PURPOSE OF REVIEW                                            PERFORMANCE RATING KEY

                                               

q       Probationary Review                                            Exceeds expectations                        E

q       Other (explain)                                                     Meets expectations                            M

______________________                                        Areas for improvement                      I

                                                                                       Not applicable                                  NA

 

 

ESSENTIAL FUNCTIONS:

1.       Maintains confidentiality of all patient information.

q       Communication patient’s information only with individuals directly involved in the patient care.

q       Discuss patient’s personal information only in an appropriate place at an appropriate time.

q       Carries out decisions and action in an ethical manner that ensures human autonomy, dignity, and rights.

q       Provides peers with constructive comments in a confidential manner that protects and enhances working relationships.

q       Responds to constructive comments from peers and supervisors in a positive manner, respecting their desire for confidentiality.

Comments:

 

 

Rating: _____

 

2.       Maintains self, ambulance, equipment and supplies in a prepared state to respond to all emergencies.

q       Responds to calls in appropriate time, manner, uniform, ready to work.

q       Performs vehicle checkouts completely and timely.

q       Reports any malfunctioning equipment to supervisor or replaces/repairs appropriate items as needed.

q       Restocks ambulance after calls and completes necessary clean up of cot, vehicle and equipment.

Comments:

 

 

Rating: _____  

 

3.       Communication effectively with patients, members, and the public.

q       Explains procedures completely and understandably to each patient and their family answer their questions and concerns effectively.

q       Communicates from the field with medical Control and other EMS agencies when appropriate. Contacts Wright County when 10-8, 10-76, 10-23, 10-24. Contacts Medical control with requests for advanced procedures and to give patient report.

q       Provides and accepts constructive criticism in a positive manner.

q       Can effectively present to the public, the function of the department as part of the EMS System.

q       Acts as an informal role model for First responders and EMT-basic students during their ride time.

Comments:

 

 

Rating: _____

 

4.             Operates ambulance and equipment in a safe and efficient manner.

q       Observes posted speed limits and traffic control devices, uses seat belt at all times.

q       Follows departmental policy regarding driving speed while on emergency dispatches.

q       Uses back-up alarm and emergency lights and sirens when appropriate.

q       Demonstrates proficiency in proper disposal of sharps.

q       Takes proper precautions when dealing with hazardous environments as they pertain to the vehicle and it is integrity.

Comments:

 

 

Rating: _____

 

5.       Performs patient assessment.

q       Performs appropriate and thorough patient assessment including triage in multiple patient situations.

q       Performs a complete physical examination based on chief of present illness, physical findings, pertinent negatives, and environment, past medical history, and signs and symptoms.

Comments:

 

 

Rating: _____

 

6.       Applies knowledge and skills of emergency pre-hospital care and treatment, including personal safety, utilization of additional resources as needed, provides appropriate level of care for situation and provides adequate transportation of each patient.

q       Utilizes appropriate safeguards when confronted with possible hazardous situations, does not rush in without due concern for self and member’s. Takes appropriate measures to provide for scene safety.

q       Dispatches the aid of EGPD and EGFD or other EMS agencies when needed to control of situation.

q       Initiates BLS and ALS procedures at appropriate time utilizing good judgement for prioritization of care.

q       Choose correct route and speed of travel for specific situations.

Comments:

 

 

Rating: _____

 

7.       Meets all physical activity and visual acuity requirements as specified by the job description.

q       Incurred no work-related injuries or illnesses due to poor/inadequate physical condition.

q       Utilizes adequate sleeping patterns so as not to experience undue fatigue during alarm calls.

Comments:

 

 

Rating: _____

 

8.       Routinely displays properties associated with acceptable patterns for behavior and interpersonal relationships.

q       Have no disciplinary actions beyond a verbal counseling.

q       Has no complaints concerning a consistently visibly poor attitude, is tactful and diplomatic.

q       Is receptive to change and helps to implement change in a cooperative manner.

Comments:

 

 

Rating: _____

 

9.       Assists with Community EMS Education and promotes a positive image to the public.

Comments:

 

 

Rating: _____

 

10.   Adapts well, emotional and intellectually, to change situations as they arise in various work areas.

q       Manages stressful situations appropriately when dealing with life threatening patient conditions, or while in potentially hazardous environments.

q       Performs a variety of duties with no loss of efficiency or quality of work.

q       Maintains constant mental alertness and is able to prioritize duties for effective time management.

q       Displays proficiency in calculating drug dosages, administering medications via all acceptable routes, and initiating and maintaining medicated intravenous infusions without having medication errors occur and reports filed for the period of this appraisal.

q       Utilizes acceptable techniques for initiating intravenous infusions and develops proficiency in same as shown by successful completion of skills maintenance program minimums.

q       Maintains a patient airway utilizing oral/nasal airways, combi-tube, edotracheal tubes, suctioning devices, and oxygen administration equipment.

q       Recognizes various life threatening dysrhythmias and treats appropriately according to protocols procedures.

q       Utilizes appropriate cleaning measures and dressing for various soft tissue injuries.

q       Takes a leadership role when confronted with multiple patients in performing triage and prioritizing care and transport of injured persons.

q       Display adequate knowledge of our service area, knows how to initiate a mutual aid response and understands common practices when tiering with outside agencies to provide advanced pre-hospital care.

Comments:

 

 

Rating: _____

 

11.   Adheres to policies and regulations set forth by the Department, and the State of Iowa Department of Public Health, EMS section as they apply.

q       Is familiar with, and adheres to general, departmental polices as they are set forth in the saftey, procedure book and Exposure Control Plan

q       Is aware of, and complies with, State requirements for functioning as an EMT/Paramedic in Iowa.

Comments:

 

 

Rating: _____

 

12.   Assumes share of additional on call and scheduling needs.

Comments:

 

 

Rating: _____