Day 1 :
UCLA Medical Center, Los Angeles, USA
Cathy Rodgers Ward, PhD, RN, NEA-BC is an experienced nurse executive and researcher and was most recently the Chief Nursing Officer for the past 18 years at the UCLA Medical Center in Los Angeles, California, designated three times as a Magnet facility. Dr. Ward also holds an appointment as clinical faculty in the UCLA School of Nursing. Her research has focused on the effects of nursing leadership on patient outcomes in hospitalized patients. Under Dr. Ward’s direction, UCLA achieved high patient satisfaction with overall quality of care ranking above the 90th percentile nationally and nurse satisfaction ranked above the 95th percentile. Dr. Ward has received many awards including the 2017 UCLA Leadership Award, 2015 Distinguished Alumni Award from the University of Alabama in Birmingham, the 2015 Transformational Leadership Award at UCLA, and the United States 2011 Nurseweek National Management Nurse of the Year.
Statement of the Problem: The implementation of healthcare reform requires new innovative nursing care models. Smaller work teams have been shown to increase teamwork in nursing. Smaller work teams provide for increased communication and accountability, closer supervision, better support for new staff, and increased knowledge of the patient condition. This study examines the effect of an innovative care team model using smaller, geographic work teams on patient outcomes, continuity of care and teamwork. Methods and Theoretical Orientation: This study was conducted on three hospital units in an academic medical center. Nurses in these units were divided into equal teams with equal bed counts. Nurses were assigned to one team and one geographic area only. Success of the model was assessed after one year including clinical outcomes, patient satisfaction, nurse continuity and nurse teamwork. Results: Nurse continuity improved in all units as evidenced by the average number of new RN encounters (including day and night shifts) decreased from 4.49 per patient to 3.94 per patient. The percent of team intactness was 87.4% indicating the model was successfully followed. Patient length of stay (LOS) in the hospital decreased across units by 14% therefore reducing overall costs. Patient satisfaction scores were variable across units. Satisfaction with nursing teamwork and nursing trust mean scores improved significantly (p=.04) across units. Conclusions and Significance: Developing smaller, more cohesive teams yields benefits of improved continuity of care for patients and improved patient outcomes. Improved continuity of care for patients may lead to safer care and improved engagement for nurses. Defining smaller work teams in a distinct geographic area is a model that shows promising results in developing teamwork among nurses and improving patient care.
Rutgers University, USA
Joanne P. Robinson is a University Professor at Rutgers, The State University of New Jersey, USA. Dr. Robinson is known for her contributions to gerontological and urologic nursing. Her research on lower urinary tract symptoms in older adults has been supported by the USA’s National Institute of Nursing Research, recognized with six awards, and merited appointment to the board of the Center for Clinical Investigation of the Wound Ostomy and Continence Nursing Society (2011-2015). Currently, she chairs the Nursing Education Subcommittee of the International Continence Society. Dr. Robinson has been a Fellow of the American Academy of Nursing since 2011.
Problem Statement: Lower urinary tract symptoms (LUTS) are an important but often neglected issue in patients with Parkinson’s disease (PD). The purpose of this presentation is to highlight findings from a series of studies conducted over the past decade that expand evidence about the prevalence and impact of LUTS in male PD patients and their spouse caregivers. Theory and Methods: Guided by the Theory of Unpleasant Symptoms and family systems theory, four studies were conducted. All participants were recruited from the movement disorders clinic of a Veterans Affairs Medical Center. Study designs were: retrospective with total population sampling (N=271 clinic records); cross-sectional with convenience sampling (N=88 men with PD and LUTS); and qualitative descriptive with purposive sampling of cross-sectional study participants (N=11) and their spouses (N=15). Data from clinic records and interviews (structured and semi-structured) were analyzed using statistical procedures and content analysis (directed and conventional). Findings: Most patient participants had mild PD symptoms, yet UI prevalence was 24% and 92% in retrospective and cross-sectional studies respectively. Patients had limited awareness of the neurologic contributions of PD to LUTS. Embarrassment, bother, and diminished self-esteem jeopardized their relationships, intimacy, social life, and travel. Spouses understood that PD caused LUTS and empathized with their husbands; however, they still experienced bother and emotional distress related to LUTS and coped primarily by “dealing with it.” Patients and spouses relied mostly on do-it-yourself strategies to manage LUTS – some ingenious and some ill-advised. Conclusions: LUTS may be highly prevalent in the early symptomatic phase of PD, negatively affects patients and families, and often escapes the attention of providers. We recommend: screening patients and families for LUTS issues in all stages of PD; inquiring about burden and management strategies; and referring to urology providers as needed. LUTS treatment deserves designation as a priority area for PD research.
College of Licensed Practical Nurses of Alberta, Canada
Leah Adeline Phillips, PhD, Director of Research and Policy, College of Licensed Practical Nurses of Alberta, Canada. Dr. Leah Phillips is the Director of Research and Policy at the College of Licensed Practical Nurses of Alberta (CLPNA), an Adjunct Professor in the School of Public Health and the Faculty of Rehabilitation Medicine at the University of Alberta, Canada. She has a Bachelor of Arts (Honors) in Psychology; a Masters of Arts in Sociology, a Doctorate of Philosophy in Public Health Sciences and in 2017 completed a Fellowship for Health Systems Improvement. Dr. Phillips’ work supports the regulatory mandate for the Licensed Practical Nurse profession. Using best evidence to develop regulatory policy, Dr. Phillips strives to collaborate with researchers and innovation stakeholders to create knowledge on LPN practice, lead and facilitate research to support regulatory excellence, use the best empirical evidence to support and create evidence informed policy.
Statement of the Problem: In Canada, all nurses are required to engage in evidence-based practice (EBP) as an entry-to-practice competency; however, there is little research that examines Licensed Practical Nurses’ (LPNs’) information seeking behaviors or preferred sources of knowledge to conduct EBP. Due to the differences in education and roles of LPNs and Registered Nurses (RNs), it is both necessary and important to gain an understanding of how LPNs utilize evidence in their unique nursing practice. The purpose of this study was to investigate how LPNs source knowledge for their nursing practice.
Methods: A descriptive, cross-sectional survey of LPNs from Alberta, Canada asked participants to rank sources of knowledge that inform their practice. Responses were correlated with age and years of practice. Analysis of variance was used to determine if there were significant mean differences between average scores and place of employment.
Results: LPN participants used similar sources of knowledge as RNs. The top source of knowledge for both RNs and LPNs was the information they learn about each individual client and the least utilized sources of knowledge were articles published in nursing, medical, and research journals, tradition, and popular media. This finding is consistent with previous studies on RNs that found nurses do not often access current research evidence to inform their practice.
Conclusions: Since relatively few LPNs access nursing and research journals, it is important to tailor EBP education information to the workplace context. Future avenues of research might explore the potential of using in-services and webinars to disseminate information and skills training on EBP to the LPNs, as this was a popular source of practice knowledge.
Bournemouth University, UK
Time : 10:00-10:30
Professor Ann Hemingway is a registered nurse and professor of public health she is chair of the European Academy of Caring Science and a member of the Cochrane Collaboration Global Priorities in Nursing Review Group. Ann`s research is focused on the reduction of inequities in health and wellbeing through public health action. Ann is regularly commissioned to undertake international and UK based research projects. She is also a regular author in international journals with a specific focus on public health and the reduction of inequities in health and wellbeing.
Addressing health inequities and promoting wellbeing has been identified as an important area for nursing practice and research both in the UK and internationally, both within the nursing and health care literature and within national and international scrutiny and discussion documents. Nurses are critical as they act both as individual care co-ordinators and team leaders, nurses bring people centred care closer to the communities in which they are needed most. Indeed nurses may be members of deprived or marginalised communities and as such have intimate knowledge of the determinants of health in local areas. In addition nurses are often first to respond to emergencies and often provide care to under-served populations and communities around the world. Nurses can be engaged across the spectrum of public health interventions, this paper will outline how nurses can help to reduce inequalities and inequities in health and specifically outline the areas which nurses can help to tackle in relation to the social determinants of health for instance by targeting vulnerable populations to improve health outcomes and access to services.
This paper will explore the importance of nurses being able to ‘see’ via a first person perspective the life world of another being as caring insiders; as opposed to potentially adopting an objectifying, third person perspective. A philosophical underpinning for this practice will be presented, the life world perspective. The paper will suggest that although experienced practitioners may well be integrating this approach into their practice as we require the reduction of inequities in health to be a focus for nurses and nursing students working across hospital, the community and primary care internationally; we also need to offer a philosophical underpinning which helps build these approaches into nurses caring practice.
rsing and the Armstrong Institute for Patient Safety, USA
Keynote: The role of nurses in coordinating and implementing patient safety in psychiatry over 2 decades
Time : 09:30-10:00
Dr. Geetha Jayaram is a senior faculty member in the Departments of Psychiatry, the School of Health Policy and Management, Global Health, and The Armstrong Institute for Patient Safety at Johns Hopkins University School of Medicine in Baltimore, Maryland. She directs a community psychiatry inpatient service, has directed several outpatient programs, and is an attending physician in the Department of Psychiatry at Johns Hopkins Hospital. She had a private practice for over 2 decades. As a highly respected clinician leader and administrator, she has developed and directed a quality assurance program that is unique in psychiatry.
- Apply science to nursing safety methods to evaluate them
- Utilize a systems perspective
- Minimize the impact of errors and maximize recovery in nursing practice.
Over the past two decades, safety climate research has been widely explored in other high reliability industries including railways, nuclear power plants, commercial aviation, manufacturing, and other industries. The first effort at identifying and outlining safety initiatives in psychiatry occurred through the cohesive efforts of the Patient Safety Committee of the American Psychiatric Association in 2002 and by the American Psychiatric Nursing Association in 2012. With regulatory bodies and insurance companies, emphasis on the safety movement in Psychiatry has focused on the psychiatrist/nursing interface. Safety failures causing sentinel events have repeatedly highlighted several areas: failure to train, thoroughly assess, communicate, monitor, & provide resources for patient protection, including a safe environment. Ways to avoid continuous observation and promote de-escalation will be discussed.
Among improvements made in this area are screening for and prevention of aggression, preventing inpatient suicide, providing the correct level of observation and instructing observers; preventing medication errors with medication reconciliation, detecting system flaws and preventing adverse events such as falls. Risk assessments by nurses as our frontline staff are of paramount importance. Methods and tools used to promote safety will be discussed and examples provided.
Overall, establishing a climate of safety and promoting a culture of safety with the involvement of leaders will be reviewed.