Day 1 :
- Nursing Management, Nursing Education,, Paediatric Nursing
Chair
Tracy Rhinewalt
Mississippi University for Women
Session Introduction
Julia C.Stecker
Pacific Lutheran University College of Nursing, WA 98447, USA
Title: Patients-Centered Early Mobility Interventions for the Critically Ill
Biography:
Julia C. Stecker is a Board-Certified Wound Care Nurse (CWCN) and Doctor of Nursing Practice (DNP) student with the Pacific Lutheran University (PLU) in Tacoma, Washington State, USA. Julia is passionate about pressure injury prevention, venous and arterial wounds, and compression therapy for leg wounds. Her nursing background includes inpatient and outpatient wound care, involuntary psychiatric treatment, home health, and community health. In 2008, Julia lived in the Amazon rain forest for ten months providing nursing care for the Yanomami tribe living in isolated areas.
Abstract:
Immobility in critically ill patients can lead to devastating health consequences. In a scenario where patients do not qualify for the standardized early mobility algorithms, patients might be at risk of receiving limited, suboptimal or even no interventions for early mobility at all. This quality improvement study aims to identify the current literature to support patients-centered interventions. The goal is to promote early mobility in critically ill patients unable to tolerate interventions from standardized progressive mobility algorithms. A gap analysis in the Coronary Care Unit (CCU) of an academic hospital in the Seattle area reviewed a need to tailor interventions for patients with limited mobility. A systematic investigation included retrospective literature review.The literature suggests there are two main groups of identified barriers for the delay in early mobility in chronically ill patients. The first barrier is patients-related and the second is institutional-related. An intervention to minimize patients-related barriers include correctly identifying and managing underlying causes that lead to mobility intolerance. It includes addressing and correcting the respiratory and cardiovascular imbalance, pain, physical limitation or temporary physical restriction, and patient preferences when it comes to mobility. The evidence from the literature indicates promoting staff education, use optimization of current resources, use of an interdisciplinary team and use of technology may minimize institution-related barriers. Adopting patients-centered interventions can eliminate the barriers standing between patients and the actions from staff for the promotion of early mobility.
Felicia Akers Bullington
Columbus State University, 31907, USA
Title: Effect of Enforced Nurse to Patient Ratios on Nurse Satisfaction and Burnout
Biography:
Felicia Bullington is near completion of her MSN in Nursing Leadership at the age of 30 years from Columbus State University. She is the Care Transition Coordinator of Phoebe Worth Medical Center, a critical access hospital in southwest Georgia.
Abstract:
A research study was conducted to explore the effect of sub-optimal nurse-to-patient ratios in the inpatient setting on nurse satisfaction, retention, and burnout. The study sought to determine if enforced nurse-to-patient ratios would mitigate the negative effects of inadequate staffing for both nurses and the patient population. The results of the study substantiated numerous data from previous research. A moderately strong negative correlation exists between nurse satisfaction and nurse-to-patient ratio. A weak positive correlation was evident in nurse burnout and sub-optimal staffing. A weak positive correlation was also present between sub-optimal staffing and interest to find other employment. The relationship between nurse staffing and patient outcomes is well known. Adequate staffing ensures that nurses are able to meet the needs of patients and their families and provide safe, quality care. However, the effects of nurse staffing on nurses is equally relevant and just as important. With the realities of the current nursing environment and the projected shortages predicted for the future of nursing, an enforced nurse-to-patient ratio can improve job satisfaction, nurse retention, and address the high rate of nurse burnout.
Key Words: nurse patient ratio, retention, satisfaction, burnout
Diana Zelman
Toronto Western Hospital, Ontario L4J 9H9, Canada
Title: Safe Handling of Sharps in the Operating Room
Biography:
Diana Zelman has been a registered nurse since 2016 and began working as a registered nurse for Toronto Western Hospital shortly after completing her Bachelors of Nursing Science from Ryerson University.
Co-Investigator: Fiona O'Neill, RN, BScN
Fiona O'Neill is a registered nurse who works at the Toronto Western Hospital operating room. She has worked in the operating room since graduating from Queen's University in 2015 with a Bachelors of Nursing Science. Since beginning in the operating room, she has become a mentor and preceptor to new staff, been the principle investigator of a Krembil nursing project and continues to be involved in unit initiatives.
Abstract:
A sharp injury can be a stressful event for any team member in the operating room. A Krembil quality improvement project was conducted in 2018 to identify gaps in knowledge related to management of sharps in the operating room and create a culture of safety among operating room nurses. Data collected using incident reports between 2015-2017 among four UHN sites including Toronto Western Hospital revealed a high number of sharp injuries among members of the OR team – a trend which does not appear to be declining. Utilizing the latest standards from ORNAC and AORN, as well as input from Toronto Western Operating room nurses, a new Sharp Safety Standard of Practice was created. Practices in accordance with safe sharp management guidelines are expected to result in reduced percutaneous sharp injuries and enhanced patient and staff safety in the OR. This poster aims to share of the knowledge gained and lessons learned developing a standard of practice as well as educate nurses on changes in practice regarding sharp safety in the operating room. The outcomes of implementing a safe sharp management SOP will also be outlined.
Andrew Appello
Felcian University, School of Nursing, NJ, 07070, USA
Title: Acute Rhinosinusitis: Antibiotic Stewardship and Promoting Watchful Waiting
Biography:
Andrew Appello is a licensed acupuncturist, clinical herbalist, and registered nurse practicing in NJ for the past 12 years. He is currently finishing a program in nursing to become licensed as a Family Nurse Practitioner. His interests include natural living, holistic and alternative therapies and reducing the use of pharmaceuticals in the population.
Abstract:
Inappropriate prescribing of antibiotics is a contributing factor to drug resistance. As a result, overprescribing has become a medical dilemma in the United States. In the case of acute adult rhinosinusitis, clinical guidelines state that the majority of infections are viral and do not respond to antibiotic therapy. Watchful waiting with supportive care is the appropriate treatment in these cases. However, acute rhinosinusitis is the fifth most common diagnosis for which antibiotics are prescribed in the US, 82% of patients with the diagnosis are prescribed antibiotics. Research shows that clinicians do not uniformly adhere to treatment guidelines; therefore, clinicians must be trained in appropriate prescribing according to acute rhinosinusitis guidelines. Antibiotic stewardship programs may be used to decrease antbiotic prescribing, increase patient satisfaction, and enhance provider satisfaction. Tactics used in these programs include provider training on patient education, negotiation strategies, holding firm, delayed prescribing, and knowing when to giving in. Barriers to implementation exist as these interventions require significant human resources including collaboration among clinical and non-clinical personnel and they require adequate capabilities from information technology. However, the advanced practice nurse is a collaborative provider and, therefore, is in a unique position to facilitate the changes needed to implement such a program in the clinical setting.