2nd World Congress on

Nursing

November 28-30, 2016, Abu Dhabi, UAE

Scientific Programme(Day 1 : Nov-28-2016)

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Keynote Speaker

Janine E. Janosky
University of Michigan-Dearborn, U.S.A
Title: Population and community health-centered innovations for workforce preparation and public health and healthcare systems

Biography: Janine E. Janosky, Ph.D. serves as the Dean of the College of Education, Health, and Human Services at the University of Michigan-Dearborn and a Professor of Health and Human Services. Dr. Janosky is an expert in achieving impactful health initiatives and in implementing higher education programs and initiatives. Previously, Dr. Janosky served as the Vice President and lead of the Center for Clinical and Community Health Improvement at Austen BioInnovation Institute in Akron (ABIA). Through her leadership, a national model focused upon public-private-philanthropic partnerships was developed and implemented, named an Accountable Care Community. Her work was recognized in Forbes and had earned her a White House Champion of Change recognition. Also, Janine served as the Vice Provost for Research at Central Michigan University where she led the effort to facilitate research opportunities, administer intellectual property activities, direct university commercialization endeavors and technology transfer activities, and develop innovative educational programs. Prior to joining Central Michigan University, Dr. Janosky served in a number of academic and administrative roles at the University of Pittsburgh. These included serving as the Executive Director of the University of Pittsburgh School Of Medicine’s Center for Primary Care Community-Based Research, an entity she envisioned and created.

Abstract: An overarching goal in the health community is to foster and develop social and physical environments that promote wellness and good health for all, in addition to high quality healthcare delivery systems. An important consideration in working toward this goal is addressing the impact of social determinants, including economic stability, education, social and community context, health and health care, and the neighborhood and built environment. The focus of this presentation will be on the development and implementation of higher education health and wellness population and community-centered academic education and training programs for workforce preparation. Typically academic programs are designed as subject-specific and didactically focused. Through academic innovation, these include experiential, problem-based, and service-learning as well as known concomitant determinants and interactions that together impact wellness and good health. This presentation will provide the context for the interrelationships of these determinants, the need for workforce preparation, the benefits and challenges of these programmatic approaches, as well as anticipated near future careers and professions.


Keynote Speaker

Harrison Applin
Northern Lakes College, Canada
Title: Nursing graduate entry-to-practice competency, curriculum methodology and the application of competency in caring for clients and their families

Biography: Dr. Harrison Applin PHD, RN is an academic leader and researcher with skillsets specializing in strategic and workforce planning, comprehensive institutional planning and education spanning across post-secondary institutions, industry, government, and health systems in Canada. As the chief academic and operations lead as Dean, Health and Human Services and The Center for Teaching and Learning at Northern Lakes College he is inspired to support competent, motivated and successful student outcomes for sustainable workforce and communities. His academic research focuses on competencies in nursing with expertise in applied research, academic research, practice outcomes, curricula and leadership. His current research includes: Induce Hypothermia Post Cardiac Arrest Critical Care : Brain Cooling Study at The Royal Alexandra Hospital, Alberta, Canada, Indigenous Health in Rural Northern Communities in Alberta, and Integrating the Community Health Promotion Professional in an authentic-land based Cultural Seminar. Dr. Applin is an indigenous person who speaks with passion and respect.

Abstract: Nursing-graduate competence is necessary to ensure safe, ethical, and legal practice for clients across their lifespan. Methods such as problem-based learning (PBL) and non–problem-based learning (NPBL) are used in nursing education to bridge the gap between theory and practice and improve graduate competence. The objective of this research was to compare the differences in competence between graduates from a PBL nursing program and those from an NPBL nursing program. This study involved a convenience sample of 121 nursing graduates in Alberta, Canada, who had been practicing for at least six months in a graduate role and whose nursing program utilized a PBL or an NPBL curriculum. The data-collection instruments included self-reports, and the data analysis involved descriptive statistics (mean, mode, and median) and inferential statistical tests (t tests and ANOVA) to determine the differences in the two groups’ mean scores. There was no statistical significance in the mean scores between the two groups, which indicates no difference in entry-to-practice competency preparation after the completion of a four-year nursing program. The teaching method may be perceived as an important variable for change and support for the graduate’s competence; however this study indicates no difference between PBL and NPBL course-delivery methods. The significant finding is that all four-year nursing programs in Alberta that use PBL or NPBL support CARNA’s entry-to-practice competencies. The graduates were asked how their nursing program prepared them to meet the competencies listed in the questionnaire, and the following themes emerged from the data: PBL—critical thinking, evidence-based practice, competencies as evaluation tools, self-directedness, and teamwork; and NPBL—clinical practice, competencies as evaluation tools, and critical thinking.


Integrating Caring for Families in Nursing Education
Session Chair:
Patricia Chesser-Smyth
Waterford Institute of Technology, Ireland


Session Introduction

Sheila A Ryan
University of Nebraska Medical Center, USA
Title: How to best teach transformational leadership to nursing students

Biography: Professor, Charlotte Peck Leinemann and Distinguished Alumni Endowed Chair, and Director of International Programs at the University of Nebraska Medical Center College of Nursing. Expertise focuses on helping faculty and students expand opportunities with internet-based education, quality improvement of health-care delivery models and international partnerships. International nursing partner projects are or have been with Jiao Tong University in Shanghai, China, Al-Zaytoonah Private University in Amman, Jordan, and with schools of nursing in Yerevan, Armenia and the Central Asian Republics (CAR). Dr. Ryan has served as President of NLN, an executive officer for AACN. Additionally, she has served in leadership roles of several foundation programs: PEW Health Education Commission, RWJ/IOM Health Policy Fellowship Program, Commonwealth Fund for Nurse Executive Fellowships and Macy Foundation for Interprofessional Education. Dr. Ryan is a member of the Institute of Medicine and a fellow in the American Academy of Nursing and has served on many programs and committees for the past two decades. She was a nursing dean for 22 years at two universities and has board service with IHI, IBHI and RJW/IOM committees. She was formerly Chair of the Board of AIHA, American International Healthcare Alliance, Chair of the Board For Institute for Behavioral Health Improvement, IBHI, and serves on the board for GEDI, Global Educational Development Institute

Abstract: Aim of the study/ Purpose: Report on active learning strategies to teach transformational leadership to graduate nursing students. Introduction in brief: Nursing students have been taught leadership theories and skills for decades in almost all levels of nursing education. Traditional methods have included didactic content about leadership, professional organizations, roles and management activities. As an occupation, nurses are traditionally effective at taking orders, following orders and controlling for order. Yet to participate as transformational leaders, students are better served with action strategies in 1) practicing group engagement and collaboration, 2) exercises in innovation and creativity and vision, 3) risk-taking not risk avoiding and 4) the art of pattern recognition and self-organizing, not controlling for order. Procedures/ Methods: Examples for each of the four activities will be described briefly. Students in this three year trial include PhD and DNP beginning their studies in a shared course. No distinction is made between or among them for expectations or outcomes. Outcome activities include a shared presentation about improving the health outcomes of one ethnic minority group; an Innovation exercise about marsh mellows, a purpose paper and a brief commitment description to one transformative clinical change. Results: Student course evaluation comments will be shared. Conclusion: A major recommendation is for students to engage actively in the practice of activities required for transformative leadership. Students can then analyse the personal competencies required for these changes in leadership. They must no longer rely on ‘organizational others’ to lead them in transformation.


Edel Mc Sharry
St Angleas College Sligo, Ireland
Title: A clinical teaching and learning model; based on evidence of best practice

Biography: Edel qualified as a Registered General Nurse in 1986. Her clinical background was mostly in the critical care areas where she worked in the UK, North America and Ireland. For the past 20 years she has worked as a lecturer and course coordinator on undergraduate and post graduate programmes. Edel’s teaching interests include nursing the acutely & chronically ill adult; simulated learning in the clinical laboratory; intercultural communication and research. Research interests include clinical education; telemedicine and professional internationalisation

Abstract: Aim This study aimed to explore the clinical teaching and learning within a preceptorship model in an acute care hospital in Ireland. Introduction: A preceptor ship model of clinical teaching was introduced to support the new all-graduate nurse education programme in the Republic of Ireland in 2002. How this model impacted on students’ learning in clinical practice or the pedagogical practices of the preceptor was not fully explored. Furthermore the question of what constitutes effective teaching and learning in clinical practice at undergraduate level had not been clearly identified in the literature. The educational theories of cognitive apprenticeship and situated learning supported the theoretical framework that underpinned this study Methods: A qualitative research study of a purposively selected sample of 13 students and 13 preceptors, working together in four clinical areas in one hospital in Ireland was undertaken. Methods were semi-structured interviews, analysed thematically, complemented by documentary analysis relating to the teaching and assessment of the degree students. Ethical approval was gained from the hospital’s Ethics Committee Results: This paper focuses on best practice cases where preceptors’ pedagogical practices promoted students’ performance and thinking. Key findings in relation to preceptors’ teaching strategies that enhanced the students’ knowledge, clinical reasoning and problem solving skills will be discussed. Findings that elucidated effective preceptor-student learning experiences in terms of good learning outcomes for the student will be presented. Conclusions A best practice clinical teaching and learning model is offered based on the evidence of this study, recommendations as to its further development will be outlined. Concepts such as cognitive apprenticeship (Collins 2006), scaffolding (Vygotsky 1978) and learning in communities of practice (Lave 2009, Wenger 2009), can be helpful in providing a theoretical bases for preceptor education and competencies.


Rana M. Jaber
California State University, USA
Title: Cultural awareness and cultural competency among nurses and nursing students: A literature review

Biography: Dr Rana, started her career as a registered nurse more than 24 years ago. As a nurse, she enjoyed being able to help patients and their families, but since the beginning she had a passion for teaching. She started orienting newly hired nurses, especially the new graduates, who not only need the knowledge or the skills, but also the support and guidance. After several years of teaching in a clinical setting, she moved onto teaching students at nursing colleges in Jordan and California. She has taught clinical, skills, and theory nursing courses at private universities and colleges in California. For the last 6 years, she has been teaching undergraduate nursing courses at California State University, some of the courses she has taught are pathophysiology, nursing informatics, and cultural diversity. She earned her Masters in nursing from California State University, Fullerton in 2006, and early this year she completed her doctorate degree in nursing practice from Western University of Health Sciences. During her graduate studies, she focused on her scholarly work on nursing education, cultural awareness, and cultural competency among nurses and nursing students. She found that nurses as well as other health care providers in the United States – the country with the greatest diversity – are facing challenges dealing with multicultural populations. She believes in order for nurse educators to prepare nurses to be culturally competent with nursing students. Assessment of nursing students' cultural awareness is an essential and initial step in improving nursing education and therefore improving the nursing practice.

Abstract: The U.S. Census Bureau projected by 2050, populations historically identified as “minorities” will make up approximately 50% of the U.S. population. Achieving a healthy nation is impossible without healthy minority populations and eliminating racial and ethnic health disparities. Nurses in the U.S. are providing care to ethnically diverse clients, and the care needs to be delivered with a culturally competent approach. Culturally competent care is essential in daily nursing practice. The purpose of this scholarly work was to assemble knowledge to inform the development of best practices for nurses and nursing students in regard to cultural awareness, knowledge, skills, encounters and desire. The Process of Cultural Competence in the Delivery of Healthcare Services Model provided the theoretical framework for this review of the literature. A rigorous literaturereview design was used to search and critique the available literature in regard to the cultural awareness, knowledge, skills, encounters, and desire among nurses and nursing students. When inclusion and exclusion criteria were applied thirteen qualitative studies, nineteen quantitative studies, five mixed method studies, and sixteen non-research articles were critiqued. Resultsreveledno evidence at Level I and limited evidence at the high quality rating indicatingthere is a deficit in the nursing literature exploring this topic. Only six pieces of evidence had both a level II and good quality. Themes were extracted from the available evidence by comparing and contrasting the studies’ findings. The five identified themes indicated nurses and nursing students lack knowledge and skill in providing culturally competent care and there is an immediate need for nurses to receive specific education focusing on cultural awareness. Determining the levels of cultural awareness and cultural competence is an essential step in order to provide the required education. Findings indicated no one curricular approach appears to be superior for teaching cultural content. The lack of good quality and high level evidence created a limitation for a major change in nursing education and practice, yet provided a significant opportunity for research.


Joao Manuel Garcia do Nascimento Graveto
Nursing School of Coimbra, Portugal
Title: The literacy in professional nursing in peripheral venous catheterization procedures

Biography: Dr. Joao Manuel Garcia do Nascimento Graveto RN, MSc, PhD. Special Certificates: 1997, 1st Course of Specialization in Rehabilitation, Nursing School Dr. Ângelo da Fonseca; 2009, Diploma of Academic Merit as a recognition of the relevant services provided to the Uni-C V in the area of training in Health – Undergraduate Course in Nursing. Special Interest & Researches Done: Principal investigator: projects focuses on evaluating of Prevention of Infections associated with Health Care. Productivity/Main Achievements: 6 publications in international/national journals.; 14 international communications and Poster; 8 publications in book of conference proceedings; 5 educational films related to technical and nursing procedures (intradermal therapy, subcutaneous therapy, intramuscular therapy, placement, maintenance of technical and removal of nasogastric tube, urinary catheterization technique in man and woman); 5 photographic textbooks on the same techniques; 2 national / international awards.; 7 monographs to undergraduate (five in nursing and two in technical clinical analysis); 3 master's theses (MSN) completed; 4 master's theses (MSN) in orientation; 2 PhD Thesis in orientation. Other Information: Founding Member of the chapter of the Honour Society of the Nursing School of Coimbra (ESEnfC) – Portugal of the “Honor Society of Nursing, Sigma Theta Tau International”; Member of the Entrepreneurship Office of ESEnfC; Member of the Office of Support to Newly Graduates in ESEnfC; Member of the coordination committee of the undergraduate course in nursing of ESEnfC; Member of the Technical-Scientific Board of the Health Sciences Research Unit: Nursing; Member of the Technical-Scientific Board of the Nursing School of Coimbra; Member and Vice President of the Pedagogical Board of the Nursing School of Coimbra; Teacher of the course units of Nursing Fundamentals, Techniques and Procedures I (1st year, degree in nursing-Nursing School of Coimbra and University of Cape Verde) and Nursing Fundamentals, Techniques and Procedures II (2nd year, degree in nursing-University of Cape Verde); In the last 10 years Professor João Graveto had received 12 prizes and distinctions in international congresses and events.

Abstract: Introduction: The peripheral venous catheterization is a common practice in the hospital setting with risk of nosocomial infections. Few empirical studies have evaluated the relationship between nurses' knowledge of national and international recommendations on this procedure and its applicability in clinical practice. Objective: To know the scientific evidence on the literacy of nursing professionals in the peripheral venous catheterization procedure. Methods: This is anIntegrativeliteraturereview (ILR) according to Cochrane Handbook of scientific studies published in reference databases, between 2009 and 2014. Survey conducted in April 2014, were selected following the PICOD model and previously defined inclusion/exclusion criteria. Results: Mostly nurses have knowledge about the guidelines of peripheral venous catheterization procedure, however they not always mobilize for the provision of nursing care. For example, 89.7% of nurses said they needed to wear gloves in the salinization of CVP, yet only 30.5% used gloves (Moncaico & Figueiredo, 2009, p. 623-624). Also the educational activities allowed reflective and update the knowledge of professionals about this procedure times, conceiving objective and desired changes in behavior and increase adherence to recommendations, with consequences on the applicability of this quality of care. For example, Ahlqvist et al. (2006 apud Oliveira & Parreira, 2010, p.142) mentions that after the implementation of the guidelines, the number of satisfactory nursing care increased by 12%. Conclusions: The literature identifies as essential the continuous training of professional nurses about the PIC procedure. In particular, national and international protocols, such as the Guidelines of CDC.Nursing care related to peripheral venous catheterization procedure should follow the recommendations based on scientific evidence, in order to reduce complications and costs associated with the care and increase the safety and welfare of the pacient. More inputs are needed for further research in this area.


Dympna O Connell
St Angela's College, Ireland.
Title: Breaking down boundaries: Cultural influences in the international classroom

Biography: Dympna O'Connell qualified as a Registered Children's Nurse and a Registered General Nurse and has worked for several years in both divisions, in Ireland and abroad. She undertook a Bachelor of Nursing Studies (Hons) in University College Dublin (UCD) and completed a Master of Health Sciences (Hons) at UCD in 2002. Since then Dympna has worked as a lecture in the Department of Nursing at UCD and in the last 10 years as a lecturer in the Department of Nursing, Health Sciences and Disability Studies at St Angela's College, Sligo, Ireland. She is coordinator of the Postgraduate Diploma in Health Sciences and the Master of Health Sciences programmes within the College. She is module leader for the masters research modules and other modules across nursing programmes. Her research interests are related to learning in the clinical environment; classroom teaching and learning dynamics; psychosocial determinants of health in children and adults.

Abstract: The last decade has seen a steady rise in the number of international students choosing Ireland a study destination. A substantial body of literature shows that international students struggle with adaptation to life and study in the host country.Less well understood are the experiences of these students in the international classroom and cultural influences on the processes of teaching and learning. Aim of the Study To explore Indian nurses’ experience of academic education in the West of Ireland. Method A qualitative exploratory study was conducted, employing in-depth interviews with 14 Indian nurses undertaking a full time, one-year International Bachelor of Nursing programme in West of Ireland. Ethical approval was granted by the Research Ethics Committee: Sligo Regional Hospital. Thematic analysis was carried out using a qualitative coding process and was supported by NVivo. Findings While missing home and loneliness were common features of the participants’ transition experiences, participants’ stoical attitudes in relation to these can be explained by reference to India’scollectivist culture and the sense of duty that these students felt towards supporting their extended families. Feeling of isolation and a lack of connection with host students featured prominently; with participants identifying the reduced potential for language development and cultural learning. While India has a strong power-distance culture,most students enjoyed the transition to less formal relationships with lecturers.However, power-distance culture between the cohort members themselves did impact negatively on classroom dynamics and influenced both the teaching and learning processes. Conclusions and Implications Student support services within host institutions should be fully informed of the unique transition challenges that face international students and should devise supports to assist students adapting to the new culture. Lecturing staff should be aware of how culture can influence teaching and learning, lecture-student relationships and classroom dynamics.


Mieke Embo
University College Arteveldehogeschool Ghent and University Ghent, Belgium
Title: Embo’s continuous workplace learning model: integrating learning, assessment and supervision in health care education

Biography: Mieke Embo is head of the midwifery department at the University College Arteveldehogeschool Ghent, postdoctoral researcher and guest professor at the University of Ghent (Pedagogy; Master in Nursing and Midwifery). She studied Nursing, Midwifery, Masters in Health Management and defended in 2015 her PhD at the University of Maastricht (Netherlands). As head of the Midwifery programme she has led and been involved in numerous projects in the fields of education, practice and research at home and abroad. Her special interests include quality management, change management, competency-based education and workplace learning.

Abstract: Introduction: Workplace learning has increased in popularity over the last decades and clinical workplaces remain important learning environments in health care education. Modern theories conceptualise workplace learning as a self-regulating continuous process of competency development. Nevertheless, workplace learning in the field of health care education is featured by discontinuity: many programmes include short periods of training in different disciplines; learning processes are often separated from assessment processes; and it is difficult to achieve continuity in supervision, both within and across workplaces. The question therefore is how workplace learning can be organised in such a way that ongoing competency development is optimally stimulated throughout the workplace learning curriculum. The following three research questions were put forward in this thesis: 1) How can learning, assessment and supervision in the workplace be integrated with the aim to support a continuous developmental process?; 2) What are the implications for the design of workplace learning?; and 3) What is the effect on summative assessment? Methods: Answers to the research questions were based on four consecutive studies and one theoretical paper, all published in peer review journals. Two qualitative studies used a content analysis approach to explore students' and clinical supervisors' perceptions on how an integrated workplace learning instrument facilitated learning, assessment and supervision in practice. A subsequent mixed-method study explored how two reflective writing activities stimulated reflection at different degrees of granularity during workplace learning. A cross-sectional and retrospective-longitudinal correlation cohort study was used to investigate the relationship between reflection and performance and how reflection contribute to competency development. These studies provided the empirical evidence for designing a workplace learning model. Results: We have shown that it is possible to integrate the numerous components of workplace learning into an evidence-based and feasible workplace learning model: the ‘Integrated learning Assessment and Supervision Competency Framework’ or Embo’s continuous workplace learning model. The results make clear that promoting continuous competency development requires an integration of competencies, learning (reflection and feedback on performance and on competency development), assessment (self-, formative and summative assessment), and supervision (observers, learning guides and assessment committee). The model is featured by a programmatic view on the workplace learning curriculum and a focus on the conditions to support continuous learning. An integrated model has important implications for the design of the workplace learning programme. The latter needs to be revised in such a way that a formative reflection and feedback continuum is established, active involvement in learning and supervision is encouraged, and collaboration in learning is facilitated. The results suggest that these effects on formative learning are valuable for summative assessment. A twofold assessment strategy (assessment of competencies and professional competence) creates an assessment continuum at the workplace. Discussion: Respondents noted important barriers to the positive effects of an integrated model on the learner’s developmental process. Successful implementation rely on the extent to which essential conditions are met. Conclusion: This research provides new perspectives on continuous workplace learning in the context of a discontinuous workplace learning environment.


Dr Linu Sara George
Manipal University, India
Title: Factors affecting learning among B.Sc Nursing students

Biography:

Abstract: Aim of the study: The objective of the present study was to identify the factors, which affect learning as perceived by the students. Introduction: Nursing education prepares the students from different cultures and beliefs to be competent in rendering professional nursing care to people of all ages, in all phases of health and illness in a variety of settings. Nursing students require learning and retaining various skills and knowledge in the area of medical, behavioural and biological science. The learning experience of the students is influenced by many factors. Method: Design: Descriptive Survey design. Setting: Selected Colleges of Nursing. Sample: 414 Bacculearate nursing students enrolled in selected colleges of Nursing. Sampling technique: Purposive sampling technique. Tools: Rating scale on factors affecting learning. Data analysis: Factors were identified by exploratory factor analysis using extraction method of principal component analysis with varimax rotation. Results: Majority (73.7%) of the samples were of 22-25 years of age, 93.2% were females, majority (38.9%) were studying in the 4th year of nursing, 50% of them had chosen nursing as a career owing to job security as the reason, 58.7% of them did not spend time every day for their studies and majority (89.1%) had English as their medium of instruction in PUC. Factor analysis identified five factors (Learning environment, Supportive services, Teacher characteristics, Learner challenges and Personal factors) that affect the student learning. Conclusion: The perception of the respondents had influenced the identification of factors affecting learning. The study findings will help the faculty members to take the necessary action.


Mouhanad Hammami
Wayne State University School of Medicine, USA
Title: “Expat Arab Health Professionals: Brain Drain or Brain Gain?”

Biography: A graduate of Aleppo University, Syria, Dr. Hammami completed his postdoctoral research in Pediatrics at the Newborn Center of the University of Tennessee in Memphis, and then accepted a faculty appointment at Wayne State University School of Medicine in Detroit, Michigan and a research position at the Detroit Medical Center, Department of Pediatrics. In 2006 he was granted the American Medical Association (AMA) foundation for Excellence in Medicine and Leadership award for his public health advocacy and community work. He was awarded the “Health Policy Champion Award” by the Michigan Department of Community Health in 2011, Arab American of the Year in Medicine in 2012 and nominated by the White House for Heroes for Health in 2013. Dr. Hammami served as Executive Director of the National Arab American Medical Association (NAAMA) from 2006 to 2009 and then elected as national president for 2011. He currently serves as the Chief of Health Operations of Wayne County Department of Health and Human Services and County Health Officer for Wayne County where he oversees all health related operations for the 13th largest County in the Nation. Dr. Hammami is responsible for promoting and assuring health and quality of life by providing, maintaining, developing and coordinating a wide-range of innovative and fiscally responsible educational and health services including technology intitatives. Dr. Hammami is a member of several professional and honor societies and has had many publications in various peer reviewed medical journals.

Abstract: Annually, 100,000 scientists, engineers, physicians, and other experts migrate primarily from eight Arab countries: Lebanon, Iraq, Syria, Jordan, Egypt, Tunisia, Morocco and Algeria. Some reports indicate that as many as 50% of physicians, 23% of engineers and 15% of scientists from these countries end up emigrating to Europe, USA and Canada. They migrate because of disparities in income, political or economic obstacles to scientific research in countries of origin, socio-political instability, or lack of a proper environment to create and conduct scientific research in Arab countries. Additionally, skills and competencies are marginalized and unappreciated in many cases. These competences have been attracted by western countries which provide them with facilitated entry and settlement, financial incentives, employment, and research opportunities to pursue their professional interests. Arab countries must seek to better understand and address the reasons for emigration of highly skilled professionals by providing a more competitive, innovative and attractive professional environment for skilled workers, particularly scientific researchers and health professionals. At the same time, Arab countries of origin must also recognize and develop the opportunities that exist to leverage the skills and talents of their expatriate communities, tapping into the desire of many migrants to engage and support their home countries in development. The presentation will discuss issues related to migration of Arab Health professionals and the role of migrant health competencies in promoting the health sector in Arab countries.


Providing Quality Care & Reducing Family Healthcare Costs
Session Chair:
Deborah Stevens
Arab Euro Home Nursing, UAE


Session Introduction

Deborah Stevens
Arab Euro Home Nursing, UAE
Title: Developing a Pressure Ulcer (PU) incidence and outcomes key performance indicator for home care facilities

Biography: Deborah Stevens trained as a Registered Nurse in London, UK. A lifelong learner, Deborah has specialized certifications in Orthopedics from RNOH and Renal Transplant and Dialysis from Charing Cross Hospital, London. With a background in surgical and emergency nursing she is additionally a dedicated American Heart Association BLS Instructor for over 15yrs. Completing her Masters in Healthcare Administration 2010, Deborah consolidated this with the NAHQ qualification: Certified Professional in Healthcare Quality (CPHQ) in 2012 and in 2015 became an AHRQ TeamStepps Master Trainer. Deborah previously worked at Sheikh Khalifa Medical City as the Outpatient Specialty Clinics Manager for five years and then from March 2011 to December 2015 in the strategic role of Quality and Safety Manager for their Nursing Division. Her legacy in her role of Site Coordinator for the National Database of Nursing Quality Indicators (NDNQI) led nursing to win the coveted Press Ganey Award for Best International Hospital in 2014. Deborah took up the challenging position of Nursing Director in January 2016 for an established Abu Dhabi Home Care Company (Arab Euro) and Primary Health Center, Intercare. Her mission is to bring nursing staff to a level of practice in quality and safety that would be acknowledged by the community as excellent and provide a learning organization for the staff as well as motivate for JCI accreditation. A passionate public speaker with dynamic presentation skills and sought-after panelist participant, Deborah says that internationally the UAE is recognized as one of the fastest emerging healthcare economies in the world, respected for its foresight and development in leading global initiatives. Deborah firmly believes that cultivating teamwork is the way forward to improving patient safety and strongly advocates for Compassionate Care to be recognized as the patients 6th Vital Sign

Abstract: Aim of the study Improve quality of patient care by standardizing use of the Braden Scale for Predicting Pressure Sore Risk© and the Skin Assessment Tool© in the home care setting. Specifically adapt, build and introduce tools which measure incidence of pressure ulcers acquired at point of hospital stay, community or within a home care-managed patient setting. Enable trending for quality of care provided by our facility. Introduction in brief It’s challenging having to deal with patients at risk for pressure ulcers (PU). PU’s are easier to prevent than treat. When prevented, the strain upon patient, family, health care providers and overall healthcare costs decrease. The presenters integrated existing validated tools and adapted measures to help quantify improved quality of nursing care. Using outcomes to promote sustainability, they introduced a new approach to state of the art home nursing. Procedures Formulating a tool satisfying HAAD’s JAWDA quality performance standards. Implementing a change rollout throughout the organization. Mandating NDNQI PU Modular Learning. Introducing weekly Braden Scale reporting and monthly PU surveys. Building and adjusting the process as needs identified. Introducing wound Care rounding to apply latest expertise knowledge. Results A Key Performance Indicator, the tools serve to quantify evidence reflective of quality outcomes of care resulting throughout the spectrum of healthcare facilities. From a home care perspective the initiative supports a lean process monitoring care administration & intervention, measuring &sustainability. Lowering the risk of PU occurrence and introducing PU healing reduction practices. Conclusion Patient care can be an arduous task when we’re dissatisfied with the results of our plan of care. Validated tools can measure the quality of care rendered. Quantifying outcomes and reviewing improved application of care benefits patients and families. Adapting tried and tested methodologies helps meet health authority standards, providing a safer care environment and responds to the healthcare authority challenge: reduce patient harm. Acknowledgements Arab Euro Home Nursing, Dr. Mazin, Nursing Director; Deborah Stevens, RN Graceamanda Quizon, Team Leaders, RNs


Jelena Roganovic
University of Rijeka, Croatia
Title: Late effects of treatment for childhood cancer

Biography: Dr Roganovic is the Full Professor of Pediatrics, School of Medicine Rijeka, and the Head of the Division of Hematology and Oncology, Department of Pediatrics, Clinical Hospital Centre Rijeka. She is a certified member of many national and international pediatric hematological and oncological societies. Dr Roganovic is the author of more than 300 publications, abstracts and proceedings and several book chapters. She serves as a reviewer and editorial board member for more than 40 journals. Dr Roganovic received several awards, including Patients' Choice Award Winner, City of Rijeka Annual Award and University of Rijeka Foundation Award.

Abstract: During the past decades, significant advances have been made in treatment of pediatric malignancies, with more than 80% of children being cured. Therapy responsible for this excellent survival rate can also produce adverse long-term health-related outcomes, referred to as late effects. Late effects manifest years after completion of cancer treatment. It is estimated that 60% of pediatric cancer survivors develop at least one chronic condition and almost 30% experience serious or life-threatening complications during adulthood. The common late effects of childhood cancer encompass several broad domains including growth and development, organ function, reproductive capacity, second malignancies, and psychosocial sequelae. Late effects can be anticipated based on therapeutic interventions, but the magnitude of risk and manifestations in an individual survivor are influenced by numerous factors which are tumor-related, treatment-related and host-related. Any organ system can potentially be affected. Late effects also contribute to an excess risk of premature death among long-term survivors. Relapsed primary cancer remains the most frequent cause of death, followed by cause-specific mortality from subsequent primary neoplasms, and cardiac and pulmonary toxicity. Childhood cancer survivorship is a national public health priority. Long-term follow-up care has taken place in a variety of settings: primary care clinics (pediatrics, internal medicine, family practice), oncology clinics (pediatric and adult), and specialized long-term follow-up clinics. To facilitate survivor and provider access to appropriate follow-up care, compendium of exposure- and risk-based health surveillance recommendations has been developed, including guidelines, health links and comprehensive reviews. It is estimated that 300,000–500,000 European citizens are survivors of a childhood cancer. PanCare is a pan-European multidisciplinary network of health professionals, survivors of a pediatric malignancy and their families, collaborating to reduce the frequency, severity and impact of late side-effects of treatments, with the aim to ensure that every survivor of childhood cancer receives an optimal long-term care.


Lena Andersson
University in Uppsala, Sweden
Title: Heart failure patients’ perceptions of received and wanted information

Biography: Lena Andersson, works at University in Uppsala, Sweden

Abstract: Aim of the study/ Purpose: The aims of the study were to 1) investigate heart failure patients’ perceptions of received and wanted information, and 2) identify possible differences regarding received and wanted information in relation to gender, age, marital status and level of education. Introduction in brief: Patients with heart failure are often handled in primary healthcare. In order to perform self-care activities they need knowledge and information. The information is usually provided by nurses or physicians. However, problems have been identified that are related to information. These problems include patient-related factors but also information-related factors implying that patient information can be perceived as challenging by both patients and healthcare professionals. Procedures/ Methods: Patients with heart failure (n=192) were recruited in 2014 from six primary healthcare centers in Sweden. Data were collected by a postal questionnaire. Results: A majority of the respondents agreed they had received information about the condition and the medication. Within primary healthcare most respondents had been informed about medication, but they wanted more information about continued care and treatment, medication, and their condition. Younger respondents and respondents with a higher level of education received significantly more information. Men and respondents with a higher educational level wanted information about medication. Conclusion: The results show that patients with heart failure can need more information even if they have already been informed. Age, gender and level of education are factors that can influence what subjects the patients want to be informed about. Acknowledgments This research was supported by the Centre for Clinical Research Sörmland/Uppsala. University. The authors thank Hans Eriksson Centre for Clinical Research Sörmland/ Uppsala University for assistance with statistical analysis


Ehsan U Khan
King’s College London, UK
Title: The e-PAD project: Clinical assessment using a 7-inch tablet

Biography: Dr. Khan is working as a nurse educator from past 16 years; he did his specialising in bioscience education. He is qualified as a nurse since 1993 and did work in critical care and coronary care before embarking on a PhD in physiology. He has completed his PhD and is employed as a lecturer in King’s College London. Apart from lectureship on physiology and pharmacology he leads the faculty e-learning development and also is a programme leader for an international Masters program. His research interests include the pedagogy of e-learning and e-assessment and currently he is involved in projects related to same areas.

Abstract: Aim of the Study To evaluate the use of 7 inch tablets in completing nurseclinical competency assessments. Introduction The use of hand held devices has been associated with improved efficiency, accuracy of data input and timely clinical decision making (Bischoff &Hinojosa 2013). These devices, however, have concerns regarding appliance and data security (Galliher et al., 2008). Clinical competency in placement is normally assessed using hardcopy documents. This project piloted the use of 7-inch tablets in the assessmentof clinical competency in practice for year 1 nursing students using an online / offline submission. Methodology 31pre-registration nursing students were allocated 7-inch tablets loaded with a digitalised version of their competency document. Their experience of use was assessed by questionnaire (71% response rate) and focus groups. Questions included their opinions regarding mobile devices and experiences of completing the competency document. Results The data suggest that students had positive feelings regarding hand-held devices and completing their competency assessments using the 7-inch tablet. However their perception of structure and navigation of the digitised document varied,with the majority of responses neutral to positive, with some responses most negative. Conclusion This is the first study to assess the use of7-inch tablets in completing this clinical assessment document. Despite difficulties in navigating within the system, students liked to use a hand-held device for their clinical assessment in practice. However to ensure success, clinical support is an important dynamic and needs to be factored into roll-out preparations.


Dilek Yılmaz
UludagUniversity, Turkey
Title: Critical thinking levels of first and last grade nursing students in turkey

Biography: She was born in Eskişehir-Turkey in 1985. After completion of her elementary, middle and high school education in Eskişehir, she obtained her Bachelor’s degree in Nursing from EskişehirOsmangazi University, School of Health, and Department of Nursing in 2006. She received her Master’s degree from EgeUniversity-Turkey, Institute of Health Sciences in 2011. She received her PhD from Ege University, Institute of Health Sciences in 2016. She has been working as aninstructor at Uludağ University in Bursa since 2012. She publishedresearch papers in various academic journals in English and in Turkish on her primary research interestswhich are including safe drug administration, pain management, patient safety, nursing care practices, safe respiratory system applications. She teaches courses in fundamentals of nursing, patient safety, ergonomics in nursing.

Abstract: Aim of the study/ Purpose: This study was conducted to investigate the level of critical thinking of first and last year nursing students and the factors affecting the critical thinking. Introduction in brief: In each daily, theoretical and clinical fields, in the decisions which needed for implementation and maintenance; nurses need to think adequately, creative and effective in the resolution of various ethical issues they faced and think critically in providing effective nursing care. Procedures/ Methods: This descriptive and cross-sectional designed research, was conducted with a total of 156 first and final year nursing students which were participating voluntarily, thought to be they had a difference in their level of critical thinking and were studying at a state university which is in Turkey’s western area (1ST GRADE= 70, 4TH GRADE=86). Research data was collected with student information form and the California Critical Thinking Disposition Inventory (CCTDI) which was developed by Facione (1990) and subjected to reliability and validity test by Kökdemir (2003) in Turkey. In evaluation of the data; number, percentage, mean ± standard deviation and the Independent t test, one-way analysis of variance (ANOVA) and Pearson correlation analysis were used. Results: The mean age of students is 20.94 ± 1.85 (min: 18, max: 27) and 76.3% of students were female. Critical thinking disposition scale mean score of the students was found to be 192.89 ± 20.40. Among sub-dimensions of the scale, it was found that the maximum meanscore was with analytical thinking (49.77± 5.14), the lowest was with searching true (25.63 ± 5.15). In research, it was found that the students who were last year, male and were having mothers which had level of education as high school and college had higher mean scores of critical thinking. In addition, fathers’ education level of the students, the families’ economic status, age and academic success were observed to not affect the level of critical thinking. Conclusion: As a result of this study, overall level of critical thinking of students participating in the research was found to be lower but in last year students it increased significantly.


Nthomeni Ndou
University of Venda, South Africa
Title: Instrumental support of professional nurses caring for HIV/AIDS patients Tshwane district of Gauteng province, South Africa.

Biography: Nthomeni Ndou works as a professor at University of Venda, South Africa

Abstract: Caring for patients diagnosed with HIV/AIDS related illnesses at the hospital setting, poses a number of challenges to the hospital professional nurses who need instrumental support. The study sought to explore and describe instrumental support of the professional nurses caring for patients diagnosed with HIV/AIDS related illnesses.The study was conducted at one of the Tshwane district hospitals.Professional nurses’ instrumental support was examined focusing more on tangible assistance provided by the hospital.Qualitative approach using explorative, descriptive and contextual designs were employed in order to collected data.A purposive sampling method was used to select 25 participants who participated in individual face to face interviews. Data gathered from the participants were analysed using Tesch’s eight steps of open coding techniques. The findings of the studyrevealed ineffective professional nurses’ support on physical safety, human resource management and supply of medical, cleaning and safety materials.The findings further indicate that the hospitalsupports the professional nurses by addressing instrumental challengeshence prevention of fatigue, physical stress, ill-health, resignation and poor HIV/AIDS care to patients diagnosed with opportunistic infections and related diseases. It is recommended that instrumental support of professional nurses caring for patients diagnosed with HIV/AIDS related illnesses be adequately provided by the hospital and the nurse managers.


Karla Gutierrez
Seha Dialysis Services Mafraq, UAE
Title: Nurse led kidney transplant referral for dialysis patients in Abu Dhabi

Biography: Graduated with a degree of Bachelors of Science in Nursing in 2006 in Manila Doctors College in the Philippines and also acquired a RN license under the Board of Registered Nursing in USA a year after. Her current area of practice is nephrology nursing mainly in dialysis under SEHA Dialysis Services Mafraq, UAE. She is also a part of link nursing in her facility of which is vascular access care, patient and family education and kidney transplant link.

Abstract: Purpose:The aim was to promote awareness of transplantation in patients currently undergoing hemodialysis, and to facilitate pre transplant work up for patients and living related donors who were willing and suitable. Introduction:More than 1,000 patients with ESRD are currently undergoing dialysis in Abu Dhabi. Kidney transplantation (KT) is considered as the optimal treatment of choice for patients with end stage renal disease (ESRD). Renal services in Abu Dhabi include a Kidney Transplant Centre in Sheikh Khalifa Medical City (SKMC) which commenced operation in 2008 and SEHA Dialysis Services (SDS), which provides all inpatient and outpatient dialysis for over 1000 patients in Abu Dhabi including the western Region. Methods:In 2013 the SKMC Transplant Team and SDS commenced a nurse-led collaboration. The aim was to promote awareness of transplantation in patients undergoing hemodialysis and to facilitate pre transplant work up for patients and living related donors who were willing and suitable. Two link nurse representatives from SDS were identified to assess potential candidates and coordinate with SKMC KT team through a referral pathway. Results:To date 47 patients have been referred to transplant team over the last 3 years (2013-2016). Of these referrals, 13 patients have successfully received KT. Most of the patients (27) who did not progress to the transplantation are due to their inability to bring donors in the country. Other reasons are failure to find a good match, donor health issues, and willingness of the family to donate. Conclusion:An integrated, multidisciplinary, renal care approach where designated dialysis nurses work as transplant link nurses in cooperation with the transplant team successfully increases the number of patients with ESRD receiving kidney transplant.