47^th World Congress on Nursing & Health Care August 22-23, 2018 Singapore

Biography:

Umesh Sharma, MD is a Consultant in Hospital Medicine for the Mayo Clinic Health System and an

Assistant Professor of Medicine: Mayo Clinic College of Medicine. He has a Master of Business Administration from the Univ. of Massachusetts, Amherst, Isenberg School of Business and leads Clinical Integration of Hospital Medicine departments across various sites in Mayo Clinic Health System in WI, MN

Abstract:

Primary research objective: Evolving healthcare environment frequently creates an environment ripe for potential conflicts. The primary objective was to review literature and identify causes of physician conflict and understand the process of optimal conflict management.

Methodology: Conflicts can be categorized as functional (constructive) or dysfunctional (destructive) in nature and can be influenced by a variety of factors at individual, interpersonal, and organizational level. An individual’s perception and response to a conflict is influenced by a variety of factors. Most conflicts arise as a result of system issues, however as people and emotions get involved, the nature and complexity of the conflict rapidly evolves. Timely diagnosis and root cause analysis is crucial in highlighting where and what type of intervention is appropriate as well as management of emotional conflicts at every level.

Main findings: Conflict can be managed differently depending on nature, leverage, value of resolution, time frame, and competing priorities to name a few. Window of opportunity exists between the cognition and behavioral response to a conflict, where one can engage in seeking to understand the other party’s position and engage in emphatic listening. Setting goals with consideration of best and worst case scenarios and post-conflict interaction is essential.

Conclusions: Successful conflict management requires an equal emphasis on the preparation as well as the process of addressing conflict. Optimal conflict management tends to have a tremendous impact on that particular individual, surrounding people, and the existing work culture.

Biography:

Jennifer Tavares-Kitchen, MBA, MSN, RN, Advocate Children’s Hospital, USA

Abstract:

Background: Bedside nursing care, which provides critical assessments, evaluations and interventions, is an essential component of patient safety measures. Hospitals, however, have overburdened the nurses with an enormous amount of additional administrative and operational tasks designed to ensure compliance with external and internal regulatory requirements imposed by health care agencies, insurers and the hospital itself. This has left the nurses little time to spend with patients, which may have led to decreased satisfaction and increased risk.

Objective: Review, analyze and reduce the number of the nurses’ administrative and operational tasks, demonstrating that this can be achieved without compromising regulatory compliance and increasing the time nurses spend with patients at the bedside.

Methods: Tasks that had nothing to do with direct patient care were tabulated and presented to a review committee of frontline nurses. The Committee recommended the elimination and/or modification of about one third of those tasks. It also recommended the designation of a circulating nurse who can provide support to whomever is overburdened. A pilot project utilizing this modified workflow model was implemented on one of the medical-surgical units. A time and motion study was conducted to evaluate whether this model can result in increased bedside nursing care. The results were compared to the results of an earlier study we conducted which had monitored the standard workflow model.

Results: The modified workflow model consisted of five components: decreased EMR charting time (charting by exception), eliminating phone calls from the pharmacy and laboratory, optimizing nurses’ time finding supplies by implementing a two-bin system, bedside shift report and access to the medication room. Bedside care increased from an average of 64 minutes per patient, per shift, to 85 minutes (32%). The staff reported increased associate, physician and patient satisfaction and a better handle on obtaining relevant, meaningful and timely patient assessments and evaluations. The modified workflow model did not result in compromising regulatory compliance.

Conclusion: It is possible to decrease or modify many of the administrative and operational tasks imposed on the nursing staff and increase the amount of time spent at the bedside without violating 2

the mandated regulatory policies. Bedside nursing care improved the hospitals’ health care outcomes.

Recommendations:

• Implement the modified workflow model on all the medical-surgical units

• Modify or eliminate more tasks not related to direct patient care

• Develop and implement a structured process allowing the nurses to provide ongoing bedside patient assessments and evaluation, specifically at the time of admission and following a procedure

• Be more receptive to the suggestions of the front-line staff on how to further improve care delivery

Biography:

Hu Jiadai has her expertise in evaluation and passion in improving the health and wellbeing. During her undergraduate period in Southern Medical University(Guangzhou, China), she’s major was midwifery. Now she is a graduate student in department of nursing, Sichuan University. Her research orientation is nursing education and her advisor is Professor Li Jiping.

Abstract:

Statement of the Problem: It has been proved that maternal self-efficacy was a significant predictor of parental behaviour and evidence have shown that social support was also associated with maternal self-efficacy. However, few studies explore the relationship between the expectation gap of postpartum support and the maternal self efficacy in primiparas. The purpose of this study is to investigate the relationship between the expectation gap of postpartum support and the maternal self efficacy in primiparas. Methodology & Theoretical Orientation: This study was a cross-sectional questionnaire survey which assessed 99 primiparas from a maternity hospital. Chinese version of postpartum support questionnaire and chinese version of maternal self efficacy questionnaire were administered to evaluate participant maternal self-efficacy and postpartum social support, respectively. Findings: The mean score of primipara maternal self-efficacy was 75.69±11.16 and the mean score of the expectation gap of postpartum social support was 33.18±25.4. The postpartum social support expectation gap had a negative relationship with the maternal self-efficacy score (r = -0.347, P < 0.001). Conclusion & Significance: The expectation gap of postpartum support of primipara was associated with the maternal self-efficacy. It is important to evaluate the social support of primipara and provide targeted social support which can improve the the maternal self efficacy of primiparas.

Biography:

The presenter is a nursing student studying Bachelor Degree of Health Sciences (Major in Nursing) at Tung Wah College in Hong Kong. Ms. Li is the representative of the group to give the presentation in the conference

Abstract:

Background: Nursing care plan is a well-known tool in nursing education and clinical practice. It is useful to design a comprehensive plan for clinical judgment using the nursing process that includes assessment, goal-setting, implementation, and evaluation. Since nursing care plan can benefit patient outcomes and interprofessional communication, the skills and practice of writing care plan are emphasized in current nursing education. However, little is known about the experience of writing care plan for clinical practice among undergraduate nursing students. Method: A phenomenological qualitative study was conducted using purposive sampling. The focus group interview with 3 to 5 participants was performed at an educational institution. Purposive sampling was used. The open-ended questions were used to allow participants to freely express their feelings. Data saturation was applied to determine the sample size. Colaizzi’s method was adopted for analysis. Results: There were 15 participants joined in this study. Based on their experiences on writing care plan in classroom, there were 4 major themes identified including advanced skill development, preparation for clinical practice, building up confidence on clinical performance and difficulties between reality and theory. Students expressed that care plan writing was useful to enhance knowledge and skills as well as to prepare clinical practice. However, some barriers can affect the application of care plan in clinical settings. Conclusion: The results increase the insights of nurse educators to guide students from writing nursing care plan in classroom to its application in clinical settings. More support from clinical supervisors can also improve writing and application of nursing care plan effectively in clinical settings among nursing students. Further research can be conducted to verify and compare the effectiveness of nursing care plan in clinical practice among various nursing schools. (283 words)

Biography:

Raymond G. Cervantes completed his Bachelor of Science in Nursing from Catanduanes State University and is currently taking his Master’s of Science in Nursing Major in Nursing Administration at Concordia College- Manila. He is also the Unit Manager of the Critical Care Unit of San Juan De Dios Educational Foundation Inc. (Hospital). He is the Committee Chairman of the Proactive Review of Opportunity-Based Enhancements (P.R.O.B.E) Team, previously the Research Team of San Juan De Dios Educational Foundation Inc. (Hospital). He presented a study about the Assessment of Medication and Treatment Administration Barriers: Leading to Monthly

Medication Administration and Treatment Safety Huddle at the Association of Nursing Service Administrators of the Philippines (ANSAP). He has also one poster presentation about the CAMP- ME (Collaborative Assembly of Managers Proactively Moved by Engagement) as an Effective Strategy in Raising Delegation, Teamwork and Collaboration at ANSAP.

Abstract:

The potencies and ascendancies in utilizing practical strategies to empower nursing leaders in facing the realities of the nursing profession are paramount to the challenges of the 21^st century. In San Juan De Dios Educational Foundation Inc. (Hospital), the Nursing Service Division implemented the CAMP-ME, which proactively transformed the mind-set of the nurse managers’ towards teamwork and collaborative engagements and their delegation capacities. This study determined the association of the nurse managers’ teamwork and collaborative engagements and their preparedness to delegate. This study utilized  the quantitative descriptive-correlational research design. Convenience sampling was used in this study. All 126 Staff Nurses evaluated their Charge Nurses in the unit; 33 Charge Nurses evaluated their Unit Managers; and 14 Unit Managers evaluated their Section Managers from the 21 nursing units of the hospital. The first part of the survey consisted the dimensions of Collaboration and Teamwork; the second part of the survey was the Nurse Managers’ Preparedness to Delegate (Sub-Scale 1); and the third part was the Nurse Managers’ Preparedness to Delegate (Sub-Scale 2). The extent of the nurse managers’ teamwork and collaborative engagements to take responsibilities were highly effective (x=3.58) and their preparedness to delegate (x=3.47) in the execution of their tasks to achieve specific goals. In terms of the association between the Teamwork and Collaboration and the Nurse Managers’ Preparedness to Delegate (sub-scale 1 and 2), findings revealed that there is significant correlation (p=0.01) between the 2 major parameters.

Biography:

Hui Yang has completed her undergraduate degree at the age of  23 years from Jilin University，China . Now she is a graduate student of Sichuan University majoring in Nursing

Abstract:

Objective:The aim of this study was to estimate the level of self-care agency and explore its associated factors in discharged patients with systemic lupus erythematosus(SLE) in Southwest China.

Method: A cross-sectional study was conducted between July and October 2016 and all discharged patients were from a tertiary general hospital in Southwest China. The self-care agency was assessed by the Exercise of Self-care Agency Scale(ESCA). Pain and fatigue were assessed by the visual analog scale(VAS). The disease activity was measured using Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). Physical and mental health were evaluated by the physical (PCS) and mental component summary (MCS) of the instrument SF-36, version 2. Multivariate regression analysis was performed to explore the associated factors of self-care agency.

Result: A total of 123 discharged patients were recruited. The mean of ESCA was 86.29. In univariate analysis, self-care agency of discharged patients have the difference in gender, work status, educational level, household income and disease activity( P<0.05 ). Additionally, higher BMI, higher level of fatigue and worse mental health was found in patients with lower self-care agency( P<0.05 ). The stepwise multivariate regression analysis showed that male( P = 0.001 ), lower educational level(P=0.003), lower household income( P<0.001 ) and worse mental health( P <0.001 ) could predict lower self-care agency.

Conclusion: This results indicated that the discharged patients with SLE had a middle level of self-care agency in Southwest China. The lower level of self-care agency was assessed with male, lower educational level, lower household income and worse mental health. These findings pointed out the importance of targeted intervention to enhance the self-care agency of discharged patients with SLE.

Biography:

Jiang Lingjun has her expertise in evaluation and passion in improving the health and wellbeing. During her undergraduate period in Hubei University of nationalities(Hubei, China), she’s major was nursing. Now she is a graduate student in department of nursing, Sichuan University. Her research orientation is community nursing and her advisor is Professor Liu Suzhen

Abstract:

Statement of the Problem: Chronic disease is increasing in prevalence and has become a major public health problem in the world cause it’s high morbidity, mortality and serious economic burden . And it is generally accepted that the primary care in community is the most effective way to control chronic disease. Due to the high prevalence of chronic disease and the shortage of general practitioners, exploration of nurses’ role in general practice team has been highlighted and the benefits of nurse-led care in community has been recognized in many countries. While in our country, nurses play little role in the medical team. Therefore, according to the practical experience in abroad, the present study explored the community nurse-led management care for chronic patients in the context of primary care health services. Methodology & Theoretical Orientation: In this randomized study in southwestern China, a nurse-led chronic disease management was developed and implemented for 2 years in primary care institutions in two major chronic disease areas: hypertension and type-2 diabetes. This study investigated the effects of nurse-led chronic illness management on self-care behavior change and health care service utilization among these patients .190 participants(102 with hypertension and 88 with diabetes)were randomly allocated to the study group , while 193 participants(102 with hypertension and 91with diabetes)  were assigned to the control group . The study group received group education and case management in addition while the control group received GP-led usual care including blood pressure(glucose) monitoring, telephone follow-up and home visit only. The primary endpoint to be tested was the patients’ self-care behavior assessed by self-administrated questionnarie. Second endpoints were the changes in patients’ health care services utilization. Data was collected at three time points,the baseline ,1year after intervention ,and the terminal assessment after 2 years. Findings: The intervention group had a significant higher self-care behavior score than the control group after 24 months(4.01±0.44 VS 3.75±0.46,p<0.05) and the analyses showed a significant improvement in self-care behavior score(F=17.981,P=0.000) within the study group from baseline to 24 months(not in control group). Community clinic visit frequency was significantly reduced in the two groups (P<0.05),the experimental group reduced more, with 53.1% patients taking a monthly visit.Hospital outpatient visit rate was obviously reduced in study group(P=0.012). No significant reduce was found in emergency-department visits and hospitalizations. Conclusion & Significance: A nurse-led chronic disease management can effectively promote the patients’ self-care behavior and led to a better use of health care services.

Biography:

Samia farouk mahmoud has completed his PhD at the age of 30 years from Faculty of Nursing- Zagazig University, Egypt, in the Community Health Nursing department. The director of the electronic result at the faculty and the director of the administrative staff in the college as a standard in quality and currently the director of the specialized program at the Technical Institute of Nursing. I hope to receive the Nobel Prize in Nursing. I worked as a master and doctorate in the field of special education

Abstract:

Epilepsy is a major health problem frequently seen among intellectual schools. Students having seizures bother their teachers. The aim of this study was to evaluate the effect of nursing intervention on improving intellectual school teachers' performance toward students with epilepsy in Sharkia Governorate. A quasi-experimental design was used in this study.  A purposive sample composed of 163 teachers from 13 intellectual schools working at least two years. Three tools were used: Tool (I): A self-administered questionnaire consisting of two parts: Part (A) was used to collect data pertaining to socio-demographic characteristics of the teachers. Part (B) involved questions regarding teacher's knowledge about epilepsy. Tool (II): An observational checklist to evaluate teacher’s practices regarding management students with epilepsy. Tool (III): to assess attitudes of teachers toward students with epilepsy. Results: the most of studied teachers were married. Additionally, statistically significant improvements were detected in the teachers' knowledge, practices, and attitudes, from pre-sessions to immediately after and 3 months of post sessions where the total mean score of their knowledge increased from 9.61±3.30 in pre-sessions, to 19.35±1.73 immediately post sessions and 18.67±2.61, at 3 months of post sessions. The total mean score of their practices increased from 3.31±5.081 pre-sessions to 26.72±5.46 immediately post sessions and 24.83±6.71, at 3 months of post sessions. The total mean score of their attitudes increased from 13.62±2.25 in pre-sessions, to 16.38±1.83 immediately post sessions. Therefore, it is recommended that, in-service training educational sessions to be carried out periodically among all intellectual schools teachers'.

Biography:

Alaa is a PhD student at the College of Human and Health Sciences in Swansea University, UK. She is working as a lecturer in the department of Medical Surgical Nursing in Princess Nourah University in Saudi Arabia.

Abstract:

Introduction

Breast cancer is the most commonly diagnosed cancer in Saudi women. The cancer and treatment can produce many different psychosocial issues and physical symptoms. Different studies reported a low overall quality of life among Saudi women with breast cancer. There is evidence that self-management support (SMS) interventions delivered by nurses have the potential to help reduce these symptoms and enhance the quality of life. In Saudi Arabia, the provision of SMS is unknown and therefore, this study aims to develop and test the feasibility of an intervention to support Saudi women with breast cancer.

Methodology

This study is guided by Medical Research Council (MRC) framework for developing and evaluating complex interventions which involve a systematic multistage process. Stage one involved an evidence synthesis by conducting a systematic literature review and qualitative in-depth interviews using a purposive sampling with 23 Saudi women newly diagnosed with breast cancer in three hospitals to understand their needs and concerns. Ethical approval and consents were taken and the theoretical saturation of data were achieved. The digitally-recorded data and field notes were transcribed, organized using MAXQDA software and analysed using a thematic analysis. Stage two included developing a self-management programme by applying a theory and evidence to identify effective components to support patients alongside consultations with health care professionals and patients. Stage three will include a training workshop for nurses to ensure fidelity who will implement intervention on patients using a pre- and post-intervention study to evaluate its feasibility, acceptability, and potential impact using mixed method.

Result:

The literature and qualitative study showed that those women have physical, psychosocial, practical, and informational needs. The theory of social learning and self-confidence developed by Bandura has been applied and the literature shows that components such as: group-based intervention, education, goal setting, action plans, and navigating health system and resources are effective to support patients successfully. The rest of stages will be conducted soon.

Conclusion:

Saudi women with breast cancer experience challenges to manage disease and treatment-related symptoms. It is anticipated that delivering self-management intervention will help to enhance quality of life.

Biography:

Janine Duran started her nursing career in 2007. Prior to that, she was working as an Account Executive in McCann Erickson World Group, a multinational advertising agency. She decided to move to the US, to pursue nursing and worked in SBH (St. Barnabas Hospital) as an ED nurse from 2008. In the last 4 years, she transitioned from charge nurse, nurse manager and ED nursing director. 

Abstract:

Transformational leadership is a style of leadership where a leader works with subordinates to identify needed change, creating a vision to guide the change through inspiration, and executing the change with committed members of a group.  Emergency Departments are increasingly confronting challenges such as overcrowding, understaffing, increased waiting times, poor patient satisfaction and staff burnout.  Transformational leadership can play a key role in revitalizing and assisting stressed Emergency Departments where resource limitations present real and consistent roadblocks to significant performance improvement, staff morale and motivation.

As a transformational leader, once must find ways to influence and change behavior. Integral to creating changes in the different issues in the Emergency Department is staff engagement. Due to patient-care demands and increasing institutional requirements, staff members are becoming increasingly overwhelmed by the amount of information they receive and initiatives with which they must comply. Traditionally, hospital leaders use a linear approach to communicate with staff. An example is a manager reads a policy to staff ,with the expectation that they will follow the requirements.

As hospitals become increasingly tactical in their approach to innovation, it is recognized that the top-down approach to performance improvement is ineffective. The most valuable asset in the workplace is the staff (Drucker, 1954). Their engagement and productivity can dictate the success of a project.

So, how do hospital leaders influence staff to engage in the hospital’s initiatives and facilitate change? Innovative marketing strategy as an innovative approach ED staff engagement utilizing marketing strategy as an innovative approach.

Marketing is the “process of creating, communicating, delivering, and exchanging offerings that have value to customers” and the target audience (American Marketing Association, 2017). The basic premise of marketing is to influence consumer behavior and drive change.

Biography:

The researcher is eighteen (18) years old, a senior high school graduate from Monsignor McClancy memorial High School, New York and is currently studying in San Beda University in the Philippines as a 1^st year nursing college student. She has a background in doing a research paper and is knowledgeable enough about the big changes in the current health issues. Helping others have been always my passion and I’d like to take this opportunity to help the transgender women who are taking pills to be informed about the it.

Abstract:

Contraceptive pills are taken by women to help them when it comes to preventing pregnancy, it works by stopping a sperm cell from meeting an egg cell which is called fertilization. This surprisingly works on males that have a desire to transform intro the opposite gender and gradually exhibit female traits with continuous use of pill. According to Tyler, the exposure to the chemical content of the pill can have a sensitive effect on the transgender or intersex (2017). The main objective of this research is to inform the transgender women (TGW) users about the possible physiological effect of the use of contraceptive pills and how a frequent user manages these changes in their everyday life. Thus, study obtained selected transgender women and provided surveys to around four to seven TGW: whether they are aware about the pill and why they maintained it. The assumed result of the study is that contraceptive pills only have an effect if they use it regularly because irregular use is not enough to throw a man’s contraceptive users because of the quick judgment of people. The study that there are effects of contraceptive pills among men physiologically and some were able to manage to stay living a normal life but still need more knowledge and information about the pills they take.

Biography:

Dr Wu has completed her PhD from National Taiwan University at 2015. She is a Assistant professor at Department of Nursing, Shin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan, R.O.C.

Abstract:

Background and aim: Taiwan is a high endemic area for hepatitis B virus (HBV), with approximately 17% of the general public was seropositive for HBV.  Because of the high population prevalence of blood-borne viruses such as HBV in Taiwan, healthcare workers (HCWs) in this country may be facing higher seroconversion occupational risks stemming from percutaneous injuries (PIs) compared to other developed countries. The aims of this study were to calculate the incidence rate of HBV high infection risk PIs for Taiwan’s HCWs and to estimate the annual number of HBV seroconversion after high infection risk PIs for those HCWs.

Methods: This analysis includes data from Chinese EPINet between 1 January 2012 and 31 December 2012.  Incidence rate was calculated by using the number of the full-time equivalent HCWs in the hospitals which contributed reporting of the HBV high infection risk PIs. The national HCWs number of seroconversion after HBV high infection risk PIs was estimated by incidence rate, the probabilities (12%~31%) of seroconversion in literature review and the numbers of national HCWs in Taiwan.

Results:  1.The incidence rate of HBV high infection risk PIs is 0.44/100 FTEs for Taiwan’s HCWs. 2.The annual number HBV seroconversion is estimated to be 11~28 for Taiwan’s HCWs. If consider the underreporting rate, the number may been estimated to be 52~133.

Conclusions: The estimated number of HBV seroconversion is a reminder and an alert to all HCWs. It should be provided a comprehensive Hepatitis B vaccine delivery plan for all medical personnel, in particular medical personnel and support workers, to enhance immunity and reduce occupational injuries.

Biography:

Will update soon!!

Abstract:

The importance of active learning has continued to increase in Japan. The authors conducted classes for first-year students who entered the nursing program using the problem-based learning method which is a kind of active learning. Students discussed social topics in classes. The purposes of this study were to analyze the post-class essay, describe logical and critical thinking after attended a Problem-Based Learning (PBL) course. The authors used Mayring’s methodology for qualitative content analysis and text mining. In the description about the skills required to resolve social issues, seven categories were extracted: (recognition of diverse social issues), (attitudes about resolving social issues), (discerning the root cause), (multi-lateral information processing skills), (making a path to resolve issues), (processivity in dealing with issues), and (reflecting). In the description about communication, five categories were extracted: (simple statement), (robust theories), (respecting the opponent), (communication skills), and (attractive presentations). As the result of text mining, the words extracted more than 100 times included “issue,” “society,” “resolve,” “myself,” “ability,” “opinion,” and “information.” Education using PBL could be an effective means of improving skills that students described, and communication in general. Some students felt difficulty of communication resulting from characteristics of Japanese.

Biography:

Dr. Mi-Ae You is a professor from college of nursing, Ajou University and teaching student about pediatric nursing. She has published research papers in international journals and has been serving as a reviewer.  One of her interest areas of research is safe administration of medication. She is currently conducting the project granted from government entitled development and evaluation of mobile web based program about safe medication administration for Kids’ parent. 

Abstract:

With regard to administering medication, parents sometimes mix up medicines or administer medication improperly due to complicated methods, and experience difficulties in administering the correct dosages. It is important to first determine how much parents know about administering medication. As mothers are primary caregivers, this study set out to assess how much mothers know about administering medication, and their related educational needs. Further, this study aimed to identify the factors that affect the administration of medication to children at home. Methodology: Five mothers who had administered medication to their preschool children at least once were randomly sampled as the study’s research subjects. The research data were collected through one-on-one in-depth interviews. Data analysis was conducted by analyzing the interview responses to some of the main questions, based on the notes taken in the interview. Conclusion & Significance: The caregiver who usually (most often) gave medication to the children was their mother, and every mother who participated in this research responded that she had administered fever reducers and antibiotics to her children. Some of them stated that they had been told how to administer medication by doctors or pharmacists, but had not been given information about side effects or precautions. They also responded that they sometimes stopped administering the prescribed medication to their child when his or her symptoms disappeared, and stored the remaining medication for possible future needs of the child’s siblings. They added that proper education on administering medication was needed for them to safely administer medicine to their children. The findings showed that the mothers who participated as research subjects in this study had different experiences of administering medication, and relevant education based on correct knowledge was needed for them to administer medication safely at home.