Kee-Hsin Chen

Taipei Medical University | TMU · College of Nursing

Purpose: This study aimed to evaluate the efficacy of high-frequency chest wall oscillation for sputum expectoration and hospital length of stay in patients with acute exacerbations of chronic obstructive pulmonary disease. The improvements in pulmonary function and oxygenation were also investigated. Patients and methods: This systematic review...

Network meta‐analysis (NMA) compares effectiveness and/or safety of several interventions by combining both direct comparisons of interventions and indirect comparisons across trials based on a common comparator. In real word practice, NMA has become an increasingly popular and influence tool used for decision making on clinical effectiveness and c...

Aims: To evaluate the effectiveness of the cold intervention on relieving migraine symptoms among adult patients with migraine. Designs: A systematic review and meta-analysis of randomised controlled trials (RCT) and non-RCT studies were performed. Data sources: We searched five electronic databases including Cochrane Library and Cochrane CENT...

Background: Delirium remains significantly undetected in the intensive care unit (ICU). Little is known regarding the level of delirium care knowledge among critical care nurses in Taiwan. Purpose: This study was designed to investigate the level of knowledge about delirium care among critical care nurses using a multiple-choice question quiz....

Objectives Breathlessness is common among terminally ill patients with cardiorespiratory disease or cancer. The experience may induce secondary physiological and behavioral responses that limit patient well-being and independence and cause emotional distress. Methods We conducted a meta-analysis on randomized controlled trials (RCTs) that examined...

(Can J Anesth/J Can Anesth. 2021;68:137–147) Cricoid pressure (CP) is used during induction of anesthesia to minimize the risk of pulmonary aspiration in high-risk patients. CP compresses the cricoid cartilage and occludes the esophagus, and prevents gastric insufflation during mask ventilation. There is not clear agreement on the effectiveness or...

Background: Total serum bilirubin (TSB) is used in managing neonates with jaundice, but clear evidence on its association with major outcomes is lacking. Objectives: We evaluated the association between TSB and kernicterus spectrum disorder (KSD). Methods: We searched PubMed, EMBASE, and CENTRAL till July 2021. Two authors independently select...

Objective Needle procedures are the most common source of pain, anxiety, and fear among children. A combination of a cooling ice-pack and/or a vibrating motor for pain management in children has been evaluated in trials, but their overall effects await a synthesis of the available evidence. Method Comprehensive search was conducted using Cochrane,...

Sarcopenia is a disease of gradual loss of muscle mass in elderly people, and the most common treatment options include nutritional supplementation and exercise. Vitamin D has potential beneficial effects for skeletal muscle tissue and has often been included in nutritional therapy formulations. However, the therapeutic effect of vitamin D for the...

Purpose of this letter was to explore the trends regarding methodological flaws of systematic review and meta-analyses (SRMAs) based on retraction notes in the past decades, and the categories of reasons for the retractions. Content analysis with descriptive statistics, Cochran Q test, and multinomial logistic regression were used. Based on 187 rec...

Background Postoperative delirium is the most common complication of surgery particularly in older patients. Aims The current study aimed to summarize the commonly used delirium assessment tools in assessing postoperative delirium (POD) and to estimate the incidence rates of POD. Methods A systematic review that included empirical cohort studies...

Background Sialorrhea often happens in patients with neurologic disorders, and botulinum toxin (BoNT) which inhibits acetylcholine activating may be an effective treatment for drooling. This systematic review and meta-analysis of randomized control trials (RCTs) aim to evaluate the efficacy and safety of BoNT in adults and children with sialorrhea...

Aims To evaluate the effects of a simulation-based education programme on critical care nurses’ knowledge, confidence, competence and clinical performance in providing delirium care. Design Single-blinded randomized controlled trial. Methods Registered nurses who work in intensive care units were recruited from a university-affiliated acute major...

Background Burn injuries may have both physiological and psychological consequences. Numerous studies have reported the use of music therapy during burn injury treatment, but the optimal timing for music therapy remains unclear. Therefore, we performed a systematic review and meta-analysis of randomized controlled trials on patients with burn injur...

Background: This study formulated clinical guidelines for assessing nasogastric tube placement and for health education guidance according to evidence-based recommendations. Method: This study used a single group, pre- and postintervention design. Purposive sampling was used to recruit participants from nursing institutions in Taiwan. Results:...

Background: Research about skin-to-skin care (SSC) experiences in early period after birth has focused on mothers and infants. Purpose: The purpose of this study was to determine the outcomes of paternal skin-to-skin care (P-SSC) in both fathers and infants. Methods: The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed/MEDLINE,...

This meta-analysis aimed at investigating the impact of oral vitamin C supplementation on the post-procedural recovery of orthopedic patients, including functional outcomes and complex regional pain syndrome type I (CRPS I). Literature search using the Medline, Cochrane Library, and Embase databases from inception till March 2021 identified seven e...

Aims To systematically summarize and quantify the effects of foot reflexology on improvements in sleep disturbances. Design Systematic review and meta‐analysis. Data sources Datasets including PubMed, Web of Science, Scopus, EMBASE, Cochrane Library, Google Scholar, CINAHL and two Chinese electronic databases (i.e., AiritiLibrary and China Nation...

Background Lack of evidence regarding whether a useful examination instrument such as an multiple choice question (MCQ) quiz is reliable for assessing delirium care knowledge. Aims and objectives To develop and psychometrically test a MCQ‐based quiz for assessing the delirium care knowledge of critical care nurses. Design Instrument development a...

Background: The second stage of labor begins with complete dilatation of the cervix until delivery of the fetus. After the cervix has fully dilated, the caregiver/nurse will provide guidance to the mother regarding the push technique for delivering the fetus (immediate pushing, IP). Because some women receive analgesic medications during labor, th...

Background Delirium is associated with serious adverse health outcomes, particularly increased intensive care unit (ICU) stay and mortality rate. Critical care nurses lack sufficient knowledge about delirium and it remains undetected and poorly managed. Aim In this protocol, the development, implementation and evaluation of the INDICATION (INnovat...

Study objective An estimated 80% of older people undergoing surgery develop postoperative delirium (POD) making them a high-risk group. Research in this area is growing fast but there is no established consensus on strategies for POD prevention or management. A systematic review and meta-analysis were conducted to synthesise data on clinical interv...

PurposeThis meta-analysis aimed to assess the impact of cricoid pressure (CP) application on intubation outcomes.SourceElectronic databases (i.e., MEDLINE, PubMed, Embase, and Cochrane review) were searched from inception to 2 June 2020 for randomized-controlled trials that assessed the intubation outcomes in adult patients using laryngoscopic appr...

Because the analgesic effect of vitamin C against acute pain remains poorly addressed, this meta-analysis aimed at investigating its effectiveness against acute postoperative pain. A total of seven randomized controlled trials with placebo/normal controls were identified from PubMed, Cochrane Library, Medline, Google Scholar, and Embase databases....

Objectives: The objective of the study is to evaluate the therapeutic effect of hyoscine N-butylbromide (HBB) in active phase of labor and its safety to mother and fetus. Methods: A systematic literature search was conducted on Cochrane Library, Pubmed, EMBASE, CINAHL, ClinicalTrials.gov and three databases in Chinese up to March 31, 2020. Rando...

Background: Inhaled hypertonic saline (HS) has shown benefit in decreasing airway edema in acute bronchiolitis which is the most common lower respiratory infection resulting in dyspnea among infants under 2 years old. The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of HS in the implementation of treatmen...

Background: Critical care nurses are in the best position to detect and monitor delirium in critically ill patients. Therefore, an optimum delirium assessment tool with strong evidence should be identified with critical care nurses to perform in the daily assessment. Aim: To evaluate and compare the diagnostic performance of delirium assessment...

Background Hemoptysis, a common symptom of different lung diseases, engenders shortness of breath and increased mortality. Tranexamic acid (TXA), a commonly used antifibrinolytic agent, can control bleeding. However, the effects of its use on pulmonary hemorrhage have rarely been discussed.Objective We conducted this systematic review and meta-anal...

Introduction: Acute bronchiolitis is the most common lower respiratory infection in children. It is particularly prone to dyspnea among children under two years old. Inhaled hypertonic saline (HS) has recently been shown to be a favorable therapy, because of its facility to draw fluid from the submucosa and adventitial spaces, decreasing airway ede...

Objectives: To review and examine the evidence on diagnostic test accuracy of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) for predicting delirium risk in critically ill patients. Research methodology: This meta-analysis included studies reporting the diagnostic performance of PRE-DELIRIC between 2012 and 2019. The Cochrane Library, MEDL...

Background: Research findings based on patient-important outcomes (PIOs) provide more useful conclusions than those that are based on surrogate outcomes. It is unclear to what extent PIOs are represented in neonatal randomized controlled trials (RCTs). Objectives: We determined the proportion of PIOs in neonatal RCTs included in Cochrane Neonata...

1.本手冊的編寫主要參考2004 年由中央健康保險局、財團法人國家衛生研究院、財團法人醫院評鑑暨醫療品質策進會所編寫的「臨床診療指引發展手冊」，以及當今國際間各主要臨床指引發展先進國家規範之臨床指引發展步驟，並邀請國內專家以德菲法共識程序、焦點團體及專家訪談等步驟制定而成，期能適用國內臨床指引發展、更新或應用之情境。 2. 本手冊所揭之操作流程，係供任何對臨床指引發展有興趣之單位參考，指引發展單位可能為政府主管機關、醫療專業團體／機構、或是病人團體等。 3. 本手冊實際運用上，不宜過於拘泥制式標準程序，致欠缺執行之彈性，各章節內容及有關方法學之建議可視發展當時之實際情形，因時因地制宜、並述明。 4. 礙於台灣對於指引發展、更新及推廣之權責單位尚無共識，本手冊內容以指引發展之流程及方法學之介紹...

Shared decision making (SDM) has been advocated in Taiwan since 2016, and medical institutions have begun to engage in SDM promotion and patient decision aid (PDA) implementation. However, the effectiveness of SDM implementation has not yet to be systematically assessed. We conducted a focus group interview with patients with chronic kidney disease...

Background: Delirium is hard to be detected and diagnosed in the intensive care unit (ICU) settings. Delirium prediction model (PREdiction of DELIRium in ICu patients, PRE-DELIRIC) was developed to assist critical healthcare professionals to predict delirium effectively. This study aimed to evaluate the predictive accuracy of the PRE-DELIRIC model....

Background: The introduction of Neonatology as a subspecialty in 1960 has stimulated an enormous amount of neonatal research. A large proportion of neonatal randomized-controlled trials (RCTs) have been included in the Cochrane reviews, within which methodological quality or risk-of-bias (ROB) assessment is an integral feature. Objectives: We de...

Aims: To evaluate and compare the diagnostic performance of the confusion assessment method for the intensive care unit (CAM-ICU) and the intensive care delirium screening checklist (ICDSC) in diagnosing delirium in critically ill patients. Methods: PubMed, Embase, CINAHL databases were searched for studies published in English or Mandarin up to De...

Background Post‐operative complications after anti‐tumour necrosis agent treatment for Crohn's disease (CD) have been analysed with conflicting results. Aim To assess the effects of pre‐operative anti‐tumour necrosis factor (TNF) therapy on post‐operative complications within 30 days post‐operatively in patients with CD undergoing abdominal surger...

25 位完成問卷填答，平均年齡 39 歲。結果顯示，此培訓模式能提升實證實務能力 認知及自我效能；所有組別完成實證護理前三步驟之口頭報告，成果通過刊登於專業研討會。 結論： 透過產業及學界師資結合之培訓課程，能有效的提升護理人員對實證實務能力認知、自 我效能與實務能力，亦提升學員對實證護理問問題、資料搜尋及嚴格評讀文獻的成果展現能力。

Sir William Osler established the first journal club (JC) at McGill University in 1875. The main purpose of the JC is to appraise the recent scientific literatures and promote clinical application. In clinical work, periodical JCs can promote the process of knowledge translation. The aims of this study were to explore the effect on competencies of...

Background Meta-analysis is often regarded as one of the best sources of evidence for clinical nurses due to its rigorous design and scientific reflection of the true results of nursing interventions. The quality of a meta-analysis is critical to the work of clinical decision-makers. Therefore, the objective of this study was to use the JBI guideli...

PRISMA 2009 checklist. (DOC)

PurposeThe purpose of our study is to carry out a Bayesian network meta-analysis comparing the efficacy of different antimicrobial lock solutions (ALS) for prevention of catheter-related infections (CRI) in patients with hemodialysis (HD) and ranking these ALS for practical consideration. Methods We searched six electronic databases, earlier releva...

Background: Laser resurfacing is used to minimize wrinkles, solar scars, and sequelae of acne. Objective: Purpose of the systemic review was to compare resurfacing outcomes of CO2 laser and erbium: yttrium-aluminum-garnet (erb:YAG) laser therapies. Methods and materials: Medline, Cochrane, EMBASE, Google Scholar databases were searched until A...

In 1992, Gordon Guyatt coined the term "evidence-based medicine", which has since attracted worldwide attention. In 2007, the Institute of Medicine's Roundtable on Evidence-Based Medicine set the goal that 90% of clinical decisions would be supported by accurate, timely, and up-to-date clinical information and would reflect the best available evide...

Background: In 2014, the American Society of Clinical Oncology published an updated clinical practice guideline on axillary lymph node dissection (ALND) for early-stage breast cancer patients. However, these recommendations have been challenged because they were based on data from only one randomized controlled trial (RCT). We evaluated the ration...

Background: Directors of nursing (DONs) have an important influence in the dissemination of evidence-based practice (EBP) in hospital settings. The current study examined how the knowledge, skills, and behaviors of DONs changed when EBP was implemented during a 5-year, nationwide promotional campaign providing EBP-related information resources and...

Background: Postoperative pain resulting from surgical trauma is a significant challenge for healthcare providers. Opioid analgesics are commonly used to treat postoperative pain; however, these drugs are associated with a number of undesirable side effects. Objective: This systematic review and meta-analysis evaluated the effectiveness of acupu...

PRISMA Checklist. (DOC)

Introduction Catheter-related infection (CRI) is a difficult clinical problem in renal medicine, with blood stream infections occurring in up to 40% of patients with haemodialysis (HD) catheters, conferring significant rates of morbidity and mortality. Several approaches have been assessed as a means to prevent CRI. Currently, an intervention that...

Background and aims: Journal clubs (JCs) are well-recognized quality improvement strategy used by health practitioners to update relevant health literature. JC also used in the evidence-based practice (EBP) education of healthcare professionals. The aims of this study were to assess the effectiveness in promoting EBP education and multidisciplinary...

Background and aims: Smartphone applications (apps) are surging in popularity in everyday life. However, little is known about the effectiveness of integrating apps in healthcare professional education. This study investigated the perception and intention in using LINE apps, a common instant message app in Taiwan, during an evidence-based practice...

Although evidence-based practice (EBP) has been widely investigated, few studies have investigated its correlation with a clinical nursing ladder system. The current national study evaluates whether EBP implementation has been incorporated into the clinical ladder system. A cross-sectional questionnaire survey was conducted nationwide of registered...

Appendix S1. Questionnaire Survey.

Background Ventilator-associated pneumonia (VAP) is a very common nosocomial infection in intensive care units (ICUs). Ventilator-associated pneumonia occurs in a considerable proportion of patients undergoing mechanical ventilation and is associated with substantial morbidity, mortality, and excess cost. Therefore, strategies that effectively prev...

Background: Teaching Evidence-based practice (EBP) should be evaluated and guided by evidence of its own effectiveness. As educators implementing EBP training, they need instruments to evaluate the learning outcomes of trainees. For that reason, to develop a reliable and minimal time-consuming instrument is necessary. Purpose: The aim of this study...

Generally, the written feedback from each participant was generally positive (89%; 54/61). The participants reflected that feedback provided by facilitators immediately at the end of each station is a good way of measuring their improvements and gaining insights into areas which they needed to work on. Participants had gained and learned a lot when...

Objective: To evaluate the effectiveness of clinical pathways (CPs) for paediatric asthma on length of hospital stay, additional visits due to asthma exacerbations, hospital cost, manpower and workload required for implementing CPs. Methods: Studies were eligible if they met the following criteria: children (≦18 years) with asthma, hospital or e...

New graduates report intense stress during the transition from school to their first work settings. Managing this transition is important to reduce turnover rates. This study compared the effects of an externship program and a corporate-academic cooperation program on enhancing junior college students' nursing competence and retention rates in the...

Background Systematic reviews provide a synthesis of evidence for practitioners, for clinical practice guideline developers, and for those designing and justifying primary research. Having an up-to-date and comprehensive review is therefore important. Our main objective was to determine the recency of systematic reviews at the time of their publica...

Background Implementation of clinical practice guidelines (CPGs) can reduce medical practice variations and enhance effectiveness. In 2008, the Taiwan Department of Health delegated the development of CPGs on six health topics. By February 2010, these CPGs had been completed. Methods The Appraisal of Guidelines Research and Evaluation (AGREE) inst...

The aim of this study was to establish a scoring system, Neonatal Facial Image Scoring System (NFISS), for investigating the pain responses in neonates during routine venipuncture. We collected 1998 facial images from 19 infants during the first phase of this study and identified twelve features of the facial image: normalized scale for NFISS (scal...