Scientific Program

Day 1 :

Keynote Forum

Sharon Jackson

National Clinical Implementation Specialist for Sunrise Senior Living USA

Keynote: Knowing Initializes Learning: You Must Know Yourself to Grow Yourself

Time : 10:00-10:40

Biography:

Sharon Jackson is a Member of the John Maxwell Team. She received her MSN Degree in Nursing Administration from Xavier University in 2007 and BSN Degree from Silliman University in 1990. She is a Board Certified Nurse- Executive (NE-BC) by the American Nurses Credentialing Center (ANCC).She currently works as a National Clinical Implementation Specialist for Sunrise Senior Living in the US and Canada. She was a Speaker on Transformational Leadership in the 4th Annual Educational Conference of the Philippine Nurses Association of Metropolitan DC (PNAMDC) Spring Hill Suites in Alexandria, VA, USA.

Abstract:

The world is filled with people with great talents and great passion and yet these people are nowhere to be seen leading, changing and making a mark in this world. These are gifted individuals who live confused and frustrated because they don’t know the direction they are going. This keynote speech will focus on how knowing your strengths, weaknesses, interests and opportunities – basically, knowing where you are will catapult you to reach your full potential. The talk will revolve around becoming aware of your own identity to help you find your passion and purpose in life and the steps that you need to take to reach it. The presentation is meant to embolden and empower the participants to be the leaders that they are and be the catalyst for change in nursing and in the world.

Keynote Forum

Bernat-Carles Serdà

Health Sciences Faculty, University of Girona, Spain

Keynote: Lecture versus self-directed Methodologies in university students' learning

Time : 10:40-11:20

Biography:

Bernat-Carles Serdà is a teacher and researcher in the Health Sciences Faculty, (University of Girona, Spain). His research focuses on Quality of Life and chronic malignancies. Nowadays is supervising several thesis using mixing methods in this research field. He has achieved several pre-doctoral and post-doctoral grants for international academic stays.

Abstract:

This study compared the effectiveness of teaching and learning methodologies based on knowledge transfer (lecture) with approaches that emphasized self-directed learning (Problem-Based Learning [PBL] and Reflective Learning [RL]), in a sample of 230 undergraduate nursing students and 8 professors. A mixed-methods study was carried out in a university school of nursing: quantitative methods were used to analyse the outcomes achieved by university students and compared the effectiveness of the various methods based on the students' final examination scores; and qualitative analysis evaluated the factors that affected student learning in each of the three study arms: lecture, PBL and RL. The quantitative results show a better score for RL compared to PBL and the traditional lecture format. Qualitative findings indicate that self-directed methodologies result in higher-quality outcomes in student acquisition of content knowledge. Our results suggest two findings: methodologies focused on knowledge transfer (lecture) and those that favour self-directed learning (PBL and RL) are complementary; each approach has specific functions that cannot be replaced by the other two; and,  self-directed learning methodologies, which are distinguished by their promotion of active student participation contribute most significantly to improving student learning. (Hajrulla 2014) Various studies have recommended the promotion of these methodologies in higher education considering them a necessary pathway for the preparation of competent professionals, as our findings also suggest. (Fook 2007) In this context that self-directed learning is a key strategy to promote individual abilities for learning continuum. The PBL and RL approach can help to foster professional knowledge and quality learning in higher education. Our research contributes to better understanding of self-directed (reflective) learning and professional practice development.  We concluded that simultaneous use of diverse instructional techniques constitutes the best instructional approach. It could be useful in the future to design instruments to evaluate specific skills associated to each technique.

  • Nursing

Session Introduction

Alison Hasselder

Anglia Ruskin Univeristy,UK

Title: How do Knowledge and Understanding of Sleep Deprivation influence Clinical Decision making of Intensive Care Nurses when managing Sleep in Critically Ill Patients?
Speaker
Biography:

Alison Hasselder is a PhD student at Anglia Ruskin and Dr. Leslie Gelling and Dr.Stewart Piper are her supervisors. She is currently an Adult Field Lecturer at the University of East Anglia and runs the Dissertation and Clinical decision Making Modules.

Abstract:

Sleep deprivation holds many consequences for critically ill patients including slower recovery, decreased resistance to infection and neurological problems such as delirium (Dick-Smith 2017). A shift in nursing and institutional culture is required to apply sleep promotion strategies and research, and to minimise unpleasant outcomes for patients (Dick-Smith 2017). This paper will present provisional data from both phases of this Constructivist Grounded Theory approach. It will emphasie what has been learnt about nurses’ decision making and how this can influence the quality of sleep their patients achieve in the Intensive Care Unit (ICU).  It will particularly focus on exploring the categories, three main themes and core category of Professional and Regulatory Compliance that have now been identified as part of phase 2 of the study. The links between these will be explained. These include the theme of “not on my shift behavior” and the role that clinical audit may have on junior nurses’ decision making. Data has been collected from 15 participants that have been interviewed with semi structured, relating this to established models of decision making and cognitive processes discussed in the literature focusing on, and exploring, nurses’ decision making in relation to sleep deprivation in the ICU.

Anam Hakim Tejani

Aga Khan University Hospital, Karachi

Title: A small yet major initiative for the Prevention and Reduction of Pressure Ulcers in ICU setting of Tertiary Care Hospital.
Speaker
Biography:

Anam Hakim Tejani is currently working as a Clinical Nurse Instructor at Cardiac Intensive Care Unit, The Aga Khan University Hospital, Karachi, Pakistan

Abstract:

Background:

At present, pressure ulcers are one of the leading concerns for health care professionals working at Intensive care units all around the globe, which has a greater impact on morbidity of a patient, thus increases average length of stay.  However, its development can be prevented by the utilization of evidence-based nursing practice.

Literature review:

Pressure ulcers development is one of the third costly issues after cancer and cardiovascular diseases (Ghanee, R and Gavami, H, 2010). Florence Nightingale in 1859 wrote, “If he has a bedsore, it’s generally not the fault of the disease, but of the nursing” (Barton, 2009). Nursing practices are vital to prevent pressure ulcer, and its timely evaluation, assessments within 12 hours after admission have been recommended for critically ill patient (He, Tang, Ge & Zheng, 2016).

Aim:

To reduce hospital acquired pressure ulcers in the intensive care unit using the ‘skin care bundle’. Also, to assess the application of preventive measures at high risk patients for pressure ulcers in Cardiac intensive care unit and the evidence of applied pressure ulcer care bundle in intensive care settings.

Methods:

It was an experimental study which was conducted in CICU, targeting post-cardiac surgical patients. A tool was developed to assess and prevent the occurrence of pressure ulcers. Moreover, pressure ulcer monitors were delegated for spot checks in all three shifts including morning, evening and night. Additionally, another tool was developed by keeping in view the standardized nursing care for specific stages of pressure ulcers.

Findings:

The sample consisted of 343 patients admitted in CICU in the first two quarters of year 2018–all the patients underwent through open heart surgery. The study findings showed significant decrease in the occurrence of pressure ulcers and length of stay of post cardiac surgical patients. The pressure ulcers were decreased from 4.7% to 0.5%. Moreover, all applied pressure ulcer preventive measures in this study are in line with the guidelines of the EPUAP.

Awais Jamil

Shaukat Khanum Memorial Cancer Hospital Lahore Pakistan

Title: Reducing Central line associated Blood stream Infections at Cardiac Intensive Care Unit: Quality Initiative
Speaker
Biography:

Awais Jamil is currently working as Clinical Nurse Manager at Shaukat Khanum Memorial Cancer Hospital Lahore Pakistan.

Abstract:

Introduction: Central line associated blood stream infections (CLABSI) are the most common complication of central catheters in Cardiac surgery patients. If it occurs it can cause increase length of stay, financially overburdened and influence on mortality and morbidities was.

Objective(s):  To initiate quality project in Cardiac intensive care unit to reduce the incidences of central line associated blood stream infection.

Design: Combined Cohort Study to implement and evaluate intervention to improve patient safety.

Settings: Cardiac Intensive Care Unit Aga Khan University Hospital Karachi.

Methodology: Identification of infection control link nurses (ICLN) and their training. Educational sessions for staff in collaboration with infection control nurse, based on the “My 5 Moments for Hand Hygiene” approach, and the correct procedures for hand rubbing and hand washing, to all health-care workers. Secondly we prohibited overcrowding in patient area and reinforce cardiothoracic team to do morning round outside patient bed site area to eradicate infection. Start awareness sessions and reinforce health care and patient care attendant adding 2% CHLOEHEXIDINE and alcohol swabs in each patient bin and we also encourage the visitors how to attend the patient and importance of hand hygiene. We follow contact precautions on infected patients by attendant.

Results: Quarterly monitor central line blood associated infection rate as per 1103 central line catheter days during the sustainability period 22 weeks after intervention period and we achieved 22 week silver Award from infection control department

Conclusion:  To decrease the incidence of blood stream infection accomplished in 9 months post implementation phase and this clinical practice was sustained to maintain this results.  This will also impact on the morbidity and reduce the cost rate which will be more beneficial for the patients as well as organizations.

  • Forensic Nursing

Session Introduction

Lucy Love

Mountain Healthcare,UK.

Title: Developing the Nurse Role in Pediatric Forensic examinations across the UK.
Speaker
Biography:

Dr Love is an Associate Medical Director for Mountain Healthcare, a major provider of forensic medical services and SARCs (Sexual Assault Referral Centers) for complainants of sexual assault in the UK.  She has been a Sexual Offences Examiner for 20 years, including the evaluation of child sexual abuse and regularly appears in court as an expert witness. She is a recognized trainer of Sexual Assault Nurse Examiners and Pediatric Medical Examiners in the UK. She also works in the NHS as a Psychosexual Therapist.

Abstract:

The role of the nurse as a Pediatric Sexual Assault  Examiner [SANE] has been established in the USA for many years. However, in the UK, this role has traditionally been carried out by doctors ( Pediatricians and Forensic Medical Examiners -FMEs). Pediatrician’s are a limited resource, already overloaded with their general pediatric work  and often unwilling to work in the high-profile arena of Child Sexual Abuse [ CSA]. Forensic nurses are already used widely  and successfully across the UK to examine adult complainants of rape. The training requirements to enable  nurses to provide a reliable, high quality pediatric forensic service  are discussed for areas of the UK, where pediatricians are unable or unwilling to perform the role.

  • Cardiovascular Nursing

Session Introduction

Hend M. Elazazey

King Saud bin-Abdulaziz University, Saudi Arabia

Title: Effect of Inspiratory Muscle Training on Clinical Outcomes of Patients Undergoing Cardiothoracic Surgeries
Speaker
Biography:

Dr. Hend M. Elazazey is Assistant Professor in Medical Surgical Nursing Department, King Saud bin-Abdulaziz University, King of Saudi Arabia, have a more than 30 years of experience in clinical and education setting both in  hospital and education institutions, has more than 20 research published papers in respected  international journals, supervised more than 8 master and PhD thesis, attended many national and international conferences.

Abstract:

 

Cardiothoracic surgery is associated with a significant risk of serious complications. So, cardiothoracic surgical patients require intensive care management postoperatively. Many of these complications are likely caused in some part by the exaggerated systemic inflammatory response to cardiopulmonary bypass (CPB).Postoperative pulmonary complications (PPCs) are the most frequently observed complications after cardiothoracic surgery, of which pneumonia and atelectasis are the most common. PPCs have significant clinical and economic impact associated with increasing morbidity, length of stay and associated cost. Inspiratory muscle training is a therapeutic strategy that aimed at preventing post-operative pulmonary complications. Aim: this study aimed to study the effect of inspiratory muscle training on clinical outcomes of patients underwent cardiothoracic surgeries.

Materials and Method: A quasi-experimental study was conducted in Cardiothoracic Surgery Department at Student Hospital affiliated to Tanta University. A sample of 40 adult patients of both sexes underwent cardiothoracic surgeries based on statistical power analysis were selected and divided into 2 equal groups: Group 1 (Control Group): was received routine hospital care. Group 2 (Study Group): was received pre and postoperative inspiratory muscle training which was implemented by the researcher. Three tools were used to collect data: Tool (I) Cardiothoracic Patient Assessment Tool. Tool II Cardiovascular and Respiratory System Assessment Tool,Tool III Clinical Outcome Assessment Tool. Results: The incidence of post-operative pulmonary complications was higher in the control group (70% and 60%) while it was (30% and 25%) of the study group during the 5th and 7th post-operative day respectively. Duration of stay in ICU was longer in thecontrol group4-17 days while it was 2-9 days in the study group. None of the study group compared to fifth (20%) and fourth (25%) of the control group needed re-intubation and ICU readmission respectively. A high proportion of the study group (55% and 70%) had dyspnea relieved by practicing of inspiratory muscle training compared to none of the study group.

Conclusions and Recommendations: Inspiratory muscle training is an effective strategy in improving patient's outcomes after cardiothoracic surgery. It was recommended that all cardiothoracic surgical patients should receive pre and post-operative inspiratory muscle training as a daily routine care.

  • Nursing Practitioners

Session Introduction

Michelle Boltz

Critical Access Hospital, USA

Title: Nurse Practitioners: Providing Sustainable Care Across Diverse Rural Populations in the USA
Speaker
Biography:

Dr. Michelle Boltz has spent her Nursing career practicing full spectrum primary family medicine in arctic Alaska with the Inupiaq people and providing secondary hospitalist services in an isolated critical access hospital in mountainous Montana. On the forefront of rural health services, Dr. Boltz has pioneered the use of telemedicine in direct patient care and the development of sustainable organizational health care delivery systems that meet the unique needs of the diverse communities they serve.

Abstract:

Health care providers in rural locations face unique logistical and resource challenges, often times as isolated professionals. Join Dr. Boltz in an interactive sharing of individual rural nursing experiences and exploring common ground and regional ingenuity in meeting these challenges. Providing sustainable, culturally competent care requires strong integration with existing community assets and strategies that account for the distinctive circumstances of each community.  Dr. Boltz shares her experience as Chief of Village Services for the North West Arctic Alaska working together with the Alaska State Community Health Aide program providing full spectrum primary care in remote villages across the state.

Rural hospital closures significantly affect both the economic and physical health of communities. Since 2010, more than 75 rural hospitals have closed with an estimated shortage of 45,000 physician providers by 2020, a crisis affecting over 90 million rural Americans. In response to this shortage, the hospitalist role is increasingly being allocated to Nurse practitioners, who have been shown to be a valuable resource by reducing length of stay and improving hospital profit compared to physician hospitalists without affecting readmissions or mortality. This shift is supported by American federal health care organizations as demonstrated by The Institute of Medicine’s landmark 2010 report, The Future of Nursing, which includes recommendations to allow advance practice registered nurses (APRNs) to practice to the full extent of their education and licensure in order to increase access to and quality of care in our struggling health care system. Dr. Boltz shares her expertise in developing and implementing a successful Nurse Practitioner hospitalist program in a rural Montana critical access hospital.

Day 2 :

Keynote Forum

Sharon Jackson

National Clinical Implementation Specialist for Sunrise Senior Living USA

Keynote: Transformational Leadership: The Key to Create Change

Time :

Biography:

Sharon Jackson is a Member of the John Maxwell Team. She received her MSN Degree in Nursing Administration from Xavier University in 2007 and BSN Degree from Silliman University in 1990. She is a Board Certified Nurse- Executive (NE-BC) by the American Nurses Credentialing Center (ANCC).She currently works as a National Clinical Implementation Specialist for Sunrise Senior Living in the US and Canada. She was a Speaker on Transformational Leadership in the 4th Annual Educational Conference of the Philippine Nurses Association of Metropolitan DC (PNAMDC) Spring Hill Suites in Alexandria, VA, USA.

Abstract:

The healthcare industry is gripped by leaders who are conventional thinkers, most of them, if not all cannot think outside the box. They tend to follow status quo and senseless processes and protocols. This key note speech aims to enthused leaders who are forward -thinkers who are MULTIPLIERS OF THE SMARTS of the greatest assets of the organization - the WORKFORCE. It aims to help facilities to succeed by positioning the right individuals in the right position to be GREAT advocates for change in promoting quality, innovation, system and legislative changes.

Keynote Forum

Bernat-Carles Serdà

Health Sciences Faculty, University of Girona, Spain

Keynote: Defining Quality of Life across the cancer continuum

Time :

Biography:

Bernat-Carles Serdà is a teacher and researcher in the Health Sciences Faculty, (University of Girona, Spain). His research focuses on Quality of Life and chronic malignancies. Nowadays is supervising several thesis using mixing methods in this research field. He has achieved several predoctoral and post-doctoral grants for international academic stays.

Abstract:

Introduction: The QoL paradigm is multidimensional, dynamic and modular, and its definition differs across the cancer continuum. The challenge in the interpretation of QoL data in clinical research is that QoL is influenced by psychological phenomena such as adaptation to illness.

Purpose: This research aims to obtain a valid and sensitive assessment of QoL change over the cancer continuum, and to evaluate a rehabilitation programme aimed at inverting the observed decrease in QoL when patients return to daily living activities.

Design: The sample comprised 66 men. Patients were first assessed to establish a baseline (P1-diagnosis). This was followed by a post-test (P2-discharge) and a then-test measurement (P3-retrospective evaluation) and after returning home patients were randomized in experimental and control groups. The experimental group attended a rehabilitation programme over 24 weeks (P4).

Results: The results show that from baseline to post-test, QoL decreased significantly. The recalibration then-test confirmed a low QoL in all periods evaluated. Significant differences between the experimental and control groups proves the positive effect of the Exercise Rehabilitation Programme (ERP) on QoL.

Conclusions: Understanding the real dynamic of QoL over time would help to adapt rehabilitation programmes by improving sensitivity and efficacy and provide professionals with a more accurate perception of the impact of treatment and side effects on patients’ QoL. Our results underline the importance of changing the approach adopted by health professionals towards one of proactive management on patients’ QoL until their complete recovery in daily life.

  • Nursing Education

Session Introduction

Anam Hakim Tejani

Aga Khan University Hospital, Karachi, Pakistan

Title: Challenges faced by Undergraduate Nurses while enrolling in Master’s Program
Speaker
Biography:

Anam Hakim Tejani is currently working as a Clinical Nurse Instructor at Cardiac Intensive Care Unit, The Aga Khan University Hospital, Karachi, Pakistan

Abstract:

Background:

In today’s world, Higher education plays a vital role in the progress of individuals as it assists in the advancement of knowledge and serves as a ladder in the career progression. Besides, it plays an important role in a country's economic development from the generation of new information, research and innovations. Similarly, in nursing profession there is an utmost need of highly qualified work force with updated knowledge, advanced medical and technical skills and research information for the application of evidenced based practice. According to population pyramid, it is estimated that by 2020, there would be growing number of older population and health care systems would be striving to deal with the aging related health issues and non- communicable diseases. But, restricted education and lack of knowledge among nurses may result in errors that put the patients’ health and life in danger. Therefore, rationalized information is crucial for the prevention of errors and for providing high quality care. This study is aimed to explore the factors and details of the challenges that are being encountered by the undergraduate nurses while enrolling in Master’s Program. Also, to identify the alternate ways to assist them in overcoming the underline challenges.

Methodology:

The qualitative descriptive exploratory design was used. Purposive sampling was done and data was collected through IDIs. IDIs were conducted with 5 Bachelors in Science and Nursing (BScN) Graduate Nurses, 5 Post RN-BScN Year II students and 5 Masters in Science and Nursing (MScN) students involving three, MScN Year I students and two, MScN Final Year students. The participants belonged to different age groups and have completed their Nursing diploma or undergraduate degree from different institutions at Government and Private Sectors. Before the interview, participants were explained about the project purpose and consent forms were signed by the participants. The interviews were recorded after taking permission from each of the participant which was later utilized for preparing the transcript. The participants were also requested to fill the tool for evidence purpose.

Findings:

Some of the major barriers towards decrease nurses enrollment in graduate program have appeared at personal, professional and at the educational levels. The data was analyzed by making categories which were classified in main themes. It was identified that most of the participants were facing difficulty to manage time, some had had family responsibilities while, many of the students verbalized that it was difficult for them to get themselves prepared for the admission test as they were in ambiguity while preparing for their admission test and they found English section quite difficult. Whereas, some of the undergraduate nurses lack research knowledge which is the key component of Master’s Program. Additionally, least exposure to evidenced based practice was also one the factor which was resisting them to get enrolled for Higher Education because, it was difficult for them to solve scenario based questions requiring integration of clinical experience. During analysis, it was also found that, there is no proper implementation of curriculum at undergraduate level as some of the course objectives were not met and there were limited teaching learning methodologies. Also, there was restricted advanced preparation for higher education as they were being taught about the basic concepts only.

Conclusion:

Despite all challenges and knowledge gaps, undergraduate nurses of Pakistan are striving hard to get graduate studies. Now it is the time to improve the quality of nursing care and motivate them through career-oriented higher education which needs financial investment, job security, further capacity building and backup support in the field. Review of undergraduate nursing education curriculum by Sindh Nurses Education Board is also in need to address the knowledge gap of undergraduate nurses and to upgrade the education level of Nursing Institutes as, nurses play an integral role in patient’s care and Organizational upliftment.

  • Public Health Nursing

Session Introduction

Faiza A.Abou El-Soud Said Shahin

King Saud Bin Abdel Aziz University for Health Sciences, Saudi Arabia

Title: Application of Trans-theoretical Model of Change on Foot Care Management among Diabetic Patients: Prevention Better than Cure
Speaker
Biography:

Dr. Faiza has completed her RN, BSN, and MSN, PhD. She was acting as assistant professor College of Nursing, Menuofiya University since 7 years before 2010-2017.  In addition, I was associate professor, community health nursing, RAK-MHSU, UAE for 6 years 2010-2015. Currently, she is assistant professor, community health nursing specialty, King Saud Bin Abdel Aziz University for Health Sciences - College of Nursing, Riyadh. In addition, she was chairperson of the Continues Educational development at RAK-CON-UAE and she was a member in many academic and nonacademic committees. She acts as a supervisor of postgraduate nursing students of their dissertation as well as shared in many community projects that are served community and academic fields. She had published more than ten papers in national and international journal. The area of research interest is health promotion and risk reduction at various target population in the community settings.

Abstract:

Diabetic foot ulcer is one of the most common consequences of uncontrolled blood glucose level, which takes place in 15% of people with diabetes, and precedes 84% of all diabetes-related lower-leg amputations that have the adverse effect on the diabetic patients causing physical, psychosocial, and financial burden as well as an economic burden on health care system. The aim of the study is to improve foot care management among diabetic patients by applying the Trans theoretical Model of Change. Design: A quasi-experimental design was conducted with a systematic random sample. Study sample: 154 patients who were selected from the registration system were divided equally into (77 study group) and (77 control group). Setting: the study was conducted at the outpatient diabetic clinic affiliated to Tanta University Hospital and Segar primary health care center affiliated to ministry of health, Tanat Governorate, Egypt. Tools: three tools were used for the purpose of data collection (I) Bio-socio-demographic characteristics questionnaire ;( II) Trans-theoretical Model scale and (III) Diabetes Management Self-Efficacy Scale (DMSES). A survey was conducted by using Arabic version of self-reporting questionnaire to assess the stages of change and self-efficacy among the studied groups as a baseline and during the implementation of foot care intervention program. Results revealed that, there was a statistical significant difference in the stages of change of the Trans theoretical Model for diabetic foot care management of the study group compared to the control group at 2, 4, and 6 months after implementation of intervention program. In addition, there was a statistical significant difference in Diabetes Management Self-Efficacy Levels between study groups who received program intervention compared to control group 6 months after intervention. Recommendation: encouraging nurses who are dealing with diabetic patients to use the Trans theoretical Model of change or other health promotion models to enhance diabetic patient for foot care management, and adoption of healthy behavior.