Day 14 :
- Emergency Nursing | Critical Care Emergency Nursing | Cancer Nursing | Trauma Emergency Nursing | Cancer Therapy & Treatment | Breast Cancer Nursing | Cancer Biomarker | Mid-wife Emergency Nursing | Types of Emergency Nursing
Chair
Pauline Rose
Princess Alexandra Hospital, Australia
Co-Chair
Fahad Zeed Alanezi,
University of Southampton, United Kingdom
Session Introduction
Pauline Rose
Princess Alexandra Hospital, Australia
Title: Concurrent radiation therapy and chemotherapy for anal cancer: Retrospective chart audit of autonomous nursing practice in radiation oncology
Biography:
Pauline Rose has worked in Radiation Oncology for the past 32 years, and is the Clinical Nurse Consultant for Radiation Oncology at the Princess Alexandra Hospital in Brisbane, Australia, which was the first Magnet Hospital in the southern hemisphere. She completed her PhD in 2010 and is a Credentialed Cancer Nurse (Australia). She was a Content Author for the Cancer Institute New South Wales for radiation therapy education modules for nurses and is a regular reviewer for the European Journal of Oncology Nursing. She has published in a range of peer-reviewed journals focusing on person-centred and individualized nursing care in the radiation oncology department, and was instrumental in 1995 in introducing a primary nursing/collaborative practice model into the radiation oncology department, which continues to provide person-centred care to patients every day.
Abstract:
Autonomous nursing practice is the hallmark of radiation oncology nursing in the study setting in Brisbane Australia. This setting utilises a primary nursing/collaborative model to support the large numbers of patients treated daily. Anal cancer represents approximately 2% of all gastrointestinal cancers, and sphincter-preserving treatment, combining radiation therapy and chemotherapy, has become standard treatment. However, acute toxicities are as high as 80%. Radiation oncology nurses assess their patients regularly, and refer to medical and allied health professionals as necessary. The aim of this retrospective chart audit is to determine the extent of patients’ toxicities and the nursing interventions to support their quality of life and reduce admission to hospital. This study audited patients treated for anal cancer over a 2 year period at a Radiation Oncology Department in Brisbane Australia. Data was analysed using a visual toxicity display spreadsheet, and SPSS Version 23. Eligible patients were identified from the radiation oncology information system. The audit examined documented toxicities by nurses across the course of treatment, interventions, referrals to allied health professionals and admission rates. Sixteen patients were identified: 11 females and 6 males. Toxicities consistent across all patients were pain, diarrhoea, moist desquamation of groins and perianal area, nausea, mucositis, fatigue and dysuria. Admission rates were 64.7%: 5 females and 2 males. 47% of patients scored >5 on the distress thermometer at baseline, with 2 females expressing embarrassment at the site of cancer, and 3 patients having underlying psychological disease. Six patients had pain at baseline in the 4-10 range (median 5.00); 3 not entered. Missing chart information included irregular documentation of weight. Referrals were made by radiation oncology nurses to social workers, occupational therapists, and dietitians. The common toxicities resulting from concurrent anal chemoradiation affected all patients audited, with differences only in severity and timing. Proactively improving bowel regimens, hydration, analgesia and weight monitoring as part of a formal clinical pathway may result in less toxicity during and following the course of treatment.
Lucus Christoffersen
Idaho State University, USA
Title: Rural Emergency, Trauma, and Critical Care Management: Preparing facilities to care for critically-ill patients
Biography:
Lucus Christoffersen is an Assistant Professor at Idaho State University, teaching Adult Health Nursing to undergraduate nurses, with the clinical components. He has been active in teaching certification courses and working as the President for Utah Emergency Nurses Association
Abstract:
Rural emergency departments have a unique role in the care of critically ill patients. Nurses serve as the primary caregivers in these intense and time-sensitive situations. With the increase of hospital accessibility for rural populations, do the facilities have the capabilities to care for critically ill patients? Do nurses and care providers have the necessary education and training to care for patients that require high levels of care and extra resources? This lecture will discuss some of the vital tasks that nurses and health care providers should perform to make sure that they are prepared to receive and care for critically ill patients at their facilities. Some of the topics include facility preparation, training and education, how to deal with small team dynamics, and collaboration with larger facilities. This lecture helps give managers and leaders at rural facilities helpful information that they can use to better plan and prepare their staff and facilities for critically-ill patients
Silwal Pratibha
Tribhuvan University Teaching Hospital, Nepal
Title: Organophosphorus poisoning at Tribhuvan University Teaching Hospital, Emergency Department
Biography:
Abstract:
Organophosphorus is most common poisoning in Nepal. Many cases among poisoning the majority are organophosphorus poisoning. As known farming is main occupation here. Most of the people are dependent on farming. Organophosphorus (OP) is choice of pesticide for them and is easily available. But in another way many people use them for threatening purpose, especially among young girls and boys. Most of the case presented in our emergency, are from low economic background. Very simple discussion among husband & wife result in poisoning incident. OP pesticide intoxications are estimated at three million per year worldwide with approximately 3, 00,000 deaths. Most of the OP pesticide poisoning and subsequent deaths occur in developing countries following the deliberate self-ingestion. The case fatality rate following the deliberate ingestion of OP pesticides in developing countries in Asia is 5-20%, we have taken data of six months from Sep 2017 to Feb 2018. During this period, we had found 123 organo phosphorus poisoning cases. This data is collected from TUTH, emergency department. Among them only few cases have ingested in large amount. But majority of cases have ingested few amount. Among total cases, 65 patients were discharged on their request some of them are not worried despite of telling the consequences of poisoning, whereas others were not serious about their family members. In TUTH emergency most of the poisoning cases were managed. But according to the seriousness of the case some were referred to other center for high dependency unit due to unavailability of enough critical care units.
Eivind Richter Andersen
Stavanger University Hospital, Norway
Title: Women’s experience of acute skin toxicity following radiation therapy in breast cancer
Biography:
Eivind Richter Andersen works as a Radiation Therapist at Stavanger University Hospital in Norway. He is especially devoted in patient follow-up and radiation induced side effects, focusing on patient perspective.
Abstract:
Purpose: Acute skin toxicity is experienced by 70%–100% of patients receiving radiation therapy following breast cancer. Most studies focus on skin appearances and treatment of such reactions, not the experience. Increased knowledge about patients’ experience will contribute to provide tailored patient care. Thus, the purpose was to investigate patients’ experiences of acute skin toxicity following radiation therapy for breast cancer.Patients & Methods: Semi-structured in-depth interviews were conducted with seven women, 2–3 weeks post-treatment. Five broad areas of inquiry were investigated: 1) experiences from the development of skin reactions; 2) experiences in day-to-day life; 3) coping strategies; 4) experiences of information; and 5) experiences from the aftercare. The interviews were analyzed in line with qualitative content analysis.Results: The main theme: “Not so bad itself, but it comes on top of everything else” was identified, based upon three categories: 1) unique experience of the skin; 2) it is something about the psychological aspect; and 3) experience of information.Conclusion: Acute skin toxicity following breast cancer treatment may affect many dimensions of patients’ lives. Experiences are complex, individual, and not necessarily consistent with visible changes of the skin. A holistic approach is necessary to provide treatment and support according to patients’ individual needs.
Heidi Martin
University Medical Center of New Orleans, USA
Title: Sexual assault in the emergency department: Are we missing something?
Biography:
Heidi Martin is a Forensic Nurse with a strong foundation in ED psychiatric nursing. She has built her career by working as an ED Nurse in a Level 1 trauma centre and expanded to forensics to address the needs of this population. She also likes kitties and coffee.
Abstract:
Lack of education leads to a missed opportunity. Education is a necessary component for all members of a multidisciplinary team who provide victim-centred care in an Emergency Department (ED). Awareness of signs and symptoms of psychological trauma is key in preventing sexual assault victims from slipping through the cracks. Often, external injuries are focused on and in cases of sexual assault the crime may be missed in its entirety; this oversight has the potential to not only create a risk for sexually transmitted diseases but may also return the patient to a dangerous environment in the event of trafficking cases. Healthcare providers have an obligation to appropriately identify and respond to victims of sexual assault, without the appropriate education, public health and public safety concerns are created. The evolution of societal awareness and concern, moving to action and intervention begins with bedside nursing in the clinical setting. This initial step is a nursing intervention that when judiciously applied, identifies these unique cases. Psychiatric knowledge combined with a victim-centred response creates successful interventions in addressing neuro-trauma. For patients that are post-sexual assault, a visit to the ED may see them present anywhere on a spectrum from an acute psychotic episode to mild anxiety or even complete denial. The nature of sexual assault tends to create complex psychological trauma that is expressed differently from patient to patient. My experience as a psychiatric and ED nurse at a Level 1 trauma centre has equipped me to better identify victims of sexual assault and therapeutically engage patients with neurotrauma during forensic medical examinations. All ED nurses should be provided with the basic tools and training to identify victims.
Shuei-Chen Chin,
Mennonite Christian Hospital, Taiwan
Title: Applying lean methods and team resource management to reduce medication errors in nurses of emergency
Biography:
Shuei-Chen Chin is a Head Nurse in Emergency department. She holds a Master's degree from Tzu Chi University in Taiwan. She has worked in intensive care units for 15 years and in emergency department for six years.
Abstract:
The purpose of this project is to reduce medication errors in emergency nurse. From January 1, 2015 to December 31, 2016, the medication error of our emergency department was 0.02% (16/83,322). A survey of medication errors using the eight types of waste analysis showed that the number of errors was 164 (32.2%). Causes include: waste of defects, waste of inventory, waste of action, waste of processes and waste of human resources, therefore, create a project. The proposed improvement plan is: Establish a standard procedure for emergency medication, the implementation of drug standard process according to the rules, medication process is smooth; do not disturb bulletin board, references recommended to use "do not disturb in medicine" sign to remind patients or their families to avoid mistakes nursing staff; conduct clinical teachers to teach the standard course of medication consistency, apply human resources, invite emergency room clinical teachers and teaching content and methods of consistency to discuss, for new employees to teach the relevant standard medication process, to avoid their medication errors; establish a mutual care mechanism team, take the initiative to care for the hearty colleagues, to give positive encouragement to discourse, and colleagues in the same class can remind each other and support each other, to create praise more than criticism of the friendly workplace did reduce the medication error from 32.2% to 3.13%, which not only achieved the goal of improvement, but also enhanced the patient's medication safety and also enabled the patients to obtain good care quality.
- Emergency Nursing | Refugical Emergency Nursing | Surgical Oncology Nursing | Clinical Trials Emergency Nursing | Cancer Pain Management | Prostate Cancer Nursing
Chair
Lucus Christoffersen
Idaho State University, USA
Co-Chair
Chukwurah Ndidi Juliet Ifeoma
Nnamdi Azikiwe university Teaching hospital, Nigeria
Session Introduction
Ahmet Butun
Queen's University Belfast, UK
Title: A mixed method systematic review of the reasons parents attend emergency department with their children for non-urgent conditions
Biography:
Ahmet Butun completed his Master’s degree from University of Nottingham, and his master’s dissertation focused on why parents choose to use the emergency department for children presenting with minor illness. His dissertation has been published in International Emergency Nursing. He is currently a PhD student at Queen’s University Belfast and his research project seeks to identify parental reasons for visiting ED, rather than their primary healthcare providers, in the context of developing countries.
Abstract:
Background & Aim: Non-urgent visits to emergency department (ED) services are on the increase, and the pressure on EDs is a significant global concern. The use of EDs by parents of children with non-urgent condition is an important and still unresolved problem, which is associated with overcrowding, higher costs, lower quality of care and longer waiting times. The aim of this review is to identify parental reasons for visiting ED for children presenting with non-urgent conditions.Method: Seven databases were systematically searched in August 2016. The study selection process and quality assessment were undertaken independently by two authors. Data were analysed by means of narrative synthesis.Results: 22 studies met with pre-specified inclusion criteria. Ten studies used quantitative methods, ten studies used qualitative methods, and a further two studies used mixed methods. All included studies were conducted in high-income countries and reported in English. Identified themes included perceived urgency by parents, perception regarding better care and staff expertise in the ED, proximity, out of hours availability, difficulties with obtaining a GP appointment, GP referral, lack of facilities in primary healthcare services, financial issues, need for reassurance, convenience and access issues.Conclusion: This review brings both qualitative and quantitative data together. This review may inform researchers, healthcare staff and healthcare policy makers in better understanding parental reasons for using the ED. Identifying parental reasons may help with the development of targeted interventions that seek to reduce non-urgent ED visits, which would save overstretched healthcare resources.
Biography:
Abstract:
Blood pressure of 140/90 mmHg or more or an increase of 30 mmHg in systolic and/or 15 mmHg in diastolic blood pressure over the pre- or early pregnancy level. Predisposing factors:Primigravidae more than multigravidae,Pre-existing hypertension,Previous pre-eclampsia,Family history of pre-eclampsia.,Hyperplacentosis i.e. excessive chorionic tissue as in hydatidiform mole, multiple pregnancy, uncontrolled diabetes mellitus and fetal hemolytic diseases. Directed toward decreasing the maternal BP using inpatient hospitalization or conservative management and antihypertensive medications along with increase in dietary protein and an increase in calories, if indicated. Delivery is appropriate therapy; however, delivery may endanger the fetus due to fetal lung immaturity. Expectant management (wait and watch) can be considered if the following maternal and fetal factors are present: Controlled hypertension, Urinary protein of any amount, Oliguria (< 0.5 mL/kg/hour) that resolves with routine fluid/food intake, AST or ALT greater than 2 times upper limit of normal without epigastric pain or right upper quadrant (RUQ) tenderness. Signs of MgSO4 toxicity include loss of deep tendon reflexes, including knee-jerk reflex, respiratory depression, oliguria, respiratory arrest, and cardiac arrest
Qiuping Li
Jiangnan University, China
Title: Depression, anxiety, dyadic relationships, and mutual impact between Chinese cancer patients and family care givers
Biography:
Qiuping Li, PhD and MD, Professor, Supervisor in the master’s degree. Her research interests comprise nursing education, digestive system diseases and cancer care. The major research contents mainly focus on the development and evaluation of supportive psychological intervention model for cancer patients and their family caregivers. She has accomplished 11 research projects. More than 90 articles were published by the first author or corresponding author, among which 25 were included in SCI journals. She has edited 16 textbooks and 5 monographs, and secured research funding from the National Natural Science Foundation of China (NSFC) as Principal Investigator.
Abstract:
Background: Cancer and its treatment can result in psychological distress in both cancer patients (CPs) and their family caregivers (FCs). This psychological distress acts as a significant adverse factor in both CPs and FCs. The study purposes included: (i) to assess the anxiety and depression of CPs and their FCs, and examine the dyadic relationships of anxiety and depression between CPs and their FCs; (ii) to investigate factors that may modify these relationships. Methods: Participants consisted of 641 dyads of CPs and FCs. Three types of variables were collected as potential modifying factors, including CP-related variables, FC-related variables, and family-related variables. Descriptive statistics, T-test, Pearson correlations, sub-group analysis were applied to conduct the data analysis. Results: Nearly one-third of participants experienced anxiety and depression (the Chinese version of the Hospital Anxiety and Depression Scale, C-HADS). CPs and FCs experienced a similar degree of C-HADS. Correlations (r) of C-HADS between CPs and FCs ranged from 0.25 to 0.32. Various factors influencing the anxiety and depression of dyads between CPs and their FCs were identified, including CP-related variables, FC-related variables, and family-related variables. Conclusions: Study findings call attention to the anxiety and depression, as well as the related factors in dyads of CPs and FCs. The underlined essential components and focus of intervention, which will be developed to decrease psychological distress and improve quality of life in dyads of CPs and FCs, included such areas as individual characteristics of CPs and FCs, family relationship.
Amany Mohamed Shebl
Mansoura University ,Egypt
Title: Impact of oral care protocol on the incidence and severity of stomatitis induced by radiotherapy.
Biography:
Amany Mohamed Shebl has occupied several positions as Dean of the Faculty of Nursing, Mansoura University, Egypt. Minister of Health Assistant for Human Resources all over Egypt. She was a published author of several research papers, articles, and books on nursing. She is a Reviewer in Advanced Nursing journal and Cancer Nursing journal and a Reviewer in National Authority of Quality Assurance and Accreditations. She has developed many national and international protocols (Nigerian government and United Arab of Emirates). She is one of the Developers in Nursing Education in Egypt. She has published more than 70 papers in reputed journals.
Abstract:
Oral stomatitis is a common debilitating complication of cancer radiotherapy. It results from local effects of radiation on the oral mucosa. The impact of oral stomatitis is far-reaching for patients, caregivers and the medical system. Objective: the aim of the study was to assess impact of oral care protocol to radiotherapy-induced stomatitis in cancer patients. Methods: Quasi-experimental research design was conducted in the Clinical Oncology and Nuclear Medicine Department at Main Mansoura University Hospital. The data were collected from two hundred adult patients of both sex randomized selected who corresponded to inclusion criteria and divided into two groups. Results: the result indicates increased total knowledge score for patients at immediate post more than post tests 1 and post test 2. Also it was found decreased incidence and severity of stomatitis after oral care protocol. There were a positive relation between severity and incidence of stomatitis of studied patients in relation to their knowledge. Conclusion: The implementation of oral care protocol had a positive effect on the studied patients' total knowledge scores and decrease incidence and severity of stomatitis in the study group. It was recommended that, Cancer patients should be given a written instruction plan for their radiotherapy steps and self- management measures to radiotherapy
- Poster Presentation
Location: Foyer
Session Introduction
Shiow Luan Tsay
DaYeh University, Taiwan
Title: Organizational climate, job satisfaction and practice outcome of nurse practitioners in Taiwan
Biography:
Shiow Luan Tsay has completed her PhD from University of Maryland, USA. She is the Dean of College of Nursing & Health Sciences, DaYeh University, Chunghwa, Taiwan. She is the President of Taiwan Nurse Practitioner Association. She has published more than 100 papers in reputed journals and serving as a Chief Editor for the Journal of Nursing Research (SCI).
Abstract:
The purpose of this study is to explore the relationships between organizational climate, job satisfaction and practice outcome of Nurse Practitioners (NP) in Taiwan. The study is a descriptive and correlational design. Certified nurse practitioners who are the member of Taiwan Association of Nurse Practitioner invited to participate in this study. 513 NPs completed the structured questionnaire. The research measure included the basic information form, the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ), the Misener Nurse Practitioner Job Satisfaction Scale, (MNPJSS) and the Nurse Practitioner Practice Outcome Scale (NPPOS). SPSS 22.0 Statistical Software used to coding and analyze data. Statistics include descriptive analysis, t-test, Pearson correlation coefficient, analysis of variance (ANOVA) and linear regression analysis. Results showed that the average age of NP was 36-40 years old (66%), married (64.1%), and had a Bachelor’s (71.1%) or Master’s (23.4%) education. Majority of NPs certified in medical (44.1%) or surgical (44.8%) specialty. NPs practiced in medical centers (50.9%) or regional hospitals (36.6%). The most common practice model in the acute care hospitals is collaboration with attending physicians (59.1%). 54.2% of NPs are routinely on call. The average patients load is 15 (71.1%) daily. Overall, NPs are highly trusted by physicians (94.8%), nurses (94.9%), and patients (92.6%). Study results revealed a significant positive correlation between organizational climate, job satisfaction and practice outcome (p<0.01). Linear regression analysis showed that NPs who had a working contract, additional salary as a promotion, charting bonus, special unit (ED or ICU), patient load, trust of physicians, nurse, and patients explained 15% of variances in the practice outcome, while the organizational climate and job satisfaction explained an additional 5.4% of the variance.
VÃctor J Costela RuÃz
University of Granada, Spain
Title: Nursing role in therapeutic phlebotomy in patients with polycythemia vera
Biography:
Víctor J Costela Ruíz has completed his Bachelor’s at the University of Granada and he is now enrolled in a Predoctoral contract in the Faculty of Health Sciences at the University of Granada. He has several Bachelor´s degrees (Social Work, Anthropology, Criminology and Nursing) and Master´s degrees in Anthropology and in Nursing Emergencies. He also works directly with the Hematologist Unit of the General Hospital of Granada
Abstract:
Nowadays, therapeutic phlebotomy (TP) is the first option in polycythemia vera (PV) treatment. It is a technique done by nursing staff with the continuous supervision of a doctor during the procedure. The diagnosis chriteria of PV are an increase in haematocrit more than 45% in men and more than 42% in women, and an level of haemoglobin more than 18.5 g/dL or 16.5g/dL, respectively, as well as an increase of red bloob cell count. The objetive is to determinate the nurse role in the following up of this kind of patients in order to know what are the possible complications related to TP. Be means of literature collection from different clinical database (PubMed, MEDLINE, BioMedCentral); and with keywords: nursing, polycythemia, phlebotomy, therapeutic; it has been collected 20 paperes related to this field. Thus, this group of patientes can develop several events such as those cardiovascular and cerebrovascular, arterial and venous thromboembolism, and hematologic diseases like myelifibrosis and/or acute myeloid leukaemia/mielodisplastic syndrome. It has been found that the main risk in TP along the first 3 years is thrombosis events. In patients with a high risk of thrombosis or those who are not able to tolerate therapeutic phlebotomy, it is used hydroxyurea (oral chemotherapy). Nursing function in this group of patients if highly important in order to detect complications related to TP, giving an important role to the joint medical and nursing approach.
Yu-Mei Chiu
Chin Mennonite Christian Hospital, Taiwan
Title: Comparison of the knowledge and skill of resuscitation training in nurses of emergency and critical care department
Biography:
Yu-Mei Chiu is a Specialist Nursing in emergency department. She holds a Master's degree from Taiwan Tzu Chi University. She has over 20 years of experience in first aid education and training.
Abstract:
Objectives: Aim of this study is to analyze the present performance of advanced cardiovascular life support (ACLS) knowledge and skills among nursing staffs in the emergency and critical care department of a regional hospital in Taiwan, before and after the intervention of ACLS training and context simulation.
Methods: 61 nurses were included in this study. First we evaluated the knowledge and skills before the intervention of ACLS training and evaluated again after the ACLS training. ACLS context simulation was performed three months later and the third evaluation was arranged six months later. The research parameters were included the basic information of nursing staffs, ACLS written tests, BLS and Mega code skill tests. All data have been analyzed by SPSS 24.0 software.
Results: The age, nursing status, total nursing experience years, the seniority of emergency and critical care, and frequency of practicing CPR and review of ACLS article of nursing staffs were significantly different in the result of performing ACLS knowledge and skills. After receiving ACLS education training, there were statistically significant differences. Knowledge and skills of ACLS education three months after the intervention of the situation simulation review, for the first aid of knowledge and skills of memory there is a significant retention effect.
Conclusions: The situational simulation review three months later of the ACLS course has a significant effect on the memory of the knowledge and skills for resuscitation. Therefore, the ACLS simulation review course should be arranged within three months after the initial ACLS training course to prevent deterioration of knowledge and skills. The review course would be designed in 10 to 15 minutes by the way of context simulation to increase team strategy understanding and keep CPR quality in an efficient way.
Wei Shu Lai
National Cheng Kung University, Taiwan
Title: The last duties - integration of immediate post mortem care and acute bereavement care: Development of competency-based nursing entrustable professional activities (EPAs)
Biography:
Wei Shu Lai has completed her PhD from National Cheng Kung University. She is an Assistant Professor in National Cheng Kung University in Taiwan. Her specialty is palliative care, bereavement care, comfort care, and adult nursing care
Abstract:
Integrated immediate postmortem care and acute bereavement care can help bereaved family members deal with strong emotions and physical pain caused by acute grief following the death of a patient. However, the integration of immediate postmortem care and acute bereavement care is lacking in nursing education. Competency-based milestones will be served as a framework for developing entrustable professional activities (EPAs) which may contribute to enhancing nursing students’ competence in providing adequate acute bereavement care when carrying out postmortem care. The purpose of this study is to develop competency-based nursing EPAs that integrate immediate postmortem care and acute bereavement care. Two- phase focus group was applied in this study. During phase one, six transdisciplinary experts of end-of-life care were invited to discuss the content domain, competence indicators for each milestone level, and transdisciplinary cooperation in the implementation of integrated immediate postmortem care and acute bereavement care EPAs. Data were analyzed using a content analysis approach. In second phase, a consensus meeting with the experts was held to confirm the content of EPAs, establish content validity, and accordingly develop a EPAs assessment tool. The findings in this study indicated five levels of EPAs and their competence indicators. The competency-based EPAs that integrate immediate postmortem care and acute bereavement care can serve as the basis for training in end-of-life care.
VÃctor J Costela RuÃz
University of Granada, Spain
Title: Clinical security management in outpatients with non–Hodgkin lymphoma treated with subcutaneous rituximab
Biography:
Víctor J Costela Ruíz has completed his Bachelor’s at the University of Granada and he is now enrolled in a Predoctoral contract in the Faculty of Health Sciences at the University of Granada. He has several Bachelor´s degrees (Social Work, Anthropology, Criminology and Nursing) and Master´s degrees in Anthropology and in Nursing Emergencies. He also works directly with the Hematologist Unit of the General Hospital of Granada.
Abstract:
Non–Hodgkin´s lymphoma (NHL) is an increasing disease across the board. Intravenous rituximab was first approved as NHL treatment in 1997. Normally, rituximab intravenous infusion takes more than three hours, and the subcutaneous (SC) one takes only few minutes and allows patient´s stay at home. The objective is to show nurses how to manage adverse events in SC rituximab. Be means of literature collection from different clinical database (PubMed, MEDLINE, BioMed Central, Science, CINAHL) and with keywords: Non–Hodgkin lymphoma, treatment, rituximab, outpatient’s rituximab, nursing, adverse events rituximab; we have collected 17 papers related to this field. The SC administration of rituximab in Spain began in 2016. SC formulation is administrated as a second cycle (first one must be intravenous). The most adverse events of SC treatment are neutropenia (26%), febrile neutropenia (10%) and leukopenia (8%). Administration related reaction are those related to local skin reactions like erythema, pain, swelling, pruritis, rash, bruising and myalgia in puncture zone. In spite of adverse events and local reactions, home treatment plays an important role to improve patient´s quality of life and to avoid the consequences related to the patient’s hospitalization to get the drug infusion. Nurses play a primordial function in the SC rituximab administration, as much as the one played by the doctor. It is very important to detect possible complications in patients with this treatment as those are a group of outpatients that are in continuous contact with nursing staff. Possible complications are prematurely detected to let the doctors know and take the required measures.
Olena Crechanina
Kharkiv National Medical University Ukraine
Title: The efficiency of adequate diagnostics in the treatment of metabolic crisesOlena Crechanina
Biography:
Olena Crechanina has completed her PhD from National Medical University, Department of General Medicine; and Postdoctoral studies from National Medical University, Department of Obstetrics and Gynecology. She is the General Director of Kharkiv Interregional Specialized Medical Genetic Center – Center of Rare (Orphan) Diseases.
Abstract:
Children with an acute organic aciduria in the neonatal period, as an acute metabolic crisis, need emergency specialized nursing and consultation by the clinical geneticist. The conduction of the selective screening has allowed revealing the following diseases among all children who are in intensive care units (centers for emergency medical care and disaster medicine): Glutaric aciduria type 1 (GA1) – six patients; Canavan disease – three patients; Alkaptonuria – four patients; maple syrup urine disease – five patients; 5-oxoproline aciduria (deficiency of the mitochondrial import of 2-aminoadipate) – one patient; disorders of mitochondrial oxidation of fatty acids – four patients; peroxisomal disorders – one patient; tetrahydrofolate reductase deficiency– one patient; carnitine deficiency – one patient. Three of patients with 5-oxoproline aciduria died. The rest of these patients survived. Medication that should be available in every accident emergency department of children’s hospitals: biotin, folic acid, folinic acid, hydroxocobalamin, L-arginine-HCl, L-carnitine, pyridoxal phosphate, pyridine-HCl (Vitamin B6), Na-benzoate. The chances of survival rate of children will be increased due to the presence of the mentioned medication in every accident emergency department. The received experience has increased the survival rate of children, which for today is 88.5 percent.
Biography:
Víctor J Costela Ruíz has completed his Bachelor’s at the University of Granada and he is now enrolled in a Predoctoral contract in the Faculty of Health Sciences at the University of Granada. He has several Bachelor´s degrees (Social Work, Anthropology, Criminology and Nursing) and Master´s degrees in Anthropology and in Nursing Emergencies. He also works directly with the Hematologist Unit of the General Hospital of Granada.
Abstract:
Polycythemia vera (PV) is a myeliproliferative disease characterized by an increase of erythrocitos that leads to an increase of red bool cell mass. There are several treatments to face the disease, among others, treatment with hydrox urea. The objective is to determinate the nurse role in the following up of patients treated with hydroxy urea in order to be able to early detect adverse events and resistance. Be means of literature collection from different clinical database (PubMed, MEDLINE, Bio Med Central, Science, Cinahl) and with keywords: nursing, polycytemia, hydroxy urea intolerance, hydroxy urea resistance, hydroxy urea adverse events; we have collected 28 papers related to this field. Nowadays, hydroxy urea is the first choice in patients with high risk disease, although 24% of patients can develop hydroxiurea adverse events or resistence. The most common adverse events related to the treatment with hydroxyurea are cardiovascular events, oral and skin ulcerations, vaso - oclusive pain, acute chest syndrome, avascular necrosis, retinopathy, and poor quality of life. In case of hydroxyurea resistance, treatment is not effective for patients with PV, and are in risk of thrombosis, hematologic diseases like myelifibrosis and/or acute myeloid leukaemia/mielodisplastic syndrome. In case of intolerance and/or resistance or acute adverse events, ruxolitinib (tyrosine kinase inhibitor) is usually the alternative. Nursing role in this clinic field is very important detecting in an early way possible complications or resistances related to this treatment in order to get first hand information to doctor in charge of patient´s
Yi Lin
Jiangnan University, China
Title: Feasibility and efficacy of hospital- based home care for cancer pain in advanced cancer patients
Biography:
Yi Lin is a Lecturer of Wuxi Medical School, Jiangnan University, and she is also studying for a Doctorate at the Second Military Medical University. She is a Registered Nurse, and majors in Psycho-Oncology. She has published more than 20 papers in Chinese journals.
Abstract:
Background: In patients with advanced cancer, the pain management is an essential element in a comprehensive strategy for palliative care. While most cancer patients with short hospital stay, continuity of care is an extension of pain management to discharged patients.
Objective: The aim of this study was to explore the feasibility and effectiveness of pain management for advanced cancer patients with hospital-based home care.
Method: The oncology nurses in hospital specialized in pain and palliative care (n=7) cooperated with community nurses to provide a 6-month services for pain management to advanced cancer patients at home. The feasibility and efficacy of the program was evidenced by the acceptability, satisfaction and cancer pain knowledge of the patients.
Results: A total of 192 patients with moderate to severe pain were enrolled in the study from January 2015 to June 2017. Proportion of patients receiving pain management at home and satisfaction were increased significantly every year (p<0.05), and the patient's knowledge of pain management improved significantly between the pre-post intervention (p<0.01).
Conclusions: The hospital- based home care for cancer pain can effectively improve the knowledge of pain management and satisfaction of advanced cancer patients.
Yi Lin
Jiangnan University, China
Title: Feasibility and efficacy of hospital- based home care for cancer pain in advanced cancer patients
Biography:
Yi Lin is a Lecturer of Wuxi Medical School, Jiangnan University, and she is also studying for a Doctorate at the Second Military Medical University. She is a Registered Nurse, and majors in Psycho-Oncology. She has published more than 20 papers in Chinese journals.
Abstract:
Background: In patients with advanced cancer, the pain management is an essential element in a comprehensive strategy for palliative care. While most cancer patients with short hospital stay, continuity of care is an extension of pain management to discharged patients.
Objective: The aim of this study was to explore the feasibility and effectiveness of pain management for advanced cancer patients with hospital-based home care.
Method: The oncology nurses in hospital specialized in pain and palliative care (n=7) cooperated with community nurses to provide a 6-month services for pain management to advanced cancer patients at home. The feasibility and efficacy of the program was evidenced by the acceptability, satisfaction and cancer pain knowledge of the patients.
Results: A total of 192 patients with moderate to severe pain were enrolled in the study from January 2015 to June 2017. Proportion of patients receiving pain management at home and satisfaction were increased significantly every year (p<0.05), and the patient's knowledge of pain management improved significantly between the pre-post intervention (p<0.01).Conclusions: The hospital- based home care for cancer pain can effectively improve the knowledge of pain management and satisfaction of advanced cancer patients