The main contents of the Guideline of control of healthcare associated infection outbreak (2016 edition) published by the National Health and Family Planning Commission and its application to clinical nursing work were analyzed. The following information were included: the relevant terminology of healthcare aquired infection outbreak and key issues, the management requirements about healthcare aquired infection outbreak, the epidemiological investigation and control methods of the outbreak. The aims of this guideline are improving the clinical nurses’ abilities to prevent the healthcare aquired infection outbreak, provide technical guidance on management of the outbreaks, and ensure the medical quality and patients’ safety.

At the end of 2016, the revised edition of the standard WS 310—2009, which has been used as a guide in the management and operation of the central sterile supply department (CSSD), was accomplished. The new standard WS 310—2016 is composed of three sections: the first section of the hospital CSSD including management practices (WS 310.1—2016); the second section of the hospital CCSD including cleaning, disinfection, and sterilization technique operating procedures (WS 310.2—2016); and the third section of the hospital CCSD including monitoring standards for the effects of cleaning, disinfection, and sterilization (WS 310.3—2016). Based on the previous standard, this updated WS 310 has improved the management requirements of hospital sterilization and supply centers, basic requirements and operating procedures for the disposal of diagnostic and treatment instruments, monitoring methods and requirements of sterilization effects, as well as quality control processes. The new standard is aimed at improving the centralized management of hospital sterilization and supply center continually, defining the roles of competent authorities, enhancing the management of loaned medical instruments and implants, and keeping strict quality control over the sterilization process. The new standard will have a marked impact on fulfilling the corresponding roles of the nursing management department, establishment of a talent team with specialized technique for sterilization and supply, implementation of quality control in the process of cleaning, disinfection and sterilization, and efficient control of the risks found in nosocomial infection.

ICU is an important department in control of healthcare associated infection (HAI). The "Regulation for Prevention and Control of Healthcare Associated Infection in Intensive Care Unit" published by National Health and Family Planning Commission in 2016 defined the rules and regulations in control of HAI in ICU. There is a particular standard for prevention and control of HAIs in ICU. The doctors and nurses as performers of theregulation play an important role in prevention and control of HAI.

The management of environmental surface cleaning is the basis for prevention and control of healthcare associated infection (HAIs) among the healthcare facilities. The contaminated surface is a primary source for susceptible patients to acquire pathogens. Improving the quality of environmental surface cleaning can effectively decrease the outbreak of HAIs. Enhanced terminal cleaning and disinfection can reduce 10% to 30% of HAIs caused by multidrug-resistant organism or Clostridium difficile. Inappropriate cleaning and disinfection cannot remove the surface contamination from hospital environment and even may cause pathogens spreading within hospitals. National Health and Family Planning Commission of the PRC issued "Regulation for cleaning and disinfection management of environmental surface in healthcare facilities" in the end of 2016. This paper explains the importance of environmental cleaning for clinical nursing, including the requirement of management, principles of cleaning and disinfection, daily cleaning and disinfection, enhanced cleaning and disinfection, reusing of cleaning products. The implementation and compliance with this regulation will provide a clean and safe environment for the patients.

Objective: To determine the effect of the PICC catheter/vein diameter (C/V) ratio on incidence of PICC-related venous thrombosis, and identify the optimal cut-off point of the C/V ratio. Methods: Adult patients were recruited between February 2016 and September 2016. Vein diameter at the PICC insertion site was measured using SiteRite 5 Ultrasound, and the vein was assessed by Doppler Ultrasonic examination. Participants were followed up at four weeks to determine if they developed PICC-related venous thrombosis. Receiver Operator Characteristic (ROC) was used to identify the optimal cut-off point of the C/V ratio. Results:Data were available for 247 patients. 98 patients (39.7%) developed PICC-related venous thrombosis. The differences of incidence of PICC-related venous thrombosis among different C/V ratios were significant (χ2=38.242, P<0.001). ROC curve determined that a 34% C/V ratio was the optimal cut off point (sensitivity=83.7%, specificity=71.8%). Conclusions:It was found that the C/V ratio was negatively related to the incidence of thrombosis. This study suggests that a 34% C/V ratio is the optimal cut off, and a 3Fr-PICC should be chosen if the vein diameter is (0.29~0.41) cm to prospectively prevent PICC-related venous thrombosis.

Objective: To investigate the relationship between resilience and family hardiness of patients with Inflammatory Bowel Disease (IBD). Methods: The self-designed general information questionnaire, the Chinese version of Connor-Davidson mental resilience scale (CD-RISC) and the Chinese version of Family Hardiness Index (FHI) were used to investigate 104 patients with IBD. Results: The total scores of CD-RISC and FHI of IBD patients were (62.53±14.97) and (58.61±5.95) respectively. In terms of dimensions, the scores of tenacity, strength and optimistic were (30.64±8.61), (22.34±4.96) and (9.55±2.82) respectively, and the scores of commitment, control and challenge were (27.38±3.05), (17.08±2.29) and (14.15±1.98) respectively. The Pearson analysis demonstrated that the total score and score of each dimension of CD-RISC were related with the scores of FHI (P<0.05). Multi-factor analysis showed that commitment, challenge and age could significantly predict the level of resilience (P<0.05). Conclusion: The family hardiness may be one of the influencing factors of resilience of IBD patients, and health care workers could improve family hardiness, and foster the family support to strengthen resilience of the patients with IBD, thus help the patients manage the psychological state and symptoms.

Objective: To analyze the effects of gradual and early rehabilitation exercises in bed on promoting postoperative bowel recovery in patients with colorectal cancer. Methods: Eighty colorectal cancer patients having radical surgery were randomly divided into experimental group and control group, with 40 cases in each group. The patients in experimental group began to do rehabilitation exercise in bed gradually 6 hours after the operation under nurses' direction, and the control group received routine care after the operation. Patients' recovery situation of intestinal function was compared between two groups. Results: The recovery time of bowel sounds, the first flatus time, first defecation time, first time of eating liquid and time of meeting the discharge standards were all earlier than those of the control group (P<0.05).Conclusion: The gradual and early rehabilitation exercises in bed are safe and feasible, which can effectively promote the early bowel recovery of patients with colorectal cancer after surgery.

Objective: To describe the current status of specialty nurses' knowledge sharing behavior in Jiangsu province, and to analyze the influencing factors. Methods: Totally 217 specialty nurses from 12 secondary or tertiary hospitals in Jiangsu province were recruited using convenience sampling method, and investigated by demographic questionnaire, Knowledge Sharing Behavior Scale, Knowledge Self-efficacy Scale, Practice Environment Scale-Nursing Work Index. Results: The score of specialty nurses' knowledge sharing behavior in Jiangsu province was 58.99±7.95. Stepwise multiple regression analysis indicated that nurses' age, highest educational degree, nursing working years, monthly average days of night shift, knowledge self-efficacy, and organizational support explained 40.2% of the total variance of knowledge sharing behavior. Conclusion: Specialty nurses' knowledge sharing behavior in Jiangsu province is in the middle to high level. Nursing managers could take targeted interventions according to the influencing factors to improve the knowledge sharing level among specialty nurses and to provide high quality nursing service.

Objective: To evaluate the effectiveness and safety of early active mobilization in patients with mechanical ventilation in Intensive Care Unit. Methods: The following databases such as Cochrane Library, PubMed, Web of Science, CNKI, CBM and WanFang Data electronically for Randomized Controlled Trials (RCT) were searched, and other sources as supplement was also retrieved. The quality evaluation and data extraction were carried out by two reviewers, and the Stata/SE 12.0 software was used for Meta analysis. Results: Totally 11 RCTs, 718 patients were enrolled. The results of Meta-analysis showed that the SMD of duration of mechanical ventilation was -0.77 with 95% CI (-1.30, -0.24) and the SMD of the length of stay in ICU was -0.50 with 95% CI (-0.96, -0.04) and the OR of the incidence of Ventilator Associated Pneumonia (VAP) was 0.13 with 95% CI (0.03, 0.62) and the SMD of the incidence of Intensive Care Unit Acquired Weakness (ICU-AW) was 0.36 with 95% CI (0.02, 0.71). The combined effect was statistically significant. The OR of the mortality was 0.89 with 95% CI (0.51~1.55) and not statistically significant. Conclusion: Early active mobilization is effective and safe for patients with mechanical ventilation. It can not only reduce the time of mechanical ventilation and ICU stay, but also can reduce the incidence of VAP and ICU-AW, and thus is worthy of clinical application.

Objective: To investigate the family management and control level among children with asthma, and to explore the relationship between the two variables. Methods: Totally 197 asthma children of 4-11 years old and their parents were recruited and investigated with Family Management Scale and Children Asthma Control Test (C-ACT) . Results: Parental relationship, the cognition of parents on children and children's disease were influencing factors of the control level among children with asthma. The well-controlled group mostly had accommodate mode of the family management style. For the partial-controlled group and the uncontrolled-group, the mode of the family management was endurant style. Conclusion: The family management has a certain effect on the control level from different aspects among children with asthma.

Objective: To investigate the current status and influencing factors of nurse loyalty. Methods: Using convenient sampling method, a total of 304 nurses were recruited and investigated with a self-designed Nurse Loyalty Scale from four general hospitals in Guangzhou. Results: The nurse loyalty levels were divided into very high (27.6%), high (41.8%), medium (25.6%), low (4.3%), and very low (0.7%). The average score on nurse loyalty was 89.56±15.65. Ranking of the average scores on each of the dimensions from high to low was loyalty to the patient, loyalty to the nursing and loyalty to the unit. Multiple linear regression showed that the nurse loyalty level was positively correlated with job satisfaction, and negatively correlated to the number of workplace violence. Conclusion: Overall level of nurse loyalty among the surveyed nurses is high. Job satisfaction and workplace violence are the influencing factors for nurse loyalty.

Objective: To translate the Child Vulnerability Scale and test the reliability and validity of the Chinese version in parents of children with congenital heart disease. Method: The Chinese version of Child Vulnerability Scale (CVS) was developed through the process of translation, back-translation and cross-cultural adaptation. A convenient sample of 120 parents of children with congenital heart disease was investigated using CVS to test the reliability and validity. Results: The scale content validity index (S-CVI) was 0.90, and the item content validity index (I-CVI) ranged from 0.8 to 1.0. Two common factors were extracted using exploratory factor analysis, which can explain 54.769% of the total variation. The factor loading ranged from 0.622 to 0.801. The internal consistency coefficient of the CVS was 0.791. The test-retest reliability of CVS was 0.895. Conclusion: The CVS has been proved to be reliable and valid. It can be used as a valid tool for measurement of perceived vulnerability among parents of children with congenital heart disease.

Objective: To analyze the research hotspots of international rehabilitation nursing and to explore the future trend. Methods: The biclustering analysis was adopted to analyze the rehabilitation nursing literatures in PubMed from 2006 to 2015. Results: Rehabilitation nursing has received increasing attention. The research fronts from 2006 to 2010 focused on 6 aspects which were home care, nurses' roles and patients' experience in the rehabilitation process, etc. From 2011 to 2015, researchers mainly focused on 5 fields which were the nursing occupational safety education in the rehabilitation process, patients' quality of life and the prevention of falls, etc. Conclusion: The current direction of domestic attention in the process of patients rehabilitation are the safety problems (such as falls), quality of life, functional recovery and continuity of nursing care, which all need further research in China.

Objective: To explore current status of psychological stress and its influencing factors among urban elderly residents in Desheng Community, Xicheng District, Beijing. Methods: Using systematic sampling method, 1 089 residents of the elderly in DeSheng community were randomly recruited as the participants of the study. The subjects were investigated by Psychological Stress Test and demographic questionnaire. Results: Totally 422 (38.8%) subjects' psychological stress were in normal level . The subjects in normal level of physical, cognitive, emotional and behavior dimension of psychological stress was 301(27.6%), 334(30.7%), 567(52.1%) and 678 (62.3%), respectively. Multivariable logistic regression indicated that age, gender and numbers of chronic disease were the main influencing factors of psychological stress. Conclusion: Psychological stress was in a high level among urban elderly residents in the community. We should strengthen the psychological intervention for the elderly to improve their overall health.

Objective: To develop nursing competency evaluation indicator system of gerontological nurses in China through Delphi technique. Methods: After a comprehensive literature review, theory analysis and panel discussion, the nursing competency evaluation indicator system for gerontological nurses was developed by two rounds of expert consultation. Results: The nursing competency evaluation indicator system for gerontological nurses composed of 6 first level dimension index (nursing concept, critical thinking, nursing practice, communication and cooperation, education and training, and professional development), 15 second level indicators and 54 third level indicators. The authoritative coefficient was 0.825. The coordination coefficient of Kendall coordinate W was 0.196-0.263 (P<0.01), the index of content validity is greater than or equal to 0.78, Conclusion: The development of competency assessment indicator system for gerontological nurses was scientific and reliable. It can provide evidence for the training and evaluation of gerontological nurses.

Delirium is common in elderly patients which could result in poor prognosis and clinical consequences. This article illustrates the definition, clinical manifestations and causes of delirium in elderly people, and reviews the literatures related to the delirium assessment, prevention and intervention. It is expected to provide guidance to the nursing management of delirium in elderly people in China.

Objective: To explore the effects of MDT care mode on quality of life of senile dementia patients. Methods: Using convenience sampling method, a total of 74 senile dementia patients from a pension institution were recruited from July 2015 to March 2016 and MDT comprehensive intervention was used. The scores of Activities of Daily Living Questionnaire (ADLQ) and the Quality of Life-Alzheimer Disease (QOL-AD) were compared at baseline, intervention for 3 and 6 months. Results: Scores of ADLQ subscales at 6 months later were lower than baseline and there were significantly lower in the self-care, household care, employment and recreation, communication (P<0.05). Both QOL-AD (caregivers rated) and QOL-AD (patients rated) scores were higher than baseline (P<0.05). Conclusion: MDT care mode can effectively reduce the dependence of daily life activities on senile dementia patients and improve the quality of life of them. Optimizing the MDT care mode and improving the overall quality of care need research in-depth in the further.

Objective: To develop an assessment scale of online self-regulated learning for nursing students and to test its reliability and validity. Methods: The initial scale was formulated through literature review and expert consultation. A total of 375 nursing students were investigated to screen items using critical ration, correlation analysis, Exploratory Factor Analysis (EFA) and internal consistency. A total of 527 nursing students were recruited to conduct formal investigation to evaluate the psychometric characteristics by Confirmatory Factor Analysis (CFA) and reliability test. Results: The formal scale included 36 items belonging to 8 dimensions. EFA revealed that 8 factors accounted for 63.331% of the accumulated variances. CFA indicated:χ2/df=2.345, RMSEA=0.051, GFI=0.862, NFI=0.862, IFI=0.916, TLI=0.904, CFI=0.915. The scale-level content validity index is 0.978. The criterion-related validity was 0.547 (P<0.01). The Cronbach's α coefficient was 0.931. The test-retest reliability was 0.816. Conclusion: As an instrument with good reliability and validity, this scale could be used to assess the condition of nursing students' online self-regulated learning.

Objective: To explore the effect of group collaborative training model in field training for nursing assistants. Methods: A group collaborative training model was used in field training for 60 nursing assisstants in our hospital, and data was collected after the end of the training. Results: The nursing assistants scored 88.51±7.19 in actual skill test. Patients and their families, medical staff were all satisfied with their performance, and the degree of satisfaction were all higher than 95%, and the overall degree of satisfaction was 95.8%, 96.7% nursing assistants approved group collaborative training model. Conclusion: The group collaborative training model in field training for nursing assistants could strengthen their implementation capacity, fully arouse their enthusiasm of learning, stimulate the team cooperation consciousness, enrich the content of field training, and activate classroom atmosphere, thus is worth of application.

Objective: To explore the effects of the medicine nursing network courses. Methods: Totally 305 nursing students were randomly divided into experimental group (n=153) and control group (n=151). Internet-assisted teaching mode was used in experimental group, while traditional teaching mode was used in control group. The examination scores were compared. Students' self-learning ability and critical thinking ability were evaluated at the end of the semester. Results: The stage examination scores in experimental group were higher than those of control group (P<0.05). Experimental group had significantly higher scores in total score and all dimensions of the students' self-learning ability (P<0.05). The total score of critical thinking ability, self-confidence, intellectual curiosity and cognitive maturity of experimental group were significantly higher than those of control group (P<0.05). Conclusion: The internet-assisted teaching mode can improve teaching effects and students' ability of self-study and critical thinking.

Objective: To analyze the research status and issues related to patient safety in China from 2006 to 2016. Methods: All literatures related to patient safety were sourced in the Wan- fang Database, VIP Database and China National Knowledge Infrastructure (CNKI) from 2006 to 2016. The literatures were analyzed using bibliometric analysis method. Results: A total of 218 articles related patient safety published in 106 journals were sourced. There is a trend of growth in the number of the articles since 2010, but a downward trend in recent two years. The authors came from 180 facilities, most of which were medical universities and affiliated hospitals (61.47%). Guangdong, Shanghai and Sichuan enjoyed the most share of articles. Clinical experience reports accounted of 51.83%, questionnaire survey studies accounted of 14.22%, only 8.71% were experimental studies. Tertiary and secondary hospitals were the major research facilities. Patients (including family members) and health care workers were the main subjects of the studies. The research topics mainly focused on the patients and health care workers's attitudes towards patients safety, the related factors, the participating methods and the effectiveness evaluation. Totally 8.26% of the research papers were funded by the government. Conclusion: The importance of patientsafety has attracted attention from the researchers in recent years, but the studies still have some limitations. The multi-center, randomized controlled studies aresuggested too provide evidence-based information and to enhance the quality of nursing management in patient safety.

Objective: To explore the application effect of fall prevention process management among hospitalized patients Methods: We developed fall prevention process management among hospitalized patients and applied it in clinical practice. The incidence of falls and the rate of injury were compared before and after the implementation of the fall prevention process management among hospitalized patients. Results: After the implementation of fall prevention process management, the fall rate among hospitalized patients dropped from 0.071‰ to 0.029‰ (P<0.01). Conclusion: Fall prevention process management could effectively reduce the total incidence of falls in hospitalized patients.

Objective: To investigate the current patient safety nursing status from clinical nurses' self-reports and analyze the influence factors. Methods: Totally 1 646 nurses from four hospitals were investigated by Chinese version of the Patient Safety Nursing self-rating scale. Results: The patient safety nursing status was in the upper level with the mean score of (188.37±14.12) and 94.19% score rate. Nurses with different age, department, education level, and professional title reported different patient safety nursing score (P<0.05). Multiple linear regression analysis showed that the influence factors included work years in nursing, departments and professional title. Conclusion: The nursing administrators could carry out relevant training activities about patient safety on the basis of work years, professional titles and departments of clinical nurses respectively, to improve the ability of clinical nurses' self-management and safety awareness for ensuring the patients' safety.

The current situation of specific nursing quality evaluation index system in China and abroad was summarized, and the limitations of the current research in China were analyzed and discussed.

Missed Nursing Care (MNC) means the deficiency of nursing behaviors in the care process, but may not cause adverse results. However, when MNC exists, it will lead to the poor care quality and influence patients' safety. At present, the assessment tool of MNC is MISSCARE Survey. The major purpose is to summarize influencing factors and intervention of MNC, also to put forward some suggestions and prospects for the future development of the MISSCARE Survey and interventions for MNC.

Objective: To analyze the nursing care ability of nurses in primary hospital and related factors. Methods: Totally 133 nurses in 17 hospitals in Hubei province were investigated using the Humanistic Caring Ability Scale (HCAS) questionnaire. Results: The total score of the nursing care ability was (189.45±15.34) which was in the low level. The influencing factors were ages, employment forms and positions. The top three factors that affected the practice of caring are communication difficulty between nurses and patients (32.3%), lack of professional knowledge (21.8%), not enough nurses (18.8%). Conclusion: The nursing care ability of primary hospital nurses needs to be improved. Nursing managers should ensure enough nurses in the hospital and provide equal opportunities to nurses regardless of the form of employment to enhance their sense of belonging. Continuing training is necessary to improve nurses' communication skills and professional skills to provide high quality care to patients.

Objective: To explore the relationship between resilience and post traumatic growth, and quality of life among colostomy patients. Methods: A total of 262 colostomy patients were investigated by general information questionnaire, the Chinese version of the CD-RISC Resilience Scale, Post Traumatic Growth Assessment Scale and the Chinese version of the Stoma-QOL questionnaire. Results: The scores of resilience, the post traumatic growth and Stoma-QOL were 69.45±14.26, 68.45±14.26 and 55.68±6.31 respectively; all of them were more than medium level. The QOL was positively correlated with resilience and the post traumatic growth (P<0.05). Age, education, household monthly income, payment manner of medical expenses, tenacity, self-reliance, optimism, new possibilities, interpersonal relationship, personal ability and the spiritual change were the influencing factors of QOL in colostomy patients (P<0.05). Conclusion: Resilience and post traumatic growth were correlated with QOL among colostomy patients, and nursing staff should improve the QOL of colostomy patients by considering their general conditions, resilience and post traumatic growth.

Objective: To investigate the effect of a Transtheoretical Model (TTM) based and web-based lifestyle modification on weight-loss, dietary and exercise behaviors in people with prediabetes. Methods: A convenience sample of subjects with prediabetes was randomly assigned in intervention group (n=30) and control group (n=27). Intervention group received a 3-month web-based lifestyle modification and 3-month follow-up. The control group received the same 3-month intervention 3 months later. The outcome measures were weight loss, Food Frequency Questionnare 25 score and standardized activity measurement 3 and 6 months after intervention. Results: Subjects with prediabetes at each stage of follow-up in both group had a significant loss in physical components and modification in dietary and exercise behavior by analyzing intention-to-treat (P<0.05). There was a significant interaction for group assignment and physical components, dietary and exercise behavior after the 3-month intervention (P<0.05). Conclusion: TTM-based Internet interventionon behavior modification can effectively modify dietary and exercise behavior, reduces weight and blood sugar of people with prediabetes.

Intraoperative acquired pressure ulcer could increase patients' suffering, affect postoperative rehabilitation, increase the hospitalization costs, and waste social resource. We summarized the high incidence, the risk factors assessment, and preoperative prevention and intervention of intraoperatively acquired pressure ulcer in this study to provide further evidence for prevention of intraoperative acquired pressure ulcer among surgical patients.

In this article, the authors introduced the definition and origin of forensic nursing, and the development status of forensic nursing around the world, especially in western countries such as America, United Kingdom and Canada, where forensic nursing had developed for a long time. Based on the review of international association of forensic nurses' history and related literature, the authors analyzed the feasibility of implementing forensic nursing in China.

The article summarized the influencing factors and interventions in reducing readmissions for patients with heart failure, aimed at decreasing the readmission rate and improving the quality of life for patients with heart failure.

Background: A core component of family-centred nursing care during the provision of end-of-life care in intensive care settings is information sharing with families. Yet little is known about information provided in these circumstances. Objective: To identify information most frequently given by critical care nurses to families in preparation for and during withdrawal of life-sustaining treatment. Methods: During May 2015, critical care nurses in Australia and New Zealand were invited to complete the Preparing Families for Treatment Withdrawal questionnaire. Data analysis included descriptive statistics to identify areas of information most and least frequently shared with families. Cross tabulations with demographic data were used to explore any associations in the data. Results: From the responses of 159 critical care nurses, information related to the emotional care and support of the family was most frequently provided to families in preparation for and during withdrawal of life-sustaining treatment. Variation was noted in the frequency of provision of information across body systems and their associated physical changes during the dying process. Significant associations (P<0.05) were identified between the variables gender, nursing experience and critical care experiences and some of the information items most and least frequently provided. Conclusion: The provision of information during end-of-life care reflects a family-centred care approach by critical care nurses with information pertaining to emotional care and support of the family paramount. The findings of this study provide a useful framework for the development of interventions to improve practice and support nurses in communicating with families at this time.