The accurate position of the catheter tip is the premise of the safe use of PICC. In 2021, the Chinese Nursing Association released the association standard of "The Intracardiac Electrocardiogram method for positioning the tip of Peripherally Inserted Central Catheter" to standardize the core process and key points of the Intracardiac Electrocardiogram method for positioning the tip of Peripherally Inserted Central Catheter. This article briefly interprets the core points of the standard in combination with published clinical practice evidence.

Objective: To explore the effectiveness of PICC Intracardiac Electrocardiogram technique for positioning the tip of PICC in the senior elderly patients. Methods: Retrospective study was performed. All the patients who was over 75 years old, in the geriatric department, with PICC between January 2018 to 2022 February were included. A total of 79 patients with IC-ECG were included in the study group, while 137 patients without IC-ECG were included in the control group. The accuracy of location of PICC, thrombus rate, infection rate and catheter displacement rate were analyzed. Results: The study group had significant low rate of thrombus than the control group (0 and 5.1% respectively). There were no significant differences of the accuracy of location of PICC, infection rate and catheter displacement rate between the two groups. Conclusion: IC-ECG can decrease the incidence of thrombus without increasing the other complications in the senior elderly patients with PICC. It can be used for positioning the tip of PICC in the senior elderly patients.

Objective: To summarize the application of the standardized procedure of intracavitary electrographic positioning technology in the implantation of arm infusion port in breast cancer patients in our hospital. Methods: A multidisciplinary management team was established to formulate the standardized process of electrogram positioning technology, emergency plan for disease change and treatment process without characteristic P wave changes in the implantation of arm infusion port. The standardized process was applied in the implantation of arm infusion port. Results: All 320 patients with arm infusion port implantation were successfully placed in the port at one time. The extraction rate of characteristic P wave was 98.8%, and the accuracy rate of X-ray positioning catheter tip was 96.6%. During the port implantation, 2 patients showed abnormal symptoms including palpitation and palpitations, which were all improved after active treatment. Conclusion: The standardized process of IC-ECG positioning technology is suitable for the positioning of the catheter tip in the arm infusion port, which can help medical staff to identify and deal with abnormal situations in the port in real time. This technology can improve the efficiency of the port placement, and ensure the safe indwelling of the arm infusion port.

Objective: To explore the role growth process of PICC specialist nurses and the potential influencing factors. Methods: Semi-structured interviews were conducted with 21 PICC nurses from August to November, 2021. The interview data was analyzed using Nvivo software based on constructivism grounded theory. Results: The role growth process of PICC specialist nurses could be divided into four periods, namely, the recognition period, the establishment period, the coping period and the transformation period. It was influenced by such factors as internal interest, external cognition and evaluation, job pre-admittance preparation, correct establishment of role cognition, pressure in role growth, coping strategy of role pressure, role deepening and role degradation. Conclusion: The role growth of PICC specialist nurses is a complex dynamic change process. Nursing managers can give targeted attention and guidance according to the characteristics of different periods, so as to promote the smooth transformation and growth of nurses' roles.

Objective: To explore the current situation of training and implementation of intracavitary electrocardiogram positioning technology in Hunan province. Methods: The self-designed "Intracardiac electrocardiography positioning technology training and implementation status questionnaire" was used to investigate the intravenous therapy specialist nurses in Hunan Province. The effective rate of questionnaire collection was 100%. Results: Among 413 intravenous therapy nurses, 162 (39.23%) nurses from 44 hospitals (36.07%) carried out intracardiac Electrocardiogram positioning technology. Totally 138 (33.41%) nurses independently applied intracavitary electrocardiogram positioning technology. Totally 187 (45.28%) nurses did not know the group standard of PICC advanced Electrocardiogram Positioning Technology. Totally 227 (54.96%) nurses had urgent need to carry out intracardiac electrocardiography technology. Conclusion: The IC-ECG positioning technology among nurses needs to be enhanced. It is urgent for nursing managers to strengthen the training and management level of IV therapy nurses, so as to improve the nursing quality of IV therapy in the province.

Objective: To analyze the effect of Nursing Delirium Preventive Interventions in ICU (UNDERPIN-ICU) on delirium management in patients after cardiac surgery. Methods: A historical control study was used and 237 patients were selected in CSICU of a tertiary grade A hospital as study participants. The control group (117 cases) received routine nursing measures to prevent delirium, and the intervention group (120 cases) received the UNDERPIN-ICU. The incidence of delirium, duration of mechanical ventilation, ICU stay and hospital stay were compared between the two groups. Results: The incidence of delirium, the duration of mechanical ventilation and ICU stay in the intervention group were significantly shorter than those in the control group (P<0.05). There was no difference in hospitalization time between the two groups (P>0.05). Conclusion: UNDERPIN-ICU can be used for the prevention and management of delirium in patients after cardiac surgery, which is helpful to reduce the incidence of delirium, shorten the time of mechanical ventilation and ICU stay.

Objective: To optimize the midwifery quality evaluation index system which has been developed by our team in terms of index data availability through questionnaire survey and pilot application. Methods: A questionnaire survey was conducted in the technical cooperation network of an obstetrics and gynecology hospital and maternal and child health hospital to understand the data availability of the midwifery quality evaluation index system. Based on the survey results, five institutions were selected to collect midwifery quality evaluation index system data, and five data collectors were interviewed to explore the profound reasons for the low availability of some index data, and the optimization of relevant indicators was supplemented by expert consultation. Results: The survey results of 35 medical institutions showed that the availability of some index data was low, mainly due to unclear definition, time-consuming manual statistical analysis and inability to obtain manually. According to the results of interviews and expert consultation, the research team optimized 9 contents of the 8 indicators. Conclusion: The optimized midwifery quality evaluation index system plays an important role in maintaining the rationality of the index while improving data availability and clinical practicability, which lays a foundation not only for further popularization and application but also for midwifery quality evaluation and comparison.

Objective: To explore the effects of the expressive writing in patients with laryngeal cancer after total laryngectomy. Methods: A total of 63 patients with laryngeal cancer who underwent radiotherapy in a tertiary hospital in Yinchuan from May 8, 2019 to April 30, 2021 were divided into the control group (31 cases) and the interventional group (32 cases) according to their admission date. Patients in the control group received conventional psychological guidance while patients in the interventional group received the expressive writing intervention besides the conventional psychological guidance. The post-traumatic growth, mental flexibility, and self-efficacy of patients in the two groups before and one month after the intervention were compared. Besides, the participation compliance and writing completion of patients in the interventional group were evaluated. Results: After the intervention, only the score of new possibility dimension of post-traumatic growth were increased in the control group (P<0.05). The scores of post-traumatic growth and all dimensions were increased in the interventional group (P<0.05). The scores of relationship with others, personal strength, and self-transformation dimensions of patients in the interventional group were higher than those in the control group (P<0.05). The total score of the psychological resilience scale and the scores of toughness and self-improvement were all higher than those before the intervention in the interventional group (P<0.05). The total score of psychological resilience and self-improvement dimension scores in the interventional group were higher than those in the control group (P<0.05). The self-efficacy score of patients in the interventional group was (2.31±0.29), which was higher than that of the control group (1.71±0.25) (P<0.001). There were 65.6% of the patients in the interventional group had high compliance with the participation. The completion degree of the communication and writing exposure part is 100.0%, and the completion degree of the pure writing exposure part is 78.1%. Conclusion: Expressive writing intervention can improve post-traumatic growth, mental flexibility, self-efficacy, and promote the psychological and social rehabilitation of the patients with laryngeal cancer after total laryngectomy.

Objective: To develop a pain management program for patients with oral cancer based on belief modification. Methods: The pain management program was developed by means of semi-structured interview, literature retrieval, and the Delphi technique. Results: The expert authority coefficient of the two-round consultation were 0.75 and 0.78, and the importance and feasibility of Kendall's coefficient were 0.252, 0.084 and 0.162, 0.170 (all P<0.001), respectively. The program included 6 first-level indicators, namely establishing cancer pain files, recognizing pain to avoid cognitive misunderstandings, rational use of painkillers, accepting pain, discharge guidance, summary and feedback. The program also contained 13 second-level indicators, and 18 third-level indicators. Conclusion: The content of the pain management program is reliable and scientific, and can provide reference for pain management of oral cancer patients.

Objective: To investigate the status quo of knowledge and protective behavior to surgical smoke among nurses in operating room. Methods: The operating room nurses from 26 hospitals in China were selected to carry out an online questionnaire survey. Results: The average score of the basic knowledge of surgical smoke was 74.01±2.62. The average score of the surgical smoke protective behavior was 55.02±3.13. Working years was the impact factor of the surgical smoke knowledge. Working years and technical title were the impact factors of the surgical smoke protective behavior. Conclusion: The nurses in operating room had insufficient knowledge about surgical smoke, and their protective behavior regarding surgical smoke need to be improved. Managers should have effective equipments to remove the surgical smoke and provide healthy environment to nursing staff.

Objective: To describe the feelings of nursing students providing private nursing care for patients in urology department, in order to provide reference for clinical teaching and improve quality of patients' private care. Methods: Using the phenomenological research method of qualitative research, 12 nursing students in urology department of a tertiary grade A hospital in Shanghai were selected for in-depth interview. Results: Two themes were extracted: learning experience (lack of education, nursing quality is neglected); experience of nursing care (proactive and withstand pressure, invalid coping and avoidance, lack of improvement power). Conclusion: Nursing interns have experienced intensive nursing practice involving patients' private parts in urology department; however, the quality of such operation practice is often ignored by nursing managers. Appropriate teaching methods should be selected to guide nursing students to change their attitudes and improve their sense of achievement, so as to promote the overall nursing quality of urology.

Objective: To explore the needs of health education based on mobile health in community-dwelling older patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: A semi-structured interview was conducted in 12 older patients with COPD in a community. Results: Four themes emerged from the data: usage needs, contents needs, function needs, and design needs of health education based on mobile health. Conclusion: Before providing health education based on mobile health, we should fully understand patients' needs and send accurate, easy-to-understand and targeted health information in time by mobile platform. In addition, the interface of health education software should be concise and clear, and the operation steps should be simplified as much as possible, to facilitate the use in older patients with COPD.

Objective: To investigate and analyze the risk factors of xerosis cutis in the elderly inpatients, so as to provide basis for the prevention and intervention of skin xerosis. Methods: A total of 52 hospitals in China were selected as multi-center research units. We performed skin examination for elderly inpatients (≥60 years old) using the same method and at the same period. International consensus definitions were used to identify dry skin, and demographic data, health status and the risk of pressure ulcer were collected. Single factors and Logistic regression analysis were employed to obtain the risk factors. Results: A total of 14675 cases of effective data were obtained. It was found that the total prevalence of xerosis cutis was 38.8% (5691/14675). Logistic regression analysis found that male, with risk of pressure injury, cardiovascular disease and diabetes, antibiotics, glucocorticoids and diuretics, age over 71 years and hospital stay over 8 days were independent risk factors for senile xerosis cutis. Conclusion: The prevalence of xerosis cutis in the elderly inpatients in China is high. The elderly inpatients with the above risk factors should be listed as the key elderly for the prevention.

Objective: To investigate the status of integrated medical and nursing service supply in Chongqing, so as to provide reference for the improvement of elderly care service system construction and the development of related policies. Methods: A self-designed questionnaire was used to conduct online survey on 144 integrated medical and nursing institutions and 503 community health centers in Chongqing, and 37 of them were investigated on site. Results: The integrated medical and nursing institutions mainly provide health management, regular visits, emergency rescue, and referral service, etc. Only 25.25% of community health centers actually cooperated with elderly care institutions. About one-third of elderly care institutions and community health centers with occupancy rates were lower than 50%, and 45.83% of integrated medical and nursing institutions were in deficit. About 29.17% of integrated medical and nursing institutions and 37.97% of community health centers did not provide intelligent elderly care. Conclusion: To improve the connotation of integrated medical and nursing service, unified supervision should be strengthened, demand-oriented reform on the service supply side should be promoted, and a new model of community intelligent medical and nursing services should be developed.

Objective: To systematically evaluate the risk factors of Vessel Catheter-Associated Infection (VCAI) in critical patients. Methods: The studies on risk factors of VCAI in critical patients were searched and enrolled from databases including PubMed, Web of Science, Cochrane Library, Embase, CNKI, WanFang data, VIP and CBM to do Meta-analysis using Stata 12.0. Results: A total of 20 studies with a total sample size of 17539 were recruited of which the incidence of VCAI ranged from 0.72% to 33.33%. Meta-analysis showed that older age, high APACHE II score, diabetes mellitus, basic diseases, decreased immune function, lower serum albumin level, medical staff?'s lacking experience in cannulation, repeated venipuncture, femoral vein catheterization, lumen number >1, longer stay in ICU, heavy use of antibiotics, intravenous infusion of nutrient solution, longer indwelling time were risk factors for VCAI in critical patients. Conclusion: Based on the above evidence, it is recommended to have an overall assessment of the patients before catheterization such as severity of disease, complications, immune function and so on, standardize the catheterization process, rationally select the catheterization site and lumen number, pay attention to catheter maintenance after catheterization, and minimize the indwelling time to reduce the occurrence of VCAI in critical patients.

Objective: To systematically review and synthesize the experiences of patients living with Polycystic Ovary Syndrome. Methods: We searched the following databases including PubMed, Web of Science, Embase, CBM, CNKI, WanFang Data, and VIP to retrieve all eligible qualitative studies. The literature quality evaluation criteria of the Australian JBI Evidence-based Health Care Center were used to assessed the quality of the included studies. The collection integration was used to integrate the findings. Results: A total of 10 articles were included, 50 themes were extracted, and 10 categories were summarized. Three integrated results were formed, namely, the impact of disease, disease awareness and coping style, and needs that related to disease. Conclusion: Medical professionals should fully understand the disease experiences of patients living with Polycystic Ovary Syndrome, provide support in treatment and care, encourage active response to the disease, and build a support system to improve the quality of life of patients.

Objective: To identify risk factors for delirium in patients with Coronary Artery Bypass Grafting (CABG). Methods: Computer retrieval of literature on the risk factors of delirium after CABG. The retrieval time limit is January 1, 2010 to May 31, 2021. After literature screenning, data extraction and quality evaluation, RevMan 5.3 software was used for Meta analysis. Results: A total of 19 articles were included. The statistically significant risk factors included age [OR=2.42, 95%CI (1.66-3.52)], cognitive impairment [OR=5.70, 95%CI (3.78-8.59)], depression [OR=3.76, 95%CI (2.75-5.13)], malnutrition [OR=2.56, 95%CI (1.60-4.11)], mechanical ventilation [OR=2.59, 95%CI (2.31-2.89)], cardiopulmonary bypass [OR=2.45, 95%CI (1.58-3.80)], observation time in ICU [OR=2.96, 95%CI (2.50-3.49)], cerebrovascular diseases [OR=2.48, 95%CI (1.76-3.49)], diabetes [OR=4.20, 95%CI (2.71-6.48)], anemia [OR=2.95, 95%CI (1.60-5.44)], complications [OR=3.08, 95%CI (2.21-4.31)] and increased creatinine [OR=2.28, 95%CI (1.56-3.34)]. Conclusion: There is heterogeneity in sample size, case selection and other aspects among different studies, which needs to be verified by more high-quality studies in the later stage to provide a basis for the development of clinical risk screening tools for postoperative delirium in CABG.

Objective: To evaluate the effect of Otago Exercise Program on the knee rehabilitation of patients after knee arthroplasty. Methods: CNKI, WanFang Data, VIP, FMRS, PubMed, Web of Science and Cochrane Library databases were searched, retrieved randomized controlled trials of rehabilitation exercise after knee arthroplasty using Otago Exercise Program. Retrieval time limit was from the establishment of the database to April 30th 2021. Two researchers independently completed the literature screening, data extraction and methodological quality evaluation of the included literature. RevMan 5.3 software was used for Meta-analysis. Results: A total of 6 randomized controlled trials were included. The Meta-analysis results showed that the knee flexion after Otago Exercise Program [SMD=10.71(7.92, 13.50), P<0.05], hospital for special surgery knee score [SMD=7.66 (5.55, 9.77), P<0.05], and Modified Falls Eglcacy Scale score [SMD=3.87 (2.02, 5.71), P<0.05] were higher than conventional rehabilitation exercises, but the difference of Berg Balance Scale score [SMD=1.96(-1.74, 5.67), P>0.05] was not statistically significant. Conclusion: Otago Exercise Program can promote the recovery of knee joint function in patients after knee arthroplasty and reduce the occurrence of falls. There were no reports of adverse events. However, the included studies were limited, need to be further verified by more high-quality studies.

Objective: To search and analyze the evidence related to Comprehensive Geriatric Assessment in the emergency department. Methods: We searched clinical decision-making websites, guidelines, professional association websites, evidence-based literature resources, and databases for guidelines, evidence summaries, best practices, systematic reviews, and expert consensus related to Comprehensive Geriatric Assessment in the emergency department. After the methodological quality assessment, the evidence was extracted and summarized based on professional judgments. Results: A total of 11 articles were included, involving 9 systematic reviews, 1 expert consensus and 1 guideline. A total of Thirty-seven pieces of evidence were obtained and summarized into eight aspects: effectiveness and safety, target population, assessment scope, assessment tools, assessment process, team role positioning, post-assessment intervention measures and quality control. Conclusion: Medical staff should pay attention to Comprehensive Geriatric Assessment in the Emergency Department and select the best evidence based on the actual situation to improve the standardization and systematization of the Comprehensive Geriatric Assessment in the Emergency Department and ensure patient safety.

Objective: To systematically evaluate the intervention effects of water-based exercises on health outcomes of hypertension patients. Methods: A systematic search of PubMed, Web of Science, the Cochrane Library, Embase, EBSCO, Scopus, CNKI, WanFang Data, VIP, and CBM databases was carried out to collect randomized controlled trials on water-based exercises for hypertension patients from inception to June, 2021. Results: Totally 9 RCTs involving 363 patients were included. Meta-analysis results showed that water-based exercises significantly improved blood pressure and heart rate in hypertensive patients compared with other physical therapy (P<0.05). However, there was no statistical significance in improving atherosclerosis (P>0.05). Conclusion: Compared with other physical therapy, water exercises can significantly improve blood pressure and heart rate in hypertension patients but the effect on atherosclerosis is not significant. More high-quality studies are needed in the future.

This article reviews published papers to summarize the promoting and inhibiting factors from mainly three dimensions including systematic aspects, working process and organizational aspects, hoping not only to make use of the promoting factors but also deal with inhibiting factors to ensure that clinical nursing decision-making support system is efficiently integrated into daily nursing care.

Objective: To explore the application effect of Objective Structured Clinical Examination (OSCE) in evaluating the clinical nursing competence of Enterostomal Therapist (ET). Methods: We selected ET trainees trained in Nanjing International Ostomy Therapist School from 2019 to 2020, and applied OSCE to evaluate their clinical nursing competence. Results: The average score of the 60 trainees in the assessment was 377.80±24.04, and the pass rate was 100%; the difficulty of the OSCE assessment was 0.70-0.81, and the discrimination degree was 0.21-0.70; 98.3% of the trainees and 95.0% of the examiners believed that the OSCE could fully evaluate ET clinical nursing competence. Conclusion: OSCE assessment can fully evaluate the clinical nursing competence of ET, reflect the deficiencies in the ET training process, and provide references for optimizing the training of ET.

Objective: To analyze the impact of non-violent communication training on the communication skills of clinical nurses, patients' nurse-patient trust and satisfaction. Methods: From October to December 2020, nurses in 6 wards of 3 specialties in a tertiary grade A hospital in Hunan province were selected for intervention subjects, and the hospitalized patients were observed. The nurses were assigned to control group and intervention group according to their wards. The control group (38 nurses) received the routine specialist training program, while the intervention group (38 nurses) received non-violent communication skills training besides the routine training. The nurses' clinical communication ability scale, patient's nurse-patient trust scale and the Newcastle Satisfaction with Nursing Scale were used for data collection. Results: After intervention, the nurses' clinical communication ability, patients' nurse-patient trust and satisfaction of the intervention group were higher than that of the control group (P<0.05). Conclusion: Non-violent communication skills training for nurses can improve nurses' communication ability, and the patients' nurse-patient trust relationship and satisfaction.

Objective: To explore the application effect of nurse led dynamic body mass management scheme in renal transplant patients. Methods: A urological intensive care unit was established, a dynamic weight management team led by nurses was established, and a dynamic body mass management scheme for renal transplant patients was constructed and applied in clinical practice. Results: The recovery of renal function was improved after the implementation of nurse led dynamic weight management scheme, and there was significant difference on the first day after operation (P<0.05); Hemoglobin, albumin and prealbumin increased compared with the control group, and the changes of albumin and prealbumin were statistically significant (P<0.05); The body mass of the post implementation group decreased on the 1st-3rd, 4th-7th and 8th-14th days after operation, and the difference was statistically significant (P<0.05). Conclusion: The implementation of nurse led dynamic body mass management scheme for patients after renal transplantation has a good clinical effect. Accurate dynamic body mass management promotes the recovery of patients' renal function and makes the weight management after renal transplantation develop scientifically and standardized, which is worthy of clinical promotion.

Objective: To evaluate the clinical efficacy of standardized process of the medication administration of tirofiban in patients with progressive ischemic stroke. Methods: The problems linked in the usage of tirofiban was analyzed and a standardized process of medication administration after admission was formulated, including drug administration specifications, dedicated group prescription, a fast track for nuclear magnetic examination under multi-department cooperation, special frame of drug usage, and drug substances information column. Results: Compared with the non-standardized process of medication administration, the standardized process significantly reduced the waiting time of medication administration, drug interruption time, and accurate drug bridging time, respectively. Conclusion: The standardized process of the medication administration of tirofiban in patients with progressive ischemic stroke can effectively shorten the waiting time of medication administration, drug interruption time, and accurate the drug bridging time, which is beneficial for the safety of patient’s medication administration.

Objective: To construct a clinical instrument to measure functioning of patients following cardiac rehabilitation using the International Classification of Functioning, Disability and Health (ICF) categories based on a Rasch analysis. Methods: A convenience sampling was used to conduct the questionnaire survey in a cardiac rehabilitation center. Psychometric properties were evaluated in 100 patients with CHD using Rasch analysis, such as unidimensionality, the person-and item-separation reliability and fit of ICF categories by Winsteps. Results: The Rasch refinement led to a 58-item scale. Rasch reliabilities were 0.95 (23-item body function scale), 0.96 (2-item body structures scale), 0.91 (17-item activity and participation), and 0.94 (16-item environmental factors scale). The overall Cronbach's α coefficients were 0.879. The ICF categories for patients following cardiac rehabilitation correlated well with SF-36. Conclusion: The ICF categories for patients following cardiac rehabilitation is a reliable and valid questionnaire based on the ICF checklist. It allows measurement of functioning as a unidimensional construct in patients following cardiac rehabilitation.

This paper reviews the multidisciplinary management team, time and frequency, process and nursing points of exercise rehabilitation after Left Ventricular Assist Device(LVAD) implantation, in order to provide reference for the development of relevant fields in China.

This article reviews the definition, theory basis, evaluation tools, and intervention strategies towards death anxiety in advanced cancer patients, and aims to provide reference for future researches on death anxiety of advanced cancer patients, as well as the formulation of intervention strategies.

Objective: To explore the influencing factors of hypoglycemia in patients with Type 2 Diabetes Mellitus during the perioperative period. Methods: We retrospectively analyzed the electronic data of 1410 patients with Type 2 Diabetes Mellitus who were hospitalized in Xiangya Hospital of Central South University for selective operation from July 2019 to December 2019. A total of 151 patients with perioperative hypoglycemia were treated as the casegroup, while the other 1259 cases were the control group. Logistic regression analysis was used to identify the main influencing factors of perioperative hypoglycemia in Type 2 Diabetes Mellitus patients. Results: The incidence of perioperative hypoglycemia in patients with Type 2 Diabetes Mellitus was 10.7% (151/1410). Logistic regression showed that diabetic patients undergoing surgery such as ophthalmology and otorhinolaryngology and gynecology were more likely to suffer from perioperative hypoglycemia. Diabetes duration≥10 years, Standard Deviation of Blood Glucose (SDBG)≥3 mmol/L, BMI Related Articles | Metrics

This article briefly introduced the development of Health Care Assistant in the UK including its development history, current status, and benefits. We propose suggestions on the establishment and management of nursing assistants in China aiming to provide reference for government and hospital administrators.