With the acceleration of population ageing process, the concept of medical-nursing combination service is getting more and more attention. This paper defines the meaning of medical-nursing combination from the service object, service characteristic and service subject, combs and analyzes systematically on the policy of medical-nursing combination in recent years, and proposes that nursing staff should be guided by this policy. The paper suggests that the nursing staff should grasp the policy orientation, and follow the development trend of the government and the market, and adjust the nursing professional positioning, improve the professional service ability of the nursing staff in the field of medical-nursing combination. In order to ensure that the nursing profession can take advantage of the strategic opportunity period of the national health development, it is powerful itself, and it is going to happen.

As a "pioneer" of long-term care insurance system in our country, Qingdao has more than 5 years of practical experience worth popularizing and using for reference. This article mainly introduces the status quo of Qingdao long-term care insurance system from three aspects: the service object, service forms and service content of long-term care insurance. We summarized the existing problems and puts forward relevant suggestions for the implementation of long-term care insurance system in our country in the future.

Objective: To describe the nursing station operating mode and problems. Methods: On-site inspection and self-designed questionnaire survey were conducted on 12 nursing stations in a district of Shanghai. Results: Nursing station is the important support of home-based care services for aged. Problems include lack of educations and workforce, non-standard health care skills, limited nursing items in Long-term Care. Nursing station managers, registered nurses and care workers need professional training. Conclusions: The future of nursing station includes more professional human resources, and the establishment of quality management and evaluation standard, so as to meet the needs of the community and residential care.

The elderly often have a variety of chronic diseases at the same time. The chronic diseases have high prevalence, slow progress and long duration. There are many people with both dementia and disability. So the elderly need full range of health care model (acute care, mid-term care, long-term care). Implement the entire health care for the elderly is also one of the measures that deal with the 2016 national strategy which puts forward "healthy China 2030" and "ensure people's health comprehensively during the whole process". This paper gives an overview of the current care mode of the elderly. It illustrates the problems in the care mode of the elderly in China. And based on the experience of the introduction of foreign advanced model departments in the department of geriatrics of West China Hospital, Sichuan University, this article evaluates how to bring in and localize the advanced ideas and models of care for the elderly, and introduce the Acute Care for the Elderly, the unit of comorbdity management and function promotion in frail senior and the Palliative Care Unite of West China Hospital. So that it is expected to play a certain role in the reform of the care mode of the elderly in China.

Objective: To translate the Challenging Behavior Scale (CBS) into Chinese and evaluate its reliability and validity. Methods: The Chinese version of CBS (CCBS) was translated from the original English version, back-translated and adjusted for cultural adaptation. The reliability and validity were tested in 244 caregivers of patients with Alzheimer disease. Results: The scale-level content validity index (S-CVI) of the CCBS was 0.94, and the item-level content validity index (I-CVI) of the CCBS was 0.80~1.00, which indicated a desirable content validity. Factor analysis extracted 2 common factors, which explained 56.567% of variance of the total scale, and each item had high factor loading (>0.4). The Cronbach's α was 0.827, and test-retested reliability was 0.892. Conclusion: The Chinese version of CBS has been proved to be valid and reliable. It is a valuable tool for evaluating the Challenging Behavior among patients with Alzheimer disease.

Objective: To investigate the experience of body image change among the adolescents with osteosarcoma during treatment. Methods: Indepth interviews were conducted to 10 adolescents with osteosarcoma. The interview records were analysed with the Colaizzi phenomenological data analysis. Results: Three themes were extracted, negative perception (including feeling different, less attractive and conspicuous), passive assessment (including passive self-cognition, decrease of social desire and feeling isolated), and coping style (including maintaining normality and trying to accept). Conclusion: Changes in body image have side effects on the quality life in adolescents with osteosarcoma. Healthcare providers should guide patients to develop a comprehensive understanding of the changes in body images in order to improve their life quality.

Objective: To evaluate the guidelines of physical restraint of ICU patients, and provide information for the development of physical restraint guidelines in China. Methods: Search the guidelines from related organization website and database. Evaluate the guidelines using the AGREE II instrument. Results: Four clinical practice guidelines were included in this study, among which three were from the United States and one from Canada. The three areas of the guidelines had higher scores: scope and purpose (84.26±16.15)%, clarity of presentations (76.50±12.97)%, and preciseness (66.97±21.14)%. The other three areas had lower scores: applicability (62.15±26.34)%, editorial independence (63.54±34.21)%, participants (63.54±20.36)%. The average overall score is (4.94±1.30). Two guidelines were leveled A, while other two guidelines were leveled B. Conclusion: Few guidelines with physical restraint are detected. The guidelines for application, independence and participation need to be improved. No physical restraint guideline found in China. The guidelines from abroad may be introduced to assist clinical nursing practice, and provide information to develop new guideline of physical restraint according to the present clinical environment and practice policy in China.

Objective: To introduce the Treatment Satisfaction Questionnaire for Medication (TSQM) to China, and to test its reliability and validity. Methods: Kidney transplant recipients were selected by convenience sampling from one transplantation follow-up center in one tertiary grade A hospital. Authorization was obtained from the original authors of the TSQM before the study. Results: A total of 218 valid questionnaires were obtained. The Cronbach's alpha of the whole scale was 0.707 and the internal consistency reliabilities of its four domains ranged from 0.847 to 0.961. The test-retest reliability of the whole scale and its four domains ranged from 0.930 to 0.995. Content Validity Index of TSQM was 1. The results of EFA showed that there were three common factors in TSQM, accounting for 73.256% of the total variance. Conclusion: The psychometric properties of Chinese version of TSQM proved to be good. TSQM is a concise tool to measure the satisfaction of patients who need strict medication therapy.

Objective: To investigate the dynamic changes of psychological distress in breast cancer patients after diagnosis, and determine the related factors of psychological distress. Methods: A longitudinal study design was used to evaluate the psychological distress, social support, and coping style at the time of diagnosis, and 1, 3, 6 months after diagnosis, to compared the difference and analyze the related factors of psychological distress. Results: The incidence of moderate or high psychological distress in patients with breast cancer was 63.9% (T1), 78.2% (T2), 69.4% (T3), and 33.3% (T4), and the mean score was 4.08±1.59 (T1), 4.66±1.47 (T2), 4.40±1.99 (T3), 2.89±1.60 (T4), respectively. The related factors of psychological distress included time of diagnosis, age, education level, economic status, family history, social support and coping style. Conclusion: The psychological distress is popular in breast cancer patients, and the psychological distress level is dynamic. Psychological intervention should be strengthened to improve the patients' psychosocial status.

Objective: To explore symptoms and symptom clusters during induction chemotherapy of children with malignant tumor. Methods: A total of 238 children with malignant tumor were assessed by the Chinese Version of Memorial Symptom Assessment Scale10-18 (MSAS 10-18), and exploratory factor analysis was used to identify the symptom clusters. Results: The average age of 238 children was (6.40±3.63), and 60.9% were boys. The main symptoms during induction chemotherapy included lack of energy, nervous, lack of appetite, nausea, irritable, and vomiting. Seven symptom clusters were upper gastrointestinal symptom cluster, irritable mood symptom cluster, depressive mood cluster, image impaired symptom cluster, nervous symptom cluster, skin and mucosa symptom cluster, and ingestion and excretion symptom cluster. Conclusion: Children suffered from multiple serious symptoms during induction chemotherapy, and the symptom clusters were various. Health care professionals should assess the symptoms timely, and control the main or key symptoms to relieve symptom distress of patients.

Objective: To evaluate the effects of light sedation combined with Early Mobilization and Occupational Therapy on Mechanical Ventilated patients. Methods: Seventy–two patients who were undergoing Mechanical Ventilation were randomized into an intervention group (38 patients) and a control group (34 patients). Patients in both groups were provided with pain and sedation management and ICU routine care, while light sedation combined with Early Mobilization and Occupational Therapy was implemented in intervention group. Dosage of sedative, incidence rate of delirium, oxygenation index, power of gripping, activity of daily living, length of Mechanical Ventilation and length of ICU stay were compared. The adverse events during the intervention were observed. Results: Dosage of sedative, length of Mechanical Ventilation and ICU stay in the intervention group were less than that in the control group, and oxygenation index, power of gripping and activity of daily living were significantly better than the control group (P<0.05). There were no unpredicted events during the intervention in both two groups. Conclusion: Light sedation combined with Early Mobilization and Occupational Therapy could improve patient's outcomes, and it is safe and feasible.

Objective: To investigate the current situation of the practices of the Standardized Nursing Practices for Intravenous Therapy (SNPIT) by some western region hospitals in China. To learn whether the nurses follow the standards and provide more information for pushing forward the standards. Methods: We investigated the SNPIT practices by the nurses from 110 hospitals in 10 provinces (or autonomous region) and 1 city in western region through cross-sectional study. We collected data about SNPIT practices by the questionnaire method from 14 779 nurses. Results: There was on average an infusion rate at 69.7%. The intravenous access instruments included catheter (47.1%) and steel needle (41.9%). There were 32.0%-92.7% of the nurses who knew and practiced the SNPIT strictly. The correct rate of the SNPIT practices was 41.1%. Conclusion: By data from 110 hospitals in 10 provinces (or autonomous region) and 1 city in the western region, the SNPIT has been widely used. However, the level of the practices remained not high enough. We suggest that the health and the administrative departments cooperate to further standardize the practices and promote the correct practices of the SNPIT by intensive training. It is safe and effective to regulate the nursing practices for intravenous therapy by practicing the SNPIT.

Objective: To analyze the current status and the issues of Nursing Work Environment in China in order to provide information for further research. Methods: Articles about Nursing Work Environment were retrieved and analyzed from CNKI, Wanfang database and CBM. Results: A total of 200 articles published in 63 journal were included. The number of the papers was increasing each year. Totally 43 articles (21.5%) had financial supports. Authors were located in 27 provinces, while Zhejiang province published the biggest amount of papers. The researches were mainly focused on the nursing environment of the whole hospital (78.5%). The research method was mainly survey (59.5%), while the experimental and quasi-experimental study accounted for 2.0%. The researches were mainly focused on the investigation and analysis of the working environment of nursing staff and the correlation of related variables in the working environment. Conclusion: Nursing Work Environment has been emphazed in China in recent years, but the quality, the scope and depth of the studies need to be improved. It is suggested that the researchers expand the scope of the study area, improve the research design and research contents, in order to facilitate the construction of good Nursing Work Environment.

Objective: To construct evaluation index system of core competence among preview emergency triage nurses. Methods: Totally 14 clinical nursing expertsand nursing management experts were investigated by self-designed questionnaire using Delphi expert consultation method. Results: Experts familiar coefficient was 0.849. The judgment coefficient was 0.835 and the authority coefficient was 0.705. The evaluation index system of core competence among preview emergency triage nurses included 6 firstlevel indexes, 16 second level indexes, and 50 third level indexes. The Cronbach's α was 0.807. Conclusion: The expert opinionis scientific and reliable and all showed high reliability. The results could provide references for core competence evaluation, training, assessment, and access for preview emergency triage nurses.

Dehydration is the most common problem of liquid and electrolyte imbalance among the elderly, which seriously affects their health and quality of life. This paper reviewed the assessment of dehydration and its risk among the elderly, aimed to provide references for clinical practice in China.

Objective: To investigate nurses' knowledge and attitude on pneumonia prevention and intervention for bedridden patients, to explore the influencing factors. Methods: Totally 3 903 nurses from 6 tertiary hospitals, 11 secondary hospitals and 8 first-level hospitals in 6 provinces in China, were recruited and investigated with a self-designed questionnaire using convenience sampling method. Results: The department training (90.55%) was the common approach of nurses' knowledge acquisition, and there were significant differences in the way of knowledge acquisition between nurses in different hospital levels (P<0.05). The mean scores of knowledge and attitude of pneumonia were 9.95±1.77 and 28.71±3.37, respectively. The nurses with different departments, age, educational backgrounds, job titles and positions had significantly different knowledge scores (P<0.05). The attitude score of nurses were influenced by hospital levels, educational backgrounds and employment forms (P<0.05). Conclusion: Clinical nurses have positive attitudes towards the prevention and intervention of pneumonia. And the overall level of knowledge on pneumonia for bedridden patients was in the medium level, which still need improvement. Nursing managers should strengthen systematic and rounded training to improve clinical nurses' knowledge, and conduct routine evaluation to improve training effect. Then we could standardize the behaviors of pneumonia prevention and nursing care and improve nurses' attitude towards bedridden patients and the quality of nursing service.

This paper introduces the Stopping Elderly Accidents, Deaths & Injuries Tool Kit (STEADI) released by Centers for Disease Control and Prevention (CDC) of the US and it is expected that the tool could be a useful instrument for better implementing fall prevention interventions in China.

The content and the current clinical application of the "Team Strategies & Tools to Enhance Performance & Patient Safety (TeamSTEPPS)" were summarized in this paper basing on relevant literature reviews. In addition, the value and implication of the promotion of TeamSTEPPS in future practice was further elucidated.

This paper summarized the current types of community-based rehabilitation service mode for mental illness patients including day centers, clubhouse model, transitional rehabilitation services, day hospital and other rehabilitation services such as case management, peer support, extended services, assertive community treatment and crisis intervention team, ect. It introduced the definition, development, clients, service mode, service contents of various community rehabilitation services, aiming to provide suggestions for establishing a perfect community mental health rehabilitation service system in mainland China.

Breast cancer has become one of the world's most common cancers. Breast cancer has brought serious disease burdens, especially in developing countries. Disease management is widely used in all stages of medical care. Internet-based management can improve medical resources utilization and reduce patients' economic expenditure. In this paper, we reviewed Internet-based management of breast cancer, aimed to provide reference for application of Internet in breast cancer disease management.

In this paper, the authors summarized the situation of pregnancy weight management, specific applications, problems and suggestions for implementing of mobile health intervention in the management of weight during pregnancy. It could provide reference for the study of mobile health in clinical application and future weight management.

Objective: To analyze effects of the Technology Acceptance Model in application of pressure injury management software. Methods: Based on the Technology Acceptance Model, a plan was developed to popularize the pressure injury management software, which includes: optimizing software performance, establishing standard operating procedures and popularizing softwares in different phases (trial phase, growing phase and consolidating phase), along with software training and support. From March 2016 to June 2017, this software was employed in 3 tertiary Grade A hospitals and 2 tertiary grade B hospitals with mature foundation of nursing information system in a certain province. Besides, "Quality Evaluation System of Pressure Injury Prevention in Hospitalized Patients" and "Satisfaction Evaluation System of Pressure Injury Management Softwares" were adopted respectively to evaluate the usefulness and ease of software application. Results: After implementation of the promotion program, the five hospitals acquired certain achievements in terms of increasing accuracy of pressure injury and risk degree assessment, higher accuracy of pressure injury prevention measures and the corresponding quality control measures (P<0.05). The incidence of pressure injury acquired in hospitals decreased from 2.25% to 0.65%. The average time consumed on risk assessment of pressure injury by different levels of nurses reduced from (3.43±2.69) min to (2.57±2.08) min. As to the ease of using the pressure injury management software, the overall satisfaction was 93.9%. Conclusion: The Technology Acceptance Model, which can help to improve the effectiveness of pressure injury management, enhance nurse satisfaction and get good promotion effects, is feasible and worthy of reference in popularization of pressure injury management softwares.

Xerostomia is one of the common complications of maintenance hemodialysis patients, which often leads to life quality decrease in hemodialysis patients. In this article, the assessment of xerostomia in maintenance hemodialysis patients, influencing factors, and interventions were reviewed, and it can provide reference for clinical practice and research.

It is important to take early interventions on mild cognitive impairment in the elderly to improve their cognitive status and enhance their quality of life. In this paper, the authors summarized the development of non-pharmacological interventions, including exercise, cognitive rehabilitation training, diet and emotion interventions, on mild cognitive impairment in elderly patients in recent years.

Stigma is common in patients with breast cancer which can result in social isolation, medical delay, quality of life decline and many other issues. This paper summarized the research status and intervention measures of stigma in patients with breast cancer, aimed to provide a theoretical basis for the effective intervention measures.

Objective: To optimize the process of the Rapid Response Team (RRT) in the management of critical maternal treatment. Methods: Effective improvement measures such as simplifying the early warning standard, improving the effectiveness of starting RRT call, standardized communication among medical personnel, strengthening the team's ability, were formulated, improved and evaluated for the defect factors after the team construction and investigation of its current status. Results: After the implementation of the improvement measures, the response time was shortened from (32.26±4.38) min to (21.46±3.87) min. The effective treatment rate increased from 88.5% to 93.2 %, and the ICU occupancy rate decreased from 5.4% to 3.9%. Conclusion: Optimization and practice of rapid response team in the management of critical maternal care is helpful to reduce the response time, optimize the effective treatment rate, and improve the maternal and infants' outcome.

Objective: To explore the effectiveness of evidence-based nursing practice of oral movement intervention in premature infants. Methods: Totally 58 premature infants in NICU were selected from January to August, 2017. Twenty-eight cases (from January to April) were included in the control group and 30 cases (from May to August) were included in the observation group. The control group was given routine nursing care while the observation group was given oral movement intervention on the basis of routine nursing care. Then we compared the NNS scores, the transition time of full mouth feeding and the length of hospital stay between the two groups. Results: The NNS scores were increased gradually in both group, and the difference showed statistical significant on the ninth day (P<0.05). The transition time of full mouth feeding in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the length of hospital stay (P>0.05). Conclusion: Evidence-based nursing practice of oral movement intervention can effectively improve the ability of oral feeding of premature infants and shorten the transition time of full mouth feeding, which can provide reference for the feeding of preterm infants in neonatal department.

Diabetic foot is one of the most serious complications of diabetes with high morbidity and mortality, posing a substantial health damage to patients and increasing the costs of diabetes. The early identification of risk factors can greatly delay the onset and progression of diabetic foot. This paper mainly reviewed the literature on risk screening tools and stratification system of diabetic foot, and aimed to provide reference for constructing a set of comprehensive risk screening tools and stratification system of diabetic foot with good reliability and validity, which is more suitable for diabetic patients in China.

The key ofthe electrocardiographic method for positioningtips of Peripherally Inserted Central Catheters (PICC) is to get a clear and stable ECG waveform. This paper reviews factors influencing the stability of the ECG waveform which represents the position of the tip of PICC and relevant countermeasures so as to provide guidance for operators adopting the electrocardiographic method to avoid adverse influences caused by these factors in a timely manner,and improve stability of the electrocardiographic method, which aims to promote this technology to better serve the clinical.

This article reviewed the current research status for Quality of Life instruments used for patients suffering from Venous Leg Ulcer (VLU), focusing on the structures, psychometric properties and applications of these instruments.The aim of this article is to provide information for the nurses to choose or develop Quality of Life instruments for patients with VLU in China.