The traditional nursing performance distribution takes the economic benefits of the department as the assessment content, which does not reflect the value and contribution of nursing. Nursing managers need to establish a scientific and efficient nursing vertical performance distribution system and operation mode to make the nursing system operate optimally. This article introduced the construction of the nursing vertical performance system , implementation of the new system and evaluation of the results. It is expected to provide some ideas for the development of nursing vertical performance management.

In February 2019, the National Health Commission issued the "Internet+Nursing Service" Pilot Work Plan, requiring medical institutions to provide nursing services for discharged patients or special populations suffering from diseases and limited mobility based on information technology such as the Internet. This article introduced the regional three-level linkage home care service model, explained the specific practices of this model and its role and advantages in implementing hierarchical diagnosis and treatment. It is expected to provide information for the further development of "Internet+Nursing Service".

The implementation of nurse post management is the tendency of nursing management development. Since 2012, our hospital has actively explored the scientific practice of nursing post management, post admittance system, post-based payment, right people for the right post, equal payment for the same post, and performance management. It is expected to provide reference for the scientific management and practice of nursing post in China.

This article explored the scientific and refined nursing manpower management mode, the practical demand-oriented nursing post setting and dynamic allocation method. The original management mode of Chang Gung Memorial Hospital was introduced. The vertical nursing management system was performed. The nursing manpower allocation and scheduling, the nurses' job setting and nursing manpower structure configuration was carried on based the work load. After the implementation, the quality of nursing and nurses' satisfaction was improved. It is expected to provide information to nursing managers to meet the clinical service requirements, achieve the hospital refined management, provide high quality of nursing service to patients and improve the nursing staff satisfaction.

Objective: To investigate the status quo of long-term care insurance protection recipients' selection of service items in a pilot area, and to analyze the differences in item selection by care modes and activities of daily living, so as to provide references for the development and improvement of long-term care insurance related policies. Methods: From June to July 2019, a self-designed questionnaire was used to conduct a follow-up survey on the selection status of service items for 81 long-term care insurance protection recipients in this area. Results: The average number of service items recipients chose was 9.02±2.11. There was a statistical significance between different care modes in terms of the number of service items selected and whether or not to choose fourteen of the services such as "assist eating/water and guidance" (P<0.05). There was a statistically significance between different activities of daily living in terms of whether or not to choose "assist to toilet and guidance" (P<0.05). Statistical significance was also found in the selection ratio of related service items for two activities of daily living such as "assist to toilet" and "walking on the flat ground" (P<0.05). Conclusion: The selection of service items for the recipients in the pilot area is greatly affected by policy, care mode and other service supply. It has little relevance to the activities of daily living of recipients. Therefore, in the design of the long-term care insurance system, policies should be used rationally to improve the capacity and the accuracy of service supply.

Objective: To investigate the clinical characteristics of PICC-related upper extremity asymptomatic venous thrombosis in cancer patients, and to provide theoretical basis for the early prevention of venous thrombosis. Methods: A total of 127 cancer patients with PICC catheterization from April 2017 to October 2018 were selected. Doppler ultrasound was used to examine the puncture point, 2cm above the puncture point, 10cm above the elbow fossa and armpit of the upper extremity on the side of the catheter. The examinations were before catheterization and on days 2nd, 7th, 14th, 21st, 28th, 35th, and 42nd after catheterization. Results: The incidence of asymptomatic venous thrombosis was 48.82% and the median time of thrombosis was 3 day. A total of 81 thrombosis were detected in 62 patients, of which deep vein thrombosis accounted for 23.46% and superficial vein thrombosis accounted for 76.54%. The rates of thrombus classification (I, II, III) were 51.85%, 37.04%, 11.11% respectively. Logistic regression analysis showed that ECOG (OR=9.185, 95%CI 4.770-28.262, P<0.001), venous flow velocity (OR=0.577, 95%CI 0.506-0.858, P=0.002) were associated with the development of asymptomatic thrombosis. ROC curve analysis of the risk value of venous flow velocity was 4.78 cm/s (AUC is 0.739, 95%CI 0.649-0.830). Conclusion: The incidence of PICC-related asymptomatic thrombosis in cancer patients is high. It mostly occurs 2-10cm above the puncture site. It is suggested that pre-catheterization screening and intervention measures should be conducted in high-risk population with low activity and venous flow rate ≤4.78cm/s to prevent the occurrence of asymptomatic venous thrombosis.

Objective: To translate the Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS) into Chinese and to analyze the reliability and validity. Methods: After being authorized, the Brislin model was used to translate, back-translate and adjust the culture of the SPLINTS to determine the dimensions and items of the Chinese version. The cluster sampling method was used to select 118 scrub nurses in 4 tertiary grade A hospitals for investigation to verify the reliability and validity of the scale. Results: The Chinese version of SPLINTS contains 9 items and 86 anchoring behaviors. Three common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 62.479%. The confirmatory factor analysis showed that model fit well. The average content validity index (S-CVI/Ave) of the scale was 0.93, and the item-level (I-CVI) content validity index was 0.87-1.00. The Cronbach's α of the SPLINTS was 0.743, the Cronbach's α of the dimensions ranged from 0.632 to 0.757. Conclusion: The Chinese version of SPLINTS shows high reliability and validity, which can be used to evaluate the Non-Technical Skill behaviors of scrub nurses during surgery in China.

Objective: To understand the awareness and importance of patient privacy protection by operating room nurses though developing a patient privacy protection scale. Methods: Through literature review and group meeting, an initial scale for the evaluation of patient privacy protection perception and behavior by operating room nurses was made. Delphi expert consultation method was used to construct the formal scale. Through item distributed, correlation analysis, internal consistency analysis, and factor analysis to screen items of the scale, and conduct reliability and validity tests. Results: The Cronbach's α coefficient of the scale was 0.954, the half reliability was 0.898, and test-retest reliability was 0.997. The content validity index (S-CVI) of the scale was 0.95. Three common factors were extracted through principal component factor analysis. The final formal scale includes 18 items in 3 dimensions. Conclusion: The scale has good reliability and validity, which can provide a quantifiable basis for evaluating the privacy protection level of nurses in operating room.

Objective: To investigate the status and influencing factors of cancer-related fatigue in patients with Hematopoietic Stem Cell Transplantation. Methods: A survey of 200 patients after Hematopoietic Stem Cell Transplantation was performed using the General Information Questionnaire, Cancer Fatigue Scale, and Self-rating Anxiety and Depression Scale. Results: After Hematopoietic Stem Cell Transplantation, cancer-related fatigue score was 25.37±8.40, anxiety standard score was 44.71±7.86, anxiety incidence was 26.5%, depression severity index score was 0.50±0.09, and depression incidence was 41.0%. Multiple linear regression analysis showed that anxiety and depression were the main influencing factors of fatigue, which could explain 46.1% of the total variation. Conclusion: The fatigue level of patients after Hematopoietic Stem Cell Transplantation is high, medical staff can reduce the fatigue of patients after transplantation by screening and intervention of anxiety and depression.

Objective: The competency model of emergency post was used to select the nursing staff to fight against COVID-19 by adjusting the nursing force and optimizing the allocation of nursing manpower in this special period. Methods: According to the requirements of the post competency index in the emergency post competency model, the nurses working on the front line to support Wuhan in fighting against the new epidemic situation, visiting the clinics of the system troops and strengthening the key posts in the hospital were selected, so as to reasonably allocate the manpower, increase the efficiency of first aid. Results: The model could be used to select and mobilize the anti-epidemic nurses, which was highly compatible with the new posts and tasks, and could be put into the posts quickly. Conclusion: The competency model of emergency post provided an objective, standardized and rapid management way for the adjustment and rearrangement of nursing manpower in emergency.

Objective: To evaluate effects of integrative psychological nursing intervention methods based on MPNFS Model in alleviating the psychological stress and job burnout of the frontline nurses in fighting against COVID-19. Methods: Integrative psychological nursing intervention was conducted in 47 nurses who was working in the frontline clinical departments against COVID-19. Psychological Stress Self-Evaluation Test (PSET) Scale and Chinese Maslach Burnout Inventory (CMBI) Scale were used to compare the psychological stress and job burnout of nurses before and after the intervention. Results: The PSET and CMBI scores of nurses decreased significantly after the intervention (P<0.001), and the main clinical manifestations of nurses were effectively alleviated or improved after the intervention. Conclusion: The integrative psychological nursing intervention methods is benefit to alleviate the psychological stress and job burnout of nurses working in the frontline clinical departments against COVID-19, and is helpful for them to maintain physical and mental health.

Objective: To investigate the Posttraumatic Growth (PTG) and its related factors among nursing staff working against COVID-19 in the frontline clinical departments. Methods: By convenient sampling, totally 512 nursing staff working in fever clinics and isolation wards of the COVID-19 were included between February, 2020 to April 2020 in a pointed treatment COVID-19 hospital in Wuhan. A general information questionnaire, and Posttraumatic Growth Inventory (PTGI) were used for online data collection. Results: The total score of PTGI was 64.35±7.24 among nursing staff. Multiple regression analysis showed that the related factors of PTGI included professional titles, education, original working departments, time spending on frontline clinical departments against COVID-19, whether received the training in disaster events, whether with similar working experience in some acute incidence (e.g. SARS), whether had relatives or colleagues being diagnosed with COVID-19, nurse-patient relationship satisfaction, whether with experience in the rescue of critically ill patients (P<0.05), and a total of 42.4% variation were explained. Conclusion: The PTGI among nursing staff in the frontline clinical departments were at a moderate level. It's suggested that psychological crisis intervention for medical staff should be included in the management system of epidemic prevention and control, to guide them to adopt positive coping style and establish the development of positive psychological characteristics.

Objective: To explore the cognitive, emotional and volitional experiences of nurses caring COVID-19 patients who were critically ill. Methods: Giorgi's descriptive phenomenological method was used in the study to analyze data and extract main themes. In-depth interviews were conducted on eleven nurses in the intensive care unit of a designated COVID-19 hospital in Wuhan from February 4th to 29th, 2020. Results: Through data analysis, seven themes were summarized: infection risk, high work intensity, inadequate capacity to respond to public health emergencies, tension and anxiety, guilt and helplessness, problem-centered coping and emotion-centered coping. Conclusion: By analyzing the real experiences of nurses caring critically ill COVID-19 patients in Wuhan, the measures to control psychological stress of nurses was necessary and put out, which could provide references for the development of training system for managers.

This study introduced the composition and practical experience of the emergency response system applied in the emergency department during the epidemic of COVID-19. The system included the cooperation of the whole hospital, staff arrangement and training, drills of the response system, allocation and management of goods and materials as well as environment management of the emergency department. Zero medical staff infection and effective isolation of the infected and suspected patients were achieved due to the implementation of the emergency response system ensuring the emergency management work carried out orderly during the COVID-19 epidemic, which was of great significance to the prevention and control of the epidemic.

Objective: To systematically review and synthesize the evidence on the experience of sexual life in patients with breast cancer. Methods: We searched the following databases including PubMed, The Cochrane Library, Web of Science, EMbase, PsycINFO, CINAHL, CBM, CNKI, WanFang Data, VIP to retrieve all eligible qualitative studies. A meta-synthesis was conducted to synthesize the evidence. Results: A total of 11 studies were included in the final synthesis, with 52 types of identified experiences extracted from the included studies and summarized to three themes (perception of sexual life and need for sexual knowledge; seeking support for sexually related physiological and psychological changes; change in emotional relationships with partners). Conclusions: Health care providers should pay attention to the sexual life and emotional problems of patients with breast cancer, and provide care support, guidance and encouragement during treatment, therefore to improve patients' quality of sexual life, emotional experience, and the overall quality of life.

Objective: To examine the effects of scenario simulation training based on DISC personality in nurses who are flexible in the blood drawing group of an outpatient department. Methods: From April 2019 to February 2020, nurses who met the inclusion criteria were recruited and randomized into the interventional group and the control group with 40 nurses in each group. Nurses in the interventional group received scenario simulation training based on DISC personality, while those in the control group received usual training. The scores of theory and skill examinations, perceived professional benefits, and job satisfaction were compared between the two groups. Results: The scores of theory and skill examinations, perceived professional benefits, and job satisfaction of nurses in the interventional group were significantly higher than those of nurses in the control group (all P<0.05). Conclusion: The scenario simulation training based on DISC personality can improve the comprehensive skills, perceived professional benefits and job satisfaction of nurses who are flexible in the blood drawing group of an outpatient department.

Objective: To analyze the status and influencing factors of nurses' career development in China, and to provide reference for the development of nurses' career development management strategies. Methods: From November to December 2019, a total of 70932 nurses in 23 provinces, 5 autonomous regions, 4 municipalities and 2 special administrative regions of China were selected by convenient sampling to investigate the current status of career development. Multiple linear regression analysis was conducted. Results: The nurses' career development was 3.63±0.58, the work engagement was 3.81±0.63, the career development motivation was 3.52±0.63, and the career environment was 3.59±0.69. The difference among the three groups was statistically significant (F=445921.840, P<0.001). The results of multiple linear regression analysis showed that hospital grade, age, education, personal annual income, working years, children’s situation, psychological resilience and work-family conflict were influencing factors for nurses’ career development, which could explain 36% of the total variation. Conclusion: The level of work engagement is relatively high. Psychological resilience and work-family conflict are important predictors of nurses' career development. Nursing managers can promote nurses' career development by improving psychological resilience and reducing their work-family conflicts.

Objective: To explore the effectiveness of the tutorial system of humanistic care training?on the quality of humanistic care for new nurses?based on Watson's Theory of Human Caring. Methods: A total of 110 new nurses were recruited in a Grade III Level A hospital in 2018 by convenient sampling methods. The participants were randomly allocated to the experimental group and control group, with 55 subjects in each group. Based on Watson's Theory of Human Caring, the tutorial system of humanistic care training program was developed and applied to the experimental group. The routine training was received by the participants in the control group. Data were collected before and after the participants completing training program by the humanistic care scale at the same time to the two groups. Results: After the human care training, the total scores and the scores in the dimension of concept, ability and perception of humanistic care scale in the two groups were improved. The differences between the two groups were statistically significant (P<0.05). Conclusion: Tutorial system of humanistic care training based on Watson's Theory of Human Caring improves new nurses' humanistic care quality, especially in the dimension of concept, ability and perception of the humanistic care.

Objective: To develop a stressor scale for nurses in nursing institutions and to test its reliability and validity, so as to provide an effective tool for evaluating the stress level and stressors of nurses in nursing institutions. Methods: According to literature research and semi-structured interview, qualitative interview data were analyzed and summarized by the KJ method, and the item pool was preliminarily developed, and the initial scale was formed by Delphi method. A questionnaire survey was conducted on 302 nurses in different nursing institutions in Liaoning province by using the initial scale. SPSS 20.0 software was used for statistical analysis of the data to determine the reliability and validity of the scale. Results: The stressor scale for nurses in nursing institutions consisted of 46 items; the exploratory factor analysis identified five principal factors and explained for 69.979% variance. The item content validity index ranged from 0.824 to 1.000, the scale content validity index was 0.937. The Cronbach's α coefficient of the scale was 0.892 and test-retest reliability was 0.905. Conclusion: The scale has good reliability and validity, and can be used to evaluate the stress level and stressors of nurses in nursing institutions in China.

Objective: To describe the application of ADDIE Model in the leveled training of neonatal nurses and evaluate the influences of the model on the core competence of these nurses. Methods: A team regarding leveled neonatal nurse training was established. Then neonatal nurses from our hospital were recruited to participate in the theoretical and practical training using the cluster sampling method according to 5 phases of ADDIE Model. Nurses recruited were offered assessment from three aspects including theoretical knowledge, core competence and teaching abilities before their training. Results: After the leveled training based on ADDIE Model, nurses scored higher in theoretical knowledge than before (86.08±6.68 vs 78.92±5.95, P<0.05). The total score of core competence of nurse after the training was also better than before (173.70±8.36 vs 167.22±8.30, P<0.05). Besides, nurses showed more satisfaction towards the training arrangement, teaching methods, learning atmosphere and faculty standard in the leveled training designed based on ADDIE Model than before (P<0.05). Conclusion: The leveled training of neonatal nurses developed on the basis of ADDIE Model could improved the core competence of these nurses.

This paper reviews the literature from the overview of Virtual Reality technology, the mechanism of Virtual Reality technology in the treatment of chronic pain, the application and research prospects of Virtual Reality technology in patients with various types of chronic pain, in order to provide information support for future research and clinical applications.

Objective: To analyze the effects of One-stop Intelligent Appointment Mode (OIAM) in clinical nursing skills training. Methods: A total of 210 newly recruited nurses from January to October 2019 were divided into experimental group and control group randomly. The control group were trained in the traditional method, and the experimental group was given the OIAM. The outcome measures were the exam score, the rate of nurse absence, the anxiety level before the examination, satisfaction and the waiting time for the assessment. Results: Compared with the control group, the rate of nurse absence (9.5%), the anxiety level (51.97±13.89), and the waiting time (9.67±2.40) min were significantly lower (P<0.05), the exam score and the satisfaction of nurses and tutors were significantly higher (P<0.05). Conclusion: The application of the OIAM takes into account the individual differences of nurses, which can effectively reduce the anxiety of nurses before exams and the absence rate, and shortens the average waiting time. It can improve the work efficiency of assessment and management, and can be promoted and applied.

Objective: To develop a full-process information management system for breast cancer patients based on clinical decision support, assist medical staff in making follow-up decisions and excavate the value of data, and explore the effectiveness of follow-up management for breast cancer patients. Methods: A system combined with knowledge base, reasoning engine and user communication mechanism was designed by multidisciplinary experts and put into clinical use. A total of 88 breast cancer patients admitted to the breast surgery department from December 2018 to December 2019 were selected and randomly divided into experimental group and control group. The bone marrow suppression, readmission rate, self-efficacy and satisfaction evaluation of patients in two groups were compared before intervention, 3 months and 6 months after intervention. Results: There was no difference in leukocyte, hemoglobin and platelet between the two groups before intervention (P>0.05). White blood cells, hemoglobin and platelets in the experimental group were higher than those of the control group at 3 and 6 months after intervention (P<0.05). The readmission rate at 3 and 6 months after intervention in the experimental group was lower than the control group (P<0.05). There was no difference in self-efficacy between the two groups before intervention (P>0.05). The self-efficacy of the control group was lower than that of the experimental group at 3 and 6 months after intervention (P<0.05). The patients were highly satisfied with the system. Conclusion: The development of clinical decision support system based on the follow-up characteristics of breast cancer patients meets the needs of medical staff for follow-up of patients, increases the frequency of use of the system, guarantees patient safety, and improves the efficiency of nursing service. In the long run, it reduces patient cost and reduces hospital operating cost.

This paper reviews the research progress regarding the assessment tools for cardiac rehabilitation nursing to provide reliable tools to evaluate and explore the barriers for patients' participation in cardiac rehabilitation.

The concept, assessment tools and current application of body image among patients with breast cancer were reviewed. We summarized the application of assessment tools for body image in these patients and analyzed their strength and weakness. The study is aimed to provide clinical guidelines and suggestions for researchers to select appropriate body image assessment tools for patients with breast cancer, therefore to provide references for developing culturally appropriate body image assessment tools for Chinese patients with breast cancer.

Objective: To investigate the compliance with phosphorus-controlled diets and its influencing factors in hemo-dialysis patients with hyperphosphatemia. Methods: A convenience sampling was used to recruit 172 hyperphosphatemic patients who underwent hemodialysis in two tertiary grade A hospitals in Guangxi from May 2018 to October 2019. Patients were investigated by a general information questionnaire, a dietary compliance questionnaire for hyperphosphatemic hemo- dialysis patients, and a low phosphorus diet health belief scale in hemodialysis patients with hyperphosphatemia. Results: The total score of dietary compliance of hyperphosphatemic patients was (36.39±3.55) and the overall compliance rate was 60.6%, which were at the moderate level. Multiple linear regression analysis showed that gender, education level, occupational status, dietary habits, and health beliefs about the low phosphorus diet were the influential factors of dietary compliance of hyperphosphatemic patients (P<0.05). Conclusion: The compliance of hyperphosphatemic Hemodialysis patients with phosphorus-controlled diets needs to be improved. In clinical settings, we need to pay more attention to patients who are male, employed, poorly educated, with poor dietary habits, and with weak believes in low phosphorus diet. Tailored and effective measures are suggested to these patients to improve their compliance with phosphorus-controlled diets.

Objectives: To investigate the characteristics of self-reported symptoms of patients during hospitalization after head and neck tissue flap repair, to provide a theoretical basis for subsequent symptom burden research. Methods: Convenient sample of postoperative patients who underwent tissue flap transplantation from September to November, 2017. Patients' written reports of various symptoms and discomforts were collected and analyzed. Data collection was stopped with the saturation of symptoms. Results: A total of 31 patients were enrolled, including 17 males and 14 females. Symptoms of pain, discomfort, dyspnea, difficulty in falling asleep, heat/hyperhidrosis, and dry mouth were often reported and account for more than 29.0% of the reports. Most patients (67.7%) had more than 3 symptoms, and some reported combination of 5 items (16.1%) and 4 items (12.9%). One patient reported 10 types of uncomfortable symptoms. There were no statistical differences in the number of self-reported symptoms among demographic factors, types of soft and hard tissue flaps, or whether tissue flaps were vascularized (P<0.05). Conclusion: The self-reported symptoms of patients after head and neck tissue flap transplantation are vary, but they are concentrated in a few major symptoms.

This paper summarized the knowledge, attitude and management status of Subsyndromal Delirium (SSD) by ICU nurses, as well as the countermeasures to improve the understanding of ICU nurses' SSD (strengthening training and education, supervision and evaluation and management). It is expected to improve the awareness level of ICU nurses on SSD and improve the implementation of SSD screening and intervention.

This article reviewed the concept, performance and harm of expectant fathers' fear of childbirth. It also analyzed the factors and intervention measures that affect expectant fathers' fear of childbirth. It is expected to provide information for nurses to enhance nursing care in order to reduce the expectant fathers' fear of childbirth.

This research summarizes the contents and the most commonly used communication models of Advance Care Planning, so as to provide reference for the development of Advance Care Planning in mainland China.

This article reviews the management experience and research progress of domestic medical waste in foreign countries and analyzes the types and management status of domestic medical waste in China. We put forward some suggestions to further standardize the management and research of domestic medical waste, such as improving the management regulations of domestic medical waste, clarifying the responsibilities of the government and management agencies, establishing the recycling channels, and issuing the guidelines on the classification and disposal of home medical waste as soon as possible.

This paper summarizes the theoretical models related to communication of Shared Decision Making among physicians, nurses and patients, the influencing factors and the intervention measures to improve communication of Shared Decision Making, in order to provide a reference for health care professionals to promote the implementation of Shared Decision Making from the communication level.