Foundations of Pediatric HSCT 3rd Edition Brochure

A Core Curriculum, 3 rd Edition Misty Evans, DNP APRN CPNP-AC BMTCN® Janice Nuuhiwa, MSN RN NPD-BC CPHON® Rita L. Secola, PhD RN NEA-BC CPON® FAAN Karen Wolownik, MSN RN CPNP CPHON®

Program History and Updates Originally developed from collaboration between the Pediatric Blood and Marrow Transplant Consortium (PBMTC) nursing discipline group and the Association of Pediatric Hematology/Oncology Nurses (APHON),

(Module 8), and more. Because the course is designed to teach nurse learners how to care for pediatric transplant patients at their institution, learners can expect an emphasis on the following components: • Core foundational concepts that are required before learning specific institutional practices • Embracing a multidisciplinary team approach and plan of care • Providing psychosocial support and education for patients, parents, and family members about what to do/expect during their care This course is meant to be paired with classroom training about institutional-specific pediatric transplant practices. Each module is provided in Microsoft PowerPoint® format with extensive notes

BMT? HPCT? HSCT? Oh, my! Hematopoietic stem cell transplantation (HSCT) is a rapidly evolving, relatively new field — just think about how many names you have used when referring to transplantation! Successful human application of HSCT has emerged over the last 45–50 years. What once may have been considered a “desperate clinical maneuver”

Foundations of Pediatric Hematopoietic Stem Cell Transplantation: A Core Curriculum was the first of its kind: the only “how to” publication serving nurses caring for pediatric hematopoietic stem cell transplantation (HSCT) patients. For almost 20 years, this course has been highly valued among APHON members and non-members alike who depend on its uniqueness as a well-rounded, informative resource. This new edition includes updates across nine modules, covering topics such as transplant types and sources (Module 1), administration and management of infusions (Module 4), immune re-constitution and late effects

knowledgeable about the immune system and its components. Any discussion of HSCT must begin with definitions of relevant terms and an overview of how far and how fast we have traveled to reach this point. Learners who utilize the third edition of the Foundations of Pediatric Hematopoietic Stem Cell Transplantation: A Core Curriculum can expect to begin their HSCT educational journey with an overview of HSCT that will lay the groundwork needed by any nurse who provides care to pediatric transplant patients.

now provides a cure for thousands of patients. HSCT is a complex process that will have life- long implications for the recipient. To develop an understanding of HSCT concepts, one must be

Is This Course For Me? Although the care of a pediatric HSCT patient requires a multidisciplinary team approach, the third edition of the Foundations of Pediatric Hematopoietic Stem Cell Transplantation course is designed for these target audiences: • Novice nurses with limited pediatric clinical experience and no stem cell transplant experience • Experienced nurses who don’t have hematology, oncology, transplant, or pediatric experience (these nurses may know about adult transplantation but have not cared for pediatric patients) • Nurse practitioners who may have some but not extensive transplant experience After completing this course, the nurse learner will be able to: • Identify and define the types and sources of transplants • Identify indications for transplants and ethical considerations

and references, encouraging nurse educators/ instructors to present the content in the classroom setting. A nurse educator/instructor who provides these online modules will reduce their own preparation time and time in the classroom. For the first time ever, the course includes a self-paced independent learning experience in addition to the classroom instruction benefit. Any course purchased by or for an individual learner will include recorded audio narration of all nine modules, another new update. Learners may pause or rewind the narration at any time as they progress through each module. After purchase, nurse educators/instructors will download the files from the APHON Continuing Education (ACE) Center ahead of presenting the course in the classroom setting. Individual learners will complete the online self-paced course entirely in the ACE Center. Due to the inclusion of the audio narration, a course purchased for individual use will not include

access to the presenter notes, while any course purchased and downloaded for use in the classroom setting will include the presenter notes only, without audio narration. (For additional details, please review the Terms of Use on page 6 of this brochure.) Previously comprised of 24 modules which offered 26 hours of education for 31 nursing contact hours, the third edition has been streamlined to nine modules offering approximately 8–9 hours of content. For the individual learner who completes the self-paced online version of the course, this translates into 9 continuing nursing education (CNE) contact hours provided by APHON. CNE contact hours are not provided by APHON for courses taught by nurse educators/instructors within the institutional setting. (For more details on how to claim contact hours as a self-paced or classroom learner, please see the CNE Eligibility section on page 5 of this brochure.)

• Identify the types of conditioning regimens for HSCT and their potential adverse effects • Administer and manage cellular therapy infusions • Conduct assessments specific to pediatric HSCT patients • Manage symptoms as needed and required (e.g., pain, mucositis, nausea/vomiting, and skin integrity) • Recognize the complications for each type of transplant regardless of donor source or conditioning regimen • Describe post-transplantation immune re-constitution and late effects of HSCT • Plan for safe discharge, including home and follow-up care • Maintain professional boundaries and care for self • Care for an initial, small-cohort, less complicated transplantation patient

Table of Contents This course contains nine modules that can be used by a nurse educator/instructor as individual lectures or as part of a comprehensive course. The individual learner may choose to initially complete the course in its entirety, then refer back to individual modules as needed for review. The modules appear in the recommended order of presentation as a 1–2-day course. Contributing authors and suggested teaching times are indicated for each module. Nurse educators/instructors may modify the actual length of each module depending on the audience, presentation detail, and discussion degree.

5 Recognition and Management of Toxicities Instructor/Author Misty Evans, DNP APRN CPNP-AC BMTCN®

52 Slides | 60 Minutes to Teach

Learning Objectives • Recognize common toxicities following HSCT • Identify nursing interventions to prevent and manage toxicities following HSCT

6 Common HSCT Complications Instructor/Author Karen Wolownik, MSN RN CPNP CPHON®

1 Introduction & Overview Instructor/Author Rita L. Secola, PhD RN NEA-BC CPON® FAAN

84 Slides | 90 Minutes to Teach

26 Slides | 30–45 Minutes to Teach

Learning Objectives • Describe the pathophysiology of acute and chronic Graft-Versus-Host Disease (GVHD) • Recognize the signs and symptoms of acute and chronic GVHD • Describe and demonstrate an understanding of the staging and grading guidelines for GVHD • Describe the most common prophylactic and management strategies for acute and chronic GVHD

Learning Objectives • Describe the goals of hematopoietic stem cell transplantation (HSCT)

• Describe the types of HSCT and indications for its use • Explain the ethical considerations related to HSCT 2 HSCT Types, Selections, Stem Cell/Cellular Therapy Sources 51 Slides | 45–60 Minutes to Teach Instructor/Author Rita L. Secola, PhD RN NEA-BC CPON® FAAN Learning Objectives

7 Discharge Planning and Education Instructor/Author Misty Evans, DNP APRN CPNP-AC BMTCN®

19 Slides | 25 Minutes to Teach

• Describe HSCT donor types and selections • Define HSCT stem cell sources and collections • Describe other HSCT cellular therapy

Learning Objectives • Determine appropriate discharge criteria following HSCT • Identify patient and caregiver education needs following HSCT • Explain ongoing follow-up of the post-transplant patient after the hospital discharge

3 Hematopoietic Stem Cell Transplant (HSCT) Conditioning Regimens

30 Slides | 45–60 Minutes to Teach

8 Immune Re-Constitution and Late Effects Instructor/Author Misty Evans, DNP APRN CPNP-AC BMTCN®

Learning Objectives • Describe the principles of HSCT conditioning regimens • Define types of HSCT conditioning regimens • Explain patient care and monitoring related to HSCT conditioning regimens

Instructor/Author Rita L. Secola, PhD RN NEA-BC CPON® FAAN

50 Slides | 60 Minutes to Teach

Learning Objectives • Describe the late complications of HSCT

• Recognize the risk factors associated with late complications of HSCT • Identify diagnostic tests to monitor long-term complications of HSCT • Describe the recommended survivorship follow-up for HSCT survivors

4 Administration and Management of Stem Cell Infusions

35 Slides | 45 Minutes to Teach

9 Boundaries & Self-Care

Learning Objectives • Define the different types of stem cell infusions and the implication for the use of each • Identify methods of stem cell product manipulation and explain the pros and cons of using each • Understand implications and ABO incompatibility • Describe the preparation of the patient and environment and the necessary monitoring for cell therapy infusions • Identify expected minor and serious adverse events of stem cell infusion and nursing management • Describe psychosocial considerations in caring for patients undergoing cell therapy infusions

Instructor/Author Karen Wolownik, MSN RN CPNP CPHON®

30 Slides | 45 Minutes to Teach

Learning Objectives • Identify expectations for maintaining professional boundaries when caring for chronic, long-term patients receiving HSCT • Describe a relationship-based model of care’s essential components • Define provider well-being within the context of personal and team accountability

Instructor/Author Janice Nuuhiwa, MSN RN NPD-BC CPHON®

The actual length of lectures can be changed, depending on the audience, detail of presentation, and degree of discussion.

CNE Eligibility Each 60 minutes of educational content is worth a total of 1 continuing nursing education (CNE) contact hour. Self-Paced Learners The individual learner who completes the self-paced online version of the course in the ACE Center may earn 9 CNE contact hours. All modules have an end-of-module quiz with feedback for correct and incorrect answers. Successful completion of all module quizzes is required to move forward in and complete the course and earn CNE contact hours. An individual must complete the self-paced online version of the course in the ACE Center to earn CNE contact hours provided by APHON. Classroom Setting Learners CNE contact hours are not provided by APHON for courses taught by a nurse educator/instructor within the classroom setting. Individuals who complete the course in a classroom setting are able to claim contact hours through an eligible continuing education provider, such as their institution, an ANCC-accredited provider, or elsewhere. The number of CNE contact hours available to earn when the course is taught in a classroom setting will depend on the total number of hours of presentation time. The Association of Pediatric Hematology/Oncology Nurses (APHON) APHON is the professional organization for pediatric hematology/oncology nurses and other pediatric hematology/oncology healthcare professionals. Its members are dedicated to promoting optimal nursing care for children, adolescents, and young adults with cancer and blood disorders, and their families. APHON’s mission is to support and advance nurses in optimizing outcomes for children, adolescents, young adults, and their families throughout the continuum of care for their blood disorders and cancers. APHON provides and promotes expertise in pediatric hematology/oncology nursing practice to its members and the public through educational conferences, the bimonthly Journal of Pediatric Hematology/Oncology Nursing , the quarterly newsletter APHON Counts , textbooks, patient-family educational materials, an online community that shares practice-related questions, and more. To learn more about APHON membership, products, and services, visit aphon.org, e-mail info@aphon.org, or call 855.202.9760 (US residents only) or 847.375.4724.

Editors

Misty Evans, DNP APRN CPNP-AC BMTCN® Nurse Practitioner/Assistant Professor

Rita L. Secola, PhD RN NEA-BC CPON® FAAN Clinical Service Director Children’s Hospital Los Angeles Los Angeles, California

Vanderbilt University Nashville, Tennessee

Janice Nuuhiwa, MSN RN NPD-BC CPHON® Nursing Professional Development Specialist Ann & Robert H. Lurie Children’s Hospital of Chicago Chicago, Illinois

Karen Wolownik, MSN RN CPNP CPHON® Pediatric Nurse Practitioner/Clinical Educator Maria Fareri Children’s Hospital/New York Medical College Valhalla, New York

Course Reviewers

Caroline Costello, MBA BSN RN NPD-BC BMTCN® CPON® Nursing Education Coordinator Boston Children’s Hospital Boston, Massachusetts

Ellen Olson, MS RN CPNP BMTCN® CPHON® Blood and Marrow Transplant Nurse Practitioner Children’s Healthcare of Atlanta/ Aflac Cancer & Blood Disorders Center Atlanta, Georgia

Terms of Use The APHON Foundations of Pediatric Hematopoietic Stem Cell Transplantation: A Core Curriculum, 3rd Edition (“APHON Transplant Foundations”), including copyright therein, are owned exclusively by APHON and may not be used except for the limited license as provided below. APHON grants the purchaser (“Purchaser”) of the APHON Transplant Foundations a limited license to use the APHON Transplant Foundations in a classroom setting and/or for independent study through completion of the self-paced online course in the APHON Continuing Education (ACE) Center. Without limiting the specific nature of the license above, APHON only grants Purchaser the permission to use the APHON Transplant Foundations to teach employees in Purchaser’s institution in an in-person or virtual instruction setting. The APHON Transplant Foundations may not be loaded into Purchaser’s or their institution’s learning management system, and Purchaser may not create any derivative works of the APHON Transplant Foundations including any modifications, recorded voiceovers, or other additions or changes to the APHON Transplant Foundations. Purchaser may download the PowerPoint® slides contained within the APHON Transplant Foundations exactly in their original form to their institution’s shared network to allow central access within the institution only. Purchaser may print the presenter notes and slide handouts within the APHON Transplant Foundations for use in conjunction with instruction within Purchaser’s institution. Purchaser completing the self-paced online learning experience may claim continuing nursing education (CNE) contact hours through APHON; Purchaser presenting the course in a classroom setting may offer CNE contact hours by working with an ANCC-accredited provider/approver such as their institution or elsewhere. APHON does not provide CNE contact hours for completion of the APHON Transplant Foundations within a classroom setting at Purchaser’s institution.

System Requirements The lectures are presented in Microsoft PowerPoint® format. The self-paced online learner will view the course in the ACE Center. Extensive notes and references accompany the modules for the nurse educator/instructor’s use and are in the PowerPoint® files. The current version of Microsoft Office is recommended for the optimal classroom setting experience. Viewing the files with a previous version of PowerPoint® may result in formatting errors and reduced functionality. Printing Handouts The presentation files may be distributed to participants as handouts. Follow the steps below to print the handouts: 1. Open the module file. 2. Select “File,” then select “Print.” 3. Under the “Slides” section, select the preferred option