Purpose of Your Job Position

The Assistant Director of Nursing is responsible for the implementation, monitoring, and supervision of all clinical programs in order to deliver continuity and quality of care. This position is responsible for education, orientation, oversight, direction, supervision and evaluation of all professional and certified nursing staff. The ADON is responsible for the implementation and oversight of the facility’s risk management, Quality Assurance and Quality Assurance Performance Improvement programs.

Delegation of Authority

As the Assistant Director of Nursing, you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties.

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, or is an essential function of the position.

Duties and Responsibilities

Administrative Functions

Assist the Director of Nursing in directing the day-to-day functions of the nursing service department, in accordance with current rules, regulation, and guidelines that govern the long-term care facility.

Responsible for the implementation and oversight of the facility’s risk management and quality assurance program.
Responsible for Risk Management issues relating to patient care and clinical risks, medical staff related risks, physical plant and safety risks, employee related risks, and property related risks.
Responsible for Quality Assurance/Improvement issues related to patient care practices, facility quality indicators, incident reports, deficiencies cited by government agencies, resident grievances, and plans of action to correct and respond quickly to identified quality deficiencies.

Responsible for identification and reporting of Adverse incidents.

Responsible to complete special audits of charts for identification of possible risks and areas of improvement at the request of Administration.

Responsible for developing, in conjunction with administration, maintaining and updating our written policies and procedures that govern the day-to-day functions of the nursing department and facility.

Responsible for oversight of the Infection Preventionist.

Responsible for oversight of the Infection Control and Prevention Program.

Conduct and maintain documentation of new and annual employee PPD testing and any health data on employees.

Conduct and maintain documentation of new employee, random and directed Drug Testing program.

Responsible for oversight of the Antibiotic Stewardship Program.

Responsible for the implementation and maintenance of the Flu and Pneumococcal Vaccine program for residents and employees.

Ensure the provision of care and services in accordance with facility policy and procedures and state and federal laws/regulations.

Responsible for the orientation of newly hired employees.

Responsible for provision of annual and ongoing training of all employees as required by state and federal regulations and, as identified to correct and educate employees on all topics related to long term care.

Responsible for maintenance of the Health Care Academy (HCA) system and assignment of HCA online courses and other educational/learning programs from various online sources.

Responsible for provision of and education on the Corporate Compliance- Code of Conduct to all employees, contractors, vendors, and all other service providers and ensuring certifications are completed quarterly in coordination with the Compliance Officer. 

Responsible for maintenance of the Matrix system (ePHI)

Responsible for assisting the Consultant Pharmacist

Responsible for inventory checks on Emergency Drug Kits.

Responsible to maintain current and up-to-date knowledge of all state, federal, local long term care laws/regulations.

Responsible to maintain current and up-to-date knowledge of nursing standards of practice. 

Responsible to update and maintain the QIS Staff Interview Log.

Committee Functions

Responsible for the implementation and oversight of the facility’s risk management and quality assurance(QA) program.

Responsible for implementation and oversight of the facility’s Quality Assurance and Performance Improvement (QAPI) Committee.

Serve on the Compliance and Ethics Committee

Responsible for oversight of the Infection Prevention and Control Committee.

Responsible for oversight of the Antibiotic Stewardship Program and corresponding committee.

Responsible for submitting written and/or oral reports for all committees.

Responsible for participation in reviewing, updating and developing facility policy and procedures necessary to ensure delivery of quality care to our residents and to comply with state and federal regulations.

Personnel Functions

Maintain and update Nurse Manager On-Call schedule

Ensure that a sufficient number of licensed practical and/or registered nurses are available for each shift to ensure that quality care is maintained.

Ensure that a sufficient number of certified nursing assistants are available for each tour shift to ensure that routine nursing care is provided to meet the daily nursing care needs of each resident.

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

Ensure that established policies and procedures, including dress codes, are followed by all departmental personnel.

Review complaints and grievances made or filed by department personnel.

Make appropriate reports to the Director as required or as may be necessary.

Develop and maintain a good working rapport with inter-department personnel, as well as other departments within the facility to ensure that nursing services and activities can be adequately maintained to meet the needs of the residents.

Create and maintain an atmosphere of warmth, personal interest and positive emphasis, as well as, a calm environment throughout the facility.

Meet with all shifts on a regularly scheduled basis to assist in identifying and correcting problem areas and/or to assist in the improvement of services.

Review and evaluate department's work force and make recommendations to the Director.

Conduct employee performance evaluations and competencies, and making recommendations to the Director concerning employee dismissals, transfers, etc.

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

Report occupational exposures to blood, body fluid, infectious materials, and hazardous chemicals in accordance with the facility's policies and procedures governing accident and injuries.

Nursing Care Functions

Greet newly admitted residents upon admission as necessary.

Participate in Baseline/48 hour Care Plan as required.

Make rounds with physicians as necessary.

Make rounds with the Consultant pharmacist as necessary.

Reviews charts, labs, nurses' notes etc. to ensure that they are informative, accurate and descriptive of nursing care being provided, that they reflect the resident's response to the care, that concerns are reported to the physician/administration as appropriate, and that such care is provided in accordance with the resident's wishes.

Provide direct nursing care to include, but not limited to taking TPRs, Blood pressures, starting IVs, obtaining sputum, urine and other specimens for lab tests as order by the physician/ PA/ARNP, as necessary.

Conducts oversight of provision of all clinical care, staffing and addresses any resident/family concerns that may arise and actively seeks out Administrative support to resolve issues.

Reviews the use of all restraints for compliance with our established policies and procedures and state and federal law/regulation.

Monitor for compliance with written procedures for the administration, storage, and control of medications and supplies.

Monitor medication passes and treatments to ensure that they are being administered as ordered and that treatments are provided as scheduled, as well as to identify problems, concerns or ideas for improvement and make recommendations to the Director .

Meet with residents, and/or family members, as necessary. Report problems to the Director.

Staff Development

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

Develop, implement, and maintain an effective program for annual and ongoing training of all employees which meets the requirements of state and federal regulations and facility policy and procedures

Develops and implements in-service education for employees related to internally identified concerns, new/current regulations, plans of correction and/or other needs.

Responsible for maintenance of the Health Care Academy system and assignment of HCA online courses and other educational/learning programs from various online sources.

Responsible for provision of and education on the Corporate Compliance- Code of Conduct to all employees, contractors, vendors, and all other service providers and ensuring certifications are completed quarterly in coordination with the Compliance Officer. 

Provide leadership training that includes the administrative and supervisory principles essential for administrative and supervisory staff.

Encourage employees to attend and participate in outside training programs.

Assist the Director in developing and revising the nursing training curriculum used by the facility.

Develop, implement and maintain an effective program for annual OSHA and CDC required in-services training programs; hazard communication, TB management, and blood borne pathogens standards.

Develop, implement, and maintain an effective program for advance directive in-service training for the staff, residents/resident representatives and family members.

Develop, implement, and maintain an effective program for in-service training programs for the nursing staff and ensure that these programs meet the continuing education requirements which allow licensed personnel (e.g., RNs, LPNs, CNAs, etc.) to keep their license on an active status.

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

Safety and Sanitation

Responsible for oversight of the Infection Prevention and Control program for monitoring communicable and/or infectious diseases among the residents and personnel.

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

Identify, evaluate, and classify routine and job related functions to ensure that tasks in which there are potential exposure to blood/body fluids are properly identified and recorded.

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

Monitor shift's personnel to ensure that they are following established safety regulations in the use of equipment and supplies.

Ensure that all nursing service personnel comply with established departmental policies and procedures.

Ensure that nursing service work areas (i.e., nurses' stations, medicine preparations 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 nursing service personnel follow established handwashing procedures.

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

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

Participate in the development, implementation and maintenance of the procedures for reporting hazardous conditions or equipment.

Ensure that all personnel wear and/or use safety equipment and supplies (e.g., gait belts, mechanical lifts, etc.) when moving or lifting a resident.

Equipment and Supply Functions

Recommend to the Director the equipment and supply needs of the department.

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

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

Participate in the development and implementation of the 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.

Monitor nursing procedures to ensure that nursing service supplies are used in an efficient manner to avoid waste.

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

Care Plan and Assessment Functions

Review written preliminary and comprehensive assessments of the nursing needs of each resident as necessary.

Review the development of 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 as necessary.

Review resident care plans for appropriate resident goals, problems, approaches, and revisions based on nursing needs as necessary.

Assist nursing supervisory staff (MDS, Unit Managers, Charge Nurses) to ensure that all personnel involved in providing care to the resident are aware of the resident's care plan.

Budget and Planning Functions

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

Recommend to the Director the equipment needs of the nursing 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 resident rights and responsibilities, including the right to refuse treatment.

Review complaints or grievances made by the resident and make a written/oral report to the Director 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 to resolve the complaint and the current status of the complaint as necessary.

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.

Working Conditions

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

Moves intermittently during work hours.

Is subject to frequent interruptions.

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

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

Communicates with the medical staff, nursing personnel, all other departments, contracted service providers and external entities.

Works beyond normal working hours, weekends and holidays when necessary.

Based on facility needs, this position is subject to covering nursing shifts.

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

Involved in community, civic health matters, and projects as appropriate.

Attends and participates in continuing educational programs.

Subject to injury from falls, burns from equipment, odors, assaults from hostile residents, etc. throughout the work day, as well as reactions from dust, disinfectants, tobacco smoke, and other air contaminants.

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, and acts as a liaison with the residents, their families, support departments, etc., to adequately plan for the residents' needs.

Education Requirements

Must possess, as a minimum, a Nursing Degree from an accredited college or university, or be a graduate of an approved LPN program.

Registered Nurse (RN) is preferred for buildings with 120 beds or less.

Registered Nurse (RN) is required for buildings with greater than 120 beds

Experience

Must have, as a minimum, one (1) year of experience as a supervisor in a hospital, long-term care facility, or other related health care facility.

Must have training in rehabilitative, restorative nursing practices and infection control.

Prefer experience, of at least one (1) year, in implementation of infection control programs and/or risk management.

Specific Requirements

Must posses and maintain a current, unencumbered, active license to practice as an RN or LPN in this state.

Must possess and maintain a current “Eligible’ AHCA Background Screening Status

Must be able to read, write, speak, and understand the English language.

Must possess the ability to make independent decisions when circumstances warrant such action.

Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel, and the general public.

Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care.

Must possess leadership and supervisory ability and the willingness to work harmoniously with and supervise other personnel.

Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies and procedures, etc. that are necessary for providing quality care.

Must have patience, tact, a cheerful disposition and enthusiasm, as well as the willingness to handle difficult residents.

Must be willing to seek out new methods and principles and be willing to incorporate them into existing nursing practices.

Must be able to relate information concerning a resident's condition.

Must not pose a direct threat to the health or safety of other individuals in the workplace.

Physical and Sensory Requirements

(With or Without the Aid of Mechanical Devices)

Must be able to move intermittently throughout the work day.

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 possess sight/hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of the position can be fully met.

Must function independently, 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 ill, disabled, elderly, emotionally upset, and at times hostile people within the facility.

Must be able to push, pull, move, and/or lift a minimum of 35 lbs. to a minimum height of 5 feet and be able to push, pull, move, and/or carry such weight a minimum distance of 450 feet.

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