Day 2 :
Keynote Forum
Dr K. Gupta,
Worcestershire Oncology Centre, England
Keynote: Breast Oncology: A Perspective
Biography:
In 1999, Dr Gupta qualified in medicine and surgery and was awarded the MBBS Gold Medal. After a meritorious selection, he completed the MD programme in Oncology. He went on to obtain the Diplomate of National Boards in Clinical Oncology and was admitted as a Member of National Academy of Medical Sciences. He then obtained MRCP and proceeded to complete higher specialist training in Clinical Oncology at the Christie Hospital in Manchester and obtained FRCR. Dr Gupta was awarded the Royal College of Radiologists' Award and he completed the Proton Therapy Fellowship at the MD Anderson Cancer Centre in Texas.
Dr Gupta works at the Worcestershire Oncology Centre and has a special interest in Urological (Prostate, bladder, kidney, ureter). Lower GI (Rectum, Colon, Anus) and Breast cancers. He also maintains a research portfolio via involvement in multiple clinical trials in Principal & Co-Investigator roles, and he has been the Worcestershire Oncology Clinical Audit Lead, as well. Dr Gupta is ASCO’s UK representative for the ASCO Learning Cohort and Educational Committee and has spoken at various National and International Conferences and Meetings.
Abstract:
The incidence and prevalence of cancer is ever increasing. Broadly, oncology can be divided into diagnostic and therapeutic oncology. Furthermore, there are numerous subcategories under these two broad subdivisions. The modern oncology scene now includes a wide range of treatment modalities for cancer patients, including surgery, chemotherapy, radiotherapy, immunotherapy and others. These have matured as highly complex subspecialties, requiring high level of medical and nursing expertise. Once of the pivotal roles in the oncology arena is played by the by a specialist nurse in a high input oncology subspecialty such as Breast Oncology, and this will be discussed in detail during the talk.
The role of the Oncology nurses can be complex and varied, involving interventions and communication with multiple health care professionals across primary and secondary care and other private and charitable organisations. Their contribution improves the quality and experience of care for patients, reinforces patient safety, demonstrates leadership and can increase productivity and efficiency. Oncology nurses treat and manage the health concerns of patients and work to promote health and wellbeing in the patients they care for. They integrate knowledge of cancer and medical treatments into assessment, diagnosis, and treatment of patients' problems and concerns. These will be elaborated during the presentation and more discussion with audience interactive participation would be most welcome
Keynote Forum
Al-Yami,
Clinical director for nursing quality, Saudi Arabia
Keynote: Using the Theory of Planned Behaviour to Explore the Multicultural Nursing Workforces' Behavioural Intentions to Comply with Nursing Policies and Procedures in Saudi Hospital.
Biography:
Abstract:
The nursing shortage in the Kingdom of Saudi Arabia (KSA) causes administrative difficulties and increases worries about the quality of healthcare, as well as contributing to a highly multicultural nursing workforce. The further complexities occur when work environments have a multicultural nursing workforce where nurses of different cultures interact with each other, which can lead to influencing on their compliance with nursing policies and procedures in Saudi healthcare organizations. However, it has been shown that positive attitudes, behavioural norms and the beliefs are all significantly associated with nurses' compliance with nursing policies and procedures. Evidence indicates that although nurses are increasingly compliant with nursing policies and procedures to ensure a higher quality of nursing care, there is still a wide variance in their compliance. The utility of the Theory of Planned Behaviour (TPB) has not been previously used in explaining this variance in the multicultural nursing workforce.
- Emergency Nursing | Critical Care Emergency Nursing | Cancer Nursing | Trauma Emergency Nursing | Cancer Therapy & Treatment | Breast Cancer Nursing | Cancer Biomarker | Mid-wife Emergency Nursing | Types of Emergency Nursing
Chair
Pauline Rose
Princess Alexandra Hospital, Australia
Co-Chair
Fahad Zeed Alanezi,
University of Southampton, United Kingdom
Session Introduction
Pauline Rose
Princess Alexandra Hospital, Australia
Title: Concurrent radiation therapy and chemotherapy for anal cancer: Retrospective chart audit of autonomous nursing practice in radiation oncology
Biography:
Pauline Rose has worked in Radiation Oncology for the past 32 years, and is the Clinical Nurse Consultant for Radiation Oncology at the Princess Alexandra Hospital in Brisbane, Australia, which was the first Magnet Hospital in the southern hemisphere. She completed her PhD in 2010 and is a Credentialed Cancer Nurse (Australia). She was a Content Author for the Cancer Institute New South Wales for radiation therapy education modules for nurses and is a regular reviewer for the European Journal of Oncology Nursing. She has published in a range of peer-reviewed journals focusing on person-centred and individualized nursing care in the radiation oncology department, and was instrumental in 1995 in introducing a primary nursing/collaborative practice model into the radiation oncology department, which continues to provide person-centred care to patients every day.
Abstract:
Autonomous nursing practice is the hallmark of radiation oncology nursing in the study setting in Brisbane Australia. This setting utilises a primary nursing/collaborative model to support the large numbers of patients treated daily. Anal cancer represents approximately 2% of all gastrointestinal cancers, and sphincter-preserving treatment, combining radiation therapy and chemotherapy, has become standard treatment. However, acute toxicities are as high as 80%. Radiation oncology nurses assess their patients regularly, and refer to medical and allied health professionals as necessary. The aim of this retrospective chart audit is to determine the extent of patients’ toxicities and the nursing interventions to support their quality of life and reduce admission to hospital. This study audited patients treated for anal cancer over a 2 year period at a Radiation Oncology Department in Brisbane Australia. Data was analysed using a visual toxicity display spreadsheet, and SPSS Version 23. Eligible patients were identified from the radiation oncology information system. The audit examined documented toxicities by nurses across the course of treatment, interventions, referrals to allied health professionals and admission rates. Sixteen patients were identified: 11 females and 6 males. Toxicities consistent across all patients were pain, diarrhoea, moist desquamation of groins and perianal area, nausea, mucositis, fatigue and dysuria. Admission rates were 64.7%: 5 females and 2 males. 47% of patients scored >5 on the distress thermometer at baseline, with 2 females expressing embarrassment at the site of cancer, and 3 patients having underlying psychological disease. Six patients had pain at baseline in the 4-10 range (median 5.00); 3 not entered. Missing chart information included irregular documentation of weight. Referrals were made by radiation oncology nurses to social workers, occupational therapists, and dietitians. The common toxicities resulting from concurrent anal chemoradiation affected all patients audited, with differences only in severity and timing. Proactively improving bowel regimens, hydration, analgesia and weight monitoring as part of a formal clinical pathway may result in less toxicity during and following the course of treatment.
Lucus Christoffersen
Idaho State University, USA
Title: Rural Emergency, Trauma, and Critical Care Management: Preparing facilities to care for critically-ill patients
Biography:
Lucus Christoffersen is an Assistant Professor at Idaho State University, teaching Adult Health Nursing to undergraduate nurses, with the clinical components. He has been active in teaching certification courses and working as the President for Utah Emergency Nurses Association
Abstract:
Rural emergency departments have a unique role in the care of critically ill patients. Nurses serve as the primary caregivers in these intense and time-sensitive situations. With the increase of hospital accessibility for rural populations, do the facilities have the capabilities to care for critically ill patients? Do nurses and care providers have the necessary education and training to care for patients that require high levels of care and extra resources? This lecture will discuss some of the vital tasks that nurses and health care providers should perform to make sure that they are prepared to receive and care for critically ill patients at their facilities. Some of the topics include facility preparation, training and education, how to deal with small team dynamics, and collaboration with larger facilities. This lecture helps give managers and leaders at rural facilities helpful information that they can use to better plan and prepare their staff and facilities for critically-ill patients
Silwal Pratibha
Tribhuvan University Teaching Hospital, Nepal
Title: Organophosphorus poisoning at Tribhuvan University Teaching Hospital, Emergency Department
Biography:
Abstract:
Organophosphorus is most common poisoning in Nepal. Many cases among poisoning the majority are organophosphorus poisoning. As known farming is main occupation here. Most of the people are dependent on farming. Organophosphorus (OP) is choice of pesticide for them and is easily available. But in another way many people use them for threatening purpose, especially among young girls and boys. Most of the case presented in our emergency, are from low economic background. Very simple discussion among husband & wife result in poisoning incident. OP pesticide intoxications are estimated at three million per year worldwide with approximately 3, 00,000 deaths. Most of the OP pesticide poisoning and subsequent deaths occur in developing countries following the deliberate self-ingestion. The case fatality rate following the deliberate ingestion of OP pesticides in developing countries in Asia is 5-20%, we have taken data of six months from Sep 2017 to Feb 2018. During this period, we had found 123 organo phosphorus poisoning cases. This data is collected from TUTH, emergency department. Among them only few cases have ingested in large amount. But majority of cases have ingested few amount. Among total cases, 65 patients were discharged on their request some of them are not worried despite of telling the consequences of poisoning, whereas others were not serious about their family members. In TUTH emergency most of the poisoning cases were managed. But according to the seriousness of the case some were referred to other center for high dependency unit due to unavailability of enough critical care units.
Eivind Richter Andersen
Stavanger University Hospital, Norway
Title: Women’s experience of acute skin toxicity following radiation therapy in breast cancer
Biography:
Eivind Richter Andersen works as a Radiation Therapist at Stavanger University Hospital in Norway. He is especially devoted in patient follow-up and radiation induced side effects, focusing on patient perspective.
Abstract:
Purpose: Acute skin toxicity is experienced by 70%–100% of patients receiving radiation therapy following breast cancer. Most studies focus on skin appearances and treatment of such reactions, not the experience. Increased knowledge about patients’ experience will contribute to provide tailored patient care. Thus, the purpose was to investigate patients’ experiences of acute skin toxicity following radiation therapy for breast cancer.Patients & Methods: Semi-structured in-depth interviews were conducted with seven women, 2–3 weeks post-treatment. Five broad areas of inquiry were investigated: 1) experiences from the development of skin reactions; 2) experiences in day-to-day life; 3) coping strategies; 4) experiences of information; and 5) experiences from the aftercare. The interviews were analyzed in line with qualitative content analysis.Results: The main theme: “Not so bad itself, but it comes on top of everything else” was identified, based upon three categories: 1) unique experience of the skin; 2) it is something about the psychological aspect; and 3) experience of information.Conclusion: Acute skin toxicity following breast cancer treatment may affect many dimensions of patients’ lives. Experiences are complex, individual, and not necessarily consistent with visible changes of the skin. A holistic approach is necessary to provide treatment and support according to patients’ individual needs.
Heidi Martin
University Medical Center of New Orleans, USA
Title: Sexual assault in the emergency department: Are we missing something?
Biography:
Heidi Martin is a Forensic Nurse with a strong foundation in ED psychiatric nursing. She has built her career by working as an ED Nurse in a Level 1 trauma centre and expanded to forensics to address the needs of this population. She also likes kitties and coffee.
Abstract:
Lack of education leads to a missed opportunity. Education is a necessary component for all members of a multidisciplinary team who provide victim-centred care in an Emergency Department (ED). Awareness of signs and symptoms of psychological trauma is key in preventing sexual assault victims from slipping through the cracks. Often, external injuries are focused on and in cases of sexual assault the crime may be missed in its entirety; this oversight has the potential to not only create a risk for sexually transmitted diseases but may also return the patient to a dangerous environment in the event of trafficking cases. Healthcare providers have an obligation to appropriately identify and respond to victims of sexual assault, without the appropriate education, public health and public safety concerns are created. The evolution of societal awareness and concern, moving to action and intervention begins with bedside nursing in the clinical setting. This initial step is a nursing intervention that when judiciously applied, identifies these unique cases. Psychiatric knowledge combined with a victim-centred response creates successful interventions in addressing neuro-trauma. For patients that are post-sexual assault, a visit to the ED may see them present anywhere on a spectrum from an acute psychotic episode to mild anxiety or even complete denial. The nature of sexual assault tends to create complex psychological trauma that is expressed differently from patient to patient. My experience as a psychiatric and ED nurse at a Level 1 trauma centre has equipped me to better identify victims of sexual assault and therapeutically engage patients with neurotrauma during forensic medical examinations. All ED nurses should be provided with the basic tools and training to identify victims.
Shuei-Chen Chin,
Mennonite Christian Hospital, Taiwan
Title: Applying lean methods and team resource management to reduce medication errors in nurses of emergency
Biography:
Shuei-Chen Chin is a Head Nurse in Emergency department. She holds a Master's degree from Tzu Chi University in Taiwan. She has worked in intensive care units for 15 years and in emergency department for six years.
Abstract:
Lack of education leads to a missed opportunity. Education is a necessary component for all members of a multidisciplinary team who provide victim-centred care in an Emergency Department (ED). Awareness of signs and symptoms of psychological trauma is key in preventing sexual assault victims from slipping through the cracks. Often, external injuries are focused on and in cases of sexual assault the crime may be missed in its entirety; this oversight has the potential to not only create a risk for sexually transmitted diseases but may also return the patient to a dangerous environment in the event of trafficking cases. Healthcare providers have an obligation to appropriately identify and respond to victims of sexual assault, without the appropriate education, public health and public safety concerns are created. The evolution of societal awareness and concern, moving to action and intervention begins with bedside nursing in the clinical setting. This initial step is a nursing intervention that when judiciously applied, identifies these unique cases. The purpose of this project is to reduce medication errors in emergency nurse. From January 1, 2015 to December 31, 2016, the medication error of our emergency department was 0.02% (16/83,322). A survey of medication errors using the eight types of waste analysis showed that the number of errors was 164 (32.2%). Causes include: waste of defects, waste of inventory, waste of action, waste of processes and waste of human resources, therefore, create a project. The proposed improvement plan is: Establish a standard procedure for emergency medication, the implementation of drug standard process according to the rules, medication process is smooth; do not disturb bulletin board, references recommended to use "do not disturb in medicine" sign to remind patients or their families to avoid mistakes nursing staff; conduct clinical teachers to teach the standard course of medication consistency, apply human resources, invite emergency room clinical teachers and teaching content and methods of consistency to discuss, for new employees to teach the relevant standard medication process, to avoid their medication errors; establish a mutual care mechanism team, take the initiative to care for the hearty colleagues, to give positive encouragement to discourse, and colleagues in the same class can remind each other and support each other, to create praise more than criticism of the friendly workplace did reduce the medication error from 32.2% to 3.13%, which not only achieved the goal of improvement, but also enhanced the patient's medication safety and also enabled the patients to obtain good care quality.
Shuei-Chen Chin,
Mennonite Christian Hospital, Taiwan
Title: Applying lean methods and team resource management to reduce medication errors in nurses of emergency
Biography:
Shuei-Chen Chin is a Head Nurse in Emergency department. She holds a Master's degree from Tzu Chi University in Taiwan. She has worked in intensive care units for 15 years and in emergency department for six years.
Abstract:
The purpose of this project is to reduce medication errors in emergency nurse. From January 1, 2015 to December 31, 2016, the medication error of our emergency department was 0.02% (16/83,322). A survey of medication errors using the eight types of waste analysis showed that the number of errors was 164 (32.2%). Causes include: waste of defects, waste of inventory, waste of action, waste of processes and waste of human resources, therefore, create a project. The proposed improvement plan is: Establish a standard procedure for emergency medication, the implementation of drug standard process according to the rules, medication process is smooth; do not disturb bulletin board, references recommended to use "do not disturb in medicine" sign to remind patients or their families to avoid mistakes nursing staff; conduct clinical teachers to teach the standard course of medication consistency, apply human resources, invite emergency room clinical teachers and teaching content and methods of consistency to discuss, for new employees to teach the relevant standard medication process, to avoid their medication errors; establish a mutual care mechanism team, take the initiative to care for the hearty colleagues, to give positive encouragement to discourse, and colleagues in the same class can remind each other and support each other, to create praise more than criticism of the friendly workplace did reduce the medication error from 32.2% to 3.13%, which not only achieved the goal of improvement, but also enhanced the patient's medication safety and also enabled the patients to obtain good care quality.
- Emergency Nursing | Refugical Emergency Nursing | Surgical Oncology Nursing | Clinical Trials Emergency Nursing | Cancer Pain Management | Prostate Cancer Nursing
Chair
Lucus Christoffersen
Idaho State University, USA
Co-Chair
Chukwurah Ndidi Juliet Ifeoma
Nnamdi Azikiwe university Teaching hospital, Nigeria
Session Introduction
Ahmet Butun
Queen's University Belfast, UK
Title: A mixed method systematic review of the reasons parents attend emergency department with their children for non-urgent conditions
Biography:
Ahmet Butun completed his Master’s degree from University of Nottingham, and his master’s dissertation focused on why parents choose to use the emergency department for children presenting with minor illness. His dissertation has been published in International Emergency Nursing. He is currently a PhD student at Queen’s University Belfast and his research project seeks to identify parental reasons for visiting ED, rather than their primary healthcare providers, in the context of developing countries.
Abstract:
Background & Aim: Non-urgent visits to emergency department (ED) services are on the increase, and the pressure on EDs is a significant global concern. The use of EDs by parents of children with non-urgent condition is an important and still unresolved problem, which is associated with overcrowding, higher costs, lower quality of care and longer waiting times. The aim of this review is to identify parental reasons for visiting ED for children presenting with non-urgent conditions.Method: Seven databases were systematically searched in August 2016. The study selection process and quality assessment were undertaken independently by two authors. Data were analysed by means of narrative synthesis.Results: 22 studies met with pre-specified inclusion criteria. Ten studies used quantitative methods, ten studies used qualitative methods, and a further two studies used mixed methods. All included studies were conducted in high-income countries and reported in English. Identified themes included perceived urgency by parents, perception regarding better care and staff expertise in the ED, proximity, out of hours availability, difficulties with obtaining a GP appointment, GP referral, lack of facilities in primary healthcare services, financial issues, need for reassurance, convenience and access issues.Conclusion: This review brings both qualitative and quantitative data together. This review may inform researchers, healthcare staff and healthcare policy makers in better understanding parental reasons for using the ED. Identifying parental reasons may help with the development of targeted interventions that seek to reduce non-urgent ED visits, which would save overstretched healthcare resources.
Biography:
Abstract:
Blood pressure of 140/90 mmHg or more or an increase of 30 mmHg in systolic and/or 15 mmHg in diastolic blood pressure over the pre- or early pregnancy level. Predisposing factors:Primigravidae more than multigravidae,Pre-existing hypertension,Previous pre-eclampsia,Family history of pre-eclampsia.,Hyperplacentosis i.e. excessive chorionic tissue as in hydatidiform mole, multiple pregnancy, uncontrolled diabetes mellitus and fetal hemolytic diseases. Directed toward decreasing the maternal BP using inpatient hospitalization or conservative management and antihypertensive medications along with increase in dietary protein and an increase in calories, if indicated. Delivery is appropriate therapy; however, delivery may endanger the fetus due to fetal lung immaturity. Expectant management (wait and watch) can be considered if the following maternal and fetal factors are present: Controlled hypertension, Urinary protein of any amount, Oliguria (< 0.5 mL/kg/hour) that resolves with routine fluid/food intake, AST or ALT greater than 2 times upper limit of normal without epigastric pain or right upper quadrant (RUQ) tenderness. Signs of MgSO4 toxicity include loss of deep tendon reflexes, including knee-jerk reflex, respiratory depression, oliguria, respiratory arrest, and cardiac arrest
Qiuping Li
Jiangnan University, China
Title: Depression, anxiety, dyadic relationships, and mutual impact between Chinese cancer patients and family care givers
Biography:
Qiuping Li, PhD and MD, Professor, Supervisor in the master’s degree. Her research interests comprise nursing education, digestive system diseases and cancer care. The major research contents mainly focus on the development and evaluation of supportive psychological intervention model for cancer patients and their family caregivers. She has accomplished 11 research projects. More than 90 articles were published by the first author or corresponding author, among which 25 were included in SCI journals. She has edited 16 textbooks and 5 monographs, and secured research funding from the National Natural Science Foundation of China (NSFC) as Principal Investigator.
Abstract:
Background: Cancer and its treatment can result in psychological distress in both cancer patients (CPs) and their family caregivers (FCs). This psychological distress acts as a significant adverse factor in both CPs and FCs. The study purposes included: (i) to assess the anxiety and depression of CPs and their FCs, and examine the dyadic relationships of anxiety and depression between CPs and their FCs; (ii) to investigate factors that may modify these relationships. Methods: Participants consisted of 641 dyads of CPs and FCs. Three types of variables were collected as potential modifying factors, including CP-related variables, FC-related variables, and family-related variables. Descriptive statistics, T-test, Pearson correlations, sub-group analysis were applied to conduct the data analysis. Results: Nearly one-third of participants experienced anxiety and depression (the Chinese version of the Hospital Anxiety and Depression Scale, C-HADS). CPs and FCs experienced a similar degree of C-HADS. Correlations (r) of C-HADS between CPs and FCs ranged from 0.25 to 0.32. Various factors influencing the anxiety and depression of dyads between CPs and their FCs were identified, including CP-related variables, FC-related variables, and family-related variables. Conclusions: Study findings call attention to the anxiety and depression, as well as the related factors in dyads of CPs and FCs. The underlined essential components and focus of intervention, which will be developed to decrease psychological distress and improve quality of life in dyads of CPs and FCs, included such areas as individual characteristics of CPs and FCs, family relationship.
Amany Mohamed Shebl
Mansoura University ,Egypt
Title: Impact of oral care protocol on the incidence and severity of stomatitis induced by radiotherapy.
Biography:
Amany Mohamed Shebl has occupied several positions as Dean of the Faculty of Nursing, Mansoura University, Egypt. Minister of Health Assistant for Human Resources all over Egypt. She was a published author of several research papers, articles, and books on nursing. She is a Reviewer in Advanced Nursing journal and Cancer Nursing journal and a Reviewer in National Authority of Quality Assurance and Accreditations. She has developed many national and international protocols (Nigerian government and United Arab of Emirates). She is one of the Developers in Nursing Education in Egypt. She has published more than 70 papers in reputed journals.
Abstract:
Oral stomatitis is a common debilitating complication of cancer radiotherapy. It results from local effects of radiation on the oral mucosa. The impact of oral stomatitis is far-reaching for patients, caregivers and the medical system. Objective: the aim of the study was to assess impact of oral care protocol to radiotherapy-induced stomatitis in cancer patients. Methods: Quasi-experimental research design was conducted in the Clinical Oncology and Nuclear Medicine Department at Main Mansoura University Hospital. The data were collected from two hundred adult patients of both sex randomized selected who corresponded to inclusion criteria and divided into two groups. Results: the result indicates increased total knowledge score for patients at immediate post more than post tests 1 and post test 2. Also it was found decreased incidence and severity of stomatitis after oral care protocol. There were a positive relation between severity and incidence of stomatitis of studied patients in relation to their knowledge. Conclusion: The implementation of oral care protocol had a positive effect on the studied patients' total knowledge scores and decrease incidence and severity of stomatitis in the study group. It was recommended that, Cancer patients should be given a written instruction plan for their radiotherapy steps and self- management measures to radiotherapy
- Poster Presentation