This article briefly reviewed the development of nursing sensitive quality indicators. On this basis, it expounded the connotation and extension of nursing sensitive quality indicators. Through the comparison of nursing quality sensitive indicators set released by different institutions, it extracted nursing quality sensitive indicators which conformed to general rules of quality management, and was featured with measurability, nurse leading, concern for patients' feelings,emphasison nursing thinking and effectiveness. Then, it introduced the general process and methods of developing nursing sensitive quality indicators, and way of using these indicators to continuously promote the improvement of nursing quality.With the concept of "using evidence to guide the improvement of nursing quality instead of experience management"gradually becoming a consensus, nursing sensitive quality indicators will play an increasingly important role in nursing quality management in China.

Objective: To determine the effect of the Pressure Ulcer Scale for Healing (PUSH) on evaluating pressure ulcer treatment. Methods: 455 patients (567 sites) with II-IV grade pressure ulcers were recruited in the study. The pressure ulcers were examined weekly, and the data collection tool was the PUSH. Results Significant differences were found before(8.37±3.14) and after (7.22±3.99) pressure ulcer treatment (P<0.01), except for IV stage pressure ulcer and non-hospital acquired ulcer (P>0.05). Conclusion:Pressure ulcer care overall effective in our hospital. Considering its easy availability, the PUSH can be used to track the healing progress of pressure ulcers.

Objective: To describe the characteristics of the nursingwork environment, in order to improve it.Methods:Descriptive study with 5234 nurses in five hospitals in mid-east region of China, conducted through Nursing Work Index - Revised. Results:The mean score of Nursing Work Index - Revised was 74.77±22.57. Policies and procedures received the highest mean score, and participation of hospital affairs got the lowest score. Conclusion: It is important to encourage nurses’ participation in hospital affairs and increase their salaries, in order topromote work environment and improve the quality of nursing.

Objective: To explore the effects of standardized physical restraint management on Intensive Care Unit patients. Methods: Using purposive sampling, we chose an Intensive Care Unit from a tertiary comprehensive hospital in Hangzhou to make a standardized physical restraint improvement, and compared the physical restraint rate, unplanned extubation rate, the proportion of physician orders and the correct rate of orders before and after the improvement. Results:There were statistically significant differences (P<0.01) in the physical restraint rate, the proportion of physician orders and the correct rate of orders before and after the improvement, while unplanned extubation rate has no obvious increase with the decline of the physical restraint rate (P>0.05). Conclusion: Standardized physical restraint management can obviously reduce the physical restraint rate in critically ill patients and can reduce adverse events and hospitalization expenses caused by the physical restraint. Meanwhile, there was no significant difference in unplanned extubation rate, which can ensure patients’ safety and reduce damages caused by the restraint.

Objective: To examine the relationships of nurse staffing level with nursing-sensitive patient outcomes.Methods: For this study, data was obtained from 121 tertiary hospitals in Shandong province using convenience sampling.All statistical analyses were done with the R project. The three nursing-sensitive patient outcomes variables included the incidence of falls, injury from a fall after admission, and pressure ulcers. Linear regression was employed to explore the relationships of nurse staffing level and nursing-sensitive patient outcomes. Results: A larger number of nurse staffing was significantly associated with a lower incidence of falls, injury from a fall after admission, and pressure ulcers. Conclusions:The findings suggest that hospitals could improve nursing quality by improving nurse staffing. Healthcare strategies and efforts to modify adequate nurse staffing levels are needed to improve outcomes.

This article reviewed the quality indexes of nosocomial infection management. It elaborated the importance of nosocomial infection indexes, and described the current status of researches and practices on infection indexes. This study highlighted the correlation between nosocomial infection and nursing processes,and indicated that improved nursing procedure would reduce the incidence rate of nosocomial infection.

Objective: To examine the relationships between nurse staffing levelwith quality of care and patients'outcomein intensive care unit (ICU). Methods: For this retrospective study, discharge data from 2013 to 2015 was obtained from a general ICU. Outcome measures include pressure ulcer prevalence rates, unplanned extubation, nursing adverse events, and ventilator-associatedpneumonia (VAP). The nurse staffing level was assessed by the number of patients assigned to a nurse. Linear probability model was used to assess the effects of nurse staffing on quality of care.Results:There were no statistical significances between nursing staffing level and pressure ulcers, unplanned extubation, VAP, central catheter related bloodstream infection (CRBSI) and nursing adverse events. A lower number of patients per nurse was significantly associated with a lower incidence of urinary tract infection.Conclusion: This study found that nurse staffing influence quality of nursing. The findings suggest that hospitals could promote nursing quality by improving nurse staffing.

Objective: To evaluate the effect of Music Therapy for premature infants through Meta-analysis. Methods:Relevant Randomized Controlled Trials (RCT) on music therapy for prematurity were retrieved from CENTRAL,EMBASE, PubMed, Web of Science, CNKI, CBM and Wanfang databases. The methodological quality of the eligible studies was assessed by two investigators independently. And Meta-analysis was conducted by RevMan 5.3. Results:Totally 11 eligible RCTs including 1182 premature infants were analyzed. The Meta-analysis revealed that average daily weight gain, weight in the 2nd week, intake of milk in the 5th day, intake of milk in the 10th of premature infants in music therapy group were higher than those in the control group (P<0.05). Length of hospital stays and heart rate in Music Therapy group were shorter or lower than those in the control group (P<0.05). No significant difference was identified in terms of oxygen saturation between the two groups (P>0.05). Conclusions: Music Therapy could help to increase intake of milk and weight in the 2nd week, shorten length of hospital stays, and reduce heart rate, but have no obvious effect on oxygen saturation.

Objective: To analyze the research of the peer support program in patients with diabetes, and to provide references for further research. Methods: We retrieved related literatures of peer support research in patients with Diabetes Mellitus from the database of CNKI, Wanfang and VIP. NoteExpress 2.0 and Excel were used to do analysis of literature bibliometrics.Results: Totally 95 articles were included and the quantity of articles presented a rising trend in recent years.Most research institutions were hospitals and the rates of cooperation and coauthor were low. The research types was mainly quantitative research and few qualitative research. There were also some problems, for example, lack of continuity in research region, single study population, lack of rigorous in research design, unclear diabetes typing, varying lengths of intervention time, unfavorable peer matching way, defects in quality control, and ignoring sample loss, etc. Conclusion:Diabetic patients peer support program has been paid more attention.The researchers from different institutions should strengthen cooperation, conduct more qualitative research, pay attention to improve the rigor of the research design, and to promote the further development of peer support project in patients with diabetes.

Objective: To test the reliability and validity of a Surgery-related Pressure Sore Risk Assessment Scale.Methods: Totally 261 posterior orthopaedics surgery patients during June to August, 2015 in Peking Union Medical College Hospital were recruited by convenience sampling method and investigated by the scales. Results: The Cronbach's α coefficient of the scale was 0.812 and the correlation between the assessors was 0.886. The content validity of each item ranges from 0.6 to 1 and the content validity of the scale was 0.940. Four factors were extracted by exploratory factor analysis and they could explain 58.824 percent of the total variance. The scale had a sensitivity of 87 percent and a specificity of 77 percent. The positive and negative predictive value was 3 percent and 98 percent, respectively. The Area Under Curve (AUC) was 0.832. Conclusion: The Surgery-related Pressure Sore Risk Assessment Scale is proved to be reliable and valid. It could be used to assess the press ulcer risk of surgical patients.

Objective: To explore the application of an violence risk assessment instrument HCR-20 among schizophrenia in community and examine its psychometric indexes. Methods: Participants from seven community health center in Beijing were recruited to do violence risk assessment using HCR-20. Follow-up was done during three month to record the occurrence of aggression. Results: Totally 136 of the 155 participants had been followed. Statistics revealed a satisfied predictive validity and inter-rater reliability, with the ICC of 0.72. As for accuracy, ROC analysis indicated the area under the curve of 0.78(95% CI: 0.56-0.96). Conclusion: The application of HCR-20 among psychiatric patients deems to be successful with good validity, reliability and accuracy in violence prediction. In future, through the inclusion of a variety of violence indicators, the assessment or evaluation system could be established to further improve the accuracy of violence risk assessment.

Objective: To investigate the current status and influencing factors of Post Traumatic Growth among the adolescents with chronic disease. Methods: Totally 194 adolescents with chronic disease were recruited by convenience sampling mechod. The Revised Posttraumatic Growth Inventory for Children (PTGI-CR), Perceived Social Support Scale(PSSS), and the Coping with disease (CODI) were used to measure the adolescents' posttraumatic growth and its influencing factors. Results: The total score of PTGI-CR was 15.54±7.23. The influencing factors included their age, gender,the parents' education level, family monthly income, coping style (self-consolation), and social support, which explained 26.3% of the variance. Conclusion: The PTG of the adolescents with chronic disease is in the low level. The nursing staff should find different ways to improve their post traumatic growth according to their different age, gender, the parents' education level, family monthly income, coping style(self-consolation), and social support.

Objective: To evaluate the quality of the clinical practice guidelines related to breastfeeding in hospitalized neonates by using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, and to provide reference for the development of breastfeeding guideline in China. Methods: The clinical guidelines for breastfeeding were identified and accessed by searching PUBMED database, WANFANG database, CNKI database, NGC, NICE etc.AGREE instrument was used to evaluate the quality of the latest versions of the clinical guidelines. Results: Ten guidelines were enrolled, and all were in English. Among them, 4 were breastmilk bank operation guidelines, and 8 were evidencebased guidelines. The results showed that the average scores in the 6 fields were 88.8%, 54.6%, 65.2%, 85.0%, 48.92% and 40%, respectively. Eight guidelines were positively recommended, and 2 were uncertain. Conclusion: The quality of the 10 clinical practice guidelines related to breastfeeding in hospitalized neonates was relatively high. But in the aspects of rigor in guideline development, applicability and independence, the guidelines need to be improved. The guidelines positively recommended could give good evidence and reference to promote breastfeeding in China. However, guidelines should be used according to our clinical situation, and local clinical practice guideline should be developed.

This study introduces nurse position management in France, categories of posts, job responsibilities, job training, job performance, post configuration and deployment mechanism, incentive safeguard measures, in order for our nursing position management to provide guidance and reference.

This study analyzes senior care system in France. Combined with current situation and issues of chinese elderly medical support, the study obtained the suggestions, including integration of pension and health insurance system,bring the social capital into full play, establishing and improving the referral system, accelerating the construction of community family doctor service mode, training geriatric specialists, utilizing variety of models simultaneously to meet the different needs of the elderly.

By visiting and studying at 4 teaching hospitals in France, the author learned the status of education and training management system in France. By understanding the features of their nursing management, clinical nursing service philosophy, system design of nursing stratification and training, the author pondered on the current situation of Chinese nursing management of education and training and put forward some proposal. We could learn from them in order to strengthen our nursing education and training system, increase nurses' job satisfaction so that we could promote the longterm scientific development of the nursing management.

During the 3 weeks study in France, we learned the following: French diversified health care services,the modernized hospital management strategies, particularly the fifth generation of the hospital nursing management system, talent reserve, the effective way to establish nursing management system, human resources management, teaching management through systematic training, building a master modern management knowledge and professional technical knowledge of nursing personnel. All these insights gave us a lot of inspiration when it comes to building our own nursing management team.

Objective: To evaluate the effects of nursing students pre-internship training with the model of cooperation between hospitals and university. Methods: Totally 114 students were collected, then based on class unit,they were randomized into the experimental group and the control group with 57 students each. The experimental group accepted pre-internship training with the model of cooperation between hospitals and university which include four steps observations, skill training, scenarios, and practicals; and the control group accepted traditional pre-internship training. The two groups were evaluated by Objective Structured Clinical Examination (OSCE) and the score of self-directed learning ability. Besides, the experimental group had a questionnaire survey of cognitive evaluation for the new "four steps" preinternship training. Results: There were significant differences on the score of self-directed learning ability and the OSCE grade between the two groups. 78.9% of the students in the experimental group hoped that cooperation between hospitals and university in pre-internship training would be continued. Conclusion: Cooperation between hospitals and university in pre-internship training is worthy of being popularized and applied.

Objective: To evaluate the effect of chart diet therapy on nutrition management in patients with IgA nephropathy. Methods: Totally 72 IgA nephropathy patients were randomly divided into experimental group and control group. The experimental group used the chart diet therapy to create meal plans, while the control group used the traditonal calories calculation method following up in 6 month and evaluating the nutrition status, SGA, Alb, TG, CHOL and other physiological indexes at three different times, first day of admission, 3 month follow up and 6 month follow up.Result: Compared with control group, the nutrition statu, SGA, Alb, Hb, 24-UP, BMI of experimental group were better.Conclusion: The chart diet therapy was easy to operate, and could improve the compliance and nutrition status.

Objective: To investigate the different impact of half-open and restricted visiting policy on symptoms and complications in patients with alcohol withdrawal syndrome (AWS). Methods: Forty-five patients with AWS were divided into half-open group (n=28) and restricted group (n=17). Clinical symptoms and adverse reaction between two groups were compared. Results: CAM-ICU score on day 3 in half-open group was significantly lower than restricted group (P<0.05),and AWS scale score, CAM-ICU score, SDS score and SAS score on day 7 in half-open group were also significantly lower than restricted group (P<0.05). In half-open group, ICU stay, AWS duration, and usage of sedative drugs were significantly lower compared to restricted group (P<0.05), while there was no difference of hospital acquired infection rate.The occurrence of injury and suicidal ideation in half-open group was significanty lower compared to restricted group.Conclusions: Half-open visiting policy could improve the state of AWS, decrease the occurrence of accidents, but have no effect on hospital infection. It can be used as reference in terms of creating visiting policy in ICU in future.

We established an intelligent management system with information technology in clean operating rooms.The numbers of persons in the operating rooms were controlled and monitored. The system effectively controlled the mobility of persons in the operating rooms, which could reduce surgical infection rates, and increase the management and service level of the Operating Room.

With the help of information technology, the lists of materials needed in surgery operations were collected and input into a surgical materials managing software. After the use of the software in practice, the accuracy rate of materials preparation has increased. The preparation time has become shorter. The frequency of nurses' going back for additional materials has decreased. The amount of medical consumables has been reduced. The nurses' satisfaction has significantly increased (P<0.05). The satisfaction rate of the doctors has significantly improved (P<0.05). In conclusion, the managing software is evidently proven to be able to improve the accuracy rate of preoperative preparation, to shorten the preparation time, to reduce medical consumables, and to increase satisfaction of doctors and nurses.

We analyzed the needs according to the health education characteristics of ophthalmic outpatient's health education and edited the software of health education management for clinic. We realized the collecting, storage, statistics and maintenance of patients' information, satisfied the needs of ophthalmic outpatient's health education, enhanced the standardization, safety and efficiency of ophthalmic outpatient's health education, and improved the patients' satisfaction to nursing work.

Objective: To evaluate the effect of the "sugar Guard" APP applied in the transitional care of diabetes. Methods: The APP was applied to clinic after docking with diabetes management platform developed by the First Affiliated Hospital of Guangxi Medical University. A total of 60 patients who met the inclusion criteria were recruited and divided into experimental group and control group with 30 patients in each group. On the basis of the existing health education model, the control group used telephone follow-up, while the experimental group used the "sugar Guard". Results: After 3 and 6 months' intervention, The improvement of blood glucose,blood lipid and other metabolic parameters, monitoring compliance, timely referral rates and patient satisfaction in the experimental group patients were better than those in the control group (P<0.05). Conclusion: Based on APP diabetes transitional care model, we could manage the patients scientifically and improve the patients' metabolic indicators, monitoring compliance, timely referral rate and satisfaction.

Objective: To explore the status and influencing factors of community nurses' knowledge related to insulin, and to provide evidence for improving the health-related management ability of community nurses' on diabetic patients receiving insulin therapy. Methods: A total of 267 community nurses from 31 community centers who were trained in these community nursing training bases from 2013 to 2015 were recruited. They were investigated by selfdesigned questionnaire. Results: The lowest score is 22, and the highest score is 88. The average score was 63.40±16.98.The percentage of errors on knowledge of insulin, method of using insulin pen and how to store are at the top three. There are significant difference among community nurses from different education degree, length of employment, and titles on insulin knowledge level. The results were as follows: F=3.85, P=0.02; F=10.21, P<0.01; F=21.58, P<0.01. Conclusion:Community nurses' knowledge related to insulin treatment is too poor. The organization managers should attach great importance on the knowledge-related training for community nurses, and adopting effective measures.

Objectives: To investigate the status of home medication safety in community and the needs of medication education. Methods: A total of 216 electronic questionnaire was sent to families in communities of Wuhan to investigate the knowledge of medication safety, medication management practice and education needs. Results: 92.13% participants had medication storage; 66.2% participants stored medicine inappropriately; 75.93% participants had expired medicine; 16.20% had the experience to take expired medicine; 100.00% participants discarded expired medicine inappropriately; only 50.00% of the participants took medicine on time; 46.76% and 51.39% participants followed doctors' order or medication instructions to take medicine; 73.61% of the participants needed home medication management education. Conclusion:Risks exist in home medication storage. Hospital-community-family service model should be developed to promote medication safety education, improve correct medication management behavior and community health.

Objective: To evaluate the effect of implementing hospital-community -family integrated care in patients with depression. Methods: The authors selected 54 depression patients, and then implemented hospital-community-family integration service to follow up the patients. WHO Quality of Life-Abbreviated Version (WHOQOL-BREF) and Suicidal Ideation of Self rating Scale (SIOSS) were used to evaluate the effects before and after 6-month intervention, respectively.Results: After 6-month intervention, the scores of three dimensions in SIOSS, named despair, sleep and optimistic factors were better than pre-intervention (P<0.01). The scores of physiological and psychological dimensions, and the general level of WHOQOL-BREF were higher than pre-intervention (P<0.01). Conclusion: Hospital-community-family integrated care model could effectively improve the quality of life in patients with depression, reduce the risk of suicide and ensure their safety.

Objective: To explore the effects of the 4R transitional care follow-up model on young and middle-aged gynecologic cancer patients with postoperative chemotherapy. Methods: A total of 156 young and middle-aged gynecologic cancer patients with postoperative chemotherapy were recruited.Participates were randomized to receive usual follow-up or the intervention (the 4R transitional care follow-up). Results: Compared to the usual follow-up group, the intervention group improved significantly on the functional dimension of life quality as well as reducing the level of the caregivers'burden.Conclusion: The 4R transitional care follow-up model could improve quality of life inyoung and middle-aged gynecologic cancer patients with postoperative chemotherapy, and reduce the caregivers' burden.

Objective: To investigate the current status of insulin usage and its related problems among firstly diagnosed diabetic patients in Department of Cardiology and to provide professional and educational guidance to the patients. Methods: We randomly selected 192 diabetic patients at the clinic from August 2014 to August 2015.The sample included 84 patients who were firstly diagnosed diabetes in Department of Cardiology and 108 patients who were firstly diagnosed diabetes in Department of Endocrinology. We investigated and compared the current status of insulin usage in the two Departments. Results: The percentage of injection dose as prescription are as follows: Department of Endocrinology group VS Department of Cardiology group, 76.9% VS 64.3% (P=0.049); the percentage of correct injection site: Department of Endocrinology group VS Department of Cardiology group, 94.4% VS 84.5% (P=0.023); the percentage of injection after sterilization area is dried: Department of Endocrinology group VS Department of Cardiology group, 71.3% VS 53.6% (P=0.012); the percentage of exhausting before injection: Department of Endocrinology group VS Department of Cardiology group 73.1% VS 47.6% (P<0.001); the percentage of the needle stayed more than10 seconds after injection: Department of Endocrinology group VS Department of Cardiology group, 96.3% VS 84.5% (P=0.004); the percentage of taking off the needle from the pen after each injection: Department of Endocrinology group VS Department of Cardiology group, 37.0% VS 22.6% (P=0.032). Conclusion: Patients who were first diagnosed of diabetes in Department of Cardiology received insufficient guidance of correct methods in insulin injection, so they need professional guidance about using insulin from medical professionals.

Objective: To explore the effects of music therapy combined with aerobic exercise on sleep quality among breast cancer patients during the course of chemotherapy after radical mastectomy. Methods: Totally 100 cases of female breast cancer patients receiving chemotherapy were randomly assigned to the intervention group (n=51) and control group (n=49). Implementation of routine care of patients in the control group, the intervention group received music therapy combined with aerobic exercise on top of traditional routine care. Pittsburgh Sleep Quality Index (PSQI) was used to measure the quality of sleep among the two groups at 10 days after the surgery, and after the first, third, and sixth chemotherapy courses, then the results were compared between two groups Results: PSQI scores in the intervention group after the first, third, and sixth chemotherapy, course were lower than the control group, the differences were statistically significant (P<0.05). Conclusion: Music therapy in combination with aerobic exercise can improve the patient's quality of sleep, also shows continuous improvements in various aspects of sleep reaction.

Objective: To research the effects of wound care center management with the methods of improving technique procedures combined with specialty nursing training. Method: Starting from technical improvement, 5 wound care techniques contained 30 procedure processes and 15 management processes were improved and used from 2013 to 2014 (improved application stage). Out of them, 16 procedure processes and 6 management processes were re-improved and used (optimum application stage) in 2015. Nurses were trained to use these processes by role playing, shadowing of certified wound nurse specialist, complex case report and evaluation processes in order to enhance clinician's problem solving skills.Indicators: Quaterly case study and practical exams to nurses. The number of dispute and complain, incidence of adverse events and level, number of specialty nursing clinic and wound care, technique treatment, wound healing rate and satisfactory level of patients every month and comparison of the effects of between two steps. Results: No dispute and complain happened between two stages. The adverse events level were III and IV and incidence rate was 0.01%~0.02%. The number of specialty nursing clinic and wound care visits increased. The number of debridement, negative wound pressure therapy and red light therapy in optimum application stage was more than ones in improved application stage (P<0.05) and patients satisfactory level enhanced in optimum application stage (P<0.05) and healing rate between two stages was not significant (P>0.05).Conclusion: Techniques improved combined with specialty nursing training methods were helpful to manage safety and quality for wound care center and beneficial to improve nursing quality and reduce risk of wound care complications.

Objective: To evaluate the evidence of associations between self-acceptance and mental health of plastic surgery patients. Methods: Totally 510 plastic surgery patients in a 3A hospital in Beijing were recruited by convenience sampling method. They were investigated using The Self Acceptance Questionnaire (SAQ) and The Mental Health Scale of plastic surgery patients. Results: The average score of self-acceptance was (2.71±0.35). The total score of mental health was(1.41±0.54), in which the subscale of appearance concern got the highest score (1.92±0.60). Hierarchical regression analysis showed that emotional disturbance and body image inferiority were significantly associated with self-acceptance, which explained 33.4% of the total variance. Significance was also seen for self-evaluation and self-acceptance with mental health,which explained 27.0% of the total variance. Conclusion: The level of self-acceptance and mental health of plastic surgery clients was in moderate level. Over-concern to the appearance is the main mental problem. Self-acceptance was associated with plastic surgery clients' mental health status.

Nurses' psychological contract is a hot topic in the field of nursing human resource management. This paper introduced the concept and development of psychological contract theory in nursing field, summarized its contents,dimensions and measurements, and analyzed its antecedent variables, consequence variables and moderating variables. It reviewed the present status of the research in this field, and proposed directions for researches in the future.