Validity of the Taiwan Triage and Acuity Scale in mainland China: a retrospective observational study.

OBJECTIVES: The Taiwan Triage and Acuity Scale (TTAS), developed for use in EDs, has been shown to be an excellent tool for triaging patients with high predictive performance, with an area under the receiver operating curve (AUROC) of 0.75. TTAS has been widely used in hospitals in Taiwan since 2010, but its utility has not been studied outside of Taiwan. Thus, the aim of this study was to evaluate the validity of using the TTAS in the ED of a tertiary hospital in mainland China to predict patient outcomes. METHODS: A retrospective observational study was performed on patients 14 years of age or older attending the ED of a tertiary hospital in mainland China between 1 January 2016 and 31 March 2016. The validity of the TTAS in predicting hospital admission, intensive care unit (ICU) admission, death, ED length of stay (LOS) and ED resource utilisation was evaluated by determining the correlation of these outcomes with the TTAS, AUROC and test characteristics. RESULTS: A total of 7843 patients were included in this study. There were significant differences between the TTAS categories in disposition, ED LOS and ED resource utilisation (p<0.0001). The TTAS was significantly correlated with patient disposition at discharge, hospital admission, ICU admission and death in the ED (Kendall rank correlations were 0.254, -0.254, -0.079 and -0.071, respectively; p=0.001). The AUROCs for the prediction of hospital admissions, ICU admissions and deaths in the ED were 0.749 (95% CI 0.732 to 0.765), 0.869 (95% CI 0.797 to 0.942) and 0.998 (95% CI 0.995 to 1.000), respectively. Our results demonstrated better performance using the TTAS for predictions of ICU admission and death. CONCLUSIONS: The TTAS had good validity in predicting patient outcomes and ED resource utilisation in a tertiary hospital in mainland China. Compared with the performance of the TTAS in Taiwan, our results suggest that the TTAS can usefully be applied outside of Taiwan.

Evaluation of a patient centered e-nursing and caring system.

This study aims to develop an electronic nursing and caring system to manage patients' information and provide patients with safe and efficient services. By transmitting data among wireless cards, optical network, and mainframe computer, nursing care will be delivered more systematically and patients' safety centered caring will be delivered more efficiently and effectively. With this system, manual record keeping time was cut down, and relevant nursing and caring information was linked up. With the development of an electronic nursing system, nurses were able to make the best use of the Internet resources, integrate information management systematically and improve quality of nursing and caring service.

Effects evaluation of nursing E-truck.

The research is to establish nursing E-truck, provide immediately information to nurses, patient's bedside-service. Each nursing work, through computer wireless LAN card, optic fiber network in hospital to the mainframe, to open an activated medical treatment work. Nurses can key in the patient's condition or nursing notes after take care of the patient at the patient's unit, reduce repeated copy, produce working efficiency and working satisfaction.

A program to improve the electronic working environment and computer hardware.

Information technology is the inevitable product of modern society and computerized medical information provides clinic workers with more timely and instant information. Therefore, computer hardware equipment is a must to promote computerized information system. Yet, there is low satisfaction level toward the arrangement of clinical computer equipment. The purpose of this program is to improve the satisfaction level and easiness to access to e- environment and computer hardware equipment at nursing stations. Results after the improvement and rearrangement of e-environment indicated that the satisfaction level of nursing staffs has been improved by 22.4% from 41.4% to 63.8% improving the accessibility, the interactions between and among staffs and patients, and the utilization of computer equipment.

The effect evaluation of the nursing information application on the fall down precautionary measures of inpatients.

The research is to establish the nursing information system of fall down dangerous cause estimation, build up the standard working process of fall down precaution, reduce the patients' fall down rate and injury rate. I) Build up a complete information system for standard working process of fall down precaution. II) After nurses intervened the education, there are remarkably positive promote on knowledge, attitude and action. III) After intervened the precautionary measures, the fall down rate and the injury rate are remarkably reduced.

[A conceptual analysis of professional commitment].

Professional Commitment is an attitude, and it is the core and spirit of professionalism. In addition to increasing personal stability in the profession, it also enables individuals to reach their professional goals in general. Because nurses usually have more opportunities than other health care professionals to be in contact with patients, patients receive most of their information about health care from nurses. If nurses accept professional commitment as early as possible, the quality of patient-care will be improved. That is the reason why professional commitment is regarded as the hallmark of quality in professional care. This paper will use the conceptual analysis framework developed by Walker and Avant (1995) to examine and analyze professional commitment and establish its relationship with nursing. The authors hope that it can provide nurses with the opportunity to understand this concept more fully, to support their own profession, to raise the position of the nursing profession and to guarantee the health of the general public.