Research on the Application of Evidence-Based Quality Control Circle to Improve the Implementation Rate of Airway Management Measures in Adult Critically Ill Patients

Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs Institute (JBI) evidence-based health care model, the best evidence of airway management in adult critically ill patients was obtained and applied to the clinic. Results: The total implementation rate of airway management measures in adult critically ill patients increased from 23.62% before the implementation of quality control circle to 88.82%, and the pulmonary infection rate in critically ill patients decreased from 42.31% to 21.74%, with statistical significance between the two groups (P 0.05). Conclusion: Evidence-based quality control circle activities can standardize the practice standards of airway management in critically ill patients, reduce the occurrence of patients’ airway related complications, and improve clinical outcomes.

Blood Pressure Profile and Glycemic Control of Type 2 Diabetics and Hypertensives at the Yalgado Ouedraogo University Hospital: A Review of 116 Cases

Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.

An intensive and personalised care planning programme improves clinical outcomes in patients with diabetic retinopathy:a pilot randomised controlled trial

Background:Using a pilot randomised controlled trial(RCT),to assess the short-term effectiveness of a structured diabetic retinopathy(DR)-specific,intensive,and personalised care planning(DR-IPCP)intervention on diabetes control outcomes in Singaporeans with poorly controlled type 2 diabetes.Methods:Eighteen individuals with mild-moderate DR and poor glycemic control[HbA1c≥64 mmol/mol(≥8.0%)over two consecutive 6-month readings]were randomized to DR-IPCP(n=9)or usual care(UC,n=9).The intervention included a physician consultation,an initial personalised eye consultation with a experienced diabetes nurse educator,and three behaviour change follow-up calls.HbA1c(primary outcome),lipids and blood pressure were assessed at baseline and three months post-intervention.Participant feedback regarding the DR-IPCP program was collected at three months via a semi-structured telephone interview.Results:While no significant between-group differences were observed,DR-IPCP participants experienced significant within-group reductions in HbA1c,total cholesterol,and low density lipoprotein at follow-up compared to baseline[7 mmol/mol(−0.8%),−0.64 mmol/L,and−0.66 mmol/L,respectively].No significant within-group changes in these parameters were observed in the UC group.Following the DR-IPCP intervention,participants reported a clearer understanding of the link between diabetes management;the development and progression of DR.Conclusions:DR-IPCP provides an effective short-term improvement in diabetes control parameters in DR patients with poor diabetes control.An adequately powered and longitudinal RCT is warranted to assess the clinical,patient-centred and economic potential of this programme in this population.

Construction of a New Model of Contactless Medical Services for Outpatients Based on the Project-Achieving Quality Control Circle

Objective: To carry out empirical research on the role of project-achieving quality control circle (QCC) in constructing a new model of contactless medical service for outpatients. Methods: A QCC, consisting of information office members from a grade A tertiary hospital in Wenzhou, was established to conduct a research project with the theme “Constructing a new model of contactless medical service based on outpatients’ experience.” According to the ten steps and PDCA cycle, an analysis was carried out before and after the QCC activities, focusing on improving pre-consultation services, providing steward-like services, and facilitating post-consultation management. Results: After the QCC activities, the mobile appointment rate, missed appointment rate, the proportion of smart check-ins, and the average check-in time were 55.68%, 4.02%, 39.75%, and 8.24 ± 3.66 min, respectively;in contrast, before the activities, they were 32.00%, 7.88%, 0.00%, and 14.96 ± 4.98 min, respectively;the difference between the two groups was statistically significant (χ2 = 3480.112, 4994.496;Fisher’s exact probability = 963788.570;t = 5.323, P < 0.001). Many experts have also visited the hospital to learn about this system, thus rendering social and economic benefits. Conclusion: Project-achieving QCC activities are suitable for complex situations, such as constructing a new model of contactless medical service, and can significantly improve outpatient service quality, enhance patients’ experience, and improve the abilities of circle members.

Holistic conditions after colon cancer:A randomized controlled trial of systematic holistic care vs primary care

BACKGROUND Study showed that systemic holistic care not only aids in disease treatment and physical recovery to a certain extent but also effectively enhances patient psychological well-being,social support,and overall quality of life(QoL).AIM To assess systematic holistic care impact on the recovery and well-being of postoperative patients with colon cancer.METHODS Our randomized controlled trial included 98 postoperative patients with colon cancer admitted to our hospital from June 2021 to June 2022.Patients were divided into control and study groups.The control group received conventional postoperative nursing care,whereas the study group received systematic holistic nursing care.We monitored gastrointestinal function recovery,and recorded changes in serum albumin(ALB),prealbumin(PA),psychological state,selfmanagement,self-efficacy,QoL,and the occurrence of complications in patients before,at discharge,and 2 wk post-discharge.Spearman analysis assessed correlations between psychological state,self-management,self-efficacy,and QoL of patients in the study group 2 wk post-discharge.RESULTS Following the nursing intervention,we observed significantly shorter postoperative bowel sound recovery time,anal exhaust time,and defecation time in the study group than in the control group(P<0.05).Patient ALB and PA levels,psychological status,self-management ability,self-efficacy and QoL at discharge and 2 wk post-discharge significantly improved,with greater improvements observed in the study group(P<0.05).Both groups experienced complications post-interventions,but the intervention group had significantly lower complication rate(3/49,6.12%)(P<0.05).In the study group,patient anxiety,depression,self-management and QoL scores at 2 wk post-discharge exhibited a significant negative correlation(3/49,6.12%)with QoL scores,with correlation coefficients of r=-0.273,-0.522,-0.344,and P<0.01,respectively.Conversely,patient self-efficacy scores 2 wk postdischarge showed a positive correlation with QoL scores(r=0.410,P=0.000).CONCLUSION Systemic holistic nursing significantly benefits postoperative patients with colon cancer by promoting gastrointestinal recovery,improving post-operation well-being,reducing complications,and enhancing QoL.

Relation between sleep quality and glycemic control among type 2 diabetic patients

Objective:To investigate the relation between sleep quality and glycemic control among type 2 diabetic patients.Methods:Across sectional descriptive design was used;the study sample including 125 diabetic patients was recruited at diabetic clinics in Zagazig University hospitals.The interview questionnaire sheet consists of 4 par ts:(1)demographic data,(2)medical history,(3)an Arabic version of the Pittsburgh sleep quality index(PSQI),and(4)glycated hemoglobin A1c(Hb A1c)analysis test.Results:The mean of sleep duration was the highest score of PSQI components,96.8%of diabetic patients had poor sleep quality,and 90.4%of diabetic patients had poor glycemic control.A highly statistically significant relationship was found between Hb A1c and sleep quality.Moreover,income,duration of disease and smoking were independent positive predictors of Hb A1c level,while the female gender was a statistically significant negative predictor.Additionally,female gender and income were statistically significant independent positive predictors of PSQI score.Conclusions:Poor sleep quality and poor glycemic control were very common among type 2 diabetic patients.There was a highly significant relation between sleep quality and glycemic control.

Infection control and prevention in burn victims:The role of nurses

Burn injury is a major public health concern,with an estimated 180,000 deaths each year associated with burn-related infections.The majority of these occur in low-and middle-income countries,and almost two-thirds occur in the World Health Organization African and South-East Asia Regions.There is a risk of an escalation of burn injury site infections if nurses who are directly involved in burn care do not develop a mechanism to mitigate this risk in the coming years.Hence,this study aims at explaining what burn injuries are and how nurses can prevent the occurrence of infection among burn victims.This review analyzed published studies using keywords such as burn injury,infection in burn patients,and nurses’involvement in infection prevention and control(IPC)on search engines such as PubMed,Science Direct,and Google Scholar.The literature was retrieved and reviewed for eligibility to capture just the variables indicated in this seminar objective;the date range chosen in the literature search was from 2015 to 2023.The study found that many patients die from burn injuries as a result of exposure to infection and most nurses are not adequately informed about infection control.The study also found that nurses’responsibilities include proper hand hygiene,wound care,the use of personal protective equipment,antibiotic medication,cleaning the patient’s surroundings,and preventing patient cross-contamination.Burn injuries pose a significant risk to patients,necessitating infection control and prevention.Therefore,nurses in burn units should be informed on IPC practices and also educate patients,families,and coworkers on their importance.

Control effect of structured skin care plan of integrated Chinese and Western medicine in elderly patients with incontinence-associated dermatitis

Objective:The objective of this study is to explore the clinical effects of structured skin care plan of integrated Chinese and Western medicine in intervening elderly patients with incontinence-associated dermatitis(IAD).Materials and Methods:Totally,66 elderly patients with IAD were randomly divided into the experiment group(32 cases)and control group(34 cases).The control group was given routine nursing care,while the experiment group was given a structured skin care plan.The observational course was 2 weeks.The treatment efficiency and healing time were compared between the two groups.Results:After 2-week intervention,the total effective rate of the experiment group was higher than that of the control group(97.1%vs.78.1%,X^(2)=3.913,P=0.048).The skin assessment tool score of the experiment group was lower than that of the control group(0.56±1.58 vs.1.75±2.46,Z=−−2.401,P=0.016).The healing time of the experiment group was shorter than that of the control group(7.29±4.76 days vs.10.69±6.36 days,Z=−2.280,P=0.026).Conclusion:The structured skin care plan of integrated Chinese and Western medicine showed a good effect in elderly IAD patients,and provided a reference for clinical treatment and care of elderly patients with IAD.

Application of Specialized Group Management in the Quality Control of Perioperative Nursing

Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.

Motivational interviewing to improve the self-care behaviors for patients with chronic heart failure: A randomized controlled trial

Objectives:This study aimed to investigate the effect of motivational interviewing on the self-care behaviours in patients with chronic heart failure.Methods:Sixty-two hospitalized patients with chronic heart failure were recruited in this study from April 2014 to April 2015 from a hospital.Twenty-nine patients were in the intervention group,and 33 patients were in the control group.Patients in the intervention group received four sessions of motivational interviewing,whereas those in the control group received traditional health education.At 2,4,and 8 weeks post-discharge,the intervention group underwent telephone follow-up based on motivational interviewing,whereas the control group underwent routine telephone follow-up.Primary outcome was measured using the Self-care of Heart Failure Index at baseline and at 2 months postdischarge.Results:Before intervention,the self-care behaviours scores were 79.00±48.80 in the intervention group and 88.68±29.26in the control group.No statistically significant differences were found between two groups in scores for each subscale and total scale(P>0.05).After intervention,the scores of self-care behaviours in the two groups were both improved at 155.13±35.65 for the intervention group and 115.44±22.82 for the control group with statistically significance(P<0.01).The score of self-care behaviours increased by 76.13 point in the intervention group on average,whereas 26.76 point in the control group.There was significant difference between increases in scores of self-care behaviours in two groups(P<0.01).Conclusions:The self-care behaviours of patients with chronic heart failure could be improved effectively through motivational interviewing.

Transitional care interventions to reduce readmission in patients with chronic obstructive pulmonary disease:A meta-analysis of randomized controlled trials

Objective：To objectively assess the effect of transitional care on readmission for patients with chronic obstructive pulmonary disease.Methods：The PubMed,Science Direct,Web of Science,Cochrane Library,CNKI,and Wanfang databases were searched for relevant randomized controlled trials（RCTs） published from January 1990 through April 2016.The quality of eligible studies was assessed by two investigators.The primary outcome assessed was readmission for COPD and all-cause readmission.The pooled effect sizes were expressed as the relative risk and standard mean difference with 95%confidence intervals.Heterogeneity among studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions（Version5.1.0） and determined with an I^2 statistic.Results：A total of seven RCTs that included 1879 participants who met the inclusion criteria were analyzed.The results of subgroup analysis showed significant differences in readmission for COPD at the6 month and 18 month time points and all-cause readmission at the 18 month follow-up.Transitional care could reduce readmission for COPD at the 6 month[RR = 0.51,95%CI（0.38,0.68）,P 〈 0.00001]and18 month time points[RR = 0.56,95%CI（0.45,0.69）,P 〈 0.00001,and also reduce all-cause readmission after 18 months[RR = 0.72,95%CI（0.62,0.84）,P 〈 0.0001].The reduction of all-cause readmission between the intervention and control groups in the 2nd year,however,was less than that in the 1st year.Conclusions：Transitional care is beneficial to reducing readmission for patients with COPD.Duration of≥ 6 and ≤ 18 months are more effective,and the effect weakens over intervention time,especially after the end of intervention.Both durations point to the importance of ongoing intervention and reinforcement after the end of intervention.

Glucose control in critical care

Glycemic control among critically-ill patients has been a topic of considerable attention for the past 15 years. An initial focus on the potentially deleterious effects of hyperglycemia led to a series of investigations regarding intensive insulin therapy strategies that targeted tight glycemic control. As knowledge accumulated, the pursuit of tight glycemic control among critically-ill patients came to be seen as counterproductive, and moderate glycemic control came to dominate as the standard practice in intensive care units. In recent years, there has been increased focus on the importance of hypoglycemic episodes, glycemic variability, and premorbid diabetic status as factors that contribute to outcomes among critically-ill patients. This review provides a survey of key studies on glucose control in critical care, and aims to deliver perspective regarding glycemic management among critically-ill patients.

Infection control in severely burned patients

In the last two decades, much progress has been made in the control of burn wound infection and nasocomial infections(NI) in severely burned patients. The continiually changing epidemiology is partially related to greater understanding of and improved techniques for burn patient management as well as effective hospital infection control measures. With the advent of antimicrobial chemotherapeutic agents, infection of the wound site is now not as common as, for example, urinary and blood stream infections. Universal application of early excision of burned tissues has made a substantial improvement in the control of wound-related infections in burns. Additionally, the development of new technologies in wound care have helped to decrease morbidity and mortality in severe burn victims. Many examples can be given of the successful control of wound infection, such as the application of an appropriate antibiotic solution to invasive wound infection sites with simultaneous vacuum-assisted closure, optimal preservation of viable tissues with waterjet debridement systems, edema and exudate controlling dressings impregnated with Ag(Silvercel, Aquacell-Ag). The burned patient is at high risk for NI. Invasive interventions including intravenous and urinary chateterization, and entubation pose a further risk of NIs. The use of newly designed antimicrobial impregnated chateters or silicone devices may help thecontrol of infection in these immunocomprimised patients. Strict infection control practices(physical isolation in a private room, use of gloves and gowns during patient contact) and appropriate empirical antimicrobial therapy guided by laboratory surveillance culture as well as routine microbial burn wound culture are essential to help reduce the incidance of infections due to antibiotic resistant microorganisms.

Glycemic control in critically ill patients

Hyperglycemia is common in critically ill patients and can be caused by various mechanisms, including nutrition, medications, and insufficient insulin. In the past, hyperglycemia was thought to be an adaptive response to stress, but hyperglycemia is no longer considered a benign condition in patients with critical illnesses. Indeed, hyperglycemia can increase morbidity and mortality in critically ill patients. Correction of hyperglycemia may improve clinical outcomes. To date, a definite answer with regard to glucose management in general intensive care unit patients, including treatment thresholds and glucose target is undetermined. Meta-analyses of randomized controlled trials suggested no survival benefit of tight glycemic control and a significantly increased incidence of hypoglycemia. Studies have shown a J- or U-shaped relationship between average glucose values and mortality; maintaining glucose levels between 100 and 150 mg/dL was likely to be associated with the lowest mortality rates. Recent studies have shown glycemic control < 180 mg/d L is not inferior to near-normal glycemia in critically ill patients and is clearly safer. Glycemic variability is also an important aspect of glucose management in the critically ill patients. Higher glycemic variability may increase the mortal-ity rate, even in patients with the same mean glucose level. Decreasing glucose variability is an important issue for glycemic control in critically ill patients. Continuous measurements with automatic closed-loop systems could be considered to ensure that blood glucose levels are controlled within a specific range and with minimal variability.

Effect of motivational interviewing on postoperative weight control in patients with obstructive sleep apnea-hypopnea syndrome

BACKGROUND Obesity is an important factor to cause the obstructive sleep apnea-hypopnea syndrome(OSAHS).Higher body mass index(BMI)often results in more severe OSAHS.Currently,the common measures for controlling the weight mainly include diet control,increase exercise and so on.Motivational interviewing(MI)could explore the patient’s internal state and make the patient realize his/her ambivalence,resulting in the change in his/her behavior.This process emphasizes respecting the patient’s autonomy.AIM To evaluate the effect of MI on the weight control of patients with OSAHS.METHODS A randomized controlled study was conducted in 100 obese OSAHS patients undergoing surgical treatment at Shengjing Hospital of China Medical University.The patients were divided into an intervention group and a control group,with 50 cases each.The control group was given routine health education after the operation;in addition to the regular health education,the intervention group was given MI according to a predetermined plan.Obesity-related indicators,postoperative complications,and the sleep status of both groups were evaluated before and 6 mo after the intervention.RESULTS Patients in the intervention group had significantly improved body weight,BMI,and waist and neck circumferences compared with patients in the control group(P<0.05).Regarding complications at 6 mo after operation,the incidence of cough and reflux in patients in the intervention group was significantly lower than that in the control group(P<0.05).In addition,the Epworth Sleepiness Scale and Self-Rating Scale of Sleep scores of patients in the intervention group were significantly lower than those in the control group,and the sleep status of patients in the intervention group was improved(P<0.05).CONCLUSION MI intervention has a significant advantage over postoperative routine health education.It can greatly change the lifestyle,further control the postoperative weight,reduce the occurrence of complications,improve the quality of sleep,and improve long-term postoperative efficacy in OSAHS patients.

Use of Chinese Herbal Medicine as an Adjuvant for Cancer Treatment: A Randomized Controlled Dose-Finding Clinical Trial on Lung Cancer Patients

Background: Cancer has become a leading cause of death world-wide. In Hong Kong, cancer accounted for 24.8% of deaths in 1980, rising to 31.3% in 1998. The conventional treatment of cancer usually includes surgery, radiotherapy and chemotherapy. These conventional therapies do not guarantee not relapse and are often associated with serious side effects. Using Chinese Medicine (CM) as an adjunctive treatment is commonly practiced in Chinese Communities to support patients being treated with conventional modern medicine, with the aim of alleviating the side effects, and improving self-defense and their quality of life. Well-designed and conducted clinical trials could give evidence of the efficacy of CM. This study investigated the clinical efficacy through the well designed clinical trial, and the implementation of carrying out the trial, to assess the adjuvant and supportive effect on lung cancer patients. Methods: The clinical study was designed as a randomized controlled trial to investigate the dose-dependent effects. Primary endpoint was the difference of Functional Assessment of Cancer Therapy-General (FACT-G) score. Results: 41 eligible subjects were enrolled and randomly divided into 2 groups, 21 in high dose group and 20 in low dose group. Sub-domains of PWB (Physical well-being) and EWB (Emotional well-being) as well as FACT-G total score were significantly improved in high dose group when compared with low dose group after 12 weeks treatment (p = 0.015, 0.006 and 0.012, respectively). Conclusions: Holistic approach using quality of life as parameters to evaluate the efficacy of CM is an important compromise. Well-designed clinical trial can provide convincing evidence to support CM’s efficacy. The study demonstrated that quality of life of patients with lung cancer could be beneficial from the supportive care with CM.

Survey of <i>C. difficile</i>-Specific Infection Control Policies in Local Long-Term Care Facilities

Introduction: The incidence and severity of Clostridium difficile infection (CDI) has been increasing and long-term care facility (LTCF) residents are at high risk given their age, co-morbidities, and high antibiotic exposure. Infection control policies are crucial for controlling CDI, but there are currently no regulatory guidelines in the United States. Therefore, we evaluated infection control policies in local LTCFs to define the CDI-specific policies and the administrative and staff understanding of CDI, so as to identify perceived barriers for compliance. Methods: IRB approval was sought and exemption granted, all 8 local LTCFs were asked to participate. Each facility was visited by study personnel who interviewed the administrative Infection Control Practitioner (ICP) and 3-4 Licensed Practical Nurses (LPNs) with distinct survey format. Infection control policies were then compared to the SHEA recommendations for CDI in LTCFs. Results: Of the eligible facilities, 75% (n = 6) participated. ICP (n = 6) and LPNs (n = 21) were interviewed. All facilities accept residents with active CDI and 2 had written CDI-specific infection control policies. All facilities had hand hygiene or glove use policies and 2 had policies for the use of sporicidal environmental cleaning. No facility restricted antibiotic use. Each facility has a policy to instruct their staff through in-services, either annually or upon new hire, but 33% (n = 7) LPNs reported no facility-based CDI training. While 80% (n = 17) of LPNs felt comfortable with the facility CDI policies, only 11 accurately restated it. ICPs felt the most relevant barrier to staff compliance was time constraints (n = 4, 67%), however, LPNs felt it was limited knowledge (n = 10, 48%) and poor communication (n = 2, 10%). Discussion and Conclusions: With the increasing incidence and severity of CDI in LCTF, few of the facilities surveyed had CDI-specific policies. Despite CDI-specific training, there is a perceived knowledge and communication gap for staff caring for residents with CDI.

Change in Preoperative Nervousness: A Randomized Controlled Trial in Gynecological Cancer Patients

Patients are often nervous prior to surgery and females might suffer the most. Increased nervousness needs attention as it can negatively affect postoperative recovery. Support from nurses, i.e. being present, attentive, empowering and helpful to the patient, and talking about what is on the patient’s mind, might help to reduce nervousness. However, there is a lack of evidence as to the ideal level of attention and resources to reduce preoperative nervousness. The objective of the current study was to compare a range of care combinations with standard care to female patients prior to sedation and cancer surgery primarily on difference in change in nervousness from admission until sedation before cancer surgery, measured on a Visual Analouge Scale. Using simple randomization and numbers in sealed envelopes, adult gynaecological patients scheduled for open cancer surgery were allocated to care provided by a nurse anaesthetist and: A) a surgical nurse, B) no additional care, C) a known nurse , and D) a relative. Only the statistician was blinded. The trial stopped when the calculated numbers were included. In the full analysis set, compared to standard care A) (n = 61), we observed the following mean changes and [95% confidence intervals]: B) (n = 65) 1.05 [CI: 0.298 to 1.794] with p = 0.006, C) (n = 61): -0.38 [-1.140 to 0.385] with p = 0.330, D) (n = 71): 0.23 [-0.498 to 0.967] with p = 0.528. Female cancer patients will benefit from supportive care by a surgical nurse from the time of arrival on the operating ward plus supportive care from a nurse anesthetist from 5 - 10 minutes after entering the operating ward. It is not recommended at any time to rely fully on the support of relatives. The effect on adults of preoperative painful procedures and patients’ time alone on the operating ward should be further investigated.

The Current Status and Challenges Regarding Tuberculosis Infection Control in Health Care Facilities in China

Health care facilities are a high-risk environment for generating and spreading respiratory infectious diseases such as tuberculosis （TB）. The TB prevention and treatment staff in health care facilities are responsible for the identification, diagnosis, treatment, supervision, and management of TB patients .

Factors Analysis Related towards Behavior of Nosocomial Infection Control on Family Waiting Patient

World Health Organization(WHO)predicted 1.4 million people infected Health Associated Infection(HAIs).One of the risk factors caused is behavior of nosocomial infection control on patient watcher.The purpose is to know relation behavior of nosocomial infection control on patient watcher patient in Semarang hospital and the number of participants was 61 people.Research method was observation with cross sectional approach.Sampling technique was purposive sampling.Data analysis used univariate and bivariate analysis with Pearson correlation test and chi-square test.Result showed a half of them,mean age of the participants was 45.56.Minimum-maximum values were 20-62 with standard deviation 11.114,gender in the research,most of them was female(83.6%),last education was junior high school(34,4%),most of them worked as maids(45.9%).Category of behavior of nosocomial infection control:less(44.3%),moderate(34.4%),and good(21.3%).There is a meaningful relation between behavior of nosocomial infection control behavior with age(p=0.000),education(p=0.000),and occupation(p=0.000).There is no meaningful relation between behavior of nosocomial infection control with gender(p=0.186).Conclusion:there is a meaningful relation between behavior of nosocomial infection control on patient watcher with age,education,and job,while gender does not have a meaningful relation with behavior of nosocomial infection control.Based on this research,it is recommended to be done as intervention which is able to increase behavior of nosocomial infection control on patient watcher by improving nursing service.