justkids Spring 2007
Published by Children’s Hospital, Omaha, NE
Children’s Earns Nursing Magnet Designation Children’s Hospital Strives to Prevent Child Abuse Are Video Games Bad for Kids?
Inside | New Anxiety Clinic Opens at Children’s | Page 7
c h i l d r e n’s s p o t l i g h t
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This honor further substantiates what we already knew about the extraordinary level of care that distinguishes Children’s.
” Children’s Hospital Earns
Nursing Magnet Designation
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Kathy English
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urses at Children’s Hospital are specialized in caring for children and strive to set new, higher standards of care for patients and families. And it shows. Children’s Hospital was recently honored by the American Nurses Credentialing Center (ANCC) with the acclaimed Magnet designation, a coveted award of excellence in nursing care and the highest level of nursing recognition given by the ANCC.
“This is a tremendously exciting moment in Children’s history,” says Kathy English, Children’s Hospital chief nursing officer and chief operating officer. “It’s a time to celebrate and express our deep gratitude to our compassionate nurses for the uncommon care they provide to our special patients each and every day. This honor further substantiates what we and our patients already knew about the extraordinary level of care that distinguishes Children’s.”
in the nation. Less than three percent of all hospitals have achieved this level of recognition, which ranks Children’s among the leading national hospitals. The Magnet designation was granted to Children’s after an extensive, two-year evaluation process by the ANCC. The assessment, which involved nurses, patients and community members, included interviews, site inspections and thousands of pages of documentation. “The greatest value of the Magnet honor to Children’s is the well-deserved recognition it gives our exceptional staff of caring nurses,” English says. “It is also a great recruitment and retention tool, since many nurses want to work for Magnet hospitals.”
What is Magnet? The ANCC developed the Magnet program to recognize health care organizations that provide the ultimate in nursing care and uphold the traditions and standards within the nursing profession. ANCC officials say that Magnet facilities demonstrate positive core values, such as empowerment, pride, mentoring, nurturing, respect, integrity and teamwork. The Magnet designation advances three goals: ■ To promote quality in an environment that supports professional nursing practice ■ To identify excellence in the delivery of nursing services to patients ■ To provide a mechanism to share best practices in the nursing profession. The Magnet distinction is held by only 16 other free-standing children’s hospitals
Living the Children’s Mission The nurses at Children’s Hospital understand that living the mission of Children’s—“so that all children may have a better chance to live”—extends beyond the walls of the hospital itself. Our nursing staff helps conduct community outreach programs that take the services of the hospital out to those who may never have the need to walk through our doors. Children’s Hospital administration supports and encourages this community outreach, not only for nurses but for all staff, in activities that directly or indirectly benefit the children served by the hospital. Many Children’s nurses also volunteer their time to participate and assist with special summer camps for children with various illnesses or disabilities. Extra Level of Assurance Officials with ANCC say that the Magnet designation adds an extra measure of assurance to families of patients who place loved ones under the care of Magnet facilities. Independent studies have shown that patients who are cared for in Magnet hospitals experience higher satisfaction, shorter stays, fewer complications from surgery, higher nurse-to-patient ratios and lower mortality rates. ■
Bicycle Safety: Rules to Protect Your Child Bicycles are great for helping children exercise, learn balance, develop leg muscles and have fun. However, not following proper safety rules can lead to broken bones, concussions and emergency room visits. There are three key ways you can help protect your child. ■ Be sure your child is ready for a bike, both mentally and physically. ■ Make sure the bike is the right size for your child. A bike shop can help you make a good purchase. ■ Make sure your child understands and practices safe bike-riding rules. Before riding alone, children need to practice the basics of riding, such as stopping, signaling and watching for traffic. In addition, make sure they wear a hard-shell helmet each and every time they ride a bike. Agree on a regular maintenance program with your child that includes the bike receiving a yearly check-up at a bicycle shop. Finally, remind children to keep their eyes on the road and scan constantly for walkers, other cyclists, cars, adverse road conditions, dogs or other riding hazards.
Save the Date! CycleFest Teaches Safe Riding Skills CycleFest 2007, sponsored by Children’s Hospital, the National Safety Council – Greater Omaha Chapter and Kohl’s Cares for Kids, will be held at Chalco Hills Recreation Area, 8901 S. 154th Street in Omaha, on Sunday, May 20, from noon to 3 p.m. This FREE family event teaches safe-riding skills and the importance of wearing properly fitting helmets, and also offers bike inspections and much more. Join us! Call 402-896-0454.
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c h i l d r e n’s s p o t l i g h t
Children’s hosts groundbreaking double Cochlear implant Isaac had a double cochlear implant at Children’s—the region’s first—to correct deafness that resulted from the bacterial meningitis he contracted when he was 7 months old.
Britt Thedinger, MD
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earing loss in a child can be devastating news for parents, and it changes a child’s entire world. Isaac was 7 months old when he contracted bacterial meningitis. The infection caused nerve loss in both of Isaac’s inner ears, resulting in complete deafness. Causes of hearing Loss There are two types of hearing loss. Congenital hearing loss implies that the hearing loss is present at birth. This loss can be caused by: ■ Heredity factors ■ Prenatal infections ■ Prematurity ■ Lack of oxygen ■ Maternal diabetes Acquired hearing loss appears after
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birth as a result of a condition, an injury or a disease like meningitis, measles or the mumps. What made Isaac’s case crucial was timing. At 7 months of age, Isaac was in a critical stage of speech and language acquisition and development. “Most speech and language is attained by the time a child is 18 to 24 months old, so there’s this very narrow window of opportunity to provide that hearing stimulus,” says Britt Thedinger, MD, Children’s Hospital otologist and neurologist. “The earlier it’s detected and treated, the better,” he adds. That meant restoring Isaac’s hearing was of the utmost importance in order to have a better chance to reverse his condition and give him a chance to develop normal speech patterns.
groundBreaking surgerY To combat the effects of spinal meningitis on Isaac’s ears, Dr. Thedinger performed the region’s first double cochlear implant on the child. Cochlear implant surgery involves placing a device into the inner ear. This device contains tiny electrodes that stimulate the nerve bodies still remaining in the ear. These nerve endings sense vibrations, resulting in hearing restoration. The surgery, which takes just one hour, is done on an outpatient basis, allowing the child to sleep at home in a familiar bed the very same night. Isaac’s double cochlear implant is very unique in that, typically, the procedure is done on one ear at a time and not both. In fact, there are actually very few people in the country with implants in both ears. However, no matter how unique the surgery, there was only one facility Dr. Thedinger considered when deciding where to perform the procedure—Children’s Hospital. “Children’s Hospital is an excellent hospital in which to do these types of sophisticated procedures,” he says. a Bright future Three weeks after the surgery, Isaac returned for a visit with Dr. Thedinger, where Isaac’s hearing devices were turned on. For the first time in months, Isaac was able to hear. There was no brighter light in the room than that coming from Isaac’s eyes when he heard his mother speaking to him. ■
“Bloodless Surgery” Protects Children
Mark Puccioni, MD
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Joseph Deptula, MPS, CCP
f your child needs surgery, you may be worried about blood transfusions. The chance of getting hepatitis or HIV from transfusions is now very low. However, bacterial contamination of blood, receiving the wrong blood type or other potential complications can still be a cause for concern. That’s why the experts at Children’s Hospital utilize several blood sparing techniques in surgical settings.
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“Conserving patient blood and being able to return it back to them during surgery is so much better than giving a patient a blood transfusion,” says Joseph Deptula, MPS, CCP, Children’s Hospital chief of perfusion services. “With the new devices and techniques available, we are able to provide these blood-saving techniques to newborn babies as well as our older children.” “Bloodless surgery” aims to reduce the need for donor blood from the public supply. Depending on your child’s age, size and type of surgery, here are some of the options: ■ Your child may be able to donate her own blood before surgery. ■ A physician may recommend your child receives drugs and iron supplements prior to surgery. These will help increase red blood cell counts in your child’s body, which helps the body cope and adapt with blood loss during surgery. This, in turn, allows physicians to use less donor blood products. ■ Drugs may also be given during surgery to help reduce bleeding and help protect the body’s ability to make the blood clot. This also reduces the amount of donor blood needed.
Techniques that reduce the need for donor blood during surgery help to both conserve blood products and make surgery safer for children.
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■ A cell saver machine can be used to collect blood lost during surgery. The machine cleans the “lost” blood and it is returned to the patient, even on small newborns. ■ Children’s Hospital is equipped with cerebral and deep tissue oxygen saturation monitors that tell physicians if your child is getting enough oxygen to his organs. This allows the physicians to transfuse donor blood only when the patient needs more oxygen and not based on the amount of blood lost during surgery. ■ Should your child need donor blood products, we use parts of units instead of full units of blood. This philosophy of using only what is needed allows your child to have blood product in reserve if a need arises outside of surgery. It also keeps the hospital from wasting blood products and reduces the amount of individual blood donor exposures a patient has. In addition to these blood-saving features already in place, Children’s Hospital offers a blood surgery/blood reduction and containment program for many of its patients, including those undergoing craniofacial reconstructive surgeries. “Our blood saving techniques have made a significant difference in the number of children we transfuse,” says Mark Puccioni, MD, a pediatric neurosurgeon with Children’s Hospital and assistant professor of neurosurgery with the University of Nebraska College of Medicine. “We only transfuse a fraction of the children we used to transfuse. This is significant because any time you can avoid exposing a child to the risk of blood or blood products, it’s good.” Blood conservation and bloodless surgery are not only a possibility, but the right of every patient, regardless of size. At Children’s Hospital, our highly skilled team of surgeons, nurses and other professionals work closely together to implement our special blood management program, including individualized options that are right for your child. ■
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Children’s Hospital Strives to Prevent Child Abuse April is Child Abuse Prevention Month. There is no social issue more important, no need greater, than the drive to stop child abuse. Our best weapon against child abuse is understanding and intervention.
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he majority of cases of child abuse stem from one of two problems: drug and alcohol abuse or overwhelmed caregivers,” says Dr. Jeffrey DeMare, medical director for Children’s advocacy team, which provides specialized care for abused and neglected patients. “What caregivers need to remember is that they can ask for help.” Child abuse frequently stems from family disorganization, inadequate community resources and personality disturbances. Abusive parents often love their child, but lack the ability to resist violent impulses. “If your child is crying and you’re having a hard time dealing with it, simply put your child in the crib and walk away,” says Dr. DeMare. “This will give you an opportunity to calm down and regain your composure. If you still feel frustrated, call a friend or family member to come and help.” There are several types of child abuse, and a child may suffer from more than one type. ■ Physical neglect involves not providing for a child’s basic needs, including shelter, nutrition, appropriate clothing, supervision or medical care. Neglect can also include creating an unsafe environment that can
lead to injury. Neglected children often appear hungry, dirty or listless. ■ Physical abuse is the actual infliction of injury on a child’s body. ■ Shaken Baby Syndrome is a form of child abuse caused by violently shaking an infant. The consequences can include brain damage leading to blindness, paralysis, seizures, learning disabilities or death. ■ Sexual abuse includes any sexuallyoriented act, practice, contact or interaction in which the child is used for the sexual gratification of another person. ■ Emotional abuse is the continual blaming, name-calling, frightening or rejection of a child, which often results
in the child not developing a sense of self-worth. If you suspect child abuse, contact local law enforcement or call the Nebraska Child Protective Services Hotline at 1-800-652-1999. The Iowa State Hotline number is 1-800-362-2178. Remember, failure to report child abuse also is a crime that is punishable by law. In addition, do not hesitate to seek emergency medical treatment for a child. A physician or emergency room personnel can assess and treat children for abuse and neglect. Also, teach children that abuse is not all right, and believe a child’s report of abuse. Do not blame a child for telling about abuse. Young children rarely lie about being abused. All statements should be taken seriously and reported to those who can help. ■
enjoy Your Baby
Caring for a baby can be a wonderful experience, but it can also be very frustrating when the baby won’t stop crying. This valuable brochure offers advice for parents when dealing with a crying baby. Call 402-955-6954 today to receive your FREE copy.
Mayor’s Mile good for heart and soul Heart disease and congenital heart defects are not just adult issues. Join us at the annual Children’s Mayor’s Mile Walk on Saturday, May 19, at 8:30 a.m., at the ConAgra Foods Campus, 10th and Harney Street, in Omaha. Here, you can help educate your children on the benefits of a heart-healthy lifestyle and support the life-saving research of the American Heart Association. The Children’s Mayor’s Mile is a division of the Omaha-Council Bluffs Heart Walk that specifically recognizes children who have survived or are dealing with heart disease. Children’s Hospital sponsors this annual benefit for the American Heart Association. To register or to learn more about the Children’s Mayor’s Mile Walk, call 346-0771, ext. 12, or visit http://heartwalk.kintera.org/omahacouncilbluffs.
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Lynda Madison, PhD
Get Free, Personalized Health Information Online from Children’s Almost everywhere you turn today, you can find health information. But how do you sort through it all to get what you need? Put My Health Source from Children’s Hospital to work for you. This innovative,
New Anxiety Clinic Opens at Children’s
free online service lets you decide just which health information you want. Then, and only with your permission, My Health Source delivers just what you ask for. It’s
Lauren Conaway, PhD
private, current and delivered straight to your personal e-mail address. It’s secure.
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he Family Support Center at Children’s Hospital has opened a new anxiety and compulsive behavior disorders clinic. The clinic offers specialized diagnostic and treatment services for children ages 7 to 19 who suffer from fear or anxiety symptoms. “Anxiety disorders are among the most prevalent childhood issues and frequently have a negative impact on an individual’s daily functioning,” says Lynda Madison, PhD, psychologist and director of behavioral health services at Children’s Hospital. “It can impact peer relationships and school attendance, which frequently results in depression or physical complaints.” The clinic offers both individual and group treatment options for children and their parents or guardians. Group sessions are held once a week for eight weeks with a maximum group size of eight participants. Treatment sessions focus on a variety of topics, including:
■ identifying symptoms and emotions ■ the circular nature of feelings, thoughts and behaviors ■ coping skills training ■ relaxation therapy “The goal of our clinic is to identify anxiety disorders as early as possible, and to provide skills training for both patients and caregivers,” says Loren Conaway, PhD, Family Support Center psychologist who will lead the anxiety clinic. “Interventions are most effective if parents also learn ways to support and encourage their children at home.” Evaluations and group therapy sessions are conducted by a licensed child and adolescent psychologist who specializes in anxiety disorders. “Anxieties tend to build over long periods of time,” says Conaway. “Likewise, the remedy often takes time and practice, too. While some changes occur quickly, children will keep the skills they learn in our anxiety program and use them in the future as well.” ■
And it’s all medically reviewed. To start receiving the valuable news and information that can help you make the best decisions about your family’s health, register for My Health Source now by visiting our website at www.chsomaha.org. Click on “sign up for e-news alerts” and choose the e-mail subscriptions that fit you best. Designing your own personalized health information service from My Health Source takes just minutes. Start by choosing the topics that most interest you. When we log in your e-mail address, we’ll assign you a password so your information is kept strictly private. And if you want health reminders, please provide your date of birth and gender. That’s it. We also know your interests can change, so we’ve made it easy to update your list at any time. Of course, your physician who knows you is always your best guide to good health. Yet, we know that more than 50 million Americans regularly turn to the Internet for health information.
To learn more or to schedule an evaluation interview, call the Family Support Center at 402-955-3900, and mention this article when you call.
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Are Video Games Bad for Kids?
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bout 70 percent of children live in homes with at least one video game console. Video and computer-based games score some healthy points. For example, they may boost your child’s dexterity and ability to respond and react to visual images. But there’s a flip side to all the fun. Time spent in sedentary activities, such as playing video games, contributes
justkids just kids is published by Children’s Hospital to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from a physician. © 2007. All rights reserved. Printed in U.S.A. Gary A. Perkins, President and CEO Kathy English, Executive Vice President and COO David G.J. Kaufman, MD, Medical Advisor Dannee Hartley, Public Relations Coordinator
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to childhood weight problems. Just as troubling: Experts worry about the effect of video game violence on young minds. soMe video gaMes reWard vioLenCe The violence in video games can have a major impact on young people. Too much can desensitize children to violence, make them aggressive, cause nightmares and make them wary of the world around them. Some experts believe the violence in video games may have a greater impact on children than violence on television. That’s because video games allow children to take part in virtual violence. They also “reward” children for aggressive behavior. “Know what your child is doing and watching,” says Jane Carnazzo, MD, a Children’s Physicians pediatrician. “Be interactive and ask them questions. Better yet, watch what they play and play with them. Also, look for side effects, such as nightmares or aggressive behavior. And remember, even teenagers can be affected by the use of cigarettes, alcohol or sexual content in video games.”
set soMe ground ruLes As a parent, you can fight back against video game violence by choosing games wisely. Use ratings and warning labels as a guide—not the final word. According to the Entertainment Software Rating Board, games suitable for children age 6 and older are labeled “E” for everyone. However, an “E”rated game isn’t necessarily violence-free. In one report, two out of three “E”-rated games involved some type of violence. Games labeled E 10+ have content that may be suitable for ages 10 and older. These games may contain fantasy or mild violence, mild language and or minimal suggestive themes. Games rated T (teens) have content that may be suitable for children ages 13 and older; however, these games may contain violence, suggestive themes, crude humor, minimal blood, simulated gambling or occasional use of strong language. Here are some more safe gaming tips: ■ Limit your child’s media time—including TV, computer games and video games—to one to two hours per day. Some parents use a timer to keep track of the hour or two. ■ Keep video games, televisions and computers out of children’s rooms to cut down on media time and decrease their exposure to violence. ■ Try to pick games that don’t use human or living targets or award points for killing. ■ Balance video game time with more active or educational pursuits. ■