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Program

Target Audience
The conference is designed for nurses and other health care professionals interested in recent developments in the field of pediatric endocrinology nursing, including pediatric diabetes.

Program Goals
It is PENS’ goal to promote high quality endocrinology nursing practice through this educational offering. Conference participants receive the latest information in basic to advanced practice, experience and research as demonstrated by pediatric endocrinologists and pediatric endocrinology nurses.
Program Objectives​
  • Develop new skills to improve educational and patient outcomes
  • Provide educational opportunities in pediatric endocrinology for nurses and others with expertise in the area
  • Promote the pursuit of nursing practice and research through a research presentation and poster session
  • Provide educational opportunities in the management and treatment of selected endocrine disorders
  • Provide direction for understanding health care changes
  • Objectives for each session are listed within the schedule
PENS Conference Planning Committee
Kelly D. DeGrote, RN, BSN, Chair
Sheri L. Luke, MSN, FNP-C, Co-Chair
Mary Burr, DNP, CPNP-PC
Karen Engel, RNC
Jane Torkelson, MS, RN
Leigh Pughe​, RN, MS, CPNP
Cheryl Switzer, MSN, RN, CPNP, CDE, Board Liaison

Accreditation
Application has been made to the Greater Kansas City Chapter of the American Society for Pain Management Nursing, an approved provider of continuing nursing education by the Kansas State Board of Nursing. Kansas State Board of Nursing provider number LT0279-0412.​
The above application will include approval of Advanced Pharmacology contact hours for APNs. To receive contact hours for this conference, participants must complete the online evaluation.​​​

Networking
The opportunity to develop and continue relationships with your colleagues through networking is one of the key benefits of attending the PENS Conference. Networking offers many tangible benefits to conference participants, including, but not limited to, validating your experience in providing nursing care and developing a better understanding of your practice and your role in care delivery by learning from others who are dealing with similar circumstances, solving the same problems and confronting the same issues. Take advantage of this national gathering of pediatric endocrinology nurses to learn more about national issues and trends.​​

Po​sters
PENS is providing a venue for meeting attendees to view and discuss participants’ poster presentations on Thursday evening. Visit with the poster presenters and learn about current research that will affect your clinical practice!





​​Thursday, April 25, 2019
Time ​Presentation/Event Prese​nter(s)
​12:30 p.m. - 4:3​0 p.​m.
4.5 Contact Hours​*
​Pre-Conference Workshop:
Research & Evidence-Based Practice Workshop​
​​​
TBD

12:30 p.m. - 4:3​0 p.​m.
4.5 Contact Hours​*
​Pre-Conference Workshop:
T1D & Me Program: Learn about an Educational Resource for Children with T1 and Their Caregivers​
Being diagnosed with type 1 diabetes may be overwhelming at times. Even when providers do their best to explain the diagnosis and treatments, many young patients and their parents are left wondering how they will be able to successfully manage living with the disease. Families of recently diagnosed children are mindful of keeping blood sugar levels in range, coping with blood testing and injections, deciding on which foods to eat, and just managing everyday life. In many cases, the learning curve can feel overwhelming and leave the families with “information overload”. 

To help with this problem, the T1D and Me Program has been developed by Novo Nordisk in partnership with JDRF. Using the proven Conversation Map® model, the program aims to find new and better ways to impart knowledge and build confidence in the early stages of life after diagnosis. Designed with group facilitation in mind, the program has been granted a favorable review by the AADE and can be customized to work in any pediatric diabetes treatment setting. 

Join this workshop to be trained on implementation for your center, and to order your free facilitation kit. ​
4:30 p.m. - 5:30 p.m. ​New Member/First Time Attendee Orientation & Past Presidents Reception​
5:30 p.m. - 7:30 p.m. ​Welcome Reception in Exhibit Hall
Refreshments and Appetizers Provided
                                                               

Friday, April 26, 2019​​​​​​
Time Presentation​/Event Presenter(s)
​7:30 a.m. - 8:00 a.m.​Breakfast
Breakfast Buffet Provided 
​8:00 a.m. - 9:00 a.m.
1.2 Contact Hours*
Keynote:
 Sugar Surfing Concepts (Part 1)

This presentation will cover the following:

  • Compare and contrast static versus dynamic diabetes self care decision making
  • Visual interpretation of trending BG data: the six basic features of a CGM trendline
  • How to assign significance to trending BG data
  • How to perform, practice, and refine basic Sugar Surfing models

Stephen Ponder, MD, FAAP, CDE​
9:00 a.m. - 10:00 a.m.
1.2 Contact Hours*
​General Session 1:
Differences in Sexual Development: Physical, Psychosocial, and Ethical Issues

The study of sexual differentiation has undergone dramatic changes. Advances in knowledge of genetics and hormonal regulation have expanded the understanding of Differences in Sexual Differentiation (DSD). More importantly, societal perspectives have markedly altered, (1) the perception of DSD (from a DISORDER to a DIFFERENCE), and, (2) the decision making power related to sex assignment, surgery etc. from the medical team to the parent/patient.  The purpose of this presentation is to update PENS nurses on research related to DSD and give them the opportunity to ponder ethical decisions from the perspective of the patient and parent.  This interactive session will present a complex, fascinating topic, discuss the controversies, and provide PENS nurses with the tools to advocate for patients and parents. 

Terri Lipman, PhD, CRNP, FAAN
10:00 a.m. - 10:30 a.m. ​Refreshment Break in Exhibit Hall
Coffee, Tea, Water and Soft Drinks Provided 
​                                          
10:30 a.m. - 11:30 a.m.
1.2 Contact Hours*
​General Session 2: 
Using the Clinical Lab: Practical Pearls for the Pediatric Practitioner

In this presentation by a pediatric endocrinologist who now works as a clinical laboratory director, attendees will learn practical tips on how to work with their clinical lab to ensure the best possible outcome for their patients. Interesting, true-life cases will be used to illustrate some of the key clinical learning points. We’ll answer questions such as, “How do I make sure the right test gets done for my patient?”, “What are my options if the lab says there’s not enough sample to do the test?”, or “What can I do if the results don’t seem to fit my patient’s clinical picture?”. We’ll also discuss special considerations for those involved in clinical research, and what changes in the regulatory environment may affect clinical and research practice.  

Jon Nakamoto, MD, PhD
11:30 a.m. - 12:30 p.m.
1.2 Contact Hours*
​General Session 3:
Basics of Genetics

The presenter will provide an overview of the basics of genetics, which will include the difference between DNA, genes, and chromosomes. We will cover various types of mutations, such as deletions, duplications, missense and nonsense mutations, as well as the five types of classifications, from Pathogenic to Benign. We will also cover various types of popular technology used to detect different types of mutations. Other topics will include inheritance patterns, such as autosomal dominant and recessive, and X-linked and how it relates to diseases. The presenter will also discuss the difference between clinical testing and consumer genetic testing such as through companies like 23andMe.

Mingshu Dong, MS, LCGC​
12:30 p.m. - 2:00 p.m. ​Lunch with Exhibitors
Box Lunches Provided
2:00 p.m. - 3:00 p.m.
1.2 Contact Hours*
​Concurrent Session 1:
​1A: ENDO Case Studies​

Case Study 1: Not Your Average Turners
Discuss case, presentation, evaluation, and treatment options. This is not your typical Turner Syndrome.  How AND when should this patient be treated? Should we treat with growth hormone, hormone replacement, or pubertal suppression? Participants will have the opportunity to weigh in!

Case Study 2: Exploring the Mystery of 22q Deletion Syndrome
The presenter will discuss the case of a young girl diagnosed with 22q Deletion Syndrome and many of the common issues seen in this syndrome. With more affordable and accessible genetic testing, we are seeing more individuals diagnosed with 22q Deletion syndrome. Without more knowledge about the diagnosis and the co-morbidities associated with it, it may be difficult to manage affected patients. 
Barb Lightner, APRN-CNP, CDE​
Terri Luetjen, MS, RN, CPNP, CCRC​
​1B: The Treatment of Pediatric Obesity: Beyond Lifestyle Modifications

We will first review the etiologies underlying obesity and how treatment should be tailored based upon the causes. We will then discuss the use of anti-obesity pharmacotherapy (including medication options, off-label use, practical considerations, and costs) and metabolic/bariatric surgery for the treatment of pediatric severe obesity.​

Eric Bomberg, MD
​1C: Advanced Sugar Surfing (Part 2)​

This presentation will cover the following:
  • How to apply dynamic management principles to real-life situations
  • How to learn effective diabetes self-management from problem-based examples (e.g., food, activity, stress)
Stephen Ponder, MD, FAAP, CDE
​3:00 p.m. - 3:30 p.m. Refreshment ​Break in Exhibit Hall
Coffee, Tea, Water and Soft Drinks Provided 
                                                        
3:30 p.m. - 4:30 p.m.
1.2 Contact Hours*
​Concurrent Session 2:
​2A: Insights into McCune Albright Syndrome: A Complex, Rare Disease with Individual Presentations

The presenter will provide an overview of McCune Albright Syndrome. Since MAS is a rare disease, it is important to be knowledgeable about this disease and its management, as any given practice is likely to encounter at least a few patients (perhaps more!) with this disease. 

​Lori Guthrie, RN-C, BSN, CCRC
Jamie Streit, RN, BSN

​2B: Coding and Billing: The Link between Documentation and Reimbursement Potential

In the presence of rising health care costs, it is critical for Advanced Practice Providers (APP) to be able to describe the financial impact of their role.  Documentation of the patient care provided has been a long-standing component of communication among the healthcare team. With the expansion of APPs billing for the care they provide, it is essential to have an understanding of the impact this documentation of patient care has on billing and reimbursement. This presenter will provide an overview of the components in documentation that are used to determine the level of service for care provided.  This content will assist APPs in accurately matching documentation with the level of service, allowing them to maximize billing and potentially reimbursement for the care they provide.

Jessica Atkins, DNP, CNS, RN, CPNP-PC
Marianne Buzby, MSN, CPNP-PC
​2C: Managing Type 1 Diabetes in the Young Child: Using Tools New and Old

As the incidence of type 1 diabetes in young children is increasing in the United States, diabetes providers are faced with management of these young children in larger numbers. Younger children need more daily care, and management is challenging. Diabetes providers must quickly educate families after diagnosis and then help them as they re-enter the home, work, and daycare environments while safely managing blood sugars.  The presenters will provide diabetes practitioners with many cases and examples of creative solutions that can be used in the management of young children with diabetes.

Maureen Dever, MSN, CRNP, PPCNP-BC, CDE
Melissa Andrews Rearson, MSN, CRNP
Meredith Allen, RD, CDE
4:40 p.m. - 5:40 p.m.
1.2 Contact Hours*
​Concurrent Session 3:

3A: ​50 Years of Newborn Screening in the U.S. and Globally: Midlife Crisis or New Lease on Life?​

Newborn screening (NBS) has been around for 50 years starting with PKU, which began in the 1960s and was mandatory in the U.S. in 1975. Congenital Hypothyroidism is also screened for, both in the U.S. and internationally. NBS is a public health success, but there still exists controversy over whether conditions should be screened for or not. As more successes occur with regard to gene therapies, and cost of genetic testing decreases, this will become an even more important topic of discussion. NBS seems like a very simplistic topic, and everyone thinks they understand it. However, there is a strong push to add diseases. Ethical and economic factors play an important role as well. The presenter will discuss the ways that NBS has helped with regard to endocrine conditions and how it creates challenges with regard to resources, false positives, emotional impacts on families, etc.   

Carol Van Ryzin, RN, CPNP
​3B: How to Deliver a Successful Presentation 
Craig Alter, MD
Terri Lipman, PhD, CRNP, FAAN


​3C: The Evolution of Diabetes Management: Where We've Been, Where We Are, and Where We Are Going

This presentation is for anyone from novie to advanced learners interested in diabetes management.  The goal of the presentation is to educate the audience about current and future technology to manage insulin-dependent diabetes.  In order to understand our current and future management choices, there will be a brief discussion about our past diabetes management options.

Rebecca Crespi, BA, RN, MSN, CPNP, CDE​


5:45 p.m. - 7:15 p.m.
1.8 Contact Hours*
​Poster Reception​
Research Posters Presented by Authors
Refreshments and Appetizers Provided
                                                             
7:30 p.m. - 10:00 p.m. Networking Night - On Your Own
Saturday, April 27, 2019​
​​Time Presentation​/Event​ Presenter(s)
8:00 a.m. - 9:00 a.m. Awards Breakfast​
Breakfast Buffet Provided           
9:00 a.m. - 10:00 a.m.
1.2 Contact Hours*
​General Session 4:
The Politics that Influence Pediatric Endocrine Care 

The presenter will include an overview of national trends and federal legislation that impact pediatric endocrine care. Additionally, session attendees will be provided guidance on ways to get involved in grassroots advocacy. 

Mandi Cafasso, DNP, RN, CNP
10:00 a.m. - 10:15 a.m. Refreshment Break
Coffee, Tea, Water and Soft Drinks Provided 
                                                      
10:15 a.m. - 11:15 a.m.
1.2 Contact Hours*
​General Session 5:
Mystery Cases
Craig Alter, MD
11:40 a.m. - 12:40 p.m.
1.2 Contact Hours*
Concurrent Session 4​:
​4A:  Research Visits with the Prader-Willi Population 

The presenters aim to provide insight into completing research visits with Prader-Willi patients by highlighting the unique characteristics of this population, providing examples of scenarios from previous and current studies, common barriers and challenges, and solutions and recommendations based on this information. The audience may have clinical experience with this population or research with other populations, but have not yet run PWS studies. Recently, numerous PWS studies have started with more in the pipeline, and there is a strong interest from the PWS community. As this area of research continues to expand, clinical staff who are inexperienced with PWS-specific research and are seeking to learn more can benefit from this presentation and become better prepared for studies with this population. The presenters will also leave time for questions and open discussion to further engage participants and provide additional input on this exciting topic. 

Brittany Machus, MA, CCRP
Sue Kearns, RN, MN
​​ ​4B: Pediatric Diabetes through a Developmental Lens

The diagnosis of Type 1 Diabetes is often unexpected and brings change and challenge to the individual and family.  It is important to have a developmental approach to care. Case studies will be used to explore challenges to care through the lens of developmental expectations. After presentation of case study(s) participants will explore strategies to assist with improving care. Discussion will focus on lived experience and support of the individual.  

​​Shari Liesch, APNP
4C: Weight Management

 Eric Bomberg, MD
12:45 p.m. - 1:45 p.m. ​Membership Meeting/Lunch
Lunch Buffet Provided
1:45 p.m. - 2:45 p.m.
1.2 Contact Hours*
General Session 6:
Mind the Gap: Transition from Pediatric to Adult Care for Those with Multiple Pituitary Hormone Deficiencies

Twelve percent of all young people in Australia have chronic health issues, and 90% of these young people are now living into adulthood. Patients with what were once thought of as “pediatric diseases” now live into adulthood.   This means that children with complex endocrine conditions such as multiple pituitary hormone deficiency (MPHD) will eventually grow out of a pediatric service and require ongoing care as adults.  The presenter will describe transition issues, identify the follow-up required, who will coordinate care, and when it should happen. The presenter will also discuss the challenges regarding different models of care, the difficulties of parents "letting go" and the timing of the move to adult health care services. Transition planning is a challenge for all nurses working with children with complex ongoing health care needs, and the opportunity to share expertise will allow further discussion with participants. The presenter will provide an opportunity for those with experience to share “tips of the trade” that have worked for them, and for all of us to consider the issues that need addressing for a successful transition of care to the adult medical team. 

Bin Moore, RN, CNC
2:45 p.m. - 3:15 p.m. ​Refreshment Break
Coffee, Tea, Water and Soft Drinks Provided 
                                                        
3:15 p.m. - 4:15 p.m.
1.2 Contact Hours*
Concurrent Session 5​:
​5A:  Best Practices for Transition of Care for Adolescents and Young Adults with Turner Syndrome and Applying Current Guidelines

Young women with Turner Syndrome need to be under the management of specialized physician care throughout their lifetime. Dr. Schweiger will provide the  most up-to-date information from literature for people with Turner Syndrome, including risks; especially in consideration of the assisted reproductive technologies and diabetes and the onset of other adult diseases and problems. Transition is a pivotal moment for these  young women. A continuum of appropriate adult care is crucial. The presenter leave time for open dialogue and audience participation. 

B. Michelle Schweiger, DO, MPH
​5B:  Diabetes Case Studies

Case Study 1: Steroid Induced Hyperglycemia (SIH): An Unexpected and Diverging Insulin Therapy Course in Two Patients with the Same Oncologic Diagnosis 
The presenter will compare two unique cases of steroid-induced hyperglycemia (SIH) secondary to oncologic treatments, in which rapid insulin therapy changes were required in two patients with very different clinical characteristics, including age, gender, and size. It will lend insight to the precautions necessary in safely recommending high insulin doses in the outpatient setting to a recently discharged patient with a new hyperglycemia diagnosis. The presentation will briefly describe the pathophysiology of SIH and the challenges of treatment in the context of a complex primary oncologic disease. The incidence of childhood leukemia is on the rise, and as PENS nurses we should expect an increase in SIH. Maintaining awareness of the potential drivers of extremely high insulin doses will help providers to safely treat hyperglycemia, and thereby, prevent acute and long-term complications. This presentation takes a different spin, focusing on a comprehensive response to the need for rapidly changing insulin doses while prioritizing the primary disease process, and prevention of re-hospitalization. 

Case Study 2: TBD

Michelle Marowitz, RN, MSN, CRNP, PNP-PC
Melissa Andrews Rearson, MSN, CRNP
​5C:  Writing for Publication

This presentation will focus on the following objectives:
  • Discuss the knowledge and skills necessary for writing for newsletters, journals, and other nursing related publications.
  • Identify a potential topic for publication based on your area of clinical expertise.
  • Identify potential organizational resources within the work setting that can be accessed to achieve your publication goal.
Cecily Betz, PhD, RN, FAAN​

4:25 p.m. - 5:25 p.m.
1.2 Contact Hours*
​Concurrent Session 6:
​6A: Endocrine Case Studies

Case Study 1: Water, Water, Everywhere, and Not ENOUGH to Drink: A Case of Isolated Diabetes Insipidus then Evolving Pituitary Dysfunction
This presentation will include the evaluation of polyuria/polydipsia to lead to a diagnosis of central diabetes insidious, endocrine treatment of diabetes insidious, and then additional evaluation as to the cause of central diabetes insidious. This patient's differential diagnosis includes Langerhans Cell Histiocytosis (LCH), so the presenter will also discuss endocrine considerations in the monitoring and treatment of LCH. LCH is a relatively rare diagnosis, therefore PENS participants will be able to learn from this case study to be able gain knowledge and be prepared for a patient with a similar presentation. 

Case Study 2: Neonatal Graves Disease
The presenter will provide the general pathophysiology of neonatal Grave's disease, including maternal monitoring and newborn monitoring of mother's with a history of Grave's disease despite R/I ablation or thyroidectomy.  The presenter will also discuss general medical management and lab monitoring of this newborn with eventual clearing of maternal antibodies. There is a need for APRNs and their clinical expertise in caring for these high-risk newborns as we provide much needed access to patients that are in urgent need of endocrine care.  ​

Leigh Pughe, RN, CPNP

Kara Schmid, APRN, CNP

​6B:  Screening for Depression and Eating Disorders in Youth with Diabetes

Adolescence is a time of change, and meeting the developmental tasks of this age can be daunting and confusing, even for well-adjusted teens. Adolescents are at a higher risk of depression (11%) than the general population. Depression is more common in adolescents with type 1 diabetes mellitus (T1DM) (14– 33%) and type 2 diabetes mellitus (T2DM) (14.8%). When an adolescent is faced with managing the daily self-care tasks of diabetes, life can seem overwhelming. Identifying adolescents with diabetes who have depressive symptoms is essential, due to the risk of both diabetes and psychiatric complications.

Individuals with type 1 diabetes are twice as likely to develop an eating disorder compared to those without diabetes. Diabulimia is the term used in the media to describe an eating disorder that involves intentional insulin restriction for the purpose of weight loss. Insulin omission is associated with increased risk of ketoacidosis and long-term complications and mortality occurring at younger ages. including retinopathy, nephropathy, vascular disorders and premature death. Early intervention improves prognosis for those with co-occurring eating disorders and type 1 diabetes. Raising awareness among healthcare professionals and utilizing screening tools in practice is crucial for providing appropriate medical, nutritional and psychological care.
Maureen Dever, MSN, CRNP, PPCNP-BC, CDE
Trish Lieberman, MS, RD, LDN, CDE
​6C:  Prader-Willi Syndrome Choking Prevention and Education: A Practice Change

The presenters will educate participants regarding the risk of choking in the Prader-Willi Syndrome (PWS) population. They will discuss how a quality improvement program can help lead to improving patient outcomes and safety. The presenters will inspire participants to take the information presented back to their own practices while imparting new knowledge and changing current practice.   

Amy Moffett, MSN, RN, CPNP
Kathryn Anglin, MSN, BSN, RN​

​5:30 p.m. - 6:30 p.m. Committee Meetings: Education, Research, Nominations, Conference Planning
7:00 p.m. - 10:00 p.m. Evening Event
                                                                        

Sunday, April 28, 2019
​Time Presentation/Event​ Presenter(s)
8:00 a.m. - 9:00 a.m.
1.2 Contact Hours*
General Session 7 and Breakfast:
Resiliency in Nursing: Exploring Intimate Spaces of Caring

In the ever changing matrix of health care, the health care provider continually needs to adapt. In helping others, stress may occur. Stress may impact our physical, emotional or spiritual realm. Personal concerns (ailing family members or personal illness) may shadow our ability to provide care. When the joys or storms of life strike, how does one navigate all the emotions attached to care, to not only survive, but thrive? Resiliency, the ability to bounce back despite adversity, is a dynamic process. Resiliency is “individual” and can be fostered. The ability to access resilient-reflective strengths is invaluable, as resiliency and personal health are interconnected. The goal of this session is to explore resiliency, both personally and professionally: Individual resiliency through the 7C’s (Frankowski, et al.) as promoted by the American Academy of Pediatrics through the lens of Adverse Childhood Experiences (ACEs) (Murphy, et al. and Boullier & Blair, 2018). Next, resiliency in nurse leadership will be discussed through exploration of its parts:  equanimity (conveying a sense of calm in crisis), optimism (viewing situation with positivity), and perseverance (ability to move forward with courage and energy) (Stagman-Tyrer, D.). Relationships are important in resiliency support and are often forged through caring. Reflecting on individual and collective nurse journeys will encourage participants to embrace the spirit of being an endocrine nurse (Baikie, K. & Wilhelm, K. and Liesch, S.).  The oak fought the wind and was broken, the willow bent when it must, and it survived. (Robert Jordan in The Fires of Heaven).    

Shari Liesch, APNP​
9:00 a.m. - 10:00 a.m.​
1.2 Contact Hours*
​General Session 8: 
Research Oral Presentations

  • The Influence of Social Determinants of Health on Family and Self-Management of Type 1 Diabetes in Black Single Parent Families​
  • The Impact of Change in Neighborhood Poverty on BMI Trajectory​
  • National Survey of Neonatal Growth Measurement Practices

Jennifer Morone, MA-ATR, BS-RN
Krista Schroeder, PhD, RN
Jan Foote
​, DNP, ARNP, CPNP
10:00 a.m. - 10:15 a.m. ​President's AddressCatherine Flynn, RN, MSN, APRN, CDE​
10:15 a.m. - 10:30 a.m. ​Refreshment Break
Coffee, Tea, Water and Soft Drinks Provided 
                                           
10:30 a.m. - 11:30 a.m.
1.2 Contact Hours*
​General Session 9:
Osteoporosis in Children: Cases, Workup, and Treatment

Kevin Lewis, DNP, ARNP
​11:30 a.m. ​Conference Concludes
* Subject to change based upon approval 
Total number of contact hours applied for is 25.5 (21 for the regular conference plus 4.5 for the pre-conference workshop)