Objective: To evaluate the effect of the structured Electronic Medical Record system on optimization of nursing care planning in application of Traditional Chinese Medicine (TCM). Methods: Information on syndrome differentiation, clinical symptoms and applied TCM techniques were collected and analyzed among 211 patients who were admitted to the rheumatology unit and diagnosed with "Wangbi", between October 2018 and June 2019. Results: The use of structured Electronic Medical Record system is conducive to the standardization, integration and objective collection of patient's data, therefore provides adequate data support for the optimization of nursing care planning in applying TCM. Conclusion: The use of structured Electronic Medical Record system promotes the effectiveness of implementation of nursing care plans, provides the best evidence for optimization of nursing care planning, and improves quality of care in applying TCM among patients.

The aim of this article was to introduce the clinical application of ear holographic tongbian scraping in a Traditional Chinese Medicine (TCM) special nursing clinic. We analyzed clinical cases to support its effects. It is shown that the ear holographic tongbian scraping had significant treatment effects on insomnia, constipation, scapulohumeral periarthritis and so on. The findings provide evidence for the development of innovative TCM appropriate techniques.

Objective: To investigate the effects of scraping therapy combined with acupoints application on sleep quality of patients with chronic insomnia.Methods: We enrolled 60 patients with chronic insomnia admitted in the First Affiliated Hospital of Henan University of Chinese Medicine from September 2018 to March 2019. These patients were evenly divided into the experimental group or the control group randomly. Patients in the control group received the rountine treatment of Estazolam. Patients in the experimental group received scraping therapy combined with acupoints application besides Estazolam. The treatment duration for both groups was 30 days. After treatment, we analyzed the clinical efficacy of the treatments, score of Pittsburgh Sleep Quality Index (PSQI), and treatment safety in both groups. Results: The total effective rate was 63.3% in the control group while it was 93.3% in the experimental group. The effective rate in the experimental group was significantly higher than that of the control group (P<0.01). The total PSQI scores were lower in the two groups after the treatments than those before the treatments (P<0.01). However, the total PSQI score was much lower in the experimental group than that in the control group (P<0.01). Conclusion: Scraping therapy combined with acupoints application can improve the sleep quality of patients with chronic insomnia, and its effectiveness is better than that of the routine Estazolam treatment.

Objective: To explore an effective, safe and appropriate oral care frequency in improving oral health among mechanically ventilated patients with orotracheal intubation using Traditional Chinese Medicine (TCM) oral care solution, and to provide clinical practice basis for oral care using TCM oral solutino among critical patients. Methods: A total of 171 mechanically ventilated patients admitted to ICU from October 2014 to April 2017 were enrolled for the current study. Patients were randomly divided into four groups (Group A, B, C and D) in which A through C were the intervention groups. In the intervention groups, TCM oral solution was used for oral care with different frequencies: 1 time/day (Group A), 2 times/day (Group B) and 3 times/day (Group C). Group D was the control group, in which patients received routine oral care twice a day with normal saline. The length of intervention was 7 days, and the patient's oral health was evaluated using the modified Beck oral evaluation tool and pharyngeal swab test at baseline and after the intervention was completed. Results: The mean Beck oral scores at the 7th day in each intervention group all decreased significantly compared with the scores at baseline (P<0.05). Multiple between group comparisons showed that there were statistically significant differences between each of the three intervention groups (Group A, Group B, and Group C) and the control group (P<0.05) on the Beck oral score, however, no significant differences exist among the three intervention groups that used TCM oral care solution (P>0.05). The semi-quantitative detection of oral microorganism through pharyngeal swab tests showed statistically significant differences on number of oral microorganisms on day 3, 4 and 7 among four groups (P<0.05). The between group comparisons showed that the three intervention groups that used TCM oral care solution were superior to the control group in reducing the number of oral microorganisms (P<0.0083), but no statistical differences were detected among the three intervention groups (P>0.0083). Conclusion: Using TCM solution in oral care can effectively improve oral health of mechanically ventilated patients with orotracheal intubation and reduce the number of oral microorganisms. The results of this study showed that more frequent oral care using TCM oral solution among these patients did not necessarily produce better effect in improving oral health. In terms of reducing the number of oral microorganism, there are no differences whether the oral care performed once a day, twice a day or three times a day. This suggests that oral health can be achieved by reasonablea frequency oral care using TCM oral solution among mechanically ventilated patients.

Objective: To investigate the status quo of nurse staffing in Traditional Chinese Medicine (TCM) medical institutions. Methods: A self-designed questionnaire was used to investigate nurse staffing in 805 TCM medical institutions in China in February 2019. Results: We found nursing shortage in these 805 TCM medical institutions, with staffing indices lower than relevant national standards. A majority of nurses were temporarily employed by the institutions. They mainly held the primary title. The nursing education they received was mostly based on the western nursing education system. Furthermore, unified training standards for new nurses were lacking. There was a considerable turnover rate among specialized nurses in these institutions. Conclusion: Nursing shortage exists in TCM medical institutions across the country. The makeup of titles among nurses is unreasonable. There are unstable factors among nurses which may affect their retention. We need to take further measures to optimize the makeup of TCM nursing team, so as to promote the development of this team.

With the development of the times, Traditional Chinese Medicine (TCM) nursing has gradually developed into an independent specialty. TCM nursing plays an important role in disease prevention, chronic disease management and community nursing and so on. This paper reviewed the clinical development of TCM nursing, and discussed how to give full play to the advantages of TCM nursing service under the new situation, aiming at strengthening communication and jointly promoting the development of TCM nursing discipline.

Objective: To evaluate the effect of multidisciplinary cooperating exercise on quality of life and micro-inflammatory state among patients undergoing Maintenance Hemodialysis (MHD). Methods: MHD patients consistent with inclusion criteria were randomly divided into the controls group (n=45) and the experimental group (n=42). Patients in the control group did not take any exercise intervention, while the experimental group conducted multidisciplinary cooperating exercise using smart sports bike three times a week, lasting for 12 weeks. The quality of life and micro-inflammatory state of two groups before and after intervention were assessed and compared. Results: After the intervention, the quality of life of the experimental group was higher than that of the control group (P<0.05). The scores of hypersensitive-C-reactive protein and interleukin-6 of the experimental group were lower than those in the control group (P<0.05). Conclusion: The multidisciplinary cooperating exercise could improve the quality of life and micro-inflammatory state in MHD patients, therefore it can be used as a routine treatment.

Objective: To translate and verify the reliability and validity of the Chinese version of the Gout Impact Scale (GIS). Methods: Translation was first conducted according to the translation guidelines by the International Association of Pharmaceutical Economics (ISPOR) after obtaining the authorization of the original author and the copyright company, then the reliability and validity were tested with GIS data collected from a convenient subjects of 274 gout patients from the gout outpatient department in a tertiary comprehensive hospital in Qingdao. Results: The content validity index of each item of the Chinese version of GIS was 0.800-1.000, and the average content validity index was 0.975, and the overall content validity index was 0.875. Total six factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 73.727%. The Cronbach's α for GIS was 0.928, the Cronbach's α for six dimensions ranged from 0.663 to 0.950, the test-retest reliability was 0.858. Conclusion: The Chinese version of GIS shows high reliability and validity, which can be used to evaluate the health-related quality of life in gout patients in China.

Objective: To describe the nurses' perceptions of nurse-physician collaboration and to explore the related factors. Methods: A questionnaire survey was conducted among 971 nurses in tertiary hospitals. Results: The score of nurses' perceptions of nurse-physician collaboration was 3.93±0.68, and there were 3 dimensions in nurse-physician collaboration, including information sharing (4.06±0.68), caring for each other and collaboration (3.94±0.75) and participation in patient treatment and nursing decisions (3.83±0.77). The score of nurse-physician interpersonal exchange was 4.13±0.68, and the four dimensions were respection (4.12±0.71), trusting (4.26±0.64), willingness to cooperate (4.50±0.59), and effective communication (4.03±0.68). The related factors of nurses' perceptions of nurse-physician collaboration included the departments, professional title, and the 4 dimensions of nurse-physician interpersonal exchange. Conclusion: The nurses' perceptions of nurse-physician collaboration was at a moderate level. In order to improve nurse-physician collaboration, it is necessary to pay attention to the related factors, including departments, professional title and nurse-physician interpersonal exchange.

Objective: To investigate the immunosuppressant therapy barrier of renal transplant patients and its influencing factors. Methods: A total of 181 patients with renal transplantation who met the inclusion criteria in a tertiary grade A hospital in Changsha were recruited as subjects between June and November of 2017. General information questionnaire and the Chinese version of Immunosuppressant Therapy Barrier Scale (ITBS) were used to collect data. Results: Renal transplant patients showed different degree of immunosuppressant therapy barrier. The total score of immunosuppressant therapy barrier score was (29.03±7.01), among which the uncontrollable factor dimension score was (19.00±4.68), and the controllable factor dimension score was (10.03±3.21). Among the influencing factors of therapy barrier, the time of transplantation, the age and educational level of patients were statistically significant. Conclusion: After renal transplantation, patients are facing a certain degree of immunosuppressant therapy barriers. The most common immunosuppressant therapy barrier is the high frequency and large amount of taking immunosuppressant. Patients who are younger, with lower educational level and have longer post-transplantation experience have more immunosuppressant therapy barriers than others.

Objective: To investigate the status of mindfulness of Persons Living with HIV/AIDS (PLWHA) and analyze the influencing factors. Methods: Totally 224 cases of PLWHA admitted to infectious department of our hospital were investigated by the general situation questionnaire, Mindful Attention Awareness Scale (MAAS), Berger HIV Stigma Scale (BHSS) and Perceived Social Support Scale (PSSS). Results: The MAAS scale score of PLWHA was 49.78±8.74; the educational level, the course of disease, the total score of BHSS, and the total score of PSSS were the influencing factors of the MAAS scale, which could explain 36.6% of the total variation. Conclusion: The level of mindfulness of PLWHA needs to be improved. Clinicians can take targeted nursing interventions, reduce the level of perceived stigma, and improve the level of social support, thus improving the level of mindfulness.

Objective: To analyze the effects of high-low frequency conversion auditory-exercise training on subjective sleep and objective sleep-wake behavior in patients with cerebral hemorrhage. Methods: Totally 135 patients with cerebral hemorrhage and sleep disorders in the neurology department from November 2017 to November 2018 were randomly divided into three groups, and 45 cases in each group. The control group were with daily routine nursing care, and the music group were with regular music training on the base of routine care, and the auditory-exercise training group were with high-low frequency conversion auditory-sports training on the basis of routine care. The intervention was continued for 30 days, and the Pittsburgh sleep quality index (PSQI) and polysomnography (PSG) were used to monitor subjective sleep and objective sleep-wake of patients, and the differences of PSQI and PSG before and after intervention in the three groups were compared. Results: The PSQI of patients in the auditory-exercise training group were lower than those in the other two groups (P<0.05), and the quality of sleep was improved after the intervention. The deep sleep time of patients in the hearing-exercise group was longer than those in the other two groups after intervention (P<0.05); the number of micro-wakes during non-rapid eye movement sleep of patients in the auditory-exercise training group was lower than those in the other two groups (P<0.05). Conclusion: Auditory-exercise training through high-low frequency conversion can improve the sleep quality of patients with cerebral hemorrhage and sleep disorders, optimize sleep structure, and maintain normal sleep-wake behavior.

Objective: To investigate the health beliefs and feeding behaviors in primary caregivers of infants and young children aged 6-24 months, to analyze the main related factors of them, and to provide scientific references for feeding behavior interventions. Methods: A survey was conducted among 570 primary caregivers of infants and young children aged 6-24 months with a self-designed caregivers' feeding related health beliefs scale and a feeding behavior scale. Results: The total score of caregivers' health beliefs was 74.62±6.45. The dimension with the highest score was "perceived feeding benefits" (4.30±0.57), while the dimension with the lowest score was "perceived feeding barriers" (2.85±0.70). For the behavior promoting factors, "peer parenting communication" got the highest score (4.58±0.91), and "to hire baby care professionals" got the lowest score (3.02±0.56). The median of total feeding index failed to meet the eligible standards. The total score and score of each dimension of health beliefs were strongly correlated with the feeding behaviors. Conclusion: The feeding behaviors of caregivers for infants and young children aged 6-24 months need to be improved. Promoting the feeding health beliefs of caregivers may be benefit to strength the right feeding behaviors and to improve the quality of feeding for infants and young children.

Objective: To investigate the problems and needs of home caregivers of the elderly with moderate to severe dementia. Methods: A total of 401 home caregivers of the elderly with moderate to severe dementia from 12 provinces were recruited to complete a self-designed questionnaire. Results: The top 5 safety risks among the elderly with moderate to severe dementia were irritating cough (30.2%), falls (28.4%), outreach (27.2%), lost (19.0%), and falling of bed (12.2%). The major problems reported by home caregivers were daily care (82.5%) and psychological behavior problems (51.9%). The top five caregivers' needs were caregiver's psychological adjustment skills guidance (88.5%), mental behavior response skills guidance (75.8%), daily life care skills guidance (73.1%), safety risk prevention skills guidance (72.8%), and community case management and referral services (70.8%). The top five ways to access support services were online training (86.5%), online counseling (86.0%), face-to-face counseling (84.0%), handbooks (78.8%) and community-based lectures (74.6%). Conclusion: Demented elderly home caregivers have diversified needs. It is recommended to take care of the needs of caregivers and use a variety of online and offline channels to integrate skills guidance, education and direct care services into a support system for demented elderly care.

Objective: To understand the current situation of organizational innovative atmosphere of nursing students and explore its influencing factors. Methods: Totally 411 nursing students were surveyed by Organizational Innovative Atmosphere Scale, Nursing Professional Commitment Scale and Knowledge Sharing Scale. Results: The total score of organizational innovative atmosphere, nursing professional commitment, and knowledge sharing was (73.80±10.70), (81.14±14.06) and (25.85±4.52) respectively. Multiple linear regression showed that the influencing factors were the willingness to share knowledge, the behavior of knowledge sharing, the willingness to make professional efforts, the recognition of professional value, and attending innovative courses or trainings (P<0.05). Conclusion: The level of innovative atmosphere of nursing students' organizations is slightly higher than the average level. Nursing educators and administrators of nursing colleges should enhance the innovative atmosphere of nursing students' organizations according to the influencing factors.

The training of palliative care nurse specialists not only conforms to the national health policy, but also promotes the well-being of people and the advancement of nursing. Therefore, a curriculum system including 6 main modules and 17 sub-modules was established by the Palliative Care Nurse Specialist Training Base in Hunan to train and develop palliative care nurse specialists. Clinical practice training connecting hospital, community and home (HCH) has been carried out in light of the curriculum system. As a consequence, the management of trainees and teachers became standardized and the core competencies of palliative care nurse specialists were improved so as to guarantee that nurses could do more and better in palliative care to boost the development of palliative care.

This paper reviews the presenteeism among foreign nurses, introduces the concept, the assessment tools, the incidence and impact of presenteeism in nurses, and explores the influencing factors of presenteeism behavior of foreign nurses from the individual and work level, and points out the limitation of current research. It is to provide reference for further research and management of presenteeism among nurses in China.

Objectives: To investigate the experiences of the nurses as the second victims after the adverse events. Methods: The convenient sampling method was applied. Totally 258 nurses from two general hospitals in Sichuan were included. The Second Victim Experience and Support Tool (SVEST) and Adverse Event Characteristics Questionnaire (AECQ) were performed in this study. Results: The score of the distress was (3.22±0.93), the organizational support was (2.59±0.56), turnover intentions was (3.38±1.26), absenteeism was (2.85±1.14), non-work-related support was (2.18±1.03) respectively. The variables that could explain the variation of dependent variables were the absenteeism (6.3%), organizational support (4.7%), non-work-related support (2.5%) and turnover intentions (1.6%). Conclusion: Nurses experience second victim distress after the adverse events, but they only accept low level support from the working environment. Hospital managers should provide high level of organizational support and professional psychological counseling to nurses in order to promote the nurses health.

In order to improve the quality of nursing services and enhance nursing service capabilities in the primary hospitals, Wuxi Hospital Association has organized management experts and professional specialists from the tertiary hospitals to the primary hospitals. Experts regularly visited the primary medical institutions and provided management and professional instructions. Within 5 years, the heads of the nursing departments of 8 tertiary hospitals were sent to 16 primary hospitals to provide guidances. The quality of nursing services in the primary hospitals have achieved high level.

Objective: To select, assess and summarize the available evidences on prevention of Noninvasive Ventilation (NIV) related Pressure Injuries (PI). Methods: We searched the Registered Nurses' Association of Ontario (RNAO), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), Medlive.cn, British Medical Journal Best Practice (BMJ Best Practice), UpToDate, Cochrane Library, Joanna Briggs Institute Library, PubMed, Embase, CNKI, WanFang Data, European Pressure Ulcer Advisory Panel (EPUAP), Wound Ostomy and Continence Nurses Society (WOCN), European Respiratory Society (ERS), Minnesota Hospital Association to collect literatures including guidelines, systematic reviews and consensus. The JBI evidence appraisal and recommendation system was used to evaluate the quality of studies and the level of evidence. Results: 6 references were retrieved including 2 guidelines, 1 evidence summary, 2 systematic reviews and 1 consensus. A total of 23 items of evidences were summarized with regard to identifying risk factors and locations, choosing adequate interface, assessing skin regularly, pressure distribution, using prophylactic dressings, etc. Conclusion: Healthcare workers are supposed to normalize management over noninvasive ventilation equipments and avoid the occurence of pressure related injuries to ensure the safety of patients according to correspondent evidences summarized as well as taking the specific conditions of hospitals into consideration.

This article reviews the research progress of neonatal fall, and introduces the definition, occurrence status, harmfulness, influencing factors, preventive measures and post-fall treatment process of neonatal fall, aiming to provide a basis for the research and management of neonatal falls.

Clinical Care Classification (CCC) system is a clinical care classification system developed on the basis of the Home Health Care Classification system. CCC is composed of nursing diagnosis, nursing measures, and nursing outcomes. It consists of 21 care elements covering four aspects: physiology, psychology, function and health behavior. CCC follows the nursing procedure and covers the whole process of assessment, diagnosis, outcome identification, planning, implementation and evaluation. CCC can be widely applied to patient classification and valuation, nursing plan, clinical decision support, nursing scientific research and nursing education, workload measurement, performance, cost-benefit analysis, and electronic records of nursing documents.

Objectives: To explore the effect of one-stop rapid pre-operative preparation mode in patients undergoing total joint arthroplasty. Methods: Retrospective cohort study was conducted. Patients with joint replacement surgery from December 2017 to May 2018 were assigned as the control group, and patients from June to November 2018 as the experiment group. The control group followed the traditional admission procedure and preoperative preparation mode. The experiment group implemented a one-stop quick preoperative preparation mode, which included setting up a combined hospital enhanced-recovery surgical outpatient clinic, putting forward the pre-operative examination, carrying out pre-hospital health screening and treatment by medical and nursing team for patients undergoing total joint arthroplasty. The average hospital stay, unplanned discharge rate, hospitalization satisfaction of the two group were compared. Results: Patients in the experiment group had lower average hospital stays [0~8(5.68±0.86) d vs 0~10 (6.83±1.24) d], lower unplanned discharge rates (4.9% vs 15.6%), and improved hospitalization satisfaction [ (94.39±4.32) points vs (92.30±4.89) points] than the control group, the differences between the two groups were statistically significant (P<0.05). Conclusions: One-stop rapid pre-operative preparation mode can improve the hospitalization service flow, reduce the unplanned hospital discharge rate and improve satisfaction rate and medical experience of the patients.

Spontaneous hypothermia is an independent predictor of poor prognosis and mortality in trauma patients. This article reviews the definition, incidence, risk factors and interventions of spontaneous hypothermia in patients after trauma, aiming at providing evidence for future clinical practice and research.

The review summarizes the research progress of orthostatic hypotension in early post-spinal surgery, and introduces the mechanism and causes of orthostatic hypotension in early postoperative patients with spinal surgery and the current nursing interventions to prevent this symptom. Analyze and summarize the problems existing in the current research and put forward corresponding suggestions, in order to provide reference for the prevention and research of complications of postoperative early-bed-out activities in patients with spinal surgery in China.

This article summarizes the development of cardiac rehabilitation in patients undergoing Percutaneous Coronary Intervention, focusing on the importance and content of cardiac rehabilitation care. Mainly summarized the aspects of exercise, psychological intervention, medication management, health guidance, etc., to provide a theoretical basis for clinical rehabilitation of cardiac rehabilitation.

Through the review of Chinese and foreign literature, this paper expounds the conceptual evolution, research progress and related influence of dementia worry, introduces the evaluation tools of dementia worry and analyzes the related factors of dementia worry, including sociodemographic, psychological and cognitive factors, aiming to provide reference for further research.

The paper provides a comprehensive review of the literature on the concept of dyadic coping, evaluation tools and their application in depressive pregnant women and their spouses, and aims to provide a reference for the dyadic coping intervention in depressive pregnant women and their spouses in China.

The mindfulness-based interventions during pregnancy have been proven to improve the physical and mental health of pregnant women. However, domestic research is still in its infancy. The article will summarize the origin and connotation of mindfulness and the classification and main content of mindfulness-based intervention programs as well as its application and effects on pregnant women, so as to summarize the shortcomings of existing research and propose directions for the future and provide a theoretical basis for further domestic research.

Based on the apathy model created by Massimo, this paper reviewed the influencing factors of apathy in dementia from patient, nursing staff and environmental factors to discover the advantage and disadvantage of existing studies, and to provide reference for clinician developed effective non-drug therapy intervention to improve apathy in patient with dementia in China.

This article reviews the Fear of Progression (FoP) from the clinical characteristics of FoP, the distinction of concepts, theoretical framework and intervention strategies, to provide a theoretical reference for further nursing intervention in China.

This paper reviews the nursing evaluation of patients' thirst from the related concepts, the etiology-based mechanism, the measurement scales for assessing patients' thirst, objective signs, examination indicators and so on, to provide reference for nursing practice in assessing patients' thirst and the development of patients' thirst assessment measurements in China.

The prevention and treatment of stroke is an important health care issue in China. Stroke certified registered nurses play an indispensable role in the prevention and treatment of stroke. This paper shares the experience of the Nurse Practitioner in leading Mobile Stroke Unit team for acute stroke patients' early medical treatment, and aims to provide a reference for the development of stroke specialist nurses in China.

To introduce the Clinical Scene Investigator training project of the American Association of Critical-care Nurses (AACN) from the aspects of project background, content, evaluation and achievements. We should learn from the experience, carry out relevant courses for nurse leadership change, and encourage the implementation of change projects such as continuous improvement of clinical nursing quality and application of evidence.