51^st World Nursing Leadership & Healthcare Management Conference October 04-05, 2018 Moscow, Russia

Biography:

Ziva Ariela Barel-Shoshani has five academic degrees. She has graduated B.Sc. in Mechanical engineering and M.Sc. on Agricultural engineering at the Technion -Israel Institute of Technology,  B.A in Psychology and MBA in the Open University of Israel, and M.A. in Art Therapy from Haifa University. Now she is in the final stages of her PhD studies of the School of Health and Welfare Sciences at Haifa University. The theme of her doctoral dissertation is the emotional implications in body image drawings of survivors of brest cancer. She is working as an Art therapist. And teaches physics, gifted high school students.

Abstract:

Background and Objective: Breast cancer is the most common cancer in women in Western society. Advances in medicine and technology have led to a significant reduction in the mortality rate. In many cases women with breast cancer are compelled to undergo surgery, which causes distortion or even complete removal of the breast. Hence, it is important to address the psychological consequences, especially focused on the body image, of the disease and surgery in breast cancer survivors.

Materials and Methods: The participants were 80 breast cancer survivors. The Machover Draw-A-Person (DAP) test was administered twice: first they were asked to draw themselves today, then they were asked to draw themselves as they had seen themselves pre-illness. The features in the self figure drawings of the participants who underwent different kinds of surgery were compared.  The features in self figure "today" were compared to those  in the pre-illness figure for each subject.

Results: Three indicators in the drawings distinguished significantly between the drawings of participants who underwent different  kinds of surgery: figure height, mouth, and breast signs. Four drawing indices (body outline, eyes, hands, hair ) indicated differences in self-perception pre-post cancer in the group who underwent lumpectomy, and two drawing indices (breast, hair) in the group who underwent mastectomy.

The findings in the conservation surgery group indicate anxiety, connection to self, and need for social communication. In contrast, in the mastectomy group there were more indications of interest in appearance and difficulty in speaking about their cancer.

Conclusions: It is suggested that the Machover Draw-A-Person test is a projective tool that could be used as an aid for planning supportive care for alleviating the distress of breast cancer survivors as part of a rehabilitation program.

Note. Some of the findings will be reported in the PhD thesis of the first author, conducted under the supervision of the second author; some have already been published and others are in the process of being prepared for publication.  

Biography:

Ramathuba D U pursued her PhD at North West University, RSA. She is currently an Associate Professor in the Department of Nursing at the University of Venda, RSA. She is a Registered Professional Nurse, Oncology Nurse and a Nurse Administrator. She has published more than 25 papers in reputed journals and has been reviewing manuscripts from reputable journals and presented papers nationally and internationally.

Abstract:

Background: Providing optimal care to critically ill patients poses challenges in resource poor settings due to the lack of equipment, inadequately trained personnel and limited infrastructure.

Purpose: The study explored challenges experienced by health care professionals working in resource poor intensive care units.

Methodology: A qualitative, explorative, descriptive design was used. The population comprised nurses and doctors working in intensive care unit of an hospital in the Limpopo province of South Africa. A purposive sample was selected at the participating hospital. Data were collected by means of 17 semi-structured interviews. Data were analyzed using Tesch`s method. Ethical considerations were included.

Results: Some deserving patients were not admitted to the intensive care unit due to the limited number of available beds. Nurses acted beyond their scope of practice due to a lack of adequately trained intensive care specialists. Enrolled nurses were nursing ventilated patients due to lack of intensive care trained staff. Faculty equipment was used and “used once” pieces of equipment were reused.

Conclusions: Health professionals face these challenges due to lack of resources, poor communication between staff and family; poor decision-making in poor resource settings resulting in moral distress and depersonalization. Interventions to address these challenges are necessary in healthcare setting by provision of resources and building capacity of the work force in intensive care units.

Biography:

N S Mashau has completed her PhD at the University of Venda in 2014. She is a Senior Lecturer in the Department of Public Health - University of Venda. She has published more than 15 papers in reputed journals and has been serving as an Editorial Board Member of Repute.

Abstract:

Transactional sex which is characterized by exchange of money or gifts for sexual relationships is considered sexual risk behavior because it exposes people engaging into this type of relationship to sexually transmitted infections, unwanted pregnancies and other health risks. Transactional sex is increasingly becoming common amongst students at tertiary institutions of learning. The aim of the study was to explore the perceptions of university students regarding transactional sex and its effects on health in South Africa. A qualitative approach which was exploratory, descriptive and contextual in nature was used to understand the perceptions of students regarding transactional sex. Purposive sampling technique was used to select participants. Data was collected using in-depth interviews and data saturation occurred after interviewing 18 participants. The findings revealed that university students perceive transactional sex as a material based relationship, prostitution, immoral behavior and abusive relationship. The findings further revealed that factors such as socio-economic status and peer pressure influence students to engage in transactional sex. The youth are regarded as a vulnerable group and therefore transactional sex has far reaching public health consequences.  It is of utmost importance for the communities and the government to promote sex education from early childhood at schools, churches, community gatherings and households.

Biography:

Imtiaz Ahmed has more than five years of experience in teaching, training and mentoring. He is familiar with various methodologies in teaching and exploring political sciences and other disciplines at undergraduate level. In his teaching, he is struggling to provide equivalent academic support to internal and extramural students. His research field is the management attitude and enforces him to research in the field of management and his research work is based on the determination of new ideas and skills in the branch of management. He is the member of research seminar committee in G C Mandi Bahauddin.

Abstract:

In this paper we introduce cognitive considerations for value-based strategy network. By studying some mental models of strategic developers, it creates a cognitive value-based network. This latest system can provide outcomes in several situations different from what would be predicted by the classical framework. It also helps to identify certain cognitive abilities that some firms could possess or can develop those which would allow them to increase their competitive advantage as well as some unexplored properties of strategic positions that would affect the capability to generate competitive advantages. Generally, it provides a network that allows for easier incorporation of insights from the cognitive sciences into central questions of strategy.

Biography:

Sisinyana Hannah Khunou pursued her PhD at North West University, RSA (2017). She has eleven years of teaching experience at the Nursing College and the university. Currently she is a Lecturer at University of South Africa, teaching Health Service Management. She has published four articles in accredited journals.

Abstract:

Newly qualified nurses in South Africa (RSA) are mandated to perform compulsory community service for a period of one year. The community service nurses (CSN) are allocated at different public health facilities in the South African provinces including the North West province (NWP). Several studies were conducted in other provinces regarding mentoring of the novice CSN. However there was little publication and documentation pertaining to mentoring of the CSN in NWP which is mostly rural and resource challenged. Convergent parallel mixed method design was used to collect data from CSN regarding their mentoring in NWP. In this study, both quantitative and qualitative data were collected, analyzed and merged to get corroborative results regarding mentoring of the CSN in NWP. The CSN sample size for quantitative and qualitative methods were 224 and 28 respectively. Merged results revealed a need for mentoring of CSN; possible benefits of mentoring; factors that enhance mentoring; factors that inhibit mentoring. Recommendations were done.

Biography:

Abstract:

Background: Nursing handover represents one of the basics of classical nursing practice. Recently, however, several authors have expressed dissatisfaction with the nursing handover process, arguing that much of the information transferred is either corrupted or lost during the handover, with obvious detrimental consequences for the quality of care.  Hence, research and practice yearn for studies that enlighten our understanding of the ways to improve nursing handover. Two main theoretical approaches have been suggested for investigating nursing handover: standardization and resilience.  Standardization calls for consistency in the processes and contents of nursing handover. In comparison, resilience is a more proactive approach, which focuses on nurses' anticipation of changes, constant attention, course corrections, reassessment, monitoring and feedback. This research focuses on the latter approach.

Research aims: The main aim of the current study was to understand the process of nursing handover from the perspective of the nurses participating in the handover.  More specifically, our aim was twofold: First, to identify the goals of handover from the perspective of the participating nurses; and second, to identify the cognitive, emotional and behavioral strategies nurses use when receiving and handing over shifts, which allow them to manage the information in the best manner for the benefit of the patient's care and safety.

Methods: This research employed qualitative methods. Fourteen nurses, males and females, who worked at Rambam Medical Center in Haifa, Israel, participated in the study. Sampling strategy assured that participants would represent nurses from different clinical fields, seniority, roles and clinical experience.  Research participants were interviewed individually through semi-constructed in-depth interviews. All interviews were recorded and later transcribed. Data analysis was done through content analysis.

Findings: Content analysis revealed three major themes. The first referred to the goals of nursing handover. This theme focused on the declared versus the actual goals of the handover prevalent in the ward. While all the participants emphasized the importance of the declared goals, they at the same time described how these goals were informally shaped to create goals "in practice", which had better, conform to the nursing handover. The second theme referred to the ward's personal and interpersonal factors influencing the nursing handover. This theme related to personal factors such as the nurses' seniority and reputation, interpersonal factors such as trust among staff, and handover characteristics such as work load and interruptions. These factors were often involved in the handover process, turning the handover goals into attainable ones. The third theme referred to the strategies which the nurses develop and operate to bridge the gap between declared and actual goals, and thus to better respond to the goals of the nursing handover, as they perceive it. This theme is divided into two subthemes: (1) handing over strategies and (2) receiving strategies.

Discussion: The findings of the present research are pioneering in terms of identifying the handover strategies, which nurses develop to strike a balance between efficiency and workload, on the one hand, and maintaining the quality and safety of care, on the other hand. Nine forecasting strategies were mapped. Nurse Handover strategies focused on recalling strategies aimed at recalling what the nurses perceived as the crucial information for handover. Strategies for receiving shifts focused on identifying "red warning lights" that enable receiving nurses to optimize care and to mark those cases, which require further inquiry, to develop an improved care map.

These strategies are discussed in line with theories that relate to practical and professional knowledge development. In line with this body of theories, it seems that these strategies, which were developed based on nurses' clinical knowledge, experience, clinical judgment, and intuition, enable nurses to develop the ability to foresee negative events. Nevertheless, like all heuristics, they are vulnerable to error.

Conclusions and implications: The present research have important theoretical and practical implications. The research identified nine forecasting strategies that are employed by nurses during the handover were mapped. Future research should examine the effectiveness of these forecasting strategies in preventing errors, on the one hand, and on maintaining the quality of care, on the other hand, so that they could be recommended for comprehensive practice.  Furthermore, similar research can be conducted in other medical centers and on larger populations of nurses to hear more voices and identify more strategies. Furthermore, the findings of the present research have important implications for nursing practice. First, they emphasize the importance of verbal, face-to-face nursing handover at the patient's bedside. Under these circumstances, nurses can compare the different sources of information (e.g., the information provided at the handover with personal impressions from the patient, along with written records), which allow them to turn on "red warning lights" in case of inadequacy. Second, the findings highlight the gap between the information nurses wish to receive and the information they wish to hand over. While the handing over nurses emphasized the importance of standardized pattern for delivering information, the receiving nurses were not interested in consistent and complete information; they wished only to receive the most crucial information.  Hence, it is recommended to consider changing the pattern of nursing handover, so that it is less constructed, thus enabling the receiving nurses to pose questions to the conveying personnel. Third, the research findings imply that the lack of common mental models among nurses regarding the information that must be transferred during the handover creates a lack of trust and lowers the credibility of the conveyed information.  Fourth, our research emphasizes the importance of nurses' practical knowledge and experience. Therefore, one needs to invest more in improving nurses' theoretical knowledge for their practice to be more evidence based.

Biography:

Ilana Kan pursued her MA Degree at the University of Haifa (Israel). She is the Head Nurse of Orthopedic Outpatient Clinic and a Vice Head Nurse of Ambulatory Outpatient Clinic at Rambam Health Care Campus, Haifa, Israel.

Abstract:

Leadership for quality means making it possible for everyone, every day to do better job with greater satisfaction, learning from and with their colleagues in order to improve services. It is crucial that every organization will have a framework to support ongoing quality improvement and patient safety. Nurse involvement is essential to any significant healthcare improvement initiative. As nurse leader managers and organizers, we should support our staff in developing knowledge, skills and attitudes in quality improvement and safety, by providing the learning and development opportunities or activities suitable for their role. Quality and safety are rooted in the daily work of all staff at the facility. At Rambam outpatient clinics, we establish a framework for placing nursing on the frontlines of transforming healthcare. Our goal is to provide safe care and services based on scientific evidence practice to all patients. We take efforts to ensure that all clinical plans are based on individual patient preferences, needs and values. To achieve this goal we put focus on transformational leadership at all levels of nursing. We engage and empower nurses to act as leaders in ensuring high quality patient care. We train our nurses to be leaders who can create and implement programs, products, environments to meet the patient population needs. Our strategy is to provide organizational learning opportunities for individual leaders (head nurses of outpatient clinic) and leadership teams (clinical mentor) in order to create tools and programs for all levels of nursing. For example, a training program for better compliance of hand hygiene. We create appropriate assessment tools for ongoing analysis of the current state of knowledge amongst all medical teams, quality of fulfillment of medical records and applying core principles. Staff meetings, nurse research and poster presentations provide educational platforms and involve all outpatient clinic nurses in the leading process.

Biography:

Miri Foox pursued her MA Degree at University of Haifa (Israel). She is the Director of the outpatient clinic of Rambam Health Care Campus. She worked as Head Nurse in Orthopedic Department during 1999-2014; Trauma coordinator (1996-1999) and as Deputy Head Nurse in General Surgery Department (1990-1996).

Abstract:

The head nurse manager provides leadership and is responsible for the management of the outpatient clinics and ensuring high quality patient care; provides guidance and direction to junior staff and is resposible for organizing, directing, coordinating and supervising activities for the care of patients. Other roles include the development of personnel, ensuring compliance with regulatory and professional standards, strategic planning and fostering of interdisciplinary collaborative relationships. The head nurse manager oversees formation and usage of the budget, implemention of standard care and standards of practice. This position allows for flexibility in determining priorities, programs and procedures within the framework of hospital healthcare mission, goals and objectives. We would like to present several examples of leadership and managment as follows. 1. assessment of patients: in order to ensure high quality care, treatment and follow up protocol. All out patient clinics started to use common settings for evaluation of different patient factors and conditions. In addition, every outpatient clinic performed unique assessments for its patients. For example: questionnaire for the assessment of violent behaviors in the gynecology clinic, a diabetic foot assesment for orthopedic clinic or depression assessment questionnaire for immunology clinic. 2. patient safety goals: In order to provide accurate and effective communication and collaboration, author started to use a standardized report format with adaptation for unique needs and goals for every outpatient clinic. 3. patient and family education: to better understand their medical condition and participate in their own care, we strive to inform and teach our patient a topic every month. For example, a new technology of cross linking for the ophthalmology clinic, new drug generation for patient with HCV, common allergen for allergy clinic. 4. quality improvement: Our aim is constantly to make real improvements that help patients. We investigate how processes can be more efficient, resources can be used more wise and physical risks can be reduced. Our quality program includes routine patient satisfaction surveys and questionnaires. For example, after analysis and validation of survey data we changed the appointment letter for outpatient clinics all over the country. 5. staff qualifications and education: As the coordinator of all out patient clinics at the hospital, the head nurse manager identifies the number and types of staff needed based on the hospital goals and recommendations. All the various out patient clinics work as a team in order to improve skills, knowledge, education and previous work experience. For example, training in BLS, ACLS and the use of sedation. In addition, providing skills for patient group direction or the breaking of bad news.

Biography:

Nadirbekova G E has completed Semipalatinsk Medical School. After graduation from the medical school, she began to work as a Nurse in the department of septic surgery. She has been working as a Nurse then as a Chief Nurse of the operative units at the cardiac surgery departments from 1994 till 2010. She is currently a Nursing Director at the JSC "National Research Center for Cardiac Surgery" since 2010. She has many awards for her professional merits; for selfless and noble work; devotion and love of medicine in Kazakhstan and special merits in the matter of protecting the health of population of the Republic of Kazakhstan.

Abstract:

Aim: The aim of this paper is to illustrate experience and management system of nurses’ working in National Research Center for Cardiac Surgery and its changing from 2012.

Materials & Methodology: To increase the effectiveness of nursing work at the base of the National Research Center for Cardiac Surgery the nursing project was established with following methods: Uniform work standards; Narrowed direction of nurses’ training; Sharing a clear teaching of manipulation; Continuous training; Feedback and Communication skills. In other words, there were several implementations like mobile application with information on nursing standards, psychologist consultation on personnel, constant assessment of knowledge and skills of nurses, testing and supervision of the implementation of procedures, daily training at the workplace.

Results: As a result, of our methods of organizing nursing work, we have received competent and qualified members of a multidisciplinary team. The result of the satisfaction survey before the implementation of project in 2012 was 70% (540 people), and after the project in 2017 it was 91% (621 people), doctors’ satisfaction with the nurses’ work before the project was 67% (78 people), after the project it was 91.5% (82 people), nurses’ satisfaction with their work before the project was 57% (198 people), after the project it was 87% (230 people). From the analyzed results of the study, after the implementation of the project, several errors in work related to the human factor and lack of knowledge has decreased.

Conclusions: The methods which are used to organize the work of the nursing service have helped to improve nursing processes and have contributed to the effective work of the multidisciplinary team and the reduction in the number of medical errors.

Biography:

Dale M Hilty, Associate Professor at the Mt. Carmel College of Nursing. He received his PhD in counseling psychology from the Department of Psychology at The Ohio State University. He has published studies in the areas of psychology, sociology, and religion. Between April 2017 and April 2018, his ten research teams published 55 posters at local, state, regional, national, and international nursing conferences.

Abstract:

Introduction & Aim: While completing a senior level course emphasizing the importance of interprofessional communication among health care professionals, Bachelor of Science in Nursing (BSN) Students academic learning was assessed across four time periods.

Method: 1^st assessment: Pre-test regarding the role and function of 10 health care professionals (Advance Practice Nurses, Chaplains, Ethicists, Interpreters, Occupational & Physical Therapists, Pharmacists, Registered Dietitians, Respiratory Therapists, Social Workers and Physicians); intervention 1: six or seven students formed small groups and selected one of the ten health care professionals. Students wrote a paper focusing the historical basis, education, training, legislative concerns, holistic specialization and license/certification. Students presented the paper to the class prior to submitting it for a grade. 2^nd assessment: intervention 2: a guest speaker from each of the 10 professional disciplines visited the class and shared the scope of practice, unique contributions, working relationships with Registered Nurses and holistic recommendations. 3^rd assessment: intervention 3: students assumed the role of a Registered Nurse in an interprofessional simulation including the patient, family and the 10 licensed professionals. 4^th assessment: intervention 4: in an educational intervention (Hilty Gill-Rocha, Ross, Hinze, & Clark, 2018; Hilty, Hinze, & Clark, 2018), the researchers found the Affective Domain Questionnaire (ADQ) consisted of three common factors with coefficient alpha reliability estimates ranging from 895 to 931.

Results: The first timed assessment measured changes in learning based on intervention 1. Using SPSS 25, the dependent t-test findings showed significant differences on the three ADQ common factors comparing data from Assessments 1 and 2 (questions evaluated term paper and class presentation). The second timed assessment measured changes in learning based on intervention 2. Significant differences were found comparing Assessments 1 and 3 (questions evaluated guest speaker presentations). The second timed assessment measured changes in learning based on intervention 3. Significant differences were found comparing Assessments 1 and 4 (questions evaluated the interprofessional simulation). All differences were significant at p=.001. Coefficient alpha reliability estimates are presented in a table.

Biography:

Dale M Hilty, Associate Professor at the Mt. Carmel College of Nursing. He received his PhD in counseling psychology from the Department of Psychology at The Ohio State University. He has published studies in the areas of psychology, sociology and religion. between April 2017 and April 2018 and his ten research teams published 55 posters at local, state, regional, national and international nursing conferences.

Abstract:

Study 1: The participants were approximately 500 Bachelor of Science in Nursing (BSN) students in an undergraduate program.

Hypothesis 1: Using SPSS 25, the exploratory principal axis factor analysis (EPAFA) was used to determine if the ADQ multi-dimensional construct (i.e., two or more common factors). Hypothesis 2: Determine if the reliability estimate(s) would be greater than 80 for engagement common factors.

Study 2

The participants (N=111) were senior level BSN students in an undergraduate program.

Hypothesis 1: There would be a difference between the Hilty (2017) competitive greatness (high and moderate-low scoring groups) when compared to the ADQ common factors (SPSS 25, Independent t-test).

Results

Study 1

Hypothesis 1: The EPAFA found three common factors accounting for 58% of the variance. The first factor combined the questions measuring the Krathwohl et al., (1964) theoretical categories of 2.1, 2.2, 2.3, and 3.1. The second factor groups the questions measuring the theoretical categories 3.2, 3.3, 3.4, 4.1, and 4.2. The third common factor assembled the questions measuring the 5.1 and 5.2 categories. Hypothesis 2: The coefficient alpha reliability estimates were greater than .80 (First Factor 895; Second Factor 931; Third Factor 896.

Study 2

Hypothesis 1: The competitive greatness (CG) scale was used to divide the nursing student sample into two groups. The high scoring CG group (N=62) and the moderate-low scoring group (N=49) had comparable numbers of students. Independent t-test (N=111) analyses found significant differences between the two CG groups and the second factor (p=.032) and the third factor (p=.001). There was no significant difference between the two CG groups and the first factor (p=.141).

Krathwohl, Bloom, and Masia's (1964) Taxonomy

Biography:

Dale M. Hilty, Associate Professor at the Mt. Carmel College of Nursing.  He received his PhD in counseling psychology from the Department of Psychology at The Ohio State University.  He has published studies in the areas of psychology, sociology, and religion.  Between April 2017 and April 2018, his ten research teams published 55 posters at local, state, regional, national, and international nursing conferences. 

Abstract:

Workplace bullying is one of the most harmful social stressors in organizations” (Trepanier, Fernet, & Austin, 2013, p. 123).  Long-term project goal is to develop a quantitative battery of scales to identify individuals likely to engage in workplace bullying behavior.   A comprehensive assessment would include interpersonal influence , coping, anger, teamwork, and conflict scales  which may provide  reliable and valid psychometric data.

This study is the first phase examining interpersonal influence and coping instrumentation.  Carver, Scheier, and Weintraub (1989) proposed four  coping scales which can be used to assess workplace bullying: denial (refusal to acknowledge stressor), behavioral disengagement (goal attainment reduction), mental disengagement (goal achievement distracted thinking), and restraint (not acting prematurely).   Glaser (n.d.) developed assertive, passive, openly aggressive, and concealed aggressive scales which were selected from the Interpersonal Influence Inventory. 

Participants were Bachelor of Science in Nursing undergraduate students who completed the questionnaire consisting of the  four Carver et al. (1989) coping scales and the four Glaser (n.d.) interpersonal influence scales.

• Hypothesis 1: Relationship among assertive, denial, and behavioral disengagement.
• Hypothesis 2: Relationship among passive, concealed aggressive, and mental disengagement. 
• Hypothesis 3: Small correlations among the openly aggressive, concealed aggressive, mental disengagement, behavioral disengagement, and restraint.
• Using SPSS 25, Pearson correlational analyses was used to determine the relationship among the Carver et al. (1989) and Glaser (n.d.) scales.  Coefficient alpha reliability estimates would be calculated for each scale.

Results

Hypothesis 1: Correlational analysis revealed the denial coping scale (-.388, p=.002) and behavioral disengagement coping scale (-.357, p=.005) were negatively correlated with assertive scale.  Hypothesis 2: The passive was positively correlated with mental disengagement scale (.264, p=.04).  A significant

positive coefficient was found between the  passive and concealed aggression scales (.367,  p=.004).  Hypothesis 3: Correlation coefficients among the openly aggressive, concealed aggressive, mental disengagement, behavioral disengagement, and restraint ranged from .193 to -.039.

The reported findings suggest the interpersonal influence  scales (assertive, passive, concealed aggressive, openly aggressive) and coping scales (denial, behavioral disengagement, restraint) offer a preliminary step toward developing a battery of scales designed to assess workplace bullying.