1.

Nursing tenet and convictions Tenet Conviction

Introduction to the Nursing Department

To treat patients like family, innovate with professionalism and care for the community To develop the potential of nursing personnel and nurture their skills and ethics. To provide patient focused holistic nursing care

2. Organization Chart of the Nursing Department

Nursing chief of staff Chang Shu-Fen

Nursing deputy chief Yeh Jing-Yi Head nurse Huang Huei-Mei Emergency outpatient services Head nurse Xu Mei-Jian I.C.U., operating room, supply center, nursery room Head nurse Chen Xiu-Xia The first ward of the medical and surgical gynecology department Head nurse
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Zeng Zheng-Shu The 2nd and 9th private nursing home Head nurse Huang Xiu-Lan Respiration ICU The 3rd ward of the medical and surgical department Head nurse Lee Li-Chu The 5th ward of the medical and surgical department Head nurse Wu Se-Chu The 6th ward of the medical and surgical department The 7th ward of the medical and surgical department Head nurse Lin Su-Chu The 8th ward of the psychiatry department Head nurse Shi Yao-Ping The 11th ward of the psychiatry department The 10th ward of the psychiatry department Head nurse Wu Xia-Ling The 12th ward of the psychiatry department Head nurse You Man-Ling Downtown outpatient services Nursing attendants at each unit Caretaker Janitor Associate clerk

(1) Current staff: 221 members including the chief, the deputy chief,12 head nurses, 87 registered nurses, 25
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nurses, associate clerks, janitors and assistant personnel. 1Working seniority As of 12/31, 2006
Seniority Less than 1 year 1-5 years 5-10 years 10-15 years 15-20 years More than 20 years Total Number 26 42 27 19 3 9 126 Percentage 20.6 33.3 21.4 15.1 2.4 7.2 100 Remarks

3Education
Graduate University College Occupational Total school school 3 3 10 0 16

Nursing administrativ e staff Registered 1 3 nurse Nurse 0 0 Contracted 0 6 employee Hour based 0 2 employee Sub-total 4 14 Percentage 3.2% 11.1% 2 Budding Grade instructors

30 0 43 6 89 70.6%

1 9 7 2 19 15.1%

35 9 56 10 126 100%

3.Management and Responsibilities of the

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Nursing department
1 Major responsibilities
Management and major responsibilities Nur Per 1.Employment of nursing personnel sing son 2.Nursing type: Taking nursing workforce and patient specific needs into account, the hospital ad nel uses the participation nursing approach to attentively take care of patients according to min ma nursing principles of persistence and continuity. istr nag . atio em 3.Nursing personnel promotion: n ent 4.Shift arrangement Shift arrangement is made according to a decentralized or volunteer method in order to ensure fairness. 5.Performance evaluation: Based on personnel management regulations, a system has been established for objective and fair promotion, including working performance, seniority and an advancement system. 6.Tranfer and task allocation: 7.Welfare activities: To periodically hold various communal activities including local or overseas travel once or twice a year, to relieve working pressure. Four sections: administrative training, quality auditing, community nursing and nursing standards. Led by head nurses as section chiefs and deputy chiefs, meetings are routinely called to proceed with quality control. The organization structure and responsibilities are stated in the attached chart 2. Cat.

Nursing Q.C.

Cli nic nur

1. Nursing clinic responsibilities: conduct ward clinic nursing activities To engage in hospital discharge preparation:
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sing

Started at the general 1st ward in February, 2002 and extending to the whole hospital as of 2005.

Ed Pre- Pre-job training: Depending on the number of new uca job recruits, new recruit training is held at least twice a trai year. tion ning

al trai nin g

30 class hours every year. 1.Academic studies A. The hospital has laid down an annual educational training plan, which includes case studies and short term training classes. B. Monthly study reports or case studies are scheduled by each ward. C. Employees must attend related academic discourses and disquisitions outside the hospital. D. To non-periodically view nursing operations demonstrated by the related medical units 2. Skill training A. Regular conduct of CPR and firefighting tests on nursing colleagues. B. Regular conduct of a variety of nursing skills auditing. 3. Nursing personnel training held for each specific field: including training of intensive care nurses, hemodialysis technology, anesthetic nursing technology, respiration treatment technology, operating room nursing technology, psychiatry nursing, infection control nursing workshops and information workshop. According to the number required by each unit, the nursing personnel are to be sent for training in groups. Nurs Nursing Internship e inter nshi p To work on projects and conduct research training Res

Each nursing staff member shall accumulate at least

On-the-job training

erac h
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2Community Nursing: A community taskforce was

established in September, 2002. It promotes health care activities, e.g. group health education, medical rescue, health checks, nursing consultation, nutrition consultation and CPR training.

3Home Nursing ServicesIt has been set up as from

October, 2001.

4Nursing Home: It has been open since April, 2007

offering 67 nursing beds for paying patients. Chart 2Structure of nursing quality control
Nursing Department Quality Auditing Section 1. Infection control taskforce
4 3 2 1 ISO opinion survey 2. Patient taskforce 3. Nursing skill auditing taskforce 4. Accident investigation taskforce 5. Supply and improvement taskforce surveillance 5 4 3 2 1 3 2 1

1 2

Nursing Standard Section

1. Taskforce to manage and control raw material cost 2. Taskforce to institute standard technologies 3. Taskforce to institute nursing standards 4. Taskforce to regulate a variety of document formats 5.ISO documentation management taskforce

Administrative Training
1. Administrative section 2. Teaching and activity section 3. Nursing personnel welfare taskforce.

Community Nursing
1. Taskforce to prepare hospital discharge
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2.Home nursing taskforce

4. Welfare and Night Shift Allowance

1 Night shift allowance Midnight Contracted employees: $500/day in the beginning, and shift $700/day after 15 working days Regular employees: $300/day in the beginning, and $500/day after 15 working days. Night Contracted employees: $300/day in the beginning, and shift $500/day after 15 working days Regular employees: $200/day in the beginning, and $300/day after 15 working days Profession A raise is to be given to contracted employees who pass the advancement second year advancement N1$500/month allowance N2$1000/month N3$1500/month N4$2000/month Allowance $1000/month allowance for contracted employees stationed in for special critical disease wards. units Allowance $500/month allowance for each certificate is to be given to for staff with contracted ward service employees who have ACLS and ETTC special certificates, but the allowance shall be no more than certification $1,000/month in total for each employee. Seniority Contracted registered nurses or nurses, will be promoted one advancement grade each year according to their seniority at the medical center allowance with respect to salary at regional grade hospitals and regional hospitals. In the medical center, the maximum seniority is five years and three years at regional grade hospitals. The maximum seniority at regional hospitals is two years, and four years for personnel grouped in public posts. Others 1. To provide accommodations to nursing employees working away from home 2. Each unit provides a duty dormitory 3. A working outfit and a pair of shoes are provided each year for each employee. Nursing department recreation activities are held every year, which are subsidized from the nursing fund and by the hospital.
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4. Employees are encouraged to join the employees corporative

shop and bonuses are to be distributed with year end earnings.

5. Table of Profession Advancements

20 18 16 14 12 8 6 4 2 0 1 2 0 0 2 0 1 1 88 7 12 9 6 7 8 7 20 N1 N2 N3 N4

10

90

91

92

93

94

95
2 7

number of employees promotions 6. Awarded Work

1The Q.C. circle
Earned awards in the first Medical Quality Circle Competition sponsored by Yilan County Nurses Association in 2004.
Unit Circle name Topic Key speaker Prize Silver medal Bronze medal Nursing e- bliss baby To lower the incompletion rate of nursing Huang Xiu-Lan department circle guidance for knee joint replacement and one ward surgery. participating member Nursing Sound-speed To lower the incompletion rate of the Yang Wen-Hua, department circle nursing guidance for the patients discharged from emergency treatment Sun Jie-Fen and emergency ward participating members

 2005 1. Earned a medial bronze medal in the 6th Medical Quality Circle Demonstration and competition
Unit Circle name Topic
To lower the incompletion rate of the nursing guidance for knee joint replacement surgery

Circle leader Prize and circle members

Huang Xiu-Lan and one ward participating member Medical bronze medal

Nursing E- bliss baby department circle

2. Earned awards in the second Medical Quality Circle Competition sponsored by the Yilan County Nurses Association
Unit Circle Topic Key speaker Lieu Jing-Yi Prize Gold medal Psychiatry QA circle To lower the medicine taking irregularity department rate of bipolar disorder patients after Bronze medal Bronze medal

discharge from hospital Nursing Sound-speed To enhance emergency patient satisfaction Shen Jia-Yi, Lin department circle Nursing Blue angel department circle toward nursing staff To lower the loss rate of articles taken wards of the psychiatry department Wei-Jin Xu Qiu-Yen,

care of for patients in the chronic disease Chang Zhao-Ci

Earned awards in the third Medical Quality Circle Competition sponsored by the Yilan County Nurses Association in 2006
Circle name Topic Circle leader Key speaker Prize

Integrated 3C To lower the turnover rate of Huang Shi Yao-Ping, Jin Gold star circle YY circle Fall prevention
Shu-Ping new nursing employees Qian-Yi medal To lower a veteran hospital Pan Jia- Pan Jia-Yun, Lin Silver star

pressure sore rate To lower patient fall rate

Yun Chou Jin-Hua

Jin-Yi Lu Shu-Hua, Lin Wan-Yi

medal Bronze star medal

circle This year was a victory for the hospital as it won the top three prizes in the county!!

2Innovation of nursing supplies

The colonscopy inspection trousers developed at the downtown outpatient clinic were selected as excellent work in the demonstration
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and competition of innovative nursing supplies sponsored by the Yilan County Nurses Association in 2004, and it also won third place in the demonstration and competition of innovative nursing supplies sponsored by the National Union of nurses associations, R.O.C. The downtown outpatient clinic won second place in the demonstration and competition of innovative nursing supplies sponsored by the Nurses Association in 2005. Unit Works Invented by Prize nd Downtown Thoughtful trousers with Chen Ren-Wen, 2 place outpatient palpation inspection Lee Ching-Yen, clinic Mou ShowFeng, Zeng LiYun Won second place in the demonstration and competition of innovative nursing supplies sponsored by the Yilan County Nurses Association in 2006
Unit 1W 6W Work Anzhi chair F Hugged pillow Invented by Tsai Li-Huei, Huang Wen-Yu Yi-Yuan, Huang Qian-Yi Prize 2nd place 2nd place

2Administrative Projects and Case Reports

Approved Taiwan Nursing Association administrative projects in 2005 at an approval rate of 66.6% which was higher than the 34% achieved by the Association.
1 2 3 4

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 Approved Taiwan Nursing Association N3 case reports in May, 2006 in which 4 reports out of the applied five reports were approved
Item 1 2 3 4 Topic Author

A project to lower the incompletion rate of the nursingHuang Xiu-Lan, Jin Shu-Ping, guidance for knee joint replacement surgery Yeh Jin-Yi To lower the incompletion rate of the nursing guidanceYang Chun-Lian, You Man-Ling, for patients discharged from emergency treatment in a Chang Shu-Fen regional hospital. A project to lower the loss rate of executing doctorLee Li-Chu, Lee Xue-Hong, advice Chang Shu-Fen To improve the occurrence rate of having hazardousLin Su-Chu, Lin Jing-Jing articles enter the acute disease wards of psychiatry department

representing an approval rate of 80%. The topics of the approved case reports
are as follows:

Approved Taiwan Nursing Association N3 case reports in November, 2006 in which 3 out of the applied 5 reports were approved representing an approval rate of 60%. The following are the topics of the approved case reports.
Item 1 Topic Author

A home nursing experience in taking care of a patient who suffered from cervical vertebra injury 2 A nursing experience in taking care of a patient who had artificial hip joint replacement surgery Item Topic 3 A nursing experience in taking care of a medium 1 degree retarded patient A nursing experience in taking care of a patient who had a complex urinary tract infection after artificial anal surgery.
2

Huang Pao-Su Huang Wen-Yu

Author

Wu Xia-Ling Huang Qian-Yi

A full time nursing experience in taking care of a patient who had spine repair surgery.

Chou Jing-Hua

An intensive nursing experience in taking care of a patient who had an acute myocardial infarction seizure for the first time.

You Feng-Lan

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A home nursing experience in taking care of a stroke patient infected with scabies

Wu Yi-Zhen

Approved Taiwan Nursing Association N4 administration project reports in September, 2006 in which 2 out of the applied 5 reports were approved representing an approval rate of 40%. The following are the
topics of the approved administration projects:
Item 1 Topic Author

To lower the total weight of over weight patients in the chronic disease wards of a psychiatry department A project to enhance the pressure sore healing rate in the acute disease wards of a hospital department

Shi Yao-Ping, Ma WanZhen, Zhuang Shu-Jing Chen Xia-Xia, Wu XiaLing

4Research and Development

Tabulated on 11/8/2006

Item

Name of research project

Author

Released at

Released date
2/17/2004

Release Remarks d method

In writing Grade B

1 Investigation into the

Head nurse You 2004 Counseling factors influencing Man-Ling, Head Commission urinary tract infection of nurse Lee Li-Chu research project seriously paralyzed and Chief Chang publication patients in a regional Shu-Fen teaching hospital. Investigation into the Head nurse Chen The concept and living quality of long term Mao-Chang and measurement hospitalization Chief Chang section in 2004 chronically psychiatric Shu-Fen Living Quality patients and related Workshop factors Investigation into the Head nurse Chen Medical institute living quality of long term Mao-Chang and nursing research hospitalization Chief Chang and administration chronically psychiatric Shu-Fen project workshop patients and related sponsored by the factors Counseling Commission A study to evaluate the Registered nurse Medical institute project for the Lin Wan-Yi nursing research improvement of and administration respiratory infection in a project workshop regional teaching hospital sponsored by the Counseling Commission
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7/17/2004

Poster

P.67

9/16/2004 9/17/2004

Oral

P.1-37 Excellent

9/16/2004 9/17/2004

Oral

P.38

5 The effect of daily life

10 11

12

13

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The 1st disquisition 2/25/2005 Poster demonstration held by Psychiatric Mental Health Nurses Association The project to lower the Head nurse The 17th nursing 11/26/2005 Poster incompletion rate of Huang Xiu-Lan, project nursing guidance for Registered nurse demonstration knee joint replacement Jin Shu-Ping and surgery Deputy Chief Yeh Jing-Yi To lower the The 17th nursing 11/26/2005 In writing incompletion rate of Head nurse You project nursing guidance for Man-Ling, Nurse demonstration patients discharged from Yang Chun-Lien, the emergency treatment Chief Chang in a regional teaching Shu-Fen hospital. A project to lower the loss Head nurse Lee The 17th nursing 11/26/2005 In writing rate of executing doctor Li-Chu, project advice Registered nurse demonstration Lee Xue-Hong, and Chief Chang Shu-Fen A project to improve the Registered The 17th nursing 11/26/2005 Poster occurrence rate of having nurses Lin Jingproject hazardous articles enter Jing and Lin Sudemonstration the acute disease wards of Chu the psychiatry department The ritual and behavior Head nurse Wu Sheng-Mu Journal 07/2005 Periodical for the first month after Xia-Ling giving a birth Investigation into the Registered 2005 Counseling 95.05.02 In writing effect of partial pressure nurses Chen XiuCommission reduction conducted by a Xia, Lee Li-Chu research project regional teaching hospital and Chief Chang demonstration on the healing of pressure Shu-Fen sores To lower the total weight Registered The 18th nursing 9/15/2006 In writing of over weight patients nurses Shi Yao- project evaluation in the chronic disease Ping, Ma Wanwards of a psychiatry Zhen and Zhuang department Shu-Jing A project to enhance the Registered nurse The 18th nursing 9/15/2006 In writing pressure sore healing rate Chen Xiu-Xia, project evaluation of the hospitals acute and Head nurse disease wards Wu Xia-Ling A home nursing Registered nurse The third 04/28/2007 Posters experience in taking care Wu Yi-Zhen representative of a stroke patient and Deputy conference held in infected with scabies Chief Yeh Jingthe 5th year of Yi Taiwan Long-Term Registered nurse group training on self care Lin Su-Chu capacity of the patients with chronic disease
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P.53

P.39

62-66 Grade A

Care Professional Association

Total 14 cases

7. Major Responsibilities and Telephone Numbers of Each Unit in Nursing Department

Table 3 Telephone numbers of the nursing department of Yuanshan Veteran Hospital and its wards
Representative line (03)9222141-2

Nursing department and its special units Chief office Deputy office chief

extension

Medical and surgical wards

Extension

301 228

Ward Ward Ward Ward

1 2 3 5 6 9 of

320 314 315 316 309 221 Extension 310 311 11 312

Operation room Emergency outpatient services Medical and surgical ICU Respiration treatment wards Home nursing

304 305 335

Ward Ward

331

Wards psychiatry department Ward 8 Ward 10

250

Ward
15

Nursing home

321

Ward

12

313

E.mail address of the chief of nursing department chang9369 @

mail.ysvh.gov.tw E mail address of the deputy chief of nursing department ysvh1911@mail.ysvh.gov.tw

6. Activity Recap

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