3:55 –4:15 pm Friday, September 14

Paper Presentations: Professional Practice Issues — Evidence-Based Interprofessional Palliative Care Education: Lessons for Pediatric Oncology Clinicians (222-3)

1CNE  Basis of inquiry: Clinician education and expertise in palliative care varies widely across pediatric oncology programs, creating disparities in accessing and delivering much needed services to children and their families. Providing interprofessional, onsite team training, as well as institution-wide support for ongoing palliative care education is critical to improving quality of life for pediatric oncology care recipients.

Purpose/Objectives: To describe an evidence-based practice approach for delivering comprehensive interprofessional palliative care education for pediatric oncology clinicians.

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3:35 – 3:55 pm Friday, September 14

Paper Presentations: Professional Practice Issues — Nurse-Patient Connectedness and Nurses’ Professional Quality of Life: Experiences Volunteering at a Pediatric Oncology Camp (222-2)

1CNE  Nurses working in pediatric oncology can experience unique stressors that are both professionally and personally demanding. Many pediatric oncology nurses volunteer with their local oncology camp, where there are unique opportunities for shared experiences between nurses and cancer patients/survivors outside of the clinical setting. In this session, we present findings from a mixed methods study exploring the impact of volunteering at an oncology camp on pediatric oncology nurses’ professional quality of life.

Disclaimer: [1 CH] will be awarded for attending all three paper presentations presented during this timeslot. Partial credit is not available.

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3:15 – 3:35 pm Friday, September 14

Paper Presentations: Professional Practice Issues — Moral Distress Among Pediatric Oncology Nurses: A National Sample (222-1)

1CNE  Because of the unique nature of nurse-patient relationships and the role of the nurse, nurses are routinely put into situations that expose them to the development of moral distress. Moral distress has been identified as the psychological disequilibrium, negative feeling state, and suffering experienced when nurses make a moral decision and then either do not or feel that they cannot follow through with their chosen course of action. This session will describe results of a mixed-methods study of APHON members, examining moral distress and its relationship to prognosis-related communication.

Disclaimer: [1 CH] will be awarded for attending all three paper presentations presented during this timeslot. Partial credit is not available.

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4:45 – 5:45 pm Thursday, September 13

Low Dose Ketamine Use in the Non-ICU Setting for Pediatric Hematology and Oncology Pain (209)

1CNE  Managing severe pain in children, adolescents, and young adults with oncologic malignancies and sickle cell disease present a challenge to members of the multidisciplinary team. Traditional pain treatment strategies rely primarily on opioid analgesia (Wang, 2015) in addition to complementary therapies to provide comfort. Despite these interventions, many patients report inadequate pain control and adverse effects. These side effects can range from tolerable (pruritis) and dose-dependent (constipation) to life-threatening (respiratory depression, sedation). Refractory pain is a common reason for hospital readmission in this patient population, specifically in patients with sickle cell disease or patients being treated at the end of life. Ketamine, a dissociative anesthetic used for sedation, has traditionally been administered in the operating room or in an intensive care unit (ICU) setting with stringent monitoring parameters. In patients with persistent pain despite traditional analgesic interventions, adjuvant therapy with low-dose ketamine infusions have proven beneficial (Hagedorn, 2016). Low-dose ketamine infusions are associated with opioid-sparing effects, improved pain management, and improvement in the child's ability to interact with their family (Finkel, 2007).

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3:30 – 4:30 pm Thursday, September 13

Are Your Patients with Advanced Cancer Suffering? A Nurse-Led Study Utilizing Technology to Measure Symptoms (C205)

coglogo1CNE  Nurses and nurse practitioners have the opportunity to be at the forefront of supportive care research using current technology. Through collaboration between the COG Nursing Research Subcommittee and Alex’s Lemonade Stand Foundation, a mentored nursing grant funded a multisite study investigating how children with advanced cancer experience symptoms. Minimizing suffering, including effective symptom management, in children with advanced cancer is a central value for pediatric oncology clinicians (Nuss et al., 2005). Patient-reported outcomes have been used in pediatric oncology symptom-related research (Baggot et al., 2012); however the majority of literature specific to symptoms during palliative or end-of-life care for children with advanced cancer is based upon medical record reviews and to a lesser extent, patient self–report (Hinds et al., 2007; Wolfe et al, 2015). The study purpose was to prospectively describe symptom frequency, severity, and distress level in children and adolescents with advanced cancer using patient self-report and parent proxy.

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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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