20^th World Nursing Education Conference May 22-24, 2017 Osaka, Japan

Biography:

Abstract:

Problem: Many hospitals in the United States as well as Japan, have difficulty orienting and retaining new nurse graduates. Hospitals employing graduates from their own schools of nursing as well as from other schools have been challenged with prolonged periods of orientation time (up to one year) before the new nurse graduate is able to function autonomously. Furthermore, once through orientation, hospitals are again having difficulty keeping these new nurses employed at the hospital, costing the hospital system enormous resources in terms of both money and time. Purpose: Based on a comprehensive assessment of a Japanese hospital system and its associated School of Nursing in Iizuka, Japan, a team of nursing education experts from the U.S. worked with the hospital and its school’s nursing leaders to design a customized, culturally appropriate, Transition to Practice (TTP) model for newly hired registered nurses. Methods: Through a series of focus groups and nominal group techniques involving all levels of nursing (students to the Chief Nursing Officer), the experts designed a model for Transition to Practice based on the Japanese principles of Kaizen (quality improvement) and Wakaba (nurturing the young leaf). Findings: The newly developed Transition to Practice model encompasses an Academic Service Partnership, a Preceptor Academy, and Residency for Practice. It also calls for a school of nursing curriculum redesign to emphasize readiness to practice, particularly in the senior year. QSEN competencies and KSA's serve as the core component for the school of nursing curriculum redesign, preceptor education, and residency infusion.

Biography:

Yuka Moriyama started working as an ICU nurse at Aso Iizuka Hospital (AIH) in 1987. After the clinical experience as a nurse, she completed nursing teacher-training course by Health, Labor and Welfare Ministry in 1993. Since then, she was involved in nursing education as an instructor in Aso Medical and Welfare Fukuoka College, also as a curriculum coordinator in Aso Nursing College for more than 10 years. She assumed the position of Director of Nursing Department, AIH in 2015. Now, she leads over 1,000 nurses there.

AIH was established August, 1918, 98 years of history and is the central general hospital in CHIKUHO Area（450k population) providing primary to tertiary care with 41 Departments. AIH has 1,116 beds and 2,432 employees（MD 301  NS 1,088）. Inpatient; 908/day, Outpatient; 1,899/day, ER Patients; 117/day, Average Length of Stay; 14.5 days

Abstract:

Statement of the Problem: Our Nursing Department changed its system of care delivery in hospital wards from team nursing to lean workcell nursing in April, 2015 with expectations to apply this in all wards starting in March, 2016. The main objectives are, 1) to reduce walking distance between patient’s beds and the nurse’s station, and 2) to increase the nurse’s “caring time” at patient’s bedside. The University of Pittsburgh Medical Center’s (UPMC) Department of Nursing consulted with Aso Iizuka Hospital (AIH) on Quality and Safety Education for Nurses (QSEN) which AIH then incorporated into the new graduate nurse (RN) residency program in April, 2015. Both QSEN and the lean workcell philosophy put their priority on patient-centered care delivery. The purpose of this report: is to report on the synergism of QSEN and the lean workcell within the hospital setting. Method: A clinical evaluation (CE) of new nurses was performed by experienced nurses in the same ward in June and September of 2015 and 2016. The CE was to score 22 items through the view point of knowledge, skills, and attitudes (KSA’s). Findings: The mean CE scores in June were 0.50±0.19 in 2015 (n=85) and 1.69±0.49 in 2016 (n=81)（p＜0.001）. The mean CE scores in September were 1.72±0.63 in 2015 (n=84) and 2.62±0.34 in 2016 (n=81)（p＜0.001）. Thus, the CE scores were statistically significantly improved in 2016 when the lean workcell system had been applied and standardized across all wards in the hospital. Conclusion: The lean workcell system can enhance QSEN application providing new nurses more time to spend collaborating with experienced nurses around the patient’s bedside.

Biography:

He is working as Assistant Lecturer in University of Rwanda, College of Medicine and Health Sciences, School of Nursing and Midwifery, in the Department of Mental Health Nursing. He is an experienced teacher/ Nurse educator and specialized in Mental Health Nursing and he is actively involved in academic activities including mainly teaching modules such as Health Measurement and Research, Mental Health Nursing, Psychiatry, Fundamentals of behavioral sciences, clinical placement and he is also an experienced clinician in the field of psychiatric/ mental health and has worked as practitioner and supervisor in the Psychiatric Reference Hospital and District Hospitals. Also, Mr Vedaste BAZIGA is involved in research activities having many research projects (1 already published, and another 1 accepted for publication and remaining 3 in the process of data collection). In addition, Mr Vedaste BAZIGA participates also in community outreach and he is always increasing knowledge and skills through Continuous Professional Development (CPD) in different areas.

Abstract:

Biography:

My name is Chia Hui Liao, from Taipei Taiwan. I am a Nursing PhD candidate at National Yang-Ming University. I’m also a full-time RN at Taipei Veterans General Hospital and I have worked for 15 years. I love my job and study very much, I hope my patients could get better care and benefit from my research result. There are 5 people in my family. My father died of cancer, he get the good palliative care during his terminal stage because my families believed in my nursing profession. My mother is a house wife, my sister is also a nurse, and my brother is a Airport Customs officer.

Abstract:

The purpose of this study was focused on understanding the trend change of quality of life on newly diagnosed lung cancer patients and their influential factors. A one-year prospective longitudinal research design was used. A total of 250 newly diagnosed lung cancer patients were recruited using convenience sampling from a medical center in Taipei Taiwan. The instruments including demographic data, M.D. Anderson Symptom Inventory-Taiwan form, Pittsburgh Sleep Quality Index, the Taiwan version of IPAQ-SF and WHOQOL-Taiwan version were used for data collection at the time of being diagnosed, 1-month, 3-month, and 6-month post-diagnosed. Data were analyzed using SPSS version 20.0 software package. The frequency, percentage, mean and standard deviation were used for descriptive statistical analysis and chi-square test, t-test, one-way ANOVA, Pearson’s correlation and GEE were used for inferential statistical analysis. A p-value of less than 0.05 was to be the reference for the statistical significance. The findings indicated the degree of symptoms interfered walking and PSQI score were major predictors of QOL of newly diagnosed lung cancer patients, and the global QOL of newly diagnosed lung cancer patients didn’t improve over time. The results of this study revealed the trend change of health outcomes on newly diagnosed lung cancer patients, and it could be as the references for providing care to these patients and identifying the appropriate time to implement health promotion intervention for lung cancer survivors in the future.

Biography:

Marie Collet is a RN and PhD student with a master in Health Science form Copenhagen University. She a clinical nurse specialist in Intensive Care, with special attendance to nursing education and innovation both on an executive and bedside level.. She has published 1 paper and is on the board of an international research committee, NOFI. Her main focus in research is Delirium in critical ill patients. Currently doing study on haloperidol use for treatment of delirium in Intensive Care Unit.

Abstract:

Delirium in the intensive care unit (ICU) has received more attention in the past decade. Early detection, prevention and treatment of delirium are important, and the most commonly used tool for delirium assessment is the Confusion Assessment Method for the ICU (CAM-ICU).

The aim of this study was to identify perceived professional barriers to using the CAM-ICU in Danish ICUs. With a qualitative explorative multicentre design we conducted five focus groups with nurses (n=20) and four with physicians (n=14) with a semi-structured interview guide. Strategic sampling was used to include participants with varying CAM-ICU experience at units, with variable implementation of the tool.

Using a hermeneutical approach, three main themes and nine sub-themes emerged. The main themes were (1) Professional role issues: CAM-ICU screening affected nursing care, clinical judgment and professional integrity; (2) Instrument reliability: nurses and physicians expressed concerns about CAM-ICU assessment in non-sedated patients, patients

with multi-organ failure or patients influenced by residual sedatives/opioids; and (3) Clinical consequence: after CAM-ICU assessment, physicians lacked evidence-based treatment options, and nurses lacked physician acknowledgment and guidelines for disclosing CAM-ICU results to patients.

We concluded that, ICU nurses and physicians raised a number of concerns regarding the use of the CAM-ICU for delirium detection. It might be necessary to revalidate the instrument as ICU care has changed in recent years, with lighter sedation and early mobilization of patients. We recommend that nurses and physicians receive more training in the use of the CAM-ICU to address some of the issues identified in our study

Biography:

Abstract:

Purpose:

The purpose of our survey was; a) to assess the quality and efficacy of nursing handover in our ICU b) to evaluate nurse’s knowledge about ISBAR c) to implement the concept of ISBAR in our handover and d) most importantly to improve quality of patient care by applying safer and evidenced based nursing handover techniques.

Method:

Sampling Frame

We conducted a cross sectional survey to assess the efficacy of nursing handover in our ICU at Mediclinic City Hospital. Our 15 bed ICU consist of 3 beds in isolation and 12 beds in open bay. Our nursing staff comes from different professional and cultural background. Nursing handover usually takes place at the beginning of the shift, at the time of change in patient assignment and while receiving patient from different nursing units and hospitals. The handover generally takes 15-20 minutes but it can be more or less depending upon patient’s condition.   

Audit development and formatting

The members (nurses) of quality task force of our ICU investigated and generated the assessment criteria to be included in the audit form. After several discussions within the task force and with the guidance of our unit manager final audit form was made keeping in view that it has to be concise yet covering all the aspects of handover so that it provides accurate data and is less time consuming for the auditors. The audit has to be done by the members of quality task force only.

Inclusion & Exclusion criteria

All the nurses working in our ICU (full time/part time) were included in the survey except the nurses who are member of quality task force. Also the nurses from other department and hospitals were excluded from the survey.  

Result:

Good nursing handover is vital to protect patient safety and provide quality care. Systems need to be put in place to enable and facilitate handovers. Using SBAR has helped us in managing information and deliver safe handovers. After the implementation of SBAR in our handovers, we were able to reach 95% compliance and it reduced errors significantly and improved patient outcomes.

Biography:

Abstract:

Biography:

Abstract:

Self-concept provides the foundation for ones’ professional self-concept. Gap between educational influences and healthcare system expectations influences graduate nurses’ professional self-concept and their ability to be socialized into the healthcare environment ultimately leading to poor retention and a negative professional self-concept. A comparative longitudinal study design was conducted to explore the effect of clinical experience on the nurse self concept, caring behavior and professional commitment among the final year nursing students of diploma (n=63) and bachelor level (n=52). The mean score of nurse self concept, caring behavior measurement and professional commitment is higher after the clinical internship of six months compared to pre internship among all the nursing students. There is a positive correlation between the nurse self concept, caring behavior and professional commitment. There is a significant difference in the professional commitment between the diploma and bachelor level of nursing students both pre (t=5.293, p<0.01) and post (t=3.620, p<0.01) clinical internship. 

Biography:

Sevim Çelik has completed her PhD at the age of 28 years from Istanbul University, Turkey She is the director of Bülent Ecevit University Zonguldak School of Health. She has published more than 20 papers in reputed journals and has been serving as an rewiever of international repute journals.

Abstract:

Purpose: The purpose of this study was to determine the perceptions of nursing care in the preoperative and postoperative period at the patients who hospitalized with disc hernia.

Methods: This study was designed as a descriptive study. The sample consisted of 108 patients with cervical and lombar disc hernia, admitted to the neurosurgery unit, Zonguldak, Turkey. This study was carried out between April 2015 and April 2016. Data were collected by using personal information form and Turkish version of Caring Behaviors Inventory-24. Participants considered the nurses' behaviors to be indicative of caring in each of the 4 areas measured-assurance, knowledge/skills, respectfulness, and connectedness. Data were evaluated by using descriptive statistical methods, independent sample t test, one-way ANOVA and Kruskal- Wallis tests.

Results: About 62.5% (n=5) of nurses working at the neurosurgery had bachelor’s degree. Nurses were worked between 1 and 28 years. Patients’ mean age was 48.53 ± 1.08 and 51.9% of them were male, and 51.9% had an elementary school. Most of the patients had lombar disc hernia  (78.7%). Patients had an mean 6.85±4.41days stay in the hospital. About 81% of patients thought that adequate nursing care is given. On a scale of 1 to 6, inventory mean score was 5.46 ±0.79 in the preoperative period and was 5.63 ±0.65 in the postoperative period for perceptions of nursing care among the patients. It was obtained higher scores in the knowledge/skills subscale (5.72 ±0.74) and lower scores in the connectedness subscale (5.12 ±0.94) in the preoperative period. Also, in the postoperative period, it was obtained higher scores in the knowledge/skills subscale (5.84±0.58) and lower scores in the connectedness subscale (5.32 ±0.92). It was determined that demographic characteristics were not associated with perception of nursing care of patients. (p>0.05). The perceptions of nursing care of patients positive increased significantly in the postoperative period (p=0.000).

Conclusion: This study showed that none of patients demographic characteristics correlated with their perceptions of care.  Patients perceived nurses’ caring behaviors on neurosurgery unit as positive both in the preoperative period and in the postoperative period

Biography:

Chuntana Rogerson has completed a PhD at the Faculty of Healthsciences University of Southampton in 2016. She has 20 years experience as a paediatric nurse caring for children in a regional hospital. Dealing with caregivers in rural Thailand inspired her to undertaken this research to investigate the nutritional problems they encountered and how the families managed to overcome nutritional issues.

Abstract:

The purpose of this study was to explore the nutritional problems of children with VSD in rural Thailand because they have a long waiting time for surgery.  An ethnographic approach was used to explore and understand the nutritional problems cargivers’ experienced in caring for their child with VSD within their cultural context; especially the experiences of how the families managed to overcome the issues of maintaining optimal weight prior to surgery. Ten main caregivers who were taking care of children with VSD aged 6 months to 4 years who were waiting for surgery, and ten health professionals who dealt with these children were purposively selected. Data were collected through in-depth interviews, field notes, observations, and photographs with the ten main caregivers at their homes and the health professionals were interviewed at a regional hospital. A thematic approach was used to analyse the data. The triangulated findings generated themes indicating that children with VSD in rural Thailand had difficulty in gaining or maintaining optimal weight prior to surgery, resulting from some of the knowledge the caregivers used which was inappropriate for supporting weight gain in their child. Also both the health professionals and caregivers in rural areas had limited nutritional knowledge for taking care of children with VSD, who were waiting for surgery. Additionally there were inadequate resources provided at the clinic to help support caregivers.

Biography:

Clarisse Jamiel Geronimo has completed her Bachelors Degree in Nursing at the age of 20 years from University of Santo Tomas. She is currently preparing for the upcoming Philippine Nursing Licensure Exam this November 2016. This is the first research paper she conducted for her bachelors research study together with her co-researchers from the same university. She is known for one of the pioneers of establishing a new political party inside the College of Nursing. She serves as the chairperson of Lakas ng Diwang Tomasino – Nursing Unit. She is also a member of Tomasian Cable and Television, a university wide organization and she serves as a talent, a senior jock in the UST Tiger Radio.

Abstract:

AIMS: Today’s society standardizes how an adolescent should look like. One of the traits of an ideal adolescent should be maintaining a normal body weight. Adolescents strive to be in line with the standards of the society. The aim of this study is to know and understand the lived experiences of the various adolescents who fall under the category of being overweight. It intends to find out on how their weight affects different aspects of their personal and social relationships.

METHODS: Participants were selected through the use of purposive sampling method. A semi-structured interview questions were formulated by the researchers with the grand question, “What is life like for an overweight adolescent?”The set of questions formulated were validated by the qualitative expert and translated by a language expert. With the six Filipino overweight female adolescents living in Metro Manila that have a BMI from the 85^th to 95^th percentile or a BMI of 25-29.9 was interviewed by the researchers.  The participants are aged from fourteen to sixteen years old and an informed consent and assent was secured to the participants and to their respective guardian. The Colaizzi’s method was used to analyze and interpret the gathered data from the participants.

RESULTS: The following themes emerged from the study: Awareness and Acceptance. Awareness is defined as how the female overweight adolescent have or shows realization, perception or knowledge about something such as situation, condition or problem that exists in their life. Acceptance is defined as to how female overweight adolescents embrace their condition and experiences. An eidetic insight was presented as the representation of the Weightism Phenomenon.

CONCLUSION: Through the collective analysis of the verbalizations of the participants’, the female overweight adolescents are aware of their condition and how it affects them. The different experiences they underwent made them aware of how others perceived them.

Biography:

Abstract:

Biography:

Yuanyuan Song is a nursing postgraduate student who is on her second year in West China School of Nursing in Sichuan University in China. She focuses her research on nursing education and nursing of hemodialysis patients. She was her mentor’s assistant to set up this course, collect students’ feedback and analyze data.

Abstract:

Statement of the Problem: Courses related to advanced nursing practice play an important role in nursing postgraduate education aroud the world. But in China, nursing postgraduate education started late and hasn’t set a systematic, unified core knowledge system, each school has its own curricula, nursing-specific courses are limited, many schools still use clinical medicine specialized courses as their leading courses, only a few schools has established courses related to advanced nursing practice. As a result, our school set up a course named “advanced nursing practice: theory and method” on the basis of domestic and foreign literatures in the fall of 2016. The purpose of this study is to describe the implementation of “advanced nursing practice: theory and method” and explore the effect of this course in order to reflect and summarize. Methodology: 23 students chose the course. The effect of the course was evaluated through questionnaires designed by the author as well as interviews. Findings: The majority of the 23 students gave a positive feedback about the course and thought the course so necessary and useful that they could know more about theories and methods of advanced nursing practice and the development status, evidence-based practice, trends of development of the 12 nursing specialties involved in the course. In addition, teamwork, critical thinking as well as evidence-based practice abilities of the 23 students were improved. The students also developed a better understanding of nursing career and said the course is helpful for their future occupational planning. The overall satisfaction about the course content, teaching method, and the evaluation was high. Conclusion ＆ Significance: The content, teaching method and evaluation mode of the course was creative and a satisfactory effect was achieved. The course could provide a reference for other master nursing programs in China.

Biography:

Yuqing Song is a postgraduate student of West China School of Nursing, Sichuan University. She is doing research work in the areas of nursing education, clinical nursing. Now, she has published several articles.

Abstract:

Rheumatoid arthritis is a chronic progressive autoimmune disease. Treatment is effective to control the progress of RA when patients follow medication closely. However, medication adherence is not optimal in patients with rheumatoid arthritis. Poor medication adherence will limit medication efficacy, increase disease activity and the prevalence of disability and mortality. An effective education intervention to improve medication adherence is warranted. However, the effect of telephone education intervention on medication adherence is unknown in patients with rheumatoid arthritis. 92 RA patients recruited from a rheumatology ward in Southwest China were randomized to the intervention (n = 46) or the control group (n = 46). Patients in the control group received the standard care. Patients in the intervention group received both standard care and a 12-weeks tailored telephone education intervention including four telephone education sessions. The content of the education included: knowledge about rheumatoid arthritis, treatment goal, the importance of medication taking, side effect management and reminder of medication taking. Medication adherence was measured by compliance questionnaire rheumatology at the 12th and 24th week after patients’ discharge. Disease activity was measured by Disease Activity Score 28, erythrocyte sedimentation rate and C-reaction protein at the baseline, 12th and 24th week after patients’ discharge. Patients in the intervention group had significantly higher medication adherence compared to the control group at the 12th, 24th week after 12-week telephone education intervention (all P<0.05). Erythrocyte sedimentation rate was significant lower than control group at 12th weeks (P<0.05). No difference between two groups was detected in other disease outcomes at the 12th, 24th week (P>0.05). The tailored telephone education intervention effectively improved medication adherence in patients with rheumatoid arthritis. However, no significant benefits on disease activity were detected. Thus, further studies should explore the long term effects of education intervention on medication adherence and disease activity.

Biography:

Bobby Thapa completed her M.Sc. Nursing in 2014 from Xiangya School of Nursing, Central South University, Hunan, P.R.China and recently working as an Assistant Professor at Janamaitri Foundation Institute of Health Science, Hattiban, Lalitpur, Nepal since 1yr. She completed her B.Sc.Nursing in 2008 and has published two articles; one international and one national journal related to pain management (in Chinese) and HIV/AIDS in the National journal i.e. Nepal Nursing Journal. She worked as an clinical instructor as soon as completed her bachelor degree for 2 and half years and then worked as a registered nurse in Gangalal National Heart Center, Nepal for 6 months and enrolled in Master degree of Nursing in a governmental scholarship from China.

Abstract:

Self-concept provides the foundation for ones’ professional self-concept. Gap between educational influences and healthcare system expectations influences graduate nurses’ professional self-concept and their ability to be socialized into the healthcare environment ultimately leading to poor retention and a negative professional self-concept. A comparative longitudinal study design was conducted to explore the effect of clinical experience on the nurse self concept, caring behavior and professional commitment among the final year nursing students of diploma (n=63) and bachelor level (n=52). The mean score of nurse self concept, caring behavior measurement and professional commitment is higher after the clinical internship of six months compared to pre internship among all the nursing students. There is a positive correlation between the nurse self concept, caring behavior and professional commitment. There is a significant difference in the professional commitment between the diploma and bachelor level of nursing students both pre (t=5.293, p<0.01) and post (t=3.620, p<0.01) clinical internship. However there is not any significant difference in any of the variables within the group regardless of clinical internship. Being a single child, class leader, enrolled in career planning class, perceiving nursing as a challenging job, reasons to be a nurse, course arrangement satisfaction, teacher’s care, internship satisfaction and nurse teacher’s care has identified to influence the nurse self concept, caring behavior and professional commitment among the nursing students. Thus, specific steps to deliberately embellish the foundation of knowledge in developing the self-concept of nurse and nursing students is must nowadays. 

Biography:

Shu-Hui Peng has completed her M.D. at the age of  36 from Mei Ho University in Taiwan and is studying her Master’s degree in I-Shou University in Taiwan. She has been a nursing staff in Kaohsiung Chang Gung Memorial Hospital for 25 years.

Abstract:

Alcohol-related trauma, which including drunk driving, fighting or a fall after drinking alcohol, is the main reason for sustaining trauma injury. To provide objective evidences and more complete therapeutic algorithm, this study was designed to investigate the relationship of alcohol-related trauma and the injury severity as well as medical expenses in adults. A retrospective study of the medical records and registered data in Trauma Registry System from 2009 to 2014 was performed at a medical center in southern Taiwan. The patients whose blood alcohol concentration (BAC) level≧50mg/dl was considered as alcohol intoxication group while those whose BAC level less than 50mg/dl and those who were not required for an alcohol test were deemed as patients without alcohol intoxication group. Of the total 11,033 adult patients, 929 patients with BAC (+) and 10,104 patients with BAC (–) were enrolled in this study. atients with alcohol intoxication had significantly higher rates of head/neck injury, face injury, thoracic injury, and abdomen injury, lower Glasgow coma scale (GCS) score (12.6±3.7 vs. 14.5±1.9, p＜0.001), higher injury severity score (30.8±17.8 vs. 7.7±6.5, p＜0.001), higher short-term mortality (3.6% vs. 1.2%, p＜0.001), longer hospital stay (11.4 days vs. 9.1 days, p＜0.001), and higher proportion of admission to the intensive care unit (ICU) (35.4% vs. 15.0%, p＜0.001) than those without alcohol intoxication. Alcohol-related trauma is associated to a higher injury severity and increase the cost of medical expenses.

Biography:

Siu Wun Benny Cheung  is a final year student of Bachelor of Health Science (Hons.) Major in Nursing at Tung Wah College. The study presented is Cheung’s graduation project. 

Abstract:

Hong Kong nursing students’ perceptions about clinical learning experience: A Qualitative Study: It is a qualitative study exploring the clinical learning experience of Hong Kong nursing students and factors which might affect the effectiveness of clinical learning. It helps nurse educators cultivate a more positive environment for clinical learning by tackling problems facing by nursing students over the period of clinical placement. 20 final year nursing students from Bachelor of Health Science (Hons.) in Nursing programme, who had completed the required nursing practicums, were recruited by convenience via email, social network platforms and face-to-face invitation. Focus group interviews were conducted in January 2017 at Tung Wah College. 5-6 participants were interviewed in each focus group interview. The researcher explained the purpose and potential benefits of the study, and the procedure of the interview to the participants. Information sheets with detailed explanation to the procedure, purpose of study, etc. were given to the participants; informed consents were obtained before interview started. The researcher started the interview with some ice-breaking questions to create a relaxing atmosphere to facilitate the participants to express their view on their clinical learning experience. Question guide with several open-ended questions was prepared to ensure the content of the interview matched with the research aim. Another researcher who also joined the interview acted as an observer to job down the key observation throughout the interview. The whole interview took about 1-1.5 hours and was videotaped. Content analysis was used to analyze the transcription. The preliminary analysis showed that ward environment, mentorship, relationship with ward staff, learning opportunities available in the ward, students’ learning style and supports from school were crucial factors for a positive learning experience. 

Biography:

Wan Shiuan Lin received her master degree in community health nursing from National Yang-Ming University, Taipei, Taiwan. She has special interests in “Maternal and Child Health”, “Medical Sociology and Science”, “Technology and Society(STS)”. Now Ishe is a third-year student of the doctoral program of National Yang-Ming University, Taipei, Taiwan. Moreover, she has been working at Taipei Veterans General Hospital for ten years and focusing on providing the expert advice for clinical care.

Abstract:

Early child development is a concerned problem in health care. However, the Early Intervention Policy were hard to execute in Taiwan. The purpose of this study was to explore the rationality of argumentation which the different parents argue the policy of Early Intervention Policy for Children with Developmental Delays or Disabilities in Taiwan. The document analysis and in-depth interview are adopted. In addition, policy argument and content analysis are regarded as the method of analyzing and processing data. The interview with six parents used Early Intervention Policy was based on the ethics mode of policy argumentation by Dunn. The policy process contains six steps: policy information, claim, warrant, backing, object and rebuttal. The findings of this study showed that the management mode of the expert first causes the gap of the mutual communication. However, the main experts only were the medical team, not the parents. It was worth to note that when the parents did not follow the experts’ instructions, they had been criticized as not know about the developmental delays or disabilities as well. The controversy of the ambivalent signs and the insufficiency of the integrated resource were ignored and therefore the parents were busier to assume more parental responsibility. The policy is far away from the principle of participation. This the main reason causes the dilemma of the Early Intervention Policy for Children with Developmental Delays or Disabilities in Taiwan. Some suggestions are proposed to the nursing practice, education and policy as well.

Biography:

Graduated Bachelor’s degree of Nursing (1^st Class Honours) from Boromarajonani College of Nursing, Suphanburi and now Nursing Instructor in Adult and Elder Nursing Department, Srimahasarakham College of Nursing.

Abstract:

This descriptive correlation research aimed to identify the relationship between unpleasant symptom clusters and quality of life among patients with chronic kidney disease (CKD). The theory of Unpleasant Symptoms was used as the conceptual framework. The study participants consisted of 150 patients with stage 3 to 4 CKD who were treated at CKD clinic of one tertiary hospital in Thailand and were chosen purposively. Data collection was conducted during January, 2016 to March, 2016 by using 3 forms of patient general health information, the CKD unpleasant symptoms, and Quality of Life (SF-36). Descriptive statistics and factor analysis and correlation were used to analyze the data.  Statistical significance was set at .05

                The results revealed that patients with CKD stage 3-4 had 28 unpleasant symptoms. The most frequently perceived were 4 symptoms of limbs numbness, bone and joint pain, nocturia, and fatigue. The 28 unpleasant symptoms could be grouped into 8 clusters with 52.56% of explained variance. Among 8 symptom clusters, psychological and emotional cluster was found to have the greatest severity and the strongest negative correlation with all aspect of QOL. Negative correlations were also found between the remaining symptom clusters and physical component of QOL except the urinary tract cluster.

                This study provides important information related to unpleasant symptom clusters that may deteriorate QOL of CKD patients. Nurses should address the finding in this study in planning to prevent or reduce QOL deterioration

Biography:

Chi-Wen HUANG has completed her Master’s degree at last year from China Medical University of Basic Medical Scinece. She is currently working at China Medical University Hospital of International Medical Service Center. She has been a nurse for 10 years

Abstract:

Lymphedema include congenital or secondary types. The latter is related to infection, trauma or cancer treatment with surgery or radiotherapy. The accumulation of protein-rich fluid in the subcutaneous tissue causes lymphedema and hypertrophy, increased risk of inflammation, tissue fibrosis and decreased quality of life. The modified Charles’ procedure is indicated severe lymphedema and the nursing care after operation had not been clearly described. After the modified Charles’ procedure the goals of nursing include prevention of scar hypertrophy, infection, cellulitis and skin care which are challenging issues for patients and their family. Proper management can reduce the rate of subsequent hospitalization. In this study, the data of 35 patients who underwent the modified Charles’ procedure for lower limb lymphedema were drawn from the medical records between 2010 to 2014. The outcome were evaluated after 1 year. During hospitalization the wound was treated by a special nurse according to our protocol until skin graft take. Then the patients were discharged for continuous care. The patients and their family were educated according to our instructions. In the result, the rate of recurrent infection was 28% which required admission. The rate of verrucous hyperkeratosis was 8%. The rate of regrafting was 22%. However, after modified Charles’ procedure good postoperative care is critical for good results.

Biography:

The present study was a quasi-experimental research with non-randomized control group,  posttest only design which aimed at investigating effects of a nurse-led mechanical ventilator weaning protocol on ventilator duration and weaning success of preterm infants with ventilator-nasal positive airway pressure (V-NCPAP). The study sample consisted of preterm infants who received V-NCPAP and were admitted into the pediatric and neonatal intensive care unit (P-NICU) at Sirindhorn Hospital. Twenty-nine subjects in the control group received routine weaning, while thirty subjects in the experimental group received the nurse-led mechanical ventilator weaning protocol which consisted of 3 phase : 1) pre- weaning phase 2) inter- weaning phase and 3) post- weaning phase. The research instruments composed of the nurse-led mechanical ventilator weaning protocol, the V-NCPAP record form, the nursing record form base on nurse-led mechanical ventilator weaning protocol. Data were analyzed by using descriptive statistics, chi-square test, Fisher’s probability exact test, independent t-test and Mann-Whitney U test. The study findings demonstrated that preterm infants in experimental group had ventilator duration shorter than that preterm infants in control group with statistical significance (p <.05), while weaning success in experimental group more than control group without statistical significance (p >.05).

            The study findings revealed the nurse-led mechanical ventilator weaning protocol might be could reduce ventilator duration and promote weaning success. Therefore, the further study is needed of the effectiveness of nurse-led mechanical ventilator weaning protocol in difference setting or add on other dimensional outcomes of weaning success for enhance quality of care provided to preterm infants with V-NCPAP.

Abstract:

Chonticha Kuldnarm has completed her BSN at the age of 22 years from Kaukarun College of Nursing. She is a professional Nurse at Sirindhorn Hospital, Bangkok and Master’s student, Master of Nursing Science Program (Pediatric Nursing), Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University.

Biography:

Abstract:

Biography:

Hong Kong nursing students’ perceptions about clinical learning experience: A Qualitative Study: It is a qualitative study exploring the clinical learning experience of Hong Kong nursing students and factors which might affect the effectiveness of clinical learning. It helps nurse educators cultivate a more positive environment for clinical learning by tackling problems facing by nursing students over the period of clinical placement. 20 final year nursing students from Bachelor of Health Science (Hons.) in Nursing programme, who had completed the required nursing practicums, were recruited by convenience via email, social network platforms and face-to-face invitation. Focus group interviews were conducted in January 2017 at Tung Wah College. 5-6 participants were interviewed in each focus group interview. The researcher explained the purpose and potential benefits of the study, and the procedure of the interview to the participants. Information sheets with detailed explanation to the procedure, purpose of study, etc. were given to the participants; informed consents were obtained before interview started. The researcher started the interview with some ice-breaking questions to create a relaxing atmosphere to facilitate the participants to express their view on their clinical learning experience. Question guide with several open-ended questions was prepared to ensure the content of the interview matched with the research aim. Another researcher who also joined the interview acted as an observer to job down the key observation throughout the interview. The whole interview took about 1-1.5 hours and was videotaped. Content analysis was used to analyze the transcription. The preliminary analysis showed that ward environment, mentorship, relationship with ward staff, learning opportunities available in the ward, students’ learning style and supports from school were crucial factors for a positive learning experience. 

Abstract:

Leung Sze Ching Joey is a final year student of Bachelor of Health Science (Hons.) Major in Nursing at Tung Wah College. The study presented is her graduation project. 

Biography:

Abstract:

Biography:

Ying-Ching Huang

I am a National Yang-Ming University first year doctoral student in Taiwan.

I have 10 years of clinical nursing experience in surgical department and critical department.

Abstract:

Objectives: Inpatient care is a major part of medical expense in the National Health Insurance. However, few studies explored the nature of medical costs empirically in our setting. Hemorrhoids are the most frequent anal pathology. To investigate the related factors of medical cost among the hospitalized patients survey hemorrhoids surgery.

Methods: Patients who were hospitalized for hemorrhoid surgery (ICD-9-CM; code: 455) were selected from the 2000-2013 Taiwan National Health Insurance Research Database; Data were analyzed using SPSS 22.0 software.

Results: 464,722 patients were hospitalized for hemorrhoid surgery in 2000-2013; There are 77,855 patients (16.75%) of the medical costs higher than the average (NT$24,650). High medical expenses, the male accounted for 59.42%, mean age was 56.19years, Low-income household accounted for 1.89%, Catastrophic illness accounted for  21.57%, Charlson Comorbidity Index(CCI) was 1.42, In Medical center and Regional hospital accounted for 82.59%, General Hemorrhoids surgery accounted for 34.02%, 12.51% were recurrent inpatients.

The factors related with medical costs caused by hemorrhoid surgery were gender, age, Low-income household, Catastrophic illness, Charlson Comorbidity Index(CCI), Level of care, type of operation, length of hospitalization and Recurrance.The characteristics and factors of medical cost of hemorrhoids inpatient in Table1.

Conclusion: Among the related factors, many factor had dominant impact on increase of medical cost. Therefore, providing adequate quality of care for hemorrhoid surgery patients can help post-surgery recovery and reduce the length of hospitalization, which then reduces the use of medical resources.