Day 3 :
- Emergency Nursing, Adult Health Nursing, Public Health, Midwifery, Nursing Types, Surgical Nursing, Legal Nursing
Location: Plano-Richardson
Chair
Kari Ingstad
Nord University, Norway
Co-Chair
Guang Zeng
Texas A&M University-Corpus Christi, USA
Session Introduction
Eliezer Bose
University of Texas at Austin, USA
Title: Monitoring cardiorespiratory instability: Current approaches and implications for nursing practice
Time : 09:30-09:50
Biography:
Eliezer Bose, PhD, is an Assistant Professor (tenure-track) at the University of Texas at Austin. Having trained as an Adult-Gerontology Acute Care Nurse Practitioner, his research work is focused on studying patterns of cardiorespiratory instability in acutely ill patients using time-series analysis and machine learning techniques in order to enable bed-side nurses to preemptively intervene, thereby preventing failure to rescue of the hospitalized patient.
Abstract:
As we report in (Bose, Hoffman, & Hravnak, 2016), unrecognized in-hospital cardiorespiratory instability (CRI) risks adverse patient outcomes. Although step down unit (SDU) patients have continuous non-invasive physiologic monitoring of vital signs and a ratio of 1 nurse to 4-6 patients, detection of CRI is still suboptimal. Telemedicine provides additional surveillance but, due to high costs and unclear investment returns, is not routinely used in SDUs. Rapid response teams have been tested as possible approaches to support CRI patients outside the intensive care unit with mixed outcomes. Technology-enabled early warning scores, though rigorously studied, may not detect subtle instability. Efforts to utilize nursing intuition as a means to promote early identification of CRI have been explored, but the problem still persists. Monitoring systems hold promise, but nursing surveillance remains the key to reliable early detection and recognition. Research directed towards improving nursing surveillance and facilitating decision-making is needed to ensure safe patient outcomes and prevent CRI.
Ruth Cross
Leeds Beckett University, UK
Title: Creativity and innovation in focus groups: A storyboard approach
Time : 09:50-10:10
Biography:
Ruth Cross is Acting Principal Lecturer in Health Promotion at Leeds Beckett University and Course Director for the MSc Public Health Promotion. She has researched and published widely in the field of health promotion, is a member of the Centre for Health Promotion Research in the Faculty of Health and Social Sciences and is co-editor of the International Journal of Health Promotion and Education.
Abstract:
The authors of this paper argue for the potential of creative, innovative approaches in nursing research which aim to mine experience, understanding and perspectives on a range of nursing issues. This paper therefore presents a creative, participatory approach to generating conversation in focus group discussions using storyboards. It will present real life visual data drawing on the authors’ own experiences of novel methods in qualitative research. This research has been conducted with vulnerable young women needing specialised support. Creative qualitative approaches can generate richer, more in-depth data and promote a more empowering, participatory form of research giving voice to those who are relatively excluded or marginalised. A feminist perspective underpins the approach taken and this will be explored in more detail highlighting the importance of the co-production of knowledge and the participant as an equal partner in the research process. The advantages and disadvantages of using storyboards in qualitative research will also be considered. Namely a feminist approach to research. The data collection method is then described in detail outlining each stage of the process step by step.
Conclusion
Using creative techniques within more traditional qualitative approaches may lead to further in-depth data as well as increased participation. Such approaches could be of value in nursing research in which patients, clients and service user perspectives are often vitally important.
Promise Chizurulam Onyewu
Federal University, Nigeria
Title: Impact of violation of patients rights in Nigeria public and private health facilities
Time : 10:10-10:30
Biography:
Promise is a Nigerian graduated as a registered general nursing. (2010) and Bachelor's in Nursing science. He is presently doing his Masters in public health (in view) He is Co-founder advocacy of patient right Nigeria. Member of Red Cross society of Nigeria. NOTABLE ACHIEVEMENT Best graduating student 2010. Best patient right Advocate. Certificate of merit for protection of patients & there rights. Certificate of merit from Ebonyi legislative house of assembly for my role in the sponsored bill of patient right protection. Recognition by Nigerian community in Dubai after my lectures & awareness about patient right protection.
Abstract:
A patient's bill of rights is a list of guarantees for those receiving medical care. It may take the form of a law or a non-binding declaration. Typically a patient's bill of rights guarantees patients information, fair treatment, and autonomy over medical decisions, among other rights as a young boy in 2001 when I took care of my father in the hospital who finally died as result of violation of his right as a patient, he refused surgery because of his diabetic condition but the health care provider induced him and conducted the surgery against his will. He later developed diabetic foot ulcer and died. After his death I was inspired to be a life saver and also an advocate to patient right. As I grew up I became aware of this, knowing that it is a big problem in the society. Respecting patients’ dignity has been described as a fundamental part of nursing care. Many studies, debates, discussion have focused on exploring the concept of patients’ dignity and satisfaction from the patient and nurse perspective, but knowledge is limited regarding nursing perceptions of the impediments they pose to patients’ satisfaction and experiences of the patients themselves. The main objective of my NGO is to ensure the safety of patients’ rights and satisfaction.
Edgardo D Rivera Rivera
University of Miami Miller School of Medicine, USA
Title: Hereditary pancreatitis in pediatrics
Biography:
Edgardo D. Rivera Rivera completed his MD degree from Ponce School of Medicine in Puerto Rico. He then completed his combined Internal Medicine and Pediatrics Residency at Jackson Memorial Hospital in Miami and subsequently a Pediatric Gastroenterology Fellowship at the University of Chicago. He is currently an Assistant Professor of Pediatrics at the University of Miami were he runs the Transition of Care Clinics in Inflammatory Bowel Disease, and is part of the Pancreas Center. He has published in Celiac Disease, Inflammatory Bowel Disease and Pancreatic Disease and currently serves as part of several local and national committees.
Abstract:
A 13 year-old boy with a strong family history of hereditary pancreatitis was found to have a PRSS1 mutation after been tested at age 5 for his first documented pancreatitis episode. Since then, a multidisciplinary team has been following him for the diagnosis of hereditary pancreatitis. Unfortunately, his pain episodes were severely interfering with his life and after extensive discussion a total pancreatectomy with auto islet cell transplant was performed. He is now pain free and not requiring insulin at this point. However, what is hereditary pancreatitis and how is it diagnosed? What are the management and follow up strategies needed for these patients? We aim to address these questions as well as to inform the healthcare community about this diagnosis and the importance of having a high index of clinical suspiciousness
Guang Zeng
Texas A&M University, USA
Title: Making schools the focal point for child mental health: A U.S. National policy imperative
Biography:
Guang Zeng completed her PhD in Policy Research, Evaluation and Measurement at University of Pennsylvania. As an Associate Professor at Texas A&M University-Corpus Christi, she has published reputed journals. She was previously a Minority Serving Institution (MSI) Faculty Fellow of American Evaluation Association (AEA). Further, she is a nationally certified Reviewer of single-case design research.
Abstract:
This presentation examines the U.S. federal response to the crisis in child mental health in relation to its efforts to address the crisis in public education. By presenting side-by-side federal responses to these two seemingly unrelated crises, this presentation highlights the co-occurring nature of the problems. The interconnectedness of these crises explains in part why the federal initiatives that have dealt with these problems separately, in isolation, have been minimal in their effectiveness. It is concluded, therefore, that federal efforts in improving children’s mental health and academic performance should be integrated to achieve optimal outcomes. From a national policy perspective, we recommend a broader accountability system that emphasizes both academic performance and social emotional development, and making schools the focal point for child mental health and bolstering the function of School-Based Mental Health (SBMH) services. School nurses can play an active role in helping effectuate such policy changes. Findings from an additional study compares the developmental trajectories of internalizing problems from kindergarten to fifth grade in young kindergarteners versus older peers in kindergarten will be presented. These findings further illustrate the unique roles that school nurses could play given their strategic positions in the schools.
Rita Thapa Budhathoki
Nick Simons Institute, Nepal
Title: Exploring factors affecting the motivation and job satisfaction of nurses in rural Nepal
Biography:
Rita Thapa Budhathoki has completed her Master’s degree in Social Science. She has been working in Public Health Research in Nepal specially focusing on Maternal and Newborn Health since 2003. She has presented various papers in national and international conferences and published research articles related with Reproductive Health in various national and international journals. Currently, she is working at Nick Simons Institute.
Abstract:
Delivery of good quality health services depends on motivated, satisfied health workers. Motivation and job satisfaction are also key predictors of intention to leave the workplace. We present the results of our qualitative study of nurses in the rural Nepal, exploring factors affecting their motivation. We took a qualitative case study approach, with the health institution as the case and hypothesized that remoteness affects motivation, satisfaction and intent to leave. Therefore, we sampled three health facilities that were remote, and two that were less remote. We conducted semi-structured interviews with nurses, and with in-charges. Focus group discussions were also held with health management committees, and women’s groups. Motivation appears to be affected by length of time working as a health professional, job security, community support and support of colleagues. Nurses are de-motivated if they cannot implement their skills and if infrastructure prevents them from providing good care. Nurses may be motivated while being paid low salaries and having restricted terms and conditions, but participants felt that this could not continue in the long term and nurses should be fairly compensated for their efforts. Motivated health workers need to be fairly compensated for their work and they should work in an environment that supports and encourages them to expend effort to meet the goals of the organization. We found that motivation concerns broader issues than monetary compensation, and the keenness found in younger nurses should be cultivated and maintained throughout their career.
Michael Frass
Medical University of Vienna, Austria
Title: Influence of adjunctive classical homeopathy on global health status and subjective wellbeing in cancer patients – A pragmatic randomized controlled trial
Biography:
Michael Frass has completed his MD from Medical University of Vienna. He is Specialist for Internal Medicine and Internal Intensive Care Medicine. He is the Director of the Outpatients Unit “Homeopathy in Malignant Disease” at the Medical University of Vienna. He has published almost 200 papers in reputed journals and has invented the Combitube as an emergency airway.
Abstract:
The use of complementary and alternative medicine has increased over the past decade. The aim of this study was to evaluate whether homeopathy influenced global health status and subjective wellbeing when used as an adjunct to conventional cancer therapy. In this pragmatic randomized controlled trial, 410 patients, who were treated by standard anti-neoplastic therapy, were randomized to receive or not receive classical homeopathic adjunctive therapy in addition to standard therapy. The study took place at the Medical University of Vienna, Department of Medicine I, Clinical Division of Oncology. The main outcome measures were global health status and subjective wellbeing as assessed by the patients. At each of three visits (one baseline, two follow-up visits), patients filled in two different questionnaires. 373 patients yielded at least one of three measurements. The improvement of global health status between visits 1 and 3 was significantly stronger in the homeopathy group by 7.7 (95% CI 2.3 to 13.0, p=0.005) when compared with the control group. A significant group difference was also observed with respect to subjective wellbeing by 14.7 (95% CI 8.5 to 21.0, p<0.001) in favor of the homeopathic as compared with the control group. Control patients showed a significant improvement only in subjective wellbeing between their first and third visits. Results suggest that the global health status and subjective wellbeing of cancer patients improve significantly when adjunct classical homeopathic treatment is administered in addition to conventional therapy.
Chia-Ling Li
Mackay Memorial Hospital, Taiwan
Title: A study investigating the relationship between nursing personnel’s support and their job satisfaction and intention to stay
Biography:
Abstract:
Background: In recent years, there has been nursing manpower shortage in medical workplaces. At present, many medical institutions in Taiwan have developed interdisciplinary training programs one by one to enable nursing personnel to flexibly support other divisions/departments, as well as improve their care capacity.
Methods: This comparative study enrolled a total of 142 subjects, and divided the subjects into two groups (with 71 subjects in each group, respectively). One group was nursing personnel who provided external support, while the other was nursing personnel who did not provide external support. This cross-sectional study used purposive sampling to enroll subjects, and used Minnesota satisfaction questionnaire and scale on nursing personnel’s intention to stay to conduct questionnaire surveys on the subjects. For statistical analyses, this study used descriptive statistics, one-way ANOVA, Two-sample t test, Pearson’s product-moment correlation and stepwise regression analysis to analyze the data.
Result: According to the result of analysis, this study could be briefly concluded as the following: the average age of nursing personnel was 31.96 years old, the average seniority at the current unit was 6.46 years, the average seniority at the hospital was 7.55 years, and the average total seniority of nursing work was 9.55 years; the fixed shifts of nursing personnel who provided external support were significantly positively correlated with their intention to stay (F=6.694, p=0.012), and fixed shifts (F=6.840, p=0.110), having children or not (F=5.618, p=0.006), and seniority at the current unit (5.395, p=0.002) of nursing personnel were significantly positively correlated with their intention to stay. Other background information was not significantly positively correlated with nursing personnel’s intention to stay; the job satisfaction of nursing personnel who provided external support was significantly negatively correlated with their intention to stay (γ=-0.345, p<0.01), and that of those who did to provide external support was also significantly negatively correlated with their intention to stay (γ=-0.338, p<0.01); the significant predictor of nursing personnel who provided external support was fixed shifts, and its coefficient of determination (R2) was 0.088, suggesting that this variable could explain 8.8% of the total variance of nursing personnel’s intention to stay. The significant predictor of nursing personnel who did not provide external support was fixed shifts, having children or not, and seniority at current unit, and their coefficient of determination (R2) was 0.195, suggesting that these three variables could explain 19.5% of the total variance of nursing personnel’s intention to stay. Fixed shifts could explain the maximum individual variance of nursing personnel’s intention to stay (9.0%), followed by seniority at the current unit (5.3%) and having children or not (5.2%).
Conclusion: This study is limited by money and nursing manpower, but in this era of nursing manpower reduction, this conclusion on the nurses will have a lot of help and hope for government agencies.
Nancy Goldstein
Johns Hopkins University, USA
Title: Preceptors’ readiness to assist new graduate nurses in their role transition
Biography:
Nancy Goldstein has been a practicing Nurse for over 36 years at Johns Hopkins Medical Institutions and University, caring for patients, participating in research and educating future nurses. Her DNP capstone project “Relationship of psychosocial risks and referrals by nurses to birth outcomes” focused on “Healthcare provider assessments and their intervention practices for patients affected by intimate partner violence and mental health disorders in the perinatal period. Her main areas of focus include “Mental health and women’s health”. Over the past several years, she has coordinated courses for the pre-licensure nursing students and taught courses in the nurse practitioners’ program. She has developed an expertise in “Simulation technology and inter-professional education”. She is a member of American Nurses Association and holds leadership positions in numerous professional organizations including the American Heart Association, Sigma Theta Tau and Maryland Nurses Association.
Abstract:
New graduate nurses experience many complex and transitional adjustments upon entering the workforce post education and clinical orientation. New graduate nurses are defined as nurses who recently graduated and have less than 12 months of professional experience as a registered nurse. The relationship between the new graduate and preceptor can influence whether the transition into the work environment for the new graduate is positive or negative, and consequently affect the confidence and level of competence of the new nurse. When there is effective teaching behavior by nurse preceptors, there can be a positive outcome in the development and unit specific competence of new graduate nurses. This study is designed to evaluate the effects of preceptors’ readiness to assist new graduate nurses in their role transition. A non-timed, three part, online module has been developed to prepare and educate preceptors. The module includes adult learning theory, key elements of mentoring and precepting; problem solving, effective communication, conflict resolution and lateral violence and; delivering effective constructive feedback and evaluation. This module will help to prepare and educate preceptors/nurse leaders and ensure that new graduate nurses are experiencing a positive learning environment with opportunities to build confidence and strengthen competencies. Upon the completion of the module, self-report surveys will be conducted to allow nurse preceptors to evaluate their level of preceptor readiness before and after the module experience.