Day :
- Critical care and Emergency Nursing
Midwifery Nursing
Types of nursing
Cancer and tumour nursing
Nursing Practice
Location: Westminster Ball Room
Chair
Sandra Kundrik Leh
Cedar Crest College, USA
Co-Chair
Ewa Smoleń
Medical University of Lublin, Poland
Session Introduction
Cheryl Parker
Obstetric Anesthesia Consultants, USA
Title: An innovative nursing approach to caring for an obstetric patient with Rape Trauma Syndrome - A Case Report
Biography:
Dr. Cheryl Parker is a CRNA with Obstetrical Anesthesia Consultants. An anesthesia practice which provides exclusive, 24 hour service, to the L&D units of Norton Healthcare. She completed both the Masters of Science in Nursing, and Doctor of Nursing Practice degrees at Murray State University in Kentucky. Her 22 year nursing career includes experince in Labor & Delivery, Neonatal ICU, Adult Open-Heart Recovery/ICU, and Obstetric Anesthesia. Her case report on Rape Trauma Syndrome was published in the Journal of Obstetric, Gynecologic, and Neonatal Nursing in May of 2015.
Abstract:
This case report identifies the innovative nursing approach used to facilitate care for an obstetric patient suffering with Rape Trauma Syndrome during labor. Rape Trauma Syndrome (RTS) is a post-traumatic stress disorder that can be triggered by routine procedures experienced during childbirth. An explanation of RTS, signs and symptoms, and how to avoid retraumatization during intrapartum care will be addressed. A case report is presented from a provider perspective to illustrate the seriousness of this disorder and the importance of delivering respectful care. A new approach to obstetrical routines is warranted in order to avoid further traumatizing the woman with RTS. Nurses’ creative and innovative thinking is highlighted by the description of how a YouTube video on Foley catheter placement was used to instruct a patient, allowing her to perform self-catheterization following epidural anesthesia. A brief examination of smartphone use, obstetrical websites, and Healthy People 2020 objectives is also included.
Marlene Rosenkoetter
Augusta University, USA
Title: Challenges of Global Nurse Migration: Issues and Mediators
Biography:
Dr. Rosenkoetter has over 30 years experience in nursing administration, teaching, and research. She is a recognized authority on global nursing and health care. She has numerous publications as well as national and international presentations, and has been a Fellow of the American Academy of Nursing for 25 years.
Abstract:
Internationally educated nurses (IENs) are RNs whose initial nursing education took place outside of the United States or in the U.S. territories (formerly termed foreign-trained or foreign-educated nurses). They represent a larger percentage of the U.S. nursing workforce in recent years, comprising 5.1 percent of RNs licensed before 2004, compared with 8.1 percent since then. The Philippines continued to dominate as the source country of the IEN workforce (50 percent), followed by Canada at nearly 12 percent. India supplied 9.6 percent and the United Kingdom provided 6 percent, with the contributions from India accelerating and surpassing those from the United Kingdom among recent licensees. Approximately one-quarter of IENs lived in California in 2008, with New York, Florida, and Texas each home to 10 to 12 percent of IENs. When migrated nurses begin employment in a new setting, they need an enculturation process and orientation to their new environment. This includes not only nursing approaches but medical interventions and an immersion in new technologies. This process should involves changes in their roles, their responsibilities, and the use as well as the structure of their time. They need to acquire new support groups and have opportunities to build their own self-esteem. This paper proposes a process to achieve these goals.
Rania Hosny Tomerak
Cairo University, Egypt
Title: Breastfeeding the preterm; A right must be done right
Biography:
She is a professor of paediatrics and neonatology in Cairo University. She was graduated in 1994, had his Master degree in paediatrics in 1998 and doctorate degree in paediatrics in 2001. She is an international board certified lactation consultant since 2004 (got the highest score in Egypt). She is a board member of Lactation education accreditation and approval committee in USA, which provides approval and accreditation to all.
Abstract:
Breast milk is the white blood containing almost all the factors essential for the physical, physiological and psychological maturity of the preterm infant. Its function represents a continuum of the placental function. Preterm infants are inevitably deprived of the placenta in late pregnancy so the human factor should fight to provide the baby with this white blood; the breast milk. This needs a tight strategy to be mastered by the authorized personnel in the NICU. The policy should include the guidelines of milk expression, storage, transfer and providence to the baby. Promotion of the kangaroo mother care is an important adjuvant. Proper counselling of the mother is also of utmost importance together with the post discharge support of the mothers to continue breastfeeding. There are frequently asked questions about breastfeeding but the reply are commonly confusing. A rumour concerning breastfeeding is easily transferred among doctors, nurses, friends and families, with the mother and baby paying the price. These widely spread wrong beliefs represents a major obstacle to successful breastfeeding. In this session, common misbelieves about breastfeeding are handled. Frequently asked questions during the antenatal, natal and postnatal periods are answered. Lots of infants are exposed to formula feeding without any indication. The best way to salvage these infants from this unjustified exposure to formula is proper lactation counselling of their mothers. Identifying the causes of insufficient milk supply is of utmost importance. Targeting these causes and boosting the mother’s milk should be the primary line of management. Paediatricians should be ware of the true indications for formula supplementation, not to deprive our infants of their mothers’ milk.
Anne-Kari M. Johannessen
Oslo and Akershus University College of Applied Sciences, Norway
Title: Barriers to Adult Immunizations and strategies to improve coverage
Biography:
Johannesssen completed her PhD at the University of Oslo in 2013. She has a full time position as researcher and teacher at the Faculty of Nursing and Health promotion, Oslo and Akershus University College of Applied Sciences, and holds a part time position as a senior researcher at Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway. She has a background as anestethist nurse and holds a master degree in pedagogics. She is a member of Østfold Hospital research board, and the board of Care - Health and Welfare at Oslo and Akershus University College.
Abstract:
Municipal acute units (MAU) is a new healthcare service that all Norwegian municipalities are obligated to offer their residents within January 1, 2016. These units, organized at the interface between hospital and municipal homecare services, aim to prevent or shorten hospital stays and alleviate some of the pressure on the hospital sector. Urgent inpatient municipal care involves organizational changes, and raise questions whether this creates new interfaces with increased risk of failure in patient safety. Common diagnosis for admission to a MAU are: fractures, pain conditions, leg ulcers, infections, constipation, diarrhea, pneumonia, COPD exacerbation and cognitive impairment. The patient’s average age is 75. GPs, emergency departments and outpatient polyclinics transfer patients to MAUs. The inpatient timeframe is three days. In an pilot study we have explored how user participation in treatment and care happens in a MAU. Findings show that lack of resources, short length of stay and bustle result in limited user participation. The staff collaborate well, but they strive to establish an appropriate collaboration towards the patients’ families, and professionals working at the purchaser offices in the city districts. Fragile patients, some suffering of dementia or complex somatic diseases, influence the degree of user participation. Findings in the pilot study will be important for further development of a PhD project aiming to study conditions promoting and preventing user participation from the perspectives of patients and family caregivers.
Robert Potter
Texas Health Harris Methodist- Azle, USA
Title: Can falls in the Emergency Department be prevented?
Biography:
Robert has obtained his BSN from the University of Texas-Arlington and is currently completing his studies for his MSN in Nursing Administration at the University of Texas-Arlington. Since 2012 Robert has been the nurse director for the emergency department at Texas Health Harris Methodist-Azle which is a seven bed ED that is a Level IV Trauma Center as well as a Stroke and Chest Pain accredited center. This ED has seen on average over 25,000 patients per year over the last 5 years.
Abstract:
Falls in the Emergency Department (ED) are a concern for most hospitals. Since 2005 the Texas Health Harris Methodist-Azle ED volume has been increasing and so has the number of patient falls. In 2012 the department experienced on average one fall every month. While the total number of falls was small, it was felt by nursing leadership that one fall is too many. The ED Director formed as task force of staff to examine each fall in 2012 to determine what factors impacted the patient fall and developed an action plan to address each of these. The plan was implemented in the first quarter of 2013 which resulted in a decrease of the number of falls. In the first quarter of 2014 there was an increase again in the number of falls and it was determined that this was attributed to staff turnover. Education was provided again to all staff and the subsequent quarters of that year had a decrease in the number of falls. In the first three quarters of 2015 there have been a total of 6 falls. By doing a root cause analysis (RCA) of each fall it was determined where there were opportunities to improve and education of the staff on these areas has resulted in a decrease in the number of falls.
Alisher Agzamov
Department of Anaesthesiology & ICU, KCCC, Kuwait
Title: Does Robotic Physician in ICU Enhance Nurse-Physician Collaboration Satisfaction About ICU Care Decisions?
Biography:
Dr Alisher Agzamov has completed his MD in 1981 from Tashkent University and postdoctoral PhD studies from Moscow University School of Medicine in 1991. During 1992 – 1998 He was a Senior Consultant Cardiac Anaesthesiologist of the European Cardiac Surgery Programme and Professor of Anaesthesiology of the University of Zambia and University Teaching Hospital, Lusaka, Zambia; From 1998 till up to date He is the Senior Consultant Anaesthesiologist for the Department of Anaesthesiology & ICU, Kuwait Cancer Control Center ( KCCC). Ministry of Health, Kuwait City, Kuwait. He has published more than 550 papers in reputed journals and has been serving as an editorial International board member of reputable Anaesthesia and Intensive Care Journals. His main scientific interest in fields for Anaesthesia and ICU Management Surgical and Medical ICU Oncology Patients. His using extensively Robots Physicians in ICU Management of Oncology ICU patients.
Abstract:
This study used a randomized trial to test whether Robot Physician enhances the nurse-ICU physician collaboration satisfaction about care decisions. ICU physician randomly used either the conventional telephone or the RP-7 robot (In Touch (®) Health, USA) to perform night-time rounding in a surgical ICU. The Collaboration and Satisfaction about ICU Care Decisions (CSACD) survey instrument was used to measure the nurse-physician collaboration. The CSACD scores were compared using the signed-rank test with a significant p value of ≤0.05.
RESULTS: From December 1, 2011 to December 31, 2015, 2000 off-shift nurses submitted 10600 surveys during telephone rounds and 10800 surveys during robot rounds. The median score of surveys during robot rounds was slightly but not significantly higher than telephone rounds (53 versus 50; p=0.3). However, the CSACD score was significantly increased from baseline with robot rounds (91.0 versus 42.0; p >0.01), in comparison with telephone rounds (50.0 versus 43.0; p=0.09). The mediators, including age, working experience, and robot acceptance, were not significantly (p>0.1) correlated with the CSACD score difference (robot versus telephone).
CONCLUSIONS: Robot Physician rounding in the ICU was superior to the telephone in regard to the nurse-physician collaboration and satisfaction about care decision. The working experience and technology acceptance of ICU nurses contribute to the preference of night shift rounding method from the aspect of collaboration with the ICU physician about ICU care decision-making.
Shelley Moore
Middle Tennessee State University, USA
Title: Cross-training Medical/Surgical Nurses to Pediatrics via Simulation Using Unfolding Scenarios: Effects Upon Teamwork
Biography:
Shelley C. Moore received her BSN from State University of New York Institute of Technology at Utica/Rome, NY. She received a masters of science in nursing administration from Barry University, Miami Shores, FL. She holds a PhD in Health Sciences, majoring in international health education and research. Her research interests include the study of structural empowerment in the work environment, structural empowerment within the student learning environment, clinical reasoning, decisional involvement of staff nurses, effects of simulation on teamwork. She has been an Assistant Professor at Middle Tennessee State University School of Nursing for 5 1/2 years and currently teaches online courses in the graduate program, the RN to BSN program, and ground courses in the traditional undergraduate program. Dr, Moore has published in journals, such as The Journal of Nursing Administration, International Journal of Childbirth Education, and American Nurse Today and has presented at local, regional, national, and international conferences. Dr. Moore has a 35+ year history of working in both community hospitals and academic medical centers.
Abstract:
This intervention research study included a cross-training of experienced Medical/Surgical Registered Nurses and Nursing Technicians using human patient simulation to learn care of pediatric patients. The study took place in a regional hospital in the Southern Middle Tennessee area. The purpose of the study was to educate Medical/Surgical nursing staff in caring for a pediatric population, necessitated by organizational restructuring, while studying the training’s effect on teamwork. Participants were randomly assigned to either a control group or an experimental group. All participants completed a pretest regarding perceptions of teamwork before the intervention group underwent cross-training. Comparisons of teamwork were made between the control group and experimental group. The intervention was comprised of three hours of human patient simulation with a pediatric simulator. Unfolding scenarios included the infant with fever/dehydration and the child with asthma exacerbation. The intervention group was given a post-test regarding teamwork. Pre-test/post-test comparisons were made to determine if the simulation intervention made a significant difference in perceptions of teamwork. Anecdotal debriefing results included increased knowledge in caring for pediatric patients while at the same time enhancing collaboration between the newly merged staff and the Unit Educator. Both quantitative and qualitative data will be shared during the presentation.
Jeitziner, Marie-Madlen
University Clinic for Intensive Medicine, University Hospital of Bern, Switzerland
Title: Changes in health-related quality-of-life in older patients one year after an intensive care unit stay
Biography:
After many years of critical care nursing experience, Marie-Madlen Jeitziner completed her PhD at the age of 45 from the University of Maastricht in The Netherlands. She is currently employed by the University Hospital of Bern as a researcher on the ICU and supervises master’s theses. She has published articles in Swiss and international journals and supervises projects in nursing research and development.
Abstract:
As older patients increasingly survive intensive care unit hospitalization, the long-term quality of life is also an significant outcome. Therefore, this presentation investigates the health-related quality of life; an important outcome for assessing ICU treatment, and assisting patients, relatives and healthcare professionals in selecting treatment decisions one year after an ICU stay. A prospective non-randomised longitudinal study investigated the health-related quality-of-life of older patients. The Short Form Health Survey 36 was administered 1 week after an ICU stay (retrospective baseline), and after 6 and 12 months to the study population and to an age-matched comparison group at recruitment (baseline), and after 6 and 12 months. Demographic data, admission diagnosis, length of stay, severity of illness, pain, anxiety, agitation, and intratracheal suctioning, turning and intubation were recorded. Recruitment period: December 2008 to April 2011. Health-related quality of life was significantly lower than the comparison group, both before and after the ICU stay, and showed great individual variability. Within group scores, however, were stable. Both physical and mental health scores were lower for the older patients. Renal failure, cardiac surgery and illness severity were associated with lower physical health scores. Cardiovascular illness, intratracheal suctioning and turning were associated with lower mental health scores. After discharge older patients with severe illnesses, cardiac surgery or acute renal failure need additional support. Discharge planning should ensure that support. The development and utilisation of methods to reduce distress during routine intensive care interventions such as intratracheal suctioning or turning is needed.
Yung-Mei Yang
Kaohsiung Medical University School of Nursing, Taiwan
Title: Health concerns of intimacy partner violence (IPV) among transnational marriage immigrant women in Taiwan: A thematic analysis.
Biography:
Dr. Yung-Mei Yang service as an associate professor and head of research development and international division in college of nursing, Kaohsiung Medical University, Taiwan. She earned her PhD from Queensland University of Technology (QUT), school of nursing, Australia. She has devoted herself in the nursing education for ten years. She has been a leader of multidiscipline education program in nursing education and teaching community health nursing, age care, cultural nursing and women’s health. Her researches are mostly focusing on women’s health, domestic violence and culture nursing and community health issues.
Abstract:
Background and Purpose: Public health professionals are increasingly concerned about the migration of transnational marriages across Asia. These group of families not only complicated health issues but also highly vulnerable to domestic violence for the immigrant women’s families. This purpose of this study is to explore the health concerns among domestic violence of Southeast Asian immigrant women in Taiwan.
Methods: Qualitative in-depth interview and semi-structured interview index were used for data collection. The convenient sampling and snow ball technique were used to recruit the participants. 38 transnational marriage women’s families with DV experienced were invited in this study. The thematic analysis was used to analyze the categories and themes of domestic violence health experience among battered Southeast Asian immigrant women’s family in Taiwan.
Results: 30 abused participants were completed the interview (22 Vietnamese and 8 Indonesian). Participants ranged in age from 20 to 39 years, with a mean age of 27.4 years (SD = 4.6). The levels of education for the majority of participants were elementary school and junior high school. The women’s length of residency in Taiwan ranged from 6 months to 10 years, with a mean number of 4.3 years (SD = 2.6). Five outcome themes of this study include: 1. Frequent psychosomatic complains, 2. Codependence relationships with family members, 3. Lack of efforts to seek help, 4. Isolate social networks, and 5. Acculturative stress.
Conclusions and Implications: The result of the study will contribute to develop appropriate health policy for immigrant women’s health and well-being .
Debbie McCarthy
Flinders University, South Australia
Title: Social work in the emergency department-implementation of a domestic and family violence screening program
Time : 10:00-10:20
Biography:
Debbie McCarthy completed the Bachelor of Social Work in year 2000, prior to this she was an enrolled nurse for 15yrs, during this period working in residential care facilities, palliative care and a brain injury unit. As a social worker she has been employed as a counselor for Human Services Task Force in tissue retention, has worked in various inpatient wards. She has worked as the Flinders Medical Centre Emergency Department Social Work Team Coordinator for 12yrs, having extensive experience in crisis intervention and trauma counseling; she has also designed a number of resources for consumers and staff. She established a training program for staff in the Emergency Department and Post-graduate nursing program and has been a guest speaker at various workshops in Adelaide. She is on a state-wide advisory group regarding domestic violence for education and clinical procedures. She has recently won the Excellence in Allied Health Award for the Southern Adelaide Local Health Network for her work in domestic violence.
Abstract:
Women who have experienced domestic and family violence use health services more frequently than women who have not. Early identification and intervention by the health system may reduce health problems associated with domestic and family violence and lead to saving for the health sector. This study aimed to evaluate the impact of a new domestic and family violence screening program, which was based on an ecological model and introduced by a social work team in the Emergency Department of a major metropolitan hospital. The evaluation method included an audit of social work case files to access the effect on referral rates and a survey of Emergency Department staff to obtain perceptions of the impact of the program on the staff and clients. In the 3 month period following the introduction of the program, the rate of referral to social work increased by 213%. Staff agreed that the Emergency Department is an appropriate place to ask about domestic and family violence, under certain conditions. Findings suggest that an ecological social work model provides an approach to screening for domestic and family violence that not only contributes to increased identification and supportive client interventions but may also contribute to more sustainable systemic change.
Rena Boss-Victoria
Bowie State University, USA
Title: Social determinants of healthcare outcomes revisited: The continuing persistence of disparities in communities of color
Time : 12:40-13:00
Biography:
Rena Boss-Victoria has completed her DrPH and MPH from University of Texas School of Public Health and postdoctoral studies from University of Alabama School of Public Health Injury Control Center. She is the director/Chair of the Nursing Department at the first recognized Historical Black Colleges/Universities (HBCUs) in the Eastern Region of USA. She has built her professional career on a trajectory through practice to education to research to policy. The targeted outcomes were population health improvement and increased community capacity. Much of the work focused on increased access to quality health services for populations facing disparities. She has published and presented numerous papers and has been serving as an Editorial Board Chair.
Abstract:
Over the last few two decades, a plethora of studies have documented disparities in healthcare outcomes in communities of color. Consequently, a crescendo of knowledge about, symptoms of and potential solutions to close the gaps healthcare outcomes between communities of color as other communities who consistently experience higher healthcare outcomes has exponentially grown. Moreover, efforts of government and private agencies have grown significantly. The enactment of the American Affordable Care Act by the Congress of United States of American and signed in to federal law by President Barrack M Obama represented a very important set of changes in the healthcare delivery system in the U.S. The policy changes mandated by that law are still unfolding today. Unfortunately, identified gaps that were identified long ago still persist. In fact, in some cases, identified gaps have actually increased. The current paper is focused on an analysis of three major elements regarding healthcare outcomes with the context of social determinants of healthcare and disabilities outcomes. Those elements are: Activities of Daily Living Deficit (ADLD), Service Expectation Deficit (SED), and Confidence in Service Deficit (CISD).
Julio-Cesar de la Torre-Montero
Comillas Pontifical University, Spain
Title: Competences in oncology clinical trials for nurses: A twenty year practice perspective
Time : 12:20-12:40
Biography:
Julio-Cesar de la Torre-Montero teaches Oncologic Nursing Care and Palliative Care along with Ethic and Research Methodology at Comillas Pontifical University since 2014. Before starting his full-time teaching in college, he worked at Hospital Clinico San Carlos in Madrid, Spain, being an active researcher in clinical trials. His clinical experience in the onco-hematological field spends over more than twenty years. In Europe, he has worked in primary care, implementing health education programs (Skeletal Care Academy) for patients, in order to improve their quality of life and to promote a healthy lifestyle. Overseas, he has designed and implemented Health Programs in Africa.
Abstract:
Clinical trials in nursing have special requests that need attention and specific training. From a clinical training perspective, they provide us with an extensive experience along with theoretical knowledge. In order to achieve the competences that will allow us to become experts, we need to combine the experience in the academics and clinical field. We gathered a team of experts (three nurses, two pharmacists, one physician) with clinical experience as well as an extensive trajectory as college professors in order to define several competences (general, specific, and some of them particularly designed) to be applied in a nurse study in an Oncology Clinical Trial. We named and classified these competences in several categories such as: to know the competence, to know how to design the competence and to know how to perform such competence. To describe the competences of a study nurse, we must point out that study nurses take place in a multidisciplinary team, working with proper and delegated tasks. They do not just provide nursing care such as vital signs registration and administration of the prescribed medication. Along with that, they provide health education and assessment on treatment adherence. They are also responsible for the performance of complementary techniques including: providing assistance with the quality of life questionnaire-completion, EKG recording and blood extraction (that will be necessary to determine the phase I-II kinetics, pharmacogenomics, circulating tumor cells and basic blood work). They should also be ready to respond to adverse events and reactions coming from the prescribed treatments. Related to the above mentioned skills, it is important to know not only how to perform these techniques correctly, but to know why as well as the way how to approach the patient‘s needs.
Sevgi Ozkan
Pamukkale University, Turkey
Title: Fathers' functional status during pregnancy and the early postnatal period
Time : 12:00-12:20
Biography:
Sevgi Ozkan has completed her Master and PhD at the Ege University, Faculty of Nursing. She became Associate Professor for the department of Obstetrics and Gynecologic Nursing in 2010. She is the head of the nursing department at Faculty of Health Science in Pamukale University. She has published more than 25 papers in reputed journals and has been serving as an Editorial Board Member of repute.
Abstract:
Objective: To determine the functional status of fathers whose wives were pregnant or in the early postnatal period.
Sample & Setting: The research population comprised 3750 fathers whose wives were pregnant or in the early postnatal period, and who were registered at a primary health clinic in the province centre. The research sample comprised 275 husbands of women who were registered at these clinics and who were in at least their 28th week of a normal (not at-risk) pregnancy with a single fetus, or who were in the early postnatal period (6-8 weeks postnatal) following birth of a single baby between the 38th and 42nd week without complications. Due to fathers declining to participate in the study or unable to participate because of busy work schedules, the research was completed with 155 fathers-to-be and 93 fathers; in total, 90% of the target sample was reached. A socio-demographic survey and the Inventory of Functional Status-Fathers were used for data collection and to describe the functional abilities of fathers-to-be and fathers.
Findings: No statistically significant differences were found in functional status between the husbands of pregnant women and the husbands of women in the early postnatal period. Number of pregnancies was not significantly related to any of the seven subscales of fathers' functional status; age of husband, length of marriage and occupation of wife were significantly related to one subscale; occupation of husband and health insurance were significantly related to two subscales; income status of husband and educational level of wife were significantly related to three subscales; and educational level of husband was significantly related to four subscales.
Conclusion: Although there was no significant difference in functional status for the husbands of pregnant women and the husbands of postnatal women, socio-demographic factors were found to have an effect.
Janine Farquharson
Royal Brisbane and Women’s Hospital, Australia
Title: Implementation of a midwifery group practice continuity of care model for aboriginal and Torres strait islander women and their families at the royal Brisbane and women’s hospital, Brisbane, Australia
Time : 11:40-12:00
Biography:
Janine Martha Farquharson has been a qualified Registered Nurse and Midwife since 1978 and has since obtained a Bachelor on Nursing, a Graduate Certificate in Youth and Child Health Nursing and completed a Master of Midwifery in 2011. She was involved in a publication involving a change in practice for Category 1 Caesarean Sections.
Abstract:
The Ngarrama Royal Midwifery Group Practice (NRMGP) was introduced to provide continuity of care/r for Aboriginal and Torres Strait Islander (A&TSI) women throughout the continuum of pregnancy, irrespective of their pregnancy risk. The aim of this initiative is to improve the health outcomes of this group of women, their babies and their families. This is in keeping with the government initiative to close the gap in health outcomes of Aboriginal and / or Torres Strait Islander women and their families (Closing the Gap: National Partnership Agreement on Indigenous early Childhood Development). In April 2011 the Royal Brisbane and Women’s Hospital (RBWH) Aboriginal and Torres Strait Islander Maternity Service commenced providing antenatal and postnatal care only. A combination of client feedback, increasing client numbers, and available published evidence resulted in the introduction of an All Risk Midwifery Group Practice continuity of care model for the Aboriginal community. The NRMGP Continuity of Care Model was launched on the 5th of January 2015. Data shows that 88% of women engaged with the NRMGP are attending eight or more antenatal visits, compared to 60% for non-Ngarrama A&TSI clients. The birth of low birth weight babies less than 2500g is now on par with the non-indigenous population (non-indigenous 12.06%, Ngarrama MGP 12.43%, non-Ngarrama A&TSI 53.33%). The average length of stay (ALOS) for this group of women has fallen by 1.4 days (NRMGP ALOS 2.00 days, non-Ngarrama A&TSI ALOS 3.4 days). 93% of NRMGP women have their NRMGP midwife attend them in labour.
Terri Sullivan
Emory University Hospital, USA
Title: Recognizing intimate partner violence
Time : 11:20-11:40
Biography:
Terri Sullivan is a staff nurse in the emergency department at Emory University Hospital in Atlanta, Georgia. Since graduating from Castleton State College in Castleton, Vermont she has been a nurse for over 25 years including 15 in various intensive care units. A certified emergency nurse since 2007, she has served on several state and national committees with the Emergency Nurses Association and remains active in the Metro Atlanta chapter. She is currently continuing her education with Villanova University in Villanova, Pennsylvania. Her interest in domestic violence began upon learning of an assualted pregnant patient who had been seen many times prior at the facility she worked at who had been thought of as a "frequent flier." The situation left her committed to preventing something like this from happening again. She has sought experts in the field to learn from and has published her findings in the November 2015 Journal of Emergency Nursing.
Abstract:
Domestic violence screening is a required element of emergency nursing care. Research has been conducted revealing that only 15% of patients cared for in the emergency departments are actually screened for this violence by nurses. The studied nurses identify patient presentation as a determining factor of whether or not screening will be completed and site time constraints and privacy issues as barriers to completion Opportunities exist to save lives by screening all patients for potential domestic abuse. There is no typical victim, and many will be seen multiple times before domestic abuse is unveiled. It is important for providers to know how to assess for violence and what to do if it is disclosed.
Mona Ahlberg
Vrinnevisjukhuset, Sweden
Title: Moving on in life after intensive care - partners' experience of group-communication
Time : 11:00-11:20
Biography:
Mona Ahlberg has been working as an intensive care nurse for five years and has published one paper in a reputed journal.
Abstract:
Partners have a burdensome time during and after a partners' intensive care period. They may appear to be coping well outwardly but inside feel vulnerable and lost. Evaluated interventions for partners are limited. The aim of this study was to describe the experience of participating in group- communication with other partners of former intensive care patients. The study has a descriptive intervention based design where group-communication for partners of former, surviving ICU-patients, was evaluated. Two group-communication sessions was held the partners afterwards wrote, in a notebook, about their feelings of participating in group-communications. To deepen the understanding of the impact of the sessions six of the partners were interviewed. Three categories were identified: 1) Emotional impact, the partners felt togetherness and experienced worries and gratitude, 2) Confirmation, consciousness through insight and reflection, 3) Partners of an intensive care patient are on a journey, constantly trying to adapt to the new situation and find new strategies to ever changing circumstances. Group-communications contributed to togetherness and confirmation. To share experiences with others is one way for partners to be able to move forward in life. Relevance to clinical practice: Group-communication with other patients' partners eases the process of going through the burden of being a partner to an intensive care patient. Group-communications needs to be further developed and evaluated, to obtain consensus and evidence for the best practice.
Anita Hunter
Washington State University, USA
Title: Heavy metal consumption and the effect on the child-bearing health of women and the development of their children
Time : 10:20-10:40
Biography:
Anita Hunter completed her PhD from University of Connecticut in 1994. She has been involved in global health for over 20 years in Africa, Mexico, Dominican Republic, Belfast, and Taiwan. She is a full professor and Associate Director of Nursing Programs at WSU-Vancouver Campus; as well as the Medical Director for the Holy Innocents Children’s Hospital Uganda Charitable Foundation. She has published more than 35 papers in reputed journals and over 50 professional presentations on her research across the globe.
Abstract:
Problem: Research has found that heavy metal ingestion through drinking and/or cooking with water contaminated by such elements as lead, arsenic, fluoride, selenium, cadmium, and others cause significant health problems such as cancers, cardiovascular problems, neurological damage, pulmonary, and other organ deficits in women of child-bearing age as the elements cross the placental barrier and affect fetal development; as well as in the maturing child who often incurs developmental problems and cognitive deficits.
Research question: What is the relationship between malnutrition and excretion of heavy metals in the urine on the child-bearing health of women, the physical health and developmental achievements of their children ages birth through age 12 in Uganda?
Methods: Sample size: women N=200; children birth-age 12 N=200; villages where research conducted: N=5 (3 supplied by government water sources; 2 obtained water from ground sources)
Preliminary findings: Government supplied water was evaluated by the water quality experts on the team and found to be safe from bacteria and heavy metals; water from the ground sources found to be highly contaminated by bacteria and toxic levels of heavy metals-fluoride, lead, arsenic. Participants consuming water from the ground sources were found to have significantly more pregnancy-related problems, fetal deaths, premature births, and children with developmental delays than women and children using the government water source. Final statistical analysis is still in progress.
Conclusions: Preliminary findings support current research on the effect of heavy metals on the health and well-being of child-bearing women and their children. In order for the governments of developing nations to take action on supplying clean, safe water to their constituents, hard data is essential for them to see the extent of the effects. This research is ongoing.
- Nursing Education
Nursing Management
Nursing Practice
Location: Westminster Ball Room
Chair
Alison Burton Shepherd
Care Quality Commission Specialist Advisor, UK
Co-Chair
Marlene M Rosenkoetter
Augusta University, USA
Session Introduction
Madeline Lassche, Sharifa Al-Qaaydeh
University of Utah, USA
Title: Identifying changes in comfort and worry among pediatric nursing students following clinical rotations
Time : 10:00-10:20
Biography:
Madeline Lassche teaches primarily in pediatrics and is considered an expert on pediatric respiratory and cardiovascular issues. Madeline also has expertise in writing simulation scenarios for the University of Utah, College of Nursing and Elsevier publishing. She has presented numerous times at national and international simulation conferences and is currently working with Intermountain Healthcare to deliver a local simulation facilitator course.
Sharifa Al-Qaaydeh has been a nurse at Primary Children's Medical Center's Pediatric Hematology/Oncology floor. Upon completing her MS in Teaching Nursing from the University of Utah in 2008, she became a clinical faculty member with the College of Nursing's undergraduate and graduate program. She is also a PhD student and candidate with research interests in symptom management in young children with cancer.
Abstract:
Background & Purpose: Pediatric clinical settings are stressful and anxiety-provoking environments. Previous studies indicate the greatest worry for students is causing a child pain. This study aims to replicate previous results using three different nursing programs to determine if initial results are generalizable to a greater population.
Methods: This quantitative descriptive study utilized pre-post design. The “Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool” assesses students’ perceptions regarding their clinical experiences with children, and evaluates common worries associated with pediatric rotations. Acceptable initial validity and internal consistency with Cronbach’s alpha of .806 for comfort and .766 for worry were obtained. Data were reviewed for missing values and outliers before analysis. Changes in subscale results were assessed using paired t-tests. A total of 250 students consented to participate with a total of 206 participants completed both pre/posttests.
Results: Significant (p<0.05) improvement among participants from pre-test to post-test in all areas except “helping families/children cope with painful procedures”. Clinical comfort increased while worry decreased. Correlations between study variables, age and the number of children did not have strong relationships with clinical comfort or clinical worry. However, how often students worked with children and their comfort with children did have stronger correlations with both factors.
Conclusion: The results of this study suggest student worries are often present but also manageable. Faculty can tailor post-conferences and clinical learning opportunities to address identified areas of worry and increase clinical confidence, most notably with painful procedures. These conclusions are consistent with previous research.
Juliann Perdue
California Baptist University, USA
Title: Integrating animal-assisted interventions in nursing curriculum
Time : 10:20-10:40
Biography:
Juliann Perdue has completed her Doctor in Nursing Practice (DNP) from Western University of Health Sciences in 2012. She is the Undergraduate Nursing Program Director, at California Baptist University in Riverside, California. She has specialized in animal-assisted therapy and is a certified human-animal bond intervention specialist (CHAIS). She has also peer reviewed numerous articles on complementary and alternative therapies.
Abstract:
People love their animals. Sixty-two percent of U.S. homes have pets and 75% of homes with children have at least one pet (Fine, 2010). The human-animal bond (HAB) is strong and affects the health status of patients across the lifespan. Nurses are quintessential in the assessment of the human-animal bond and implementation of animal-assisted interventions (AAI) in healthcare institutions. Complementary and alternative therapies, which include AAI, have been incorporated in the AACN Essentials of Baccalaureate Education for Professional Nursing Practice and are also part of the NCLEX blueprint. However, few nursing programs address AAI in the nursing curriculum. Curricular analysis shows three of the 26 nursing courses in the undergraduate BSN program at California Baptist University discuss AAI, and only one, Mental Health, includes theoretical content with learning activities and evaluation methods. The integrated curriculum approach suggested by Manor (1991) provides guidelines for incorporating AAI in both theoretical content and clinical application. This method was used to thread AAI throughout the nursing program in core nursing courses at each level of the program. Faculty created learning activities and evaluation methods building on critical thinking skills. A vital component of the process was to have a certified human-animal intervention specialist and trained therapy animal on staff at the School of Nursing. As a result, AAI was integrated at all levels of the nursing program.
Lynda Olender
Hunter Bellevue School of Nursing, USA
Title: The relationship between and factors influencing, the staff nurses’ perception of nurse manager caring and their perceived exposure to workplace bullying within multiple healthcare settings
Time : 11:00-11:20
Biography:
Lynda Olender has completed her PhD from Seton Hall University, NJ. She is the author of numerous articles and book chapters primarily focused on the concepts of caring, incivility and workplace bullying within nursing. She is currently a Distinguished Lecturer and Graduate Program Director at Hunter College. She is also the Co-Principle Investigator on two research initiatives: 1) a qualitative study to record the life stories of female veterans, and, 2) the impact of implementing shared governance and a professional practice model on
Abstract:
Objective: To examine the relationship between, and factors influencing, the staff nurses’ perception of nurse manager caring and their perceived exposure to workplace bullying within multiple healthcare settings.
Background: This study was based on Watson’s theoretical position (1979, 2008) that caring is reciprocal in nature and promotes caring and healing for and among each other (and including within an administrative context).
Methods: A descriptive correlational design was employed to assess staff nurses self report of nurse manage caring (using the Caring Factor Survey-Caring of the Manager, Nelson, 2010) and their perception of being exposed to negative acts meeting the definition of workplace bullying, among 156 staff nurses working within multiple healthcare settings in a large metropolitan area within the United States.
Results: Results confirmed a significant inverse relationship between nurse manager caring and exposure to workplace bullying in the nursing workplace (r = .534, p .001) meaning that as staff nurses’ perceptions of their nurse manager caring increases, their perception of exposure to negative acts (meeting the definition of workplace bullying) significantly decreases. Study findings also indicated that gender and workload negatively influenced these findings. Further, data analysis revealed that staff nurses who were females and those who worked in Medical/Surgical settings were significantly more likely to perceive their managers as caring (p < .05 respectively) and that a high workload significantly influenced the staff nurses perception of exposure to bullying (p < .05) in the workplace.
Conclusions/Clinical Relevance: In consideration of the 2025 prediction of severe nursing shortages as baby-boomer nurses retire at the same time the demand for health care will increases (AACN, 2009), study findings highlight the importance of caring leadership to ensure the health and availability of our nursing workforce. Study findings also suggest the need for shifting nurse manager work priorities to optimize their time and availability to staff at the point of care. Further, empirical findings lend support for the design and implementation of caring curriculum and related competencies for nursing leaders both within the clinical and academic work settings.
Sandra Kundrik Leh
Cedar Crest College, USA
Title: Enhancing understanding of poverty through simulation
Time : 11:20-11:40
Biography:
Sandra Kundrik Leh earned her MSN in Community Health Nursing from West Chester University and a PhD in Nursing from Widener University. She is an Associate Professor at Cedar Crest College in Allentown, PA. She is a Certified Nurse Educator and member of several professional organizations. She has published and presented in the US and abroad on a variety of topics related to nursing education, global health and community health nursing.
Abstract:
Teaching complex concepts such as poverty can be a daunting and challenging task for nurse educators. However, it is imperative that nursing students understand the health care challenges that face vulnerable populations. Textbook readings alone may not capture the depth of the issues and struggles faced by those living in poverty. Low fidelity simulation experiences, in addition to traditional teaching strategies, have shown to be effective in giving students the opportunity to gain a new level of empathy for families who struggle with few resources. Participants are compelled to examine their own attitudes, biases, and beliefs about poverty during the simulation session. By increasing students’ understanding of the complexities and challenges faced by low income families on a daily basis, they will be better positioned to provide more meaningful and effective health care. By enabling students to examine poverty from various perspectives, they can then recognize and discuss the potential for change in their local communities. This session presents an overview of an interdisciplinary-based low fidelity poverty simulation used in an undergraduate community health nursing course. The planning, implementation, and evaluation phases of the simulation experience are discussed.
Nan Smith-Blair
University of Arkansas, USA
Title: A unique educational model in transitional care of congestive heart failure patients
Time : 11:40-12:00
Biography:
Nan Smith-Blair completed her PhD from the University of Kansas in 2000. She is an Associate Professor in Nursing at the University of Arkansas whose primary duties include working with Honors students and conducting research. She has previously worked in the healthcare system at all levels of management including hospital administration. She has published more than 20 papers. She was elected as a Distinguished Fellow in the National Academies of Practice in 2014. She currently serves as President of the Southern Nurses Research Society and on the Leadership Council of the Council for the Advancement of Nursing Science.
Abstract:
Health-related quality of life (HRQOL) in individuals with congestive heart failure (CHF) is frequently compromised and associated with increased readmissions to the hospital and use of healthcare resources. Evidence supports use of various transitional care programs has been to effectively reduce effectively reduce hospital readmission rates explored. This project’s uses a unique approach that has not to our knowledge been implemented elsewhere. This novel approach to providing transitional care is comprised of nursing, social work, exercise physiology and nutrition students serving as a vehicle to transcend and bridging e the gap between hospital, home and clinic. It is consistent with the IOMs Future of Nursing: Leading Change, Advancing Health (2011) recommendation to prepare competent and skilled nurses to practice in the future healthcare system. This project demonstrates an innovative academic and practice collaboration model providing students with learning experiences in a patient-centered environment spanning the care continuum. Leveraging students and faculty with the expertise and resources in both academic and practice settings focus on overcoming individual, environmental and structural barriers to help the CHF patient achieve effective self-care management. This project is also evaluating the impact of this educational model on improved patient care outcomes. This project is a collaboration between an urban hospital, clinic based CHF clinic, and the University and the CHF patient and family. Students provide telephone and home visits to NYHA Class II and III CHF patients recently discharged from the hospital. Weekly transitional care team meetings are held to review patients and discuss appropriate plans of care. Formative and summative evaluations from students demonstrated a high degree of satisfaction. Moreover, the project was deemed successful by the hospital, CHF clinic and school of nursing in terms of student learning and patient outcomes with a decreased rate of emergency department visits and re hospitalizations.
Kathy Blair
University of Colorado, USA
Title: Combating chronic obstructive pulmonary/lung disease (COPD/COLD) by early recognition of risk factors
Time : 12:00-12:20
Biography:
Kathryn A Blair, a Professor at UCCS has been an Educator and an Advanced Practice Nurse (Family Nurse Practitioner) for over 25 years. She had written 17 refereed journal articles, book chapters, serves on several editorial boards and is active in many professional nursing organizations.
Abstract:
COPD is the fourth leading cause of death worldwide and some speculate COPD will reach the 3rd leading cause of death by 2020. Smoking and environmental pollution are well known to contribute to the development of COPD; however, there are many other risk factors that are less well known and poorly understood. If health care providers are to facilitate a reduction in COPD deaths, it is imperative that providers recognize those at risk and intervene early. This presentation will discuss the lessor known risk factors for COPD such as alpha1 antitrypsin deficiency, prematurity, occupational hazards and others. Additionally, a discussion regarding vulnerable populations will be addressed. A summary of the results of a survey exploring Colorado advanced practice nurses (nurse practitioners) awareness of risk factors will be presented.
Sylvie Robichaud-Ekstrand
University of Moncton, Canada
Title: New-Brunswick nurses’ views on nursing research and factors influencing their research activities in clinical practice
Time : 12:20-12:40
Biography:
Sylvie Robichaud-Ekstrand has completed her PhD from Montreal University and Post-doctoral studies from the Montreal Heart Institute Cardiac Rehabilitation Center, Canada. From 2005 to 2012, she was the Moncton University School of Nursing Network Director. In 2013, she became the Vice-dean of the Faculty of Health Sciences at the University of Moncton; the only French-speaking university in Atlantic Canada. As the Canadian Health Services Research Foundation Scientific Officer for nursing (1999-2001), she acquired experience with multi jurisdictional and national research dealing with health services. From 2004 to 2009, she was on the CIHR Nutrition, Metabolism and Diabetes Institute Advisory Board.
Abstract:
New-Brunswick became the first province in Canada to require a baccalaureate degree in nursing as the entry to practice, yet, nursing research activities in hospital settings remain quite low. The main objective of the study was to (a) examine nurses’ views on nursing research; exploring their value, role, interest, experience, perceived support for nursing research, and their utilization of health information technologies, and (b) to determine if age, level of education, number of years working as a nurse, and employment position were contributing factors to the research-practice gap in clinical practice. This descriptive cross-sectional multicenter study involved 1 081 nurses (65%) working in the Francophone Regional Health Authority Vitalité in New-Brunswick. Nurses valued nursing research at 82.3%. They were very keen in identifying nursing care problems to improve patient care (92.9%), to find ways to solve nursing care problems (93.8%), to be involved in collecting data on research projects. But without research supervision, few had engaged in basic research activities such as identifying a problem that led to a research project (24.5%), or presenting at a conference (6.9%). Younger, more educated nurses, and Nurse Managers and educators participated more readily in research activities, and were more competent with information technologies. Creating a collaborative clinical-academic research network is a strategy recommended for sharing research infrastructures, academic- research and clinical expertise, and patients. Concrete actions presented intend to build clinical nursing research capacity and to sustain a nursing research culture in clinical settings in New-Brunswick.
Wendy Laupu
James Cook University, Australia
Title: Polymer delivery systems augment polyphenol efficacy, for treating schizophrenia
Time : 12:40-13:00
Biography:
Wendy Laupu has completed her PhD from James Cook University. She is an adjunct Research Fellow in the Centre for Nursing and Midwifery Research at James Cook University. She is interested in non-pharmacological approaches for treating brain disorders.
Abstract:
The incorporation of drug delivery technologies appears to enhance the potential of polyphenols; to advance the field of nutritional neurobiology. Pre-clinical in vivo and in vitro evidence suggests that polyphenols may modulate brain functioning; germane to mental illness. A literary review examined the available evidence for efficacy of polyphenols, to achieve this claim. Studies whose design enabled the reporting of efficacy were considered. Randomized controlled trials or open-labeled studies were assessed. A pooled response demonstrated a positive signal for the use of bioavailable polyphenols to treat mental illness; beyond the effect size of current antipsychotic drugs. However, a very large effect size was achieved for a pilot study examining the efficacy of mangosteen extract in schizophrenia. This mangosteen extract is presumed to have crossed the blood brain barrier to modify clinical symptom domains and afford neuroprotection. This large effect size is incongruent with the expected low bioavilability of mangosteen extract; given its large molecular size and water solubility. We can speculate the enhanced bioavilability stems from the use of polymer technology during the spray drying process; used to preserve the active ingredient, alpha-mangostin. If this is so, the use of polymer technology to deliver polyphenol treatments has the potential to treat afflictions beyond schizophrenia. Mental illnesses and potentially degenerative, acquired and neurodevelopmental brain disorders (including Downs’ syndrome) may benefit in some way from the use of this technology. However, much work is required to translate this potential to clinical outcomes.
Janine Farquharson
Royal Brisbane and Women’s Hospital, Australia
Title: Implementation of a Midwifery Group Practice Continuity of Care Model for Aboriginal and Torres Strait Islander Women and their families at the Royal Brisbane and Women’s Hospital
Biography:
Janine has been a qualified Registered Nurse and Midwife since 1978 and has since obtained a Bachelor on Nursing, a Graduate Certificate in Youth and Child Health Nursing and completed a Master of Midwifery in 2011. Janine was involved in a publication involving a change in practice for Category 1 Caesarean Sections.
Abstract:
The Ngarrama Royal Midwifery Group Practice (NRMGP) was introduced to provide continuity of care/r for Aboriginal and Torres Strait Islander (A&TSI) women throughout the continuum of pregnancy, irrespective of their pregnancy risk. The aim of this initiative is to improve the health outcomes of this group of women, their babies and their families. This is in keeping with the government initiative to close the gap in health outcomes of Aboriginal and / or Torres Strait Islander women and their families (Closing the Gap: National Partnership Agreement on Indigenous early Childhood Development). In April 2011 the Royal Brisbane and Women’s Hospital (RBWH) Aboriginal and Torres Strait Islander Maternity Service commenced providing antenatal and postnatal care only. A combination of client feedback, increasing client numbers, and available published evidence resulted in the introduction of an All Risk Midwifery Group Practice continuity of care model for the Aboriginal community. The NRMGP Continuity of Care Model was launched on the 5th of January 2015. Data shows that 88% of women engaged with the NRMGP are attending eight or more antenatal visits, compared to 60% for non-Ngarrama A&TSI clients. The birth of low birth weight babies less than 2500g is now on par with the non-indigenous population (non-indigenous 12.06%, Ngarrama MGP 12.43%, non-Ngarrama A&TSI 53.33%). The average length of stay (ALOS) for this group of women has fallen by 1.4 days (NRMGP ALOS 2.00 days, non-Ngarrama A&TSI ALOS 3.4 days). 93% of NRMGP women have their NRMGP midwife attend them in labour.
X U Tuzen
Zhejiang Chinese Medical University, China
Title: A nurse-led long-term pelvic floor muscle training program in the management of female patients with overactive bladder
Biography:
Tuzhen XU has completed her MD at the age of 30 years from Zhejiang Chinese Medical University . She completed the clinical rotation for 2 months at Miami University Hospital this year. She is the nurse manager of the Second Affiliated Hospital of Zhejiang Chinese Medical University, She is interested in women incontinence and she has published more than 10 papers in reputed journals.
Abstract:
To investigate the treatment outcomes of a nurse-led long term pelvic floor muscle training in relieving the symptoms and improving the quality of life in female patients with overactive bladder. A total of 107 patients were randomized into two groups. The intervention group ( n = 54) received a 6-month nurse-led long-term pelvic floor muscle training program (three sessions a day, 15-20 times per session) and the control group (n=53) received usual care. All patients received 3-month tolterodine extended release tablets (5 mg - once daily). The treatment outcomes were measured by the Modified Oxford Scale (MOS), Overactive Bladder Symptom Score (OABSS) and the King’s Health Questionnaire (KHQ) at baseline, 3 and 6 months respectively.A total of 46 patients in the intervention group and 45 patients in the control group completed the trial. The trial revealed statistically significant differences between groups in pelvic muscle strength at 3 months following the intervention (P<0.05), but no significant difference was found between two groups in OABSS scores (P>0.05). In regards to quality of life, the experimental group showed significant improvements compared to the control group on 6 of 10 domains (P<0.05). At 6 months, there were significant improvements in OABSS scores and quality of life in the experimental group compared to the control group (P<0.05). A nurse-led long-term (6 months) pelvic floor muscle training program can alleviate OAB symptoms effectively and improve the quality of life more than a short term (3 months) pelvic floor muscle training program combined with solifenacin succinate tablets.
Catherine O Brien
St James’s Hospital, Ireland
Title: Febrile Neutropenia Risk Assessment- An Irish Perspective
Biography:
My experience to date involves over 20 years as an Oncology / Haematology nurse incorporating Bone Marrow Transplantation, Palliative care and Medical Oncology (both inpatient and daycare)in hospitals both in Ireland and United Kingdom. I have been based in St James’s Hospital, Dublin since 2001 working in both clinical and managerial positions. I completed my MSc in Clinical Practice in 2011 in University College Dublin, during which time I completed this research piece and published 2 articles
Abstract:
Purpose/ Objectives: To develop, implement and evaluate the effectiveness of a nurse-led risk assessment tool to reduce the incidence of febrile neutropenia (FN) in adult cancer patients receiving myelosuppresive chemotherapy. Design: A comparative prospective observational study was conducted in a hospital-based oncology unit. Sample: Clinical data was collected from 459 patients' charts; 233 patients (50.8%) in phase one had no intervention and 226 patients (49.2%) in phase two had a risk assessment carried out by the nurse, prior to each cycle of chemotherapy. The main outcomes captured were febrile neutropenia, dose reductions, treatment delays and hospitalisation days. Methods: International evidence-based guidelines and published nursing studies were used to develop and implement a risk assessment tool. The tool assessed the risk associated with the chemotherapy regimen and 25 patients-, treatment- and disease-related FN risk factors. Identification of one or more risk factors indicated that patients were at risk of developing FN and Growth Colony Stimulating Factor (G-CSF) should be considered. Clinical outcomes pre and post implementation were used to evaluate the risk assessment tool. Findings: There were significant reductions in the incidence of FN (15.5% vs. 7.5%) and the number of hospital days (267 vs. 131) following the introduction of the risk assessment tool. Incidence of dose reduction and treatment delays resulting from FN were lower in the second phase. There was an increase of 12.5% in the use of G-CSF in phase one (40%) versus phase two (45%). Social factors were found to have no impact on the risk of developing FN. Conclusions: Through consistent risk assessment, nurses could determine which patients were at higher risk of developing FN, leading to the more appropriate proactive use of prophylactic G-CSF use in a target population. This led to a significant reduction in life-threatening infections, hospitalisations, dose reductions and delays.
Rong HU
Fujian Medical University School of Nursing, China
Title: Comparative analysis on curriculum design and teaching mode of undergraduate nursing education between two universities in China and Australia
Biography:
Rong Hu has completed her PhD at the age of 35 years from Fujian Medical University and a year visiting scholar in Canberra University Faculty of Health. She has published more than 10 books and 38 papers in international and national journals and has been serving as an editorial board member of repute in China .
Abstract:
The nursing baccalaureate curriculum and teaching modes were compared between Fujian Medical University in China and Canberra University in Australia.There were many differences in curriculum content and structure,teaching hours,practical course,teaching mode and teaching assessment and evaluation.The curriculum design of nursing undergraduate in China should gradually go out of the mode of disease,and the courses and the class hours should be reduced. Nursing students should be encouraged to use self-learning and group collaboration learning. The teaching method of “patient experience” should be emphasized to cultivate the students’ humanistic quality,professional emotion and responsibility.
MA ANTONETTE
University of the Philippines, Philippines
Title: Roles and Impact of Nurses in Promoting Medication Adherence of Patients Under the TB-DOTS Program in District V, Mani
Biography:
The authors are fresh graduate student nurses from the University of the Philippines Manila who had an undergraduate research under the guidance of their professors: Professor Vanessa Manila-Maderal MA-HPS, RN and Dr. Cora A. Anonuevo, PhD, RN.
Abstract:
Through the National Tuberculosis Program (NTP), TB-DOTS reached and sustained 100% nationwide coverage, achieving the global target for detection of new cases. NTP Manual of Procedures (MOP) enlists functions of health workers in TB-DOTS. PURPOSE: To determine the actual roles and activities of nurses in promoting medication adherence of patients under the TB-DOTS Program in District V, Manila. METHODS: The study employed a descriptive exploratory design to gather baseline data on the actual roles and activities of nurses in promoting medication adherence. Eleven TB nurses were profiled and surveyed using a questionnaire drafted from the 2005 NTP MOP, 29 former TB patients (cured) were interviewed and a cohort of 723 TB case records were tabulated to determine the cure rate, treatment completion rate, and relapse rate for District V Manila. Descriptive statistics, content analysis, and data triangulation were performed and further analyzed using Williams et.al’s Self-Determination Model of Medication Adherence (1998). A pool of experts on TB-DOTS and health policies were consulted. RESULTS: The current treatment success rate of 73% (n=600) in District V Manila did not meet the target National Treatment Success Rate of 90%. The computed cure rate is 26.55% (n=192), relapse rate of 1.24% (n=9), treatment completion rate of 56.43%. CONCLUSION: The roles and activities of nurses related to patients’ adherence to TB medications were deemed essential towards better TB patient outcomes. The study recommends further training of nurses for them to improve in carrying out the TB treatment regimen to improve patient adherence.
Biography:
Lorie A. Brown graduated from Indiana University school of nursing with a BSN in 1982. She then attended the University of California at Los Angeles school of nursing and obtained a master’s degree. She then went on to obtain a Juris Doctorate law degree from Indiana University in 1990. Ms. Brown combines her specialties with a practice of representing nurses before the Licensing Board and empowering nurses to be fulfilled in their career and be a change agent to improve patient care.
Abstract:
Purpose: The purpose of this program is to teach nurses how to use the GIFTS system so they can create a better work environment and increase their satisfaction which ultimately improves patient care. Relevance/Significance: The GIFTS system is a viable solution that improves clinical care. It gives the nurse a decision making tool that will advance her practice, improve her satisfaction and improve patient care. Strategy and Implementation: The GIFTS system is an easily remembered tool. Remember how SBAR changed how nurses communicate? The GIFTS system can do the same thing by giving nurses a context within which to practice. All their decisions and actions should be governed by the GIFTS. I have taught the GIFTS to thousand of nurses throughout the country by speaking, books, videos. Nurses love how easy it is to remember the system and the tools really have made a huge difference in their practice. Evaluation: The GIFTS improve nurses' satisfaction and ultimately patient care. The GIFTS system help nurses practice safely because the decisions that are made using the GIFTS guide excellent patient care. Implications for Practice: The use of the GIFTS allow nurses to speak their mind in a positive solution based way, stand in their power and be a change agent to improve patient care.
Juli Verkler
Valparaiso University, USA
Title: Case Review: A Pregnant 26-Year Old with H1N1 Influenza
Biography:
Juli Verkler completed her first master’s degree in forensic science in 2009 from National University in San Diego, California. She will finish her second master’s degree in (MSN) in May of 2016. She is currently adjunct faculty at Valparaiso University. In addition, she has over 20 years of experience as an emergency and trauma nurse and has been an emergency nurse educator at several hospitals throughout her career. She has been published several times in the Journal of Emergency Nursing. She is also an active member of the Emergency Nurses Association and Sigma Theta Tau, International Honor Society of Nursing.
Abstract:
This article focuses on an actual patient case that presented to a Level II Trauma Center within the United States of America. The patient was a normally healthy 26 year old female, who happened to be approximately twenty-four weeks pregnant. She was in respiratory distress and was immediately treated aggressively for H1N1 influenza virus. Throughtout her emergency department course, the patient was placed on BiPap and stabilized. However, once she was transferred to the intensive care unit, she massively decompensated. Ethic considerations were in place for both the patient and her unborn fetus. The patient was intubated, sedated and ventilated as she was placed on the appropriate antibiotics. Extracorporeal membrane oxygenation (ECMO) support was suggested in the event that the patient continued to decompensate. As a result of the H1NI virus, the patient became severely hypoxemic, was in respiratory alkalosis, and hypokalemic. Her liver enzyme levels were significantly elevated which correlates specifically with the 2009 pandemic strain of the H1N1 disease. The patient’s course of treatment was also complicated by acute respiratory distress syndrome. At approximately 32 weeks, the baby was delivered via Cesarean section and had a good outcome. After 2 months of hospitalization the patient was discharged home. In conclusion, the patient did not receive her yearly influenza vaccination.
Hu Ziyi
West China Medical School of Sichuan University, China
Title: Relationship between emotional intelligence and resilience among emergency and ICU nurses
Biography:
Hu Ziyi has completed his bachelor degree from Shanghai Jiao Tong University. She is studying at West China Medical School of Sichuan University for her master degree at present. And her major is focused on the Nursing Management.
Abstract:
Objectives: To investigate the status quo and the relationship between emotional intelligence and resilience of emergency and ICU nurses in tertiary general hospitals in Chengdu.Methodology: A total of 660 emergency and ICU nurses were surveyed by a pack of questionnaires including the General Information Questionnaire, the Resilience Scale and the Wong and Law Emotional Intelligence Scale.Results: The average total score of the resilience scale was (123.07±23.76) and the average item score of the resilience scale was (4.92±0.95); The average total score of the emotional intelligence scale was (58.69±8.74) and the average item score of the emotional intelligence scale was (3.67±0.55); The correlation coefficient between the emotional intelligence and the resilience was 0.62 (P <0.01). Three subdimensions of the emotional intelligence including the usage of emotion, the appraisal of self-emotion, the regulation of emotion and the positions of nurses accounted for 43.3% of the variances of the resilience.Conclusions: Emotional intelligence played an important role in affecting the psychological resilience of emergency and ICU nurses in tertiary general hospitals in Chengdu, it could positively predict the resilience of nurses. The nurse managers could focus on the nurses' emotional intelligence to promote their resilience.
- Health care and management
Paediatric Nursing
Psychiatric and Mental Health Nursing
Location: Westminster Ball Room
Chair
Fang Yang
Zhejiang University, China
Co-Chair
Nan Smith-Blair
University of Arkansas, USA
Session Introduction
Amanda Jacobs
University of the Free State, South Africa
Title: “The character rests heavily within me†drama students as standardized patients in simulated-base learning
Time : 10:00-10:15
Biography:
Amanda Jacobs is currently employed by the University of the Free State, South Africa, as a lecturer of Child Psychiatric Nursing at the School of Nursing. She has 5 years’ experience of Standardized Patient Simulation as a learning strategy. Amanda holds a Master degree in Child Psychiatric Nursing and is currently busy with PhD studies.
Abstract:
Standardized patient (SP) simulation has proven effective in enhancing nursing students’ competencies necessary for mental health practice. A deeper exploration of the process from the perspective of the SP is required to enrich the authenticity of these learning experiences. The aim of this article is therefore to explore and describe the experiences of 11 drama students engaged in mental health simulations for nursing students, including how it affected them. A qualitative approach was taken and data were gathered using various techniques. Content analysis revealed that these SPs negotiated three roles during this interdisciplinary learning experience, namely of a facilitator of learning, a drama student and the person within. The drama students participating in this study revealed a sense of responsibility towards facilitating learning for the nursing students and made invaluable contributions in this regard. The study provided valuable insight into the world of an SP for the enrichment of future simulated practice learning endeavors and the professional development of all involved in the process. Feedback to the nursing students and their educators on their personal experiences during the simulation was found to be crucial in increasing understanding of nurse-patient interaction from the perspective of a patient with a mental health issue, thus enhancing future practice. Having been alerted to the personal investment required and possible risks related to character portrayal of a patient with a mental health issue, however, the nurse educators are challenged to give careful consideration to the welfare of the SPs in future endeavors.
Maria Phillips
University of the Free State, South Africa
Title: A framework resulting from implementing high-fidelity simulation in South Africa
Time : 10:15-10:30
Biography:
Maria Phillips is currently employed by the University of the Free State, South Africa, as coordinator for high fidelity simulation at the School of Nursing. She has 7 years’ experience of high fidelity simulation and is a consultant to establish simulation laboratories as a learning strategy. Maria holds a Master degree in Nursing, and is qualified in critical care nursing, traumatology and has been a critical care nurse educator for 15 years. She is currently busy with PhD studies.
Abstract:
Seven years ago, the implementation of high-fidelity simulation (HFS) was only a dream at schools of nursing at both university and college level. A philanthropic grant enabled the School of Nursing at the University of the Free State, South Africa, to establish a HFS laboratory. This process proved to be a disruptive learning experience for nurse educators. The study explored the learning experiences of nurse educators implementing HFS for the first time. An interpretative phenomenology analysis was employed to study the experiences of seven nurse educators implementing HFS in their programs. Data collection involved individual and dyadic, in-depth, semi-structured interviews, reflective journals, summaries of experiences and researcher reflective notes. Five super-ordinate themes transpired from the data, namely: frames of reference before HFPS; new world of HFPS; critical reflection; critical self-reflection and transformation in action. An unexpected outcome of the study was the emergence of a pattern whereby educators were developing as simulation educators. The learning experiences of the educators were resonant of transformative learning described by Jack Mezirow. The educators experienced simulation as a new world with its own culture, language and community. Educators’ new learning included the: management of technology and related software; pedagogy of simulation; planning and implementation of scenarios; acquisition of debriefing skills and development of other educators to implement HFS. As a result, educators reflected deeply on their frames of reference regarding educators’ roles in student learning. An adaption of strategies even reached into classroom practices to allow more student-directed learning.
Reezena H. Malaska
Chamberlain College of Nursing, USA
Title: Health literacy as a strategy to improve communication with patients
Time : 10:30-10:45
Biography:
Reezena H Malaska is going to complete her Doctor of Nursing Practice degree, DNP in December 2016 from Chamberlain College of Nursing. She is a graduate of the RGN program from Oxford Brookes University, MSN from American Sentinel University, BSN from Deaconness College of Nursing and critical care certification (CCRN) from American Association of Critical Care Nursing. She is a Trauma Critical Care RN works prn for St.Vincent Charity Medical Centre & Adjunct Clinical Instructor for the BSN and ADN programs. She had published 2 publications with a peer reviewed journal and eradio blog publications on various topics and issues in nursing in 2015.
Abstract:
Health literacy (HL), clear communication, collaborative practice, a culture of safety, culture of enquiry, promoting evidence-based practices, and patient centered care are among many recommendations made by the Institute of Medicine (IOM), regulatory agencies and experts (2010). HL, a fairly new concept, is an integral part of clear effective communication and has been recognized as having a significant impact on the “health and wellbeing,” patient outcomes, and healthcare costs. The cost of healthcare expenditures due to low HL is an additional $73 billion annually. Consider that only 12 percent of adults in the United States (US) have the necessary skills to navigate the complexities of the nation’s health care system (Agency for Healthcare Research and Quality [AHRQ], 2016). Oftentimes, patients misunderstand health instructions and are perceived as non-compliant. Adding to the complexities of caring for these populations are the social determinants of health (culture, families, communities, socio-economic status, habits, and lifestyle choices). HL is defined as “the capacity to obtain, process and understand basic health information and services, to make appropriate health care decisions or act on health information, and the ability to access or navigate the healthcare system” (AHRQ, 2015, p.2). HL applies to everyone, every health care organization and a much bigger problem than is recognized. HL is more than just about patients not understanding medical vocabulary, it is about the patient’s ability to understand health instructions, diagnosis, medications, to actively participate in their treatment, care, and informed decision-making during and after hospitalization whether sick or healthy. It is imperative that nurses, healthcare providers know how to assess each patient’s HL level prior to, and incorporate principles of HL in communication and patient teaching. If patients do not understand the healthcare instructions they will be returning to the hospital quickly after discharge. Clear, effective communication decreases medical errors, length of stays, readmission, and improves quality, safety, and outcomes.
Eman Al Thaher
Tawam Hospital, UAE
Title: “Why should I think like a researcher with wound care?â€
Time : 11:05-11:20
Biography:
Eman Al Thaher is a nurse with extensive experience in healthcare management. Most recently she leads the operational healthcare center in the United Arab Emirates. Her specific areas of experience are healthcare leadership, quality improvement, and conflict resolution and staff management. In addition, she has an outstanding occupational and environmental healthcare, customer services and project management. She was promoted from being a registered nurse to senior charge nurse for her efforts on helping the Palestinian refugees through her work with UNRWA. She was also promoted to an operational health leader through her work in the United Arab Emirates. She graduated from The University of Jordan with the Bachelor degree in nursing and during her work she was able to get her master degree in business and healthcare administration from The University of Atlanta. She will also complete her Doctorate degree in business administration from Swiss Business School within few months.
Abstract:
Background: Wound Care Quality Improvement Project was initiated due to low compliance of proper usage of wound care product (dressing) to patients by health care providers as shown in the initial audits done 47.5% staff using new methods and 52.5% staff using old methods. The goal to achieve is to provide proper wound management and to reduce the number of referral and re-admission to the hospital due to wound complication by adhering to policy and procedure related (PPG’s) of proper wound assessment and using appropriate wound dressing materials.
Objective: To educate the staff regarding proper wound care management and utilizing different types of wound dressing. In addition; involving patient and families in their plan of care. Moreover, to motivate all staff to update their knowledge in current trends of wound care by attending workshops, seminar and lecture related to wound care management. Last but not least, familiarize the staff of the availability of latest dressing materials. And finally, to collect, analyze and evaluate outcomes within specific time frame e.g. every 3 months’ time.
Data Collection: Firstly, we formed a multidisciplinary team composed of Nurses, Assistant Nurses and doctors. Secondly, audit the type of dressing being used and the progress of the healing process. Furthermore, to create a tool to be used in conducting a survey that will reflect the reasons of compliance and non-compliance. Next, perform a pilot study by selecting 2 cases and follow it up within 2 weeks’ time. Together with educating and involving patients regarding their plan of care by demonstration and explanation and document in CERNER (electronic patient files) and lastly; to involve the wound care specialist and Purchasing department regarding the availability of dressing materials. Data Analysis includes conducting a survey. Also, conducting result of pilot study where it was found that, from the 29 patients audited for the month, 45% did not adhere to the appropriate use of the new wound care products. Further, from the 25 patients audited for the following month, 60% did not adhere to the appropriate use of the new wound care products. Therefore, it is a must that the audit cycle should be repeated monthly for 6 months then quarterly until 100% compliance. Criteria of audit are the compliance of staff to use the new wound care products, monthly.
Josephine Etowa, Brianna Krekoski
University of Ottawa, Canada
Title: Exploring the experiences of indigenous nursing student mentees
Time : 11:20-11:35
Biography:
Josephine B Etowa is a Full Professor and Loyer-DaSilva Research Chair in Public Health Nursing in the Faculty of Health Sciences at the University of Ottawa. Her program of research which is grounded in over twenty-five years of clinical practice in the areas of maternal-newborn and child health (MNCH) and in public health nursing include studies that examine the work life experiences of nurses from various social locations. She has published studies on mentoring as a resource for Aboriginal nurses and currently leads University of Ottawa, Aboriginal nursing students’ recruitment and retention initiative.
Abstract:
In response to a growing body of knowledge about Indigenous health and the recently released Truth and Reconciliation Commission’s report, many Canadian health professions education programs have begun to develop programs to enhance the recruitment and retention of Indigenous students. This paper will present the recent findings of a qualitative study that examined the barriers and facilitators to Indigenous nursing student success in a Canadian undergraduate nursing program. Indigenous students and Indigenous nurse mentors were interviewed using semi-structured interviews and focus groups to understand the nature of their experiences using a descriptive qualitative research approach. Thematic analysis method was used to analyze and interpret data, revealing 5 main themes, namely; 1) Adapting to a new environment; 2) Building local social environments; 3) Lack of cultural pedagogy; 4) Racism at multiple levels; and 5) Mobilizing social supports. This paper will present these five major themes including a discussion of the effects of colonialism and the inaccurate depiction of Indigenous communities in education and how the organizational culture of academic institutions continues to undermine positive efforts made to enhance the success of Indigenous students. Participants of this study described a paucity of accessible institutional support for Indigenous nursing students, which fostered personal tenacity and community resourcefulness to succeed. The paper will conclude with the proposal of a way forward for Schools of Nursing in Canada to foster a climate of cultural safety and support for the success of Indigenous nursing students.
Emma Pagels Mardhed
Lund University, Sweden
Title: Clinical outcome and patient perspectives on opiate maintenance treatment for opiate dependence
Time : 11:35-11:50
Biography:
Emma Pagels Mårdhed is a registered Psychiatric Nurse with a Master Degree in Nursing. She is a PhD candidate at the Faculty of Medicine at Lunds University since Mars 2015.
Abstract:
Opioid Maintenance Treatment (OMT) with Methadone or Buprenorphine is a well-documented and successful treatment in opiate dependence. A new aspect on OMT is the patients’ own experience of the treatment. Earlier on, the efficiency of the treatment (OMT) has been measured with more “hard data” such as mortality, drug overdoses and criminality. There is an increasing focus on evaluating the effects of OMT on quality of life, and voices are being raised to evaluate the content of the treatment from the patients’ own perspective. This study aims to investigate the patient satisfaction and its importance in OMT, both in out-patient treatment and in in-patient withdrawal treatment of individuals with an opiate dependence, and its potential impact on treatment outcome. Four different surveys are being used, three in the out-patient setting, investigating the satisfaction with OMT in general one investigating the satisfaction with the actual medication and one in the in-patient setting, investigating the satisfaction of their in-patient withdrawal treatment. In addition to this, baseline-data as well as follow-up data will be collected to study potential correlations of the patients’ satisfaction with the course of the treatment.
Tekleweini Kidane
Eritrean Nurses Association (ERINA), Eritrea
Title: Patterns for acute postoperative pain management in the national referral hospitals in asmara, eritrea
Time : 11:50-12:05
Biography:
Tekleweini Welday Kidane has completed his Bachelor of Science in General Nursing from University of Asmara in 2006, and his Post-graduate study in Nurse Anesthesia from Asmara College of Health Sciences in 2010. Since Post-graduate study completion, he has been working as a Lecturer and Deputy Head of Anaesthesia department in Asmara College of Health Sciences and Consultant Nurse Anaesthetist in Orotta National Referral Hospital. He has done several clinical researches and has being working as a member of research and ethical committee in Asmara College of Health Sciences.
Abstract:
Objectives: The aim of this study was to evaluate the current practice of acute postoperative pain management in the 3 major referral hospitals of Asmara, Eritrea.
Methods: Cross sectional survey of 50 (out 70) medical professionals who care for postoperative patients by means of a questionnaire was used as a method. The questionnaire included 16 questions in the following categories: availability of analgesic drugs, pain assessment, prescribing pattern of analgesics for post operative pain management, tools, equipment, techniques, judgment about adequacy of analgesia, causes of inadequacy, documentation of pain and consequent treatment and continuing medical education regarding pain management. The 50 postoperative care providers were 12 surgeons, 13 nurse anaesthetist, 5 nurses and 20 health assistants.
Results: None of the participants reported the use of regional analgesia, transdermal patches ormultimodal approach. The majority (75%) of the participants preferred NSAI as a sole analgesic (Diclofenaci.m.) followed by Pethidinei.m. Analgesia was reported to be inadequate by majority (52%). Poor documentation was observed as eighty percent of nurses and health assistants don’t document any patient complaints and/or consequent interventions. The major constraint reported was lack of continuing medical education after graduation (92%). Other problems were unavailability of analgesic drugs (68%), improper prescription of the analgesia (58%) and underutilization of Physician service to manage pain (52%).
Conclusion: There is a major need for improving the overall approach to postoperative pain bycontinuing medical education in postoperative pain management for all post operative care providers. Standard guidelines for postoperative pain management have to be installed by a multidisciplinary team including clear prescription of multimodal treatment, guidelines on pain assessment/ documentation and resulting treatment. Permanent availability of drugs included in the guidelines and physicians/anaesthetists to revise treatment if necessary have to be assured.
Leesuk Ferencsik
Adventist University of Health Sciences, USA
Title: The lived experience of nurses transitioning to electronic medical records usage: A phenomenological inquiry
Time : 12:05-12:25
Biography:
Leesuk Ferencsik is a registered nurse (RN), an Assistant Professor at Adventist University of Health Sciences (ADU), Orlando, Florida. She has been a RN since 1989 and worked in both South Korea and the United States on long-term care facility, health clinic and all three levels of care: medical surgical unit, progressive care unit (PCU), and intensive care unit (ICU) in various acute care hospitals. Before she became a nursing faculty at ADU, she worked as a clinical nurse educator for a multisystem ICU, Surgical PCU, and Transplant Unit. She has a passion for teaching and learning. She was very pleased when she became a nursing faculty at ADU where she can do both: learning and teaching. She earned a Bachelor of Science in Nursing from the Korea Open University, South Korea, Master’s degree in Nursing Education from the University of Phoenix, and nursing PhD from Barry University, College of Nursing and Health Sciences, Miami, Florida.
Abstract:
Background: One of the most pressing global issues in health care settings is patients’ safety. In an effort to decrease medical errors and improve the quality of patient care, many health care organizations have adopted an electronic medical record (EMR) system. However, to date, the lived experience of the nurses transitioning to EMR is not clearly understood.
Purpose: The purpose of this study was to explore the lived experience of nurses transitioning to EMR usage.
Philosophical Underpinnings: This qualitative study followed van Manen’s phenomenological perspectives under the naturalistic (constructivist) paradigm with the research question, “What is the experience of nurses transitioning to electronic medical records (EMRs) usage?”
Methods: A qualitative phenomenological methodology was used for this study. A purposive sample of 15 nurses who have experienced transitioning to the EMR usage was selected. Data collection occurred with in-depth, semi-structured interviews using open-ended questions. Data analysis was guided by Max van Manen’s (1990) phenomenological method, which includes describing, interpreting, textual writing and rewriting.
Results: Four core themes Doubting, Struggling, Accomplishing, and Embracing emerged. Three subthemes: Balancing time between computer and patients and Increasing workloads and responsibility, which are subthemes of Struggling, and Leaving human interaction behind, a subtheme of Accomplishing emerged from this qualitative, phenomenological investigation. These themes illuminated the lived experience of 15 nurses transitioning to EMR usage. Thomas Kuhn’s (1996) process of scientific inquiry provided a framework to gain a deeper understanding of this phenomenon.
Conclusions: This study explored the lived experience of nurses transitioning to EMR usage in hospital settings. The results of the inquiry highlighted the essence of participants’ experience by revealing their doubt about the EMR’s functionality, struggle with transitioning and using the new EMR system, accomplishment of successful transition to the EMR system, and finally acceptance of technology in their daily work practice.
Ewa Smoleń
Medical University of Lublin, Poland
Title: Structure of working time of pediatric nurses in Poland
Time : 12:25-12:45
Biography:
Katarina Pihl Lesnvoska are a registred nurse and PhD student with three accepted manuscript. The preliminary daEwa Smoleń completed her Doctoral studies in distinction. She is the Chair and Department of Management in Nursing, Faculty of Health Sciences, Medical University, Lublin, II Faculty of Medicine with English Language Division; she worked as an instructor, Chair of Nursing, at Pomeranian Pedagogical Academy, Słupsk from 2003 to 2004. Currently she is working as an Assistant at Medical Institute, Department of Nursing, Jan Grodek State Higher Vocational School, Sanok.te for PhD competion is January 2017.
Abstract:
Introduction: Effective time management is an important element in the process of the management of health care management. Recognition of the structure of activities performed by nurses allows better working time management and, simultaneously, conditions the improvement of the quality of services within the health care system. The objective of the study was the determination of the structure of working time of pediatric nurses.
Materials & Method: The study was conducted during 2012-2014 in six wards of three levels of reference in Poland. Consent for the study was obtained from the Bioethics Committtee at the Medical University in Lublin. The study was conducted using working time measurement methods, continuous observation and snap-shot observation techniques. Data was collected by standardized research instruments; 24 continuous observations and 6,830 snap-shot observations were performed. The p values p<0.05 were considered statistically significant.
Results: Indirect nursing constituted the highest percentage of working time of pediatric nurses, while direct nursing occupied one-third of working time. The lowest percentage in the structure of working time of pediatric nurses was observed with respect to the fractions – coordination and organization of work. This fraction constituted the lowest percentage in hospital wards of the second and third level of reference. Statistically, the fraction: non-duty activities and breaks at work were more often observed in hospital wards of the first level of reference, compared to the second and third levels. In the structure of working time in the ward in a pediatric hospital, on the day and night shifts, significant differences were found related with performance of particular activities. On the day shift prevailed direct nursing, as well as coordination and organization of working time. On the night shift dominated activities associated with indirect nursing and breaks at work.
Conclusions: In the structure of working time of pediatric nurses, indirect nursing constituted the highest percentage of working time (48.2%). One-third of working time was devoted to direct nursing (30.3%). Pediatric nurses devoted the lowest percentage of their working time to the fractions-coordination and organization of work. The fraction – non-duty activities and breaks at work constituted 12.8% of working time.
Mei Juan Cao
Hangzhou Normal University, China
Title: The elderly’s community needs in China: A survey promoting aging in place
Time : 12:45-13:05
Biography:
Cao Mei Juan has completed her PhD from The Second Military Medical University of P.R China. She is the vice dean of Hangzhou Normal University School of Medicine, a professor of nursing science. She has published more than 80 papers in reputed journals and has been serving as an editorial board member of repute.
Abstract:
Background: Globally demographic changes are creating an urgent task to promote aging in place strategy and it is imperative to determine the older people’s needs to support aging in place.
Aim: To investigate older people’s needs to provide reference for promoting the aging in place practice.
Methods: A total of 568 elderly people in Xiacheng district, Hangzhou, China, were recruited by stratified sampling in this cross-sectional survey in 2009-2011. A questionnaire from an Idaho study, the US, was adopted..
Results: We found that 88.9% of the elderly were satisfied with their community and 97.2% satisfied with their life quality. Health problems and difficulties in seeking health care increased with age and were serious in the past 12 months. In daily living, house repairing and housework services were the top 2 troubling things. It was also found that the social and health promoting service needs were high in the elderly and varied in different age groups.
Limitations: The adaptation of questionnaire could have been influenced by distinctive socioeconomic and cultural factors, so further validation is needed. The disabled who were bed-ridden and those who could not verbally communicate were excluded, which might have affected the findings.
Conclusion: A majority of the elderly surveyed lived in a healthy life while aging at home, but they needed more supportive health insurance to take care of their long term health problems, assistant programs to help with heavy house choirs, and more recreational programs to maintain their health. The culturally-adapted questionnaire might have objectively and comprehensively identified the community services needs of the local elderly and thus could be referred to for other studies.
Maya Ebrahimi Zanjani
University of South Australia, Australia
Title: Health concerns of intimacy partner violence (IPV) among transnational marriage immigrant women in Taiwan: A thematic analysis.
Biography:
Maya Ebrahimi Zanjani is a PhD student at the University of South Australia in the School of Nursing and Midwifery and a project officer in the Centre for Cultural Diversity in Aging in Melbourne. She has been a Registered Nurse in Iran and Australia. The challenges of working as an Overseas Qualified Nurses with English as a second language in the Australian Aged Care System has led her to research this topic. She is specifically investigating the Overseas Qualified Nurses’ adjustment into the Australian Health Care System.
Abstract:
Recruiting Overseas Qualified Nurses (OQNs) from developing countries has been practiced as a solution to the shortage of the nursing workforce in developed countries, such as Australia. The need for Qualified Nurses will increase due to increasing chronic diseases following an escalating ageing population. The transition of OQNs into developed countries’ health care system is challenging and this group of nurses face difficulties integrating into such systems. The common challenges reported in many studies are language barriers, cultural disparities and the lack of support in the work place . Among the many articles reviewing, critisising and analysing the experience of OQNs in the Australian hospital settings none examines how these group of nurses adjust into the Australian aged care settings. OQNs face different challenges in Residential aged care facilities (RACFs) due to different expectations compared to the hospital environment and the concept of Residential aged care in nursing practice. Therefore, proposed research aims to identify the adjustment challenges and issues confronted by OQNs. It will investigate the individual, social, cultural and service-related factors that enable or hinder successful integration of OQNs into the Australian Health Care System (AHCS). The study is an exploratory and descriptive mixed method investigation. A quantitative and qualitative method. Quantitative questionnaire data are analysed through SPSS and thematic analysis is applied to analyse qualitative data. Research findings and their implications for practice and future research will be discussed.This study will contribute new and unique insights to knowledge in relation to key factors influencing integration of OQNs into the AHCS and their adjustment into Australian society.
Anita Jasmine Valerio
University of Santo Tomas, Philippines
Title: ASSESSMENT OF CULTURAL COMPETENCY OF FILIPINO IMMIGRANT NURSES
Biography:
Anita Jasmine Valerio is Currently working at University of Santo Tomas, Philippines
Abstract:
This quantitative study is a survey to assess the cultural competency of Filipino Immigrant Nurses. The study was conducted via online using social networks such as email, vibers and facebook in contacting the respondents and sending them the website where they can take the survey. The researchers then gathered and analyzed the data to support the study. The goal of the researchers is to evaluate whether the Immigrant Filipino nurses are competent. It also tackles the relationship between awareness, knowledge and skills in terms of cultural competency. Included in the study are information gathered inside literatures that supports the research.
Hamid Hussain
Health Centers Department. Primary Health Care Services Sector, Mangalore, Iraq
Title: Job satisfaction, burnout and Associated Factors among Nurses in Health facilities
Biography:
Hamid Hussain is currently working at Health Centers Department. Primary Health Care Services Sector, Mangalore, Iraq
Abstract:
Background: Health care workers job satisfaction and burnout are constant public health concerns. Burnout predispose to rapid staff turnover, absenteeism or illness that ends in decreased job satisfaction. Burnout and satisfaction among nurses are serious conditions that threaten their own and patients health. Objectives :To explore levels and determinants of job satisfaction and burnout among nurses working in Primary Health Care facilities, Dubai Health Authority, Dubai, UAE. Methods: A cross sectional study targeting all nurses working at PHC centres (400) was carried out using self-administered questionnaires containing socio-demographic, work related, personal health status, burnout (emotional exhaustion, depersonalization, and personal accomplishment) and satisfaction variables. Results: Overall nurses reported moderate satisfaction levels and low burnout state. Correlation between burnout and job satisfaction was significant, weak and of opposite course. Burnout increased in older and divorced nurses. Emotional exhaustion related significantly to high income level, performing physical activity and nurses’ intention to leave. Emotional exhaustion had intermediate correlation to job satisfaction. Depersonalisation was higher in nurses with chronic disease and had negative association to job satisfaction. Personal accomplishment had significant positive correlation to nurses’ job satisfaction. Perception of personal accomplishment increased with age, high BMI levels and in nurses with chronic disease. Conclusion: Findings from this study contributes to the understanding of the relationship between nurses' job satisfaction and burnout syndrome and points out that nurses burnout is not uncommon among nurses working in PHC in Dubai. Nurses burnout and satisfaction levels proved to have special characteristics relating to the unique composition of health care in the UAE. The study also indicates that some dimensions of job satisfaction and burnout had proven to be relevant to nurses’ turnover tension. Recommendations: There is a need to develop periodic screening for signs of distress, burnout or dissatisfaction, and to establish preventive strategies that are practical and can be implemented within the current healthcare structure. This will result in increasing nurses’ satisfaction, commitment and motivation which will in time reflect on the quality of healthcare services and daily performance indicators.
Ediscyll Lorusso
St George’s University Hospitals Foundation Trust, United Kingdom
Title: Low Molecular Weight Heparin Prophylaxis Adherence in Postnatal Women
Biography:
Ediscyll Lorusso has completed her Bachelor degree in Nursing at the age of 19 years from University of Perpetual in Philippines and had her Coronary Care studies from St George’s University Hospitals in London. She has been working as Thromboprophylaxis Clinical Nurse Specialist and Anticoagulation Sister since 2009 in the same hospital. She and her team was awarded second place in the Best Obstetrics VTE Prevention Programme category in 2012. This abstract “Low Molecular Weight Prophylaxis Adherence in Postnatal Women “have won the People’s Choice poster award on 4th December 2015 presented by St Georges University hospitals.
Abstract:
The prothrombotic state of pregnancy is part of the normal physiological adaptation and is thought to have evolved in order to meet the haemostatic challenges of childbirth. It has also been attributed to some women’s predisposition to maternal venous thromboembolic (VTE) disease and this in itself remains one of the leading causes of maternal deaths in Europe and the USA (Van De Velde, 2013). A recent introduction of VTE risk assessments and national venous thromboembolism prophylaxis guidance for use during childbearing had resulted in an initial fall in maternal deaths compared to previously reported trends (CEMACE, 2011 & Knight, 2014). Of the women who died of VTE in the UK, 56% of them received substandard care (CEMACH, 2011 & Knight, 2014). A package of poor VTE risk assessment, inadequate thromboprophylaxis and a failure to robustly investigate women’s newly presented symptoms suggestive of VTE, all contributed to that substandard care (CEMACE, 2011). Of the women who died of pulmonary embolism, 79% of them had identifiable VTE risk factors (RCOG, 2009). Engagement with VTE prophylaxis requires childbearing women who have been assessed as having a high risk of developing thrombosis to self-administer a low molecular weight heparin (LMWH) by subcutaneous injection, with drug Dalteparin the primary LMWH stocked by this hospital trust. Currently 34% of all postnatal women at St George’s hospital require VTE prophylaxis. As adequate thrombophylaxis compliance may reduce the risk of VTE in maternity patients by up to two-thirds (RCOG, 2009), adherence to these prescribed medications is an essential part of reducing the incidence of venous thromboembolic disease during childbearing and preventing maternal deaths.
- Risk Factors in Nursing and Healthcare professional
Nutrition and Health
Cardiovascular Nursing
Location: Westminster Ball Room
Chair
Anita Hunter
Washington State University, USA
Co-Chair
Lynda Olender
Hunter Bellevue School of Nursing, USA
Session Introduction
Alison Burton Shepherd
Care Quality Commission Specialist Advisor, UK
Title: “Face in the crowd†loneliness and isolation in the elderly, impact and prevention
Time : 13:50-14:10
Biography:
Alison Burton Shepherd works as a Nurse Practitioner/Non-Medical Prescriber for an Independent Walk in Centre. She is also a Specialist Advisor (nursing) for the Care Quality Commission. She is also a Qualified Nurse Teacher and a Teaching Fellow for the Higher Education Academy. As a Registered Nutritionist, she also has an interest in obesity and malnutrition management.
Abstract:
Loneliness and social isolation are two subjective complex terms with no standardized definition within the literature. Whilst loneliness can affect both young and old, older people are considered to be more vulnerable to both loneliness and isolation particularly after; suffering personal loss of friends and family, reduced mobility, or limited income (Burton-Shepherd 2015) In 2010 A meta-analyses from Holt-Lunstad et al identified that the effects of loneliness and isolation may exceed the mortality rates from disease such as obesity and may also equate to mortality rates seen from smoking 15 cigarettes per day. Furthermore Cacioppo (2014) argues that the effect of loneliness on physical health carries twice the health risks of obesity alone. However a poll of UK GP’s suggested that 36% of doctors did not believe that loneliness made a significant contribution to early mortality (Age UK 2011). This is somewhat controversial and therefore the aim of this presentation is to highlight the importance of loneliness in the elderly and provide practical suggestions as to how nurses may intervene.
Marlene M Rosenkoetter
Augusta University, USA
Title: Challenges of global nurse migration: Issues and mediators
Time : 14:10-14:30
Biography:
Marlene M Rosenkoetter has over 30 years experience in nursing administration, teaching, and research. She is a recognized authority on global nursing and health care. She has numerous publications as well as national and international presentations, and has been a Fellow of the American Academy of Nursing for 25 years.
Abstract:
Internationally educated nurses (IENs) are RNs whose initial nursing education took place outside of the United States or in the U.S. territories (formerly termed foreign-trained or foreign-educated nurses). They represent a larger percentage of the U.S. nursing workforce in recent years, comprising 5.1 percent of RNs licensed before 2004, compared with 8.1 percent since then. The Philippines continued to dominate as the source country of the IEN workforce (50 percent), followed by Canada at nearly 12 percent. India supplied 9.6 percent and the United Kingdom provided 6 percent, with the contributions from India accelerating and surpassing those from the United Kingdom among recent licensees. Approximately one-quarter of IENs lived in California in 2008, with New York, Florida, and Texas each home to 10 to 12 percent of IENs. When migrated nurses begin employment in a new setting, they need an enculturation process and orientation to their new environment. This includes not only nursing approaches but medical interventions and an immersion in new technologies. This process should involve changes in their roles, their responsibilities, and the use as well as the structure of their time. They need to acquire new support groups and have opportunities to build their own self-esteem. This paper proposes a process to achieve these goals.
Soo Hoo Soon Yeng
University of Technology Sydney, Australia
Title: Health-related quality of life after primary percutaneous coronary intervention for ST-Elevation myocardial infarction: An age comparison study
Time : 14:30-14:50
Biography:
Soo Hoo Soon is a final stage PhD student at the Faculty of Health, University of Technology Sydney. She is currently working in the Department of Cardiology, Royal North Shore Hospital, Sydney, as a clinical research nurse and co-investigator for studies in cardiovascular health and interventional cardiology. She has recently published in international journals and the results from her research on Health-related quality of life in patients with ST-elevation myocardial Infarction (STEMI), on cardiac rehabilitation and rapid Field Triage of STEMI patients.
Abstract:
Health-related quality of life (HRQOL) is an important measure of cardiovascular health status for patients with ST-elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI). With an aging global population, it is important to determine what predicts physical and mental HRQOL outcomes during recovery following PPCI. A sample of 246 consecutive STEMI patients completed both the SF-12 and the Seattle Angina Questionnaires (SAQ) at 4 weeks and 6 months after the index PPCI. Using a comparative, descriptive and repeated measures design, baseline demographics and HRQOL were compared by age ≥70 years or more and <70 years during PPCI recovery in order to determine the impact of age and the predictors of HRQOL outcomes. All aspects of HRQOL improved across age groups and over time, except for angina frequency and mental health. Older people aged ≥70 years had worse physical HRQOL (SF-12 and SAQ) but higher angina frequency and QOL (SAQ) scores including better mental health during recovery. Angina stability was the only HRQOL domain that showed a large interaction effect (0.316) between age and time (F=0.15, df=1, p=0.02). Age, length of hospital stay, gender, partnership status and number of stents deployed were independent predictors of HRQOL after PPCI for STEMI cohorts. Apart from the mortality and mobidity benefits of rapid PPCI, HRQOL assessment for STEMI patients during recovery is less investigated, particularly for older patients aged 70 years or more.
Christine Pollock
Edinburgh Napier University, UK
Title: How mentors use feedback on student performance to inform practice assessment in pre-registration nursing programs in Scotland
Time : 14:50-15:10
Biography:
Christine Pollock is a Senior Lecturer at Edinburgh Napier University. She is currently undertaking Doctoral Studies with the University of Durham, School of Education. Her research interests are in nursing education and the effectiveness of social media in education.
Abstract:
Aim: The aim of the presentation was to identify ‘How mentors use feedback on student performance to inform practice assessment in pre-registration nursing programs in Scotland.’ This will include feedback from members of the inter-professional (IP) team, patients and carers.
Objectives: Present the key themes from the literature reviews; Identify how mentors elicit the Inter-professional team, and patients and carers views of student performance in practice assessment within pre-registration nursing programs; Present the findings of the study and Identify recommendations for mentor preparation programs in Scotland based on the project findings.
Results: Thematic analysis revealed the topics of relationships, timing, and formal versus informal methods of gathering data about student nurses’ performance in practice and achieving their competencies.
Malene Missel
Copenhagen University Hospital, Denmark
Title: Regaining familiarity with own body after treatment for operable lung cancer – A qualitative longitudinal exploration
Time : 15:10-15:30
Biography:
Malene Missel has a Masters in Nursing and has completed her PhD in March 2016 from faculty of health and medical sciences, Copenhagen University Denmark. She is working as a clinical nurse specialist at the department of thoracic surgery with care, nursing and rehabilitation for patients with operable lung cancer.
Abstract:
Little is known about the experiences of operable lung cancer patients during treatment in a clinical setting based on fast-track surgery. The study aimed to explore (1) the embodied meaning of illness in patients with operable lung cancer during treatment to 4 months after surgery and (2) patterns of change over time that may affect the patients’ daily lives. Twenty patients referred for lung cancer surgery were interviewed three times, corresponding to potential critical transition points following surgery: hospitalization; hospital-to-home transition; and resumption of daily life activities. Data collection, analysis and interpretation followed a phenomenological hermeneutical approach inspired by Ricoeur and the theoretical framework was grounded in Merleau-Ponty’s phenomenology of perception. The findings reveal the process patients went through in regaining familiarity with their own body after lung cancer treatment. Through the post-operative trajectory the patients’ resumption of daily activities involved adjusting to a new awareness of everyday life, physical restrictions and their perception of themselves. The findings are expressed in four sub-themes: (1) perceptions of embodied alterations; (2) transformation of embodied structures in the transition from hospital to home was unexpectedly challenging; (3) embodied perceptions of the inter-subjective world; and (4) transforming embodied disruptions into bodily awareness. Patients experienced a smooth treatment trajectory regarding physical consequences of illness and treatment which might be due to the fast-track surgery. Clinicians should be aware of patients’ experiences of illness to facilitate patient reconstitution of own identity.
Michelle Finch
Middle Tennessee State University, USA
Title: Emotional intelligence and empathy of nursing students in an immersive capstone clinical course
Time : 15:30-15:50
Biography:
Michelle L Finch will complete her PhD in Nursing Education in August 2016 from Nova Southeastern University in Ft. Lauderdale, FL. She is Assistant Professor at Middle Tennessee State University since August 2010. She is a Certified Pediatric Nurse for 11 years. For the past three years she has been the School of Nursing Faculty Senate Representative. She is active in faculty committees as well as teaching, service, and community activities. She has published one article in 2014.
Abstract:
The purpose of the study is to determine if there is a change in levels of Emotional Intelligence (EI) and empathy in senior students who complete an immersive capstone clinical practice experience in the final semester of a generic baccalaureate nursing program. Nursing education must address EI and empathy education in its curriculum. A suggested starting point is in the clinical setting. Incorporating EI and empathy as students care for patients in the immersive capstone clinical experience is hypothesized to increase those levels which can be effective. Students must learn how to understand and manage emotions in themselves and others and there is no more appropriate environment to learn those skills than in an immersive clinical capstone course.
Hypothesis 1: There is a difference between scores in Emotional Intelligence and empathy among senior generic BSN nursing students before and after completing a capstone clinical practice experience in the final semester of a baccalaureate nursing program.
Hypothesis 2: There is a difference in scores of emotional intelligence and empathy related to gender among senior generic BSN nursing students who experienced a capstone clinical.
Hypothesis 3: There is a difference in scores of emotional intelligence and empathy among generic BSN students with prior healthcare experience who complete a capstone clinical. Statistical tests will be run to assess student’s performance on the EI tool and presented at conference.
Charlotta Sunnqvist
Malmo University, Sweden
Title: Grasping the dynamics of suicidal behavior: Combining time-geographic life charting and COPE ratings
Time : 16:10-16:30
Biography:
Charlotta Sunnqvist has been working as nurse for 20 years and completed her PhD 2009 from Lund University and pursuing her Post-doctoral studies from Malmo University. She is the senior lecturer of Malmo University and works with Nurse Specialist Program in Psychiatric care at advance level. She has published more than approximately 15 publications and one book chapter in Oxford Textbook of Suicidology and Suicide Prevention.
Abstract:
A variety of factors have been identified as being risk factors for suicidal behavior. One of them is the way a person deals with stressful situations. It is not the stressor alone that leads to a serious outcome, but rather the way in which the person perceives and responds to it. The aim of this study was to explore whether a time-geographic life charting, combined with a survey of a person’s coping capacities over time, elucidates the pathway to suicidal behavior, and therefore could be useful in suicide prevention. Twenty-three patients were recruited shortly after a suicide attempt. The time geographic life charting was drawn together with the patient and COPE inventory ratings were used separately and in combination. According to COPE ratings, the participants could be divided into three groups using different coping strategies: (1) adaptive, (2) maladaptive, and (3) both adaptive and maladaptive coping. Within these subgroups, three different pathways to suicidal behavior were described and illustrated. We conclude that time-geographic life charting used in combination with the pattern of coping strategies may be helpful when assessing risk of suicidal behavior. It seems that the combination catch all relevant factors and strengthens the comprehensive picture of the patient’s life situation.
Yvonne Sawbridge
University of Birmingham, UK
Title: Nursing is hard emotional labor-time to care for the carers?
Time : 16:30-16:50
Biography:
Yvonne Sawbridge is a nurse by profession, and worked in a variety of senior posts, latterly as a Director in the NHS, for many years prior to joining the University of Birmingham as a Senior Fellow. She has a Masters degree in Healthcare Policy and Management and has published numerous articles in practice and peer-reviewed journals since becoming an academic. She is currently co-editing a nursing text book on compassion due to be published in 2016.
Abstract:
Poor nursing care has been the subject of considerable debate in the UK following The Francis report which provided a stark account of poor care in a large NHS Hospital. There were many factors that contributed to this organizational failure. One aspect that is often overlooked is the need to care for staff despite the growing evidence base. West (2012) stated “When we care for staff, they can fulfill their calling of providing outstanding professional care for patients”. Nursing involves emotional work and the concept of emotional labor provides a means of making this element of caring more visible and enables appropriate action to be taken to mitigate against the negative impact of unsupported emotional laborers. The challenges associated with implementing support systems were identified by two action research studies in a range of organizations. Based on this experience and the evidence relating to other approaches an ‘Improvement Lab’ method was utilized, as service improvement methodologies. Key stakeholders were invited to a workshop and provided with an introduction to and the evidence behind a number of existing support systems, to help them decide which would have the best ‘fit’ for their organization. The process enables them to develop a deeper understanding of the various models of support, and then consider how they might begin to implement this in their organization. This paper will present an analysis of the process, and make recommendations for nursing management, focused on how organizations can better support nursing staff in practice.
Beth DeKoninck
Indiana Wesleyan University, USA
Title: Skin cancer screening in primary care: A challenge to advance practice nurses
Time : 16:50-17:10
Biography:
Beth DeKoninck completed her DNP at Vanderbilt University and has practiced as a family nurse practitioner for 20 years. Her research is published in JAANP and has been presented at Advanced Practice Nurse/Advance Nursing Practice Congress in Germany, Coalition of Advanced Practice Nurses of Indiana, and other APN conferences. She has spoken on healthcare topics in Nigeria, at Mayo Clinic and the Medforum Seminar in China. While maintaining a clinical practice, she is faculty at Indiana Wesleyan University and Adjunct Faculty at Vanderbilt University. She enjoys medical missions abroad to Nigeria, Haiti, Myanmar, Sri Lanka and Sierra Leone.
Abstract:
Based on current literature, melanoma rates are increasing in both men and women in Canada, while other cancer types have been decreasing in prevalence. The importance of early recognition is an important healthcare discussion as the 5 year survival rate of a Stage I melanoma is 95-100% as compared to Stage IV melanoma survival rates of 16%. This podium presentation will inform Advance Practice Nurses of the need for skin cancer screening in their patient population through the use of total body skin exams. Information on the prevalence of melanoma and non-melanoma skin cancers will be discussed, along with the associated morbidity and mortality which exists. Skin cancer screening as compared to other cancer screening exams will be reviewed and attention will be given to patient perceptions of TBSE as well as potential barriers to screening. The performance of a total body skin exam will be discussed along with a brief mention of identification and triage of worrisome lesions. Finally, an example of a skin screening program implemented for the medically underserved will be presented.
Magfiret Kasikci
Ataturk University, Turkey
Title: The effect of structured education provided to multiple sclerosis patients on self-care agency
Time : 17:10-17:30
Biography:
MaÄŸfiret Kara Kaşıkçı obtained her PhD from University of Ä°stanbul. Currently, she is a Professor at the Faculty of Nursing University of Atatürk. Her research interests include care of chronic illness, nursing education, nursing ethics and nursing theories. She has published numerous publications in reputed journals as well as national and international presentations. She is involved in several research projects and a reviewer in many nursing journals.
Abstract:
Aim: The aim of this study is to determine the effect of structured education with self-care deficit theory that is provided for multiple sclerosis patients on self care agency.
Materials & Method: The study was conducted between June 2013 and March 2016. The study included 400 volunteer patients who are registered in Neurology Policlinics in Ondokuz Mayis University Health and Research Center between August 2012 and August 2015. The patients randomly were divided into two groups as interference and control group. There were 30 patients on in each group. In addition to their routine policlinic pursue the patients who were in interference group received education which was structured according to Orem’s Self-Care inefficiency theory and pursued 4 weeks either by phone or meeting face to face. The control group patients however were applied routine policlinic pursues and talked with them once in a month on the phone or face to face when the patient requested. “Patient introduction form”, “Bartle Index”, “Brief Disability Questionnaire” and “Exercise of Self Care Agency Scale” were used to collect the data. Patient introduction form”, “Bartle Index”, “Brief Disability Questionnaire” was used when met with the patients first time and “Self – Care Agency Scale” was applied at the end of 6th month.
Findings: Exercise of Self Care Agency Scale pretest point average of the interference group patients was defined as 94.53+17.34 and final test average was defined as 112.56+15.57. When the pretest and final test results among the group were compared it has been confirmed that the statistical difference is very meaningful (p<0.001). Exercise of Self Care Agency Scale pretest average was defined as 99.33+18.54 and final test average was defined as 108.76+16.14. When the pretest and final test results among the group were compared it has been confirmed that the statistical difference is very meaningful (p<0.05). However in the evaluation among groups it was determined that the difference between experiment and control was not statistically meaningful (112.56+15.57, p>0.05).
Conclusion: At the end of the research it was determined that the education structured with Orem’s Self-Care Deficit Theory is efficient on the Multiple Sclerosis patients self-care agency.
Mette Kjerholt
Roskilde Hospital, Denmark
Title: How to develop an innovative nursing practice culture, when working in a hospital setting with a battlefield of competing rationales
Time : 17:30-17:50
Biography:
Mette Kjerholt was trained as RN in 1984 and has a Diploma in leadership in health care, a Master degree in Learning and changing processes and in Nursing Science and obtained her PhD degree in Health Science from University of Southern Denmark in 2011. She was employed as clinical nurse specialist Post-doc in Department of Hematology, Roskilde hospital. In January 2015, she became Research leader of Unit of Nursing Research, and clinical nurse specialist in the department.
Abstract:
In my PhD project I investigated how health care professionals communicated about older chronically ill patients in and across sectors according to secure continuity and the patients’ own perspective in the trajectories. The research design was action research and research methods were field studies. The results showed that the participants were aware of how to ensure continuity and integration of the patients’ own perspective, but they rarely pursued them in practice. Overall hindering factors were organizational values and lack of time. They felt caught in a value conflict between nursing professional values and system value, which caused a feeling of powerlessness and maintaining status quo in their practice. After dissemination of my PhD, I was employed as post.doc in a department of hematology, and due to the results of my PhD project, me and the head nurse wanted to develop an innovative person-centered nursing practice culture, where the staff felt empowered to develop and change their practice according to nursing professional values. A participatory approach to developing clinical practice was chosen, as it is collaborative, contributes to personal and organizational development and advances professional practice knowledge. After 4 years we can document, that the participatory approach has increased the quality of patient care, the patient satisfaction and the nurse’s satisfaction in the department. The approach has furthermore positively changed the nurse’s mindset towards a feeling of empowerment and influence of their clinical practice.
Sylvie Robichaud-Ekstrand
University of Moncton, Canada
Title: Coping self-efficacy predicting stage transition and fat reduction dietary habits in coronary artery disease and diabetic outpatients
Time : 17:50-18:10
Biography:
Sylvie Robichaud-Ekstrand has completed her PhD from Montreal University and Post-doctoral studies from the Montreal Heart Institute Cardiac Rehabilitation Center, Canada. From 2005 to 2012, she was the Moncton University School of Nursing Network Director. In 2013, she became the Vice-dean of the Faculty of Health Sciences at the University of Moncton; the only French-speaking university in Atlantic Canada. As the Canadian Health Services Research Foundation Scientific Officer for nursing (1999-2001), she acquired experience with multi jurisdictional and national research dealing with health services. From 2004 to 2009, she was on the CIHR Nutrition, Metabolism and Diabetes Institute Advisory Board.
Abstract:
To delay cardiovascular complications in Coronary Artery Disease (CAD) and diabetic patients, dietary management is crucial, and requires dietary changes in food contents, food habits, and meal patterns. Behavior change used to be regarded as a two-stage process, from unhealthy to healthy behavior, until more social, emotional, and cognitive factors were found to interact in the course of behavioral change. Using three coping self-efficacy factors at baseline, a predictive correlational study was designed to project stage transition and dietary fat reduction habits at six months. Coping self-efficacy included negative affective, positive social and difficult situations. Dietary fat reduction habits consisted of substituting high-to low-fat foods, modifying meat to decrease fat content, avoiding frying foods, replacing high-fat foods with fruits or vegetables, and avoiding fat as a spread or flavoring. Coronary Artery Disease (n=333) and diabetic (n=208) patients completed the Dietary Habits Questionnaire, Stage of Change scale, and Coping Self-efficacy Dietary Habit scale at baseline and at six months. Higher self-efficacy when feeling emotionally vulnerable, and during inconvenient situations which make eating low-fat foods difficult were, respectively, 1.222 and 1.302 times more likely to predict forward stage transitioning or remaining in the maintenance stage. Higher self-efficacy during inconvenient situations, and stage transition, were 2.097 times and 2.805 more likely, respectively, to predict substituting foods, modifying meat, and avoiding frying. Low coping self-efficacy individuals, especially when feeling emotionally vulnerable, would benefit from strategic interventions aimed at substituting high- to low-fat foods, modifying meats, and avoiding frying.
- Women Health Nursing
Gerontological Nursing
Location: Westminster Ball Room
Chair
Juliann Perdue
California Baptist University, USA
Co-Chair
Sevgi Ozkan
Pamukkale University, Turkey
Session Introduction
Hifsa Altaf
Maries Stopes Society, Pakistan
Title: Healthcare innovation and its impact on quality of services in pakistan
Time : 13:55-14:15
Biography:
Hifsa Altaf is a public health professional with over 14 years of experience providing expertise in family planning and reproductive, maternal and community health. She has international field experience, primarily in Asian countries, working with leading reproductive health & family planning organization “Marie Stopes Society (MSS) Pakistan”. As a General Manager she leads the quality component of the MSS Pakistan program along with supporting programs in London and other Asian countries. She has been a speaker at numerous international health forums such as the Urban Health Conference in San Francisco, USA and has been acknowledged for her contributions by organizations such as the WHO and Pakistan Nursing Council.
Abstract:
The players in Healthcare System of Pakistan comprise public, private, formal, non-formal, traditional, and modern with traditional, faith based and NGOs. The health seeking behavior depends on factors like cost, access, gender, trust, literacy and perceived quality. Quality Healthcare has remained questionable even with the qualified healthcare providers, especially in case of, reproductive health and ambulatory services. Private medical sector in Pakistan is currently providing 35% of total ambulatory out of pocket services; yet, quality is well below standards. Social franchising has emerged as an increasingly popular method of private sector healthcare service delivery across the developing countries. Social Franchise is a partnership system with private local healthcare providers to increase awareness, demand, access, choices and quality healthcare services to under-served poor communities. A research was conducted to see the impact of this network on provision of medical, emergency & reproductive health services in 20 remote areas of Sindh (Karachi, Hyderabad, Sukkur) and Punjab (Multan) where either the services were limited or non-existent. A sample 120 private healthcare providers was selected from both urban and rural Pakistan. Pretest, intervention and post-test method were used to compare a trained control group of service providers with un-trained one. The performance was assessed on two indicators i.e. knowledge and counseling skills as per the standard checklists. It revealed that training had marked improvement of 32% in both the skills of service providers. Client feedback revealed improvement in quality of healthcare services in terms of service delivery which was easy, affordable, safe, timely, friendly, and with dignity. Thus the training and social franchise set-up had positive impact on the quality of health services to the target population with improved ambulatory services and reduced mortality & morbidity ratios in reproductive health in Pakistan.
Fang Yang
Zhejiang University, China
Title: Measurement of resilience in Chinese older people
Time : 14:15-14:35
Biography:
Fang Yang has completed her PhD from the Second Military Medical University and Post-doctoral studies from University of Edinburgh School of Nursing. She is now been as the Professor of Nursing as well as Associate Dean of School of Nursing of Zhejiang University City College, China. Also she is employed visiting professor of School of Nursing, Midwifery & Social Care of Edinburgh Napier University, UK from 2014 till now. She has published more than 50 papers in reputed journals and has been serving as 6 Editorial Board Member of repute including 2 international journals.
Abstract:
The increasing number of older people in the Chinese population poses additional healthy problems to those faced in the Western world. Resilience has been identified as a personal construct which may contribute to the process of healthy ageing in older people. To date, no measurement instrument has been tested in to evaluate resilience in Chinese older people. A descriptive cross sectional study was then designed and made implementation which aims to examine the psychometric testing and clinical application of the Chinese version of the Resilience Scale (RS) in Chinese older people by forwarding and backwarding translation procedures used to obtain semantic equivalence of the original English version of the Resilience Scale. Content validity was examined by identified experts, followed by exploratory factor analysis, item-to-total correlation, Cronbach’s alpha co-efficients and test-retest reliability. Then the 25-item Chinese version Resilience Scale (RS-CN) was completed by 461 Chinese older people. Result is shown that Cronbach’s alpha for the total Chinese version of the Revised Resilience Scale was 0.947, with a range of 0.848-0.893 for the subscales. Item to total correlation coefficients ranged from 0.505-0.746 and items were excluded with item to total correlations coefficients lower than 0.4. The test-retest reliability of the total scale was 0.799, subscale test-retest reliability ranged from 0.605-0.620.The exploratory principal components analysis with varimax rotation revealed RS-CN to have a four factor structure. It is concluded from the study that the RS-CN is a valid and reliable instrument for the measurement of the concept of resilience in Chinese older people. Also the results of this study provide cross-cultural evidence for the potential application of this scale in Chinese older people. Measurement of resilience in older people will potentially allow clinical nurses to provide appropriate psychological care for older people.
Amado Patricia Kathryn
University of Miami, USA
Title: The lived experience of breast cancer in the surveillance phase of recovery: A liminal process
Time : 14:35-14:55
Biography:
a speaker in the nursing profession. She has spoken at international conferences and schools of nursing regarding her creation of luminal pathways in transitioning through chronic illness. Her research formed the basis of a concept analysis framework which she is developing to advance nursing practice. Her past and present positions include Sigma Theta Tau, Delta Epsilon Iota International Honor Society and are an active member of the NLN and the ISNCC.
Abstract:
Background: Breast cancer is one of the most prevalent types of cancer today among women of all ages. Many women are being diagnosed each year and learning to cope with a chronic illness. Accompanying the victory of survivorship, however, are challenges in the surveillance phase of recovery. Surveillance is the time after surgery, chemotherapy and /or radiation is complete and the patient is continues to be receiving regular scheduled check-ups by the oncologist. Breast cancer survivors face many fears during this period of time, including fear of recurrence, loss of health, or fear of dying from the disease to name a few.
Purpose: The purpose of this study was to illuminate the lived experience of women after they have undergone their treatment regime for breast cancer and have entered the surveillance phase of recovery. This study gave a voice to the women’s experience through their life story and the resiliency they demonstrated while transitioning to a new life within the context of illness.
Methods: A purposive sample of 13 women ages 25-75 years old from survivorship clinics in south Florida was selected to explore the question: What is the lived experience of women with breast cancer in the surveillance phase of recovery? Data collection was gathered with one-hour semi-structured interviews and was audio- taped, transcribed for verification, and member checked by the researcher. Data analysis included interpretation and description of textual writing guided by van Manen’s (1990) six activities of research methodology.
Results: The themes that arose from the study were transilience, transition, and acceptance. Liminality was the foundational essence of the themes in this study and was paramount in creating a pathway to moving forward as well as understanding the ambiguity and uncertainty experienced by women affected by breast cancer.
Conclusion: This research study exposed the complexities of the health challenges confronting women living with breast cancer while in the surveillance phase of recovery. A significant element of this lived experience understood the threshold between wellness and illness which the women unreservedly shared. Gaps in current literature highlight the need for additional research to understand the utility of liminality in all stages in the survivorship trajectory.
Catherine O’Brien
St James’s Hospital, Dublin, Ireland
Title: Febrile neutropenia risk assessment- An Irish perspective
Time : 14:55-15:15
Biography:
Catherine O’Brien has an experience of over 20 years as an Oncology / Hematology nurse incorporating Bone Marrow Transplantation, Palliative care and Medical Oncology (both inpatient and daycare) in hospitals both in Ireland and United Kingdom. She has been based in St James’s Hospital, Dublin since 2001 working in both clinical and managerial positions. She completed her MSc in Clinical Practice in 2011 in University College Dublin, during which time she completed this research piece and published 2 articles. In her current position as Lead Cancer Nurse she is responsible for clinical leadership. This incorporates staff education & development at post-graduate university and clinical level; clinical practice development; clinical research. She is clinically based at least one day per week which involves providing nurse-led chemotherapy clinics.
Abstract:
Purpose/ Objectives: To develop, implement and evaluate the effectiveness of a nurse-led risk assessment tool to reduce the incidence of febrile neutropenia (FN) in adult cancer patients receiving myelo-suppresive chemotherapy.
Design: A comparative prospective observational study was conducted in a hospital-based oncology unit.
Sample: Clinical data was collected from 459 patients' charts; 233 patients (50.8%) in phase one had no intervention and 226 patients (49.2%) in phase two had a risk assessment carried out by the nurse, prior to each cycle of chemotherapy. The main outcomes captured were febrile neutropenia, dose reductions, treatment delays and hospitalization days.
Methods: International evidence-based guidelines and published nursing studies were used to develop and implement a risk assessment tool. The tool assessed the risk associated with the chemotherapy regimen and 25 patients-, treatment- and disease-related FN risk factors. Identification of one or more risk factors indicated that patients were at risk of developing FN and Growth Colony Stimulating Factor (G-CSF) should be considered. Clinical outcomes pre and post implementation were used to evaluate the risk assessment tool.
Findings: There were significant reductions in the incidence of FN (15.5% vs. 7.5%) and the number of hospital days (267 vs. 131) following the introduction of the risk assessment tool. Incidence of dose reduction and treatment delays resulting from FN were lower in the second phase. There was an increase of 12.5% in the use of G-CSF in phase one (40%) versus phase two (45%). Social factors were found to have no impact on the risk of developing FN.
Conclusions: Through consistent risk assessment, nurses could determine which patients were at higher risk of developing FN, leading to the more appropriate proactive use of prophylactic G-CSF use in a target population. This led to a significant reduction in life-threatening infections, hospitalizations, dose reductions and delays.
Ming-Huei Lu
MacKay Children's Hospital, Taiwan
Title: Using Participant Action Research (PAR) to assess special care nursery nurses’ attitudes toward caring for bubble continuous positive airway pressure (BCPAP) patients
Time : 15:15-15:35`
Biography:
Ming-Huei Lu started working at the Newborn Center of the Mackay Memorial Hospital in 1986 after graduation from the Nursing Department of the Kaohsiung Medical University, Kaohsiung, Taiwan. Two years later, she was promoted to the position of Associate head nurse of the Newborn Intensive Care Unit due to her performance. Four years after that, she was further promoted as head nurse of the Pediatric Ward. In 2000, she was appointed as the Surgery Supervisor of the department as a result of her continuous hard work for the hospital. During the 8 years prior to that, she spent two years working on and completed her Master’s degree on nursing administration at Taipei Medical University, Taipei. As of today, she served as Surgery Supervisor for 5 years and Pediatric Supervisor and Director for 9 years. In 2010, she went to Nationwide Children’s Hospital in USA for being a visiting scholar. She provided leadership in working effectively and cordially with my colleagues to upgrade the quality of nursing services for the hospital. Currently, she is a Doctoral candidate of National Yang-Ming University.
Abstract:
Purpose: The Special Care Nursery (SCN) in the study hospital is starting to use BCPAP. The SCN nurses have had little prior BCPAP experience. It is important to understand the attitudes and experiences of the SCN nurses before providing appropriate training. This study used PAR to assess the attitudes of SCN nurses who cared for BCPAP patients.
Method: The PAR method was used because it emphasizes and applies concepts of empowerment, participation, and trust during the study to understand nurses’ needs in exploring their experiences caring for BCPAP patients. Through the use of PAR nurses can be motivated and actively involved in activities to improve their knowledge and skills to care for BCPAP patients. SCN nurses were invited to participate in this study through focus group interviews. The interviews were conducted once in a two-week period. Each interview lasted about one and one half hours. The interview questions assessed the SCN nurses’ experiences and attitudes caring for BCPAP patients, and the resources that were important to relieve the stress of caring for these patients. All interviews were recorded and transcribed immediately after each interview.
Result: Participants considered BCPAP patient care to be complex and stressful because of their lack of training about BCPAP. Participants doubted whether patients were appropriately treated with BCPAP compared with other alternatives, and whether premature infants treated with BCPAP had suitable resources. Participants stated that SCN nurses did not have as much physician oversight as neonatal intensive care nurses. Participants requested more training in BCPAP techniques. Participants suggested that BCPAP patients should be placed in a special unit managed by neonatal physicians instead of placing them in regular pediatric units.
Conclusion: This study identified training needs for SCNs who care for BCPAP patients. Increased cooperation is needed between neonatal intensive care nurses and neonatal physicians to ensure that optimal care is given to BCPAP patients admitted to an SCN. This is important information for quality improvements in the care of BCPAP patients in an SCN.
Miyuki Komachi
International University of Health and Welfare, Japan
Title: Personal resilience and post-traumatic stress symptoms in families of patients admitted to the intensive care unit in Japan
Time : 15:35-15:55
Biography:
Miyuki Komachi received her PhD from the University of Tokyo in 2013. She is currently a lecturer at the Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Japan. Her research interest includes post-traumatic stress symptoms among nurses working in hospitals and families of patient admitted to a hospital. She has published 2 papers in reputed journals.
Abstract:
Objectives: Families of patients in the intensive care unit (ICU) often experience sever stress such as post-traumatic stress symptoms (PTSS). Little is known about the experience of families of patients admitted to the ICU. This study is to examine the association between personal resilience and PTSS in families of ICU patients in Japan.
Methods: In this cross-sectional study, all families (N=144) at two teaching and advanced treatment hospitals were recruited at early ICU admission, and 77 of them completed a questionnaire (response rate, 53.5%). Family members provided demographic data and clinical characteristics of patients, and completed the Impact of Event Scale-Revised (IES-R) and the Conner-Davidson Resilience Scale (CD-RISC).
Results: The ratio of family members whose IES-R scores were above 25 was 29.9% (23 of 77) of total participants, and CD-RISC mean score was 48.5 (SD=±16.1). A significant negative relationship was observed between personal resilience and PTSS. In logistic regression analysis, variables correlated with the CD-RISC were sex (female) of participant and experienced loss of a family member.
Conclusions: Low personal resilience predicted PTSS among family members of ICU patients. This result may indicate that personal resilience reduces the onset of PTSS.
Renae Lynn Dougal
Saint Alphonsus Regional Medical Center, USA
Title: Family presence during invasive procedures in the emergency department
Time : 15:55-16:15
Biography:
Renae Lynn Dougal completed her Master's Degree from Gonzaga University. She is a Nursing Research and Education Specialist at Saint Alphonsus Regional Medical Center (Trinity Health System), Clinical Instructor for the School of Nursing, Accelerated Program, Idaho State University, and adjunct instructor for Gonzaga University.
Abstract:
The purpose of the study is to evaluate experiences, attitudes, and stress of healthcare personnel, patients, and family who were present during resuscitation and/or invasive procedures performed on adult patients in the emergency department (ED). A need was identified for a policy regarding family presence (FP) during these procedures. A literature review was completed, evidence critiqued and leveled. Several publications focused on pediatric settings, fewer focused on adult patients in specialty areas. A study by Duran, et al. (2007) found no completed studies about FP during resuscitation and/or invasive procedures performed in the ED. A family member is described as a person with an established relationship with the patient; this may include a relative, significant other, legal guardian, caregiver, or friend. The ED healthcare team is mainly composed of nurses, trauma surgeons, physicians, respiratory technicians, social workers, and chaplaincy. Presence is being with a patient in an authentic relationship promoting mutual respect, honesty, and dignity. A quantitative non-experimental design was used. Likert-style surveys were adapted with permission from a survey by Duran, et al. (2007). Three versions of the survey were created for patients, family members present during the event, and the ED healthcare team. Anticipate that findings will show nurses have a more receptive attitude than other healthcare personnel to family member(s)’ presence during resuscitation and/or invasive procedures, and family member(s)' and patients have decreased stress and positive attitudes regarding family member(s)’ presence during a resuscitation and/or invasive procedure performed in the ED.