New Knowledge, Innovations & Improvements
The Adolescent and Young Adult (AYA) program at University Health offers an innovative approach to serving an often overlooked demographic. The AYA team brings professional comfort, care and specialized medical services to patients whose ages fall between childhood and adulthood. Through technical knowledge, compassion and services tailored to this age group, they have developed a culture that makes the patients feel connected to a caring community.
Imagine being 19 years old, ready to face the world and immerse yourself in all the beautiful challenges that lie ahead. As you prepare to venture out, you find your plans interrupted by an inexplicable, lingering sickness. You undergo a battery of tests and are diagnosed with Acute Lymphoblastic Leukemia (ALL). You are forced into a terrifying battle that will test your will, unnerve your family and threaten your life. It will take a toll on your friends, strip you of your security and confound your attempts to perform ordinary daily tasks. Then you find you are not alone. Your AYA program and its specially trained nurses become your community of hope.
Brandon, one of our patients, has been through this experience. He was diagnosed in November with high-risk Pre B Cell ALL. He has been in and out of the Pediatric Intensive Care Unit after receiving induction therapy to treat his ALL. He has experienced multiple complications, but after three months of treatment and care he is now at Reeves Rehabilitation Center hoping to receive a bone marrow transplant after completing rehab.
Brandon’s mother has been with him at all times throughout this battle for his life. She has stayed by his side and often gone without sleep. The AYA nurses bring her treats and helped to arrange gift cards for their family, and found a way to get Brandon new eyeglasses after his were broken during transport to San Antonio.
Our AYA nurses care for our patients to heal not only the body, but also the heart. We want to bring your mother, who has watched over you every moment, the peace of mind that comes with knowing her family is secure and healthy. It is this peace that bolsters a parent’s ability to fight for his or her child and give you strength as he or she sits faithfully by a patient’s side. To the AYA nurses, you are more than a patient. You give us the opportunity to provide healing comfort, care and support so you can continue your journey and become who you are meant to be. Whatever your goal in life, we will apply our skills, programs, knowledge and heart to help you see your way through.
The AYA Unit fills a critical need, with a specially trained team of physicians, nurses, social workers, nurse navigators and others who focus on our patients and their families. The AYA Unit also creates a vital sense of community for our patients.
Alma Saravia was 19 years old, recently married and pregnant with her first child when Patricia Aguillen, also known as Nurse Patty, called. Aguillen asked Saravia, to participate in University Health’s Nurse-Family Partnership.
The Nurse-Family Partnership program was created to educate new moms on prenatal care, infant care, child development, nutrition, parenting skills and the importance of planning future pregnancies. These meetings take place in the comfort of their own home. The Nurse-Family Partnership nurses provide home visits every two weeks.
“It helps any first-time mom,” Saravia said. “You’re never ready to be a parent. We had just gotten married and were going through bumps in the road. Trying to learn to live with each other — and getting pregnant right away. It was difficult.”
Nurse Patty worked with Saravia through her pregnancy and the first two years of her son Edward’s life. Nurse Patty offered guidance, information and emotional support. Nurse Patty has worked with approximately 150 moms in the nine years she’s been with the program.
“I learned that I was baby’s first teacher,” Saravia said. “And by teaching him, I gained my baby’s trust. That’s the most important thing for an infant, gaining their trust. I learned about positive discipline. You’re the parent. Your child is going to do what you do.”
“She really wanted to be a good mom,” Aguillen said. “I feel a connection to these moms — especially the young moms.”
While in the Nurse-Family Partnership program, Saravia pursued her dreams of becoming a nurse and received her bachelor’s degree in 2017. Today, she is a nurse in the Neonatal Intensive Care Unit at University Health. Now Edward, her son, is a healthy 7 year old.
Funding for the program is provided by the State of Texas’ Health and Human Services Commission. The Nurse-Family Partnership’s goals include:
- Improve pregnancy outcomes by helping women engage in good preventive health practices, including thorough prenatal care from their healthcare providers, improving their diets and reducing their use of cigarettes and other harmful substances
- Improve child health and development by helping parents provide responsible and competent care
- Improve the economic self-sufficiency of the family by helping parents develop a vision for their own future, plan future pregnancies, continue their education and find work
University Health’s Neonatal Intensive Care Unit (NICU) has earned the highest designation from the American Academy of Pediatrics and is now a designated Level IV NICU.
The new designation was created in an effort to improve maternal and neonatal outcomes. To establish the new rules, the Texas Perinatal Advisory Council developed to standardize neonatal levels of care based on guidelines from the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.
The neonatal level of care designation rule became effective June 9, 2016. The designation is an eligibility requirement for Medicaid reimbursement and compliance of House Bill 15, 83rd legislature, effective Sept. 1, 2018. The rules went into effect March 1, 2019. University Health’s NICU applied to the American Academy of Pediatrics to be surveyed for compliance in June 2017.
The achievement was a collaborative effort among nursing leadership, physicians and all service lines to accomplish and meet the requirements. A program plan was compiled that described the capabilities and services we offer to our patients. It gave a perspective as to what we do well and where we have an opportunity to improve outcomes for these vulnerable patients.
The American Academy of Pediatrics survey team was comprised of physicians, nurse practitioners nurses, and a representative from the Texas Department of State Health Services. The team reviewed our processes and our compliance with the rules. After this two-day process, no deficiencies were found. In November 2018, we were designated a Level IV NICU. This is the highest level of care for a Neonatal Intensive Care Unit.
University Health leadership has established a dementia-friendly initiative to improve the safety and quality of care for persons with dementia admitted to acute care. Vice President and Associate Chief Nursing Officer, Charles Reed PhD, RN, CNRN, collaborated with Dr. Carole White, professor, and Nancy Smith Hurd, chair in Geriatric Nursing and Aging Studies, UT Health San Antonio, School of Nursing, to win a grant from Sigma Theta Tau, International to support the initiative.
Staff has conducted focus groups with bedside nurses and technicians to ascertain their knowledge, experiences and concerns in caring for patients with dementia and their interactions with caregivers. The focus groups also listened to the challenges caregivers face, all of which has led to improved care for the patients and their caregivers.
Staff members from the Center for Clinical Excellence won an additional grant from the University Health Foundation to purchase materials for a Diversional Activity Program to benefit patients with dementia. An interdisciplinary group that included a nurse educator, occupational therapists and a speech therapist created a pocket guide for the Diversional Activity Program. The program helps occupational therapy staff assess patients to determine their current stage of dementia and provide appropriate diversional activities. The activities keep patients engaged, which reduces restlessness, anxiety and agitation, and can help prevent complications associated with hospitalization.
Recognizing the impact dementia has on our community and patients, a University Health team participated in the Walk to End Alzheimer’s in October 2018, and raised approximately $1,000 toward this initiative. In addition, University Health representatives attended the Dementia-Friendly San Antonio Town Hall at the UT Health School of Nursing – the first major step for San Antonio to become designated a dementia-friendly city. University Health continues to collaborate with the goal of becoming the first dementia-friendly health institution in Texas.