March 30, 2016

33016MOD640

Don’t forget to sign up to participate in the 2016 March for Babies walk on Sunday, April 24, at 9 a.m. at the University of Houston. Whether you join a Texas Children’s team or start your own team, the five-mile walk promises to be a fun day out with people who share our passion for improving the health of babies.

Last year, Texas Children’s March for Babies team was no. 9 among corporate teams for the walk, collectively raising more than $64,000. This year, as a Signature sponsor, Texas Children’s goal is to raise $120,000 that will support the March of Dimes.

“If each hospital department/unit raises an average of about $1,500, with 35 participating teams, we will reach our goal,” said Judy Swanson, vice president of Texas Children’s Newborn Center. “Texas Children’s is off to a great start with a $75,000 contribution from the system to date.”

At the March for Babies walk, there will be family teams, company teams and people walking with friends. To donate or sign up for a Texas Children’s team, type TCH in the team search bar and select your team.

If you want to build your own team, please identify a spirited organizer in your department to be a team captain for Texas Children’s. Once identified, please send their contact information to Sharla Weindorff. Contact Sharla at Ext. 4-2011 if you have further questions.

Timeline

  • Friday, April 8 – Walker registration due is $25 and includes a Team TCH shirt and a BBQ ticket at the walk
  • Friday, April 22 – All walker donation forms due. Each walker’s fundraising goal is $100 to earn the March of Dimes 2016 T-shirt
  • Sunday, April 24 – March of Dimes Walk, University of Houston

To learn more about March for Babies, click here.

Helpful tips to prepare for the walk

Before lacing up your shoes, Texas Children’s Employee Health and Wellness offer tips to help you prepare and become more comfortable with what to expect during the five-mile walk.

  • Fuel up before the walk. It is important to give your body ample time to breakdown the needed nutrients and allow your stomach to settle before your race. So eat something, such as multigrain bread, fruits or vegetables, about three hours beforehand.
  • Make sure to stretch before the walk. Stretching with help lengthen your muscles, give you a longer stride and prevent any injuries.
  • Always warm up by starting off your walk with a slower pace for about 5 minutes. After you feel like your muscles are warm, pick up the pace. Challenge yourself and walk at different intervals, fast for 3 minutes, slower pace for 3 minutes.
  • Dress for 15 to 20 degrees warmer. It is also important to not overdress. Check out the weather forecast and dress for 15 to 20 degrees warmer as this is how much your body will warm up once you start running. If it is going to be cold, bring expendable clothing that you are okay with not getting back, and shed these after you warm up.
  • Find your pace. Pay attention to your heart rate and breathing. Remember, this walk is for you, so don’t worry about others around you or their race times. Instead, focus on breathing and walk at a pace where your heart rate is elevated. However don’t overdo it, you should be able to walk and carry a conversation at the same time.
  • Use good walking posture. Make sure to stand up straight, head up, abdomen flat, shoes pointing straight ahead, and use an arm swing.
  • Stay hydrated during the walk. Keeping your body hydrated is essential is key to success. Be sure to carry water. As the temperatures rise make sure that you maintain your hydration. In very hot weather, add in a sports drink to help replenish your electrolytes.

Here are 7 tips on how to pick out the perfect walking shoes.

  1. A walker’s foot hits heel first and then rolls gradually from heel-to-toe. So, you will need a flexible sole and more bend in the toe than a runner. You should be able to twist and bend the toe area.
  2. Look for a shoe that is light weight and breathable. The last thing you want is a heavy walking shoe.
  3. Make sure the shoe that fits properly. Be sure your foot has enough room in the toe box. There should be a thumbnails width (or about a half inch) between your toes and the end of the shoe. The shoe should be wide enough in the toe that your toes can move freely. Your heel should not slip, and the shoe should not pinch or bind, especially across the arch or ball of your foot.
  4. Try on new shoes at the end of the day or after your walk when your feet may be slightly swollen. Also be sure to wear the same socks you will be wearing during your walks. This can make a huge difference in how the shoe fits. Try on both shoes. Your feet may not be the same size (really!).
  5. Walk around for a few minutes on a hard surface. It is worth the effort to find the right shoe for you and it is worth spending a few extra dollars.
  6. Wear your shoes in the house for a few days to try them out. Don’t venture outdoors until you are sure the shoes are going to work for you. (If the shoes are not going to work out you will want to exchange them before scuffing them up outside.)
  7. Keep track of how many miles you have put on your shoes, and replace them every 300 to 600 miles (480 to 970 km). (If you are wearing very light weight shoes, are overweight, or you are hard on your shoes stay toward the low end on mileage.) To extend the life of your shoes be sure to only wear them only for your walks. Also rotating two pair of shoes will give them time to “bounce back” between walks.
March 15, 2016

31616Shareyourmoment640

Did you know approximately 16 babies are born every day at Texas Children’s Pavilion for Women? With each birth, every mother has memories of those first precious moments together. We want to hear about yours.

We will feature a new story each Friday on Texas Children’s Facebook page. If interested in submitting your own, please email PFWmarketing@texaschildrens.org and include the following:

  • A few photos of your first moments together (preferably candid)
  • A short description of the memories you have from those first moments

All submissions will be reviewed but not all guaranteed. This campaign is limited to only Texas Children’s Pavilion for Women patients. If your submission is chosen, someone from our Marketing team will reach out via email.

March 8, 2016

We did it!

Texas Children’s Pavilion for Women recently received the Baby Friendly Hospital (BFH) designation – an impressive milestone that demonstrates the value of teamwork and our nurses’ commitment to educating and supporting new mothers on the benefits of breastfeeding.

Launched by the World Health Organization and the United Nations Children’s Fund in 1991, the BFH Initiative encourages and recognizes hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding. Baby Friendly USA awards the designation to birthing hospitals that successfully implement the Ten Steps to Successful Breastfeeding.

“While achieving the baby friendly hospital designation was a lengthy four-phase process,” said Women’s Support Services Director Nancy Hurst, “this designation means that we are providing the highest level of care related to breastfeeding education, instruction and support for our patients.”

To meet the rigorous criteria for the BFH designation, the Pavilion for Women implemented numerous breastfeeding practices to ensure our nurses, obstetricians, and pediatricians are well trained to teach mothers how to breastfeed and maintain lactation, even when separated from their infants, which can occur when babies are confined in the neonatal intensive care unit (NICU) for long-term care. Implementing these evidence-based practices required tremendous teamwork between and among departments and staff.

“We collaborated with leaders and staff from all areas of the Pavilion for Women including OB and Maternal Fetal Medicine clinics, labor and delivery, mother-baby units, perioperative services and women’s specialty unit,” Hurst said. “We also educated environmental services, volunteer services and other ancillary areas on what BHF is and what it means for our patients.”

Several evidence-based breastfeeding practices initiated at the Pavilion for Women include:

  • Helping mothers breastfeed within one hour of birth
  • Teaching mothers to respond to their infant’s early feeding cues rather than schedule feedings
  • Encouraging “rooming in” so mothers and infants can stay together 24 hours a day
  • Implementing immediate skin-to-skin contact between mother and baby following delivery
  • Standardizing prenatal education to educate women about the benefits of breastfeeding
  • Providing 20 hours of didactic and skills-based education and instruction to all nursing staff caring for mothers and babies at the Pavilion for Women
  • Feeding infants only breast milk and providing mothers with resources for lactation support prior to leaving the hospital
  • Promoting Breastfeeding Champions Program to inspire nurses to become role models for other nurses by reminding them why it is important to encourage women to breastfeed

“New mothers often times do not succeed in breastfeeding because there are no systems in place to support them,” said Prenatal Education Program Manager Anne Wright. “Since 88 percent of the mothers who deliver at the Pavilion for Women want to breastfeed, it’s important that we implement and sustain practices that ensure their success.”

After giving birth to two sets of twins at the Pavilion for Women, Elizabeth Shackouls recalls how incredibly supportive the nursing staff was in helping her overcome certain breastfeeding challenges after both pregnancies.

“The nurses helped me figure out latch issues and when I became discouraged, they assured me things would be easier with time and supported me through every feeding,” Shackouls said. “Even long after I was discharged, I continued to seek the nursing team’s advice on various issues and always felt like they were there for me no matter what. The renowned nursing staff and the exceptional care they provide patients are instrumental in setting Texas Children’s apart from other hospitals.”

Nurse Girija Babu, who is also a breastfeeding champion in her group, described the journey toward BFH designation as an “incredible” experience.

“By achieving this milestone, we’re ensuring our nursing mothers receive the support they need during and after their hospital stay,” Babu said. “We  are also grateful to our OB providers and anesthesia team for their continuous support in making sure newborns are placed skin to skin on the mother’s chest soon after birth.”

For more information about Baby Friendly USA, click here.

February 23, 2016

22416simulationinside640The neonatal team at Texas Children’s Pavilion for Women is always prepared for special deliveries – taking care of newborns is what they’re trained to do. But earlier this month, the neonatal intensive care unit (NICU) received a special delivery that wasn’t quite what you’d expect.

Texas Children’s Simulation Center hosted an open house to introduce Tory, a high-fidelity infant mannequin, and the newest addition to the first-ever Neonatal Comprehensive In Situ Simulation Program launched at the Pavilion for Women’s Newborn Center. The simulation equipment and supplies were purchased with a generous $200,000 grant from the M.D. Anderson Foundation, which will also support an in situ simulation program for the Emergency Center and Critical Care, as well as one for the NICU in West Tower once a dedicated space for simulation has been identified.

“We’re grateful to our Newborn Center leadership for dedicating a simulation room at the Pavilion,” said Dr. Jennifer Arnold, medical director of the Simulation Center. “Now, our NICU providers can train in their actual practice environments during regular workdays to enhance individual and team performance – particularly in high-risk situations – and improve patient outcomes and safety.”

The in situ simulation program focuses on improving crisis resource management skills, one of which is role clarity. During a code, the potential for confusion and chaos can easily set in as responders attempt to care for a patient in a high-risk medical emergency. Clinicians responding to a code may not always be sure of their roles or the roles of their team members when they arrive, and that’s when in situ simulation training becomes crucial to patient safety and care.

“First, we conducted tests to determine the necessary roles in a crisis, whether it’s a resuscitation or a code,” said Dr. Mona Khattab, one of the in situ simulation program directors for the NICU. “By having the necessary personnel at the code, we alleviate staff overcrowding and ensure optimal efficiency and clear communication are achieved while delivering lifesaving treatment to our NICU patients.”

Inside the simulation room, colored labels – red, yellow and green – are affixed to the floor that encircle the bedside. These labels identify the specific roles of each of the code response participants and directs them to their position on the floor during a medical emergency.

  • The red team consisting of clinicians and nurses stand in the innermost circle closest to the bedside where they provide direct patient care.
  • The yellow team is positioned behind the red team. They support patient care providers by documenting the code, handing over equipment, managing the ventilator and medication and blood prep drawers, and providing mentorship and consultations to the team leader as needed.
  • The green team stands in the back of the room near the code cart and provides overall code and room support to ensure everything is running seamlessly.

“When a text message page is sent, the unit reports to the simulation room as if it were an actual page in the unit to respond to a code,” said Kellie Kainer, assistant director of Nursing for the NICU at the Pavilion for Women. “We give them a brief history of the patient and alert them to the code.”

The in situ simulations will occur every Thursday and last 10 minutes followed by 20 minutes of debriefing. The NICU teams alternate every week and are selected based on their current assignment and the flow of the unit on that particular day.

“We’re focusing on one specific patient case so that everyone gets exposure to that case,” said Dr. Leigh Ann Cates, a neonatal nurse practitioner and a program director for the in situ simulation program. “As our program expands, we hope it will become a model for in situ simulations in other units of the hospital.”

In preparation for this training, all clinicians within the Newborn Center complete an online pre-simulation course through Healthstream. The Simulation Center developed a series of powerpoint presentations covering crisis resource management skills, an orientation to simulation, and what to expect during simulation such as a confidential and psychologically safe learning environment.

February 16, 2016

A year ago, Knatalye and Adeline Mata lay on an operating table at Texas Children’s Hospital conjoined from the chest to the pelvis. For the next 26 hours, a team of surgeons and support staff separated the girls in an historic and intricate procedure meticulously choreographed to ensure that each step of the process would lead to and support the steps to come. Throughout the procedure, the Mata family stood by, waiting and praying for good news.

Just before 10 a.m. on February 18, 2015 the family counted their prayers as answered when they saw their girls, apart for the first time in adjacent rooms in the Pediatric Intensive Care Unit, where they were cared for by a team of specialized nurses. Since then, the almost 2-year-old twins have been discharged from the hospital and are living relatively normal lives in Littlefield, Texas with their parents Elysse and John Eric, 6-year-old brother Azariah and 5-month-old sister, Mia.

“The girls are both doing awesome,” said Dr. Darrell Cass, one of the lead surgeons in the separation case. “Neither have experienced any complications and both are making steady progress.”

Knatalye is beginning to walk, talk and eat by mouth. Adeline is meeting milestones as well. Her lungs are continuing to improve and she is slowly being weaned from ventilator support. Both girls are still undergoing physical and occupational therapy.

Several members of the medical staff involved in the girl’s care got to see how much Adeline and Knatalye have grown and how far they’ve come during a recent visit the Mata family made to Texas Children’s for follow-up appointments with pediatric subspecialists monitoring the twins’ health and development.

Aimee Renaudin, one of Adeline and Knatalye’s primary nurses in the Neonatal Intensive Care Unit, said she is amazed that the girls are doing so well.

“You would never know how they started off their lives together,” she said. “Elysee and Eric have taken such good care of them.”

Dr. Oluyinka Olutoye, the other lead surgeon in the separation case, said it’s a blessing to see how far Adeline and Knatalye have come.

“It’s always a joy to see the changes that have gone on,” he said. “They’ve gone from just being little babies to now trying to walk and talk and interact with you.”

John Eric said his daughters have far exceeded his expectations and that he and Elysee are enjoying being able to care for the girls at home.

“It’s nice to be able to have all of us together and to be able to wake up and know that they’re there,” Elysee said. “It’s fun to be able to be mom and dad, which we didn’t get to do for the first 10 months of their lives.”

The Mata family will return to Texas Children’s this summer for a checkup. During that visit, surgeons will operate on Knatalye, removing the metal struts used to stabilize her rib cage and to close her chest wall.

To read more about their journey click here. See photos from the Mata family’s latest visit to Texas Children’s below.

January 12, 2016

11316perioperativeinside640If you ask Nakeisha Archer, president-elect of the Greater Houston Chapter of the Association of periOperative Registered Nurses (AORN), who inspired her to pursue nursing, there’s one person who comes to mind – her grandmother.

“When I was a little girl, my grandmother shared stories about how she loved taking care of patients in their homes,” Archer said. “She was a private duty nurse and the joy she derived from helping others motivated me to become a nurse.”

After graduating from nursing school with several clinical rotations under her belt, Archer spent six years as a labor and delivery nurse, which included a few years as a travel nurse. Before obtaining her MBA in health care management, she realized her niche was in the operating room (OR).

“I spent a lot of time in the OR as a labor and delivery nurse but I knew there was more to learn,” Archer said. “After completing a perioperative internship program, that’s when my passion for periop began.”

As assistant director of Perioperative Services at Texas Children’s Pavilion for Women, Archer leads a dynamic team of more than 40 nurses who assist with the planning, implementation and evaluation of patient care before, during and after surgery. These activities include patient assessment, creating and maintaining a sterile and safe surgical environment, providing pre- and post-operative patient education, monitoring the patient’s physical and emotional well-being and working closely with the surgical team to provide safe patient care during each phase of the surgical care process. Archer also collaborates with her non-nursing team whose roles are critical to the perioperative process. These include secretaries who schedule new cases, surgical technologists who scrub the cases, and perioperative care technicians and anesthesia technicians who provide specialized team support.

“Perioperative includes the entire surgical experience,” Archer said. “We see between 175 to 210 cases per month which include open, robotic and laparoscopic surgeries to treat a number of gynecological conditions including cancers, urological issues, as well as general surgery, fetal interventions, caesarean deliveries and in vitro fertilization procedures.”

The Pavilion for Women has four Main OR’s, two OR’s in labor and delivery, one procedure suite in the Main OR, and two procedure rooms in the Reproductive Endocrinology and Infertility Clinic. Two more Pavilion for Women Main OR surgical suites will open in May 2016 bringing the total to six OR’s to meet the increasing demand for perioperative services.

Archer says the need to hire and retain experienced perioperative nurses to fill these new positions is one of her top priorities. She says the best way to home “grow” our nursing staff is by providing consistent educational tools and internship programs to cultivate their skills so they can easily adapt to this fast-growing nursing specialty.

“We have a lot of openings right now in periop on the Pavilion side because we’re growing,” Archer said. “Most hospitals that do not have a shortage of experienced OR nurses offer a consistent internship and residency program every six months. When you keep that pipeline going and keep those nurses coming in and consistently train them, they will be ready to be placed in their new roles.”

Since joining the Pavilion for Women two years ago, Archer is thrilled to offer the second perioperative internship program for nurses later this month. This endeavor, which will continue every six months, is part of a joint partnership with Texas Children’s Pediatric Perioperative Services.

When Archer assumes her position as AORN president in May, her passion to advance educational opportunities for nurses will be one of her primary goals.

“One of the things that I think we as leaders don’t always do is have a really good succession plan for our nurse leaders as well as our nurses who are leading at the bedside,” Archer said. “We need to provide them with opportunities to grow and re-energize their periop voices by engaging members around issues that impact them.”

Leading a multi-generational nursing workforce has become a tremendous challenge too. Archer plans to collaborate with nursing leaders to help reframe perceptions about generational differences and to view these attitudinal and behavioral differences as potential strengths.

While much of Archer’s day is spent attending meetings, rounding with nursing and physician staff and staying abreast of all the cases scheduled for each day, she says at the end of the day, her greatest joy is taking care of her patients – just like her grandmother did.

“On a really good day, I can go to our waiting area and have conversations with some of the patients and families, and make sure that things are going well,” Archer said. “That’s really the fun parts of the job. If we could do that all day, it would be really good.”

August 25, 2015

What would you do if your pregnant patient, who was five centimeters dilated, told you in the examination room, “I need to get married before I have my baby?”

For Dr. Karla Wagner and her Maternal Fetal Medicine (MFM) team at Texas Children’s Pavilion for Women, the response to their patient’s request was a no brainer. Instead of saying no, they embraced this rare and exciting opportunity.

“We knew how important it was for our patient to get married before her baby arrived,” said Aimee Jackson, a nurse practitioner and clinical manager for maternal medicine at Texas Children’s Fetal Center. “It wasn’t a matter of, “Can it happen?” It was more like, “It will happen.”

With little time on their side, the MFM staff sprung into action to fulfill their patient’s wedding wish. Within an hour, they pieced together a simple, yet elegant ceremony for expectant mom Stephanie Tallent and her soon-to-be husband Jason Nece.

The couple planned to get married over the weekend, but their plans abruptly changed on August 21 when Wagner discovered during Stephanie’s reassessment exam that she was five centimeters dilated and her baby was still breeched. Luckily, the couple had their marriage license in the car along with a white sundress that Stephanie planned to drop off at the dry cleaners.

With these two items checked off the list, the rest of the components for the ceremony fell perfectly into place.

“Stephanie got the good luck tradition for a bride,” Wagner said. “She borrowed a beautiful pearl necklace from one of my nurses, we found something blue, we decorated the room with flowers, and I gave her a bouquet of roses that I grabbed from my office so she could hold it as she walked down the aisle.”

The staff rounded up the wedding troops to ensure every detail of the ceremony was covered. Texas Children’s videographer Wally Crow and photographer Allen Kramer captured the ceremony, maternal fetal scheduler Ashanti Riggs sang a cappella and the hospital’s chaplain Johnna Faber officiated the ceremony.

Wagner’s primary nurse Susan Hardee Crosky played the “Wedding March” on her cell phone, as Wagner walked her patient down the hallway aisle into Clinical Room 3 where Stephanie and Jason exchanged their vows in front of a congregation of roughly 25 Texas Children’s MFM employees.

At the end of the ceremony, the staff quickly scrawled on a piece of paper, “Just Married” and stuck it on the back of Stephanie’s wheelchair before she was whisked away to the delivery room. Later that afternoon, Stephanie and her husband welcomed their precious baby girl, Sophia, who was delivered by caesarean section.

“I love the maternal fetal department,” Stephanie said. “They pulled everything together at the last minute and did an unbelievable job. We cannot be any happier than we are right now.”

For Wagner, she is proud of her team who went above and beyond to meet the spiritual needs of her patient.

“We value the importance of family and spiritual values,” Wagner said. “We all came together as a team on such short notice to make this couple’s wish come true, while at the same time, meeting the medical needs of our other patients in clinic.”