When we donate our funds we ask the doctors in the children's hospitals,

"What will help the kids in their care the most "

We are proud to be funding the positions below.

The Oncology unit at Westmead, provides advanced training for young paediatricians in the field of childhood cancer treatment and research, by way of an externally funded Oncology Fellowship for 12 months, extendable to 24 months by negotiation. This is an invaluable source of training for the Fellow as it exposes the Fellow to a broad spectrum of childhood cancers and their management under the supervision of the departments consultants and provides excellent opportunities for the Oncology Fellow to develop his or her competency as a young specialist.

The Oncology Fellow supervises three medical house staff and is responsible for the day to day medical care of all the departments in-patients, and assists in the day to day management of the out-patients in the Oncology Treatment Centre, involving close liaison with medical house staff, nursing staff and especially families. 

Oncology is a very specialised area and without this position, the patients would be looked after by hospital registrars who rotate departments every 3 months.

Having an Oncology Fellow means that patients receive a greater standard of care and expertise through:

(1) Continuity of Care - the Oncology Fellow gets to know the patients and their families, building trust with them because the child is cared for by the same doctor throughout the course of their treatment and

(2) The Oncology Fellow passes on their knowledge to junior medical staff and oncology nursing staff and is involved in clinical research. 

The Oncology Fellow is indispensable in the care of  children with cancer. BACK

Rhonda Rytmeister
The Oncology Unit at Westmead, uses donated funds to employ a     full-time psychologist in the department who is an invaluable member of our allied health support team.   The Oncology psychologist is freely available to all patients and their families should they need to talk to someone. The psychologist treats the 'family' as a unit and not just the individual child. The role of the Psychologist is varied and includes the following:
•	Provides counselling and support to children and families who have been newly diagnosed with cancer. Helps them deal with stress management and anxiety.  Families can be particularly under strain if one of the parents needs to give up their job to care for the sick child.
•	Provides therapy for parents to deal with anxiety and depression.
•	Helps parents with behavioural management of their child and children with pain management.
•	Uses CBT (cognitive behaviour therapies) to help children cope with painful procedures, (eg teaches them to push the thought of pain to the back of their mind and train them to focus on being healthy again in the future).
•	Liases with schools and helps facilitate the child's entry back into a normal school life.
•	Provides home visits to grieving families (bereavement support)
•	Conducts neuro-psychological assessments
•	Runs weekly discussion groups for parents this is a place where they can talk freely and gain support from each other
•	Helps children (especially teenagers) cope with feeling 'left out' of normal social life
•	Helps facilitate communication between child and parent (eg often a child will know that they are dying, yet the parents don't know the child knows)
•	Aids communication between parent and doctor
•	Helps kids and families who are coming off treatment (often parents think they are meant to be happy as their child is finishing treatment yet they often have fear and anxiety that the cancer will come back)
•	Explores spiritual issues with the families. Often the families start to think about deeper issues (is there a higher purpose for this, am I being punished etc) and often turn to the psychologist just to explore these thoughts
The Psychologist is indispensable in the support that is provided to patients and their families. BACK

Advances in design of medical equipment and surgical techniques now permit almost all children receiving treatment for cancer to have a permanent and comfortable in- dwelling tube inserted into the blood- stream known as a central venous line (CVL)  The availability of the CVL means that blood tests, required often on a daily basis for blood counts and other essential monitoring during treatment, can be collected painlessly by sampling the CVL rather than by painful finger pricks or venipunctures.

This position is fully supported by Westmead's, Haematology and Pathology departments.  A registered nurse is available each weekday morning to access the CVLs of all Oncology patients requiring blood tests for their routine treatment, removing the need for hundreds of painful finger pricks each week.

By providing telephone liaison and treatment planning with families each afternoon, the CVL nurse is also a valuable component of the Oncology Unit's participation in clinical trials supervised by the prestigious U.S.-based Clinical Oncology Group, comprising hundreds of similar oncology units through the United States and other countries. The Oncology Unit at Westmead has been a member of C.O.G. since 2000.  Participation in C.O.G. ensures our patients have access to the most up-to-date and reliable treatments for childhood cancer.

Each morning, the CVL/COG Nurse draws blood via central lines from 20-30 outpatients  in the Haematology Department.

In the afternoons the CVL/COG Nurse  conducts essential case management and liaison with families for oncology children enrolled on Clinical Oncology Group trials to help ensure compliance with protocols/treatment programs.

The benefits to the children is painless blood collection, in contrast to the countless finger-pricks they currently endure, as well as advances in treatments obtained through Clinical Oncology Group trials. BACK

Most of the remarkable advances in the improved cure rate for childhood cancer have occurred because of the advent of multi-centre, and now international, clinical trials of treatment. This allows the current most effective therapy for a particular childhood cancer to be compared to a slightly different experimental therapy which may prove even more effective. Successful participation in such trials requires assiduous recording of data, and reporting of that data to the national or international centres that are supervising each treatment trial.

Many of our patients are entered on national or international trials of therapy, to enable outcomes of treatment to be compared and continuously improved.

The treatment of childhood cancer is complex, and requires administration of complicated regimes of cancer-fighting drugs known as chemotherapy for periods of up to two years. As many as nine different drugs may be involved. In order for the treatment to have the best chance of succeeding, it must be administered accurately, and the results recorded in department records for later analysis.

The Oncology Unit currently employs three full-time Clinical Research Associates to provide the required data management. One of these staff members is paid for by government funds allocated to the hospital's budget. The salary for the other two positions are met by donated funds, BACK

Most routine treatment of childhood cancer is administered on an outpatient basis (no overnight stay). This means Westmead’s young patients can return home and get back to school soon after treatment is started. It also means that children spend less time in hospital and this helps improve the morale of both patient and family.

Treatment however,  often requires two to three visits to the department each week for tests and injections of planned treatment. This makes the Oncology Treatment Centre one of the busiest areas in the entire hospital as between 20-30 patients arrive at the Oncology Treatment Centre each weekday for routine treatment.

The oncology unit uses donated funds to employ additional medical practitioners to work in the Oncology Treatment Centre. They provide essential hands-on care to children requiring treatment (for example venipunctures, lumbar punctures, chemotherapy injections). They also assess the patients to ensure they are well enough to receive the next planned part of treatment. They make a significant contribution to reducing unpleasant waiting times and helping our patients get on their way home quickly again. They also become very well known and trusted by the patients and their families and form an invaluable component of our support program. BACK

Shannon Tracey, position 1

Melanie Boulton, position 2

The Department of Social Work requested and received funding, for two new social work positions in the oncology unit.  The additional positions were required to address the growing need for support services for families with children with cancer.  These positions are providing crisis support to parents and children at the time of diagnosis or relapse in the child's condition and extend services to siblings and other family members.  BACK

Anne Senner

Clinical Nurse Consultant, for Clinical Practice Research and Development

Working within the Centre for Children's Cancer and Blood Disorders

The Centre for Children’s Cancer and Blood Disorders (CCC&BD) at Sydney Children’s Hospital, Randwick with the donated funds from Kids with Cancer Foundation Australia have employed a Clinical Nurse Consultant for Clinical Practice Development and Research. 

This nursing position was created to address a strategic goal of the CCC&BD to encourage and promote the use of and development of nursing research to enhance the care of children with cancer and blood disorders.  Kids with Cancer Foundation Australia have allowed this to become a reality. 

The Clinical Practice Development and Research Position has three distinct areas of practice:

1.      Promote the use of nursing research to change practice.

2.      Encourage the development of nursing research through support and mentorship.

3.      Supporting staff’s professional development 

Examples of initiatives that would not have been possible without the funding from the Kids With Cancer Charity are:

·         Improving Fever and Neutropenia Management: This quality improvement project aimed to decrease the time it takes for a child who arrives at a hospital with a fever to receive their first dose of intravenous antibiotics.  This singe event has been shown to decrease a child’s risk of dying from infection.

This initiative was started at SCH, R but has not been rolled out in Emergency Departments and Paediatric Units throughout NSW so that children who live in rural or remote areas receive the same standard of care as those who can attend Sydney Children’s Hospital, Randwick.  The Clinical Nurse Consultant had the time and resources to collaborate with the Emergency Department to develop this project as well as support the evaluation of its effectiveness. This project was nominated for a NSW Baxter Award for Excellence.

·         Evaluation of Adolescent Cancer Care Services: We are currently evaluating the services we provide adolescents with cancer.  The CCC&BD is currently evaluating how we manage young people with cancer and are developing resources for the young people to help them with their cancer journey.  The Clinical Nurse Consultant has been able to support the Nursing and Allied Health Team members to nurture this project as well as support the team members in their own development.  The CNC has supported members of the team who would otherwise not become involved, become involved in practice improvement initiative.  This mentoring is integral to the development of future nursing leaders in paediatric oncology. A second arm of this project is lobbying state and national governmental bodies to highlight the gaps in cancer care for adolescent and young adults in NSW.

·         Independent Nursing Research: The Clinical Nurse Consultant for Practice Development and Research is initiating independent nursing research projects into cancer symptoms in young children.  The aim of this research is to develop a greater understanding of the symptom experience of young children who undergo cancer treatment.  Greater understanding of symptoms in young children will lead to better management of these symptoms.

·         We would like to thank Kids with Cancer for their generosity and continuous support for the Clinical Nurse Consultant Position

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Felicity Wright

Oncology Pharmacist

Pharmacist’s play a vital role in the care for children with cancer and are an important part of the cancer health care team. The role of the Oncology Pharmacist encompasses a wide range of activities.  Increases in the numbers of patients requiring chemotherapy and increases in the complexity of cancer treatments, has led over recent years, to increasing pressure on the mechanisms needed to prepare and support chemotherapy administration and in the provision of clinical pharmacy services to the CCC&BD.

Oncology pharmacy services are extremely labour intensive and hence are particularly vulnerable when demand upon them is increasing. The increasing workloads experienced by the CCC&BD in recent years have continually challenged the current staffing mix and has led to a gradual reduction in the clinical services performed by the pharmacist. This was necessary in order to ensure the timely and safe supply of large numbers of aseptically prepared chemotherapy products that are required on a daily basis.

There was an urgent need to address the increasing oncology pharmacy workload with the investment in a second specialist pharmacy position. Kids with Cancer Foundation supporting this position has helped improve the provision of clinical pharmacy services and ensure the safe use of medications for all patients treated within the CCC&BD. These include prescribing:

• Chemotherapy of all patients treated at SCH is almost always prescribed on the basis of protocol. These protocols detail the combination of drugs to be used including doses, routes and methods of administration. These protocols can be very complex and there is a potential for a variety of prescribing errors. Chemotherapy drugs are powerful agents where a small error can lead to toxicity on one hand or inadequate dosing on the other. The supervision of all chemotherapy prescribing by a Pharmacist minimises the potential for these medication errors.
• Chemotherapy is routinely prescribed by rotational junior medical staff under the supervision of the Pharmacist. 
• The pharmacist plays an important and significant role in reviewing all medications prescribed by Clinicians, this includes all inpatient and outpatient chemotherapy, supportive drug therapies (antibiotics, antiemetics, total parenteral nutrition) and discharge medications.
• In addition to supervision of chemotherapy prescribing, the oncology pharmacist in the acute care setting conducts a daily medication chart review. Oncology patients are routinely treated with a multitude of medications and supportive therapies. This chart review is an essential function to improve and promote the quality of use of medicines in a cancer care setting. Pharmacist’s check all medication doses are safe to administer, advise on compatibilities of intravenous drugs and monitor for drug interactions and side effects. This assists in minimising medication errors.

These role’s performed by the Pharmacist’s will ensure the correct drug is administer to the correct patient at the correct dose on the correct day. In addition to Medication Dispensing, the Pharmacist is also involved with Patient and Staff Education on the medicines.

Xiaolu Wang

Clinical Research Associate / Data Manager

The Clinical Research Associate / Data Manager is responsible for accurate collection, maintenance, validation and analysis of data relating to children treated for cancer and blood disorders. This position is also responsible for ensuring that appropriate processes are in place for studies to be opened, and children enrolled.

It is demonstrated that children who are treated on clinical trials have better outcomes than those who are not. In response to this, the majority of children treated by the CCC&BD are enrolled on clinical trials if one is available. It is vital that data be collected from patient records and sent to the managing centre so that information can be aggregated and the impact of treatment evaluated.

The role of the data manager is to forward samples to the centre coordinating the trial, to ensure monitoring tests and scans are completed as per the treatment schedule and forward copies to study coordinator, and most importantly to extract this information about treatment, delays and any complications or side effects from all relevant sources, including external treating facilities. Another important role is compiling protocols for ethics submissions to ensure that all studies are appropriate to enrol children onto, and are not placing children at risk.

There has been a significant increase in workload for the data managers over the past 2 years. It was recognised by the department, that in order to maintain the high standards and quality of data of previous years, further staff was required, and we thank Kids with Cancer Foundation for providing that funding required for the additional position.

Belinda Goodenough

Behavoural Science Researcher

Work over the past years has been directed towards generating a vigorous and dynamic research programme in all aspects of psychosocial support and functioning of the child and family with cancer and chronic haematological disorders. The following key research areas have been identified:

1. Reducing the stress and suffering which is caused by the delivery of cancer care to the children and their families, especially for rural families separated by cancer treatment - over 50% of the children treated in the Centre for Children’s Cancer and Blood Disorders come from outside the Sydney metropolitan area.
2. Bereavement outcomes and follow-up in parents whose children have died
3. Cancer survivorship and long-term adjustment issues for families
4. Processes of communication and coping in the treatment span. This is a diverse set of topics ranging from staff-family communications about disease, treatments and symptom management (including use of complementary and alternative medicines), through to personal resource variables of family members (both negative and positive, and potentially including cultural diversity).

As well, this position will directly supervise all areas of activity associated with projects in the Behavioural Science and Psychosocial Research Programme. It will conduct research in psychological and social issues relating to cancer in children and adolescents, for children treated by the Centre for Children’s Cancer and Blood Disorders.

The Behavioural Sciences Researcher will interact with other staff of the Centre for Children’s Cancer and Blood Disorders. This will be in the form of either consultancy and planning role in specific research teams within the Centre, or developing and conducting research projects of their own. Research projects may be in collaboration with other relevant national and international teams. The position will be responsible for the following: supervision of research staff and senior and junior levels; supervision of post-graduate students (annual minimum of one PhD and two masters); designing research projects; writing submissions to ethics and funding committees; analysing statistical and textural data; authorship of peer-reviewed papers and conference presentations; and supervision of under-graduate student placements. The Senior Scientific Officer may also provide consultancy, as appropriate, on statistical, computing and scientific methods in behavioural and psychosocial research, to other members of the CCCBD.

This position is incredibly valuable within CCC&BD and we are very grateful for KWCF’s ongoing support for this role.

Alana Tassie

We made a three year commitment to fund an additional social work position at the hospital.  The protocol for social workers includes intensive support and assistance for patients and families during the early acute phase after diagnosis and ongoing services throughout the treatment process. The existing social workers had difficulty maintaining ongoing services to outpatients and the routine daily visits to in-patients and their families because of the increased number of referrals.  Other areas of work were neglected in order to deal with the immediate needs of families. In particular the parent group, services to siblings, and ongoing service to outpatients had suffered over the preceding year. An additional social worker will allow for a reorganisation of the workload so that there is adequate cover for leave and improved continuity of service for outpatients, as well as resumption of the group program for parents.

The certainty of funding for the three year period allows for continuity of service and further analysis and planning enhancing an improved social work service to cancer patients and their families. We are most grateful for this opportunity to expand the services we provide to patients and families with the help of the Kids with Cancer Foundation." A/Proff. Glenn Marshall

At the completion of our three year commitment to fund the oncology social work position at the hospital we were approached by the head of the department with a request to continue our funding for this vital position.  Alana Tassie had replaced Kate Lenthen in the position and we were pleased to be in a position to be able to assist once more with a payment for a fourth year.

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