5^th World Holistic Nursing Conference June 10-11, 2019 Helsinki, Finland

Shamim Ahmad Bhat is working as a Consultant Emergency Medicine in Dept. of Emergency Medicine King Saud Medical City Riyadh. He is a board certifi ed from India and currently holding the chair of Academic and research co coordinator in the same department. He is also holding the chair of deputy program director for Saudi diploma in emergency medicine. He is the director of the TRR (KSMC and ALFRED University) training in King Saud Medical City. He is a part of the panel of evaluators and examiners for Saudi board of Emergency Medicine, approved by Saudi commission for health specialties.

Statement of the Problem: Toxicology is one of the subspecialty which has grown leaps and bounds in the recent years worldwide. Intoxication constitutes a global burden and most of the emergency physicians are worldwide facing diffi cult cases of intoxication more over arrival of an intoxicated unresponsive patient makes it more diffi cult for the treating physicians to approach their management. Researchers have reported diverse diff erent approaches for managing such cases and international bodies are framing day in and day out

the updated guidelines for such cases. Th e purposes of this literature review are to identify the recent TOX oriented ACLS guidelines and compare them with the recent evidence.

Method: Aft er looking through the recent 2015 ACLS guidelines in relation to TOX affl icted patients presenting with cardiac arrest or instability in terms of neuro and hemodynamics, a through literature review was done for the most commonly poisoning patients and the guidelines were compared to the recent standard evidence available related to various poisoning cases. Following this the level of evidence and recommendations made were also evaluated. Th is all was done to have an evidence-based approach for the commonest poisoning

induced instability and cardiac arrests and incorporate it for the board residency residents of emergency medicine. In addition, it was anticipated to form a general consensus for treating such cases in future and clear off some of the myths related to treatment involved for such cases.

Findings: Th e comparison of the recent guidelines from ACLS and the evidence in its support proved most of the treatment has weak evidence as to the disbelief of most of the treating physician. Some of the antidotes used in current practice are at the edge of being disrepute and are no more recommended to be standard of care e.g. Flumazenil in BZD poisoning.

Conclusion: Th is literature review made it clearer that it is needed to review the standard guidelines every now and then in terms of the supporting evidence against or in favor of it particularly if it is a subspecialty

like TOX.

Dercan Gencbas has completed her PhD from Gulhane Military Medical Academy, Public Health Nursing Department and Postdoctoral studies from Atılım University in Turkey. She is the Assistant Professor of Faculty of Health Science, Nursing Department. She has a lot of articles which was published in reputed journals. Her research interests are elderly health, school nursing and standard classifi ed nursing data systems.

There are many scales to measure Urinary Incontinence (UI). Nursing Outcomes Classifi cation (NOC) scales are ideal for use in the nursing process for comprehensive and holistic assessment with surveys available. For this reason, the purpose of this study is to evaluate the validity of the NOC outcomes and indicators used for UI. Th is research is a methodological study. In addition how much NOCs will contribute to recovery aft er the nursing intervention was assessed by experts. Scope validations have been applied and

calculated according to Fehring 1987 work model. Total of 55 experts rated Fehring as a “senior degree” with a score of 90 according to the expert scoring. Aft er the expert opinion, these weighted scores obtained for NOC indicators were classifi ed critical, supplemental or excluded. In the NOC system, 5 NOCs proposed for nursing diagnoses for UI were proposed. Th ese outcomes are Urinary continence, urinary elimination, tissue integrity, self-care toileting and medication response. Aft er the scales are translated into Turkish, the weighted average of the scores obtained from specialists for the coverage of all 5 NOCs. Aft er the opinions of the experts, 79 of the 82 indicators were calculated as critical, 3 of the indicators were calculated as supplemental. All NOCs were identifi ed as valid and usable scales in Turkey. In this study, fi ve NOCs were verifi ed for the evaluation of the output of individuals who have received nursing knowledge of UI and variant types.

Emily Taylor is an F2 Trainee at St Helens and Knowsley Teaching Hospitals with particular career aspirations and interest in emergency medicine and research.

Introduction: Ambulatory Emergency Care (AEC) was introduced in 2012 via NHS Elect. St Helens & Knowsley Teaching Hospitals (STHK) was early adopters-cohort 3 in 2013. We are challenging the concept of emergency care-delivering same day care and avoiding admitting patients overnight unnecessarily. ED AEC worked closely with inpatient specialties to achieve this, through development of new protocols and clinics. Performance audits have shown reduction in time to be seen reduction in admission and decreased

length of stay in hospital. STHK is an exemplar site for AEC, being one of only a few UK EDs to house AEC. To continue improving we decided to evaluate patient experience in AEC to gain the patient’s perspective of this new service.

Method: A questionnaire involving one qualitative question and nine quantitative questions was distributed to patients. Data was collected over two months. Questions were based on STHK core standards (attitude, communication and experience).

Results: Quantitative results provided ratings of excellent/good/average/poor/very poor. Qualitative results included patient’s comments. We had 80 responses: 80% excellent or very good feedback noted for staff attitude, which involves staff professionalism and delivery of care; patient experience showed 62% excellent or very good experience which involves length of stay, comfort, quality of care and feeling supported; communication shows 67% excellent or good which incorporates information provided to patients.

Conclusion: Significant positive feedback for care delivery and staff professionalism with some areas for improvement. Action points that have been developed for the future are amended SOP to emphasize communication with the patient, patient information leafl ets, FAQ posters and improved signage. We plan to re-audit aft er implementation of changes.

Binu Sharma is a Senior Vice President Nursing Services at Columbia Asia Hospitals India. She received Nightingale Award for Nursing Leadership. She was a Founder Member Association of Nurse Executives India. She have presented various research papers and have been a speaker at various national & international events with a special focus on Patient Safety, Infusion Safety and Infection control.

Leaders do more than delegate, dictate and direct, the American Nurses Association (ANA) writes. Leaders help others achieve their highest potential. Nurse managers are crucial to a medical establishment. Their presence is one of the reasons why most hospitals are functioning as smoothly as they should. A biennial survey of hospitals and health systems conducted in 2007 by the Governance Institute found that only 0.8 percent of voting board members were Chief Nursing Offi cers compared with 5.1 percent who were vice presidents for medical aff airs. New qualifi ed nurses and new nurse managers are oft en expected to hit the ground running with no management training. A management framework is required to provide a consistent approach to management development for all staff in healthcare, irrespective of discipline, role, function or seniority. Simply giving someone the title of leader or manager does not make them profi cient in that role and the titles themselves may be misleading. Given the importance of good management in creating a

healthy work environment, it is crucial that the diff erences and challenges of these roles are acknowledged to create more realistic expectations of those who hold them. Internationally, there is strong evidence that role ambiguity can discourage junior nurses from taking up leadership roles. As a result, career pathways and training opportunities need to be actively championed. A 2009 survey of primary nurses in New Zealand for example found that 82 per cent of respondents were keen to advance their careers by training for a leadership

role. Despite these positive fi gures however, the same report found that only 30 per cent of respondents felt satisfi ed with the current level of career progression on off er to them

Conclusion: Being visionary and proactive when faced with a healthcare system defi ned by rapid change and chaos is perhaps the most important of all the qualities listed. Today’s healthcare organizations face continual change in the form of organizational restructuring, quality improvement and employee retention. Such change brings with it feelings of pride and stress in equal measures. Nurse leaders need to embrace change, adapt to it and in doing so re-energize and empower the workforce with their management skills.

Kwan Sharis joined in nursing community, Sharis worked as a nurse in the maternity ward. In 2016, he began to transfer to teaching work and became a nursing instructor at Caritas College.

Background & Aim: Clinical practice is a vital component in nursing education that provides students with real-life opportunities to practice in hospital and community settings. Nevertheless, with an increasing complexity of the healthcare system, accountability for patient care and expectations for higher-quality service from the general public, clinical practicum can be a very stressful experience for nursing students. Th is study aimed to examine the eff ectiveness of using adventure-based training in enhancing the self-effi cacy, resilience and competency among nursing students towards clinical practicum.

Methods: A pilot Randomized Controlled Trial (RCT), two-group pretest and repeated posttest, betweensubjects design was conducted in a tertiary  institution. Twenty (20) baccalaureate nursing students were invited to participate with 10 students received 1-day adventure-based training (experimental group) and another 10 students received the same amount of time and attention as the experimental group but not in such a way as to have any specifi c eff ect on the outcome measures (placebo control group) before clinical practicum. Adventure-based training was based on the experiential learning theory that emphasize on physical challenge, periods of refl ection, overcoming adversity and team work building. Most importantly, the training allowed students to experience the “cannot” and learn to achieve the “can”; such experience could enhance students’ self-effi cacy and resilience, consequently improved their competency for clinical practicum. Participants’ self-effi cacy, resilience and competency were assessed at the time of recruitment, 1-week, 3-months and 6-months aft er clinical practicum.

Results: Participants in the experimental group reported statistically signifi cant higher levels of self-effi cacy (p<0.01), resilience (p<0.01) and competency (p<0.01) than those in the placebo control group.

Conclusion: Adventure-based training was found to be eff ective in enhancing nursing students’ competency, self-effi cacy and resilience towards clinical practicum. Th e fi ndings of the pilot study support for a large RCT on the eff ectiveness and sustainability of such training.

Tomasz Iwanski is the Doctor of Health Sciences and has completed his Master of Nursing. He has completed his post-graduation degree in Medical Law. He is a Specialist in Organization and Management and is a Certifi ed Tutor. He is a Lecturer, Trainer of medical personnel, education, social welfare, police, in the fi eld of diagnostics and organization of assistance to victims of violence. He is the Creator of diagnostictherapeutic standardization regarding the treatment of abused child, standard of nursing diagnostic and therapeutic procedures with victims of violence, based on the assumptions of the European Quality Assurance Network-EuroQuan (The European Quality Assurance Network) by

Donabedian theory. He is also a Member of the PARPA council for the prevention of domestic violence for many years. He is the Editor in Chief of the magazine, Human-Health Integration in PWSZ Oswiecim where he works now as an Academic Teacher being also Vice Director of the Institute of Health Sciences.

The problem of domestic violence occurs in all societies and cultures and for many years it’s been regarded as an important social issue especially in Western Europe. At that time, international organizations created plenty of documents advising the member States of the European Union, to take changes in law and practice in order to raise the eff ectiveness of combat with domestic violence and to provide victims of violence with assistance and eff ective interaction for domestic violence perpetrators. Up to this day in Poland,

domestic violence was not seen as a purely pathological phenomenon. Initially, the problem was marginalized and silenced, because families with a domestic violence problem carefully hid these facts, especially in contact with health care system. Th erefore, it was necessary to determine the role of nurses as people of fi rst contact with the patient, which in the event of diagnosis of symptoms which indicate violence can take an appropriate diagnose and therapeutic measures which would lead to the prevention of domestic violence. Th e main objective was to determine the level of knowledge of professionally active nurses and students of nursing connected with the problem of domestic violence (279 active nurses and 281 students of nursing). Th e author used a questionnaire. Both groups of respondents did not recognize the long-term eff ects of domestic violence; they well recognize factors infl uencing the violence development. Respondents experienced violence in their families and problem of violence is oft en found in work of nurses and students’ private environment. Both groups rated their knowledge at the secondary level. Nurses and students perceive a nurse as a person who can prevent domestic violence and have their place in an interdisciplinary team procedure called blue bear, implementation of procedures designed for nursing standard diagnoses and therapeutic procedure in case of violence in the family.

Statement of problem: Challenges to recruitment and retention include amongst other, an aging population, increased work load and unattractive salary packages. Researchers have focused on recruitment, such as an insuffi cient pool of nursing doctoral graduates and a lack of resources for nursing schools.Th e focus of the analysis was to examine what attracted the nurse educators to teaching, how they were recruited to nursing education. Th e study also aimed to investigate retention of educators. Research Methodology: An exploratory descriptive design, using a quantitative approach, was used in this study. A structured questionnaire was used.

 

Results: According to the respondents, who are nurse educators, knowing what their responsibilities are and how much authority they have were the retaining factors in their position. Recommendations: On final analysis several recommendations were proposed:

1. It was recommended that the study should be cascade to other

provinces for comprehensive report of nurse educator experiences. 2. Th e researcher also recommended the second translation Factors infl uencing the recruitment and retention of nurse educators in a selected higher education Institute of Nursing in Mpumalanga, South Africa

Lata Mandal is pursuing her Doctoral research as a full time research scholar in Sri Ramachandra Institute of Higher Education. She has served as a Critical Care Nurse for more than 15 years in the Indian Military Nursing Service. She is an Active Member of the Nursing Research Society of India and has publications in various national journals.

Prioritized care is a term used to defi ne nurses’ inability to carry out holistic care for patients. Literature and the world view suggest that this phenomenon of prioritized care challenges the basic concept of nursing care. It has also been closely linked with issues of patient safety, satisfaction and has been negatively

associated with nurse’s job experience. A quantitative study was undertaken among 100 staff nurses in a tertiary care hospital of South India to identify the activities that nurses gave least and most priority and to also explore the factors responsible for nurse’s decision for prioritization. Findings revealed that individual needs based interventional care like emotional support and teaching, basic care interventions like mouth care, ambulation, etc. were given less priority by nurses. Activities related to therapeutic and diagnostic procedures

like administration of medications, were given more priority majority of nurses cited inadequacy of human resource and communication failure as reasons for prioritization. Th e fi ndings suggested a deviation of nursing practice from the original holistic concept of the discipline. Nurse leaders need to acknowledge measure and prevent prioritization to ensure a climate of patient safety and better professional experience for nurses.

Shae Krizia Romualdo has pursued her Bachelor of Science in Nursing from Saint Louis University. She has worked as a Registered Nurse in Attendo Suomi. She is currently working as a Practical Nurse in Finland.

The setup of emergency medicine may vary greatly in fi rst world countries in contrast to developing countries such as the Philippines. In my experience as a general nurse in a primary hospital in my home country, I could say that doctors, nurses and the whole health care team make the most out of the limited

resources that we have. Th e primary hospital I’ve been working in caters to over 3,000 company employees, their dependents, and the residents of the outlying communities. Due the large population of people the hospital covers, nurses are trained to have a keen clinical eye and triage the patients as soon as they walk in the emergency room. Nurses are very oft en the fi rst ones to receive a patient, make a detailed interview, history taking, assess vitals including ECG and do initial interventions such as administering oxygen, starting IV lines and of course starting CPR even before doctor’s orders. Th is fast-paced routine is set up to be able to deliver care immediately as we have few doctors and the doctors had to rely on nurses’ reports, assessments

and initial interventions before they proceed with the course of care. Th is also means that nurses have more hands-on training, bigger responsibilities as we always have to do something fi rst before the next doctor is available and we have more interaction with the patients. We know that every second count in saving one’s life so nurses have to act fast, more independently and be resourceful.