Children’s Team Performs Breakthrough Robotic Neurosurgery

Our very best pediatric neurosurgeons, neurosurgical anesthesiologist, radiologists, nurses and staff all came together in an environment of excellence last week to perform the first robotic operating surgical assistant (ROSA™) guided bilateral thalamic responsive neurostimulation (RNS) for a young child. This incredible milestone took place in our new Hubbard Center world-class surgery suite to provide the most advanced and precise technology with real-time advances — unique to this region.

Afshin Salehi, M.D., M.S., Pediatric Neurosurgery, assistant professor, UNMC Division of Pediatric Neurosurgery, Department of Neurosurgery shared, “This procedure is offered in only a handful of centers in the country for the toddler age range. Our team should be proud of what they accomplished, and the medical breakthroughs being made at Children’s so more children and their families can live their very best lives. Nothing is more important or inspiring to us.” 

With a new robotic operating surgical assistant/ROSA robot and intraoperative MRI (iMRI), Children’s has combined robotics with OR and MR for the safest and best outcomes.  It’s just one way this fully contemporary surgical suite provides the most advanced and precise technology in the region. “It’s a real game changer for neurosurgery in that it can be used for tumor cases, epilepsy cases, laser cases, pituitary lesions, and stereo-tactical purposes,” adds Dr. Salehi.

What to Expect as New myChildren’s Platform, Mobile App Launches March 17

With the transition to the new myChildren’s platform on Thursday, March 17, 2022, the same daily news and intranet content on myChildren’s and The Pulse (for providers) will be accessible via a mobile app, as well as on desktop. The new myChildren’s mobile app will offer team members—many with limited access to their inbox or a desktop computer—information they can access anytime, anywhere. 

On the morning of March 17, all team members will receive an email from The Pulse that offers a tip sheet, frequently asked questions and how-to videos about the platform with instructions for downloading and navigating the mobile app.

While both the desktop and mobile versions of myChildren’s home page will look slightly different, they will offer the same content currently available. Some security features are necessary for mobile users, such as logging in to access files and ensure a tailored content experience.   

New features and benefits of the new myChildren’s platform include:

  • Easy access from your phone to the myChildren’s apps and resources you use frequently, including Policy Stat, Clinical Pathways, My Service Center, Bugs & Drugs and much more. 
  • Frequently called numbers and the entire Children’s contact directory are now accessible on your mobile device.
  • Opportunities for increased engagement – like, comment and post photos on stories in The Pulse and myChildren’s from your desktop or on the go.
  • Recipients of The Pulse and The Leader newsletters will be able to access stories on both desktop and mobile versions and will continue to receive email prompts to check out new content. 
  • A search bar that will enable users to find resources quickly on both the desktop and app. 

To help the web team prioritize a smooth transition, there continues to be a freeze on intranet text and document changes. Updates will only be made to the new platform during this time. Please continue to refer any requested changes to [email protected]

Hubbard Nutrition Center Streamlines Milk Preparation

A hidden gem of the new Hubbard Center for Children is its Nutrition Center, a state-of-the-art lab for centralized milk preparation, located on the 7th Floor NICU. Having a dedicated space to receive, store, process and prepare expressed breastmilk and specialty formula away from the bedside helps the Nutrition Center team to prevent contamination, improve accuracy and prevent misadministration. This lab, which is unique both locally and to the region, has also proven to improve patient safety, nurse productivity, patient satisfaction and health outcomes.

Tammi Martin, Nutrition Center and Lactation Services, is a champion for this program, and she envisions becoming a regional and national leader recognized for the provision of safe breastmilk and formula.

 “The construction of the Hubbard Center opened the door to develop this program, which offers countless benefits. Research shows how valuable this service is to the hospital and families,” she says.

The Nutrition Center team handles all specialized nutrition needs for patients of all ages, not just formula and breastmilk specifically. One critical feature of the lab is its bar-coding software, which safeguards against errors associated with recipe calculations, feeding administration and violations of expiration parameters—and it interfaces with Epic. Trained nutrition technicians, strict cleaning and PPE guidelines and countless daily processes help ensure a safe, clean environment that optimizes patients’ growth and development while improving their health outcomes.

Beyond storing, prepping and delivering formula, breastmilk and other specialized nutrition needs daily, the Nutrition Center acquires pasteurized donor human milk from the Human Milk Banking Association of North America (HMBANA) regulated Mother’s Milk Bank in Denver to provide human milk when needed for its sickest babies. With 2 oz. and 4 oz. bottles of donor milk available, the team aims to minimize waste. These are scanned into the bar code system and used for qualified infants.

“The Nutrition Center is Children’s way of saying that we value the milk that these mothers are providing and strive to store and prepare it to promote the best outcomes for their baby,” Tammi adds.

Shaping the Future of World-Class Pediatric Neurosurgery with iMRI

Step into the Hubbard Center’s world-class pediatric surgical suites with Afshin Salehi, M.D., Pediatric Neurosurgery, and Travis Kruse, M.D., division chief, Pediatric Radiology, to see the future of pediatric neurosurgery with interoperative magnetic resonance imaging MRI/iMRI. Watch this video to learn more about iMRI innovation at Children’s.

By combining operating room/magnetic resonance (OR/MR), Children’s is gathering real-time information for the safest and best outcomes. It’s why this fully contemporary surgery suite provides the most advanced and precise technology in the region — all uniquely designed for even the smallest child.

Children’s state-of-the-art Pediatric Neurosurgery and Pediatric Radiology partnership means less pain and faster recovery times. It’s the latest in minimally invasive neurosurgical techniques, and the very best for kids.

A Voice for Families: Inside the Family Advisory Board

Children’s Hospital & Medical Center makes a concerted effort to not only listen to feedback from families but values these voices. Started in 2008, the Family Advisory Board represents nearly every specialty at Children’s with each family bringing their own perspective. This open line of communication not only fosters a welcoming environment for families, but helps Children’s improve the life of every child.

Watch a video here.

Updated Support Tools Now Available for Obtaining Peripheral and Central Lines

Over the past year, a multidisciplinary group has worked on updating the line algorithm that supports providers in determining the appropriate line choice and helps nurses triage how to obtain access. This now includes a PIV Evaluation Tool (PIVET), which guides nurses in determining when to attempt access or when to contact an expert resource such as the vascular access team (VAT). Additionally, the algorithm clarifies the roles and responsibilities for sharing this decision-making with caregivers and obtaining consent for PICC lines.

Click here to see the algorithm, which can also be found on Children’s intranet in the IV Therapy Care & Management Policy

Thanks go to Ashley Thompson, VAT manager, Bobbi Hohman, PICU educator, and Larisa Bos, 6 Med/Surg educator, and the rest of the Line Algorithm work group for their support in this work. Please contact Ashley Thompson or Lauren Maskin, M.D., with any feedback or questions.

Shadow Learner Programs Restart with New Guidance

“The shadows return” – sounds like a Halloween movie – it actually refers to recent Incident Command changes and approvals related to Children’s shadow learner programs. The option to have shadow learners on our campus has been approved, as long as the area and staff being shadowed feel that the process can be done in a safe and efficient manner. 

The Office of Education coordinates all shadow education opportunities at Children’s because students must sign non-disclosure agreements, provide proof of immunizations and have a staff member available to follow. 

For students in accredited programs who want to shadow to gain extra experience, such as medical students or students in a rehab program, we ask them to start the request process with their school coordinator. Schools often have additional requirements or need to coordinate with other students with similar interests. The school coordinator will then work with Children’s Office of Education coordinators to schedule and onboard the students.

Students outside of a Children’s accredited program who want to explore a possible future in a health profession, such as an undergrad pre-med student wanting to apply to medical school, should apply on ChildrensOmaha.org. The online registration system will go live in a few days.

Both kinds of shadow learners are processed through Children’s online student registration system, My Clinical Exchange.

Please be patient while these programs are restarted. For regularly scheduled educational programs, please allow six weeks from request to the planned rotation. This allows time for scheduling and verification of all requirements. Students, residents and fellows already in the process of onboarding at Children’s, and who have a deadline to meet graduation requirements, are prioritized.

  • All shadow learners must be vaccinated for COVID-19. The Office of Education is not granting waivers for non-accredited programs.
  • Shadow learner opportunities are for college students and above.
  • High school “Day in the Life” experience is under revision and will be the next program to return to Children’s.

These shadow learner opportunities are not the same as the nursing student observation program that restarted on March 1. That program has already relaunched and has its own set of guidelines. Please direct any questions to the academic team within the Office of Education.

COVID-19 Guidance Provided to Patients and Families

As the surge of COVID-19 slows down, it remains important to remind patient families of what they can do to protect against infection, as well as provide guidance on what to do in case of a COVID-19 infection. Effective immediately, basic, protective guidance on COVID-19 will be printed with every after-visit summary (AVS) for the Emergency Department, inpatient and Surgical Services. This will print automatically and be maintained by Med/Surg leadership in collaboration with Children’s Physicians leadership.

For patients with COVID-19 or who are awaiting test results, more specific instructions about COVID-19 will be printed automatically, based on if COVID-19 is on the patient’s Problem List. Please make sure the Problem Lists are updated, as this will ensure the correct information is provided to patient families and will help us collect data that can impact patient care. The instructions are also available in Spanish.

For the Specialty Pediatric Center and Children’s Physicians offices, this information will be optional to print; it will not be automated.  Please send comments or questions to your area leader or Lauren Maskin, M.D.

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