Objective: To investigate the incidence and risk factors of unplanned readmission in elderly patients with ischemic stroke, and to develop the risk prediction model. Methods: Totally 328 elderly inpatients with ischemic stroke in the neurology ward of a tertiary hospital in Beijing were recruited from September 2018 to October 2019. The general information survey questionnaire and the Readiness for Hospital Discharge Scale (RHDS) were used for the questionnair survey, and the patients were followed up to 31 days after discharge. Results: Totally 52 patients (15.9%) were readmitted. Marital status, smoking, hypertension, hyperlipidemia, atrial fibrillation, ADL score, hospitalization days, and RHDS score were independent risk factors for unplanned readmission in elderly patients with ischemic stroke (P<0.05), AUC was 0.995, the maximum value of the Youden index was 0.790, and the sensitivity was 94.2%, the specificity was 84.8%, and the cutoff value was 0.148. Conclusion: The risk prediction model of unplanned readmission in elderly patients with ischemic stroke established in this study was with a good predictive effect, and it could be used in early identification of those elderly with high-risk in unplanned readmission.

Objective: Comprehensive Geriatric Assessment (CGA) was used to evaluate the incidence of dysphagia in inpatients aged over 80 and to analyze its risk factors. Methods: Inpatients aged over 80 years admitted to geriatric department in a tertiary hospital in Wuhan were included by convenience sampling from December 2018 to September 2020. Watian drinking water test, polypharmacy, activities of daily living, Mini-Mental State Exam, Geriatric Depression Scale, Mini Nutritional Assessment Short Form, Fried frailty criteria, grip strength, upper arm circumference and calf circumference were used in the CGA. Logistic regression analysis was used to analyze the risk factors of dysphagia. Results: Totally 110 hospitalized patients aged 80 and above were included, and the overall incidence of dysphagia was 70.9%. The multivariate analysis showed that polypharmacy, malnutrition, weaker grip strength and less upper arm circumference were risk factors for dysphagia in elderly inpatients, OR were 35.267, 18.985, 0.843, 0.740, respectively (P<0.05). Conclusion: The incidence of dysphagia was relatively high in elderly inpatients. CGA should be carried out early to screen the risk factors of elderly patients with dysphagia. It's necessary to take some interventions to improve swallowing function, prevent complications, and improve the quality of life for elderly inpatients.

Objective: To develop the assessment index system for the demand of discharge planning of elderly inpatients, and to provide references for early identification of elderly patients with high demand in transitional care. Methods: Through literature research, Delphi method and analytic hierarchy process, the framework of the assessment index system for the demand of discharge planning of elderly inpatients and the weight value of each assessment index were constructed. Results: The recovery rates of the two rounds of Delphi expert consultation were 100% respectively and the authoritative coefficients of experts was 0.929. After 2 rounds of expert consultation, the variation coefficients of each first-level index ranged from 0.06 to 0.21, and the coefficient coordination was 0.208, the variation coefficients of each second-level index ranged from 0 to 0.20, and the coefficient coordination was 0.140. Finally, the assessment index system contained 9 first-level indicators and 34 second-level indicators. Conclusion: The assessment index system for the demand of discharge planning of elderly inpatients can provide unified standard for clinical nurses to assess the demand of discharge planning, and can early identify the elderly patients with high demand in transitional care.

Objective: To explore the effect of multidisciplinary teamwork-based Enteral Nutrition (EN) management model in elderly patients with multimorbidities. Methods: The elderly patients with multimorbidities in neurolgy department were included and divided into a control group and an observation group, and the multidisciplinary teamwork-based EN management model was implemented in the observation group. Results: The start-up time of EN in the observation group was shorter than that in the control group (P<0.001), the incidence of feeding interruption was lower than that of the control group, and the control rate of 7-day feeding was higher than that of the control group (P<0.05); the level of Hb, Alb and CRP after 14 days was better than those in the control group (P<0.001); the incidence of diarrhea, vomiting, and aspiration in the observation group were lower than those in the control group (P<0.05). Conclusion: Multidisciplinary teamwork-based EN management model in elderly patients with multimorbidities was beneficial to improve the early initiation of EN and control the nutrition-related indicators. Nurses working in their full role in the team could beneficial to improve EN tolerance and reduce the complications.

Objective: To explore the effects of intellectual technology-based nursing strategy in nursing work in geriatric ward. Methods: An intelligent nursing system that included central information large screen, central intelligent monitoring system, intelligent companion system, intelligent infusion monitoring system, intelligent engine and knowledge base system and other intelligent was used in geriatric ward, and the application effect was evaluated. Results: After the application of intellectual technology-based nursing strategy, the incidence of nursing adverse events and restraint rate in geriatric ward decreased (P<0.05); the quality of clinical care, the patient and family satisfaction and nurse satisfaction increased (P<0.05). Conclusion: The application of intellectual technology-based nursing strategies in geriatric ward is benefit to optimize the traditional nursing workflow, and improve the quality of nursing care, nursing safety, patient and nurse satisfaction.

Objective: To investigate the cognition, attitude and behavior about colorectal cancer and the screening of colorectal cancer and its relevant factors among first degree relatives of hereditary colorectal cancer patients in Guangzhou. Methods: Totally 274 subjects were investigated by a self-designed demographic questionnaire and the Chinese version of Cognitive Questionnaire for Colorectal Cancer and were analyzed by chisquare test and logistic regressive. Results: There were 165 cases (60.2%) had a high level of cognition about colorectal cancer, 65 cases (23.7%) had middle level of cognition about colorectal cancer and 44 cases (16.0%) had a low level of cognition about colorectal cancer. 144 cases (52.6%) had positive attitude about colorectal cancer screening. 63 cases (23.0%) had accept colorectal screening. Multivariate logistic regression analysis showed that colorectal cancer cognition, index patiemt's diagnosis, age, sex, marital status, medical insurance and suffering from chronic diseases were related to the factors of behavior about colorectal screening (P<0.05). Conclusion: The level of cognition about colorectal cancer among first degree relatives of hereditary colorectal cancer patients was a little high. However their screening rate of colorectal cancer was low. Medical staff should pay attention to relevant factors and develop targeted intervention to improve the level of cognition among first degree relatives of hereditary colorectal cancer patients and to promote their screening behavior.

Objective: To construct PICC risk early warning self-assessment indicators for home-based cancer patients to help them identify PICC risks and provide early interventions. Methods: The items and classifications of PICC risk early warning self-assessment indicators were preliminarily drafted by the task group of vascular access through literature review and finally determined by expert consultation with 15 clinical and nursing experts in the vascular access field. Results: Nine high-risk, six medium-risk and four low-risk early warning self-assessment indicators were determined for home-based cancer patients. The experts’ positive coefficient was 100.0%, the authority coefficient was 0.96, the coordination coefficient was 0.181, and the variation coefficient ranged from 0 to 0.304. Conclusion: The PICC risk early warning self-assessment indicators for home-based cancer patients was scientific and applicable. They can provide a scientific early warning self-assessment system for home-based cancer patients.

Objective: To investigate the effect of online and offline rehabilitation intervention on the function of upper limb and body image among patients with breast reconstruction after breast cancer surgery. Methods: Convenience sampling was applied and a total of 117 cases of postoperative breast reconstruction patients who underwent surgery in the department of plastic surgery for breast cancer were recruited from January 2017 to January 2019. Potential participants were randomly divided into the intervention group (n=59) or control group (n=58). Patients in the control group received routine nursing care. The intervention group received online and offline rehabilitation intervention mode on top of routine nursing practice. The DASH simple upper limb function assessment scale was used to evaluate the upper limb function of the patients, and the body image self-rating scale and quality of life scale for breast cancer patients were used to evaluate the body image and quality of life of the patients. Data collection were conducted at 2-week and 12-month after surgery. Results: The results showed that 12 months after the operation, the upper limb function, quality of life and self-evaluation of body image in the intervention group were significantly improved than those in the control group, with statistically significant differences (P<0.05). Conclusion: The online and offline rehabilitation intervention can promote the rehabilitation of upper limb function, and improve the body image level and quality of life of patients with breast reconstruction patients after breast cancer surgery.

Objective: To develop a scale to assess the core competence of master prepared nurses and to test the reliability and validity of the scale. Methods: The initial scale was formulated by literature review and Delphi expert consultation. Totally 210 graduates of Master of Nursing Specialists were selected by purposive sampling to examine the reliability and validity of the scale. Results: The scale consisted of 5 dimensions and 48 items. The exploratory factor analysis showed the cumulative contribution rate was 71.208%. The content validity of the scale was 0.986, the Cronbach's α coefficient was 0.977, and the split-half reliability was 0.878. Conclusion: The Core Competence Scale has been suggested to be reliable and valid for assessing core competence of graduates of Master of Nursing Specialists.

Objective: To study the current situation and influencing factors of needlestick injuries among pediatric nurses in China. Methods: A total of 12 707 pediatric nurses in 100 hospitals from 27 provincial administration units across the country were included in this retrospective survey. Results: The incidence of needlestick injuries in pediatric nurses was 7.9%, and 75.9% of these needlestick injuries were not reported to the hospital in writing. In total, 37.9% needlestick injuries occured in the process of collecting, arranging, and classifying the items at work station, with the highest incidence. The related factors of needlestick injuries in pediatric nurses included departments of working, years of working , nursing positions and titles. The results of multiple linear regression analysis showed that the average number of patients required to perform superficial vein puncture per day was the influencing factor of needlestick injuries in pediatric nurses. Conclusion: The incidence of needle stick injury is high in pediatric nursing in China. The nursing managers should implement the prevention education of needlestick injury, form different training programs according to the different level of nurses, and establish a complete and convenient reporting system for needlestick injuries. Those nurses and processes with a higher incidence of needlestick injuries are the key objects to be paid attention to.

Objective: To investigate the status of functional independence in patients with Post-Stroke Urinary Incontinence (PSUI) and its effect on social participation, quality of life and psychological status. Methods: Totally 153 inpatients from rehabilitation departments or neurology departments of 8 hospitals of different grades in Nanjing were selected. The patients were investigated by using general data information questionnaire, Function Independence Measure, Incontinence Quality of Life Questionnaire, Impact on Participation and Autonomy Questionnaire and Self-rating depression scale. Results: The scores of FIM was (62.03±26.61). Hierarchical regression showed that functional independence independently accounted for 57.3% of the variation in social participation, 17.0% of the variation in quality of life, and 15.9% of the variation in depression. Conclusion: The functional independence of patients with PSUI is poor. Functional independence reduces the quality of life and social participation level of patients and aggravates the negative emotions of patients. Medical staff should pay attention to the bladder rehabilitation training of patients with PSUI, so as to improve the functional independence of patients.

This paper discussed the construction and implementation of the emergency nursing specialist care support for health disparity alleviation at the Renmin hospital, in Wufeng Tujia nationality autonomous county in Hubei province. We also described the process, guarantee mechanism and effect of care support in health disparity alleviation, as well as the strategies for precise care support. This study will assist health care providers at the country level hospitals to promote and develop the emergency nursing specialist care support system, therefore explore the scope of the care support in alleviating health disparity.

Objective: To analyze the work experience of practicing "Internet + nursing services" for nurses in Xinjiang. Methods: The phenomenological research method of qualitative research was employed. We conducted face-to-face semi-structured interviews with twelve nurses from a certain Level Three Grade A hospital in Xinjiang region who had work experience of "Internet + nursing services". Seven-step phenomenological data analysis method by Colaizzi was used to analyze the interview data and extract the themes. Results: Nurses' work experience of "Internet + nursing service" in Xinjiang can be summed up into four main themes: ①Nurses had a clear intention to practice "Internet + nursing services" and had good working experience;②"Internet + nursing services" was widely recognized and accepted by patients and their family members of various ethic groups; ③Giving full consideration to ethnic characteristics and needs was the main issue when the "Internet + nursing services" was carried out in Xinjiang region; ④Nurses practicing "Internet + nursing services" hoped to make an improvement in their comprehensive skills, especially the communication skills with minorities and the independent problem-solving skills when practicing in remote areas. Conclusion: "Internet + nursing services" is acknowledged by medical staff and patients, which proves the professional value of nurses. At the same time, the current development of "Internet + nursing services" also needs to adapt to the regional characteristics and local culture of Xinjiang so as to promote the long-term development of "Internet + nursing services" in Xinjiang.

A series of drug withdrawal symptoms usually appear in newborns who are exposed to opioids before birth, which is called Neonatal Abstinence Syndrome (NAS). In recent years, the incidence rate of NAS has increased significantly. The new nursing mode focusing on non-pharmacological intervention and ward management has become more and more important in the treatment of neonatal abstinence, which can significantly shorten the length of hospital stay and reduce the use of drugs. This review will explore the management of NAS, review its development history, scoring tools, different management methods, and summarize suggestions to improving neonatal care for NAS.

Objective: To investigate the effects of workplace mindfulness on job burnout and psychological stress of nurses who took care of patients with COVID-19. Methods: From January 2020 to February 2020, 120 nurses who provided bedside care to patients with COVID-19 were selected to participate in the study. The job burnout questionnaire (MBI-GS), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate the job burnout and psychological stress before and after the intervention. Results: After the implementation of workplace mindfulness intervention, scores of job burnout, HAMA and HAMD of 120 nurses were significantly lower than those before the implementation, with statistically significant differences (P<0.05). Conclusion: Workplace mindfulness intervention can effectively decrease job burnout and psychological stress of nurses who took care of patients with COVID-19. It is of great significance to promote the physical and mental health of the clinical anti-epidemic first-line nurses and relieve their occupational and work stress.

Objective: To summarize and discuss the construction and management of medical flow directions in the infection ward in Wuhan Huoshenshan Hospital during COVID-19 pandemic. Methods: Within a limited time period, a medical team of Wuhan Huoshenshan Hospital quickly divided the infected areas into the following three areas: polluted, potential polluted and clean area. They set up flow directions for personnel, materials and medical waste, and established a complete set of protective measures and management mechanism. Results: After 2 months' operation, the established medical flow directions and related management mechanism met the requirements of prevention and control for COVID-19, achieved high-quality and efficient treatment goal of patients and "zero infection" of medical staff. Conclusion: The process and system design for the construction and management of medical flow directions in Wuhan Huoshenshan Hospital are safe and reasonable, which is expected to play a reference role in the prevention and control of similar public health emergencies in the future.

Objective: To investigate the psychological states of ICU nurses who participated in the treatment of COVID-19 at different stages. Methods: Purpose sampling method was applied. Twelve ICU nurses who participated in the treatment of COVID-19 were interviewed using semi structured interview. Data were analyzed using content analysis. Results: Nurses showed excitement, nervousness and self-confidence when receiving the task to Wuhan. From arriving at the task area to the first four weeks of work, they felt fear, anxiety, helplessness and difficulties. From the fifth week of performing the task, they expressed homesickness, fatigue, indifference, confidence, emotion and gratitude. Conclusion: The psychological states of ICU nurses participated in the treatment of COVID-19 are different at different stages. Nursing managers should provide enough support to ICU nurses during public health emergencies. It is important to assist nurses to actively respond to the challenges in order to improve the quality of life of the patients.

Objective: To assess the application effects of grid management strategies towards medical auxiliaries in a general hospital during the anti-epidemic period of Corona Virus Disease 2019 (COVID-19). Methods: Medical auxiliaries were management objects in this research. Management effects were traced and evaluated by establishing grid infection control team, defining responsibilities, refining content and conducting grid management strategies. Results: After one-month use of grid management strategies in the prevention and control of hospital infection, staff management score increased from 3.00±1.41 to 4.17±0.75, manual skill score increased from 3.50±1.38 to 4.67±0.52, theoretical knowledge score increased from 3.63±1.30 to 4.60±0.60, total score increased from 3.40±1.31 to 4.60±0.60. All these differences were statistically significant (P<0.05). Conclusion: During anti- epidemic period of COVID-19, grid management strategies towards medical auxiliaries could raise their awareness of infection prevention and control, and increase their manual skills. In addition, strategies used in this study could urge medical auxiliaries to strictly obey prevention and control measures to decrease or avoid the occurrence of cluster transmission and nosocomial infection. Meanwhile, they could strengthen the connotation construction of nursing unit management.

Objective: To summarize the evidence regarding functional exercise for stroke survivors and provide implications for clinical practice. Methods: We searched databases and resources of evidence-based medicine to collect the evidence, including guidelines, systematic reviews, expert consensus regarding functional exercise in stroke survivors. Results: A total of 8 guidelines, 4 systematic reviews and 1 expert consensus were included. Then 20 evidences were extracted and categorized into 7 dimensions, including organization, evaluation method, exercise time, exercise intensity, exercise strategies, health education and follow-up. Conclusion: This study summarized the evidence of functional exercise for stroke survivors, and provided implications for clinical practice, which has the potential to standardize functional exercise and improve the quality of nursing practice.

Objective: To develop blood glucose management strategies to standardize nurses' practice and reduce the incidence of neonatal hypoglycemia. Methods: The maintenance strategies were preliminarily established by searching the databases and synthesizing the evidence. Literature appraisal was done. Then the Delphi method was used to make the strategies localized. Result: A total of 213 articles were retrieved in this study and 9 articles were included. Four dimensions with 31 strategies were established, including "prevention and identification hypoglycemia", "accurate measurement of blood glucose", "screening/monitoring and treatment", and "discharge and education". Conclusion: The blood glucose management strategies based on the evidence and Delphi method was scientific and practical and it was beneficial to standardize the management of neonatal hypoglycemia.

This article summarized the application of the smart bracelet as activity monitors in early postoperative mobilization from the aspects of accuracy, effectiveness, feasibility and practicability, in order to provide reference for clinical practices and related research.

Objective: To develop a pain control management platform for patients after hepatobiliary surgery by using Virtual Reality (VR) technology, and to explore its application effects. Methods: 110 patients with selective hepatobiliary surgery were recruited and divided into experimental group and control group by the sequence of admission and random number table. The control group received the routine nursing care, while the experimental group was intervened at five times of postoperative pain with the help of postoperative pain control management platform in addition to the routine nursing care. The Numerical Rating Scale (NRS) was used to assess the pain at 12 h, 24 h, 48 h, 60 h and 72 h after the surgery. The pain scores, the first time of getting out of bed, the first time of anal exhaust and the sleep duration after the surgery were compared between the two groups. Results: NRS scores of the experimental group were significantly lower than those of the control group (P<0.05). The first time of getting out of bed after the surgery for the experimental group and for the control group was (8.38±2.02) h and (11.06±2.41) h, respectively. The first time of anal exhaust after the surgery for the experimental group and for the control group was (9.44±3.97) h and (12.60±2.80) h, respectively. The sleep duration after surgery for the experimental group and for the control group was (7.87±2.19) h and (6.13±2.13) h. All of the differences were statistically significant (P<0.05). Conclusion: Virtual Reality pain control management platform can effectively and significantly reduce the pain of patients and accelerate the recovery of patients.

This paper aims to review the application of robots in children with Neurodevelopmental Disorders regarding the classification, application and demand of robots, and provides reference for the nurses' application of robots in the care and rehabilitation of children with Neurodevelopmental Disorders.

Objective: To analyze the effect of narrative nursing clinical practice on improving the quality of humanistic care of psychiatric nurses. Methods: From July 2018 to October 2019, using a convenient sampling method, 341 nurses from a tertiary psychiatric hospital in Beijing were selected as the research objects. A one-year narrative nursing project was implemented and evaluated by Nursing Caring Characters Assessment Tool (NCCAT). Results: After the implementation of the narrative nursing project, the total score of humanistic care quality and the scores of each dimension were significantly higher than those before implementation (P<0.05). Conclusion: Developing clinical practice based on narrative nursing can effectively improve the humanistic care quality of psychiatric nurses, and then promote the improvement of their nursing quality.

Objective: To investigate the status of core midwifery competencies of midwives. Methods: A total of 432 midwives in 27 hospitals above Grade Two in Anhui province were investigated by using the Midwife Core Competency Scale. Results: The average score of core midwifery competencies was 3.94±0.60. Midwives' competency for pregnancy and labor and delivery care had the highest score, while their competencies for newborn care and public health care as well as pre-pregnancy care were relatively low. There were significant positive correlations between core midwifery competencies and individual factors of age, years of clinical work, years of midwifery practice, professional title, hospital grade, marriage status, graduated major, education, format of compilation, position, participation in teaching or not and obtainning maternal and infant qualification certificate. Conclusion: The overall midwifery competency level among Anhui province midwives are good, however, there are still obvious differences in the level of development in all aspects. The professional midwifery education system in China should be further improved. Hospital managers should implement specific training and management strategies according to the current status of midwives' competence, to give full play to the role of midwives, so as to promote the comprehensive improvement of midwives' core competence.

Objective: To establish an "1+1+1" training system for newly appointed head nurses and to explore its effect. Methods: Based on the current situation and requirements of the core competencies of newly appointed head nurses, an "1+1+1" training system was established through literature review, expert discussion and validation. A total of 15 new head nurses employed in 2017 participated in this one-year systematic training which included "one-week concentrated theoretical training + one-week shadowing in clinical practice + one-year one on one mentoring". To evaluate the implementational effect of the training system, the core competence score and satisfaction of the training system were collected using questionnaires. A self-evaluation among head nurses was also conducted by semi-structured interview. Results: The core competence score of the head nurses was greatly improved after completion of the systematic training (P<0.05). The overall satisfaction score of newly appointed head nurses was 38.33±2.44. The results of qualitative interviews showed that the training system was reasonable, increased new head nurse's learning interest and promoted their role transformation. Conclusion: The "1+1+1" training system for newly appointed head nurses effectively improves their core competencies, promotes their role transformation, and increased their administrative capability.

Objective: To explore the applicability of the Acute Physiology And Chronic Health Evaluation II (APACHE II) and modified the Nursing Activities Score (NAS) among hospitalized patients in prediction of nurse staffing allocation in the adult Neurology Intensive Care Units (ICU). Methods: Totally 314 cases in the Neurology ICU were estimated using APACHE ?II and modified NAS to predict the demands for nurse staffing. The predicted nurse staffing were compared with the actual nurse-patient ratio in the unit. Results: Significant differences were found between the actual and predicted nurse-patient ratio according to patients' scores on APACHE ?II and modified NAS. The actual nurse-patient ratio remained was the lowest, the modified NAS prediction was in the middle, while the APACHE ?II prediction was identified as the highest. The APACHE??II prediction of nurse-patient ratio ranged from 0.50?:?1.00 to 1.50?:?1.00; APACHE ?II was more applicable to predict nurse-patient ratio in nurse staffing regard to the care of hospitalized patients with different Glasgow Coma Scale (GCS), different length of hospital stay and different disease diagnosis. Significant differences were found between day sfift and night shift according to modified NAS. Conclusion: APACHE??II can be used to adjust the manpower demand of ICU patients in Neurology ICU when patients are serious, the length of hospital stay is long and there are complications; NAS can be used for human resource allocation in different shifts, especially in daytime and with large amount of basic nursing.

Objective: To explore the effect of standardized strategies for the prevention of ICU bronchoscope-associated Multidrug-Resistant Organism (MDRO) in the whole procedure. Methods: A historical control study was adopted. The patients with artificial airway who received bronchofiberscopy in our ICU were divided into 2 groups, control (from January to December 2017) (n=322) or intervention (from February 2018 to January 2019) (n=330) group. Routine bronchoscopy procedure and reprocessing methods were applied in the control group. While standardized strategies for prevention of ICU bronchofiberscopy-associated MDRO in the whole procedure were adopted the intervention group. The number of MDRO isolated from the sputum culture specimens on the 3rd day after bronchocopy, and the colonization/infection rate of MDRO in lower respiratory tract were compared between the two groups. The compliance of hand hygiene and self-protection measures in healthcare professionals, qualified rate of the knowledge regarding the prevention of bronchocopy-related MDRO were compared between the two groups as well. Results: The total isolation rate of MDRO in the intervention group was significantly lower than that in the control group, χ2=99.326, P<0.001; Acinetobacter baumannii (MDR/PDR-AB) was found higher (3.94%) in the control group than the intervention group (0) (χ2=34.816, P<0.001). The infection/colonization rate in the intervention group was lower than the control group, χ2=19.556, P<0.001; χ2=61.566, P<0.001. The compliance of hand hygiene and self-protection measures of healthcare professionals, as well as the qualified rate of the knowledge of prevention bronchocopy-related MDRO in the intervention group were significantly higher than those in the control group (P<0.05). Conclusion: The standardized strategies for the prevention of ICU bronchofiberscopy-associated MDRO in the whole procedure can reduce the incidence of bronchoscope-related MDRO nosocomial infection.

This article reviewed the adverse consequences of physical restraints in Intensive Care Unit (ICU) and their improvement measures. It is expected to standardize the use of physical restraints in adult ICU and provide information for nursing staff to reduce the incidence and adverse consequences.

This paper described the concept, application, outcome and theoretical basis of painting therapy, focusing on the application of painting therapy in symptom management of patients with malignant tumors. Painting therapy, as an auxiliary medical method to relieve the symptoms of patients with malignant tumors, could relieve the pain experience, anxiety and fear level of patients, improve the depressive symptoms of cancer patients, and relieve cancer-related fatigue. It could help the patients to manage symptoms by non-verbal expression, projecting adverse symptom experience and promoting the production of optimal psychological state. It is expected to provide information for oncology nursing staff to carry out painting intervention related research and clinical practice.

By reviewing the literature of artificial airway microaspiration, the concept, detection methods, influencing factors, clinical management and prevention, this review aims to provide reference for the management of artificial airway patients.

Objective: To explore the effects of discharge preparation service in the perioperative period of breast cancer patients. Methods: This study was a quasi-experiment design. In the control group, 55 breast cancer patients received conventional care and telephone follow-up after discharge from September 2018 to June 2019.In the experimental group, another 55 breast cancer patients received discharge preparation service from July 2019 to April 2020. The discharge readiness, limb swelling, shoulder joint mobility, discharge guidance quality, and the quality of life were compared. Results: The difference in aspect of discharge preparation, quality of discharge guidance, motion of shoulder joint and quality of life between experimental and control group was statistically significant (P<0.001), while no statistically significant difference in the degree of limb swelling (P>0.05). Conclusion: The application of discharge preparation service can effectively reduce the occurrence of postoperative shoulder joint mobility disorder and improve the quality of life of the patients in the perioperative period.

An efficient vascular access is particularly important for successful Therapeutic Plasma Exchanges (TPE). Currently, the most commonly used vascular access devices include peripheral and central venous catheters in TPE. Such two kinds of vascular access have their own characteristics in application and nursing care in TPE. This article reviewed the characteristics, choices and care of complications in this two kinds of vascular accesses. We aimed to provide evidence for clinical nursing and improve the efficacy and safety of plasma exchange.