Ethics: Mrs. Moonjeli functions as a patient advocate/navigator, treating patients and families with respect, dignity and courtesy as defined by the American Association of Nurses Code of Ethics (1995). She fosters positive relationships with patients and families and delivers the services with respect to patients and family’s knowledge, values, beliefs and cultural backgrounds in a non- judgmental and nondiscriminatory manner. She honors the patients and family perspectives and choices. For example, last week, an end stage heart failure patient who is on inotrope dependent and on high diuretic dose walked into the clinic for his follow up visit after hospital discharge . He gained approximately thirty pounds within two weeks and his legs …show more content…
Moonjeli determines that non VA fee service consults are initiated appropriate for Atlanta VAMC patients only and assists other VAs to initiate the consult in a timely manner to facilitate a safe, effective and efficient care. She analyzes the available resources within the home VA and then coordinates the consults approval process with those responsible for approval of fee services as well as the fee service department to assure policy is followed and the patient receives appropriate care. She continues to work to ensure that patients from other VAs are evaluated in a timely manner to eliminate the unnecessary Fee Consults for consulting VAs. She assures that an appropriate non VA care fee consults for a heart transplant and for the percutaneous structural valve repair/ implantation. She demonstrates the appropriate and discretionary use of non-formulary drugs, resulting in cost avoidance, reviews medication use by the patient with cardiology Pharm D so that appropriate medication choices are made. She assures medications bought by patients are properly documented. She coordinates the care provided by Nashville VAMC or Richmond VAMC and outside VA like Emory or Vanderbilt to assure that no replication of services are delivered. She assures that outside VA providers are properly communicated prior to prescribing the medications at the VA CPRS. She appropriately collaborates with other providers is regarding the medications, doses, refills, etc. for the proper management of the patient acute and chronic condition. She reviews the equipment maintenance and submits the proper request to the correct person by providing the vendor information and cost analysis. For example, she coordinated with outpatient pharmacy tech to get the LVAD dressing kit from other VA VAD centers. She organizes the home health care and Milrinone therapy with the home health coordinator to reduce the hospital days for the HF patients and follows their lab data weekly and reduces the