Influencing factors of dysmenorrhoea among hospital nurses: a questionnaire survey in Taiwan.

OBJECTIVES: Nurses are at high risk of dysmenorrhoea while working with patients. The study objectives were to: (1) describe the demographic and menstruation characteristics of dysmenorrhoea, knowledge about dysmenorrhoea and menstrual attitudes towards menstruation among dysmenorrhoeal and non-dysmenorrhoeal hospital nurses; (2) identify significant differences between the groups; and (3) examine factors influencing dysmenorrhoea. METHODS: This cross-sectional survey used a structured questionnaire, administered at two hospitals in southern Taiwan. Participants included hospital nurses at least 18 years of age who agreed to participate. All participants were recruited through random sampling. The questionnaire included demographic data, the Dysmenorrhoea Knowledge Scale and Menstrual Attitude Scale (MAS). RESULTS: A total of 420 nurses completed the questionnaire. Among them, 297 (70.7%) had experienced dysmenorrhoea in the past 6 months and 123 (29.3%) had not. Significant differences in age (P<0.001), marital status (P<0.001), childbearing status (P<0.001), age at menarche (P<0.05) and rotating three shift ratio (P<0.05) were identified between the dysmenorrhoea and non-dysmenorrhoea groups. Analysis of the MAS results revealed significant differences between the groups regarding consideration of menstruation as a debilitating (P<0.001) or bothersome event (P<0.05), anticipation and prediction of menstruation onset (P<0.01) and denial of any effects from menstruation (P<0.001). Results of the multiple logistic regression showed that predictive factors included age <40 years (4.46 vs 1.00), working three shift rotations (2.07 vs 1.00), marital status (2.59 vs 1.00), acknowledging menstruation as a debilitating event (2.72 vs 1.00) and denial of effects from menstruation (2.59 vs 1.00). CONCLUSIONS: These findings could help nursing managers to create a caring and friendly work environment for hospital nurses at risk of dysmenorrhoea.

Effectiveness of trauma team on medical resource utilization and quality of care for patients with major trauma.

BACKGROUND: Trauma is one of the leading causes of death in Taiwan, and its medical expenditure escalated drastically. This study aimed to explore the effectiveness of trauma team, which was established in September 2010, on medical resource utilization and quality of care among major trauma patients. METHODS: This was a retrospective study, using trauma registry data bank and inpatient medical service charge databases. Study subjects were major trauma patients admitted to a medical center in Tainan during 2009 and 2013, and was divided into case group (from January, 2011 to August, 2013) and comparison group (from January, 2009 to August, 2010). RESULTS: Significant reductions in several items of medical resource utilization were identified after the establishment of trauma team. In the sub-group of patients who survived to discharge, examination, radiology and operation charges declined significantly. The radiation and examination charges reduced significantly in the subcategories of ISS = 16 ~ 24 and ISS > 24 respectively. However, no significant effectiveness on quality of care was identified. CONCLUSIONS: The establishment of trauma team is effective in containing medical resource utilization. In order to verify the effectiveness on quality of care, extended time frame and extra study subjects are needed.

The effects of contextual and structural factors on patient safety in nursing units.

BACKGROUND: Because of limited research on patient safety from a macrolevel perspective, our understanding of how to reduce the risk of system failures that impact patient safety outcomes in Taiwanese healthcare organizations is limited. PURPOSE: We conducted this study to explore the relationships between macrolevel factors and patient safety outcomes. METHODS: Structural contingency theory was used as the framework for the study. A cross-sectional design was used, and data were collected from self-administered questionnaires. Head nurses and registered nurses working in 64 in-patient nursing units at three hospitals participated in the study. A tailored design method was used for data collation, and the data collection lasted 3 weeks during the winter of 2010. Data were aggregated from the individual to the unit level, and path analysis was used to examine the hypothesized model. RESULTS: Sixty-two head nurses (96.8%) and 977 staff nurses (72%) completed and returned the questionnaire. Eta-squared coefficient (η), interitem consistency (rwg), and F ratio results showed that data at the individual level are appropriate for aggregating to the unit level. These findings show that nursing units with high degrees of professional autonomy, comparatively higher proportions of nursing experts, and relatively large unit sizes tend to have higher rates of medication errors. In addition, we found high degrees of unit technology associated with higher rates of medication errors and patient falls. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: These findings suggest a link between macrolevel factors and patient safety outcomes. This study shows that redesigning continuing education programs encourages nurses to participate in patient safety training and understand the nursing unit characteristics that enhance patient safety outcomes to improve the patient safety of nursing units.

Developing and applying a cross-disciplinary team handover information system.

In order to avoid medical errors, it is very important to communicate with the medical team correctly, timely and efficiently. One of main reasons for the poor outcome of multidisciplinary handover in hospital is lacking effective tools for multidisciplinary handover. The project aimed to develop a workflow-based multidisciplinary handover information system, integrated with medical record browsing, multidisciplinary handover and event tracking, to improve the correctness and effectiveness of communication among the medical team members.

Dysmenorrhoea and self-care behaviours among hospital nurses: a questionnaire survey.

AIMS AND OBJECTIVES: To investigate self-care behaviours and its predictors for dysmenorrhoea among hospital nurses. BACKGROUND: Dysmenorrhoea is an important issue in hospital nurses for its influence on job performance and quality of patient care. Given the difficulties in reorganising work schedule for taking menstrual leave in Taiwan, it is necessary to improve the comfort level of nurses during menstruation. DESIGN: A cross-sectional correlation study using a structured questionnaire. METHODS: A convenience sampling method was used to select two hospitals in Southern Taiwan, and participants were recruited by random sampling method. Questionnaire used in the study contained personal information, Dysmenorrheic Knowledge Scale, Menstrual Attitude Scale and Dysmenorrheic Self-Care Behavior Scale (DSCBS). Two hundred and ninety-seven participants had experienced dysmenorrhoea in the last six months, with the prevalence rate of 70·7%. RESULTS: Results showed the average age of the participants was 30·3 years, and 252 participants (82·4%) self-perceived they were bothered by dysmenorrhoea. The score of DSCBS was 29·9 (±5·3). The results of stepwise multiple regression analysis revealed the predictors of DSCBS included whether the participants (1) were married, (2) had irregular menstruation, (3) had received health education on dysmenorrhoea, (4) visited doctor for dysmenorrhoea, (5) knew they may take menstrual leave and (6) were identified with menstruation as a natural event. The r(2) was 18·4%. CONCLUSIONS: Hospital nurses' self-care behaviour for dysmenorrhoea is suggested to be improved through enhanced peer support and caring. RELEVANCE TO CLINICAL PRACTICE: The prevalence rate of dysmenorrhoea among hospital nurses is high. Most of them take analgesics to reduce pain to return to work. We recommend hospitals to provide women-friendly workplace and empowerment activities to improve the self-care ability and comfort level of nurses during menstruation.

Factors influencing nurses' intentions toward the use of mobile electronic medical records.

The purpose of this study was to investigate the factors influencing nurses' intentions toward the use of mobile electronic medical records, based on the Theory of Diffusion of Innovations. The cross-sectional study used a structured questionnaire for data collection, focusing on the nurses of a large hospital in southern Taiwan. A total of 720 valid questionnaires were returned yielding a response rate of 82.0%. Multiple regression analysis of the responses identified three innovative characteristics, compatibility, complexity, and observability, as significantly influencing nurses' intentions toward adopting mobile electronic medical records, whereas relative advantage and trialability did not. In addition, nursing seniority affected nurses' intentions significantly toward adopting mobile electronic medical records. Implications of effects of the factors and future research directions are discussed.

RETRACTED: Perceived health consequences, memory impairments, and subjective memory complaints of elderly individuals exposed to polychlorinated biphenyls (PCBs) and polychlorinated dibenzofurans (PCDFs) in Taiwan.

The Publisher regrets that this article was an accidental duplication of an article in Computers and Geotechnics. The duplicate article has therefore been withdrawn.

Factors determining hospital nurses' failures in reporting medication errors in Taiwan.

This study examined factors that were determined to lead to failures in reporting medication administration errors (MAEs) for 838 frontline nurses from 5 teaching hospitals in Taiwan. The underreporting of these errors is a challenge to medication safety improvement. Results showed that 337 (47%) participating nurses had failed to report self- or coworker-MAEs and 376 nurses (52.4%) had not failed to report. The strongest predictors of the failure were experience of making MAEs, differences in attitude toward reporting self- and coworker-MAEs, and perceived MAE reporting rate in current work. The reporting barriers of fear, perception of nursing quality, and perception of nursing professional development significantly contributed to failure to report. Educating nurses about the goals of incident reporting systems and using MAE data to enhance patient safety culture is recommended. Further, hospital administrators should provide information and encouragement to nurses whose responsibility it is to report MAEs.