Golda Cabanban

* Actively participates in team development, achieving dashboards, and in accomplishing department goals and objectives.

* Abstracts information from medical records and accurately enters data into an internal or external database such as Society of Thoracic Surgeons(STS), using data collection methods prescribed for the American Heart and Stroke Associations, The Joint Commission, and other vendors.

* Creates data quality reports from the database to identify missing data elements. Identifies and communicates trends in documentation opportunities to relevant RN Concurrent Reviewers and Leadership.

* Reviews medical records and other data resources for variations in care against applicable criteria for assigned indicators. Abstracts relevant data. Indicators include but are not limited to: autopsy review, use of blood and blood products, moderate sedation, medication administration, surgical case review, mortality review, etc.

* Participates in activities of relevant improvement teams as indicated. Carries out special studies, as needed, to identify quality concerns and utilization of resources.

* Demonstrates knowledge of relevant Microsoft Word, as well as hospital and external data systems to support the essential functions of the job.

* Demonstrates competency by using judgment and clinical knowledge base to apply criteria to information in the medical record ( medications and standards of care)

* Utilizes available resources, including online help, pop-up definitions for data element information, Joint Commission, and vendor web sites/abstraction study guides, etc. to maintain current knowledge of abstraction criteria and changing guidelines.

* Maintains an awareness of abstraction and reporting deadlines. Organizes job functions and work assignments to be able to effectively complete assignments within established time frames.

* Seeks, maintains and increases knowledge and skills which impact the performance of self and others, including mandated

education, inservices, department meetings, formal education, leadership skills, etc., as well as hospital and department policies, procedures, protocols.

* Collaborate with providers to follow quality standards and procedures to minimize errors and optimize patient experience.

• Contributed educational and clinical expertise to help optimize training courses and boost student learning.
• Supported student educational and vocational planning to help each optimize learning strategies and reap long-term career benefits.
• Oriented and provided instruction to students during clinical rotations.
• Assessed student knowledge levels and abilities with detailed assessments.
• Delivered information and valuable instructions to students during clinical rotations.
• Oversaw clinical environments to help students advance knowledge and abilities.
• Educated nursing students on successful methods for performing nursing skills and critical thinking techniques.
• Compiled, administered and graded assignments to evaluate and record student comprehension levels.

• Updated patient charts with data such as medications to keep records current and support accurate treatments.
• Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
• Provided direct patient care, stabilized patients, and determined next course of action.
• Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
• Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
• Managed care from admission to discharge.
• Monitored patient reactions to drugs and carefully documented findings.
• Administered medications via oral, IV, and intramuscular injections and monitored responses.
• Provided emotional support to patients and their families.
• Managed quality care for patients with heart failure, end-stage renal disease and coronary artery disease.
• Participated in evidence-based practice project implementation, nursing competency development and nursing simulation activities.
• Evaluated patient histories, complaints, and current symptoms.
• Educated family members and caregivers on patient care instructions.
• Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
• Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
• Equipped patients with tools and knowledge needed for speedy and sustained recovery.
• Managed patients recovering from medical or surgical procedures.
• Conducted ongoing monitoring and evaluations of behaviors and conditions, and updated clinical supervisors with current information.
• Facilitated therapeutic communication, conflict resolution and crisis intervention by redirecting negative behaviors and helping patients regain or improve coping abilities.
• Implemented care plans for patient treatment after assessing physician medical regimens.
• Led teams in driving successful patient outcomes by prioritizing standard of care and best practices.