This article reviewed the definitions and models of transitional care, and explored the trends of transitional care practice in China and abroad. Three measures to improve the quality of transitional care research and practice were recommended, including: to provide scientific basis for national decision, to produce high-quality research evidences, and to identify the global direction of transitional care development and the priorities of research in transitional care.

Rapid growth in the development and use of Advanced Practice Nursing (APN) roles is expected to occur over the next decade. Situating the clinical responsibilities of these roles within models of care delivery designed to achieve improved patient and health systems outcomes will be important for ensuring their successful implementation and impact. Transitional care models are one approach to leveraging the clinical experience and expertise of nurses in advanced roles. The purpose of this paper is to describe the need for and define transitional care followed by a summary of the target patient populations, characteristics and outcomes of advanced practice nurse-led models of transitional care. Strategies senior nurse managers and leaders can use to develop and evaluate new models of transitional care involving APN roles will be provided.

To discuss the national health demand with the development of transitional care under the background of the Health China, and the opportunities and challenges of transitional care. The authors introduced the development of their hospital’s transitional care system since 2007, including the transitional care service mode, framework, and effects. They discussed multiple transitional care service programs, including discharge planning, referral services, long-term care, home care, chronic diseases case management, follow-up counseling, and external liaison, based on nearly 10 years of exploration and practice. Their experience provided a new thinking for the development of transitional care in China, and was helpful to promote long-term care insurance system and nurses’ multi-spot practice.

The aim is to introduce and offer personalized and one-to-one health management information to signatory stroke patients of Fangzhuang Community Health Service Center by their family doctor service team, based on the Intelligent Family doctors Optimized Coordination model to integrate community resources as well as data from the Community Health Management Platform. The two-way referral channel has been established to build a "hospital-community-home" continuation of care platform, in order to address the present and potential issues for those discharged signatory stroke patients, and provide schemes and ideas to practice of the combination of medical treatment and endowment. After preparation and practice in advance, the two-way referral channel has been applied well, and the "hospital-community" dual referral system has been achieved, so as to verify the path is effective. Meanwhile, the concept of "up and down linked, continual nursing and multiparty cooperation" has been put into practice.

Objective: To analyze the effect of comprehensive transitional care among colostomy patients with rectal cancer. Methods: Rectal cancer patients who will undergo colostomy surgery were recruited from three tertiary grade A hospitals in Guangzhou and randomly divided into intervention group and control group with 56 patients in each group finally finishing all the study. The patients were investigated by Stoma Quality of Life-Chinese Version, Stoma Self-Efficacy Scale, Stoma Self-Care Scale-early stage version before discharge, 1 month and 3 months after discharge. Results: The scores of stoma self-care ability, stoma self-efficacy, and daily routines and social interaction dimensions of quality of life among colostomy patients in intervention group were significantly higher that those in the control group (P<0.05), while the total score of quality of life in two groups had no significant difference (P>0.05). Conclusion: Comprehensive transitional care could improve the stoma self-care ability and stoma self-efficacy, but have little effect on the total score and two psychological dimensions of quality of life. When designing the transitional care interventions, we should pay more attention to patients’ psychological counseling.

Objective: To explore the influence of continuous nursing method on the development of premature infants. Methods: The 60 premature infants were randomly assigned into the control group and intervention group. The premature infants in the control group received the standard care, while the intervention group received the continuous nursing support. Results: There were significant differences between the body weights of the two groups in the third (P<0.05) and sixth month (P<0.05) respectively. There was significant difference between the body length of the two groups in the sixth month (P<0.05). Conclusion: Continuous nursing method can promote the development of premature infants, and enhance their quality of life.

Objective: To identify risk factors for Peripherally Inserted Central Catheter (PICC)-related Deep Vein Thrombosis (DVT) in elderly inpatients and develop a predict model of PICC-DVT. Methods: The data from 564 elderly inpatients receiving a PICC in PLA General Hospital between January 2008 and December 2015 were retrospectively analyzed. Cox proportional hazards model was used to identify risk factors and develop the PICC-DVT risk assessment model. The patients were stratified by risk of PICC-DVT using Jonckheere trend test. The model was evaluated by receiver operating characteristic curve (ROC). Results: Atrial fibrillation (AF), atherosclerosis, recent operation and prior vein thrombosis (VTE) were the key risk factors (P<0.05). PICC-DVT risk index=1.302χ1 (prior VTE) +0.775χ2 (recent operation)+0.596χ3 (AF)+0.610χ4 (atherosclerosis). With the increase of risk index, the incident of PICC-DVT increased significantly. The area below the ROC curve of the model was 0.73. Conclusion: AF, atherosclerosis, recent operation and prior VTE were the independent risk factors of PICC-DVT. The predict model is reliable in predicting PICC-related deep venous thrombosis.

Objective: To explore the experience in breast cancer patients before and after informing their parents of cancer diagnosis. Methods: The qualitative research was adopted. In-depth interviews were conducted with 19 breast cancer survivors. Data were analyzed by content analysis method. Results: Most interviewees had gone through the process of not informing their parents to inform them. The psychological experience before breast cancer patients informing their parents of cancer diagnosis includes worried about increasing the psychological burden of parents, worried about affecting parental health, thinking parents can't help them, feeling aggrieved and heart tired. There are positive and negative psychological experience after breast cancer patients informing parents. Positive psychological experience including parents are stronger than we expected, intimacy increased and psychological burden reduced. Negative psychological experience includes feeling guilty about parents and a sense of restraint. Conclusion: The psychological experience before breast cancer patients informing their parents of cancer diagnosisis more negative. The psychological experience after breast cancer patients informing their parents is complex, mainly positive psychological experience. Nurses should understand the psychological experience in breast cancer patients and help them to establish a good family support system.

Objective: To explore family role functioning and psychological experiences of young breast cancer patients when facing the disease. Methods: In this qualitative research, in-depth interviews were conducted with 15 young women with breast cancer. Data were analyzed by using content analysis method. Results: The family role functioning was impaired during hospitalization. Meanwhile, the patients felt low self-worth and guilty, worried about their children and marriage. Role stress and role motivation rose when the patients came home. Family role functioning recovered during the convalescence. Patients felt happy and satisfied. Patients' psychological experience changes with family role functioning. Conclusion: The psychological experience was influenced by patients' family role functioning. Nurses should understand the psychological experience of young breast cancer patients and provide appropriate support to help young patients back to normal life as soon as possible.

Objective: To investigate the impact of ICU nurses' organizational silence and job satisfaction on their turnover intention by establishing a structural equation model between them. Methods: Totally 205 ICU nurses from three tertiary grade A hospitals in Qingdao were investigated with Silence Behavior Scale, Mc Closkey/Mueller Satisfaction Scale (MMSS) and Turnover Intention Scale. Results: The scores of organizational silence, job satisfaction and turnover intention were 2.83±0.51, 3.01±0.36, 2.19±0.74. Organizational silence was negatively related to job satisfaction, and positively related to turnover intention. Job satisfaction played a mediating role between organizational silence and turnover intention. Conclusion: ICU nursing managers should pay attention to the impact of organizational silence on job satisfaction and turnover intention, and take measures to reduce nurses' organizational silence, improve job satisfaction to reduce turnover intention.

Objectives: To investigate the current status of insulin injection technique among patients with self-injection of insulin, and to explore the influencing factors of the insulin injection technique. Methods: Totally 246 patients were recruited and investigated by the self-designed injection technique of insulin questionnaire and patients' attitude on insulin scale. Results: The mean score of insulin self-injection technique was (28.24±5.08). Injection site rotation, needle treatment, and needle replacement were the weakest links among patients with self-injection of insulin. Multiple linear regression results showed that marital status, initial knowledge source, and attitude barrier were the influencing factors of self-injection technique score. Conclusion: Injection technique among patients with self-injection of insulin is still not standardized. Nurses should give the targeted guidance according to the patients'weak links. In order to improve the injection technique, we recommended that the diabetic nurses should implement initial injection education for the patients, and pay attention to divorced or widowed patients and patient attitudes to insulin.

Objective: To explore the current situation and influence factors of PICC care in children with cancer during intermittent chemotherapy. Methods: The 114 children with cancer and their parents were investigated with self designed questionnaire, which included items of knowledge, attitude and behavior about PICC maintenance. Results: The total score of the questionnaire was (79.83±10.18). The score of the knowledge, attitude and behaviour of PICC maintenance was (29.61±5.87), (15.60±2.32) and (34.63±4.66) respectively. The age of children, parents education level and family income had influence on the PICC maintenance level. Conclusion: Nurses can provide education on PICC maintenance based on the children's age and their parents' background to reduce the side effects of PICC during intermittent chemotherapy, and improve the quality of life of the children with cancer.

We designed and applied intelligent infant anti-theft system, connected it with HIS and mobile nursing information system in real-time, and realized the real-time data exchange. Nurses could accomplish the operation of maternal-infant pairs, alarming, and temporary out by the intelligent interactive terminal. The intelligent infant anti-theft system could timely and efficiently show the infant's location information, achieve a full range of regional monitoring, prevent theft of infant in hospitals, and ensure infant security.

Objective: To explore the application of flipped class model based on SPOC in the course of pediatric nursing. Methods: The flipped class model based on SPOC was delivered to 137 undergraduate students in the course of pediatric nursing, in which online teaching before class and offline teaching in class included.Students finished teaching video, online testing and online discussion autonomously through teaching platform before the class,while the class session was dedicated to more active deeper learning by feedback and answer questions, further group exercises, case analysis and summary. Results: All of the 137 students participated in watching video course ware and the discussion online before class actively. The accuracy of online test was high, and the accuracy of test for groups in class even reached 100%. According to the questionnaire survey, most students thought the flipped class model based on SPOC was suitable for the teaching and benefit for their study, and the contents of teaching were excellent or good. Conclusion: The flipped class model based on SPOC is benefit for the development of nursing students' active learning, clinical thinking, and their study performance and efficiency.

Objective: To explore the specialized training methods of pediatric rehabilitation nursing specialist. Methods: According to the nature of pediatric rehabilitation, The standard of nursing specialist training in pediatric rehabilitation was made based on the Nursing Specialist Training Program which was made by National Health and Family Planning Commission. The contents of pediatric rehabilitation training include children's growth and development, movement track, cognitive development, disease rehabilitation, rehabilitation assessment, functional training and rehabilitation nursing. The contents and the methods of training and evaluation were also refined.Results:Nurses' abilities were significantly improved in theory and operational skills in nursing specialists. Nurse specialists can solve pediatric patients' problems based on specialized theory and technology. Conclusion: With the improved theory and operational skills in nursing specialists, the quality of care and patient satisfaction in pediatric rehabilitation were improved.

Early Warning Score system (EWSs) is one of the most efficient nursing management tool for early warning. It could rapidly identify potentially critical patients and guide the medical staffs to take intervention. It has gradually applied to the newborn from adult patients and plays a positive role. Newborns are a special group of clinical patients, their quality of care has always been the attention of the society. This paper reviews the application status and development of EWSs in neonatal clinical care, thus to provide reference for enhancing the management of newborn safety and improve the quality of newborn care.

This paper introduced diagnostic standard, incidence rate and related factors of feeding intolerance briefly. We summarized the feeding strategies in preterm infants with feeding intolerance from feeding food types, feeding methods and assisted interventions in aboard and in China in order to provide reference for pediatric medical staff to prevent or treat feeding intolerance. We recommended that we should uniform feeding intolerance diagnostic criteria and establish a more standardized and effective feeding strategy to enhance the effect of nutrition support in preterm infants.

Objective: To explore the working environment and the sense of career success of nurses in the emergency department and analyze the impact of working environment on the sense of career success. Methods: The 160 nurses in two tertiary hospitals in Beijing were investigated using Chinese version of Career Success Scale (CCSS) and Nursing Work Index-Revised (NWI-R) questionnaires. Results: The total score of the CCSS is 31.42±5.60. The scores of the three dimensions from high to low are outside competitiveness (3.30±0.61), inside competitiveness (2.74±0.81), career satisfaction (2.66±0.67) respectively. Multiple regression analysis showed that times of training from outside of hospital in the general data, and involvement in hospital development and quality of nursing service in the working environment are the impact factors of career success in the emergency nurses, which explained 43.4% of the total variance. Conclusion: The sense of career success in the emergency nurses is in a low level. The working environment has a significant impact on the nurses career development. The nurse managers should improvethe working environment in the emergency department to enhance the nurses' sense of career success and stabilize the nursing professionals.

To review the process and strategies of nursing Business Process Reengineering, its inspirations for clinical applications, and the research and application progress of the theory of Business Process Reengineering in Chinese clinical nursing, so as to provide suggestions for better nursing management.

Objective: To explore the effect of different absorb moisture materials on the wet surgical equipment package and to improve the sterility quality of surgical equipment package. Methods: Using random classification method, we observed 920 surgical instrument packages with different packaging materials, including single-layer cotton, double-layer cotton, special gauze absorbent pad and disposable medical absorbent paper. After the pressure steam sterilization process, we compared the incidence of wet packages. Results: The wet package rates of double-layer cotton in cotton or non-woven packaging were 10.4% and 20.0%, respectively, which was significantly different (P<0.05). The wet package rates of special gauze absorbent pad in cotton or non-woven packaging were 8.7% and 31.3%, respectively, which was significantly different (P<0.01). When using cotton as the outer package, the wet package rates of double-layer cotton and single-layer cotton were 10.4% and 24.3%, respectively, which was significantly different (P<0.05). When using cotton as the outer package, the wet package rates of special gauze absorbent pad and single-layer cotton had significantly different (P<0.05). Conclusion: When using the same absorbent material, the incidence of wet packages in cotton with double-layer cotton or special gauze absorbent pad were lower than that of non-woven packaging. When using different absorbent materials, single-layer cotton as the outer packaging and special gauze absorbent pad had the highest incidence of wet package in cotton and in non-woven packaging, respectively.

Unplanned readmission is very common among stroke patients. It is a burden not only to patients themselves but also to the medical system. In the meanwhile, the prevalence of unplanned readmission may reflect the health care quality of first-time hospitalization. This paper aims to analyze the reasons and countermeasures of unplanned readmission among stroke patients, so as to provide references for reducing unplanned readmission and improving health care quality.

Objective: To investigate the current status and difference of pregnancy stress between first-time and second-time pregnant women. Methods: A total of 591 pregnant women (first-time and the second-time pregnant women)were investigated with Maternal Stress Scale. Results: ①Both stress levels were at moderate level, there was no difference in the general score and all pressure factors between both of them. ②The first stressor of both of them was worrying about the maternal and neonatal health and safety, followed by worrying about the neonatal care and free time decrease after the labor. ③The influence factor of stress in first-time pregnant women was relationship with parents-in-laws, accounted for 34.1%. The influence factors of stress in second-time pregnant women were relationship with husbands, gender expectation of the second baby, accounted for 45.7%. Conclusion: Both pregnant women may have different pressure sources. It is suggested to provide different relief measures for different pregnant women.

We set up special nursing posts to strengthen nursing preparation before coronary CT examination. The good image quality rates in the study group and in the control group was 89.130% and 58.696%, respectively. The difference had significance (P<0.01). We found out that the key point for nursing preparation before coronary CT examination was breathing exercises and the nursing staff in CT room should pay more attention to nursing preparation before coronary CT examination.

Objective: To explore the overall research focus and frontier of elderly care. Methods: Using Web of Science and CNKI as data sources to retrieve the literature about elderly care published from 2007 to 2016, the authors drew mapping knowledge through operating CiteSpace. Results: In recent ten years, the published literature on elderly nursing increased year by year abroad, while the volume of domestic documents in 2007-2009 showed an upward trend, and then slowly grew in 2009-2011, at last decreased in 2011. Elderly care study in the United States was in the leading position, those in Australia and China tied for the second place (while 6% in Taiwan of China, only 3% in mainland China). The studies in abroad mainly focused on the humanistic nursing, evidence based nursing and transitional care while those in China focused on chronic diseases and surgical nursing. Foreign studies paid more attention on psychological care and the research method. The studies of traditional Chinese medicine care and quality control circle reflect the uniqueness of elder care research in China. Conclusion: There is a certain gap compared with the international research on elderly care in mainland China, the depth and breadth of the studies need to be expanded. The elderly care system suited to Chinese national conditions needs to be explored to promote the healthy development of the elderly nursing career.

Objective: To investigate the Immunosuppressive Medication adherence and analyze its associated factors in liver transplant recipients. Methods: It was a single-center, cross-sectional study. Convenience sampling method was used to select qualified liver transplant recipients. The instruments included the demographic information and Basel Assessment of Adherence to Immunosuppressive Medication Scale. Results: A total of 262 qualified liver transplant recipients were included in this study. Medication non-adherent rate was 57.6% (151 cases). And failing to take medication on time was the worst aspect (45.4%). Patients who had complications or rejection reaction had worse medication adherence than those who had no complication. Besides, obese patients had worse medication adherence than patients with normal BMI. Conclusion: Medication non-adherence in liver transplant recipients was common in this study. To promote medication adherence in liver transplant recipients, medical staff should deal with the rejection signs timely, prevent complications after transplantation, and take interventions to enhance medication adherence in liver transplant recipients accordingly.

Objective: To evaluate the effects of Ear-Acupressure in management of constipation. Methods: The authors searched Pubmed, The Cochrane Library, CNKI, VIP from inception to 20th April 2016, and retrieved Clinical Controlled Trials (CCTs) or Randomized Controlled Trials (RCTs) or Systematic Review (SR) in which Ear-Acupressure was used as an intervention to constipation, and all the trials were published in English or Chinese. The methodological quality of included studies was assessed according to the standard of Cochrane systematic review. RevMan 5.3.3 software was used for Meta-analysis. Results: 16 studies (1632 cases) were included. The methodological quality of most studies was low. The results of Meta-analyses showed that Ear-Acupressure improved the effects of constipation management and decrease the constipation incidence significantly compared to the control group. Conclusion: Ear-Acupressure shows an effective tendency in management of constipation, but this conclusion needs to be verified by more high quality studies.

With the aggravating aging trend of the population and the rapid increasing burden of chronic diseases, health coaching has been increasingly applied in chronic disease management. The purpose of this review is to introduce the application status of health coaching in chronic disease management in other countries, and prospect the application future in China.

Due to the recent increase in the elderly population in China, the concerns of high-quality end-of-life care have increased. The aim of the paper is to describe elderly patients' needs of hospice care, in order to improve the quality of end-of-life care. It provides references for the development of better hospice care, and to establish a hospice care system.

This article summarizes the development status quos of anesthesia nursing in China. The educations and training, qualification certification and scope of practice have not formed a standardized and unified system, therefore, it needs to be further developed and improved. This article reference the matured experience from developed countries, forecast the future direction of anesthesia nursing in China, and provide reference for future standardization for this specialty.

Sleep disturbance is a common problem among ICU patients, which is characterized by abnormal sleep architecture, sleep fragmentation, lack of rhythm and poor subjective sleep quality. Sleep disturbance has many adverse impacts on ICU patients' physiology, psychology and prognosis, and it has severely affected the rehabilitation of patients. The research progress on the assessment methods and intervention measures of ICU patients’ sleep are reviewed in this article. This review provides clinical medical staffs with a comprehensive understanding about sleep disturbance in ICU patients so as to provide better intervention strategies for ICU patients.

Objective: To assess the effect of follow-up intervention by telephone combined with short message on dietary adherence in rural Peritoneal Dialysis (PD) patients. Methods: Totally 103 rural PD patients were selected from September 2014 to June 2015. They were randomly divided into control group (52 cases) and intervention group (51 cases). Patients in the control group got routine health education, while the patients in intervention group received follow-up intervention by telephone combined short message after discharge. Renal Adherence Attitudes Questionnaire (RAAQ) and Renal Adherence Behavior Questionnaire (RABQ) were used to investigate their dietary adherence at baseline, 1,3 and 6 months after discharge, respectively. Results: The patients in intervention group had shown a better dietary adherence than that in the control group. The time interaction effects also existed by Repeated Measures analysis. Conclusion: The follow-up intervention by telephone combined short message could improve the dietary adherence of the rural peritoneal dialysis patients.

Objective: To describe ICU patients’ self-report assessment of sleep, examine the relationship between patients' self-reported sleep and their reported sleep by the bedside nurse, and describe the strategies suggested by patients to promote sleep. Methods: An exploratory descriptive study was undertaken with communicative adult patients consecutively recruited in 2014–2015. Patients reported sleep using the Richards–Campbell Sleep Questionnaire (score range 0-100 mm; higher score indicates better sleep quality), with nursing assessment of sleep documented across a five level ordinal variable. Patients were asked daily to describe strategies that helped or hindered their sleep. Ethical approval for the study was gained. Descriptive statistical analysis was performed [ median (interquartile range) ]; relationships were tested using Spearman's rank correlation and differences assessed using the Kruskal–Wallis test; P<0.05 was considered significant. Results: Participants (n=151) were recruited [age: 60 (46-71) years; ICU length of stay 4 (2-9) days] with 356 self-reports of sleep. Median perceived sleep quality was 46 (26-65) mm. A moderate relationship existed between patients’ self-assessment and nurses’ assessment of sleep (Spearman's rank correlation coefficient 0.39-0.50; P<0.001). Strategies identified by patients to improve sleep included adequate pain relief and sedative medication, a peaceful and comfortable environment and physical interventions, e.g. clustering care, ear plugs. Conclusion: Patients reported on their sleep a median of 2 (1-3) days during their ICU stay, suggesting that routine use of self-report was feasible. These reports revealed low sleep quality. Patients reported multiple facilitators and barriers for sleep, with environmental and patient comfort factors being most common. Interventions that target these factors to improve patient sleep should be implemented.