Start Date: 08/21/2022

End Date: 11/19/2022

Status: Open

Total Positions: 1

Skill: *Registered Nurse

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
5 Brady Farrell is a twenty-eight bed medical unit, which provides patient and family centered care to patients with the diagnosis of COPD, Pneumonia, Asthma, Ventilator (Chronic patients, tracheostomy patients, renal patients requiring hemodialysis, peritoneal dialysis and the general medical patient requiring telemetry monitoring (cardiac) and continuous oximetry.

Ages of Patients Served
The unit provides services to adult and geriatric patients.

Current Services for Patients and Patients’ Families:

• Frequent Procedures, Processes, Services
? Ventilator procedures
? Tracheostomy
? Respiratory Therapy
? Pulse Oximetry
? Hemodialysis
? Telemetry
? Pharmacy
? Physical Therapy
? Occupational Therapy
? Care Progression
? Peritoneal Dialysis
? Spiritual Care
? Palliative Care
? Speech Therapy

• Scope and Complexity of Patient’s Care Needs
Patient care is provided along the acute care continuum beginning with diagnosis, system management therapy, discharge planning needs and end of life care. Particularly complex patients such as ventilator patients, telemetry patients and continuous pulse oximetry patients who are acutely ill and require frequent monitoring of all systems, patient and family education and psychosocial support.

• Criteria for Entry to Services
The criteria for admission to the Respiratory Unit includes:
? Hemodynamically stable patients
? Stable mechanically ventilated patients
? Renal patients requiring hemodialysis or peritoneal dialysis
? Patients requiring centralized oximetry
? Patients requiring aggressive pulmonary toilet
? Stable medical patients who require telemetry
• Hours of Operation
The 5 Brady Farrell Unit is in operation 24 hours a day, 365 days a year.


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, in collaboration with the patient, family, and other health care team members such as respiratory therapy, physical therapy, occupational therapy, physician assistants, Nurse Practitioners, nutrition, case management and spiritual care, in order to facilitate the patients’ progress.
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 safe discharge.

Staffing

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

• Budgeted
Optimum staffing is achieved by establishing staffing patterns which provide an optimum number of hours of care per patient day.

• Minimum
A staffing plan is developed to include the number and mix of staff to meet anticipated needs of patients.

• Qualifications of Staff (Changes in Census, Acuity)
Qualifications required of staff are indicated in respective job descriptions for each employee.

? Clinical Care Coordinators
? Social Workers
? Professional RN
? Respiratory Therapist
? Patient Care Technicians
? Physical Therapist/Assistant
? Occupational Therapist/Assistant
? Senior Information Associate
? Information Associate
? Speech Therapy

Professional staff are required to have a current New York State license to practice in their profession and have CPR certification. Staff nurses are required to complete Level I Critical Care Program: Cardiac portions, with theoretical and clinical validation of competency, Medical Surgical Core Competency, and Ventilator Class and clinical Competency as covered in Unit Competency Checklist.

Non professional staff [PCT, Senior IA/IA] are required to meet standards in respective Competency Checklist . 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 use of excess hours, overtime, per diem staff, 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 5BF 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 5 BF 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
1. Rounding
2. Medical QI
3. Medical Grand Rounds
4. Development and Revision of Standards of Care

Plan to Improve Quality of Care

Philosophy
The philosophy of 5 Brady Farrell’s quality improvement is congruous with that of the department and the hospital. We believe that continuous quality improvement is an essential component of nursing care. Quality improvement is a creative, dynamic process by which standards are developed and actions are taken to ensure achievement of them.

CQI is the responsibility of all professional nurses and all staff participate in creative activities to monitor and improve patient care. Key principles include:
- Employee participation, planning and execution at the staff nurse level.
- Comprehensive evaluation of all aspects of the practice of nursing (structure, process, outcome).
- Integration with higher level activities through communication systems and quarterly reporting.

Scope of the Quality Improvement Program
The 5 Brady Farrell Quality Improvement Program will include:
o Research into evidence based practice standards of care as they relate to major groups of patient populations.
o Recommendations to the appropriate councils for changes in practice, standards etc.
o Identification of actual/potential problems and documentation of the problem resolution process.
o Monitoring of management indicators; including turnover, patient acuity and unit activity.
o 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.
o Identifica