To exert the radiation effect of high-quality nursing resources and improve the nursing service ability of primary hospitals is the key to establish a high-quality and efficient nursing service system, and is an urgent move to deepen the medical reform. Based on the national health policy and social needs, the project of "radiation of high-quality resources to the community" was organized by the platform of Shanghai Nursing Quality Control Center. Through regional linkage, tertiary hospitals carried out standardized training for nurses in primary and community medical institutions, established the implementation scheme of radiating high-quality nursing resources including training, ward rounds and further study to primary and community medical institutions and evaluated its implementation effect, actively explored the new ideas, new methods, new initiatives of extending high-quality nursing services to primary hospitals, and to improve the nursing service ability of primary hospitals, to promote the in-depth and sustainable development of high-quality nursing service in Shanghai.

The problem of uneven distribution of medical resources is becoming more and more serious. It is urgent to push forward the reform of medical treatment and the construction of medical partnerships. In order to match the ability of primary nursing staff in our country with the transitional care mode of "hospital-community-family" linkage, the purpose of this article is to introduce the practice of community diabetes management nurses' training based on the mode of tutorial system, and to provide some reference for improving the management ability of chronic diseases of community nurses.

Objective: To implement the hospital-community linkage blood glucose management project and evaluate its effects. Methods: According to clinical investigation, the hospital-community linkage blood glucose management project was designed and implemented to promote high-quality nursing care. In this project, the hospital-community diabetes intensive management mode and the blood glucose information management system were established. The diabetes health education system was improved as well. Results: The specialized nursing ability of nurses and the self-management ability of diabetic patients in community were significantly enhanced (P<0.05). Clinical indicators of inpatients were also improved. The proportions of hyperglycemia and hypoglycemia were reduced, proportion of detecting blood glucose 15 minutes after treatment of hypoglycemia was enhanced (P<0.05). Conclusion: The hospital-community linkage blood glucose management project can help optimize blood glucose management and enhance nursing service capacity effectively. Clinical outcomes of patients could be improved by promoting high-quality nursing care.

Objective: To analyze the effect of hospital-community linkage model in enhancing the ability of community nurses in Traditional Chinese Medicine (TCM) nursing service. Methods: From January to August, 2018, a collaborative group was set up as the basis of the practice team, and the practice plan was drawn up by referring to the findings of 13 community health service centers and relevant literature. The practice plan was adjusted by expert group meeting, and the ability of community nurses in TCM nursing service was improved through basic training and intensive training. Results: After the implementation of the hospital-community linkage model, the ability of community nurses in TCM nursing service was significantly improved (P<0.05), and the number of TCM nursing technical items and service personnel were significantly increased. Conclusion: Hospital-community linkage model is an effective way to improve the ability of TCM nursing service in community hospitals and an effective way to provide transitional care service for patients.

Objective: Based on the Shanghai Traditional Chinese Medicine (TCM) clinical training network construction project, a training program of TCM nursing knowledge and skills for Shanghai community nurses was developed and evaluated, which aimed to improve the ability of community nurses to provide TCM services, promote relocation of excellent nursing resources of TCM. Methods: Through the combination of online teaching, centralized teaching and clinical practice training, 960 nurses in 240 community health service centers in Shanghai and 66 TCM nursing teachers in 16 secondary training bases were trained and examined by questionnaires and tests to evaluate the effects of this training. Results: In this training, the qualified rate of trainees was 98.7%, of which 62.4% were excellent. After the training, the scores of TCM nursing knowledge, belief and attitude of the community nurses all differed from before (P<0.01). Conclusion: This training is effective, which have promoted the effective implementation of "allocating quality nursing resources to the grassroots hospitals", improved the skills of TCM nurses and enhanced the use of TCM nursing techniques of community nurses.

Objective: To analyze the implementation and influence of transitional care model under the linkage of hospital-community-family in Peritoneal Dialysis (PD) patients. Methods: 15 streets were divided into 2 groups using the random number table method. PD patients of the control group were given routine follow-ups by PD clinic and telephone followed ups, while PD patients of the experimental group received transitional care services under the linkage of hospital-community-family aside from routine follow-ups. After one year of intervention, parameters including the treatment of PD patients, the occurrence of complications, the time of peritonitis and the peritoneal dialysis adequacy of the two groups were compared. Results: Through comparing the two groups, the Drop-Out Rate (DOR) declined, the Time Of Treatment (TOT) increased; the incidence of peritonitis, the time when peritonitis appeared, the urea removal index (Kt/V), the weekly abdominal penetration adequacy (CCL) and the medical expenses of patients were improved (P<0.05). Conclusion: The development of transitional care model under the linkage of hospital-community-family can increase the availability of PD continuous care, improve the participation degree of PD patients and bridge the vacancy of community service function, which has achieved good social and economic benefits. And thus this mode can be promoted for wider use.

Objective: To investigate the occurrence and risk factors of ICU acquired dysphagia. Methods: The prospective cohort study was conduct from April 2017 to December 2017 at Respiratory Intensive Care Unit and Surgical Intensive Care Unit of Beijing Chao-yang Hospital. According to continuous sampling and convenient sampling method, tracheal intubation and extubation patients who were admitted to our hospital and met with the inclusion criteria were selected. The self-designed questionnaire was used to collect the observation indexes related to dysphagia in the enrolled patients, and swallowing function was assessed by Standardized Swallowing Assessment scale 4 hours after tracheal extubation. Results: A total of 154 patients were enrolled in this study, including 55 patients with dysphagia, the incidence rate was 35.7%, but for the prolonged extubation (≥2 d) patients, the incidence increased to 64.1%. By logistic regression analysis, three related factors were identified for acquired swallowing disorders, which were the duration of endotracheal intubation (P=0.001, OR=2.099), APACHE II score (P<0.001, OR=1.324) and arrhythmia (P=0.022, OR=4.177). Conclusion: The incidence of ICU acquired dysphagia was high, especially for delayed extubation patients, the incidence was significantly increased. Prolonged mechanical ventilation time, increased APACHE II score and arrhythmia are the risk factors of ICU acquired swallowing disorders. This suggests that the medical staff should pay higher attention to patients with these characteristics, assess the swallow function early after extubation and identify high-risk patients.

Objectives: To establish a patient-oriented structured electronic follow-up system, which could ensure the standardization, systematization and homogenization of the platform. Methods: The follow-up system for discharged patients was devised through adoption of the unified modeling language as well as structured analysis and design in the light of the information management system currently employed by the hospital and the practical needs of patients. Results: The system which is easy operate, possesses multiple functions including automatic introduction of follow-up information, doing query and search, making follow ups and appointments, data collection and analysis. Since the use of the system, the average follow-up time for each patient decreased from 6.50 minutes to 3.87 minutes, and the follow-up efficiency of nurses was significantly improved. The follow-up rate of discharged patients increased from 31.20% to 42.34%. The completion rate of the follow-up target was 100.00%. Conclusion: The structured follow-up system could improve work efficiency and the quality of follow-up.

Objective: To investigate and learn the willingness of delayed retirement among senior nursing staff (with a title of associate professor of nursing or professor of nursing) and the relevant influencing factors for the sake of providing scientific evidences for formulating relevant policies. Methods: A questionnaire survey was conducted on 375 senior nursing staff who came from ten tertiary hospitals in Jiangsu province by the self-designed questionnaire. Results: Totally 78.9% respondents were opposed to delaying the retirement age, while 75.7% respondents were not willing to delay the retirement age. What's more, health status (69.3%), having children or elderly people to look after (56.0%) and policy provisions (53.3%) were top three factors affecting the choice of whether to delay retirement. Conclusion: Most in-service senior nursing staff object to delay the retirement age and concern about the delay of retirement. Managers need to develop individualized programs of retirement according to senior nurses' personal willingness.

Objective: To analyze the stoma related pressure and related factors in patients with permanent colostomy. Methods: A total of 251 permanent colostomy patients were invited to complete a general information questionnaire, the Stoma Pressure Scale, Social Impart Scale, the Conner-Davidson Resilience Scale and the Social Relationship Quality Scale. Results: The total score of colostomy pressure was 69.22±10.82; the multiple regression analysis indicated that postoperative time, previous medical history, per capita monthly income, discrimination perception, resilience and social relationship were predictors for the pressure of permanent colostomy patients ,which explained 52.0% of the variation. Conclusion: The pressure of permanent colostomy patients is serious and it is affected by several factors. The intervention should be taken according to relevant factors of individual, family and social to reduce the pressure of patients.

Objective: To analyze the service requirements and related factors of the integration of medical care, elderly care and nursing care among community elderly in Hangzhou, and aim to provide reference for the establishment of the integration of medical care, elderly care and nursing care service model in Hangzhou. Methods: A convenienced sample of 210 elders from 5 communities of Hangzhou were selected and investigated by a self-designed questionnaire about the service requirements and influencing factors of the integration of medical care, elderly care and nursing care. Results: The service requirements of health education (4.65±0.30), health management (4.50±0.50) and general medical needs (4.24±0.29) were on the top three of the integration of medical care, elderly care and nursing care model in the community elderly in Hangzhou. The related factors of the service requirements included the age, the types of illness and per capita monthly income (P<0.01). Conclusion: Health education and health promotion, and promoting the hierarchical treatment, developing health service in Chinese medicine s were the key measures to provide the integration of medical care, elderly care and nursing care model that meets the needs of the aged in home.

Objective: To understand the current situation of the second fertility desire of female nursing workers and its influencing factors under the comprehensive two-child policy. Methods: A total of 104 412 female nursing workers were selected by convenient sampling to collect information on the second parental desire, social characteristics and self-efficacy. Results: About 38.4% of female nursing workers had no intention of having two children, 31.4% were uncertain and 30.3% had clearly second fertility desire. Disordered multiple classification logistic regression analysis showed that age, education level, job title, personal annual income, marital status, departments, the living area and self-efficacy were all involved in the equation. Conclusion: The age, education level, job title, personal annual income, departments, the living area, marital status and self-efficacy are the main influencing factors of the second fertility desire of the female nursing workers.

Objective: To identify the barriers and influencing factors of early mobilization in ICU patients, and aim to provide clinical reference for the establishment of early mobilization program. Methods: A convenienced sample of 290 patients were selected in ICU from a Level-3 Hospital in Lanzhou, and identified the barriers of early mobilization and its influencing factors by a self-designed early mobilization records. Results: The main barriers of the early mobilization in ICU patients with mechanical ventilation were tracheal intubation, sedation, and the main barriers of those without mechanical ventilation were lacking of physician support and instability of the circulatory system. The logistic regression showed that the related factors of early mobilization included the stays in ICU, muscle strength and duration of mechanical ventilation. Conclusion: There were many obstacles to early mobilization and the influencing factors of barriers was limited. It is necessary to know more about the influencing factors, and pay more attention to the barriers of the early mobilization of ICU patients.

Objective: This study aimed to determine the technical difficulty coefficient of common nursing operations in Tianjin. Methods: Totally 2 082 nursing administrators and senior nurses were selected through convenient sampling, and were offered a questionnaire produced on the basis of relevant literature reviews to evaluate the difficulty score of 84 common nursing operations, which were decided first according to the technical difficulty coefficient of each operation item through weighted linear sum method and then revised through Delphi method. Results: The familiarity, judgment coefficient and authority of the respondents were 0.66, 0.88 and 0.77, respectively, and the inter-rater reliability was 0.455. The three most difficult nursing operations weredefibrillation, care and maintenance of central veins and gastric lavage through machines, while the three least difficult ones were body temperature measurement, body weight measurement and height measurement. Conclusion: The difficulty coefficient of clinical nursing operations varies greatly. Scientific measurement of technical difficulty of nursing operations provides a basis for the overall technical difficulty assessment and workload analysis of clinical departments, and offers further theoretical support for the rational allocation of human resources and the establishment of performance appraisal programs.

The construction of nursing emergency team is an important part of the construction of hospital emergency system. Nursing emergency team is an important human resource guarantee when emergency events occur. Establish a hospital nursing emergency team that includes key departments such as emergency department and critical medical department, and integrates nursing personnel from special departments such as operating room and supply room. The standardization of personnel allocation plan and the adoption of theoretical teaching, first aid skill operation training, scenario simulation exercise and emergency rotation training methods to carry out comprehensive training can effectively improve the nursing emergency capacity and ensure the quality and efficiency of emergency rescue. In addition, attach importance to psychological quality training.

Objective: To investigate the moral distress and job burnout among nurses in emergency department of tertiary grade A hospitals in Beijing, and to explore their relationships. Methods: A convenience sample of 256 nurses in emergency department of 7 tertiary grade A hospitals from six different districts in Beijing were investigated by a self-developed general information questionnaire, the Chinese version of Moral Distress Scale and Maslach Burnout Inventory. Results: The score of Moral distress was 60.43±16.07 and the score of job burnout was 63.41±16.23 of emergency nurses. The shift (t=1.917, P=0.018) and the education background (F=3.091, P=0.047) were the related factors of moral distress. While job burnout was related with the work experience (F=4.097, P=0.007) and the nature of employment (F=4.391, P=0.013). The Pearson correlation coefficient of distress and job burnout was 0.323 (P<0.001). Conclusion: Moral distress and job burnout were prevalent among emergency nurses in tertiary grade A hospitals in Beijing. The correlation between moral distress and job burnout was confirmed in the study. It is suggested that the nursing managers should take measures to reduce job burnout of nurses in emergence department for the healthy and sustainable development of the nursing team.

In order to prevent the development of the female Pelvic Floor Disorder (PFD), the PFD Specialized Nursing Team was established in our hospital. The information system for the assessment, screening, treatment and rehabilitation of PFD was set up based on the Internet, Internet of Things, cloud computing, big data analysis and other advanced technology. The information system consisted of multiple modules including assessment, treatment, health education, home services and evaluation of PFD. It is expected that the information system will encourage the development of PFD specialized nurses and improve the quality of life of women with PFD.

Objective: To optimize the health education process for postpartum stress urinary incontinence and promote parturients' compliance of postpartum pelvic floor exercise to avoid postpartum pressure urinary incontinence. Methods: A WeChat platform for mobile health education was developed to prevent postpartum stress urinary incontinence. Results: After the use of mobile health education through the WeChat platform, the rate of maternal pelvic floor screening increased significantly (62.1% VS 94.4%), the daily pelvic floor functional exercise time of parturients was significantly prolonged (6.4 minutes VS 14.6 minutes), and the incidence of pressure urinary incontinence of parturients decreased significantly (8.3% VS 5.3%). Conclusion: The mobile health education offered through the WeChat platform has obvious advantages, including effectively improving the compliance of pelvic floor muscle function exercise and reducing the incidence of postpartum pressure urinary incontinence.

This paper summarizes the necessity of the service quality assessment of the long-term care facilities and the related researches on international service quality assessment tools of the long-term care facilities, and provides reference for the establishment of standard service quality assessment tools for the long-term care facilities in China.

Objective: To investigate and analyze the influencing factors of the readiness for hospital discharge of patients with gastric cancer under the concept of Enhanced Recovery After Surgery (ERAS). Methods: A convenient sampling method was used to select 141 gastric cancer patients who were discharged from our hospital underwent radical surgery. Questionnaires were performed using the discharge check list, information questionnaire, and Readiness for Hospital Discharge Scale (RHDS) for adults and the influencing factors were analyzed. Results: The total score of 141 patients in RHDS was (151.36±15.64). The scores in the 4 dimensions were: score of self-condition (35.01±5.75), score of disease knowledge (60.08±10.89), score of post-discharge ability (23.31±4.41). and score of expected social support after discharge (32.96±4.10). Compared with the score of other items, physical symptoms, understanding of the next treatment plan, and medical care support after discharge were relatively lower. Multiple linear regression analysis showed that age, place of residence, and occupation were the major factors influencing the score of RHDS. Conclusion: The methods of RHD for patients with gastric cancer should be suited the development of ERAS. Nursing staff should strengthen care for discharge preparation of gastric cancer according to different ages, places of residence, occupations, and relatively weak items of RHDS.

Objective: To improve the compliance of Pelvic Floor Muscle Training (PFMT) during perinatal period, and promote the postpartum rehabilitation of women. Methods: The 82 pregnant women from January 2016 to June 2016 were assigned to the control group with a routine care model. The 91 pregnant women from July 2016 to January 2017 were assigned to intervention group. We developed appropriate measures and activities around "improving the compliance of PFMT during the perinatal period". We analyzed the maternal PFMT compliance and delivery rate. Results: There was no significant difference in the spontaneous delivery rate between the two groups (P>0.05). The compliance of PFMT in the intervention group was significantly higher than that in the control group (P<0.05). Conclusion: Through the training of nursing staff and pregnant women, and establish guidelines for perinatal RFMT management, we improve the compliance of PFMT for perinatal pregnant women, and promote the continuous improvement of the quality of clinical care.

Objective: To investigate the status quo and influencing factors of self-management in patients with atrial fibrillation (AF). Methods: Totally 151 AF patients were investigated for the situation of self-management with general information questionnaire and Self-management scale for AF patients who taking warfarin. Results: The total score of patients' self-management was 38.26±9.24. Regression analysis showed that education level and understanding of disease were influencing factors of patients' self-management ability. Conclusion: The self-management ability in AF patients was low. Nurses should promote their self-management ability according to different education level and understanding of disease.

Objective: To implement the exercise therapy for children with Hematopoietic Stem Cell Transplantation (HSCT), and assess its feasibility. Methods: Eligible HSCT children admitted to a specialized children's hospital in Shanghai during 2016 January to 2017 March were enrolled. All the children were instructed with aerobic exercise and resistance exercise therapy with a cycle ergometer, under the supervision of the therapist or trained nurse. The basic information, energy expenditure and monitoring data were assessed and documented. Results: Totally 31 children among the 44 cases completed the therapy, and the total number of exercises was 363. Only one child stopped exercise due to nausea. Most exercise indexes showed a trend of falling first and then rising, with the lowest point in the fourth week. While the change trend of passive exercise time was just opposite. Conclusion: Moderate or low intensity aerobic exercise and resistance exercise therapy for children with HSCT is acceptable with the assessment, guidance, and monitoring of the clinical professionals.

Objective: To investigate the early ambulation of patients with Total Knee Arthroplasty (TKA). Method: A convenienced sample of 190 patients with TKA from a Beijing three-level hospital were investigated with a self-designed early ambulation questionnaire. Results: Totally 8.4% of the 190 patients ambulated within 24 hours after surgery, 54.2% within 24 to 48 hours, and 32.1% within 48 to 72 hours after surgery. The earliest time of ambulation was 7.5 hours after surgery. Most patients ambulated within 2 to 3 days after surgery. The lasted time of first ambulation was 3 to 5 minutes, the distance was 0~250 meters, the range was mainly the bedside, and the doctors were the most important assistants. The early ambulation group were with earlier catheter and wound drain removal, a higher percentage of ECG Monitoring removal within 24 hours (P=0.017, P=0.037, P=0.049), earlier first straight leg raising (P=0.01), higher level of albumin index after surgery (P=0.009, P<0.01), better rehabilitation self-efficacy and the desire to ambulate (P=0.021). Conclusion: Most patients with TKA ambulated in 2 to 3 days after surgery, the most popular activities were standing by the bed or walking on the ground.

The pain belief and cognitive ability of patients with chronic pain can affect their coping style and quality of life. This paper reviewed the research instruments for chronic pain patients and the intervention measures of pain belief. Intervention measures included cognitive behavioral therapy, acceptance and commitment therapy and Stanford self-management mode. It is expected to provide information for nursing staff to improve patients’ cognition of pain, ability of self-management and quality of life.

Medical adhesives are frequently used in clinical practice, especially on the children in intensive care units, and the skin injury caused by adhesives will do a lot of harm. This article illustrates the concept and classification of Medical Adhesive-Related Skin Injury, with the current prevalence status in critically ill children, and analyzes the influencing factors comprehensively, so as to provide references for further prevention and improve nursing quality.

The assessment and management of Malignant Fungating Wounds (MFW) in cancer patients are critical to improve their quality of life. In this article, we reviewed the assessment and management of MFW. The assessment included patients' and caregivers' assessment, and local wound assessment. The assessment tools included Toronto Symptom Assessment System for Wounds, Wound Symptoms Self Assessment Chart, TELER System and Malignant Fungating Wound Assessment Tool. Wound management mainly included malodour, pruritus, exudate, bleeding and pain management. It could provide reference for wound specialist nurses, and promote the development of wound specialist nursing in China.

This paper provides a comprehensive review of the literature on the assessment tools, influencing factors and effective strategies to improve health literacy in patients with Chronic Heart Failure, and aims to provide reference for future studies.

This paper introduces the concepts of family resilience, describes the development process, assessment content, applicable population, scoring methods, reliability and validity, as well as application status of commonly used assessment tools for family resilience of cancer patients, aiming to provide guidance for clinical staff to select targeted family resilience assessment tools for different groups of people. Meanwhile, this paper also provides references for researchers to develop targeted family resilience assessment tools for cancer patients.

To introduce the nursing undergraduate education system of Queensland University of Technology in Australia, including management system, teaching form, curriculum system, theoretical framework, assessment methods, and clinical practice. We make an analysis of its characteristics, and hope that nursing colleagues can use relevant experience to develop our nursing undergraduate education in China.

With the increasing application of Shared Decision Making in nursing, this paper reviewed the concept of Shared Decision Making, the method of decision support and the related Shared Decision Making models, in order to provide reference for domestic scholars to carry out the related research.

Introduce the definition of physical restraints internationally, review the current status, causes, impacts, and methods of reducing physical restraints in domestic and international long-term residential aged care facility, so as to provide a reference for the standardization of physical restraints in Chinese long-term residential aged care facility and reduce the usage rate of physical restraints.