Staff Nurse - Wound Care Clinic
Under the supervision of the C linical Manager, performs the primary function of an RN in assessing, planning, implementing and evaluating the care of patients in the Wound Healing C enter. Is responsible for meeting the established WHC Standards of Nursing Practice in the management of all assigned patients. Assists physicians with the development and implementation of wound treatment plans and participates in performance improvement review activities. Acts within the guidelines of federal and state laws, JC AHO Standards and professional and ethical practice. Also administers hyperbaric oxygen therapy and diagnostic testing to patients of the Department of Hyperbaric Medicine, under the supervision of a hyperbaric physician. All therapeutic and diagnostic modalities will be ordered by the hyperbaric physician.
Role Specific Competencies
1. Clinical - Assessment
- Initiate a nursing assessment of patient's condition upon admission.
- Assess and interpret reports communicating findings with the assigned physician.
- Recognize and assess initial alterations in the patient's body systems and verbalize this to other members of the health care team.
- Organize assessment data for accuracy, completeness and confidentiality.
- Record assessment data in an orderly fashion and communicate, revise and verbalize pertinent information to other health care team members.
- Assess, stage, and measure wounds accurately and in accordance with policy.
- Photograph wounds according to policy and procedure.
- Complete in an accurate manner all admission nursing chart forms.
- Assess compliance to the clinical pathway and be instrumental in bringing to the attention of the physician or health care team missing components.
- Identify patient care situations that require intervention, implement nursing actions and evaluate responses.
- Identify patient/family education and discharge needs and implement a teaching plan of care.
2. Clinical - Planning
- Document a plan of care accurately for all assigned patients.
- Identify the patient's present and potential problems from the assessment.
- Determine patient's health status and incorporate into the plan of care.
- Collaborate with physician to develop a plan of care based on assessment data. Develop and implement a teaching plan.
- Prioritize problems according to impact on health status.
- Formulate desired outcomes specific to patient's problems and WHC protocols.
- Ensure desired outcomes that are mutually agreed upon by the patient, family (when appropriate) and the nurse.
- Formulate desired outcomes that are specific and measurable within a certain time frame and consistent with other health provider's expectations.
- Identify home health care needs, evaluate support systems, and identify patient teaching needs from admission to discharge.
- Participate in implementing planned changes and activities to improve care.
- Hold self and staff accountable for the delivery of quality nursing care.
- Promote harmonious relationships and favorable attitudes among the team members.
- Assess whether the plan of care is effective with the physician and is instrumental in initiating changes as necessary.
- Implement wound care and HBO protocols when clinically indicated.
- Individualize care according to age specific population.
- Assist physician with wound therapy.
- Accurately complete the superbill and ensure that all orders and charges are initiated accurately.
- Coordinate activities with other disciplines (rehab, nutrition, diabetic education, home health, DME, nursing homes and other ancillary services).
- Evaluate achievement or lack of achievement of desired outcomes.
- In collaboration with the physician and other health care members, revise the plan of care and continuously reassess and evaluate until desired outcome is obtained.
- Complete the 4 week reviews in a timely manner and ensure all recommendations to the plan are activated in the physician orders.
- Participate in quality improvement/staff meetings.
- Function as a case manager for a defined patient population.
- Coordinate office visits, pre-procedure work-ups, and patient education with the multidisciplinary team.
- Foster continuity of care between WHC and care taker (home, hospital, HH etc)
- Coordinate the use of clinic staff, exam room space, and supplies.
- Prepare for clinic to enable accurate and complete updates to the physician.
- Assist others within the clinic.
- Triage telephone calls and assist with scheduling.
- Maintain an open, professional communication line with patients, physicians, and staff.
- Safely operate all clinical equipment in the clinic.
- Maintain appropriate infection control procedures.
- Maintain skills and knowledge through training and continuing education.
- Monitor condition of equipment and report malfunctions to C linical Manager.
- Adhere to time and attendance policies. Support and adhere to NHC and Hospital policy and procedures.
- Demonstrate professionalism and commitment to the mission statement of the Department of Hyperbaric Medicine, as well as Client Hospital at all times.
- Demonstrate a working knowledge of the policies and procedures of Hyperbaric Medicine.
- Perform transcutaneous oxygen monitoring testing as ordered and per departmental policy.
- Ascertain that the patient's diagnosis is one of the appropriate approved disorders for Hyperbaric Oxygen Therapy, and that the said diagnosis is clearly entered on the patient's charts/records.
- Implement the physician's orders as indicated by the patient's treatment plan.
- Educate patient and/or patient's family as to the benefits, risks, contraindications, and safety issues of hyperbaric oxygen therapy before treatment.
- Perform blood glucose monitoring as ordered and indicated by patient diagnosis.
- Inspect the patient prior to the commencement of each Hyperbaric Oxygen Therapy session to ensure all safety standards are being adhered to, i.e. 100% cotton attire, no makeup, no hairspray, etc.
- Perform the hyperbaric treatments and monitor the patient during therapy.
- Perform dressing changes and/or wound care within scope of practice, as ordered and participate in clinic when HBO volumes are below par.
- Take serial photographs of the wound for reporting of the patient's progress.
- Evaluate the patient outcome and meet with the manager and the hyperbaric physician to discuss patient treatment and adjust treatment as necessary.
- Consult with hyperbaric physician regarding any adverse reactions.
- Document treatment notes and maintain patient treatment/diagnostic records.
- Complete the patient's treatment charges, if required.
- Perform quality control daily on department glucometer, or as required by policy.
- Clean and maintain the equipment according to infection control standards.
- Maintain continuous quality improvement duties and chart audits.
- Answer telephone inquiries and schedule patient treatment times.
- Perform marketing duties as needed, intra- and interdepartmental.
- Perform an inventory check, and maintain a record of supplies and laundry items.
- Maintain equipment and checks backup air and oxygen supplies on a daily basis.
- Perform data entry into the Wound Information Data System and collate reports as requested by the director.
- Orient new employees as necessary.
- Participate in New Patient Reviews to assess for HBO indicators.
Qualifications and Experience
- Current RN licensure in state of Maryland
- Minimum of 2 year's med-surg experience. Wound Care experience preferred.
- Routinely lifts objects under 50 pounds.
- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Significant lifting is required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to stand, walk, use hands to finger, handle or feel, reach with hands and arms, and talk or hear. The employee is occasionally required to sit, climb or balance, stoop, kneel, crouch, or crawl, and smell.
- The employee must frequently lift and/or move up to 50 pounds and occasionally lift and/or move patients.
- Specific vision abilities required by this job include close vision, distance vision and color vision.