UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Job Description
Performance Evaluation
Period Covered by this Performance Evaluation: _____________ TO ______________
Unlicensed Clinical Positions
Employee Name:
Department/Unit:
Current Title:
Current Title Code:
CLINICAL CARE
PARTNER/Career 8883/Per Diem
8884
Supervisor Name:
Supervisor Title:
Approved Title (for reclassifications only):
Methods of Measurement Include the Following:
Direct Observation
Feedback from staff or patients
Documentation
PI Reports
Approved Title Code (for
reclassifications only):
AGES SERVED
Neonates (< 30 days)
Infants (> 30 days and < 1 year)
Pediatrics (> = 1 year & < 13 years)
Adolescents (> = 13 years & 18 years)
Adults (> = 18 years to < 65 years)
Geriatrics (> = 65 years)
Not Applicable
Place an “X” if over 20% of work is exposed to one or more of the following conditions:
Confined area
Exposed to weather
COMPETENCIES:
INITIAL:
Noise Exposure
Vibrations
UCLA Healthcare Dept. Specific Orientation
Extreme temperatures
Atmospheric conditions
Potential allergenic/irritant conditions
Other (specify)
Department of Nursing/Job Specific
SUMMARY STATEMENT:
Clinical Care Partners deliver patient care under the direct supervision of registered nurses. Performs basic patient care skills, follows infection control practices,
positions, transfers and transports patients, takes vital signs, collects specimens, accurately observes, reports and charts, performs range of motion and assists
with feedings, self-care and elimination needs.
TYPE OF SUPERVISION RECEIVED:
Under the direction of the Unit Director/Clinical Nurse Manager and/or designee.
D - Does Not Meet Expectations
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Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Duties and Tasks
I.
Rating
D
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Comments
CUSTOMER RELATIONS
Demonstrate positive interpersonal Skills and caring behaviors in working
with patients, significant others, and members of patient care team.
1.
2.
3.
4.
5.
6.
7.
8.
Facilitate a calm, orderly, professional and quiet environment
Coordinate flows of communication between appropriate staff
Answer patient call lights in a courteous and timely manner, as
appropriate
Respect customer/staff individuality
Consistently model exceptional interpersonal skills and caring behavior in
working with patients, significant others and members of patient care team
Introduce self as Clinical Care Partner
Effectively respond to the unique needs of neonatal, pediatric, adolescent,
adult, and/or geriatric patients as needs arise
Assist with directing flow of visitors to the Unit
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D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Duties and Tasks
II.
Rating
D
M
Comments
PATIENT CARE DUTIES
Assist patients with admitting procedure:
1.
Set up room for admission and transfers in
2.
Orient patient to environment and routine of unit
3.
Take care for patient’s personal property, label and store personal items
4.
label door, urinals, bedpans, measuring devices, water pitchers, and all
patient equipment
5.
Report observations and pertinent information to assigned RN regarding
patient’s condition immediately
Assist patients during transfer procedure/discharge:
1.
Prepare and assist with the collection and transfer of personal items and
equipment
2.
Accompany patient during transport/discharge as needed
3.
Replace bed and bedside tables as needed
Provide for patients’ personal hygiene:
1.
Provide A.M. and P.M. care on a routine basis
2.
Provide oral hygiene and denture care
3.
Provide skin care as directed
4.
provide hair care and shampoo as needed
5.
Provide perineal care/incontinent care
6.
Provide Indwelling catheter care
7.
Assist with shaving of male patients
8.
Check patient’s ID band every shift
9.
Report Patient Observations and pertinent information to assigned staff
nurse
10. Report problems or changes in patient’s condition immediately
11. Assist ambulatory patients to bathroom; assist with bedpans, urinals and
commodes
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D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Duties and Tasks
Rating
D
M
Comments
Assist patients with meals and nourishment:
1.
Assist and feed patients as needed
2.
Observe aspiration precautions for all patients
3.
Assist with completing menu and place in designated area as necessary
4.
Deliver and collect trays as necessary
5.
Document food intake for calorie count as ordered
Assist patients with meals and nourishment:
1.
Assist and feed patients as needed
2.
Fill humidifier bottles when not attached to patient
3.
Suction oral cavity as directed/needed
4.
Assist patient with incentive spirometer
5.
Perform CP (chest percussion) as directed
6.
Assist patients in coughing, deep breathing and position changes as
directed
Assist in providing patient safety and comfort measures:
1.
Follow standard precautions for all patients
2.
maintain and reinforce isolation policy
3.
Implement and maintain heel protectors, special mattress/bed and other
pressure reduction devices as directed
4.
Apply and monitor restraints as directed per hospital protocol
5.
Maintain individual patient safety, e.g., side rails up, brakes locked and call
bells within reach, and initiate fall precautions as directed
6.
Respond to/report alarms immediately to RN
7.
Provide care to patients who are at risk of harming self and others per
departmental/hospital policy
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D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Duties and Tasks
Rating
D
M
Comments
Maintain a clean and orderly environment:
1.
Change bed linen on a routine basis and as needed
2.
Assist in tidying patients’ rooms and personal effects
3.
Keep bedside supply trays stocked per unit protocol (except for NPH)
4.
Maintain cleanliness of patient’s special equipment
5.
Remove unused equipment and/or supplies from room and place in
designated area for pick-up or storage
6.
Routinely check each patient’s bedside to ensure that call bell, light and
room clock are accessible and functioning
7.
Assist in the identification of environmental (i.e. frayed cords, spills, wet
floors, etc.) hazards and report to appropriate personnel
8.
Keep corridors uncluttered
- Remove or arrange for removal of unnecessary equipment
- Maintain neatness of linen rooms
- Empty linen hampers as appropriate and keep all linen off the floor
9.
Maintain refrigerator logs as directed
10. Perform/assist with ER cart and defibrillator checks as directed
11. Maintain unit based equipment as directed
Perform and record vital patient information:
1.
Take and record height and weight, intake and output, temperature, pulse,
respiration, blood pressure, pain and/or pulse oximetry as directed
2.
Complete required documentation on flow sheets per unit protocol
3.
Perform EKG as directed
4.
Perform the role of a Monitor Tech as directed (except for NPH)
5.
Set up and maintain monitoring equipment (except for NPH)
6.
Empty drainage bags (Indwelling, Jackson-Pratt, and Hemovac)
7.
Provide population specific/unit protocols care
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D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Duties and Tasks
Rating
D
M
Comments
Assist with pre-operative/post-operative/special procedures as directed:
1.
Provide pre-op scrubs and preps as directed
2.
Assist in removing or taping of jewelry, removal of dentures or other
articles (wigs, glasses, etc.)
3.
Label patient’s belongings with patient’s name and ID, secure and
store all belongings
4.
Prepare beds for post-operative/procedural patients
5.
Assist with non-sterile dressing changes and wound care
Assist patients with activity and mobility:
1.
Assist patient in position changes, dangling and ambulation
2.
Assist patient in and out of bed
3.
Assist in the application and removal of anti-embolic and pulsatile
stockings, as directed
4.
Assist with PT/OT Care such as:
- Range of motion
- Transfers
- Endurance activities
- Application of splints, prosthetics and orthotic support devices
- Feeding for dysphagia patients
- ADL practice/training for home care
Perform special procedures as directed:
1.
Sitz bath
2.
Breast care
3.
Perineal care
4.
Provide Seizure precautions as directed
5.
Provide patient observation as assigned
6.
Collect all specimens as directed
D - Does Not Meet Expectations
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D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Duties and Tasks
Rating
D
M
Comments
Assist with post-mortem care:
1.
Assist with care and labeling of body according to policy
2.
Assist with packing, labeling and transferring of belongings
III.
ADDITIONAL PATIENT CARE DUTIES
1.
2.
3.
4.
5.
Perform start of shift and end of shift fresh drinking water service to all
patients unless contraindicated by dietary restrictions
Perform DASH Monitor setup routinely and also in emergencies
Perform daily refrigerator temperature log checks as assigned
Perform medication, lab, or blood product retrieval from the Pneumatic
tube station while practicing universal precautions and in compliance
with OSHA guidelines
Provide patient and family individualized escort service to assigned
room and perform initial room orientation including call bell usage,
television overview, bathroom location, electronic bed rail functions,
and identification of assigned Registered Nurse name
IV.
MISCELLANEOUS DUTIES
Assist with duties as assigned by the charge nurse/shift coordinator:
1.
Assist with checking and stocking cart supplies and assist with
charging of patient charge items
2.
Assist in tracking and inventory of equipment
3.
Participate in Nursing Department committees or projects and
communicate outcomes to staff and Unit Director/Clinical Nurse
Manager
4.
Pick up and deliver supplies as directed
V.
TRAINING
Demonstrate a willingness to assist other members of the team while
maintaining performance of individual duties
1. Assist in orienting new personnel
2. Participate in work-related continuing education and communication
activities
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Page 7
D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Duties and Tasks
Rating
D
M
Comments
VI. PROFESSIONAL AND INSTITUTIONAL STANDARDS (CCP specific)
1.
2.
3.
4.
5.
6.
7.
8.
9.
Observe institutional/unit standards and requirements regarding work
schedule commitments
Report to charge nurse/shift coordinator, giving destination when
leaving unit for any period of time
Give report to the oncoming personnel at shift’s end as directed
Adhere to Unit Interpersonal Standards as applicable
Adhere to department Attendance Standards including hours of work
Support that telephone and computer usage is for patient care
business only
Seek and accept guidance from Unit Director/Clinical Nurse Manager
or appropriate person to accomplish job duties
Participate in work-related meetings and/or represent unit on task
forces/committees/projects as requested
Accept delegated duties from Unit Director/Clinical Nurse Manager
and/or appropriate personnel as requested
D - Does Not Meet Expectations
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Page 8
D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Duties and Tasks
Rating
D
M
Comments
VII. UCLA C-I-CARE/Patient Experience Practices: MY COMMITMENT TO CARE
 Observe and practices all the Service Standards listed in the “World Class
Practices” (which I have read and signed)
o Practice C-I-CARE when interacting with patients, their families, visitors
or internal customers
o Connect with the patient and family members by addressing them as
Mr./Mrs., or by the name that they prefer
o Introduce yourself and your role
o Communicate what you are going to do, how long it is going to take, and
how it will impact the patient
o Ask and anticipate and/or family needs, questions or concerns
o Respond to patient and/or family questions and requests with immediacy
o Exit courteously and/or with an explanation of what will come next (or
when you will be back to check on them)
o Practice C-I-CARE phone etiquette during all phone interactions
 Always exercise courtesy whenever patients, family members, visitors and
co-workers are present
o Respect privacy and dignity of our patients, family members, visitors and
co-workers
o Maintain professionalism in the presence of patients, their families,
visitors and co-workers
 Observe departmental Patient Experience plan, competencies and practices
o Act as a role model, verbally and behaviorally demonstrating skill,
enthusiasm, positive problem solving, commitment and loyalty to the
profession and the organization
o Participate in positive problem solving by providing suggestions and
possible solutions to identified concerns/problems in the work place
 Comply with Health System Workplace Conduct Policy
o Engaging in disruptive behaviors that interfere with or prevent
normal work functions or compromise patient safety, including
passive or active behaviors will not be tolerated as stated in the HS
Workplace Conduct Policy
 Comply with Health System Dress Code Policy and practices
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Page 9
D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Duties and Tasks
Rating
D
M
Comments
VIII. INSTITUTIONAL AND/OR PROFESSIONAL STANDARDS







Comply with HIPPA and Confidentiality Policies and procedures as they
apply to the job
Comply with Department f Public Health (DPH), The Joint Commission and
other accreditation and regulatory agencies standards
Adhere to all Hospital Policies and Procedures
Knowledge and adherence to Infection Control and Environment of Care
Guidelines and Procedures as described in the annual education module
Demonstrate adherence to the requirements for using the electronic
medical record
Demonstrates understanding of institutional and department specific
emergency management procedures/responsibilities to maintain personal,
patient, and co-worker safety, maintains competencies in these areas, and
participates in disaster/emergency related exercises and education.
Demonstrates understanding of institutional and department specific safe
patient handling procedures/responsibilities and maintain a level of
competency on the proper use of departmental lift equipment to ensure
personal, co-worker and patient safety
VIIII. PERFORMANCE IMPROVEMENT
 Adhere to current organizational Performance Improvement priorities
 Participate in quality studies through data collection and dashboard data
collection
 Make recommendations and take actions to improve structure, system or
outcomes
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Page 10
D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Duties and Tasks
Rating
D
M
Comments
CLINICAL CARE PARTNER: PSYCHIATRIC ADDENDUM
Patient Care Duties:
1. Perform systematic inventory of patient’s belongings in the patient’s
presence:
 Remove sharps, mirrors, glass, weapons, and medications, secures
them and inform the admitting RN
 Identify valuables and inform admitting RN
 Complete personal belongings form, sign and give to admitting RN
2. When patient’s behavior becomes disruptive, provide initial interventions and
inform RN
3. Assist patients with meals and nourishment:
4. conduct patient rounds per shift/unit procedure and ensure patient safety
5. Assist with management of the milieu ensure a therapeutic environment
 Utilize therapeutic communication techniques according to population
specific/unit protocols.
 Individualize specific verbal/non-verbal interactions to patient and
situation.
 Monitor patient behavior and reports changes to RN.
 Manage physically and verbally aggressive patient using least restrictive
measures.
 Ensure patient status is maintained per departmental policy and
procedure, e.g. Suicidal Observation, Constant Observation, Constant
Eyesight
 Participate in meaningful activities with patients to meet their
diversionary needs.
 Observe and report to RN the patient’s response following individual and
group activities.
6. Function as group activity leader as directed by RN
7. Provide one to one care as directed by RN for patient safety and/or
therapeutic intervention
8. Accompany and remain with patient for clinic appointments, clinical
Laboratory, radiology tests and school
9. Assist with Pre and Post ECT patients care as directed by the RN
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D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Skills, Knowledge and Abilities
(Disregard this section for performance evaluations)
REQUIREMENTS:
List any equipment (machines, tools, office appliances or motor vehicles) required to do the job, with or without a reasonable
accommodation. Indicate whether use is seldom, occasional, frequent, or constant.
CPR:
License:
Certifications:
CNA or other as listed
under SKA #1
See Nursing Policy and Procedure Equipment Manual.
Degree:
Experience:
D - Does Not Meet Expectations
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Page 12
D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
Skills, Knowledge and Abilities
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Current California Certification of Nursing Assistant OR current enrollment in a state approved nursing school
program, with a minimum of one completed med/surg rotation
Foreign trained RN considered. CNA certification would be required within 12 months
Graduate from an approved nursing program; CNA certification is required within one year of an appointment as a
CCP
Knowledge of basic computer fundamentals preferred
Ability to speak clearly and distinctly using appropriate English vocabulary and grammar
Ability to understand oral and written directives
Ability to read and write Standard English text
Ability to perform basic arithmetic computations (add, subtract, multiply, and divide)
Demonstrates an understanding of basic medical terminology and abbreviations
Ability to organize and prioritize work to complete assignments in a timely manner
CCP
Importance:
Required or Preferred
Required
Required
Required
Required
Required
Required
Required
Required
Required
Required
For Neuropsychiatric Hospital, refer to Psychiatric Addendum
If overall rating is “Does Not Meet Expectations”, please complete Future Plans and Actions Section.
According to the Employee Performance Evaluation Policy, an overall rating of “Does Not Meet Expectations” requires an action plan and a follow-up
performance evaluation in either a three-month or six-month period depending on the time needed to demonstrate improved performance. Action plan
steps must be objective and measurable with a defined time frame. The date of the follow-up performance evaluation will reset the performance
evaluation due date.
Does Not Meet Expectations
Meets Expectations
Comments:
Future Plans and Actions:
D - Does Not Meet Expectations
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Page 13
D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria
UCLA Health System
JOB DESCRIPTION/PERFORMANCE EVALUATION
CCP
Accomplishments / Contributions:
Employee Comments:
To update our files, please answer the following questions:
Have you received a higher education degree in past 12 months:
Yes ______No______
If Yes, in what field:_______________________________________
Type:_____________
Have you received a national certification in the past 12 months:
Yes ______No______
If yes, please list and bring a copy of certificate to Nursing Resources:__________________
Employee Signature
I have reviewed this Job Description and/or Performance Evaluation
Date
Evaluator Signature
Date
Department Head or Designee Signature
Date
D - Does Not Meet Expectations
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Page 14
D:\533575102.doc
Revised 3/04, 05/08, 04/13
Directions: You have the option of checking the large boxes next to the headings or of checking the small boxes to indicate performance for each
criteria