Objective To evaluate ECG-aided tip localization of peripherally inserted central catheter(PICC),and to explore the predictive value of in vitro measurement length to optimal length.Methods Convenience sampling method was used to recruit 743 patients from 18 tertiary hospitals in 11 provinces.Patients received ECG-aided tip localization during PICC placement.After PICC was inserted,orthophoria chest radiograph (OCR) was conducted to check whether the tip position of PICC was appropriate.Results Totally 624 valid questionnaires were collected.OCR showed that all tips of PICCs were located in the optimal position.The optimal length was positively correlated with in vitro measurement length (r=0.920,P＜0.01).Linear regression showed regression equation was Y(the optimal length inserted through left basilic vein)=4.290+0.897X(in vitro measurement length)(R2=0.834,F=942.459,P＜0.001),and Y(the optimal length inserted through right basilic vein)=3.097+0.922X(in vitro measurement length)(R2=0.855,F=2055,P＜0.001).Conclusion Change of P-wave can be used to guide PICC placement and predict tip location.ECG-aided tip localization of PICC is accurate,and can be used as an alternative way.Besides,regression equation can be used to predict the optimal length of PICC.

Objective To compare the difference of training field of nurse specialist between America and China, and offer proposals to the development of Chinese nurse specialist. Methods Network information resources and citespace were used to conclude and compare training field of nurse specialist. Results The nurse specialist training in America has a mature system meanwhile it is not yet mature in China. Conclusions Reference to the mature development experience of America, combining the actual situation of China, suitable strategy should be developed for the Chinese nurse specialist training.

Objective:To use the best evidence of noninvasive mechanical ventilation related pressure injury prevention in the clinic guided by integrated promoting action on research implementation in health services framework (i-PARIHS) and evaluate its effect.Methods:This study is an unsynchronized before and after control study. Convenience sampling method was used to select patients receiving non-invasive mechanical ventilation from 7 wards of Beijing Hospital from October 2019 to September 2021. A total of 575 patients receiving non-invasive mechanical ventilation from October 2019 to September 2020 were included in the control group and 602 patients from October 2020 to September 2021 were included in the trial group. The control group adopted the usual care measures, and the trial group applied the prevention program for noninvasive ventilation related facial pressure injuries. The incidence of pressure injury was compared between the two groups. Nurses in 7 wards were investigated before and after the intervention program to compare the changes of knowledge level.Results:In the control group, there were 354 males, 221 females, aged (77.13 ± 14.49) years old; in the trial group there were 392 males, 210 females, aged (75.60 ± 14.27) years old. The incidence of pressure injury in the trial group was lower than the control group, but showed no significant difference ( P>0.05). In the control group, 11 cases suffered pressure injury, including 5 cases in stage 2, 6 cases in stage 3 and above. There were 9 cases in the trial group, including 8 in stage 2 and 1 in stage 3 and above. The severity of pressure injury in the trial group was lower than that in the control group, and the difference was significant ( χ2 = 3.83, 4.11, both P<0.05). The scores of the nurse′pressure injury knowledge increased from (6.77 ± 1.53) points to (7.15 ± 1.47) points, with a significant difference ( t = -2.31, P<0.05). Conclusions:Management of the prevention of noninvasive mechanical ventilation related facial pressure injury through evidence-based practice can reduce its incidence, reduce its severity, and it is beneficial to improve the clinical nurses' prevention knowledge and clinical practice level of facial pressure injury related to non-invasive mechanical ventilation.