September 9, 2014

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Premature infants have special nutritional needs. Since their fragile bodies cannot consume as much breast milk as full-term babies, they need extra nutrients, minerals and protein to help them grow.

A recent Baylor College of Medicine study led by Texas Children’s Neonatologist Dr. Amy Hair, and published in The Journal of Pediatrics, found that adding a cream supplement in the diets of premature infants improved their growth outcomes in the Neonatal Intensive Care Unit (NICU).

“When premature babies are born, their lungs and other organs are still developing,” said Hair. “They need extra calories to help them grow adequately while in the NICU, thus improving their long-term health and developmental outcomes.”

Hair’s study examined 78 NICU infants weighing less than three pounds at Texas Children’s Newborn Center and the University Health System at San Antonio. Half of the infants received an exclusive human milk diet consisting of mother’s own milk or pasteurized donor breast milk, and a protein fortifier. The other half received the exclusive human milk diet plus a cream supplement derived from pasteurized human milk fat. Researchers found that premature infants who received the cream supplement had better growth outcomes in terms of weight and length than infants who received just the exclusive human milk diet.

“Premature babies can tolerate only a certain amount of feedings since their stomach and intestines are extremely sensitive,” said Hair. “The cream supplement is a natural way to give them fat and boost their caloric intake without changing the volume of milk.”

Texas Children’s is the first hospital in the world to add human milk-based cream to the diets of infants who weigh less than 3.3 pounds. Since our tiniest NICU patients are fed an exclusive human milk diet, this has significantly reduced the rate of necrotizing enterocolitis, a severe and potentially deadly intestinal infection common in premature infants.

“A mother’s milk is the best nutrition a baby can have, which is why we feed only breast milk to the babies in our NICU,” said Nancy Hurst, director of Women’s Support Services at Texas Children’s. “We depend on the generous mothers who donate their excess breast milk to our Milk Bank to ensure our NICU infants have a better chance of survival during this critical stage in their young lives.”

Additionally, Texas Children’s Pavilion for Women has implemented numerous breastfeeding programs for new mothers to ensure their babies get off to a healthy start. The hospital’s focus on neonatal nutrition underscored by its initiatives to promote successful breastfeeding, has helped Texas Children’s inch closer towards achieving the Baby-Friendly Hospital designation.

Click here to learn more about Texas Children’s Milk Bank Donation Program, and click here to read Dr. Hair’s Journal of Pediatrics study.

August 19, 2014

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Imagine preparing more than 600 syringes or bottles of milk every day for an average of 80 hungry infants in the Neonatal Intensive Care Unit (NICU) at Texas Children’s Newborn Center. That’s roughly eight feedings per day for each baby in the NICU who receives human milk prepared by the Milk Bank.

Preparing milk for these fragile newborns is more than just pouring it into a bottle. Our Milk Bank technicians follow strict procedures and high quality standards to ensure the right milk is delivered to the right baby.

“It’s one of the hardest jobs to fill because it requires meticulous attention to detail, exceptional math skills, the ability to multi-task and follow procedural guidelines at the same time,” said Kristina Tucker, manager of Texas Children’s Lactation and Milk Bank Services. “Our technicians spend most of their time on their feet preparing the milk that will nourish our tiniest and most vulnerable NICU patients.”

82014MilkBankinside640After the mothers’ expressed milk is delivered to the Milk Bank on either the fourth floor of the West Tower or the eighth floor of Texas Children’s Pavilion for Women, our technicians verify the information on the labeled bottles, scan it into the system, and store the mother’s breast milk and pasteurized donor milk in large freezers and refrigerators until they are ready for use.

Every day is a busy day at the Milk Bank. From the time our technicians begin their 10-hour shift at 7:30 a.m., they’re working around the clock to ensure all feed orders from physicians are filled and ready for delivery to the NICU at 5 p.m. Despite working in a fast-paced environment, there is no room for error. Every order, which contains the physician’s instructions, is examined numerous times before the milk bottles and syringes are sent to the NICU nurses who feed the babies.

“Sometimes physicians will request that certain fortification products be added to the milk,” said Michelle Jones, a Milk Bank technician at Texas Children’s. “Since each baby’s nutritional needs are different, our primary goal is to make sure the babies receive the right fortified milk which is critical to their care.”

When fortifying the milk, technicians may add complex proteins, carbohydrates and minerals including Prolacta® products which include a cream supplement made from human milk fat that is added to the diet of premature infants who weigh less than 3.3 pounds. These products are derived from pasteurized donor breast milk and when added to mother’s own milk, provide an exclusive human milk diet for these small, vulnerable infants thereby protecting them from infection and disease.

“Most premature babies require these additional additives to help them grow,” said Nancy Hurst, director of Women’s Support Services at Texas Children’s. “The fortifiers add calories and nutrients to the milk without changing the volume since premature babies can tolerate only a certain amount of feedings.”

Once the milk is mixed, prepared and delivered to the NICU, the mission is accomplished.

At the end of the day, it doesn’t matter how many hours these Milk Bank technicians work or how much their feet hurt from standing all day. What matters the most to them is that all the babies receiving breast milk have been fed.

“It’s all about feeding the babies,” said Jones, who has worked at Texas Children’s Milk Bank for eight years. “It brings me great joy to see the positive impact that my colleagues and I have on these infants, and the trust that the parents have in us to ensure their babies’ nutritional needs are met.”

KTRK recently spotlighted a Houston-area family whose NICU baby benefited from Texas Children’s Milk Bank services. Click here to watch the video.

For more information on how to donate breast milk to the Milk Bank, click here.

August 12, 2014

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The Family Fertility Center recently hosted an open house to showcase its impressive, state-of-the-art laboratory and in vitro fertilization (IVF) clinic located on the third floor of Texas Children’s Pavilion for Women.

Dr. William Gibbons and his team provided tours to demonstrate how the laboratory’s high-tech equipment is helping couples reach their dream of starting a family.

“We use the most advanced fertility treatments available to help families achieve healthy pregnancies,” said Dr. William Gibbons, director of the Family Fertility Center and chief of reproductive endocrinology services at Texas Children’s. “We want our patients to know they’re not alone in this journey, and that our highly-skilled team of endocrinologists and obstetric anesthesiologists will provide the most comfortable treatment possible to meet each couple’s individual needs and concerns.”

81314FertilityClinicinside640Unlike other fertility clinics out there, Texas Children’s Family Fertility Center is the first in Houston to offer the EmbryoScope, an embryo monitoring system that provides continuous moving time-lapse images of embryos as they grow. This technology allows our physicians to identify the healthiest embryo to transfer to the patient, which has been shown to improve IVF success. Our facility also features micro-incubators equipped with fiber-optic, real-time pH monitoring to protect the quality of the embryo environment.

Additionally, the Family Fertility Center has partnered with The University of Texas MD Anderson Cancer Center to help cancer patients achieve their dream of conceiving a baby; Women faced with cancer have the option of preserving their fertility before they undergo chemotherapy and/or radiation treatments.

“Building families is what our mission is all about,” said Gibbons. “We’re here to serve you, and we look forward to offering the most advanced fertility treatments available in our new state-of-the-art facility.”

Click here to view a video tour of Texas Children’s Family Fertility Center. If you have questions, want to schedule an appointment, or learn more about the benefits available to full-time Texas Children’s Hospital employees, call Ext. 6-7500.

August 5, 2014

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It was off to camp for several members of Texas Children’s pediatric neurology team and their patients. They made the trek to Camp For All, a beautiful, barrier-free recreational facility in Burton that helps children with special needs experience the thrill of camping and nature, just like normal kids their age.

Each summer, Camp For All hosts Camp Spike ‘n’ Wave, a weeklong camping expedition for children and teens with epileptic seizures. They build new friendships, unleash their independent, adventurous spirit, and focus less on their disability.

“We don’t want their medical condition to completely define who they are,” said Dr. Gary Clark, the camp’s lead physician and chief of Neurology and developmental neuroscience at Texas Children’s. “Wheelchair bound or not, every child can accomplish just about anything they set their minds to.”

Unlike traditional camps, Camp For All has no barriers. The entire 100,000 square foot facility – including cabins, bathrooms, showers, and sidewalks – are completely wheelchair accessible. The sidewalks are wide enough to accommodate side-by-side wheelchairs. And, every child is able to participate in all activities, regardless of the severity of their disability. If a wheelchair bound child wants to canoe, the child is placed in a sling and lowered into the canoe with a crane so they can explore nature on the water, just like their able-bodied peers.

“I will never forget how one of our wheelchair bound patients got to go on the big swing, which is essentially a big zipline,” said Sterling Myers, a camp volunteer and pediatric neurology nurse at Texas Children’s. “It made me smile to see the campers cheer each other on at every activity and boost each other’s self-esteem.”

More than 120 children with epilepsy participated in adrenaline-pumping activities like rockwall climbing, zip lining, horseback riding, rope courses, archery, biking, fishing, canoeing, swimming, karaoke, and arts and crafts.

8614Campinside640“It was great to see their fearlessness,” said Dr. Shannon Dicarlo, a pediatric neurology physician and former fellow at Texas Children’s. “They didn’t let their epilepsy get in the way of going about their lives, making friends, and having fun.”

Behind the scenes, our Texas Children’s medical team made sure the kids received superior care away from home. Every child at camp required medication for their seizures. Texas Children’s pharmacists filled and labeled prescriptions onsite according to the patients’ electronic medicine administration record generated at the hospital.

“When you think about it, we operated a mobile hospital right here at the campground,” said Clark. “It’s all about meeting our children’s needs.”

Camp Spike “n” Wave provides unique training opportunities for fellows to observe how their clinical decisions can impact their patients. It’s not every day that physicians see patients have seizures or struggle to swallow a fistful of pills. When these happen, highly trained camp counselors, along with Texas Children’s physicians and nurses, spring into action.

“This year, we trained a 6-year-old how to swallow pills,” said Dr. Geetanjali Rathore, a pediatric neurology fellow at Texas Children’s. “He shed a few tears the first time, but by the end of the week, he became a champ at swallowing pills.”

Camps, like Camp Spike ‘n’ Wave, wouldn’t be possible without the diligent efforts of Texas Children’s own, Dr. Robert Zeller, chief of the Blue Bird Circle Clinic, who collaborated tirelessly with other physicians and organizations to create Camp For All in 1993.

“I had a patient with epilepsy who couldn’t go to camp because camps wouldn’t accept children with this condition,” said Zeller. “This prompted me to develop a camp for disabled children who can discover life without barriers. It’s my way of giving back to my patients.”

July 22, 2014

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“Please don’t hurt me. Heal me, and be nice to me.”

In that order, those are our patients’ most basic needs. Preventing errors and not harming patients are the most important responsibilities of every Texas Children’s employee.

Organization-wide Error Prevention Training launched last week to help ensure every one of us is equipped with the information and tools to keep patients safe.

This video explains why preventing errors is so critical and how each of us can make care safer at Texas Children’s.

“We take care of the sickest of the sick at Texas Children’s, and when you’re taking care of that many severely ill children, it’s a real challenge,” said President and CEO Mark A. Wallace. “Everyone recognizes that creating a safe environment – focusing on safety and error omission – is job one. Doing no harm to our patients is first and foremost.”

The Error Prevention work launched as part of the CareFirst initiative, began in January. CareFirst is primarily two things: an intense study of our core clinical areas at the main campus and an aggressive, strategic plan for how we will address our most crucial needs in those areas. The initiative is focused on the main campus Emergency Center, Critical Care units, and the Operating Rooms/PACU, because these areas provide the highly complex services that our most critically ill patients need. While CareFirst centers around expanding to better accommodate the critical needs of these high patient volume areas, its purpose is greater.

“If we don’t have the right environment, the right tools, the right people or the right structure, then it becomes very challenging to deliver the very best possible care – the safest care,” said Surgeon-in-Chief Dr. Charles D. Fraser. “Systems under duress – whether it be in the operating room or the emergency room or the intensive care unit – where there’s duress, then people become fatigued or distracted, and that’s an environment that is ripe for an error.”

The staff and employees involved in CareFirst work are vetting options to create the physical space and support needed in the core patient care areas. Combined with the Error Prevention training that kicked off last week, CareFirst ultimately will advance our efforts to ensure an optimal environment to receive and give the safest possible care.

“CareFirst is about making a promise to every child and woman who comes here that we will not harm them and equipping our facilities to ensure we keep that promise,” Wallace said. “It is far more comprehensive and much more important than expanding and building. It’s about doing what’s right for our employees and medical staff, and most importantly, what’s right for our patients, their families and their care. Ultimately, it’s about putting the care and safety of all of our patients and our people first.”

Error prevention training began in Hematology/Oncology in mid-July and will continue throughout other clinical areas over the next several months. In addition, online training will be provided for all non-clinical employees. Ultimately, every staff member and employee within Texas Children’s will receive error prevention training.

“My wish, my hope for every one of the 10,000 employees that will be going through training, that will hear about CareFirst, is that they stop and think about their individual role in supporting and delivering on zero harm,” said Chief Nursing Officer Lori Armstrong. “Everyone plays a role.”

July 15, 2014

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The Center for Children and Women is now dispensing eyeglasses. The addition of this service brings comprehensive optometry care to patients. After completing an eye exam, patients who need eyeglasses can immediately select from the many stylish frames that are available for children of all ages. This new service allows The Center’s patients to have all their optometry needs taken care of without leaving the building.

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In addition, The Center’s onsite optometrist makes it easy for Texas Children’s Health Plan members to keep up with eye exams. “I’m so proud to be a part of the Center and the value it provides the community,” says Dr. Brook Komar, The Center optometrist. “And now, in addition to their medical care, the patients can get all their eye care needs met in the same place. This is exciting.”

On May 20, all eyes were on Noel as staff members celebrated the first child receiving glasses at The Center for Children and Women. When Noel’s mom was asked what she thought of the experience, she said, “The process was very easy, and I am happy that The Center is so close to my home. Everyone has been so nice; they have taken good care of us.”

For more about information about The Center for Children and Women, visit JoinTheCenter.org.

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With the national and local demand for Acute Care Pediatric Nurse Practitioners, Texas Children’s and Texas Tech University have entered into a partnership agreement that supports faculty roles for APRNs, Priscila Reid MS, RN, FNP, CPNP-AC and Julie Kuzin, MSN RN CPNP-PC/AC. Students will enter the program this fall and will benefit from the expertise of these two APRNs that are dedicated to patients and families at Texas Children’s through advancing nursing education and training.

AC-PNPs practice in a variety of settings not only in the hospital’s intensive care and subspecialty units, they extend their practice to the community in caring for the technology dependent child and the chronically ill child with special needs. Historically, the hospital has relied on an abundance of residents to staff the 24/7 units. The shortage of residents and the mandate to reduce resident work hours from the Accreditation Council for Graduate Medical Education (ACGME) has led many hospitals to rely on acute care nurse practitioner to provide quality patient care. With the shift in the model of using more acute care PNPs, the need for education and training has increased.

The partnership between Texas Tech University Health Science Center and Texas Children’s Hospital allows for Reid and Kuzin to have a paid faculty position with the university while still spending half of their time in the patient care setting at the hospital. We believe that this partnership will strengthen the recruitment of AC-PNPs at Texas Children’s.

“We are positioning Texas Children’s to step into the 21st Century to make a difference in patient outcomes by ‘advancing nursing practice through advanced practice nursing,” said Elizabeth “Charley” Elliott, director of advanced practice providers.
The courses will officially begin in the fall.