The traditional subject-centered nursing curriculum and pedagogy can hardly fit in the distance learning.Based on the principles of adult learning and professional development of nurses, The School of Distance Learning for Medical Education (SDLME) launched teaching reform of online nurse training, a series of curriculum wereput into practice.The curriculum displayed superiority of distance learning, combined theory with clinical practice, which could provide theoretical and practical implication to improve nursing distance education in China.

This article analyzed the concepts of nursing professional core competence, and reviewed literatures about core competence-based nursing education,including curriculum design, teaching strategies and assessments.

Nurse-patient relationship coordination and dispute processing is a course of distance learning innovation system in nursing major for top-up program and it is based on professional tasks. Four learning situations from simple to the complex that meet the development rule of nursing ability and matched learning tasks for complete nurse-patient relationship coordination and dispute processing were designed by Expert Worker Workshop. Students completed learning tasks by selected and analysis clinical cases based on specific learning situation. The practice on 115 students of 2013-2015 grade has achieved expected effect. 74.50% of the students selected and learned the cases in line with the teaching requirements and 86.62% of the students achieved the teaching requirements. After learning, the academic record showed upward trend overall and students' ability to apply theory to practice was improved obviously which was helpful for improving clinical work ability.

COMET model is a multidimensional, across-profession competence assessment model, which is theoretically based on New Vocationalism, Situational Learning Theory, Law of Vocational Development and Action Oriented Theory. There are three dimensions covered by COMET model, including requirement (competence level), content and action. Characterized in advanced theory basis, comparability among professions or regions, comprehensiveness in competence assessment and openness in method, COMET model distinguishes itself from traditional competence assessments. Since the application of COMET model in nursing has just begun, it is necessary to broaden the empirical research in the future.

Objective: To improve students’ comprehensive practice ability so as to meet requirements of the clinical nursing undergraduate by applying the theory of logical starting point to set and implement graduate practice courses for upgraded training students from the network school (experimental classes). Methods: Firstly, students accomplished the patient’s overall care based on their working task. Then they submitted a typical case nursing plan and completed the following practice courses according to the case. The contents of the project included: writing an individualized nursing care plan based on the changes of condition; conducting health education activities relating to the case; asking and answering questions for knowledge points involved in the case and evaluating the learning effects. Results: Totally, 18 students involved in the experimental class at the first session and 11 of them were qualified. The highest score of the comprehensive assessment was 89.00 and the median score was 71.75. Besides, the score of clinical typical cases, clinical nursing plans, multiple choices questions and analysis, giving a lecture by PPT or making a popular science video were 22.00, 10.50, 16.00, and 13.00,respectively. Conclusions: The setting and implementation of nursing practice courses based on the theory of logical starting point can promote students to solve clinical problems with scientific thinking methods and can help students learn to break up targets, and to make plans and improve learning goals by themselves.

Problem solving care is a network-based curriculum for bachelor students of School of Distance Learning for Medical Education of Peking University. The aims of the article were to summarize experience of curriculum reform,implementation and evaluation of the curriculum. Advantages and problems of curriculum design and implement were also analyzed.

Objective: To develop and implement courses for distance nursing education based on clinical practice research findings. Methods: The course "Comprehensive Training for Nursing Clients with Specialized Conditions" for undergraduate students in Peking University School of Distance Learning was developed based on clinical practice research findings. The effect of education was evaluated. Results: All of the students passed the course, the average score was 85.31±7.61. 60.0% of the students thought the course was difficult, 53.3% of the students thought the course could meet most of their learning needs. Conclusion: The distance nursing education courses based on clinical practice research findings can improve students' comprehensive ability of nursing practice.

Objective: To determine the risk factors of thrombosis associated with Peripherally Inserted Central Catheters among cancer patients. Methods: The research was conducted in two tertiary Grade A general hospitals in Guangzhou. It was a retrospective study from January to December, 2014. We recruited the eligible patients and investigated their demographic data, medical history and complications within 3 months of catherization, and then used multiple logistic regression analysis to determine PICC related thrombosis risk factors among cancer patients. Results:Risk factors positively associated with thrombosis were diagnosed cancer for more than seven month, metastases, history of radiation, and fat emulsion/mannitol infusion, and the value of OR and 95% CI were 1.832 (1.092-3.386), 2.358 (1.113-4.996), 4.348 (1.902-9.941), 3.442 (1.044-11.341) respectively. Conclusion: The risk factors of PICC related thrombosis among cancer patients included diagnosed cancer for more than seven month, metastases,history of radiation, fat emulsion/mannitol infusion.

The incidence of breast cancer has been increasing in recent years. It is a serious threat to women's physical and mental health. In the meantime, Mindfulness-based Stress Reduction (MBSR) has been widely used as a psychological therapy in western countries, and it is proven to be effective to improve the quality of life of breast cancer patients. This study retrospectively analyzes the application of mindfulness based stress reduction therapy concept and content, existing problems and the effects of mindfulness based stress reduction in breast cancer patients, and summarizes the deficiencies in the treatment and future research directions, in order to provide reference and basis for the implementation of mindfulness based stress reduction in breast cancer patients.

Objective: To improve fall the management of risk prevention in cancer inpatients through the empirical analysis, in order to promote continuous improvement the quality of management falls. Methods: Select 60 cases of adverse events of fall from 2013 to 2015 to empirical analysis. Through the revised fall assessment, to establish falls management quality evaluation indicators(including structure-process-result), to improve the quality of fall management, build a result oriented, with emphasis on the evaluation, prevention and intervention process monitoring, the management mode.Results:After six months of data collection and effective observation and sum up, to compare the evaluation indexes of fall and management strategies. Fall rate dropped from 0.9 ‰ to 0.38 ‰. Conclusions: Through the empirical analysis, to provide evidence-based basis for the continuous improvement of fall management in cancer inpatients. Fall assessment index is applied to each clinical nursing unit and quality control, which are more targeted, standardization, and help to improve the quality management of fall in the hospital, to ensure the safety of patients.

Objective: To construct a core competency framework for wound/ostomy nurse specialist. Methods:Nineteen wound/ostomy certified specialists from tertiary hospitals in Beijing, Shanghai, Guangdong, and Shandong were consulted with three-round Delphi studies. Results: The degree of experts' opinion concentration were very high. The authority of the expert advisory coefficient was 0.90, familiar coefficient was 0.85, and determination coefficient was 0.95.The coordination coefficient of primary and secondary and third indicators were 0.495, 0.472, 0.282, respectively. The indicator system consisted of 6 first-level indicators, 19 second-level indicators and 69 third-level indicators. Conclusion:The core competence evaluation index system is reliable and valid. It can provide reference standards for training and evaluation of wound/ostomy nurse specialist.

Objective: To explore the relationship between clinical nurses' knowledge sharing behavior on their core competency. Methods: A total of 448 nurses from three tertiary hospitals in Hunan were recruited and investigated by the Knowledge Sharing Behavior Scale and the Competency Inventory for Registered Nurse (CIRN). And the relationship between knowledge sharing behavior and competency inventory was analyzed. Results: The mean score of the Knowledge Sharing Behavior Scale and the Competency Inventory for Registered Nurse were (2.36±0.69) and (2.78±0.55),respectively. The total score and the score for each dimension of the Knowledge Sharing Behavior Scale were all positively correlated with the total score of the Competency Inventory for Registered Nurse (P<0.01). Stepwise multiple regression analysis have shown that the score for three dimensions of the Knowledge Sharing Behavior Scale such as organizational communications, personal interactions and communities of practice could explain 39.9% of the variance for clinical nurses' competency inventory after controlling the demographic variables. Conclusion: Nursing administrators should take scientific and feasible intervention measures to improve clinical nurses' knowledge sharing behavior and promote the development of nurses' core competency based on the present situation of clinical nurses' knowledge sharing behavior.

Objective: To investigate graduate nursing students' attitude towards research integrity and research misconduct. Methods: Totally 220 graduate nursing students were recruited conveniently and surveyed with a self-designed questionnaire. Results: Most of the graduate students (91.8%) thought research integrity were important or very important.The total score of attention level on research integrity was (13.30±3.61). The attention levels of the first year graduate students and the students who had never published papers in key journals or never received research integrity training were low (P<0.05). The graduate students thought that research misconduct mainly affected the prestige of the researcher's academic field (4.45±0.79), public's faith on researchers (4.45±0.78) and the researcher's academic reputation (4.44±0.74).They considered the lack of the academic supervision (77.7%), influence of social environment (77.3%), insufficient research ability (74.1%), defect of academic morality (62.3%) and the quantitative evaluation of research (61.4%) as the main causes of research misconduct. Conclusion: Graduate nursing students have realized the importance of research integrity.However, further education is needed to improve graduate students' attention level on research integrity and recognition of research misconduct. Creating research integrity atmosphere, improving academic supervision and evaluation mechanism,and strengthening comprehensive quality of graduate students are necessary for improving the research integrity of graduate students.

Objective: To identify the status and impact factors of ICU patients' discomfort, and provide references for interventions of reducing ICU patients' discomfort level. Method: Totally 185 patients transferred from ICU in 3 tertiary Grade A hospitals were recruited in this study, the participants were investigated with Chinese version-IPREA questionnaire, Critical-Care Pain Observation Tool, Simplified Acute Physiology Score, Richmond Agitation-Sedation Scale and Disease-related Questionnaire. Results: The mean total score of discomfort scale was (3.35±0.93). Thirst and isolation got the highest scores, and coldness and lack of information got the lowest. Multiple step-wise regression analysis showed that mechanical ventilation, marital status, duration of mechanical ventilation, SAPS II score, physical constraint hours, sedation, accounted for 31.2% of the total variances. Conclusions: ICU patients experience significant levels of discomfort, clinical staff should take timely and appropriate intervention strategies to improve ICU patients' comfort.

Objective: To study the status quo and its influential factors on nursing associations undertaking the transferring of government functions. Methods: This study was a cross-sectional study and the research object were 62 leaders with Vice Deputy or above title from nursing associations throughout the country. The self-disigned questionnaire was used in the study. Results: A total of 13 government functions could be transferred to nursing associations. There were some factors that may influence the positive outcomes of the transfer, and the top 4 obstacles were: the lack of laws and regulations (80.6%), administrative intervene, lack of independence of nursing associations (61.3%), the lack of the ability to self fund (58.1%), and the lack of qualified evaluation experts and staffs (45.2%). Conclusions: Nursing associations value talent development and evaluation. However, challenges exist in the transferring process and need to be solved in order to better promote the idea.

Objective: To explore effects of Mini Clinical Evaluation Exercise (Mini-CEX) applied to teaching the course of fundamental nursing for baccalaureate nursing students. Methods: Totally 102 nursing students were randomly divided into control group (n=51) and an observation group (n=51), the control group taught using traditional method, while the observation group was taught using traditional method with Mini-CEX. Results: Test scores of operation skills, the average score of humanistic caring ability and the average score of Classroom Atmosphere Assessment Scale in the experimental class were significantly higher than those in the control class. Conclusion: Mini Clinical Evaluation Exercise applied to teaching the course of fundamental nursing for baccalaureate nursing students, which improve students comprehensive quality.

Objective: To explore the relationship between teaching efficacy and working engagement among nursing teachers. Methods: Totally 148 nursing teachers from a tertiary general hospital in Dalian were recruited and investigated by the Teaching Efficacy Scale and the Utreeht Work Engagement Scale. Results: The scores of teaching efficacy and working engagement were (102.64±12.73) and (48.68±8.95). The results of Pearson correlation analysis showed that teaching efficacy and working engagement were significantly correlated (P<0.05). The results of hierarchical regression analysis showed that self-teaching efficacy and teaching efficacy could explain 16.1% of the variance of teachers' working engagement, they were positively predictive indicators on working engagement. Conclusion: Nursing managers should take effective measures to cultivate clinical nursing teachers' teaching efficacy, to maximize nurses' working engagement,so as to improve clinical nursing education quality.

Objective To explore the establishment on educational training system for caregiver in medical support binding models for patients with cerebrovascular disease. Method Establish an educational training system by pre-job training,practical training, continuing education training and regular assessment. Result The preliminary system on training and management for caregiver have formed, the qualification building of caregiver have been completed basically, and the professional skill and professional quality have been increased greatly. Conclusion The system of educational training for caregiver is adaptive in medical treatment which combined with pension institution, and it is worth to further improve and promote.

With the increasing trend of aging in China, the combination of medical and endowment model has gradually become the inevitable choice for China's endowment industry. At present, in our country the nursing human resource quality does not match the combination of medical and endowment model which put forward 3 new demands of occuptional care skills and related knowledge, keen attention to the elderly mental health, and a high degree of occupational identification.Learning from the developed countries experience of training endowment care workers, China should establish a endowment care worker training system from riching training content, establishing hierarchical training system, cultivating occupational identification and establishing macro endowment care workers training plan, in order to improve the comprehensive quality of endowment care workers and to promote the combination of medical and endowment model development.

Objective: To explore the effectiveness of a home based physical activity program based on the Transtheoretical Model among COPD patients in stable phase. Method: Totally 120 COPD patients in stable phase were recruited from outpatient clinic of Peking Union Mecdical College Hospital from October 2013 to April 2015. We divided them into intervention group and control group. Patients in control group received routine education about home based physical exercise, while patients in intervention group received 8-week telephone follow-up based on the Transtheoretical Model besides routine education. Results: There were statistically significant differences (P<0.05) in the process of behavior change(cognitive level and behavior level), decisional balance (interest and obstacle factors) and self-efficacy between the two groups.More patients in intervention group participated in home based physical activity than those in control group. Conclusion: The home based physical activity program based on the Transtheoretical Model could promote the patients' participation.

Objective: To explore the impact of continuing care for discharged disabled elderly patients. Method:Firstly, conduct preliminary assessment on discharged patients, and select elderly disabled patients with catheter and (or)patients with open wounds. Secondly, conduct telephonic assessment after 1 to 2 weeks of discharge, and home visit to provide patient education on catheter care and wound care, and build continuing care platform. Result: Compared with before, the readmission and complication rate reduced. Conclusion: The implementation of continuing nursing service mode in general hospitals can decrease the readmission rate of the elderly patients with disability.

Objective: To systematically analyze the research trend of hospitalized patients' falls in China, so as to provide evidence for future studies. Methods: Articles about falls published from 2004 to 2015 were retrieved from CBM,CNKI and Wanfang databases, and were analyzed systematically. Results: Altogether 827 articles published in 251 journals were retrieved. Authors were located in 28 provinces and most were in medical institutions. Most articles were clinical research, and about 17.7% were randomized controlled trials. The subjects were mainly old patients. Most research focused on analysis of reasons and prevention of falls, evaluation of scales, and the effect of multi-factorial tools for the quality control of falls prevention, etc. There was no standard clinical guideline for the management of hospitalized patients' falls at present. The references were mainly Chinese literatures (91.5%), and only 8.5% were in foreign languages. Only 5.9% of them were supported by research funds. Conclusion: The falls of inpatients have attracted wide concerns by clinical staff.Multi-center and high-quality RCT were needed. A more effective and feasible preventive intervention is needed, so as to provide more powerful evidence for falls prevention.

Objective: To explore the attitude level of patient participation in patient safety and its influencing factors among inpatient with hand injury. Method: Totally 311 patients with hand injury were recruited and answered Patient Safety Questionnaire. Results: The total average score of the participation was 3.71±0.54, the average score of self participation attitude was 4.03±0.52, the average score of self defensive attitude was 3.91±0.68, the average score of self protective attitude was 3.81±0.84, the average score of information acquirement was 3.42±0.59 and the average score of proactive disclosure and inquiry was 3.39±0.97. Hospital nature, education level of patients, hospitalization rate and occupation were influencing factors. Conclusions: Patients have strong motivation to participate, but lack of understanding of the condition and lack of initiatives. Therefore, clinicians should communicate well with patients, provide necessary information regarding their test results and treatment options, ultimately, improve the participation rate from the patients.

Objective: To evaluate the application effect of the warning signs and prevention schemes on the aspiration safety management among the elderly patients. Methods: Totally 168 patients were recruited and divided into observation group (88 cases) and control group (80 cases) according to admission time. The control group was given routine aspiration education, while we designed aspiration warning signs and prevention scheme for the observation group based on the standardized swallowing assessment and aspiration risk classification. We compared the incidence of feeding aspiration during hospitalization between the two groups. Results: During hospitalization, the patients in the observation group eat 5380 times and aspiration occurred 41 times (0.76%) with 37 choked cough, 4 choking, and 0 asphyxia. The patients in the control group eat 4824 times and aspiration occurred 172 times (3.57%) with 148 choked cough, 23 choking, and 1 asphyxia.The aspiration incidence rate between the two groups was statistically significant (P<0.01). Conclusion: The implementation of the warning signs and prevention schemes could improve the vigilance, scientificalness and pertinence of nurses' work,and the patients could accept and understand easily. This is an effective management method of preventing aspiration.

Objective: To explore the preliminary construction of nursing care safety index based on the process of dental treatment. Methods: Through literature review and experts' group discussion, the authors designed the preliminary construction of nursing care safety quality index. Then Delphi method was used to revise the indicators. Results: After two rounds of Delphi procedure, the opinion of the experts became consistent. Questionnaire collecting rates of the two rounds were both 100%, and cooperation index were 0.237 and 0.258 respectively (P<0.01). Five quality indicators were confirmed, including health education rate, implementation rate of protective measures, incidence of oral soft tissue injuries, incidence of ingestion/aspiration, and incidence of fall/dropping from chair. Conclusion: The nursing care safety quality index in dental clinic was scientific, reliable, and feasible, which could provide basis for improvement of nursing safety in dental clinic.

This study constructed a regional collaborative distance nursing education module on the Shengjing Medical Alliance network platform. The integration and sharing of high quality nursing education resources could be realized in the area, and the training needs of nurses in the union hospitals could be satisfied. In this paper, we made a specific description of the structure and function of each part of the distance education module, and hoped to provide some help for how to carry out distance nursing education among the regional alliance hospitals.

Objective: To explore the effect of implementing an intelligent intravenous infusion system on improving safety. Methods: A controlled clinical trial was used to compare the error rates in the process of intravenous infusion before and after implementing this intelligent system. Two wards in a certain secondary hospital in Shanghai were determined as experimental and control group and the error rate in the two wards were collected by researchers from Oct 2014 to Sep 2015. Results: After intervention, the error rate in the experimental group which implemented the intelligent intravenous infusion system significantly decreased to 0.42%, while the rate in the control group remained 4.31%. Conclusion: The intelligent intravenous infusion system could significantly reduce the error rate in the process of intravenous infusion and improve safety by rationally adjusting drop speed, and improve ways of checking and working environment.

There has been widespread application of exercise intervention in patients with schizophrenia. This article summarized the implementation, safety, feasibility and effects of exercise in patients with schizophrenia. The shortcomings of current interventions were also analyzed. It may provide suggestions to promote the rehabilitation of patients with schizophrenia.

By analyzing the characteristics of psychiatric patients with hospital infection and analysis of infection causes, summarized psychiatric infection in the study of key problems and psychiatric infection prevention and control measures are pointed out. In order to provide information for clinical nursing practice and nursing science and research.

By reviewing health literacy of diabetes patients, we illustrated the concept and assessments of health literacy for diabetes, effective strategies to improve diabetes health literacy and practical implications for future studies.

Subsyndromal Delirium (SSD) patients often show symptoms such as fluctuation of consciousness level, inattention, perceptual and thinking disorders. They don't meet the diagnostic criteria of full delirium, but their clinical outcomes will be impacted by SSD severely. SSD will lead to higher mortality, prolonged length of hospital stay and duration of mechanical ventilation.SSD has been highly concerned by researchersin the world. This article reviewed the epidemiology, etiology, diagnosis, treatment and clinical outcomes of SSD, so that to provide evidence for nurses to recognize and monitor patients' consciousness level in an effective way.

Analyze the challenge of nursing stratification management in China, the existing challenges including:the standard is not unified; job system separates from position system; hierarchical training and assessment systems need to be improved; nursing stratification management information system is still unmature. In order to sovle this, it is possible for us to integrate title system and position system to establish a unified stratification standard. And we may construct new multi-level training modes to improve hierarchical training and assessment. Also we can try to make full use of internet technology to improve information systems. All of these can promote the development of nursing stratification management system, and ultimately improve the nursing quality.

Horizontal violence is widespread in nursing workforce, which has become a major problem of the nursing profession and society.Horizontal violence causes adverse impact on nurses' mental and physical health, and even reduces the quality of nursing care and the development of nursing profession.Nursing managers should take effective measures to reduce horizontal violence and improve nursingcare quality.

This paper reviewed the research progress of disinfection method in the daily maintenance process of PICC, such as PICC disinfection site, disinfector choice and disinfection time. We aimed to provide guidance for nurses to prevent bacterial colonization and to establish uniform disinfection procedures and standards.