Exceptional Experiences at Community Health Network

A Community clinical nurse specialist and the network director of epilepsy/pulmonary DRG management, are featured in an in-depth video about Community Health Network’s world-class performance in preventing ventilator associated pneumonia (VAP). All of the network’s seven ICUs have gone at least one year without a VAP.

The video serves as a VHA Inc. Leading Practice Blueprint that maps out all of the steps that have been proven to lead the most effective and efficient care for VAP. Produced by VHA, the video was developed after VHA recognized Community Hospital East as a leading practice hospital for its work in preventing VAP. The video will serve to educate and encourage 1,400 VHA member hospitals nationwide to adapt and adopt these practices into their patient care patterns.

“This is the ultimate jewel in our crown of safety and quality achievements. VHA thought so and blueprinted it for all of VHA,” says Glenn J. Bingle, M.D., chief medical officer and network vice president, medical and academic affairs.

The National Council on Radiation Protection and Measurements (NCRP) stated that in 2006 Americans were exposed to seven times the medical radiation than they had been 25 years before, largely due to higher utilization of CT. Reports in the medical literature and popular press are generally revising upward the risks associated with medical levels of radiation exposure.

Parents of pediatric patients may become concerned and seek clarification and further information if you recommend an imaging study that uses radiation. What can you tell them?

While the total number of CT scans has grown, the average radiation dose per exam has actually fallen by a factor of 2 to 3 since the early 1980s. The Alliance for Radiation Safety in Pediatric Imaging has formulated a campaign and pledge known as “Image Gently”. Community Health Network and its partners have signed that pledge, and adhere to specific reduced dose scan protocols tailored for the body habitus of the child, in addition to using special shielding techniques.

Encourage parents to understand both the risk and the benefit of a CT. The risk from a single CT scan is believed to be very low but uncertain.  A CT scan of the chest or abdomen equals an amount of radiation equal to three years of that received from background sources. A chest x-ray equals about 10 days of background, and an extremity x-ray is about one day of background.

The American College of Radiology has collected and analyzed data to periodically publish appropriateness criteria for imaging decisions. The CHN radiologist is always ready to consult with referring physicians to determine which imaging exam is most appropriate to deliver the needed information. They can be reached at 317-621-5369.

Visit the Image Gently website (www.imagegently.org), download and make available the information brochure “What Parents Should Know about Medical Radiation Safety” and encourage them to keep a record of imaging studies to avoid unnecessary repeated studies. Finally, use the resources available to you within the Community Health Network; the radiologist and medical physicist.

On June 10^th (the second Wednesday of June), 2009, Dr. Scott Engum of Pediatric Surgical Associates, will be presenting Pediatric Grand Rounds, “The Pediatric Acute Abdomen”. Dr Engum will be discussing the evaluation and differential diagnosis of acute abdominal pain in pediatric patients.

Pediatric grand rounds are generally provided monthly and are eligible for CME. We provide these offerings usually on the first Wednesday of the month at 7:30 a.m., in the multi-service conference rooms on the 3rd floor of the professional building. Coffee will be served.

If you have any questions about this, you can contact Dr. Robert Lindeman at Community North’s pediatric unit at 317-621-5474.

On May 6th, 2009, Dr. Dave Hertz, Community North Hospital NICU Medical Director, will be presenting Pediatric Grand Rounds, “The Late Preterm Infant”. Over the years, there has been an increase in the number of late pre-term infant deliveries.  Although many perceive these children to do well, recent studies indicate that these children have more medical issues than previously thought. Dr Hertz will take us through some of the problems these children encounter.

Pediatric grand rounds are generally provided monthly and are eligible for CME. We provide these offerings on the first Wednesday of the month at 7:30 a.m., in the multi-service conference rooms on the 3rd floor of the professional building. Coffee will be served.

If you have any questions about this, you can contact Dr. Robert Lindeman at Community North’s pediatric unit at 317-621-5474.

Dissolvable tobacco, made from finely milled tobacco and food grade binders, in the form of strips is being marketed in Indiana. These products will be sold in child resistant packaging, but resemble candy or breath-mints. Each strip contains 60% to 300% of a single cigarettes nicotine dose. If a child were to ingest multiple strips, this could certainly pose a health hazard with symptoms ranging from pallor, tremor, diaphoresis, and emesis to bradycardia and hypotension, possibly even seizures and coma.

Another concern is the teenage populations’ surreptitious use of smokeless tobacco, as the dissolvable strips do not leave odor on clothes or cause smokers-breath. Parents should be made aware that this product poses an increased risk to children, whether by accidental ingestion in younger children or in the form of tobacco abuse in teenagers.

I recently had the opportunity to work on a video for Community Health Network’s Rehab & Sports Medicine Centers. Nancy Lewark and Josh Blanchard talked about what they love about their work, and gave an overview of services offered at Community’s nine Rehab & Sports Medicine Centers. Take a look!

Pediatric occupational therapists can help children of all ages. Once a physician refers a child to occupational therapy, a registered occupational therapist will perform an evaluation. This evaluation will include a history, physical assessment and developmental assessment. Things like range of motion, strength, fine motor coordination and functional status of daily activities (such as handwriting, dressing, bathing or feeding). After the evaluation, the therapist will discuss a child’s treatment plan with the parent/guardian and child and explain the expected frequency and duration of therapy sessions. Each child’s treatment plan is specifically designed to address their unique deficits. Subsequent therapy visits may include activities to increase upper body and fine motor strength and coordination, training for independence in activities of daily living, home exercise instruction for strengthening and sensory integration. Regular updates are sent to the referring physician and goals may be changed or updated based on the child’s progress. Visit our web page to learn more about the pediatric therapy services offered through Community Rehab & Sports Medicine Centers.