Independently performs routine and complex ultrasound examinations. Evaluates the nature of critical and emergency procedures, and rearranges patients scheduled to accommodate them. Maintains records and electronic files of patients examined. Cross-indexes interesting cases for teaching purposes. Applicants pending the completion of educational, or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education. There are no specific educational requirements for this occupation. Education may be substituted for experience only at the GS-4 and GS-5 levels. English Language Proficiency. Medical Instrument Technicians must be proficient in spoken and written English in accordance with VA Handbook 5005, Part II, Appendix G27. Licensure or Certification. Licensure or Certification is not required for this occupation; however, it is strongly desirable at GS-6 or above as evidence of possession of the essential knowledge, skills, and abilities. For certain functional areas at the higher levels or supervisory assignments, specific certifications appropriate to the specialty are indicated in this standard under "Titles and Certification/Registrations". Diagnostic Ultrasound Technicians operate diagnostic ultrasonic scanning equipment to produce cross sectional and two-dimensional pictures of internal organs and body structures used to diagnose diseases and other medical conditions. Registration is offered by Cardiovascular Credentialing International (CCI) or by the American Registry of Diagnostic Medical Sonographers (ARDMS). May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: GS-9 Requirements: (a.) Experience. At least 1 year of experience comparable to the next lower grade level, which is directly related to the duties of the position to be filled, and must fully meet the KSAs at that level. This would be specialized experience which demonstrates possession of the knowledge required in order to provide all aspects of diagnostic ultrasonography services. In addition, the candidate must demonstrate the following technical KSAs and the potential to acquire the assignment specific KSAs designated by an asterisk (*): (b.) Demonstrated Knowledge, Skills, and Abilities. KSAs 1, 2, and 3 are appropriate for all positions at this level. KSAs 4 and 5 are to be used in accordance with their appropriateness for the specific assignment. 1. Knowledge of the more complex examination and treatment procedures and techniques in order to provide training and supervision in these procedures, to evaluate and initiate performance improvement projects, and to write policies, procedures, and protocols that pertain to diagnostic ultrasonography. *2. Knowledge of JCAHO and other regulatory requirements. 3. Ability to communicate effectively and professionally with employees at varying grade levels. *4. Ability to manage and supervise employees. *5. Ability to provide, or provide for, staff development and training. (c) Certification. Registration by Cardiovascular Credentialing International (CCI) or by the American Registry of Diagnostic Medical Sonographers (ARDMS) is highly desirable. Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS) certifications are also desirable. (d) Assignment. The GS-9 is above the full-performance level for medical instrument technician (diagnostic ultrasound). For all assignments above the full performance level, the higher-level duties must consist of significant scope, complexity (difficulty), and range of variety, and be performed by the incumbent at least 25% of the time. At this level the technician is required to perform a full range of procedures including special complicated examinations for which there are no standard instructions or procedures. They perform independent portable ultrasound examinations in the intensive care units, emergency room, surgery, and throughout the Medical Center when required. They also work independently on evenings, nights, and weekend tours of duty as scheduled and/or when on call. In addition, this position would typically include knowledge of standards of medical practice in applicable medico-legal responsibilities in diagnostic ultrasound procedures; developing protocols and clinical research projects; developing and updating technical policy and procedure manuals; as well as teaching the correct methodology of diagnostic ultrasound procedures, theory of operations, and theory of interpretation of results to trainees. Creditable Experience - Knowledge of Current Medical Instrument Technician Practices. To be creditable, the experience must have required the use of knowledge, skills, abilities and other characteristics associated with current Medical Instrument Technician practice appropriate to the identified specialty area. Specialized developmental experience obtained under supervision of appropriately certified individuals may be credited at higher levels and is addressed in individual appendices. Quality of Experience. Experience is only creditable if it is equivalent to at least the next lower grade level and is directly related to the position/specialty to be filled. Training. Completion of appropriate training such as in-service training programs, on the job training, training acquired while in the Armed Forces, government sponsored developmental training programs, and/or training under physicians certified in the functional area will be allowed on a month-for-month basis through the GS-5 level. References: VA Handbook 5005 Part II, Appendix G27, Medical Instrument Technician Qualification Standards. Physical Requirements: Lifting (15 lbs. and over); carrying (up to 20 lbs.); pulling and pushing (up to 2 hours); reaching above shoulder; standing and walking (up to 3 hours); bending (up to 1 hour); use of fingers/hands; ability for rapid mental and muscular coordination simultaneously; near vision correctable at 13 - 16"; hearing (aide permitted) ["CLINICAL RESPONSIBILITIES A. Advises radiologists or referring physician of significant abnormalities that would require their immediate attention and visualization while the patient is undergoing examination. B. Performs ultrasound examinations of the abdomen, neck, chest. gyn and extremities, retroperitoneal space for the purpose of acquiring high quality examinations that assist in the diagnosis and treatment of patient medical disorders C. Participates in the training of physicians, students and radiology technicians so that these individuals may acquire an understanding of the principles of ultrasound and how it relates to other diagnostic exams. D. Performs routine clerical procedures for the purpose of maintaining accurate ultrasound records so that easy recall of patient examinations may be achieved. This requires maintaining a diagnostic log, patient schedule log, and procedure log, editing and when necessary, registering patients in the Radiology Information System \\RIS). E. Makes multiple simultaneous settings and adjustments in operation of equipment to insure accurate results. On the basis of radiologic findings, determines necessary ultrasonic procedures to yield definitive diagnostic findings. F. Assists the radiologist in the performance of cyst punctures, aspiration biopsies (liver, kidneys, thyroid), and catheter placements for the purpose of diagnostic: treatment using ultrasound techniques. This requires the ·use of surgical sterile techniques, syringes, needles, contrast, etc. G. Develops and maintains patient prep procedures so that patients and wards understand the proper preparations for ultrasound examinations in an effort to minimize delays of examinations. These preps are disseminated either by written prep8ration information or by telephone conversation. H. Explains examinations to be performed to the patients so· that an understanding of the purpose of the study as well as any requirements of the patients are thoroughly understood. This is done so that an adequate ultrasound study may be obtained in an effort to get diagnostic examinations for the purpose of treatment and diagnosis of disorders. Obtains Consent from the patient or authorized person to perform invasive procedures. I. Gathers related information such as patient chart, x-rays; CT's, and MRl's etc., so that correlation of examinations to other studies may be made by the radiologist in: diagnosis and recommendation of treatment for medical disorders. J. Distributes ultrasound examinations and related information to the radiologist responsible for the interpretation of the exams. This is done so that treatment based on diagnosis may be effectuated in a timely manner. K. Performs quality assurance testing on the ultrasound unit using phantoms, test tools, test check lists, etc. for the purpose of assuring peak performance of the ultrasound equipment. Maintains the quarterly records of the quality assurance testing so that easy reference is available should servicing be necessary. L. The incumbent must be aware of and practice the safety policies/procedures of the medical center, and participate in quality assurance activities as directed. M. Performs irregular hour emergency scans on standby, 24 hours per day coverage. Requires the technologist be available within 45 minutes from receipt of call so that proper and effective emergency care can be given to the patient. N. The primary age of patients treated and cared for are normally at the geriatric level,.e. 60 years of age or older, although occasionally there may be younger patients between the ages of 18??60 years· of age that require care. The position requires the incumbent.to possess or develop an understanding of the particular needs_ of these types of patients. Sensitivity to the special needs of all patients in respect to age, developmental requirements, and culturally related factors must be consistently achieved. Work Schedule: Intermittent: Schedule will vary, including on-call rotations Financial Disclosure Report: Not required Position Title/Functional Statement #:Medical Instrument Technician Diagnostic Ultrasound/PD000000"]

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