Simplest Way to Establish COVID-19 Quarantine Observation Wards Within 24 Hours.

Reducing nosocomial transmission within health care facilities is important, but the number of negative-pressure airborne infection isolation rooms for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is limited. It is a daunting challenge to cope with a surge of suspected infectious patients in hospitals. We installed air exhaust fans on the windows to change the pressure direction within the wards rapidly. The best location for the fans was 90 cm from the floor and 90 cm from the edge of bed whether the indoor air conditioners were on or off. The noise level should be <60 dB(A) as per government regulations. General wards can be transformed into makeshift negative-pressure rooms easily and effectively within 24 hours, which is really the simple, fast, and effective way for the transformation being applied.

Health Care Providers' Perceptions of Maternal Health Concerns in the Solomon Islands.

PURPOSE: The objective of this study was to explore the maternal health risk factors and sentinel events among women in the Solomon Islands, from the viewpoints of health care providers in the Solomon Islands. DESIGN AND METHOD: Three focus group interviews were conducted in July and August 2011 at a secondary referral hospital in an urban area. The study consisted of 10 registered nurses and 11 skilled birth assistants. Thematic analysis was used for this qualitative data analysis. FINDINGS: Six major themes were emerged from the data: (a) environmental hazard: malaria, (b) malnutrition: iron deficiency anemia, (c) adolescent pregnancy, (d) betel nut chewing, (e) cultural beliefs influencing women's health, and (f) difficulty accessing health care services. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The results of this study provide a useful first step toward identifying specific maternal health risks among women in the Solomon Islands. The findings may assist the health sector and midwives/antenatal educators to better understand the health risks and reduce the disease burden among pregnant women in South Pacific countries. The results may also contribute to the development of policies to improve maternal health and to accelerate progress toward the fifth target goal of UNICEF's Millennium Development Goals.

Accessibility assessment of the Health Care Improvement Program in rural Taiwan.

CONTEXT: An experimental Health Care Improvement Program (HCIP) was initiated by the Bureau of National Health Insurance in 1997 to improve the accessibility of health care in several rural, mountainous districts. PURPOSE: This longitudinal study evaluated service availability, utilization patterns, and effectiveness of services under the HCIP in the A-Li Mountain District. METHODS: Outpatient claims made by residents in the A-Li Mountain District were extracted from the database of the National Health Insurance program. Changes in utilization pattern and volume were analyzed. Satisfaction levels were assessed by 2-stage face-to-face interviews with local residents. FINDINGS: After the HCIP, the average population served by each doctor decreased 75%, and total outpatient visits increased 15.4%. The total number of in-district outpatient visits increased 83.6%. The proportion of in-district outpatient visits to all visits increased from 22.1% to 35.1%. The total in-district outpatient visit fee claimed increased 100.2%, and the total out-of-district outpatient visit fee claimed increased only 7.2%. About 60.4% of the residents were not satisfied with overall health care services before the HCIP. The proportion decreased to 32.4% after the HCIP. CONCLUSIONS: The HCIP improved accessibility, enriched local medical care resources, changed the utilization pattern of some residents, and increased residents' satisfaction level. A well-managed program with stabilized financial resources is more likely to succeed if it also respects cultural differences and responds to community needs.

[Noise reduction at an emergency intensive care unit of medical center in southern Taiwan].

This project was the result of numerous complaints from patients and their families about high levels of human and mechanical noise inside the emergency intensive care unit (EICU) of a major medical center in southern Taiwan. Other complaints were made by members of the medical staff, who claimed that they could not hear the alarms built into medical equipment. The project entailed a data inventory, analysis, and the identification of noise sources. Maximum mechanical noise level was measured at 79.6 dBA. After classifying noise sources as non-mechanical or mechanical, we established a list of objectives and used 13 approaches to achieve them. As a result, average reduction in mechanical noise volume was 11.72 dBA (14.47%) and in non-mechanical noise volume 10.5 dBA (14.0%). Still, we were only successful in protecting 50% of all EICU patients from noise disturbance levels according to the guidelines established in the Noise Prevention Act that is used in the United States. We therefore recommend that noise monitoring systems be added in order to increase the percentage of EICU patients who are protected from unnecessary noise.