Day 2 :
The Ohio State University, USA
Time : 09:05-09:35
Dianne Morrison Beedy joined The Ohio State University in 2018 as Chief Talent and Global Strategy Officer and Centennial Professor of Nursing. She was a Fulbright Scholar (Scotland), recently listed on Fulbright Specialist roster, and had a Senior Administrator Fulbright Award (France). She served as College of Nursing Dean and Senior Associate Vice President of University of South Florida Health. Her awards include the International Nursing Research Hall of Fame, and Florida and New York State Distinguished Researcher, sexual risk reduction intervention for adolescent girls, HIP Teens, recognized by the CDC and US Department of Health and Human Services. She has over 250 publications and over $12 million in research funding and is a Fellow in the American Academy of Nursing, the National Academies of Practice, and the American Academy of Nurse Practitioners. She serves on several boards and chosen by the International Council of Nurses as a Global Nursing Leadership Institute Fellow.
Despite the call globally for a dramatic increase in board memberships for women and diverse candidates, and the focus on improving the health of nations and communities through the service of nurses on boards, few nurses are aware of the benefits of board membership or the steps to make such roles a reality. In November, 2014, twenty one US organizations came together to announce a new, nationwide effort to get 10,000 nurses onto boards of directors by 2020. Similarly, in collaboration with the International Council of Nurses, the 3-year Nursing Now Campaign seeks to empower nurses to take their place at the heart of tackling 21st century health challenges. Taking a place at the table through board service can move nurses to advanced leadership and C-suite positions. Understanding approaches to identifying and successfully achieving board membership and skills for effective board service will be presented. A work plan for developing a blueprint for first-time entry into board service or for progressing up to more complex, prestigious boards will be discussed. Board membership can be a career catalyst for nurses while providing much-needed diversity and unique skill sets to boards ultimately improving organizational outcomes.
Tallinn Health Care College, Estonia
Time : 09:35-10:05
Irma Nool is affiliated to Tallinn Health Care, Estonia. Irma Nool has her expertise in critical thinking in nursing practice, enhancing the quality of nursing care. She has completed her Master of Public Health at University of Tartu from 2003-2006, Bachelor of Nursing at University of Tartu from 2003-2006 and Nurse Tallinn Medical School from 1992-1993
Statement of the Problem: Growing interest in using NANDA-I nursing diagnoses has been observed in health care facilities due to the fact that it ensures using common terminology for patient’s health assessment and in planning nursing care. Nursing documentation is uneven in quality in Estonia which hinders the availability and continuity of nursing care. Quality standards and indicators are not used for consistent assessment. Nurses are filling nursing records and do not consider them to be part of the entire nursing process. It leads to poor-quality nursing documentation, which prevents communication between simple, structured and focused professionals, which in turn affects the quality of patient care. The aim of the study is to describe the quality of nursing documentation in Tallinn Children Hospital. The research is quantitative, descriptive study.
Methodology & Theoretical Orientation: Sample was taken from nursing records before and after NANDA-I nursing diagnoses training for nurses. The selection criteria’s were: patient had to be in hospital for at least three days and there was individual nursing care plan for the patient. Data collection was done during September 2016 - March 2017. D-Catch instrument, the 4-score Likert scale were used. Data analysis: SPSS 19.0, descriptive statistics, means and t-test were used.
Results: 87 nursing record from 8 departments were evaluated (42 before and 45 after training). The results showed statistically reliable differences in the improvement of the quantity of the structure of nursing record (t(85)=-3.004, p=0.004), quality of nursing anamnesis (t(85)=-2.915, p=0.005), quantity of nursing diagnoses (t(85)=-4.387, p<0.0001), quality of nursing diagnoses (t(85)=-5.768, p<0.0001), quantity of nursing interventions (t(85)=-2.982, p=0.004), quality of nursing interventions (t(85=-4.343, p<0.0001), quantity of assessment (t(85)=-2.439, p=0.017) and quality of assessment (t(85)=-3.209, p=0.002). No statistically reliable differences were found for the quantity of nursing anamnesis and the legibility of documentation.
Conclusion & Significance: The study showed the importance of NANDA training in application of new documentation requirements in nursing practice.
Networking & Refreshments 10:05-10:25 @ Foyer
Cardiovascular Nursing | Nurse Practitioners | Certified Nurse-Midwives | Gynecology | Clinical Nurse Specialist | Critical care and Emergency Nursing | Nursing Leadership and management | Telemedicine and e-health | Disaster Nursing | Public Health and Nursing | Universal health care
Tallinn Health Care College, Estonia
California State University, USA
Adventist University of Health Sciences, USA
Title: The lived experience of nurses transitioning to electronic medical records usage: a phenomenological inquiry
Time : 10:25-10:45
Leesuk Ferencsik is a Registered Nurse (RN) and Assistant Professor at Adventist University of Health Sciences, Orlando, Florida. She has been a RN since 1989 and worked in both South Korea and the United States on long-term care facility, health clinic, and all three levels of care: medical surgical unit, progressive care unit (PCU), and intensive care unit (ICU) in various acute care hospitals. Before she became a Nursing Faculty at ADU, she worked as a Clinical Nurse Educator for a multisystem ICU, Surgical PCU, and Transplant Unit. She has a passion for teaching and learning. She was very pleased when she became a Nursing Faculty at ADU where she can do both: learning and teaching. She earned a Bachelor of Science in Nursing from the Korea Open University, South Korea, Master’s degree in Nursing Education from the University of Phoenix, and Nursing PhD from Barry University, College of Nursing and Health Sciences, Miami, Florida. She had also completed a year-long Healthcare Simulation Certification Course at University of Central Florida.
Background: One of the most pressing global issues in health care settings is patients’ safety. In an effort to decrease medical errors and improve the quality of patient care, many health care organizations have adopted an electronic medical record (EMR) system. However, to date, the lived experience of the nurses transitioning to EMR is not clearly understood.
Purpose: The purpose of this study was to explore the lived experience of nurses transitioning to EMR usage.
Philosophical Underpinnings: This qualitative study followed van Manen’s phenomenological perspectives under the naturalistic (constructivist) paradigm with the research question, what is the experience of nurses transitioning to electronic medical records (EMRs) usage?
Methods: A qualitative phenomenological methodology was used for this study. A purposive sample of 15 nurses who have experienced transitioning to the EMR usage was selected. Data collection occurred with in-depth, semi-structured interviews using open-ended questions. Data analysis was guided by Max van Manen’s (1990) phenomenological method, which includes describing, interpreting, textual writing and rewriting.
Results: Four core themes: doubting, struggling, accomplishing, and embracing emerged. Three subthemes: Balancing time between computer and patients and Increasing workloads and responsibility, which are subthemes of struggling, and leaving human interaction behind, a subtheme of accomplishing emerged from this qualitative, phenomenological investigation. These themes illuminated the lived experience of 15 nurses transitioning to EMR usage. Thomas Kuhn’s (1996) process of scientific inquiry provided a framework to gain a deeper understanding of this phenomenon.
Conclusions: This study explored the lived experience of nurses transitioning to EMR usage in hospital settings. The results of the inquiry highlighted the essence of participants’ experience by revealing their doubt about the EMR’s functionality, struggle with transitioning and using the new EMR system, accomplishment of successful transition to the EMR system, and finally acceptance of technology in their daily work practice.
King University, USA
Title: Coping strategies of prelicensure registered nursing students experiencing student-to-student incivility
Time : 10:45-11:05
Robin Ann Foreman has been in nursing academia for over ten years. She teaches the Psychiatric/Mental Health course in the BSN Program and the Nurse Educator track specific courses in the MSN Program. She began studying interpersonal relationships and conflict management among nurses after her clinical students began experiencing incivility. Her doctoral dissertation investigated student-to-student incivility among prelicensure registered nursing students. She identified behaviors student nurses consider to be uncivil and coping strategies students employ when they are confronted with incivility. Her future work will be to develop educational programs to help nursing students have positive outcomes when uncivil behaviors are encountered using the ICE faculty intervention model for nursing student incivility: identification, coping skills, and empowerment. Critical social theory, oppressed group behavior theory, and the transactional model of stress and coping have guided this research.
Statement of the Problem: Incivility is rude or discourteous behavior that demonstrates a lack of respect for others. Some nurses purposefully target each other with uncivil behaviors. Incivility has invaded the nursing educational environment with deleterious results. Uncivil behaviors perpetrated by nursing students against other nursing students cause psychological and physiological distress for victims and witnesses. The purposes of this study were to identify the behaviors that constituted lateral student-to-student incivility, determine the frequency of experienced student-to-student incivility, and describe the coping strategies employed by prelicensure registered nursing students experiencing lateral student-to-student incivility.
Methodology & Theoretical Orientation: This quantitative descriptive study recruited prelicensure registered nursing students in associate degree, baccalaureate degree, and diploma programs using nonprobability convenience sampling through the email member list of a national student nursing organization. Critical social theory was the study framework to explore the meaning of civil and uncivil student-to-student interactions and behaviors in daily academic life. Participants completed the Ways of Coping (Revised) survey and the Incivility in Nursing Education Revised (INE-R) survey anonymously online via email accounts.
Findings: The most frequently occurring incivility behavior was the use of media devices for purposes unrelated to the current educational task. Planful problem-solving (PP) was the coping strategy most often employed by participants. Data was analyzed comparing participants’ nursing program levels, ages, genders, and ethnicities using descriptive statistics and Kruskal-Wallis analyses.
Conclusion & Significance: Four behaviors were identified as highly uncivil: threats about weapons; threats of physical harm; property damage; and discriminating comments toward others. This is a positive finding as civil societies consider these activities unacceptable, and often illegal. Recommendation for a universally accepted definition of academic incivility within the discipline of nursing is promoted so civil behavior can be modeled by educators and taught to students.
The Ohio State University, USA
Time : 11:05:11:25
Dianne Morrison Beedy joined The Ohio State University in 2018 as Chief Talent and Global Strategy Officer and Centennial Professor of Nursing. She was a Fulbright Scholar (Scotland), and recently listed on the Fulbright Specialist roster, and had a Senior Administrator Fulbright Award (France). She served as College of Nursing Dean and Senior Associate Vice President of USF Health, University of South Florida. She developed a sexual risk reduction intervention for adolescent girls, HIPTeens, recognized by the CDC and US Department of Health and Human Services as an exemplary evidence-based intervention for HIV/STI/teen pregnancy prevention. She has received numerous awards for her work; International Nursing Research Hall of Fame, Florida Top 100 Nurses, Excellence in HIV Prevention Award from Association for Nurses in AIDS Care, and Florida and New York State’s Distinguished Researcher. She has over 250 publications including award-winning book on intervention research, and over $12 million/research funding.
The #MeToo movement has highlighted a prevalent problem facing women, the risk of sexual violence by men. Females who experience sexual violence or abuse are more likely to engage in risky behaviors as teens and later on in life. Little is known about the prevalence of such threats faced by adolescent girls, thus, the purpose of this study was to describe the risk faced by 738 urban girls ages 15-19 enrolled in a randomized controlled trial testing HIPTeens, a sexual risk-reduction intervention. Using audio computer-assisted self-interviews, we collected data describing girls’ experiences with men pressuring, threatening or forcing them to have: (a) sex play, (b) attempted intercourse or (c) actual penetrative sex. We assessed whether a man used his position of authority or substances to do so. Unfortunately, every behavior assessed was reported by at least some of the girls in our sample. One-half reported they had given in to sex play (fondling, kissing, petting but not intercourse) when they didn’t want to because they were overwhelmed by a man’s continual arguments and pressure; one-quarter reported having done so multiple times. Even the least frequently endorsed question “How often have you had sexual acts (anal, oral or penetration by objects other than a penis) when you didn’t want to because a man threatened you or used some degree of physical force?” was reported by 10% of girls. These findings should raise alarm over the frequency with which teen girls are sexually pressured, coerced or victimized, often by men who use their position of authority or providing substances (to an underage child) to perpetrate such acts. Tailored evidence-based interventions that integrate strategies that focus on both sexual violence and HIV prevention can help improve both outcomes. Further research addressing interventions targeting males is critical.
Thompson Rivers University, Canada
Title: The effect of faculty lead gentle persuasive approaches training has on nursing students to manage responsive behaviors
Time : 11:25-11:45
Tracy Christianson is a tenure track assistant professor in the School of Nursing at Thompson Rivers University. With over 25 years of nursing practice and teaching experience, her research focus is a blend of nursing education, gerontology, and rural health issues with an emphasis on improved practice and quality of care. Dr. Christianson has completed a number of research projects and has disseminated research findings at conferences and in peer-reviewed journals.
Problem Statement: Nurses face a high level of risk of violence compared with other workers, with higher frequency towards those who are younger and less experienced. Risk of violence is similar for health care aides (HCA), and nursing students, with HCAs experiencing the highest rate of injury because much of their work and clinical practice is in residential care settings where many patients are at risk for challenging behaviors due to cognitive changes.
Purpose: The purpose of this project was to evaluate the effects of Gentle Persuasive Approaches© (GPA) training had on students' knowledge and ability to care for patients who have the potential for responsive behaviors. GPA is a training program recognized in Canada as best practice in the management of responsive behaviors of patient and provides the learner with the skills to interact and intervene to diffuse escalating care situations.
Methodology: A mixed-methods approach with a quasi-experimental, repeated measures design was used with nursing students (health care assistant [HCA] & bachelor of nursing [BSN]) who had limited exposure to the practice setting. The intervention took place over three phases with two HCA cohorts completing GPA through self-paced online modules (e-learning) with a two-hour face-to-face post e-learning review (Phases 1 & 2). Phase 3, the third HCA cohort and 1/2 of the BSN cohort received GPA training face-to-face (Phase 3) with GPA trainers, with the other half of the first year BSN cohort as the comparison group. Repeated measure questionnaires were administered pre-GPA, post-GPA, and post-clinical practice. At the close of each clinical practice, focus groups allowed students to reflect on how GPA prepared them for managing responsive behaviors.
Findings: Although the project is not yet complete at the time of this abstract submission, preliminary results are indicating positive results. Students recognize signs of changes in behaviors that may lead to responsive behaviors. Students describe their ability to manage and redirect patients to decrease such behaviors. Physical techniques learned and practiced in the GPA training helped students confidently manage physical aggression.
Conclusion: While no scientific conclusions can be made at present, preliminary data indicates GPA may have had a positive impact on confidence, skill, and knowledge manage responsive behaviors.
Tallinn Health Care College, Estonia
Title: Intervention possibilities to violence against children in interdisciplinar teamwork using simulation and e-learning methods
Time : 11:45-12:05
Marika Merits is lecturer and psychologist in Chair of Midwifery at Tallinn Health Care College since 1995. She received diploma in Special Education and Psychology in University of Tartu. She has built different psychology Subjects in Nursing and Midwifery curricula, also she is involved in a number of international and local projects like Violence and Abuse, Improvement of Afghanistan Midwifery etc.
Background: Violence is not an inevitable consequence of the human condition. The full range of all forms of violence against children are only now becoming visible, as is the evidence of the harm it does. Governments are increasingly acknowledging and enforcing their human rights obligations to children, and recognising the prevalence and long-term impact of violence. The prevalence of violence against children in Estonia continues to be on high level. In Estonia the legal framework of intervention for police and the healthcare has been developed, but the cooperation between the institutions is weak, and therefore a victims support is too low and not effective. Necessity for common learning subject is caused by the need to offer for victims (children) the effective complete solutions, combining the healthcare and police work intervention.
Aim: To describe how students of two higher education institution learn to intervate possibilities to violence against children in interdisciplinar teamwork using simulation and e-learning methods. The emphasis is on common learning of nurse students and police students.
Design: Learning subject volume is 4 ECTS, the participating students are from Tallinn Health Care College (midwife and nurse students) and Estonian Academy of Security Sciences (security and police students). Combained course design contains: e - learning in Moodle environment and contact learning - a theory of violence and the impact to children, the legislation in Estonia and interdisciplinar teamwork in helping target group of victims; simulation practice is build up in various cases and intervention by combining healthcare and police work. Preparation lasted for one year, as a result the common learning subject was build up.
Findings: The subject needs some improvement. A students feedback is colleceted by the questionnaire in Moodle environment and by the instant feedback in the closing seminar. The following suggestions were brought up: to involve social workers as well victim assistance that solutions would be more effective, to add more complicated, and various cases and to improve the common part of Moodle environment. A satisfaction was expressed that nurse, midwife and police students will be able to share a mutually necessary information and act professionally by ensuring for victims the effective complete solutions and support. Innovation in education including shared learning on the example of the two higher education institution using e-learning and simulation by enhancing the interdisciplinar teamwork in the interventing of target group of victims.
Kingston University, UK
Time : 12:05-12:25
Maria Ponto is an Associate Professor at School of Nursing at Kingston University and St. George’s University of London and a Visiting Professor at Lapland University in Finland. She is a Nurse, Midwife and Psychologist and has links with many European Universities. She has run MSc programmes since 1996 in the UK and St. Petersburg in Russia and has given many lectures and presentations at international conferences. She has undertaken and supervised commissioned research in nursing and education.
This presentation will discuss potential and actual problems that may occur when carrying out commissioned research. For instance if the commissioned research is from an organisation that anticipates finding positive evidence for changes or interventions they introduced, this can create conflict if data do not show this. Sometimes access to the sample is through the organisation and the researcher has no control over data collection or methods for data collection. This can create anxiety for the researcher and may compromise their objectivity. The presentation will also discuss how to deal with such problems and will provide examples of strategies that can be used to maintain empirical rigor whilst fulfilling commissioned obligations.
California State University, Fullerton, USA
Title: Implementation of the Edinburgh postnatal depression scale at a psychiatric ambulatory clinic
Time : 12:25-12:45
Nnenna Weathers, PhD is an Assistant Professor in the School of Nursing at California State University Los Angeles where she is Director of Nurse Practitioner programs. Her research interest is in HIV and in other health disparity related research.
We evaluated the use of the Edinburgh postnatal depression scale (EPDS) as a screening tool to prevent the misdiagnosis of postpartum depression (PPD). The Stetler model (SM) was used to guide implementation of the EPDS in an ambulatory psychiatric setting for this quality improvement project. Women diagnosed with PPD during an eight-week period immediately prior to the implementation of the EPDS were compared with women diagnosed with PPD using the EPDS during an eight-week period. Three psychiatrists and one nurse practitioner (NP) agreed to implement the EPDS. A total of 29 pre- and post-implementation postpartum women (PPW) met inclusion criteria for this project making up the final sample. A total of 21 PPW were screened with the EPDS. Of those, 21 (100%) were diagnosed with PPD compared to six/eight (75%) PPW diagnosed with PPD without the use of the EPDS. Participating psychiatrists and the NP diagnosed two (25%) patients with non-postpartum depression and anxiety during the eight-week period when the EPDS was not used. Screening for postpartum depression with a tool that supports objective measurement of symptoms may help to more accurately diagnose PPD, and thus with more appropriate treatment of PPD.
Lunch Break 12:45-13:35 @ Peacock Restaurant
Time : 14:35-14:55
Vibeke Lohne is a Nurse and a Professor at University of OsloMet. She has a degree (Dr Polit) from University of Oslo and her main research focus is on hope, dignity in critically illness and in the context of rehabilitation, and on family caregivers.
Aim: This paper focus on experiences of hope and hoping in different clinical nursing contexts.
Background: Hope is an important part of everybody’s life. However, less focus has been on similarities and differences on experiences of hope in different contexts of suffering and health.
Methods: This study of synthesized empirical knowledge from twelve research studies was based on methods of concept development. Findings from each study were compared to increase the typology and particular patterns of hope, clarifying and modifying the essence of hope.
Results: A synthesized understanding of the empirical findings revealed the following categories: despairing hope, uncertain hope in the acute and critical nursing context, struggling hope, flexible and creative hope related to the context of rehabilitation and universal and existential hope in the context of prevention and health promotion. The essences of hope which rose from the different contexts were possibilities, expectations, destiny, vitality and freedom.
Federation University Australia, Australia
Title: The use of visual art as a method to enhance health professionals’ communication with adolescents living with type 1 diabetes
Time : 14:55-15:15
Ainsley James is a Published Researcher with over twelve years in Clinical Practice and twelve years in Academia. Her clinical practice experience includes general nursing, orthopaedics, child and adolescent health, and experience as an Undergraduate Clinical Educator. She currently teaches undergraduate nursing and midwifery students at Federation University Australia. She has an extensive list of publications with her most recent being issues in recruiting young people to research. She was the recipient of an Australian Postgraduate Association (APA) Scholarship, enabling fulltime PhD candidature with Monash University. Her PhD research explored and described the lived experience of young people aged 16-24 years with type 1 diabetes. Using Max van Manen’s approach to phenomenology, her research utilised visual images created by the participants and textual descriptions from interviews, to discover and provide insights into the lived experience of young people with type 1 diabetes.
Purpose: The purpose of this paper is to describe the use of visual media, as a person-centred approach that health professionals should consider during therapeutic interactions with adolescents living with type 1 diabetes. This paper reports on a research study that adopted visual media produced by young people living with type 1diabetes to share their experiences. The visual media functioned as both a conduit for communication and a strategy for establishing relationships.
Methods: Using van Manen's phenomenological approach, ten participants (nine females, 1 male) aged 16-24 years participated in the research. Each participant created artwork representing their lived experience in photographs, drawings and collages. Participants provided interpretations of the artwork, which complemented a phenomenological interview exploring their experience of living with type 1 diabetes. This process added depth, richness and rigour to their shared stories and informed the analysis of data and interpretation of findings.
Results: Art in the form of visual media is a powerful representation of lived experience and provides young people with a creative channel to express themselves. Using art as an approach to therapeutic interactions enhanced communication between participants and researcher by engaging the participants in the research process, enhancing therapeutic interactions by focusing on the visual media produced, and facilitating conversations regarding lived experience; all resulting in rich descriptions of the lived experience of type 1 diabetes. Insights and future opportunities are provided for researchers contemplating the use of art in qualitative research studies, such as phenomenology and lived experience.
Conclusions: Art is a valid and creative form of research data and is also a valuable tool for qualitative researchers wanting to involve young people as participants. Adopting age appropriate communication methods is a necessary skill health professionals must develop if they are to be effective practitioners.
Robin Trust, South Africa
Time : 15:15-15:35
Penny Gill has been a Nurse for over fifty years in Cape Town, South Africa. Recently she retired as a University Lecturer. She is a Pediatric Nurse and has been a Nurse Educator since 1986. Her special interests are curriculum design and the use of innovative teaching strategies using educational technology. Since 2008 she has been the Coordinator of an Extended Nursing Curriculum Program at a Cape Peninsula University of Technology where previously educationally, disadvantaged first year degree nurses complete their first year over two years. This program has enabled her to spend time with her students in developing various teaching strategies using modern technology to help the students engage with the curricular content using guided constructivism. The students then successfully integrate into the second year mainstream degree program.
Story-telling is an ancient human craft handed down from generation to generation. Digital storytelling (DST), the modern equivalent, is defined as a short first person multi-media video narrative that documents human life experience, ideas or feelings through story-telling. Research shows that DST, if integrated appropriately into the curriculum, can promote student-centered learning strategies such as reflection for deep learning, project-based learning, collaborative learning; development of digital literacies and the effective integration of technology into teaching and learning. All of these can enhance student engagement and contribute to student success. This paper is based on lessons learnt in an on-going DST project at a Cape Peninsula University of Technology, in South Africa. This project followed the Centre for Digital Storytelling workshop model which focuses on the collaborative sharing and developing of stories in so-called story circles and implemented participation and learning techniques such as Community Maps (which are visual techniques to explore the students’ diverse backgrounds). The project emphasized narrative, visual and digital modalities over text, in order to increase confidence levels in students with low academic literacy skills levels. The researcher investigated the effectiveness of DST in teaching and learning amongst forty-five first year extended curriculum nursing students, by drawing on students’ perceptions of the impact of DST as an alternative teaching and learning method. Qualitative methods of collecting data were used, which included focus group interviews with the students to elicit their perceptions on the effectiveness of DST for teaching and learning in nursing education. The inductive method of analysis was used to analyze data. The paper will present the impact of this study for teaching and learning; challenges encountered in the implementation of DST; and strategies for enhancing meaningful use of DST for teaching and learning amongst extended curriculum nursing students, as well as recommendations for future use.
Networking & Refreshment Break 15:45-16:05 @ Foyer
University of Malta, Malta
Time : 16:10-16:30
Michael Galea is a Clinical Psychologist and Senior Lecturer at the Mental Health Department, Faculty of Health Sciences, University of Malta. He read Master’s in Pastoral Theology from the University of London, UK, a Master’s in Science in Pastoral Psychology from the University of Loyola, Baltimore, MD, USA. Furthermore, he did his Doctorate in Clinical Psychology from the same university. He has worked in different settings and with various populations, including addiction counselling (Sedqa), as a Consultant Psychologist (Malta Prison system), family and individual psychotherapy (Appogg, Cana Movement). Besides private practice, he is a Senior Lecturer at the Mental Health Department, University of Malta. He has authored a number of peer-reviewed journal articles and chapters in books, and is working on two new books, besides those already published. He is a regular participant in a popular live TV show on mental health - related subjects, which includes phone-in participations as well. His current research interests include stress and burnout at work, post-traumatic growth and psychology of religion & spirituality.
Nursing profession is a highly stressful vocation. Participants (N=241), who work in three different hospitals in Malta, were assessed on the impact of burnout on their holistic wellbeing. Nurses completed the Maslach Burnout Inventory-Human Services, the Satisfaction with Life Scale, the Faith Maturity Scale, the Positive and Negative Affect Scale, the Big Five Personality Inventory, and demographic variables. Results from this cross-sectional correlational study indicated that: a) Professional nurses in Malta suffer from high levels of burnout, particularly from high exhaustion and depersonalization and low professional accomplishment; b) As expected, burnout negatively correlated with subjective well-being; and c) A path analysis indicated the progressive impact of burnout, ﬁrst on one’s personality and affective mood, and eventually on one’s wellbeing and spirituality. The implications and recommendations from these results were discussed.
Federation University, Australia
Time : 16:30-16:50
Joanne Porter currently works at the School of Nursing, Midwifery and Healthcare at Federation University Australia, Gippsland campus. She teaches into the undergraduate program, and postgraduate higher degree supervision. She has worked both in Metropolitan and regional health facilities predominantly in emergency departments and intensive care units. Her research interests include, deteriorating patient outcomes, simulation, and emergency care research. Her PhD through Monash University used a mixed methods approach to investigate the affect family presence during resuscitation (FPDR) had on personnel in the emergency department. She currently holds the position of Senior Lecturer and has an extensive research history with a number of publications and competitive grants.
Aim: The aim of this paper is to report and showcase the development of an education training package using video scenarios utilizing the acronym ER-DRIP to teach clinicians on how to implement family presence during resuscitation (FPDR).
Background: The practice of allowing family to be present during resuscitation has been debated in emergency departments since the early 1980’s, with evidence that the practice and implementation of FPDR is inconsistent despite formal endorsement. This study aimed to develop an education package for emergency nurses, paramedics and medical personnel in order to develop competence in the implementation of FPDR.
Method: The acronym ER-DRIP (emergency personnel, reassurance, diagnosis, regular up-dates, interventions and prognosis) was developed following a state wide survey, a period of resuscitation observation and interviews with emergency personnel in Victoria. An education training package was developed, which provides students with a series of videos together with discussion notes which aims to develop the skills necessary to successfully implement FPDR for both pediatric and adult patients. The three scenarios include a pediatric respiratory arrest, a myocardial infarction and a stroke victim.
Results: A total of three scenarios were written and filmed with the use of simulation trained live actors, emergency personnel and paramedics aiming to mimic resuscitation events.
Conclusion: FPDR, although widely endorsed is practiced inconsistently. Additional training and education around the implementation and practice of FPDR was identified as essential, the training package aims to build clinical confidence and competence.
Washington State University, USA
Title: Developing a critical skills assessment for disaster response military personnel: a pilot study
Time : 16:50-17:10
Denise Smart has her expertise in military population health and occupational health. Her focus is on workplace safety during training and real-world military disaster responses for National Guard medical personnel. She has experience of over 22 years as a Navy Nurse and Public Health Officer for the Air National Guard before retiring in 2012. She has been working closely with Dr. Lois James (Co-Investigator) on this two-year research project
Purpose/Aims: Prior to starting our two-year National Guard sleep study, our research team was faced with the challenge of identifying a method of measuring medical decision making in a military field setting that would be non-disruptive to the disaster response training exercises underway. Thus, the purpose of this pilot study was to select an appropriate set of medical calculation questions and basic life support (BLS) questions sensitive enough to detect fatigue-related critical skills deterioration.
Rationale: Demands of our larger study and the urgency of needing information to guide which questions to employ required us to gather preliminary evidence regarding the similarity of the response time and difficulty of the questions used to measure medical decision making. As such, we used Doctor of Nursing Practice (DNP) and Baccalaureate of Science Nursing (BSN) students as a proxy for National Guard medical personnel.
Method: Thirty-seven students who were enrolled in a DNP program or a BSN program participated in this study. Over the course of three days, student participants were sent five questions in the morning and five questions in the evening. On the fourth day, students were sent 10 questions in the morning and 10 questions in the evening. DNP students received medication calculation questions and BSN students received BLS questions. All questions were drawn from standardized test bank sources, were multiple choices and were thoroughly reviewed by the research team for relevant content prior to study testing.
Results: Twenty-five (50%) and twenty-eight (56%) of the 50 BLS and medication calculation questions met the selection criteria of average response times between 10 and 50 seconds and accuracy of at least 80%. From these, 16 questions were selected from both sets with smaller standard deviations, minimum response times of at least 5 seconds and maximum response times less than 90 seconds.
Implications: In order to test the impact of sleep deprivation, fatigue, or any other stressors on critical decision making skills of military medical personal during field training operations it was necessary to develop a test battery of questions that are sensitive enough to detect variation due to human factors. Our study accomplished this objective, and the resulting medication calculation and BLS questions can be used to readily assess deterioration in critical decision making skills within a field setting.
Young Researchers Forum
Sichuan University, China
Wen Yan is a Master graduate student majoring Geriatric nursing of West China School of Medicine, Sichuan University.
Objective: To compare the status of the awareness rate of the guidelines on falls in the elderly and attitude towards the guideline among nurses in secondary hospitals and tertiary hospitals in Sichuan Province.
Methods: From April to June 2017, a total of 800 nurses from 8 secondary hospitals and 8 tertiary hospitals in Sichuan Province with a convenient sampling method were recruited to conduct questionnaire survey on the awareness rate of knowledge of falls in the elderly and attitude towards guidelines for comparative analysis.
Results: The awareness rate of all nurses on the knowledge of fall in the elderly was 26.3%, there was significant difference in the awareness rate of the guidelines for falls among the elderly (22.6% vs. 29.9%, χ2=5.358, p<0.05) between the secondary hospitals and the tertiary hospitals. The nurses’ attitudes towards the guideline between the secondary and tertiary hospital were statistically significant [(54.60±6.39) vs. (58.06±6.88), t=7.291, p<0.001].
Conclusion: The awareness rate of nurses' knowledge of elderly fall guideline in the secondary hospitals and the tertiary hospitals was low, nurses’ attitudes towards guidelines were both positive in the two level hospitals. It is suggested to use nurses' positive attitude to guideline and train nurses in systematic professional anti-fall by setting guidelines for intervention of fall in elderly patients in hospital so as to reduce the incidence of falls in hospitalized elderly patients.
Sichuan University, China
Zhao Wenting is a postgraduate student at West China Hospital of Sichuan University, majored in geriatric nursing. She has published more than 2 papers in her first year in Master’s degree. She loves her career in nursing, and wants to help more people to live better.
This paper introduced the basic concept, development background, development situation and pattern of acute care of the elderly unit, so as to improve the public cognition and development of acute care of the elderly unit. The practices of acute care of the elderly unit could improve the hospital outcome of elderly patients and enhance the quality of life.
Poster Presentations 13:35-14:05 @ Foyer
Bente Nordtug works as an Associate University Professor at Nord University, at Faculty of Nursing and Health Sciences. Her research topics are social support, caring burden and mental health of informal caregivers of people with chronic illnesses. As a Nurse, she is specialized in dementia caring.
People with dementia often wish to be treated with acceptance and respect in spite of their illness. The more dementia advances, the greater the need is to hold the pieces of the past together in the person’s current memory. Mapping a person’s life story and identifying areas of personal relevance can help caregivers to understand their background; it may also help them maintain a sense of positive self-esteem. Thus, the work-related narratives of people with dementia may be used to counteract the effects of cognitive decline, even when a person’s narratives seem insignificant to others. Twelve home dwelling persons in early stages of dementia were interviewed about their former work lives. The researcher recorded and took note of the participants’ verbal narratives and observed facial, vocal, and emotional expressions while they shared their work narratives. Thematic content analyses of verbal utterances and non-verbal expressions were later interpreted with regard to the underlying meaning of the statements and momentary changes in the participants’ self-esteem. During their lifetimes, all participants had been involved in several types of work: paid, unpaid, part-time, and full-time. Their motivation for choosing their past work was influenced by values of their contemporary culture. Mostly they narrated positive events from their paid work that underscored the importance of formal recognition and acknowledgement. However, they often felt that unpaid work was taken for granted and not fully recognized by family or society. Those who had come to terms with their illness had positive feelings about their past contributions in their former paid work. Some wrestled with accepting their illness; they were grieving their losses, regardless of former success. Caregivers may use parts of work narratives to elevate the self-esteem and quality of life of people with dementia.
University of Alicante, Spain
José Siles-González has his expertise in nursing history and culture care. The Structural Dialectic Model of Care SDMC) has its origin in a mid-1990s doctoral thesis entitled “Family structure and social role of women in Alicante, 1868-1936”, which employed this model for the first time. We are part of a research group at the University of Alicante: "Culture of Care” (http://web.ua.es/es/cultura-cuidados/). SDMC presents an integrated approach to socio-cultural and biological systems from nursing perspective. The SDMC has been used in cultural history research and in cultural studies of care. A cross-disciplinary approach was adopted in the construction of this model, which among other things is based on structuralist and functionalist premises. From structuralism, the model incorporates the contributions of Lévi-Strauss.
Introduction: The structural dialectic model of care provides a data analysis method that facilitates understanding and clarifies the meaning of the data as well as identifying their structural and functional characteristics.
Objective: To demonstrate the relevance of the structural dialectic model of care for data analysis in historical and anthropological studies of nursing, considering events, motivations, scenarios and characteristics.
Method: The characteristics and functions of the model are described and explained through an analysis of its application in seven doctoral theses (2009-2016).
Results: The structural dialectic model of care has three structures: the functional unit (ideology), the functional element (social agents) and the functional framework (scenarios). It contributes to the analysis of historical and cultural data on nursing, clarifying the processes of social representation.
Conclusions: The structural dialectic model of care constitutes a useful methodological tool for historical studies of nursing, organizing analysis of the data according to the dynamic and dialectical nature of their structures.
Tallinn Health Care College, Estonia
Lily Parm is a Chair of Nursing and Lecturer at Tallinn Health Care College, Estonia. She has completed her MSc in Nursing, Faculty of Medicine, University of Tartu and Nurse Specialty Training (health education) at Tallinn Health College, Estonia.
Background: The learning environment affects the development of clinical skills and gives students an opportunity to apply the theory gained in practice. Students need a supportive learning environment. Studies results in 2007 Estonia revealed some problems in instruction and the learning environment satisfaction.
Aim: The aim was to describe the Tallinn Health College and Tartu Health College nursing students' assessment of the learning environment and supervision in clinical practice and to compare the results to a survey conducted in 2007.
Method: Data was collected in 2012 using the questionnaire of clinical learning environment and supervision instrument (CLES). The sample consists all nursing students from courses II and III from Tallinn and Tartu Health Colleges (n=302), who had undergone at least one of the clinical practices. The students` assessment was given on a 5-point Likert scale. Statistics analysis: SPSS 20.0, statistical descriptive statistics, χ2 test, t-test and Spearman correlation analysis were used.
Results & Conclusions: The biggest improvement in comparing the results of two surveys was in the clearness of department`s vision (t(446)=6.048, p<0.0001) and nursing documentation (t(445=2.369, p=0.019). The most highly evaluated was the supervision, which was based on mutual trust and the positive attitude of the individual mentor. The lowest levels were assessed for individual supervision experiences and assessing clinical learning environment. The most highly rated was the head nurse`s management style and the lowest rating was for the atmosphere of the department. Compared with 2007 and 2012 results of the research, there was an increase in satisfaction with clinical practice.
Kaire Sildver is lecturer in Chair of Midwifery at Tallinn Health Care College in Estonia. She has been on the Chair of Midwifery since 2014. She received diploma in Midwifery at 2010 from Tallinn Health Care College and Master Degree (MSc) in Public Health- Epidemiology in University of Tartu 2014. She is involved in several Projects and Research field.
Background: In healthcare disciplines, theory and practice are very closely associated with each other. This research is important in order to know the factors that affect the quality of the specialty internship of midwifery. The whole foundation of learning, however, is based on the relationship between the mentor and the student relationship, the success and the quality of the performance of the internship depends on it. The important role is played by the personality characteristics of the mentor and the student, their theoretical and practical knowledge and skills, professional competence, personal values, communication skills and ethical attitudes. Lack of experience in practice impacts negative influence in future working as midwife.
Purpose: To describe and analyze the satisfaction levels of the midwives at East-Tallinn Central Hospital Women’s Clinic concerning the organization of clinical practices and the affected factors.
Design: The research method of this study is empirical and based on qualitative data analysis. In order to collect data, semi-structured interviews have been conducted with three different focus groups which were recorded on videotape. The analysis of the data relies on discourse analysis which includes the transcription of audiovisual material, codification, analysation and presentation of results. All subjects of the survey have been informed about ethics and the benefits received from the results in raising the quality of the internship.
Findings: A broad consensus exists among the midwifery mentors working at East Tallinn Central Hospital Women's Clinic that from the hospital's point of view clinical practices are well-organized. The organization of the practices carried out by the school brings forth positive comments from the mentors who applaud the fact that trainees show up at the practices correctly and face their expectations. Pitfalls are seen in the school's preparation of the trainees. When comparing the results of the mentors’ interviews with the scientifically acknowledged theory, one can claim that the mentors’ mentoring methods are on a high level. The mentors are aware that their responsibilities include the instruction, training and assessment of the trainees, and they believe that a safe environment has an important role in passing the training successfully. Trainees, patients and hospital collective influence the internal environment of the department. Additionally, it turns out that the most challenging aspect of providing instruction from the view of the mentors is the resultant lack of time.
University of São Paulo at Ribeirão Preto College of Nursing (EERP-USP), Brazil
Emilia C Carvalho RN, PhD is a Senior Professor at University of São Paulo at Ribeirão Preto College of Nursing (EERP-USP), Brazil. She is a Teacher and Advisor of nursing students in doctoral, master’s and undergraduate courses. She has several clinical researches published in journals. She has experience on the following subjects: nursing process, simulation, communication, and clinical trials. She has a Scholarship in Research Productivity of the National Council for Scientific and Technological Development – CNPq.
The construction of a virtual learning object must follow recommended steps to obtain its validity and effectiveness with the target public. The area of interest of this virtual learning object was the peripheral venous semiology, essential content for nursing practice. This methodological study had its aim in developing and validating a virtual learning object following the six phases proposed by Andrade et al.: educational design, computational modeling, environment implementation, ergonomic, pedagogical and usability assessments. The first three steps (object construction steps) includes: theme choice, pedagogical reference, degree of freedom of navigation, layout and incorporation of media. The latter steps comprise the virtual learning object validations with experts (computer science and area of study) and with the target audience. Construction steps: a literature review was initially undertaken for content selection. Free navigation was the one selected; so that the student could choose the learning path according to their interest and difficulties. The layout and the media were defined according to the content. PowerPoint and HTML5Point programs were used, which allowed the object to be made available in HTML format and work on different devices. Validation steps: three nursing experts and three computer science experts evaluated the virtual object. Some points were identified that needed adjustments in the content and the composition of the virtual object. After the corrections, the version validated by the experts was presented to 20 undergraduate nursing students; they evaluated the usability (motivation and interest). Among the results, 95% were certainly satisfied and all the participants considered that the object will certainly bring some assistance in their work as a nurse. Valid strategies are useful as alternative resources in nursing teaching. The methodological steps used to construct the learning object were adequate and enable the development of a quality material, validated in terms of content, appearance and usability.
New York University Langone Health, USA
Mary Kiely holds a DNP from the University of Alabama at Birmingham and a Master of Science in Nursing from Hunter College in New York. She practices full-time as a level III Adult Nurse Practitioner and is ANCC certified in Rheumatology. Her specialty is in Infusion Therapy. She has published and presented posters on her area of expertise at the Rheumatology Nurses Society’s annual national conferences and within NYU Langone Health. She is also on the Faculty of the New York University Rory Meyers College of Nursing with the adult-gerontology primary care nurse practitioner program.
Statement of the Problem: The national framework and preferred practices for palliative and hospice care quality recommends advance care planning (ACP) as an ongoing discussion throughout an adult’s lifetime. A health care proxy (HCP) is a written advanced directive enabling anyone 18+ years of age to appoint another person(s) to make medical decisions if temporary or permanent incapacity occurs. Less than 35% of Americans, however, have ACP directives. Patients with chronic immune-mediated inflammatory diseases (CIID) including systemic connective tissue disorders, rheumatoid arthritis, and inflammatory bowel diseases have increased morbidity and mortality risk due to cardiovascular events. The quality improvement goal is to implement a plan that encourages these patients to engage in ACP discussions to make early decisions about their future care.
Supporting Evidence: The most common patient barrier to ACP is a lack of awareness regarding advanced directives. A recent study revealed 79% of advanced practice nurses (APNs) identified an educational need to increase knowledge and ease of discussion about ACP.
Methodology: Patients with CIID treated in a non-oncology infusion center present an opportunity to discuss this issue. As an intervention the APN meets with infusion patients prior to initial infusion to introduce ACP, educate them about a HCP and facilitate document completion.
Measure: A retrospective review of the medical record for evidence of HCP education and document completion.
Results: N=320 patients with an increase from 12.9% to 30% of patients with designated HCP on record post counseling.
Conclusion: Initiating a conversation about designating a HCP increased the number of patients with HCPs.
Recommendations: Educational initiatives for patients and APNs in outpatient departments will increase the likelihood of incorporating ACP into patient care. Respecting Choices Last Steps® is an established program in 287 U.S. medical centers focused on developing skills for early ACP discussions.
Western Cape College of Nursing, South Africa
Evalina Van Wijk is a Psychiatric Nursing Lecturer in Department of Psychiatric Nursing, Western Cape College of Nursing Cape Town, South Africa and she is responsible for the advanced Psychiatric Nursing module. She obtained her Doctor of Philosophy (PhD) in the year 2011 at the University of Cape Town, South Africa.
Statement of the Problem: Various authors have alluded to the fact that the successful access, recruitment and retention of participants are some of the most challenging phases of any longitudinal research project. Yet, many publications describing longitudinal qualitative studies of sexual assault fail to provide a detailed report on the processes followed, the difficulties experienced, as well as the reasons for such difficulties. To fill theses gaps, the researcher describes the strategies applied to access, recruit and retain the participants for the entire six-month period post rape. The challenges encounter during recruitment and data collection are also described.
Methodology & Theoretical Orientation: A longitudinal inquiry, using the hermeneutic-phenomenological approach of Paul Ricoeur was used to investigate the lived experience of male intimate partners of female rape victims in Cape Town. The research question that guided the study was: what are the lived experiences of intimate partners of female rape victims during the six months following the rape? To gain access to the intimate partner through the rape victim, the attending medical or nursing staff at the forensic units identified female rape victims who were in an intimate relationship with a partner of any gender, as disclosed by the victim. This was done either directly after the rape or at their 72-hour follow-up visit. The selection of study participants involved purposeful sampling. After providing their informed consent, nine intimate partners of female rape victims living in Cape Town, South Africa, participated in four separate face-to-face, semi-structured interviews as follows: (a) within 14 days of, (b) a month after, (c) three months after and (d) six months after the rape.
Findings: The challenges and strategies that were pertinent in maintaining participation of recruits were: Location of participants for follow-up interviews, sensitivity to the participant’s emotional life, strategies to keep participants motivated, ensuring participants’ safety, providing monetary incentives, planning for termination of researcher-participant relationship and ethical considerations.
Conclusion & Significance: Male intimate partners of female rape survivors are active help seekers; however it is not always easy to locate them for follow-up interviews and to keep them motivated during the six months following the rape of their female partners.
Recommendations: The need to continue to identify creative and effective ways to access, recruit and retain intimate partners of female rape survivors during longitudinal qualitative research is warranted.
Catherine Connolly is currently working as a Clinical Nurse Manager 1 in the Emergency Department in St. James’s Hospital, Dublin, Ireland. She is passionate about critical care, trauma and improving emergency nursing. Her study has the potential to create a new pathway for improving all critical care patient transfers.
The literature reviewed highlighted that any transfer of the critically ill patient puts them at increased risk of significant mortality. Patient transfers often form one part of a patient’s experience during a hospital admission, whether it is a transfer from the ED to an inpatient bed, the X-ray department or to ICU. ED nurses, in everyday clinical practice, deal with the transfer of critically ill patients and participate in every part of the transfer process. Although there are international and national guidelines available on intra-hospital transfers, it is acknowledged that there are hospitals where these guidelines are not used and transfer policies are not developed. However, ED nurses have a professional responsibility to a patient requiring transfer and those undertaking patient transfers should be appropriately qualified, experienced and trained. The need for standards and training in patient transfers has been emphasised but ED nursing staff involved in patient transfers are often not trained or experienced. It was the aim of the researcher to explore emergency nurses’ experiences regarding the intra-hospital transfer of critically ill patients from the ED to ICU, with the hope of identifying ways in which the current process may be enhanced. A qualitative descriptive design was used which involved semi-structured individual interviews. Participants were selected from the ED of an acute teaching hospital in the Republic of Ireland. A total of 10 respondents were chosen for the interviews which were audio recorded and transcribed verbatim. The data was analysed using thematic analysis and findings were discussed with reference to existing literature and the objectives of the study.
Qualitative analysis of the data showed that there is no structured approach to patient transfers. The findings indicate that ED nurses’ experiences of patient transfers were mainly negative. However, a lack of formal training and education could be attributed to this. ED nurses are regularly faced with the transfer of the critically ill patient from the ED to ICU. This study aims to contribute to the quality of patient transfers and make recommendations for the enhancement of this process, in the research study site.
Sam Gormley is affiliated to University of Waterloo, Canada. Sam Gormley research interests include Nursing and Healthcare.
The objective of this research was to explore how frontline health practitioners, namely nurses, perceive and practice the medical assistance in dying (MAiD) policy enacted June 2016 in Canada. Furthermore, this study investigates how perceptions, biases, and beliefs may influence practitioners' communication with patients, families of patients, and other practitioners. Nurses were surveyed regarding their professional or personal experience with MAiD, illuminating several factors that influence nurses’ participation and support during the MAiD process. This research helps to address gaps in the literature concerning Canadian health practitioner attitudes, practice and behaviours relevant to MAiD.
This study employs a multi-method approach, using online surveys and follow-up interviews. The participants are practicing, retired, and student nurses from primary care facilities and accredited nursing programs. The participants comprise a small convenience sample of Canadian nurses.
Preliminary findings suggest that the variables that influence practitioner's support for and engagement with MAiD are complex and intersecting. These early findings support extant literature, suggesting that personally held beliefs and values have a perceived impact on practice and engagement with MAiD.
It is hoped that these findings can inform directions for future research as well as contribute to the currently small but growing body of literature informing best practice for health care practitioners involved in end-of-life-care. It is anticipated that the findings of this study will contribute to a description of how Canada's MAiD policy translates into practice in a clinical setting, with an emphasis on the involvement of nurses.