Objective: To construct and evaluate the evidence-based early mobilization protocol for patients with acute ischemic stroke. Methods: An evidence-based early mobilization protocol for patients with acute ischemic stroke was developed and integrated into clinical practice based on evidence, clinical scenarios, and patients need. Results: Totally 39 ischemic stroke patients received tailored intervention. The start time of mobilization after admission was reduced, the rate of early mobilization within 24 hours was increased, the outcome after 14 days of stroke was improved, shortened the length of hospital stay. Conclusion: The construction and application of evidence-based early mobilization protocol may facilitate the implementation of early mobilization, improve outcomes of stroke patient, and enhance nursing quality.

Objective: To construct Chronic Kidney Disease (CKD) case management model and to analyze its clinical effect. Methods: Formed a nurse-led management model of CKD by selecting and traning specified nurses of CKD management center, modifying responsibility of specified nurses, opening nursing clinic. Results: Totally 2 763 CKD patients received case management. The follow-up rate increased from 47.4% to 55.6%, standard high quality low protein diet rate increased from 21.2% to 36.5%, smoking rate reduced from 41.3% to 37.3%, periodical examination rate increased from 46.7% to 50.3%, blood pressure control rate increased from 60.9% to 64.1%, blood lipid control rate increased from 46.9% to 51.4% (P<0.05). The number of project grants, published papers, obtained patents, and awards gained by specified nurse increased significantly. Conclusion: The Case Management Model to CKD Patients in clinical practice, it improved the management level of CKD, improved the quality of specialized nursing, and promoted nursing quality.

Objective: To establish and manage the whole province PICC care network, monitor the process of catheter care of patients with PICC catheter, provide the continuous care of same quality for patients with PICC line. Method: We established a catheter caring network that radiates all levels of medical institutions of the whole province with our hospital as center, tertiary grade A hospitals of other cities as sub-center and county-level and community hospitals as service stations by developing referral procedures, training nurses in PICC caring site, monitoring the quality of PICC caring site, improving the self-management level of PICC patients. Results: The number of PICC caring sites of Guangxi increased from 21 to 133, the number of nurses at PICC care site increased from 79 to 232, the catheterization rate increased from 35.0% to 76.0%, the PICC caring examination qualified rate of nurse increased from 53.9% to 88.4%, the caring missing rate of PICC dropped from 40.0% to 10.9%. Conclusions: By establishing PICC maintenance network and developing regional collaborative nursing, we can provide fast, efficient and high-quality nursing for patients with PICC, standardize catheter maintenance during the intermittent period of chemotherapy, improve patients satisfaction, provide reference for graded diagnosis and treatment.

Objective: To construct a nurse-led respiratory care team working mode in the pulmonary rehabilitation of critically ill patients and analyze its effect. Method: Constructed a nurse-led respiratory care team, developed work responsibilities and system, optimized clinic work processes and content, and finially formed a patient-centered horizontal joint vertical pulmonary rehabilitation management mode. Data of resting pulmonary function test and cardiopulmonary exercise testing and other tests in 396 patients undergoing pulmonary rehabilitation mode after operation and during rehabilitation in 2017 was analyzed. Results: The patients' pulmonary function improved compared with postoperative after the respiratory care team's pulmonary rehabilitation management. Standard using rate of ventilator, team consultation workload, Ventilator Associated Pneumonia incidence rate, ICU 24 hours reintubation rate, hospitalization expenses and other indicators were all improved. Conclusion: Nurse-led respiratory care team improves pulmonary function in critically ill patients. The mode has high feasibility and potential for replication. It can also expand the development direction and competencies of nurses.

Objective: To analyze effects of multidisciplinary team management on improving nutritional status in patients with post-stroke dysphagia. Methods: We established multidisciplinary collaborative team and based on the existing problems of nutritional management in post-stroke patients, we modified nutrition assessment process, standardized the nutrition management program and improved the quality control system. Nutritional indicators of stroke patients with dysphagia before and after intervention by multidisciplinary team were compared. Results: The nutritional screening rate was 100%. Six months after discharge, there were statistically significant differences in NRS scores and BMI between the two groups (P<0.05). Conclusion: Multidisciplinary collaborative team can improve the nutritional status in patients with post-stroke dysphagia.

Objective: To translate MISSCARE Survey-Patient from English to Chinese, and evaluate the reliability and validity of the Chinese version of MISSCARE Survey-Patient. Methods: Brislin translation model was applied for literal translation, back translation and translation. Cultural adjustment was performed through expert committee discussions and pre-tests. Convenient sampling method was used. Totally 225 patients in a tertiary hospital in Xuancheng City was investigated to test the reliability and validity of the Chinese version of MISSCARE Survey-Patient. Results: The average content validity index of the scale level (S-CVI/Ave) was 0.936, and the content validity index of the item level (I-CVI) was between 0.833 to 1.000. Three factors (communicative care, basic care and timely care) were extracted by factor analysis, which could explain 65.0% of the total variance of the Chinese version of MISSCARE Survey-Patient. The total Cronbach's α coefficient was 0.888, the Cronbach's α coefficient of each dimension was between 0.734~0.887. The total test-retest reliability was 0.843, and the test-retest reliability of each dimension was between 0.769~0.821. Conclusion: The Chinese version of MISSCARE Survey-Patient can be used to investigate the quality of nursing care and patient safety in the hospitals in China.

Objective: To analyze the effects of stratified follow-up intervention on self-efficacy, self-management and glucose metabolism in type 2 diabetic patients. Methods: A total of 100 patients with type 2 diabetes in the department of endocrinology in a tertiary grade A hospital were randomly divided into the experimental group (n=50) and the control group (n=50). The patients in the control group were given routine follow up, meanwhile patients in the experimental group were treated according to the standards of stratified follow-up. The self-efficacy, self-management ability, fasting blood-glucose, 2 hours postprandial blood glucose and glycosylated hemoglobin were measured before and after the intervention. Results: After 6 months of intervention, the scores of self-efficacy and self-management in the experimental group were significantly higher than those in the control group (P<0.05). Compared with the control group, the fasting blood glucose, postprandial blood glucose and glycosylated hemoglobin decreased in the experimental group (P<0.05). Conclusion: Stratified follow-up can improve the self-efficacy and self-management ability of patients with type 2 diabetes mellitus, and effectively improve the glucose metabolism. It is an effective follow-up plan for patients with diabetes mellitus.

Objective: To explore the mental process of Posttraumatic Growth during chemotherapy in patients with trophoblastic tumors, and to provide evidence for psychological care of patients with trophoblastic tumors. Methods:Ten cases of trophoblastic tumor patients were interviewed in depth using phenomenological research methods in qualitative research. The results were analyzed by Claizzi's phenomenon data 7-step analysis method, and the themes were analyzed and refined. Results: A variety of factors could promote the Posttraumatic Growth process of patients, mainly reflected in the four dimensions: self-efficacy improvements, positive social support, pursuing new life, and suffering-derived altruistic behavior. Conclusion: Patients with trophoblastic tumors have obvious Posttraumatic Growth during chemotherapy. Nurses can reinforce the positive psychology of patients with trophoblastic tumors and implement comprehensive nursing for their Posttraumatic Growth characteristics. It will provide a new perspective for psychological care of these patients.

Objective: To evaluate the effect of "Help Her Heal" couples communication intervention for breast cancer patients' spouses. Methods: A sample of 104 spouses from a hospital in Beijing were randomly divided into the intervention group (52) and control group (52) from June 2017 to September 2018. Those in the control group were provided with the health manual guidance, and those in the intervention group were enrolled in the program of "Help Her Heal" on the base of the care of control group. The spouse skills of husband and the anxiety and depression level of both couples were compared before the intervention, immediately after the intervention, and one month and three months after the intervention. Results: The score of Spouse Skills Checklist in the intervention group were higher than those in the control group (P<0.05), the score of the State Anxiety Inventory, and The Center for Epidemiological Survey Depression Scale of the couples in the intervention group were lower than those in the control group (P<0.05) after intervention (P<0.05). Conclusion: "Help Her Heal" program is benefit to improve the communication between the couples and the spouse's self-care ability and reduce the anxiety, and depression level of breast cancer couples.

Objective: To explore the relationship between work alienation and the management of aggression and violence attitude of emergency nurses. Methods: Totally 252 emergency nurses from seven tertiary grade A hospitals were recruited by convenience sampling between July and September 2018. The Management of Aggression and Violence Attitude Scale (MAVAS) and the Nurses' Work Alienation Questionnaire were used in the investigation to collect relevant data. Results: The average score of MAVAS was 90.35±16.48 and the score of each dimension from high to low were internal reasons, interaction between medical workers and patients, external reasons and management dimension. The average score of work alienation was 45.12±7.23. Multiple regression analysis showed that experience of hospital violence, working time in emergency department, work alienation and training related to violence could influence the management of aggression and violence attitude of emergency nurses, which could explain 51.1% variation of MAVAS. Conclusion: Nursing managers in emergency department should strengthen the training and exercise of violence prevention and control, improve nurses' awareness, especially those who work in the emergency department for a short period of time, and take individualized measures to reduce the sense of work alienation, and ensure the effective implementation of violence management methods.

Objective: To evaluate the prophylactic effects of honey use on radio or chemotherapy-induced oral mucositis and associated pain. Methods: Such databases as The Cochrane Library, PubMed, Web of Science, CBM, VIP, CNKI and Wanfang Data were searched up to September 2018 for randomized controlled trials (RCTs) about honey use on radio or chemotherapy-induced oral mucositis and associated pain. According to the inclusion and exclusion criteria, two reviewers independently screened each database, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.3 software. Results: Fifteen RCTs involving 856 patients were included. The meta-analysis showed that honey was significantly better in lowering the risk of mucositis [RR=0.48, 95% CI (0.35, 0.66), P<0.001], pain associated with mucositis (P<0.05), mouth fungal colonization [RR=0.21, 95% CI (0.09, 0.49), P<0.001], treatment interruptions [RR=0.10, 95% CI (0.01, 0.75), P=0.02] and weight loss [MD=-3.72, 95% CI (-6.86, -0.57), P=0.02]. And honey use could also delay the onset of severe mucositis. Conclusion: Current evidence shows that honey is a reasonable treatment for radio or chemotherapy-induced oral mucositis and associated pain, but more RCTs are still needed.

Objective: To investigate the status of stigma, social support and quality of life in patients with lung cancer, and to establish a structural equation model to clarify the relationships between these three variables. Methods: A questionnaire survey was conducted among 264 lung cancer patients in a provincial tertiary cancer hospital from January to August in 2017. Cataldo Lung Cancer Stigma Scale, Social Support Rating Scale, and Functional Assessment of Cancer Therapy-Lung were included in the questionnaire. Results: The total score of stigma in lung cancer patients was (71.11±14.91); the total score of social support was (39.10±11.53); the total score of quality of life was (85.39±23.48). Stigma was negatively correlated with social support and quality of life (P<0.01). The results of structural equation modeling showed that stigma had a direct negative effect (β=-0.301, P<0.01) and an indirect negative effect (β=-0.100) on quality of life. Social support only had a direct positive effect on quality of life (β=0.250, P<0.01). Conclusion: The stigma of lung cancer patients was at medium to high level. Health care professionals should take effective measures to alleviate lung cancer patients' stigma and increase their social support level, so as to improve their quality of life.

Objective: To discuss and explore the parents' experience in different stages of hormone replacement therapy for their children with short stature based on "Timing It Right". Methods: Patients whose children were receiving hormone replacement therapy for short stature in our hospital were recruited using purposeful sampling and interviewed by semi-structured interviews. And the 7-step analysis of Colaizzi phenomenology was applied to analyze data collected during the research. Results: 5 subjects including the stress response being strong in the diagnosis of short statue, different attitudes during the treatment, helplessness when getting prepared to discharge, difficulties in coping with stress in adjustment phase and complex feelings and needs during the adaptation period were summarized. Conclusion: The experience of the parents of children with short stature are changing dynamically. Therefore, medical staff are supposed to provide individualized nursing and treatment according to the experience and needs of parents in different stages of treatment in a planned and continuous manner, and improve the compliance of patients. The continuous nursing mode through integrating medical staff and patients together is conducive to the healthy growth of children physically and mentally.

Nurses' organizational silence is a group phenomenon and has a profound impact on both organization and individual development. The paper focused on the influence of individual, social and organizational factors on nurses' organizational silence, reviewed the current research progress, aimed to provide theoretical references to future research.

Objective: To measure nursing workload in cardiothoracic surgery department by the work sampling method, and to analysis the proportion of nursing work. Methods: The nursing work status observation table was complied. The time interval method such as random starting point was used to observe the randomly selected nursing staff every 5 minutes, in order to determine the immediate working status. Results: The study obtained 1 766 valid data. The workload rate of cardiothoracic surgery was as high as 96.3%, direct care accounted for 12.0%, indirect care accounted for 62.5%, related care accounted for 4.5%, other nursing work accounted for 17.2%, and personal time accounted for 3.7% of nursing work. Conclusion: The findings suggest that nursing workload is high in cardiothoracic surgery. The proportion of direct nursing time is low, and a certain amount of time is wasted in nursing work. Nursing work needs to be modified and improved. Human resources and performance allocation needs to be adjusted compared with other departments.

This paper analyzed the multidisciplinary team cooperation clinical alarm management model. Based on the four aspects of the alarm life cycle, the author identified the relevant factors and countermeasures affecting the alarm-related adverse events. It is expected to strengthen the alarm management and reduce alarm-related adverse events.

Objective: To investigate the effects of nursing intervention used to reduce the adverse events of insulin pump in non-endocrinology department. Methods: A nursing task force was set up to carry out the project action of "reducing adverse events of non-endocrine insulin pump", comparing the adverse events of non-endocrine insulin pump and the pass rate of insulin pump nursing quality indicator for inpatient before and after the intervention. Results: The incidence of adverse events of insulin pump was significantly decreased in patients using insulin pump in non-endocrinology department (P<0.05), and the qualified rate of nursing quality index of insulin pump was significantly increased (P<0.05). Conclusion: Application of nursing project improvement is helpful to the link quality control of patients with insulin pump in non-endocrinology, increasing the pass rate of insulin pump nursing quality indicator for inpatient, and reducing the incidence of adverse events; helping to achieve standardized management of non-endocrine insulin pumps and ensure patient safety.

Objective: To explore the current situation of the management of surgical instruments and related factors. Methods: Totally 594 head nurses of operating rooms in hospitals of level 2 and above from 30 provinces were investigated.The self-designed questionnaire was applied, which included items about the management mode of surgical instruments, foreign surgical instruments, endoscopic instruments and ophthalmic instruments. Results: The management of surgical instruments is mainly based on extensive experience management. There are deficiencies in maintenance, quality inspection, elimination and renewal, system detection, management of foreign instruments and ophthalmic instruments. Conclusion: The management of surgical instruments has not reached a scientific and meticulous level, and there are hidden risks in surgical safety. Managers should make effort to establish a quality evaluation system for surgical instrument management to protect the safety of surgical patients.

Clinical medical institutions are increasingly aware that standardized language is essential for the implementation of electronic medical record. The electronic nursing information system urgently needs to use a standardized language, and the Clinical Care Classification System provides a new method for recording patient care in electronic health record System. This paper reviewed the establishment process, the framework and coding structure and the research and application progress of Clinical Care Classification System. It is expected to provide reference for further study and practice.

Objective: To introduce the background, implementation process and evaluation of operating room patient transport information system. Methods: Based on the original operation patient delivery process in a tertiary grade A hospital in Beijing, and aimed at modifying the problems existed in weak links and key nodes, an operation room patient transport information system was designed. Total 2 450 surgical patients in this hospital in June 2017 were divided into traditional transfer group and transport information system group. Results: There were significant difference between the two groups in nurses' recording time for patient information, workers' recording time for workload, waiting time of patients before surgery (P<0.05). Conclusion: The patient transport information system in operating room is benefit to ensure the truth and accucary of relevant information, to improve the efficiency of surgical patient transport, and to provide reference for effective management of human resources.

With the aggravation of the aging situation in China, the incidence of dementia in the aged has increased year by year. The treatment and management of its symptoms is receiving increasing attention. In the middle and late stages of dementia process, agitation behavior occurs in 18%-87% of patients with dementia. Simulated Presence Therapy, as a non-pharmacological intervention, has been applied to patients with dementia, which could reduce or alleviate its agitation. This article reviews the current application and its effects of Simulated Presence Therapy in patients with dementia, aiming to provide reference for future intervention research in our country.

This paper provides a comprehensive review of the literature on the screening, screening guidelines and the influencing factors of cervical cancer in HIV-positive women at home and abroad, to provide scientific references for developing cervical cancer screening guidelines and reducing the incidence and mortality of cervical cancer in HIV-positive women in the future.

This paper reviewed the status and assessment tools of frailty in kidney transplant recipients, in order to provide references for early clinical recognition of frailty and intervention.

This paper reviewed the oral care during pregnancy from four aspects: changes of oral environment, assessment tools of oral health, prevention of oral problems and common oral diseases, to provide references for medical staffs.

Child Life program aims to alleviate the negative emotional experience during their hospitalization and improve the compliance with the medical procedure by simulating scenes and role-playing. Constructing a professional nursing team with specialized knowledge and skills is very important. The nursing department and human resources department jointly set up and select clinical nursing staff as part-time Child Life counselors. Professional systematic training courses were given by the department of Clinical Social Work. A total of 22 clinical nurses were recruited. Case tracking or clinical scenario intervention were two main forms for the Child Life counselors to practice, using targeted game kits.

Objective: To explore the application and clinical effects of comprehensive process management in the prevention and control of Incontinence Associated Dermatitis (IAD). Methods: A process management team was established to improve the current prevention and nursing of clinical IAD through normal, optimized and reengineered procejures so as to implement comprehensive process management. Results: Significant differences were observed in comparison of IAD incidence, severity of IAD, time needed to recover and patients' family satisfaction before and after the intervention (P<0.05). Conclusion: The nursing of incontinence-associated dermatitis in elderly patients has been normalized, scientific and processed using comprehensive process management, which can effectively prevent incontinence-associated dermatitis and improve the nursing process.

This review interpreted the concept and development of role strain, introduced chronic family caregiver role strain measurement tools and analyzed its influencing factors. Summarized the main interventions for family caregiver role strain of people living with chronic diseases. It is expected to provide references to build chronic family caregiver role strain intervention programs based on Chinese culture.

Home-based assisted Peritoneal Dialysis is defined as peritoneal dialysis performed at home with the assistance of a family member, a community-based nurse or others for patients with self-care difficulties. At present, considerable attention has been attached to home-based peritoneal dialysis as a dialysis modality to cope with the needs of elderly patients with End-Stage Renal Diseases. This paper reviews and analyzes the modality and clinical effectiveness of assisted Peritoneal Dialysis. Some suggestions are provided for future studies.

Objective: To explore the effects of chronic myelocytic leukemia (CML) standard management program based on structure-process-outcome model. Methods: A total of 106 CML patients were randomly assigned to the standard management program group (n=53) and the control group (n=53). On the basis of Donabedian's quality of care program of structure-process-outcome, standardized management service was provided to intervention group, while, the control group received general nursing care. Results: After the intervention, the results indicated that there were significant differences in scores of medication compliance between the two groups (t=2.628, P=0.010); there were no significant differences in Quality of Life (QOL) between the two groups (t=0.008, P=0.993). After six months of the intervention, there were significant differences between the two groups in the medication compliance (t=8.117, P<0.001) and QOL (t=2.572, P=0.012) respectively, with higher scores in the intervention group. Conclusion: Standardized CML management program can effectively improve the medication compliance and QOL in patients with CML.

Perinatal Depression is a significant impact on both mother and child. Choosing effective interventions is the key to prevent and treat the Perinatal Depression. This paper reviewed fourkinds of interventions including health education and promotion, general social support, psychotherapy, and pharmacotherapy for Perinatal Depression. It is aimed to provide guidance for clinical selection of effective interventions.

This paper introduced the definition of the caregivers' burden as well as the burden of caring elder patients with hip fracture. Besides, influencing factors and interventions on family caregivers of elder patients with hip fracture were reviewed and the necessity to improve caring interventions in order to reduce the burden of family caregivers were put forward.

Objective: To analyze the safety and comfortability of early postoperative diet following sedated colonoscopic polypectomy in day surgery. Methods: 360 patients were randomly assigned to routine oral group and early oral feeding group. Both groups were given clear semi-liquid diet before operation. Bowel preparation with compound polyethylene glycol electrolyte solution was done 4 hours before operation. The routine oral group received total fasting with intravenous infusion, oral clear fluids were begun up on the first postoperative day and solid foods on the fourth day as tolerated. In the early oral feeding group, clear fluids were begun up to two hours after surgery, followed by semi-liquid on the first postoperative day, and solid foods three days later as tolerated. The clinical outcomes (abdominal pain and hypoglycemial reaction), bowel movement, bleeding and infusion volume, were compared between the two groups. Results: The hypoglycemial reaction, infusion volume and first defecating time were significantly different between the two groups (P<0.05). No significant differences were noted in abdominal pain and bleeding (P>0.05). Conclusion: Early oral feeding after sedated colonoscopic polypectomy in day surgery appears to be safe, and reduce patients' discomfort

The paper summarized the development of hospice and palliative care nursing core competence and training programs. The hospice and palliative care nursing in China is at the early stage, and the training programs need to be improved. It is expected to enhance our hospice and palliative care nursing training program based on the previous experiences.