Breast feeding is unique to provide health and growth to newborn babies, as well as positive feedbacks to mothers. Medical personnel is a critical factor to initiate a successful learning curve. Hospital stay after delivery relatively is short, normal delivery stays for 3 days, C-section stays for 6 days. Medical facilities usually offer learning information on brochures or other paper-form reading materials. Due to the physical burden experienced by mother, they tend to spend the most part of attention to their own body recovery, and pay little or no attention to study. It turns most efforts into waste and non environmental-friendly. Verbal instruction by personnel also has its handicap on issues such as inconsistency and lack of time sufficiency. How to provide the most effective way to fulfill the needs for new mothers and sufficient essential health education is always a great challenge to Medical personnel. Cell phone and network is gaining popularity in daily life nowadays, and a proven auxiliary tool for bringing attention and promoting effective learning. Purpose on investigation of effectiveness in network education to breast feeding after baby delivery. The search is divided into experimental and control group. There are 56 in experimental group; 56 in control group. Result: Recognition rate raised from 72.3% to 96.2%. Satisfactory rate on learning raised from 50.0% to 95.2%. Conclusion :Learning by network is a learning process driven by the need of each individual, emphasized by highly self motivation. Breath feeding is a complicated and physical dependent learning curve, therefore using integration of literature, animation, motion pictures, and visual aide will overcome the traditional difficulties faced by medical personnel. Promoting breast feeding is heavy-load and time-consuming task. For the purpose of long-term propaganda and under limited human resources conditions, the clinic adaption of this learning protocol will bring win-win situation.

Introduction】Alzheimers Disease (AD) accounts for a high percentage of dementia at over 60%. As dementia incidence doubles every 5 years from 65 years old onwards, developing a countermeasure is an urgent issue. As a countermeasure, the effectiveness of cognitive function training tasks such as dual-task (performing two tasks simultaneously) and n-back task (a delayed recall task for items shown n steps earlier) have been verified. Furthermore, it has been verified lyrics accompanied with sound or rhythm are stored easily by the memory, but difficult to remember when without sound or rhythm. It was hypothesized that combining rhythmic music with repeated memory tasks would improve memory performance. It was also predicted that stress associated with memory tasks would be alleviated by the relaxing effect of music. The purpose of this study is to verify a new training method combining rhythmic music and repeated memory tasks. An intervention study was conducted over 3 months, and compared results from the intervention group and the control group. 【Method】Screening test for mild cognitive impairment: Montreal Cognitive Assessment (MoCA test) and; Stress check: Measured α-amylase levels of saliva taken from the sublingual gland. Analysis was conducted by a corresponding t-test, comparing the control group and intervention group results. 【Results】In comparison to the control group, cognitive function was significantly improved and distress was reduced in the intervention group. 【Conclusion】Repeated memory tasks combined with rhythmic music were effective both in improving memory capacity and reducing stress.

The traditional teaching are mainly classroom teaching, nursing adopt passive learning, resulting in low willingness to learn; diversified training, teaching is usually a variety of ways to use each other, hoping to learner-centered, the use of multiple teaching and interesting of the flipped classroom, the development of new nurse can be interested in learning. The purpose of this research is to compare the traditional teaching and diversified training, whether to increased the satisfaction of teaching and training of new nurse and preceptors, and this result can be used as a reference for nursing education training content. This research, the experimental design of the experimental before and after the test, selects a new nurse in the Taiwan hospital 30, preceptors 30, in the Diversified teaching and training program before and after the intervention. The questionnaire was evaluated with a satisfaction questionnaire, and the data were analyzed by χ2 test, t-test and ANOVA. Quantitative research results showed: the satisfaction of the 30 new nurse was 94.8 points (100 points), and the satisfaction of preceptors was 96.4 points (100 points).The experimental group was significantly larger than the control group (p <.05), show that diversified instructional training program are effective. Qualitative research results show t: positive view that Objective structured clinical skills, flipped classroom, E-learning and reflection vs. feedback and other diversified teaching methods, can effectively improve the quality of teaching. Results: The new nurse and preceptors are sure that this training program shows that “The use of diversified training to construct a "learner-centered" clinical teaching model " will help new nurse to successfully transition to clinical roles, and apply multiple approaches for effectiveness evaluation, as a reference for nursing clinical teaching model. It is suggested that future research can focus on the consensus of preceptors, as a measure of consistency.

Urine retention is a common complication of postpartum women, postpartum more than 6 hours can not solve their own urine and urine more than 500-700ml ,will perform indwelling catheterization, but causes maternal inconvenience, also increases the cost of medical care, Use the bladder scanner to reduce maternal urine retention, So that medical staff first assessment of maternal bladder residual urine, as soon as possible to help their own urination, reduce urine retention and indwelling catheterization ratio. Methodological: This study was Quasi-Experimental Design, divided into two groups (experimental group and control group) a total of 50 people, the control group did not use the bladder scanner; The experimental group was added to the bladder scanner to detect bladder residual urine, for the first time, please urinate the urine and then use the bladder scanner to detect residual urine, more than 500ml will be indwelling catheterization, the residual urine volume between 200-500ml in the fourth hour for the second assessment, two intervention measures were based on the postpartum urine retention assessment scale. Result: The use of bladder scanners can effectively reduce the effectiveness of maternal urine retention, the control group did not use the bladder scanner for the number of indwelling catheter 15 people, more than Residual urine volume are between 700-900ml , Indwelling catheterization days more than 2 days ratio accounted for more than 50%, the number of indwelling catheterization in the experimental group was 5, Residual urine volume are less than 550ml, retention catheter for 1 day to remove the catheter. Conclusion : The results of this study using bladder scanners can really reduce postpartum women, effectively reduce maternal urine retention and indwelling catheterization ratio, reduce maternal uncomfortable caused by indwelling catheterization and reduce medical costs and nursing care hours, Improve the quality of care.

Question statement: Respiratory tract infection is the primary cause of the death of children under five years of age. The disposal will be spray treatment, but the child patients usually resist clinically. Thus it affect the treatment result. Before treatment, therapeutic play , instructions and technical operations, can be useful for preschool child patients to transfer pressure and fear, to increase acceptance, and to understand practical usefulness. Purpose : To explore the acceptance of respiratory therapy of the preschool child patients, to improve the effective discharge of sputum of the hospitalized children, and to evaluate the effect of therapeutic play on preschool child patients' respiratory therapy. Methodological and theoretical orientation: This study was Quasi-Experimental Design, Enrolled 3-6-year-old pre-school young children of the Division of Pediatrics wards in a certain regional hospital as the subjects, divided into two groups (experimental group and control group) to a total of 40 people. The control group did not use the therapeutic play; the experimental group was added the guiding play type of therapeutic play. Taking into account the development characteristics of hospitalized children, and therefore to use self-designed LED blowing device and some real medical supplies for therapeutic play before the treatment. Afterwards, we can realize the usefulness of practical uses by persuading parents to fill out Child Temperament Scale and Nursing Guidance Satisfaction Questionnaire .result: The use of therapeutic plays improve the effectiveness of respiratory therapy. In the experimental group, the interventional measures can significantly improve the correlation coefficient of child temperament and emotional regulation (p <.05) and Nursing Guidance Satisfaction reaching 97.1% Conclusion: The use of therapeutic play can improve the effectiveness of treatment, can also reduce the hospital hospital pressure and fear, thereby enhancing the quality of clinical care and care and professional ability.

Question statement: Respiratory tract infection is the primary cause of the death of children under five years of age. The disposal will be spray treatment, but the child patients usually resist clinically. Thus it affect the treatment result. Before treatment, therapeutic play , instructions and technical operations, can be useful for preschool child patients to transfer pressure and fear, to increase acceptance, and to understand practical usefulness. Purpose : To explore the acceptance of respiratory therapy of the preschool child patients, to improve the effective discharge of sputum of the hospitalized children, and to evaluate the effect of therapeutic play on preschool child patients respiratory therapy. Methodological and theoretical orientation: This study was Quasi-Experimental Design, Enrolled 3-6-year-old pre-school young children of the Division of Pediatrics wards in a certain regional hospital as the subjects, divided into two groups (experimental group and control group) to a total of 40 people. The control group did not use the therapeutic play; the experimental group was added the guiding play type of therapeutic play. Taking into account the development characteristics of hospitalized children, and therefore to use self-designed LED blowing device and some real medical supplies for therapeutic play before the treatment. Afterwards, we can realize the usefulness of practical uses by persuading parents to fill out Child Temperament Scale and Nursing Guidance Satisfaction Questionnaire .result: The use of therapeutic plays improve the effectiveness of respiratory therapy. In the experimental group, the interventional measures can significantly improve the correlation coefficient of child temperament and emotional regulation (p <.05) and Nursing Guidance Satisfaction reaching 97.1% Conclusion: The use of therapeutic play can improve the effectiveness of treatment, can also reduce the hospital hospital pressure and fear, thereby enhancing the quality of clinical care and care and professional ability.

Breast feeding is unique to provide health and growth to newborn babies, as well as positive feedbacks to mothers. Medical personnel is a critical factor to initiate a successful learning curve. Hospital stay after delivery relatively is short, normal delivery stays for 3 days, C-section stays for 6 days. Medical facilities usually offer learning information on brochures or other paper-form reading materials. Due to the physical burden experienced by mother, they tend to spend the most part of attention to their own body recovery, and pay little or no attention to study. It turns most efforts into waste and non environmental-friendly. Verbal instruction by personnel also has its handicap on issues such as inconsistency and lack of time sufficiency. How to provide the most effective way to fulfill the needs for new mothers and sufficient essential health education is always a great challenge to Medical personnel. Cell phone and network is gaining popularity in daily life nowadays, and a proven auxiliary tool for bringing attention and promoting effective learning. Purpose on investigation of effectiveness in network education to breast feeding after baby delivery. The search is divided into experimental and control group. There are 56 in experimental group; 56 in control group. Result: Recognition rate raised from 72.3% to 96.2%. Satisfactory rate on learning raised from 50.0% to 95.2%. Conclusion :Learning by network is a learning process driven by the need of each individual, emphasized by highly self motivation. Breath feeding is a complicated and physical dependent learning curve, therefore using integration of literature, animation, motion pictures, and visual aide will overcome the traditional difficulties faced by medical personnel. Promoting breast feeding is heavy-load and time-consuming task. For the purpose of long-term propaganda and under limited human resources conditions, the clinic adaption of this learning protocol will bring win-win situation.

The use of physical restraint is high in prevalence and it is being an important issue in hospital care in Hong Kong. Using of physical restraint is controversial in the past decades owing to the concern on extensive or misuse in daily patient care. Nurses’ perception and knowledge on using the physical restraint play a pivotal role on care decision. In view of this, scholarly works had shed light on educational approach to the health care profession on the way of using physical restraint. Research evidence has now been suggested that educational strategies in different approach are beneficial to enhance health care professions’ knowledge and practice in using physical restraint. Besides, different levels of evidence significantly shown that there are positive impacts in terms of fall reduction, shift of application mode, increase use of alternatives, practical skills enhancement, and reduce prevalence of restraint-associated injuries. This paper aimed at exploring the best available research evidence regarding the educational strategies to the health care profession on using physical restraint. The selected evidence are critically appraise that follow by the justification for clinical change. Further, recommendations to develop the best evidence-based practice on educate health care profession on using physical restraint are suggested. The possible outcome indicators of the educational strategies including the aspect of knowledge, attitude and practice of the health care profession are discussed. The nursing implication of the proposed practice change can improve patients’ quality of life during hospitalization as well as promoting continuing nursing education in patient care. References: 1. Huang, H. T., Chuang, Y. H., & Chiang, K. F. (2009). Nurses’ physical restraint knowledge, attitudes, and practices: The effectiveness of an in-service education program. Journal of Nursing Research, 17(4), 241-248. 2. Lai, C. K., Chow, S. K., Suen, L. K., & Wong, I. Y. (2011). The effect of a restraint reduction program on physical restraint rates in rehabilitation settings in Hong Kong. Rehabilitation Research and Practice, 2011. 3. Martin, A., Krieg, H., Esposito, F., Stubbe, D., & Cardona, L. (2008). Reduction of restraint and seclusion through collaborative problem solving: A five-year prospective inpatient study. Psychiatric Services, 59(12), 1406-1412. 4. Nasrate, H., Shamlawi, A., & Darawad, M. W. (2017). Improving ICU nurses’ practices of physical restraints in Jordan: Effect of an educational program. Health, 9(12), 1632-1643. 5. Omolewa, P. (2012). The impact of instructive educational program on physical restraint reduction in acute mental health hospitals. Walden University

Normal saline, Betadine and chlorhexidine are the common dressing solu􀆟 ons in Hong Kong healthcare fi eld, which tap water (TW) is not considered as proper dressing solu􀆟 on because it contains bacteria and unknown substances. However, to review the guidelines, some overseas countries accept TW dressing. A fundamental study had already been performed in Hong Kong which the poten􀆟 al benefi ts may be discovered. This study is to review whether it is be􀆩 er to use TW as dressing solu􀆟 on compared to normal saline in a pa􀆟 ent with the superfi cial wound when it comes to infec􀆟 on rate. To compare the water treatment in Hong Kong and the USA, the chemical materials including hydrated lime, chlorine, alum, powdered ac􀆟 vated carbon are used in water purifi ca􀆟 on system. In the USA, studies and applica􀆟 on of tap water have already performed and found that TW does not induce more infec􀆟 on in both acute and chronic wound. The water quality in Hong Kong is similar to the USA that TW is safe as an alterna􀆟 ve cleansing solu􀆟 on. It shows benefi ts using TW in dressing. There is not only easily accessible in the community, but also more cost-eff ec􀆟 ve in a health-care facility. So it possesses the poten􀆟 al to be an alterna􀆟 ve solu􀆟 on to sodium chloride. TW is recommended for superfi cial wound dressing because of less life-threatening and most common in use. As TW dressing is safe, it may introduce to nursing implica􀆟 on. Community nurse may perform TW dressing in homecare and may educate pa􀆟 ents’ to do TW dressing by themselves. The community geriatric assessment team may educate old age home staff s to perform TW dressing. Advanced prac􀆟 ce nurses (APNs) may act as leaders of the evidence-based prac􀆟 ce team and help formulate guidelines. In addi􀆟 on, the APNs may develop a TW dressing commi􀆩 ee for promo􀆟 ng TW dressing through nursing conferences. To kick off the nursing implica􀆟 ons, some prac􀆟 ce change plans should include, such as holding TW dressing workshop, developing TW dressing guidelines, and se􀆫 ng up a commi􀆩 ee of TW dressing. Reference: 1 Fernandez R., Griffi ths R. (2012). Water for wound cleansing. Cochrane Database of Systema􀆟 c Reviews. (2): 1-30. 2. Weiss EA, Oldham G, Lin M, Foster T, Quinn JV. (2013) Water is a safe and eff ec􀆟 ve alterna􀆟 ve to sterile normal saline for wound irriga􀆟 on prior to suturing: a prospec􀆟 ve, double-blind, randomised, controlled clinical trial. BMJ Open, (3): 1-7. 3. Zamani M, Panah FS,Esmailian M, Azizkhani R., Yoosefi an Z, Soltani M. (2015). Eff ects of irriga􀆟 on with diff erent solu􀆟 on on Incidence of Wound Infec􀆟 on. Iranian Journal of Emergency Medicine. (2):64-69. 4. Chan MC, Cheung K, Leung P. (2016). Tap Water Versus Sterile Normal Saline in Wound Swabbing: A Double-Blind Randomized Controlled Trial. Journal of Wound, Ostomy and Con􀆟 nence Nursing. 43 (2):140-147.

Menopause is an intermediate period between young adulthood and elderly adulthood. The crisis that women with menopause are facing includes physical and career developing stagna􀆟 on, pressure of educa􀆟 ng children, imbalanced rela􀆟 onship in the marriage, and confusion of self-iden􀆟 ty. The signs of menopause are listed as the followings: 1. personal life, environment, condi􀆟 on or ac􀆟 vi􀆟 es start changing. 2.Herself appeals some signs of behavior, thinking, and emo􀆟 on regarding the changes in life. 3. interac􀆟 on with the environment is shown in personal changing process. This ar􀆟 cle uses the analysis steps of Walker and Avant to describe the defi ni􀆟 onal features of intermediate period, case report, the causes and the results, and measuring tools of menopause symptoms. Given with this ar􀆟 cle, nurses can increase the knowledge of menopause intermediate period to help women to go through this period of their lives. References: 1. Sobel R. (1996). Moods: A menopause polemic.Maturitas. 24:125-127. 2. Goossens E, Hilderson D, Moons P. (2012). Coaching through transi􀆟 on: A challenge for cri􀆟 cal care nurses. Australian Cri􀆟 cal Care. 25:1-2. 3. Schumacher KL, Meleis AI. (1994). Transi􀆟 ons:A central concept in nursing. Image-The Journal of Nursing Scholarship.26:119-127. 4. Chick N, Meleis AI. (1986). Transi􀆟 on: A nursing concern. In P. L. Chinn (Ed.), Nursing research methodology: Issue an dimplementa􀆟 on. 237-257. Rockville, MD:Aspen Publishing.

Problem: In order to achieve good therapeu􀆟 c eff ect of swallowing, we fi nd that the obstruc􀆟 on factors of swallowing treatment are oral residual sputum and neglect oral hygiene. Before treatment, oral care can not only improve oral hygiene and remove sputum, but also improve oral sense, dry mouth and saliva Flow, and thus promote appe􀆟 te. Purpose: To improve the eff ec􀆟 ve of oral hygiene of hospitalized stroke dysphagia pa􀆟 ent, and to evaluate the eff ect of oral hygiene care program on stroke swallowing therapy. Methods: This study intends to adopt Randomized Clinical Trials (RCT), using purposive sampling at a teaching hospital in northern Taiwan, and choosing adults 50 years or older as the subjects in two rehabilita􀆟 on wards. This sample will then be randomly divided people into experimental group (n=30) and control group (n=30). In the control group, providing original swallowing treatment and health educa􀆟 on for pa􀆟 ent. The experimental group was added oral care program before the swallowing treatment. To evaluate swallowing func􀆟 on for hospitalized stroke swallowing therapy pa􀆟 ent by swallowing frequency and func􀆟 onal oral intake scale. Result: A􀅌 er oral hygiene care program for three weeks(21 days), swallowing frequency improved signifi cantly in the interven􀆟 on group, compared to the control group (p < 0.05). A􀅌 er oral hygiene care program for two weeks(14days) and three weeks(21 days), all of which has signifi cant improvement in func􀆟 onal oral intake(p < 0.05). Conclusion: The use of oral hygiene care program can improve the eff ec􀆟 veness of original swallowing treatment. Reference: 1. Arnold, M., Liesirova, K., Broeg-Morvay, A., Meisterernst, J., Schlager, M., Mono, M.L., and H. Sarikaya, 2016. Dysphagia in Acute Stroke: Incidence, Burden and Impact on Clinical Outcome. PLoS ONE, 11: e0148424. 2. Chipps, E. Gatens, C. Gnter, L. Musto, M. Dbis-Bohn, A. Gliemmo, M. Dudley, K.Holloman, C. Hoet, A. E.and T. Landers, 2014. Pilot study of an oral care protocol on poststroke survivors. Rehabilita􀆟 on Nurse, 39: 294-304. 3. Crary, M.A. Mann, G.D. and M.E. Groher, 2005. Ini􀆟 al psychometric assessment of afunc􀆟 onal oral intake scale for dysphagia in stroke pa􀆟 ents. Archives of Physical Medicine and Rehabilita􀆟 on, 86: 1516-1520. 4. Huang, K. L. Liu, T. Y. Hang, Y. C. Leong, C. P. Ln, W. C. and Y. P. Pong, 2014. Func􀆟 onal outcome in acute stroke pa􀆟 ents with oropharyngeal Dysphagia a􀅌 er swallowing therapy. Journal of Stroke & Cerebrovascular Diseases, 23: 2547-2553. 5. Kim, E.K. Park, E.Y. Sa Gong, J.W. Jang, S.H. Choi, Y.H. and HK. Lee, 2016. Las􀆟 ng eff ect of an oral hygiene care program for pa􀆟 ents with stroke during in-hospital rehabilita􀆟 on: a randomized single-center clinical trial. Disability Rehabilita􀆟 on, 15: 1-6. 6. Yu, P. Fu, Q. Shi, J. Tao, W. Pang, H. Cen, X. and X. Liu, 2016. Eff ects of Diff erent Levels of Caregiver Training on Oral Hygiene A􀅌 er Stroke. Journal of the American Geriatrics Society, 64: 1335-1140.

In Taiwanese nursing homes, the use of physical restraints on residents as a protec􀆟 ve measure is fairly common. However, physical restraints can be seen as a viola􀆟 on of human rights, and there is no guarantee of the eff ec􀆟 veness or safety of such physical restraints. Scholars from around the world have been strongly advoca􀆟 ng restraint-free care in long-term care ins􀆟 tu􀆟 ons. Therefore, the aim of this study was to evaluate the eff ec􀆟 veness of a mul􀆟 factorial interven􀆟 on for care providers to reduce physical restraints in nursing homes. Method: A cluster randomized controlled trial was conducted using pretest-pos􀆩 est control group design. A purposive sampling of par􀆟 cipants was chosen from care providers of 4 nursing home ins􀆟 tu􀆟 ons in Taiwan (n= 67), who were then randomly assigned to the experimental group (2 nursing homes, n= 33) or the control group (2 nursing homes, n= 34). The experimental group underwent mul􀆟 factorial interven􀆟 ons to reduce physical restraint (including developing rou􀆟 nes for physical restraint, promo􀆟 ng ins􀆟 tu􀆟 onal policies to reduce the use of physical restraint, developing alterna􀆟 ve methods, educa􀆟 on, and consulta􀆟 ons). Results: Care providers in the experimental group showed signifi cant improvements in knowledge (p < .01), a􀆫 tude (p < .05), and observed behavior (p < .05) pos􀆩 est. Conclusion: Mul􀆟 factorial interven􀆟 ons to reduce physical restraint are eff ec􀆟 ve in improving the knowledge, a􀆫 tude, and behavior of longterm care providers. Future implementa􀆟 on into clinical prac􀆟 ce could improve the quality of nursing care. Reference: 1. Gulpers, M. J. M., M. H. C. Bleijlevens, E. Capezu􀆟 , E. V. Rossum, T. Ambergen and J. P. H. Hamers, 2012. Preven􀆟 ng belt restraint use in newly admi􀆩 ed residents in Nursing Homes: a quasi-experimental study. Int. J. Nurs. Stud., 49: 1473-1479 2. Gulpers, M. J. M., M. H. C. Bleijlevens, T. Ambergen, E. Capezu􀆟 , E. V. Rossum and J. P. H. Hamers, 2013. Reduc􀆟 on of belt restraint use: Long-term eff ects of the EXBELT interven􀆟 on. J. Am. Geriatr Soc., 61: 107-112 3. Huang, H. C., Y. T. Huang, K. C. Lin and Y. F. Kuo, 2014. Risk factors associated with physical restraints in residen􀆟 al aged care facili􀆟 es: a community- based epidemiological survey in Taiwan. J. Adv. Nurs., 70: 130-143 4. McCann, T. V., J. Baird and E. Muir-Cochrane, 2014. A􀆫 tudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpa􀆟 ent units. B. M. C. Psychiatry., 14: h􀆩 p://www.biomedcentral. com/1471-244X/14/80 5. Testad, I., T. E. Mekki, O. Førland, C. Øye, E. M. Tveit, F. Jacobsen and Ø. Kirkevold, 2016. Modeling and evalua􀆟 ng evidence-based con􀆟 nuing educa􀆟 on program in nursing home demen􀆟 a care (MEDCED)—training of care home staff to reduce use of restraint in care home residents with demen􀆟 a. A cluster randomized controlled trial. Int. J. Geriatr. Psychiatry., 31: 24-32