The Medical Instrument Technologist- Vascular Lab Ultrasound position is above the full performance level. The technologist is a specialist among a diverse group of diagnostic ultrasound professionals. These technologists are qualified by professional credentialing, academic and clinical experience to provide the most complex and non-routine procedures to obtain the results required for clinical diagnosis and documentation for the best possible patient care. Basic Requirements: Citizenship. Citizenship of the United States. (Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with chapter 3, section A, paragraph 3g, this part.) 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. See the grade requirements part of this standard for information regarding educational substitutions. 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". For all specialties identified in this standard, Basic and Advanced Cardiac Life Support certifications are desirable. Training which does not result in official certification does not meet this definition. Grandfathering Provision. The following is the standard grandfathering policy for all Title 38 Hybrid qualification standards. Some of these provisions may not apply to this occupation. Please carefully review the qualification standard to determine the specific education and/or licensure/certification/ registration requirements that apply to this occupation. All persons employed in VHA in this occupation on the effective date of this qualification standard are considered to have met all qualification requirements for the title, series and grade held, including positive education and licensure/certification/registration that are part of the basic requirements of the occupation. For employees who do not meet all the basic requirements required in this standard, but who met the qualifications applicable to the position at the time they were appointed to it, the following provisions apply: Such employees in an occupation that does not require a licensure/certification/registration, may be reassigned, promoted, or demoted within the occupation. Such employees in an occupation that requires a licensure/certification/registration, may be reassigned, promoted up to and including the full performance (journey) level, or demoted within the occupation, but may not be promoted beyond the journey level or placed in supervisory or managerial positions. Such employees in an occupation that requires a licensure/certification/registration only at higher grade levels must meet the licensure/certification/registration requirement before they can be promoted to those higher grade levels. Employees who are appointed on a temporary basis prior to the effective date of the qualification standard may not have their temporary appointment extended or be reappointed, on a temporary or permanent basis, until they fully meet the basic requirements of the standard. Employees initially grandfathered into this occupation, who subsequently obtain additional education and/or licensure/certification/registration that meet all the basic requirements of this qualification standard must maintain the required credentials as a condition of employment in the occupation. If an employee who was retained in an occupation listed in 38 U.S.C. § 7401(3) under this provision leaves that occupation, the employee loses protected status and must meet the full VA qualification standard requirements in effect at the time of reentry to the occupation. Physical Requirements. See VA Directive and Handbook 5019. English Language Proficiency. Medical Instrument Technicians must be proficient in spoken and written English in accordance with chapter 2, section D, paragraph 5a, this part. Grade Determinations: GS-9. In addition to the core competencies defined at the GS-8 full performance level, positions at this grade may be lead, supervisory, or non-supervisory with specialized advanced knowledge and assignments. 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 (*): 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. 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. * Knowledge of JCAHO and other regulatory requirements. Ability to communicate effectively and professionally with employees at varying grade levels. * Ability to manage and supervise employees. * Ability to provide, or provide for, staff development and training. 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. Assignments. 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. Special Assignments. Non-supervisory diagnostic ultrasound technicians may have assignments that because of their nature substantially exceed the full performance level. The Professional Standards Board will review proposed non-supervisory special assignments for the GS-9 level and make a determination regarding their appropriateness. These assignments are expected to be relatively few in number and must represent substantial additional responsibility over the full performance level. Preferred Experience: Registered Vascular Technologist (RVT) or Registered Vascular Specialist (RVS) Basic Life Support (BLS) 3 years vascular ultrasound experience in an IAC accredited vascular lab in a hospital setting. Performing Possess the knowledge, skills, and abilities to perform all vascular ultrasound procedures, routine to the most complex. Must have complete and thorough knowledge of cross-sectional anatomy and of the arterial and venous system. Possess the knowledge, skill, and abilities to organize all exam images and data in a detailed typed preliminary report in the PACS system and Computerized Patient Record System (CPRS). Responsible for providing preliminary findings and critical/acute results to ordering providers or reading provider. Maintains effective control of the ultrasound area by coordinating, planning, organizing, and executing the daily work potential to expedite workflow patterns within the department. Schedules patients for exams. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is GS9. The actual grade at which an applicant may be selected for this vacancy is GS9. Physical Requirements: See VA Directive and Handbook 5019. ["The GS-9 Vascular Technologist preforms the following: a. Patient assessments involving, verifying patient identification and the requested procedure is appropriate for the patient history and complaints. The technologist is expected to take a history and review the patient medical record in addition to assessing the patient's ability to tolerate the procedure and determining if any contraindications to the procedure exist. These skills distinguish the Vascular MIT form a technician who preforms an examination by rote. Obtaining this highly specialized set of skills required adequate training and clinical experience. b. Performs high quality ultrasound examinations and other diagnostic modalities to analyze the data of the neck, abdomen and extremities that will assist in the diagnosis and treatment of patient medical disorders. c. Technologist is responsible for performing, but not limited to, the following specialized studies, and all examinations performed in the Vascular Lab require a pertinent examination: i. Peripheral arterial and digital artery evaluations, requiring segmental blood pressure measurements in the arms and legs as well as blood pressure measurements using both Doppler ultrasound and plethysmography in the toes and fingers. Exercise testing requiring use of treadmill with pre and post exercise measurements. ii. Venous Studies- Use of ultrasound Doppler velocity detector and the color imaging device to survey peripheral in both the upper and lower extremities, recording the flow signals as required. Distinguishing between normal and abnormal venous flow patterns in response to a variety of manipulations. Evaluate for both venous obstruction and venous insufficiency. iii. Non-invasive cerebrovascular evaluation including the recording and interpretation of pulse wave Doppler velocity waveforms from the cervical carotid arteries. Distinguishing between the internal and external carotid flow pattern and must be aware of how these patterns are altered in disease. This study also requires the use of the color flow Doppler to obtain non-invasive images of the cervical carotid vessels in normal and disease state, interpreting the images and wave forms generated as is required. iv. Temporal Artery-Use of duplex ultrasound to evaluate the temporal artery, recording flow signals and measurements a required. Distinguishing between normal and abnormal findings. v. Abdomen duplex-Evaluating abdominal arteries with Doppler and color flow to identify abnormalities, stenosis and/or occlusions. vi. Non-invasive surveillance of grafts (vein and PTFE), endovascular stents (iliac, EVAR, FEVAR, renal and cerebrovascular) assess flow hemodynamics and stent contour; dialysis access pre-operatively and pre-cannulation and mesenteric/splanchnic artery evaluation. Specialized requests for preop evaluations (ie forearm flap used in mandibular reconstruction, radial artery evaluation for CABG). vii. Operate vascular lab equipment and assists Vascular Surgeon during procedures or surgery cases. Technologist is knowledgeable in sterile technique and procedure. Assists the vascular and general surgeons in surgery for intra-op carotid endarterectomies, bypass grafts of the lower extremities and other necessary surgical cases. d. Operates PACS and/or ISCV workstations for the purpose of making digital records of ultrasound examinations so that future ultrasound examinations may be compared. e. Advises the vascular surgeons or referring physicians of significant abnormalities that would require their immediate attention and visualization while the patient is undergoing examination. f. Provide a summary of findings to the physician to aid in patient diagnosis and management. Generates a typed preliminary report in the digital archival and reporting system and ensures report is transferred to the patient's CPRS in Vista Imaging. Enters examination information into database. g. Use independent judgment and systematic problem-solving methods to produce high quality diagnostic information optimizing patient care. To document changes over time, compares current images to previous study images. h. Participates in the training of physicians, nurse practitioners and students so that these individuals may acquire an understanding of the principles of ultrasound and how it relates to other diagnostic exams. i. Gathers other related information such as patient x-rays, etc. so that the correlation of examinations to other studies may be made by the vascular surgeons in the diagnosis and recommendation of treatment for medical disorders. Work Schedule: 7:30am to 4pm Functional Statement #: Relocation/Recruitment Incentives: not authorized Permanent Change of Station (PCS): Not authorized"]

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