Supporting the Development of Informatics Competencies Among Senior Nurse Leaders in Canada

This poster will provide an overview of the various initiatives completed to support the development of informatics competencies among senior nurse leaders in Canada. These initiatives have included a literature review to uncover competencies of relevance to the Canadian context, and a Delphi study to achieve consensus on the competencies for Canada. Current and future plans will be discussed to translate these competencies into practice among senior nurse leaders.

1502 UK National Survey of Huber Needle Availability for Deflation of Gastric Band Balloon in The Acute Setting

Introduction The laparoscopic gastric band was popularised in the 1990’s. The procedure involves placement of an adjustable band around the proximal stomach, aiming to induce satiety and offering a surgical solution to morbid obesity. Complications such as band slippage and erosion, together with succession by sleeve gastrectomy and gastric bypass which offer more significant weight loss has meant the procedure has gone out of favour. However, their legacy continues with a stream of patients presenting annually with complications, many of whom have travelled abroad for the procedure. The aim of this study was to examine Huber needle availability in acute surgical units nationally. Method All acute general surgical admission units across the UK were identified from the National Emergency Laparotomy Audit database. The senior nurse managing each unit was contacted by telephone and asked three questions; whether their hospital has an elective bariatric service on site, whether they review acute bariatric emergencies and whether the unit stocks Huber needles. Results 151 acute general surgical units were identified across the UK, of which 60% responded. 30/90(33%) have an elective bariatric service on site and 65/90(72%) reviewed acute bariatric patients. 8/90(8.9%) stock Huber needles for the acute deflation of gastric bands. Conclusions Patients presenting acutely with gastric band complications typically need urgent deflation of the gastric band. The Huber needle is a non-coring needle used for gastric band adjustment, preventing damage to the port. The Huber needle is a low-cost item and should be stocked by all acute general surgical units.

Improvement of the professional orientation system, adaptation and promotion of nursing staff in medical organization

The aim of the study is to improve the system of vocational guidance, adaptation and promotion of nursing personnel in a medical organization. Results: an assessment was made of the organization of vocational guidance, factors affecting labor adaptation, the conditions necessary for promotion up the career ladder and the role of a senior nurse in all designated areas. Conclusion: The personnel management system implies, first of all, a well-functioning procedure for the entry of new employees into the organization, which allows to reduce material costs, time costs, staff turnover, psycho-emotional stress. The formation of a positive attitude of new employees to work, in the future, is influenced by a conscious choice of profession (professional orientation) and the possibility of career advancement.

Applying the Synergy Model to inform the nursing model of care in an inpatient and an ambulatory care setting: The experience of two urban cancer institutions, Hamilton Health Sciences and Grand River Regional Cancer Centre

The incidence and prevalence of cancer continues to rise throughout Canada. Approximately one in two Canadians are expected to develop cancer at some point in their lives (Canadian Cancer Society, 2021). As the complexity and acuity of individuals with cancer increases, there is increased necessity to define the ideal nurse-to-patient ratio and patient caseload for nurses in specialized oncology settings. Two senior nurse leaders, faced with the need to determine the most appropriate model to inform the nursing model of care within their respective care areas, collaborated and decided to implement the Synergy Model. The Synergy Model is a professional practice model developed by the American Association of Critical Care Nurses (AACN). In the Synergy Model, nursing care reflects the integration of nurses’ knowledge, skills, attitudes, competencies, and experience to meet the needs of patients and families (Curley, 2007). This model provides a framework for matching nursing resources based on patient care needs and has been adapted in various care settings. The model, however, has not been applied in a surgical oncology inpatient unit or in an oncology ambulatory care setting. Using a quality improvement methodology, the Synergy Model was piloted in these new areas and found to be effective. The Synergy Model can be utilized to determine the need for additional nursing resources with specialized oncology nurses and appropriate skill mix of intraprofessional nursing teams. It can also be used to assess adult oncology patients who present to the ambulatory systemic care suite for unscheduled care related to symptomatic concerns.

The role of the leader in governing communication and formation of social and psychological climate in the collective in medical organization

The aim of the study the role of a leader in managing communication and shaping the microclimate in a team. Results: the senior nurse in the department forms and maintains the social and psychological climate in the department. She is a team player, empowered and empowered, uses a business-like style of communication in solving assigned tasks, while providing for the construction of communication on trust. Conclusion: the ability to build relationships with people, to find an approach to them, to win them over is necessary for every leader, this ability is the basis of life and professional success. The formation of a favorable socio-psychological climate of the labor collective is one of the most important conditions for the struggle for the growth of labor productivity.

Task-shifting to improve asthma education for Malawian children: a qualitative analysis

Background Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced asthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention. Methods We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified. Results Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach. Discussion Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage. Trial registration The RCT was registered in the Pan African Clinical Trials Registry: PACTR201807211617031

Medical crisis checklists in the emergency department: a simulation-based multi-institutional randomised controlled trial

BackgroundStudies carried out in simulated environments suggest that checklists improve the management of surgical and intensive care crises. Whether checklists improve the management of medical crises simulated in actual emergency departments (EDs) is unknown.MethodsEight crises (anaphylactic shock, life-threatening asthma exacerbation, haemorrhagic shock from upper gastrointestinal bleeding, septic shock, calcium channel blocker poisoning, tricyclic antidepressant poisoning, status epilepticus, increased intracranial pressure) were simulated twice (once with and once without checklist access) in each of four EDs—of which two belong to an academic centre—and managed by resuscitation teams during their clinical shifts. A checklist for each crisis listing emergency interventions was derived from current authoritative sources. Checklists were displayed on a screen visible to all team members. Crisis and checklist access were allocated according to permuted block randomisation. No team member managed the same crisis more than once. The primary outcome measure was the percentage of indicated emergency interventions performed.ResultsA total of 138 participants composing 41 resuscitation teams performed 76 simulations (38 with and 38 without checklist access) including 631 interventions. Median percentage of interventions performed was 38.8% (95% CI 35% to 46%) without checklist access and 85.7% (95% CI 80% to 88%) with checklist access (p=7.5×10−8). The benefit of checklist access was similar in the four EDs and independent of senior physician and senior nurse experience, type of crisis and use of usual cognitive aids. On a Likert scale of 1–6, most participants agreed (gave a score of 5 or 6) with the statement ‘I would use the checklist if I got a similar case in reality’.ConclusionIn this multi-institution study, checklists markedly improved local resuscitation teams’ management of medical crises simulated in situ, and most personnel reported that they would use the checklists if they had a similar case in reality.

Task-shifting to Improve Asthma Education for Malawian Children: a Qualitative Analysis

Background:Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced asthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.Methods:We conducted 6 focus group discussions, including 15 children and 28 carers, and individual interviews with 4 lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified. Results:Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, , and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approachDiscussion:Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.Trial Registration:The RCT was registered in the Pan African Clinical Trials Registry: PACTR201807211617031