Objective: To develop and validate avenous thromboembolism risk management system for inpatients.Methods: A panel of VTE specialized nurses was recruited. Based on literature review and clinical practice, a venous thromboembolism risk management system was developed by focus group interview method. Results: Based on the risk management system, the amount of patients that received VTE risk management increased significantly, and nurses raised the awareness of VTE prevention. Combined with hospital information system, identify VTE high-risk departments, and perform proper nursing strategies. Conclusion: The use of the venous thromboembolism risk management system for inpatients can reduce risk of VTE, and promote nurses' VTE prevention strategies.

Objective: To explore the effect of project management on perioperative DVT prevention of patients with spinal fractures. Methods: A historical and comparative method was used. A total of 138 patients with spinal fractures were selected from August 2016 to July 2017 by cluster sampling. Sixty-eight patients were included in the control group from August to December 2016. Seventy patients were included in the observation group from March to July 2017. The control group was treated with regularly thrombus control measures. The observation group was treated with multidisciplinary vascular access project management measures. The incidence of thrombosis, results of laboratory tests, hospital stay and patient satisfaction, the feeling and attitudes toward physician-nurse collaboration were compared between the two groups. Results: The incidence of DVT in the observation group was lower than that in the control group (P<0.05). The hospitalization days of the observation group were fewer than that of the control group, and patients’ satisfaction was higher than the control group. The differences were statistically significant (P<0.05). After the implementing of the multidisciplinary vascular access project management, the attitudes towards physician-nurse collaboration and the degree of cooperation between doctors and nurses were slightly higher, while the differences were not statistically significant. Conclusion: Multidisciplinary vascular access project management has a good effect on the perioperative prevention of DVT in patients with spinal fractures, and it is helpful to reduce the length of hospital stay, improve patient satisfaction, and strengthen physician-nurse collaboration.

This paper reviewed 6 published Risk Assessment Models (RAMs) for predicting venous thromboembolism. We discuss the generalizability, validation and guideline recommendation were compared, and implications for their use in clinical practice.

The incidence of deep vein thrombosis is increasing, which is a serious threat to patients’ health and lives. graduated compression is a safe and worthy method to deep vein thrombosis. This article summarize the mechanism, indications and contraindications, methods, nursing problems and strategies of stockings to provide references to clinical practice.

Objective: To comparatively analyze the current status of the prevention of VTE between non-operating departments and operating departments from the tertiary grade A hospitals by multiple center surveys, so as to provide guidance for clinical nursing work to carry out comprehensive prevention of VTE in hospitals. Methods: Using a self-designed questionnaire, we conducted a survey on 5 278 nurses from 29 provinces (municipalities and autonomous regions) at the 2015 Symposium of Chinese Nursing Association of Surgical Nursing. Among them, 3 062 nurses were from operating departments, another 2 216 nurses were from non-operating departments. Results: The standardized prevention procedure and risk assessment for VTE in the operating departments were obviously better than those in the non-operating departments, and the P values were 0.042 and 0.046, respectively. Nurses' overall knowledge level of VTE in operating departments was higher than those in non-operating departments, P=0.001. There was still lack of national standardized procedures of the prevention and nursing for VTE. Conclusion: At present, it is urgent to establish the consensus on the prevention and nursing for VTE in China, and comprehensively and rapidly promote the standardization and homogenization of the clinical prevention and nursing work for VTE, and improve clinical nurses' prevention and control level for VTE at the same time.

Objective: To investigate the effects of risk assessment and pulmonary embolism prophylaxis among hospitalized patients, provide a reference for regulating nursing standard to reduce pulmonary embolism occurrence. Methods: Risk assessment and stratified pulmonary embolism prophylaxis strategies were applied to all hospitalized patients. Results: The pulmonary embolism diagnosis rate was improved; risk assessment rate reached 77.50%, targeted prevention strategies utilization rate was 22.71%. There were less pulmonary embolism high-risk patients in internal medicine, and more in surgery department. Patients who received pulmonary embolism prophylaxis had significantly lower prevalence than who did not. Conclusion: Nurses were capable to implement pulmonary embolism risk assessment and identify high-risk patients, while prophylaxis strategies need to be improved. The effects of risk assessment and prophylaxis strategies should be improved by training, quality control and resource allocation.

Objective: To evaluate effects of intradialytic exercise (IDE) on dialysis adequacy and sleep quality in patients undergoing maintenance hemodialysis (MHD). Methods: MHD patients consistent with inclusion criteria were randomly divided into the experimental group and the controls group. Patients in the experimental group did IDE individual progressive training with smart sports bike on basis of routine care three times a week. And the control group received routine care for 12 weeks. The dialysis adequacy and sleep quality of two groups before and after intervention was observed and compared. Results: After the intervention, the urea clearance index (KT/V) of the experimental group was higher than that of the control group (P<0.05). The score of sleep quality of the experimental group was lower than that in the control group (P <0.05). Conclusion: IDE can improve the dialysis adequacy and sleep quality in MHD patients.

Objective: To explore the working condition and psychological experience of geriatric nursing graduates after working in nursing home. Methods: The face-to-face,semi-structured, and in-depth interview were conducted for nine geriatric nursing graduates , guided by phenomenological methodology. Colaizzi's 7-step analysis method was used to sort out, analyze, summarize and refine. Results: Four main themes came out including the job stressor in nursing home; the match between working position and specialty was low; complex interpersonal relationship; opportunities for further study and continuing education were few. Conclusion: The employment situation and the quality of employment of geriatric nursing graduates are worthy of attention. The reasons for the graduates' choice of geriatric nursing institutions are complicated, and their working pressure is heavy, the match degree of working position and specialty is low, and there are many problems in interpersonal communication. The schools and geriatric nursing agencies can change the teaching and management methods, strengthen learning and training, help develop good career planning and other methods to reduce the work pressure, improve the bad mood after work to promote the nursing quality of geriatric nursing agencies.

Objective: To explore the current status and influencing factors of self-perceived burden among postoperative stoma patients. Methods: Totally 151 postoperative stoma patients were recruited to complete demographic questionnaire, Self-Perceived Burden Scale, Medical Coping Modes Questionnaire and Stoma-QOL scale. Results: The mean score of Self-Perceived Burden Scale was 39.62±8.81, which was in moderate level, with 50.3% patients in high level. The influencing factors of self-perceived burden of postoperative stoma patients include avoidance, educational level, stool leakage and stink rate and confrontation. Conclusion: Stoma patients has serious level of self-perceived burden. Nurses should encourage patients to face difficulties and challenges, learn stoma care skills, and communicate with others actively. Besides, stoma patients who has lower educational level should be paid more attention.

Objective: To develop family Caregiver Burden Scale for cancer patients (CBS-CP) according to Chinese culture background. Methods: We evaluated its reliability and validity based on the pre-survey results of developing CBS-CP. Results: The Content Validity Index (S-CVI) of CBS-CP scale was 0.936. The Exploratory Factor Analysis (EFA) results showed that the 5 factor model was consistent with the five-dimension design in conceptual framework of caregiver burden. The Cronbach's α and the test-retest reliability of the total scale and the five factors of CBS-CP were all greater than 0.7. Conclusion: The findings showed that both the reliability and validity of the CBS-CP were good. It was also proposed that future studies are needed to evaluate the reliability and validity of the CBS-CP based on large sample of the formal investigation.

Objective: To investigate the Operating Room (OR) nurses' awareness and behavioral intention of intravenous infusion, and analyze the related factors. Methods: Using convenient sampling method, 222 OR nurses from 222 hospitals of different levels were included in this study. A self-designed questionnaire was used to investigate the nurses' knowledge, behavioral intention and training needs of intravenous infusion. Results: The OR nurses' basic knowledge of intravenous infusion was in the medium level (53.3%). The nurses' infusion behavior intention was more positive (87.4%) than that of others (t=2.662, P=0.010), if there were regular training courses about intravenous infusion in their hospitals. Conclusion: The OR nurses' knowledge of intraoperative intravenous fluids was insufficient. Regular training was useful for improving their behavioral intention. Nursing educators and administrators should pay attention to the training of nurses' knowledge and concepts of intravenous infusion.

Objective: To explore the application of OH pressure ulcer assessment scale in elderly inpatients. Method: The inclusion criteria are aged60 years old and Barthel Index <60. Totally 286 inpatients were included in this study. Results: The Spearman correlation coefficient of OH pressure ulcer assessment scale was 0.995. The distribution of pressure ulcer risk level was significantly different between OH pressure ulcer assessment scale and Braden Scale (P<0.01); The Coincidence rate of OH pressure ulcer assessment scale was higher than Braden Scale (P<0.05). OH pressure ulcer assessment scale consumed less time by the nurses than Braden Scale (P<0.01). Conclusion: The OH pressure ulcer assessment scale is convenient and effective for elderly patients.

Objective: To investigate the ICU settings of Health Care Institutions in Ningxia and the present situation of nurse specialists and to provide the references to the development of training foundation. Methods: Totally 125 nurses trained and awarded certification by the ICU training foundation of Ningxia were asked to answer the self-designed questionnaires by convenience sampling method. Results: There were 8 hospitals that failed to well found the ICU. Besides, the first 3 items of the core competence upgrade ranked after the training were exploit the simple respirator, basic nursing for critically ill patients and use the monitor safely. Conclusion: Based on the capital investment and working, the development of nurse specialists in Ningxia shall consider the integration of its national characters as part of standardized training, and formulate a suite of regulations to well manage this group, from relationship of administrative, cultural acquires, salary treatment and attendance rules to the methods of performance appraisal.

Objective: To investigate and understand job tasks of nurses with different professional titles in hospitals of various levels in China, so as to provide references for the establishment of nursing qualification examination system matching with the clinical requirements. Methods: Typical layered sampling method was adopted to select proper samples in 7 geographical zones and 3 types of medical institutions. We used the "Questionnaire of Job Tasks of Nurses with Different Professional Titles" to investigate 9 034 nurses in these selected medical institutions. Results: The average score of the item "nurses' task execution frequency" was (3.09±0.71) points, and the average score of importance evaluation was (3.35±0.50) points. The correlation analysis of execution frequency and importance evaluation of each dimension showed a significant positive correlation (P<0.01). Variance analysis showed that task execution frequence of nurses with different titles and the importance evaluation of each dimension was significantly different (P<0.05), while tasks execution frequency of nurses in hospitals of various levels and the importance evaluation of part dimensions were significantly different (P<0.05). Conclusion: Professional title and hospital level had an influence on tasks execution frequency of nurses and the importance evaluation, so the nurse professional setting and the advanced examination reform should take these two factors, i.e. hospital level and nurses' professional titles into serious consideration.

Objective: To analyze the research progress of nurses' job burnout in China. Methods: "Nurse" and "burnout" or "fatigue" as subjects were searched in Wanfang Datebase in order to describe the status and influencing factors of nurses' job burnout in China. Results: 92 articles were retrieved. The incidence rates of emotional exhaustion, depersonalization, and reduced personal accomplishment were over 30%, 12% and 12% respectively. Institutional factors, such as staffing and profession title, were main influencing factors. Comprehensive occupational support measures for individual nurses were helpful in alleviating nurses' job burnout. Conclusion: Nurses' job burnout situation should not be ignored in China. It should be paid more attention to by policy researchers.

Objective: To explore new graduate nurses' changes of occupational stress and to identify factors that impact on their transition to the workforce. Methods: This study applied a longitudinal design with four follow-ups survey during 2014 and 2015. Results: The mean score of occupational stress was 2.63±0.10, and reached highest in the fourth month (2.75±0.68). The four domains and total score varied significantly during the first year (P<0.05). Tasks in critical care was the strongest stressor and reached highest in the fourth month after employment (3.29±0.85); tasks in general care got highest in the very beginning (2.90±0.84); leadership and management reached highest in the fourth month (2.68±0.85) and interpersonal relationships got highest score in the eighth month (2.41±0.81). Occupational stress was significantly correlated with residence, education background, rotation and work independently in day shift (P<0.05). Conclusion: Occupational stress of new graduate nurses changed with time in the first year of employment. Nursing managers need to identify impact factors of different stages, provide appropriate orientation for new graduate nurses to adapt to their work environment.

Nursing workload measurement is the basis of nursing human resource allocation and could provide important basis for nursing performance management. It is important to introduce the concept of "weight" when measuring workload. We could consider the number of nursing work and at the same time fully reflect the operational risk and technical difficulty. It could improve the workload measurement and rational allocation of nursing human resources, establish a scientific performance appraisal system, and stable nursing staff. We reviewed the progress of the application of weighted nursing workload to provide reference for the follow-up study.

Objective: To reduce the risk of infant theft in hospital. Methods: Healthcare Failure Mode and Effects Analysis (HFMEA) was used in this study. The authors built a team to analyze and prioritize the potential failure modes, identify the root causes and redesign the process of infant safety management. Results: It reduced the risk of the infant theft; and the infant safety system was set up in the hospital. Conclusion: HFMEA was effective to reduce the infant theft risk and ensure infant safety system.

Objective: To investigate the current status of nursing regarding prevention and control of Catheter-Related Blood Stream Infections (CRBSI), and compared it with the best practice guideline. Methods: A questionnaire survey was conducted in 122 hospitals in 15 provinces from July 1st to 30 th, 2015. The questionnaire was designed according to guidelines both domestic and abroad. Results: 2 176 nurses (88.0%) used sterile drape as maximum sterile barrier precaution, 2 048 nurses (82.8%) adopted iodophor or iodine tincture for skin disinfection; 1 271 nurses (51.4%) changed transparent dressings twice a week; 1 039 nurses (42.0%) chose not to change CVCs without indications; 94 nurses (3.8%) chose to use bath fluid with chlorine. Conclusion: Currently the best practice guideline hass not carried out well in China. There is still a great gap between the best practice guideline and the current clinical nursing. The nurses' knowledge and practice of the best practice guideline of prevention and control CRBSI should be improved.

Objective: Based on the information platform, using the concept of total quality management and ISO 9000 "process control" for falls prevention, so as to reduce the incidence of falls in hospitalized patients. Methods: Established fall-prevention information platform. Set up four function modules and implemented full-path management of falls prevention. Then, bundles of care and key indexes for process monitor were formulated. Implemented the process control on the bases of macro and micro data , carried out different levels and division of fall-prevention process control, implemented time scale falls-prevention process control and monitored the feedback. Results: After the implementation of informational process control, the rate of inpatient fall decreased significantly (P<0.05), and the rate of implementations of fall-prevention process indexes promoted significantly (P<0.05). Conclusions: Implementation of the informational process control reduce the rate of inpatient fall. It also helps to achieve effective and efficient management to prevent falls, so as to guarantee the safety of patients.

Objective: To evaluate the impact of mobile and Internet technology using in case management provided to breast cancer patients after surgery. Methods: 150 patients with breast cancer after modified radical mastectomy from March to August 2016 were recruited. Participants were assigned to a test group that had access to an Internet and mobile phone-based case management program (n=75) or to a control group (n=75) that received regular case management program. Postoperative complications, quality of life and patients' satisfaction of the two groups were compared on baseline, 1 month and 2 months after intervention. Results: At the end of the study period, the test group reported a significantly lower postoperative complication incidence rate. The differences of quality of life (100.40±4.88 vs 96.44±4.01) and patients' satisfaction (12.21±0.86 vs 11.87±1.26) 2 months after intervention of the two groups were statistically significant (P<0.05). Conclusion: Mobile and Internet technology using in case management can reduce postoperative complications, improve the quality of life and patients' satisfaction.

Objective: To evaluate the clinical effectiveness for patients and benefits for medical personnel of pre-filled saline syringes compared with manual operation. Methods: We searched public literatures in Pubmed, the Cochrane Library, Embase, CNKI, WanFang Data and VIP databases for the period up to March 2015. The search terms used were: flush, pre-filled saline syringes and pre-loaded syringes. RevMan 5.3 Software was used to conduct the review after the quality assessment of included studies. Results: In total, 46 studies were included for a further analysis. As for patients' benefits, Meta-analysis results showed significant greater effects of pre-filled saline syringes versus manual operation in reducing catheter-related blood stream infections (odds ration [OR] 0.23, 95% CI : 0.16, 0.34, P<0.001), occlusions (OR 0.38, 95% CI : 0.24, 0.60, P<0.001), and extending catheter indwell time (Mean difference [MD] 0.51d, 95% CI : 0.34, 0.67, P<0.001). As for medical personnel's benefits, this analysis also represented evidence of pre-filled saline syringes in reducing the rate of needlestick injury (OR 0.21, 95% CI : 0.07, 0.61, P=0.004) and medical personnel's operation time (MD -1.37min, 95% CI : -1.56, -1.18, P<0.001) when compared with manual operation. Conclusion: Compared with manual operation, pre-filled saline syringe is a better option for patients to reduce the rate of catheter-related bloodstream infection, occlusions and extend catheter indwell time, and for health workers to reduce the rate of needlestick injury and operation time as well. It's meaningful to apply pre-filled saline syringes in clinic.

Venous Thromboembolism (VTE) has the characteristics of occult onset, high morbidity, high disability, high mortality, and low diagnostic rate. VTE not only endanger the lives of patients, but also increase medical expenses of their families and government. Prevention and management of VTE have become a global issue. This paper reviewed the prevention and control system of venous thromboembolism, which included the establishment of the management system, risk assessment and preventive methods, information reporting system, health education and discharge management.

"Internet plus" represents a kind of new economic form. By health education for pregnant and parturient women through the Internet, self-healthcare consciousness and abilities can be improved, the number of prenatal visits will be increased, and both cesarean section rate without medical indication and postpartum complications rate would bedecreasedsignificantly so as to better protect the maternal and newborn safety ,and improve the quality of population birth. This Paper briefly introduces the current situation of "internet plus" health education model for pregnant and parturient women with in china, and then discusses about the problems in this model, and finally put forward the prospects in order to provide reference for the development of the "internet plus" health education model for pregnant and parturient women in China.

In this review, the authors described the concept of symptom clusters and briefly introduced its mechanism, and then summarized the research status of the non-pharmacological interventions from two aspects, named single intervention and comprehensive intervention. Meanwhile, the problems in these interventions and the future study focus have been discussed in this review.

Objective: To describe the current status and influencing factors of illness perception in patients with Interstitial Lung Disease, and explore the effects of the influencing factors which can be intervened, such as resilience, on illness perception. Methods: A cross-sectional design was used in this study. The Connor-Davidson resilience scale, the Brief Illness Perception Questionnaire (BIPQ) and the demographic scale were applied to investigate the 170 interstitial lung disease patients. Results: The score of illness perception and resilience was 56.02±11.09 and 56.53±10.35 respectively, and the resilience was negatively related to the illness perception (r=-0.423, P<0.001). The multiple linear regression analysis showed that dyspnea, the illness duration and the resilience explained 34.9% variance of the illness perception. In addition, hierarchical regression analysis showed that the resilience alone explained 5.3% variance of the illness perception. Conclusion: The Interstitial Lung Disease patients have negative illness perception. Transitional care and functional exercise should be taken to improve the dyspnea. Moreover, healthcare providers should take some interventions on resilience to improve the illness perception of patients.

Objective: To explore the effects of cardiopulmonary rehabilitation nursing on cardio-pulmonary function of inpatients with Coronary Artery Bypass Grafting (CABG). Methods: Convenient sampling method was applied. Totally 100 subjects were randomly located into rehabilitation group and control group. Both groups accepted general nursing care. The rehabilitation group also accepted the cardiopulmonary rehabilitation nursing, which included exercise therapy, respiratory training and patient education, with kinesitherapy as the central regimen. Before and after the surgery, the ultrasonic examination and cardiopulmonary exercise testing were conducted to evaluate the patients' cardio-pulmonary function. Results: There were no significant differences between rehabilitation group and control group in cardio-pulmonary function before nursing intervention. After nursing intervention, there was significant differences between the two group in the LVED (P<0.05). The VO2max of rehabilitation group in CPET is statistically higher than the control group (P<0.05). Conclusion: Early phase I cardiopulmonary rehabilitation nursing can improve the cardio-pulmonary function and aerobic endurance on the inpatients after CABG. It is suggested that the cardiopulmonary rehabilitation nursing to be performed in the related nursing practice.

This article reviewed the registration and management of nursing practice in American, the experience of American nurses' independent practice, and then some opinions about the multi-site nursing practice in China were put forward based on the current situation of nursing practice in China, with the intent of providing information and guidance for the exploration of multi-site nursing practice in China.

We reviewed the concept of caregiver preparation, the assessment instruments for caregiver preparation, the influencing factors and the intervention measures of the family caregiver preparation in order to provide references for further study.

Background: Suctioning is an integral component of care for patients who are intubated and ventilated in an Intensive Care Unit (ICU). There appears to be no published data of physiotherapy suctioning practices in Australia or New Zealand. Objective: To describe suctioning practices and the factors which have shaped these practices, of experienced physiotherapists working with adults who are intubated and ventilated in an ICU across Australia and New Zealand. Areas of investigation focused on: (i) suctioning approach (i.e. open vs. closed system); (ii) use of adjuncts to suctioning such as hyperoxygenation, hyperinflation and saline lavage; (iii) use of subglottic suctioning and; (iv) factors influencing suctioning practices. Methods: Electronic surveys were emailed to experienced physiotherapists working in ICUs across Australia and New Zealand which had the capacity to intubate and ventilate adult patients for ≥24h. Results: The participation rate was 84.8% (112/132). Closed suction system was used in most ICUs (97/112, 86.6%). Hyperoxygenation was commonly performed on 'all' or 'most' patients before suctioning (71/112, 63.4%), but less frequently after suctioning (38/112, 33.9%). Hyperinflation was infrequently performed on 'all' or 'most' patients before (22/112, 19.6%) or after suctioning (22/112, 19.6%). Saline lavage and subglottic suctioning were infrequently performed on 'all' or 'most' patients (3/112, 2.7%; 17/112, 15.2%, respectively). 'Personal experience' and 'established practice in the ICU' had the greatest influence on suctioning practices. Conclusion: Most ICUs in Australia and New Zealand are equipped for closed system suctioning. As hyperoxygenation minimises desaturation during suctioning, there may be scope for a larger proportion of physiotherapists to use this adjunct. The practice of hyperinflation before and after suctioning was uncommon despite the emerging evidence for improved lung compliance with this procedure. Subglottic suctioning was infrequently available as a choice for physiotherapists despite the strong evidence, which suggests an evidence-practice gap.