Chin-Yi Huang

Changhua Christian Hospital, Chang-hua Pei-pu, Taiwan, Taiwan

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Publications (9)13.42 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Evidence-based practice is important to.clinical health care professionals. Clinical nurses can make informed decisions by applying the best evidence to their care. However, standardized curricula on evidence-based medicine are lacking in nursing education programs. This study evaluated a critical appraisal education program and assessed its value in increasing nurses' knowledge of critical appraisal and confidence in their critical appraisal skills. A controlled before-and-after study design was used. The education program integrated lectures,practice, and group discussion. A questionnaire was used to evaluate participants' knowledge and confidence in critical appraisal pre- and postintervention. Participants' knowledge and confidence in critical appraisal improved significantly postintervention(both p < .001 ). A 1-day, small group discussion education program can effectively improve nurses' knowledge and confidence in critical appraisal. Educators and administrators may replicate this education program to improve the quality of nursing care
    The Journal of Continuing Education in Nursing 01/2013; 44(1):43-8. · 0.71 Impact Factor
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    ABSTRACT: Paediatric patients with out-of-hospital cardiac arrest (OHCA) due to trauma pose difficult challenges in resuscitation. Trauma is a major cause of OHCA in children. The aim of this study was to determine which factors were related to predicting a sustained return of spontaneous circulation (ROSC) in paediatric OHCA patients with trauma. This retrospective study comprised 115 paediatric patients (56 traumatic and 59 non-traumatic OHCA patients) aged younger than 18 years who had been admitted to the emergency department (ED) from January 2000 to December 2004. We analysed the demographic data and the factors that may have influenced sustained ROSC in the group of OHCA paediatric patients with trauma. The non-trauma group was established as a control group. Survival analysis was used to compare differences in survival rate between trauma and non-trauma OHCA patients. Receiver operating characteristic (ROC) analysis was used to determine the significant in-hospital CPR duration related to sustained ROSC. Initial cardiac rhythm on arrival (P=0.005) and the duration of in-hospital CPR (P<0.001) were significant factors. Patients with PEA or VF had higher rate of sustained ROSC than those with asystole (PEA: P=0.003, VF: P=0.03). In the survival analysis, OHCA children with trauma had a lower chance of survival than non-trauma children as the interval from the scene to the ER increased (P=0.008). Based on the ROC analysis, the cut-off values of in-hospital CPR duration were 25min in OHCA paediatric patients with trauma. Several significant factors relating to sustained ROSC were determined in the OHCA paediatric patients with trauma; most importantly, we found that in-hospital CPR may have to be performed for at least 25min to enable a spontaneous circulation to return.
    Resuscitation 07/2007; 74(1):83-9. · 4.10 Impact Factor
  • Wei-Tai Huang, Chin-Yi Huang, Yung-Tai Chung
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    ABSTRACT: To compare the time taken for tracheal intubation, hemodynamic changes, and perioperative morbidities between the GlideScope (GS) video laryngoscope and the Trachlight (TL) with manual inline stabilization. Prospective, controlled, randomized study. Operating room. 60 ASA physical status I and II patients scheduled for elective surgery with general anesthesia. Patients were randomly assigned to the GS group or TL group (n = 30 for each group). Noninvasive blood pressure and heart rate at preinduction; preintubation and one, three, and 5 minutes after successful intubation; grade of face mask ventilation; number of intubation attempts; intubation time; apnea duration; mucosal trauma; lip or dental injury; and presence of hypoxia, were all recorded. The intubation attempts and perioperative safety data were comparable between the two groups. Intubation time and apnea duration were significantly shorter in the TL group than the GS group. All variables one minute after intubation were greater than baseline values except systolic blood pressure (SBP) in TL group. Both systolic blood pressure (SBP) and the degree of change of SBP from the baseline value one minute after intubation in TL group were significantly less than those of the GS group. Trachlight offers a faster intubation and a milder hemodynamic response than GS.
    Journal of Clinical Anesthesia 04/2007; 19(2):110-4. · 1.15 Impact Factor
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    ABSTRACT: Other acute abdominal diseases in children can confound the signs and symptoms of appendicitis, resulting in misdiagnosis and unnecessary appendectomy. In this study, we used discriminant analysis of serum inflammatory biomarkers to determine which acute abdominal diseases could mimic appendicitis, and further analyzed these diseases based on different age groups. We prospectively collected 417 patients aged from 4 to 18 years with clinically suspected acute appendicitis in the pediatric emergency department. We selected the significantly higher serum biomarkers for appendicitis as the discriminating variables. Furthermore, we analyzed the definitive diagnoses of patients with normal appendices who could not be predicted by discriminant analysis. Patients with acute appendicitis had significantly higher leukocyte counts (p < 0.01), neutrophil counts, (p < 0.01) and C-reactive protein concentrations (p < 0.01 ) than those with normal appendices. The discriminant power of these three serum biomarkers in acute appendicitis was 76 percent. Acute abdominal diseases which mimicked appendicitis included acute gastroenteritis, nonspecific abdominal pain, urinary tract infection, and upper respiratory infection with gastrointestinal upset. Serum biomarkers may serve as helpful discriminators to predict the presence of pediatric appendicitis. But, some acute abdominal diseases mimicking appendicitis should be considered during differential diagnosis of acute appendicitis to avoid making misdiagnosis and performing unnecessary appendectomy.
    Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi 01/2007; 48(3):125-30.
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    ABSTRACT: In the 21st Century, evidence-based nursing (EBN) may provide a mechanism by which nurses can manage the explosion in published information in the literature, introduce new techniques, effectively control healthcare costs, and increase attention on nursing quality and health outcomes. The objective of this paper is to share the experience implementing evidence-based nursing. We had applied strategies to implement evidence-based nursing care in our hospital since 2002. Over a more than three-year period (January 2002 to October 2005), we held 46 basic course sessions (around 1,840 attendees) and 58 advanced course sessions (around 500 attendees). There are 445 clinical questions with answered reports, Most questions related to foley care, central vein care and peripheral intravenous injection. Our nursing department revised three guidelines on nursing care skills related to suction and foley and nasal-gastric feeding to meet local conditions. Based on our subjective experience, promotion and implementation of EBN is feasible and helpful to update knowledge and decrease variance in clinical nursing care. However, further outcome research is needed in the future in order to obtain more objective evidence.
    Hu li za zhi The journal of nursing 11/2006; 53(5):52-7.
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    ABSTRACT: The aim of this prospective study was to determine whether the change between the initial and subsequent analysis of serum inflammatory markers measured 6 to 10 hours later could improve diagnostic accuracy in appendicitis. The study group comprised 225 patients who presented to hospital with equivocal signs of appendicitis from 2003 to 2004. Based on the period from the onset of symptoms to admission, receiver operating characteristic (ROC) curves were used to determine cutoff values of the changes between primary and repeated laboratory examinations in diagnosing appendicitis. ROC analysis showed that the cutoff values for the change in total percentage neutrophil count on the first day after onset of symptoms (3.2%), and a change of in CRP concentration above the baseline on the second day (9.5 mg/L) and the third day (17.0 mg/L) after onset of symptoms were significant parameters for diagnosing acute appendicitis. The cutoff values of the change in total neutrophil count on the first day after onset of symptoms and the change in CRP on the second and third days after onset of symptoms during in-hospital observation may serve as useful parameters to surgeons in differentiating acute appendicitis from other acute abdominal diseases.
    Surgery 07/2006; 139(6):789-96. · 3.37 Impact Factor
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    ABSTRACT: Dead-on-arrival (DOA) children pose difficult challenges in resuscitation because of the very low survival rate. In this study, we aimed to analyze the factors that may be related to predicting successful cardiopulmonary resuscitation (CPR). We reviewed the hospital records of 120 DOA children aged younger than 18 years who had been admitted to the emergency department (ED) from 2000 to 2004 and analyzed related factors that may have influenced initial CPR in the non-trauma DOA children. Survival analysis was used to compare differences in survival rate between the non-trauma and trauma DOA children. Receiver operating characteristic (ROC) analysis was used to determine the predictive in-hospital CPR duration related to success of initial CPR. We found the initial cardiac rhythm (P = 0.007), pre-hospital basic life support (BLS) (P < 0.001), mode of transportation (P = 0.019), the period from scene to hospital (P=0.025) and the duration of pre-hospital BLS (P = 0.003) were the significant factors related to initial successful CPR in non-trauma DOA children. Based on the ROC analysis, the cutoff value of in-hospital CPR duration was 23 minutes in non-trauma DOA children. We found that in-hospital CPR should be performed for at least 23 minutes in nontrauma DOA children for spontaneous circulation to return.
    Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi 01/2006; 47(6):278-83.
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    ABSTRACT: The purpose of this study is to survey the use of combination antipsychotic therapy (CAT) in the psychiatric outpatient clinic of a general hospital. Patients who received at least 2 antipsychotics in the psychiatric outpatient clinic of a general hospital in 1 month (August 1-31, 2003) were identified, and their retrospective chart review was performed. Using a questionnaire, we surveyed the clinicians on why 2 antipsychotics were prescribed, why long-term CAT was used, and whether the problems were solved by CAT. We studied 957 patients diagnosed with schizophrenia and related disorders in 1 month. A total of 119 patients (12%) were prescribed at least 2 antipsychotics. Among these 119 patients, 91 (76%) were prescribed 2 types of first-generation antipsychotics (FGAs), and 15 patients (16%) were prescribed a second-generation antipsychotic medication and a low-dose FGA medication. The clinicians' main reasons for CAT were to treat insomnia (84%) and psychotic symptoms (83%). The results of this study revealed that 12% of the patients received CAT in the clinical practice. Most patients were prescribed 2 FGAs. The clinicians' reasons for prescribing CAT in Taiwan were to treat insomnia and psychotic symptoms.
    Comprehensive Psychiatry 01/2006; 47(5):421-5. · 2.38 Impact Factor
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    ABSTRACT: Determining the different cutoff values of C-reactive protein (CRP) on the basis of how long the patient's symptoms were present can be used to early predict acute appendicitis. We analyzed retrospectively from 2001 to 2004 the hospital records of 568 patients who underwent appendectomies for suspected appendicitis. Receiver operating characteristic analysis has shown that CRP measurement can increase the diagnostic accuracy in acute appendicitis. The cutoff values of CRP concentration taken as the first, second, and third days after onset of symptoms that distinguish acute appendicitis from other acute abdominal diseases were 1.5, 4.0, and 10.5 mg/dL, respectively; the values that distinguish perforated appendicitis from other acute abdominal diseases were 3.3 mg/dL (first day), 8.5 mg/dL (second day), and 12.0 mg/dL (third day). The different cutoff values of CRP concentration may serve as a useful predictive parameter in the early diagnosis of acute appendicitis on the first 3 days after the onset of symptoms.
    American Journal of Emergency Medicine 08/2005; 23(4):449-53. · 1.70 Impact Factor