June 20, 2017

As the Department of Surgery continues to expand in the community at Texas Children’s Hospital West Campus and Texas Children’s Hospital The Woodlands, ongoing training is needed to be able to offer high-level surgical procedures.

Otolaryngologists Dr. Deidre Larrier and Dr. Mary Frances Musso have been leading that charge when it comes to training operating room staff in the removal of aerodigestive foreign bodies – obstructions in the esophagus and/or trachea.

Such obstructions can be emergent, and require rapid response using specialized equipment. During a four-year period between 2011 and 2015, there were 556 obstruction cases, 64 of which occurred at West Campus.

“The instruments used in obstruction procedures are very specific and are not used in general surgical procedures,” Larrier said. “Thus the need for supplemental training for our OR support staff.”

Led by Larrier, the training is for OR nurses and scrub technicians. The half-day course includes a lecture, hands-on skills lab, and in-situ simulation.

Musso is taking the Texas Children’s Hospital simulation instructor course this summer, which will allow her to enhance her mentoring skills during these sessions. Larrier is already an instructor and was instrumental in helping establish simulation education at the hospital. She leads the otolaryngology simulation sessions for not only OR staff but also residents, fellows, and mid-level providers. She recently led a training for Advanced Practice Providers on tonsillectomy surgery and the complications that can occur following such procedures.

“Dr. Larrier’s training of OR staff in the removal of aerodigestive foreign bodies and esophageal obstructions was very well received here in the Woodlands,” said Dr. Charles Hughes, a member of the otolaryngology team in The Woodlands. “Both Ramon Enad and Tom Cunningham, our OR staff leads, felt it was extremely beneficial for staff, in that these procedures are high risk and infrequent.”

Musso said, West Campus staff is very appreciative of the training and that it has helped improve their skills using this specialized equipment and treating these patients. “We plan to repeat this training session annually at West Campus to maintain the staff’s skill level.”

Larrier said she will gladly continue such training, something she views as a testament to how much the surgical capability at West Campus and in The Woodlands has grown.

January 17, 2017

11817CNOR640For the third year in a row, Texas Children’s Hospital has been named CNOR Strong by the Competency and Credentialing Institute (CCI).

To achieve this recognition, more than 50 percent of a hospital’s operating room (OR) nurses’ must undergo a rigorous process that involves mastering high standards of perioperative practices before nurses can earn their individual CNOR certification.

“Words cannot express how proud I am to be the leader of an OR that is CNOR strong for the third year in a row,” said Amanda Austin, manager of Surgical Services at Texas Children’s. “It has been amazing to watch the dedication and drive grow amongst the OR nurses who worked extremely hard to achieve this milestone. They are showing their passion for what they do.”

While obtaining the CNOR designation is not an easy task and requires lots of study and preparation, this nationally recognized certification exemplifies Texas Children’s commitment to being the best of the best in the delivery of safe patient care.

“It all goes back wholeheartedly to being patient advocates that set the highest bar for the care we provide to our sleeping patients,” said Nakeisha Archer, director of Perioperative Services at Texas Children’s Pavilion for Women and president of the Greater Houston Chapter of the Association of PeriOperative Registered Nurses. “We are proud of being designated as a whole, and putting the Pavilion for Women on the map as the first women’s hospital to become CNOR strong internationally.”

Research shows that nurses who earn the CNOR credential have greater confidence in their clinical practice. A team of CNOR certified nurses who have mastered the standards of perioperative practice furthers a culture of professionalism and has been correlated to improved outcomes in surgical patients.

In a recent study published in the journal of the Association of Perioperative Registered Nurses, hospitals with high rates of specialty nursing certifications saw significant lower rates of central-line associated bloodstream infections among surgery patients. The study also found that a 10 percent increase of CNOR’s and other support certified nurses resulted in an 8 to 16 percent reduction in surgical infections.

“I am honored to be involved with an institution and perioperative departments that have a commitment to excellence,” said Janet Winebar, director of Perioperative Services at West Tower. “I commend the individual OR RNs who have worked so hard to achieve this honor and their leaders for supporting them.”

April 8, 2014

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Intense study focuses on critical needs of main campus core areas

At the beginning of this year, some pretty exciting things happened at Texas Children’s: a new system-wide mission statement announcement, celebration of the organization’s 60th birthday and the groundbreaking of the new Texas Children’s Hospital The Woodlands. But something even bigger and more imperative was going on behind the scenes: CareFirst.

In January, Texas Children’s launched CareFirst, an intense study of the core areas throughout the main campus. It involves a rigorous, eight-month planning process to help evaluate the hospital’s critical needs and set the right course for the future.

CareFirst initially will center around the needs of three areas:

  • the Emergency Center
  • Critical Care
  • Operating Rooms/PACU.

View this video to see why these areas need our attention.

“In the past several years, we’ve grown our programs and our physical footprint in the community to provide care where there was growing need,” said President and CEO Mark A. Wallace. “CareFirst is about focusing on the pressing needs at our main campus and reinvesting in the core clinical areas.”

In a video Wallace distributed last week, he documented a recent visit to the three core areas. In the videos, Dr. Paul Sirbaugh takes Wallace through the Emergency Center, which receives 50 percent of all 911 and EMS transports in Houston. In the Operating Rooms/PACU, Dr. David Wesson and Judy Swanson explain how some rooms barely accommodate the advanced technology required to take care of our patients. And in Critical Care, Dr. Lara Shekerdemian and Dr. Paul Checchia describe the balancing act involved in taking care of patients who now are surviving because of the care we provide and subsequently requiring longer hospital stays in our over-crowded ICUs.

CareFirst is such a high priority that Texas Children’s Board of Trustees, administrative leaders at all levels, physicians and many Texas Children’s employees have been engaged in the effort. The work teams are dedicating considerable time to CareFirst to move thoughtfully, but swiftly, and Wallace plans to unveil the findings and plans for the next stage of CareFirst at the beginning of fiscal year 2015.

“This will be one of the most difficult initiatives we have ever undertaken,” Wallace said. “Many areas will be impacted, and at times, this is going to challenge us. But I know it is the right thing to do for our patients and their families. It’s about ensuring that exceptional care continues to be first and foremost at Texas Children’s.