• | The ED CTL collaborates with the patient, significant others, and health care providers in addressing patient arrival, placement, and throughput in the ED. The CTL establishes patient care assignments based on abilities of nursing personnel and patient acuity. The CTL provides supervision and consultation to team members as needed and ensures delegation and supervision of care in accordance with nurse practice acts and professional nursing role. |
• | Initiates multidisciplinary collaboration to positively impact the outcomes of care provided. Effectively communicates with the medical staff, Case Manager, and Nurse Manager to solve complex multidisciplinary problems. |
• | Communicates with referring facilities and emergency medical services regarding patients expected in the ED. |
• | Coordinates the flow of patient admissions, transfers, and discharges with other CTLs as needed. Ensures distribution of workload among team members and determines assignments based on skills and abilities of the team through effective delegation and supervision. |
• | Coordinates the reception and delivery of the team’s shift report. |
• | Initiates steps to support and enhance the patient’s responsibility and self-determination in decision making concerning health, treatment, and wellbeing. Involves the individual patient/family in identification of requirements/perceptions of learning needs and preparation to assume self-care upon discharge. |
• | Acts as a leader through participation in unit/clinic and/or departmental shared governance structure to improve care. |
• | Evaluates effectiveness of teaching interventions and patient/family level of understanding and adjusts teaching and plan of care accordingly. |
• | Implements policy on Advanced Directives. |
• | The CTL ensures coordination and the effective provision of patient care on the Coordinated Care or other relevant practice team. The CTL systematically and continuously collects and assesses data in collaboration with the multidisciplinary team to provide therapeutic care with the patient and family. |
• | Establishes an in-depth database by assessing the behavioral and physiologic status of the patient utilizing interview, observation, physical examination, and other available data. |
• | Integrates nursing interventions into the multidisciplinary plan of care, incorporating appropriate standards of care and practice and patient outcomes. Effectively communicates with the case manager to solve complex multidisciplinary patient care issues. Routinely rounds with the case manager, physician, and/or other multidisciplinary team members to evaluate patient progress and plans. |
• | Incorporates discharge/home care planning into the multidisciplinary plan of care on an ongoing basis. In collaboration with the case manager, reviews clinical variances and ensures implementation and evaluation of interventions to meet identified needs. |
• | Sets priorities adapting to changing patient and unit/clinic situations. Initiates action to reduce or correct risk in response to data indicating urgent and/or emergent risk to the patient. Monitors care provided by team members and adjusts patient care assignments based on changing patient and/or unit/clinic needs. |
• | Assumes responsibility and accountability for effectively managing nursing care of individual patients. Ensures that newly admitted patients are assigned to a team member for the shift. |
• | Documents the nursing process to reflect a comprehensive and integrated approach to patient care. |
• | Evaluates patient’s responses to care based on effectiveness of nursing interventions/actions in relationship to established outcomes and collaborates with medical staff, CTL, Case Manager, and/or Nurse Practitioner regarding clinical variances and recommended changes to the plan of care. Acts as a clinical consultant/resource to other nursing team members. |
• | Performs systematic nursing assessment, recognizes abnormalities, and integrates findings into critical pathway or multidisciplinary plan of care. Critical elements include physical examination, assessment of readiness to learn, psychosocial assessment, functional assessment, and (depending on setting) utilization of specific assessment scales including the Braden scale, pain assessment and functional assessment, and developmental level scales. |
• | Completes all necessary elements of the patient assessment health profile on admission or new to clinic and in accordance with appropriate departmental standards. |
• | Initiates the critical pathway in collaboration with the Case Manager or multidisciplinary care team. In absence of a critical pathway, initiates the multidisciplinary plan of care by establishing individualized, measurable patient goals and outcomes in consultation with the patient, family, and health care team. |
• | Interprets overt and subtle data to determine physiologic or psychosocial risk. |
• | Teaches patient, family, and/or other care provider critical knowledge and skill necessary to accomplish self-care regimes and manage decision making of continuing care needs. Ensures that patient and family demonstrate knowledge of health status, treatments, skills, medications, and adaptive behaviors gained as a result of teaching interventions. |
• | The CTL considers factors related to safety, effectiveness, knowledge, and skill of team members and cost in planning and delivering care. The CTL demonstrates knowledge of the UW Health care delivery system as multidisciplinary and multifaceted with a variety of entry and access points along the care continuum. |
• | Acts as a clinical and operational leader. Contributes to and supports the effective management of the unit/clinic. |
• | Provides leadership for incorporating standards of practice, clinical practice protocols, etc. into practice in order to maximize clinical effectiveness. |
• | Identifies unit/clinic operational issues and identifies, implements, and evaluates strategies designed to address duplication of patient care services and system inefficiencies. |
• | Identifies opportunities and participates in evaluations designed to measure the impact of new products and technology on patient outcomes or enhancements to the care delivery process. |
• | The CTL uses research findings in practice and acts as a leader in the improvement of patient care processes, identifying and resolving problem areas. |
• | Provides leadership in executing organizational improvement activities. Identifies strategies to incorporate innovations or practice improvements into care delivery processes. Acts as a clinical leader/consultant incorporating changes in practice to reflect new advances and ensure effectiveness of interventions. |
• | Analyzes recurring clinical practice issues and develops plans to address identified issues. |
• | Demonstrates knowledge of and incorporates research findings related to clinical specialty. |
• | Utilizes data to assess the outcomes of care provided to the team. Collaborates with the Case Manager, Clinical Nurse Manager, and/or other clinical leaders to implement strategies to improve care. |
• | The CTL applies expert clinical knowledge in nursing practice and assumes responsibility of the professional development of self, other nursing staff, and students. |
• | Serves as a preceptor. Works directly with new employees to see that planned orientation to the unit/clinic is accomplished. Evaluates clinical competency, communication, participation as a team member, and skills in delegation and supervision as required. |
• | Plans patient care assignments to ensure orientation, instruction, direction, and evaluation of students assigned to the unit/clinic. |
• | Acts as a clinical expert; shares knowledge gained through participation in continuing education activities. |