Objective: To examine the current status of nursing care for adult patients with critically ill respiratory conditions pre-extubation, and analyze the barriers to clinical practice, providing a basis for advancing evidence translation. Methods: Based on evidence integration, we established audit indicators and conducted a baseline investigation from April to September 2024, and through focus group interviews, analyzed the barriers and facilitating factors. Results: This study included a total of 28 pieces of evidence summaries and formulated 18 audit indicators. Among them, the implementation rate of 11 indicators in the nurse audits was less than 60%, and the implementation rate of 2 indicators in system audits was 0. The 48-hour extubation success rate was 85.7% in the patient outcome indicators. The incidence of pre-extubation delirium and pain was high, at 33.3% and 76.2% respectively. The main obstacles were the complexity of evidence content; inadequate knowledge, attitude, and behavior of nurses; insufficient collaboration among medical, nursing, and technical teams; and a lack of training, assessment, procedures, standards, evaluation tools, and observation scales related to extubation management. The main facilitating factors included the attention of managers, recognition and support from medical, nursing, and technical teams, and nurses' awareness of improving their professional abilities. Conclusion: There is a significant gap between the clinical practice and evidence for the pre-extubation care management of critically ill adult respiratory patients. We should further optimize the barriers and facilitating factors, and develop feasible implementation plans to ensure the clinical translation of evidence.

Objective: To explore the application effects of the safety management strategy based on the SHEL (Software-Hardware-Environment-Liveware) model in the intra-hospital transport of patients undergoing Extracorporeal Membrane Oxygenation (ECMO) treatment, and to provide a reference for the safety management of ECMO transfer. Methods: Using the purposive sampling method, 23 ECMO patients in the respiratory intensive care unit of a tertiary grade A hospital in Beijing from January 2021 to December 2022 were admitted to the control group, and the routine ECMO transport process was implemented. The 23 ECMO patients admitted from January 2023 to March 2024 were selected as the intervention group, in which the safety management strategy based on the SHEL model for ECMO intra-hospital transport was implemented. The ECMO transport efficiency, the occurrence of transport-related adverse events and the comprehensive disposal ability of the team were compared between the two groups. Results: The intervention group demonstrated significantly reduced pre-transport preparation time [(12.59±1.27) min vs (13.62±1.52) min] and transport transit time [(23.53±2.16) min vs (25.44±3.16) min] compared to the control group (P<0.05). Scores for both technical ability (78.40±0.55 vs 76.20±1.79) and non-technical ability (18.20±0.84 vs 15.60±1.82), as well as the overall scores (96.60±1.14 vs 91.80±3.56)were significantly improved (P<0.05). There was no significant difference in transport-related adverse events between the two groups (P>0.05). Conclusion: Nursing intervention based on the SHEL model can effectively enhance the efficiency of ECMO transportation and the comprehensive disposal ability of the team, and improve the safety of ECMO transportation within the hospital.

Objective: To examine the current management status of intra-hospital transport of mechanically ventilated patients in ICU, and to provide evidence for improving transport safety. Methods: Based on the Systems Engineering Initiative for Patient Safety (SEIPS) model, a questionnaire was developed and used in a cross-sectional survey of 975 ICU nurses and 80 nursing managers from hospitals of different levels using convenience sampling method between February and March 2025. Results: The median implementation rate for intra-hospital transport was 43.45% (18.89%, 66.36%). In terms of departmental transportation organization management, the items with relatively low feedback included: establishing and applying an invasive mechanical ventilation in-hospital transportation risk scoring system (27.50%), establishing an invasive mechanical ventilation in-hospital transportation quality evaluation standard (46.25%), etc. Practices with lower compliance included: pausing enteral nutrition 30 minutes and checking gastric emptying (61.85%), checking cuff inflation and pressure before transport (74.26%), and monitoring respiratory depression during transport for patients on sedatives or muscle relaxants (73.64%). Conclusion: ICU nurses generally perform well in transporting mechanically ventilated patients. However, there is a need to enhance the awareness of systematic patient assessment and whole-process monitoring. The mismatch between high-load transport tasks and human resource allocation should be addressed by strengthening human resource allocation and capacity building. Meanwhile, organizational management and process optimization of transport should be implemented to promote safe and efficient execution of transport.

Objective: To establish an out-of-hospital Cardiopulmonary Resuscitation (CPR) training course for caregivers of patients at high risk of cardiac arrest, and to provide reference for the implementation of clinical patient education training. Methods: A mixed-methods research approach was employed, integrating literature review and the Delphi expert consultation method to develop a "psychological-theoretical-skills" CPR training course for family caregivers. Convenience sampling was employed to recruit 120 family caregivers of cardiac surgery patients from September to December 2024 as the study subjects. Participants were randomly assigned to the intervention group (n=60) and the control group (n=60). The experimental group received the out-of-hospital CPR training course constructed in this study, while the control group received the traditional education model. The differences in emergency response ability of the family caregivers anxiety status, nursing burden, and psychological resilience before and after the intervention were compared. Results: The training significantly improved family caregivers' theoretical scores [(32.45±3.35) vs (26.57±5.30)] and skill pass rates (80.0% vs 72.7%) in CPR (P<0.01), and the effect of the intervention group was better than that of the control group (P<0.01). Both training methods reduced anxiety and nursing burden and enhanced psychological resilience, but the improvement effects of the intervention group were more significant (P<0.01). Conclusion: The out-of-hospital CPR training course based on Delphi consultation can significantly improve the CPR first aid ability of family caregivers for patients at high risk of cardiac arrest, and effectively improve the psychological state of family caregivers.

Objective: To explore the dynamic attenuation trend of artificial airway cuff pressure in obese patients through continuous monitoring, aiming to provide reference for clinical nursing staff to optimize and regulate the cuff pressure of artificial airways in obese patients, and improve the safety and effectiveness of the cuff pressure of artificial airways management. Methods: Obese patients (BMI≥28.0 kg/m2) who underwent mechanical ventilation in the ICU of a tertiary grade A hospital from December 2024 to April 2025 were recruited as the research participants by purposive sampling method. According to the maximum limit of artificial airway cuff pressure recommended by the guidelines, the pressure was adjusted to 30 cmH2O. The cuff pressure monitoring gauge was used to monitor and record the actual pressure every hour. Using the continuous monitoring time of the patients' cuff pressure as the variable and <25 cmH2O as the outcome, the Kaplan-Meier curve for the monitoring of artificial airway cuff pressure in obese patients was drawn, and the changes in artificial airway cuff pressure over time in obese patients were observed. Results: The cuff pressure initially set at 30 cmH2O dropped below the safe range in 10.17% of patients after 1 hour, and the cumulative proportion reached 57.63% after 4 hours. After 8 hours, only 23.73% of patients maintained the cuff pressure at 25 cmH2O. The results showed that the median time for the patients' cuff pressure to be <25 cmH2O was 4 hours (95% CI: 2.8-5.2). Conclusion: The attenuation rate of cuff pressure in obese patients is relatively fast. It is recommended to increase the monitoring frequency in clinical work or use continuous cuff pressure monitoring equipment for dynamic management to ensure that the pressure remains within a safe range.

Objective: To develop a questionnaire to evaluate clinical nurses' knowledge, attitudes, and practices in recognizing and managing in-hospital stroke, providing a validated tool to assess their current competencies in stroke identification and emergency care. Methods: Based on the Knowledge-Attitude-Practice theory, the item pool of the questionnaire was established through a comprehensive approach, which encompassed an in-depth literature review, Delphi expert consultations, and pilot survey. Subsequently, a total of 448 clinical nurses were surveyed by using convenience sampling method in Ganzhou in October 2024 to conduct item analysis as well as reliability and validity tests on the questionnaire. Results: The final questionnaire consisted of 34 items in 3 dimensions. The content validity at the item level ranged from 0.830 to 1.000, and the average content validity of the questionnaire was 0.960. Exploratory factor analysis extracted a total of 6 common factors, with a cumulative variance contribution rate of 60.225%. Confirmatory factor analysis showed that the factor loading of each item ranged from 0.532 to 0.837, indicating a good model fit. The overall Cronbach's α coefficient of the questionnaire was 0.943, the test-retest reliability was 0.933, and the split-half reliability was 0.765. Conclusion: This questionnaire, which demonstrates good reliability and validity, can thus be employed as an instrument for comprehensively assessing the knowledge, attitude, and practice levels of clinical nurses in relation to in-hospital stroke recognition and management.

Objective: To analyze the influencing factors of nurses' medication safety behavior and the interaction mechanism among these factors, to provide a scientific basis for nurses' medication safety management. Methods: From November to December 2024, a total of 626 nurses from three tertiary general hospitals in the New District of Suzhou were selected through cluster sampling. The General Information Questionnaire, the Medication Safety Management Training Questionnaire, the Nurse Medication Environmental Perception Scale, the Chinese version of Safety Attitudes Questionnaire, the Medication Safety Competence Scale for clinical nurses, the Knowledge, Attitude and Practice Questionnaire of Nursing Interruptions, and the Nurse Medication Safety Behavior Questionnaire were used for the investigation. The influencing factors of nurses' medication safety behavior and the mechanism of action of these factors were analyzed through the structural equation model. Results: The score of nurses' medication safety behavior was 48.50±8.60. The model fitting indicators of the structural equation model were χ2/df=2.908, CFI=0.947, GFI=0.952, NFI=0.922, TLI=0.928, RMSEA=0.055, and IFI=0.947. Nurses' medication safety competence (β=0.383), nurses' perception of the medication environment (β=0.271) directly and positively influenced nurses' medication safety behavior. Medication safety management training [β=0.123, 95% CI (0.013, 0.361)], nurses' perception of the medication environment [β=0.095, 95%CI (0.010, 0.305)], nurses' attitude towards medication safety [β=0.077, 95%CI (0.005, 0.268)], and knowledge, attitude, and practice regarding nursing interruptions [β=0.120, 95%CI (0.009, 0.369)] could indirectly and positively influence nurses' medication safety behaviors through nurses' medication safety competence. Conclusion: Nurses' medication safety behavior is at a moderately high level. Medication safety management training and management of nursing interruption events should be implemented, nurses' perception of the medication environment should be enhanced, nurses' attitudes towards medication safety should be strengthened, and nurses' medication safety competence should be improved. Thus, nurses' medication safety behaviors would be promoted.

Objective: To translate Workforce Agility Scale into Chinese and test its reliability and validity among clinical nurses, aiming to provide an effective tool for the assessment of workforce agility among clinical nurses in China. Methods: The Chinese version of the Workforce Agility Scale was formed through translation, back translation, cultural adaptation and pilot-testing. From November 2024 to January 2025, 824 clinical nurses from 7 hospitals in Tianjin and Qingdao were conveniently selected for reliability and validity testing. Results: The Chinese version of the Workforce Agility Scale contained 36 items in 3 dimensions. The cumulative variance contribution rate of the three common factors was 65.203%. Confirmatory factor analysis showed that the model fit well. The scale-level content validity index was 0.944, and the item-level content validity index ranged from 0.900 to 1.000. The Cronbach's α coefficient of the total scale was 0.898, the test-retest reliability was 0.924, and the split-half reliability was 0.826. Conclusion: The Chinese version of the Workforce Agility Scale has good reliability and validity among clinical nurses. It can be used to evaluate the workforce agility of clinical nurses in China.

Objective: To explore the factors influencing help-seeking behaviors for cancer symptoms in cervical cancer patients and provide evidence for early diagnosis, early treatment, and improved treatment outcomes. Methods: Using phenomenological methods and purposive sampling method, cervical cancer patients hospitalized in a tertiary grade A hospital in Beijing from August to November 2024 were selected as subjects. Data were collected via semi-structured in-depth interviews and analyzed using content analysis, based on the social ecological model. Results: Three main themes and 12 sub-themes were identified: micro system (disease cognition, knowledge level, screening attitude, health beliefs, symptom severity and persistence), meso system (health knowledge dissemination, work and family responsibilities, social support, economic condition), and macro system (disease stigma, healthcare accessibility, past medical experiences, insurance policies). Conclusion: Help-seeking behaviors in cervical cancer patients are influenced by personal, environmental, and policy factors. Healthcare workers can offer targeted interventions based on the social ecosystem to promote these behaviors, achieving early diagnosis, early treatment, and better outcomes.

Objective: To investigate the prognosis of Post-Stroke Dysphagia (PSD) in the acute phase and its influencing factors, aiming to provide a reference for early implementation of personalized rehabilitation nursing measures. Methods: Hospitalized patients with PSD in a tertiary grade A hospital in Beijing were selected by convenience sampling method from May 2014 to April 2024. The swallowing function outcome was determined by Kubota Water Swallowing Test (WST) and Videofluoroscopic Swallowing Study. Logistic regression was used to analyze the influencing factors of swallowing function prognosis. Results: A total of 541 patients were included and 38.08% of patients' swallowing function was recovered two weeks after the stroke. The results of regression analysis showed that the score of Glasgow Coma Scale (GCS)<15 (OR=0.157, 95%CI: 0.047-0.526) and nasogastric tube placement at admission (OR=0.002, 95%CI: 0-0.016), initial WST score of Grade 4 (OR=0.004, 95%CI: 0-0.055) and WST score of Grade 5 (OR=0.001, 95%CI: 0-0.016) were unfavorable factors for the prognosis of PSD, and the higher level of serum albumin (Alb) at admission (OR=1.275, 95%CI: 1.097-1.482) was a favorable factor. Conclusion: The prognosis of patients with PSD in the acute phase is influenced by the patients' score of GCS, the Alb level, nasogastric tube placement at admission, and the initial score of WST. Therefore, nurses should identify patients' prognosis and influencing factors at an early stage and provide them with targeted rehabilitative care measures to improve their rehabilitation outcomes and quality of life.

Objective: To construct and validate a risk prediction model for Acute Postsurgical Pain in patients after hepatectomy, so as to provide a reference for the management of Acute Postsurgical Pain in patients after hepatectomy. Methods: The data of 477 patients undergoing hepatectomy admitted to a tertiary grade A hospital in Wenzhou from January 2019 to December 2023 were retrospectively analyzed, and they were devided into a training set (n=318) and a validation set (n=159) at a ratio of 2?:?1. The risk factors of Acute Postsurgical Pain were examined by multivariate Logistic regression analysis. A predictive model and nomogram were respectively established. The internal validation of the model was performed using the validation set and the Bootstap method, and 200 patients admitted from January to May 2024 were selected for the external validation. Results: Age, previous surgical history, preoperative chronic pain, surgical approach, and surgical duration were independent risk factors for Acute Postsurgical Pain in patients with hepatectomy. The area under the ROC curve (AUC) of the training set model was 0.764, with a sensitivity of 80.1% and a specificity of 58.6%. After Bootstrap correction, the AUC of the model was 0.765, the sensitivity was 76.9%, and the specificity was 65.5%. The results of the Hosmer-Lemeshow test for the training set showed that χ2=9.830, P=0.277. The AUC of the validation set was 0.785, the sensitivity was 77.1%, and the specificity was 66.2%. The results of the Hosmer-Lemeshow test for the validation set showed that χ2=3.399, P=0.907. The AUC of the externally validated and corrected dataset was 0.709, the sensitivity was 76.5%, and the specificity was 58.7%. The results of the Hosmer-Lemeshow test showed that χ2=7.590, P=0.475. Conclusion: The risk prediction model constructed in this study has good performance and can provide reference for clinical medical staff to early predict Acute Postsurgical Pain in patients with hepatectomy.

Objective: To develop an evidence-based fall prevention management protocol for hospitalized patients based on the Comprehensive Unit-based Safety Program and evaluate its clinical effectiveness, and to provide references for improving the systematic management of falls in hospitalized patients. Methods: Based on literature review and expert consultation, an evidence-informed fall management protocol was developed. A stepped-wedge cluster randomized trial design with purposive sampling was employed. Nursing units with fall incidence rate higher than the hospital-wide average from 2020 to 2022 and their nurses were selected as participants. Intervention began in June 2023, the pre-intervention phases followed routine nursing practices with reference to the hospital-wide unified fall management documents, while the post-intervention phases implemented the evidence-informed fall management protocol. Outcomes included fall incidence, injury rates, and nurses' safety attitudes and safety culture cognition levels. Results: Eight nursing units and 158 nurses were included. After the intervention, the incidence (0.49‰) and injury rate (25.00%) of falls were lower than before (1.06‰ and 68.18%), nurses' safety attitude and safety culture cognition scores were higher than before, the differences were all statistically significant (P<0.05). Conclusion: The developed evidence-informed fall management protocol exhibits scientific rigor and practical applicability, reduces the incidence of falls and injury rate, and promotes nurses' safety attitude as well as safety culture cognition.

Objective: To construct and evaluate a whole process closed-loop management model of injectable drugs in outpatient Maintenance Hemodialysis (MHD) patients, and to provide references for patient medication safety management. Methods: The Healthcare Failure Mode and Effects Analysis was applied to improve the management of injectable drugs for MHD patients, and a new whole-process closed-loop management model was implemented from November 1, 2023. Totally 235 MHD patients and 22 hemodialysis nurses in a tertiary grade A hospital in Shanghai were selected by convenience sampling method. Patients from May to October 2023 were used as the control group, and patients from November 2023 to April 2024 were used as the intervention group. The incidence rate of injectable drug safety hazard events, rate of drug non-use, compliance rate for hemoglobin and ferritin levels, and satisfaction of patients and nurses were compared respectively before and after the application of the closed-loop management model. Results: The incidence rate of drug safety hazard events decreased from 2.60% (6 cases) to 0. The number of unused injectable drugs decreased from 2829 cases (10.73%) to 0. The hemoglobin compliance rate increased from 65.96% to 82.13% and ferritin compliance rate increased from 18.30% to 31.06%. Both patients' and nurses' satisfaction increased significantly. The differences above were all statistically significant (P<0.001). Conclusion: The implementation of a whole-process closed-loop management model for injectable drugs ensures the effective execution of prescriptions for MHD patients, significantly reduces drug-related safety hazards, and improves anemia-related indicators. These improvements contribute to increase satisfaction among both patients and nurses.

Objective: To assess the effectiveness of a WeChat-based case management model in improving postoperative lymphedema and quality of life in patients with gynecological cancer, so as to provide guidance for expanding the application of case management strategies for postoperative lymphedema in this population. Methods: A non-concurrent controlled study was conducted at a tertiary grade A hospital in Suzhou. Patients diagnosed with postoperative Lower Limb Lymphedema (LLL) following gynecological oncology surgery were conveniently selected and divided into two groups. The control group (n=37) who was admitted from Oct to Dec 2023, received standard care during hospitalization and attended follow-up appointments at the Vascular Surgery Outpatient Department and the Lymphedema Nursing Outpatient Department three and six months after the surgery. The intervention group (n=36) who was admitted from Jan to Mar 2024, received a case management model facilitated by a case manager through a WeChat program. Both groups were evaluated using the volume of the affected limb, the score of Lymphedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphedema (Lymph-ICF-LL) Scale. Results: Thirty-five patients in each group completed the study. The volume of the affected limb and the total scores of Lymph-ICF-LL Scale were significantly lower in the intervention group compared to the control group three and six months after the surgery. Repeated-measures ANOVA revealed statistically significant differences in time, group and interaction effects (P<0.05), indicating that the intervention group experienced greater improvements in LLL and quality of life. Conclusion: The WeChat-based case management model can improve the volume of lymphedema limb and quality of life in LLL patients.

Objective: To identify and analyze the key factors influencing the quality of "Internet+ Nursing Service", and provide references for improving the quality of "Internet+ Nursing Service". Methods: From January to June 2024, the influencing factors of the quality of "Internet+ Nursing Service" were encoded hierarchically by the grounded theory, and the relationship matrix of the influencing factors of the quality of "Internet+ Nursing Service" was constructed through the Decision Making and Trial Evaluation Laboratory (DEMATEL) model, and the DEMATEL graph was drawn. Results: Five core categories (system layer, technology layer, demand layer, supply layer and social layer) and 29 main categories were encoded. Eleven key influencing factors of the quality of "Internet+ Nursing Service" were quantitatively identified, including five key driving factors (service process and norms, nurse safety guarantee system, platform construction, personal safety early warning technology, and patient trust in nurses) and six core problem factors (patients' understanding of service safety and risks, patients' evaluation and feedback on service quality, nurses' willingness to engage, nurses' service attitude, public opinion orientation, and publicity intensity). Conclusion: The quality of "Internet+ Nursing Service" is influenced by the interaction of multiple influencing factors, and different factors have different influencing ways and degrees. Improvement of the quality of "Internet+ Nursing Service" should be carried out from aspects such as improving the system, strengthening the technical support, focusing on both the supply and demand sides, and optimizing the social environment.

Objective: To conduct a systematic evaluation for qualitative studies on the experience of dietary restriction in patients with Inflammatory Bowel Disease (IBD), to inform the formulation of dietary management strategies for clinical healthcare professionals. Methods: Search qualitative studies on the restricted dietary experience of patients with IBD and integrate the results by the pooled integration method. Results: A total of 14 articles were included, 37 research results were refined, and 7 categories were formed, and 3 integrated results were integrated, which were the manifestations of patients' dietary restriction behaviors, the challenges encountered during dietary restrictions, and patients' self-management processes in dietary adjustment. Conclusion: The restricted dietary behaviors of IBD patients lack scientific basis and are associated with various negative experiences. Healthcare providers should improve the scientific validity of patients' dietary restrictions and focus on monitoring their psychological well-being and help patients facing the challenge.

Objective: To synthesize evidence on discharge follow-up for patients at risk of Venous Thrombo-embolism (VTE) and guide clinical staff in developing follow-up plans. Methods: We systematically searched relevant databases, including associations and guidelines websites, and literature databases, for evidence on VTE discharge follow-up. The search covered clinical decisions, expert consensus, guidelines, standards, and systematic reviews from database inception to October 20, 2024. Retrieved literature was quality-assessed, and key evidence was extracted and summarized. Results: Totally fourteen articles were included: 6 guidelines, 5 expert consensus articles, 2 clinical decisions, and 1 systematic review. We summarized 29 pieces of evidence across six aspects: follow-up principles, personnel and subjects, timing and frequency, methods, content, and quality control. Conclusion: This study provides evidence-based recommendations for clinical staff to develop scientific, standardized, and personalized discharge follow-up plans for VTE-risk patients.

Objective: To systematically evaluate nurses' ability to accurately identify ultrasound B-lines and pleural effusion using Point-of-Care Ultrasonography (POCUS) in screening cardiogenic dyspnea, and clarify the required intensity of standardized training, so as to provide evidence-based basis for emergency and critical care ultrasound nursing training and the application of monitoring technologies. Methods: Chinese and English databases were comprehensively searched to recruit diagnostic accuracy trials which evaluated the use of ultrasound B-lines or pleural effusion by nurses to screen cardiac dyspnea from their inception to March 31, 2025. Two reviewers independently screened the articles, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was performed using Meta Disc 1.4. Results: A total of eight studies were identified with 847 patients. All nurses received structured ultrasound training, with a focus on developing the ability to identify B-lines and pleural effusion. After training, the pooled sensitivity, the pooled specificity, the pooled positive likelihood ratio, the pooled negative likelihood ratio, the pooled Area Under the Summary Receiver Operating Characteristic Curve (AUC), the pooled Kappa value, the pooled ICC value of nurse-performed POCUS to identify B-lines in screening cardiogenic dyspnea were 0.94 [95% CI (0.90, 0.97)], 0.84 [95% CI (0.79, 0.88)], 7.34 [95% CI (2.12, 25.44)], 0.08 [95% CI (0.03, 0.19)], 0.968 (SE=0.019), 0.79 [95% CI (0.70, 0.85)], and 0.87 [95% CI (0.82, 0.91)]. For the nurse-performed POCUS to identify pleural effusion in screening cardiogenic dyspnea, the sensitivity ranged from 0.88 to 0.98, the specificity ranged from 0.73 to 1.00, and the coefficient of agreement ranged from 0.66 to 0.96. Conclusion: Nurses can accurately acquire and interpret lung ultrasound images after training, demonstrating good diagnostic efficacy for cardiogenic dyspnea and having the potential for clinical application and promotion.

Objective: To systematically evaluate the qualitative research on the real experience of bereavement care of medical staff, and provide evidence-based basis for medical staff to better carry out bereavement care services. Methods: The qualitative studies on the real experience of medical staff participating in bereavement care were searched from domestic and foreign common databases from their inception to February 15, 2025. The evaluation tool for qualitative research was used, and the research results were integrated by aggregative integration method. Results: A total of 15 articles were included to extract 60 research results which were summarized into 10 new categories, forming 4 integrated results, including understanding of bereavement care, complex inner experience when participating in bereavement care, the challenges faced by participating in bereavement care, and the coping strategies to improve bereavement care. Conclusion: Bereavement care requires teamwork, so the managers of medical institutions could establish interdisciplinary bereavement care teams. Meanwhile, paying attention to the mental health status of medical staff participating in bereavement care to enhance their self-efficacy through education and training. Moreover, it's suggested to develop bereavement care aids to reduce the work burden of healthcare professionals to promote the implementation and advancement of bereavement care services.

The development of specialist nurses in China has shown steady growth driven by multiple factors, including policy and standardization support, growing social demand, innovative practical applications, advancements in higher education, and a more rigorous selection and training process. However, challenges, such as talent shortages, lack of standardized criteria, insufficient positions, gaps between education and practice, and uneven development persist. This article outlines the current status of specialist nurse development in China, analyzes both facilitating and constraining factors, and explores future trends, providing insights for the high-quality cultivation and advancement of specialist nurses.

Objective: To explore the working experiences of non-anesthesia nurses transitioning to anesthesia nursing positions in tertiary general hospitals, so as to provide a reference for formulating training strategies for transferred nurses. Methods: A descriptive phenomenological method was used in this study. Eleven tertiary general hospitals in Jiangsu province were selected from June to October 2024 by convenience sampling, and 15 transferred nurses from these hospitals were recruited by purposive sampling. Semi-structured interviews were conducted and the interview data were analyzed by Colaizzi 7-step method. Results: A total of 4 main themes including 10 subthemes were identified, namely adaptation challenges during the early stage of job transition, adaptation strategies for the transition, professional growth and self-actualization, and transition needs. Conclusion: The transition process of non-anesthesia nursing positions to anesthesia nursing positions involves numerous challenges. It is suggested that healthcare institutions should understand the needs of transferred nurses, promote positive transition adaptation strategies, and support their professional growth and self-actualization to meet the rapidly growing talent demands in the specialized field of anesthesia nursing.

Objective: To understand the current situation of ICU nurses' safety behaviors and explore the role of error management climate on mediating multiple leadership styles of head nurses and ICU nurses' safety behaviors, thereby providing evidence-based insights for nursing management practices. Methods: A questionnaire survey was conducted among 446 ICU nurses selected by convenience sampling method using the general data questionnaire, Multifactor Leadership Questionnaire, Error Management Climate Scale and Nurse Safety Behavior Questionnaire. A mediation effect analysis was subsequently performed. Results: The total score of ICU nurse safety behaviors was 52.60±5.28. The mediation effect test showed that error management climate had a mediating effect (β=0.37, P<0.05) on the relationship between multiple leadership styles of head nurses and ICU nurses' safety behaviors, accounting for 63.79% of the total effect. Conclusion: The score of safety behaviors of ICU nurses is at a moderate to high level, on which the error management climate plays a partial mediating effect. Nurse managers are suggested to implement multiple leadership styles to not only enhance the team's perception of errors, but also reduce the pressure of nurses in perception of errors, which will work together to improve ICU nurses' safety behaviors.

Objective: To establish a training management system for Central Sterile Supply Department (CSSD) specialist nurses and evaluate its application effectiveness, aiming to provide a reference for improving the training quality of specialist nurses in CSSD. Methods: A panel in the form of virtual teaching and research office for CSSD specialist nurse training management was established. The Delphi method was employed to develop specialized training courses, along with organizational management frameworks, training assessment protocols, and feedback evaluation program. This training management system was implemented across four training sessions from May 2021 to July 2024. Data on trainees' satisfaction, training outcomes, and their post-training performance were collected and analyzed. Results: The training management system encompassed both theoretical and practical courses. A total of 975 trainees obtained specialist qualifications, with a satisfaction rate of 96.96%. Back to their clinical work, trainees had demonstrated significant accomplishments in publication of papers, patents granted, career advancement, and participation in compiling books, etc. Conclusion: The establishment and implementation of a standardized specialized training management system comprehensively enhance the competency of CSSD specialist nurses, providing sustainable talent development for the long-term advancement of China's CSSD nursing.

Objective: To construct a training transfer program for psychiatric specialist nurses, explore its practical effect in the re-training of psychiatric specialist nurses in hospital and provide theoretical innovation and practical reference for the cultivation of psychiatric specialist nurses. Methods: By using the literature research method and the expert consultation method, a training transfer program for psychiatric specialist nurses was constructed based on the goal-driven theory. It was applied to the in-hospital re-training of 30 psychiatric specialist nurses in the mental health center of a tertiary grade A hospital in Zhejiang province from January to December 2024. Core competencies of psychiatric specialist nurses were compared before and after implementation of the program, and clinical practice effectiveness was evaluated. Results: After the implementation of the training transfer program for psychiatric specialist nurses, the total score of core competencies of specialist nurses (196.10±3.74 vs 182.30±6.73), clinical practice ability (58.47±1.11 vs 54.87±2.54), consultation and guidance ability (30.97±5.62 vs 28.73±5.82), nursing management ability (50.97±1.96 vs 46.77±2.82), nursing research ability (34.23±1.22 vs 31.60±1.54), and professional development ability (22.47±0.82 vs 21.33±1.12) were all higher than those before application (P<0.05). Conclusion: The training transfer program for psychiatric specialist nurses can effectively enhance the core competencies of psychiatric specialist nurses, thereby promoting the high-quality development of specialized nursing in psychiatry and psychology.

Objective: To develop a Central Line-associated Bloodstream Infection (CLABSI) prevention and control platform for the Intensive Care Units (ICUs), and to explore its application effects, in order to provide references for the prevention and control of ICU CLABSI. Methods: Guided by user-centered design and human-computer interface theory, a systematic search was conducted for factors related to CLABSI and laboratory indicators in ICUs. The platform monitoring contents were incorporated to form the ICU CLABSI prevention and control platform. The platform was officially applied in 22 different level hospitals across the country in July 2023. A total of 101 ICU nurses from each hospital were conveniently recruited to evaluate the usability of the platform. The differences in indicators such as the incidence of CLABSI in patients, compliance rate of medical staff's operational behavior and nurses' satisfaction rate were compared before and after the application of the platform. Results: The usability evaluation scores of ICU nurses for the platform was 70.0±16.9, indicating good usability of the platform. After the application of the platform, the number of patients with CLABSI decreased from 10 cases (1.5%) to 0, the quarterly percentage change in the number of patients with CLABSI was -44.3%, with statistically significant differences (both P<0.05). Both the compliance rate of medical and nursing operations and nurses' satisfaction rate increased with statistically significant differences (both P<0.05). Conclusion: The CLABSI prevention and control platform for the ICU can reduce the occurrence of CLABSI, standardize medical and nursing operations, and improve the satisfaction of nursing staff. The platform is worth of promotion in the clinical practice.

Objective: To develop a Digital Comprehensive Geriatric Assessment (DCGA) system, and explore its application effect in elderly health assessments within nursing homes, providing scientific support for personalized health interventions. Methods: The DCGA system was developed based on the national standard "Geriatric Assessment Guidelines" and international Comprehensive Geriatric Assessment framework. Selecting elderly individuals residing in a nursing home in Hangzhou between July and October 2024 as the study subjects using convenience sampling method. The DCGA system was used to assess self care ability, cognitive function, and frailty state. The efficiency and consistency of system evaluation and manual evaluation were compared. Results: The DCGA system had four core functions: full-process information management (elder list module); dynamic updated elderly profiles (elder profile module); multi-dimensional health assessment (elder assessment module); intelligent reports and decision support (elder report module). The system successfully completed health assessments for 196 elderly individuals. The assessments revealed that 95.9% of the elderly individuals had varying degrees of functional dependency, 75.0% exhibited cognitive impairment, 57.6% were in a state of frailty or pre-frailty. The average time for using the DCGA system and manual evaluation was 12 minutes and 45 minutes, respectively. The two evaluation methods had a high degree of consistency in the determination of ability level classification results (Kappa coefficient of 0.86). Conclusion: The DCGA system enables a comprehensive assessment of elderly health. Its standardized assessment process and data visualization features provide effective support for health management in nursing homes, demonstrating strong potential for wider application.

To explore the latest application status of digital health technologies in Central Venous Access Devices, reviews its application forms and its application in the selection of central venous access, reducing patients' discomfort during placement surgery, tip positioning, health education, complication monitoring and management, regular maintenance after placement, and operation training, to provide a reference for the practice of Central Venous Access Device indwelling and management in China.

Cancer-related cachexia is an independent risk factor for postoperative death. Nutritional prehabilitation, a preoperative management approach derived from Enhanced Recovery After Surgery, aims to enhance patients’ nutritional status, accelerate recovery, and ultimately improve their prognosis and quality of life. This review synthesizes current research on nutritional prehabilitation for patients with cancer cachexia, examining its implementation, postoperative effects across different stages of cachexia, and the major limitations and future challenges, with the aim of informing evidence-based strategies for nutritional prehabilitation in oncology.

Objective: To conduct a scoping review of studies on the application of Ecological Momentary Intervention (EMI) in the physical activity of elderly patients with chronic diseases, providing reference for optimizing the application of EMI in the management of chronic diseases in the elderly. Methods: Using scoping review methodological framework, relevant literature was retrieved from domestic and international databases, with the search period from database inception to February 28, 2025. Results: A total of 20 articles were included. EMI interventions were predominantly delivered via applications and wearable devices, categorized mainly as simple and interactive EMIs. Momentary assessments focused on behavioral data and contextual variables. Trigger rules included user-initiated, fixed-time, random-time, and decision-rule triggers. Intervention content comprised static and dynamic components, presented through visual feedback, haptic feedback, and motivational messages. Intervention outcomes covered both short and long-term effects. EMI has been widely applied in cancer, diabetes, and coronary heart disease patients, with initial evidence of feasibility and acceptability. Physical activity increased by 29-220 minutes/week, steps increased by 297.7-1920 steps/day, and sedentary time decreased by 21-262.2 minutes/day. Intervention engagement ranged from 33% to 100%. Conclusion: EMI is feasible and effective in enhancing physical activity in elderly patients with chronic diseases, but intervention engagement needs improvement.