Objective: To evaluate the effect of systematic training on improving nurses' knowledge and attitudes towards common complications among bedridden patients and decreasing the incidence of patients' complications. Methods: Nurses were recruited from 25 different grade hospitals and received systemtic nursing training about common complications(including pressure ulcer, Deep Vein Thrombosis, pneumonia, and urinary tract infections) among bedridden patients. The training content were developed by systematic literature review and expert discussion. Training SOP (Standard Operating Procedure) was developed and lectures, pocket books and online learning platform were used to train the nurses. Totally 3 903 nurses were recruited in the study as control group before the training program while 4 043 nurses were recruited as experimental group. Nurses' knowledge and attitudes and incidence of patient complications were measured to evaluate the training effects. Results: After systematic training, nurses' knowledge scores for all 4 complications were significantly increased (P<0.05), while the attitudes scores for Deep Vein Thrombosis, pneumonia, and urinary tract infections were also significantly improved (P<0.05). The incidence of pressure ulcer, pneumonia, and urinary tract infections were also decreased after training. Conclusion: The systematic training is an effective way to improve nurses' knowledge and attitudes and reduce the incidence of common complications among bedridden patients. It is worth for further popularization and application.

A series of non-punitive measures in nursing safety culture were promoted to construct a non-punitive safety culture in nursing care. The "four-tier" management system and functions were strengthened. The fair culture, reporting culture, learning culture, on-site management culture and indicator culture were encouraged. From 2014 to 2016, the incidence of pressure injury decreased by 65.63%, the prevalence of needle stick injury decreased by 44.00%, the incidence of nursing defects decreased by 100.00%. In addition , the rate of self report of adverse events increased by 39.17% from 2014 to 2017. The non-punitive voluntary error reporting system facilitates patients to live in a safety nursing environment.

This article reviewed the safety of patients at home and abroad and its impact, the nurse's practice environment and its significance, the impact of nurses' practice environment on patient safety. The authors also provides suggestions for optimizing nurses' practice environment and improving patient safety.

This article reviewed the selection principle of infusion path, management of infusion devices and equipments, management of medication safety, prevention of infusion-related complications, management of inter- and intra-hospital transport, and education for nurses. It is expected to improve the nursing management during the process of infusion therapy and to ensure the safety of infusion therapy for critically ill patients.

The article illustrated the development and implementation status of nursing safety education at home and abroad as well. The aim is to provide suggestions for nursing safety education at the present stage which may contribute to better education in China.

Objective: To evaluate the inter-rater reliability and diagnostic accuracy of the determination criteria of sputum retention among elderly patients with non-artificial airway. Methods: For inter-rater reliability, twenty patients were evaluated 76 times by two researchers on the basis of the criteria simultaneously and we calculated the consistency rates of each indication and the Kappa analysis. For accuracy of the criteria, we conducted 361 evaluations among 58 patients based on the criteria, and the results of nurses assisted discharging sputm were used as reference standards. The evaluations were completed before nurses assisted patients to discharge sputum with discharging sputum positive and no sputum negative. The sensitivity, specificity and other indexes were calculated. Results: The consistency rates for each indicators between the two researchers were more than 85%, and the Kappa was 0.79. The sensitivity of the criteria for determination of sputum retention was 80.51% with the specificity 91.57% , the odds ratio 44.86, the Youden index 0.72, the positive likelihood ratio 9.55, the negative likelihood ratio was 0.21, and the area under the ROC curve 0.86. Conclusion: The initial clinical validation shows that the criteria have good inter-rater reliability and accuracy. The results of this study could facilitate clinical nurses to detect sputum retention.

Objective: To explore the status of work engagement, and the effects of organizational justice and organizational support on nurses' work engagement. Methods: A total of 1 065 nurses from 7 hospitals in Beijing were surveyed with a package of questionnaires. Results: The mean score of work engagement was (3.54±1.49), and 21.0% of those subjects showed work engagement at a high level. Structural equation model analysis showed that organizational justice (β=0.536, P<0.01) and organizational support (β=0.289, P<0.01) were positively associated with nurses' work engagement, which could explain 31% variance of nurses' work engagement. And organizational support partly mediated the effect of organizational justice on nurses' work engagement. Conclusion: Clinical nurses' work engagement was at a low level. Managers should perfect nurses' performance evaluation and distribution systems so as to enhance nurses' work engagement through creating a fair and supportive organizational environment.

Objective: To evaluate the effects of normal saline (NS) and heparinized saline (HS) in maintening patency of arterial lines for invasive arterial blood pressure monitoring. Methods: The following electronic database were investigated: PubMed, EMBASE, the Cochrane Library, CBM, CNKI, VIP and WanFang The studies of Randomized Controlled Trials (RCTs) on the effects of NS versus HS in arterial lines were included. Two reviewers independently screened literature, extracted data and assessed the risk of bias from all identified studies. Then RevMan 5.3 software was used for meta-analysis. Results: A total of 14 RCTs involving 1 593 patients were included. For the risk of bias, 3 articles are A grade and 11 are B grade. The results of meta-analysis showed that there were significant differences between the NS group and HS group in the occlusion rate, the incidence of bleeding, incidence of coagulation changes and the catheter indwelling days. However, the results showed that there were no significant differences in the incidence of arteritis. Conclusion: The heparinized saline can reduce the occlusion rate in remaining potency of arterial lines and expand the catheter indwelling days for invasive arterial blood pressure monitoring. Normal saline may reduce bleeding rate and coagulation function changes in patients. Their effect on the incidence of arteritis is not found different. To provide the right solution to the patients, the nurses should considering the patients' sensitivity to heparin, the life expectancy of the catheter and the risk of obstruction.

Objective: To evaluate the effect of oral immune therapy in premature infants. Methods: We searched Cochrane Library, PubMed, Embase, Web of Science, CINAHL, CNKI, Wanfang, and VIP for RCTs about oral immune therapy in premature infants. We selected studies according to inclusion and exclusion criteria, extracted data and assessed their quality. Data were analyzed by RevMan 5.3. Results: 10 studies with 623 premature infants were included. The results showed that the incidence rates of hospital infection [RR=0.35, 95% CI (0.17, 0.73), P=0.005], sepsis [RR=0.54, 95% CI (0.37, 0.77), P=0.0007], and intolerance of enteral feedings [RR=0.46, 95% CI (0.28, 0.75), P=0.002] were all significantly different between the sterile or normal saline group and the colostrum group. The days starting oral feeding [MD=-2.57, 95% CI (-4.84, -0.29), P=0.03] and the days reaching full enteral feeding [MD=-4.99, 95% CI (-8.54, -1.45), P=0.006] were both significantly different, too. However, there were no significant difference in the incidence rate of necrotizing enterocolitis [RR=0.54, 95% CI (0.22, 1.33), P=0.18] between these two groups. Conclusion: Oral immune therapy reduced the incidence rate of hospital infection, sepsis and intolerance of enteral feedings, and shorted the days starting oral feeding and the days reaching full enteral feeding. But it did not improve the incidence rate of necrotizing enterocolitis. Due to the insufficiency of studies included, high-quality studies with large sample size are needed to further evaluate the effect of oral immune therapy.

Objective: To investigate the readiness of primary caregivers of ICU patients who were transferred out of ICU and analyze factors affecting readiness of the major caregivers. The aim is to provide some references for improving the caregivers' readiness and providing health education for the caregivers. Methods: Totally 200 primary caregivers of patients transferred out from ICUs of three tertiary hospitals were selected as subjects using the method of convenience sampling from August to December of 2017. Relative information of those subjects was collected through the general information questionnaire and the primary caregiver readiness scale. Results: The average readiness score of the main caregivers of ICU outpatients was (13.87±4.78) points. Multiple linear regression analysis showed that the primary caregivers' age, educational level, gender and care experience, presence or absence of co-carers as well as the patients' age were factors affectingreadiness of those primary caregivers (P<0.05). Conclusion: The readiness of primary caregivers ofpatients transferred out of ICU is not satisfying. When caregivers are women, at a younger age, with higher educational level as well as caring experience, their readiness could be relatively higher. In addition, the presence of co-carers and patients being at younger age could also lead to higher readiness.

Objective: To investigate the level of readiness for hospital discharge and the influencing factors in patients with Chronic Heart Failure (CHF). Methods: Totally 316 CHF patients were selected. Readiness for Hospital Discharge Scale (RHDS), Quality of Discharge Teaching Scale (QDTS)and Self-Care of Heart Failure Index (SCHFI) were applied. Results: The total score of readiness for hospital discharge was relatively low (138.58±15.11). Linear regression analysis revealed that first hospitalization, discharge reason, age, drugs, duration of disease, quality of discharge guidance, and self-care index were influencing factors of readiness for hospital discharge. Conclusion: The level of readiness for hospital discharge in CHF patients are quite low. Nursing care can improve patients quality of discharge and self-care ability in order to optimise the level of readiness for hospital discharge.

Objective: To investigate the current status and influencing factors of PICC maintenance knowledge among nurses of primary hospitals in Hunan province. Methods: By stratified random cluster sampling, totally 552 nurses of primary hospitals in Hunan province were recruited and investigated by self-designed questionnaires. Results: The mean score of the PICC maintenance knowledge was 63.36±14.36. The accuracy of PICC maintenance knowledge in different dimensions was statistically significantly different (P<0.05). Multiple linear regression analysis showed that the professional titles and the types of hospitals were the influencing factors of PICC maintenance knowledge among nurses of primary hospitals in Hunan Province. Conclusion: The nurses of primary hospitals in Hunan province have poor knowledge about PICC maintenance. Except health education dimension, other dimensions of knowledge status of PICC maintenance were in the low or middle level. The nurses in the community hospitals have worse knowledge of PICC maintenance compared with those in health clinics in towns and townships. The standardized PICC maintenance training for nurses of primary hospitals in Hunan province need be carried out urgently.

Objective: To investigate the current status and influencing factors of midwives' attitudes towards safety culture in general hospitals in Suzhou, and provide references for promoting management work and safety culture in delivery rooms. Methods: A total of 342 midwives from 17 general hospitals were recruited and investigated by the Chinese version of Safety Attitudes Questionnaire (C-SAQ), the Conditions of Work Effectiveness Questionnaire-II (CWEQ-II) and Psychological Empowerment Scale (PES). Results: The score of safety culture attitudes were 127.23±14.39, the overall positive agreement rate was 79.7%. The nature of work, weekly working hours, informal rights, the meaning of work, and work autonomy were the influencing factors of midwifes' attitudes towards safety culture (P<0.05). Conclusion: Hospital administrators should strengthen the human resource management and improvement of midwives and offer midwives of contract systems more support. Furthermore, it is necessary to improve midwifes' attitudes towards safety culture through promoting team communication and cooperation, bettering their professional skills and enhancing their perception of the meaning of work.

Objective: To identify those of high error rates and non-compliance in the current quality indicators through analyzing the nursing quality data generated by the information system, then develop overall and specific quality improvement measures to improve nursing care quality. Methods: We established the data collection process through the hospital information system, collected the quality data at one, three and six months after quality improvement process. And then we compared them with the care quality data of December 2016. During the whole process, we set up three steps, including the data screening, data analysis, and formulating a series of improvement measures, to improve the care quality. Results: All of the six indicators evaluated have been improved than before (P<0.05). Four indicators improved significantly three month later, one indicator mostly improved at the first month, and the other one indicator improved obviously at the sixth month. Conclusion: The objective quality data could help us to find problems that need to be solved urgently from the perspective of quality management, and avoid bias from on-site subjective evaluation, so as to promote the development of nursing quality management.

Objective: To establish a subspecialty management system in operation room and apply it to clinical work. Methods: We set up positions for team leaders and specialty nurses, and made clear job descriptions, so as to make the team leaders as the cores of their teams. The team leaders were totally responsible for clinical operation coordination, quality and safety, teaching and training, nursing research and material supply. Results: This system enhanced the professional development of all subspecialties in operating room. Conclusion: This system could improve the quality of operation coordination and the level of professionalization in operating room. Meanwhile, it provides nurses a clear direction for future career development.

Objective: Summarizing the post setting, the work duties, and the standardized training program of anesthesia nurses in our hospital, to provide reference for the professional development of anesthesia specialist nurse in our country, this paper. Methods: The post of anesthesia nurse was set up since August 2013 in our hospital. Defining the work duties and establishing standardized training for 51 anesthesia nurses, and evaluating the effect of standardized training by theoretical operation skill tests, situational simulation comprehensive ability test and questionnaire survey. Results: All the 51 anesthesia nurses passed all the tests with excellent scores after the standardized training, and they were competent for the post of anesthetic nurses, they can do the monitor and nursing of perioperative patients independently, and the feedback of training is satisfied. Conclusion: Setting up the post of anesthesia specialist nurse and exploring a set of standardized training program can benefit the efficiency and safety of anesthesiology, and it is an inevitable trend to standardize the management of anesthesia and promote the professional development of nursing. Setting up the post of anesthesia specialist nurse is a need for the future development of anesthesiology.

Objective: To investigate the status of health education competence of community nurses in Shenzhen City and analyze the influencing factors. Methods: Totally 465 community nurses who came from 172 communities in Shenzhen City were investigated by a questionnaire with the scale of health education competence of community nurses. Results: The mean score of the total score of the scale of health education competence of community nurses is 3.97±0.61. Among the four dimensions, the score of the competence of implement and evaluation was the highest (4.09±0.85), while the score of the competence of assessment was the lowest (3.87±0.82). The score of the competence of communication and learning of nurses from community health center was significantly higher than those nurses from community health stations (P<0.05), while there were no significant differences in health education competence of community nurses with different academic degrees, professional titles, lengths of nursing employment. Conclusion: The overall level of health education competence of community nurses in Shenzhen City is good, but it still needs to be improved, especially in the competence of assessment.

Objective: To investigate the job setting of specialty nurses and the status of advanced nursing practice in Xinjiang, and provide basis for the training and use of specialist nurses. Methods: Nursing departments and 780 specialty nurses from 4 of the tertiary grade A hospitals in Urumqi and Shihezi in Xinjiang were investigated by questionnaires. Results: There were 10 specialty nurse positions and 3 specialist outpatient clinics in the four hospitals. The educational qualifications for these positions were junior college or above. The top three dimensions of advanced nursing practice were the contingency (3.27±0.82), the clinical nursing (3.26±0.78), and the clinical judgment (3.11±0.69). The specialty nurses with different educational levels had different advanced nursing practice except the clinical nursing and systematic thinking dimension (P<0.05). There was a statistically significant difference in the clinical judgment and collaboration dimension between the nurses with different professional titles and working years (P<0.05). The specialty nurses with different job titles scored different points in the clinical inquiry dimension (P<0.05). Conclusion: Specialty nurse positions had been set up in various hospitals in Xinjiang, but there was lack of standard for setting these positions. The directly clinical practice ability in advanced nursing practice was rather good, but the clinical inquiry and evidence-based nursing practice ability were weak. There were differences in the advanced nursing practice among specialty nurses with different educational levels, professional titles, and working years. All of these conditions may restrict the development of advanced nursing practice.

Objective: To analyze the relationship between emergency response ability and emergency related knowledge, attitude of primary nurses in public health emergencies. Methods: In May 2017, 343 primary nurses from county hospitals and township public health centers were investigated with the emergency response ability scale, emergency knowledge scale and emergency attitude scale. Pearson correlation analysis was used to explore the relationship among emergency knowledge, emergency attitude and response ability of primary nurses. Results: The score of emergency response ability of primary nurses in public health emergencies was (3.43±0.81), which was at a moderate level. According to Pearson correlation analysis, the general score of emergency response ability and the score of each dimension were positively correlated with emergency knowledge and emergency attitude score (P<0.05). Conclusion: The general level of emergency response ability of primary nurses in public health emergencies was not high, nursing administrators and educators should strengthen the related knowledge and attitude of primary nurses, further improve the level of emergency response ability.

Objective: To investigate the nursing manpower allocation and post management of Central Sterile Supply Department (CSSD) in western China. Methods: The convenient sampling method was used to recruit 232 hospitals in 9 provinces to do the investigation. Results: The higher the hospitals level were, the lower the ratios of nurses to the hundred beds were with 1.12±0.86 in the tertiary grade A hospitals, 1.58±0.91 in the tertiary grade B hospitals, and 1.92±1.07 in the secondary grade A hospitals (P<0.05). The higher the level of the hospitals were, the higher the nurse's undergraduate degree were, the more nurses with the working years of 1~2 were, the lower the number of transporting post, manual cleaning, mechanical cleaning, sterilization were, the higher the number of regional leader, hospital infection management assistant and continuing education training specialis were (P<0.05). In the western region, only 10.83% of tertiary grade A hospitals are equipped with scientific research assistants with 4.76% in tertiary grade B, hospital and 2.86% in second grade A hospital. Conclusion: In western China, the managers of CSSD should optimize the nursing manpower allocation and strengthen post management, and improve nursing's education and position competence, and give support to scientific research to meet the needs of professional development.

Objective: To develop a training program of the transitional care for patients with chronic obstructive pulmonary disease (COPD) and evaluate the outcomes. Methods: The training model is designed based on the COPD nursing experience in our hospital and real transitional care provided in Xuhui District, Shanghai. Totally 144 nurses from 16 3rd grade hospitals, 2nd grade hospitals and community health centers were recruited to participate in the training program. The training program was offered for 12 months repeatedly. Results: After training, all nurses passed the written test and nursing-procedure performing test. The scores for written test rose from 60.43±12.12 to 94.31±3.28. The scores for nursing-procedure performing test rose from 67.42±5.85 to 89.42±4.63 (P<0.001). The nurses reported that their transitional care competence for COPD patients were enhanced and suggested the training model should be generalized. Conclusion: It can be an effective training model if we combine nursing resources of 3rd grade hospitals with that of community health service centers. This model can not only improve nurses' abilities to provide transitional care for COPD patients but also enhance channels connecting hospitals, communities and families.

Objective: To explore the continuous improving strategies of PICC catheterization rate in primary hospitals. Methods: Total 188 cases with PICC catheterization were investigated. Fishbone diagram was used to analyze the main related factors of accurate PICC catheterization rate, and the coping cluster strategies included establishing the cooperation mechanism of PICC nursing team, developing standardized vascular assessment tools, and selecting cases according to the risk-benefit principle. Results: The PICC catheterization rate increased from 93.1% to 97.5% after the continuous improving strategies. Conclusions: The cluster measures can improve the placement rate of PICC, and it benefits the further popularization of PICC technology in primary hospitals.

The use of physical restraints have many adverse effects on older people both physically and psychologically. Therefore, to minimize the use of physical restraints has been required by many countries. This article mainly introduces the definition of physical restraints, nursing staff's feelings about applying physical restraints to elderly people, and the influencing factors of the minimization of physical restraints use among older people. It is aimed to provide evidences for minimizing the use of physical restraints among older people in China.

The article reviewed the current related studies on indwelling PICC in lower extremity venous in infants. Its clinical characteristics and effects were introduced from the aspects of application, insertion process, catheter related complications and influence factors in order to provide evidence and reference to PICC insertion for newborns.

Along with the increase of long-term cancer survivors, their Quality of Life (QOL) need more attention. It is necessary to use special tools to evaluate their QOL. In this review, the definition of long-term cancer survivors, the current status of QOL and its measurement tools and influencing factors were summarized. It provided reference for studying the QOL of long-term cancer survivors in China.

Objective: To investigate the effects of mindfulness yoga training on anxiety, sleeping and childbirth fear among pregnant women. Method: Total 102 pregnant women from a tertiary hospital in Changsha were included, and they were randomly divided into two groups, the control group received routine mental nursing care, and the intervention group did mindfulness yoga training on the basis of routine mental nursing care. The scores of anxiety, quality of sleeping and childbirth fear of two groups were compared before and after the intervention. Results: After 4-week intervention, the scores of anxiety, quality of sleeping and childbirth fear of the intervention group were significantly lower than those of the control group (P<0.05), and the rate of cesarean section in the intervention group was significantly lower than that in the control group (26.9% vs 48.0%, P<0.05). Conclusion: Mindfulness yoga training can relieve anxiety, improved sleep quality, and reduce the childbirth fear level of pregnant women, and promote spontaneous delivery.

In recent years, along with the gradual increase of the cancer incidence in the world, the psychological stress cognitive processing research of cancer patients had gradually become a research hotspot. Based on the concept of rumination and two-factor model analysis, we reviewed the development trends, influencing factors and intervention measures of rumination. It was suggested that we should distinguish the difference of psychological cognitive processing mechanism under different reflection of cancer patients. The aim of this review was promoting further studies on cancer patients' rumination, and providing new ideas and theoretical reference for clinical nurses to carry out psychological intervention.

Objective: To explore the effects of systematic stress management programme on job stress and burnout of ICU nurses in Cardiac Surgery department. Methods: A total of 50 ICU nurses in cardiac surgery department were selected by cluster sampling, the systematic stress management program was lasted for 8 weeks, and the Chinese version of nurse job stressor questionnaire and the Chinese version of Maslach Burnout Inventory (MBI) were used to assess the nurses, job stress and burnout before and after the intervention respectively. Results: The level of job stress and burnout was decreased significantly after 8-week intervention (P<0.01 for both). Conclusion: The systematic stress management is benefit to relieve the job stress and reduce the burnout of ICU nurses in Cardiac Surgery department.

This article introduced the implementation of the Vizient/AACN Nurse Residency Program in the University of North Carolina Hospital from perspectives of organization, contents, methods and evaluation. Specific suggestions were brought up based on the current status of the Nurse Residency Programs in China, in order to provide reference for further training.