Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 33rd Euro Nursing & Medicare Summit | Holiday Inn Edinburgh | Edinburgh, Scotland.

Day 2 :

Keynote Forum

Marie T O’Toole

Rutgers University, USA

Keynote: Dual degrees and international collaborations: Best practices

Time : 09:35-10:05

Conference Series Euro Nursing 2018 International Conference Keynote Speaker Marie T O’Toole  photo
Biography:

Marie T O’Toole has been involved in international outreach related to rehabilitation and curriculum development. Her work has been funded by the United States Agency for International Development (USAID), the Health Resource Services Administration (HRSA), the Fund for Improvement of Secondary Education (FIPSE) program of the United States Department of Education and the Erasmus+ program of the European Commission on Higher Education. In 2017 she served as a Fulbright Specialist in Jordan. Her primary program of research is academic lexicography. She has served as the Editor of multiple editions of dictionaries and encyclopedias, including the award winning Mosby Dictionary of Medicine, Nursing and Health Professions. She continues to edit the Mosby series of dictionaries.

Abstract:

Statement of the Problem: Health is a global concern. Diseases cross international boundaries, as do health care providers. There is a worldwide shortage of nurses prepared to respond to the needs of diverse populations both locally and globally. The Bologna Accord is an educational reform movement that profoundly influenced nursing education in the European Union. The need for more information on this and other programs that support cost-effective models and mechanisms encouraging global collaborations that prepare a well-educated global workforce is critical.

 

Methodology: A consortium of academic institutions from the United States and the European Union worked collaboratively to explore funding mechanisms in both governmental and non-governmental agencies that support the preparation of health care professionals for international educational activities. Long-term follow up of participants in existing programs was conducted via social media outreach, personal communication and interviews with both faculty and student participants.

 

Results: Best practices for the creation of sustainable international partnerships that advance the preparation of a global workforce exist. Those practices include internal and external funding to support collaboration, the development of a degree program that does not extend the length of study for participants and exchanges that specifically address the need for knowledge, skills and language capabilities that prepare students for practice in multiple settings. Opportunities also exist for nurses in practice to participate in meaningful global outreach with appropriate educational preparation.

Keynote Forum

Monette Mabolo

Moses H Cone Memorial Hospital, USA

Keynote: We “Catheter Acquired Urinary Tract Infection” a problem!

Time : 10:05-10:35

Conference Series Euro Nursing 2018 International Conference Keynote Speaker Monette Mabolo photo
Biography:

Monette Mabolo has completed her Doctorate in Doctor of Nursing Practice at American Sentinel University in Aurora, Colorado with a focus on Executive Leadership. She is currently the Director of 30 bed heart failure unit at Moses Cone Memorial Hospital, a 500 bed acute care hospital that is a part of a six hospital enterprise in Southeastern North Carolina. She has presented numerous evidence based posters to various national nursing conferences including the American Nurses Association and the American Association of Critical Care Nurses.

Abstract:

Description: Indwelling urinary catheters are commonly used for heart failure inpatients to support strict intake and output monitoring related to IV diuretic administrations. In our 30 bed heart failure unit, high indwelling catheter utilization and high Foley days led to increased catheter acquired urinary tract infection (CAUTI). As we drilled down the problem, we identified inconsistent use of the nurse driven urinary catheter protocol and inaccurate documentation of I & O. These triggers prompted our team to use the IOWA model to identify best practices in CAUTI prevention.

 

Materials & Methods: Using the IOWA model, the team reviewed literature for best practice strategies. Baseline data on I & O documentation and catheter care practices were collected. Staff were re-educated on the urinary catheter guidelines, proper Peri and Foley care, use of nurse driven protocol to discontinue Foley catheter and I&O documentation through daily huddle messages and one on one staff education. Practice was changed in Intake and Output documentation of catheter output to every 4 hours; Foley/Peri care annual competency was established and the team selected a Nurse tech and a nurse to be CAUTI champions.

 

Results: The unit CAUTI rate in 2013 was 3.16 with 7 CAUTI’s and 949 Foley utilization days. After staff re-education and practice change in 2014, the CAUTI rate decreased to 1.22 with 1 CAUTI and 807 in Foley utilization days. In 2015 the unit CAUTI rate continued to decline despite a slight increase in Foley utilization of 924 days. By 2016, the unit continued to be CAUTI free and for 2017, they remain CAUTI free with 598 days of Foley utilization.

 

Conclusion: This evidence based project positively impacted practice by promoting early removal of Foley catheters and accurate documentation of Intake and output. The results demonstrate a dramatic and consistent decrease in CAUTI rates, as well as a decrease in catheter days. Adherence to Protocol driven care and commitment to maintaining increased staff awareness has dramatically reduced the incidence of CAUTI on this department resulting in the unit’s achievement of 3 years CAUTI free.

  • Sessions:
    Health Care and Management | Clinical Nursing | Nursing Leadership and Management | Adult Health Nursing | Psychiatric and Mental Health Nursing | Geriatrics and Gerontology | Obstetric and Gynecology Nursing | Nutrition & Health

Session Introduction

Dale M. Hilty

Mount Carmel College of Nursing, USA

Title: Being Best a Nursing Student Can Be, Continuous Self-Improvement, & Linear Regression Analyses

Time : 10:55-11:15

Speaker
Biography:

Dale M. Hilty received his PhD in counseling psychology from The Ohio State University Department of Psychology.  He has published studies in the areas of psychology, sociology, and religion.  Between April 2017 and April 2018, his ten research teams published 55 posters at local, state, regional, national, and international nursing conferences.  He has taught undergraduate level courses for approximately 25 years.

Abstract:

Purpose & Research Question/Hypotheses:

It is hypothesized that nursing student performance in educational and clinical settings are significant different when comparing continuous self-improvement (CSI) versus non-continuous self-improvement (NCSI) constructs.

Theoretical Framework & Rationale:

CSI students use three-dimensional processing in the classroom and clinical settings.  The three dimensions are:  "X" = outcome, "Y" application of critical thinking and concepts from theory (i.e., external), and "Z" deep level learning, knowledge, and personal growth (internal).  CSI nursing students  focus on continuous self-development  rather than course lecture and textbook material.  NCSI students are two-dimensional ("X" = outcome, "Y" application of critical thinking and concepts from external theory).

Method:

The Wooden Pyramid of Success Questionnaire (WPSQ) was used to differentiate CSI and NCSI nursing students.  CSI and NCSI students have completed the Big 5 Personality Factors, Conflict Handling scales,

anger constructs, academic grades, patient education constructs, attachment style constructs, engagement and disengagement scales, affective domain constructs, and compassion constructs.

Results:

Using the WPSQ to separate CSI and NCSI students into groups, statistically significant differences have been found related to personality, conflict handling, anger,  grades, patient education, attachment, engagement, disengagement, affective domain, and compassion.  Significant differences range from p=.001 to p=.03.

Biography:

Teus Brand is an occupational Physician working in The Netherlands. He developed expertise in finding and evaluating literature on the adverse effects of working conditions on pregnancy outcomes and making the information available for health professionals in every day practice. Therefore, a Dutch guideline on this topic has been written in 2007 as well as a part of a publication of the Health Council of The Netherlands on preconception care. Recently, the guideline has been updated. And in the new preconception indication list, the information on the effects of preconceptional exposure of hazardous working conditions will soon become available to health professionals involved in obstetric care such as general practitioners, midwifes, gynecologists and occupational physicians.

Abstract:

Introduction & Aim: To find and use scientific evidence about the influence of working conditions on reproductive outcomes for practical use in a guideline for occupational and a website for pregnant women, parents to be, health care professionals and policy makers.

Methods: We searched the literature for evidence concerning the effects of working conditions before, and during pregnancy on pregnancy outcome and development during early childhood. The working conditions with effects on pregnancy outcome were summarized in six groups: physically or mentally heavy work, shift work, chemical substances, physical factors (like noise) and infections. We looked at the following pregnancy outcomes spontaneous abortions, preterm birth, low birth weight, hypertension and congenital malformations and developmental problems at early school age.

Use of Evidence: A practical guideline was made for occupational physicians in Netherlands and was recently updated. It can be used by physicians in advising pregnant women and women breastfeeding their child. In another report preconception care: a good beginning, the chapter about working conditions underlines the effect of exposure before conception on the embryo and fetus. In the third place the evidence was used on websites, for parents to be or pregnant women and can be used for preventive measures regarding working conditions preconceptionally or during pregnancy.

Conclusion: There is growing evidence that working conditions before and during pregnancy can increase the number and severity of pregnancy complications. There is also evidence that early intervention can prevent this increase of pregnancy complications. The available evidence has been used for a guideline for occupational physicians and on a website for parents to be in order to take preventive measures. A summary of the evidence will be presented together with examples to use the evidence in counseling before conception and during early pregnancy.

Jody Gill-Rocha

Mount Carmel College of Nursing, USA

Title: Design & implementation: Patient education skill training for BSN nursing students

Time : 11:35-11:55

Speaker
Biography:

Jody Gill-Rocha is an Assistant Professor at Mt. Carmel College of Nursing.  She is the Academic Department Leader for the Medical-Surgical course.  Professor Gill-Rocha teaches the Adult Acute Care course, and is the course coordinator of the Infusion Therapy Lecture & Simulation course.  She recently received the 2017 Excellence in Nursing-Nurse Educator Award.  During the past year, she has published 10 posters at the local, state, regional, national, and international nursing conferences.

Abstract:

For healthcare providers, their educational training is organized from the perspective of illness rather than health (Spector, 2017).  According to Bastable (2014), successful patient outcomes are associated with patient education.  Even though patient education has been an integral part of nursing practice, most Registered Nurses report not having formal preparation to be a successful educator.

In a preliminary educational investigation, the purpose was to create a patient education for junior level students in a Bachelor of Science Nursing program based on faculty lectures, faculty laboratory demonstration, and student demonstration of skill in a simulation laboratory.  Based on the patient education curriculum, students could chose from the following topics: heart failure, mi/stent, open heart surgery/equipment lines, sepsis/shock/mods, ventilators/ards, traumatic brain injury, and burns.  Prior to the skill demonstration in the simulation laboratory, students selected one of the eight topics and submitted a term paper summarizing the topic and created a communication script describing how the information would be presented to the patient. 


ANOVA Repeated Measures analyzed student responses to nine cognitive questions from week one, five, and eight.  The ANOVA analysis found eight statistically significant (p=.001-.004) main effects and 21 post hoc effects (p=.001-.009).  Eleven statistically significant effects (p=.001-.031) were found which demonstrated the positive self-reported affective changes by the nursing students.  Alpha reliability estimates ranged from .758 to .907.  Students scoring high on a measure of continuous self-improvement had statistically significant (p<.01) positive associations with cognitive, affective, engagement, and behavioral measures.

Aretha Oliveira

National Cancer Institute, Brazil

Title: Bedbath in Intensive Care Unit: Implications to nursing care

Time : 11:55-12:15

Speaker
Biography:

Aretha Oliveira has her expertise in critical care nursing. Specialist in cardio-intensive nursing. Nurse of Intensive Care Unit/ Post-operative Unit of National Cancer Institute (Brazil). Member of research group Cardiovisão in Federal Fluminense University. Master degree in Sciences of Health Care. She has years of experience in research, evaluation and teaching both in hospital and education institutions.

 

Abstract:

The hospital environment aims at care for people with health disorders, who have specific needs. This service is delivered by professionals in various sectors within specific health units. Seriously ill patients need more specialized environments, which can guarantee the preservation of vital organ functioning and maintained clinical stability. In Brazil, two techniques to perform the bedbath are normally used: the traditional bath, using water and soap, and, in smaller scale, the disposable bath. Regardless the technique used, it is necessary to turn the patient from side to side to perform the complete body hygiene, and this is a possible way to modify the patients hemodynamic and ventilation, besides increasing the energetic metabolism and glucose consumption.  When we analyze special populations, like cardiological and oncological patients, it is possible to notice that despite the mobilizations, there is no substantial effect on the hemodynamic state, as we can see in some studies developed by our research group. More recently, it was demonstrated that this procedure can reduce blood glucose analyzed by the arterial blood before and after the bath. These data are crucial for nursing care, supporting decision-making and patient evaluation during the procedure, rendering a safer nursing care.

 

Monette Mabolo

Moses H Cone Memorial Hospital, USA

Title: Caution! Clabsi free zone
Speaker
Biography:

Monette Mabolo has completed her Doctor in Nursing Practice at American Sentinel University in Aurora, Colorado with a focus on executive leadership and her Master’s degree in Nursing at Duke University, School of Nursing. Currently, she is the Director of a 30 bed heart failure unit at Moses H Cone Memorial Hospital, a 500 bed acute care hospital that is a part of a 6 hospital enterprise in southeastern North Carolina. She has presented numerous evidence based posters and podium presentations to various national nursing conferences including the American Nurses association, American Association of Critical Care Nurses and the North Carolina Nurses Association.

Abstract:

Background: Central lines, particularly peripherally inserted central catheters are commonly used for Heart Failure inpatients to support strict intake and output monitoring related to IV diuretic administration.

In our 30 bed Heart Failure Department, the use of PICC line led to high central line blood stream infection or CLABSI.  As we drilled down on the problem, we identified inaccurate I & O documentation and staff knowledge deficits. These triggers prompted us to use the Iowa Model to identify best practices in CLABSI prevention.

Purpose of the Study: To reduce the incidence of Central line Blood stream Infections on adult heart failure patients, by combining intentional daily rounding and focused staff education.

Methods (Include study design, sample, and setting): Using the Iowa Model, our unit Research council under the umbrella of our Shared Governance Council, reviewed the literature for best practice strategies. Baseline data on I & O documentation and central line care practices were collected. With the full engagement of Department Leadership, staff were re-educated on the central line catheter care guidelines, and I & O documentation through daily huddle messages and one on one staff education.  Post-education, documentation was audited by Leadership daily for 60 days with the team continuing audits monthly. Daily rounds re-educated staff on the practice standard and adherence to the central line guidelines such as scrub the hub as a department priority.

Results: Implementation of daily rounding combined with focused staff education dramatically reduced the units CLABSI rate. By FY14 CLABSI rate was 0 and to this date, the unit has achieved 6 years of CLABSI free.

Conclusions and Nursing Implications: This EBP project has positively impacted practice by:

•           Improving staff morale through teamwork

•           Increasing patient satisfaction

•           Decreasing Central line utilization and central line days

•           Promoting early removal of central line

•           Enhancing understanding of how evidence based practice impacts clinical practice

•           A total saving for the hospital of $1.2M

Protocol driven care and increased staff awareness has dramatically reduced the incidence of CLABSI on our department resulting in the unit’s achievement 6 years CLABSI free

Speaker
Biography:

Hulya Leblebicioglu is working as a Research Assistant at Ege University in Izmir. She has completed her Master’s degree at Ege University. She is pursuing her PhD at Ege University, Faculty of Nursing. She has participated in four international oral presentations and has published three articles.

Abstract:

Introduction: When considered changing health care needs, nursing profession needs profession members who are researchers, creative, able to reaching knowledge, information producing and knowledgeable. Thus entrepreneurial and innovative concepts are most important for nurses. When evaluated in terms of nursing profession, entrepreneurship is part of making decisions to improve the skills of nurses and can be applied in business environment, besides this, it is part of decision making in the career planning and development process that nurses undertake. Entrepreneurial nurses can operate in the marketing, public and private sectors. On the basis of entrepreneurial in nursing, there ability to solve a problem that exists in maintenance practices, ability to manage the process in the developing the product from idea, to evaluate the opportunities well and to commercialize the product. Nurses should be innovative to protect and improve health, to prevent diseases, to find better ways to care for and treat diseases, and to obtain new information. A nurse who can be characterized as innovative is a high-level practitioner who is responsible for transforming an innovative into a profitable product. An innovative nurse should be able to apply research results and blood-based product evaluation results at the same time while enabling the organization to reduce costs or make profits from practice.

 

Aim: The purpose of the study is to examine the relationship between enterpreneurship and being individual innovative in nurse academicians who work in different levels of the higher education institutions. The population of the study is consisted of nurse academicians (N=502) who work in the 11 higher education institutions which providing undergraduate nursing education in Aegian region. The sample of the study was consist of nurse academicians (N=216) who are volunteer to participant to study. A questionnaire which was consisted from descriptive characteristics, entrepreneurship scale, and individual innovator scale was used as data collection tool. Data was collected with face to face interwiev method between the date February 2017–December 2017. Permission has been obtained from the ethics committee and related institutions for the conduct of the research. Descriptive statistical methods (Number, Percentage, Mean, Standard deviation) by using SPSS (Statistical Package for Social Sciences) for Windows 22.0 program, were used in the analysis of the data. The Spearman / Pearson correlations was used for examine the relationship between dependent and independent variables of the study and the effect was tested by regression analysis. The error margin was accepted as 0.05 in the study.

 

Results: The fiftyfour point six percent (54.6%) of the nurse academicians who are participate in the study are in the age group of 23-33, 97.2% of them are women and 48.6% of them are graduate from doctoral degree, 21.3% of them are faculty members of Fundamentals of Nursing Department, 59.3% of the nurse academicians participating in the study have the title of research assistant, 65.3% of them were worked for 1-10 years. According to the results of the study, there is a statistically significant positive correlation between general entrepreneurship scale points and general individual innovation scale points. Accordingly, as the level of general entrepreneurship value increases, the level of individual individual innovation increases. In addition, there were statistically significant positive relationships between general entrepreneurship sub-dimensions such as management and organizational incentives, individual motivation, transparency and openness, individual competence, constructive business environment, innovation promotion, development and general level of individual innovativeness. A statistically significant was found as a result of regression analysis which was made made to determine the relation between general of individual innovation and general entrepreneurial level. It has been found that the relationship with entrepreneurship variables (explanatory power) is very weak as a determinant of innovation level. The level of general entrepreneurship behavior of nurse academicians increases the level of general individual innovation value. In the first step, the effects of entrepreneurial dimensions on the idea leadership are examined. Entrepreneurial dimensions predicts the idea leadership and explain 21.8% of the variance. Management and organization promotion of the nurse academicians increase the level of innovation promotion, development levels idea leadership. According to the standardized regression coefficient (Beta), the relative importance of the independent variables on the probability of opinion leadership are development, promoting the management and organization and encouring innovation.

The levels of individual motivation of nurse academics reduce the level of thought leadership. However, there was no statistically significance in determining the power of transparency and openness, individual competence, constructive business environment. In the second step, the effects of entrepreneurial dimensions on change resistance are examined. The dimensions of entrepreneurship predict the level of change resistance and explain about 08% of the variance. The level of management and organization incentive of nurse academicians increase the resistance level of change. The level of individual motivation of nurse academicians reduces the level of resistance to change. In the third step, the effects of entrepreneurial dimensions on risk taking are examined. Entrepreneurial dimensions predict the level of risk taking and explain 21% of the variance. The level of encouraging innovation and level of development of nurse academicians increases the level of risk taking. The development creates the most increasing effect on risk taking, it is followed by encourages innovation. The individual motivation level of nurse academicians reduces the risk taking level. The effect of entrepreneurship values of nurse academicians on general individual innovation behavior was examined. As a result of regression analysis, the relationship between management and organization promotion, individual motivation, transparency and openness, individual competence, constructive business environment, innovation promotion, development and general individual innovation were found to be statistically significant.

It has been found that the relationship between management and organizational promotion which is a determinant of the general level of individual innovation and individual motivation, transparency, and openness, individual competence, constructive business environment, promoting innovation, and development (explanatory power) are very weak. The level of promotion the management and organization of nurse academicians increases the level of general individual innovation. The level of development of nurse academicians increases the level of individual innovation. The most increasing effect on overall individual innovation is development, followed by the level of management and organization incentive. The level of individual motivation of nurse academicians reduces the level of individual innovation.

 

Discussion and Conclusion: The special purpose of the study is to determine the extent to which individual innovation levels of nurse academicians are effective in increasing their entrepreneurship. The findings of the study showed that there is a significant relationship between the variables, and the effects on individual innovation dimensions, although not all entrepreneurial dimension. In other words, the seven sub-dimensions referred to above and entrepreneurship explains 19% of the total variance on the innovation case. To be innovative of the nurse academicians is possible by the management’s supports for innovative thinking, gives employees the opportunity to develop ideas, encouraging employees to look beyond their limits. According to the results of the research; because of nothing of enough studies on the relationship between entrepreneurship and individual innovation in nursing profession and other professions, it is assumed to be beneficial the further research in this regard in terms of applications in the area.

Keywords: Nursing, Innovation, Entrepreneurship

Break: Lunch Break 12:55-13:45 @ Traders Restaurant

Salpy Akaragian

Armenian International Medical Fund, USA

Title: The prevalence of high blood pressure in Armenians

Time : 13:45-14:05

Speaker
Biography:

Salpy Akaragian completed her PhD from University of California, Los Angeles.  She is the Founder and President of Armenian International Medial Fund and Former director of UCLA Health’s International Nursing Program and Nurse Credentialing.  She has published, received many local, national and international awards.  She is served on the California Board of Registered Nursing as a board member and was a Magnet appraiser for American Nurse Credentialing Committee.  In June 2018, after 44 years of Nursing Career, Salpy retired from UCLA Health.  Her continuous conducting international research and projects, and serves as a consulted to Ministry of Health of Armenia.

Abstract:

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Armenia (World Health Rankings, 2012).  Limited data exists on the prevalence of risk factors and other contributors to the development of CVD.  Understanding the prevalence of various risk factors is a critical first step towards addressing the burden of disease among any population.  This descriptive, cross-sectional study, examined the prevalence of HBP and risk factors associated with HBP in a select group of Armenian men and women ages 21 and older, living in Armenia.

The convenience sample was predominantly of middle-aged females, married, and had a high school education or higher.  Over half of the adults of the sample were prehypertensive or hypertensive.  Over three-quarters of the participants never smoked and over half of the consumed alcohol in the past 12 months.  The nonparametric Spearman correlations indicated that BP level had significant moderate to large correlations with age, mean systolic blood pressure, mean diastolic blood pressure, body mass index (BMI), waist and hip circumference, total cholesterol, low density lipoprotein cholesterol, triglycerides, waist-hip ratio, and with self and family reported history of HBP and heart disease.  The results of the stepwise multiple regression model indicated that BP levels were higher with greater waist circumference, a personal history of HBP, high total cholesterol, being male and older age.  Furthermore, respondents scored low for adhering to taking prescribed antihypertensive medication(s).  The findings of the study cannot be generalized, it must be duplicated in Yerevan and in other 10 regions of Armenia.

Speaker
Biography:

Dr. Patricia Clayton-LeVasseur completed her PhD at Barry University and has over 20 years of nursing expereince. Currently, Dr. Clayton-LeVasseur is an Assistant Professor at Adventist University of Health Sciences and Director of Education for First Choice Telehealth. She has published several articles in peer-reviewed journals and is a board member of the Omni Chi Chapter of STTI.

Abstract:

Nurses impact almost every patient receiving healthcare, yet there is a global nursing shortage which stifles the capability of providing safe and effective healthcare. Successful recruitment and retention of traditional and non-traditional pre-licensure nursing students is vital to address this global deficit. The purpose of this qualitative, phenomenological inquiry is to explore the lived experience of non-traditional student nurses who have successfully graduated from a generic baccalaureate nursing program. This qualitative inquiry is guided by Moustakas’ transcendental phenomenology, using a descriptive and heuristic approach. In-depth interviews using open-ended questions guide data collection. Data analysis followed Moustakas’ methodology. From the analysis of the data, Challenging, Autonomy with its sub-theme Altruism, Supporting, and Transforming with the sub-theme of Motivation, emerged as the themes from the lived experience of non-traditional nursing students who had successfully graduated from a baccalaureate nursing program. The findings were linked to the concepts of the Self-Determination Theory. Nursing faculty, healthcare administrators, and policy-makers should recognize and actively pursue educational supports that will facilitate the learning needs of a non-traditional nursing student.

Zenaida Carbon

John Muir Health, USA

Title: Early Extubation after cardiovascular surgery

Time : 14:25-14:45

Speaker
Biography:

Zenaida Carbon RN, BSN, CCRN is a Charge nurse of an extremely busy cardiovascular intensive care @ John Muir Medical Center Concord, California :over 300 open heart surgery/year; a robust transaortic valve (TAVR)  program; cardiac assist device (impella) ;IABP;CRRT therapies . Over 31 years of clinical nursing experience; 29 dedicated to critical care. She is a Mentor, trainer; ACLS/BLS instructor; Cardiac care course instructor; IABP trainer/instructor; administrative nursing supervisor. She is an Ambassador for American Association of Critical Care Nurses. She has Worked as Director of Nursing at Windsor Rosewood.

Abstract:

Purpose:

To increase the percentage of patients who are extubated within 3 hours following cardiovascular surgery.

 

Relevance/Significance:

Endotracheal intubation and mechanical ventilation are required treatment modalities during major surgical procedures, and are maintained in the early post-operative period until the patient is able to support his own respiration. While they are essential forms of treatment, they pose risk for iatrogenic complications and must be discontinued as soon as possible to prevent barotrauma, ventilator-associated respiratory infection, and discomfort. 

 

Early extubation following cardiovascular surgery has been a goal for almost two decades, although the time for extubation changed many times through the years.  In the 1990’s, mechanical ventilation was continued through the night and patients were extubated early on the morning of post-op day 1.  Soon after, the Society of Thoracic Surgeons encouraged clinicians to discard concerns about extubating patients in the middle of the night, and recommended a more aggressive goal of extubation within 12 hours.  More recently the extubation goal has been reduced to the current standard of 6 hours.

 

The Cardiovascular Surgery Performance Improvement Committee meets monthly to evaluate clinical practices and improve outcomes for patients undergoing cardiac surgery. The inter-professional group is comprised of surgeons, anesthesiologists, clinical nurses, nurse leaders, respiratory therapists (RT), case managers, cardiac educators and quality management nurses.  During informal discussions between a thoracic surgeon and the clinical nurse charge nurses in the Cardiovascular ICU (CVICU), they decided to focus their efforts on practice changes that would enable some patients to reach an even more aggressive goal: extubation within 3 hours post-surgery. 

 

Strategy and Implementation:

July, 2017 – Initial practice changes

  • Education of staff - The three unit Charge Nurses lead daily quality and safety “shift huddles” with the staff, and used these huddles to educate staff about the new goal, solicit input for alterations in practice that would assist with earlier extubation, and to share their experience when practice changes were tried.
  • Feedback to anesthesiologist – The anesthesiologist’s phone numbers were distributed to the clinical nurses.  If the patient is unable to be extubated within 3 hours, the clinical nurse sends a text to the anesthesiologist to inform him/her of the reason for the inability to extubate.  In this way the anesthesiologist receives timely feedback about the patient’s ability to be extubated.
  • Data tracking by clinical nurses – Nurses tracked information about each patient: name, medical record number, date of procedure, surgeon, anesthesiologist, nurse and respiratory therapist, and extubation time.  Space was provided for the clinical nurse to add comments about the reasons the patient could not meet the 3 hour extubation goal.
  • Communication of anticipated extubation time to all staff – Upon arrival to the room, the patient’s nurse or the RT writes the anticipated extubation time on the patient’s white board.  This alerts all care providers to the target time, and encourages everyone on the team to work toward the same goal.

August, 2017 – Additional practice changes initiated

  • Extubation kits stocked – Previously, when staff determined that a patient was ready for extubation, the RT would need to leave the room to collect three simple items: a chux, 10cc syringe for balloon deflation, and a nasal cannula.  In practice, extubation was often delayed because the RT who left the room was side-tracked and asked to perform another task elsewhere in the unit. The team remedied this by changing the room preparation process, and placing these items in the room when it was prepped to accept the patient from surgery.  This small change ensured that the items necessary for extubation were present when needed, allowing extubation to proceed without any delay.
  • Medications – The group encouraged the use of intravenous Acetaminophen for management of pain.  This drug is quite effective in relieving pain and is advantageous in this population because it does not cause the drowsiness or respiratory depression that is characteristic of an opiate.

 

Evaluation/Outcomes:

The graph below demonstrates the success of this unit-level project that was initiated and led by the three charge nurses in the CVICU.The daily discussions they held during huddles provided opportunity for repetitive reinforcement of best practices and facilitated participation by all staff, which produced sustained and steady improvement.The early extubation project, with leadership by the charge nurses and participation by nursing, respiratory therapy and physicians represents an improved outcome associated with an interprofessional quality improvement activity, led (or co-led) by a clinical nurse.

 

Implications for Practice:

These practice changes can be adopted by any critical care unit to increase the percentage of patients who can be extubated earlier, reducing patient discomfort and reducing the risk for complications associated with mechanical ventilation.

Speaker
Biography:

I am 30 years old. I work as a research assistant at Ege University in İZMİR. I started my academic studies at Ege University and I completed master degree. I am continuing Ph.D. from Ege University Faculty of Nursing. My department is Fundamentals of Nursing.  I have  4 international oral presentations and 3 publications.

 

Abstract:

Introduction: When considered changing health care needs, nursing profession needs profession members who are researchers, creative, able to reaching knowledge, information producing and knowledgeable. Thus entrepreneurial and innovative concepts are most important for nurses. When evaluated in terms of nursing profession, entrepreneurship is part of making decisions to improve the skills of nurses and can be applied in business environment, besides this, it is part of decision making in the career planning and development process that nurses undertake. Entrepreneurial nurses can operate in the marketing, public and private sectors. On the basis of entrepreneurial in nursing, there ability to solve a problem that exists in maintenance practices, ability to manage the process in the developing the product from idea, to evaluate the opportunities well and to commercialize the product. Nurses should be innovative to protect and improve health, to prevent diseases, to find better ways to care for and treat diseases, and to obtain new information. A nurse who can be characterized as innovative is a high-level practitioner who is responsible for transforming an innovative into a profitable product. An innovative nurse should be able to apply research results and blood-based product evaluation results at the same time while enabling the organization to reduce costs or make profits from practice.

Aim: The purpose of the study is to examine the relationship between enterpreneurship and being individual innovative in nurse academicians who work in different levels of the higher education institutions. The population of the study is consisted of nurse academicians (N=502) who work in the 11 higher education institutions which providing undergraduate nursing education in Aegian region. The sample of the study was consist of nurse academicians (N=216) who are volunteer to participant to study. A questionnaire which was consisted from descriptive characteristics, entrepreneurship scale, and individual innovator scale was used as data collection tool. Data was collected with face to face interwiev method between the date February 2017–December 2017. Permission has been obtained from the ethics committee and related institutions for the conduct of the research. Descriptive statistical methods (Number, Percentage, Mean, Standard deviation) by using SPSS (Statistical Package for Social Sciences) for Windows 22.0 program, were used in the analysis of the data. The Spearman / Pearson correlations was used for examine the relationship between dependent and independent variables of the study and the effect was tested by regression analysis. The error margin was accepted as 0.05 in the study.

Results: The fiftyfour point six percent (54.6%) of the nurse academicians who are participate in the study are in the age group of 23-33, 97.2% of them are women and 48.6% of them are graduate from doctoral degree, 21.3% of them are faculty members of Fundamentals of Nursing Department, 59.3% of the nurse academicians participating in the study have the title of research assistant, 65.3% of them were worked for 1-10 years. According to the results of the study, there is a statistically significant positive correlation between general entrepreneurship scale points and general individual innovation scale points. Accordingly, as the level of general entrepreneurship value increases, the level of individual individual innovation increases. In addition, there were statistically significant positive relationships between general entrepreneurship sub-dimensions such as management and organizational incentives, individual motivation, transparency and openness, individual competence, constructive business environment, innovation promotion, development and general level of individual innovativeness. A statistically significant was found as a result of regression analysis which was made made to determine the relation between general of individual innovation and general entrepreneurial level. It has been found that the relationship with entrepreneurship variables (explanatory power) is very weak as a determinant of innovation level. The level of general entrepreneurship behavior of nurse academicians increases the level of general individual innovation value. In the first step, the effects of entrepreneurial dimensions on the idea leadership are examined. Entrepreneurial dimensions predicts the idea leadership and explain 21.8% of the variance. Management and organization promotion of the nurse academicians increase the level of innovation promotion, development levels idea leadership. According to the standardized regression coefficient (Beta), the relative importance of the independent variables on the probability of opinion leadership are development, promoting the management and organization and encouring innovation.

The levels of individual motivation of nurse academics reduce the level of thought leadership. However, there was no statistically significance in determining the power of transparency and openness, individual competence, constructive business environment. In the second step, the effects of entrepreneurial dimensions on change resistance are examined. The dimensions of entrepreneurship predict the level of change resistance and explain about 08% of the variance. The level of management and organization incentive of nurse academicians increase the resistance level of change. The level of individual motivation of nurse academicians reduces the level of resistance to change. In the third step, the effects of entrepreneurial dimensions on risk taking are examined. Entrepreneurial dimensions predict the level of risk taking and explain 21% of the variance. The level of encouraging innovation and level of development of nurse academicians increases the level of risk taking. The development creates the most increasing effect on risk taking, it is followed by encourages innovation. The individual motivation level of nurse academicians reduces the risk taking level. The effect of entrepreneurship values of nurse academicians on general individual innovation behavior was examined. As a result of regression analysis, the relationship between management and organization promotion, individual motivation, transparency and openness, individual competence, constructive business environment, innovation promotion, development and general individual innovation were found to be statistically significant.

It has been found that the relationship between management and organizational promotion which is a determinant of the general level of individual innovation and individual motivation, transparency, and openness, individual competence, constructive business environment, promoting innovation, and development (explanatory power) are very weak. The level of promotion the management and organization of nurse academicians increases the level of general individual innovation. The level of development of nurse academicians increases the level of individual innovation. The most increasing effect on overall individual innovation is development, followed by the level of management and organization incentive. The level of individual motivation of nurse academicians reduces the level of individual innovation. Discussion and Conclusion: The special purpose of the study, is to determine the extent to which individual innovation levels of nurse academicians are effective in increasing their entrepreneurship. The findings of the study showed that there is a significant relationship between the variables, and the effects on individual innovation dimensions, although not all entrepreneurial dimension. In other words, the seven sub-dimensions referred to above and entrepreneurship explain 19% of the total variance on the innovation case. To be innovative of the nurse academicians is possible by the management’s supports for innovative thinking, gives employees the opportunity to develop ideas, encouraging employees to look beyond their limits. According to the results of the research; because of nothing of enough studies on the relationship between entrepreneurship and individual innovation in nursing profession and other professions, it is assumed to be beneficial the further research in this regard in terms of applications in the area.

 

Keywords: Nursing, Innovation, Entrepreneurship

 

Speaker
Biography:

She graduated in first place from Hacettepe University in 1989. She won the İhsan Dogramacı Superior Merit Award and Science Incentive Award. She earned her pilot’s license from Republic of Turkey Ministry of Transport. She studied about counseling on assisted reproductive techniques at Liverpool Women’s Hospital Reproductive Medicine Unit in United Kingdom on the British Council Research Scholarship. She earned a certificate in management and leadership in nursing. She is an active member of Thematic Network leadership work group. She studied as a research scholar at Kent State University College of Nursing in 2006 for 3 months. In 2007, she worked on a project named “Development of Leadership Skills in Nursing Doctoral Students” at University of Michigan Faculty of Nursing on an international research scholarship which was supported by International Network for Doctoral Education in Nursing (INDEN) and Sigma Theta Tau and provided to only three people around the world every year. She worked as a research assistant at Hacettepe University School of Nursing in the Maternity and Women's Health Nursing Division from 1990 to 1997. She was promoted to assistant professor in 1998, associate professor in 2006 and professor in 2012. She worked as a Co-Head of Nursing Department, Erasmus Department Coordinator, Head of Strategic Planning Group and board member of Hacettepe University Women’s Research and Implementation Center (HUWRICH) between 2009 and 2011. Her interest subjects are sexuality and reproductive health and management and leadership. She is member of national and international nurse’s organizations such as INDEN and Sigma Theta Tau. She has been working as a Director of Nursing Services at Hacettepe University Hospitals between 2012-2016 and Founding Dean of Faculty of Nursing. She has published more than 70 papers, 15 grant projects, eight books as an editor and author, and more than 100 presentation in the national and international congress. She is also invited speaker more than 60 congress and symposium. She has working as a Dean Fac ulty of Health Science and Director of Nursing of MLPCare in Istinye University.

 

Abstract:

The purpose of this study was to investigate the effect of home care service on the sexual satisfaction of patients with gynecologic cancer. Sexual health and sexual satisfaction was greatly affect in patients with gynecological cancer depending on the disease and its treatments. Prospective randomized case control study. This study was conducted with 70 patients, of whom 35 patients were in the intervention and 35 patients were in the control group. Data were collected using An Interview Questionnaire, Home Visit Monitoring Questionnaire and Golombok Rust Inventory of Sexual Satisfaction. The intervention group patients were provided with the nursing care service through hospital and home visits (1st and 12th weeks) within the framework of a specifically developed nursing care plans. The control group was monitored without any intervention through the hospital routine protocols (1st and 12th weeks). Data were evaluated using Chi square, McNemar’s, independent t test and one-way ANOVA tests. It was found that, within the 12-week post-discharge monitoring period as compared with the time before treatment, patients within the intervention group (those receiving home care services) experienced fewer sexual problems as compared to the control group (patients not receiving home care services). This study found home care services to be efficient in improving the sexual health and sexual satisfaction of patients with gynecological cancer.

Keywords Sexual satisfaction _ Sexual health _ Home care service _ Sexuality assessment _ Gynecological cancer _

 

 

Jia GUO

Peking University Health Science Centre, China

Title: Resilience of older adults with Dementia and implications for Nursing and Care

Time : 15:25-15:45

Speaker
Biography:

Dr. Guo is a clinical psychologist with research interest in cognitive impairment among older adults, resilience in older age, aging and elderly care, lifespan development, as well as the development of health concept. She received both her PhD and MSc degrees from the University of Edinburgh in UK. Her previous work has been focused on children and adolescence, their developmental trajectories and mental health. Currently she is doing research among older adults and those with cognitive impairment in particular, and teaching at Peking University Health Science Centre in China.         
 

Abstract:

Although the conventional image of older adults especially those with dementia are often associated with disability and dependence, there has been evidence to support the claim that older people with or without dementia do not necessarily fit into that stereotype and many people with dementia continue to maintain wellbeing and live a meaningful life despite clinical neuropathology. In line with the biopsychosocial perspective to take account factors to the person and their social contexts which contribute to the individual’s resilience in face of adversity, it is therefore important to work out what helps and hinders in this respect.

The aim of this research was to explore the individual and social attributes and mechanisms of resilience among older adults with dementia. The study consisted of (1) a thematic literature review on international and local Chinese publications; (2) a mixed-method research on resilience of older adults with dementia. Findings of literature review revealed a knowledge gap in Chinese literature on resilience of older people in comparison with international publications; little is known about resilience of people with cognitive deterioration as dementia is often considered as negating the ability to develop resilience. Empirical results suggested most people with dementia understand the concept of resilience and feel they have the capacity to be resilient. Apart from similarities with results in Western literature on attributes and mechanisms of resilience, results in this study demonstrated cultural differences and individual diversities. Findings not only add to local evidence on resilience literature, but also contribute to the understanding of ethnic and cultural differences, and further lead to international comparison. In relation to clinical practice, results suggest that nurses should be aware of patients’ resilience when prioritising care and designing interventions. Implications for older people with dementia, policy makers, service providers, and the wider community were also discussed.

Speaker
Biography:

Ms. Tania L. Simmons Rn, BSN has been a registered nurse for 22 years. She has years of expereince working in healthcare and  has a dual specialty which includes Neurosurgery Oncology and Ears, Nose and Throat Oncology at The James Cancer Reasearch and Solove Institue. She is a speaker and has presented at The National Nurses Business Association in The United States of America. She is also a entreprenuer who has her own LLC and has a heart for improving healthcare in developing countries. She currently is working on her master’s degree as an Family Nurse Practitioner at The Ohio State University in Columbus , Ohio.  She has also helped and assisted in The Bladder Cancer Walk of Ohio last year and helped fundraise for Bladder Cancer initiatives and cutting edge research. She has also partnered in clinical trials to help change protocol and clinical practice for bladder cancer patients in order to help facilitate early diagnosis.  She also is CEO and Founder of Healing For The Nations, LLC.

Abstract:

Aim : This Quality Improvement Project objective is to introduce and assess a process change to potentially reduce costs in a hospital setting related to medical waste and repurpose medical supplies in order to help others in The United States of America as well as other nations.

Methods: The methods which are being used come from an approach to help foster collaboration amongst the neighboring hospitals and medical facilities to decrease medical supply waste and increase patient satisfaction as well as humanitarian relief efforts across the nation and into many developing countries by medical missions and aid.

Results: Eight different nations have been helped thru the use of repurposed medical supplies, which decrease medical waste and helped many people in the process. Communities have been helped and hospitals have seen collaboration with other medical institutions as well as humanitarian relief organizations to bringing about and sustaining real change which increase patient outcomes substantially.

Conclusion: Medical supply waste is in the top ten financial concerns for our industry when addressed real change can happen, aid to be brought to people in real need that otherwise would not get it. We can make this happen together – be the change. 

Break: Networking & Refreshments 16:05-16:25 @ Academy Lounge
Speaker
Biography:

Genevieve V. Angel is a Registered Nurse with 30 years of experience, including senior executive leadership for general acute hospitals; acute long-term care hospitals; ambulatory segments of healthcare; case management, hospital revenue cycle, nursing administration, regulatory compliance, payer denial management, utilization review, clinical documentation improvement process, quality improvement and risk management. She holds a B.S.N. and an M.B.A. in International Business. She is a loving wife and a mother of two. She is an entrepreneur of several small businesses in the U.S.A. and South East Asia.

Abstract:

Despite the vast challenges to adopting modern resources, change is inevitable, and we are processing a much higher volume of information. We may benefit by focusing on improving, than invest more time in tracking and reporting. In an atmosphere where case managers are multitasking more than ever before, organizing the way one absorbs technology may be the key to maximizing personal and professional usage.

Case Managers face advancing more complex challenges and changes than ever before. Among the challenges are the on-going changes due to regulatory agencies and healthcare continuous reform, which we have yet to at least partially resolve. The purpose of this discussion is to identify inspirational values that enhance digital efficiencies and that which mitigate technological hindrances.

  • Poster Presentations 17:45-18:15 @ Academy Lounge

Speaker
Biography:

Dale M. Hilty received his PhD in counseling psychology from The Ohio State University Department of Psychology.  He has published studies in the areas of psychology, sociology, and religion.  Between April 2017 and April 2018, his ten research teams published 55 posters at local, state, regional, national, and international nursing conferences.  His colleagues sharing the author line of this poster are: Ann Waterman, PhD, RN; Bev Gish, MS, RN; Jody Gill-Rocha, MS, RN; Erin Dougherty, MSN, RN, Kerry Fankhauser, DNP Candidate, MS, RN; Mary Yoder, MS, RN; Patty Severt, MSN.

Abstract:

Introduction:

In four-year baccalaureate programs, nursing students begin actual nursing courses in the second year. Since most beginning nursing students are developing an authentic perception of a nurse, students are highly motivated and enthusiastic about the nursing panel (NP) experience.  The NP consists of seasoned nursing faculty members, and is used to socialize these beginning nursing students into the profession of nursing.

Method:

NP experience lasts 90 minutes.  First, the NP members introduce themselves and share their nursing background.  Second, students ask questions. In the last 5 years approximately 400 students have been participants.  This innovative, interdisciplinary teaching approach assists students in developing authentic nursing knowledge and perceptions.  Examples of strategies: nursing faculty on the panel being oriented to the content in the non-nursing class, a caring and respectful educational environment, students come prepared with questions, and all faculty engage in the discussions.                                           

Qualitative Findings

The outcomes: Enhanced learning, positive student evaluations, awareness of the role of the nurse, reciprocal connections, student and faculty satisfaction, increased knowledge of the profession of nursing, nurse self-concept images, and nursing values (trust, caring, unconditional positive regard).  These outcomes were derived from student evaluations and reflection papers.      

Quantitative Findings

Calling & Vocation Questionnaire (CVQ) was used to assess the presence of, and search for, a calling.  CVQ exploratory factor analysis revealed six reliable common factors (subscales) forming CVQ-Presence and CVQ-Search scores.  CVQ items provided pre-/post-test evaluating the NP.  Using SPSS 25, dependent t-test analyses found significance (p=.001-.042) on all CVQ common factors.

Speaker
Biography:

Dale M. Hilty, Associate Professor, received his PhD in counseling psychology from The Ohio State University Department of Psychology.  He has published studies in the areas of psychology, sociology, and religion.  Between April 2017 and April 2018, his ten research teams published 55 posters at local, state, regional, national, and international nursing conferences.  Two additional colleagues share the authorship of this poster.

Abstract:

Fernandez's (2001) Anger Parameters Scale (APS) conceptualizes anger activity according to frequency, duration, intensity, latency, and threshold.  The first three of the five parameters are based on the Multidimensional Anger Inventory (MAI) subscales while latency and threshold measures are related to pain and other perceptual responses (Fernandez, 2010). "Thus, we have five parameters measuring (i) how often one gets angry, (ii) how long the anger lasts, (iii) how strong the anger is, (iv) how quick to anger, and (v) how sensitive to provocation" (Fernandez, Day, & Boyle, 2015, p. 92).  Cronbach reliability estimates for an adult community sample (Fernandez, Vargas, & Day, 2010) were .85 (Frequency), .90 (Duration), .62 (Intensity), .88 (Latency), and .74 (Threshold).  Five anger parameters were extracted with a principal components analysis (PCA).  "A separate PCA analysis based on the subscale inter-correlations led to a one-component solution ... termed the Degree of maladaptiveness of anger ... The parameters are internally consistent and supported by preliminary factor analytic investigation."  Fernandez and colleagues (2014) report significant differences on the frequency, intensity, and duration scales with the forensic sample (N=125) having high scores on these three parameters than a non-forensic (N=182) samples.

The purpose of the educational intervention was to apply the Fernandez five parameters model (frequency, duration, intensity, latency, threshold) to the constructs of hunger and pleasure.  Participants were 130 traditional undergraduate nursing students.  Principal-axis factor analysis and Cronbach reliability estimates found two common factors were extracted for the hunger and pleasure constructs with reliability coefficients above .80.

Speaker
Biography:

Dale M. Hilty received his PhD in counseling psychology from The Ohio State University Department of Psychology.  He has published studies in the areas of psychology, sociology, and religion.  Between April 2017 and April 2018, his ten research teams published 55 posters at local, state, regional, national, and international nursing conferences.  His colleagues sharing the author line of this poster are: Ann Waterman, PhD, RN; Bev Gish, MS, RN; Jody Gill-Rocha, MS, RN; Erin Dougherty, MSN, RN, Kerry Fankhauser, DNP Candidate, MS, RN; Mary Yoder, MS, RN; Patty Severt, MSN.

Abstract:

Purpose & Research Question/Hypotheses:

It is hypothesized that interdisciplinary team-teaching with cognitive-affective strategy would increase student engagement by demonstrating relationship between nursing specialties and statistics.

Theoretical Framework & Rationale:

Many students come to college with rudimentary understanding of statistical principals.  Students report high levels of motivation and self-efficacy for nursing courses, and low levels of motivation and self-efficacy for the statistics course based on past beliefs, attitudes, and experiences.  They also lack the critical thinking skills necessary to apply statistical principles in order to understand the profound impact of evidence in nursing.  This difficulty is compounded by their apparent lack of passion about statistics, resulting in an inability for the knowledge to take root. 

Method:

The Health Statistics is designed to introduce the nursing students to statistics.  Seven nurse faculty offer 20-minute presentation in their area of expertise (e.g., angina, hypertension).  Statistics faculty provide a 10-minute demonstration converting nursing constructs to nursing research variables with hypothetical-fictional data based on published findings.  Students received a graded worksheet assignment and interpreted the SPSS findings based on ANOVA and linear regression.

Results:

First, pre-post (five knowledge/comprehension questions) data showed significance (p=.001-.031) using dependent t-test. Second, qualitative theme analysis reported students found meaning, relevancy to nursing practice. Third, thirty students volunteered to design and implement research projects not for class/grade for the purposes of developing a professional poster.  Four, the interdisciplinary team reported experiential learning while designing the guiding worksheet questions which students applied to patient care and self-care.

Speaker
Biography:

Jody Gill-Rocha is an Assistant Professor at Mt. Carmel College of Nursing.  She is the Academic Department Leader for the Medical-Surgical course.  Professor Gill-Rocha teaches the Adult Acute Care course, and is the course coordinator of the Infusion Therapy Lecture & Simulation course. She recently received the 2017 Excellence in Nursing-Nurse Educator Award.  During the past year, she has published 10 posters at the local, state, regional, national, and international nursing conferences.  Her colleague sharing the author line of this poster is Dale Hilty.

Abstract:

In a preliminary educational intervention, the primary goal was to norm the Burch, Heller, and Freed (2014) 63-item questionnaire (i.e., Student Engagement Survey; SES) on a sample of BSN nursing students.  Burch et al. (2014) believed learning activities, learning outcomes, and student engagement influence the development of the SES items.  The participants (N=360) were BSN nursing students.  Hypothesis 1: Determine whether engagement measured with the SES items would be a multi-dimensional construct.  Hypothesis 2: Determine if the reliability estimates would be greater than .80.   Hypothesis 3: SES engagement common factors would be negatively correlated with the avoidance coping, mental disengagement, and behavioral disengagement scales.

Exploratory principal axis factor analysis found four common factors (eigenvalues: 17.176, 3.807, 2.942, and 2.151) accounting for 63.6% of the variance.  Forty-one (41) of the 63 items loaded on one of the physical engagement, cognitive engagement, deep learning engagement, and engagement skills factors.  Coefficient alpha reliability estimates were .921 (Physical), .961 (Cognitive), .905 (Deep Learning), and .937 (Engagement Skills).  Hypotheses 1 and 2 were supported by these findings.  A correlational analysis found weak negative correlation coefficients among the four engagement common factors, avoidance coping, mental disengagement, and behavioral disengagement scales.  Support for hypothesis 3 was found.

It appears nursing educators can use the four engagement common factors, with alpha reliability estimates greater than .80, in educational interventions with nursing students.  The statistical findings provide preliminary validity for the engagement common factors based on the negative correlations with the avoidance coping, mental and behavioral disengagement scales.

Speaker
Biography:

Yannic Bonnez completed his master of Nursing and Midwifery in 2013, while working at a geriatric ward and the Artesis Plantijn University College (Antwerp). The past years, he taught at the University College, especially at the domain of research and geriatrics. At the same time, he cooperated at different scientific studies.            
 

Abstract:

Background

Yearly, 10% of older adults living in nursing homes (NH) are hospitalized. The goal is to study the relation between (changing) vital parameters and negative health outcomes, and to develop an instrument able to detect early signs potentially giving rise to physical decline.

Method

Weekly assessing vital signs in 170 NH residents (≥65years) during 8 weeks. Medical records were consulted for the Katz-scores and registration of hospitalizations. This abstract was based on preliminary baseline data.

Results

10% of residents were hospitalized and 3% died during follow up (n=170). A significant positive correlation was found between heart ritme (HR) and hospitalization(r=0,152;p<0,05), HR and death(r=0,214;p<0,05) and a significant negative(moderate) correlation between saturation and death(r=-0,353;p<0,001). Those who were hospitalized had a significantly higher HR(p<0,05). A lower HR was found in the survivor group vs those who died(p<0.05).

Discussion       

Literature supports the hospitalization percentage(10%) and confirms that higher HR gives rise to elevated risk for hospitalization and death. However, this has mainly been studied in people with increased cardiovascular risk in hospitals. Limitations of the current study are a small sample size and possible confounders (eg infection without hospitalization).

Conclusion

HR positively correlates with hospitalization and death in persons living in NH. A negative correlation was found for saturation and death. A significantly higher HR was found in those who died or were hospitalized. Expansion of the cohort and further research on the optimization of a screening tool is foreseen within this project in order to make more profound pronouncements on the topic.

Elena Del Sordo

National Transplant Center, Istituto Superiore di Sanità, Italy

Title: The Italian national transplant operational Centre: The role of nurses
Speaker
Biography:

Lucia Rizzato is a Nursing coordinator – Nurse Executive Manager at Italian National Institute of Health – Ministry of Health – Rome, Italy. 1991 – 1999 Padua Hospital, Surgical Department III – Liver Transplant Division – Director Prof. A. Maffei Faccioli. Activity as support to division management.

 

Abstract:

From November 4, 2013, the Italia national transplant operational Centre (CNTO) itself as sole interlocutor operating nationally, interfacing directly with the regional centers and ensuring h/24 support necessary for the operational management of the national programs. Centralizing management of allocations and also of waiting lists for national programs certainly has advantages:

  • streamline the path allocation through standardization of processes;
  • provide an unambiguous interpretation of the rules that currently govern the programs and therefore more effective to apply;
  • promote capacity interlocutory and a higher degree of authority;
  • a real-time control of donations, allocative flows and the outcome of processes.

By reference to a national average of 4 donors a day and considering the fact that every donor must still be reported to the CNTO in order to evaluate the potential use for national programs, the operational core is composed of six nurses coordination to be distributed on 3 shifts of 8 hours each (3 for each time slot and 3 off). It also requires six doctors who rotate in shifts to diagnostic problems. The head of the operating CNTO is a nurse manager.


Nurses coordination physically carry out their activities in the workplace;
- the staff removed the leaves turn only after transmitting the written instructions to staff upright;
- for each round of coordination should be prepared a written report of the activities;

  • The operational headquarters must be equipped with all the technological equipment and the supports they need to perform their assigned functions (PCs, printers, video conferencing equipment, fixed and mobile telephony, and internet connection).

The role of the nurse is recognized by the entire national network.

Speaker
Biography:

Nasser Ibrahim Abu-El-Noor received the Ph.D. degree in Health Care Policy from the Department of Public Administration and Urban Studies at the University of Akron, Akron, Ohio, USA. Topic of dissertation: Barriers to health care and quality of life of prostate cancer survivors residing in Gaza Strip and received the Master of Nursing Administration from Marquette University, Milwaukee, Wisconsin, USA as a Fulbright Scholar. Currently, he is working as an Associate Professor at the faculty of Nursing, Islamic University of Gaza
 

Abstract:

Background: In Palestinian, 10% of deaths among children under the age of five are related to infections or infectious diseases. Practice of infection prevention and control reduces the number of hospital-acquired infections. The purposes of this study were to explore health care team perceptions of causes of hospital-acquired infections and to develop, implement and measure the impact of infection prevention program in the ICU of a specialty pediatric hospital in Gaza Strip.

Methods: A quasi experimental with pretest-posttest design was used. All nurses and physicians were included in this study. Five dimensions were measured and investigated pre and post-intervention. An infection control educational program was designed and implemented.

Results: After implementing the staff-developed program, the five dimensions were improved: using sharp box increased from 46.6% to 90%, doing gloves and scrubbing improved from 53.3% to 55%, frequency of hand washing increased from 47.2% to 79.3%, awareness of Palestinian protocol of infection prevention increased from 27.5 to 80% and positive swabs cultures decreased from 56% to 34.6%.

Conclusion: The study recommends rebuilding an the infection control committee, motivating and encouraging work team to apply control infection measures through training and continuous education, providing the necessary medical supplies. These are besides continuous monitoring and follow up from the administration.

Key words: Infection control, infection control standards, hospital-acquired infection, Gaza, Palestine.