Objective To study the effect of new barrel theory in improving evaluation of hospitalized patients. Methods Eight hundred hospitalized patients from September 2012 to August 2013 were randomized equally into the control group and the observation group.The last one or two items affecting patient satisfaction from the control group were used as objectives to be improved.Causal effect analysis was done pertinent to the items and the worksheet was bettered and improved and then enforced.The two groups were compared after intervention with new barrel theory in terms of satisfaction of patients during admission and discharge. Result The satisfaction of patients in the observation group during admission and discharge was significantly better than that in the control group(P<0.05).Conclusion The new barrel theory used to detect the flaws in nursing service and improve the workflow can improve assessment from the patients so that the management quality can be enhanced.

Objective To investigate the association of occupational stress,social support,type D personality and physical health of nurses.Methods Cross-sectional study design was adopted.We used cluster sampling to investigate 1 287 nurses serving in one tertiary hospital and two second-class hospitals in Guangzhou.The questionnaire was anonymous answered.The content of questionnaire included the demographic data,occupational stress of nurses,social support,type D personality and physical health,etc.SPSS 13.0 was used for statistical analysis,including descriptive analysis,Pearson correlation analysis and path analysis.Results 1 192 of questionnaires were effective.The occupational stress was negatively related with the physical health status and social supports,and social support was positively related with the physical health status.The type D personality was negatively related with social supports and the physical health status,while positively related with occupational stress.Conclusions Occupational stress can make directly negative effect on the physical health.Social support has a directly protective effect on physical health.Type D personality makes direct and indirect negative effect on the physical health of nurses.

Objective To explore the role of problem-based learning(PBL) nursing ward round on critical thinking capacity of nurses from surgical departments. Methods All nurses from surgical depart-ments were randomly divided into the experimental group(86 nurses) and the control group(85 nurses) by drawing lots. Objects from the experimental group received PBL nursing ward round training twice a week for 8 months, while those from the control group used the traditional nursing ward round training. The influ-ence of the different teaching methods on the critical thinking capacity of the nurses was assessed before and after the training, using critical thinking disposition inventory-Chinese version (CTDI-CV). Results Total critical thinking capacity was improved significantly in the experimental group after the training. All sorts of critical thinking characteristics were strengthened in different degree. Conclusions PBL nursing ward round training can effectively facilitate the critical thinking capacity of surgical nurses.

Objective To explore the relationship between work-family conflict and turnover inten-tions in nurses and find out the key points to reducing turnover intentions by releasing individuals' work-family conflict. Methods Cross-sectional study method was used in this investigation. By using cluster sampling method, 1287 nurses from some top-level and third-class general hospital were investigated. The questionnaire of work-family conflict and turnover intentions scale were used in this research and the re-suits underwent analysis. Results The score of turnover intentions in nurses was positively correlated with the level of their work-family conflict (r=0.233,P<0.01). Stress,behavior and time dimension were related factors of turnover intentions(r=0.243,0.191,0.176,P<0.01 ).After control of demographic factors, the turnover intentions deviation that can be explained increased by 7%. Conclusions The score of work-family conflict is one of the predicators of turnover intentions. A developing measure should be taken to reduce turnover intentions by releasing work-family conflict in nurses.

Objective To explore the effect of multiple-formed nursing teaching ward-round.Methods Trainings and practices about muhiple-formed nursing teaching ward-round were executed to clinical instruction teachers.Results 95.9%of nursing students were satisfied with the quality of nursing teaching ward-round.After training ang practices,the evaluation to the nursing teaching ward-round and the scores of theoretic and operation examination of nursing students raised significantly(P＜0.05).Conclusions The trainings and practices improve the teachers' ability of utilizing multiple-formed nursing teaching ward-round,which not only enhance the students' study initiative,but also improve the query of nursing teaching teaching ward-round.

Objective To identify the sounces of occupational stress and explore the relationship between occupational slreas and social support for nurses in ICU.Methods A descriptive and correlation design was used in this study.From July to October in 2007,159 nurses from 8 ICU and 160 nurses from common wards completed the questionnaires.Statistical analysis was performed for the investigation results.Results The ayes age score of occupational stress for nurses in ICU was (3.41±0.73),which was in a moderate to high level.The main stress was that they regarded nursing as a high risk career,maximums working intensity,always overload work and frequent night-shift.While the average score of occupational stress for nurses in common wards was (3.29±1.05).The main stress was that they regarded nursing as a high risk career,Score of occupational stress between nurses in ICU and com wards had no statistical difference(P＞0.05).There was a significant negative correlation between occupational stress and social support for nurses in ICU(r=-0.159,P＜0.05).And the sup port by friends was into the equalion by multi-linear regression.Conclusions The level of occupational stress for murses in ICU was fairly hish.Scientific management of human resource,reducing work pressure of nurses and workloed,exerting various social support will benefit for reducing the stress of nurses in ICU.

Objective To apply Plato analysis method to clinical cases which were reported from clinical nursing, finding out the key link of the risks which were related to the cases:the key age, the key period, the key spectrum of disease and the key projects, etc. To carry out the feedforward control of the quality of care, and ensure the quality and safety of nursing. Methods A database were set up including clinical special cases, high-risk cases, security hidden danger cases and emergency cases. Thetwo eightprinciple of Plato analysis method was used to find out the main factors, the principal contradiction, the key hazard and the key problems of the cases, etc. The aim was to provide guidelines of risk analysis, risk prevention and risk aversion for nurses, and improve their consciousness of security hidden danger, and reduce security hidden danger cases. Results The results of 207 cases collected from 2014 to 2015 showed that the main risks involved the age groups were 41-80 years old and 21-30 years old. The major risks involved the spectrum of disease were the nervous system, cardiovascular disease, surgical anesthesia related problems, kidney disease, cancer and respiratory system. The major risks involved the time were the midnight, morning and afternoon. The major risks involved the locations were sickroom, emergency room, auxiliary inspection departments and outpatient. The major risks involved items were disease mutation, psychological problems, medication safety and instrument safety, among the disease mutation, timely discovered, rescued 13 patients with heart and breathing pause, stop 13 patients who attempted suicide. Since the Plato analysis method was applied to identify the security risks of the clinical cases, the number of falling, all kinds of pipe shed, skin problems and suicides were decreased from 6, 6, 7, 5 in 2014 to 2, 2, 2, 1 in 2015, declining trend year by year. Conclusions Applying the Plato analysis method to identify the security risks of the clinical cases which can find out the main problems of cases and improve nursing quality and management efficiency.

Objective To explore the effects of two methods for deep endotracheal suction.Methods Forty patients who had ineffective airway clearance or lung infections or refused suction were randomly divided into observation group (n=21) and control group (n=19).Temporay airway was established by using oropharyngeal airway.Then,the control group received subglottic suction after pading the shoulder with ordinary pillow (≤10cm),while the observation group received subglottic suction after pading the shoulder with homemade pillow (=15cm).The two groups were compared in terms of sputum suction effect and mucosal injury.Results There was no incidence of mucosal injury in the observation group but three in the control group.The times of suctioning in the observation group were fewer than those of the control group and the volume for suctioning was larger as well (allP<0.05).Conclusion Deep endotracheal suction through oropharyngeal airway,shoulder elevation for 15cm,temporary indwelling of suction tubes can achieve better suction effect without corresponding complications.

Objective To investigate the risk factors of obstruction of central venous catheter(CVC)in the intensive care unit(ICU). Methods One hundred and thirty-three adult patients in ICU with CVC were included in the study. The difference of the position of catheters, duration of indwelling catheters,selection of sealing solution,blood platelet(PLT)count,prothrombin time(PT),international normalized ratio(INR),activated partial thromboplatin time(APTT),thrombin time(TT)and fibrinogen(FBG)were studied between two groups of patients(with and without the obstruction of CVC).Results In 117 cases,there were no catheter obstruction,accounting for 88.0%. Catheter obstruction occurred in 16 cases,accounting for 12.0%,10 cases of which the catheters were partially blocked,accounting for 7.5%and in 6 cases completely blocked,accounting for 4.5%.There were significant differences in the duration of indwelling catheters,PLT and FBG levels between the two groups of patients(all P<0.05).There was no significant difference in the position of catheters,selection of sealing solution and PT,INR,APTT,TT level between the groups(all P>0.05).Conclusion Prolonged time of indwelling CVC,high levels of PLT and clotting fibrinogen are the risk factors of the obstruction of CVC in ICU patients.

Objective To construct evaluation standards for pediatric nursing responsibility. Methods With the method of expert enquiry for Delphi, coefficient of variation of each index through expert grading and Kendall W′s coordination coefficient were used to test the coordination degree in opinions among experts. After the coefficient of larger variation and lower weight were removed , the elements of nursing duty were ranked based on the weight by using hierarchy analysis method. Results The established practical pediatric nurses responsibility evaluation standard consisted of 3 modules, with 11 dimensions and 33 items. The Cr expert authority coefficient was between 0.77~0.90, with an average of 0.88. The variation coefficient of each index was low, ranging between 0.013 0.135 (<0.25). The Kendall W′s coordination coefficients of the primary, secondary and tertiary indicators were 0.482, 0.552 and 0.438, respectively, with significant differences in the coordination coefficient (P<0.001). Conclusion The experts are active and authoritative in participating in the standard establishment and they highly agreed on the standard , which indicates that the established the standard is reliable in a higher degree.