Displaying items by tag: General Clinical Practice

2:15 – 3:15 pm Saturday, September 15

Are You an APN Searching for COG Supportive Care Guidelines? COG Guideline Development/Endorsement Process with Practical Applications (C234)

coglogo 1CNE Since the 1970s survival rates for most types of pediatric cancer have continued to improve, with about 80% of patients now expected to become long-term survivors. However, this incredible success requires intensive treatments that are often associated with significant acute and long-term side effects. These side effects of pediatric cancer therapy can negatively impact a patient’s symptom experience and quality of life. Lack of effective symptom management can potentially impact outcomes through delays in proven curative treatments, dose reductions, and patient nonadherence to the treatment plan.

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2:15 – 3:15 pm Saturday, September 15

DSRCT: A Pediatric Oncology Rarity (230)

1CNE  Desmoplastic small round cell tumor (DSRCT) is one of the rarest pediatric tumors and was only recently classified in 1989. Categorized under sarcomas, DSRCT under the microscopic is a fusion of a both a wilms and ewing sarcoma gene. Although known as a mostly surgical tumor, chemotherapy, radiation, and new treatments like immunotherapy are vital in the battle against this fatal disease. DSRCT is known mostly in the adolescent and young adult population, where the rate of occurrence is predominantly in males. In a retrospective cohort analysis published in 2014 from the Journal of Cancer Epidemiology, the 5-year survival rate was found to be just 33.3% (Lettieri, Garcia-Filion, Hingorani, 2014). Factors impacting survival rate are the overall oncology role to treatment and management.

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3:15 – 4:15 pm Friday, September 14

Beyond the Cure: The Children’s Oncology Group’s Efforts to Improve Outcomes for Pediatric Cancer Patients Long after Treatment has Finished (C223)

coglogo1CNE  Childhood cancer survivors are living longer than ever before, with overall survival rates exceeding 80%. As a result, survivors also are living with chronic late health effects related to their curative treatments, with 40% of survivors experiencing a severe, disabling, and life-threatening or fatal late effect at 30 years post-treatment. Late effects may include second malignancies, endocrinopathies, cardiomyopathy, infertility, pulmonary function deficits, renal/ocular/auditory disorders, neurocognitive deficits, and metabolic syndrome. Recent studies report that cumulative incidence of late effects may be even higher than previously reported, with survivors having 3 to 5 treatment-related chronic health conditions by the age of 50.

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4:45 – 5:45 pm Thursday, September 13

DNR, DNET, DNI: The Alphabet Soup of Resuscitation (208)

1CNE  Caring for infants, children, adolescents, and young adults through the end of life is challenging. "Getting the DNR" is terminology that many nurses are used to hearing; they may even be the ones asking for clarification of "code status" as their patients come closer to the end of their lives. This presentation will clarify definitions and abbreviations commonly used including DNR, AND, and DNET, and the meaning these terms have for the hematology/oncology team, patients, and families. How we talk with families will be reviewed, including discussions of data, what we are not going to do, and asking them to make impossible decisions. Finally, suggestions for discussing goals of care and recommendation and the role of hope will be discussed and practiced.

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3:30 – 4:30 pm Thursday, September 13

Putting the Horse before the CAR–T! Educating Nurses on Algorithms to Recognize Cytokine Release Syndrome and CAR–T Related Encephalopathy Syndrome (203)

1CNE  Chimeric antigen receptor (CAR) therapies, recently approved by the U.S. Food and Drug Administration (FDA) for the treatment of hematologic malignancies in pediatric and adult populations, offer remarkable promise for patients with previously treated-refractory disease. Kymriah™, the first FDA-approved agent for the treatment of children and young adults up to 25 years of age with relapsed or refractory B–cell acute lymphoblastic leukemia, demonstrates an overall remission rates 83%. Significant, potentially life-threatening toxicities accompany these promising outcomes, most notably cytokine release syndrome (CRS) and CAR–related encephalopathy syndrome (CRES). Early identification and strategic management of symptoms are critical to support positive patient outcomes. An interprofessional team developed evidence-based algorithms for the diagnosis and management of CAR therapy-related toxicities.

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3:30 – 4:30 pm Thursday, September 13

Introduction to Radiation Therapy: What Should a Nurse Know? (202)

1CNE  Radiation therapy is an integral component of the overall management for many children with cancer. Better understanding of radiation therapy will improve the ability of nurses and advanced practice providers to care for these children. Review will include the underlying mechanisms of radiation in treating cancer and provide an overview of the common clinical indications for radiation. The presentation will provide an overview of the radiation planning and treatment process including dosing and fields using several case studies of children with different diagnoses. Common acute toxicities and management approach will be covered. Finally, common late effects and recommended follow-up care will be discussed. Read more...

Integrative Medicine in Pediatric and Adolescent Oncology: An Overview for the Nurse and Nurse Practitioner (008)

3.25CNE  The journey through cancer therapy is complex. While no two patients experience it the same way, there are predictable similarities when considering patient age, diagnosis, and therapy that is administered. Common problems encountered by many patients include diminished energy and physical stamina, neuropathy, disturbed sleep, poor appetite, weight loss, and exaggerated nausea.

Integrative medicine combines mainstream medical therapies with complementary therapies for which there is high quality scientific evidence of safety and effectiveness. In the setting of active treatment for children and adolescents with cancer, it consists primarily of complementary therapies intended to support general health or to limit specific treatment related toxicity. Numerous modalities may fall within this category, including dietary modification, nutrient and botanical supplements or applications, guided imagery, aromatherapy, acupuncture, and massage. It is estimated that 30–70% of pediatric patients use integrative medicine strategies; since this is by parental report, many studies likely underestimate their use.

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5:30 – 6:30 pm Friday, September 14

General Session: Social Media and Nursing......Where are we now? (103)

1CNE  In today’s world, social media has become a prominent form of communication, networking, and social interaction. As access to these platforms of communication and information expand, so must our understanding of the benefits and impact on the delivery of healthcare. As patient advocates, nurses have an obligation to explore the current climate and prevalence of social media use and its impact on patients, families, and the entire healthcare team.

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10:15 – 11:15 am Saturday, September 15

General Session: Communicating with Adolescents at End of Life: Ethical Dilemmas and Practical Solutions (104)

1CNE  Background: Discussing advanced illness and end-of-life with adolescents and young adults (AYAs) is difficult due to complexities of family and medical systems, developmental issues and the challenges of addressing grief of patients, families, and staff. Ethical dilemmas often present as barriers to good palliative communication.

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9:45 – 10:45 am Friday, September 14

General Session: Oral Medicine for Pediatric Hematology/Oncology Nursing (102)

1CNE  Pediatric hematology/oncology nurses are responsible for the comprehensive care of children with diverse and complex medical conditions, including both non-malignant and malignant diseases. For reasons related to both underlying disease pathology as well as treatment-related toxicities, this unique patient population is at risk of developing a wide spectrum of oral complications that can significantly impact patients.

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