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Table of Content
15 July 2021, Volume 21 Issue 7
Special Planning
Nursing practice of hospice and palliative care in general hospital
GUO Na, SUN Rui, SHA Rui, KANG Qian, LIU Qian, ZENG Yaoxin, NING Xiaohong
Chinese Nursing Management. 2021, 21 (7):  961-965.  DOI: 10.3969/j.issn.1672-1756.2021.07.001
Abstract ( 386 )   PDF (2521KB) ( 399 )  
Taking Peking Union Medical College Hospital as an example, focusing on the role of nursing staff in hospice and palliative care service, work contents of palliative care nurses, nursing practice mode, training of nursing specialists, promoting of construction of volunteer team and dissemination of hospice and palliative concept, etc., to introduce the nursing practice of hospice and palliative care in general hospital, in order to provide reference for promoting the development of hospice and palliative care in China.
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The exploration and practice of carrying out the hospice co-care model in cancer specialist hospitals
YU Yang, LU Hong, ZHANG Ying, XIA Juan, PENG Jing
Chinese Nursing Management. 2021, 21 (7):  966-970.  DOI: 10.3969/j.issn.1672-1756.2021.07.002
Abstract ( 293 )   PDF (2261KB) ( 523 )  
In the exploration of the hospice care suitable for cancer specialist hospitals, our hospital has formed a hospice co-care model, that is, the hospice co-care team and the original treatment team jointly provide services and build flexible hospice wards and the medical conjoined unit mode. Collaborate medical units share palliative care bed and co-care mode. The content of this mode includes multidisciplinary team symptom management, comfort care, spiritual care, grief counseling, psychological and social support, etc. Through the implementation of the hospice co-care model, we provide multiple medical decisions for the end-stage cancer patients and their family members, and take care of their feelings throughout the course of the disease. It has accumulated a lot for the practice of hospice care and explored a hospice co-care model suitable for the national condition.
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Construction and practice of hospice care nurse specialist training management program
LIU Xiangyu, BU Xiaofan, XIAO Haixia, XU Xianghua, WANG Ying, DING Yanming, XIAO Yazhou, CHEN Yongyi
Chinese Nursing Management. 2021, 21 (7):  971-975.  DOI: 10.3969/j.issn.1672-1756.2021.07.003
Abstract ( 263 )   PDF (2154KB) ( 665 )  
This paper summarized the management system, theoretical courses and clinical practice training system construction, training effect, etc. of hospice care nurse specialists, analyzed the problems to be improved existing in the hospice care nursing specialized training currently, and put forward the corresponding strategies. In the hope of providing reference for the follow-up development of training content and methods to hospice care nurse specialists, as well as enhancing the training quality of hospice care nurse specialists.
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The cultivation of caring and empathy ability for hospice care nurses based on the health-related quality of life theory
DONG Xue, HE Ruixian, GAO Mohan, WEI Jianjian, WANG Li, GAO Jian, WEI Wei, RUAN Nanting
Chinese Nursing Management. 2021, 21 (7):  975-979.  DOI: 10.3969/j.issn.1672-1756.2021.07.004
Abstract ( 205 )   PDF (3325KB) ( 384 )  
Objective: To analyze the effects of caring and empathy ability training based on the health-related quality of life theory on hospice care nurses' caring and empathy ability. Methods: By using the convenient sampling method, a total of 70 hospice care nurses were selected as the intervention group (35 cases) and the control group (35 cases) according to the random number table from March 22 to April 11, 2021. The control group received routine nursing training, while the intervention group received caring and empathy ability training based on the health-related quality of life theory on the basis training of the control group. The difference of caring and empathy after the training between the two groups were observed. Results: The caring ability (t=3.541, P=0.001) and empathy ability (t=2.687, P=0.009) of the intervention group were higher than those of the control group after training. Conclusion: Caring and empathy training based on the health-related quality of life theory can improve the caring and empathy ability of hospice care nurses. The study provides a reference for the training of hospice care nurses which has good clinical application value.
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The construction and practice of the training base for hospice care nurse specialists based on Kolb's Learning Cycle
LI Xuying, FAN Rongrong, XIAO Yazhou, CHEN Yongyi, SHEN Boyong, WANG Ying, QIU Cuiling, YANG Siyu
Chinese Nursing Management. 2021, 21 (7):  980-983.  DOI: 10.3969/j.issn.1672-1756.2021.07.005
Abstract ( 277 )   PDF (1909KB) ( 486 )  
Objective: Establishing hospice care training base for nurses, exploring training mode based on Kolb's Learning Cycle and cultivating specialized nurses with high knowledge and high skill level, to play a leading role in hospice care. Methods: We developed a "5 multiple and 1 interaction" mode to provide students with comprehensive training, including multidimensional contents, multiple teaching methods, multiple practice institutions, multiple assessment form, multiple platform and interaction between practice and theory, guided by students' demand, Kolb's Learning Cycle and post competence. Results: Since we became hospice care training base, we've successfully held 2 training courses and trained a total of 87 nurses, as well received 48 students for practice. The teaching quality has been continuously improved and the construction of training base in turn promoted the development of hospice care in hospital. Conclusion: The establishment of hospice care training bases meets the needs of nurses. It is necessary to continue to strengthen the construction, improve the training system, and cultivate more high-level talents.
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The development status of hospice care volunteers service: a review
DING Yanming, HUANG Ziye, WANG Yi, ZHAO Lingwei, LIU Fei, WANG Yingxin
Chinese Nursing Management. 2021, 21 (7):  984-987.  DOI: 10.3969/j.issn.1672-1756.2021.07.006
Abstract ( 282 )   PDF (1895KB) ( 398 )  
This paper summarized the roles orientation, personality characteristics, relevant laws, service places, service contents, service effects and significance of the volunteers, regulations and policies, organization and management, training and education in hospice care, aimed to provide suggestions for developing the hospice care volunteer service in China.
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Topical Issues
The application of COX's Interaction Model of Client Health Behavior on tobacco cessation interventions for patients with tobacco dependence
XIANG Qiu, WANG Xia, XU Suqin
Chinese Nursing Management. 2021, 21 (7):  991-996.  DOI: 10.3969/j.issn.1672-1756.2021.07.008
Abstract ( 241 )   PDF (2938KB) ( 598 )  
Objective: To explore the effect of COX's Interaction Model of Client Health Behavior on smoking cessation for tobacco dependent patients. Methods: A convenience sample of 77 tobacco-dependent patients from a smoking cessation clinic in a tertiary first-class hospital in Wuhan was divided into groups according to the time of visit. Among them, 38 patients from November 2018 to January 2019 were the control group, and routine smoking cessation interventions were used. Another group of 39 patients from February to April 2019 was the observation group and was implemented smoking cessation interventions based on the COX's Interaction Model of Client Health Behavior. Results: There were statistically significant differences in the time effect, grouping effect, and interaction effect of tobacco dependence scores between the two groups of patients (P<0.05). After the intervention, the scores of tobacco dependence in the observation group were lower than those in the control group at one month and six months after the intervention, and the difference was statistically significant (P<0.05); in the two groups of smoking craving scores, the main effect of patient time was significant (P<0.001) , while the main effect of grouping was not significant (P>0.05). There was a statistically significant difference in smoking craving scores between the two groups of patients one month after the intervention (P<0.05). There was no significant difference in smoking craving scores between the two groups of patients six months after the intervention (P>0.05). The smoking cessation rate of 1 month and 6 months after intervention in the observation group was higher than that in the control group (P<0.05), and the observation group had a high recognition of smoking cessation intervention based on the COX's Interaction Model of Client Health Behavior. Conclusion: The smoking cessation interventions based on the COX's Interaction Model of Client Health Behavior can help reduce the tobacco dependence and further increase the smoking cessation rate. Patients have a high degree of acceptance on the interventions. However, there is no improvement in their smoking cravings.
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Content analysis of mainstream media reports on nurses during COVID-19 in China
SHANG Siyuan, XING Weijie, DENG Hanyu, WANG Fan
Chinese Nursing Management. 2021, 21 (7):  997-1002.  DOI: 10.3969/j.issn.1672-1756.2021.07.009
Abstract ( 531 )   PDF (2477KB) ( 407 )  
Objective: To analyze the media images of nurses during COVID-19 from the perspective of China's mainstream media reports. Methods: Systematically search the reports about nurses in the six national media during the COVID-19 epidemic from January 1, 2020 to May 15, 2020. Mixed content analysis was used to extract, induce and quantify the surface features of the included reports, such as the reported characters, places and genres and to qualitatively analyze the potential features of the included reports, namely as the media image of nurses. Results: A total of 637 reports were included finally with communication as the main genre. Nursing administrators, young nurses and male nurses were the main report objects. By extracting 17 typical codes, a total of 7 media images were concluded, which were the courageous countermarching people, the devoted rescuers, the conscientious innovators, the responsible young people, the male nurses who hold up half of the sky, the administrators who crack a hard nut and the ordinary people with true emotions. Conclusion: The mainstream media in China described the multiple media image of nurses during COVID-19, but the reports and interpretations of nurses' professional practice innovation and improving patient outcomes are not abundant enough. It is expected to promote more professional and profound media image of nurses in the future.
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Standard development for constructing the humanistic nursing care demonstration ward
BU Mengru, ZHAI Huimin, WANG Ying, GAN Junli, YANG Yi
Chinese Nursing Management. 2021, 21 (7):  1002-1008.  DOI: 10.3969/j.issn.1672-1756.2021.07.010
Abstract ( 297 )   PDF (4816KB) ( 394 )  
Objective: To formulate the standards and criteria that are scientific and feasible for constructing a humanistic nursing care demonstration ward, therefore provide a reference for the ward construction. Methods: Based on the results of preliminary qualitative research and literature review, the "standard" was drafted and developed via Delphi and Analytic Hierarchy Process(AHP). Results: The effective response rates of the two rounds of the Delphi consultation were 92.6% and 96.0%, with the authoritative coefficients being 0.89 and 0.88, respectively. The Kendall harmony coefficients of the necessity, rationality and feasibility of the first round consultation indexes were 0.345, 0.392 and 0.257 (all P<0.001), respectively, while those of the second round consultation indexes were 0.541, 0.401 and 0.381 (all P<0.001), respectively. The final "standards" include three domains: the general goals (2 indicators), the humanistic nursing implementation guidelines (5 first-level indicators, 11 second-level indicators, 55 third-level indicators) and assessments (2 first-level indicators, 4 second-level indicators, 11 third-level indicators). Conclusion: The results showed that the construction process of the "standards" for the humanistic nursing care demonstration ward was scientific, with relevant content and feasible components, which demonstrated certain degree of scientific nature and reliability.
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Research Papers
Investigation and analysis of multiple symptoms in children and adolescents with malignant solid tumors during radiotherapy
LIU Yanyan, SUN Jing
Chinese Nursing Management. 2021, 21 (7):  1009-1013.  DOI: 10.3969/j.issn.1672-1756.2021.07.011
Abstract ( 198 )   PDF (3263KB) ( 373 )  
Objective: To describe the experiences and burden of children with solid tumors during radiotherapy. Methods: By convenient sampling, a total of 128 children aging 5-18 years old with solid tumors undergoing radiotherapy were recruited from the radiology department of a tertiary hospital in Shanghai from October 2018 to December 2019. The questionnaires including the general information questionnaire and the Memorial Symptom Assessment Scale (MSAS) were used to evaluate the various symptoms of tumor patients during radiotherapy. Results: The incidence of symptoms ranged from 13.3% to 71.9%, of which the top five were nausea, hair loss, lack of energy, vomiting and dry mouth and the top 5 symptom burden were hair loss, nausea, lack of energy, vomiting and no appetite. The average scores of physical symptoms, global distress index and MSAS score in children who did not receive chemotherapy in the past week were significantly less than those of children receiving chemotherapy in the last week (P<0.01). Effects of age, gender, and disease type on the symptom burden in all dimensions showed no statistically significant differences (P>0.05). Conclusion: Children with solid tumors suffer from a variety of adverse symptoms during radiotherapy, especially those who undergo chemotherapy at the same time. Medical staff should focus on giving targeted guidance based on the symptoms and burden of the children during radiotherapy.
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Analysis of different types of physical activity participation in low-risk patients on exercise rehabilitation after Percutaneous Coronary Intervention
TONG Sumei, WANG Yating, FENG Xiaolin, LIU Ping, XU Shunlin
Chinese Nursing Management. 2021, 21 (7):  1014-1018.  DOI: 10.3969/j.issn.1672-1756.2021.07.012
Abstract ( 194 )   PDF (3197KB) ( 382 )  
Objective: To analyze the participation of different types of physical activities in low-risk patients with exercise rehabilitation after the Percutaneous Coronary Intervention (PCI) and provide evidence for health education. Methods: A total of 226 low-risk patients with exercise rehabilitation after PCI were recruited by using a convenient sampling method and investigated by self-designed general information questionnaire and International Physical Activity Questionnaire. Results: The types of physical activity from high to low participation rate were physical activity in leisure time (84.5%), physical activity in housework (47.3%), physical activity in work (43.0%), and physical activity in transportation (40.3%). Univariate analysis showed that physical activity in leisure time had statistical differences with gender, discomfort symptoms in physical activity, and the extent of discomfort symptoms affecting physical activity (P<0.05). There were statistically significant differences between physical activity in housework and gender (P<0.05). Physical activity in work and occupation were statistically significant (P<0.05). In terms of physical activity in transportation, gender, age, the course of coronary heart disease, and the type of using artery during PCI were all statistically significant (P<0.05). Conclusion: The participation rate of physical activity in low-risk patients with exercise rehabilitation after PCI is low. Nurses should pay attention to the health education of physical activity, provide personalized and scientific education, and guide safety monitoring to patients.
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Stigma and its related factors in patients with Spinal Cord Injury
HUANG Ruirui, LIU Annuo, LI Lunlan, QI Jinmei
Chinese Nursing Management. 2021, 21 (7):  1019-1025.  DOI: 10.3969/j.issn.1672-1756.2021.07.013
Abstract ( 248 )   PDF (3943KB) ( 390 )  
Objective: To investigate the stigma and its related factors in patients with Spinal Cord Injury (SCI). Methods: Totally 188 patients with SCI were included by convenience sampling from a tertiary grade A hospital in Anhui province during September 2018 to December 2019. The general information questionnaire, Social Impact Scale, Perceived Stress Scale, Perceived Social Support Scale, and General Self-Efficacy Scale were used to collected data. Results: The score of stigma in patients with SCI was 55.98±10.73. The related factors of stigma included the status of marriage, education level, ASIA disability grade, injury severity, perceived stress, perceived social support and self-efficacy, which accounted for 75.3% of the total variation. Conclusion: Stigma in patients with SCI was at a moderate level. Providing patients with more companionship, support and communication would be benefit to reduce the pressure, improve their coping ability and reduce the stigma.
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Construction and effects of early mobilization program for postoperative patients with colorectal cancer
ZHU Shiqin, DENG Bo, SONG Meixuan, XU Linxia, XU Liang, LI Xianrong
Chinese Nursing Management. 2021, 21 (7):  1025-1030.  DOI: 10.3969/j.issn.1672-1756.2021.07.014
Abstract ( 243 )   PDF (2974KB) ( 709 )  
Objective: To evaluate effects of the early mobilization program for patients with colorectal cancer. Methods: By reviewing the literature, based on Enhanced Recovery After Surgery (ERAS), combined with the clinical practice of gastrointestinal surgery in a tertiary grade A hospital in Sichuan province, the early mobilization program for patients with colorectal cancer was formed. From January to October 2019, ninety colorectal cancer patients were selected and randomly divided into control group (n=45) and experimental group (n=45). The control group was given routine ERAS interventions during the perioperative period, while the experimental group was implemented an early mobilization program in 1 to 3 days after the operation. The early postoperative recovery indicators were compared between the two groups. Results: The walking distance, step number, and sleep time of the experimental group were higher than those in the control group in 1-3 days after operation (P<0.05). There were statistically significant differences between the two groups in time of first getting out of bed, time of first exhausting, and time of postoperative hospital stay (P<0.05). The 15-item Quality of Recovery score of the experimental group was higher than control group in 1-3 days after operation, and the Visual Analogue Scale score of the experimental group was lower than control group (P<0.05). Conclusion: Early mobilization program for colorectal cancer patients was safe and feasible, which can improve the quality of early postoperative recovery.
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Evidence-based Nursing
The real experience of living with a tube in adult patients with home enteral tube feeding: a Meta-synthesis of qualitative studies
XUE Min, HAN Jing, ZHAI Xiaoyuan, ZHOU Min
Chinese Nursing Management. 2021, 21 (7):  1031-1037.  DOI: 10.3969/j.issn.1672-1756.2021.07.015
Abstract ( 247 )   PDF (4475KB) ( 391 )  
Objective: To systematically review the real experience of living with a tube in patients with home enteral tube feeding and provide evidence-based guidance for the home care service system. Methods: We searched databases including Web of Science, Cochrane Library, PubMed, PsycINFO, Embase, CNKI, CBM, VIP, Wanfang Data from inception to March 2020. The JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of studies. The Integrating Methods was applied to integrate the results. Results: A total of 75 findings were extracted from 17 qualified studies and then 4 synthesized results were summarized from 9 new categories. Integration result 1: decision making for home tube feeding (individualized decision and supporting needs for decision). Integration result 2: the loss of normal life (negative body experience, negative psychological experience, and negative experience of social life). Integration result 3: adjusting to the new normal (self coping and positive psychological adjustment). Integration result 4: the challenges and values of family tube feeding (transitioning back to oral and value of home enteral tube feeding). Conclusion: The staged experience reveals the positive feelings and difficulties of the tube feeding process. Healthcare workers should pay more attention to patients' needs, and provide dynamic, multi-aspect, and transitional medical care service.
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Evidence-based nursing application of invasive mechanical ventilation in critically ill children
WANG Wenchao, SHEN Ju, SHEN Weijie, GU Ying, HU Jing, WU Guangying
Chinese Nursing Management. 2021, 21 (7):  1038-1043.  DOI: 10.3969/j.issn.1672-1756.2021.07.016
Abstract ( 202 )   PDF (3628KB) ( 640 )  
Objective: To improve the assessment, routine maintenance and extubation process of invasive mechanical ventilation in critically ill children through the best evidence application of invasive mechanical ventilation in critically ill children, so as to reduce ventilator-associated pneumonia in critically ill children. Methods: According to the clinical evidence practice application mode of JBI evidence-based nursing center, a total of 17 best evidences were summarized, and 15 quality review indicators were formulated combined with clinical situation and professional judgment through systematic search and quality evaluation of literature related to invasive mechanical ventilation in critically ill children. The i-PARIHS evidence-based practice conceptual framework was used to analyze the obstacles and formulate the action plan. Results: After two rounds of audit, medical staff's knowledge of evidence-based invasive mechanical ventilation was obviously enhanced, and their compliance of eight evidences was significantly improved (P<0.01), and the incidence of ventilator-associated pneumonia in critically ill children showed a downward trend. Conclusion: The application of evidence-based nursing program of invasive mechanical ventilation in critically ill children can standardize the evidence-based nursing behaviors, improve the evidence-based compliance of nurses, and reduce the incidence of ventilator-associated pneumonia.
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Risk factors of Post-extubation Dysphagia among patients in Intensive Care Units: a Meta-analysis
LIN Yeqing, FENG Yongshen, SHAO Mengye, NI Hong, ZHANG Lifeng
Chinese Nursing Management. 2021, 21 (7):  1044-1052.  DOI: 10.3969/j.issn.1672-1756.2021.07.017
Abstract ( 335 )   PDF (5054KB) ( 396 )  
Objective: To systematically review the risk factors of Post-extubation Dysphagia (PED) among patients in intensive care units, so as to provide basis for timely identification of those with high risk of PED and take effective preventive measures. Methods: We searched PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang data, VIP, and CBM databases from inception to February 6,2020. Literatures on potential risk factors of PED among patients in intensive care units were reviewed. Cochrane handbook 5.1.0, Newcastle-Ottawa scale and AHRQ Quality Assessment Forms were used to perform quality appraisal. Review Manager 5.3 was used to perform Meta-analysis. Results: A total of 19 studies, including 5293 patients were analyzed. Significant risk factors for PED included age [MD=6.23, 95% CI (4.52-7.95)], gender [OR=0.75, 95% CI (0.60-0.94)], intubation duration [MD=66.46, 95%CI (58.12-74.79)], with heart failure [OR=2.65, 95%CI (1.84-3.82)], arrhythmia [OR=1.87, 95%CI (1.08-3.26)], atrial fibrillation or atrial flutter [OR=2.74, 95%CI (1.75-4.28)], chronic kidney disease [OR=3.66, 95%CI (2.38-5.63)], postoperative cerebrovascular accident [RR=4.37, 95%CI (1.68-11.35)], left ventricular ejection fraction [OR=0.57, 95%CI (0.38-0.85)], examination with esophageal ultrasound [RR=1.83, 95%CI (1.05-3.19)], APACHE II score [MD=3.68, 95% CI (1.00-6.35)] and the admission way to ICU [OR=2.84, 95% CI (1.05-7.71)]. Conclusion: Age>65y, female, with long tracheal intubation time, with heart, cerebrovascular and kidney diseases, low left ventricular ejection fraction, esophageal ultrasound usage, high APACHE II score and emergency admission to ICU are risk factors of PED.
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Interpretation of COSMIN risk of bias checklist
SHI Yuexian, ZHANG Haiming, HUANG Yaqi, WU Liang, LIU Fei, SHANG Shaomei
Chinese Nursing Management. 2021, 21 (7):  1053-1057.  DOI: 10.3969/j.issn.1672-1756.2021.07.018
Abstract ( 735 )   PDF (2079KB) ( 537 )  
Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) risk of bias checklist was developed for standard the methodological quality of studies on measurement properties of existing Patient-Reported Outcome Measures, which contained 10 boxes and a total of 116 items. We aim to introduce COSMIN risk of bias checklist to researchers and users in china, in view of basic information, assessment items and evaluation criterion.
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Psychological experience of patients with Hematopoietic Stem Cell Transplantation: a Meta-synthesis
LIU Shujia, GU Jiaxin, HU Wei, ZHANG Kun, XU Xiaodong, WANG Ting, YAN Xia
Chinese Nursing Management. 2021, 21 (7):  1057-1063.  DOI: 10.3969/j.issn.1672-1756.2021.07.019
Abstract ( 185 )   PDF (4242KB) ( 386 )  
Objective: To synthesize findings of qualitative studies on experience of patients with Hematopoietic Stem Cell Transplantation (HSCT), so as to fully understand patients' psychological needs and provide better evidence for clinical work. Methods: We searched databases including the Cochrane Library, Joanna Briggs Institute Library, PubMed, Embase, Scopus, Web of Science, CINAHL, Psyc INFO, CNKI and CMB from inception to May 2020 to collect qualitative studies on psychological experience of patients with HSCT. The quality of included studies was evaluated with JBI Critical Appraisal Tool for qualitative studies. The results were integrated by integrating methods. Results: A total of 18 studies were included and 86 complete findings were grouped according to similarities to form nine new categories. These categories resulted in four synthesized findings: negative emotions of HSCT patients, positive emotions of HSCT patients, urgent needs of HSCT patients, and post-transplant debugging of HSCT patients. Conclusion: Healthcare workers should pay more attention to the psychological changes and information needs of HSCT patients, and provide necessary support to help improve the quality of life.
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Nursing Education
The development and evaluation of the tibial fracture simulation based on Standardized Patients
JIN Sanli, LU Qian, PANG Dong, YANG Ping, LI Bingbing, LI Ke
Chinese Nursing Management. 2021, 21 (7):  1064-1068.  DOI: 10.3969/j.issn.1672-1756.2021.07.020
Abstract ( 916 )   PDF (2188KB) ( 502 )  
Objective: To develop and evaluate the tibial fracture simulation based on Standardized Patients. Methods: Based on Jeffries theory, a tibial fracture simulation based on Standardized Patient was designed according to the International Nursing Association for Clinical Simulation and Learning (INACSL) standards of best practice. The simulation was run among 150 nursing undergraduates of grade 2016 and 2017 in our school, and evaluated by them using Simulation Design Scale (SDS) and the Debriefing Assessment for Simulation in Healthcare (DASH). Results: The scores of SDS and DASH were 4.47-4.62 and 6.25-6.53 respectively, which were in a high level. Conclusion: The tibial fracture simulation based on Standardized Patients is feasible in the teaching of undergraduate nursing students and the evaluation results are good.
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Nursing Safety
The application and efficiency of management program for unintentional injury of pediatric inpatients based on the High Reliability Organization Theory
LIU Yan, CUI Cui, TANG Fangfang, LENG Hongyao, ZHENG Xianlan
Chinese Nursing Management. 2021, 21 (7):  1069-1073.  DOI: 10.3969/j.issn.1672-1756.2021.07.021
Abstract ( 166 )   PDF (2637KB) ( 362 )  
Objective: To introduce High Reliability Organization Theory to standardize the management of unintentional injury of pediatric inpatients, and to reduce the incidence of unintentional injury of pediatric inpatients. Methods: Based on High Reliability Organization Theory, the management system of pediatric inpatient unintentional injury adverse events was established and implemented. Results: After applying High Reliability Organization Theory to manage pediatric unintentional injury, the incidence of unintentional injury was reduced by 0.061‰. The implementation rate of pediatric unintentional injury quality management indicators and nurses' ability to deal with unintentional injury were significantly improved (all P<0.05). Conclusion: The management practice of pediatric accidental injuries based on High Reliability Organization Theory can effectively reduce the incidence of unintentional injury of pediatric inpatients, improve the management ability of nursing staff to deal with unintentional injury of pediatric inpatients, and ensure the safety of patients.
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The impact of injurious falls on the length of stay and medical expenses of hospitalized patients
ZHAO Min, SU Xiaoxia, LI Shuguang, ZHAO Qi, JIANG Hong
Chinese Nursing Management. 2021, 21 (7):  1074-1078.  DOI: 10.3969/j.issn.1672-1756.2021.07.022
Abstract ( 396 )   PDF (2914KB) ( 391 )  
Objective: To understand the impact of injurious falls on the length of stay and medical expenses of hospitalized patients and to provide a reference for reducing the incidence of injurious falls and financial burden of patients and optimizing the allocation of medical resources. Methods: A retrospective study was conducted by recruiting 234 inpatients who had fall injuries that occurred from January 2014 to December 2018 in three hospitals of Shanghai. According to the occurrence of injuries after falls, these patients were divided into the injury group and the non-injury group. The differences in the length of stay and medical expenses between the two groups were compared. Results: The median length of stay in the injury group was 18.00 days, and the median medical expenses was CNY 26496. The length of stay in the non-injury group was 12.00 days with the medical expenses being CNY 18809; the differences between the two groups were statistically significant (P<0.05). And severe injurious falls resulted in longer length of stay and more medical expenses. Conclusion: Injurious falls can cause additional financial burden on patients. Scientific and effective preventive measures should be actively formulated to reduce the occurrence of injurious falls to ensure the safety of patients in hospital and improve the quality of medical services.
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Human Resource
Career success sense and its related factors among Geriatric Nurse Specialists
WU Yanping, XU Renhua, WANG Yunwen, LI Ming'e, ZHOU Yanfen, LU Yutong, ZHANG Yanfang, WANG Chuanxia
Chinese Nursing Management. 2021, 21 (7):  1079-1083.  DOI: 10.3969/j.issn.1672-1756.2021.07.023
Abstract ( 256 )   PDF (2907KB) ( 387 )  
Objective: To investigate the sense of career success of Geriatric Nurse Specialists (GNS) and analyze its related factors. Methods: A total of 321 GNS from 25 provinces were investigated with a cross-sectional survey using the general information questionnaire, the Career Success Scale, and the Practice Environment Scale. Results: The score of career success sense was 35.11±8.40. The nursing work environment score was 97.52±14.86. Income satisfaction, published papers or books could explain 27.5% of the career success. Staffing and resource adequacy, nurses participation in hospital affairs could explain 29.0% of the career success. Conclusion: The sense of career success of GNS is above the middle, and needs to be improved. Managers may enhance the sense of nurses' career success by improving the nursing work environment, reducing frequency of night shift, improving working conditions, expanding the scope of specialist nurse training, improving teaching and research ability.
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Transitional Care
Discussion on the model of tertiary grade A hospital-community hospital linkage in promoting the development of community wound care specialization
LI Huijuan, FU Xiaojin, LIU Jin, QIN Qiang, TAO Zhenhui, GUAN Hui, DING Yanming
Chinese Nursing Management. 2021, 21 (7):  1083-1087.  DOI: 10.3969/j.issn.1672-1756.2021.07.024
Abstract ( 236 )   PDF (2629KB) ( 475 )  
Objective: To explore the tertiary grade A hospital-community hospital linkage model based on the promotion of wound care specialization in community, and analyze its effects. Methods: The 3C strategic triangle model was used to develop specific hospital-community linkage strategies, to promote wound care specialization continuously. Results: Since the implementation of 3A-hospital-community linkage in 2016, the median number of patients, person-time and income of community wound care increased from 12.5 and 36.5 in 2016 to 65.5 and 18.5 in 2019 respectively (P<0.05). The frequency of home-based dressing change increased from 0 times in 2016 to 130 times in 2019, and the number of wound types increased from 6 in 2016 to 17 in 2019. The number of patients transferred from community hospitals to 3A hospitals, the number of patients transferred from 3A hospitals to community hospitals, and the number of consultation by wound care experts in community hospitals increasing from 0 in 2016 to 56, 20 and 48 respectively in 2019 and becoming stable gradually. Conclusion: The 3A-class-tertiary-hospital-community-hospital linkage strategy based on 3C strategic model has effectively promoted the development of community wound specialization, improved the wound care ability of community nurses.
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Information Management
Effect of WeChat-based teach-back education on anxiety and depression symptoms in fathers of neonate
JIAN Xin, LI Junyan, OUYANG Yanqiong
Chinese Nursing Management. 2021, 21 (7):  1088-1093.  DOI: 10.3969/j.issn.1672-1756.2021.07.025
Abstract ( 193 )   PDF (3450KB) ( 375 )  
Objective: To explore the effect of WeChat-based teach-back education on alleviating depression and anxiety in fathers of neonate. Methods: A total of 80 spouses of pregnant women who were registered in one hospital were included from January to April 2020, and the participants were divided into control group and intervention group according to the delivery sequence of maternal births, with 40 cases in each group. Those in the control group were with routine postpartum care, and those in the intervention group were with WeChat-based teach-back education. Anxiety and depression were observed before and after the intervention. Results: There were 36 participants in the control group and 37 in the intervention group completed the investigation. After 6 weeks of intervention, the EPDS score of the control group was 6.31 ± 3.14 and 3.78 ± 2.64 in the intervention group, and the S-AI score was 35.11 ± 7.84 in the control group and 30.65 ± 7.41 in the intervention group, respectively. The differences were statistically significant (P<0.05). Conclusion: The WeChat-based teach-back education is benefit to reduce the negative psychology, including anxiety and depression of fathers of neonate, which is worthy of promotion in clinical practice.
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Research progress on the construction and application of web-based Patient Decision Aids
ZHENG Hongying, YANG Linning, XU Jiehui, HU Jiale, YANG Yan
Chinese Nursing Management. 2021, 21 (7):  1093-1097.  DOI: 10.3969/j.issn.1672-1756.2021.07.026
Abstract ( 189 )   PDF (1854KB) ( 546 )  
This paper summarizes the construction, application context and quality evaluation criteria of web-based Patient Decision Aids, so as to provide reference to develop web-based Patient Decision Aids for domestic scholars.
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Advanced Nursing Practice
Risk factors of postoperative occipital pressure injury among pediatric patients undergoing liver transplantation
CHEN Zheying, JIANG Jianping, ZHOU Sui, LU Jin
Chinese Nursing Management. 2021, 21 (7):  1098-1101.  DOI: 10.3969/j.issn.1672-1756.2021.07.027
Abstract ( 169 )   PDF (2623KB) ( 392 )  
Objective: To analyze the risk factors of occipital pressure, injury after living donor liver transplantation in in infants and young children. Methods: Prospectively observed and collected clinical data and postoperative occipital pressure injury in pediatric patients who received living donor liver transplantation in our hospital from October 2018 to December 2019, and analyzed the related risk factors of occipital pressure injury. Results: The incidence of occipital pressure injury was 6.4% (14/220). The independent risk factors for occipital pressure injury were the temperature difference between the occipital compression area pre-operation and the core of nasopharynx during operation >0.7℃, the temperature difference between the occipital compression area pre-operation and its peripheral extension 2 cm area during the operation >1.0℃, the skin temperature difference of the occipital compression area pre-operation and post-operation >1.0℃. Conclusion: It is recommended that the occipital and surrounding skin temperature of pediatric undergoing living donor liver transplantation should be monitored in real time. Protective intervention should be taken to prevent the occurrence of pressure injury for those susceptible pediatric.
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Optimization of enteral nutrition infusion process for patients with severe craniocerebral injury based on Health Failure Mode and Effect Analysis
YU Qiang, LIU Qiaomei, ZHAO Liping, LUO Zheng, XU Can
Chinese Nursing Management. 2021, 21 (7):  1102-1107.  DOI: 10.3969/j.issn.1672-1756.2021.07.028
Abstract ( 149 )   PDF (3106KB) ( 375 )  
Objective: To optimize the procedure of enteral nutrition infusion for patients with severe craniocerebral injury using Health Failure Mode and Effect Analysis (HFMEA) and explore its clinical effects. Methods: A total of 131 patients with severe craniocerebral injury admitted from July 2016 to January 2018 receiving conventional enteral nutrition infusion were selected as the control group, and 145 patients with the same diseases admitted from February 2018 to August 2019 receiving HFMEA-based enteral nutrition infusion were recruited as the observation group. The risk priority number (RPN), feeding intolerance symptoms and nutritional indicators of the two groups were compared. Results: After the process optimization, the RPN value and the incidence of feeding intolerance in the observation group were significantly lower than those in the control group, and the differences were statistically significant (P<0.05). Serum total protein, albumin, transferrin, prealbumin and total lymphocyte counts of the observation group were higher than those of the control group on the 4th, 7th and 10th day, and the differences were statistically significant (P<0.05). Conclusion: With the help of HFMEA, nurses can effectively screen the failure risks of enteral nutrition infusion in patients with severe head injury, build a targeted optimization process and cooperate with medical staff of multiple departments to significantly reduce the incidence of feeding intolerance and optimize both enteral nutrition infusion and nursing quality to improve their nutritional status and clinical outcome as a whole.
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Reviews
Research progress and thinking on Narrative Competence in Medicine of health care workers
LIANG Xinyue, WANG Qiujing, LI Yan, BO Yuqiao, YANG Chuanchuan, WU Xue, SUN Shengnan, ZHANG Ge
Chinese Nursing Management. 2021, 21 (7):  1107-1111.  DOI: 10.3969/j.issn.1672-1756.2021.07.029
Abstract ( 300 )   PDF (1850KB) ( 475 )  
This paper reviewed the concept, clinical application value, assessment tools, and training methods of Narrative Competence in Medicine. In response to the current situation of Narrative Competence in Medicine of health care professional in China, we proposed reflections on the construction of a localized medical narrative education curriculum system and education model, inter-professional teamwork to build a narrative medicine alliance, and balancing work efficiency and narrative efficiency. The aim is to provide a reference for cultivating healthcare professionals with more medical humanistic spirit and building a harmonious doctor-patient relationship in China.
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Research on the work adjustment disorder of nurses
YANG Qiuhong, TIAN Lingyun, SU Yanan, GAO Huimin, LIN Pan, LI Wan, LI Yinglan
Chinese Nursing Management. 2021, 21 (7):  1112-1116.  DOI: 10.3969/j.issn.1672-1756.2021.07.030
Abstract ( 256 )   PDF (1933KB) ( 475 )  
This research will summarize the research status of concepts, theoretical models and assessment tools of work adjustment disorder, probe into the relative influencing factors and put forward viable countermeasures for nurses. And it is also hoped to provide a theoretical basis for reducing the level of work adjustment disorder and ensuring the nursing quality and safety management.
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The application and enlightenment of narrative research in nursing
HOU Jiakun, ZHOU Hongzhen, TU Yan, WANG Xiaoyan, HU Ruidan, LIU Yangyang
Chinese Nursing Management. 2021, 21 (7):  1116-1120.  DOI: 10.3969/j.issn.1672-1756.2021.07.031
Abstract ( 504 )   PDF (2721KB) ( 420 )  
Narrative research, as a new qualitative method emerging in international nursing field in recent years, is a process of understanding, analyzing and commenting on experience. This article summarized the concept of narrative research, and reviewed the procedures, application status of it in nursing. This paper aimed to strengthen the nursing researchers' understanding of narrative research and promote the development of narrative research in nursing in China.
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