October 21, 2014

During the past few weeks, you have heard from various leaders across the organization as to why they want you to get your flu shot. Now, it’s time to hear from your colleagues in other parts of the organization.

All six of the people below received their seasonal flu vaccine the first day it was offered at Texas Children’s. Listen to their stories to find out why they got the flu shot and why they think you should too.

Elizabeth Rincones, a patient care assistant with Texas Children’s Hospital, said she got the flu vaccine to protect herself and the children here at the hospital.

“We take care of kids every day, and if we are exposed to the flu, we could potentially expose them,” she said. “So, I think it’s very important to get the flu shot every year.”

Paige Simmons, a development associate with Texas Children’s, is pregnant with her first child and said she got the influenza vaccine to protect herself and her baby. Simmons urged other pregnant women to do the same.

“Definitely be vaccinated,” she said. “Little babies, they can’t handle it (the flu), so we need to watch out for them.”

Richard Lion is a fellow with Pediatric ICU Services and works with some of the sickest patients in the hospital. He said he got his flu shot because he didn’t want to put his patients at an increased risk of getting an infection that can be deadly to those with compromised immune systems.

“It’s well known that influenza is a terrible thing for them to experience,” Lion said. “Therefore, you can’t take any chances of putting them at risk.”

Clara Diaz, a patient care assistant who works with children who have pulmonary issues, said she gets the flu vaccine because she herself is at high risk of suffering complications from the infection.

“I already have asthma, so this lets me go,” Diaz said. “I can keep on working without stopping the work flow.”

Sarah Koohmaraie, a transplant coordinator, said she gets the flu shot every year to protect herself, her patients and her dad, who is a transplant recipient.

“I can’t think of anything more important,” she said of getting the vaccine. “The flu doesn’t discriminate, it gets everyone. So, the more people who get vaccines the better.”

Melvin Sergeant, a staff technician in Radiology, said he gets the flu shot because he knows firsthand what it’s like to have the infection.

“I’ve had the flu twice and I was hospitalized for it,” Sergeant said. “So, now I protect myself.”

Sergeant said other Texas Children’s employees should do the same.

“Please take the flu shot,” he said. “It will help you, plus it’s free.”

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 on Connect. 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.

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 October 21, almost 65 percent of employees had gotten a flu shot.

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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 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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Dr. Larry Hollier, Jr., chief of Plastic Surgery at Texas Children’s, was recently appointed chairman of Smile Train’s medical advisory board. Smile Train is the largest cleft charity in the world with a mission of identifying teams of physicians and healthcare providers worldwide who are capable of performing surgery on children with cleft lip and palate problems.

In his role as chairman of the organization’s medical advisory board, Dr. Hollier supervises a group of physicians and healthcare providers from countries around the world to ensure Smile Train provides the safest care for these children.

Dr. Hollier has been on numerous trips sponsored by Smile Train to Haiti, both before and after the earthquake in 2010. With the help of other local organizations, he also has traveled to Southeast Asia, Central America and Africa to care for children with cleft deformities and serious burn injuries. Texas Children’s plastic surgeons Dr. Laura Monson traveled to Egypt and Dr. Edward Buchanan traveled to Tanzania to treat these children as well.

Cleft deformities and serious burn injuries often are left untreated in less developed countries, leading to a lifetime of disfigurement. Smile Train tries to help resolve some of these issues and is involved in 87 countries with 2,100 partner surgeons in more than 1,100 hospitals. The organization’s team of physicians and healthcare providers have treated more than 1 million patients since Smile Train was created a decade ago. This year they already have cared for more than 120,000 children.

October 7, 2014

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A suspected Ebola case that presented at Texas Children’s Hospital West Campus last Thursday tested the organization’s preparedness plan. The good news is our staff at West Campus handled the case confidently and proficiently. The better news is that the patient tested negative for Ebola.

“At this time, there are no confirmed cases of Ebola at Texas Children’s Hospital,” said Texas Children’s Physician-in-Chief Dr. Mark W. Kline. “We are currently monitoring a case at West Campus, but the patient’s initial blood test for the Ebola virus has been reported as negative by the Texas public health laboratory.”

Standard protocol requires the Centers for Disease Control and Prevention (CDC) to conduct a confirmatory parallel test. Final test results were received from the CDC on Saturday and have been reported as negative. The patient also was tested for malaria, and that test was positive. The patient currently is being treated for malaria.

The patient arrived at the West Campus Emergency Center on Thursday afternoon. Diligent screening of the patient allowed for immediate isolation as outlined in our protocol for handling suspected cases of Ebola. The organization recently elevated screening activities at all Texas Children’s facilities based on these protocols. For the past two months, we have been implementing a detailed plan to identify, isolate and treat suspected cases of Ebola if necessary.

“As you know, our physicians and staff are among the best in the world,” Kline said. “We are thoroughly prepared to safely and confidently treat any patient who exhibits symptoms of potentially contagious diseases.”

You can review specific information about Texas Children’s preparedness plan on Connect.

Be mindful of the media

There is a lot of information with varying levels of accuracy in the media about Ebola. We encourage all staff and employees to be smart about how you communicate about this information.

Remember your role and responsibility to uphold the privacy of Texas Children’s patients.

Be mindful of any comments you share on social media. Always be respectful of organizational confidentiality.

All media requests and/or social media concerns should be directed to Public Relations Director Christy Brunton at 281-684-3184. If you are contacted by any media, please redirect them to Christy.

The best way to handle any concerns you may have is to educate yourself. The most accurate and current information about Ebola is on the Centers for Disease Control and Prevention website: www.cdc.gov

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Research done by Texas Children’s ophthalmologists could put doctors one step closer to understanding why some children go blind.

Dr. Mohamed Hussein, assistant professor of ophthalmology with Baylor College of Medicine, recently collaborated with three of his colleagues at Texas Children’s and three of his colleagues at other institutions to evaluate the association of autonomic drug use to the development and severity of retinopathy of prematurity – one of the leading cause of blindness in developing countries.

The group’s findings were published in the current issue of the Journal of the American Association for Pediatric Ophthalmology and Strabismus, and reveal a significant association between the use of autonomic drugs, the development of ROP and the need for ROP treatment.

“What this means,” said Hussein, the lead author of the journal article, “is that we may be closer to having a better understanding of the theory of how ROP happens.”

To date, researchers have not been able to determine the exact cause for the disease that blinded soul musician Stevie Wonder, actor Tom Sullivan and jazz singer Diane Schuur. Most research has focused on an infant’s oxygen levels since ROP primarily affects premature babies who received intensive neonatal care, including oxygen therapy.

“No one had looked at ROP and autonomic drug use,” Hussein said. “Now we have, and now more research can be done to find a cause.”

Until then, Hussein said he is not ready to advocate recommendations regarding the use or the dose of the autonomic nervous system drugs used in neonatal intensive care units.

“These medications are used a lot in the NICU, so I’m not saying don’t use them,” he said. “More studies need to be done.”

Ultimately, Hussein said he hopes his research will lead to the cause of ROP as well as a way to prevent and better treat the disease, which affects between 5 percent and 8 percent of NICU babies in developed countries and up to 30 percent of NICU babies in developing countries.

“ROP is a big problem for pediatric ophthalmologists,” Hussein said, adding that the disease is becoming more prevalent with the increased survival rate of premature babies. “There is a real need for more information.”

October 2, 2014

On Tuesday, the Centers for Disease Control and Prevention (CDC) confirmed the Ebola diagnosed in the United States.

“An adult patient who traveled recently from Liberia to Dallas became ill and was admitted to a hospital there,” said Texas Children’s Hospital Physician-in-Chief Dr. Mark Kline.

“Having this case in Dallas, only 270 miles away, might engender fear, especially among health care workers who come in contact with patients who might have a suspected case of Ebola, but the factors that led to this epidemic in West Africa are not present here in Texas or the United States.”

Kline emphasized the U.S. will never suffer the kind of Ebola epidemic that Africa is experiencing today because of the hygienic conditions here and, in particular, because of the infection control practices in U.S. hospitals. Texas Children’s leaders remain confident about our preparedness plans should we receive a patient with Ebola at one of our sites.

“We’ve concentrated our efforts on the main portals of entry to the hospital and the system – for example, the Emergency Center and our primary care practices across the community,” Kline said. “We’ve gone from passively screening with posted signage to active screening. Every child and family is being asked specifically ‘Have you traveled in the past 21 days? If so, has any of that travel been to West Africa and, specifically, to the countries that have been impacted by Ebola?’ ”

If the answer to those questions is “yes,” Texas Children’s has a plan in every setting for moving the child and the family to an isolated area for further evaluation.

How Texas Children’s has prepared

Texas Children’s leaders in Infection Control, the Emergency Centers, Critical Care, Emergency Management, Texas Children’s Pediatrics and other areas monitor daily Ebola updates and recommendations from the CDC and the World Health Organization. They regularly assess Texas Children’s preparedness as it relates to the most current information, and there is a plan in place in the unlikely event we receive a patient with the disease.

Preparation has included:

  • Simulation exercises and thorough education in areas that may be a point of entry for a patient with Ebola symptoms.
  • Development of specific protocol outlining the steps we will take should we receive a patient with Ebola symptoms, including designated isolation rooms in the Emergency Centers and the PICUs.
  • Securing an inventory of appropriate personal protective equipment (PPE), including full-coverage protective suits, which have been deployed to Texas Children’s Main and West campuses, Pavilion for Women and transport services (Kangaroo Crew).

“We’re doing everything we can to make certain that if we see a case of Ebola we will not have secondary cases among health care workers or among the other patients and families we serve,” Kline said.

“I’m very, very confident that with all of the policies and procedures and infection control precautions we have in place we will maintain our ability to care for patients and families and to care for one another as well.”

Important facts to remember about Ebola

Most of the population in West Africa doesn’t have Ebola.
As of September 30, there had been about 6,500 cases of Ebola diagnosed in Guinea, Liberia, Senegal and Sierra Leone. However, more than 20 million people live in these countries. This means fewer than 1 percent (.03 percent) have the virus – 99.97 percent of the residents in these countries do not have Ebola.

Diagnosis occurred in Dallas, but the disease source is still in Liberia.
Tuesday’s news revolves around the first case of Ebola that was diagnosed in the U.S. However, the source of transmission originated in Liberia – not here. Nothing has changed about the epidemiology of this virus in the U.S.

Ebola is not a highly infectious disease.
Ebola is a bloodborne pathogen – it is not transmitted like the flu or other airborne viruses. It is spread only when symptoms are present.

The CDC is the best source of information, not the media.
The best way to allay any concerns is to educate yourself. The most current information about Ebola is available online from the Centers for Disease Control and Prevention.