Madridge Journal of Nursing

ISSN: 2638-1605

5th International Nursing Conference

Oct 23-25, 2019, Rome, Italy
Scientific Session Abstracts
DOI: 10.18689/2638-1605.a4.001

Development of an Augmentative and Alternative Communication app. for Makaton

Susan Carlisle

Queenʼs University Belfast, UK

As part of the theme of communication in phase one undergraduate nursing curriculum students are asked to produce an information leaflet to help enhance communication with patients and clients. As a result of this exercise students were finding out about Makaton as an augmentative alternative communication tool (AAC) and asked if they would have opportunity to learn this skill as part of the programmer.

Aim: Provide undergraduate nursing students with the information and skills necessary to engage patients / clients with a communication deficit. Develop a teaching tool on Makaton which is up to date, current and easily accessible. It is hoped by developing this app. nursing students will have a greater understanding of communication deficits and be able to provide patient centered care that is considerate to the individual needs.

Methods:

Stage 1: Purchase the license for Makaton

Stage 2: The development of a teaching tool template that includes all the essential aspects required for Makaton training.

Stage 3: Collaboration with a computer technician to produce video clips, podcasts, interactive tests and hyperlinks to key areas.

Stage 4: Transferring the multimedia outputs into an app. accessible for students.

Stage 5: Pilot app. with year 1 undergraduate students and year 1 teachers

Stage 6: App. made available to all year 1 students.

Stage 7: Evaluation of app.

Outcomes: By providing nurses with an easy to use aid memoire this should improve communication and clientʼs satisfaction with the service.

The importance of Makaton as an Augmentative and Alternative Communication methods is highlighted.

Conclusion: By developing this app. nursing students will have a greater understanding of communication deficits and be able to provide patient centered care that is considerate to the individualʼs needs.

Biography:
Susan Carlisle has been a Registered nurse with the Nursing and Midwifery Council (NMC UK) for 40 years. She has been involved in Nurse Education for many years, lecturing in the School of Nursing and Midwifery, Queenʼs University since 1997. As Year Lead is responsible for all aspects regarding delivery of year one of the BSc Nursing program. She is constantly reviewing curriculum content to ensure all students are given opportunities to deliver safe, compassionate and respectful patient care. By using creative ways to encourage thinking and knowledge around the patient experience challenging students to think how care is delivered.

Presenteeism among Nursing Students in Three Countries

Catharine Critz*, Hobie Etta Feagai*, April Akeo, Mieko Tanaka, Juh Hyun Shin, Michael Erickson, Mari Ikeda, Haruyo Moriya and Kyoko Ozaki

Hawaii Pacific University, USA

Background: Presenteeism, the act of going to work while sick, is associated in nursing with increases in medication errors, patient falls and lower self-reported quality of care with costs exceeding those of absenteeism. Presenteeism is well documented in nurses who work in hospitals around the globe but little is understood about presenteeism among nursing students.

Objectives: This mixed methods study described presenteeism in lecture and clinical experiences among nursing students from Honolulu, Tokyo and Seoul (N = 390).

Settings: A multi-city study conducted in the United States, Japan and South Korea.

Participants: Undergraduate nursing students enrolled in Bachelor of Nursing programs.

Method: A self-administered survey containing demographic characteristics, questions related to presenteeism and space for open ended responses was used.

Results: While nearly all student respondents believed going to class and clinical experiences put their classmates and patients at risk, the overall presenteeism rate was 85.5% for class and 69.5% for clinical experiences. There were significant differences between universities for reasons for presenteeism, however, the predominant reasons for class or clinical presenteeism were: No opportunity to make up work, missed content and fear of exam or course failure. The data indicated that there was less presenteeism for clinical experiences than for lecture classes suggesting that clinical absences carry a greater consequence.

Conclusion: Nursing students in three culturally different cities report going to class and clinical experiences while sick despite recognizing the safety risk. Nursing students need to learn responsible health and safety practices during their education in preparation for employment and professional practice. Nursing programs need to scrutinize policies related to absences to ensure that presenteeism is not promoted and provide alternative learning experiences for students who miss class or clinical experiences.

Biography:
Dr. Critz and Dr. Feagai are professors of nursing at Hawaii Pacific University in both the undergraduate and graduate departments. Dr. Critz, a pediatric nurse practitioner also maintains a private practice in developmental pediatrics. Dr. Feagai also practices as a Family Nurse Practitioner in a private urgent care clinic. They share a research interest in nursing student education.

A Blueprint for Conducting Systematic Program Evaluation in Nursing Education

Rosemarie Suhayda* and Mary C. Zonsius

Rush University, USA

The major goal of educational assessment is to establish the value, worth or quality of an educational program. In health-care education, quality is judged not only by the extent to which a program graduates competent health-care providers, but also by the extent to which the program demonstrates effective assessment and evaluation processes and outcomes.

The purpose of this presentation is to provide a blueprint for systematically evaluating a nursing education program. Stufflebeamʼs CIPP Model will serve as the framework for designing a comprehensive program evaluation that incorporates accreditation standards. The CIPP acronym represents context, input, process and product evaluation that encompass all aspects of establishing program effectiveness. Emphasis will also be given to curriculum monitoring and evaluation from curriculum mapping through formative and summative assessment of student learning. Data collection and analysis strategies will be addressed to include direct and indirect measures, quantitative and qualitative measures, test-blueprinting and creating rubrics for evaluation. Attention will also be given to how data are used to inform program improvements and demonstrate program effectiveness to major stakeholders.

Biography:
Dr. Suhayda is the Associate Provost for Institutional Research, Assessment and Accreditation for Rush University in Chicago, Illinois, a renowned academic medical center. She is also the Assistant Dean for Evaluation for the Rush University College of Nursing. Dr. Suhayda has over 30 yearsʼ experience in nursing education, that includes over 20 yearsʼ experience in program evaluation. She has published and consulted in the areas of learning assessment, curriculum mapping and program evaluation. Dr. Suhayda serves as a reviewer for the Higher Learning Commission and the Commission on Collegiate Nursing Education.

Antibiotic Stewardship: A Process Improvement in Long-Term Care

Jewel Enriquez-Wilson

Chamberlain University, USA

The problem:

• There is an increase in antibiotic prescribing on patients in the long-term care unit without adherence to specimen collection of culture prior to antibiotic prescribing

• There is an increase of misuse of antibiotics in the case of viral infections, minor infections and ineffective dosing of antibiotics

The purpose:

• Education and teaching of nurses and physicians about proper adherence to specimen collection of culture prior to antibiotic prescription

• And Optimal use of antibiotic prescription

Collection of data from the pre-intervention phase shows significant trend indicating patients are often prescribed antibiotics without any specimen collection, resulting in inappropriate treatment to bacterial infections. The trend places patients at risks for super infections. The purpose of the project is to implement the antibiotic stewardship program in a long-term care unit and promote a steadfast resolution to optimize use of antibiotics and adhere to specimen collection of culture prior to antibiotic prescribing.

For the antibiotic stewardship project, the PICOT states: For nursing staff in a long-term care unit, does the implementation of an evidence-based antibiotic stewardship program, versus current practice of improper adherence of collection of cultures prior to antibiotic prescribing, improve the adherence of specimen collection for culture prior to antibiotic prescribing, in an 8-10-week timeframe?

Two-way percentage table was used to cross-tabulate the adherence of specimen collection for culture prior to antibiotic prescribing before and after implementation. Kai-square test of independence was used to determine if there was a relationship between adherence of specimen collection for culture prior to antibiotic prescribing. The percentage of YES to collection of specimen of culture for pre-intervention is 30.3%. The percentage of YES to collection of specimen of culture for post-intervention is 67.6%. The adherence to specimen collection of culture has shown significant improvement from pre-intervention to post intervention.

Biography:
In her years of professional nursing experience, Dr. Wilson developed the skills to deliver impeccable health care services towards patients; thus, making the same exemplary effort to deliver exquisite services to nursing students, nurses and patients. Dr. Wilson likes to express her level of resilience, keen attention to detail, flexibility and adaptability. Dr. Wilsonʼs knowledge in research and education fosters a learning environment for nurses. She is also competent in her current role as an educator. She is prepared to critically analyze policy / laws / ethics to develop, evaluate and advocate for regulation and delivery of nursing and health care services.

Academiaʼs Opportunity and Obligation to Address Nurse-To-Nurse Incivility at the Baccalaureate Level

Jennifer A Brunworth

Maryville University, USA

The purpose of this study was to determine if studentʼs perceptions about their confidence and self-efficacy related to addressing incivility in nursing would change if provided with education modules and specific coping techniques. The sample was a convenience sample of senior-level undergraduate nursing students enrolled in the researcherʼs leadership course. A survey, adapted by Thompson and George (2016) from the General Self-Efficacy Scale (GSES) (Schwarzer & Jerusalem, 1995) was administered to obtain baseline information pertaining to their confidence regarding identifying, managing and crafting appropriate professional responses to incivility. Students were then given instruction about incivility in nursing including defining and recognizing incivility, consequences of incivility in nursing, effective communication, professionalism, cognitive rehearsal, responding to incivility, organizational and professional expectations related to incivility and locating organizational resources for assistance. After completing the education modules, students repeated the survey to determine if there were changes in their perception of confidence and self-efficacy related to addressing incivility. Results of the survey suggest that the targeted educational modules can be associated with a statistically significant increase in the respondentʼs confidence and self-efficacy related to managing and responding to incivility using coping techniques and effective communication.

Biography:
Dr. Jennifer Brunworth, EdD, MSN, RN is an Assistant Professor of Nursing at Maryville University. She received her Doctorate in Higher Education Leadership from Maryville University in May 2019, her Masters of Science in Nursing from Regis University (2014) and her Bachelors of Science in Nursing from University of Colorado-Denver (2004). She currently teaches in the graduate and undergraduate nursing programs at Maryville University. Additionally, Dr. Brunworth is an officer in the Sigma Theta Tau International Omicron Iota chapter. Her passion is promoting and restoring professionalism and civility in the academic and clinical nursing environment.

Educational Interventions to Decrease Anxiety and Increase Self-Confidence in NP Studentsʼ Learning How to Document a SOAP Note

Nina A Zimmermann

Maryville University, USA Approriate documentation of a patient history and physical exam is a core competency for nurse practitioner (NP) programs. This study aimed to investigate NP studentsʼ self-confidence and anxiety while learning how to document a patient history and physical exam. A NP student survey that included the Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM©) scale was used pre and post a revised Advanced Health Assessment course. Two independent samples of NP students participated before (n = 100) and after (n = 59) the intervention was implemented. Using a non-paired t-test, a significant increase in NP studentsʼ self-confidence was found pre- (M = 114.9, SD = 22.4) to post-intervention (M = 122.3, SD = 19.5), p < .05. A decrease in reported anxiety was found, but this result was not significant. Implementing teaching tools such as a Subjective, Objective Assessment and Plan template and video patient scenarios increased NP studentsʼ self-confidence in learning how to document a patient history and exam.

Biography:
Nina A Zimmermann is a board-certified adult nurse practitioner and Director of the NP Program & Assistant Professor of Nursing at Maryville University in St. Louis. She obtained her MSN in Nursing Education at Barnes-Jewish College in 2005, post-masters, ANP Certificate at Maryville University in 2009 and doctoral degree in Higher Education Leadership at Maryville University in May, 2019. Nina has 25 years of nursing experience and has published & presented nationally. She is currently an officer of the Omicron Chapter of STTI Nursing Honor Society. Her clinical practice is a primary care clinic at the Sunnen Corporation in St. Louis, MO.

Simulation as an Educational Strategy to Increase Medication Error Identification in Licensed Practical Nurses

Deryus Tillman

Columbus State University, USA

To introduce simulated instruction to licensed practical nurses with less than five years experience, to validate and enhance accuracy in medication error identification and error reporting. A pre and post project design was used. A pre-test to evaluate baseline knowledge regarding medication administration and common errors was given to ten participants prior to a one hour long instructional simulation activity. Following the activity an identical posttest was given to assess changes in competency. A paired-samples t-test was conducted to compare both pre and post test scores. The analysis revealed a mean pre-test score of 84 with a standard deviation of 4.69 (SD = 4.69) and a mean post-test score of 92.4 with a standard deviation of 2.67. The results suggest that medication error identification accuracy increases when individuals participate in a one-hour simulation instruction experience.

Biography:
Dr. Deryus J. Tillman DNP RN received his undergraduate degree from Georgia Southern University in Georgia. He completed his Masterʼs training at Jacksonville University in Jacksonville, Florida and his doctorate at South University in Savannah, Georgia. Dr. Tillman has over eight years of critical care experience. Dr. Tillman has over five years experience teaching at both the undergraduate and graduate levels. He is active in a variety of civic and professional organizations including Kappa Alpha Psi Fraternity Inc., Phi Sigma Pi National Honor Fraternity, American Nurses Association, Black Nurses Rock Inc., and Sigma Theta Tau International Honors Society of Nursing.

Exploring Patient Perspectives about their Cancer Care Experience

Margaret I Fitch

University of Toronto, Canada

Introduction: Delivering person-centered care begins with understanding the perspectives of individuals who are the recipients of care and their experiences interacting with the cancer system. This project explored the views of individuals with cancer regarding their experiences with cancer care through a qualitative analysis of questions on the Ambulatory Oncology Patient Satisfaction Survey (AOPSS).

Methods: The project was designed as a descriptive qualitative analysis of written responses to the AOPSS survey. Files from seven jurisdictions were accessed for written comments from respondents to a final open-ended question on the AOPSS survey: Is there anything else you would like to tell us about your cancer care experience? The qualitative analysis was guided by two questions: 1) what is the nature of the written comments and 2) what are the key messages or significant themes within the written comments? Key ideas were collated across all provinces to identify significant themes within the national set.

Results: The sample included comments from 6,232 individuals aged 30 and older; 42.5% were completely positive, 29.7% were completely negative, 19.8% were mixed and 7.9% were neutral. Four broad themes emerged: 1) characteristics of a ‘positive’ experience, 2) personal care, 3) interaction with health care providers and 4) service delivery. Respondents cited being treated as an individual with respect and dignity, clear communication, access to relevant and timely information and care delivery that takes their needs into account as important. Communication, consistency and ongoing interactions with staff were highlighted as essential elements of a positive patient experience. There is still significant variation in the delivery of person-centered care as evidenced by negatively oriented comments.

Conclusion: Our results underscore the importance of having tools in place to ensure health care organizations have timely information about their patientsʼ concerns.

Biography:
Dr. Fitch has a Bachelor of Nursing (Dalhousie University) and Masters of Science in Nursing and Doctorate (University of Toronto). Dr Fitch is Professor (Adjunct) in the Lawrence S Bloomberg Faculty of Nursing and Professor in the School of Graduate Studies at the University of Toronto. Dr. Fitch is Editor-in-Chief for the Canadian Oncology Nursing Journal. She maintains a research program in supportive cancer care. Dr. Fitch was the Founding President of the Canadian Association of Nurses in Oncology and served as the President of the International Society of Nurses in Cancer Care.

The Efforts on using Online Video in Fundamental Nursing Skill Education

Masako Nakamura*, Mina Sakurai, Yasue Yamazumi and Ruriko Nakahara

Kyoritsu-Womenʼs University, Japan

Background: In Japan, the importance of nursing skill education is emphasized. Students used to watch DVD's of video which were educational material for improving their nursing skill. However, they do not watch the DVD's of video anymore, because of being accustomed to use smartphone and PC. For this reasons, we made educational online videos so that student can access whenever they want.

Purpose: In this research, we clarified the possibility and problems of using online video in fundamental nursing skill education.

Methods:

1. Researchers made videos of basic nursing skills with commentary narration.

2. The video was fixed with tripod and set up with 3 angle including overhead.

3. The nurse performed with student performance speed.

4. The video can be seen in the campus network system (kyonet).

5. Researchers asked the students about what they felt about the video.

Results: We made videos of over 40 fundamental nursing skills. The students can see the videos using smartphones on the campus network system. The student said, "The video was good and easy to understand visually" "It was good where we could see a model a number of times with the video" "It was nice to be able to confirm immediately with the video whenever I want". Conclusions: Fundamental nursing skills are contents that students learn for the first time. Students need to learn nursing skills in a short time. In order to improve nursing skills, it is necessary for students to practice repeatedly and also needs to see model performance. It is suggested that watching model videos on network systems by students is effective for improving nursing skills.

Biography:
Dr. Masako Nakamura has completed her Doctor of Sport Sciences from Waseda University Japan. She is an Associate Professor of Fundamental of Nursing at Kyoritsu-Womenʼs University Faculty of Nursing. Her interest are coaching in nursing, use of simulation in nursing and nursing education.

Conduct of Technical Test of Vital Sign Measurement by Animation

Yasue Yamazumi*, Mina Sakurai, Masako Nakamura, Shoko Takeyasu and Ruriko Nakahara

Kyoritsu Womenʼs University, Japan

This report is an educational practice report in which the technical examination of vital signs measurement was conducted by moving images of students' skills in the 2017 health assessment theory. At University A, using the in-house network system (Kyonet), we conducted class development by blended learning that combines e-learning in the unit of vital sign measurement. The vital sign measurement unit enables students to view audiovisual materials and materials for blood pressure measurement that feels particularly difficult on Kyonet and it is possible to take a picture of vital sign measurement among students and upload it to Google Drive.

I think that it was effective as a teaching method from the fact that the technical test by the animation was carried out, (1) reflection by watching self-practice, (2) patient feedback and peer feedback from the role of the observer were able to be performed. From now on, it is important to prepare a learning environment that understands the skills and difficulties that students are not good at and encourages repeated practice while identifying the individual achievement status.

Biography:
Yasue Yamazumi has expertise in Fundamentals Nursing. She is Senior Lecturer of Kyoritsu Womenʼs University. Education: 2009 Fukuoka Prefectural University, Nursing Education (MS). She is also a PhD student. Professional Experience: 1997-2009: Clinical training staff, 2009-2013: Assistant Professor, Adult Nursing, Fukuoka Prefectural University, 2013-2016: Senior Lecturer, Fundamentals Nursing, Division of Nursing, School of Medicine, National Defense Medical College.

Traditional vs. Flipped: A Study of Two Teaching Methodologies

Annette M Peacock-Johnson

Saint Maryʼs College, USA

Background: The flipped classroom is a teaching methodology that focuses on constructivism, incorporating asynchronous video lectures, reading assignments and other technology based resources outside the classroom while using problem-solving activities in the classroom.

Research Question: The objective of this project was to evaluate the effectiveness of the flipped classroom versus a traditional lecture / discussion teaching methodology on student learning outcomes for content on Diabetes Mellitus in a baccalaureate nursing program.

Methods: An independent samples t-test was used to determine if there was a significant difference in test scores between 51 students who participated in a traditional classroom versus 52 students who participated in a flipped classroom on content related to diabetes mellitus. Paired t-tests were used to determine if there was a relationship between quiz scores before, immediately after and 30 days later for students who participated in the flipped classroom experience. Lastly, students were surveyed to elicit feedback regarding the flipped classroom versus the traditional classroom teaching methodology.

Results: The mean for the studentsʼ scores in the flipped classroom group was 76.7 while the mean for the studentsʼ scores in the traditional classroom group was over four points lower at 72.6. This difference was not statistically significant (t-value = -1.77, df = 101, p = .08) but demonstrated practical significance. Results of the paired t-tests were significant across all three pairs and suggested that students continued learning from the flipped classroom immediately following and 30 days after the experience. Further, over 70% of students agreed that the flipped classroom learning activities facilitated their knowledge of the nursing care of individuals with diabetes mellitus.

Conclusion: While the creation of flipped classroom materials (recorded webcasts, unfolding case scenarios, etc.) was time intensive, statistical measures suggested that the flipped classroom teaching methodology was more effective in promoting student learning and retention than traditional classroom lecture / discussions.

Biography:
Dr. Annette Peacock-Johnson is an Associate Professor of Nursing at Saint Maryʼs College in Notre Dame, Indiana, USA, where she teaches graduate and undergraduate nursing students. She is a seasoned nurse educator who has presented nationally and internationally on topics related to nursing pedagogy. Her publications include articles on clinical topics including diabetes mellitus and nursesʼ perceptions of caring. Dr. Peacock-Johnsonʼs research interests include management of diabetes, perceptions of caring, relationship-based care and relational communication techniques.

Functional Decline and Hospitalization: Self Care in the Elderly and the Challenges of Rehabilitation

Armenio Guardado Cruz1* and Ana Claudia Coito2

1Nursing School of Coimbra, Portugal
2University Hospital Center of Coimbra, Portugal

The events of hospitalization in elderly people imply changes in the personʼs autonomy and leads to dependence situation, mainly in the area of self-care. The self-careʼs functional capacity can be affected by several factors, causing dependence and diminished quality of life.

Aim: To verify if there is a functional decadence to the self-care in old patients admitted in the Medicine Service BA of CHUC, looking at the functional capacity for the self-care in pre-internment, admission and discharge. The variables age, gender and hospitalization time were analyzed as possible factors influencing functional decline.

Methodology: A longitudinal observational study with repeated measures in an accidental non- probabilistic sample of 52 elderly patients hospitalized during July 15 and November 15, 2017. Data collection was performed with an adapted version of InterRAI-CA-PT (Amaral et al., 2014) applied at the time of admission and discharge, following all ethical-legal procedures.

Results: Functional decline was observed in hospitalized old patients between pre-internment, admission and discharge. The evaluations of AIVDʼs and AVDʼs showed global increase of dependence level during internment, being more evident this increase between pre-internment and admission (Z = -4,718 e p = 0,00; X2 = 45,852 e p = 0,00; X2 = 55,843 e p = 0,00). The variables age and hospitalization time shows a positive correlation with the increase of functional decline in discharge.

Conclusion: These results explain a need of a patientsʼ careful evaluation, through suitable mediation planning in order to minimize the impact in patientsʼ life hospitalization. In the promotion area of autonomy and functional decline minimization, the rehabilitation nurse must take the main role as a direct worker with patients through their specific skills, but also as a trainer in the nursing team improving actions which allow health gains. We suggest new studies that analyze the effectiveness of rehabilitation nurses' interventions in this area.

Biography:
Armenio Guardado Cruz is a researcher at the Health Sciences Research Unit: Nursing (UICISA:E) and coordinating research projects (promotion mobility to revent functional decline of dependent adult and elderly; promotion of the autonomy of people undergoing health transition processes). He is a supervisor of masterʼs dissertation in rehabilitation nursing and occupational health. He is an author of several scientific publications and communications in National and international meetings and congresses. He has completed his PhD in University of Extremadura, Spain (2007), Master in Occupational Health, Coimbra University (1996), Graduation in Nursing (1988) with a specialization in Rehabilitation Nursing (1989), Postdoc in Nursing, Rio de Janeiro State University (2015).

Assessing Clinical Judgment in Pre-Licensure Nursing Students

Mary Wcisel

Saint Mary's College, USA

Nursing clinical is a very complex environment for students and faculty. Students are required to apply classroom concepts to their assigned patient, who often have more than one diagnosis. It is difficult for students to identify how one diagnosis may impact another diagnosis. The challenge for clinical faculty is to assess that students are providing safe patient care. In addition, it is the responsibility of the clinical faculty to assess that students are developing clinical judgment.

Two strategies, concept mapping and individual conferences, are utilized to assess the clinical judgment of nursing students. In the development of the concept map, the student is required to organize and establish relationships between the patientʼs diagnoses and chart data. During clinical, the student and the faculty meet to discuss the concept map. The student explains the concept map, including the data that supports the medical / surgical diagnoses. In assessing clinical judgment, the student discusses the patientʼs current and / or potential complications (s) and the specific data that supports the development of the complication (s). How would the student know that the complication was occurring? What action would the student take? If an intervention was implemented, how would the student assess the effectiveness? What data would support the effectiveness of the intervention?

Comments from students and clinical faculty on the concept maps and the clinical conference have been extremely positive. Studentsʼ have commented that the clinical conferences helped them “put all the pieces together”. The clinical faculty identified that they were able to assess the strengths and limitations of the studentʼs clinical judgment. It also provided an opportunity for the clinical faculty to implement strategies to improve clinical judgment in weaker students.

This presentation will discuss the benefits and challenges of concept mapping and individual clinical conferences in assessing clinical judgment in pre-licensure baccalaureate nursing students.

Biography:
Mary Wcisel is an Associate Professor of Nursing at Saint Mary's College in Notre Dame, Indiana, USA. She began her career teaching in a practical nursing program and then moved to an associate degree program. For the past 18 years she has been teaching in a baccalaureate program. In her current position, she teaches physical assessment and fundamentals to sophomore students and an advanced medical-surgical course to senior students. Mary is also interested in developing strategies to assist students in passing the nursing licensure exam.

Emergency Department Fall Reduction

William G Zic

Saint Xavier University, USA

Current literature suggests that a multitude of fall prevention methods, practices and tools exist and are widely available for organizations to choose from.

Goal: The main goal of the project was to reduce or eliminate falls by implementing a customized set of AHRQ patient fall reduction guidelines in the ED.

PICOT: For adult patients age 18 and over in the ED at West Suburban Medical Center, how can the implementation of AHRQ Patient Fall Reduction Guidelines, compared to current practice, effect patient fall outcomes, over an 8-week time period?

Method: Falls in the ED were calculated using a standard patient fall calculation method (number of patient falls x 1000 / number of patients seen in the ED). The KINDER 1 Fall Risk Assessment Tool was used to identify patients at risk for falls. Prior to implementation of AHRQ guidelines, the average annual fall rate was 1.06%. The fall rate percentage at the completion of this project was 0.30% over an 8-week time frame from (January 6, through March 2, 2019). During project implementation, one (1) total patient experienced a fall. The number of patients meeting KINDER 1 fall risk assessment criteria was 328 (n=328) out of 3,323 (n=3,323) adult patients (1 in 10). Patients age 17 or younger were omitted from project participation. When a patient was identified as a fall risk, additional standard patient fall interventions were also implemented (beds in lowest position, fall risk wristband and non-skid socks applied to patients).

Results / Outcomes: Fall rate comparison (quarterly 2018 vs. project implementation) showed, with a 95% confidence interval, no major change in fall rate percentages during the length of this project. However, there was a definite downward trend that was well established.

Nursing Implication: Additional research is needed to compare quarterly fall rates, perhaps using AHRQ recommendations, over an extended period of time in order to better understand underlying causes that contribute to patient falls in the ED across various health systems.

Biography:
William G. Zic has been in the Professional Nursing Industry for more than 20 years. His background includes: Critical Care (CVICU), ED, Critical Care Transport (Air and Ground), Nursing Leadership as ICU Manager and most recently, Academia as Professor of Nursing.

New Modalities in Nursing Education Inter-Collaborative Education

Maryann Godshall

Drexel University, USA

New methods of delivering nursing education are needed in todayʼs complex healthcare environment. Traditional methods of teaching facts, student memorization and testing to determine learning are not adequately preparing nursing students for the practice environment. A major obstacle new graduate nurseʼs face is communicating, working with and collaborating with other disciplines. One method to bridge this gap is developing inter-collaborative experiences for medical residents, nurses and other disciplines while in school. An inter-collaborative simulation experience delivering “bad news” and discussing palliative care options to live standardized or simulated patients (SPʼs) will be discussed. Conclusions found were that all participants felt this experience enhances their ability to interact with patients, families and work with other disciplines collaboratively. This experience created life-long experience and skills new nursing professionals can utilize in the practice environment.

Biography:
Dr. Maryann Godshall, PhD, RN, CNE, CCRN, CPN is an Assistant Clinical Professor at Drexel University College of Nursing and Health Professions. She obtained her BSN from Allentown College of St. Francis DeSales and her MSN from DeSales University. She has a post-masterʼs degree in Nursing Education from Duquesne University, Pittsburgh, PA. Dr. Godshall completed her PhD at Duquesne University. Her research topic was “Exploring Learning of Pediatric Burn Patients through Storytelling”. Dr. Godshall has worked in Adult Medical-Surgical Telemetry and comprehensively in pediatrics. She continues working in Pediatric Critical Care and Pediatric In-patient Rehabilitation nursing. She has been a nurse for over 25 years. She holds certifications in Pediatrics, Pediatric Critical Care and as a Nurse Educator. She has been teaching for over 15 years in both the university and hospital settings. Dr. Godshall is co-editor of The Certified Nurse Examination (CNE) Review Manual (2016) and wrote Fast Facts of Evidence Based Practice, 3nd Ed (2016); Springer Publishing Company”. She has numerous publications and speaks both nationally and internationally on a variety of topics including nursing education, pediatrics and her research with pediatric burn patients.

The Lived Experience of Integrating Emotional Intelligence (EI) in an Advanced Practice Nursing Program

Kimberly Garcia

Drexel University, USA

Advanced practice psychiatric nurses are facing increased stress levels and burnout due to the shortage of psychiatrists in the United States. Nursing faculty are charged with preparing students for the reality of clinical practice. Psychiatric nurses are particularly vulnerable to emotionally charged encounters, as they work with individuals experiencing chronic mental health disorders. In order to meet the needs of their patients, it is expected that psychiatric nurses will maintain their own wellbeing. One way to meet this need is to integrate emotional intelligence (EI) in the nursing curriculum. EI facilitates the ability to accurately identify emotions in oneself and others, use emotions to facilitate reasoning, understand emotions and manage emotions in oneself and in stressful situations. Experts have questioned whether EI can be taught or developed. Research suggests that training programs focusing on EI increase feelings of control and competence. High EI is also associated with lower stress and burn out. Teaching concepts related to EI offers many benefits to psychiatric nurses. Not only can they enhance their own understanding of their emotional triggers and responses, they can use the information in clinical practice, helping patients to enhance their own self-awareness. As a result, patients can seek timely mental health treatment when their symptoms become more pronounced.

The Relationship between Organizational Learning and Individual-Level or Ward-Level Organizational Socialization: A Cross-Sectional Survey on Acute Hospital Nurses

Keiko Ishii*, Yukie Takemura, Naoko Ichikawa, Keiko Kunie and Ryohei Kida

The University of Tokyo, Japan

Objective: This study aimed to investigate the association between individual-level or group-level organizational socialization (OS) and Organizational Learning (OL) sub processes: information acquisition, information distribution, information interpretation, information integration and organizational memory.

Methods: A cross-sectional study using anonymous self-report questionnaires was administered to 1077 nurses at 34 wards in two university hospitals in Japan from August to October 2018. OS and OL were measured using existing scales. Multi-level analyses using two-level hierarchical linear modeling (HLM) with fixed effects were conducted. Individual-level OS was analyzed using group-mean centering and ward-level OS was analyzed using each wardʼs average OS score. Individual-level OS and ward-level OS were used as independent variables, OL sub processes as a dependent variable and personal characteristics and critical thinking of each nurse as covariates.

Results: Excluding responses with no indication of consent and missing responses of both OS and OL scales and 10 wards with response rate under 50%, 466 nurses from 24 wards were analyzed. The average target number of nurses for analysis in each ward was 18.1. Although the estimated coefficients of OS were small, individual-level OS was positively and significantly associated with all organizational learning processes. On the other hand, ward-level OS was positively and significantly associated with information interpretation, information integration and organizational memory.

Conclusion: Although it is necessary to increase individual-level OS to foster all OL processes, ward-level OS also needs to be heightened to foster the three sub processes that come after information interpretation. Specifically, in order for members to convert newly generated knowledge into explicit knowledge, understand it as ward-wide common knowledge and establish it as a routine in the ward, it may be desirable to maintain a high ward-level as well as individual-level OS (282).

Biography:
Keiko Ishii, RN, MHS, is a doctoral student in the Department of Nursing Administration, Graduate School of Medicine, The University of Tokyo. After completing her undergraduate courses, she worked as an RN in two university hospital in Tokyo for 10 years. Based on her clinical experiences, she believes that organizational learning is effective for the development of nursing organizations. She is interested in organizational dynamism, the interaction between groups and individuals within medical organizations and knowledge management. The current study is based on her experience, where changing the organization and routinization of evidenced-based-care is difficult in a team with members who have acquired high organizational socialization.

Human Trafficking and How Nurses can make a Difference

Alicia L Shields

Shields of Light and Grand Canyon University, USA

Human trafficking is a global issue and nurses can make a difference. According to the International Labour Organization (2017) there were 40 million people in 2016 who were victims of modern slavery. It is also estimated that “88% of trafficking victims access health care during their trafficking situation” (The Polaris Project, 2019). The problem is that clinicians are not thinking about human trafficking and often do not even know what to look for. The goal of this talk is to bring awareness to a global audience about human trafficking, discuss the different types of trafficking, make attendees aware of nursingʼs role in human trafficking, signs to look for and who to contact. In this presentation we will also look at anti human trafficking efforts around the globe and our role as nurses. The audience will be introduced to a variety of organizations involved in prevention and recovery and will be given ideas on how to get involved in prevention efforts.

Biography:
Alicia Shields is a masters prepared registered nurse who has a passion for anti-human trafficking efforts. She volunteers for anti-human trafficking organizations, is a Certified Anti Human Trafficking Advocate and was appointed by the City of Phoenix Mayor to the Mayors Anti Human Trafficking Task Force. Alicia has spent the last 5 years as a Chief Nursing Officer and is now currently teaching at the University full time. Alicia also has a healthcare and leadership consulting business. More than anything, Alicia loves spending time with her husband and three young children. Even her children are involved in anti-human trafficking efforts and as a family they make bracelets, sell them and donate the money to anti human trafficking organizations.

Closing the Gap: Health Care Facility Staff and Patientʼs Awareness of and Attitudes to Implementation of Electronic Medical Records (EMR)

Riaz Akseer1*, Dhillon K2, Tan E3, Alhosani M1, Hossain MM2,4, Lim SHE1,2 and Jamaludin A1

1Abu Dhabi Womenʼs College, United Arab Emirates
2Perdana University-Royal College of Surgeons in Ireland, Malaysia
3RCSI Royal College of Surgeons in Ireland, Ireland
4Hamdard University Bangladesh, Bangladesh

The Electronic Medical Record (EMR) is an electronic filing system that manages patientʼs medical records from numerous sources comprising clinical data archives, laboratory reports, clinical decision algorithms, specific medical vocabulary, as well as pharmaceutical and clinical documentation submissions. These records may be accessible in the organisation with multi-level accessibility based on user-dependent authentication. As the system provides an organised and integrated patient-specific medical history, it enables healthcare professionals to make better diagnosis and provide quality care services.

The aims of this study was to understand the global perspective of EMR and its implementation as well as to locate the gaps of knowledge that still exists in understanding EMR in patients as well as hospital staff.

All major bibliographic databases such as PubMed and Google Scholar and several specialist datasets such as PsycINFO, MEDLINE and EBSCOhost. from the previous 10 years (2007-2017) was employed in our search. Citations of papers that used a reference standard was incorporated for assessment of quality.

Our findings indicated a divergence between patients' expectations and actual practice. Patient concerns were that practice staff other than doctors had ready access to their medical records in addition to non-medical information. Assumption of confidentiality was expected to be maintained by indifference, however, personal control over access and content in general was not seen as a replacement for a good face-to-face explanation. In the event if patient confidentiality is not maintained, especially in an electronic environment, litigation against healthcare organisations will increase rapidly as patients become increasingly empowered to question procedures in medicine.

Security of information can be achieved through good modelling procedures, end-user training and refresher courses must be done more often and finally controls of access will need to be implemented via passwords and digital signatures.

Biography:
Dr. Riaz Akseer is an MD-PhD, he is currently working as a Division Chair / Assistant Professor of Health Science in Abu Dhabi Womenʼs College, Higher Colleges of Technology. He is also an adjunct Professor at Health Sciences Department, Brock University St. Catharines, Ontario, Canada. Dr. Akseerʼs research is focused on patient centeredness and evidence based medicine. In addition to teaching and research, Dr. Akseer also has several years of clinical and healthcare management experiences in national and international levels.

Managing Dental Emergencies, Identifying Oral Cancer and Improving Oral Health Outcomes

Kimberly Dexter

George Mason University, USA

This presentation is completed and been developed to teach both registered and dental nurses how to manage dental emergencies and identify oral cancer. It will provide a review of oral anatomy including dentition, gingival tissues and oral landmarks. Attendees will also learning how to identify oral cancer, provide assistance and proper referral for an evaluation. The session will cover other important patient education topics such as teaching the proper dental hygiene techniques for mandible or maxillary factures and managing incidents of avulsed teeth.

Purpose and Target Audience: The educational session has been developed to provide dental and nursing education to both registered and dental nurses. It is applicable to clinical operations, academic departments, students and leaders.

Keywords Step: Keywords in this presentation will be dental, trauma, emergency, oral cancer, avulsed teeth, facial fractures, patient management and outcomes.

Learning Objective #1: The participants will be able to name dentition, gingival tissue and dental landmarks within the oral cavity.

Learning Objective #2: The attendees will be able to identify the manifestations of cancer in the vestibule.

Learning Objective #3: The participants will be able to describe the proper oral hygiene techniques for patients with mandible and maxillary fractures.

Learning Objective #4: The attendees will be able to teach their patients how to manage avulsed teeth incidents from facial trauma or accidents.

Abstract: This presentation has been developed to teach advanced practice, registered and dental nurses on how to manage dental emergencies and identify oral cancer. It will provide a review of oral anatomy of dentition, gingival tissues, oral landmarks and include dental terminology. It is important that all of these health professionals know this information as it is prudent to the documentation of patientsʼ chief complaint (s). Advanced practice, dental and registered nurses must be able to describe the existing or presenting problem. Effective interprofessional communication is essential to improving patientsʼ outcomes. Attendees will learn how to identify oral cancer and assist the patients with a properly written referral for an evaluation. The World Health Organization (WHO) reported, there is an estimated 657,000 new cases of oral cancer and more than 330,000 deaths every year. As healthcare providers, we should be promoting oral cancer self-screening examination to be conducted by the patients at least once a month. Healthcare professionals should be completing oral cancer examinations at every medical and dental visit. The course session will cover how to manage dental trauma events or life threating emergencies. Along with providing patient education on topics such as: teaching the proper dental hygiene techniques for mandible or maxillary fractures and management of avulsed teeth. The National Institute of Health (NIH) reported approximately 30 million children and adolescents are involved in sports annually in the United States. The impact of dental injuries can be significant. More than five million teeth are avulsed in the United States every year. Treatment is estimated to cost at a total $500 million annually. Dental trauma patients should be evaluated in the dental office instead of the hospital emergency departments. An avulsed tooth can be treated by a dentist and re-implanted can occur if the tooth been properly handled. The expected outcome is to prevent tooth loss caused by improper management at the time of injury. Patients may call the dental or medical office asking how to handle this type of incident. Advanced practice, registered and dental nurses should be able to triage the patient, provide dental education and assist with obtaining emergency services.

Biography:
Mrs. Kimberly Dexter is both a registered dental hygienist and nurse in the United States. She has many years of experience in both professions. Highlights of her career are: She managed and worked in dental clinics for over thirty years. Specifically, Virginia Commonwealth University Health Systems Medical Dental Clinic and creating their dental electronic medical record. She has worked in various specialties in nursing including jails. At Prince William County her role was the managing health authority and nurse manager. Now she is currently working as a mental health nurse at a Crisis Stabilization Unit at a local Community Service Board and a Doctorate Primary Mental Health Nurse Practitioner student at George Mason University School of Nursing (graduation date 5/2020). Institution organization name: Epsilon Zeta Sigma Theta Tau International Chapter

The Implementation of a Synchronous Telemedicine Platform Linking Off-Site T Pediatric Intensivists and On-Site Fellows in a Pediatric Intensive Care Unit: A Feasibility Study

Mahmoud Nadar

University of Quebec Outaouais, Canada

Objective: The aim of this study was to assess the feasibility of implementing a synchronous telemedicine platform in a pediatric intensive care unit (STEP-PICU).

Method: A prospective mixed study was conducted. Two sources of data were mobilised: A survey with structured questionnaires and direct non-intrusive observation.

The study site was the PICU of a university hospital. Usersʼ perceptions of six aspects of the STEP-PICU were studied: Telemedicine system quality, data quality, quality of technical support, use of the new system, overall satisfaction and system benefits.

Results: During the 6-month experimentation period, use of the telemedicine platform was rather limited and fell short of the promoterʼs expectations. The mean scores for the six user perception dimensions were low, with no differences between the two groups of users. A Mann-Whitney test showed that being an off-site pediatric in- tensivist or on-site fellow did not make a statistically significant difference in responses on system quality (p = .518), data quality (p = 1.00), quality of technical support (p = 1.00), system use (p = .556), overall sa- tisfaction (p = .482), or benefits (p = .365). The low use of the STEP-PICU was attributed to three root causes: Human factors, the platformʼs functionalities and technical problems.

Biography:
Mahmoud Nadar research interests lie in the area of using new developments in telemedicine technologies to provide whole-person care. He is interested in investigating the use of different information and communication technologies to bridge geographic distance and improve healthcare delivery for the elderly, for people living at home with chronic and life-threatening illness and for persons having undergone surgery. He examines the feasibility of integrating a tele-health program in the current healthcare system. This includes the development of a combination of interventions targeted at the patient, the family, healthcare providers and the healthcare organization. The goal of the program is to provide access to quality care and to improve patientsʼ and familiesʼ quality of life. An important part of this program of research is exploring how an interpersonal relationship can be developed using a video-conferencing approach.

Registered Nurses Attitudes Toward and Evaluation of the Internet for Seeking Health-Related Information (HRI)

Shahrazad M Ghuzlaan

Jordan University of Science and Technology, Jordan

Background: The Internet would help nurses to access online databases, in addition to evidence-based, practice-related information. The Internet is an infinite source of information, upon which anybody can post and upload information. Therefore, the health-related information searching process might be misleading and might lead to incorrect, inaccurate or out-of-date information. Nurses should be capable of evaluating the online evidence, in order to effectively and safely integrate it in their practice.

Purpose: The purpose of the study was to assess RNs' internet use for seeking health-related information and their attitudes towards doing so. The current study also aimed to assess RNsʼ evaluation of the internet HRI.

Method: A quantitative, descriptive, cross-sectional design was utilized. A convenient sample of 300 Jordanian RNs participated in the current study. Participants were recruited from different public, private and university hospitals in 6 Jordanian Governorates, using a structured self-reported questionnaire.

Results: The results revealed that 74.0% of the studyʼs participants used the Internet for seeking health-related information, while 9.7% did not use the Internet at all. Of the internet-using RNs, 95.7% held positive attitudes towards using the internet for seeking health-related information.

Among the Internet-using RNs, only 36.3% thought that, in general, most of the information they found on the Web was credible. While, about 61.5% thought that only some of the Internet HRI was credible. The criteria which nurses relied on to evaluate the retrieved HRI varied. Criteria included checking the author (50%), websites last date of update (50%), affiliation from a well-known organization (28.2%), availability of citations (1 participant). Some RNs evaluated the retrieved information based on their knowledge (20.5%) and area of practice (31.6%). Google ranked the first among the websites used to retrieve HRI with 44.6% of nurses, while online databases were used by less than 10% of RNs. Evidently, fewer RNs were aware of specific criteria for evaluating the internet HRI.

Conclusion: Jordanian RNs are in need of further coaching and training regarding evaluation criteria of Internet HRI. Improving nurses computer and Internet capabilities can be achieved by integrating the roles and the collaboration of administrators, researchers and educators / trainers. The findings of the current study can be used as the basis for future studies in the field of Nursing Informatics, especially in Jordan.

Biography:
Shahrazad M. Ghuzlaan, is a clinical nurse educator, graduated from Jordan University of Science and Technology with a masterʼs degree in Acute Adult Care Nursing. For the past 10 years, she worked in Private Sector Cardiology and Oncology hospitals in Jordan in addition to Nursing Education in Saudi Arabia. Her experience also included clinical nursing, academic, NGO and ACLS training fields. A part-time trainer at JET for Training & Consultation. An active member at Sigma Nursing-Psi Kappa Chapter. Recently, she joined Jordan Paramedics Society for OCHA & UNHCR Projectsʼ Referrals. Presented “Towards a less stressful Nursing workplace” at Madridge Conferences-Nursing 2017, Barcelona, Spain.

Policy Makers Position on the Implementation of Social Support for Women during Childbirth

Olabisi Fatimo Ibitoye1*, Phetlhu D.R2 and Gloria Thupayagale-Tshweneagae1

1University of South Africa, South Africa
2University of the Western Cape, South Africa

Background: Promoting respectful care at childbirth is key to improve quality of care and promote utilization of maternal and child health services. Women generally gave birth surrounded by family members and with the support of other women, but with the movement of birth to the hospitals, this valued tradition was lost and women became subject to and dependent on medical technology and hospital routines trample on natural birthing process and has contributed to low utilization of maternal health care services in the pubic health facilities among other factors in Nigeria .

Aims: The study examine the hospital policy makerʼs perceptions and attitudes to Continuous Labour Support (CLS) of women choices in public health facilities in the South-West region of Nigeria

Method: This qualitative, exploratory and descriptive study involved Nurse/Midwives (n = 45) and 14 hospital policy leaders selected in seven public health facilities in Ondo state, Nigeria. Focus group discussions and individual interviews were conducted until data saturation occurred. Data was analyzed through Teschʼs method of thematic analysis yielding 3 major themes and 6 subthemes.

Results: The study findings reveal only occasional/discretional practice of CLS in the public health facilities, lack of policy and guideline for its implementation was also reported. The study participants expressed a positive disposition to CLS introduction and use women preferred person or persons from their social networks based on beneficial effect to all stakeholders. However, CLS implementation in public health facilities in Nigeria will depend largely on the formulation of policy statement regarding CLS and complete overhauling existing infrastructure with adequate measures to address other challenges identified in the study.

Biography:
Dr. Olabisi Fatimo Ibitoye is currently a postdoctoral research fellow at the University of South Africa, Pretoria. She has worked as an educator lecturer and a former vice principal at the school of midwifery, Ministry of Health, Ondo State Nigeria. She also served in the capacity of the state facilitator for the Mandatory Continious Proffessional Development Programme (MCPDP) for Nurses in Ondo from 2016- 2018. She bagged her PhD in Nursing from the University of Western Cape, South Africa in 2017. Her research focus and interst is in Maternal, Child and Adolescent health.

Usage of Medicinal Plants amongst the Khoisan Community in Campbell: Griqualand West, South Africa

David D. Mphuthi* and Abel J. Pienaar

University of South Africa, South Africa

African indigenous people, together with their healers, rituals and medicines have been around since time immemorial and is it estimated that over 80% of the African native population use indigenous medicines to meet their health care needs (WHO, 2003). Study followed qualitative approach and data was collected using “lekhgotla”. Two themes emerged during data analysis which was done following the thematic data analysis.

Themes that emerged were (1) Heritage and relationship of community with medicinal plants and (2) Usage and preparation process of medicinal plants.

The results revealed that there has been a prolonged engagement of the community and the medicinal plants. The community has the trust on the plants more than the western medicine. The results also revealed the trust and reliance on the nature and cosmos by these native nation. It was also revealed that although the western science can doubt the measurements of indigenous people, to them they are so real and scientific. The harvesting and preparation of medicinal plants cannot be done by anyone but the person chosen by the spirits.

In was concluded from the study that, the indigenous people have been using their own way of treating the sick since time immemorial. Their belief system cannot be changed or influenced by the western approach. The trust that has been built by these nation, about the indigenous medicinal plants, is deep and cannot be eradicated but it has to be respected.

Biography:
David started his nursing career in 1992 when he completed the bridging course leading to Registration as a general nurse. In 1998 completed Diploma in Midwifery. In 2000 completed the Diploma in Nephrology. In 2004 completed the B,Cur (Ed et Adm) OHN. Complete M.Cur (Health Services Education) in 2010. Completed PhD (Nursing) in 2016. David has also a vast experience in teaching as he taught in several institutions like NMMU (UPE), Baragwanath Nursing College, PfundzoNdenzhe Nursing College (Carletonville), Wits University and now Senior lecturer at UNISA. He has presented oral and poster papers in several conferences. David has also been part of the panel discussions and chaired several conferences. He is also currently supervising masters students of which three have completed. He has published some articles in journals and also has contributed a chapter in a book titled “Handbook of Research on theoretical perspectives on Indigenous Knowledge Systems (IKS) in developing countries”. David is now the president of Renal Care society of South Africa.

An Analysis of Scores Obtained by Undergraduate Nursing Students using Poster Presentations as the Assessment Method

Johanna McMullan

Queens University Belfast, UK

Background, including underpinning literature and wherever possible, the international relevance of the research

Poster presentations are being used increasingly as a method of assessment in nursing (Davis, 2000). Although published accounts of their use are scant in this country, there is evidence that the method stimulates a positive attitude to learning (Halligan, 2007), facilitates applying the theory of research and nursing to the practice setting (Conyers & Ritchie, 2001) and enables the development of transferable skills which will ultimately serve to enhance care delivery (Handron,1994).

The authors module contains a poster presentation summative assessment worth 20%. The group consists of undergraduate first year students who are studying general adult nursing and several “branch” students who in second year will branch into childrenʼs, mental health, learning disability nursing and midwifery. McMullan (2016) found the students enjoyed the poster presentation and found it developed many skills that were beneficial to their development as a nurse such as communication and literature critique However, this study also raised students concerns, the main being that marking was subjective and “it depended on who marked you” as to whether you got a high score or not, a common opinion held by students, the literature would suggest (Falchikov, 2013). Secondly, students revealed they believed that mature students would do better as they had more of the skills necessary for a good presentation from previous life experience, that females would find this an easier task than men and that branch students would get better scores than their general adult nurse colleagues.

Despite employing clear marking criteria (Tisi et al, 2013) support for new markers and a robust internal and external moderation of marks which is regarded as good practice (Bloxham, 2009) we were still faced with uncertain reliability and certainly a lack of faith in the robustness of the marking by students (Bell, 2013). An extensive search found no literature whatsoever that investigated the scores awarded from poster scores except for scant reporting of claims of reliability based on the spread of marks (Jackson, 2000, Huntley-Moore, 2005).

Aim(s) and/or research question(s)/research hypothesis(es)

The aim of this paper therefore is to investigate marks awarded following poster presentations through statistical analysis of variables which could influence the reliability of scores as discussed.

1. There is no statistically significant difference between the scores obtained by students in various “branches” compared to other students.

2. There is no statistically significant relationship between the age of the student and the score obtained.

3. There is no statistically significant difference between the scores awarded by various markers.

4. There is no statistically significant relationship between experience of marker and the score awarded.

5. There is no statistically significant difference between the scores obtained by males and females.

Research methodology/research design, any ethical issues and methods of data collection and analysis

The scores awarded to the September 2018 (n = 362) curely. Scores were analyzed using various tests with SPSS:

Ho 1: ANOVA

Ho 2: Spearman.

Ho 3: ANOVA

Ho 4: Pearson correlation

Ho 5: Independent T-test t

Biography:
Johanna McMullan clinical background in acute care. She practiced in the Emergency Department, Intensive Care and as Bed Manger to the level of Senior Sister in St. Georges and East Surrey hospitals in London. She has been in Education since 2002 working as an NVQ assessor in the Belfast Trust and in Queens as Lecturer in Education since 2004. She teaches life Science to both undergraduate and postgraduates and specializes in Trauma and Emergency Care. Her area of research interest is Education especially assessment, student experience and users and careers involvement.

Screening Program for Cervical Cancer is it a Need in Bahrain?

Jameela Mukhaimer

University of Bahrain, Bahrain

Cervical Cancer is one of the most curable disease if discovered in early stages, screening for detection of cervical cell changes is a simple testing called Pap-smear. Cervical screening by Pap-smear is preventive practice for women, it will aid in identifying the abnormal cell changes or infections. In Bahrain the cervical screening found to be law, even when it offered free of charge for all postnatal and annual well women exam by Ministry of Health (Mukhaimer.J, 2009). Thus, studying the pattern of cervical screening result is warranted to identify the need for women heath program.

Methods: This is a retrospective study using patients chart review for private primary health care center, it is aimed to identify the result of the cervical screening and the percentage of abnormal pap-smear for all women attending post-natal and annual well women examination over a period of 4 years from 20015 to 2019.

Results: A chart review for 190 women who attended postnatal and well women clinic, 74.2 percent were for annual examination, while 25.78 percent were for postnatal examinations. It showed that 58.42 percent had abnormal cervical cell results; 39.47 had normal cervical cell and 2.1 had CINI

Conclusion: More than 50% of the screened women had abnormal results, annual well women percentage for screening was higher than postnatal screening which indicates the demand for annual cervical screening program.

Recommendation: There is a need for women health program that includes cervical screening for all women as well as specialty clinic to continue the management and follow up care. Additionally, its essential to conduct a larger scale studyin Bahrain to study the Bahraini women practice of cervical screening.

What Makes A Scholarly Leader?

Samy A Azer

King Saud University, Saudi Arabia

With the changes to curricula and the changes introduced to the profession, one might wonder what constitutes scholarship in nursing education. Scholarship in nursing education is neither about completing a degree in health profession education nor is it about demonstrating excellence in teaching. Instead, a scholarship is a continuum of progressive achievements. Productivity in scholarship means the generation of new knowledge and the advancement of practices in the profession. The work environment is vital for enhancing scholarsʼ skills, engagement and longevity. Organizational culture is essential for cultivating scholarship and the development of leadership. In this keynote lecture, I will attempt to define what is meant by scholarship and identify measures by which one can demonstrate scholarly achievements. While the scope of scholarship at one time focused on teaching and research, this model has been expanded to include new domains. Contribution to educational scholarship has to be public, available for critical review and accessible for other scholars. In this keynote lecture, I will redefine scholarship, discuss domains contributing to scholarship and explore emerging challenges facing scholars and scholarly work in health professions including nursing.

Biography:
Professor Samy Azer is an Australian physician and medical academic and educator. He was honoured to contribute to medical education in several countries. He graduated with a Bachelor in Medicine and Surgery and completed his training in gastroenterology and hepatology in the 80s. He obtained PhD from the University of Sydney in hepatology and a Master in Education from the University of New South Wales. He is a Fellow of the American College of Gastroenterology and obtained a Master of Public Health from the University of New South Wales. He is a Fellow of the Royal Society of Biology and a Fellow of the Royal Society of Medicine.
He was a Senior Lecturer in Medical Education at the University of Sydney from 1997 to 1998 at that time the university was introducing a new PBL program. Then he was invited to join the University of Melbourne from 1999 to 2006 to support the team in medical education unit introducing the new PBL program and changing the curriculum.
He is a Visiting Professor of Medical Education at the University of Toyama, Japan and has helped the Faculty of Medicine in establishing its Medical Education Unit. He was Professor of Medical Education and Chair of Medical Education Research and Development Unit, Faculty of Medicine, Universiti Teknologi MARA, Malaysia from 2007 to 2009. During that time he was a key element in helping the Faculty to be ready and prepared for accreditation of its program. The program was credited for 5 years and the university was the first to be credited in Malaysia.
Professor Azer was a consultant to the Victorian Postgraduate Medical Foundation (VMPF), Australia. He has been invited to review curricula in Medicine, Nursing, Dentistry, Pharmacy, Occupational Therapy and Speech Pathology.
He is Professor of Medical Education and the Chair of Curriculum and Research Unit at King Saud University College of Medicine and has played a significant role in introducing the new curriculum and preparing the College for accreditation. The program was accredited for 7 years in 2011. Professor Azer has been invited as a keynote speaker to conferences in Australia, South East Asia, Sweden, Turkey, the Middle East countries and the United States. He has over 100 original articles published in international journals most of them are on medical education. He authored four textbooks on Medical Education. He is Editor at PLOS ONE, United States, Editor at MEDICINE, the United States and on the Editorial Board of BMC Medical Education, the United Kingdom and a Topic Editor of Frontiers in Medicine, a partner of Nature Group, Switzerland.

Depression in Patients with Cardiovascular Disease

Heidi Winslow

University of North Carolina at Wilmington, USA

Depression is common among patients with cardiovascular disease. This evidence-based project was designed to evaluate the impact of a practice improvement intervention for screening and referrals in cardiac patients with depression. The American Heart Association Advisory Council recommends depression screening, treatment and support to provide adequate diagnosis, treatment and follow-up to patients. Cardiac rehabilitation (CR) is a coordinated effort of structured treatments including depression screening of patients upon admission. The problem is current depression screening and referrals are not being documented electronically in the CRsetting limiting real-time communication amongst the healthcare team. Descriptive data (number of patients screened, positive screens documented and number of appropriate referrals completed electronically) were collected and evaluated. This project successfully implemented a new electronic Patient Health Questionnaire 2-9 (PHQ2-9) depression and referral screening document flow sheet. A 30-day post intervention chart audit revealed a 97% documentation improvement rate for PHQ2-9 surveys. 11% of the patients screened positive for moderate depression. 27% of those patients received a documented referral. Improving the current charting system to an electronic charting system should enhance communication between members of the cardiac multidisciplinary team to improve patient care. Further research and staff education need to occur to align patients with moderate to severe depression with a referral. The overall goal of this project was to provide the best evidence for practice improvement in depression care for patients with cardiac disease.

Biography:
Heidi Winslow is working as full-time Lecturer at the University of North Carolina at Wilmington School of Nursing. In addition to teaching, she is staff registered nurse in the Cardiac Rehabilitation Unit at New Hanover Regional Medical Center in Wilmington, NC. Her research interests are using technology to improve depression in patients with chronic medical conditions.

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