Day 2 :
University of Tennessee Health Sciences Center, USA
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.
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.
Dalhousie School of Nursing, Canada
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.
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.
Seton Hall University, USA
Time : 11:20-12:05
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.
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.