Tammy Altiparmak

Case Management
• Actively and independently performs a wide range of functions as a nurse in assessing individual health care plans and reviews.
• Collaborates with Medical, Dental, and Behavioral Health Advisor and as indicated on screening guidelines.
• Determines Invitees' medical eligibility to serve overseas by thoroughly reviewing information submitted on medical histories, physical examinations, and supporting documents.
• Determines final medical clearance prior to staging, assuring records are complete and transferred to the receiving Peace Corps Medical Officers (PCMOs).
• Prepares and presents cases for appeal to the Pre-Service Review Board.
• Documents appropriate and accurate information in the Peace Corps Applicant Health Record, assuring that reports from all providers are also included.
• Prepares and sends appropriate letters to Invitees based on decisions made as to medical eligibility, medical deferral, or the need for additional information. Communicates with Invitees via the medical application portal and documents appropriate information in the
Peace Corps Health Record.
• Organizes information collected from multiple sources into the medical records. Incorporates
current documentation standards and regulations in recording the medical information.
Maintains communication between and among all team members for a smooth flow of
processes. Displays strong understanding of eligibility requirements in processing
clearances. Uses automated systems to document and track a variety of data related to
medical clearance program management.
Quality Assurance Activities
• Participates in quality improvement activities to enhance the screening review process.
• Identifies situations or opportunities through clinical practice or data analysis that would
enhance quality assurance activities. Conducts or participates in research activities geared

towards enhancing operational efficiency and effectiveness. Provides recommendations
and assistance on improving processes to increase efficiency.
• Ensures that medical clearance processes are managed properly and completed in a timely
manner while monitoring continuity and quality of actions.
• Problem-solves individually or with the team to resolve issues, prevents negative outcomes,
inefficiencies, and ensures appropriate use of organization resources. Problems may
include individual or automated information system based issues.
Information Source
• Serves as an information source on Invitee medical clearances and maintains confidentiality as required by law, regulations and policies. Uses office automation systems and various software packages to accomplish work and maintain information. As required, prepares
correspondence, reports, briefing information, etc. using health information systems and database.
• Participates in meetings to discuss the impact of change in policies on the clearance processes, clarify new procedures, and recommend or implement new administrative guidelines.
• As assigned, participates in OST planning discussions to share information related to pre-service medical clearance processes and requirements.

• Taught patients how to improve lifestyle choices, dramatically reducing chance of symptom reoccurrence.
• Equipped patients with tools and knowledge needed for speedy and sustained recovery.
• Administered medications and treatment to patients and monitored responses.
• Collaborated with clinic Pharmacist to initiate a diabetic shared medical appointment (SMA).
• Focused care management for veterans with chronic pain management , diabetes, hypertension, as well as other high acuity concerns.

• Clinical nurse manager in charge of clinical flow and efficiency of  resident care received by Primary Care Physicians, as well as  Dental, Podiatry, and Ophthalmology services.
• Supervises 3 registered nurses,  7 Licensed Practical Nurses, 2 Certified Nursing Assistants, 2 Pharmacy Technicians, 1 Ophthalmology Technician, and 2 Medical Records Technicians.
• Represents Ambulatory Care and Home Care on Performance Improvement Committee, Falls Committee, as well as Pharmacy and Therapeutics Committee.
• Collaborates with Infection Control Preventionist  through the designation of a hand hygiene champions in both home care and ambulatory care,  oversight of tuberculosis surveillance program, and supporting antibiotic stewardship initiatives.
• Negotiated a shared immunization program with Department of Defense. This program results in 80-100 thousand dollars saved for the agency. 
• Piloted Veterans Affairs 12 hour work schedule in the Ambulatory Clinic. The measurable outcome resulted in the elimination of 1 FTE, and a 50% reduction in overtime expenditures.
• Facilitated an on-going assessment of Independent Living Plus (home care) resident/family needs and implementation of interdisciplinary team care plan.

• Developed and implemented nursing care plans.
• Developed patient care plans, including assessments, evaluations and nursing diagnoses.
• Specialized in the nursing care of patients with chemical dependency.
• Strong leader for nursing personnel assigned to the unit/shift.
• Facilitated an on-going assessment of patient/family needs and implementation of interdisciplinary team care plan.
• Investigated and reported issues relating to patient care or conditions that might hinder patient well-being.
• Chronic patient care in med-surg unit, adeptly handling all aspects of treatment from medication to wound care to monitoring for 5-7 patients per shift.

• Serve as a nurse manager to the 36 bed long-term care unit where I oversee and manage 22 clinical and support staff in patient care activities while maintaining a high level of staff morale and professionalism.
• Complete performance ratings, initiate and carry out any disciplinary actions and/or performance improvement plans as needed.
• Self-directed with astute judgment skills. High level of personal accountability.
• Collaborate with the interdisciplinary team, director of nursing and upper management to define and direct nursing care in order to achieve the best patient outcomes while utilizing applicable agency protocols.
• Monitors the quality of healthcare delivered in order to ensure the unit is operating within the goals and standards set by by accrediting bodies, such as The Joint Commission (TJC) and Commission on Accreditation and Rehabilitation (CARF) Facilities.
• Serves as Wound Care Coordinator (WCC). The role of the WCC is to oversee and monitor treatment progress, consult with members of Wound Care Team for recommendations about durable medical equipment and nutritional changes to enhance healing process.
• Serve as a liaison to external stakeholder and community civilian/military health partners in advocating for additional resources that may not be within the budgetary constraints of the agency.
• Coordinates and chairs the weekly interdisciplinary meetings. This meeting is focused on the holistic needs of the patients such as personal concerns, changes in pharmacological therapy, additional rehabilitative interventions to support aging in place, and to inform or update family/ court appointed advocates. The approach is always patient centered.
• Partners with case management to monitor patients admitted to acute care facilities. The purpose to advocate for additional needs such as skilled sub-acute care or hospice/palliative consultations.
• Serves as a resource to staff LPNs in identifying acute changes in patients health. Communicates changes or assessments to attending physicians. Evaluates and coordinates care for new admissions and transfers.
• Monitors environment of care and appropriateness of ordered pharmacological interventions for long term care areas. Conducts weekly audits of medication utilized from medication dispense system
• Conducts monthly chart audits in order to identify changes in patient health status, follow up on performance improvement objectives, and potential educations needs for staff.
• Reports and discusses performance improvement objectives assigned on a monthly basis. Serves as a member of the performance improvement team.

• Nursing Supervisor for 110 bed skilled nursing facility. Oversaw care flow for an average of 90-100 patients per shift. Supervised 4-6 licensed RN/LPN and 12 CNAs per shift.
  
• Developed patient care plans, including assessments, evaluations and nursing diagnoses.
• Delegated staff nurse and CNA duties.
• Strong leader for nursing personnel assigned to the unit/shift.
• Specialized in the nursing care of patients with chemical dependency, post orthopedic surgical interventions (i.e. joint replacements, orthopedic interventions needed due to multiple traumas related to auto accidents etc., requirements for significant wound treatment, PICC management and long term antibiotic therapy.
• Served as resource and practicing nurse in the care and management of patients with acute and chronic renal disease and diabetes.
• Responded to all emergencies by initiating resuscitation efforts until EMS arrived, and coordinating transfers to higher level of care.
• Participated in annual survey by the Department of Health and assisted with any plan of corrections required.
• Educated staff about guidelines and standards set forth by the Department of Health. Discussed best practices related to patient safety in order to enhance patient care outcomes.
• Supported plan of action to improve infection control practices through education and prevention. Focused primarily on the reduction of transmission of MRSA, C-diff, and reduction of CAUTI among geriatric care population within long term care settings.
• Coordinated follow-up care to external facilities such as dialysis, surgeons, and specialty physicians.
• Monitored labs, reported results, and consulted with physicians about changes to pharmaco-therapeutic plans and medication regimens. Example of such medications would include coumadin and mycin class antibiotics.
• Experience with a rapidly changing environment as it is not uncommon to receive anywhere from 2-6 admissions per shift.
• Support and reinforce rehabilitative skills patients learn from therapists.

• Liaised between patients and physicians to ensure patient comprehension of treatment plans.
  
• Instructed patients and family members on proper discharge care.
• Closely monitored acute conditions.
• Ensured HIPAA compliance.
• Carried out treatment orders for patients with chronic and acute health problems such as MI, arrhythmias, asthma, COPD and pneumonia.
• Developed patient care plans, including assessments, evaluations and nursing diagnoses.
• Performed basic physical assessments of adults and geriatric population.
• Ensured efficacy of treatments through monitoring of treatment regimens.
• Followed infection control procedures.
• Assisted patients with daily functions.
• Monitored fluid intake and output levels.
• Measured urine and delivered specimens to lab.
• Provided all daily living tasks to enhance quality of life for elderly patients.
• Assisted patients with bathing, dressing, feeding, lifting and transferring.
• Experience with various medical conditions including Parkinson\'s, Dementia, Diabetes, Cancer, Alzheimer\'s and Renal and Cardiac disease.
• Collected blood, tissue and other laboratory specimens and prepared them for lab testing.
• Strong leader for nursing personnel assigned to the unit/shift.
• Participated in unit-based Quality Assurance Program by ensuring that all documentation meets the gold standards mandated by the specialized Joint Commission designated Orthopedic accreditation.
• Proficient in safely administering blood and blood products, total parenteral nutrition, monitoring the efficacy and safety related precautions as it pertains to personal controlled analgesia.
• Proficient in administration of commonly ordered medications such as narcotics, anti-emetics, Proton pump inhibitors and many others by way of Intravenous push method.

• Served as a Licensed Practical Nurse/Patient Care Technician in major, minor and Triage care areas of Emergency care.
• Cared for patients from all socio-economical backgrounds and throughout the entire life span
• Familiarity with core measures as they relate to emergency care.
• Proficient with intravenous starts and lab draws for all age ranges and/or challenging disease processes that may interfere with successful outcomes.
• Set up and assisted with all suture/ stapling procedures as it relates to a range of traumas or varying types lacerations.
• Identified safety concerns and implemented standing interventions as it pertained to the needs of Psychiatric related patients present for evaluations.
• Proficient in BCLS and ACLS. Assumed supportive role during codes in progress i.e. cardiac monitoring, intravenous access, EKG, obtaining and processing specimens for lab analysis.
• Assisted ER physicians in GYN examinations, processed tissues and specimens as ordered.
• Proficient in Meditech electronic medical record system.
• Prepared and applied orthopedic splints as ordered.
• Performed patient teaching about usage of durable medical equipment and various disease processes as ordered.

  ● Monitor blood sugar logs / discuss regimen changes with M.D         

  ●Wound care/Skin Care

  ●PO, IM, IVPB, G-tube Medication Administration

  ● Set up special procedures /Case Management

• Over saw 30 to 50 bed LTC and Sub-acute units
• Floated to various units depending on staffing needs
• PRN relief house Supervisor for 215 bed facility
• Delivered and administered daily doses of oral, IVPB, G-tube medications.
• Updated charts to reflect changes in patient conditions, monthly summaries, and care plans. Assessed residents for acute changes of condition



·  Pre-operative nurse for scheduled GI procedures

·  Recover patients post GI procedures after conscious sedation

 ·  Monitor Telemetry activity post-operatively

 ·  Initiate IV catheters and give ordered IV fluids pre and post operatively

· Deliver and administer daily doses of oral, IVPB, G-tube, respiratory

   medications. Monitor IVF and IV sites. Initiate IV sites.

 · Update charts to reflect changes in patient conditions, update care    plans. Assess patients for acute changes of condition

 · Monitor telemetry activity and report acute changes to MD-follow telemetry protocols ordered.

· Held 13 week contracts in various hospitals in the areas of Med-Surgical, Telemetry, LTC, Rehab nursing.

· One private duty case during this time- client expired in August 1997

•Updating charts to reflect changes in patient conditions, monthly summaries, updating care plans. Assess residents for acute changes of condition 

• Charge Nurse 30 to 60 bed LTC and Sub-acute units
• Float to various units depending on staffing needs
• Delivered and administered daily doses of oral, IVPB, G-tube medications.