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 understand nursing managers′ expectations towards nurses′ energy level stratification so as to provide the basis for the establishment of a scientific nurses′ level stratification. Methods Questionnaires were used to investigate 148 nursing managers who were randomly selected from level three class A 10 hospitals in Beijing. Results A total of 55 nursing managers (37. 2%) thought that nurses′stratification could be divided into four levels, 29 (19. 6%) for five levels and 37 (25. 0%) for six levels among 148 nursing managers. A total of 148 nursing managers believed that nurses′ education background, professional title, working experiences, ability of nursing clinical, teaching ability, scientific research ability and so on should be considered as indicators of nurses′ level stratification and expressed their expectations towards nurses′energy level stratification. Conclusions It is appropriate to divide nurses′stratification into four to six levels. Many indicators should be fully considered in the specific stratification to reflect the professional value of all nurses in maximum extent. Expectations of the managers towards nurses′ energy level stratification provide a good foundation for building a scientific and objective nurses′ level stratification and a sustained development career path for nurses.

Objective To revise the medication error evaluation scale and to explore its clinical application effect .Methods The medication error cases from January 2007 to November 2012 were analyzed , and the expert reasoning conference was held to discuss and revise the medication error evaluation scale based on the statistical results .The historical controlled study was used in this study , and 84 medication error cases from January 2007 to November 2012 were chosen as the control group , and 8 cases from December 2012 to May 2013 were chosen as the observation group .All cases were surveyed by the revised medication error evaluation scale , and the incidence rate of medication error was compared between two groups .Results The incidence rates of serious medication error , intravenous administration error , intramuscular/subcutaneous administration error , high-risk drug medication error were respectively 0.54, 1.97, 1.37, 0.95/100,000 occupied bed day in the control group, and were higher than 0.00, 0.62, 0.62, 0.00/100,000 occupied bed day in the observation group, and the differences were statistically significant (χ2 =54.000, 70.368, 28.267, 95.000, respectively;P<0.01 ).Conclusions The revised medication error evaluation scale can reduce the incidence rate of medication error to some extent , but the further study is still needed to explore its long-term application effect .

Objective To investigate the profession development status of IV nurse team in a part of level-3A hospitals in China.Methods The questionnaire designed by intravenous therapy professional committee of CNA was used to investigate the status of IV nurse team in 584 departments of 147 hospitals in 27 provinces.Results IV teams were built in 135 hospitals, accounting for 91.8%.The lowest ratio of the total nurse number to that of trained nurses was 1∶0.05, and the lowest ratio of the total nurse number to that of PICC placement nurses was 1∶0.069.22.7%-35.4% departments had more PICC placement nurses than trained nurses, and 10.1%-16.8%departments had PICC placement nurses than trained nurses .Conclusions Many achievements have reached in IV nurse team in China , but problems still exist in IV nurse team construction . Positive measures , such as setting training and examination standards for IV nurse , unifying certification and making other policies , should be taken to promote the professional development of IV nurse team in China .

Objective? To investigate cultivation and current working situations of PICC specialist nurses (SNs). Methods? Using convenience sampling method, all trainees who participated in PICC advanced training course held by Chinese Nursing Society from 3rd to 7th July 2017 were selected as the research objects. All the nurses were investigated a Cultivation and Current Working Situations of PICC Specialized Nurses designed by the Professional Committee of Intravenous Therapy of Chinese Nursing Society. A total of 82 questionnaires were distributed and 82 valid questionnaires were collected. The research data were analyzed by SPSS 16.0 software. Results? A total of 82 trainees were recruited from 65 hospitals from 18 provinces, cities and autonomous regions. There were 34 (52.3%) hospitals having open and transparent criteria for selecting SNs. 45 (69.2%) hospitals reimbursed the cost of PICC training courses, while 20 (30.8%) hospitals' bonuses were unaffected. The median ratio of total intravenous therapy SNs to total registered nurses in their departments was 0.125. Of 82 PICC specialist nurses, 34 (41.5%) were on nursing management posts, 40 (48.8%) worked in and out of the hospital, 37 (45.1%) worked in specialist nursing clinics, 51 (62.2%) were nursing consultants, 50 (61.0%) worked as specialist nurses educators, 19 (23.2%) took scientific research subjects and 24 (29.3%) published academic papers after participating in specialist nurse training. Conclusions? In recent years, the team of PICC specialist nurses has developed rapidly, the work place has been expanded, and the work content is more abundant. However, there is no open selection criteria for PICC specialist nurses in many hospitals. Payment support for PICC specialist nurses during training is not fully guaranteed. The role orientation of PICC specialist nurses needs to be further clarified. The role of specialist nurses has not been fully played and their scientific research ability needs to be further improved. It is suggested that nursing administrators should formulate the training, use and management system of specialist nurses, set up specialist nurses posts, and promote the rational development of specialist nurses.

Objective To explore the correlation between nurses′ preventive behavior against needle stick injuries and perception of risks, hospital safety climate as well as provide some references for strategy making. Methods In accordance with a multi-stage sampling method, questionnaires were used to collect data from 1 012 nurses in 8 level three class A general hospitals. Results The average scores of nurses′ preventive actions toward needle stick injuries and hospital safety climate were (3. 71 ± 0. 50) and (3. 91 ± 0. 53) respectively. Nurses with high perception of risks accounted for 67. 1%. In addition, the Spearman correlation analysis suggested that nurses′preventive behavior was negatively correlated with perception of risks (r= -0. 093,P<0. 01), while it positively correlated with hospital safety climate (r=0. 463,P<0. 01). Conclusions Clinical nurses should have further regulations for protective behavior against needle injuries. We can take measurements actively to reduce nurses perception of risks and create safety work climate that can be benefits for nurses taking favorable protective behavior and reducing the incidence of needle injuries.

Objective To explore how to define the difficulty and time measurement of nursing items in general wards in level three grade A hospital in Beijing, so as to provide evidence for nursing workload measurement. Methods By literature review, we self-designed nursing items scale, and selected 30 nurses conveniently for the each item assessment of workload. After screening nursing items again, 10 nurse clinicians had been chosen for semi-structure interview. Finally, we selected 9 nurse clinicians to take part in the discussion meeting, in order to acquire a suitable difficulty assessment and time measurement of nursing items. Results Our study confirmed 64 nursing items at the end, and all items were suitable for difficulty assessment and time measurement, and included the work items of personal care assistant and field staffs, but never contained some items, which could not measure time, such as grade one nursing. Conclusions The nursing items had some certain development and updating recently in level three grade A hospital in Beijing, and this study acquires 64 nursing items, which are all normal clinical nursing activities and suitable for difficulty assessment and time measurement, can be cornerstone for a reasonable and accurate nursing workload measurement.

Objective To explore a good operational method for nursing working hour measurement. Methods The research group identified nursing work items suitable for difficulty evaluation and time measurement, and the observation and standard measurement were used to get the data. Results 399 nurses were recruited from March to April, 2014, and their mean length of working years were (10. 24 ± 8. 12). A total of 1 887 nursing items time measurement were completed and the mean time of 59 nursing items were measured. The minimum of weighed took 23. 58 s, and the maximum of taking care of serious surgical patients took 1 934. 10 s. In addition, the time of 5 nursing work items of couldn′t get as they were uncommon in clinical nursing. Conclusions The quantitative performance evaluation could be achieved by working hour measurement, combined with the difficulty factor and frequency.

Objective To explore the correlation between nurses′ status of career planning and job satisfaction, turnover intention, so as to provide evidence for stabilizing nurse team and reducing nurse lost. Methods A total of 1139 nurses were recruited by multi-stage sampling method from 10 level three class A hospitals and were investigated by nurse′s career planning current status questionnaire, nurse′s job satisfaction questionnaire, nurse′s turnover intention questionnaire. Results The average scores of nurse′s career planning and job satisfaction were (3. 85 ± 0. 50) and (3. 18 ± 0. 89). Fifteen nurses intended to leave the present hospital after 1 year, and 173 nurses were not sure whether to leave present hospitals. The correlation was positive between nurses′career planning and job satisfaction (r=0. 372,P<0. 01), but it was negative between nurses′career planning and turnover intention (r= -0. 114,P<0. 01). Conclusions Nurse managers should strengthen nurse′s career planning, help nurses to make their own career planning, so as to enhance nurses′job satisfaction, reduce nurse flow, and reach win-win of personal and hospital.