To maximize the quality of life across the life journeys of the whole population, many developed countries are developing a person-centered, integrated care system. This paper introduced the latest guidelines and research topics of the World Health Organization, taking UK, US and Singapore as examples, identifying each country's major characteristics in implementing integrated care. It is expected to help the policy makers to understand the opportunities and effects to participate the WHO integrated care program.

International resident assessment instrument (interRAI) is now involving in more than fourty countries and districts. It is an international collaborative to improve evidence-based clinical practice and policy making. We tried to summarize the implementation of interRAI systems in geriatric medicine and gerontology by referances review, especially focusing on patients management, health care quality contral,resources usage, transitional care and telemedicine. These successful expereince may be helpful in improving the quality of health care in China.

Program for All-inclusive Care for Elderly (PACE) is a good role model for the community-based elderly care in China. It could reduce the health cost and improve the access. To apply the modified PACE model in the community-based elderly care in China will be practical.

Our team reviewed literature systematically and synthesized the findings of dementia caregiving interventions in Chinese population. We found that caregiver interventions varied in length, frequency, approach, and outcome indicators. There are many issues that we should consider to develop dementia caregiver interventions in the future.

The Science of Happiness is the new scientific field of Psychology since 2000. It has great impact on life science and becomes the theoretical foundation of Happy Management of Life and Senior Care. Based on the theory of Happy Senior Care, "Nursing Care" was suggested to upgrade to "Grand Care", including New Goal/Standard—Happier Life, New Principle/Skill—more focus on respect the need and right of the multi-level whole life of seniors care, and New Mission-Senior care professionals should become a "manager" of the senior care system with comprehensive skills, in order to fulfill the responsibility for senior's happy life.

Objective: To investigate the status of intestinal preparation for colonoscopy in old people and to analyze the influential factors. Methods: The data from 180 elderly patients who underwent colonoscopy at the Digestive Endoscopy Center of a tertiary hospital in Shanxi province from January to April 2018. General information , information on intestinal preparation, and information on social support status were collected by endoscopists. BBPS was used to evaluate patients' intestinal cleanliness during the course of the procedure. Logistic regression was used to data analysis. Results: In elderly patients with colonoscopy, the incidence of unqualified bowel preparation was 32.8%. Logistic regression analysis showed that the failing of bowel preparation correlated to the patient's history of abdominal surgery, diabetes history, exercise and eating habits, the type of diet of patients on the day before the examination, and medication time, dose accuracy, tolerance, defecation traits before patient examination, patient's educational level, and social support status. Conclusion: Intestinal readiness before colonoscopy remains low in elderly patients, and many factors have effects on intestinal cleansing in elderly patients. Relevant medical workers should identify factors of intestinal insufficiency and provide targeted nursing measures, and thus improves the quality of intestinal preparation in elderly patients.

Objective: To investigate the current status of children's pain management practice in domestic hospitals, and to provide basic data for the development of sensitive indicators of pain management quality in children. Methods: Directors of nursing department and head nurses in 66 hospitals were recruited with self-designed children's pain management status questionnaires. Results: A total of 33 general hospitals, 21 specialized hospitals and 12 maternal and child health hospitals were investigated, including 492 departments of PICU, NICU, Pediatrics, Pediatric Surgery, Outpatient, and General Hospital Pediatrics. Among them, 42 hospitals (63.64%) carried out child pain management. However, only 8 hospitals (12.12%) achieved full coverage of the child's pain assessment, including all outpatients and hospitalized children. 39 hospitals (59.09%) developed a pain management system. 300 departments (60.98%) did not undergo routine pain assessment. There are also varying degrees of differences in the assessment tools and analgesia methods. Conclusion: Children pain management have not yet fully covered in domestic hospitals. Children's pain management needs to be further regulated. It is necessary to establish a standardized child pain management program or guide to improve the quality of pain management in children.

Objective: To investigate the status and influence factors of' role stress of nurses in the second trimester of pregnancy in Urumqi, Xinjiang. Methods: A cross-sectional survey was conducted among 152 second-gestation nurses in 6 third-grade general hospitals in Urumqi, Xinjiang Uygur Autonomous Region using general information questionnaire, Chinese version of nursing staff role conflict and role fuzzy scale. Results: The scores of the stress scale among 152 second-pregnancy nurses were 58.42±7.56. The influencing factors were the number of night shifts each month, ethnic groups, department and support from the peer group. Conclusion: The role stress of pregnant nurses is at medium level. Nursing managers should reduce the workload and provide more support to the nurses during pregnancy.

Objective: To explore the effect of nurse-led multidisciplinary team for pain management in fast track surgery of orthopedics. Methods: A non-synchronous controlled study was conducted by conveniently selecting 98 patients who underwent joint replacement in the Department of Orthopedics and Traumatology of our hospital from January 2017 to June 2018. Among them, 48 patients admitted from January 2017 to September 2017 were in the control group and 50 patients from October 2017 to June 2018 were in the observation group. Indicators including postoperative pain, exhaust and defecation time, average hospitalization days and patient satisfaction were observed and analyzed in order to determine the practical effect of multidisciplinary pain management mode. Results: In the multidisciplinary cooperative pain management mode, the pain intensity of patients in the observation group at 24 hours and 48 hours was lower than that of the control group, and the time of exhaust and defecation and hospitalization was shorter than that of the control group with patient satisfaction being higher than that of the control group. The difference between the two groups was statistically significant (P<0.05). Conclusion: The multidisciplinary cooperative pain management mode with nurses as leaders entails significant and useful effects on pain control, including shorter postoperative rehabilitation time and improved patient satisfaction.

Objective: To investigate the incidence and risk factors of postoperative delirium (POD) in elderly hip fracture patients and evaluate the predictive efficacy of these risk factors. Method: The subjects who met the inclusion criteria were evaluated by the self-designed postoperative delirium influencing factors questionnaire and the FRAIL scale before the operation, and the full version of Confusion Assessment Method was used to diagnose POD, and the clinical manifestations were recorded after the operation. The risk factors of POD were determined by multivariate Logistic regression analysis, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy and determine the cut-off value. Results: POD occurred in 63 of 217 patients (29%). Multivariate analysis showed that age, preoperative frailty, stroke, intraoperative hypoxia, and length of ICU stay were risk factors for POD. ROC curve analysis showed that age, preoperative frailty and length of ICU stay were with moderate predictive efficacy, stroke and intraoperative hypoxia were with low predictive efficacy for POD. The cut-off value of age, ICU stay and frailty status were 80 years old, 1 day and pre-frail respectively. Conclusion: The incidence of POD is high in elderly hip fracture patients. Age over 80, preoperative pre-frail or frailty, a history of stroke, intraoperative hypoxia and ICU stay more than 1 day could predict the occurrence of POD.

Objective: To determine the impact of family cohesion and adaptation on coping styles of postpartum women with Pelvic Floor Dysfunction. Methods: A total of 143 postpartum women with pelvic floor dysfunction were recruited and investigated through Medical Coping Modes Questionnaire (MCMQ), Family Adaptation and Cohesion Evaluation Scales II (FACES II). The relationship between family support and coping styles of postpartum women with Pelvic Floor Dysfunction was analyzed. Results: The scores of real cohesion, real adaptation and ideal adaptation of postpartum women with Pelvic Floor Dysfunction were significantly lower than the domestic norms (P<0.05). In terms of coping style, scores of facing realities were significantly lower than those of domestic females, and the scores of avoidance and submission were significantly higher than those of domestic females (P<0.01). Regression analysis showed that real family adaptation, dissatisfaction of family adaptation, real family cohesion and dissatisfaction of family cohesion could explain 10.9%, 10.6% and 10.4%, respectively, of the total variance of the facing, avoidance and submission coping of postpartum women with pelvic floor dysfunction after demographic variables being controlled. Conclusion: The level of family cohesion and adaptation of postpartum women with Pelvic Floor Dysfunction is low with relatively negative copying styles. And the family cohesion and adaptation is an important factor that affects patients' responses. Intervention towards family cohesion and adaptation might improve the level of copying.

Objective: In order to promote the whole-process management of patients in the department of bone trauma under the guidance of holistic care, solve the problems caused by reexamination of radiography after discharge, limb dysfunction, and stitch removal, as well as ensure the safety of patients after discharge. Methods: Our hospital opened the special nurse-led clinic on bone trauma in December 2015, and standardized the operation mechanism of the nursing clinic. The services provided by the clinical department of orthopaedic trauma care included evaluation of patients' symptoms and limb function, rehabilitation and exercise guidance, health education, stitch removal, psychological counseling and follow-up. Results: During the two years, 2 843 times of evaluation of patients' symptoms and limb function were carried out, as well as 2 796 times of rehabilitation and exercise guidance, 2 433 times of guidance of auxiliary equipment usage, 2 612 times of stitch removal, 2 838 times of health education, 2015 times of psychological counseling, 827 times of follow-up and 32 times of nursing consultation. The satisfaction degree of patients and families and physicians cooperating with nurses reached 99.10% and 99.32%, respectively. Conclusion: The practice of nurse-led orthopaedic trauma clinic in our hospital provide references for promoting the effective operation of the specialist nursing clinics and guaranteeing the quality of nursing service.

Objective: To explore the effectiveness of career group counseling intervention on the career adaptability in new graduated nurses, and to provide references for improving new nurses' career adaptability. Methods: Totally 84 new graduated nurses were divided into the intervention group and the control group by random number method. Nurses in the control group received routine training, and those in the intervention group received a group career counseling intervention based on Savickas theory for 8 weeks besides routine training. Results: The scores of the total career adaptability, the career concern, the career curiosity and the career confidence in the intervention group were improved after the intervention (P<0.05), and were higher than those in the control group (P<0.05). Conclusion: Career group counseling can improve the career adaptability of new graduated nurses.

Objective: To investigate the current status of magnetic level in tertiary general hospitals and analyze the influence of nurses' general characteristics on it, and to provide reference for improving the magnetic level of hospitals. Methods: Totally 1 830 clinical nurses from five tertiary general hospitals were enrolled to complete general information questionnaire and the Chinese version of the Essentials of Magnetism Scale (C-EOM). Results: The total average score of C-EOM was (1.88±0.69); the highest score was "control over nursing practice", the lowest score was "cultural values"; multiple regression analysis showed that academic qualifications, employment status, working experience and marital status were the influencing factors of different dimensions of the C-EOM, respectively (P<0.05). Conclusion: The magnetic level of hospitals was generally lower and the general characteristics of nurses had little influence on it.

Objective: To explore the application of cloud robotics (JIT system) on the transportation of high value consumables in the Level 2 warehouse in operating room. Methods: The 140 gastrointestinal surgery operations with the need of high value consumables transportation during December 2017 to February 2018 were selected, and they were divided into the cloud robotics transportation group and the traditional manual transportation group by random number. The transportation time, check time, and medical professionals' satisfaction of operation on high value consumables were compared. Results: For the transportation of high value consumables, cloud robotics were better than traditional manual method. There was statistical significance between each operation of two groups' mean delivery time, check time of high value consumables and medical professionals' satisfaction (P<0.01). Conclusion: Cloud robotics can optimize the management process of high value consumables, it's benefit to decrease the inventory of high value consumables, save the delivery time, save the nursing manpower, and is worth of highly recommended.

Objective: To investigate the current status of pipeline care quality in medical institutions in Suzhou, and to provide a basis for further construction of pipeline safety care strategies and the quality improvement. Methods: A field survey was conducted to investigate the pipeline care quality in 36 different medical institutions in Suzhou. Results: A total of 1 443 pipelines were involved in 36 medical institutions. Most of the pipelines were gastric tubes (25.8%), followed by catheters (23.4%) and central venous catheter (20.1%). The incidence of pipeline care problem was 41.79%,and the most prominent of which was the pipeline labeling, with an incidence of 20.51%. The incidence of pipeline problems in nursing homes was higher than that in secondary and tertiary hospitals. Pipeline care management was conducive to reducing pipeline problems. The incidence of tracheal catheter problems was higher than other pipelines. The longer the patients were hospitalized, the more pipeline problems would occur. Conclusion: The quality of pipeline care in medical institutions needs to be improved. Medical institutions should formulate pipeline safety care strategies based on scientific evidence, strengthen pipeline risk management, and continuously improve the quality of pipeline care in medical institutions, to ensure patients' safety.

Objective: To explore the effect of maternal and infant health management nursing stations on the home care for mothers and infants. Methods: Totally 80 primiparae delivered in our hospital from October 2017 to February 2018 were selected as the control group, and 80 primiparae delivered in our hospital from March 2018 to August 2018 were selected as the observation group. Both groups received routine nursing care during hospitalization and routine discharge guidance before discharge. At follow-up, the control group was managed by the community health service center after discharge, while the observation group was managed by a maternal and infant health management nursing station in the community health service center. The incidences of poor healing of postpartum perineal or abdominal incisions, acute mastitis, and exclusive breastfeeding rate at 6 months of postpartum were compared. The incidences of neonatal jaundice, delayed umbilical cord shedding and diaper dermatitis were also compared. Results: The incidences of postoperative acute mastitis and poor perineal incision healing were lower in the observation group than that of the control group; the rate of exclusive breastfeeding in the observation group was higher than that of the control group within 6 months of postpartum; the incidences of neonatal jaundice, umbilical cord shedding and diaper dermatitis were lower in the observation group than that of the control group, and all the differences were statistically significant (P<0.05). Conclusion: The establishment of maternal and infant nursing station for home care can improve maternal and infant home care effects, reduce maternal postpartum complications and promote exclusive breastfeeding, which is worthy of promotion.

Objective: To investigate the knowledge, attitude and current situation of first-aid knowledge and related skills in college teachers in Hengyang City, and to provide the basis for establishing and improving the training of first-aid knowledge and skills of teachers in colleges and universities. Methods: From March to May, 2018,totally 220 teachers in universities in Hengyang were investigated with the self-developed questionnaire. Results: Only 25.5% of the teachers had attended the first-aid training. The correction rate of first-aid knowledge of medical and non-medical teachers was compared, the P value of the following items were less than 0.05: the primetime of first-aid, hemostasis, scald, lifting and fixing fracture patieuts, and the compression position, frequency, compression to ventilation ratio of CPR, etc. Compared the willingness of the two groups, the P value of being willing to give first-aid to strangers was less than 0.05, which showed that medical teachers were more willing to help strangers than non-medical teachers. Conclusion: The situation of pre-hospital emergency knowledge and skills of college teachers is not optimistic. On the basis of changing the concept of public first-aid, we should strengthen the popularization and training of first-aid knowledge of college teachers as "first responders" from the level of self-rescue and mutual rescue skills.

The new medical education reform strongly advocates the corporation of nursing talents cultivation and professional qualifications needs. Based on the review of relevant literature and policy, we compared the commonalities and differences among the cultivation of Master of Nursing Specialist, the new nurses' standardized training and the nursing specialist training. Then, a correlational and coupling analysis (coupling logic, coupling conditions and coupling effects) of the three viable were conducted. We intended to provide a reference for the joint program among the cultivation of Master of Nursing Specialist, the new nurses' standardized training and nursing specialist training.

Objective: To evaluate the quality and analyze the contents of the clinical practice guidelines on childhood asthma, and to provide references for the construction of health education program for children with asthma in China. Methods: Guidelines on childhood asthma from websites of clinical practice guidelines, asthma professional organizations and databases published internationally in recent 5 years were searched, then the quality evaluation of included guidelines was carried out using AGREE II. Results: We identified 9 guidelines, of which 8 were in English, one was in Chinese, and 6 were evidence-based guidelines. The average AGREE II standardized scores in 6 domains were 52.78% (scope and purpose), 37.04% (stakeholder involvement), 27.89% (rigor of development), 47.84% (clarity of presentations), 31.25% (applicability) and 24.54% (independence), respectively. For overall quality, 5 of them were grade B and 4 of them were grade C. Totally 35 recommendations of education and management on childhood asthma were extracted. Conclusion: The qualities of included guidelines were at the average level. The rigor of development, clarity of presentations, applicability and independence of guidelines need to be improved. We should learn from foreign high-quality evidence for localization practice, and to guide the development of asthma education and management of children in China.

In this paper, the recent research progress on psychological disorders and influencing factors of post-intensive care syndrome in family caregivers and the corresponding interventions is summarized so as to provide references for the psychological care of patients family in ICU.

Objective: To analyze the application of the empowerment guidance program in the primary caregivers of stroke patients. Methods: A total of 80 primary caregivers of stroke patients in the inpatient department in a hospital from January 2018 to April 2018 were selected and divided into observation group (40 cases) and control group (40 cases) by the random number. Those in the control group were with the routine nursing education, and those in the observation group were with the empowerment guidance program and the routine nursing education. The scores of caregiver preparedness and comprehensive care ability of primary caregivers in two groups were compared. Results: The scores of caregiver preparedness were 25.98±3.21 in the observation group and 22.10±4.01 in the control group, total scores of comprehensive care ability were 116.38±9.92 in the observation group and 101.51±9.79 in the control group after 2 weeks of admission. The scores of caregiver preparedness and comprehensive care ability in the observation group were significantly higher than those in the control group (P<0.05). Conclusion:The empowerment guidance program can improve the caregiver preparedness and comprehensive care ability in the primary caregivers of stroke patients, and the empowerment guidance program is benefit to improve the quality of long-term family care.

Objective: To develop a structured treatment and education program for diabetic patients receiving peritoneal dialysis in China. Methods: Based upon the analysis of patients' needs and through learning from other established structured treatment and education programs in China, the first draft of a structured treatment and education program was designed in line with the systematic design model of instruction, education theories, guidelines and literature reviews. Then expert conferences were organized to further revise the draft and decide the final version of the program. Results: The final draft of the program delivered by doctors and nurses together was established, which included learning objectives, contents and curriculum appraising indicators and the like. Conclusion: Being scientific, accurate and standardized, the program was vivid and easy to understand and thus worthy of further clinical studies.

This paper reviewed the connotation and elements of Advance Care Planning (ACP), as well as the implementation process and application effects of ACP in the early stage of dementia patients. It also pointed out the advice for future research. The proposal was to provide theoretical support and methodological reference for the development of ACP for dementia patients in China.

Objective: To retrieve, analyze and summarize the best available evidence on symptom management of Feeding Intolerance among critically ill patients with nasogastric tube feeding. Methods: To collect literatures involving guideline, evidence summary, best practice information, recommended practice and systematic review, we searched the BMJ best practice, PubMed, Cochrane Library, Ovid, EMbase, CNKI, WanFang Data, National Guideline Clearinghouse, The National Institute for Health and Care Excellence, Registered Nurses' Association of Ontario, American Society for Parenteral and Enteral Nutrition, European Society for Clinical Nutrition and Metabolism, et a1. Results: We eventually recruited 23 references, including 4 clinical practice guideline, 1 evidence summary, 8 systematic review, 5 randomized controlled trials, 2 quasi-experimental studies, 2 cross-sectional studies and 1 diagnostic test accuracy study. After rigid appraisal, we finally concluded 26 items of best evidence concerning Feeding Intolerance assessment, body position, nutrition formula, feeding method, monitoring gastric residual volume and management of common symptoms. Conclusion: Clinical nurses should use evidence-based symptom management scheme to deal with Feeding Intolerance, which can provide security for critically ill patients with nasogastric tube feeding.

In this article, we reviewed the occurrence, adverse effects, influencing factors, assessment tools and preventive measures of senile osteoarthritis disability. It was suggested that medical staff should consider the influencing factors of senile osteoarthritis disability and take preventive measures accordingly. All of the studies could provide reference for disability prevention in elderly patients with osteoarthritis.

Objective: To explore the construction of the disaster relief nursing management system in hospitals, and to build a disaster relief team with comprehensive theoretical skills and multiple abilities to respond to emergencies. Methods: A disaster nursing preparation group was set up, and the training objectives were set. Totally 200 nurses with the qualifications from emergency department, ICU department and operating room department were selected to receive the training, and the training results were assessed with disaster knowledge and skills test. Results: Through the construction of disaster nursing management system and comprehensive and systematic training, the nurses' awareness rate of disaster theoretical knowledge and skills qualification rate were, respectively, 30.5%, 51.5% before training, while the rate was statistically increased to 54.5% and 66.0% respectively after training (P<0.05). Conclusion: By constructing the disaster nursing management system and carrying out scientific and reasonable disaster rescue training, the comprehensive emergency rescue ability of the disaster relief team can be effectively improved, and a professional and high-level nursing emergency rescue force can be built for the hospital.

This article reviews the concept of psychological distress, the assessment tools, influencing factors and interventions of psychological distress in patients with chronic heart failure, in order to provide direction and basis for the follow-up study of psychological distress.

PICC is widely used among patients with hematologic malignancies. However PICC-related thrombosis is one of the most common and serious complications. In this study, the risk factors and prevention strategies of PICC catheter related thrombosis related thrombosis were investigated among patients with hematological malignancies. It is expected to provide a reference for reducing the incidence of PICC catheter related thrombosis.

Intracavitary electrocardiogram means that in the process of PICC catheterization, the guide wire or saline column is used as the intracavity electrode instead of right shoulder electrode of the standard surface electrocardiogram to enter the superior vena cava and obtain the atrial P wave to know the position of PICC tip. Intracavitary electrocardiogram has been increasing applied in newborns because of the advantages on localization accuracy, safety, time and cost saving. This article reviews the basis of intracavitary electrocardiography in the positioning of neonatal PICC, the choice of lead and guidance, the advantages and limitations, to provide references for clinical application.

Objective: To explore the effects of early comprehensive nursing intervention combined with early visits by volunteers for patients with breast cancer. Methods: A total of 368 breast cancer patients were recruited from Jan. 2015 to Sept. 2017, and one additional early visit by rehabilitation volunteers were implemented on the basis of routine health education. The Herth Hope Index and the Functional Assessment of Cancer Therapy-Breast were assessed before intervention and in 30 days of being diagnosed. Results: The scores of hope and quality of life of patients in 30 days of being diagnosed were significantly improved compared with the score before the intervention (P<0.05). Conclusion: Early comprehensive nursing intervention benefits the improvement of hope and quality of life of patients with breast cancer.

This paper introduced the development mode of emergency hospice care abroad, including the emergency department-based consultation programs initiated by the hospital palliative care team, the hospice care initiated by the emergency department ambulance nursing staff, and emergency department partnerships with hospice providers. It is suggested that the emergency department in China should carry out multi-team cooperation on the development of the hospice care model, which can promote the effective identification and management of hospital hospice care patients, and provide the best care and service for the last journey of life.

In this paper, we introduced the pain management nursing in Oregon Health and Science University Hospital from the goal of pain control, pain assessment, safe pain management and on-the-job training. Our country's hospital can utilize foreign hospital's experiences to establish and improve the nursing standard of pain assessment, safe management, medical order execution, on-the-job training and so on, which can provide references for improving the quality of hospital pain management and nursing service.