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Background: Patient safety culture is an indicator of healthcare quality and a topic of global importance in medical care. Purpose: In this study, the attitudes towards patient safety culture of nursing staff working in the emergency, intensive care, and general wards are compared before and during the COVID-19 pandemic. Methods: A retrospective research design was utilized and an anonymous questionnaire survey conducted on the Taiwan Patient Safety Culture Survey web-based platform system was used to collect the data. The survey was administered in a regional hospital in northern Taiwan between 2018 and 2020. The 1,540 nursing personnel who participated in this study worked in the emergency, intensive care units, or general adult ward. The analysis focused on assessing participant attitudes towards patient safety culture in terms of both the overall score and sub-dimensions. Results: The participants were mostly female and between 21 and 30 years old. A majority had completed a diploma or university education. The two analyses revealed the highest and lowest average scores were earned, respectively, in the "teamwork" and "resilience" dimensions of patient safety culture. In 2020, the average scores for all dimensions were lower than in 2018, and the average scores for the emergency and critical care group were lower than those for the general adult ward group. Sub-dimension analysis showed that the general adult ward group earned significantly higher scores in "teamwork" across all three sub-dimensions compared to the emergency and critical care groups. The general ward group exhibited the most significant score decline between the two surveys. Conclusions/ Implications for Practice: Overall scores were found to have decreased during the COVID-19 pandemic period (2020). Notably, emergency and intensive care nurses earned consistently lower scores, likely due to the severity of patient conditions and increased pandemic-related workloads and stress. "Resilience" scores were the lowest among all nursing staff, with the most significant drop seen in general ward nurses. Enhancing nursing staff education and training as well as addressing their psychological well-being will be crucial to improving patient safety culture attitudes. Managers should provide infection control, resilience training, and psychological counseling to help nurses manage the challenges posed by infectious diseases effectively and enhance patient safety culture. [ABSTRACT FROM AUTHOR]

Work environments at healthcare organizations involve biological, chemical, and physical risks. Healthcare providers adhere to safe work practices and promote organizational activities proactively to improve practice safety and patient safety, both of which are closely linked to quality of care. In light of the limited research on safety culture and employee safety performance in the healthcare industry, this paper was developed to introduce the concept of hospital safety climate; the factors known to influence the safety climate in hospitals and safety performance and outcomes; and related safety climate measurement tools from the perspective of promoting safe performance among hospital healthcare providers. We recommend management create a safe work environment to reinforce employees' positive perceptions about the commitment of management to safety and subsequently promote shared beliefs regarding workplace safety and motivate employees to create a safer work environment. In addition, healthcare providers' perceptions of the safety climate should be assessed to identify strengths and weaknesses in the safety climate, guide the development of related improvement measures, and enhance the safety-climate perceptions of employees. [ABSTRACT FROM AUTHOR]

The prevalence of potentially inappropriate medication (PIM) use is high, presenting a serious public health problem. In older adults, PIM increases the risks of adverse drug events, falls, hospitalizations, and emergency treatments as well as related medical expenses. The currently popular criteria for determining medication appropriateness and several common medication appropriateness assessment tools are introduced in this paper, including the Medication Appropriateness Index, the Beers criteria series, the Screening Tool of Older Person's Prescriptions (STOPP) and the Screening Tool to Alert doctors to Right Treatment (START) series, Thailand criteria, and the PIM-Taiwan criteria, with the goal of facilitating their application by medical professionals in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Vascular closure devices such as angioseal are used as alternatives to traditional compression haemostasis. Although the safety and efficacy of angioseal are confirmed, their use remains controversial because of the potential complications of these devices compared with those of traditional compression haemostasis. The aim of this study was to compare the access site complication rate, the predictive factors for these complications, and patient comfort levels after coronary procedures with traditional compression or angioseal haemostasis. Methods: Data were collected from a cardiac unit in a medical center in northern Taiwan. A total of 130 adult patients were recruited and equally divided into two groups according to the method of haemostasis used after the coronary procedure: a traditional compression group and an angioseal group. We observed the incidence of access site complications, including bleeding, oozing, haematoma formation, and arteriovenous fistula formation. In addition, we used a 0-10 numeric rating scale to assess soreness, numbness, and back and groin access site pain after 1 h of catheter removal and immediately before getting out of bed. Results: The overall incidence of complications was 3.8 % (n = 5), which was not significantly different between the two groups (p = .06). The propensity score-adjusted multivariate analyses revealed that the only independent predictor for access site complications was an age of >70 years (OR, 10.44; 95 % CI, 1.81-60.06; p = .009). Comfort levels were higher in the angioseal group than in the traditional compression group. Conclusions: Angioseal used after coronary procedures did not increase the incidence of complications relative to that associated with traditional compression haemostasis; however, it increased patient comfort levels. Health personnel should pay special attention to the predictive factor for access site complications after coronary procedures, such as age >70 years. [ABSTRACT FROM AUTHOR]

Background: After a stroke, patients often suffer from varying degrees of disability that require acute inpatient treatment and extended care at home. Therefore, the caregivers assume multiple responsibilities that can result in stress, particularly when their own needs are inadequately addressed during the patient's recovery. Objectives: This study aimed to explore the changing needs of family caregivers of stroke patients and factors related to the needs in four stages, before the transfer from intensive care unit to neurological unit, before discharge, 2 weeks post-hospitalization, and 3 months posthospitalization. Methods: The design of this study was based on longitudinal research, and the participants were family caregivers of stroke patients. Sixty family caregivers were recruited in this study. Data were collected at four time points by questionnaire. Results: We found that the total number of needs of family caregivers decreased as the illness duration increased and that needs differed significantly between the four time points (P,0.01). Although the needs were different in each stage, health information, professional support, and community networks were the leading need domains in all four stages. The major factors affecting the care needs of family caregivers were the National Institutes of Health Stroke Scale scores of patients on admission, length of hospital stay, and physical dependence of patients. Conclusion: Family caregivers expected to obtain assistance and related care information from professionals during the course of the disease. Assessing the needs of family caregivers is important for health care workers in understanding problems from the caregivers' perspectives. Relevant information and counseling should be provided to family caregivers to help them access support when needed. [ABSTRACT FROM AUTHOR]

Background: New graduates report intense stress during the transition from school to their first work settings. Managing this transition is important to reduce turnover rates. This study compared the effects of an externship program and a corporate-academic cooperation program on enhancing junior college students' nursing competence and retention rates in the first 3 months and 1 year of initial employment. Methods: This two-phase study adopted a pretest and posttest quasi-experimental design. All participants were graduating students drawn from a 5-year junior nursing college in Taiwan. There were 19 and 24 students who participated in the phase I externship program and phase II corporate-academic cooperation program, respectively. The nursing competence of the students had to be evaluated by mentors within 48 hours of practicum training and after practicum training. The retention rate was also surveyed at 3 months and 1 year after beginning employment. Results: Students who participated in the corporate-academic cooperation program achieved a statistically significant improvement in nursing competence and retention rates relative to those who participated in the externship program (p < 0.01 and p < 0.05, respectively). Conclusions: The corporate-academic cooperation program facilitates the transition of junior college nursing students into independent staff nurses, enhances their nursing competence, and boosts retention rates. [ABSTRACT FROM AUTHOR]

This study reviewed historical nursing intervention studies in Taiwan and analyzed results based on sample characteristics, methodology characteristics, and content characteristics. Historical studies were split into four groups, G1970, G1980, G1990, and G2000, based on the decade in which they were published. A comparison was then made to identify significant differences between G2000 and other groups. A total of 103 nursing intervention studies were analyzed in this study. Results included sample characteristics of studies conducted primarily by single-disciplinary research teams, although multidisciplinary studies showed a growth trend across decades, with the number of multidisciplinary studies significantly greater in G2000 than in other decades. Nursing practice was the main area of research, clients were the major participants studied, and hospitals provided the principal research setting. No statistical difference was noted in the abovementioned variables. In terms of methodology characteristics, questionnaires were used most frequently to collect data. A quasi-experimental design was the primary research design employed. Although the number of experimental designs has increased significantly in recent years, most studies specified their inclusion criteria. Reliability and validity of instruments were more clearly specified in recent decade groups than in earlier decade groups. Methodology rigor has improved in recent years, achieving a statistically significant difference between G2000 and other groups in all categories, with the exception of instrument validity. In terms of content characteristics, health education was the leading intervention type. Most interventions were categorized as tertiary prevention, with perceptual outcome used most often as the outcome indicator. However, no statistical differences in content dimension variables were identified between G2000 and other groups. In summary, the number of nursing intervention research cases has risen, and research methodology rigor has improved in recent decades. However, no statistically significant differences in sample characteristics and content characteristics between the most recent and earlier decade groups were found. Suggestions for future domestic nursing intervention studies based on study findings are made at the conclusion of this article. [ABSTRACT FROM AUTHOR]

Educational evaluation is a priority policy of the Ministry of Education and student learning outcome is an important criterion used in educational evaluation work. The purpose of this study was to evaluate the learning outcome of a newly developed course for doctoral students entitled, Nursing Research Seminar. The course was one semester in length and required students to attend 2 hours of class per week. Student learning outcome was evaluated based on the level of understanding students had of course objectives. The six objectives of this course were: evaluating and integrating research papers; enhancing critical thinking skills; gaining an in-depth understanding of the literature related to topics of interest; enhancing ability to construct research proposals; guiding student dissertation work; and refining critical research skills. Data were collected from the responses provided by 25 students on a 5-point Likert-type evaluation form based on course objectives filled out during the last class of the semester. Descriptive and non-parametric statistics were adopted. Results showed: (1) The average post-course score (24.76 ± 2.89) was significantly higher than the pre-course score (18.40 ± 5.52); (2) Students realized significant improvements in all six objectives at the end of the course; (3) There were statistically significant differences in improvement scores in all six objectives for students in different years of their doctoral program; (4) The lower the year in the program, the higher the improvement scores for each course objective; (5) The two objectives of the six that saw the most significant improvements were "gaining an in-depth understanding of the literature related to topics of interest", and "enhancing critical thinking skills". Because of the small sample size, conclusions drawn from this study should be treated as tentative. Findings provide preliminary information supporting the importance and necessity of offering the Nursing Research Seminar course to nursing doctoral students. The course provided different benefits to students at different years in the program and, overall, research results encourage that this course continue to be offered. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the incidence of postoperative delirium among elderly patients and to examine the interrelationship between basic vulnerability and precipitating factors for delirium. Design and Methods: This was a prospective cohort study. Data were collected in a tertiary medical center in Taipei, Taiwan. From the 1st to the 5th postoperative day, nurses assessed patients using a confusion-screening tool. Patients with signs of delirium were closely examined for changes in behavior and cognitive status and vital signs, and laboratory data were collected to further validate the organic etiology of delirium. Patients were finally diagnosed according to the DSM-IV criteria in consensus meetings. Subjects: Seven hundred and one elderly patients, that were admitted consecutively for elective orthopedic or urologic surgery, were enrolled in this study. All subjects met the following criteria: (1) 65 years of age or older; (2) able to communicate orally in Chinese, and (3) not unconscious, delirious, deaf, or aphasic upon admission. Results: The overall incidence of delirium among these subjects was 5.1%. Logistic regression analysis identified that older age and preexisting cognitive impairment were vulnerability factors, and that the use of psychoactive drugs was a precipitating factor for delirium. Patients with both basic vulnerability and the precipitating factor had a 56-fold increased probability of delirium (0.28 vs. 0.005 in comparison with those who did not exhibit these factors). Conclusion: Few risk factors of postoperative delirium in the older Chinese sample were identified. The only modifiable risk factor appears to be the use of psychoactive drugs.Copyright © 2000 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]