October 21, 2014

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By Lori Armstrong

As a nursing community, our thoughts are with both Nina Pham and Amber Vinson, the two nurses in Dallas who contracted Ebola after caring for a patient who died from this disease after returning from Liberia. These two new cases are the first confirmed transmissions of Ebola in the United States.

Nurses play such a critical role in the care of every patient. The treatment provided in situations such as these highlights the amazing work of nurses and the inseparable link between outstanding nursing care and patient care outcomes.

Ebola is a serious illness, and as a nurse myself, I understand and share the concerns that nurses and health care providers across the country have about Ebola. Texas Children’s is committed to providing the very best care to patients with suspected or confirmed Ebola while ensuring the safety of our caregivers. Nursing leaders are partnering with Infection Control and our physician colleagues to ensure the best protocols and procedures are in place, and I am confident that Texas Children’s Hospital is prepared.

Since suspected Ebola patients will be cared for by the nurses and physicians in the Emergency Centers, Pediatric ICUs, the Women’s Assessment Center, and in the Labor and Delivery Unit, it is unlikely that many of you will come in contact with an Ebola patient at the hospital. However, for those who may care for these patients, extensive training is being provided. We are so thankful to our dedicated colleagues in these areas for their participation in all the training and preparation that is ongoing.

We will support and protect our health care team

While caring for our patients remains our focus at Texas Children’s, we are also intensely focused on protecting our physicians, nurses and staff. Keeping each one of you safe as you care for these patients means that we will provide you with state-of-the-art personal protective equipment (PPE), extensive training and education in the use of PPE, and ongoing communication.

Personal protective equipment such as impervious jumpsuits or gowns, gloves, eye protection, facemasks and shoe covers are readily available and frontline employees are being trained on the proper use of this isolation equipment. We will use PPE practice drills as well as simulation to ensure competency of all employees who will be providing direct care to these patients.

Education and communication is of utmost importance, and we are doing everything possible to stay up to date with the latest information and share it with those who will be directly responsible for these patients’ care. As new information becomes available, leaders will work to quickly understand any new recommendations, make changes and communicate those changes to you.

Our preparedness has been tested

As mentioned, designated teams are in place and I am confident we are taking the right precautions to be prepared should an Ebola patient arrive at Texas Children’s. Two weeks ago when a patient who returned from Sierra Leone presented at our West Camus Emergency Center with a fever, the patient was immediately isolated and subsequently transferred to the PICU. The appropriate teams were notified and protocols were followed.

Our staff was ready and performed flawlessly. They were careful, deliberate and efficient, and the right care was provided. The patient was discharged several days later after a negative Ebola test. The entire leadership team and I are so proud of the way this team provided expert care and executed all of the appropriate protocols while supporting the patient, patient’s family and each other.

This is reassurance that we are well prepared to care for patients with Ebola.

We will keep you thoroughly informed

As professional nurses, I encourage all of you to stay up to date on the latest Ebola information we are sharing regarding our response and readiness.

Please check Connect regularly. You can also visit the external Connect news site at www.texaschildrensnews.org anytime. We also will continue posting information here on our Voice of Nursing blog. And as always, your nursing leaders and I are here to support each and every one of you and answer any questions you may have about our preparations.

The voice of nursing is especially critical during our preparation and planning for patients with Ebola. Therefore, your input, suggestions, questions and feedback are welcomed and appreciated. You will continue to play a vital role in the coming days, weeks and months.

I am honored to work among such compassionate, dedicated nurses. I have never been prouder of our team for taking such great measures to care for patients who need us most. You inspire me to be a better nurse and a better leader.

October 17, 2014

In a news conference held earlier today at the Capitol in Austin, Texas Governor Rick Perry announced initial recommendations for better containment and care of diagnosed Ebola patients in Texas.

Perry was advised by the 17-member Texas Task Force on Infectious Disease Preparedness and Response that he created earlier this month, days after the first case of Ebola was diagnosed in the U.S.

“One of the lessons learned over the last few weeks is the importance of having specialized facilities for bio containment and for training health care workers in order to manage the complex care required by patients with Ebola,” said task force member Dr. Peter Hotez who also is director of the Texas Children’s Center for Vaccine Development. “A key recommendation from the task force calls for the creation of such facilities.”

Perry’s task force recommended state designation of Ebola Treatment Centers equipped to treat and care for adult patients with confirmed Ebola. These state-designated Ebola treatment facilities would be equipped to provide highly specialized infectious disease care, including infection control and protection of health care workers, decontamination, waste management, complex early stage experimental therapies, and various coordination and communication capabilities with local, state and federal partners.

The group specifically recommended University of Texas Medical Branch/ Galveston National Laboratory (UTMB/GNL) for the treatment and care of adult patients with Ebola. UTMB/GNL is a leading resource for all aspects of high consequence infectious diseases like Ebola. In a statement released by UTMB on Thursday, the organization said it has the expertise to safely and effectively care for Ebola patient needs, and there already is a plan in place for staffing and fluid decontamination. UTMB also houses a qualified incinerator.

Additional recommendations from the task force include:

  • Establishment of two Ebola Treatment Centers in Texas
  • Establishment of specialized patient transport teams
  • Expanded training of infectious disease protocols for health care workers
  • More testing labs for infectious disease
  • Increased authority for Department of State Health Services chief to issue Enforceable Control Orders

The task force will have its first hearing on October 23 to focus on medical and public health preparedness for initial identification and isolation of patients with Ebola or similar high-consequence infectious diseases and will submit initial assessments and recommendations by December 1 for consideration by Governor Perry and the Texas Legislature.

To view details of the task force’s recommendations, please visit here.

The task force has not made recommendations for the care of pediatric patients or pregnant women, but Hotez said they are studying the matter and will have additional recommendations soon. In the meantime, Texas Children’s is maintaining its focus on the preparedness plans already in place.

“The recommendations for adult care do not impact our planning and preparation,” said Texas Children’s Physician-in-Chief Dr. Mark Kline. “We will continue to train and over prepare our health care team to confidently treat any patient who exhibits symptoms of any potentially contagious disease.”

October 14, 2014

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The flu can place a heavy burden on the health and well-being of children and their families. That burden can be especially heavy for those whose immune systems already are compromised.

“In hematology and oncology, we have a large number of patients who are immunocompromised,” said Dr. David Poplack, director of the Texas Children’s Cancer Center. “That means they are at a much greater risk of suffering an infection.”

If that infection is the flu, it could mean an extended hospital stay, the worsening of chronic health problems or, in some situations, even death.

To best protect our immunocompromised patients from influenza, those patients, their families and the health care workers who treat them should get a flu vaccine.

In addition to people with compromised immune systems, people who have the following medical conditions also are at high risk of developing flu-related complications:

  • Asthma
  • Chronic lung disease
  • Heat disease
  • Blood disorders
  • Endocrine disorders
  • Kidney disorders
  • Liver disorders
  • Metabolic disorders

“Because we treat so many people with these types of conditions here at Texas Children’s,” Poplack said. “We must have all of our employees and anyone who comes in contact with these patients immunized with the flu vaccine.”

About 5,500 Texas Children’s employees already have gotten their flu vaccine. Now it’s your turn to be part of the solution and help yourself as well as our high risk patients.

Employee Health is administering free seasonal influenza vaccinations to all Texas Children’s employees, Baylor College of Medicine employees working in Texas Children’s facilities, Texas Children’s medical staff and volunteers. Leaders from Texas Children’s Pediatrics, Texas Children’s Health Centers and The Center for Women and Children will inform their staff about seasonal flu vaccination details.

Click here to view vaccination schedules for both Main and West Campuses. Employee Health strongly encourages you to get your vaccine at one of the times listed on the schedule. If you are unable to do so, please schedule an appointment to get the flu vaccine at the Employee Health Clinic after October 1.

And, remember, getting an annual flu shot is part of Texas Children’s P3 incentive plan, which is an important component of the total rewards you receive at Texas Children’s Hospital. As part of P3 , we are striving for at least 90 percent of our staff to get vaccinated by Monday, December 1. As of October13, almost 65 percent of employees had gotten a flu shot.

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They say everything’s bigger in Texas and we definitely represented our state well at the national nursing Magnet® conference in Dallas last week. More than 7,000 nurses and nursing executives from top hospitals came to celebrate Magnet Recognition® and gathered to share evidence-based practices. Amongst them were a group of 52 Texas Children’s nurses and nurse leaders. It was an honor to represent the incredible nursing team at Texas Children’s and a truly inspirational experience.

This year’s conference was my third and I had the great pleasure of presenting along with my colleague Jackie Ward, RN Asst. Vice President of Nursing. Our presentation, “A framework for leadership development and succession planning” was amongst four podium presentations and three poster presentations by nurses and leaders from Texas Children’s. This was our chance to shine and present to the other hospitals what our nursing team has been doing to improve outcomes and reach for excellence in nursing care. It was amazing to see so many hospitals that are striving for nursing excellence in one place. There were nurses from all over the world focused on improving outcomes and achieving Magnet® status. We also had a specific pediatric session where all the pediatric hospitals came together to discuss how to achieve positive outcomes within pediatric subspecialties.

During the conference, talk of Ebola was rampant, as Dallas is the site for treating an Ebola patient. I toured Children’s Medical Center Dallas Hospital, and was asked screening questions related to international travel. During the conference, we discussed our plans for Ebola screening, and Texas Children’s is right in line with other hospitals in preparations.

The theme of this year’s conference, “think big, go magnet,” went hand-in-hand with our state’s larger than life mentality. It was an opportunity to share great ideas and be inspired to do big things to improve patient care through nursing. We were especially proud to represent Texas Children’s as our own neonatologist and star of TLC’s The Little Couple, Dr. Jennifer Arnold kicked off the conference as the keynote speaker. Dr. Arnold gave an inspirational talk highlighting the strong partnerships between nursing and physicians in planning and coordinating patient care.

It wasn’t all business at this conference. One of my favorite moments of the trip was a pizza night for Texas Children’s nursing staff where we got to kick back, relax and have some fun getting to know the other nurses better. After a week away from the hospital, I am happy and excited to bring back everything I learned to share with the rest of my team and really put best practices to use here. The Magnet® conference is a chance to be reminded of how important of a role you play in the patients’ lives. You walk away proud to be a nurse, inspired to do great things, and pumped about the Magnet program®.

Texas Children’s Hospital West Campus is excited to announce the addition of five new members to its surgical team: otolaryngologist Dr. Karina Cañadas, minimally invasive pediatric general surgeon Dr. Charles Hartin Jr., orthopedic hand surgeon Dr. Thomas Hunt III, hand and microvascular surgeon Dr. Mitchel Seruya and otolaryngologist Dr. Matthew Sitton.

“I am thrilled to welcome five new surgeons to our team,” said Dr. Allen Milewicz, chief of community surgery at Texas Children’s Hospital West Campus and associate professor of Surgery and Pediatrics at Baylor College of Medicine. “In addition to being able to provide more convenient access for patients, the arrival of these new surgeons will allow expansion of the high quality expert services available at Texas Children’s Hospital West Campus. These pediatric specialists are bringing new treatments and state-of-the-art techniques to children and families in our community.”

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Dr. Karina Cañadas, otolaryngologist

Cañadas, who also serves as assistant professor at Baylor, completed her undergraduate degree at the University of Rochester. She earned her medical degree from Georgetown University and went on to complete her residency at Yale University School of Medicine. Cañadas was a pediatric otolaryngology fellow at Baylor.

Cañadas’ clinical interests include airway reconstruction, pediatric head and neck masses, vascular malformations and sinus surgery. Her research interests include adipocyte differentiation in hemangiomas, vascular malformations and fetal and post natal airway evaluation. Cañadas is a member of the American Academy of Otolaryngology and the American Thyroid Association.

Dr. Charles Hartin Jr., minimally invasive pediatric general surgeon

Hartin, who also serves as assistant professor at Baylor, earned his undergraduate degree at the University of Alabama at Birmingham. He received his medical degree from University of South Alabama College of Medicine and completed his general surgery residency at State University of New York at Buffalo. Hartin completed two fellowships, one in pediatric surgery research at Women & Children’s Hospital of Buffalo, and one in pediatric surgery at Baylor.

Hartin’s clinical interests include minimally invasive surgery using the fewest and smallest incisions for procedures. His other clinical interests include neonatal surgery, oncology, chest wall deformities, complicated abdominal wall defects, and trauma. Hartin is a member of the American Pediatric Surgical Association, American College of Surgeons and the American Academy of Pediatrics.

Dr. Thomas Hunt III, orthopedic hand surgeon

Dr. Thomas Hunt III, professor and chair of the department of orthopedic surgery at Baylor, has dedicated his career to treating sports injuries of the hand, wrist and forearm in athletes of all ages and at all levels of ability. He serves in the capacity of team physician for a national football league franchise, national medical advisor for professional golf and as a resource for elite athletes worldwide. Hunt is a graduate of Stanford University and Vanderbilt University School of Medicine. He completed his orthopedic surgery residency, along with a research fellowship focused on bone regeneration, at the University of Kansas. He also completed a fellowship in hand, upper extremity, and microsurgery at the Hospital of the University of Pennsylvania. Recently, he graduated with a Doctor of Science Degree in Administration-Health Services from University of Alabama in Birmingham.

Hunt is a board-certified orthopedic surgeon who holds a certificate of added qualification in hand surgery. He is a member of numerous national and regional specialty societies including the American Society for Surgery of the Hand, American Association for Hand Surgery, American Orthopaedic Society for Sports Medicine, American Academy of Orthopaedic Surgeons and the American Orthopaedic Association.

Dr. Mitchel Seruya, hand and microvascular surgeon

Seruya, who also serves as assistant professor of plastic surgery at Baylor, received his undergraduate and medical degrees at Columbia University. He completed his residency at Georgetown University and his craniofacial and hand/microvascular fellowships at Royal Children’s Hospital in Melbourne, Australia.

Seruya’s clinical interests include neonatal brachial plexus palsy, cerebral palsy, congenital hand anomalies and traumatic hand injuries. His research interests are focused on understanding clinical outcomes following pediatric upper extremity surgery and optimizing functional restoration. Seruya is a candidate member of the American Society of Plastic Surgeons and the American Society of Maxillofacial Surgeons.

The Hand and Microvascular Surgery Clinic at Texas Children’s Hospital treats patients with congenital hand defects, traumatic hand injuries as well as acquired hand ailments. The clinic team, which includes Seruya and Hunt, is comprised of a multidisciplinary group of hand surgeons, nurses, occupational hand therapists and medical assistants. A fully functional radiology suite is adjacent to the clinic, streamlining the process from diagnosis to management.

Dr. Matthew Sitton, otolaryngologist

Sitton, who is also an assistant professor at Baylor, earned his undergraduate degree at Mississippi College. He completed his medical degree at the University of Mississippi School of Medicine and his otolaryngology/head & neck surgery residency at Medical College of Wisconsin. Sitton was a pediatric otolaryngology fellow at Baylor.

Sitton’s clinical interests include acquired and congenital head and neck masses, vascular malformations, thyroid disorders, hearing loss and salivary management. His research interests include quality improvement and clinical outcomes. Sitton is a member of the American Thyroid Association, American Society of Pediatric Otolaryngology and American Academy of Otolaryngology.

October 7, 2014

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“I’m ecstatic to introduce to you our Voice of Nursing blog,” said Lori Armstrong, chief nursing officer.

As the largest segment of the Texas Children’s workforce, the nurses are the heart and soul of this organization. You are at the bedside of the children and women who trust their care to us. You truly make a difference in the outcomes of our patients.

Through the reinvention of nursing, we have taken many steps toward helping our nursing staff be the strongest it can be. At 2,500 strong, I truly believe we are the best we’ve ever been. You now have access to better education, you have more colleagues to help with the incredible patient volumes, and your nurse leaders are now closer to the unit to help meet your needs. Our nurses are more qualified than ever to care for the increasingly complex cases we see each day.

Together, we do tremendous work here, and this blog is a place for Nursing to shine. It’s a tool to: communicate about new, successful approaches to patient care; share advice about things that have made a difference in your career; or tell us about a patient who has changed the way you care for others. The Voice of Nursing is a place for you to share your stories. These stories may give you ideas for implementing successful practices in your own units, or they may just help you get through a rough day at work. This is your space to inspire other nurses and share our successes with colleagues across the organization.

I hope you find this blog informative and inspirational, but more than anything, I hope it starts an open conversation between all of us. You will hear from me, and I hope to hear from you.

So let’s get started!

Jump to areas of interest. On the right-hand side, you will find the strategic areas the blog will address. You can use these tabs to go back to stories that may interest you and read what your colleagues have shared in the past.

Connect and comment. Below each post you’ll find room to comment. I encourage you to leave your thoughts after each blog that inspires you. I encourage open feedback that’s also courteous and respectful.

Make sure to write to me as well.

Subscribe. There is a button on the column to the right of the page which gives you the option to subscribe. When you subscribe, you’ll receive the new blog posts in your email inbox once a week. I highly encourage it!

I’m so excited about the Voice of Nursing. This is our space for your voice – let’s start the conversation.

September 23, 2014

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Flu season is right around the corner and leaders at Texas Children’s want you to protect yourself and your patients by getting a seasonal influenza vaccine.

Throughout this year’s flu season, you will hear from leaders across the organization about why you should get vaccinated and how you can encourage your co-workers to do the same. Texas Children’s CEO and President Mark A. Wallace delivers the first message of this year’s flu campaign here:

Quick, Easy, Free

The Centers for Disease Control and Prevention predicts this year’s flu season will begin in October but recommends people get vaccinated now to ensure they are protected, explaining it takes about two weeks after vaccination for antibodies to develop and provide protection against the illness.

Texas Children’s is making that task quick, easy and free for all of its employees. Starting from 6:30 a.m. to 5:30 p.m. on Tuesday, September 23, on The Auxiliary Bridge and from 6:30 a.m. to 11 a.m. and noon to 2 p.m. at West Campus’ lobby, Employee Health is administering free seasonal influenza vaccinations to Texas Children’s employees, Baylor College of Medicine employees working in Texas Children’s facilities, Texas Children’s medical staff and volunteers. Leaders from Texas Children’s Pediatrics, Texas Children’s Health Centers and The Center for Women and Children will inform their staff about seasonal flu vaccination details.

Click here to view future vaccination schedules for both Main and West Campuses. Employee Health strongly encourages you to get your vaccine at one of the times listed on the schedule. If you are unable to do so, please schedule an appointment to get the flu vaccine at the Employee Health Clinic after Wednesday, October 1.

P3 Incentive Plan

In addition to helping you stay healthy, getting an annual flu shot is part of Texas Children’s P3 incentive plan, which is an important component of the total rewards you receive at Texas Children’s Hospital. Employees working in other parts of Texas Children’s have their own incentive plans, all of which encourage workers to get a flu vaccine.

As part of P3, we are striving for at least 90 percent of our staff to get vaccinated. We were successful in achieving that goal last year, and organization leaders are confident that with YOUR support we’ll reach our goal again this year.

“Getting your flu vaccine is a big part of our compensation program, but most importantly, it’s about quality, service and safety for all of our patients, families and for you,” Texas Children’s President and CEO Mark A. Wallace said. “I’m going to get the flu vaccine and I want you to be right behind me.”

Additional information regarding Texas Children’s influenza vaccination policy can be found here. As a reminder, staff should be in compliance by Monday, December 1.