards of practice, the Certified Nursing Assistant (CNA) participates in the delivery of patient care and participates in the remote telemonitoring protocol. The role encompasses the provision of direct clinical and support services to patients and families across the health care continuum, functioning as an effective member of the health care team by contributing to the efficient operation of the patient care unit, and accountability for fiscally sound, quality, safety, patient/family centered care with the goal of improved clinical outcomes.
Status: Part Time, Day and Every Other Weekend
Clinical Practice: Under the direction of the registered nurse (RN), performs a variety of appropriately delegated patient care interventions for patients and their families within the scope of his/her role.
1.1 Collaborates with the safety team (RNs, nurse manager, MDs, and CNAs) throughout the shift to assess and reassess the appropriateness for remote telemonitoring per established safety protocol and policy and procedure. Able to work independently and prioritize responsibilities for the shift. Effectively communicates the status of delegated task completion and outcomes of patient data findings to the RN and safety team throughout the shift.
1.2 Maintains timely ongoing verbal communication with RN throughout the shift regarding patient condition. Notifies RN immediately of any significant change in a patient's condition and/or monitoring alarms (for example: change in vital signs, change in patient's mental status, abnormal blood sugar, patient fall, patient concerns with care). Summons appropriate staff if telemonitoring patient re
CMEquires in person assistance and/or use the stat alarm on the telemonitor equipment when appropriate to promote patient safety.
1.3 Upon initial contact with patients, visitors, and staff, identifies self as a CNA and introduces self to patient by name using the AIDET communication format. Wears appropriate name badge which identifies self as a CNA. Participates in handoff of pertinent patient information and behaviors at change in caregiver and throughout shift when giving on patients to colleagues.
1.4 Accurately collects and records patient data (vital signs, intake and output, blood sugar, weights, restraint care/monitoring, other) and complies with hospital documentation standards to ensure a complete and accurate patient record.
1.5 Accurately interprets & utilizes medical abbreviations and terminology in accordance with hospital policy.
1.6 Initiates a prompt response to all patient call lights and seeks assistance from co-workers as appropriate.
1.7 Assists with admission, discharge, and transfer of patients as appropriate for the remote patient safety observer protocol in inpatient or ambulatory area patients. Completes section of the Functional Health Assessment upon admission when assigned this role. Prepares room for admission and ensures patients have appropriate identification bands upon admission and throughout their hospitalization. Transports patients and their belongings, equipment and supplies, as needed and as part of the transfer/discharge process.
1.8 Makes routine patient room rounds to address patient needs.
1.9 Provides and/or assists with basic hygiene including but not limited to: bathing, dressing, mouth care, shaving, perineal and bowel care, foley care, application of condom catheters, emptying urinals and ostomy bags and other associated hygiene tasks.
1.10 Provides basic skin care including but not limited to:, back rubs, application of non-medicated ointments, application of elastic stockings, ace wraps, and venodynes, turning and repositioning patients every two hours, and other associated tasks.
1.11 Sets up patients for meals and assists them with feeding and opening food containers; maintaining calorie counts and recording intake/output measures (I and Os).
1.12 Performs basic oral suctioning.
1.13 Performs post mortem care.
1.14 Assists nurse/health team members during simple and complex treatments or procedures.
1.15 Provides basic preoperative care and readies the patient for the OR in conjunction with the RN.
1.16 Collects, labels, and sends/transports specimens with the appropriate lab slips/requisitions.
1.17 When ambulating patients uses safe and proper technique, applies safety devices using hydraulic lifts or bed scale as needed.
1.18 When assigned to provide one-on-one (1:1) or one-on-two (1:2) patient care, performs the duties of the certified nursing assistant for the patient assigned.
1.19 Identifies emergency / crisis situations and initiates appropriate response actions within the scope of her/his role, including immediate communication of such events to the registered nurse. Seeks help or advice as soon as possible when patient poses a threat to self or others.
1.20 Performs EKGs and phlebotomy services as directed.
1.21 Performs basic patient testing, including but not limited to: sugar and acetone, glucose finger stick, O2 saturation, etc.
1.22 Maintains competence by successfully completing all assigned education/training. Demonstrates understanding and proficiency in the use of video monitoring equipment. Is proficient in application of external monitors and telemonitoring camera equipment set up. Provides continuous observation and surveillance of assigned patients using remote patient observer telemonitoring equipment.
II. Support Services: Under the direction of the RN, works cooperatively with all health care team members to provide a variety of support services to meet patient, family, and staff needs within the scope of his/her role.
Addresses patient comfort and information needs by providing informative, non-clinical information to patients and families, orienting patients/visitors to the hospital, unit, patient room services, distributing patient mail/flowers, arranging room to ensure necessary personal care items are available & accessible (includes call lights), distributes nourishments, changes linens & clothing, refill ice packs, run patient errands or other duties as assigned by the RN.
Answers the telephone identifying unit, self & role; responds to caller's need within the scope of role, or takes and delivers messages in a timely manner.
In conjunction with the RN, responsible for initiating patient belongings tracking form and for properly securing patient belongings in accordance to hospital policy. Consults with RN if patient refuses to secure their belongings or have their belongings sent home with family member or friend.
III. Work Rules, Standards, & Competency Compliance: Acts in a manner that supports a positive and collaborative work environment and that is congruent with established standards, policies, procedures, and regulations within the scope of his/her role.
3.1 Works cooperatively with all staff members and takes appropriate steps to resolve interpersonal conflicts. Seeks assistance from RN or off-Shift Nurse Manager as needed.
3.2 Participates in staff meetings and appropriate inservices. Responsible for reading and reviewing minutes and clinical updates on the unit. Maintains accurate education record in Healthstream. Maintains competencies required to perform the role.
3.3 Complies with established practice standards, policies, procedures, protocols, guidelines, and regulations, (for example: DPH, JCAHO, Boston fire codes, OSHA).
3.4 Reviews and is knowledgeable of appropriate policies, procedures and work rules.
3.5 Dresses appropriately according to dress code requirements, including wearing uniform and visible hospital I.D. badge while on duty.
3.6 Assists in the orientation of new staff; serves as a resource to float staff.
3.7 Adapts to changing patient and unit needs including but not limited to: offers assistance to other team members, floating, adjusting assignments, etc. Coordinates break time with patient safety observer CAN colleague under the direction of supervising RN
3.8 Communicates with charge nurse/supervisor to coordinate break periods with unit activities. Maintains visibility on the unit and does not leave work area without appropriate notification to the RN.
3.9 Delivers care in a non-judgmental, non-discriminatory manner that is sensitive to and demonstrates respect for patient diversity.
3.10 Acts in a manner that protects confidentiality of patient, employee and hospital information at all times.
IV. Care of Unit Environment, Equipment, Materials and Supplies: Performs a variety of environmental and inventory activities to ensure a safe, clean and appropriately equipped environment for patients, visitors and staff within the scope of his/her role.
4.1 Initiates and performs spot and spill cleaning as needed, including biological spills. Assists with locating and transporting equipment for periodic sonic cleaning.
4.2 Makes routine room rounds to unclutter, clean, and organize patient rooms/areas when needed.
4.3 Checks inventories, and restocks/replaces/assembles patient equipment and supplies. Maintains and re-stocks safety supplies as needed.
4.4 Appropriately disposes of trash, soiled linens, medical waste & disposable items.
4.5 Performs regular checks per policies to ensure that equipment is operating properly and has current safety inspections/expiration dates before patient use. Identifies broken/expired equipment/supplies; removes from service, and notifies RN. Provides equipment delivery to appropriate repair sites as requested.
4.6 Maintains appropriate equipment logs and records.
4.7 Performs initial cleaning/decontamination of equipment/materials, e.g., removing reusable equipment from isolation rooms, and arranges for terminal cleaning as appropriate. Clean and decontaminate Remote Video Monitor camera and equipment in between patient use.
4.8 Provides basic patient equipment care including but not limited to: changing hearing aide batteries, cleaning/preparing breast pumps, etc.
5.1 Interprets/translates for patients/family/visitors when conversant in her/his native language.
5.2 Utilizes hospital's values as the basis for decision making and to facilitate the division's hospital mission.
5.3 Follows established hospital infection control and safety procedures.
5.4 Performs all other duties as assigned.