Better Pre-treatment and Chemotherapy Administration

Nurse-identified solution to near-misses in pretreatment lab evaluations was effective in improving chemotherapy administration; however, continued efforts may be needed to sustain the practice changes.

Oncology nurses often find themselves multitasking in a fast-paced environment. Routine tasks such as evaluating lab results prior to administering chemotherapy may become automatic, increasing the risk for near-misses. For this project, a near-missis defined as “orders approved by nurses but halted by pharmacy.” 

Data collected over 6 nonconsecutive weeks identified a total of 36 near-misses (range, 4 to 11 near-misses/week). A nurse-led intervention was developed with the goal of reducing the number of near-misses by 50% over 3 months, explained Ayo Sato-DiLorenzo, RN, BSN, OCN, BMTCN, a nurse educator at Beth Israel Deaconess Medical Center in Boston.

For this study, the researchers created a process map to understand baseline nursing processes, a staff survey to understand existing barriers as identified by staff nurses, and a cause-and-effect diagram to categorize each existing barrier and visually present its influence on the system. 

Potential causes identified in a staff survey included lack of clear treatment criteria, delays in lab processing, and patients distressed by long wait times. Group brainstorming sessions by staff nurses produced a variety of possible interventions. Ideas were organized in priority/pay-off matrix and each evaluated for its merit based on 2 domains: perceived ease in implementation and perceived effectiveness. 

These efforts produced 2 potential interventions. A 2-nurse lab check during order verification and using the “display the last day” feature in the electronic medical record to limit lab display to the most recent results only.

Over 9 weeks, only 1 near-miss was identified. Post intervention surveillance collected 7 months after intervention initiation identified 11 near-misses over 6 weeks (range, 0 to 3 near-misses/week). Although this data demonstrated that the near-miss rate was still lower than pre-intervention rates, a slight increase had occurred since the initial implementation was noted.

A follow-up survey of the staff nurses called out the barriers to full success: a return to past habits and the primary nurse simply telling the second verifying nurse that pretreatment labs have been verified.

For More such research insights join us at the International Conference on Community Nursing and Public Health, November 19-21, 2018, Cape Town, South Africa

Last few speaker slots open.
Submit your abstracts now at
https://community.nursingconference.com/abstract-submission.php

John Hunt

Program Manager

Community Nursing 2018

47 Churchfield Road, London, W3 6AY, United Kingdom

Phone +44-2088190774
Email: community@nursingconference.com

Gender Equality in Public Health

One might expect to see a high degree of gender equality in the global health sector, but a new report shows how its organizations are falling embarrassingly short on addressing gender disparities. Over the past few decades, the international community has tasked itself with achieving a wide range of social and environmental objectives, many of which are enshrined in the United Nations Sustainable Development Goals (SDG) for 2030.

But it has also been realized that far too many efforts to fulfil global commitments lack the meaningful reporting mechanisms needed to succeed. If the global community is indeed serious about translating lofty pronouncements into real progress for people and the planet, this will have to change.

Consider public health, an issue that affects everyone. The global agenda in this area determines the norms and standards that shape how public and private actors promote health, prevent disease, and administer care. It encompasses research initiatives and global public goods such as vaccines and emergency-preparedness programs for epidemic outbreaks. And it brings people together to work toward providing universal health coverage and ensuring everyone’s right to health.

In the SDG framework, the separate issues of gender and health are intertwined, because gender itself is a major driver of health outcomes. Gender can influence whether one smokes tobacco, exercises regularly, or has access to nutritious food. And given that over 75 per cent of the health workforce worldwide is female, it also often determines who will care for the sick.

For decades, the global health community has paid lip service to the critical role of unequal power relations, particularly relating to gender, in determining health outcomes. At this point, one might expect to see a high degree of gender equality in the health sector. But a recent report by the advocacy and accountability group Global Health 50/50 shows otherwise.

In fact, the report, which reviewed 140 organizations working in the global health sector, makes for disturbing reading. Many of these organizations are falling embarrassingly short on addressing gender disparities. Half of the organizations’ strategies do not include a specific commitment to gender equality; and while a third do focus on the health of women and girls, they make no mention of gendered risks.

The situation is even worse for men and boys, who, regardless of country, can expect to live shorter, unhealthier lives than their female peers. According to the Global Health 50/50 report, only a third of organizations take a gendered approach to the health needs of the whole population, and no organizations target men and boys specifically.

Moreover, only 43 per cent of the organizations that were surveyed have specific measures in place to support women’s careers in public health, despite the overwhelmingly female composition of the health workforce. It should come as no surprise that the majority of these organizations are run by men. Across the full sample, 80 per cent of board chairs and 69 per cent of chief executives are male.

One of the report’s more dismaying findings is that two-thirds of the organisations do not disaggregate data by sex. Without data, transparency, and adequate reporting on gender disparities, there can be no progress toward gender equality.

Still, the report’s findings are not all negative. The Swedish International Development Cooperation Agency, the Bangladesh-based organization BRAC, Save the Children International, and The Global Fund to Fight AIDS, Tuberculosis, and Malaria are among a dozen or so organizations that perform well across the board. What they have in common are committed leaders who have taken proactive steps to ensure progress.

The successful organizations have all adopted clear policies and roadmaps for driving organizational change. They have established systems of accountability, including measures to ensure that gender competence is included in job descriptions and staff performance evaluations. And they have created flexible work environments, featuring parental leave and other family-oriented policies.

Join the dialogue on gender equality at Community Nursing 2018

Last few speaker slots open

Submit your abstracts now

John Hunt
Program Manager
Community Nursing 2018
47 Churchfield Road, London, W3 6AY, United Kingdom
Email: community@nursingconference.com

Phone +44-2088190774

Nurses' Workload Linked to Patient Safety

When nurses' workload exceed "optimal" levels, the possibilities of a patient safety incident are inflated by up to roughly 30% and therefore the chances of patient mortality are spiked by around 40% according to a recent study.

The analysis is the first of its kind which explores the connection between nurse workload and patient outcomes on a day to day basis. The researchers gathered primary data from thirty-six units in four Finnish hospitals which included data on nursing workload, staffing, patient safety incidents and mortality rates. The info was collected daily for over one year.

Depending on the kind of patient safety incident, once nursing work exceeded the "optimal" level, the chance of a patient safety incident increased by 8% to 32%! The risk of patient mortality saw a hike of around 43% as and when workload exceeded this level.

The study discovered once workload languishes below that level, leaving nurses with longer periods to treat patients, the risks of a safety incident was around 25% lower.

Although various studies demonstrate the possibly harmful result that inadequate nurse staffing has on patient care, the authors argued some results are "inconsistent" and therefore the association between staffing and rates of mortality and patient safety factors isn’t always easy to figure out.

However, through the analysis of daily data on nurse staffing and safety, the researchers claim that it would be much easier to see figure out the connections with certainty.

Still, the authors emphasized how it remained unclear which method was able to best avoid patient safety incidents and deaths. To determine this, the authors said larger studies over a longer period of time are necessary.

For more such insights into Nursing and Public Health join us at the CNE accredited International Conference on Community Nursing and Public Health - September 17-18, 2018 - Cape Town, South Africa.

Submit your abstracts now at https://community.nursingconference.com/abstract-submission.php 

John Hunt

Program Manager

Community Nursing 2018

47 Churchfield Road, London, W3 6AY, United Kingdom

Phone +44-2088190774
Email: community@nursingconference.com

Improving Nurse-Patient Relationship by Means of Storytelling

A study meaning to discover methods for limiting racial and social hindrances in medicinal services, published in the journal Creative Nursing, investigated the act of narrating stories to make a superior comprehension between cultures. Better patient outcomes may be achieved by deeper understanding of transcultural differences, which can be facilitated by means of storytelling between Nurses and Patients. Tammy Sinkfield Morey, explored the conscious use of storytelling by six nurses in a project called Story Care. Her study was titled “Diversity, Inclusion, and Storytelling: Connecting Across Cultures to Give Meaning to Patients’ Whole Health”. The six nurses for her project were selected at random from a small non-profit paediatric speciality healthcare facility. They were asked to nurture trust so as to gain insights into nurse patient relationships.

The Project Goals were:

·         Enhance satisfaction of patient and family

·         Improve nurse–patient interactions to encourage a genuine trusting relationship

·         Create engagement that promotes mutuality within the nurse–patient experience

·         Enable a situation that completes consciousness of self as well as others

·         Encourage opportunities for recognizing the need to know more

The participant practitioners were asked to keep brief accounts of their interactions with the patients and their results. The results were full of emotional and enlightening accounts and the interactions conveyed an appreciation for the nurses’ presence. Stories that raised consciousness about biases and prejudice, and stories that discovered more similarities than differences between cultures were also exchanged.

Successful storytelling practices offers the prospect of better understanding of cultural needs and an opportunity to drastically improve the nurse-patient relationships in the health care environment. Stories of inequalities in health care among diverse populations can cultivate consciousness and trust within nurse-patient relationships.

John Hunt,

Program Manager,

Community Nursing2018,

47 Churchfield Road, London, W3 6AY, United Kingdom

Phone +44-2088190774

Email: community@nursingconference.com

Nurses and Community Workers Go into Overdrive to Combat Harsh End to UK Winter

As parts of UK remain snow clad with flights being cancelled and highways being shut off, there’s no rest for the nurses. Nurses and health workers battled through the snow to get to their work places and keep UK’s Health Infrastructure up and running. Many nurses stayed overnight in their hospitals and surgeries so that they could attend their following shifts and the patients did not have to suffer any hardships due to the adverse weather conditions. In an interview with a major media network a Paediatric Nurse who stayed over at her hospital stated that she had suffered so badly to reach work that she had to resort to social media to ask people with suitable vehicles to help her reach her hospital. Some NHS staff even walked hours in the snow to get to and from their workplaces. NHS were quick to express their gratitude to Dr Glen Allaway, a Devon based General Practitioner, who had spent two consecutive nights caught up in his Health Care centre so that he could be there for his patients.

Several villagers had stepped up to help Community Health Care professionals to reach villages that were completely cut off due to the snow.

Community outreach workers could be seen in the wee hours of the morning trying to help the homeless who would suffer most due to the brutal end to this winter. 

Community Nursing 2018 would like to express its gratitude to all healthcare professionals who took great perils to serve us even in such harsh weather conditions.

Join us at Community Nursing 2018, Cape Town, South Africa on 17-18 September to show your support to our health workforce. 

We assure you that it won’t be freezing in Cape Town!!!

For details please visit community.nursingconference.com

Best Regards,

John Hunt,

Program Manager,

Community Nursing2018,

47 Churchfield Road, London, W3 6AY, United Kingdom

Phone +44-2088190774

Email: community@nursingconference.com

Alcohol Use Linked to Dementia Onset

Alcohol use disorders are a major risk factor for all types of dementia, including early-onset dementia, according to recently published findings.

Michaël Schwarzinger, MD, Ph.D., and colleagues from France and Canada analysed adult patients admitted to hospitals between 2008 and 2013 to evaluate the link between alcohol use and dementia risk.

The study authors wrote that while some literature suggests a beneficial effect of light to moderate drinking on cognitive health, moderate drinking is consistently associated with damage to the brain.

Between 2008 and 2013, there were 31.6 million adults aged 20 years or older who were discharged from French metropolitan hospitals. The researchers learned that 1.1 million of those patients were diagnosed with dementia and therefore included in the analysis.

Of those patients, there were about 57,000 cases of early-onset dementia. Most of those, nearly 40%, were alcohol-related or had an additional diagnosis or alcohol use disorders, the researchers determined and was equally true for both men and women. However, the researchers did add that alcohol use was not included in the recent dementia review published by the Lancet Commission examining dementia prevention, intervention, and care.

Notably, they wrote, when patients were under the age of 65 years, the most common cases of dementia were alcohol-related, or the patients otherwise qualified for a diagnosis of alcohol use disorders.

“Alcohol-related dementia should be recognized as one of the main causes of early-onset dementia,” they wrote. “Additionally, clinicians should be better aware of the role of alcohol use disorders in dementia onset over the lifetime, which seems to be a risk factor often omitted.”

The study authors offered a variety of reasons for their findings. Among them, heavy drinking can lead to permanent structural and functional brain damage because of the ethanol. Plus, heavy drinking can lead to other conditions which damage the brain, such as epilepsy, head injury and vascular diseases. Heavy drinking can also be linked to smoking, depression and low education, they wrote. These factors have led to formulating a specific diagnosis for alcohol-related dementia.

Come join the discussion at Community Nursing 2018, September 17-18, 2018, Cape Town, South Africa.

Visit us at https://community.nursingconference.com

John Hunt,

Program Manager,

Community Nursing2018,

47 Churchfield Road, London, W3 6AY, United Kingdom

Phone +44-2088190774

Email: community@nursingconference.com

Zero Harm in Health Care Delivery

As part of the Hippocratic Oath, “Primum non nocere”, the Latin phrase that means "First, do no harm" is a basis for ethics taught in medical school. Preventing harms associated healthcare delivery is of paramount importance to improve patient safety. Although much of these are likely preventable, some harm may be unavoidable. For example, post-operative bleeding may occur and be harmful in spite of impeccable surgical technique. Much of the discussions on avoidable harm events nowadays focus on hospital acquired conditions (HAC) including the infamous “never events”. This term was coined in response to extremely shocking medical errors (such as wrong-site surgery) that should always be avoided. In the UK, a framework exists for Never Events by the National Patient Safety Agency which include a core list of such events and implementation tools for practitioners. The NQF list (a list of such never events) has come to signify adverse events that are unambiguous (clearly identifiable and measurable), serious (resulting in death or significant disability), and are generally avoidable. So even in the context of the NQF “Never Events”, it is accepted that they are not always preventable.

While a goal of zero harm is advice able, this may not always be feasible. Many practicing clinicians are dismayed by general statements about eliminating all harm, but may be more willing to engage in discussions about substantially reducing the risk of or eliminating preventable harm. Therefore, developing a better understanding of the nature of preventable harm could lead to unambiguous communication. 

Come lend your hand in this effort  at Community Nursing 2018, September 17-18, 2018, Cape Town, South Africa.

Visit us at https://community.nursingconference.com

John Hunt,

Program Manager,

Community Nursing2018,

47 Churchfield Road, London, W3 6AY, United Kingdom

Phone +44-2088190774

Email: community@nursingconference.com