Objective To investigate compliance of breast cancer patients with postoperative peripherally inserted central catheter (PICC) in terms of upper limb motion, to formulate practical plan of upper limb motion, and to improve the compliance in the patients with PICC catheter.Methods A total of 75 patients after breast cancer operation with PICC for chemotherapy were selected from Department of Thyroid and Breast Surgery for upper limb activity instructions.Plan-Do-Check-Act method was used to evaluate the feasibility and effectiveness.Two cycles were performed in two weeks.Patients' compliance was assessed by the inquiry method.Results After practicing and refining nursing process, perfecting the risk assessment table, adjusting the education time, etc., the cognition and acceptance of the significance of upper limb motion were improved in the patients.The compliance of the patients to the upper limb motion instructions was satisfactory.Conclusions The upper limb motion scheme in this study was modified and perfected through application, research, and practice.This scheme could enhance the compliance of patients in terms of upper limb motion.

Nutritional risk screening 2002 (NRS2002) is the first choice of nutritional risk screening tools suggested by multiple guides at home and abroad, since its characters including easy-to-use, evidence based medicine, objective to improve clinical outcomes. It was indicated that clinical application of NRS2002 was applicability and predictability in nutritional risk, which helped to standardize nutritional support and clinical outcomes of patients. It is important to correctly note and use NRS2002. This study is to review the research progress of NRS2002, explores its consequence in nutrition support and provide evidences for formulating effective nutritional interventions.

The day surgery mode and nursing model are diversified, and the importance of high quality day surgery care is becoming more and more important in the daytime operation. This paper analyzed the day surgery nursing model constantly explored by many large hospitals in accordance with their own development requirements, and their certain achievements. Nursing model of day surgery is mainly composed of three aspects including pre-hospital nursing, hospitalization nursing and continuous nursing, each link is very important. Therefore, it is necessary to adopt a variety of management measures to improve the quality of day surgery nursing from many ways, increase the safety of day operation and improve the patient's satisfaction. The scientific nursing model and high quality nursing will inevitably improve the effect of day surgery, which will bring great social effect and economic benefit.

Objective To investigate the quality of nursing care after the application of tracer methodology in patients undergoing chemoradiotherapy with peripherally inserted central catheters (PICC),evaluate the nurses' adherence to the procedural protocol of PICC,and calculate the number of infectious complications related with the placement.Methods We compared the nurses' adherence to the procedural protocol and the number of infectious complications before (April 2014 to June 2015) and after (July 2015 to October 2016) the tracer methodology was applied at the Chemoradiotherapy Center of Ningbo First Hospital in July 2015.Results After the tracer methodology was introduced to the care of patients with PICC,the nurses had better adherence to the procedural protocol,as shown in the rise of quality control score from (94.00± 3.35) to (97.87± 1.42).The incidence of infectious complications dropped significantly (all P＜0.001).Conclusion The clinical application of tracer methodology can improve the quality of nursing for patients with PICC,reduce the incidence of PICC-related infectious complications,and promote patient safety.

Objective To investigate the clinical effects of painless concept in nursing of patients underwent urology outpatient surgeries. Methods From June to December 2014, according to the outpatient number, 100 patients underwent urology outpatient operation in our hospital were randomly divided into the control group and the observation group, with 50 cases in each group. Patients in the control group received routine nursing, while patients in the observation group received standardized pain assessment on the basis of routine nursing. Intervention measures were carried out and preemptive analgesia was used. Adverse drug reactions were evaluated and dealt with. Degree of pain, and satisfaction with pain control pf patients were assessed. The difference of 10 clinical nurses in knowledge and attitude towards pain management before and after the intervention was evaluated.Results The number of patients in the observation group with postoperative pain score ≥5 points and needing pain medication was 3 cases, while the number in the control group was 22 (χ2=19.26,P<0.01). The number of patients whose satisfaction score >90 was 46, while it was 38 in the control group (χ2 =4. 762, P<0. 05 ) . After training, the scores of 10 clinical nurses in pain management knowledge and attitude were significantly increased from (17.58±4.0) to (34.00±5.3) (t=7.820,P<0.01). Conclusions By promoting painless conception in outpatient operating nursing, we provide the patients with a scientific, standardized, and feasible working style of pain control. The overall satisfaction is improved, and pain management knowledge attitude of nurses in outpatient department are enhanced.

Objective To explore application effects of the tracking management mode in outpatient rescue vehicles. Methods From June 2015 to July 2016 Ningbo First Hospital of Zhejiang Province applied the tracking method to track the whole process of drugs in rescue vehicles in the outpatient care unit and the quality of the equipment section. According to the tracking results, improvement measures were made and implemented in time. The first-aid medicine in rescue vehicles, the quality of item management, the time of checking rescue vehicles and the nurses′ satisfaction degree with the use of rescue vehicles were compared between before and after the implementation of the tracking management mode. Results After the implementation of the tracking management mode, the average score of the first-aid medicine in rescue vehicles and the quality of item management was( 99.12±0.88) points. The time of checking rescue vehicles was (11.24 ±1.42) min. The nurses′ satisfaction degree of using rescue vehicles was ( 98. 37 ± 1. 63 ) points. Before the implementation, they were (95.56±1.51)points,(18.00±2.51) min and(93.37±2.24) points, respectively. The differences of scores were all significant before and after the implementation of the tracking management mode (t=7.344,8.751,6.508;P<0.01). Conclusions The application of the tracking management model improves the first-aid medicine in outpatient rescue vehicles and the quality of item management, reduces the nurses′time of checking rescue vehicles and improves the nurses′ satisfaction degree with the use of rescue vehicles.

ObjectiveTo explore the application of the management by wandering around (MB-WA) model in the management of outpatient service,listen to the nurses and patients in the outpatient service,induct nurses to pay attention to the nursing quality,enhance the collaboration awareness of nurses,improve the quality of nursing and the satisfaction of patients.Methods The MB-WA model was implemented from January 2016. According to the clinical nursing quality control score table,nursing managers went to the clinical line,handed out the outpatient satisfaction questionnaire,found out the problems in the clinical nursing,promptly formulated and implemented measures to consolidate the quality of improvement.Results After the implementation of the MB-WA model in 2016,the scores of triage nursing quality (96.27±0.69),nursing etiquette (98.33±1.31), nursing operation (96.97±1.26),management of emergency medicine instrument (99.36±0.44),and patient satisfaction (91.11±2.56) increased when compared to the scores before the implementation in 2015 [(95.10±1.08),(95.31±1.24),(95.47±1.15),(95.56±1.51) and (81.15±4.68)]. The differences were statistically significant (P<0.05).Conclusions The ME-WA model help the managers to directly access the clinical problems,provide timely and targeted interventions,achieve the goal of the cooperation of nurses, participate the outpatient management,increase the outpatient management quality and management level of managers,and improve the service quality.

Objective To explore the effects of patient-participating nursing mode in improving the nursing quality for chemotherapy patients in day-care ward. Methods A total of 80 cases of chemotherapy patients in the Day-care Ward of Ningbo First Hospital from April to September 2017 were selected and randomly divided into control group and observation group, with 40 patients in each group. Routine nursing care was applied in the control group. On the basis of routine nursing, patient-participating nursing mode was applied in the experimental group. The safety of intravenous chemotherapy (venous exudation and phlebitis), patient satisfaction and quality of life of the two groups were observed and compared. Results The incidences of phlebitis, venous exudation and patient satisfaction of the control group were 22.5%, 5.0% and 80.0% respectively. Those of the observation group were 15.0%, 0% and 97.5% respectively, and the differences were statistically significant (P< 0.05). After the application of patient-participating nursing mode, the patients in the observation group were superior to the control group in their overall condition, body, role, cognition, emotion and social support. The scores of fatigue, insomnia, loss of appetite, diarrhea and constipation were lower than those of the control group, and the differences were statistically significant (P<0.05). There were no statistical differences in the incidences of nausea and vomiting, pain and shortness of breath (P> 0.05). Conclusions Patient-participating nursing mode is conducive to improve the safety and effectiveness of intravenous chemotherapy, reduce the adverse reactions of chemotherapy, and improve patient satisfaction and quality of life to some extent.

Objective To investigate the status of anxiety, depression and family function in infertile patients in day-care wards , and to explore the effects of continuing nursing on their negative emotions and family adaptability. Methods A total of 50 infertile women patients who were treated in day-care ward from February to August 2017 were selected in this study using systematic sampling. The participants were randomly divided into the intervention group (n=24) and the control group (n=26). The control group was given routine education and general psychological care at discharge. In contrast, the intervention group received continuous nursing after discharge which including establishing follow-up files, conducting group psychotherapy, and health education through the internet. Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Family Assessment Device (FAD) were used for the assessment before and two months after the discharging. The spontaneous ovulation rate and natural pregnancy rate were compared between two groups. Results There were no significant difference in HAMA scores between the two groups (P> 0.05). The HAMD score in the intervention group was significantly lower compared with the control group after two months of intervention (P< 0.01). After the intervention, the scores of communication skills, role positioning skills and behavior control dimensions regarding the family function in the intervention group were significantly lower than those in the control group (P<0.05). Moreover, the spontaneous ovulation and natural pregnancy rate in both groups increased but had no significant difference between two groups (P>0.05). Conclusions The continuing nursing has a good clinical effect on improving the depression and family function of infertile patients in the day-care ward. It is an extended service based on humanistic care and is worth developing in the day-care ward.

Objective To use Six Sigma management to administrate the procedure when ambulatory surgery patients enter into the operating room, so as to reduce surgery interval and improve utilization rate of the operating table. Methods We included 514 patients with day surgery from October 2016 to April 2017 through the Hospital Information System (HIS) of Ningbo First Hospital. Then we adapted the 5 methods of Six Sigma management including definition, measurement, analysis, improvement, control to analyze the data. By observing the delay rate of operation, the reason of delay in operation was analyzed, and the main problems of each time node were refined and improved. A total of 687 patients admitted from May to October 2017 were selected as the post intervention group and the results were evaluated. Results After the implementation of Six Sigma management, we found that the delay rate of ambulatory surgery was decreased from 12.26% to 1.16%, the difference was statistically significant (χ2=65.039,P<0.01). Conclusions The application of Six Sigma management in day surgery can effectively reduce the delay of day surgery, decrease surgery interval and improve the utilization rate of the operation.