9th UCG edition on
Nursing and Patient Safety Conference  

April  06-08, 2021|Dubai, UAE

CALL FOR ABSTRACTS

The Utilitarian Conferences Gathering is glad to invite Nurse, Registered Nurse, Practitioners, Professors, Authors, Researchers, and Students to upload their abstracts and papers for oral presentation, poster presentation, workshop, special sessions to be presented at 9th UCG edition on Nursing & Patient Safety Conference on April 06-08, 2021|Dubai, UAE with its motto “Nursing and Patient Safety: Join hands for Patient Safety in Covid19 Pandemic”

Abstract Submission Deadline: November 30, 2020

Abstract submission for #NPSUCG2021 is open and you are welcome to submit your abstracts. 

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Sessions of the 9th Emirates UCG edition on Nursing & Patient Safety Conferences

Keynote Tittle: Five Leadership Strategies to Maneuver the Effects of COVID
Keynote Speech Presented By Dr. Viola Pierce, USA

Keynote Tittle: Leadership Walk Rounds for Patient Safety
Keynote Speech Presented By
Dr. Farook Mirza, Canada

Keynote Tittle: Emotionally intelligent coping strategies in times of uncertainty
Keynote Speech Presented By Dr. Aline Nassar, Australia

Keynote Tittle: Introduction for Quality and Patient Safety methodology & arrangement for ESR on healthcare providers & committees
Keynote Speech Presented By
Mr. Saed Al Nobani, UAE

Keynote Tittle: Digital Health Promotion
Keynote Speech Presented By
Ms. Hend Abdullah Al Jaffar, KSA

Keynote Tittle: Perception of the Effects of Critical Nurses Long Working Hours on Vigilance & Patient Safety in Ramallah
Keynote Speech Presented By Ms. Amal Ibrahim, Jordan

Speech Tittle: Development of an Education Intervention to Decrease Sedentary Behaviors in an Adult Family Practice Population
Presented By Dr. Lauryn Frost, USA

Speech Tittle: Self-compassion and emotional intelligence in nurses
Presented By Dr. Mariam El Houchaimi, UAE

Speech Tittle: Systems Thinking
Presented By Ms. Reem AlAhmed, KSA

Speech Tittle: Difficulties in facing alone the demands of treatment experiences of the hemophiliac adolescent
Presented By Ms. Ana Claudia Acerbi Rodrigues, Brazil

Speech Tittle: Self-leadership in a critical care outreach service to obtain quality patient care
Presented By Dr. Carine Prinsloo, South Africa

Speech Tittle: Sustaining Culture of safety while Implementing zero harm program
Presented By Ms. Lina Mohammed Obaid, KSA

Speech Tittle: Challenge in Real Healthcare Quality Implementation versus Accreditation
Presented By Dr. Marwa El-Saidy, UAE

Speech Tittle: Strategies to mitigate and manage compassion fatigue amongst nurses working in Antiretroviral (arv) clinics: exploration of literature
Presented By Dr. Mercia Jane Tellie, South Africa

Speech Tittle: Predictors of satisfaction of life among Omani adolescents and young adults: A cross-sectional study
Presented By Dr. Omar Al Omari, Oman

Speech Tittle: Satisfaction of people with Mellitus Diabetes and Arterial Hypertension with primary health practices
Presented By Mr. Alexandre Lins Werneck & Mr. Anderson da Silva Rosa, Brazil

Speech Tittle: Developing Nursing Care for People with Skin Ulcers: Integrality Perspective
Presented By Ms. Giovana Andrade Frederico, Brazil

Speech Tittle: Ethical Challenges of Social Media in Healthcare
Presented By Ms. Sarah Idriss, KSA

Accepted Tittle: SEO For Doctors: The Challenges & Tactics to Address in 2020
Presented By Mr. Hayk Saakian, USA

Accepted Tittle: What are the effects of hostile environments on refugee and migrant children and young people accessing healthcare? 
Presented By Mr. Darran Martin, UK

Accepted Tittle: E-Learning Vs Traditional Learning: It’s Effect on Nursing Students’ Knowledge Retention and Skills
Presented By Ms. Hissah Rajae Alanazi, KSA

Accepted Tittle: Reflexões: o movimento Nursing Now e o Slow Nursing
Presented By Mr. Bruno Vilas Boas Dias, Brazil

Accepted Tittle: Quality in Healthcare: Past 100 years & Today
Presented By Dr. Jalal Al Alwan, UAE

Accepted Tittle: Building a Culture of Safety Teamwork & Communication
Presented By Dr. Jalal Al Alwan, UAE

Accepted Tittle: Strategies for Improving working conditions of public hospitals in South Africa: A health and safety problem
Presented By Dr. Zodwa M. Manyisa, South Africa

Learn the 9th UCG edition on Nursing & Patient Safety Conference

Nursing is the form of science and art, using medically and clinically approved practices and procedures but with heart. Nursing is tending to the minds, bodies, and the spiritual essence of your patients. According to the book, the Nursing and Nurse practice is never having enough time to complete tasks and figuring which time savers are not dangerous shortcuts. It has great observational and supporting skills to note what you see, hear, smell, and sense about a person.

Nursing is nurturing. Nursing is the adrenaline pumping as you race against the time. Nursing has the conscience – reporting a symptom that you’re tempted to skip because it will mean new orders, more medicines, more procedures, more paperwork, etc. Nursing and job role fatigue hits you after you leave your job.

Nursing is the extra mile to return a call to a patient’s health and family or listen to a patient’s health concerns. Nursing is worrying about documenting legalities well in case you are called into court. Nursing is following facing the state, rules, federal, or other inspections, and reaching doctors in the middle of the night. Nursing is excellent wages and most of the benefits but must be done for the love of the work and the patients’ benefit.

Nursing is a kind of noble occupation, but most of all, nursing is a passion for people -to alleviate suffering in any small way possible; to teach a coping skill; to listen with empathy; to care. In nursing, you learn two important lessons (taught to me by a prized professor): #1 – no matter how a person is acting, they are doing the best they can at that moment. #2 – People, even those with severe disabilities, are more like us than different.
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The patient’s safety and their medical records are important to maintain the quality of care that the patient receives. Accuracy of medical records is important because it determines the treatment that matches the patient. On the other hand, it is the patients’ responsibility to keep their records available even if they plan to switch to a physician in a different hospital. This is possible with electronic health record apps, enabling patients to remotely access and share their records.
What can be done to ensure accurate patient information, then? Well, the most basic thing is to ensure that the patient is correctly identified. Proper patient identification, in other words, is a must. Proper patient identification means that the proper information is being retrieved by the caregivers, based on which healthcare services can be providers to the patients.

Right Patient helps ensure that the proper patients are identified every time they contact their healthcare providers.

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The Midwives are providers of women’s health and Health Nursing, including preconception care, birth control, pregnancy and delivery, postpartum care, newborn care (up to 30 days after birth), cancer screening, peri and post-menopausal care, and primary care. The scope of Midwifery practice depends on the various type of training and licensing provisions in various states, provinces, and countries. Women’s Health Nursing and Midwives can be women or men; however, most midwives are female. Midwives can be trained “on the job” or in universities. Most US locations require midwives to be nurses first and obtain Master’s level training in midwifery.

The Women Health Nursing and Midwifery is the subject of a woman’s assistance during her childbirth process in an OBS & GYN specialist’s presence. A woman nurse and men nurse can be a midwife as the subject is included in the curriculum. A midwife can be a man also.
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Nursing Practice and Research tends to take on the opportunity to exercise better judgment in clinical care situations. Many also get to do independent practice within the nursing scope that may have been limited when you were at the beginner’s stage. Patricia Benner aptly describes this perspective in her theory of “From Novice to Expert.” She says that a nurse goes through a ladder of professional success as her knowledge and skills in her specialty area increases. You will be at the expert level or expected to exercise some level of expertise when you become a Doctor of Nursing Practice. But also, you would have gained years of experience due to the years of pieces of training that you have gone through. That could potentially spell a difference but in no way should be looked upon as a form of competition because the professions are unique from each other but meet at the point of care to collaborate.

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Nursing informatics is part of the healthcare informatics specialty. It differs from clinical informatics or healthcare informatics because it specifically requires the person to have nursing experience.

What does it encompass? The ability to analyze, implement, test, train, troubleshoot, and support applications used in the health care field, mainly with a nursing emphasis.

Anyone can typically get a nursing informatics degree after obtaining a bachelor’s in nursing since most informatics programs are master’s degrees. There are tons of job descriptions out there. For example, you can be a trainer, an informatics coordinator, an informatics specialist, an informatics consultant, an informatics project manager, and tons of other titles. The main thing to remember is that all these titles revolve around implementing a software program in a hospital or health care setting.

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Pediatric Nursing, your patients are (more apparently) growing. Of course, adults continue with this. That’s what there’s the geriatric nursing on the other end of the lifespan. But for pediatric nursing, growth is much more obvious and tends to have a heavier bearing in providing and managing care. Nursing and Healthcare needs to take this growth and development into extensive consideration not to hamper it while patients receive treatment. The various types of treatment need to be both effective at alleviating illness and maintaining continued growth.
Parents and guardians are around. In both biological and legal terms, your patients have little to no capacity to assert themselves, especially their treatment. This is what the guardian or parent’s intervention comes in so they may be able to make decisions on patients’ behalf. Also, Informing and educating both the patient and the parent/guardian as a group/family or even individually is critical for treatments to proceed by way of cooperation. Communication’s obviously trickier.

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Public health Nursing is all about the advancement and improvement of the health and public health by developing practices, methods, and policies that will ultimately support the protection of a community’s health.

Public health Nursing could be done through health policy implementation, interventions, or health education programs that could reduce harmful exposures for individuals of a community.

Public health is kind of a broad field with many interesting career paths available here, but definitely don’t go into it unless you’re passionate about the general field. As usual, the quantitative side of things (biostatistics, etc.) pays better than more policy-oriented positions overall.

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Health Promotion & Nursing care is the process of enabling people to increase control over, and to improve, their health. Healthy City is a kind of movement that is a way to achieve health promotion at municipal levels. Health Promotion focuses on creating healthy settings—schools, workplaces, homes, and public places. Health promotion is the way to go. If somebody wants an in-depth understanding of why people make health decisions and engage in health behaviors, then Health Promotion is a great area to study. Health Promotion is a great background to study as one is looking for a career to impact the healthcare field, such as medicine, public health, nursing, etc. If someone is looking to learn to implement, design, and evaluate health promotion programs, Health Promotion is highly beneficial. Should everyone study Health Promotion? I don’t think so. Someone should lead these efforts for them to be productive and effective. Everyone aware of the secrets of improving health; they’ll develop a way to resist it or make themselves impervious to its methods, theories, and models (if that makes sense). Although it knows Health Promotion can help people in terms of preventative health and awareness.

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Clinical Nursing is nursing practice; it means assessing and evaluating a patient’s condition and, based on your nursing skills and education, formulating an action. Nursing is not “cookie-cutter” interventions. It’s not a one size fits all approach. It is impossible to teach every scenario during your Nursing education. Here is where Critical Thinking skills come into play and experiencing Clinical Nursing.

The Clinical Nurse Leaders (CNLs) have a range of possible roles. Here is more about the role of the accrediting body Clinical Nurse Leader

The focus is on improving care for specific patient populations using clinical depth on knowledge and experience/expertise and the latest research and data tools as a summary statement.

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Genetics nursing is a nursing claim to fame that centers around giving hereditary medical services to patients. The coordination of Genetics nursing qualities into nursing started during the 1980s and has been a moderate yet significant cycle in improving medical services’ nature for patients accepting hereditary and genomic-based consideration from attendants. Displaying the United Kingdom, the United States basically settled many basic skills as a lot of rules for enrolled attendants. Through the agreement cycle, the fundamental skills were made by the directing panel and gave the moderate competency and extent of training for enlisted attendants conveying hereditary medical services to patients.

The Nursing Code of Ethics and other moral establishments were set up for hereditary qualities nursing to give guidelines when moral issues create. A Genetics qualities nurture is an authorized proficient medical caretaker with a custom curriculum and preparing in hereditary qualities. Hereditary qualities medical caretakers help individuals in danger or are influenced by infections with a hereditary part accomplish and look after well-being. Numerous normal sicknesses are currently known to have a hereditary part, including malignancy, coronary illness, diabetes, and Alzheimer’s.

Genetics nursing qualities attendants perform hazard appraisal, dissect the hereditary commitment to illness hazard, and examine the effect of danger on medical care the board for people and families. They also give hereditary qualities training, give nursing care to patients and families, and directly examine hereditary qualities.

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Diabetes Specialist Nurses (DSNs) are essential in giving great patient consideration and advancing self-care the executives. DSNs work completely in diabetes care and might be utilized in an assortment of care settings. A DSN is frequently the primary purpose of contact for individuals, alluding them to other master administrations. A joint position articulation on how DSNs can improve tolerant results and convey practical consideration, delivered by Diabetes UK, the RCN, and Training, Research and Education for Nurses on Diabetes (TREND-UK), is accessible here. Capabilities identifying with diabetes nursing, dietetics, and podiatry can be found here. DSN’s will likewise give preparing, instruction, and backing to non-master medical care experts, including GP’s, attendants in essential, optional, and network settings and care homes.

All nursing staff has a significant job and clear obligations when treating individuals with diabetes. Nursing groups from over the nursing range, including word-related well-being medical attendants, attendants working in general well-being, and school medical attendants, will probably come into contact with individuals who have diabetes or are having tests to analyze diabetes. Practice attendants have an especially indispensable function as they regularly do yearly diabetes and foot check. Practice nurture specifically assumes a clinical function in screening, keeping up, and supporting individuals with diabetes.

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Coronavirus Deadly Impact on Humans

It’s not hidden at all how the coronavirus has affected the world. It is not restricted to one city, country, but the whole world and Researchers are working day and night to find the cure for this deadly virus. Few countries claimed that they had discovered it but how far it is working is still unknown. Cases of Covid-19 are increasing day by day, and the top ten badly affected countries are the USA, India, Brazil, Russia, Colombia, Peru, Mexico, Spain, Argentina, South Africa. The graph of cases may increase or decrease in the future if the people follow the guidelines as per the World Health Organization (WHO);

1. Maintain at least 1 meter of distance with others whether they are affected or not because you can’t predict coronavirus’s initial stage. Maintain even more distance when you are indoor.
2. Do not touch your face, eyes, nose at any cost without washing or sanitizing your hands.
3. While stepping out, you must put on your mask while you return.
4. Clean your hands before and after wearing your mask.
5. Make sure to cover your mouth, nose, and chin properly.
6. While talking, doesn’t put your mask down.
7. Avoid Gatherings and indoor areas.

Most important is eating healthily, do exercises, maintain social distance, cover your face while sneezing with a hanky; if not available, use your elbow.

Don’t panic at all, follow the safety guidelines, and stay at home.

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Gastroenterology Nursing is a medication field that centers around the strength of the stomach related framework, including the stomach and insides. Sicknesses and diseases of the stomach related lot regularly produce entirely awkward side effects and will frequently influence the body’s wellbeing overall. For instance, some gastroenterology issues can influence the number of supplements the body retains. Gastroenterologists and gastroenterology attendants center around treating and thinking about people experiencing illnesses and the stomach-related lot issues.

Endoscopy is a typical method used to analyze gastroenterological messes. An endoscopy methodology includes embedding a fiber-optic cylinder with a camera into the entrails to get a perspective on the digestion tracts covering. Gastroenterology Nursing nurture that spends significant time performing and helping with these techniques is alluded to as gastroenterology/endoscopy attendants or basically endoscopy medical caretakers.

Gastroenterology Nursing strategies (especially endoscopy systems) can be awkward and upsetting for the patient, so gastroenterology attendants must be talented at the technique (to limit agony and inconvenience) and have a quieting bedside way (to help quiet the patient).

When first gathering with a patient, a gastroenterologist and gastroenterology attendant will frequently audit the patient’s clinical history, indications, and crucial signs. A gastroenterology attendant will likewise frequently be answerable for gathering tests and performing other symptomatic methodology, for example, x-beams, ultrasounds, and barium purifications. Endoscopy medical caretakers will help during or perform endoscopy methodology.

Thinking about and treating gastroenterology persistent is a significant piece of being gastroenterology nurture. As gastroenterology nurture, you will frequently help clarify the various alternatives accessible to patients just as the advantages and dangers. You may likewise assist patients with taking prescriptions and offer them guidance on sustenance. During surgeries, a gastroenterology medical caretaker may likewise be approached to help also.

Long haul care after gastroenterology issues is likewise now and again fundamental. Gastroenterology medical caretakers assist patients with setting themselves up for existence with gastrointestinal issues. They may offer exhortation on what to eat and what not to eat, for example, or how to oversee indications related to their issues.

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Patient Safety in Pharmacy: As medical services suppliers, drug specialists make a vow that peruses, to some degree, “I will apply my insight, experience, and aptitudes as well as could be expected to guarantee ideal results for my patients.”1 Ideal results incorporate the sheltered utilization of meds bringing about the ideal advantage to the patient’s wellbeing. While there are numerous activities that drug specialists can make to satisfy this vow and add to ideal results, this distribution features eight explicit drug specialist activities that improve tolerant wellbeing inside the medical care framework. Drug specialists regularly make these eight moves in the day by day practice across persistent consideration settings. The activities were ordered by a specialist board of drug specialist pioneers and different supporters from an assortment of patient consideration settings. The activities are not recorded in a particular request. For each activity, model situations show how drug specialists address explicit patient consideration issues through their activities and the results and the way those activities have on persistent well-being.

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Home Care Safety: The health care system continues its shift away from its historically predominant focus on inpatient healthcare, driven by monetary, economics, demographics, patient wish & preference, and technology. Yet homecare patient safety in the home care setting is less well understood than patient safety in other settings. The majority of people in the United States rely on insurance and do not have an unlimited amount of funds to pay for private home care. If the insurance company doesn’t pay for private home care, you have to do it, and it can be incredibly expensive. What’s the point of paying for home care if it costs so much you lose your home? Not to mention, some patients are too ill to be safely cared for at home without risking others’ safety in the house. My grandmother suffered from dementia, and in the end, she was convinced my mother, her only child, was trying to kill her for her money (she was broke). Despite her frailty, she could be quite strong when she was desperate, and trying to restrain her could become difficult since we didn’t want her hurt. She was completely broke, my mom was disabled and living month to month, and I had a child going through chemo for leukemia and was struggling to pay the rent.

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Mental health nursing, otherwise called mental nursing, is a particular field of nursing practice that includes the consideration of people with an emotional well-being issue to assist them with recouping and improve their personal satisfaction.

Mental health nursing attendants have progressed information on the appraisal, determination, and treatment of mental problems that causes them to give specific consideration. They normally work close by other wellbeing experts in a clinical group with the point of giving the ideal clinical results to the patient.

Dysfunctional behavior can influence people of all ages, ethnic beginnings, or financial status. Thus, a psychological well-being attendant may need to work with a wide range of people from different foundations.

National Nursing Staff Development Organization Congress, National Organization for Associate Degree Nursing Congress, National Organization of Associate Degree Nurses Congress, National Organization of Practical Nursing Education and Service Congress, National Practitioner Associates for Continuing Education Congress, National Private Duty Association Congress, National Student Nurses Association Congress, Navy Nurse Corps Association Congress, NCNA Council of Nurse Practitioners Congress, Coastal Region NCNA Council of Nurse Practitioners Congress, Eastern Region NCNA Council of Nurse Practitioners Congress, Wake Central Region North American Nursing Diagnosis Congress, Association Northeast Pediatric Cardiology Nurses Congress

Proceedings of Nursing UCG Conferences

Mobile Simulation training for Rural Health Providers

Introduction:  The team in family practice often meets life-risk patients. Simulation is an excellent way for health care worker to train their skills in a safe environment. But sadly, learning with simulations in healthcare is usually not available to professionals.

We have developed a mobile simulation unit (SIM mobile) that will enable all medical teams in primary healthcare access to modern simulation equipment.

We have used SIM mobile to conduct simulations in over 20 different locations in Slovenia (Community health centres, prehospital units). At the end of training the participants filled out a question form about their previous experiences with use of simulations in healthcare, their need for this kind of education and availability of this kind of education. At the beginning and in the end we have measured the intake and outtake theoretical knowledge of every individual.

SIM mobile is a mobile education unit which brings state of the art, hands–on training, using high fidelity human patient simulators, to prehospital and hospital professionals. A mobile simulation experience that can be brought to healthcare professionals in rural and frontier communities, thus reducing the need for providers to travel for training.

All of the participants have said that the physical environment of SIM mobile was very comfortable and appropriate for learning and training. 10% of the participants have said that they have the access to simulation based learning in their workplace, but the equipment is too old and not realistic enough. All of the participants have agreed that the SIM mobile is a great program for renewal of knowledge for experienced doctor and nurse.

Pre- and post-evaluation experiment of qualification indicates that the level of knowledge in simulation is higher for 48 %.

This study has showed that the use of SIM mobile can be practical and efficient for maintaining proper medical team education available. SIM mobile was successfully used in this study across all of Slovenia to ensure proper education for medical teams in primary healthcare for 20 CHC.

The main advantage of SIM mobile is that it can make simulation equipment available to a broad spectre of medical teams in primary healthcare and is not limited by geographical position.

References: [1] Ballangrud, R. Hall‐Lord, M. L. Hedelin, B. in Persenius, M. (2014). Intensive care unit nurses’ evaluation of simulation used for team training. Nursing in critical care, 19(4), 175-184. [2] Dowson, A., Russ, S., Sevdalis, N., Cooper, M. & De Munter, C., 2013. How in situ simulation affects paediatrics nurses clinical confidence. British journal of nursing, 22(11), pp. 610, 612- 617. [3] Kalisch, B. J. Aebersold, M. McLaughlin, M. Tschannen, D. in Lane, S. (2015). An intervention to improve nursing teamwork using virtual simulation. Western journal of nursing research, 37(2), 164-179. [4] Kren, A., Benkovič, R., Zafošnik, U. (2017). Treatment of emergency medical conditions – Simulation-based learning in healthcare. Fakulteta za zdravstvene cede Novo mesto. [5] Pena, G. Altree, M. Babidge, W. Field, J. Hewett, P. Meddern, G. (2014). Mobile Simulation Unit: taking simulation to the surgical trainee. General surgery, 85, 339-243. [6]  Roh, Y. S. in Lim, E. J. (2014). Pre-course simulation as a predictor of satisfaction with an emergency nursing clinical course. International journal of nursing education scholarship, 11(1), 83-90. [7] Stockwell, D. C. in Slonim, A. D. (2006). Quality and safety in the intensive care unit. Journal of Intensive Care Medicine, 21(4), 199-210. [8] Zafošnik, U. Benkovič, R. Marković, D. (2018) Simulacije – sodobna metoda učenja za dvig kakovosti v zdravstvu. 27. letna konferenca Slovenskega združenja za kakovost in odličnost, november 2018, Portorož.

Biography: Lecturer Uroš Zafošnik, Registered Nurse, MSc of social works, was working as head nurse of emergency services in CHC Maribor for four years before starting work in emergency services of CHC Ljubljana, where he worked for three years. Curently he is Head and Coordinator of SIM Centre now for five years. He is also international ITLS and MTS instructor and besides that he was involved in a working group designing standards for triage at Ministry of Health Slovenia. He is also a lecturer at Faculty of health sciences Novo Mesto.

Ethical Challenges of Social Media in Healthcare

Introduction: Social media and technology has played a big role in engaging the patient in the treatment process. It is now a  tool that supports the healthcare process, facilitates information access and brings people together. Patients nowadays are able to control their own healthcare needs through social media and technology.  However, social media and technology has also introduced ethical challenges in healthcare involving patient privacy and confidentiality.

Objective: The advancement in technology has positively and negatively impacted the medical sector. Social media may have played a big role in enhancing the patient-doctor relationship in many ways, but it has also led to limited privacy and security issues. These issues constitute potential ethical problems arising from social media use in health care. This paper will shed light on the ethical issues to be considered when social media is used in healthcare.

Methods:

Google search engine was used to find websites, articles, conferences, or reports related to the ethical aspects of using social media in healthcare.

Conclusion:

The use of social media is essential in this era and every sector is trying to take advantage of it. However, the abuse of data needs to be prevented to preserve the privacy and confidentially of patients.

While security of social media websites can be enhanced, physicians need to understand that social media websites cannot be 100% secure. It is in this perspective that ethical principles and practices need to be revisited to guide healthcare operations.

Abiding by the ethical and professional commitments will definitely maintain the patient-doctor relationship and public trust in the medical profession. Additionally, setting strict guidelines for healthcare professions on the use of social media will decrease the risks and legal issues of using social media.

References:

[1] Denecke K. Ethical aspects of using medical social media in healthcare applications. Stud Health Technol Inform 2014;198:55-62

[2] Chretien KC, Kind T. Social media and clinical care: ethical, professional, and social implications. Circulation 2013;127:1413–21.

[3] Rozenblum R, Bates DW. Patient-centred healthcare, social media and the internet: the perfect storm? BMJ Qual Saf 2013.

[4] Dyer KA. Ethical challenges of medicine and health on the Internet: a review. J Med Internet Res 2001;3(2):E23.

[5] Mayer MA, Leis A. How medical doctors and students should use Social Media: a review of the main guidelines for proposing practical

recommendations. Stud Health Technol Inform 2012;180:853-7.

[6] American Medical Association Policy: Professionalism in the Use of Social Media (2012) https://mededu.jmir.org/article/downloadSuppFile/4886/28296.

[7] British Medical Association: Social media, ethics and professional (2017) https://www.bma.org.uk/advice/employment/ethics/social-mediaguidance-for-doctors

[8] Grobler C, Dhai A. Social Media in the healthcare context: Ethical challenges and recommendations. S Afr J BL 2016; 9(1): 22-25

Biography: Sarah Idriss has completed her Bachelor degree in Healthcare Administration from University of Houston Clearlake in Dec , 2016. She is currently working as a compliance specialist in the Ministry of Health in Saudi Arabia. She has previously worked as a compliance specialist as well at Dr. Sulaiman al Habib hospital in Saudi Arabia. Prior she worked as a Greenlight expert in UBER. She has completed her internship in the united states in June 2016 working with Hospice. She is looking forward into contributing her experience in the healthcare management.

Satisfaction Of People With Mellitus Diabetes And Arterial Hypertension With Primary Health Practices

Introduction:  Diabetes mellitus and arterial hypertension are public health problems that impact people, families and the community. User satisfaction is one of the indicators of the quality of health services and influences human health. Important deficits in care are observed in Primary Health Care1-4. Objective: investigate health practices in the care of people with DM and AH in a Basic Health Unit based on user satisfaction. Method: cross-sectional, descriptive study, conducted in a basic health unit. The characterization of the subjects, health monitoring and satisfaction were based on data from 109 users, with descriptive and inferential analysis. Results: women (73.3%), average age (66 years), attended in programmatic consultations (93.3%) and educational groups (58.7%). There was a correlation between age and medical consultation (p = 0.047). The majority considered themselves satisfied with health practices and aspects asked, with better evaluation among younger people. Inadequacies in care practice for the evaluation of feet and the participation of users in decisions about clinical treatment were identified. Conclusions: the practices are structured in consultation with nurses, doctors, educational groups and spontaneous demands. Satisfactory evaluation prevailed according to the participants, demonstrating that there is no relationship between the technical dimensions recommended for care and user satisfaction.                

References:

[1] Brazil. Ministry of Health. Department of Health Care. Department of Primary Care. Strategies for the care of people with chronic illness: diabetes mellitus. Brasília (DF), 2013. [2] Salci, MA, Hörner MBS, Guerreiro DMVS. Primary care for people with diabetes mellitus from the perspective of the care model for chronic conditions. Latin American Journal of Nursing. 2017; 25: 1-8. [3] Fertonani H et al. Health care model: concepts and challenges for Brazilian primary care. Ciência & Saúde Coletiva. 2015, 20(6): 1869-1878. [4] Brazil. Law no. 8,080 of September 19, 1990. Organic Health Law. Provides for the conditions for the promotion, protection and recovery of health, the organization and functioning of the corresponding services and other measures. Diário Oficial da União, Brasília (1990 Jan. 20); Sec.1. p.18055.

Biography: graduated in 2016 at Paulista Nursing School in Federal University of São Paulo, Brazil. Postgraduate in Nursing in Primary Care with an emphasis on Family Health Strategy from the Medical School of São José do Rio Preto, Brazil. She is interested, involved and stands out in the Nursing area in the Collective Health dimension. She published five scientific articles and seven abstracts presented and published in congress/journals. He received the 1st with professors / researchers from Paulista Nursing School. Lugar Trabajos Libres WUWHS Young Investigator AWARD, World Union of Wound Healing Societies/COMLHEI-2019.

Conflicts And Mediation In Primary Care: Reflections To Worker Health And Care Management

Introduction: Health work involves aspects that deserve attention from peers / leaders, related to diversity can generate conflicts / compromise the health of workers / users of services. Objectives: To know and analyze knowledge about conflicts / mediation in Primary Health Care. Methodology: Integrative review, articles (2009-2019), DECS: Conflict; Worker’s health; Primary Health Care; Community Health Agents; Nursing. Results: 23 articles published in Brazilian journals, evidence VI.

Figure 1: Scientific productions in the period of 2009-2019, Santo André (SP), Brazil, 2019. n=23.
Figure 2: Quantitative of scientific productions, focusing on the proposed thematic categories, 2019, Santo André (SP), Brazil, 2019.
Considerations: dissatisfaction / conflicts and illness are frequent among professionals, compromising safe and quality care for the population. Understanding the needs of workers and developing mediation strategies is essential for the health of those involved.

References: Use the brief numbered style common in many abstracts, e.g., [1], [2], etc. References should then appear in numerical order in the reference list, and should use the following abbreviated style:

[1] Author A. B. and Author C. D. (1997) JGR, 90, 1151–1154. [2] Author E. F. et al. (1997) Meteoritics & Planet. Sci., 32, A74. [3] Author G. H. (1996) LPS XXVII, 1344–1345. [4] Author I. J. (2002) LPS XXXIII, Abstract #1402.
Biography: graduated in 2016 at Paulista Nursing School in Federal University of São Paulo, Brazil. Postgraduate in Nursing in Primary Care with an emphasis on Family Health Strategy from the Medical School of São José do Rio Preto, Brazil. She is interested, involved and stands out in the Nursing area in the Collective Health dimension. She published five scientific articles and seven abstracts presented and published in congress/journals. He received the 1st with professors / researchers from Paulista Nursing School. Lugar Trabajos Libres WUWHS Young Investigator AWARD, World Union of Wound Healing Societies/COMLHEI-2019.

Sustaining Culture Of Safety While Implementing Zero Harm Program

Introduction:

Aim: The purpose of this study is to ensure the sustainability of safety culture while implementing Zero Harm Program.

Background: Over the last decade Zero Harm and its many variant including zero incidents, zero injuries, injury free, incident free and always free has been a commonly adopted and expressed safety value.

Zero Harm program is a new approach for improvement that aiming to prevent any harmful incident to patient or employee that involving adverse impact on safety, health, environment, quality, productivity, etc. with a diverse range of consequences.

Methods:  A new tool of Zero Harm will be implemented among all units in order to measure and report the harmful incidents. Different types of quantitative measures of safety performance will be used to provide information about the organization safety culture such as “hospital acquired pressure injury, hospital acquired infection, fall adverse event and the number of medication administration actual error”. During the study, the team uses a parallel chart to monitor the trend of number of days without harm and the number of incident reports.

Expected Result: The expected results of this study are: 1. The new concept of Zero Harm will support the organization in decreasing the number of harmful incident of the patients during the hospitalization period. 2. The use of Zero Harm Tool is helpful to support leaders in collecting and drawing a clear picture on the unit performance in preventing the harmful incidents.

Implication on patient Experience: One of top priority during the hospitalization period is to provide a high quality of care to the patients with no harm and provide an exceptional experience to the patients and their families.

Biography: Lina Obaid has completed her Bachelor Degree in Nursing Science from Jordan University in 2007 followed by Master Degree in Public Health from the same university in 2010 and certified by the Jordan Society for Quality as a certified Quality Manager. She is the Nursing Quality Supervisor in Sultan Bin Abdul-Aziz Humanitarian City. She has facilitate and lead more than 20 Performance Improvement Project by using different Quality Methodologies. She is one of the key note speakers at the yearly Nursing Management and Leadership Course and Nursing Rehabilitation Course.

Development of an Education Intervention to Decrease Sedentary Behaviors in an Adult Family Practice Population

Introduction:

Background and Purpose: There is a lack of scientific literature examining the knowledge of the negative effects of sedentary behavior for adults in the United States (U.S.) and for interventions to reduce such behaviors. The purpose of this project was to understand adult family practice patients’ perceptions regarding sedentary behaviors and to develop an educational tool for primary care providers.

Methods: A quality improvement project was conducted with a convenience sample of

20 participants. A baseline assessment survey was developed to identify gaps in knowledge regarding sedentary behaviors. A website was developed based on the needs assessment survey. The website was assessed by expert consultants for usability and learnability with the Systems Usability Scale (SUS) (Lewis, Utesch, & Maher 2015). The consultants also commented on content reliability of the website. The SUS has been determined to be a valid and reliable assessment tool for website evaluation.

Conclusions: Results of the initial survey indicated that patients are interested in learning more about sedentary behavior modification. The patient preferred education tool (PPET), a website, was developed and found to be usable and learnable as determined by the results of the SUS survey, as indicated by the results of the SUS scores. The SUS grades tools to determine the usefulness of the tool. Scores range from zero to one hundred. A score greater than sixty-eight is considered a positive score (Sauro, 2011). The SUS results were usability 86.7, and learnability 91.7. Therefore, the tool could be useful for primary care providers to utilize when discussing sedentary behaviors.

Implications for Practice: Chronic disease is a leading cause of morbidity and mortality in the adult population. Management of chronic disease is a significant financial burden on the health care system. An educational tool designed with patient input will assist providers with reducing sedentary behaviors and therefore decreasing chronic diseases.

References::

[1]  Author, unknown. (2016). Chronic Diseases: The Leading Cause of Death and Disability in the United States. Retrieved from: http://www.cdc.gov/chronicdisease/overview/u

2 Halloway, S., Buchholz, S. (2016). Sedentary Behavior: Considerations for a Nurse Practitioner. The Journal for Nurse Practitioners. Retrievedfrom:http://www.npjournal.org/article/S1555-4155(16)30488-3/fulltxt

3 Kerr, J., Marshall, S. J., Godbole, S., Chen, J., Legge, A., Doherty, A. R., . . . Foster, C. (2013). Using the SenseCam to improve classifications of sedentary behavior in free-living settings. American JournalofPreventiveMedicine,44(3),290-296. doi://dx.doi.org.ezproxy.neu.edu/10.1016/j.amepre.2012.11.004

4 Lewis, J. R., Utesch, B. S., & Maher, D. E. (2015). Measuring perceived usability: The SUS, UMUX-LITE, and AltUsability. International Journal of Human–Computer Interaction, 31(8), 496-505. doi:10.1080/10447318.2015.1064654

5 Loprinzi, P. (2015). Sedentary Behavior and Medical Mulitmorbidity. Physiology and Behavior. Retrieved from http://dx.doi.org/10.1016/jphysbeh.2015.08.016

6 Owen, N. Sugiyama, T. Eakin,E. Gardner, P. Tremblay, M. Sallis, J. (2011). Adult’s Sedentary Behavior: Determinants and Interventions. American 18 Journal of Preventative Medicine. Retrieved from: http://www.sciencedirect.com.ezproxy.neu.edu/science/article/pii/ S0749379711003229

7 Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

8 Rhodes, R. Rachel, M. Temmel, C. (2012). Adult Sedentary Behavior: A Systematic Review. American Journal of Preventative Medicine.Retrievedfrom: http://www.sciencedirect.com.ezproxy.neu.edu/science/article/pii/S07493797110 0910X

9 Rohm,D. Young, M. Hivert, A. Camhi, S. Ferguson, J. Katzmarzyk,P.Lewis, C. Neville, O. Perry,C. Siddique J. and Yong, C. (2016). Sedentary Behavior and Cardiovascular Morbidity and Mortality.Circulation2016Retrievedfrom: https://doi.org/10.1161/CIR.0000000000000440

10 Sauro, J. (2011). Measuring Usability with the Systems Usability Scale Retrieved from:https://measuringu.com/sus/

11 Young, D. R., Hivert, M., Alhassan, S., Camhi, S. M., Ferguson, J. F., Katzmarzyk, P. T., Yong, C. M. (2016). Sedentary behavior and cardiovascular morbidity and mortality: A science advisory from the american heart association. Circulation, 134(13), e262. doi:10.1161/CIR.0000000000000440

Biography: Dr. Lauryn LeGacy Frost  has completed her DNPfrom  Northeastern University. She teaches with the Nursing epartment of the University of New Hampshire. She also provides care to a variant of patients in  rural practice acute care  centers And Healing Societies/COMLHEI-2019.

Strategies To Mitigate And Manage Compassion Fatigue Amongst Nurses Working In Antiretroviral (Arv) Clinics: Exploration Of Literature

Introduction:

Nurses who work in the HIV field care for large numbers of HIV-positive patients.1 The demanding nature of the care needed by HIV-positive patients causes nurses to become physically and emotionally exhausted, resulting in an increase in nurses’ vulnerability to develop compassion fatigue.2 Compassion fatigue is an extreme state of tension and preoccupation of nurses with the suffering of those in their care and can negatively impact on nurses’ health.3 The key to prevention of compassion fatigue is awareness and various strategies to manage compassion fatigue are described in the literature.4,5 Compassion fatigue affects the individual’s health, family, work performance, relationship with employers and the ability to provide empathetic care – hence the need to prevent and manage it.6,7,8,9,10

The objective of this paper is to describe strategies to mitigate and manage compassion fatigue. The search for literature from articles was guided by search terms, namely: compassion fatigue, compassion fatigue prevention and management strategies were conducted using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Google Scholar and Ebscohost and included English language articles published in peer reviewed journals between 2008 and June 2018. The selected articles were reviewed and synthesised for this paper. The preliminary search identified 50 articles, of which 29 met the inclusion criteria. However, manual searching of the reference list of articles was undertaken to search for additional articles that would fit the inclusion criteria. Various strategies to prevent and manage compassion fatigue were described in selected articles, including, Accelerated Recovery Program (ARP), bereavement support, debriefing, psychological support, mindfulness-based training, resiliency programmes and self-care.

Key words: Accelerated Recovery Programme, bereavement support, compassion fatigue, compassion satisfaction, debriefing, mindfulness-based training, resilience, self-care

Heading Styles:  The section heads in this template use the correct style (upper and lower case, bold, followed by a colon).

References:

  1. Visser, C. A., Wolvaardt, J. E., Cameron., D & Marincowitz, G. J. O. (2018). Clinical mentoring to improve quality of care provided at three NIM-ART facilities: A mixed method study. African Primary Health Care Family Medicine, 10 (1), a1579. https://doi.org/10.4102/phcfm.v101.1579
  2. Bam, N. E., & Naidoo, J. R. (2014). Nurses experiences in palliative care of terminally–ill HIV patients in a level 1 district hospital. Curationis, 37(2),1-19.
  3. Houck, D. (2014). Helping nurses cope with grief and compassion fatigue: An educational intervention. Clinical Journal of Oncology Nursing, 18(4), 454-458.
  4. Hesselgrave, J. 2014. Coping with compassion fatigue in pediatric oncology nursing. Oncology Times. [cited 2014 October 20]. Available from: http://journals.lww.com/oncology-times/Fulltext/2014/08101/Coping_with_Compassion_Fatigue_in_Pediatric.1.aspx
  5. Gates, D. M., & Gillespie, G. I. (2008). Secondary traumatic stress in nurses who care for traumatised women. The Association of Women’s Health, Obstetric and Neonatal Nurses, 37(2), 243-249. DOI:10.1111/j.1552-6909-2008-00228.x
  6. Al-Majid, S., Carlson, N., & Kiyohara, M. (2018). Assessing the degree of compassion satisfaction and compassion fatigue among critical care, oncology and charge nurses. The Journal of Nursing Administration, 48(6), 310-315. DOI:10.10997/NNA.000000000000620.
  7. Adimando, A. (2017). Preventing and alleviating compassion fatigue through self-care: An educational workshop for nurses. Journal of Holistic Nursing, XX(XXXX), 1-14. Doi:10.1177/0898010117721881.
  8. Cocker, F., & Joss, N. (2016). Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review. International Journal of Environmental Research and Public Health 2016, 13(618), 1-12. doi:10.3390/ijerph13060618.
  9. Potter, P., Deshields, T., Berger, J.A., Clarke, M., Olsen, S., & Chen, L. (2013). Evaluation of a compassion fatigue resiliency program for oncology nurses. Oncology Nursing Forum, 40(2), 180-187
  10. Boyle, D. A. (2011). Countering compassion fatigue: A requisite nursing agenda. Online Journal of Issues in Nursing, 16(1):1-11.

Biography: M J Tellie have completed her PhD at University of Pretoria in South Africa in 2016. She is currently working as Senior Lecturer at University of South Africa in Health Studies Department.  Her passion is HIV/AIDS, TB and health and wellbeing of nurses. She has presented a number of papers at different AIDS conferences and ICN conferences. She have published more than 1 abstracts and co-authored 2 abstracts in accredited journals.

Meditation and Positive Energy

Introduction:  The therapeutic effects of yoga provide a comprehensive review of the benefits of regular yoga practice. As participation rates in mind-body fitness programs, yoga continues to increase. It is important for health care professionals to be informed about the nature of yoga and the evidence of its many therapeutic effects regarding many ailments. Therapeutic yoga is defined as yoga postures and practice to the treatment of health conditions. Instruction in practices and teachings prevent, reduce or alleviate physiological, emotional pain, suffering or limitations. Yoga practice has been proven to enhance muscular strength, body flexibility and endurance; it promotes and improves respiratory and cardiovascular function as well as recovery from addiction, reduces stress, anxiety, depression and chronic pain. It also improves sleep patterns and enhances overall well-being and quality of life. Continued practice leads to changes in life perspective, self-awareness and a sense of energy and enjoyment. A 5,000 year old tradition, yoga, is regarded in the Western world as a holistic approach to health and classified as a form of Complementary and Alternative medicine.

Heading Styles:  The section heads in this template use the correct style (upper and lower case, bold, followed by a colon).

References: Cathryn has completed her Yoga Teacher training in 2015 from SamaCore Yoga & Barre in Mount Dora, Florida. She teaches classes at rehabilitation centers, yoga studios and private clients and continues to hone her teaching skills. She has a meditation video on YouTube and is currently pursuing a degree in holistic health practices.

Ultrasound in Female Infertility: 2D and CD

In today’s world one cannot think of female infertility practise without ultrasound. First modality of choice for investigation is undoubtedly ultrasound. More so as it is readily available, relatively inexpensive and radiation free. After a detailed history one can go ahead with an ultrasound scan in the first visit itself to rule out any major abnormality of the uterus, tubes and ovaries. Transabdominal and transvaginal scanning to begin with and further follow up by TVS tells us regarding the status of changes in the endometrium and ovaries during different phases of the cycle. Baseline scan to assess ovarian reserve and rescanning with follicular monitoring for timing of HCG helps in increases chances of an infertile couple to get pregnant.

Various pathologies can be assessed and detected by high resolution ultrasound. One needs to be aware of what to look for and this paper is going to serve that purpose. 2D ultrasound tells us more about the anatomy and color Doppler, power angio and spectral Doppler depict the perfusion status which indirectly correlates with the hormonal mileu. Thin linear endometrium to triple layered to pre or peri-ovulatory to an echogenic luteal endometrium and antral follicles to mature follicles and impending ovulation to confirming ovulation and finally corpus luteum formation is seen on ultrasound scan.

References :

  1. Andreotti RE, Thompson GH, Janowitz W, Shapiro AG, Zusmer NR. Endovaginal and transabdominal sonography of ovarian follicles. J Ultrasound. 1989;8:555.
  2. Fanchin R. Assessing uterine receptivity in 2001. Ultrasonographic glances at the New Millennium. An N Y Acad Sci. 2001;943:185-202.
  3. Ivanovski M, Lazarevski S, Popovik M, et al. Assessment of endometrial thickness and pattern in prediction of pregnancy in an in vitro fertilization an embryo transfer cycles after ovarian stimulation. Macedonian Medical Review. 2007;4-6:117-24.
  4. MY Chang, CH Chiang, TT Hsieh, et al.Use of the antral follicle count to predict the outcome of assisted reproductive technologies

Fertil Steril, 69 (1998), pp. 505-510

  1. A Kurjak, S Kupesic-Urek, H Schulman, et al.Transvaginal color flow Doppler in the assessment of ovarian sand uterine blood flow in infertile women

Fertil Steril, 56 (1991), pp. 870-873

  1. AC Fleischer, CM Herbert III, AC WentzSonography in gynecologic infertility emphasizing transvaginal scanning
  2. AC Fleischer, R Romero, FA Manning, et al. (Eds.), The Principles and Practice of Ultrasonography in Obstetrics and Gynecology (4th edition), Appleton & Lange, East Norwalk (1991), pp. 597-607

Dr. Kuldeep Singh has been practicing ultrasound for over 18 years in South Delhi, INDIA. He is known for his ultrasound skills in Anomaly Scanning, Color Doppler Scanning and High risk pregnancy evaluation. He has more than 150 lectures in various national and international conferences. He has more than 100 articles and chapters to his credit and has authored 16 books on Ultrasound in Obstetrics, Gynecology and Infertility. His books have been translated into Spanish, Chinese and Portugese. The IMAGING SCIENCE AWARD was honored to him at the AICOG 2008. He has been appointed as associate director of Ian-Donald Inter University School of Medical ultrasound.

Strategies For Improving Working Conditions Of Public Hospitals In South Africa: A Health And Safety Problem.

Background and objectives:  In south Africa, employees in public hospitals work under horrific conditions and as a result they are subjected to psychological stress, low morale and burnout. These poor working conditions were attributed to poor infrastructure, inadequate resources, poor interpersonal relationships, flawed communication channels, lack of support and unsafe environment. The purpose of the study was to propose strategies for improving working conditions of public hospitals in Mpumalanga Province, South Africa.

Research design and methods: An explorative sequential mixed method approach was used for this study. The study comprised two phases, namely:

Phase 1:  Qualitative approach.

Thirty-two participants were purposefully selected to participate in the qualitative study. The sample comprised senior managers, middle managers, operational managers, occupational health nurses and employee representatives. In-depth individual interviews were used to obtain information regarding the statuses of the working conditions of public hospitals in Mpumalanga Province.

Phase 2: Quantitative approach

This phase comprised a total of 344 employees. A self-administered questionnaire was used to obtain data from different categories of employees, namely; nurses, doctors, physiotherapists, pharmacists and other health care providers as well as administrative officers.

Findings:

The study suggests that Improvement should focus on enablers such as leadership commitment, infrastructure, resources, interpersonal relationships, support and education and training, appointment of more occupational health nurses, compliance to the health and safety standards and guidelines, improving security systems in the institutions and holding frequent health and safety meetings between safety officers, managers and employees.

Key Concepts: employees, improving working conditions, public hospitals, occupational health and safety, strategies.

E-Learning Vs Traditional Learning: It’s Effect on Nursing Students’ Knowledge Retention and Skills

Abstract: In the information era of the 21st century, nurse educators must acknowledge that the benefits of technology are accompanied by challenges, which are apparent in both the clinical and classroom settings. Teaching and learning are no longer confined to the classroom or the school day. There are many technologies that can offer a great deal of flexibility in when, where, and how education is delivered. The responsibility of nursing educators is to teach the students to become discriminating users of information technology .Considering these constant and rapid changes, it is critical that learners in health care area be taught with latest knowledge and keep pace with up to date information. In response to these environmental and informational changes, there should be appropriate changes in information delivery strategies by health care education institutions. Methods: A true experimental research design was conducted on 50 nursing students (25 study group and 25 control group). The researcher conducted a live online discussion session by using Big Blue Button application. The researcher also added some resources and activities to the MOODLE. On the other hand, the control group was instructed by traditional lecturing method at the faculty’s classroom. The researcher conducted a live online demonstration and re-demonstration session using Big Blue Button application. The researcher also added some resources and activities to the MOODLE. On the other hand, the control group was instructed by traditional demonstration and re-demonstration method at the faculty’s laboratory. The scores of tools I and II were compared for each students’ group before and after the interventions (either E-learning or traditional sessions), then the difference among each group was estimated in order to determine the effect of E-learning teaching strategy versus traditional teaching strategy. Results: significant positive relation r=0.40; p<0.05 between the total knowledge and the total performances after the application of Electronic learning among the study group, while there was no significant relation r=0.11; p>0.05 between the total knowledge and the total performance after the application of traditional method among control group. Conclusion: E-learning is shown to be effective in changing the students’ attitude from being passive to active learners and also in promoting their clinical practice.  It encouraged students to learn independently and translate their knowledge to practice.

Key words: traditional learning; e-learning; knowledge retention, skills

Improving Nurse-to-Nurse Handoff

Seventy percent of errors or sentinel events are attributed to poor communication during nurse handoff (Small et al., 2016). One identified barrier to poor communication is a standardized process for handoff (Stewart, 2017).  Since communication is the foundation of patient care, it is crucial to provide accurate, up-to-date information in a timely manner to the oncoming nurse. The purpose of this project was to implement bedside nurse-to-nurse handoff reports using a standardized tool, the SBAR tool. This implementation took place in the emergency department, a complex environment where information can easily be miscommunicated or omitted due to the chaos of the setting. However, nurse-to-nurse handoff is significant in every department and should be consistent. Posters were placed in the department to remind staff of the SBAR tool. Nurses were instructed on the importance of proper handoff and educated on using the SBAR tool and performing bedside report by providing a mandatory learning experience to all nurses to education them on the SBAR tool, how to give a proper handoff, and tips for bedside reporting to help them be effective and efficient in their handoff. Improved handoff and communication between nurses are predicted to result in decreased incident reports and medication errors, as well as, increased patient satisfaction scores. Data will continue to be evaluated over a six-month period to assess these findings.

Biography

Carrie Clark completed her ASN from Tri County Technical college in 2003, then returned to school to complete her BSN from University of Lousiana at Lafayette in 2017. She is scheduled to graduate with her MSN from Columbus State University in December 2019. Much of her background is in labor and delivery and NICU, however she currently works as a team leader in a rural hospital emergency room. While unpublished at the time of this submission, she is looking forward to contributing input from her experience to the nursing profession.

Preventing Healthcare Acquired Infections: Staff Education is Crucial

CAUTIs and CLABSIs are the two most common types of HAIs among hospitalized patients in the United States. These infections cause a significant increase in healthcare costs as well as increase length of hospital stays, critical care admissions, increased morbidity and increased mortality rates. Education of frontline nursing staff is a crucial component to promote better outcomes in patients with central lines and indwelling urinary catheters. Education of staff on care and maintenance of these devices increases compliance therefore prevents costly CLABSIs and CAUTIs. Participants were presented with educational information on urinary catheter and central line care, including a checklist for each. Participants utilized the checklists for two weeks and completed a survey at the end of the two weeks. The feedback provided from the participants yielded evidence of improved delivery of care and maintenance of central lines and urinary catheters. The feedback from this project concluded that education of frontline nursing staff is an effective method to increase staff awareness and compliance of prevention measures, therefore, improve care and maintenance of central lines and indwelling urinary catheters and decrease CLABSI and CAUTI rates.

Key Words: Catheter-associated urinary tract infections, Central line-associated bloodstream infections, healthcare-associated infections, evidence-based guidelines, infection prevention, central line care, indwelling urinary catheter care.

Preventing Healthcare Acquired Infections: Staff Education is Crucial Central line associated bloodstream infections (CLABSIs) and catheter associated urinary tract infections (CAUTIs) cause poor hospital outcomes and increase hospital stays, costs, and mortality rates. It is imperative to educate nursing staff on prevention measures related to these devices. One of the most important ways to decrease risk factors associated with a CLABSI or CAUTI is by following strict guidelines for care and maintenance of these devices. Educating nursing staff on care related to maintenance of these devices is crucial to prevent healthcare acquired infections caused by central line accesses and indwelling catheters. Patients with healthcare acquired infections are at risk for longer hospital stays, increased intravenous antibiotic therapy, extended critical care interventions, and increased mortality rates. Urinary infections are one of the most common hospital related infections. According to Holt, Grant, and Thompson-Brazill indwelling catheters account for about 40% of urinary tract infections (CAUTIs) across the United States, each year (2017). Evidence-based literature supports that meticulous catheter care is important to prevent infections, especially among the elderly, immunocompromised individuals, and the critically ill. This group of patients are most likely to require catheters for longer intervals due to their hemodynamic instability however, a central line is a risk factor for development of sepsis.

Central venous catheters are another common source of hospital acquired infections. Patients with chronic diseases, cancer, and multiple trauma require central line accesses to manage disease processes during their hospital stay. This group of patients are at risk for developing central-line associated bloodstream infections (CLABSIs) therefore central line care is important to prevent infections. Central lines infections are linked to 12-25% of mortalities in the United States every year (Atilla, Doganay, Celik, Demirag, & Kilic, 2017).

The purpose of this paper is to educate nursing staff on measures to prevent hospital acquired CLABSIs and CAUTIs. Prevention of these infections will decrease the number of intensive care admissions related to sepsis, decrease healthcare costs, length of stay, and decrease the number of mortalities related to CLABSIs and CAUTIs. Hand hygiene is the number one method to prevent infection and education of nursing staff is imperative. Gupta, Sharma, and Saxena report that there are more than 100,000 deaths annually and 30 % of healthcare-associated infections are preventable with evidenced-based infection prevention measures (2018).

Significance of the Problem to Nursing Practice

The purpose of this paper is to discuss education of front-line nursing staff on evidence-based prevention measures for indwelling catheters and central venous access devices to improve patient outcomes related to CAUTIs and CLABSIs. Educating healthcare staff on CAUTI and CLABSI prevention is important which reduces risk factors associated with hospital acquired infections. Individuals with three or more chronic diseases, traumatic injuries such as burns, and multiple trauma require indwelling catheters and central venous access devices for hemodynamic monitoring, especially in critical care settings. A case study conducted by Shirley Johnson revealed that CLABSIs and CAUTIs are the most prevalent hospital acquired infections affecting 1 out of every 25 hospitalized patients in the United States ((2018). Proper handwashing technique is imperative to prevent transfer of pathogens which may lead to a CAUTI or CLABSI.

CAUTIs are linked to increased length of hospital stay, increased healthcare cost, and increased risks of mortality. Indwelling catheters places individuals at risk for a CAUTI therefore, it is important to educate nursing staff on measures to reduce risk. According to Deghanrad et al., urinary tract infections (UTIs) caused by indwelling catheters are one of the most prevalent hospital acquired infections which are easily preventable with education and implementation of CAUTI protocol bundles (2019).

Critical care patients and other hospitalized individuals require central line devices for numerous reasons. Among some of the most common reasons are hemodialysis, long term antibiotic therapy, vasoactive agents, total parenteral nutrition (TPN), inability to obtain peripheral accesses, and hemodynamic monitoring. Central venous accesses require strict aseptic technique with insertion, site care, and dressing changes as well as evidence-based infection prevention measures to reduce blood-borne infections. Prevention of CLABSIs can be reduced by education hospital staff on preventative measures. A study by the University of Vermont Medical Center and University of Vermont College of Medicine concluded that education of nursing staff on central line care and maintenance of central access devices increases nursing staff competence and compliance (Page, Tremblay, Nicholas, & James, 2016).

This is an educational project which will be implemented on a twenty-five bed, medical-surgical unit with front-line nursing team members. The participants are registered nurses (RNs) and Medical Assistants (MAs) with various years of experience, ranging from one year or less to twenty years of experience. The objective of this project is to increase nursing staff knowledge of measures to prevent CLABSIs and CAUTIs of patients with indwelling catheters and central lines. This project is composed of a power point video presentation which includes a CAUTI and CLABSI checklist, post questionnaire, and a survey. RNs and MAs will be asked to participate in this voluntary project by watching a video presentation on prevention of CLABSIs and CAUTIs and use the checklist during care of patients with central lines and indwelling urinary catheters.

Theoretical Framework

The incidence of CLABSI and CAUTIs has led to increased length of hospital stay, increased length of days in critical care units, increased healthcare costs, and mortality rates of individuals who were hospitalized for unrelated illnesses. According to Holt, Grant, and Thompson-Brazill, 40% of health care-associated infections in the United States are caused by CAUTIs (2017). Education of frontline nursing staff on care of indwelling catheters and central lines is necessary to prevent hospital acquired CAUTIs and CLABSIs. Education will include staff members who are involved with assisting the patient with daily care which includes nurses and patient care techs. Providing staff with education will increase their awareness of potential risks of infection and reinforce measures to prevent infections, therefore causing a change in behavior. The theoretical framework that will be used to support this project and help implement change is Lewin’s Change Theory.

Kurt Lewin’s original theory is designed to cause a change which is composed of two forces, driving forces and restraining forces (McEwen and Wills, 2019). The focus of the change is front-line nursing staff who are involved in direct patient care. This includes medical assistants, nursing students, and nurses because they will be inserting catheters, managing catheter care, managing central line care, bathing patients, transporting, and repositioning patients. Nursing staff education includes prevalence and incidence rates of CAUTIs and CLABSIs, preventative measures, and care and management of indwelling catheters and central lines devices. This change will increase awareness and influence a change in staff behavior to decrease risks of hospital acquired CLABSIs and CAUTIs. Implementing awareness and compliance of measures to prevent CAUTIs and CLABSIs will serve as driving forces for a change. The goals of these measures are to increase patient safety and promote better outcomes indicated by effective staff education and compliance. Restraining forces are represented by the nursing staff who are resistant to education and change. According to Lewin both forces must be identified in order to cause a change and restore equilibrium and the driving forces must surpass the restraining forces to cause an effective change (McEwen and Wills, 2019).

Review of Literature

Two of the most common infections leading to sepsis among hospitalized patients are caused by central lines and Foley catheters. These infections can be prevented when protocol is followed by hospital staff when inserting central lines and catheters. Most bacterial infections caused by indwelling urinary catheters are related to inadequate cleansing of the perineum. Current trends for most hospitals and healthcare facilities include bundles and checklists for central line and catheter insertion and care. Review of the following articles support evidence that education of front-line nursing staff increases awareness and compliance of prevention measures for CLABSIs and CAUTIs therefore, reducing risks of related infections caused by central lines and indwelling Foley catheters. Search keywords used: central line infections, prevention of infections, CLABSI, CAUTI, catheter care, central line care, urinary tract infections, evidence-based nursing, prevention of bloodborne infections, and hospital-acquired infections. Search databases used: Consumer Health Complete-EBSCOhost, Medical Information, Academic Search Complete, and Advanced Placement Source.

Literature Related to Prevention of CLABSIs and CAUTIs

Johnson et al. (2018) conducted a case study which identified CAUTIs and CLABSIs as the first and second leading causes of hospital acquired infections. The purpose of the study was to increase front line staff awareness and ways to reduce risks associated with these infections. According to the article central lines usually end in the great vessels such as the aorta, subclavian, vena cava, or femoral veins. Central lines and indwelling catheters were used for hemodynamic monitoring and infusion therapy in hospitalized patients. This study discussed increased healthcare costs related to these two infections, education of staff caring for these devices and measures to prevent infections, and quality control measures. This study concluded that prevention of CLABSIs and CAUTIs is a team effort and education of front-line staff is an effective measure to help reduce hospital-acquired infections.

A recent review article concluded that study of HAI data is relevant to improving safety and decrease of CAUTIs and CLABSIs. Study of such data includes current guidelines related to date of event of HAI, new HAIs in patients with previous infections, types of intravascular lines and related bloodstream infections, and urinary analysis to determine a healthcare related CAUTI. This review article relevant because it proves that following protocol to prevent HAIs can prevent expensive CAUTIs and CLABSIs. According to the article up to 30 % of patients with quality control preventative measures in place will remain free of HAI (Gupta et al., 2018, p. 18).

A research article by the Turkish Journal of Medical Sciences, is relevant because the article revealed that central line infections are responsible for increased mortality rates among critical care patients across the nation. Data from this article revealed a 54.4% survival rate and a 45.6% death rate of patients with indwelling catheters (Atilla et al, 2017). The study also provided relevant data on characteristics and risk factors for CLABSI mortalities among patients in intensive care units.

Literature Related to CLABSIs

Meticulous central line care is imperative to prevent CLABSIs. Conley’s article discusses evidence-based guidelines and standards such as hand hygiene, skin antisepsis with chlorhexidine, and strict aseptic technique during insertion of central lines (Conley & Brown, 2016). The article concluded that evidence-based standard for central line placement and care improved measurable patient outcomes. It also concluded that nursing staff education and rationale to support reason for change are critical to understanding and peer influence to change. This article is significant to this project theoretically because it supports the Kurt Lewin’s theory of change. The goal is to improve patient outcomes related to CLABSIs, staff members are the restraining forces, and education and awareness of possible infections are the driving force to change.

The following study by Palkar & Patel is relevant because it provides literature to support that CLABSIs are preventable. CLABSI rates are estimated at an annual incidence of 200,000-400,000 and are related to increased medical expenses, longer length of hospital stays, mortality and morbidity (Palkar & Patel, 2016). This study was conducted at hospital which implemented disinfectant caps for central lines. After education of the nursing staff on guidelines for disinfectant cap use, the policy was implemented. The study revealed a 52 % decrease rate in CLABSIs, which they concluded was not only due to the disinfectant cap implementation. The hospital implemented education for staff insertion of central lines and nursing education for central dressing changes.

Cancer patients are at high risk for infections related to decrease immune responses and central line access devices (Page et at., 2016, p. 78). Staff education increases positive patient outcomes related to central line access use as supported by the following study conducted at the University of Vermont Medical center. It is relevant to this project because the study used education to help reduce central line infections in patients on an oncology unit. Nurses on the oncology unit were given a 31-question multiple choice questionnaire which was designed to identify knowledge deficits related to central line care. After identifying knowledge deficits an educational curriculum was developed and all nursing staff met with the educator individually and a post test was completed by each staff nurse. The post test results were 100% which supports staff education as a tool to help decrease CLABSI rates.

Literature Related to CAUTIs

Current evidence-based measures include measures to place indwelling catheters only when necessary and to remove as soon as possible. Urinary catheters account for about 40% of all healthcare associated infections annually and most of those infections are caused by prolonged duration of urinary catheters (Holt et al., 2017, p. 78). This article is relevant because it discusses importance of assessing patient for bacteriuria and identifying organisms for effective antimicrobial treatment. Proper treatment reduces the risks of drug resistant organisms which is prevalent in patients with indwelling urinary catheters. This article provides relevant nursing management measures of patients with indwelling urinary catheters. Measures include the following: avoid unnecessary insertion of urinary catheters, remove as soon as medically possible, and assess for alternatives to catheter placement.

This study is significant because it was conducted to determine if CAUTI bundles reduce the rates of CAUTIs in patients with indwelling catheters since these type infections cause about 70% of urinary tract infections in hospitalized patients (Dehghanrad et al., 2019). The study did show a reduction in the number of CAUTIs after bundles were implemented. The study determined that the reduction rates were not a significant amount and that the study would need implementation with a larger sample group and time period.

This article by McNeil is relevant to this project because it provides basic evidence-based education guidelines to prevent CAUTIs. It discusses risks related to the presence of indwelling catheters and four essential components to prevent CAUTIs. These measures are only place when medically necessary, use strict aseptic technique during insertion, use evidence-base guidelines for catheter management, and remove as early as possible (McNeil, 2017).

Conclusion of Literature

Current literature supports clinical evidence that CLABSIs and CAUTIs are preventative. Evidence-based practice proposed placement of central lines and indwelling urinary catheters should be avoided if other alternative measures are available. Front-line medical staff should be educated on guidelines for strict hand hygiene, aseptic technique for central line and indwelling catheter insertion, management of lines and catheters. All central lines and catheters should be removed as soon as possible. Following these evidence-based guidelines and measures has shown a significant decrease in the number of CAUTIs and CLABSIs among hospitalized patients across the United States (McNeil, 2017).

Methodology

According to Palkar & Patel CLABSI rates are estimated to be 200,000- 300,00 annually (2016). The purpose of this project is to provide education to improve nursing care related to central lines and indwelling catheters and decrease risks of hospital acquired CLABSIs and CAUTIs. This project employs a video presentation which delivers educational information on HAIs, the two most common causes of HAIs, care and maintenance of central lines and indwelling urinary catheters, and problems related to CLABSIs and CAUTIs. Evidence-base studies has proved that checklists are useful to improve delivery of healthcare therefore, a CAUTI and CLABSI checklist was developed and utilized as a tool help prevent infections related to HAIs caused by urinary catheters and central lines. Central line and indwelling catheter infections in hospitalized patients are the leading cause of sepsis. CAUTIs lead to 13,000 deaths annually in the United States and about 70% of CAUTIs are preventable using evidence-based prevention measures (McNeil, 2017).

Participants will watch the video presentation and practice documentation on the CAUTI and CLABSI checklist provided in the presentation. Participants will complete a test prior to beginning the two-week project. The test and practice documentation will serve as a method to evaluate knowledge and understanding of care and maintenance of these two devices and use of the CAUTI and CLABSI checklist. Copies of the CAUTI and CLABSI checklists will be provided to participants and they will complete a checklist on each patient with a central line or indwelling urinary catheter. Participants will complete a survey at the end of the two weeks which will provide feedback related to delivery of care and maintenance of central lines and urinary catheters. The information from this project will be used to determine if education of frontline nursing staff is an effective method to increase staff awareness and compliance of prevention measures, therefore, improve care and maintenance of central lines and indwelling urinary catheters and decrease CLABSI and CAUTI rates.

The participants for this project are composed of nurses and medical assistants (MAs) caring for hospitalized patients on a medical surgical unit. The participants were chosen because they are involved in direct patient care of patients who may require central venous lines and indwelling urinary catheters. Participants will be invited to take part on a voluntary basis, patients will be informed, and verbal permission granted prior to including patients in the study. To maintain confidentiality and compliance with HIPPA regulations, no names or patient identification information will be documented on the checklists.

Discussion

CAUTI and CLABSI prevention is important to decrease healthcare costs, mortalities, and length of hospital stays. These HAIs are easily preventable by thorough nursing care and maintenance of devices. This project utilized education as a tool to increase awareness among RNs and MAs in the hospital setting. The project consisted of a power point video presentation on nursing care measures to prevent infections in patients with central lines and indwelling urinary catheters. Some participants were able to come to the original video presentation and explanation of the proposed project. Those who were not able to attend were emailed the video with specific instructions for the project. As expected, participants expressed that the educational information presented in the video presentation was a helpful reminder on how important care and maintenance of devices is to prevent HAIs. Current literature supports education of staff on knowledge deficits and development of standardized care for maintenance of central lines and urinary catheters (Page, Tremblay, Nicholas, & James, 2016).

One RN who contributed to the project stated that the care instructions provided in the video presentation were an important aspect that can be easily missed during a busy shift. Simple tasks such as examining central line dressings and intravenous line tubing are often overlooked however, the CLABSI and CAUTI checklists reminded staff of tasks related to care during their shift. Current literature supports that CLABSIs can be prevented with use of consistent evidence-based standards of care that focus on central line-associated bloodstream infection prevention measures (Conley, 2016).

The participants completed a survey at the end of the two-week project. All RN and MA participants rated the project a 5 on a scale of 1 to 5, indicating the effectiveness of the project, therefore impacting compliance with nursing care and maintenance of central lines and catheters. Survey information provided from the MA participants discussed that they educated their patients on importance of baths and catheter care therefore, patients were more compliant with CHG baths and linen changes.

Conclusion

HAIs are associated with the use of central lines and indwelling urinary catheters and are a major complication of hospitalized patients across the United States. CLABSIs and CAUTIs are a main safety concern and are related to increased healthcare costs, poor hospital outcomes, increased length of hospital stays, and increased mortality rates. The evidence of this study concludes that education of lead nursing staff is key to compliance with care and maintenance of central lines and urinary catheters. This project increased nursing staff awareness of infection prevention measures and compliance with care and maintenance of devices. Some patients are discharged home with these devices. In the future, nursing educational projects for patients who require central lines or indwelling urinary catheters at home may benefit from this type of educational program. These educational guidelines and maintenance precautions may prevent CLABSI and CAUTI complications as well as, increase better patient outcomes. CAUTI and CLABSI checklists could be laminated and placed on bulletin boards in staff breakrooms or patient rooms who have central lines and urinary catheters to set a reminder of care. CAUTIs and CLABSIs are one of the most common reasons of deaths in the hospitalized patient, therefore it is necessary that we do our part in decreasing incidence and improving patient care.

References

Atilla, A., Doganay, Z., Celik, H. K., Demirag, M. D., & Kilic, S. S. (2017). Central line associated bloodstream infections: Characteristics and risk factors for mortality over a              5.5-year period. Turkish Journal of Medical Sciences, 47: 646-652. Retrieved from http://journals.tubitak.gov.tr/medical/

Conley, S. B. & Brown, C. G. (2016). Central line-associated bloodstream infection prevention:      Standardizing practice focused on evidence-based guidelines. Clinical Journal of Oncology Nursing, 20(1), 23-26.

Dehghanrad, F., Nobakht-e-Ghalti, Z., Zand, F., Gholamzadeh, S., Mohammad, G., & Rosenthal,       V. (2019). Effect of instruction and implementation of preventative urinary tract infection bundle on incidence of catheter associated urinary tract infection in intensive     care unit patients. Electronic Journal of General Medicine, 16(2), 1-9. Retrieved from   https://doi.org/10.29333/ejgm/94099

Gupta, R., Sharma, S., & Saxena, P. S. (2018). Changing panorama for surveillance of device- associated healthcare infections: Challenges faced in implementation of current guidelines. Indian Journal of Medical Microbiology, 36(1), 19-25. Retrieved from http://www.ijmm.org

Holt, S., Grant, M., & Thompson-Brazill, K. A. (2017). Reducing carbapenem exposure: Extended-spectrum b-lactamase catheter-associated urinary tract infection management.  Critical-Care Nurse, 37(5), 78-84. Retrieved from https://doi.org/10.4037/ccn2017648

Johnson, S. (2018). A case study of organizational risk on hospital-acquired infections. Nursing     Economics, 36(3), 128-135. Retrieved from http://search.ebscohost.com/login

McEwen, M., & Wills, M. W. (2019). Theoretical basis for nursing (5th ed.) Philadelphia, PA: Wolters Kluwer.

McNeill, Lauren. (2017). Back to basics: How evidence nursing practice can prevent catheter- associated urinary tract infections. Urologic Nursing 2017. 37(4) 204-206.     doi:10.7257/1053-816X.2017.37.4.204

Page, J., Tremblay, M., Nicholas, C., & James, T. (2016), Reducing oncology unit central line associated bloodstream infections: Initial results of simulation-based educational intervention. Journal of Oncology Practice, 12(1), 83-87.

Palkar, V. & Patel, V. (2016). The impact of disinfectant cap implementation on central line- associated bloodstream infections. Infectious diseases. 48(8), 646-648.            http://dx.doi.org/10.3109/23744235.2016.1174339

What are the effects of hostile environments on refugee and migrant children and young people accessing healthcare?  

Abstract: The hostile environment can be defined as a collection of immigration controls existing within public service providers across the UK. Financial and criminal punishment has been put in place to ensure employers, landlords, private sector workers, NHS staff and other public sector servants are regularly checking people immigration status as they access services (Liberty, 2018).  Such harassing conduct is predominantly based on a person’s protected status, which includes age, gender reassignment, marital status, pregnancy, disability, race (including nationality, ethnicity or national origin), religious beliefs, gender or sexual orientation (UK Government, 2010). Due to the nature of these policies, those directly targets and innocent incorrectly involved can face barriers accessing housing, healthcare, education, work, setting up a bank accounts or getting a driver’s licence (Liberty, 2018).

The focus of research was on children and young people as their ability to access health services plays an important role in their early health and formative norms in future life (Lungu et al, 2016). The United Nations Sustainable Development Goals prioritises increased access, educating communities on good health, improving life expectancy and tackling common killers associated with child maternal mortality as key to improving child and young people health across the world, including the UK (UN, 2015).  The focus on refugee and migrant children and young person is due to their background and how it may impact their ability to access healthcare. Children of national parents are more likely to access healthcare, including emergency departments, compared to migrant children from low income families (Ku & Jewers, 2013).

Such influences from a hostile environment on adults, parents, can lead to negative parental behaviours that impacts the child physical and psychological well-being including rejection, low affection, conflict and strict control (Matthews et al, 1996). Alongside this, children themselves can become exposed to the components of this environment, reacting with aggression, hostility (Andreas and Watson, 2009) and conflict (Cumming et al, 2004).

Biography:

Pursuing a career in paediatric nursing following ten years management experience working on social development across the public, private and voluntary sectors both in the UK and abroad. Founder of Homeless Rugby CIC.

Perception of the Effects of Critical Nurses’ Long Working Hours on Vigilance and Patients` Safety in Ramallah district  

Introduction: Working for long hours favors increasing of daytime sleepiness and decreasing the state of nurse’s vigilance, offering a greater risk of injuries and work accidents that affect the quality of nurse’s performance and patient’s safety (Seitz, 2016). Nurses who work in this setting may experience decreased ability to provide optimum care to patients. Thus, for enhancing and improving nurses’ performance and patients` safety, there is a need to better understand fatigue and sleepiness and their association with each other as well as performance and patient’s safety (Weinstein, 2016).
Objective: The study assesses the effects of long working hours of nurses in critical care units on vigilance and patients` safety in Ramallah city. The study was conducted at two major hospitals Palestine Medical Complex and Al-Istishari Arab Hospital at the first quarter of 2018. Method: A cross -sectional design was used. A structured questionnaire was used to collect data. A total of 233 critical care nurses were included in the study, the response rate was 78.5%. The study assessed four domains: level of vigilance during the long working hours, Patient safety level during the long working hours, Patient Safety/Frequency of Events Reported and Duties affected by vigilance and patients’ safety.
Results: Study findings shows that the nurses reported a relatively high prevalence degree of long working hours (42.61%). Also, the study finds a real significant difference between working more ≥12daily , ≥40 h /weekly and vigilance and, no relationship between long working hours and patient safety were recorded ( p=.737). On the other hand, age, gender, current position and place of work show no significance in relation with vigilance and patient safety. Finally, a significant difference between level of nurses vigilance were  found between the two hospitals, and nurses at Palestine Medical Complex were eventually more alert.

Conclusions: The study suggested that nurses to get as much sleep as possible before starting long working hours improves their performance, prevents fatigue and
keeps them alert and vigilant. Limiting consecutive long working days to a maximum of 4 days and making sure there is adequate rest time between successive shifts.
References: AbuAmshah, M., (2014).Effects of Shift Work Paradigms on Job performance of Nurses in The Palestinian Health Sector.An-Najah National University, Palestine
https://scholar.najah.edu/sites/default/files/Majd%20Abu%20Amshah_0.pdf
AbuRuz EM., Abu Hayeah MH, (January. 2017).Insomnia Induced by Night Shift Work is Associated with Anxiety, Depression, and Fatigue, among Critical Care Nurses. HIKARI Ltd. DOI: http://www.m-hikari.com/asb/asb2017/asb1-4-2017/p/aburuzASB1-4-2017-2.pdf
Akerstedt, T., (1988). Sleepiness as a consequence of shift work. Journal of Sleep research and sleep medicine. 11,(1) 17-34. http://dx.doi.org/10.1093/sleep/11.1.17.
Åkerstedt T, Axelsson J, Kecklund G, Lindqvist A, & Attefors R. (2003). Hormonal changes in satisfied and dissatisfied shift workers across a shift cycle. Journal of
Applied Physiology, 95, 2099-2105. DOI: https://books.google.ps/books?isbn=184855544X Al-Ameri MHI (2017) Night Shift and its Impact upon
the Quality of Life of Nurses Working at the Teaching Hospitals of the Medical City Complex in Baghdad City, Iraq. J Nurse Care 6: 414. doi:10.4172/2167-1168.1000414
Alhola, P., & Polo-Kantola, P. (2007). Sleep deprivation: Impact on cognitive performance. Neuropsychiatric Disease and
Treatment, 3(5), 553–567. AL-Ishaq M. (2008Nursing Perception of Patient Safety at Hamad Medical Corporation in the State of Qatar. Https://scholarworks.iupui.edu/bitstream/…/All%20Moza%27s%20Dissertation.pdf
Allen,A., Park,J., Adhami,N., Adhami,S., Tholin,H., Dodek,P., Rogers,A., & Ayas,N.(2014). Impact of work
schedules on sleep duration of critical care nurses. Am J Crit Care. 2014 Jul;23(4):290-5. doi:10.4037/ajcc2014876.

Biography: Amal Ibrahim has completed her Master degree in Health Management and Policies from Al-Quds University in Palestine in 2018. She is currently working as Medical Referral Coordinator in Al Najah National University Hospital. She has previously worked at the World Bank assisting administrative & management support to all external experts. Prior she was Administrative Assistant in Saudi Arabia. She was awarded Employee of the year in 2012.While
unpublished at the time of this submission; she is looking forward to contributing input from her experience to the healthcare Management.

Difficulties in facing alone the demands of treatment experiences of the hemophiliac adolescent.  

Introduction: A qualitative study conducted with seven hemophiliac adolescents, who did not follow the recommended treatment by multidisciplinary team. Hemophilia is an inherited and life long disorder transmitted genetically by chromosome X. The data were collected through semi structured interviews and were grouped according to the meaning of their speeches. The initial question was “Tell me why you don’t follow the recommended treatment to hemophilia?” And them, another questions were formulated depending on the concepts expressed by interviewed adolescents. The objective was to understand the reasons why the adolescent does not adhere to hemophilia treatment. As results, we could observe that this population cannot overcome the demands and difficulties of the recommended treatment by themselves, they are not able to face the responsibilities inherent to the needs imposed by their health condition. Besides, they expressed their own judgement on what is appropriate to their treatment and does not considered preventive aspects essential to their lives. Other feeling expressed were the disbelief on the effectiveness of recommended actions as well as dissatisfaction with care received in the Hemophilia Service. At the time of this study, prophylaxis was not a reality in our country and patients need to be examined by a physician after every visit to the service. Although we had trained physicians on duty 24/7, depending on the period there were possible delay on the attention to them what cause in satisfaction. The
results reinforced the importance of family support to guarantee continuously treatment for adolescent in transition to adult life. Additional subsidies to rethink care provided to them in specialized services is mandatory to facilitate the delivery of assistance to this population. Nowadays, due to conjucted efforts of hemophilia society, care treaters and Ministry of Health, this community is able to perform prophylaxis what minimize this burden.
Biography: Ana Claudia Acerbi Rodrigues is Registered Nurse of Hemophilia Service from Universidade Federal de São Paulo since 2002. She has Master Degree and is a PhD student in Pediatric Nurse from Universidade Federal de São Paulo. She participated as a member of Nurse’s Committee of World Federation of Hemophilia (2012 – 2018) and Brazilian Federation of Hemophilia (2007 – 2011).

SELF-LEADERSHIP INA CRITICAL CARE OUTREACH SERVICE TO OBTAIN QUALITY PATIENT CARE.  

Introduction: Hospital patients located in general wards tend to have more complex problems and a higher number of co-morbidities than in the past, increasing the probability that patients general ward will show signs of deterioration. Delayed or missed recognition of deteriorating patients contributes to serious adverse events in general wards, with abnormal vital signs observable up to 48 hours before an adverse event [1]. These challenges resulted in the development of Critical Care Outreach Service (CCOS). Nurses should take the lead in recognizing the deterioration in patient and utilize behavior and cognitive strategies in managing deteriorating patients. The ability to respond and initiate health interventions confirms the role of self-leadership in CCOS.
Purpose: Nurses experiences on their self-leadership in CCOS were explored to obtain insight into their self-leadership in CCOS.
Research design: A qualitative phenomenology research approach were followed. Focus groups were held with nurses working in a private hospital providing the CCOS in South Africa. It became clear that self-leadership intended to develop personal efficiency through three categories of individual-level approaches; namely (i) behavioral focused actions, (ii) natural reward (motivational) actions and (iii) constructive thought (cognitive) patterns[2]. The findings showed that these approaches came to the fore in the data analyzed in this study.

References::
[1] Preece, M.H.W., A. Hill, M.S. Horswill, and M.O. Watson. 2012. “Supporting the detection of patient deterioration: Observation chart design affects the recognition of abnormal vital signs.” Resuscitation 83: 1111-1118. [2] Van Wart, M. 2015.
Dynamics of Leadership in Public Service Theory and Practice 2nd edition. New York: M. E. Sharoe Inc.
Biography: Carine Prinsloo received her B Cur Ed et. Admin with critical care and Masters degree (cum laude) at the University of Johannesburg South Africa. She completed her PhD in nursing management at the University of the Western Cape 2018. She was working in a private hospital from 1993 in Pretoria as a Critical Care Outreach nurse expert until January 2018. She joined the University of South Africa as a lecturer in nursing management in February 2018.

PALLIATIVE PATIENT AT PRIMARY LEVEL – LEARNING WITH SIMULATIONS IN HEALTHCARE. 

Introduction: Simulations in healthcare are a great way for all healthcare workers to train their skills in a safe environment. Participants get experience in managing difficult interventions with simulations that do not happen regularly in clinical environment. Because of this we have prepared a training program in CHC Ljubljana, Simulation Centre.
The program is called Palliative patient at primary level – learning with simulations in healthcare. We think that it is very important for the healthcare teams in primary healthcare level to regularly train in field of palliative care. With training they raise their skill level and reduce stress so they have more confidence in their field of expertise. This also prevents unwanted mistakes in clinical environment and thus raises safety level of our patients.
Palliative patient at primary level – learning with simulations in healthcare is an interactive workshop with a lot of practice work which is done for maximum of 12 trainees. Training is being managed by three instructors who use a method of Learning with simulations in healthcare ( theory, skills, simulations, debriefing ). This way of education has a lot of benefits especially regarding equipment: simulator of a palliative patient that responds as a real person, simulator of a cannula with blood reflux … We rate this program as a very successful because our trainees have rated it with maximum score in 98% and their knowledge results were excellent ( intake knowledge was 40%, outtake knowledge was 85%).

References: [1] Ballangrud, R. Hall‐Lord, M. L. Hedelin, B. in Persenius, M. (2014). Intensive care unit nurses’ evaluation of simulation used for team training. Nursing in critical
care, 19(4), 175-184. [2] Dowson, A., Russ, S., Sevdalis, N., Cooper, M. & De Munter, C., 2013. How in situ simulation affects paediatrics nurses clinical confidence. British journal of nursing, 22(11), pp. 610, 612- 617. [3]

Kalisch, B. J. Aebersold, M. McLaughlin, M. Tschannen, D. in Lane, S. (2015). An intervention to improve nursing teamwork using virtual simulation. Western journal of nursing research, 37(2), 164-179. [4] Kren, A., Benkovič, R., Zafošnik, U. (2017). Treatment of emergency medical conditions – Simulation-based learning in healthcare. Fakulteta za zdravstvene cede Novo mesto. [5] Pena, G. Altree, M. Babidge, W. Field, J. Hewett, P. Meddern, G. (2014). Mobile Simulation Unit: taking simulation to the surgical trainee. General surgery, 85, 339-243. [6] Roh, Y. S. in Lim, E. J. (2014). Pre-course simulation as a predictor of satisfaction with an emergency nursing clinical course. International
journal of nursing education scholarship, 11(1), 83-90. [7] Stockwell, D. C. in Slonim, A. D. (2006). Quality and safety in the intensive care unit. Journal of Intensive Care Medicine, 21(4), 199-210. [8] Zafošnik, U. Benkovič, R. Marković, D. (2018) Simulacije – sodobna metoda učenja za dvig kakovosti v zdravstvu. 27. letna konferenca Slovenskega združenja za kakovost in odličnost, november 2018, Portorož.
Biography: Lecturer Uroš Zafošnik, Registered Nurse, MSc of social works, was working as head nurse of emergency services in CHC Maribor for four years before starting work in emergency services of CHC Ljubljana, where he worked for three years. Curently he is Head and Coordinator of SIM Centre now for five years. He is also international ITLS and MTS instructor and besides that he was involved in a working group designing standards for triage at Ministry of Health Slovenia. He is also a lecturer at Faculty of health sciences Novo Mesto.

SELF-LEADERSHIP INA CRITICAL CARE OUTREACH SERVICE TO OBTAIN QUALITY PATIENT CARE.  

Introduction: Hospital patients located in general wards tend to have more complex problems and a higher number of co-morbidities than in the past, increasing the probability that patients general ward will show signs of deterioration. Delayed or missed recognition of deteriorating patients contributes to serious adverse events in general wards, with abnormal vital signs observable up to 48 hours before an adverse event [1]. These challenges resulted in the development of Critical Care Outreach Service (CCOS). Nurses should take the lead in recognizing the deterioration in patient and utilize behavior and cognitive strategies in managing deteriorating patients. The ability to respond and initiate health interventions confirms the role of self-leadership in CCOS.
Purpose: Nurses experiences on their self-leadership in CCOS were explored to obtain insight into their self-leadership in CCOS.
Research design: A qualitative phenomenology research approach were followed. Focus groups were held with nurses working in a private hospital providing the CCOS in South Africa. It became clear that self-leadership intended to develop personal efficiency through three categories of individual-level approaches; namely (i) behavioral focused actions, (ii) natural reward (motivational) actions and (iii) constructive thought (cognitive) patterns[2]. The findings showed that these approaches came to the fore in the data analyzed in this study.

References::
[1] Preece, M.H.W., A. Hill, M.S. Horswill, and M.O. Watson. 2012. “Supporting the detection of patient deterioration: Observation chart design affects the recognition of abnormal vital signs.” Resuscitation 83: 1111-1118. [2] Van Wart, M. 2015.
Dynamics of Leadership in Public Service Theory and Practice 2nd edition. New York: M. E. Sharoe Inc.
Biography: Carine Prinsloo received her B Cur Ed et. Admin with critical care and Masters degree (cum laude) at the University of Johannesburg South Africa. She completed her PhD in nursing management at the University of the Western Cape 2018. She was working in a private hospital from 1993 in Pretoria as a Critical Care Outreach nurse expert until January 2018. She joined the University of South Africa as a lecturer in nursing management in February 2018.

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