November 10, 2015

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It’s called the “Watcher List” and simply put, it is for patients who need a little extra attention. Any physician, nurse or resident can place a patient on the Watcher List if they are concerned that patient may need a higher level of care. A patient on the list is given extra attention by care providers who have a plan in place should the patient’s condition deteriorate quickly.

“Generally the plan is to increase global awareness of these patients for an extra set of eyes,” said Chief Resident Tolulope Adebanjo. “Each week there is a safety resident who oversees the Watcher List for each unit ensuring the proper steps are taken to escalate care for a patient should it become needed.”

The program was enacted by the quality and safety team as a measure to increase patient safety. It began as a pilot program on a few units and expanded to a system-wide acute care initiative. Since going into effect, the number of codes on each floor have dramatically decreased. The new system allows for the rapid response team (RRT) to be called into action more quickly and efficiently before a patient decompensates.

“For our nurses, the Watcher List allows for peace of mind knowing the entire care team is aware of the patients who may require the most attention on the unit and that there is a plan to ensure the patient receives the appropriate care,” said Assistant Clinical Director of Inpatient Nursing Monica Simmons. “The nurses have the most interaction with the patients and play a key role in communicating with the care teams about each of these patients.”

“The key to good patient care is communication so the Watcher List is one way that we communicate our level of concern about patients,” said Chief Resident Kim Lehecka. “It’s a really systematic way to communicate concerns easily and efficiently while being able to quickly prioritize.”

Patients on the Watcher List have a greater chance of being moved to a higher acuity unit. The criteria for the list varies from floor-to-floor and may include abnormal vital signs, abnormal labs, a patient on high risk medication and a variety of other causes. The list is available for teams across the organization and helps coordination across units when a patient may need to be moved. Higher acuity units are in constant communication with the others on what the needs may be throughout any given day.

“It’s a common language,” Adebanjo said. “It’s a patient who needs to be frequently assessed with the potential to get really sick very quickly.”

The list allows a greater preparation for adverse events and a plan of action that could mean a better outcome. The charts on each patient shows the reasons they are on the Watcher List as well as the plans of action should the RRT need to be called. A patient is taken off of the list when their condition improves, but not without a conversation between a multidisciplinary team.

September 22, 2015

For Aleida Stark, RN, each time a new patient receives their diagnosis at Texas Children’s Cancer and Hematology Centers, she begins a new puzzle. The care that is required for patients in the very complex world of hematology and oncology requires a massive amount of coordination. That work is taken on by nurse coordinators who serve as the point of contacts for families, patients and providers. The nurses in this role are constantly moving around the puzzle pieces to ensure everything fits.

“As nurse coordinators, we’re in charge of making sure the families understand their diagnosis,” Stark said. “Our job is to empower the patients and families and educate them to recognize events that need to be reported back to their care providers.”

Stark works closely with Dr. Donald Mahoney, director of Texas Children’s Hematology Center.

“We deal with very complicated problems here and these problems are not simply managed with a brief office visit,” Mahoney said. “It requires extended care support and that’s where the nurse coordinator fits the critical role.”

The role is one that has been present for adult cancer and hematology patients for years, but Texas Children’s is the first to create a role to this extent for the pediatric Hematology and Oncology patient population. Denise Tanner-Brown, clinical director of the Cancer and Hematology Center said the role has recently been reshaped to more closely align with the patients’ and providers’ needs and is growing with seven new positions added in the hematology/oncology and bone marrow transplant outpatient areas with recruitment currently underway.

“Cancer and Hematology care is so complex and our patients touch so many different services in the organization and many times they felt lost in a big and complex system,” Tanner-Brown said. “Our patients needed a central person to help them along the way that’s what they have found in our nurse coordinators.”

The nurse coordinator is with the patient throughout their care at Texas Children’s. From their outpatient clinic visits to any time they are admitted to the hospital or visit the Emergency Center, their nurse coordinator is there to ensure continuum and coordination of care. For the nurses in this role, the relationships are unlike any other area of care.

“There is a different level of satisfaction in this role because you see the entire continuum of care,” Tanner-Brown said. “In this role, you experience the successes, challenges and emotional roller coasters along with the families throughout the months or years they are in our care.”

Tanner-Brown said the right person for this position must be compassionate as they deal with patients in the most vulnerable moments of their lives and must be self-motivated with a great sense of collaboration.

For those interested in applying, contact Debora Harris, assistant director of Bone Marrow Transplant Clinic or Judy Holloway, assistant director of Hematology/Oncology Clinic.

July 21, 2015

72215nursingeducation640Nurses from all over the organization are invited to join an around-the-clock nursing professional day designed to educate through knowledge sharing. The 24-hour event is a first-of-its-kind seminar-style program that allows nurses with expertise in specific areas to present, sharing their knowledge with their colleagues. The nursing professional day is aimed at improving patient care and promoting professional development and nursing excellence. It fosters collaboration and teamwork within the vast department of more than 2,700 nursing professionals.

The day was organized based on identified learning needs gathered from a survey sent out to nurses across the organization.

“The concept came about in order to educate and develop all nurses via ‘knowledge sharing’ on a global scale in a meaningful and impactful way,” said Leslie Morris, one of the event’s organizers. “The purpose of this day is to promote professional development of registered nurses throughout the organization.”

The sessions provide increased knowledge and clinical skills. Participants will receive up to six hours of CNE credit with no fees.

Various topics are approached by different nurses presenting to their colleagues from across the organization.

The sessions include:

  • Building Relationships
  • Workplace Civility
  • Team Collaboration
  • Crucial Conversations
  • Escalating Concerns
  • Delegation
  • Managing Conflicts
  • Team Building
  • Communication with patients and families
  • Specialty Certification
  • Nursing Portfolio
  • Risk Management
  • Legal Issues
  • Ethics in Care
  • Evidence Base Practice
  • Disease Management
  • Treatment Decisions
  • Quality Improvement
  • Documentation Practice
  • Standard of Care
  • Code Management
  • Patient and Family Education
  • Trauma

The day will be a come-and-go format and does not require registration. The 24 hour period is designed to encourage all nurses to join for as long or as little as they can throughout their workday or before and after work. The session is coordinated in the 24-hour format to allow both day and night nurses to take advantage.

Nursing professional day will be held from 8 a.m. Wednesday, July 29, to 8 a.m. Thursday, July 30, on the fourth floor of the Pavilion for Women.

Texas Children’s Hospital is an approved provider of continuing nursing education by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

June 30, 2015

7115nursingplan640Last week, Chief Nursing Officer Mary Jo Andre met with a room full of nursing leaders at the monthly Nursing Congress meeting to outline the framework of an aggressive 100-day plan for nursing.

Andre said she and other leaders are examining all nursing feedback from the past several months to determine where to prioritize efforts to improve the overall work environment/satisfaction of the care team. She shared her vision to modify the patient care manager role to allow more time for leadership and management in support of care at the bedside. Andre encouraged ideas for cultivating staff satisfaction in support of nursing retention with a renewed commitment to a healthy work environment and a culture of transparency.

“In my 29 years at Texas Children’s, I have learned the importance of being transparent, and I want our nurses to know I take my promise seriously,” Andre said. “I also want that same assurance of transparency from all of you. I know we will have the strongest nursing team if we are able to collaborate together through open dialogue around what your needs are.”

During the meeting, she asked for feedback and followed up with a survey to all nurses and nursing leaders. Andre plans to use the survey to help prioritize areas of concern and immediate improvements needed. Once the survey closes, the feedback will be used to refine the 100-day plan, which Andre aims to share with the organization in July. Among the items on her agenda as she examines plans for the next 100 days are:

  • Patient care assistants (PCA): the need for additional PCA positions to support optimal patient care delivery
  • Patient care managers (PCM): the need to allocate more of their time to mentoring/coaching staff and leading their teams
  • Float pool: the need to build a float pool to reduce dependence on contract/OT utilization
  • Resource nurse role: the need to adjust this role and grandfather in non-BSN nurses and others that previously served in the charge nurse role
  • Flexible staffing: the need to build a different model that enables more nurses to work part-time/per-diem

In addition, Andre emphasized the need for all nurses to stay at Texas Children’s and help with building and implementing this plan for change. She explained that nursing turnover at Texas Children’s, while in line with the national average, presents particular challenges as the organization is trying to significantly grow the nursing workforce. Andre asked nursing leaders to take immediate action to encourage and retain nurses on their teams and said she hopes many of the changes proposed in the 100-day plan will improve nursing satisfaction and retention as well as ensure continued excellence in quality and outcomes.

“I wholeheartedly believe our nurses are at the heart of our organization and our mission, and I strongly support the improvements we will begin making in the next 100 days and beyond,” said John Nickens, executive vice president over nursing. “We have tremendous support from leaders across the organization, and I know it will take every one of you to help our nursing team be the best it can be.”

All staff nurses are asked to complete this short survey by Friday, July 3 to help Andre and her leadership team as they strategize and set a framework for next steps.

May 12, 2015

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It’s hard to contain the celebration of nursing at a place like Texas Children’s to just one week. Every day there is a story of a nurse who’s going above and beyond to impact patient care, experience and outcomes. A nurse who is holding the hands of a parent who’s received tough news about their child. A nurse who’s by the bedside of a patient whose own family can’t be there during treatments. A nurse who leaves behind his own family on holidays and weekends to be with families in the hospital. A nurse who calms the fears of a mom-to-be as she prepares to give birth to her first child. Nurses leave a lasting impression on every patient and they’re at the core of the experience patients have while in our care.
Each year, as the nation celebrates nurses across the country, Texas Children’s takes a moment to join in and praise the hard work being done across our own community by the Texas Children’s family nurses.

This year’s Nurses Week celebrations included town halls held by Senior Vice President and Chief Nursing Officer Lori Armstrong, poster presentations, cookie deliveries, blessing of the hands, a webinar, an education fair, a Fiesta Bar Friday and massages.

Nurses highlighted this week for their dedication to nursing include Nursing Excellence Award winners and Houston Chronicle Salute to Nurses honorees. The nine Nursing Excellence Award Recipients included:
Staff Nurse of the year: Natalie McBain
Preceptor of the year: Lauren Mayer
Rookie of the year: Megan Riordan
Certified nurse of the year: Shannon Frost
Leader of the year: Tarra Kerr
Teams of the Year: Texas Children’s Health Plan – Nurse Family Partnership Program and Texas Children’s System Hospital Acquired Pressure Ulcer Skin Champions
APRN of the year: Jessica Geer
Friend of Nursing: Hasti Taghi

Click here to view the photo gallery of the luncheon

Perhaps the most special moment of the Nursing Excellence award luncheon came as a surprise for Armstrong. The nursing leadership team presented the chief nursing office with a plaque recognizing a new award named in Armstrong’s honor. The Lori Armstrong Patient Experience Award will be given to one worthy nurse annually beginning next year as an acknowledgment of Armstrong’s own dedication to patient experience.

The Houston Chronicle Salute to Nurses included Vicki Wiest from the Meyer Center for Developmental Pediatrics and Donna Daigle Tinsley from Texas Children’s Cancer Center who were both among the top 10 award recipients.

Click here for more on the Houston Chronicle Salute to Nurses honorees

In addition to the two nurses honored in the top 10, 20 other Texas Children’s nurses were recognized as being among the top 150 in the Greater Houston area.

Heidi Aghajani
Denise Allen
Toronda Baker
Emily Garrie
Chelci Gray
Melody Hellsten
Joy Hesselgrave
Amy Jeppesen
Patsy Jones
Michael Jordan
Melanie Knapp
Erica McMillian
Joellan Mullen
Jada Randall
Melissa Silvera
Tammy Stanford
Katharine Tittle
Amy Turner
Elizabeth Wuestner
Nicole Zola

February 17, 2015

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Texas Children’s Hospital recently participated in Junior Achievement’s largest youth gathering called JA Inspire to provide thousands of eighth graders hands-on exposure to some of the region’s best employers.

Representatives from Human Resources, Nursing and the Emergency Center spent three days at the event’s career fair in Pasadena and another three days at the event’s career fair in Cypress encouraging students to explore and prepare for potential career opportunities in health care. They talked to the students about how multi-faceted the health care industry is and provided the students with information that will help them learn about relevant coursework and curriculum as they prepare for high school and beyond.

“It was so nice to see the look on the students’ faces when we described working at a pediatric hospital,” said Liz Wuestner, a clinical specialist for the Emergency Center. “These young people are our future health care providers, and it was a great opportunity to inspire them to pursue a degree in nursing.”

Chief of Emergency Medicine Dr. Paul Sirbaugh was a featured speaker at the event in Cypress and said afterward that he “had forgotten how rewarding it is to interact with middle school students who have so much passion and excitement for the future.”

“They see no barriers, only possibilities,” he said.

The JA Inspire event is just one of the many ways Texas Children’s Hospital continues to grow its footprint in the community. Our organization will continue to have a presence at events similar to JA Inspire to help build the future talent pipeline.

February 10, 2015

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Texas Children’s Talent Acquisition team is partnering with Nursing to recruit talented nurses in the Emergency Center, Critical Care (ICUs) and the operating rooms, and you can help.

We will have a job fair this week and again later this month, targeting recruitment of nurses in these areas. These upcoming job fairs are part of a broader effort – 100 nurses in 100 days campaign –  to recruit professionals in roles where there is critical need.

  • This week’s job fair is 8 a.m. to 3 p.m. Friday, February 13, on the fourth floor of Texas Children’s Pavilion for Women.
  • The second job fair is 8 a.m. to 3 p.m. Tuesday, February 24, at Texas Children’s Hospital West Campus.

Recruit and E.A.R.N.
Tell family and friends about the job fairs, and share your positive experiences as a Texas Children’s employee. If you’re successful in helping us fill one of these positions, you’ll even be rewarded through the E.A.R.N. (Everyone’s A Recruiter Now) employee referral program. The E.A.R.N. program pays up to $5,000 for specific job referrals.

100 Nurses in 100 Days E A R N Flyer – Hot Jobs

If you have friends who are interested in joining the Texas Children’s nursing team, please encourage them to visit jobs.texaschildrens.org/nursing.