25^th World Nursing and Nurse Practitioner Conference October 22-23, 2018 Osaka, Japan

Biography:

Gaganpreet Khaira is a Nurse Practitioner in Mental Health and Primary Care in Victoria, Australia. She has an extensive experience in psychiatry working across various psychiatric settings. Besides the clinical work, her passion lies in teaching and providing coaching and mentorship to other nurses. She also delivers lectures at the Monash University and is involved in various health care improvement projects.

Abstract:

Nurse practitioners’ align their practice within the nursing philosophy utilizing their advanced skills and extensions to practice and expect to be recognized as advanced practitioners in the nursing field. But the boundaries are blurred as their roles often cross roads with medical profession making it harder for most NPs to understand and describe their professional identity in a health care system. This affects the nurses’ transition into their new role as NP and can lead to feeling isolated in a multidisciplinary team. The roles of mentors, coach and teachers has been found valuable in assisting NPs adjust with their role identity and professional socialization. This study aims to discuss the available literature and studies into this area and utilize presenter’s personal experience to assist new or aspiring NPs to achieve and maintain professional identity and gain work satisfaction.

Biography:

Nizar Abdul Majeedkutty is an astute Physical Therapist and sagacious rehab science researcher currently working as Head of Department of Physical Therapy, Faculty of Medicine and Health Sciences at Universiti Tunku Abdul Rahman, Malaysia. His research interest spans a variety of topics in physical activity, multi-sensory reweighting, sedentary behavior and diabetic peripheral neuropathy. He has presented his research findings at international conferences, published articles in prolific journals and was awarded with scholarships and research grants. He serves as an Associate Editor and Reviewer for high end academic journals from United States. He has also served as the Head of Department of Physical therapy at Mahatma Gandhi University, Kerala, India. He has obtained his Post graduate degree in Physical Therapy from Mahatma Gandhi University, India.

Abstract:

Diabetic peripheral neuropathy is the most common complication of diabetes mellitus both in developed and developing countries. It is found in about 10% of diabetic patients at diagnosis and in the majority of patients of 25 years and more. Patients with pre-diabetes may also develop neuropathies that are similar to diabetic neuropathies. Loss of feeling in the lower limbs is a high risk for limb amputation. Extremely long axons originating in the small neuronal body are vulnerable on the most distal side as a result of mal-nutritional axonal support or environmental insults. Asians have a strong ethnic and genetic predisposition for diabetes and have lower thresholds for the environmental risk factors. As a result, they develop diabetes at a younger age and at a lower body mass index and waist circumference when compared with the Western population. The health care costs for the disease management are increasing although outcome is far from the optimum. As a result, complications of diabetes such as diabetic peripheral neuropathy and foot ulcers are common and the economic burden is very high, especially among the poor. Despite efforts to make an early diagnosis and to halt the progression of diabetic neuropathy, currently there is no effective treatment available at a global level, except for tight control of blood glucose. Non-pharmacological treatments like physical therapy can improve the overall quality of life of diabetes mellitus patients with peripheral neuropathy and alleviate them from the symptoms of diabetic neuropathy. This workshop presents the recent advances regarding assessment and different treatment strategies used in physical therapy to manage diabetic peripheral neuropathy and presents evidence and conditions for its applications.

Biography:

Mai Taki has completed Nursing and International Nursing program and got national qualifications of Nurses and Public Health Nurses. After graduation she was engaged in cardiovascular surgery patients including congenital heart disease and intensive care management of cardiovascular internal medicine. After that, she has worked as a Lecturer at a nursing junior college, a Policy Planning Manager of the Japan Nursing Association and an Associate Professor at a nursing college. Currently she is the Director of Nursing Management in Kyoto.

Abstract:

Japanese National Qualification: We have three national qualifications in Japan. These are nurse, midwife and public health nurse. To become a midwife and public health nurse, the qualifications of nurses are required. There are seven ways to become a nurse in Japan.

When had the discussion about APRN started? The first discussion about APRN in Japan was held in 2004. One of trigger was anesthesiologist shortage. The number of surgeries decreased and several hospitals were forced to go bankrupt. The Japan Hospital Association said at medical subcommittee of the social security council of the Ministry of Health, Labor and Welfare (MHLW). Japan should also train nurse anesthetists like the United States.

Under the cooperation of IFNA: After that, I exchanged information with International Federation of Nurse Anesthetists (IFNA) and worked hard to establish Japanese anesthesia professional nursing master course. The first graduate school was founded in 2010 and has increased to four schools in 2018. IFNA founded in 1989, is currently playing a central role in anesthesia nursing. IFNA has 43 country members, including Japan.

Credentialing system in Japan: Worldwide, APRN is classified into 4 types, CRNA, CNM, NP and CNS. But in Japan, both the curriculum and accredited organizations have various credentialing systems. In addition, MHLW designated and began new nursing system that calls training system for nurses to perform specific medical interventions since 2015. There are thirty-eight specific interventions and grouped into 21 categories. It includes specific anesthesia nursing.

Who is APRN in Japan? Japan Association of Nursing Programs in Universities defines APN as only “Certified Nurse Specialists” and “Japanese Nurse Practitioners”. Anesthesia management is one of the important and specialized fields of APRN in Japan, but they have not been able to conduct their role under Japanese system yet.

Biography:

Tamami N Shimada has worked for more than 20 years as a Visiting Nurse and in 2011 completed a Master of Nurse Practitioner course from Japan. In addition, she manages a visiting nurse station and day care for children and adults requiring intensive medical support. She also a Director of the Japanese Organization of Nurse Practitioner Faculties (JONPF), Director of the Kawasaki City Nursing Association and Ambassador of TOUCH (Treat Observe and Understand Children with special Hope).

Abstract:

Progress in medical technology has benefited many child who cannot live without medical support, but there are not so many place to spent time by themselves and so we opened a day care and after-school program for children and adults who require medical support. In the context of this program Ultrasonography (US) is being used to estimate these patients for a range of conditions, such as pulmonary congestion and edema, remains of a meal on epiglottic vallecula, measuring the volume of urine. US is used to assess respiratory condition, swallowing and measuring the amount of urine in the bladder by using SonoSite iViz (Fuji Film) and Vscan Dual Probe (GE Healthcare). The use of US is effective for evaluating pulmonary movement. Some patients have a firm thorax with poor movement together with an equally poor pulmonary movement, and we can evaluate the difference between right and left by the use of US. We can easily recognize pulmonary congestion and edema from a tissue like image and characteristic B line. We have provided pulmonary physical therapy, suction and positioning to improve their condition. This treatment has reduced respiratory rate and improved percutaneous oxygen saturation, however we cannot determine the effect of this treatment by US alone. On checking the pyriform sinusitis and epiglottic vallecula, abnormalities present as a bright mass. Improving the method of cleaning the mouth and teeth after each meal reduced the fever that such patients were experiencing. Measuring the volume of urine by means of US was used to determine the need to use a catheter. US was effective for understanding various conditions such as pulmonary congestion and edema, remains of a meal on epiglottic vallecula, measuring the volume of urine, but was not sufficiently sensitive to measure the effect of improvement in short-term care.

Biography:

Hitomi Fukunaga has been working as a Nurse since 1987. She entered Kanagawa University, School of Law, to extend her carrier and graduated  in 1997. Working as a Nurse, she accomplished the Master course of International University of Health and Welfare to be a Nurse Practitioner in 2011. Since then, she has taken care of patients of diabetes and other chronic diseases, mostly out patients, as a Nurse Practitioner at Musashikosugi Hospital, Nippon Medical School in Kawasaki City. Presently she is a Nursing Chief Director of the hospital. The most of her effort is made for education of nurses, work-life balance of nurses, safety and ethics of the hospital.

Abstract:

Background & Aim: Gestational Diabetes Mellitus (GDM) education was implemented by a Nurse Practitioner (NP) once a week in Nippon Medical School Musashikosugi Hospital. Here, we present the effect of such education over the period 2011-2015 for patients with GDM.

Methods: From 2011-2015 there were 267 patients with GDM from 4626 pregnant women and 247 GDM patients were analyzed. At 26-28 weeks of gestation, a 75g OGTT was performed and patients with more than one point positive for Japanese GDM diagnostic criteria received clinical education for GDM management every 2 weeks. Education encompassed dietary advice, which was suitable for patient life style and instruction in self-monitoring of blood glucose or insulin injection.

Results: One point positive patients were 145 (58.7%), two points positive patients were 82 (33%) and three points positive patients were 20 (8%) in Japanese GDM diagnostic criteria. 46 (18.6%) patients received insulin therapy. Glycated albumin was 13.1±0.13% (mean±2SD) at the first visit to our center and 12.8±0.08% (mean±2SD) in the period of delivery (p<0.01). Weight of the new born was 3083±476 g (mean±2SD). 79 (32%) patients received Cesarean section. There were 2 still births and one of them was twins.

Findings: It is important to educate intensively to give an understanding of therapy for GDM over short periods. Since we educated the patients in outpatient　departments, the education provided was suitable for the patient’s own lifestyle. The education by the NP is useful for treating GDM patients to ensure normal gestational periods and normal newborn.

Biography:

Xiaohui Miao has completed her MD from Sichuan University, China. Currently she is pursuing PhD from Sichuan University majoring in Gerontological Nursing. She has published 9 papers in reputed journals.

Abstract:

Purpose: In the present study, we investigated the supply and demand of health care service for the elderly in West China, so as to provide scientific data for building the elderly care service system.

Methods: The elderly (≥60 years) were enrolled from 9 provinces in the West China between December 2016 and August 2017 by various sampling methods. The elderly’s demographic data were collected. We used the questionnaire Demand of Health Care Service for the elderly to investigate the supply and demand of health care service for the elderly in West China. All participants completed the questionnaire by themselves.

Results: A total of 7541 participants were enrolled from nine provinces in the West China. The most demanded health care service were periodic physical examination (66.1%), disease monitoring (64.2%), respect (62.7%), guidance for the chronic disease (59.3%) and guidance for disease monitoring (58.4%). The most not demanded were catheter care (70.4%), fracture care (69.8%), wound care (69.1%), sex guide (69.0%) and language rehabilitation (67.8%). The most demanded but not supplied were community first aid (39.9%), green channel (39.5%), emergency call (39.2%), first aid guide (36.8%) and guidance for the chronic disease (36.6%).

Conclusion: Our findings indicated that health monitoring and health education were most demanded among the elderly in West China. Emergency support and chronic disease management should be supplied more to meet the demands. The government, hospital and society should supply more health care service focusing on the above aspects to perfect the elderly care service system.

Biography:

Wenwen Wu has completed her undergraduate at the age of 21 years from Sichuan University. Now she is a master student of Sichuan University majoring in gerontological nursing. She has published 1 paper in reputed journals.

Abstract:

Background: As China's population ages, the demand for care for the elderly is gradually increasing. Appropriate activities to maintain the ability of daily life in the elderly is an important measure to reduce the need for care of the elderly. However, some traditional Chinese concepts affect the maintenance of elderly activities and self-care ability. Objectives: The aim of this study were to understand the status of activities and bed rest in elderly patients, and to examine to what extent older Chinese patients views on “the importance of activities", "bedrest".

Methods: Survey questionnaire. Convenience sample (N = 993 hospitalized patients) from geriatric wards.

Results: There were 41.1% of senile patients doing some exercise before admission, 41.6% of senile patients bed rests all day or most of the time during hospitalization. For the activities and the rest of the bed rest of the view that “the activity is very important to the health”, 82.5% answer “yes”; “long time bedrest is not good for the body “, 76.2% answer “yes”; ”If the body has any uncomfortable, it is best not have activity”, 45.7% answer “yes”; " Being bedridden taken care by others and not needing to take care of yourself is a lucky affair”, 45.8% answer “yes”.

Conclusion: Older people with chronic diseases before admission to active exercise fewer people, hospitalized elderly patients bed rest more people, some elderly people can’t correctly understand the activities and bedrest, related to health Knowledge mission.

Biography:

Joanes Faustine Mboineki is a Registered Nurse with 5 years of experience in academic teaching. He has received Bachelor’s degree in Nursing from St. John’s University of Tanzania and Master’s degree in Nursing Education from Zhengzhou University in China. He is currently pursuing Doctoral degree in Nursing Oncology at Zhengzhou University in China.

Abstract:

Background: Despite the innovation of effective strategies in health care sector, accessibility of health care services remains a global challenge compromising the quality of care and leading to poor outcomes. 303,000 women worldwide died in 2015 due to complications of pregnancies or childbirth, 99% of these deaths occurred in low and middle-income countries because of poor access to health care services. Poor accessibility of health care services in Tanzania hinders the achievements of health care system goals. The shortage of incompetent health care professionals, Regular stock out of essential drugs and medical costs influence the poor accessibility of health care services. The integration of Nurse Practitioner (NP) role has not been given enough attention to resolve current existing and emerging problems facing Tanzania health care system.

Purpose: The purpose of this study was to explore the status of health care delivery and its influences in the integration of NP role in low resource country Tanzania.

Methods: The study was descriptive cross-sectional that used quantitative methods to collect data from health care providers. Purposive and convenience sampling technique applied to collect data from 237 health care providers using semi-structured questionnaire. The questionnaire was developed by a researcher then approved by School of Nursing, Zhengzhou University. The tool had questions to collect demographic information, barriers affecting effective health care and the implementation of NP role. Data were entered into SPSS version 20 and analyzed using descriptive statistics, chi-square test (X²) and logistic regression.

Results: A total of 237 health care providers were included in the study, of which majority 96 (40.6%) belonged to the age group 21-30. The number of health care providers in regard to their professions constituted 91 (38.4%) clinicians, 139 (58.7%) nurses and 7 (3%) medical attendants. Respondents reported that there is shortage of health workforce, health care provider must provide care to 31-40 patients (55%) per shift, P≤0.001. Majority of respondents 112 (47.3%), P=0.048 said the shortage has caused the health care system to use untrained medical attendants to reduce the gap. Four patients as an average reported to encountering difficulties in paying their medical bills, Pearson Chi-Square=158.343 and P≤0.001. Respondents 60 (25.3%) reported that it takes more than 2 weeks for specific drugs to be available when are out of stock, with Pearson Chi-Square 53.47 and PË‚0.001. Participants mentioned reasons for integration of NP role, NPs are needed in Tanzania to work in rural primary health care facilities under-served by doctors X²=52.895 CI: 0.079-0.304 and PË‚0.001. The use of NPs will reduce medical costs among patients by reducing frequent hospitalizations X²=21.014, 95% CI: 0.208-0.598 and PË‚0.001. Finally, respondents mentioned tasks to be performed by NPs including conducting a comprehensive assessment, diagnosing, ordering tests, treating and prescribing.

Conclusion: The development of NPs role is inevitable and NPs must work in rural primary health care facilities underserved by doctors. However, NPs will deliver quality health care service only under the availability of medical equipment and drugs supply.

Biography:

Shuxin Zhong has completed her nursing degree from The West China College of Medicine, Sichuan University. She has published more than 4 papers in journals.

Abstract:

In recent years, cardiovascular disease has become a threat to human’ health, stroke is a leading death cause, which maintain a progressive increase in morbidity rate, becoming the main reasons of the increase of medical expense as well as the burden of disease. Through the effective integration and utilization of community, hospital and family resources, continuous nursing makes the seamless connection between medical service institutions and becomes an inevitable trend of the development of medical service industry. Discharge planning as an important part of continuous nursing, improving the medical service quality, ensuring the continuation of care orderly and effective implementation, improving patient outcomes, shorten the length of hospital stay, reducing readmission rate, which is an essential part of Europe and the United States national health care system. At present, the discharge planning in China is in the initial stage of exploration. This article reviews the present situation of the discharge planning of stroke.