February 14, 2017

21417WallofHope250On September 8, 2011, Katy Haynes, a former neonatal nurse at Texas Children’s, became the patient family when her daughter, Maggie, was cared for at Texas Children’s neonatal intensive care unit (NICU).

Maggie was diagnosed with a giant omphalocele, a condition in which the abdominal muscles do not close properly and the intestines push out into the umbilical cord creating a large sac. She spent two weeks in the NICU.

“The staff started out as my colleagues and in the end, became the caregivers to our sweet Maggie,” Haynes said. “I truly owe Maggie’s short NICU stay to the great team that took care of her. They trusted me as a nurse and her mother, and worked with me to create a care plan that would work both in the NICU and at home.”

Today, Maggie is a thriving 5 year old. Despite having abdominal surgery, she is a strong, compact, muscular powerhouse. Haynes say her daughter excels at gymnastics and anything that she sets her mind to accomplishing.

The Haynes family is one of 10 NICU families featured in the second installation of the Wall of Hope, a permanent photography exhibit that was unveiled during a special ceremony on February 9 at Texas Children’s Pavilion for Women. The exhibit will be housed on the fourth floor of West Tower.

“The Wall of Hope was created to inspire and give hope to families who currently have a baby in the NICU at Texas Children’s,” said Family Centered Care Specialist Tamara Thrasher-Cateni, who worked with the Newborn Center Family Advisory Committee (NCFAC) and Facilities to coordinate the Phase II initiative and unveiling ceremony. “Babies born prematurely or with health issues can spend weeks and months in the NICU, so this exhibit is a way to celebrate all they have overcome.”

The Wall of Hope exhibit features 10 portraits chronicling each patient’s challenges throughout their time in the NICU and showcasing how they are thriving today.

“This event was emotional, informative and refreshing,” said Erika-Michelle Best, whose daughter, Nalah, was treated for osteogenesis imperfecta, also known as brittle bone disease, in the NICU for 14 weeks. “It is refreshing to know that you’re not alone. It is also an honor to know Nalah’s story can help someone else, uplift someone, brighten their day and most importantly give them hope.”

The unveiling ceremony also included remarks from Texas Children’s Chief of Neonatology Dr. Gautham Suresh, NICU Nursing Director Heather Cherry, and Newborn Center Vice President Judy Swanson.

“Looking at the photographs of our NICU graduates, listening to the parents speak about their children with pride and describing how much joy the children brought to their families, I am reminded about the true reason why all of us come to work every day at Texas Children’s,” Suresh said. “I feel privileged to serve and give our patients and their families the best care possible. I am humbled by the strength and resilience of the children and their families.”

January 24, 2017

12517Barcodemilk640On January 17, Texas Children’s implemented barcode scanning for breast milk to reduce administration errors system-wide by ensuring that the correct breast milk is delivered to the right baby every time.

“Since 80 percent of breast milk orders originate in the NICU, we implemented barcode scanning in our Newborn Center last September as part of a pilot project which produced amazing results,” said Texas Children’s Patient Care Services and Clinical Informatics Director Jennifer Sanders. “We are excited to deliver this functionality across our Medical Center campus, the Pavilion for Women and West Campus.”

Using the same barcode scanning system to prevent medication administration errors, the Positive Patient Identification (PPID) process incorporates Epic Rover, a mobile software application that uses barcode technology to positively match breast milk orders to the right patient, subsequently reducing the potential risk of adverse patient safety events during the milk handling process.

Once Epic Rover is downloaded to an iPod Touch equipped with a scanner or sled, a nurse scans the barcode on the patient’s wristband and the barcode on the breast milk container at the patient’s bedside instead of having to manually check it prior to a feeding. The milk order documentation then flows real-time from Epic Rover into Epic, which also documents any supplements added to the breast milk.

“Since using Epic Rover in our Newborn Center, our compliance rates have consistently soared above the 95 percent goal,” said Texas Children’s Clinical Informatics Manager Erin Davies. “We have avoided documented near misses where Epic Rover detected the wrong breast milk with the wrong baby, which demonstrates the tremendous impact barcode scanning has on ensuring the safety of our patients.”

The successful implementation of Epic Rover at Texas Children’s involved the collaboration of several departments including Clinical Informatics, Information Services, Food and Nutrition Services, Milk Bank, Pharmacy, Nursing, and the Nursing Professional Development team that helped apply PPID safety protocols to breast milk.

Barcode scanning for breast milk will also go live at Texas Children’s Hospital The Woodlands when the facility opens this spring.

12517RebaHillawardsinside640The 17th Annual Reba Michels Hill Memorial Grand Rounds were held recently. Awards were given to Neonatology non-physicians who have made a significant contribution to advancing the quality to which Dr. Hill was dedicated: compassionate commitment to education, patient care, research and family.

January 17, 2017

11817drhair175Dr. Amy Hair, neonatologist and director of the neonatal nutrition program at Texas Children’s Hospital, was selected by the American Society for Nutrition (ASN) to receive the 2017 Samuel J. Fomon Young Physician Award.

This award is given to a physician within 10 years of completion of medical postdoctoral training for outstanding work in the general area of pediatric nutrition, infant growth or body composition.

Hair will be presented with the award at the ASN’s awards ceremony on April 23 in Chicago. Hair is nationally known for her leadership in advocating for human milk feeding for very low birth weight infants and has published numerous studies related to human milk feeding.

January 10, 2017

11117clabsi640Texas Children’s neonatal intensive care unit (NICU) 2 nursing team has a big reason to celebrate – they reached 365 days and counting with zero central line-associated bloodstream infections (CLABSI), which demonstrates the value of team work and our hospital’s commitment to cultivating an environment for safe patient care.

In November 2015, NICU 2 reported three CLABSI infections. Since then, the rate of CLABSI occurrences has dropped to zero.

“Last fall, we were concerned about the number of CLABSIs we were having not only in the NICU but across the organization,” said NICU Clinical Nurse Specialist Alex Luton. “Together, with our infection control counterparts in education and vascular access, we implemented a massive educational initiative that trained more than 2,000 nurses across the organization on several key skills in central line care.”

Besides opening dialogue with the bedside nurses and care providers to identify and close any gaps observed around central line care, current hospital policies and practices were reviewed against national standards to identify areas of care that could be standardized to reduce CLABSI occurrences.

“Prior to this initiative, units had their own way of accessing and maintaining the central line,” said NICU Education Coordinator Rachel Leva. “Now, all nurses follow the same standard procedure for central line maintenance across the hospital system which has significantly helped us reduce our CLABSI rates in NICU 2.”

Creating the new role of central line resource nurses (CLRNs) has also provided an added layer of support for CLABSI prevention. To help bedside staff focus on other important patient care responsibilities, the CLRNs round on all patients with central lines during every shift.

“By providing central line care support and education, we’ve been able to address concerns early before they potentially manifest into a bloodstream infection,” said Ivy Lynn Ersan, a CLRN in NICU 2. “For instance, if a patient sweats a lot or has a lot of secretions, we may need to check on the patient more frequently per shift and change the dressing sooner than later to ward off an infection.”

Other strategies implemented in NICU 2 to reduce CLABSI include:

  • Central Line Champions Program – Specially trained to observe and audit central line care practices, these champions serve as coaches to ensure compliance with proven CLABSI prevention strategies. While all NICU staff are trained in CLABSI prevention, central line champions undergo more intensive training and must attend monthly educational sessions.
  • Hand Hygiene – NICU 2 nurses participated in a house-wide hand hygiene competition and posted signs in the unit as a visual cue to keep hand hygiene top of mind. NICU 2 leadership worked closely with Facilities to ensure ample supply of free standing hand sanitizer in the unit.
  • Weekly CLABSI meetings – Meetings are held every Tuesday to review and share information on CLABSI occurrence and identify any gaps in practice that need to be addressed. Attendees at these meetings include members from the vascular access, infection control and CLRN teams. A representative from Facilities also attends to ensure the working environment is conducive to safe patient care.

NICU 2 Assistant Clinical Director Tanya Williams says one important aspect that helped NICU 2 nurses achieve this milestone was their questioning attitude.

“Our nurses are not afraid to ask questions when something doesn’t seem right,” Williams said. “I think fostering this culture of a questioning attitude is how we were able to get this far. I am so incredibly proud of our nurses and our CLABSI partners for helping us achieve this patient safety milestone.”

January 4, 2017

1517nicuweddingpg640When baby Lucas was born 24 weeks prematurely at Texas Children’s Pavilion for Women on October 28, he weighed 1 pound, 12 ounces. For weeks, Phil DeCarlos and Lilly Nguyen watched their little son fight to survive, spending every day by his bedside in the neonatal intensive care unit (NICU).

“Some days were long and scary while other days were stable,” DeCarlos said. “We promised Lucas that every day we’re going to be here, so 65 days, 66 days, we’ve been here every day for our son.”

But as the holidays inched closer, DeCarlos made a huge decision on December 15.

“Something just clicked and I said, I am not waiting anymore. On that day, I went and got the ring.”

A few days later, as he was putting his plan together, he realized he needed some help.

“Phil asked if we could help him arrange a surprise engagement proposal to his girlfriend next to their newborn son’s isolette,” said Tina Babb, nursing manager in the NICU at the Pavilion for Women. “We were so touched by this request that our nurses quickly sprang to action to make this moment possible.”

But there was one problem – they didn’t have much time to prepare. The proposal would happen a few hours later. So, with the clock ticking, the nursing team worked with DeCarlos to prepare the room before Nguyen arrived for what she thought would be a family photo shoot with their son.

DeCarlos laid out the items – a white bib he decorated with hearts and roses, a diamond ring, a blanket to cover the isolette, and a cartoon caption that read, “Will you marry my Papa?” The caption was placed next to Lucas’ head and the diamond ring was attached to his bib with a posy.

When it was time to pop the question, the nurse opened the isolette. Nguyen leaned over, and seconds later, she tearfully said, “Yes!” Immediately, the room erupted in applause for the newly engaged couple.

“It was such an emotional moment for all of us,” said Pavilion for Women’s NICU clerical assistant Debra Staples, who gave the nurses a heads up about the surprise proposal a few hours in advance. “It was so nice to see our nurses and staff come together to make this happen for our patient family.”

The couple’s love story didn’t end there. DeCarlos and Nguyen got married on New Year’s Day in the Children’s Chapel at Texas Children’s with Chaplain Johnna Faber officiating the ceremony. More than 30 guests, including several of the nursing staff, witnessed the two exchange their vows.

But there was one special guest the couple wanted to include in their celebration. After the private ceremony, the couple went upstairs to the NICU to see Lucas, now 4 pounds 4 ounces, dressed up in a tuxedo fit for the occasion.

“We are grateful to have him be a part of our wedding,” Nguyen said. “We wouldn’t change it for the world. Our hope is that he gets stronger and can come home with us and one day we’ll be able to share these stories with him.”

Click here to watch KHOU’s video of the wedding ceremony.

December 13, 2016

121416beckywhiteaward640Becky White, a former neonatal nurse and now patient care coordinator at Texas Children’s, recently won the Patients’ View Institute (PVI) Partners in Healing Award during a national ceremony in Washington, D.C. co-sponsored by The Leap Frog Group. Chief Quality Officer Dr. Angelo Giardino also accepted this award on behalf of Texas Children’s.

Each year, this award honors a patient’s story that demonstrates how a partnership between a patient or their loved ones, and their hospital care team, achieved a healing health care event or experience.

When White was pregnant with her son, Wade, doctors told her that her child may not survive due to medical complications. Miraculously, Wade pulled through but his road to recovery would be a difficult one. Born with complex health issues, Wade would undergo more than 50 surgeries before he turned 5.

As the mother of a son with special needs, White struggled trying to communicate effectively with her son’s medical team, at times feeling like she wasn’t being heard. So, she decided to go back to school to become a pediatric nurse, hoping that her medical background could help overcome this communication barrier.

“My experience as a NICU nurse helped me to communicate more effectively with my son’s doctors,” said White, a patient care coordinator at Texas Children’s. “It also gave me the opportunity to connect with hospital executives to help them relate data and patient outcomes to the actual patient experience.”

These opportunities emerged after White read a blog post from Texas Children’s President and CEO Mark A. Wallace about customer service and what every employee can do to ensure patients and their families have an exceptional experience at Texas Children’s. Touched by this blog, White emailed Wallace to share her thoughts and experiences as a parent of a Texas Children’s patient and as a neonatal intensive care unit (NICU) nurse.

“I was very appreciative that our CEO took the time to respond to my email,” White said. “After our initial meeting, Mr. Wallace invited me to shadow him for one day so I could experience firsthand what our administrative leadership team does behind the scenes to support our frontline staff and employees.”

Wallace also shadowed White in the NICU where he met with patient families and Texas Children’s NICU leadership and nurses who shared the remarkable improvements their teams have made to improve patient safety and enhance the overall NICU experience for patients and their families.

“My experience with Becky was just another reminder that whether we work at the bedside or behind the scenes, everyone matters and everyone’s perspective has value,” Wallace said. “Everyone’s work is essential at Texas Children’s, and when we all share this same intense passion for the mission, we drive it forward.”

So far, more than 40 hospital executives have accompanied Becky in the NICU, which prompted leaders to create an organization-wide Executive Rounding Program to be implemented in other areas of the hospital. The program has helped improve communication and empathy with patients and their families.

By advocating for her son, becoming a nurse, and helping health care administrators to better understand patient and family issues, Becky’s story represents an important patient perspective – one that others on both sides of the bedrail can learn from.

Click here to read White’s Voice of Nursing blog about her experience shadowing Mr. Wallace. Click here to read Mr. Wallace’s perspective of his experience rounding with White in the NICU.