Assistant Director Of Nursing Services

Purpose of Your Job Position

The primary purpose of your job position is to assist the Director of Nursing Services in planning organizing, developing, and directing the day-to-day functions of the Nursing Service Department in accordance with current federal, state, and local standards, guidelines, and regulations that govern our facility, and as may be directed by the Administrator, the Medical Director, and/or the Director of Nursing Services, to ensure that the highest degree of quality care is maintained at all times.

Delegation of Authority

As the Assistant Director of Nursing Services, you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties. In the absence of the Director of Nursing Services, you are charged with carrying out the resident care policies established by this facility.

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 Services in planning, developing, organizing, implementing, evaluating, and directing the day-to-day functions of the nursing service department, in accordance with current rules, regulations, and guidelines that govern the long-term care facility.
• Participate in developing, maintaining, and updating our written policies and procedures that govern the day-to-day functions of the nursing service department.
• Ensure that reference material (i.e., PDR'S, Federal and State Regulations, etc.) maintained at the nurses' stations is current. Recommend to the Director written material that will assist the nursing service department in meeting the day-to-day needs of residents.
• Ensure that the Nursing Service Procedures Manual is current at all times and reflects the day-to-day nursing care procedures used by this facility.
• Develop and periodically update nursing service objectives and statements of philosophy.
• Assist in developing and implementing a nursing service organization structure.
• Make written and oral reports/recommendations to the Director as necessary/ required, concerning the operation of the nursing service department.
• Periodically review the department's policies, procedure manuals, job descriptions, etc. Make recommendations for revisions of policies, procedures, etc., to the Director of Nursing Services.
• Assist in developing methods for coordinating nursing services with other resident services to ensure the continuity of the residents' total regimen of care.
• Ensure that all nursing service personnel are following their respective job descriptions. Participate in developing, maintaining, and periodically updating the written job descriptions for each level of nursing personnel in accordance with the Americans with Disabilities Act, OSHA, and other pertinent laws and regulations.
• Participate in the development, maintenance, and implementation of the facility's quality assurance program for the nursing service department.
• Participate in facility surveys (inspections) made by authorized government agencies as requested by the administrator or director of nursing services.
• Participate in developing, implementing, and periodically updating the resident's written discharge plan.
• Assist the resident and Discharge Planning Coordinator in planning the nursing services portion of the resident's discharge plan.
• Perform administrative duties such as completing medical forms, reports, evaluations, studies, charting, etc., as necessary.

Committee Functions

• In the absence of the Director, serve on, participate in, and attend various committees of the facility (i.e., Infection Control, Policy Advisory, Pharmaceutical, Budget, Quality Assurance & Assessment, etc.).
• Serve on the Quality Assurance and Performance Improvement Committee as directed.
• Assist the Director in preparing written and/or oral reports of the nursing service programs and activities to submit to such committee(s).
• Participate in the development, maintenance, implementation, and updating of the written policies and procedures for the administration, storage, and control of medications and supplies.
• Schedule, attend, and participate in developing the agenda for the Care Plan Committee meetings as necessary.
• Participate in regularly scheduled reviews of the discharge plans and make such plans available to the Care Plan Committee as required or as may be necessary.
• Evaluate and implement recommendations from established committees as they may pertain to nursing services.

QAPI

• Knowledgeable in data collection, data analysis methodology, and performance improvement methods needed to support and lead performance improvement projects
• Collaborate with the quality committee and senior leaders to prioritize and develop QAPI efforts
• Lead performance improvement projects and provide education and coaching in order to build needed skills in others to lead PIPs
• Participate in multidisciplinary QAPI activities
• Knowledge of current Performance Improvement Initiatives

Personnel Functions

• Assist the Director in determining the staffing needs of the nursing service department.
• Recommend to the Director the number and level of nursing personnel to be employed.
• Assist the Director in the recruitment and selection of nursing service personnel.
• Ensure that a sufficient number of licensed practical and/or registered nurses are available for each tour of duty to ensure that quality care is maintained.
• Ensure that a sufficient number of certified nursing assistants are available for each tour of duty to ensure that routine nursing care is provided to meet the daily nursing care needs of each resident.
• Ensure that all nursing assistants are enrolled in or have graduated from an approved nursing assistant training program.
• Develop work assignments and schedule duty hours, and/or assist nursing supervisory staff in completing and performing such tasks.
• Ensure that all nurse aide trainees are under the direct supervision of a licensed nurse.
• Schedule work assignments and duty hours.
• Delegate to the Charge Nurses and Nurse Supervisors the administrative authority, responsibility, and accountability necessary to perform their assigned duties.
• Assist the Director in preparing performance evaluations as directed.
• Participate in the development and implementation of performance evaluations for the nursing service department.
• Make daily rounds of the nursing service department to ensure that all nursing service personnel are performing their work assignments in accordance with acceptable nursing standards. Report findings to the Director.
• Monitor absenteeism to ensure that an adequate number of nursing care personnel are on duty at all times. Report problem areas to the Director.
• Monitor the professional nurses' licensing status to ensure that they remain current. Inform nurses at least 30 days in advance of their license expiration date.
• Review complaints and grievances made or filed by department personnel. Make appropriate reports to the Director as required or as may be necessary.
• Ensure that departmental disciplinary action is administered fairly and without regard to race, color, creed, national origin, age, sex, religion, handicap, or marital status.
• Interpret the department's policies and procedures to personnel, residents, visitors, and government agencies as necessary.
• Ensure that all nursing personnel participate in the facility's TB testing program.
• Report occupational exposures to blood, body fluids, infectious materials, and hazardous chemicals in accordance with the facility's policies and procedures governing accident and incidents.

Nursing Care Functions

• Participate in the interviewing and selection of residents for admission to the facility, including the PASARR screenings.
• Provide the Director with information relative to the nursing needs of the resident and to the nursing service department's ability to meet those needs.
• Inform nursing service personnel of new admissions, their expected time of arrival, room assignment, etc.
• Ensure that rooms are ready for new admissions.
• Greet newly admitted residents upon admission. Escort them to their rooms as necessary.
• Make rounds with physicians as necessary.
• Inform the Director when physician visits are not made in a timely manner.
• Encourage attending physicians to record and sign progress notes, physicians' orders, etc., on a timely basis and in accordance with current regulations.
• Ensure that direct nursing care be provided by a licensed nurse, a certified nursing assistant, and/or a nurse aide trainee qualified to perform the procedure.
• Review nurses' notes to ensure that they are informative and descriptive of the nursing care being provided, that they reflect the resident's response to the care, and that such care is provided in accordance with the resident's wishes.
• Schedule daily rounds to observe residents and to determine if nursing needs are being met.
• Monitor medication passes and treatment schedules to ensure that medications are being administered as ordered and that treatments are provided as scheduled.
• Report medication errors to the Director.
• Provide direct nursing care as necessary.
• Report problem areas to the Director. Assist in developing and implementing corrective action.
• Authorize the use of restraints when necessary and in accordance with our established policies and procedures.
• Ensure that residents who are unable to call for help are checked frequently.

Staff Development

• Participate in developing, planning, conducting, and scheduling in-service training classes that provide instructions on "how to do the job," and ensure a well-educated nursing service department.
• Develop, implement, and maintain an effective orientation program that orients the new employee to the facility, its policies and procedures, and to his/her job position and duties.
• Provide leadership training that includes the administrative and supervisory principles essential for Nurse Supervisors/Charge Nurses.
• Encourage Nurse Supervisors/Charge Nurses to attend and participate in outside training programs. Schedule times as appropriate.
• Assist the Director in developing and revising the nursing assistant training curriculum used by the facility.
• Assist the Director in planning and conducting universal precautions in-service training.
• Assist the Clinical Educator in developing annual OSHA and CDC in-service training programs for hazard communication, TB management, and bloodborne pathogens standard.
• Assist the Clinical Educator in developing advance directive in-service training programs for the staff and community.
• Assist support services in developing, implementing, and conducting in-service training programs that relate to the nursing service department.
• Assist the Clinical Educator in the development of in-service training programs for the nursing staff. 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

• Assist the Safety Officer in developing safety standards for the nursing service department.
• Assist the Director and/or Infection Preventionist in identifying, evaluating, and classifying routine and job-related functions to ensure that tasks in which there is potential exposure to blood/body fluids are properly identified and recorded.
• Ensure that 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 nursing service personnel to ensure that they are following established safety regulations in the use of equipment and supplies.
• Ensure that nursing service work areas (i.e., nurses' stations, medicine preparation 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 all nursing service personnel follow established departmental policies and procedures, including appropriate dress codes.
• Ensure that nursing service personnel participate in and conduct all fire safety and disaster preparedness drills in a safe and professional manner.
• Assist the Infection Control Committee in the development, implementation, and revising of written aseptic and isolation techniques.
• Participate in the development, implementation, and maintenance of the infection control program for monitoring communicable and/or infectious diseases among the residents and personnel.
• 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., back brace, mechanical lifts, etc.) when moving or lifting a resident.
• Report missing/illegible labels and MSDSs to the safety officer or other designated person.

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 needs 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 service department.

Care Plan and Assessment Functions

• Participate in the development of written preliminary and comprehensive assessments of the nursing needs of each resident.
• Assist the Resident Assessment/Care Plan Coordinator in planning, scheduling, and revising the MDS, including the implementation of RAPs and Triggers.
• Participate in the development of a written care plan (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.
• Encourage the resident and his/her family to participate in the development and review of the resident's plan of care.
• Assist in the scheduling of care plans and assessments to be presented and discussed at each committee meeting.
• Ensure that all personnel involved in providing care to the resident are aware of the resident's care plan. Ensure that nursing personnel refer to the resident's care plan prior to administering daily care to the resident.
• Review nurses' notes to determine if the care plan is being followed.
• Review and revise care plans and assessments as necessary, but at least quarterly.
• Develop and maintain a good rapport with all services involved with the care plan to ensure that a team effort is achieved in developing the resident's comprehensive care plan.
• Be sure that staff members are providing care that reflects the wishes of the resident.

Budget and Planning Functions

• Participate in the preparation of and planning of the nursing service department's budget and submit to the Director for his/her review, recommendations, and/or approval.
• Keep abreast of economic conditions/situations, 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 service 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 the residents' responsibilities and rights including the right to refuse treatment.
• Review complaints and 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 taken to resolve the complaint and the current status of the complaint.
• Ensure that appropriate notices are received by the resident before his/her room or roommate is changed.
• 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.
• Review the facility's advance directive policies and procedures with resident and/or family members as necessary.

Working Conditions

• Works in office area(s) as well as throughout the nursing service area (i.e., drug rooms, nurses' stations, resident rooms, etc.).
• Moves intermittently during working hours.
• Is subject to frequent interruptions.
• Is involved with residents, personnel, visitors, government agencies/personnel, etc., under all conditions and circumstances.
• Is subject to hostile and emotionally upset residents, family members, personnel, and visitors.
• Communicates with the medical staff, nursing personnel, and other department supervisors.
• Works beyond normal working hours and on weekends and holidays when necessary.
• Is subject to call-back during emergency conditions (e.g., severe weather, evacuation, post-disaster, etc.).
• Is involved in community/civic health matters/projects as appropriate.
• Attends and participates in continuing educational programs.
• Is subject to injury from falls, burns from equipment, odors, etc., throughout the work day, as well as to reactions from dust, disinfectants, tobacco smoke, and other air contaminants.
• Is 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 a liaison with the residents, their families, support departments, etc., to adequately plan for the residents' needs.

Education

Must possess, as a minimum, a Nursing Degree from an accredited college or university.

Experience

• Must have, as a minimum, one year(s) of experience as a supervisor in a hospital, long-term care facility, or other related health care facility.
• Must have experience in rehabilitative and restorative nursing practices.

Specific Requirements

• Must possess a current, unencumbered, active license to practice as a Registered Nurse in this state.
• 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 workday.
• 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 be able to see and hear or use prosthetics that will enable these senses to function adequately to ensure that the requirements of this position can be fully met.
• Must function independently, and 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 the ill, disabled, elderly, emotionally upset, and, at times, hostile people within the facility.
• Must be able to push, pull, move, lift and carry.
• May me necessary to assist in the evacuation of residents during emergency situations.

Regulatory Compliance - QAPI

• Receive direction from the Nursing Home Administrator on overall QAPI objectives for the organization.
• Be knowledgeable in data collection, data analysis methodology, and performance improvement methods needed to support and lead performance improvement projects.
• Identify opportunities for improvement through analysis of data, observation of operations, and consultation with leadership and staff.
• Collaborate with the quality committee and senior leaders to prioritize and develop QAPI efforts.
• Lead performance improvement projects and provide education and coaching in order to build needed skills in others to lead PIPs.
• Participate in multidisciplinary QAPI activities.

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