Marvin Flores
San Antonio,TX
Summary
Seasoned Clinical Nurse Coordinator with a proven track record at Metropolitan Methodist Hospital, showcasing exceptional skills in clinical documentation and interdisciplinary collaboration. Spearheaded quality improvement initiatives, achieving a notable impression during a Joint Commission visit. Demonstrates a strong blend of clinical leadership and patient advocacy, ensuring high standards of healthcare delivery and patient satisfaction.
Overview
20
20
years of professional experience
Work History
Clinical Nurse Coordinator
Metropolitan Methodist Hospital
01.2024 - Current
- Led my team of 5 RN members and 1 technician, in driving successful patient outcomes by prioritizing standard of care and best practices amongst 20 unit and 6 bedside dialysis patients. Recent Joint Commission visit, commissioner was impressed and highly regarded our team for our exemplary achievement especially on best practices on infection prevention and accuracy of dialysis treatment orders written individually for every patient vs HD machine setting.
- Facilitated therapeutic communication, conflict resolution and crisis intervention by redirecting negative behaviors and helping patients regain or improve coping abilities.
- Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.
- Leveraged feedback and process improvement opportunities to create safer and healthier environment and increase patient satisfaction.
- Provided patient assessments and care plans. Educated patients on self-care techniques to promote better health outcomes.
- Maintained accurate patient records and documentation according to clinic standards. Ensured compliance with infection control policies and procedures.
- Managed inventory of supplies to ensure adequate stock levels at all times.
- Participated in multidisciplinary team meetings to discuss individual patient cases and coordinate care plans across departments.
- Assisted in the development of quality improvement initiatives within the clinic setting.
- Responded to emergency situations with speed, expertise and level-headed approaches to provide optimal care, support and life-saving interventions.
- Developed strategies to improve operational procedures and reduce costs.
- Managed day-to-day operations of the department including scheduling tasks and assigning duties.
- Implemented departmental policies and standards in conjunction with management to streamline internal processes.
Nurse Clinic Supervisor, Inpatient Dialysis
University Health System
07.2020 - 11.2023
- Administered medications and treatment to patients and monitored responses.
- Advocated for and strived to protect health, safety, and rights of patient.
- Collaborated with leadership to devise initiatives for improving nursing satisfaction, retention and morale.
- Performed frequent checks on life support equipment and made necessary adjustments to preserve optimal patient conditions.
- Provided strong leadership and guidance to nurses being a "go to person".
- Evaluated performance of staff nurses, contributing to professional development and recognized their effort during huddle.
- Successfully resolved internally conflicts between 2 staff who had an argument regarding patient assignments in the absence of the unit's PCC and Director of Operations.
- Performed weekly audit of treatment flow sheets and machine disinfection logs. Coaching memos and re evaluation of improvement on the cited deficiencies by non-compliant staff performed with an outcome yielding an average percentile rating of above 97% consistently.
- With the knowledge of the Patient Care Coordinator (PCC), I conceived and initiated the "cheat sheet tool" on treatment flow sheet documentation including the start up checklist guide applicable for both unit and bedside machines which had a great impact on the consistent achievement of an overall above 97% monthly flowsheet documentation compliance.
- Continuously finding opportunities of improvement particularly on increasing communication among the staff on the disinfection of HD machines especially those that were used overnight. The use of laminated color coded tags hanging on every machine will signal the unit's staff preventing fall outs on disinfection and daily regeneration of portable ROs with softener.
- Participated actively with PCC, Director of Operation (DO) and Educator in conducting the unit's annual skills fair wherein I educated the staff on the different aspect involved in peritoneal dialysis treatment, central venous catheter (CVC) dressing changed, proper way of accessing its ports and packing it with normal saline, Heparin and the procedure on clearing a partial or complete occlusion of CVAD with Alteplase. Cathflo in vial is diluted slowly with 2.2 ml sterile water for injection and rolled gently in between our palms until totally dissolved, do not shake. Get new 3 ml syringes aspirate the Cathflo according to the volume of each CVC lumen.
- Reminded and strategically assisted staff on scheduling work and education, promoting timely completion of the assigned annual e-learning and compliance with regulation.
- Assisted the PCC on bi weekly creation of staff schedule ensuring accuracy and adequacy of staff.
- Contingency plan put together in place in case outcome other than usual occur.
- Conducted Fire Drill quarterly in our unit and huddled after what needs to improve and supplemental education of staff on areas related to it needing improvement.
- Collaborated with the staff in formulating new ways to improve handoff communication with bedside RNs creating a template of questionnaire that heightens patient's safety and superb customer satisfaction.
- Performed technical audit to ensure compliance as per AAMI standards. Weekly meeting held with PCC, DO, and Biomed to discuss the findings on the audit, follow-up on scheduled monthly preventive maintenance including the monthly cultures for the water system, portable ROs and hemodialysis (HD) machines, and accurate inventory of the units machines that are tagged out of service and tagged as back up, to accommodate the influx of ESRD patients.
- Reviewed daily the water, chlorine, bicarb logs in comparison with the approved reference range for any out of parameter readings; Phoenix meter calibration for out of parameter values including its disinfection before start and end of the day ; acid/bicarb wands, blue clamps disinfection logs if performed at the end of the previous day; the timer on the water softener, carbon tanks back wash timers should all be synchronize with actual time and must be locked. Level of salt pellets in the brine tank above water. For out of parameter results, the opener and charge RN will notify Biomed and PCC/Supervisor, DO, and Medical Director for guidance. No treatment will be initiated for the meantime until the issue is resolved and Medical Director will order consequently.
- Conducted daily rounds in the treatment room inspecting for discolored or stained ceiling tiles, presence of blood specks on dialysis machines, back splash zones, cardiac monitors and its leads, TVs, wall boxes, oxygen and suction regulators, curtains dividing the treatment bays and it due date of replacement, drain pipes for build up and leaks, floor for stripped or loose tiles, sharp containers must not be over 3/4 full, needles must have its guard engaged, biohazard trash must contain used dialyzer and bloodlines including syringes with over 1 ml blood in it. Regular trash must only contain used empty syringes, plastics, empty saline bags, and other essential trash adhering to the goal of safe and infection-free working environment.
- Conducted one of four weekly infection control audit and addressing on the spot fall outs and same day in-service training for the staff.
- Audited and trended early termination of tx and AMA form signed by patients; any intra dialytic complications, incident report on blood loss occurred during dialysis treatment, conducting stand down huddle to collaborate with staff on the reasons and ways to avert frequency of its occurrence. Outcome, observed trend decreased significantly to zero. Reported during the monthly QAPI meetings.
- Documented and trended vital signs every 15 minutes including telemetry waveform observation to evaluate current patient conditions.
- Met regulatory compliance by auditing logs, weekly, on all plumbed eye wash stations, plumbed shower for water pressure and temperature and bottled eye wash for discoloration, leak, integrity, and expiration.
- At times assumed Charge RN responsibilities and before the day starts, checked crash cart readiness- expiration dates on the defibrillator pads, on emergency medicines list, defibrillator battery fully charged and tested for its expected function, portable O2 tank full as seen on the indicator, working suction and its supplies, algorithm for adult ACLS/CPR hanging on its IV pole and presence of the back board.
- On the Glucometers, performed daily control test and inspected expiration of its control solution and glucose strips, must be 3 months from its initial use and or expiration date on the bottle whichever comes first. Daily inspection of the treatment, water, equipment, and supply rooms for cleanliness and orderliness and addressed immediately with the Techs assigned for any fall outs or non-compliance.
- Established and maintained positive relationships with residents, physicians, hospital staff from other departments, patients and families through collaborative communication with the pursuit to provide high standard quality of care.
- Held regular huddle creating opportunity to mentor nursing staff, and listen to concerns and providing counsel and resolution.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Worked with healthcare team to develop new dialysis treatment flow sheet and other log forms, improving clinical documentation and accountability.
- Acted as a role model in promoting the value of discipline by reporting to work on time, teamwork and oneness.
Staff RN II (TDI West/ UH Inpatient Dialysis
University Health System
09.2017 - 07.2020
- Greeted clients and guests and assisted with variety of questions to foster exceptional customer service.
- Reviewed all the logs in the morning before the HD treatments start. On the water log, made sure the water system was adequately rinsed, readings from water hardness through RO rejection percent were within required parameters, salt pellets in the brine tank above the water, total residual chlorine log must read
- Reviewed Bicarbonate tank disinfection log for absence of disinfectant prior mixing bicarb solution and its conductivity must read plus or minus 2 of the base conductivity with the use of a Phoenix meter.
- Phoenix meters must be disinfected, checked for absence of disinfectant and recalibrated as needed prior its use. At the end of the day Phoenix meter must be rinsed with RO water 3 times then Neo care solution rinsed 3 times and let dwell overnight and then wiped it with bleach solution wipes prior storage.
- Acid storage tanks must have adequate acid in them. Mixed acid prior transferring it to its appropriate tank must have a documentation that the unit Biomed and RN checked the pH, temperature with the use of a Hydrometer.
- Inspect the crash cart daily prior start of HD treatment in the unit. The seals on its drawers must be intact, Defibrillator machine and chest pads are connected and ready to go, full oxygen tank available including its tubing and accessories same as the suction machine and algorithm for BLS and ACLS. Assignment of individual role during Code Blue or on Rapid response events must be delegated appropriately among the staff present in the unit.
- Maintained designated evacuation routes for the unit passable at all times in case of an adverse event. Emergency "take off" supply cart must be accessible and portable. Supplies in it routinely checked monthly and recorded on the attached log.
- Reinforced unit awareness to all staff by conducting on spot brain exercises that will significantly improved spontaneous response time to execute effectively RACE and PASS.
- Collaborated with unit's patient care technicians on inspecting and reporting immediately the HD/portable machines were properly disinfected prior day as documented on its individual disinfection logs, wiped down efficiently including the back splash areas of the multiple bays in the HD unit, occular inspection of the presence of the hand crank behind the HD machine and always plugged on the red outlet or outlets equipped with emergency back up power.
- At the end of the day, rounded in the treatment room reviewing HD machines logs for appropriate disinfection and documentation of disinfection made for the day.
- Reminded staff to tag appropriately the machines needing disinfection and regeneration found in the equipment room, and coordinated to the night RNs, and the RNs with late treatments, to achieve a 100% compliance rating on machine disinfection.
- Conducted daily accurate inventory of the units HD/portable machines that were up and running in contrast with the patients census to be able to plan and implement a cost effective productivity.
- With the use of a questionnaire template put together for the unit in collecting important information during handoff report from patient's primary RN, we were able to gather a brief, clear perspective of patient's current status thus direct us to working collaboratively with other disciplines towards achieving a single goal, utmost quality care of every dialysis patients.
- Continuously implemented a culture of best practices that were proven effective in research, in caring for our patients aim at mainly on infection prevention starting on the care of the patients access, central lines or AV fistulas or grafts and re education of patients the importance of their "life line" and adherence to treatment and nutrition.
- Provided patients and loved ones with information about conditions, treatments, possible outcomes and in-home care promoting patient adherence to treatment and unwavering support by the family that will greatly play a big role in their success.
- Promoted self-advocacy in patients to aid in mitigating family and health, care-provider relationships throughout treatment. Planned treatments and carried out physical and pharmacological interventions.
- Completed thorough and accurate documentation of care in full compliance with standards established by the institution.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
- Achieved departmental goals and objectives by instituting new processes and standards for in-patient care.
- Practiced patient safety by way of proper identification using 2 identifiers- worn ID bracelet and verbal confirmation by the patient.
- Prior initiation of treatment consent for hemodialysis and blood products must be obtained from patient or a family member,in situation patient's condition dictates it, together with provider and a witness, treatment order must be in placed and current serology result available in the EMR.
- Tirelessly advocated infection prevention starting with hand hygiene and washing of AV access with soap and water thoroughly and keeping CVC dressing dry and intact to include assessing possible signs of infection like discoloration, warm sensation, sensitivity, swelling, presence of exudate, fever and chills.
- Timely intervention and notification of the provider on the occurrence of intradialytic complications and outcome of the intervention made.
- Educated continuously those patients who were non-compliant on the risk of not adhering to their treatment prescription.
- Kept work flow easy through dynamic teamwork, respect and professionalism towards coworkers and patients.
- Resolved conflicts between staff members in a timely manner while maintaining professionalism.
- Always with high spirit and willingness to respond to customer queries and complaints and perform service recovery prudently.
- Precepted and trained newly hired staff regarding policies and operations of the unit, on how to properly operate the HD and peritoneal machines as well as independently able to resolve the issues in timely manner thereby increasing productivity and cost effective care.
- Instructed and reinforced the skills and knowledge gained by the Techs promoting efficiency of work and self-worth.
- Received Gold award twice due to selfless support to the unit during the snowstorm back in December 2017, when there was staffing shortage in TDI and driving through slick, icy road without thinking about my own safety. Recognized excellent performance among staff members through rewards and recognition programs.
- Responded sensitively and competently to service customers with diverse cultural backgrounds.
Staff RN
Fresenius Medical Care NA
03.2010 - 07.2017
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Monitored patients' conditions and reported changes in physical presentation, appearance, and behavior to discuss treatment with physicians.
- Assessed physical, psychological, physiologic, and cognitive status of 12 patients at a given shift.
- Administered medications via oral, IV, and intramuscular injections and monitored responses of those 12 patients medicated while on hemodialysis treatment in the clinic.
- Directed patient care by initiating and following through with plan of care, continuing care, and discharge instructions.
- Communicated with healthcare team members of 2 LVN and 3 PCT to plan, implement and enhance treatment strategies at a given shift.
- Provided skilled, timely and level-headed emergency response to critically ill patients.
- Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
- Led teams in driving successful patient outcomes by prioritizing standard of care and best practices.
- Evaluated patients to develop and update treatment plans while anticipating day-to-day needs.
- Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
- Educating patients on access related infection prevention that changed tremendously the practice and compliance of the patients regarding thorough washing of the AV access in the unit setting.
- Activated AV access infection surveillance on a button hole access on a patient in the clinic that prevented the progression of an early stage of infection and prompted timely antibiotic treatment that prevented long hospitalization and unplanned expense.
- Collaborated with the other RNs on anemia management thereby seen with improved levels of Hemoglobin by the patients in the unit.
- Established tight rapport with patients made them adhere religiously with their scheduled dialysis treatment.
Charge RN
Dimmit County Memorial Hospital
12.2004 - 02.2010
- Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
- Coordinated nursing care on a 25-bed unit through staff assignments, assisting and rounding with physicians, monitoring patient orders, and communicating with ancillary departments.
- Supervised and managed daily scheduling, tasking, and administration.
- Collaborated with other healthcare professionals to provide quality patient care.
- Conducted daily shift briefings to inform staff, 4 LVN and 3 nurses' aide of changes in patient care assignments.
- Managed patients recovering from medical or surgical procedures.
- Observed and documented patient factors such as diets, physical activity levels, and behaviors to understand conditions and effectively modify treatment plans.
- Educated family members and caregivers on patient care instructions.
- Equipped patients with tools and knowledge needed for speedy and sustained recovery.
- Delivered high level of quality care to diverse populations while overseeing patient admission and triaging based on acuity and appropriate department admission.
- Conveyed treatment options, diagnosis information and home care techniques to patients and caregivers to continue care consistency.
- Quickly responded to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Performed triage on incoming patients and determined severity of injuries and illnesses.
- Acquired training and certifications on ACLS, PALS, and TNCC ( Trauma Nursing Core Course) for Emergency Department duties.
Education
Bachelor of Science - Nursing
Union Christian College
San Fernando, La Union, Philippines03.1994
Skills
- Clinical documentation
- Quality improvement
- Care coordination
- Healthcare technology
- Patient health education
- EMR systems
- Patient advocacy
- Evidence-based practice
- Interdisciplinary collaboration
- Clinical leadership
- Team development
- Performance improvement
- Electronic charting
Clinical Nurse Coordinator of the Month
Awarded on November 15, 2024 at Metropolitan Methodist Hospital in the monthly leadership meeting. According to the Director of Inpatient Dialysis and I quote " Marvin has been a great addition to our team with years of experience and knowledge. I appreciate his calmness in dealing with pressure and respectful approach to patients and colleagues. He is a great nurse and I am happy he is with us" and quote.
Gold Award
During the Snowstorm on December, 2017 at TDI outpatient dialysis clinic. Awarded to me by Esmiralda Hinojosa, was my PCC for my unwavering dedication to work and selflessness.
Gold Award
Inpatient Dialysis, related to February 2021 week long Texas freeze. Award received for my exemplary dedication and support to our unit catering to the hemodialysis treatment needs of University Health System outpatient dialysis clinics impacted by this inclement weather.
Certificate of Eligibility
Awarded to me by Civil Service Commission, San Fernando, La Union, Philippines on September 6, 1996. Was elected as "Sangguniang Kabataan (Youth Council) Chairman of our community. Served for 4 years representing our youth in the community council, organizing sports and feeding program for the kids of indigent locale. This certificate of eligibility qualifies me for appointment in a government position, subject to the provisions of Civil Service Law and Rules and other requirements of the position applied for.
Timeline
Clinical Nurse Coordinator
Metropolitan Methodist Hospital
01.2024 - Current
Nurse Clinic Supervisor, Inpatient Dialysis
University Health System
07.2020 - 11.2023
Staff RN II (TDI West/ UH Inpatient Dialysis
University Health System
09.2017 - 07.2020
Staff RN
Fresenius Medical Care NA
03.2010 - 07.2017
Charge RN
Dimmit County Memorial Hospital
12.2004 - 02.2010
Bachelor of Science - Nursing
Union Christian College
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