Day 1 :
- Nursing Care Management | Nursing Care Education and Research | Cancer Nursing Care | Midwifery Nursing Care
Tung Wah College, Hong Kong
Background: Nurses are required to work collaboration with other healthcare disciplines. Small group work, as one of collaborative learning, is a favorable teaching method to develop and foster personal and professional attributes in nursing education. Evidence showed that this approach enhances knowledge and multi-skill development. Since nursing students are involved in small group work, their experience of learning attributes in small group work is under-investigated. Therefore, the aim of this study was to understand perspectives of learning attributes among undergraduate students in small group work. Method: A qualitative design with a purposeful sample was conducted. Data were collected using an in-depth focus group interviews. Results: Four groups of undergraduate students were interviewed. Three main categories, including self-motivation potentials, empowerment of interactive group dynamics, and barriers were derived towards students’ learning in small group work. Each theme consists of key components that are crucial to direct supporting areas for optimizing students’ learning in small group learning. Based on these identified themes, students can engage in small group learning with certain degree of knowledge enhancement and multi-skill development. The barriers students experienced reduce their feeling of satisfaction and achievement in small group learning. Conclusion: Small group work is an effective teaching mode to enhance knowledge and skill development in nursing education. Such development embraces personal and professional attributes of all-rounds. A multi-disciplinary teamwork is required to achieve optimal patient outcomes in current healthcare services. Effective collaborative training becomes an essential component in nursing education. All themes identified in this study affect students’ learning and performance in collaborative small group learning. The results provide directions for nurse educators to create appropriate collaborative small group working environment in order to enhance students’ learning in knowledge and skills. Educators need to be aware of barriers and develop corresponding strategies to facilitate students’ learning.
Tung Wah College ,Hong Kong
Dr. Anson Tang is currently an Assistant Professor at Tung Wah College of Hong Kong. She has been working in the field for over 10 years and has enormous experience in teaching various nursing programmes in hospitals and tertiary institutions. She is also the programme leader of the baccalaureate nursing programme at the College and has been involving in various programme accreditation exercises. Her recent research interest is nursing education especially on innovative teaching and learning methods.
Background: Nursing students are facing much stress in the course of study especially in the clinical practice component. The unpredictable and complex clinical environment imposes them much pressure and the way they cope with the pressure is essential as the inappropriate coping will definitely have negative impact on the quality of patient care. Since limited literature is available to report the factors affecting their stress level during clinical practicum and their coping strategies in Hong Kong, this study aims to explore the factors affecting nursing students’ stress level and their common coping strategies. Method: A cross-sectional study was conducted to explore nursing students’ stress level, stressors and coping methods during clinical practice in Hong Kong. Baccalaureate nursing students who had completed all clinical practicums required by the undergraduate nursng programme were the accessible population. Simple random sampling was used to randomly select students from a class list of that nursing programme by drawing lot. The participants had to complete the self-reported questionnaire which comprised the demographic survey, Assessment of Stress among Nursing Students and COPE Inventory. Results: A total of 131 eligible students returned the questionnaires with a response rate of 100%. They perceived that the most stressful events during the practicum were performance of practical activities and professional communication. Participants were prone to use problem or emtion-focused coping strategies but they will use non-functional coping strategies especaiily in female students. Female students used more social support, mental disengagement and focus on and venting emtions as compared to those in male students (p<0.05). Conclusion: nurse educators and clinical mentors shall pay more attention to students whom may tend to use non-functional coping methods to deal with their stress. Further studies may focus on investigating the association between the characteristics of students and the use of non-functional coping strategies.
Kwassui Women’s University, Japan
Yoshiko Yamaguchi has received her Ph. D in Kyushu University, Japan. Currently, she is working as research associate in Home Care Nursing, Faculty of Nursing, Kwassui Women’s University, Japan. She has successfully completed her responsibilities as reviewer for 11 papers from year of 2016 to 2017. She is serving as an editor of International Journal of Nursing & Clinical Practices and Journal of Comprehensive Nursing Research and Care. And she is honorary president of the scholarly association IAPHLSR: International Association for Promotion of Healthcare and Life-Science Research. She has been awarded as a best presentation of 7th International Conference on Healthcare, Nursing and Disease Management, 2016, Singapore. (Oral presentation), and as a best paper of Journal of Japan Academy of Nursing Administration and Policies, (Research article), 2013.
Shortage of nurses is a serious problem in many countries. Previous research reported that nurses' intention to leave work was related to family variables, such as parenting or work-family interface (e.g., work-family conflict and work-family enrichment). We conducted an empirical research to identify the relationship between nurses’ intention to leave work and their family variables. The following results were derived: (1) parenting was not directly related to nurses’ intention to leave work, (2) female nurses’ intention to leave work was affected by their gender role orientation rather than their actual family role (female nurses who have traditional gender role orientation feel more intention to leave work than nurses who are egalitarian), however, there was no significant relation among male nurses, (3) nurses in hospitals and nursing homes showed that work-family conflict was directly and positively associated with their intention to leave work, however, there was no significant relation among home healthcare nurses, (4)work-family culture and family stress were directly positively related to home healthcare nurses’ intention to leave work, (5) the intention of hospital nurses’ in their twenties to leave nursing was negatively related to work-family culture, however, there was no significant relation in other age groups. Thus, we concluded that nurses’ family variables had complex effects on their intention to leave work.
Hawaii Pacific University, USA
Dr. Kathleen Burger is a professor of nursing at Hawai¢i Pacific University on the island of Oahu. Her over twenty years experience in nursing education include teaching in undergraduate, graduate, and doctoral nursing programs as well as program administration. Dr. Burger holds a PhD in nursing from Duquesne University, MSN from Drexel University, MSEd from Long Island University, and has been a National League for Nursing (NLN) certified nurse educator (CNE) since 2005. Her research interests center on nursing education and the meaningful connection of educational outcomes to workplace competencies.
Nursing practice in today’s dynamic healthcare workplace is an increasingly complex and cognitively distracting enterprise in which multiple and shifting sources of information must be accurately interpreted and acted upon, while also managing workflow interruptions. Stress and cognitive overload are frequently reported by novice nurses and these are known to exacerbate human error. To ensure the delivery of safe, qualitypatient care additional nursing education strategies are needed to adequately prepare graduates for this level of cognitive complexity.
Recent and accumulating neuroscientific research suggests a strong correlation between the regular practice of focused meditation such as mindfulness meditation (MM) and enhanced attentional capacity. Regular practice of MM is also associated with improved feelings of well-being, compassion, and other mental-health benefits useful in mediating stress. This study examined these findings in the context of nursing education by measuring the differences between pre-licensure nursing students who meditated and those who did not on attentional efficiency, stress, and mindfulness outcomes . Students who participated in four weeks of daily MM practice demonstrated significant improvement to executive attention efficiency as compared to a non-meditating control group. Additional outcomes specific to the meditation group were reduced stress and increased mindfulness. These results support consideration of meditation training as a curriculum innovation for increasing attentional efficiency of nursing students as well as improved self regulation of stress, each of which may in turn improve the delivery of safe, quality patient care.
United States of America
Among heart failure patients in rural communities, nurse practitioners play an essential role in consulting and working along with other healthcare professionals, such as nurses, nutritionists, therapists, pharmacists, and physicians. A quality improvement project was developed to ensure that selected core measure sets from the Centers of Medicare and Medicaid Services (CMS) for heart failure management were met in the outpatient setting of a rural family practice in the Southeastern US. Patients 18 years of age or older with the diagnosis of heart failure were included which is International Classification of Diseases (ICD) version 9 code of 428.0. A sample of 56 patients was used. The clinical staff included one physician, two nurse practitioners, and one physician assistant. The project director analyzed the charts for 1) use of angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) medication or document for contraindication and 2) report of left ventricular function (echocardiogram or cardiac catheterization). The intervention included providing chart prompts to the providers and nursing staff to increase compliance with CMS core measure standards for heart failure management. The pre-QI audit identified 49 patients or 87.5% of the study population who met the ACEI or ARB medication criteria prior to the intervention. After the intervention, 54 patients or 96.4% were brought up to compliances. The pre-QI left ventricular assessments identified 49 patients or 87.5% that already had an echocardiogram or heart catheterization in their chart. After the post QI audit, 53 patients or 94.6% were brought up to compliance.
Khon Kaen University, Thailand
Mrs.Suteera Pradubwong has completed master degree of nursing for 12 years from Khon Kaen University. She is the Nurse specialist and Nurse Coordinator for nursing care Patients with Cleft Lip and Palate at Tawanchai Cleft Center and Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. She has published more than 10 papers in reputed journals.
Background: Tawanchai Cleft Center, KhonKaen University has continually organized the comprehensive care development project for patients with cleft lip and palate in Khon Kaen province for 5 years. The project targets to improve the participants’ quality of life in 5 aspects comprising of health, education, livelihood, social, and empowerment.
Objective: To evaluate outcomes of Quality of Life Program.
Material and method: The descriptive study was conducted during May 5-6, 2017 Khon Kaen Province. There were total 108 participants. The activity in day one included personality development and lecture on patients care. The second day activity included of 5 stations which involved 5 aspects development. Data was collected through questionnaires and assessment form. Statistical analysis was carried out using percentage and content analysis during 3 months periods (May – July 2017).
Results: Most of participants were male with number of 24 persons (57%). The majority deformities were RCLP with 14 persons (33%). According to the 5-aspects development model, the health aspect was provided for participants including of health status assessment, health care advice, and experience sharing. The education aspect activity was family planning. The livelihood aspect provided education and career opportunities knowledge. The social aspects encouraged the socialization. And for the empowerment aspect, the activities were conducted by enhance self-esteem and assertiveness. The program assessment revealed that the participants had high satisfaction at percentage of 89 ( = 4.45).
Conclusion: The participants successfully achieved knowledge and care giving advice. They had opportunity to share experience in health care, education, social, livelihood, and empowerment which contributed to the abilities to express their feeling and become self-assertive. Therefore, the project should continually organize and include family, friends, and community to achieve best quality of life.
Graceland University, USA
Dr. Wilaiporn Rojjanasrirat is a Professor and Director of Research and Scholarship at Graceland University School of Nursing, Independence, Missouri. She is currently teaching research and evidence-based courses in the MSN and DNP on-line nursing programs. Her research focuses on promoting and supporting breastfeeding mothers, health promotion in vulnerable populations, psychometric development and testing, and educational evaluation. Dr. Rojjanasrirat also serves as a current president of the Greater Kansas City Lactation Consultant association, and a Board Finance Committee Chair of the Mother and Child Health Coalition of Greater Kansas City, Missouri.
Background: The needs for evidence-based practice (EBP) competencies stemmed from the increasing demands of measurable quality and efficiency of current healthcare outcomes. Thus, assessment of learning and teaching of EBP are essential components of nursing curricula to prepare graduates as effective providers for the future healthcare workforce.
Purpose: To evaluate EBP competencies by comparing knowledge, attitudes and practices (KAP) of EBP scores among online graduate nursing students in Master’s (MSN) and Doctor of Nursing Practice (DNP) programs.
Design: A cross-sectional study was conducted at a private university in Mid-Western, USA.
Methods: The samples included 60 online graduate nursing students from three cohorts were invited to participate in the project. The new MSN students were asked to complete the survey prior to taking an EBP course. The exiting MSN and DNP student groups completed the survey following completion of the EBP application courses. The Evidence-based Practice Questionnaire (EBPQ) (Upton, 2006) was used to measure EBP competencies. Descriptive statistics ANOVA were used for comparison of EBP-KAP scores across groups.
Results: A total of 60 online graduate students participated in the survey. The mean age of students was 37 (SD=8.7). The mean EPB knowledge scores approached significance level among three group, F(2, 54) = 3.019, P = .057. Although a progressive increase in attitudes and practices of EBP scores was noted, no statistically significant differences among groups were found. Having research experience was the best predictor of EBP knowledge/skills (r = .29, P = .03). Years of experience as a professional nurse and completion of a research or EBP course in the past were not associated with knowledge/skill, attitudes or practice of EBP.
Conclusion: Students EBP-KAP did not differ significantly across groups. Further studies are needed to track students’ before and after graduation for a more robust analysis and interpretation of EBP competencies.
University of Texas Health Science Center ,USA
Hyochol Ahn received his PhD degree in Nursing Science in May 2012, and an Associate Professor and the Theodore J. and Mary E. Trumble Distinguished Professor in Aging Research at the University of Texas Health Science Center School of Nursing. His overall research goal is to establish a program of clinical and translational research that enhances health and independence in older adults using innovative technologies to optimize pain management. He have a strong background as a computer engineer as well as extensive clinical experience as a registered nurse (RN) and adult nurse practitioner-board certified (ANP-BC). He received a Sigma Theta Tau International Alpha Theta Chapter grant as principal investigator in 2011 for a project that examined pain and functional outcomes in older adults. In addition, he served as principal investigator of a grant funded by the National Center for Advancing Translational Sciences and the University of Florida Clinical and Translational Science Institute that investigated ethnic group differences in pain and mobility disability
Osteoarthritis (OA) is the most common arthritic condition, a leading cause of pain and disability in people 45 years and older. There is a growing interest in non-pharmacologic interventions targeting central nervous system pain processing, such as transcranial direct current stimulation (tDCS), for this population owing to its neuromodulatory effects. A panel of experts at the European Chapter of the International Federation of Clinical Neurophysiology recently recommended that stimulation with anode over the primary motor cortex (M1) and cathode over contralateral supraorbital region (SO) for possible efficacy among populations with chronic pain. However, few studies have examined the efficacy of tDCS on experimental pain sensitivity. Thus, we sought to assess the preliminary efficacy of M1-SO tDCS on punctate pain in adults with knee OA pain. We conducted a double-blind, randomized, sham-controlled pilot clinical study in 40 community-dwelling participants with knee OA. The participants were randomly assigned to receive either five daily sessions of 2mA tDCS for 20 minutes or sham tDCS. A calibrated nylon monofilament delivering a target force of 300 grams was applied and verbal ratings of the pain intensity on a scale of 0 to 100 following 10 contacts were obtained to assess their sensitivity to punctate mechanical stimuli on the index knee. The mean age was 59 years (SD = 8 years), and 53% were female. After five daily sessions, the active tDCS group had a marginally greater decrease in mechanical punctate pain (-3.62 ± 4.72) than the sham group (4.12 ± 6.48). The mean difference between groups was 7.75 ± 8.02 (t=0.96, df=38, p=.34, Cohen’s d = 0.30). Although our primary results were nonsignificant, there is a preliminary suggestion that tDCS targeting primary motor cortex may reduce mechanical punctate pain sensitivity in adults with knee OA. Further studies with stronger dose of tDCS and larger samples are needed.
Mrs. Tippawan Muknumporn has completed Bsc.(Nursing & midwife level 1) at the age of 22 years from Faculty of Nursing , Khon Kaen University and postdoctoral studies at the age of 25 years from Anesthesiology Department , Faculty of Medicine, Khon Kaen University. She is the Supervisor of Nurse Anesthetist.
Background: Anesthetic unit is one of the nine units in Srinagarind Hospital that provides care for patients with cleft lip/palate (CLP). Various complications are adverse outcomes that can occur in these patients during the operation. To prevent these complications the key performance index (KPI) for anesthetic nurses should be developed.
Objective: To develop and monitor the KPI of the quality of care in patients with CLP in anesthetic unit of Srinagarind Hospital.
Material and Method: The descriptive method was used in this study. The researchers obtained the demographic and illness history data of the patients from medical records. Moreover, focus-group discussions were performed among anesthetic nurses to identify proper nursing care to prevent operative complications. Themes emerged from medical records and focus-group discussions were used to develop the KPI which was used as a nursing practice guideline to prevent complications. Also, the information technology system was developed to record and monitor the KPI. The researchers tested the KPI with 67 patients who underwent an operation in Srinagarind Hospital from March to June 2014. The results were measured and analyzed using frequency and percentage distributions.
Results: Out of 67 patients, 21 (31.34%) had cleft lip, 30 (33.78%) had cleft palate, 13 (19.40%) had abnormalities of the mouth and nose, and 3 (4.48%) had fistula in the palate, respectively. Two KPIs were developed including the prevention of intra- and post-operative complications (such as respiratory problems, bleeding, nausea, and vomiting) and pain management. By using the KPIs, 66 patients (98.5%) had no complications during the operation. Only one patient (1.2%) had nausea.
Conclusion: The KPI is proper for anesthetic nurses to use with the CLP patients who undergo an operation.
Key word: Key Performance Index, Quality of Care, Cleft, Anesthetic
Sichuan University School of Medicine, China
MengQin Zhang has completed her bachelor's degree in 2015 from XiangYa School of Medicine, Central South University, in Changsha, Hunan Province. She’s learned nursing skills in the Second XiangYa Hospital of Central South University for 1 year from 2015 to 2016.She is a nursing master candidate majoring in Obstetrics and Gynecological Nursing in the West China College of Medicine, Sichuan University.She has published 2 papers in the first year's study. Her master's project is midwifery nursing which is going on.
Background: Since 1995, the WHO have restricted the liberal use of episiotomy, stating that restrictive episiotomy has a number of benefits.Despite of that, episiotomy is still the most common surgical procedure performed on women and the incidence of episiotomy reported internationally differs considerably. Most indications of episiotomy are not congruent with practice guidelines. The aim of the study was to identify incidence and indications of episiotomy in a certain tertiary hospital in Chengdu. Objectives: To assess the incidence of episiotomy and risk factors of mediolateral episiotomy during vaginal birth, to assist midwifves in identifying women who are at especially high risk for episiotomy,and to provide relative evidence to change episiotomy practice and reduce the episiotomy rate ultimately. Methods:A retrospective study was performed using data from the hospital-based birth registry system for 1624 normal vaginal singleton deliveries of a fetus in cephalic presentation at term without the use of vacuum extraction and forceps over a period of 6 months from January to June 2017.Multivariable logistic regressions were used to identify combinations of risk factors of episiotomy. Main outcome measures were episiotomy rates, odds ratios for risk factors: age, minority, parity, gestational age﹥40 weeks, birthweight, transverse outlet(TO), biparietal diameter (BPD) and femur length(FL) of fetus, and some labour complications. Statistical analyses were performed using IBM SPPS Version 22.0. Results: The episiotomy incidence was 41.7% (677/1624), 50.4% (625/1240) for primiparas and 13.5% (52/384) for multiparas (p<0.001). Risk factors for episiotomy were birth weight﹥3500g(OR,1.39;95%CI,1.06-1.83;P=0.019), Gestational age﹥40 weeks(OR,1.29;95%CI,1.03-1.62;P=0.029), BPD(OR,2.23;95%CI,1.53-3.25; p<0.001),maternal age(OR,1.04;95%CI,1.01-1.07;P=0.038). We found protective effects of multiparas(OR,0.13;95%CI,0.09-0.18;p<0.001)and large for TO(OR,0.52;95%CI,0.38-0.71; p<0.001). No significant difference were found in FL ,minority, and labour complications such as gestational diabetes mellitus(GDM), pregnancy-induced hypertension(PIH), heart disease in pregnancy. Conclusions: The episiotomy rates differed significantly in parity and BPD, indicating the misleading perceptions of prolonged second stage and large for fetal head. With reduction in episiotomy rates as a goal, we suggest that a focus group study is to explore midwives' reasons for performing episiotomies.
Sichuan University, China
Ping Ni has got her bachelor degree in nursing in 2012. She is a nursing master candidate in West China School of Medicine, Sichuan University now. She has finished her one-year internship in a grade A tertiary hospital, and now is an intern in West China Hospital, Sichuan University.
Objective: The purposes of this study was to assess the effectiveness of a web-based diabetes education project on diabetic knowledge of nurses from non-endocrinology departments.
Methods: This research was conducted on 542 nurses from 10 hospitals. They were asked to register on the Johnson & Johnson Diabetes Institute and take the course called “Specialized Training Program on Blood Glucose Management of Inpatients”. The course consists of 4 major sections and 8 subsections. Nurses registered on the website and logged into the site to take courses according to their own time. Tests were used to measure diabetic knowledge before and after the intervention. Each pre- and post-test consists of 10 questions each worth 10 points .Descriptive statistics analyzed demographic data, and t-test compared data before and after the intervention by SPSS.
Results: After the intervention, all the mean scores were above 80 points (out of 100).The pre-test mean score of Blood Glucose Monitoring was (80.30±20.47) which increased to (92.41±9.75) in post-test(t=-12.107,p<0.001). The pre-test mean score of Emergency Treatment for Hyperglycemia/Hypoglycemia Crisis was (93.86±8.18) and increased to (96.37±7.68) in post-test(t=-14.776,p<0.001). For Nursing of Hypoglycemic Agents, it increased to(89.19±10.14) from (74.78±17.37)(t=-15.562,p<0.001).The last part mean score was (77.10±17.54) and increased to (92.13±7.81) (t=-4.371,p < 0.001).
Conclusion: Web-based diabetes education can increase diabetic knowledge of nurses from non-endocrinology departments, and this might have a positive effect on nursing quality and clinical outcomes of patients.
Tung Wah College, Hong Kong
Dr. Luk obtained her Bachelor and Master of nursing in Sydney University. Her doctoral degree was obtained from Hong Kong Polytechnic University and her research interest is care for infertile couples. She is currently work in School of Nursing, Tung Wah College as senior lecturer.
Background: Infertility is a condition affect couple as unit. The aim of the study is to identify infertility-related stress, and to determine the levels of self-esteem, sexual satisfaction, perceived intimacy, and partnership support among infertile couples.
Method: This is a cross-sectional study
Results: Total 113 couple’s questionnaires were analyzed and presented in this report. The results of this study show that infertile couples in Hong Kong were bothered by infertility-related stress. Women suffered significantly more than men in the areas of social concern, sexual concern, and relationship concern. Women viewed parenthood as a more important issue than men and would go to any effort to achieve it (women 76.1% vs. men 59.3%). About half of the women (57.5%) and men (49.6%) did not think that their sex life was wonderful, and claimed that their partner was not very sensitive to their sexual needs or desires. Luckily, more than eighty percent of the participants in this study reported that they experienced partner support. The correlation results in females indicated that increased levels of partner support, intimacy, and sexual satisfaction are associated with higher self-esteem and lower levels of infertility-related stress. The correlation in males indicated that increased levels of perceived intimacy and sexual satisfaction are associated with higher levels of self-esteem and lower levels of infertility-related stress.
Conclusion: Interventions to strengthen partnership support among couples and their sexual satisfaction and intimacy will be an essential topic in the future to help infertile couples address their infertility-related stress.