Programs/Services

Consent for Blood Transfusions

Effective as of March 8, 2011 written (signed) informed consent for blood transfusion are mandatory for all Children's patients requiring blood or blood components.

Cerner will prompt for confirmation of written (signed) consent based on established rules. The provider must check one of four options:

  • Transfusion Consent-1 Transfusion Only
  • Transfusion Emergency Situation [No Consent]
  • Transfusion Consent-Entire Visit
  • Transfusion Consent-1 year Hemonc Only
  • Inpatients currently receiving transfusion therapy may continue transfusion support without a written (signed) consent. Signed consent will be required with the next encounter.
  • There will be no changes to the Surgery or ECMO consent form or process relating to transfusion.
    Policy:
  • It is the responsibility of the attending physician to obtain signed informed consent before the start of transfusion therapy. The attending physician may delegate the act of obtaining consent to a fellow, resident, nurse practitioner, or physician assistant. The act of obtaining consent may NOT be delegated to a staff nurse or to clerical personnel.
  • Refusal of transfusion support must be documented in the Problem List in Cerner.
  • In an emergency situation, transfusion may occur without a written consent with a note in the medical record documenting the circumstances requiring transfusion.
  • If telephone consent is necessary, a witness is required.
  • The signed consent form will be scanned into the EMR. Compliance in obtaining signed informed consent will be monitored.

Resources:
1.    Consent for Blood/Component Transfusion form. Located under Forms/Medical Records/Medical Records Forms/Administrative
2.    Blood Transfusion Information-Patient/Family Education sheet. Locate under
References/Clinical/Patient Education 
Questions:
Contact: Kristin Mascotti, MD, Transfusion Service Medical Director, (612) 813-6712
Judy Zier, MD, Transfusion Committee Chair, (651) 220-6018
Judy Wenzel, Transfusion and Tissue Service Manager, (612) 813-8562

Gastroesophageal Reflux parent education

The apnea program at Children's - Minneapolis is offering a new Gastroesophageal Reflux (GER) program for parents of infants with significant GER symptoms. This program has been offered by the Children's - St. Paul infant apnea program for the past 10 years and has been well received by providers and families alike.

The GER program will be available for both inpatients and outpatients. For inpatients, select the "GE Reflux consult (Apnea Program)" order in Cerner. Outpatient referrals can be made by calling the apnea program at (612) 813-5831 or faxing an order to (612) 813-6168. Apnea nurses will schedule education directly with the family.

The GER Program provides families with the following:

  • Assistance in arranging outpatient diagnostic testing as requested by the referring physician (as appropriate)

Education for parents regarding:

  • GER diagnosis (test results, if done)
  • Rationale for treatment
  • Physiological aspects of GER
  • Special feeding/burping techniques
  • Positioning suggestions for feeding, sleeping, and wake periods
  • Appropriate use of a Danny Sling (cloth brace)
  • Infant CPR and aiding an obstructed infant

Follow-up phone calls to:

  • Assess infants' clinical progress
  • Answer questions
  • Reinforce medication use (if applicable)
  • Reinforce feeding and positioning recommendations

William Wheeler, MD, medical director for the Children's - Minneapolis apnea program, will provide medical supervision for this expanded service. 

Primary physicians will be consulted for medication as necessary and parents directed to continue routine follow-up for weight checks and dose adjustments as therapy is warranted. 

Please direct questions to Pam Stading, patient care manager, at (612) 813-6434 (x56434) or the Children's - Minneapolis apnea program at (612) 813-5831 (x55831).

New food allergy testing program

In September 2011, Children’s hospitalist program, along with five Twin Cities-area allergists (see list below), introduced a program that will allow children with significant food allergies to be tested by Children’s Hospitalist group to determine if their ability to tolerate the allergens has increased. 

This program is a response to requests by allergists to develop a program that will allow testing by the Hospitalist group for these children who, due to risk of anaphylaxis, must be observed for long periods of time. The testing is currently being conducted in Children’s Short Stay Unit by the individual allergists.

For more information on this program, including allergists wishing to take part in the program, please contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it. , medical director of Children’s hospitalist program.

Allergists involved in the program:

Thomas Helm, MD
Allergy and Asthma Care
Maple Grove

Nancy Ott, MD
Southdale Pediatric Associates
Edina

Naveen Sikka, MD
St. Paul Allergy & Asthma
St Paul

Allan Stillerman, MD
Allergy & Asthma Specialists
Minneapolis

Michael Wexler, MD
Advancements in Allergy and Asthma
Minnetonka

Pediatric single-incision laparoscopy "virtually scarless"

SILS"When laparoscopy was first used in pediatrics, parents would marvel that their child's surgery was done using only very small incisions," said David Wahoff, MD, PhD, a surgeon with Pediatric Surgical Associates and a Children's professional staff member. "But now, with single-incision laparoscopy, there's really no visible scar. Parents just can't believe it's virtually scarless."

While single-incision laparoscopy has been conducted for more than a decade on adult patients, it only recently has been performed on pediatric patients.

Wahoff is one of only a handful of surgeons in the Twin Cities to perform single-incision laparoscopic procedures on pediatric patients.

Because single-incision laparoscopy involves only a small incision through a patient's umbilicus, the procedure is as close to a scarless procedure as there exists today.

How it works

  • The procedure uses specialized instrumentation, including a port, which facilitates the insertion of three cannulae through which instruments are passed.
  • The instruments work together to provide surgeons with 360-degree rotation and hand-like access to a patient's abdomen.
  • The port also features a valve that allows surgeons to inflate the abdomen for optimal instrument access.

Advantages over open surgery

  • greatly reduced pain and scar tissue
  • a faster recovery
  • much lower incidence of infection

Advantages over multi-point laparoscopy

  • less pain for patients
  • virtually no scarring
  • minimal recovery time

"A real paradigm shift"

The three most common pediatric procedures that single-incision laparoscopy is used for are cholecystectomies, appendectomies and intestinal resections, often in instances of Crohn's disease.

In adults, the procedure has been used to treat an ever-growing list of complex gynecologic, urologic and colorectal conditions. Wahoff believes the procedure’s use in pediatric patients will follow a similar course.

"As we move forward, I think most pediatric procedures will at least be attempted through a single site and expanded to a multi-site laparoscopy only if the situation warrants," said Wahoff, who has performed laparoscopic procedures on children for more than 12 years.

"It represents a continued movement toward minimally invasive techniques — a real paradigm shift."

Children’s and St. Cloud Hospital partner on cancer/blood disorders pediatric care

Children’s and St. Cloud Hospital partner on cancer/blood disorders pediatric care  
Children in Central Minnesota needing pediatric specialty care for cancer and blood disorders will now be able to stay closer to home through an expanded partnership between St. Cloud Hospital and Children’s Hospitals and Clinics of Minnesota.


The new formalized cancer and blood disorders partnership will: 
•    Keep children closer to their family, doctor and home when possible, and provide a continuum of care to Children’s - Minneapolis campus when specialized care is required.
•    Give St. Cloud Hospital access to Children’s treatment guidelines, protocols and recommendations. 
•    Allow oncologists and hematologists from Children’s to be more present at St. Cloud Hospital, scheduling outpatient visits several days each month.
•    Help improve the lives of sick children and drive better outcomes through co-management and coordination of  care at the site that is most appropriate for treatment and for patients and their families.
•    Provide educational opportunities for physicians related to pediatric cancer and blood disorder specialty care. 

The partnership helps meet the growing and evolving medical needs of patients and families throughout Central Minnesota by improving access to high quality, family-centered care for kids fighting cancer and blood disorders. It formalizes a 10-year relationship between St. Cloud Hospital and Children’s and allows both organizations to builds upon the success of a collaborative care model. Already the new partnership has helped St. Cloud Hospital form a Pediatric Sedation Program this past spring, and talks are underway to expand the relationship into neurosciences within the next year.