Antipsychotic and other tranquilising medicines are prescribed to help care staff manage behaviour in one-quarter of older people living in Australian long-term care homes. While these medicines pose significant health risks, particularly for people with dementia, reliance on their use occurs when staff are not educated to respond to resident behaviour using nonpharmacological approaches. There is strong evidence in the literature to suggest that person-centred responses can help reduce these behaviours in long-term care residents, in respect of being able to provide them with personal care without resistance and in helping the person attain well-being, despite physical, social and cognitive limitations. The Halting Antipsychotic use in Long-Term care (HALT) single-arm study assessed whether a person-centred care intervention was effective in reducing antipsychotic use in 139 people 60 years and over with changed behaviours living in 24 Australian long-term care homes. A train-the-trainer approach delivered person-centred care education and support for 22 HALT (nurse) champions and 135 direct care staff, along with non-pharmacological dementia management education for visiting general practitioners (GP)and individualised antipsychotic deprescribing protocols for participating residents. At 12 months follow-up approximately three-quarters of the HALT study residents remained deprescribed without an escalation in the behaviours for which antipsychotics were previously prescribed.The HALT nurse champions completed open-ended questionnaires and semi-structured interviews to identify the contextual elements they considered most critical to achieving success with the study intervention. They reported that person-centred approaches helped care staff to respond proactively to resident behaviours in without reliance on antipsychotic medicines, enabled by managerial support, nurse champion empowerment to lead change and the re-education and cooperation of the residents’ GPs and their families. These findings emphasise the importance of a whole systems approach to initiate and sustain care practice improvements in dementia services.
Lynn Chenoweth is Professor of Nursing, Centre for Healthy Brain Ageing, University of NSW, Australia. Lynn’s interdisciplinary research program focuses on: safe and effective health and aged care systems; healthy ageing in life transitions; and person-centred models of dementia and aged care. She has led 65 funded research studies of over $AU6M and is CI on studies worth $AU9M, has 165 peer-reviewed publications and15 book chapters.
A survey, post the introduction of an electronic medical records software system into clinics, was conducted. A total of 146 physicians (MD), 24 physicians’ assistants (PA) and 34 nurse practitioners (NP) responded. Results showed that PAs and NPs spent more time each day using a computer than did MDs. Around 50% of MDs and NPs reported less face-to-face patent time with the EMR, and also most said that this hinders their interactions with patients. Over half of the health professionals found the EMR difficult to use. A majority of all respondents reported increased frequency of at least weekly neck, shoulder and back discomfort. Around half of all respondents reported an increased frequency of right wrist discomfort since introduction of the EMR. Half of the respondents wrote comments and all of these were negative and critical of the EMR, its adverse impact on productivity and the poor design of the workplace to support more intensive computer use. Results emphasize the importance of carefully planning workspaces for EMRs and incorporating ergonomic workstation design features and ergonomics education into healthcare environments when an EMR is being implemented.
Alan Hedge has completed his PhD from the University of Sheffield, Sheffield, UK. He is a professor of ergonomics at Cornell University, USA and he also directs the Cornell Human Factors and Ergonomics Laboratory. He has published 4 books, 41 book chapters and more than 250 papers in refereed journal and refereed proceedings journals. He serves on the editorial board member of several journals.
Changes in western health care since the middle of the last century at best has been incremental. This has largely been due to the interplay of an interconnected web of social, political, technological, and economic factors that result in changes that more or less support the status quo. However, the growth and implementation of artificial intelligence (AI) in the healthcare industry sets the stage for disruptive changes, that can rapidly transform how we deliver and receive care and subsequently educate and train health workers. The focus of this presentation will be to first comment on the impact of AI on health workers (e.g., new roles and skills mix), highlighting the impact for different disciplines (e.g., Nursing and Medicine). Rapid changes in any industry require a resilient workforce that can develop new specialized skills. Therefore, there will be a need to change our approach to education to implement strategies to nurture resilience in new trainees and to continuously support a resilient health workforce. Worldwide females represent 67 per cent of the employed health workforce. The review of materials for this commentary will use a gender lens to better appreciate the impact of AI on both male and female health workers.
Dr Brenda Gamble: Associate Dean/Associate Professor, Faculty of Health Sciences at the University of Ontario Institute of Technology Ontario Canada. Research interest includes quality and patient safety in the medical laboratory; health human resources.; interprofessional practice and education; and the development of simulations for the classroom and clinical setting. Brenda employs a mixed methods approach to research that includes not only generating new knowledge but also the implementation and evaluation of the programs that the knowledge generation informs. The research conducted by Brenda involves collaborative partnerships with local, provincial and national partners both in the public and private sector.
Emotional intelligence in new graduate nurses can be developed for social and academic purposes. It is the ability to perceive evaluate, express feelings, understand the sentimental knowledge, together with regulating these emotions in a manner that establishes both emotional and intellectual growth (Bellack, 1999). The author further argues emotional intelligence incorporates elements such as emotional expressions and regulation, self-awareness, and empathy. These skills facilitate social success while enabling people to structure relationships that enable them to read their emotions and respond accurately (Bellack, 1999). Educators can teach emotional intelligence by demonstrating it before they expect to get it from their students (Bellack, 1999). The instructor should manage his/her emotions effectively since the students will copy how he/she copes with stressful occurrences while teaching them. Johnson (2015) affirms that being dependable and trustworthy are good concepts for educators because they act as role models for healthcare students. Another mechanism to employ in teaching nursing students about the emotional intelligence is through incorporating the competencies into the expected outcomes in the curriculum (Bellack, 1999). In this case, educational institutions should improvise strategies of measuring these competencies as a graduation checkpoint. Bellack (1999) maintains that emotional intelligence is essential for effective job performance despite the type of work and the setting. The element is vital in generating increased interest in the healthcare sector. Emotionally intelligent individuals seem to be satisfied with their tasks thus embracing job satisfaction, which influences quality care to the patients. New graduate nurses who lack emotional intelligence may experience stress since the aspect is important in contributing the to the person’s ability to adapt socially, be effective in teamwork, cope well with environmental pressures and with stress (Bellack, 1999). Working in a stressful environment can cause burnouts to the nurses who may eventually leave the profession. Millennial new nurses may experience a feeling of anxiety relating to their performance, the workload and fear of making mistakes. However, emotional intelligence can improve the feeling of ownership towards their work, which improves job satisfaction. Another shortcoming of lacking emotional intelligence in nurses is the fact that they encounter difficulties in caring for patients while offering support and comfort to their family (Bellack, 1999). Emotional intelligence is essential in critical care nursing where patients suffer from life-threatening diseases that require emotional support from the nurses. Nagel (2016) supports the argument that the nurses who lack emotional intelligence will fail to offer the much needed social support to the patients thus resulting to poor patient outcomes. New graduate nurses who lack emotional intelligence may find it hard to balance between the demands of a nurse and manage their own emotions. Lack of emotional intelligence in millennial new nurses may also result to negative attitudes, slow adaptability, and decrease the orientation towards positive values (Romanelli et al., 2006). The nurses can also fail to develop effective working relationships or be efficient in teamwork if they have not practiced and embraced emotional intelligence. Such deficiency will prohibit professional growth among the new graduates and the development of their skills (Bellack, 1999). It is worth noting that emotional intelligence is essential in preparing nurses to work in the complex nursing industry.
Lorrie Blitch has her master’s degree in nursing education and pursuing a doctorate in nurse anesthesia. Lorrie has had an impressive and diverse background in nursing and management. She owns The Magellan Christian Academy for the past 18 years, acute care nursing educator, Board of Directors for the Banyan School, formernaval officer, critical care nurse, professor, medical-legal consultant, and toxicology. Lorrie has written in professional journals. She is an author of children’s books achieving book of the month on Amazon. Lorrie is currently owner of Magellan Christian Academy, acute care educator for Banner Health System in Phoenix, AZ and sits on the Board of Directors of the Banyon School New Deli, India.
The professional practice of nursing and other health professions is being transformedlargely through the convergence of science and technology. Each day brings more news of the impact of these changes onprofessional practice. While policy proposals, changes to laws and regulations, and new diagnostic and therapeutic regimens reflect the traditional sources of change; healthcare is entering an era of rapidly evolving digital technologies that will fundamentally change what it means to be part of the nursing and health professions. Among those technologies are: portable and direct-to-consumer diagnostics and therapeutics; artificial intelligence in medical decision-making; precision medicine enhanced by digital biology; augmented reality; and affective computing.New reports are frequently published on the changing state of the medical profession and the required reforms in medical curricula that will enable more effective entry into contemporary practice. Common themes include renewed emphasis on communication, teamwork, risk-management and patient safety. These are important reforms, but they are insufficient given what is coming.Increased and focused attention needs to be given to addressing what is the most fundamental change of all: nursing and health professions practice is rapidly transitioning from the information age to the age of artificial intelligence. The consequences of this transition are profound anddemand the reformulation of current educational programs most often attended by learners and practitioners. A guiding principle in this reformulation is thatstudents and practitioners understand the implications of the difference between “information” and “artificial intelligence” in clinical practice.
C. Donald Combs, PhD serves as vice president and founding dean of the School of Health Professions at Eastern Virginia Medical School (EVMS) in Norfolk, VA. In addition to being recognized as a Fellow of the Society for Simulation in Healthcare (SSH), Dr. Combs holds senior faculty appointments in the EVMS School of Health Professions, the Department of Modeling, Simulation and Visualization Engineering at Old Dominion University, the University of Paris-Descartes and the Taipei Medical University. Dr. Combs holds degrees from South Plains College, Texas Tech University and the University of North Carolina — Chapel Hill.
Prenatal education programs run by obstetric nurses regardless of the theoretical foundation that supports them focus on dealing with pain, stress and increasing the confidence of women in their ability to give birth, in addition to preparing them together with their partners for childbirth and paternity and the development of social support networks. However, there are controversial opinions on the effectiveness of prenatal education programs. The lack of evidence on the cost-effectiveness of current programs is remarkable. So far, affirmations of success and need seem not to be based on scientific reports, but on the beliefs of future parents and health workers. This secondary research protocol aims to evaluate the impact of prenatal education programs taught by obstetric nurses to optimize the development of the labor of primiparous women at the hospital level. The rapid evidence assessment (REA) methodology is developed. Inclusion criteria were published randomized clinical trials, meta-analyses and systematic reviews from 2013 to 2018. The databases are PubMed, Trip dataBase, Web of Science, Scielo, Cochrane Library and other sources of indexed journals and thesis. The measurements will be made in studies in which the general effect of prenatal education programs on primiparous in labor is measured, and the impact of these programs. The expected result is to optimize the development of labor and delivery and the subsequent care of the newborn. The conclusions will be made taking into account the main findings on the question REA posed.
Ligia Patricia Rojas-Valenciano has completed his Ph.D. at the age of 45 years from UNED University. She is Cathedratical Professor and Researcher in the University of Costa Rica. She is 25 years of experience like a nursing professor in different areas of the Nursing discipline and 11 years in the hospital practice. She is a registered nurse and midwife, coordinator of Evidence-based Nursing Research Collaboration Program in Costa Rica, Coordinator of Master’s Degree in Gynecological, Obstetric and Perinatal Nursing in the Postgraduate in Nursing Sciences at the University of Costa Rica. Editor in Chief of the Current Nursing Journal of Costa Rica. She has published papers in international and national journals and participates as a peer reviewer in several nursing journals. She has participated in world congress and conference like a speaker and keynote.
Approaching perinatal palliative care from an interdisciplinary approach is imperative to achieving the quality of life desired by families when an infant is diagnosed prenatally with lethal anomalies or when survival would be accompanied by a high risk of unacceptably severe morbidities. Caring for families during this difficult and stressful time includes developing a plan prenatally and ensuring all members of the team including the family are involved in the decision-making process. Providing families an opportunity to prenatally discuss their wishes with the perinatal palliative care team aides the family throughout the pregnancy to make decisions important to them. With 48 prenatal palliative care consults over the last five years, our team has discovered the importance of team collaboration. Our team includes maternal fetal medicine, clinical social work, a nurse coordinator, genetics counselor, chaplain, pediatric cardiology, neonatology, cardiothoracic surgery and other pediatric specialties in order to maintain a unified approach to care while establishing a plan for the remainder of the pregnancy. This well-established plan outlines care for both mom and baby and provides appopriate treatments to maximize the baby’s quality of life as well as ensures a peaceful and dignified death. Since dying, death and berevement with a newborn is such a challenging time, providing competent, compassionate medical care and support throughout the pregnancy, labor and delivery, postpartum and anniversery dates proves signficantly advantageous for the emotional well-being of these families.
Amanda Freedman has completed her Masters of Science in Nursing Administration from the University of Phoenix, USA and her Clinical Nurse Specialist Post-Masters certificate as an advanced practice nurse from East Carolina University, USA. She is the program coordinator at Duke University Medical Center’s high risk perinatal program. She has published in reputable journals, served as PI in several nursing research studies, taught in various nursing programs as well as presented at more than 30 events locally, state-wide and nationally.
In the United States, more health care organizations are recognizing the critical importance of strong partners in leadership via a dyad and triad leadership model with Physician, Nursing, and Administrative Leaders. The Chief Nursing Officer (CNO) is a key player in this partnership model. Physicians and Nurses have the advantage of a long history of working together for the best interest of the patient. However, moving toward a true partnership requires a shared vision for the organization and their patients, and new behaviors must be learned. This is further supported by the Magnet Program where the CNO is expected to be a part of the Senior Leadership Team and a part of the Strategic Planning Process. Administrators have been key in the Strategic Planning Process and are now finding collaborations with physicians and nurses to be the new norm associated with Value-Based Care. This presentation will review the current and future state of health care dyads and triads and what is needed to create effective leadership teams. Audience participants will be able to: • Discuss “partners in leadership” via the dyad and triad leadership models • Examine the benefits and challenges of the models and the relationship to System transformation • Define leadership behaviors needed to create effective partnerships • Examine the dynamics of shifting power and sharing power
Debra A. Harrison, DNP, RN, NEA-BC has completed her Doctorate of Nursing Practice (DNP) from the University of North Florida, USA and her undergraduate degrees from Winona State University, Minnestoa, USA. She retired in 2016 after 40 years with Mayo Clinic, the last 10 years as Chief Nursing Officer for Mayo Clinic in Jacksonville, Florida. She is currently working as an Executive Coach and teaches DNP courses for Nursing at the University of North Florida. She has done numerous presentations and published 10 articles in peer-reviewed journals. Jeffrey P. Harrison PhD, MBA, MHA has completed his PhD in Health Services Research from Virginia Commonwealth University, USA, his MBA from William and Mary, Williamsburg, VA, USA and his MHA from the Medical College of Virginia, USA. He is a Professor in Health Administration. He has authored thirty nine professional articles and three book chapters. In 2016, he completed the second edition of his book: “Essentials of Strategic Planning in Healthcare” published by Health Administration Press. He is a Certified Healthcare Executive and a Fellow in the American College of Healthcare Executives.
Context: Palliative care is now increasingly accepted as an essential component of comprehensive, high-quality care for critically ill patients. Problem: Although many proven effective interventions to promote the integration of a palliative approach in this particular setting are being published, the quality of descriptions is remarkably insufficient to allow replication or build on research findings. Consequently accumulating data suggest that few interventions are actually implemented in other clinical settings. Objective: This communication aims to describe the evolutionary process that led to the development of a two component palliative approach intervention. Method and result: A qualitative inquiry of action research was chosen for this study. This research method is recognized as an effective way to promote collaboration and sustainable organizational change. Based on a rigorous needs analysis, this study took place over a 16 months period in a Canadian ICU and required two cycles of exploration-reflection-action. Conclusion: By placing the ICU clinician in an active committed position, the iterative nature of the action research process allowed members of this team to understand their own reality, to learn and to build their own knowledge and to act on their own future.As many would suggest, our results are inextricably linked to the environment in which they were generated, but we strongly believe that the research method proposed by this study could inspire other clinical settings.
Diane Guay is a critical care professor who has devoted nearly 20 years in critical care nursing. Improving end of life care in critical care setting constitutes her main research interest. She is particularly interested in qualitative and collaborative research methods.(
Individuals with intellectual/developmental disabilities (IDD) including Autism have a higher risk of obesity, diabetes mellitus (DM) and cardiovascular disease (CVD) than the general population. Aerobic exercise and nutritiondecrease risk for CVD and DM.Stockton’s Get Fit interprofessional community program offers those with IDDan opportunityto stay active and healthy. Nursing, Physical and OccupationalTherapy studentsare trained to provide nutrition education and exercise activities to decrease the risk of chronic diseases. This presentation discusses the design, implementation, and results of this innovative interprofessional program. Sample: 48participants with a primary diagnosis of IDD, ages ranged from 16-65 years (mean 36), 19 female, 29male. Eighty percent had a secondary diagnosis of HTN, mental Illness, DM or hypercholesterolemia. Intervention: Nutrition class for 30 minutes followed by exercisefor one hour,twice a week, for 12 weeks. Measures: Height, weight, body circumference, body composition), body mass index (BMI), 6-minute walk, Timed Up and Go (TUG), Sit and Reach, curl up, plank, push up and QOL measured before and after each 12-week program. Data were collected over five years. Limitations: Some refused data collection due to injury, illness, or mood. Inter-rater reliability may be an issue due to different data collectors during each 12 week program Results: Pre-to post-program independent t-tests showed significant decreases (p<0.05) in BMI and Sit and Reach. Body fat composition, body weight, and TUG decreased but not significantly. Non-significant increases in cardiovascular endurance, curl up, plank, pushup and QOL were also noted.
Dr. Joan Perks completed her PhD from Widener University, USA. She is an Associate Professor and Coordinator of the Nursing Program at Stockton University, USA. Dr. Perks, APN-C, CEN, CRNI, CNE teaches nursing and nutrition. Dr. Mary Kientz OTD is an Associate Professor of Occupational Therapy and received her doctorate from the University of Kansas, USA. Dr. Kientz is an expert in autism. Dr. M. Alysia Mastrangelo PT, PhD, FACSM, is a full professor at Stockton University and received her doctorate in Kinesiology/Exercise Physiology at Temple University. Dr. Mastrangelo conducts research supported by the Center for Disease Control and Prevention
Staphylococcus is part of the human flora and it is often involved in severe infectious diseases. The most vulnerable places are hospitals. We studied this genus in several groups: carriers and infectious cases of different hospitals (Lima,Perú). In both groups a common characteristic was resistance to antibiotics. Initially they were known as coagulasepositive,Staphylococcus aureus, and coagulase-negative staphylococci (CoNS) such as Staphylococcus epidermidis. The pathogenic species were characterized and identified with the known tests, coagulase and DNAse, including markers to typify the epidemic phagetypes, resistance to some antibiotics and mercuric ion. The identified phagetypes were characteristic of the epidemic strains (Lab of pathogenic cocci of Medical School Ribeirão Preto/USP). To characterize Staphylococcus coagulase negative of infectious intrahospital origin (postoperative, most frequent urinary) was included tests that identified the species using the model recommended by Kloss&Schleifer (authors of classification of CoNS, 1981). We used Dendogramcluster to CoNS classification and tests to detect exotoxins, antibiogramm and genetic transfer of resistance to antibiotics by transformation. Interesting results were obtained in this studies carried out in the Genetics Laboratory of the Technische University,of Munich, where it was shown that are coagulase-negative staphylococci that transfer multiresistence to Staphylococcus aureus strains and not the opposite. In the last times my research has been oriented to the bacteria of the oral cavity, ecosystems and to those involved in infectious processes causing periodontal diseases and caries, several methodologies have been applied to identify them, using conventional methodologies and PCR according to J. Slots et al of the Southern California University.
CorsinaVelazcoHenriques,Full Professor of the TropicalMedicineInstitute, SanMarcos University, Lima-Peru. Created and organized the NationalReferenceLaboratory for Phage typing Staphylococcus aureus, linked toColindale England(1972). She did studies on the detection of this bacteria in carriers as wellStaphylococcus sp of infectious cases, both intrahospital origin. In Portugal formed the OralMicrobiologyLaboratory of the IUCS collaboration JSlots andContreras of theUniversityCalifornia, and D.Duffaut of UniversityToulouse. She applied for International Fellowships obtained for postgraduate studies at the Instituteof Microbiology UFRJ-RioJaneiro and to develop research using advanced, conventional and genetic transfer methodologies in theUniversities ofBonn andMunich. She was invited tointegrate international delegations of scientific exchange in Universities, Johannesburg,CapeTown,Beijing andShanghai.
Background:Challenge Based Learning (CBL) has been found to be an effective educational strategy to facilitate students in developing essential soft skills for 21st century such as critical thinking, creativity and collaboration skills, etc. Qualitative studies reported positive learning experience of students with CBL. However, scanty attention has been paid on the perception of educators towards this educational strategy. Objective: To explore the experience of nurse faculty in teaching nursing course using CBL approach. Method: It was a case study describing the teaching experience of a group of 5 nurse faculty teaching public health with CBL in a self-financing tertiary institution in Hong Kong. Focus group interview was used to explore their teaching experience. The whole interview lasted for 1.5 hours. Content analysis was used to summarise and interpret the data. Results & Discussion:Educators agreed that CBL could facilitate nursing students to develop soft skills and was timely to introduce this educational strategy in nursing education. They expressed that a regular and explicit training on applying CBL in teaching should be offered to facilitate faculty to apply this approach into different courses. Also, modification of the CBL process was required to better fit the existing curriculum and balance the workload on both students and teachers. Conclusion:It was consensus that CBL could added extra value to nursing training in addition to current learning and teaching approaches. The best way of integrating CBL into the curriculum needs further reviewed.
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.
Healthcare Champions role to prevent and control infections in healthcare facilities by using advance strategies and to decrease transmission of infectious diseases from healthcare workers to patients and vice versa is very crucial. We will understand why Hand hygiene, Isolation, standard Precautions and correct use of personal protective equipment (PPE) during the patient care are important, to reduce healthcare associated infections and Occupational health hazards. We shall share Quality improvement methodologies (FOCUS-PDCA & FMEA) and importance of implementations in healthcare facilities. We shall discuss about post exposure Interventions to infectious disease in healthcare field and how to prevent and treat employee and also share guidelines for work restrictions to employees suffering from infectious diseases like Meningococcal Meningitidis, HAV, HBV, HCV, HIV, MDRO, RSV, Varicella, TB and Influenza. According to Centers for disease control and prevention (CDC), results of a project known as the HAI Prevalence Survey (2014 Data) were published in 2016. The Survey described the burden of HAIs in U.S. hospitals, and reported that, in 2011, there were an estimated 722,000 HAIs in U.S. acute care hospitals. Additionally, about 75,000 patients with HAIs died during their hospitalizations.
Dr. Muhammad Wasif Rashid Chaudhary has 15 years of experience in Healthcare Executive management and Leadership in the UAE. His role at Via Medica International Healthcare LLC is Medical Director with additional assignment as Director Quality. VMIH is American owned facility and head office is in DC Washington. VMIH has multidivisional services and CARF Accredited Facility. Dr Wasif has occupied many diverse roles in hierarchy Healthcare management in the past. UAE licensed General Physician and practicing medicine. Proactive and strong role in strategic Leadership, he has. He is Certified Six Sigma Green Belt, Total Quality management and also holding a Prestigious credentials i.e., Certified Professional in Healthcare Quality (CPHQ). Dr. Wasif has achieved MBA degree from Delaware University USA. His passion in Healthcare is to improve existing/current processes and systems by utilizing Quality Improvement tools which lead to Safe, Timely and high quality, effective care of the patients. He is key note speaker of many International Conferences, including USA and Canada.
Feeding difficulties affect an estimated 25% to 35% of normally developing children. In order to prevent ensuing long-term impairments, clinicians emphasize the need for timely treatment. While multidisciplinary assessment and treatment is often recommended and parent training is also encouraged, existing literature on programs combining both approaches is scarce. To reduce patient wait times, the Children’s Hospital of Eastern Ontario (CHEO) developed an interprofessional group (IG) program offered to families on the waiting list. As part of a preliminary study, twenty-nine children (mean age of 26 ± 8.2 months) and their families attended four weekly group sessions and a one-month follow-up. Parents completed the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) pre and post treatment. Paired t-tests found composite scores for frequency of feeding difficulties and parental problems to be significantly lower post treatment (p = 0.01 and p = 0.09, respectively); thus, establishing the IG approach as an effective modality for children with feeding challenges. A follow-up study was then conducted to document parents’ perception of the IG service delivery model. The Measuring Process of Care (MPOC)-20 was used to evaluate their satisfaction with the care they received (n = 20). The model scored high across all five constructs (mean range = 5.1 to 5.9), demonstrating that, in addition to being effective, the CHEO IG program provides quality family-centered care.
Carrie Owen is a registered Occupational Therapist specialising in infants, toddlers, children and teens with feeding challenges. Carrie is the creator and coordinator of the Interprofessional Feeding Groups for children between the ages of 5 months to 14 years at Children’s Hospital of Eastern Ontario. She is presently studying the effectiveness of the feeding group for children between 4-12 years of age. Carrie was the principal author on a manuscript published in the Journal, Nutrition in Clinical Practice. Her teaching experience includes the University of Ottawa, Toronto and York. She has published in Today’s Parent magazine.
The question addressed in this research study was, “Is there a difference in medication adherence for African American women diagnosed with unstable high blood pressure from a community health clinic setting who monitor their blood pressure daily and use the OnTimeRx® smartphone application versus those who use the Omron BP786 monitor?”The Stroop Color and Word Testwas administered pretest to screen for cognitive deficits which may interfere with the participants’ ability to operate the equipment used in this research study. After achieving t-scores of 30 in all three test areas, the participants were consented and randomized into one of two study conditions (treatment group or control group). Throughout the study, all participants were contacted on a weekly basis for follow-up and to answer study-related questions. Handouts were provided as a secondary measure to augment verbal instructions. After 28-days of data collection, medication adherence was measured with the Morisky Medication Adherence Scale-8. In this post-test (only) study, all 67 participants submitted their blood-pressure values to the primary investigator; and all 31 treatment-group participants submitted their compliance (adherence) scores. Results suggested the treatment group demonstrated significantly better medication adherence than the control group (Mann-Whitney U=393, p-value=0.037); and, the estimated marginal means of the treatment group’s systolic blood pressure was significant (p-value-0.002). These findings suggested smartphone technology can have a positive influence on high blood pressure management.
Dr. Monroe has completed her PhD at Texas Woman’s University.As a previous staff-nurse, she has worked in the field of cardiovascular nursing since 1991. She has worked as nurse educator since 2007. Currently, she is a clinical assistant professor at PVAMU-CON. She has published previously on this same topic; and serves on the editorial board of a nursing journal.
When confronting chronic and/or serious illness many individuals wish to be active participants in determining the treatment and care provided to sustain optimal quality of life. As healthcare professionals, our goal is to facilitate a conversation with the individual and /or their family or other advocates that supports that person’s life journey and addresses their physical, social, spiritual, and emotional needs, as well as their values and cultural traditions. Through this discussion, we assist the person in using a systematic approach to identify and coordinate a plan of care to maintain quality of life
Marjorie Ann Risola is a nursing clinical consultant and educator in the continumm of care in Geriactrics. She has served as Chairman Healthcare Quality Important Best Practice Committee for a number of years, as well an active lecturer. She has published papers in nursing journals and currently serving as an editorial broad member.
The literature showed high mortality rates for children and competency gaps of trained Paediatric Nurse Specialists (PNS). The purpose this study was describe the needs assessment in preparation for the development of a Problem Based Learning (PBL) approach to produce reflective Paediatric Nurse Specialists (PNS). Data were collected from a stratified random and purposive sample of 70 PNSs on demographic information, performance and importance of PNS activities, PNS competencies, as well as the prevalence of child health problems at urban, semi-urban and rural hospitals in selected Eastern Cape Province municipalities. Quantitative data were analyzed with descriptive techniques such as frequencies, means and standard deviations, while thematic content analysis was applied to qualitative data. The quantitative data showed high prevalence rates in child health problems, a high perception of PNSs importance, but low PNSs competencies due to shortage of human and material resources. Four themes emerged from the qualitative data analysis revealing factors prohibiting service delivery of PNSs, special training needs of PNSs, prevalent health problems in children and personal interventions. Empowering reflective PNSs on paediatric emergencies and modifiable factors for improved child health service delivery and reduce child mortality rates. The results justified the essential need to develop PBL programme for PNSs. The results justified the essential need to develop a PBL programme for PNSs.
Nomntu Melitafa is a PhD student, has completed her Master’s degree in Nursing Education at the age of 57 years from University of Fort Hare and has B A Nursing degree majored with Nursing Administration and Community Nursing Sciences at Potchefstroom University, Diploma in Advanced Nursing Education (North West University), Diploma in Paediatric Nursing (East London Nursing College), Diploma in Midwifery and Diploma in General Nursing (East London Nursing College). She is a nurse Lecturer and Coordinator of B Cur nursing undergraduate programme. She has two pending papers for publications. She is a moderator of Post Basic Paediatric Nursing.
Teamwork during obstetric emergency ensures good outcomes for both the woman and her baby. Effective teams are characterised by mutual respect, support, and cooperation among team members. This qualitative, interpretive, phenomenological analysis study was conducted on a purposive sample of five, fourth-year Bachelor of Nursing Science student midwives at the University of Fort Hare (UFH). In-depth semi-structured interviews were conducted. Data analysis applied the interpretative phenomenological analysis method. Superordinate theme demonstrated teamwork elicited four clustered themes namely delegation of duties, the importance of teamwork, team support, and confident team leader. The participants recognised that there should be a team leader who is capable of delegating duties to other team members in the management of an obstetric emergency, Participants were confident not only to assign duties but to be kept updated of the intervention. They expressed the need to work collaboratively as a team to achieve thedesired goal of providing quality care to the woman. The participants maintained that the team must be supportive and be able to help in decision making during simulation of an obstetric emergency. A sense of mutual respect is echoed by some participants in the process of caring for the woman. Some participants were confident at being team leaders and could see themselves as leaders in the real-life clinical situation. The participants acknowledge the importance of teamwork in resolving obstetric emergencies. The importance of delegating duties to other team members, providing updated progress report ensures better outcomes for the woman.
Zukiswa Brenda Ntlokonkulu has completed her Masters’ degree IN Nursing Education from the University of Fort Hare and is a prospective PhD candidate. She is a Lecturer at the University of Fort Hare Nursing Science Department undergraduate programme and a simulation laboratory manager. She has published one paper in a reputed journal and two more are under review
Globally the population is aging and due to the increase in disability and disease associated with age, older people are more likely to require assistance to attend to the activities of daily living. For some older people this assistance will be provided in residential care homes.Older people often enter residential care homes direct from hospital and nurses play a vital role in these transfer decisions, yet how nurses make transfer decisions is unknown. Qualitative descriptive methods informed by Husserl’s phenomenology were used in this study to explore health professionals’ transfer decision making. Data were analysed through Colaizzi’s seven step method. The purpose of this presentation is to explain how the Australian nurses’ in this study made transfer decisions with older people from hospital to residential care homes. This is one aspect of a larger multidisciplinary study that explored health professionals’ transfer decisions in an Australian setting from hospital to residential care homes. Results revealed that the nurses in this study tended to use clinical judgement developed through training and experience to make transfer decisions. They used collaborative processes and while they found some transfer decisions straightforward others were difficult. Their transfer decisions were frequently made under pressure to make decisions quickly with limited decisional support. The nurses in this study aimed to make appropriate transfer decisions with older people in hospital yet many found it difficult. Nurses may benefit from more structured guidelines and support when making difficult transfer decisions.
Tiffany Northall is a Registered Nurse and Lecturer in Nursing at Western Sydney University. Tiffany holds a Bachelor of Nursing and a Masters of Nursing Research. Tiffany has specialised for over 20 years in the care and management of older people in hospital with a specific interest in palliative care, dementia and transfers of care. She is currently a PhD candidate focusing on the transfer process from hospital to residential care.
Candida species as part of commensal microflora in humans are usually the etiological agents causing infections. To investigate yeast colonization in the oral cavities, we collected oral rinse from each participant at 10 nursing homes in Taiwan. Among 158 of 204 residents colonized by yeasts. 52 ones were colonized by C. albicans alone and 106 were colonized by at least one non-C. Albicans yeast species. Interestingly, 70, 41, and 47 were colonized by one, two, and more than two species, respectively. Among the 320 isolates, comprising 12 fungal genera and 33 species, Candida albicans (40.3%) was the dominant species, followed by Candida glabrata (15.9%), Candida parapsilosis (10.6%), Candida tropicalis (6.9%), and Trichosporonasahii (5.6%). Residents having more dentures (OR, 1.037; 95% CI 1.006–1.07; p = 0.02) or dry mouth (OR, 2.012; 95% CI 1.062–3.811; p = 0.032) were more likely to be colonized by a high density of yeast [colony-forming unit (CFU) > 10]. Furthermore, elderly having yeast CFU > 10 (OR, 6.156; 95% CI 2.709–13.989; p = 0.001) or age > 70 years (OR, 2.435; 95% CI 1.057–5.607; p = 0.037) were more likely to be colonized by multiple species. Hence, to boost oral health among the residents at nursing homes, it is important to diminish the risk of yeast colonization among those with dentures and hypo salivation.
Hsiu-Jung Lo has completed her PhD from Indiana University at Bloomington, USA and postdoctoral researches from Whitehead Institute for Biomedical Research, USA. She is the Deputy Director of National Institute of Infectious Diseases and Vaccinology, and the Executive Secretary of National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Taiwan. She published more than 70 papers in reputed journals.
Dr. Sledge has served in a variety of roles within Psychiatry as well as Yale University. Within Psychiatry, he was Clinical Director of the Connecticut Mental Health Center until he moved in 1996 to the Medical Directorship of Psychiatry at Yale-New Haven Hospital. From 1995 to 2005, he was also Master of Calhoun College and participated in a variety of administrative roles in Yale College including Chair of the Council of Masters. He is a psychoanalyst as well as a health services investigator and innovator of clinical services.
Dr. Petra Staiger has worked in the clinical and research field of addiction for the last 15 years. She has a well-respected national and international reputation in this area with a strong track record in managing large research grants. Her research expertise is in investigating the etiology and treatment of individuals with addictive behavior problems with a particular focus on those with complex needs (i.e., polydrug users, co-morbid mental health problems). Dr. Staiger currently manages as a lead investigator a number of large research grants. Dr.Staiger's research has been presented at national and international conferences and she has published extensively in refereed international journals.
Professor Richard M Ryan is a professor at the Institute for Positive Psychology and Education at the Australian Catholic University and a research professor at the University of Rochester. He holds a Ph.D. in Clinical Psychology from the University of Rochester. He has over 30 years experience researching human motivation. He is a clinical psychologist and co-developer with Edward L. Deci of "Self- Determination Theory (SDT)", one of the most influential theories of human motivation.With over 300 papers and books in the areas of human motivation, personality, and psychological well-being, Ryan is among the most cited and influential researchers in psychology and social sciences today. Reflective of Ryan’s influence internationally, he has been recognized as one of the eminent psychologists of the modern era, Post-World War II. Richard M. Ryan is one of the leading theorists of human motivation ranking among the top 1% of researchers in the field. Based on his scholarly impact (H-index: 162), He is also among the most cited researchers in psychology. Ryan has lectured in more than 80 universities worldwide, and consulted with numerous organizations, schools, clinics, and health-care initiatives. Recipient of distinguished career awards from multiple societies for his contributions to the field on motivation, personal meaning, and self and identity, Ryan is also a Fellow of the American Psychological Association, the American Educational Research Association, and an Honorary Member of the German Psychological Society (DGP). He has held numerous editorial posts, including having been Editor-in-Chief of Motivation & Emotion. He has also been a James McKeen Cattell and Leverhulme Fellow, and a visiting scientist at the National Institute of Education in Singapore, the University of Bath, UK, and the Max Planck Institute, Berlin. More details: SDT website: http://selfdeterminationtheory.org/ Publications: http://selfdeterminationtheory.org/authors/richard-ryan/ Wikipedia: https://en.wikipedia.org/wiki/Richard_M._Ryan Bio: http://selfdeterminationtheory.org/ryan-faculty-bio/ LinkedIn: https://www.linkedin.com/in/richard-m-ryan-425a4945/ Twitter: https://twitter.com/richardmryan3 Facebook: https://www.facebook.com/selfdeterminationtheory
Brain injury is the leading cause of death and disability world wide. And traumatic intracranial ballistic, blast and penetrating injuries are all very important part of traumatic neurosurgery in the United States as well as the rest of the world. Traumatic brain injuries (TBI) have been considered a signature injury for our recent wars in the Middle East. In the United States it has been estimated that someone experiences a gunshot wound approximately every 5 minutes and that a person dies ever six minutes. The alarming escalation of mass shootings within the last few years is self-explanatory. This report will evaluate the ballistics of gunshot injuries, results of blast injuries, and a discussion of penetrating injuries. Treatment for these injuries will be discussed in detail.
Dr.Gene Bolles practiced at Boulder Community Hospital for most of his career until joining the faculty at the University of Colorado Department of Neurosurgery in 1994. He practices at Denver Health and Hospital Authority. Dr. Bolles is a consultant with the military and has practiced in Germany and recently in Afghanistan and Iraq. He is active in the World Federation for Neurosurgery.
The demographic changes towards a larger share of elderly in the population implies consequences for the demands for helth care services povided by home nurses. The larger number of multimorbid citizens in combination with structural changes of the health care system resulting in shorter hospital stays place home nursing in a central role to deliver effective health care services taking into consideration how to make the most of the resources available. The aim of the study was to examine factors related to home care nurses stating that specific visits could have been managed by other health care professionals. A cross-sectional survey was performed in the Danish municipality of Silkeborg September 2016. All home nurses in day time shifts registered alle their visits at citizens’ using a questionnaire of their experience of the visit. In total, 941 visits were registered by home nurses. The nurses considered substitution by other health care professionals possible in 28.3% of all visits, especially with old citizens, unplanned visits, if medicine management was the reason for encounter, and if need for extra health care services arose during the visit. Adjusted estimates from multiple regression analysis showed that visits with citizens more than 75 years of age and unplanned visits were statistically significantly associated with possible substitution (prevalence ratios of 1.28 (p=0.050) and 1.34 (p=0.019), respectively). The study provides new knowledge on a under-examined part of the Danish health care system and contributes to discussions op how to optimise use of health care resources.
With the fast aging population in many countries, the demand for home care is likely to increase considerably in the coming years. The growing complexity of home care services, pressures to discharge patients quicker, and the increasing vulnerabilities of homecare clients all contribute to adverse events in home care. Adverse drug reactions and falls are among the most common adverse events experienced by home careclients. A sample of suchevents was selected from the incident report databases of homecare staff in six different programs in three Canadian provinces (Ontario, Albertaand Manitoba). Nurses and other home care staff in these six programs analyzed 27 fall- andmedication-related events (13 cases with a client fall and 14 cases with a medication-related adverse event).Interviews were conducted with clients, family members, home care workers,and case managers to get a broad representation of adverse events and contributing causes. Classification of causes indicates that patient and environmental factors were common infall events, while organization and management factors along with patient, task, team, and individual factors were common inmedication-related events. Home care settings create specific challenges in identifying and mitigating risks. Some factors, such asvariations in home environments, are difficult to address. However, changing care coordination structures and communicationmethods could ameliorate other factors, including poor communications among staff and limited team and cross-sector communication and coordination. Ensuring that medication ordering and administration processes are optimized for home environments would also contribute to safer care.
Regis Blais has completed his PhD from the Université du Quebec at Montreal and postdoctoral studies from the University of Copenhagen. He is currently Vice-dean, Academic at the School of Public Health and researcher at the Public Health Research Institute at the University of Montreal, Canada. He was the co-lead of the study ‘’Safety at home: A Pan-Canadian home care safety study’’. He has published more than 100 papers in peer-reviewed journals.
INTRODUCTION. Healthy lifestyle decreases the risk of having diseases and improve overall performance. Students at academic institutions are likely to experience unhealthy lifestyle possibly due to excessive university demands. OBJECTIVE.The general health status of Health Science Center (HSC) students at Kuwait university was not measured, therefore the purpose of this current study was to explore general health status of these students. MATERIAL AND METHODS. The study design was non-experimental, descriptive, and cross-sectional. A convenient sample among HSC students was recruited. Our survey instrument consisted of demographic sheet and General Health Questionnaire including 4 sections about sleep, nutrition, physical activity, and stress. RESULTS. 224 students from all 7 majors in HSC participated in this study (6.7% males, 93.3% females). Students of different majors demonstrated poor sleeping pattern (p=.031) with the highest percentage (80%) of dentistry followed by occupational therapy (60.7%), and radiologic sciences (58.6%). Also, the results showed that students demonstrated poor nutritional habits (P=.019). In addition, in the physical activity section, the majority of the students were not physically active (n=134, 59.8%). There was a strong significant difference between groups with regards to their level of stress (df=7, F=65.33, P< .000). Hence, radiologic sciences reported to have the highest level of stress (154.5), whereas dentistry students had the lowest stress level compared to other students (7.85.1). CONCLUSION. The study findings indicated that Health Science Center students generally demonstrated poor health status. Therefore, we recommend the integration of health and wellness programs for these students to ensure better healthy lifestyle and thus desired educational performance. KEYWORDS. Health Status, stress, Students, Kuwait University,
• Background: The disequilibrium between the number of calories that people consume and burn leads to obesity. The body weight satisfaction is an important factor for adolescents because it is correlated with fulfillment of personal interactions and overall life happiness. The aim of this study was to identify the relationship between obesity and depressive symptomsfor high school students in Kuwait. • Methods: A Non-experimental and correlational study was implementedat 6 governmental schools in Kuwait. From all grades 198 participated in this study. They were assessed using the Beck Depression Inventory II as well as sociodemographic questionnaire to collect data. The weight and height of the participants were measured to report the Body Mass Index (BMI). Spearman correlation and independent-samples t-test were used to analyze the results. • Results: The participants included 50% males and 50% females. The results indicated that 17.2% and 15.2% of the participants were overweight and obese, respectively. The results showed that there was not a significant correlation between BMI and depressive symptoms (r= 0.119; P=0.095).However, the results indicated that males had significantly higher BMI compared with females(p =0.006)whereas females had significantly more depressive symptoms than males (p = 0.045). • Discussion: About one third of the students showed increased BMI that might cause future health related problems. This increase in BMI could be due to sedentary lifestyle and poor nutrition. Unlike the published literature, the increased BMI of students was not significantly associated with depressive symptoms. • Conclusion: Although there were some students with high BMI, there was no significant correlation between BMI and depressive symptoms. We recommend the inclusion of wellness programs in the governmental high schools to address potential health problems students might encounter in the future. • Keywords: Wellness Program, students, obesity, Lifestyle.
Birth plans are legal documents with wrote intentions during pregnancy about declared birth preferences for women and her baby considering practices, procedures, expectations, personal desires and treatments. According to 2018 World Health Organization recommendations intrapartum care for a positive childbirth experience, birth plan need to be individualized according to the woman’s needs and preferences to support better care. Objectives: To understanding the women’s experiences related to birth decision process at Brazilian Public Health System about planning birth care based on birth humanized law. Method: Qualitative research included six women invited using snowball sample who attended antenatal care at public health system during pregnancy. This research was approved for University Research Ethic Committee in 2017 (Registration number 2.109.233). Results: Six categories of experience were described: Depend on personal effort, search and own luck to achieve desired birth; Since the beginning of pregnancy planning birth causes fear; Several providers and different care settings not meaning better care for women in planning birth; Birth plan is not used at public Health System in Brazil; Few participation was realized birth planning process; Between planning and real: unapproachable humanized care. Conclusion: Women`s speaches showed that during decision process there are two diferent women profile. Those councious searching for an alternative humanized model of care and others who desire humanized care but stay outlier of this model. Individual birth plan with reliable conscious birth choices is not real for women`s at Brazilian Public Health System.
Luciana Magnoni Reberte Gouveia has completed her PhD from University of Sao Paulo School of Nursing and PHD visitor programe from University of Sydney, AUS. She is a nursing professor of University of Sao Paulo School of Nursing, a public organization. She has published more than 10 papers in scientific journals. She is a nurse midwive and had experience as a coordinator of nurse midwifery program.
Medication errors are preventable human errors, and they are costly. Each year in the U.S., severe preventable medication errors occur in close to 4 million inpatient admissions and 3.3 millions of outpatient visits. A grossly inappropriate 7,000 patients die from preventable medication errors in the U.S. each year, as recorded in the report To Err Is Human. Medication errors cost a total of $21 billion expenditure every year. In many cases, looking back at the medication errors hardly goes beyond a comment that “he/she was busy or distracted”. Similarly, looking forward past the events does not raise more than “be more careful next time”. The truth is, we should not blame the healthcare workers who made the medication errors. We should look at it from a broader perspective of how the medication errors happened, and in this case, the healthcare system. Healthcare technology is integral to assessment and monitoring of patients and to the provision of treatment. It also helps with access to vital information and can enhance communication. We would like to share with you King Abdullah Medical City experience with pharmacy automation solutions and HIS implementation and improvement in order to provide the best patient care, ensure medication safety, improve patient health outcomes, improve patient experience, give more time for nurse to spend with patients. And its correlation to nurse’s satisfaction, patients and medications safety.
Tariq Saad Tamim completed his M.Sc. Pharmacology in 2009, B. Pharm. 2006 UMST Khartoum Sudan and Head of Pharmacy automation & Informatics | Pharmaceutical Services Administration king Abdullah Medical City since July 2010, Quality control officer at Central Medical Supplies 2007.
The socio-economic problems in Nigeria have forced people to look in the way of herbal drugs for cure for their medical challenges. This is because the price of orthodox drugs in the market has skyrocket over the years. The health implications of these herbal drugs intake have not been thoroughly considered by its users or medical experts in Nigeria. Garlics rich in garlic acids, Pb and CO related compounds that are found in herbal drugs have been found to cause hearing loss in Nigeria. The government needs to enact policies to eradicate or control the intake of herbal drugs and its related compounds especially as it’s freely sold on the streets this day. Keyword:health,challenges and drugs
Bello Hassan Onimisi is a PhD candidate from medicinal/pharmaceutical chemistry department in olabisi onabanjo university in sagamogun state of nigeria.my area of interest are drug discovery,bioinformatics,data science and nano technology.
Empowering patients and understanding their perspectives are crucial for healthy lifestyle behavioral changes. Compared with conventional face-to- face interventions, mobile phone text messaged-based intervention has been suggested as a cost effective and innovative alternative for healthy lifestyle promotion. The aim of this study was to develop and test a mobile phone text message-based program in empowering and enhancing healthy lifestyle behavioral changes for patients after screening colonoscopy. This is a three-month exploratory sequential mixed-methods study. In Phase One, the qualitative data of the participants’ perceived benefit-barriers to lifestyle behavioural changes was collected, analysed and used as messages for bank of mobile phone texts. In Phase Two, the participants were divided into Intervention and Control groups randomly. The participants in intervention group will receive 4 mobile phone text messages per week for 12 weeks. A total of 129 (Intervention n=65; control n=64) participants were recruited. The statistical results illustrated that there was no improvement in health related quality of life [PCS (P=0.301) MCS (P=0.12)] and overall healthy lifestyle pattern (P=0.649) between baseline and three months follow up for participants in control group. In contrast, the participants of intervention group showed improvement in health related quality of life [MCS scores (P=0.000)], better overall healthy lifestyle pattern (P=0.000), more physical activity (P=0.000), adopt better nutrition (P=0.000) and better stress management (P=0.004). Mobile phone text message-based intervention program was feasible and showed beneficial effect in empowering and enhancing healthy lifestyle behavioral changes for patients after screening colonoscopy.
Kim Choy is a doctoral student at University of Bath. She is the senior lecturer in School of Health Sciences at Caritas Instute of Higher Education, Hong Kong
Personalized genomic medicine is a promising approachto optimize treatment effects of otherwise modestly efficaciousmedications, by selecting the “right” patient therapeutically and potentially with a minimum of adverse events.Recently, in a randomized double-blind clinical trial of 283 alcohol-dependent individuals of European descent, we demonstrated that the 5-HT3 antagonist ondansetron, presumably through its neuromodulatory effects at postsynaptic 5-HT3 receptors, was efficacious in reducing drinking among those who were carrying 5′-HTTLPR: LL and rs1042173:TT genotype combination in the serotonin transporter gene, compared to non-carriers.In this study, participants were not significantly less likely to drink if they received ondansetron than if they received placebo. When the study population was sub-grouped using the of 5′-HTTLPR: LL and rs1042173:TT genotype combination as a biomarker, ondansetron was found to reduce drinking with a large effect size. In a subsequent analysis conducted to search for additional genetic biomarkers in order to expand the population size that can be effectively treated with ondansetron, we reported 3 genetic markers in HTR3A and HTR3B genes. Addition of these genetic markers increased the population size from 16% to 34% within European ancestry populations. Hence, the search for more genetically-informed subgroups for ondansetron as well as other modestly efficacious medications tested for AUD, continues. Further validation of these pharmacogenetic findings required for application to standard clinical care are underway.
Professor Johnson is a licensed physician and board-certified psychiatrist throughout Europe and in the United States. He graduated from the University of Glasgow in Scotland with an MBChB in 1982, obtained an MD in biomedical sciences in 1993, and earned a Doctor of Science in medicine in 2004, specializing in neuroscience and neuropharmacology.Prof. Johnson has published over150 papers in leading journals, served as an editor of high impact journals and has been a recipient of more than 70 grants/contracts from the U.S. National Institutes of Health for investigating therapeutics for alcohol and other substance use disorders.
The Nursing Direction of the “Centre Hospitalier de Luxembourg” organized a nursing research project around the innovation in nursing practices for hospital service organizations. The purpose of this project is: • To generate the self-criticism of the professional and make him or her responsible for the care of patients through the writings in the nursing files • To move from the notion of nurse responsibility to the notion of nursing team responsibility • To standardize care plans by clinical picture • To develop a safety culture • To anticipate skills, and be an actor in the training objectives of the team • To drive towards multidisciplinary responsibility • To validate that all the activities of the nursing project are well completed and that the set objectives are well achieved and thus ensure that the team has responded to the expectations and needs of the patient, to the promised quality. • To capitalize on the differences detected in the closing of the record To date, it is a real asset and brings out many added values for the benefit of patients and the professional development of our teams. This project has enabled a professional transformation of our managers within our institution leading them to ensure and assume managerial responsibility but also to develop a local clinical management. The managerial position of the head of unit around this innovative project contributes to individually and collectively empowering each member of the team towards autonomy in his self-criticism. It is conducive to ethical reflection, creativity and the development of professional talent. The closing of the record is one of the key tools that helped to achieve the accreditation of our institution according to Join Commission International standards.
Graduated from the Provincial Nursing school in Namur and entitled of the Luxembourgish Graduate Degree, Monique Birkel was first lecturer the Nursing school of Luxembourg (LTPS). As a manager, she organized the continuous training of care professionnals in the Centre Hospitalier de Luxembourg (CHL). Monique Birkel is now director of Nursing in the CHL sinc 2001 . She was also appointed and serves as refering director for quality in CHL.
There are several models for ethical decision making in nursing. However, most of these apply to an individual nurse faced with an ethical dilemma. In the real world of nursing and healthcare, ethical dilemmas and decisions seldom involve a single person. In the United States, as in the world, there is an evolving emphasis on interdisciplinary team-based collaborative care. The following 10-step decision making process was developed by the author(Slusser, Garcia, Reed, & McGinnis, 2019) as a suggested approach that is more specific to interprofessional team-based decision making incorporating the Interprofessional Education Collaborative Expert Panel (IPEC, 2011;2016) values/ethics sub-competencies for interprofessional collaboration Identify the decision to be made. 1. Whose decision is it to make? 2. Identify the stakeholders. Who will be affected by the decision? 3. Decide how the team will make the decision. Will it be based on ethical principles? What process will be used? 4. Identify and gather information relevant to the decision. 5. Identify all available options(based on the information from the first four steps). 6. Analyze the risks, benefits, costs, and feasibility of the options. Triple Aim operates here 7. Choose the “best” option. Information from the first 6 steps must be considered, and each team member must have the opportunity to contribute. 8. Implement the decision. 9. Evaluate the outcome. The presentation will explain each step of the process and how it works through the use of a case study.
Dr. Reed is Associate Professor at Stockton University. She received her MSNand PhD in Nursing from University of Pennsylvania. She engaged in post-doctoral study in Sleep & Chronobiology at the University of Pennsylvania School of Medicine. She is a certified Advanced Practice Nurse in mental health. She was an adjunct professor in Nursing at the University of Pennsylvania and Allegheny University, and held a joint position as Nursing Research Coordinator at Cooper University Hospitalfaculty at Rutgers University. She has numerous peer-reviewed publications and international presentations. She is a member of Alpha Eta, and Theta Sigma International Nursing Honor Society.
Background Surgical ward has about 600 adult patients needing operation per year. When patients have operation, pain is one of the most important symptoms to control effectively. During pre and post operative care nurses work continuously and closely with the patients and are the best persons to assist with pain relief. They need to have knowledge and ability about pain assessment and pain management. The objective was to study outcomes of pain management in process and outcome indicators. Method: This is a participation action research. The sample population were 11 nurses and 61 patients. This study was divided into 3 phases: Phase 1. Situation review about the clinical outcomes of pain management from nurses note, interview patients and nurses. Phase 2 searching to find the best way to promote pain management, then mutual agreement. Phase 3 implementation and evaluation Result outcome process showed that nurses used pain assessment tools and records. The pain re-assessment improved 26 percent. Patients received pain medication as soon as needed 95 percent. Non-pharmacological management was used in positioning 59.2 percent. Patient satisfaction with pain management were 98.4 percent. Conclusion and suggestion Outcome process nurse used pain assessment tools and pain document which met the goal of pain management process. Pain re-assessment is improved, patients were very satisfied with pain management. However, further consideration required for non pharmacological management. Biography: I graduated Bachelor of Science(Nursing) in 1988 then worked in surgical ward. In 2002 graduated Master of Public Health. Now I am a nurse specialist and ward head in university hospital in the North East of Thailand. Our work is taking care of patients pre and post operation.
Will be update soon