Objective To investigate effect of hierarchical care model applied in pediatric ward.Methods Hierarchical care model was applied from June 2015,and nursing quality before and after the implementation of hierarchical care model was compared.Accidental rate,nursing errors incidence and prevalence of red buttocks were compared.Results After hierarchical model,ward management,nursing instruments,disinfection and isolation,intensive care,primary care scores,primary care nursing theory and operation assessment score,specialist nursing theory and operation assessment scores were significantly higher than the implementation of hierarchical care before (P ＜ 0.05).After the hierarchical model of care,no accidents and nursing errors occurred,the red buttocks rate was 1.07 percent,which were significantly less than hierarchical care before (P ＜ 0.05).Conclusion Hierarchical model of care can effectively reduce the occurrence of accidents care,and error events,and help to improve work ability and management level of nursing department.

Objective To investigate effect of hierarchical care model applied in pediatric ward.Methods Hierarchical care model was applied from June 2015,and nursing quality before and after the implementation of hierarchical care model was compared.Accidental rate,nursing errors incidence and prevalence of red buttocks were compared.Results After hierarchical model,ward management,nursing instruments,disinfection and isolation,intensive care,primary care scores,primary care nursing theory and operation assessment score,specialist nursing theory and operation assessment scores were significantly higher than the implementation of hierarchical care before (P ＜ 0.05).After the hierarchical model of care,no accidents and nursing errors occurred,the red buttocks rate was 1.07 percent,which were significantly less than hierarchical care before (P ＜ 0.05).Conclusion Hierarchical model of care can effectively reduce the occurrence of accidents care,and error events,and help to improve work ability and management level of nursing department.

Objective:To study the epidemiological and genetic characteristics of coxsackievirus B3 (CVB3) circulating in Guangdong Province from 2008 to 2021.Methods:This study collected the specimens of hand, foot, and mouth disease (HFMD) cases from 2008 to 2021 that were positive for other enteroviruses except for enterovirus 71 (EV71), coxsackievirus A16 (CVA16), and CVA6, as well as the specimens of herpangina and neonatal infection cases from 2020 to 2021. Enteroviruses in these specimens were detected and their types were identified. CVB3 strains were isolated and the entire VP1 sequences of CVB3 strains were amplified and sequenced. The genetic features of CVB3 strains were analyzed using DNAStar 7.1 and MEGA 6.06 software packages.Results:Among 3 484 HFMD cases positive for other enteroviruses from 2008 to 2021, CVB3-positive cases accounted for 1.6% (57/3 484); among 560 cases of herpangina from 2020 to 2021, CVB3-positive cases accounted for 2.1% (12/560); one neonatal infection case in 2021 was positive for CVB3. CVB3-positive cases accounted for 67.1% (47/70) in 2021 and 18.6% (13/70) in 2020, while there were less than five cases in other years. Forty-eight CVB3 strains were isolated and the entire VP1 sequences of 26 CVB3 strains were obtained. Phylogenetic analysis indicated that the CVB3 strains could be divided into eight genotypes (A-H) and the strains of genotypes A, D and E were prevalent in the Chinese mainland. The 26 CVB3 strains isolated in Guangdong Province shared 80.2%-100.0% nucleotide homology, and belonged to two genotypes of D and E, with genotype D prevalent from 2008 to 2017 and genotype E prevalent from 2020 to 2021.Conclusions:CVB3 is prevalent sporadically in Guangdong Province from 2008 to 2017, but the epidemic intensity increased during 2020 and 2021. CVB3 strains of genotypes D and E are prevalent in Guangdong Province during 2008 to 2021, with genotype E being the prevalent genotype during 2020 and 2021.