Pattern and efficiency of nursing service is the core issues of elderly care service. Nursing care in elderly care service not only has its own professional value, but also has the value of appreciation that utilized resources efficiently in professional integration. This paper discussed nursing service value by elaborating function position of nursing, valuable activity, nursing service pattern in elderly care service, to illustrate the feature of nursing service in elderly care service, which may provide a reference for nursing staffs.

Objective: To understand the current status of the bed occupancy rate of long-term care facilities in Beijing and explore its influencing factors. Then, comparing the bed occupancy rate between public facilities and private facilities so as to provide evidence for the management of facilities and policy-making of government. Method: This study investigated 362 long-term care facilities by using self-made questionnaire. Result: The median rate of bed occupancy was 49.67 (22.11, 78.33) %. The multiple regression analysis showed that the rate of bed occupancy would be influenced by per bed number of staffs, per bed number of nursing attendants, per bed number of certified nursing attendants, rate of insured bed, percentage of public residents, medical service contract with nearby health facilities, medical service covered by insurance. The covariance analysis showed that the bed occupancy rate difference between public facilities and private facilities was no statistic meaning. Conclusion: The bed occupancy of long-term care facilities in Beijing was on a low level. The bed occupancy rates were no difference between public long-term care facilities and private facilities. Facilities and government should consider manpower allocation, bed insurance, medical service and the percentage of public residents synthetically to improve the rate of bed occupancy.

Objective: Understanding the factors that influence the service cost of Beijing pension, providing a theoretical basis to make better choice of pension organizations and endowment policies for the people. Method: Using a convenient sampling method, in 2013 a research was conducted to 270 pension organizations. The context of the survey included information about what the pension organization is, about the employees, the elderly taken in, and of the cost that cover the stay. Result: The fundamental service cost was 2682.26 (1637.91, 3357.95) RMB. Multi-regressions show that the cost was effected by in which district, the ratio of inner- outer district , the organization's quality, admitted head count, the ratio between healthy- in need of help, the age factor (81-90),area of the facility, amount of nursing beds, the ratio between licensed-unlicensed care workers and how the total bed count effects the statistics of the fee. Conclusion: The basic expenses can be wavered by the factors listed above, and resulting in being able to choose the right facility needed.

Objective: To investigate the level, distribution and influencing factors of cost of care in dementia patients living in public elderly homes, and provide references for reasonable distribution of social resources and exploring the best care management mode for dementia patients. Methods: Totally 103 dementia patients were recruited from two public elderly homes in Beijing and Guangzhou. The cost was estimated through questionnaires and the influencing factors were analyzed using multiple linear regression analysis. Results: The average cost of dementia patients in public elderly homes was (3974.6±1782.9) RMB per month,nearly 47 695 RMB per year. The direct medical cost and direct non-medical cost accounted for 59.10% and 37.84%, respectively,while the indirect cost accounted for 3.05%. Regression analysis showed that educational level, ability of daily living and severity of dementia were influencing factors of cost. Conclusion: The cost of care in dementia patients living in elderly homes is relatively high,which brings economic burden to the family and society. The cost is higher in patients with higher educational level, poorer ability of daily living and mild dementia patients. It is suggested to make better resources relocation to ensure high-quality care and reduce the cost of dementia patients.

Objective: To evaluate health behavior change theory to the rehabilitation effect of patients with elderly bedridden at home after discharge from hospital. Method: 120 cases of elderly patients in bed were randomly divided into control group and experimental group by in hospital time order. Respectively, the outreach team evaluate patients family rehabilitation nursing plan.The control group was given conventional propaganda and telephone follow-up after discharge. Experimental group was developed family rehabilitation nursing plans according to the health behavior change integration theory. Compared the two groups of patients discharged from hospital, 6 and 12 months after discharge in daily living, quality of life and other aspects of rehabilitation by using Activity of Daily Living Scale (ADL) and Quality of Life Questionnaire. Results: The patients discharged from hospital for 6 months, 12 months physiological and psychological field, the individual subjective feeling of the overall quality of survival ,the overall subjective health, daily life ability scores were higher than in the control group, the difference was statistically significant(P<0.05). Two groups in environmental, social, differences are not significant (P>0.05). Conclusion: The application of the theory of health behavior change for elderly patients in bed home rehabilitation, can significantly improve the patients' quality of life and daily life ability.

Objective: To investigate the job satisfaction status of emergency nurses in tertiary public hospitals in Beijing, and analyzed key influencing factors of job satisfaction. Methods: The Minnesota Satisfaction Questionnaire (MSQ) (Simple Version)was used in this survey. A total of 319 emergency nurses from five tertiary public hospitals in Beijing were included in this study.The authors also analyzed the social?demographical information and tried to figure out their impacts on job satisfaction. Results:Overall satisfaction score (3.48±0.64) of emergency nurses in five hospitals was in the median to upper level. The score (4.16±0.68)of colleague relationship and cooperation between the departments dimension was the highest. While the score of (2.41±0.31)working pressure dimension was the lowest. The emergency nurses’ job satisfaction score in B hospital (3.71±0.55) was the highest,which was rather satisfied. While job satisfaction score in C hospital (3.26±0.68) was the lowest, this lied in the general level.Variance analysis and multiple linear regression analysis showed that the education level, employment category and professional title were the influencing factors of emergency nurses’ job satisfaction in Beijing.Conclusion: Managers need carry out several measures, such as increasing social benefits, accelerating the construction of emergency specialist nurse training system, and improving the promotion system, to stimulate the working enthusiasm of emergency department nurses, and then the quality of emergency nursing could be continuously improved.

Ojective: To explore the acceptance level of disability in poststroke patients and its related factors.Methods:Totally 120 poststroke disabled patients were investigated by the Barthel Index Rating Scale (BI), the Acceptance of Disability Scale (AODS) and self-designed questionnaire. Results: The general score of AODS was 78.49±9.46, which showed medium 1evel of disability acceptance. The main influencing factors for the acceptance level were duration, the level of ADL, age,educational level. Conclusion: For patients with low level of acceptance of disability, medical staff should recognize in the earlier stage and evaluate their cognitive status synthetically. A targeted psychological cognitive intervention, health guidance and early rehabilitation training are necessary to promote the patient body function recovery and improve the level of mental health and quality of life.

Objective: To develop a Organizational Citizenship Behaviors(OCB) scale for nurses in China, and to provide a proper instrument for hospital managers to better evaluate nurses' OCB. Methods: The original items of OCB scale for nurses were collected through nominal group interview, and were selected and revised through Delphi expert consultation method and item analysis technique based on questionnaire survey of nurses. Results: There were 53 original items collected through interviewing 172 nurses, and 34 items were deleted or modified during 2-round expert consultation, and we got a 37-item pretest scale. Five items were deleted according to item analysis results based on the survey among 317 nurses. Finally, 32 items of OCB scale was reserved with all 32 items' CR values >3, the total score correlations >0.50, and loading factor values>0.50. Conclusion:This study developed an OCB scale for nurses through group interview, expert consultation and item analysis technique based on questionnaire survey. The scale has good differentiation and homogeneity.

Objective: To describe the feelings of patients at the beginning of the hemodialysis and provide the bases for individualized psychological care. Methods: The in-depth interview was conducted on 9 patients at the beginning of the hemodialysis individually. The data were analyzed by qualitative content analysis method. Results: The feelings of patients in the early stage of hemodialysis included negative emotions and positive emotions. The negative emotions were despair, anxiety, fear,anger or resistance, complaint, remorse. The positive emotions were accepted, hopeful and seeking information. Conclusion: The negative emotions of hemodialysis patients in the early stage are significant. We should understand the patients' needs and provide the individualized care for them.

Objective: To explore the current status and influencing factors of self-efficacy in COPD patients, in order to provide reference for nurses to make further self-efficacy intervention strategy. Methods: Totally 109 COPD patients staying in a Respiratory Unit at 2 Tertiary hospitals in Beijing from Sept, 2013 to Dec, 2014 were collected. These patients were medically stable after treatment and took the Chronic Disease Self-Efficacy Evaluation questionnaire. T test and variance analysis were used for variable selection; Multiple regression analysis was used again to statistical significant index. Results: The average score of selfefficacy in COPD patients was only 2.89±1.86 (range from 1 to 10 for each item), and frequency of acute exacerbation, severity of disease and resident condition were influencing factors. Conclusions: The level of self-efficacy in COPD patients is relatively low,and its stronger influencing factors, especially those factors that can be intervened by nurses still need further exploration.

Objective: To compose key elements of Master of Nursing Specialist training program, and to provide a feasible reference for nursing education and management department. Methods: Researched 31 domestic and international graduate nursing programs, studied the most relevant literature from online database and/or participated school official websites within the past 5 years, ultimately forming a preliminary Delphi enquiry questionnaire which including 6 level one indicators: training objectives, students enrollment, length of study, curriculum system, practical competencies and evaluation requirements; and 145 level two indicators. With three rounds of the Delphi expert consultation, all the indicators were to analyzed and filtered from statistical and practical view. Results: Totally 26 experts participated in the inquiry, the authority coefficient value is 0.88. The chi-square test of Kendall's W value is significance with P<0.01. The details of nursing graduate training program curriculum were finalized with 6 level one indicators and 68 level two indicators. Conclusions: The training program curriculum developed through this study can provide practical reference to nursing education administrative organizations.

Objective: To explore the Implementation method of "Chinese type MOOC" of basic knowledge and technique of first aid network sharing course and observe the learning effect. Methods: Totally 522 students of Suzhou International Education Park who took the basic knowledge and technique of first aid sharing course were educated by hybrid MOOC and flipped classroom teaching. Students' grades were analyzed and a survey questionnaire was taken to understand the overall progress of course learning and evaluation from students in terms of the teaching mode. Results: Students' examination qualified rate is 90.23%, the overall situation of the students on the course learning score is well, more than 80% of the students expressed satisfaction with the teaching mode. Conclusions: High-quality teaching resources can be shared and achieve better teaching effect through the network platform to carry out a shared course teaching.

Objective: To explore the effect of seminar teaching method on critical thinking abilities among advanced vocational nursing students in Geriatric Nursing teaching. Methods: A total of 156 advanced vocational nursing students enrolled in 2011 from class 1 to class 3 were divided into the control group, which were received traditional teaching method. In the meanwhile,a total of 159 students from class 4 to 6 were divided into the experimental group, which were taught by seminar teaching method.We evaluated the effect using Critical Thinking Disposition Inventory- Chinese Version (CTDI-CV) and theoretical examination.Results: After seminar teaching, the differences on the subscales of truth-seeking, open-mindedness, analyticity, systematicness,curiosity, cognitive maturity had statistically significance (P<0.05). The differences on the subscale of critical thinking had no statistically significance. The scores of theoretical examination in the experimental group were higher than those in the control group (P<0.01). Conclusion: Seminar teaching method can effectively improve learning and critical thinking abilities of advanced vocational students.

Objective: To compare the effects of the Action-oriented Teaching in secondary vocational medical nursing teaching with the traditional teaching model. Methods: By analyzing and comparing the degree of nursing students to master the theoretical knowledge, medical nursing practice skills, case analysis and the nurse qualification mock exam scores to determine the effects of the new teaching model. Results: Action-oriented Teaching method can improve the secondary vocational nursing students' practical operation ability, case analysis ability, communication ability and nursing comprehensive vocational ability. It can improve nursing students' skills in nurse qualification examination to a certain extent.

In order to improve the overall utilization rate of medical resources in China, many regions have formed Teaching Hospital Group. But due to the system problem, there are some differences between the principle part and the attached part, a scientific management model is needed for guidance. The synergetics-theory, a model built for the Teaching Hospital Group, plays an important role for theory and practice.

Objective: To explore the effect of the modular curriculum in fundamental nursing science. Methods: Grade 2012 nursing undergraduate students (n=38), as experimental group, performed the reformed curriculum setting of one curriculum with 5 modules in fundamental nursing science for teaching. Grade 2010 nursing students (n=49), as control group, performed the prereformed curriculum setting of four independent courses for teaching. Results: The final scores and the excellent and good rates had no significant differences between the experimental group and the control group (P>0.05). But the satisfaction score with the curriculum in the experimental group was higher than the control group (P<0.01). Conclusion: The modular curriculum reform in basic nursing science maintained the high learning effects, and received the high satisfaction feedback from students.

Objective: To explore the relationship between psychological empowerment and turnover intention, and accomplish the Structural Equation Model. Methods: The convenience sampling method was used to in this study. The psychological empowerment scale, psychological capital scale and turnover intention scale were used to investigate 507 ICU nurses from 5 hospitals. SPSS 13.0 and Amos 17.0 software were used to analyze the date. Results: The scores of psychological empowerment, psychological capital were different among nurses with different nursing years, education level, and income level (P<0.05). And turnover intention scores of nurses with different nursing years and income level were different (P<0.05).Structural Equation Model showed that psychological empowerment had a direct effect (λ2=0.47, P<0.001) on psychological capital. Psychological capital had a direct effect on turnover intention (λ2=-0.62, P<0.001).Psychological empowerment had a direct effect (λ1=-0.81, P<0.001) and indirect effect (λ2=-0.29, P<0.001) through psychological capital which explained 21.28% of the variance of turnover intention. Conclusion:Psychological capital has an effect on ICU nurses' turnover intention. The administrator should use appropriate intervention to increase nurses' psychological capital, so as to improve psychological empowerment to deal with turnover intention.

Objective: To explore the effect of using Quality Control Circle (QCC) on improving the patients' satisfaction of dealing with exudate of peritoneal drainage tube. Methods: We established a QCC team, with the activity theme of "improving patients' satisfaction of dealing with exudate of peritoneal drainage tube after operation". On-site investigation was performed and targeted value was confirmed. Those factors that influenced patient satisfaction were analyzed and countermeasures were formulated and implemented according to three main factors. Results: The patients' satisfaction of dealing with exudate of peritoneal drainage tube was improved from 86.67% to 93.85% (P<0.05) after performing QCC. The scores of staff nurses' professional knowledge about peritoneal drainage tube and comprehensive quality of participants in QCC team, were improved after performing QCC(P<0.05). Conclusion: QCC activities could standardize the treatment method of dealing with exudate of peritoneal drainage tube,improve the patients' satisfaction, and enhance the team spirit and quality management abilities of nursing staffs.

Patient and Visitor Violence in hospital environment is a quite important problem that the medical staff, especially nurses, should face to. The complex reasons and diverse forms need long-time response and guidance. This article summarized the definition, types, current status, reasons and countermeasures of Patient and Visitor Violence among the domestic and aboard nurses,and provided references for the nurses to effectively cope with the Patient and Visitor Violence.

Objective: To identify problems of OR safety management approach, discover issues, propose ways to improve,and ultimately to enhance surgical patient safety. Method: Randomly selected 46 trainees who attended "surgical patient safety management training program" in Chongqing to take the "Surgical safety management approach questionnaire for surgical team members". Result: The average score of management approach is 2.55±1.00. Several significant items were detected among different qualifications and different hospital level. Both of the individual and management put patient safety as primary concern. 86.96% of the respondents agreed that they had made errors in OR, medical errors are discussed to prevent recurrence, and confidential reporting system that documents medical errors is important for safety, 19.57 of them agreed that "Errors committed during patient management are not important, as long as the patient improves". Conclusion: OR managers have positive attitude on surgical patient safety and good understanding on medical error. But still need improvements on questioning, adverse event reporting,multidisciplinary teamwork coordination and effective communication.

We summaried the experience of construction of drug safety information warning mechanism in our hospital based on the hospital information system platform. We designed different reminder warning caveat for six kinds of drugs, through the hospital Wi-Fi connecting with mobile I-touch scanner, strengthened the management of drug safety, made up the traditional high-risk drug use and management deficiencies, reduced the incidence of adverse drug events, guaranteed the accuracy, safety and therapeutic effects of patient drug use, improved nurses' work efficiency, promoted information construction in our hospital,and improved the management level of the hospital.

Objective: To investigate the KAP level and influencing factors of Knowledge-Attitude-Practice on common safety risks in caregivers of elders in communities. Methods:We investigated 280 caregivers caring the elders from 4 communities in Chongqing with a self-designed questionnaire about the KAP on common safety risks of elders. Results: The total average score was 61.72±6.99, and the influencing factors of KAP on common safety risks of elders were education level, profession, knowledge of the caregivers, as well as the ages, residence, diseases state, history of safety risks of the people cared. Conclusion:The current KAP level on common safety risks of elders needs to be improved and nurses in the communities should give a overall as well as targeted health education to the caregivers.

Objective: To analyze the causes of 89 nursing adverse events, and to put forward the effective preventive countermeasures. Methods: Nursing Department of a special hospital in Xinjiang collected the adverse events in 2014 and analyzed it retrospectively. The occurrence of adverse events of nurses with different titles, different occur time and different outcomes were statistically analyzed. Results: The occurrence of adverse effect of infusion was the highest (58.4%), and the junior nurses are more likely to lead to the occurrence of adverse events (93.3%). Conclusion: The analysis of adverse events could provide important information for nursing safety management, especially for preventable adverse events, furthest avoid or reduce the occurrence of nursing adverse events, promote nursing adverse events to optimum outcome, guarantee the patients' safety, and avoid nursing disputes.

Objective: To evaluate follow-up compliance of patients with CKD stage 3-5 in the nutrition clinic, and explore its related factors. Methods: The data of 468 patients with CKD stage 3-5 who got nutrition files created from January 2007 to December 2012 were retrospectively analyzed. Logistic regression was used to analyze the influencing factors of follow-up compliance. Patients' demographic data, family support, baseline renal function and serum albumin level were all included in the analysis. At the same time, the subjective reasons of poor adherence were explored. Results: There were 213 cases that still got follow-up at present. Their data were included in this analysis. Their average follow-up time was (26.85±22.37) months,average age (47.16±13.79), 64 cases (30.05%) had regular follow-up. The Logistic regression analysis showed that family support(OR=2.448, P<0.001), eGFR (OR=0.638, P=0.038), Alb (OR=0.932, P=0.043) were influencing factors of follow-up compliance.Family support had positive correlation with the follow-up compliance. While eGFR and Alb level had negative correlation with the compliance. Eight themes were obtained after interviewing with the patients with poor compliance, and it was found that those patients had not recognized the importance of long-term nutrition management yet. Conclusion: The follow-up compliances of patients with CKD stage 3-5 in the nutrition clinic need to be improved. Nursing education of patient's family should be strengthened to increase their consciousness of the diet nutrition monitoring and management. Hierarchical management according to patients' kidney function and nutrition level should be implemented to prevent malnutrition effectively.

Objective: To understand the basic situation of medical staff work experience and its influencing factors analysis and comparison of the doctors and nurses, to give references for the work to improve the medical staff experience. Methods:Stratified cluster method to extract 466 health care workers, personal basic conditions and work experience of the survey, the data are descriptive analysis and logistic regression analysis. Results: Work experience score of doctor is 79.15±8.90, paramedics score is 79.82±8.18; Logistic regression analysis marital status, average weekly working time on the job satisfaction of nurses, age,highest level of education affect physician job satisfaction; average weekly working time, the average monthly number of night shift nurses affect occupational stress, professional titles, each average workweek influence doctors occupational stress; working years affect turnover intentions nurses, doctors age affect their turnover intention. Conclusion: The validity and reliability of the scale is good; nursing job satisfaction is higher than the doctors and their professional degree of tension lower than doctors, both turnover intention considerable degree; have a spouse, a shorter average weekly working time nursing job satisfaction higher degree, the higher the age, the higher the degree of Bachelor of doctor job satisfaction; shorter average weekly working time, night work, the less the average monthly number, the lower the degree of tension vocational nurses; doctors, professional titles the higher average weekly working time is longer, it is also lower occupational stress; the lower the number the longer the work in nursing turnover intention and the greater the age, the lower the longer the average weekly working time of doctors turnover intention.

Objective: To investigate the current status and influencing factors of pre hospital stroke symptoms and cope knowledge among residents in Harbin. Methods: Totally 574 residents with high risk for stroke and their caregivers in Harbin were recruited and investigated by Pre Hospital Stroke Symptoms Coping Test. Results: The mean score for the questionnaire was (59.45±16.16), which was in a moderate to inferior level. Three parts, cope of typical symptoms with convulsive, the typical symptoms, and typical symptoms with vomiting, had highest score according to the standardized scores, Multiple linear regression analysis showed that the influencing factors included bad living styles (smoking, drinking), educational background,medical examination, and stroke awareness (P<0.05). Conclusion: The pre hospital stroke symptom and management knowledge among residents in Harbin is in a moderate to inferior level, which was influenced by bad living styles (smoking, drinking),educational background, medical examination, and stroke awareness.

Objective: To optimize special medical examination appointment process, reduce appointment waiting time, and improve patient’s satisfaction. Methods: The special examination appointment center was established. They developed a new booking platform to provide centralized appointment service for both outpatient and inpatient. Results: After the establishment of the special examination appointment center, the amount of special examination appointment obviously increased (331 024 person-times VS 380 062 person-times), treatment time of the patients decreased significantly (44 198 hrs VS 3695 hrs). Conclusion: The concentrated medical appointment service has obvious advantages in general hospital, which could effectively save the patients’ waiting time for special examination, reduce hospital costs, and improve patients’ satisfaction.

Objective: To evaluate the effect of Fast-Track Surgery (FTS) during perioperation period for urology surgery patients. Methods: We selected 100 urology surgery patients who accept operation treatment as the research object, and through randomized single blind digital way, they were divided into the control group and the observation group with 50 cases in each group. The control group were given conventional operation nursing, the observation group throughout the FTS concept in the perioperative period nursing process. We compared two groups of patients with perioperative heart rate, blood pressure and temperature stress changes, and recorded two groups patients of postoperative hospitalization time, solid food tolerance time,ambulation time, two groups of patients' satisfaction survey. Results: ① The observation group patients before 30 minutes of heart rate, blood pressure values were better than the control group,it had significant difference (P<0.01), but no statistical difference of temperature value (P>0.05); postoperative 30min, observation group of patients with heart rate, blood pressure and temperature values were relatively stable than control group, and had statistically significant difference (P<0.01). ② The observation group patients' solid food tolerance time, ambulation time and postoperative hospitalization time were shorter than the control group(P<0.01). ③ The observation group patients' satisfaction rate significantly more than the control group, the difference had statistically significant (P<0.01). Conclusion: The concept of FTS can meet the demand of department of urology patients during perioperative period, shorten the recovery time, improve the patients' satisfaction to nursing work.

Delirium and ICU-acquired weakness fatigue have high incidence in ICU. Delirium and ICU-acquired fatigue will prolong mechanical ventilation and hospital stay, increase mortality, and cause cognitive disorder and lose of function. Preventing delirium and ICU-acquired fatigue is key for quality of nursing care. Any single measure alone is difficult for preventing delirium and ICU-acquired fatigue due to it's complexities'. The ABCDE sedatives and analgesics bundle is an evidence-based and multidisciplinary strategy to reduce sedative exposure, promote liberation from mechanical ventilation, and improve post-ICU cognitive function and functionality.The purpose of this article is explore the ABCDE bundle for management the sedatives and analgesics.

Based on the concept analysis of resilience, this article reviewed current situation, influencing factors and intervention measures of resilience among cancer patients and pointed out limitations of the current studies, so as to promote further study on resilience in cancer nursing, and provide guidance for taking targeted interventions to improve patients' resilience.

Discharge planning is a main pattern of transitional care. The authors reviewed the current study status of discharge planning in China, including background, team members, application in chronic disease and the influencing factors of discharge planing formulation and implementation.

Emergency treatment is the key element for the prognosis of stroke patients.This article analyzed the current problems of stroke emergency treatment process, discussed the necessity and importance of stroke emergency treatment process, transplanted the theory and technology of "business process reengineering" to put forward the idea of stroke emergency process reengineering,changed stroke emergency treatment process from "the series" to "parallel connection", and proposed the corresponding support and guarantee measures, including establishment of multidisciplinary team, developing information sharing platform, and setting up related system and standards.

With 3 months' clinical study in operating room at State University of New York (SUNY) Downstate Medical Center,the author thoroughly introduced the clinical status in operating room, especially in medical flow and detail management, including the preparation before operation, the check during the operation, the service after the operation, medication management. These detailed description can certainly provide inspiration to other nursing colleagues.

A brief introduction on the clinical nursing education in SUNY Downstate Medical Center was given in this article,including new staff orientation, continuous nursing education, clinical service education and learning needs assessment. And then the author made a discussion based on the present status of clinical nursing education in China.