Objective: To explore the application effects of chain management pathway led by wound specialist nurses in the management of breast cancer wounds. Methods: A chain management team of breast cancer wounds led by wound specialist nurses were composed by Nursing Department, Wound Care Clinic and other related departments. Malignant Fungating Wounds (MFWs) Chain management was carried out for patients with high-risk breast cancer wounds from four aspects of early screening, early diagnosis, early intervention and continuous follow-up. Results: Since May 2019 to May 2022, 4300 patients with breast cancer were enrolled, including 925 patients with high-risk breast cancer wounds and 115 patients with cancer wounds. Before and after the implementation of breast cancer wound chain management, the total scores of patients with breast cancer wound were (196.23±3.11) and (67.28±6.17) respectively. The average pain scores of each stage before and after implementation were (8.23±1.10) and (2.12±0.61) respectively, the average scores of exudate volume were (22.35±3.26) and (11.21±4.63) respectively. The average satisfaction of patients after implementation was 95.84%. Conclusion: The chain management pathway led by wound specialist nurses in the management of breast cancer wounds is beneficial to early control of wound symptoms, which can enhance the quality of life of the patients.

This paper summarized the research progress in palliative care of Malignant Fungating Wounds in recent years. It analyzed the related concepts, development status, palliative care model, symptom management, psychosocial support, and effect evaluation in palliative care of Malignant Fungating Wounds. The existing issues in the research were presented. The direction and trend of future research were proposed to provide reference for the practice and research in palliative care of malignant fungating wounds.

Objective: To summarize the experience of perioperative nursing management of Malignant Fungating Wounds, and to improve the treating efficiency of such difficult wounds, and to emphasize the importance of multidisciplinary team-based nursing management system with wound therapists as the core in the treatment of Malignant Fungating Wounds. Methods: A total of 108 patients with Malignant Fungating Wounds admitted to the Chronic Wound Clinic of one general hospital from May 2019 to May 2022 were included. The patients accepted comprehensive perioperative nursing management led by wound therapists and supported by multidisciplinary team. Results: Totally 98 patients (90.7%) achieved wound healing by primary intention when the sutures were removed 2 weeks after the operation. 10 patients (9.2%) had delayed healing due to fat liquefaction, secondary infection, partial skin margin necrosis after transplantation. By adopting personalized debridement and tissue vitality promotion strategy, the delayed healing wounds all achieved healing by secondary intention in 3 to 5 weeks. Conclusion: A perioperative nursing management system with wound therapists as the lead of the multidisciplinary team can promote the healing rate and healing efficiency of Malignant Fungating Wounds. It is expected that future clinical practice and study can promote the optimization of this system.

Objective: To investigate the status quo of knowledge, attitude and practice on Malignant Fungating Wounds management in oncology nurses and analyze its influencing factors. Methods: A convenience sampling method was used to survey 687 oncology nurses. The survey tool were a self-designed general information questionnaire, and questionnaires on knowledge, attitudes, and practices of oncology nurses on Malignant Fungating Wounds management. Results: The scores of oncology nurses on knowledge, attitude and practice were 14.94±3.12, 58.62±6.76 and 70.71±25.17 respectively. The result of multiple regression analysis showed that professional title, wound training and knowledge of Malignant Fungating Wounds management were the influencing factors of knowledge (P<0.05). Position, wound training and knowledge of Malignant Fungating Wounds management were the influencing factors of attitude (P<0.05). The classification of the City, wound training experience and knowledge of Malignant Fungating Wounds management were the influencing factors of practice (P<0.05). Conclusion: Oncology nurses have positive attitudes on Malignant Fungating Wounds management, but their knowledge and behavioral practices are relatively poor. Nursing managers should pay attention to the training of oncology nurses in Malignant Fungating Wounds management knowledge and skill, and further promote the related work of Malignant Fungating Wounds management, and improve the level of nursing for patients with Malignant Fungating Wounds.

Objective: To summarize the experience in risk management of patients with Malignant Fungating Wounds (MFWs) bleeding in a Multi-Disciplinary Treatment (MDT) model. Methods: A MDT team was established and led by enterostomal therapist. The risk management included developing a wound bleeding risk plan, systematically assessing the bleeding risk of patients with MFWs, identifying the risk levels, reinforcing the notification step by step, implementing wound management following the TIME principle and Chinese chronic refractory wound diagnosis and treatment principles, and adopting continuous nursing. Results: In recent 3 years, a total of 167 patients were treated in wound care center. No accidental bleeding adverse events were reported. No complaints and disputes were recorded during dressing change. The patients satisfaction reached 98.3%. Conclusion: The risk management of patients with MFWs bleeding under the MDT model can establish security system for patients from the medical, legal, management aspects. The patients received safe and effective treatment through MDT and optimized workflow.

Objective: To explore the management pathway for patients with Malignant Fungating Wounds (MFWs) based on specialized nursing studio and evaluate its clinical practical effects. Methods: The specialized nursing studio and clinical departments were collaborated to form a specialized multidisciplinary team for patients with MFWs. Through group discussion and dynamic evaluation, systematic and precise nursing plan were developed. Nursing services were expanded including online interaction, teaching, gratuitous treatment and other activities. Results: A total of 11 patients with MFWs were cared for in the studio, 11 sets of individualized care plans for patients with MFWs were formulated, 4 free community clinics and 4 community voluntary classes were conducted. The satisfaction of patients and their families was over 95%. Conclusion: The practice of multidisciplinary team based on specialized nursing studio provides dynamic and precise care services for patients with MFWs, and promotes the professional development of MFWs nursing, which is worthy of clinical reference and application.

Objective: To explore the application effects of empowerment education program in caregivers of children with congenital megacolon enterostomy. Methods: Totally 56 children with congenital megacolon who underwent enterostomy and their caregivers in our hospital from January 2019 to December 2021 were randomly divided into experimental group and control group, with 28 cases in each group. The control group received routine health education during hospitalization, and the experimental group received empowerment education on this basis. The care ability scores of the main caregivers of the two groups and the incidence of postoperative complications were compared. Results: After 3 months of intervention, the scores of five dimensions of main caregivers in the experimental group were significantly lower than those in the control group (P<0.05). The incidence of postoperative complications was significantly lower than that in the control group (P<0.05). Conclusion: Empowerment education is helpful to enhance the care ability of caregivers of children with congenital megacolon enterostomy, promote them to deal with problems in a positive way, reduce the occurrence of postoperative complications, and then improve the health outcome of children.

Objective: To meet the needs and improve the compliance of patients with Stress Urinary Incontinence for Pelvic Floor Muscle Treatment, and improve the symptoms of urinary incontinence, design and develop an intelligent pelvic floor rehabilitation APP and evaluate its application effect. Methods: Through literature review, the APP designed and developed by widely soliciting from clinical medical staff, patients and nursing teachers in colleges. From September 2020 to December 2021, 81 elderly female patients with Stress Urinary Incontinence in a tertiary hospital in Beijing were investigated by convenient sampling method. The acceptability of the intelligent pelvic floor rehabilitation APP was evaluated, and the compliance of Pelvic Floor Muscle Treatment and urinary incontinence before and after the use of the intelligent pelvic floor rehabilitation APP were evaluated. Results: The APP contains knowledge learning, exercise reminding, personalized courses, vibration mode, exercise interest, visual exercise feedback, exercise data statistics, interactive platform 8 modules. The overall acceptance score of 81 patients using intelligent pelvic floor rehabilitation APP was 141.27±11.37. After using intelligent pelvic floor rehabilitation APP for 7 weeks, the compliance of Pelvic Floor Muscle Treatment and urinary incontinence were significantly improved (P<0.05). Conclusion: Patients have a high acceptance of intelligent pelvic floor rehabilitation APP. The application of this APP can enhance the enthusiasm and compliance of patients' Pelvic Floor Muscle Treatment, and improve urinary incontinence, which is worth popularizing.

Objective: To examine the effects of a individualized multicomponent exercise program in older patients with frailty. Methods: A total of 108 patients with frailty were randomly divided into the observation group (n=55) and the control group (n=53). Patients in the control group received routine care, and patients in the observational group accepted the multicomponent exercise program. The balance ability, fall efficacy, frailty state and physical activity ability of the two groups were compared. Results: After the intervention, there were differences in balance ability, fall efficacy, physical activity ability, and frailty composition ratio between the two groups (all P<0.05). Conclusion: Individualized multi-component exercise management program can effectively improve patients' frailty state, physical activity ability, balance ability and reduce the risk of fall.

Objective: To develop a Family-Integrated Care (FICare) program for premature infants during hospitalization, and to provide a reference for the application of FICare. Methods: A research team was established. A draft was formed regarding the FICare program for premature infants during hospitalization based on the cross-sectional survey, semi-structured interviews and literature review. The Delphi method was used to conduct 2 rounds of expert consultation, and the items were discussed and revised based on expert opinions. Results: Two rounds of consultation were carried out in 18 identical experts, and the effective response rate of the questionnaire was 100.0%. The expert authority coefficient was 0.92, the coefficient of variation of each item in the second round was 0-0.15, the Kendall’s concordance coefficient was 0.16 (P<0.01), and the importance value was 4.33-5.00. A FICare program for premature infants during hospitalization was finalized, including 6 first-level items (organizational structure, environmental support, team training, family evaluation, family participation, and effect evaluation), 21 second-level items, and 45 third-level items. Conclusion: The FICare program for premature infants during hospitalization formed in this study is scientific and reliable with strong clinical application value.

During the period of regular prevention and control of COVID-19, as the only designated medical security institution for the Beijing Winter Olympic Games, Peking University Third Hospital launched a special diagnosis area for the Winter Olympic Games and implemented closed-loop management. In order to maximize the performance of human resources and ensure the nursing quality for the Winter Olympic, we strengthened nursing management, sorted out the working processes and accurately controlled the work details. This paper introduced the nursing management practice of the special area for the Olympic Winter Games from the aspects of the setting of the special area and the configuration of facilities, the formulation and improvement of the working processes, the nursing management of human resource and quality, and the prevention and control of hospital infection.

This paper reviewed the nursing management practice of medical security in XXIV Olympic Winter Games curling event venue (National Swimming Center), summarized the experience and discussed the problems. We hope to provide references regarding the medical security for other relevant personnel who will participate in large international winter events, especially curling event.

This article summarized the experience in the preparation and nursing management of the emergency department of the polyclinic during the medical security period of the Beijing Olympic Winter Games. It introduced the preparation of diagnosis and treatment area, preparation of personnel, the model of closed-loop management, emergency treatment process, disinfection management, disposal of medical materials and waste, etc. In the background of epidemic prevention and control work, it is expected to provide reference for the medical security work of holding similar large-scale international sports events in the future.

This paper summarized the work done by the polyclinic of Beijing Yanqing Winter Olympic Village on the "comprehensive preparation, professional setting and detailed control" of goods and materials under the requirements of the prevention and control of the COVID-19 and in combination with the characteristics of large-scale sports events in winter, which not only ensured the smooth operation of the comprehensive clinic, but also laid a solid foundation for providing timely, scientific and effective high-quality medical and nursing services for the events.

Objective: To translate the Diabetes Fear of Injecting and Self-testing Questionnaire (D-FISQ) into Chinese, and to test its reliability and validity in children with Type 1 Diabetes Mellitus. Methods: The Chinese version of the D-FISQ was developed by using Brislin translation model including translation, back translation and cross-cultural adaptation. A total of 196 children with Type 1 Diabetes Mellitus were recruited by a convenience sampling to evaluate the reliability and validity of the scale. Results: The Chinese version of D-FISQ contains the Fear of Self-Testing (FST) and Fear of Insulin Injecting (FSI) scales, and the exploratory factor analysis of both subscales extracted 4 common factors, the cumulative variance contribution of FST was 61.769% and that of FSI was 62.812%. The Cronbach's α coefficient for total scale was 0.911 and the content validity index was 0.96. The Cronbach's α coefficient for FST subscale was 0.802 and the test-retest reliability was 0.831. The Cronbach's α coefficient for FSI was 0.833 and the test-retest reliability was 0.833. Conclusion: The Chinese version of the D-FISQ has good reliability and validity and can be used as a tool to assess the fear of insulin injecting and self-testing in children with Type 1 Diabetes Mellitus.

Objective: To develop an intervention program for the dietary management of gestational diabetes mellitus patients based on Health Action Process Approach (HAPA) and nudges strategies. Methods: The first draft of a dietary management program for gestational diabetic patients based on a combination of HAPA and nudges strategies was developed using literature review and group discussion. Then a two-round expert correspondence was conducted with 16 experts using the Delphi expert correspondence method to form the final draft of the intervention program. Results: Two rounds of expert consultation were conducted to construct the program with 3 primary indicators (pre-intentional phases, intentional phases, and action phases), 9 secondary indicators, and 25 tertiary indicators. The expert authority coefficients were 0.804 and 0.886, respectively; the Kendall coordination coefficients for the two rounds of correspondence were 0.226 and 0.261, respectively, with statistically significant differences (P<0.001). Conclusion: The intervention program for dietary management of gestational diabetes patients constructed in this study is reliable and practical, and provides a reference basis for the care measures related to dietary management of gestational diabetes patients.

Objective: To explore the influencing factors of exercise behavior of frail elderly live in a care institution. Methods: In-depth interview using phenomenological method was conducted with 12 frail elderly people in a care institution in Beijing from April to May, 2021, and Colaizzi's 7-step analysis method was used for data analysis based on the COM-B model. Results: Facilitators of exercise behavior included perceived exercise benefits, emotional support from major social relationships, variety of access to exercise knowledge, interpersonal interaction promoting. Barriers of exercise behavior included insufficient awareness of exercise, limited physical activity, poor state of illness, negative psychology of life status, environment constraints. Conclusion: The exercise behavior of the frail elderly is affected by a variety of factors, and the medical staff should take targeted measures to increase the participation of the elderly in exercise behavior to improve the weakness, and promote healthy aging.

Objective: To summarize the evidence-based evidence for the prevention of Arteriovenous Fistula (AVF)dysfunction, and to evaluate its clinical effects. Methods: We searched relevant guidelines, expert consensus and systematic reviews for the prevention of AVF dysfunction and summarized the best evidence to construct evidence-based practice program. The program was applied to clinical practice, and the incidence of AVF dysfunction, the cognitive level of nurses and patients related knowledge and the the change of examination item execution rate before and after implementation were evaluated. Results: Before and after evidence-based practice, there was no significant difference between the two groups on incidence of AVF dysfunction (P=0.171). There was a statistically significant difference between the two groups on the scores of knowledge questionnaire (P<0.001). There was a statistically significant difference between the two groups on nurses' and patients' implementation rates of review items (P<0.001). Conclusion: The evidence-based practice program for preventing AVF dysfunction can improve nurses' and patients' awareness of relevant knowledge, promote the implementation of preventive measures for AVF dysfunction, and further implementation will help to reduce the incidence of dysfunction.

Objective: To select and summarize the evidence of non-drug intervention for Chemotherapy Induced Nausea and Vomiting, so as to provide evidence for clinical nurses. Methods: We collect evidence including guidelines, evidence summaries, best practice information booklets, recommended practice, systematic reviews, expert consensus and original studies. The search time limit was from 1 January 2010 to 28 November 2021. Three researchers given evidence-based training completed independently the quality evaluation of the literature, extracted and summarized the evidence that met the quality standards. Results: Totally 15 articles were selected, including 2 expert consensus, 3 guidelines, 8 systematic reviews and 2 randomized controlled trials. The collected evidence referred to six aspects including living care, diet care, psychological care, TCM care, exercise intervention and comprehensive intervention with a total of 10 pieces of content. Conclusion: It is suggested that the best evidence should be chosen and adopted according to the clinical environment, professional skills and patients' wishes to form the best non-drug intervention for Chemotherapy Induced Nausea and Vomiting to relieve symptoms and improve nursing quality.

Objective: To evaluate and summarize the evidence related to Cardiac Rehabilitation(CR) compliance management in patients with Ischemic Heart Disease (IHD). Methods: The literature related to the compliance management of cardiac rehabilitation in patients with IHD were systematically searched from domestic and foreign databases. Results: A total of 21 articles were included, including 2 guidelines, 14 systematic reviews, 3 clinical decisions, and 2 randomized controlled trials. A total of 22 best evidences were extracted from 5 aspects: overall policy, in-hospital management, out-hospital management, sports training and special population management. Conclusion: Further, based on the theory of knowledge transformation, local modification can be carried out in the process of evidence transformation and targeted selection of evidence can be used to formulate the CR compliance management plan of IHD patients in accordance with CR stage and individual situation, and improve CR participation rate, compliance rate and completion rate of patients. Ultimately improve the clinical symptoms and prognosis of patients, and improve the quality of life.

Objective: Through the construction and application of the clinical risk active identification and monitoring system, we aim to promote nurses to establish systematic thinking of risk management, to actively identify and avoid clinical risks, and to ensure patient safety. Methods: Based on the hospital nursing management information system platform, the risk identification and monitoring system module was constructed and applied in clinical practice. Results: From June 2021 to September 2021, the system identified a total of 282 potential clinical risk events, including 7 patients with risk of injury (2.48%), 12 patients with risk of medical examination (4.26%), 35 patients with risk of medical treatment (12.41%), and 5 employees with risk of injury (1.77%). There were 26 cases of environmental risk (9.22%), 176 cases of public health event risk (62.77%), and 20 cases of other risk (7.09%). The incidence of avoiding potential risk was 99.65%. Conclusion: The establishment of early and active risk identification mechanism is an important way to control the occurrence of adverse events. The application of clinical risk active identification and monitoring system can improve the awareness of clinical active identification of potential risks and provide guarantee for patient safety.

Objective: To investigate the compliance of key measures to prevent Central Venous Catheters (CVC)Catheter-Related Bloodstream Infection (CRBSI) of medical staff and analyze its influencing factors. Methods: A self-made questionnaire was developed. From December 1, 2021 to February 20, 2022, 301 medical staff in 43 hospitals in Hunan province were investigated by convenience sampling. Multiple linear regression was used to analyze the influencing factors of medical staffs' compliance with key measures to prevent CVC CRBSI. Results: The medical staffs scored (89.74±14.04) points for overall compliance of key measures to prevent CVC CRBSI. The type of hospital, attending training and the number of indwelling catheters per month were the influencing factors of compliance of key measures to prevent CVC CRBSI. Conclusion: The compliance of medical staff with the key measures to prevent CVC CRBSI is generally good, but the compliance of skin disinfection, the establishment of maximum sterile barrier, ultrasound-guided puncture and catheter fixation needs to be improved. Hospital administrators should take targeted intervention measures to improve the training of CVC insertion for medical staff, incorporate CVC insertion into the process quality evaluation, regularly assess the workload of medical staff, flexibly allocate manpower, and improve the compliance of medical staff with the key measures to prevent CRBSI.

This article reviewed the application status of the mobile health in transitional care of cancer pain, illustrated the mobile health needs in transitional care of cancer pain, introduced the fields of mobile health application in care of cancer pain, and analyzed and summarized the availability and effects of the mobile health application in transitional care of cancer pain. Suggestions and future development direction are proposed in this paper to provide reference for better applying mobile health in transitional care of cancer pain.

Objective: To design and implement an immersive Virtual Reality (VR) speech rehabilitation system for patients with oncological aphasia. Methods: A total of three cases of brain tumor patients who were hospitalized in a tumor center of a tertiary grade A hospital in Guangzhou from November 2021 to February 2022 were selected by convenience sampling. The speech rehabilitation training software loaded by a brand VR all-in-one machine was used for immersive VR speech rehabilitation training. Before and after the intervention, the Chinese Language Screening Test (CLAST) was used to evaluate the rehabilitation effects. Results: The average CLAST score of the patients before the intervention was 11. After the intervention, the total CLAST score, and the scores of each dimension such as naming, repetition and picture recognition were all improved. Patients who participated in the immersive VR speech exercise all agreed that the system was easy for understanding and use. In addition, patients who participated in the intervention gave two suggestions to improve rehabilitation system. Conclusion: The immersive VR speech rehabilitation system can improve the speech function of patients to a certain extent. However, its clinical effectiveness still needs further investigation. The system will be improved and promoted in the future.

Objective: To explore the reform plan of performance pay and verify its effect. Methods: On the basis of literature research and thematic discussion, the index system of nursing performance assessment was clarified, and the nursing performance compensation distribution scheme was constructed, which was assisted by the performance comprehensive management and service platform. The satisfaction of nurses and patients were compared before and after the application of the scheme. Results: After the comprehensive performance management and salary distribution scheme based on job workload was established, the job satisfaction of nursing staff increased, and the difference was statistically significant (P<0.05). The patient satisfaction increased. Conclusion: After clinical practice and continuous improvement, the nursing performance allocation scheme can fully mobilize the work enthusiasm of nurses, improve nursing quality and improve hospital operation, which can be used for reference.

Objective: To explore the service experience of nurses in the initial stage of "Internet + Nursing Service". Methods: From May to August 2021, 14 nurses who had work experience in "Internet + Nursing Service" were recruited from a tertiary grade A hospital in Beijing by purpose sampling. Face-to-face semi-structured interviews were performed to collect data and thematic analysis was conducted to analyze the data. Results: Nurses' work experience of "Internet + Nursing Service" can be summed up into 3 themes: ①Negative experiences, including nervous and dispute worries;②Positive experiences, including process adaptation and benefit discovery; ③The expectation of "Internet + Nursing Service" management, including reducing travel time, increasing consumables configuration, reducing safety risks, increasing training exchanges, expanding service scope and adjusting service duration. Conclusion: Nurses have negative experience and positive experience in the initial stage of "Internet + Nursing Service", and diversified expectations for the management of "Internet + Nursing Service". This study provides a practical basis for further promoting the sustainable development of "Internet + Nursing Service".

Objective: To reduce the packaging cost of endoscopic instruments by packaging them in the same sterilization mode. Methods: Retrospective selection of 3000 cases with laparoscopic surgery in gastrointestinal department from January to December, 2019 as the single-packaged endoscopic instruments control group, and 3000 cases with the same surgery in the same department from January to December, 2020 as the combined packaging of endoscopic instruments observation group. The cost, work efficiency and personnel satisfaction were compared between the two groups. Results: Compared with those in the control group, the packaging cost reduction was 52.2%, the readiness rate, standard placement rate and qualified rate of packaging of endoscopic surgical instruments in observation group were higher (P<0.05), while the equipment loss rate was reduced (P<0.05), and the time on preparation and opening packages was less in the observation group (P<0.05). Conclusion: Combined packaging of endoscopic instruments with the same sterilization method can greatly reduce the packaging and medical expenses cost, improve work efficiency and instruments efficiency, and thus meet the needs of hospital management.

Objective: To analyze the application value of Donabedian quality theory in improving the quality of duodenoscope cleaning. Methods: A total of 420 duodenoscopes contaminated after the treatment of biliary and pancreatic diseases were selected from March to October 2021 in the Digestive Endoscopy Center of a tertiary grade A hospital in Nanjing as the intervention object. From March to June, routine visual inspection was used to manage the quality of duodenoscope cleaning. From July to October, Donabedian quality theory was used to establish three-dimensional indicators of structure-process-results, to improve the quality of duodenoscope cleaning. Eighty duodenoscopes before and after the intervention were checked to monitor the outcome indicators randomly. Results: After intervention, the duodenoscope cleaning standard was clarified, and the daily cleaning number of endoscopes per employee was decreased. The rate of correct pretreatment at the bedside, the rate of hand hygiene, the rate of correct cleaning of the apex cap, the rate of correct cleaning of the clamp lifter cavity, and the rate of correct cleaning of the apex increased, and the differences were statistically significant (all P<0.05). The forceps lifter Relative Light Unit cleaning rate, the biopsy lumen Relative Light Unit cleaning rate were significantly improved, which were statistically significant (all P<0.05). Conclusion: Donabedian quality theory can standardize the cleaning process of duodenoscope and improve the cleaning quality, and is worthy of promotion.

This paper reviews the concept, theoretical basis, evaluation and identification, main research contents and main intervention methods on symptom clusters of patients with chronic diseases, in order to provide reference for medical staff to develop strategies related to symptom cluster management of patients with chronic diseases.

This article reviews the current status of the prevention, assessment, treatment and dressing selection of diabetic foot, and proposes comprehensive management strategies, such as setting up an interdisciplinary team for diabetic foot care, establishing a support system for shared decision-making, implementing standardized treatment for triage according to the severity of the condition, building an information management platform, and offering remote management under the epidemic and patient-centered health education, in order to provide reference for the clinical prevention and treatment of diabetic foot.

This paper reviews the origin and development, common modes, contents and implementation, and existing problems of Diabetes Self-Management Support, aims to provide reference for clinical medical staff and managers to develop more reasonable, effective and standardized self-management support programs for patients with Type 2 Diabetes Mellitus.