Hu li za zhi The journal of nursing
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Review
[Common antimicrobial-resistant bacteria in nosocomial infections in Taiwan and their prevention].
Infections caused by antibiotic-resistant bacteria, especially multidrug-resistant strains (MDR) that cause difficulties in clinical treatment, have long been a problem of global concern. Drug-resistant strains of common nosocomial infections in Taiwan include Gram-positive coccal methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, and Gram-negative bacilli such as carbapenem-resistant Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae, among others. About 10 to 20% of Gram-negative bacteria that encode extended-spectrum β-lactamases are resistant to cephalosporin, a third generation antibiotic, and the fluoroquinolone-resistance rate has continued to increase in recent years. ⋯ However, healthcare workers' adherence to recommended hand hygiene practices is unacceptably low worldwide, making the promotion of hand hygiene a major challenge for infection control experts. Therefore, as a first step of preventing the spread of MDR bacteria, knowledge of hand hygiene and adherence to hand hygiene practices must be required of healthcare workers. Such should help reduce nosocomial infections significantly and upgrade healthcare quality.
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Nausea and vomiting is a common post-operative complication that exacerbates patient discomfort and puts tension on suture lines, which may cause hematomas beneath surgical flaps and place patient at risk of aspiration pneumonia. Nausea and vomiting decreases patient comfort and satisfaction and increases hospital stay length and costs. Postoperative nausea and vomiting are common occurrences. ⋯ The author further worked to recommend a care management protocol based on findings. This paper describes risk factors of postoperative nausea and vomiting and the related drugs, prevention procedures, and treatment recommendations. Finally, the author developed a simple care flow chart suited for use in internal clinical situations that may provide a valuable reference for medical professionals.
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Pressure ulcers were an increasingly significant problem among patients in the authors' ward. The eight patients diagnosed with pressure ulcers (0.42% of all inpatients) during the first half of 2009 represented a 140% increase over the first half of 2008 (0.28% of all inpatients). ⋯ Results demonstrate the effectiveness of using the proposed methods to reduce pressure ulcer incidence and enhance nursing care quality.
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Some nurses do not have the skills necessary to evaluate general ICU patient condition and the meaning of laboratory data adequately. This can influence nursing care quality and patient safety. Between October 16th and 29th, 2009, this project employed a checklist to evaluate nursing assessment accuracy in medical and surgical ICUs. The unexpectedly low accuracy rate of two-thirds (63.4 percent) was caused by factors including poor nursing assessment cognizance, lack of experience performing nursing assessments, nursing assessment skills taught only to experienced nursing staff, and a lack of nursing assessment guidelines. ⋯ This project effectively improved nursing assessment accuracy and may be considered and referenced by relevant medical organizations.
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This study explores critical research issues in nursing policy and management in Taiwan from a healthcare system perspective that considers resources, programmes and organisations, service delivery, policy and management, and economic support. Findings suggest the following: In terms of resources, priority issues include quantity planning, active surveillance, planning methodology, and estimation of work life expectancies for nursing manpower. ⋯ In terms of policy/management and economic support, priority issues included minimum nursing manpower requirements by law or medical institution standards and the relationship between the social insurance payment system and development of the nursing profession. The last section of this paper makes suggestions on practical ways to improve nursing policy and management research in Taiwan.