L
Ma
y
1
4- is v uc ow t 17 n i l e le ,2 K iot t D 014 L o uis ville M arr
2014
k
ow
y n
ou
nt
Photos Courtesy of Louisville Convention & Visitors Bureau
Photos Courtesy of Louisville Convention & Visitors Bureau
PENS
NAL CONFERENCE O I T A N
REGISTRATION BROCHURE
2014 NATIONAL CONFERENCE
2
REGISTRATION BROCHURE
Purpose
Program Objectives
The Pediatric Endocrinology Nursing Society (PENS) is committed to the advancement of the art and science of pediatric endocrinology nursing. This includes the establishment and continued development of standards of practice, the enhancement of nursing research, the advancement of clinical expertise and the promotion of recognition of excellence in nursing practice.
■■ Develop new skills to improve educational and patient outcomes
Program Description The National Conference provides a forum for educational opportunities as well as a chance to interact with colleagues and experts in the field of pediatric endocrinology. The faculty will present information on a variety of pediatric endocrine disorders, as well as topics of general interest to nurses and other health care professionals. Teaching methods will include lectures, interactive sessions, discussions, workshops and poster sessions
■■ 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 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
Accreditation This activity has been submitted to the Ohio Nurses Association (OBN-001-91) for approval to award contact hours. The Ohio Nurses Association is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
Target Audience
In order to receive contact hours for this conference, participants must complete the evaluation.
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.
Networking
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.
The key benefit of attending the PENS Conference is the opportunity to develop relationships with your colleagues through networking. 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 discovering that others 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.
PENS Conference Planning Committee
Message Board
Tamara Nenadovich, RN, Chair Kelly DeGrote, RN Maryann Johnson, BSN, RN Meg Keil, PhD, CRNP Cheryl Switzer, MSN, RN, CPNP, CDE Valerie Verdia, RN Cathy Metzinger, AAS, RN, CDE, Board Liaison
PENS will provide a message board to facilitate networking. Bring your questions and ideas to post for response by your colleagues. If you have a special interest, arrange to meet others with that same interest. Participants are encouraged to post job listings as well.
Posters In 2014, PENS is offering participants poster presentations to view and discuss on Thursday evening. Visit with the poster presenters and learn about current research that will affect your clinical practice!
2014 NATIONAL CONFERENCE
3
REGISTRATION BROCHURE
Hotel Information
Registration Information Early Registration: On or before March 13, 2014 Regular Registration: Between March 14 and April 21, 2014 Onsite Registration: After April 21, 2014 You will receive a confirmation letter approximately two weeks after receipt of your registration form. Confirmation letters will not be sent after April 21, 2014. Payment must accompany the registration form. Registration forms received without payment will not be processed until payment is received. Registration fees include educational program, networking events and all meal functions.
Louisville Marriott Downtown 280 West Jefferson St. Louisville, KY 40202 800-533-0127 502-627-5045 The newly renovated Louisville Marriott Downtown Hotel is ideally suited for a fantastic National Conference. This four-diamond hotel recently received the 2014 Excellent Award by TripAdvisor®. Guests will enjoy the close proximity to attractions such as the KFC YUM Center and Fourth Street Live!, a popular dining and entertainment district just steps away from the hotel. The historic Main Street and the famous cuisine district NuLu are both a short walk away. As this city is best known for the Kentucky Derby, just a short ride away one can visit Churchill Downs – home of the Kentucky Derby, Kentucky Oaks and the Breeder’s Cup Racing.
Cancellation & Transfers Cancellations and transfers must be requested in writing and postmarked, faxed or emailed by April 21, 2014. Refunds will be issued following the conference. A $50 administrative fee will be assessed. Cancellation requests must include the reason for the cancellation. If you transfer your registration to another person, please include a completed registration form for that person with your written request. Requests for cancellation postmarked, emailed or faxed after April 21, 2014, are not refundable.
Room rate: $164 plus tax per night single/double occupancy Reservation deadline: Book by Monday, April 21, 2014, to receive the group room rate. Visit http://bit.ly/KoHC05 to reserve your room online. If you need additional reservation assistance, please call 1-800-266-9432.
Taxi: Taxis are approximately $18 one-way.
ou
L
The Louisville Marriott Downtown hotel is located 8 miles from the Louisville International Airport (SDF).
NAL CONFERENCE O I T A N is v
2014
ill e
PENS Exhibitor Hotline 877-936-7367 – www.pens.org
k
y
Transportation Information
K
uc ent
2014 NATIONAL CONFERENCE
4
Conference Program Schedule Tuesday, May 13, 2014 5:00 p.m. – 8:00 p.m.
Registration
5:00 p.m. – 6:00 p.m.
New Member/First Time Attendee Reception
Wednesday, May 14, 2014 8:00 a.m. – 5:00 p.m.
Registration
8:00 a.m. – 9:00 a.m.
Breakfast
9:00 a.m. – 9:15 a.m.
Welcome & Opening Remarks Catherine Metzinger, AAS, RN, CDE – President
9:15 a.m. – 10:15 a.m.
Keynote Address: Building a Cohesive Leadership Team Deanna Philpot, Senior Consultant, People Strategy Consulting, LLC
10:15 a.m. – 10:30 a.m.
Break
10:30 a.m. – 12:30 p.m. Basic Endocrine CONCURRENT SESSION 1A – Endocrine Case Presentations A Young Girl with Type 1 Diabetes, Hypothyroidism, & Now, Adrenal Insufficiency At the end of this session, participants will be able to: Describe the association between diabetes and adrenal insufficiency Identify two symptoms of adrenal insufficiency expected in a person with Type 1 diabetes Discuss the treatment of adrenal insufficiency Describe the role of the nurse practitioner in managing the care of a person with Type 1 diabetes, hypothyroidism and adrenal insufficiency Endocrine Issues with Shprintzen-Goldberg Syndrome At the end of this session, participants will be able to: Discuss the definition and evaluation of precocious puberty Name at least two treatment options for precocious puberty Endocrine Case Study At the end of this session, participants will be able to: Develop a list of possible differential diagnoses which have these presenting signs and symptoms Identify possible lab and other studies which would be needed to help identify the correct diagnosis Identify current management modalities used for the identified diagnosis The Complex World of Hormone Excess – Severe Cushings in an Adolescent Female At the end of this session, participants will be able to: Describe the clinical phenotype of Cushing syndrome Provide an overview of the evaluation of a child with Cushing syndrome Discuss nursing management of comorbidities of Cushing syndrome
Patty Graves, RN, CPNP, CDE
Mako E. Sather, RN, MSN, CPNP
Nancy Ann Varni, CPNP, MS, MBA
Judith Lowitz, RN, CPN; Meg Keil, PhD, CRNP, NICHD
10:30 a.m. – 12:30 p.m. Diabetes CONCURRENT SESSION 1B – Diabetes Case Presentations Growth Failure Preceding Onset of Type 1 Diabetes: Drowning in Differential Diagnoses At the end of this session, participants will be able to: Identify the onset of the child’s growth failure List the physiologic causes of growth failure Describe how psychosocial issues impact on growth KM: 11-Year-Old with Type I Diabetes, Graves Disease, Vitilgo & Epilepsy with History of Premature Adrenarche At the end of this session, participants will be able to: Identify the link between autoimmune disease and Type I diabetes Identify stressors associated with management of Type I diabetes Identify why insulin pump therapy may be beneficial for children
REGISTRATION BROCHURE
Terri Lipman, PhD, CRNP, FAAN
Karen Bucci, MSN, PNP-BC, APRN, CDE
2014 NATIONAL CONFERENCE
5
10:30 a.m. – 12:30 p.m. Diabetes
continued
Co-morbidities of the Noncompliant Patient with Type 1 Diabetes At the end of this session, participants will be able to: Identify two comorbidities associated with noncompliant Type 1 diabetic patients Screen for two comorbidities related to noncompliant Type 1 diabetic patients He Has Diabetes? Are You Sure? At the end of this session, participants will be able to: Review the differential diagnosis for hyperglycemia and diabetes Name the laboratory tests used to confirm the diagnosis of diabetes Name the tests used to differentiate between Type 1 and Type 2 diabetes 12:30 p.m. – 2:00 p.m.
Maureen Dever, MSN, PNP-BC, CDE
Cheryl Switzer, MSN, RN, CPNP, CDE
Leadership Luncheon
2:00 p.m. – 3:00 p.m. GENERAL SESSION 2 – Thyroid: Diagnosis, Treatment & Management of Various Thyroid Disorders At the end of this session, participants will be able to: Discuss the pathophysiology of hypothalamic-pituitary-gonadal axis Describe the diagnosis of precocious and delayed puberty Describe treatment options for both precocious and delayed puberty
Pisit Pitukcheewanont, MD
3:00 p.m. – 5:00 p.m. Basic Endocrine CONCURRENT SESSION 2A – Endocrine Case Presentations A Young Girl with Type 1 Diabetes, Hypothyroidism, & Now, Adrenal Insufficiency At the end of this session, participants will be able to: Describe the association between diabetes and adrenal insufficiency Identify two symptoms of adrenal insufficiency expected in a person with Type 1 diabetes Discuss the treatment of adrenal insufficiency Describe the role of the nurse practitioner in managing the care of a person with Type 1 diabetes, hypothyroidism and adrenal insufficiency Endocrine Issues with Shprintzen-Goldberg Syndrome At the end of this session, participants will be able to: Discuss the definition and evaluation of precocious puberty Name at least two treatment options for precocious puberty Endocrine Case Study At the end of this session, participants will be able to: Develop a list of possible differential diagnoses which have these presenting signs and symptoms Identify possible lab and other studies which would be needed to help identify the correct diagnosis Identify current management modalities used for the identified diagnosis The Complex World of Hormone Excess – Severe Cushings in an Adolescent Female At the end of this session, participants will be able to: Describe the clinical phenotype of Cushing syndrome Provide an overview of the evaluation of a child with Cushing syndrome Discuss nursing management of comorbidities of Cushing syndrome
REGISTRATION BROCHURE
Patty Graves, RN, CPNP, CDE
Mako E. Sather, RN, MSN, CPNP
Nancy Ann Varni, CPNP, MS, MBA
Judith Lowitz, RN, CPN; Meg Keil, PhD, CRNP, NICHD
2014 NATIONAL CONFERENCE
6
3:00 p.m. – 5:00 p.m. Diabetes CONCURRENT SESSION 2B – Diabetes Case Presentations Growth Failure Preceding Onset of Type 1 Diabetes: Drowning in Differential Diagnoses At the end of this session, participants will be able to: Identify the onset of the child’s growth failure List the physiologic causes of growth failure Describe how psychosocial issues impact on growth KM: 11-Year-Old with Type I Diabetes, Graves Disease, Vitilgo & Epilepsy with History of Premature Adrenarche At the end of this session, participants will be able to: Identify the link between autoimmune disease and Type I diabetes Identify stressors associated with management of Type I diabetes Identify why insulin pump therapy may be beneficial for children Co-morbities of the Noncompliant Patient with Type 1 Diabetes At the end of this session, participants will be able to: Identify two comorbities associated with noncompliant Type 1 diabetic datients Screen for two comorbidities related to noncompliant Type 1 diabetic patients He Has Diabetes? Are You Sure? At the end of this session, participants will be able to: Review the differential diagnosis for hyperglycemia and diabetes Name the laboratory tests used to confirm the diagnosis of diabetes Name the tests used to differentiate between Type 1 and Type 2 diabetes 5:30 p.m. – 7:30 p.m.
Terri Lipman, PhD, CRNP, FAAN
Karen Bucci, MSN, PNP-BC, APRN, CDE
Maureen Dever, MSN, PNP-BC, CDE Cheryl Switzer, MSN, RN, CPNP, CDE
Welcome Reception – Exhibit Hall
Thursday, May 15, 2014 7:00 a.m. – 9:00 a.m.
Poster Set-Up
7:00 a.m. – 4:30 p.m. Registration 7:45 a.m. – 8:45 a.m. BREAKFAST SESSION – An Overview of Growth Assessment & the Endocrine System At the end of this session, participants will be able to: Utilize tools of growth assessment Recognize the common feedback loops of endocrinology and the difference between primary and secondary endocrine disorders Review endocrine causes of abnormal growth State two endocrine causes of abnormal growth
Colleen Weber, RN, BSN
9:00 a.m. – 10:00 a.m. GENERAL SESSION 3 – Traumatic Brain Injury-Related Endocrinopathies At the end of this session, participants will be able to: Review normal physiology and the mechanism of TBI Review the literature in adults: incidence, time of onset, when to screen and intervene Review the literature in children: incidence, time of onset, when to screen and intervene Discuss the variability in the literature and incidence of abnormalities based on limitation in each reference
Kent Reifschneider, MD
10:00 a.m. – 11:00 a.m. GENERAL SESSION 4 – Diabetes Care & Education: History & Progress At the end of this session, participants will be able to: Describe the inception and history of diabetes education Identify technologic difficulties and progression steps for the treatment of diabetes Describe the heritage and direction of diabetes education 11:00 a.m. – 11:25 a.m. Break in the Exhibit Hall
REGISTRATION BROCHURE
Jean Roemer, MSN, MN, CPNP, CDE
2014 NATIONAL CONFERENCE
7
11:30 a.m. – 12:30 p.m. GENERAL SESSION 5 – Endocrine Care for Transgender Adolescents: A Field in Transition At the end of this session, participants will be able to: Discuss the diagnostic criteria and evaluation methods used in diagnosis of gender dysphoria (GD) Discuss different treatment approaches to GD Review barriers to care for this population Describe specifics regarding medications and procedures used to treat GD in adolescence, including indications, side effects and anticipatory guidance 12:30 p.m. – 2:00 p.m.
Daniel Shumer, MD
Lunch with Exhibitors
2:00 p.m. – 3:00 p.m. Basic Endocrine CONCURRENT SESSION 3A – What to Expect from an Endocrine Visit At the end of this session, participants will be able to: Describe the endocrine visit evaluation process Explain potential diagnostic testing Describe implications for care and treatment of patients and families with endocrine disorders List key points of education for patients and families with endocrine disorders
Maryann Johnson, BSN, RN, MEd
2:00 p.m. – 3:00 p.m. Advanced Practice CONCURRENT SESSION 3B – Tale of Two Trans Moms: This Isn’t Your Mother’s Child Rearing Experience At the end of this session, participants will be able to: Describe the criticality of the situation of transgendered individuals and their families Identify what these transgendered patients and their families are looking for from you Discuss transgender 101 basics to increase your knowledge base and be better informed to better support your transgendered patients and their families
Carolyn Riley; Denise Ridenour
2:00 p.m. – 3:00 p.m. Diabetes CONCURRENT SESSION 3C – Diabetes Management: Is There a Place for Social Media & e-Learning? At the end of this session, participants will be able to: Define the history of electronic tools in the use of diabetes education and information dissemination Discuss electronic tools for diabetes management and information dissemination that exist now Discuss the use of social media as a way to reach families whose children have diabetes Define the steps that a center would take to develop the use of electronic tools and social media as a means to reach patients
Melissa Andrews Rearson, MSN, CRNP
3:05 p.m. – 4:05 p.m. Basic Endocrine CONCURRENT SESSION 4A – Roadmaps in the Management of Sex Chromosome Aneuploidies (SCA) At the end of this session, participants will be able to: Review evidence on what is known about the presentation of sex chromosome aneuploidy in children including 47 XXY, 47 XYY, 47 XXX, 48 XXXY and 49 XXXXY Discuss the needs of patients and their families Review bioethical considerations when counseling patients and their families Describe how nurses in endocrine practice can play a more active role in the management of care for SCA-affected children
Sharron Close, PhD, MS, CPNP-PC
3:05 p.m. – 4:05 p.m. Advanced Practice CONCURRENT SESSION 4B – Bone Age Interpretation: How Well Do You ‘Read’? At the end of this session, participants will be able to: Define two conditions that exhibit abnormal findings in a Bone Age (BA) film Define delayed, normal and advanced bone age reading Define the physical differences between open and closed epiphyses on a BA film
REGISTRATION BROCHURE
Fran L. Waite, RN
2014 NATIONAL CONFERENCE
8
3:05 p.m. – 4:05 p.m. Diabetes CONCURRENT SESSION 4C – Emerging Adulthood & the Transition of Care At the end of this session, participants will be able to: Review timing considerations for transition from pediatric to adult- centered care Identify challenges faced by the emerging adult with T1DM Describe ways to create a successful transition from pediatric- to adult-centered care Discuss key factors that should be considered when developing a transition-in-care program Provide information on helpful resources for transitioning care 4:00 p.m. – 6:30 p.m.
Exhibit Hall Open
4:30 p.m. – 6:30 p.m.
Poster Session/Reception
7:30 p.m. – 10:30 p.m.
Evening Event
Jean Roemer, MSN, MN, CPNP, CDE
Friday, May 16, 2014 8:00 a.m. – 3:00 p.m.
Registration
8:00 a.m. – 9:00 a.m.
Breakfast
9:00 a.m. – 10:00 a.m. GENERAL SESSION 6 – Can I Draw You a Picture? Using Art Therapy to Gain Insight At the end of this session, participants will be able to: Recall two art therapy assessments used to gain insight about the patient Identify two art therapy interventions utilized with pediatric endocrine patients Participate in creating an art piece related to coping with body image changes
Elizabeth Sanders Martin, LPCC, LPAT, ATR-BC, CCLS
10:05 a.m. – 11:05 a.m. GENERAL SESSION 7 – Glycogen Storage Disease: What You Need to Know about This Rare Condition At the end of this session, participants will be able to: Identify the enzyme deficient in Glycogen Storage Disease (GSD) Type I, and describe the biochemical abnormalities that occur in this disorder Discuss why patients with other types of GSD develop ketotic hypoglycemia Describe the treatment of glycogen storage disease Identify long-term complications of glycogen storage disease, and that most or all can be avoided with appropriate treatment and good metabolic control Discuss recent advances in research and future directions
Laurie Tsilianidis, MD
11:05 a.m. – 11:15 a.m. Break 11:15 a.m. – 12:00 p.m. GENERAL SESSION 8 – Parent Health Literacy and Communication with Diabetes Educators in a Pediatric Diabetes Clinic: a Mixed Methods Approach At the end of this session, participants will be able to: Describe current research trends in health literacy Discuss lifestyle management options for the Klinefelter patient and family 12:00 p.m. – 1:15 p.m.
Awards & Membership Meeting Luncheon
REGISTRATION BROCHURE
Sharron Close PhD, MS, RN, CPNP-PC; Carol J. Howe, PhD, RN, CDE
2014 NATIONAL CONFERENCE
9
1:30 p.m. – 2:30 p.m. Basic Endocrine CONCURRENT SESSION 5A – Identification & Problem Solving for Patient Dissatisfaction At the end of this session, participants will be able to: Describe the endocrine visit evaluation process Explain potential diagnostic testing Describe implications for care and treatment of patients and families with endocrine disorders List key points of education for patients and families with endocrine disorders
Maryann Johnson, BSN, RN, MEd
1:30 p.m. – 2:30 p.m. Advanced Practice CONCURRENT SESSION 5B – Tale of Two Trans Moms: This Isn’t Your Mother’s Child Rearing Experience At the end of this session, participants will be able to: Describe the criticality of the situation of transgendered individuals and their families Identify what these transgendered patients and their families are looking for from you Discuss transgender 101 basics to increase your knowledge base and be better informed to better support your transgendered patients and their families
Carolyn Riley; Denise Ridenour
1:30 p.m. – 2:30 p.m. Diabetes CONCURRENT SESSION 5C – Deciphering the Numbers: Diabetes Management Using Electronic Tools At the end of this session, participants will be able to: Discuss strategies for obtaining diabetes management information from blood glucose meters, insulin pumps and continuous glucose monitors in the clinic setting Discuss data interpretation and its role in evaluating daily diabetes management Review how data management using electronic tools can be essential in diabetes management
Melissa Andrews Rearson, MSN, CRNP
2:35 p.m. – 3:35 p.m. Basic Endocrine CONCURRENT SESSION 6A – Writing for Publication At the end of this session, participants will be able to: List knowledge and skills necessary for writing for newsletters, journals and other nursing-related publications State the significance of an editorial query Describe the steps to integrate the levels of the editorial process List appropriate topics for submission based on the type of article and the proposed audience
Terri Lipman, PhD, CRNP, FAAN; Cecily Betz, PhD, RN, FAAN
2:35 p.m. – 3:35 p.m. Advanced CONCURRENT SESSION 6B – Hypoglycemia: Symptom or Diagnosis? At the end of this session, participants will be able to: Discuss how hypoglycemia is defined Describe the differential diagnosis of hypoglycemia in a neonate and child Discuss diagnostic testing for hypoglycemia Discuss congenital hyperinsulinism Identify the various treatment options available for each disorder of hypoglycemia, including hyperinsulinism
Amanda Lee, MSN, CRNP
2:35 p.m. – 3:35 p.m. Diabetes CONCURRENT SESSION 6C – Accurate Carbohydrate Counting & Using Insulin to Carbohydrate Ratios At the end of this session, participants will be able to: Define carbohydrate counting Determine the grams of carbohydrate in foods using the nutritional food label and other carbohydrate-counting resources Utilize insulin to carbohydrate ratios 3:35 p.m. – 7:00 p.m.
Networking/Free Time
3:45 p.m. – 5:15 p.m.
Committee Meetings Education Committee Research Committee Nominating Committee Conference Planning Committee
7:00 p.m. – 10:00 p.m.
Evening Event
REGISTRATION BROCHURE
Anna Maria Bertorelli, MBA, RD, LDN, CDE
2014 NATIONAL CONFERENCE
10
Saturday, May 17, 2014 8:00 a.m. – 1:00 p.m.
Registration
8:00 a.m. – 9:00 a.m.
Breakfast
9:00 a.m. – 10:00 a.m. GENERAL SESSION 9 – Adrenal Insufficiency: Fix It before It Breaks At the end of this session, participants will be able to: Discuss the presentation of acute and chronic adrenal insufficiency Provide an overview of adrenal physiology as it relates to adrenal insufficiency Categorize the causes of adrenal insufficiency in childhood into a logical differential diagnosis Provide a rational approach to the prevention and treatment of adrenal insufficiencies
Mitchell E. Geffner, MD
10:15 a.m. – 11:15 a.m. Basic Endocrine CONCURRENT SESSION 7A – Creating Endocrine Education Materials for Patients & Families At the end of this session, participants will be able to: Discuss the process of creating an endocrine teaching curriculum and resulting patient/parent education materials
Michelle Lawrence, RN, MSN; Diana Swisshelm, RN, BSN; Lori Casnellie, RN; Anne Planicka RN, CPN; Pamela Burwinkel, RN, BSN
10:15 a.m. – 11:15 a.m. Advanced Practice CONCURRENT SESSION 7B – Androgen Replacement Therapy Options & Dose Titration in Hypogonadal Male Adolescents At the end of this session, participants will be able to: Identify causes of hypogonadism in adolescent males Discuss dose initiation of androgen replacement therapy and titration of doses
Kevin Lewis, PNP, APRN
10:15 a.m. – 11:15 a.m. Diabetes CONCURRENT SESSION 7C – Pediatric Diabetes: A Developmental Approach At the end of this session, participants will be able to: Review human growth and variants Discuss the large for gestational age (LGA) infant Explore constitutional tall stature Review growth hormone excess and common genetic syndromes associated with tall stature 11:30 a.m. – 12:30 p.m.
Lunch/Closing Speaker – Compassion Fatigue: The Personal Toll in Difficult Times Donna White, BSN, MSN
12:30 p.m. – 12:45 p.m.
Closing Remarks
Shari Liesch, MSN, APNP, CDE
Photos Courtesy of Louisville Convention & Visitors Bureau and Dan Dry
REGISTRATION BROCHURE
PENS 2014 NATIONAL CONFERENCE REGISTRATION FORM
11
PENS Executive Office, P.O. Box 14516, Lenexa, KS 66285-4516 Fax 913-895-4652 Register Online: www.pens.org Final registration deadline is April 21, 2014. If you are registering after April 21, please bring your completed paperwork and payment with you to the conference.
STEP ONE: Registration Information First Name
M .I.
Credentials (LIST 2 ONLY)
Last Name
Employer
Home Work Preferred Address – please indicate home or work City
State
Daytime Telephone Number
Zip
Country
Fax
E-mail Address
SPECIAL NEEDS I will need assistance:___________________________________________________ I have the following dietary requirements: Gluten Free Vegetarian
Vegan Other:____________________________
Session 1 Session 2 Session 3 Session 4 Session 5 Session 6 Session 7 A A A A A A A B B B B B B B C C C C C
EMERGENCY CONTACT INFORMATION Name Relationship
D. RSVP! Please indicate which concurrent sessions you are interested in attending. Your assistance will help us assign each speaker to an appropriately sized room. Please check one session letter for each column.
Phone Number
Please indicate which functions you will be attending:
This is my first PENS conference.
Tuesday, May 13
Do not provide my contact information on vendor lists or on the
New Member/First-Time Attendee Reception
pre-registration attendee roster.
STEP TWO: Registration A. Full Conference Registration On or Between After 4/21 before 3/13 3/14 & 4/21 (on-site)
Member Non-Member
$450 $575
$525 $650
$675 $800 0 Section A Total: __________
B. Single Day Registration Check desired day: Wednesday Thursday Member $200 Non-Member $325
Friday
Wednesday, May 14 Breakfast Lunch Session Welcome Reception
Thursday, May 15 Breakfast Session Lunch with Exhibitors Poster Reception Evening Event
Friday, May 16 Breakfast Awards & Membership Lunch Evening Event
Saturday, May 17 Breakfast Lunch Session
Saturday Cancellations & Transfers 0 Section B Total: __________
C. Spouse/Guest Registration (only includes evening events of Thursday and Friday) _____ Spouse/Guest $200 (if you register for both, or $125 each for Thursday or Friday) My Guest will be attending the evening event on: Thursday Friday Guest Name(s): 0 Section C Total: __________
Cancellations and transfers must be requested in writing and postmarked, faxed or emailed by April 21, 2014. Refunds will be issued following the conference. A $50 administrative fee will be assessed. Cancellation requests must include the reason for the cancellation. If you transfer your registration to another person, please include a completed registration form for that person with your written request. Requests for cancellation postmarked, emailed or faxed after April 21 are not refundable. If you register after April 21, please bring your registration form and payment with you to the conference as it WILL NOT be processed at the PENS Executive Office after that date.
12
PENS 2014 NATIONAL CONFERENCE REGISTRATION FORM, continued STEP THREE: Total Fees Enclosed A. Full Conference Registration
0 $____________
B. Single Day Registration
0 $____________
C. Spouse/Guest Registration
0 $____________
0 TOTAL ENCLOSED: $____________ All fees must be paid in U.S. dollars, with checks drawn in U.S. funds on U.S. banks. Purchase orders are NOT accepted.
Check (made payable to PENS)
PENS Tax ID: 38-2757646
Register online at www.pens.org.
American Express MasterCard Visa Discover Card Number Expiration Date Cardholder Name Cardholder Signature
Please return this form with the TOTAL AMOUNT DUE to: Register online at: www.pens.org By Mail: PENS P.O. Box 14516 Lenexa, KS 66285-4516
By Overnight Courier ONLY: PENS 18000 W. 105th St. Olathe, KS 66061
By Fax (with credit card information): 913-895-4652
Contact the PENS Executive Office for further information: 913-895-4628.
2014 NATIONAL CONFERENCE
13
REGISTRATION BROCHURE
Faculty Listing Daniel Shumer, MD Clinical Fellow in Endocrinology Boston Children’s Hospital, Division of Endocrinology Boston, Mass.
Melissa Andrews Rearson, MSN, CRNP Pediatric Nurse Practitioner Children’s Hospital of Philadelphia Philadelphia, Pa.
Patty Graves, RN, CPNP, CDE Pediatric Nurse Practitioner Central Ohio Pediatric Endocrinology and Diabetes Services Columbus, Ohio
Cecily Betz, PhD, RN, FAAN Associate Clinical Professor of Pediatrics University of Southern California Los Angeles, Calif.
Maryann Johnson, BSN, RN, MEd Denise Ridenour Pediatric Endocrine Clinic Nurse Zelienople, Pa. Hasbro Children’s Hospital Providence, R.I. Carolyn Riley Zelienople, Pa. Michelle Lawrence, RN, MSN Education Specialist II Jean Roemer, MSN, MN, CPNP, Cincinnati Children’s Hospital CDE Medical Center, Division of Pediatric Nurse Practitioner Endocrinology Childrens Hospital of Pittsburgh Cincinnati, Ohio – UPMC Pittsburgh, Pa. Amanda Lee, MSN, CRNP Pediatric Nurse Practitioner Elizabeth Sanders Martin, LPCC, Children’s Hospital of LPAT, ATR-BC, CCLS Philadelphia Expressive Art Therapist Philadelphia, Pa. Kosair Children’s Hospital Louisville, Ky. Kevin Lewis, PNP, APRN Clinical Assistant Professor Mako Sather RN, MSN, CPNP West Virginia University, Nurse Practitioner Department of Pediatrics Rocky Mountain Pediatric Charleston, W.Va. Endocrinology Littleton, Colo. Shari Liesch, MSN, APNP, CDE Nurse Practitioner/Certified Diabetes Educator Children’s Hospital of Wisconsin Neenah, Wis.
Lisa Davis, MSN, CNP Pediatric Endocrinology Nurse Practitioner Akron Children’s Hospital Akron, Ohio Maureen Dever, MSN, PNP-BC, CDE Pediatric Endocrine/Diabetes Nurse Practitioner St. Christopher’s Hospital for Children Philadelphia, Pa.
Fran Waite, RN Endocrine Regional Clinical Coordinator Genentech Cary, N.C. Colleen Weber, RN, BSN Clinical Coordinator Genentech St. Louis, Mo. Donna White, BSN, MSN Addiction Specialist Lemuel Shattuck Hospital Boston, Mass.
PENS
Judith Lowitz, RN, CPN Clinical Research Nurse National Institutes of Health Rockville, Md. Deanna Philpot People Strategy Consulting Louisville, Ky. Pisit Pitukcheewanont, MD Associate Professor of Pediatrics Children’s Hospital, Los Angeles Los Angeles, Calif.
NAL CONFERENCE NATIO ou
2014
k
4- is v uc w 17 e n t tt D o , 2 ill e K 014 io L o uis ville M arr
L
Ma
y
Mitchell Geffner, MD Professor of Pediatrics, Keck School of Medicine; Chief Division of Endocrinology, Diabetes, and Metabolism Children’s Hospital Los Angeles Los Angeles, Calif.
Terri Lipman, PhD, CRNP, FAAN Associate Professor University of Pennsylvania Philadelphia, Pa.
Nancy Ann Varni, CPNP, MS, MBA Endocrine Nurse Practitioner CHOC Children’s Hospital Costa Mesa, Calif.
n
Sharron Close, PhD, MS, CPNP-PC Clinical Instructor Columbia University School of Nursing New York, N.Y.
Laurie Tsilianidis, MD Associate Staff, Pediatric Endocrinology Cleveland Clinic Children’s Cleveland, Ohio
y
Lori Casnellie, RN Care Manager, Endocrinology Cincinnati Children’s Hospital Cincinnati, Ohio
Diana Swisshelm, RN, BSN Endocrinology Nurse II Cincinnati Children’s Hospital Cincinnati, Ohio
ow
Pamela Burwinkel, RN, BSN Endocrinology Nurse II Cincinnati Children’s Hospital Cincinnati, Ohio
Kent Reifschneider, MD Children’s Hospital of The Kings Daughters Norfolk, Va.
1
nt
Karen Bucci, MSN, PNP-BC, APRN, CDE Connecticut Children’s Medical Center Hartford, Conn.
Anne Planicka, RN, CPN Cincinnati Children’s Hospital Cincinnati, Ohio