September 2, 2015

9315SIUinside640Texas Children’s veteran nurse Sondra Morris recently was chosen to lead the Special Response Team’s nursing unit.

Nurses will make up a significant portion of the specially-trained portion of the team, which will be called to action if the soon-to-be-complete Special Isolation Unit at Texas Children’s Hospital West Campus is activated. The eight-bed unit is designed for children with highly contagious infectious diseases. Similar to the four other biocontainment units in the country, the one at Texas Children’s will be one of the only in the United States designated just for children.

“Sondra is the best person for this job for many reasons, one of the main ones being she has led nursing teams in the Intensive Care Unit and the Emergency Center,” said Shannon McCord, director of patient services at West Campus. “She has skill and expertise in working with the unexpected.”

Morris joined Texas Children’s 20 years ago as a graduate nurse in the pediatric intensive care unit (PICU). During her time with the PICU, Morris worked as a transport nurse and later became a nurse manger.

As the Kangaroo Crew was becoming its own department, Morris transitioned to the nurse manager for that team. She spent five years there and completed her Master’s of Science in Nursing Management before moving to the Emergency Center as the assistant clinical director.

Last year when Morris learned about the creation of the Special Isolation Unit, she said she applied for the nursing leader position because she thought “it would be a unique, challenging and innovative unit that would be full of new opportunities, one of which would be building a unique nursing team that will take care of highly infectious patients, such as those with Ebola, MERS or other highly infectious pathogens.”

To date, at least 40 nurses across the Texas Children’s system have volunteered to be part of the nursing unit on the Special Response Team. The unit will work with a group of physicians, medical technologists and environmental service technicians if the Special Isolation Unit is activated.

There will be three to six nurses assigned to a patient based on the acuity of the case. Some nurses will be by the bedside while others will be observing, documenting and helping other team members donn and doff personal protective equipment.

Recruitment of all positions is ongoing. To learn more about joining the Special Response Team, click here.

“I already am impressed by the team’s dedication and passion for learning and for their willingness to care for this vulnerable patient population,” Morris said. “While I hope to rarely activate the SIU team, I am confident these patients will be in the best place to receive the best care possible.”

The decision to build a special isolation unit came last year after an unprecedented Ebola outbreak, resulting in the realization that we must be prepared to handle emerging infections as an institution. This new unit, which is scheduled to open in October, will incorporate all of the latest scientific and technological approaches to biocontainment, including negative air pressure, laminar air flow, high-efficiency particulate air (HEPA) filtration, separate ventilation, anterooms, biosafety cabinets, a point-of-care laboratory, special security access, autoclaves and incinerators. There will be two levels of protection from airborne particles, as well as a comprehensive waste management plan, among other safety features.

It will be fully equipped to care for any infant or child with a serious communicable disease, with all of the measures available to assure safety of the health care team, other patients and their families. A point-of-care biosafety level 3 laboratory will enable the care team to monitor the progress of patients and perform rapid detection methods to identify unusual pathogens. Housed at Texas Children’s Hospital West Campus, the unit is anticipated to have capacity for eight patients, all in private rooms.

This specialized unit will be led by Dr. Gordon Schutze, who will serve as medical director, as well as Dr. Judith Campbell and Dr. Amy Arrington, who will be the unit’s associate medical directors. The Special Response Team will staff the unit and will be trained in infection control, hospital epidemiology and management of infectious diseases in the critical care setting. The staff will maintain their certification through participation in ongoing educational activities.

When the Special Isolation Unit isn’t activated, it will be used as a new acute care unit for West Campus. Morris is assistant clinical director of 5 West when the Special Isolation Unit isn’t being used.

August 10, 2015

bench-and-beside-Header1Bench and Bedside is a digest of the previous month’s stories about the clinical and academic activities of our physicians and scientists. We welcome your subsmissions and feedback.

July 7

Texas Children’s Hospital launches pediatric Thyroid Tumor Program

Texas Children’s Hospital recently formed a new pediatric Thyroid Tumor Program dedicated to the diagnosis and treatment of children and young adults with thyroid tumors, cancer and diseases. Read more

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Radiology expansion promotes environment of collaboration

New and improved office space for the Department of Pediatric Radiology brings together all radiologists in one large reading room and houses the department’s offices in one centralized location. The expansion also provides space for daily morning huddles. These changes help ensure the hospital’s imaging services are available for patients in a timely manner. Read more

July 14

Dr. Susan Blaney elected chair of CPRIT Advisory Committee on childhood cancers

Dr. Susan Blaney, deputy director of Texas Children’s Cancer and Hematology Centers, was recently elected to serve as chair of the Cancer Prevention & Research Institute of Texas (CPRIT) Advisory Committee on Childhood Cancers (ACCC). Blaney, who has been a member of the committee for three years, will serve a two-year term. Read more

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Health Center staff prepares for transition to community hospital setting

With the opening of the outpatient and subspecialty building at Texas Children’s Hospital The Woodlands just 15 months away, steps are being taken to ensure the transition for staff, patients and their families is seamless. One such step was taken June 25 and 26 when staff and leaders at the Woodlands Health Center and staff and leaders at the West Campus Outpatient and Subspecialty Building met and discussed what it’s like to go from working at a small community health center to a community hospital. Read more

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Texas Children’s opens first-of-its-kind pediatric Heart Failure Intensive Care Unit

Texas Children’s Heart Center and the section of Critical Care Medicine cut the ribbon July 6 on a new, first-of-its-kind pediatric Heart Failure Intensive Care Unit. This highly-specialized 12-bed unit focuses on the treatment of children with heart failure, as well as those requiring intensive care before and after heart transplant. Read more

July 14

Young investigator given research boost from national grant

Dr. Rikhia Chakraborty is a young scientist with a distinct goal – to find the causes that potentially lead to Langerhans cell histiocytosis (LCH), a rare cancer mainly affecting pediatric patients, and determine the best way to prevent and treat the disease. Chakraborty’s research was recently recognized by Alex’s Lemonade Stand Foundation with a Young Investigator Grant worth $100,000. Read more

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Hour-long documentary on Mata conjoined twins to air on Discovery Life Channel

An hour-long documentary on the formerly conjoined Mata twins aired on the Discovery Life Channel on July 16 . The program spotlighted Texas Children’s Hospital’s efforts leading up to and after the historic surgery that separated Knatalye Hope and Adeline Faith Mata. Read more

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Department of Surgery makes great strides 2010-2015

During his annual state of the department meeting, Surgeon-in-Chief Dr. Charles D. Fraser Jr. highlighted the impressive efforts within the Department of Surgery. Read more

 

 

July 20

A new community hospital partnership allows patients to deliver at CHI St. Luke’s Health – The Vintage Hospital

Pregnant members of Texas Children’s Health Plan – The Center for Children and Women Greenspoint location recently received some big news. They can now deliver their babies at CHI St. Luke’s Health – The Vintage Hospital located in Northwest Houston. Read more

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Texas Children’s conference empowers HH patients, families

On July 11, Texas Children’s Hospital and Hope for Hypothalamic Hamartomas hosted an educational conference to empower patients and their families affected by a rare and often devastating brain condition. Hypothalamic Hamartoma (HH) is a noncancerous tumor of the hypothalamus that causes uncontrollable seizures, early puberty, hormonal imbalances and cognitive and behavioral problems. Read more

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World renowned epileptologist, colleagues visit Texas Children’s Hospital

World renowned epileptologist Dr. Helen Cross and two of her colleagues visited Texas Children’s July 9 and July 10 to get more information on the Medtronic Visualase system, which uses real-time MRI-guided thermal imaging and laser technology to destroy lesions in the brain that cause epilepsy and uncontrollable seizures. Read more

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Leaders prepare for opening of special isolation unit

Clinicians recently participated in a detailed simulation to prepare for the soon-to-be-open special isolation unit. The state-of-the-art facility will open its doors in October and a Special Response Team will stand ready to receive children suspected of having a highly contagious disease. Read more

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End-of-treatment bell brings hope for cancer patients

Patients at the Texas Children Cancer and Hematology Centers now can ring a bell in both the inpatient and outpatient units at the end of their treatment. Listen to a song Purple Songs Can Fly artist and cancer survivor Christian Spear wrote and dedicated to patients entering a new phase of their lives with the ringing of the end-of-treatment bell. Read more

July 21

ICD-10: Let’s reach 100 percent educational compliance by September 1

On October 1, Texas Children’s and other hospitals around the nation will convert to the federally-mandated ICD-10 coding system to better report patients’ diagnoses and inpatient procedures. To ensure we are ready systemwide for this transition, employees must complete their required online education and training by September 1. You can access your assigned e-learning module here. Read more

July 28

Texas Children’s Auxiliary awards given to Gargollo and Rosenfeld

The Texas Children’s Hospital Auxiliary awarded urologist Dr. Patricio Gargollo the Denton A. Cooley Fellowship in Surgical Innovation Award and orthopedic surgeon Dr. Scott Rosenfeld the Outcomes Fellowship Award for 2015. Each award totals $75,000. This is the fourth year the Department of Surgery has received funding from the Texas Children’s Auxiliary. Read more

July 28

NRI study: Insufficient energy production by mitochondria can lead to neural degeneration

In a fascinating study recently published in PLOS Biology, Dr. Hugo Bellen, Manish Jaiswal and their colleagues at the Jan and Dan Duncan Neurological Research Institute at Texas Children’s found that insufficient energy production by the mitochondria can cause photoreceptor neurons in the retina to degenerate. Read more

July 28

Fraser celebrates 20 years with Texas Children’s Hospital Heart Center

Thanks to the vision of legendary heart surgeon Dr. Denton H. Cooley and the leadership of Texas Children’s Hospital Surgeon-in-Chief Dr. Charles D. Fraser Jr ., the Texas Children’s Hospital Heart Center is one of the most active pediatric heart programs in the United States, setting a record with 32 heart transplants in 2014 and consistently treating the most complex heart issues every day. Read more

81015cancer300July 28

Texas Children’s expands crucial care to cancer and hematology patients in developing countries

Texas Children’s Cancer and Hematology Center physicians are crossing the globe to provide care for children suffering from cancer and blood disorders. Watch a video to see how the care they provide continues to reach new populations. Read more

July 28

Zarutskie’s arrival, expertise complements patient care at Family Fertility Center

Dr. Paul Zarutskie recently joined the Family Fertility Center at Texas Children’s Pavilion for Women. With more than 30 years in the field of reproductive medicine, Zarutskie combines his expertise and compassionate approach to patient care to help infertile couples achieve their dream of starting a family. Read more

August 14

Transplant Services team to host pediatric transplant symposium

Texas Children’s Hospital Transplant Services team is hosting the 2015 Pediatric Transplant Symposium at Texas Children’s Hospital. Learn how to register for this conference. Read more

August 4, 2015

8515chagas640They’re often referred to as “kissing bugs,” but a bite from a Triatomine can pose a serious health threat. These small insects carry the parasite that causes Chagas disease. Chagas is a parasitic infection caused by a single cell parasite, known as a trypanosome that has the ability to infect the heart often causing severe and debilitating heart disease. Recently, the Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development, received a grant of $1.8 million from the Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation. The grant will fund accelerated development of the first therapeutic vaccine for Chagas disease in humans, in a development program under the direction of Drs. Peter Hotez, Texas Children’s Hospital endowed chair in Tropical Pediatrics, and Maria Elena Bottazzi, deputy director of Sabin product development partnership.

“Chagas disease is considered one of the most important neglected tropical diseases affecting Central and South America, but the kissing bugs are also here in Texas, but so far there has been minimal activity toward active surveillance of the disease,” Hotez said. “This grant will help us create a vaccine that is used as an innovative immunotherapy, administered to those infected with trypanosomes to prevent the development of heart disease.”

Bottazzi said this funding is critical to making a real impact toward understanding and treating this neglected tropical disease.

“This is instrumental funding that will not only accelerate the product development but also close the gaps in evaluating parallel vaccine targets which will allow a higher probability of success,” Bottazzi said. “It will allow to transition rapidly into clinical safety evaluations which will bring the vaccine program closer to making a difference in the field and the afflicted populations.”

It’s difficult to determine when an individual has been infected with the parasite because most patients could go decades without symptoms. About a third to a fourth of those infected will eventually progress to severe heart disease, at times even resulting in sudden death. Dr. Kristy Murray, director of the Laboratory of Viral and Zoonotic Diseases, said it’s hard to pinpoint individuals who are infected because there are no real initial symptoms. Most of the patients being monitored at this point are those who have donated blood to a blood bank and tested positive.

“With the current studies being done, we’ll better understand the real at-risk population and formulate screening around that,” Murray said. Chagas disease is one of the most common diseases of people living in poverty in Latin America. One of the real surprises for us is finding evidence of transmission of the disease here in Texas,” said Hotez.

Dr. Murray said in Texas, the affected population also includes people with unique occupational or recreational exposures, for example hunters and campers. She said this isn’t to sound the alarm, but to be aware to take precautions such as staying inside in shelters or a tent to avoid the creatures that feed at night.

Ultimately, the Chagas disease vaccine could benefit up to 10 million people living with Chagas disease in the Western Hemisphere. Hotez hopes with the help of the Kleberg grant, the vaccine will be ready for clinical testing within the next few years.

June 16, 2015

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Maddie’s Mission, a Katy-based organization dedicated to educating people about a common virus that can cause a serious infection in your unborn baby, recently donated more than $40,000 to the CMV Research Fund to benefit congenital CMV research conducted at Baylor College of Medicine and Texas Children’s Hospital.

Hundreds of children with a diagnosis of congenital CMV, or cytomegalovirus, are part of the program led by pediatric infectious diseases specialist Dr. Gail Demmler-Harrison, an international expert who has spent more than 30 years caring for children affected by the condition.

CMV infections can be prevented during pregnancy, a vulnerable time to catch CMV, through “an ounce of CMV awareness and three simple precautions that include not sharing food or drink with a young child, avoiding kissing young children near the lips or cheek but rather kiss them on top of the head and giving them a big hug, and washing hands carefully after changing diapers or wiping runny noses,” Demmler-Harrison said, adding that Maddie’s Mission promotes “knowledge is key to no more CMV.”

Awareness of the potentially deadly virus is the goal of Maddie’s Mission, which was started by Farah and Patrick Armstrong last year after they lost their 12-day-old daughter, Maddie, to complications caused by CMV. Since then, the Armstrongs have thrown themselves into educating people about CMV and supporting groups devoted to finding out more about the virus, how to treat it, and possibly how to prevent CMV in pregnant women.

Physicians at Texas Children’s Hospital have treated many children affected by congenital CMV. One such child, who is shown in the adjoining photo, is Malcolm Alaimo. Malcolm travels from South Carolina for special treatments and is doing well. Another child Texas Children’s physicians have treated for CMV is Lillian Grace Salerno. Lillian has gotten antiviral treatment, hemispherectomy brain surgery, and other therapies for her congenital CMV infection at Texas Children’s Hospital, and has done well ever since.

“CMV is the most common virus most people have never heard of,” Dr. Demmler-Harrison said. “It does not often make the headlines or the evening news.”

Demmler-Harrison added that she is extremely appreciative to Maddie’s Mission for its donation and that it will be put to good use.

May 5, 2015

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Here at Texas Children’s, we proudly embrace the role of trailblazers to accelerate health care for our patients and their families. Unified in our infinite passion for the mission, we continuously innovate ourselves to meet new medical challenges and situations.

In December, we announced our plan to build an eight-bed special isolation unit at Texas Children’s Hospital West Campus. The unit is designed for children with highly contagious infectious diseases. Similar to the four other biocontainment units in the country, the one at Texas Children’s will be one of the only in the United States designated just for children.

5615SIUinside640“Having the best qualified people running the special isolation unit is key to its success,” said Dr. Gordon Schutze, the unit’s medical director. “Everyone involved will be specially trained in infection control, hospital epidemiology and management of infectious diseases in this special care setting.”

This elite Special Response Team will include physicians, registered nurses, medical technologists and environmental services technicians. The physicians and registered nurses will make up the care team while the medical technologists will perform special specimen testing in a state-of-the-art lab within the special isolation unit. In addition, the environmental services techs will handle waste processing from the unit through an autoclave.

The leaders dedicated to selecting the members of the Special Response Team have begun the process and are asking those who are interested in being a part of this unique and exciting team to raise their hands.

“Being part of this elite team will be an honor and a privilege,” said Dr. Judith Campbell, one of the unit’s associate medical directors.

Dr. Amy Arrington, the unit’s other associate medical director, agreed and said those who are selected to be on the Special Response Team will be getting the chance of a lifetime to impact care delivery. “The care that will be given inside the special isolation unit will be state-of-the art,” she said.

Texas Children’s leaders would like to have the members of the Special Response Team chosen and in place by this summer. At that point, the team will begin a series of ongoing training exercises that will ready them to be deployed to the SIU if it were to be activated.

To learn more about joining the Special Response Team, click here.

About the Special Isolation Unit

Since the decision to build a special isolation unit was made five months ago, members of a multidisciplinary team created specifically for the unit have visited two of the premiere biocontainment units in the country at Emory University in Atlanta and Nebraska Medical Center in Omaha.

Many of the lessons learned by these organizations have been incorporated into the design of the special isolation unit at Texas Children’s and can be seen in a mock-up of the unit that was recently built on the fourth floor of West Campus. Construction of the unit is anticipated to begin in May and the unit should be fully operational in October.

“This unit will help us do what we do best and that is care for children with some of the most serious and complex medical conditions,” West Campus President Chanda Cashen Chacón explained. “The organization’s decision to create a special isolation unit illustrates the level of competency and skill we have here at Texas Children’s.”

April 14, 2015

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While Ebola is no longer dominating the headlines, ongoing training and preparations ensure we remain ready to handle highly infectious diseases.

In the months since the Ebola concern, Texas Children’s has stock piled personal protective equipment (PPE) and, most recently, acquired 30 powered air purifying respirators (PAPRs). A PAPR covers the head to protect emergency responders from chemical, biological, radiological and nuclear agents. This addition to our PPE inventory helps ensure the safety of our health care professionals when they are treating patients with highly infectious diseases.

“We were well-prepared before, and we’re even better prepared now,” said Dr. Judith Campbell, medical director of Infection Prevention and Control. “We’ve always been in compliance with the CDC. Now we have the benefit of having visited both Nebraska and Emory where patients with highly contagious infectious diseases are frequently cared for, giving us an added level of knowledge.”

The infectious disease leadership team recently observed a PPE donning and doffing exercise used to successfully contain the disease at Emory Healthcare and Nebraska Medicine. The team also received a tour of their special isolation units (SIU).

The visits to Emory and Nebraska also helped in the design of Texas Children’s first special isolation unit. The unit is designed to care for a broader range of infectious diseases. Campbell said the unit and a special response team will be dedicated to caring for patients with highly contagious infectious diseases.

“When we talk about the SIU, it really is with the intent of taking care of any unusual infectious disease that’s highly contagious,” Campbell said. “There are a lot of infectious diseases emerging. Given we are a global society, it’s certainly possible that there may be another pathogen that could have the kind of impact that Ebola has had.”

Texas Children’s leaders have worked with health care facilities across the country and with the Centers for Disease Control and Prevention to share best practices that will continue to prepare us for the possibility of receiving a patient with highly contagious infectious diseases, such as Ebola. The organization continues to monitor the situation with information from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).

“We’re confident that, in many aspects, our preparation exceeds that of most other hospitals,” Campbell said. “We want to make sure we have the highest level of protection for our health care professionals.”

March 17, 2015

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Due to the increased number of measles cases in the United States, Texas Children’s Hospital has put appropriate plans in place to care for a patient with this highly contagious disease. The hospital also is making sure all employees are protected against this infection.

Employee Health and Wellness Director Jill Fragoso said nearly 98 percent of Texas Children’s employees have received the measles-mumps-rubella (MMR) vaccine or are immune by titer. She added that all employees can get a free MMR vaccine at the Employee Health Clinic.

“At Texas Children’s, we want to do everything possible to make sure our staff remains healthy and are immune to measles, and vaccination is the best way to do that,” Fragoso said. “Though much focus has been on measles cases in children, adults can pose an even greater risk of passing along the infection because of travel and the amount of people with whom we come in contact.”

Fragoso added that in addition to keeping ourselves safe, “we have a public health commitment to protect our coworkers, our families, our patients and our communities.”

If you aren’t sure whether you need the measles vaccine, medical personnel at the Employee Health Clinic can check your records or do a blood test to see if you carry antibodies to the infection. Please call Ext. 4-2150 to make an appointment today.

As for patient care, Dr. Judith Campbell, medical director of Infection Prevention and Control, said Texas Children’s Hospital is treating patients with suspected or confirmed measles like we would any other airborne transmitted infectious disease.

“Workflows are in place to identify and isolate suspected cases of the measles,” Campbell said. “There also are several mechanisms and venues in place to educate frontline employees about measles, an infection that was considered eradicated from the United States in 2000.”

In 2014, however, the United States saw a record-breaking number of confirmed cases of the infection, 644 from 27 states, including Texas where there has been one reported case since January, according to the Centers for Disease Control and Prevention.

In addition, measles is still common in many parts of the world, including some countries in Europe, Asia, the Pacific and Africa. Worldwide, an estimated 20 million people get measles and 146,000 people, mostly children, die from the disease each year.

“The CDC is urging health care professionals to consider measles when evaluating patients with febrile rash and to ask about a patient’s vaccine status, recent travel history, and contact with individuals who have febrile rash illness,” an agency flier about the infection says. “The government agency also is urging people to get vaccinated against the potentially deadly disease.”

Facts about the measles according to the CDC

What are the measles: Measles, also known as morbilli, rubeola, or red measles, is a highly contagious infection caused by the measles virus.

Can the measles be serious: Yes. About one in four people in the United States who get measles will be hospitalized; one out of every 1,000 people with measles will develop brain swelling, which could lead to brain damage; and one or two out of 1,000 people with measles will die, even with the best care.

How does the virus spread: Measles is an airborne disease that spreads easily through the coughs and sneezes of those infected. It may also be spread through contact with saliva or nasal secretions. Nine out of ten people who are not immune who share living space with an infected person will catch it. People are infectious to others from four days before to four days after the start of the rash. People usually only get the disease at most once.

What are its symptoms: The most common symptoms of measles are fever, runny nose, red eyes and rash. The rash is classically described as a generalized red maculopapular rash that begins several days after the fever starts. It starts on the head or back of the ears and, after a few hours, spreads to the head and neck before spreading to cover most of the body, often causing itching.

How is it prevented: The best protection against measles is measles-mumps-rubella (MMR) vaccine. MMR vaccine provides long-lasting protection against all strains of measles.

Vaccine Recommendations: The CDC recommends all children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.

Health care personnel should have documented evidence of immunity against measles. Health care personnel without evidence of immunity should get two doses of MMR vaccine, separated by at least 28 days. Adults who are not health care personnel and who do not have evidence of immunity against measles should get at least one dose of MMR vaccine.