Objective: To investigate the establishment and advanced nursing practice status of Nurse-Led Clinics in tertiary hospitals in China. Method: A convenient sampling of 330 tertiary hospitals was conducted using a self-designed questionnaire, covering 19 provinces (autonomous regions and municipalities) in China. Results: Totally 926 Nurse-Led Clinics were established. The top five clinics were Peripherally Inserted Central Catheter (PICC) care, wound/stoma/incontinence care, diabetes mellitus health education, perinatal care and peritoneal dialysis care. In total, there were 2701 registered nurses working in the Nurse-Led Clinics. Among them, 81.2% had a bachelor or higher degree of nursing. Specialist nurses qualification authentication of health administration departments or nursing academic associations were necessary for clinic nurses, comprised 55.8% and 55.2% of cases, respectively. 61.2% of hospitals had set up the charging expense for diagnosis and treatment in Nurse-Led Clinics. Notably, 82.1% of them emphasize that a lack of supporting policies was the main difficulty when establishing clinics, while 73.6% reported the major barrier to operate Nurse-Led Clinics was a lack of explicit charge standard. Conclusions: Nurse-Led Clinics in China experience a rapid growth. The effectiveness of Nurse-Led Clinics in service delivery and clinical outcomes are expected. It is suggested that relevant regulations and policies should be set up, in order to improve the practice environment and facilitate the sustainable development of Nurse-Led Clinics in China.

Objective: To explore the current status of nursing practice in Nurse-Led Clinics in China. Methods: A multi-center cross-sectional survey of 1 181 nurses was conducted using a self-designed questionnaire. Results: Totally 1 181 registered nurses working in Nurse-Led Clinics completed the questionnaire. The average age was 40.23±7.06 yrs. Among them, 84.3% had a bachelor or higher degree in nursing, 32.4% worked in Peripherally Inserted Central Catheter (PICC) Clinics. They spent about 20 minutes with eachpatient.87.6% of them thought their work can improve the accuracy and adherence of treatment, and facilitate patients’ recovery. 69.3% of the nurses suggested that no nursing prescription right was the main issue. Conclusions: Nurse-Led Clinics in China experience a rapid growth. The effectiveness of nurse-led clinics in service delivery and clinical outcomes can be expected. The relevant regulations and policies are expected in order to improve the development of Nurse-Led Clinics in China.

Objective: To investigate the development and needs of specialized nursing service for outpatients in Beijing municipal hospitals. Methods: a self-designed questionnaire was applied to investigate the specialized nursing service for outpatients in 22 municipal hospitals. Results: A total of 55 specialized nursing services were provided to outpatients. The IV care, ostomy wound care and diabetes health education accounted for 63.64%. Two forms of nursing services were identified: working with the physicians or working independently. About 72.22% of the nurses had the specialized nurse qualification, or intermediate professional titles, or at least 10 years work experiences. The number of visits was between 0.5 days to 7 days each week. The overall visits were 214 832 in 2016, and in the next year, 76 234 new vists would be added. Conclusion: The specialized nursing services are becoming very demanding for outpatients. It is expected to improve the qualification requirements of the nurses, complete the standards of services, and establish the regulations for the specialised nursing services.

National Health Service of UK plays important roles in primary care. It’s noteworthy that the nurses brought great cost-effectiveness in the management of chronic diseases in community. This article explained the model of community health centres and multiple roles of community nurses in UK. It is expected to clarify the roles of the community nurses and nurse practitioners in the management of chronic diseases in China.

Objective: To assess the effect of the specific nurse-led clinic. Methods: The key steps of nurse-les clinic running included strengthening the selection and training of nursing specialists in specific nurse-led clinic, formulating standard operation procedures for each technique skill and working process, clarifying the duty and responsibility of nurses in specific nurse-led clinic, improving the quality control system and so on. Results: After the implementation of specific nurse-led clinic, the annual outpatient visits and nursing consultation had increased steadily. Besides, the satisfaction of colleagues, doctors and patients improved (P<0.05). More lectures were given by these specialty nurses, and more papers were published by them. Conclusion: The practice of the specific nurse-led clinic is beneficial to resolve the difficult care problems of patients and promote the nursing professional development.

In order to improve nursing quality of postoperative breast cancer patients' limb, and to explore the establishment and standardized management programmeof breast lymphedema care clinic, we actively introduced and carried out breast lymphedema care clinic from September 2015. Through standardized management of hardware set, personnel preparation, clinic process and the work duties of nursing clinic, we cleared service objects and determined nursing outpatient duties range, not only to speed up greatly the connotation construction of specialist nursing but also to provide specialist nurses' career development environment. This paper could provide reference for advancing the specialty professional transitional care.

Objective: To explore the effect of auricular pressure on post-operative gastrointestinal function recovery in cholecystectomy patients. Methods: We searched CNKI, CBM, VIP, WANFANG Data, PubMed, EMBASE, SCI and The Cochrane Library to collect RCTs about auricular pressure on post-operative cholecystectomy patients. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Then RevMan 5.3 software was used for Meta-analysis. Result: Totally 9 RCTs involving 1 060 patients were recruited. The results of meta-analysis showed that significant differences were found between the two groups in bowel sound recovery time [MD=-9.45, 95% CI (-13.55, -5.35), P=0.01], the anus evacuation time [MD=-11.64, 95% CI (-15.63, -7.65), P<0.001], the meal recovery time [MD=-6.50, 95% CI (-6.78, -6.22), P<0.001]. Significant differences were observed in discomfort reaction including abdominal distention [OR=0.18, 95% CI (0.11, 0.28), P<0.001], vomiting and nausea [OR=0.26, 95% CI (0.11, 0.63), P=0.003], and Visual Andogue Scale (VAS) [MD= -1.22, 95% CI (-2.37, -0.08), P=0.04] between two groups. Conclusion: Auricular pressure could help shorten the time of bowel sounds recovery, the anus evacuation time and the meal recovery time, and reduce the VAS and the occurrence rate of abdominal distention and vomiting and nausea. However, large sample size and high-quality studies are still needed.

Objective: To explore the adaptive challenge of patients with Age-related Macular Degeneration (AMD) during therapy, in order to provide reference for continuous nursing care. Methods: It was a phenomenological study, and a total of 22 cases were recruited and recieved with semi-structural interviews. Results: Four themes were generalized including requirements for control, conflicting emotions, social relationship disorder, and the unbearable pressure of treatment. Conclusions: We should learn advanced rehabilitation model and intervention measures from foreign countries, develop suitable intervention project for China's, and extend the role of healthcare providers from technical experts who provide care for patients to experts who manage disease with patients and help them and their family to develop adaptive skill thus ultimately improve the quality of life of patients with AMD.

Objective: To test the reliability and validity of the evaluation questionnaire of head nurses leadership. Methods: Totally 440 nurses were recruited from five tertiary level first class hospitals in Hangzhou, Ningbo and Shaoxing. Exploratory factor analysis, Cronbach's α and Correlation coefficient measurement were conducted to test the reliability and validity of questionnaire. Results: The evaluation questionnaire of head nurses leadership contained five factors and 44 items; the cumulative variance contribution rate was 73.444%; Cronbach's α was 0.988; Cronbach's α of 5 factors were 0.837 to 0.978; the correlation coefficient of each index item and total were 0.597 to 0.854; the retest reliability was 0.791. Conclusion: The evaluation questionnaire of head nurses leadership has good reliability and validity and can be used in the evaluation of head nurses leadership.

Objective: To analyze the clinical effect of curvilinear supine position on preventing intra-operative pressure ulcers in surgical patients. Methods: The patients were randomly divided into experimental group (50 cases) and control group (51 cases). The patients in experimental group were given the curvilinear supine position and the patients in control group accepted traditional supine position. The incidence of pressure ulcer, the peek pressure of the high-pressure areas, patients′ comfort and doctors′ satisfaction were compared between the two groups. Results:①After positioning, the peek pressures of occipital, caudal, and heel of experimental group were much lower than those of the control group (P<0.05). The pressure decrease of the shoulder blade was not obvious. But, the pressure of the lower leg in the experimental group was higher than control group (P<0.05).②The percentage of patients feeling comfortable with the position in the experimental group was higher than that in the control group (P<0.01). ③The pressure decreases on the sacral and heel persistently of the experimental group with prolonged operation time (P<0.01).④The incidence of intra-operative pressure ulcer immediately after surgery in experimental group was zero, much lower that of the control group (9 cases of stage I pressure ulcer) (P<0.01), and there were no pressure ulcers occurred in both two groups 24 hours after operation. Conclusion: Curvilinear supine position has a positive effect on lowering the interface pressure through pressure redistribution and continuous decompression to the high-pressure areas of the surgical patients, so as to effectively reduce the incidence of intra-operative pressure ulcers, improve patients′ comfort and the quality of nursing in operation room.

Objective: To investigate undergraduate nursing students' cognition level and attitude towards hospice care, and to provide references for developing hospice care course in medical colleges and schools. Methods: Self-designed questionnaire survey was conducted in 1 156 undergraduate nursing students in Guangxi. Results: The average score of hospice knowledge was 16.10±5.04 with the average accuracy 61.8%. Only 19.8% of the students would like to be engaged in hospice care career in the future. Multiple linear regression analysis showed that schools, grades, gender, origin and religious beliefs were influencing factors on cognition degree. Logistic regression model showed that the experience of talking about death with family members and the death of family members affect their attitude towards hospice care. Conclusion: The current cognition degree of hospice care among the undergraduate nursing students in Guangxi is not high. The majority are holding negative or skeptical attitude towards the development of hospice care. Therefore, we should improve the hospice care development by finding out the influencing factors to strengthen the hospice care education and to renew their concepts among undergraduate nursing students.

Objective: To investigate the impact of working environment on nurse-nurse relationship, so as to provide references to improve nurse-nurse relationship. Methods: A total of 372 nurses in 2 general hospitals were investigated with Gallup Workplace Audit Scale and Nurse-nurse Relationship Scale. Results: The total score of nurse-nurse relationship was 77.88±12.91. The mean score of the Gallup Workplace Audit was 43.10±9.54. There was a positive relationship between nurse-nurse relationship and working environment (P<0.01). Marital status, age, and working departments were influencing factors of nurse-nurse relationship (P<0.05). Controlling the influences of these variables, the nurses' working environment was an important factor to predict nurse-nurse relationship (P<0.01). Conclusion: The working environment has positive effect on nurse-nurse relationship. The administrators should pay more attention to the improvement of working environment, to stabilize the nursing team, to establish good nurse-nurse relationship, and to improve quality of nursing.

Objective: To explore the influencing factors of postoperative sore throat grading after the oral trachea intubation among ICU patients. Methods: From April 2015 to October 2016, 382 ICU patients who could understand postoperative sore throat scale were recruited and investigated the postoperative sore throat tracheal intubation grading and age, sex, intubation urgency, air pressure, intubation time, deflated way, whether drawing during suction, positions, catheter extubation models, types of catheter, etc. We analyzed the correlation between sore throat factors and grading. Results: Logistic regression analysis showed that air pressure, intubation time, deflated way, drawing ratio, position were the influencing factors of sore throat grading. Conclusions: Through analyzing the influencing factors of sore throat grading, we could take effective measures to reduce the occurrence of sore throat or sore throat grading and to improve patients' comfort.

Objective: To assess clinical nurses' cultural care competence of caring the Hui nationality patients in Ningxia province and influential factors. Methods: Totally 472 clinical nurses answered the self-designed questionnaire by the convenience sampling method. Results: The cultural care competence of clinical nurses was poor. Knowledge and practice scores were poor, and the score of attitude was higher in level.Univariate analysis showed that nationality, age, work experience, educational background , Hui cultural interest and training experience were significantly associated with knowledge score (P<0.05). Nationality, educational background, Hui cultural interest were significantly associated with attitude and practice score (P<0.05). Pearson correlation analysis revealed that there were positive correlations with knowledge, attitude and practice of cultural care competence (P<0.05); Multivariate regression analysis indicated that nationality, Hui cultural interest, knowledge and attitude were significantly associated factor with cultural care competence practice (P<0.05). Conclusion: The cultural care competence of clinical nurses needs to be enhanced. It will be essential to integrate local cultures and customs with training programs in order to promote cultural care competence.

Objective: To explore the undergraduate nursing students' perspectives on the phenomenon of online autonomous learning in the new media and provide reference for better use of new media in nursing education. Methods: Eighteen undergraduate nursing students were selected by purposive sampling. Data were collected by in-depth interviews and analyzed using phenomenological procedures. Results: Undergraduate nursing students' experience towards the online learning included flexibility, loneliness and the lack of network resource. Conclusion: The results of this study suggest that educators and network builder should promote the development of online education, increase interactions during learning, develop an evaluation system of online learning and strengthen the management of network resources, so as to improve the application of new media in the field of nursing education.

Objective: To explore the method and effects of the qualification certification training of special nurses in department of neurosurgery. Methods: The hospital post qualification certification theory training course for the nurses in the department of neurosurgery developed by the research group, professional skills training and clinical practice manual were adopted to train 37 nurses. The theory, skills, clinical practice ability assessment, evaluation of professional basic ability and training job satisfaction were used to evaluate the effect of training. Results: Through training, 30 nurses were qualified and training qualified rate was 81.1%. The scores of self-rating professional ability of nurses were higher than before (P<0.05). Nurses were satisfied with the training job. Conclusion: Hospital nursing qualification certification training can improve special nursing ability of nurses in department of neurosurgery. In addition, it can improve the quality of nursing and ensure the safety of nursing.

Objective: To analyze the training mode of aviation medical rescue nurse specialist suitable for Chinese national conditions, and to establish the qualification standards and training standards for the aviation medical rescue specialist. Methods: Retrospectively analyzed the training situation of the aviation medical rescue specialist nurses in our center from September 2010 to September 2016, and summed up the practical experience of the training of the aviation medical rescue specialist in the past 6 years. We made a training plan for aviation medical rescue specialist nurses according to "specialist nursing nurse training program" issued by the National Ministry of Health and the professional training of the specialist nurses at home and abroad, combined with the characteristics of nursing professional and the training of specialist nurses in Beijing. Training content included medical knowledge, knowledge related to aviation flight and comprehensive training. The methods of teaching, situational simulation training, case analysis and clinical practice were used in teaching. Through professional training and examination, in which objective structured clinical examination accounted for 30%, theory examination 15%, operational examination 15%, study report 15%, nursing review writing 15%, training attendance 5% and training performance 5%, above 80 points was qualified and given certification. Re-training was conducted after 5 years of certification, and continuing certification was given if qualified. Results: A total of 30 nurses accepted aeromedical rescue training, and the mean score of examination achievement was 86.7. Through the systematic professional training, nurses' knowledge related to the aviation rescue, specialized knowledge, skills and comprehensive quality were improved significantly. Conclusion: The training of aviation medical care nurse specialist achieved significant effects in our center, which was an effective mode to train aviation medical care nurse specialist.

Objective: The study was conducted to develop and establish an effective guideline of high-fidelity simulation training in urology nurse specialists. Methods: The high-fidelity simulation training was designed based on literature review, policy, and experts' opinion. The conventional training was applied to 37 students in 2015 for 3 months, and the high-fidelity simulation training was applied to 29 students in 2016. An improvement of specialized knowledge, nursing skills, critical thinking and core abilities was assessed and compared between two groups. Results: The high-fidelity simulation training enhanced the knowledge and skill of urology nurse specialists (P<0.05), and improved critical thinking, problem solving and emergency handling (P<0.05). However, there were no statistical significances in communication ability, teaching and research ability (P>0.05). Conclusion: High-fidelity simulation training can improve urology nurse specialists' knowledge, skill, and core capabilities, which is an effective and feasible training method. In the future, simulation courses and research programs can be applied to improve comprehensive ability.

RCA2 is further improved basing on RCA. Actions and control parts of resultand process have been added to RCA2, which has clearly pointed out that the final goal of actions would be improvement of actions and results so as to increase action efficiency and result effectiveness as well as recurrence of adverse events. This paper described basic concepts and procedures of RCA2 combining with application of clinical practice, so as to provide reference to nursing managers.

Objective: To develop the outcome evaluation indicator system for hospital transitional care of chronic illness. Methods: Literature review and Delphi technique were used to develop the outcome assessment indicator system for transitional care of chronic illness. The Analytic Hierarchy Process (AHP) was used to determine the weights of all indexes. Results: 4 first-level, 10 second-level and 38 third-level indicators were included in the final outcome assessment indicator system for transitional care of chronic illness. Authority coefficients of two-round expert consultations were 0.84 and 0.88, coordination coefficients of indicators of all levels ranged from 0.312 to 0.434 in the two-round expert consultations. Conclusion: Centralized experts' opinions, high level of experts' enthusiasm and authority were found for the outcome assessment indicator system, which can provide powerful basis for evaluating the outcome of hospital transitional care of chronic illness.

Objective: To explore and understand the current status of occupational cognition of nurses for elderly people and their nursing practice quality in nursing homes in Changchun, and analyze as well as discuss the relationship between them. Methods: Totally 345 nurses for elderly people in nursing homes in Changchun joined the survey and were investigated with the Questionnaire of Nursing Occupational Cognition and High Quality Nursing Practice. Results: The total score of occupation cognition of nurses for elderly people in nursing homes was (70.47±12.51), while the total score of high quality nursing practice degree was (97.05±18.15); occupation cognition of nurses for elderly people in nursing homes and dimensions of their quality of nursing practice were positively correlated (P<0.05); degree of certainty and sense of intitutional influence were two important variables to predict the quality of nursing practice. Conclusion: Improvement of the quality of nursing practice could be achieved through improvement of the level of occupational cognition of nurses for elderly people in nursing homes. Relevant departments of the government should offer more policy support and pay more attention to nursing staffs' education and training systems, increase the level of occupation cognition of nurses for elderly people in nursing homes so as to improve the quality of nursing practice, offer better pension services and promotethe construction and development of pension institutions.

Nursing sensitive quality indicators could measure nursing quality quantitatively. Obtaining the data of nursing sensitive quality indicators from information platform could improve the accuracy and timeliness. In this article, the authors reviewed the concept, content of nursing sensitive quality indicators and the present situation, advantages, problems and corresponding countermeasures of using information platform in monitoring nursing sensitive quality indicators. It could provide reference for nursing managers to use information platform to monitor nursing sensitive quality indicators.

Objective: To evaluate the applicability of six illness-severity scoring systems to assess children with Congenital Heart Diseases (CHD). Methods: Intra-class Correlation Coefficient (ICC) was used to measure the inter-rater reliability. Area under ROC curve and Hosmer-Lemeshow goodness of fit test were used to assess the performance of the instruments. Results: 1 284 children with congenital heart diseases were included. The discriminatory power of the specific score for CHD was better than the others (AUC>0.75). The calibration capability of PRISM III, PIM2, and specific score for CHD were tolerable (P>0.05) . Conclusion: The specific score for CHD is better than non-specific instruments for the evaluation of children with CHD.

This paper summarized the current status of discharge planning at home and abroad, including concept, contents, executors as well as the application in heart failure patients. We proposed suggestions concerning the domestic application of discharge planning in heart failure patients to promote the development of discharge planning in heart failure patients in China.

Objective: To investigate the impact of family care on the medication compliance in HIV/AIDS patients with highly active antiretroviral therapy (HAART). Methods: Totally 112 HIV/AIDS patients receiving free HAART 1-95 months were enrolled in the study. The Family Care Index (APGAR) and Morisky Medication Adherence Scale 8-item version (MMAS-8) were applied to investigate their family care and medication compliance. Results: The score of family care was (7.26±2.75) and the score of medication compliance was (6.94±1.20). The total score of family care, the score of fitness and cooperation degree are positively correlated with medication compliance. Conclusion: Family care is the important factor influencing the medication compliance of HIV/AIDS patients with HAART. To improve the medication compliance of HIV/AIDS patients, we could encourage their family members to accept patients' situation of HIV infection, make decisions about medicine taken together, and enhance their ability to solve related issues.

The relationship between the subjective cognitive decline and the incidence of dementia is found in existing researches. According to the related researches, subjective cognitive decline is the outcome of subjective assessment without abnormalities in objective neuropsychological assessment, which could be the earliest discernible sign of Alzheimer. It could be influenced by demographic characteristic, personality and mood status. The prognosis can be predicted by biomarker, mood status. In this field, the conceptual framework and the relationship with dementia need to be further clarified, and the results of related studies provide a new perspective for the prevention and diagnosis of dementia, and can provide reference to nursing intervention.

Objective: To investigate operating room nurses' knowledge, attitudes and behaviors about preventing Inadvertent Perioperative Hypothermia (IPH) and their influencing factors in secondary and tertiary general hospitals in Shanxi province. Methods: We used a self-designed questionnaire about knowledge, attitudes and behaviors about preventing IPH to survey 852 operating room nurses in 45 hospitals. Results: The scores of nurses' knowledge, attitudes and behaviors about preventing IPH were (9.87±3.77), (40.50±5.50) and (43.29±5.93) respectively, and they were positively correlated with each other (P<0.001); Meanwhile, hospital level, educational background, job title, position, length of working in the operating room, training times of related contents were influencing factors of nurses' knowledge, attitudes and behaviors scores. Conclusions: The score of operating room nurses' knowledge, attitudes and behaviors need to be further strengthened. All hospitals should provide more financial support to improve their heat preservation facilities and heat preservation process to ensure the safety and comfort of surgical patients.

Objective: To investigate the effect of After-Action Review (AAR) on preventing indwelling PICC dislodgement. Method: The AAR facilitators conducted inpatients' PICC management from October 2015 to February 2016. The initiative was composed of six steps, namely, comparison (assessment, goal review and discussion of current situation), scenario reconstruction (timely, staged and final reconstruction), key points (personnel, expertise and equipment), action improvement (reform of patient education, cuff improvement and maintenance skill), validation and documenting. Results: The rates of PICC dislodgement significantly decreased from 25.4% (46/181) to 13.0% (28/215), the differences of which were statistically significant (χ2=9.930, P=0.002). Conclusion: The findings suggest that After-Action Reviews constitute a specific venue through which nurses can decrease indwelling PICC dislodgement rates.

Objective: To analyze how to establish the multidisciplinary integrative diabetes management mode, and its effects on the management of diabetes patients in non-endocrinology departments. Methods: The nursing department led to set up a steering committee of diabetes management, selected excellent nurses from each department to form the diabetes management team. Knowledge training was given to the diabetes management team members.The whole process management of diabetes patients in non-endocrinology departments was developed and implement. Results: The diabetes management knowledge of nurses in non-endocrinology departments rose after training (P<0.01). The quality of blood sugar monitoring in the hospital was increased. Conclusion: Multidisciplinary integrative management to hospitalized diabetes patients could improve the quality of diabetes care, and promote a systematic and normative diabetes care.

Objective: To analyze the status and influencing factors of social avoidance and distress among permanent colostomy patients. Methods: A total of 228 permanent colostomy patients were invited to complete a general information questionnaire, the Social Avoidance and Distress Scale (SADS), Social Impact Scale (SIS), Self-Concealment Scale (SCS) and Self-Esteem Scale (SES). Results: The SADS scores were 13.32±3.27. The results of multiple regression analysis indicated that age, occupation, postoperative time, stigma self-concealment and self-esteem were predictors of social avoidance and distress, which explained 60.4% of the variance. Conclusion: The level of social avoidance and distress in permanent colostomy patients was slightly high, and was affected by several factors. Health care professionals should strengthen patients’ self-esteem, decrease their stigma and self-concealment, in order to improve their social activities.

The paper made a comparative analysis of the development process, the hierarchical structure and the main contents of the commonly nursing terminology system in foreign countries. It was proposed that nursing procedure was the main theoretical basis of the framework of foreign nursing terminology system, which further classified and defined the nursing terminology focusing on nursing diagnosis, nursing measures and nursing outcomes. Most foreign nursing terminology classification systems were divided into 2-3 levels. The higher or lower the level of the terminology was, the more abstract or more specific the meaning of the concept represented.

With the population aging process is accelerating and the sharp rise of the number of elderly population, the mental health of the elderly has become the international social problem that no one can afford to neglect. Psychological resilience and its protective factors can help individuals cope with pressure, improve mental health and play an important role in maintaining physical and mental health of the elderly. In this paper, we reviewed the psychological resilience and its effect on health outcomes of the elderly at home and abroad and provided a new view angel to improve physical and psychological health for the elderly.

Background: In prehospital setting, a severe traumatic brain injury (TBI) requires tracheal intubation, sedation and mechanical ventilation pending the initial imagery. An early neurological wake-up test (ENWT), soon after the initial imaging assessment, allows a rapid neurological reassessment. This strategy authorises an initial clinical examination of reference with which will be compared the later examinations. Objective: The main objective of this study was to describe the characteristics of the patients who underwent an ENWT, and to determine its causes of failure. Methods: We conducted a retrospective, observational, single-centre study including all intubated TBI admitted in the trauma centre. An ENWT was defined as cessation of sedation within 24 h after TBI. Data concerning patient characteristics, CT-scan results, and outcomes were extracted from a prospective register of all intubated TBI admitted in the ICU. Characteristic of ENWT and causes of failure were retrieved from patient files. A multivariate logistic regression model was developed to determine the risk factors of ENWT failure. Results: During 7 years, 242 patients with intubated TBI were included. An ENWT was started in 96 patients, for an overall rate at 40%. The ENWT was stopped in 38 patients (39.5%), mostly due to neurological deterioration in 27 cases (71%) or respiratory distress in 10 cases (26%). Significant predictors of ENWT failure were: the presence of subdural hematoma with a thickness >5 mm on first imagery (OR=3.2; 95%CI [1.01-10.28]), and an initial GCS score <5 (OR=7.4; 95%CI [1.92-28.43]). Prevalence of poor outcome at 1 year was lesser in patients with successful ENWT compared to those with failure or absence of ENWT: 4% vs. 48% and 49% (P<0.0001). Conclusion: The ENWT is achieved in 40% of patients, with a success rate of 60.5%. In presence of a subdural hematoma with a thickness >5 mm or an initial GCS score <5, an ENWT failure may be expected.