My Child Matters Nurses Awards

My Child Matters Nurses Awards

My Child Matters Nurses Awards / 2018 /

3rd My Child Matters Awards

for Paediatric Oncology Nurses

2018

Program which recognizes and celebrates the role of nurses in the fight against childhood cancer in developing countries.

Application File

You may complete this form electronically and send it by email, or print the form, complete it in writing, and send it by post as a paper copy.

Project Title
[fill in]
Your First Name (Given Name)
[fill in]
Your Last Name (Surname)
[fill in]
Your Gender
[fill in]
Your Job or Post Title
[fill in]
Your Address
[fill in]
Your Email
[fill in]
Your Phone Number
[fill in]
Name of YourOrganization
[fill in]

To be sent to the Sanofi Espoir Foundation before March 1st, 2018.

By email: / with the title: 2018 My Child Matters Nurses Awards

By regular postal mail:Fondation Sanofi Espoir- 262 boulevard Saint-Germain, 75007 Paris – France

AWARD REGULATIONS

Eligibility (project) / You
If you are a qualified nurse practitioner, we invite you to participate in this international program that will recognize and celebrate the role of nurses in the fight against childhood cancer in resource-constrained settings. You must conduct the project in a low- or lower-middle income country.
Your Project
It should be designed to help fight against childhood cancer and improve the care of children with cancer, particularly in resource-limited settings.
Your project should come under one of the three following categories:
Education:
  • Improve the training of qualified nursing personnel.
  • Improve information provided to the public, raising awareness in families and in the larger community.
Professional Practices:
  • Develop new solutions, services, procedures, techniques and tools to improve access to quality care, which may include palliative care.
  • Improve the psychological care of children, together with their families and caregivers.
  • Encourage nurses to network with other nurses and healthcare professionals in the field of paediatric oncology, and share their experiences in the field of childhood cancer care.
Research:
  • Develop nursing skills and research capacity
  • Develop and highlight innovative approaches to nursing service and practice, in order to improve the care and quality-of-life of children with cancer.

Eligibility (structure) / Submissions of initiatives are invited from all individual qualified nurses, or teams of healthcare professionals led by an individual qualified nurse, who have developed an innovative initiative in the field. Funds must be distributed to an established association, non-governmental organization, hospital, university or research organization rather than to individuals.
Selection Criteria / 1)Your project must be designed to help fight against childhood cancer and improve the care of children with cancer, particularly in resources-limited settings.
2)The duration of the project should be one year initiated within the year you received the grant funding.
3)You will be expected to complete an interim report after six months and a final report after one year.
The winning projects will be selected based on the following key criteria. Please address as many as applicable in your application:
  • Innovation
  • The ability to improve the care of children suffering from cancer and improve their chances of survival
  • The potential for adapting the concept to other communities or regions
  • Cultural fit
  • Promoting health education
  • Community impact of innovation
  • Sustainability

Grant / Financial support: 10000€ per project
Up to 5 projects selected by a committee of experts
Geographical Area / The project application/action must focus on children with cancer and/or nurses in low- or lower-middle-income countries.
Project Duration / The project will be implemented over a period of 12 months
Examination of the Application / Your project will be reviewed by a jury composed of experts in the field of pediatric oncology from SIOP, SIOP Nurses’ Group Steering Committee and a representative from the Sanofi Espoir Foundation.
Submission Deadline / Before March 1st, 2018 at
Or by regular post mail at Fondation Sanofi Espoir - 262 boulevard Saint-Germain, 75007 Paris – France

YOUR PROJECT

Background:
Describe the background of your project, and the problem(s) you want to address. (Max. 1,000 Words)

Type your answer here (box will expand with text).

Summary of your Project:

Tell us the purpose of your project, the methods for your project, including the role of nurses, and whether it is an ongoing project (including the expected start date) or a new project (Max. 500 words)

Type your answer here (box will expand with text).

Type of Project (please tick the box which best describes your project):

  • Practice
  • Research
  • Education

Timeline of your project proposal:

Please complete the attached project Timeline

Expected Results:
What results do you expect to come from this project? What is the expected impact on children with cancer in your country and elsewhere?

Please include how many patients you plan to support and/ or healthcare professional you plan to train.
(Max. 1,000 Words)

Type your answer here (box will expand with text).

OVERALL PROJECT OBJECTIVES

Project Objectives / Activities / Output/ImpactIndicators (qualitative, quantitative)
1.
2.
3.
4.
5.
Added Value of the Project (what makes it unique or specific):

BUDGET

Outline of your project budget:

Please complete the attached project budget.

Is the MCM award funding to be used as partial support or supplementary funding? If yes, please specify the amount of support and name of the other organization/s.

Type your answer here (box will expand with text).

ADDITIONAL DETAILS

Please describe the expected outcome of your project one year after receiving the grant. For example, will the project be sustained at the site or replicated elsewhere?

Type your answer here (box will expand with text).

Is there anything else you would like to tell us about your project?

Type your answer here (box will expand with text).

OtherContacts:

Please list any collaborators on the project:

First Contact

First Name
Last Name
Gender
Affiliation
Address
Phone
Email address

Second Contact

First Name
Last Name
Gender
Affiliation
Address
Phone
Email address

Third Contact

First Name
Last Name
Gender
Affiliation
Address
Phone
Email address

I confirm that I own the rights to my innovative project (including supporting documents) and agree to have it published bySanofi Espoir Foundation.

I confirm that I have obtained the consent of all persons featured in the supporting documents that I have provided.

I hereby agree to be contacted by the Sanofi Espoir Foundation with respect to my project as needed.

Date______

Signature______

Printed Name in Full ______

Title ______

I certify that I am a nurse.

I am NOT a nurse, I am a ______

1

Top View