RESUMEN
OBJECTIVES: The aim of this systematic review was to critically appraise published clinical trials designed to assess the effect of Traditional Chinese Medicine (TCM) on the management of constipation. METHODS: Databases searched included both English and non-English articles published in the Cochrane library, MEDLINE, CINAHL, AMED, EMBASE, China National Knowledge Infrastructure (CNKI), and the Chinese Electronic Periodical Services (CEPS). Studies reviewed included randomized controlled trials and controlled clinical trials. Methodological quality was assessed using the modified Jadad scale. RESULTS: One hundred and thirty-seven (137) studies met the inclusion criteria, of which 21 were high-quality trials (n = 2449). Eighteen (18) were Chinese herbal medicine (CHM) and 3 were acupuncture trials. The primary outcome measure was total effective rate. CHM was more effective than conventional medicines in eight trials. Of the 10 remaining CHM trials, 9 compared the study CHM with another CHM and the results were significant in 4 trials. The effective rate was significantly higher in the intervention group than in the placebo group in the last CHM study. One (1) of the three acupuncture trials compared acupuncture with a conventional medicine, one trial with Sennae folium, and one trial with deeper acupuncture on Tianshu (ST 25). The therapeutic effect in the treatment group was more effective than that in the control group in all three studies. CONCLUSIONS: TCM interventions appear to be useful to manage constipation. Significant positive results were found in 15 high-quality studies. However, only 21 of the 137 publications identified attained high Jadad scores. There was heterogeneity in diagnostic procedures and interventions among the studies. Outcome indicators were also different. Hence, the results should be interpreted cautiously.
Asunto(s)
Terapia por Acupuntura , Estreñimiento/terapia , Medicamentos Herbarios Chinos/uso terapéutico , Fitoterapia , Ensayos Clínicos como Asunto , Humanos , Medicina Tradicional China , Hojas de la Planta , Senna , Resultado del TratamientoRESUMEN
AIMS: To (1) develop and implement a Nursing Process Support System in Chinese (NPSSC) enabling computerised documentation for nursing home residents, (2) evaluate the efficiency of NPSSC, (3) assess obstacles to the use of the NPSSC and (4) assess nurse users' satisfaction with the NPSSC. BACKGROUND: Long-term care facilities in Taiwan have been slow to computerise resident's medical records. The development and implementation of a computerised documentation system provides a way to enhance nursing documentation in long-term care settings and can prevent hazards that result from documentation errors. DESIGN: Quasi-experimental. METHODS: This study used one group pre/post-test. Five nursing homes in Taiwan were included in the study. Twenty-seven nurses used the NPSSC to computerise 396 residents' medical records. Using the NPSSC allowed nurses to enter health assessment data into the computer system, which automatically triggered appropriate nursing diagnoses. The NPSSC included geriatric nursing interventions and the use of alternative Chinese therapies. RESULTS: Obstacles that hindered nurses' use of the NPSSC were identified and possible solutions to overcome these hindering factors were discussed. The use of the NPSSC significantly improved nursing documentation in that resident's records were organised and consistent and nurses were able to complete a comprehensive care plan within 48 hours. Nurses reported a higher satisfaction in nursing documentation after the implementation of the NPSSC than previously. CONCLUSIONS: This study suggested a pathway to develop and implement a computer-based, user-friendly nursing documentation system for nursing homes. This study may be used as a template for implementing computerised documentation worldwide. Relevance to clinical practice. Nursing home providers may consider implementing the NPSSC to replace the traditional hand-written documentation system. An effective use of in-service programs within the workplace helped ease the transition from hand-written documentation to the computer-based NPSSC.
Asunto(s)
Cuidados a Largo Plazo , Proceso de Enfermería , Adulto , Femenino , Humanos , Persona de Mediana Edad , Encuestas y Cuestionarios , TaiwánRESUMEN
A decrease in the use of physical restraints in Intensive Care Units (ICUs) is an important indicator of quality of nursing care. This quasi-experimental study examined the effect on nurses of a session of continuing education aimed at reducing the use of restraints. At a medical center in southern Taiwan, 37 novice nurses were surveyed about their knowledge, perception, attitude and clinical practice of restraint use in 11 ICUs. Two instructors then taught a four-hour continuing education class on patient restraint standards, principles for reducing physical restraint use, and alternatives to restraining. Data were analyzed by paired t-test and the results of identical structured questionnaires which participants received before and after the lecture, showed that, afterwards, knowledge (t = -6.04, p <.01), perception (t = 4.76, p <.01), and attitude (t = 3.93, p <.01) toward restraint use had significantly improved. The continuing education improved the nurses ' knowledge and attitude toward restraint use and may therefore enhance the quality of care provided to ICU patients.
Asunto(s)
Actitud del Personal de Salud , Cuidados Críticos , Educación Continua en Enfermería/normas , Capacitación en Servicio/normas , Personal de Enfermería en Hospital , Restricción Física , Adulto , Competencia Clínica/normas , Cuidados Críticos/normas , Cuidados Críticos/estadística & datos numéricos , Evaluación Educacional , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Unidades de Cuidados Intensivos , Investigación en Educación de Enfermería , Personal de Enfermería en Hospital/educación , Personal de Enfermería en Hospital/psicología , Evaluación de Resultado en la Atención de Salud , Evaluación de Programas y Proyectos de Salud , Indicadores de Calidad de la Atención de Salud , Restricción Física/normas , Restricción Física/estadística & datos numéricos , Encuestas y Cuestionarios , TaiwánRESUMEN
This 18-month study used a structured questionnaire to explore the roles of nursing care on the occurrence and consequences of unplanned endotracheal extubation (UEE) in intensive care units in Taiwan. Experiencing UEE were 225/1176 (22.5%) intubated patients: 91.7% were self-extubations and 8.3% were accidental. Self-extubations occurred most frequently during night shifts and in the care of nurses with less working experience. Accidental extubations occurred most frequently in patients undergoing routine nursing procedures, usually required immediate re-intubation and were associated with more complications. An appropriate nurse-to-patient ratio, better working procedures and continual nursing education programs might help reduce occurrence and complications of UEE.