Hospice care is one of the key medical fields in China. It involves the health care of patients in the end of the life cycle, concerns the important problems of people's well-being, and is also an important problem to be solved when building a healthy China. Under the background of building a healthy China, this paper analyzed the current status and shortcomings of hospice care in China, and put forward some suggestions to promote comprehensive and healthy development of hospice care.

Through continuous exploration and practice, our hospital has established a hospice care unit and formed a hospice care model of our hospital, which was implemented by multi-disciplinary collaborative model with the main content of pain and other symtom control, comfort care, psychological, spiritual and social support, death education and so on. Through the "whole person" and "whole family" care of the hospice care team, the physical symptoms of patients were effectively controlled during their hospitalization and the patients and their families relieved their mental pressure and psychological burden and increased their satisfaction.

This paper introduces the practice and exploration in Changzheng Zhen Community Healthcare Center of Putuo district of Shanghai during the national level community hospice care pilot work, supported by city and district policies, from the aspects of hardware construction, team building, system flow, service content, publicity and education, quality control, etc. So as to form a community hospice service mode combining home and hospitalization, and develop thinking and outlook for this case.

We described the development of home-based hospice care model and introduced the content, methods and management of this model, the composition of core team personnel and the training of team members. We need to promote the development of home-based hospice care from four aspects: top-level design and standards of hospice care, fully utilizing the service capacity of community health centers, introducing social organizations to participate, and improving the support levels for family members and patients.

As an integral member of multidisciplinary team for hospice care, medical social workers play important roles and functions in hospice care practice. This paper describes the importance of social work and elaborates the multiple roles of medical social workers as evaluators, implementers, coordinators at hospice care practice. It also provides more suggestions for the development of medical social workers in hospice care.

Objective: To systematically evaluate the effect of Manual Lymphatic Drainage (MLD) on the prevention and treatment of Breast Cancer Related Lymphedema (BCRL), and provide high-quality evidence for the rational development of Breast Cancer Related Lymphedema prevention and treatment programs. Methods: The data were retrieved of randomized controlled trials (RCTs) about the effect of MLD on prevention and treatment of BCRL from PubMed, EMBASE, The Cochrane Library, CMB and CNKI databases from inception to Mar,2018. Two independent evaluators screened and evaluated the quality of the study according to the inclusion and exclusion criteria of the study. RevMan5.3 software was used for Meta analysis. Results: A total of 9 RCT studies involving 1 112 patients were included.Meta analysis results showed that the effect of MLD on BCRL prevention was statistically significant compared with other measures [OR=0.31, 95%CI (0.12,0.83), Z=2.33, P=0.02]. The effect of MLD on treatment of BCRL was not statistically significant compared with other measures [SMD=0.17, 95%CI (-0.08,0.41), Z=1.34, P=0.18] [WMD=-0.21, 95%CI (-1.54,1.12), Z=0.31, P=0.76]. The evidence intensity of prevention of BCRL by MLD was moderate. The strengths of two evidences for MLD treatment of BCRL were moderate and low, respectively. Conclusion: Existing evidence shows that compared with other nursing methods, MLD can effectively prevent the occurrence of BCRL, but cannot effectively treat the swelling degree of BCRL patients' limb, and the pain relief effect on the affected limb is not good. Clinical nurses should guide the patients to carry out MLD at the early stage after breast cancer surgery, and manage the patients after surgery using comprehensive nursing measures, so as to improve their health outcomes and improve their quality of life.

Objective: To investigate community health care providers' attitude towards end-of-life care, death and caring for dying patients, and analyze the correlation among them. Methods: Totally 132 community health care providers of nine community health institutions in Changzhi city were investigated. Data was analyzed by SPSS 22.0 software. Results: The average scores of attitude towards dimensions of death were: neutral accptance (3.84±0.57), fear of death (3.13±0.76), death avoidance (3.02±0.71), escape acceptance (2.68±0.84), approach acceptance (2.66±0.78). The average scores of attitude towards end-of-life care, caring for dying patients were (3.47±0.44), and (3.43±0.33) respectively. Natural acceptance was moderately correlated with the sense of care centered on patients and their families (r=0.562, P<0.01). There was a moderate correlation between the effectiveness of end-of-life care and the feelings of caring for dying patients (r=0.509, P<0.01), and the sense of care centered on patients and their families (r=0.604, P<0.01), the total score of attitude towards end-of-life care and the feelings of caring for dying patients (r=0.595, P<0.01), and the sense of care centered on patients and their families (r=0.576, P<0.01). Conclusion: Community health care providers' attitude towards death, end-of-life care and caring for dying patients are positive. There is a strong correlation between attitude towards end-of-life care and attitude towards caring for dying patients.

Objective: To investigate the knowledge and practical behavior of dysphagia management of geriatric nursing assistants, and to provide references for dysphagia management in nursing home in China. Methods: Totally 358 geriatric nursing assistants from 30 nursing homes in Hunan province was investigated by Dysphagia Management Knowledge Questionnaire, and the feeding behavior of 87 geriatric nursing assistants were observed and recorded based on the Structural Feeding Observation Table. Results: The score of dysphagia management knowledge was 15.84±3.69, and the item "Watery liquids are the safest substances to drink" got the lowest correct rate. In the feeding behavior, only 3 geriatric nursing assistants (4.4%) completely "offers choice in what sequence food and beverage is fed". Conclusion: It is necessary to strength targeted knowledge and skills training, and improve food service processes and management standards, to regulate the service behavior of geriatric nursing assistants, and improve the quality of aged care service.

Objective: To evaluate the effects of telerehabilitation in patients with Cerebral Palsy through Meta-analysis. Methods: Database such as Cochrane Library, PubMed, Web of Science, CNKI, VIP and Wanfang were searched to retrieve Randomized Controlled Trials (RCT) on telerehabilitation for Cerebral Palsy. The Meta-analysis was conducted by RevMan 5.3 after data extraction and quality appraisal of the eligible RCTs. Results: A total of 9 RCTs were included in this study, with a total of 281 subjects.The results of Meta-analysis supported the effectiveness of telerehabilitation on improving the function of standing, walking, running and jumping, and increasing the limb sensitivity of the patients with Cerebral Palsy (P<0.05). It failed to support the effectiveness of improvement of walking speed and reduction of the muscle tone of lower limb (P>0.05). When the Pediatric Balance Scale (PBS) was used as the evaluation criteria, the balance function of patients with Cerebral Palsy could be significantly improved (P<0.05). When the Timed-Up and Go Test (TUGT) was used as the evaluation criteria, there was no significant effect on the balance function of children with Cerebral Palsy (P>0.05). Conclusion: Telerehabilitation can significantly improve the motor function and increased the limb sensitivity of patients with Cerebral Palsy. However, it failed to enhance the effect of improving walking speed and reducing the muscle tone of lower limbs on patients with Cerebral Palsy. There is no conclusion on promoting the balance function of patients with Cerebral Palsy, which needs further research to verify.

Objective: To reevaluation the systematic review of the impact of all Rapid Response Systems (RRS) on clinical outcomes in inpatients. Method: The Cochrane Library, PubMed, Medline, CINAHL, EMBASE, CNKI, CMB, WANFANG and VIP database were searched for systematic review or Meta analysis of the impact of all RRS on clinical outcomes in inpatients. Two authors independently screened literature, extracted data and assessed the quality of included studies using the AMSTAR scale. Results: A total of 14 systematic reviews were included. The AMSTAR evaluation results showed that only 4 articles were of high quality, and the worst items in the report were "whether a list of included and excluded research literature was provided" (12 articles), and "whether publishing status was considered in including criteria" (11 articles)" whether a preliminary design scheme was provided" (11 articles), followed by "whether the relevant conflicts of interest were explained" (10 articles). Conclusion: The quality of methodology in systematic review is generally poor. The RRS plays a positive role in the prognosis of in patients, while it still needs further discussion and verification to recommend in clinical to optimize the management of adverse events. It also indicates nurses should improve their professional level to meet the needs of RRS.

Objective: To investigate the quality of life in patients with stable schizophrenia and the impact factors. Methods: 455 outpatients with stable schizophrenia from 5 psychiatric hospitals were surveyed by the general situation questionnaire, Generic Quality of Life Inventory-74 (GQOLI-74), Positive and Negative Symptoms Scale (PANSS), and Connor-Davidson Resilience Scale (CD-RISC). Results: The score of GQOLI-74 was (43.34±7.66); the score of CD-RISC was (66.19±14.36). Multivariate stratified regression showed that marital status, family monthly income, PANSS score, and CD-RISC score were main influencing factors of quality of life in patients with stable schizophrenia, explaining 32.5% of the total variation. CD-RISC score independently explained 13.0% of the total variation. Conclusion: The quality of life in patients with stable schizophrenia is generally poor, which is affected by marital status, family monthly income, severity of symptoms and psychological resilience. The results highlight the importance of improving psychological resilience to promote the quality of life in patients with schizophrenia.

Objective: To develop an Advance Care Planning (ACP) Readiness Scale in Chinese cultural background and to test its reliability and validity, and to provide an evaluation measurement for scientific research and practice in hospice care. Methods: Based on the literature review results, interviews of patients and experts, dimensions and items of ACP Readiness Scale were proposed. Totally 113 cases of community chronic disease patients were investigated to testify validity and reliability of ACP Readiness Scale. Results: The ACP readiness scale consists of three dimensions, including attitude, belief, and motivation, and totally 22 items. The I-CVI was 0.8-1.0, and the S-CVI/Ave was 0.986. The Cronbach's α coefficient of the scale was 0.923, and the Cronbach's α coefficients of attitude, belief, and motivation dimensions are 0.900, 0.880, and 0.835, respectively. The cumulative explanatory variable of the three factors of structural validity was 59.998%, which was within the acceptable range of measurements. Conclusion: The ACP Readiness Scale is with good reliability, validity and feasibility, and can be used as an evaluation tool for ACP readiness in Chinese chronic disease patients.

Objective: To analyze the effect of mobile micro-learning method in nursing training of Pressure Injury. Methods: 15 departments were divided into two groups using random number table method. The control group used the traditional centralized theory teaching method, and the experimental group used the mobile micro-learning method. The effects of the two groups of training and the clinical practice results after six months were compared. Results: The theoretical and operational assessment scores of the experimental group were higher than those of the control group (P<0.05). The nurses approved mobile micro-learning method (P<0.05). The incidence of Pressure Injury, the accuracy of risk assessment, the accuracy of wound assessment, the qualification rate of record and patient satisfaction were significantly improved (P<0.05). Conclusion: The mobile micro-learning method can improve the nursing quality and for patients with Pressure Injury and self-learning ability, and provide visual observation path for trainers, which is conducive to improving the quality of training.

Objective: To analyze the effect of flip classroom-based mixed teaching model in foreign nursing specialty. Methods: A convenience sample of 180 foreign-related nursing students in grade 2016 were randomly divided into the observation group and control group, and there were 90 students in each group, respectively. In the one-year fundamental nursing practice teaching, the traditional teaching method based on flip classroom model was used for the control group, and the flip classroom-based mixed teaching model was used for the observation group. Results: The results showed that the score of operating skills performance, the self-directed learning ability, and the satisfaction degree of teaching in the observation group were all significantly higher than those in the control group (P<0.001). Conclusion: The flip classroom-based mixed teaching model is worth to be popularized in the practice teaching of nursing.

Objective: This study investigated the experience and needs of neurosurgery patients' parents in using healthcare mobile phone applications in a children's hospital, in order to provide references for improving the quality of transitional care. Methods: Convenience sampling method was performed. Totally 150 patients' parents in neurosurgery were investigated using a self-designed questionnaire. Results: The mean score of mobile phone using experience was 48.37±7.62, which was in the medium range. 93.3% participants were willing to install novel healthcare mobile phone applications. The median score of healthcare mobile phone applications using confidence was 39.0, which was high. Moreover, significant differences of participants' confidence were found in age, education and residence (P<0.05). Conclusion: The study suggested that more targeted and practical healthcare mobile phone applications should be developed to meet parents' needs, and promote transitional care quality.

This paper provides a comprehensive review of the literature on definition of Mobile health and its advantages in contraception for women of childbearing age, the specific application of Mobile health in contraception for women of childbearing age at home and abroad, and presents a consideration and prospection of the existing problems in this filed, in order to promote the clinical application of Mobile health, to increase the contraception success rate in women of childbearing age, and to provide reference for future research in this filed.

Objective: To develop and apply the training information system for nurses in different levels based on competency to promote their practical experience and improve the training quality. Methods: On the basis of training plans for nurses in different levels and the nurses' information system that Peking University Third Hospital has already had, an nursing training information system based on competency was developed and evaluated in this study. Results: The average score of satisfaction of nursing managers and nurses about this system was 94.34±15.51 and 89.46±15.70, respectively. The dimension "running and design" got the lowest score and the dimension "effects of results" got the highest score. Conclusion: The training information system for nurses in different levels based on competency provides an excellent and scientific platform to standardize the management of nurses' training, which is also an useful tool for nurses to record their training. It makes information and resources more shared and improves the training quality and efficiency of nursing management to motivate nurses to pursue a better career development.

Objective: To explore a new mode and method of case manager training program in oncology hospitals. Method: Case manager training program was designed and implemented, including the selection, training and assessment of case managers candidates, the formation of case management teams, the establishment of systems and workflow, the design of case management manuals and the implementation of case management mode. Totally 44 clinical nurses were trained as case managers. They were followed up in November 2018. Results: The case managers were all satisfied (100%) with the training program. The qualified rate of follow-up of case managers was 90.5%. Conclusion: It is practical for our hospital to perform new training program to train case managers. It is expected the case manager can provide qualified nursing care to oncology patients.

The article systematically collected and combed the periodical literature about the new nurses' transition shock; summarized and analyzed the research progress of the transition shock from the perspective of summary, investigation status, influencing factors and intervention. It is aimed to provide basis for stabilizing the nursing team, carring out the implementation of the reform for hospital managers and improving hospital nursing quality by individualized education and management.

Objective: To establish work content for the role of ICU liaison nurse in transitional care. Methods: Based on the theory of interface interaction barriers principle, we analyzed the ICU nursing safety problems in the transition period. By using the interface management way and combining the literature analysis and field observation, the work content of liaison nurse item pool was built. The Delphi expert consultation method was adopted to conduct two rounds of consultation for 19 medical and nursing experts in the field of critical illness. Results: Three first-level items, nine second-level items and twenty-seven third-level items were constructed. The effective recovery rate of 2 rounds of expert consultation were 95% and 100%, the range of item importance and operability variation coefficient was between 0.05 and 0.24, the expert authority coefficient was between 0.81 and 0.87, the coordination degree was between 0.163 and 0.211 (P<0.01). Conclusion: The work content of ICU liaison nurse in the transitional care has high reliability and scientificity, which can provide a basis for carrying out ICU transitional care in clinic.

This article reviewed and analyzed the training and management of diabetes specialist nurses at home and abroad from several aspects including the entry conditions, training requirements, job responsibilities and service areas and brought up some relevant countermeasures to problems at home. It is expected to provide references for the development of diabetes specialist nurses in China.

Objective: To analyze the leadership of head nurses in tertiary grade A hospitals in Zhejiang province by using latent category analysis. Methods: Head nurses who met the inclusion and exclusion criteria in 11 tertiary grade A hospitals in Zhejiang province were selected from October 2017 to December 2017 by cluster convenient sampling method. The demographic questionnaire and the Chinese version of MAS were used in the investigation. Results: The latent category model showed that 736 head nurses were divided into high leadership category (12.64%), medium leadership category (55.84%) and low leadership category (31.52%). The three latent categories of head nurses had significant statistical differences (P<0.05) in the number of hospital beds, years of work, age and participation in management training, while there were no statistical differences (P>0.05) in the departments, length of service as head nurse, academic degree or professional title. Conclusion: By the category analysis of the head nurses’ leadership, it was found that there are three types of leadership in the head nurse in tertiary hospitals, which are irrelevant to the length of service as head nurse, professional title and education background, and years of work, the number of beds and participation in management training and other professional experiences has a significant relationship, providing a reference for further development of the head nurses' tiered management training.

Objective: To develop scientific and practical index system for patient safety reporting. Methods: Literature research, group discussion and Delphi method were used to establish the index system. Results: The recovery rates of the two rounds of questionnaires were 97.1%, 100% respectively. The authoritative coefficients of experts was 0.909. In the second round, variation coefficients of each item ranged from 0 to 0.18, and coefficient coordination was 0.371. The final index system consisted of 9 first-level indicators and 13 second-level indicators. Conclusion: The formulation method of index system for patient safety reporting is reliable, which can provide information for hospital medical staff to report and learn typical cases of patient safety.

In this article, the concept of fall prevention self-management, assessment tools, impact factors, and intervention strategies were discussed, in order to provide references for further research on fall prevention self-management in elderly people. We also aim to improve patients' self-manage ability of fall prevention to reduce fall incidence, and improve patient safety.

This article systematically showcased international technical guidelines against workplace violence in health sector. Based on international experience, this article analyzed the systematic gap between China and international society, combined with evidences from practice in China in relevant area, proposed suggestions of workplace violence prevention and control for health care workers with systematic approaches.

Objective: To analyze the effects of 1M3S-based PDCA quality control model in blood transfusion nursing practice. Methods: Historical control study was performed, totally 414 patients with blood transfusion from May 2016 to April 2017 were enrolled into the control group, and 396 patients with blood transfusion from May 2017 to April 2018 were included in the observation group. The control group adopted traditional blood transfusion process and quality control mode, while the observation group adopted 1M3S-based PDCA circulation management mode. Results: The unqualified rate of samples, the incidence rate of adverse blood transfusion reaction and the return rate of blood products to blood bank in the observation group were all significantly lower than those in the control group (P<0.05), and the satisfaction degree of patients in the observation group was higher compared with the control group (P<0.05). Conclusion: The 1M3S-based PDCA quality control management mode is benefit to improve the nursing quality in blood transfusion.

Objective: To analyze the effects of setting up chronic diseases nursing clinic in community health centers by specialist nurses from tertiary hospital. Methods: Established hypertension and diabetes nursing clinic in community health center, and established the working system for community chronic disease nursing clinic. The general working indicators of the community chronic disease nursing clinic from September 2017 to February 2018, and the outcomes of patients with hypertension and diabetes after 3 and 6 months of the intervention were collected. Results: There were 86 and 95 patients signed up for hypertension and diabetes nursing care clinic, respectively. After 3 months and 6 months of intervention, the achieved rate of the main indicators for hypertension management was 70.93% and 87.20% respectively, and 23.15% and 40.00% for diabetes respectively. Conclusion: Setting up chronic disease nursing clinic in community health centers is benefit to improve the chronic disease management level, the implementation of tiered medical consultation system and the patients' satisfaction. In the future, policy supports and scientific management system are needed for the long-term implementation of the community chronic disease nursing clinic.

Objective: To establish and evaluate the effects of nursing follow-up system for cancer patients after discharge. Methods: By setting up team, building system frame, setting up the database, and functional exploitation to establish and improve the nursing follow-up system. A total of 2 470 patients with cancer pain were included in the study. The medication compliance, pain scores and common complications were assessed in 1, 2 and 3 weeks after discharge, respectively to evaluate effects of the nursing follow-up system. Results: The nursing follow-up system for cancer patients integrated nursing follow-up, rehabilitation guidance, patient experience and statistical analysis, and was with the national software copyright. The pain degree decreased 1, 2 and 3 weeks after discharge (P<0.05). There was no significant difference in medication compliance scores in 1, 2 and 3 weeks after discharge (P>0.05). Conclusion: The nursing follow-up system for cancer patients is benefit for medication compliance, pain control, prevention of some complications and patients' medical experience, and the patients can get relatively stable health guidance and continuous care from hospitals to families.

Objective: To explore the effect of health intervention based on health ecology theory on rehabilitation of patients with Total Knee Arthroplasty. Methods: Totally 72 patients were randomly divided into control group and observation group. At discharge and after discharge, the control group received health intervention according to the routine of Total Knee Arthroplasty, while the observation group received health intervention based on health ecology theory. HSS scale and SF-36 scale were used to evaluate the knee joint function and quality of life of patients in both groups at discharge, 3 months and 6 months after discharge. Results: HSS scale scores and SF-36 scores of the two groups showed no statistical difference at discharge (P>0.05). The scores of HSS scale and SF-36 scale in the observation group were higher than those in the control group at 3 months and 6 months after discharge, and the difference was statistically significant respectively (P﹤0.05). Conclusion: Health behavior intervention program based on health ecology theory can effectively improve the joint function and quality of life of patients with Total Knee Arthroplasty.

This review of evidences for different birth positions during the second stage of labor included classification of birth positions, application actuality and the impacts of different birth positions on maternal and neonatal outcomes. Different birth positions had their own advantages and disadvantages. Therefore, midwives should help women choose appropriate birth positions according to the maternal well-being, fetal well-being and progress of labor for an improved maternity care and a qualified puerpera-centered midwifery.

Objective: To investigate the knowledge and attitude of medical staff in various specialties on early mobilization in Acute Ischemic Stroke patients and to explore its influential factors. Methods: It was a cross-sectional study. A total of 253 medical workers from 6 tertiary hospitals, 3 secondary hospitals from 4 cities in Jiangsu province were recruited by convenience sampling and surveyed with self-designed questionnaires. Results: The median scores of knowledge and attitude of medical staff were 68(62, 74) and 68(63, 73). Logistic regression analysis showed that level of hospitals, time of specialty, whether received training or not were influential factors for medical staff's knowledge and attitude of early mobilization in patients with Acute Ischemic Stroke. Conclusion: The knowledge and attitude of medical staff on early mobilization in Acute Ischemic Stroke patients should be improved. Most medical staff have realized the benefits of early mobilization, but they worried about the risk of early mobilization too much. Thus training should be enhanced and resources should be shared to improve their knowledge and attitude.

Objective: To investigate the influencing factors of postoperative fever after painless bronchoscopy, so as to provide references for the prevention of postoperative fever. Methods: We investigated the postoperative fever of the inpatients with painless bronchoscopy in our hospital from July to December, 2017 and multivariate Logistic regression model was used to analyze the influencing factors of postoperative fever. Results: Totally eighty patients (16.0%) of the 500 inpatients who underwent bronchoscopy developed fever after surgery. The results of multivariate analysis showed that preoperative plaque index, intraoperative biopsy or lavage and operative time were the risk factors of postoperative fever after bronchoscopy. Conclusion: The higher preoperative plaque index, the longer intraoperative biopsy or irrigation, and the longer operative time were, the greater the possibility of postoperative fever was. In order to prevent postoperative fever, it is suggested that we should strictly obey the operation guide, shorten the operative time, and take effective measure before the operation to reduce the plaque to improve the oral hygiene condition of the patient.