Tracking Hospital Visitors/Chaperones during the COVID-19 Pandemic.

OBJECTIVE: The coronavirus disease (COVID-19) is an emerging infectious disease with strong infectious power and fatality rate. To protect national health, government agencies have regulations on hospital chaperoning and visiting. This article presents the development and implementation of a monitoring system for hospital visiting and chaperoning during the COVID-19 pandemic. The study aimed to create a hospital visiting and chaperoning monitor system that uses nation-wide data sources to more accurately screen hospital visitors and chaperones, assist contract tracing, and prevent transmission of severe acute respiratory syndrome coronavirus 2. METHODS: This project was implemented in 57 ward units of an academic medical center. The system was connected to the National Health Insurance (NHI) system and Hospital Information System (HIS), and built on the data of everyone who accessed either the hospital or ward using an NHI smart card or national identification card. To shorten the time for manual identification, we also developed a new system of "app for appointment visits and chaperones" to make appointments online. RESULTS: After the implementation of the system, data from visitors and chaperones in the nursing information system could be accessed. Given that all data were registered in the HIS visiting/chaperoning monitor system, an epidemic investigation could be performed whenever there was a confirmed case. CONCLUSION: Through the establishment of this system, people entering the ward can be accurately controlled, and all the contacts of potential cases can be traced.

Action research on neonatal nursing staff: Experiences caring for bubble continuous positive airway pressure patients.

The objective of this study was to understand the experiences of special care nursery (SCN) nurses tending patients on bubble continuous positive airway pressure (bCPAP). The action research (AR) method with focus group interview was used, and five focus-group interviews were conducted between November 2015 and January 2016. Twenty SCN nurses who had cared neonates on bCPAP for at least one shift were recruited and interviewed. Six themes were revealed in two stages. The first stage was "experience of change," three themes evolved: "resistance to change," "lack of confidence on new care model," and "request administrative supports and resources from the hospital level." The second stage was "willing to take challenge," three themes evolved: "pursuit of proficiency in bCPAP care," "mastering bPCAP: acquiring self-efficacy, becoming competent, and collaborating as a team," and "the development of creative care methods." In the future when confronted with nurses resisting to new policies or changes, administrators should embrace their emotions, address their insecurity and fear, and provide adequate training to improve confidence through familiarity. Application of this model can help with policy implementation, thereby improving the overall caring quality.

The influence of personality traits and socio-demographic characteristics on paediatric nurses' compassion satisfaction and fatigue.

AIMS: To explore the level of and the association between, compassion satisfaction and fatigue of paediatric nurses; to determine the association between personality traits and compassion satisfaction and fatigue; to identify the determinants of compassion satisfaction and fatigue. BACKGROUND: Paediatric nurses are prone to experiencing compassion fatigue associated with caring for children with illness and their families, yet its connection with nurses' personality traits remains unknown. DESIGN: A cross-sectional descriptive study design was used. METHODS: The data collection used three instruments measuring socio-demography, responses to the compassion satisfaction and fatigue test and the revised NEO personality inventory. The study used descriptive, correlation and multiple regression analysis for the data collected between April - July 2014. RESULTS: From 173 female paediatric nurses, two-thirds worked in critical care units and indicated a satisfactory level of compassion satisfaction and a low level of compassion fatigue, despite a lack of association between the two concepts. Four determinants-agreeableness, extraversion, conscientiousness and engaging with outdoor activities-were predictive and explained 43.6% of total variance of compassion satisfaction. Two risk factors of compassion fatigue identified were less emotional stability and singlehood (marital status) and these explained 26.1% of total variance of compassion fatigue. CONCLUSION: Support for improving agreeableness and emotional stability in paediatric nurses' workplaces including involvement in the outdoor activities and an increase in social connection may enhance compassion satisfaction and prevent exhaustive compassion fatigue.

Pathways of emotional autonomy, self-care behaviors, and depressive symptoms on health adaptation in adolescents with type 1 diabetes.

BACKGROUND: Adolescents with type 1 diabetes mellitus (T1DM) need to adapt physically and psychologically to the impact of diabetes. PURPOSE: The purpose of this study was to examine the pathways of emotional autonomy, depressive symptoms, and self-care behaviors to glycosylated hemoglobin (HbA1c) levels and quality of life (QoL) in adolescents with T1DM. METHODS: Cross-sectional design was used in this study. Self-reported questionnaires and medical records were used to collect data from 265 adolescents with T1DM by convenience sampling in Taiwan. DISCUSSION: Structural equation modeling indicated that self-care behaviors directly positively influenced life satisfaction QoL but negatively influenced HbA1c levels. Depressive symptoms directly negatively influenced self-care behaviors and life satisfaction QoL. Emotional autonomy directly negatively influenced self-care behaviors and life-satisfaction QoL but directly positively influenced depressive symptoms. CONCLUSION: Emotional autonomy seems to be a risk factor contributing to poor health adaptation. Health care providers need to help adolescents with T1DM to balance the pursuit of emotional autonomy and health adaptation.

Nonreassuring fetal heart rate decreases heart rate variability in newborn infants.

BACKGROUND: Nonreassuring fetal status (NRFS) refers to a compromised fetal condition which implies hypoxia. The influence of intrapartum hypoxia on autonomic nervous system function in early postnatal life is unknown. This study explored the influence of NRFS on the heart rate variability (HRV) of newborn infants. METHODS: Singleton newborn infants delivered through Cesarean delivery (CD) with indications of elective purpose (n = 32), dystocia (n = 29), or NRFS (n = 22), and through vaginal birth (VB) (n = 80) were consecutively collected. HRV parameters including standard deviation of average NN intervals (SDANN), low frequency (LF), high frequency (HF), LF%, HF%, and total power (TP), were obtained for analysis in 3 days postpartum. An independent t-test or one-way ANOVA was used to compare differences in numeric data. RESULTS: SDANN, HF, HF%, and TP of newborn infants in the VB group were significantly higher than those in the CD group. The NRFS group had significantly lower SDANN, HF, and TP than those of the elective group, and significantly lower HF, HF%, and TP than those of the dystocia group. CONCLUSIONS: Newborn infants delivered through Cesarean section had lower HRV, especially those who experienced NRFS during labor. The long-term effects of changes of HRV in neonates require further evaluation.

The multimethod evaluation of a nursing information system in taiwan.

The purpose of this study was to evaluate the impact of a nursing information system on nurses' daily practice. A multimethod evaluation was used that combined both quantitative and qualitative approaches to explore the influence of this technology from different perspectives. The data collection methods included the following: an evaluation scale of the system function, focus group interviews about the users' experiences, and work sampling observation of their work pattern. The data were collected from October to December 2006. The data analysis contained 623 valid questionnaires, 24 nurses' interview content, and 22830 observed nursing activities. Overall, the results indicated that nurses gave a positive evaluation of the technology in their work routine. However, they were concerned about the inadequacy of the hardware devices and response time, training and workflow change, and personal interactions with physicians and patients. Nurses on the night shift spent more time on documentation than on any other nursing activities during the three shifts. The users' technology adoption could be attributed to device sufficiency and function, content design, and workflow efficiency. It is recommended that organizations provide sufficient computer devices, ensure the content design for nursing documentation, and implement expectations for interdisciplinary cooperation.

Impact of a nursing information system on practice patterns in Taiwan.

The purpose of this study was to measure changes in nursing practice patterns between the beginning stage and a later phase of implementing the nursing information systems. The study was a two-stage data comparison analysis. The data were collected during the first 2 weeks and 1 year after installing the nursing information system. Nursing activities were checked from a list with 83 items. Data were collected by a work sampling strategy during two 2-week periods in November 2004 and November 2005. For both stages, nurses spent about 20% of their time on direct care, 25% on indirect care, 9% on unit-related activities, 30% on documentation, and 15% on personal time. After 1 year of using the nursing information system, nurses spent more time on documentation but less on indirect care and unit-related activities. When unit patient census was high, nurses spent more time on direct care. Issues regarding evaluating the impact of information systems on practice patterns were explored.