Day 1 :
Keynote Forum
Naznin Esphani
; University of Maryland School of Medicine
Keynote: Constipation/Silent Constipation: A Potential Killer, although Under/Never Addressed
Biography:
Naznin Esphani, MD has completed her M.B.B.S from Madras University and postgraduate studies from Howard University, and Fellowship in Palliative Medicine from University of Texas MD Anderson Cancer Center. She is an associate medical staff in Hospital Medicine at Anne Arundel Medical Center and Clinical Assistant Professor at University of Maryland School of Medicine. She has presented several papers, at both national and International Conferences, and has several published articles.
Abstract:
Constipation is a common digestive complaint , and often distressing to patients, Patients, many a time a time, may be oblivious to the fact that they are silently and gradually mounting excessive colonic fecal retention/impaction despite everyday bowel movements. Patients with constipation/ silent excessive colonic fecal retention ± fecal impaction (ECFR ± FI) may not only experience heavy symptom burden, and impaired quality of life but the economic burden due to constipation, and/or its potential complications, on the patient, caregiver and the healthcare industry is enormous. Constipation/silent constipation, if left untreated/undertreated, may potentially cause catastrophic complications, or maybe lethal. A retrospective chart review on 100 patients with gastrointestinal symptoms showed that of the the 100 patients enrolled who were found to have significant coprostasis on abdominal xray, 54 (54%) did not complaint of constipation. Radiologists reported evidence of coprostasis in only 56% .Of the 64 (64%) patients who were treated for coprostasis, 24 (24%) were probably adequately treated, 26 patients were inadequately treated, and 14 patients were probably inadequately treated. Constipation/Silent Constipation and/or its potential complications ought to be prevented, and considered in the differential diagnosis for any gastrointestinal symptoms (or constipation equivalent symptoms), and appropriately addressed. Health professionals from all disciplines including clinicians, nursing staff, nurse auxiliary, , need education, on the simple tools to prevent evaluate, diagnose, and manage constipation/silent constipation appropriately. Constipation has to be revisited and clinicians/medical residents/students/nursing students/nursing staff, other ancillary medical staff has to get familiarized with term “ Silent Constipation. An interdisciplinary approach may be needed to manage constipation/silent constipation.
- Patient Safety, Patient Safety Factors, Patient Safety & Nursing Education
Chair
Naznin Esphani
University of Maryland School of Medicine
Session Introduction
Visanth V.S
All India Institute of Medical Sciences, Patna, India
Title: Protocol development on Evidence-based guidelines for management of signs and symptoms of respiratory tract infections in children
Biography:
I am Hansmukh Jain working as Assistant Professor cum Principal& Nursing Superintendent at All India Institute of Medical Sciences Patna, under Ministry of Health Family Welfare Government of India. As Researcher Reviewer & Member of National advisory Board in International Journal of Pediatric Nursing, Member of National Journal of Geriatric Teaching and Administration both in hospital and Nursing Education as Master Trainer(TOT) Strengthening Midwifery Education In Bihar, By JHAPIEGO USAID, Master Trainer for Basic Life Support Course at All India Institute OF Medical Science Patna, Member of Editorial Board, Member National Editorial Advisory Board International Journal of Pediatrics Nursing,
Abstract:
Respiratory tract infections in children are one of the most common reasons for parents consulting health professionals. Nurses have an important role in managing children with RTIs. Nurses are the first healthcare professional to come into contact with children and their parents in their hospital setup. Management of RTIs will enable the nurse practitioner to manage RTI. The objective of the need assessment is to assess the knowledge of care givers regarding management of signs and symptoms of respiratory tract infections in children and prepare the evidence-based guidelines for RTIs. Study among 10 nursing officers working in pediatric ward of AIIMS Patna. Structured interview schedule was administered to collect the data. For developing evidence-based guidelines, systematic review was done to know the pathway to manage the signs and symptoms of RTIs in children revealed that majority of nursing officers 60% had poor knowledge, 30% had average knowledge and 10% had good knowledge regarding signs and symptoms of RTI in children. Based on the results, i.e. situational analysis and systematic review evidence-based guidelines for management of signs and symptoms of respiratory tract infection in children developed. Clinical practice Guidelines are systematically developed statements of appropriate care designed to assist staff nurses to make decisions about appropriate health care for specific clinical circumstances. Evidence-based nursing practice is the integration of best research evidence with clinical expertise and patient values. KEY WORDS: -RTI, EBP, Knowledge, guidelines.
Karishma Lalani
Mediclinic City Hospital , Dubai, UAE
Title: Improving the quality and efficacy of nursing handover in an ICU by using ISBAR
Biography:
Karishma has completed her BScN in 2008. She has over 8 years of international critical care experience. She has worked at different nursing positions ranging from bedside to clinical instructor. She is currently working as a Registered Nurse in ICU at Mediclinic City Hospital Dubai. She has been involved in various research projects at hospitals she worked and has a few publications as well.
Abstract:
Introduction:
Nursing handover is a critical component of health-care quality and safety. According to WHO & JCI, 2007, a handover is the process of passing patient-specific information from one caregiver to another for the purpose of ensuring patient care continuity and safety. According to Riegel, 2005, nursing handover is a system of nurse-to-nurse communication between shift changes intended to transfer essential information for safe, holistic care of patients. The nursing handover process is considered to be a crucial part of providing quality care in a modern healthcare environment (Pothier et al. 2005) and the quality of a report given may delay an individual nurses ability to provide care for up to 1 to 2 hours (Hansten, 2003). SBAR is a structured method for communicating critical information that requires immediate attention and action contributing to effective escalation and increased patient safety. SBAR can also be used effectively to enhance handovers between shifts or between staff in the same or different clinical areas.
Purpose:
To asses, how ISBAR can help in improving the quality and efficacy of handover in an ICU.
Method:
A systematic review of research articles from 2009-2016 was performed.
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 ISBAR can help in managing information and deliver safe handovers. Its implementation can reduce errors significantly and improve patient outcomes.
K. M. Yacob
Marma Heatth Centre,Kochi ,Kerala,India
Title: Why W neurons decreases and C neurons increases in fever?
Biography:
A practicing physician in the field of healthcare in the state of Kerala in India for the last 30 years and very much interested in basic research. My interest is spread across the fever , inflammation and back pain,. I am a writer. I already printed and published nine books in these subjects. I wrote hundreds of articles in various magazines.
After scientific studies we have developed 8000 affirmative cross checking questions. It can explain all queries related with fever
Abstract:
As you aware, if temperature increases (Absence of fever)after 31 degree Celsius , Warm sensitive neurons increase their firing rate and inhibit Cold sensitive neurons as core temperature increases. As temperature drops, the firing rate of Warm sensitive neurons decreases, reducing their inhibition, and Cold sensitive neurons which respond by increasing their firing rates.
On the contrary to increase of temperature, in fever the firing rate of Warm sensitive neurons decreases, the firing rate of Cold sensitive neurons increases as core temperature increases. inhibit warm sensitive neurons. The temperature increasing and decreasing controlled by the brain. The firing rate of Warm sensitive neurons and Cold sensitive neurons also controlled by the brain.
Melissa Pennington
Meritus Medical Center 11116 Medical Campus Rd. Hgerstown
Title: Organization-Wide Initiatives to Improve and Prevent Workplace Violence
Biography:
My name is Melissa Pennington and I hold a bachelor’s degree in nursing. I am board certified through the ANCC in medical surgical nursing, and certified though ONS to administer chemotherapy to cancer patients in the United States of America. My desire to help end workplace violence stemmed from an incident that occurred when my med-surg unit was threatened with mass violence via firearms. Following the incident, I spoke up. I was chosen to sit on the American Nurses Association Forum to End Nurse Abuse and sit on the workplace violence forum at the Meritus Medical Center.
Abstract:
Statement: Workplace violence by patients and visitors toward healthcare staff has increased significantly in recent years. Approximately 20% of workplace violence incidents are reported by staff due to time constraints and fear of retribution. Increased violence has led to higher rates of turnover, burnout and an unhealthy work environment. Ultimately it impacts the quality of care by reducing patient satisfaction and the potential for patient harm.
Methodology: An interprofessional approach was utilized to develop a comprehensive plan for reduction of workplace violence incidents across the organization using an “All hands on deck” process. A Workplace Violence Forum was established with representatives from nursing, administration and non-nursing departments.
Solution:The workplace violence prevention plan and timeline was developed and included the following strategies: 1) employee de-escalation education and training, 2) visitor badging and wanding system, 3) enhanced security and sheriff coverage in the emergency department and main hospital lobby, 4) badge reader entry for the critical care unit, 5) redesigned ED behavioral health area, 6) revised workplace violence, family presence and visitation policies, 7) updated patient rights and responsibilities and 8) community and staff education on workplace violence.
Findings: Post–implementation of the violence prevention strategies the rate of employee workplace violence incidents decreased to 0.64 per 1000 patients days/visits by June 2018 with continued sustained improvement. The “All hands on deck” process introduced a culture of safety housewide and the workplace violence prevention plan increased reprting of violent incidents, decreased burnout and created a healthy work environment.