Marlene Ramos

PRN Recertification Visits

• Performed accurate documentation of patient assessments, interventions, and outcomes in compliance with regulatory standards.
• Educated patients on disease management, self-care techniques, and wellness strategies to improve long-term health outcomes.
• Assessed patients to determine individual needs and develop care plans in coordination with multidisciplinary healthcare professionals.
• Updated patient charts with data such as medications to keep records current and support accurate treatments.

• Responsible for Oversight of all Agency nursing services
• Development, Implementation, and routine review of the Plan of Care of the pediatric client
• Evaluation/Assessment, and admission of clients to appropriate services
• Interviewed and hired highly talented individuals bringing great skills and passion to daily jobs
• Monitored, analyzed, and corrected staff performance to raise standards of practice
• Implemented ongoing learning strategies such as in services, instructional literature, and supervised hands-on sessions to help nurses and staff improve understanding of medical equipment and care best practices
• Implement new policies and educate staff on changes
• Collaborated with social services, referral sources, and other treatment professionals to meet patient care needs
• Developed and adjusted work schedules for 150 staff in collaboration with the nursing coordinator
• Increased referral rates by providing excellent service and building meaningful relationships with patients and healthcare providers
• Thorough review of clinical documentation and client files for insurance denial appeals
• Assist clients in Fair Hearing process to justify medical necessity for skilled nursing services in collaboration with Medicaid appointed legal aid.

Care of Pediatric Clients in the Home.

• Supported patients'' physical and emotional well-being through compassionate communication, play therapy techniques, and age-appropriate activities.
• Reduced hospital readmissions through proactive management of chronic conditions and timely interventions for acute health issues among pediatric patients.
• Collaborated with families and healthcare teams to design tailored interventions addressing developmental, behavioral, or cognitive challenges faced by pediatric patients.
• Safeguarded patient privacy by adhering to HIPAA regulations and maintaining strict confidentiality in all aspects of care provision and documentation.
• Enhanced family satisfaction by collaborating with physicians and other healthcare professionals to develop and implement individualized care plans for pediatric patients.
• Optimized medication adherence among pediatric patients through clear communication of dosing instructions, potential side effects, and the importance of consistent use as prescribed.
• Ensured continuity of nursing care during critical staff transitions by providing thorough hand-off reports to incoming nurses regarding each patient''s medical history, current condition, treatment plan goals, and any outstanding concerns.
• Served as an advocate for pediatric patients during medical consultations.
• Promoted patient safety by diligently monitoring vital signs, administering medications, and swiftly addressing any medical concerns or changes in condition.
• Mentored junior nurses entering the field of pediatric home health care by sharing knowledge about best practices related to assessment skills, effective communication strategies, and safe medication administration techniques
• Provided care to client with medically complex needs through mixing and administration of Total Parenteral Nutrition via Curlin Pump, and Enteral Nutrition via Kangaroo and Infinity Pumps.

• COVID Screening for WellsFargo Staff
• Monitored Symptoms and Temperature for staff on a PRN basis.
• Provided teaching and guidance to available resources and testing centers
• Appropriate documentation of assessment, findings, and intervention.
• Maintained patient confidentiality.
• Self-motivated, with a strong sense of personal responsibility.
• Strengthened communication skills through regular interactions with others.

• Responsible for Oversight of all Agency nursing services in the absence of the Director of Clinical Services
• PRN QA
• Review of nursing documentation for compliance with Medicaid guidelines for Private Duty Nursing
• Training of clinical staff and served as a resource for questions regarding nursing services for staff/clients.

• Responsible for Oversight of all Agency nursing services.

• Direct patient care as needed
• Obtaining/creating/maintaining supporting documents in a timely manner
• Responsible for continuous review of all aspects for 47 clients to include: appropriate utilization of services; ensuring continued skilled need; monitoring of home-bound status; review of documentation in the medical record; maintenance of interdisciplinary communication and discharge planning
• Use health assessment data to determine nursing diagnosis
• Initiates the plan of care, making necessary revisions as patient status, and needs change
• Develop a care plan, which establishes goals based on nursing diagnosis and incorporates therapeutic, preventive, and rehabilitative nursing actions
• Regularly re-evaluate patient nursing needs
• Responsible to reassess the patient within 24 hours following a change in condition or discharge from an inpatient setting
• Assure that the documentation of services provided is accurate and timely
• Provide adequate staff education/training
• Maintain privacy and confidentiality of patient, family, and team
• Evaluate client care provided by home clinical staff
• Consulted with clinicians to devise and manage effective ongoing care plans for at-risk patients
• Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols to optimize performance and safety.

• Worked closely with families, and physicians, as well as other medical and healthcare professionals to develop and implement a comprehensive plan of care
• Specialized care for Congenital/Genetic disorders, Ventilator Dependence, Tracheostomy, and G-Tubes
• Trained family members on patient care and management of individual conditions
• Cultivated rapport with patients and caregivers, utilizing effective communication with parents and children of all age groups
• Received, transcribed, and implemented telephonic, written, and verbal orders
• Documented patient assessment, evaluation, and responses to therapy to facilitate therapeutic intervention
• Assisted in the development and implementation of service plans related to nursing and patient health care needs
• Demonstrated clinical competence in administering care to support physician orders, nursing care plans, and policies
• Changed out tracheostomies put gastrostomy buttons
• Appropriate use of Mechanical Ventilator (Trilogy 100), CPT, Cough Assist, IPV
• Administered prescribed medication and treatment in accordance with physician orders
• Reported changes in patients' status to appropriate specialists and clinical supervisors
• Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing changing conditions to avoid deterioration and hospitalizations.

• Private Duty Nursing Care for Pediatric Clients

• Private Duty Nursing Care for Pediatric Clients

• Private Duty Nursing Care for Pediatric Clients

• Provided care to a variety of pediatric and adult clients in the home setting
• Medication administration and enteral feeds
• Seizure management and intervention
• Diabetic management, insulin administration, vital sign monitoring, and wound care
• Foley catheters
• Patient teaching: medication, lifestyle modifications, and pain management
• Quality assurance and review of documentation.

• Skilled Nursing Visits for geriatric clients under the supervision of an RN on a PRN basis
• Diabetic management, glucose monitoring, insulin administration, IM Injections, vital signs monitoring, teaching, and wound care.