Scientific Program

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Day 2 :

  • Nursing Types

Session Introduction

Katherine Pollard

University of the West of England, UK

Title: Measuring quality in community nursing (QuICN): A mixed methods study
Speaker
Biography:

Katherine Pollard obtained a PhD in 2007 and has a clinical background in midwifery. She has been working as a researcher in health and social care in the United Kingdom since 2001 and is currently a Senior Research Fellow in the Nursing and Midwifery Department, Faculty of Health and Applied Science, University of the West of England, Bristol.

Abstract:

In the United Kingdom, clinical commissioning groups (CCGs) commission care from service providers. A key priority is providing domiciliary community nursing care for patients, many with complex conditions and co-morbidities. Care quality is typically measured through quality indicator schemes; however, little is known about relevant processes for community nursing. The University of the West of England, Bristol, led a multi-institutional mixed-methods study to identify how community nursing quality indicators are selected and applied, and their perceived usefulness in practice. With National Health Service ethics approval and incorporating public participation, the study comprised three phases (April 2014-December 2016): 1) A national survey determined the range of indicators used in community nursing care in 2014/2015. 2) In-depth qualitative data were collected through observations, interviews, focus groups and documents in five case sites, each comprising a CCG and its associated service provider. Findings revealed that lack of stakeholder involvement in indicator selection processes, particularly front-line staff, patients and carers, impacts negatively on indicators’ application and perceived usefulness. 3) The research team used study findings to draft good practice guidance. Ten national workshops targeting mixed groups of commissioners, provider managers, front-line staff, patients and carers were held between June and September 2016 to test the findings and gain stakeholder feedback on the draft guidance. This presentation will share key findings from the case study data and discuss how these findings together with feedback from workshop delegates can contribute to practice and inform the evidence base about monitoring and measuring quality in community nursing care.

  • Pregnancy & Midwifery
Speaker
Biography:

Mrs. Seani Adrinah Mulondo is a lecturer at the University of Venda, School of Health Sciences, department of Advanced Nursing Science. She obtained her Master’s Degree from University of Venda in 2010. She is presently pursuing with her PhD studies and has published four papers in accredited journals from her PhD study topic. Her special field of research is based on Maternal Health. She is serving as a reviewer of the African Journal For Physical, Health Education, Recreation And Dance (AJPHERD)

Abstract:

Globally, approximately 70% of pregnant mothers access Antenatal Care (ANC) at least once in pregnancy. In South Africa (SA), approximately 95% - 97% of pregnant mothers attend ANC although majority present late after 20 weeks of pregnancy and some may have only one visit due to various factors. The purpose of this study was to assess behavioural factors associated with late presentation at ANC in Limpopo Province, SA. A qualitative, exploratory approach was used. Population comprised of pregnant mothers who were attending ANC at Primary Health Care (PHC) facilities. Non-probability, purposive sampling method was used to sample 40 pregnant mothers. Data were collected using Focus Group Discussions (FGDs). Data were analysed qualitatively through open coding method. Findings revealed that knowledge deficiency related to Basic Antenatal Care (BANC), advanced maternal age of 40 years and above feel ashamed of pregnancy, ignorance and laziness of pregnant mothers to attend ANC services and unhealthy lifestyle such as abuse of alcohol were associated with late presentation at ANC. There is a need to develop an intervention programme to increase pregnancy awareness among mothers of child bearing age.

  • Cancer Nursing
Speaker
Biography:

Christina Louise Lindhardt has completed her Ph.D. from the University of Southern Denmark at The Department of Health Sciences. Currently she is doing her Postdoctoral studies from the same university as well as working at The University College of Zealand with research. She has published in reputed scientific journals.

Abstract:

Background: The prevalence of cancer is rising in the elder generation as development of cancer treatment increase. Subsequently a larger population of elderly patients live with cancer. To relieve the pressure on specialized hospital wards, there is a need to develop monitoring systems as well as integrating patients and relatives in the treatment in their own home as in the hospital.

Aim: The aim of this study is to implement and validate vital sign technologies to test temperature, pulse blood samples in hospital wards and in patient’s home. Further generate knowledge about patients and relatives experience and use of vital sig technologies. Oncology nurses’ perception, attitudes and experience of care practices in relation to vital sign monitoring is explored.

Methods: The project test four innovative vital sign technologies in patients admitted to partner hospitals in Denmark and in Germany. The user perspective include qualitative data obtained by anthropologic observational studies, and qualitative interviews with patients, relatives and healthcare professionals. The validation of the vital sign technologies is performed by quantitative analysis and compared to usual measures of vital signs.

Results: Results will be available in spring 2017 and for presentation at the Berlin conference.

The project is a part of European Union’s INTERREG 5a Program  - Innocan (Innovative high technological cancer treatment Denmark-Germany). The design includes elements according to Medical Technology Assessment. Collaborating partners include private companies aiming to get new welfare-technological solutions into the market. Partners in the project are: University College Zealand (UCSJ), Design School Kolding(DSK), Health Innovation Center Zealand (PFI), University Hospital Nastved (Lead Partner), University Hospital Odense, Opeon Aps, Danish Cancer Society, University Clinic Schleswig-Holstein Lubeck, University Clinic Schleswig-Holstein Kiel, Cancer register Schleswig-Holstein.

Speaker
Biography:

Dr. Shou Yu (Cindy) Wang is from Taiwan. She is interested in supportive care (especially in complementary and alternative medicine (CAM) use) and palliative care in cancer. Now, she is an assistant professor at Department of Nursing Asia University in Taiwan

Abstract:

A survey indicated that 34% of Amreican had used complementary and alternative medicines (CAM) in the previous year. One study found that 95.8% of adults in the community are using CAM in Taiwan. One study explored Australia nurses responses towards cancer patient who use CAM found that nurses are open, sceptical, or ambivalent towards patients who use CAM. Regarding cancer patients’ family responses to cancer patients who use CAM, there are no similar studies to explore in much depth. Therefore, the purpose of this study is to explore family caregivers’ views and responses to people with cancer who use CAM in Taiwan. Ground theory (GT) was employed in this study. GT approach is a dynamic process whereby people give meaning to the actions of others. Sixteen participants were recruited and volunteered to participate in this study.

 

Five categories emerge regarding family of cancer patients’ responses and actions to people with cancer who use CAM. The process include: CAM use between patients and family, The purposes of using CAM, The actions of using CAM, Health care professionals’ stands of CAM use process, The needs of family caregivers. The core category is “nothing is more important, as long as he/she is comfortable”. It is expected that this study is able to offer the context of family of cancer patients’ responses and actions to people with cancer who use CAM. Furthermore, relevant in-service education can be suggested in order to enhance heath care professionals’ understanding regarding family of cancer patients’ perspectives regarding CAM.

  • Heart & Cardiovascular Nursing

Session Introduction

Christy Cotner

California Baptist University, USA

Title: Improving self-efficacy through a nurse practitioner led heart failure program
Speaker
Biography:

Christy has completed her MSN FNP at California State University Dominguez Hills, and is nationally certified through AANP. She is currently completed her DNP in the study of self- efficacy. She is the director of the family nurse practitioner program at California Baptist University. Additionally, she works in internal medicine at Riverside Medical Clinic. She has been an RN for over 18 years and in that time have developed various programs which include an emergency room case management program, gastric bypass program, acute care cardiac nurse practitioner program, and the medical home model. She is an active member of CANP.

Abstract:

In 2016, I established a heart failure program in a large primary care clinic. The fundamental goals of this clinic were to decrease hospital readmissions and improve patient outcomes. In the U.S., three trillion dollars a year is spent on health care. 50% of that is concentrated on patients >65 years old with at least one chronic disease, heart disease being the most common. Heart failure readmissions are a significant burden on the nation’s healthcare system. The thirty-day readmission rates for the diagnosis of heart failure across the nation is 25%. The astonishing factor is that 75% of these readmissions have been deemed preventable. So, the question remains, why can’t we as health care professionals prevent them? I began the heart failure program in hopes of closing the gap from hospital to home, however, in the midst of gathering data something amazing happened. I began to ask the right questions and found that many of the patients that were unsuccessful had one common theme. They scored low on their self-efficacy questionnaire that was given on their first visit to the heart failure program. Self-efficacy is the belief in one's capability to succeed. Various studies have shown that despite the severity of a patient’s disease, those with high self-efficacy showed improved quality of life and fewer hospitalizations. I believe by improving our patient’s self-efficacy through education and empowerment we can improve our patient’s quality of life, and decrease the overwhelming burden of frequent hospitalization on the healthcare system.

Speaker
Biography:

Selda Arslan was born on 15th January 1980 and graduated at Celal Bayar University Nursing School in 2001 and after that she started to work as a research assistant Selcuk University Health High School. She completed her master's degree in medical nursing in 2005 and doctoral degree in same department in 2012. Her prioritized areas of interest are oncology and rehabilitation nursing. Currently, she is working as an assistant professor at Selcuk University Faculty of Health Sciences.

Abstract:

Objective: This study was planned to determine the knowledge levels and affecting factors about cardiovascular risk factors among individuals living in a central family health area.

Methods: This descriptive- correlational type study was performed between March-April 2013 with the participation of 121 individuals that for any reason a central family health. Questionnaire and Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale developed by Arıkan et al were used to collect the data of the study. In the assessment of the data, percentage distributions, average, standart deviation, t test on independent groups, one-way variant analysis, Kruskal Wallis Variance Analysis, Mann Whitney U test were used. Data were analyzed using SPSS 22 software.

Results: The average age of the individuals was 40,68±13,63, 70,2 % were female, 81,8% were married. Cardiovascular disease risk factors knowledge level mean score of individuals was found to be 20,21±4,39 (min 8-max 27). Total score (ranging between 0-28) of cardiovascular disease risk factors knowledge level was high. There was a significant relationship between the cardiovascular disease risk factors knowledge level mean scores and age (p<0.01), educational status (p<0.01), body mass index (p<0.01), the state of chronic disease in individuals (p<0.05).

Conclusion: In consequence of this study, it is recommended for nurses, who are an important member of healthcare staff, to render health training and consulting service to individuals regarding prevention and management of cardiovascular diseases risk factors.

  • Pediatric Nursing
  • Surgical Nursing
Speaker
Biography:

Jasmine Schmidt completed her Doctorate in Nursing Practice with an orthopaedic emphasis from Grand Canyon University. She is current faculty at California Baptist University College of Nursing in Riverside, California. Dr. Schmidt is orthopaedic nurse certified and wound care certified. She was the founding director of the Spine and Joint Institute in Southern California and is an orthopaedic nurse leadership consultant, as well as legal nurse consultant and educator, for growing organizations. Dr. Schmidt has spoken nationally and internationally on orthopaedics, customer service, wound care, and cultural diversity and served on a number of committees to promote quality and innovation.

Abstract:

Different orthopedic medical groups have different practice guidelines for MRSA testing and decolonization. Some orthopedic surgeons perform targeted MRSA decolonization and many orthopedic surgeons perform no decolonization preoperatively for elective total joint replacement (TJR) patients. With a forecasted 600% increase in total joint replacement surgeries over the next two decades, there is an expected increase of 20% rise in orthopedic post-operative complications and surgical site infections (SSI). SSI in TJR patients is not only costly for the health care organization, it is life and limb threatening to the TJR patient. Though many hospitals teach their TJR preoperative patients to perform a cleansing wash completed by the patients the night before surgery and the pre-operative staff wash the affected area day of surgery; neither the surgeon's office nor the hospital universally decolonize the nares and complete body (including a wash behind the ears and in the groin) which increases the patient's risk for SSI. In order to obtain and sustain quality outcomes, clinical health care providers must be willing to look at the MRSA decolonization research translated from cardiac preoperative patients, intensive care units, acute care floors throughout various hospitals, and pre-operative cesarean section patients to the pre-operative elective TJR orthopedic patient population. We must continue to expose orthopedic physicians and nurses to new ways of improving patient outcomes and properly leading change. By presenting and applying evidence based practices regarding universal, targeted, and the lack of MRSA decolonization to pre-operative elective orthopedic TJR patients prior to surgery, we can enhance clinical practice and improve patient outcomes in regard to postoperative complications and SSI.

Outcomes:

Review evidence based practice guidelines and outcomes for universal, targeted, and lack of MRSA decolonization on preoperative patients.

Explore the opportunities for implementation of the evidence based practices to the preoperative elective total joint replacement patient for decreasing postoperative complications and SSI.

Speaker
Biography:

Annamaria Bagnasco completed her PhD in 2010 at the University of Genoa, Italy. Since October 2011 she is Assistant Professor & Researcher in Nursing area at the Department of Health Sciences - University of Genoa. She has published more than 80 papers in reputed scientific journals.

Abstract:

Background: An observational prospective study of the perioperative procedures for prevention of surgical site infections (SSIs) was carried out in a tertiary referral teaching hospital in Liguria, Italy, to evaluate their adherence to international and national standards.

Methods: A 1-month survey was performed in all surgical departments, monitored by turns by trained survey teams. Data regarding pre-surgical patient preparation and intraoperative infection control practices were collected.

Results: A total of 717 elective interventions were actively monitored in 703 patients who underwent surgery. Hair shaving was performed mainly using a razor (92%) by the nurses (72.8%) on the day before the operation (83.5%). All of the patients were showered, either with a common detergent (87%) or with an antiseptic solution (13%). Antimicrobial prophylaxis was administered properly in 75.7% of the patients at induction of anaesthesia; however, according to current Italian guidelines, inappropriate prophylaxis was provided in 55.2% patients. Appropriate antisepsis of the incision area was done in 97.4% of the operations, and nearly 90% of the interventions lasted less than the respective 75th percentile. The doors of the operating theatres were mostly open during the duration of the operation in 36.3% of the cases.

Conclusions: This review of infection control policies identified significant opportunities for improving the safety and the quality of routine surgical practice.

Speaker
Biography:

Serife Kursun graduated from Istanbul University Florence Nightingale Nursing School in 1998. After graduation, she worked as a nursing for two years in general surgery at a university hospital and after that she started to work as a research assistant Selcuk University Health High School then completed her Master's degree in surgical nursing in 2004, her doctoral degree in same department in 2010. Now she is working as an assistant professor in the nursing department at Selcuk University, Faculty of Health Sciences, Turkey

Abstract:

Aim: The research has been done restrictively and in correlational condition in order to determine the problems of individuals aged 65 and older, they live at their homes after surgical operation, to the situation of having a trouble and socio-demographic characteristics, health features and the status of receiving information

Method: The research has been done between the dates of 15th of March and 16th of July in the clinics of brain surgery, general surgery, eye diseases, thoracic surgery, gynecology, cardiovascular surgery, ear, nose and throat surgery, orthopedics and traumatology, plastic and reconstructive surgery and urology in university hospital in Konya. The Research population was consisted of 907 individuals aged 65 and older who stayed in surgery clinics and had operation. The research has been performed with 227 patients by using stratified sampling method. A questionnaire developed by the researcher was used for collecting the data. In the first meeting, the data were collected by the researcher face to face in the rooms of patients and in the second meeting, they were collected face to face in policlinics a week after the discharge and the data of the patients who were not seen were collected by meeting on the phone. The mean, standard deviation, median, frequency and rate, Mann Whitney U test, Pearson's and chi-square test (Yates Continuity Correction, Fisher’s Exact test and Fisher Freeman Halton) have been used for analyzing the data.

Results: There was determined in the study that 74,4% of old people live problems at their homes after the discharge. There was determined that the problems were mostly towards the operating zone (64,3%) and self-care activity (52,9%) and the  problems which were lived in minimum  level were towards the use of drugs (5,7%) and gastrointestinal system (10,1%), while the kinds of problems lived at homes after the operation  were examined. While the status of providing benefits of the discharge education given towards the experienced problems was asked, it was determined that 67,8% of patients specified that this education became beneficial. There was determined a relation between some facts as sexuality, who is responsible for the domiciliary care, previous periods while the patient stayed at hospital, surgery hospital where the patient stayed, the status of staying at hospital after surgery , length of at the total hospital stay and the situation of living problems at home  (p<0,01).

Conclusion: Consequently, there has been seen that the old individuals live some problems about the pain and self-care after surgery and the discharge education given is adequate. Relevance to clinical practice: Nurses may be advised to provide adequate discharge training to the patient and his / her family for home care of elder individuals after surgical intervention and to make attempts to gain necessary knowledge and skills.

  • Clinical Nursing
Speaker
Biography:

Emilia Campos de Carvalho, RN, PhD is Senior Professor  of  University of São Paulo. She was Dean of the  Ribeirão Preto College of Nursing – Brazil. Dr Carvalho maintains involvement in Brazilian Nursing Association,   NANDA-I and  Sigma Theta Tau International- Rho Upsilon Chapther  . She is the advisor of students of the doctoral, masters and undergraduate courses in nursing. Has many clinical researches published in national and international journals.

Abstract:

This randomized clinical trial was performed to evaluate the effect of foot reflexology on the feet of 78 people susceptible to skin rupture, by the nursing outcome Tissue Integrity: skin and mucous membranes1. In the initial phase, the feet of the participants were evaluated by 20 indicators2 (score 1 to 5). The score of the nursing outcome was determined by the average of their indicators' scores. Participants were randomized into two groups: Intervention  (n = 40), that received 16 sessions of foot reflexology in the eight-week period; Control  (n = 38), that received usual care. In the final phase, the score of the nursing outcome was determined again. The Intervention Group presented, at the beginning of the study, the average score of 4.64 (SD = 0.28) and, at the end, of 4.90 (SD = 0.13); the Control Group presented, in the initial phase, average score of 4.66 (SD = 0.22); and, in the final phase, of 4.50 (SD = 0.26). There was equivalent in the scores presented by the groups (intergroup analysis) at the beginning (p = 0.951), and differences between them at the end (p < 0.001).  When comparing the two periods (intragroup analysis), there was an increase in the Intervention Group scores (p < 0.001) and decreased in the Control Group scores (p < 0.001). After the intervention, participants of the Intervention Group showed improvement and the participants of the Control Group showed worsening in the score of the nursing outcome "Tissue Integrity: skin and mucous membranes".

Speaker
Biography:

Qian Chen has completed his PhD  from Sichuan  University. She is the charge nurse of Department of Geriatrics West China Hospital, and the Associate Professor of Sichuan University. She has studies associated with geriatric syndrome. She has published more than 30 papers  about it in chinese journal.

Abstract:

Background: The incidence of deglutition disorders in elderly inpatients had reached  30%, which increased the incidence of complications and death.

Objective: To verify the effectiveness of multi-disciplinary intervention model led by nurses for functional deglutition disorders elderly inpatients .

Methods: By cluster sampling, 73 patients were in the intervention group, who accepted multidisciplinary intervention, and 72 patients in the control group, who received traditional care. The objects were investigated at baseline, collected the data after 30 days and 90 days. The questionnaires contents included: demographics, Kubota Water Swallow test, MNA-SF, aspiration pneumonia etc.

ResultsThe demographics, swallowing function between two groups had no statistical significance(P>0.05). The ration of SSA in intervention group was significantly higher than that in control group (67.1% v.s. 44.4%). the difference had statistical significance ( Z=8.964,P =0.011). The incidence of aspiration pneumonia in the 90 days in the intervention group was lower than that in the control group(5.5% v.s. 23.6%). The incidence of malnutrition in the intervention group was lower than that in the control group(2.7% v.s. 11.1%), both with statistical significance(P<0.05).

Conclusion: The Nurses-led multi-disciplinary intervention model of deglutition disorders elderly inpatients contributed to improve the swallowing function, and reduce the incidence of aspiration pneumonia and malnutrition of elderly patients with deglutition disorders.

Speaker
Biography:

I am 49 years old. I worked as a clinician and manager nurse for about 15 years. I started my academic studies at Dokuz Eylül University and I completed Ph.D. from Ege University.  I am continuing Postdoctoral studies from Pamukkale University Faculty of Health Science, Nursing Department (Fundamentals of Nursing). I have more than ten published papers in different journals.

Abstract:

Post-operative period of first two days with Coronary Artery By-pass Greft (CABG) has severe pain (11-20%). The reasons of post-op pain in CABG are deep breathing and coughing exercises (DB&CE), moving and rotation in the bed. Pain during DB&CE results in opening the rib cage, pressure on the wound and stress on the sternum lines. DB&CE is important to prevent for puImonary complications. If pain is not controlled during DB&CE, morbidity and mortality risk can be increased. Although the frequently used pharmacological methods can reduce the pain at a certain level they leads to side effects (sedation, nausea, constipation etc.). Also pharmacological interventions are not enough to control the increase of pain by itself, especially the pain related to deep breathing and the cough. Non-pharmacological methods are easy to use and safe adjuvant therapy with low cost. Effects of the cold therapy are analgesic increase of pain threshold, reduce the use of analgesics, anti-inflamatory, spasm relaxing, increase mobility, and improve rehabilitation. Cold therapy effectively decreases the pain in the activities of coughing and mobilization. It is known that combinational therapy of pharmacological and non-pharmacological methods is more successful in CABG (78%) by randomized controlled trial. Our study showed that cold therapy has a positive effects on pain management in the early period of postcardiac surgery by randomised crossover clinical trial. Thereby application of cold therapy should be encouraged as an alternative treatment for pain management in early post-operative period in patients with median sternotomy.

Speaker
Biography:

Ling Feng has completed her master from Sichuan University and has worked in nursing for more than a decade. She is the head nurse of the neurology department of West China Hospital, Sichuan University,China. She has participated in many activities related to academic research. She is the member of the Chinese nursing association. She has published more than 20 papers in reputed journals and has editted three books.

Abstract:

Objective: To investigate and effectiveness evaluation grading management in neurology nursing management.

Methods: Selecting nurses and patients in neurology, Using Minnesota Satisfaction Questionnaire Scale (MSQ) short scale and Nursing Care Quality Assessment Scale to evaluation and compare nurse satisfaction and patient satisfaction before and after the implementation of grading management.

Results: After the implementation of grading management, nurses’ satisfaction are improved, the dimensions especially  "nurse's own sense of accomplishment", "full play to their ability" “work and reward” improved significantly; patients’ satisfaction as "health education", "awareness of nurse", "ability to work" also improved compared with before the implementation of grading management, Studies have shown statistically significant (P <0.05) ; another ,the nursing research have increased significantly.

Conclusion: Nurse grading management clearly defined job responsibilities at all grades, can improve work initiative; grading nurses’ training and assessment can help nurses’ career planning, improve the nurse enthusiasm for work, to achieve the nurse and patient satisfaction.

  • Poster Session

Session Introduction

Marcia Malone-Tedder

Houston Methodist Willowbrook Hospital, USA

Title: Introduction of midline IV option: Preparing staff for practice changes
Speaker
Biography:

Marcia Malone-Tedder completed her BSN and Master’s in Nursing at Wichita State University in Wichita Kansas, USA.  She has 40 years of nursing experience including 10 years in Vascular Access.  She is certified in Critical Care (CCRN) and Vascular Access Board Certified.  She has presented posters at the Association of Vascular Access Scientific Meetings in 2014 and 2016 and is active in the local vascular access network. She is the Vascular Access Program Leader at Houston Methodist Willowbrook Hospital.

Abstract:

IV access is a continuing challenge for nurses and patients report dissatisfaction with multiple IV sticks. Typically, there are two options for IV access: traditional peripheral IV or central line placement. Often PICC lines are placed in patients with difficult or limited venous access. Midline IV catheters offer an additional alternative for patients with limited IV options and can be used for long term IV therapy up to 29 days. While midline catheters have been available, our facility did not have a midline product and was not using them for IV therapy. A midline product trial was initiated, but there were concerns regarding confusion between midlines and PICC lines and possible misuse of midlines as PICC lines. In order to address these concerns, a comprehensive education program was developed for nursing staff and physicians that delineated the differences and similarities between midlines and PICC lines. An IV Access Decision Algorithm was developed to guide clinicians in selecting the appropriate option. In addition to ordering a PICC or a midline, clinicians could consult the vascular access team to assess and recommend IV access. Over a 6 month trial period, 150 midlines were placed. No TPN or medications requiring central line administration were given; however, Activase (Cathflo) was given twice in midlines misidentified as PICCs. Three physicians documented midlines as PICC lines and two nurses referred to midlines as PICC lines when troubleshooting, but there was no evidence that the midline was mistakenly used as a PICC. Midline IVs are a viable option for many patients, but as midline IVs become more common, more education is needed to ensure that midlines remain a safe alternative for IV access.

Speaker
Biography:

Constantin Vintilescu RN, MSN Critical Care nurse in Intensive Care Unit at Veteran Administration Hospital, New Jersey, and Trinitas Regional Medical center .Adjunct faculty instructor in Trinitas Regional Medical Center School of Nursing, Elizabeth, New Jersey. Currently I am a DNP student at Rutgers University School of Nursing Newark, New Jersey. I have published two articles in Nursing Journals.

1. Harold’s Story, in the Student Voice section of Creative Nursing, Volume 19, Issue3, 2013

2. Simulation: A learning Tool for OB Nurses in the Journal of Nursing Practice Applications & Reviews of Research, Vol 3 No 2, July 2013. This was a collaborative study with two of my classmates from Grad School (Monina A. Franco-Tantuico and Luz- Patricia Torres

Abstract:

Nutritional support is very important for critically ill adult patients. Nasogastric tube (NGT) and Orogastric tube (OGT), are very important for critically ill patients .OGT/NGT can be used for initiation of enteral feeding, medication administration and lavage fluid aspiration. Insertion of the NGT/OGT is done currently as a blind placement at the patient’s bedside. Prior enteral feeding, and medication administration the NGT/OGT placement must be verified. In many health care institutions, placement verification is done through chest x-ray. This method is costly and exposes patients to unnecessary radiological exposure increasing patient’s harm.

There have been many research studies with different methods and technology devices to determine the safest, and less expensive, method for placement verification of nasogastric/ orogastric (NGT/OGT) tube. Insertion of NGT/OGT is a high risk procedure, considering the possible complication of misplacement. The placement of NGT/OGT inserted for enteral feeding require accurate verification for prevention of multiple complications. Even during the insertion, there is a risk of aspiration if patient is vomiting at the time of procedure.

Regardless of the  institution, caring for the patients with NGT/OGT, is an important responsibility for nurses, and require many interventions as : carefully insertion of the NGT/OGT, safely  removal of it when it is not needed, assessing the correct placement in the stomach, measuring and  securing the tubes and, monitoring the patient throughout the process.. Patient outcomes are influenced by nurses’ interventions and management of the nasogastric tube. It is important that nursing care follow the best evidence based practice available. Health care providers are ensuring that all the adult patients with NGT/OGT in critical care are safe, and are receiving evidence based practice care across the country over the course of their illness.  However there have been an increased number of incidents and misplacement of NGT/OGT in adult hospitalized patients with serious complications. Registered Nurses around the country value the application of scientific evidence-based practice to guide and improve the quality of healthcare for better outcome.  

Recent evidence suggests that official statistics greatly underestimate the occurrence of complications from misplaced nasogastric (NG) tubes, even when detected (Weinberg & Skewes 2006). NGT may be misplaced in the brain, especially in patients with maxillofacial trauma (Pillai et al 2005), or after endoscopic skull base surgery (Hanna et al 2012). Inadvertent placement of a NGT into the brain of a patient with a traumatic defect in the cribriform plate is a problem that has been recognized for decades but reports of this complication still occur (Rahmi et al 2005).  Serious complications were associated with the malposition in 14 (28 %) of the patients ; these included eight instances of pneumothorax that required chest tubes and one that required endotracheal  tube and intubation, as well as five cases of pneumonia( Taylor, 2014).

There are variety of practices related to the accurate method of verifying the NGT/OGT placement.

The purpose of this systematic review is to conduct a comprehensive research to reconcile the evidence and determine what method for  verification of nasogastric/orogastric (NGT/OGT)  tube placement reduce complications in adult hospitalized patients.

Inclusion Criteria:  This systematic review will incorporate studies related to hospitalized patients who require nasogastric tube for enteral feeding, medication or abdominal decompression. In those patients placement verification of NGT/OGT is very important for patient safety.

Data collection: All project data will be extracted from research studies using a modified Joanna Briggs Institute (JBI) data extraction form

Conclusions & Implications:  Cortrak Enteral Access System, is a new electromagnetic tube placement device that could eliminate the need for x-ray placement verification of NGT/OGT. The review of literature research revealed the evidence that support the use of Contrak Enteral Access System (Creel et al, 2007).   Cortrak enteral electromagnetic tube feeding is a new practice for NGT/OGT placement verification. The use of an electromagnetic tube placement device, such as Cortrak, is potentially the safest and most efficient practice method in current healthcare practices (Roberts et al, 2007). The Cortrak 2 has FDA clearance to be used in confirming tube tip location in lieu of X-ray.

This, in effect, leads to reduced cost and improved patient safety (Sackett et al, 2007). The research literature suggests that the use of Cortrak enteral electromagnetic tube placement device would be more beneficial than existing practices.

This Cortrak Enteral electromagnetic tube feeding placement device needs to be implemented and standardized in hospital settings. The research shows that twelve aspiration events occurred among 276 patients (prevalence, 4.4%; 95 % confidence interval, 2.2% to 7.6%).  In this study the incidence of aspiration as 2.4 % per 1000 tube-feeding days (95% confidence interval, 1.2 to 3.9 per 1000) (Mullan & Roubenoff, 1992). Electromagnetic placement devices have been suggested as a replacement for radiographic confirmation of feeding tube placement at the bedside, although adverse outcomes have been reported, implying that a high level of user expertise may be necessary to obtain consistently  positive results (Metheny,2014).

Speaker
Biography:

Emilia Campos de Carvalho, RN, PhD is Senior Professor of University of São Paulo– Brazil. She maintains involvement in Brazilian Nursing Association, NANDA-I and Sigma Theta Tau International- Rho Upsilon Chapther and is the advisor of students of the doctoral, masters and undergraduate courses in nursing. Has many clinical researches published in journals.

Abstract:

The aim of this study was to verify the difference in the diagnostic reasoning between sophomore and senior year undergraduate students in a clinical simulation, evaluated by the Diagnostic Thinking Inventory (DTI). Nursing students participated individually in a high-fidelity clinical simulation (scenario + debriefing); the purpose was to evaluate the patient with sickle-cell disease, to diagnose an acute pain and to make appropriate interventions. The design and implementation of scenario was elaborate based in NLN/ Jeffries Simulation Theory1 . After simulation, they responded to DTI2 , validated for Brazilian culture with nursing students3 . It is a Semantic Differential Scale (6 points, score 41-246 points) that evaluates the flexibility in thinking (21 items) and evidence structure knowledge in memory (20 items) that in this sample presented Alfa Cronbrach 0.82. The scores were compared (total and two domains) of two groups of students. Participants were 41 students, 90% female, mean age 23.8 years; 56% intermediate level. The average of the total DTI scores did not differ between groups (by T student Test; p= 0,334). There was no difference between the mean responses for domain flexibility in thinking (by T student Test; p= 0,125) and structure knowledge in memory domain (by U Mann Whitney Test; p= 0,765). The groups demonstrate similar performance considering the total and domains scores of DTI. Although the findings may reflect the performance of groups of students, given the sample size, are

needed similar studies for new data to be integrated into these.

Speaker
Biography:

Jennifer M. Laper- Ifferte BSN, RN has been practicing as a nurse for over 20 years.  Presently, she is an infusion case manager for Coram/CVS Health servicing the New York area. Mrs. Laper-Ifferte will receive her MSN with a concentration in nursing education February of 2017 through Excelsior College.

Abstract:

Peripheral intravenous catheter access and management have been emphasized as areas for development in infusion management, however, routine exposure for registered nurses employed in home infusion and ambulatory infusion settings may not be extensive and consistent. In 2016, an education module and clinical competency program titled Peripheral Access and Management was developed for registered nurses employed in the home and ambulatory infusion setting. It was initiated with the intent of converting current, evidence based research into best practice. Subject matter covered include; vasculature knowledge, access device selection, pre-insertion techniques, continuing assessment, complications and interventions. Learning is delivered asynchronously via an online module with accompanying precepted insertion competencies. The intent of this education module is to increase the breadth and skill level about peripheral intravenous insertion and management practices. Fundamentally, this will lead to a growth in favorable patient outcomes.

Speaker
Biography:

Cris Renata Grou Volpe is currently teaching at the University of Brasilia -UNB, Master of Health Sciences University of Sao Paulo and a PhD in Nursing at the Graduate Nursing Program (UNB). It has experience in nursing, with emphasis on fundamental nursing, medical and gerontology acting on the following topics: nursing in adult health and elderly, medicine, nursing in public health, semiotics / semiotics and nursing process.

Abstract:

The present study aimed to identify the most prevalent nursing diagnoses in elderly patients in a geriatric outpatient clinic in the Federal District, Brazil, according to NANDA Taxonomy II relating them to the depression and mental scales. This is a descriptive, observational study of 40 elderly people over 65 years attended at the geriatric clinic. Data collection took place in March 2010 for 60 days. The scales of EDG and MEEM were used. The Pearson's chi-square were used for associations and the significance level of p <0.05. The Geriatric Depression Scale (EDG) and the Mental State Mini Exam (MMSE) were used. This study was approved by the Ethics Committee of the Health Department of the Federal District. The most prevalent nursing diagnoses were: disturbed sensory perception; decreased cardiac output; Impaired dentition; Impaired memory; Risk of falls and insomnia. The indexes of depressive symptoms by EDG were 35% and the cognitive alterations by the MEEM were 60%. There is a significant association between social isolation, risk of loneliness, chronic sadness and hopelessness in relation to the depression indexes demonstrated by the scale. SDs significantly associated with cognitive impairment by MMSE were: poor knowledge and impaired memory. Older people tend to have cognitive deficits and depressive symptoms, especially older ones, and dependence on how much wings activities of daily living. The most prevalent related factor with impaired memory was excessive environmental changes and poor cognition was cognitive limitation.

Speaker
Biography:

Yu-Ping, Huang has completed her PhD from Griffith University School of Nursing and Miderwifery. She is an Associated Professor and teachs at National Quemoy University School of Nursing. She has published more than 20 papers in reputed journals and has been serving as a reviewer for international and national jourals.

Abstract:

Acute lymphocytic leukemia (ALL) is the most common childhood cancer. Although advanced cancer treatments have significantly improved the survival rate, parents of such children experience considerable stress when their children are diagnosed with the life-threatening illness, particularly 1 year within the diagnosis. Thus, this Taiwan-based qualitative study explored mothers’ caring experiences during 3 months to 1 year after their children were newly diagnosed with ALL. A Heideggerian phenomenological approach was adopted to explore meaning to the mothers caring for their children. Data collection involved semistructured interviews and a hermeneutic analysis was performed. Interviewees were 12 mothers. The interview content elucidated four main themes and eight subthemes:

1. Difficulty in associating cancer with their healthy child, including seeking but not solving the problem and feeling troubled by the disease symptoms continuous.

2. Shock and fear after ALL diagnosis, including the shock of having a child with a life-threatening disease and feeling frightened of critical and intensive medical interventions.

3. The need for time to deal with cancer in their life, including the time to manage the sick child and familial emotions and conflicts and to accept and conduct the cancer care activities.

 4. Fighting for the child’s life, including following health professionals’ recommendations and prioritizing the sick child and related treatments. The mothers were completely shocked when their children were diagnosed with ALL; however, they calmly followed the physician’s treatment protocol and changed their jobs to care for their children during this critical period to ensure their children’s life safety.

Minju Kim

Dong-A University, Department of Nursing, South Korea

Title: Career maturity by self-esteem levels in Korean high school students
Speaker
Biography:

Minju Kim got her PhD degree from University of Illinois at Chicago at 2010. She is a assistant professor in Dong-A University in Busan, Korea. Her research area is end-of-life decsion making and elderly care.

Abstract:

The purpose of this study was to examine career maturity in Korean high school students and identify factors associated with career maturity in the high self-esteem group and  low self-esteem group. This study used the data from  the Korean Welfare Panel Study, which was an national wide stduy and recruited samples by using  the complex sampling method.  A total of 496 high school students were completed the survey, including caree maturity, self-esteem, depression and anxiety, variables regrading school life, and  relationship with parents and friends. All data were analyzed with SPSS Ver. 23.0 by using complex sample analyses.  In the results of bivariate analyses, gender,  overall grades, study stress, teacher attachment, parental participation in education and supervision, peer attachment, and depression and anxiety were associated with career maturity in the low self-esteem group. However, school year, career consulting experience, overall grades, study stress, teacher attachment, parental participation in education and supervision, peer attachment, and depression and anxiety were associated with career maturity in the high self-esteem group.  The results of logistic regression analyses showed that parental participation in education, peer attachment, and depression and anxiety were significantly associated with career maturity in the low self-esteem group, while career consulting experience, overall grades, teacher attachment, parental participation in education, and perental supervision were significantly associated with career maturity in the high self-esteem group. In conclusion, it is neccessary to develop different programs by levels of self-esteem to enhance career maturity in high school students.

Speaker
Biography:

Francine Lima Fulquini has completed a bachelor's nursing degree at Ribeirão Preto College of Nursing, PAHO/WHO Collaborating Center for Nursing Research Development - University of São. She is currently a master's student at the same Institution. Since 2014 she has been a member of the Sigma Theta Tau-Honor Society of Nursing

Abstract:

Lymph node evaluation helps to identify signs of health changes, justifying the relevance of their teaching. Considering the importance of acquiring skills to identify and document the presence and characteristics of lymph nodes¹, a teaching aid for this evaluation was built by us in an instrucional module, which consists of a physical prototype for skills training and a recording instrument. At this experimental, randomized-controlled study, we examined the contribution of this instructional module in teaching assessment and documentation of lymph node characteristics in nursing students. In the experimental group, palpation in prototype A and free annotation of the observed characteristics was performed followed by training with the Instructional Module (palpation in the prototype B + standardized instrument record). The control group palpated prototype A and made the notes freely. After, a new prototype C was offered to the groups for palpation and free annotation. Twenty-seven nursing students participated in this phase, which 96% were females and 3.57% were males, with an average age of 20 years. Comparing the two groups, it was noticed an increase in the correctness according to the register of consistency characteristics (112%, 50%), mobility (300%, 128.57%) and coalescence (225%, 0%) among the experimental and control groups, respectively. In the experimental group there was an increase in the percentages of correct answers in all evaluated characteristics. In the control group, the increase only occurred in two of the evaluated characteristics and was less evident when compared to the experimental group.  

¹ ZAGO, M. A.; FALCÃO, R. P.; PASQUINI, R. Hematologia: Fundamentos e Prática. São Paulo: Atheneu, 2004. 1081 p.

Speaker
Biography:

Cristina M Zamarioli, has completed her Undergraduation Course and her Mastery Program both from the University of São Paulo at Ribeirão Preto College of Nursing and Specialization in Clinical Oncology from the National Cancer Institute. She is a PhD Student, and has interesting in nursing cancer and nanotechnoloy studies.

Abstract:

Skin lesions are the target of nursing research and because of its impact on patients’ life the prevention of these injuries is of great interest. In previous studies was developed a formulation to protect the skin against injuries. However, before it can be applied for this purpose, it is need a preliminary safety test. Thus, the aim of this study was to evaluate the safety of a topical formulation containing microparticles of chamomile coated with chitosan on healthy volunteers’ skin. It is an experimental, controlled and double blind study conducted with 35 volunteers. After approval of the Ethics Committee on Human Research of the Ribeirão Preto School of Nursing, participants applied the formulation with microparticles in a forearm and the same formulation without microparticles in the other forearm during four weeks. The evaluation was performed by objective measurements of erythema, melanin, skin pH using biophysical skin techniques and also was evaluate to burning, itching, heat and pain. The results showed a slight increase in erythema in all skin areas evaluated. The amount of melanin decreased slightly in the area of formulation application. There was a pH increase in all skin areas evaluated. Regarding the subjective parameters of pain, burning, itching and heat only one participant at the end of the evaluation reported mild pain sensation on the area where the microparticle formulation was applied, which was rapidly, alleviated a few minutes after application. There was no change in evaluation of discoloration and edema parameters. We can conclude that the formulation is safe for skin application. In addition, more studies involving prevention of skin injuries will be carried out.

Speaker
Biography:

Shuyuan Chao completed her Doctoral degree in 1997 from University of San Diego, School of Nursing. She is a professor in Hungkuang University. She had been the Director of Nursing Department in the University, and the associate president in Chung Gung Institute of Nursing in Taiwan. She has published more than 20 papers in reputed journals and had served as an editorial board member of Journal of Nursing, The Journal of Medical Informatics, and The Journal of Science Education.

Abstract:

The purpose of this project was to develop, implement and evaluate the workshops for CNIs to facilitate with CNIs’ teaching practices in clinical situations. The project included a series of workshops, which were conducted in the year of 2015. In total, there were 109 CNIs participants from three nursing schools in Middle Taiwan. The workshops were implemented in small groups which were programmed by CNIs’ expertise and were facilitated by a senior faculty for each group. Based on the adult learning theory, we set a supportive and cooperative climate for the CNIs’. The workshops were implemented in sequence every two month , as follows, (1) Introduction of facilitating group and assess CNIs’ needs,(2) challenges of clinical teaching ,(3) communication between student nurses and CNIs, (4) how to provide supportive environment for student nurses; (5) innovative teaching strategies development. The CNIs share their experiences with each other in the group and the CNIs were encouraged to upload their experiences and opinions on the website we made for communicating and exchanging ideas. A self-administered structural questionnaire including five dimensions, i.e. “ environmental transformation”, “ innovative teaching”, “communication”, “ implementation of teaching”, “evaluation of learning performance”, was administered at the beginning and the end of the project to evaluate the effectiveness of this project. 94 innovative teaching plans/strategies were developed by the CNIs. The CNIs’ teaching efficacy showed significant improvement after participating the program, and achieved statistical significance. The program enhanced the CNIs’ teaching efficacy and facilitated to develop an innovative teaching plan.

Speaker
Biography:

Ming-Yueh Tseng has completed her PhD in Nursing from Graduate Institute of Clinical Medicine Chang Gung University. She is the Assistant Professor in Mei-Ho University in Taiwan and  specialty is  in nursing education and  long-term care.

Abstract:

The purpose of this study was to explore work adaption for newly graduated nurses during their first year of nursing career. A qualitative approach with narrative inquiry to nurses who were graduated in 2014 and clinical preceptor with purposive sampling and snow ball sampling. A total 18 newly graduated nurses and 4 clinical preceptors were recruited, each one completed interviews between 1 to 5 times. The results derived from this study would share the knowledge about “phenomenon of adaptation”. Three stage of “phenomenon of adaptation” were: “challenge and changeable stage”, “grow up stage”, and “stabilization stage”. In “challenge and changeable stage“, the themes were revealed included a lack of support and belonging in clinical settings, insufficient career planning, insufficient nursing competences to handle various situations, challenge by various clinical situations, a lack of communication skills, value of nursing, clinical reasoning, and self-confidences. In regard to “grow up stage”; most new nurses were struggles with multiple work stress, caring severe patients and highly difficulties, and adjust the time lag with night shift. In “stabilization stage”; new nurses presented with confidence to nursing profession, recognize the hardness and achievement, fulfilled thankfulness, however, due to the hardness in nursing profession, some of them started to exam nursing career critically. The competence and preparation for newly graduated nurses would be in summed with 8 letters of alphabet: “SURVIVAL” which were “S (support network)”, “U (useful tailored plan)”, “R (resilience)”, “V (vivid scenario)”, “I (interdisciplinary communication)”, “V (value of nursing)”, “A (adjusting to environment)”, and “L (learning by doing)”. In suggestion, nursing school should reform curriculum, teaching strategies, and clinical practicum to enhance nursing students’ clinical competence and preparation.

Lok Yan, Chu

The Hong Kong Polytechnic University, Hong Kong

Title: Nurses in street attire: Facilitator of recovery process?
Speaker
Biography:

Lok Yan, Chu is currently a final-year undergraduate in BSc (Hons) in Mental Health Nursing in The Hong Kong Polytechnic University. She has been a student research assistant under an assistant professor in Centre of Gerotological Nursing at school since June 2016. She was also the editor of two publications related to pain management in people with Dementia. “Nurses in street attire: Facilitator of recovery process?” is the first research project that she was a co-investigator working with her research teammates. She has been nominated to join a nursing exchange programme in National University of Singapore in the summer of 2016.

Abstract:

The Recovery Model has been introduced in Hong Kong since 2010. Recently, the policy of uniform in rehabilitation ward has changed to allow staff wear their own clothes to better fit the Recovery Model. The effects of nursing staff wearing street attire have been under discussion over the past decades in the United States, the United Kingdom and Australia. However, this literature is of limited value to the psychiatric services in Hong Kong, where no related research has been conducted. The aim of the study was to explore Hong Kong mental health nurses’ views about wearing street attire within an in-patient rehabilitation unit in regards to facilitating patients’ recovery process. A qualitative descriptive study method, utilizing individual in-depth semi-structured research interview, was employed in this study. Interview data were content analyzed from the perspective of post-positivism. A total of 11 interviews were conducted with nurse participants. The analysis process initially identified 177 open codes, which were merged into 81 nodes. Finally, 3 main themes and 9 sub-themes were identified. Main themes were ‘building up rapport with patients’, ‘street attire helps deinstitutionalization’ and ‘different approaches to maximize the benefit and to minimize the risk’. A majority of nurse participants positively viewed the policy of wearing street attire in a psychiatric rehabilitation unit, they felt the policy was potentially beneficial to patients’ recovery process. Street attire is not the only key to recovery, nurses are recommended to be aware of their skills in taking care of patients, to further maximize the benefit of the policy.

Selma Sakhri

Maherzy School of Medicine, Algeria

Title: Biphosphonate in neoadjuvant advanced breast cancer
Speaker
Biography:

Pr Selma Sakhri has completed her Ph.D. at the age of 27 years from Algiers University and Postdoctoral studies from Maherzy School of Medicine. She has published many papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

The use of Zoledronic acid (ZA) is an established place in the treatment of malignant tumors with a predilection for the skeleton of interest (in particular metastasis). Although the main target of Zoledronic acid was osteoclasts, there are preclinical data suggested that Zoledronic acid may have an antitumor effect on cells other than osteoclasts, including tumor cells. Antitumor activity, including the inhibition of tumor cell growth and the induction of apoptosis of tumor cells, inhibition of tumor cell adhesion and invasion, and anti-angiogenic effects have been demonstrated .

From (2012 to 2014), 438 patients were included respondents the inclusion criteria, respectively. This is a prospective study over a 4 year period. Of all patients (N = 438), 432 received neoadjuvant chemotherapy with Zoledronic acid. The primary end point was the pathologic complete response in advancer breast cancer stage. The secondary end point is to evaluate Clinical response according to RECIST criteria; estimate the bone density before and at the end of chemotherapy in women with locally advanced breast cancer, Toxicity Evaluation and Overall survival using Kaplan-Meier and log test.

The Objective response rate was 97% after (C4) with 3% stabilizations and 99, 3% of which 0.7% C8 after stabilization. The clinical complete response was 28% after C4 respectively, and 46.8% after C8, the pathologic complete response rate was 40.13% according to the classification Sataloff. We observed that the pathologic complete response rate was the most raised in the group including Her2 (luminal Her2 and Her2) the lowest in the triple negative group as classified by Sataloff.

We found that the pCR is significantly higher in the age group (35-50 years) with 53.17%. Those who have more than 50 years in 2nd place with 27.7% and the lower in young woman 35 years pCR was 19%, not statistically significant, the pCR was also in favor of the menopausal group in 51, 4%, and 48, 55% for non-menopausal women. the average duration of overall survival was also significantly in the subgroup(Luminal -Her2, Her2) compared with triple negative. It is 47.18 months in the luminal group vs. 38.95 in the triple negative group. Was observed in our study a difference in quality of life between (C1) was the admission of the patient, and after (C8), we found an increase in general signs and a deterioration in the psychological state C1, in contrast to the C8 these general signs and mental status improves, up to 12, and 24 months. The results of this study suggest that the addition of ZA to néoadjuvant CT has potential anti-cancer benefit in patients (Luminal -Her2, Her2) compared with triple negative with or without menopause status.

  • R.Colman the effects of adding Zoledronic acid to néoadjuvant chemotherapy on tumor response : exploratory evidence for direct anti-tumor activity in breast cancer
  • PNAS journal , Repurposing of biphosphonates for the prevention and therapy of no small cell    lung ,breast cancer , November , 2014

- EBCSG group Bisphosphonates, bone, and breast cancer recurrence July 24, 2015      

Speaker
Biography:

JiYeong Seo got her PhD degree from Kyungpook  National University, Daegu, Korea. She is assistant professor in Catholic University of Pusan.

Abstract:

The purpose of this study was to examine career maturity in Korean high school students and identify factors associated with career maturity in the high self-esteem group and  low self-esteem group. This study used the data from  the Korean Welfare Panel Study, which was an national wide stduy and recruited samples by using  the complex sampling method.  A total of 496 high school students were completed the survey, including caree maturity, self-esteem, depression and anxiety, variables regrading school life, and  relationship with parents and friends. All data were analyzed with SPSS Ver. 23.0 by using complex sample analyses.  In the results of bivariate analyses, gender,  overall grades, study stress, teacher attachment, parental participation in education and supervision, peer attachment, and depression and anxiety were associated with career maturity in the low self-esteem group. However, school year, career consulting experience, overall grades, study stress, teacher attachment, parental participation in education and supervision, peer attachment, and depression and anxiety were associated with career maturity in the high self-esteem group.  The results of logistic regression analyses showed that parental participation in education, peer attachment, and depression and anxiety were significantly associated with career maturity in the low self-esteem group, while career consulting experience, overall grades, teacher attachment, parental participation in education, and perental supervision were significantly associated with career maturity in the high self-esteem group. In conclusion, it is neccessary to develop different programs by levels of self-esteem to enhance career maturity in high school students.

Speaker
Biography:

Emilia Campos de Carvalho, RN, PhD is Senior Professor of University of Sao Paulo. She was Dean of the Ribeirão Preto College of Nursing – Brazil. She has interest in Nursing Education, Nursing Clinical, Clinical Simulation and Nursing Process

Abstract:

Anxiety is one of psychopathological comorbidity most frequent in cancer patients. Thus, the

identification of the feeling of anxiety and related factors it is important to treat this condition. The proposal of this Cross-sectional study is to investigate the correlation between state and trait anxiety and the socio-demographic variables of patients with colorectal cancer in the preoperative. Fifty patients hospitalized for surgical treatment of colorectal cancer fill out a form about sociodemographic questions (age, gender, education, socioeconomic and marital status and religion) and the State-Trait Anxiety Scale. Statistical analyses were performed using the Spearman correlation coefficient and the Pearson correlation coefficient. We observed that women have higher levels of trait anxiety that men (r=0,401; p=0,004). Regarding the state anxiety, older people have lower levels of anxiety (r = -0,302; p=0,033), women are more anxious than men (r=0,333; p=0,018). Literature says that younger people live certain situations, such as worries about the children and career, which can generate more anxiety1. Regarding sex, men tend to have more difficulty to express their feelings and admit their weakness or vulnerability due to social standards2. According to the data of this study, it is concluded that women have higher levels of trait anxiety and state anxiety than men and older people have lower levels of state anxiety than younger. Nurses should observe the characteristics of the patients so that they can provide more appropriate care to the profile of each patient.

Speaker
Biography:

Watchara Suktae has teached student nurses at Boromarajonani College of Nursing, Sawanpracharak Nakhonsawan for 25 years . She is a specialist in Neonatal Nursing.

Abstract:

The Propose of this quasi-experimental research were 1) to compare pre and post khowledge of nursing students’ premature newborn nursing care by using simulation 2) to compare the  khowledge of nursing students’ premature newborn nursing care between an experimental group and a control group 3) to study the opinion of nursing student after using simulation. The sample groups used in this research were 60 nursing students in 2014 academic year. The subjects were divided into 2 groups, 30 were assigned tobe in control group and 30 were assigned to be in an experimental group by simple random sampling. The instruments were learning lesson plan using simulation, Focus group question and test about premature newborn nursing care. The data were analyzed by using percentile,average and t-test

            The research revealed that:

            1. Nursing students who learning by using simulation had better scores in post khowledge about  premature newborn nursing care than that in pre- khowledge.

            2. Nursing students who learned by using simulation had better scores in post khowledge about  premature newborn nursing care than Nursing students who learned normally.

Hei Tung, Ip

The Hong Kong Polytechnic University, Hong Kong

Title: Nurses in street attire: Facilitator of recovery process?
Speaker
Biography:

Hei Tung Ip is currently a final year candidate of Bachelor of Science (Honours) in Mental Health Nursing in The Hong Kong Polytechnic University. She has involved in a research concerning nurses in street attire as a facilitator of patients’ recovery. She also joined different activities related to nursing, a service program, “growing resilience of children in post-disaster contexts”, to hold activities for children in Sichuan in 2015. She has been a member of the Dance Society. She enjoys singing and occasionally performs with her band mates in campus.

Abstract:

The Recovery Model has been introduced in Hong Kong since 2010. Recently, the policy of uniform in rehabilitation ward has changed to allow staff wear their own clothes to better fit the Recovery Model. The effects of nursing staff wearing street attire have been under discussion over the past decades in the United States, the United Kingdom and Australia. However, this literature is of limited value to the psychiatric services in Hong Kong, where no related research has been conducted. The aim of the study was to explore Hong Kong mental health nurses’ views about wearing street attire within an in-patient rehabilitation unit in regards to facilitating patients’ recovery process. A qualitative descriptive study method, utilizing individual in-depth semi-structured research interview, was employed in this study. Interview data were content analyzed from the perspective of post-positivism. A total of 11 interviews were conducted with nurse participants. The analysis process initially identified 177 open codes, which were merged into 81 nodes. Finally, 3 main themes and 9 sub-themes were identified. Main themes were ‘building up rapport with patients’, ‘street attire helps deinstitutionalization’ and ‘different approaches to maximize the benefit and to minimize the risk’. A majority of nurse participants positively viewed the policy of wearing street attire in a psychiatric rehabilitation unit, they felt the policy was potentially beneficial to patients’ recovery process. Street attire is not the only key to recovery, nurses are recommended to be aware of their skills in taking care of patients, to further maximize the benefit of the policy.

Speaker
Biography:

Jarujit Prajit has received certificate of Advanced Practice Nurse in Anesthesia in the year 2012. She has completed M.N.S. (Nursing Administration) in the year 2016 from Khonkaen University, Thailand. She is the Nurse Anesthetist at Thepparat Nakhonratchasima Hospital and also secretary of  Nursing  Union  of  Thailand.

Abstract:

Pain is an emotional discomfort experience. The effective pain management leads to less complications and helps patient get quick recover. Thepparat Nakhon Ratchasima Hospital is one of the general hospitals that have many surgery cases annually. These cases include general surgical procedures, orthopedic and obstetric surgery. The accumulative surgery cases in the year of 2013, 2014, and 2015 were 2,634, 4,504 and 5,405 respectively. The patients receiving anesthesia were that of 1,409, 2,763 and 3,273 respectively. The study purposes were to survey the patient’s perception of pain within 24 hours after surgery and develop the postoperative pain management system. The cross-sectional study of 60 patients, anesthetic nurses made a visit to patients within 24 hours after anesthesia to record pain score routinely. Patients received, 63.33% of the total patients received general anesthesia and 36.67% of the total were spinal analgesia. Postoperative interview within 24 hours by anesthetists revealed that percentages of patients went through mild pain, moderate pain, and severe pain were 33.33%, 31.67%, and 35.00%. Post-operative patients faced the post-operative pain within 24 hours at the level of moderate to severe pain were 66.67 %. The interview data of post-operative pain among 60 patients receiving surgical treatment reveals informative perception of pain. There was also a high incidence of moderate to severe pain in these particular patients. These could relevant aspect for healthcare service providers to improve nursing care plan for pain management.

Speaker
Biography:

Yu-Ping, Huang has completed her PhD from Griffith University School of Nursing and Miderwifery. She is an Associated Professor and teachs at National Quemoy University School of Nursing. She has published more than 20 papers in reputed journals and has been serving as a reviewer for international and national journals

Abstract:

Hematopoietic stem cell transplantation (HSCT) is the preferred treatment over chemotherapy and radiotherapy for children with recurrent cancers. However, HSCT has adverse side effects such as infection, sepsis, and graft-versus-host disease. Hence, HSCT is performed in isolation wards; this can cause immersive stress in the treated children and their primary caregivers. Thus, a phenomenological study was conducted using semistructured interviews to explore the roles and functions of health professionals from the perspectives of mothers who took care of their children with cancer in isolation rooms during HSCT. The time between HSCT preparation and leaving the isolation room after HSCT completion was considered the HSCT period. This study recruited 34- to 54-year-old mothers (n = 12) of children aged 11 months to 14 years. The results revealed that the roles and functions of health professionals were as follows: (1) trainer, teaching mothers the necessary skills and knowledge to take care of their children in isolation rooms; (2) supporter, listening and offering encouragement to the mothers and providing them with emotional support; (3) experience guide, sharing with the mothers their experiences of certain symptoms in their children during HSCT; (4) companion, undergoing the entire process with the mothers to provide a sense of security; (5) eyewitness, witnessing and understanding the meanings of HSCT and the mothers’ involvement; (6) monitor and detector, identifying early signs or symptoms of HSCT complications; and (7) care provider, administering drugs and providing care. The mothers’ anxiety and distress were reduced when they encountered caring and supportive health professionals.

Speaker
Biography:

Cristina M Zamarioli, has completed her Undergraduation Course and her Mastery Program both from the University of São Paulo at Ribeirão Preto College of Nursing and Specialization in Clinical Oncology from the National Cancer Institute. She is a PhD Student, and has interesting in nursing cancer and nanotechnoloy studies

Abstract:

This study aimed to identify the critical incidents reported by students during activities in a practical field, involving knowledge acquired in the discipline of Semiology and Semiotechnics (anamnesis, physical examination and nursing process). It is a study with a qualitative approach, using the technique of critical incident, used to identify relevant events for the individual. The elements of the critical incidents (situation, behaviors and feelings generated) were obtained in cursive written form about positive or negative experiences. Students enrolled in the nursing undergraduate course (n = 62); 25.8% of the intermediate years and 74.2% of the final years; 90.3% female; Age group of 19 to 35 years (mean of 23.2 years). There were mentioned situations related to: anamnesis and the physical examination of patients in different scenarios, clinical conditions and age ranges; the development of the nursing process; the interaction of the student with patients, care team (with the teacher or supervisor). The reports that portrayed student behavior were analyzed. The positive feelings identified (61.3%) include self-satisfaction and recognition and predominated among the students. The negatives were related to the technical difficulty, represented by impotence, anxiety and insecurity, predominating among intermediate students. These reports portray the use of the knowledge of Semiology in different experiences throughout the course. Also, they allow the improvement of the work plans of the disciplines, especially for the identification and prevention of stressful situations that generate negative feelings. It should be the goal of the teacher to offer teaching that will generate student satisfaction and lower stress load.

San Yuet, Kwok

The Hong Kong Polytechnic University, Hong Kong

Title: Nurses in street attire: Facilitator of recovery process?
Speaker
Biography:

San Yuet Kwok is currently a final year undergraduate student in BSc (Hons) in Mental Health Nursing in The Hong Kong Polytechnic University. She is a undergraduate member of Pi Iota Chapter of Sigma Theta Tau International, Hong Kong since 2016. She has been a student assistant for data collection and data entry in a research project. “Nurses in street attire: Facilitator of recovery process?” is the first research project that she was a co-investigator with her research teammates.

Abstract:

The Recovery Model has been introduced in Hong Kong since 2010. Recently, the policy of uniform in rehabilitation ward has changed to allow staff wear their own clothes to better fit the Recovery Model. The effects of nursing staff wearing street attire have been under discussion over the past decades in the United States, the United Kingdom and Australia. However, this literature is of limited value to the psychiatric services in Hong Kong, where no related research has been conducted. The aim of the study was to explore Hong Kong mental health nurses’ views about wearing street attire within an in-patient rehabilitation unit in regards to facilitating patients’ recovery process. A qualitative descriptive study method, utilizing individual in-depth semi-structured research interview, was employed in this study. Interview data were content analyzed from the perspective of post-positivism. A total of 11 interviews were conducted with nurse participants. The analysis process initially identified 177 open codes, which were merged into 81 nodes. Finally, 3 main themes and 9 sub-themes were identified. Main themes were ‘building up rapport with patients’, ‘street attire helps deinstitutionalization’ and ‘different approaches to maximize the benefit and to minimize the risk’. A majority of nurse participants positively viewed the policy of wearing street attire in a psychiatric rehabilitation unit, they felt the policy was potentially beneficial to patients’ recovery process. Street attire is not the only key to recovery, nurses are recommended to be aware of their skills in taking care of patients, to further maximize the benefit of the policy.

 

Tin Wai,Chang

The Hong Kong Polytechnic University, Hong Kong

Title: Nurses in street attire: Facilitator of recovery process?
Speaker
Biography:

Tin Wai was born and raised in Hong Kong. She is a year 5 student of Mental Health Nursing. Last summer, she completed a leadership course and a nutrition course in Alverno College in the US under the student exchange programme offered by the School of Nursing. In 2014, she went to Hui Long Guan Hospital for clinical placement for three weeks in Beijing. In her free times, she likes to have quality chats with her friends, making little improvisation on some songs, reading theological books and playing with her lovely Chinchilla and Scottish Fold.

Abstract:

The Recovery Model has been introduced in Hong Kong since 2010. Recently, the policy of uniform in rehabilitation ward has changed to allow staff wear their own clothes to better fit the Recovery Model. The effects of nursing staff wearing street attire have been under discussion over the past decades in the United States, the United Kingdom and Australia. However, this literature is of limited value to the psychiatric services in Hong Kong, where no related research has been conducted. The aim of the study was to explore Hong Kong mental health nurses’ views about wearing street attire within an in-patient rehabilitation unit in regards to facilitating patients’ recovery process. A qualitative descriptive study method, utilizing individual in-depth semi-structured research interview, was employed in this study. Interview data were content analyzed from the perspective of post-positivism. A total of 11 interviews were conducted with nurse participants. The analysis process initially identified 177 open codes, which were merged into 81 nodes. Finally, 3 main themes and 9 sub-themes were identified. Main themes were ‘building up rapport with patients’, ‘street attire helps deinstitutionalization’ and ‘different approaches to maximize the benefit and to minimize the risk’. A majority of nurse participants positively viewed the policy of wearing street attire in a psychiatric rehabilitation unit, they felt the policy was potentially beneficial to patients’ recovery process. Street attire is not the only key to recovery, nurses are recommended to be aware of their skills in taking care of patients, to further maximize the benefit of the policy.

Anakin Ying Kin Long

The Hong Kong Polytechnic University, Hong Kong

Title: Nurses in street attire: Facilitator of recovery process?
Speaker
Biography:

Anakin Ying Kin Long is going to complete his undergraduate degree at the age of 22 years from the Hong Kong Polytechnic University. He is a student of mental health nursing program. He has accomplished clinical placement in medical and surgical unit, psychogeriatric unit, admission unit and substance abuse unit.

Abstract:

The Recovery Model has been introduced in Hong Kong since 2010. Recently, the policy of uniform in rehabilitation ward has changed to allow staff wear their own clothes to better fit the Recovery Model. The effects of nursing staff wearing street attire have been under discussion over the past decades in the United States, the United Kingdom and Australia. However, this literature is of limited value to the psychiatric services in Hong Kong, where no related research has been conducted. The aim of the study was to explore Hong Kong mental health nurses’ views about wearing street attire within an in-patient rehabilitation unit in regards to facilitating patients’ recovery process. A qualitative descriptive study method, utilizing individual in-depth semi-structured research interview, was employed in this study. Interview data were content analyzed from the perspective of post-positivism. A total of 11 interviews were conducted with nurse participants. The analysis process initially identified 177 open codes, which were merged into 81 nodes. Finally, 3 main themes and 9 sub-themes were identified. Main themes were ‘building up rapport with patients’, ‘street attire helps deinstitutionalization’ and ‘different approaches to maximize the benefit and to minimize the risk’. A majority of nurse participants positively viewed the policy of wearing street attire in a psychiatric rehabilitation unit, they felt the policy was potentially beneficial to patients’ recovery process. Street attire is not the only key to recovery, nurses are recommended to be aware of their skills in taking care of patients, to further maximize the benefit of the policy.

Speaker
Biography:

Abstract:

Public hospitals across the country are flooded by patients diagnosed with HIV/AIDS-related illnesses. South African Acquired immunodeficiency syndrome (AIDS) has completely changed the medical landscape and placed a great burden on the shoulders of professional nurses. The purpose of the study is to explore and describe instrumental support of the professional nurses. Challenges faced by the professional nurses were Fatigue, ill-health, resignation and poor HIV/AIDS care to patients admitted with opportunistic infections. The study was conducted at one of the Tshwane district hospitals of Gauteng province, South Africa. Instrumental support was explored focusing more on tangible assistance provided by the hospital and hospital nurse managers. A qualitative approach with explorative, descriptive and contextual designs were employed. Purposive sampling method was used to select 25 participants who participated in individual face to face interviews. Data gathered from the participants were analysed using Tesch’s eight steps of open coding techniques. The findings of the study revealed that the hospital and nurse managers did not provide effective tangible support. It was recommended that instrumental support of professional nurses caring for patients diagnosed with HIV/AIDS related illnesses be effectively provided by the hospital and the nurse managers through the development of the model to address challenges.

Speaker
Biography:

SHU-YIN CHU She working in Chi Mei Medical Center of  Medical ward  for 10 years. She has been Nurse Practitioner and new nurses' of clinical  nursing  preceptors.

Abstract:

Introduction/background: When vocal cord paralysis occurs, emergency endotracheal intubation or tracheostomy is required to maintain respiratory tract patency. Tremendous pressure in face of surgery pose extreme threats and burdens to patients in multiple ways. the use providing guidance on effective self-management and establishing good nurse-patient communication channels, thereby improving awareness and enhancing the coping ability in patients.

Purpose/methods: The case study was by tracing the root causes concerning clinical handling and overall surgery pressure management for the patient, for care intervention and strategic measures for three areas were conducted. (1) Emotional orientation: good nurse-patient relationships were established through proactive care and support based on three principles, ”observing (visiting), heeding (listening) and communicating (explaining)”, to guide the patient towards positive thinking. (2)Problem orientation: guidance and consultation on health education. (3) Structural orientation: the aim was to strengthen familial and social care structures.

Results: Through three major orientations interventions did effectively improve the patient’s ability to cope with pre-surgical anxiety and pressure and to accept the post-surgical impact on the patient’s disease with a positive attitude and learn what to pay attention to after tracheostomy and knowledge about the disease, thereby achieving self-care and a positive coping strategy.

Conclusions: Good communication between healthcare teams and patients combined with the also effectively reduce anxiety in patients and their families with surgery by providing appropriate guidance on information about disease-related personalized care and clarifications regarding issues, thereby easing pressure and increasing patient confidence in health maintenance.

Speaker
Biography:

Abstract:

Abstract: Auditing is part of the management, and through audits process could determine which of the systems implemented does not meet regulatory requirements and needs to be improved. To apply the audit system in the infection control of medical institutions could maintain the  inpatient safety in intensive care unit , improve the quality  and reduce cost of medical care, provide a safe working environment.


Purpose / Methods: This study method based on the current situation analysis and literature review, applying system diagram to summarized three main problems: 1. inappropriate management of care team members. 2. Inadequate environmental cleaning. 3. insufficient of dressing carts. Applying quality control circle PDCA approach, the improvement strategies were including: 1. developed audit checklist of hand hygiene and hand bacterial colony collection 2, implementation bedside equipment and environmental sterilizing in three shifts 3 for the isolation patients, using a simple dressing plate to avoid cross-infection.


Results: The audit inaccuracy rate decreased from 7.82% to 3.41%, the infection density decreased from 10.06 ‰ to 7.60 ‰, and the average cost of medical supply was reduced 3,580 NT / month. Antibiotics use DDD decreased from 15g per person per day to 10g, the use of the amount of drugs accounted of hospital expenses from 46%to 30%.


Conclusions: Infection control is an ongoing task for the intensive care unit, from establishment of the concept, supervision, audit to habits developed, from cleaning workers to department directors, whether it is a brief contact with the radiologist, pharmacist, dietitian, or physician, respiratory therapist, or close contact with the 24-hour care staff, all health care deliverer need to work together to provide a high quality and safety medical environment.