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Aims: This study aims to examine coronavirus disease 2019 (COVID‐19) pandemic‐related work factors for adverse effects on the mental health and whether organisational strategies attenuate these effects. Background: COVID‐19 pandemic has led to increased work burden and mental health risks for nurses. Methods: A total of 1499 Taiwanese full‐time nurses completed a web‐based questionnaire between July and December 2020. Pandemic‐related work conditions, namely, increased working hours, caring for COVID‐19 patients, occupational stigma and redeployment, were assessed. Organisational strategies to combat pandemic‐related work stressors including compensation to workers and adequate protection equipment were surveyed. Outcome measures were intention to leave, burnout and depression assessed using validated questionnaires. Results: Redeployment, increased working hours and occupational stigma were associated with adverse mental health and intention to leave in logistic regression analysis. Caring for COVID‐19 patients was negatively associated with depression. Adequate compensation for workers modified the association between redeployment and burnout. Conclusions: Pandemic‐related work conditions were associated with adverse mental health and intention to leave. Organisational strategies attenuated the adverse impact of the pandemic. Implications for Nursing Management: Efforts to decrease stigma and organisational strategies including compensation for workers and adequate protection equipment provision should be adopted to improve nurses' health during a pandemic. [ABSTRACT FROM AUTHOR]

A large‐scale survey study was conducted to assess trauma, burnout, posttraumatic growth, and associated factors for nurses in the COVID‐19 pandemic. The Trauma Screening Questionnaire, Maslach Burnout Inventory, and Posttraumatic Growth Inventory‐Short Form were utilized. Factors associated with trauma, burnout, and posttraumatic growth were analysed using logistic and multiple regressions. In total, 12 596 completed the survey, and 52.3% worked in COVID‐19 designated hospitals. At the survey's conclusion in April, 13.3% reported trauma (Trauma ≥ 6), there were moderate degrees of emotional exhaustion, and 4,949 (39.3%) experienced posttraumatic growth. Traumatic response and emotional exhaustion were greater among (i) women (odds ratio [OR]: 1.48, 95% CI 1.12–1.97 P = 0.006; emotional exhaustion OR: 1.30, 95% CI 1.09–1.54, P = 0.003), (ii) critical care units (OR: 1.20, 95% CI 1.06–1.35, P = 0.004; emotional exhaustion OR: 1.23, 95% CI 1.12–1.33, P < 0.001) (iii) COVID‐19 designated hospital (OR: 1.24, 95% CI 1.11–1.38; P < 0.001; emotional exhaustion OR: 1.26, 95% CI 1.17–1.36; P < 0.001) and (iv) COVID‐19‐related departments (OR: 1.16, 95% CI 1.04–1.29, P = 0.006, emotional exhaustion only). To date, this is the first large‐scale study to report the rates of trauma and burnout for nurses during the COVID‐19 pandemic. The study indicates that nurses who identified as women, working in ICUs, COVID‐19 designated hospitals, and departments involved with treating COVID‐19 patients had higher scores in mental health outcomes. Future research can focus on the factors the study has identified that could lead to more effective prevention and treatment strategies for adverse health outcomes and better use of resources to promote positive outcomes. [ABSTRACT FROM AUTHOR]

A chronic shortage of working nurses has led hospitals in Taiwan to close wards and reduce bed numbers. Work overload and job stress are major causes of this shortage. The purpose of this study is to propose a solution to improve the nursing workload situation. We reviewed literature articles and conference presentations to synthesize relevant measures, which included reforming the current care model; using innovation to simplify nursing practice; and creating a culture of workplace respect and inter-team cooperation. Based on this, we proposed our nursing retention strategy after reviewing national Department of Health development policies on nursing manpower. [ABSTRACT FROM AUTHOR]

The nursing process consists of five interrelated steps: assessment, diagnosis, planning, intervention, and evaluation. In the nursing process, the nurse collects a great deal of data and information. The amount of data and information may exceed the amount the nurse can process efficiently and correctly. Thus, the nurse needs assistance to become proficient in the planning of nursing care, due to the difficulty of simultaneously processing a large set of information. Computer systems are viewed as tools to expand the capabilities of the nurse's mind. Using computer technology to support clinicians' decision making may provide high-quality, patient-centered, and efficient healthcare. Although some existing nursing information systems aid in the nursing process, they only provide the most fundamental decision support – i.e., standard care plans associated with common nursing diagnoses. Such a computerized decision support system helps the nurse develop a care plan step-by-step. But it does not assist the nurse in the decision-making process. The decision process about how to generate nursing diagnoses from data and how to individualize the care plans still reminds of the nurse. The purpose of this study is to develop a pilot structure in electronic nursing record system integrated with international nursing standard for improving the proficiency and accuracy of plan of care in clinical pathway process. The proposed pilot systems not only assist both student nurses and nurses who are novice in nursing practice, but also experts who need to work in a practice area which they are not familiar with. [ABSTRACT FROM AUTHOR]

The nursing process consists of five interrelated steps: assessment, diagnosis, planning, implementation, and evaluation. In the nursing process, the nurse confronts a great deal of data and information. The amount of data and information may exceed the amount the nurse can process efficiently and correctly. Thus, the nurse needs assistance to become proficient in the planning of nursing care, due to the difficulty of simultaneously processing a large set of information. Thus, some form of assistance will be needed to help nurses to become more proficient in planning nursing care. Using computer technology to support clinicians' decision making may provide high-quality, patient-centered, and efficient healthcare. Although some existing nursing information systems aid in the nursing process, they only provide the most rudimentary decision support – i.e., standard care plans associated with common nursing diagnoses. Such a computerized decision support system helps the nurse develop a care plan step-by-step. But it does not assist the nurse in the decision-making process. The decision process about how to derive nursing diagnoses from data and how to individualize the care plans still remains in the mind of the nurse. The purpose of this study is to develop a pilot structure in an electronic nursing record system integrated with international nursing standards for improving the proficiency and accuracy of the plan of care in the clinical pathway process. The pilot system has shown promise in assisting both student nurses and beginner nurses. It also shows promise in helping experts who need to work in a practice area that is outside of their immediate domain. [ABSTRACT FROM AUTHOR]

Regular aerobic exercise can reduce blood pressure and is recommended as part of the lifestyle modification to reduce high blood pressure and cardiovascular risk. Hypertension itself, or/and pharmacological treatment for hypertension is associated with adverse effects on some aspects of quality of life. This study was performed to evaluate the effects of regular endurance exercise training on quality of life and blood pressure. Patients with mild to moderate hypertension (systolic blood pressure 140–180 or diastolic blood pressure 90–110 mm Hg) were randomized to a moderate-intensity aerobic exercise group training for 3 sessions/week over 10 weeks or to a non-exercising control group. Health-related quality of life was assessed with the Short Form 36-item Health Survey (SF-36) at baseline and after 6 and 10 weeks. In the 102 subjects (47 male, mean age 47 years) who completed the study, reductions in blood pressure in the exercise group at 10 weeks (− 13.1/− 6.3 mm Hg) were significant (P < 0.001) compared to baseline and to the control group (− 1.5/+ 6.0 mm Hg). Unlike the control group, the exercise group showed an increase in exercise capacity from 8.2 ± 1.6 to 10.8 ± 2.2 METS (P < 0.01) and showed higher scores on 7 out of 8 subscales (P < 0.05) of the SF-36. Improvement in bodily pain and general health sub-scores correlated with reduction in systolic blood pressure. Regular endurance training improves both blood pressure and quality of life in hypertensive patients and should be encouraged more widely. [ABSTRACT FROM AUTHOR]

: BackgroundPatients with white coat hypertension comprise a substantial portion of the hypertensive population. Previous reports have shown that moderate-intensity regular exercise training in patients with mild hypertension usually reduces blood pressure (BP), but there is a lack of data regarding individuals with white coat hypertension. This study was performed to evaluate whether programmed exercise was effective in reducing BP in patients with white coat hypertension and whether it also had beneficial effects on other biochemical parameters.: MethodsA total of 42 patients (23 men and 19 women) with white coat hypertension (mean 24-h ambulatory BP 119.2 ± 6.6/78.3 ± 5.8 mm Hg) were divided randomly into two groups: control (n = 20) (no exercise), and moderate-intensity exercise (n = 22). The training group exercised three times per week at the prescribed exercise intensity using a treadmill exercise program. Blood pressure, heart rate, and biochemical parameters were monitored every 4 weeks for 12 weeks.: ResultsSignificant reductions in clinic and ambulatory BPs were seen in the exercise group after only 4 weeks regular exercise training and these persisted over the 12-week study. The mean maximal reductions in clinic BP were 11 mm Hg for systolic and 5 mm Hg for diastolic pressure. Significant reductions were found in plasma total cholesterol (−6.1%), low-density lipoprotein cholesterol (LDL-C) (−14.1%), and triglyceride (−11.4%). Elevation of high-density lipoprotein cholesterol (HDL-C) (+11.2%) was also noted.: ConclusionsThese data, which are clinically significant, suggest that 12 weeks of exercise training can result in successful reduction of BP and favorable changes in the lipid profile that would be beneficial to patients with white coat hypertension. [Copyright &y& Elsevier]

Background: Nurses comprise a group in the healthcare team that is exposed to the highest levels of workplace violence. This not only causes negative emotions in nurses and adversely impacts the institution and the body and spirit of the nurses but also affects the quality of nursing care., Purpose: The aim of this study was to determine the prevalence of physical and psychological workplace violence experienced by the nursing staff and to identify the perpetrators of violence, the reactions of the victims, and the policies developed by employers to prevent violence., Methods: This cross-sectional study was conducted using a stratified sampling method across different levels of healthcare institutions on the nursing personnel registered with the Taipei Nurses Association. The number of subjects was allocated according to hospital level. A total of 2,931 subjects were recruited, of whom 2,627 participated in this study., Results: Over two-thirds (70.6% ) of participants had experienced workplace violence, of whom 31.0% had experienced physical violence and 66.0% had experienced psychological violence. A multiple logistic regression analysis showed that nurses who were married, who had less than one year of work experience, or were over 50 years of age were at lower risk of physical and psychological violence. Those who had a university education or higher faced a higher risk of psychological violence. The most common perpetrators were identified as patients. The aftermath reactions from the victims were varied, with the most prevalent being "telling the perpetrator to stop the violence", "telling friends or family," and "reporting the incident to a senior staff member". The perpetrators were mostly dealt with using a verbal warning, while the second-most common strategy was taking no action. Only 2.3% ‡6.8% of the victims notified the authorities about the violence because of the following primary reasons: "useless," "not important," and "fear of negative consequences." The major strategies that were adopted by employers to prevent violence included "security measures," "improvement of surroundings," and "training.", Conclusions: Prevention of violence must be improved comprehensively using the strategies of physical facilities, management, education, and policies.

In 1992, Gordon Guyatt coined the term "evidence-based medicine", which has since attracted worldwide attention. In 2007, the Institute of Medicine's Roundtable on Evidence-Based Medicine set the goal that 90% of clinical decisions would be supported by accurate, timely, and up-to-date clinical information and would reflect the best available evidence by 2020. However, the chasm between knowing and doing remains palpable. In 2000, the Canadian Institute of Health Research applied the term "knowledge translation" to describe the bridge that is necessary to cross the gap between research knowledge and clinical practice. The present paper outlines the conceptual framework, barriers, and promotion strategies for evidence-based knowledge translation and shares clinical experience related to overcoming the seven layers of leakage (aware, accepted, applicable, able, acted on, agreed, and adhered to). We hope that this paper can enhance the public well-being and strengthen the future health care system.

Background: An effective organizational infrastructure is essential to successfully implement and sustain an evidence-based nursing (EBN) practice. Although EBN has been promoted in Taiwan for more than 10 years, variations in the organizational policies and strategies necessary to support EBN among healthcare organizations have prevented effective implementation. Barriers to the implementation of EBN located at the organizational level have also been reported. The need for a model that focuses on the organizational infrastructure to promote EBN in Taiwan has therefore become increasingly apparent., Purpose: This study aims to develop a model that contains the key contextual elements of organizational infrastructure necessary to effectively promote EBN, especially in hospital settings., Methods: A steering committee drafted the components and related strategies of the proposed model. Delphi technique was used to obtain consensus on the proposed model among a group of experts with expertise in EBN. Thirty experts participated in all three rounds of the Delphi survey. To confirm the appropriateness of the proposed model for clinical settings, the model was further reviewed by a focus group composed of experts with experience in implementing EBN or evidence-based medicine in hospitals. The strategies were then further modified based on the suggestions of this focus group, and only those strategies that best fit hospital settings were retained., Results: Five key contextual elements and related strategic processes were identified, including equipment, policy, training courses, outcome indicators, and reward plans. The resultant model was named EPCOR, an acronym composed of the names of each identified element., Conclusions/implications for Practice: EPCOR is a comprehensive model of organizational infrastructure and strategic procedures for implementing EBN in hospital-based settings in Taiwan. Organizations may use the EPCOR model to initiate and implement EBN practices and then to evaluate their effectiveness.

The significant changes in nursing manpower utilization in Taiwan over the past two decades are due in large part to the implementation of the National Health Insurance program and the rising need for long-term care. The changes have impacted clinical nursing manpower utilization in two important ways. Firstly, there has been a substantial increase in overall demand for nursing manpower. In particular, the need for clinical nurses has nearly quadrupled during this time period. Secondly, the level of difficulty involved in patient care has risen dramatically, with factors including increased disease severity and increased care quality expectations, among others. These changes, coupled with demands on nursing manpower imposed from other sectors, underpin and further exacerbate the problem of nursing manpower shortages throughout the healthcare system. To raise the quality of the nursing work environment, the Ministry of Health and Welfare (MOHW) brought together Taiwan's key professional nursing organizations to promote 10 care-reform strategies, establish the nursing-aid manpower system, and create the nursing classification system as an approach to effectively attract nurses to take positions in the medical system.