Development of specialized nursing in operation room showed an inevitable trend, yet further exploration was still necessary to figure out a proper development path suitable to the condition of China. This literature review was made focusing on current practice guidelines about specialized nursing development in operating room and hot issues regarding pressure ulcer, surgical site infection as well as deep venous thrombosis, aiming at pointing out problems and suggesting recent research development of nursing in operation room in our country so as to improve the overall service capabilites of nursing specialists in operating room and to promote comprehensive, coordinated and sustainable development of nursing in operation room at the same time.

Objective: To investigate the current situation of nursing human resources in operating room. Methods: A self designed questionnaire was used in this study. The general information, the number of operation, nursing human resources allocation, operation room management, nursing education and training in the operating rooms of 2 039 hospitals in 31 provinces and cities in China were investigated. Results: Number of operation rooms/Number of nurses in the operating room (median)=1/2. Education level was dominated by undergraduate degree (47.98%), the proportion of the nurses with undergraduate degree or above was 48.76%. The professional title is mainly in primary level (38.80%). The operating room which was managed by nursing department or hospital accounted for 75.04%. There were 1210 (59.34%) hospital operating rooms setting up Post anesthesia Care Unit (PACU), it was more than that (37.61%,1083) of the survey in 2012 (χ2=226.701, P<0.001). The Operating room which had carried out position management and hierarchical management accounted for 69.45% and 74.99%, respectively. There were 66.16% of the hospitals had specialized nurses training in the operating room. Conclusion: Nurses education level in the operating room was dominated by undergraduate degree, primary level nurses had the biggest proportion. More than half of the hospitals had set up PACU. Meanwhile, position management and hierarchical management have been widely used in operating room in China.

To analyze the problems during the management of dressing room of Operating Room and introduce the intelligent management system of scrub shirts/pants combining with the HIS. The distribution and reclamation of keys for lockers, and the scrub shirts/pants were managed by this intelligent system. In this paper, the authors also analyzed the design character and application of this system. They tailored the system based on the clinical needs to improve the user's experiences and management efficiency.

Objective: To analyze the application effect of information technology in the practice of the quality and safety management. Methods: Totally 15 750 patients who got surgery from January to March in 2016 was arranged as control group, while 20 225 patients who got surgery from January to March in 2017 were worked as experimental group. The patients in control group were managed by the traditional manual work and a single information system management method while the patients in experimental group were managed by the information technology. Results: The clinical practice standard ability in experimental group improved significantly. The on-time rate of the first operation was 92.62%. Before anesthesia and the patient’s departure, the execution rate of operation security check in the different operation stage has shown the statistical difference. The duration of transfusing blood to patients decreased. The rate of tracking goods quality was 95.45%. The frequency of the first and second level quality control increased. The patients’ satisfaction score was 96.41±12.64. All of the evaluation indexes had the significant difference compared with the control group (P<0.001). Conclusion: Building the quality and safety management system of the operating room based on the information technology showed an excellent application effect in clinical management practice. It was an innovation mode of intelligent information technology management in the operating room with realizing the real-time information resource sharing between objects and objects, objects and people, people and people.

Taking our hospital as an example, this article summarized the practice experience of developing operation room nursing in county hospitals through support and assistance from provincial hospitals. Great improvement could be seen regarding talent training, nursing quality control and humanism of the operation room in the county hospital assisted. Sugerons’ satisfaction over operation room nursing was increased from 75.6% to 94.8%, operation staff and anesthesiology staff’s satisfaction degree increased from 78.8% to 97.1%, and satisfaction degree of patients and their families increased from 90.2% to 99.8% after support and assistance was given to the operation room of the county hospital.

Objective: To develop sensitive indicators of nursing outcome for permanent colostomy patients with Omaha system and nursing outcomes classification system. Methods: Totally 27 experts were investigated using three rounds of Delphi consultation methods to get the common opinion of experts and develop sensitive indicators of nursing outcome for patient with permanent colostomy. Results: After three rounds expert consultation, the effective response rates were 96.6%, 100.0%, 96.4%, respectively, and the authorities coefficient were 0.895, 0.899, 0.909, respectively. The coordination coefficient of primary, secondary, and third indicators were 0.340, 0.379, 0.402, respectively, with P values all less than 0.01. The sensitive indicators of nursing outcome for permanent colostomy patients consisted of 4 domains, 10 first-1evel indicators, 21 second-level indicators, and 69 third-1evel indicators. Conclusion: The development of nursing outcome-based sensitive indicators could provide basis for targeted transitional nursing mode for permanent colostomy patients.

Objective: To explore and understand the influence of head nurses' transformational leadership behaviors on ICU nurses' innovative efficacy. Methods: Totally 409 ICU nurses from three hospitals were selected to join the study, using the general information questionnaire, head nurses' transformational leadership behaviors scale and innovative efficacy scale for investigation. Results: The average score of transformational leadership behaviors scale was 99.49±18.52 points, the avarage score of ICU nurses' innovative efficacy was 71.23±15.61 points. ICU nurses' professional title an head nurses' transformational leadership behaviors scores were main influence factors of ICU nurses' innovative efficacy (P<0.05). Conclusion: Since transformational leadership behaviors could play a positive role in improving nurses' innovative efficacy, head nurses should properly adopt transformational leadership behaviors to arouse and promote the innovative efficacy of ICU nurses andimprove the quality of ICU nursing service.

Objective: To explore status of mental resilience and its influencing factors among hysterectomy patients. Methods: A total of 119 hospitalized hysterectomy patients were investigated by the general questionnaire, Connor-Davidson Resilience Scale (CD-RISC), Simplified Coping Style Questionnaire (SCSQ) and Social Support Rating Scale (SSRS). Results: The total mental resilience score of hysterectomy patients was 61.13±16.07; Factors including age, marital status, negative coping, objective support and utilization of support entered the mental resilience regression equation of hysterectomy patients,accounting for a total of 56.0% of all the variation. Conclusion: Hysterectomy patients have poor mental resilience; Factors including age, marital status, negative coping, objective support and utilization of support could exert important influence onmental resilience of hysterectomy patients.

Objective: To explore the hope level and its influence factors of patients with HIV/AIDS (PWHA) who received antiretroviral therapy (ART), and provide theoretical basis to improve their quality of life. Methods: Totally 206 PWHA receiving free ART 1~109 months were recruited to the study through convenience sampling. The Herth hope scale was applied to measure the hope level and its influence factors were statistically analyzed by logistic regression analysis. Results: The average score of hope level of the 206 PWHA was (36.2±3.89), and the scores ranked in three dimensions from high to low were as follows: taking positive action (12.48±1.73), having a positive attitude to the present and the future (11.98±1.35), and maintaining positive relationship with others (11.74±1.47). The results of the logistic regression analysis indicated that self-identification of HIV infection, monthly income and HIV transmitted way might be the important influencing factors of the hope level of PWHA receiving ART. Conclusion: The PWHA receiving ART in China have a medium or high level of hope. Assisting them to accept the fact of HIV infection, rationally treat with their sexual behavior and acquire social support, could benefit for increasing their hope level and improve their survival quality of life.

Objective: To provide a new approach to nursing research learning for nursing staff, and to meet their needs of learning knowledge of nursing research, and to improve the research literacy of participants via this platform. Methods: Based on the teaching theory of constructivism, we established internet learning platform for nursing research courses based on Moodle and SCORM, and applied nursing research training program for baccalaureate nursing students of Grade 2015. The application was evaluated by self-designed questionnaire after the end of training program. Results: The total score was 56.62±7.90 and the mean score was 4.04±0.56, web site design, teaching content, and learning interest and ability were 3.72±0.61, 4.30±0.58, 4.16±0.64, respectively. Conclusion: This platform is scientific and reasonable and results in a good application effect. It could provide a better network learning environment and rich teaching resources for learners to increase their learning flexibility, to expand the knowledge of nursing research, to stimulate the learning interest and autonomy of the learners, to facilitate the interaction between teachers and students, and to realize the sharing of learning resources.

Objective: To investigate nursing informatics competencies and its influence factors of higher vocational nursing students. Methods: A total of 280 nursing students were selected by using stratified sampling method and investigated by the questionnaire of nursing informatics competencies. Results: The total score of nursing information ability was 80.68±14.59, the average score of basic computer knowledge and skills was 3.18±5.55, 2.18±0.68 for applied computer knowledge and skills, and 3.27±0.87 for clinical informatics attitudes. The grade, studying computer before university, duration of studying computer, computer grading and practicing in hospital were the influence factors of nursing informatics competencies. Conclusion: The nursing informatics competencies of higher vocational nursing students were at low level. Schools should strengthen nursing informatics education in order to improve nursing informatics competencies of nursing students, and to improve their adaptive capacities to nursing practice.

Objective: To explore the characteristics of Chinese clinical teaching mode for pediatric Master of Nursing Specialist, and to lay the foundation for the training of high level application talents of pediatric nursing specialists. Methods: We used three level clinical teaching mode for pediatric Master of Nursing Specialist for a period of 6 months intervention in a certain university hospital from the management system, organizational structure, teaching plan, content and methods, the construction of teachers, evaluation criteria and other aspects, and tested the core competence before and after the intervention through the questionnaire survey. Results: The core competence score of pediatric master of nursing specialist increased from 144.94 (33.30) to 167.88 (25.32). Clinical nursing, critical thinking / scientific research, education/consulting were the largest increasing dimensions. The total score and dimension scores of clinical nursing, critical thinking/scientific research, education/ counseling, professional development, interpersonal relationship dimensions had significant difference before and after intervention (P<0.05). Conclusion: The establishment of holistic clinical teaching mode can effectively promote the core competencies of pediatric master of nursing specialist, especially in clinical nursing, critical thinking / scientific research, and education/ counseling.

Objective: To study the impact of maintaining duration of sleep after night shifts to sleep quality of pediatric ICU nurses. Methods: Pittsburgh Sleep Quality Index (PSQI) was used to investigate 109 pediatric ICU nurses to assess the effect of the intervention that maintaing duration of sleep after night shifts.Results: Before the intervention, the score of PSQI of pediatric ICU nurses was (7.79±1.43), 60.73% of the pediatric ICU nurses had sleep disturbance. There were statistically significant differences in duration of sleep, sleep quality and total score comparing with nurses of pediatrics ward (P<0.01). One year after implementing the intervention, the scores of each subscales of PSQI were lowered than baseline, except for sleep efficiency (P>0.05). Conclusion: The sleep quality of pediatric ICU nurses was poorer than pediatrics ward nurses. Maintaining the duration of sleep after night shift can improve their sleep quality.

Proper allocation of ICU nurses is important for the care quality and patients' safety, and assessment of nursing workload is a prerequisite for adequate staff allocation. This article reviewed the commonly used ICU nursing workload measurements and compared the characteristics of these tools, so as to provide reference for ICU nursing managers and researchers.

Objective: The aim of this study was to discuss the method that could develop and optimize the human resource distribution of operating room nursing. Methods: Auxiliary nurses were publicly recruited and have been systematically trained and evaluated to implement unprofessional and indirect operating room nursing practice which used to be completed by conventional operating room registered nurse. Results: This reformation have established a relatively stable and highly qualified nurse assistant team. In the premise that ensures nursing safety, it have reduced human resources costs, improved working efficiency and operating room nursing satisfaction. Conclusion: High-qualified auxiliary nurses could be responsible for unprofessional and indirect operating room nursing work.

Objective: To explore the effects of implementation of quality management over integrated nursing that combining traditional Chinese and western medicine in the treatment of advanced cancer pain. Methods: Totally 78 hospitalized patients with advanced cancer pain from January to December of 2015 were selected as the control group, while 69 hospitalized patients from January 2016 to January 2017 were selected as the experimental group. On the basis of standardized treatment in the control group, patients in the experimental group also received integrated nursing care that combining traditional Chinese and western medicine under nursing quality management. Results: On the 10th day of admission, score of pain relief, occurance of breakthrough pain and quality score of life were better in the experimental group than in the control group, and the difference was statistically significant (P<0.05). Conclusion: Quality management over integrated nursing that combining traditional Chinese and western medicine can effectively control cancer pain and improve patients' quality of life, which is worthy to be used in the standardized management of cancer pain.

Objective: To optimize hospitalized treatment process of intravenous thrombolysis among patients with ischemic stroke, to shorten Door-to-Needle Time (DNT), and to improve the thrombolysis rate within the hospitalized time window of intravenous thrombolysis. Methods: We established a "parallel treatment" model for hospitalized treatment process of intravenous thrombolysis and used the observational and quasi-experimental research methods to compare the time from the hospital to medication (DNT), the rate of thrombolysis within the hospitalized time window, the time of key links and clinical outcomes before and after process optimizing. Results: After the process optimizing, the median DNT was 62 minutes which was shorter than that before the process optimizing (P<0.01), and the thrombolysis rate increased by 76.3% within the time window. The median time from nurse admissions to the emergency doctors admissions was shortened 3 minutes (P<0.01), and the median time from nurse admissions to thrombolysis doctors admissions was shortened 9 minutes (P<0.01). The median time from nurse taking a blood sample to test outcomes returning was shortened 23 minutes (P<0.01), and the median time from nurses admissions to CT completing was shorten 13 minutes (P<0.01). The median time of family decision time was shortened 12 minutes (P<0.01). The median time of hospital stays was shortened 2 days (P<0.01). Conclusion: The effect of hospitalized optimized treatment process of intravenous thrombolysis is obvious, and DNT time, the time of key links, and the thrombolysis rate within the hospitalized time window has been improved, and the prognosis of patients have been improved.

Objective: To describe the characteristics and analyze risk factors for medication near-miss errors stemming from the NICU work system based on self-incident reports from staff nurses. Methods: Data on medication errors were collected from a convenience sample of 42 NICU nurses at four hospitals in Beijing from January 2014 to December 2015. The ASSESS-ERRTM Medication System Work sheet was used to collect the data of possible system risk factors resulting from the near-miss error. Grey Relational Analysis was used to examine the associations between the five medication-use processes and the 10 risk elements. Results: A total of 134 medication near-miss errors were reported by nurses. The order prescribing stage had the most medication near-miss errors (58.2%). The highest systemic risk factor was critical drug information missing (ξ2=0.425), and the rank of risky stage was: repackaging prescribing dispensing administering monitoring/ education. Conclusion: Analyzing the possible system risk factors resulting from the near-miss error could be a useful method for nurses to generate hierarchical risk-control strategies and improve medication safety for neonates.

The "1+1" management model was adopted to enhance the safety of post discharged patients with portable catheters and unremoved stitches. Under this concept, the role of urological nurse specialists was refined to improve the quality of nursing and patients' satisfaction. The application of this new working model reduced the complications and optimized patients experience.

Objective: To investigate the chemotherapy-induced nausea and vomiting smart phone application among chemotherapy patients. Method: Convenience sampling method was performed. Totally 335 chemotherapy patients were investigated using a self-designed questionnaire. Results: The total average score of demand for CINV app was (4.10±1.12). The top three requirements are the "function" (4.36±1.02), professional consultation (4.28±1.61), guidelines (4.14±1.10). Conclusion: Patients with different education level, occupation and main caregivers have different demands for CINV app. The CINV app design should be guided by the demand of the patients with different background, to make the mobile nursing more personalized, and to improve the efficiency and quality of the follow-up.

Objective: To describe bowel symptoms in mid and low rectal cancer patients after sphincter-preserving surgery (SPS) and analyze the relationship between their bowel dysfunction and quality of life. Methods: A total of 199 patients were recruited and respondents were investigated by Memorial Sloan-Kettering Cancer Center (MSKCC) Bowel Function Instrument, EORTC QLQ-C30, demographic and disease/treatment questionnaires. Results: The mean score of the MSKCC Bowel Function Instrument among participants is 63.14±10.79. The mean score of QLQ-C30 is 68.74±22.37. MSKCC Bowel Function Instrument scores and QLQ-C30 scores were positively correlated (r=0.339, P<0.01). Conclusions: Patients with mid and low rectal cancer will experience multiple bowel symptoms after SPS. And the quality of life of patients is closely associated with the severity of the bowel dysfunction. Therefore, health care providers should help their patients to cope with bowel symptoms in order to improve their quality of life.

Objective: To evaluate the effect of smartphone applications on self-management of patients with type 1 or type 2 diabetes mellitus. Methods: Randomized Controlled Trials (RCTs) or quasi-Randomized Controlled Trials (quasi-RCT) regarding smartphone-based intervention on self-management in patients with diabetes were retrieved. Assessment of evidence and data extraction were conducted by two reviewers independently. The Meta-analysis was conducted using RevMan 5.3 software. Results: 5 studies were included in the Meta-analysis. The results showed that the scores of self-management on diet, exercise, blood glucose monitoring and medication in the intervention groups were higher than those of control groups (P<0.05). The score of foot care was lower than that of control group, while the difference was not statistically significant (P>0.05). Conclusion: Smartphone-based intervention can effectively improve the self-management behavior of patients with diabetes mellitus in diet, exercise, blood glucose monitoring and medication, except for foot care.

Objective: To describe the level of illness perception in COPD patients, and identify the influencing factors of illness perception. Method: Questionnaire was utilized in this study. Totally 128 COPD patients were recruited from a tertiary general hospital in Beijing. Brief Illness Perception Questionnaire was used to collect data of illness perception. Multiple linear regressions were used to determine the influencing factors of illness perception. Results: The average total score of illness perception was 46.02±10.28. The items were ranked from high to low according to the average score, the first three items were concern, timeline and identity. Multiple linear regression analyses indicated that the influencing factors were degree of dyspnea, depression and age. Conclusion: Illness perception of patients with COPD should be improved. The patients with dyspnea, depression or young age should be given intensive nursing care.

Specialist Breast Nurses (SBN) play different roles in Multidisciplinary Team (MDT), which include administrators, information providers and coordinators between health providers and patients. This article aims to explain the definition of SBN, the composition and function of breast cancer MDT, and the necessity of the SBN during the process of comprehensive treatment in order to help the SBN guide future clinical practice.

Object: To explore the knowledge, attitude and practice (KAP) of Incontinence-Associated Dermatitis (IAD) among ICU nurses. Methods: Self-designed questionnaire was applied to investigate the KAP of 486 ICU nursing staff in 21 provinces and 2 cities in China. Results: The scores of KAP from high to low were attitude, knowledge and practice. Conclusion: The knowledge and practice about IAD of ICU nurses need to be improved. On site training about IAD is necessary to enhance the nurses' KAP. It is expected the nurses provide high quality nursing care to patients with IAD.

Objective:To investigate the status quo of venous nursing in 20 hospitals in Zhuzhou. Methods: We investigated 249 inpatient departments of 20 hospitals in Zhuzhou by using questionnaires. Results: Totally 9 hospitals established intravenous therapy groups and 1 hospital established PICC outpatient department. Totally 16 hospitals implemented the training of the promulgated Intravenous Therapy Nursing Technique Operation Specification in 2014, but the participants were limited. The current status of the Specifications implementation was not satisfactory and the irrational use of intravenous infusion tools was particularly prominent. Conclusion: Some hospitals in Zhuzhou established well-established intravenous therapy nursing system, but the overall level needs to be improved. We should integrate regional resources and establish reasonable management model in order to improve intravenous transfusion level of the whole region.

Objective: To investigate medication literacy of discharged patients with acute coronary syndrome and analyze its influencing factors. Method: A total of 253 discharged patients with acute coronary syndrome was investigated with the Medication Literacy Questionnaire for discharged patients. Results: The score of medication literacy was (4.75±1.42). Two variables which had significant difference on medication literacy of discharged patients with acute coronary syndrome were age and education level (P<0.05). Conclusions: Medication literacy of discharged patients with acute coronary syndrome is not high enough, and medical staff should take corresponding measures to help patients improve it.

Objective: To analyze the influencing factors of quality of sexual life of patients after radical hysterectomy and their sex-related demands for extended-nursing service. Methods: Patients after radical hysterectomy within 5 years in our hospital were enrolled by convenience sampling method. We investigated their quality of sexual life, the influencing factors, and their sex-related demands for extended-nursing service. Results: The results of a linear regression analysis showed that age, education level, economic status, occupational status, anxiety, depression, postoperative sexual instruction of patients as well as their partners were influencing factors of quality of sexual life, accounted for 80.3%. In terms of the sex-related demands for extended-nursing service, Wechat communication (64.4%), duration>1 year (82.7%), nurses as the main intervention subject (58.1%), sexual knowledge introduction (92.1%), sexual health education (91.1%) had the highest degree of acceptance. Conclusions: Nurses should use modern communication tools to provide extended-nursing service for both patients with a wide range of hysterectomy and their partners, in order to obtain a higher degree of acceptance and intervention effects.

Objective: To investigate the relationship between family response, parents coping strategy and asthma control in children. Method: Totally 213 children with asthma and their parents were investigated using convenience sampling method in one hospital. The Family Management Measure (FaMM), the Coping Health Inventory for Parents (CHIP) and Childhood Asthma Control Test (C-ACT) were used to investigate the relationship between family response, parents coping strategy and asthma control in children. Results: There were significant differences in FaMM and CHIP with different asthma control (P﹤0.05). Child daily life, condition management ability and parent maturity were positively correlated with asthma control respectively (P﹤0.01). Condition management effort, condition management difficulty and view of condition impact were negatively correlated with asthma control respectively (P﹤0.01). The sub-scales of CHIP were positively correlated with asthma control respectively (P﹤0.01). Conclusion: The family response and parents coping strategy have a close relationship with asthma control in children. The nursing staff should pay attention to the adaptive process of the whole family and encourage parents to adopt positive coping strategy to get enhanced asthma control results.

Objective: To explore and describe the experience of Post Traumatic Growth of parents of children with rheumatic diseases. Methods: Phenomenological research methods and semi-structured individual interviews were used to get a clear understanding of the experience of the parents' post traumatic growth. And 10 parents whose children were diagnosed as rheumatic diseases were recruited to have semi-structured interviews. Results: Through inductive thematic analysis, three themes were derived, including nine sub-themes. The key themes were the insights on life (treasure for life, new values as to life priorities, self adjustment to accept the reality), increased personal strength (self dependence, self enhancement), improved interpersonal relationship (greater sense of closeness and family togetherness, cherish the parent-child love, benefit from peer and other professional support, empathy and promotion of altruism). Conclusion: The experience of post traumatic growth of parents can be used as a breakthrough point to explore the growth potential of children's parents after trauma, and ultimately improve the PTG level of children's parents.

Objective: To investigate ICU nurses' knowledge, attitudes and practice about patients' sleep status. Methods: Totally 133 ICU nurses from ICU specialist nurse training course were recruited using convenience sampling method and investigated online using self-designed "ICU nurses' knowledge, attitudes and practice about patients' sleep status questionnaire". Results: About 82.0% respondents described they didn't know how to assess patients' sleep status. Nearly 80% nurses had never heard about sleep evaluation tools. Only 12.8% responders had received related training. Over 80% respondents thought ICU nurses have the responsibility to evaluate patients' sleep status every day. Nearly 90% respondents thought the ICU should supply some training program about patient's sleep status evaluation and made related protocols. Less than 40% respondents recorded patients' sleep status and less than 5% respondents described that their units provided some sleeping monitoring equipment. Conclusion: ICU nurses have positive attitude towards managing patients' sleep status, but lack related knowledge and behavior. Nursing managers should develop knowledge's about solving ICU patients' sleeping deprivation and these knowledge should be put into ICU specialist nurse training program, so as to guide ICU nurses' practice to relieve ICU patients' sleeping deprivation and improve patients' sleep quality in ICU.

This study carried out a standardized training and assessment programme for non-endocrine specialist nurses to establish a diabetes management team. The nurses' individualized health education could improve hospitalized patients' satisfaction degree.

Background: Use of noninvasive ventilation (NIV) has extended beyond intensive care units (ICUs), becoming usual practice in emergency departments (EDs) and general wards. Objective: To analyse the relationship between nursing care and NIV outcome in different hospital units. Methods: Treatment success/failure, interface intolerance and complications were evaluated according to patient characteristics, nursing care provided, and procedures used. Complications analysed included bronchoaspiration, pneumothorax, skin lesions, inability to manage secretions, eye irritations, deteriorating level of consciousness, gastric distension, and excessive air losses around the mask. Results: Of 387 patients, 194 (50.1%) were treated in ICU, 121 (31.3%) in ED, 38 (9.8%) postsurgery, and 34 (8.8%) in general wards. Regression analysis, adjusted for APACHE score and NIV indication, showed 3.3 times greater risk of NIV failure [95% CI (1.2-9.2) ] in a university-hospital ICU with <50 NIV cases/year, compared to a community hospital ICU. In ICUs and general wards, NIV was suspended in 12% of patients due to interface intolerance. Acute-on-chronic lung diseases (ACLD) had lower risk of NIV failure [OR 0.2, 95% CI (0.06-0.69) ] and lack of humidification was not associated with treatment failure [OR 0.2, 95% CI (0.1-0.4) ]. Poor secretion management was linked to pneumonia [OR 2.5, 95% CI (1.1-5.9) ] and early weaning/extubation [OR 3.3, 95% CI (1.2-8.9) ]. Interface intolerance was associated with conventional ICU ventilators [OR 4.4, 95% CI (2.1-9.2) ] and nasal skin lesions with excessive air losses [OR 2.4, 95% CI (1.1-5.3) ], especially with oronasal masks [OR 3.5, 95% CI (1.1-11.3) ]. Conclusion: Acute respiratory failure patients with pneumonia admitted to general wards had increased interface intolerance and NIV failure. Rotating mask types could improve NIV success in any unit administering this therapy.