摘要：Objective: To investigate the risk factors related to the development of pressure sores in critically ill surgical patients and to establish a basis for the formulation of effective precautions. <br> Methods: A questionnaire regarding the factors for pressure sores in critically ill surgical patients was created using a case control study with reference to the pertinent literature. After being exam-ined and validated by experts, the questionnaire was used to collect data about critically ill surgical patients in a grade A tertiary hospital. Among the 47 patients enrolled into the study, the 14 who developed nosocomial pressure sores were allocated to the pressure sore group, and the remaining 33 patients who met the inclusion criteria and did not exhibit pressure sores were allocated to the control group. Univariate and multivariate logistic regression analyses were employed to examine the differences in 22 indicators between the two groups in an attempt to identify the risk factors for pressure sores. <br> Results: According to the univariate analyses, the maximum value of lactic acid in the arterial blood, the number of days of norepinephrine use, the number of days of mechanical ventilation, the number of days of blood purification, and the number of days of bowel incontinence were sta-tistically greater in the pressure sore group than in the control group ( P<0. 05) . The multivariate logistic regression analysis revealed that the number of days of norepinephrine use and the level of lactic acid in the arterial blood were high risk-factors for pressure sores ( P<0. 05) . <br> Conclusions: The best method for preventing and control pressure sores in surgical critically ill patients is to strongly emphasize the duration of the critical status and to give special attention to patients in a continuous state of shock. The adoption of measures specific to high-risk patient groups and risk factors, including the active control of primary diseases and the application of de-compression measures during the treatment of the patients, are helpful for improving the quality of care in the prevention and control of pressure sores in critically ill patients.

摘要：Objective: To standardize pain management in the anesthesia recovery period and improve the effects of analgesia on acute postoperative pain. <br> Methods: Using healthcare failure mode and effect analysis (HFMEA), we analyzed the primary cause of patients' pain and subsequently determined the process and risk priority number (RPN). <br> Results: Actions were taken to improve patients' pain. After using HFMEA, the experimental group's visual analog scale (VAS) scores were lower than those of the control group at 1 h and at discharge from the post-anesthetic intensive care unit (PAICU). The differences were statistically significant (P<0.05). <br> Conclusions: The application of failure mode and effect analysis can relieve pain and improve the quality of nursing.

摘要：Objective:The purpose of this empirical study was to investigate the evaluation indexes of nursing research results and to provide references for the optimization of nursing research results and their clinical applications.Methods:A total of 150 clinical nursing studies were randomly selected,the clinical applications of their results were investigated,and the results were evaluated using the evaluation indexes of nursing research achievements.Results:The results of 101 clinical nursing studies were promoted through their application,accounting for 82.79％,but they were mostly promoted and applied in small areas.When the evaluation indexes of nursing research results were used to evaluate the results,the scores for the applied results were higher than those of unapplied results,and the difference was statistically significant (P ＜ 0.05).Considering the levels of the results,the scores of the results of studies at the national level were higher than those of studies at the municipal and hospital levels;the scores of the results of studies at the provincial level were higher than those at the hospital level;and the scores of the results of originally innovative studies were higher than those of partially innovative studies.The differences were statistically significant (P ＜ 0.05).In terms of overall scores,the scores of the results at the provincial level were higher than those at the hospital level,and the difference was statistically significant (P ＜ 0.05).Conclusions:The evaluation indexes of nursing research results in this study can scientifically and effectively evaluate the level,value,and effectiveness of the nursing research results and can promote the clinical application of the optimized results.

摘要：Objective: To evaluate the adjuvant treatment of acute stage symptoms and quality of life of patients with bullous pemphigoid (BP) with ozone.Methods: We included 74 patients with moderate and severe BP hospitalized from July 2018 to December 2020. The par ticipants were randomly divided into the control group and the ozone group, with 37 patients in each group (n = 37). The control group used tap water to wash the whole body, and mupirocin ointment was used for the erosions. The ozone group used ozone water to wash the whole body, and the erosion place was coated with ozone oil. The bullous pemphigoid disease area index (BPDAI) score of BP disease was used to observe the clinical symptoms and skin lesions of the two groups before and on day 3, 7, and 14 after treatment. Pruritus and sleep were observed before and on day 3, 7, and 14 after treatment. The Dermatology Life Quality Index (DLQI) was used to observe the quality of life before and after treatment and the adverse reactions were recorded. Results: The total BPDAI score and erythema score in the ozone group were significantly different from those in the control group on day 3, 7, and 14 after treatment (P < 0.050). The scab drying time and erosion drying time of ozone group were shorter than that of control group (P < 0.001). There were statistically significant differences between the ozone group and the control group in pruritus score and sleep score on day 3, 7, and 14 after treatment (P < 0.001). There was statistically significant difference in skin disease quality of life between the two groups 14 days after treatment (P < 0.001). No significant adverse reactions and complications were observed in both groups. Conclusions: Ozone external use can rapidly improve the acute stage of edema erythema, erosion, and itching of BP, improve the quality of life of patients, is an effective treatment method, and wor thy of clinical promotion.

摘要：Objective: The associations between social support and burnout were explored in ICU nurses of Shanghai. <br> Methods: We performed a cross-sectional study of 356 ICU nurses by applying random cluster sampling. Data were collected using self-reported questionnaires under the instruction of trained investigators. Data on emotional exhaustion, depersonalisation and feelings of low personal ac-complishment etc. were collected, calculated and analyzed. <br> Results: The participants had a mean age of 26. 96 years ( SD 4. 07) . The mean value ( M) and stand-ard deviation ( SD) of emotional exhaustion was M=31. 85, SD=8. 38, those of depersonalisation was M=11. 69, SD=5. 54 and those of feelings of low personal accomplishment was M=19. 79, SD=7. 02. The high degree of emotional exhaustion ( EE) , depersonalisation ( DP) , and lack of personal accom-plishment ( PA) were revealed to be 76. 4%, 39. 6%, and 94. 9%, respectively. The major influencing factors of emotional exhaustion included support from co-workers( b=0. 343, t=1. 98, P=0. 049) , tak-ing leave( b=-1. 182, t=-3. 747, P=0. 001) , requisition of work( b=-1. 41, t=-2. 369, P=0. 018) , and supervisor support( b=-0. 524, t=-3. 926, P=0. 001) . The major influencing factors of depersonalisa-tion were support from the supervisor( b=-0. 333, t=-4. 146, P=0. 001) , age( b=-0. 89, t=-2. 272, P=0. 024) and requisition of work( b=-0. 148, t=-2. 124, P=0. 034) . There was a positive co-relationship between personal accomplishment and supervisor support. <br> Conclusions: Supervisor support, age, and requisition of work were the major influencing fac-tors of depersonalisation. In addition, supervisor support plays an important role in low personal accomplishment. Further research should focus on supervisor support, co-worker support, time on leave, and requisition of work associated with emotional exhaustion.

摘要：Objective: To systematically evaluate the effectiveness of fall prevention and balance function in the elderly. <br> Methods: Databases, including PubMed, Web of Science, Cochrane Library, Chinese Biomedical Literature Database (CBM), and CNKI were electronically searched, and the relevant references of the included papers were also manually searched. Two reviewers independently screened the articles according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. A meta-analysis was performed using the Cochrane Collaboration's RevMan 5.1 software. <br> Results: Six randomized controlled trials (RCTs) involving 2796 participants were included. The results of the meta-analysis showed that compared with a physiotherapy intervention, Tai Chi could significantly reduce the incidence rates of falls [relative risk (RR) ? 0.82, 95% confidence interval (CI) (0.73, 0.92)], while there were significant differences in the Timed Up and Go test, Functional Reach Test and Berger Balance Scale. <br> Conclusions: Tai Chi is effective in reducing the risk of falls and improving balance in the elderly.

摘要：Objective: To describe the revolution and research status of Advances in Psychological Science. Methods: A total of 3060 articles published in Advances in Psychological Science from 1983 to 2014 were analyzed with the information visualization method using Citespace software from the aspects of pub-lications, cited frequency and downloads, funding, organizations, authors and keywords. Results: The results showed that the amount of literature published annually had an upward tendency, and 49.4％ of the papers were supported by national or provincial projects. Institutions such as the Chinese Academy of Sciences (CAS) and the normal universities were rated in the forefront of the sci-entific research output. Xiting Huang, Hong Li and Yuejia Luo were at the top of the list of prolific authors. Conclusions: A new pattern of cooperative development of the theory and application in the field of psychological research is forming.

摘要：Objective: The purpose of this study was to address the issues that occur during the B-ultrasound guided peripherally inserted central catheter (PICC) process and to give a summary of the effective management to these issues accordingly. <br> Methods: The information was collected retrospectively on all of the 1950 PICCs inserted during the 2-year period from July 2013 to July 2015. PICC catheter insertion was performed using the Seldinger approach and was delivered from the basilic vein to the superior vena cava in a B-ultrasound guided manner. Moreover, the point raised during the PICC process would be treated immediately. <br> Results: All of the PICCs were inserted successfully. The problems encountered are shown in the inserted central catheter (PICC) process, such as failures of venipuncture, the problem of inserting guide wire, the catheter was difficult to be delivered etc. <br> Conclusions: The B-ultrasound guided approach enhanced the average success regarding the PICC insertion, particularly for the subset with a poor condition in the elbow superficial vein. Due to the items that emerged in the PICC process, the effective prevention prior to surgery and treatment during the operation would be necessary.

摘要：Objective: To investigate the main risk factors of peripherally inserted central catheter (PICC) related upper extremity deep venous thrombosis and establish the risk predictive model of PICC-related upper extremity deep venous thrombosis. <br> Methods: Patients with PICC who were hospitalized between January 2014 and July 2015 were studied retrospectively; they were divided into a thrombosis group (n ? 52), with patients who had a venous thrombosis complication after PICC, and a no-thrombosis group (n ? 144), with patients without venous thrombosis. To compare between the two groups, significantly different variables were selected to perform multivariate logistic regression to establish the risk-predictive model. <br> Results: The PICC catheter history, catheter tip position, and diameter of blood vessel were the key factors for thrombosis. The logistic regression predictive model was as follows:Y ? 3.338 t 2.040 ? PICC catheter history t1.964? catheter tip position ?1.572? diameter of vessel. The area under the receiver operating characteristic curve for the model was 0.872, 95%CI (0.817e0.927). The cut-off point was 0.801, the sensitivity of the model was 0.832, and the specificity was 0.745. <br> Conclusions: The PICC catheterization history, catheter tip position, the diameter of blood vessel were the key factors for thrombosis. The logistic regression risk model based on these factors is reliable for predicting PICC-related upper extremity deep venous thrombosis.

摘要：Objective: To present a model of extended home nursing support provided through WeChat for pediatric colostomy patients between the first and second surgery to support parents and to assist them in nursing possible complications at home, to reduce colostomy complications caused by improper care, to improve the quality of life of patients at home and to ensure the success of the recovery and second surgery. Methods: A combination of relevant clinical information, health care guidelines, and training as well as the establishment of a specific monitoring protocol was provided to the parents during the patient’ s first hospitalization. A support system for nursing the colostomy was established with regular follow-up via WeChat after the patient’ s first discharge from the hospital using a predetermined protocol. During the 3 to 6 months of home care in-between the colostomy operations, the charge nurse initiated the phone follow-up and provided specific, individual guidance and feedback. If necessary, extended serv-ice at predetermined intervals was provided in the 1st week, the 1st month, the 2nd month and the 3rd month. Results: Extended assistance for the home care of patients with pediatric colostomy complications im-proved the quality of life of the patients and caregivers and was accepted by all parties involved upon in-troduction. The assistance provided support for the parents at all hours, efficiently reduced the level of complications for this type of patient and facilitated fast referrals to hospital care in cases of emergen-cies. Furthermore it paved the way to successful second stage surgeries, provided direct feedback to the charge nurse and improved the work satisfaction and sense of achievement of the nurses involved. Conclusions: All 80 cases supported by WeChat successfully underwent two-stage pediatric colostomy operations. The response of the parents and the medical staff involved was very positive. This method is easy to use, economical to operate and could be applied generally to support home care.

摘要：Objective: To investigate the effect of the nursing path on postoperative complications after endoscopic submucosal dissection (ESD). <br> Method: Patients' nursing paths for ESD were established based on a systematic analysis of relevant literature, previous clinical procedures and consultation with chief physicians from a gastroenterology department. Forty patients were divided into the observation or control group and were assigned to follow the nursing path or the conventional path after an ESD, respectively. Next, the incidence of postoperative complications of these two groups was measured, primarily assessing the occurrences of bleeding, perforation, infection, and anxiety. <br> Results: The incidence of complications after ESD in the observation group was remarkably lower than that of the control group (P<0.05). <br> Conclusion: The nursing path for ESD has a positive role in reducing certain frequent complications that occur after ESD, particularly infection and anxiety;in addition, the nursing path optimizes nursing care in patients with gastrointestinal stromal tumor.

摘要：This paper describes the definition of venous thromboembolism and introduces to personalized venous thromboembolism risk assessment tools overseas. Thoughts are given on the development, amendment, application and validation of these tools. The paper provides a reference for building personalized venous thromboembolism risk assessment tools in China.

摘要：Objective: To explore the application of plan–do–check–action (PDCA) cycle in the management of the naked medicine dispensing about the automatic package and to analyze the practice improved in the quality of naked medicine dispensing medicine management. Methods: The PDCA theory was used to analyze the data, to find out the causes of the problem, and to formulate the corresponding countermeasures to intervene. The data of the naked medicine/adverse drug events satisfaction degree of the inpatients in 18 inpatient departments given for the adoption of PDCA cycle in January 2017 were set as the observation group. The number of the naked medicine/adverse drug events satisfaction degree of patients in 18 inpatient departments before adoption of PDCA cycle in December 2016 was set as the control group. The number of the naked medicine/adverse drug events satisfaction degree of patients in 18 inpatient departments before and after adoption of PDCA cycle was observed and analyzed. Results: The number of the naked medicine/adverse drug events after implementing the method of PDCA cycle management rate was significantly lower than before the implementation method of PDCA cycle management, and the difference had statistical significance (P < 0.05). The satisfaction degree of the inpatients after implementing the method of PDCA cycle management rate was significantly higher than that before the implementation method of PDCA cycle management, and the difference had statistical significance (P < 0.05). Conclusion: Application of PDCA cycle in the management of the naked medicine dispensing about the automatic package can help to reduce the adverse drug events, to improve the safety of drug treatment, and to increase the patients' satisfaction degree.

摘要：Objective:The aim of this study was to explore the safe and effective method of expectoration in the preoperative period of patients with lung cancer resection and to promote the rehabilitation of patients.Methods:A total of 100 cases of lung cancer patients undergoing elective surgery were divided into the observation group and the control group,with 50 cases in each group.The control group was treated with vibration expectoration vest for expectoration during the pefioperative period,and the observation group was treated with respiratory function exerciser that has expectoration function in the perioperative period,three times a day,and the effect was evaluated after 5 days.Results:The number of patients in the observation group after the first expectoration time was significantly less than that of the control group (P＜0.001).Pain score,pulmonary atelectasis,and pulmonary infection rate of the observation group were significantly lower than those of the control group;the hospitalization time was significantly shorter than that of the control group;and the difference was statistically significant (P＜0.05).Conclusions:Lobectomy for lung cancer patients with perioperative respiratory training for respiratory function exercise,compared with conventional methods,is helpful for postoperative expectoration and to reduce the incidence of adverse events.

摘要：This paper reviews the concept, research condition and research progress of hierarchical division in nursing ladder management in China;points out the problem and outlook of this area.

摘要：Objective:The aim of this study was to explore whether positive emotion mediates the relationship between job burnout and turnover intentions among Chinese nurses.Methods:A cross-sectional survey was conducted in the present study.Full-time registered nurses (n =150) from Grade A hospitals in Tianjin were surveyed.Pearson correlation,hierarchical regression analyses,and the Sobel test were used in the study.Results:The results illustrated that positive emotion mediated the relationship between burnout and nurses' turnover intention.Conclusions:Nursing administrators should pay more attention to the benefits of positive emotions on working motivation.It is helpful to relieve burnout in the working process so that nurses are willing to remain in their current employment.

摘要：Background:The flipped classroom has generated considerable interest in nursing education in the last few years,especially in higher education in China.However,research to date has been insufficient to confirm the effectiveness of the flipped classroom approach.Since most of the Chinese studies are published in Chinese journals,they may not be easily accessible to international researchers.Therefore,this meta-analysis aimed to review the effectiveness of a flipped classroom in nursing education both in English and Chinese databases.Objective:The aim of the present study was to identify the robust available evidence about the effectiveness of flipped classrooms in nursing education through a systematic review and meta-analysis.Methods:A systematic search of English databases,including PubMed,EMBASE,Science Director,CINAHL and Google Scholar,and Chinese databases,including Chinese National Knowledge Infrastructure (CNKI),WanFang Data,VIP Information and Chinese Biomedical Literature (CMB),were conducted to identify peer-reviewed studies that met the inclusion criteria.Two reviewers independently performed study identification with Endnote X7 software and used Excel to extract data.The risk of bias in the included studies was assessed with Cochrane Collaboration's risk of bias tool,and a meta-analysis was conducted using RevMan 5.3 software following the guidelines proposed by PRISMA reporting standards with the protocol register No.CRD42016041826.Results:A total of 29 studies were included in systematic review.There was a significant post-intervention improvement in academic performance both in knowledge with a pooled random-effects standardized mean difference of 1.13 and skills with a pooled random-effects standardized mean difference (SMD) of 1.68.Students' self-learning abilities were also improved with a pooled random-effects SMD of 1.51 compared with traditional lecture.In the subgroup analysis,we found that the effect sizes had high fidelity in terms of nursing degrees and research settings.There was a high rating of flipped classroom pedagogy from teaching evaluations,study satisfaction,study attitude and improvement in critical thinking and problem-solving skills.Conclusions:These results indicated that a flipped classroom might help nursing students improve in knowledge,skills,attitudes,self-learning,study satisfaction,critical thinking and problem-solving skills.We recommend adopting this approach for nursing education reform.There is a call for robust empirical research and unification of appraisal standards for further support of the effectiveness of the flipped classroom.Furthermore,a meta-regression analysis is also recommended to explore the sources of heterogeneity in included studies.