Construction of regional medical consortium has become a deepening health system reform, an important measure to promote the structural optimization and adjustment of the layout of medical resources, has been in improving ability of primary hospital services, two-way referral, and achieved initial results fairness and availability of the maintenance of health service. As an important part of the medical and health professional team, nursing should play the role of preventing disease and promoting health. Therefore, actively take advantage of nursing resources medical center, through training, to carry out various forms of cooperation and mutual communication, idea, innovation mechanism, improve together, make efforts for the construction of health Chinese.

With constantly deepening of the reform of state health care system in recent years, the service mode of medical alliance has got rapid advance, the grading diagnosis and treatment system has been carried out gradually, and requirement of nursing service has also changed in accordance with adjustment of medical pattern. This paper combined the progress of grading diagnosis and treatment work in Beijing and aimed to propose specific ideas and work suggestions regarding construction of nursing management within the system of grading diagnosis and treatment of medical service in order to make sure and prompt the development of nursing could satisfy requirement of medical and health service development as well as people's health needs.

Illustrated by the case of medical alliance, this paper describes the function and application of remote education and training module, remote nursing consultation module, nursing quality monitoring and evaluation module, nursing adverse events report and analysis, anonymous publicity and prevention module on the informatization network platform. It aims to improve the management ability of nursing administrators in medical allience and promote further development of nursing specialty under the context of medical allience.

Objective: To integrate and figure out measures to help and support community nursing by exploring the methods of using and managing Clinical Nurse Specialists under the context of medical alliance. Methods: Totally 18 Clinical Nurse Specialists were selected as talent resources to set a good example through aspects of management, expertise and service catering directly to community health, so as to drive the homogenization of community nursing. Results: Clinical work ability of those community nurses has been improved so as to win trust of patients in community. Conclusion: The use of Clinical Nurse Specialists under the context of medical alliance has fully embodied the concept of consistent service and resources sharing, facilitated the promotion of quality nursing resources to grass-level units, and accelerated the healthy and fast development of community nursing system of medical alliance to meet community residents' needs.

Making a summing up of the practical experience of nursing management in the background of medical union. Two approaches to nursing management have been proposed: implantable management would be adopted in the entrusted management of public hospitals; meanwhile, strategies of talent cultivation, professional guidance and resource sharing could be used in the loose union hospitals.

Objective: To translate Barriers to Enteral Feeding Critically Ill Patients Questionnaire, and to test its reliability and validity. Methods: English version of the questionnaire was translated and back-translated according to Brislin translation model. The reliability and validity of the final Chinese version of the questionnaire was tested on a sample of 545 ICU nurses (345 in Hangzhou tertiary grade A hospital) in Zhejiang Province. Results: Chinese version of the questionnaire included 19 items and 3 subscales. Three factors were extracted by exploratory factor analysis, which could explain 69.084% of total variance. The Cronbach's α coefficient (0.875) and test-retest reliability (0.825) was acceptable. The range of item-level content validity index (I-CVI) was from 0.88 to 1.00. The average of scale-level content validity index (S-CVI/Ave) was 0.98. The results of confirmatory factor analysis showed that all obtained fit values were satisfactory with Chi-square/degrees of freedom 2.110, Root Mean Square Residual 0.150, Root Mean Square Error of Approximation 0.075, Goodness-of-Fit Index 0.853, Adjusted Goodness-of-Fit Index 0.812, Tucker-Lewis Index 0.835, Incremental Fit Index 0.859, Comparative Fit Index 0.856, and Parsimony Goodness of Fit Index 0.669. Conclusions: Chinese version of the questionnaire is reliable and valid, and is an effective tool to assess enteral feeding among critically ill patients.

This paper reviewed the definition, development status and the practice effects of Post-ICU Clinic in overseas, and analyzed its problems, so as to provide reference to the development of Post-ICU Clinic in our country.

Objective: To translate the Richards Campbell Sleep Questionnaire (RCSQ) into Chinese in order to test the reliability and validity of the Chinese version of RCSQ among Chinese ICU patients. Methods: The original RCSQ was translated into Chinese and back translated then modified for cultural adaptation according to Brislin' two person translation guidelines. The final version was sent to the author for comments. Five experts evaluated the content validity of the Chinese version of RCSQ. Sixty ICU patients were selected to participate the study by convenience sampling method to complete the Chinese version of RCSQ from April to July in 2016 in a tertiary grade A general hospital of Beijing. Internal consistency reliability and test-retest reliability of the Chinese version of RCSQ were measured. Results: The content validity of the Chinese version of RCSQ was 0.840, the Cronbach's α was 0.874 and the test-retest intra-class correlation coefficient was 0.912. Conclusion: The reliability and validity of Chinese version of RCSQ was good and suitable for the sleep evaluation among ICU patients in China.

Objective: To explore the experience of the elderly living in medical-nursing combined pension institutions to provide a reference for nursing quality improvements. Methods: Four medical-nursing combined pension institutions were selected and 21 residents participated semi-structured in-depth interviews. The transcribed interviews were analyzed using meaning categorizing. Results: Tangibility, reliability, assurance, empathy, continuity and fairness were extracted from the experience. Conclusion: The experience of the olderly for medical care needs to be further mined, and enhancing the comfort of all the elderly should be the goal of institution management. The experience survey of the edlerly is helpful in inspecting what they actually focus on, and thus may help managers for quality improvement in medical-nursing combined pension institutions.

Objective: To translate the Nurse Spiritual Therapeutics Scale (NSTS) into Chinese and evaluate the reliability and validity of the questionnaire. Methods: After translation and cross-cultural adaptation, the Chinese version of NSTS was applied to a sample of 153 hospitalized cancer patients. Exploratory factor analysis was performed for validity test. The internal consistency was evaluated. Results: CVI of Chinese version of NSTS was 0.95. Five factors were extracted with cumulative contribution rate of 76.8%. The Cronbach's alpha was 0.79. Conclusion: The Chinese version of NSTS is suggested to be reliable and valid. It is applicable to hospitalized cancer patients in China.

Objective: To explore the impact of nurse-physician collaboration and job engagement on nurses' work performance, and to establish a model of their relationships. Methods: Totally 309 nurses in a tertiary Grade A hospital in Beijing were recruited and investigated by Nurse-physician Collaboration Scale, the Utrecht Work Engagement Scale, and Work Performance Scale. Results: Both nurse-physician collaboration and job engagement had a direct and positive impact on nurses' work performance. In the meanwhile, job engagement also had a mediating effect between nurse-physician collaboration and nurses' work performance. Conclusion: Nursing administrators should take effective measures to promote the collaboration between nurses and physicians in order to enhance nurses' job engagement and work performance.

Objective: The research aims to understand the meaning of self-management in elderly patients with chronic diseases from the perspectives of under new rural cooperative medical insurance. Methods: Totally 204 elderly patients with chronic disease were recruited from outpatient and ward of a second level hospital in Fangshan district by convenience sampling. Self-management behaviors of patients with chronic disease were estimated by Self-management Behavior Scale. Results: Elderly patients were lack of physical exercises; duration of exercise was well enough. The scores of cognitive symptom management and communication with physicians were poor. Age, gender, education, disease type, disease education were related to patients' self-management behaviors (P<0.05). Conclusion: Self-management behaviors of rural elderly patients with chronic diseases were poor. Education in strategies to implement self-management is needed for rural elderly patients.

Objective: To investigate the influencing factors of the level of hope and its associations with the social support among family caregivers of patients with advanced cancer. Methods: A convenient sample of advanced cancer patients and their family caregivers from five tertiary level first class hospitals in Xi'an were selected. The hope level and social support of family caregivers of advanced cancer patients were investigated with Herth Hope Index and Social Support Rating Scale, and self-designed questionnaire was used to investigate the general, disease and care related conditions of advanced cancer patients and their caregivers. Results: The hope level score of family caregivers of advanced cancer patient was 36.57±4.65, which was a medium to high level; the total score of social support was 37.27±7.38, and it was higher than the Chinese norm (P<0.01); the hope level was positively correlated with social support (r=0.412). Multiple regression analysis showed that the influencing factors of level of hope in caregivers were caregiver support utilization, evaluated physical condition of the patient by caregiver, objective and subjective support, the total household monthly income and age. Conclusion: The medical workers should pay more attention to caregivers of cared patient with poor condition in two weeks, lack of social support, older and economic difficulties and provide knowledge and care support for them to improve their level of hope.

Objective: To investigate the epidemiologic features of Skin Tears in hospitalized patients, and to provide references for effective wound prevention and management. Methods: We recruited 14 tertiary hospitals to participate in the multicenter cross-sectional survey. Totally 964 trained nurses inspected the skin from head to toes and assessed severity classification, location, injury causes among hospitalized patients who stayed in hospital ≥24 hours, were 18 years old, and signed informed consent using same tool, methods and process in same time duration. Results: We got 18 806 effective patients. The Skin Tears' prevalence was 1.06% (199/18 806). Prevalence of Skin Tears for male was more than that for female (P<0.05). The prevalence of patients with ≥60 years old were higher than that in patients with <60 years old (P<0.05). The patients with longer hospitalized stay had higher incidence of Skin Tears (P<0.05). The incidences of Skin Tears for patients with risk of pressure ulcer, low albumin, anemia and Skin Tear history were obviously higher (P<0.05). Skin Tears severity of the third grade was 48.74%. Conclusion: All of Skin Tears in hospitals were hospital-acquired. Patients with risk of pressure ulcer, low albumin, anemia, Skin Tear history and long hospitalized stay were the key persons to prevent skin tear.

In this paper, the authors reviewed the origin, development and current situation of human-centered education on Alzheimer in foreign countries, including the objective, contents and methods of this kind of education. It may be helpful to provide some suggestions on establishing suitable Alzheimer education strategy in China.

Objectives: To set up an observed symptom-guided structured nursing records system for new nurses' training. Methods: According to the requirement of the standardized training, the authors designed the symptoms-guided nursing records system based on literature review. After experts consulting and pilot application, they introduced it to the mobile nursing information system. And then they analyzed the satisfaction of the new nurses and the teachers who used this system to train new nurses. Results: The satisfaction of new nurses and teachers were 91.81% and 84.44%, respectively (P>0.05). The time spending on the observed symptom-guided structured nursing records online was significantly lower than the manual entry time (P<0.05). Conclusion: The observed symptom-guided structured nursing records system applied in new nurses' training linked standard training with clinical practice without interruption, minimized the conversion cycle from learning to practice. It could improve the recording efficiency of nurses; and reflect the disease characteristics of different disciplines.

Objective: To investigate the conflict management model and emotional intelligence status of pediatric nurses, and analyze the influence of emotional intelligence on conflict processing mode. Methods: Totally 413 pediatric nurses from four tertiary hospitals in Zhengzhou were selected by convenient sampling method. The Rahim Organizational Conflict Inventory-II and Wong & Law Emotional Intelligence Scale were used to investigate their conflict patterns and emotional intelligence. Results: The most commonly used conflict treatment modes of pediatric nurses were integration, concession, compromise, escape and domination. Pediatric nurses can manage emotions well; the descending order of the four emotional management abilities was self-emotional monitoring, use of emotion, regulation of emotion and other's emotional appraisal, respectively. Emotional intelligence was positively correlated with conflict management (r=0.499, P<0.01). Conclusion: The emotional intelligence of pediatric nurses is an important factor influencing the conflict processing mode. Managers should pay attention to improve the emotional intelligence of nurses and guide nurses to adopt appropriate conflict management mode to alleviate the contradiction between nurses and patients and make nurses to provide high quality services to children more efficiently.

Objective: To explore job satisfaction status of operating room nurses in tertiary public hospitals in Beijing, analyze its influencing factors, in order to provide basis for taking corresponding interventions. Methods: Public hospital staff satisfaction questionnaire was used to investigate 427 nurses in operating room in Beijing tertiary public hospitals and data was collected and analyzed. Results: Nurses' job satisfaction of operating room nurses in tertiary public hospitals in Beijing was influenced by years of working, gender, education, position, and income level (P<0.05), and work sense of responsibility and sense of achievement scores (4.01±0.23) was the highest, while work pressure scores (1.73±0.16) was the lowest. Conclusion: Values of nursing service in the operation room should be evaluated scientifically, a fair and reasonable salary and welfare system should be established, and the job satisfaction of nursing staff in operation room will be improved.

Objective: To explore the current status and influencing factors of quality of working life among nurses in emergency department. Methods: A total of 211 emergency nurses from 7 tertiary general hospitals in Jiangsu province were recruited and investigated by Work Quality of Life Scale and Resilience Scale. Results: The mean score of quality of working life and resilience was 95.61±15.20 and 54.98±12.10, respectively. Both were lower than the average level. And resilience and emergency working years were correlated with quality of working life and could explain 40.6% variation of quality of working life. Conclusions: Resilience could significantly affect quality of working life of nurses. Nursing managers could improve quality of working life of emergency nurses by increasing their resilience.

With the newly issued policies of medical reform, township hospitals will return to its public welfare nature gradually. High level nursing care is needed in township hospitals. However, nursing quality management has revealed some problems which cannot be ignored. In this paper, the authors reviewed the problems and countermeasures of township hospital nursing management in the situation of new medical reform. The aim was to improve the quality of nursing management in township hospitals, accelerate health care reform progress, and to ensure high quality medical care services for rural residents.

Objective: To explore the effects of extended nursing intervention inelderly patients with Chronic Heart Failure. Methods: Totally 100 patients with Chronic Heart Failure were randomly divided into experimental group (n=50) and control group (n=50). Patients in control group accepted usual discharge guidance, while patients inexperimental group accepted individualeducation for 3 months. The 6 MWT were performed at discharge and three months later. Rehospitalization of the patients within three months were recorded. Results: At the end of three months, there was significant difference in 6MWT between the control group (198.64±18.87) m and the experiment group (476.42±23.25) m (P<0.05). There was significant difference in rehospitalization rate between the two groups as well (P<0.01). The reospitalization rate of the control group was 40.0% (20 cases), while the experiment group was 12.0% (6 cases). Conclusion: Transitional care can improve the quality of life in elderly patients with Chronic Heart Failure.

Objective: Using Omaha System to evaluate the health problems and current status for Diabetes Mellitus (DM) patients. Methods: A total of 50 DM patients were enrolled by convenience sampling. Problem classification system and outcome evaluation system of Omaha System were used to evaluate health problem and current status. Results: Health problems of DM patients were distributed in the physical and health-related behaviors and the ratio were 50.3% and 30.0%; the common health problems were nutrition, residence, physical activity, medication regimen, and so on. At the Likert 5 grade score of outcome evaluation system, 82.6% patients in cognition score was 2 to 3 and it indicated minimal cognition; 82.6% patients in behavior score were 3 to 4 and it indicated appropriate behavior usually; 95.7% patients in condition score were 3 to 4 and it indicated minimal signs/ symptoms. Conclusion: There were some problems at physical and health-related behaviors of DM patients and their cognition level were low. In order to improve patients' cognition, the community nurses should carry out health education by taking lectures, seminars and other methods.

Objective: To explore the effective method for infusion distribution in Pharmacy Intravenous Admixture Service (PIVAS). Methods: Fixed location management, combined with color management and hospital information system management was used to optimize infusion distribution. Results: The efficiency and accuracy of infusion distribution were significantly improved after the application of fixed location management. Conclusion: The application of fixed location management in PIVAS could not only improve the efficiency and accuracy of infusions distribution, but also reduce labor waste.

Objective: To investigate nurses' knowledge-attitude-behavior about Central Line Associated Blood Stream Infection (CLABSI) in Guangdong province, in order to provide reference for making clinical guidelines. Methods: A self-designed questionnaire about nurses' knowledge-attitude-behavior of CLABSI was distributed to 382 nurses from 86 hospitals in Guangdong in 2015. Results: The mean scores in knowledge of CLABSI was 110.59±18.98 which was in good level. The attitude and behavior of nurses were both positive with mean scores 97.88±4.68 and 85.46±10.61. There were significant differences among the nurses in different education background, different hospital ranks and different regions in Guangdong (P<0.05). Conclusion: Nurses in Guangdong have got good knowledge, positive attitude and behaviors for preventing CLABSI. However, there is still a gap among different hospitals and regions. The nurse managers should strengthen the exchange of medical information and balance the medical resources among different regions, and continue the infusion training among nursing staff.

Objective: To investigate the cognition on nursing practice standards for intravenous therapy among nurses at tertiary general hospitals in Ningxia, in order to provide reference for the improvement of the quality on intravenous therapy. Methods: The questionnaire of cognition on nursing practice standards for intravenous therapy was used to investigate from March to April in 2016. Results: There was statistically significant (P<0.05) difference between Grade A and Grade B hospitals in Ningxia in terms of time to implement intravenous nursing practice standards for intravenous therapy, improving the quality of nursing, clinical training, application and revision of the related nursing system, quality control standards, operational procedures and training organizers' cognition. Conclusion: Differences may exist in the cognition on nursing practice standards for intravenous therapy among nurses at different grade tertiary general hospitals in Ningxia general hospitals in Ningxia.

As the number of perinatal women increasing, how to do a comprehensive maternal care has become a big problem for medical staff. Antenatal maternal depression is a common psychological problem in pregnant women.It has negative impact on maternal and child health and family harmony, so it is necessary to give them psychological intervention and support timely. In this paper, the authors analyzed the related factors, assessment methods of antenatal depression, interventions and effects comprehensively, and summarized the lack of current interventions and future research directions.

Objective: To explore the true experience in the process of bowel preparation for patients undergoing colonoscopy in order to provide scientific evidence for the future specific nursing measures. Methods: Guided by the phenomenological research method, we performed in-depth interviews and analyzed their experience to 20 patients who underwent colonoscopy. Results: Three themes were formed: the complex psychological state; difficulties obtaining specialized information guidance; desiring for comfort and support from others. Conclusion: In the future clinical work, we should follow patient center, find the deficiency of clinical work in advance and strive to make a targeted solution. Ultimately, we have to reduce the discomfort patients might experience in order to improve the overall satisfaction rates.

Objective: To investigate current status of temperature protection during the operations, and to provide the corresponding basis for the intervention. Methods: The patients who had surgeries in a tertiary Grade A hospital during 2015.1.1-6.30 were recruited by convinience sampling method. The questionnaire designed by the researchers was used to collect the data. Results: Totally 9 369 cases were data-collected. About 4 764 (50.8%) patients were taken temperature protection. About 1 353 (53.4%) patients who were older than 60 years old were taken temperature protection and the rate was higher than that in other age group (P<0.01). The ratio of keeping warm in different departments had significant difference (P<0.05). Among all methods of temperature protection, the warming blankets or warm air heater were used most frequently. Conclusion: The active warming measures during the operation is relatively low. It is very important to promote the awareness of warming patients actively, take different measures to maintain the stability of the patient's temperature, and to pay more attention to the elders.

Objective: To explore the effect of caregiver synchronous management on family function and blood glucose control among patients with type 2 diabetes. Methods: Totally 40 hospitalized patients with type 2 diabetes and their caregivers were recruited and received health education, out-patient follow-up and telephone follow-up. Knowledge level and family function of patients and their caregivers and patients' HbA1c level were tested during hospitalization, 3 and 6 months after discharge to compare the difference of different stages. Results: Knowledge level and family function of patients and caregivers and patients' HbA1c all improved significantly after intervention (P<0.05). Repeated measures analysis of variance showed the main time effect of family function and all dimensions of patients and caregivers had statistical significance (P<0.05). Conclusion: Caregiver synchronous management could improve the knowledge level and family function of patients with type 2 diabetes and their caregivers and patients' HbA1c.

Chronic Low Back Pain (CLBP) is a major health problem worldwide. Interventions based on exercises have been the most commonly used treatments for patients with this condition. The Pilates method has been one of the most popular exercise programs used in clinical practice. This paper reviewed the available evidence on the efficacy of the Pilates method in patients with Chronic Low Back Pain.

Objective: To explore home exercise and related factors in patients undergoing maintenance hemodialysis (MHD). Methods: Three hundred and thirty-six patients with MHD were investigated with questionnaire based on the transtheoretical model. Results: Totally 60.7% of the patients with MHD had regular exercise,and 39.3% of the patients had irregular exercise. The score of perceived importance of exercise was 7.41±2.37, and the score of self-confidence was 7.18±2.63. The Exercise Self-Efficacy Scale was 56.68±13.77, and the Dialysis patient-perceived Exercise Benefits and Barriers Scale was 69.72±6.29. There were significant differences between the patients with regular exercise and patients with irregular exercise in the perceived importance, self-confidence, Exercise Self-Efficacy Scale, and Dialysis patient-perceived Exercise Benefits and Barriers Scale (P<0.05). The patients of younger age and higher education level possessed a larger proportion of irregular exercise. Conclusion: Patients with MHD need regular exercises. It is suggested to provide health education to patientswith MHD to encourage regular exercise.

SBAR (Situation-Background-Assessment-Recommendation) is a standardized communication tool to optimize effective nursing communication.This paper summarizes the application status of SBAR in nursing work based on huge amount of literature reviews, including disease reports to MD, change of shift report, patients transfer report, and nursing education. The ultimate goal is too to make the model more widely used in nursing field and improve the quality of nursing.

Quality of old-age care services is directly related to elderly's health and quality of life, related to the development of old-age care service industry. Quality evaluation is an important part of reflecting the current status of old-age care service and improving the quality of old-age care services. This paper reviewed current quality evaluation system of old-age care service in China, so as to promote further study and provide guidance for practice.

Objective: To provide a snapshot of the prevalence of abnormal body mass index (BMI) in a sample of Intensive Care Unit (ICU) patients; to identify if any medical specialty was associated with abnormal BMI and to explore associations between BMI and ICU-related outcomes. Methods: Retrospective observational audit of 735 adult patients (median age 58 years) admitted to the Sir Charles Gairdner Hospital 23 bed tertiary ICU between November 2012 and June 2014. Primary outcome measure was patient BMI: underweight (<18.5 kg/m2), normal weight (18.5–24.99 kg/m2), overweight (25–29.99 kg/m2), obese (30–39.99 kg/m2) or extreme obese (40 kg/m2 or above). Other measures included gender, acute physiology and chronic health evaluation II score, admission specialty, length of Mechanical Ventilation (MV), Length of Stay (LOS) and mortality. Results: Compared to the general population there was a higher proportion of obese patients within the cohort with the majority of patients overweight (33.9%) or obese (36.5%) and median BMI of 27.9 (IQR 7.9). There were no significant differences between specialties for BMI (P=0.103) and abnormal BMI was not found to impact negatively on mortality (ICU, P=0.373; hospital, P=0.330). Normal BMI patients had shorter length of MV than other BMI categories and the impact of BMI on ICU LOS was dependent on length of MV. Overweight patients ventilated for five days or more had a shorter LOS, and extremely obese non-ventilated patients had a longer LOS, compared to normal weight patients. Conclusion: Although the obesity–disease relationship is increasingly complex and data presented reflects categorical BMI for patients admitted to a single ICU site it may be important to consider the cost implications of caring for this cohort especially with regard to MV and LOS.