Day 1 :
Central Connecticut State University, USA
Keynote: Using digital clinical experiential learning to enhance student learning and promote medication administration safety
Time : 09:15-10:00
Nancy Peer, PhD, MSN, RN, CNE, is an Associate Professor in Nursing at Central Connecticut State University, New Britain, USA. She has taught in all course levels of the traditional Baccalaureate Nursing Program, as well as in the RN-BSN Program. She has published research focusing on experiential learning, cultural competency, and innovative teaching strategies in teaching medical-surgical nursing. She is currently developing curriculum for a new Master’s of Nursing Program, and is excited about the use of digital learning strategies to enhance student success.
Statement of the Problem: Decreased clinical time and the ability to practice nursing skills in patient settings, such as medication administration, has fostered interest in using simulation and digital technology in nursing education. Research has shown that medication errors are associated with a lack of nursing knowledge, nursing skill, and nursing experience, as well as a lack of education on medication administration. Technology is a useful tool but does not replace the use of nursing knowledge/skills or the use of nursing process, which will also improve medication administration and decrease medication administration errors. In using relatively new digital clinical technology with nursing students in an undergraduate nursing program, data can be collected and analyzed to determine the impact of said technology on student learning. These digital clinical experiences encompass virtual hospital patients who will assist the student nurse in utilizing the nursing process to practice medication administration. The students will be assigned three practice patient scenarios (basic, intermediate and complex), which will include all of the pertinent information the student will need to practice safe medication administration. To assess learning, an “unguided” digital experience will be completed and graded as part of their final course assessment. The incorporation of these digital clinical experiences are aimed at providing experiential learning and hands-on practice of pharmacology nursing knowledge and skills – skills that will not be practiced in a clinical setting until course completion. Faculty intend that the use of this digital technology will enhance student learning, while providing the tools to promote medication safety, as outlined below.
Debi Tracy had the honor to assist hundreds of couples learn HypnoBirthing® to have the birthing experience they created in their sessions. She was a Childbirth Educator for over 15 years plus a clinically trained Hypnotist specializing in women’s health including fertility, pregnancy and postpartum, she is also a steering committee member of birth keepers and past representative for OMAEP. She is a faculty member of HypnoBirthing® International along with being on staff at South Nassau Communities Hospital and she is an active member of LIDA. She is a birth and post-partum doula trained by CDI and a Prenatal Yoga Teacher. She has been a guest speaker at The Ross School’s Center for Well Being, St. George’s Hospital in Bermuda and a guest on News12 plus The Stir blogspot. She has worked with Suzanne Arms, Karen Brody, Jennie Joseph, Gena Kirby, and Debra Pascali-Bonaro along with the infamous Ina May Gaskin. Her most important credential is, however, her personal experience as having learned the method first as an expectant mother with all the fears, feelings, doubts and concerns that one faces when traveling the journey of pregnancy, childbirth and motherhood.
Instinctive birthing is much more than just a process or a method for “getting baby out” at the end of 9 months. Instinctive Birthing is a natural, normal, healthy, emotional and spiritual experience. It has its own innate rhythm and flow. Our program is based on the premise that a healthy woman, carrying a healthy baby, having a healthy pregnancy and experiencing a healthy labor can reasonably expect to be able to birth her baby calmly, safely, more comfortably and in a shorter length of time. We are not alone in assuming the previous premise and we definitely were not the first. In 1891, an obstetrician living in Buffalo New York authored a book entitled “Easier Child Birth” - an unusual title for that period of time. Even more surprisingly, is the fact that this concept existed as early as 370 BC when Hippocrates stated, “Birth is a natural, normal human function that needs no meddlesome interference.” His contemporary, Aristotle, subscribed to a similar belief and further states, “we must be aware of the mind body relationship in birth and must also consider the emotional factor.”
Time : 11:05-11:50
Dariusz Wojciech Mazurkiewicz holds Scientific Degree of Doctor of Medical Sciences in the Discipline of Medicine. He is a Graduate of Medical University, Technical University and Life Sciences University. He is educated and trained in the field of midwifery, health sciences, mental health, life sciences and hospital care investigation. He is a member of the European Society for Traumatic Stress Studies and a member of the American Association for the Advancement of Science (AAAS). He is scientifically focused on issues linked to: The impact of a mass terrorist attack on the health of an expectant mother and her fetus as well as the course of pregnancy and delivery; Mental disorders in victims of the world trade center attack on September 11,2001; Women's health and pregnancy problems issues.
Statement of the Problem: At present, in the event of a mass terrorist attack, the possibility of a pregnant, birthing or postpartum woman and her newborn obtaining proper medical attention from a midwife is questionable. This situation is certainly a new challenge for midwives and physicians in Poland. The raised factors are vital issues and not limited to European Union. The main subject shall be adopted as a global problem.
Purpose of this study: The purpose of this study is to describe legal regulations defining the autonomy and scope of midwives duties to be a qualified independent medical professional to assist a pregnant, birthing and postpartum woman, her unborn child and/or her newborn, in an extreme situation, such as a terrorist attack.
Methodology & Theoretical Orientation: It was conducted that research-based analysis of the source materials consisting of the data derives from Supreme Chamber of Nurses and Midwives in Poland; National Council of Nurses and Midwives in Poland; Gazette of the Republic of Poland, Journal of Laws of 20 October 2015, Pos. 1739; Gazette of the Republic of Poland, Journal of Laws of 05 June 2012, Pos. 631; the European Resuscitation Council Guidelines for Resuscitation 2015; the EU law in force in Poland (European Commission, DIRECTIVE 2005/36/EC National legislation: Law of 15 July 2011 on Nurse and Midwife Professions); curriculum outlines for professional midwifery higher education in Poland; scientific literature and recommendations.
Findings: In the study it was found a terrorist threat as a gap in the teaching of obstetrics and midwifery; restricted availability of pharmacological agents for use by midwives in event of a terrorist attack; lack of authorizations under a midwife license to perform perimortem Caesarean delivery (PMCD) in event of a terrorist attack.
Conclusions: A new implications are necessary for policy and practice to keep midwives in their profession to provide adequate quality and quantity of health care in event of a terrorist attack
- Military Nursing | Neonatal Nursing | Nursing Education and Research | Emergency Nursing | Cancer Nursing
Location: TRIBECA 1
Central Connecticut State University, USA
Kathmandu University School of Medical Sciences, Nepal
Tupler Technique, USA
Julie Tupler is a Registered Nurse, Certified Childbirth Educator and Certified Personal Trainer. She has developed the Maternal Fitness® Program in 1990 and for over 25 years has been teaching and developing the Tupler Technique® Program for treatment of diastasis recti for women, men and children and also preparing clients for abdominal surgery and pregnant women for labor. She is an expert on treating diastasis recti. New York Magazine calls her the guru for pregnant women. She has been featured on many national television programs such as the Today Show, Regis & Kelly as well as in fitness, medical, and women's health magazines.
Learning how to push in labor is one of the most important skills a pregnant woman can learn during her pregnancy. Yet, it is not routinely taught by medical professionals or childbirth educators. It is a skill that needs to be practiced during pregnancy, so it can become second nature when pushing in the second stage of labor. You cannot teach someone a new skill when they are in pain in labor. It takes at least 21 days to learn and practice a new skill. The best-case scenario for learning how to push in labor is with the Tupler Technique®, is in the second trimester. The art of pushing is all about developing transverse muscle strength and awareness so in labor a pregnant woman can push with her strengthened transverse muscle while relaxing her pelvic floor muscles. Tightening the pelvic floor muscles while pushing without using the transverse muscle can put a lot of force on the pelvic floor putting a woman at risk for prolapses, urinary incontinence and hemorrhoids. The transverse muscle is the inner most abdominal muscle and the one that is used in pushing. Pregnancy creates a condition called diastasis recti which is a separation of the outermost abdominal recti muscles. If a woman has a diastasis before she gets pregnant, diastasis recti will get even larger during pregnancy from expanding uterus. A large diastasis will not only put a pregnant woman at risk for a C-section but it will make pushing much more difficult. The muscles need to be close together to move in the right direction to push effectively. This direction is front to back. When they are separated they move in a sideways direction. Thus, it is important to make a pregnant woman’s diastasis smaller during pregnancy with the Tupler Technique® Program. The Tupler Technique® makes a diastasis smaller by healing connective tissue by approximating both the abdominal muscles and the connective tissue, protecting the connective tissue from getting stretched and strengthening both the abdominal muscles and connective tissue with the Tupler Technique® exercises. The 4 step Tupler Technique Program is: (1) Exercises: Elevator, contracting and head lifts; (2) Wearing the diastasis rehab splint and holding a splint starting in week 4 of the program; (3) Transverse awareness: Using the transverse muscle with activities of daily living; (4) Getting up and down from seated to back lying and back lying to seated and seated to standing. When doing the seated exercises, it is important to work the abdominal exercises “separately” from the pelvic floor muscles. So, in labor a pregnant woman can then push with her strengthened abdominal muscles and relax her pelvic floor muscles. Practicing the skill of pushing while having a bowel movement is important so it is second nature for her to work her abdominal muscles separately from her pelvic floor muscles when pushing in labor to be able to get the baby out faster while protecting her pelvic floor! Holding or wearing a splint in labor helps keep the muscles close together. Learning how to push before labor can make a pregnant woman’s pregnancy, labor and recovery a more rewarding experience.
Susanne N Richterich is currently serving as an Army Nurse Corps Recruiter and Officer In Charge of the Army Healthcare Recruiting Center in Fort Hamilton, NY. She has joined the Army as a combat medic in 2003. She has commissioned as an Army Nurse Corps Officer in 2009. She has deployed in support of Operation Katrina as a combat medic in 2005 and she has deployed in 2012/13 in support of Operation Enduring Freedom/Afghanistan. In her most recent deployment to Kuwait in 2015/16, she has supported Operation Spartan Shield as the Brigade Nurse of 2nd BDE, 1ID. She is currently pursuing her Master’s Degree in Human Resources with an emphasis on Management.
The relevance of violence against nurses has become in the past two decades more emergent (Ditmer, 2011, p. 18). In fact, work violence has become a problem of pandemic proportions, and nurses compared to other professionals are exposed three times higher to violence at the workplace (Ditmer, 2011, p. 18). The authors Atabay, Cangarli, Gunay, & Katrinli (2010) produced evidence from using a mixed method research that work violence stems from both, individual and organizational behavior. Discerning which organizational political, and individual factors subscribe to different peer bullying behaviors, can guide the prevention of this behavior in the future (Atabay, et al., 2010, p. 618). The authors Brown, Ferris, Lian, & Morrison (2014) researched the co-depend relationship of supervisors and subordinates. The study revealed a reciprocal behavior pattern, which showcases that the source of violent behavior is not always easy to identify (Brown, et al., 2014, p. 661). Beck & Blum (2015) propose a solution by implementing collective responsibility to minimize aggressive behavior. The three-step program is a pro-active approach, where the aggressor becomes part of the solution instead of the problem (Beck & Blum, 2015, p.88).
Eli Marie Wiig is a Registered Nurse, pursuing her PhD Degree. She is an experienced Clinical Nurse, Teacher and Manager. She works as a special advisor at a resource-center in the addiction field in Norway. Her passion is to improve health and wellbeing conditions for disadvantaged children, especially children in families with substance-abusing parents. Her research with substance-dependent mothers has provided qualitative knowledge useful for providing improved treatment and support for such families. Her research includes a study on pregnant substance-abusing women in involuntary treatment. Since Norway is the only country with this kind of legislation, results from this treatment may be particularly interesting for an international audience.
Background: Children born to substance-dependent mothers who themselves had an upbringing disturbed by parental substance-abuse problems, are at particular high risk of adverse childhood experiences, dysfunctional family life, and to develop psychological problems, including substance dependence. There is a need to develop more knowledge on helpful interventions for these vulnerable pregnant women and families. In Norway, use of coercion against pregnant substance-abusing women to prevent drug exposure for the unborn child, was legalized in 1996. Despite promising experiences no other country has adopted a similar Act.
Aims: 1) To explore how substance-dependent mothers describe the association between childhood experiences with substance-abusing parents and their own role as caregivers. 2) To explore the social support available for these families 3) How do the professionals at this family-ward describe the aims and interventions in the treatment and their therapeutic roles? 4) How does coercion influence pregnant women’s attachment to the unborn child?
Methods: Using purposeful sampling, 17 pregnant women and mothers, admitted to in-patient substance abuse treatment, were in-depth interviewed, eight of them in involuntary treatment. Nine of the mothers’ significant, others were interviewed to explore the characteristics of the social support available. Then focus-group interviews with 15 professionals were included. Data were analyzed using systematic text condensation and thematic analysis.
Findings: The substance-dependent pregnant women were satisfied with being incarcerated and expressed that this helped them stay abstinent and start an attachment process. Mothers from families with substance abuse described having lived their whole lives on ‘the edge of society’, and were facing a complex rehabilitation process. All mothers worked to abstain from substances, process traumatic experiences, build supportive social networks and to establish safe family environments for themselves and their children. The significant others’ relationships with the mothers were close, consistent and reliable although they were themselves exposed to adverse experiences and cumulative psychosocial and socioeconomic risk factors. Dual treatment of families with parental substance dependence appeared to be complex and challenging, but in-patient treatment was described as well suited for using present-moment situations therapeutically. Some professionals found it challenging to embrace the whole family and concentrated their attention mainly on the parent, or on the well-being of the child. This work seemed to be an area of low prestige, and some professionals had problems staying emotionally balanced. Consequently they needed to take care of their own emotion regulation and time to improve cooperation and support each other.
Kathmandu University School of Medical Sciences, Nepal
Sushila Shrestha has obtained her Masters’ in Community Health Nursing and enjoys sharing her knowledge and skills. She is competent in research and published original research articles in national and international journals. Currently, she is working as a Faculty of Community Health Nursing in Kathmandu University School of Medical Sciences. She worked as a Coordinator of BSc Nursing second year students for 3 years. She has supervised more than 20 theses as an advisor. She has been an organizing member of first and second international nursing conference held in Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
Background: Health facility delivery is considered as critical strategy to improve maternal health. The Government of Nepal is promoting institutional delivery through different incentive programmes and the establishment of birthing centers.
Objective: The objective of this study was to identify utilization of institutional delivery and its associated factors.
Methods: A descriptive cross-sectional study was carried out among the mothers of less than five children in Dhungkharka, Kavre District, Nepal. Pre-tested questionnaire was administered to 170 mothers between 15-45 years of age group. Household survey was done by using purposive sampling technique and face to face interview technique was used to collect the data from 1st July to 30th December 2014. Data was analyzed using simple descriptive statistic with SPSS version 16. Association with institutional delivery was assessed by using chi-square test.
Results: Among the total participants, 90.0% of them had institutional delivery. The higher proportions of institutional delivery were found in both literate mothers (p=0.001) and literate husband (p=0.023).The proportion of institutional delivery among the mothers decided by their relatives (husband, father/mother-in-laws and other family members) for institutional delivery had higher portion (p=0.048) of institutional delivery than participants who decide themselves. But the study was not able to find out the significant association between institutional delivery and age of mothers, husband’s occupation and number of children, number of ANC visits and distance to nearest health facility for delivery.
Conclusion: Utilization of institutional delivery was much higher than national figure. Institutional delivery was associated with both educational status of mothers and their husband. Decision made by husband, mother in-law, father in-law and other family members were also associated with institutional delivery. So, to increase institutional delivery, family members need to be encouraged for safe motherhood programme.
Jordan University of Science and Technology, Jordan
Salwa Obeisat Associate professor in the Maternal and Child Health Department at the Faculty of Nursing, Jordan University of Science and Technology, Jordan. She obtained her Doctorate in Nursing Science from the Catholic University of America in 1999. She was the Dean of Nursing at the Hashemite University in Jordan, between the years 2003-2006. She served as a temporary consultant for national and international organizations including WHO, Jordanian Nursing Council, and Higher Population Council. She is currently a member of several university committees, her research publications in the area of women's health, adolescence, and infertility.
Statement of the problem: Obesity had become a global issue and a major public health concern, because of its impact on the public health. Obstetric and midwifery evidences reported that maternal obesity an important issue, because of its associated complications like: obstructed labors, infections and hemorrhage. People who are obese are often stigmatized and blamed for their weight. Nurses and midwives are not immune to obesity-related stigmatization and the literature features evidences of their negative attitudes towards obese patients. In Jordan, limited numbers of studies were conducted to investigate obesity–related issues. The purposes of this study were to assess nurses and midwives attitudes toward overweight and obese women during the childbirth in the North of Jordan, and to investigate the relationships between nurses and midwives selected socio-demographic characteristics and their attitudes.
Methodology: A descriptive, cross-sectional design was utilized. A convenient sample of 95 midwives and 30 nurses, who were working in the childbirth unit were recruited. A self-administered questionnaire consisted of three sections: demographical data, Arabic version of Fat Phobia Scale (FPS), and the Arabic version of Nurse's Attitudes toward Obesity and Obese Patients Scale (NATOOPS).
Findings: Majority Jordanian nurses and midwives held negative attitudes toward overweight and obese women during childbirth. Midwives held less negative attitudes than did nurse. The majority of participants were perceived the overweight and obese pregnant women during childbirth as overate people, shapeless, slow and unattractive. Age, specialty, education and years of experience were found to be associated with nurses and midwives attitudes.
Conclusion & Significance: Nurses and midwives negative attitudes toward overweight and obese pregnant women are a cause for concern. Therefore, maternal obesity was needed to be more adequately addressed in basic education courses, and in the continuing professional education classes of practicing nurses and midwives.
Azad University-Saveh, Iran
Hossein Fallahi is working in Azad University in Iran. His research interest includes oncology nursing and psychology.
In this research which is selected in a clear remedy naming biofeedback has been done toward anxiety reduction. In this method a simple random sampling has been used. To start this research, 200 nurses who work in oncology section in Tehran hospital has been selected, after a Cattell anxiety test performance, about 36 people whose test result was significantly selected, and they were categorized randomly in three experimental, placebo and control groups. After 12 treatment session (using biofeedback (GFR) device), Cattle anxiety test is performed as a posttest. Considering nature of grading scale which was distance type and also sampling method which was based on experimental research branch of pretest-posttest with control group, for data evaluation Covariance resulting was used. Considering performed evaluation, came to the conclusion comparing performance of three groups in latest anxiety result of fluctuation there were severe differences. Main point indicates that an average grading of testing group was lower than other 2 selected groups. Finally considering achieved result can come to the conclusion and result is that treatment and remedy with biofeedback method can be more effective in anxiety reduction.
University of Louisiana, USA
John Ray Broussard was born on 10-04-1970 and raised in Lafayette, Louisiana. Mr. Broussard was born to be lecturing on Midwife Nurses. While in College, he studied, Mass Communications & Psychology with a minor in Theater obtaining his BFA. During his studies he was a member of the Louisiana National Guard, a Deseret Storm Veteran, receiving 2 Army Accommodation Medals for innovation, now enjoying full VA benefits. He holds 3 separate Patents for the Oil and Gas Industry which aide in performance and safety. Dr. Broussard enjoys serving as a Chaplin at the Lafayette parish correctional facility every other Thursday evening and has a few different retirement communities he serves as Chaplin as well. Currently working with his local Police Chief supplying EDMR Therapy as a tool for actual live debriefing of officers who we catch in advance to prevent PTSD, as well as Working with Evangeline Oaks Retirement community and Our Lady of Lourdes Medical center. Have worked with the College of Nursing at the University of Louisiana, Lafayette. Now known as a thought and emotional control coach.
At the young age of 19, My Mission has been to “Inspire others to happiness with in and Peace of mind”. The Material being presented contains the inner - workings and its outer effects under the heat of battle while in the line of duty. Resulting with several different ways to temporarily suppress disruptive emotions along with any traumatic scene that could cause PTSD. Developing the awareness to tame the amygdala during all emergency deliveries. Teaching - several options and proper ways one could debrief thyself at will. Apply the EMDR process for, reliving the short time repressed emotions and processing them out for good. At end of day same day is best time. The memory of event will not be forgotten; however the different physical pains will disappear, leaving no feeling for the emotion. You will leave this session with beautiful Gold nuggets of key information to have the ability to stay calm allowing full focus and attention to detail, Learning the ability to know the difference between Empathy and doing a job that needs to be done in a very confident way as they should bring comfort to every new mother and others welcomed in the birthing room. You will learn how to instantly identify, every person in a setting and an know who’s who! You know, that person that will be in charge no matter what, but most important, knowing how to handle each individual in the room including the doctor. I am constantly coming up with several practices to bamboozle the Amygdala to allow for total emotional thought control during the heat of battle, being 100% on the job at hand. Taking into account the reality of the situation, knowing that the patient is not in any way related to one another, giving away more professional & scientific approach from the start. The key is keeping the chatter down in your head as those disruptive thoughts come to you, now you will have a way to catch them and turn them to gold as I create a very visual image throughout the talk, as the nuggets of my talk become embedded into the brain of the listener.
Department of Health, World Vision US, USA
Alfonso Rosales is Maternal and Child Senior Advisor of WVUS’ International Program Division, where he is focused on program design and evaluation research for maternal and child health, with special emphasis on community case management and obstetric emergencies management at the community level. Before joining WVUS in 2012, he worked at various international non-governmental organizations such as child fund international, catholic relief services and international rescue committee. He has worked at field level in several African, Asian and Latin American countries, including complex emergency posts, as well as headquarters positions. For the last 20 years, he has been focused on Facility and Community IMCI, providing technical assistance to country programs in Honduras, El Salvador, Nicaragua, Philippines, Cambodia, Indonesia, South Sudan, Somalia and Kenya. In the same topic, he has authored one manual on C-IMCI for Community Health Workers, as well as several publications, and participated in several international conferences on the topic. Since 2005, he has also been working in the development of maternal and neonatal interventions for hard to reach communities in rural settings and in fragile state context. In this topic he has led the development of tools for improving resolution capacity for identification and community case management of obstetric and neonatal emergencies, as well as referral systems. He has published and presented several studies on strengthening health systems to provide essential health coverage among hard to reach populations of women and children, including fragile state context. He served on the Board of Directors of CORE Group. Currently, he is the Chair Person of the Health System Strengthening Working Group.
Background: Indonesia’s progress on reducing maternal and newborn mortality rates has slowed in recent years, predominantly in rural areas. To reduce maternal and newborn mortality, access to quality and skilled care, particularly at the facility level, is crucial. Yet, accessing such care is often delayed when maternal and newborn complications arise. Using the “Three Delays” model originated by Thaddeus and Maine (1994), investigation into reasons for delaying the decision to seek care, delaying arrival at a health facility, and delaying the receiving of adequate care, may help in establishing more focused interventions to improve maternal and newborn health in this region.
Methods: This qualitative study focused on identifying, analyzing and describing illness recognition and care-seeking patterns related to maternal and newborn complications in the Jayawijaya district of Papua province, Indonesia. Group interviews were conducted with families and other caregivers from within 15 villages of Jayawijaya who had either experienced a maternal or newborn illness or maternal or newborn death.
Results: For maternal cases, excessive bleeding after delivery was recognized as a danger sign, and the process to decide to seek care was relatively quick. The decision-making process was mostly dominated by the husband. Most care was started at home by birth attendants, but the majority sought care outside of the home within the public health system. For newborn cases, most of the caregivers could not easily recognize newborn danger signs. Parents acted as the main decision-makers for seeking care. Decisions to seek care from a facility, such as the clinic or hospital, were only made when healthcare workers could not handle the case within the home. All newborn deaths were associated with delays in seeking care due to caretaker limitations in danger sign identification, whereas all maternal deaths were associated with delays in receiving appropriate care at facility level.
Conclusions: For maternal health, emphasis needs to be placed on supply side solutions, and for newborn health, emphasis needs to be placed on demand and supply side solutions, probably including community-based interventions. Contextualized information for the design of programs aimed to affect maternal and newborn health is a prerequisite.