Objective Based on the theory of the Balanced Score Card framework and using Delphi method and analytic hierarchy process to construct the clinical nursing staff performance appraisal index evaluation system and provide reference for clinical nursing staff post management. Methods According to the theory of Balanced Score Card, constructed the preliminary establishment of index system for performance evaluation of clinical nursing. Used Delphi method to interview 26 nursing experts to select clinical nursing performance evaluation indicator. In the end, applied hierarchical analysis to determine index weight at all levels. Results Conducted two rounds of expert consultation;distributed 2 rounds of questionnaires by 27 and 26;recycled by 26 and 25;the recycling rate was 96.3%and 99.1%. It showed that the active coefficient of experts was higher. The degree of experts′authority was 0.89, which meaned the higher authority. Through two rounds of expert consultation, the Kendall coordination coefficient was 0.199-0.388. The significant test indicated that it was statistically significant (P<0.05), which meaned the experts tend to agree. After two rounds of expert consultation, the final clinical nursing staff performance appraisal indicators included 4 first-class indexes, 10 secondary indexes, 24 third-class indexes. Each index weight was determined by the analytic hierarchy process. In primary index, the internal process, learning and growth, performance indicators and the weight of customer satisfaction were 0.3, 0.3, 0.3 and 0.1 respectively. In secondary index weight, the top three were the work′s quality, post, and quantity. In the third class index weight, the top three were undertaking clinical work, annual nurse competence grading and the person-time of critical patients′management or surgical patient management. Conclusions Based on Delphi method and analytic hierarchy process to determine the clinical nursing staff performance appraisal evaluation index, whic can provide theoretical basis for clinical nursing staff post management.

Objective To establish a set of scientific and quantifiable performance management standard system by using Balance score card rationale so as to supply effective results management base for nursing regulator. Methods Delphi method was used to screen each level of nursing evaluation of performance standard and confirmed its weight;meanwhile, the sort of nursing care unite and nursing load were counted accordance with work intensity, risk degree and technological complexity etc and initially built performance management standard system. Results Accordance with the balance score card rationale and internal process, finance, customer, learning and growth four dimensions, a set of performance management standard and was established, including 4 first class indicator, 10 second class indicator and 32 third class indicator were derivative. The internal process, finance, customer, learning and growth factors were 29.44%, 37.56%, 20.32%, and 12.68%respectively. Conclusions Performance management standard system covers objectives of nursing management of Grade three General Hospital, and which is full of an objective, scientific, operational system possibilities, and can be used to multi-angle evaluate nursing performance, dynamic implement nurses management and achieve strategic goals.

Objective:To explore the value of circ_0054633 in early diagnosis and prognosis prediction of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in children with severe pneumonia.Methods:A retrospective case-control study was conducted on children with diagnosed severe pneumonia admitted to Tianjin Children's Hospital from July 1, 2022, to February 29, 2024. The clinical data was collected by electronic medical record system and clinical follow-up, including gender, age, lung injury prediction score (LIPS), pediatric critical illness score (PCIS), serum circ_0054633, interleukin-6 (IL-6), the indicators of the arterial blood-gas analysis, oxygenation index (PaO 2/FiO 2) within 24 hours of admission and the survival status of 28 days. According to whether ALI/ARDS occurred, they were divided into the ALI/ARDS group and the non-ALI/ARDS group. The differences of clinical data between the two groups were compared, and multivariate Logistic regression was used to analyze the risk factors for ALI/ARDS in children with severe pneumonia. The receiver operator characteristic curve (ROC curve) will be used to explore the early diagnostic value of ALI/ARDS in children with severe pneumonia. The patients of ALI/ARDS were divided into mild group, moderate group and severe group according to the level of PaO 2/FiO 2. The levels of serum circ_0054633 and IL-6 in various severity ALI/ARDS were compared. The differences of serum circ_0054633, IL-6 levels, PCIS score and LIPS score were compared between the two groups of ALI/ARDS patients according to different prognoses in 28 days, as well as the correlation between various risk factors and circ_0054633. Results:A total 74 children with severe pneumonia were included, with 34 cases in the ALI/ARDS group and 40 cases in the non-ALI/ARDS group. In ALI/ARDS group, there were 9 cases in the mild group, 15 cases in the moderate group and 10 cases in the severe group; while 12 cases died and 22 cases survived after 28 days. The serum circ_0054633, IL-6 level and LIPS score were higher in the ALI/ARDS group than the non-ALI/ARDS group, while the PCIS score was lower, and the two groups had significant difference. Multivariate Logistic regression analysis showed that circ_0054633 was independent predictors of ALI/ARDS in children with severe pneumonia [odds ratio ( OR) = 3.853, 95% confidence interval (95% CI) was 1.912-7.805, P = 0.017]. ROC curve analysis showed that the cut-off values for circ_0054633 in the diagnosis of ALI/ARDS were 3.955, sensitivity was 79.4%, specificity was 92.5%, area under the ROC curve (AUC) was 0.892. The serum circ_0054633 and IL-6 levels were higher in the children who died in 28 days than the children who were survived, while the PCIS score was lower, and the two groups had significant difference. Spearman correlation analysis showed that the level of circ_0054633 in children with ALI/ARDS was positively correlated with 28-day mortality and IL-6 ( r value was 0.675, 0.763, respectively, all P < 0.001), but negatively correlated with PCIS score ( r = -0.626, P < 0.001), while no significant correlation with LIPS score ( r = 0.389, P = 0.023). Conclusion:The level of serum circ_0054633 has a better value in early diagnosis and prognosis prediction of ALI/ARDS caused in children with severe pneumonia.