Day 1 :
Keynote Forum
Jane Hippenmeyer
Amgen Europe, Switzerland
Keynote: Introducing biosimilar therapeutic products in oncology: The critical need for nurse education
Time : 09:30-10:10
Biography:
Jane Hippenmeyer completed her Doctor of Pharmacy degree in the USA at the Philadelphia University of the Sciences. She held the position of Drug Information Manager at Memorial Sloan Kettering Cancer Center (MSKCC) in New York City for a period of seven years before joining the pharmaceutical industry. For the last 14 years, she has worked at Amgen Europe within the Medical Affairs Department focused on the launch of various Oncology Biologic products including Neulasta, XGEVA, Blincyto and most recently the Oncology Biosimilar products, for which she is currently the European Medical Director, preparing for the launch of trastuzumab, bevacizumab and rituximab biosimilars.
Abstract:
European nurses have had experience with biosimilar molecules in oncology for over 10 years. However, these biosimilars were of small molecule supportive care drugs including granulocyte-colony stimulating factor (G-CSF) and erythropoietin (EPO). Currently the large molecule therapeutic monoclonal antibodies are arriving in hospitals as the patents for drugs such as MabThera, Herceptin and Avastin expire. In order for patient acceptance and healthcare providers (HCP) adoption for successful cost savings to the health care systems, the role of the nurse in patient education will be critical. The pathway leading to regulatory approval should be understood by nurses so that they can properly educate patients on these therapies. In addition, a proper understanding of the creation and manufacturing of these biologic products should be appreciated. A discussion guide for use by nurses with their patients will be proposed to the audience for consideration. Questions regarding common misunderstandings will be addressed during this session.
Keynote Forum
Debbie McCarthy1
Flinders Medical Centre, Australia
Keynote: Social work in the emergency department-implementation of a domestic and family violence screening program
Biography:
Debbie McCarthy completed Bachelor of Social Work degree in year 2000. She was an enrolled Nurse for 15 years; during this period, she worked in residential care facilities, palliative care and a brain injury unit. As a social worker, she has been employed as a Counsellor for Human Services Task Force in tissue retention, has worked in various inpatient wards. She has worked as Social Work Team Coordinator in Flinders Medical Centre Emergency Department for 12 years, having extensive experience in crisis intervention and trauma counselling. She has also designed a number of resources for consumers and staff. She established a training program for staff in the Emergency Department and post-graduate nursing program and has been a guest speaker at various workshops in Adelaide. She has recently won the Excellence in Allied Health Award for the Southern Adelaide Local Health Network for her work in domestic violence
Abstract:
Women who have experienced domestic and family violence use health services more frequently than women who have not. Early identification and intervention by the health system may reduce health problems associated with domestic and family violence and lead to saving for the health sector. This study aimed to evaluate the impact of a new domestic and family violence screening program, which was based on an ecological model and introduced by a social work team in the emergency department of a major metropolitan hospital. The evaluation method included an audit of social work case files to access the effect on referral rates and a survey of emergency department staff to obtain perceptions of the impact of the program on the staff and clients. In the three months period following the introduction of the program, the rate of referral to social work increased by 213%. Staff agreed that the emergency department is an appropriate place to ask about domestic and family violence, under certain conditions. Findings suggest that an ecological social work model provides an approach to screening for domestic and family violence that not only contributes to increased identification and supportive client interventions but may also contribute to more sustainable systemic change
Networking & Refreshments 10:50-11:10 @ Breakout Area
- 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.