[A Quality Improvement Project for Reducing Work-Related Stress of Nurses in Converting an Oncology Ward Into a Designated COVID-19 Ward During the COVID-19 Pandemic].

BACKGROUND & PROBLEMS: The community spread of SARS-CoV-2 occurred during the COVID-19 pandemic in May 2021 in Taiwan. Due to the large number of COVID-19 patients, demand for healthcare capacity had also increased. In response to the massive influx of patients with COVID-19 in our hospital, a designated COVID-19 ward was established. In addition, the oncology ward was also quickly transformed into a designated COVID-19 ward that shared staff and work schedules with the originally designed COVID-19 ward during the pandemic period. The process of setting up the ward, training personnel, and providing independent care to COVID-19 patients and the period of professional cooperation with medical staff from the infectious disease ward caused great burden and pressure on nurses. PURPOSE: The objective of this study was to reduce the work-related stress index from 20.2 to 15. RESOLUTION: Cross-training and in-service courses were implemented to assist the oncology nurses to learn nursing care for patients with COVID-19. Five solutions were discussed and implemented in a timely manner. The interventions included the unifying the logistical flows between wards, optimizing ward environments, providing education and training on COVID-19, launching a new communication platform to facilitate discussions and gather various opinions, and implementing flexible scheduling. RESULTS: The stress index score declined from 20.2 to 8.2 on the stress and anxiety to viral epidemics-9 scale. CONCLUSIONS: The findings of this study may be referenced to assist nurses and nursing managers when making preparations to transform oncology wards into designed COVID-19 wards.

Effectiveness of Cognitive-behavioral Program on Pain and Fear in School-aged Children Undergoing Intravenous Placement.

PURPOSE: This study aimed to evaluate the effects of cognitive-behavioral program on pain and medical fear in hospitalized school-aged children receiving intravenous (IV) placement. METHODS: This study used an quasi-experimental design. Thirty-five participants were assigned to the experimental group and 33 to the control group in the acute internal medicine ward of a children's hospital. The cognitive-behavioral program entailed having the patients read an educational photo book about IV placement before the procedure and having them watch their favorite music video during the procedure. The outcome measures were numeric rating scales for pain intensity and fear during the procedure. RESULTS: After applying the cognitive-behavioral program, the mean scores on pain and fear decreased in the experimental group. However, the difference in pain intensity between these two groups was nonsignificant. The intensity of fear in the experimental group was significantly lower than that in the control group. CONCLUSION: In this study, the cognitive-behavioral program used with school-aged hospitalized children promoted less fear during IV placement. The results of this study can serve as a reference for empirical nursing care and as care guidance for clinical IV injections involving children.

[Reducing fear in preschool children receiving intravenous injections].

BACKGROUND & PROBLEM: Our pediatric medical ward administers an average of 80 intravenous injections to preschool children. We found that 91.1% exhibit behavior indicative of fear and anxiety. Over three-quarters (77.8%) of this number suffer severe fear and actively resist receiving injections. Such behavior places a greater than normal burden on human and material resources and often gives family members negative impressions that lower their trust in the healthcare service while raising nurse-patient tensions. Using observation and interviews, we found primary factors in injection fear to be: Past negative experiences, lack of adequate prior communication, measures taken to preemptively control child resistance, and default cognitive behavioral strategies from nursing staff. PURPOSES: This project worked to develop a strategy to reduce cases of severe injection fear in preschool children from 77.8% to 38.9% and achieve a capacity improvement target for members of 50%. RESOLUTIONS: Our team identified several potential strategy solutions from research papers and books between August 1st, 2009 and April 30th, 2010. Our proposed method included therapeutic games, self-selection of injection position, and cognitive behavioral strategies to divert attention. Other measures were also specified as standard operating procedures for administering pediatric intravenous injections. RESULT: We applied the strategy on 45 preschool children and identified a post-injection "severe fear" level of 37.8%. CONCLUSIONS: This project was designed to reduce fear in children to make them more accepting of vaccinations and to enhance children's positive treatment experience in order to raise nursing care quality.