Day 2 :
Keynote Forum
Heather Mac Donald
University of New Brunswick, Canada
Keynote: Getting back into the game: Returning to work after depression
Time : 09:00-09:25
Biography:
Heather MacDonald completed a Master’s degree in Nursing at the University of Toronto, Canada and a PhD at the University of Manchester in the UK. Currently, she is a Professor in the Faculty of Nursing at the University of New Brunswick, Canada. Her Doctoral work examined respite for parents who were caring for children who required complex care. This paper comes from that work.
Abstract:
In this grounded theory study, 40 English speaking women from a rural province of Canada were interviewed to learn about their experiences of returning to work after a depression. Women described getting back in the game as being difficult and challenging as they have not completely recovered by the time they returned to work. However, they felt compelled to return to work in order to keep their jobs, in order to resume health and social benefits, and to reinstate their wages. A number of themes emerged from the interview data. These included the presence of stigma, the active pursuit of silence and battling adversity. Each of these core themes serves to describe the women’s experiences of returning to work. The women described wearing a mask or “putting on a face” to combat the stigma associated with their illness. In this presentation, the three themes will be discussed along with a thorough description of wearing a mask. Strategies that employers can employ to ease the transition back to work will be discussed.
Keynote Forum
Karl Goodkin
East Tennessee State University, USA
Keynote: HIV risk factors in persons with severe mental illness
Time : 09:25-09:50
Biography:
Karl Goodkin is a professor and chair of the ETSU Department of Psychiatry and Behavioral Sciences. He comes to ETSU from Los Angeles, where he served as the director of mental health at the AIDS Healthcare Foundation. Prior to his role there, Goodkin served as professor of psychiatry and biobehavioral sciences at the University of California at Los Angeles and at the Cedars-Sinai Medical Center where he also was the director of clinical research for several years.
Abstract:
The prevalence rate of HIV infection among persons with severe mental illness varies significantly across studies but is known to be higher (range: 4-23%) than that of the general population (<1%). General population risk factors associated with HIV infection have been verified as sources of infection in this group. A recent meta-analysis was done that examined 373 reports of which 91 articles were assessed. It was reported therein that the prevalence of blood-borne viral infections (HIV, HCV and HBV) in people with serious mental illness were on par with the general population in regions with high prevalence of blood-borne viruses. The conclusion was made that the data supporting a higher prevalence of blood-borne viral infections among people with serious mental illness might have been over-estimated. Yet, most of the analyzed studies consisted of convenience samples from in-patient psychiatric treatment settings, and the research demonstrates that data from persons with seriously mental illness who are not in treatment are needed to optimally approximate the generalizability to the entire population. Control for non-injection substance use disorder is also relevant, as is the percentage of persons with co-infections--dual and triple. Most importantly, factors beyond generally acknowledged HIV risk factors were not consistently controlled in the analyzed studies. The severity of cognitive impairment and psychotic symptoms needs to be controlled in this population, as those variables directly reduce the planned use of risk precautions for sexual activity and injection drug use-related HIV risk behaviors. Future studies of HIV infection risk in this population would benefit significantly from the employment of a random sampling approach incorporating controls for the severity of cognitive impairment and of psychotic symptoms among the study participants as well as for non-injection substance use disorder, presence of co-infections and homelessness. Cognitive impairment and psychotic symptoms have generally not been controlled in these studies but are known to prevent the accurate assessment of risk to self and the development of plans to reduce HIV risk in high-risk behavior settings among persons with severe mental illness. Prevention research should aim to individually assess the impact of these additional specific contributory factors in addition to the traditional HIV risk factors in this vulnerable population.
- Clinical Nursing, Cancer Nursing, Cardiac Nursing, Pediatric Nursing, Women Health Nursing
Location: Plano-Richardson
Chair
Heather Mac Donald
University of New Brunswick, Canada
Co-Chair
Robert Scoloveno
Rutgers University School of Nursing-Camden, USA
Session Introduction
Irene Kane
University of Pittsburgh, USA
Title: Fetal Alcohol Spectrum Disorders (FASD) prevention and practice through national partnerships
Biography:
Irene Kane is an Associate Professor of Nursing with extensive clinical, teaching and research experience in developing and teaching health promotion programs emphasizing disease prevention and health management to improve psychobiological wellbeing. She is a certifi ed Screening Brief Intervention and Referral to Treatment (SBIRT) trainer with over 25 papers published in peer-reviewed journals and share SBIRT training knowledge, skills and outcomes to address substance use identification and brief interventions earlier along the continuum of use, misuse, abuse and dependence.
Abstract:
Background: All health professionals, especially nurses, are uniquely positioned to identify, intervene with and educate women about risks associated with excessive alcohol use. Nurses can: identify women at risk for alcohol-exposed pregnancy (AEP); deliver evidence-based interventions to at-risk women and; provide referrals as necessary. The Centers for Disease Control (CDC) has funded University of Pittsburgh, School of Nursing in collaboration with University of Alaska and University of California at San Diego to disseminate information about alcohol screening and brief intervention (SBI) for prevention of AEPs and fetal alcohol spectrum disorders (FASD). Alcohol use among women of child bearing age (18 to 44 years) has remained high over the past several decades (CDC, 2014, 1999; SAMHSA, 2004). Alcohol use screening is not a routine standard of care, and yet, FASD training for nurses can be effective.
Aim: Aims of this study are to: Describe the findings from the nursing environmental scan related to information on FASD; describe the gaps in nurses’ knowledge related to FASD and; collaborate with national nursing partner organizations to increase the reach and number of nurses trained to use alcohol SBI to prevent AEPs and FASDs.
Results: An environmental scan was completed to identify evidence-based/evidence-informed training materials and resources related to alcohol SBI and FASD. The environmental scan reviewed existing literature, statements of national nursing organizations, and training curricula. Over 400 items initially were obtained. Abstracts were used to narrow down to the most relevant material. Thus, 125 items were reviewed in-depth and rated on several factors including coverage of alcohol SBI, FASD issues and potential patient reach and sustainability. Results point to areas where nurses can improve their knowledge, attitudes and behaviors related to alcohol SBI for AEPs and FASD.
Conclusion: This extensive process will serve as the basis to complete a national training plan for nursing practice around implementation with multiple nursing organizations.
Mozhdeh Tahghighi
Curtin University of Technology, Australia
Title: Resilience, compassion satisfaction, compassion fatigue, depression, anxiety, stress in nurses working shift work in Australia- Phase 1 results
Biography:
Mozhdeh Tahghighi has a Bachelor of Nursing, and has completed her Master of Nursing from the University of Western Australia. She is a PhD candidate in Psychology (third year) at Curtin University. She is working on resilience of nurses working shift work in Australia, which is a first Australian study. Also, she is Registered Nurse in this country.
Abstract:
The overall aim was to investigate the impact of shift work on resilience in nurses and to determine whether nurses who work shifts have different mental health/professional quality of life outcomes compared to those who work regular hours. This study examined data collected from registered and enrolled nurses (n=1495) as part of a 2013 online self-report study among employed nurses who were members of the Queensland Nurses’ Union. Generalized Linear Mixed Model analysis revealed shift workers had significantly lower scores on the compassion satisfaction measure; however, this was a very small effect. There were no significant differences between shift and non-shift workers on depression, anxiety, stress, resilience, secondary traumatic stress and burnout. Nurses working shifts showed significantly lower levels of compassion satisfaction compared to non-shift worker nurses; however, they did not indicate they will leave the profession compared to non-shift worker counterparts.
Sofi Dhanaraj
Queen Elizabeth Hospital Birmingham, UK
Title: Hepatocellular carcinoma in immigrant population: Impact of viral status
Biography:
Sofi Dhanaraj has completed her BSc in Nursing from Madras Medical College, Chennai, India. She has worked for 18 years in the field of Nursing including more than 14 years in Oncology Services. She completed her BSc in Palliative Care Nursing in 2006 from Birmingham City University, United Kingdom (UK) and MSc in Clinical Oncology in 2014 from University of Birmingham, UK. She has been working in Liver Services as a Clinical Nurse Specialist in Hepato-Pancreato-Biliary (HPB) Oncology for the past three years at Queen Elizabeth Hospital Birmingham, UK. She has published one paper in a reputed journal.
Abstract:
The incidence and mortality rates of hepatocellular carcinoma (HCC) have been rising in the United Kingdom over the last 30 years. The aim of this research was to study the frequencies of chronic hepatitis B and C virus (HBV and HCV) infection and their associations with HCC in immigrant populations. We also aimed to compare the results with the native UK population. The research data was largely collected prospectively for studies on the serological diagnosis of HCC on all immigrants and native UK patients with HCC who were seen at Queen Elizabeth Hospital Birmingham, UK, between 2007 and 2012. Additional relevant data was collected retrospectively. 17% of HCC cases in the UK arose among immigrants and there was a notable difference in the primary aetiology between the natives UK and immigrants. HBV and HCV-related diseases were the main cause of HCC in immigrants (accounting for 92% of immigrant but only 27% of native cases) and there was a significant difference in the median survival between the two groups (median survival=15.461 and 22.599 months respectively). Immigrant populations may be at increased risk of HCC because of their viral status, there is a need for recognition that this risk group should be screened for HBV and HCV infection so that early diagnosis and appropriate HCC screening may enhance early detection of HCC and result in better survival.
Lois E Rockson
Rutgers Biomedical and Health Sciences, USA
Title: Cancer screening among peer-led community wellness center enrollees
Biography:
Lois E Rockson is pursuing her PhD in Urban Systems with a focus in Urban Health in the Joint Doctoral Program at New Jersey Institute of Technology, Rutgers School of Nursing, and Rutgers University, Newark. Her dissertation work focuses on “Cancer screening among immigrants from the Caribbean Basin”. She completed her Master’s in Public Health at University of Medicine and Dentistry of New Jersey’s School of Public Health in 2008 and; a Joint Master’s in Health Professions Education at Seton Hall University and University of Medicine and Dentistry of New Jersey’s School of Health Related Professions in 2001. She is an Assistant Professor at Rutgers School of Health Related Professions, Department of Clinical Laboratory Science’s. This study was the result of an interdisciplinary collaborative study with Rutgers School of Health Related Professions, Department of Psychiatric Rehabilitation and Counseling Professions.
Abstract:
Growing evidence shows that disparities exist in health services for those with mental disorders served by the public mental health system. This study assessed the use of cancer screening services among New Jersey residents enrolled in publically funded mental health programs. Self-administered surveys were completed by 148 adults who utilize services at peer-led community wellness centers throughout New Jersey. The survey instrument collected data on their use of breast, cervical and colorectal cancer screening services as well barriers to receiving such preventative services and their perceptions on their overall health. Schizophrenia spectrum disorders were the most common self-reported psychiatric condition. More males than females participated in the study with African Americans and Whites participating equally. Most participants perceived their overall health as excellent (17%) or good (45%). Screening for colorectal cancers (42%) was low when compared to the general population (57%). Physicians not advising patients to receive cancer screening tests emerged as the main cause of low screening rates. Wellness initiatives designed and initiated by peers, collaborating with other health care providers may improve adherence to cancer screening measures.
Nahla Tayyib
Umm Al-Qura University, Saudi Arabia
Title: Testing the effectivness of pressure injury bundle in adult intensive care: A cluster randomised controlled trial
Biography:
Nahla Nahla Gadir Tayyib has over 14 years of experience as a Registered Nurse. She has completed her PhD in Nursing in 2016 at Queensland University of Technology, Australia. She has worked as an Assistant Proferssor in Nursing Faculty at Umm al-Qura University, Saudi Arabia. Currently, she is a member of the Sigma Theta Tau International Honor Society of Nursing. Her research interest includes “Wounds, particularly pressure injury”. She has nine published articles in this field.
Abstract:
Pressure injuries (PIs) have been identified as a worldwide problem that contribute significantly to increasing health care costs, compromise an individual’s health, and in some cases contribute to mortality. The intensive care context poses special challenges to preventing PIs developing due to the high acuity of patients and the highly invasive nature of interventions and therapies which critically-ill patients receive. In response to these challenges, we test the effectivness of PI care bundle, to reduce the incidence of PIs in ICU in Saudi Arabia. This study was conducted in multicenter critical care units, Saudi Arabia. Of the 140 patients who admitted to ICUs during the enrolment period, 70 with 728 days of observation were in the control group and 70, with 784 days of observation, were in the intervention group, the mean age in control and intervention group was 52 and 47.5, respectively. Almost 71% of both groups were male. There was no significant differences between both groups in all demographic characteristics and all clinical characteristics except time in operation room. Survival was improved with the intervention, with 12 PIs among intervention group and 37 PIs among patients receiving standard skin care. The Poisson regression model infers that the rate of any new PIs in the intervention group is 70% lower in the intervention group than the control. Timely implementation of a bundle of measures to reduce PIs demonstrated a significant reduction in PIs development in Saudi Arabia ICU.
Antoinette Barton-Gooden
University of the West Indies School of Nursing, Jamaica
Title: Physical restraint usage at a teaching hospital: A pilot study
Biography:
Antoinette Barton-Gooden is a Lecturer at UWI School of Nursing. Her research interests include “Patient safety issues, sickle cell disease, nursing leadership and tobacco smoking”. Issues surrounding restraint usage has been an area of focus as it impacts patient safety and dignity during care. Direct involvement in clinical teaching and supervision has highlighted the need for strengthening nursing leadership and systems change to create a safety culture in healthcare settings in Jamaica.
Abstract:
Statement of the Problem: Physical restraint usage is widespread in acute care settings and contributes to patient injuries and death. Nurses are ambivalent about the practice and face moral dilemma when it is used. However, little is known or documented about the use of physical restraints in Jamaica.
Aim: The purpose of the study is to examine the use of physical restraints among adult patients on the medical-surgical wards and one psychiatric unit at a teaching hospital in Jamaica.
Method: This mixed-methods study utilized a restraint prevalence tool to directly observe 172 patients and conduct 47 chart audits. Two focus group discussions with nurses and medical doctors working on the wards and unit were conducted. Qualitative data were audio taped, transcribed and thematically analyzed using a comparative matrix. Quantitative data was analyzed using SPSS® version 17.
Results: The prevalence of use of physical restraints was (75%) on the medical-surgical wards. Bedrails accounted for 70%, while limb and trunk restraints using stockinet and leather straps (5%). No restraint usage was observed on the psychiatric unit. Limb restraints were inappropriately applied (43%), and no doctors’ order or written consent was seen (90%). Focus group discussants were female ages 20-39 years, with 8-36 months experience in the area. They reported feelings of sadness, guilt and fear regarding the use of physical restraints. Also, restraints were necessary when the patient was at risk for harm to self and others. Majority reported being unaware of the policy (83%), not being formally trained in restraint application, but had learnt from peer observation.
Conclusion & Significance: High prevalence of bedrails was a standard procedural practice to prevent patient falls. Nurses and doctors experienced moral dilemma when restraints are used. Adequate institutional support and integration of evidence-based information is necessary to enhance patient safety.
Maria Irma Bustamante
St. Paul University Surigao, Philippines
Title: Behavior change through photovoice: A St. Paul university manila exemplar
Biography:
Irma Bustamante has been in nursing practice and nursing education for the last 35 years. She rose up from a community health nurse, staff nurse, senior nurse, and director of nursing services; in education, she moved from instructor to full professor and has taught in the Diploma Program, Bachelor’s Program, Master’s and PhD Programs for Nursing. Her interest in research includes both quantitative and qualitative methodologies. Currently, she is the Dean of St. Paul University Manila’s College of Nursing and Allied Health Sciences. She acts as the corresponding author for this conference.
Abstract:
It has been observed that food wastage is high among the St. Paul University Manila dormers and canteen customers. This study analyzed the reasons behind food wastage and attempted to elicit behavior change by the use of photovoice methodology as an innovation in a biphasic study–the descriptive analytical technique and analysis of narratives. The study was anchored on the core values of Paulinian education specifically on the wise use of resources and Fogg’s 2012 Behavior Model. The research participants were 20 dormers of the university. They were asked to take the photo of their food before and after eating. Their views towards the photos they have taken were consequently asked. The data gathered through the informal interview were analyzed qualitatively. They generally felt that food is an important resource that should not be wasted. However, they added that the reasons why they did not consume the food that they have taken on their plates was because it was “Not Delicious” nor appetizing. The food being served is prepared in university cafeteria kitchen. The views of the dormers towards the way the food is being prepared and served has been imparted to the cafeteria administration. A dialogue has been facilitated to heighten awareness on the food wastage issue. The findings indicated that students were open to change their behavior towards food wastage. The use of photovoice is a promising way to bring out behavior change.
Jason Alcorn
Mid Yorkshire Hospitals NHS Trust, UK
Title: An exploration of BCG treatment for non-muscle invasive bladder cancer: A mixed methods approach
Biography:
Jason Alcorn is in the final stages of completing his professional Doctorate from the University of Huddersfield, West Yorkshire, England. He is currently the Lead Nurse for Urology Cancer in the Mid Yorkshire Hospitals NHS Trust, a specialist urology cancer center in West Yorkshire, England. He has been nursing for more than 15 years and has published 5 papers in reputed journals and is a reviewer for the International Journal of Urological Nursing.
Abstract:
Since the turn of the 20th century, Bacillus Calmette-Guerin (BCG) treatment for non-muscle invasive bladder cancer (NMIBC) has been in and out of favor. However, only a small proportion of patients, as low as 16%, complete what is seen as the preferred treatment option. The treatment itself presents issues, which are reported in the literature as being side effects, which can be from mild to severe and local to systemic. An integrative-based literature review was conducted to generate a broad overview of the existing knowledge for BCG treatment. A significant number of articles were identified. The major conclusion from the literature review is that BCG treatment, when given through an induction and maintenance regime, significantly reduces the risk of progression and recurrence, but can cause withdrawal of over 80%. This could be through side effects that the patient and the nurse need to be aware of. This review also highlighted that there is a lack of research from the UK and that there is a paucity of research showing why patients withdraw from BCG treatment. This formed the basis of a mixed methods study, which has been carried out in a large district general hospital, to explore the influences that cause patients to withdraw from BCG treatment. The conclusion is that there are multiple factors that cause patients to withdraw from BCG treatment e.g. physical, psychological (including emotional), age and the social impact, that nurses need to be aware of and to minimize to keep patients on the preferred treatment.
Carol Hewart
Plymouth Hospitals NHS Trust, UK
Title: Improving patients sleep: Reducing light and noise levels on wards at night
Biography:
Carol Hewart has completed her Degree in Health Studies. She has 12 years Renal Nursing experience before moving to Operational Support for three years. She is currently a Clinical Site Manager and Specialist Nurse. She has published nursing related journal articles.
Abstract:
Much research has been undertaken regarding the psychological and physiological effects of sleep deprivation on patients in hospital. However, there are very few suggestions regarding measures that could be taken to address this. Members of the Acute Care Team (ACT) visit the wards at night and have become increasingly aware of the high noise and light levels during these times. We care for critically ill patients in general wards and have noticed an increase in the length of stay along with other complications that may be caused by inadequate and interrupted sleep. Two audits were carried out in 2015 to assess noise and light levels on wards at night, with the aim of offering suggestions regarding ways to reduce recovery time and length of stay. A survey of the light levels was undertaken in addition listening to the noises on the wards between the hours of 23:00 and 03:00. Some objections were voiced as some staff understood us to be asking them to work in poor lighting as opposed to low lighting conditions, and to be silent when carrying out their work. The repeat audit indicated that the majority of wards had adopted the recommendations, many noting that their patients now appeared less confused and more settled. It is possible, with low- and no-cost interventions to reduce noise and light levels on the wards, thus enhancing recovery. Further studies could be undertaken to look at specific issues and discussion regarding the maintenance of the new measures.
Yasmaine Karel
Evans University of Applied Sciences, Netherlands
Title: Effect of routine diagnostic imaging for patients with musculoskeletal disorders: A metaanalysis
Biography:
Yasmaine Karel has almost completed her Ph.D. at the age of 28 years from the Erasmus University in Rotterdam. She is a teacher and researcher for the department of Health at the Avans University of Applied Sciences and has been a board member of the European Society for Shoulder and Elbow Rehabilitation.
Abstract:
Purpose
The increasing use of diagnostic imaging has led to high expenditures, unnecessary invasive procedures and/or false-positive diagnoses, without certainty that the patients actually benefit from these imaging procedures. This review explores whether diagnostic imaging leads to better patient-reported outcomes in individuals with musculoskeletal disorders.
Method
Databases were searched from inception to September 2013, together with scrutiny of selected bibliographies. Trials were eligible when: 1) a diagnostic imaging procedure was compared with any control group not getting or not receiving the results of imaging; 2) the population included individuals suffering from musculoskeletal disorders, and 3) if patient-reported outcomes were available. Primary outcome measures were pain and function. Secondary outcome measures were satisfaction and quality of life. Subgroup analysis was done for different musculoskeletal complaints and high technological medical imaging (MRI/CT).
Results
Eleven trials were eligible. The effects of diagnostic imaging were only evaluated in patients with low back pain (n = 7) and knee complaints (n = 4). Overall, there was a moderate level of evidence for no benefit of diagnostic imaging on all outcomes compared with controls. A significant but clinically irrelevant effect was found in favor of no (routine) imaging in low back pain patients in terms of pain severity at short [SMD 0.17 (0.04–0.31)] and long-term follow-up [SMD 0.13 (0.02–0.24)], and for overall improvement [RR 1.15 (1.03–1.28)]. Subgroup analysis did not significantly change these results.
Conclusion
These results strengthen the available evidence that routine referral to diagnostic imaging by general practitioners for patients with knee and low back pain yields little to no benefit.
Tendai Nzirawa
Queens University Hospital, UK
Title: Early discharge from the neonatal unit, who does it actually benefit?
Biography:
Tendai Nzirawa completed her Under-graduate Diploma in Nursing in 2005 at City University, London and Bachelor of Science with Honours in Nursing (Neonatal Care) in 2012 at City University, London. Currently, she is pursuing his/her Master of Science in Nursing (Neonatal Care) at London Southbank University, London. Since 2010, she has been involved in setting up and running a Neonatal Parent Support Group with other health professionals. She set up a Down Syndrome Parent Support Group, run it with the assistance of two mothers who have children with Down syndrome. In 2012, she participated at European Academy of Pediatric Societies.
Abstract:
Over the last 10 years, there has been a drive to move health services from hospital to community. Part of this has been driven forward, by hospitals participating in the UNICEF Baby Friendly Initiative. The role of the community neonatal nurse is to ensure that there would be no brakes, therefore this initiative will continue being driven forward right until the parents and infant have settled in their home environment. The data from our service has identified an increase of infants being discharged early, mostly before their expected date of delivery, with home oxygen and at times with nasogastric feeding tube. Since 2009, at least 18 infants are discharged per year from our neonatal unit, and at least five infants are discharged per year with nasogastric tube feeding. This indicates an estimated average of £600 per day being saved per cot space. The argument would be that, not only do we save financial and increase the cot availability, but this would reduce the parental anxiety and fears by discharging these complex infants to not only bond with their families but increase their developmental milestones. Two recent surveys done within our service have shown that parents value the support they receive at home from our service, and felt there was no increased stress caring for their baby on home oxygen.
Lori Persico,
Northwell Health-Hofstra University, USA
Title: Interprofessional Education: The key to advance professional practice and quality outcomes
Biography:
Lori Persico is a doctoral candidate at Molloy College. Persico has held numerous clinical, administrative, tenured faculty, and nurse educator positions over her remarkable 30+ year career within Nursing. She holds certifications in Nursing Professional Development and is a Certified Health Simulation Educator. She was recognized as Faculty Exemplar for the Arnold P. Gold Grant Mentoring and Professionalism in Training for physicians and nurses. At the Patient Safety Institute, she has collaborated in over 90 interprofessional programs. Publications include Interprofessional education: Partnerships in the educational process, and Interprofessional Education in the Healthcare Setting, in the book, Progress in Education.
Abstract:
The curriculum for healthcare professionals is primarily dictated by the demands of the specific discipline. Detailed curricula are essential to develop professional healthcare providers such as nurses, physicians and pharmacists. In traditional educational methods create a system or process where professionals operate in isolation from each other. A siloed structure inhibits effective communication, patient-centered care and safety. Today the focus in healthcare has shifted towards a more patient-centeredness approach using interprofessional collaboration to achieve optimal patient outcomes. Nurses are at the forefront of patient care and play a key role in quality patient care and improved patient outcomes. Interprofessional education is one type of academic strategy that nursing educators can incorporate into educational curricula.