Purpose: This study was done to investigate nurses' knowledge of, and compliance with the multidrug-resistant organism (MDRO) infection control guidelines. Methods: A survey questionnaire was developed based on the institutional and national guidelines and was administered to a convenience sample of 306 nurses in a university hospital. Results: The mean score for knowledge was 33.87 (percentage of correct answers: 82.61%). The percentages of correct answers for basic concepts, route of transmission, hand washing/protective devices and environment management were 74.27%, 94.29%, 92.90% and 75.54% respectively. The mean compliance score was 4.15 (range: 1-5). The compliance scores for education, communication, contact precaution, disinfection, surveillance culture, and hand washing were 3.29, 4.05, 4.20, 4.50, 4.40 and 4.48 respectively. Nurses indicated "lack of time (30.06%)", "lack of means (10.78%)" and "lack of knowledge (9.48%)" as reasons for noncompliance. Conclusion: While most educational programs have focused on hand washing or use of protective devices to prevent transmission of MDRO in acute care settings, hospital nurses' knowledge of the basic concepts of MDRO and environmental management has remained insufficient. Nurses are relatively non-compliant to the guidelines in the areas of education (staff, patient, family) and communication. Comprehensive educational programs are needed to decrease hospital infection rates and to improve the health of patients.
Objectives : Routine vaccination against influenza is recommended for all people aged 65 years or more. Without active encouragement to receive the vaccine, the rate of compliance is generally low. A study was undertaken to assess and compare the effectiveness of two reminder systems in improving the influenza vaccination rate. Methods : A total of 2,017 patients aged 65 or over in a tertiary care hospital family practice center were randomly assigned to a control, a telephone reminder, or a postcard reminder group before the influenza season in 1998. The outcome measure, receipt of vaccination, was determined by telephone interview. Demographic and clinical characteristics were checked through the medical chart review. Results : Among the 1,312 patients who actually received reminders and interviewed, the vaccination rate was 46.7% in the control group, 56.3% in the postcard reminder group, and 63.3% in the telephone reminder group. Vaccination compliance was significantly higher in people reminded by telephone (Odds ratio [OR], 2.00; 95% confidence interval [CI], 1.52-2.64) and postcard (OR, 1.55; 95% CI, 1.18-2.02) compared to that in the control group. Of the characteristics investigated, number of high risk co-morbidity was positively associated with vaccination compliance while current smoking was negatively associated. Conclusions : This result suggests that telephone and postcard reminders can significantly improve compliance with influenza vaccination in this group of Korean elderly. However, additional strategies need to be developed to encourage vaccination among noncompliant.
Background: The elevated risk of occupational infection such as tuberculosis among health workers in many countries raises the question of whether the quality of occupational health and safety (OHS) and infection prevention and control (IPC) can be improved by auditing. The objectives of this study were to measure (1) audited compliance of primary health-care facilities in South Africa with national standards for OHS and IPC, (2) change in compliance at reaudit three years after baseline, and (3) the inter-rater reliability of the audit. Methods: The study analyzed audits of 60 primary health-care facilities in the Western Cape Province of South Africa. Baseline external audits in the time period 2011-2012 were compared with follow-up internal audits in 2014-2015. Audits at 25 facilities that had both internal and external audits conducted in 2014/2015 were used to measure reliability. Results: At baseline, 25% of 60 facilities were "noncompliant" (audit score<50%), 48% "conditionally compliant" (score >50 < 80%), and only 27% "compliant" (score >80%). Overall, there was no significant improvement in compliance three years after baseline. Percentage agreement on specific items between internal and external audits ranged from 28% to 92% and kappa from -0.8 to 0.41 (poor to moderate). Conclusion: Low baseline compliance with OHS-IPC measures and lack of improvement over three years reflect the difficulties of quality improvement in these domains. Low inter-rater reliability of the audit instrument undermines the audit process. Evidence-based investment of effort is required if repeat auditing is to contribute to occupational risk reduction for health workers.
Lee, Su Jin;Park, Hyang Sook;Han, Jin Hee;Kim, Hae Jin;Seo, Min Won;Choi, Eun Ah;Im, Eun Young;Choi, Mi Ran;Choi, Sun Suk;Park, Kwang Ok;Kim, Kyung Ok
Journal of Korean Clinical Nursing Research
/
v.15
no.3
/
pp.5-16
/
2009
Purpose: This study was done to provide effective nursing interventions using an individualized educational program designed to contribute to the knowledge, compliance and physiologic parameters (serum potassium, phosphorus and interdialytic weight gain) of non-compliant hemodialysis patients. Methods: There were 22 participants in the experimental group and 19 in the control group. Nurses with rapport with patients provided education to non-compliant hemodialysis patients for 20 minutes three times a week for six weeks. This education program consisted of individual consulting, telephones conversations regarding hemodialysis, and requests for patient support from patients' families and colleagues. Results: Hypothesis 1; "Knowledge about hemodialysis in the experimental group will be higher than the control. group" was not supported. Hypothesis 2; "Compliance will be higher in the experimental group than in the control group", and Hypothesis 3; "Physiologic parameters of experimental group will improve" were supported as serum potassium and interdialytic weight gain decreased, but results were not consistent for phosphorous. Conclusion: This program for non-compliant patients increased compliance and improved physiologic parameters. Therefore, this educational program should be effective as a nursing intervention.
While metabolic syndrome(MS) is rapidly expanding and dietary pattern, the known risk factor of MS, goes through heavy transition to western diet, not many researches have been done on the association between dyslipidemia and dietary factors in Korean adults. The purpose of this study was to investigate the association between compliance with dietary guidelines and dyslipidemia among Koreans. The subjects of 399 adults who visited health examination center were classified into dyslipidemia(n=180) and control(n=219). Diagnosis of dyslipidemia was based on NCEP-ATPIII criteria(triglyceride>=150mg/d, HDL-C<50mg/dl for male, HDL-C<40mg/dl for female). A questionnaire based interview was done to collect information on compliance with dietary guidelines, general characteristics and health related behaviors. Anthropometric variables were measured during the survey. Mean compliance score of dietary guideline was significantly lower in dyslipidemia group than in control. It was associated negatively with waist circumference and positively with serum HDL-cholesterol(p<0.05). Risks of dyslipidemia were significantly decreased in the group with highest dietary guideline score, high serum triglyceride levels(OR=0.484, 95% CI=0.268-0.875), abdominal obesity(OR=0.296, 95% CI=0.159-0.553), and dyslipidemia(OR=0.481, 95% CI=0.266-0.869). These results indicated that increasing compliance with dietary guidelines could be an effective strategy to lower the risk of dyslipidemia among Koreans.
Journal of Institute of Control, Robotics and Systems
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v.13
no.4
/
pp.320-328
/
2007
This paper presents a stiffness modeling of a low-DOF parallel robot, which takes into account of elastic deformations of joints and links, A low-DOF parallel robot is defined as a spatial parallel robot which has less than six degrees of freedom. Differently from serial chains in a full 6-DOF parallel robot, some of those in a low-DOF parallel robot may be subject to constraint forces as well as actuation forces. The reaction forces due to actuations and constraints in each serial chain can be determined by making use of the theory of reciprocal screws. It is shown that the stiffness of an F-DOF parallel robot can be modeled such that the moving platform is supported by 6 springs related to the reciprocal screws of actuations (F) and constraints (6-F). A general $6{\times}6$ stiffness matrix is derived, which is the sum of the stiffness matrices of actuations and constraints, The compliance of each spring can be precisely determined by modeling the compliance of joints and links in a serial chain as follows; a link is modeled as an Euler beam and the compliance matrix of rotational or prismatic joint is modeled as a $6{\times}6$ diagonal matrix, where one diagonal element about the rotation axis or along the sliding direction is infinite. By summing joint and link compliance matrices with respect to a reference frame and applying unit reciprocal screw to the resulting compliance matrix of a serial chain, the compliance of a spring is determined by the resulting infinitesimal displacement. In order to illustrate this methodology, the stiffness of a Tricept parallel robot has been analyzed. Finally, a numerical example of the optimal design to maximize stiffness in a specified box-shape workspace is presented.
In this study, factors influencing the parking policy compliance (i.e. levying a garage option on car buyers) were identified, and then, were applied to the theory of planned behavior. To find out the influence of factors and their path, the study built a parking policy compliance model using structural equation modeling. The independent variables such as attitude, subjective norm, perceived behavioral control had positive effects on the parameter describing the efforts to secure his garage, but the parameter impact on the dependent variable was not significant. In the end, the independent variables affected the dependent variable was not significant. The perceived behavioral control utilizing regulations had positive effects on the parking policy compliance behavior, but past behavior such as street parking and prowling to find a free parking space had a negative effect on parking policy compliance behavior.
This study is aimed at developing a cardiac rehabilitation program and enlightening the effects of the program on patient's health behavior compliance, cardiovascular functional capacity, and quality of life. Using a quasi-experimental approach the nonequivalent control group pretest - posttest design was accepted for this study. The subjects of this study consisted of 55 patients with ischemic heart disease at the Cardiac Center of 'G' Hospital located in Inchon from May 1, 1998 to April 30, 1999. The patients were divided into two groups: the experimental group, which participated in the cardiac program with 30 patients and 25 patients of a control group were not involved in the program. There were two phases in the cardiac rehabilitation program: the first phase was a team approach education. It focused on reducing the risk of ischemic heart problems. The second phase was individual training by using a home based exercise program, which was comprised of 8 weeks, three sessions per week, 40-60 minutes per session, and followed by consultation. Every session involved 20-40 minutes of aerobic exercise at 40-60% of heart rate reserve, 11∼13 RPE and 10 minutes of warm-up and 10 minutes of cool-down exercises. The experimental tools for the study were the health behavior compliance scale developed by Lee, Yoon-hee (1992), and quality of life scale developed by McGirr et al.(1990). RPPsubmax were measured by the treadmill. The collected data was processed by SPSS and analyzed by χ²test and t-test. The results of this study were as follows: 1. The health behavior compliance in experimental group was significantly increased (t=5.091, p=.000) when compared to the control group. 2. RPPsubmax also decreased significantly in the experimental group when compared to the control group(t=-2.109, p=.040). 3. The quality of life significantly improved in the experimental group (t=3.853, p=.000) as compared to the control group. As the above results of this study revealed, the effectiveness of the cardiac rehabilitation program of the study was confirmed. It increased the health behavior compliance for reducing the risk of further coronary events, enhanced the cardiovascular functional capacity, and eventually improved the patient's quality of life.
It is generally accepted that the delivery of health care is undergoing many changes specially those related to acute, contagious disease care and to the increase of chronic illnesses which can not be cured but are controlable. The health care practitioner can not be soley responsible for the control of their clients' care. Because the clients will play a vital role in controlling their illnesses, long term participation by both the health care provider and the client is necessary. Since most individuals with hypertension do not experience signs or symptoms, the disease is difficult to detect and even when diagnosed, clients do not comply well with their hypertension regimens. The noncompliant client is at increased risk for compliants involving the heart, brain, kidney and other organs. In an effort to explore methods of increasing patient participation in and adherence to treatment programs for hypertension, the researcher used health contracting to promote self care. The research questions are; 1) Will the health contracting increase compliance in health behavior and reduce the blood pressure\ulcorner 2) If clients comply with their regimens will this reduce their blood pressure\ulcorner The research design utilized in this study was a quasi-experimental design. A purposive sample, was abtained from two churches in the 1. area, consisting of 64 clients with hypertension. The data was collected from the middle of January to the 1st of September 1985. Randomization was only of the two church groups into experimental and control groups. Compliance with health behavior related to the hypertensive regimen, blood pressure and body weight were measured, compared and analyzed. In the experimental group measurements were made 6 times; one month before the education program after education program when health contracting was done and 4 more times once a month for 4 months. In the control group measurements were made 3 times; one month before the education program after the education program, and once 4 months later. There was no health contracting. The data were analyzed by t-test, Pearson correlation and ANOVA according to purpose of the study. The result of this study may be summarized as follows: The result related to the hypothesis on the effect of health contracting are as follows: H$_1$; “The hypothesis that the experimental group, with a health contractual agreement will demonstrate increased compliance levels for health behavior than the control group” was supported(t=-5.29, df=62, p=.000). H$_2$; “The hypothesis that the experimental group, with a health contractual agreement, will demonstrate a greater reduction in blood pressure than the control group” was supported (for systolic blood pressure t=2.72, df=62, p=.009, for diastolic blood pressure t=1.95, df=62, p=.050). H$_3$; The hypothesis that the greater the compliance of the client with health behavior the lower the client's blood pressure will be was partially supported (for systolic pressure r=-.2981, p=.008, for diastolic pressure r=-.1720, p=.087). From the examination of the results of this study it can be concluded that the interaction between the nurse and the client, contracting to define goals and reinforcing compliant behavior, leads to improved compliance with health care behaviors and thus to an increase in the effectiveness of nursing care. Further consideration need to be given to the inclusion of the concept of health contracting in primary nursing and to further research in this area.
This study is intended to provide information to menopausal women so they can control their symptoms. The basic data was gathered by interviewed 200 postmenopausal women on a HRT program. The women were questioned about their perception of menopause and compliance to the therapy with the fellowing result $71.7\%$ of the women experianced hot flushes, and $64.1\%$ experienced short term memory loss and some psychological symptoms. The women reported that these symptoms reduced their quality of life. $53\%$ of the women responded that menopause is a natural state and $59.1\%$ agreed to HRT based on their doctor's recommendation. $76.2\%$ of the women reported that HRT was effective, with $74.7\%$ reporting reduced hot flush symptoms $67.3\%$ of the women reported compliance with the medication schedule. and $43.9\%$ reported periodic non-compliance. Although HRT has been shown to be an effective treatment, the study found that less than $10\%$ of postmenopausal women are currently being treated and these treated women are generally negligent in continuing with HRT, The study recommends that a program be developed that explains the benefits and risks of HRT to be distributed to patients being treated by doctors and pharmacists. In conclusions, It is very important for hormone replacement therapy on menopausal women to take more intensive medication consultation to increase medication compliance and effectiveness of pharmacotherapy.
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