Nurses' wound care competency in a sample of hospitals in Northern Vietnam.

BACKGROUND: This study aimed to investigate the current situation regarding wound care by nurses in eight hospitals in the north of Vietnam, in order to plan the training for nurses to enable them to achieve the National Basic Competency Standards for Nurses. METHODS: A cross-sectional descriptive prospective study was conducted from June 2020 to October 2020, with nurses in eight hospitals in four provinces of Northern Vietnam - Hanoi, Quang Ninh, Thai Nguyen and Bac Ninh. Data were collected based on a checklist of direct observation of nurses who provide wound care. The two main indicators were the knowledge score and the practical capacity/competence of the nurses in wound care. RESULTS: A total of 518 nurses participated in the study, the mean age was 32.25±7.31; with 438 (84.6%) being female. Clinical experience of less than 10 years was reported by 63.6%; college education level (diploma) was reported by 58.1%, university level by 28.2%; and post-university level by 4%. The highest mean scores for knowledge were found in the categories of health education for patients, followed by care of clean wounds, communication skills and team work, management and professional development and pressure ulcer wound care. Under the practice domain the highest mean scores were ability to plan wound care, followed by self-evaluation, identification of wound types and implementation of wound care plans. CONCLUSIONS AND RECOMMENDATIONS: The results showed that when judged against the competency standards, nurses' level of wound care competency needs to be improved. Also that there is a distinct theory-practice gap, which must be addressed. It is recommended that hospitals should conduct training for all nurses using the basic competency standards for Vietnamese nurses to improve the quality of care.

Responding to adverse patient safety events in Viet Nam.

BACKGROUND: The psychological and professional impact of adverse events on doctors and nurses is well-established, but limited data has emerged from low- and middle-income. This article reports the experiences of being involved in a patient safety event, incident reporting and organisational support available to assist health professionals in Viet Nam to learn and recover. METHOD: Doctors and nurses (1000) from all departments of a 1500-bed surgical and trauma hospital in Viet Nam were invited to take part in a cross-sectional survey. The survey explored respondents' involvement in adverse events and/or near miss, their emotional, behavioural and coping responses, experiences of organisational incident reporting, and the learning and/or other consequences of the event. Survey items also assessed the availability of organisational support including peer support and mentorship. RESULTS: Of the 497 respondents, 295 (59%) experienced an adverse event in which a patient was harmed, of which 86 (17%) resulted in serious patient harm. 397 (80%) of respondents experienced a near miss, with 140 of these (28%) having potential for serious harm. 386 (77%) reporting they had been affected professionally or personally in some way, with impacts to psychological health (416; 84%), physical health (388; 78%), job satisfaction (378; 76%) and confidence in their ability (276; 56%) commonly reported. Many respondents were unable to identify local improvements (373; 75%) or organisation-wide improvements following safety events (359; 72%) and 171 (34%) admitted that they had not reported an event to their organisation or manager that they should have. CONCLUSIONS: Health professionals in Viet Nam report impacts to psychological and physical health as a result of involvement in safety events that reflect those of health professionals internationally. Reports of limited organisational learning and improvement following safety events suggest that patient safety culture is underdeveloped in Viet Nam currently. In order to progress work on patient safety cultures and incident reporting in Viet Nam, health professionals will need to be convinced not only that they will not be exposed to punitive action, but that learning and positive changes will occur as a result of reporting safety events.

A Separated Receptor/Transducer Scheme as Strategy to Enhance the Gas Sensing Performance Using Hematite-Carbon Nanotube Composite.

Nanocomposite structures, where the Fe, Fe2O3, or Ni2O3 nanoparticles with thin carbon layers are distributed among a single-wall carbon nanotube (SWCNT) network, are architectured using the co-arc discharge method. A synergistic effect between the nanoparticles and SWCNT is achieved with the composite structures, leading to the enhanced sensing response in ammonia detection. Thorough studies about the correlation between the electric properties and sensing performance confirm the independent operation of the receptor and transducer in the sensor structure by nanoparticles and SWCNT, respectively. Nanoparticles with a large specific surface area provide adsorption sites for the NH3 gas molecules, whereas hole carriers are supplied by the SWCNT to complete the chemisorption process. A new chemo-resistive sensor concept and its operating mechanism is proposed in our work. Furthermore, the separated receptor and transducer sensor scheme allows us more freedom in the design of sensor materials and structures, thereby enabling the design of high-performance gas sensors.

Improving hospital death certification in Vietnam: results of a pilot study of injury-related fatalities.

BACKGROUND: Vietnam has prioritised the establishment of a civil registration system for deaths but as yet is unable to report accurate national statistics for the population of 93.5 million people due to inadequate mortality data. Verbal autopsy data suggest that injury is a third leading cause of death (by International Statistical Classification of Diseases and Related Health Problems 10th Revision chapters) in Vietnam, with road traffic injuries in particular a significant and increasing challenge. The study aims to present a more accurate profile of the number and probable causes of these deaths based on data collected hospitals using a version of the WHO death certificate modified for the Vietnamese context. METHODS: Death data collected from Viet Duc Surgical and Trauma Hospital in Vietnam between 1 March 2013 to 31 March 2015 was analysed to explore the number and probable causes of deaths for deaths resulting from an injury. RESULTS: A total of 1616 deaths were recorded for Viet Duc Hospital, of which 73% (1181/1616) were associated with an injury. Most (83%; n=871/1049) injury-related deaths for which immediate cause of death was documented were as a result of head/brain injuries. Injury-related deaths were most commonly caused by from traffic accidents (72%, 853/1181). The majority of patients suffering injury-related deaths were discharged home to die (93%, 1097/1181). CONCLUSION: The study confirms some findings from previous studies about deaths from injuries, while disagreeing with others, highlighting the challenge for Vietnam in collecting these data. Gathering detailed death data provides essential evidence on which to base decisions about allocation of government funding and policy for injury prevention and treatment.

P2Y12 Reaction Units Threshold for Implementing Modified Antiplatelet Preparation in Coil Embolization of Unruptured Aneurysms: A Prospective Validation Study.

Purpose To identify and apply an optimized P2Y12 reaction units (PRU) threshold for implementing modified antiplatelet preparation to prevent thromboembolic events in patients nonresponsive to clopidogrel (clopidogrel nonresponders) undergoing coil embolization of unruptured aneurysms and to evaluate the clinical validity. Materials and Methods The optimal PRU threshold for prediction of thromboembolic events was determined with the Youden index in post hoc analysis of a previous, prospectively enrolled cohort of 165 patients in whom the antiplatelet regimen was not modified. This optimal PRU threshold was used to define clopidogrel nonresponders in a prospective validation study of 244 patients. Standard preparation (aspirin, clopidogrel) was maintained for 126 patients responsive to clopidogrel (clopidogrel responders, 51.6%), and modified preparation (aspirin, prasugrel) was prescribed prior to embolization for 118 clopidogrel nonresponders (48.4%). Fifty-seven clopidogrel nonresponders from the previous cohort who did not receive the modified preparation were included as a historical control group. Thromboembolic and bleeding events were compared among groups by using logistic regression analysis. Results Post hoc analysis from the previous cohort yielded PRU of at least 220 as the optimal threshold for modified preparation selection. The thromboembolic event rate of the clopidogrel responders (one of 126 [0.8%]) was lower than that of the historical control group that received standard preparation (seven of 57 patients [12.3%]; adjusted risk difference [RD], -10.1%; 95% confidence interval [CI]: -18.5, -1.7; P = .015) and was similar to that of clopidogrel nonresponders who received modified preparation (one of 118 [0.8%]; adjusted RD, -0.5%; 95% CI: -3.1, 2.1; P = .001 for noninferiority; P = .699 for superiority). Bleeding event rates did not differ among groups (four of 126 clopidogrel responders [3.2%] vs four of 57 clopidogrel nonresponders that received standard preparation [7.0%] [adjusted RD, -4.5%; 95% CI: -11.1, 3.4; P = .228] vs five of 118 clopidogrel nonresponders that received modified preparation [4.2%] [adjusted RD, -0.6%; 95% CI: -5.8, 4.2; P = .813]). Conclusion Patients undergoing coil embolization of unruptured aneurysms, regardless of clopidogrel responsiveness, had low thromboembolic risk when using PRU of at least 220 as the threshold for implementing modified antiplatelet preparation with prasugrel. © RSNA, 2016 Online supplemental material is available for this article.

Evaluating a training programme at Viet Duc University Hospital in Vietnam.

UNLABELLED: Vietnam's nursing competency standards (VNCS) were issued in 2012 as the legal framework on which the continuous nursing training programme are designed and developed. OBJECTIVES: The study aimed to assess the knowledge, skills, and attitudes as well as the confidence of nurses regarding wound care at Viet Duc University Hospital before and after a new educational intervention. METHOD: A comparative descriptive study was carried out in 2014 at Viet Duc University Hospital. The study reviewed knowledge, skills, attitude and confidence among nurses working in seven clinical departments. The data collection tools included a 48-knowledge-item self-administered questionnaire, a sixteen-item skills set, and attitude-item observation sheet and a thirteen confidence level-item observation sheet, adapted for the field of wound care. Data were loaded into Epidata version 3.1 and analysed with SPSS version 16.0. RESULTS: The mean pre-training knowledge, skill, attitude and confidence scores were (117.78±24.94), (53.61±10.26), (54.39±8.02) and (1.18-3.59), respectively, while the corresponding post-training scores were (148.68±16.54), (62.33±8.40), (60.80±8.75) and (1.50-4.15) p<0.0001. CONCLUSIONS AND RECOMMENDATIONS: This was the first cohort to undergo the new training programme and has shown promising initial results; however, it also demonstrates that the training content, while leading to positive changes, does in some areas need to be further developed and then disseminated across the hospital to all nurses who provide direct wound care for patients.

A giant thrombus in the right atrium of a patient with acute promyelocytic leukemia M3.

Acute promyelocytic leukemia is a special type of acute myeloid leukemia. Patients with this disease are at high risk of complications. Right atrial thrombosis is a rare but potentially serious complication. A 55-month-old girl with acute promyelocytic leukemia M3 was in her last phase of treatment. Radiologic examination revealed an echo structure in the right atrium that was still present after 6 weeks of anticoagulation treatment with enoxaparin. Cardiac surgery was performed to remove the mass, which was found to be a calcified thrombus. Although this is a rare occurrence, recognition of the possibility of a calcified thrombus may minimize misdiagnosis and allow surgical retrieval if the thrombus is sufficiently large.

A Complicated Case Report of Coronary Artery Fistula.

Background: Coronary artery fistulas (CAFs), also, known as coronary arteriovenous malformation, are aberrant connections between coronary arteries and other structures, such as other artery branches or heart chambers. CAFs are infrequent and asymptomatic in young patients, but symptoms and complications become more frequent with age. CAFs can affect hemodynamic parameters and lead to complications, such as myocardial ischemia, heart failure, arrhythmia, and infective endocarditis. Objective: The aim of this article was to present a typical CAF case with severe symptoms who underwent successful embolization to resolve their symptoms. Case presentation: A 50-year-old Vietnamese male visited our cardiac outpatient clinic (S.I.S General Hospital, Can Tho, Vietnam) because of exertional dyspnea and chest pain. Signs of congestive heart failure and abnormal murmur were not presented on chest auscultation. Diagnostic digital subtraction angiography was performed to determine the detailed angioarchitecture of the CAF, revealing a fistulous connection between the left anterior descending artery (LAD) and the LV chamber through an aneurysm. In addition, the RCA measured 7 mm in diameter with a fistula (16 × 9 mm) draining into an aneurysm and then terminating into the LV chamber. The patient had an RCA aneurysm with a fistula into the LV. It was treated successfully by closing the fistula with a vascular plug. Access to the fistula was complex and difficult because of complications due to the CAF. After the procedure, the patient had no chest pain or shortness of breath and was discharged after three days. After six months, he was taking dual antiplatelet therapy and antihypertensive medications and felt better. We performed contrast computed tomography (CT) to examine the fistula after a year, which showed the successful closure of the fistula without any relevant alteration in the coronary artery. Conclusion: CAF closure is indicated if patients have symptoms or secondary complications, and percutaneous closure is a safe and effective method to manage CAF. A CAF is rare and does not have specific symptoms, making it difficult to diagnose. Most patients are asymptomatic and have serious recent complications. Currently, the percutaneous transcatheter method is popular because it is noninvasive and successful in most patients.

Deposition of zinc cobaltite nanoparticles onto bismuth vanadate for enhanced photoelectrochemical water splitting.

During the past few decades, photoelectrochemical (PEC) water splitting has attracted significant attention because of the reduced production cost of hydrogen obtained by utilizing solar energy. Significant efforts have been invested by the scientific community to produce stable ternary metal oxide semiconductors, which can enhance the stability and increase the overall production of oxygen. Herein, we present the ternary metal oxide deposition of ZnCo2O4 as a route to obtain a novel photocatalyst layer on BiVO4 to form BiVO4/ZnCo2O4 a novel composite photoanode for PEC water splitting. The structural, topographical, and optical analyses were performed using field emission scanning electron microscopy, X-ray diffraction, high-resolution transmission electron microscopy, and UV-Vis spectroscopy to confirm the structure of the ZnCo2O4 grafted over BiVO4. A remarkable 4.4-fold enhancement of the photocurrent was observed for the BiVO4/ZnCo2O4 composite compared with bare BiVO4 under visible illumination. The optimum loading of ZnCo2O4 over BiVO4 yields unprecedented stable photocurrent density with an apparent cathodic shift of 0.46 V under 1.5 AM simulated light illumination. This is also evidenced by the flat-band potential change through Mott-Schottky analysis, which reveals the formation of p-ZnCo2O4 on n-BiVO4. The improvement in the PEC performance of the composite with respect to bare BiVO4 is ascribed to the formation of thin passivating layer of p-ZnCo2O4 on n-BiVO4 which improves the kinetics of interfacial charge transfer. Based on our study, we have gained an in-depth understanding of the BiVO4/ZnCo2O4 composite as high potential in efficient PEC water splitting devices.

A novel low-temperature resistive NO gas sensor based on InGaN/GaN multi-quantum well-embedded p-i-n GaN nanorods.

In gas sensors, metal oxide semiconductors have been considered as favorable resistive-type toxic gas sensing materials. However, the higher temperature operation of metal oxides becomes a barrier for their wide range of applications in explosive and flammable gas environments. In this regard, great efforts have been devoted to reducing the operating temperature of the sensor. We demonstrated a chemical resistor-type NO gas sensor based on p-i-n GaN nanorods (NRs) consisting of InGaN/GaN multi-quantum wells (MQW). The sensor exhibited superior NO gas sensing performance to p-type GaN NRs. Furthermore, it also showed a remarkably improved response and fast recovery under UV irradiation (λ = 367 nm) of different UV intensities (7 to 20 mw cm-2) under reverse bias. The sensing performance of MQW-embedded p-i-n GaN NRs was enhanced with the boosted response by 4-fold at 35 °C under UV irradiation. The significant decrease in the resistance of the sensor under UV irradiation was mainly due to the extraction of photo-generated carriers under reverse bias, which can enhance the ionization of oxygen molecules. In addition, the effect of relative humidity (30%-60%) on the gas sensing performance was also manifested in this study. The selectivity of the sensor was determined by using other gases (NO, NO2, O2, NH3, H2S, CO, and H2), which exhibited a low response towards all tested gases other than NO. The experimental results demonstrated that p-i-n GaN NRs with InGaN/GaN MQW is a promising material for the detection of NO gas. Specific emphasis was laid on the enhanced response of p-i-n GaN NRs in reverse bias under UV irradiation.

Mechanistic Insight into Surface Defect Control in Perovskite Nanocrystals: Ligands Terminate the Valence Transition from Pb2+ to Metallic Pb0.

Organolead halide perovskite nanocrystals (NCs) have emerged as promising materials for various optoelectronic applications. However, their practical applications have been limited due to low structural integrity and poor luminescence stability associated with fast attachment-detachment dynamics of surface capping molecules during postprocessing. At present, a framework for understanding how the functional additives interact with surface moieties of organolead halide perovskites is not available. Methylammonium lead bromide NCs without surfactants on their surface provide an ideal system to investigate the direct interactions of the perovskite with functional molecules. When the oleic acid is used in a combination with n-octylamine, its contribution to surface passivation is significantly increased by protonating the alkyl amine to the corresponding ammonium ion. Our results demonstrate that the Br vacancies at the nonpassivated surface result in a reduction of Pb2+ to Pb0 by trapping electrons generated from the exciton dissociation, which provides a main pathway for exciton trapping.

CuO-Decorated ZnO Hierarchical Nanostructures as Efficient and Established Sensing Materials for H2S Gas Sensors.

Highly sensitive hydrogen sulfide (H2S) gas sensors were developed from CuO-decorated ZnO semiconducting hierarchical nanostructures. The ZnO hierarchical nanostructure was fabricated by an electrospinning method following hydrothermal and heat treatment. CuO decoration of ZnO hierarchical structures was carried out by a wet method. The H2S gas-sensing properties were examined at different working temperatures using various quantities of CuO as the variable. CuO decoration of the ZnO hierarchical structure was observed to promote sensitivity for H2S gas higher than 30 times at low working temperature (200 °C) compared with that in the nondecorated hierarchical structure. The sensing mechanism of the hybrid sensor structure is also discussed. The morphology and characteristics of the samples were examined by scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), UV-vis absorption, photoluminescence (PL), and electrical measurements.

Improving hospital death certification in Viet Nam: results of a pilot study implementing an adapted WHO hospital death report form in two national hospitals.

BACKGROUND: Viet Nam does not have a system for the national collection of death data that meets international requirements for mortality reporting. It is identified as a 'no-report' country by the WHO. Verbal autopsy reports are used in the community but exclude deaths in hospitals. METHODS: This project was undertaken in Bach Mai National General Hospital and Viet Duc Surgical and Trauma Hospital in Viet Nam from 1 March 2013 to 31 March 2015. In phase 1, a modified hospital death report form, consistent with the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, was developed. Small group training in use of the report form was delivered to 427 doctors. In phase two, death data were collected, collated and analysed. In phase three, a random sample (7%) of all report forms was checked for accuracy and completeness against medical records. FINDINGS: During the 23 months of the study, 3956 deaths were recorded. Across both hospitals, 222 distinct causes of deaths were recorded. Traumatic cerebral oedema was the immediate cause of death (15% of cases, 575/3956 patients), followed by septic shock (13%, 528/3956), brain compression (11%, 416/3956), intracerebral haemorrhage (8%, 336/3956) and pneumonia (5%, 186/3956); 67% (2639/3956) of patients were discharged home to die and 33% (1314/3956) of deaths were due to a road traffic accident, or injury at home or at work. CONCLUSIONS: This study confirms the viability of implementing a death report form system compliant with international standards in hospitals in Viet Nam and provides the foundation for introducing a national death report form scheme. These data are critical to comprehensive knowledge of causes of death in Viet Nam. Death data about patients discharged home to die is presented for the first time, with implications for countries where this is a cultural preference.

NO gas sensing kinetics at room temperature under UV light irradiation of In2O3 nanostructures.

In2O3 nanostructure sensors were fabricated by arc-discharging a source composed of a graphite tube containing indium. The NO gas sensing properties, as well as the morphology, structure, and electrical properties, were examined at room temperature under UV light illumination. In particular, the response and recovery kinetics of the sensor at room temperature under various UV light intensities were studied. The maximum response signal was observed at an intermediate UV light intensity, which could be corroborated by a nano-size effect based on the conduction model of a resistive chemical nano sensor. The mechanism for the enhanced adsorption/desorption kinetics for NO in an air environment under UV light irradiation is discussed in detail. Furthermore, the general requirements of the sensor, including the stability, repeatability, and selectivity, are discussed.

Impact of mandatory motorcycle helmet wearing legislation on head injuries in Viet Nam: results of a preliminary analysis.

OBJECTIVE: To compare estimated prevalence of head injuries among road traffic injury patients admitted to hospitals, before and after the introduction of a mandatory helmet law in the Socialist Republic of Viet Nam. METHODS: Before and after study of all road traffic injury patients with head injuries admitted to 20 provincial and central hospitals 3 months before and after the new law came into effect on 15 December 2007. Relative risk was computed and comparison made for the periods of 3 months before and after the new law. RESULTS: The study found a 16 percent reduction in the risk of road traffic head injuries (4683 to 3522; relative risk [RR] 0.84; 95% confidence interval [CI] 0.81-0.87) and an 18 percent reduction in the risk of road traffic death (deaths in hospital plus injured patients discharged to die at home; 566 to 417; RR 0.82; 95% CI 0.73-0.93). CONCLUSIONS: Over the first 3 months of the comprehensive mandatory helmet legislation there has been a significant reduction in the risk of road traffic head injuries among patients admitted to 20 hospitals. The Viet Nam Government's decision to require all motorcycle riders and passengers to wear helmets is suspected of leading to positive road safety benefits and should be seen as a policy example for other low- and middle-income countries with a high utilization of motorcycles for transport.