Day 2 :
Keynote Forum
John F. Inciardi
Touro University of California, USA
Keynote: A grand unifying theory of everything true in clinical research
Time : 10:40 AM to 11:20 AM
Biography:
John F. Inciardi has lectured extensively at home and abroad on topics related to causal inference. During this time he has developed coursework related to this topic at several universities and has received teaching awards in recognition of these efforts. As a faculty member of the Departments of Pharmacy and of Internal Medicine at the University of California, Dr. Inciardi has been a long-time mentor to residents and fellows during the design and analysis phases of their health-related investigations. He holds doctoral degrees in both pharmacy and clinical epidemiology
Abstract:
When judging the effects of treatment, health-care providers face the critical task of distinguishing truly causal relationships apart from mere (non-causal) associations. Unfortunately, the task of identifying ‘biasing pathways’ that alter the true effect of an exposure is often a daunting and frequently overlooked adventure. As a result, today’s health-care provider faces a bewilderment of seemingly contradictory reports, some of which appear in highly regarded medical journals. Epidemiologic studies are commonly constructed around three types of variables: Exposure, outcome and a ‘third’ variable that carries the potential to bias the exposure-outcome relationship. The recent merger of graphical probability theory with established methods for constructing causal diagrams has led to the creation of sophisticated yet highly intuitive tools for establishing causal inference. This seminar will provide an update on contemporary methods for identifying common threats to the validity of a clinical investigation. The speaker will argue that health care providers by virtue of their education and training are uniquely qualified to provide the expert knowledge requisite for establishing
causal inferences. Participants should be able to meet the following course objectives:
1. Define confounding from the traditional perspective and from the (modern) structural alternative.
2. Identify sources of confounding and selection bias given a directed acyclic graph that accurately conveys the
expert knowledge of the investigator.
3. Create strategies to adjust or remove biasing pathways responsible for creating confounding and selection bias.
Keynote Forum
Stephen Jacobs
The University of Auckland, New Zealand
Keynote: Thriving at work as a framework for building highly engaged RNs, motivated and committed to quality patient care
Time : 10:40 AM to 11:20 AM
Biography:
Stephen Jacobs PhD (Medicine) DipTchg BA is a senior lecturer in the School of Nursing at the University of Auckland. He lectures in leadership and management. He is the PhD Advisor and coordinates the Bachelor of Nursing (Honours) programme. He also coordinates the Nurse Wellbeing Project, working in partnership with health providers and School of Nursing academics using research to assist providers develop new management approaches and educational programmes that will support nurses to thrive.
s.jacobs@auckland.ac.nz
Abstract:
This research is the first step in a long-term research programme answering the question: What is the best way to prepare nurses for, and support nurses in, their roles in the nursing workforce so that they flourish in their roles? The School of Nursing delivers a New Entry To Practice (NETP) programme for nurses from different undergraduate providers who are now working in different organisations. Baseline information together with information on the factors that influence intention to leave provides the core information from which a co-design approach is being taken with hospital providers to explore new ways of managing the nursing workforce. The research follows a strengths-based Appreciative Inquiry (AI) co-design model, working with nurses on the floor and nursing mangers creating a workforce management model that supports nurses to thrive while also meeting the need of a hospital to provide quality service. Nurses at the end of their NETP year, and years two and three after their NETP year, are being asked what aspects of their training and their workplace have supported them to thrive as new nurses, and then what their dream training and support would be. The
benefits of this research will be a greater understanding of training and instructional factors that impact on the ability of early career nurses to thrive. From this basis, further research will work with nurses, educational institutions and health providers to co-create improved systems of training and support that may assist with the thriving and retention of nurses.
Keynote Forum
LeAnne Young
Memorial Healthcare System, USA
Keynote: When they can’t tell you why it hurts: The importance of implementing a nonaccidental trauma guideline
Time : 11.40 AM - 12.20 PM
Biography:
LeAnne Young is the Pediatric Trauma Coordinator at Memorial Regional/Joe DiMaggio Children's Hospital (an ACS verified Adult Level I and Pediatric Level II Trauma Centre) in Hollywood, FL. Her professional career has predominantly focused on the care of the pediatric trauma patient and trauma nursing education. Throughout her 12 years as a pediatric trauma nurse, LeAnne has held leadership positions in trauama program administration, worked in trauma clinical research, and post-acute trauma care management. She is an active member in the STN on the ATCN and Pediatric committees and serving as co-chair of the non-accidental trauma work group.
leyoung@mhs.net
Abstract:
Introduction: According to the Federal Child Abuse Prevention and Treatment Act of 2010, Child Maltreatment is defined as “any recent act or failure to act on the part of a parent or caregiver which results in any of the following: death, serious physical or emotional harm, sexual abuse and/or sexual exploitation” (CAPTA, 2010). Child Maltreatment remains a significant problem in the United States, accounting for over 700,000 reported victims in 2014; resulting in approximately 1580 deaths; an average of 4 deaths each day (Centres for Disease Control, 2014). Proper identification and assessment of victims of child maltreatment is essential for healthcare providers. However, many practitioners and healthcare systems do not have a standardized approach to the identification and assessment process, resulting in variations in management. This is especially true in cases of non-accidental trauma. By establishing a non-accidental trauma guideline, a trauma program can facilitate a standardized process, minimize practitioner bias, and minimize the risk of missing potential victims of abuse
Objectives:
1.Child Maltreatment remains a significant problem within the United States, resulting in approximately four paediatric deaths each day.
2.The identification and management of patient with suspected non-accidental traumatic injuries requires a systematic approach
3.A standardized non-accidental trauma guideline helps eliminate healthcare provider biases.
Case Presentation/Project Design: Over the course of a year the Paediatric Trauma Program identified several opportunities for improvement in the assessment and management of patents with suspected non-accidental trauma at a community based Paediatric Trauma Centre. During this time there was no established non-accidental trauma guideline. This necessitated the need for the development of a standardized non-accidental trauma guideline to be utilized for patients presenting to the Emergency Department and for direct admission inter-facility paediatric trauma transfers. The development and approval process for the standardized guideline involved a multi-disciplinary approach and took place over the course of eight months. Since the implementation of the guideline there have been no missed injuries in patients with suspected non-accidental trauma.
Discussion/Future Steps/Conclusion: A non-accidental trauma guideline provides a standardized approach to the identification, assessment, and management of patients with suspected non-accidental trauma, and is an essential component in any Paediatric Trauma Program. This type of guideline is equally important in combined programs or in Adult Trauma Programs that also manage paediatric trauma patients. While the development and implementation of a standardized guideline is an important first step, trauma programs must also conduct ongoing monitoring to ensure that the guideline is being followed as part of their performance improvement process.
- Types of Nursing Education | Nursing Research and Evidence Based Practice | Future of Nursing Education | Legal Nursing Professional and Continuing Nursing Education | Teaching Strategies in Nursing Education | Pediatric Trauma
Chair
Stephen Jacobs
The University of Auckland, New Zealand
Session Introduction
Shelene Giles
FIG Education, USA
Title: Nurse life care planning: Beyond the bedside and into the courtroom
Time : 10:00 AM to 10:40 AM
Biography:
Shelene Giles is a licensed Registered Nurse and her certifications include Certified Nurse Life Care Planner, Certified Life Care Planner, Certified Rehabilitation Counsellor, Medicare Set-Aside Consultant Certified, and Legal Nurse Consultant Certified at Hendersonville, NC, USA. She has extensive knowledge in the specialty practice of nurse life care planning. She holds college degrees in Nursing, Rehabilitation Counselling, Psychology, and Business Administration. Decades ago, her career began in assisting those with disabilities in the community. Her attention moved toward understanding the effects and life-changing events of a catastrophic injury/illness. She discovered the valuable impact of nurses in the litigation settlement process. She specializes in determining future cost of care in catastrophic cases. She provides her knowledge as an expert witness. Between 2007 – 2009, she served on the AANLCP Executive Board as President. She is an internationally recognized speaker/ instructor/mentor/coach and has peer-reviewed publications. She has gained a reputation for being an effective hands-on and compassionate educator.
shelene@figeducation.com
Abstract:
The American Nurses Association (ANA) defines nursing as the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. Nursing is a key element in patient survival as well as in the maintenance, rehabilitation, and preventive aspects of healthcare. Nurses utilize their education and professional experience to develop a nursing care plan for patients in a medical setting. The nursing care plan and the nursing process have been taken beyond the bedside and into the courtroom. This specialty practice is Nurse Life Care Planning - dealing with individuals who sustained a catastrophic injury/ illness resulting in litigation, outlining a plan of care with associated costs, and testifying on behalf of the patient’s needs. Just as the bedside, the nursing process is the foundation of Nurse Life Care Planning. We are entrepreneurs of a nurse owned business. We have chosen to step away from the bedside – but not step away from our roots as a nurse. We have taken our nursing skills to a higher level. We are the highest paid nurses in the world. We are nurses that specialize in Life Care Planning. Studies show there is a growing need for Nurse Life Care Planners who advocate for patients in the courtroom. This presentation will explain the specialty practice of Nurse Life Care Planning, define the method of Nurse Life Care Planning, demonstrate the nursing process beyond the bedside, and introduce nurses into an entrepreneurial mindset.
Azahara Torres Santos
University of León, Spain
Title: Nursing role in the assessment and nutritional support in oncological patients
Time : 12.45 PM - 13.10 PM
Biography:
Azahara Torres Santos graduated in nursing degree by the University of León (Spain) between 2010 - 2014. When she finished her degree in 2014, she started to work in a nursing home, where she was in charge of 49 residents, in order to acquire professional experience. After one year and a half working there, she decided to try working as a nurse in a different country and moved for a job in an Endocrine and Elderly Care ward in Basildon and Thrurrock University Hospital in UK, and worked there nearly two years and a half. Back in Spain, in her native country, she got a job in the Leon University Hospital where she had her placements during the degree. Currently she is working there in general medicine and palliative care. She do not have any specialization or post graduated master although she studied several post graduated courses to keep me up to date. However, her professional career has been performed mainly on the elderly care field which find rewarding.
azahara_cisneros@hotmail.com
Abstract:
Cancer is a disease with great importance in the sanitary field due to the high morbi-mortality. Cancer patients have a high risk of malnutrition as consequence of the deterioration of the disease itself and the gastrointestinal effects of the treatment against the disease. A large number of studies have shown that the presence of malnutrition in cancer patients reduces the prognosis, the effectiveness of the treatment as well as the quality of life of these people. There are several tools that allow assessing the nutritional status of the oncological patient before, during and after treatment. The systematic use of these assessment instruments contributes to the rapid detection of patients at risk or with malnutrition, and allows the early implementation of nutritional support strategies to help the treatment and improve the quality of life. The role of nursing in malnutrition related to cancer is crucial at the time of making the nutritional assessment and monitoring of patients during the process.
Objective: To know the different tools for the nutritional assessment of the oncological patient and its effectiveness in the detection of the risk or stage of malnutrition. On the other hand, it is proposed to determine the nutritional strategies based on scientific evidence, that are needed in order to establish care for cancer patients with malnutrition. Material and methods: This bibliographical review was achieved through the search of scientific evidence in Pubmed, google academic, LILACS and Cochrane Library databases. The search was limited to articles published in the last five years, and its critical reading.
Results and conclusions: The studies reviewed show the existence of several nutritional assessment tools that are effective in detecting and monitoring malnutrition in cancer patients. However, they determine that these instruments are not routinely used in clinical practice, not taking into account the effects of malnutrition on the disease and its treatment. It has been also detected that there are various beneficial nutritional strategies that depend
on the individual status of the patients
Conclusion: due to the importance of nutritional status in the prognosis and quality of life of cancer patients, it is necessary for health professionals to systematically use the available nutritional assessment tools and apply adequate
nutritional support.
Maria Pratt, Lynn Martin and Ruth Chen
McMaster University, Canada
Title: A multimodal orientation for clinical nursing instructors
Biography:
She is currently an Assistant Professor and Faculty Lead for the BScN Accelerated Stream at McMaster University, Canada. Dr. Pratt’s doctoral research focused on the evaluation of unsatisfactory student performance in professional nursing practice courses from the clinical faculty perspective. One of her research recommendations was to develop a multimodal orientation program for novice clinical faculty. She recently completed the Priority Area in Learning and Teaching (PALAT) grant from MacPherson Institute for Leadership, Innovation and Excellence in Teaching based on this research recommendation. Her other research interests include Scholarship of Teaching and Learning in Higher Education, Student Engagement in Large Group PBL and Clinical Lab, and Interprofessional Simulation Learning. Her primary teaching responsibilities are with the undergraduate program. She teaches PBL courses and supervises professional practice students in adult medical-surgical, oncology, and maternal-child practicum settings.
prattm@mcmaster.ca
Abstract:
There is a growing body of literature on the ‘failure to fail’ unsatisfactory students in nursing and other professional health disciplines. While passing underperforming students can pose serious consequences for patient safety, it can also negatively impact the credibility of educators, nursing institutions, and the nursing profession. Clinical instructors comprise a nursing faculty group that plays a fundamental role in evaluating the learning and development of students. A study at a collaborative undergraduate nursing program in Hamilton, Ontario, Canada revealed that novice and part-time (sessional) clinical instructors tended to pass students who did not achieve course requirements due to personal, professional, and organizational factors associated with failing struggling students. This study further revealed the clinical evaluation process to be emotionally draining for instructors who have
failing students. This current quality improvement project involving a multimodal orientation for novice and parttime clinical instructors was designed to address the clinical nursing faculty concerns that emerged following the study described above. The multimodal orientation consisted of didactic, interactive, and mentorship experiences to develop faculty members’ skill with assessment and evaluation of unsatisfactory students in clinical practice. Ten novice participants with three or fewer years of clinical teaching experience participated in an initial workshop on the ‘failure to fail’ phenomenon and learned how to support struggling students in clinical practice. Then, over two semesters from September 2017 to April 2018, participants were paired with experienced clinical instructors for mentorship. Participants were interviewed at the end of the academic year about the usefulness of the multimodal orientation. Most participants’ accounts revealed that the workshop helped increase their understanding about managing unsatisfactory students in clinical practice. The importance of assigned mentors in assisting novice instructors to navigate clinical teaching and evaluation of unsatisfactory students cannot be understated. This quality improvement project highlights that providing instructors with knowledge, skills, and mentorship during their early clinical teaching careers can develop their confidence in their evaluative clinical teaching roles.
Maria del Carmen Yuste Bazan
Thurrock Community Team, Spain
Title: Literacy review over sedation in patient with non-invasive ventilation therapy
Biography:
Maria del Carmen Yuste Bazan obtained her Nursing Degree in Cadiz University (Spain) and after that she studied a Post-Degree in Urgency and Emergency in The European University from Madrid (Spain). Currently, she is working in Thurrock Community Team (Grays) as community nurse. Previously she was working two years in Basildon hospital (Basildon) in an acute respiratory ward as registered nurse, three years in a nursing home (WZC Koning Albert I, Dilbeek, Brussel, Belgium) as registered nurse and nine years in emergency ward in Gregorio Marañon Hospital (Madrid, Spain) as emergency nurse.
mcyustebazan@gmail.com
Abstract:
Background: NIV is a type of assisted respiration consisting on a machine that delivers a positive pressure into the lungs without using an invasive artificial airway in order to obtain effective inspirations. Usually, when the therapy
starts the patient could refer symptoms like anxiety or discomfort, triggering agitation and doing the therapy ineffective.
Aim: The aim of this study is to observe if giving sedation previous NIV therapy could enhance the efficacy of this treatment.
Methods: For this investigation, qualitative methodology has been used with a literature review design. The scientific search has been done over originals studies which analyse the benefits to provide sedation before NIV treatment. The analysed database have been Lilacs, Pubmed, Chocrane Library and BVC Portal Regional. Sedation and non-invasive ventilation have been used as descriptors. The period of analysis covered from 1st January 2014 until 1st January 2019. Different selection criteria have been applied.
Results: The articles which have passed the review process show that sedation before NIV is beneficial for the patient, decreasing the usual symptoms and the agitation, therefore, increasing the efficacy of the therapy. Some researches
state that one of the adverse effects of the sedation is respiratory depression, however, giving an effective dose has not presented any problems. In addition, the administration of sedation before NIV has shown to be cost effective
reducing the hospital admission.
Conclusion: Even though the scientific literature surrounding the subject of this investigation is limited, the current research suggests that the use of sedation previous NIV treatment provides more benefits than adverse effects. However, more investigations are required to provide stronger evidences that support these findings.
Noelia Ruz Vazquez
Basildon and Thurrock University Hospitals NHS Trust, UK
Title: Electronic cigarettes as an aid for smoking cessation: A nursing approach to their benefits, risk and health complications
Biography:
She is a registered nurse qualified in 2013 by the University of Valladolid, Spain and working for the NHS in Basildon and Thurrock University Hospital since 2016.
noeliaruz91@gmail.com
Abstract:
Introduction: Nowadays, smoking is considered one of the most important preventable mortality causes. Smoking cessation in unquestionable beneficial for public health, as it has been proved in several scientific studies, even when
some of the techniques used are not completely harmless, such as Electronic cigarettes. Nurses have the duty to keep their knowledge updated, so they can develop their best care. The main objective of this study is to recognise the benefits and risks of E-cigarettes as an effective tool for smoking cessation, so nurses could beneficiate from this information on their daily basis.
Methods: It was employed a qualitative methodology with a literature review as a study design. The research was made about original publications that analyse the benefit/risk of E-cigarettes use against conventional cigarettes, between January 2013 and December 2018. Databases used were PubMed, Google Scholar, CINAHL, LILACS and Cochrane Library. Descriptors “DeCS” used were “vaping”, “lung disease”, “smoking” and “tobacco”, utilizing as Boolean operator “and”. As inclusion criteria, original publications written in English and/or Spanish were accepted, as well as full text publications, studies carried through in humans of both sexes who were over 18, and with a sample over 30 individuals. Several publications related to the topic of study were dismissed due to the realisation of chemical test of diverse substances included in e-cigarettes as lab test. After passing all the selection criteria previously described, a last filter was applied using the critical reading tool “CASPe”, obtaining a total of 8 articles that have been included on this report.
Results: 203 studies were initially identified, but just 21 were considered relevant after screening, and just 8 were eligible after passing CASPe. Overall, the analysed results prove that E-cigarettes are one of the most efficient alternatives to quit smoking without professional support. However, E cigarettes use is related to more breathing difficulties and more prevalence of COPD and Asthma, compared to non-smokers.
Conclusions: E-cigarettes may be considered as an interesting tool for smoking cessation in terms of risk/benefit if it is compared to other therapies. However, it could not be considered harmless and further research is needed.
Vumilia Bettuel Mmari
University of Dodoma, Tanzania
Title: The implementation fidelity of competency based curriculum for pre service nursing and midwifery programme in Tanzania
Biography:
Vumilia B. Mmari is a PhD candidate at the University of Dodoma (UDOM) pursuing Doctor of Philosophy in Nursing Education. She is a Nurse Educator
completed MSc degree in Nursing Sciences at Muhimbili University of Health and Allied Sciences (MUHAS) in 2010. In 2015/2016 Vumilia joined Tanzania
Institute of Project Management (TIPM) for Monitoring and Evaluation Programme. She is now working at the Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC) as a National Training Coordinator for Nursing and Midwifery and Community Health Training Programmes at the ministry’s headquarters in Dodoma, Tanzania. She has been serving as a curricula development expert and training materials designer.
vumiliammari@yahoo.com
Abstract:
Ten years of nursing and midwifery Competency Based Education and Training (CBET) curriculum implementation the government of Tanzania has made various interventions to support its implementation. Nurse educators were oriented on the implementation of CBET curriculum and training materials, skills laboratories were established and schools were equipped with ICT facilities. Despite all these efforts there is no evidence on how nursing and midwifery CBET curriculum is being implemented since its adaption in 2008 and major revision in 2017. Thus, the balance between the designed curriculum and implemented curriculum is not known. This lack of implementation information greatly limits interpretation of the effectiveness of the curriculum for the intended programme. The aim of this study is to investigate the implementation fidelity of the Pre service Nursing and Midwifery CBET curriculum among nurse educators in Tanzania. Descriptive cross sectional concurrent mixed method design will be employed, where both qualitative and quantitative approaches will be used to investigate the implementation fidelity of nursing and midwifery CBET curriculum among nurse educators in Tanzania. Population of this study are nurse educators, 215 nurse educators who will be randomly selected to administer questionnaires. In qualitative approach purposeful sampling approach will be used to reach key informants with rich information on the implementation of CBET curriculum for nursing and midwifery pre service programme in Tanzania. Principal of saturation will determine the sample size. Fidelity checklist also will be used to review documents such as CUM master rotation plan, session plans, skills laboratory and clinical rotation schedules. The modified implementation fidelity conceptual framework will be used to investigate the implementation fidelity for pre service nursing and midwifery CBET curriculum in Tanzania. Four elements (Educators characteristics, Adherence, Dosage and quality of delivery) will be treated together for better understanding of the implementation process for nursing and midwifery programme in Tanzania. Below is the conceptual framework of the study.
Conclusion and significance: There is no information on the implementation fidelity of the pre service nursing and midwifery CBET curriculum in Tanzania. The study will establish the degree of implementation fidelity of the nursing and midwifery CBET curriculum in Tanzania. Furthermore, will provide valid inferences to interpret the effectiveness of the CBET curriculum for the intended programme.