12^th Nursing and Healthcare Congress October 03-05, 2016 Vancouver, Canada

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. 

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.

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.

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.

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. 

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.

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.

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. 

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.

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.

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.

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.

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.

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.

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.

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.

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. 

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. 

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.

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.

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.