Objective: To enhance the implementation of the standards by publicizing and carrying out 3 hospital central sterile supply department standards in China. Methods: We took the effective measures of training, hospital accreditation or special inspection methods to publicize and carry out the standards. Results: The hospitals pay attention to disinfection and supply work,and the central sterile and supply department gradually implemented the standards. Conclusions:Publicizing and carrying out the standards could promote the development of disinfection supply professional.

Objective: To investigate the effects and problems of 3 professional standards implementation in Central Sterile Supply Department (CSSD) of the hospitals in Anhui province. Methods: The CSSD professional standards tracing evaluation questionnaire made by Hospital Infection Control Standard Committee of the Ministry of Health was used in the survey of 105 hospitals and the Departments of Public Health from 8 cities and 63 counties. Results: The main implementation of 3 standards by administrative department of health in 8 cities included making provisions on administration in the region, inspecting institutions based on the standards, and accepting it into the accreditation in hospital. They all organized relevant people to attend the provincial training program. Nosocomial infection and CSSD personnel accounted for the highest proportion (>90%), the second was staffs from health administrative sectors, administrative leaders in hospitals and staffs in nursing department (>80%).Sixty two hospitals obtained CSSD acceptance certificate issued by provincial Bureau of Health. Among of them, 98% CSSDs were newly built or expanded after 3 standards announced. But some problems existed, for example, the qualified CSSDs were insufficient to help surrounding medical institutions, which influenced the effects of 3 standards in advancing social management.CSSD centralized management, disposition of exotic instruments and mega-, excess medical devices needed further standard regulations. Conclusion: The CSSD centralized management ability should be expanded. The qualified CSSDs should play important roles in improving disinfection quality of primary medical organizations and preventing hospital infection, as well as promote the thoroughly implementation of 3 CSSD professional standards.

Objective: To explore the establishment of CSSD specialty personnel training program. Methods: Based on the overall arrangements of National Institute of Hospital Administration of National Health and Family Planning Commission of China (NHFPC), the training program was designed to provide theoretical (60%) and practical (40%) courses. After the training,the trainees would attend writing test and practical skill evaluation. Meanwhile, Q&A session about the training courses was provided to the participants. They were encouraged to write down their learning experiences, advices and comments to the training program. Those who passed the training test would get the CSSD Specialty Training Certificate and Continuous Education Points.Results: Among the trainees in 4 training sessions, 95.05% thought they had big achievements and 97.70% were satisfied with the training program. Conclusion: Nine Practice Training Bases for CSSD had been established by National Institute of Hospital Administration of NHFPC, where the backbone personnel from other CSSDs could visit and learn in the training bases. It would be helpful to promote the implementation of three national standards on CSSD, improve the overall qualities of specialized personnel,enhance the scientific, normalized, standardized and specialized management of CSSD through continuous improvements, and ultimately ensure patients' safety.

Objective: To explore the value and meaning of helping sterilization and supply work in primary hospitals of western area.Methods: We established sterilization and supply special committee and delivered professional training and conferences. Taking West China Hospital as representative, we converged the strength of hospitals with advanced management and abound resources to establish the training base of sterilization and supply. We implemented of a two-week national training programme and a one-week provincial training programme, The training included theoretical knowledge and operational skills training. We undertook a survey to explore the training effect and the performance and satisfaction before and after training had significant difference. Results: The establishment of the special sterilization and supply special committee marked the formation of the group. Through various forms of training and on-site guidance, the average score of theoretical knowledge improved from 76 before training to 88 after training. Two Greade hospitals standardized the hospital process and system and their satisfaction reached 96%. Conclusion: Regional differences cause an imbalance of sterilization and supply development. Various approaches of academic activities promote the improvement of the professional level and become the needs and trends of professional development. The establishment and delivery of the training base could enhance the overall professional level and central sterile supply management.

Objective: To explore centralized management of hospital supplies in Central Sterile Supply Department (CSSD).Methods: The system management, equipment classification management, information system management and processing flow of surgical instruments were enhanced in the CSSD. Results: The reusable instruments from all of the divisions in the hospital were intensively managed in the CSSD. The clinical needs were fully met. Conclusion: The improvement of the system, process and human resources management in the CSSD could realize centralized supply management in the hospital.

Objective: By using the CSSD-training workshops, to improve the ability of primary hospital CSSD's staff to deal with problems faced in the work, and to increase the service ability and work quality. Methods: According to the different requirements and situations of primary hospital CSSDs, diverse activities theme of CSSD-training workshops were designed and participants range were limited to stimulate staff's work enthusiasm and subjective initiative, then to find the solutions to problem altogether. Conclusion: The CSSD-training workshops could promote primary hospital staff's problem-solving capability. The workshop is an effective method to train and improve the work efficiency in primary hospital CSSDs.

Objective: To understand the stutus of humanistic care ability among vocational nursing students and to discuss its influencing factors, for the purpose of exploring ways to improve overall human care abilities. Methods: Totally 407 nursing students with 2012 enrollment from a vocational nursing school in Fujian were sampling in the survey. The survey used"humanistic care ability questionnaire". Results: The humanistic care ability of vocational nursing students was in the middle level with the average score of 125.39±16.30; The scores were highly influenced by gender, residence, specialty, relationship withpeers and the attitude toward nursing. Conclusion: The ability to provide humanistic care among vocational nursing students needs to be improved. Nursing education should be person-oriented and strategic. Nursing educators need to pay more attention on students with poor attitude and interpersonal skills when it comes to humanistic care ability learning and practice.

Objective: To investigate the current status and influencing factors of work adjustment disorder among reemployment nurses. Methods: Totally 74 reemployment nurses who worked in a tertiary Grade A hospital in Jiangsu province for over half a year were recruited and interviewed by the Work Adjustment Disorder Scale, Organizational Citizenship Behavior Scale, Nurse Stressors Scale, and Nurse Career Identity Scale. Results: The mean score of work adjustment disorder among reemployment nurses was (22.60±3.74). Multiple linear regression analysis showed that nurse working stressors and job-hopping frequency were the predictors of work adjustment disorder among reemployment nurses. Conclusion: Nursing managers should analyze the reasons of working stressors among reemployment nurses, take effective measures to reduce their stress, pay attention to cultivate reemployment nurses' satisfaction and loyalty to the hospital and decrease their job-hopping frequency.

Objective: To develop a specific Stroke Premonitory Symptoms Alert Questionnaire (SPSAQ) , and to test the validity and reliability of the scale. Methods: Totally 290 cases with stroke risk and their families were recruited using the convenience sampling method to test the internal consistency, face validity, content validity and discriminant validity of the questionnaire. We tested test-retest reliability of the questionnaire using a convenient sample of 96 cases with stroke risk and their families. Results: We finally got a 9 items of SPSAQ. The CVI, KR-20, and test-retest reliability of the SPSAQ was 0.84, 0.798 and 0.729, respectively. Items difficulty (P) and degree of differentiation (D) ranged from 0.63 to 0.86 and 0.24 to 0.75, respectively.Conclusions: SPSAQ has good reliability and validity which indicate the initial objective of the scale development.

Objective: To investigate the level and influencing factors of core competency of Critical Care Nurses in Changsha tertiary-A general hospitals, and to provide an evidence for clinical intervention and administration. Methods: Stratified random cluster sampling method was adopted to investigate 600 critical care nurses in 5 tertiary-A general hospitals in Changsha with Comprehensive Inventory of Core Competency for Critical Care Nurses. Results: The average score of the scale was 355.73±41.41 and the score of 6 dimensions ranked the last three were professional knowledge and skills (71.85±14.39), individual and professional development competence (62.39±17.93) and academic competence (47.36±18.63). Multiple linear regression analysis showed that department, working years and title were the main factors, which explains 31.5% variances. Conclusion:The level of core competency for critical care nurses in Changsha tertiary-A general hospitals is above medium, and the level of individual and professional development competence and academic competence is poor. Nursing administrators should take effective measures according to the influencing factors of core competency of Critical Care Nurses.

Objective: To examine the relationship between stigma and the quality of Life among convalescent schizophrenia patients, and to explore the mediating effect of social support and coping style between stigma and the quality of life. Methods:The perceived Devaluation-Discrimination Scale, Simplified Coping Style Questionnaire, Social Support Rating Scale, and the Schizophrenia Quality of Life Scale were used to investigate the convalescent schizophrenia patients. Results: Structural equation model fit index: χ2/df=1.673, GFI=0.950, AGFI=0.903, RMSEA=0.061. Stigma, social support and coping style among convalescent schizophrenia patients could predict the quality of life directly. Social support and coping style played a mediating role between stigma and the quality of life. Conclusions: Mental professionals should pay more attention to stigma effect on quality of life among convalescent schizophrenia patients in their clinical practice.Based on summarizing the different paths, we should improve the quality of life of the patients. by path- based intervention.

Patients with Alzheimer's disease may develop dysphagia along with the disease progression. The swallowing disorders can result in dehydration, malnutrition, infection, aspiration pneumonia and even death. Because of its high incidence and poor outcome, dysphagia in patients with Alzheimer's disease got more and more attention in recent years. The authors reviewed the nursing interventions of dysphagia in Alzheimer's disease patients. It can provide some reference for implementing comprehensive measures in clinical practice.

Objective: To explore the reasons for delay in seeking for mental health care in patients with geriatric depression.Method: An individual-deeply interview was conducted with 108 geriatric depressive patients; their help-seeking history was selfreported retrospectively. Content analysis was used to interpret the data. Result: The most frequently mentioned reason for delay in seeking for mental health care timely was lack of knowledge about depression (93.5%) and difficulty of identifying depression symptoms for non-psychiatric health care providers (91.4%). In addition, prejudice towards mental disease (60.5%) and being ignored or negatively treated by family member (21.1%) were also important barrier factors. Conclusion: The under diagnosis and under treatment of geriatric depression is a public health issue, which should be obtained more concern. The information of depressive disorder should be spread among older adults; and more training about knowledge and skills related to geriatric depression should also be strengthened for primary care providers.

Objective: To explore the sleep quality and its influencing factors of rural left-behind elderly in Hunan province.Methods: To investigate the sleep quality and it's influencing factors of the 566 rural left-behind elderly with Pittsburgh Sleep Quality Index (PSQI) and demographics. Results: The average score of PSQI of the 566 rural left-behind elderly was 7.50±3.81,42.1% elderlys had bad sleep quality. Female, illness within two weeks, and poor ADL skills are the main risk factors,while strong social support and children return are the positive factors. Conclusion: The overall sleep quality of rural left-behind elderly is poor and can be affected by social-psychological and physical factors. Various means should be taken to improve the overall sleep quality among the elderly.

Objective: To conduct experimental study to explore the effects of death education in nurses. Methods: A controlled study was performed in nurses of an Emergency Department to examine the effectiveness and feasibility of the death education curriculum plan. Results: After the education, the nurses in experimental group had lower scores in two domains,including fear of death, and death avoidance, and higher scores in natural acceptance and approach acceptation than that of control group. Conclusion: The curriculum could positively influence the death attitudes of nurses.

Objective: To analyze the schooling model of foreign-concerned nursing education in university of Chinese Medicine and to provide the reference for the construction of this specialty. Method: Questionnaire was developed based on the theoretical study, literature review and focus group panel meeting. Experts from 23 Schools of Nursing in the universities of Chinese Medicine were consulted. Result: The Competency of Standard for Bachelors in Nursing were developed, as well as the advice on curriculum design.Conclusion: In order to ensure the quality of education,the educational mission should be standardized, competency of undergraduate students should be defined, core curriculum should be added, language learning and practice ability should be consolidated and the ability of foreign-concerned nursing practice should be enhanced. This research may provide the comprehensive suggestions for schooling model development of this specialty.

Objective: To explore the mode of hospital and college joint orientation training of ICU nurses. Methods: A total of 280 college students in Department of Nursing in Henan Medical College for Staff and Workers from March 2011 to June 2013 were trained according to Hospital and College Joint Orientation Training Program for ICU Nurses. Results: By the hospital and college joint orientation training of ICU nurses, the mean scores of theory, clinical practice, and the patients' satisfaction was 95.74, 97.89, and 99.38 respectively. The incidence of nursing adverse events was 1.78%. Conclusion: Hospital and college joint orientation training of ICU nurses, which emphasizes early intervention, joint collaboration and practicing, achieves a significant effect and is feasible.

Objective: To improve qualified rate of inpatient emergent blood sample transportation and to ensure clinical nursing quality. Methods: We established Quality Control Circles to improve transportation link of inpatient emergent blood sample. Results: Qualified rate of inpatient emergent blood sample transportation significantly increased from 21.20% to 81.12%(P<0.001). Conclusions: Implementation of Quality Control Circles could motivate personnels' initiative, standardize working behavior, improve working quality and increase qualified rate of inpatient emergent blood sample transportation.

In this review, we have thoroughly described the concept of nursing identity, professional identity levels of nurses worldwide and its importance in clinical nursing. Moreover, there has been a detailed review and summary of measurement tools,influential factors and latest strategies on professional identity development, which might provide the theoretical basis for the Chinese nursing identity studies.

Objective: To investigate the effect of implementing nursing position management. Methods: Six tertiary hospitals in Xi'an were divided into control group and intervention group. The intervention group implemented nursing position management and the control group implemented the original management. The intervention effects were investigated and analyzed in five dimensions, including physician evaluation, nurse evaluation, patient evaluation, quality of care and utilization of inpatient services by assessment indicator system of nursing position management. Results: The score were all higher in the intervention group than that in the control group (P<0.05) after one year intervention.The entire evaluation of four dimensions of physician evaluation, nurse evaluation, quality of care, and utilization of inpatient services was carried out by difference in difference method. The results showed a significant effect of the implementation of nursing position management. Conclusion: It was conducive to improve the physician and nurse's recognition degree on nursing position. The patient satisfaction, care quality,and the utilization of inpatient services also improved.

Objective: To set up and evaluate the effectiveness of full time clinical assistant nurse in emergency joint clinic.Methods: We constructed the personnel allocation and responsibility of full time clinical assistant nurse in emergency joint clinic,and compared the average waiting time, adverse events rates, patient satisfaction, and clinic bed occupancy rate in ER in one year before and after implement. Results: The waiting time of grade III patients was shortened from 8.59±2.03 to 4.38±1.13 minutes,the adverse events rates was reduced by 36 cases, patient satisfaction was increased from 90.67% to 97.00%, clinic bed occupancy rate was fell from 1.13% to 0.92%, the differences were all statistically significant (P<0.05). Conclusion: The implement of full time clinical assistant nurse can optimize emergency medical order, facilitate dynamic observation of emergency patients, find condition change in time and ensure the safety of patients.

Objective: To analyze the probability and characteristics of occurrence of the near miss for the identification of hospitalized patients with venous transfusion. Methods: We collected the data from the information system about the the probability of occurrence of the near miss for the identification of hospitalized patients with venous transfusion in 2013 and calculated the difference among the operating nurses of different ages, educational backgrounds, job titles, departments and shifts. Results: The probability of occurrence of the near miss for the identification of hospitalized patients with venous transfusion was 0.320‰. The probability of occurrence of the near miss among nurses of different ages, educational backgrounds and job titles had no significant difference, however, the probalility among nurses of different departments and shifts had significant statistical difference. Conclusion: Double-check process management, the identity confirmation management in night shift, and popularization of a hand-held terminal bed check system should be strengthened in the departments of high probability of occurrence of near miss.

Objective: To explore the practice effects of aggressive behavior management under Joint Commission International (JCI) standards among in-patients with schizophrenia Methods: We recruited 80 cases with aggressive behavior among schizophrenic patients and managed them under JCI standards for 3 weeks. We established risk management team,improved attack training, assessed systematically and comprehensively, and evaluated and improve the quality continuously.Results: Attack risk assessment indicated that we reduced risk grade III from 13.75% to 6.25% and risk grade IV from 11.25% to 3.75% after using JCI management. There were significant difference between the scores of each factor and total weighted score of Modified version of the overt behavior scale (MOAS), and the scores of each factor of Nurses Observation Scale for Inpatinent Evaluation (NOSIE) before and after intervention (P<0.01). Conclusion: JCI standard management could reduce the irritability and hostility of patients, improve their social interests, promote their social ability recovery, reduce their attack risk grade, reduce the occurrence of aggressive behavior, and guarantee nursing safety.

Objective: To check out the function of Root Cause Analysis in analyzing the pathological specimen delivery errors in operating room. Methods: An RCA team was set up to analyze the proximate cause and the ultimate cause of error by using the method of RCA, and then the improved measures were proposed and carried out. Results: Before using the method of RCA, the average error rate was 1.03%. After using RCA, the average error rate dropped to 0.26%; Nurse had a positive selfassessment.Conclusion: RCA is a scientific method in the management of pathological specimen delivery flow. RCA method can not only improve the comprehensive ability of nurses ,but also can realize the goal of patient safety in operation room.

Objective: To investigate the effects of Quality Control Circle (QCC) in decreasing the rate of unplanned stop of Continuous Blood Purification (CBP). Methods: Decreasing unplanned stop rate of continuous blood purification was set as the primary subject of QCC activities. The authors investigated the incidence of unplanned stop of CBP, analyzed reasons and established countermeasures accordingly. And the differences of unplanned stop rate of CBP and satisfaction level of nurses in cooperation department before and after QCC were compared. Results: The unplanned stop rate of CBP decreased from 25.45% to 10.87% after QCC (P<0.01). And the satisfaction degree of nurses increased significantly (P<0.05).Conclusion: QCC activities could decrease the unplanned stop rate of CBP and improve the cooperation of multi-disciplinary team and care quality of CBP.

Objective: To investigate on the proper use of insulin in diabetic patients. Methods: Telephone interviews were conducted among 160 diabetic patients who are being treated inpatient or outpatient at Beijing Anzhen Hospital, Captial Medical University affiliated institution. Questionaires were focused on the proper administration of insulin and patients demographic.Results: 98.8% of patients were able to store unopened vials of insulin correctly; 94.4% of patients were able to attach insulin needles correctly; 34.4% patients were able to properly dispose the used needles after insulin administration;16.9% of patients were compliant with change of needles. The difference between inpatients and outpatients was statistically significant when it comes to rewarming the insulin after taken out from the refrigerator and pinching the skin with injection. Conclusion: Diabetic educations need to be improved on the following areas: replacing of the needles, disposal of used needles, and washing hands before insulin administration. Diabetic education in the early onset is significantly important to patients in order to improve the proper use of insulin.

Objective: To explore the influencing factors of carrying out evidence-based nursing practice for clinical nurses and to provide reference for the development of clinical evidence-based nursing practice. Methods: Totally 431 nurses in tertiary Grade A hospitals were recruited using convenience sampling method and investigated by Development of Evidence-Based Practice Questionnaire (DEBPQ) among clinical nurses. Results: Formulating nursing measures on the basis of experience,lacking time to obtain the latest information, the difficulty of searching and using evidence, no supporting colleagues, and lacking confidence were the top factors. Conclusions: The nursing work depending on experience, nurses lacking ability of searching and using evidence, and no supporting working environment ,hinder the development of clinical evidence-based nursing practice. The hospital's administrators should build hospital organizational culture atmosphere, encourage nurses to deliver scientific research and technological innovation, give nurses' relevant training, and help them to learn how to search and use evidence,in order to improve nursing measures and the quality of nursing service.

During the "11 · 22" Sinopec group oil pipeline leak explosion accident in Qingdao, the Nursing Department immediately initiated the emergency response plan, set up the nursing rescue leadership team, and initiated the emergency team, dispatched nurses reasonably, and emphasized the first option assumes for overall responsibility.Moreover, psychological guidance followed the rescue. The Nursing Department played an important role during the medical rescue, and the routine nursing practice was maintained at the same time.

Objective: To explore the construction and development of specialty nursing under Multidisciplinary Treatment(MDT) for head and neck cancer. Methods: After establishing multidisciplinary medical team, the team members implemented multidisciplinary discussion process, hierarchical training of professional nurses, and problem based case discussion. And then they developed patient-centered case management model through tracking clinical nursing pathway. Results: Satisfaction among the patients, doctors and nurses improved obviously. Professional knowledge, familiar level of patients' condition and team building status in nurse team improved significantly as compared with before (P<0.01). Conclusion: The construction of specialty nursing under the MDT mode could significantly improve the nurses' professional abilities to provide high quality care for patients.

Objective: To evaluate the effect of pain management system based on JCI standard. Methods: A series of pain management methods was set up based on JCI standard, including improvement in pain assessment and record, and standardized training of pain management related knowledge. Totally 412 new nurses received the knowledge training of pain management system. Results: After 6 months pain management, The scores of pain management in 412 nurses increased from (61.85±1.53)to (87.46±2.87) (t=9.52, P<0.01), The satisfaction scores of using the pain care record improved from (3.12±0.51) to (4.82±0.64)(t=5.04, P<0.05). The pass rate of pain care record increased from 61.17% to 97.72%. Conclusion: Pain management system based on JCI standard could effectively improve the staff nurses' pain related knowledge and ensure patients' safety and care quality.

Objective: To implement doctor-nurse integration management model in examination refund process in respiratory ward, and to reduce patients' economic losses and confidence crisis to hospital. Methods: The authors analyzed the primary cause of examination refund and set up the flow path for different examination refund. Dynamic monitoring and timely information feedback also were used to check the implementing status. The data of examination refund were compared before and after doctor-nurse integration management. Results: After application of doctor-nurse integration management, the times of examination refund significantly decreased from 53 to 23, no examination refund events occurred before and after discharge settlement (P<0.05). Conclusion: Doctor-nurse integration management model could reduce the times of examination refund, and increase patients' satisfaction to medical staff and hospital.

To review literature on influencing factors of depression in people with spinal cord injury, and summarizes the major psychological interventions. It recognized that Mindfulness Training interventions was seldom used, and it is necessary to use this method to explore the development of a set of psychological intervention model for spinal cord injury patients with depression.

Pediatric burn is a key factor of accidental children injury, whose incidence rate is high in the worldwide.Accidental pediatric burn may affect family members to various extent. This paper reviewed papers of the influence of pediatric burn on family members in China and abroad and summarized the relevant nursing interventions so as to provide references for the care of burn children and their parents.

The functional exercise compliance plays an important role in rehabilitation of postoperative patients with breast cancer. Therefore, the authors reviewed the functional exercise compliance in postoperative patients with breast cancer, so as to provide references to promote the rehabilitation of this population.

Through visiting Pittsburgh medical center, the authors had a general understanding of US nursing practice and would like to share their knowledge with Chinese nurses from three aspects. The first was US nursing administration, including general situation of local hospitals, nurses' qualification, allocation and work time, nursing information management, nursing safety and motivation. The second was clinical nursing, including nurses' professional qualities, nursing assessment, visiting rules, infection prevention and control, use of items and team work. The third one was humanistic services. These may provide references for the nursing development in our country.

The study proposed the education philosophy of "student-oriented" by summing up the teaching knowledge of Comfort Care in the Meiho University of Taiwan and combining the teaching situation in vocational nursing students. In order to improve vocational nursing students' comprehensive abilities, we should adopt multi-teaching methods, establish a multidimensional cross system of teaching evaluation, and highlight the humanistic and integrity characteristics of nursing.