Day 2 :
Keynote Forum
Samir H Shah
University of Tennessee Health Sciences Center, USA
Keynote: Innovation in earlier identification of pediatric severe sepsis: Application of an electronic pediatric severe sepsis screening tool (E-assist study)
Biography:
Samir H Shah MD, MBA is a pediatric critical care physician and researcher. He is a clinical expert in managing patients in the pediatric and cardiac critical care units. His clinical research focuses on the philosophy that a patient’s outcome can be improved by using predictive modeling, creating appropriate trigger alerts and team education. Dr. Shah is the Chief of Pediatric Critical Care Medicine at the University of Tennessee Health Sciences Center / Le Bonheur Children’s Hospital. He holds the position of Professor in the division of Pediatrics and he is the Fellowship Program Director of Pediatric Critical Care Medicine at UTHSC. Earlier, Dr. Shah was a faculty in Pediatric Critical Care and Emergency Medicine at the University of Manitoba, Canada. Dr. Shah received his MD at Seth G. S. Medical College and completed his training in Pediatric Surgery at Grant Medical College in India. He completed his Pediatric Critical Care Medicine training at UCLA – Harbor, CA and a fellowship in Pediatric Cardiac Critical Care at Children’s Hospital Los Angeles / USC. Dr. Shah received his Masters of Business Administration from the University of Tennessee. He has published more than 25 papers in reputed journals and has been serving as an editorial board member for journals related to Pediatric Critical Care.
Abstract:
Background: Earlier recognition of pediatric Severe Sepsis (SS) is critical for timely goal-directed therapy and improving patient outcomes. Early indicators of SS and therapy administered in response to an Electronic Medical Record (EMR)-integrated, pediatric SS screening algorithm ('sniffer') have not been described.
Methods: All adolescents (13-18 years) admitted to Le Bonheur Children's Hospital from over a 1-year period (n=3138) were screened using an EMR SS screening algorithm. Demographics, diagnoses, and interventions on all patients were collected for potential CRS cases.
Results: Using mixed logistic regression on 15 alert indicators, pulse (p=0.004), temperature (p=0.008), ALT (p=0.015) and BUN/Creatinine ratio (p=0.013) were found to be key independent determinants of pediatric SS. Alert-mediated, early goal-directed therapies (administered within 6 hours of a positive alert) were fluid bolus (33%, n=12), antibiotic use (61%, n=44), and oxygen support (96%, n=55). The median time (hours) from the first positive alert to therapy was 9.4 - fluid bolus (IQR 3.1-68.9), 5.3 - antibiotic use (IQR 1.8-9.6), and 0.8 - oxygen support (IQR 0.4-1.6). True positive cases (n=66) had increases in hospital length of stay (LOS; in days) - 5.4 (p=0.004); ICU LOS - 8.5 (p<0.001); mechanical ventilator use - 3.3 (p=0.003); pressor support - 0.8 (p=0.17). SS mortality was 2.5% (n=5).
Conclusions: An EMR-integrated SS real-time screening algorithm offers the potential to facilitate early goal-directed therapy and decrease sepsis-related mortality.
Keynote Forum
Shelley L Cobbett
Dalhousie School of Nursing, Canada
Keynote: Scaffolding digital clinical environments and contextual learning as preparation for active learning strategies
Biography:
Shelley L Cobbett, a Registered Nurse, completed her Doctoral studies in education in 2006. She has been a Nurse Educator for almost 30 years with expertise in curriculum development and evaluation, both in the face-to-face environment and online. She is the Curriculum Development and Implementation Lead for a new innovative BScN Degree program. The majority of her research is focused on nursing education and pedagogical best practices.
Abstract:
Assigned prior to class readings are an integral part of most post-secondary courses. Inherent in the use of prior to class readings is an assumption that students have the skill and ability to distinguish what is salient and what is not when they are preparing for class. Is this a fair assumption with students who are learning new information? Perhaps more importantly, is this best pedagogical practice? Over 70% of students do not complete required to class readings making active learning to achieve higher level cognitive work difficult to implement when students are not prepared for application of the content. This presentation will showcase how one nursing curriculum is maximizing use of a digital clinical environment (DCE) and online contextual learning to prepare students for active learning in the face-to-face environment. Participants will meet Tina Jones™, our virtual patient, and view how we have integrated the use of this DCE to enable students to arrive fully prepared for active learning related to history and health assessment. Our use of “class passes” will be highlighted as an exemplar of providing direction to novice learners related to the salient aspects of information that they are to acquire, leading to significant, interactive learning experiences. Secondly, the use of safeMedicateTM will be highlighted as to how medication administration and dosage calculation knowledge, skills and abilities are scaffolded throughout the program. Lastly, student and faculty evaluations will be shared with suggestions for future improvement.
Keynote Forum
Jamesetta A Halley-Boyce
Seton Hall University, USA
Keynote: Servant and virtuous leadership- Complementary styles to assure success
Time : 11:20-12:05
Biography:
Jamesetta A Halley-Boyce has been a Registered Nurse and a Seasoned Healthcare Executive for decades. She has served in a number of offices in the hospital’s C-Suite including CEO, COO and Chief Nurse Executive Officer. She maintains her own consultant firm, JHBALS Spectrum International, Inc. and additionally serves as an Associate Professor and the Director of the Health Systems Administration Graduate Program in the College of Nursing at Seton Hall University. She is professionally recognized for her continuous pursuit of excellence in education and service delivery, her grace, and for her humanistic, servant leadership style.
Abstract:
Leadership has been the topic of discussion for centuries; Schools of Business delight in educating leaders. Mintzberg’s classic article entitled, “What Do Manager’s Do,” (HBR, 1973) seeks to define management roles verses leadership. From Aristotle to Bible leaders, there has always been the belief that to lead is to be a servant. Many would argue that being a servant, being humble, is in contemporary times, a sign of weakness in a leader. Yet, Greenleaf, who introduced the concept of Servant Leadership in his writing and Havard with his dissertation on Virtuous Leadership were both confident of the leader’s ability to achieve success. The observer could be assured of the successful outcomes of those leaders who apply one or better in concert, both, of these leadership styles, are favored with success in the delivery of Healthcare today. Servant Leadership seeks first to serve the interest of the followers encouraging the followers to assure the accomplishment of the organization’s goals and fulfill the organization’s mission. It is the concept of “Caring for the Caregivers,” who will in turn give their very best Nursing care to their patients. Advancement of a shared version is achieved by addressing the highest priority needs, empowering and developing followers who themselves will become servant leaders as well. Virtuous Leadership ignites a contagious effect to strive for personal/individual greatness, while simultaneously empowering followers to reach their fullest potential. The two styles are complementary and when utilized in concert, exponentially enhances the effectiveness of the leader, the performance and engagement of the followers and assures the delivery of care that is compassionate, therapeutic, safe, financially sound and culturally appropriate in an organization where the leaders at every level of the hierarchy are Magnanimous, Inclusive Servant Leaders.
- Nursing Management | Clinical Nursing| Nursing Education and Career | Nursing Practice
Location: Holly
Chair
Thomas Hagerty
LaGuardia Community College, USA
Co-Chair
Jamesetta A Halley-Boyce
Seton Hall University, USA
Session Introduction
Thomas Hagerty
LaGuardia Community College, USA
Title: Patients’ hospital experiences and Peplau’s theory of interpersonal relations in nursing
Biography:
Thomas Hagerty, PhD, MSEd, RN, CCRN is a bedside Nurse in the 18-bed Neurological Intensive Care Unit of New York Presbyetrian Medical Center – Columbia Campus, and also a part-time adjunct professor of Nursing at LaGuardia Community College. He holds a PhD in Nursing from the City College Graduate Center in New York.
Abstract:
Background: Though hospital reimbursement is tied to patient experience survey results, there have only been small improvements in hospitalized patient’s experiences as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Hospitals known for nursing excellence provide higher-quality patient experiences, as measured by the HCAHPS survey. Previous research supports an alternate factor structure of HCAHPS survey results, based on a nursing theory of interpersonal relations.
Objectives: The main goal of the study was to test whether a nursing theory-based factor structure of items on the HCAHPS survey can make significant contributions to the prediction of patients’ overall hospital rating and likelihood to recommend that hospital to family and friends. Finding support for this conceptualization of the items arguably supports a theory-based model.
Methods: We tested our hypotheses through hierarchies of ordinal logistic regression models, a type of generalized linear model, conducted on the HCAHPS survey results from one large, urban, five-campus academic medical center in the mid-Atlantic region of the US.
Results: The hierarchies of models supported a positive relationship between a nursing theory-based factor structure of HCAHPS data and patients’ evaluations of their hospital experiences.
Pervell Dunbar
University of North Georgia, USA
Title: End-of-life caring and the informal caregiver
Biography:
Pervell Dunbar hails from Kingston Jamaica. In 1967, she received a scholarship to study at the Hastings School of Nursing in Sussex, England and graduated in 1970. In 1972, she completed her midwifery studies in Dumfries, Scotland. She continued her pursuit of nursing advancement and excellence in the US, graduated in 1999 with a BS in Nursing Administration from Barry University in Miami. She obtained MBA degree in Health Management from the University of Phoenix in 2002 and in 2008, she completed her MSN at Florida Atlantic University in Boca Raton. Finally, being a life-long lover of learning, she received her Doctorate in Nursing Practice from Walden University in 2015; her published paper was “Nursing Care for Terminal Patients in Intensive Care Units.” Noting the gap in communication and compassion among her peers while caring for patients at end of life or with chronic conditions, she felt she could best influence change and make a difference by getting enhanced qualifications. In her professional career she has worked over thirty years clinically and administratively, with patients of all ages with a focus mainly in Emergency medicine and Intensive Care nursing, and Gerontology.
Abstract:
Caring of patients at end-of-life can be quite daunting to the caregiver. Patients’ psycho-social and spiritual needs are sometimes neglected in the healthcare setting. Transitioning patients from healthcare facilities to home with care being given by informal caregivers can be overwhelming. It requires a comprehensive and prioritized array of relevant and coordinated community resources. A review of researched documents established that informal caregivers who provide care and assistance do so with few supportive services. The purpose of this paper is to create an environment of care that gives solace to those who are in various stages of grieving, while educating the community through supportive care provided to informal caregivers. The social change proposed here is to bring awareness to society that informal caregivers are irreplaceable; it goes beyond family love, there is simply not enough money or workers that can replace that bond of caring. Jean Watson’s Caring Model is appropriate for this presentation.
Gugu Ndawo
University of Johannesburg, South Africa
Title: A model to facilitate authentic learning in nursing education
Biography:
Gugu Ndawo is working as a Lecturer in Department of Nursing at University of Johannesburg. Her research interest includes Nursing Education and Nursing Practice.
Abstract:
Objectives: To develop and describe a model to facilitate authentic learning in nursing education.
Methods: A qualitative design (De Vos, Strydom, Fouché & Delport, 2011:95) for theory generation (Chinn & Kramer, 2015:220) was used to develop a model. The conceptualisation was done according to Dickoff, James and Wiedenbach’s (1968:415-435) theoretical framework using the six elements of practice theory.
Results: The nursing education is the context which is a dynamic, challenging and ever-changing context that occurs within and highly influenced by the legal, ethical and professional boundaries at the international, national, provincial, local and learning institutions’ levels. The facilitator is the agent who possesses the 4Cs “Super Skills” for the 21st Century namely critical thinking, creativity, collaboration and communication which enable them to create an authentic learning environment. The learner is the recipient of the authentic learning activity who is an active participant in their own learning to develop the 4Cs “Super Skills” for the 21st Century. The facilitator strives to facilitate authentic learning through the facilitation of learners’ meaningful, realistic and active engagement which is dynamic. The process and procedure occur within three phases of authentic learning. The learner is, thus, developed into a competent, critical, autonomous, independent, lifelong graduate desirable for the twenty-first century global healthcare system as an outcome of authentic learning.
Conclusion: The model can be used to produce nurse practitioners who are critical, reflective, creative and innovative thinkers who will be able to make astute clinical reasoning and judgment as well as rational decisions in order to solve client’s complex problems.
Biography:
Yuan Li has accomplished her Bachelor degree in 2016 from Tianjin Medical University and now is furthering her studies from West China School of Medicine, Sichuan University. She always gets great passion in improving the health and wellbeing of human.
Abstract:
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Non-valvular AF is associated with a fivefold increase in the risk of ischemic stroke and systemic embolism. Although warfarin or the recently introduced anticoagulants can significantly reduce thromboembolic events in at-risk patients with AF, these medications are associated with severe hemorrhagic adverse effects and declined treatment compliance. Besides, catheter ablation (CA) therapy for AF is an effective rhythm control strategy for patients with symptomatic, drug-refractory AF, but its role in stroke prevention remains unproved. Expert consensus regards catheter ablation as a symptomatic treatment which should not be indicated with the sole purpose of stopping anticoagulation. On the other hand, left atrial appendage occlusion (LAAO) is to prevent thromboembolism has solid theoretical basis in that left atrial appendage is the source of thrombi in up to 90% of patients with nonvalvular AF and the positive effect of LAAO is arising with gradually overcome of the learning curve. Therefore, combining AFCA and LAAO, two percutaneous interventions that share some procedural issues and technical requirements, could reduce the incidence of stroke in selected high-risk patients while simultaneously relieving AF symptoms in a single session. As an innovative method with complicated procedure，the combined surgery undoubtedly post new challenges towards cardiac nursing profession. How to implement holistic nursing strategies to improve patient outcome are now confronted with cardiac nursing staff.
Biography:
Zhao Wenting has completed her Bachelor’s degree in Tianjin Medical University. Currently, she is a first-year Master’s student in Sichuan University, majored in Geriatric Nursing. She has a passion for Nursing and wants to help elder people to live better.
Abstract:
Introduction & Aim: This study was conducted to assess the venous thromboembolism prevention related knowledge, attitude and practice of nurses in geriatric department of tertiary hospitals and to give scientific basis of improving the prevention level.
Methods: 416 nurses in geriatric department from 9 tertiary hospitals in Sichuan province were investigated about their venous thromboembolism prevention knowledge, attitude and practice by using a self-design questionnaire.
Results: The total scores of venous thromboembolism prevention related knowledge, attitude and practice of 416 nurses were 70.42±8.32. Multiple Linear Regression indicated that education, professional title, experience of taking care for the patients with venous thromboembolism and the latest time of learning knowledge are the influence factors of the scores. Correlation analysis indicated that knowledge, attitude and practice are positively correlated.
Conclusions: The venous thromboembolism prevention related knowledge and practice of nurses in geriatric department remains to improve, targeted training should be provided to different nurses by nurse managers. Nurse managers should improve the knowledge of nurses, so that they can enhance the attitude and practice of prevention.
Mahmoodi Zohreh
Alborz University of Medical Sciences, Iran
Title: Association of maternal working condition with low birth weight: The Social determinants of health approach
Biography:
Mahmoodi Zohreh is working as a faculty member in Alborz University of Medical Sciences. Her research interest includes healthcare management, Midwifery research and Psychological well-being.
Abstract:
Background: The socioeconomic conditions have made more job opportunities available to women. This has created interest to conduct studies on the effect of working lifestyle on pregnancy outcomes.
Aim: This study was conducted with the aim to assess the relationship between mothers’ working status as a social determinant and the incidence of low birth weight (LBW) of the newborn.
Subjects & Methods: This case–control study was conducted on 500 women with normal weight infants (control group) and 250 women with LBW infants (case group) in selected hospitals in Tehran. Data were collected using a researcher‑made questionnaire, designed to assess the effect of mothers’ prenatal lifestyle, as a social determinant, on LBW of the newborn. A section of the questionnaire involved assessment of mother’s working condition in terms of the work environment, activities, and job satisfaction. Data were analyzed using Chi‑square and logistic regression tests.
Results: LBW among employed mothers was 5 times more likely than unemployed ones (odds ratio=5.35, P<0.001). Unfavorable work conditions such as humid environment, contact with detergents, and being in one standing or sitting position for long hours were significantly associated with LBW (P<0.001).
Conclusion: The present study showed that unfavorable work conditions were associated with LBW; therefore, they need special attention.