11^th International Conference on Geriatrics Nursing and Palliative Care October 21-22, 2019 Amsterdam, Netherlands

Biography:

Mrs Charmaine Attard achieved a BSc in Nursing in 1994 and went on to read an MSc in Nursing with the University of Manchester in 2006 and   a Post Graduate Diploma in Business Administration with the University of Leicester n 2016. After graduating Mrs Attard worked for a number of years in the acute areas of care within St. Luke’s Hospital and Capua Palace Hospital. In 1999 she went on into long term care, where she managed a private home for the elderly.  In 2006 she went on to become Operations Manager and in 2009 left long term care and took up the post of Director of Nursing and Midwifery at Mater Dei Hospital where in 2013 Mrs Attard was given the post of Director of Care at Karin Grech Rehabilitation hospital.  In 2015 Mrs Attard joined AX Holdings as Director of Care of Hilltop Gardens overseeing care given both in the care home and in the apartments.  She currently is the general manager of Hilltop Gardens, an appointment given to her in 2017. Mrs Attard is also holds a part time assistant senior lecturer post at the University of Malta where she teaches nursing students within the Faculty of Health sciences.

Abstract:

Just under 2000 persons are diagnosed with cancer every year in Malta, with the figure expected to shoot up to over 2,100 by 2020. At present, Hospice Malta offers a wide range of services for terminally ill patients and their families, including day care and home care however no residential or inpatient palliative care is provided in the country to date. Our only oncology hospital on the island constitutes of 24 beds which falls short of demand and supply when this caters for the whole population of Malta.

As a result of this a number of palliative clients find themselves on acute hospital wards which are not able to cater for their specific needs during this period. Simblija Care Home is a privately run nursing home in Malta which seeks to address the needs of persons who need palliative care, including respite for their carers or end of life care. Within our model of care we adopt a holistic approach to both the individual and the respective family and the existent network of support. We hope to address physical needs, like pain control, and also to their psychological needs which often involves counselling services. Our services extend further and encompass spiritual assistance when requested. Different professionals are brought in the care cycles, as are occupational therapists and physiotherapists. In this way we assist the person achieve better quality of life and their families to find support and assistance. This is a new residential service offered by a care home for elderly in the palliative stages.

The paper provides a critical SWOT analysis of the introduction and roll out of this innovative much needed service in Malta. It is believed that the reflective evaluation of this service is of interest to other parties who are gauging need or planning such services in other contexts.

Biography:

Dr. Amy Clements-Cortés, Assistant Professor, University of Toronto, Faculty of Music; Music Therapy Instructor & Graduate Supervisor, Wilfrid Laurier University; and Academic Coordinator & Instructor, Ryerson Chang School. She is a Registered Psychotherapist, Past-President of the World Federation of Music Therapy, and Managing Editor of the Journal of Music and Medicine. She is published in multiple journals and has given over 100 invited academic and conference presentations.        

Abstract:

Relationships are often a cause of substantial psychological pain for patients and their families at end-of-life. Anticipatory grief is commonly experienced by dying persons, focusing on multiple issues including: the loss of relationships, as well as the loss of forthcoming life events of which they will not be able to participate. Music therapy is commonly used in palliative care settings to address anticipatory grief, and is a valuable therapy for addressing relationship concerns.

At the end-of-life people often express intense gratitude about their lives and love for the people they have known. In gratitude we celebrate who we are to one another and the ways in which our lives have been shaped, loved, and moved by others. When realizing that death is imminent people often have a particular need to hear that their actions have made a difference and that that they have made a contribution in this life. Subsequently they need to express to their loved ones sentiments of love and appreciation for their actions. Songwriting is an important and effective tool for patients wishing to express sentiments at end-of-life to help them facilitate completing relationships. This short video presentation will highlight the case of one palliative care patient and the important role songwriting played in helping her say thank you, I love you and goodbye.

Biography:

Mauceri Filippo graduated in nursing in 2018 with a grade of 103 out of 110. He worked for 4 months in medicine and now works in a nursing home. On 4 April 2019 he presented his study on sepsis at the National Congress of Riccione and this study was awarded as the first research of all congress.

Abstract:

Sepsis is a very frequent and serious disease, although still poorly understood. It affects 20-30 million people worldwide, about 250,000 in Italy alone, of which 1 in 4 does not survive. The purpose of my research is to understand how sepsis is managed in the Emergency Room, what is still to be improved and what can be improved. The study population includes patients admitted to the Emergency Unit of Siena from 01/09/2017 to 02/28/2018, who respond positively to inclusion in the study. At the end of the data collection the sample includes 102 patients. Many variables have been studied that help to understand nursing management of septic patients. The variables: Sex; Age; Methods of arrival at the emergency room; Admission codes used; Discharge codes used; Patients who received the qSOFA score; Values qSOFA; Patients who were given the antibiotic within the first hour; Patients who have been treated with Procalcitonin; Patients who underwent blood gas analysis; Average PCR, Procalcitonin and Lactate values; Patients whose blood cultures were performed; Results of blood cultures performed; Patients who were treated with other cultures; Etiology of bacteria resulting from blood cultures; Etiology microorganisms resulting from other cultures; Patient hospitalization time; Frequency of septic patients at the emergency room in the various months; Follow up. These variables collected if analyzed in multiple hospitals could make a difference in the management of sepsis with the possibility of saving more lives.

Biography:

Stephanie Bruce, DNPc, RN, ACNS-BC, APNP is an associate professor at Alverno College and resides in Milwaukee, WI. She has a clinical background in geriatrics, inpatient physical rehabilitation, and occupational health. She has expertise in undergraduate curriculum development related to pharmacology, geriatrics, nutrition, simulation, and hospital-based clinicals. Her doctoral dissertation is on the effect of an asynchronous webinar education module on caregivers’ knowledge, skills, and attitudes toward older adults to provide quality geriatric medication management in a home care setting.

Abstract:

Potentially inappropriate medication use continues to be a concern in geriatric care. It has been 28 years since Beers et al (1991) first published guidelines on medication safety in older adults. Since that time, multiple revisions of this tool have been published in the literature (American Geriatrics Society, 2012; American Geriatrics Society 2019 Beers Criteria Update Expert Panel, 2019). According to the National Committee for Quality Assurance (2017), older adults continue to be prescribed medications that have been widely accepted to increase harm. Surveillance of prescribed medications post hospital discharge to home health care services is necessary because approximately one third of older adults using these services have at least one potentially inappropriate medication on their current medication list upon admission (Lohman et al., 2017; Alhmoud, Khalifa, & Bahi, 2015). What research has shown is best practice is not consistently reaching the patient. The objective of this presentation is to improve geriatric medication management through the dissemination of an educational module using the American Geriatrics Society 2019 Updated AGS Beers Criteria and Knowles Theory of Learning as a framework. This module includes a review of factors that put older adults at increased risk for adverse drug events, specific drugs and drug classes that have a high potential for toxicity in older adults, strategies to prevent common medication-related problems in older adults, and reviews how to conduct a comprehensive medication review. This presentation is appropriate for nurses, prescribers, social workers, and physical/occupational/speech therapists in a variety of settings.

Biography:

Leila Joy Cazon is an Assistant Professor of Nursing at Silliman University of Dumaguete City, Philippines. She received her Master’s in Nursing from the same University. She is presently pursuing her Doctor of Science in Nursing, major in Gerontology at Cebu Normal University, Cebu City, Philippines. She has been an educator for 14 years. She had a chance to present her paper in the 2^nd Technological Competency as Caring in Nursing last August, 2018 in Tokushima, Japan and the 8^th International Conference of Nurses in Cebu City, Philippines last November, 2018 and was honored to be the third Best Podium presentor.

Abstract:

Lately, internet use has been increasingly ordinary and is source of benefits concerning information, communication and health purposes. Technological improvement like all inventions has its pros and cons. Internet users can link to social media and search for data using the internet. This study examined the use of the internet for health information by older adults. The Technology Acceptance Model (TAM) was applied to determine the predictiveness of perceived use, perceived usefulness, perceived ease of use and attitude toward internet use for health information.

Purposive sampling was used to obtain 53 internet user older adults who met the eligibility criteria. A questionnaire was adapted to gather the demographic data, the frequency of internet use and physical health were collected. No similar study had been found on this topic in the Philippine setting.

Majority of the respondents are 60 years old, females, college degree holders, and have used the internet for 1-5 years to search for health information. The regression analysis reveals that age and education cannot be associated with the usefulness of internet use for health information and that usefulness of internet use for health information, ease of internet use, and magnitude of use of the internet have nothing to do with older adults' health status (α=0.05). It is suggested that this research study should be replicated on a larger sample from different settings for understanding possible relationships of other variables that may be significant predictors of the older adults’ ability to use the internet for health information.

Biography:

Mrs Charmaine Attard achieved a BSc in Nursing in 1994 and went on to read an MSc in Nursing with the University of Manchester in 2006 and   a Post Graduate Diploma in Business Administration with the University of Leicester n 2016. After graduating Mrs Attard worked for a number of years in the acute areas of care within St. Luke’s Hospital and Capua Palace Hospital. In 1999 she went on into long term care, where she managed a private home for the elderly.  In 2006 she went on to become Operations Manager and in 2009 left long term care and took up the post of Director of Nursing and Midwifery at Mater Dei Hospital where in 2013 Mrs Attard was given the post of Director of Care at Karin Grech Rehabilitation hospital.  In 2015 Mrs Attard joined AX Holdings as Director of Care of Hilltop Gardens overseeing care given both in the care home and in the apartments.  She currently is the general manager of Hilltop Gardens, an appointment given to her in 2017. Mrs Attard is also holds a part time assistant senior lecturer post at the University of Malta where she teaches nursing students within the Faculty of Health sciences.

Abstract:

In this day and age where technology has taken over a large part of our lives, the thirst for actual physical human interaction is growing. The statistics show that in a world full of social media, people are actually lonelier.

However is physical interaction easy to implement? In a world where professionals are afraid of being sued for the wrong move, where they are afraid that actions may be misread and taken badly, how easy it is to perform this interaction through actions like touch? As a nurse, I have personally gone through life being taught that as a nurse’s touch is one of the best ways to comfort a person.  A pat on the shoulder, a hand held, a hand placed on the arm…..all can say a thousand unsaid words and portray up close that a professional really cares and is there for you. However, just last February (2019) the Medical Defence Union in the UK (MDU) advised its doctor members that “Doctors must be able to comfort and show human compassion to their patients, but physical contact can easily be misinterpreted particularly if coupled with other words or actions the patient may feel are inappropriate” This in turn may result in a complaint against a doctor.

In contrast a new industry is blooming which provide professional “cuddlers” whilst others have built “tranquility chairs” which embrace a person sitting in it. What have we come to and where are we heading professionally? Are we becoming as Cocazza (2018) states a “touch-averse” society”? And if we are, to what end? What are the repercussions of going down this road?

At birth babies bond better when they are cuddled and held close by their mothers, children run for comfort in the arms of loved ones when they fall or are upset, friends hug each other or hold each other when passing through difficult moments. Linden (2016) talks about a child that can be born deaf or dumb and yet grow emotionally and physically well, however if deprived from touch will not only suffer from emotional and psychiatric difficulties but from physical conditions too. So how can we become as Francis (2014) states “touch averse”?  When it is such a source of comfort.  He goes on to say that that he is concerned as “…this lack of touch is not good for mental health”. In a world where mental illness is already on the rise this is truly worrying.   

However in today’s society, where we are very sensitive about boundaries, it makes it hard to find the right way forward.  I teach my nursing students that touch is comforting. I mentor my staff that touch can comfort and console the dying and the distressed. Yes, touch can sometimes be misinterpreted and yes we need to be vigilant when we use it because of culture, maybe confusion like in the case of dementia, or gender differences. But it cannot be something we abolish or something we do not practice. The world is already too lonely for people not to connect through touch. I have seen patients slip away peacefully with their hand being held by a professional. I have seen patients consoled with a nurse’s hand around their shoulder while they cry after receiving bad news, a patient soothed with a caress, as they were in unbearable pain or holding the hand of a  relative who just cannot bear seeing their loved one going through chemotherapy and suffering the cruel effects of the treatment. Some pain, medicine cannot relieve and when as professionals we are presented with certain situations, it is just the consolation of offering ourselves through touch which helps us, even as carers to cope. Personally these moments were the most beautiful moments in my career as a nurse, and they were why I chose to be part of a caring profession. If we lose the strength of touch or hide behind law suits or fear, then we have I feel, lost the very soul of caring and an integral part of our role as professionals.

As Keats said “Touch has memory” and if we want to create good memories for our patients and also for ourselves as carers then we must recognize that touch is and always should be an integral part of our practice.

Biography:

Pamella Cristina de Carvalho Lucas is a PhD student in health sciences, University of São Paulo, School of Nursing (EEUSP), Brazil. Adult and elderly health specialist nurse from the EEUSP. Interested in the following areas: Geriatrics and Gerontology, Long Term Care, Care of the elderly, Caregiver of the elderly, Family and Aging

Abstract:

The elderly population in Brazil is estimated at 29.4 million (≥ 60 years), by the year 2060 may reach 73 million people. In the city of São Paulo, the elderly contingent has already reached the 1.7 million mark. The present study is part of SABE (Health, Well-being and Aging), a longitudinal study of multiple cohorts developed to trace the living and health conditions of the elderly in São Paulo. The objective was to describe how are the elderly residents in the city of São Paulo regarding the difficulties to perform activities of daily living. Participants in the fourth cohort (n = 1236), conducted in 2017, were 57.1% female and 42.9% male. The average age was 74.3 years.  Regarding activities of daily living, 46% of participants reported difficulties for instrumental activities of daily living (IADL), which ultimately tell about the possibility of the elderly living alone; and 24% of them had difficulties for basic activities of daily living (ADL), requiring caregivers. 60% of the elderly reported multimorbidity, with osteoarticular disease being the second most prevalent (33.8%). 28.1% were widowed, 6.2% single and 17.2% lived alone; conditions that predict greater need for assistance, not always being covered by families and services. In an accelerated context of population aging, there are important challenges for Brazilian public policies that need to adapt to the new and growing social and health demands in order to meet the needs of the elderly population.

Biography:

Steven gained his MSc at the London School of Economics and Political Science in Social Work and Social Policy, qualified as a Psychotherapist, and completed his MPhil in Child and Adolescent Mental Health in 2008. He worked in Child and Adolescent Mental Health (CAMH) services and then appointed Head of Child and Adolescent Mental Health at Anglia Ruskin University in 2002 where he designed a multi-disciplinary award-winning course. Steven has presented his research in Russia, Spain, Australia, Hong Kong, Buenos Aries, Greece, Scotland and the UK specialising in cyber bullying, multi-cultural service provision, refugees and asylum seekers, and feminist practice.

Abstract:

Across the globe, ADHD prevalence is estimated around 5 per cent. It’s a figure that’s been rising for decades. For example, Sweden saw ADHD diagnoses among 10-year olds increase more than sevenfold from 1990 to 2007. Similar spikes have been reported from other countries, too, including Taiwan and the US, suggesting this may be a universal phenomenon. In fact, looking at dispensed ADHD medication as a proxy measure of ADHD prevalence, studies from the UK show an even steeper increase and a corresponding rise in the numbers treated: from an estimate of 0.5 per 1,000 children diagnosed 30 years ago, to more than 3 per 1,000 receiving medication for ADHD in the late 1990s. The rates in the USA have risen too, but from a much higher base; from about 12 per 1,000 30 years ago to about 35 per 1,000 in the late 1990s, with the increase continuing. However, recent studies have demonstrated an under-diagnosis among girls possibly due to their social conditioning to be less extrovert. This paper will consider the reasons for the increased prevalence rate; how easy is it to diagnose ADHD without being influenced by ‘normative social expectations’? Is there a culture of medicalising problems which are within a wide range of individual personalities and family or community cultures? And under austerity economics is there a risk that short-term fixes will be preferred to long-term structural changes in quality of family life to mitigate prevalence?

Biography:

Mrs Charmaine Attard achieved a BSc in Nursing in 1994 and went on to read an MSc in Nursing with the University of Manchester in 2006 and   a Post Graduate Diploma in Business Administration with the University of Leicester n 2016. After graduating Mrs Attard worked for a number of years in the acute areas of care within St. Luke’s Hospital and Capua Palace Hospital. In 1999 she went on into long term care, where she managed a private home for the elderly.  In 2006 she went on to become Operations Manager and in 2009 left long term care and took up the post of Director of Nursing and Midwifery at Mater Dei Hospital where in 2013 Mrs Attard was given the post of Director of Care at Karin Grech Rehabilitation hospital.  In 2015 Mrs Attard joined AX Holdings as Director of Care of Hilltop Gardens overseeing care given both in the care home and in the apartments.  She currently is the general manager of Hilltop Gardens, an appointment given to her in 2017. Mrs Attard is also holds a part time assistant senior lecturer post at the University of Malta where she teaches nursing students within the Faculty of Health sciences.

Abstract:

Just under 2000 persons are diagnosed with cancer every year in Malta, with the figure expected to shoot up to over 2,100 by 2020. At present, Hospice Malta offers a wide range of services for terminally ill patients and their families, including day care and home care however no residential or inpatient palliative care is provided in the country to date. Our only oncology hospital on the island constitutes of 24 beds which falls short of demand and supply when this caters for the whole population of Malta.

As a result of this a number of palliative clients find themselves on acute hospital wards which are not able to cater for their specific needs during this period. Simblija Care Home is a privately run nursing home in Malta which seeks to address the needs of persons who need palliative care, including respite for their carers or end of life care. Within our model of care we adopt a holistic approach to both the individual and the respective family and the existent network of support. We hope to address physical needs, like pain control, and also to their psychological needs which often involves counselling services. Our services extend further and encompass spiritual assistance when requested. Different professionals are brought in the care cycles, as are occupational therapists and physiotherapists. In this way we assist the person achieve better quality of life and their families to find support and assistance. This is a new residential service offered by a care home for elderly in the palliative stages.

The paper provides a critical SWOT analysis of the introduction and roll out of this innovative much needed service in Malta. It is believed that the reflective evaluation of this service is of interest to other parties who are gauging need or planning such services in other contexts.

Biography:

Marianne Kaasik has worked in children´s psychiatry since 2015. In 2015 she started as a nurse assistant in Tartu University Hospital´s Psychiatric Clinic children´s department. In the second half of 2015 the adolescent unit was finished and she continued working there. In the beginning of 2016 she graduated as an RN. In 2017 she started working in South Estonian Hospital´s mental health office for children and adolescent. She helped to create a network between mental health professionals, local police department and other institutions that work with kids and teenagers. In the other half of the year 2017 Marianne started working in Maarjamaa Hariduskolleegium which is a middle school for children with mental health and behavioral problems administrated by the Ministry of Education and Science. She continues networking between the school and mental health professionals. In 2018 she completed her mental health nurse studies and since then works as a certified mental health nurse.

Kadri Niin has worked in South Estonian Mental Health Center for Children and Adolescent in Tartu University hospital since year 2014 and as a RN since 2017 and intends to complete the mental health nursing studies by 2020. She mainly works with adolescents from age 13 to 17 with various mental health issues. Kadri also does follow-up appointments with adolescents who have checked out of hospital and has planned to increase participation in out-patience treatment services in the near future. Kadri values the protection of patient’s rights and human dignity and as a graduated midwife she also values sexual education as a human right and self-protection

Abstract:

South-Estonian Mental Health Center for Children and Adolescent in Tartu University Hospital was created in partnership with Norwegian Institute of Public Health. In 2015 new adolescent in-patient unit opened its doors. Now the mental health center has two separate in-patient wards – one for children up to 13 years and the other for adolescents until they reach adulthood. Mental health center has the most modern environment for hospital treatment in Estonia which provides diagnostics and treatment procedures for children and teenagers with mental disorders. The clinic also provides out-patient treatment services, cooperating and networking with mental health offices all across Estonia. A team of specialists provide care in case of various mental health issues like: depression, anxiety, eating disordes, schizoaffective disorders, behavioral and addiction problems, developmental issues and etc. The team working with kids consists of psychiatrists, psychologists, mental health nurses, teachers, social workers, speech therapists and caretakers. The working team tries to apply various methods of psychotherapy, including cognitive-behavioural group therapy.

Biography:

Nopparat Chaichumni has completed her PhD from Prince of Songkla University. She is Advance Practice Nurse of people with Schizophrenia and people with Dementia. She has published more than 10 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Abstract:

The purposes of this experimental research were to compare the quality of life in the elderly persons with BPSD before and after received the Thai culturally-based mutual support group program and compare the quality of life in the elderly persons with BPSD who received the Thai culturally-based mutual support group program, and those who received the regular caring activities. Study samples composed of 70 elderly persons with BPSD and 70 caregivers were recruited according to the inclusion criteria from the elderly persons with BPSD attending outpatient ward in Suan Saranrom and Songklanagarind Hospital. There were 35 subjects in each experimental and control groups. These samples were matched pair by age, sex and the educational level. The experimental group received the Thai culturally-based mutual support group program, whereas the control group received the regular caring activities. Research instruments were the Thai culturally-based mutual support group program and the QOL-D-Thai scale. These instruments were examined for content validity by five psychiatric experts. The reliability of the scales by Cronbach’s Alpha coefficients was .93. Statistical techniques utilized by data analysis were percentage, mean, standard deviation and t-test. Major results of this study were: The quality of life in the elderly persons with BPSD who received the Thai culturally-based mutual support group program after the experiment was significantly increased than that before at the .05 level. 2. The quality of life in the elderly persons with BPSD who received the Thai culturally-based mutual support group program was significantly increased than those who received the regular caring activities at the .05 level. The results of this study showed that the Thai culturally- based mutual support group program have implicated for enhancing the quality of life in the elderly persons with BPSD.

Biography:

Mrs Charmaine Attard achieved a BSc in Nursing in 1994 and went on to read an MSc in Nursing with the University of Manchester in 2006 and   a Post Graduate Diploma in Business Administration with the University of Leicester n 2016. After graduating Mrs Attard worked for a number of years in the acute areas of care within St. Luke’s Hospital and Capua Palace Hospital. In 1999 she went on into long term care, where she managed a private home for the elderly.  In 2006 she went on to become Operations Manager and in 2009 left long term care and took up the post of Director of Nursing and Midwifery at Mater Dei Hospital where in 2013 Mrs Attard was given the post of Director of Care at Karin Grech Rehabilitation hospital.  In 2015 Mrs Attard joined AX Holdings as Director of Care of Hilltop Gardens overseeing care given both in the care home and in the apartments.  She currently is the general manager of Hilltop Gardens, an appointment given to her in 2017. Mrs Attard is also holds a part time assistant senior lecturer post at the University of Malta where she teaches nursing students within the Faculty of Health sciences.

Abstract:

In this day and age where technology has taken over a large part of our lives, the thirst for actual physical human interaction is growing. The statistics show that in a world full of social media, people are actually lonelier.

However is physical interaction easy to implement? In a world where professionals are afraid of being sued for the wrong move, where they are afraid that actions may be misread and taken badly, how easy it is to perform this interaction through actions like touch? As a nurse, I have personally gone through life being taught that as a nurse’s touch is one of the best ways to comfort a person

In today’s society, where we are very sensitive about boundaries, it makes it hard to find the right way forward.  I teach my nursing students that touch is comforting. I mentor my staff that touch can comfort and console the dying and the distressed. Yes, touch can sometimes be misinterpreted and yes we need to be vigilant when we use it because of culture, maybe confusion like in the case of dementia, or gender differences. But it cannot be something we abolish or something we do not practice. The world is already too lonely for people not to connect through touch. I have seen elserly slip away peacefully with their hand being held by a professional. I have seen elderlyconsoled with a nurse’s hand around their shoulder while they cry after receiving bad news, a patient soothed with a caress, as they were in unbearable pain or holding the hand of a  relative who just cannot bear seeing their loved one going through chemotherapy and suffering the cruel effects of the treatment.

This paper hopes to cover some of the contoversies regarding touch, whilst evaluating it’s importance in an elderly patient’s journey and the repurcussions of having professionals shy away from touch in today’s world.

As Keats said “Touch has memory” and if we want to create good memories for our patients and also for ourselves as carers then we must recognize that touch is and always should be an integral part of our practice.

Biography:

Abstract:

Objectives

1. Review the second generation atypical antipsychotics (SGA) LAIs.
2. Understand the differential pharmacokinetics (pK) of deltoid vs. gluteal injections.
3. Discuss Canadian nursing best practice and patient acceptance.

Introduction

The (SGAs) risperidone, paliperidone, aripiprazole are available in Canada as long acting injections (LAIs) given at intervals of two weeks to three months. Although initially developed as formulations for gluteal intramuscular (IM) injection, all are now approved for deltoid injection in volumes of up to 2.7 mL (for paliperidone 3-monthly). 

Methodology

The international literature was reviewed in the context and discussed in the context of Canadian nursing best practice.

Results

Recent data suggest deltoid vs. gluteal IM injections are associated with shorter TMAX and greater CMAX, thus potentially offering a different exposure and clinical response and tolerability. For mental health clients deltoid injections are associated with less stigma, greater convenience and greater practicality in multiple clinical scenarios. Current Canadian nursing practice recommends gluteal as the preferred route for irritating, viscous and larger volumes, with a maximum of 2 mL in a well-developed deltoid muscle.

Conclusion

Advantages and disadvantages of deltoid vs. gluteal IM injections of LAIs should be considered in the context of Canadian nursing best practice, pK and real world practicality.

Biography:

Pamella Cristina de Carvalho Lucas is a PhD student in health sciences, University of São Paulo, School of Nursing (EEUSP), Brazil. Adult and elderly health specialist nurse from the EEUSP. Interested in the following areas: Geriatrics and Gerontology, Long Term Care, Care of the elderly, Caregiver of the elderly, Family and Aging

Abstract:

The elderly population in Brazil is estimated at 29.4 million (≥ 60 years), by the year 2060 may reach 73 million people. In the city of São Paulo, the elderly contingent has already reached the 1.7 million mark. The present study is part of SABE (Health, Well-being and Aging), a longitudinal study of multiple cohorts developed to trace the living and health conditions of the elderly in São Paulo. The objective was to describe how are the elderly residents in the city of São Paulo regarding the difficulties to perform activities of daily living. Participants in the fourth cohort (n = 1236), conducted in 2017, were 57.1% female and 42.9% male. The average age was 74.3 years.  Regarding activities of daily living, 46% of participants reported difficulties for instrumental activities of daily living (IADL), which ultimately tell about the possibility of the elderly living alone; and 24% of them had difficulties for basic activities of daily living (ADL), requiring caregivers. 60% of the elderly reported multimorbidity, with osteoarticular disease being the second most prevalent (33.8%). 28.1% were widowed, 6.2% single and 17.2% lived alone; conditions that predict greater need for assistance, not always being covered by families and services. In an accelerated context of population aging, there are important challenges for Brazilian public policies that need to adapt to the new and growing social and health demands in order to meet the needs of the elderly population.

Biography:

Dr. Amy Clements-Cortés, Assistant Professor, University of Toronto, Faculty of Music; Music Therapy Instructor & Graduate Supervisor, Wilfrid Laurier University; and Academic Coordinator & Instructor, Ryerson Chang School. She is a Registered Psychotherapist, Past-President of the World Federation of Music Therapy, and Managing Editor of the Journal of Music and Medicine. She is published in multiple journals and has given over 100 invited academic and conference 

Abstract:

Relationships are often a cause of substantial psychological pain for patients and their families at end-of-life. Anticipatory grief is commonly experienced by dying persons, focusing on multiple issues including: the loss of relationships, as well as the loss of forthcoming life events of which they will not be able to participate. Music therapy is commonly used in palliative care settings to address anticipatory grief, and is a valuable therapy for addressing relationship concerns.

At the end-of-life people often express intense gratitude about their lives and love for the people they have known. In gratitude we celebrate who we are to one another and the ways in which our lives have been shaped, loved, and moved by others. When realizing that death is imminent people often have a particular need to hear that their actions have made a difference and that that they have made a contribution in this life. Subsequently they need to express to their loved ones sentiments of love and appreciation for their actions. Songwriting is an important and effective tool for patients wishing to express sentiments at end-of-life to help them facilitate completing relationships. This short video presentation will highlight the case of one palliative care patient and the important role songwriting played in helping her say thank you, I love you and goodbye.

Biography:

Leila Joy Cazon is an Assistant Professor of Nursing at Silliman University of Dumaguete City, Philippines. She received her Master’s in Nursing from the same University. She is presently pursuing her Doctor of Science in Nursing, major in Gerontology at Cebu Normal University, Cebu City, Philippines. She has been an educator for 14 years. She had a chance to present her paper in the 2nd Technological Competency as Caring in Nursing last August, 2018 in Tokushima, Japan and the 8th International Conference of Nurses in Cebu City, Philippines last November, 2018 and was honored to be the third Best Podium presentor.

Abstract:

Lately, internet use has been increasingly ordinary and is source of benefits concerning information, communication and health purposes. Technological improvement like all inventions has its pros and cons. Internet users can link to social media and search for data using the internet. This study examined the use of the internet for health information by older adults. The Technology Acceptance Model (TAM) was applied to determine the predictiveness of perceived use, perceived usefulness, perceived ease of use and attitude toward internet use for health information.

Purposive sampling was used to obtain 53 internet user older adults who met the eligibility criteria. A questionnaire was adapted to gather the demographic data, the frequency of internet use and physical health were collected. No similar study had been found on this topic in the Philippine setting.

Majority of the respondents are 60 years old, females, college degree holders, and have used the internet for 1-5 years to search for health information. The regression analysis reveals that age and education cannot be associated with the usefulness of internet use for health information and that usefulness of internet use for health information, ease of internet use, and magnitude of use of the internet have nothing to do with older adults' health status (α=0.05). It is suggested that this research study should be replicated on a larger sample from different settings for understanding possible relationships of other variables that may be significant predictors of the older adults’ ability to use the internet for health information.

Biography:

Bronwyn Huggins is a fourth-year psychiatry resident at SUNY Downstate Medical Center in Brooklyn, NY where she also completed medical school. She has worked within a community hospital setting for nearly eight years, working with minority populations, treating the severely mentally ill. She has seen how the psychosocial stressors that plague this demographic influence the mental wellbeing of individuals, and how this trauma impacts subsequent generations. She is particularly interested in the area of preventative care and developing interventions during the partum period to minimize the potential for inter-generational trauma transmission. Dr. Huggins plans to continue her research and clinical work when she will begin a fellowship in Women’s Mental Health at New York University.

Abstract:

Women who experience minimal support during the pregnancy period are at greater risk to develop mood disorders before, during and after pregnancy. When mood disturbances are compounded by psychosocial stressors such as intimate partner violence (IPV), poor social supports, lack economic mobility and social capital, community disruption, unstable housing, etc.—women are more likely to experience chronic illness, and oftentimes less likely to seek care. Research has shown that increased stress on mother during pregnancy translates to stress on the fetus. By extension, after a child is born, the untreated mood disorder can lead to subsequent trauma in the form of physical and emotional neglect, poor mother-baby attachment that culminate in a variety of adverse childhood experiences and increased risk for the development of mental illness in the child, thus continuing a cycle of non-biological inherited illness. This form of inter-generational trauma disproportionately affects lower socioeconomic populations. I intend to present a case report of a 21 y/o black woman who presented who is HIV+, perinatally infected and intermittently adherent to ART. She presented with her 11-month old son, with complaints of feeling ‘overwhelmed’. She reported features of PTSD, IPV, substance use, poor psychosocial supports, neurovegetative symptoms and passive suicidal ideation. During the interview, the infant grew cranky and the patient exhibited low frustration tolerance and irritability, displaced on the child. The infant was tended by a case manager while we completed the assessment and scheduled follow-up. The patient did not adhere to follow-up, despite continued outreach efforts. The purpose of this report is to highlight the experience of women who seek help only when in crisis, and bring attention to the need for earlier interventions in efforts to break the cycle of mental illness stemming from psychosocial/epigenetic factors.  

Biography:

Mauceri Filippo graduated in nursing in 2018 with a grade of 103 out of 110. He worked for 4 months in medicine and now works in a nursing home. On 4 April 2019 he presented his study on sepsis at the National Congress of Riccione and this study was awarded as the first research of all congress.

Abstract:

Sepsis is a very frequent and serious disease, although still poorly understood. It affects 20-30 million people worldwide, about 250,000 in Italy alone, of which 1 in 4 does not survive. The purpose of my research is to understand how sepsis is managed in the Emergency Room, what is still to be improved and what can be improved. The study population includes patients admitted to the Emergency Unit of Siena from 01/09/2017 to 02/28/2018, who respond positively to inclusion in the study. At the end of the data collection the sample includes 102 patients. Many variables have been studied that help to understand nursing management of septic patients. The variables: Sex; Age; Methods of arrival at the emergency room; Admission codes used; Discharge codes used; Patients who received the qSOFA score; Values qSOFA; Patients who were given the antibiotic within the first hour; Patients who have been treated with Procalcitonin; Patients who underwent blood gas analysis; Average PCR, Procalcitonin and Lactate values; Patients whose blood cultures were performed; Results of blood cultures performed; Patients who were treated with other cultures; Etiology of bacteria resulting from blood cultures; Etiology microorganisms resulting from other cultures; Patient hospitalization time; Frequency of septic patients at the emergency room in the various months; Follow up. These variables collected if analyzed in multiple hospitals could make a difference in the management of sepsis with the possibility of saving more lives.