To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
The Neuromonitoring Specialist is responsible for setting up, performing, troubleshooting and disconnecting all modalities of neuromonitoring in critically ill patients with neurosurgical, neurovascular and neurological disease. The procedure and monitoring set up includes, but is not limited to: scalp EEG, transcranial motor evoked potentials, transcranial Doppler studies (TCDs), Near Infrared Spectroscopy (NIRS), physiologic neuro-multimodal monitoring such as MOBERG including invasive multimodality monitoring (CBF, Licox, ICP, depth EEG, microdialysis). The NMS provides adequate monitoring with proficiency in troubleshooting technical problems, and keeps the neurointensivists and neurophysiologists informed of any issues relating to data streaming, processing and review. This position requires a high level of interpersonal skills interacting effectively with physicians, care team members (nurses, advanced practice providers) and other technical personnel. The NMS will also perform duties outside of direct neuromonitoring including assistance with equipment maintenance and supply inventory.
Responsibilities: 1. Clinical Applications:
a)Participates in daily rounds with care team on neuro critically ill patients requiring neuromonitoring to facilitate and perform appropriate neuromonitoring testing procedures as ordered.
b)Performs, facilitates and/or supports the acquisition of data from the following procedures and monitors in conjunction with licensed personnel as appropriate in the Neuro-Intensive Care Unit: Transcranial Doppler studies (TCDs), Near Infrared Spectroscopy (NIRS), real-time integrated neuromonitoring (MOBERG), and invasive multimodality monitoring including; Cerebral Blood Flow (CBF) measurement, Brain Tissue Oxygenation Monitoring (Licox), Intracranial Pressure (ICP), depth EEG, and microdialysis.
c)Performs evoked potentials of all modalities including motor evoked potentials in the critically ill population including: transcranial motor evoked potentials (tMEP), Somatosensory Evoked Potentials (SSEP), Brainstem Auditory Evoked Potentials (BAEP), Visual Evoked Potentials (VEP), and Cortico-Cortical Evoked Potentials (CCEPs).
d)Documents sedation used, dosage, and effects (if applicable) in appropriate neurodiagnostic systems, technical notes and annotations.
e)Reports critical test results and clinically significant events to the interpreting physician and documents this communication according to departmental policy and procedures.*
f)The NMS is responsible for discontinuance of neurodiagnostic monitoring per orders including removal of electrode paste/collodion/adhesive from the patient's scalp and hair.
h)Performs procedures according to national American Clinical Neurophysiology Society (ACNS) guidelines and other national standards as appropriate.
*Critical test results: any values/interpretations where delays in reporting may result in serious adverse outcomes for patients. MA Coalition for Prevention of Medical Errors; www.macoalition.org/document/CTRPractices.pdf 2. Analysis:
a)Responsible for differentiating physiologic and non-physiologic artifact from cerebral activity, recognizing possible artifactual waveforms, documenting (on the recording) patient movements, replacing electrodes and monitors exhibiting questionable activity and troubleshooting for possible electrical interference.
b)Independently and in conjunction with CE/CIT and vendor technical support provides timely and accurate documentation and troubleshooting of equipment and software malfunctions.
c)Responsible for review and analysis of data generated from multimodal monitoring including but not limited to aforementioned procedures. Examples include simultaneous co-registration of a variety of data sets such as EEG and NIRS signals. 3. Operational Throughput:
a)Develops competencies in neuromonitoring modalities, procedures and protocols unique to Yale New Haven Health.
b)Generates monthly statistical reports based on database queries and EMR data abstraction.
c)Develops proficiencies with new equipment, supplies, and technology for effectiveness of care.
d)Develops monthly par levels and ensures adequate levels of disposable and reusable neuromonitoring supplies are maintained.
1.Graduation from a Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredited Neurodiagnostic Technology (NDT) Program accredited college or university institution preferred.
2.A bachelors degree in degree or equivalent experience in scientific discipline related to the biological sciences. Education to include course work in anatomy and physiology; preferably specialized in neuroanatomy and neurophysiology.
Minimum of 2 years of experience in performing neurodiagnostic procedures.
1.Must hold one of the following credentials in the neurodiagnostic services provided, which can include but are not limited to: REEG T*, REPT*, CLTM*, CNIM*, RNCST**, RPSGT***
2.Current BLS certification.
*The REEGT, REPT, CLTM, and CNIM credentials are granted by ABRET Neurodiagnostic Credentialing and Accreditation (ABRET). www.abret.org
**The RNCST credential is granted by AAET The Nerve Conduction Association (AAET). The R.NCS.T. credential has replaced the R. ED T. credential. www.aaet.info
***The RPGST credential is granted by the Board of Registered Polysomnographic Technologists (BRPT). www.brpt.org
Proficiency with use of databases, neurodiagnostic systems (Natus, Moberg, and Synergy a plus), general computer skills; including but not limited to software, hardware and networking. Competent in hospital EMR and Cloud Suite systems such as Epic and Infor. Demonstrates outstanding organizational ability to manage multiple tasks in a timely manner. Requires excellent communication skills to clearly and concisely communicate verbally and in writing with peers, superiors physicians and ancillary departments. Requires the ability to adapt to urgent deadlines or rapidly changing priorities and maintain composure in high stress situations at all times. Demonstrates sound judgement with complex decision making and critical thinking. Requires excellent interpersonal skills in dealing with coworkers, management, and other Health System and Hospital employees and patients.
Accountable for producing recordings, studies and data of exceptional quality in accordance with national guidelines and accepted medical standards. Provides day to day throughput in the neuromonitoring space and provides input regarding future needs. Develops and refines procedures under the supervision of administrative and clinical leadership. Reports equipment issues to IT liaison in a timely fashion. Accountable for adhering to departmental budget with respect to supply cost and utilization.
Ensures personal adherence to Yale New Haven Health Standards of Professional. Ensures patient and staff safety, regulatory readiness and compliance in accordance with OSHA, TJC, and DPH requirements.
In personal and job related decisions and actions, consistently demonstrates the values of integrity (doing the right thing), patient-centered (putting patients and families first), respect (valuing all people and embracing all differences), accountability (being responsible and taking actions), and compassion (being empathetic).
Works effectively with complex neuromonitoring devices and computerized neurodiagnostic equipment. Modifies standard recording technique as necessary to achieve optimal examination results. Renders preliminary technical descriptions of EEGs and other studies. Assists with various other neuromonitoring procedures as needed. Exercises autonomy in performance of operational duties and makes recommendations regarding process improvements.
3.Reaching including above/below shoulder height
5.Pulling and pushing > 50 pounds
6.Carrying or pushing 7.Frequent bending /stooping/crouching/twisting and continuous repetitive movements
Lighting bright and dim, mechanical hazards, hazardous substances, infectious diseases, ionizing/non-ionizing radiation and toleration of temperature ranges 60 to 75 degrees F.