36^th Global Nursing Care & Education Conference 2018-08-29 Boston, Massachusetts, USA

Biography:

Dr. Ubani is the founder/CEO of Nursedrcomications.com, an online platform, and provider of networking services on issues of clinical practices, health policies, and nursing education. He writes, publishes, lectures, and consults on issues related to outcome-based, patient-centered clinical practices. He advocates for holistic approaches to healthcare management, health policy, and innovative healthcare delivery systems to support diversity in healthcare leadership. His scholarship focuses on collaborative healthcare practices among clinicians and the establishment of health system cultures that reflect the diversity of populations. To promote interdisciplinary collaboration and patient-centeredness, he champions what he calls the "right care" for the client. He conducts education sessions, online seminars/workshops and direct classroom teaching to provoke critical thinking among clinicians in the areas of interdisciplinary collaboration, and best practice models for patient-centered caring.

Abstract:

Statement of the Problem: New healthcare delivery paradigm now focused on cost savings and quality-based health outcomes would require that nurses play central roles in patient care but there is lack of synergy in the use of nursing evidence-based protocols to complement medical protocols.

Methodology: A mixed methods approach of data collection and analysis in surveys, structured interviews, and open discussion forums explored clinical attitudes on the use of nursing evidence-based protocols (EBP) among a convenience sample of 50 nurses, 12 physicians and, 3 administrators. Nurse-physician Communication Tools (NPCT) generated responses from participants. Concepts from the Trans-theoretical Model of Behavior Change (TMM) provided guidelines for implementing provider interaction at different stages of the project.

Findings: Effective communication among clinicians enhances the use of nursing EBPs. Nurse-physician collaboration influenced the use of nursing EBPs through meaningful interactions and shared experiences and NPCT provided a mechanism for practice changes needed to enhance clinical collaboration and the use of nursing EBPs. Implications for practice indicate the use of NPCT to enhance nurse-physician collaboration to bridge gaps in practice and reduce healthcare costs. Future studies on these specific relationships including the lack of nurse-physician communication mechanisms and limited use of nursing EBPs in clinical settings is recommended to understand the other effects of human interactions, emotions, and personal experiences.

Conclusion: Nursing EBPs implemented in this study fostered interdisciplinary learning and clinical collaboration when applied in a meaningful interactive bonding environment using the NPCT.

Biography:

Dr. Tiffany Kelley is the Founder and CEO of Nightingale Apps LLC and iCare Nursing Solutions LLC. Nightingale Apps began with  Know My Patient ®, a patent-pending mobile application designed to provide nurses with patient information at their fingertips while on their patient care unit. Her second company, iCare Nursing Solutions LLC, provides consulting and education services to healthcare organizations and nursing informatics professionals in need of health IT and/or informatics solutions to address their daily operational needs. Dr. Kelley is the author of Electronic Health Records for Quality Nursing and Health Care. She has served on the BOD for AMIA and currently a Director for ANA Mass. Kelley earned her Ph.D. from Duke University, her MS and MBA from Northeastern University and BSN from Georgetown University. Dr. Kelley was recently awarded the Smart Health award for Excellence in Healthcare Innovation in 2018. 

Abstract:

Biography:

Dr Karin Ciance has more than 34 years of experience in nursing including medical-surgical, rehabilitation, urgent care, women's health, and management. She received her Diploma in Nursing from Worcester City Hospital School of Nursing, a Bachelors of Science in Nursing from Worcester State College, a Master's of Science in Community Health Nursing from Worcester State College, and a Doctor of Nursing Practice from Walden University. Dr Ciance has served as Adjunct Faculty and Faculty Mentor for several local colleges and universities including Worcester State University, Massachusetts College of Pharmacy and Health Sciences, and Atlantic Union College. She is the Executive Director for Greenwood Street Medical Clinic in Worcester, Massachusetts. Her current areas of interest are fall prevention and simulation in nursing practice.

Abstract:

Purpose of Study: The purpose of this pilot study was to determine the effects of the Sure Steps® Falls Prevention Program on the incidence of falls for adults aged 65 years and older living in their homes.

Rationale and Significance: In the United States, each year one in three adults aged 65 years and older has a fall resulting in a higher risk for mortality. The Centers for Disease Control and Prevention (CDC) estimates that at least 25,000 older adults in the US die as a result of falls. Falls affect the quality of life for elders, increase healthcare system expenditures, and place a burden on nursing care.

Description of Methodology:  Phase 1: Nurses reviewed with the participants’ a medication log, a symptom log, and the fall prevention Sure Steps® guidebook. Physical therapists obtained a Falls Efficacy Scale (FES) score, providing individualized education related to balance and exercise routines.   Phase 2: Follow-up telephone surveys were conducted on a monthly basis for one year, consisting of four questions while reviewing the Falls Efficacy Scale assessment.

Subjects: Ten adults aged 65 years and older living in the community receiving services from the Visiting Nurses Association (VNA) were enrolled in the Sure Steps® Falls Prevention Program.  A convenience sample was utilized from the participants who met inclusion criteria.

Findings: No falls were reported by participants who received monthly telephone follow-up surveys over the one year timeframe.  All participants’ adhering to the exercise routine that made the recommended home modifications either had an improved FES score or remained the same.

Conclusions: The Sure Steps® Program decreased the fall risk for the sample group while increasing their overall confidence with their ability to prevent a fall. Based on the implications of this pilot study, staff received training on the Sure Steps® Fall Prevention Program at four additional office sites of the VNA.  Educating, and engaging, elders in the Sure Steps® Fall Prevention Program has the ability to prevent falls and enable elders to lead more productive lives should future studies correlate with finding adoption by all agencies is possible.

Recommendations for Future Study: Further study with a larger sample size and comparison group is warranted to determine the larger scale effects of the program. This could identify causal relationships and whether patient education; the combination of the individualized strength and balance exercise routine; coupled with the medication and symptom log reduced the incidence of falls. The Sure Steps® Fall Prevention Program could be used by other visiting nurses and homecare agencies across the state and the United States to provide more detailed definitive data on program outcomes.