Thathamkulam initiates interdisciplinary projects to improve organizational performance. He is also involved in performance activities at the Medical center level. For example, a patient had scheduled for retina eye surgery, who has been taking Warfarin on daily basis. His Coumadin INR level was 1.7 prior to the surgery. There was no protocol that the Warfarin needs to stop before the surgery. The patient was referred to the Coumadin clinic by the pre-op NP for evaluation. Since the Coumadin INR was within the therapeutic level, the Coumadin clinic recommendation was to continue with the surgery. The surgery team preceded the surgery without stopping the medication. But unfortunately patient had Retrobulbar hemorrhage during the surgery and the team had to stop the surgery immediately. Patient lost 10% of his eye sight due to the surgery. The Root Cause Analysis (RCA) was recommended due to the incident, and Mr. Thathamkulam volunteered to be a part of the RCA committee. The committee recommended for checking the Coumadin INR level on the same day prior to the surgery. In collaboration with the APOC team members, Chief of Eye Care Line, and Quality Management, Mr. Thathamkulam took an initiation and planning to create an in-service for the Eye clinic pre-op team and APOC team, including fellows, residents and staff surgeons, Anesthesiologists, NP, and nurses regarding Coumadin work up for the patient, who is taking Coumadin on a daily basis, prior to any eye surgery. …show more content…
Thathamkulam is an active member of the unit council and collaborates with the other interdisciplinary and nursing team members in research activities to improve veteran care. He promotes evidence based practice and demonstrates leadership in incorporating findings from literature into practice. He is striving to contribute nursing knowledge by conducting research that discovers, examines, and evaluates knowledge and theories to improve healthcare practice. The Clinical, technical, and administrative issues were identified in the overall developmental process for the research. All his eye clinic staff members are up-to-date on the training process through utilizing evidence based practices and follow IRM regulations on documentation. For example, he created a new employee orientation package for the Eye clinic staff with the help of a Lead Health Technician and a nurse that would allow new employees to become familiar with the unit, pr-op and eye surgery protocols, policies, and procedures. The team met every week to discuss the various problems and shortcomings of the current system. We concluded that a new orientation pathway must be developed. We first developed a new employee orientation policy and procedures for the Eye clinic that unified and streamlined the process. We then proceeded to develop a new orientation package based on findings from previous evidence based practice studies. We extended the orientation process to 5-6 week program, with each week focusing