With the advancement of various domestic nursing talents cultivation, the clinical nursing teaching work has been continuously expanded, and a multi-level clinical nursing teaching system has been formed at this stage. This paper discussed the composition and development of clinical nursing teaching system. It is expected to provide reference for related clinical nursing teaching and management.

Traditional Chinese Medicine (TCM) nursing technology is an important strategy for nurses to provide TCM nursing services to patients. Guided by the holistic nursing theory and syndrome differentiation view, nursing works need to be carried out and implemented in combination with specific clinical situations. Nurses are required to have situational practice capabilities of TCM nursing technology. In this study, the new training method were explored. The TCM nurses were arranged in the real clinical situation. The clinical training method was problem oriented, and it combined theory and practice. The training contents were adjusted as needed. This new training method can improve nurses' situational practical ability of TCM nursing technology. It is expected to provide information for TCM nurses training in the future.

Objective: To explore the effect of dual-tutors combined with Balint group in improving training experience and core competence of new nurses. Methods: Totally 64 new graduate nurses from a tertiary level hospital in 2018 were taken as control group, receiving routine clinical rotation and training. The 59 new graduate nurses in 2019 were taken as intervention group, each one has their own dual-tutors and coached with Balint group model. The training experience, training satisfaction and core competence of the two groups were analyzed and compared at the end of their training. Results: After intervention, for the new nurses in the intervention group, the score of the training experience, training satisfaction and core competence were higher than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: the combination of dual-tutors and Balint Group can improve the training experience and satisfaction of new nurses, help them establish professional spirit and improve their core competence, which is worthy of further promotion and application.

In order to improve the quality of clinical nursing work, and meet the needs of the competency development of nurses in the emergency department, we established on-the-job training system for nurses in emergency department based on organizational learning theory. Through the implementation of full-staff training, whole-process management and team learning measures, the theoretical level of nurses at all levels had been improved (P<0.05) and the operational skills had been stabilized. The overall satisfaction of nurses to training was 94.39%, and the number of nursing adverse events decreased.

Objective: To explore the application effects of ADDIE model in improving the nursing ability of neuroscience nurses. Methods: Based on the five stages of ADDIE model, a specialized nursing training program was developed by a team of specialized clinical nursing teachers. Totally 106 new nurses in the Department of Neurology at 2018 were assigned to the experiment group, and accepted the specialized training program. The 66 new nurses in Department of Neurology at 2017 were assigned to the control group and accepted normal training program. The training effects were analyzed at the end of the training programs. Results: The experimental group had higher scores than the control group in the theoretical knowledge, operation skills and specialty ability (P<0.05 respectively). The teaching satisfaction of experiment group was 89.6%. Conclusion: The specialized nursing training program based on ADDIE model can improve the nursing ability of neuroscience nurses.

Standardized training is an important measure for nursing students to turn into qualified nurses, and it plays a key role in cultivating excellent nursing talents. The number of postgraduate nurses has increased. However, the standardized training method for newly recruited postgraduate nurses is still in the exploratory stage. In view of the characteristics and professional development needs of nurses with graduate degree, our hospital clarified the goals and significance of standardized training, analyzed the bottleneck problems in standardized training, and initially formed a training mode for nurses with graduate degree. This training mode is competence oriented, nurses centered and personalized training with innovative teaching methods. Through continuous exploration and improvement, the training mode has been standardized, and achieved good results. It is expected to provide information for the standardized training management of newly recruited postgraduate nurses in our country.

Objective: To explore the application value of the combined delirium prediction model in ICU patients. Methods: The E-PRE-DELIRIC model and PRE-DELIRIC model were implanted into the critical information system to integrate into a combined delirium prediction model. The performance of the combined delirium prediction model was evaluated using the statistical indicators of the evaluation model. Results: The area under the ROC curve of the combined delirium prediction model was 0.815, the area under the ROC curve of the PRE-DELIRIC model was 0.800, and the area under the ROC curve of the E-PRE-DELIRIC model was 0.777. The Z test showed that the validity of the combined delirium prediction model was statistically different from that of the E-PRE-DELIRIC model and the PRE-DELIRIC model (P<0.05). Conclusion: The combined delirium prediction model has a better prediction value, which can effectively screen out different risk groups of delirium, and provide an important reference for the delaminating management of delirium.

Objective: To study the level of physical activity and its influencing factors in Hematopoietic Stem Cell Transplantation (HSCT) patients, and to provide references for further intervention to improve the physical activity in HSCT patients. Methods: A total of 217 patients with HSCT from 9 tertiary Grade-A hospitals in Beijing were included by convenient sampling method. The International Physical Activity Questionnaire, Hospital Anxiety and Depression Scale, Revised Piper Fatigue Scale, the Exercise Self-Efficacy Scale, and Social Support Scale were used to collect data. Results: In this study, 161 (74.19%) patients had insufficient physical activity, 44 (20.28%) patients had moderate physical activity, and only 12 (5.53%) patients had active physical activity. Ordinal Logistic regression analysis showed that age, depression, fatigue, social support level and whether with complications were the influencing factors of physical activity in HSCT patients (P<0.05). Conclusion: The physical activity in HSCT patients is insufficient. It is recommended to implement targeted measures to provide the patients with more activity guidance, so as to help them to know the disease accurately, and to improve their physical activity level.

Objective: To construct the index system of interprofessional collaboration core competence for ICU nurses, and to provide theoretical reference for the clinical practice and education of ICU nurses. Methods: The index system framework was built based on literature analysis. The first draft of index system was formed through experts consultation meeting. Two-round Delphi consultations was conducted among 16 experts. The competency index system was finalized according to experts' suggestions. Results: The final index system had 6 first-level indicators, 15 second-level indicators and 43 third-level indicators. Conclusion: The index system established in this study can provide theoretical basis for management and education of ICU nurses.

Objective: To explore and discuss the effects of narrative intervention on relieving the anticipatory grief of spouses of patients with advanced gastric cancer. Methods: A total of 64 patients with advanced gastric cancer receiving chemotherapy from February 2019 to January 2020 in the three wards of the Oncology Department of a tertiary Grade A hospital in Zhengzhou and their spouses were recruited and divided into the experiment group and the control group according to the time of their admission with 32 cases in each group. Research objects in the experiment group were given narrative intervention by spouses while the other group received normal psychological guidance. Besides, all the spouses were assessed separately before intervention, 12 weeks after intervention using Connor-Davidson Resilience Scale (CD-RISC) and Anticipatory Grief Scale (AGS) for analysis and comparison. The compliance of the experiment group was also assessed. Results: The AGS score of the experiment group after 12 weeks of intervention was (69.70±6.31), which was significantly lower than that of that of the control group (93.28±9.38) with statistically significant differences (P<0.05); the CD-RISC score of the experiment group was (76.97±7.00), which was higher than that of the control group (58.34±9.87) and the differences were statistically significant (P<0.05); 53.3% of the spouses in the experiment group showed high compliance in written narrative. Conclusion: Narrative intervention by spouses can effectively relieve the anticipatory grief of patients with advanced gastric cancer and improve the mental resilience of their spouses.

Objective: To study the barriers of implementing WHO Ten Steps to promote the success of breastfeeding in baby-friendly hospitals, so as to provide reference for improving the efficiency of breastfeeding support. Methods: A total of 22 nurses from four Baby-Friendly Hospitals were interviewed in depth, and the data were analyzed by phenomenological analysis. Results: In hospital, execution Ten Steps was faced with obstacles from nurses (knowledge and ability deficiency, insufficient belief in supporting exclusive breastfeeding and concerns about obstetric safety); obstacles from hospitals (hospital system defects, personnel and time constraints, insufficient training and inconsistent professional opinions); obstacles from maternal and their families and social (poor maternal breastfeeding knowledge and attitude, poor family support, and unfriendly social environment). Conclusion: We call for to create a friendly environment for breastfeeding, and it needs the collaboration of nurses, hospitals, mothers, families and society, so as to minimize the barriers to the implementation of Ten Step and improve the efficiency of breast-feeding support in clinical practice.

Objective: To construct a cognitive function intervention program for ICU patients with Subsyndromal Delirium and to verify its clinical application effect. Methods: Based on evidence-based construction of cognitive function intervention program for Subsyndromal Delirium patients. 222 cases of sublingual patients in ICU of a tertiary grade A hospital were conveniently selected as study subjects. The control group (113 cases) received routine nursing measures, and the intervention group (109 cases) received the cognitive function intervention program for patients with Subsyndromal Delirium. The differences in duration of subsyndromal, conversion rate, incidence of delirium, cognitive function, sleep quality, length of hospital stay and mechanical ventilation between the two groups were compared. Results: After intervention, the duration of Subsyndromal Delirium was decreased, the conversion rate was increased, the incidence of delirium was decreased, and the cognitive function was improved (P<0.05). There was no significant difference in sleep quality, length of hospital stay and mechanical ventilation between the two groups (P>0.05). Conclusion: The cognitive intervention program is clinically operability. The implementation of the program is beneficial to improve the outcome and enhance the cognitive level of patients, but the effect of the program on the sleep quality, the length of mechanical ventilation and the length of hospital stay is not significant.

Objective: To investigate the characteristics of single and multiple falls in the elderly admitted to the hospital with fall injuries, compare and analyze the risk factors of multiple falls, and provide references for clinical prevention and intervention. Methods: A cross-sectional survey was conducted to collect data on the health status, physical structure and function, activities and participation, environment and individual information of the elderly admitted to the hospital after falls. According to the number of falls in the past year, the participants were divided into the single fall group and the multiple falls group, then the characteristics and risk factors of the two groups were compared and analyzed. Results: A total of 201 patients were enrolled in the study, of whom 43 experienced multiple falls, accounting for 21.4% of the total number. There was a statistically significant difference between the elderly with multiple falls and single fall in terms of pain, abnormal muscle strength in the upper limbs, and the use of walking aids (P<0.05). Conclusion: Among the elderly people who have been injured by falls, multiple falls were related to pain, abnormal muscle strength in the upper limbs, and the use of walking aids. Nurses can identify high-risk elderly at an early stage, and organize multi-disciplinary teams to intervene, thereby reducing the risk of multiple falls and fall injuries in a year.

Objective: To describe and analyze the perception and behavior of ICU nurses for hospice care through Meta-integration. Methods: Databases including The Cochrane Library, PubMed, Embase, Web of Science, CINAHL, PsycINFO, Chinese biomedical literature database (CBM), CNKI, WanFang Data and VIP were searched. All qualitative studies meeting the criteria were included, and Meta-integration method was used to analyze and integrate the data. Results: A total of 17 studies were included involving 68 clear results. Thirty-four new categories were formed and 4 main points were obtained: professional duties of ICU nurses in hospice care, emotional experience of ICU nurses in hospice care, interpersonal communication in hospice care, and obstacles in hospice care practice. Conclusion: ICU nurses have a relatively accurate and comprehensive understanding about their responsibility in hospice care, but they still lack of communication skills, psychological counseling, energy and time. The hospital should provide systematic training of hospice care and emotional counseling and psychological support to ICU nurses regularly, so as to help ICU nurses master the skills needed for hospice care, and promote the development of hospice care in ICU environment.

Objective: To integrate and evaluate the best evidence for nutrition management of patients after bariatric surgery. Methods: A search for evidence on the guidelines and expert consensus in databases such as BMJ Best Practice, UpToDate, Cochrane Library, JBI Library, CNKI and WanFang Data. The Appraisal Guidelines for Research and Evaluation (AGREE II) and the literature evaluation standards of the Joanna Briggs Institute were used to evaluate the quality of included studies. Then the evidence review and grade recommendation were carried out through the expert meeting. Results: A total of 16 articles were finally included, and 24 pieces of evidence were summarized from 6 aspects of phased diet, eating habits, nutrient intake, nutrition support, follow-up and health education, and nutrition monitoring. Conclusion: There are abundant evidence of nutrition management of patients after bariatric surgery, which is conducive to nursing staff to carry out nutrition management and make clinical decisions scientifically. It could also provide more scientific and comprehensive nutrition management for patients after bariatric surgery and improve their weight loss outcome and quality of life.

Objective: To summarize the evidence related to non-drug management of delirium and Subsyndromal Delirium in ICU, in order to promote knowledge translation, optimize delirium management and improve patient outcome. Methods: According to the evidence summary process issued by the Knowledge To Action project team, the evidence was retrieved, screened, evaluated, extracted and integrated. We searched and selected articles in both Chinese and English databases, websites of guidelines, related societies and clinical trial registration websites. After screening the articles, three researchers independently appraisal articles using validated tools. Qualitative evidence synthesis was formed to implicated the best practice of non-drug management of delirium and Subsyndromal Delirium in adult ICU patients. Results: Totally 47 articles were included for the evidence synthesis, 47 pieces of evidences including risk prediction, screening, prevention and treatment in delirium and Subsyndromal Delirium were summerized. Conclusion: The evidence for non-drug management of delirium and Subsyndromal Delirium is feasible, which could be translated to clinical practice to further verification.

Objective: To synthesize qualitative studies on cancer patients and families' experience about Advance Care Planning (ACP), so as to provide references for the clinical implementation of ACP. Methods: We searched databases including PubMed, CINAHL, Web of Science, Embase, PsycINFO (Ovid), CBM, CNKI, Wan Fang Data and VIP from inception to February 2020 to collect qualitative studies on cancer patients and families' experience about ACP. We use JBI Critical Appraisal Checklist for Qualitative Research to evaluate the quality of literature. After quality assessment, Meta-synthesis was used to summarize and explain the results. Results: Eight qualitative studies were included involving 33 results and eight categories. Three integrated themes were extracted: Acceptance of ACP by patients and their families; Feelings of cancer patients and their families towards ACP and Advices for implementation of ACP. Conclusion: There are ambivalent feelings among cancer patients and their families who involved in ACP. Initially they usually confront ACP but have positive feelings after acceptance. The awareness and acceptance of ACP among our citizens could be enhanced by publicity of the whole society. Individualized assessment by medical personnel and appropriate decision aid models to implement ACP should be offered to ultimately improve end-of-life quality of cancer patients.

Objective: To systematically evaluate the relationship between physical restraint and the risk of delirium in ICU patients. Methods: Search PubMed, EMbase, CENTRAL, Web of Science, CBM, CNKI, VIP and WanFang Data database for cohort studies on the relationship between physical restraint and the risk of delirium in ICU patients. The retrieval time was from the establishment of the database to December 31, 2020. Two researchers independently screened the literature and extracted data according to inclusion and exclusion criteria. The Newcastle-Ottawa Quality Scale (NOS) was used to evaluate the quality of the included studies, and the RevMan 5.3 software was used to conduct Meta-analysis of the data. Results: A total of 13 studies involving 5948 patients were included. Meta-analysis results showed that physical restraint could increase the risk of delirium in ICU patients [OR=6.47(3.40-12.31), P<0.001]. The results of subgroup Meta-analysis showed that the risk of delirium in physical restraint patients in comprehensive ICU or specialized ICU increased [OR=7.30(3.13-17.05), P<0.001; OR=5.67(1.84-17.51), P=0.003]; physical restraint of ICU patients in Asian or non-Asian regions increased the risk of delirium [OR=4.86(2.56-9.23), P<0.001; OR=14.96(2.34-95.62), P=0.004]. Conclusion: Current evidence suggested that physical restraint may increase the risk of delirium in ICU patients and more high-quality studies are needed to verify the above conclusions.

Objective: To explore the deep experience of organizational silence behavior of male nurses in the emergency department and provide references for nursing managers to stabilize the resources of male nurses. Methods: The phenomenological method was used in this study. 14 male nurses working in the emergency department were given semi-structured interviews, and the data were analyzed using the Van Manen analysis method. Results: The experience of organizational silence of male nurses in the emergency department was distilled into 3 themes: fear and apprehension in silence, awe and obedience in silence, and comity and harmony in silence. Conclusion: Nursing managers should pay attention to the insecurity of male nurses' speeches, create a positive organizational atmosphere, improve nursing management beliefs, and actively listen to the diverse voices of nurses, so as to break the organizational silence and stabilize male nurses' resources.

WHO-ILO interim guidance, COVID-19: Occupational health and safety for health workers, was updated on 2nd February 2021. This document aligns with relevant WHO and ILO guidlines, it was developed on the basis of expert opinions from an independent international group of experts with new and emerging scientific evidences. It provides guidance for protecting occupational health and safety of health workers in the fight against COVID-19 worldwide. This article reviews the developing process of the guidline, summarizes the latest progress of regulations and standards on occupational health for health workers in China, furthermore, this article contributes recommendations on improving policy system of occupational health protection for health workers in China.

Objective: To understand the nurses' experience and support status as the second victim in psychiatric patient safety incidents, and analyze the related influencing factors. Methods: In July 2020, 220 nurses with second victim experience in two psychiatric hospitals were selected by convenience sampling method. The Second Victim Experience and Support Tool (SVEST) and Simplified Coping Style Scale were used to investigate. The multiple linear regression analysis were conducted. Results: The score of the SVEST of psychiatric nurses was (73.50±10.71). The average score of psychological distress dimension was the highest (4.02±0.74), and the average score of support from relatives and friends was the lowest (2.30±0.79). Multiple linear regression analysis showed that working years, marriage status, leadership support and coping style were the factors influencing the experience and support level of the second victim, explaining 42.5% of the total variance. Conclusion: In psychiatric patient safety incidents, nurses face the greatest psychological distress as the second victims, mainly relying on the support of relatives and friends. Hospital managers should pay attention to nurses who are the second victims in patient safety incidents and provide them with corresponding support for different influencing factors.

This literature review summarizes the current status of research on the categories of clinical alarms, the causes of alarm fatigue, and strategies and interventions for coping with alarm fatigue. It provides implications for constructing protocols to decrease alarm-related adverse events in order to improve nurses' work satisfaction and ensure patient safety.

Objective: To evaluate the effect of NICE weight loss management model on obese and overweight type 2 diabetic patients in community. Methods: Obese or overweight type 2 diabetic patients who were transferred to a community health service center from the Endocrine Department in a tertiary Grade-A hospital between April 2018 and April 2019 were selected, with 136 in the experimental group and 131 in the control group. Those in the control group received the hospital-community integrated management mode, and those in the experimental group received NICE weight loss management mode on the basis of hospital-community integrated management. The metabolic indexes, self-management ability were compared between two groups before and 3 months after the intervention. Results: After 3 months’ intervention, the decrease of blood glucose, blood lipid, BMI, blood pressure in the experimental group were significantly greater than those in the control group (P<0.05), and the self-management ability was better in the experimental group (P<0.05). Conclusion: NICE weight loss management mode is effective to control the blood glucose, BMI, blood pressure and blood lipid for obese or overweight type 2 diabetic patients, and is benefit to improve the self-management ability and quality of life for patients.

Objective: To evaluate the effect of cross-specialty mobile health education platform in patient education. Methods: Based on the re-development of WeChat public platform and Web pages the interdisciplinary health education database, functional terminal and management terminal were established to realize the sharing of health education knowledge among different specialties. The satisfaction of patients and the health education ability of nurses before and after the use of platform in pilot departments were compared. Results: After the use of cross-specialty mobile education platform, the satisfaction of patients increased from 86.59±10.03 to 90.66±8.00, and the health education ability of nurses increased from 139.29±20.48 to 150.30±18.19, which were both statistically different (P<0.005). Conclusion: The establishment and application of cross-specialty mobile health education platform is benefit to promote the exchange and integration of cross-professional knowledge, improve the health education ability of nurses and the satisfaction of patients, and enhance the overall health education effect and quality.

Objective: To establish a prognostic-related sensitive Post-Anesthesia Care Unit (PACU) nursing quality indicator system. Methods: Johns Hopkins evidence-based nursing method was used to synthesize the evidence. The sensitive indicators, connotations and calculation formula of PACU nursing quality were initially drawn up. Two-round Delphi method was used for screening, demonstration and correction. Results: Three first-level indicators (structure, process, and results), five second-level indicators (human resources, practice environment, nursing process, adverse events, and nursing effect), and eighteen three-level indicators (bed-to-nurse ratio, nurse satisfaction rate, nurse hand washing compliance, and integrity rate of emergency medicines and equipment, patient identification accuracy rate, intravenous administration accuracy rate, recovery assessment accuracy, pain assessment accuracy, anesthesia record sheet qualification rate, unplanned extubation rate, unplanned tracheal tube reintubation rate, unplanned rate ICU transfer rate, incidence of delayed recovery, incidence of aspiration, new incidence of skin pressure injury in PACU, incidence of bed fall, rewarming rate of hypothermia patients, and pain treatment efficiency) were established. The expert authority coefficients for the two rounds of expert inquiries were 0.90 and 0.91 respectively, the positive coefficients were 0.91 and 1.00, and the Kendall coordination coefficient was 0.30- 0.52 (all P<0.05). Conclusion: The sensitive indicators of nursing quality in PACU developed in this study, which supervises the quality of nursing from three aspects: structural quality, process quality, and result quality. The sensitive and prognostic-related nursing quality indicators can provide a basis for the evaluation and monitoring of nursing quality in PACU.

Objective: To develop the sensitive quality index system of psychiatric nursing and to provide standard and quantitative reference for monitoring and evaluation of nursing quality in psychiatric hospitals and department of psychiatry in general hospitals. Methods: We set up a research team and took the three-dimensional evaluation model of structure-process-outcome as the theoretical basis. The primary index was determined by using literature review and analysis, and experts discussion. The index was further revised according to two-round Delphi consultations. Results: The final sensitive quality index system of psychiatric nursing included 3 first-class indicators and 19 second-class indicators. The positive coefficients in the two rounds of expert consultation were all 100.0%, and the authoritative coefficient was 0.905 and 0.918 respectively. The coordination coefficient ranged from 0.112 to 0.148 (P<0.05). Conclusion: The sensitive quality index system of psychiatric nursing based on Delphi method is scientific, credible and practical, which is beneficial to the management and continuous improvement of psychiatric nursing quality.

The radiation-induced mucositis, along with other associated symptoms, such as mucositis-related pain, xerostomia, thick saliva and dysphagia, etc. are common co-existing oropharyngeal symptoms identified in patients with head and neck cancer during radiotherapy. This review aims to elaborate and summarize the general impacts, available assessment methods, influencing factors, and management strategies of the oropharyngeal symptoms experienced by patients with head and neck cancer, therefore, to provide evidence for future research on symptom management among these patients and offer references in guiding clinical practice.

The article aims to review different theories and their application progress in Venous Thromboembolism (VTE) protection, explore the advantages and limitations of each theory, and analyze its research prospects in future VTE prevention practices, in order to provide new research ideas for future research.

Apathy is one of the most common neuropsychiatric symptoms in patients with dementia and assessing the patient's apathy symptoms timely and effectively and giving targeted treatment and interventions can improve outcome. In this paper, the common assessment tools of apathy in dementia patients were reviewed from the perspective of single dimension and multi-dimension, including the development process, the object of application, measurement content, reliability and validity, the application status, etc., aiming to provide a reference for Chinese scholars to select appropriate assessment tools of apathy.

The quantity and quality of day surgeries have been improved with the promotion of the national policies and the development of medical technology. Nursing as a vital guarantee for the successful implementation of day surgeries is not supposed to be ignored, so this paper summarizes the nursing management regulations for the day surgery center in West China Hospital Sichuan University. The process mode of admission preparation, schedule surgery in ward, the follow-up after discharge, as well as the framework, configuration and core ability training of human resources, team structure, nursing quality management indicators and quality specification of day surgery nursing is included in this article, which hopes to provide references for the standardization of nursing management of day surgery, so as to promote the standardized and high-quality development of day surgery in China.

In this paper, we summarized and analyzed the specific issues exposed by our public health institutions during fighting against the COVID-19. We provided some suggestions focusing on: reforming the management system of disease control organizations, strengthening the composition and function of the disease control system, improving the capacity of disease control institutions, enhancing the training and motivation on human resource, strengthening legal guarantees and enhancing CPC's leadership on the disease prevention and control system.