Judy Diaz Leyva
Pflugerville,Tx
Summary
Compassionate and caring Home Health Bi- lingual Registered Nurse with 16 years' experience in geriatric care. Proficient in managing multiple cases involving SOC, Recerts, ROC, intake coordinating and optimizing patient care. Supervising RN's, LVN's and nursing aides in the care of the patients. Skilled in assessments, documentation, performing TB skin tests, flu vaccines, wound care, cultures, insulin administration, specimen collection, catheterizations, phlebotomy, executed orders for mobile x-rays, EKG's, Echo's and Dopplers for the geriatric population. I also have had Tele health experience in the correctional setting in the rural area of West Texas. I am currently certified with BLS by American Heart Association, certified with Texas Board of Nursing, current with immunizations required and I have reliable transportation and currently insured. I am a passionate, dedicated, team oriented, and loyal. I am willing to help other team members with their work. I work above and beyond to succeed in the work setting. I also work independently with little supervision and can perform other duties as needed and instructed.
Overview
22
22
years of professional experience
Work History
PCC
Advanced Home Health
Pflugerville, Texas
02.2021 - Current
- Completed day-to-day duties accurately and efficiently.
- Contributed innovative ideas and solutions to enhance team performance and outcomes.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Director of Nursing
Cuidado Casero Home Health
Austin, Texas
04.2020 - 02.2021
- Conducted regular staff meetings to discuss patient care and operational updates.
- Developed training materials for new staff on procedures and compliance standards.
- Collaborated with multidisciplinary teams to enhance patient service delivery processes.
- Reviewed patient assessments and addressed concerns with nursing teams promptly.
- Implemented quality assurance measures to improve care consistency across services.
- Provided support during audits, ensuring documentation met organizational standards.
- Served as a resource person for questions related to professional practice issues within the facility.
- Monitored patient progress and adjusted care plans as needed.
- Provided guidance, mentorship, and support to newly hired nurses.
- Participated in interdisciplinary team meetings to discuss patient care issues.
- Assessed patient care needs and developed individualized care plans.
- Coordinated with physicians, pharmacists, dietitians, and social workers to ensure comprehensive patient care.
- Developed educational materials for nursing staff on various topics related to quality improvement initiatives.
- Assisted in the development of clinical competency programs for staff.
- Conducted quality assurance audits to evaluate adherence to standards of care.
Rn Intake Coordinator/previous Case Manager RN nurse
Seton Home Health
Austin, Tx
04.2019 - 04.2020
- Home Health Nurse and Rn intake coordinator. Worked in the Field as an Rn Home Health Nurse with experience in geriatric care. Proficient in managing multiple cases involving SOC, Recerts, ROC, Discharge visits and optimizing patient care.
- Supervising RN's, LVN's and nursing aides in the care of the patients.
- Performed assessments, documentation, teaching on disease processes, medications and wound care for the geriatric population.
- I currently work an intake position created by the company and manage intake for three agencies in the Burnet, Kyle and Austin area, I which I set up new patient referrals along with re verifying existing or returning patients as indicated by policy.
- I manage working with Navi Health, all scripts, Focura faxes in obtaining all referrals coming in from hospital, rehab, orthopedic, wound care and physician referrals.
- Currently have switched to HCHB from Devero software. I am also trained in Focura software and have worked with Kinnser and McKesson software in the past.
- Provided direct patient care in home settings, ensuring comfort and safety.
- Educated patients and families on health management and disease prevention strategies.
ADON/RN Case manager
Cuidado Casero Home Health
Austin, Tx
02.2018 - 02.2019
- Assisted DON with clinical activities, reviewing oasis, POC, recerts, resumptions, discharges and transfers.
- Making sure POC are individualized, care is coordinated, on site field visits are scheduled.
- Assisted in managing clinical operations, assisted in the recruitment, interviewing and selection of team members.
- Assisted in care coordination between caregiver and staff, assisted in case conference twice a month.
- Collected team reports, assist on site evaluations/training if needed, report any problems or findings to DON.
- Assisted in direct and coordinated continuity, quality and safety of all services ordered by the physician and delivered by the field nurses.
- Assisted in field visits and on call rotation as needed.
- Assisted the DON in monitoring QAPI program, emergency preparedness program and collaborated with DON and team member of the healthcare team to ensure compliance of quality improvement.
- Performed chart audits to identify documentation areas in need of improvement and develop a monthly chart audit report summary.
Home Health Nurse
Pecos County Memorial Hospital
Fort Stockton, TX
10.2017 - 01.2018
- Assessed patient's condition and nursing needs, set goals and implemented appropriate nursing actions to meet the goals.
- Formulated a written nursing Plan of Care.
- Coordinated and participated in direct and indirect patient care activities in accordance with patient's written Plan of Care.
- Continually evaluated the effectiveness of the patient's Plan of Care and the delivery of nursing care.
- Documented in a timely matter all events which influenced patients care and submit all appropriate reports.
- Supervised and taught other nursing personal as well as scheduled LVN visits for the patient care.
- Educated and instructed patient and caregivers on managing diet, safety, medications and disease processes and helped them achieve a level of independence, wellness and the ability to stay out of hospital.
Charge nurse
Lynaugh Correctional Unit
Fort Stockton, Tx
02.2017 - 01.2018
- Charge Nurse position in managing shift with nurses, planning, assigning assignments, and assisting DON with quality assurance of charts.
- Providing health maintenance, preventative and primary nursing care for adult inmates by providing day to day medical issues with inmates and responding to medical emergencies and taking charge of scene until EMT arrives when physician or NP assistants were not present.
- Provided pharmacology dispensing practices, documented record keeping in EMR Smart program, prepare and assisted physicians and medical providers during exams and treatments, monitor medical supplies ensuring availability of needed supplies are available.
- Complied with office policies, procedures, protocols and regulations within the correctional facility.
MDS position
Fort Stockton Living and Rehab Nursing Center
Fort Stockton, Tx
09.2016 - 02.2017
- Worked MDS position in managing cases with admissions, recerts, managing the care of the patients by assessing, documenting, developing care plans, for a skilled facility.
- Completed accurate charts on a timely manner.
Home Health Nurse/Field nurse
Saint Joseph Home Health
Midland, Tx
03.2016 - 08.2016
- Managed multiple cases involving SOC, Recerts, ROC and optimizing patient care.
- Supervising RN's, LVN's and nursing aides in the care of the patients.
- Performed assessments, documentation, and wound care for the geriatric population.
Home Health RN Nurse/Case Manager
Pecos County Memorial Hospital
Fort Stockton, TX
10.2009 - 08.2015
- Traveled to patient's home and assisted living facilities to eval and treat patients recently discharged from hospital or referred from physician offices who suffer from chronic conditions.
- Assess patient's condition and nursing needs, develop and implement/formulate a patient centered nursing plan of care in coordination with the patient and family along with multi- disciplinary team, set goals and prescribe appropriate nursing actions to meet the goals in accordance with the Plan of Care.
- Continually evaluate the effectiveness of the patient's Plan of Care and the delivery of nursing care.
- Document in a timely matter all events which influenced patients care and submit all appropriate reports.
- Supervise and teach other nursing personal as well as scheduled LVN and HHA visits for patient care.
Charge Nurse, RN
Pecos County Memorial Hospital
Fort Stockton, TX
04.2009 - 10.2009
- Overseeing patient admissions, transfer and discharges.
- Supervising nursing staff and monitoring their needs.
- Coordinating daily administrative duties, including schedules, making appropriate nursing assignments and patient care during the assigned work period while making the necessary changes required in the work environment.
- Checks environment for patient safety.
- Check Patient medical record to determine that all order have been ordered and carried out, checks laboratory test are posted, record patients progress, or lack of progress is described in medical records, monitor vital signs, evaluate individual and collective outcomes of the patient care provided during the shift, providing patient care to acceptable standards and reporting changing needs and outcomes to the health care staff.
Home Health Nurse LPN
American Home Health
Fort Stockton, TX
07.2003 - 04.2009
- Followed patients Plan of Care from the supervising RN.
- Administered basic nursing care such as taking vital signs, providing wound, care, inserting catheters, and vein puncture for lab work.
- Educated patients on medications, HTN, CHF, Diabetes and other chronic diseases as ordered by PCP.
- Maintained documentation on all health concerns and reported them to supervising RN.
Education
Associate - Nursing
Midland College RTTC
Fort Stockton, TXSkills
- Care coordination
- Patient assessments
- Electronic charting
- Quality assurance
- Staff mentorship
- Healthcare compliance
- Clinical operations
- Multidisciplinary collaboration
- Patient education
- Case management
- Problem solving
- Time management
- Team leadership
- Conflict resolution
- Training & Development
- Supervision and leadership
Timeline
PCC
Advanced Home Health
02.2021 - Current
Director of Nursing
Cuidado Casero Home Health
04.2020 - 02.2021
Rn Intake Coordinator/previous Case Manager RN nurse
Seton Home Health
04.2019 - 04.2020
ADON/RN Case manager
Cuidado Casero Home Health
02.2018 - 02.2019
Home Health Nurse
Pecos County Memorial Hospital
10.2017 - 01.2018
Charge nurse
Lynaugh Correctional Unit
02.2017 - 01.2018
MDS position
Fort Stockton Living and Rehab Nursing Center
09.2016 - 02.2017
Home Health Nurse/Field nurse
Saint Joseph Home Health
03.2016 - 08.2016
Home Health RN Nurse/Case Manager
Pecos County Memorial Hospital
10.2009 - 08.2015
Charge Nurse, RN
Pecos County Memorial Hospital
04.2009 - 10.2009
Home Health Nurse LPN
American Home Health
07.2003 - 04.2009
Associate - Nursing
Midland College RTTC