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PA PQC Learning Collaborative - Shared screen with speaker view
Terri Chaires
25:04
Terri Chaires, MSN, RN Director of Patient Services for Obstetrics and NICU for WellSpan Chambersburg Hospital
Lisa Lehett
25:05
Lisa Lehett UPMC Horizon
Sarah Cooper St Clair Health
25:09
Sarah Cooper RN, Clinical Educator - Family Birth Center St Clair Hospital
iTerrie (She, Her)
25:11
Terrie HawkinsReproductive Healthcare Coordinator at Prevention Point Philadelphia
Fran Doyle
25:17
Fran Doyle, DIrector Maternal Child Services, Penn Medicine, Chester County Hospital
Mary Beth Kollar
25:17
Good Morning! Mary Beth Kollar, LPCClinical Case Manager for SUD in pregnancy program at Lehigh Valley Health Network
Dawn Horst
25:23
Dawn Horst-Manager of Women and Children's Community Health at Penn Medicine Lancaster General
Michelle Djevharian
25:25
Michelle Djevharian CNM
josephm
25:25
Michelle Joseph, Pediatric Clinical Lead, Doylestown Hospital
Ann Giazzoni
25:26
Ann Giazzoni Senior Program Manager, BH Integration UPMC Health Plan
Krista Flaherty
25:30
Krista Flaherty, LCSWAllegheny Health NetworkManager Perinatal Hope Program
Amy Stauffer
25:36
Amy Stauffer, CRNP
shannon's iPhone (2)
25:40
Shannon Hittle Manager the Birthplace at Riddle Hospital Media PA
Cathy Henderson
25:42
Cathy Henderson, Director of MAT at WellSpan Health
Jami’s iPhone
25:42
Jami Marks, Director of Health ChoicesGeisinger Health Plan
Amanda Arnold
25:44
Amanda Arnold, RN St Clair Health FBC
Amy Cruz
25:47
Amy Cruz, MD, OBGYN physician, Penn State Hershey Medical Center
Michelle Djevharian
25:49
Michelle Djevharian CNM, Einstein Medical Center Montgomerty
Courtney Lott
25:59
Courtney Lott, Service Coordinator, Crozer Health
Jacqueline Drahos
26:02
Jacqueline Drahos, Quality Manager AHN WPH. Good morning!
Amy Stauffer
26:10
Amy Stauffer, Penn State Health, CRNP with Maternal Fetal Medcine
Traci Jennings
26:12
Traci Jennings, NNP Penn State Hershey Medical Center
Ann Torregrossa
26:32
Ann Torregrossa, Director, PA Health Funders Collaborative
Christina Harris
26:34
Christina Harris, Early Childhood Lead for ECCS with the Office of Child Development and Early Learning.
Abby Newman
26:42
Abby Newman, Operations Manger, The Family Place at Geisinger Lewistown Hospital.
Debra Bogen, Allegheny County, PA
26:44
Good morning - Debra Bogen, Allegheny County Health Department
Janine Richard
26:53
Janine Richard, MSN, RN, Clinical Director of Women & Children's Services, WellSpan York Hospital
Erin Redding
26:56
Erin Redding, LSW Geisinger Free2BMom Behavioral Health Case Manager
DKNITTLE
26:59
Debr Knittle RN
Sarah Worthington
27:02
Sarah Worthington, outpatient OBGYN social worker at Temple
DKNITTLE
27:02
Team Coordinator
Kim Costello
27:09
Kim Costello, DO, CPE, FAAP, Director of Neonatology at St. Luke's University Health Network, Executive Director of NICU Operations at Onsite Neonatal Partners
DKNITTLE
27:10
Geisinger Bloomsburg Hospital
Sharon Register
27:21
Sharon Register, RN, Project Manager Main Line Health
Bob Cicco
27:23
Hi, Everyone! Bob Cicco, neonatologist from Pittsburgh
Pam O'Donnell
27:33
Pam O'Donnell, MSN, RN, Programmatic Nurse Specialist, UPMC Altoona
Donna Allen
27:34
Good Morning! Donna Allen, RN Nurse Home Visitor, Nurse Family Partnership of Schuylkill County
DKNITTLE
27:46
Debra Knittle Geisinger Bloomsburg Hospital Maternity Center
Joanne Balasavage
27:48
Joanne Balasavage CRS Free2BMom Geisinger Wilkes-Barre, PA
leonardka2
27:50
Kim Leonard CRNP Director of Magee WHSL of UPMC Northern Pod
Heather Enright
27:52
Heather Enright Perinatal Safety RN at Reading Hospital - Tower Health
Annette Myarick
28:00
Eileen Thompson, PA Chapter, American Academy of Pediatrics
Jen Sullivan
28:09
Jen Sullivan, OB Nurse Manager at Evangelical Community Hospital
Donna McCarthy
28:09
Donna McCarthy, Clinical Registered Nurse Supervisor, Geisinger Women's Health, Scranton, PA.
Jrthomas
28:14
Julie Rose Thomas, Administrative Team Coordinator at Geisinger Community Medical Center Childbirth Center- Scranton, Pa
Susan Ashley Savage - HUP
28:15
Good Morning! Ashley Savage QI Data Coordinator and IBCLC for the ICN at Hospital of the University of Pennsylvania
Norma Parker Bryan
28:37
Good Morning. Norma Bryan, RN BSN Mount Nittany Medical Center
Brittney Bogar
28:46
Brittney Bogar, RN, Penn State Health Hershey Medical Center
Franca Dalibor
29:35
Franca Dalibor, CRS and CRS Coordinator for the Geisinger Health System
leeanne.minihan@pinnacletreatment.com
30:29
Good Morning All, Leeanne Minihan, Case Manager/Counselo at Williamsport Family Medical (MAT Outpatient )
Lisa Murphy
30:57
Good morning. Lisa Murphy, Clinical Practice Nurse Leader at the Women and Babies Center at Penn State Health
Vivian Petticord
32:02
Good Morning! Vivian Petticord RNC, Director Womens Health Service Line UPMC Magee-Womens Hospital
Jill Henrich
32:39
Good Morning! Jill Henrich - Safe Care Manager for Northumberland County through Greater Susquehanna Valley United Way
madie hartman
32:56
Madie Hartman DO Assistant Professor of Family and Community Medicine Penn State Hershey Medical Center
Pauline Taylor
33:51
Good Morning Everyone your virtual packet is here: https://www.whamglobal.org/march-31st-2022-learning-collaborative
Pauline Taylor
41:42
PA PQC teams can request trainings via an online form at https://www.whamglobal.org/pa-pqc-initiatives
Celina Migone
59:15
Can you please comment on your recommendations for breastfeeding when the mother has polysubstance use, specifically marijuana use.
Amy Lembeck
01:06:19
Studies have demonstrated the lower breastfeeding rate in this population and postulate it is related to stigmata of the health care team, less available resources, guilt, and Mom's ability to take the time to breast feed between support groups/meetings/dosing. How do you combat some of these hurdles?
Pauline Taylor
01:08:16
link to this resource on our website:https://www.whamglobal.org/list-documents/557-breastfeeding-traffic-light-tool/file
Kerin Kohler
01:08:58
Yes, please address marijuana use and breastfeeding or even breastmilk feeding as recent studies are showing poor and continued neurologic issues.
Lisa Lehett
01:09:16
excellent thanks for the links to resources!
Celina Migone
01:10:03
Agree. I am interested in counseling in relation to polysubstance use, specifically marijuana use.
iTerrie (She, Her)
01:12:06
Thanks
Ann Giazzoni
01:13:54
is Dr Bogen's slides available on the PQC website?
Pauline Taylor
01:15:52
Yes, we will be posting Dr. Bogen's slides to the website shortly
Ann Giazzoni
01:16:06
thanks Pauline!
Jen Sullivan
01:16:33
Yes thank you, will be nice to share with our pediatricians!
Donna Volpe
01:19:07
Its remarkable that just by moving from Finnegan scoring to ESC, we can decrease LOS by 18 days, not have to wean babies off Morphine, have parents as primary caregivers in their baby's care, and promote breastfeeding. And it just costs us the price of a boarder room and a hospital meal we provide to parents. Plus it's just the right thing to do!
Elizabeth Dierking
01:22:38
Also wondering about THC and methamphetamine use and breastfeeding...
Donna Volpe
01:22:52
I think it becomes more an education for nursing about biases at times with SUD moms
Donna Volpe
01:23:20
ESC is more about opiates
Donna Volpe
01:23:45
Subutex methadone
Donna Volpe
01:24:23
WE have not had moms positive meth and BF.
Elizabeth Dierking
01:24:45
I think many of us are seeing more polysubstance abuse and are just wondering if the same principles apply.
Donna Volpe
01:25:14
I worked in WA state docs would caution about THC and BF as its legal
Lisa Lehett
01:26:29
continued active poly substance abuse would rule out ESC
Elizabeth Dierking
01:27:11
Helpful! So your experience would suggest that we can continue to encourage breastfeeding in our OUD moms provided they meet some of the discussed criteria but discourage if any other substance is on board?
Celina Migone
01:28:34
How does polysubstance use rule out ESC?
Pauline Taylor
01:28:41
Link to Dr. Bogen's slides: https://www.whamglobal.org/list-documents/580-overview-of-breastmilk-feeding-guidelines-for-substance-usel/file
Celina Migone
01:29:26
We've been focused on optimizing non pharmacologic management. And, really "ESC" is more of the scoring tool, and it is used for all infants that are being evaluated for withdraw.
Celina Migone
01:30:05
Does this mean that you use a different scoring tool for polysubstance use? And, how do you define polysubstance use?
Donna Volpe
01:35:47
As Celina said ESC is used as a scoring tool; is the baby eating, sleeping and consolable? It is used with babies exposed to methadone, Subutex/suboxone, as with those drugs moms can usually breastfeed. For our criteria, these moms must be in a recovery program and their UDS only positive for those drugs, no illicit drugs such as meth,etc...non prescribed drugs.
iTerrie (She, Her)
01:36:52
Can’t hear
Celina Migone
01:39:59
I also try to approach THC reduction counseling similar to alcohol and nicotine/cigarettes. Yes, it's legal. But, we discourage use during BF.
iTerrie (She, Her)
01:40:58
I can hear now
iTerrie (She, Her)
01:43:15
Will they allow me to ask a questionRobert is introducing other guests to share
iTerrie (She, Her)
01:44:11
Thanks
iTerrie (She, Her)
01:45:23
Thanks
Debra Bogen, Allegheny County, PA
01:46:39
yes - love that traffic light which is why I included it in the slides!
Celina Migone
01:46:59
Thanks! We think it's really helped!
iTerrie (She, Her)
01:49:08
No problem
Robert Ferguson
01:50:17
Terrie is a Reproductive Healthcare Coordinator from Prevention Point Philadelphia
Celina Migone
01:52:46
Thanks for bringing that up Terrie. It's a great point!
Celina Migone
01:53:06
And will keep me aware of the need to keep up to date with CDC recommendations.
Debra Bogen, Allegheny County, PA
01:58:40
Here are some resources for medications and lactation National Library of Medicine Website​LactMed (APP – free) ​https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm​Motherisk (Toronto Sick Kids)​http://www.motherisk.org/women/index.jsp​877-439-2744 Motherisk Helpline​
Debra Bogen, Allegheny County, PA
01:58:42
Organization of Teratology Information Specialists​http://mothertobaby.org/ ​866-626-6847
iTerrie (She, Her)
02:00:55
This is greatThank you
Jill Henrich
02:25:21
In my position, I am most times having a discussion and then leaving space and making myself accessible. In the days following, I normally hear from the mother after she has had time to process our conversation. This is so important!
Amy Stauffer
02:50:42
Are Antiracial tools available that you had at end of presentation?
Amy Stauffer
02:55:59
thank you
Lisa Lehett
02:59:41
excellent talk it is very enlightening
Shawndel Laughner
03:00:03
Loved this - Thank you!
leonardka2
03:00:22
Wonderful presentation on such an important topic!
Jill Henrich
03:00:25
Dr. Mittal - your presentation was fantastic. Thank you for sharing
Steven Guo
03:00:32
Thank you for joining us, Dr. Mittal! Appreciate your insights
Donna McCarthy
03:00:51
Thank you Dr. Mittal. Great presentation.
heppek
03:01:15
Thk you Dr Mittal, very helpful presentation.
Lisa Lehett
03:08:05
I think that understanding how the birth experience itself can be traumatizing even in someone without a history of PTSD. any unexpected outcome should be explored post delivery even if it is just not meeting the expectation of a vaginal delivery
Chaunda Cunningham, Healthy Start, Inc. (she/her)
03:08:54
Very true. Not only the birth experience but the prenatal care.
Robert Ferguson
03:09:28
Dr. Mittal's email is lmittal@bwh.harvard.edu if you would like to follow-up with her.
Robert Ferguson
03:12:43
Elissa Concini (speaking) is Women's Health Quality and Safety RN at Geisinger
Lisa Lehett
03:13:32
or the fear and trauma of an emergency c/s
Jennifer Condel, PA PQC Team/QI Coach
03:22:01
Thank you for submitting your Quarterly QI updates! As a reminder, information from these documents are compiled and posted for peer to peer sharing: https://www.whamglobal.org/list-documents/581-pa-pqc-team-qi-key-interventions-and-peer-learning-3-31-22-learning-session/file