Objective: To construct a data-driven decision-making-based management model for unplanned extubation of Peripherally Inserted Central Catheters (PICC) and evaluate its effects, in order to provide evidence for refined quality management. Methods: Guided by the Six Sigma framework, a data-driven decision-making-based model for PICC unplanned extubation among patients with hematological diseases was developed through clinical investigation and expert discussion, and implemented from October 2024. Nurses' knowledge scores of PICC unplanned extubation prevention, process quality inspection scores, PICC-related risk information awareness rates, and the incidence of unplanned extubation in patients were compared before and after the model implementation. The U control chart was used to monitor the stability of intervention effects. Results: After the model implementation, nurses' knowledge scores of PICC unplanned extubation prevention increased from 71.62±15.75 to 82.54±10.81 (P<0.001). Process quality inspection scores and PICC-related risk information awareness rates were also improved (P<0.001), and the incidence of PICC unplanned extubation remained at a low level for 6 consecutive months. Conclusion: The model can improve nurses' knowledge regarding PICC unplanned extubation, and enhance their risk perception and capability for process quality control, providing a reference for data-based lean management of central venous catheters.

Objective: To develop a process quality control toolkit for the prevention of central venous Catheter-Related Bloodstream Infections in blood purification, in order to provide a reference for reducing infection incidence and improving specialized nursing quality. Methods: The initial draft of the Process Quality Control Toolkit for Preventing Central Venous Catheter-Related Bloodstream Infections in Blood Purification was formulated based on a literature review. Two rounds of Delphi expert consultations were conducted among 30 experts in September and November 2025, respectively. The toolkit was revised according to the results of expert consultations. A pilot clinical implementation was carried out in 44 hospitals in Guangdong province from January to March 2026. The toolkit was further refined with clinical feedback to form the final version. Results: The questionnaire response rate of both rounds of consultation reached 100%. The expert authority coefficients were 0.927 and 0.933, and Kendall's coefficients of concordance were 0.274 and 0.361, respectively (all P<0.001). A total of 11 pieces of feedback were collected during the pilot clinical implementation. The final toolkit covered 8 dimensions, such as organization and management, core prevention and control principles for catheter-related operations, and pre-procedure assessment for catheter-related operations, involving 55 nursing measures in total. Conclusion: The developed toolkit has favorable scientificity and reliability with comprehensive contents, which can serve as a practical tool for standardized management of central venous catheters for blood purification.

Objective: To evaluate the effects of risk-stratified closed-loop intervention on the prevention of Venous Thromboembolism (VTE) in patients after thoracic surgery, in order to provide evidence for VTE prevention and control. Methods: A convenience sampling was used to recruit 312 surgical patients from the department of thoracic surgery at a tertiary grade A hospital in Xining. Patients admitted from January to December 2024 were assigned to the control group and received conventional perioperative care, while those admitted from January to December 2025 were assigned to the intervention group and received a risk-stratified closed-loop intervention protocol. Differences in structure, process and outcome quality indicators between the two groups were compared. Results: The incidence of postoperative VTE in the intervention group was lower than that in the control group (1.28% vs 6.41%, P<0.05). The intervention group exhibited lower postoperative peak D-dimer and shorter postoperative length of hospital stay (P<0.05). Process quality indicators such as the completion rate of VTE risk assessment after admission were superior to those in the control group (P<0.05). Conclusion: The risk-stratified closed-loop intervention can improve the quality of VTE prevention and reduce the incidence of VTE in patients undergoing thoracic surgery.

Objective: To construct safety management evaluation indicators for hospitalized adolescents with Non-Suicidal Self-Injury (NSSI), providing a theoretical basis for their NSSI risk management and psychiatric nursing quality improvement. Methods: Based on the M-SHEL accident analysis model, a preliminary draft of the indicators was developed through literature analysis. The Delphi expert consultation method and the Analytic Hierarchy Process were applied for indicator screening and weight determination. Results: Totally 15 experts were invited to participate in two rounds of consultation. The questionnaire response rates were 100.0% and 86.7%; the authority coefficients were 0.897 and 0.917, respectively; and the Kendall's W values were 0.143 and 0.270 (both P<0.001), respectively. The final evaluation indicators consisted of 5 first-level indicators (Management risk, Software risk, Hardware risk, Environmental risk, Liveware risk), 15 second-level indicators, and 53 third-level indicators. Conclusion: The safety management evaluation indicators are structurally sound, scientifically grounded, and highly operable. It demonstrates strong practical value and potential for application, and can serve as a reference for clinical risk assessment and management.

Objective: To explore factors influencing cognitive training participation among patients with mild cognitive impairment, and to provide practical evidence for constructing effective training implementation strategies. Methods: Purposeful sampling was used to select 17 patients with mild cognitive impairment from September 2024 to February 2025. These individuals were recruited from the cognitive center, and cognitive training nursing clinic of a tertiary grade A hospital in Nanjing, as well as through community screening. Semi-structured interviews were conducted, and content analysis was used based on a multi-theory model. Results: Three themes (participation intention, behavioral initiation, and behavioral maintenance) and ten subthemes (perception of disease risk, perceived benefits of training, behavioral self-efficacy, barriers to access and utilization of resources, trade-offs between economic costs and value, positive emotional transformation, self-regulation in behavioral practice, social environmental support, time preference, and practical limitations caused by frailty and comorbidities) were extracted. Conclusion: The participation of patients with mild cognitive impairment in cognitive training is affected by a complex interplay of multiple factors. Medical staff should optimize implementation strategies based on these influencing factors to help transform cognitive training from effective to practical implementation.

Objective: To develop clinical implementation strategies for perineal warm compresses in the second stage of labour, in order to promote their routine adoption and dissemination in clinical practice. Methods: Guided by the Consolidated Framework for Implementation Research (CFIR), a mixed-methods study was conducted to identify barriers and facilitators to the application of this technique. A modified nominal group technique was employed to determine the key barriers. The Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change matching tool (CFIR-ERIC) was utilised to generate strategies corresponding to these key barriers, which were subsequently refined through a Delphi expert consultation. Results: The study identified 12 barriers to the implementation of the technique. Following prioritisation, seven key barriers were selected, including the high complexity of the technical procedure, lack of standardised operational protocols, and the absence of practice habits among healthcare professionals, etc. A bundle of five implementation strategies was developed: optimising warm compresses equipment and materials, establishing standardised operating procedures, developing and distributing educational materials, conducting training and cultivating key trainers, and forming a collaborative group for dynamic evaluation. Conclusion: The clinical implementation strategy for perineal warm compress during the second stage of labor developed in this study is highly targeted, comprehensive, and of high scientific validity and clinical reference value.

Objective: To explore the latent profile and influencing factors of early postoperative recovery quality in patients with diabetes mellitus undergoing major abdominal surgery for digestive system diseases, and to provide insights for the development of intervention strategies. Methods: Convenience sampling was employed to select 370 inpatients with diabetes mellitus who underwent major abdominal surgery for digestive system diseases from two tertiary grade A general hospitals in Zhenjiang and Wuhu from February to July 2025 as the research participants. The General Information Questionnaire, the Chinese version of the Quality of Recovery-40 Questionnaire (QoR-40), the Diabetes Specific Quality of Life Scale (DSQLS), the Hospital Anxiety and Depression Scale (HADS), and the Social Support Rating Scale (SSRS) were used for investigation. Latent profile analysis was performed on the early postoperative recovery quality of the participants, and Logistic regression analysis was conducted to explore the influencing factors of different classes. Results: The early postoperative recovery quality of diabetic patients after major abdominal surgery for digestive system diseases could be divided into three distinct latent classes: high-quality physical and mental balance group (39.46%), moderate-quality pain-dominant group (36.76%), and low-quality physical and mental distress group (23.78%). Age, operation duration, postoperative complications, duration of diabetes mellitus, preoperative blood glucose control, social support, and anxiety and depression levels were independent influencing factors of class membership (all P<0.05). Conclusion: Three distinct types of early postoperative recovery quality exist in diabetic patients undergoing major abdominal surgery for digestive diseases. Medical staff should implement targeted interventions according to these influencing factors.

Objective: To explore the dilemmas faced by operating room medical staff in the position management of orthopedic surgery in prone position, and to provide references for improving the nursing quality of orthopedic surgery. Methods: Purposive sampling method was used to select 11 orthopaedic specialist nurses, 2 orthopaedic surgeons, and 2 anaesthesiologists in the operating theatre of a tertiary grade A hospital in Hubei province from March to May 2025 for semi-structured interviews. Thematic analysis was used to analyse the data. Results: Four main themes and six subthemes were identified, including insufficient professional competence of the surgical team (lack of skills and experience, poor team communication and coordination), difficulties in positioning high-risk patients, limitations in equipment and technical support (constraints of prone positioning devices, limited real-time monitoring technologies), and inadequate implementation of standards and procedures (unclear operational guidelines, insufficient assessment and feedback). Conclusion: Medical staff in operating rooms face multiple dilemmas and challenges in managing the prone position during orthopedic surgeries, which are related to key factors including the professional incompetence of medical personnel, individual patient variations, equipment and technical conditions, and process execution.

Objective: To analyze eye movement behaviors of ICU nurses during visual search for abnormal data on electrocardiogram (ECG) monitors, so as to provide evidence for improving nurses' ability to identify abnormal monitoring data. Methods: From November 2024 to February 2025, 34 ICU nurses from 3 tertiary grade A hospitals in Beijing were recruited via convenience sampling. A cognitive experimental programming software and an eye tracker were adopted to record nurses' recognition performance of different types of abnormal data on ECG monitors, together with total task response time, first fixation arrival time, average fixation duration, total fixation duration and fixation count. Results: There was a statistically significant difference in ICU nurses' recognition accuracy for different types of abnormal data (P<0.05). The recognition accuracy was the lowest for abnormal blood pressure and heart rate data, with median recognition accuracy values of 68.99% and 75.62%, respectively. Statistically significant differences were also found in eye-tracking indicators across different types of abnormal data (P<0.05). Subjects in the study exhibited the shortest total fixation duration (M=11.59 s) and average fixation duration (M=8.30 s), as well as the lowest fixation count (M=75.50) for abnormal respiration data, while subjects showed the longest total fixation duration (M=37.06 s) and average fixation duration (M=15.98 s), together with the highest fixation count (M=147.50) for abnormal ECG data. Conclusion: ICU nurses have relatively poor capacity to recognize abnormal blood pressure and heart rate data. Abnormal ECG signals impose high cognitive processing difficulty. Strategies should be developed to optimize ICU nurses' attention allocation and information processing capacity for abnormal data on ECG monitors, so as to further promote nursing quality in ICU.

Objective: To develop the Professional Ideology Assessment Scale for nursing undergraduates and test its reliability and validity, in order to provide a tool to identify their professional ideology status and implement individualized training. Methods: Rodger's concept analysis, literature review, Delphi expert consultation, and pre-survey were used to develop the scale. A total of 456 and 572 nursing undergraduates were recruited through online surveys in two phases for the reliability and validity testing of the scale. Results: The exploratory factor analysis extracted four common factors, explaining 62.756% of the total variance. Confirmatory factor analysis indicated a good model fit: χ2/df=4.536, CFI=0.913, TLI=0.905, RMSEA=0.079, SRMR=0.036. The Item-level Content Validity Index ranged from 0.890 to 1.000, and the Scale-level Content Validity Index was 0.966. The Cronbach's α coefficient of the total scale was 0.967, and the split-half reliability was 0.927. The final scale consisted of 4 dimensions (professional cognition, professional drive, professional expectation, and professional values) with 34 items. Conclusion: The Professional Ideology Assessment Scale for nursing undergraduates demonstrates good reliability and validity and can effectively assess the level of professional ideology among nursing undergraduates.

Objective: Based on the Symptom Experience Model (SEM), this study aimed to explore the symptom experiences of older adults with Subjective Cognitive Decline (SCD) at a specialized cognitive impairment outpatient clinic, in order to provide a reference for early identification, assessment, and support. Methods: A descriptive qualitative research design was adopted. Using purposive sampling, semi-structured interviews were conducted from September to December 2023 with 17 older adults experiencing SCD at a cognitive impairment outpatient clinic of a tertiary grade A hospital in Suzhou. The interview guide was developed based on the SEM. Data were analyzed using directed content analysis to extract themes. Results: A total of four themes and 11 sub-themes were identified: multi-dimensional experience of cognitive decline, multi-factorial attribution of cognitive decline, emotional responses and psychological adjustment related to dementia risk, and coping strategies characterized by the coexistence of passive avoidance and active management. Conclusion: The symptom experiences of older adults with SCD are multi-dimensional. Their symptom perception, attributional evaluation, emotional responses, and coping behaviors interact with each other. Healthcare professionals should based on memory complaint assessments, further focus on patients' attribution styles, emotional experiences, and coping patterns to provide individualized early support.

Objective: To explore the care management experiences of primary caregivers of elderly ostomy patients at different stages of diagnosis and treatment through journey mapping, and to provide evidence for developing supportive interventions across the entire caregiving journey. Methods: A descriptive qualitative study was conducted from July to September 2025. Fifteen primary caregivers of patients were purposively recruited from two campuses of a tertiary grade A hospital in Hefei. Data were collected through semi-structured interviews and analyzed using conventional content analysis. A caregiver journey map was subsequently developed based on the analysis. Results: Based on the stage of the care journey as the horizontal axis, the care management of primary caregivers of elderly ostomy patients was summarized into 19 themes, including insufficient treatment-related information, imbalance between psychological and material support, etc. Conclusion: Primary caregivers of elderly ostomy patients exhibited dynamic care management characteristics throughout the entire disease and stoma care journey, care tasks, emotional experiences and other aspects of care management varing across different stages. Future efforts should focus on improving healthcare professional-led information support systems and establishing stoma therapist-led continuous follow-up and caregiving skills training programs to provide sustained and standardized professional support, thereby enhancing caregivers' psychological adaptation and caregiving competence and ultimately improving the quality of home-based care for elderly ostomy patients.

Objective: To clarify latent classes and their influencing factors of frailty trajectories in geriatric patients with Acute Myocardial Infarction (AMI) after discharge, and to provide references for precise prevention and scientific management of frailty in the geriatric. Methods: A convenience sampling method was used to select geriatric patients with first-diagnosis AMI in the chest pain center ward of a tertiary grade A hospital in Shandong from May 2023 to May 2024 as the survey subjects. The FRAIL scale was used to assess frailty at discharge, 1 month, 3 months, and 6 months after discharge. The Latent Class Growth Model was used to identify trajectories, and Logistic regression was used to analyze the influencing factors of trajectories. Results: A total of 226 patients with AMI completed all follow-up surveys, and three different frailty trajectories were identified: the low-level stable group (36.7%), the medium-level slow-declining group (50.0%), and the high-level declining group (13.3%). Logistic regression analysis results showed that age, educational level, anxiety, social support level, white blood cells level, N-terminal natriuretic peptide precursor level, and hemoglobin level were influencing factors for patients' frailty trajectories (P<0.05). Conclusion: Geriatric patients with AMI show different frailty trajectories after discharge. Nurses should develop intervention plans based on different trajectories, stages, and influencing factors to achieve precise and continuous care.

Objective: To construct a "Zero-Time Exercise (ZTEx)" intervention plan for Chronic Obstructive Pulmonary Disease (COPD) older adults with oral frailty, and to provide a reference for improving their oral health status. Methods: Based on the concept of ZTEx, the first draft of the plan was developed through literature analysis, semistructured interviews, and research group discussions. The Delphi technique was then used to conduct two rounds of expert consultation among 20 experts in related fields to revise, improve and eventually establish the final draft. Results: The response rate in both rounds was 100%. The expert authority coefficients were 0.84 and 0.89, and Kendall's W were 0.232 and 0.223 (all P<0.001), respectively. The final ZTEx intervention plan is comprised of 6 first-level indicators, 15 second-level indicators, and 37 third-level indicators. Conclusion: The ZTEx intervention plan is scientific, targeted, and comprehensive to serve as a reference for oral health management in COPD older adults.

Objective: To develop a prevention and management program for osteosarcopenia in elderly patients with hip fracture and to evaluate its effectiveness, so as to provide a reference for clinical practice. Methods: Guided by a fracture liaison service model as framework, the program was developed through a literature review and expert consultation. Elderly hip fracture patients hospitalized in the orthopedic department of a tertiary grade A hospital in Jiangsu province were recruited. Forty-four patients hospitalized from September 2024 to February 2025 were assigned to the control group and received standard care, while forty-two patients hospitalized from March to August 2025 were assigned to the intervention group and received the developed program. Grip strength, bone metabolism markers, hip function, and osteoporosis self-management behavior of patients at three months postoperatively were compared between the two groups. Results: At 3 months postoperatively, there was no statistically significant difference in the incidence of osteosarcopenia between the intervention group (35.7%) and the control group (54.5%) (P>0.05). However, the intervention group exhibited significantly higher grip strength [(19.82±1.33) kg vs (19.19±1.31) kg], greater improvements in bone metabolism markers, and higher scores in hip function and osteoporosis self-management compared with the control group, all with statistically significant differences (all P<0.05). Conclusion: The developed program is scientifically sound and feasible, which can effectively improve elderly hip fracture patients’ grip strength, promote positive bone metabolism, and enhance their hip function and self-management behaviors.

Early activity is vital for ICU patients' functional recovery. However, these patients face unique challenges, including acute physiological disorders, sedation and analgesia, and impaired capacity for autonomous decision-making, which render their ability to engage in active participation lower than that of general ward patients. Yet, their engagement such as knowledge, skills, confidence, and willingness remains key to initiating and sustaining mobilization. This review examines the concept, significance, influencing factors, assessment tools, and intervention strategies for engagement in ICU early activity, aiming to inform personalized programs.

Objective: To gain an understanding of the facilitators and barriers in implementing early mobilization in patients after Pancreaticoduodenectomy (PD), so as to provide the reference for promoting the implementation of early mobilization. Methods: This study was a qualitative study. From February to April 2023, 14 patients who had undergone PD in the Pancreas Center of a tertiary grade A hospital in Nanjing were recruited as interview participants. Purposive sampling was employed. Data were collected through semi-structured, face-to-face interviews and analyzed using thematic analysis. Results: Three themes and 4 subthemes were extracted in regard to the facilitators. Four themes and 9 subthemes were extracted in regard to the barriers. The 3 themes of facilitators were correct cognition about early mobilization, trust in medical staff and good social support. The 4 themes of barriers were symptom distress after surgery, the influence of negative emotion, lack of a specific early mobilization plan and the limitations from clinical context. Conclusion: There are some facilitators and also some barriers regarding early mobilization after PD. Medical staff should strengthen the facilitators and weaken the barriers by taking a series of actions in order to promote the patients' compliance with early mobilization after PD.

Objective: To develop a competency-based training program for Advanced Practice Nurses (APNs) and verify its practical application effect, so as to provide reference for the cultivation of high-level specialized nursing talents in China. Methods: The competency framework and training demands for APNs were formulated based on a systematic literature review, expert consultation and investigation. A training program was established covering training objectives, syllabus, admission criteria, faculty standards, training base accreditation standards, curriculum design, assessment and evaluation. An integrated management mechanism led by the nursing association, the continuing education committee, specialized committees, clinical training bases, and clinical preceptors was implemented to guarantee standardized and effective training delivery. From November 2024 to March 2026, the program was piloted in four specialties (intensive care nursing, oncology nursing, emergency and critical care nursing, wound ostomy and continence nursing) in two phases and its effectiveness was evaluated. Results: A total of 156 trainees participated in the two training phases. In formative evaluation, the score of the work reflection diary was 96.08±3.22, and the score of nursing case reports was 94.94±3.13, the average summative evaluation score was 85.12±6.46. Trainees reported high satisfaction with the overall training, with an average satisfaction score of 4.90±0.30 for general core courses, 4.90±0.32 for specialized advanced courses, and 4.93±0.27 for clinical practical training. Conclusion: The competency-based training program for APNs is comprehensive and reliable, providing a practical framework for exploring the cultivation of high-level nursing professionals in China.

Objective: To construct a training program for airway clearance techniques in critically ill children based on the Learn, See, Practice, Prove, Do, Maintain (LSPPDM) framework, so as to provide a reference for the effective implementation of the training. Methods: Guided by the theory of Trusted Professional Activity, clinical diagnosis, treatment and nursing practices of airway clearance techniques were extracted from electronic medical record systems to develop a practice list for airway clearance techniques in critically ill children. On the basis of a literature review combined with the practice list, a preliminary training program was formulated according to the LSPPDM framework. Two rounds of Delphi expert consultation were conducted to revise the items and finalize the program. Results: The expert response rates of the two consultation rounds were both 100%. The expert authority coefficients were 0.918 and 0.932, respectively. The coefficients of variation ranged from 0 to 0.160 and from 0 to 0.140, and the Kendall’s concordance coefficients were 0.166 and 0.170 (all P<0.001). The final program included stages, training duration, training contents, training methods and assessment methods. Conclusion: The training program for airway clearance techniques in critically ill children based on the LSPPDM framework is highly scientific, which can provide a reference for the effective implementation of airway clearance technique training and the improvement of professional competence of medical staff.

Objective: To explore the role transition experiences, practical challenges, and support needs of nurses in atrial fibrillation management within the context of digital health, in order to provide references for developing a nursing practice system adapted to the digital era. Methods: A descriptive phenomenological study was conducted, guided by the role theory. Between January and June 2025, 15 nurses and 16 patients with atrial fibrillation were purposively sampled from the cardiology department of a tertiary grade A hospital in Wuhan for semi-structured interviews. Additionally, three focus group discussions (with 28 participants) and a three-month period of participatory observation were conducted. Data were analyzed using Colaizzi's seven-step phenomenological analysis. Results: Four integrated themes were identified: model reconstruction of atrial fibrillation (risk-stratified monitoring, proactive closed-loop care pathway, and remote service extension), role reconstruction (data coordinators, remote coaches, technology enablers, and innovation managers), practical barriers to integrating and promoting digital health technology (insufficient system interoperability, data overload coupled with role ambiguity, and the digital divide), support deficits (lack of personalized training, multidimensional performance incentives, and interdisciplinary collaboration networks). Conclusion: Digital health technologies have driven the expansion of nurses' managerial roles by reshaping the model of atrial fibrillation management. Support systems need to be established to resolve practical dilemmas through role clarification and empowerment.

Objective: To develop an information-based management platform for operating room instruments and equipment, evaluate its application effectiveness, to provide a reference for the information-based management of instruments and equipment in operating rooms. Methods: A historical control method was adopted in a tertiary grade A specialized hospital in Jinan. From July to December 2024, manual and paper-based reconciliation methods were used for recording and managing operating room instruments and equipment. From January to June 2025, the information-based instruments and equipment management platform was implemented as an intervention. Comparisons were made between the pre- and post-intervention periods regarding the equipment usage registration rate, daily maintenance qualification rate, equipment fault response time, repair timeliness rate, overdue return rate, nursing staff assessment scores, surgeon satisfaction, and operational costs. Results: After the intervention, the equipment usage registration rate, daily maintenance qualification rate, repair timeliness rate, nursing staff assessment scores, and surgeon satisfaction were all significantly improved compared to the pre-intervention period. Meanwhile, equipment fault response time, overdue return rate, and operational costs were significantly reduced. All differences between the pre-intervention and post-intervention groups were statistically significant (P<0.05). Conclusion: The information-based management platform for operating room instruments and equipment can significantly enhance management efficiency and maintenance quality, reduce operational costs, and promote refined and intelligent management in the operating room.

Elevated noise exposure is prevalent in the NICU and may compromise preterm infants' physiological stability, sleep, and neurodevelopment. Therefore, the acoustic environment is a key monitorable and modifiable component of developmental supportive care. This review synthesizes current evidence regarding the potential mechanisms by which the NICU acoustic environment affects auditory neurodevelopment, identifies common noise sources and management challenges, and discusses emerging strategies, including intelligent acoustic monitoring, alarm management, active noise reduction, standardized nursing practice, and individualized auditory support. It aims to provide a reference for intelligent management of the NICU acoustic environment and auditory neuroprotection in preterm infants.

Objective: To conduct a scoping review of studies on the application of mobile applications in home-based self-management for patients with Chronic Heart Failure (CHF), and to provide evidence for future research and clinical practice. Methods: Relevant studies were systematically searched in both Chinese and international databases from their inception to December 31, 2025. The included literature was then summarized and analyzed. Results: A total of 25 studies were enrolled, the main functions of mobile health applications in home-based self-management for CHF patients included self-monitoring and recording, goal setting, medication management, risk alerts and feedback, health education, and social support. Besides, the main outcome indicators were self-management, quality of life, clinical outcomes, mental health, and user experience. Conclusion: Mobile applications are feasible for home-based self-management of CHF patients to some extent. However, further refinement of the functional contents of those applications remains necessary to better meet the diverse needs of patients, and more high-quality studies are needed to validate their effectiveness.

With the accelerated population aging worldwide, the rising prevalence of chronic diseases and functional impairment among the elderly has become increasingly severe. Meanwhile traditional care models face core constraints such as workforce shortages and inadequate capacity for personalized support. In this context, Brain-Computer Interface technology is rapidly integrated into the field of geriatric care, demonstrating significant application potential. This paper not only reviews its fundamental concepts and application advances, but also systematically examines its current practices and potential in improving motor function, assisting cognitive intervention, supporting mental health care, and constructing intelligent home-based support systems for older adults, as well as discussing its future development pathways to provide evidence-based references for promoting the precision and intelligent upgrading of geriatric care services in China.

Objective: To evaluate an Internet of Things (IoT)-based intelligent logistics management platform for surgical instruments and provide evidence for refined instrument management. Methods: The platform was built through IoT deployment across the operating room and Central Sterile Supply Department, unique chip-based identification of instrument sets, intelligent pre-allocation, and automated circulation by logistics robots. Surgical instruments used in 5,016 operations performed from May to July 2025 in a tertiary grade A hospital in Zhejiang province were assigned to the observation group, while 5,887 operations during the same period in 2024 served as the control group. Efficiency, safety, and economic outcomes were compared before and after platform implementation. Results: After implementation, the daily inventory-checking time in the sterile storage area decreased from 203.90±1.14 min/day to 24.73±0.16 min/day (P<0.001). The intraoperative instrument localization rate increased from 82.13% to 98.37%, and the instrument turnover rate increased from 87.50% to 97.61% (all P<0.001). For safety outcomes, the incidence of instrument handover abnormalities decreased from 1.65% to 0.22%, and the pre-allocation defect rate decreased from 8.77% to 1.28% (all P<0.001). For economic outcomes, both the processing cost per instrument set and labor costs were lower in the observation group than those in the control group. Conclusion: This platform can reduce nurses' time spent on instrument processing, improve instrument localization and turnover efficiency, decrease pre-allocation defects and handover abnormalities, reduce safety risks, optimize resource utilization, and help control hospital operating costs.

Artificial Intelligence (AI) technology has gradually demonstrated its potential in the field of multimodal data fusion, providing new ideas for the intelligent assessment and precise staging of pressure injuries. This article conducts a literature review to determine the current status of AI-based multimodal data fusion methods and their applications in the management of pressure injuries, and analyze the future development trends to promote the intelligent management of pressure injuries.

Objective: To conduct a scoping review on the application of Quantified Self (QS) technologies in home-based fluid management for patients with Chronic Heart Failure (CHF), and to provide a reference for home-based fluid management of CHF patients. Methods: We conducted a literature review according to the scoping review framework by searching relevant Chinese and English databases from their inception to April 30, 2025. Then the included studies were summarized and analyzed. Results: A total of 29 studies were included, according to which QS technologies encompassed mobile apps, wearable devices, remote monitoring systems, and sensor-driven digital games. The key components involved data monitoring, early warning feedback, educational support, interactive communication, behavioral incentives, and personalized decision-making. Additionally, the outcome types included self-management behaviors, quality of life, physiological indicators, clinical outcomes, knowledge and psychological status, as well as acceptability and feasibility. Conclusion: The application of QS technologies for home-based volume management in CHF patients suggested feasibility, effectiveness, and safety. In the future, efforts should focus on enhancing technology integration and age-friendly design, leveraging medical consortia to promote digital collaboration among hospitals, communities, and households, and establishing a new model for home-based volume management.

Reflective practice is a practical model that promotes professional growth through continuous process of learning, reflection and action based on experience. As an important form of reflective practice in nursing, clinical case reviews play a key role in risk identification, skills training, and quality improvement. This article reviews the definition, characteristics and frameworks, common forms, auxiliary tools, application value and development trends of clinical case reviews to provide references for the formulation of standardized processes and effect evaluation of clinical case reviews.

Objective: To conduct a scoping review on the economic value of Advanced Practice Nurse (APN), providing a reference for relevant studies. Methods: Based on the scoping review framework, a systematic search for studies on the economic value of APN was conducted in domestic and foreign databases. The search period ranged from the inception of each database to September 12, 2025. The included studies were comprehensively analyzed by two researchers. Results: A total of 34 studies were included, all of which were from abroad. The economic value of APN was demonstrated in nursing care for different types of diseases, such as cardiovascular diseases, gastrointestinal diseases, respiratory diseases, urinary diseases, orthopedic and rheumatic diseases, neurological and psychiatric diseases, etc. The evaluation indicators, assessment tools, and effects for the economic value of APN mainly involved four aspects: cost-benefit, cost-efficiency, cost-effectiveness and cost-utility. Conclusion: This study has confirmed the economic value of APN. Future research should focus on establishing a standardized framework for evaluating the economic value and conducting more high-quality, long-term health economic evaluations, so as to provide evidence for the optimal allocation of nursing resources, the improvement of hospital service efficiency, and the refinement of medical insurance payment policies.