Day 16 :
- Nursing Care | Cancer Nursing | Nursing Education and Career | Nursing Practice
Location: Holly
Chair
Bridgett Byrd Sellars
Winston-Salem State University, USA
Co-Chair
Shelley L Cobbett
Dalhousie School of Nursing, Canada
Session Introduction
Benedict B Benigno
Northside Hospital, USA
Title: The Use of PARP inhibitors in the management of patients with recurrent cancer of the ovary
Biography:
Benedict B Benigno is a world-renowned Gynaecologic Surgeon and Oncologist who has spent his career treating women with ovarian cancer. He received his MD degree from the Georgetown University School of Medicine, and completed his residency in Obstetrics and Gynecology at St. Vincent’s Hospital and Medical Center in New York City. He completed two fellowships in Gynaecologic Oncology, one at the Emory University School of Medicine in Atlanta and the other at the MD Anderson Hospital and Tumor Institute in Houston. He is the Founder and President of University Gynecologic Oncology and the Director of Gynaecologic Oncology at Northside Hospital in Atlanta, Georgia. He is a member of many societies including the Society of Gynecologic Oncologists, the Felix Rutledge Society, and the American Society of Clinical Oncologists. He has published numerous articles and textbook chapters, and travels the world speaking on various aspects of gynaecologic cancer.
Abstract:
Cytotoxic chemotherapy, in one form or another, has been used to treat patients with cancer of the ovary for over 60 years. These drugs are poisonous, and the dosage and interval between treatments are modified only by the body’s ability to withstand repetitive poisoning. Chemotherapy works by interfering with cell division and is extremely toxic. For the past two years, oncologists have had access to an entirely new and exciting class of drugs, the PARP inhibitors, and they have revolutionized the care of these patients. PARP inhibitors work at the very strands of the DNA. The PARP enzyme helps repair single strand breaks in the DNA of the cancer cell, thus allowing the cancer cell to survive and continue acting as a cancer cell. When this enzyme is inhibited, the cancer cell dies. I will go into the use of these drugs and their mechanism of action, duration of response, and complications. I will spend considerable time discussing the importance of genetic testing in patients with ovarian cancer, and how mutations in the BRCA gene are related to the use of the PARP inhibitor drugs.
Joyce Bredesen
Metropolitan State University, USA
Title: Developing non-traditional experiences to enhance student learning within the community
Biography:
Joyce Bredesen, DNP, RN, PHN, is an Associate Professor of Nursing at Metropolitan State University in St Paul, Minnesota. Her expertise and passion is teaching public health nursing. She teaches both undergraduate and graduate nursing courses primarily in Public Health Nursing. She also is faculty advisor for DNP students and their projects. Her research interests are working primarily with underserved populations. Her most recent research includes work with PhotoVoice and Parkinson’s disease. She has done research with the homeless population in Minnesota, as well as women’s health care issues in both India and Senegal.
Abstract:
With the high demand of clinical sites and placements needed for students within the community setting, the creation of sustainable academic-community partnerships provides a challenging yet exciting opportunity for development of programming. While community health nursing faculty have a well-established history of utilizing clinical sites with a broad range of learning opportunities for students, the need for clinical sites is increasing. Experiences within the community, collaboration and coordination of care across disciplines are crucial to understand and manage the complexities of health in today’s world; especially with our ageing population and increase in chronic conditions. Community Health Nurse Educators are charged with preparing students to work with vulnerable and underserved populations. Involving nursing students in the assessment, planning, and implementation process for setting up community Wellness Centers assists in developing leadership skills. Delivery of care and access to services, especially for underserved populations, is further enhanced by having the nursing students modify services through continued assessment and evaluation of the needs of the populations they are working with. A School of Nursing within an urban area partnered with community members to develop a Wellness Center, focusing on the needs of underserved populations. This partnership has developed inter-professional educational opportunities that offer the nursing students a unique experience in relationship building that assists in developing trust and respect, as well as having direct contact with the public. Collaborating, setting role expectations, and developing shared goals, provides the new baccalaureate nurse competencies that will assist in yielding better patient outcomes.
Bridgett Byrd Sellars
Winston-Salem State University, USA
Title: Journey to excellence: Transforming the care delivery process through service excellence training and standards of professionalism
Biography:
Bridgett Byrd Sellars, PhD, RN, FACHE, NE-BC is currently the Director of RN to BSN Program and Associate Professor at Winston-Salem State University in the Division of Nursing. Her research program focuses on Transformational Leadership Practices and Patient Outcomes. Her most recent work in a prior role as the Chief Nursing Officer at a Community Hospital was implementing nursing excellence standards to improve patient outcomes.
Abstract:
Strong patient satisfaction begins with a healthy work environment that engages staff and provides quality patient care. A rural community hospital engaged on a ‘Journey to Excellence’ that included implementation of service excellence standards to improve patient outcomes. These standards included hardwiring hourly rounding, implementing director rounding, conducting service excellence training for all employees, and standardizing uniform dress code colors based on discipline. The changes resulted in improved community perception of professional image of nursing, improved patient satisfaction, and decreased wait times for call bell responses. Hourly rounding compliance was self-reported through documentation by the staff, and was measured by leadership interviews with patients and families during daily rounding. Service excellence training, including ‘No Passing Zone’ training; to ensure all team members were educated about patient care standards and expectations. The community perception was measured through qualitative feedback from board meeting members and the Patient Family Advisory Council. They reported that nurses were perceived as being more professional, and it was easier to identify who the nurse was. These measures helped to validate improvement in the patient experience, and better-quality care.
Patti Owen
Northside Hospital Cancer Institute, USA
Title: Delivering quality in a large community cancer program
Biography:
Patti Owen is the administrative director of the North side Hospital Cancer Institute (NHCI), the largest comprehensive community hospital cancer program in Georgia, with over 9,000 analytic cancer cases diagnosed and/or treated annually. She is responsible for administrative leadership of system-wide oncology services including: 4 inpatient units, 36 infusion centers, 6 radiation oncology centers, 11 disease-site specialty programs, quality, support services and community outreach. For the past 28 years, Patti has dedicated her career to developing a cancer program recognized for outstanding quality. The NHCI has received local and national recognition for quality through numerous accreditations, certifications, grants and partnerships. Patti graduated with a Bachelor of Science in Nursing from Towson State University in 1983 and with a Master of Science in Adult Health Nursing with Oncology Subspecialty and Management Minor from Emory University in 1988.
Abstract:
North side Hospital Cancer Institute (NHCI) is one of the largest and most respected cancer programs in the southeast. With 9,000 analytic cases/year, the mission is to deliver high quality cancer care which required an infrastructure with three focus areas: 1) Oncology Analytics, 2) Disease-site multidisciplinary care (MDC), and 3) Culture of continuous readiness. As the foundation for data management, Oncology Analytics houses the cancer registry and facilitates the establishment of clinical databases to support delivery of high quality care. New demands are generated from growth in cancer incidence, geographic footprint, and provision of care in a value-based system. The need for oncology nurses has increased due to required clinical experience for management of registry functions specific to cancer program needs. With experience as a NCI Community Cancer Program enhanced our oncology service line strategy. MDC infrastructure is consisting of disease-site administrative teams and cancer conferences completed the continuum of care by establishing clinical guidelines, an essential mechanism to reduce variation, control cost, improve adherence, and enhance communication. Nurses from multiple roles (administrative, quality, clinical care, navigation, and research) are integral to this infrastructure. Synergy of Oncology Analytics and MDC Teams supports the creation of a continuous readiness culture with on-going education and monitoring. Incorporating standards into daily processes and demonstrating a sustained level of compliance is the expectation. For a large community cancer program is experiencing a rapid growth, many strategies in these focus areas were implemented to maintain/ensure the delivery of quality cancer care.
Nancy G Cameron
East Tennessee State University, USA
Title: User experience design in online nursing education
Biography:
Nancy G Cameron is an Associate Professor at East Tennessee State University in Johnson City, Tennessee. She has been teaching online and developing online courses for 10 years and has multiple certifications in online education. She has been on the receiving end of online education and has lived the student perspective.
Abstract:
A new methodology in course design is emerging that characterizes satisfaction from a User Experience (UX) standpoint. A storyline of head, heart, and hands for the student, matches with the academic instructional design of cognitive, affective, and psychomotor learning. UX designed courses are poised to be the next iteration in course design to meet student and university needs for retention and graduation. Increasing student retention and graduation is crucial for maintaining and increasing performance-based funding in educational institutions. Meeting common student needs early in the program can provide the resources and support needed for overcoming future barriers to graduation. Preloading student satisfaction and success factors into an online program orientation course can strengthen the potential for student retention and success. A completely online Master of Science in Nursing (MSN) program orientation course was developed to meet the identified common student needs, as compiled by Cameron (2013). The program provides early access to the MSN program’s Learning Management System (LMS), access to peer support, faculty advisor, and university resources. Students were taught the basic structure of courses (including content, discussions, quizzes, and drop boxes) to ease the stress of the first few weeks of class. Graduate study requirements and expectations were explained along with the differences between online and face-to-face study. Students received guidance in balancing work, life, and study. Students were given opportunities to practice the most commonly used technologies in the program.
Biography:
Victoria Marie Indyk, PhD, RN has been a Felician Sister for 48 years. She was born and raised in Detroit and graduated in 1969 from St. Casimir High School in Detroit, MI. Her Madonna University education included earning a BSN (1975) and a MSN (1993). Doctoral studies were at Wayne State University where she earned a PhD in Nursing (2007). She has worked as a Professor of Nursing at Madonna University for the past 20 years and enjoys teaching undergraduate nursing students on all levels. Her Doctoral research was on Osteoporosis in postmenopausal nulliparous women religious. Research also completed on Osteoporosis in veiled Arab Muslim women living in Southeast Michigan and Healthcare Needs In Jacmel, Haiti. She does volunteer services at St. Frances Cabrini Clinic for the poor and United Neighborhood Initiatives in Southwest Detroit. She also has coordinated community health fairs with nursing students at various locations including in Detroit, Farmington Hills, and Livonia, MI. She has a great love and compassion for the people of Haiti. She travels to Jacmel, Haiti three times per year for Mission Trips and has completed 9 trips with nursing students and faculty from Madonna University to help with healthcare and outreach programs at the Felician Sisters Mission in Jacmel, Haiti.
Abstract:
Background: Jacmel, Haiti is an impoverished and underserved state that is affected by many natural disasters, disease and generations of systemic poverty. This rocky, mountainous area lacks running water, basic sanitation, and the people have little money and minimal job opportunities to pay for the basics of health, food, shelter, and education.
Aim: The purpose of this study is to assess the needs of Jacmel, Haiti and to show how Madonna University Nursing Department is assisting the Felician Sisters Mission to address these needs.
Methods:Utilizing the Leininger’s Sunrise Enabler Model, this study focused on assessing the needs of Jacmel, Haiti and looked at how the Felician Sisters’ Mission in Jacmel have developed programs to meet the pressing needs of this population.
Results & Discussions: Results of the study showed that the Madonna University nursing faculty and students are able to assist and provide direct healthcare to the people of Jacmel through the many programs of the Felician Sisters Mission including helping at the Mobile Clinic that provides healthcare to 28 village sites, giving classes on hand washing and disease prevention, dental care instruction, helping at the Soup Kitchen that feeds 50-60 children daily, providing water buckets and filters for the Water Woman Blessing program, and bringing clothes, shoes, and other needed supplies for the Felician Mission.
Geneva M Edwards
Unlawful Medicine LLC Buford, USA
Title: Avoiding the mishaps in healthcare provision
Biography:
Geneva M Edwards is a medical professional with more than 35 years of experience in healthcare provision. She is a registered nurse, a certified medical investigator, a certified legal nurse consultant and an established medical writer. She holds a Master’s of Science in health service administration, a Master’s of Science in biological sciences, a medical Doctorate degree from a World Health Organization affiliate and she completed Post-doctoral fellowship training in researching and analyzing medical data at the Center for Disease Control and Prevention in Atlanta Georgia. Her passion lies in caring for the elderly and investigating what happens when medicine and the law collides. She is BAI certified and works as an investigator with Locator’s International.
Abstract:
Legal Medicine consists of a broad range of legal, medical, and ethical issues, as well as human rights and rights of individuals. This discipline specialty is necessary in the healthcare profession because healthcare providers have a duty to act in a patient’s best interest always. If healthcare professionals fail to meet this duty they can and will be charged in a court of law. Medical Malpractice is defined as the legal cause of action that occurs when a healthcare professional deviates from the standard of care in his or her profession, thereby causing harm to a patient and it happens when a patient is harmed by a healthcare professional who failed to meet the standard of care. When a healthcare provider does not meet the standard of care, they have breached their contract with their patient. The concept of the standard of care is often discussed among healthcare providers, and yet the legal definition of this term is frequently not understood. It is estimated that 7–17 malpractice claims are filed per 100 healthcare providers every year with emergency healthcare providers on the front lines of healthcare provision and therefore are frequently involved in medical malpractice cases. Many healthcare professionals need to review evidence-based practices that focus on standard of care and review the best research and clinical expertise to assist them in meeting the needs of patients, far beyond optimum care provision; helping them avoid any mishaps along the way.
Sunny Alperson
Old Dominion University, USA
Title: Finding healers within: Mind-body self-compassion training for nursing and other healthcare professionals
Biography:
Sunny Alperson is a Professor at Graduate Nursing Program at ODU Norfolk VA. She received her PhD from USD, CA and was awarded a Post-doctoral research training fellowship at NIH and another fellowship in Integrative Medicine at the University of Arizona Center for Integrative Medicine under mentoring of Dr. Andrew Weil. Her clinical training is NP; she currently practices in Gerontology. Her research interests include body-mind meditation interventions and the science of compassion, and the application of Qigong and Tai Chi to the health and well-being of patients and healthcare professionals.
Abstract:
Background: With changes of demographics and increased chronic diseases, vulnerable patients need what evolutionary biologists call the ingredients responsible for lasting survival: love, good will, cooperative spirit, inter-connectedness, and compassion from healthcare professionals (HCPs). However, these qualities have been disappearing in modern high stress work environments, with many studies demonstrating increased plasma cortisol and other stress biomarkers in HCPs’ blood. Despite the problem, self-care pedagogy is a missing element in healthcare professions’ education.
Objective: To describe two pilot study results of a new compassion tool for HCPs, Mind-Body Self-Compassion Tai Chi Qigong (MBSC-TCQ). MBSC-TCQ integrates eight simple Tai Chi/Qigong movements with a compassion mantra to enhance integrated absorption of a compassion construct.
Method: Repeated measure pre-post intervention designs were employed in both studies. Participants in the first study were DNP students in an Integrative Medicine workshop format; the second study was conducted with professional caregivers at an Alzheimer facility for 5 consecutive weeks.
Results: Integrative medicine attitudes questionnaire, mindful self-compassion scale, and spirituality perspective scale were significantly elevated in both studies. Measures in the second study, including general self-efficacy, psychological well-being were significantly increased and care burden was decreased. A secondary hypothesis for caregiver impact on patient behaviour was measured with Ativan use and behavioural incident reports; both were significantly reduced one month post intervention compared to one month prior. Strong emotional receptiveness for compassion training was present in both study groups. With further studies, MBSC-TCQ shows potential as a useful tool that can be disseminated in educational and clinical settings.
- 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.