Consumer Reports, is generally known for reviewing shiny new things we all want, like cell phones, TVs and cars. But in their most recent edition, they featured a story about things we cannot see and do not want – blood stream infections in children.
The report reviewed the central line bloodstream infection data from 2010 in pediatric intensive care units (PICU’s) of 92 children’s hospitals around the country and then ranked these hospitals based on their infection rate.
In the report, the PICU at Children’s – St. Paul was one of just five PICU’s reporting zero bloodstream infections in 2010, earning them the highest possible rating. The PICU at Children’s – Minneapolis was one of 29 hospitals who earned the second highest rating because they reported less than half as many blood stream infections as the national average.
Children’s has a track record for this kind of success. From 2006 to 2010, our PICUs combined had a 91 percent reduction in hospital acquired central line bloodstream infections.
Children’s is proud of our PICU staff for being able to accomplish this significant feat. In fact, at this writing, the PICU at Children’s –St. Paul has accomplished 891 days without a central line blood stream infection – that’s over two and a half years! What is fantastic about this is not where we land in the rankings, statistics, or even the accolades that go with this report, but the fact that patients – babies, children and teens – came to us for care and got that without acquiring a devastating, even life-threatening, infection.
We are the first to admit we are not perfect. Blood stream infections continue to be an issue that demands vigilance. We strive to replicate the St. Paul PICU success in all of our departments because our patients deserve a safe, healing environment. We know that every statistic on a report represents a child, and a family. It requires constant attention to provide safe care, especially when it comes to the invisible pathogens that can take a life.
So how are we doing this? Children’s has a culture of patient safety that believes even one hospital acquired infection is unacceptable. Our ultimate goal is to get to zero bloodstream infections and then to stay there. It’s a lofty goal because we live in a world of germs; ICU patients are particularly vulnerable. But, we have already shown we know how to prevent blood stream infections through leadership commitment, bedside staff expertise, constant vigilance, measuring, reporting and by transparently sharing our results.
Our staff who insert central lines go through an insertion checklist based on best practices much like an airline pilot goes through a pre-flight checklist. Our nursing staff maintain the cleanliness of the patient and the central lines 24/7 and continue to expertly manage the care of each child, so not one leaves our hospitals sicker than when they came.
Our rounding teams ask themselves daily if central lines are still needed because, as each day passes, the lines become a greater infection risk. Parents and visitors are taught to properly wash their hands when entering a patient’s room, before and after touching the child, and family members are encouraged to speak up when they have concerns.
To ensure that we continue our transparency, departments such as infection prevention and control, quality, lab, pharmacy and many others work tirelessly behind the scenes to monitor, measure and report our progress – sharing what we know, learning from it and constantly improving.
I’m proud to be part of the team effort at Children’s that allowed us to achieve this remarkable recognition. Together we will continue to work on behalf of our little ones who count on us for only the best care.
Patsy Stinchfield, MS, CPNP
Director
Infection Prevention and Control
Influenza is a serious respiratory illness. In 2010 alone, 122 kids died from complications from the flu—three of those children were from right here in Minnesota.
We at Children’s want to help bring that number to zero by educating the public and by providing families access to flu vaccinations.
Help us spread the word by sharing this infographic. Getting the flu vaccine will help protect you, your child, and reduce these numbers—it’s never too late to make sure your child is vaccinated.
Children’s Hospitals and Clinics of Minnesota have programs and services to support influenza prevention. For more facts about the flu and the programs we offer, visit: http://www.childrensmn.org/services/flu/
Parenting is already a difficult job; now imagine parenting from your hospital bed – or worse, being so ill you need to rely on someone else to parent your child or children. A hospitalized parent may be separated from their children, perhaps too ill to communicate, and the other parent or family member is too stressed to recognize the children’s needs. Families struggle with separation and uncertainties with illness and hospitalizations, especially with sudden or traumatic medical events.
Parents and family members are often stumped at the best way to talk to kids about such situations. Children can sense when something is going on and overhearing information can lead to misunderstandings or misperceptions. When a loved one is ill it is important to be honest with children and communicate with them at a level they can understand. Taking a moment to talk with your children not only helps them, it may relieve some of your stress. Parents are often surprised at how easy this kind of conversation can be – children usually have some information and are eager to be included.
Three important parts of your conversation should include the following:
Mom or Dad is seriously ill (or grandparent, etc.) – Talking about an ill parent will not make a child any more upset than they already feel and it presents an opportunity for them to express, to a caring adult, how they are feeling.
The name of the illness or injury – If a parent has been diagnosed with cancer – it is okay to use the appropriate word. Children don’t often have bad associations with these words. It will also be helpful if they want to share their story with a friend or teacher.
Your best understanding of what may happen – Explain what you believe will be your hospital course AND how this might affect them, “My doctor wants me to stay in the hospital until my infection has gone and daddy will be home with you” or “I’m planning to stay in the hospital until the end of the week but then I’ll make regular visits at the clinic to get medicine called chemotherapy; you will continue to go to school.”
Ask your child what they want to know, and be open and honest. Use age-appropriate words along with correct terminology to describe the illness. Children will retell your story and if you worry about saying the words yourself, kids pick up on that. You may need to reassure yourself too – people do have strokes and get better. I encourage parents to be hopeful but honest. The worst way children can learn information is overhearing it. Be mindful of what and how you share details of your illness, it might not feel fair to your children if they learn their cousins know more about the illness than they do.
Two – Six year old children need information and reassurance
Children often think they can cause something bad to happen – reassure that they did not cause this illness or injury. Explain the illness on their level; don’t assume they won’t be affected somehow. A two year old may not understand your illness, but they will know that a parent is not home or there are changes in routines.
Children often think illnesses can be contagious – reassure that they cannot catch the illness.
Children will want to know how they will be impacted – explain to them with detail the best you can. Routine is important and equals security to children. Keep children informed of their routine or any changes to their routine.
Six – Twelve year old children may desire detailed information
In addition to some of the other information, this age group can handle more information, but may get some of their information from peers, media, and online resources.
Be sure to check in frequently in case they have new questions and concerns.
Teenagers can have a variety of reactions and responses
Provide lots of detailed information. They want to be treated like adults even if their physical and cognitive changes interfere with producing very mature, adult-like behavior.
Make sure they have someone outside the immediate family to talk to on a regular basis, but discuss privacy issues, in case you want your personal info kept within the family.
Developmentally, teens are working on separating and being their own person. This can be challenging since they want to spend time with friends but feel pressure (internal and external) to be home with an ill parent.
Resources
How to Help Children Through a Parent’s Serious Illness (Kathleen McCue, 1994)
Raising an Emotionally Healthy Child When a Parent is Sick (Paula Rauch and Anna Muriel, 2006)
Did you know some cereals have more sugar per serving than a Twinkie?
Dr. Nicole Omann, a pediatrician at Children’s, spoke on KSTP this weekend about the importance of watching your child’s weight, and the shocking amounts of sugar found in some cereals.
Two studies about kids’ health were released last week. The first study revealed that not enough doctors are telling parents their children are overweight. The Archives of Pediatric & Adolescent Medicine surveyed 4,985 parents of children ages 2 to 15 who had a body mass index in the 85th percentile or higher, asking them if they had ever been told by a physician or health professional that their child was overweight. Only 22.4 percent of parents reported they had.
Your child’s weight is something you should monitor closely year-round, Dr. Omann said, not just during annual check-ups.
As for the cereal, Dr. Omann urges parents to have breakfast options like oatmeal, fruits and eggs for their kids instead of sugary cereals. The Environmental Group study listed the best and worst cereals for kids, with Kellogg’s Honey Smacks and Post Golden Crisp topping the list of worst cereals for kids. Read the full report on the sugar in children’s cereals.
When a child is diagnosed with cancer or a blood disease, it impacts the entire family. At Children’s Hospitals and Clinics of Minnesota, we not only treat the child, we care for the whole family. It’s this unique treatment philosophy — combined with world-class facilities, clinical expertise, leading technologies and remarkable outcomes — that makes Children’s the best place for pediatric cancer and blood disorder treatment.
Santa made virtual visits to bring holiday cheer from the North Pole right to kids’ rooms at Children’s – Minneapolis yesterday. Santa used Cisco TelePresence to video chat with kids who can’t leave their rooms or have visitors, and he even shared a big secret with one of our patients!
We’ve hosted a video contest for high school and middle schools across Minnesota the last two years as part of our efforts to teach kids about influenza prevention. We’re excited to announce we’re hosting the contest again this year!
The contest gives students a chance to use their creativity and video skills to create a public service announcement about the importance of flu prevention. Last year’s winner was Bloomington-Jefferson High School, with the video featured above. The students who did the video earned $3,000 for their school.
We’ll award the top three videos $3,000, $1,500, and $1,000, thanks to generous support from Kohl’s Cares. The three winning videos will be distributed to middle and high schools throughout Minnesota. We’ll also host a celebration at the winning school to recognize the students’ work.
We’re thrilled to share that we have once again been named one of the top hospitals in the country by the Leapfrog Group!
The annual award recognizes hospitals for quality and efficiency. Only 10 pediatric hospital awards were given out this year, and we received two of them. This is the fifth time Children’s has received the Leapfrog Award. We are the only children’s hospital in the five-state area to receive this honor.
It’s more important than ever for hospitals to make the most of their resources while still delivering the best possible care. We’ve been a leader in developing new ways to increase efficiency, whether it’s in the design of new buildings and spaces or helping find ways for care teams to collaborate more easily.
The Leapfrog Awards are based on a national survey that measures hospitals’ performance in crucial areas of patient safety and quality. You can see all of the results at leapfroggroup.org.
We launched our new end-of-year giving campaign this week, including three new commercials that focus on the importance of giving locally, our pediatric cancer program and how we treat every kid who walks through our doors. As you consider giving during the holiday season, please remember what it means to take care of Minnesota kids. Please consider making a gift. Your support makes all the difference.
A sick kid without insurance is still a kid. And we treat every kid who needs it. Last year alone, we provided more than $50 million of care that wasn’t covered by insurance. Your support helps make this possible.
We treat more kids with cancer than any other hospital in the state. From clinical research to pain management to early physical therapy, your donations help us provide local kids with the very best cancer care.
Your support helps ensure that local kids will continue to receive some of best pediatric care in the country. Hey, we’re Minnesotans. We believe in taking care of our own.
Dr. Stefan Friedrichsdorf, director of Pain and Palliative Care and Integrative Medicine at Children’s, is on a two-week trip overseas to train caregivers about pediatric pain management. Last week, he was in Zambia, Africa, for the 1st Annual Pediatric Palliative Care Symposium. He taught more than 150 professionals at an event sponsored by the CDC/Atlanta and the US President’s Emergency AIDS Fund. This week, he’ll be in Cyprus for “Advanced Pain Medicine & Palliative Care for Children: Workshop for Professionals in Pediatric Hematology / Oncology,” where he’ll teach the Middle East Cancer Consortium about pediatric pain management, teaching Israelis and Arabs in the same room, united by a desire to help children in pain. Read all posts about his trip.
Tuesday, Nov. 22
In Zambia (a democratic and very safe country) in southern-central Africa, there are 6.8 million children 0-17 years of age. Most international help is geared toward HIV/AIDS (120,000 infected children 0-14 years) and malaria. Pediatric cancer, however, seems forgotten. There is only one pediatric cancer ward in the country here at the University Teaching Hospital (UTH), which has about 180 new diagnosis/year, usually stage 3-4.
The visit to UTH Thursday morning was very sobering and had a deep impact on both Dr. Michelle Meiring (Red Cross Children’s Hospitals, Cape Town, South Africa) and me.
In addition to physical pain, we saw so much emotional pain in the faces of the children and their caregivers — such a need for palliative care and for support of their amazing staff that are doing what they can with what they have.
One case that struck a deep cord with us was that of a wonderful dad who has spent a year at the bedside of his son but now has to go home, so won’t be able to complete the second year of treatment for leukaemia. What a difficult decision to make! I also chatted to a mom whose daughter (just diagnosed with AML) is one of a set of twins. Mom comes from the Eastern Province, so will not be able to go home and will have to spend a year or more at the bedside on a chair next to her daughter.
I believe there are no facilities for parents to sleep. There were 34 patients crammed into two small wards. Probably many of these children could be receiving outpatient chemo, which would decrease the crowding if there was family accommodation nearby. It looked like they had run out of some of the chemo drugs, which probably means they need to be more selective on who they treat and don’t. Lots of ethical dilemmas in that ward. There was one patient with relapsed leukaemia who they didn’t have chemo for.
There are only two pediatric oncologists in the hospital, plus pediatric residents; treatment protocols are from the U.S. or U.K. The children do NOT have any central lines, meaning intravenous access is very difficult. Many children received morphine. However, painful procedures such as lumbar puncture and bone marrow aspirations were not done with any analgesia/sedation. (I worked with the team to introduce ketamine/benzodiazepine OR nitrous gas, both which is available in the hospital.)
The unit has NOT partnered with any African or Western pediatric hem/onc Center. They need our help!
We’re thrilled to share that we have once again been named one of the top hospitals in the country by the 
