Proceedings of 19th AnnuaI Conference 169

plan to improve and standardize the care in our pediatric patient population. Having a single level of care, one of the required standards for Joint Commission on Accredi- tation of Healthcare Organizations, affirmed the need to formulate an acceptable solution to this “high risk, low volume” procedure.

Pediatric oncology patients are commonly sedated for various invasive and noninvasive procedures for diagnosis and/or treatment. Most of these procedures, in our institution, are performed in remote areas of the hospital by staff who have little experience with the specialized needs of children. As a result, pediatric nursing staff assigned to deliver the sedating agent and provide monitoring of the child expressed feelings of isolation and were concerned that the response time of trained help in the event of an emergency would be inadequate. In addition, the diagnostic imag- ing staff was frustrated by the time commit-

ment and planning needed to sedate a child. To address the problem adequately, the inter- disciplinary planning team was formed. The primary recommendation was to develop a Pediatric Sedation Service under the Division of Anesthesia. In addition, a comprehensive sedation training program was developed to improve the knowledge and skills of the pediatric, diagnostic imaging, and radio- therapy nursing staff.

This presentation addressed: (1) issues of sedating children in a primarily adult institu- tion; (2) the Sedation Training Workshop; (3) the evaluation of the program based on sur- veys before and after the program; (4) docu- mentation findings before and after imple- mentation of the sedation program; and (5) the current policy on sedation in our institu- tion. In addition, a time line was shared for individuals and/or institutions who would like to develop a similar program.

Education Abstracts

Parents’ Time Out: An Educational/Support Group for Parents

Julie C. Garcia, RN, MSN, CPON, Clinical Nurse Specialist, San Antonio, TX, Lona Roll, RN, MSN, CNS, and Susan Smith, CCLS II

A flexible parent group offering educa- tional as well as social support was needed to meet the special needs of the parent popula- tion at our center. A multidisciplinary ap- proach was taken to develop the group by Child Life and Nursing.

It was found that more formalized or serial educational groups were not meeting the immediate needs of our population. Because many of our families are from outside the city, it was difficult to maintain a consistent group of parents. Patients that were not admitted did not want to travel a long dis-

tance for group meetings. In addition, the large number of Hispanic families in our program made it necessary for us to be able to provide for their unique needs when they came for treatment.

Formal and/or serial informational/sup- port groups have consistently failed at our center. In an effort to provide families with the information they needed and also offer group support, we thought it was important to provide some type of group activity. Par- ents were surveyed to determine their needs. It was found that parents wanted a group that could easily change to meet their immediate needs. They also wanted to hear from other parents about how they were dealing with certain issues. After determining the type of group they wanted, parents were again sur- veyed to ascertain which topics were impor- tant to them. A list of 20 topics were chosen. Outlines and objectives were completed for

170 Proceedings of 19th Annual Conference

each topic so that if one member of the team was not available, another member could speak to that topic.

Parents’ Time Out (PTO) is an informa- tional/support group that meets twice weekly on the pediatric oncology unit. Parents of children that are currently admitted either on the inpatient oncology unit or the bone mar- row transplant unit are invited to attend. Parents are asked to choose a topic of discus- sion for the session. An informal presentation of the topic chosen is followed by discussion.

Ongoing, informal evaluations of the pro- gram are done monthly. The parents have enjoyed the flexibility of the program. One more topic has been added, to make 21 topics available. The team involved with the group feels we have improved patient out- comes by developing a group that truly meets parents’ needs. Participation varies depend- ing on the population hospitalized, but over- all the group has been successful.

Because most cancer centers serve a large geographical area, it is difficult to maintain a consistent group for educational or support purposes. Therefore, a more flexible pro- gram may better meet the needs of that population. We have found increased partici- pation and improved satisfaction with this type of program.

Oceans of Love: A Lesson for Care in the Emergency Department

Renee Keefe, Director, Emergency Department, Community Medical Center, Toms River, NJ

The purpose of this study was to educate the emergency department about the special needs of the pediatric oncology patient. Sev- eral children had presented to the depart- ment for minor injuries or illness and had a less than optimal experience.

After several patient complaints, a focus group was established in the emergency department to evaluate the care given to pediatric oncology patients, increase aware- ness of the staff to their special requirements, facilitate movement of these patients through the department, and increase customer satis-

faction. Oceans of Love is an organization in Ocean County, NJ, that was established for these children and their parents and we solic- ited their help as we developed this project. The emergency department nurses inter- viewed the parents and children, assessed their needs and requirements, and obtained a history of their illness and family situation on a registration day.

That day served to familiarize the parents and children with the staff and provided us an opportunity to educate them with our plans for implementation. The children who were unable to attend were interviewed individu- ally in their homes. After this registration day, a multidisciplinary team was gathered and the following changes were implemented:

(1)

(2)

(3)

(4)

(5)

Children would be preregistered with the emergency department, so they could be brought through the lobby quickly. The emergency medical ser- vices and emergency department kept a file of children. An on-call list of the nurse managers was established so that administration would be aware that an Oceans of Love child was in the department. Educational materials were developed and presented. Issues concerning the laboratory, x- ray, and pharmacy were identified and processes developed to rectify the is- sues. Central line access education was implemented.

Telephone and personal interviews with the children and their parents identified a need for individualized care. Evaluation in- cluded mailed surveys, telephone surveys and reports from a continuous quality im- provement team.

Most emergency departments have little experience with pediatric oncology patients and therefore when presented with these patients do not understand the special needs of these patients. As they proceed through the department, issues like isolation, central line access, specific lab values and the psy- chological impact on these children were all