“Pediatric Nursing on the Move”
October 25, 2010

POSTER ABSTRACT
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Author/Presenter Information
(Please list only one corresponding author and up to two additional authors)

 
First Name
Middle
Last Name
Credentials (Nursing Degree(s))

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State
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  Additional Author 1 (optional)
First Name
Middle
Last Name
Credentials (Nursing Degree(s))
Email Address
Affiliation/Institution
  Additional Author 2 (optional)
First Name
Middle
Last Name
Credentials (Nursing Degree(s))
Email Address
Affiliation/Institution
  Poster Information
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Title of Poster
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Objectives of Poster
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After viewing this poster presentation the learner will be able to:

Abstract Summary

(250 words is the maximum. Please ensure the abstract addresses the objectives listed above.
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quotation marks and single quotes as word special characters do not transfer correctly.)

If my abstract is selected to be presented at the Seventh Annual Pediatric
Nursing Conference, I agree to be present at the conference as a paid
attendee; have my poster prepared and displayed at the designated times and
to be present in the poster presentation area, during poster viewing times.
I also give permission for duplication of my poster abstract in any
electronic/printed materials published in relation to the Seventh Annual
Pediatric Nursing Conference.

 
Biographical Data - PSNA -2010
 
This individual is: (Check all that apply)
Administratively Responsible Person   Planning Committee Member   Presenter/Content Specialist
 

Educational Activity Faculty/Content Specialist: Describe your knowledge and expertise in this topic area

Conflict of Interest Disclosure

Having an interest in an organization does not prevent a speaker from making a presentation, but the audience must be informed of this relationship prior to the start of the activity and any potential conflict must be resolved. In order to ensure balance, independence, objectivity, and scientific rigor at all programs, the planers and faculty must take full disclosure indicating whether the planner, faculty, or content specialist and/or his/her immediate family members have an relationships with sources of commercial support, e.g. pharmaceutical companies, biomedical device manufacturers and/or corporations whose products or services are related to pertinent therapeutic areas. All planners, faculty and content specialists participating in CE activities must disclose to the audience any

A. Relationship with companies who manufacture products used in the treatment of the subjects under discussion
B. Relationship between the planner, faculty, or content specialist and commercial supporter(s) of the activity and/or
C. Intent to discuss unlabeled uses of a commercial product, or an investigational; use of a product not yet approved for this purpose.

All information disclosed must be shared with the audience either on the program handouts, advertising and/or audiovisual presentation.

A. Is there a relationship with companies who manufacture products used in the treatment of the subjects under discussion:

If yes, list company(ies) with relationship:

Relationship Name of Commercial Company(ies)
Research Support
Speaker’s Bureau
Consultant
Shareholder
Other Support
Large Gift(s)
 

B. Is there a discussion of unlabeled uses?

If yes, you must disclose this information during your presentation. How will you do this?

1. Verbal statement during the presentation
2. Information provided on handouts
3. Information provided in audiovisuals
4. Other, please describe below

C. How will any conflict of interest be resolved?

   1. Have discussed this conflict with individual who is now aware of and agrees to our policy.
   2. Presenter has signed a statement that says s/he will present information fairly and without bias.
   3. RN with minimum of BSN or designee will monitor session to ensure conflict does not arise.
   4. Not applicable since no conflict of interest.
   5. Other: Describe:

All information disclosed must be shared with the audience whether on the program handouts, advertising, and/or audiovisual presentation.

By checking this box, I am providing my electronic signature approving all the information entered above.