A Comparison of Two Cross-Sectional Studies on Successful Model of Introducing Nursing Information System in a Regional Teaching Hospital in Taiwan.

Nursing information system introduction is an important measure for hospital nursing departments to promote the clinical practice of nursing with both efficiency and quality. A comparison of two cross-sectional study designs was adopted, and the information systems success model, as proposed by DeLone and McLean (2003), was used to explore the effectiveness of the six dimensions of system quality, information quality, service quality, use, user satisfaction, and net benefits at 6 and 12 months after the introduction launch of the nursing information system in hospitals. Multiple regression analysis was used across the two cross-sectional studies. The research results found that the nursing information system conformed to the information systems success model, and half a year to 1 year after the introduction of the nursing information system, use affected the nursing information system net benefits via the mediator variable of user satisfaction; however, the effect of full mediation changed to partial mediation effect with time. The research results can be used as a reference for hospitals and nursing administrators for the newly developed nursing information system.

Nonnutritive sucking and oral sucrose relieve neonatal pain during intramuscular injection of hepatitis vaccine.

CONTEXT: Newborns are subject to pain during routine invasive procedures. Pain caused by immunization injections is preventable, but remains untreated in neonates. OBJECTIVES: The purpose of the study was to compare the effectiveness of three nonpharmacological pain relief strategies on newborns' pain, physiological parameters, and cry duration before, during, and after hepatitis B intramuscular (IM) injection. METHODS: In this prospective, randomized clinical trial, we enrolled 165 newborns (gestational age, ≥36 weeks). The infants received IM injections and were randomized to three treatment groups: nonnutritive sucking (NNS), 20% oral sucrose, or routine care. Pain was measured by the Neonatal Facial Coding System, physiological signals by electrocardiogram monitors, and cry duration using a stopwatch. RESULTS: Pain was significantly lower among infants in the NNS (B=-11.27, P<0.001) and sucrose (B=-11.75, P<0.001) groups than that in controls after adjusting for time effects, infant sleep/wake state, number of prior painful experiences, and baseline pain scores. Infants in the NNS and sucrose groups also had significantly lower mean heart and respiratory rates than the controls. Cry duration of infants receiving sucrose was significantly shorter than those in the NNS (Z=-3.36, P<0.001) and control groups (Z=-7.80, P<0.001). CONCLUSION: NNS and oral sucrose can provide analgesic effects and need to be given before painful procedures as brief as a one-minute IM injection. Sucrose orally administered two minutes before injection more effectively reduced newborns' pain during injection than NNS. Both nonpharmacological methods more effectively relieved newborns' pain, stabilized physiological parameters, and shortened cry duration during IM hepatitis injection than routine care.

Uniformed service nurses' experiences with the severe acute respiratory syndrome outbreak and response in Taiwan.

Severe Acute Respiratory Syndrome (SARS) had an enormous effect on Taiwan's public health and the nation's economy. To prevent the spread of the epidemic, the government implemented strategies and measures for the control of the epidemic. The Ministry of National Defense also fully supported epidemic prevention by mobilizing all necessary human and material resources. Under the plan executed by the Ministry of National Defense, the SongShan Armed Forces Hospital became Taiwan's first hospital dedicated exclusively for the treatment of patients with SARS. Uniformed Service Nurses' devoted to caring for patients with SARS during the outbreak made significant contributions to the prevention and control of SARS.

Relationships between nurse care-giving behaviours and preterm infant responses during bathing: a preliminary study.

AIMS: The purpose of this study was to explore the relationships between specific nurse care-giving behaviours and preterm infant behavioural responses during bathing and to identify nurse behaviours associated with infant 'stress'. BACKGROUND: Although recent advances in medical technology have improved neonatal intensive care, the high mortality and morbidity rates in preterm infants have not decreased proportionally. As caregivers strive to reduce infant mortality and morbidity, a factor for consideration is which caregiver behaviours are associated with preterm infant well-being. DESIGN: A descriptive correlational design. METHOD: Convenience samples of 24 preterm infants and 12 nurses were recruited. A total of 120 baths were videotaped. Infant and nurse behaviours were measured using the coding schemes developed by the researchers. Pearson coefficient correlation, non-parametric Kruskal-Wallis test, t-test and generalised linear models were methods for data analysis. RESULTS: As nurses provided more support, stress was reduced in the infants, and their self-regulation during the bath was enhanced especially by the use of 'containment' and 'positional support'. Conversely, non-therapeutic caregiver behaviours including 'rapid and rough handling' of the baby, 'chatting with other people' and 'inappropriate handling' increased infant 'stress' during the bath. CONCLUSION: The findings provide new information about the link between care-giving and infant responses and how caregivers can better interact with preterm infants during a very sensitive period of brain development. RELEVANCE TO CLINICAL PRACTICE: How nurses take care of the preterm infants influences their responses to care-giving stimuli. To interact better with the infant during care-giving procedures, nurses need to provide more supportive care-giving behaviours especially 'position support' and 'containment' based on the infant's needs, and avoid care-giving that may be too rough and occur too quickly without attending the baby's stressful signals, positioning the baby in hyperextension posture, or chatting with other people during procedures.

Infective endocarditis in an urban medical center: association of individual drugs with valvular involvement.

OBJECTIVES: Injection drug users (IDUs) develop more right-sided infective endocarditis (IE) than non-IDUs, but it is not known whether this risk is specific to any particular injected drug. This study reviews the clinical characteristics of IE in an urban population and examines the association of drug type with manifestations of IE. METHODS: A retrospective cohort of 247 cases of IE was analyzed. Demographic, clinical, microbiologic, and echocardiographic data were collected. RESULTS: Our cohort featured a 74% IDU rate, most with heroin. Staphylococcus aureus was the most prevalent organism. S. aureus IE was more likely to occur in IDUs versus non-IDUs (OR 5.5, p<0.0001). Enterococcus faecalis IE was less likely to occur in IDUs (OR 0.21, p=0.02). Tricuspid valve (TV) IE was more likely to occur in IDUs (OR 4.37, p=0.001), while mitral valve (MV) IE occurred less commonly in IDUs (OR 0.40, p=0.005). TV IE occurred more frequently in heroin users vs. IDUs not using heroin (OR 4.03, p=0.033). CONCLUSIONS: The epidemiology of IE in this cohort is different from that reported recently in other cohorts, likely due to the high prevalence of IDU. Heroin use may underlie the association between IDU and right-sided endocarditis.

Quality of life and related factors for people living with HIV/AIDS in Northern Taiwan.

The purpose of this study was to identify the variables related to quality of life in the population of individuals living with HIV/AIDS (PLWHA) in Taiwan. Purposive sampling was used to identify subjects from the outpatient departments (OPD) of three teaching hospitals and one sexually transmitted disease (STD) clinic in the Taipei area. For this study, the questionnaire included a demographic data sheet, physical-symptom distress and mood-disturbance scales, a personal-resource questionnaire (PRQ85-II) and a quality-of-life index (QLI). A total of 114 subjects completed the questionnaire. The results revealed that higher quality of life was associated with less mood disturbance (r = -.72; p <.001), reduced physical-symptom distress (r = -.47; r <.001), and higher levels of social support (r =.57; p <.001). PLWHA life quality was reflected accurately by mood disturbance, social support, physical-symptom distress, self-perceived mode of HIV transmission, and major source of financial support. These variables accounted for 60.9 % of QOL variance. As mood disturbance was the strongest predictor of quality of life, psychosocial intervention for mood disturbance should be emphasized and developed in future studies.