An outpatient Urgent Care Bay within a pediatric cancer and hematology center.

Time-sensitive medical care is essential for pediatric patients undergoing treatment for a hematologic or oncologic condition. Such patients commonly experience acute symptoms related to routine childhood illness and/or their underlying disease or therapy. An Urgent Care Bay (UCB) staffed by a designated nurse and medical provider was established within Texas Children's Cancer Center Outpatient Clinic to provide time-sensitive, same-day diagnostic and therapeutic medical care during clinic hours for patients with acute, non-life-threatening symptoms. The number of patients seen in UCB, chief complaint, underlying diagnosis, and disposition was reviewed. To establish timeliness of care, the authors reviewed the time of referral to the UCB provider or nurse, time of arrival to UCB, time evaluated by providers, and time of initiation of treatment. The addition of an UCB to Texas Children's Cancer Center Outpatient Clinic has shown to allow for rapid assessment and initiation of treatment while avoiding unnecessary emergency room care.

Neuroblastoma: What the nurse practitioner should know.

PURPOSE: To provide a comprehensive review of the background, diagnosis, and primary care management of neuroblastoma (NBL) and to describe the pathophysiology, signs and symptoms, and diagnostic tests for the patient with NBL. DATA SOURCES: Extensive review of the worldwide scientific literature on the condition, including primary care articles and studies performed. CONCLUSIONS: NBL is one of the most common tumors of childhood and clinical presentation depends on the site of the primary tumor as well as the presence and location of any metastasis. Treatment includes a combination of surgery, chemotherapy, and radiation, as well as the newer immunotherapy. IMPLICATIONS FOR PRACTICE: NBL is often identified in the primary care setting, and it is important to be able to recognize the presentation and correctly manage the disease. The clinical presentation of NBL, the vital facts needed to ensure that this diagnosis will not be overlooked, and follow-up in a primary care setting will be reviewed.