REGISTERED AND LICENSED VOCATIONAL NURSES PERFORMANCE BASED WORK STATEMENT IN ADDITION TO THE BASIC CONTRACT, THE FOLLOWING EXTENDED DESCRIPTION APPLIES. 1. GENERAL. 1.1. DESCRIPTION OF WORK. 1.1.1. The contractor shall provide the services of Registered and Licensed Vocational Nurses at (Location). Working areas include special care units (Critical Care, the Emergency Room, and the Burn Unit); the Operating Rooms, and NonIntensive care units consisting of Adult Medical Surgical Wards, Ambulatory Care Unit, Recovery Room, and outpatient clinics including pediatrics. 1.1.2. This is a personal services contract and is intended to create an employer-employee relationship between the Government and the individual Health Care Provider (HCP). The performance of the individual HCP under this contract is subject to day-to-day supervision, clinical oversight and control by healthcare facility personnel comparable to that exercised over military and civil service HCPs engaged in comparable work. 1.1.3. Performance Measures (Sample) 22.214.171.124. Outcome. The contractor will provide qualified personnel who will fulfill the requirement to provide Registered and Licensed Vocational Nursing services at a standard enabling the MTF to provide such services at a high level of quality. 126.96.36.199. Standards. Acceptable measures include: fill rate-95%; employee turnover rate-30% per year; substantiated patient complaints-max 2 per year per provider. Other performance evaluation factors will be monitored that are not quantified by numerical measurements which include: contractor providing personnel exceeding the minimum qualification standards; timely patient follow-up when necessary; patient customer service comments; provider and contractor relationship with hospital staff/government contracting personnel; compliance with hospital policy and procedures. 188.8.131.52. How Measured. Department/clinic supervisory personnel will monitor provider performance through government information systems and records, patient records, customer service information, contractor reports, and time sheets. 1.2. QUALIFICATIONS. 1.2.1. Registered Nurses (RN) must possess an Associate, Diploma or Baccalaureate degree in Nursing from an accredited school of nursing from at least one state or territory in the U.S. Licensed Vocational Nurses must be a graduate from an accredited school of nursing. All nurses must be a health care provider for a minimum of one (1) year prior to employment by the contractor. 1.2.2. Medical surgical nurse must have a minimum of one (1) year of medical/surgical nursing experience within the last three (3) years. Critical Care Nurses shall have one (1) year critical care experience within the last three (3) years. ER nurses shall have either one (1) year experience in critical care or emergency room in the last three (3) years. Operating Room RN’s shall have one (1) year experience in the operating room in the last three (3) years. Burn Unit nurses shall have at least one (1) year experience caring for burn patients in the last four (4) years. At the discretion of the COR, medical/surgical nurses may receive training and certification in Conscious Sedation, at the expense of the government. Pediatric nurses shall have at least one (1) year experience caring for pediatric patients in the last three (3) years. 1.2.3. Have and maintain current certification in Basic Cardiac Life Support (BCLS) certified by the American Heart Association or American Red Cross Standards. Critical Care, Emergency Room and Burn Care nurses must maintain current certification in Advanced Cardiac Life Support (ACLS). 1.2.4. Documentation of training and skills appropriate to the RN or LVN particular specialty, i.e., Med/Surg, Critical Care, Burn Unit and OR to include a copy of the nursing skills assessment checklist; results for the medication and competency test. In addition, all LVN’ s must have documentation of Intravenous (IV) and Nasogastric (NG) procedures. 1.4. HOURS OF PERFORMANCE. The contractor shall provide nursing personnel to support a seven (7) day/week, 24-hour/day operation to include holidays. Below is an example of common shift times which consist of eight (8) work hours with a non-paid 30 minute lunch or dinner break, and a 12 hour shift with a 30 minute non-paid lunch or dinner break. The maximum number of shift hours to be scheduled in a twenty-four hour period is twelve. Day Shift 0645-1515 IC Evening Shift 1445-23 15 Night Shift 2245-0715 7A-7P 0645-1915 7P -7A 1845-0715 Any eight- (8) hour day shift may begin between the hours of 0600 to 1300. 1.4.1. Full Time Personnel: Nurses who will normally work 30-40 hours per week on rotating shifts Sunday through Saturday, including Federal holidays. Nurses may also be required to work over 80 hours in a two-week period (pay period) resulting in overtime. 1.4.2. Pool Personnel: Nurses who will be requested to work in the absence of the full time employee, or during periods of increased patient census. Pool nurses will not be guaranteed a specific number of hours per pay period. 4. CONTRACTOR FURNISHED PROPERTY. The contractor shall ensure all nurses have white uniforms for performance under this contract. 5. SPECIFIC TASKS. Health care nursing personnel provided by the contractor shall perform essentially the same services as those required by any Army or government service health care professional of similar experience and in similar duty assignments. Contract individuals will not be placed in a supervisory roll but may assist in providing orientation and other activities as deemed appropriate by Department of Nursing administrative officials. Contract nursing personnel shall attend and participate inpatient nursing reports, patient care conferences, team conferences, discharge planning, and ward staff conferences as deemed appropriate by the head nurse. the duties listed below shall be applicable to the indicated nursing specialty/care ward. 5.1. MEDICAL/SURGICAL NURSE RN AND LVN 5.1.1. Obtains patient history and pertinent family history. 5.1.2. Assesses patient/family knowledge level, develops and implements a plan of instruction and documents demonstrated level of understanding. LVN shall not assess but will implement and document. Assessment plans will be targeted at age specific needs. 5.1.3. RN shall assess patient and plan for appropriate nursing care. RN and LYN shall document care given and progress of patient in the patient’s medical record. 5.1.4. Administer medications and blood products with the knowledge of actions and usual dosages of commonly used drugs. For RN only: Anti-cancer chemotherapy drugs are excluded unless contractor’s employee has obtained appropriate documented education in cancer chemotherapeutic drugs and administration. LVN shall not administer IV push medication or start blood product transfusions. 5.1.5. Manages care of patients for a wide range of procedures of an advanced nature and difficulty where there is a high risk for infection and bodily functions are mechanically assisted by life support equipment. (Applicable to Bum Unit Nurses) 5.1.6. Manage and ensure proper procedures are followed with the tissue/skin bank and blood bank. (Applicable to Burn Unit Nurses) 5.2. OPERATING ROOM RN (In addition to Medical Surgical Nurse and LVN duties above) 5.2.1. Performs pen-operative duties to include: assessing, planning, implementing, and evaluating age-specific nursing care across all ages. 5.2.2. Assesses patient/family knowledge level, implements a plan of instruction and documents demonstrated level of understanding. 5.2.3. Performs circulating and scrub duties as required. Takes counts (Needle, sponges, etc.), labels, handles, and assures proper disposition of surgical specimens. Utilizes numerous and complex operating room equipment. 5.2.4. Initiates, maintains, and completes pen-operative documentation. 5.2.5. Implements individualized nursing plans to include safety precautions, correct positioning, infection control precautions, aseptic practices, qualified personnel assignments, medications, supplies and equipment. Assesses progress of surgical procedures and patient responses through sophisticated clinical observations. 5.3. PEDIATRIC NURSE RN 5.3.1. Performs assessment for pediatric patients ranging in age from newborn to sixteen years. 5.3.2. Recognizes normal growth and development for ages 4 days to 21 years. 5.3.3. Performs blood drawing (i.e., heel stick for dextrostix, hematorcrits, bilirubins, complete blood counts, blood cultures, and blood chemistries). In addition, performs phlebotomies. 5.3.4. Manages nursing care and utilizes equipment for patients in traction, croup tents, and cardiac/apnea monitors. 5.3.5. Assists with therapeutic/diagnostic procedures such as spinal taps. 5.3.6. Monitors intravenous fluid administrations to include maintaining normal rates of infusion. 5.3.7. Restrains patients safely. 5.3.8. Performs nebulizer treatments. 5.3.9. Performs in and out catheterizations. 5.3.10. Administers medications via oral, intradermal, intramuscular, intravenous, subcutaneous, topical and rectal routes. 5.4. CRITICAL CARE NURSE RN AND LVN AND BURN NURSES. 5.4.1. Performs critical care duties to include: assessing, planning, implementing, and evaluating age-specific nursing care across all ages. Documents utilizing the DON documentation standards. 5.4.2. Assess patient/family knowledge level implement a plan of instruction, and documents demonstrated level of understanding. 5.4.3. Manages patients requiring hemodynamic monitoring, titration of vasopressor drugs, and a wide range of procedures of an advanced nature and difficulty where there is a high risk for infection and bodily functions are mechanically assisted by life support equipment. 5.4.4. Communicates pertinent patient information to the charge nurse and/or physician as appropriate. RN transcribes and verifies transcription of physician orders. 5.4.5. Administers medications and blood products with the knowledge of actions and usual dosages of commonly used drugs. LVNs shall not administer IV push medications or start blood products. 5.4.6. Manages and ensures proper procedures are followed with the tissue/skin bank (Burn Nurses) and the organ donor bank. 5.4.7. Assists with invasive procedures and management, such as SwanlGanz insertion; balloon pump management, temporary pacemaker insertion.
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