Treatment Nurse

RN License Qualification: Registered Nurse

Job Title Variation: Wound Nurse

Reports to: Director of Nursing and/or ADON

Supervises: None

Classification: Non-Exempt Hourly

Position Description

Responsible for the center’s general application of the skin management program. Responsible for delivering safe, efficient and effective treatment to heal various types of wounds, including surgical openings, ulcers, bed sores, feeding tube sites, and abscesses. Required to assess wounds, create and implement treatment plans, monitor infections and signs of various infections, and clean wounds. Operates within the scope of practice defined by the state Nurse Practice Act.

Principal Responsibilities

• Perform resident skin assessments, obtain treatment orders, administer treatment as ordered, and document appropriately to ensure that resident skin integrity is improved and/or maintained.
• Administer treatments as prescribed within standard nursing practice guidelines and in full compliance with established infection control protocols. • Coordinate and lead weekly wound rounds and processes, including rounds, measurements, interdisciplinary care plan review, treatment recommendations, physician orders, and required documentation.
• Documents findings appropriately and contacts physician to make recommendations for new or revised treatment orders; Monitors the progress of wound healing and makes recommendations for changes as appropriate.
• Receives, transcribes and implements new treatment orders in a timely manner.
• Monitors the progress of wound healing and makes recommendations for changes as appropriate.
• Collect, analyze and provide pressure ulcer information to nursing staff and other nursing personnel.
• Maintain records of pressure ulcers and skin alterations including risk assessment, prevention and minimizing activities; Performs and records weekly pressure ulcer assessment and measurement documentation; Identify and maintain effective methods to gather pressure ulcer and skin alteration related information; Calculates weekly / monthly pressure ulcer rates.
• Investigate and identify center practices and risk minimizing measures, including accurate completion of Braden risk scales on admission, implementation of preventive interventions.
• Monitor timely implementation of preventive interventions for at risk residents, including new admissions, individuals with skin alterations and individuals at risk for development of skin alterations.
• Coordinate completion of ongoing pressure ulcer and skin alteration tracking activities and implements measures to improve outcomes, including employee education.
• Recommend education for employees and other nursing personnel to minimize and, or prevent center acquired skin alterations and pressure ulcers.
• Educate newly hired nursing staff on Skin Practice Guide requirements and Skin Resource Library including wound assessments, preventive interventions, care planning, treatment selection options, documentation requirements and education resources available.
• Collaborate with administrator, medical director or his/her designee, Director of Nursing and other members of health care team on Skin Practice Guide. • Evaluate availability of needed supplies for wound care and coordinate ordering with central supply. • Assist the Director of Nursing and medical director with case review for center acquired pressure ulcers.
• Monitor changes in state and federal regulations and current industry-standard practices; Keeps current with industry trends through ongoing specialized education in the area of skin and wound management
• Provide monthly, quarterly and annual reports including recommendations for changes in center practice for the Quality Assurance and Performance Improvement Committee.
• Other duties, responsibilities and activities may change or assigned at any time with or without notice.

Direct Care Responsibilities

• Charts progress notes in an informative, factual manner that reflects the care administered as well as the resident’s response to care.
• Follows established procedure for charting and reporting all reports of incident/accidents (residents & employees).
• Identifies and reports changes in condition to supervisor, physician and family.
• Accurately identifies skin changes and follows the Company skin management protocols.
• Orders and reports diagnostic tests timely.
• Communicates resident changes at the beginning and completion of each shift with the nurse leaving and coming on to the shift. • Completes documentation to reflect progress or lack of progress of resident’s skin management.
• Accurately completes and is familiar with the forms used throughout the resident’s chart.
• Participates and conducts (as appropriate) investigations related to any alleged abuse.
• Ensures that the progress notes are reflective of the care plan and that the approaches on the care plan are being followed. Special Nursing Care Responsibilities
• Demonstrates knowledge and ability to work with: NG/tube: insertion, placement, irrigation; Colostomy care: irrigation; Foley catheter care: insertion, Irrigation; Catheter application; Straight catheterization;
• Demonstrates knowledge and ability to work with: Tube feeding: hanging and labeling, operation of pump, calculating intake and output, assuring dietary, recommended feeding allowances are maintained, monitoring the weights of residents, assessing for abdominal distention, feeding tube placement, residual.
• Demonstrates knowledge and ability to implement: Positioning techniques; Transfer techniques; ROM exercises.
• Demonstrates knowledge and ability to implement: Emergency procedures: properly administer s O2, suctions, performs CPR, and uses the ambu bag; glucometer checks.
• Demonstrates knowledge and ability to work with: IVs: conducts IV site care, applies and monitors a Heparin Lock, mixes, hangs and administers IV solutions to residents, can compute rate of IV fluid administration, operates the infusion pump.
• Demonstrates knowledge and ability to work with: Suctioning: tracheotomy, nasotracheal; Tracheotomy care; Gastrostomy care: irrigation, placement check; Sterile technique.
• Demonstrates knowledge and ability to work with: mechanical ventilation, indication of ventilation; understand the difference between oxygenation and ventilation, identifying initial parameters, settings and special issues associated with ventilator setup, trouble shoot and recognizing alarms; and evaluate patient response to the ventilator; recognize the cause of low pressure and high pressure on ventilation care; basic and advance airway; pulmonary assessment; and maintaining patient airway and devices.
• Demonstrates knowledge and ability to implement: Collection of lab specimens; Isolation techniques. General Responsibilities • Attends and participates in scheduled training, educational classes, and meetings to maintain current certification as applicable; Attends and participates in in-service training as mandated by regulatory agencies and company policy.
• Adheres to work schedules in completing and performing assigned tasks; completes all assigned tasks in a timely manner as instructed by the direct supervisor.
• Meets acceptable center attendance requirements; notifies facility before late arrival to or absence from work according to established center policy. • Cooperates with other facility personnel to ensure that services can be adequately maintained to meet the needs of residents; creates and maintains an atmosphere of warmth, personal interest, and positive emphasis, as well as a calm environment.
• Adheres to established employee policies.
• Adheres to established dress code.

Customer Service Responsibilities

• Models customer service principals throughout the center and promotes appreciation of our customer’s needs.
• Treats residents, residents’ family members, visitors and fellow employees with courtesy, respect, and dignity.
• Presents professional image through appearance, behavior and speech.
• Explains procedures to residents before administering services.

Residents Rights

• Understands, upholds and promotes the rights of the residents.
• Ensures residents can exercise rights without interference, coercion, discrimination, or reprisal from the facility.
• Ensures protected health information is kept confidential.
• Ensures resident concerns/complaints are responded to with tact and urgency.
• Reports allegations of resident abuse, neglect and/or misappropriation of resident property.
• Coordinates effective communication with Residents and Companions by assuring all arrangements for providing interpreters and/or other auxiliary aids and services needed by Residents and Responsible Party are made, including scheduling interpreters through outside agencies and scheduling staff interpreters, if any; and ensuring appropriate maintenance, repair, replacement and distribution of auxiliary aids.

Safety and Sanitation

• Follows established safety policies and procedures.
• Identifies and corrects safety hazards; reports safety concerns as required.
• Observes safety needs of residents as indicated in care plan.
• Wears and/or uses safety equipment and supplies when indicated and properly trained to use.
• Demonstrates job-specific knowledge of fire and disaster preparedness during drills or actual situations.

Staff Development

• Attends and participates in scheduled in-service training, educational classes and meetings to maintain current certification as applicable and as managed by regulatory agencies and company policies.
• Ensures that small group meetings are held per company policy.
• Communicates new Policy & Procedures and regulations to staff to ensure compliance.

Qualifications

• Graduate of an approved Registered Nurse program and licensed in the state of practice, required.
• One-year experience providing specialized treatments in long term care setting.
• Minimum of 2 years of nursing experience in a Skilled Nursing Facility preferred.
• Current BLS/CPR certification (All SNFs; ALFs as required by state). Travel
• Local travel to attend company trainings and/or workshops.

Principal Contacts
• Works closely with Nursing staff, residents, families, physician and vendors

The Rehabilitation Center of Independence provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.