Scientific Program

Day 1 :

Keynote Forum

Monika Tukacs

Columbia University Irving Medical Center, USA

Keynote: Extubation during extracorporeal membrane oxygenation therapyin adults: A qualitative study on experts’ perceptions

Time : 09:45-10:30

Biography:

Monika Tukacs has her expertise in extracorporeal membrane oxygenation (ECMO), its physiology and clinical application, and is passionate about evidence-based research in ECMO. Her pioneering in early recognition of the importance of liberating from invasive mechanical ventilation during ECMO is fundamental. The paucity in literature has led her to perform a qualitative study on experts’ perceptions about ECMO and Extubation in adult patients. This ground-breaking investigation has already raised an interest of researchers internationally. She has recently been asked to join in developing and conducting a multi-center prospective research study on the topic. Her contribution to this innovative application of ECMO therapy trailblazes the path towards the future of contemporary ECMO

 

Abstract:

Statement of the Problem: Extracorporeal membrane oxygenation (ECMO) is a modification of intraoperative cardiopulmonary bypass used in adults for severe cardiac, cardiopulmonary or respiratory failure. Used as salvage therapy for decades, its application proliferated fourfold, and the number of ECMO centers threefold over the past 10 years. 1 Additionally, while invasive mechanical ventilation (IMV) during ECMO therapy has been the mainstay in airway management, the practice of liberation from it is growing, especially as removal of the endotracheal tube (extubation). 2, 3 However, the timing and the process leading to extubation remains a conundrum. 4, 5 Moreover, the literature lacks any extubation guidelines applicable for ECMO in adults and is scarce for the rising need of clinicians. 5 The aim of this study was to better understand perceptions of expert clinicians regarding extubation during ECMO in adults, and utilization of a guideline/algorithm.

Methodology & Theoretical Orientation: A qualitative study was utilized, including purposeful sampling, a homogeneous approach and focus group discussions. It was conducted at an international conference with a dedicated focus group room at the conference venue. Discussions were recorded and transcribed verbatim, followed by qualitative content analysis performed concurrently and independently by both co-researchers.

Findings: Participation in this study was global and included experts in ECMO. Experts described managing airway during ECMO differently and having difficulties in achieving extubation. Of the ten themes identified, two were the main focus of discussions: extubation guideline and work culture. Fifteen percent of experts reported having a guideline, and all described it as desired. The culture was labelled to be powerful with variations in approach to extubation during ECMO.

Conclusion & Significance: Experts unanimously agree on the usefulness of an Extubation guideline/algorithm for the majority of ECMO patients. The study suggests collecting data on evidence-based practice, as a prospective cohort research study. 

Refreshments and Networking Break: 10:30-10:50 @ Foyer

Keynote Forum

Kathleen Diatta

Capella University, USA

Keynote: A student’s journey: Examining the efficacy of the academic preparation of BSN students and readiness to enter practice

Time : 10:50-11:40

Biography:

Dr. Diatta is an experienced clinician and leader with 32 years of nursing experience including twenty years of direct bedside experience plus 12 years of progressive leadership. She earned her BSN from SUNY Brockport (Magna Cum Laude) and her PhD in Philosophy with a concentration in Adult learning and Postsecondary Education (Graduating with Distinction). She is a Transformational leader and mission driven. She has great experience in curriculum development, training, and teaching. Her experience with creating Training Scenarios & Clinical Simulations, motivating nursing staff to “want” to achieve Strategic initiatives, and the deep-rooted experience of working with research processes, implementation methods, outcome measures, and finding clinical evidence that speaks towards Nursing Theory and utilizes Adult Learning Practices. She has managed as many as 135 staff members as a leader and career successes include motivating nursing staff to embark on and secure Beacon silver and Gold status.
 

Abstract:

The concept of critical thinking (CT) has perplexed employers and researchers in the field of nursing for decades. The nursing profession is under intense pressure to hire clinicians who exhibit CT skills. A review of the literature has shown that the divide between bedside clinicians and nursing faculty has led to the separation of academic educators from clinical practices. As a result, new graduates come into the clinical setting inadequately prepared to meet the clinical demands of today’s hospitalized patients. The purpose of this study was to explore the experience of new graduate nurses from a Baccalaureate program and their transition into clinical practice. A generic qualitative approach sought to describe and understand the topic of interest, with respect to nurses’ preparedness to meet the demands of their profession. The results of the study found that the new graduate nurses did not feel confident entering the workforce of the nursing profession. Study participants reported the lack of skills training as the major reason for their feelings of being ill-prepared in the clinical setting. Collaboration between academia and hospital settings must focus on shared responsibilities for meeting the learning needs of new graduates. In so doing, this will enhance the quality of care provided and patient safety.
 

Keynote Forum

Diane Baruch

New York Presbyterian Hospital, USA

Keynote: Effects of glycemic control, graft choice, BMI, and diabetes on the development of sternal wound infections in cardiac surgical patients

Time : 11:40-12:30

Biography:

Diane Baruch DNP MBA RN CCRN-K NE-BC is an experienced manager with over thirty years of experience in the fields of cardiac and critical care. She has worked at both Mount Sinai in NYC and Northwell Health on Long Island, and currently works as the Patient Care Director for the cardiothoracic step-down unit and remote telemetry center for New York Presbyterian Hospital in New York City. She recently graduated from George Washington University in Washington, D.C. with her DNP. 

Abstract:

Background: A complication of cardiac surgery, the sternal wound infection (SWI) rate in our organization has risen in three years to twice the state benchmark. The internal mammary arteries are routinely used in our institution for its long-term patient survival benefit, which can increase SWI risk. The biochemical effect of stress hyperglycemia in critically ill patients is a contributing factor to the development of infection. Glycemic control reduces infection risk by avoiding the body’s metabolic syndrome. The purpose of this study was to determine if there is a difference in glycemic index, graft choice, BMI and diabetes in cardiac surgery patients who have developed SWI and those who did not.
Methodology: Our longitudinal study was a retrospective medical record review conducted in an academic medical center. 130 cardiac surgery patients developing a SWI were matched with 130 patients who did not. Regression analysis compared differences in glycemic index, graft choice, BMI, and diabetes.
Results: The majority of the sample were male (61%) white (62%), and obese (52%); 76% underwent a coronary artery bypass graft procedure. Patients were 2.8 times more likely to develop a SWI (p <.001) when their mean blood glucose on the day of surgery was above160 mg/dl. Mean blood glucose on post-operative day #1 (p =.70) and #2 (p =1.00) were not significant. No differences were found in the relationship of graft choice and SWI (p =.61). Females were two times more likely to develop a SWI than males (p = .02). 72% of the sample with a BMI of 30 and above developed a SWI (p =<.001). There was no difference (p =.19) in the relationship of history of diabetes and SWI.
Conclusion: I Improved blood glucose management targeting a mean blood glucose below 160 mg/dl on the day of surgery may help prevent SWI.
 

Lunch Break: 12:30-13:30 @ Hotel Restaurants

Keynote Forum

Michele Roccella

University of Palermo, Italy

Keynote: Autism spectrum disorders in children affected by Duchenne Muscular Dystrophy

Time : 13:30-14:15

Biography:

Michele Roccella is a Professor and Director of the School of Specialization in Child Neuropsychiatry at the University of Palermo, Italy. He graduated in Medicine and Surgery and Specialization in Child Psychiatry at the University of Palermo. He was the National Secretary of the Italian Society of Pediatrics (SINPI) from 1996 to 1998. Michele Roccella has published more than 450 articles in national and international journals

Abstract:

Objective: Duchenne Muscular Dystrophy (DMD) is a progressive neuromuscular condition that has a high rate of cognitive and learning disabilities as well as neurobehavioral disorders, some of which have been associated with disruption of dystrophin isoforms. Recent studies have pointed to an increased risk for intellectual disability and autism among affected males. The aim of the present study was to describe a case series of children with DMD that have also the presence of autism spectrum disorders (ASDs). they have been assessed by means of standardized autism scales and the most appropriate psychoeducational treatment is herein discussed.
Methods and Results: In order to evaluate and identify the presence and intensity of autistic symptoms have been used the childhood autism rating Scale and autism diagnostic Observation Schedule tools. Moreover, in order to assess the intelligence of subjects and their lower limb function, Wisch-r intelligence scale and Vignos function scale were used, respectively. A typical behavior included a preference for being alone, and selective interest in privileged objects used in a stereotyped manner, motor fretting, and attention instability were present in all children. By the administration of these scales was confirmed the presence of ADSs in all subjects.
Conclusion: It is important for clinical practice to consider this association increased.
 

Keynote Forum

Sawsan Alyousef

King Fahad Medical City, Saudi Arabia

Keynote: Implementation of medical simulation to improve pediatric health

Time : 14:15-15:00

Biography:

Sawsan Al Yousef is Director of Saudi Commissioner for Health specialty for PICU Fellowship Examination committee, Saudi Arabia. She is an a assistant Professor in king Saud Bin Abdulaziz University and Health Science, Clinical and Research Pediatric Critical Care fellowship from University of Western Ontario, Canada, 2001, Clinical Pediatric Respiratory, University of Toronto, Canada, Arab and Saudi Board of Pediatrics, 1997.Currently Appointed as Consultant Pediatric Intensive Care and Pulmonory at King Fahad Medical City(KFMC),Chairperson of Post Graduate Simulation Department at Center for research, Education, Simulation enhance training (CRESENT)KFMC. 

Abstract:

Medical simulations aim to imitate real patients, anatomic regions, clinical tasks, virtual reality devices and electronic manikins or to mirror real-life situations in which medical services are rendered. Simulation – based learning (SBL) applies these modalities. Benefits of medical simulation includes safe environment, mistake forgiving, trainee focused vs. patient focused, controlled, structured, proactive clinical exposure, reproducible, standardized, debriefing, deliberate and repetitive practice. Medical simulation can assess professional competence as patient care, medical knowledge, practice-based learning & improvement, communication skills, professionalism and systems-based practice. Patient safety priorities are at the forefront of health providers' concerns. The see one, do one, teach one philosophy certainly should be eliminated. This is best summarized by “simulators have the potential to take the early and dangerous part of the learning curve away from patients”. Simulation has rapidly evolved as a learning tool and technology over the past 15 years and has been shown to be an effective method for teaching. Despite this, the field of pediatric medicine is still in the primitive stages of adopting simulation. The reasons cited for this include: the high cost of simulators, a dearth of didactic curricula to accompany the psychomotor skill learned on a simulation, the wide variability and/or lack of consistency that exists among the simulation platforms, and a complete absence of large trials showing that this expensive technology actually improves patient outcomes. Despite all this, the Saudi Commission for health specialty now mandated and added certain simulation courses into pediatric R1 curriculum. From June 2017- May 2018 an condensed simulation course for pediatric R1 training resident under Saudi commission for health specialty was conducted once per month at CRESENT, KFMC, the course is 5 days include the following simulation sessions: pediatric airway management with crew resource management, central line insertion under US guidance, chest X-ray and ABG interpretation, Lung Ultrasound, thoracentesis, chest tube insertion, bone marrow aspiration and biopsy, lumbar puncture, basic to advance cardiac simulation session. Total of 125 candidates were involved, in which all of them had undergone pre-course knowledge and clinical assessment test followed by post course knowledge and clinical assessment test at the end of the course (similar to the pretest) plus the candidates had retention assessment test 6 months later with similar to pre and post assessment tests. The preliminary result showed 100% improvement in the scores at post knowledge and clinical assessment test compared to pre-assessment test and non-had decline results. The retention assessment test is pending but the preliminary result is promising as till now the scores were above precourse assessment test. 100% of them found these courses are enjoyable, safe, not stressful and very useful training methods, 97% enjoyed it mostly because it is repetitive, and mistakes are forgiven with zero hazards to patients.100% feels video debridement following medical scenarios is very helpful as it clarify areas for improvement much better than conventional training. In conclusion, although Simulation courses is expensive, but it plays important role in patient safety so at the end it is cost effective so would encourage to make it mandatory in the curriculum for all pediatric residents and fellow.
 

Refreshments and Networking Break: 15:10-15:30

  • Pediatrics | Neonatal Neuromuscular Disorders | Evidence Based Practice | Role of Nurses
Location: Bleriot 2

Session Introduction

Ohood Alrehailli

King Fahad Medical City, Saudi Arabia

Title: Cross sectional study about physicians’ disclosure of medical error to patient/family: The case of Saudi Arabia
Speaker
Biography:

Ohood Abdullah Alrehaili is working as a paediatrician at Children Specialized Hospital at King Fahad Medical City, Saudi Arabia. She completed Bachelor of Medicine and Surgery, MBBS from Taibah University, Saudi Arabia. In 2016 she completed the Mechanical Ventilation for Pediatrics Course, In 2017 she completed Central Line Insertion Under Ultrasound Guidance Course and Airway Management Course for Pediatric. She participated in many national conferences. Ohood Abdullah Alrehaili is the member of Hereditary Blood Disorder Association, Sanad Children Cancer Support Association, Zahra Breast Cancer Association

Abstract:

Background: Patient safety is a hot topic in healthcare, especially with the increasing incidence of medical errors.

Objectives: To identify major causes and nature of medical errors; to detect main issues and challenges in terms of disclosure of medical errors to the patient and/or their family members; and to form a background for development of more constructive strategies of disclosure of medical errors in the healthcare system of Saudi Arabia.

Methods: Cross sectional study conducted by using a self-administered questionnaire distributed among the Doctors and family of Saudi Aribia.

Results: Doctors are less likely to disclose their mistakes to patients and their families unless the medical error is fatal. The common barriers to disclosing medical errors include concern that the disclosure could trigger a harmful reaction by the patient/family, concern that the disclosure could result in a lawsuit, and lack of formal training in error disclosure. Also, doctors are less likely to admit the error when explaining the incident and are likely to apologize without admission of the same.

Conclusion: It is important to sensitize doctors that disclosing medical errors is beneficial for them and patients

Izzah Baridah

Hermina Hospital Balikpapan, Indonesia

Title: Predictors of optimal breastfeeding practices among mothers who have less than 24 months of age children in Hermina Hospital Balikpapan, Indonesia
Speaker
Biography:

Izzah Baridah is a pediatrician in Hermina Hospital Balikpapan, Indonesia. She completed her MBBS in Islamic University of Indonesia studies. She has published 5 papers in reputed journals, more than 10 articles medicine on national medical magazine

Abstract:

Background: The prevalence of exclusive breastfeeding (EBF) for the first six months of life has remained low worldwide. The result of Basic Health Research Indonesia 2010 showed that the coverage of exclusive breastfeeding until 6 months were lower than the exclusive breastfeeding coverage target in Indonesia that 80 %. Even though breast feeding is accepted and praised behaviour, mothers do not always follow the recommendations on breast feeding in Indonesia. Thus, this study aims to determine the optimal breastfeeding practices and associated factors among mothers of children age less than two years in Hermina Hospital Balikpapan, Indonesia.

Methods: Community-based cross-sectional study was conducted in Hermina Hospital Balikpapan using structured interviewer administered questionnaire. The collected data was analyzed using SPSS version 16.0. Logistic regression analysis was used to identify factors associated with optimal breastfeeding practices.

Results: A high proportion 67 (65.6%) of mothers were breastfed their infants sub-optimally while only 48 (47.1%) mothers were breastfed their infants optimally. Wealth index, Educational level of mothers, knowledge and partner Support of EBF were predictors of optimal breast-feeding practices.

Conclusions: Below half (47,1 %) of the mothers were breastfed their infants optimally. Breastfeeding promotion program is essential to encourage the practice of timely initiation of breastfeeding. Breastfeeding promotion programs are needed for mothers, and should include health extension workers, low socio-economically, health-care providers and maternity institutions

Masoumeh Nazarian

Loughborough University, UK

Title: Design lessons from the analysis of nurse journeys in a hospital ward
Speaker
Biography:

Masoumeh is a University Teacher and Research Associate at Loughborough University, UK. She is a qualified architect and was awarded a PhD award in 2014 for her thesis titled “Nursing staff productivity – the role of layout and people circulation”. In her earlier career, Masoumeh was a research assistant in Architectural Research Centre of IUST. She also worked as an architect in two private architectural practices before winning her PhD scholarship from EPSRC in 2010. She continued her profession as University Teacher since 2014 as well as working as a Guest Lecturer in IUST and part-time Assistant Professor in ShD University.

Abstract:

Objective: The objective is to establish design strategies to help minimize nurse journeys and inform future decision-making. The impact of the ward layout was investigated through a case study ward in a multi-specialty hospital in Tehran. Background: Nurse teams have the most direct contact with ward patients. Time spent on activities not part of care provision should be minimized. Literature suggests that a significant part of nurses’ time is spent moving between different places within wards, which emphasizes the importance of ward layout.

Methods: The ethnographic method was adopted for observing nurses’ actions based on routes that form a significant share of nurses’ daily journeys. Data were collected from 42 nursing staff over 120 hours during different shifts. This provided empirical data on the frequency of each journey which revealed meaningful patterns. Approximately 1300 room-to-room journeys were made. Conclusions were drawn about the criticality of each route.

Results: There is a significant difference between the frequencies of different routes in the case study ward. The distances between origins and destinations of the most frequently used journeys must remain minimal. Awareness of less frequent routes allows for greater flexibility in ward design.

Conclusion: Arrangement of ward spaces can minimize journey times. Healthcare planners and designers can explore the implications of chosen systems on walking distance and, consequently, the nursing staff productivity. For existing wards, re-arrangement of space utilization can improve staff productivity. The recommendations can be applied wherever productivity is influenced by walking distances

Nahrida Nazir Band

Hamad Medical Corporation, Qatar

Title: Health care transformation and advanced nursing practice in Qatar
Speaker
Biography:

Nahrida Nazir Band is an Advanced Clinical Nurse Specialist (ACNS) at National Center for Cancer Care and Research (NCCCR), working with Hamad Medical Corporation since 2006 in different nursing and administrative roles. She holds a master’s degree in advanced nursing Practice from University of Calgary. She has served as Chairperson of Professional Practice group of ACNSs at NCCCR. Her research interest mainly focus on outcomes of Clinical Nurse specialist Role, Exploration of advance nursing roles, Health and Wellness of breast cancer patients, risk factors that contributes to breast cancer and provision of optimum support to breast cancer patients after their diagnosis.
 

Abstract:

Description of this paper: The National Cancer Strategy 2011 2016 (NCS) launched under the patronage of Her Highness Sheikha Moza Bint Nasser, has been a driver for significant improvements in cancer services in Qatar. The State of Qatar has undertaken initiatives to advance the nursing profession. One of these initiatives was the introduction of a new nursing career framework in one of the major governmental hospital in Qatar. One of the major changes with this new nursing career framework was the introduction of advanced practice nursing roles. The Clinical nurse specialist’s role was implemented in Qatar in 2011 in a governmental cancer care center, with recruitment of six well experienced CNSs from the United Kingdom (UK). In addition, the University of Calgary in Qatar initiated a master’s in nursing degree (MN) in 2013. The 24 students enrolled in this program, were prepared to enact a CNS role in oncology. The UK trained CNSs in the cancer care center prepare these MN students for their future practice in clinical settings.
 
Purpose: This paper will talk about the emergence of Clinical Nurse Specialist role in Qatar and the health care transformation brought to health care system through the introduction of clinical nurse specialist’s role in Qatar. In addition, the challenges faced by this group of nurses will be discussed. Evidence based recommendations for these issues faced by CNSs from comprehensive literature review will be presented.
 

Break: Closing Ceremony