here - National University of Singapore

TRENDS Seminar
(Topics in Research and Education for Nursing Development in Singapore)
Date:
Venue:
Time:
Monday, 30th March 2015
Level 2, ALCNS Conference Room
Block MD 11, Clinical Research Centre
National University of Singapore
You are invited!
2.30pm to 4.30pm
First Topic: Exploration of works systems and its impact on situational awareness (SA)
among scrub nurses in an ophthalmic operating theatre
Abstract: Operating Theatre is a complex and intimidating environment. Disparities and
vulnerabilities of human factors within the operating theatre are observed to be higher as
compared to any other settings within healthcare. While many factors are linked to medical errors
and adverse events, studies have shown, non-technical skills like communication, team-work and
situational awareness (SA) are essential and yet not fully emphasized. Although there is existing
knowledge in acute settings whereby longer and complex procedures are being studied, very little
is understood from ambulatory perspective.
In today’s rapid evolution of technology and escalating cost, many surgical procedures are done in
ambulatory setting. Therefore, a systematic evaluation on individual differences within an
ambulatory operating theatre is necessary in order to improve existing SA training models ability
in a dynamic environment.
Speaker: Ms Loh Huey Peng is the Assistant Director of Nursing at the
Singapore National Eye Centre (SNEC). Her perioperative experience and
background have given her opportunities to be actively involved in quality
improvement, risk and patient safety management in SNEC.
Ms Loh obtained her Masters in Heath Administration and Advanced
Diploma in Perioperative and is currently pursuing her part-time Doctoral
of Philosophy studies at the Alice Lee Centre for Nursing Studies (ALCNS),
National University of Singapore (NUS).
She was invited to present her quality improvement projects at the World Association of Eye
Hospital. Her project has received several awards and was also published at the Joint Commission
Patient Safety Journal. She awarded with the MOH Merit award in 2009, National Day Efficiency in
2011 and Sing Health Excellence Award in 2014.
Organized by the Alice Lee Centre for Nursing Studies, NUS
Second Topic: Spontaneous alteration in brain temperature after adult acute severe
traumatic brain injury (TBI): relationship to outcome and association with
neurophysiological parameters
Abstract: Temperature and neurophysiological parameters had been suggested to have an impact on
outcome of TBI patients. The relationship of acute spontaneous alteration of brain temperature, temperature
differences (brain temperature – core body temperature) on intracranial pressure (ICP), cerebral perfusion
pressure (CPP), brain tissue oxygenation (PbtO2), pressure reactivity index (PRx) and outcome in this group
of patients are not well-studied.
This study aims to 1) examine the correlation between brain and core rectal temperature;
2) investigate the relationship on brain temperature and temperature gradient differences (brain
temperature minus core rectal temperature) during the first 72 hours post severe traumatic brain injury with
ICP, CPP, PbtO2, and PRx, ICU mortality and length of ICU stay; 3) develop and validate a risk prediction
model for mortality after severe traumatic brain injury.
The hypothesis are: 1) There is highly positive correlation between brain and core rectal temperature; 2)
Changes in brain temperature over first 72 hours after severe traumatic brain injury is associated with
changes in neurophysiological parameters; 3) Brain temperature values over the first 72 hours of monitoring
are predictive of mortality; 4) Risk factors, such as, presence of multiple injuries and subarachnoid
hemorrhage, hypoxia (SpO2<90%) and hypotension (SBP < 90 mmhg) on admission, predict ICU and 6
month mortality in severe traumatic brain injury. Retrospective review of prospective observational cohort
study conducted in NICU, National Neuroscience Institute (Tan Tock Seng campus), Singapore, one of the
hospital admitting most TBI cases and pioneer center for brain tissue oxygenation in Singapore.
Data collected on brain and rectal temperature, ICP, CPP, PbtO2, and PRx at 20-sec intervals via in-house
software between July 2002 and Jan 2013 will be analyzed. ICU and hospital length of stay (LOS), survival
upon ICU discharged and 6 months Glasgow outcome score (GOS) will also be assessed.
Patient
characteristics will be described using appropriate statistics. Correlation of brain temperature and
temperature gradient differences (Tbr – Tc) with ICP, CPP, PbO2, and PRx will be studied using correlation
coefficients and linear regression methods. Logistic regression method will be used to explore associations
between brain temperature (Av, min, max) and dichotomized outcomes, such as GOS, LOS ICU, LOS hospital
and mortality. Prognostic models for mortality will be developed using logistic regression by incorporating
potential risk factors into the models. Discriminating ability of these models will be evaluated using AUC
statistics. Further, k-fold cross validation will be used to check the validity of these prognostic models.
Alternatively, we are also interested in looking at alterations in brain temperature and neurophysiological
parameters during the first 72-hours and their associations with each other as a different time series. Such
data will be analyzed using related appropriate statistical methods. All statistical tests will be two-sided and
P < 0.05 will be considered as statistically significance.
This study will address current literature gaps and methodological limitation to provide valuable
information of the relationship of brain temperature and neurophysiological parameters on outcome during
spontaneous temperature alteration to help refine TBI management to minimize secondary brain insult and
better prognosticate outcome.
Speaker: Ms Lee Kah Keow currently works at the National
Neuroscience Institute (NNI) as a Nurse Clinician in Neurosurgery
Department. Her research interest relates to head trauma and
neurovascular conditions.
Ms Lee is pursuing her part-time Doctor of Philosophy (PhD) studies
at the Alice Lee Centre for Nursing Studies (ALCNS), National
University of Singapore (NUS).
Organized by the Alice Lee Centre for Nursing Studies, NUS
Third Topic: Effects of a smartphone-based intervention in coronary heart disease (CHD)
prevention among working population: a pilot randomized controlled trial
Abstract: Coronary heart disease (CHD) is the most prevalence type of cardiac disease among
adults. Most of its risk factors, such as tobacco smoking, obesity, physical inactivity and high blood
pressure are preventable. Mobile technology has well developed during the last decade.
The advent of mobile health intervention will bring a new era for disease prevention and health
promotion.
The aim of this study is to examine the feasibility and possible effectiveness of a smartphone-based
intervention, named “Care4Heart”, in improving the awareness and knowledge of coronary heart
disease (CHD), and enhancing healthy lifestyle behavioural changes for working population in
Singapore.
A pilot, two-arm RCT is adopted to test the feasibility and possible effectiveness of a newly
developed smartphone application (app), named Care4Heart, on CHD prevention. A convenient
sample of 80 working people will be recruited from a tertiary university of Singapore, with 40
subjects randomised into the intervention group. The participants in intervention group will
receive a 4-week smartphone app intervention, whereas those in the control group will not be
offered such intervention. Participants’ awareness, knowledge and behavioural risk factors will be
assessed at baseline and 4 weeks post-treatment using Heart Disease Fact Questionnaire-2,
Behavioural Risk Factor Surveillance System and Perceived Stress Scale. Data will be analysed
using IBM SPSS 22.0.
If this project is a success, a novel CHD prevention tool – “Care4Heart” app will be employed
nationwide, which will not only benefit the working population, but also the country by providing
efficiency and sustainability to the public healthcare system.
Speaker: Ms Zhang Hui is a teaching fellow from the Alice Lee Centre for
Nursing Studies (ALCNS), National University of Singapore (NUS).
She is a registered nurse with speciality in orthopaedics nursing.
She has strong research interest in nursing education and advanced
technology in healthcare setting. Ms Zhang Hui is also currently pursuing
her part-time Graduate Research studies with ALCNS, NUS.
Organized by the Alice Lee Centre for Nursing Studies, NUS
Fourth Topic: Perceptions of survivorship care needs and supportive programmes among
breast cancer survivors in Singapore
Abstract: Breast cancer is the most common cancer affecting women globally. While treatment
advancements have improved survival rates, several side effects and symptoms are precipitated
and the need for health care professionals to assist breast cancer survivors to cope with ill-effects
after cancer treatment is critical.
This study aims to explore the needs, perceptions and preferences for survivorship care and
investigate the barriers and facilitators of engaging in survivorship programmes provided through
various modes of delivery among breast cancer survivors in Singapore through focus group
discussions.
Purposive sampling will be used to recruit participants. A total of 4 to 6 qualitative focus groups
with 6 to 10 participants per group will be carried out to explore the study aims. The moderator
will utilize a semi-structured interview guide to facilitate discussion and all sessions will be
audio-taped with permission from the participants. An observer will also be present to observe
and record non-verbal cues.
Data generated will provide in-depth information which will guide the development and enhance
the delivery of a survivorship care or supportive programme for local breast cancer survivors.
Speaker: Ms Lim Yee Ting Ethel is currently pursuing her
Doctor of Philosophy (PhD) studies at Alice Lee Centre for Nursing
Studies (ALCNS), National University of Singapore (NUS),
on a full-time basis under the NUS Research Scholarship.
She has received her Bachelor of Nursing (Post-Registration) with
University of Sydney in 2009 under the Alice Lee – Institute of
Advanced Nursing Scholarship Award and completed training for the
Advanced Diploma in Critical Care Nursing in 2011 with
Ngee Ann Polytechnic.
As a registered nurse, Ms Lim has practiced in general medical wards
and in medical, surgical and burns intensive care units.
In 2012, she joined the National University of Singapore as a Research
Assistant and received on-the-job training on research-related skills
and knowledge, mainly in the field of oncology nursing.
Organized by the Alice Lee Centre for Nursing Studies, NUS