Exploring the Outcomes and Satisfaction of Automated Physiological Monitoring Systems Among Nurses.

Vital signs are central to the assessment of physiologic functions of patients and must be included in the electronic health record. The purpose of this retrospective and cross-sectional design study was to evaluate use of-and satisfaction with-automated physiological monitoring systems. Usage data from a hospital database were analyzed 3, 6, and 12 months after implementation of the automated system (June 2018 to May 2019). In addition, questionnaires were completed by 168 nurses, and 20 nurses were interviewed between August/September 2020 and October/November 2020, respectively. Results revealed that usage frequency of automated physiological monitoring devices increased steadily with user familiarity. Although respondents indicated general satisfaction with the devices, system downtime, sufficiency of the battery charge, and data transmission speed were identified as needing correction to smooth workflow and boost work efficiency. Although most interviewees considered devices easy to use, some mentioned transmission speed of the gateway, scanner sensitivity, and accuracy of the ear thermometer as needing improvement. For nurses to use automated physiological monitoring devices fully, a user-friendly design in functions and features is vital, and in-service training and a streamlined workflow are recommended to facilitate technology adoption.

Effect of interactive cognitive-motor training on eye-hand coordination and cognitive function in older adults.

BACKGROUND: Poor eye-hand coordination is associated with the symptoms of the early stage of cognitive decline. However, previous research on the eye-hand coordination of older adults without cognitive impairment is scant. Therefore, this study examined the effects of interactive cognitive-motor training on the visual-motor integration, visual perception, and motor coordination sub-abilities of the eye-hand coordination and cognitive function in older adults. METHODS: A double-blind randomized controlled trial was conducted with older adults. Sixty-two older adults were randomly assigned to the experimental (interactive cognitive-motor training) or active control (passive information activity) group, and both groups received 30 min of training each week, three times a week for 8 weeks. The primary outcome was eye-hand coordination, which was further divided into the sub-abilities of visual-motor integration, visual perception, and motor coordination. The secondary outcome was cognitive function. The generalized estimating equation was used to examine differences in immediate posttest, 3-month posttest, and 6-month posttest results between the two groups. Additionally, the baseline effect sizes were compared with the effect sizes of the immediate posttest, 3-month posttest, and 6-month posttests for the experimental group. RESULTS: There were no statistically significant differences between the intervention and control groups. The only statistically significant difference between the groups was in the attention dimension of cognitive function (p = 0.04). The visual-motor integration results showed a small to moderate effect size for pre post comparisons. CONCLUSIONS: The 24 sessions of interactive cognitive-motor training showed no difference to an active control intervention. In the future, this intervention could be further investigated to establish whether it can be superior to an active control group in other populations. TRIAL REGISTRATION: The study protocol has been published on Chinese Clinical Trial Registry (ChiCTR) (registry no.: ChiCTR-IOR-14005490 ).

Effectiveness of executive function training on mental set shifting, working memory and inhibition in healthy older adults: A double-blind randomized controlled trials.

AIMS: The aim of this study was to evaluate the effectiveness of executive function training on mental set shifting, working memory and inhibition for healthy older adults. BACKGROUND: Executive functions control and guide individuals' behaviours through a top-down cognitive model and have been regarded as the exhibition and integration of various high-level cognitive functions. However, prior studies have rarely focused on the subcomponent indicators of executive function, such as mental set shifting, working memory and inhibition in healthy older adults. DESIGN: Randomized controlled trial. METHODS: A total of 62 participants were recruited between January 2015 - March 2017, with both groups attending a 30-min training session three times per week for 8 weeks. Executive function training group received the training content that focused on the mental set shifting, working memory and inhibition. Active control group engaged in passive information activities. The primary outcome was mental set shifting, measured by the Wisconsin card sort test. The secondary outcomes were working memory measured by digit span and inhibition measured by the Stroop color word test. RESULTS: The executive function training group had statistically significant higher scores of mental set shifting and working memory at immediate follow-up and that its effect on mental set shifting could be maintained for 3-6 months. However, this training did not have any statistically significant results on inhibition. CONCLUSION: The executive function training may be an effective preventive intervention for healthy older adults. Future studies are recommended to include a broader range of participants with different levels of cognitive function.

Prospective Discussion on December-Month Introduction of Voice Nursing and Health Education System.

A cross-sectional study was conducted on the 12th month of using the voice nursing and health education system. Work sampling method was used to observe for 120 hours, and 39 satisfaction questionnaires were collected. The results showed that the usage rate of voice health education system accounted for 14.3% of nursing guidance tools. Pearson analysis showed that user satisfaction and usage efficiency had the greatest impact (p < .001). When the system's ease of operation and stability meet expectations, the care guidance process can be improved.

Trend Analysis of Inpatient Medical Adverse Events in Taiwan (2014-2020): Findings From Taiwan Patient Safety Reporting System.

OBJECTIVES: Medical adverse event (MAE) reporting and management are essential for patient safety campaigns. An epidemiological assessment of MAE trends is crucial for understanding the effectiveness of patient safety improvement efforts. This study analyzed the trends of inpatient MAEs, focusing on MAE incidence and harm severity. METHODS: Longitudinal secondary data (over 2014-2020) on MAEs reported by 18 hospitals were retrieved from the Taiwan Patient-safety Reporting system. The numbers and incidence rates (per 1000 inpatient days) of reported MAEs were calculated. The harm severity levels of six major MAE categories were analyzed. Trend and generalized estimating equation analyses were conducted to investigate changes in MAE patterns. RESULTS: Trend analyses revealed significant decreasing trends in the number (4763-3107 per year; Jonckheere-Terpstra test = -1.952, P = 0.05) and incidence rates (0.92-0.62 per 1000 inpatient days; ß = -0.5017, P = 0.00) of harmful MAEs over 7-year study period. Among the most frequently reported MAEs, tube-related events exhibited the most significant decreasing trend (28%-23.8%; Jonckheere-Terpstra test = -2.854, P = 0.00). The reported numbers, incidence rates, and severity of falls and tube-related events dropped significantly. CONCLUSIONS: By analyzing representative longitudinal MAE data, this study demonstrated the effectiveness of nationwide patient safety improvement campaigns in Taiwan. Our data reveal significant reductions in the reported numbers, incidence rates, and severity of several major MAEs. Specifically, our data indicate significant reductions in the incidence and severity of tube-related events, which can be beneficial for patient safety improvement efforts.

Labour pain control by aromatherapy: A meta-analysis of randomised controlled trials.

BACKGROUND: Aromatherapy is a treatment method that applies fragrant extracts from herbal plants, existed long ago in medical history as a major treatment approach and now used as an auxiliary treatment and sometimes a major treatment for pain and stress management, including those that occur in labour. AIM: We aimed to conduct a meta-analysis of randomised controlled trials of the effectiveness of aromatherapy on labour pain and duration reduction. METHODS: We searched the Pubmed, EMBASE, Cochrane Central Register of Controlled Trials, Google Scholar and Clinicaltrials.gov for randomised controlled trials investigating the effectiveness of aromatherapy on labour pain and duration. RESULTS: A total of 17 trials with low-risk labouring women were included for meta-analysis using the Review Manager 5.3. Meta-analyses showed that aromatherapy reduced labour pain in the transition phase and the duration of active phase and third stage labour; a trend toward shortened duration was observed in the second stage. Also, aromatherapy had no influences on emergency caesarean section, membrane rupture, and spontaneous labour onset. CONCLUSION: Our findings suggest that aromatherapy is effective in reducing labour pain and duration, and generally safe to the mothers. However, due to the heterogeneity across trials in some of the outcomes, further trials with device-based pain measurements, larger sample size, and more stringent design, should be conducted before strong recommendation.

Illness Perceptions and Return to Work in Patients With Moderate to Severe Injuries.

AIM: Research indicates that injured patients' illness perceptions constitute a strong influence on their return to work (RTW). This study examined the relationships between illness perceptions and RTW in injured patients. DESIGN: A prospective cohort design was employed. METHODS: One hundred fifty-six patients were recruited from three hospitals, and 132 completed follow-up data at 3 months after injury. Three-month illness perceptions were measured using the Chinese Illness Perception Questionnaire Revised-Trauma. Return to work was defined as being able to return to a paying job covered by national work insurance. RESULTS: Non-RTW in injured patients tended to occur among patients who were older, less educated, more severely injured, and more likely to be admitted to intensive care units than patients who did RTW. Return to work patients also had more positive illness perceptions than non-RTW patients. Illness perceptions were associated with non-RTW, but the most important determinants of non-RTW were serious injury and older age. CONCLUSIONS: This study provides evidence to indicate that illness perceptions, personal data, and illness characteristics are associated with injured patients' RTW or non-RTW. The role of rehabilitation nurses may be extended accordingly based on findings from this study. IMPLICATIONS FOR PRACTICE: Case management with an interprofessional team may have positive impacts on RTW in injured patients. Rehabilitation nurses should identify patients' expectations of RTW and should work with an interdisciplinary team to develop interventions to reshape the patients' perceptions of returning to work, facilitating their transition back to work, if possible.

Memory-focused interventions for people with cognitive disorders: A systematic review and meta-analysis of randomized controlled studies.

BACKGROUND: A better understanding of people with cognitive disorders improves performance on memory tasks through memory-focused interventions are needed. OBJECTIVES: The purpose of this study was to assess the effect of memoryfocused interventions on cognitive disorders through a meta-analysis. DESIGN: Systematic review and meta-analysis. DATA SOURCES: The online electronic databases PubMed, the Cochrane Library, Ovid-Medline, CINHAL, PsycINFO, Ageline, and Embase (up to May 2017) were used in this study. No language restriction was applied to the search. REVIEW METHODS: Objective memory (learning and memory function, immediate recall, delayed recall, and recognition) was the primary indicator and subjective memory performance, global cognitive function, and depression were the secondary indicators. The Hedges' g of change, subgroup analyses, and meta-regression were analyzed on the basis of the characteristics of people with cognitive disorders. RESULTS: A total of 27 studies (2177 participants, mean age=75.80) reporting RCTs were included in the meta-analysis. The results indicated a medium-to-large effect of memory-focused interventions on learning and memory function (Hedges' g=0.62) and subjective memory performance (Hedges' g=0.67), a small-to-medium effect on delayed recall and depression, and a small effect on immediate recall and global cognitive function (all p<0.05) compared with the control. Subgroup analysis and meta-regression indicated that the effects on learning and memory function were more profound in the format of memory training, individual training, shorter treatment duration, and more than eight treatment sessions, and the effect size indicated the MMSE score was the most crucial indicator (ß=-0.06, p=0.04). CONCLUSIONS: This is first comprehensive meta-analysis of special memory domains in people with cognitive disorders. The results revealed that memory-focused interventions effectively improved memory-related performance in people with cognitive disorders. An appropriately designed intervention can effectively improve memory function, reduce disability progression, and improve mood state in people with cognitive disorders. Additional randomized controlled trials including measures of recognition, global cognitive function, and depression should be conducted and analyzed.

Effect of interactive cognitive motor training on gait and balance among older adults: A randomized controlled trial.

BACKGROUND: Aging is a normal degenerative process that results in a decline in the gait and balance performance of older adults. Interactive cognitive motor training is an intervention that integrates cognitive and motor tasks to promote individuals' physical and cognitive fall risk factors. However, the additive effects of the interactive cognitive motor training on objective quantitative data and comprehensive descriptions of gait and balance warrants further investigation. OBJECTIVES: To investigate the effect of interactive cognitive motor training on older adults' gait and balance from immediate to long-term time points. DESIGN: A double-blind randomized control trial. SETTINGS: Four senior service centers and community service centers in Taiwan. PARTICIPANTS: 62 older adults who met the inclusion criteria. METHODS: The study participants were older adults without cognitive impairment, and they were randomly allocated to the experimental group or active control group. In both groups, older adults participated in three sessions of 30-min training per week for a total of 8 weeks, with the total number of training sessions being 24. The primary outcome was gait performance, which was measured using objective and subjective indicators. iWALK was used as an objective indicator to measure pace and dynamic stability; the Functional Gait Assessment was employed as a subjective indicator. The secondary outcome was balance performance, which was measured using iSWAY. A generalized estimating equation was used to identify whether the results of the two groups differ after receiving different intervention measures; the results were obtained from immediate to long-term posttests. RESULTS: Stride length in the pace category of the experimental group improved significantly in immediate posttest (p = 0.01), 3-month follow-up (p = 0.01), and 6-month follow-up (p = 0.04). The range of motion of the leg exhibited significant improvement in immediate posttest (p = 0.04) and 3-month follow-up (p = 0.04). The Functional Gait Assessment result indicated that statistically significant improvement was observed in immediate posttest (p = 0.02) and 12-month follow-up (p = 0.01). The results of balance performance showed that the experimental group attained statistically significant improvement in centroid frequency in the immediate posttest (p = 0.02). CONCLUSIONS: The research results validated that the 24 sessions of the interactive cognitive motor training intervention significantly improved gait and balance performance. Future studies should extend the sample to communities to promote the gait and balance performance of community-dwelling older adults without cognitive impairment and reduce their risk of falling and developing gait-related diseases.

Effectiveness of Light Therapy in Cognitively Impaired Persons: A Metaanalysis of Randomized Controlled Trials.

OBJECTIVES: To explore the effects of light therapy on behavioral disturbances (BDs), sleep quality, and depression. DESIGN: Meta-analysis of randomized controlled trials. SETTING: PubMed, Cochrane Library, Medline, EMBASE, Web of Science, and clinicaltrials.gov of selected randomized controlled trials and previous systematic reviews were searched. PARTICIPANTS: Cognitively impaired persons. MEASUREMENTS: Information was extracted on study characteristics, quality assessment, and outcomes. Outcome measures included BDs, sleep quality, and depression. RESULTS: Nine randomized controlled trials were examined. The results showed that light therapy has a moderate effect on BD (g = -0.61) and depression (g = -0.58) and a small effect on total sleep time at night (g = 0.25). Subgroup analysis indicated that a light intensity of 2,500 lux or greater has a greater effect on depression than an intensity of less than 2,500 lux (P = .03), and the low risk of bias in blinding was superior to the RCTs deemed to be of high or unclear risk of bias in blinding in terms of BD (P = .02). CONCLUSION: Light therapy can relieve BD, improve sleep quality, and alleviate symptoms of depression for cognitively impaired persons.

Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis.

BACKGROUND: This is the first meta-analysis to compare the treatment effects and safety of administering donepezil alone versus a combination of memantine and donepezil to treat patients with moderate to severe Alzheimer Disease, particularly regarding cognitive functions, behavioral and psychological symptoms in dementia (BPSD), and global functions. METHODS: PubMed, Medline, Embase, PsycINFO, and Cochrane databases were used to search for English and non-English articles for inclusion in the meta-analysis to evaluate the effect size and incidence of adverse drug reactions of different treatments. RESULTS: Compared with patients who received donepezil alone, those who received donepezil in combination with memantine exhibited limited improvements in cognitive functions (g = 0.378, p < .001), BPSD (g = -0.878, p < .001) and global functions (g = -0.585, p = .004). Gradual titration of memantine plus a fixed dose and gradual titration of donepezil as well as a fixed dose and gradual titration of memantine resulted in limited improvements in cognitive functions(g = 0.371, p = .005), BPSD(g = -0.913, p = .001), and global functions(g = -0.371, p = .001). CONCLUSION: Both in the 24th week and at the final evaluation point, the combination of donepezil and memantine led to greater improvement in cognitive functions, BPSD, and global functions than did donepezil alone in patients with moderate to severe Alzheimer Disease.

Using ADDIE Model to Develop a Nursing Information System Training Program for New Graduate Nurse.

This study is to develop a nursing information system (NIS) training program, and takes a local community teaching hospital in Taiwan for example. We adopt the ADDIE model to develop our NIS training program. We preliminaries followed the framework of the model to design a NIS training program, and implement it for the newcomers' training of nursing information system. After training course, the self-efficacy report has a significant (p<.000) improved compare to pre-test, and 88% of participants passed the pragmatic exam.