Edith Naguna

Performed in-person and telephonic care/case management for geriatric and adult health plan members with complex and chronic health conditions: diabetes, cardiac diseases, hypertension, mental health, obesity etc.

Optimized health management among health pan members across the care continuum, to ensure quality and appropriate service delivery and to prevent Emergency Room and Hospital admission and readmission.

Evaluated ongoing health care needs, goals of treatment and available resources of each health plan members and referral to appropriate community resources.

Collaborated with interdisciplinary teams to develop and implement comprehensive care plans tailored to individual patient needs.

Provided physical, psycho-social assessments, medication management and chronic disease management of home health patients.

Advised and coached patients progressing from hospitals, rehabilitation facilities and other medical organization to at-home treatment settings.

Coordinated care with various health care resources and stake holders within Kaiser Permanente and other community and social resources.

Assessed and managed needs of chronically-ill and acute patients with well coordinated treatment strategies.

Administered life-saving medications and therapies under strict protocols, guiding patients towards recovery from acute illnesses or injuries.

Served as a preceptor for new nurses entering the critical care field, sharing knowledge and expertise to facilitate successful integration into the team.

Guided patients, caregivers, and family members on plans of treatment and helpful resources available locally to support care.

Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.

Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.

Communicated with healthcare team members to plan, implement and enhance treatment strategies.

Promoted patient and family comfort during challenging recoveries to enhance healing and eliminate non-compliance problems.