Objective: To review the studies on the application of "Internet +" symptom management in cancer patients in order to guide future research and clinical practice. Methods: Using the JBI scope review framework as the methodological guidance, nine Chinese and English databases were systematically searched from the databases inception to December 25, 2024. Two researchers conducted literature screening, data extraction, and summary analysis. Results: A total of 21 articles were included in this study. The main forms of the "Internet +" symptom management for cancer patients were WeChat, mobile applications and internet websites, with functions covering symptom assessment and monitoring, health education, online interaction, and other issues. Research results indicated that "Internet +" symptom management has significant effects in improving symptoms, psychological status, quality of life, and adherence. Conclusion: Multi-carrier based "Internet +" symptom management can provide convenient and real-time services for cancer patients, but the comprehensiveness and systematism still need to be further improved.

Objective: To explore the operational model and management strategies of an oncology dysphagia nursing clinic, and to evaluate its effects on patients' outcomes. Methods: Based on the model of Participatory, Evidence-based, Patient-centered Process for APN role development, implementation, and evaluation (PEPPA), a needs analysis was conducted among oncology dysphagia patients and healthcare providers. Guided by this framework, an online-offline integrated oncology dysphagia nursing clinic was launched in June 2023. Certified practitioners performed standardized screening, developed comprehensive rehabilitation plans, and tracked patients' outcomes, achieving integrated specialized care encompassing dysphagia screening, assessment, planning, implementation, follow-up, and referral. The quality improvement strategies included establishing clinic protocols, forming a multidisciplinary team, enhancing institutional support, and strengthening reporting. Key outcomes monitored were oral intake recovery rates and aspiration pneumonia incidence. Results: Post-implementation, 41 patients (80.4%) achieved oral intake functional recovery, with significant improvement in swallowing function compared to that of baseline (P<0.05). Aspiration pneumonia incidence during home care was 2.0% (1/51). Conclusion: The oncology dysphagia nursing clinic effectively promotes functional recovery in cancer patients with swallowing disorder and advanced specialized oncology nursing practices.

Objective: To systematically organize and compile evidence on home-based exercise for patients with cancer during their rehabilitation, offering practical advice for implementing exercise programs for cancer survivors. Methods: Using the '6S' evidence hierarchy pyramid, an extensive literature review was performed utilizing both subject headings and free-text terms in Chinese and English databases. A top-down search approach was used to find studies on home-based exercise interventions for cancer patients in the rehabilitation phases, covering the period from the start of the databases to December 31, 2024. The included studies underwent thorough quality evaluation, followed by evidence extraction and synthesis. Results: Fourteen articles were included, consisting of ?2 clinical guidelines, 6 systematic reviews, 4 expert consensus, and 2 evidence summaries. Thirteen evidence-based recommendations were compiled across four areas: exercise risk assessment and testing, exercise prescription development, exercise monitoring and follow-up, and strategies to motivation. Conclusion: This study consolidates existing evidence regarding home-based exercise rehabilitation for patients with cancer, providing an evidence-based foundation for patients, caregivers, community healthcare providers, and clinicians.

Objective: To develop and preliminarily apply a management program for immune-related cutaneous adverse events in patients with lung cancer, and provide reference for related clinical practice. Methods: From February to May 2023, the first draft of the management plan was developed using literature research and interviews, guided by the modified dynamic symptom model. It was revised after the presentation at an expert meeting. Convenience sampling was employed in the study. Routine care was provided to the participants in the control group who were admitted in November 2023. A management program for immune-related cutaneous adverse events in lung cancer immunotherapy was provided to patients in the intervention group who were admitted in December 2023. Pre- and post-intervention comparisons were made between the two groups on skin reaction incidence, self-care abilities, health-promoting lifestyles, and psychological status. Results: The management program for immune-related cutaneous adverse events in lung cancer patients consisted of two parts including a preventive management program and a therapeutic management program. After the intervention, the incidence of immune-related cutaneous adverse events in lung cancer immunotherapy in the intervention group and control group was 31.0% and 48.3% respectively, with no statistically significant difference (P>0.05). While there were statistically significant differences in self-care ability between the two groups, with higher self-care ability scores in the intervention group (P<0.05). Conclusion: The management program is constructed based on evidence, combining patient needs and expert opinions, and has good scientific validity and reliability, providing a reference for healthcare professionals to carry out the prevention and management of immune-related cutaneous adverse events in lung cancer patients.

Objective: To explore the effects of the E-Coach health management model on nutritional status of patients with lung cancer, so as to provide a reference for standardized and scientific management of nutrition in lung cancer patients. Methods: A total of 78 lung cancer patients admitted to a tertiary hospital in Jilin province from June 2023 to June 2024 were recruited and were randomly assigned to the control group and observational group evenly. Patients in the control group received routine care and patients in the observational group received care based on the E-Coach health management model. The nutritional status, quality of life, physical activity and compliance with the nutrition management of the two groups were collected on the day of enrollment (T0), intervention completion (T1), and 3 months after intervention completion (T2). Results: At T1, the incidence of malnutrition in the intervention group was 56.4%, lower than the 94.8% in the control group, and the difference was statistically significant (χ2=15.656, P<0.001); Significant differences were also observed regarding prealbumin, albumin and hemoglobin levels, as well as quality of life, physical activities, and compliance with the nutrition management between two groups (P<0.05). Participants' nutritional status (except for muscle mass), quality of life, physical activities, and compliance with the nutrition management at T2 were statistically different between two groups (P<0.01). Conclusion: The nutritional management program can effectively improve the nutritional status, quality of life, and physical activity ability of lung cancer patients. The intervention is worthy of promotion in clinical practice.

Objective: To construct and assess the effectiveness of a thirst symptom management program for patients with Chronic Heart Failure, offering a potential reference for clinical thirst care. Methods: Based on symptom management theory, we built a protocol for managing thirst based on a comprehensive review of existing literature and expert consultation. Patients from cardiology and CCU wards of a tertiary hospital in Nantong city from November 2023 to February 2024 were selected by convenience sampling method as research subjects, and randomly divided into either control group or intervention group using the random number table method, with 43 patients in each group. While the control group received routine treatment and care, the intervention group participated a one-week intensive thirst management program in addition to the standard care. Results: The newly developed thirsty management program comprised three components: thirst experience, thirst management strategy, management effect and 10 contents, 37 specific contents. A total of 39 patients in each group completed this study. On the 7th day and 28th day of the intervention, the intervention group experienced significantly lower levels of thirst intensity (2.69±1.52 and 1.85±0.99), distress (15.87±4.99 and 14.87±5.12), and duration (3.49±1.32 and 2.72±1.12) compared to the control group. Improvement in moistness of oral mucosal in the lips and tongue were also more pronounced in intervention group, with statistically significant (P<0.05). None of the two groups occurred cardiac death within 28 days after discharge. The readmission rate within 28 days after discharge in the intervention group was lower than that of the control group, but the difference was not statistically significant (P>0.05). Conclusion: The thirst symptom management program for patients with Chronic Heart Failure is a scientific, reliable, comprehensive, and actionable, and is effective in improving thirst symptoms in clinical applications.

Objective: To explore the application effect of Lean Six Sigma based full chain closed-loop nursing management in elderly patients with chronic diseases, and provide reference for optimizing service processes and improving medical experience in clinical nursing management practice. Methods: Using convenience sampling method, select a tertiary Grade A comprehensive hospital in Qingdao as of 273 elderly patients admitted to the hospital from March to June 2023 were selected as the control group, and 273 elderly patients admitted from July to October 2023 were selected as the observation group. The observation group was treated with a full chain closed-loop nursing management process based on Lean Six Sigma. Compare the differences between two groups of patients in terms of the time required for handling entry and exit procedures, evaluation of nursing service experience, and the quality of humanistic care provided by nurses. Results: The time required for patients in the observation group to complete admission and discharge procedures was (5.51±1.76) and (2.36±0.55) minutes, respectively, which was shorter than that of the control group (59.03±4.23) and (59.69±3.56) min, and the nursing service experience evaluation and nurse humanistic care quality were better than the control group, with statistically significant differences (P<0.001), nursing service experience evaluation, and nurse humanistic care quality compared to the control group, with statistical significance (P<0.001). Conclusion: Applying the full chain closed-loop nursing management based on Lean Six Sigma to elderly patients with chronic diseases can effectively shorten the time required for patients to handle entry and exit procedures, improve patient nursing service experience and nurse humanistic care quality, and provide reference for further clinical promotion and application.

Objective: To translate the Ethical Decision-Making Confidence scale (EDMC) into Chinese and examine its reliability and validity, so as to provide an effective assessment tool for research on the ethical decision-making confidence of nurse managers in China. Methods: Following Brislin's model, the original scale was translated, back-translated, culturally adapted and pre-investigated to form the Chinese version of the EDMC scale. Using the convenience sampling method, a total of 433 head nurses from 8 general hospitals in Jinan were surveyed from September 2023 to January 2024 to evaluate the reliability and validity of the scale. Results: The Chinese version of the EDMC scale consisted of 2 dimensions and encompassed a total of 16 items, with a cumulative variance contribution rate of 66.310%. The results of confirmatory factor analysis showed that χ2/df=1.319, RMSEA=0.038, GFI=0.931, AGFI=0.909, NFI=0.943, indicating a good model fit. The item-level CVI of the EDMC was 0.975, and the scale-level CVI was 0.969. The correlation coefficient between the EDMC scale and the psychological empowerment scale was 0.752. The overall Cronbach's α coefficient of the scale was 0.933, while the Cronbach's α coefficients of the confidence in skill and behavior dimensions were 0.937 and 0.902 respectively. The Spearman-Brown broken half reliability coefficient was 0.906. The retest reliability of the scale was 0.881, and the retest reliabilities of the confidence in skill and behavior dimensions were 0.836 and 0.885, respectively. Conclusion: The Chinese version of EDMC has good reliability and validity and can be used as an assessment tool for the ethical decision-making confidence of nurse managers.

Objective: To analyze the application effect of the Early Goal-Directed Mobilization protocol in mechanically ventilated patients and provide a theoretical basis for promoting early activity in the ICU. Methods: A convenience sample of 60 mechanically ventilated patients admitted to the respiratory ICU of a tertiary grade A hospital in Ningxia from January to May 2024 was selected for this study. Patients admitted from January 1 to March 15 were assigned to the observation group (n=30), and those admitted from March 16 to May 29 were assigned to the intervention group (n=30). The observation group received routine nursing care, while the intervention group received the Early Goal-Directed Mobilization protocol. Various outcomes were compared between the two groups, including mechanical ventilation time, rate of out-of-bed activities, time to initiate early out-of-bed activities, ICU length of stay, ICU costs, and incidence of adverse events. Results: The intervention group had significantly shorter mechanical ventilation time, (10.89±2.16) days vs (13.13±2.70) days, higher rate of out-of-bed activities (80.0% vs 46.7%), earlier time to initiate out-of-bed activities, (3.10±0.91) days vs (6.87±1.84) days, shorter ICU length of stay, (8.39±1.60) days vs (14.59±3.37) days, lower ICU costs, (39104.86±4277.54) yuan vs (52492.48±7876.25) yuan, and lower incidence of pulmonary infection (3.3% vs 26.7%) and pressure injury (3.3% vs 30.0%) compared to the observation group, with statistical significance (P<0.05). Conclusion: The Early Goal-Directed Mobilization protocol can effectively promote the recovery of mechanically ventilated patients, reduce mechanical ventilation time and ICU length of stay, decrease the incidence of pulmonary infection and pressure injury, significantly reduce ICU costs, and notably increase the time to initiate early out-of-bed activities and the rate of out-of-bed activities. It is worthy of clinical application and promotion.

Objective: To explore the relationship among task complexity, cognitive load, and guideline adherence of ICU nurses, and the mediating effects of cognitive load on perceived task complexity and guideline adherence of ICU nurses, to assist nursing managers in rational human resource allocation. Methods: A convenience sampling method was used to recruit 213 ICU nurses from three tertiary Grade A hospitals in Beijing from October 2023 to March 2024. The Chinese version of the Task Complexity Scale, the Cognitive Load Measurement Scale, and the Guideline Adherence Scale were used for data collection. Correlation analysis, multiple regression analysis, and mediating effect analysis were conducted. Results: ICU nurses' perceived task complexity were positively correlated with guideline adherence scores (r=0.561, P<0.01), and germane cognitive load was positively correlated with guideline adherence scores (r=0.823, P<0.01). Multiple linear regression results showed that perceived task complexity (β=0.227, P<0.001) and germane cognitive load (β=0.717, P<0.001) were both positive predictors of guideline adherence scores. The bootstrap test indicated that the mediating effects of germane cognitive load between task complexity and guideline adherence among ICU nurses was 0.215 (95%CI:0.148-0.288), accounting for 59.55% of the total effects. Conclusion: Germane cognitive load plays a partial mediating role between task complexity and guideline adherence. Nursing administrators should actively implement intervention strategies based on the factors influencing the guideline adherence of ICU nurses.

Objective: This systematic review was designed to assess the impact of High-Intensity Interval Training (HIIT) on the risk factors of cardiovascular diseases among children and adolescents, to offer reference for clinical guidance on the standardized HIIT training for these patients. Methods: We searched database to collect randomized controlled trials evaluating the effects of HIIT on the risk factors of cardiovascular diseases in children and adolescents from the inception of the database to March 31, 2024. Two evaluators independently screened the literature, extracted information and evaluated the risk of bias of the included studies. Then Meta-analysis was performed using Review Manager 5.3. Results: Ultimately we included 12 studies, comprising 367 study participants. The results showed that HIIT could reduce body fat percentage (BFP%) [MD=-1.70, 95%CI (-2.42, -0.99), P<0.001], lower total cholesterol (TC) [MD=-0.37, 95%CI (-0.67, -0.07), P=0.02], low-density lipoprotein (LDL) [MD=-0.33, 95%CI (-0.56,-0.10), P=0.005], and triglycerides (TG) [MD=-0.33, 95%CI (-0.41, -0.24), P<0.001]. According to the subgroup analysis, compared with patients having HIIT 2 times per week, those having HIIT 3 times a week were observed to have better BFP% improvement. Bicycle training (85%-95% VO2peak) was more efficacious than shuttle run in improving subjects' BMI and BFP%. Conclusion: HIIT has the potential to ameliorate the body fat percentage of children and adolescents as well as other cardiovascular disease risk factors. Children and adolescents who perform HIIT for more than 12 weeks, with a training frequency of 3 times per week and an intensity of 85%-95% VO2peak are more likely to obtain the desired results.

Objective: To systematically retrieve, evaluate, and summarize relevant evidence related to the practice of debriefing in medical scenario-based simulation, thereby providing references for optimizing simulation-based medical education. Methods: Following the "6S" evidence model, a top-down search was conducted in relevant databases and websites for literature on the application of debrifing in clinical scenario simulation teaching practices from the inception of the database to November 17, 2024. Researchers evaluated the the quality of the included literature and screened the evidence, which was then translated, summarized and synthesized. Results: A total of 8 literature, including 1 best practice report, 2 guidelines, 5 systematic reviews were enrolled. Finally, 22 pieces of evidence were summarized into 5 aspects, namely prebriefing, timing and duration of debriefing, forms of debriefing, practical approaches of debriefing, the skill requirements of teachers. Conclusion: Teachers should integrate clinical teaching situations and specific teaching objectives to select the appropriate evidence for debriefing in teaching practice, aiming to enhance the quality of debriefing in clinical simulations.

Kidney transplant patients have some degree of decisional conflicts in medical decision-making process, and serious decisional conflicts can hinder the formation of medical decision-making and have negative effects on the treatment of patients. This paper summarizes the concept of decision-making conflict, the current situation at home and abroad, the evaluation tools, influencing factors of kidney transplant patients, and proposed some suggestions and countermeasures, so as to provide references for further research on decision-making conflicts and the resolution of related problems in China.

Objective: To analyze the mediating roles that psychological resilience and perceived control between social support and psychological distress among kidney transplant recipients, aiming to provid references for formulating intervention strategies for reducing the psychological distress of kidney transplant recipients. Methods: Using convenience sampling, a questionnaire survey was conducted among 428 kidney transplant recipients in the stable stage at a tertiary grade A hospital in Changsha from August to December 2023. The survey instruments encompassed the Distress Management Screening Measure, the Multidimensional Health Locus of Control, the Connor-Davidson Resilience Scale, and the Social Support Rating Scale. Path analysis was performed using Mplus 8.3 software. Results: The prevalence of psychological distress among the 428 kidney transplant recipients was 37.9%. The path analysis showed that the direct effect of social support on psychological distress was not significant, the indirect effects of social support on psychological distress were -0.019 and -0.007 through the mediating effects of psychological resilience and opportunity control. Social support indirectly influenced psychological distress through psychological resilience via opportunity control, and the indirect effect of chain mediation was -0.004. Conclusion: Psychological resilience and perceived control of opportunity play a chain mediating role between social support and psychological distress of kidney transplant recipients.

Objective: To investigate the current situation of self-management among kidney transplant recipients, and analyze the relationships of interactions among influencing factors, so as to provide references for medical staff in developing self-management programs for kidney transplant recipients. Methods: Using convenience sampling method, 265 kidney transplant recipients who were followed up by outpatient departments in three tertiary grade A hospitals in Beijing and Changsha from October 2020 to March 2021 were enrolled. The patients were investigated using the self-designed general data questionnaire, the Chronic Disease Self-efficacy Scale, the Kidney Transplant Recipient Self-management Support Scale, the Kidney Transplant Recipient Self-management Scale, and the Hospital Anxiety and Depression Scale. The structural equation model was constructed using AMOS 24.0 software. Results: The scores of self-management were 95.00 (84.00, 103.00). The structural equation model showed that self-management support (β=0.572, P<0.001), self-efficacy (β=0.176, P=0.004) and education level (β=0.150, P=0.015) had a direct effect on self-management, and depression indirectly affected self-management through self-management support (β=-0.159, P<0.001), and economic burden indirectly affected self-management through self-efficacy (β=-0.021, P=0.011). Conclusion: The self-management level of kidney transplant recipients is at a good level. Clinical staff can improve the self-management support level and self-efficacy of patients by formulating targeted intervention measures.

Objective: To develop a medication adherence behavioral intervention program for renal transplant patients and evaluate its clinical application effects, aiming to provide references for improving patients' medication adherence. Methods: Based on the health belief model and the theory of planned behavior, a behavioral integration theory was developed. Guided by this theory and combined with behavior change techniques, a medication adherence behavioral intervention program for renal transplant patients was developed through two rounds of expert consultation. By convenience sampling, 30 patients who underwent kidney transplantation at a tertiary grade A hospital in Changsha from August to December 2023 were selected. They were divided into a control group and an intervention group using a random number table, with 15 cases in each group. Serum creatinine levels, medication knowledge scores, medication belief scores, and medication adherence scores were compared between the two groups. Results: The constructed intervention program included 6 dimensions covering 23 specific items. Preliminary application results indicated that there were statistically significant differences between the two groups in scores of medication belief, perception of medication necessity, and concerns about medication (P<0.05). Conclusion: The medication adherence behavioral intervention program for renal transplant patients can effectively enhance patients' beliefs in medication and perception of the necessity of taking medications, and alleviate patients' concerns about taking medications. It provides valuable insights for research on improving the medication adherence in renal transplant patients.

Objective: To develop a follow-up checklist of home care for lung transplant recipients, aiming to provide scientific and effective follow-up tools for continuous care services for patients. Methods: Based on the literature review of the Omaha problem classification system, lung transplant recipients and lung transplant nurses were interviewed in a semi-structured way, and two rounds of expert consultation by correspondence were conducted to form the first draft of the nursing follow-up checklist. Using a convenience sampling method, ten nurses and twenty lung transplant recipients from a tertiary grade A hospital in Beijing were selected as the research subjects from January to February 2024 to preliminarily test the feasibility of the home care follow-up checklist for lung transplant recipients and form the final draft of the follow-up checklist. Results: The experts' positivity coefficients of the two rounds were 93.33% and 100.00%, respectively, with the expert authority coefficient being 0.92 and the Kendall harmony coefficient being 0.234 and 0.156, respectively (P<0.001). The final home care follow-up checklist for lung transplant recipients included four primary items: environmental domain, psychosocial domain, physical domain and health-related behavior, 23 secondary items and 62 tertiary items. Lung transplant recipients considered that the home care follow-up checklist was comprehensive and the follow-up nurses were highly satisfied. Conclusion: The follow-up checklist of home care for lung transplant recipients is comprehensive, scientific, reliable and practical. It can provide scientific and standardized support for nurses to follow up with patients.

Objective: To investigate the retraining needs of specialist nurses in Shanxi province based on their post competencies, providing a reference for the development of a retraining system for specialist nurses. Methods: A cluster sampling method was employed to recruit 1419 specialist nurses from 11 cities in Shanxi province as the research participants in March 2023. Based on scores from the Post Competency Self-Rating Scale for Specialist Nurses, cluster analysis was used to categorize different types of post competencies. The Specialist Nurse Retraining Needs Questionnaire was utilized to analyze the retraining needs of nurses with varying competency types. Results: A total of 99.4% of specialist nurses exhibited a positive attitude towards retraining, with "more than 48 hours (over six days)" being the most preferred training duration and "once a year" as the desired frequency. Statistically significant differences were found in retraining participation, reasons for participation, training formats, and learning content among nurses with different competency types (P<0.05). Furthermore, significant differences in retraining learning content were observed among specialist nurses working in oncology, intensive care units, operating rooms, and blood purification, depending on their competency types (P<0.05). Conclusion: There is heterogeneity in the competency level of specialist nurses and there is still room for improvement. It is necessary to carry out targeted retraining according to the specific needs of specialist nurses with different competency types and different professional directions, so as to promote the consolidation and improvement of specialist nurses' knowledge and skills.

Objective: To investigate the current status of human resource allocation and management of medical nursing assistants employed by hospital in China, providing a reference of decision-making to promote their management in clinical practice. Methods: A cross-sectional survey was conducted from July to October 2023. Sixty-two hospitals located in the east, middle, west, and northeast regions of China were selected through convenience sampling. A self-designed questionnaire was used to collect data on the allocation and management of medical nursing assistants employed by hospital. Results: The median ratio of the number of medical nursing assistants employed by hospital to hospital beds among 62 hospitals was 0.036, and the median ratio of medical nursing assistants employed by hospital to nurses was 0.055, with no statistically significant difference across hospitals of different grades (P>0.05). Allocation standards for medical nursing assistants were reported in 27 hospitals (43.5%), although these standards varied across hospitals. Most hospitals (87.1%) employed medical nursing assistants through labor dispatch companies, and among the 42 hospitals that provided cost information, the median costs was 3870.0 CNY per person per month. The main responsibility of medical nursing assistants employed by hospital included cleaning care (80.6%), and living care (79.0%). A "one-to-many" working mode was adopted in 72.6% of hospitals, with most medical nursing assistants working 5 days per week and 8 hours per day, although longer working hours were reported in some cases. All hospitals provided training for medical nursing assistants employed by hospital, and 53.2% required certification before starting to work. Work quality supervision was implemented in all hospitals, and 40.3% of hospitals had established quality evaluation criteria by nursing department. Conclusion: Hospitals have become the main body of quality management for medical nursing assistants. The work content of medical nursing assistants in various hospitals is basically consistent, and their work modes are diverse. It is necessary to gradually explore scientific and reasonable allocation standards of medical nursing assistants.

Objective: To analyze the spatial differences and dynamic evolution process of nursing human resource allocation in Anhui province, predict the development trend of nursing human resources, and provide reference for optimizing nursing human resource allocation in Anhui province. Methods: Nursing human resource data was extracted from Anhui province from 2013 to 2022. Dagum Gini coefficient and kernel density estimation methods were used to analyze the spatial differences and dynamic evolution process of nursing human resource allocation in Anhui province, and exponential smoothing method was used to predict the development trend of nursing human resources in Anhui province. Results: The regional differences in the allocation of nursing human resources within Anhui province from 2013 to 2022 had been narrowing year by year. In terms of dynamic evolution, the level of nursing human resource allocation in Anhui province continued to improve, showing a trend of gathering. In terms of demand forecasting, the number of registered nurses in Anhui province is expected to reach 374600 by 2030, and the number of registered nurses per thousand people will be 6.16. Conclusion: The total amount of nursing human resources in Anhui province is continuously increasing, and the level of allocation is constantly improving. The government should strengthen the construction of nursing teams, strengthen control and allocation and improve nursing service models, in order to further enhance the level of nursing human resource allocation in Anhui province.

Objective: To explore the relationships among second victim distress, ruminative contemplation, and job burnout in nurses, and to examine the mediating role of ruminative contemplation in the relationship between second victim distress and job burnout in nurses. Methods: A total of 535 nurses who had experienced adverse events were recruited by convenience sampling method from 7 tertiary grade A hospitals in Beijing, Anhui, and Shanxi provinces from December 2023 to March 2024. A survey was conducted by the general information questionnaire, the Second Victim Experience and Support Tool, the Event-Related Rumination Inventory and the Maslach Burnout Inventory, and the data was analyzed by structural equation model. Results: The scores for second victim distress, intrusive ruminative contemplation, deliberate ruminative contemplation, and job burnout among nurses were (42.05±8.56), (14.64±7.70), (15.67±7.32), and (54.09±16.41) points, respectively. Ruminative contemplation, with both intrusive and deliberate ruminative contemplation as independent intermediary variables, had an effect on job burnout. Specifically, the total effect of second victim distress on job burnout was 0.398 (P<0.001), and the total indirect effect was 0.162 (P<0.001), with the mediating effect accounting for 40.70% of the total effect. Conclusion: The level of job burnout among nurses experiencing second victimization is relatively high and requires further improvement. Nursing administrators should take measures to alleviate the distress of nurses as second victims, guide them to transform intrusive rumination into purposeful rumination, and thereby reduce their levels of job burnout.

Objective: To apply Root Cause Analysis (RCA) to medication administration errors in an informatization context and to explore improvement strategies, providing guidance for reducing such errors. Methods: A retrospective analysis of 17 medication error incidents that occurred from January 2018 to May 2024 was conducted. The main causes were analyzed using a fishbone diagram, and the "5WHY" method was employed to delve into the root causes, and develop improvement strategies based on these causes. Results: By monitoring barcode scanning compliance, various types of scanning rates improved. Supervision of nurses' behavior, revision and detailing of medication administration processes, optimization of self-prepared medication coding procedures, and intelligent management of diluent expiration dates reduced the occurrence of medication errors. Conclusion: In an informatization context, managers need to continuously optimize and improve strategies based on the root causes of medication errors, leveraging the advantages of information technology to better assist nurses in administering medications and reduce the occurrence of medication errors.

Effective medical information security education can improve the information operation technology and personal information security awareness of medical workers, to reduce the occurrence of medical information security violations. In this paper, the relevant literature is comprehensively analyzed and summarized, and the concept of medical information security, the object, content, form of education and the hindering factors of education implementation are reviewed. Combined with the current information technology and medical informatization background, suggestions are put forward to provide reference for the development of information security education in the medical field.

This article discusses the application of artificial intelligence in nosocomial infection prevention and control nursing for emerging infectious diseases, highlighting the existing challenges and response strategies. The aim is to provide insight for future changes in work models, nursing management strategies and innovations in the prevention and control of nosocomial infections. Additionally, it discusses the construction and development of nursing informatization, providing a broader perspective and reference for advancing intelligent infectious disease prevention and control efforts.

Objective: To apply the Lean Six Sigma method to the analysis and optimization of the turnover surgery process, so as to improve the overall efficiency of turnover surgeries in the operating room and provide innovative solutions for the refined management of hospital operating rooms. Methods: An intelligent scheduling system was utilized to achieve the autonomous assignment of surgical tasks and the rational allocation of human resources for auxiliary staff. A total of 1576 surgeries before the workflow improvement and 1611 surgeries after the improvement were retrieved in July 2024. The time taken to admit patients to the operating room, the interval between turnover surgeries, the patients waiting time, and the satisfaction of medical staff were compared. Results: After improvement, the time taken to transfer patients into the operating room was reduced to 12 (7, 19) minutes. The interval between consecutive surgeries was shortened to 15(10, 22) minutes. Patient waiting time was decreased to 17(12, 21) minutes. The timeliness of task completion and the accuracy of time control of auxiliary staff were significantly improved, all of which were statistically significant (P<0.01). Conclusion: Applying the Lean Six Sigma method to the optimization of the workflow of auxiliary staff can improve the efficiency of consecutive surgeries, the satisfaction of medical staff, and enhance the efficiency of the hospital.

Objective: To explore and describe the barriers affecting adherence to Comprehensive Decongestive Treatment in patients with Breast Cancer-Related Lymphedema (BCRL), providing evidence for the development of effective clinical interventions. Methods: A descriptive qualitative research method was employed, with purposive sampling used to recruit 15 patients with BCRL, 3 lymphedema therapists, and 3 physicians in a tertiary hospital in Hainan province from October 2023 to March 2024. Data were collected through focus group interviews and analyzed using qualitative content analysis, integrating deductive and inductive approaches to identify recurring themes. Results: A total of 12 themes spanning 3 levels of the social-ecological system. At the microsystem level, barriers included inadequate risk perception, lack of confidence in treatment efficacy, low self-efficacy, the burden of comorbidities, and changes in body image and comfort. At the mesosystem level, role conflict, inadequate dichotomous support for coping, limited interpersonal interactions, and inadequate social support were identified. At the macrosystem level, limited healthcare resources, insufficient institutional support, and a lack of standardized professional training were noted as key challenges. Conclusion: Adherence to Comprehensive Decongestive Therapy in patients with BCRL is hampered by a complex interplay of factors across multiple systematic levels. Addressing these barriers through targeted interventions informed by the identified themes may improve adherence and enhance patient nursing quality.

Objective: To explore the effectiveness and safety of an intelligent infusion system based on Convolutional Neural Network (CNN) for visual recognition in clinical practice, in order to provide references and insights for the intelligent management of infusion systems in general wards. Methods: The study selected 280 patients (140 cases each before and after the application of the intelligent infusion system) and 16 nursing staff from a general surgery ward of a tertiary grade A hospital in Hangzhou by convenience sampling method at October 2022 and March 2023 as the subjects of the study. Then the workload of nursing staff, patient satisfaction, and noise levels in the ward before and after the intervention were compared. Results: Due to the usage of the intelligent infusion system, nurses spent less time going back and forth between the nurse station and the wards (P<0.05); patient satisfaction with the intelligent infusion system increased (P<0.05); the frequency of nursing staff responding to calls decreased (P<0.05); noise levels in the ward except at nighttime were lower than before (P<0.05). Conclusion: The intelligent infusion system based on CNN for visual recognition can reduce the workload of nursing staff, improve patient satisfaction, and is of significant value in improving the quality of infusion nursing and the ward environment.

Chronic post-surgical pain significantly impacts patients' quality of life and imposes substantial socioeconomic burdens. The Transitional Pain Service (TPS) achieves the foresight and sustainability of chronic postoperative pain management through preoperative assessment and prehabilitation, perioperative multimodal analgesia, and continuous post-discharge interventions. This article reviews the components, implementation strategies, and outcomes of the Transitional Pain Service, exploring its contributions to improving the efficiency of chronic postoperative pain management. Based on the current state of pain management in China, the paper offers insights and recommendations to inform and optimize domestic chronic postoperative pain management practices.

These years have witnessed the specialized development of the nursing staff. And the certification of clinical nurse specialist is essential to improve the specialized nursing service and meet the needs of diversified professional nursing. As a scientific research method to explore clinical practice, a Role Delineation Study can promote the definition and optimization of specialist nurses's roles to enhance the quality and legal significance of specialty nurse certification. This article combs the implementation process of Role Delineation Study, summarizes its value in the certification of clinical nurse specialist in the United States, and explores its inspiration to clinical nurse specialist certification in China, in order to provide a reference for promoting its application in the certification and training of clinical nurse specialist in China.