Requests for Long GI Tube Placement Can be Made in Epic

Providers wishing to have a radiologist place or advance a GI tube from the nose into the small bowel can make the request in Epic. Enter an order for RF Long GI Tube Placement. This procedure does not require an interventional radiology consult order. This is primarily performed by the pediatric radiologists. If placement is requested after 5 p.m., every effort will be made to schedule the procedure the following morning. If the placement or advancement is unsuccessful, the pediatric radiologist will consult with the interventional team.

For any questions, please email Melinda Beroshvili, Radiology, or call 402-955-5621.

Anti-Infective Time Out Initiative Begins Oct. 16

The Anti-Infective Time Out (ATO) initiative is a formal process which prompts a reassessment of the continuing need for, and choice of, anti-infectives after a period of time. An ATO will be performed and documented for all Children’s inpatients when on anti-infective therapy for 48 hours. A pharmacist will prompt the time out during the admitting team’s rounds, or contact the admitting team to complete the document. The ATO document will then become a part of the patient’s medical record.  The Pharmacy and Therapeutics committee approved the requirement that duration of therapy be indicated when any systemic anti-infective is initiated.

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Children’s Receives 2019 Women’s Choice Award® as Best Children’s Hospital

Children’s has been named as Best Children’s Hospital by the Women’s Choice Award®, a referral source for the best in health care. The designation of Best Children’s Hospitals is based on a point system and self-reported data from almost 60 children’s hospitals in the nation.

“Our Best Children’s Hospitals award helps raise awareness of the top quality care offered for children—not only the critically ill—with specialists, services and technologies for their unique needs,” said Delia Passi, founder and CEO of the Women’s Choice Award.

“We found in our studies that 75 percent of women associate children’s hospitals with care for seriously ill children, and nearly 50 percent of women are unfamiliar with the offerings of a children’s hospital,” said Passi.  “Our goal is to help moms—and parents—make educated, confident decisions about where to take their children for a wide range of health care services.”

The list of 38 award winners, including Children’s, represents hospitals that have met the highest standards for child care.

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Pediatric Endocrinology Clinic Moving to Cass Street

On Oct. 8, Children’s Pediatric Endocrinology clinic will begin seeing patients at 8552 Cass Street. The clinic is located on the first floor as patients enter from the south side, where convenient parking is available. The new location provides many enhancements, including more exam rooms, more family education classrooms, more providers – for more convenient appointment times – and the latest tablet technology, so families can complete questionnaires and survey responses regarding their visit in real time.

Clinic hours are 8 a.m. to 4:30 p.m., and the phone number will remain the same, 402-955-3871.

Children’s is ranked in U.S. News and World Report’s Best Children’s Hospitals for Diabetes & Endocrinology, and the American Diabetes Association just renewed recognition for Children’s diabetes education program.

Trauma Program Receives Verification from American College of Surgeons

Children’s Pediatric Trauma program has been re-verified as a Level 2 Trauma Center by the Verification Committee, an ad-hoc committee of the American College of Surgeons (ACS). This achievement recognizes our trauma center’s dedication to providing optimal care for injured patients.

Verified trauma centers must meet the essential criteria that ensure trauma care capability and institutional performance.  According to Shahab Abdessalam, M.D., medical director of Pediatric Trauma, this is the third time Children’s has completed the trauma verification process through the ACS.  “This visit reaffirmed what we already know; that we take excellent care of our pediatric trauma patients,” said Dr. Abdessalam. “With our excellent team here at Children’s, we will continue to be the leader in the region for caring for all injured children.”

After Fighting Cancer, Nebraska Girl Advocates in Washington, D.C., for Sick Children & Families

Eleven-year-old Grace Fry of Lincoln, Neb., is a fighter, having fought acute myeloid leukemia—one of the most challenging childhood cancers to treat. Now, with Grace in remission, she and her family are taking on a different kind of fight—sharing their experience to advocate for the nation’s most medically complex, vulnerable children. They never thought they’d need Medicaid coverage… until they did, and they learned firsthand how critical the program is for millions of American families with sick children. Now, they’re advocating for legislation to strengthen Medicaid for families already bearing the heavy burden of illness.

On Oct. 2-3, the Fry family is meeting with Nebraska legislators in Washington, D.C., alongside representatives from Children’s Hospital & Medical Center, encouraging them to support the Advancing Care for Exceptional Kids Act. Grace and her family will meet with Senators Deb Fischer and Ben Sasse, and Representatives Don Bacon, Jeff Fortenberry and Adrian Smith.

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New Strep Test Available Oct. 8

Starting on Monday, Oct. 8, Children’s will begin using eSwab for specimen testing. eSwab is a liquid-based multi-purpose collection and transport system that maintains viability of aerobic, anaerobic and fastidious bacteria. It consists of a flocked swab and a screw-capped transport tube containing 1 mL of liquid Amies medium. eSwab provides more accurate molecular results with no need for cultures. This test replaces the current Rapid Strep with reflex to culture in the hospital, Emergency Department, Care4U and specialty clinics. It is not available at Children’s Physicians or Urgent Care locations at this time. Expected turnaround time is 30 minutes from the time it reaches the lab.

To perform this test:

  • Order Group A Strep by PCR (LAB4169)
  • Collect eSwab by swabbing throat and break the swab off into the vial
  • Label the swab, collect in Epic and send to Lab

Contact Tess Karre, M.D., with questions.

Epic Update: Route Will Be Required on All Outpatient Medications

Starting Oct. 3, all outpatient prescriptions will include route as a mandatory field.  Requiring the route will assure the medication ordered has the correct route. In addition, when route is included, electronic dose checking is available. This change is being made in response to a patient who received an outpatient optic ear drop prescription instead of an ophthalmic drop prescription needed for the eye infection. Route indication is already required for all inpatient medications.

Be Alert to Enterovirus Symptoms

Non-polio enteroviruses are very common, causing 10 to 15 million infections and tens of thousands of hospitalizations annually in the U.S. The majority of those infected are asymptomatic or only mildly ill, typically with features of the common cold, but some people can become seriously ill. Infants, children and those with weakened immune systems are more likely than healthy adults to have a serious illness.

Symptoms of mild illness may include:

  • fever
  • runny nose, sneezing, cough
  • skin rash
  • mouth blisters
  • body and muscle aches
  • viral conjunctivitis
  • hand, foot and mouth disease

Some non-polio enterovirus infections can cause more serious illnesses, such as:

  • viral meningitis (infection of the covering of the spinal cord and/or brain)
  • viral encephalitis (infection of the brain)
  • myocarditis (infection of the heart)
  • pericarditis (infection of the sac around the heart)
  • acute flaccid paralysis (a sudden onset of weakness in one or more arms or legs)
  • inflammatory muscle disease (slow, progressive muscle weakness)

Enteroviruses are transmitted through direct contact with gastrointestinal or respiratory secretions from an infected person or via contact with fomites. Hand washing and cleaning of high-touch surfaces are important prevention strategies.

Additional information on seasonal enteroviruses is available from the Centers for Disease Control and Prevention (CDC) on the link below.

Severe Illness in Nebraska in 2018:

There have been cases of viral meningitis and encephalitis occurring in Nebraska this summer, often caused by enteroviruses at this time of year. Physicians and care providers should remain alert to enteroviruses as a potential cause of these infections, even if the cerebrospinal fluid (CSF) polymerase chain reaction (PCR) BioFire panel is negative.

Enteroviruses can also lead to acute flaccid paralysis (sudden onset of flaccid limb weakness). There is an ongoing CDC evaluation of any cases meeting this definition, regardless of confirmed etiology.

Additional detailed information from local public health and from the CDC on diagnosis and treatment of acute flaccid myelitis (AFM) is available on the links below. Contact Kari Simonsen, M.D., with further questions.

Viral Meningitis

Non-Polio Enterovirus

Acute Flaccid Myelitis

Douglas County Health Department

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