March 21, 2017

On March 17, the 500th liver transplant was performed in the Main ORs at Texas Children’s Hospital. Dr. John Goss, medical director of Transplant Services and surgical director of the Liver Transplant Program at Texas Children’s, led the team who transplanted a donor liver into a 5-year-old boy. This volume has only been accomplished by a handful of pediatric programs in the U.S., and Texas Children’s is now among this distinguished group.

The multidisciplinary team involved in the milestone included: surgeons Drs. John Goss, Christine O’Mahony, Thao Nguyen and Abbas Rana; anesthesiologists Drs. Paul Hopkins and Ann Ng; physician assistant, Marielle Faraone, and nursing circulator Jana Brunet, with surgical techs Susan Burnicle and Danielle Govea. Transplant coordinator, Ashton Bramlett, organized the transplant, ensuring all were informed and kept the parents updated.

The extended liver transplant team includes: anesthesiologists Drs. Rahul Baijil, Carlos Campos, Nicholas Carling, Yang Liu, David Mann, Nihar Patel, Steven Stayer, William Waldrop and Kenneth Wayman. Perioperative Services staff on the liver transplant team includes: nurses Theresa Bagley, Jana Brunet, Anita Hadley, Lindsay Meade, Audra Rushing and Wendy Sison, with surgical techs Megan Izaquirre and Marlon Wilkins.

“I would like to congratulate everyone at Texas Children’s who has contributed to the development of our Liver Transplant Program,” said Dr. Charles D. Fraser Jr., surgeon-in-chief at Texas Children’s. “Reaching this significant milestone is a reflection of the incredible teamwork and dedication of those who care for our transplant patients each day.”

The institution’s first liver transplant was completed on September 14, 1988. In 2013, the program performed 43 liver transplants, the largest number completed in one year at Texas Children’s.

Imagine spending several months trying to find the pathogen responsible for a cluster of Burkholderia cepacia infections among critically ill, hospitalized patients. For infection preventionists, solving this mystery can be a daunting task but not impossible if you have the epidemiology skills and collaborative resources in your investigative toolbox.

When Texas Children’s had a small outbreak of B. cepacia infection last year, Texas Children’s Quality and Safety Director Elaine Whaley immediately sprang into action to identify the cause of the outbreak. Her extensive experience in infection prevention and control coupled with her professional networking skills helped her locate an infection preventionist at another pediatric hospital one-thousand miles away who had experienced a similar outbreak. Together, they identified the pathogen responsible for the B. cepacia outbreak in their respective hospitals.

Partnering with Infection Preventionist Angela Rupp of Lurie Children’s Hospital of Chicago, their collaborative investigation expedited the nationwide recall of liquid docusate, a medication used to treat constipation. This product was later found to be contaminated with the bacterium B. cepacia, which was directly responsible for the sudden outbreak of infection at both hospitals.

As a result of their work and commitment to promoting a culture of safe patient care, Whaley and Rupp will be recognized with the Heroes of Infection Prevention Award during a special ceremony in Portland by the Association for Professionals in Infection Control and Epidemiology (APIC).

“It is a great honor to have one of our own be nationally recognized for this heroic award in patient safety,” said Trudy Leidich, Texas Children’s assistant vice president of Quality and Safety. “We are grateful to Elaine and our Infection Control team for identifying the direct source of contamination in order to keep our patients safe and free from preventable harm.”

B. cepacia is the name for a group of bacteria that can be found in soil and water and are often resistant to antibiotics. The bacterium can cause life-threatening infection in high-risk, medically complex children, such as children with cystic fibrosis and immunocompromising conditions.

In February 2016, when a small cluster of patients at Texas Children’s and Lurie Children’s Hospital came down with B. cepacia infection, Whaley and Rupp initiated separate outbreak investigations. But once the two hospitals’ clusters were confirmed to be identical, the patients were combined to facilitate the investigation.

After thorough analyses, their investigation found that the ducosate product at each hospital came from the same manufacturer. After reporting these findings to the Centers for Disease Control, the Food and Drug Administration was called into the investigation which subsequently resulted in a national product recall. This recall protected patients at Texas Children’s and patients at other pediatric hospitals across the nation from this serious pathogen.

Howdy, the mascot for the Houston Livestock Show and Rodeo, paid a visit on March 15 to several patients on the 12th and 21st floors of West Tower.

The mascot brought several smiles to the faces of the children, many of whom will be unable to attend the livestock show and rodeo this year.

The visit was a chance for the children and their families to get a small taste of an event that draws more than 2 million visitors from across the globe to Houston’s NRG Stadium each year.

Click here to learn more about the event, which concludes on Sunday, March 26.

The Auxiliary Gift Shop recently opened its new location on the first floor of the Pavilion for Women.

The gift shop replaces the Pavilion Express gift shop near the Fresh Bistro and is conveniently located for patients, families, employees and volunteers just off the main lobby of the Pavilion for Women.

The shop features a variety of gifts, fresh flowers, candy, snacks and drinks. Its hours of operation are 7 a.m. to 7 p.m. Monday through Friday and noon to 5 p.m. Saturday and Sunday.

Brooke Mulkey of Orthopedic Surgery, is the latest Texas Children’s Super Star employee. “Working in pediatrics is unique. You are challenged daily with the needs of the patient and their family.” Read more of her interview below and find out how you can nominate a Super Star.

Your name, title and department. How long have you worked here?
Brooke Mulkey, RN, BSN, CPN, clinical program coordinator in Orthopedic Surgery. I have worked for Texas Children’s for five and a half years.

What month are you Super Star for?
December 2016

Tell us how you found out you won a super star award.
My Practice Administrator called a meeting and announced the award to me and the clinic.

What does it mean to be recognized for the hard work you do? How has the organization helped you achieve your personal and professional goals?
I am honored to be recognized for the hard work.

What do you think makes someone at Texas Children’s a super star?
Working in pediatrics is unique. You are challenged daily with the needs of the patient and their family. It also is equally rewarding. A Super Star employee goes beyond what is expected, anticipates the need of patients, families and even their coworkers.

What is your motivation for going above and beyond every day at work?
I enjoy helping people and I believe every patient deserves the best care possible.

What is the best thing about working at Texas Children’s?
Working with people who share my same passion.

What does it mean to you that everyone at Texas Children’s is considered a leader? What is your leadership definition?
A leader is someone who goes above and beyond what is expected. Someone who has the ability to recognize problems and create solutions.

The nursing team on 14 West Tower (WT) has reached an impressive milestone – 500 days and counting without a Central Line Associated Blood Stream Infection (CLABSI). Training, practice, diligence, team work and a collaborative focus on safety contributed to this team accomplishment.

Several new patient safety procedures were implemented to achieve this goal. Twice a year, each nurse on the unit completed return demonstration on a sterile dressing change and a sterile cap change during Critical Competency sessions, and thereafter got checked off on these skills at least once per quarter.

The unit recently started a new system in which all nurses are divided into three groups. Each group is assigned to a specific time of the year. During their assigned time, they work with central line champions to verify their central line maintenance techniques are up to par and are given real time live feedback. These observations ensure that each nurse performs these specialized skills in the safest and most evidence-based manner.

“We care for many patients on 14 WT who have central lines,” said Karen Santos, nightshift patient care manager on 14 WT. “Our team has been greatly involved and highly motivated to learn and diligently follow all of the correct steps and processes it takes to care for central lines.”

The Unit Quality Practice Council members also have been involved in these efforts to prevent CLABSIs by engaging all staff members on the importance of proper care of central lines. The unit has six nurses who volunteered to become central line champions. They attend monthly meetings to learn more about central line care, share any new knowledge and information with the rest of the team, complete monthly observations of central line care and access, help with annual check-offs, and act as safety advocates for our patients with central lines.

The 14 WT team takes pride in keeping our patients healthy, safe, and free of central line infections. The unit’s leadership team recognized this 500-day milestone with an early morning breakfast celebration to show how proud and appreciative they are of each and every nurse who helped bring this goal to fruition.

The countdown of success is constantly on display to remind 14 WT team members to keep patient safety on the forefront of their minds. Safety is our priority!

Lois Gabriel, Clinical Product Coordinator role in Supply Chain, died March 13, 2017 at the age of 71 after an extended illness.

Lois joined Texas Children’s Hospital May 15, 1978. She worked for many years as a nurse manager in the Texas Children’s Newborn Center. In later years of her career she moved in to the Clinical Product Coordinator role in Supply Chain before retiring in 2014.

For those that knew her she was a gem with such a calming presence and a mentor and friend to many. Lois is truly missed.

Please keep her son and family in your prayers.