Fragments
of the information presented to the ECET:
After opening the event, the ECET board
presented the programme and welcoming the participants.
- Luisa Salani, Italy – Caring gestures and thoughts from the voices of nurses – about a study and its phases: Starting point – A qualitative phenomenological study : 340 nurses – Method and data analysis – Caring for the other: dedicated time, paying attention, respecting other, trying to establish relationship with patient, satisfying the patient’s needs, being concerned with the emotional decision etc.
- Taking time for caring gestures and words – in the daily practice nurses have to decide to which kind of patient dedicate more time
- Paying attention – is the first caring action. Nurses should have an open mind..
- Acting with delicacy, Touching patient’s body – a wide range of caring actions emerged from nurses’ stories
- Being on the alert: nursing surveillance – while I was giving the medication I spoke to him ( patient) and I could feel a strange way of breathing , so I asked himself if he was having problems.
- Impacting on context to facilitate the act of caring.
Caring from
Italian nurses’ perspective: it is a practice carried out through competent
actions and willingness to intentionally take care of the patient. It involves
an international and prompt care. Comparing our results with international
studies. Caring generates caring – to support the ethical tension that nurse
caring requires in contexts exposed to continuous suffering and to the cure of
incurability.
- How research is helping or should help caring / taking over nurses. Ermellina Zanetti,
- Experience a relationship of closeness with nurses
- To be informed
- Receive a continuous attention ; “caring for” behaviors that indicate to patients that nurses “care about” them.
Nurses –
patient interactions: Virtually all nurse-patient interactions could be categorized
into one of the following areas:
- Getting to know each other
- Translating (explain, informing etc.)
- Expert compassion (includes genuine
concern ad a “ connection”)
- Patients’ concerns focus more on the
availability of a nurse to attend to their specific requests than on
“closeness’ with a nurse
- When nurses are readily available to
“care for” patients this can potentially result in patients believing that
nurses “care about” them
FROM NURSING SCIENCE TO PATIENT NEEDS: A LONG JOURNEY
Unversita degli Studi di Firenza, Mario Del Vecchio
Some fundamental steps:
- Nursing
science
- Nurses
capabilities and skills
- Nurses
number
- The
roles that nurses play and the tasks they perform
Four priorities in FNOPI ( 2017) document (Italian
document):
- To
expand the scope of practice
- To
practice in a safe environment:
- To
practice in full partnership with physician and other health professionals/
high quality in multi-professional team
- To
be open to and ready for the future: in a changing world the choices of the
professional community should be more “pulled by the future” than “pushed by
the past”.
Profession’s strategies – a wider perspective:
- In
designing their strategies nurses, as any other professional, tend to adopt a
strict disciplinary perspective
SIMPOSIUM
Pier R. Spena ( FAIS Italy) attended and held
an welcome speech session, with entero-stoma therapist Natascia Tonarelli and
Sarah Rusell ( Clinical Exercise Specialist)
Me + recovery programme
- Recovery after stoma surgery – what
does recovery look like ? exercise guidelines and research; what do nurses say?
What do the patients say?
- Ostomate , own experience surgery
diverticulosis , no information about exercises for abdominal ;
Importance – confidence
What advice do you give your patients about
physical activity and exercise after stoma surgery?
Confidence spiral: urgery, rebuilding
confidence, increased activity, no loss muscle, less pain, more confidence.
What are the benefits of physical activity?
How much physical activity should you do?
Percentage of respondents NO meeting guidelines for physical activity (150 minutes of moderate activity per week).
Physical Activity after surgery with hernia
Patient Comments 2018:
- Need
more advise about abdominal exercises “I wish I’d been advised and how to
prevent them”
- I
am scared to do exercise in case I get a
hernia
- Exercises
is so important in the recover process, But it is never discussed.
Do you think patients should be given specific
information about physical activity? Patients answers – yes
Guidelines – Patients should be advised to
commence core abdominal exercises 3 – 4 days post surgery
Exercise and cancer – exercise is safe –
before, during and after treatment – it helps to combat side effects and
reduces risk of recurrence, may help body fight cancer 7 aid treatment.
Suggested guidelines:
Everyone is different – people with stoma can
make any exercise they want, Appropriate core /pelvic floor exercises , Regulate
intra-abdominal pressure ( IAP)
Goals of me recovery (Sarah Rusell speaker)
- Return
to normal activity , work and life soon
- Rebuild
confidence – physical and mental
- Core
muscle and pelvic floor function
- Empower
– enable – focus on positives
- Increase
physical activities
3. Natascia Tonarelli – Enterostomal therapist – Cisanello Hospital Pisa
Event in Pisa with the support of Convatec for patients for exercises, patients do exercises all together
After finding out about the “Me+ recovery” – patients have learned movements, started to do exercises etc.
25 JUNE 2019
Welland symposium
Manuka Honey Workshop – Hydrocolloid containing Manuka honey as a first
line defence in maintaining peristomal skin health.
Speaker: Dr. Duale Mahdi, research scientist
Why skin integrity is at the Heart of Stoma Care?
- Skin – the interface
Protection – mechanical
impact, fluids, radiation, infection; thermal regulation; endocrine function/ Vitamin
D; sensation
- Skins structure – formed by hypodermis,
derma, epidermis – 3 lays
Structure of the
Epidermis:
- Stratum Corneum Structure:
Key components: 1)
Corneocytes contain keratin and compounds referred to as natural moisturizing
factor ( NMF), b) Intracellular Lipid bilayer
Skin hydration (
moisture- associated skin damage)
Consequences of Moisture
Damage:…(..)
- The
pH of human organs is tightly regulated by acid- base homeostasis varying
between 1 to 8
- “normal”
pH skin is acidic in range of 4.1 – 5.8
- Skin
pH bacterial growth in particular staphylococcus aureus which has an optimal pH
of 7.5
Peristomal Skin Complication
– common – estimated to be approx. 70 %
– expensive – treatment cost for severe case of Peristomal skin complication
– is the flange simply an adhesive plate? It has a huge impact on peristomal skin protection
– why have an additive such as Manuka honey in the baseplate? = natural, safe ( ingestible), strong etc
High level
of MGO are present in Manuka Honey from the nectar of the flower of the Manuka
bush ( Leptospermum Scoparium) , indigenious to New Zeeland.
UMF
trademark is giving for the original of the honey , on the content pure.
- Low
pH, High sugar content, hydrogen peroxide,
- Reported
benefits of Medicinal Honey ( anti-inflammatory activity, is used in wound
dressing to stimulate and rapidly heal skin, used in burns etc)
Peristomal
skin in study ( for flat appliances, not convex)
- 61
% saw improved peristomal skin and increased in their QOF
- 93%
comfortable
- 88%
felt secure
- 68%
Improved or healed
Conclusions:
- Honey
is safe
- String
positive clinical results
- Leading
core research that will be continued to share
26 June 2019
Information
about colostomy for people with limited health literacy, by NL
Purpose
Development
of information that helps doctors and nurses to give better explanations to
people who are getting a colostomy, but are experiencing difficulty in
understanding medical information.
Method:
- Desk
research among ostomy nurses which showed that people with limited health
literacy are getting less extensive information
- Simplifying
existing texts in proper consultation with ostomates and stoma-nurses
- Providing
the texts with simple medical illustrates
- Submitting
the texts and drawings to people with limited health literacy.
Results:
- A
set of colostomy-cards “colostomy after colon cancer” which are presented to
ostomy nurses
- A
training for ostomates and stoma-nurses about health literacy and communication
- Plans
and commitment to develop more similar information in 2019.
Isabella Grosu
