Pediatric Oncology Safety Simulation (223-2)

Pediatric Oncology patients are at high risk for rapid deterioration given their severity of illness, toxicity of interventions and associated immunosuppression. Pediatric Oncology focused escalation of care for patients experiencing clinical deterioration continues to present significant challenges within healthcare. At the current institution a two-year review of inpatient and outpatient oncologic emergencies was evaluated, and a comprehensive Oncology Safety Simulation Program was developed.The Oncology Safety Simulation Program has offered a hands on multi-disciplinary approach to educating physicians, nurse practitioners, nurses and pharmacists on safe practices during Oncology medical emergencies. Outcome data has been tracked to evaluate attendees' satisfaction and attendees' evaluation of their ability to utilize the education to change practices at the bedside. Data has been tracked with regards to use of intramuscular epinephrine administration during anaphylaxis and time to implementing the sepsis protocol during a sepsis workup. The simulation process development timeline will be reviewed, outcome data will be shared and latent safety effects will be reviewed.

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HSCT for MPS disorders (Hunters and Hurlers), (217-2)

Hematopoietic Stem Cell Transplant (HSCT) is best known as a treatment modality for hematologic malignancies, some solid tumors, and various autoimmune disorders. It is lesser known as a means to halt progressive symptoms in certain chromosomal inherited disorders such as Hunters and Hurlers disease. Patients with Hunters and Hurlers are born with an inherited x-linked chromosomal disease where sugar molecules are unable to be broken down and digested by the body causing both physical and mental disabilities. There is no cure for these diseases but HSCT is an intensive therapy that has shown promise with these diagnoses, helping to stop progression of symptoms of disease.

Two case studies of children who underwent HSCT at our center, one for Hunter’s and one for Hurler’s, will be presented from both a medical and psychosocial standpoint. How these children first presented, how HSCT affect their disease, the complications they underwent during their HSCT, and the complex psychosocial aspects of receiving chemotherapy as well as an extended hospitalization.

Learning Objectives:

• The learner will describe the role of Hematopoietic Stem Cell Transplant in the treatment of non-malignant diseases.
• Identify conditioning regimens and their unique complications for non – malignant diseases.
• The learner will describe the psychosocial needs of hematopoietic transplant patients and their families when they undergo a complex regiment such as HSCT.

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The Role of the Pediatric Clinical Research Nurse in the Management of Severe Aplastic Anemia (208-1)

Severe aplastic anemia (SAA) is a serious and life-threatening condition with an unknown etiology, involving improper production of stem cells due to damaged bone marrow. Without functional stem cells, the body is depleted of red blood cells, white blood cells, and/or platelets. With only 600 to 900 cases diagnosed each year in the U.S. alone, SAA is rare. Most patients are only provided supportive care measures: receiving blood transfusions to manage symptoms and adhere to complex medication regimens to limit complications; however, advancements in treatment of SAA are made possible through clinical research trials. The Clinical Research Nurse (CRN) must address the clinical needs of the research patient, but also be sensitive to the psychosocial and ethical issues of supporting pediatric research patients. This case study presents a 7-year old Mongolian patient, “M.B.”, with refractory SAA, who failed standard immunosuppressive therapy and failed to engraft from a previous expanded umbilical cord stem cell transplant. M.B. was enrolled in a clinical research protocol in which he underwent a haplo-identical transplantation using peripheral blood stem cells and post-transplant GVHD prophylaxis using Cyclophosphamide. M.B.’s complex clinical trajectory will unfold over the course of the case study, with the role of the Clinical Research Nurse highlighted. In addition to clinical complications, the COVID-19 pandemic added an additional layer of psychosocial and ethical complexities for M.B. and his family to navigate. Application of the Clinical Research Nurse Domain of Practice ensures that the bedside nurse addresses the holistic needs of the research patient and caregiver at the bedside, while also maintaining the integrity of the research protocol. Read more...

Building a Sickle Cell Nurse Champions Program to improve patient care and nursing performance (200)

The social upheaval throughout the country during the summer of 2020 raised international awareness about the inequities people of color face throughout their lives. Sickle cell disease (SCD) patients are a particular group that experiences healthcare disparities. The Sickle Cell Nurse Champion Program was created as a novel educational program to improve patient care and nursing performance. To build this program, we conducted a needs assessment from our patients and parents. Read more...

Safe Zone Training (006)

Healthcare professionals are now interacting with more members of the LGBTQ+ community in their practices. How comfortable are you with engaging your patients and their families in conversations regarding sexuality and gender? Do you know and understand the current words and definitions used by the LGTBQ+ community? Do you understand what an ally is?  Can you describe the differences between diversity and inclusion? During this session, Teresa will lead discussions on these topics and help engage in activities that will allow you to reflect on your own knowledge and thoughts around your LGBTQ+ patients and families. At the end of this session, you will be “Safe Zone” trained. Teresa will also explore how you can bring about change in your institution to increase inclusion and provide better patient and family experiences. Read more...

General Session: APHON Advocacy: Ask, Tell, Ask (104)

This session will outline the basics of advocacy and APHON’s Advocacy Agenda. Opportunities for engagement in advocacy will be described along with their associated time commitments. A demonstration of making a legislative “ask” will be performed to provide attendees with the tools and confidence they need to advocate for APHON’s priorities locally and nationally. Read more...

General Session: State of Nursing: Pediatric Hematopoietic Stem Cell Transplantation: A Glimpse of the Past, Current State, a Glance of the Future (102)

Over the last 60 years, significant advances in in hematopoietic stem cell transplantation (HSCT) has provided improvements in effective treatment or cure and overall survival for many patients. There has been considerable HSCT progress and success in a variety of pediatric malignant and non-malignant diseases. This state of the science presentation will be providing the evolution and current and future highlights of Pediatric HSCT as it relates to disease conditions, stem cell sources, conditioning regimens, cellular immunotherapy, toxicity related treatments and supportive care. Read more...

The Future of Nursing 2020-2030: What We All Need to Know (224)

In 2021, the National Academy of Medicine (NAM), formerly known as the Institute of Medicine (IOM), released the report Future of Nursing (FON) 2020-2030: Charting a Path to Achieve Health Equity. This most recent report is the third report on the future of nursing, initially created with the sponsorship of the Robert Wood Johnson Foundation (RWJF) published in 2011 (National Academy of Sciences). Nurses at all levels need to be familiar with the needs of the profession and how they can get involved and make a difference for themselves and their patients. Read more...

Renewed Hope for the Future: Menin Inhibitors for Relapsed/Refractory Leukemia (233)

Prognosis for pediatric patients and adolescents with multiple relapsed/refractory leukemia remains grim. Many have received relapsed protocols, CAR-T therapies, stem cell transplants and yet, the disease returns. In the past, the next discussion in this patient population would lead towards palliation and quality of life, with little hope for cure. Recent advancement in therapy for children with refractory leukemia has introduced the use of menin inhibitor in patients with KMT2A/MLL and NPM1 mutations, providing a number of young patients with another chance of remission and a chance at a cure. Read more...

It's All About the Messaging-Pediatric Palliative Care and Communication (218)

Each year, approximately 16,800 children are diagnosed with cancer. With this diagnosis comes both the hope for a cure and the fear of death. Both hope and fear require our attention and understanding. Children diagnosed with cancer need skilled intradisciplinary treatment teams that provide guidance and support in decisions related to therapy modalities aimed at treating the cancer. Aiming for cure is the hope of all children and families facing a cancer diagnosis. Goals of therapy become very important to designing the best treatment for the child.

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