[Applying Multiple Strategies to Enhance the Completion Rate of Critical Care in COVID-19 Patients].

BACKGROUND & PROBLEMS: Taiwan entered the community transmission stage of COVID-19 in May 2021, with numbers of locally confirmed cases and critical cases increasing sharply. Medical institutions deployed special units to treat patients. In our hospital, a special COVID-19 intensive care units staffed with nursing personnel across various specialties was established. The rate of COVID-19 critical care completion among nurses in this unit was 79.1%. The reasons for non-completion were found to include limited intensive care standards for COVID-19; inadequate training, teaching aids, and practice manuals; and the overwhelming amount of new COVID-19-related information and updates. PURPOSE: The aim of this project was to increase the team's COVID-19 critical care completion rate from 79.1% to 93.5%. RESOLUTIONS: Multiple strategies were implemented, including: (1) providing online education and training, (2) establishing a platform for sharing COVID-19-related updates, (3) creating a QR-code accessible COVID-19 reference database, (4) creating a COVID-19 practice manual, and (5) providing simulation training sessions on wearing personal protective equipment during critical care. RESULTS: The critical-care completion rate for patients with COVID-19 infection increased significantly in this unit from 79.1% to 98.2%, which exceeded the project goal. CONCLUSIONS: Implementing a multi-strategy intervention that includes both online and simulation training may be effective in improving the critical care completion rate for patients with COVID-19 infection.

The impact and distinction of 'lipid healthy but obese' and 'lipid abnormal but not obese' phenotypes on lumbar disc degeneration in Chinese.

BACKGROUND: Lipid abnormality and obesity have been proposed to be associated with lumbar disc degeneration, but little is known about the effect of 'lipid healthy but obese' (LH-O) and 'lipid abnormal but not obese' (LA-NO) phenotypes on lumbar disc degeneration in Chinese. The study aims to determine the impact and distinction of LH-O and LA-NO phenotypes on lumbar disc degeneration in Chinese, and to identify the association of related factors with risk of lumbar disc degeneration. METHODS: A total of 678 individuals were included with lumbar magnetic resonance imaging, serum lipid levels and anthropometric measurements. Obesity was defined on the basis of body mass index or waist to hip ratio (WHR). Pfirrmann score and Weishaupt's scale were utilized to assess the degree of disc degeneration and facet joint degeneration. RESULTS: The incidence of the LH-O and LA-NO phenotypes were 11.4% and 18.1%, respectively. LA-NO phenotype demonstrates a high incidence for disc degeneration (P < 0.05), while LH-O phenotype confers a severe disc degeneration grade (P < 0.05). No statistical difference in the percentage of severe facet joint degeneration grade in each group (P > 0.05). Elevated triglycerides and greater WHR may be the risk factors for lumbar disc degeneration in Chinese. CONCLUSION: LH-O and LA-NO phenotypes are common with different status of disc degeneration in Chinese. Elevated triglycerides and abdominal obesity appear to play crucial roles in the development of lumbar disc degeneration.