Director of Nursing Services General Description:
Responsible for the overall management of resident care 24 hours a day, seven days per week. Functions include: performing a variety of duties to provide quality nursing care to residents and to coordinate total nursing care for residents; implementing specific procedures and programs; participating with the Assistant Director of Nursing Services and providing guidance to the Nurse Manager in establishing specific goals; determining work procedures and expediting work flow; complying with operating policies and, procedures, state requirements, Department of Health regulations, and Federal Health Care Administration regulations; communicating with and supervising appropriate personnel; providing daily reports and other periodic reports; performing all the duties of an RN, LPN, and certified nursing assistant when required. In the absence of the Executive Director, assumes responsibility for the Facility. Essential Duties:
1. Perform various duties to provide quality nursing care to residents to maintain or attain the highest practical level of functioning and to coordinate total nursing care for the residents as illustrated by the following:
a. Ensures that a sufficient number of qualified supervisory and supportive nursing personnel are assigned for each unit/shift to meet the resident needs.
b. Assists the ADNS in the planning of staff development programs that will enhance staff knowledge of quality resident care.
c. Makes focused rounds daily with supervisors and charge nurses as appropriate.
d. Participates in coordination of resident services through departmental and appropriate staff committee meetings, according to the Resident Care Policies and Procedures Manual.
e. Conducts periodic review to verify that the nursing requirements of each resident admitted to the Facility are reviewed and that the physician is consulted in planning resident care.
f. Maintains and evaluates statistics for: pressure sores, resident Accident and Incidents, number N/G tubes, number of justified Foley catheters, resident census, and resident and employee infections.
g. Reviews closed charts of expired residents for the presence of appropriate documentation and discharge orders.
h. Conducts periodic reviews of Care Plans to verify they are interdisciplinary and updated by the Charge Nurse as changes occur.
i. Checks periodically for documentation for residents on 24-Hour Report.
j. Checks periodically for skilled documentation for Medicare services.
k. Checks on each unit for completed MARS, TARS, and flow forms periodically.
l. Reviews Accidents and Incidents (A/I) and develops an appropriate plan to prevent future accidents and incidents. Conducts periodic reviews of documentation for inconsistencies on each unit.
m. Reviews medical record documentation on referrals and advises Executive Director on whether nursing requirements can be met.
n. Reviews change of condition/24-Hour Report daily and deletes residents from the report as needed.
2. Establishes and maintains resident care systems per standardized procedure that are consistent throughout the Facility. These include:
a. Unit Management System for group assignments and nursing assistant responsibilities.
b. Restraint Reduction System to verify restraints are at a minimum, and that restraints are released at least every two hours, or per Care Plan. Restraint releases are to occur on the unit at the same time or per Care Plan, and be observed by a licensed staff member.
c. Turning and Positioning System to verify schedules are followed every two hours or per Care Plan.
d. Resident Ambulation System to verify effectiveness and adherence to resident ambulation program.
e. Scheduling System to verify scheduling for nurses and cna's is completed in a fair and consistent manner.
f. Nourishment/Supplements System to verify nourishments/supplements are passed according to developed schedule.
g. Cleanliness System to verify that environment is clean, orderly and organized. Reviews written cleaning schedules.
h. Infection Control System to verify residents are not at risk for infection.
i. Pharmacy System to verify correct meds are received timely, meds are discarded timely and properly and costs are appropriate for resident payer
sources; and med room and med carts are monitored for policy compliance.
j. Lab System to verify labs are drawn timely, and in accordance with doctors orders.
3. Conducts periodic review of appropriate staff to ensure nursing personnel have valid and current licenses.
4. Audits specific resident care issues on a daily basis. Devises a Monthly Planning Calendar as a minimum guideline for reviewing care issues. The calendar will reflect weekend and night shift reviews as well as day shift reviews.
5. Observes Stage III and IV pressure sores and significant skin issues on a weekly basis, evaluating documentation and treatments. QUALIFICATIONS:
Education/Training: Maintains a current, valid license as a registered professional nurse in good standing (RN). Must have current CPR certification. A.D.A ((Americans with Disabilities Act)(as amended)) REQUIREMENTS: Must be able to bend, stoop, push, pull, and walk and stand for most of the working day. Requires manual dexterity sufficient to provide hands-on care to residents as well as to operate standard office machines such as fax, telephone, etc. Requires normal range of hearing and vision. Must be free from communicable diseases that pose a "direct threat" to the health or safety of others and which cannot be eliminated by a reasonable
accommodation. Must be able to lift a minimum of 50 pounds, and transfer and transport residents. Must be able to carry and transport supplies. Must be able to pass a post-offer, pre-employment physical health examination as a condition of employment. Must be capable of performing the essential functions of the job, with or without reasonable accommodation(s). Skill(s): Proficient reading, writing, grammar, and mathematics skills; proficient interpersonal relations and communicative skills; knowledge of drug interactions, side effects, and incompatibilities; decision-making skill; proficient assessment skills; basic computer skills; able to operate various medical and office equipment; auditory and visual skills. Must be able to communicate in English, both verbally and in writing, and possess sufficient communication skills to perform the tasks required.
Experience: A minimum of five year's experience in nursing service administration preferred. Additional education or experience in such areas as rehabilitative or geriatric nursing is preferred.
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