Start Date: 09/18/2022

End Date: 12/17/2022

Status: Open

Total Positions: 3

Skill: RN Medical / Surgical

Duration: 13 - Weeks

Location: NY - St. Peter's Hospital

Shift Start Time: 07:00:00

Shift End Time: 19:00:00

Description:
Type of Patients Served
6 Brady Farrell is a twenty-eight bed Medical/Surgical unit, which provides care to acutely ill patients. It offers care for the sub specialties of Thoracic, Neurosurgical, Vascular and Orthopedic overflow. Telemetry and Oximetry monitoring is available.


Ages of Patients Served
The unit serves adults and geriatric patients.

Current Services for Patients and Patients’ Families:

• Frequent Procedures, Processes, Services
Post-Operative care
Physical Therapy
Occupational Therapy
Respiratory Care
Wound Care
Cardiac Monitoring
Oximetry Monitoring
Spiritual Care
Social Work
Speech Therapy

• Scope and Complexity of Patient’s Care Needs
Patient care is provided along the continuum, beginning with diagnosis, system management therapy, and provision of a safe discharge plan. Particularly complex patients such as Esophagectomy, Thoracotomy, 2 Stage Neurosurgery and post Craniotomy patients are acutely ill and require frequent monitoring of all systems and extensive patient/family education and psychosocial support.

• Criteria for Entry to Services
Patients may be admitted to the unit (inclusive of the step down) via the emergency department, the post anesthesia care unit, inter-unit transfer, and electively.

• Hours of Operation
The unit operates twenty-four hours a day, seven days a week.



Methods Used to Assess Patient/Patient Population Care Needs
Each patient’s care is assessed, planned for, implemented and evaluated by a Registered Professional Nurse. The Team Leader and Clinical Care Coordinator in conjunction with the primary nurse is responsible for collaborating with additional members of the health care team as indicated, such as respiratory therapy, physical therapy, occupational therapy, physician assistants, Nurse Practitioners, nutrition, case management and spiritual care, in order to facilitate the patients’ progression of care.

Methods Used to Determine Extent to Which Patient Needs are Met and Services Adjusted
The Registered Professional Nurse, in collaboration with the patient, family, and other health care team members, establishes and modifies plans of care that are reflective of the knowledge of aggregate populations and comprehensive to the continuum. Each plan is developed to facilitate a safe discharge.

Staffing

Staffing Plan
A staffing plan is developed to include the number and mix of staff to meet anticipated needs.

• Minimum
Optimal staffing is achieved by establishing staffing patterns, which provide a minimum number of hours of care per patient day.

• Qualifications of Staff (Changes in Census, Acuity)
Qualifications required of staff are indicated in respective job descriptions for each employee. Patient Focused Care is the delivery model and includes the following roles:
? Team Leader [RN]
? Professional [RN, PT, PTA. OT, OTA,RT]
? Clinical Care Coordinator C3 RN
? Social Worker
? Speech Therapist
? Patient Care Technician
? Information Associate, Senior Information Associate

Professional staff [RN, PT, OT, PTA, OTA and RT] are required to have a current New Your State license to practice in their profession. All RN/PT/OT/RT staff are required to be CPR certified.

Non- professional staff [PCT’s, IA’s] are required to meet standards in respective OAPI’s. PCT’s are required to be CPR certified.

• Methods Used to Adjust Staffing
When census, case mix or other factors vary from the plan, the staffing level is adjusted through the use of excess hours, overtime, per diem staff, Clinical Resource Team, agency personnel including travelers, and redistribution of staff between units.


Methods for Communication, Collaboration, and Functional Relationship with Other Departments and Services
A. Internal: In order to provide for collaborative, informed, participation of all staff members within 6BF unit staff meetings are held monthly. There are several communication boards located within the unit. Notices for all meetings are posted and/or communicated by e-mail. Additional announcements, updates, and information is also shared via email.

B. External: Communication is accomplished through collaborative programs within the Medical/Surgical Centers. Communication between the Medical-Surgical units occurs at monthly meetings. Communication occurs between the Medical-Surgical units, other units within Patient Care Services, and other hospital departments, including divisional and hospital based committees is also a means of communication.

C. A collaborative relationship exists between the staff of 6BF and various other hospital departments and services including, Pharmacy, Clinical Engineering, Cardiac Services, Nutrition, Social Work and Continuing Care, Rehab Services (PT, OT, Speech, and Auditory), Home Care, Medical Records, and Materials Management. Spiritual Care’s presence addresses the role of spirituality to team members, focusing on providing a holistic approach of care for patient and team. There is a sharing of resources and knowledge between units within Patient Care Services.

Medical Staff Integration/Relationship
Program of care meetings are convened to review outcomes, identify opportunities, action plans and to strategize for future programmatic growth. Active participation by physicians, professional and paraprofessional care givers allows for excellence in programmatic integrity as well as team relationships.

Plan to Improve Quality of Care:

Philosophy
The philosophy of the 6 Brady Farrell quality improvement program is congruous with that of the department and the hospital. We believe that continuous quality improvement is an essential component of nursing care. Evidence Based Quality improvement is a creative, dynamic process by which standards are developed and actions are taken to ensure achievement of them.

Quality Outcomes is the responsibility of all Patient Care Providers. All staff are expected to participate in activities to monitor and improve patient care. Key principles of Quality Improvement include employee education, participation, planning and execution at the staff nurse level. Comprehensive evaluation of all aspects of nursing (structure, process, outcome) is continuous. Quality outcomes are shared with staff through communication systems and quarterly reporting.

Scope of the Quality Improvement Program
The 6 Brady Farrell Quality Improvement program will include:
? Research into Evidenced Based standards of care as they related to the major groups of patient populations.
? Recommendations to the appropriate councils for changes in practice, standards etc.
? Identification of actual/potential problems and creation of PDSA’s to create solutions.
? Monitoring of management indicators; including turnover, patient acuity and unit activity.
? Utilization of monitoring tools/audits on a concurrent and retrospective basis, utilizing sources such as medical record, risk profile, observation, research study, clinical study, patient/satisfaction surveys and clinical case reviews.
? Identification of unit goals with quarterly updates.

Plan to Improve
Foster an environment where the best decisions are made by the right person, in the right time, and for the right reason.


• Patient Safety/Quality
1. Medication Safety
2. Patient Falls with Injury
3. Cauti/Clabsi
4. JCAHO Patient Safety Standards

• Infection Control
1. Standard Precautions
2. Needle sticks
3. Nosocomial/Community Acquired Infections
4. Catheter Associated Infections