DDA Nurse - Self Directed, residential agencies - Baltimore, MD
(2016-09)
Delegating Nurse/Case Manager for individuals with developmental and/or intellectual disabilities in Maryland.
Registered Nurse Case Manager - Ideal Healthcare Solutions, LLC - Catonsville, MD
(2012-02)
Home Care services provider
- Delegate nursing functions, and teach medication administration to medication technicians.
- Services provided for clients in assisted living according to COMAR regulations.
- Services also provided to clients in residential settings.
- Supervision of home health aides.
- Provide initial and ongoing patient assessment and care planning.
- Provide patient medical case management services.
- Provide patient and family disease education and management.
- Create and maintain required OHCQ policy and procedures for residential service agency
- Annual employee training and credentialing updates.
Delegating Nurse Case Manager - Bay CSS
(2017-07 - 2019-01)
- Initial Nursing Assessments, with updates as needed, for all Employment Services, Day, and Community Supports Services participants assigned; includes Self-Medication Assessment and Choking/Aspiration Pneumonia Risk Assessment
- Development of Nursing Care Plans and updates as needed for all individuals requiring delegated nursing functions
- Nursing reviews of health status and delegated care (i.e., "45-day reviews") for all individuals requiring delegated nursing functions; reviews/assessments may be required more often according to individuals' needs
- Teaching and/or written verification of teaching and competency of staff in the performance of delegated nursing functions
- Regular review (at least annually) and documentation of staff competency in the performance of delegated nursing functions
- On-call nursing coverage for all assigned sites and individuals Monday-Friday business hours for assigned Day Services program(s)
- Participation in weekend on-call rotation for Residential Services services from Friday evening to Sunday evening, shared by all Day and Employment Services delegating RNs
- Appropriate, prompt response to emergencies and other health issues reported by staff
- Follow-up of individuals' health status in the event of significant changes, especially including discharge from hospitals or other care facilities, to determine need for additional staff training or changes in Nursing Care Plan
- Written recommendations/guidelines for Self-Medication, shared with the team for any individuals with self-medication as part of IP goals
- Liaison with home caregivers, families, and Residential Services provider agencies regarding individuals' health care, for individuals in Day Services
- Share teaching of MTTP and Two-Year Clinical Medication Update classes on equitable basis with Arc Residential RN's (may vary according to MTTP training personnel and schedule)
- Teaching, supervision, and support of LPNs, CNAs, Certified Medication Technicians (CMTs) and other Arc staff involved in individuals' health care
- Attendance at day services staff meetings.
- Arrangements for return of unused/expired medications for Day Services participants to appropriate family members or authorized agency personnel
- Attendance at IP meetings where health issues are a significant/critical part of the IP process
- Consistent, thorough, and timely documentation of all nursing assessments, visits, teaching, and interventions
- Ensure compliance with all DDA and Maryland Board of Nursing policies and directives
- Communication with day services Program Directors and Coordinators, Employment Services Program Directors and Administrators, and Community Supports Coordinators, regarding health care issues of participants
- Teaching and counsel for individuals where applicable to help them achieve and maintain optimum health
- Attendance at a minimum of two out of four DDA Nurses' Quarterly meetings.
Transition Guide Nurse - Johns Hopkins Home Care Group
(2014-07 - 2017-07)
- Collaborated with multi-disciplinary team to decrease the incidence of <30 day hospital readmissions by identifying and assisting the patients to set goals and manage behaviors.
- Educated and assist the hospital multidisciplinary team with the communication, coordination and collaboration necessary for the success of the Readmissions Program.
- Communicated with multi-disciplinary team consisting of the individual's primary care physician, medical specialists, social worker, case manager, psychiatrists, hospital nursing staff, family, community agencies and informal support networks.
- Participated in discharge education classes on unit or organizes, as needed.
- Knowledge of "red flags": ensuring patient's knowledge about indicators that suggest that his or her condition is worsening and how to respond.
- Identified home safety concerns prior to discharge when possible and during phone calls and home visits (i.e.: medical equipment, food, safety evaluation). d. Assists the patient/family in addressing safety concerns.
- Utilized "teach back" to ensure patient has knowledge and understanding of condition, medication, and hospitalization.
- Applied patient engagement techniques such as "motivational interviewing" to strengthen the patient's motivation towards self management.
- Monitored the patient's health and advocated for the patient in terms of educational needs and community needs.
REM Case Manager - IHM - Owings Mills, MD
(2012-07 - 2014-01)
- Long term case management for recipients who received services through REM (Rare and Expensive Case Management) with Medicaid in the state of Maryland.
- I ensured adequate insurance coverage as well as resources to meet their needs while giving them the opportunity to remain in the community as opposed to a hospital or institutional setting.
- Coordinated home care services, appointments, prescriptions, medical equipment and supplies with the family, Primary Care Physician and specialists.
- Reviewed cost utilization data and make recommendations for services to DHMH that effectively keep cost down while allowing for optimal care to be provided.
- Addressed holistic needs of the client and family to encourage optimal health in the community and providing resources they are found to be eligible for.
- Patient and family health education for targeted populations with chronic disease conditions or high cost specialty care.
Local Care Coordinator - Healthways - Columbia, MD
(2011-10 - 2012-07)
- Provided on-site consultation to PCP offices and Care Coordination Team providers related to implementation of the Medical Home model including development and documentation of care plans for individual patients.
- Developed and maintained strong working relationships with primary care physicians to integrate the Medical Home program into their practices while serving as an extension of the PCP office.
- Implemented of clinical practice guidelines and work process/patient flow improvements. Followed-up with parties as appropriate.
- Developed clinical reports for use in primary care office records, facilitating physician support of patients in behavior change.
- Assist members in coordination of any additional tests, images and consults with specialists as deemed appropriate by the PCP in developing the Care Plan. For assigned patients with multiple prescriptions, assessed for efficacy and drug interaction/side effects.
- Mitigated issues and aided in patients removing barriers to care.
- Conducted patient and family education in support of Standards of Care guidelines and related health issues using the most appropriate modality for the patient.
- Collaborated with families, guarantors and other service providers to facilitate care coordination and information sharing within HIPAA and other regulatory guidelines.
- Referrals to appropriate community agencies such as crisis intervention, and counseling agencies for medical, mental, physical, financial and social needs.
- Document and update activity in multiple systems to ensure compliance with company protocols.
Medical Case Manager - Associates In Rehabilitation - Baltimore, MD
(2011-02 - 2011-10)
- Display working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.
- Assess patient's current health status, resource utilization, past and present treatment plan and services; prognosis, short and long term goals, treatment and provider options on an initial and ongoing basis.
- Obtain from treating physician/medical provider medical narratives, and treatment plan. Discussed questionable orders to decrease utilization of insurance.
- Maintain effective communication while providing medical and disability education to patients and their family.
- Address treatment alternatives, coordinate cost effective health care and rehabilitative services.
- Via research and negotiation effectively reduced the cost of needed treatment and durable equipment
- Evaluate the effectiveness and results of currently offered health care and programs and intervened if detected any contravention of norms at the hand of health experts. Evaluated cases to eliminate unnecessary treatment.
- Demonstrate ability to gather and analyze data and establish plans to improve trends, processes, and outcomes within the guidelines of the workers' compensation rules and regulations of the governing states.
- Demonstrate ability to establish collaborative working relationships with claims adjusters, employers, patients, medical staff, attorneys and all levels of employees.
- Work closely with delegated or contracted providers, groups or entities (as assigned) to assure effective and efficient care coordination.
- Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously
- Provide assistance to the adjusters and support staff in facilitating their understanding of specific medical situations.
- Provide assistance to adjusters in setting financial reserves.
- Inform adjusters of potential medical issues that will impact the claim.
Registered Staff Nurse/Charge Nurse - Sinai Hospital - Baltimore, Maryland
(2003-06 - 2010-01)
- Provided expertise to range of patients with variety of chronic and acute illnesses.
- Initiated and maintained IV therapy, administered medications via central, picc and peripheral lines.
- Proficient in assessing and treating patients according to their medical history and plan of care.
- Coordinated patient and family teaching, along with discharge planning.
- Served as charge nurse and advisor to fellow nurses and other hospital staff.
- Coordinated and delegated care responsibilities.
- Communicated in an effective and efficient manner with all teams to resolve identified problems.
Clinical Nurse Manager - Parnes, May, McKay, Lee and Associates
(2008-07 - 2009-01)
- Managed a nursing staff of 15 at a pediatric primary care practice.
- Enforced approved administrative policies.
- Served as a resource to nursing and other non direct care staff on patient care issues.
- Directed staff in requisite care techniques and office appropriate procedures.
- Coordinated staff orientations and performance evaluations / competency reviews.
- Developed and implemented departmental policies, procedures in accordance with regulatory requirements.
- Maintained proficiency in cutting edge medical testing equipment, quality assurance, quality control, equipment maintenance, data and material management and workplace safety.
- Responsible for scheduling, directing, training and counseling staff.
- Maintained effective working relationships with other departments.
- Created new strategic policies for development of performance improvement initiatives that improved overall agency quality of care
- Maintained infection control practices; consistent application of infection control and safety policies.
- Provided regular and periodic reports to administrator on patient care issues.
- Participated with management team in establishing department goals.
- Coordinated functions for mandatory state audits.
