ER_UC_Department_Performance_Work_Statment_10_20_2015.pdf

PWS No.: 08‐01 20 October 2015

Performance Work Statement (PWS) for Nonpersonal Services

Registered Nursing Emergency Room/Urgent Care ‐ Outpatient Department

Table of Contents

Section Page

1.0 General 1 – 2

2.0 Definitions 3 – 5

3.0 Government Furnished Information, Property, & Services 6

4.0 Contractor Furnished Equipment 7

5.0 Performance Based Requirements 8 – 9

6.0 Contractor Qualification Requirements 10

7.0 Federal Torts Claim Act (FTCA) 11

8.0 Challenges to Conflicts 11

9.0 52.249‐12 Termination (Personal Services) (Apr 1984) 11

10.0 Performance based Matrix 12

11.0 List of Attachments and Exhibits 13

PWS No.: 08-01 20 October 2015

Performance Work Statement (PWS)

Nonpersonal Services

Registered Nursing Emergency Room/Urgent Care ‐ Outpatient Department

1.0 General: This performance work statement describes the requirements for Nonpersonal service nursing services to support the mission of the Indian Health Service (IHS).

1.1 Background: IHS is an agency within the U.S. Department of Health and Human Services and is responsible for providing federal health services to American Indians and Alaska

Natives. The provision of health services to members of federally recognized tribes grew out of the special government to government relationship between the federal government and Indian tribes. The IHS is the principal federal health care provider and health advocate for the Indian people. The goal is to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American

Indians and Alaska Natives. The IHS currently provides health services to approximately

1.5 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 34 states.

There is a nationwide shortage of nurses which is amplified by the remote and rural areas served by the Indian Health Service. This performance work statement covers requirements for the Navajo, Phoenix and Tucson Areas. The positions to be filled may include: Registered Nurse (RN), Licensed Practical Nurse (LPN), Operating Room Technician

(ORT), Obstetrics Technician (OBT), Nursing Assistant, Health Technician, and Medical

Assistant for the provision of outpatient, inpatient, and community health nursing services.

1.1.1. Navajo Area Indian Health Service (NAIHS) administers health centers and hospitals providing health care to approximately 201,583 members of the Navajo

Nation. The Navajo Nation is the largest Indian tribe in the United States and has the largest reservation, which encompasses more than 25,516 square miles in northern Arizona, western New Mexico, and southern Utah, with three satellite communities in central New Mexico. The NAIHS is the primary provider of inpatient, ambulatory care, preventive and community health, and environmental health services for members of the Navajo Nation and the San Juan Southern

Paiute Tribe.

1.1.2 Chinle Comprehensive Health Care Facility (CCHCF) provides medical care for approximately 35,000 Navajo. Serving a rural area, many of our patients travel 100 miles round trip to receive care and do not have electricity or running water in their homes. And, most of our elderly patients speak only Navajo, and live according to traditional Navajo cultural practices. The Chinle Comprehensive Health Care Facility and Ambulatory Care Center is a 60 bed inpatient hospital and outpatient facility. Services offered are: Adult inpatient and Pediatric Inpatient Care, Outpatient Primary Care, Adult Intensive Care, Emergency Medicine, General Surgery, Podiatry, OBGYN, Labor & Delivery, Women's Health, Midwifery, Mental

Health, Pharmacy, Optometry, Dental, PT, OT, Speech Pathology, Audiology, Lab, Public Health and School Health. THE ARIZONA DEPARMENT OF HEALTH SERVICES

DESIGNATES CCHCF AS A LEVEL IV TRAUMA CENTER, SEPTEMBER 9, 2013 TO

SEPTEMBER 9, 2016.

1.2. Scope: The Contractor shall provide nursing services in accordance with section 5.0, performance based requirements and the attached Scope of Work (Department Specific).

1.2.1. Duties and responsibilities may encompass outpatient, inpatient and community health nursing services to IHS patients.

1.2.2. Place of Performance: Services are to be performed at hospitals, clinics and other healthcare facilities in the Navajo Area Indian Health Service within the State of

Arizona, New Mexico. Services shall be performed in the Emergency Room/Urgent

Care Department at Chinle Comprehensive Health Care Facility, Chinle, Arizona

86503.

1.2.3. Period of Performance: Will be flexible to allow for short term (8 weeks), long term

(1‐year to 3‐year) and, where feasible, include intermittent support to meet unplanned needs that develop on a frequent basis.

1.3. Applicable Documents: Please see the web link listed unless document is listed as an attachment.

1.3.1. The Joint Commission on Accreditation of Healthcare Organizations (The Joint

Commission) http://www.jointcommission.org

1.3.2. Centers for Medicare and Medicaid Services (CMS) Standards http://www.cms.hhs.gov

1.3.3. Accreditation Association for Ambulatory Health Care (AAAHC) http://www.aaahc.org

1.3.4. Section 231 of Public Law 101-647, the Crime Control Act of 1990.

http://www.policyalmanac.org/crime/archive/crs_federal_crime_policy.sh tml

1.3.5. Section 4087 of Public Law 101-630, the Indian Child and Family Violence Act.

http://www.nicwa.org/policy/law/protection/index.asp

1.3.6. Health Insurance Portability and Accountability Act (HIPAA) of 1996.

http://www.cms.hhs.gov/hipaa

1.3.7. Privacy Act of 1974. http://www.usdoj.gov/oip/privstat.htm

1.3.8. Revised American Nurses Association Code of Ethics and Standards of Practice and

Care (1996) http://www.nursingworld.org

1.3.9. State Nurse Practice Act for the Contractor’s licensing state. http://medi smart.com/practice.htm

1.3.10. IHS Service Unit and Health Center Policies, Procedures and Protocols. (See section

11.0 for a list of attachments and exhibits)

1.3.11. Computer Security Act of 1980

http://www.ihs.gov/adminmggrresouces/computersecurityact

1.3.12. Federal Code of Conduct http://www.ihs.gov

1.3.13. IHS General Directives http://www.ihs.gov/adminmggrresouces

1.3.14. IHS Computer Security Directives http://www.ihs.gov/adminmggresources

1.3.15. Nurse License Look up http://www.nursys.com

2.0 Definitions

2.1. Acceptance: Constitutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements, except as provided in FAR subpart

46.5 and subject to other terms and conditions of the contract.

2.2. Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) conform to the contractual requirements.

Government approval does not relieve the Contractor from responsibility for compliance with contract requirements.

2.3. Area: A defined geographical region for Indian Health Service administrative purposes.

Each Area Office may administer several Service Units.

2.4. Code of Ethics: The Revised American Nurses Association Code of Ethics and Standards of

Practice and Care, published in 1996 by the American Nurses Association which makes explicit primary goals, values and obligations of the nursing profession.

2.5. Contracting Officer (CO): A Government employee with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.6. Contractor: The individual awarded a legal binding contract to provide supplies and services.

2.7. Contracting Officer’s Representative (COR): A federal employee who assists the ordering/issuing activity contracting officer in the administration of task orders issued under this contract. The COR is primarily responsible for the technical assistance and day-to-day program management of the ordering activity’s task orders. Ordering activities may have different designators for this employee (e.g. GTR – Government Technical

Representative, COTR–Contracting Officer’s Technical Representative, or PO Project

Officer).

2.8. Cooperative Attitude: Behavior that is positive and displays a willingness to perform assigned patient care tasks and to be a team player.

2.9. Cultural Awareness: Realization and respect for American Indian and Alaska Native practices.

2.10. Customer: Patients, staff and visitors of an IHS service unit and health center.

2.11. Customer Evaluation/Input: Written comments made to the Contracting Officer regarding the Contractors performance. This is one of the criteria used to evaluate the Contractor’s performance.

2.12. Dependability: Qualities of being trusted and being able to repeat the same task to yield the same result.

2.13. Federal Acquisition Regulation (FAR): The FAR is the primary regulation for use by all Federal

Executive agencies in their acquisition of supplies and services with appropriated funds.

2.14. Government Vehicle: An IHS owned motor vehicle or a vehicle leased by IHS through agreements with the General Services Administration (GSA) or through commercial rental agreements.

2.15. Health Center: A facility physically separated from a hospital, with a full range of ambulatory services including at least primary care providers, nursing, laboratory, and x-ray which are available at least 40 hours a week for outpatient care.

2.16. Nonpersonal Services: A contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees, as defined in FAR 37.

2.17. Ordering Activity: An authorized user of IHS that may issue a task order to obtain required services under this contract.

2.18. Ordering Activity Contracting Officer: A Government employee of IHS authorized and warranted to issue task orders and to make subsequent task order modification(s) under this contract. The Ordering Activity CO has the authority to make initial determinations on all matters of dispute regarding task orders.

2.19. Orientation: An activity designed to provide basic familiarization of the facility and transition the nurse into the IHS Service Unit and/or Health Center and the nursing unit where the services will be provided.

2.20. Other Direct Cost (ODC): Reimbursement provided for payment for non‐Government quarters, but shall cease once Government quarters, trailers space, or any other types of housing accommodation become available.

2.21. Past Performance Information: Relevant information regarding a contractor’s actions under previously awarded contracts. This includes the contractor’s record of conformance to specifications and to standards of good workmanship; the contractor’s record of containing and forecasting costs on any previously performed cost reimbursable contracts;

the contractor’s adherence to contract schedules, including the administrative aspects of performance; the contractor’s history for reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor’s business-like concern for the interest of the customer.

2.22. Patient Outcome: End result of nursing care.

2.23. Performance based Matrix: Lists the services to be monitored and the standards to be applied.

2.24. Personal Protective Equipment (PPE): The equipment used to protect medical personnel from exposure to biological, chemical, and radioactive hazards.

2.25. Service Unit: The local administrative unit of IHS.

2.26. Standards of Practice and Standards of Care: Authoritative statements by which the nursing profession describes the responsibilities for which its practitioners are accountable. The standards provide direction for professional nursing practice and a framework for the evaluation of practice. The standards of professional nursing practice may pertain to general or specialty practice.

2.27. Supervisor: Government employee authorized to provide verbal and written performance direction to the Contractor that the Contractor must follow without exception.

2.28. Task Order: An order issued in accordance with the terms of the contract that details an ordering activity’s specific requirements. An ordering activities written order to obtain services, at a minimum will include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number, and the ordering activities task order number.

2.29. Tour of Duty: The time of day the nurse is scheduled to perform nursing care duties.

2.30. Valid Patient Complaint: Justifiable accusation made by a patient and supported by investigation.

2.31. Verifiable Emergency: An unexpected/unplanned absence by the contractor requiring valid documentation to confirm the occurrence.

3.0 Government Furnished Information, Property and Services

3.1. Information: Government unique information related to this requirement, which is necessary for Contractor performance, will be made available to the Contractor. The

Contracting Officer or designee will be the point of contact for identification of any required information to be supplied by the Government.

3.2. Joint Use by the Government and the Contractor: Except for the property and service listed in 3.3 and 4.0, the Government will provide, for joint use by the Government and the

Contractor, all necessary equipment, supplies, and clinic space to perform the services under this contract.

3.3. Contractor Exclusive Use:

3.3.1. Personal Protective Equipment (PPE): The Government will furnish the Contractor with appropriate PPE other than specified in paragraph 4 of the contract.

The Government will be responsible for any repair, cleaning, and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

3.3.2. The Government will provide facility specific contractor identification badges for each contractor. A minimum fee of $10.00 will be charged for lost or destroyed badges.

3.4. Training: Facility specific orientation/training necessary for the Contractor to perform the required duties, e.g., IHS information technology (IT) systems and operational procedures.

Training will be provided ONLY if the subject matter is necessary to improve or enhance the quality of nursing services or includes mandates made by the IHS Service Units/Health

Centers while the nurse is working under this contract. Training will not be provided for the purpose of continuing education, career development or individual development.

3.5. Supervisor: The Contactor is subject to the supervision and direction of James “Jim” Priest, Supervisory Clinical Nurse or his designee for this order.

3.5.1. Contracting Office Representative (COR): Georgina Nez is primarily responsible for monitoring the technical progress including surveillance and assessment of performance for this order.

3.5.2. Point of Contact: Hazel Tso, Program Assistant. (928)‐674‐7190

4.0 Contractor Furnished Property

4.1. Except for the property specified in paragraph 3 as government furnished, the Contractor shall provide all uniforms and other personal medical instruments subject to the following:

4.1.1. Uniforms and Lab Coats: Uniforms and Lab Coats shall conform to the requirements of the Indian Health Service Manual, Part 3 Chapter 4 and meet the approval of the Chief Nurse Executive at each IHS facility.

4.1.2. Other personal medical instruments: “Other personal medical instruments” are defined as Contractor owned items may include but not limited to stethoscope, scissors, as appropriate to the work unit. The Contractor shall not use unsafe equipment or supplies at any time during performance of this contract. All

Contractor furnished equipment and supplies shall be subject to inspection by the

Government and must be approved by the COR prior to use by the Contractor. The

Government reserves the right to prohibit the use of any materials, supplies, or equipment.

5.0 Performance Based Requirements: The Contractor shall provide nursing services in the delivery of patient care to the Indian Health Service. Specific tasks include the following:

5.1. Nursing Duties:

5.1.1. The Contractor shall perform nursing duties and manage patient’s needs as described in the (PD), identified by the Service Unit and as directed by Supervisor.

5.1.2. The Contractor shall perform in accordance with the competency standards listed in Exhibits, paragraph 11.

5.1.3. The contractor shall provide professional nursing services in direct patient care as follows:

A. Provide full range of emergency/urgent care to patients of all age ranges.

B. Exercise Knowledge of the nursing process and its application to clinical practices in order to provide individualized, goal oriented nursing care to the adult patient.

C. Exercise knowledge of scientific and psychosocial nursing theory, principles, practices, and techniques in order to plan and provide quality nursing care which meets the physical, spiritual, and social‐cultural needs of the Indian patient.

D. Exercise knowledge of biological aspects of disease processes and illness in order to recognize complications and implement appropriate therapeutic intervention required.

E. Exercise knowledge of the medications and dosages in order to recognize their desired effects, side effects, and complications of their use.

F. Analyze the results of various medical procedures and translate them into appropriate nursing interventions.

G. Work effectively and harmoniously within the health care teams and with

Native American patients and their families.

H. Contractor shall follow facility policies and procedures, JACHO, OSHA, I.H.S.

and other federal licensing, accreditations, and regulating body standards.

I. Coordinate care teams, offer guidance, and support to team members.

J. Teach and offer appropriate health education to staff, patients, and customer owners.

K. Perform clinical procedures, intravenous access, and phlebotomy, point of care laboratory testing, IV infusions, EKG, SVN Respiratory Treatments and response to emergency codes.

5.1.4. Contractor shall be subject to peer review per Joint Commission standards.

5.1.5. Contractor shall meet the Safety management reporting requirements in accordance with the Service Unit Safety Measure Policy.

5.1.6. Contractor shall be responsible for all applicable Federal, State, and Local Taxes, Meals, Travel/Transportation. Lodging is provided but must be paid for by the contractor or contract agency. Government quarters are available at prevailing rental rates plus utilities, as applicable, if government quarters are utilized. The Contractor shall be responsible and liable for the proper care of government owned or leased property furnished in occupied quarters.

5.2. Work Schedule:

5.2.1. The Supervisor at each IHS facility shall determine specific tour of duty. The contractor shall work 100% of the contracted hours. Contractor shall work shifts following the unit’s hours of 12.5 hour shifts totaling 7 shifts/2 week period, may work weekends, holidays, rotating day and night shifts, as scheduled by the SCN based on the unit’s need for coverage.

5.2.2. Work Flexibility. As directed by the Supervisor, the Contractor shall rotate into other duty sections as needed to support patient care.

5.2.3. The Contractor shall obtain approval of the department Supervisor or designee prior to any absence from work. If the length of the absence exceeds eight (8) work hours the Contractor shall request approval at least fifteen (15) days, (the exception is verifiable emergencies) in advance of the desired absence.

5.2.4. Approval of leave is contingent upon availability of a qualified replacement.

5.2.5. The Contractor shall provide written documentation from a qualified health care provider for absences of three (3) or more consecutive days, due to illness, stating:

A. The cause of the current illness or incapacitation AND

B. Indicating the Contractor as contagious or non‐contagious.

The Government reserves the right to examine and or re‐examine any Contractor who meets the criteria.

5.3. Conduct: The Contractor shall meet standards as listed in the Federal Code of Conduct.

5.4. Performance Evaluation:

5.4.1. The Contractor’s performance will be evaluated in accordance with the standards set forth in the contract and Performance-based Matrix of section 10.0.

5.4.2. Substantiated reports written by any customer dealing with patient safety, infection control, or other procedure that adversely affects patient outcome constitutes a breach of contract.

5.5. Identification of Contractor:

5.5.1. The Contractor shall wear a government issued contractor identification badge during performance of duty. PIV cards are issued after 6 months at Service Unit.

5.6. Management of Medical Information: The Contractor shall manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific policies and protocols.

5.6.1. The Contractor shall ensure adherence to DHHS IT system security policies and procedures. The IT policies and procedures will be made available to the

Contractor.

5.6.2. The Contractor shall immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

5.7. IHS Information Technology Systems:

5.7.1. In performance of this contract, the Contractor shall adapt to and successfully utilize IHS information technology systems that are deemed by the Supervisor as necessary for acceptable contractor performance.

5.7.2. The Contractor shall ensure that IHS information technology system security policies and procedures are adhered to. The IT policies and procedures will be made available to the Contractor at each IHS facility.

6.0 Contractor Qualification Requirements:

6.1. Experience. The Contractor shall have thirty-six (36) months of nursing experience, with a minimum of twelve months (12) in the specialty required by the contract, unless otherwise approved by the Contracting Officer.

6.2. License/Registration. All nurses shall possess a current, valid, unrestricted nursing license in a state, the District of Columbia, the Commonwealth of Puerto Rico, or a Territory of the United States, throughout the term of this contract.

6.2.1. Motor Vehicle Operator’s License. If required by the position, the Contractor shall possess a valid state driver’s license throughout the term of this contract.

6.3. Certifications. Current Basic Life Support (BLS) is mandatory.

6.3.1.1. Degree or diploma from a professional nursing program approved by the legally designated state accrediting agency at the time of the program was completed by the applicant.

6.3.1.2. Current BCLS, ACLS, PALS and Trauma Certification (i.e. TNCC, ATCN)

6.3.1.3. Experience that equips the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled.

6.4. Health Requirements/Conditions of Employment:

6.4.1. Medical Evaluation. The Contractor shall provide a fitness for duty certificate issued by a licensed physician to perform the proposed job without significant risk to personal health or the health and safety of others.

6.4.2. Immunization. The Contractor shall also provide the following documentation:

Immunity to Rubella, Mumps, Measles

Immunity to Hepatitis B series

History of chicken pox (varicella) disease or positive titer

Tetanus Diphtheria (Td) within the last 5 years

Documentation of receiving a TB Mantoux skin test (PPD) within the past 12 months with documentation of follow‐up for a positive test.

A signed declination of the Hepatitis B vaccination series will be accepted.

Tdap (Tetnus, diphtheria and pertussis)

6.5. Language Requirements and Cultural Awareness. The Contractor shall read, understand, speak, and write English to effectively communicate with patients and other health care workers, and shall be respectful of the local, American Indian and Alaska Native culture.

6.6. Information Technology Skills. The Contractor shall possess basic knowledge, skills, and abilities to use a computer.

6.7. Orientation: All nurses providing service under this contract shall attend mandatory orientations and training specified by the government.

6.8. Background Checks: As directed by the Contracting Officer, the Contractor shall provide all requested information necessary to perform Level I and Level II background checks. The

Contractor shall comply with the requirement to obtain security investigations. The

Contractor shall work with the IHS to ensure that the pre‐employment screening process includes the appropriate investigation questionnaires and forms to be completed. All completed forms will be reviewed by the Contractor and forwarded to the Supervisor. The

Contractor will be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

7.0 Federal Tort Claims Act (28 USC 1346 (B), 1946): Previously, health care providers working at Indian Health Service or Tribal facilities under non‐personal services contracts—such as locums tenens providers—were generally not covered under the Federal Tort Claims Act and had to secure their own malpractice insurance. However, the recently passed 25 U.S.C. 1680c(e) may extend Federal Tort Claims Act coverage to these “non‐Service health care practitioners” who are given clinical privileges and who provide health care services to patients eligible for services from the Indian Health Service or under an ISDEAA contract.

8.0 Challenges to Conflicts: For any inconsistency between supervisor directions, this Performance

Work Statement, attachments and exhibits, the following order of precedence will apply:

(a) First Priority: Supervisor’s directions

(b) Second Priority: Position Description (attached)

(c) Third Priority: Performance Work Statement Exhibits

(d) Fourth Priority: Performance Work Statement Narrative

9.0 52.249-12 Termination (Personal Services) (Apr 1984):

The Government may terminate this contract at any time upon at least 15 days’ written notice by the Contracting Officer to the Contractor. The Contractor, with the written consent of the

Contracting Officer, may terminate this contract upon at least 15 days’ written notice to the

Contracting Officer.

9.1. Any Contractor employee demonstrating impaired judgment shall not be allowed to continue working immediately on the contract. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

PWS No.: 08-01 30 September 2015

10.0 Performance – based Matrix

Performance based Task Indicator Standard Quality Assurance Incentives

State the end results or outputs that you, the customer will formally accept or reject.

For the requirement, state the feature(s) of end result that will be surveilled.

For each “indicator,” state a performance level that, when met, means the task has been performed satisfactorily.

This Standard describes “What Success Looks Like.”

For each “Standard”, state the method used to check performance (i.e.

random sampling, 100% inspection, periodic inspection, customer complaints).

List Positive and Negative

Incentives. Address method of linking payment to quality of service.

Contractor shall provide

Nursing services in the delivery of patient care to the Navajo Area Indian

Health Service.

Competency

Compliance

Patient Outcomes

Professionalism

Credentialing

Documentation

Service Quality

Perform 100% required tasks at 100% of the required competencies (refer to 11.0)

100% compliance with IHS Service Units and/or Health Centers published Policies; Procedures; Standards of Care;

and hospital and nursing Protocols.

No reports of breached patient safety, infection control, and other procedures that might adversely affect patient outcome.

Performance characterized by continual cultural awareness and focus on customer service. 100 percent adherence to the Nursing Code of Ethics and Federal Code of Conduct.

Uninterrupted credentialing as defined in 6.0 to 6.8 for period of contract.

100% percent of all documentation meets established IHS Medical Facility, JCAHO, and CMS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession.

Satisfaction with quality of service is evidenced by valid customer inputs.

See QASP. Surveillance systems will include periodic inspections and customer complaints.

Payment of contract price for satisfactory service.

Contractor performance will be evaluated using the Contractors Performance Assessment Report (CPAR). The evaluation will be considered when future IHS Contract selections are made.

PWS No.: 08-01 30 September 2015

11.0 List of Attachments and Exhibits. To be provided by the Contracting Officer upon request.

11.1. Attachments

1. Position Description (Service Unit specific)

11.2. Exhibits Applicable to the Navajo Area HIS

11.2.1. Written Competency Assessments

a. Confidentiality/HIPAA/Patient’s Rights

b. EMTALA Compliance Exam, 2004

c. Age Specific Competency Verification

d. RN Medication Administration Competency Examination

e. RN Medication Administration Competency Verification

f. Intravenous Therapy Exam

g. Venipuncture Procedure Skills competency Verification

h. Pain Management Competency Verification

i. Restraints

j. Soft Restraint Application Competency Verification

k. Hard Leather Restraint Application

11.2.2. Contract Nurse Orientation Check List

11.2.3. Contract Nurse Orientation Competency Verification Instructions

11.2.4. Contract Nurse Billing Information

11.2.5. Standard Emergency Codes

11.2.6. Confidentiality: Legal and Ethical Concerns in Healthcare

11.2.7. EMTALA – Emergency Medical Treatment and Labor Act

11.2.8. What are Age‐Specific Competencies?

11.2.9. An Introduction to the Navajo Culture

11.2.10. Verbal and Telephone Orders

11.2.11. Medication Administration

11.2.12. Pain Management

11.2.13. Latex Allergy

11.2.14. Focus Charting

11.2.15. Patient Restraints

11.2.16. Charge Nurse Duties: Responsibility and Expectation

11.2.17. Nursing Standards

11.2.18. Standards of Nursing Practice