8th World Nursing Education and Evidence Based Practice Conference

King Faisal Medical complex, KSA

Palliative care and end-of-life (EOL) care are complex aspects of patient care that require specialist input from multidisciplinary teams. The transition from palliative caren to EOL care can be challenging to address in discussions with patients, but is a necessary aspect of care planning and shared decision-making. However, nurses may not be facilitating optimal communication in these instances.

Marwa Ahmed Elgharably is a Cardiology specialist in the Egyptian ministry of health. She did her research work in Menoufia university hospital, Egypt.

Objectives: This registry represents data from Cardiac Care Unit CCU of Menoufia University Hospital, as representative to tertiary academic centre in Egypt, and provides an epidemiological snapshot of the female HF patients, their risk profile and short-term outcome during hospitalization. Methods: It is a local single center cross sectional observational registry of CCU patients one year from July 2015 to July 2016. Data were collected through special software program. Women with clinical and laboratory evidence of HF were systematically studied. Results: From 1006 patient admitted to CCU, 345(34.3%) were females; 118(42.6%) of them and 178(26.9%) out of 661 male patients had evidence of HF. Women with HF showed 11.7% prevalence of the total CCU admissions. 72.7% were HFrEF and 27.3% were HFpEF. Compared to men, women with HF were older in age, more obese, more likely to be asymptomatic than men, had higher prevalence of associated co-morbidities, less likely to be re-admitted for HF and less likely to have ACS and PCI. Valvular diseases and cardiomyopathies were the commonest etiologies of their HF. Women had more frequent normal ECG, higher EF% and smaller LA size. No difference in medications and CCU procedures. While females had shorter stay, no significant difference in hospital mortality compared to male patients. Conclusions: Despite higher prevalence of HF in females admitted to CCU and different clinical charaterestics and etiology of HF, female gender was associated with similar prognosis during hospital course compared to male gender.

Ulviyya Eyubova is a PhD Student at the Azerbaijan Medical University located at Azerbaijan. Research interests are in the field of Heart Disorders and evolving modern treatment methods for the same.

Being a very common condition among the whole population of the world, often leading a life-threatening illness and having high risk and mortality rate, chronic heart failure is also a major public health problem for the world. According to data provided in 2017, 26 million people worldwide suffer from heart failure. These reasons include especially malnutrition and obesity, diabetes mellitus that is increasing every year, increase in smoking, hypertension, and an increase of alcohol consumption. Our goal is to investigate what has been achieved in the treatment of chronic heart failure patients with a Left Ventricular Ejection Fraction (LVEF) < 40% recent years. In recent years, it is revealed that brain natriuretic peptide has been crucial in the pathogenesis of heart disease. The activity of natriuretic peptides, in particular B-type natriuretic peptide, causes a number of significant cardiac and renal effects. Thus, B-type natriuretic peptide has a significant role in the diagnosis of heart failure and in the evaluation of its prognosis. However, natriuretic peptides can not last long in the body and break down quickly. This process is mainly due to neprilysin and that is why, neprilysin inhibition is needed in order to prevent the process. Due to this reason, we tried to investigate the results of the complex medical treatment method performed with the combination of sacubitril / valsartan which is neprilysin inhibitor in chronic heart failure patients. We also investigated the device treatment methods used in the treatment of these patients, particularly the cardiac resynchronization therapy. Finally, we investigated the results of the complex medical treatment method performed with the combination of sacubitril / valsartan in comparison with the results of the device treatment methods.

A senior Specialist in Critical Care Nursing has his expertise in Adult Intensive Care Services, His evaluation of improving the Nursing Practice in ICU is more often open for evaluation model based on responsive constructivists between Ward Nurses and ICU Nurses and creates new pathways. He has built this model after years of experience in Both ICU and Rapid Response Team.

Purpose: Determine the effectiveness of staff education programs and the implementation of guidelines for rapid response teams to ensure that at risk patients are prioritized and followed appropriately. Methods: A staff education program for hospital ward staff who would be utilizing the rapid response system was started. Staff were taught when and how to activate the rapid response system. Emphasis on activating the system early was reinforced along with the benefits of early treatment for at risk patients. A strict criterion for the rapid response team was developed that focused on finding and treating the patients that would benefit the most from advanced care during an ongoing crisis. Following the educational program and criteria implementation to the rapid response program, we reviewed our yearly statistics to determine if there was any benefit achieved from this process. Results: We observed a steady increase in rapid response activations over the year. The number of referrals & active patients being seen by rapid response both trended upward thru the year1. Our crude mortality rate decreased steadily as the year progressed2. This occurred as our educational programs and guidelines were being implemented. We will follow this investigation with more specific indicators and develop KPIs for our teams internally to monitor the effectiveness of the program moving forward. Conclusions: Training programs that target general healthcare staff and implementation of rapid response criteria to more effectively reach at risk patients can have a dramatic improvement of a rapid response service and decrease mortality.