This paper introduced the practice of intravenous thrombolytic in hospital process reengineering among patients with acute ischemic stroke in our hospital since July 2015. We established the thrombolytic stroke group, the multi-department cooperation, organization system, and pre-hospital emergency system which are the keys to the intravenous thrombolytic treatment in hospital process among patients with acute ischemic stroke. The results showed that the Door-to-Needle Time (DNT), the time of the blood sampling, the decision time of the family members, the time of the blood examination were shortened obviously.

Objective: To explore the effect of hospital-community-family nursing intervention model on the rehabilitation of stroke patients. Methods: Totally 56 stroke patients were recruited by convenience sampling method and delivered 1 years of hospitalcommunity-family nursing intervention model. We evaluaged the patiens daily life ability and quality of life before the intervention and 12 months after the intervention. Results: The scores of Barthel and stroke quality of life in 12 months after the intervention were significantly improved than that before intervention and the difference was statistically significant (P<0.05). Conclusion: The hospital-community-family care intervention model could improve the daily life ability and the quality of life of stroke patients.

Objective: To explore the influencing factors of Intra-Abdominal Pressure in the process of enteral nutritional support among patients with severe stroke, and to provide references for monitoring Intra-Abdominal Pressure among patients with severe stroke. Methods: Totally 80 patients with severe stoke who received enteral nutrition were recruited and measured Intra-Abdominal Pressure by bladder pressure method within 1 week after admission. The influencing factors of Intra-Abdominal Pressure were investigated by self-designed questionnaire. Results: The 80 patients measured 1680 times of Intra-Abdominal Pressure and 22 patients have high Intra-Abdominal Pressure (297 times). Having abdominal distention was related to the high Intra-Abdominal Pressure (P<0.001). GCS 8 and mechanical ventilation were the influencing factors of Intra-Abdominal Pressure(P<0.05). Conclusion: If patients with severe stroke have low GCS score (GCS 8), with mechanical ventilation or having abdominal distention in the process of enteral nutrition, Intra-Abdominal Pressure measurement would be helpful. The results could guide safe nutrition support and provide references for adding nursing monitoring indicators.

Objective: To explore the method and effect of home nursing care for patients with cerebral apoplexy based on information technology management platform. Methods: A prospective study was used to study the stroke patients in the family physician service agreement with the community health service center in Fangzhuang. Take electronic file data as a baseline, the self-designed questionnaire was used to search the object of study basic information, health assessment, sick of home care needs investigation. 12 months after the intervention, the disease control, life and quality of life of the patients were evaluated by 6 months after the intervention. At the same time, the patient's family visit to the assessment of the situation into a chronic disease management information platform, to give a continuous chronic disease management. Results: In 6 months and 12 months after treatment, the patients' self-care ability index (Barthel) and quality of life (SIS) score were higher than those in control group, the difference was statistically significant. Conclusions: In the information chronic disease management service model of community stroke patients with home care service work, timely and accurate access to patient health status, the implementation of continuous: related care,standardized stroke patients with community management, improve the patient's self-care ability and quality of life.

Objective: To understand the mental health status and its influencing factors of primary family caregivers of diabetes patients. Methods: The self- rating depression scale (SDS), self-evaluation of anxiety scale (SAS) were used to investigate 150 caregivers of patients with diabetes. The influence of demographic characteristics on their psychological status were analyzed.Results: The average SAS score of diabetic patients' caregivers was 41.22±5.53, the average score of SDS was 45.02±8.28, both of them were higher than those of the national norm (P<0.05). Multiple linear regression analysis showed that diabetes type, medical payment scheme and whether or not having the need to monitor patients' diet were the main factors influencing the caregivers'anxiety; while diabetes type, medical payment scheme, patients' blood sugar control levels and whether or not full-time care were the main factors influencing the caregivers' depression. Conclusion: Medical staff need pay more attention on mental health status of primary family caregivers of diabetes; strengthen the social support to improve their psychological health level.

Objective: To explore the current status of happiness and influencing factor of elderly people under homebased care in Beijing. Methods: Information of happiness and influencing factors of 215 old adults in 2 Beijing communities was collected using questionnaire survey. Results: The total score of the happiness of old adults was (33.90±10.62). The score of positive affection and negative affection were (7.47±2.82) and (2.44±2.80), positive experience and negative experience were (8.93±3.60) and (4.06±3.47). The happiness of old adults was positively correlated with number of children and intelligent level. Factors influencing the happiness feeling included mental health, the energy of the elderly, physiological functions and general health. Conclusion: During the care process for old adults, care givers should pay attention to the psychological health,psychological health and the spiritual needs of the elderly, prevent brain function decline, and enhance the happiness of the elderly.Their children should give them more respect and support to increase the subjective happiness of the elderly.

Objective: To analyse experiences of taking care of patients with Alzheimer Disease by family members. Methods:The authors searched Pubmed, EBSCO, EMBase, CINAHL, Cochrane, CNKI and other databases. Qualitative researches which reported the caregivers' experiences of taking care of patients with Alzheimer Disease were enrolled, appraised and synthesized.Results: Eight qualitative studies were recruited. Seven themes were identified: confronting nursing care problems, physically exhausted, mental stress, financial burden, sacrifice, adjustment and seeking help, mental motivation and gains. Conclusion: Stress is the most notable experience for caregivers. However, through sacrifice and adjustment, they may have mental motivation and gains.

Objective: To investigate the treatment-seeking delay status of patients with esophageal cancer, analyze influencing factors based on medical health ecology model. Methods: Purposive sampling method was used to select 345 hospitalized patients with esophageal cancer from four hospitals in Jinan, Shandong Province. The questionnaire included general information, medical information, health literacy scale, Revised Health Hardiness Inventory (RHHI-24), and Social Support Scale (SSS). Results: Incidence of treatment-seeking delays was 33.75% in this study. Based on the healthy ecological model, the upstream influencing factors of patient delay in patients with esophageal cancer were: whether the family members engaged in medical field, resident type, and family income. Midstream factors included smoking status, alcohol consumption, healthy values,exogenous health control concept, objective and subjective support, and utilization of support. Downstream factors were gender,age, and chronic complications. Conclusion: Patients delay was quite common in patients with esophageal cancer. Appropriate measures should be taken to promote timely medical intervention to improve 5-year survival of patients.

Objective: To explore and analyze the current research status and development tendency of disaster nursing in recent 15 years in China. Methods: The CBMDisc database, CNKI and WanFang data were searched for literatures on disaster nursing from January 1st, 2000 to January 1st 2015, Microsoft Excel 2007 was adopted to establish the database, then the literature retrieved were sorted and analyzed. The growth of the literature, publication distribution, core journals, research subjects and so on were analyzed by bibliometrics methods. Results: A total of 267 articles related to disaster nursing were retrieved. The number of the literatures was on the rise as a whole. There were more literatures (90 articles , 33.71%) in Sichuan province and Beijing municipality. The institutions which published more articles were Chinese People's Armed Police Force General Hospital and West China Hospital of Sichuan University, a total of 25 articles (9.36%). The journals that published more literatures were Nursing Journal of Chinese People's Liberation Army , Chinese Nursing Research and Journal of Nursing Science, a total of 81 articles(30.34%). The primary document types were theoretical discussion and experienced summary, a total of 153 articles (57.30%).There were 69 articles(25.84%) having foundation support. Conclusion: Public and researchers paid more and more attention on disaster nursing in recent years. The research on disaster nursing is increasing currently, but the evidence levels of disaster nursing documentary were still low. The related research focused on disaster nursing education and training recently.

Objective: To explore the anxiety situation and influencing factors of pregnant women before parturiency.To provide clinical gist for the further nursing intervention. Methods: All 418 pregnant women were investigated with the questionnaire about general condition and State-trait Anxiety Inventory (STAI), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ) before parturiency after admission. Results: The score of State Anxiety Inventory(S-AI) was (45.25±9.27). Among the 418 cases, there were 184 cases whose score was above upper limit of the norm. The positive rate of S-AI was 44.02%. Multiple regression analysis show that negative coping, the first delivery, anxiety quality, focus on fetal gender, introverted personality and the history of abnormal pregnancy were the risk factors, join in pregnant women school,positive coping, agreeing with mother's role, good relationship between mother-in-law and daughter-in-law and social support were the protective factors (R2=0.982, F=1891.744, P<0.001). Conclusion: The pregnant women have generally anxiety before parturiency. They are mainly influenced by the psychosocial factors. The targeted nursing intervention should be done to reduce anxiety of the pregnant women.

Objective: To explore the effectiveness of mix-methods training program on premature infant care of parents.Methods: Self- designed questionnaires were applied to investigate 180 parents of premature infants about care knowledge, skills before and after training when the babies were hospitalized. Results: After training, the caring knowledge and skills on premature infant care of the premature infants' parents improved (P<0.001). Conclusion: The premature infants' parents had obviously improved their knowledge and skills after the mix-methods training program. It could be helpful for their home care after the premature infants discharge.

In the past, people did not attach importance to neonatal pain. This paper has reviewed the definition, origin and mechanism of neonatal pain and the effect of pain on the neonate. It pointed out the importance and necessity of neonatal pain management. Then, this paper analyzed a variety of neonatal pain assessment tools and non-pharmaceutical interventions to provide reference for neonatal pain management.

The authors reviewed literatures on Post-Traumatic Stress Disorder (PTSD) of children in PICU; they verified the relationship between PICU hospitalization and child's mental abnormalities. Sometimes, PICU hospitalization even caused PTSD and influenced the life quality of children and the whole family. They summarized the precautions and interventions for PTSD to increase medical staff's attention of children's mental status during PICU hospitalization,furthermore, prevent or decrease the incidence of PTSD.

Objective: To investigate the relationship between self-management skills and quality of life among communitydwelling patients with hypertension. Methods: Totally 212 cases of community-dwelling patients were measured with selfdesigned Self-management Skills of Hypertension Scale and Short Form Health Survey (SF-36). The t-test and Pearson's correlation were used to analyze the data. Results: The mean score for self-management skills was 77.22±8.52, and the mean score for SF-36 was 73.39±14.14. The total score of SF-36 in patients with good self-management skills was higher than those with poor self-management skills. Conclusion: The overall level of self-management and quality of life among community-dwelling hypertension patients in Chengdu were in moderate level, which was suboptimal.

In 2014, our hospital established family care nurses training base. Through stratified training and scientific management, the retired veteran cadres could receive care in their homes which are equal to hospital standardized management,so as to realize family care as a unit. The establishment and implementation of family care nurses is the future social demand, is the cutting edge of elderly chronic disease care, and establish the foundation for promoting the elderly nursing vocational training.At present the family care nurses training in our hospital has been normalized and standardized.

Objective: To explore the relationship between psychological capital, work engagement and turnover intention among primary nurses in Traditional Chinese Medicine (TCM) hospitals. Methods: Totally 527 primary nurses from three tertiary hospitals affiliated to Zhejiang University of Traditional Chinese Medicine were investigated using the Chinese Version of Nurses' Psychological Capital Questionnaire-Revision (PCQ-R), Chinese Version of Utrecht Work Engagement Scale (UWES),and the Nurses' Turnover Intention Scale(NTIS). Results: There was a significantly correlation between psychological capital,work engagement and turnover intention among primary nurses (P<0.05). Psychological capital and work engagement negatively predicted the turnover intention level. Hierarchical regression analysis showed that optimism, devotion, health condition and education background entered the regression equation of turnover intention. Conclusion: Enhancing primary nurses' psychological capital and improving work engagement may decrease their turnover intention.

This paper summarized the concept of resilience, the commonly used measurement tools and made a comparative analysis on the relevant research and the influencing factors of nurses’resilience. On the basis of this, the research prospects and management implications were put forward.

Objective: To investigate the ability of performing activities of daily living and nursing care workload for inpatient cholecystolithiasis patients. Methods: Totally 125 inpatient cholecystolithiasis patients were selected from a local hospital.The direct nursing hours and Barthel index were recorded. Results: We found negative correlation between the activities of daily living and direct nursing time. Barthel index is the lowest about (30.64±8.87) on the surgery date, but the direct nursing time is the highest about (61.67±8.39) min. Conclusion: The ability of performing activities of daily living is the significant factor influencing nursing workload, which should be taken into consideration in nursing staffing.

Job evaluation is systematic process to define the value of each position. It is the key step in the post management.Analyzing the methods and effects of the nursing job evaluation is beneficial in establishment of a scientific nursing job evaluation system in China. This article reviewed the generation and development, methods, application and research status, shortage and prospects of nursing job evaluation, in order to provide basis for further study of the nursing job evaluation.

Objective: To investigate the obstacles of transitional care among secondary and tertiary general hospitals.Methods: A total of 43 nursing managers and 1829 clinical nurses in 43 general hospitals were investigated by a transitional care obstacles questionnaire. Results: The biggest obstacles during transitional care included human resource shortage, lack of national policies, laws and regulations, undefined charging standards, imperfect hospital-community transfer system, ability shortage of nurses and low awareness of patients.Different obstacles were faced between nursing managers and clinical nurses, and between secondary and tertiary hospitals. Conclusion: Great challenges of transitional care existed in hospitals. Hospitals could set up specialized institutions and multidisciplinary teams, formulate standard transitional care procedures, and improve patients’and families’ conceptions of transitional care. Medical organizations could formulate laws, regulations, charging standards and hospital-community transfer system to promote the development of transitional care.

Objective: To improve the quality of nursing records and management effectiveness through design and application of the nursing records completeness checking tool. Methods: According to JCI accreditation standards for patients'assessment and medical records quality measuring elements, combining their clinical work experience, the authors designed the nursing records completeness checking tool. It included four primary indicators, named initial nursing evaluation, re-evaluation,health education assessment, and care plan; and 24 secondary indicators. About 5% -10% of the operating records of each nursing unit were extracted and checked monthly by a quality control specialist. Three level results named "yes, no, or not applicable (NA)"were used for the evaluation. Results: The nursing records complete rate increased 2.77% (P<0.05) after using the nursing records completeness checking tool. Nursing reassessment, health education assessment and care plan record completeness increased 3.59%, 2.25% and 9.12% , respectively (P<0.05). Record completeness of secondary indicators, including constraint assessments,special examination/treatment, nursing diagnosis, diagnosis-related factors, and the nursing goal achieving time record, increased 15.83%, 17.04%, 22.25%, 16.05%, and 8.42%, respectively (P<0.01). The evaluation of nursing records completeness checking tool application showed that the satisfaction on four primary indicators design was 96.0%, 92.0%, 90.0%, and 90.0%. The recognition degree of "Yes, No, NA" judgment methods was 90.0%; and 92.0% nurses believed that it could improve the completeness of the nursing records. The average checking time for one set of nursing records shortened 49.4% compared with before. Conclusion:Application of nursing records completeness checking tool could effectively improve the quality of nursing records.

Objective: To investigate the nurses and the doctors' attitude towards doctor-patient dispute. Methods: Totally 353 nurses and 306 doctors from 7 hospitals in Beijing were selected conveniently and surveyed with a self-made questionnaire.Results: The nurses' and the doctors' identification rates on the causes of doctor- patient dispute had significant differences (P<0.05) on 4 items, named unreasonable medical visit process, the medical staffs' service attitudes, medical staffs' sense of responsibility,and the medical staffs' medical skill. But they all agreed that the gap between therapeutic efficacy and the patients' expectation,overloaded medical staffs, different understandings on therapeutic efficacy between the medical staffs and the patients, patients'dissatisfaction with the society or the other issues, the communication problem between the medical staffs and the patients were important causes for doctor-patient dispute. In terms of the concerns after doctor-patient dispute, the nurses' and the doctors'identification rates had no significant differences (P>0.05) except item "negative effects on professional title evaluation". The identification rates which were more than 90.0% included disturbance of daily life and work from patients' entanglement,impairing working enthusiasm, negative effects to hospital and departments' performance. In terms of precautions to doctorpatient dispute, the nurses' and the doctors' identification rates had no significant differences (P>0.05) except 2 items, optimization medical visit process and shortening the waiting time, and positive news media orientation to the public. Furthermore, the nurses'and the doctors' identification rates on 7 items were all above 90.0%, such as improvement of the relevant laws and regulations,balance of the medical service resources, optimizing treatment process and shortening the waiting time, positive news media orientation to the public, improving the medical skill, communication skill and service attitudes of medical staff. Conclusion:Comprehensive measures, including guiding the public understand the medical process correctly, and improving relevant legislation further, could be helpful to reduce the occurrence of doctor-patient dispute and resolve them properly.

Objective: To explore the influence on bed occupancy from improving quality of care procedure. Method:Compare the bed occupancy rate and patients satisfaction before and after with improving of bed reservation, admission and discharge managements procedure in breast oncology floor from October 2013 to March 2014. Result: Bed occupancy rate increased from 88.4% to 104.3% with the improving of quality of care procedure. Patient satisfaction rate increased from 67.0% to 88.3%. Conclusion: Improving quality of care procedure can improve the bed occupancy rate and patient satisfaction rate.

In order to effectively alleviate the problems such as more patients versus limited beds and hard admission versus higher cost, our hospital has launched two modes of day care ward. One is day care ward combined with general ward, and the other is independent day care ward only. Both of them have achieved good results so far. This paper introduced the differences of two day care ward modes in operation management and service process, compared the efficiency indicators of two day care wards in 2014, analyzed their advantages and disadvantages in the management respectively, and proposed countermeasures for their shortcomings to meet the requirements of the new medical reform and improve the management of different day care wards.

Objective: To explore the effect of applying Quality Control Circle (QCC) to improve instrumental cleaning quality. Methods: We carried out QCC activities, grasped the current situation, analyzed the cause of incomplete instrumental cleaning, developed and implemented the strategies, and attained the continuous quality improvement. Results: The unqualified instrumental cleaning rate decreased from 2.30% to 0.58% by visual inspection before and after the implementation, and the difference was statistically significant (P<0.01). Conclusion: The QCC can effectively improve the quality of medical instruments cleaning quality.

Objective: To investigate the intention of reporting adverse events among clinical nursing students and analyze its influencing factors. Methods: Randomly selected 188 nursing students from 4 teaching hospitals in Tianjin via convenient sampling, apply common questionnaries to investigate the cognition, intention and barriers on reporting adverse events. Results:The score of the reporting intention questionnaire was (9.89±3.85), the score of barriers was (3.14±0.39). The reporting intention was influenced by educational background, safety training, adverse event experiences and reporting significance (P<0.05).Conclusion: Schools and hospitals should strengthen patient safety education for clinical nursing students, emphasizing the significance of the reporting and create a non-punitive culture, so as to improve their safety awareness and improve the intention of adverse events reporting.

Objective: To investigate the knowledge status of occupational protection for blood-transmitted disease in logistics staff from a primary hospital. Methods: The authors investigated and analyzed the knowledge of the protection measures against occupational exposure to blood-transmitted diseases among the logistics staff of their hospital through a questionnaire survey.Results: Only 27.32% of all respondents acquired protection knowledge through training organized by the hospital; in terms of selfprotection attitudes, 53.61% of all respondents paid attention but lacked of action, 11.86% had no awareness and took no protection measure; 31.44% had not been vaccinated with Hepatitis B vaccine; the rate of correct answers to relevant questions on bloodtransmitted diseases was only 57.84%. Conclusion: Hospital administrators should pay attention to and enhance the education and management of front-line logistics staff's knowledge of blood-transmitted diseases, improve their compliance on self-protection,and timely vaccinate them, in order to effectively prevent or reduce the possibility of infection of blood-transmitted diseases.

Objective: To explore the effects of visual education on prevention of fall in inpatients. Methods: Having analyzed the incidence of falls of inpatients from January to December in 2013 and obtained the topmost causes, we made videos and pictures for fall prevention. Lastly, we applied scenario and videos education accompanied by normal care to patients at high risk of falling in five wards from April 2014 to March 2015. We compared the incidence of falls of patients between baseline and post-intervention.We also randomly surveyed inpatients' cognition, behavior, and satisfaction to fall prevention measures. Results: The constituent ratio of inpatients at low, medium and high risk of fall in pilot ward were not significant between pre and post-intervention (P>0.05). The incidence rate of falling of inpatients before and after the intervention, link relative ratio, significantly lower (28.26%~46.34%), has clinical significance. the inpatients' cognition and behavior of prevention of fall were obviously improved (P<0.01). The satisfaction of prevention measures were 91.76%. Conclusions: Inpatients with medium and high risk of fall are the main groups of the falling.Visual education accompanied with falling grading care could effectively reduce the incidence of falls in inpatients and improve inpatients' awareness and satisfaction of fall prevention, and can also effectively reduce the potential medical disputes.

Objective: To analyze the causes of unplanned extubation. Methods: Sixty-three unplanned extubation reported during January 2012 to December 2014 at our hospital were collected and analyzed, patients' age and gender, professional title and working years of the duty nurse involved in unplanned extubation, the occurrence time and the clinical department distribution were all analyzed. Results: Male, elder and unconsciousness were the risk factor for unplanned exbubation, the incidents happened more frequently at night than in daytime, and more frequently in ICU and surgical department than others. The duty nurses were more likely to be the junior staffs (P<0.01) and within five working years (P<0.01). Conclusion: The unplanned extubation cause analysis can provide reference to patient safety management. It is very important to assess high-risk patients, strengthen the key links management, and improve the nurses' safety knowledge to reduce the unplanned extubation.

This paper introduced the concept, structure and the research progress of acceptance of nursing information system, and analyzed and summarized the influencing factors of nurses' acceptance on nursing information system from different aspects in order to provide references for improving nurses acceptance.

This paper introduced the application of information management in the promotion of evidence-base nursing practice from four aspects, which were establishing evidence-based nursing database, the application of Clinical Decision Support System, the development of mobile information technology and the establishment of WeChat or Website platform. Then they provided appropriate suggestions for the construction of nursing informatics in the trend of evidence-based nursing practice.

The lung transplantation center in our hospital established a nurse-based case management model with a multi-discipline cooperation and comprehensive management. In the different stages of treatment in lung transplantation, case management nurses delivered "multi to one" service model for patients with lung transplantation and their families according to their unique responsibility, and provided professional, individualized full-range service during the whole treatment. The model achieved good effects.

Objective: To investigate the best way of pregnant women school under Chinese national conditions. Methods:Totally 108 cases of pregnant women in pregnant women school were chosen as the experimental group, and carried out in accordance with the concept of family-centered care. The specific pattern was: after determined the main family member who was going to take care of the maternal and figured out the learning needs, formulated the related course and operation practice. Then invited all the family members who were mentioned above to participate in the pregnant women school. Another 103 pregnant women in pregnant school were chosen as control group who were given routine teaching without any requirement to their family members. Make effect evaluation before intervention and in postpartum 42 days respectively. Result: For the experimental group,the total score of teaching effect was statistically significant different compared with the control group (P<0.05). Conclusion: Family-centered nursing concept used in pregnant women school education can improve the effect of education, promote the harmonious relationship between nurses and patients, and reduce or avoid conflict by the differences between traditional method of neonatal care and modern nursing concept in the family.

Objective: To explore the effect of team midwifery model on primiparas' childbirth efficacy and birth outcomes.Methods: The primiparas who established the birth cards in our hospital were recruited by the convenience sampling method and divided into the control group and observation group. The 89 primiparas in the control group received routine delivery service, while 92 primiparas in the observation group received team midwifery service. The primiparas' childbirth efficacy and birth outcomes were compared between the two groups. Results: The scores of childbirth efficacy in the observation group were significantly higher than those in the control group (P<0.01). The rate of cesarean section, labor analgesia and bleeding volume 2 hours postpartum in the observation group were significantly lower than those in the control group (P<0.05). The duration of first and second stage of labor in the observation group were significantly shorter than those in the control group (P<0.05). Conclusions: Team midwifery service model could improve primiparas' childbirth efficacy, birth outcomes, and service quality in the department of gynecology.