Objective To apply the feedback closed-loop management systemin the telephone follow-up service for discharged patients to increase patient satisfaction and improve the quality of nursing. Methods From January 2015,telephone return visit to discharged patients were analyzed, a summary of dissatisfaction events, analyze the causes every month. Then,the improvement measures for nursing quality were put forward and the effects were evaluated to form a closed-loop management system. Results After the application of feedback closed-loop management system,there was a significant difference in patients' satisfaction with nursing service between the first half (with the incidence of 91.77%,3657/3985) and the second half (with the incidence of 95.76%,3610/3770) of 2015 (χ2=52.22, P < 0.01). Of the 9 items of dissatisfaction recorded in the questionnaire, significant difference was observed in 8 items, as service attitude, hospitalizing education, personal care, question answering, nurse's operation, health education, respect, clean environment and the discharge instructions. The incidence of each item was 2.11%(84/3985), 0.23%(9/3985), 0.35%(14/3985), 0.33%(13/3985), 0.30%(12/3985), 2.99%(119/3985), 0.33%(13/3985), 0.58%(23/3985), 2.58%(103/3985) in the first half of 2015 respectively, compared to 1.09%(41/3770), 0.05%(2/3770), 0.05%(2/3770), 0.08%(3/3770), 0.21%(8/3770), 0.64%(24/3770), 0.85%(32/3770), 0.21%(8/3770), 1.25%(47/3770) in the second half of 2015 respectively (χ2=4.084-59.088,P<0.01 or 0.05). However, no significant difference was observed in the nurse operational between the first half (0.30%) and the second half (0.21%) in 2015 (χ2=0.596, P>0.05). Conclusions Feedback closed-loop management systemic a scientific management theory. It can increase patient satisfaction with nursing service,improve the quality of nursing,and make quality management more scientific and effective .

Objective: To explore the application effect of video teaching combined with Teach-back method in rehabilitation training of patients with hemiplegia. Methods: The patients with glioma in eloquent area in department of neurosurgery were selected as the research subjects, grouped by time sequence of admission. Between July 2016 to August 2016, 30 patients were selected as control group. Between September 2016 to November 2016, 30 patients were selected as observation group. The control group using conventional department of neurosurgery postoperative routine nursing and hemiplegia rehabilitation education. The observation group was given feedback teaching method on basis of the control group. On the third days after operation, 2 weeks after operation and 4 weeks after operation respectively, the muscle strength, activities of daily living and satisfaction of two groups were evaluated. Results: The recovery of muscle strength of the lower limbs of the observation group was better than the control group at 4 weeks after operation (t=5.015, 5.320, P<0.05); At 2 weeks after operation and 4 weeks after operation, the daily living ability score of the observation group was higher than the control group (t=5.360, 6.510, P<0.05); There were statistically significant differences in the scores of daily living ability between the two groups at different time points (F=68.64, 65.07, P<0.01); The observation group had higher scores of daily living ability than the control group (t=2.315, P<0.05) ; At 2 weeks after operation and 4 weeks after operation, the patient satisfaction of the observation group was higher than the control group (t=2.042, 4.317, P<0.05) . Conclusion For glioma patients with postoperative limb movement disorders, feedback teaching method combined with rehabilitation training can promote the recovery of muscle strength, especially the lower limbs, improve the ability of daily living and the satisfaction of patients.

Objective To explore the effect of solution focused approach on the job burnout of nursing interns, and provide theoretical and practical basis for the post-intervention practices.Methods From September 2014 to May 2016 in a level three class A general hospital of Beijing, fresh nursing graduates who interned in hospital were selected as study objects. A total of 40 nursing interns were divided into control group from June 2014 to March 2015, using the nursing core competency-based education model for teaching, while 42 students were selected to the observation group from June 2015 to March 2016, based on control group teaching model added solution focused approach. Before and after the internship, nursing burnout scale, turnover intention scale, graduation comprehensive skills assessment scores were used to evaluated all interns in two groups. Results The differences had no statistical significance in gender, age, educational background, job burnout, intention of turnover, scores of theory and skill operation before internship (P>0.05). After internship, the job burnout and turnover intention of observation group was lower than that of control group, but the students comprehensive examination scores was higher than that of control group (P<0.05).Conclusions Solution focused approach as a model of psychological intervention can reduce the job burnout and turnover intention and improve the quality of intern practice.

The standardized training of nurses in clinical is the main form of "pouring into teaching", which leads to the training nurses received knowledge inactively and restrains the enthusiasm on learning and the improving of innovation, so it could not reach the satisfied effects of teaching. The scenario-leading teaching can analysis the characteristics of clinical training nurses and can use different teaching model according to different demands, so that it is necessary to achieve teaching according to people and subjects. This article introduce the basic contents and application of standardized training in neurosurgery for nurses teaching, so as to provide clinical evidence for clinical standardized training nurses.

Objective To explore the effect of Microsoft PowerPoint health education mode on network platform on releasing the preoperative anxiety of selective the neurosurgical surgery patients. Methods A total of 180 neurosurgery patients who were undergoing elective neurological surgery from September 2015 to August 2016 were enrolled in this study, and randomly divided into experimental and control group with 90 cases in each. The control group received traditional health education before surgery. While on the basis of the control group, the experimental group received Microsoft PowerPoint health education on network platform. The state anxiety inventory(S-AI) in state anxiety inventory(STAI) was used to compare the anxiety status of the two groups one day before surgery. The satisfaction level was investigated and compared by the satisfaction questionnaire survey. Results The S-AI score of the control group was (53.54±7.58), significantly higher than the observation group (41.16±3.58), with statistical difference (t=-20.911, P< 0.01). Satisfaction of the experimental group (95.6%) was higher than the control group (86.7%),and the difference was statistically significant (χ2=4.390, P<0.05). Conclusions The Microsoft Power Point health education mode on network platform can reduce the degree of anxiety in patients who are undergoing selective surgery and improve the patients' satisfaction with health education.

Objective To explore the effects of solution-focused approach on improving negative emotions among chronic subdural hematoma patients with trepanation and drainage.Methods From January to December 2017,a total of 100 chronic subdural hematoma inpatients in Beijing Tiantan Hospital of Capital Medical University were divided into control group and observation group by the random number table,50 cases in each group.Control group carried out routine nursing.On the basis of that in control group,observation group provided health education by five-step of solution focused approach.Patients of two groups were evaluated with the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) on admission and at discharge.Results The scores of SAS and SDS of patients in observation group were (35.00±5.222) and (37.28±5.091) respectively at discharge lower than those [(38.40±6.550) and (41.26±7.001)]in control group with significant differences (P＜0.05).Conclusions Solution-focused approach can improve negative emotions among chronic subdural hematoma patients with trepanation and drainage.It is worth to be popularized and applied in clinic.

Objective? To explore the effects of closed sputum suction, open-closed sputum suction and open sputum suction on intracranial pressure levels in patients with severe craniocerebral injury and mechanical ventilation when the head of bed elevated by 30°. Methods? Totally 36 patients who were admitted in Beijing Tiantan Hospital, Capital Medical University from October 2016 to December 2017 and conformed to the inclusion and exclusion criteria were selected consecutively by convenient sampling. The patients received closed suction (CS), open-closed suction (OCS) and closed suction (OS) as needed. The intracranial pressure (ICP) values shown on the intracranial pressure monitor were recorded at 2 min before, during and after suction as well as 5 min and 15 min after suction. Arterial blood was collected for blood gas analysis at 15 min before and after suction. The patients' partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) were also recorded. Results? The patients intracranial pressure increased when the three different suction methods were used. ICP values for OS, OCS and CS were (20.02±4.93), (16.00±4.82) and (16.08±4.42) mmHg, respectively (F=8.523,P＜0.01). There was statistical difference in ICP values at 2 min after suction between the patients received CS, OCS and OS (F=4.082,P＜ 0.05), but there was no statistical difference in ICP values at other time points between these patients (P＞ 0.05). There was no statistical difference in PaO2 and PaO2 values before and after suction using different methods (P＞0.05). Conclusions? When the head of bed is elevated by 30°, OCS and CS show small effects on ICP values in patients with severe craniocerebral injury and mechanical ventilation and do not affect the effects of sputum suction.

Objective? To explore the pressed abdominal belt on promoting restore of brain organization structure among chronic subdural hematoma (CSDH) patients with trepanation and drainage. Methods? From January to November 2017, we selected 72 CSDH patients of neurosurgery in Beijing Tiantan Hospital, Capital Medical University. All of the patients were divided into experimental group and control group with the random number table, 36 cases in each group. Control group carried out routine treatment and nursing care. On the basis of that in control group, experimental group applied pressed abdominal belt until discharge. We compared the restore distance of brain organization structure of patients between two groups three days after surgery. Results? Three days after surgery, the restore distance of brain organization structure by imaging of CT was (17.19±7.18)mm in patients of experimental group and (12.83±8.42)mm in patients of control group with a statistical difference (t=2.26, P＜0.05). Conclusions? Pressed abdominal belt as a simple and effective adjunctive therapy can promote restore of brain organization structure among CSDH patients with trepanation and drainage.

Objective? To explore the effects of chewing gum on recovery of gastrointestinal function in patients with intraspinal tumors after surgery. Methods? Totally 214 patients with intraspinal tumors treated in the Neurosurgical Ward of Spinal Cord and Spine of Beijing Tiantan Hospital, Capital Medical University from May 2018 to May 2019 were selected and divided into control (n=107) and observation (n=107) groups. Patients in the control group received conventional anti-constipation care, including postoperative dietary guidance, abdominal massage guidance and rehabilitation training, while patients in the observation group chewed 2 pieces of gum four times a day, each time for 10-15 min after awaking from anesthesia on the basis of conventional nursing care. Both groups received interventions for 7 d. The incidence of constipation and abdominal distension, time of first defecation and oral comfort scores after 7 d postoperatively. Results? The incidence rate of constipation and abdominal distension was 7.48% and 15.89% in the observation group, lower than 25.23% and 37.38% in the control group, and there were statistically significant differences between the two groups (χ2=12.331, 12.650; P＜0.05). The time of first defecation was (19.22±5.64) h in the observation group, earlier than (27.08±6.61) in the control group, and there was statistically significant difference between the two groups (t=-9.366,P＜ 0.05). The oral comfort score after 7 d postoperatively was (8.59±1.13) in the observation group, higher than (5.12±2.66) in the control group, and there was statistically significant difference between the two groups (t=-12.420,P＜0.05). Conclusions? Chewing gum can accelerate the recovery of gastrointestinal function in patients with intraspinal tumors after surgery and improve their oral comfort.