Women and Children’s Health Program at the Saint John Regional Hospital

Physicians (Doctors)

• Pediatrician – specializes in the care of children
• Ophthalmologist – eye conditions and diseases
• Endocrinologist – glands and hormone conditions
• Neurologist – brain and nervous system conditions
• Hematologist – blood conditions

Medical Consultants – Many of these doctor specialists are located at the IWK and are accessed as needed.

• Cardiologist – heart conditions
• Nephrologist – kidney (urine) conditions
• Gastroenterologist – intestinal conditions and nutrition
• Orthopedic Surgeon – bone and muscle conditions
• Plastic Surgery Care Team provides care to infants, children, and adolescents with congenital (existing from birth) and acquired abnormalities

Nursing

• Nurse Manager – supervises all nursing staff, team leaders and unit clerks
• Charge Nurse – RN who leads the nursing shift and is responsible for daily coordination of unit activities
• Nursing – performs and coordinates your child’s daily care

Child Life Specialist – provides recreational and educational programs to support children and families throughout their hospital experiences

Unit Clerk – provides clerical support, schedules patient appointments and provides general information about the Pediatric Unit

Lactation Consultant – available to assist with breastfeeding and pumping

Social Worker – available for parental support and may help with family concerns and accessing government and community resources (example: Fuel the Care)

Respiratory Therapist – helps diagnose and treat children with breathing issues

Pharmacist – supports the medical team and families with medication information

Spiritual Care – available for spiritual and religious care, and emotional support (religious affiliation not required)

Clinical Nutrition (Dietitian) – provides advice and counselling about diet, food and nutrition

Physiotherapy – assists in early detection of health conditions and provides treatments for injury and disease. Methods include massage, heat/cold therapy and exercise

Speech Language Pathology – Speech-language pathologists are involved in promotion, prevention, counselling, and education services to clients, families, caregivers, other professionals, and the public regarding all aspects of communication and swallowing.

Occupational Therapy – focuses on helping children develop, recover or maintain meaningful activities of daily life (example: self-care, education, work, social)

Psychology – provides assessment and treatment of mental health issues to children and their families

During your child’s hospital stay, a doctor will usually see your child on a daily basis; other specialties who have been consulted will see your child according to their plan of care. Parents are encouraged to participate and ask questions about their child’s care. In case of any emergency after hours, there is a pediatrician on call and available.

Parents and families are the most important member of their child’s health care team. You are your child’s voice and a vital part of your child’s care team. While your child is here, we encourage you to actively participate in their care. Children are welcome to visit as long as they are supervised by an adult.

Family Presence at Horizon

If you have any questions about the care your child is receiving, please speak to a member of the pediatric care team. Our team is always available to answer your questions.

Click here to find out about Horizon’s Patient- and Family-Centred Care model.

Parking

Horizon Parking Information

• Parking passes may be purchased at the Security Office (Level 2C Tower) Monday to Friday, 8 a.m. to 4 p.m. Debit and credit cards are accepted.
• The booth accepts cash and debit/credit cards.
• You can pay for parking using “Hot Spot” parking.
• There is designated stork parking at the main entrance.
• Disabled persons parking (DPP) is available in front of the Emergency Department, in the main parking lot and in a designated parking area adjacent to the main entrance. The DPP lot is a pay upon exit system with debit and credit card only.
• Click here for a parking map of the SJRH and click here to learn more about parking at Horizon’s facilities.

The Pediatric Unit is located on 4AS.

Telephone number: 506-648-6432

Access to the unit

Pediatrics is a secured unit; during daytime hours we request all parents and visitors check in at the nursing station before going to the child’s room. After hours, the main doors to the pediatric unit are locked and you must ring before entering. The intercom is mounted on the wall outside the entrance to the unit and it rings directly into the nursing station.

Please ensure you wash your hands upon entry and exit to the Pediatric Unit. There is a hand sanitizer dispenser located at the entry to the unit as well as the entrance to individual patient rooms.

Once your child is admitted to the hospital, you will be given a tour of the unit so you and your child are comfortable with your surroundings.

During the admission process, the following activities will occur: measurement of height and weight, physical exam, review patient history, and an Identification Bracelet (ID) will be placed on your child’s wrist or ankle.

During your stay, you may meet our child life specialist who has expertise in child development and is here to help your child adjust to their illness or hospital stay.

What to bring

Here are a few of the things you may want to bring to the hospital with you:

• Your child’s Medicare Card and health insurance information or card.
• Toiletries – Please bring items such as toothbrush, toothpaste, unscented shampoo and body wash.
• Favourite toys or blankets – These items can make your child feel more comfortable in this new environment.
• Footwear – Items such as non-skid slippers or shoes.
• Comfortable clothing – For you and your child.
• Personal food items – May be labelled and stored in the patient/family kitchen area.
• Medical aids – If your child uses eyeglasses, hearing aids, braces, crutches, etc., please bring them with you.
• Home medications – Most medications are provided but occasionally a medication is not available in the hospital pharmacy.
• Electronic devices are permitted in most cases – please check with your pediatric care team.

The hospital assumes no responsibility for loss or damage to your personal property.

What items are available in the Pediatric Unit

• Breast pumps
• Diapers and wipes
• Age-appropriate toys and games
• Televisions with DVD players upon request (no cost)
• Television rentals
• Wi-Fi in all rooms
• The kitchenette has certain food items for patients, and food storage available for personal use

4AS Pediatric Inpatient Unit Kitchenette:

Pediatric High Dependency Unit

The pediatric high dependency unit is located on the pediatric inpatient unit. In this area, care is provided for infants, children and teens who require close observation. Children admitted may be placed on cardiac-respiratory monitoring and have more frequent assessments.

Depending on the type of care required, your child may temporarily receive care in the adult Intensive Care Unit. If it is necessary for your child to be transferred to the IWK Health Centre in Halifax, the pediatric care team will provide information and support.

Child Life Services

Child life specialists promote coping through play, preparation, education and self-expression. Please click here for more information on child life services offered at the Saint John Regional Hospital.

Family/Games Room:

Playroom – Child Life:

Patients, families and visitors will be advised of our infection control policies.

Hand Washing

Proper hand hygiene with an alcohol-based hand rinse (ABHR) or soap and water is the single most important way to prevent the spread of infections. Protect your child from the spread of germs by cleaning your hands when you enter and exit your child’s room/bed space and when you to the common areas of the unit such as the kitchen and family room. Remind your family and visitors to do the same. Hand sanitizers are located outside each patient room and throughout the hospital.

Remember you are your child’s voice so it is ALWAYS OK TO ASK OTHERS TO CLEAN THEIR HANDS!

Other Helpful Hints to Prevent Infections

• Isolation Precautions – If your child is on isolation precautions, this means they cannot leave their room to visit the activity/playroom or other common areas on the nursing unit. In addition to handwashing your nurse will review if gowns, mask and or gloves are required.
• We know you want to spend as much time with your child as possible but when you have colds or other infectious illnesses (flu, diarrhea, vomiting, fever, rash, etc.) it is best to stay at home. Ask your family and friends to do the same. This will help to keep your child and all the others in the unit well. You can always ask us for advice in your decision.
• Cold sores are a virus. If you or your family are experiencing symptoms it is important a mask is worn over the affected area. You must not touch the cold sore and always clean your hands with alcohol-based hand rinse.

The Horizon Pediatric Patient Information brochure contains important safety information. A copy is available in all patient rooms and upon request from your nurse.

While in hospital, your child’s safety is a priority. Keep staff informed of any changes you notice.

It is important to:

• Ask questions about any part of your child’s care (such as diagnosis and treatment plan).
• Trust your feelings and report anything you think may be wrong.
• Know who to contact to get test results (such as blood work) and ask if you have questions after your visit.
• Know and tell us what medication(s) your child takes at home.
• Know and tell us about any allergies.
• Tell us if you have been in hospital or had surgery before.

Other things you should know:

• Horizon promotes a scent-free environment. We ask you and your family and visitors not to use scented products. These include perfume, cologne, aftershave, hygiene products, and scented soaps/detergents.
• If you need help finding your way around the hospital, ask our unit staff, Information Help Desk, or Security Desk staff. There is also signage on the walls to assist you.

Preventing Abduction

It is important for families to be aware of security procedures and what can be done to prevent child abduction. Every hospital has procedures and equipment in place to keep your child safe.

Staff will review security procedures on admission.

Patients under 16 years of age are not permitted to leave the unit unless accompanied by a designated adult. If you are taking your child off the unit or leaving the hospital on an approved pass then please inform the nursing staff.

ALERT staff immediately if you are curious or concerned about people entering your room, or those inquiring about your child, even if they are wearing a hospital uniform.

Staff Identification

All Horizon staff must wear a Horizon-issued photo identification (ID) badge in a clearly visible location. You have the right to see the Horizon photo ID badge of your health care providers – never allow your child to be taken anywhere by someone without ID. Any time your child must leave their room for tests or procedures, you may accompany your child.

ASK us to introduce ourselves.

Patient Identification

On admission to the hospital, an identification (ID) band will be placed on your child. In addition to your child’s name and ID number, the identification band(s) will identify any allergies (red) or risk for falls (yellow). For your child’s safety, your child must wear these identification bands throughout their entire stay. It is important your health care provider identifies your child by name and looks at the identification band before: giving any medication and/or performing any treatment, intervention or procedure. If the identification band(s) comes off, please inform your health care provider as soon as possible to have it replaced.

ASK us to check your child’s hospital identification band.

Allergies

It is very important to let us know if your child has any allergies to medications, food, environment and/or latex. If your child has allergies, a red identification band is placed on your child during admission.

NOTE: Due to the risks associated with latex allergies, rubber balloons are not permitted in the hospital.

TELL us about your child’s allergies.

Medication Safety

Know what medications your child is taking and why they are taking them. Make sure you know the name, amount, and how many times a day it is taken. A list of current home medications is available from your pharmacy on request. Remember to include any over-the-counter medications like acetaminophen (Tylenol®), ibuprofen (Advil®), vitamins, herbal products, and/or supplements.

Inform your health care provider about any medications you have brought with you to the hospital; personal medication belonging to you/your child should never be kept at your child’s bedside.

ASK us about your child’s medicine during your visit and before you go home.

Make sure you understand how to take it, when to take it, and any side effects to expect.

Play Safe

Play is an important part of your child’s adaptation to hospital and recovery. In addition to a playroom which is available throughout the day, toys are also available for you to bring back to your child’s room. All toys must be washed between patient uses. Therefore, please do NOT return toys to the playroom. Once used, these toys are to remain in your child’s room until discharge.

NOTE: In common waiting areas we encourage the following safety tips:

• Ensure children are supervised at all times.
• Check with staff before bringing in food or drinks.
• Always keep the doorways clear.
• Ensure your electronic devices/toys are charged for use to avoid tripping hazards of cords.

ASK to speak to a child life specialist, where available. Child life specialists are trained professionals with expertise in helping children and their families cope with the stress and uncertainty of illness, injury and treatment. Therapeutic play, preparation and education can reduce fear, anxiety and pain for children.

Internet Safety

Please be aware if your child is accessing the free Wi-Fi available through the hospital and read the terms of agreement. Monitor your child’s internet use as the hospital is not able to guarantee the safety of all sites.

Safety Tips:

• Review the social networking sites your child visits and ensure they do not contain identifying information (photos, profile, online diary, etc.).
• Be aware and involved in what sites your child is accessing including their activities and interaction (example: gaming sites with chat options).
• Healthy sleep patterns are important for recovery. Be mindful of screen time.

Privacy and Confidentiality

Thank you for protecting the privacy of others. Please ask permission before:

• Taking pictures or videos.
• Posting information about patients, families and staff on social networks.
• Sharing information from your visit.

Preventing Falls

Horizon uses the Humpty Dumpty Falls Prevention Program™ to assess and identify children at risk for falls. Children at a high risk for falls will be identified with a yellow bracelet and a Humpty Dumpty sign at their bedside. Always make sure the call bell is within reach so you or your child can get help. Some medications can make your child sleepy or dizzy which can cause your child to be unsteady on his/her feet and increase the risk of falls.

To decrease the risk of falls, make sure to:

• Use of side rails as directed by staff.
• Never leave your child unsupervised in a highchair or infant swing.
• Ask for help to assist your child to sit, stand or walk if needed.
• Use non-skid footwear that fits.
• Accompany your child to the bathroom when medical equipment is attached, and also when getting up for the first time after surgery.

The Humpty Dumpty Falls Prevention Program™ Parent Education information poster is available on admission. Please feel free to discuss this with the nursing staff if you have any questions or concerns.

ASK us about our Humpty Dumpty Falls Prevention Program™.

Preventing Pressure Sores/Skin Breakdown

Pressure ulcers are sores that are caused by constant pressure on your child’s skin. Horizon uses the Braden Scale and Braden Q Scale to assess and identify children at risk of pressure sores and skin breakdown. Your child’s nurse will assess your child’s risk on admission, then ongoing throughout their hospital stay.

From these assessments, if your child is considered at any time to be at moderate or high risk of developing pressure sores or skin breakdown, your child’s nurse will provide you and your child with recommendations for additional precautions and interventions.

Risk factors for developing pressure ulcers include:

• Decreased activity/mobility – children who stay in a bed, chair or wheelchair for long periods of time or their condition makes it difficult for them to change position without help.
• Moisture left on the skin from sweating or unclean diapers.
• Constant pressure from equipment such as an oxygen mask, splint, IV or feeding tubing.
• Although poor nutrition does not cause pressure ulcers, it does place a person at higher risk of developing pressure ulcers.

Steps to prevent pressure ulcers include:

• Walk and change of position often unless the doctor tells you not to.
• Avoid repeatedly pulling or rubbing skin against a surface (example: use a sheet to move a child if sliding down in bed).
• Check skin for redness and report any areas of concern.
• Use a soft cloth and be gentle when bathing. Avoid rubbing or massaging a reddened area.
• Keep skin dry by quickly cleaning any moisture from sweat or urine. Frequent diaper and linen changes as needed.
• Eat a healthy balanced diet. Ask to talk to a dietitian if at risk for pressure ulcers and not eating well.

TELL us if you notice any new areas where redness and skin breakdown may be a concern.

Tubing, Lines and Cords Safety

Infants and children may be at risk for becoming entangled when intravenous and/or monitor lines are in place.

Your child’s nurse will assess your child for risk of entanglement on admission, then ongoing throughout their hospital stay. From these assessments, if your child is considered at risk of entanglement at any time, your child’s nurse will provide you and your child with recommendations for additional precautions and interventions.

It is important to let staff know if you will not be in the room with your child, or if you have seen your child tangled in any lines or tubing.

Safety tips to prevent entanglement and strangulation include:

• Clear unnecessary items from the child’s bed.
• Keep bed adjusted to prevent access to cords.
• Netting or clothing may be used to secure tubings.
• Secure oxygen tubing under the chin rather than behind the neck.
• Never put anything (necklaces, soothers, etc.) around your child’s neck.

TELL us if you have to leave your child alone for an extended period.

Bed Safety and Safe Sleep

Children less than three years of age are safer in a crib even though they may not be in one at home. Crib and bedside rails must be locked in the full ‘up’ position at all times. Never leave a crib or bed with side rails down or in the middle position unless someone is standing directly at the bedside. Even leaving for a moment to go to the bathroom while your child is sleeping, and the rails are down could lead to a fall.

• The height of the bed should remain in the lowest position to prevent falls.
• Do not have an infant/child sleep in the cot/bed with you.
• All infants/children placed in cribs will be assessed to determine whether a crib dome is needed.
• All toys/food should be removed from the crib/bed when your child is sleeping.
• Do not leave strings, wires, cords, necklaces, beads, etc. in the crib.
• Reposition your child when the arm/leg is ‘sticking out’ between crib rails.

Preventing Entrapment

Safety tips to prevent entrapment include:

• Use a seat belt with equipment as babies can slide down and trap their heads.
• Place children in developmentally appropriate beds.
• Mattresses should fit snugly in cribs and beds.
• Keep beds in lowest position with brakes on.

Tubs, Baths and Showers Safety

• Ensure small children are constantly supervised in the tub/shower.
• Be sure you can reach the call bell at all times.
• Make sure the water temperature is not too hot before placing your child in the tub/shower.
• It is important to know how your child may be affected by their medication before taking a bath or shower.
• Empty the tub as soon as your child finishes bathing; a tub of water must never be left unattended.

Guidelines to Support Safe and Respectful Spaces

• The Pediatric Unit is a safe and respectful environment; we expect all patients, family, staff, and visitors to interact and treat each other in a respectful manner. Any issues should be immediately reported to the Charge Nurse and/or Nurse Manager.
• Disrespectful behaviour will not be tolerated. Individuals acting inappropriately may be asked to leave the hospital and the police may be contacted. The Security Desk is located on Level 2. Security personnel are on duty 24 hours a day, seven days a week.

Rights and Responsibilities

Horizon’s Patient Representative Services provides information, support, encouragement and assistance to patients, families and staff in all our facilities during a patient’s health care experience.

This service reflects our commitment to patient- and family-centred care and enables us to be more responsive to patients’ concerns and questions.

Please click here to learn more about Horizon’s Patient Representative Services.

Discharge planning will start at the time of your child’s admission and continue throughout your stay. We aim to let families know the discharge date as far in advance as possible so together we can make sure everything is in place on the day of discharge. Children are discharged from inpatient care when:

• Family and the health care team agree the goals of admission have been met.
• The admission diagnosis or problem is medically stable, and/or the situation is manageable at home, with or without support services.
• The doctor has written the discharge order.
• Appropriate community support and follow-up care have been arranged.

In normal circumstances, children will only be discharged from hospital into the care of the parents(s), legal guardian, or a legally recognized substitute decision maker. If alternate arrangements are required:

• The alternate person must be a responsible adult and provide proper identification.
• Written permission/consent to allow the person to take responsibility for the child.

Before leaving the hospital, make sure you have:

• Information on how you can expect your child to feel, symptoms to watch for and what to do if they occur.
• Instructions about eating, drinking, and activity.
• Instructions for treatments to be done at home.
• A list of medications to be given at home, including new prescriptions. Know what to take, when to take it and for how long.
• Personal belongings including home medications, if stored in nursing medication room.
• If necessary, a plan for community supports including appointment times and contact numbers.

Fuel the Care Program

Please click on the link below to learn more about Fuel the Care, a program by Irving Oil that provides free fuel gift cards to parents who must frequently travel for their children’s medical care. To access the program through the Saint John Regional Hospital, please contact the Social Work Department at 506-648-6828.

Fuel the Care
Since 2002, Fuel the Care has helped bridge the distance between home and hospital by providing fuel gift cards to families travelling to receive medical care for a child.

Social Pediatrics

New Brunswick Social Pediatrics is an interprofessional, community-based approach to care for children and their families in New Brunswick. Click here for details.

• Canadian Paediatric Society – Caring for Kids
• The Hospital for Sick Children – About Kids Health
• Government of New Brunswick – Immunization Program Guide
• Government of Canada – A Parent’s Guide to Vaccination
• Canada’s Food Guide
• Asthma Canada
• Atlantic Provinces Pediatric Hematology Oncology Network (APPHON)
• Cystic Fibrosis Canada
• Diabetes Canada
• UpToDate – Patient Education