Antibacterial effects on dry-fast and traditional water-based surgical scrubbing methods: a two-time points experimental study.

This study determined the in-use effects of dry-fast and traditional hand-washing surgical scrubs among operating room staff members. This is a static group comparison study with purposive sampling. A total of 156 staff members were recruited in an operating room in a medical center located in southern Taiwan. The participants were divided into traditional and dry-fast hand-washing groups. Microbial counts were measured right after the two groups finished surgical scrubbing and at the completion of surgery. The results showed that the use of dry-fast antisepsis has a better persistent effect (P = 0.001), more nurses chose dry-fast antisepsis than surgeons (P = 0.012), and the post-operation number of colonies for nurses was significantly higher than that for surgeons (P = 0.003). Operating room nurses are long-term and frequent users of antibacterial agents, and their requirement of skin protection is higher. The dry-fast technique has the advantage of being less irritating to the skin and less time consuming; therefore, brush-free and dry-fast antisepsis is recommended.

Exploring the acceptance of telecare among senior citizens: an application of back-propagation network.

OBJECTIVE: This study employed a new method (nonlinear method) called back-propagation network [BPN] to analyze the adoption model of telecare. It is important to inform professionals of the need for medical statistics knowledge to better evaluate new technologies, particularly in health technologies assessment agencies. METHODS: This study used face-to-face interviews to collect senior citizens aged over 60 years in Taiwan, and it used BPN based on the technology acceptance model to identify a telecare adoption model. Lastly, this study compared traditional methods and the BPN method. RESULTS: The BPN method is much better than traditional method. Moreover, the main research result showed that people's perceived usefulness must be raised to effectively increase the adoption of telecare. Education and training for ease of use of telecare for users appear especially important. In sum, this research recommends making the operation interfaces of telecare more user-friendly and providing a demonstration system for practice, so that users would be more comfortable using the system. The findings of this research suggest that, to develop training for users to use telecare, it is likely to be helpful to reduce users' anxiety and improve usage of telecare. CONCLUSIONS: The utilization of the adoption model of telecare established by the BPN method of artificial neural networks is feasible. These findings may offer significant reference for subsequent studies.

[Project to enhance bone bank tissue storage and distribution procedures].

BACKGROUND: Organ and tissue transplantation are now commonly preformed procedures. Improper organ bank handling procedures may increase infection risks. Execution accuracy in terms of tissue storage and distribution at our bone bank was 80%. We thus proposed an execution improvement project to enhance procedures in order to fulfill the intent of donors and ensure recipient safety. PURPOSE: This project was designed to raise nurse professionalism, and ensure patient safety through enhanced tissue storage and distribution procedures. RESOLUTION: Education programs developed for this project focus on teaching standard operating procedures for bone and ligament storage and distribution, bone bank facility maintenance, trouble shooting and solutions, and periodic inspection systems. RESULTS: Cognition of proper storage and distribution procedures rose from 81% to 100%; Execution accuracy also rose from 80% to 100%. CONCLUSIONS: The project successfully conveyed concepts essential to the correct execution of organ storage and distribution procedures and proper organ bank facility management. Achieving and maintaining procedural and management standards is crucial to continued organ donations and the recipient safety.

[A project to promote patient positioning accuracy in operating rooms].

BACKGROUNDS: Inappropriate patient positioning during surgery causes respiratory pattern changes, inadequate gaseous exchange, tissue hypoperfusion and disruption of skin integrity. Inadvertent loosening of positioning devices on a patient in our ward during surgery caused surgical field contamination. We thus proposed a project to promote patient positioning accuracy in operating rooms to improve patient safety. PURPOSES: This project was intended to promote accurate patient positioning by operating room nurses, raise nursing professionalism, ensure patient safety, and avoid unnecessary patient injury. RESOLUTIONS: Under the project, we held educational training programs, developed patient positioning standard operating procedures (SOPs) and check lists, inspected all positioning assistance devices, purchased additional belt restraint straps, and conducted periodic monitoring. RESULTS: Patient positioning execution accuracy increased from 80% to 100%; cognition of patient positioning increased from 88% to 100%. CONCLUSIONS: The operating room committee adopted the proposed procedures and they are now SOPs in all operating rooms at our hospital. We suggest including the SOPs developed in this project in continuous education programs and urge making well-designed positioning assistance devices available to protect patient safety during surgery.

[A proposal to improve operating room nursing personnel adherence to mandated X-ray protection measures].

BACKGROUND: Cognition of and attitudes toward personal radiation protection amongst operating room nurses have been shown to be inappropriate and insufficient. Research has shown that adherence to full radiation protection measures in the operating room is at only 64 percent. Improvements targeting radiation protection measure compliance were thus developed in order to enhance employee welfare and working environment safety. PURPOSE: Raise the rate at which radiation protection measures are properly executed in order to provide a safe, high quality working environment for nursing staff and to establish a safe working environment. RESOLUTION: The following were identified as able to influence positively the proper implementation of radiation protection measures: (1) hold programs and training courses on radiation protection; (2) ensure adequate rack space in the operating room for lead-lined vests, install warning signals to indicate when a radiation source is active, and mandate that all personnel wear radiation monitoring badges; (3) edit and update radiation protection manuals; and (4) set up standard operation procedures for maintenance and radiation facility cleaning. RESULTS: Correct execution of radiation protection measures rose from 64% to 100%; cognition of radiation hazards and protection increased from 68.4 to 100 (on a scale of 0 to 100); and correct radiation facility maintenance and cleaning rose from 43% to 100%. CONCLUSIONS: Enhancement of radiation protection cognition through in-service-training courses and the provision of appropriate protection facilities can raise radiation protection and self-protection abilities amongst medical staff. We strongly recommend that a course on radiation protection be included in the continuing nursing education curriculum for operating room staff. Enhancing radiation protection cognition further is necessary.

Exploring the key factors in the choice of home telehealth by using the health belief model.

The health belief model (HBM) was used in this study to identify and explore key factors in home telehealth. This study interviewed 369 people in Taiwan. A confirmatory factor analysis examined the reliability and validity of the measurement model, while the structural equation modeling technique was used to interpret the causal model. Lastly, multivariate analysis of variance and Scheffe's test were used to find the relationship between demographic parameters and behavioral intention to use home telehealth. The results reveal that HBM can be considered a good-fit model. This study considers the critical factors related to home telehealth that affect users. It facilitates the formation of a more comprehensive overall evaluation system.

Innovative health care delivery system--a questionnaire survey to evaluate the influence of behavioral factors on individuals' acceptance of telecare.

The purpose of this research is to explore people's intention to use telecare and evaluate the degree of influence that behavioral factors on individuals' acceptance of telecare. The subjects are residents of Taiwan. The Structural Equation Modeling (SEM) technique was used to analyze the forecasting model applied to telecare. The results show that this model has good explanatory power for the behavioral intentions of using telecare. Among factors influencing the behavioral intentions of using telecare, the strongest factor is attitude, followed by the perceived usefulness, the perceived ease of use, subjective norms, and personal innovativeness, respectively. The findings of this study may serve as a reference to future studies.

Model construction for the intention to use telecare in patients with chronic diseases.

Objective. This study chose patients with chronic diseases as study subjects to investigate their intention to use telecare. Methods. A large medical institute in Taiwan was used as the sample unit. Patients older than 20 years, who had chronic diseases, were sampled by convenience sampling and surveyed with a structural questionnaire, and a total of 500 valid questionnaires were collected. Model construction was based on the Health Belief Model. The reliability and validity of the measurement model were tested using confirmatory factor analysis (CFA), and the causal model was explained by structural equation modeling (SEM). Results. The priority should be on promoting the perceived benefits of telecare, with a secondary focus on the external cues to action, such as promoting the influences of important people on the patients. Conclusion. The findings demonstrated that patients with chronic diseases use telecare differently from the general public. To promote the use and acceptance of telecare in patients with chronic diseases, technology developers should prioritize the promotion of the usefulness of telecare. In addition, policy makers can strengthen the marketing from media and medical personnel, in order to increase the acceptance of telecare by patients with chronic diseases.

Application of grey system theory in telecare.

As a superiority to conventional statistical models, grey models require only a limited amount of data to estimate the behaviour of unknown systems. Grey system theory can be used in the effective factor assessment, and used in large samples where data are not available or uncertain whether the data was representative. Therefore, the purpose of this study was to adopt grey system theory to discuss older adult users' opinions on the telecare and its effect on their quality of life. This study surveyed the older adult users of Taiwan as subjects. User perception of the telecare services was collected via face-to-face interview. The grey system theory was used to examine the model. The results showed that the overall living quality has the greatest effect on the perceived effects of the telecare on their quality of life, followed by the acquisition of information, accessibility of medical care services, and safety. This finding may serve as a reference to future studies and it also shows that the grey system theory is a feasible analysis method.