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Based on the design of an infectious disease hospital in Tianjin, this study provides reasonable airflow organization design guidance and operation guidance for the negative pressure isolation wards in the hospital buildings through computational fluid dynamics (CFD) numerical simulation. In this study, a theoretical analysis was carried out on the demand for the air change numbers provided in different standards of the negative pressure isolation ward. This study compares the pollutant discharge time and carries out the energy consumption analysis. Finally, this study gives reasonable ventilation frequency of the negative pressure isolation ward during the outbreak of infectious period, and provides guidance for its air conditioning operation. [ABSTRACT FROM AUTHOR]

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Background & Problem: Urinary tract infection (UTI), one of the most common types of healthcare-associated infections, is associated with increased hospital stay durations and healthcare costs. Our unit is located in the internal medicine ward of a medical center. In 2020, infection control data revealed a rise in the UTI rate to 2.03‰, which was higher than the hospital-wide average of 1.52‰. This prompted the initiation of this improvement project. Purpose: The aim of this study was to develop effective solutions to address UTI-related issues, improve the knowledge and skills of nurses and caregivers involved in UTI care, reduce indwelling catheter duration and environmental sources of infection, and, ultimately, decrease the incidence of UTIs in our ward. Resolutions: Through problem analysis, nurses and caregivers were found to lack sufficient UTI-care-related knowledge and skills, leading to an increase in infection cases. A UTI assessment and standardized workflow were developed. Self-learning materials were provided, and regular assessments were conducted. Urine bag labels and bilingual perineal hygiene videos were designed. In addition, an antimicrobial bed scale was developed to reduce the potential sources of infection. Results: Six months after project implementation, a significant improvement was found in the accuracy of UTI care among nurses and caregivers. The average indwelling catheter duration decreased to 4.7 days and the UTI rate dropped to 1.48‰, successfully achieving the project goals. Conclusion: The authors recommend incorporating UTI-prevention knowledge and skills into pre-employment training and promoting the use of antimicrobial bed scales to significantly reduce the incidence of UTIs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To observe the clinical efficacy of Xiao’er Kechuan liquid in the treatment of respiratory syncytial virus pneumonia in children, so as to probe into its effects on inflammatory factors and immune function levels in children. METHODS: A total of 80 children with respiratory syncytial virus pneumonia admitted into the pediatric ward of the hospital from Sept. 2019 to Sept. 2021 were extracted to be divided into the control group and observation group using a random number table method, with 40 cases in each group. The control group was given conventional treatment, whiled the observation group was given Xiao’er Kechuan liquid orally on the basis of the control group, both group were administrated for 7 days. The clinical efficacy, changes of immune function related indicators and inflammatory factors [ interleukin( IL)-6, IL-8, procalcitonin (PCT)] levels were observed and compared between two group before and after treatments. RESULTS: The total effective rate of the observation group was 97. 5% (39 / 40), significantly higher than that of the control group (82. 5%, 33 / 40), with statistically significant difference (P<0. 05). The disappearance time of fever, cough and wheezing in the observation group were shorter than those in the control group, with statistically significant difference (P<0. 05). After treatment, the serum CD3+ and CD4+ levels in the observation group were significantly higher than those in the control group, while the CD8 + level was significantly lower than that in the control group, with statistically significant differences ( P < 0. 05); the inflammatory factors (IL-6, IL-8, PCT) levels in the observation group were significantly decreased after treatment, and the difference was statistically significant compared with those in the control group (P<0. 05). CONCLUSIONS: Xiao’er Kechuan liquid for the treatment of respiratory syncytial virus pneumonia can enhance the immunity of children, reduce inflammation reaction and improve clinical symptoms. [ABSTRACT FROM AUTHOR]

Background and objective Lung cancer is the first leading cause of morbidity and mortality among the malignant tumors, which has become a hot issue in current research. Clinically, lung cancer is divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) according to the pathological types. NSCLC includes adenocarcinoma, squamous cell carcinoma and other types of lung cancer, accounting for about 80% of all lung cancer. Venous thromboembolism (VTE) includes deep venous thrombosis (DVT) and pulmonary embolism (PE), which is a recognized complication in lung cancer patients with higher morbidity and mortality. The aim of this study is to determine the incidence of DVT and reveal the risk factors for DVT in the postoperative patients with lung cancer. Methods We collected 83 postoperative patients with lung cancer admitted to the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital from December 2021 to December 2022. All these patients were examined by color Doppler ultrasound of lower extremity vein upon admis-sion and after operation to analyze the incidence of DVT. In order to explore the possible risk factors for DVT in these patients, we further analyzed the correlations between DVT and their clinical features. At the same time, the changes of coagulation function and platelet were monitored to investigate the value of blood coagulation in the patients with DVT. Results DVT occurred in 25 patients after lung cancer operation, and the incidence rate of DVT was 30.1%. Further analysis found that the incidences of postoperative lower limb DVT were higher in lung cancer patients of stage III+IV or over 60 years of age (P=0.031, P=0.028). D-Dimer level in patients with thrombosis was significantly higher than that in non-thrombus patients on the 1st, the 3rd, and the 5th day after operation (P<0.05), and there was no significant difference in platelets and fibrinogen (FIB) (P>0.05). Conclusion The overall incidence of DVT in our center after lung cancer patients operation was 30.1%. Late-stage and older postpatients were more likely to develop DVT, and these patients with higher D-Dimer values should be considered the possibility of VTE events. [ABSTRACT FROM AUTHOR]

Objective: To understand the terminal disinfection control measures in wards of designated hospitals for novel coronavirus (hereinafter referred to as "COVID-19") pneumonia and monitor their disinfection effects. Methods: The terminal disinfection was carried out in the isolation ward of the Fifth Affiliated Hospital of Sun Yat-sen University, and the air and surface were sampled and tested before and after terminal disinfection, and the environment after terminal disinfection was sampled and tested to evaluate the disinfection effect. Results: Terminal disinfection was carried out in 14 isolated wards. 156 airborne bacteria samples and 254 surface samples were collected before and after terminal disinfection. After terminal disinfection, 209 environmental nucleic acid samples were collected to evaluate the disinfection effect. The pass rate of air disinfection effect in all isolated wards after terminal disinfection was 100.00%, which was higher than the pass rate of air disinfection effect before terminal disinfection at 76.20% (P<0.05); the effect of surface disinfection after terminal disinfection was 94.88%, It was 71.65% higher than the qualified rate of surface disinfection before terminal disinfection (P<0.05); the environmental nucleic acid test results after terminal disinfection were all negative. Conclusion: After terminal disinfection, all indicators in the isolation wards of the Fifth Affiliated Hospital of Sun Yat-sen University meet the requirements of terminal disinfection evaluation. [ABSTRACT FROM AUTHOR]

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. Conclusion: 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. [ABSTRACT FROM AUTHOR]

To address the problems of large operating costs and fairness between doctors and patients in the current hospital bed scheduling, this paper proposes a multi-objective stochastic programming model for single department bed allocation considering hospital operating costs and patient fairness. First, this paper proposes a weighted measure of responsiveness and access to reflect the fairness of the doctor-patient relationship based on relevant hospital-based policies, and establishes a multi-objective stochastic programming model considering the operational cost of the hospital; second, to facilitate the algorithm solution, a linearization method is introduced to process the complex model into a mixed integer linear model; finally, the improved NSGA2 algorithm solve the multi-objective problem The improved algorithm enhances the convergence and diversity of the algorithm, and the experimental results verify the validity and applicability of the model by adjusting different parameters for different numerical experiments. [ABSTRACT FROM AUTHOR]

This study explores the risk factors for glioma, in order to provide a scientific basis for the further etiology research and prevention of glioma. Methods: A case-control study method was used. All the cases, who consist of 109 patients with pathologically diagnosed glioma, were recruited from the patients treated in the Beijing Tiantan Hospital Affiliated to the Capital Medical University and Beijing Shijitan Hosptial Affiliated to the Capital Medical University from June, 2017 to October, 2018. And controls of117 people. Study subjects were interviewed in the hospital ward, using a structured questionnaire administered by trained interviewers. The risk factors related to glioma were analysed by Logistic regression. Results: The results of unvariable analysis showed that there might has association between glioma and poorer sleep quality (OR=1.468, 95%CI:1.275-2.275), shorter sleep time (OR=1.797, 95%CI:1.070-3.015）, lower sleep efficiency （OR=2.992, 95% CI:2.259-3.964）, and Pittsburgh sleep scale total score (OR=1.180, 95% CI:1.093-1.272）, the results were statistically significant (P<0.05). Adding other exporse factors, the results of multi-logistic regression analysis results showed that there might has association between glioma and poorer sleep quality （OR=1.457, 95% CI: 1.060-2.002）, and lower sleep efficiency (OR=4.267, 95% CI: 2.634-6.914）, also the results were statistically significant (P<0.05). Conclusion: This study use a case-control study, through logistic regression analysis, found that worse sleep quality and low sleep efficiency might be positive to the occurence of glioma. As a pilot study, hoping can provide a scientific basis for the further etiology research and prevention of glioma. [ABSTRACT FROM AUTHOR]

Patients with chewing disorders and dysphagia often take nutrition via nasogastric tube feeding. Patients with indwelling nasogastric tubes often experience discomfort, resulting in increased incidences of self-extubation and slippage. Frequent changes or misplacement of the nasogastric tube may also cause patient safety issues such as aspiration pneumonia, gastrointestinal trauma, and pneumothorax. Collaboration within the interdisciplinary team is needed to provide proper nasogastric tube care prior to placement, during the indwelling process, and during the removal of the nasogastric tube. Interdisciplinary teams should develop standardized procedures for nasogastric tube care, initiate swallow screening, oral care and training early, and develop a care plan for nasogastric tube removal. An evidence-based, practical example of nasogastric tube care implemented by an interdisciplinary team in a neurology unit is presented in this article. Interdisciplinary teams may assist patients to prepare to return to a normal tube-free life using individualized, safe, and dignified nasogastric tube care to improve quality of life. [ABSTRACT FROM AUTHOR]

Background: The subacute respiratory care unit is an important relay station where respirator-dependent patients may access subsequent chronic respiratory care. Although there is relatively little information in the literature regarding respirator disconnections in subacute respiratory care units, assisting patients to disconnect successfully from respirators is a primary challenge for care teams. Purpose: The purpose of this study was to understand respirator disconnections and the factors affecting these events in subacute respiratory care units to improve the effectiveness of ventilator weaning and reduce the burden on families and medical care providers. Methods: This was a retrospective chart review study. Patients admitted to the subacute respiratory care unit for respiratory training during the study period from January 2016 to December 2019 were recruited as subjects and the data were collected from the Chang Gung Medical Research Database's health insurance secondary data using a selfmade transcription form. Results: The ventilator weaning success rate of the subjects in this study was 78.5%. A bivariate analysis revealed that consciousness status; disease severity; rapid shallow breathing index; days of hospitalization in a respiratory care center; days of ventilator use; blood urea nitrogen, white blood cell, hemoglobin, and blood albumin levels; and mean caloric intake were each significantly associated with successful ventilator withdrawal. The predictors of ventilator weaning in respiratory care center patients were identified as disease severity, rapid shallow breathing index, days of ventilator use, white blood cell level, and hemoglobin level. Conclusions / Implications for Practice: Respirator-dependent patients should be evaluated and monitored as early as possible. Moreover, a ventilator weaning plan should be included as a regular testing and monitoring item. Also, a respirator removal program should be provided on a case-by-case basis. Individualized ventilator weaning programs may reduce the burden on families and medical care providers. [ABSTRACT FROM AUTHOR]

Objective: To investigate the value of co-stimulatory molecule CD86 in evaluating sepsis in emergency infected patients. Methods: Patients who were18 years or older and had infection or were clinically highly suspected of infection admitted to the emergency intensive care unit and wards of Renji Hospital (affiliated to Shanghai Jiaotong University School of Medicine) between September 2019 to September 2020 were prospectively observed. According to the Sepsis 3.0, patients were divided into a sepsis group and a non-sepsis group. We recorded the clinical data of all patients, and checked all their complete blood cell, peripheral blood mononuclear cell (PBMC) CD86 and HLA-DR expression level, C-reactive protein (CRP), procalcitonin (PCT), albumin (ALB), lactic acid (Lac), serum interleukin level and calculation of CRP/ALB ratio, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte cell ratio (LMR) within 24 hours of admission. We compared the differences of the above indicators between the groups, and then further use the Logistics regression model for multivariate analysis. Results: A total of 91 patients were enrolled: 49 sepsis patients (15 deaths, 30.6%), 42 non-sepsis patients (0 deaths). In the sepsis group, the levels of CD86%, Neutrophils (N), CRP/ALB, NLR, IL-6, IL-10, SIL-2R, CRP, PCT were significantly higher than in the non-sepsis group (P<0.05), while HLA-DR, LY (lymphocytes), PLT (Platelets), ALB and LMR were significantly lower in the sepsis group than in the non-sepsis group (P<0.05). Multivariate Logistics regression analysis established the CD86 model and HLA-DR model, and found that in the CD86 model, CD86 respiration rate (RR), LYand PCT were independent predictors for sepsis (P<0.05), and the OR values were 1.539 (1.148-2.064), 1.141 (1.009-1.290), 0.280 (0.097-0.811)and 1.036 (1.005-1.068), respectively. In the HLA-DR model, HLA-DR and LY were found to be independent predictors for sepsis (P<0.05), with OR values of 0.971 (0.953-0.988) and 0.290 (0.117-0.718). Finally, the CD86 model, HLA-DR model and APACHII score were analyzed by ROC curve, and the areas under the curve (AUC) were 0.870 (0.796-0.944), 0.793 (0.700-0.887), 0.754 (0.653-0.855), respectively. Conclusion: The CD86 of PBMC in sepsis patients is increased, and HLA-DR is decreased. CD86 and HLA-DR can be used as early predictors for the occurrence of emergency sepsis. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the pre-review and intervention of medical orders of Chinese patent medicine in all wards of Beijing Friendship Hospital, Capital Medical University ( hereinafter referred to as " our hospital"), so as to reduce clinical medication errors and unnecessary drug repercussion and ensure the safety of clinical medication. METHODS: In 2020, totally 32 512 medical orders of Chinese patent medicine were pre-reviewed in all wards of our hospital, and irrational medical orders were summarized and analyzed. RESULTS : In 2020, of the 32 512 medical orders of inpatient ward medication and discharge medication in our hospital, 356 were wrong medical orders ( 1. 09%), mainly for orthopedic rheumatism wards, tumor wards and urology wards. Among the 356 wrong medical orders of Chinese patent medicine, there were 183 wrong medical orders ( 51. 40%), which were mainly manifested as long-term medical orders; there were 173 medical orders for off-label drug use( 48. 60%), including offlabel single dose, wrong medication frequency, off-label dose of the total number of medical orders and off-label dose of discharge medication, mainly involving drugs such as Maren soft capsules and Ganmao Qingre granules. CONCLUSIONS: Clinical pharmacists play an important role in ensuring the safety of clinical medication, while the professional level of clinical pharmacists themselves needs to be improved. Meanwhile, clinicians should strengthen the understanding of Chinese patent medicine dosage form, and the improvement of cognition for clinicians to drug instructions is an important measure to ensure the safety of clinical drug use. [ABSTRACT FROM AUTHOR]

Objective To explore the impact of nursing hierarchical management on the quality of nursing care in the oncology department. Methods 44 nurses in the Department of Oncology at Air Force Hospital of Western Theater from June 2019 to June 2020 were selected. The routine management measures for nurses (control group) were implemented from June to December 2019, and nursing hierarchical management for nurses (observation group) was implemented from January to June 2020. The nursing quality level, nursing satisfaction, happiness score and cancer pan nursing quality indexes of the two groups of nurses were compared. Results The nursing quality scores of the observation group were significantly higher than those of the control group (all P < 0. 05). The satisfaction degree of the observation group was significantly higher than that of the control group (P < 0. 05). The occupation! well-being scores of the observation group were significantly higher than that of the control group (P < 0. 05). The accuracy rate of cancer pan assessment and the satisfaction rate of pain control in the observation group were significantly higher than those in the control group (both P < 0. 05). Conclusion The hierarchical management of nursing can effectively improve the quality of nursing care in the oncology department and can improve nurses' occupational well-being, which is worthy of research and promotion. [ABSTRACT FROM AUTHOR]

This study aimed to reduce the number of environmental microorganism colonies in the hemodialysis room. A biological fluorescence reaction assay revealed 47.6% of unqualified colonies in the room. Our analysis identified the following reasons for this finding: cleaning tools are dirty and indiscriminately used, medical instruments once cleaned are not returned to their positions, the bleaching solution is not properly prepared, the cleaning personnel is insufficient and are not working properly, and the patient unit is not cleared. By implementing the principles of 5S phases Sorting, Straightening, Systematic cleaning, standardize and Sustain, the medical equipment cleaning work specifications, the development of cleaning work specifications, the production of reminder slogans, the modification of the use of cleaning tools, the implementation of clearances between class and class, etc., and the implementation of environmental cleaning work, a reduction in the the colony failure rate from 47.6% to 7.9% was achieved. Thus, developing habits to implement and monitor a clean environment can maintain patient safety and improve quality of care. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of maternal sound stimulation combined with non-nutritive sucking on oral feeding of premature infants. Premature infants (200 cases) hospitalized in the neonatal ward of our hospital from January 2018 to December 2018 were selected as the study objects and randomly divided into the control group (70 cases), study group A (65 cases) and study group B (65 cases). The control group was routinely managed according to the routine management of neonatology. Study group A was given pure maternal sound stimulation on the basis of routine management, while study group B was given non-nutritive sucking management on the basis of routine management and pure maternal sound stimulation. The feeding process, feeding performance, body mass growth and feeding intolerance score of each group were compared. The PMA at beginning of oral feeding and transition time of study group A and study group B were significantly shorter than that of the control group, and study group B was significantly shorter than that of study group A, with statistically significant differences (P<0.05). The feeding efficiency at beginning of oral feeding and feeding efficiency at full oral feeding of study group A and study group B were significantly higher than that of the control group, and study group B was significantly higher than that of study group A, with statistically significant differences (P<0.05). The body mass at full oral feeding and body mass at discharge of study group A and study group B were significantly lower than that of the control group, and study group B was significantly lower than study group A, with statistically significant differences (P<0.05). The difference of feeding intolerance scores between study group B and control group was statistically significant (P<0.05). Maternal sound stimulation combined with non-nutritive sucking can promote the process of oral feeding, improve the oral feeding performance, reduce the incidence of feeding intolerance, and speed up the time of recovery to birth body mass. [ABSTRACT FROM AUTHOR]

Objective: To analyze potentially inappropriate medication (PIM) and risk factors in older inpatients in Suining Central Hospital of Sichuan Province, so as to provide evidence for rational application of drugs. Methods: Based on the Criteria of potentially inappropriate medication in older patients in China, a statistical analysis was made on the older inpatients hospitalized in the gerontic ward of the hospital from July to December 2017. Single factor chi-square test and multiple logistic regression were used to identify risk factors. Results: Totally included in the study were 1196 older inpatients, of whom 758 were involved in PIM, accounting for 63.38%, and 726 inpatients were of drug-related PIM, accounting for 60.70%, and 110 inpatients were of disease-related PIM, accounting for 9.20%. Single factor chi-square test showed that there was close association between PIM and the number of diseases, the number of combined medication, the hospitalization days, insomnia, hypertension, blood coagulation disorder or anticoagulant therapy, chronic obstructive pulmonary disease (CGPD), diabetes and pain, with statistically significant difference ( P < 0.05). Multiple logistic regression analysis showed that the number of diseases (≥10 diseases), the number of combined medication (10-19 drugs), the number of combined medication (≥20 drugs), insomnia, hypertension, CGPD, osteoporosis, diabetes and pain were influential factors of PIM, also with statistically significant difference (P<0.05). Conclusion: There are more PIM in older inpatients in the hospital, which is the result of the interaction of various influential factors such as the number of diseases the number of combined medication insomnia hypertension diabetes and pain. [ABSTRACT FROM AUTHOR]

Blood specimen collection is a critical step in medical treatment. Any mistake in the collection and transport of blood specimens can adversely affect patient diagnosis, delay treatment, or worse jeopardize patients' lives. Based on the 2012 statistics, the monthly average blood specimen rejection rate was 1.91% in our ward, which was significantly higher than our hospital average (0.92%). After analyzing potential causes of blood specimen errors, the primary causes were established: low cognition of the blood specimen collection, high percentage of specimens did not arrive at laboratory within 60 minutes after collection, and low rate of vacutainer utilization. To address these issues, the project team held several courses on blood specimen collection and transportation, cross-department review on specimen collection and transportation, review the storage and promotion of vacutainer, and review the storage and transportation of blood specimen. After the introduction of this project, our staffs can effectively reduce the rejection rate of blood specimens from 1.91% to 0.74%, successfully reaching the project's intended goal. [ABSTRACT FROM AUTHOR]

Background: The promising effects of smoking cessation for coronary artery disease (CAD) patients include decreased risks of subsequent clinical events and mortality. However, most CAD patients continue to smoke after being hospitalized for a cardiac event. Purpose: To explore the factors that are associated with successful smoking cessation in CAD male patients at 3 months after hospital discharge. Method: A correlational design was applied. A convenience sample (N = 165) was recruited from the cardiac wards of two medical centers in northern Taiwan and 154 of these completed the 3-month follow up. The medical charts of the participants were reviewed to obtain their disease-related factors. All of the participants finished one questionnaire during their hospital stay. This questionnaire collected data on participant demographics, smoking and quitting history, and nicotine addiction as well as the causal attribution of heart disease to smoking, importance of smoking outcomes, self-efficacy for quitting, and post-discharge intention to quit. Information on post-discharge smoking status was collected via phone calls to the participants at three-months after hospital discharge and, for participants who claimed to have not smoked since discharge, was further confirmed by measuring their expired CO (carbon monoxide) level. Multiple logistic regression analysis was used to examine the identified predictors of successful smoking cessation. Results: The 3-month self-reported rate of abstinence was 37.01% (n = 57), while the rate of abstinence as confirmed by expired CO was 31.17% (n = 48). Those with acute coronary syndrome, longer hospital stays, and higher postdischarge intention to quit were more likely to quit smoking. Conclusions / Implications for Practice: The abstinence rate as confirmed by expired CO for hospitalized male patients with CAD is more accurate than the rate obtained by self-reporting. Healthcare providers should stress the importance of smoking cessation, especially for those who have been diagnosed with angina, are hospitalized for shorter periods of time, and indicate a lower post-discharge intention to abstinence. [ABSTRACT FROM AUTHOR]

This project aims to improved the therapeutic efficacy for skin eczema in respiratory care ward(RCW). The definition of effective in the context of this project is the reduction of eczema surface area equal or higher than 30%. The baseline survey found the effective treatment rate was 30% only, which facilitated the project. We therefore conducted a transdisciplinary assessment and identified three major causes of the ineffective treatments: Incorrect patient body cleaning, incomplete documentation of patient skin assessment by the nursing staff, and misuse of prescribed ointments by the nursing staff. In response, a multidisciplinary strategy was implemented, including standardization of bed bath skills with regular inspections, establishment of standard skin assessment chart as basis for evaluation and drug administration, and standardization of skin ointments application with checklist and illustration cards. After the implementation of the nursing interventions, the therapeutic efficacy improved drastically from 30% to 70%, and the medical cost successfully reduced. Skin care is essential in the medical services in RCW, and we have shown that our multidisciplinary nursing strategy could improve the therapeutic efficacy for skin eczema in the reported RCW patients and the cognition of nursing staff and assistant nurses in eczema care. [ABSTRACT FROM AUTHOR]

Background & Problem: Nasogastric (NG) tubes are used for providing nutrition to patients who have dificulties swallowing. However, the dificult process of repeatedly inserting NG tubes may lead to gastric erosions. Purpose: The rehabilitation ward in this study had an NG tube slippage rate of 2.26% in 2012, signiicantly higher than the same rate in 2011. A proposal was developed to design better techniques for nurses to perform NG tube insertions in order to decrease the rate of NG tube slippage. Resolution: The following were identiied as the major causes of NG tube slippage: (1) caretaker is unfamiliar with NG tube care instructions, (2) caretaker disengages NG tube constraints, and (3) improper rotation of patients or carelessness when turning patients. Therefore, the following solutions were proposed: (1) establish an NG tube safety standard operating procedure, (2) publish bilingual (English and Bahasa Indonesia) pamphlets providing instructions on the correct method of securing and placing the NG tubes, (3) make bilingual (English and Bahasa Indonesia) instructional videos showing the correct method for securing and placing the NG tubes, (4) fabricate a novel tube constraint tool (the constraint ball) that is easy to use, (5) install creative bedside NG tube warning signs, and (6) reinforce the importance of NG tube constraint and placement among caretakers. Results: The NG tube slippage rate was reduced from 2.26% to 0.77%, and was maintained at 0.75% during the follow-up period. The caretaker assessment further showed 100% understanding of the implemented NG tube safety procedures. Conclusion: This proposal was established using literature research, problem identiication, and creative problem solving to achieve an effective reduction in NG tube slippage as well as to enhance nursing quality. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the relationship between cost and revenue for inpatient nursing activities in general wards. Methods: Data were collected from 12 medical-surgical wards in one general hospital from January 1 to December 31, 2010. The nursing activities were categorized into 2 groups according to nursing service payment type in terms of the Korea health insurance system. Descriptive statistics were used to identify nursing activities and nursing activity costs. Results: Of 140 nursing activities identified as performed in general wards, payment for 69 items was included in nursing management fees. The percentage of each cost for the nursing units was 90% for labor, 4% for materials, and 6% for operating expenses. The cost for medical support nursing service accounted for 38% of costs and nursing management fees, 62%. The average profit and loss was -237,257,000 won. The cost recovery rate for nursing service was only 44%. Conclusion: The results indicate a need to measure the economic value of nursing activities performed in general wards and use it as a basis for establishing an adequate reimbursement system for nursing service. [ABSTRACT FROM AUTHOR]

Providing safe medical materials is the responsibility and the obligation of the hospital,a medical care manager shares the same obligation to attain balance regarding the double requirements for cost control and supply quality. The project had selected a surgical wardof a university hospital located in Southern Taiwan as research subject. It was discoveredthat the planned items of medical materials in the wards and their monthly cost were 6%higher than other related wards of similar nature. A further audit revealed that the accuracy of medical material management in the wards was only 64.7%. Cause analysis indicated that the reasons for the low accuracy included inappropriate storage of materials, unclear storage labels, lack of complete IT programme, insufficient knowledge in taking and using materials and lack of educational training plans. The project was implemented to improve the situation and several measures were executed, including planning medical material storage facility, developing simple labels, constructing a standard IT programme, and arranging in-service educational trainings. Consequently, the material management accuracy in the wards increased from 64.7% to 86.7%. The executed results complied with the project aims,ensured the safety of medical material utilization and furthermore guaranteed the quality of nursing care. (Tzu Chi Nursing Journal, 2012; 11:3, 77-86) [ABSTRACT FROM AUTHOR]