Hani A Ismail

Assessment & discharge plan

• facilitate daily Team huddles.
• After initial assessment completed and develop a discharge plan.
• PCP identificaation & coordinate follw up Appts.
• Identifying and coordinate DC Pharmcy needs and any required authorizaiorn for post-acute services ex: home health, infuion, DME etc.

Discharge Locations

• Home, Hospital to hospitall, Jail, Return to ALF and AFH, Medical Respite.

Continued care and services

• any specialty follow ups
• Home health, Dialysis, Methadone clinics for SUD
• Wound Vac
• IV inusion/Tube feeds/TPN
• DME and Home Vent

Coordination

• Coordinate with multi-disciplinary care team with patients and their family about safe discharge plan
• Participate and complete any long length of stay patients and their follow up items
• Verify demographics and insurance information, resources/funds for medications, Durable medical equipment, etc
• Ensured compliance with regulatory standards concerning utilization review, ethical decision making and legal aspects of case management practice.

• floated to MICU, SICU, and occasionally to the PACU.

• Provided care Including but not limited to post-operative craniotomy patients, neurologically unstable patients, immediate post-cerebral vascular embolization, aneurysm coiling or balloon occlusion, patients with acute onset of seizure activity, requiring emergent interventions, and any neurosurgical/neurological patient who experiences an exacerbation of a previous medical condition requiring critical interventions.
• Educated patients and families regarding diagnosis, prognosis, treatments, medications, lifestyle modifications.

Schedules, leads, and oversees the day-to-day activities of a defined team of critical care specialty nurses and support staff, ensuring adherence to appropriate Federal, State, and local regulations and guidelines, University policies, and accepted critical care nursing protocols and procedures. Coordinates services with other patient care units. Provides a full range of direct nursing services and patient care as appropriate.