GENERAL SUMMARY/ OVERVIEW STATEMENT:
• Collaborates effectively and provides effective communication with members of the healthcare delivery team.
• Follows an assigned work schedule that meets patient care needs in areas of responsibility
• Responsible for conducting extracorporeal circulation and ensuring the safe management of cardiopulmonary function during any medical procedure where it is necessary to support the patient's cardiopulmonary function. Provides continuous monitoring of the necessary physiologic variables during cardiopulmonary bypass, ventricular assist support, and other mechanical circulatory support procedures. Performs moderate complexity point of care (POC) testing for Activated Clotting Time (ACT)/Circulating Heparin concentration and Blood Gas analysis.
• Responsible for participation in intra-operative red blood cell salvage/platelet rich plasma sequestration program, when applicable.
• Responsible participation in intra-operative heated chemotherapy programs, when applicable.
• Reviews training and/or educational materials at regular intervals to maintain a competent working knowledge of procedures and technologies .
• Attends training and completes competencies, training requirements, regulatory requirements and credentialing with regard to technologies and programs that require such documentation: Massachusetts licensure, ABCP board certification, point of care blood gas and anticoagulation testing, mechanical circulatory support, cell salvage, heated chemotherapy, isolated organ preservation, and others.
• Participates in a program of maintenance, cleaning and calibration of equipment in areas of responsibility
• Evaluates new and existing products and technologies. Implements the use of new or existing products on the prescription of an ordering physician.
• Fully completes electronic and written medical record documentation
• Attests to perfusion time-card through electronic or written payroll program(s)..
PRINCIPAL DUTIES AND RESPONSIBILITIES:
The chief, lead and staff perfusionists will perform duties and responsibilities as defined by the current year's Massachusetts perfusion licensure description of scope of practice:
(1) A fully licensed perfusionist may perform those functions and services which are necessary for the support, treatment, measurement or supplementation of a patient's cardiovascular,circulatory or respiratory systems or other organs, or any combination of those organs orsystems; or which ensure the safe management of that patient's physiological functions through the monitoring and analysis of those bodily systems.
(2) The functions and services which may properly be performed by a fully licensed
perfusionist include, but are not necessarily limited to, the following:
(a) use of extracorporeal circulation and associated therapeutic and/or diagnostic
(b) use of long-term cardiopulmonary support techniques, including extracorporeal carbon
dioxide removal and extracorporeal membrane oxygenation and associated therapeutic
and/or diagnostic technologies;
(c) use or performance of counterpulsation;
(d) use or performance of ventricular assistance;
(e) use or performance of autotransfusion;
(f) use or performance of blood conservation techniques;
(g) use or performance of myocardial preservation and/or organ preservation techniques in
connection with the performance of procedures involving cardiopulmonary bypass;
(h) use or performance of extracorporeal life support services or techniques;
(i) use or performance of isolated limb perfusion services;
(j) use or performance of techniques involving blood management, advanced life support
and other related functions;
(k) administration of pharmacological and therapeutic agents through the extracorporeal
circuit or through an intravenous line pursuant to an order from a duly licensed physician;
(l) administration of anesthetic agents through the extracorporeal circuit or through an
intravenous line pursuant to an order from, and under the direct supervision of an
(m) use or performance of physiologic monitoring;
(n) use or performance of central hypothermia or hyperthermia;
(o) use or performance of hemoconcentration, hemodilution or hemofiltration;
(p) performance of anticoagulation monitoring;
(q) peformance of blood gas and blood chemistry monitoring and/or analysis;
(r) performance of hematologic monitoring and/or analysis; and
(s) the observation of signs and symptoms related to perfusion services, the determination
of whether such signs or symptoms exhibit abnormal characteristics, and the implementation
of appropriate reporting of the same;
(t) the implementation of perfusion protocols, initiation of emergency procedures or
implementation of changes in such emergency procedures in connection with any of the
functions or services described in 267 CMR 4.01(2)(a) through (j); and
(u) participation in clinical research protocols.
(3) All functions and services performed by a fully licensed perfusionist shall be performed
pursuant to the orders of, and under the supervision of, a physician who is duly licensed to
practice medicine in the Commonwealth of Massachusetts by the Massachusetts Board of
Registration in Medicine.
(4) In lieu of a patient-specific order from a licensed physician, a fully licensed perfusionist
may perform any or all of the functions and services enumerated in 267 CMR 4.01(1) or 267
CMR 4.01(2) pursuant to a written perfusion protocol which has been adopted or approved by
the health care facility in which that licensed perfusionist performs perfusion functions or
services, as long as:
(a) The protocol has been developed by a fully licensed perfusionist, a physician licensed to practice medicine in the Commonwealth of Massachusetts by the Massachusetts Board of Registration in Medicine who is actively engaged in the practice of cardiovascular surgery, and an anesthesiologist, a licensed physician, who is actively engaged in the practice of cardiovascular anesthesia;
(b) The protocol adequately addresses the conditions and circumstances under which
licensed perfusionists may perform the particular perfusion function(s) or service(s) covered by the protocol, and the manner in which such functions or services will be performed;
(c) The protocol is reviewed and updated annually; and
(d) The protocol is made available to the Board for review immediately upon request from any duly authorized representative of the Board.
(5) A fully-licensed perfusionist may implement perfusion protocols, make changes in such protocols, and/or institute emergency procedures, based upon his or her observations and analysis of signs and symptoms related to the implementation of perfusion services.
4.02: Scope of Practice for Provisionally Licensed Perfusionists an individual who holds a provisional license to practice perfusion issued by the Board pursuant to 267 CMR 3.06 may perform any or all of the functions and/or services enumerated in 267 CMR 4.01, as long as:
(1) He or she performs all such functions and/or services in accordance with all applicable requirements of 267 CMR 4.01; and
(2) He or she performs all such functions and/or services under the supervision and direction of a perfusionist who holds a full license to practice perfusion issued by the Board and who provides the level of supervision required by 267 CMR 3.06(7).
Must hold a bachelor's degree or higher in chemical, physical, or biological science or medical laboratory technology from an accredited college or university.
Must be certified and be in good standing with the American Board of Cardiovascular Perfusion.
Must hold a license to practice perfusion, in good standing, in the Commonwealth of Massachusetts
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
A comprehensive understanding of perfusion equipment and operation normally acquired in two years of training.
Good judgment enhanced by sound analytic abilities to enable quick assessments with immediate reaction to make changes for unexpected situations.
Sound knowledge of clinical physiology necessary to conduct the best possible perfusion for any given patient.
Ability to act independently in the operation of the equipment. Ability to work in crisis situations when preparation time is a factor in successful treatment. Requires one to three months' break-in time to become familiar with the hospital's equipment and procedures.
Ability to work smoothly, efficiently, and enthusiastically as a member of a close functioning team which acts as one unit. Must be able to interact effectively with the medical staff, nursing staff, and various other departments throughout the hospital.
Work involves considerable mental concentration during bypass when constant attention must be paid to monitoring signals and machine function. Moderate physical abilities may be required during routine and emergent cases.
Cardiac Perfusionist, Age Related Competencies
In the conduct of adolescent, young adult, adult, senior adult, and geriatric cardiopulmonary bypass (CPB) there are no age specific competencies. Based upon a thorough review of perfusion practices, there are no age specific clinical imperatives nor are there any therapeutic modalities or management schemes warranted in the conduct of CPB. Although the incidence of certain disease processes (pathologies) is more prevalent in the aging populating, the conduct of CPB is altered in no age specific way.
Works in an environment where exposure to blood and blood products is present. Must take proper precautions, including the proper use of personal protective equipment, handling and disposing of perfusion equipment.
Work includes administering hazardous drugs, inhalation anesthetics, and chemotherapeudic agents. Perfusionists must take proper steps, donning personal protective gear and scavenging anesthetic waste gas.
Exposure to colder than normal temperature in operating room.
Exposure to some noise from equipment motors, and other devices in the operating room.
Some lifting and moving of heavy equipment is required.
On call responsibility requires working alone evening, night, and weekend hours with limited or lack of backup for breaks.
Because of the consequence of error and mental and visual involved, constant stress is experienced.
The staff perfusionist has no supervisory role.
HOSPITAL WIDE RESPONSIBILITIES:
Works within legal, regulatory, accreditation and ethical practice standards relevant to the position and as established by BWH/Partners; follows safe practices required for the position; complies with appropriate BWH and Partners policies and procedures; fulfills any training required by BWH and/or Partners, as appropriate; brings potential matters of non-compliance to the attention of the supervisor or other appropriate hospital staff.
Brigham and Women's Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, national origin, sexual orientation, protected veteran status, or on the basis of disability.