Angela Gartner has seen patients breathe easier with a new form of therapy at Fremont Health.
She cites the case of a 91-year-old woman, who was nearing the end of her life. In the past, the woman would have needed a BiPAP device to help her breathe.
Instead, she was able to use the Heated High Flow (HHF) system. With this system, the woman could breathe without having to wear a mask — so she was more comfortable and could talk with her family. The HFF was gentler on her delicate skin as well.
“It’s changed our world and the patients’ world,” said Gartner, a registered respiratory therapist and cardiopulmonary clinical coordinator at Fremont Health.
Since Fremont Health began using it in January, the HHF has helped provide a cost savings of at least $30,000 over the traditional BiPAP therapy. That savings doesn’t include what it would cost to use ventilators in the various cases.
It’s decreased the length of hospital intensive care unit stays and ventilator use for patients, Gartner said.
On Wednesday morning, Gartner was among health professionals sharing improvements made in more than 15 Fremont Health departments.
Tables with storyboards detailing the improvements filled part of the hospital’s lobby for The Quality Expo. The expo, which took place in observance of National Quality Week for health, helped provide recognition for people in the various departments and was open to the public.
“We asked individuals or departments within the organization that had quality projects or performance improvement projects to put them together on a storyboard,” said Bev Johnson, director of clinical effectiveness, care management and patient safety.
The projects were those that occurred in the last 12 to 24 months.
Gartner began researching the HFF two years ago in an effort to decrease ventilator usage and lengths of hospital ICU stays, provide more comfort for patients and even improve their nutrition.
Her research involved other area hospitals and new critical care guidelines.
The HHF was put into use starting in January.
In the last seven months, Gartner said there’s not only been a $30,000 cost savings with the new therapy, but more than 20 percent decreases in the length of stay in the intensive care unit and also in ventilator use.
Gartner said the HHF helps decrease the work patients must do to breathe and improves oxygen levels in their blood.
It creates a greater flow of oxygen and more pressure, incorporating heat and humidity which makes it more comfortable for patients.
Gartner said cited patients coming into the emergency department with severe shortness of breath and low oxygen levels, who were heading toward ventilator use, but were able to use the HHF.
“We were able to quickly turn around their condition and prevent ventilator use,” she said.
She noted something else.
“We’ve had so many patients who would have ended up on a ventilator. They couldn’t tolerate the BiPAP mask,” she said.
She points out the situation involving a patient with shortness of breath, who came to the emergency department. A BiPAP was used for the patient.
The patient was agreeable, but then had severe claustrophobia and couldn’t tolerate the mask. He also had a full beard and mustache and maintaining the seal on the mask caused problems for the staff.
Staffers talked to a physician about using the HHF.
The HHF therapy was used. It proved comfortable and the patient could tolerate the therapy. His condition improved, Gartner said.
In many cases, the new therapy also has improved nutrition for patients.
When patients must wear a mask and can’t eat, they can become malnourished — which can slow the healing process. Malnourished patients also have higher rates of complications and mortality.
With the new system, which involves tubes placed in the nose, the patients can eat.
The HHF is also visually less traumatic for patients and their families.
Gartner said this system is less expensive to purchase and run.
Fremont Health has five adult and two nursery HHF units. It’s had 102 adult HHF cases.
Gartner said the BiPAP is still valuable and used when more support is needed.
“This gives us another tool,” she said. “We have other option now.”
Earlier this year, high school students from around the state gathered at the State Capitol in Lincoln for the 19th Capitol Forum on America’s Future.
Of the nearly 100 students that participate the event held in March, was a group of five Howells-Dodge high school students along with teacher Scott Polacek.
Leading up to the Capitol Forum, teachers, including Polacek, representing rural, urban, public and private schools across the state engaged their students in discussion of our nation’s future in a changing international environment.
“First we prepare a curriculum so the kids can kind of understand what the United States’ role should be in the world, so we prepare that ahead of time and then debate the same curriculum again on Capitol Forum day,” Polacek said. The students from Howells-Dodge included Simon Kristiansen, Dax VanLengen, Kalli Brester, Samantha Brester, and Oscar Hernandez. All of which were enrolled in the school’s Current Issues class.
“We obviously already talk a bunch of issues anyway in the class, but this really helps foreign policy hit home for the kids,” Polacek said.
At the Capitol Forum, the students and their teachers visited the State Capitol to report and deliberate on the concerns of their classmates and interact with members of Nebraska’s congressional delegation about global issues and foreign policy.
Nearly 100 students, representing over 1,500 of their classmates, gave presentations and debated their various choices during the day-long event in March.
“There are kids from Class A schools, Class D schools and there is a lot of diversity that you wouldn’t see on an average school day,” Polacek said. “The best part about it for me is that we have kids that may be on one side of the political spectrum and on that day they might get stuck having to debate the issue from a completely different side than they are used to.”
“So the shoe is really on the other foot, it’s really good to get different opinions about how people see things.”
Results from the events were compiled, and released on October 17th, showing that high school students from across Nebraska were strongly divided in choosing the most appropriate U.S. policy for dealing with foreign policy issues including immigration, environment, terrorism, poverty and human rights.
Thirty-four percent of participating students said they preferred a foreign policy that focused on international cooperation by diplomacy, treaties, trade and U.S leadership of the United Nations to deal with security and global problems. Thirty-three percent of students advocated for a policy which would cut back on foreign involvement and primarily deal with the internal challenges of America, such as its economy, school systems, health care and protections against terrorism.
The third preference of students (21 percent) was a policy that focused on homeland security, halting the spread of nuclear weapons, cultivating key trade relationships and ensuring access to crucial raw materials.
In a ranking of top concerns, 41 percent of students said they were worried about nuclear, biological and chemical weapons ending up in the hands of terrorists. Students (39 percent) also admitted to worries about worldwide poverty, hunger and disease. Another top response (37 percent) had to do with the U.S draining its resources trying to solve the problems of other nations.
Along with presenting and debating each other, participating students also had the chance to pick the brains of some of the state’s elected officials.
“Usually it is a teleconference so Deb Fischer, Adrian Smith, Jeff Fortenberry, and Ben Sasse will talk to us,” Polacek said. “The kids ask the big questions, high school kids don’t hold stuff back usually, and the politicians usually answer straight, not like politicians, but to their own people, Nebraskans.”
According to Polacek, for students at Howells-Dodge, Capitol Forum day has been a great way to get students thinking about foreign policy and excited about civics and the political process in general.
“It’s one of the best activities for kids that we can offer, it really gets them pumped up about the process,” he said. “We wouldn’t miss it, it is a really good reward and experience for the kids.”
Other schools that participated in the Capitol Forum included: Ashland-Greenwood High School, Bellevue West High School, Duchesne Academy, Falls City High School, Hampton High School, Hastings High School, Hemingford High School, Holdrege High School, Lincoln North Star High School, Louisville High School, Nebraska Lutheran High School, Norfolk High School, Platteview High School, Stanton High School, Sterling High School, Waverly High School, West Holt High School, Wilcox-Hildreth High School, and York High School.
Area residents interested in the current status of the Fremont Community Solar Farm project have two upcoming opportunities to receive updates about what all the approximately $2 million project entails.
From 5-7 p.m. Thursday, Oct. 19, those gathering at Keene Memorial Library will listen to City Administrator Brian Newton, along with Michael Shonka, another Nebraska solar power advocate, speak about various topics surrounding the Fremont project and solar energy as a whole.
Those unable to attend the Thursday conversation are invited to attend a Smart Energy Talks Nebraska presentation happening from 9 a.m. through 2 p.m. Saturday, Oct. 28, at the University of Nebraska at Omaha inside of the Milo Bail Student Center. The panel discussion will focus on the importance of renewable energy in communities and the challenges and benefits of electric vehicles on the grid.
Newton said that he was invited to talk primarily because Fremont’s Community Solar Farm offers a unique opportunity that the dozen-or-so others scattered around the state of Nebraska do not.
What is unique about Fremont’s 1.5 megawatt, 5,000 panel farm, is that those utilizing the farm’s energy have the choice to buy actual panels on the farm, or to avoid a long-term commitment and upfront payment by subscribing to blocks of the panel’s monthly energy output.
The farm, which sold out in 7 weeks, is comprised of 180 residential customers and approximately 20 commercial customers. There is a pretty even mix among people who subscribed to blocks of energy output and those who purchased panels at an upfront cost of $180 per panel for a 20-year term – the approximate life of the solar farm.
The farm is currently under construction on a 10-acre plot of land located south of Jack Sutton Drive. All customers utilizing the plot had the chance to purchase solar shares that would cover up to 80 percent of their used Kilowatt hours.
On average, residential customers in Fremont use about 1200 KW hours monthly, Newton said. Those who purchased panels have an estimate return on their investment in approximately 9 years. While there is a slightly elevated monthly utility cost, there were up-front benefits to purchasing panels.
“The reason a lot of people decided to buy the panels is because they get 30-percent back on the $180 panel price the first year because of the investment tax credit,” Newton said.
Newton said that a majority of people he’s spoken with elected to get involved with the solar farm because it has a positive impact on the environment. But with that being said, it also makes some business sense.
“It’s a lock on their energy for 20 years, and a lot of people said, ‘wow, that’s a good deal, where else can I lock in my energy price for 20 years?,’” he said. “So it made business sense to them, too.”
Currently, approximately 70 customers are on the waiting list to get involved with the next phase of the Community solar Farm, Newton said.
As best as he knows, Fremont has the only solar farm in Nebraska that gives people the choice to purchase panels or to subscribe to blocks of energy output.
“I don’t want to say that we are the early adopters, or that we are on the bleeding edge, but I certainly think we are on the leading edge,” Newton said. “And that’s thanks to the Utility and Infrastructure Board and City Council for wanting to diversify some of our energy. You’ve got to have leaders that believe in this first before you can even offer it.”