Mercy RN CVICU Policy

CATHOLIC HEALTH SYSTEM JOB DESCRIPTION AND PERFORMANCE EVALUATION FORM
(FOR NON-EXEMPT AND EXEMPT/NON-MANAGEMENT POSITIONS)
JOB TITLE REGISTERED NURSE (CARDIO THORACIC UNIT B) EMPLOYER MERCY HOSPITAL OF BUFFALO EMPLOYEE NAME
DEPARTMENT NUMBER 6190 FACILITY/HOSPITAL NUMBER 400 MANAGER RESPONSIBLE FOR MAINTENANCE/TITLE:
***For HR Use Only***
DEPARTMENT NAME Cardiothoracic Unit REVISED /ESTABLISHED DATE REVISED 9/25/07 EVALUATION PERIOD FROM: TO: GL # NATURAL CLASS CODE KRONOS
JOB CODE 42560
SALARY GRADE 121
FLSA STATUS
EEOC CODE P
JOB SUMMARY: Coordinates the nurse care for patients by assessing, planning, implementing and evaluating. Participates in patient and family teaching. Provides leadership by working cooperatively with ancillary, nursing and other patient team personnel in maintaining standards for professional nursing practice in the Cardiothoracic Critical Care Unit. REPORTS TO: Nurse Manager SUPERVISORY RESPONSIBILITIES: None AGE GROUPS: CLINICAL POSITIONS ONLY. Neonate 0 28 days Pediatric 29 days - 12 years Adolescent 13 17 years Adult 18 64 years Geriatric 65 years and above
Last saved by Jessie 09/25/2007 1
SKILL AND EDUCATIONAL REQUIREMENTS (MINIMUM): EDUCATION: Graduate from an accredited Registered Professional Nursing Program. Current registration as registered nurse in New York State. Current BLS validation and ACLS validation. EXPERIENCE: Must have one (1) year of recent (within 6 months) critical care experience. Must successfully complete cardiothoracic training program as defined by education competencies. KNOWLEDGE, SKILL AND ABILITY: Participates in educational conferences and upgrades and maintains professional knowledge and skills related to the area of responsibility, maintains confidentiality, understands legal aspects of job function, and adheres to hospital policies and procedures. Role involves a variety of problems to be solved under general guidelines, and calls for a variety of decisions, some of which are complex and must be referred to a resource person. Assists in directing a small group of employees performing similar or related tasks of semi-skilled nature. Instructs employees. Assigns, contributes to evaluating performance, and maintains efficiency of staff assigned to him/her. Has an obligation to conserve supplies, equipment and time in a cost-effective environment.
Last saved by Jessie 09/25/2007
WORKING CONDITIONS: PHYSICAL EFFORT:
Activity & Strength

MEDIUM
Equivalent Strength Level Occasiona Frequent 2.7 to 5.3 Constant l 5.4 to 8
0 to 2.6 hours/day hours/day hours/day
Activity Low Lift (floor to

knuckle)
21-50 lb 21-50 lb 21-50 lb 21-50 lb
11 - 20 lb 11 - 20 lb 11 - 20 lb 11 - 20 lb
1 - 10 lb 1 - 10 lb 1 - 10 lb 1 - 10 lb
Mid Lift (knuckle to

shoulder) above)
High Lift (shoulder and Full Lift (floor to shoulder) Carry Push Pull Overall Strength Category
21-50 lb 11 - 20 lb 1 - 10 lb 21-50 lb 11 - 20 lb 1 - 10 lb 21-50 lb 11 - 20 lb 1 - 10 lb 11 - 20 lb 21-50 lb 1 - 10 lb
Activity Walk Climb Stairs Stoop Kneel Crouch Reach (immediate) Reach (overhead) Handling Fingering Last saved by Jessie 09/25/2007
Job Demand Frequent Occasional Frequent Occasional Occasional Frequent Occasional Frequent Frequent 3
Dictionary Of Occupational Titles
Constant (C) 67-100% Workday

Frequent (F) 34-66% Workday Occasional (O) 0-33% Workday Not Present (N)
Sitting Standing Push Cart Pull Cart
Occasional Constant Frequent Frequent
INTERNAL/EXTERNAL RELATIONSHIPS: INTERNAL: Interacts with all members of the health care team. EXTERNAL: Interacts with outside contracted providers and outside healthcare facilities.
MAJOR TASKS, DUTIES AND RESPONSIBILITIES 1. Utilizes the nursing process to meet patient needs.
CRITERIA/STANDARD (if established) Coordinates the delivery of care by the interdisciplinary team.
Employe e Self Rating
Evaluato r Rating
Validatio n Method (O/D/C)
Comments/Acti Plan for Ratings of 0 or 1
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
O D C O D C O D C O D C O D C O D C
Performs assessment/data collection independently in a systematic manner focusing on physiologic and cognitive status. Establishes a plan of care, with multidisciplinary care team, which is patient focused, prioritized and encompasses the continuum of care. Communicates plan of care and all pertinent clinical data to the appropriate member(s) of the healthcare team in a timely manner. Utilizes computer applications as appropriate.
Formulates patient centered goals/outcomes based on assessment date

6
MAJOR TASKS, DUTIES AND RESPONSIBILITIES
CRITERIA/STANDARD (if established) Provides rationale for patient care which is based on nursing knowledge to achieve desired patient outcomes. Recognizes clinical and diagnostic changes in patient status.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
O D C O D C O D C O D C O D C
Initiates action related to patients change in condition and unexpected response to care. Evaluates patient response to care and revises plan based on ongoing assessment and goal/outcome attainment. Participates in the development and implementation of patient/family teaching.
MAJOR TASKS, DUTIES AND RESPONSIBILITIES 2. Maintains Clinical Practice
CRITERIA/STANDARD (if established) Performs according to established protocols in emergency situations to include informing appropriate person and documenting events.
Evaluato r Rating
1 2 3 4
1 2 3 4
O D C
CRITERIA/STANDARD (if established) Institutes emergency procedures according to ACLS protocols in response to changes in patients condition and/or cardiac/respiratory arrest. Participates in house-wide code team response.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
O D C O D C O D C O D C
Administers medications safely with knowledge of action, side effects and contraindications, including those requiring titration and monitoring. Demonstrates the ability to assess and interact with patients and families from differing religious/social/cultural backgrounds and utilizes appropriate resources for this purpose. Demonstrates appropriate care, prevention and treatment of dermal ulcers and follows established skin care protocols. Incorporates proper principles of body mechanics during
9
O D C O D C
CRITERIA/STANDARD (if established) Maintains a safe environment by keeping call light in reach, room free of clutter, personal items (water, tissues) within reach. Implements alternative strategies to reduce restraint use.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Demonstrates the use of the least restrictive approach to patient restraint in clinically justified situations. Applies restraints according to procedure.
Assesses/observes, intervenes according to hospital policy when caring for a patient in restraints. Completes the nursing record and all other required documentation accurately, legibly and completely.
10
CRITERIA/STANDARD (if established) Demonstrates ability to serve as Charge Nurse:
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Demonstrates appropriate delegation skills.
Assigns patients based on patients needs.
Attempts to resolve immediate staffing problems.
Utilizes the medical chain of command.
Demonstrates ability to Achieve IV access.
11
CRITERIA/STANDARD (if established) Performs Intravenous Site Care (Central Peripheral)
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Performs Venipuncture for Blood Testing.
Performs BGTs (Blood Glucose Testing).
Inserts Nasogastric Tubes
Provides enteral feeding
Inserts foley catheters
12
MAJOR TASKS, DUTIES AND RESPONSIBILITIES 3. Practices according to New York State Nurse Practice Act, regulatory code of New York State Department of Health and JCAHO Standards.
CRITERIA/STANDARD (if established) Advocates Patients Bill of Rights.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Strictly follows hospital and department policies and procedures.
Demonstrates an awareness of professional standards and scope of practice within nurse practice act. Participates in quality improvement activities as appropriate.
13
MAJOR TASKS, DUTIES AND RESPONSIBILITIES 4. Assumes personal responsibility for professional development and continuing education.
CRITERIA/STANDARD (if established) Participates in hospital sponsored inservices and continuing education programs/activities. Seeks educational opportunities relevant to unit specific care. Develops and initiates personal goals yearly.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
O D C O D C
O D C O D C
Participates in unit/nursing/ hospital/medical staff meetings/ committees.
14
MAJOR TASKS, DUTIES AND RESPONSIBILITIES 5. Promotes an environment in which the patient care team works cooperatively towards positive patient outcome.
CRITERIA/STANDARD (if established) Respects and protects the confidentiality of all patient, hospital and peer information. Is able to adapt to changes when required.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Responds to constructive criticism in a positive manner.
Works at establishing a good rapport and cooperative relationship with staff.
15
MAJOR TASKS, DUTIES AND RESPONSIBILITIES 6. Age Specific Competencies
CRITERIA/STANDARD (if established) Geriatric Population: o Orients patient to environment. o Introduces self. o Speaks slowly and distinctly, looks at patient. o Identifies sensory deficits that can affect understanding. o Ensures hearing aid, glasses, dentures are in place. o Assesses fragility of skin and implements measure to maintain skin integrity. o Determines mobility of body parts. o Recognizes and reports signs and symptoms of neglect. o Maintains body temperature. Adult Population (age 18-64): o Assesses changes related to aging. o Assesses whether illness threatens or diminishes home or work capabilities.
Evaluato r Rating
1 2 3 4
1 2 3 4
O D C
1 2 3 4
1 2 3 4
O D C
16
MAJOR TASKS, DUTIES AND RESPONSIBILITIES 7. Demonstrates ability to provide care for the patients requiring mechanical ventilation.
CRITERIA/STANDARD (if established) Identifies normal values and waveforms (PA, CVP, PCWP, RA, arterial pressures, PVR, SVR) Obtains PCWP
Evaluato r Rating
1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4
O D C O D C
17
CRITERIA/STANDARD (if established) Performs cardiac outputs and interprets values and provides interventions based on protocol. Demonstrates ability to properly care for pressure line system.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Demonstrates ability to troubleshoot monitoring problems.
Maintains sterility for dressing changes according to policy.
Performs mixed venous blood sampling from PA catheters according to protocol
18
MAJOR TASKS, DUTIES AND RESPONSIBILITIES 8. Demonstrates ability to provide care for the patients requiring mechanical ventilation.
CRITERIA/STANDARD (if established) Provides airway management for a patient with an ET tube: o Suctioning o Oral care o Taping tube o Cuff technique o documentation Provides airway management for a patient with a trach: o Suctioning o Trach Care o Oral Care o Cuff Technique o Changing trach o Trach holder o Documentation Obtains arterial blood gases.
Evaluato r Rating
1 2 3 4
1 2 3 4
O D C
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Interprets abg values and provides interventions based on protocol.
Recognizes different modes of ventilation used for weaning and provides interventions as appropriate.
19
CRITERIA/STANDARD (if established) Demonstrates/verbalizes extubation technique.
Evaluato r Rating
1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4
O D C O D C
Provides psychosocial support: o States alternative ways to communicate. o States the indications for ventilator sedation o Encourages family involvement. o Coordinate interdisciplinary efforts.
20
MAJOR TASKS, DUTIES AND RESPONSIBILITIES 9. Demonstrates ability to care for immediate postoperative cardio thoracic patient.
CRITERIA/STANDARD (if established) Provides care for patient recovering from anesthesia and/or conscious sedation. Demonstrates airway management techniques
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Performs and documents post-operative assessment.
Performs hemodynamic monitoring and provides interventions per protocol. Monitors fluid and electrolyte status and provides interventions per protocol. Transfuses blood products per protocol.
21
CRITERIA/STANDARD (if established) Assesses physiologic values and performs interventions per protocol.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Maintains potency of chest tubes and monitors drainage.
Uses sterile technique for dressing changes.
Assesses wound(s) for signs of infection and/or healing.
22
CRITERIA/STANDARD (if established) Documents findings.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Assesses pain based on pain scale and provides appropriate interventions.
Assesses and interprets cardiac rhythms and provides appropriate interventions inclusive of transcutaneaus pacing, transvenous pacing and defibrillation per protocol. Performs neurological assessments.
Collaborates with case management to identify and meet discharge needs.
Assesses patient for signs & symptoms of post surgical depression.

23
MAJOR TASKS, DUTIES AND RESPONSIBILITIES 10.Demonstrates ability to provide care for the patient requiring hemodialysis.
CRITERIA/STANDARD (if established) Recognizes changes in fluid status including weight changes, Intake & Output, CVP readings and other associated physiological changes. Monitors laboratory values. Verbalizes components of assessment.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
11.Provides nursing care for the cardiac patient.
Demonstrates appropriate treatment and follow-up.
Follows established pathways/protocols.
12.Implements plan of care to meet nutritional requirements.
Assesses nutritional intake.
24
CRITERIA/STANDARD (if established) Monitors intake and output and weights.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Assesses bladder and bowel function.
Knowledgeable regarding appropriate lab values for patients at nutritional risk. Verbalizes patient assessment prior to, during and following sedation.
13.Provides care to the patient receiving conscious sedation.
Demonstrates proper utilization of scoring sheet for documenting.
Demonstrates knowledge of drugs used for IV conscious sedation.
25
CRITERIA/STANDARD (if established) Identifies procedures/tests indicting use of IV conscious sedation. Assesses ability/desire for learning.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
14.Provides patient/family teaching.
Incorporates adult learning techniques.
Assesses understanding of concepts.
Formulates alternative strategies when applicable.
Documents discussion and patients/familys understanding of material.
26
MAJOR TASKS, DUTIES AND RESPONSIBILITIES 15.Demonstrates ability to provide care for the patient receiving intra-aortic balloon pump, counter pulsation therapy.
CRITERIA/STANDARD (if established) Demonstrates understanding of anatomical and physiological parameters of IABP. Recognizes waveforms for effective inflation and deflation.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
16.Provides care to the patient receiving epidural pain management.
Assists with insertion of IABP Verbalizes patient assessment and patient response to the pain management regime. Demonstrates epidural pump set-up.
Utilizes pain scale.
27
CRITERIA/STANDARD (if established) Teaches patient the pain scale.
Evaluato r Rating
1 2 3 4 1 2 3 4 1 2 3 4
1 2 3 4 1 2 3 4 1 2 3 4
O D C O D C O D C
Notifies MD when pain is not controlled.
Removes epidural catheter.
BEHAVIORAL FACTORS
Last saved by Jessie 09/25/2007 28
The following Behavioral Factors apply to ALL employees.

CRITERIA/STANDARD (if established) Complies with Attendance Policy and reports to work on time Employ ee Self Rating 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Evaluat or Rating 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Validatio n Method (O/D/C) O D C O D C O D C O D C O D C O D C
BEHAVIORIAL FACTOR
Comments/Act n Plan for Ratings of 0 or 1
1. Attendance/Reliability
Meets requirements for attendance at department meetings Communicates appropriately with patients, visitors and coworkers
2. Customer Service
Demonstrates sensitivity to cultural diversity
Exhibits excellent Customer Relations skills Demonstrates commitment to Mission and Core Values of CHS of compassion to our patients and commitment to excellence by improving staff performance.
29
3. Mission and Core Values of Catholic Health System
BEHAVIORIAL FACTOR
CRITERIA/STANDARD (if established) Annual Health Assessment completed on:
Employ ee Self Rating 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Evaluat or Rating 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Validatio n Method (O/D/C) O D C O D C O D C O D C O D C O D C
4. Employee Health Requirements
5. Patient Rights
Demonstrates knowledge of and adheres to Patient Bill of Rights
Maintains patient confidentiality Adheres to principles of Infection Control
6. Infection Control
7. Safety
Attend annual Safety InService Date attended:
Identifies safety hazards and provides a safe environment for patients, visitors and associates
30
BEHAVIORIAL FACTOR
CRITERIA/STANDARD (if established) Date attended:
Employ ee Self Rating 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Evaluat or Rating 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Validatio n Method (O/D/C) O D C O D C O D C O D C
8. Mandatory Educational Programs
9. Corporate Compliance
Demonstrates knowledge of and adheres to CHS Corporate Compliance Plan and Standards of Conduct. Identifies area of compliance risk with job duties and departmental activities. Compliance training, date completed.
PART II: DEMONSTRATION OF CORE VALUES

INSTRUCTIONS: Assess the employees demonstration of each core value and place a check in the box next to the phrase that best describes the degree to which the employee demonstrates that core value. Use the comment section to clarify your rating. 1. Reverence for the dignity of each person We believe that each person is a manifestation of the sacredness of human life. This core value affirms that each person has special value, a unique set of gifts and talents that help further the ministry of the Catholic Health System. Indicators that exemplify this value include: Shows sincere interest in each person; expresses appreciation; apologizes for misunderstandings, inconveniences or mistakes; is widely trusted, adheres to provisions of Patient Bill of Rights. Needs Improvement (1) Last saved by Jessie 09/25/2007 Acceptable/Solid Performance (2) 31 Commendable (3) Outstanding (4)

Comments:
2. Compassion- We demonstrate our connectedness to each other through inclusive and compassionate relationships. This core value affirms that the workplace is a community of persons, committed to a common mission, who depend upon and support each other. Indicators that exemplify this value include: Spends the extra effort to put people at ease; extends hospitality graciously; builds rapport well; brings out the best in people; listens with empathy to understand others thoughts, feelings, and concerns; treats all persons whom we serve and with whom we work with respect and compassion; shares wins and successes; shares credit for accomplishments with others. Needs Improvement (1) Comments: Acceptable/Solid Performance (2) Commendable (3) Outstanding (4)
3.
Justice for All, Especially Those Who are Poor and Disadvantaged We advocate for a society in which all can realize their full potential and achieve the common good. This core value affirms that the organization demonstrates a special commitment to serving those who are economically and spiritually poor through the manner in which we provide programs and services in a way that is truly responsive to their needs. In addition, policies and practices of the organization, internal and external, conform to the principles of social justice. Indicators that exemplify this values include: Treats others justly and respectfully; respects diversity; recognizes and appreciates the need and circumstances of persons who are poor; responds with empathy to those who are less fortunate; is seen as one who cares about and actively takes initiatives to conserve the resources of the earth; stands up for what is believed to be right, even in the face of adversity; adheres to provisions of Patient Bill of Rights. Needs Improvement (1) Acceptable/Solid Performance (2) Commendable (3) Outstanding (4)
Comments:
32

4. Excellence We care for and strengthen the ministry and all resources entrusted to us by continually striving for service excellence . This core value affirms that everyone in the organization is committed to the principles of performance improvement in fostering our service culture. Indicators of this value include: Is grounded in the spiritual roots of our healthcare ministry; supports work/life balance for self and others; seeks opportunities to acquire new skills; is open and direct in providing feedback and suggestions to others; maintains a sense of humor; brings out the best in others; realizes the importance of their work in contributing to the mission. Needs Improvement (1) Comments: Acceptable/Solid Performance (2) Commendable (3) Outstanding (4)
33
PART III: COMPLIANCE WITH CHS STANDARDS & PROGRAMS

STANDARDS/PROGRAMS DATE COMPLETED YES NO
Employee Health Assessment Current Infection Control Practices Observed Corporate Compliance Training Current Mandatory Education Current Adheres to Safety Standards
If NO is checked for any of the above, contact your HR Representative immediately.
34
PART IV: GOALS

STRENGTHS AND ACCOMPLISHMENTS Identify the three most significant strengths or job accomplishments. 1. 2. 3.
FUTURE GOALS Identify three developmental goals and/or training needs. 1. 2. 3.
The following three (3) factors typically carry equal weight in the assessing an associates performance. 35
A minimum score of 2 is required in all three (3) sections to deem that an associate has met the minimum performance level equating to satisfactory job performance for this evaluation period. An overall rating of 1 4 is determined by averaging the scores of all three (3) factors. A score for ANY of the three (3) factors that is not indicated as greater than 2 will require a formal action plan to be compiled by the manager in conjunction with an HR Representative. The plan must be specific to the responsibilities, competencies and/or behaviors identified for improvement or further development. The Action plan document must be compiled within thirty (30) days of the associates performance evaluation meeting.
OVERALL RATING
FACTORS OVERALL MAJOR DUTIES, TASKS AND RESPONSIBILITIES RATING OVERALL DEMONSTRATION OF VALUES RATING OVERALL PURSUING EXCELLENCE EIGHT (8) EXPECTATIONS RATING OVERALL PERFORMANCE RATING [Average of above three (3) Factors]
___________________________________ Managers Signature & Job Title Date
_________________
Date
_________________________________ _____________ Associates Signature
Is a formal action plan required for this associate? SUMMARY OF MANAGERS COMMENTS: COMMENTS:
Yes
No SUMMARY OF ASSOCIATES
Date Received: HR use only
Date Entered:
Entered By:
Rater Signature & Job Title

SUMMARY OF EMPLOYEE COMMENTS: Last saved by Jessie 09/25/2007 36
Date
37

Mercy RN CVICU Policy

Diunggah oleh

Informasi Dokumen

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

Mercy RN CVICU Policy

Diunggah oleh

Hak Cipta:

Format Tersedia

CATHOLIC HEALTH SYSTEM JOB DESCRIPTION AND PERFORMANCE EVALUATION FORM

(FOR NON-EXEMPT AND EXEMPT/NON-MANAGEMENT POSITIONS)

JOB CODE 42560

SALARY GRADE 121

Last saved by Jessie 09/25/2007

WORKING CONDITIONS: PHYSICAL EFFORT:

Activity & Strength

Activity Low Lift (floor to

21-50 lb 21-50 lb 21-50 lb 21-50 lb

Mid Lift (knuckle to

21-50 lb 11 - 20 lb 1 - 10 lb 21-50 lb 11 - 20 lb 1 - 10 lb 21-50 lb 11 - 20 lb 1 - 10 lb 11 - 20 lb 21-50 lb 1 - 10 lb

Dictionary Of Occupational Titles

Constant (C) 67-100% Workday

Sitting Standing Push Cart Pull Cart

Occasional Constant Frequent Frequent

Last saved by Jessie 09/25/2007

Last saved by Jessie 09/25/2007

Employe e Self Rating

Validatio n Method (O/D/C)

Comments/Acti Plan for Ratings of 0 or 1

Formulates patient centered goals/outcomes based on assessment date

Last saved by Jessie 09/25/2007

MAJOR TASKS, DUTIES AND RESPONSIBILITIES

Employe e Self Rating

Validatio n Method (O/D/C)

Comments/Acti Plan for Ratings of 0 or 1

Last saved by Jessie 09/25/2007

MAJOR TASKS, DUTIES AND RESPONSIBILITIES 2. Maintains Clinical Practice

Employe e Self Rating

Validatio n Method (O/D/C)

Comments/Acti Plan for Ratings of 0 or 1

Last saved by Jessie 09/25/2007

MAJOR TASKS, DUTIES AND RESPONSIBILITIES

Employe e Self Rating

Validatio n Method (O/D/C)

Comments/Acti Plan for Ratings of 0 or 1

Last saved by Jessie 09/25/2007

MAJOR TASKS, DUTIES AND RESPONSIBILITIES

Employe e Self Rating

Validatio n Method (O/D/C)

Comments/Acti Plan for Ratings of 0 or 1

Last saved by Jessie 09/25/2007

MAJOR TASKS, DUTIES AND RESPONSIBILITIES

CRITERIA/STANDARD (if established) Demonstrates ability to serve as Charge Nurse:

Employe e Self Rating

Validatio n Method (O/D/C)

Comments/Acti Plan for Ratings of 0 or 1

Demonstrates appropriate delegation skills.

Assigns patients based on patients needs.

Attempts to resolve immediate staffing problems.

Utilizes the medical chain of command.

Demonstrates ability to Achieve IV access.

Last saved by Jessie 09/25/2007

MAJOR TASKS, DUTIES AND RESPONSIBILITIES

CRITERIA/STANDARD (if established) Performs Intravenous Site Care (Central Peripheral)

Employe e Self Rating

Validatio n Method (O/D/C)

Comments/Acti Plan for Ratings of 0 or 1

Performs Venipuncture for Blood Testing.

Performs BGTs (Blood Glucose Testing).

Inserts Nasogastric Tubes

Provides enteral feeding

Inserts foley catheters

Last saved by Jessie 09/25/2007