Perfusionist III, ECMO Services

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Rotating - 12 Hour (United States of America)

A Brief Overview

The Perfusionist is responsible for operating extracorporeal circulation equipment during any medical situation where it is necessary to support or temporarily replace the patient's circulatory or respiratory function. All actions of the Perfusionist are performed as prescribed by an attending physician and in accordance with SHC policy. Perfusionists perform all routine and advanced clinical and non-clinical functions as described in Perfusion Service Protocols, Policies and Guidelines and in conformance with the Scope of Practice outlined in the California Perfusion Titling Act (Business & Professions Code 2590) as well as the Ethical Standards of the American Board of Cardiovascular Perfusion (ABCP) Under the direction of and in consultation with a physician(s), Perfusionists set up and operate the heart-lung machine and other sophisticated equipment used in the operating room, such as physiological monitoring instrumentation, and related ancillary equipment, which keeps the patient alive while a surgeon is operating on them by supporting their circulatory and respiratory functions. The Perfusionist manages the patient's altered physiological functions throughout the procedure.

In addition, Perfusionists, directed by the surgeon and anesthesiologist, are responsible for regulating the patient's levels of oxygen and carbon dioxide; for measuring selected laboratory values such as blood cell count; and for monitoring circulation.

? At times, Perfusionists administer blood products, anesthetic or other pharmaceutical agents through the cardiopulmonary bypass circuit on prescription and/or appropriate protocol. The Perfusionist is responsible for the monitoring of blood gases and the adequate anticoagulation of the patient, induction of hypothermia, hemodilution, and other duties, when prescribed.

? The Perfusionist is knowledgeable concerning the variety of equipment available to perform extracorporeal circulation functions and provides consultation to the physician in the selection of the appropriate equipment and techniques to be used.

What you will do

• Demonstrates competency in operating the various types of perfusion equipment available at Stanford that includes but not limited to:

• Heart/Lung Machines: Roller blood pumps: Sorin, Jostra

• Centrifugal blood pumps: BioMedicus

• Bard CPS System

• Variety of Oxygenators

• Temperature Regulation Devices - Heater/Coolers:

• Intra-Aortic Balloon Pumps: Datascope, Bard, Arrow

• Ventricular Assist Devices: BioMedicus

• Autotransfusion Machines: Heamonetics, Medtronic

• Blood Saturation Monitors:

• Blood Gas analyzers: I-stat

• Coagulation Monitors: Hemochron, Hemotec

• Hemodynamic Pressure Transducers

• Hemoconcentrators:

• Cardioplegia delivery systems: Sorin, Medtronic

• Accessory Equipment: Blenders, Vaporizers, Sat/Hct monitors, Bubble and level detectors.

• Knowledge requirements to the above equipment; to also include trouble-shooting skills.

• Demonstrates a comprehensive knowledge of all policies and procedures concerning clinical perfusion.

• Provide special perfusion services as described under the guidelines found in the established manual of clinical protocols and procedures of SHC and/or through direct order of the physician.

• Identify the needs of the patient regarding types of equipment, priming solution, and methodology in consultation with the surgeon and anesthesiologist.

• Communicate accurate information to the surgeon and the anesthesiologist pertaining to the patient response to the extracorporeal procedure.

• Provide adequate "Conduct of Perfusion" for each patient undergoing cardiac surgery utilizing the heart-lung machine in accordance with established surgeon and SHC protocols.

• Provides safe performance, monitoring and/or management of perfusion that includes but are not limited to:

• Extracorporeal circulation/ cardiopulmonary support

• Counterpulsation equipment set-up and operation

• Circulatory Support with Ventricular Assist Devices

• Extracorporeal membrane oxygenation

• Autotransfusion and Blood conservation techniques

• Myocardial preservation

• Anticoagulation and Hematologic monitoring/analysis

• Physiologic monitoring/analysis

• Blood gas and blood chemistry monitoring /analysis

• Techniques of Hyperthermia and Hypothermia

• Techniques of Hemodilution

• Techniques of Hemofiltration

• Techniques of Profound Hypothermia and Circulatory Arrest

• Techniques of Retrograde and Antegrade Cerebral Perfusion

• Administration of medication, blood components and anesthetic agents via the extracorporeal circuit

• Techniques of Veno/Venous bypass

• Techniques of Vacuum Assisted Venous Drainage (VAVD) and Kinetic Assisted Venous Drainage (KAVD)

• Maintains aseptic technique in assembling and operating perfusion equipment.

• Follow manufacture operating instructions for equipment and disposables.

• Utilize safety devices when available on equipment.

• Assists in the transport of VAD or high-risk patients to Stanford Hospital.

• Works in a variety of clinical settings where patients require perfusion services e.g. ICU's, Cath lab and operating rooms.

• Records and maintains all data pertinent to extracorporeal procedures to ensure that an adequate record of the procedure is developed.

• Correctly documents patient care and charges utilizing Stanford Hospital and Clinics approved documents.

• Performs other related and incidental duties as needed or assigned.

• Additional Responsibilities

• Level III Perfusionists

• May perform such functions as are consistent with the Level Descriptor narrative, including at least one approved annual project related to supplies and cost savings, education of staff, metrics to improve patient care, protocol development, or department process improvement.

• Level IV Perfusionists

• May assume responsibility for the clinical management of the department during an assigned shift.

• DEPARTMENTAL QUALITY ASSURANCE AND IMPROVEMENT RESPONSIBILITIES

• Completes in a timely manner, hospital required regulatory modules and training requirements.

• Provide necessary documents to maintain current "personnel file". (i.e. ABCP certificate, TB test, CPR certificate, continuing education)

• Provide all documentation as required by Hospital.

• Assist in data collection, data base maintenance and analysis of all Perfusion data related to research, cost analysis, and clinical outcome studies.

• Manages and monitors the provision of quality, cost-effective patient care in accordance with standards of practice and SHC policies and procedures.

• Record and maintain all data pertinent to Perfusion Services management

• Participate in team effort at cost containment of disposable supplies and drugs.

• Perform required inspection of equipment and supplies stored in other areas of hospital.

• Implements and evaluates systems and practices which facilitate smooth workflow and desired outcomes. Solicits input from Department of Anesthesia, Department of Cardiovascular Surgery, managers, and staff. Recommends changes and enhancements to the Perfusion Department Manager.

• Works with Perfusion Director to develop, maintain, and evaluate a comprehensive continuous quality improvement program that complies with Operation Room Region Services and the hospital at large.

• Proactively uses problem solving process to identify, prevent, or resolve clinical or departmental related problems, utilizing the chain of command, as necessary.

• Assist in administration and department operation, including all follow-up documentation and reporting, and reports events to Perfusion Director.

• Responsible for self-assessment of skill level and seeking resources to learn new skills or clinical knowledge to maintain currency in position.

• Apprises self and complies with the policies and procedures of Stanford Hospital and Clinics.

• Continuously assesses and improves personal performance based on "customer" needs; participates in improving performance and services which benefit staff, patients, and other customers

• ADDITIONAL FUNCTIONS AND RESPONSIBILITIES

• Participate in the education of Hospital staff, Nursing staff, and associate Perfusionist as appropriate. Assists with the education and training of Perfusion students as needed.

• Participates in research studies as required.

• Participates in SHS/Departmental Committees and Task Forces as Requested.

• Maintains an effective working relationship with staff, managers, and physicians.

• Contributes in a positive manner to department.

• Demonstrates flexibility in assignment.

• Able to work in a fast-paced environment with individuals of diverse cultural backgrounds.

• NON-CLINICAL RESPONSIBILITIES AND DUTIES

• Cleaning of equipment (heater/coolers, IABP consoles, Heart-Lung Machines, supply carts, Biomedicus pumps).

• Retrieval of supplies assists in stocking, unloading supplies, rotating stock when replacing supplies.

• Assure adequate inventory of supplies, medications, cardioplegia and equipment to meet all anticipated patient needs including emergency procedures

• Participate in general cleaning of pump workroom and associated storage rooms.

• Practice environmental safety such as cleaning up spills and broken glass immediately, closing cupboard doors, picking up trash and dirty linen, etc.

• Arranging equipment in the clinical environment and pump room to avoid fire and safety hazards.

• Attend mandatory in-services as required by hospital.

• Handle equipment safely, carefully, and within biomedical engineering's recommendation.

• Inform biomedical department of needed repairs and maintenance.

• COVERAGE AND ON-CALL RESPONSIBILITIES

• On-Call responsibilities will be designated on the monthly call schedule.

• The On-call Perfusionist is required to respond to any requests for perfusion service throughout the day of On-Call responsibility. On-Call responsibility is for 24 hours and begins at 0600 and ends at 0559 the following morning.

• The On-call Perfusionist is expected to arrive at the hospital within 60 minutes from the time the request for service is made.

• It is the responsibility of the Perfusionist on-call to remain available and inform the OR front desk as to the most efficient method of contact.

Qualifications

• Education, training, and clinical experience in perfusion that meet the requirements of the State of California as stipulated by Business and Professions Code Sections 2590-2596.

• BLS - Basic Life Support

• CCP

Required Knowledge, Skills and Abilities

• Ability to demonstrate proficiency in operating and modifying extracorporeal circulation and cardio-pulmonary support systems and ancillary devices (e.g., blood gas analyzers, autotransfusion devices, etc.).

• Ability to anticipate and respond appropriately to potentially serious situations involving the patient and technical problems that may arise.

• Knowledge of cardiovascular anatomy, physiology, and pathophysiology, and extracorporeal circulation technology, including adjunctive techniques.

• Knowledge of cardiac disease, defects, and congenital anomalies.

• Knowledge of organ preservation, sterile and perfusion supplies, such as extra-corporeal oxygenators, tubing circuits and cannulae.

• Knowledge of pharmacology of blood, fluids and medications administration and interaction with extra-corporeal devices.

• Knowledge of blood components, plasma composition of the human body in association of support by extra-corporeal circuits and devices.

• Knowledge of the following areas in relation to clinical perfusion:

• Anatomy and physiology;

• Pathophysiology;

• Pharmacology

• Applied Sciences (e.g., biochemistry, physics);

• Hematology; and

• Computer technology.

• Ability to fully take part in on-call duties required by the surgery service.

• A high degree of discretion and judgment is essential as Perfusionists often make immediate and independent critical decisions to ensure patient safety.

• Ability to follow orders, take directions, and implement written perfusion protocols.

• Ability to use formula and applied mathematics.

• Ability to learn and apply Joint Commission standards and protocols of general operating room procedures and departmental policies and protocols.

• Meets the requirements for the Perfusionist Level I

• CCP-ABCP: Active certification as a Certified Clinical Perfusionist (CCP) by the American Board of Cardiovascular Perfusion (ABCP)

• Demonstrate competency in ECMO and related support modalities and techniques, has completed ECMO 101.

• Demonstrate competency in basic perfusion techniques for all procedures currently performed at Stanford Health Care

• Demonstrate competency in at least one Mechanical Circulatory Support Devices

• Demonstrate characteristics that promote a healthy team environment

• Works well with other members of the team and represent department in a positive light - as measured by CI CARE, any complaints resolved

• Be in good standing with surgery and anesthesia (MDs approve of promotion, any complaints resolved)

• Level III Perfusionist shall

• Demonstrate competency in all perfusion techniques for all procedures currently performed at Stanford Health Care

• Demonstrate competency in all Mechanical Circulatory Support Devices

• Actively precept and mentor in a positive fashion (able to receive negative and positive feedback from students, new hires, and all other staff)

• Be approachable in demeanor to facilitate relevant discussion

• Able and willing to take direction from Director of Perfusion

• Able to accept feedback and criticism from other members of team, Director of Perfusion, and MD's, with positive outcome

• Demonstrate ability to transfer knowledge and foster a positive learning environment for Level I and II Perfusionists, as well as visiting students

• Must be clinically competent and independent with ability to be productive and work smart with little to no direction

These principles apply to ALL employees:

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford's patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family's perspective:

• Know Me: Anticipate my needs and status to deliver effective care

• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health

• Coordinate for Me: Own the complexity of my care through coordination

#LI-BS1

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale: Generally starting at $100.40 - $113.07 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.

At Stanford Health Care, we seek to provide patients with the very best in diagnosis and treatment, with outstanding quality, compassion and coordination. With an unmatched track record of scientific discovery, technological innovation and translational medicine, Stanford Medicine physicians are pioneering leading edge therapies today that will change the way health care is delivered tomorrow.

As part of our spirit of discovery, we also leverage our deep relationships with luminary Silicon Valley companies to develop new ways to deliver preeminent patient care.

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