Item

Pre-

test

Post-

test

Improvement

rate

1. Evaluating and managing rejection in transplant patients

Able to examine rashes, desquamation, or swelling in the transplanted arm

78.9%

100%

↑21.1%

Able to evaluate urine volume and color changes in patients

21.1%

100%

↑78.9%

Able to identify possible inflammatory markers and liver and kidney abnormalities in a blood test

15.8%

89.5%

↑73.7%

Able to monitor vital signs in patients

78.9%

100%

↑21.1%

Able to immediately inform the chief physician or attending physician

89.5%

100%

↑10.5%

Able to correctly select photographs of rejection phenomena

89.5%

100%

↑10.5%

2. Identifying and managing transplanted arm and abnormalities

Able to use ear thermometer to measure arm temperature and determine whether remonitoring must be carried out; the chief physician or attending physician must be notified if the temperature difference is ± 2 ℃.

100%

100%

0%

Able to evaluate transplanted arm color, state normal skin color, and immediately inform the chief physician or attending physician if there is a color change, e.g., reddening is an abnormality, pallor indicates possible arterial obstruction, and a purplish-black color change may indicate venous obstruction.

78.9%

89.5%

↑10.6%

Able to use blood-oxygen monitor to measure transplanted-arm blood-oxygen concentration; the chief physician or attending physician must be notified if the blood oxygen decreases and differs from the contralateral limb.

42.1%

100%

↑57.9%

Able to evaluate transplanted-arm elasticity and capillary-filling time via palpation, state that normal elasticity is present and normal capillary-filling time is 2–3 seconds; the chief physician or attending physician must be notified if there is any abnormality.

89.5%

100%

↑10.5%

Able to correctly identify possible conditions if the temperature of the transplanted arm falls from 36℃ to 30℃, the skin color becomes pale, and the blood-oxygen concentration decreases from 99% to 89%.

63.2%

100%

↑36.8%

3. Anti-rejection drugs

Able to correctly match drug cards to drug names

52.6%

100%

↑47.4%

Able to state the administration time for the anti-rejection drug Prograf and that it should be taken on an empty stomach or after meals

73.7%

100%

↑26.3%

Able to state the administration time for the anti-rejection drug Cellcept and that it should be taken on an empty stomach or after meals

73.7%

100%

↑26.3%

Able to state the administration time for the anti-rejection drug Prednisolone

84.2%

100%

↑15.8%

Able to state the side effects of the anti-rejection drug Prograf

26.3%

94.7%

↑68.4%

Able to state the side effects of the anti-rejection drug Cellcept

15.8%

100%

↑84.2%

Able to state the administration time for the anti-rejection drug Prednisolone

73.7%

100%

↑26.3%

4. Hand-transplant patient ward and material preparation

Able to state the protective-isolation measures used in a single-bed ward

100%

100%

0%

Able to state that all materials used in the ward must be wiped twice with 0.06% bleach

42.1%

94.7%

↑52.6%

Able to state that all materials used in the ward must be irradiated with an ultraviolet lamp for at least 6 hours

89.5%

94.7%

↑5.2%

Able to state the materials needed in the ward

78.9%

100%

↑21.1%

Able to state that an isolation trolley (containing a surgical cap, surgical mask, sterile surgical gown, clean gloves, and hand sanitizer) must be placed at the entrance of the ward

89.5%

100%

↑10.5%

Able to state that a used-clothes bucket (for collecting surgical gowns) must be placed at the entrance of the ward

84.2%

100%

↑15.8%

Able to state that a dustproof mat must be placed at the entrance of the ward (and changed daily)

94.7%

94.7%

0%

Able to put on infection-control equipment correctly before entering the hand-transplantation ward

78.9%

100%

↑21.1%

5. Hand-transplant patient diet preparation and health education

Able to state that several 1000 ml sterile distilled-water bottles must be provided

78.9%

100%

↑21.1%

Able to state that assistance is required to order intra-hospital meals for transplantation patients. After the physician has determined that the patient can consume outside food, health education must be carried out to ensure that raw food, unpeeled fruits, and unboiled water are avoided. As the patient is taking anti-rejection drugs, s/he cannot consume grapefruit. Outside food must be microwaved for 1 minute before consumption.

68.4%

100%

↑31.6%

6. Dressing change for the transplantation wound

Able to correctly prepare the materials required for a dressing change for a hand-transplant patient

10.5%

84.2%

↑73.7%

Mean accuracy

67.7%

98.0%

30.3%