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Context: Patients with cancer-related pain and concurrent substance use disorder (SUD) present a unique set of challenges for palliative care clinicians. A structured forum for interdisciplinary collaboration is needed to effectively manage this complex population. Objectives: Describe the feasibility and acceptability of a palliative care Complex Pain Board (CPB), an interdisciplinary team meeting to provide concrete care recommendations for patients with cancer-related pain and concurrent SUD and/or psychosocial complexity. Methods: We conducted a retrospective analysis of cases presented at CPB between May 2021 and June 2022 and a cross-sectional analysis of CBP participant surveys. Results: Among 28 cases included for analysis, gastrointestinal cancers (n = 7, 25.9%) and multiple myeloma (n = 5, 18.5%) were the most frequent cancer diagnoses. Primary reasons for referral were SUD (n = 22, 78.6%) and provider/team distress (n = 13, 46.4%). The most frequent recommendations made at CBP were encouraging interdisciplinary collaboration (n = 18, 64.3%), maintaining healthy boundaries (n = 15, 53.6%), and SUD management (n = 13, 46.4%). Of 14 scheduled meetings, most meetings involved the presentation of ≥1 cases (n = 12, 86%). Among 40 CBP participant surveys, most attendees (n = 38, 95%) were likely or highly likely to continue to attend. Conclusion: CPB is a feasible and acceptable intervention that allows for palliative care clinicians to collaborate and receive interdisciplinary team feedback and peer support on the management of patients with cancer-related pain and concurrent SUD and/or psychosocial complexity in the ambulatory care setting. Key Message: A regular, interdisciplinary team meeting (CPB) is a feasible and acceptable intervention to help palliative care clinicians manage challenging cases involving patients with cancer and concurrent SUD and/or psychosocial complexity. [ABSTRACT FROM AUTHOR]

Background: Increased access to interprofessional palliative care is needed in ambulatory oncology settings. To achieve this, Dana-Farber Cancer Institute launched a collaborative drug therapy management clinic, PharmPAL, where credentialed advanced practice pharmacists lead independent patient visits. Methods: As part of a pilot project focused on clinical innovation, we analyzed PharmPAL referrals and pharmacist interventions between July 2020 and June 2021. We extracted referral patterns, patient hospitalizations, and deaths from the electronic medical record. Outpatient palliative care clinicians completed a survey to determine pharmacist needs and overall satisfaction with PharmPAL. Results: From July 2020 to June 2021, PharmPAL constituted 4.7% (299/6305) of all outpatient palliative care encounters. Most palliative care clinicians (86% [6/7]) reported a desire to increase PharmPAL availability. No patient hospitalizations or deaths were attributed to PharmPAL visits. Conclusion: PharmPAL increased access to palliative care services. All clinicians reported satisfaction with PharmPAL. We continue to assess the impact PharmPAL has on clinic operations and provider satisfaction. [ABSTRACT FROM AUTHOR]

1. Participants will self-report the ability to develop and evaluate the benefits of an interdisciplinary team-based approach to improve the care of patients with palliative care needs and concurrent substance use disorder. 2. Participants will self-report the ability analyze the shared interdisciplinary challenges of caring for patients with palliative care needs and concurrent substance use disorder and identify tools to improve interdisciplinary collaboration. This poster describes the feasibility and acceptability of a Complex Pain Board to provide concrete care recommendations for palliative care patients with pain and concurrent substance use disorder. The intervention was feasible and acceptable within our ambulatory palliative care setting and allowed for interdisciplinary collaboration on challenging cases. Patients with palliative care needs and concurrent substance use disorder present a unique set of challenges for palliative care clinicians (1). A structured forum for interdisciplinary collaboration and peer support may help improve the management of this complex population (2-3). Describe the feasibility and acceptability of a palliative care Complex Pain Board (CPB), an interdisciplinary team meeting to provide concrete care recommendations for patients with palliative care needs and concurrent substance use disorder and/or psychosocial complexity. We conducted a retrospective analysis of cases presented at CPB between May 2021 and June 2022 and a cross sectional analysis of CBP participant surveys. The majority of the scheduled meetings had ≥1 cases for presentation (86%). Primary reasons for referral to CPB were substance use disorder (n=22, 78.6%) and provider/team distress (n=13, 46.4%). The most frequent recommendations made at Complex Pain Board were interdisciplinary collaboration/ team collaboration (n=18, 64.3%), maintaining healthy boundaries (n=15, 53.6%), and substance use disorder management (n=13, 46.4%). Among 40 CBP participant survey respondents, most attendees (n=38, 95%) were likely or highly likely to continue to attend. CPB provided an opportunity for an interdisciplinary team to collaborate on the management of challenging cases. The intervention was both feasible and acceptable within our ambulatory palliative care practice. Models of Palliative Care DeliveryInterdisciplinary Teamwork / Professionalism [ABSTRACT FROM AUTHOR]

With the United States obesity rate at 34% in adults and 17% in children, and increased inactivity among young people, the authors decided to create an interdisciplinary (art and health) lesson that they hoped would raise student awareness on the subject. In this article, the authors describe how their middle-school students created an artwork of a "healthy" and "unhealthy" composite head. (Contains 1 online resource.)

The article presents clinical procedures and interventions that must be done by nurses to a patient suffering from hypernatermia. A sample situation is provided wherein an 84-year-old man is brought to an emergency department due to recurrent seizure. Nurses are advised to establish seizure precautions, provide supplemental oxygen and administer antiepileptic drugs as prescribed. It is also important to frequently assess the patient's neurologic status and educate him on the importance of adequate fluid intake.