Wednesday, March 21

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7:15–8:30 a.m. (1.25 contact hours) Optional Sessions - Select Only One

300: Developmental Delays and Behavioral Conditions in Young Children (Developmental Behavioral mini-track) — Susan Van Cleve, DNP, CPNP ​
Young children under five years of age who display developmental delays or behavioral conditions should be evaluated in a comprehensive manner by nurse practitioners in primary care. This session will focus on how to assess, accurately diagnose and treat children who have developmental delays, disruptive behaviors, symptoms of anxiety or autism or ADHD symptoms and will include the use of developmental and behavioral screening and assessment tools to assist with accurate diagnosis. Strategies for behavioral and pharmacologic interventions will be described, including those strategies that focus on building resilience in children and supporting parents and can be performed by the nurse practitioner.

301: Strategies to Eliminate Use of Corporal Punishment and Encourage Positive Parenting (Maltreatment and Toxic Stress mini-track) — Julie Loyke, RN, MSN, CPNP-AC/PC; Gail Hornor, DNP, CPNP; Amy Terreros, DNP, RN, APRN; and Carrie Donnell, MSN, CPNP ​
This session will explore corporal punishment (CP) in terms of definition, epidemiology, risk factors and consequences. The development of individual practice strategies to address CP use and encourage positive parenting concepts will be presented. Ways that advanced practice registered nurses can participate in more global initiatives to eliminate the use of CP locally, nationally and world-wide will be discussed. A current national initiative to raise public/parental awareness regarding negative consequences of CP use, The No Hit Zone, will be explored.  Participants will be provided with the strategies and tools necessary to implement a No Hit Zone in their facility.

10:30–11:45 a.m. (1.25 contact hours) Concurrent Sessions – Select Only One

302: Critical Illness-Related Corticosteroid Insufficiency: Cases to Ponder (AC) — Jennifer Joiner, MSN, CPNP​-AC/PC
Critical illness-related corticosteroid insufficiency in children (CIRCI) occurs when severe illness and stress causes enhanced activity of the hypothalamic‐pituitary‐adrenal axis (HPA), but the patient has inadequate production of cortisol or resistance to cortisol that leads to relative or functional adrenal insufficiency. Recommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients were published in 2008, and since that time algorithms for treatment in pediatrics have been published, but practice consistency is lacking. In this discussion, we will navigate typical case presentations, and in future situations the acute care pediatric nurse practitioner will be able to calmly decide on treatment measures instead of being "stressed out"!

303: Medications and Breastfeeding (Rx) (Breastfeeding mini-track) — Frank Nice, RPh, DPA, CPHP 
Various factors come into play when a breastfeeding mother is taking medications. Issues include the use of prescription drugs, over-the-counter (OTC) medications, recreational drugs, galactogogues and herbals, among others, by breastfeeding women. A framework used in counseling breastfeeding women is provided for healthcare professionals, including lactation consultants. Objectively weighing the benefits of drugs and breastfeeding versus the risks of drugs and not breastfeeding, in most cases, allows for lactation consultants to give current and practical advice to mothers and healthcare professionals who counsel mothers.

304: Fracture vs. Break: Is There a Difference? — Jenny Weiner, CPNP​
This session will provide information regarding pediatric fractures and fracture management. Discussion will include describing types of fractures and understanding X-rays with examples. This session is ideal for both acute and primary care practitioners, as it will detail surgical and nonsurgical treatment options and potential complications of fracture management.

305: Reframing the Dialogue for Pediatric Health Policy — Kristi Westphaln, CPNP and Eileen Fry-Bowers, MSN, PhD​
From ideology to pragmatism, welcome to an innovative session that will illuminate and inform future discussions surrounding child healthcare policy. Specific aims of this presentation include: 1. Investigation of the historical progression of child rights in the United States, 2. Discussion of how child rights influence previous and present trajectories for child health care and education policy, and 3. Identification of opportunities for child healthcare reform that infuse social justice, life course health development and the unique health care needs of children. Through a synthesis of pediatric clinical and legal expertise, this presentation will help attendees of all pediatric clinical backgrounds and levels of experience navigate through the partisan rhetoric embedded within pediatric health policy and provide context to help reframe policy conversations to positively impact child health care.

306: Anxiety and Depression after Concussion (Mental Health mini-track) — Roni Robinson, RN, MSN, CRNP ​
Over the last 10 years, the topic of concussion has received a significant amount of attention in both the medical literature and lay media; despite this increased awareness, there is still significant confusion and controversy surrounding not just the definition of concussion, but also its diagnosis and management. The science behind the pathophysiology and lack of evidenced-based data contribute to this dilemma. Emerging evidence demonstrates that these increasingly more common injuries can lead to poor neurological outcomes and functional disabilities that adversely affect not only academics, but the social, behavioral and emotional aspects of quality of life. This presentation will review data from peer-reviewed literature that describes current state regarding mental health and concussion and will discuss why concussed youth are at an increased risk for anxiety, depression and suicide. Case studies will be used to demonstrate various ways mental health issues can present after concussion.
The NAPNAP Foundation is pleased to underwrite this educational opportunity.

307: Big Data in Behavioral Health (Developmental Behavioral mini-track) — Kimberly Erlich, MSN, RN, MPH, CPNP, PMHS ​
This presentation examines successful applications of big data to behavioral health (BH), using real-world case studies as a method for learning how big data can be used to benefit the BH of individuals and populations. Specific applications to be discussed include crowdsourcing and the use of social media to inform mental health screening and diagnosis, and the use of artificial intelligence in prevention, screening, diagnosis and treatment. The speaker explores benefits and challenges of using technology to gather data that could be applied to BH. This presentation is relevant for clinicians who care for anyone with BH needs, and also could be useful for primary care providers or others who work with adolescents (and their family members) who may already be unknowingly using or contributing to data sets that have the potential to impact BH.

308: Genetic Causes of Autism (Genetics and Genomics mini-track) — Sharon Anderson, DNP, NNP-BC, APNG​
Although an underlying genetic diagnosis may account for only a small percentage of individuals with autism, recognizing the clinical phenotype associated with a genetic etiology is imperative to offering genetic consultation, testing, recurrence risk and anticipatory guidance. This presentation will provide a brief overview of autism observed in the context of recognized syndromes and known causal genes. Common genetic causes of autism such as fragile X and rett syndromes and PTEN will be discussed.

309: Child Maltreatment Screening and Anticipatory Guidance (Maltreatment and Toxic Stress mini-track) — Gail Hornor, DNP, CPNP  and Pamela Herendeen, DNP, PPCNP-BC​
This concurrent session will discuss the importance of screening and anticipatory guidance for child maltreatment and its psychosocial risk factors. A variety of validated evidence-based screening tools for all forms of child maltreatment and its risk factors will be provided to participants. Indications for reporting child maltreatment will also be presented along with the concept of minimal facts interviewing of children and caregivers to provide child protective services with adequate information to investigate without traumatizing the child or the investigation.  

Noon-1:30 p.m. (1.0 contact hour) General Session Lunch - Preregistration and ticket required.

313: Vector-borne Infections in Children: A Moving "Target" — Karen Bloch, MD, MPH 
Participants will learn clinical features of arthropod-borne diseases relevant to practitioners in the United States.  Best practices for the diagnosis and treatment of tick and mosquito-borne diseases and recommended prevention practices to avoid infection domestically and among travelers will be discussed.
The session is sponsored by DEET Education Program.

1:40-2:55 p.m. (1.25 contact hours) Concurrent Sessions – Select Only One

314: Common Pediatric Respiratory Emergencies (AC) — Valarie Eichler, MSN, CPNP-PC/AC

315: Breastfeeding to Buffer Early Life Exposures to Toxic Stress (Breastfeeding mini-track) — Sunny Hallowell, PhD, PPCNP-BC, IBCLC ​
Numerous organizations including the American Academy of Nursing and the American Academy of Pediatrics have identified exposure to toxic stress in childhood as a public health policy concern of high priority. Alleviation of early exposures to toxic stress that may reduce the effects of adult diseases (e.g., obesity, diabetes, hypertension and cardiovascular disease) should be viewed as developmental disorders that begin early in life. Rich serve-and-return experiences shape brain architecture and develop when caregivers are sensitive and responsive to an infant’s signals and needs. From birth, feeding behaviors shared by parents and infants are fundamental serve-and-return relationships. This presentation highlights the novel idea that breastfeeding may be more than providing nutrition to an infant, rather an intervention to build fundamental parenting relationships that may mitigate the effects of toxic stress.

316: Pediatric Dyslipidemia (Rx) — Casey Elkins, DNP, NP-C, CLS, FNLA​
Pediatric primary healthcare providers are often the first primary healthcare point of contact for patients with dyslipidemia. Understanding the etiology, early pathophysiology and potential reversability of atherosclerosis in pediatric patients can have long lasting effects and significantly decrease the mortality of these patients. This presentation will review up-to-date, evidence-based lifestyle and pharmacotherapeutic management of risk factors in children and adolescents with dyslipidemia.

317: Scope, Role, Are You Underutilized? How to Evaluate NP role vs. Scope of Practice — Aimee Jennings, RN, MSN, PNP-AC/PC, Carmel A. McComiskey, DNP, PPCNP-BC, CPNP-AC, FAANP, FAAN , Joe Don Cavender, RN, MSN, CPNP-PC , April Kapu, DNP, APRN, ACNP- BC, FCCM, Stacy Krause, PA-C, Meredith Lahl-Foxx, MSN, MBA, APRN, PCNS-BC, PPCNP-BC, CPON,  Shannon Fitzgerald, ARNP, MSN and Jill Gilliland, MBA
Join this dynamic, interactive panel as we discuss scope of practice and utilization of Nurse Practitioners nationwide. We will review the results of five organizations to see the wide variations.  Then we will discuss building a business case for changing underutilized roles and adding new roles within an organization.

318: Suicide Prevention (Mental Health mini-track) — Naomi Schapiro, RN, PhD, CPNP and Shawna Sisler, MS, MAPP, RN, PHN, CPNP, PMHS​
Primary care providers are on the front lines in the evaluation and triage of suicidal children and adolescents. Given the limited access to specialized mental health care, it is critical for pediatric providers to make an informed judgment about referral to urgent versus emergency mental health services. This workshop will provide practice in applying nationally recognized algorithms to determine risk and protective factors, and developing safety plans for suicidal youth.
The NAPNAP Foundation is pleased to underwrite this educational opportunity.

319: Prematurity: Not Just for Infants Anymore (Developmental Behavioral mini-track) — Michelle Kelly, PhD, CRNP 
The U.S. preterm birth rate has ranged from 10-12 percent for the last 20 years, with the largest percentage of children born prematurely comprised of those born between 32-36 weeks of gestation, who experience low-severity, high-prevalence neurodevelopmental and special healthcare needs. This presentation will highlight the gap in healthcare provider and K-12 educator knowledge regarding current health and neurodevelopmental outcomes. Myths and misperceptions as well as an overview of current outcome research and National Survey of Children’s Health data will be presented. Recommendations for healthcare providers and educational professionals will be offered.

320: Integrating Genetics and Genomics into Practice (Genetics and Genomics mini-track) — Stephanie Offord, RN, MSN, FNP-BC, AGN-BC and Gina Lewis, MSN, PNP-C ​
In the era of precision based medicine, genomic discoveries hold the key for personalized health care, however most advanced practice nurses have not received formal education in genetics. A wide gap between advances in genetics and application into practice exists. Let’s review the fundamentals of genetics, jump into basics genetic testing and learn what all advanced practice providers should know about genetics at it relates to precision-based medicine.

321: The Assessment of Child Maltreatment (Maltreatment and Toxic Stress mini-track) — Pamela Herendeen, DNP, PPCNP-BC; Gail Hornor, DNP, CPNP and Katie Doughty, MS 
This presentation will include information on the assessment of physical abuse, sexual abuse, emotional abuse, medical child abuse and neglect. Mechanisms of injury management, diagnostic testing, examination of cases of medical child abuse that include covert video surveillance, and reporting tips will be included. Safety, supervision, medical and educational concepts will be discussed in terms of neglect.  ​

3:05-4:20 p.m. (1.25 contact hour) Concurrent Sessions – Select Only One

322: Manage These Cardiac Dsyrhythmias (AC) — Vanessa Kalis, DNP​
This presentation will be a case-based approach to cardiac dysrhythmias. Dysrhythmias to be examined include ectopic atrial tachycardia, supraventricular tachycardia, catecholaminergic polymorphic ventricular tachycardia and more. We will review EKGs, common clinical presentations, and discuss key ways to distinguish between dysrhythmias. Finally, evidence-based treatment will also be discussed.

323: Lactation Support in a Pediatric Primary Care Office (Breastfeeding mini-track) — Kristin McHarg, CPNP, IBCLC ​
Many new mothers receive breastfeeding support in the hospital, but lack follow up once they are discharged.  NPs in a pediatric office are uniquely qualified to provide that support; assessing the infant’s wellbeing and breastfeeding effectiveness at each visit. This session will discuss frameworks for creating a breastfeeding friendly office, various types of lactation training available, how to incorporate lactation into your busy schedule and how to bill and get reimbursed for the services you provide.

324: Asthma Essentials (Rx) — Tammy Rood, DNP, ​APRN, CPNP-PC, AE-C​​
This session will describe ways nurse practitioners can incorporate EPR-3 clinical guidelines for asthma, using EPR-3 tables to guide care decisions in asthma management. Participants will receive information on essential asthma tools to improve asthma care (digital flow meters to measure lung function and the In-Check Dial to assess/coach inhaler technique); age appropriate techniques to improve inhalation and delivery of inhaled medicines; key asthma messages to deliver to patients/families; and guidelines for reimbursement in asthma care. Participants will identify key action steps for improving asthma care and gain confidence to identify, assess and monitor their patients with asthma.

325: Cultivating Effective Pediatric Academic-Practice Partnerships — Anne Derouin, DNP, APRN, CPNP, FAANP​
This presentation will highlight evidence-based strategies, available resources and best practices that promote effective and sustainable academic-practice partnerships which ensure rewarding experiences for pediatric nurse practitioner learners while maintaining efficient and affordable clinical routine for both the Faculty and an expert preceptor. The presentation highlights outcomes of academic-practice partnerships from the three points of view (faculty/staff, clinical preceptor and learner) and suggests a road-map for faculty attendees who are interested in developing sustainable partnerships in their own communities.

326: Prevention of Substance Misuse and Addictive Disease (Mental Health mini-track) — ​Laura Searcy, MN, APRN, PPCNP-BC​ 
Substance misuse disorders represent one our nation’s most critical public health challenges; robbing people of life and health, and profoundly effecting families and communities. This presentation reviews the scope and consequences of the disease of addiction and the prevention, screening, early intervention and management of substance abuse disorders, and the unique vulnerability of youth to addictive disease. Key concepts from the Surgeon General’s Report “Facing Addiction in America” will be reviewed. The current opioid addiction epidemic will be discussed as it  illustrates deeper and more pervasive issues of attitudes, beliefs and behaviors as they relate to substance use and misuse. Pediatric APRNs  are uniquely positioned to apply this knowledge within healthcare practices and systems, and as healthcare experts in their communities.
The NAPNAP Foundation is pleased to underwrite this educational opportunity.

327: Assessment and Treatment of Infant Behavioral Health Problems (Developmental Behavioral mini-track) — ​Donna Hallas, PhD, CPNP, PMHS, FAANP
The best available evidence reveals that assessment for potential problems in mother-infant relationships at prenatal visits, delivery, and throughout early infancy are critical for the accurate diagnosis and treatment of infants with emotional and behavioral health problems to prevent life-long adverse outcomes for the infants. Current evidence reveals that infants may display clinically significant and emotionally harming behavioral health problems, however, these problems are often undiagnosed and subsequently untreated during infancy.  Furthermore, the lack of diagnosis and treatment during infancy is correlated to displays of aggressive behaviors during toddler and preschool years. This interactive presentation will use a problem-based teaching/learning framework to provide the requisite knowledge base for PNPs/FNPs to assess, diagnose and treat infants with emotional or behavioral problems by planning evidence-based, office-based interventions with the goal of identifying and improving the development of the infant’s emotional and behavioral health.

328: Congenital Disorders of the Newborn (Genetics and Genomics mini-track) — Jessica Peck, DNP, RN, MSN, CPNP-PC, CNE,CNL
According to the CDC (2017), congenital anomalies are the number one cause of mortality in infants under one year of age, accounting for 20 percent of all infant deaths. Because of the rapid advances being made in modern pediatric medicine, many of these disorders can be quickly abated by advances in surgical and/or medical therapies. Failure to accurately diagnose congenital diseases in a timely manner increases the risk of poor long-term outcomes, intellectual and/or physical disability, and death. Of most critical relevance, the explosion of knowledge and technology in the field of genomics has dramatically changed the lens with which APRNs diagnose and manage medical conditions. This session will review advanced physical assessment skills and screenings available to identify common congenital anomalies with genomic implications.

329: Toxic Stress and the Developing Brain (Maltreatment and Toxic Stress mini-track) — Linda Frye, PhD, RN, CPNP
Lecture, discussion and case presentation will be used to define toxic stress, including examples of stress and how it can become toxic. The increasing prevalence and number of children at risk for toxic stress will be presented. The effects of toxic stress from the prenatal stage through adolescence will be discussed. Methods to identify toxic stress and critical interventions will be presented.

4:30-6 p.m. (1.5 contact hours)

330: Case Studies in Acute Care Acid-Base and Fluid Derangements (AC) — Jennifer Joiner, MSN, CPNP-AC/PC and Heather Herrera, MSN, RN, CPNP-AC/PC​
It is imperative that acute care pediatric nurse practitioners provide thoughtful and careful fluid and electrolyte replacement therapies to our young, and in many cases very fragile children. This discussion will review acid-base balance, gap/non gap acidosis, MUDPILES, and fluid calculations in relation to pediatric critical care. Three case studies will then be reviewed, each with their own unique acid-base balance disturbances that required vigilant care and thoughtful management strategies. Acute care pediatric nurse practitioners won’t get lost in the MUD as they sort through PILES of data to best treat their critically ill patient with fluid and electrolyte disturbances.

4:30-5:30 p.m. (1.0 contact hour) Concurrent Sessions – Select Only One

331: The 10th Month of Pregnancy: Supporting Breastfeeding in the Early Days (Breastfeeding mini-track) — Mary Ryngaert, MSN, ARNP, IBCLC ​
The challenges that come with welcoming a new baby are significant watershed moments in a family’s life. Caring for the newborn along with recuperating from pregnancy and delivery can make learning how to breastfeed especially challenging. Pediatric nurse practitioners can make the difference for families who choose to breastfeed. Let's talk about how to assist families to navigate this important time and meet their breastfeeding goals.

332: Periodic Fevers in Children (Rx) — Betsy Roth-Wojcicki, MS, CPNP​
When fevers reoccur in healthy children and persist on almost a monthly basis without an infectious cause pediatric nurse practitioners and their physician colleagues are often at a loss. Over time parents miss work, children miss school and visits to a primary care offices become frustrating because no definitive source for the fever is identified. This presentation will address the common periodic fevers syndrome to include: PFAPA, FMF, HIDS, MWS and TRAPS. Common presenting symptoms for each of the periodic fever syndromes will be addressed along with how the pediatric nurse practitioner can start the initial workup in the primary care office. Suggestion of when to refer to Rheumatology will be discussed along with current treatment plans.

333: The Impact of Childhood Poverty: Screening & Advocacy for the NP — ​Pamela Herendeen, DNP, PPCNP-BC
This presentation will review a variety of evidence-based screening tools and assessment strategies to assist the NP in the identification of children and families living in poverty.  As health care is re-examining methods to improve care and reduce costs; there will be opportunities to restructure our health care system that will enhance our care for children and families that live in poverty.  Advocacy efforts will include public policy, medical homes, behavioral health integration, building on family strengths, community awareness/education and other specific interventions for our families.​

334: Carving Through the Issues of Self-harm (Mental Health mini-track) — Dana DeShon, DNP, APN, CPNP-PC ​
Non-suicidal self-injury (NSSI) has become an ever increasing mental health problem over the last decade. Sports check-ups, well exams, and illnesses bring patients into primary care offices. It is during these visits that visual signs of NSSI can be recognized either voluntarily or by physical assessment. Identifying with the patient and probing further is warranted for the future safety of the pre-teen/adolescent. Brief action planning and offering pharmacological and non-pharmacological techniques are tools that can be used within primary care with a pre-teen/ adolescent with NSSI.
The NAPNAP Foundation is pleased to underwrite this educational opportunity.

335: Understanding and Advocating for Children with Learning Disorders (Developmental Behavioral mini-track) — Catharine Critz, PhD, CPNP, PMHS, APRN-Rx​ 
Learning challenges are often a concern raised in pediatric office visits, yet providers often lack understanding of learning differences. This presentation will focus on the diagnostic criteria for specific learning disorders, the elements of a learning evaluation, how to interpret evaluation results and best practices for advocating for children with learning differences within the educational system.

336: Mucopolysaccharidosis: Keys to Early Recognition and Intervention (Genetics and Genomics mini-track) — Lindsay Torrice, MSN, CPNP-PC
Mucopolysaccharidoses (MPS) is a group of rare inherited lysosomal storage disorders with devastating progressive physical and/or neurological symptoms, generally resulting in limited life expectancy.  Treatments are available for some forms of the disorder, although current therapies are most effective at preventing disease progression rather than reversing symptoms.  Therefore, early detection and intervention are imperative.  Due to the array of possible presentations, a child with MPS may not receive diagnosis until 1 to 3 years of age or older, although clinical symptoms can be present as early as age 4 to 6 months in the more severe forms of the disorders. Clinical suspicion is of utmost importance in recognizing possible features of these disorders and initiating evaluation and specialist referral.​

337: Trauma Informed Care (Maltreatment and Toxic Stress mini-track) — Linda Frye, PhD, RN, CPNP
This presentation will include lecture, discussion, and case presentations to define trauma, traumatic experiences, the influence of trauma on the physical and mental health of the victim, and the long-term effects of trauma. Current information on the number of children experiencing or at risk for trauma will be discussed. Incorporating trauma informed care into practice and critical interventions will be included.
E-Chapter is pleased to support this session.

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